Le carcinome hépatocellulaire (HCC) est le cancer du foie le plus répandu et représente la seconde cause de décès par cancer dans le monde. Un mauvais pronostic et l'absence de traitement efficace en font un problème majeur de santé publique dans les pays en voie de développement, notamment en Asie du Sud-Est, justifiant pleinement la recherche de molécules ou d'approches thérapeutiques nouvelles contre l'HCC. Ce travail porte sur la recherche de molécules isolées de plantes vietnamiennes actives contre l'HCC. La première approche a consisté en un criblage pharmacologique de 33 substances naturelles qui a conduit à l'identification de 7 ent-kaurane diterpénoïdes isolés de Croton kongensis Gagnep. présentant des propriétés antiprolifératives originales. La seconde approche, par criblage in silico d'une banque de 354 substances naturelles, a permis d'identifier la solasonine comme inhibiteur de l'interaction mortalin - p53 induisant l'apoptose dans la lignée cellulaire humaine HepG2. / Human hepatocellular carcinoma (HCC) is the most common type of liver cancer, the second most common cause of death from cancer worldwide. A very poor prognosis and a lack of effective treatments make liver cancer a major public health problem, notably in less developed regions, particularly in Eastern Asia. This fully justifies the search of new molecules and therapeutic strategies against HCC. The present work focused on finding bioactive compounds from Vietnamese plants against HCC. The first approach used classical screening of 33 natural compounds which resulted in the identification of 7 ent-kaurane diterpenoids isolated from Croton kongensis Gagnep. as potential agents. The second approach aimed at identifying molecules that could abrogate the interaction between Mortalin and p53 by in silico screening of a database of 354 natural compounds, which allowed the identification of Solasonine as a potent inhibitor of p53 - mortalin interactions.

There is little head-to-head evidence comparing interventions available for juvenile idiopathic arthritis (JIA). This review involved a series of systematic reviews and network meta-analyses (NMAs) to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological interventions among patients with JIA. Outcomes were the American College of Rheumatology Pediatric 30 (ACR Pedi 30) (disease response), its six composite outcomes, pain relief, health-related quality of life, and physical and emotional functioning. There was some evidence that etanercept had greater reduction in the number of joints with active arthritis compared to abatacept for polyarticular-course JIA and that canakinumab had improved ACR Pedi 30 over rilonacept. Non-pharmacological interventions showed no significant results for efficacy but were safe overall. Most included studies were low-quality and many were excluded from analysis because of unclear reporting or no results for outcomes of interest. As more studies are conducted this will improve the estimates from the NMAs.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-13T14:09:49Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Zenaide S Monte - Tese Doutorado - Defesa 15-jul-2016.pdf: 10509605 bytes, checksum: 9a625f96607c0ccae6d58b896ba38772 (MD5) / Made available in DSpace on 2017-07-13T14:09:49Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Zenaide S Monte - Tese Doutorado - Defesa 15-jul-2016.pdf: 10509605 bytes, checksum: 9a625f96607c0ccae6d58b896ba38772 (MD5) Previous issue date: 2016-07-15 / CAPES / Compostos heterocíclicos do tipo pirimidina são conhecidos pela enorme riqueza de seus potenciais biológicos e farmacológicos. Numerosas reações de heterociclização que permitem a obtenção dessa classe de compostos são igualmente reconhecidas, devido à diversidade de atividades e do conhecimento prévio de inúmeras viabilidades sintéticas. As modificações estruturais obtidas na busca da otimização das rotas sintéticas conferem às novas moléculas diferentes propriedades físicas e alteram a reatividade das moléculas, acarretando em mudanças na distribuição nas células e nos tecidos. Essas discretas modificações estruturais podem revelar efeitos biológicos que haviam estado latentes ou eclipsados pelos efeitos colaterais do composto protótipo. Sendo assim, o presente trabalho apresenta a síntese por método convencional dos derivados da pirimidina 3a-q e 5o-q. Estes compostos foram avaliados quanto às propriedades duais: Antimicrobiana e Fotoluminescência, estas apresentaram resultados promissores, podem