La Maladie d’Alzheimer (MA) est la première cause de démence au monde. Un fort coût de prise en charge, associé une faible efficacité des traitements actuels font de la découverte d’une thérapie efficace une priorité. Dans ce contexte les récepteurs sérotoninergiques de type 4 (5-HT4R) représentent une cible prometteuse. En effet, l’utilisation d’agonistes des 5-HT4R chez l’animal entraîne à la fois des effets pro-mnésiants et anti-amnésiants et une action sur la physiopathologie de cette maladie. Par ailleurs, l’aspect multifactoriel de la MA a conduit à faire émerger ces derniers années un consensus quant à la nécessité du développement de stratégie thérapeutique multi-cibles. Dans un premier temps, nous avons démontré l’intérêt de l’association d’un inhibiteur de l’acétylcholinestérase (IAChE) - l’un des rares médicaments disponibles, à un agoniste des 5-HT4R (RS67333) sur les performances de mémoire de travail et de référence chez la souris. Par la suite et afin de mieux comprendre les mécanismes mises en jeu dans les effets anti-amnésiant du RS67333, nous avons étudié les effets de la stimulation des 5-HT4R sur la plasticité synaptique mesurée au moyen d’une approche ex vivo au niveau de la région CA1 de l’hippocampe chez la souris saine NMRI. En effet, la plasticité synaptique, est un élément essentiel des processus d’apprentissage et de mémoire. Une première étude chez la souris saine a montré que la stimulation des 5-HT4R inhibait la potentialisation à long terme (LTP) induite par stimulation thêta-burst (TBS). Nos résultats suggèrent que l’inhibition de la LTP par l’agoniste est médiée par une modification de la neurotransmission GABAergique. La dernière partie de mes travaux a porté sur un modèle transgénique murins mimant certains des aspects de la MA (souris 5xFAD). Ainsi, si la stimulation des 5-HT4R conduisait à des résultats similaires en terme de transmission synaptique de base ou de plasticité à long-terme, elle modifie de façon importante la plasticité à court terme. L’ensemble de ces résultats obtenus ex vivo nécessiteraient d’être associé à des mesures in vivo, pour faire le lien entre les effets sur la plasticité synaptique et les performances de mémoire. Nos travaux montrent l’existence d’une association entre les 5-HT4R et la transmission GABAergique dans la modulation de la plasticité synaptique hippocampique de la région CA1. Plus généralement, ils renforcent l’intérêt de stratégies multi-cibles contenant notamment un agoniste des 5-HT4R. / Alzheimer’s disease (AD) is the first cause of dementia in the world. Due to its high cost of care combined with the lack of efficient treatment, the discovery of an effective therapy is a priority. In that regard, 5-HT4R are a promising target. Indeed, preclinical studies showed promnesic and anti-amnesic effect of 5-HT4R agonist as well as a disease-modifying effect on amyloid processing. Furthermore, given the multifactorial aspect of AD pathophysiology, there is a consensus concerning the necessity for multi-target therapy to treat effectively this disease. First, we confirmed the beneficial effect of a combined treatment with galantamine, an IAChE, and RS67333, a 5-HT4R agonist, on working and reference memory performances in a pharmacological model of scopolamine-induced amnesia. Then, for a better understanding of the mechanisms involved in 5-HT4R stimulation-induced increase in memory performances, we investigated the effects of such stimulation on CA1 area synaptic plasticity. Indeed, synaptic plasticity is a key component of learning and memory processes. Through ex-vivo electrophysiological recordings, we demonstrated that 5-HT4R activation impairs TBS-induced LTP in wild-type healthy mice. Further experiments suggested that such impairment involves a modulation of GABAergic neurotransmission. In addition, a third study on a transgenic model of AD (5xFAD mice) showed similar results. These results, obtained exclusively ex vivo, need to be associated with in vivo experiments to close the gap with behavioral experiments and allow an interpretation of memory performances through synaptic plasticity modifications. Our work shows the existence of an interplay between 5-HT4R and GABAergic transmission in the regulation of synaptic plasticity in hippocampal CA1 area. Furthermore, we strengthen the interest toward multi-target treatment involving 5-HT4R agonists in the field of AD.

