No description available.

Background In the as of yet uncurable Parkinson´s disease aggregation of α-syn is an accelerator of pathogenesis. Oligomers of α-synuclein is considered to be neurotoxic hence blocking the endocytosis of aggregated α-syn is possibly a way of preventing pathogenesis. With a protein construct of the Receptor X (RX) previously shown to bind α-syn, it can be possible to bind soluble aggregated α-syn and decrease neuron endocytosis.  Aim The aim of this study was to express, purify and trimerize two different protein constructs of RX to study the binding to α-syn monomers & oligomers and if the proteins have higher affinity to α-syn oligomers. Methods In this study two RX constructs was produced with mammalian cell transfection and purified with Strep-Tactin affinity chromatography; D1, D123mut and D123 which affinity to α-syn monomers and oligomers were studied with ELISAs. Indirect ELISAs were optimized and conducted, a competitive ELISA with D123 was tested with poor reliability.  Results The results show that D1 could not be determined pure enough to examine its α-syn binding ability. D123mut was pure enough for ELISAs but did not show adequate binding to α-syn. D123 did show binding to α-syn in an indirect ELISA.  Conclusion The results were not as promising as expected and did not distinctly help strengthen the theory of a recombinant RX protein as a viable drug. Although there is potential, optimization of both protein constructs and methods used is essential for future studies of RX as a therapeutic protein.

The biopharmaceutical industry is constantly developing biological drugs, resulting in increased levels of product related impurities having similar characteristics as the target. The aim of the ligand project was to address future challenging purifications by developing new ligands for future resins for the biopharmaceutical industry. The purpose of this study was to develop a high-throughput screening method and use it to compare 15 novel multimodal anionic exchange ligand analogues with two reference ligands, for future polishing steps in the downstream process. The protein binding behavior of the ligands were studied with alkaline phosphatase, human serum albumin, α-chymotrypsinogen A and a monoclonal antibody as model proteins, at various pH values and salt concentrations. The selection process of the model proteins was based on stability studies, a study of their adsorption to the 96 well plate, and their binding behavior on three of the ligand analogues and one reference ligand. The percent protein bound to the ligands at the various conditions was calculated and presented in plots in order to study their binding behaviors. The calculated values were also used in order to evaluate the results in principal component analysis, creating chromatographic diversity maps. The maps were used to get an overview of the differences and similarities of the ligand analogues compared to the reference resins, which can be used for selecting ligands for future research and biomanufacturing. Four analogues and one reference ligand were also studied in a column format where different gradients were used, which confirmed the obtained results in the plate experiments.

Introdução A artrite reumatoide (AR) é uma doença crônica autoimune degenerativa, de alta prevalência e alta morbimortalidade, com difícil diagnóstico em todo o mundo. O seu pronto diagnóstico e o rápido início com medicamentos modificadores do curso da doença (MMCD) impactam de forma relevante o prognóstico do paciente. Para alguns pacientes os MMCDs sintéticos não serão eficazes e este paciente deverá receber então um MMCD biológico, medicamento este de alto custo para o paciente e o sistema de saúde. Objetivo - Explorar as trajetórias percorridas na busca por cuidado por pacientes com AR em uso de MMCD biológico no município de São Paulo. Métodos - Pesquisa qualitativa, de caráter exploratório, com orientação analítico-descritiva, mediante entrevistas semiestruturadas com questões abertas, iniciada após prévia aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido dos entrevistados. Os sujeitos são pacientes em uso de MMCD biológico para tratamento de AR dispensados pelo SUS. Foi utilizada a ferramenta do itinerário terapêutico (IT) para entendimento do caminho escolhido por estes pacientes na busca por cuidado em saúde. Resultados e Discussão Entre os entrevistados, a busca de cuidado ocorreu tardiamente, normalmente sem a suspeita de que se tratasse de doença reumática degenerativa. Os primeiros profissionais acessados foram o médico clínico geral ou o ortopedista, que raras vezes investigaram com atenção os sintomas relatados para em seguida proceder o encaminhamento adequado e rápido do paciente para o reumatologista. Nos ITs descritos, os tratamentos na sua maioria são constituídos apenas pelos medicamentos, e sem a participação de outros profissionais no acompanhamento além do reumatologista. Os pacientes entrevistados chegaram até o MMCD biológico após tentativa de controle da doença com os MMCDs sintéticos, conforme descreve o protocolo de tratamento do Ministério da Saúde. Há nos ITs descritos diversos atores representantes da iniciativa privada, que apoiam e influenciam estes pacientes na escolha dos seus caminhos por cuidado de saúde, que devem ser melhor compreendidos em estudos futuros / Introduction Rheumatoid arthritis (RA) is a chronic degenerative autoimmune disease of high prevalence and with high morbidity and mortality, worldwide difficult to diagnose. Its prompt diagnosis and rapid onset with disease modifying drugs (DMARD) have a relevant impact on the patient\'s prognosis. For some patients, the synthetic DMARDs will not be effective so these patients should receive a biological DMARD - a high cost medication both to the patient and the health system. Objective - To explore the trajectories performed by patients with RA using biological DMARD in the search for care in the city of São Paulo. Methods - Qualitative research, with an exploratory character, with analytical-descriptive orientation, through semi-structured interviews with open questions, initiated after prior approval of the Committee on Ethics in Research and informed consent of the interviewees. The subjects are patients using biological DMARD to treat RA that were dispensed by SUS. The therapeutic itinerary tool (TI) was used to understand the path chosen by these patients in the search for health care. Results and Discussion Among those interviewees, the search for care occurred late, usually without the suspicion that there was a degenerative rheumatic disease. The first accessed professionals were the general practitioner or the orthopedist, who rarely ever investigated the reported symptoms with attention to direct the patient to the rheumatologist quickly. In the described TIs, the treatments are mostly composed only by the medicines, and without the participation of other professionals in the follow-up besides the rheumatologist. The patients interviewed reached the biological DMARDs after an attempt to control the disease with synthetic DMARD, as described in the Ministry of Health recommendations. There are several actors representing the private sector described in the TI\'s, who support and influence the patients in the choice of their care pathways, which should be better understood in future studies

