PDE4 Inhibitor Research Articles

STIM/Orai Inhibition as a Strategy for Alleviating Diabetic Erectile Dysfunction Through Modulation of Rat and Human Penile Tissue Contractility and in vivo Potentiation of Erectile Responses

Stromal interaction molecule (STIM)/Orai calcium entry system appears to have a role in erectile dysfunction (ED) pathophysiology but its specific contribution to diabetic ED was not elucidated. To evaluate STIM/Orai inhibition on functional alterations associated with diabetic ED in rat and human penile tissues and on in vivo erectile responses in diabetic rats. Rat corpus cavernosum (RCC) strips from nondiabetic (No DM) and streptozotocin-induced diabetic (DM) rats and human penile resistance arteries (HPRA) and corpus cavernosum (HCC) from ED patients undergoing penile prosthesis insertion were functionally evaluated in organ chambers and wire myographs. Erectile function in vivo in rats was assessed by intracavernosal pressure (ICP) responses to cavernous nerve electrical stimulation (CNES). Expression of STIM/Orai elements in HCC was determined by immunofluorescence and immunoblot. Functional responses in RCC, HCC and HPRA and STIM/Orai protein expression in HCC. In vivo erectile responses to CNES. Inhibition of Orai channels with YM-58483 (20 µM) significantly reduced adrenergic contractions in RCC but more effectively in DM. Thromboxane-induced and neurogenic contractions were reduced by STIM/Orai inhibition while defective endothelial, neurogenic and PDE5 inhibitor-induced relaxations were enhanced by YM-58483 (10 µM) in RCC from DM rats. In vivo, YM-58483 caused erections and attenuated diabetes-related impairment of erectile responses. YM-58483 potentiated the effects of PDE5 inhibition. In human tissues, STIM/Orai inhibition depressed adrenergic and thromboxane-induced contractions in ED patients more effectively in those with type 2 diabetes. Diabetes was associated with increased expression of Orai1 and Orai3 in ED patients. Targeting STIM/Orai to alleviate diabetes-related functional alterations of penile vascular tissue could improve erectile function and potentiate therapeutic effects of PDE5 inhibitors in diabetic ED. Improving effects of STIM/Orai inhibition on diabetes-related functional impairment was evidenced in vitro and in vivo in an animal model and validated in human tissues from ED patients. Functional findings were complemented with expression results. Main limitation was low numbers of human experiments due to limited human tissue availability. STIM/Orai inhibition alleviated alterations of functional responses in vitro and improved erectile responses in vivo in diabetic rats, potentiating the effects of PDE5 inhibition. STIM/Orai inhibition was validated as a target to modulate functional alterations of human penile vascular tissue in diabetic ED where Orai1 and Orai3 channels were upregulated. STIM/Orai inhibition could be a potential therapeutic strategy to overcome poor response to conventional ED therapy in diabetic patients. Sevilleja-Ortiz A, El Assar M, García-Gómez B, et al. STIM/Orai Inhibition as a Strategy for Alleviating Diabetic Erectile Dysfunction Through Modulation of Rat and Human Penile Tissue Contractility and in vivo Potentiation of Erectile Responses. J Sex Med 2022;19:1733-1749.

Apremilast-induced increases in acute ethanol intoxication and decreases in ethanol drinking in mice involve PKA phosphorylation of GABAA β3 subunits

