RESUMO
Syntheses and evaluation of pyrrolidin-2-imines and 1,3-thiazolidin-2-imines as inhibitors of nitric oxide synthase (NOS) are discussed. An extensive SAR was established for pyrrolidin-2-imines class of compounds. The amidines came out as the most potent inhibitors in addition to displaying selectivity.
Assuntos
Inibidores Enzimáticos/química , Iminas/química , Óxido Nítrico Sintase/antagonistas & inibidores , Pirrolidinas/química , Tiazóis/química , Avaliação Pré-Clínica de Medicamentos/métodos , Inibidores Enzimáticos/farmacologia , Iminas/farmacologia , Óxido Nítrico Sintase/metabolismo , Pirrolidinas/farmacologia , Tiazóis/farmacologiaRESUMO
OBJECTIVE: To determine (1) the prevalence and nature of connexin 26 mutations in a cohort of Australian children with non-syndromic hearing loss, and (2) the carrier frequency of the common connexin 26 mutation (35delG) in the general population. DESIGN: A cohort, case-finding study. Mutation analysis was performed on DNA extracted from white blood cells, buccal cells, or Guthrie blood spots. SETTING: A hearing loss investigation clinic and a deafness centre in two Australian capital cities, 1 January 1998 to 31 October 2000. PARTICIPANTS: (1) 243 children (age range, 4 weeks to 16 years; median, 4 years), attending hearing loss clinics in Sydney and Melbourne; (2) 1000 blood samples obtained from anonymous Guthrie card blood spots collected in 1984 [corrected] by the Victorian Clinical Genetics Service as part of the newborn screening program. MAIN OUTCOME MEASURES: (1) The prevalence and types of connexin 26 mutations in a cohort of children with prelingual deafness; (2) the carrier frequency of the common connexin 26 mutation, 35delG, in the general population. RESULTS: Connexin 26 mutations were identified and characterised in 52 (21%) of the 243 children; 14 different mutations, including four previously unreported mutations (135S, C53R, T123N and R127C), were identified. The common 35delG mutation was found in 56 of the 104 alleles (ie, 86 of the connexin 26 alleles in which a mutation was positively identified). The mutations V371 and M34T were also relatively common. The carrier frequency of connexin 26 mutations and of the common 35delG connexin 26 mutation in the Victorian population was estimated to be 1 in 54 and 1 in 100, respectively. CONCLUSIONS: Mutations in the connexin 26 gene (especially the 35delG mutation) are a common cause of prelingual hearing loss in Australia.
Assuntos
Conexinas/genética , Perda Auditiva Neurossensorial/genética , Mutação , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Conexina 26 , Genótipo , Perda Auditiva Neurossensorial/classificação , Perda Auditiva Neurossensorial/epidemiologia , Heterozigoto , Humanos , Lactente , Fenótipo , Prevalência , Índice de Gravidade de DoençaRESUMO
Four hundred eighty-two adolescents who were diagnosed with at least one mental disorder were studied to determine the predictors of suicidal ideation and suicide attempts. Major depression was predictive of suicidal ideation and suicide attempts for both genders. Chronic stress was found predictive of male suicidal ideation, while low self-esteem and high family dysfunction were found to be predictive of suicidal ideation in females. Statistical trends suggest that females with comorbid alcohol use/conduct disorder were approximately three times more likely to have attempted suicide than those with only one of these conditions. Clinicians working with adolescents should be aware that, while depression remains the number one clinical risk forsuicidal behavior, risk factors for suicidal ideation may be different than those for attempted suicide and may vary by gender.
Assuntos
Alcoolismo/psicologia , Transtornos Mentais/psicologia , Tentativa de Suicídio/psicologia , Adolescente , Alcoolismo/diagnóstico , Comorbidade , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/diagnóstico , Determinação da Personalidade , Fatores de Risco , Autoimagem , Tentativa de Suicídio/prevenção & controleRESUMO
Tuberculosis (TB) remains a leading cause of infectious disease in the world today and therapies developed over the last forty years are becoming increasingly ineffective against resistant strains of Mycobacterium tuberculosis. In an effort to explore new mechanisms for drug development, we have investigated the enzymes of the diaminopimelate biosynthetic pathway as potential targets. Specifically, dihydrodipicolinate reductase, the essential gene product of dapB, was screened for novel inhibitors. Inhibitors were identified both by a molecular modeling approach which utilized the available crystal structure of the enzyme with an inhibitor bound at the active site as well as by more conventional screening strategies. The resulting compounds contain a number of structural motifs and were all found to be competitive with respect to the DHDP substrate. The K(i) values for the inhibitors range from 10 to 90 microM. The molecular modeling approach was very effective in identifying novel inhibitors of the enzyme. These compounds were obtained at a higher frequency based on the number of compounds analyzed than those inhibitors discovered via conventional screening. However, conventional screening proved beneficial in identifying compounds with greater structural diversity.