There is scarce information on the fate of cardiac progenitor cells (CPC) in the embryonic heart after chamber specification. Furthermore, the role of acetylcholinesterase (AChE) during heart development is unknown, despite record of its presence in the myocardium. Although three molecular variants of AChE (R, H and T) exist due to alternate splicing, temporal and spatial distribution of these splice variants during cardiac ontogeny is not well characterized. We hypothesized that the AChE “R” splice variant (AChE-R) is involved in directing lineage commitment of mouse ventricular CPCs to the conduction cell phenotype. It is possible that AChE may promote the breakdown of ACh and block the effects of ligand-binding via M2 receptors present on the surface of CPCs. Our study has also provided a platform to suggest that AChE may play a role in the molecular mechanisms underlying functional diversification of myocardial cells into conduction system cells during ontogenesis.

INTRODUÇÃO: O componente inflamatório se constitui em potente foco de estudo e intervenção no manejo das anormalidades da Síndrome Metabólica. Estudos recentes demonstram que a Galantamina, um anticolinesterásico que potencializa a via antiinflamatória colinérgica, reduz a adiposidade visceral e suprime a liberação excessiva de adipocinas e citocinas pró-inflamatórias em modelos experimentais com animais obesos. Este estudo propôs a investigação dos efeitos do tratamento com Galantamina nos componentes da modulação autonômica cardiovascular, nos níveis de marcadores inflamatórios, em parâmetros hemodinâmicos e bioquímicos, nos níveis da gordura visceral abdominal e epicárdica, bem como em marcadores do estresse oxidativo, em portadores de SM. MÉTODOS: Estudo prospectivo, randomizado, duplo-cego, placebo-droga (paralelo) realizado com 60 pacientes de ambos os sexos e idade entre 18-50 anos, que preenchiam os critérios para SM. Todos os pacientes foram amplamente avaliados para se excluírem condições que pudessem interferir no estado inflamatório, e gravidez. Os pacientes foram randomizados na razão 1:1 para receberem placebo ou Galantamina, com dose inicial de 8 mg por 04 semanas, que foi aumentada para 16 mg por 8 semanas (total 12 semanas). Análise de variância para medidas repetidas foi usada para comparar diferenças entre os grupos, antes e após o tratamento. RESULTADOS: O grupo que recebeu Galantamina apresentou melhora da modulação simpato-vagal ao leito cardiovascular, menores níveis dos marcadores pró-inflamatórios (TNFalfa, IL-6, sCD40L), de leptina e de lipoperoxidação lipídica, e maiores níveis de adiponectina e das enzimas antioxidantes superóxido desmutase e catalase. Apresentou ainda melhora do metabolismo de glicose, caracterizada pela redução dos níveis de insulina e do índice HOMA. Esses efeitos foram independentes da perda de peso e da redução de gordura visceral. CONCLUSÃO: Nossos resultados indicam uma eficácia, anteriormente não reconhecida, da Galantamina na regulação dos níveis marcadores inflamatórios e estresse oxidativo e em aliviar a resistência à insulina em pacientes com a Síndrome Metabólica. Esses resultados demonstram ainda que a estimulação colinérgica pode aprimorar o manejo e tratamento da MetS / BACKGROUND: Inflammatory profile constitutes a powerful focus of study and intervention on the management of abnormalities related to metabolic syndrome (MetS). Recent studies demonstrated that Galantamine, an anticholinesterase that enhances the cholinergic anti-inflammatory pathway, reduces visceral fat and suppresses the excessive release of adipokines and proinflammatory cytokines in obese experimental models. This study sough to investigate the effects of treatment with Galantamine on cardiovascular autonomic modulation components, inflammatory markers levels, hemodynamic and biochemical parameters, abdominal visceral and epicardial fat levels, as well as markers of oxidative stress, in patients with MetS. METHODS: A prospective, randomized, double-blind, placebo-drug (parallel) study was performed with 60 patients of both sexes and aged between 18-50 years, who met the criteria for MetS. All patients were widely evaluated to exclude conditions that might interfere in the inflammatory condition, and pregnancy. The patients were randomized in a 1: 1 ratio to receive placebo or Galantamine, with an initial dose of 8 mg for four weeks, which was increased to 16 mg for 8 weeks (total 12 weeks). Variance analysis for repeated measures was used to compare the differences between groups, before and after the treatment. RESULTS: The group that received Galantamine showed improvement of cardiovascular sympathetic-vagal balance, lower levels of pro-inflammatory markers (TNFalfa, IL-6, sCD40L), leptin and lipid peroxidation. Besides, the level of adiponectin, anti-oxidants superoxide dismutase enzymes and catalase were increased in the Galantamine group. Therefore, it was also observed improvement of the glucose metabolism, characterized by reduction of the insulin levels and HOMA index comparing Galantamine with Placebo. These effects were independent of the weight loss and of the visceral fat reduction. CONCLUSIONS: Our results indicate efficiency, not previously recognized, of the Galantamine on the regulation of inflammatory markers levels and oxidative stress, as well as in reducing insulin resistance in patients with MetS. These results further demonstrate that the cholinergic stimulation can improve the management and treatment of the MetS

