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1.
Expert Opin Drug Metab Toxicol ; 20(8): 817-825, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39021252

RESUMEN

BACKGROUND: Carbamazepine is one of the most commonly used antiseizure medications. Although carbamazepine pharmacokinetics in epileptic patients is well described, much less is known about these processes in the patients who experienced self-poisoning episode by this drug. Therefore, the aim of our investigation was to perform population toxicokinetics of carbamazepine and its metabolite carbamazepine-10,11-epoxide in adults. RESEARCH DESIGN AND METHODS: Software program NONMEM and the ADVAN2 TRANS2 subroutine were used for establishing a population toxicokinetic model for the estimation of clearance and volume of distribution based on of the sum values of carbamazepine and carbamazepine-10,11-epoxide concentrations. RESULTS: Our results indicated that the adult patients' ability to eliminate carbamazepine and carbamazepine-10,11-epoxide following acute carbamazepine self-poisoning was strongly associated with the high levels of CRP and ASP, as well as by the treatment with sedation. CONCLUSIONS: Our study should provide better understanding of the toxicokinetics of carbamazepine taken in overdose and better management of patient population admitted to hospital.


Asunto(s)
Anticonvulsivantes , Carbamazepina , Toxicocinética , Carbamazepina/farmacocinética , Carbamazepina/administración & dosificación , Carbamazepina/toxicidad , Carbamazepina/análogos & derivados , Humanos , Anticonvulsivantes/farmacocinética , Anticonvulsivantes/administración & dosificación , Anticonvulsivantes/toxicidad , Adulto , Masculino , Femenino , Persona de Mediana Edad , Modelos Biológicos , Sobredosis de Droga , Adulto Joven , Programas Informáticos , Anciano
2.
Int J Gen Med ; 16: 1239-1250, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37065979

RESUMEN

Purpose: The aim of this study was to analyze data on gabapentinoid-related attendances to the National Poison Control Center of Serbia (NPCC), particularly abuse cases; to estimate its changes and to compare it with trends in national consumption rates of these drugs. We also aimed to analyze the main characteristics of the study population and to investigate the major clinical effects in poisoned patients. Patients and Methods: This is a retrospective study of patients admitted to the NPCC for acute poisoning involving gabapentinoids from 1 May 2012 to 1 October 2022. Results: There were 357 (95.5%) pregabalin-related and 17 (4.5%) gabapentin-related poisoning cases in 302 patients. Abuse of pregabalin was detected in 27.8% (84/302), while gabapentin abuse occurred in 0.7% (2/302) of all patients. A steady increase in rates of pregabalin poisoning and abuse cases strongly correlated with the increase in overall consumption of this drug, while there were no significant changes in rates of gabapentin consumption, poisoning and abuse rate during the study period. Most patients who abused pregabalin pregabalin were males (84.5%) and the median age was 26 years (range: 15-45 years). Almost 60% of patients who abused pregabalin (48/84) belonged to the migrant population. Co-ingestions occurred in 89.4% of pregabalin-related cases (319/357), resulting in more severe poisoning. The most often co-ingested drugs were benzodiazepines and among them clonazepam was detected in the largest number of cases. Conclusion: The poisoning and abuse cases involving pregabalin are on the rise in Serbia, which coincided with an increase in its overall consumption during the study period. Isolated pregabalin ingestions resulted in mild poisoning, although severe symptoms such as coma and bradycardia were recorded. When prescribing pregabalin to patients at risk of abuse caution is needed. Strengthening the measures for dispensing of pregabalin may reduce the risks associated with its abuse.

3.
Biomolecules ; 12(3)2022 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-35327564

RESUMEN

Vascular endothelial growth factors (VEGFs) are the key regulators of blood and lymphatic vessels' formation and function. Each of the proteins from the homologous family VEGFA, VEGFB, VEGFC and VEGFD employs a core cysteine-knot structural domain for the specific interaction with one or more of the cognate tyrosine kinase receptors. Additional diversity is exhibited by the involvement of neuropilins-transmembrane co-receptors, whose b1 domain contains the binding site for the C-terminal sequence of VEGFs. Although all relevant isoforms of VEGFs that interact with neuropilins contain the required C-terminal Arg residue, there is selectivity of neuropilins and VEGF receptors for the VEGF proteins, which is reflected in the physiological roles that they mediate. To decipher the contribution made by the C-terminal sequences of the individual VEGF proteins to that functional differentiation, we determined structures of molecular complexes of neuropilins and VEGF-derived peptides and examined binding interactions for all neuropilin-VEGF pairs experimentally and computationally. While X-ray crystal structures and ligand-binding experiments highlighted similarities between the ligands, the molecular dynamics simulations uncovered conformational preferences of VEGF-derived peptides beyond the C-terminal arginine that contribute to the ligand selectivity of neuropilins. The implications for the design of the selective antagonists of neuropilins' functions are discussed.


