Statins research unfinished saga: desirability versus feasibility

Drugs in the same class are generally thought to be therapeutically equivalent because of similar mechanisms of action (the so-called "class effect"). However, statins differ in multiple characteristics, including liver and renal metabolism, half-life, effects on several serum lipid components, bioavailability and potency. Some are fungal derivatives, and others are synthetic compounds. The percentage absorption of an oral dose, amount of protein binding, degree of renal excretion, hydrophilicity, and potency on a weight basis is variable. These differences may be even greater in diabetic patients, who may present diabetes-induced abnormalities in P450 isoforms and altered hepatic metabolic pathways. Thus, it is obvious that head-to-head comparisons between different statins are preferable than trial-to-trial comparisons. Such assessments are of utmost importance, especially in cases in which specific populations with a distinct lipid profile and altered metabolic pathways, like diabetics, are studied. It should be specially pinpointed that patients with metabolic syndrome and diabetes constitute also a special population regarding their atherogenic dyslipidemia, which is usually associated with low HDL-cholesterol, hypertriglyceridemia and predominance of small dense LDL-cholesterol. Therefore, these patients may benefit from fibrates or combined statin/fibrate treatment. This policy is not accomplished since in the real world things are more complex. Trials would require very large sample sizes and long-term follow-up to detect significant differences in myocardial infarction or death between two different statins. Moreover, the fact that new compounds are under several phases of research and development represents an additional drawback for performing the trials. Ideally, head-to-head trials regarding clinically important outcomes should be conducted for all drugs. Nonetheless, the desirability of performing such trials, which epitomize modern evidence-based medicine, is frequently superseded by the feasibility dictated by pragmatic and economic circumstances. In the latter case, in absence of solid systematic documentation of comparable health benefits and long-term safety, both researchers and practicing physicians should allude to the weight of scientific endorsement behind the arguments and seek for the possible strengths and weaknesses intrinsic to each specific study. In any case, conclusions based on surrogate endpoints cannot completely substitute head-to-head comparisons regarding patients' outcome.     

Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms

This paper reviews the research evidence concerning the intergenerational transmission of trauma effects and the possible role of epigenetic mechanisms in this transmission. Two broad categories of epigenetically mediated effects are highlighted. The first involves developmentally programmed effects. These can result from the influence of the offspring's early environmental exposures, including postnatal maternal care as well as in utero exposure reflecting maternal stress during pregnancy. The second includes epigenetic changes associated with a preconception trauma in parents that may affect the germline, and impact fetoplacental interactions. Several factors, such as sex‐specific epigenetic effects following trauma exposure and parental developmental stage at the time of exposure, explain different effects of maternal and paternal trauma. The most compelling work to date has been done in animal models, where the opportunity for controlled designs enables clear interpretations of transmissible effects. Given the paucity of human studies and the methodological challenges in conducting such studies, it is not possible to attribute intergenerational effects in humans to a single set of biological or other determinants at this time. Elucidating the role of epigenetic mechanisms in intergenerational effects through prospective, multi‐generational studies may ultimately yield a cogent understanding of how individual, cultural and societal experiences permeate our biology.     

Iron deficiency induces reversal of dopamine dependent circadian cycles: differential response to d-amphetamine and TRH

Rats made nutritionally iron-deficient (ID) have significantly diminished haemoglobin, serum iron and hypothermic response to d-amphetamine (15 mg/kg). The reduction of d-amphetamine induced hypothermia is comparatively greater in the dark than in the light period. Neither TRH (1 mg/kg) nor CG 3703, a peptidase resistant TRH analogue (1 mg/kg), induced hypothermia in control of ID animals. However, in combination with d-amphetamine, TRH and CG 3703 did not alter the hypothermic effect observed initially with d-amphetamine. In contrast to control animals, ID rats treated with saline or d-amphetamine (15 mg/kg) exhibited a greater degree of motor activity in the light as compared to the dark period. However, the overall activity (light plus dark) was unchanged in the ID group. The motor activity in response to TRH or CG 3703 was not changed as a result of iron-deficiency. These differential responses may be due to a more pronounced action of d-amphetamine on dopaminergic system, which is known to be changed in iron-deficiency, and of TRH and CG 3703 on the noradrenergic neurones.     

Temporal variation in fish community structure in a newly created wetland lake (Lake Agmon) in Israel

Lake Agmon was constructed in summer 1994 in the northern part of the drained Lake Hula swamp, as part of the Hula Reclamation Project. One of the main goals of the project was to attract aquatic and semi- aquatic birds to the area as a basis for planned eco-tourism and one of the main concerns of the project was the potential for increased proliferation of mosquitoes (including vector species of malarial parasites). There was a perceived need, therefore, to establish and maintain a suitable fish community. This present study documents the developments in the fish community in Lake Agmon between May 1995 and December 1996. The lake was initially stocked with two fish species, Tilapia zillii and Gambusia affinis, to control mosquitoes and to provide suitable small- bodied forage species for piscivorous birds. Subsequent stocking also included Oreochromis aureus, and Cyprinus carpio. Additional species were established by immigration from the Jordan River. Relatively large species ( e.g., Clarias gariepinus and C. carpio) flowed into the lake as eggs or juveniles, whereas the smaller species ( e.g., Hemigrammocapoeta nana, Pseudophoxinus kervillei and Aphanius mento) entered the lake as adults. In the first year, eight fish species were found in Lake Agmon: T. zillii, G. affinis, C. gariepinus, C. carpio, Capoeta damascina, P. kervillei, Acanthobrama lissneri and H. nana. Of these, T. zillii, G. affinis and H. nana were dominant, though the relative abundance of H. nana was very low in spring, and increased during summer. In the second year, O. aureus, A. mento and Anguilla anguilla also occurred in the lake. The density of P. kervillei increased, in comparison with the previous year. The relative proportions of juvenile and adult fish also changed in the second year. A high percentage of young T. zillii was found during the first spring, decreasing in the summer and autumn. The proportion of juveniles of both G. affinnis and H. nana was very low during the first year, but increased during the second. These results indicate that the fish community of Lake Agmon had not stabilized by the end of 1996 and that further changes in relative abundances, and species, age and sex compositions should be expected.     