Alzheimer’s disease is a progressive neurodegenerative disorder generally affecting people above the age of 65 years. Even though the pathophysiological hallmarks of AD were established more than a hundred years ago, there is yet to be a drug that can stop its characteristic neuronal damage. Of the five currently FDA-approved drugs, galantamine has a unique mechanism of action. Apart from being an AChE inhibitor, galantamine can effectively potentiate (positive allosteric modulator) the effect of agonists at nAChRs at concentrations lower than those required for its action as an AChE inhibitor. Perhaps the clinical benefits observed with galantamine are associated mainly with its nAChRs-PAM action and not its AChE inhibitory effect. Inhibiting AChE causes a delay in the degradation of ACh and a prolonged presence of ACh might act at either nAChRs or mAChRs. By indirectly targeting mAChRs as well, AChE inhibitors may lead to potential side effects. Hence there is a need for specific nAChR agents. The aim of this study was to identify the structural features of galantamine that contribute solely towards its a7 nAChR-PAM effect. In doing so, we wish to divorce the structural features that might be important for interacting with AChE. Using the deconstruction approach, we have synthesized structurally abbreviated analogs of galantamine. To study the probable interactions, we docked these molecules in human a7 nAChR homology models. Ultimately, it is of interest to determine which analogs retain the PAM activity of galantamine and to address that, a preliminary screening was performed with a select few analogs using the two-electrode voltage clamp technique

INTRODUÇÃO: O componente inflamatório se constitui em potente foco de estudo e intervenção no manejo das anormalidades da Síndrome Metabólica. Estudos recentes demonstram que a Galantamina, um anticolinesterásico que potencializa a via antiinflamatória colinérgica, reduz a adiposidade visceral e suprime a liberação excessiva de adipocinas e citocinas pró-inflamatórias em modelos experimentais com animais obesos. Este estudo propôs a investigação dos efeitos do tratamento com Galantamina nos componentes da modulação autonômica cardiovascular, nos níveis de marcadores inflamatórios, em parâmetros hemodinâmicos e bioquímicos, nos níveis da gordura visceral abdominal e epicárdica, bem como em marcadores do estresse oxidativo, em portadores de SM. MÉTODOS: Estudo prospectivo, randomizado, duplo-cego, placebo-droga (paralelo) realizado com 60 pacientes de ambos os sexos e idade entre 18-50 anos, que preenchiam os critérios para SM. Todos os pacientes foram amplamente avaliados para se excluírem condições que pudessem interferir no estado inflamatório, e gravidez. Os pacientes foram randomizados na razão 1:1 para receberem placebo ou Galantamina, com dose inicial de 8 mg por 04 semanas, que foi aumentada para 16 mg por 8 semanas (total 12 semanas). Análise de variância para medidas repetidas foi usada para comparar diferenças entre os grupos, antes e após o tratamento. RESULTADOS: O grupo que recebeu Galantamina apresentou melhora da modulação simpato-vagal ao leito cardiovascular, menores níveis dos marcadores pró-inflamatórios (TNFalfa, IL-6, sCD40L), de leptina e de lipoperoxidação lipídica, e maiores níveis de adiponectina e das enzimas antioxidantes superóxido desmutase e catalase. Apresentou ainda melhora do metabolismo de glicose, caracterizada pela redução dos níveis de insulina e do índice HOMA. Esses efeitos foram independentes da perda de peso e da redução de gordura visceral. CONCLUSÃO: Nossos resultados indicam uma eficácia, anteriormente não reconhecida, da Galantamina na regulação dos níveis marcadores inflamatórios e estresse oxidativo e em aliviar a resistência à insulina em pacientes com a Síndrome Metabólica. Esses resultados demonstram ainda que a estimulação colinérgica pode aprimorar o manejo e tratamento da MetS / BACKGROUND: Inflammatory profile constitutes a powerful focus of study and intervention on the management of abnormalities related to metabolic syndrome (MetS). Recent studies