Asunto(s)
Neuropilinas , Factor A de Crecimiento Endotelial Vascular , Ligandos , Neuropilinas/química , Neuropilinas/genética , Neuropilinas/metabolismo , Péptidos , Factor A de Crecimiento Endotelial Vascular/genética , Factor A de Crecimiento Endotelial Vascular/metabolismo , Factores de Crecimiento Endotelial Vascular
4.
Chembiochem ; 23(1): e202100463, 2022 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-34647407

RESUMEN

Vascular endothelial growth factors (VEGFs) regulate significant pathways in angiogenesis, myocardial and neuronal protection, metabolism, and cancer progression. The VEGF-B growth factor is involved in cell survival, anti-apoptotic and antioxidant mechanisms, through binding to VEGF receptor 1 and neuropilin-1 (NRP1). We employed surface plasmon resonance technology and X-ray crystallography to analyse the molecular basis of the interaction between VEGF-B and the b1 domain of NRP1, and developed VEGF-B C-terminus derived peptides to be used as chemical tools for studying VEGF-B - NRP1 related pathways. Peptide lipidation was used as a means to stabilise the peptides. VEGF-B-derived peptides containing a C-terminal arginine show potent binding to NRP1-b1. Peptide lipidation increased binding residence time and improved plasma stability. A crystal structure of a peptide with NRP1 demonstrated that VEGF-B peptides bind at the canonical C-terminal arginine binding site. VEGF-B C-terminus imparts higher affinity for NRP1 than the corresponding VEGF-A165 region. This tight binding may impact on the activity and selectivity of the full-length protein. The VEGF-B167 derived peptides were more effective than VEGF-A165 peptides in blocking functional phosphorylation events. Blockers of VEGF-B function have potential applications in diabetes and non-alcoholic fatty liver disease.


Asunto(s)
Neuropilina-1/metabolismo , Péptidos/metabolismo , Factor B de Crecimiento Endotelial Vascular/metabolismo , Humanos , Neuropilina-1/química , Péptidos/química , Unión Proteica , Factor B de Crecimiento Endotelial Vascular/química
5.
Microorganisms ; 9(10)2021 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-34683420

RESUMEN

Plant growth promoting bacteria (PGPB) are used as biostimulants to improve the growth and yield as well as the quality of crops. In the present study, nine strains of PGPB and one solid mix consisting of two of them were evaluated on the cultivation of industrial tomato under specific soil and climatic conditions. The results showed that Bacillus licheniformis treatment increased dry weight of the tomato plants by 39%, and the photosynthetic rate was increased by Priestia megaterium 9.9%. The application of Bacillus subtilis, Bacillus amyloliquefaciens, Priestia megaterium, and Bacillus licheniformis increased mean fruit weight per plant 26.78-30.70% compared to that of control. Yield per plant was increased 51.94% with the use of Bacillus licheniformis compared to that of control. The quality of the fruits in nearly every bacteria strain was improved. Bacillus pumilus and the mix of Priestia megaterium and Azotobacter chroococcum (1:1) increased the most total soluble solids in the tomato fruits (4.70° Brix), and Priestia megaterium increased content in lycopene and total carotenoids by 52.8% and 25%, respectively; Bacillus pseudomycoides increased Pectin methylesterase (PME) activity (24.94 units/mL), and Bacillusmojavensis, along with the mix of Priestia megaterium and Azotobacter chroococcum, increased Poligalacturonase (PG) activity the most (30.09 and 32.53 units/mL, respectively). Most of the bacteria strains presented an increased antioxidant activity significantly better that that of the control up to 31.25%. The results of this study confirmed that the use of PGPB as biostimulants can improve the yield and the quality of industrial tomato.

6.
Sci Rep ; 11(1): 17747, 2021 09 07.
Artículo en Inglés | MEDLINE | ID: mdl-34493757

RESUMEN

Deregulation of synaptic function and neurotransmission has been linked with the development of major depression disorder (MDD). Tianeptine (Tian) has been used as antidepressant with anxiolytic properties and recently as a nootropic to improve cognitive performance, but its mechanism of action is unknown. We conducted a proteomic study on the hippocampal synaptosomal fractions of adult male Wistar rats exposed to chronic social isolation (CSIS, 6 weeks), an animal model of depression and after chronic Tian treatment in controls (nootropic effect) and CSIS-exposed rats (lasting 3 weeks of 6-week CSIS) (therapeutic effect). Increased expression of Syn1 and Camk2-related neurotransmission, vesicle transport and energy processes in Tian-treated controls were found. CSIS led to upregulation of proteins associated with actin cytoskeleton, signaling transduction and glucose metabolism. In CSIS rats, Tian up-regulated proteins involved in mitochondrial energy production, mitochondrial transport and dynamics, antioxidative defense and glutamate clearance, while attenuating the CSIS-increased glycolytic pathway and cytoskeleton organization proteins expression and decreased the expression of proteins involved in V-ATPase and vesicle endocytosis. Our overall findings revealed that synaptic vesicle dynamics, specifically exocytosis, and mitochondria-related energy processes might be key biological pathways modulated by the effective nootropic and antidepressant treatment with Tian and be a potential target for therapeutic efficacy of the stress-related mood disorders.


