DETERMINATION OF THE STABILITY OF A LOCAL ANESTHETIC BROMOKAIN TRANSDERMAL THERAPEUTIC SYSTEM

Aim. To study the stability of biocompatible microemulsion composition-based bromokain transdermal therapeutic systems (TTS) in order to confi rm the original shelf life and to identify the most appropriate TTS composition for storage.Materials and methods. The stability test using accelerated aging method was performed on the samples of TTS containing 50 and 100 mg of bromokain. Physicochemical properties of TTS were analyzed at the end of the 1st, 2nd, 3rd, and 6th month of storage. The physical confi guration of the dosage form, the content of bromokain in TTS, and drug release were evaluated at each stage of the study. The content of bromokain in the samples was recorded using high performance liquid chromatography (HPLC). As a control for each method, the newly manufactured TTS forms were used.Results. Unlike the samples containing 50 mg of bromokain, TTS with 100 mg of the anesthetic demonstrated changes in the physical confi guration and deterioration of the functional properties after the 6th month of storage. The quantitative content of the substance in TTS containing 50 and 100 mg of bromokain met the requirements of regulatory documentation (RD) at allphases of the experiment and was within 50,0 ± 5,0 mg and 100,0 ± 10,0 mg, respectively. The release profi le of TTS with 50 mg of bromokain has remained unchanged during storage and complies with the RD. TTS with 100 mg of bromokain after the 3rd month of storage had a deviation from the release profi le indicated in the RD.Conclusion. The shelf life of 2 years at t = 25 °C preset by us for samples of TTS containing 50 mg of bromokain has been confi rmed. According to the test results, samples of TTS with the content of bromokain of 100 mg were declared unstable and unfi t for storage under the selected storage conditions

Полиморфизм 3435c>T гена ABCB1 (rs1045642) не влияет на профиль эффективности и безопасности миртазипина у пациентов с депрессивными расстройствами, коморбидными с алкогольной зависимостью

Background. Mirtazapine is used to treat patients with depressive disorders. A large proportion of patients in this group do not adequately respond to mirtazapine therapy, while many develop undesirable drug reactions of type A. According to the previous studies, P-gp is involved in the biotransformation of mirtazapine, the activity of which is highly dependent on the polymorphism of the gene encoding it.Aim. The aim of our study was to study the effect of mirtazapine gene polymorphism on the efficacy and safety of mirtazapine therapy in patients with depressive disorders, comorbid with alcohol dependence.Materials and methods. The study included 119 male patients with depressive disorders, comorbid with alcohol dependence (age 38.7 ± 16.0 years). As a therapy, mirtazapine was used at a dose of 37.8 ± 13.8 mg / day. Evaluation of the effectiveness profile was carried out using psychometric scales. The safety profile was evaluated using the UKU Side-Effect Rating Scale. Genotyping was carried out by polymerase chain reaction in real time.Results. In the course of the study, results statistically significant in terms of evaluating efficacy and safety were not obtained (HAMD scores at the end of the course of therapy: (CC) 2.5 [2.0; 4.0], (CT) 2.0 [ 1.0; 3.0] and (TT) 2.0 [1.0; 3.0], p > 0.999; according to the UKU scale: (CC) 3.0 [2.8; 3.0], ( CT) 3.0 [3.0; 3.0] and (TT) 3.0 [3.0; 3.0], p > 0.999).Conclusion. The study of 119 patients with depressive disorders comorbid with alcohol dependence showed that 3435C> T polymorphism of the ABCB1 gene (rs1045642) does not affect the clinical efficacy and safety of mirtazapine.Введение. Миртазапин используется для лечения пациентов с депрессивными расстройствами. Немалая доля пациентов данной группы не отвечает должным образом на терапию миртазапином, при этом у многих отмечается развитие нежелательных лекарственных реакций типа А. По результатам ранее проводимых исследований показано, что в биотрансформации миртазапина принимает участие гликопротеин P, активность которого в высокой степени зависит от полиморфизма кодирующего его гена.Цель. Изучить влияние полиморфизма гена ABCB1 на эффективность и безопасность  терапии миртазапином у пациентов с депрессивными расстройствами, коморбидными с  алкогольной зависимостью. Материалы и методы. В исследование было включено 119 пациентов мужского пола с депрессивными расстройствами, коморбидными с алкогольной зависимостью (средний возраст (38,7 ± 16,0) лет). В качестве терапии использовали миртазапин в дозе (37,8 ± 13,8) мг/сут. Оценка профиля эффективности производилась с помощью  психометрических шкал. Профиль безопасности оценивался с помощью  валидизированной шкалы UKU Side-Effect Rating Scale. Генотипирование проводилось методом полимеразной цепной реакции в режиме реального времени.Результаты. По результатам исследования не получены статистически значимые результаты в показателях оценки эффективности и безопасности (баллы по шкале HAMD в концу курса терапии: (CC) 2,5 [2,0; 4,0], (CT) 2,0 [1,0; 3,0] и (TT) 2,0 [1,0; 3,0], p > 0,999; по шкале UKU: (CC) 3,0 [2,8; 3,0], (CT) 3,0 [3,0; 3,0] и (TT) 3,0 [3,0; 3,0], p > 0,999).Заключение. Продемонстрировано отсутствие влияния полиморфизма 3435C>T гена ABCB1 (rs1045642) на показатель клинической эффективности и безопасности миртазапина