Assuntos
Antituberculosos/farmacologia , Proteínas de Bactérias/antagonistas & inibidores , Inibidores Enzimáticos/farmacologia , Mycobacterium tuberculosis/enzimologia , Oxirredutases atuantes sobre Doadores de Grupo CH-CH , Oxirredutases/antagonistas & inibidores , Sítios de Ligação/efeitos dos fármacos , Ácido Diaminopimélico/metabolismo , Di-Hidrodipicolinato Redutase , Desenho de Fármacos , Inibidores Enzimáticos/química , Ligação de Hidrogênio , Cinética , Modelos Moleculares , Estrutura Molecular , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/metabolismo , Conformação Proteica , Sulfonamidas/farmacologiaRESUMO
OBJECTIVE: The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item instrument designed by the World Health Organization to assess problematic drinking. The objective of this study was to conduct confirmatory factor analysis of the AUDIT in a sample of adolescents and young adults who were treated in emergency departments. METHOD: Adolescents and young adults (N= 103, 55 males), ranging in age from 12 to 20.9 years (mean [SD] age = 17.5 [2.1]), completed the AUDIT. Confirmatory factor analyses were conducted using LISREL 8.20 software to test the one-factor, two-factor and three-factor solutions for the AUDIT reported in the literature. RESULTS: Goodness-of-fit indices indicated that a correlated two-factor solution, consisting of a consumption factor and an alcohol-related-problems factor, provides the best fit to the data. The three-factor solution fits the data equally well, but Factor 2 (dependency) and Factor 3 (problems) correlate 1.00. The one-factor solution did not provide a good fit to the data. CONCLUSIONS: Our findings support those of others who have reported that the AUDIT assesses a consumption factor and an alcohol-related problems factor among primary care patients at risk for problematic drinking behavior.
Assuntos
Transtornos Induzidos por Álcool/epidemiologia , Tratamento de Emergência/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Adulto , Distribuição de Qui-Quadrado , Criança , Análise Fatorial , Feminino , Humanos , MasculinoRESUMO
A series of substituted 2-aminopyridines was prepared and evaluated as inhibitors of human nitric oxide synthases (NOS). 4,6-Disubstitution enhanced both potency and specificity for the inducible NOS with the most potent compound having an IC50 of 28 nM.
Assuntos
Aminopiridinas/síntese química , Inibidores Enzimáticos/síntese química , Óxido Nítrico Sintase/antagonistas & inibidores , Aminopiridinas/farmacologia , Inibidores Enzimáticos/farmacologia , Humanos , Relação Estrutura-AtividadeRESUMO
BACKGROUND: Major depression and suicide are associated with fewer serotonin transporter (5-HTT) sites. The 5'-flanking promoter region of the 5-HTT gene has a biallelic insertion/deletion (5-HTTLPR). We assayed prefrontal cortical (PFC) 5-HTT binding in major depression and suicide and examine the relationship to the 5-HTTLPR allele. METHODS: Postmortem brain samples from 220 individuals were genotyped for the 5-HTTLPR polymorphism. Binding of 5-HTT was assayed by quantitative autoradiography in the PFC of a subset of subjects (n = 159). Clinical information, including DSM-III-R Axis I diagnoses, was obtained by psychological autopsy and medical chart review. RESULTS: Binding to 5-HTT was lower in the ventral PFC of suicides compared with nonsuicides and was lower throughout the PFC of subjects with a history of major depression. The 5-HTTLPR genotype was associated with major depression but not with suicide or 5-HTT binding. CONCLUSIONS: A diffuse reduction of 5-HTT binding in the PFC of individuals with major depression may reflect a widespread impairment of serotonergic function consistent with the range of psychopathologic features in major depression. The localized reduction in 5-HTT binding in the ventral PFC of suicides may reflect reduced serotonin input to that brain region, underlying the predisposition to act on suicidal thoughts. The 5-HTTLPR genotype was not related to the level of 5-HTT binding and does not explain why 5-HTT binding is lower in major depression or suicide. Arch Gen Psychiatry. 2000;57:729-738
Assuntos
Proteínas de Transporte/genética , Transtorno Depressivo/genética , Glicoproteínas de Membrana/genética , Proteínas de Membrana Transportadoras , Proteínas do Tecido Nervoso , Polimorfismo Genético , Córtex Pré-Frontal/metabolismo , Regiões Promotoras Genéticas/genética , Serotonina/genética , Suicídio/estatística & dados numéricos , Adulto , Autorradiografia , Proteínas de Transporte/metabolismo , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Expressão Gênica , Genótipo , Humanos , Masculino , Glicoproteínas de Membrana/metabolismo , Transtornos Mentais/diagnóstico , Transtornos Mentais/genética , Pessoa de Meia-Idade , Serotonina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina , Fatores Sexuais , Suicídio/psicologiaRESUMO