demonstrated that Galantamine, an anticholinesterase that enhances the cholinergic anti-inflammatory pathway, reduces visceral fat and suppresses the excessive release of adipokines and proinflammatory cytokines in obese experimental models. This study sough to investigate the effects of treatment with Galantamine on cardiovascular autonomic modulation components, inflammatory markers levels, hemodynamic and biochemical parameters, abdominal visceral and epicardial fat levels, as well as markers of oxidative stress, in patients with MetS. METHODS: A prospective, randomized, double-blind, placebo-drug (parallel) study was performed with 60 patients of both sexes and aged between 18-50 years, who met the criteria for MetS. All patients were widely evaluated to exclude conditions that might interfere in the inflammatory condition, and pregnancy. The patients were randomized in a 1: 1 ratio to receive placebo or Galantamine, with an initial dose of 8 mg for four weeks, which was increased to 16 mg for 8 weeks (total 12 weeks). Variance analysis for repeated measures was used to compare the differences between groups, before and after the treatment. RESULTS: The group that received Galantamine showed improvement of cardiovascular sympathetic-vagal balance, lower levels of pro-inflammatory markers (TNFalfa, IL-6, sCD40L), leptin and lipid peroxidation. Besides, the level of adiponectin, anti-oxidants superoxide dismutase enzymes and catalase were increased in the Galantamine group. Therefore, it was also observed improvement of the glucose metabolism, characterized by reduction of the insulin levels and HOMA index comparing Galantamine with Placebo. These effects were independent of the weight loss and of the visceral fat reduction. CONCLUSIONS: Our results indicate efficiency, not previously recognized, of the Galantamine on the regulation of inflammatory markers levels and oxidative stress, as well as in reducing insulin resistance in patients with MetS. These results further demonstrate that the cholinergic stimulation can improve the management and treatment of the MetS

High Pressure Liquid Chromatography (HPLC) is a well-known and widely used analytical technique which is prevalent throughout the pharmaceutical industry as a research tool. Despite its prominence HPLC possesses some disadvantages, most notably slow analysis time and large consumption of organic solvents. Ultra Pressure Liquid Chromatography (UPLC) is a relatively new technique which offers the same separation capabilities of HPLC with the added benefits of reduced run time and lower solvent consumption. One of the key developments which facilitate the new UPLC technology is sub 2-µm particles used as column packing material. These particles allow for higher operating pressures and increased flow rates while still providing strong separation. Although UPLC technology has been available since early 2000, few laboratories have embraced the new technology as an alternative to HPLC. Besides the resistance to investing in new capital, another major roadblock is converting existing HPLC methodology to UPLC without disruption. This research provides a framework for converting existing HPLC methods to UPLC. An existing HPLC method for analysis of Galantamine hydrobromide was converted to UPLC and validated according to ICH guidelines. A series of statistical evaluations on the validation data were performed to prove the equivalency between the original HPLC and the new UPLC method. This research presents this novel statistical strategy which can be applied to any two methodologies to determine parity. / Chemistry

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-07-27T14:45:59Z No. of bitstreams: 1 Fernando Oliveira Costa.pdf: 1199928 bytes, checksum: f721f323b7b101614061ea44e7dd6cb3 (MD5) / Made available in DSpace on 2015-07-27T14:45:59Z (GMT). No. of bitstreams: 1 Fernando Oliveira Costa.pdf: 1199928 bytes, checksum: f721f323b7b101614061ea44e7dd6cb3 (MD5) Previous issue date: 2014-02-21 / The metabolic syndrome (MetS) consists of a combination of conditions that tend to cluster together, and increase the risk of type 2 diabetes and cardiovascular disease. The components of the metabolic syndrome include central (abdominal) obesity, elevated fasting glucose, dyslipidemia (abnormally high triglycerides and low high-density lipoprotein cholesterol), and elevated blood pressure. MetS is also associated with proinflammatory and prothrombotic states, non-alcoholic liver steatosis, obstructive sleep apnea and reproduction disorders. Although a common unifying physiopathological mechanism is not known, central obesity and inflammation play a major role in MetS and upon each of its components. The MetS has reached epidemic proportions and to date there are no proven pharmacological