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First reboxetine trial results reported
THE LANCET
SCIENCE AND MEDICINE
New plaque protein identified in brains of people with Alzheimer’s disease absent” in brains of controls and of other neurodegenerative diseases (Am J Pathol 1997; 151: 69–80). The new lesions “may be even more specific to AD than amyloid plaques”, notes Trojanowski, who is now trying to clone the gene for AMY117. If this “illuminating and potentially very significant” finding is confirmed, notes Zaven Khatchaturian, who is director of the Alzheimer’s Association Ronald and Nancy Reagan Research Institute (Chicago, IL, USA), it could “provide fresh targets for therapies and give us a new diagnostic marker for the disease”.
newly discovered protein in plaque-like lesions in the brains of people with Alzheimer’s disease (AD) seems abundant, widespread, and “highly specific” for the disease, says John Trojanowski, director of the University of Pennsylvania’s Alzheimer’s Disease Center (Philadelphia, USA). He suspects that the protein, AMY117, may play “a crucial role in the development and progression” of the dementing illness. Trojanowski’s team were exploring components of neurofibrillary tangles in brains from patients with AD with a panel of 59 monoclonal antibodies developed to study tangles. Four antibodies did not recognise hyper-
phosphorylated tau, a key protein in the tangles, but instead reacted with a protein that was in numerous plaque-like lesions. “We thought, ‘how boring—another amyloid plaque-associated protein’, and we shoved it off to the side”,Trojanowski recalls. But the plaques containing AMY117 did not colocalise with those containing -amyloid. “They were in the same cortical and subcortical gray-matter regions, but they weren’t the same lesions.” The team found that AMY117positive plaques were “abundant” in the brains of sporadic cases of AD and in brains from people with Down’s syndrome, but “rare or
First reboxetine trial results reported
Can male-pattern baldness be prevented?
S
elective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are invaluable for treating depression but response is variable. So, data on reboxetine, a drug with a different mode of action, were well received at the World Congress on Biological Psychiatry (Nice, France, June 22–27. Reboxetine is a selective norepinephrine reuptake inhibitor with several interesting features, including a good effect on social functioning. Stuart Montgomery (Imperial College School of Medicine, London, UK) said that reboxetine seems effective, safe, and well tolerated, adding that it should improve the quality of life of patients. Patient-centred considerations also received a boost from data on sexual dysfunction caused by SSRIs. Marcus Waldinger (Leyenburg Hospital, The Hague, Netherlands), presented controlled head-to-head data for four SSRIs. Delay in time to ejaculation in healthy volunteers treated with fluvoxamine was similar to that in those treated with placebo. Fluoxetine, paroxetine, and sertraline caused increased delay. Oestrogen deficiency secondary to hyperprolactinaemia may exacerbate symptoms in schizophrenic women. This can no longer be accepted as the price of medical care, warned Ruth Dickson (University of Calgary, Canada). She called for prolactin assessment when giving neuroleptics to women.
Marilynn Larkin
Erectile dysfunction was more comromising results on treating malemon in the treatment group than in pattern baldness with oral the placebo group (1·3% vs 0·7%). finasteride were reported by Keith Elaine Fuchs (University of Kaufman (Merck Research Chicago, IL, USA) discussed the role Laboratories, Rahway, NJ, USA) at of keratin genes in the autosomal the World Congress of Dermatology dominant skin blistering in Sydney, Australia diseases, epidermolysis (June 15–20). bullosa simplex. Some Kaufman presented cytoskeletal proteins in data from phase III studskin are similar to those ies where 1879 men aged in the nervous system, 18–41 years with stage II she reported. In knockor higher androgenic out mice absence of alopecia were treated the bullous pemphigoid with finasteride for 12 antigen gene produced months. Non-vellus hair minor skin blistering as counts increased from expected but also senbaseline by an average of Happy to be bald? sory neuronal degenera14·0 hairs per cm2 in the tion. Fuchs noted that rare patients treated group but decreased by 2·3 have epidermolysis bullosa combined hairs per cm2 in the placebo group. with muscular dystrophy, a phenoGlobal scalp photography showed type very similar to that of her knockregrowth of hair in 9% of treated out mice. These patients have plectin men—baldness continued to worsen gene mutations, she noted. in 8% of them. Decreased libido occurred in 1·8% of treated men but in only 1·3% of the placebo group. Robin Marks
P
The Image Bank
A
News in brief Antimicrobial resistance A global surveillance programme to track the spread of bacterial infections and antibiotic resistance was announced last week. At least 36 000 bacteria will be tested in the first year. The programme is being coordinated by the University of Iowa Medical School and the Eijkman-Winkler Institute (The Netherlands) and is funded by Bristol-Myers Squibb.
Safer smoking? A prospective study involving 21 520 men aged 35–64 when recruited in 1975–1982 has looked at the effect of switching from cigarettes to pipes or cigars on the incidence of lung cancer, ischaemic heart disease, and chronic obstructive lung disease. Although switching from cigarettes reduces disease, men who switch never achieve the lower risk of pipe or cigar smokers who have never smoked cigarettes (BMJ 1997; 314: 1860–63).
