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sábado, 26 de março de 2011

Substância forma osso novo em pacientes com osteoporose

RIO - Um estudo internacional realIzado por meio de biópsia óssea em 268 indivíduos que sofrem de osteoporose, doença que fragiliza os ossos, especialmente depois da menopausa, mostrou que a substância ranelato de estrôncio não só diminui a reabsorção óssea, uma das causas de fraturas graves, mas estimula a formação de tecido ósseo. A notícia pode ajudar a melhorar o tratamento de dez milhões de brasileiros que vivem com o problema. A pesquisa "Construindo novas evidências em Osteoporose" foi realizada em 75 centros em 12 países, incluindo Europa, América do Norte, América do Sul e África do Sul, entre fevereiro de 2010 e de 2011.

No Brasil foram acompanhados 76 pacientes durante um ano, submetidos a biópsias em intervalos de seis meses e 12 meses. A pesquisa, divulgada na última quinta-feira no Congresso Europeu de Osteoporose e Osteoartrite, em Valencia, na Espanha, comparou os efeitos do uso de medicamentos do tipo bisfosfonatos, como o alendronato, receitados para reduzir a absorção óssea, e o ranelato. E este último ajudou a formar novo tecido ósseo.

- Este estudo demonstrou que o ranelato de estrôncio estimula a formação óssea, sendo opção importante no tratamento da osteoporose, dependendo da avaliação médica - diz Cristiano Zerbini, diretor do Centro Paulista de Investigação Clínica e Presidente da Sociedade Brasileira de Osteoporose, que participa do congresso em Valencia.

Existem duas células mais importantes na saúde do osso. Uma delas, o osteoblasto, é responsável por produzir osso novo (formação óssea). A outra, o osteoclasto, é responsável pela remoção do osso antigo (reabsorção óssea). As duas células trabalham em conjunto mantendo a integridade do esqueleto. Na osteoporose pode haver diminuição da formação óssea, aceleração da reabsorção ou ambos, explica Rosa Maria Rodrigues Pereira, coordenadora do estudo no Brasil, professora da USP e Presidente do Comitê de Osteoporose da Sociedade Brasileira de Reumatologia.

Os bisfosfonatos, tomando como exemplo o alendronato, são drogas que diminuem a reabsorção óssea, enquanto o ranelato de estrôncio tem ação dupla. Para avaliar os resultados da biópsia nos pacientes, os médicos usaram exames de densitometria e laboratoriais.

- Este é o maior estudo usando biópsia óssea para analisar o mecanismo de ação de um medicamento para tratar osteoporose. Os resultados iniciais mostram efeitos promissores do ranelato de estrôncio na formação óssea em comparação com o bisfosfonato -

Nova droga prolonga vida de pacientes com câncer de pele melanoma

RIO - A primeira droga indicada para prolongar a vida de pessoas com câncer de pele melanoma foi aprovada esta sexta-feira pelo FDA, órgão do governo americano responsável pela regulamentação de alimentos e drogas.

A droga, Yervoy, foi desenvolvida pelo Bristol-Myers Squibb, e é um novo tipo de medicamento contra o câncer que funciona por estimular o próprio sistema imunológico a combater o tumor.

- Esta é realmente a primeira vez no campo do mealona que existe uma droga que prolonga a sobrevivência de maneira significativa - comemora Gerald P. Linette, professor assistente de Medicina na Universidade de Washington, em St. Louis.

Em um estudo clínico randomizado, pacientes com melanoma metastático tratados com Yervoy viveram, em média, 10 meses, comparado com 6,4 meses dos pacientes de outro grupo, que receberam um tratamento que seria de baixo efeito.

Após dois anos, mais de 20% dos tratados com Yervoy estavam vivos, comparados com 13,7% do outro grupo.

O laboratório responsável pela droga divulgou que cobraria US$ 120 mil pelo tratamento completo, que consiste em quatro infusões no decorrer de três meses.

Foram registrados cerca de 68 mil novos casos de melanoma nos EUA no ano passado e 8.700 mortes, segundo a Sociedade Americana de Câncer. O número de casos tem crescido, provavelmente devido à exposição ao sol sem a proteção apropriada durante a juventude.

O melanoma, quando é detectado precocemente, como uma verruga na pele, pode ser removido cirurgicamente. Mas, uma vez que tem metástase ou disseminação, o tratamento torna-se muito difícil. Várias drogas falharam em testes clínicos. A última aprovada por a interleukin-2, em 1998. Ela, no entanto, é tão tóxica que raramente é usada.