interventions that simultaneously target all of the components of this syndrome. Inflammation plays an important role in the pathogenesis of the MetS. Recently, it was discovered that inflammation can be regulated by neural, cholinergic mechanisms and a cholinergic drug, the acetylcholinesterase inhibitor galantamine suppresses abnormal inflammation and alleviates MetS pathologies in rodents. The fact that galantamine is an approved drug, used to treat patients with Alzheimer´s disease with a known safety profile, will facilitate its clinical application in another situations. We hypothesize that treatment of subjects with the MetS with galantamine will result in alleviation in the MetS clinical conditions and inflammation. The objective of our study was to initiate an investigation on the safety profile of galantamine in MetS patients, with special attention on autonomic, hemodynamic and cognitive parameters. A randomized, double-blind, prospective study evaluated clinical, autonomic, hemodynamic and cognitive variables of patients with MetS in two moments: before treatment (basal state) and after 28 days of treatment with galantamine 8 mg daily. There was a statistical tendency in reducing systolic blood pressure in the HRV with Finometer® in patients under galantamine (124.4 ± 4 vs 119.7 ± 3.7 mmHg, basal and 28 days values, respectively) and also a reduction in diastolic blood pressure (72.5 ± 1.3 vs 67.2 ± 1.7 mmHg, basal and 28 days values, respectively). Paradoxically, an increase in the sympathetic modulation of the heart was observed with the HRV study measuring the LF (nu) value (46.2 ± 3.8 vs 57.1 ± 3.4 basal and 28 days, respectively) and a decrease in the parasympathetic modulation HF (nu) value (53.8 ± 3.8 vs 43.0 ± 3.4, basal and 28 days, respectively). We did not observe any significant change in cognitive domains. Our conclusion is that treatment with galantamine 8 mg exhibits a safe clinical profile and can be used in MetS patients. / A síndrome metabólica consiste na combinação de condições agrupadas e aumentam o risco para diabetes tipo 2 e doença cardiovascular. Seus componentes incluem obesidade central, níveis aumentados de glicose, dislipidemia caracterizada por aumento de triglicérides e baixos níveis de HDL e aumento da pressão arterial. Também está associada a um estado proinflamatório, a um estado protrombótico, a esteatose hepática não-alcoólica, apnéia obstrutiva do sono e a desordens reprodutivas. Apesar da não determinação de um mecanismo fisiopatológico unificador, obesidade central e inflamação parecem ser centrais na síndrome metabólica e nos seus componentes individuais. A síndrome metabólica tem alcançado proporções epidêmicas universais e até o presente não há intervenção farmacológica comprovada que atue simultaneamente em todos os seus componentes. Sabe-se hoje que o processo inflamatório tem um papel importante na patogenia da síndrome. Recentemente foi evidenciado que a inflamação pode ser regulada por mecanismos neurais colinérgicos, e que a galantamina, um inibidor da acetilcolinesterase, suprime a inflamação e atua nos componentes da síndrome diminuindo a patogenia em roedores. O fato de a galantamina ser uma droga já aprovada e de perfil seguro em portadores de demência facilita seu uso em outras situações clínicas. Considerando a hipótese de que a galantamina causará melhora da inflamação e dos outros distúrbios relacionados, o objetivo deste estudo foi iniciar a investigação sobre o perfil de segurança da galantamina em pacientes com síndrome metabólica, em especial, em parâmetros hemodinâmicos, autonômicos e de cognição. Realizamos um estudo prospectivo, duplo-cego e randomizado, que avaliou os dados clínicos e os parâmetros descritos, no momento basal e após 28 dias de uso de galantanima (8mg por dia), em portadores de síndrome metabólica. Houve uma tendência à redução da PAS, avaliada batimento-a-batimento com o Finometer no grupo que usou galantamina (124,4 ± 4 vs 119,7 ± 3,7 mmHg, respectivamente basal e após 28 dias de uso, p=0,04), o mesmo ocorrendo com a PAD (72,5 ± 1,3 vs 67,2 ± 1,7, p=0,005), respectivamente basal e após 28 dias de uso). De forma paradoxal, ocorreu um aumento da atividade simpática na modulação autonômica para o coração, avaliada por meio do estudo da variabilidade da freqüência cardíaca como atestado por um valor LF (nu) (46,2 ± 3,8 vs 57,1 ± 3,4 , p=0,0005)), e redução da modulação parassimpática, representada pelo valor do HF (nu) (53,8 ± 3,8 vs 43,0 ± 3,4, p=0,0005) respectivamente basal e após 28 dias de uso. Não observamos alterações significativas nos testes que avaliam o domínio cognitivo dos indivíduos. Concluímos que a dose utilizada de galantamina tem um perfil de segurança clínica que permite expandir seu uso em pacientes portadores de síndrome metabólica.