Effect of macrophage-activating factor (GcMAF-RF) upon ex vivo polarization of macrophages, activation of dendritic cells and production of cytokines by human whole blood cells

This article is the second communication in a series of articles devoted to the effects of a domestic preparation of macrophage-activating factor (GcMAF-RF) and assessment of its biological properties. The aim of this work was to study the effect of the GcMAF-RF upon M0 → M1 polarization of macrophages (Mph), and activation of the professional properties of ex vivo generated antigen-presenting dendritic cells (DC), as well as on ex vivo production of pro-inflammatory (TNFα, IL-1β, IL-6, IFNγ, IL-17, IL-18) and anti-inflammatory (TGF-β, IL-4, IL-10) cytokines, growth factors (IL-2, GM-CSF, G-CSF, VEGF) and chemokines (MCP, IL-8) by the whole blood cells from healthy donors. Mph and DC were generated from the monocytes (3 to 5×106 /ml) derived from adherent fraction of peripheral blood mononuclear cells (MNC) of healthy donors. Granulocyte/macrophage colony-stimulating factor (rhGM-CSF) was used to obtain Mph, whereas DC production was induced by GM-CSF and interferon-α. To provide M1 polarizing signals, bacterial lipopolysaccharide (LPS from E. coli 0114:B4) was used in controls. In experimental series, GcMAF-RF was added 48 h before the end of culture. The stimulating effect of the obtained Mph and DC upon cell proliferation was assessed in allogeneic mixed culture of leukocytes (alloMLC) using radiometric technique, by 3 H-thymidine incorporation. The influence index (IR) of Mph or DC upon allo-SCL was calculated as the ratio of the proliferative response of MNCs in the presence of Mph, or DC to the level of spontaneous MNC proliferation. To determine the cytokine production by human whole blood cells ex vivo, peripheral blood samples from 3 donors with two replicate GcMAF-RF preparations were used, at a total of 6 points. All variants of the study were carried out with mitogen-activated and non-activated blood cells. The cytokine content was determined by the ELISA assays. The effects of GcMAF-RF were quantified as a fold increase (FI), i.e., the ratio of cytokine production in the presence of GcMAF-RF to the level of their spontaneous production. It was shown that the GcMAF-RF preparation was as effective, as lipopolysaccharide (LPS), the standard Mph and DC activator which induces polarization of differentiated M0-macrophages into M1 cells and final maturation of DCs, manifesting by a significant increase in their allo-stimulatory activity in a mixed leukocyte culture (allo-MLC). Moreover, GcMAF-RF stimulates production of numerous cytokines and chemokines (TNFα, IL-1β, IL-6, IL-18, IL-4, IL-10, GM-CSF, G-CSF, VEGF, IL-8), by blood cells (granulocytes, lymphocytes, monocytes), thus indicating direct participation of the macrophage activator GcMAF-RF in various immune processes. The domestic GcMAF-RF drug induces polarization of macrophages M0 → M1, final maturation of DCs and allostimulating activity of Mf and DCs, and is also able to effectively stimulate circulating blood cells to synthesize cytokines/chemokines with pro-inflammatory and immunoregulatory activities

Влияние трипсина на биохимические и функциональные свойства децеллюляризованного суставного хряща свиньи

