MERRF/MELAS overlap syndrome: a double pathogenic mutation in mitochondrial tRNA genes.

BACKGROUND: Myoclonic epilepsy with ragged-red fibres (MERRF) and mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) are established phenotypes of mitochondrial encephalomyopathy. The m.8356T>C transition in the mitochondrial tRNA(Lys) gene is a pathogenic mutations of MERRF. The m.3243A>G transition in the mitochondrial tRNA(Leu) gene is detected in most MELAS patients. Although previous analyses of double mutations in mitochondrial DNA (mtDNA) were useful for discussing their nature, many unsolved questions remain. OBJECTIVE: To describe the clinical and genetic features of a family with the above mtDNA double-point mutations and discuss the role of double mtDNA mutations in diverse clinical features in the family. PATIENTS AND METHODS: The proband was a 23-year-old woman with MERRF harbouring m.8356T>C and m.3243A>G transitions in mitochondrial tRNA genes. We assessed clinical aspects of her and those of her three relatives and performed mutation analyses on their mtDNA. RESULTS: Phenotypes of the four patients were MERRF, MERRF/MELAS overlap syndrome and asymptomatic carrier. We hypothesise that the course of the phenotype of this family begins with MERRF and is followed by MELAS. This double mutation was heteroplasmic in blood of all four patients but with different rates in each patient, while m.8356T>C appeared homoplasmic and m.3243A>G was heteroplasmic in muscle of the two examined cases. No other mutations were detected in the total mtDNA sequence in this family. CONCLUSIONS: This is the first reported case of a double-point mutation in mtDNA, both of which were heteroplasmic and pathogenic for the established phenotypes.

Up-regulation of hepatic LDL receptor gene expression by monatepil, a novel calcium antagonist, in high cholesterol diet-fed Japanese monkeys.

The action of the novel antihypertensive calcium antagonist monatepil on the hepatic LDL receptor was investigated at the gene expression level to clarify the mechanism of its hypolipidemic effect. In cholesterol-fed control monkeys, the LDL receptor mRNA level decreased to approximately 30% of that in the normal diet-fed monkeys. However, the administration of monatepil increased LDL receptor mRNA to normal levels (three- to fourfold stimulation). It is suggested that monatepil raises the number of LDL receptors in liver tissue and that this increase may accelerate the removal of plasma LDL. Treatment with prazosin, an alpha 1-adrenoceptor antagonist, also increased the LDL receptor mRNA level, but this restorative effect was much weaker than that of monatepil, suggesting that mechanisms additional to its alpha 1-adrenoceptor blocking activity are involved in the hypolipidemic effect of monatepil.

Inhibitory effect of monatepil maleate on acyl-CoA:cholesterol acyltransferase activity in the liver of cholesterol-fed Japanese monkeys.

We have previously demonstrated that monatepil maleate, AJ-2615, a new calcium antagonist endowed with alpha1-adrenoceptor blocking property, has antiatherosclerotic and plasma lipid-lowering effects in Japanese monkeys fed on a cholesterol-rich diet. To clarify the mechanisms on plasma lipid-lowering action, we investigated the effect of monatepil maleate in these monkeys on hepatic acyl-CoA:cholesterol acyltransferase (ACAT) activity. Both ACAT activity and esterified cholesterol content in the livers of monkeys fed on a cholesterol-rich diet for 6 months significantly increased about 7- and 16-fold, respectively, as compared with those in monkeys fed on a standard diet. Monatepil maleate (30 mg/kg/day for 6 months, orally) inhibited the increases of ACAT activity and esterified cholesterol content by 51% and 71%, respectively. In in vitro experiments, monatepil maleate inhibited ACAT activity in a concentration-dependent manner, whereas it did not affect 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase activity. A kinetic analysis revealed that monatepil maleate was a noncompetitive type inhibitor of ACAT. Hepatic ACAT activity was significantly correlated to hepatic esterified cholesterol content (r = 0.775, P < .0001), to plasma very low density lipoprotein (VLDL) content (r = 0.765, P < .0001) and to plasma total cholesterol content (r = 0.573, P < .005) in the monkeys. These results suggest that ACAT-inhibiting effect of monatepil maleate plays an important role in the reduction of hyperlipidemia.