Asunto(s)
Antidepresivos/farmacología , Trastorno Depresivo/tratamiento farmacológico , Mitocondrias/efectos de los fármacos , Nootrópicos/farmacología , Proteoma/efectos de los fármacos , Aislamiento Social , Vesículas Sinápticas/efectos de los fármacos , Tiazepinas/farmacología , Animales , Ansiolíticos/farmacología , Ansiolíticos/uso terapéutico , Antidepresivos/uso terapéutico , Trastorno Depresivo/fisiopatología , Modelos Animales de Enfermedad , Evaluación Preclínica de Medicamentos , Regulación de la Expresión Génica/efectos de los fármacos , Hipocampo/efectos de los fármacos , Hipocampo/ultraestructura , Masculino , Mitocondrias/fisiología , Proteínas del Tejido Nervioso/biosíntesis , Proteínas del Tejido Nervioso/genética , Nootrópicos/uso terapéutico , Mapeo de Interacción de Proteínas , Ratas , Ratas Wistar , Transducción de Señal/efectos de los fármacos , Tiazepinas/uso terapéutico
7.
BMJ Mil Health ; 166(2): 99-102, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32086265

RESUMEN

Recent uses of nerve agents underline the need of early diagnosis as trigger to react (initiating medical countermeasures, avoiding cross-contamination). As organophosphorus (OP) pesticide poisoning exerts the same pathomechanism, that is, inhibition of the pivotal enzyme acetylcholinesterase (AChE), a portable cholinesterase (ChE) test kit was applied in an emergency room for rapid diagnosis of OP poisoning. OP nerve agents or pesticides result in the inhibition of AChE. As AChE is also expressed on erythrocytes, patient samples are easily available. However, in most clinics only determination of plasma butyrylcholinesterase (BChE) is established which lacks a pathophysiological correlate, shows higher variability in the population and behaves different regarding inhibition by OP and reactivation by oximes. The ChE test kit helped to diagnose atypical cases of OP poisoning, for example, missing of typical muscarinic symptoms, and resulted in administration of pralidoxime, the oxime used in Serbia. The ChE test kit also allows an initial assessment whether an oxime therapy is successful. In one case report, AChE activity increased after oxime administration indicating therapeutic success whereas BChE activity did not. With only BChE at hand, this therapeutic effect would have been missed. As inhibition of AChE or BChE activity is determined, the CE-certified device is a global diagnostic tool for all ChE inhibitors including carbamates which might also be misused as chemical weapon. The ChE test kit is a helpful point-of-care device for the diagnosis of ChE inhibitor poisoning. Its small size and easy menu-driven use advocate procurement where nerve agent and OP pesticide exposure are possible.


Asunto(s)
Sustancias para la Guerra Química/envenenamiento , Inhibidores de la Colinesterasa/envenenamiento , Contramedidas Médicas , Agentes Nerviosos/envenenamiento , Pruebas en el Punto de Atención , Diagnóstico Precoz , Humanos
8.
Drug Dev Res ; 81(4): 491-500, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31958155

RESUMEN

Neuropilin-1 (NRP1) is emerging as an important molecule in immune signaling where it has been shown to modulate the actions of TGF-ß1 in macrophages and regulatory T cells. The development of cost-effective and reliable assays for NRP1 binding is therefore important. We synthesized three new NRP1 small molecule fluorophores and examined their performance as fluorescent polarization probes. One molecule DS108 exhibited favorable binding and fluorescent characteristics and allowed us to establish a simple assay suitable for medium to high throughput screening of small molecules.


Asunto(s)
Colorantes Fluorescentes/metabolismo , Ensayos Analíticos de Alto Rendimiento/métodos , Neuropilina-1/metabolismo , Colorantes Fluorescentes/síntesis química , Transducción de Señal , Factor de Crecimiento Transformador beta1/metabolismo
9.
Sci Rep ; 9(1): 18143, 2019 12 02.
Artículo en Inglés | MEDLINE | ID: mdl-31792253

RESUMEN

Pathological healing characterized by abnormal angiogenesis presents a serious burden to patients' quality of life requiring innovative treatment strategies. Glycosaminoglycans (GAG) are important regulators of angiogenic processes. This experimental and computational study revealed how sulfated GAG derivatives (sGAG) influence the interplay of vascular endothelial growth factor (VEGF)165 and its heparin-binding domain (HBD) with the signaling receptor VEGFR-2 up to atomic detail. There was profound evidence for a HBD-GAG-HBD stacking configuration. Here, the sGAG act as a "molecular glue" leading to recognition modes in which sGAG interact with two VEGF165-HBDs. A 3D angiogenesis model demonstrated the dual regulatory role of high-sulfated derivatives on the biological activity of endothelial cells. While GAG alone promote sprouting, they downregulate VEGF165-mediated signaling and, thereby, elicit VEGF165-independent and -dependent effects. These findings provide novel insights into the modulatory potential of sGAG derivatives on angiogenic processes and point towards their prospective application in treating abnormal angiogenesis.