Unexpected Action of Bisphenol A on the Inner Ear of Certain Vertebrates

ScienceDaily (Mar. 25, 2011) — Bisphenol A, whose impact on reproduction and development is the subject of numerous studies, induces anomalies in the inner ear of embryos of certain vertebrates. This new, completely unsuspected effect has been demonstrated on zebrafish and Xenopus, a type of frog, by a team headed by Vincent Laudet of the Institut de Génomique Fonctionnelle (CNRS/ENS de Lyon/Université Lyon 1) in collaboration with researchers from Inserm, the Muséum National d'Histoire Naturelle and INRA.
Close-up side view of a 4-day-old zebrafish embryo. The otic vesicle, the future inner ear of the fish, can be seen with a properly formed otolith, colored yellow, in the center.
Published in the journal BMC Developmental Biology, these results illustrate, for the first time, the sensitivity of the inner ear in vertebrates to bisphenol A. The study demonstrates that the effects of this chemical compound on the embryonic development of animals, including mammals, now needs to be explored in greater depth.

Bisphenol A (BPA) is a synthetic chemical compound widely used in the industrial manufacture of polycarbonate type plastic containers and other everyday items such as CDs, spectacles, certain plastic bottles and some baby bottles. It is also employed in epoxy resins used in the internal linings of tin and drink cans, and in dental amalgams. However, BPA can modify the hormonal balance of vertebrates by directly interacting with hormonal receptors or with the enzymes that ensure the metabolism of these hormones: it is an endocrine disruptor. In fact, BPA is capable of binding to estrogen receptors, female sexual hormones, and mimicking their action in the body. For this reason, it is now classified as a "category 3 reprotoxin," in other words, as a "substance which causes concern for human fertility" due to "possible" (albeit not conclusively demonstrated) "toxic effects" on reproduction.

Risk assessments have led to the definition of a tolerable daily intake (TDI) of 50 µg of BPA per kg body weight per day, i.e. 2.5 mg per day for a person who weighs 50 kg. Until now, most of the studies carried out to characterize and evaluate its effects on the human body have focused on the reproductive function and the development of the brain.

The researchers focused on the effect of this compound on embryonic development by exposing zebrafish (Danio rerio) eggs to increasing concentrations of BPA (from 1 mg/L to 20 mg/L). The results were surprising, to say the least: following exposure to BPA, most of the zebrafish embryos developed abnormalities of the otoliths, the small structures of the inner ear that control balance and play a role in hearing. Otolith aggregates formed in 60% of the embryos. Other, less frequent abnormalities of the inner ear were also observed. Above a concentration of 15 mg/L, all of the zebrafish developed abnormalities. However, this dose corresponds to a very acute exposure, much higher than the possible range of exposure levels in humans.

Going further, the scientists repeated their experiment on another vertebrate of the amphibian family, Xenopus. Once again, they observed the development of abnormalities in the inner ear, suggesting that this effect could exist in other vertebrates. The team has thus brought to light an unexpected and hitherto unobserved effect of BPA. Obviously, no conclusion can be reached for humans as long as the action mechanisms have not been completely elucidated and in-depth research has been carried out on mammals and on humans in particular.

In addition, the researchers observed that these anomalies persisted even when estrogen receptors -- the conventional targets of bisphenol A -- were blocked, implying that BPA could attach to another receptor. This newly discovered effect could therefore be completely independent of estrogen receptors.

This work clearly demonstrates that, apart from its reprotoxic effects, bisphenol A at quite high doses also has an effect on embryonic development. It also shows that this compound has more target sites than previously thought. Finally, it opens new research avenues to characterize the way in which bisphenol A functions, and to correctly evaluate its effects.

This work benefited in particular from support from ANR and the European Commission.

In Vivo Systems Biology: Using Computer Models, Systems Biologists Can Predict Complicated Behavior of Cells in Living Animals

ScienceDaily (Mar. 25, 2011) — Biological systems, including cells, tissues and organs, can function properly only when their parts are working in harmony. These systems are often dauntingly complex: Inside a single cell, thousands of proteins interact with each other to determine how the cell will develop and respond to its environment.