Possible involvement of endothelin in thromboxane A2 receptor agonist (U-46619)-induced angina in the rat.

The thromboxane A2 receptor agonist, U-46619 ((5Z, 9 alpha, 11 alpha, 13E, 15(S))-9,11-(methanoepoxy)prosta-5,13-dien-1-oic acid) (10 micrograms/kg), induced a typical ischemic change (ST elevation) in the electrocardiogram on intracoronary arterial administration in the rat. The elevation of the ST segment induced by U-46619 was significantly reduced by pretreatment with anti-endothelin-1 rabbit serum. The plasma concentration of endothelin-1 dose dependently increased at the time of ST segment elevation after U-46619. These results indicate that endogenous endothelin-1 partly contributes to coronary spasmodic angina induced by thromboxane A2 in rats.

Involvement of dopamine D3 receptors in the area postrema in R(+)-7-OH-DPAT-induced emesis in the ferret.

We investigated the possible involvement of dopamine D3 receptors in R(+)-7-hydroxy-2-(N,N-di-n-propylamino)tetraline (R(+)-7-OH-DPAT)-induced emesis in the ferret. The R(+)enantiomer of 7-OH-DPAT (0.03-1 mg/kg, s.c.) caused emesis in a dose-dependent manner, whereas the S(-)enantiomer, even at 1 mg/kg s.c. failed to induce emesis. Quinpirole (0.1-1.0 mg/kg) and apomorphine (0.3 mg/kg, s.c. only) also elicited an emetic response. S(-)-Eticlopride, which has a high affinity for the dopamine D3 receptor, antagonized R(+)-7-OH-DPAT (0.3 mg/kg, s.c.)-induced emesis (ID50 1.4 micrograms/kg, s.c.). R(+)-7-OH-DPAT (0.1-1.0 microgram) administered into the 4th cerebral ventricle dose dependently induced emesis within 1 min of dosing in ferrets. Intracerebroventricularly administered S(-)-eticlopride (0.01-1 microgram) also inhibited the emesis induced by s.c. administration of R(+)-7-OH-DPAT. The emetic effect of R(+)-7-OH-DPAT was unaffected by abdominal vagotomy but was markedly reduced by ablation of the area postrema. These results suggest that dopamine D3 receptors in the area postrema play an important role in R(+)-7-OH-DPAT-induced emesis in the ferret.

Prevention by the new Ca2+ channel antagonist, AJ-3941, of loss of endothelium-dependent relaxation after subarachnoid hemorrhage in rats.

AJ-3941 ((+/-)-(E)-1-(3-fluoro-6,11-dihydrodibenz[b,e]-oxepine-11-yl ) -4-(3-phenyl-2-propenyl)-piperazine dimaleate; CAS No. 143110-70-7), a cerebrovascular-selective Ca2+ channel antagonist having anti-lipid peroxidative action, was reported to prevent cerebral vasospasm following subarachnoid hemorrhage in rats. The present study was undertaken to determine whether AJ-3941 protects the impairment of cerebroarterial endothelium-dependent relaxation which is concomitantly induced with cerebral vasospasm. Subarachnoid hemorrhage biphasically suppressed the response to acetylcholine in rat basilar artery, at 0.5 h (n = 4; P < 0.06) and 1 day (n = 5; P < 0.05) after subarachnoid hemorrhage. The reduction of the responses was correlated significantly to the degree of vasospasm determined angiographically. This reduction was accompanied by a 49% increase of arterial lipid peroxide contents. Endothelium-independent relaxation in subarachnoid hemorrhage rats was preserved in response to 3-morpholinosydnonimine, sodium nitroprusside and papaverine. AJ-3941 prevented (n = 6-8, P < 0.05) the suppression of the acetylcholine-induced response and the increase in lipid peroxide content in subarachnoid hemorrhage rats. These results suggest that AJ-3941 could exert its vasospasmolytic effect by preserving endothelial function through its anti-lipid peroxidative action, in addition to its inhibition of vasospasmogen-induced vasoconstriction related to intracellular Ca2+ mobilization.

A dopamine D3 receptor agonist, 7-OH-DPAT, causes vomiting in the dog.