Asunto(s)
Glicosaminoglicanos/metabolismo , Ácido Hialurónico/farmacología , Factor A de Crecimiento Endotelial Vascular/metabolismo , Sitios de Unión , Sulfatos de Condroitina/farmacología , Simulación por Computador , Glicosaminoglicanos/química , Células Endoteliales de la Vena Umbilical Humana , Humanos , Proteínas Inmovilizadas/metabolismo , Modelos Moleculares , Simulación del Acoplamiento Molecular , Simulación de Dinámica Molecular , Neovascularización Fisiológica , Fosforilación , Dominios Proteicos , Esferoides Celulares , Relación Estructura-Actividad , Resonancia por Plasmón de Superficie , Factor A de Crecimiento Endotelial Vascular/química , Receptor 2 de Factores de Crecimiento Endotelial Vascular/metabolismo
10.
Expert Opin Drug Metab Toxicol ; 14(9): 979-988, 2018 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30028640

RESUMEN

BACKGROUND: The aim of the study was to evaluate the bioequivalence of two itraconazole 100 mg capsule formulations. RESEARCH DESIGN AND METHODS: The single-center, open-label, randomized, three-period, three-sequence, reference-replicated, cross-over study included 38 healthy subjects under fed conditions. In each study period (separated by a 14-day washout), a single oral dose of the test (T) or reference (R) product was administered. Blood samples were collected at pre-dose and up to 72.0 h after administration. The calculated pharmacokinetic parameters, based on the plasma concentrations of itraconazole and hydroxy itraconazole, were AUC0-72h, AUC0-∝, Cmax, Tmax, T1/2 and Kel. RESULTS: The 90% CI for the test/reference geometric means ratio for the parent compound, itraconazole, was in the range from 85.29% to 116.07% for AUC0-72h. Since the coefficient of variation (CV) for the reference product was 44.95% for Cmax, the 90% CI for this parameter for itraconazole was 93.49-133.78%, which was within the proposed limits of the EMA for bioequivalence of 72.15-138.59%. During the study, 4 subjects encountered a total of 14 mild adverse events. CONCLUSIONS: The use of the reference-scaling approach with 3-period design (TRR, RTR, and RRT) was an efficient way to demonstrate that two commercially available oral itraconazole formulations met the predetermined bioequivalence criteria.


Asunto(s)
Antifúngicos/administración & dosificación , Itraconazol/análogos & derivados , Itraconazol/administración & dosificación , Administración Oral , Adulto , Antifúngicos/farmacocinética , Área Bajo la Curva , Cápsulas , Estudios Cruzados , Femenino , Semivida , Humanos , Itraconazol/farmacocinética , Masculino , Persona de Mediana Edad , Equivalencia Terapéutica , Adulto Joven
11.
J Med Chem ; 61(9): 4135-4154, 2018 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-29648813

RESUMEN

We report the design, synthesis, and biological evaluation of some potent small-molecule neuropilin-1 (NRP1) antagonists. NRP1 is implicated in the immune response to tumors, particularly in Treg cell fragility, required for PD1 checkpoint blockade. The design of these compounds was based on a previously identified compound EG00229. The design of these molecules was informed and supported by X-ray crystal structures. Compound 1 (EG01377) was identified as having properties suitable for further investigation. Compound 1 was then tested in several in vitro assays and was shown to have antiangiogenic, antimigratory, and antitumor effects. Remarkably, 1 was shown to be selective for NRP1 over the closely related protein NRP2. In purified Nrp1+, FoxP3+, and CD25+ populations of Tregs from mice, 1 was able to block a glioma-conditioned medium-induced increase in TGFß production. This comprehensive characterization of a small-molecule NRP1 antagonist provides the basis for future in vivo studies.


