The distribution and morphology of neuronal degeneration were observed and analyzed in each sector of the zona incerta in a lithium‐pilocarpine (LiCl) Wistar rat model of status epilepticus in 12, 15, 18, 21, and 25‐day‐old rats and survival intervals of 4, 8, 12, 24, and 48 hours. Status epilepticus was induced via intraperitoneal (IP) injection of LiCl (3 mmol/kg) 24 hours before an injection of pilocarpine (40 mg/kg, IP). Motor seizures were suppressed by paraldehyde (0.3‐0.6 ml/kg, IP) two hours after status epilepticus onset. Animals were anesthetized using urethane and perfused with phosphate‐buffered saline followed by 4% paraformaldehyde. Brains were sectioned and Nissl stained for map guidance, with fluoro‐Jade B fluorescence used to detect degenerated neurons. Fluoro‐jade B‐positive neurons were plotted to a standard stereotaxic atlas, their distribution was quantified, and their long‐axis diameter was measured. Fluoro‐jade B‐positive neurons were found in pups aged 15 days and older 24 hours after status epilepticus, in which their numbers increased, and their perikaryon size decreased with advancing age. Thus, neuronal damage severity was dependent on age and survival interval. Neuronal damage was only found in the rostral sector of the zona incerta, a region that exhibits a small number of inhibitory neurons and is reciprocally connected to the limbic cortex. This system of hyperactivity, coupled with inhibitory neurons, may be the underlying cause of the neuronal degeneration and explain why it was confined to the rostral sector of the zona incerta.

• MeSH
• chlorid lithný toxicita   MeSH
• degenerace nervu * patologie   etiologie   MeSH
• fluoresceiny MeSH
• krysa rodu rattus MeSH
• modely nemocí na zvířatech MeSH
• neurony * patologie   MeSH
• novorozená zvířata MeSH
• pilokarpin toxicita   MeSH
• potkani Wistar MeSH
• status epilepticus * patologie   chemicky indukované   komplikace   MeSH
• věkové faktory MeSH
• zona incerta * patologie   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Interleukin-2-inducible T-cell kinase (ITK) and Bruton's tyrosine kinase (BTK) are two important members of the Tec family with crucial roles in immune system function. Deregulation in ITK and BTK activity is linked to several hematological malignancies, making them key targets for cancer immunotherapy. In this study, we synthesized a series of azaspirooxindolinone derivatives and evaluated their cytotoxic activity against ITK/BTK-negative and positive cancer cell lines, followed by enzymatic inhibition studies to assess the ITK/BTK kinase selectivity of two hit compounds. Several compounds demonstrated selective cytotoxicity against ITK- or BTK-expressing cells. Compound 3d exhibited high cytotoxicity in ITK-positive Jurkat (IC50 = 3.58 μM) and BTK-positive Ramos (IC50 = 3.06 μM) cells, while compound 3j showed strong cytotoxicity in Ramos (IC50 = 1.38 μM) and Jurkat (IC50 = 4.16 μM) cells. Compounds 3a and 3e were selectively cytotoxic in Jurkat cells (IC50 = 9.36 μM and 10.85 μM, respectively), while compounds 3f and 3g were highly cytotoxic in Ramos cells (IC50 = 1.82 μM and 1.42 μM, respectively). None of the active compounds exhibited cytotoxicity in non-cancer cell lines (IC50 > 50 μM), demonstrating their selectivity for malignant cells. Enzyme inhibition assay showed that 3d is a selective ITK inhibitor (IC50 = 0.91 μM) with no detectable BTK inhibition, aligning with its strong activity in ITK-positive cells. In contrast, compound 3j did not inhibit ITK or BTK enzymatically, suggesting an alternative mechanism of action. These findings highlight 3d as a promising ITK inhibitor and warrant further investigation to elucidate its mechanism of action.

• MeSH
• inhibitory proteinkinas * farmakologie   chemická syntéza   chemie   MeSH
• lidé MeSH
• molekulární struktura MeSH
• nádorové buněčné linie MeSH
• oxindoly farmakologie   chemie   chemická syntéza   MeSH
• proliferace buněk účinky léků   MeSH
• proteinkinasa BTK * antagonisté a inhibitory   metabolismus   MeSH
• protinádorové látky * farmakologie   chemická syntéza   chemie   MeSH
• racionální návrh léčiv * MeSH
• screeningové testy protinádorových léčiv * MeSH
• simulace molekulového dockingu MeSH
• spirosloučeniny chemie   farmakologie   chemická syntéza   MeSH
• tyrosinkinasy * antagonisté a inhibitory   metabolismus   MeSH
• vztah mezi dávkou a účinkem léčiva MeSH
• vztahy mezi strukturou a aktivitou MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• atogepant,
• MeSH
• antagonisté CGRP receptorů aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• klinická studie jako téma MeSH
• lidé MeSH
• migréna * farmakoterapie   MeSH
• monoklonální protilátky aplikace a dávkování   terapeutické užití   MeSH
• peptid spojený s genem pro kalcitonin MeSH
• piperidiny aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• pyridiny aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• pyrroly aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• spirosloučeniny aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• tryptaminy aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH

