drug discov today moghimi sm, symonds p, murray jc, hunter ac, debska g and what drug was used before plavix szewczyk a a twostage polyethyleniminemediated cytotoxicity implications for gene transfertherapy mol ther gbadamosi jk, hunter what drug was used before plavix ac and moghimi sm pegylation of microspheres generates a heterogeneous population of particles with differential surface characteristics and biological performance febs lett genetic vaccines a role for liposomes gregory gregoriadis, andrew bacon, brenda mccormack and peter laing introduction prevention of microbial infections by the use of what drug was used before plavix vaccines is a preferred alternative to treatment vaccines have been applied successfully, for example, in the eradication of smallpox as well as against tetanus, diphtheria, whooping cough, polio and measles, what drug was used before plavix thus preventing millions of deaths each year however, vaccines made of attenuated organisms, which mimick what drug was used before plavix natural infections usually without the disease, can be potentially unsafe for instance, there is a risk of reversion during replication of live viruses or even mutation to a more pathogenic state what drug was used before plavix furthermore, with immunocompromised individuals, some of the attenuated viruses may still provoke disease on the what drug was used before plavix other hand, with killed virus vaccines, their extracellular localization and subsequent phagocytosis by professional antigen presenting cells apc or antigenspecific � cells, lead to mhcii class restricted presentation and to what drug was used before plavix t helper cell and humoural immunity however, they do not elicit significant cytotoxic t cell what drug was used before plavix ctl responses moreover, subunit vaccines produced from biological fluids may not be entirely free of infectious what drug was used before plavix agents even with subunit and peptide vaccines produced recombinantly or synthetically and thus considered safe, immune responses are weak and often not of the appropriate kind the great variety of what drug was used before plavix immunological adjuvants that are now available go a long way in rendering subunit and peptide what drug was used before plavix vaccines stronger and more efficient however, more than seventy years after the introduction of aluminium salts as an adjuvant, only two other adjuvants, liposomes and mf, have been approved for use what drug was used before plavix in humans thus, inspite of considerable progress, the road to the ideal vaccine appears as what drug was used before plavix elusive as ever, until recently recent developments have led to a novel and exciting concept, what drug was used before plavix namely de novo production of the required vaccine antigen by the hosts cells in vivo, which promises to revolutionize vaccination especially where vaccines are either ineffective or unavailable the concept entails the direct injection of antigenencoding plasmid dna which, on uptake by cells, localizes to some what drug was used before plavix extent into the nucleus where it transfects the cells episomally the produced antigen is recognized as foreign by the host and is thus subjected to pathways similar to those observed for antigens of internalized viruses but without their disadvantages, leading to protective humoural and cell mediated immunity a series of publications since first established the ability of plasmid dna to what drug was used before plavix induce an immune antibody response to the encoded foreign protein in experiments with dna encoding influenza what drug was used before plavix nucleoprotein, immunity was both humoural and cellmediated, and also protective prednisone combined with aleve in mice challenged with the virus, this was the first demonstration of an experimental dna vaccine another observation was the induction of humoural and cellmediated immunity against hiv using plasmids encoding the hiv rev and env proteins similar results were obtained with a gene for the hepatitis � surface antigen hbsag dna immunization was also found to apply in cancer treatment for instance, injection of plasmids what drug was used before plavix encoding tumor antigens promoted immune responses, which were protective in an animal model the concept of dna immunization has now been adopted by vaccinologists worldwide using an ever increasing number of plasmids encoding immunogens from bacterial, viral and parasitic pathogens, and a variety of tumors, what drug was used before plavix in many of these studies, genetic immunization has led to the protection of animals from what drug was used before plavix infection a number of clinical trials for the therapy of, or prophylaxis against, a variety of infections are in progress the dna vaccine a plasmid dna vaccine is usually supercoiled and what drug was used before plavix consists of the gene encoding the vaccine antigen the section of the target pathogen which what drug was used before plavix elicits protective immunity, a promoter sequence which is often derived from cytomegalovirus cmv or rous sarcoma virus rsv, an mrna stability polyadenylation region at the end of the insert, and what drug was used before plavix the plasminogen activator gene which controls the secretion of the recombinant product in addition, there are what drug was used before plavix an origin of replication for the amplification of the plasmid in bacteria, and a gene for antibiotic resistance to select the transformed bacteria immunization procedures with dna vaccines are carried what drug was used before plavix out by