atuar como boas sondas fluorescentes. Foram realizados também estudos Espectrofotométricos em diferentes solventes além de determinarmos o Cálculo do Orbital Molecular de Fronteira nesta série. Realizou-se também a nanoencapsulação em lipossomas para o composto 3o. Obtivemos também p-arilamidinas 3a-j por método convencional e avaliamos as propriedades Antimicrobiana e Citotóxica, as quais apresentaram resultados significativos. Realizamos a síntese dos derivados pirimidínicos 3a-f e 6a-f pelo método em Irradiação em micro-ondas, em fase sólida e em solução, respectivamente. Estudamos também para estes as propriedades Antimicrobiana e Antioxidante, cujos os resultados foram satisfatórios. Foram obtidos bons rendimentos para todos os compostos obtidos. Um estudo inédito de RMN bidimensional, COSY, HSQC e HMBC foram aplicados às pirimidinas foi realizado, proporcionando a caracterização estrutural destes compostos. Os resultados obtidos apresentaram significativa potencialidades biológicas, farmacológicas e fotofísicas. / Heterocyclic compounds of pyrimidine are known for rich biological and pharmacological potential. A number of heterociclic reactions that enable the obtention of this class of compounds are also recognized, due to the diversity of activities and prior knowledge of their various synthetic viabilities. The structural modifications obtained in search for the best synthetic routes confered different physical properties on the new molecules and altered the reactivity of the molecules, resulting in changes in the distribution in cells and tissues. These discrete structural changes may reveal biological effects that may have been latent or eclipsed by the side effects of the compound prototype. This work presents the synthesis by conventional method of derivatives from pyrimidine 3a-q and 5o-q. These compounds were evaluated for dual properties: antimicrobial and photoluminescence. They showed promising results can act as fluorescent probes. Spectroscopic studies were carried out with different solvents and the Frontier Molecular Orbital calculation for this series was determined. Nanoencapsulation of liposomes for the compound 3o was prepared. The conventional method was used to obtain 3a-j p-arilamidinas. Results were significant for the antimicrobial and cytotoxic properties. Finally, the synthesis of pyrimidines derivatives 3a-f and 6a-f by a new method, solid phase micro-wave and in solution, respectively was carried out. We have studied both the Antimicrobial and Antioxidant properties with satisfactory results. Good yields were obtained for all compounds obtained. New studies of two-dimensional NMR, COSY, HSQC and HMBC were performed besides the characterization of the compounds by standard methods. The results show that the compounds obtained have great biological, pharmacological potential and Photophysical.

Fabry disease is an inherited X-linked recessive disorder caused by mutations in the galactosidase alpha (GLA) gene, leading to deficiencies in α-galactosidase A (α-GAL) enzyme production. α-GAL, a lysosomal glycosidase, catalyzes the removal of a terminal α-galactose; however, loss of α-GAL activity leads to accumulation of globotriaosylceramide (an endogenous substrate) and the eventual onset of the disease. Approved treatments for Fabry disease include enzyme replacement therapy and pharmacological chaperone therapy. In the latter treatment, 1-deoxygalactonojirimycin (DGJ), a pharmacological chaperone, is administered to Fabry disease patients, leading to increased enzymatic activity. The DGJ iminosugar acts as a competitive inhibitor of α-GAL, and upon addition at sub-inhibitory concentrations, the α-GAL activity in the cell increases. At pH 7.5, the DGJ binds and stabilizes both wild type and mutant α-GAL and can thus drive the folding of the α-GAL protein (Guce 2011). DGJ has been clinically approved to treat a subset of the more than 900 known mutations in the GLA gene. These approvals come from the chaperone activity data published by Amicus Therapeutics (Benjamin 2017). However, these assays cost money, time, and effort to perform, and novel mutations are discovered annually. Using molecular dynamics energy calculations in the Schrödinger software package, we developed a model to predict successful chaperoning of the mutants. Overall, the results are directly applicable to Fabry disease, but could also be applied to the much larger family of protein folding diseases, including Alzheimer's, Parkinson's and Huntington's diseases.