BACKGROUND: Atogepant, an oral calcitonin gene-related peptide receptor antagonist, has been approved for the preventive treatment of migraine, but its efficacy and safety in people who have been failed by conventional oral preventive migraine treatments has not yet been evaluated in a dedicated clinical trial. The ELEVATE trial evaluated the safety, tolerability, and efficacy of atogepant for the preventive treatment of episodic migraine in participants for whom two to four classes of conventional oral preventive treatments have failed. METHODS: ELEVATE was a randomised, double-blind, placebo-controlled, parallel-group, phase 3b trial done at 73 sites in Canada, the Czech Republic, Denmark, France, Germany, Hungary, Italy, the Netherlands, Poland, Russia, Spain, the UK, and the USA. Adults (18-80 years) with episodic migraine who had previously been failed by two to four classes of conventional oral treatments for migraine prevention were randomly assigned (1:1) using interactive web response technology to oral atogepant 60 mg once a day or placebo, stratified by baseline monthly migraine days, number of treatment classes participants have been failed by, and region. The primary endpoint was change from baseline in mean monthly migraine days across the 12-week treatment period in the off-treatment hypothetical estimand (OTHE) population, which included participants in the safety population (all participants who received ≥1 dose of study intervention) who had evaluable data available for the baseline period and for one or more of the 4-week post-baseline periods (whether on treatment or off treatment). The primary endpoint was analysed using a mixed model for repeated measures and a fixed-sequence procedure was used to control for multiple comparisons. The trial is registered with ClinicalTrials.gov (NCT04740827) and EudraCT (2019-003448-58), and is completed. FINDINGS: Between March 5, 2021, and Aug 4, 2022, 540 participants were screened, 315 were randomly assigned, and 313 participants (280 [89%] female, 33 [11%] male, and 300 [96%] White) received at least one dose of study intervention. In the OTHE population, which comprised 309 participants (155 assigned to placebo and 154 to atogepant), least squares mean changes from baseline in monthly migraine days across 12 weeks were -1·9 (SE 0·4) with placebo and -4·2 (0·4) with atogepant (least squares mean difference -2·4, 95% CI -3·2 to -1·5; adjusted p<0·0001). The most common treatment-emergent adverse event with atogepant was constipation in 16 (10%) of 156 participants (vs four [3%] of 157 for placebo). Serious adverse events occurred in four [3%] of 156 participants in the atogepant group vs none in the placebo group, and treatment-emergent adverse events resulting in treatment discontinuation occurred in three [2%] in the atogepant group vs two [1%] in the placebo group. INTERPRETATION: Atogepant 60 mg once a day was safe, well tolerated, and showed significant and clinically relevant reductions in mean monthly migraine days compared with placebo across 12 weeks in patients with episodic migraine who had previously been failed by two to four classes of conventional oral preventive treatments. Atogepant might be an effective preventive treatment option for patients in this difficult-to-treat population. FUNDING: Allergan (now AbbVie).

• MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• lidé MeSH
• migréna * farmakoterapie   prevence a kontrola   MeSH
• monoklonální protilátky * terapeutické užití   MeSH
• piperidiny * MeSH
• pyridiny * MeSH
• pyrroly * MeSH
• spirosloučeniny * MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: An unmet need exists for focal segmental glomerulosclerosis (FSGS) treatment. In an 8-week, phase 2 trial, sparsentan, a dual endothelin-angiotensin receptor antagonist, reduced proteinuria in patients with FSGS. The efficacy and safety of longer-term treatment with sparsentan for FSGS are unknown. METHODS: In this phase 3 trial, we enrolled patients with FSGS (without known secondary causes) who were 8 to 75 years of age; patients were randomly assigned to receive sparsentan or irbesartan (active control) for 108 weeks. The surrogate efficacy end point assessed at the prespecified interim analysis at 36 weeks was the FSGS partial remission of proteinuria end point (defined as a urinary protein-to-creatinine ratio of ≤1.5 [with protein and creatinine both measured in grams] and a >40% reduction in the ratio from baseline). The primary efficacy end point was the estimated glomerular filtration rate (eGFR) slope at the time of the final analysis. The change in eGFR from baseline to 4 weeks after the end of treatment (week 112) was a secondary end point. Safety was also evaluated. RESULTS: A total of 371 patients underwent randomization: 184 were assigned to receive sparsentan and 187 to receive irbesartan. At 36 weeks, the percentage of patients with partial remission of proteinuria was 42.0% in the sparsentan group and 26.0% in the irbesartan group (P = 0.009), a response that was sustained through 108 weeks. At the time of the final analysis at week 108, there were no significant between-group differences in the eGFR slope; the between-group difference in total slope (day 1 to week 108) was 0.3 ml per minute per 1.73 m2 of body-surface area per year (95% confidence interval [CI], -1.7 to 2.4), and the between-group difference in the slope from week 6 to week 108 (i.e., chronic slope) was 0.9 ml per minute per 1.73 m2 per year (95% CI, -1.3 to 3.0). The mean change in eGFR from baseline to week 112 was -10.4 ml per minute per 1.73 m2 with sparsentan and -12.1 ml per minute per 1.73 m2 with irbesartan (difference, 1.8 ml per minute per 1.73 m2; 95% CI, -1.4 to 4.9). Sparsentan and irbesartan had similar safety profiles, and the frequency of adverse events was similar in the two groups. CONCLUSIONS: Among patients with FSGS, there were no significant between-group differences in eGFR slope at 108 weeks, despite a greater reduction in proteinuria with sparsentan than with irbesartan. (Funded by Travere Therapeutics; DUPLEX ClinicalTrials.gov number, NCT03493685.).

• MeSH
• biologické markery MeSH
• dítě MeSH
• dospělí MeSH
• fokálně segmentální glomeruloskleróza * komplikace   farmakoterapie   patofyziologie   MeSH
• hodnoty glomerulární filtrace MeSH
• indukce remise MeSH
• irbesartan * aplikace a dávkování   škodlivé účinky   terapeutické užití   MeSH
• kreatinin MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• proteinurie * farmakoterapie   etiologie   MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• randomizované kontrolované studie MeSH

BACKGROUND: Sparsentan, a novel, non-immunosuppressive, single-molecule, dual endothelin angiotensin receptor antagonist, significantly reduced proteinuria versus irbesartan, an angiotensin II receptor blocker, at 36 weeks (primary endpoint) in patients with immunoglobulin A nephropathy in the phase 3 PROTECT trial's previously reported interim analysis. Here, we report kidney function and outcomes over 110 weeks from the double-blind final analysis. METHODS: PROTECT, a double-blind, randomised, active-controlled, phase 3 study, was done across 134 clinical practice sites in 18 countries throughout the Americas, Asia, and Europe. Patients aged 18 years or older with biopsy-proven primary IgA nephropathy and proteinuria of at least 1·0 g per day despite maximised renin-angiotensin system inhibition for at least 12 weeks were randomly assigned (1:1) to receive sparsentan (target dose 400 mg oral sparsentan once daily) or irbesartan (target dose 300 mg oral irbesartan once daily) based on a permuted-block randomisation method. The primary endpoint was proteinuria change between treatment groups at 36 weeks. Secondary endpoints included rate of change (slope) of the estimated glomerular filtration rate (eGFR), changes in proteinuria, a composite of kidney failure (confirmed 40% eGFR reduction, end-stage kidney disease, or all-cause mortality), and safety and tolerability up to 110 weeks from randomisation. Secondary efficacy outcomes were assessed in the full analysis set and safety was assessed in the safety set, both of which were defined as all patients who were randomly assigned and received at least one dose of randomly assigned study drug. This trial is registered with ClinicalTrials.gov, NCT03762850. FINDINGS: Between Dec 20, 2018, and May 26, 2021, 203 patients were randomly assigned to the sparsentan group and 203 to the irbesartan group. One patient from each group did not receive the study drug and was excluded from the efficacy and safety analyses (282 [70%] of 404 included patients were male and 272 [67%] were White) . Patients in the sparsentan group had a slower rate of eGFR decline than those in the irbesartan group. eGFR chronic 2-year slope (weeks 6-110) was -2·7 mL/min per 1·73 m2 per year versus -3·8 mL/min per 1·73 m2 per year (difference 1·1 mL/min per 1·73 m2 per year, 95% CI 0·1 to 2·1; p=0·037); total 2-year slope (day 1-week 110) was -2·9 mL/min per 1·73 m2 per year versus -3·9 mL/min per 1·73 m2 per year (difference 1·0 mL/min per 1·73 m2 per year, 95% CI -0·03 to 1·94; p=0·058). The significant reduction in proteinuria at 36 weeks with sparsentan was maintained throughout the study period; at 110 weeks, proteinuria, as determined by the change from baseline in urine protein-to-creatinine ratio, was 40% lower in the sparsentan group than in the irbesartan group (-42·8%, 95% CI -49·8 to -35·0, with sparsentan versus -4·4%, -15·8 to 8·7, with irbesartan; geometric least-squares mean ratio 0·60, 95% CI 0·50 to 0·72). The composite kidney failure endpoint was reached by 18 (9%) of 202 patients in the sparsentan group versus 26 (13%) of 202 patients in the irbesartan group (relative risk 0·7, 95% CI 0·4 to 1·2). Treatment-emergent adverse events were well balanced between sparsentan and irbesartan, with no new safety signals. INTERPRETATION: Over 110 weeks, treatment with sparsentan versus maximally titrated irbesartan in patients with IgA nephropathy resulted in significant reductions in proteinuria and preservation of kidney function. FUNDING: Travere Therapeutics.