OBJECTIVE: Suicidal behavior is highly prevalent in borderline personality disorder and major depressive episode, although the characteristics of suicide attempts in the two disorders are believed to differ. Comorbidity of borderline personality disorder and major depressive episode may obscure characteristics of suicide attempts that are uniquely related to the psychopathology of each disorder. We compared suicidal behavior in patients with borderline personality disorder, major depressive episode, and borderline personality disorder plus major depressive episode to determine whether characteristics of suicide attempts differed between groups and if aspects of core psychopathology predicted specific attempt characteristics. METHOD: Eighty-one inpatients with borderline personality disorder, including 49 patients with borderline personality disorder plus major depressive episode, were compared to 77 inpatients with major depressive episode alone on measures of depressed mood, hopelessness, impulsive aggression, and suicidal behavior, including lifetime number of attempts, degree of lethal intent, objective planning, medical damage, and degree of violence of suicide methods. RESULTS: No significant differences were found in the characteristics of suicide attempts between patients with borderline personality disorder and those with major depressive episode. However, patients with both disorders had the greatest number of suicide attempts and the highest level of objective planning. An increase in either impulsive aggression or hopelessness or a diagnosis of borderline personality disorder predicted a greater number of attempts. Hopelessness predicted lethal intent in all three groups and predicted objective planning in the group with both disorders. Medical damage resulting from the most serious lifetime suicide attempt was predicted by number of attempts. CONCLUSIONS: Comorbidity of borderline personality disorder with major depressive episode increases the number and seriousness of suicide attempts. Hopelessness and impulsive aggression independently increase the risk of suicidal behavior in patients with borderline personality disorder and in patients with major depressive episode.
Assuntos
Transtorno da Personalidade Borderline/psicologia , Transtorno Depressivo/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Agressão/psicologia , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Comorbidade , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Hospitalização , Humanos , Comportamento Impulsivo/diagnóstico , Comportamento Impulsivo/epidemiologia , Comportamento Impulsivo/psicologia , Masculino , Pessoa de Meia-Idade , Prevalência , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Fatores de RiscoRESUMO
BACKGROUND: Impulsive aggression in patients with personality disorders is associated with diminished levels of cerebrospinal fluid (CSF) 5-HIAA, blunted neuroendocrine responses to serotonergic agonists, and decreased glucose utilization in the prefrontal cortex. We tested the hypothesis that impulsive aggression in borderline personality disorder (BPD) may be associated with diminished serotonergic regulation in the prefrontal cortex, using positron-emission tomography (PET) neuroimaging during pharmacologic challenge with d,l fenfluramine (FEN). METHODS: A 2-day, single-blind, placebo-controlled FEN challenge study was conducted in five patients with BPD (and no Axis I MDD) and eight healthy control participants. On Day 1, 4 mCi [(18)F]-fluorodeoxyglucose (FDG) was injected 3 hours after ingestion of placebo; on Day 2, FDG was injected 3 hours after ingestion of.8 mg/kg to 60 mg of d,l fenfluramine. After 30 min, a 45-min emission scan was acquired on the Siemans/CTI 951r/31 scanner. PET data were aligned to MR images and analyzed by Statistical Parametric Mapping (SPM96). RESULTS: In response to placebo, uptake of FDG was greater in control participants than patients in large areas of the prefrontal cortex including medial and orbital regions bilaterally (BA 10-11), left superior temporal gyrus, and right insular cortex. There were no areas in which patients had greater relative regional uptake than control participants. In response to FEN, relative regional uptake of FDG (relative to placebo) was greater in control participants compared to patients in medial and orbital regions of right prefrontal cortex (BA 10), left middle and superior temporal gyri (BA 22-23), left parietal lobe (BA 40), and left caudate body. CONCLUSIONS: Patients with BPD have diminished response to serotonergic stimulation in areas of prefrontal cortex associated with regulation of impulsive behavior.
Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Encéfalo/metabolismo , Fenfluramina/farmacocinética , Fluordesoxiglucose F18/metabolismo , Compostos Radiofarmacêuticos/metabolismo , Inibidores Seletivos de Recaptação de Serotonina/farmacocinética , Tomografia Computadorizada de Emissão , Adolescente , Adulto , Transtorno da Personalidade Borderline/metabolismo , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Comportamento Impulsivo/diagnóstico , Comportamento Impulsivo/metabolismo , Masculino , Pessoa de Meia-Idade , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/metabolismo , Método Simples-CegoRESUMO
This study investigated the impact of recent life events and social adjustment on suicide attempter status in 34 patients with major depression, 24 patients with borderline personality disorder, and 22 patients with co-morbid major depression and borderline personality disorder. Suicide attempters reported more recent life events and scored lower on a measure of social adjustment in their families and overall social adjustment, compared with non-attempters. Borderline disordered and borderline or depressed patients were more likely to have attempted suicide than patients with major depression only. Recent life events did not predict attempter status. Lower social adjustment in the immediate family and lower overall social adjustment were predictive of suicide attempter classification, regardless of diagnosis. Borderline disordered patients low on overall social adjustment were over 16 times more likely to have attempted suicide than patients diagnosed with major depression only. Recent life events may elevate suicide risk in groups already at high risk for suicide completion, whereas high levels of social adjustment may be protective against stress-related suicidal behavior.
Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Acontecimentos que Mudam a Vida , Ajustamento Social , Tentativa de Suicídio/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Transtorno da Personalidade Borderline/psicologia , Transtorno Depressivo Maior/psicologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Inquéritos e Questionários , Fatores de TempoRESUMO
To examine the role of axonal ion deregulation in acute spinal cord injury (SCI), white matter strips from guinea pig spinal cord were incubated in vitro and were subjected to graded focal compression injury. At several postinjury times, spinal segments were removed from incubation and rapidly frozen. X-ray microanalysis was used to measure percent water and dry weight elemental concentrations (mmol/kg) of Na, P, Cl, K, Ca, and Mg in selected morphological compartments of myelinated axons and neuroglia from spinal cord cryosections. As an index of axon function, compound action potentials (CAP) were measured before compression and at several times thereafter. Axons and mitochondria in epicenter of severely compressed spinal segments exhibited early (5 min) increases in mean Na and decreases in K and Mg concentrations. These elemental changes were correlated to a significant reduction in CAP amplitude. At later postcompression times (15 and 60 min), elemental changes progressed and were accompanied by alterations in compartmental water content and increases in mean Ca. Swollen axons were evident at all postinjury times and were characterized by marked element and water deregulation. Neuroglia and myelin in severely injured epicenter also exhibited significant disruptions. In shoulder areas (adjacent to epicenter) of severely injured spinal strips, axons and mitochondria exhibited modest increases in mean Na in conjunction with decreases in K, Mg, and water content. Following moderate compression injury to spinal strips, epicenter axons exhibited early (10 min postinjury) element and water deregulation that eventually recovered to near control values (60 min postinjury). Na(+) channel blockade by tetrodotoxin (TTX, 1 microM) perfusion initiated 5 min after severe crush diminished both K loss and the accumulation of Na, Cl, and Ca in epicenter axons and neuroglia, whereas in shoulder regions TTX perfusion completely prevented subcellular elemental deregulation. TTX perfusion also reduced Na entry in swollen axons but did not affect K loss or Ca gain. Thus graded compression injury of spinal cord produced subcellular elemental deregulation in axons and neuroglia that correlated with the onset of impaired electrophysiological function and neuropathological alterations. This suggests that the mechanism of acute SCI-induced structural and functional deficits are mediated by disruption of subcellular ion distribution. The ability of TTX to reduce elemental deregulation in compression-injured axons and neuroglia implicates a significant pathophysiological role for Na(+) influx in SCI and suggests Na(+) channel blockade as a pharmacotherapeutic strategy.