Le travail réalisé dans cette thèse a consisté en deux parties principales; la première partie a été centrée sur l’isolement de métabolites marins bioactifs, en mettant l'accent sur l'utilisation de techniques intégrés et modernes pour l'exploration chimique de deux éponges marines sélectionnées pour leurs activités cytotoxiques et antiinfectieuses. L’inhibition du Quorum Sensing pour explorer les activités antibiofilms a été utilisée. L’étude chimique de la première éponge Monanchora sp., a permis l'isolement et l'identification de vingt-huit composés guanidiniques et polycycliques, dont onze nouveaux. De la deuxième éponge Suberea ianthelliformi, nous avons pu isolé et identifié douze métabolites de type bropmotyrosines incluant huit alcaloïdes nouveaux dont les tétrabromotyrosines de la famille psammaplysenes. Les composés isolés ont été évalués pour leurs activités biologiques, en particulier pour les activités ciblées, cytotoxicité et inhibition de quorum sensing (QSI). De nombreux composés se sont avérés cytotoxiques sur plusieurs lignées cellulaires cancéreuses à des concentrations allant du micro au nanomolaire, en particulier les produits pentacycliques de la famille des crambescidines 800 et 814 alcaloïdes (CI50 = 4.5 nM). Ces résultats sont présentés à la fin du manuscrit. La deuxième partie concerne la synthèse bioinspirée du fragment guanidinique et tricyclique central des crambescidines et batzelladines. La synthèse totale de deux analogues tricycliques de merobatzelladine B a été ainsi réalisée. La stratégie de synthèse est essentiellement basée sur une réaction bioinspirée et inspiré de la stratégie de Robinson lors de la synthèse de la tropénone. / The work achieved in this thesis consisted two main parts; the first part was centered to the l marine natural product program, with emphasis on using modern and integrated techniecs for the chemical exploration of two promising marine sponges for the discovery of new marine secondary metaboilites along with their biological evalutions as anticancers, antibiotics, antifouling and antibiofilms. The chemical exploration of the first marine sponge Monanchora sp., afforded the isolation and identification of twenty-eight compounds, included eleven new compounds. The second marine sponge Suberea ianthelliformis, we were able to isolate and identify twelve marine metabolites included four known compounds and eight new tetrabromo tyrosine alkaloids related to psammaplysenes family. The isolated compounds were evaluated for their biological activities, in particular for cytotoxicity, quorum sensing inhibition (QSI) and antibiofilms. Almost of the isolated compounds exhibited interesting high cytotoxic activity against several cancer cell lines ranging from micro to nanomolar scale, in particular the isolated pentacyclic crambescidin 800 and 814 guanidine alkaloids showed strong cytotoxicity with IC50 = 4.5 nM. The second part was concerning with the bioinspired synthesis of the central tricyclic guanidinic fragments of the polycyclic marine alkaloids, batzelladines/crambescidins, in addition to the total synthesis of two stereoisomeric analogues of merobatzelladine B tricyclic alkaloid. Successfully, we had achieved a four steps short stratgy to access the tricyclic guanidinic portion of the batzelladine alkaloids, based on a bioinspired Robinson multicomponant reaction.