R(+)7-hydroxy-N,N-di-n-propyl-2-aminotetralin (R(+)-7-OH-DPAT), a selective dopamine D3 receptor agonist, (0.03-0.3 mg/kg, s.c.) dose-relatedly caused emesis, whereas S (-)-7-OH-DPAT at even 1 mg/kg did not induce emesis in dogs. Apomorphine (0.03-0.3 mg/kg, s.c.) or quinpirole (0.03-0.1 mg/kg, s.c.) also caused emesis in a dose-dependent manner. The potency of R(+)-7-OH-DPAT in inducing emesis was the same as that of apomorphine and quinpirole. On the other hand, SKF-38393 (1 and 3 mg/kg, s.c.), a selective D1 receptor agonist, failed to induce emesis in dogs. The emesis induced by R(+)-7-OH-DPAT (0.3 mg/kg, s.c.) was inhibited by S(-)-eticlopride (0.01-0.1 mg/kg, s.c.), a potent D2 and D3 receptor antagonist but not by SCH-23390 (1 mg/kg, s.c.), a selective D1 receptor antagonist or clozapine (1 mg/kg, s.c.), a D4 receptor antagonist. These results indicate that dopamine D3 receptors play an important role in the genesis of emesis in dogs.

U-46619-induced ischaemic electrocardiographic changes in rats: preventive effects of prostacyclin and nitroglycerin.

The anti-anginal effect of nitroglycerin and prostacyclin was examined using, as an index, the ischaemic electrocardiogram (ECG) change (ST elevation) induced by intracoronary arterial injection of 9,11-dideoxy-11 alpha,9 alpha-epoxymethano-PGF2 alpha (U-46619), a stable thromboxane A2 agonist, in anaesthetized rats. The ST elevation induced by U-46619 (5-20 micrograms kg-1, i.c.a.) was dose-dependent and reproducible. U-46619-induced ST elevation was markedly prevented by the pretreatment of intravenous administration of prostacyclin (0.01 micrograms kg-1), and to a lesser extent by nitroglycerin (0.3 mg kg-1). Simultaneously, platelet count decreased significantly in the coronary arterial blood which indicated that platelet aggregation was enhanced by U-46619. The decrease of platelet count in coronary arterial blood at the time of ST elevation was significantly suppressed by prostacyclin (0.1 microgram kg-1, i.v.), but not by nitroglycerin (0.3 mg kg-1, i.v.). These results suggest that the ST elevation induced by intracoronary arterial injection of U-46619 may be derived from spasm of coronary artery and platelet aggregation in the intracoronary artery in rats.

Alacepril, an angiotensin-converting enzyme inhibitor, prevents cerebral vasospasm in subarachnoid hemorrhage model in rats.

The effects of angiotensin-converting enzyme (ACE) inhibitors was investigated on the development of cerebral vasospasm and on the endothelium-dependent relaxation in the rat subarachnoid hemorrhage (SAH) model. Alacepril or enalapril was used as an ACE inhibitor with or without a thiol moiety in the structure. SAH rats or sham-operated rats were produced by the injection of homologous blood or artificial cerebrospinal fluid into the cisternal magna, respectively. In the SAH rat, cerebral vasospasm was observed at 24 h after blood injection. Acetylcholine (Ach)-induced relaxation in basilar arteries from SAH rats significantly decreased compared to that from sham-operated rats, although the relaxation induced by 3-morpholinosydnonimine, sodium nitroprusside or papaverine did not decrease. These results suggest that the endothelium cell function of basilar arteries in SAH rats is damaged. Alacepril prevented both the development of cerebral vasospasm and the suppression in the Ach-induced relaxation of basilar artery in SAH rats. However, enalapril did not prevent the suppression of Ach-induced relaxation in SAH rats, despite the tendency to prevent cerebral vasospasm. Therefore, it is suggested that the preventive effect of alacepril on cerebral vasospasm could be based on its protective effect on endothelium-dependent relaxation system.

Successful cochlear implantation in a patient with mitochondrial hearing loss and m.625G>A transition.