We previously showed that apremilast, an FDA-approved PDE4 inhibitor, selectively alters behavioral responses to ethanol and certain GABAergic drugs in a PKA-dependent manner in C57BL6/J mice. Here, we investigated if PKA phosphorylation of β3 GABAA receptor subunits is involved in apremilast regulation of ethanol, propofol, or diazepam responses. Apremilast prolonged rotarod ataxia and loss of the righting reflex by ethanol and propofol in wild-type mice, but not in β3-S408A/S409A knock-in mice. In contrast, apremilast hastened recovery from the ataxic and sedative effects of diazepam in both genotypes. These findings suggest that apremilast modulation of ethanol and propofol behaviors in wild-type mice is mediated by β3 subunit phosphorylation, whereas its actions on diazepam responses involve a different mechanism. The PKA inhibitor H-89 prevented apremilast modulation of ethanol-induced ataxia. Apremilast sensitized wild-type males to ethanol-induced ataxia and decreased acute functional tolerance (AFT) in females but had no effect in β3-S408A/S409A mice of either sex. These results could not be attributed to genotype differences in blood ethanol clearance. There were also no baseline genotype differences in ethanol consumption and preference in two different voluntary drinking procedures. However, the ability of apremilast to reduce ethanol consumption was diminished in β3-S408A/S409A mice. Our results provide strong evidence that PKA-dependent phosphorylation of β3 GABAA receptor subunits is an important mechanism by which apremilast increases acute sensitivity to alcohol, decreases AFT, and decreases ethanol drinking.

Design and Synthesis of PDE2A Inhibitors for the Treatment of Parkinson's Disease

AbstractGrowing evidence confirms the potential of PDE inhibitors including PDE 1, 2, 4, 7 and 10 inhibitors for the treatment of Parkinson's disease, a public health problem. There is a great need to find a way to prevent and delay the disease. Therefore, a series of novel quinolinone derivatives were synthesized and investigated for their ability to inhibit PDE2A. Most of the synthesized compounds have shown good activity against PDE2A. Among these analogues, compound 5 i exhibited most potent PDE2A inhibition with IC50 values about 0.049 μM. This compound also showed good selectivity over other PDEs. Docking simulation was performed to insert compound 5 i into the crystal structure of PDE2A at the active site to determine the binding mode. More importantly, compound 5 i exhibited excellent reversal of MPTP‐induced PD model and low acute toxicity in vivo. Based on these results, compound 5 i was evaluated as a promising candidate for the treatment of Parkinson's disease.

Investigation of atropisomeric transformation of a novel PDE4 inhibitor with tetrahydroisoquinoline-based amide group and its primary study of binding to HSA

In this study a kinetic and thermodynamic atropisomeric transformation due to a hindered rotation around the tetrahydroisoquinoline-based amide group was investigated. Quantum chemistry calculations were applied to investigate the transformation under the gas phase and several solvents with different polarity, and then evaluated by dynamic HPLC determination. It was found that the transformation rate of constants and the half-life time varied under the influence of solvent polarity and temperature and the energies of rotational barrier were determined ranging between 87 and 92 kJ∙mol−1. A primary binding study with HSA confirmed a rapid interconversion under the simulated physiological conditions. It is therefore suggested to take this atropisomeric compound as a racemic mixture for its future drug development.

The Complexity and Multiplicity of the Specific cAMP Phosphodiesterase Family: PDE4, Open New Adapted Therapeutic Approaches.

Cyclic nucleotides (cAMP, cGMP) play a major role in normal and pathologic signaling. Beyond receptors, cyclic nucleotide phosphodiesterases; (PDEs) rapidly convert the cyclic nucleotide in its respective 5′-nucleotide to control intracellular cAMP and/or cGMP levels to maintain a normal physiological state. However, in many pathologies, dysregulations of various PDEs (PDE1-PDE11) contribute mainly to organs and tissue failures related to uncontrolled phosphorylation cascade. Among these, PDE4 represents the greatest family, since it is constituted by 4 genes with multiple variants differently distributed at tissue, cellular and subcellular levels, allowing different fine-tuned regulations. Since the 1980s, pharmaceutical companies have developed PDE4 inhibitors (PDE4-I) to overcome cardiovascular diseases. Since, they have encountered many undesired problems, (emesis), they focused their research on other PDEs. Today, increases in the knowledge of complex PDE4 regulations in various tissues and pathologies, and the evolution in drug design, resulted in a renewal of PDE4-I development. The present review describes the recent PDE4-I development targeting cardiovascular diseases, obesity, diabetes, ulcerative colitis, and Crohn’s disease, malignancies, fatty liver disease, osteoporosis, depression, as well as COVID-19. Today, the direct therapeutic approach of PDE4 is extended by developing allosteric inhibitors and protein/protein interactions allowing to act on the PDE interactome.

Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature.

BackgroundCutaneous lupus erythematosus (CLE) and dermatomyositis (DM) are autoimmune diseases that present with a wide variety of cutaneous manifestations. In both cases, first-line therapy includes topical corticosteroids. Patients may present with more widespread disease requiring systemic treatments, including corticosteroids, traditional immunosuppressants, or antimalarials. Due to their complex nature, both CLE and DM remain difficult to treat and continue to cause significant distress to patients.ObjectiveTo summarize the most recent literature on the safety and efficacy of novel treatment modalities for CLE and DM.MethodsA literature search was conducted on PubMed using search terms “(dermatomyositis) AND (treatment)” and “(cutaneous lupus) AND (treatment)”. Additional search terms included specific names of biologic agents, phosphodiesterase inhibitors (apremilast), and JAK inhibitors.ResultsJAK inhibitors, PDE-4 inhibitors, and biologics have shown promise in reducing cutaneous symptoms of both CLE and DM, including reduction in SLE Disease Activity Index 2000 (SLEDAI-2K), Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), British Isles Lupus Assessment Group (BILAG), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), and Disease Activity Score (DAS).ConclusionWhile there have been recent advancements in the treatment for CLE and DM, further research and clinical trials are required to better elucidate which therapy is best for individual patients.

Cyclic nucleotide phosphodiesterases as therapeutic targets in cardiac hypertrophy and heart failure.

Cyclic nucleotide phosphodiesterases (PDEs) modulate the neurohormonal regulation of cardiac function by degrading cAMP and cGMP. In cardiomyocytes, multiple PDE isozymes with different enzymatic properties and subcellular localization regulate local pools of cyclic nucleotides and specific functions. This organization is heavily perturbed during cardiac hypertrophy and heart failure (HF), which can contribute to disease progression. Clinically, PDE inhibition has been considered a promising approach to compensate for the catecholamine desensitization that accompanies HF. Although PDE3 inhibitors, such as milrinone or enoximone, have been used clinically to improve systolic function and alleviate the symptoms of acute HF, their chronic use has proved to be detrimental. Other PDEs, such as PDE1, PDE2, PDE4, PDE5, PDE9 and PDE10, have emerged as new potential targets to treat HF, each having a unique role in local cyclic nucleotide signalling pathways. In this Review, we describe cAMP and cGMP signalling in cardiomyocytes and present the various PDE families expressed in the heart as well as their modifications in pathological cardiac hypertrophy and HF. We also appraise the evidence from preclinical models as well as clinical data pointing to the use of inhibitors or activators of specific PDEs that could have therapeutic potential in HF.

Influence of heat processing on the anti-inflammatory activity of fresh Smilax glabra based on PDE4 inhibition.

Smilax glabra Roxb. (SG) is widely used as functional food with various beneficial effects. Fresh SG without processing has been eaten directly for anti-inflammation from ancient China, while the underlying mechanism remains underexplored. This study aims to investigate the anti-inflammatory activity of fresh SG by using metabolites profiles, affinity ultrafiltration mass spectrometry, PDE4 enzyme inhibition assay, and in silico analysis. Encouragingly, fresh SG showed promising anti-inflammatory effect with IC50 value (0.009μg/μL) on PDE4 was about 12 times higher than that of processed SG (0.110μg/μL). Astilbin was identified as the main bioactive compound of fresh SG responsible for PDE4 inhibitory activity. We found that heat processing strongly affected astilbin isomerization, leading to significant changes in contents and PDE4 inhibitory activities of four astilbin isomers, resulting in decreased anti-inflammatory activity of fresh SG. This finding will provide theoretical basis for systematic research and food/nutraceutical applications of fresh Smilax glabra in the future.