1. SUMMARYMyeloperoxidase (MPO) which belongs to the peroxidase family, is found in mammalian neutrophils. This heme enzyme contributes to the production of (pseudo)halogenous acid such as HOCl which oxidizes proteins, cell membrane, DNA and RNA causing death for the pathogens. It has an antimicrobial effect due to HOCl secreting inside the phagosomes of the neutrophils, whereas it will be released outside neutrophils causing oxidative damages for the host tissues. Proteins, lipids, lipoproteins, DNA and RNA are potential targets of the MPO resulting in several chronic syndromes. Many researchers have discovered the harmful effects of MPO and its products demonstrating its role in many inflammatory chronic diseases such as: Cardiovascular diseases as in atherosclerosis. MPO contribution in atherosclerosis development has been demonstrated. Neurodegenerative diseases also was related to MPO: such as Alzheimer’s disease (AD), multiple sclerosis (MSc) and Parkinson’s disease The enzyme has been also pointed out in other diseases such as renal disease and cancer.For these reasons, MPO as a target of drug discovery has attracted the attention of many researchers. X-ray 3D structures were resolved for this enzyme, biological activity and mechanism of action were investigated in depth, and many medicinal chemists have investigated and screened for new MPO inhibitors. Indeed, this cumulative work including X-ray data, the role of MPO in different pathologies, MPO inhibitory mechanism of action, screening and various chemical entities that inhibit MPO, provided sufficient elements to start a new drug design and drug discovery process on MPO.The aim of the present study was to apply a rational drug design approach to the myeloperoxidase inhibition: from in silico to pharmacological activity. This includes:─ Conducting high throughput virtual screening in order to find new potential hits to inhibit MPO followed by mechanism of inhibition determination. ─ Selecting one hit and then implementing a whole pharmacomodulation process in order to increase the potency of the inhibition greater than the starting hit and to improve the selectivity.Firstly, a rational drug design process was launched to find new hits using high throughput virtual screening. The chosen database for the screening was ASINEX database published in ZINC.X-ray structure of human peroxidase complexed to cyanide and thiocyanate (PDB 1DNW) was selected to conduct High-Throughput Virtual Screening (HTVS). Three successive protocols with different levels of accuracy in the docking and scoring processes were used starting with HTVS, followed by Standard Precision (SP) and finally with Xtra Precision (XP). The quality of the docking process performed was validated by docking a set of 60 chosen molecules of varying chemical structure and known as MPO inhibitors. From the result of the HTVS conducted on 1,350,000 compounds, the 100 best compounds were selected. Among them, 81 molecules were available for purchase from ASINEX, those compounds were tested with a MPO inhibition assay. Thirty-two compounds (39 %) were active, but only 8 compounds were selected, featuring different chemical structures with IC50 values ranging between 0.46 ± 0.07 and 12 ± 3 μM. Among these molecules, two compounds were the best and considered as hits. One has purinedione structure which is similar with the structure of thioxanthine derivatives (F9, IC50=0.46±0.07μM). The second compound has a hexahydropyrimidine structure (A1, IC50 = 0.5 ± 0.1 μM) The most common interactions found among all 8 docked ligands are the ionic bond with Glu102 and a stacking (shifted or not) with pyrrole ring D of the prosthetic group. Hydrogen bonds with Glu102, Thr100, Gln91, Arg239, or the propionate groups of the heme are also found in several docked geometries of the complexes. Interestingly, interactions with Glu102 and pyrrole ring D of the heme were also seen with fluorotryptamine derivatives and also salicylhydroxamic acid (SHA).For measuring MPO-dependent LDL oxidation, the two best compounds were tested. Compounds A1 and F9 showed good inhibition on MPO-dependent LDL oxidation (62 ± 6, 4.5 ± 0.9, 11 ± 2% and 11 ± 2, 2.6 ± 0.8, 6 ± 4%, respectively).Consequently, in order to determine the mechanism of inhibition transient-state kinetics were further investigated of all the 8 selected compounds.Both new lead compounds (A1 and F9) act as electron donors of both Compound I and Compound II of MPO. The reaction with Compound I was significantly faster (k2 ≫ k3). As a consequence, the enzyme is trapped in the Compound II state. They reversibly inactivated the enzyme blocking the harmful halogenation activity of MPO by transferring it to the MPO peroxidase cycle. In the present study, 8 active and reversible MPO inhibitors were selected. They act as electron donors of the oxidoreductase and efficiently block the