[pt] Métodos baseados na cromatografia líquida micelar (MLC) com detecção fluorimétrica foram desenvolvidos para dois estudos de caso. No primeiro deles, seis B-carbolinas (harmol, harmalol, harmane, norharmane, harmine e harmaline) foram plenamente separadas de modo a se aplicar o método para a determinação dos alcaloides em formulações de Passiflora incarnata L., extrato seco de Passiflora alata Dryander e em urina. A separação foi realizada em coluna cromatográfica C18, utilizando fase móvel tamponada (pH 8,0) contendo 220 mmol L-1 de dodecilsulfato de sódio (SDS)/acetonitrila (97/3 por cento v/v). A detecção fluorimétrica permitiu que se atingissem limites de detecção (LOD) abaixo de 3,6 ng g-1 com repetibilidade e precisão intermediária entre 0,1 e 5 por cento. As incertezas combinadas associadas à concentração das B-carbolinas ficaram entre 1 e 9 por cento. O método proposto foi comparado ao método baseado na cromatografia eletrocinética micelar (MEKC) com detecção absorciométrica e os resultados com MLC se mostraram superiores do ponto de vista da capacidade de detecção (por serem os alcaloides naturalmente muito fluorescentes) e de recuperação. Para as amostras de fitoterápicos, o harmol foi quantificado tanto nas amostras de medicamento de Passiflora incarnata quanto em urina de voluntário após a administração de fitoterápico. O harmine foi detectado apenas na amostra de medicamento. Os alcaloides norharmane, harmine e harmaline foram identificados no chá misto de Maracujá, no qual continha em sua composição extrato seco de Passiflora alata Dryander. Na segunda abordagem, um método por MLC foi desenvolvido para a determinação de galantamina e de seus principais metabólitos (N-desmetil galantamina, O-desmetil galantamina, epigalantamina e N-óxido galantamina). A separação da galantamina e dos metabólitos foi feita utilizando coluna cromatográfica C18 com porosidade de 300 angstroms e fase móvel constituída de tampão (pH 5,0) contendo 25 mmol L-1 de SDS/acetonitrila (97/3 por cento v/v). A detecção fluorimétrica permitiu limites de detecção abaixo de 343 ng g-1, repetibilidade e precisão intermediária entre 2,2 e 4 por cento. As incertezas combinadas associadas à concentração de galantamina e dos metabólitos ficaram entre 0,3 e 11 por cento. Ensaios de recuperação foram realizados em amostra de urina fortificada com padrões da galantamina e metabólitos e os resultados obtidos ficaram entre de 91,4 e 114,8 por cento. A comparação entre o método por MLC e o método por cromatografia líquida de alta eficiência com fase reversa foram feitas com amostras de medicamento cujo princípio ativo era o hidrobrometo de galantamina. Os resultados dos teores de galantamina e as variâncias das medidas obtidas por ambos os métodos foram estatisticamente iguais. A sensibilidade da curva analítica obtida por MLC foi duas vezes maior do que a encontrada por cromatografia por fase reversa. Análises de urina de ratos coletadas após a administração do medicamento foram realizadas com o método proposto, sendo que a galantamina mais os metabólitos N-óxido galantamina e N-desmetil galantamina foram identificados nas amostras. Para melhor avaliar o efeito de amplificação de fluorescência da galantamina pelo ambiente organizado, experimentos foram feitos com a separação cromatográfica de fase reversa e com a adição de solução rica em micelas de SDS após a passagem do analito pela coluna cromatográfica. As condições de separação incluíram o uso de coluna cromatográfica C18, fase móvel constituída por tampão (pH 5,0) contendo 2 por cento de propano-2-ol (v/v)/ acetonitrila (80/20 por cento v/v). A solução micelar de SDS (100 mmol L-1), misturada à fase móvel após a coluna cromatográfica, foi preparada com a mesma composição da fase móvel. A sensibilidade da curva analítica de galantamina foi três vezes maior quando o meio micelar foi usado. O resultado prova que o ambiente micelar favorece a medição fluorimétrica de galantam / [en] Methods based on micellar liquid chromatography (MLC) with fluorimetric detection have been developed for two case studies. In the first, six B-carbolines (harmol, harmalol, harmane, norharmane, harmine and harmaline) were fully separated allowing the application of the method for the determination of these alkaloids in Passiflora incarnata L. formulations, in Passiflora alata Dryander dry extract and in urine. The