Objective: to study the effect of trypsin pretreatment in the porcine articular cartilage decellularization protocol on the ability to restore the biochemical composition and functional properties of the resulting finely dispersed tissue-specific scaffold when co-cultured with human adipose-derived stem cells (hADSCs).Materials and methods. Porcine articular cartilage was micronized to a maximum size of 250 μm. The resulting porcine articular cartilage microparticles (CMps) were treated with trypsin (0.05, 0.25, 0.50%) / EDTA solution at +37 °C for 24 hours. Then, the CMps were successively incubated for 24 hours in three surfactant solutions containing 0.1% sodium dodecyl sulfate and increasing concentration of Triton X-100 (1, 2, 3%) at room temperature and in DNase I solution at +37 °C for 48 hours. The degree of change in the biochemical composition and the ability of decellularized CMps (DCMps) scaffolds within cell-engineered constructs (CECs) to support hADSC adhesion and proliferation, as well as their potential ability to exert a stimulatory regenerative effect, were then assessed. DNA, glycosaminoglycans (GAGs) and collagen content in the DCMps and CECs were examined. The morphology of the samples was examined using histological and immunohistochemistry staining.Results. Histological analysis showed that there were no cells and detritus in the DCMp samples. Pretreatment of CMps samples гыштп a solution with the lowest content of trypsin (0.05%) / EDTA in the samples retained 5.14 ± 0.87 ng/mg DNA in the samples, while GAG content decreased to 5.34 ± 0.9 μg/mg and collagen to 154 ± 34 μg/mg. By day 28 of CEC cultivation, adherent cells had produced their own extracellular matrix (ECM) containing GAGs and collagen. The amount of DNA in it was 6.30 ± 0.11 μg/CEC and that of GAGs was 19.36 ± 0.73 μg/CEC.Conclusion. Pretreatment with trypsin allows achieving uniformly complete decellularized CMps. At the same time, onset of changes in the ECM composition indicates a decrease in the ability of hADSCs to synthesize GAGs and type II collagen during co-culturing with DCMps. The increased proliferative activity of adherent hADSCs, as well as the tissue specificity of the DCMp scaffold will allow further research towards a hydrogel matrix capable of enhancing the specific and stimulating regenerative potential when co-cultured with cells of the same phenotype.Цель работы: исследовать влияние включения в протокол децеллюляризации суставного хряща свиньи стадии предобработки его трипсином на способность к восстановлению биохимического состава и функциональных свойств полученной мелкодисперсной тканеспецифической матрицы при сокультивировании с мезенхимными стромальными клетками жировой ткани человека (МСК ЖТч).Материалы и методы. Суставной хрящ свиньи микронизировали до размеров не более 250 мкм. Полученные микрочастицы суставного хряща свиньи (МХс) обрабатывали раствором трипсина (0,05; 0,25; 0,50%) / ЭДТА при +37 °С в течение 24 часов. Далее МХс последовательно инкубировали в течение 24 часов в трех растворах поверхностно-активных веществ, содержащих 0,1% додецилсульфат натрия и повышающуюся концентрацию Triton Х-100 (1, 2, 3%), при комнатной температуре и в растворе ДНКазы I типа при +37 °C в течение 48 часов. Затем оценивали степень изменения биохимического состава и способность децеллюляризованных МХс (ДМХс) матриц в составе клеточно-инженерных конструкций (КИК) поддерживать адгезию МСК ЖТч, их пролиферацию, а также потенциальную способность оказывать стимулирующее регенерационное воздействие. В ДМХс и КИК исследовали содержание ДНК, гликозаминогликанов (ГАГ) и коллагена. Морфологию образцов исследовали с использованием гистологического и иммуногистохимического окрашивания.Результаты исследования. Гистологический анализ показал отсутствие клеток и детрита в образцах ДМХс. При предварительной обработке МХс раствором с наименьшим содержанием трипсина (0,05%) / ЭДТА в образцах сохранилось 5,14 ± 0,87 нг/мг ДНК, при этом снизилось содержание ГАГ до 5,34 ± 0,9 мкг/мг и коллагена до 154 ± 34 мкг/мг. К 28-м суткам культивирования КИК выявлена наработка адгезированными клетками собственного внеклеточного матрикса (ВКМ), содержащего ГАГ и коллаген. Количество ДНК в нем составляло 6,30 ± 0,11 мкг/КИК, а количество ГАГ 19,36 ± 0,73 мкг/ КИК.Заключение. Предобработка трипсином позволяет достичь равномерной полной децеллюляризации МХс. Вместе с тем наступившие изменения состава ВКМ свидетельствуют о снижении способности МСК ЖТч в процессе сокультивирования с ДМХс синтезировать ГАГ и коллаген II типа. Увеличение пролиферативной активности адгезированных МСК ЖТч, а также тканеспецифичность ДМХс-матрицы позволят продолжить исследования в направлении создания гидрогелевой формы матрикса, способной повысить специфический и стимулирующий регенераторный потенциал в процессе сокультивирования с клетками того же фенотипа