halogenation activity with reversible inactivation. Two of the selected compounds have a submicromolar activity and inhibit MPO-dependent LDL oxidation. The high-throughput virtual screening was proved to be a successful tool to find new leads of MPO inhibitors. Conducting HTVS on a large-scale database enabled selection of novel scaffolds of MPO inhibitors never explored before in less time and at less expenses.Finding 8 new different chemical scaffolds through the first step of this drug discovery process led us to choose a new hit, compound A1, which has a hexahydropyrimidine structure, compound F9 was not chosen despite being more active due to its similarity to compounds discovered by AstraZeneca. To conduct pharmacomodulation, a validation of the docking procedure was conducted by comparing the X-ray structures of MPO with 2-(3,5-bistrifluoromethylbenzylamino)-6-oxo-1H-pyrimidine-5- carbohydroxamic acid, HX1, and SHA in the X-ray structures of human MPO in complex with cyanide and thiocyanate (PDB code 1DNW) as well as in complex with HX1 (PDB code 4C1M). Compound A1 was docked into both target structures 1DNW and 4C1M. In both cases, A1 showed almost the same poses.Based on the binding modes of A1, different strategies were developed for the design of derivatives which were mainly focused on the substitution of the aromatic rings A and B, the 2 amino groups and the side chain bridges.Pharmacomodulation was carried out on the hit A1 with different strategies:─ Investigating the role of hydroxyl groups on both aromatic rings─ Shifting the position of the amino groups in the hexahydropyrimidine ring to obtain piperazine derivatives and introduction of fluorine ─ Eliminating of one ring and of an amino group in the hexahydropyrimidine ring leading to piperidine derivatives ─ Opening the hexahydropyrimidine ring while keeping amine function and changing the length of the bridge between this amino group and aromatic ring as well as the impact of substitutions on aromatic rings.─ Hybridization of fluorotryptamine derivatives (effective MPO inhibitors) with hit A1.Based on of the docking experiments, 37 designed compounds were synthesized. The assessment of inhibition of the chlorination activity of MPO was undertaken over the 37 compounds. The hit A1 IC50 = 500 nM. The best compounds inhibiting MPO exhibited the following characteristics:─ One amino group on the bridge between aromatic rings was sufficient for the establishment of binding to Glu102 ─ The presence of three methylene groups between the secondary amine and an aromatic ring improved the inhibition of chlorination and thus decreased the IC50 values. These results showed that the position of the hydroxyl group is important. The distance between the hydrogen bond acceptor (HBA) group of one aromatic ring and the amino group is very important. The docking experiments of bisarylpropylamine derivatives showed ionic and hydrogen bonding interactions between Glu102 and hydroxyl group on aromatic ring linked to the longer side chain.─ Hybridized compounds which carry a fluorotryptamine instead of the phenol ring obtained by hybridization of hit A1 and the potent MPO inhibitors fluorotryptamine derivatives. Actually, compound 38 (which had one aromatic ring and a propyl bridge attached to indole ring) had an IC50 = 54 nM which was 10 times more powerful than the starting hit.The 3 best compounds were tested to examine the transient kinetics. They act as electron donors of the oxidoreductase and efficiently shift MPO from the chlorination cycle to the peroxidase cycle. Due to the similarity of the best compound 38 to serotonin it was tested with the two other best compounds on serotonin transporter (SERT) to examine the selectivity between MPO and SERT.Compound 38 had higher selectivity over MPO but the best selective compound was 28 that contains two aromatic rings carrying one hydroxyl and one fluorine.Electron density maps were conducted to predict the site of oxidation. Results suggested it occurs preferentially at the benzene ring or the indole ring in the best compounds.Determination of redox potentials for the synthesized compounds were tested. Best compounds act as electron donors allowing a one-electron reduction of Compound I.In conclusion, the present study succeeded through rational drug design including structure-based drug design and HTVS to identify new chemical entities for MPO inhibition. Eight compounds were more active than the starting hit A1 with submicromolar inhibition potency. Hybridization and structure based design also gave improvement of selectivity of inhibitors against MPO such as compound 38. Bis-arylalkylamine derivatives are a new group of MPO inhibitors with higher selectivity which could be a new hit for future development. / Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie) / info:eu-repo/semantics/nonPublished

No description available.