Asunto(s)
Inmunomodulación/efectos de los fármacos , Neuropilina-1/antagonistas & inhibidores , Bibliotecas de Moléculas Pequeñas/farmacología , Linfocitos T Reguladores/efectos de los fármacos , Linfocitos T Reguladores/metabolismo , Factor de Crecimiento Transformador beta/biosíntesis , Inhibidores de la Angiogénesis/química , Inhibidores de la Angiogénesis/farmacología , Animales , Antineoplásicos/química , Antineoplásicos/farmacología , Línea Celular Tumoral , Diseño de Fármacos , Humanos , Ratones , Modelos Moleculares , Conformación Molecular , Ácidos Pentanoicos/química , Ácidos Pentanoicos/farmacología , Bibliotecas de Moléculas Pequeñas/química , Linfocitos T Reguladores/inmunología , Factor A de Crecimiento Endotelial Vascular/farmacología
12.
Sci Rep ; 8(1): 6282, 2018 04 19.
Artículo en Inglés | MEDLINE | ID: mdl-29674678

RESUMEN

Arsenic contamination of drinking water affects more than 140 million people worldwide. While toxic to humans, inorganic forms of arsenic (arsenite and arsenate), can be used as energy sources for microbial respiration. AioX and its orthologues (ArxX and ArrX) represent the first members of a new sub-family of periplasmic-binding proteins that serve as the first component of a signal transduction system, that's role is to positively regulate expression of arsenic metabolism enzymes. As determined by X-ray crystallography for AioX, arsenite binding only requires subtle conformational changes in protein structure, providing insights into protein-ligand interactions. The binding pocket of all orthologues is conserved but this alone is not sufficient for oxyanion selectivity, with proteins selectively binding either arsenite or arsenate. Phylogenetic evidence, clearly demonstrates that the regulatory proteins evolved together early in prokaryotic evolution and had a separate origin from the metabolic enzymes whose expression they regulate.


Asunto(s)
Aniones/análisis , Arsénico/análisis , Proteínas de Unión Periplasmáticas/química , Secuencia de Aminoácidos , Cristalografía por Rayos X , Familia de Multigenes , Proteínas de Unión Periplasmáticas/metabolismo , Filogenia , Conformación Proteica , Proteobacteria/clasificación , Proteobacteria/genética , Homología de Secuencia de Aminoácido , Especificidad por Sustrato
13.
FEBS J ; 285(7): 1290-1304, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29430837

RESUMEN

Neuropilin-1 (NRP1) is a transmembrane co-receptor involved in binding interactions with variety of ligands and receptors, including receptor tyrosine kinases. Expression of NRP1 in several cancers correlates with cancer stages and poor prognosis. Thus, NRP1 has been considered a therapeutic target and is the focus of multiple drug discovery initiatives. Vascular endothelial growth factor (VEGF) binds to the b1 domain of NRP1 through interactions between the C-terminal arginine of VEGF and residues in the NRP1-binding site including Tyr297, Tyr353, Asp320, Ser346 and Thr349. We obtained several complexes of the synthetic ligands and the NRP1-b1 domain and used X-ray crystallography and computational methods to analyse atomic details and hydration profile of this binding site. We observed side chain flexibility for Tyr297 and Asp320 in the six new high-resolution crystal structures of arginine analogues bound to NRP1. In addition, we identified conserved water molecules in binding site regions which can be targeted for drug design. The computational prediction of the VEGF ligand-binding site hydration map of NRP1 was in agreement with the experimentally derived, conserved hydration structure. Displacement of certain conserved water molecules by a ligand's functional groups may contribute to binding affinity, whilst other water molecules perform as protein-ligand bridges. Our report provides a comprehensive description of the binding site for the peptidic ligands' C-terminal arginines in the b1 domain of NRP1, highlights the importance of conserved structural waters in drug design and validates the utility of the computational hydration map prediction method in the context of neuropilin. DATABASE: The structures were deposited to the PDB with accession numbers PDB ID: 5IJR, 5IYY, 5JHK, 5J1X, 5JGQ, 5JGI.


Asunto(s)
Arginina/química , Neuropilina-1/química , Arginina/metabolismo , Sitios de Unión , Simulación por Computador , Cristalografía por Rayos X , Humanos , Hidrógeno/química , Ligandos , Modelos Biológicos , Estructura Molecular , Neuropilina-1/metabolismo , Resonancia por Plasmón de Superficie
14.
Structure ; 24(11): 2008-2015, 2016 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-27720589

RESUMEN

Neuropilins (NRPs) are single-pass transmembrane receptors involved in several signaling pathways that regulate key physiological processes such as vascular morphogenesis and axon guidance. The MAM domain of NRP, which has previously been implicated in receptor multimerization, was the only portion of the ectopic domain of the NRPs for which the structure, until now, has been elusive. Using site-directed mutagenesis in the linker region preceding the MAM domain we generated a protein construct amenable to crystallization. Here we present the crystal structure of the MAM domain of human NRP1 at 2.24 Å resolution. The protein exhibits a jellyroll topology, with Ca2+ ions bound at the inter-strand space enhancing the thermostability of the domain. We show that the MAM domain of NRP1 is monomeric in solution and insufficient to drive receptor dimerization, which leads us to propose a different role for this domain in the context of NRP membrane assembly and signaling.