Discovery of novel PDE4 inhibitors targeting the M-pocket from natural mangostanin with improved safety for the treatment of Inflammatory Bowel Diseases

Inflammatory Bowel Diseases (IBDs) are chronic disorders with iterative intestinal mucosal inflammation which remain unmet medical needs. PDE4 inhibitors were reported to be novel anti-IBD agents, but their clinical use was hampered by side effects such as emesis and nausea. Herein, structure-based discovery of natural mangostanin (1) targeting the M-pocket resulted in the novel and potent PDE4 inhibitor 22d (IC50 = 3.5 nM) and favorable physico-chemical properties. X-Ray study revealed that 22d interacted tightly with the M-pocket and maintained the key interactions between PDE4 and roflumilast. Worthy to note that compounds 22d and our previously reported 4e and 18a, originating from mangostanin, all caused no emesis on beagle dogs at the oral dose of 10 mg/kg, confirming the safety superiority of scaffold in mangostanin derivatives over that in positive roflumilast. Finally, administration of 22d (5.0 mg/kg, twice-daily) exhibited comparable anti-IBD effects to the positive control dipyridamole (25.0 mg/kg, twice-daily) in the dextran sulfate sodium (DSS)-induced IBD mice model, indicating its potential as a novel anti-IBD agent.

Abstract P1076: Phosphodiesterase 1 (pde1) Modulates CAMP Signaling At The Sarcolemmal Membrane

Phosphodiesterases (PDEs) regulate cyclic nucleotide-mediated cell signaling and offer a therapeutic means to leverage cardiac function. FDA-approved PDE3 inhibitors increase myocyte contractility by enhancing L-type calcium channel activity and sarcoplasmic reticulum (SR) calcium (Ca 2+ ) load, but cause fatal arrhythmias in patients with heart failure. The PDE1 inhibitor ITI-214 is a novel inotrope that increases cardiac contractility in animal models and human patients with heart failure. Mechanistically, PDE1 inhibition leads to activation of the L-type Ca 2+ channel without altering the SR Ca 2+ load or myofilament-Ca 2+ sensitivity. The net result is enhanced myocyte contractility with comparatively less Ca 2+ increase and arrhythmias. PDE inhibition increases cAMP levels to activate protein kinase A (PKA), a pathway that regulates Ca 2+ handling and cycling. These results led us to hypothesize that PDEs 1 and 3 differ in localized domains where each controls cAMP-mediated signaling. Live-cell imaging experiments were performed in acutely isolated guinea pig myocytes expressing Förster resonance energy transfer (FRET) sensors to monitor changes in cAMP levels. These sensors were targeted to specific sarcolemmal domains or more generally to the cytosol. Our results showed that PDE1 inhibition is the predominant regulator of cAMP at the non T-tubular sarcolemmal membrane compared to other cAMP-hydrolyzing PDEs (PDE3 and 4). In contrast to PDE1, PDEs 3 and 4 were more indiscriminate and modulated cAMP in the cytosolic as well as in membrane domains. Upon beta-adrenergic stimulation, however, PDE4 but not PDEs 1 or 3 became the predominant cAMP modulator at the T-tubular membrane domain. These results provide evidence that PDE1 is a major regulator of sarcolemmal membrane cAMP, suggesting that PDE1 inhibitory effects upon the L-type Ca 2+ channel is localized to this domain. In future studies, we will examine if PDE1 inhibition selectively activates PKA in this region, and seek to identify the interacting proteins that support PDE1 modulation of sarcolemmal cAMP/PKA signaling. Resolving this cell signaling difference would provide mechanistic insight into a novel inotrope that has already completed a Phase II clinical evaluation in patients.

Rolipram and pentoxifylline combination ameliorates experimental diabetic neuropathy through inhibition of oxidative stress and inflammatory pathways in the dorsal root ganglion neurons.

