Cystic fibrosis clinical results

While certain behavioral and nonbehavioral diseases are believed to be monogenic, diseases such as Huntington s, cystic fibrosis, Marfan, and Hirschsprung result in the specified disease, and the outward appearance or result (phenotype) of the disease varies between individuals. For instance, for Marfan syndrome, there is a level below which the mutant protein does not exhibit itself in an outward manner. Most of these diseases have modifier genes that cause modifications in the outward demonstration of the disease and play a key role in the clinical symptoms. Further, the particular metabolic pathways are often varied, with several of the steps being important and the importance of each mechanistic pathway may differ with every individual. 

The ease of application, the minimization of systemic side effects, and the increased drug penetration directly into the target region resulted in extensive clinical use of iontophoresis mainly in the transdermal field. This technique has been utilized for administration of local anesthetics [2-5], sweat chloride testing in cystic fibrosis patients by transcutaneous delivery of pilocarpine [6,7], administration of vidarabine to patients with herpes orolabialis [8], fluoride administration to patients with hypersensitive dentin [9,10], and gentamicin delivery for the management of burned ears [11],... 

Genetic alterations or abnormalities of germ cells, some of which can be caused by toxicant exposure, can be manifested by adverse effects on progeny. The important health effects of these kinds of alterations may be appreciated by considering the kinds of human maladies that are caused by inherited recessive mutations. One such disease is cystic fibrosis, in which the clinical phenotype has thick, dry mucus in the tubes of the respiratory system such that inhaled bacterial and fungal spores cannot be cleared from the system. This results in frequent, severe infections. It is the consequence of a faulty chloride transporter membrane protein that does not properly transport Cl ion from inside cells to the outside, where they normally retain water characteristic of healthy mucus. The faulty transporter protein is the result of a change of a single amino acid in the protein. 

A major respiratory disease for which treatment with DNase 1 can be considered is cystic fibrosis (CF) [45,46], The CF defective gene leads to a dysfunction of the exocrine secretory glands, often resulting in both severe gastrointestinal as well as resoiratorv clinical svmntoms. Patients suffer from the obstruction of the... 

These findings prompted the development and evaluation of the currently available form of inhaled tobramycin, which is sterile and free of preservatives. The benefit of maintenance therapy with this inhaled tobramycin is supported by the results from two 24-week, multicenter, randomized, double blind, placebo-controlled clinical trials [6]. In these studies, patients with cystic fibrosis were at least six years of age, with an FEVj between 25% and 75% predicted. All subjects had evidence of colonization with Pseudomonas aeruginosa. Exclusion criteria included an elevated serum creatinine or colonization with Burkholderia cepacia, which is typically resistant to tobramycin. Subjects in the active treatment arm received inhaled tobramycin 300 mg twice daily through... 

Initial experiences with aerosolized antimicrobial therapies appeared in the literature more than 50 years ago. Until the early 1990s, the quality of the evidence supporting this strategy in the management of lung infections was poor. Recently, results from well-controlled clinical trials have established a role for inhaled antibiotics, particularly aminoglycosides, as suppressive therapy for patients with cystic fibrosis. Cyclic therapy with inhaled tobramycin reduces the frequency of pulmonary exacerbations and improves lung function. 

PPL Therapeutics reported positive results of its Phase II clinical trial using transgenic BSSL to treat patients with pancreatic insufficiency [63]. The milk-derived product was equally as effective as Creon , the current market leader used to improve digestion and restore fat absorption to normal levels. Creon capsules are administered orally and contain delayed-re-lease microencapsulated porcine pancreatic pancrelipase. Six patients with chronic pancreatic insufficiency were successfully treated, four patients having chronic pancreatitis and one suffering from cystic fibrosis. The larger commercial opportunity for this product is for premature infants... 

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