Recombinant human acetylcholinesterase is secreted from transiently transfected 293 cells as a soluble globular enzyme

1. Coding sequences for the human acetylcholinesterase (HuAChE; EC 3.1.1.7) hydrophilic subunit were subcloned in an expression plasmid vector under the control of cytomegalovirus IE gene enhancer-promoter. The human embryonic kidney cell line 293, transiently transfected with this vector, expressed catalytically active acetylcholinesterase. 2. The recombinant gene product exhibits biochemical traits similar to native "true" acetylcholinesterase as manifested by characteristic substrate inhibition, a Km of 117 microM toward acetylthiocholine, and a high sensitivity to the specific acetylcholinesterase inhibitor BW284C51. 3. The transiently transfected 293 cells (100 mm dish) produce in 24 hr active enzyme capable of hydrolyzing 1500 nmol acetylthiocholine per min. Eighty percent of the enzymatic activity appears in the cell growth medium as soluble acetylcholinesterase; most of the cell associated activity is confined to the cytosolic fraction requiring neither detergent nor high salt for its solubilization. 4. The active secreted recombinant enzyme appears in the monomeric, dimeric, and tetrameric globular hydrophilic molecular forms. 5. In conclusion, the catalytic subunit expressed from the hydrophilic AChE cDNA species has the inherent potential to be secreted in the soluble globular form and to generate polymorphism through self-association.     

Diurnal Cycles of Sulfate Reduction under Oxic Conditions in Cyanobacterial Mats

Diurnal cycles of sulfate reduction were examined in a well-developed cyanobacterial mat which grew in an outdoor experimental hypersaline pond system at a constant salinity of 75 ± 5% for 3 years. Vertical profiles of sulfate reduction were determined for the upper 12 mm of the microbial mat. Sulfate reduction activities were compared with diurnal variations of oxygen and sulfide concentrations measured by microelectrodes. Significant activity of sulfate-reducing bacteria was detected under aerobic conditions during the daytime, with maximal activity at 2 p.m. When comparing sulfate reduction activities in sediment cores taken at 6 a.m. and 12 a.m. and incubated at a constant temperature in the light and in the dark, a distinct stimulation of the activity in the vertical profile of sulfate reduction by light was evident. It is therefore concluded that the maximal in situ activities, measured at 2 p.m. in the chemocline of the cyanobacterial mat, cannot be attributed to diurnal changes of temperature alone. The response of sulfate-reducing bacteria to the addition of specific carbon sources was significantly different in the cyanobacterial layer, the anoxygenic phototrophic bacterial layer, and the permanently reduced layer of the microbial mat. Sulfate reduction in the mat layer exposed to high oxygen concentrations as a result of cyanobacterial oxygenic photosynthesis was enhanced only by glycolate; in the microzone where the chemocline is found during the daytime, ethanol was the only carbon source to enhance sulfate reduction, while both ethanol and lactate enhanced this activity in the permanently reduced zone.     

Enhanced Brain Cell Proliferation Following Early Adrenalectomy in Rats

We have previously demonstrated an increase in adult brain DNA content in rats adrenalectomized on postnatal day 11. The present studies examined cell proliferation in cerebral cortex, cerebellum, hippocampus, and midbrain-diencephalon following adrenalectomy at this age. Compared to sham-operated controls, adrenalectomized animals showed increased [3H]thymidine incorporation into DNA (measured at 1 h following a pulse injection) in all brain regions at 7 and 14 days postsurgery. In some areas, the effect was already present as early as 2 days following adrenalectomy. Chronic replacement with corticosterone prevented this increase in DNA labelling in a dose-dependent manner. When cell proliferation in the cerebral cortex and cerebellum was independently assessed by measuring changes in thymidine kinase activity, enzyme activity was significantly elevated in both areas at 7 and 14 days postsurgery. Finally, histological examination of the cerebellar cortex suggested a delayed disappearance of the external granular layer in several cerebellar lobules of adrenalectomized animals. Overall, these findings indicate that day-11 adrenalectomy leads to a prolonged stimulation of mitotic activity in areas where cell formation at this time is exclusively glial (i.e., cerebral cortex and mid-brain-diencephalon) as well as in areas where postnatal neurogenesis is also occurring (cerebellum and hippocampus). It is hypothesized that this stimulation results from the removal of a tonic inhibitory effect exerted by circulating glucocorticoids in the normal intact animal.