Diabetic neuropathy (DN) is the most challenging microvascular complication of diabetes and there is no suitable treatment for it, so the development of new agents to relieve DN is urgently needed. Since oxidative stress and inflammation play an essential role in the development of DN, clearance of these factors are good strategies for the treatment of this disease. According to key role of cyclic adenosine monophosphate (cAMP) in the regulation of oxidative stress and inflammatory pathways, it seems that phosphodiesterase inhibitors (PDEIs) can be as novel drug targets for improving DN through enhancement of cAMP level. The aim of this study was to evaluate the effects of rolipram, a selective PDE4 inhibitor, and pentoxifylline, a general PDE inhibitor on experimental model of DN and also to determine the possible mechanisms involved in the effectiveness of these agents. We investigated the effects of rolipram (1mg/kg) and pentoxifylline (100mg/kg) and also combination of rolipram (0.5mg/kg) and pentoxifylline (50mg/kg), orally for five weeks in rats that became diabetic by STZ (55mg/kg, i.p.). After treatments, motor function was evaluated by open-field test, then rats were anesthetized and dorsal root ganglion (DRG) neurons isolated. Next, oxidative stress biomarkers and inflammatory factors were assessed by biochemical and ELISA methods, and RT-PCR analysis in DRG neurons. Rolipram and/or pentoxifylline treatment significantly attenuated DN - induced motor function deficiency by modulating distance moved and velocity. Rolipram and/or pentoxifylline treatment dramatically increased the cAMP level, as well as suppressed DN - induced oxidative stress which was associated with decrease in LPO and ROS and increase in TAC, total thiol, CAT and SOD in DRG neurons. On the other hand, the level of inflammatory factors (TNF-α, NF-kB and COX2) significantly decreased following rolipram and/or pentoxifylline administration. The maximum effectiveness was with rolipram and/or pentoxifylline combination on mentioned factors. These findings provide novel experimental evidence for further clinical investigations on rolipram and pentoxifylline combination for the treatment of DN.

Cyclic adenosine monophosphate/phosphodiesterase 4 pathway associated with immune infiltration and PD-L1 expression in lung adenocarcinoma cells.

BackgroundThe cyclic adenosine monophosphate/phosphodiesterase 4 (cAMP/PDE4) pathway is involved in inflammation and immune regulation; however, the effect of cAMP/PDE4 on immune infiltration and immune evasion in lung adenocarcinoma (LUAD) remains unclear.MethodsCBioPortal, which is the The Cancer Genome Atlas (TCGA) online database, and the Kaplan Meier plotter were used to analyze the association between genes and the prognosis of TCGA-LUAD. Tumor Immune Estimation Resource (TIMER) was used to analyze the association between gene expression and immune infiltration. The Genecards database was used to identify the transcription factors of related genes. The lung adenocarcinoma cell line H1299 and A549 were treated with cAMP pathway drugs. Flow cytometry and qRT-PCR were used to detect the PD-L1 protein and gene expression, respectively. A one-way analysis of variance with Tukey’s post-hoc test or a Student’s t-test were used.ResultsIt was found that PDE4B and CREB1, which are downstream genes of the cAMP/PDE4 axis, were differentially expressed in LUAD and adjacent tissues and are correlated with the prognosis and immune infiltration of LUAD. In the CBioPortal database, cAMP pathway genes are closely related to programmed cell death-ligand 1 (PD-L1) expression in TCGA-LUAD. The protein-protein interaction revealed that there was a direct interaction between CREB1/CREBBP, which are the downstream molecules of the cAMP/PDE4 axis, and MYC; additionally, MYC was predicted to bind to the PD-L1 transcription site and regulate PD-L1 expression. CREB1 was also predicted to transcriptionally bind to both MYC and PD-L1. These results predicted the interaction network of cAMP/PDE4/CREB1/CREBP/MYC/PD-L1, and the core factor may be related to MYC. In the cell experiment, forskolin (an adenylate cyclase activator) and zardaverine (a PDE4 inhibitor) enhance the cAMP pathway and decrease PD-L1 expression, while SQ2253 (an adenylate cyclase inhibitor) inhibits the cAMP pathway and increases PD-L1 expression of the LUAD cell lines H1299 and A549, and MYC regulation by these drugs was positively correlated with PD-L1 regulation, which verified the regulation of the cAMP/PDE4 pathway on MYC and PD-L1.ConclusionsThis study showed that the cAMP/PDE4 pathway may play an important role in PD-L1 regulation and immune infiltration in LUAD.