Long-term effectiveness of secondary prevention in patients with acute coronary syndrome

Aim. To investigate the levels and prevalence of main risk factors (RFs) in patients with acute coronary syndrome (ACS), to evaluate the long-term effectiveness of secondary prevention and its agreement with Russian and international guidelines (2005-2006).Material and methods. A cross-sectional, retrospective analysis of medical histories was performed for 278 patients, hospitalized at the Moscow Regional Cardiology Centre (Zhukovsky) and State Research Centre for Preventive Medicine (Moscow) with myocardial infarction (MI). A subsequent questionnaire survey and examination of these patients provided the general information and the data on laboratory and instrumental test results, number of hospitalizations, work status dynamics, and current treatment.Results. Both in-hospital and long-term prevalence of RFs was high: for body mass index (BMI) ≥ 25 kg/m2 – 34,62%, for systolic blood pressure (SBP) ≥140 mm Hg – 26,28%, for smoking – 18,22%, for clinical symptoms of depression and anxiety – 19,23% and 23,42%, respectively. Heart rate (HR), blood lipids, and fasting blood glucose levels were higher than the respective target levels.Conclusion. The long-term RF prevalence in MI patients was high, with inadequate effectiveness of secondary preventive measures, and insufficient clinical implementation of existing international and local standards of CV prevention and therapy

TAKOTSUBO SYNDROME AS ACUTE FORM OF MICROVASCULAR ANGINA. CLINICAL CASE

The mechanisms of stress-induced cardiomyopathy (takotsubo syndrome) have not been fully determined. A clinical case of the development of stressinduced cardio-myopathy in a patient with microvascular angina is presented. A 73-year-old woman was hospitalized to the cardiology clinic with a diagnosis of acute circular myocardial infarction (elevation ST II, III, aVF, V2-6, positive troponin test). According to coronary angiography stenosis of coronary arteries were not identified. According to echocardiography the following abnormalities were revealed: decrease in global contractility of the myocardium, hyperkinesia of the basal parts of the left ventricle and at the same time akinesia of the apex and hypokinesia of the middle segments of the left ventricle. After 1 month a contractility of the myocardium was normal, there were no zones of violation of contractility. It was suggested that the patient had takotsubo syndrome. Anginal pain due to physical and emotional stress with unchanged coronary arteries suggested primary microvascular angina. It was confirmed by the presence of endothelium-dependent vasodilation disorders that were revealed by positron emission tomography of myocardium with cold pressor test and peripheral arterial tonometry. This clinical case demonstrates one of the discussed pathogenetic mechanisms of the takotsubo syndrome – generalized microvascular spasm. As the patient suffered previously from chronic microvascular angina, it seems logical in this case to regard stress-induced cardiomyopathy as an acute form of microvascular angina

Еprosartan therapy effectiveness in arterial hypertension patients after stroke or transient ischemic attack

Aim. To study effectiveness, safety, and dynamics of cognitive function in eprosartan therapy among arterial hypertension (AH) patients after stroke (S) or transient ischemic attack (TIA), comparing to standard antihypertensive therapy. Material and methods. The study included 60 AH patients, who underwent S or TIA. All participants wee randomized to two equal groups. Mean age in Group I was 62,2±7,8 years, in Group II – 59,8±6,7 years; AH duration - 9,5±3,5 and 9,8±3,2 years, respectively. For 3 months, Group I received eprosartan (600 mg/d), as monotherapy or combined with hydrochlorthiazide, if target blood pressure (BP) level was not achieved. Group II received standard antihypertensive therapy. At 4 visits, BP, heart rate, body mass index were measured; medication tolerability were assessed. At the baseline and at the end of the study, electrocardiography, echocardiography, 24-hour BP monitoring (BPM), psychological testing with Beck and MMSE questionnaires were performed. Results. In 2 patients (6,7%) from control Group II, recurrent TIA episodes were registered. In both groups, a significant positive dynamics of all manually measured BP parameters was observed. At the end of the study, BP positive dynamics was more manifested in eprosartan group. Moreover, in Group I, depression and cognitive dysfunction levels substantially decreased. Conclusion. Eprosartan is an effective antihypertensive agent for AH treatment, with cerebroprotective effects in S and TIA patients, that could be used as monotherapy or in combination with a diuretic