Introdução A artrite reumatoide (AR) é uma doença crônica autoimune degenerativa, de alta prevalência e alta morbimortalidade, com difícil diagnóstico em todo o mundo. O seu pronto diagnóstico e o rápido início com medicamentos modificadores do curso da doença (MMCD) impactam de forma relevante o prognóstico do paciente. Para alguns pacientes os MMCDs sintéticos não serão eficazes e este paciente deverá receber então um MMCD biológico, medicamento este de alto custo para o paciente e o sistema de saúde. Objetivo - Explorar as trajetórias percorridas na busca por cuidado por pacientes com AR em uso de MMCD biológico no município de São Paulo. Métodos - Pesquisa qualitativa, de caráter exploratório, com orientação analítico-descritiva, mediante entrevistas semiestruturadas com questões abertas, iniciada após prévia aprovação do Comitê de Ética em Pesquisa e consentimento esclarecido dos entrevistados. Os sujeitos são pacientes em uso de MMCD biológico para tratamento de AR dispensados pelo SUS. Foi utilizada a ferramenta do itinerário terapêutico (IT) para entendimento do caminho escolhido por estes pacientes na busca por cuidado em saúde. Resultados e Discussão Entre os entrevistados, a busca de cuidado ocorreu tardiamente, normalmente sem a suspeita de que se tratasse de doença reumática degenerativa. Os primeiros profissionais acessados foram o médico clínico geral ou o ortopedista, que raras vezes investigaram com atenção os sintomas relatados para em seguida proceder o encaminhamento adequado e rápido do paciente para o reumatologista. Nos ITs descritos, os tratamentos na sua maioria são constituídos apenas pelos medicamentos, e sem a participação de outros profissionais no acompanhamento além do reumatologista. Os pacientes entrevistados chegaram até o MMCD biológico após tentativa de controle da doença com os MMCDs sintéticos, conforme descreve o protocolo de tratamento do Ministério da Saúde. Há nos ITs descritos diversos atores representantes da iniciativa privada, que apoiam e influenciam estes pacientes na escolha dos seus caminhos por cuidado de saúde, que devem ser melhor compreendidos em estudos futuros / Introduction Rheumatoid arthritis (RA) is a chronic degenerative autoimmune disease of high prevalence and with high morbidity and mortality, worldwide difficult to diagnose. Its prompt diagnosis and rapid onset with disease modifying drugs (DMARD) have a relevant impact on the patient\'s prognosis. For some patients, the synthetic DMARDs will not be effective so these patients should receive a biological DMARD - a high cost medication both to the patient and the health system. Objective - To explore the trajectories performed by patients with RA using biological DMARD in the search for care in the city of São Paulo. Methods - Qualitative research, with an exploratory character, with analytical-descriptive orientation, through semi-structured interviews with open questions, initiated after prior approval of the Committee on Ethics in Research and informed consent of the interviewees. The subjects are patients using biological DMARD to treat RA that were dispensed by SUS. The therapeutic itinerary tool (TI) was used to understand the path chosen by these patients in the search for health care. Results and Discussion Among those interviewees, the search for care occurred late, usually without the suspicion that there was a degenerative rheumatic disease. The first accessed professionals were the general practitioner or the orthopedist, who rarely ever investigated the reported symptoms with attention to direct the patient to the rheumatologist quickly. In the described TIs, the treatments are mostly composed only by the medicines, and without the participation of other professionals in the follow-up besides the rheumatologist. The patients interviewed reached the biological DMARDs after an attempt to control the disease with synthetic DMARD, as described in the Ministry of Health recommendations. There are several actors representing the private sector described in the TI\'s, who support and influence the patients in the choice of their care pathways, which should be better understood in future studies

Detta examensarbete är utfört på uppdrag av företaget SHL Group AB, som producerar injektorer för patienter med kroniska sjukdomar. Injektorerna är anpassade för att patienten själv ska hantera dem i hemmet. Läkemedel som tas fram idag blir allt mer komplexa vilket kan leda till större volymer och längre injektionstider. Syftet med detta examensarbete var att ta fram ett injektionskoncept anpassat för större volymer samt hanterbar för reumatiker vid långa injektionstider. Fokus på projektet har legat kring användarstudier och den kreativa processen. För att ta reda på vilka behov som produkten behöver tillgodose har intervjuer och enkätundersökningar genomförts med reumatiker. Idéprocessen utfördes med hjälp av flera olika kreativa verktyg så som persona, Kanomodellen, House of Quality och brainstorming. Med hjälp av dessa verktyg togs fyra olika koncept fram och arbetet resulterade i en injektorhållare som under injektionen spänns fast på kroppen. / This is a thesis project carried out on behalf of the company SHL Group AB, which produces injectors for patients with chronic diseases. The injectors are adapted to the patient's own handling of them at home. Drugs that are being developed today are becoming more complex, leading to larger volumes and longer injection times. The purpose of this degree project is to develop a concept that is adapted to larger volumes and manageable for rheumatics at long injection times. The focus of the project has been user studies and the creative process. In order to find out which needs the product has to meet, interviews and questionnaires with rheumatics have been conducted. The idea process was performed using several creative tools such as persona, The Kano Model, House of Quality and brainstorming. Using these tools, four different concepts were developed and the work resulted in an injector holder that is fastened onto the body during injection.