Assuntos
Axônios/fisiologia , Água Corporal/metabolismo , Eletrólitos/metabolismo , Neuroglia/fisiologia , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/fisiopatologia , Medula Espinal/metabolismo , Oligoelementos/metabolismo , Animais , Axônios/efeitos dos fármacos , Axônios/metabolismo , Cobaias , Técnicas In Vitro , Neuroglia/efeitos dos fármacos , Neuroglia/metabolismo , Medula Espinal/fisiopatologia , Compressão da Medula Espinal/metabolismo , Compressão da Medula Espinal/fisiopatologia , Tetrodotoxina/farmacologia , Fatores de TempoRESUMO
Genes coding for homologs of the highly conserved cell division protein FtsZ were isolated from Bartonella henselae and Bartonella quintana, the causative agents of cat scratch disease and trench fever, respectively. DNA fragments coding for the ftsZ open reading frames (ORFs) were cloned into Escherichia coli following PCR amplification with primers based on the ftsZ sequence of the closely related species Bartonella bacilliformis. The amino acid sequences predicted from the cloned B. henselae and B. quintana ftsZ ORFs are 81 to 83% identical to the corresponding protein in B. bacilliformis. Like the FtsZ protein of B. bacilliformis, the B. henselae and B. quintana homologs are about twice as large as the FtsZ proteins reported in most other organisms. Localized sequence differences within the C-terminal coding regions of the Bartonella ftsZ genes were used as the basis for species-specific identification of these organisms at both the DNA and protein levels. Oligonucleotide primers which permit the amplification of an ftsZ fragment from each of the Bartonella species without amplifying DNA from the other two species were designed. Anti-FtsZ antisera raised in rabbits against synthetic peptides corresponding to the relatively divergent C-terminal regions were shown via Western blot analysis to react only with the FtsZ protein from the cognate Bartonella species. These observations raise the possibility that the differences in ftsZ sequences can be used as the basis for diagnostic tests to differentiate among these closely related pathogens.
Assuntos
Proteínas de Bactérias/genética , Bartonella/classificação , Doença da Arranhadura de Gato/diagnóstico , Proteínas do Citoesqueleto , Febre das Trincheiras/diagnóstico , Sequência de Aminoácidos , Animais , Proteínas de Bactérias/química , Proteínas de Bactérias/imunologia , Proteínas de Bactérias/isolamento & purificação , Bartonella/genética , Bartonella henselae/classificação , Bartonella henselae/genética , Bartonella quintana/classificação , Bartonella quintana/genética , Sequência de Bases , Western Blotting , Clonagem Molecular , DNA Bacteriano/isolamento & purificação , Dados de Sequência Molecular , Fases de Leitura Aberta , Reação em Cadeia da Polimerase , Coelhos , Alinhamento de Sequência , Análise de Sequência de DNA , Especificidade da EspécieRESUMO
OBJECTIVE: To describe 15 patients examined for hypocalcemia, skeletal disease, or both in whom the diagnosis of celiac disease was subsequently made. DESIGN: Observational case series. PATIENTS: Fifteen patients (7 women and 8 men) were examined for hypocalcemia (n = 11), skeletal disease (n = 3), or both (n = 1). The diagnosis of celiac disease was subsequently made. The mean age of the patients was 62 years, and 11 patients were 60 years of age or older. RESULTS: Four patients had no gastrointestinal symptoms, 7 patients had mild or intermittent gastrointestinal symptoms, and 4 patients had persistent diarrhea. Ten patients had experienced weight loss. The serum total alkaline phosphatase level was elevated in 10 of 15 patients, the parathyroid hormone level was elevated in all patients, and the urinary calcium level was low in all 6 of the patients tested. The level of 25-hydroxyvitamin D was frankly low in 4 patients, marginal in 8 patients, and normal in 3 patients. Bone mineral density was reduced in all 8 patients in whom it was measured. CONCLUSIONS: Celiac disease should be considered in patients with unexplained metabolic bone disease or hypocalcemia, especially because gastrointestinal symptoms may be absent or mild. Advanced age does not exclude the diagnosis of celiac disease.