chromatographic separation was performed on a C18 column using a buffered mobile phase consisting of disodium hydrogen phosphate (pH 8.0) containing 220 mmol L-1 of sodium dodecyl sulfate (SDS)/acetonitrile (97/3 percent v/v). The fluorimetric detection allowed limits of detection (LOD) below than 3.6 ng g-1 to be achieved with intermediary precision and repeatability between 0.1 and 5 percent. The calculated combined uncertainties of the concentration of B-carbolines were between 1 and 9 percent. The proposed method was compared with the method based on micellar electrokinetic chromatography (MEKC) with absortionmetric detection. The MLC results were superior from the viewpoint of the detection power (since they are very fluorescent alkaloids) and also in terms of recovery. The harmol was quantified in Passiflora incarnata phitotherapic samples and in urine collected from a voluntary after of the administration of herbal medicine. The harmine was detected only in the phitotherapic sample. The norharmane, harmine and harmaline alkaloids were identified in Passion Fruit tea, which contained dry extract of Passiflora alata Dryander. In the second approach, a method for MLC was developed for the determination of galantamine and its main metabolites (N-demethyl galantamine, O-demethyl galantamine, epigalantamine and N-oxide galantamine). The separation was performed using a C18 chromatography column with porosity of 300 angstroms and with mobile phase consisting of buffer (pH 5.0) containing SDS (25 mmol L-1)/acetonitrile (97/3 percent v/v). The fluorimetric detection enabled LOD below 343 ng g-1 with intermediate precision and repeatability between 2.2 and 4 percent. Combined uncertainties for concentration of galantamine and metabolites were between 0.3 and 11 percent. Recovery experiments were performed on urine samples fortified with galantamine standards and metabolites with results between 91.4 and 114.8 percent. A comparison between the proposed MLC method and reverse phase high performance liquid chromatography was made using medicine samples containing galantamine hydrobromide as the active principle. Galantamine levels and variances achieved with these methods were statistically equal. The analytical curve sensitivity by MLC was two times higher than that found with reverse phase high performance liquid chromatography. Analysis of rat urine, collected after the administration of the medicine, were performed with the proposed method enabling the identification of galantamine, N-oxide galantamine and N-demethyl galantamine. To better evaluate the fluorescence amplification effect of galantamine in the organized environment, experiments were made with conventional chromatographic separation and post-column addition of the aqueous solution rich in micelles. The separation conditions included the use of C18 chromatographic column, mobile phase consisting of buffer (pH 5.0) containing 2 percent of propan-2-ol (v/v)/acetonitrile (80/20 percent v/v). The micellar solution of SDS (100 mmol L-1), added after the chromatographic column, was prepared with the same composition of the mobile phase. The column temperature was 25 degrees C and the sample volume was 20 uL. The sensitivity of the analytical curve of galantamine was three times higher when the micellar solution was mixed, proving that the organized environment favors the galantamine fluorescence even at flow regime. Recoveries with or without post-column mixing with the micelle rich solution were between 97.5 and 102.2 percent.

The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. The purpose of this supplement is to provide a concise reference of the newly available literature to support the existing information regarding the known adverse effects of commonly prescribed medications or abused drugs. The information covers peer-reviewed publications from January 2016 to December 2016. This review focused on CNS stimulants and drugs that suppress appetite. It covers amphetamines (including lisdexamfetamine, methamphetamine and 3,4-methylenedioxymetamphetamine), methylphenidate, atomoxetine, modafinil and armodafinil, methylxanthines (caffeine), monotherapies and combinational therapies that suppress appetite (lorcaserin, phentermine, phentermine/topiramate) and medications used in Alzheimer's disease and cognitive decline (rivastigmine, donepezil and memantine).