OBJECTIVE: We present a patient with mitochondrial hearing loss and a novel mitochondrial DNA transition, who underwent successful cochlear implantation. CASE REPORT: An 11-year-old girl showed epilepsy and progressive hearing loss. Despite the use of hearing aids, she gradually lost her remaining hearing ability. Laboratory data revealed elevated lactate levels, indicating mitochondrial dysfunction. Magnetic resonance imaging showed diffuse, mild brain atrophy. Cochlear implantation was performed, and the patient's hearing ability was markedly improved. Whole mitochondrial DNA genome analysis revealed a novel heteroplasmic mitochondrial 625G>A transition in the transfer RNA gene for phenylalanine. This transition was not detected in blood DNA from the patient's mother and healthy controls. Mitochondrial respiratory chain activities in muscle were predominantly decreased in complex III. CONCLUSION: This case indicates that cochlear implantation can be a valuable therapeutic option for patients with mitochondrial syndromic hearing loss.

Long-lasting antagonistic effects of monatepil on Ca2+ current in guinea-pig ventricular cells.

Monatepil maleate (CAS 103377-41-9, AJ-2615), a new derivative of dihydrodibenzothiepins, showed dose-dependent inhibition of Ca2+ current (ICa) in single cardiac cells isolated from guinea-pig ventricle. ICa was elicited by depolarization from -40 mV to +10 mV at 0.2 Hz. IC50 value of monatepil for the peak ICa at +10 mV was 18.7 nmol/l. The ICa inhibition was still sustained 30 min after washout, indicating that monatepil had long lasting activity in the mammalian single muscle cell.

Anti-arrhythmic effects of a new calcium antagonist, monatepil, AJ-2615, in experimental arrhythmic models [corrected].

1. To characterize the anti-arrhythmic properties of a new calcium antagonist, monatepil [corrected], AJ-2615, the preventive effects of AJ-2615 were compared with those of the existing calcium antagonists, diltiazem and verapamil, in experimental models of arrhythmia. 2. AJ-2615 (0.1-3.0 mg/kg, i.v.) suppressed ventricular arrhythmias induced by adrenaline (10 micrograms/kg, i.v.) in rats. AJ-2615 (0.1 mg/kg per min for 2 min, i.v.) also suppressed atrial tachycardia induced by aconitine (0.01% aconitine solution) in rats. 3. In these activities, AJ-2615 was comparable to or more potent than diltiazem and verapamil which are widely used for the treatment of arrhythmia. 4. In pro-arrhythmic activity, AJ-2615 was less potent than diltiazem and verapamil. 5. These results suggest that AJ-2615 would be a safer anti-arrhythmic agent, with less proarrhythmic liability than diltiazem and verapamil.

Relative contribution of alpha 1-adrenoceptor blocking activity to the hypotensive effect of the novel calcium antagonist monatepil.

Monatepil, a novel calcium antagonist, has alpha 1-adrenoceptor blocking activity; in the present study, we examined the relative contribution of this alpha 1-blocking activity to its hypotensive effect. Monatepil and diltiazem produced dose-dependent hypotensive effects in anesthetized rats with the same potency. Prazosin and monatepil inhibited the L-phenylephrine (L-PE)-induced pressor response, whereas diltiazem scarcely did. The injection of prazosin produced a decrease in blood pressure (BP) in anesthetized rats. The decrease was recovered with angiotensin II (AII) infusion in a dose-dependent manner. We developed a new rat model by first intravenously injecting prazosin and then infusing AII in anesthetized rats. In this model, diltiazem produced the same hypotensive effect as it did in pretreated conditions, although the hypotensive effect of monatepil was attenuated by 20-35% as compared with pretreated conditions. These results suggest that monatepil exerts alpha 1-adrenoceptor blocking action in vivo and 20-35% of the hypotensive effect of monatepil is attributed to its alpha 1-adrenoceptor blocking activity.

Renin inhibitory effect of 2-[4-(4'-chlorophenoxy)phenoxyacetylamino]-ethylphosphorylethanolamine (PE-104) in vitro and in vivo.

The renin inhibitory activity of 2-[4-(4'-chlorophenoxy)phenoxyacetylamino]ethylphosphorylethanolamine (PE-104) was examined in vitro and in vivo. PE-104 inhibited the reaction between dog renal renin and homologous plasma angiotensinogen. The Ki value was 2 mM and the inhibitory mode was competitive and reversible. Data concerning the relationship between renin inhibitory activity and the chemical structure indicated that the whole structure was required for inhibitory activity of PE-104. PE-104 did not inhibit the caseinolytic activities of pepsin, papain and trypsin at 10 mM, the dose of which inhibited renin activity by more than 80%. In normotensive rats, infusion of PE-104 (20 mg/kg/min) abolished increases in blood pressure, plasma renin activity and plasma angiotensin I concentration after injection of renin. In two kidney model renal hypertensive rats, infusion of PE-104 resulted in decreases in blood pressure, plasma renin activity and plasma angiotensin I concentration.