Assuntos
Doenças Ósseas Metabólicas/etiologia , Doença Celíaca/diagnóstico , Hipocalcemia/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/fisiopatologia , Doença Celíaca/sangue , Doença Celíaca/complicações , Doença Celíaca/fisiopatologia , Diagnóstico Diferencial , Feminino , Humanos , Hipocalcemia/sangue , Hipocalcemia/fisiopatologia , Masculino , Pessoa de Meia-IdadeRESUMO
The effect of the potassium channel blocker, 4-aminopyridine (4-AP), on conduction of action potentials in injured guinea pig spinal cord axons was measured using isolated tracts in oxygenated Krebs' solution at 37 degrees C. The dose-response characteristics of acutely and chronically injured axons were compared. The maximal improvement of conduction occurred in acutely injured axons at a concentration of 100 microM 4-AP, but in chronically injured spinal cord at 10 microM. The threshold for significant response to 4-AP was between 0.5 and 1 microM in chronically injured cords, and between 1 and 10 microM following acute compression injury. The difference in susceptibility to potassium channel blockade may be related to underlying differences in the mechanism of conduction block at the two stages of injury. Initially, junctions between axons and myelin are acutely disrupted, altering primarily the leakage resistance of the myelin sheath and periaxonal space. In chronically injured cords, there is widespread but incomplete process of repair in the lesion site, which leaves many axons partially myelinated. The difference in sensitivity to 4-AP suggests there is also some modification of the accessibility of axonal potassium channel or a change in their affinity for the drug.
Assuntos
4-Aminopiridina/farmacologia , Potenciais de Ação/efeitos dos fármacos , Condução Nervosa/fisiologia , Traumatismos da Medula Espinal/fisiopatologia , Medula Espinal/fisiopatologia , Doença Aguda , Animais , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Cobaias , Técnicas In Vitro , Condução Nervosa/efeitos dos fármacos , Medula Espinal/efeitos dos fármacos , Medula Espinal/fisiologiaRESUMO
Psychological autopsies are an important research tool in establishing risk factors associated with suicide. We report the results of a validity study comparing psychological autopsy-generated DSM-III-R diagnoses in suicides and non-suicides with chart diagnoses generated by clinicians who had treated the subjects prior to death. The Structured Clinical Interview for DSM-III-R Disorders (SCID-P) and the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) were used to make independent post-mortem diagnoses. Comparison of research diagnoses with clinician ante-mortem diagnoses generated kappa coefficients of 0.85 for Axis I diagnoses and 0.65 for Axis II conditions. These kappa coefficients compare favourably with direct patient interview reliability studies. This provides evidence for the validity of the psychological autopsy as a method of determining psychiatric diagnosis.
Assuntos
Transtornos Mentais/diagnóstico , Equipe de Assistência ao Paciente , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Suicídio/psicologia , Acidentes/psicologia , Adolescente , Adulto , Idoso , Morte Súbita , Feminino , Homicídio/psicologia , Humanos , Masculino , Transtornos Mentais/classificação , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Variações Dependentes do Observador , Transtornos da Personalidade/classificação , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia , Psicometria , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
Recombinant human inducible nitric-oxide synthase (rH-iNOS) was expressed in the baculovirus system and purified by a novel immunoaffinity column. rH-iNOS and its native counterpart from cytokine-stimulated primary hepatocytes exhibited similar molecular mass of 130 kDa on SDS-polyacrylamide gel electrophoresis, recognition by antipeptide antibodies, specific activities, and IC50 values for inhibitors. The active dimeric form exhibited a specific activity range of 114-260 nmol/min/mg at 37 degrees C and contained 1.15 +/- 0.04 mol of calmodulin/monomer. The enzyme exhibited a Soret lambdamax at 396 nm with a shoulder at 460 nm and contained 0. 28-0.64 mol of heme/monomer. Dithionite reduction under CO yielded an absorbance maximum at 446 nm, indicating a P450-type heme. Imidazole induced a type II difference spectrum, reversible by L-Arg. 2-Amino-5,6-dihydro-4H-1,3-thiazine (ADT) was competitive versus L-Arg (Ki = 22.6 +/- 1.9 nM), reversed the type II difference spectrum induced by imidazole (Kd = 17.7 nM), and altered the CO-ferrous absorbance of rH-iNOS. L-Arg did not perturb the CO-ferrous adduct directly, but it partially reversed the ADT-induced absorbance shift, indicating that both bind similarly to the protein but interact differently with the heme.