Asunto(s)
Calcio/metabolismo , Mutagénesis Sitio-Dirigida/métodos , Neuropilina-1/química , Neuropilina-1/genética , Sitios de Unión , Cristalografía por Rayos X , Proteínas de Unión al ADN/metabolismo , Dimerización , Humanos , Modelos Moleculares , Neuropilina-1/metabolismo , Unión Proteica , Dominios Proteicos , Estructura Secundaria de Proteína , Factores de Transcripción/metabolismo
15.
Vojnosanit Pregl ; 73(3): 234-8, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27295906

RESUMEN

BACKGROUND/AIM: Benzodiazepines are among the most frequently ingested drugs in self-poisonings. Elderly may be at greater risk compared with younger individuals due to impaired metabolism and increased sensitivity to benzodiazepines. The aim of this study was to assess toxicity of benzodiazepines in elderly attempted suicide. METHODS: A retrospective study of consecutive presentations to hospital after self-poisoning with benzodiazepines was done. Collected data consisted of patient's characteristics (age, gender), benzodiazepine ingested with its blood concentrations at admission, clinical findings including vital signs and Glasgow coma score, routine blood chemistry, complications of poisoning, details of management, length of hospital stay and outcome. According the age, patients are classified as young (15-40-year old), middle aged (41-65-year old) and elderly (older than 65). RESULTS: During a 2-year observational period 387 patients were admitted because of pure benzodiazepine poisoning. The most frequently ingested drug was bromazepam, the second was diazepam. The incidence of coma was significantly higher, and the length of hospital stay significantly longer in elderly. Respiratory failure and aspiration pneumonia occurred more frequently in old age. Also, flumazenil was more frequently required in the group of elderly patients. CONCLUSION: Massive benzodiazepines overdose in elderly may be associated with a significant morbidity, including deep coma with aspiration pneumonia, respiratory failure, and even death. Flumazenil is indicated more often to reduce CNS depression and prevent complications of prolonged unconsciousness, but supportive treatment and proper airway management of comatose patients is the mainstay of the treatment of acute benzodiazepine poisoning.


Asunto(s)
Benzodiazepinas/envenenamiento , Coma/epidemiología , Sobredosis de Droga/epidemiología , Neumonía por Aspiración/epidemiología , Insuficiencia Respiratoria/epidemiología , Intento de Suicidio/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Antídotos/uso terapéutico , Bromazepam/envenenamiento , Estudios de Cohortes , Coma/inducido químicamente , Diazepam/envenenamiento , Sobredosis de Droga/tratamiento farmacológico , Femenino , Flumazenil/uso terapéutico , Humanos , Incidencia , Tiempo de Internación , Lorazepam/envenenamiento , Masculino , Persona de Mediana Edad , Neumonía por Aspiración/inducido químicamente , Insuficiencia Respiratoria/inducido químicamente , Estudios Retrospectivos , Serbia/epidemiología , Adulto Joven
16.
Vojnosanit Pregl ; 73(2): 146-51, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27071281

RESUMEN

BACKGOUND/AIM: Flumazenil is benzodiazepine receptor antagonist. It has been studied for a various indications, including reversal of sedation after surgery or diagnostic procedures, awakening of comatose patients in benzodiazepine overdose, or for symptomatic treatment of hepatic encephalopathy. Some drugs, like theophylline, may prolong its elimination half-life. Considering the long half-life of diazepam and its metabolites, concomitant use of theophylline may reduce the need for repeated dosing of flumazenil in patients with acute diazepam poisoning. The aim of this study was to introduce a reliable and accurate method for determining the concentration of flumazenil after therapeutic application in patients with acute poisoning, and using that method to assess whether the kinetics of flumazenil change in the presence of aminophylline (combination of theophylline and ethylenediamine in a 2:1 ratio) applied as concomitant therapy. METHODS: Blood samples from patients with acute diazepam poisoning that received flumazenil at the dose of 0.5 mg, or the same dose with 3 mg/kg of body weight of aminophylline, were collected 1, 3, 10, 30, 60, 120 and 240 min after its intravenous administration. Samples were prepared by solid-phase extraction on Oasis HLB cartridges with ethylacetate as extracting agens. Flumazenil was determined by liquid chromatography with mass spectrometry (LC-MS) in single ionmonitoring mode at m/z 304. Separation of flumazenil from matrix compound was performed on Lichrospher RP-8 column usingthe mixture of acidic acetonitrile and 20 mM of ammonium acetatein water (55 : 45) as a mobile phase. RESULTS: The applied analitycal method showed excellent recovery (94.65%). The obtained extracts were much cleaner than the extracts obtained by the sameextractant in the process of liquid-liquid extraction. The limit ofdetection of the LC-MS method described in this paper was 0.5 ng/mL and the limit of quantitation was 1 ng/mL. In the patientstreated with both flumazenil and aminophylline, the eliminationconstant for flumazenil was significantly lower and the elimination half-life was longer (p < 0.05) in comparison with the same parameters in.the patients who received flumazenil alone. CONCLUSION: The applied LC-MS method for the determination of flumazenil in serum samples of patients with acute diazepam poisoning is rapid, sensitive, precise and specific. Concomitant use with theophylline significantly prolonged elimination of flumazenil during the treatment of acute poisonings with diazepam.