Phosphodiesterase 4D contributes to angiotensin II-induced abdominal aortic aneurysm through smooth muscle cell apoptosis

Abdominal aortic aneurysm (AAA) is a permanent expansion of the abdominal aorta that has a high mortality but limited treatment options. Phosphodiesterase (PDE) 4 family members are cAMP-specific hydrolyzing enzymes and have four isoforms (PDE4A-PDE4D). Several pan-PDE4 inhibitors are used clinically. However, the regulation and function of PDE4 in AAA remain largely unknown. Herein, we showed that PDE4D expression is upregulated in human and angiotensin II-induced mouse AAA tissues using RT-PCR, western blotting, and immunohistochemical staining. Furthermore, smooth muscle cell (SMC)-specific Pde4d knockout mice showed significantly reduced vascular destabilization and AAA development in an experimental AAA model. The PDE4 inhibitor rolipram also suppressed vascular pathogenesis and AAA formation in mice. In addition, PDE4D deficiency inhibited caspase 3 cleavage and SMC apoptosis in vivo and in vitro, as shown by bulk RNA-seq, western blotting, flow cytometry and TUNEL staining. Mechanistic studies revealed that PDE4D promotes apoptosis by suppressing the activation of cAMP-activated protein kinase A (PKA) instead of the exchange protein directly activated by cAMP (Epac). Additionally, the phosphorylation of BCL2-antagonist of cell death (Bad) was reversed by PDE4D siRNA in vitro, which indicates that PDE4D regulates SMC apoptosis via the cAMP-PKA-pBad axis. Overall, these findings indicate that PDE4D upregulation in SMCs plays a causative role in AAA development and suggest that pharmacological inhibition of PDE4 may represent a potential therapeutic strategy.

Optogenetic manipulation of cyclic guanosine monophosphate to probe phosphodiesterase activities in megakaryocytes.

Cyclic guanosine monophosphate (cGMP) signalling plays a fundamental role in many cell types, including platelets. cGMP has been implicated in platelet formation, but mechanistic detail about its spatio-temporal regulation in megakaryocytes (MKs) is lacking. Optogenetics is a technique which allows spatio-temporal manipulation of molecular events in living cells or organisms. We took advantage of this method and expressed a photo-activated guanylyl cyclase, Blastocladiella emersonii Cyclase opsin (BeCyclop), after viral-mediated gene transfer in bone marrow (BM)-derived MKs to precisely light-modulate cGMP levels. BeCyclop-MKs showed a significantly increased cGMP concentration after illumination, which was strongly dependent on phosphodiesterase (PDE) 5 activity. This finding was corroborated by real-time imaging of cGMP signals which revealed that pharmacological PDE5 inhibition also potentiated nitric oxide-triggered cGMP generation in BM MKs. In summary, we established for the first-time optogenetics in primary MKs and show that PDE5 is the predominant PDE regulating cGMP levels in MKs. These findings also demonstrate that optogenetics allows for the precise manipulation of MK biology.

