[Published 22nd March 2011 03:20 PM GMT]

1. A shared anesthetic binding site

Though general anesthetics are commonly used in medicine, how they work on a molecular level is poorly understood. New research suggests that certain ligand-gated ion channels share a binding site for a couple different general anesthetics; knowledge which could help in the development of new drugs.

H. Nury et al., "X-ray structures of general anaesthetics bound to a pentameric ligand-gated ion channel," Nature, 469:428-31, 2011. Evaluations by Ashley Fiamengo and Roderic Eckenhoff, UPenn; Edward Bertaccini, Stanford Univ Sch Med; Douglas Raines, Mass Gen Hosp; Gregg Homanics Univ Pitt; Stuart Forman, Mass Gen Hosp; Xiangdong Chen and Douglas Bayliss Univ Virg Hlth Sci Cntr. Free F1000 Evaluation


2. A new C. diff treatment?

Clostridium difficile colonies Image: Wikimedia commons, CDC/Dr. Holdeman

The antibiotic vancomycin is the standard treatment for infection by increasingly virulent strains of Clostridium difficile, but recurrence rates are high. A phase III clinical trial of more than 600 patients showed that treatment with a new, more narrow-spectrum antibiotic, fidaxomicin, can reduce the recurrence rate.

T.J. Louie et al., " Fidaxomicin versus vancomycin for Clostridium difficile infection," N Engl J Med, 364:422-31, 2011. Evaluations by Carmel Curtis and Peter Wilson, Univ Coll Lon Hosp; Joyce Popoola, St George's Hosp, UK; Venkataraman Subramanian, Univ Nottingham; Vinay Acharya and Tor Savidge, Univ TX Med Branch. Free F1000 Evaluation


3. Better ventilation, more transplantable lungs

Using a lower tidal volume and higher levels of positive end-expiratory pressure than is commonly used to ventilate brain dead patients can significantly increase the probability that their lungs will be harvestable for transplant.

L. Mascia et al., "Effect of a lung protective strategy for organ donors on eligibility and availability of lungs for transplantation: a randomized controlled trial," JAMA, 304:2620-7, 2010. Evaluations by Alexander Benson and Ivor Douglas, Univ CO Denver Hlth; Thomas Luecke, Univ Hosp Mannheim, Univ Heidelberg; Claude Guerin, Hospices Civils de Lyon. Free F1000 Evaluation

4. A mechanism for endocrine tumor troubles

Mutations in a potassium channel gene could be the root of certain types of hormone-secreting endocrine tumors, which cause severe hypertension, constitutive hormone production and unrestrained cell proliferation.

M. Choi et al., "K+ channel mutations in adrenal aldosterone-producing adenomas and hereditary hypertension," Science, 331:768-72, 2010. Evaluations by Peter J Fuller, Prince Henry's Inst of Med Rsrch, Australia; Lee S Weinstein, NIDDK/NIH. Free F1000 Evaluation

5. The microRNA behind hypertension

A microRNA, miR-204, is critical to the etiology of pulmonary arterial hypertension (PAH). In both humans and mouse models with PAH, downregulation of miR-204 caused enhanced proliferation and reduced apoptosis of pulmonary artery smooth muscle cells, two consequences of the condition.

A. Courboulin et al., "Role for miR-204 in human pulmonary arterial hypertension," J Exp Med, 208:535-48, 2011. Evaluations by Brian Graham, James Hunt and Rubin Tuder, Univ CO Denver; Matthias Brock and Lars Huber, Univ Hospl Zurich. Free F1000 Evaluation

6. New molecular phenotypes for asthma

Inflammation caused by a specific type of T-helper cells (Th2), which is mediated by a specific suite of cytokines, is characteristic of most cases of asthma. Now, researchers can distinguish between two subtypes of asthma -- Th2-high and Th2-low -- based on expression of certain cytokines in bronchial biopsies, among other molecular phenotypes.

P.G. Woodruff et al., "T-helper type 2-driven inflammation defines major subphenotypes of asthma," Am J Respir Crit Care Med, 180:388-95, 2009. Evaluations by Bradley Chipps, Capital Allergy and Respiratory Cntr; Pranab Haldar, Inst Lung Health, UK; Kristie Ross and James Chmiel, Case Western Reserve Univ; Bruce Levy, Brigham & Women's Hosp. Free F1000 Evaluation

7. Real time tracking of kidney damage

A reporter gene, incorporated into the mouse genome, allowed investigators to detect, pinpoint, and quantify acute kidney injury in vivo and in real time.

N. Paragas et al., "The Ngal reporter mouse detects the response of the kidney to injury in real time," Nat Med, 17:216-22, 2011. Evaluations by Florian Toegel and Christof Westenfelder, Univ Utah Med Cntrs; Matthieu Legrand, Lariboisière Hosp. Free F1000 Evaluation

The F1000 Top 7 is a snapshot of the highest ranked articles from a 30-day period on Faculty of 1000 Medicine and, as calculated on March 17, 2011. Faculty Members evaluate and rate the most important papers in their field. To see the latest rankings, search the database, and read daily evaluations, visit http://f1000.com.


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