To understand this great complexity, a growing number of biologists and bioengineers are turning to computational models. This approach, known as systems biology, has been used successfully to model the behavior of cells grown in laboratory dishes. However, until now, no one has used it to model the behavior of cells inside a living animal.

In the March 22 online edition of the journal Science Signaling, researchers from MIT and Massachusetts General Hospital report that they have created a new computational model that describes how intestinal cells in mice respond to a natural chemical called tumor necrosis factor (TNF).

The work demonstrates that systems biology offers a way to get a handle on the complexity of living systems and raises the possibility that it could be used to model cancer and other complex diseases, says Douglas Lauffenburger, head of MIT's Department of Biological Engineering and a senior author of the paper.

"You're not likely to explain most diseases in terms of one genetic deficit or one molecular impairment," Lauffenburger says. "You need to understand how many molecular components, working in concert, give rise to how cells and tissues are formed -- either properly or improperly."

Biological complexity

Systems biology, a field that has grown dramatically in the past 10 years, focuses on analyzing how the components of a biological system interact to produce the behavior of that system -- for example, the many proteins that interact with each other inside a cell to respond to hormones or other external stimuli.

"The beauty of systems biology is that it doesn't ignore the biological complexity of what's going on," says Kevin Haigis, an assistant professor of pathology at MGH and Harvard Medical School and a senior author of the Science Signalingpaper.

"Biologists are trained to be reductionists," adds Haigis, who was a postdoctoral associate at MIT before moving to MGH. "I don't think people have failed to realize the complexity of how biology works, but people are accustomed to trying to reduce complexity to make things more understandable."

In contrast, the systems biology approach tries to capture that complexity through computer modeling of many variables. Inputs to the model might be the amounts of certain proteins found inside cells, and outputs would be the cells' resulting behaviors -- for example, growing, committing suicide or secreting hormones.

While at MIT, Haigis worked in the lab of Tyler Jacks, director of the David H. Koch Institute for Integrative Cancer Research at MIT, studying the role of the cancer-causing gene Ras in the mouse colon. He teamed up with Lauffenburger and others to computationally model Ras' behavior in cell culture.

After Haigis moved to MGH, he and Lauffenburger decided to bring this computational approach to studying living animals because they believed that studies done in cultured cells could miss some of the critical factors that come into play in living systems, such as the location of a cell within a living tissue and the influence of cells that surround it.

Inflammation

In the new paper, the researchers tackled the complex interactions that produce inflammation in the mouse intestine. The intestine contains many types of cells, but they focused on epithelial cells (which line the intestinal tube) and their response to TNF.

Previous work has shown that TNF plays a central role in intestinal inflammation, and provokes one of two possible responses in the intestinal epithelial cells: cell death or cell proliferation. Chronic inflammation can lead to inflammatory bowel disease and potentially cancer.

In this study, the researchers got the data they needed to develop their computational model by treating normal mice with TNF, then determining whether the cells proliferated or died. They found that cell fate depended on the cells' location in the intestine -- cells in the ileum proliferated, while those in the duodenum died.

The multi-faceted result would likely not have been seen in a lab dish. "In cell culture, you would have gotten one or the other," Lauffenburger says.

They also correlated the diverse outcomes with the activities of more than a dozen proteins found in the cells, allowing them to determine how the outcomes depended on quantitative combination of key signaling pathways, and furthermore, to predict how the outcomes would be affected by drug treatment. The researchers then tested the model's predictions in an additional cohort of mice, and found that they were accurate.

Modeling disease

Jason Papin, assistant professor of biomedical engineering at the University of Virginia, says that the team's biggest accomplishment is demonstrating that systems biology modeling can be done in living animals (in vivo). "You always want to move to an in vivo setting, if possible, but it's technically more difficult," says Papin, who was not involved with this research.

The researchers are now trying to figure out in more detail what factors in the intestinal cells' environment influence the cells to behave the way they do. They are also studying how genetic mutations might alter the cells' responses.

They also plan to begin a study of neurological diseases such as Alzheimer's disease. Cancer is another disease that lends itself to this kind of modeling, says Jacks, who was not part of this study. Cancer is an extremely complicated disease that usually involves derangement of many cell signaling pathways involved in cell division, DNA repair and stress response.

"We expect that our ability to predict which targets, which drugs and which patients to bring together in the context of cancer treatment will require a deeper understanding of the complex signaling pathways that exist in cancer," says Jacks. "This approach will help us get there."