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PubMedDate not supplied

[Analysis and protocolization of rasburicase use in patients with hematologic neoplasms].

OBJECTIVE: To describe the use of rasburicase in adult patients with hematological neoplasias and to present a protocol for its administration jointly prepared by the hematology and the pharmacy departments based on the scientific evidence available. METHOD: Retrospective study that reviews treatments with rasburicase administered in a tertiary 800-bed hospital from July 2002 to May 2004 to adult patients with hematological neoplasias. The following data were collected: demographic and clinical data, daily dose of rasburicase and length of treatment, plasma levels of creatinine, potassium, phosphate, calcium, LDH, uric acid and white blood cell count daily and until 48 hours after administering the last dose of rasburicase. RESULTS: Rasburicase was administered to a total of 18 adult patients (mean age of 57 years; range 27-84; 11 men and 7 women). Prior to treatment, 16 patient had high levels of LDH, 12 patients had a blood count over 50,000 white blood cells/mm3, and 11 had serum levels of uric acid above 7 mg/dl. The dose of rasburicase administered was 0.2 mg/kg/day and the median length of treatment was 5 days (range 1-10). The levels of uric acid returned to normal values in all patients. Furthermore, an statistically significant decrease of creatinine levels was observed. The other biochemical parameters studied were duly controlled throughout the treatment. CONCLUSIONS: A high variability is observed in the use of rasburicase in our patients. The hematology and pharmacy services have been working jointly to prepare a consensus-based protocol according to which, depending on the patient s risk of developing TLS (tumoral lysis syndrome), standard prophylaxis is administered to low-risk patients (intravenous hydration, alopurinol and urine alcalinization) and rasburicase is administered initially for 1-3 days to patients with high risk of developing TLS.

Adult↗
PubMedDate not supplied

Immunological properties of uricase conjugated to neutral soluble polymers.

For a comparative study of immunological properties of protein-polymer conjugates, uricase was modified with (a) poly(N-vinylpyrrolidone) 6000 Da, (b) poly(N-acriloylmorpholine) 6000 Da, (c) branched monomethoxypoly(ethylene glycol) 10000 Da, and (d) linear monomethoxypoly(ethylene glycol) 5000 Da. Spectroscopic studies performed by UV, fluorescence, and circular dichroism did not show any relevant difference in protein conformation among the native and the conjugates. Immunological studies showed that both uricase antigenicity and immunogenicity were altered by polymer conjugation to an extent that depended upon the polymer composition; in particular, monomethoxypoly(ethylene glycol) 10000 Da remarkably reduced the protein antigenicity, while unexpectedly, the poly(N-vinylpyrrolidone) derivative presented higher antigenicity than the native protein. In Balb/c mice, the native protein elicited a rapid and intense immunoresponse whereas all the conjugates induced a lower production of anti-native uricase antibodies. The rank order of immunogenicity was native uricase > uricase-poly(N-vinylpyrrolidone) > or = uricase-poly(N-acriloylmorpholine) > uricase-monomethoxypoly(ethylene glycol) 5000 Da > uricase-monomethoxypoly(ethylene glycol) 10000 Da. The four conjugates also induced anti polymer immunoresponse. Anti poly(N-vinylpyrrolidone) and anti poly(N-acriloylmorpholine) antibodies were generated from the first immunization while low levels of anti polymer antibodies were found with both poly(ethylene glycol) conjugates only after the second immunization.

Acrylic Resins↗
PubMedDate not supplied

Biopharmaceutical properties of uricase conjugated to neutral and amphiphilic polymers.

A comparative pharmacokinetic and biodistribution investigation of polymer-protein conjugates prepared with various amphiphilic polymers was carried out using uricase as a model. Four polymer-uricase derivatives have been obtained by covalent binding of a similar number of polymer chains of (a) linear poly(ethylene glycol) (Mw 5000 Da); (b) branched poly(ethylene glycol) (Mw 10 000 Da); (c) poly(N-vinylpyrrolidone) (Mw 6000 Da); (d) poly(N-acryloilmorpholine) (Mw 6000 Da). By intravenous administration to Balb/c mice, the conjugates displayed different pharmacokinetic and organ distribution behaviors. (1) The unmodified enzyme and the poly(N-vinylpyrrolidone) conjugate were the enzyme forms with the shortest and the longest permanence in blood respectively (mean residence time 45 and 4378 min). (2) Native uricase was found to localize soon after administration significantly in heart, lungs, and liver from where it was also rapidly cleared. (3) The poly(N-acryloilmorpholine) derivative showed the highest concentration levels in liver (up to 25.5% of the dose) and considerable accumulation took also place in the other considered organs. (4) Poly(N-vinylpyrrolidone)-uricase displayed a relevant tropism for liver but low uptake indexes were found for the other organs. (5) The branched poly(ethylene glycol) derivative accumulated preferentially in liver and spleen. (6) The linear poly(ethylene glycol) conjugate was, among the various uricase forms, the species with the lowest distribution levels in all the examined organs. (7) Finally, all the enzyme forms slowly disposed in kidneys with higher levels for the poly(N-acryloilmorpholine) derivative (15% after 2880 min) and unmodified uricase (14% after 1440 min).