• MeSH
• antagonisté receptorů pro angiotenzin škodlivé účinky   MeSH
• chronické selhání ledvin * MeSH
• dospělí MeSH
• dvojitá slepá metoda MeSH
• IgA nefropatie * farmakoterapie   MeSH
• irbesartan škodlivé účinky   MeSH
• lidé MeSH
• proteinurie farmakoterapie   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze III MeSH
• randomizované kontrolované studie MeSH

Úvod: Flexibilní endoskopické vyšetření polykání (FEES) je jednou ze základních metod k objektivní diagnostice poruch polykání. Principem je polykání bolusů různých konzistencí pod endoskopickou kontrolou. Z dostupných údajů i našich zkušeností vyplývá, že kvalita a výtěžnost vyšetření závisí na viditelnosti testovaného bolusu. Cíl práce: Ověřit, zda použití fluoresceinu zlepšuje citlivost FEES vyšetření v porovnání se standardním potravinářským barvivem. Metodika: Ve studii jsme u 40 pacientů provedli FEES s polknutím vody obarvené zeleným potravinářským barvivem a vody obarvené fluoresceinem. Hodnocena byla přítomnost predeglutivního leaku, stagnace bolusu v hltanu (valekulách, na stěnách hltanu, piriformních recesech), průnik bolusu do dýchacích cest na základě Penetračně-aspirační škály podle Rosenbeka (PAS), tendence k penetraci přes zadní komisuru a také subjektivní porovnání obou metod ve sledovaných parametrech. Výsledky: Výsledky prokazují statisticky významně vyšší záchyt stagnace bolusu na stěnách hltanu (p < 0,001) a ve valekulách (p = 0,038) v případě tekutiny obarvené fluoresceinem. Při hodnocení průniku bolusu do dýchacích cest dosáhla hodnota reliability (spolehlivosti) statistické významnosti (k = 0,438; p < 0,001) mezi testovanými metodami (zelené barvivo oproti fluoresceinu), což svědčí pro dobrou citlivost obou metod. Na bodové škále podle Rosenbeka (1–8 bodů) se ale metody statisticky významně lišily v hodnocení závažnosti penetrace/aspirace (p = 0,001). Při použití fluoresceinu byla detekována statisticky významně větší hloubka průniku do dýchacích cest (PAS 3,13) než při použití zeleného barviva (PAS 2,10) (p = 0,001). Při subjektivním porovnání obou metod vyšetřujícím lékařem je statisticky významně lepší viditelnost fluoresceinu ve všech hodnocených parametrech. Závěr: Studie prokázala lepší senzitivitu FEES při použití fluoresceinu v porovnání s běžně používaným potravinářským barvivem. Fluorescein se jeví jako vhodné barvivo k vyšetřování poruch polykání.