Assuntos
Óxido Nítrico Sintase/metabolismo , Protetores contra Radiação/farmacologia , Tiazinas/farmacologia , Cromatografia Líquida de Alta Pressão , Indução Enzimática , Humanos , Cinética , NADP/metabolismo , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizRESUMO
The mechanism by which carcinoembryonic antigen (CEA) causes enhancement of hepatic metastasis from colorectal cancer is not defined. We hypothesize that binding of CEA to an 80-kDa Kupffer cell receptor by the peptide sequence Pro-Glu-Leu-Pro-Lys (PELPK) induces cytokine production in the hepatic microenvironment, which then impacts on the formation of hepatic metastasis from colorectal cancer. We have, therefore, isolated Kupffer cells and treated them in vitro with CEA, its gene family member nonspecific cross-reacting antigen, PELPK-albumin conjugate, and lipopolysaccharide as a positive control. Spent media was examined for the content of cytokines interleukin (IL) 1alpha, IL-1beta, IL-6, and tumor necrosis factor alpha using the ELISA. Simultaneously, mRNA was extracted from the same cells and amplified using reverse transcription-PCR to evaluate the induction of specific cytokine transcripts. As expected, lipopolysaccharide stimulated cytokine production. CEA, nonspecific cross-reacting antigen, and PELPK-albumin induced secretion of all of the cytokines tested; the response was higher in general with PELPK-albumin. The levels of cytokine mRNA showed a similar profile. These responses were not seen when a similar but irrelevant peptide conjugate PELGK-albumin was used. These results demonstrate that binding of the peptide PELPK to the 80-kDa receptor results in the release of a series of cytokines that have the potential to activate hepatic sinusoidal endothelium. This may explain CEA-induced enhancement of experimental hepatic metastasis.
Assuntos
Antígeno Carcinoembrionário/farmacologia , Glicoproteínas/farmacologia , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Células de Kupffer/metabolismo , Fragmentos de Peptídeos/farmacologia , Fator de Necrose Tumoral alfa/metabolismo , Animais , Antígenos CD , Moléculas de Adesão Celular , Neoplasias Colorretais/patologia , Humanos , Lipopolissacarídeos/farmacologia , Neoplasias Hepáticas/secundário , Camundongos , Camundongos Endogâmicos BALB C , RNA Mensageiro/metabolismoRESUMO
Nitric oxide synthase catalyzes the pyridine nucleotide-dependent oxidation of L-arginine to nitric oxide and L-citrulline. It is a specialized cytochrome P450 monooxygenase that is sensitive to inhibition by imidazole. Steady-state kinetic studies on recombinant human inducible nitric oxide synthase (rH-iNOS) demonstrate that imidazole and 1-phenylimidazole are competitive and reversible inhibitors versus L-arginine. Structure-activity relationship and pH dependence studies on the inhibition suggest that the neutral form of imidazole may be the preferred species and that the only modifications allowed without the loss of inhibition are at the N-1 position of imidazole. Optical spectrophotometric studies of rH-iNOS with imidazole and 1-phenylimidazole yielded type II difference spectra exhibiting Kd values of 63 +/- 2 and 28 +/- 3 microM, respectively. These values were in good agreement with the steady-state Ki of 95 +/- 10 and 38 +/- 4 microM, respectively, and confirms the site of binding is at the sixth axial ligand of the heme. Imidazole (2.2 mM) also perturbed the Kd of L-arginine from 3.03 +/- 0.45 to 209 +/- 10 microM. The observed increase in the Kd for L-arginine is consistent with imidazole being a competitive inhibitor versus L-arginine. The IC50 values of imidazole and 1-phenylimidazole were lower in the absence of exogenous BH4, and both inhibitors also competitively inhibited the BH4-dependent activation of the enzyme. These data taken together suggest that the L-arginine, dioxygen, and the BH4 binding sites are in close proximity in rH-iNOS. Furthermore, these studies demonstrate the usefulness of imidazole compounds as active site probes for recombinant human iNOS.