576 Difamilast, a new topical PDE4 inhibitor, ameliorates not only chronic allergic dermatitis but also idiopathic dermatitis induced by psychological stress in mice

Difamilast is a novel PDE4 inhibitor with the strongest inhibitory activity against PDE4B among the four PDE4 subtypes. Moizerto® ointment (0.3%, 1% difamilast) has been recently approved for treatment of atopic dermatitis (AD) in Japan. Exogenous antigen stimulation or psychological stress can trigger or exacerbate AD symptoms. In this study, we evaluated the therapeutic effects of difamilast, tacrolimus, and betamethasone valerate on two different mice models of dermatitis: one was chronic contact hypersensitivity (CCH) induced by repeated application of hapten every 2 days for 52 days, the other was idiopathic dermatitis due to persistent self-scratching induced by application of hapten three times a week for 16 weeks, followed by individual housing (social isolation) for 6 months. Efficacy was assessed by repeated topical application of each drug for 4 or 6 weeks after each dermatitis established. In the CCH model, difamilast ointment group significantly improved skin hyperplasia from 0.03% to 3% dose-responsibly with inhibition of inflammatory cell infiltration such as T cells, eosinophils, and neutrophils. Betamethasone valerate ointment (0.12%) improved skin hyperplasia more strongly than 3% difamilast ointment. Tacrolimus ointment (0.1%) temporarily improved skin symptoms, but eventually had no effect. In the idiopathic dermatitis model, difamilast (1%, 3%) significantly improved skin symptoms with a decrease in MIP-1 alpha and MIP-2 content. Tacrolimus (0.1%) slightly improved skin symptoms, while betamethasone valerate (0.1%) exacerbated it. Notably, difamilast ameliorates both CCH and psychological stress-induced idiopathic dermatitis. Betamethasone valerate worsened the idiopathic dermatitis probably due to skin atrophy as steroid’s side effect and tacrolimus had weak effects in both models. Therefore, difamilast is expected to be a possible treatment for AD symptoms such as chronic allergic dermatitis and psychological stress-exacerbated idiopathic dermatitis.

Oncological and functional results after robot-assisted radical prostatectomy in high-risk prostate cancer patients.

Pentafecta is currently the standard in the comprehensive evaluation of patients undergoing radical prostatectomy, the objective of this study is the evaluation of oncological and functional outcomes in patients with prostate cancer of high risk undergoing robot-assisted radical prostatectomy. Descriptive, retrospective study of 20 cases with a diagnosis of high-risk prostate cancer. The high-risk group is composed of a prostate-specific antigen equal or greater than 20 ng/mL, Gleason score equal or greater than 8, or clinical stages T2/T3 treated with robotic approach. Biochemical control was achieved from the first six weeks after the surgical event. 75% (n = 15) had negative surgical margins. 100% of the patients (n = 20) presented urinary continence immediately after removal of the urinary catheter. Erectile function was preserved at 3, 6 and 12 months in 100% of the patients who underwent neuropreservation but with use of an PDE inhibitor. (n = 5). Complications were reported in 10% (Clavien-Dindo I-II). Robot-assisted radical prostatectomy in patients with high-risk prostate cancer is considered an appropriate treatment option in selected patients. A different experimental design is needed to define the advantages or disadvantages of this approach, as well as to determine its role and application in clinical practice.

Newly discovered biologic agent used for psoriasis treatment

Psoriasis is an autoimmune inflammatory skin disorder that affects 2–3% of the world's population. It has distinct features, such as accelerated keratinocyte proliferation and proinflammatory cytokines secretion. Topical, systemic, phototherapy, and biologic therapies are used in the treatment. Topical therapies are preferred over systemic medicines for mild to moderate psoriasis. Systemic therapies are best for severe pathological conditions. Immunosuppressants, biological agents, and recently licensed phosphodiesterase-4 (PDE4) inhibitors are some of the systemic therapies. Present therapies have a lot of drawbacks, and new discoveries in the pathogenesis of psoriasis are opening the way for novel therapeutics that target the disease at the molecular level. Multiple small molecules, PDE-4 inhibitors, biologics, and immunomodulators, as well as newly discovered Janus kinases (JAK) inhibitors, were found to be effective. This article focuses on many emerging treatments as well as presently approved psoriasis medications.

