Pharmacological management of dementia with Lewy bodies with a focus on zonisamide for treating parkinsonism
EXPERT OPINION ON PHARMACOTHERAPY
Authors: Panza, Francesco; Lozupone, Madia; Watling, Mark; Imbimbo, Bruno P.
Introduction Dementia with Lewy bodies (DLB) has no approved symptomatic or disease-modifying treatments in the US and Europe, despite being the second most common cause of neurodegenerative dementia. Areas covered Herein, the authors briefly review the DLB drug development pipeline, providing a summary of the current pharmacological intervention studies. They then focus on the anticonvulsant zonisamide, a benzisoxazole derivative with a sulfonamide group and look at its value for treating parkinsonism in DLB. Expert opinion Several new compounds are being tested in DLB, the most innovative being those aimed at decreasing brain accumulation of alpha-synuclein. Unfortunately, new drug testing is challenging in terms of consistent diagnostic criteria and lack of reliable biomarkers. Few randomized controlled trials (RCTs) are well-designed, with enough power to detect significant drug effects. Levodopa monotherapy can treat the parkinsonism in DLB, but it can cause agitation or visual hallucination worsening. Two Phase II/III RCTs of DLB patients recently reported a statistically significant improvement in motor function in those receiving zonisamide as an adjunctive treatment to levodopa. New biomarker strategies and validated outcome measures for DLB or prodromal DLB may enhance clinical trial design for the development of specific disease-modifying treatments.
Antibiotic resistance genes and bacterial community on the surfaces of five cultivars of fresh tomatoes
Authors: Sun, Yanmei; Guo, Guang; Tian, Fang; Chen, Huihai; Liu, Weijie; Li, Meng; Wang, Shiwei
Antibiotic resistance genes and bacteria (ARGs and ARB) in vegetable or fruit pose risks to ecological environment health. However, the assessment of ARGs and ARB from one popular vegetable, fresh tomato, has not been carried out before. In this study, high-throughput quantitative PCR and 16S rRNA gene Illumina sequencing technology were used to explore the antibiotic resistance characteristics of bacteria on five common cultivars of fresh tomatoes from supermarket. A total of 191 ARGs and 10 mobile genetic elements (MGEs) were detected on the tomato surfaces. The distribution profile of ARGs and MGEs was different among samples, with the organic tomatoes showing more ARGs and MGEs number and relative abundance. Aminoglycoside resistance genes strA and strB, sulfonamide resistance gene sul1, and multidrug resistance gene qac Delta 1-01 were the predominant ARGs. Dominant MGEs were transposase genes, which might promote horizontal gene transfer (HGT) of ARGs. Network analysis indicated that fifteen bacterial families might be the potential hosts of ARGs, and the detected MGEs might have positive correlation with ARGs. These results revealed the bacterial ARGs and MGEs from fresh tomato, which might help guide human to pay more attention to ecological environment impacts of ARGs and ARB on the surfaces of vegetable or fruit.