Alzheimer’s disease (AD) is a chronic, progressive neurodegenerative disorder, characterized clinically by a progressive loss of memory, cognitive function, ability to care for oneself and psychiatric symptoms. First-line agents for the treatment of AD are ChE inhibitors (DON, GAL), whose modest clinical efficacy and the high incidence of dose-limiting toxicities limit their clinical utility. In addition to AD, ChE inhibitors (PYR) are used for other medical conditions, such as myasthenia gravis (MG). Furthermore, ChE inhibitors (PYR) are used by military personnel prophylactically if impending exposure to chemical warfare agents, e.g., soman, is suspected. The purpose of this research project was to understand the effect of age on the in-vitro sensitivity of ChE inhibitors in human RBCs and plasma. Understanding possible covariates, such as age and gender, may assist in optimizing dosing regimens of ChE inhibitors and/or developing newer ChE inhibitors with better adverse effect profiles. Plasma PHYS concentrations were measured by a validated HPLC-FD method. RBC AChE activity and plasma BuChE activity were measured by a modified Ellman’s colorimetric method using the model substrates, acetylthiocholine and butyrylthiocholine, respectively. The kinetics of RBC and plasma ChE activity followed Michaelis-Menten kinetics. Acetylthiocholine was found to be a nonselective substrate (RBC AChE Km = 73 μM; plasma BuChE Km = 117 μM); while butyrylthiocholine was a selective substrate for plasma BuChE (RBC AChE Km = 130,000 μM; plasma BuChE Km = 72 μM). For the following studies, RBC AChE activity was measured using acetylthiocholine as the substrate and plasma BuChE activity was measured using butyrylthiocholine as the substrate. This research project was performed in two parts: First, mechanistic studies of PHYS, PYR, DON and GAL, explored and determined the mechanism of in-vitro inhibition of RBC AChE and plasma BuChE inhibition, as well as the in-vitro degradation of PHYS in human whole blood, plasma and RBC. PHYS was rapidly degraded in human whole blood, RBC and plasma and followed Michaelis-Menten kinetics but its degradation clearance - scaled to whole blood clearance - was only predicted to account for 4-6% (i.e., 195-261 ml/min) of the reported total body clearance for PHYS (4500 ml/min). RBCs were responsible for 60% of the whole blood clearance while plasma accounted for 40% of the whole blood clearance. Inhibition results indicated that both PHYS and PYR were nonselective and rapid suicide ChE inactivators. PYR inactivated RBC AChE more rapidly at low concentrations and inactivated plasma BuChE more rapidly at high concentrations, but inactivated both more rapidly than PHYS. PHYS was a more potent inactivator than PYR with a Ki for RBC AChE of 0.011 μM and 0.063 μM, respectively, and 0.023 μM and 0.036 μM, respectively for plasma BuChE. DON was found to be a noncompetitive inhibitor for RBC AChE (Ki,noncomp = 114 μM), but a competitive inhibitor for plasma BuChE (Ki,comp = 213 μM). GAL was found to be a competitive inhibitor for both RBC AChE (Ki,comp = 66 μM) and plasma BuChE (Ki,comp = 358 μM). The second part involved a clinical study with ten young and nine elderly healthy subjects, balanced for gender, who donated blood for an in-vitro study in order to assess any age- and gender-related differences in in-vitro sensitivity to RBC AChE and plasma BuChE inhibition to all four ChE inhibitors. Elderly adults were found to be 2-3-fold less sensitive compared to the young adults for PHYS (BuChE Ki,pss; 0.010 and 0.015 μM, young and elderly, respectively) and PYR (AChE Ki,pss; 0.12 and 0.25 μM, young and elderly, respectively) only, while neither DON nor GAL showed any age-related differences in sensitivity. The observed differences for PHYS and PYR may be due to kinetic differences in ChE inactivation between young and aged adults, rather then a difference in binding affinities/potencies. These carbamate ChE inhibitors, presumably, have a slower decarbamoylation rate in younger adults than elderly adults, which leads to the observed difference in in-vitro sensitivity. The above in-vitro results were consistent with results of a meta-analysis: In a study by Knapp et al. (1991), young males (n=6), receiving 18 mg, 24 mg and 30 mg PHYS tablets, showed similar ex-vivo plasma BuChE sensitivity to (28 %/(ng/ml)) as the in-vitro sensitivity for young males in the current study (33 %/(ng/ml)). On the other hand, in the study by Men (2004), elderly males (n=8) and females (n=8), receiving 6.7 μg/kg PHYS as 30-minute infusion, showed similar ex-vivo RBC AChE sensitivity (12 %/(ng/ml)) as the in-vitro sensitivity for elderly subjects in the current study (9.7 %/(ng/ml)). This suggests that in-vitro measurement of ChE sensitivity is predictive of ex-vivo sensitivity in clinical studies. The study results suggest that elderly adults may require a 2-3-fold higher blood concentration than young adults to achieve the same ChE inhibition. This may explain why for epistigmine, an investigational carbamate ChE inhibitor for the treatment of AD, the maximum tolerated dose observed in young adults (40 mg single dose) was lower than for older adults (90 mg/day). Higher sensitivity in young adults prevented further dose escalation, while all elderly subjects tolerated higher doses. This research may have implications for other diseases and conditions, most notably MG and as a prophylaxis of nerve gases poisoning. As patients with MG age, they may become less sensitive to PYR, the most common symptomatic treatment for MG, and an increase in dose may be required. Further, older military personnel assigned to receive PYR, may require increased doses to achieve the targeted 10% RBC AChE inhibition, necessary to protect against nerve gas poisoning.