Variations of SARS-CoV-2 in the Iranian population and candidate putative drug-like compounds to inhibit the mutated proteins

The first cases of the novel coronavirus, SARS-CoV-2, were detected in December 2019 in Wuhan, China. Nucleotide substitutions and mutations in the SARS-CoV-2 sequence can result in the evolution of the virus and its rapid spread across the world. Therefore, understanding genetic variants of SARS-CoV-2 and targeting the conserved elements responsible for viral replication have great benefits for detecting its infection sources and diagnosing and treating COVID-19. In this study, we used the SARS-CoV-2 sequence isolated from a 59-year-old man in Ardabil, Iran, in April 2020 and sequenced using Oxford Nanopore technology. A meta-analysis comparing the sequence under study with other sequences from Iran indicated long nucleotide insertions/deletions (indels) that code for NSP15, the NSP14-NSP10 complex, open reading frame ORF9b, and ORF1ab polyproteins. In addition, replicating the NSP8 protein in the study sequence is another topic that can affect viral replication. Then using the DNA structure of NSP8, NSP15, NSP14-NSP10 complex, and ORF1ab as a genetic target can help find drug-like compounds for COVID-19. Potential drug-like compounds reported in this study for their mechanism of action and interactions with SARS-CoV-2 genes using drug repurposing are resveratrol, erythromycin, chloramphenicol, indomethacin, ciclesonide, and PDE4 inhibitor. Ciclesonide appears to show the best results when docked with chosen viral proteins. Therefore, different proteins isolated from nucleotide mutations in the virus sequence can indicate distinct inducers for antibodies and are important in vaccine design.

Dupilumab for alopecia areata treatment: A double-edged sword?

Alopecia areata (AA), which is a common and inflammatory hair loss and one of the most frequent dermatological conditions with higher incidence worldwide, the complex interplay involved multiple factors was contributed to the pathogenesis that consists of immune privilege losing and destruction with autoimmune-mediated in hair follicle also the abnormal regulation of inflammatory pathways was highlighted, although it was remained unclear to date.(J Am Acad Dermatol, 78, 2018, 1) Some treatment options for AA were proposed with great advances in recent years, but the options and efficacy were limited, such as platelet-rich plasma, JAK-STAT inhibitor, PDE4 inhibitor, and others, also the good response with regrow hair of cytokine-targeted therapy like dupilumab, ustekinumab was shown.(Clin Exp Med, 21, 2021, 215; Drugs, 80, 2020, 635) Here, we present a case with onset of AA following dupilumab treatment, the chronological relationship between the AA onset and dupilumab use should be known and emphasized.

Abstract 5322: The antitumor activity and immumodulatory effect of a novel phosphodiesterase 10 inhibitor

Abstract Phosphodiesterase 10 (PDE10) is overexpressed in several types of cancer, including lung, breast and colon cancers. It has been proposed that inhibitors targeting PDE10 may exhibit antitumor activities. Previous studies have shown that PDE10 inhibition can selectively activate cGMP-dependent protein kinase to suppress oncogenic β-catenin signaling in colon cancer cells. However, the impact of PDE10 inhibitors on tumor cell immunogenicity has not been examined. Here we report the antitumor activity and immunomodulatory effect of a novel PDE10 inhibitor (ADT030) in preclinical models. We show that administration of ADT030 significantly inhibited the growth of murine colorectal cancer CT26. In a metastatic breast tumor model (4T1), ADT030 administration not only delayed the growth of the primary tumor but also reduced tumor metastasis, resulting in prolonged mouse survival. Immunological analysis revealed profound reduction of MDSCs in mice, and improved T cell tumor infiltration and function after ADT030 treatment. Moreover, the combination of ADT030 and anti-PD-1 antibody therapy led to further improved tumor growth control and mouse survival. These results implicate PDE10 as a promising therapeutic target and its inhibition may enhance the efficacy of cancer immunotherapy. Citation Format: Md Yeashin Gazi, Caitlin Brandle, Ogacheko Okoko, Xi Chen, Adam Keeton, Yulia Maxuitenko, Gary Piazza, Gang Zhou. The antitumor activity and immumodulatory effect of a novel phosphodiesterase 10 inhibitor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5322.