Bakgrund: Sedan 2002 har inte bara rubrikerna om sömnstörningar och sömnsvårigheter ökat i de stora medierna. Antalet unga med sömnstörningar ökar varje år, där unga kvinnor är den grupp som ökat mest. Enligt folkhälsomyndighetens rapport 2019 upplever mer än var tredje svensk, 39 %, sömnbesvär i någon grad. Distriktssköterskan arbetar redan med att främja god kost, motion, sunda alkoholvanor, minskad rökning, stress och våld; faktorer som påverkar hälsan i allra högsta grad. Syfte: Att undersöka vilken effekt KBT har på symptomen av sömnproblem, och om metoden applicerbar att utföras av distriktssköterskor. Metod: Systematisk litteraturöversikt där 14 studier valdes ur databaserna Cinahl, Psycinfo och Pubmed. Artiklarna bearbetades gemensamt och de kategorier som framkom återfinns nedan, under respektive rubrik. Resultat: KBT-I både i grupp och i digital form visade på signifikanta förbättringar av sömnen och dess effekt på det dagliga livet. / Background: Since 2002 not only have the headliners about sleep difficulties and sleep disturbances multiplied in the big media. The number of young people with insomnia increases each year, and young women are the group that increases the most. Last year more than every third swede, 39 percent suffered from various grades of insomnia. District nurses already play a big part in preventing disease and promoting health by giving support and knowledge to patients about healthy foods, exercising, drinking habits, smoking, violence at home and stress; all of those very much the key to individual’s health. Aim: of the study to explore how CBT-I might affect the symptoms of insomnia and if this treatment can be performed by nurses. Method: Systematic review by synthesizing 14 studies from the databases Chinal, Psycinfo and Pubmed. The studies were processed individually and thereby mutually to find emerging themes which are to be presented under each heading. Result: CBT-I both in group and in digital form showed significant improvements in sleep and its effect on daily life. / <p>Godkännandedatum: 2020-11-04</p>

Excerpt: Navari and colleagues (July 14 issue)1 report on the use of olanzapine for the prevention of chemotherapy-induced nausea and vomiting.

Bakgrund  Långvarig smärta är ett folkhälsoproblem som skapar lidande för den drabbade. Farmakologisk behandling ger inte alltid optimal effekt vilket kan leda till att personer med långvarig smärta söker sig till andra behandlingsmetoder. Därför behövs vidare forskning i de icke-farmakologiska behandlingsmetoderna för att få kunskap och information om den drabbades upplevelser av icke-farmakologisk behandling.  Syfte  Syftet var att belysa personers upplevelser av icke-farmakologisk behandling vid långvarig smärta.  Metod  En litteraturöversikt gjordes baserad på 15 vetenskapliga artiklar. Sökningen av litteratur genomfördes i två databaser CINAHL och PubMed. En kvalitetsgranskning av artiklarna utfördes med hjälp av Sophiahemmets bedömningsunderlag. Därefter gjordes en integrerad dataanalys där resultat från artiklarna analyserades och sammanställdes.  Resultat  Två huvudkategorier, Upplevd smärta och välbefinnande, samt sju subkategorier sammanställdes i resultatet. Resultat visade att icke-farmakologiska behandlingar ger en förbättring på smärtintensitet och ett ökat välmående inom både psykiska och fysiska funktioner.  Slutsats  Icke-farmakologiska behandlingsmetoder visades ha måttlig till god effekt på smärtintensitet. Smärtan försvann inte helt men en minskning i smärtintensitet gav plats för annat i personens liv, vilket ledde till en ökning i personens välmående som kan appliceras i sjuksköterskans arbete i omvårdnad av personer med långvarig smärta. / Background Persistent pain is a public health problem that creates suffering for the affected. Pharmacological treatment does not always give an optimal effect, which can lead to people with persistent pain seeking other treatment methods. Therefore, further research into the non-pharmacological treatment methods is needed in order to obtain knowledge and information about the experiences of those affected. Aim The aim was to shed light on people's experiences of non-pharmacological treatment in persistent pain. Method A literature review was made based on 15 scientific articles. The search for literature was conducted in two databases CINAHL and PubMed. A quality review of the articles was made with the help of Sophiahemmet's assessment basis. An integrated data analysis was then performed where results from the articles were analyzed and compiled. Results Two main categories, experienced pain and well-being, and seven sub-categories were compiled in the result. Results showed that non-pharmacological treatments provide an improvement in pain intensity and increased well-being in both mental and physical functions. Conclusions Non-pharmacological treatment methods have been shown to have a moderate to good effect on pain intensity. The pain did not disappear completely, but a decrease in pain intensity gave way to other things in the person's life, which led to an increase in the person's well-being that can apply in the nurse's work in caring for people with persistent pain.