Renin inhibitory effect of synthetic phosphorylethanolamine (PE-104) in the rat.

1. The renin inhibitory effect of 2-[4-(4'-chlorophenoxy)phenoxy - acetylamino]ethylphosphoryl-ethanolamine (PE-104) was examined both in vitro and in vivo. 2. PE-104 inhibited the rate of angiotensin formation from dog renin and renin substrate reaction. The Ki value was 2 mmol/l and the inhibition was competitive. 3. In normotensive rats, infusion of PE-104 abolished the increases of blood pressure and plasma angiotensin I concentration due to renin injection. In renal hypertensive rats, infusion of PE-104 decreased blood pressure and this was associated with a decrease of plasma angiotensin I concentration. 4. These observations confirm that PE-104 is a renin inhibitor.

Renin inhibition by synthetic phosphatidyl and phosphorylethanolamines.

Renin inhibitory effects of about 30 kinds of newly synthesized Phosphatidyl-E and Phosphoryl-E were studied in vitro and in vivo. Among the synthetic Phosphatidyl-E, PE (SEE ARTICLE) SERies were the most potent and these were stronger than natural Phosphatidyl-E. We also confirmed that the converison from the original Phosphatidyl-E, so called prerenininhibitor, to lyso-form to exhibit renin inhibition as mentioned by Sen et al15,16 and Baggio et al.20 was not essential. But a stronger inhibition to renin was observed in PE-72, one of synthetic Phosphoryl-E analogues. PE-104, Phosphoryl-E without long fatty acid chain, was the most potent inhibitor in this study. PE-72 and PE-104 inhibited the reaction between dog renin and substrate in a competitive way. In dogs and rats, Phosphoryl-E decreased hypertensive responce and increase angiotensin I concentration induced by the exogenous renin. Hypotensive effects of Phosphatidyl-E and Phosphoryl-E were also demonstrated in renal hypertensive rats and not in normotensive rats.

Urodynamics in acetone-induced cystitis of anesthetized rats.

We examined the bladder function of cystitis models induced by intravesical acetone instillation in urethane-anesthetized rats. Acetone (0.35 ml) at 10, 30, or 50% concentration or deionized water (sham-treatment) was instilled into the bladder via the cannula which was inserted into the lumen. Acetone was withdrawn 90 sec after instillation and the bladder lumen was washed with saline after 15 min. One hour later, the cystometrogram induced by transvesical infusion of saline (3.3 ml/hr) was measured. During cystometrography of normal (non-treated) or sham-treated group, the time required to cause micturition, reflecting bladder capacity, was 9.6 +/- 0.9 (n = 7) or 10.0 +/- 0.8 min (n = 6), respectively. In the 10% acetone-treated group, the bladder capacity was similar to that in the normal or sham group. In the 30% acetone group, the time to micturition was 4.4 +/- 0.4 min (n = 7), indicating decreased bladder capacity, although the micturition pressure and the threshold pressure were not significantly different from those in the normal or sham group. However, in the 50% acetone group, the micturition reflex disappeared. In isolated rat bladder strips, contractile responses to carbachol or electrical field stimulation in the sham and 30% acetone group were similar. While, both responses in isolated strips from the 50% acetone group were reduced. The degree of damage from degeneration and desquamation of epithelium and hemorrhage in the bladder tissue from the 30% acetone group was less prominent than in the 50% acetone group. Additionally, some tissue from the 50% acetone group showed degeneration of muscle layer. The effects of three drugs were investigated in the 30% acetone group which showed increased urinary frequency. Baclofen (100 microg/kg, i.v.) and morphine (100 microg/kg, i.v.) increased significantly the bladder capacity and the threshold pressure. Atropine (10 microg/kg, i.v.) decreased the micturition pressure. These results suggest that cystitis models induced by intravesical instillation of 30% acetone may be valuable for evaluating drugs for the treatment of urinary frequency.