Asunto(s)
Aminofilina/farmacocinética , Diazepam/efectos adversos , Sobredosis de Droga , Flumazenil , Antídotos/análisis , Antídotos/metabolismo , Antídotos/farmacocinética , Cromatografía Liquida , Precisión de la Medición Dimensional , Relación Dosis-Respuesta a Droga , Interacciones Farmacológicas , Sobredosis de Droga/tratamiento farmacológico , Sobredosis de Droga/etiología , Flumazenil/análisis , Flumazenil/sangre , Flumazenil/farmacocinética , Semivida , Humanos , Hipnóticos y Sedantes/efectos adversos , Espectrometría de Masas , Inhibidores de Fosfodiesterasa/farmacocinética , Reproducibilidad de los Resultados
17.
FEBS J ; 283(10): 1921-34, 2016 05.
Artículo en Inglés | MEDLINE | ID: mdl-26991001

RESUMEN

Neuropilin-2 is a transmembrane receptor involved in lymphangiogenesis and neuronal development. In adults, neuropilin-2 and its homologous protein neuropilin-1 have been implicated in cancers and infection. Molecular determinants of the ligand selectivity of neuropilins are poorly understood. We have identified and structurally characterized a zinc ion binding site on human neuropilin-2. The neuropilin-2-specific zinc ion binding site is located near the interface between domains b1 and b2 in the ectopic region of the protein, remote from the neuropilin binding site for its physiological ligand, i.e. vascular endothelial growth factor. We also present an X-ray crystal structure of the neuropilin-2 b1 domain in a complex with the C-terminal sub-domain of VEGF-A. Zn(2+) binding to neuropilin-2 destabilizes the protein structure but this effect was counteracted by heparin, suggesting that modifications by glycans and zinc in the extracellular matrix may affect functional neuropilin-2 ligand binding and signalling activity.


Asunto(s)
Neuropilina-2/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Zinc/metabolismo , Secuencia de Aminoácidos , Sitios de Unión , Cristalografía por Rayos X , Humanos , Neuropilina-2/química , Conformación Proteica , Homología de Secuencia de Aminoácido
18.
Glycoconj J ; 33(3): 387-97, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26059692

RESUMEN

Neuropilins are involved in angiogenesis and neuronal development. The membrane proximal domain of neuropilin-1, called c or MAM domain based on its sequence conservation, has been implicated in neuropilin oligomerization required for its function. The c/MAM domain of human neuropilin-1 has been recombinantly expressed to allow for investigation of its propensity to engage in molecular interactions with other protein or carbohydrate components on a cell surface. We found that the c/MAM domain was heavily O-glycosylated with up to 24 monosaccharide units in the form of disialylated core 1 and core 2 O-glycans. Attachment sites were identified on the chymotryptic c/MAM peptide ETGATEKPTVIDSTIQSEFPTY by electron-transfer dissociation mass spectrometry (ETD-MS/MS). For highly glycosylated species consisting of carbohydrate to about 50 %, useful results could only be obtained upon partial desialylation. ETD-MS/MS revealed a hierarchical order of the initial O-GalNAc addition to the four different glycosylation sites. These findings enable future functional studies about the contribution of the described glycosylations in neuropilin-1 oligomerization and the binding to partner proteins as VEGF or galectin-1.As a spin-off result the sialidase from Clostridium perfringens turned out to discriminate between galactose- and N-acetylgalactosamine-linked sialic acid.


Asunto(s)
Neuropilina-1/química , Procesamiento Proteico-Postraduccional , Acetilglucosamina/análogos & derivados , Acetilglucosamina/química , Acetilglucosamina/metabolismo , Glicosilación , Células HEK293 , Humanos , Neuropilina-1/metabolismo , Dominios Proteicos
19.
Vojnosanit Pregl ; 72(5): 405-13, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-26165047