James Magee
36
Vol 350 • July 5, 1997
SCIENCE AND MEDICINE
New plaque protein identified in brains of people with Alzheimer’s disease absent” in brains of controls and of other neurodegenerative diseases (Am J Pathol 1997; 151: 69–80). The new lesions “may be even more specific to AD than amyloid plaques”, notes Trojanowski, who is now trying to clone the gene for AMY117. If this “illuminating and potentially very significant” finding is confirmed, notes Zaven Khatchaturian, who is director of the Alzheimer’s Association Ronald and Nancy Reagan Research Institute (Chicago, IL, USA), it could “provide fresh targets for therapies and give us a new diagnostic marker for the disease”.
newly discovered protein in plaque-like lesions in the brains of people with Alzheimer’s disease (AD) seems abundant, widespread, and “highly specific” for the disease, says John Trojanowski, director of the University of Pennsylvania’s Alzheimer’s Disease Center (Philadelphia, USA). He suspects that the protein, AMY117, may play “a crucial role in the development and progression” of the dementing illness. Trojanowski’s team were exploring components of neurofibrillary tangles in brains from patients with AD with a panel of 59 monoclonal antibodies developed to study tangles. Four antibodies did not recognise hyper-
phosphorylated tau, a key protein in the tangles, but instead reacted with a protein that was in numerous plaque-like lesions. “We thought, ‘how boring—another amyloid plaque-associated protein’, and we shoved it off to the side”,Trojanowski recalls. But the plaques containing AMY117 did not colocalise with those containing -amyloid. “They were in the same cortical and subcortical gray-matter regions, but they weren’t the same lesions.” The team found that AMY117positive plaques were “abundant” in the brains of sporadic cases of AD and in brains from people with Down’s syndrome, but “rare or
First reboxetine trial results reported
Can male-pattern baldness be prevented?
S
elective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are invaluable for treating depression but response is variable. So, data on reboxetine, a drug with a different mode of action, were well received at the World Congress on Biological Psychiatry (Nice, France, June 22–27. Reboxetine is a selective norepinephrine reuptake inhibitor with several interesting features, including a good effect on social functioning. Stuart Montgomery (Imperial College School of Medicine, London, UK) said that reboxetine seems effective, safe, and well tolerated, adding that it should improve the quality of life of patients. Patient-centred considerations also received a boost from data on sexual dysfunction caused by SSRIs. Marcus Waldinger (Leyenburg Hospital, The Hague, Netherlands), presented controlled head-to-head data for four SSRIs. Delay in time to ejaculation in healthy volunteers treated with fluvoxamine was similar to that in those treated with placebo. Fluoxetine, paroxetine, and sertraline caused increased delay. Oestrogen deficiency secondary to hyperprolactinaemia may exacerbate symptoms in schizophrenic women. This can no longer be accepted as the price of medical care, warned Ruth Dickson (University of Calgary, Canada). She called for prolactin assessment when giving neuroleptics to women.
Marilynn Larkin
Erectile dysfunction was more comromising results on treating malemon in the treatment group than in pattern baldness with oral the placebo group (1·3% vs 0·7%). finasteride were reported by Keith Elaine Fuchs (University of Kaufman (Merck Research Chicago, IL, USA) discussed the role Laboratories, Rahway, NJ, USA) at of keratin genes in the autosomal the World Congress of Dermatology dominant skin blistering in Sydney, Australia diseases, epidermolysis (June 15–20). bullosa simplex. Some Kaufman presented cytoskeletal proteins in data from phase III studskin are similar to those ies where 1879 men aged in the nervous system, 18–41 years with stage II she reported. In knockor higher androgenic out mice absence of alopecia were treated the bullous pemphigoid with finasteride for 12 antigen gene produced months. Non-vellus hair minor skin blistering as counts increased from expected but also senbaseline by an average of Happy to be bald? sory neuronal degenera14·0 hairs per cm2 in the tion. Fuchs noted that rare patients treated group but decreased by 2·3 have epidermolysis bullosa combined hairs per cm2 in the placebo group. with muscular dystrophy, a phenoGlobal scalp photography showed type very similar to that of her knockregrowth of hair in 9% of treated out mice. These patients have plectin men—baldness continued to worsen gene mutations, she noted. in 8% of them. Decreased libido occurred in 1·8% of treated men but in only 1·3% of the placebo group. Robin Marks
P
The Image Bank
A
News in brief Antimicrobial resistance A global surveillance programme to track the spread of bacterial infections and antibiotic resistance was announced last week. At least 36 000 bacteria will be tested in the first year. The programme is being coordinated by the University of Iowa Medical School and the Eijkman-Winkler Institute (The Netherlands) and is funded by Bristol-Myers Squibb.
Safer smoking? A prospective study involving 21 520 men aged 35–64 when recruited in 1975–1982 has looked at the effect of switching from cigarettes to pipes or cigars on the incidence of lung cancer, ischaemic heart disease, and chronic obstructive lung disease. Although switching from cigarettes reduces disease, men who switch never achieve the lower risk of pipe or cigar smokers who have never smoked cigarettes (BMJ 1997; 314: 1860–63).
James Magee
36
Vol 350 • July 5, 1997