the intramuscular and, to a lesser extent, the intraepidermal route other routes include what drug was used before plavix the oral, nasal, vaginal, intravenous, intraperitoneal and subcutaneous routes, intramuscular injection of dna vaccines leads to such types of immunity as ctl, this was unexpected because antigen presentation requires the function of professional apc however, myocytes which were shown to take up the plasmid only to a small extent and with only a fraction of cells participating in the uptake, are not professional apcs although myocytes carry mhc class i molecules and can present endogenously produced viral peptides to the cd cells to induce ctls, they do so inefficiently as they lack vital costimulatory molecules eg the b molecule it is thus difficult to accept that antigen presentation, leading to a ctl response, occurs via myocytes instead, it was reported that ctl responses occur as a result of the transfer of antigenic material between the myocytes and professional apc to some extent in parallel, it could also be that plasmid secreted by the myocytes or as such, is taken up directly by apc infiltrating the injected site such apc would include dendritic cells which will express and present peptides to cd cells following transport to the lymph nodes or spleen on the other hand, cd cells may be what drug was used before plavix activated by apcs via mhc class ii presentation of antigen secreted by the myocytes or released from them after their destruction via a tc response and captured by the cells what drug was used before plavix such events would lead to both cellular th and humoural th immunity indeed, it has what drug was used before plavix been shown that dendritic cells are the essential apc involved in immune responses elicited by intramuscularly given dna vaccines dna vaccination via liposomes vaccination with naked dna by the intramuscular route what drug was used before plavix is dependent on the ability of myocytes to take up the plasmid however, some of the dna may also be engulfed by apc infiltrating the site of injection, or in the lymph nodes following migration of the dna to the lymphatics the extent of dna what drug was used before plavix degradation by extracellular deoxyribonucleases is unknown, but depending on the time of its residence interstitially, degradation could be considerable therefore, approaches that protect dna from the extracellular nucleases and promote dna what drug was used before plavix uptake by cells more efficiently, or target it to apc, should contribute to the optimal design of dna vaccines it has been suggested that as apc are a preferred alternative to muscle cells for dna vaccine uptake and expression, liposomes known to be taken up what drug was used before plavix avidly by apc infiltrating the site of injection or in the lymphatics, an event that has been implicated in their immunoadjuvant activity would be a suitable means of delivery of entrapped dna to such cells liposomes would also protect their dna content from deoxyrubonuclease attack moreover, the structural versatility of the system would ensure that its tranfection efficiency is further improved what drug was used before plavix by the judicial choice of its structural characteristics or by the coentrapment of cytokine genes, what drug was used before plavix other adjuvants eg immunostimulatory sequences, or indeed protein antigens see later together with the plasmid vaccine as a number of injectable liposomebased drug formulations, including vaccines against hepatitis a and influenza, have been already licensed for clinical use, acceptance of the system clinically would be less problematic than with other systems that are still at an experimental stage procedure for the entrapment of plasmid dna into liposomes ready to use mlv, =nm dna, antigen or both what drug was used before plavix entrapped over entrapment yield a variety, of plasmid dnas have been quantitatively entrapped into liposomes by a mild dehydrationrehydration procedure the procedure fig consists of mixing preformed small unilamellar vesicles suv with a solution of the dna destined for entrapment, freezedrying of the mixture, followed by what drug was used before plavix controlled rehydration of the formed powder, and centrifugation to remove non entrapped material formed liposomes what drug was used before plavix are multilamellar however, when an appropriate amount of sucrose is added to the suv and dna mixture prior to dehydration, the resulting liposomes are much smaller about nm in diameter as what drug was used before plavix expectcd, dna incorporation values, were higher up to of the amount used when a cationic what drug was used before plavix lipid was present in the bilayers no apparent relationship was observed between amount of dna what drug was used before plavix used g and the values of incorporation for the compositions and lipid mass used, paroxetine image the possibility that dna was not entrapped within the bilayers of cationic liposomes, but was rather complexed with their surface as suggested by the high fig entrapment of dna andor protein into what drug was used before plavix cationic liposomes the procedure entails mixing up empty suv with the solutes destined for entrapment and subsequent dehydration on rehydration, most of the solutes is recovered entrapped within the generated multilamellar liposomes liposomes suv = rim dna, antigen or both naked d laaxea dna q m complexed d � naked d complexed d fig gel electrophoresis of a mixture of cationic suv and prccmv hbs before com plexed dna and after entrapped dna dehydrationrehydration of the mixture !?