Algorithms↗
PubMed1999

Xanthine degradation and related enzyme activities in leaves and fruits of two coffea species differing in caffeine catabolism.

The degradation of xanthine was studied in young and aged leaves and in immature and mature fruits of Coffea arabica and Coffea dewevrei, which differ with respect to caffeine catabolism. Radioisotope feeding experiments showed that leaves degraded xanthine more readily than fruits but that mature fruits and aged leaves were less efficient than younger tissues. In all cases, a significant part of the recovered radioactivity was in the ureides. Xanthine dehydrogenase was characterized as the enzyme responsible for xanthine degradation, and its activity and that of uricase were consistent with the results obtained in the radioisotope feeding experiments. Activities of allantoinase and allantoate amidohydrolase could not be detected. Considerable levels of endogenous allantoin and allantoic acid were found in fruits and leaves. Therefore, ureide accumulation might be a consequence of low enzyme activity. There was no positive correlation between urease activity and the data from the radioisotope feeding experiments.

Caffeine↗
PubMed2004

Volatiles production and attractiveness to the Mexican fruit fly of Enterobacter agglomerans isolated from apple maggot and Mexican fruit flies.

We investigated two strains of uricase (+) Enterobacter agglomerans, one isolated from the apple maggot fly (AMF) and one from the Mexican fruit fly (MFF), for 1) attractiveness to MFF, and 2) production of attractive chemicals. Regarding chemicals demonstrated attractive to the MFF, the MFF bacterial strain produced more 2,5-dimethylpyrazine, 2-phenylethanol, and indole than the AMF strain, whereas the AMF, but not the MFF strain, produced 3-hydroxybutanone. Cell types that predominated in plated subcultures varied from batch to batch resulting in variation in volatiles production, especially by the AMF strain where indole was sometimes a major component of the odor and at other times not detectable. Despite the greater production of attractive chemicals by the MFF strain, the AMF strain was consistently more attractive and the MFF strain was not different from uninoculated control plates. Statistical analyses indicated negative correlations of attractiveness with production of indole, 2,5-dimethylpyrazine, and 2-phenylethanol, and positive correlation with 3-hydroxybutanone. Results support previous findings with the Mexican fruit fly that showed combinations of attractive chemicals sometimes are not attractive.

Animals↗
PubMed2004

[Physiology and biochemistry of uric acid].

In humans, uric acid is the final breakdown product of unwanted purine nucleotides. Uric acid is the last stage in purine degradation, because humans lack the enzyme uricase which converts uric acid into allantoin. Uric acid has profound beneficial effects since it scavenges potential harmful radicals in our body. However, in conjunction with genetic or environmental factors, uric acid can cause significant health problems, leading to kidney stones when it builds up in the kidneys and to gout when crystals accumulate in the joints. The levels of uric acid in the blood must be tightly controlled to minimize these detrimental effects. Normally, the body eliminates enough uric acid in the kidney, and in part also through the intestines, to keep its concentration at a healthy level in the blood (approximately 300 microM). In patients with gout or kidney stone disease, however, the body either produces excessive amounts of uric acid or its ability to eliminate uric acid is disturbed in some way. In the kidney, uric acid is reabsorbed via the uric acid transporter URAT1. This transporter is the major mechanism for regulating blood uric acid levels and therefore may prove an interesting target for future drug development.

Animals↗
PubMed2004

[Rasburicase (Fasturtec)].

Rasburicase (Fasturtec) is an enzyme that transforms uric acid to the more water soluble allantoin to be excreted by the kidneys. Rasburicase fulfills an unmet clinical need in the treatment of hyperuricemia in that it produces a more rapid action of controlling serum uric acid compared with allopurinol. Tumours with high proliferative rate and sensitive to chemotherapy such as hematological malignancies (mainly) solid tumours (occasionally) may lead to a tumor lysis syndrome. In this situation rasburicase can effectively lower serum uric acid concentrations with a secondary improvement in renal function. Hyperuricemia is the hallmark of severe gout with tophi formation. Rasburicase represents an interesting new option in controlling serum uric acid in patients with severe tophaceous gout.

Crystallization↗