An 18-month randomized double-blind study was conducted in postmenopausal women with osteoporosis to compare the effects of once-daily teriparatide 20 µg with alendronate 10 mg on bone histomorphometry. Biopsies were obtained from 42 patients. Indices of bone formation were significantly higher after 6 or 18 months of teriparatide compared with alendronate treatment.Introduction: Alendronate and teriparatide increased BMD, assessed by DXA, by different mechanisms of action, supported by changes in biochemical markers of bone turnover. The purpose of this cross-sectional study was to explore the differential effects of these two osteoporosis treatments at the bone tissue level by examining bone histomorphometric parameters of bone turnover after either 6 or 18 months of treatment. Materials and Methods:Patients were a cohort from a randomized parallel double-blind study conducted to compare the effects of once-daily teriparatide 20 g and alendronate 10 mg in postmenopausal women with osteoporosis. Transiliac crest bone biopsies were obtained after tetracycline double labeling from 42 patients treated for 6 months (n ס 23) or 18 months (n ס 14); 5 additional patients were biopsied from contralateral sides at 6 and 18 months. Biopsy specimens adequate for quantitative analysis were analyzed by 2D histomorphometry from 17 patients at 6 months (teriparatide, n ס 8; alendronate, n ס 9) and 15 patients at 18 months (teriparatide, n ס 8; alendronate, n ס 7). Data were analyzed by two-sample tests. Results: Histomorphometric indices of bone formation were significantly and markedly greater in the teriparatide group than in the alendronate group at 6 and 18 months, whereas indices of bone resorption were only significantly greater in the teriparatide group than in the alendronate group at 6 months. Bone formation and activation frequency were significantly lower at 18 months compared with 6 months in the teriparatide group, returning to levels comparable with untreated postmenopausal women. In the teriparatide group, the peak in histomorphometric bone formation indices coincided with peak levels for N-terminal propeptide of type I collagen, a biochemical marker of bone formation. The degree of mineralization was lower at 18 months than at 6 months with treatment in both groups but was not different between groups. Conclusions: These results confirm the opposite mechanisms of action of teriparatide and alendronate on bone remodeling and confirm the bone formation effect of teriparatide.
Our study can offer new insights into disease mechanisms and prevention through the analysis of risk factor information in a large sample of Mexicans.
Today, tissue regeneration is one of the greatest challenges in the field of medicine, since it represents hope after accidents or illnesses. Tissue engineering is the science based on improving or restoring tissues and organs. In this work, five formulations of chitosan/poly(vinyl alcohol)/graphene oxide (CS/PVA/GO) nanocomposites were studied for the development of biodegradable films with potential biomedical applications. The characterization of the films consisted of Fourier-transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). The antibacterial activity was evaluated in vitro against Gram-positive bacteria Bacillus cereus and Staphylococcus aureus and Gram-negative Salmonella spp. and Escherichia coli, by contact of the film above inoculum bacterial in Müeller–Hinton agar. On the other hand, in vivo tests in which the material implanted in the subcutaneous tissue of Wistar rats demonstrated that the formulation CS/PVA/GO (14.25:85:0.75) was the best antibacterial film with adequate degradation in vivo. All together, these results indicate the potential of the films using nanocomposites of CS/PVA/GO in tissue engineering and cell regeneration.
The unprecedented structure of the marine natural product brevetoxin B was elucidated by the research group of Nakanishi and Clardy in 1981. The ladderlike molecular architecture of this fused polyether molecule, its potent toxicity, and fascinating voltage‐sensitive sodium channel based mechanism of action immediately captured the imagination of synthetic chemists. Synthetic endeavors resulted in numerous new methods and strategies for the construction of cyclic ethers, and culminated in several impressive total syntheses of this molecule and some of its equally challenging siblings. Of the marine polyethers, maitotoxin is not only the most complex and most toxic of the class, but is also the largest nonpolymeric natural product known to date. This Review begins with a brief history of the isolation of these biotoxins and highlights their biological properties and mechanism of action. Chemical syntheses are then described, with particular emphasis on new methods developed and applied to the total syntheses. The Review ends with a discussion of the, as yet unfinished, story of maitotoxin, and projects into the future of this area of research.
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