Assuntos
Inibidores Enzimáticos/farmacologia , Imidazóis/farmacologia , Óxido Nítrico Sintase/química , Arginina/análogos & derivados , Arginina/metabolismo , Sítios de Ligação , Biopterinas/análogos & derivados , Biopterinas/farmacologia , Inibidores Enzimáticos/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Imidazóis/metabolismo , Isoenzimas/metabolismo , Cinética , Estrutura Molecular , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/metabolismo , Nitroarginina , Proteínas Recombinantes/química , Espectrofotometria , Relação Estrutura-AtividadeRESUMO
Resistance to the capacity of insulin to suppress lipolysis may be an important link in the association between abdominal obesity and hypertension. Furthermore, a more active renin-angiotensin system in adipose tissue may contribute to insulin-resistant lipolysis in abdominally obese hypertensive subjects. We determined nonesterified fatty acid concentrations and turnover as well as lipid oxidation under basal conditions and during steady-state euglycemia with two levels of insulinemia (72 and 287 pmol/L) in lean normotensive, abdominally obese normotensive, and abdominally obese hypertensive subjects. To assess the role of the renin-angiotensin system in determining non-esterified fatty acid turnover, we repeated studies in the abdominally obese hypertensive subjects after double-blind random assignment to placebo or enalapril for 1 month each. The main findings were the following: (1) Nonesterified fatty acid flux was significantly higher in abdominally obese hypertensive subjects at both levels of insulinemia than in either abdominally obese normotensive or lean normotensive subjects and correlated significantly with both mean blood pressure and total systemic resistance during the higher level of insulinemia. (2) Enalapril significantly improved insulin-resistant lipolysis in the abdominally obese hypertensive subjects. The improvement in insulin suppressibility of nonesterified fatty acid flux at the high hormonal concentrations correlated positively with the magnitude of reduction in blood pressure. (3) Basal lipid oxidation and suppression in response to insulin were similarly impaired in both obese groups. Resistance to the antilipolytic actions of insulin is thus a characteristic feature in abdominally obese hypertensive subjects and may be linked to the elevated blood pressure in these individuals. A more active renin-angiotensin system may partly explain the insulin-resistant lipolysis in this form of hypertension.
Assuntos
Hipertensão/fisiopatologia , Resistência à Insulina , Lipólise , Obesidade/fisiopatologia , Sistema Renina-Angiotensina/fisiologia , Adulto , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Constituição Corporal , Índice de Massa Corporal , Calorimetria Indireta , Interpretação Estatística de Dados , Enalapril/uso terapêutico , Ácidos Graxos não Esterificados/metabolismo , Feminino , Hemodinâmica , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/metabolismo , Insulina/sangue , Masculino , Obesidade/complicações , Obesidade/metabolismo , PlacebosRESUMO
The receptor-mediated interaction of Kupffer cells with carcinoembryonic antigen (CEA) has led to the identification of an 80-kDa CEA-binding Kupffer cell protein. This study is aimed at the isolation and analyses of this protein from rat Kupffer cells. The binding protein was purified using a combination of gel filtration, preparative polyacrylamide gel electrophoresis (PPAGE), and affinity chromatography using a CEA-Sepharose column. Fractions obtained from the gel filtration produced two major and few minor peaks with CEA-binding activity. Maximum reactivity was detected in the first major peak. The first major peak protein was partially precipitated following fractionation with 30% loss of activity in the precipitate. Fractions with CEA-binding activity were pooled and separated on the basis of molecular weight (MW) in PPAGE. The fractions between MW 70 and 90 kDa were pooled and affinity purified using CEA-Sepharose affinity chromatography. The purity of the 80-kDa protein was demonstrated by a single protein band on SDS-polyacrylamide gel. The protein was further identified by an anti-80-kDa binding protein antibody in Western blot analysis. The pI of the 80-kDa protein is 4.95. Amino acid analysis demonstrated no histidine; higher percentages of glutamine (13.3%), leucine (11.2%), asparagine and alanine (10.4%), and lysine (9.2%) were observed. Protein microsequencing revealed two unique sequences, one with 16 amino acids and the other with 11 amino acids. The 16-amino-acid sequence has less than 50% homology with a large sample of unrelated proteins, whereas the sequence containing 11 amino acids has 60-70% homology with the alpha chain of collagen from a variety of species but no significant homology with other known proteins, suggesting the presence of collagen-like domains in the 80-kDa receptor.