RESUMEN

BACKGROUND/AIM: Based on numerous studies in animals, the most prominent toxic effects of decabrominated diphenyl ether (BDE-209) are observed in the liver, thyroid hormone homeostasis, reproductive and nervous systems. BDE-209 exhibits its toxic effects partly through the aryl hydrocarbon (Ah) receptor and consequent induction of hepatic microsomal enzymes. The aim of this study was to assess the hepatotoxic effect vs target tissue dose of BDE-209 in the subacutely orally exposed Wistar rats. METHODS: Effects were examined on male Wistar rats, weighing 200-240 g, exposed to doses of 1;000, 2,000 or 4,000 mg BDE-209/kg body weight (bw)/day by gavage during 28 days. Animals were treated according to the decision of the Ethics Committee of the Military Medical Academy, No 9667-1/2011. Evaluation of the hepatotoxic effect was based on: relative liver weight water and food intake, biochemical parameters of liver function [aspartate amino transferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gama glutamyl transferase (γ-GT)], and oxidative stress parameters in liver homogenates [malondialdehiyde (MDA), superoxide dismutase (SOD), -SH] and morphological and pathohistological changes in the liver. For the assessment of internal dose-response relationship, lower confidence limit of Benchmark dose (BMDL) of 5% or 10% i.e. BMDL5 or BMDL10, were calculated using PROAST software. RESULTS: After the application of 1,000,2,000 or 4,000 mg BDE-209/kg bw/day, the concentrations of BDE-209 measured in liver were 0.269, 0.569 and 0.859 mg/kg of liver wet weight, (ww) respectively. Internal doses correlated with external (r = 0.972; p < 0.05) according to equation: internal dose (mg BDE-209/kg of liver ww) = 0.0002 x external dose (mg/kg bw/day) + 0.0622. Hepatotoxicity was demonstrated based on significant increase in AST and γ-GT activities and the degree of histopathological changes. The lowest BMDLs of 0.07228 mg BDE-209 /kg of liver ww, correlating to external dose of 39 mg/kg/day, indicated the increase of AST activity as the most sensitive biomarker of BDE-209 hepatotoxicity in subacutely exposed rats. CONCLUSION: The results of the present work add up to the issue ofBDE-209 toxicity profile with a focus on relationship between internal dose and hepatotoxicity. Critical internal dose for the effect on AST of 0.07 mg/kg of liver ww, corresponding to external dose of 39 mg/kg/ day, is the lowest dose ever observed among the studies on BDE-209 hepatotoxicity. For the persistent substances with low absorption rate such as BDE-209, critical effect based on internal dose in majority of cases is considered as more precisely deined than the effect established based on external dose, particularly.


Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas , Éteres Difenilos Halogenados/toxicidad , Hígado/efectos de los fármacos , Estrés Oxidativo/efectos de los fármacos , Alanina Transaminasa/efectos de los fármacos , Alanina Transaminasa/metabolismo , Fosfatasa Alcalina/efectos de los fármacos , Fosfatasa Alcalina/metabolismo , Animales , Aspartato Aminotransferasas/efectos de los fármacos , Aspartato Aminotransferasas/metabolismo , Hígado/metabolismo , Hígado/patología , Malondialdehído/metabolismo , Ratas , Ratas Wistar , Superóxido Dismutasa/efectos de los fármacos , Superóxido Dismutasa/metabolismo , gamma-Glutamiltransferasa/efectos de los fármacos , gamma-Glutamiltransferasa/metabolismo
20.
J Clin Invest ; 124(9): 4039-51, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25105365

RESUMEN

The endothelium plays a fundamental role in maintaining vascular homeostasis by releasing factors that regulate local blood flow, systemic blood pressure, and the reactivity of leukocytes and platelets. Accordingly, endothelial dysfunction underpins many cardiovascular diseases, including hypertension, myocardial infarction, and stroke. Herein, we evaluated mice with endothelial-specific deletion of Nppc, which encodes C-type natriuretic peptide (CNP), and determined that this mediator is essential for multiple aspects of vascular regulation. Specifically, disruption of CNP leads to endothelial dysfunction, hypertension, atherogenesis, and aneurysm. Moreover, we identified natriuretic peptide receptor-C (NPR-C) as the cognate receptor that primarily underlies CNP-dependent vasoprotective functions and developed small-molecule NPR-C agonists to target this pathway. Administration of NPR-C agonists promotes a vasorelaxation of isolated resistance arteries and a reduction in blood pressure in wild-type animals that is diminished in mice lacking NPR-C. This work provides a mechanistic explanation for genome-wide association studies that have linked the NPR-C (Npr3) locus with hypertension by demonstrating the importance of CNP/NPR-C signaling in preserving vascular homoeostasis. Furthermore, these results suggest that the CNP/NPR-C pathway has potential as a disease-modifying therapeutic target for cardiovascular disorders.


Asunto(s)
Endotelio Vascular/fisiología , Homeostasis , Péptido Natriurético Tipo-C/fisiología , Animales , Aneurisma de la Aorta/etiología , Aterosclerosis/etiología , Plaquetas/fisiología , Presión Sanguínea , Calcio/metabolismo , Femenino , Leucocitos/fisiología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Músculo Liso Vascular/metabolismo , Ratas , Vasodilatación/efectos de los fármacos
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