Background: Flexible endoscopic evaluation of swallowing (FEES) is one of the basic methods for objective diagnostics of swallowing disorders. The principle is to swallow boluses of various consistencies under endoscopic control. According to available data and our experience, the quality and accuracy of the examination depends on the visibility of the tested bolus. Aim of the study: Verify that the use of fluorescein improves the sensitivity of the FEES compared to a standard food colouring. Methods: In the study, we performed FEES on 40 patients using green food colouring and fluorescein dyed water. The presence of pre-deglutive leak, bolus stagnation in the pharynx (valleculas, pharyngeal walls, piriform sinuses), bolus penetration into the airways based on the Rosenbek Penetration-Aspiration Scale (PAS), tendency to penetrate through the posterior commissure and subjective comparison of both methods in parameters mentioned above were evaluated. Results: The results show a statistically significantly higher detection of bolus stagnation on the pharyngeal walls (P <0.001) and in the epiglottic valleculas (P = 0.038) with fluorescein-dyed water. When assessing airway bolus penetration, the reliability value reached statistical significance (k = 0.438; P <0.001) between the tested methods (green food colouring vs. fluorescein), which indicates good sensitivity of both methods. However, on the Rosenbek score scale (1–8 points), the methods differed statistically significantly in the assessment of penetration/aspiration severity (P = 0.001). A statistically significantly greater depth of airway penetration was detected with fluorescein (PAS 3.13) compared to green food colouring (PAS 2.10) (P = 0.001). In a subjective comparison of both methods by the examining physician, the visibility of fluorescein is statistically significantly better in all evaluated parameters. Conclusions: The study showed a better sensitivity of FEES when using fluorescein compared to conventional food colouring. Fluorescein appears to be a good colouring for diagnostics of swallowing disorders.

• MeSH
• barvení a značení metody   MeSH
• diagnostické zobrazování metody   MeSH
• dospělí MeSH
• endoskopie klasifikace   metody   MeSH
• fluorescein * farmakologie   metabolismus   MeSH
• lidé MeSH
• orofarynx diagnostické zobrazování   patologie   MeSH
• poruchy polykání diagnostické zobrazování   diagnóza   etiologie   MeSH
• prospektivní studie MeSH
• sinus piriformis diagnostické zobrazování   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Fluorescein, eosin Y, and rose bengal are dyes used in clinical medicine and considered (photo-)chemically stable. Upon extensive irradiation with visible light in aqueous solutions, we found that these compounds release carbon monoxide (CO) - a bioactive gasotransmitter - in 40-100% yields along with the production of low-mass secondary photoproducts, such as phthalic and formic acids, in a multistep degradation process. Such photochemistry should be considered in applications of these dyes, and they could also be utilized as visible-light activatable CO-releasing molecules (photoCORMs) with biological implications.

• MeSH
• červeň bengálská MeSH
• fluorescein MeSH
• fluorescenční barviva * chemie   MeSH
• světlo MeSH
• xantheny * chemie   MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• dospělí MeSH
• fluorescein MeSH
• kontaktní čočky * MeSH
• lidé MeSH
• myopie * terapie   MeSH
• optická tomografie metody   MeSH
• rohovková topografie metody   přístrojové vybavení   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

The diagnosis of solid tumors of epithelial origin (carcinomas) represents a major part of the workload in clinical histopathology. Carcinomas consist of malignant epithelial cells arranged in more or less cohesive clusters of variable size and shape, together with stromal cells, extracellular matrix, and blood vessels. Distinguishing stroma from epithelium is a critical component of artificial intelligence (AI) methods developed to detect and analyze carcinomas. In this paper, we propose a novel automated workflow that enables large-scale guidance of AI methods to identify the epithelial component. The workflow is based on re-staining existing hematoxylin and eosin (H&E) formalin-fixed paraffin-embedded sections by immunohistochemistry for cytokeratins, cytoskeletal components specific to epithelial cells. Compared to existing methods, clinically available H&E sections are reused and no additional material, such as consecutive slides, is needed. We developed a simple and reliable method for automatic alignment to generate masks denoting cytokeratin-rich regions, using cell nuclei positions that are visible in both the original and the re-stained slide. The registration method has been compared to state-of-the-art methods for alignment of consecutive slides and shows that, despite being simpler, it provides similar accuracy and is more robust. We also demonstrate how the automatically generated masks can be used to train modern AI image segmentation based on U-Net, resulting in reliable detection of epithelial regions in previously unseen H&E slides. Through training on real-world material available in clinical laboratories, this approach therefore has widespread applications toward achieving AI-assisted tumor assessment directly from scanned H&E sections. In addition, the re-staining method will facilitate additional automated quantitative studies of tumor cell and stromal cell phenotypes.

• MeSH
• barvení a značení MeSH
• deep learning * MeSH
• eosin MeSH
• epitelové buňky MeSH
• hematoxylin MeSH
• keratiny * MeSH
• lidé MeSH
• umělá inteligence MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH