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1.
Behav Brain Res ; 320: 457-463, 2017 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-27789343

RESUMO

The brain could be exposed to irradiation as part of a nuclear accident, radiological terrorism (dirty bomb scenario) or a medical radiological procedure. In the context of accidents or terrorism, there is considerable interest in compounds that can mitigate radiation-induced injury when treatment is initiated a day or more after the radiation exposure. As it will be challenging to determine the radiation exposure an individual has received within a relatively short time frame, it is also critical that the mitigating agent does not negatively affect individuals, including emergency workers, who might be treated, but who were not exposed. Alterations in hippocampus-dependent cognition often characterize radiation-induced cognitive injury. The catalytic ROS scavenger EUK-207 is a member of the class of metal-containing salen manganese (Mn) complexes that suppress oxidative stress, including in the mitochondria, and have been shown to mitigate radiation dermatitis, promote wound healing in irradiated skin, and mitigate vascular injuries in irradiated lungs. As the effects of EUK-207 against radiation injury in the brain are not known, we assessed the effects of EUK-207 on sham-irradiated animals and the ability of EUK-207 to mitigate radiation-induced cognitive injury. The day following irradiation or sham-irradiation, the mice started to receive EUK-207 and were cognitively tested 3 months following exposure. Mice irradiated at a dose of 15Gy showed cognitive impairments in the water maze probe trial. EUK-207 mitigated these impairments while not affecting cognitive performance of sham-irradiated mice in the water maze probe trial. Thus, EUK-207 has attractive properties and should be considered an ideal candidate to mitigate radiation-induced cognitive injury.


Assuntos
Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/etiologia , Compostos Organometálicos/uso terapêutico , Lesões Experimentais por Radiação/complicações , Análise de Variância , Animais , Condicionamento Psicológico/efeitos dos fármacos , Relação Dose-Resposta à Radiação , Medo/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Superóxido Dismutase/metabolismo , Tirosina/análogos & derivados , Tirosina/metabolismo
2.
Radiat Res ; 176(5): 636-48, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21854211

RESUMO

Skin exposure to ionizing radiation affects the normal wound healing process and greatly impacts the prognosis of affected individuals. We investigated the effect of ionizing radiation on wound healing in a rat model of combined radiation and wound skin injury. Using a soft X-ray beam, a single dose of ionizing radiation (10-40 Gy) was delivered to the skin without significant exposure to internal organs. At 1 h postirradiation, two skin wounds were made on the back of each rat. Control and experimental animals were euthanized at 3, 7, 14, 21 and 30 days postirradiation. The wound areas were measured, and tissue samples were evaluated for laminin 332 and matrix metalloproteinase (MMP) 2 expression. Our results clearly demonstrate that radiation exposure significantly delayed wound healing in a dose-related manner. Evaluation of irradiated and wounded skin showed decreased deposition of laminin 332 protein in the epidermal basement membrane together with an elevated expression of all three laminin 332 genes within 3 days postirradiation. The elevated laminin 332 gene expression was paralleled by an elevated gene and protein expression of MMP2, suggesting that the reduced amount of laminin 332 in irradiated skin is due to an imbalance between laminin 332 secretion and its accelerated processing by elevated tissue metalloproteinases. Western blot analysis of cultured rat keratinocytes showed decreased laminin 332 deposition by irradiated cells, and incubation of irradiated keratinocytes with MMP inhibitor significantly increased the amount of deposited laminin 332. Furthermore, irradiated keratinocytes exhibited a longer time to close an artificial wound, and this delay was partially corrected by seeding keratinocytes on laminin 332-coated plates. These data strongly suggest that laminin 332 deposition is inhibited by ionizing radiation and, in combination with slower keratinocyte migration, can contribute to the delayed wound healing of irradiated skin.


Assuntos
Moléculas de Adesão Celular/metabolismo , Lesões Experimentais por Radiação/metabolismo , Pele/lesões , Pele/efeitos da radiação , Animais , Membrana Basal/efeitos da radiação , Membrana Basal/ultraestrutura , Moléculas de Adesão Celular/genética , Movimento Celular/efeitos da radiação , Epiderme/patologia , Queratinócitos/citologia , Queratinócitos/metabolismo , Queratinócitos/efeitos da radiação , Masculino , Metaloproteinase 2 da Matriz/biossíntese , Metaloproteinase 2 da Matriz/genética , Transporte Proteico/efeitos da radiação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Lesões Experimentais por Radiação/genética , Lesões Experimentais por Radiação/patologia , Lesões Experimentais por Radiação/fisiopatologia , Ratos , Pele/metabolismo , Pele/fisiopatologia , Regulação para Cima/efeitos da radiação , Cicatrização/efeitos da radiação , Calinina
3.
Neurogastroenterol Motil ; 22(8): 919-26, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20529206

RESUMO

BACKGROUND: Radiation increases the frequency of small intestinal and colonic giant migrating contractions (GMCs). These contractions contribute to the diarrhea and cramping after radiation therapy and are coordinated with one another across the ileocolonic (IC) junction. METHODS: We investigated the coordination of contractile activity between the small intestine, cecum and colon in five canines following circumferential myotomy on the ileum at the IC junction and compared it to intact animals. Studies were performed before and during a radiation schedule. KEY RESULTS: Myotomy increased the frequency of small intestinal GMCs prior to irradiation. In intact animals, the duration and amplitude of cecal GMCs decreased when multiple contractions occurred in rapid succession. This is in contrast to small intestinal and colonic GMCs and suggests a different mechanism of propagation for GMCs within the cecum. Ileal myotomy dramatically decreased the frequency of propagating radiation-induced colonic GMCs. The total number of colonic GMCs was not altered. Colonic contractile activity was disrupted in intact animals during irradiation. However, after ileal myotomy, irradiation did not affect the pattern of colonic contractile states. Diarrhea in irradiated animals with myotomy started earlier than intact animals. This may be related to the frequency of small intestinal GMCs. CONCLUSIONS & INFERENCES: Our findings suggest importance of the enteric neural connections at the IC region to contractile disorders of both the small and large intestine. The anatomic relationship between the canine IC junction is similar to the human ileo-appendiceal-colonic region and surgical manipulations of this area may likewise affect human contractile activity.


Assuntos
Ceco/efeitos da radiação , Colo/efeitos da radiação , Motilidade Gastrointestinal , Intestino Delgado/efeitos da radiação , Contração Muscular , Complexo Mioelétrico Migratório , Animais , Ceco/fisiologia , Colo/fisiologia , Cães , Motilidade Gastrointestinal/fisiologia , Motilidade Gastrointestinal/efeitos da radiação , Humanos , Intestino Delgado/fisiologia , Contração Muscular/fisiologia , Contração Muscular/efeitos da radiação , Complexo Mioelétrico Migratório/fisiologia , Complexo Mioelétrico Migratório/efeitos da radiação
4.
Curr Drug Targets ; 11(11): 1423-9, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20583975

RESUMO

Radiation nephropathy and other normal tissue radiation injuries can be successfully mitigated, and also treated, by antagonists of the renin-angiotensin system (RAS). This implies a mechanistic role for that system in radiation nephropathy, yet no evidence exists to date of activation of the RAS by irradiation. RAS antagonists, including angiotensin converting enzyme inhibitors and angiotensin receptor blockers, are the standard of care in the treatment of subjects with other chronic progressive kidney diseases, in which they exert benefit by reducing both glomerular and tubulo-interstitial injury. These drugs are likely to act in a similar way to mitigate radiation nephropathy.


Assuntos
Antagonistas de Receptores de Angiotensina/farmacologia , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Nefropatias/tratamento farmacológico , Nefropatias/etiologia , Lesões por Radiação/tratamento farmacológico , Sistema Renina-Angiotensina/efeitos dos fármacos , Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Animais , Humanos , Rim/efeitos dos fármacos , Rim/efeitos da radiação , Nefropatias/prevenção & controle , Lesões por Radiação/prevenção & controle
5.
Int J Radiat Oncol Biol Phys ; 74(1): 192-9, 2009 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-19362237

RESUMO

PURPOSE: To study vascular injury after whole thoracic irradiation with single sublethal doses of X-rays in the rat and to develop markers that might predict the severity of injury. METHODS AND MATERIALS: Rats that received 5- or 10-Gy thorax-only irradiation and age-matched controls were studied at 3 days, 2 weeks, and 1, 2, 5, and 12 months. Several pulmonary vascular parameters were evaluated, including hemodynamics, vessel density, total lung angiotensin-converting enzyme activity, and right ventricular hypertrophy. RESULTS: By 1 month, the rats in the 10-Gy group had pulmonary vascular dropout, right ventricular hypertrophy, increased pulmonary vascular resistance, increased dry lung weights, and decreases in total lung angiotensin-converting enzyme activity, as well as pulmonary artery distensibility. In contrast, irradiation with 5 Gy resulted in only a modest increase in right ventricular weight and a reduction in lung angiotensin-converting enzyme activity. CONCLUSION: In a previous investigation using the same model, we observed that recovery from radiation-induced attenuation of pulmonary vascular reactivity occurred. In the present study, we report that deterioration results in several vascular parameters for

Assuntos
Pulmão/efeitos da radiação , Artéria Pulmonar/efeitos da radiação , Veias Pulmonares/efeitos da radiação , Lesões Experimentais por Radiação/patologia , Animais , Peso Corporal/efeitos da radiação , Feminino , Hematócrito , Hipertrofia Ventricular Direita/etiologia , Pulmão/irrigação sanguínea , Pulmão/enzimologia , Lesão Pulmonar , Doses de Radiação , Lesões Experimentais por Radiação/enzimologia , Ratos , Renina/metabolismo , Tórax/efeitos da radiação , Resistência Vascular/efeitos da radiação
6.
Curr Pharm Des ; 13(13): 1317-25, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17506717

RESUMO

Radiation nephropathy has emerged as a significant complication of bone marrow transplantation and radionuclide radiotherapy, and is a potential sequela of radiological terrorism and radiation accidents. In the early 1990's, it was demonstrated that experimental radiation nephropathy could be treated with a thiol-containing ACE inhibitor, captopril. Further studies have shown that enalapril (a non-thiol ACE inhibitor) is also effective in the treatment of experimental radiation nephropathy, as are both AII type-1 (AT(1)) and type-2 (AT(2)) receptor antagonists. ACE inhibitors and AII receptor antagonists are also effective in the mitigation (prevention) of radiation nephropathy. Other types of antihypertensive drugs are ineffective in mitigation, but brief use of a high-salt diet in the immediate post-irradiation period significantly decreases renal injury. There are differences between mitigation and treatment of radiation nephropathy that imply that different mechanisms are operating. First, a high-salt diet is effective in the mitigation of radiation nephropathy, but deleterious on the treatment of established disease. Second, AT(1) blockade is more effective than ACE inhibition for mitigation of radiation nephropathy, but equally effective for treatment. Third, the efficacy of AT(1) blockade and ACE inhibition is highly dependent on drug dose in mitigation of radiation nephropathy, but not so in treatment. Finally, while AT(2) blockade augments the benefit of AT(1) blockade in mitigation of radiation nephropathy, it does not do so in treatment. We hypothesize that while mitigation of radiation nephropathy works by suppression of the renin-angiotensin system, treatment of established radiation nephropathy requires blood pressure control in addition to (or possibly instead of) suppression of the renin-angiotensin system.


Assuntos
Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Nefropatias/tratamento farmacológico , Nefropatias/metabolismo , Lesões por Radiação/tratamento farmacológico , Receptor Tipo 1 de Angiotensina/metabolismo , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Animais , Humanos , Nefropatias/patologia , Lesões por Radiação/metabolismo , Lesões por Radiação/patologia , Protetores contra Radiação/farmacologia , Protetores contra Radiação/uso terapêutico , Receptores de Angiotensina/metabolismo , Sistema Renina-Angiotensina/efeitos dos fármacos , Sistema Renina-Angiotensina/fisiologia
8.
Int J Radiat Biol ; 81(3): 189-203, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16019928

RESUMO

There have been reports in the media and claims in the courts that radiofrequency (RF) emissions from mobile phones are a cause of cancer, and there have been numerous public objections to the siting of mobile phone base antennas because of a fear of cancer. This review summarizes the current state of evidence concerning whether the RF energy used for wireless communication might be carcinogenic. Relevant studies were identified by searching MedLine with a combination of exposure and endpoint terms. This was supplemented by a review of the over 1700 citations assembled by the Institute of Electrical and Electronics Engineers (IEEE) International Committee on Electromagnetic Safety as part of their updating of the IEEE C95.1 RF energy safety guidelines. Where there were multiple studies, preference was given to recent reports, to positive reports of effects and to attempts to confirm such positive reports. Biophysical considerations indicate that there is little theoretical basis for anticipating that RF energy would have significant biological effects at the power levels used by modern mobile phones and their base station antennas. The epidemiological evidence for a causal association between cancer and RF energy is weak and limited. Animal studies have provided no consistent evidence that exposure to RF energy at non-thermal intensities causes or promotes cancer. Extensive in vitro studies have found no consistent evidence of genotoxic potential, but in vitro studies assessing the epigenetic potential of RF energy are limited. Overall, a weight-of-evidence evaluation shows that the current evidence for a causal association between cancer and exposure to RF energy is weak and unconvincing. However, the existing epidemiology is limited and the possibility of epigenetic effects has not been thoroughly evaluated, so that additional research in those areas will be required for a more thorough assessment of the possibility of a causal connection between cancer and the RF energy from mobile telecommunications.


Assuntos
Neoplasias Encefálicas/etiologia , Telefone Celular , Neoplasias Induzidas por Radiação/etiologia , Ondas de Rádio/efeitos adversos , Animais , Análise por Conglomerados , Estudos de Coortes , Epigênese Genética , Humanos , Testes de Mutagenicidade , Exposição Ocupacional , Medição de Risco
9.
Int J Radiat Biol ; 80(1): 3-10, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14761845

RESUMO

PURPOSE: Events of the recent past have focused attention on the possibility of radiological (nuclear) terrorism and on the implications of such terrorist threats for radiation accident preparedness. This review discusses recent advances in the knowledge about how radiation injuries from such events might be treated pharmacologically, and the practical barriers to clinical utilization of these approaches. CONCLUSIONS: A wide range of pharmacological approaches are being developed in the laboratory that could greatly expand the ability to treat acute and chronic radiation injuries. However, there are currently a variety of practical and legal barriers that would prevent the actual clinical use of most of the approaches. There are also the potential weaknesses in most of the current programmes for dealing with the consequences of radiation accidents or nuclear terrorism, including the absence of widespread radiation biodosimetry capabilities and the resulting inability to triage. If a major radiation accident or terrorist event occurs, the lack of biodosimetry and treatment capabilities will be compounded by widespread public fear of 'radiation'.


Assuntos
Guerra Nuclear , Lesões por Radiação/tratamento farmacológico , Lesões por Radiação/prevenção & controle , Liberação Nociva de Radioativos , Medição de Risco/métodos , Terrorismo , Anormalidades Induzidas por Radiação/diagnóstico , Anormalidades Induzidas por Radiação/tratamento farmacológico , Anormalidades Induzidas por Radiação/etiologia , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Antioxidantes/uso terapêutico , Doenças da Medula Óssea/diagnóstico , Doenças da Medula Óssea/tratamento farmacológico , Doenças da Medula Óssea/etiologia , Catarata/diagnóstico , Catarata/tratamento farmacológico , Catarata/etiologia , Doença Crônica , Citocinas/uso terapêutico , Gastroenteropatias/diagnóstico , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/etiologia , Humanos , Legislação de Medicamentos , Seleção de Pacientes , Pentoxifilina/uso terapêutico , Padrões de Prática Médica/legislação & jurisprudência , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Cinza Radioativa/efeitos adversos , Radiometria/métodos , Insuficiência Renal/diagnóstico , Insuficiência Renal/tratamento farmacológico , Insuficiência Renal/etiologia , Insuficiência Respiratória/diagnóstico , Insuficiência Respiratória/tratamento farmacológico , Insuficiência Respiratória/etiologia , Lesões dos Tecidos Moles/diagnóstico , Lesões dos Tecidos Moles/tratamento farmacológico , Lesões dos Tecidos Moles/etiologia , Resultado do Tratamento , Triagem/métodos
10.
Curr Pharm Des ; 9(9): 737-49, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12570791

RESUMO

Radiation nephropathy has emerged as a major complication of bone marrow transplantation (BMT) when total body irradiation (TBI) is used as part of the regimen. Classically, radiation nephropathy has been assumed to be inevitable, progressive, and untreatable. However, in the early 1990's, it was demonstrated that experimental radiation nephropathy could be treated with a thiol-containing ACE inhibitor, captopril. Further studies showed that enalapril (a non-thiol ACE inhibitor) was also effective in the treatment of experimental radiation nephropathy, as was an AII receptor antagonist. Studies also showed that ACE inhibitors and AII receptor antagonists were effective in the prophylaxis of radiation nephropathy. Interestingly, other types of antihypertensive drugs were ineffective in prophylaxis, but brief use of a high-salt diet in the immediate post-irradiation period decreased renal injury. A placebo-controlled trial of captopril to prevent BMT nephropathy in adults is now underway. Since excess activity of the renin-angiotensin system (RAS) causes hypertension, and hypertension is a major feature of radiation nephropathy; an explanation for the efficacy of RAS antagonism in the prophylaxis of radiation nephropathy would be that radiation leads to RAS activation. However, current studies favor an alternative explanation, namely that the normal activity of the RAS is deleterious in the presence of radiation injury. On-going studies suggest that efficacy of RAS antagonists may involve interactions with a radiation-induced decrease in renal nitric oxide activity or with radiation-induced tubular cell proliferation. We hypothesize that while prevention (prophylaxis) of radiation nephropathy with ACE inhibitors, AII receptor antagonists, or a high-salt diet work by suppression of the RAS, the efficacy of ACE inhibitors and AII receptor antagonists in treatment of established radiation nephropathy depends on blood pressure control.


Assuntos
Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Transplante de Medula Óssea/efeitos adversos , Nefropatias/tratamento farmacológico , Nefropatias/etiologia , Rim/efeitos da radiação , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Animais , Humanos , Rim/efeitos dos fármacos , Rim/patologia , Nefropatias/patologia , Receptores de Angiotensina/fisiologia
11.
Int J Radiat Biol ; 78(10): 903-11, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12465655

RESUMO

PURPOSE: To determine whether suppression of the renin-angiotensin system (RAS) with high dietary sodium (salt) has the same beneficial effect on radiation nephropathy as suppression of the RAS with angiotensin-converting-enzyme (ACE) inhibitors or angiotensin II (AII) receptor antagonists. MATERIALS AND METHODS: Normal and irradiated rats were placed on high- or low-salt diets and assessed for effects on blood pressure, on AII levels and on the development of radiation nephropathy. RESULTS: In unirradiated animals, a high-salt diet suppressed AII and caused hypertension, while a low-salt diet produced no detectable effects. Use of a high-salt diet 3-9 weeks after irradiation exacerbated radiation-induced hypertension but attenuated the development of radiation nephropathy. Continuous use of a high-salt diet slowed the progression of radiation nephropathy, but eventually exacerbated radiation-induced hypertension and accelerated renal failure. Use of a high-salt diet in animals with established radiation nephropathy was deleterious. A low-salt diet had no effect on the development of radiation nephropathy. CONCLUSIONS: These studies provide further support for the hypothesis that the beneficial effect of AII receptor antagonists, ACE inhibitors and high dietary sodium in the prophylaxis of radiation nephropathy is due to their suppression of the RAS, not to their anti-hypertensive effects.


Assuntos
Dieta Hipossódica , Rim/lesões , Rim/efeitos da radiação , Cloreto de Sódio/farmacologia , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina/farmacologia , Animais , Transplante de Medula Óssea , Relação Dose-Resposta a Droga , Masculino , Ratos , Sistema Renina-Angiotensina , Fatores de Tempo
12.
Exp Biol Med (Maywood) ; 226(11): 1016-23, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11743137

RESUMO

Nephropathy, interstitial pneumopathy, and renal and lung fibrosis are major complications of bone marrow transplantation (BMT). This study evaluated the antifibrotic property of an angiotensin II (A2) type-1 receptor blocker (L-159,809) and compared it with those of Captopril and Enalapril, two angiotensin-converting enzyme (ACE) inhibitors, in a rat model of BMT. Male WAG/Rij/MCW rats received a preparative regimen of 60 mg/kg body wt of cytoxan (i.p., Days 9 and 8) and 18.5 Gy of total body irradiation (TBI) in six twice daily fractions (Days 2, 1, and 0) followed immediately (Day 0) by BMT. Modifiers were given in drinking water from Day 10 until autopsy, 8 weeks after BMT. Rats treated with TBI plus cytoxan alone developed severe nephropathy. Trichrome staining showed marked collagen deposition in glomeruli, renal interstitium, and renal arteries and arterioles (especially in their adventitia). Collagen deposition and renal damage were markedly reduced by the three modifiers. Of the three, L-158,809-treated rats had slightly thinner vessels and slightly less collagen than nonirradiated normal controls. The study shows the effectiveness of these drugs in the protection of the renal parenchyma from the development of radiation-induced fibrosis. It also indicates a role for angiotensin II in the modulation of collagen synthesis.


Assuntos
Antagonistas de Receptores de Angiotensina , Anti-Hipertensivos/uso terapêutico , Transplante de Medula Óssea , Fibrose/prevenção & controle , Imidazóis/uso terapêutico , Nefropatias/prevenção & controle , Radioterapia/efeitos adversos , Tetrazóis/uso terapêutico , Aldosterona/sangue , Animais , Captopril/uso terapêutico , Modelos Animais de Doenças , Enalapril/uso terapêutico , Inibidores Enzimáticos/uso terapêutico , Masculino , Ratos , Fatores de Tempo
14.
Nephron ; 89(3): 271-3, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11598388

RESUMO

Subtotal or total parathyroidectomy is sometimes required for the management of severe secondary or tertiary hyperparathyroidism. Advances in medical and dialysis care may have a beneficial effect on hyperphosphatemia and vitamin D status, which could, in turn, reduce the need for parathyroidectomy. We used the United States Renal Data System to test this hypothesis. We found that the percentage of prevalent end-stage renal disease patients undergoing subtotal or total parathyroidectomy has declined significantly from 1988 to 1998. It is likely that improved medical and dialysis care has enabled this result.


Assuntos
Falência Renal Crônica/terapia , Paratireoidectomia/tendências , Bases de Dados como Assunto , Humanos , Falência Renal Crônica/cirurgia , Paratireoidectomia/estatística & dados numéricos , Diálise Renal/estatística & dados numéricos , Estados Unidos
15.
Bone Marrow Transplant ; 27(4): 451-6, 2001 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-11313676

RESUMO

Chronic renal failure is an acknowledged late complication of BMT. It is related to the intensive chemotherapy, radiation and supporting medications. Polymorphism in the angiotensin converting enzyme (ACE) gene is associated with progression of nephropathy caused by diabetes and IgA nephropathy. We sought to determine whether ACE genotype and other clinical factors were associated with loss of renal function after BMT. We determined the genotype of 106 adult allogeneic BMT recipients, who received a similar preparative regimen, survived 1 year, and had assessment of renal function up to 3 years after BMT. We found that the distribution of genotypes was similar to the general population; 29%, 51%, and 20% for the DD, DI, and II genotypes, respectively. There was no statistical difference in patient survival between the three groups. Among all patients, the average creatinine clearance declined from 124 (95% CI 117, 131) to 89 (95% CI 78, 100) ml/min over the 36 months after BMT. Decline in renal function over time was less for patients with the DD compared to the II genotype (P = 0.040). Renal function in patients with the DD genotype was also better than those with the DI genotype, but this was of borderline statistical significance (P = 0.055). Renal shielding reduced decline in renal function compared to no shielding (P = 0.026). We conclude that the ACE genotype does not seem to influence survival, but the DD genotype may be protective against renal injury after BMT. Furthermore, we confirm that renal shielding during TBI reduces the renal injury after BMT.


Assuntos
Transplante de Medula Óssea/efeitos adversos , Peptidil Dipeptidase A/genética , Insuficiência Renal/etiologia , Adolescente , Adulto , Estudos de Coortes , Creatina/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Polimorfismo Genético , Insuficiência Renal/enzimologia , Insuficiência Renal/genética , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
16.
Radiat Res ; 155(5): 734-9, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11302771

RESUMO

Datta, P. K., Moulder, J. E., Fish, B. L., Cohen, E. P. and Lianos, E. A. Induction of Heme Oxygenase 1 in Radiation Nephropathy: Role of Angiotensin II. Radiat. Res. 155, 734-739 (2001). In a rat model of radiation-induced nephropathy, we investigated changes in expression of heme oxygenase 1 (Hmox1, also known as HO-1), an enzyme that catalyzes conversion of heme into biliverdin, carbon monoxide and iron. The study explored whether radiation induces Hmox1 expression in the irradiated kidney and whether angiotensin II (AII) mediates Hmox1 expression in glomeruli isolated from irradiated kidneys. To assess the effects of radiation on Hmox1 expression, rats received 20 Gy bilateral renal irradiation and were randomized to groups receiving an AII type 1 (AT(1)) receptor antagonist (L-158,809) or no treatment. Drug treatment began 9 days prior to bilateral renal irradiation and continued for the duration of the study. Estimation of Hmox1 levels in glomerular protein lysates assessed by Western blot analysis revealed a significant increase in Hmox1 protein at 50 and 65 days postirradiation. In animals treated with the AT(1) receptor antagonist, there was no induction of Hmox1, suggesting that AII may be a mediator of Hmox1 induction. To confirm that AII stimulates Hmox1 expression, animals were infused with 200, 400 or 800 ng/kg min(-1) of AII for 18-19 days, and Hmox1 protein levels in glomeruli were assessed. There was a significant induction of Hmox1 in glomeruli of animals infused with 800 ng/kg min(-1) of AII. These studies demonstrate that glomerular Hmox1 expression is elevated in the middle phase of radiation nephropathy and that AII can increase glomerular Hmox1 levels.


Assuntos
Angiotensina II/fisiologia , Heme Oxigenase (Desciclizante)/biossíntese , Nefropatias/enzimologia , Rim/efeitos da radiação , Animais , Pressão Sanguínea/efeitos da radiação , Indução Enzimática , Heme Oxigenase-1 , Imidazóis/farmacologia , Nefropatias/fisiopatologia , Ratos , Tetrazóis/farmacologia , Fator de Crescimento Transformador beta/fisiologia
17.
Radiat Res ; 155(3): 474-80, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11182799

RESUMO

Renal irradiation leads predictably to glomerular vascular injury, cell lysis, matrix accumulation, sclerosis and loss of renal function. The immediate effects of renal irradiation that may be associated with glomerular pathology and proteinuria are not clear in the human disease or its rat model. We hypothesized that radiation-induced injury causes immediate and subtle alterations in glomerular physiology independent of the neurohumoral and hemodynamic regulatory mechanisms. We employed a sensitive in vitro functional assay of glomerular albumin permeability (P(alb)) to demonstrate radiation-induced damage to the glomerular filtration barrier immediately after total-body irradiation of rats. In blinded experiments, control rats were sham-treated, and experimental rats received 9.5 Gy X rays. Rats were killed humanely at 1 h to 9 weeks after irradiation and glomeruli were isolated. In parallel experiments, glomeruli were isolated from normal rats and irradiated in vitro. The change in glomerular capillary permeability due to an experimental oncotic gradient was determined using videomicroscopy and P(alb) was calculated. Results show that in vivo or in vitro irradiation of glomeruli caused an increased P(alb) at 1 h. Increased P(alb) was observed up to 3 weeks after irradiation. Glomeruli from mice irradiated with 9.5 or 19.0 Gy X rays did not show increased P(alb) at 1 h postirradiation. We conclude that glomerular protein permeability of irradiated rats increases in a dose-dependent manner immediately after irradiation and that it appears to be independent of hemodynamic or systemic influences.


Assuntos
Albuminas/metabolismo , Glomérulos Renais/efeitos da radiação , Lesões Experimentais por Radiação/diagnóstico , Animais , Glomérulos Renais/metabolismo , Masculino , Permeabilidade , Lesões Experimentais por Radiação/metabolismo , Lesões Experimentais por Radiação/fisiopatologia , Ratos , Irradiação Corporal Total
18.
Radiat Res ; 153(5 Pt 2): 613-6, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10790283

RESUMO

In the United States, public concern that exposure to power-line fields was linked to cancer led to the establishment of a Congressionally mandated program, the Electric and Magnetic Fields Research and Public Information Dissemination (EMF-RAPID) Program. A major goal of the program was to "determine whether or not exposures to electric and magnetic fields produced by the generation, transmission, and use of electrical energy affect human health". Between 1994 and 1998, the EMF-RAPID program spent approximately $41 million on biological research. Much of the work funded by the EMF-RAPID program has not yet been published in the peer-reviewed literature. The U.S. National Institute of Environmental Health Sciences (NIEHS) asked that Radiation Research publish this special issue in an attempt to remedy this publication gap. The issue includes reviews of studies that were done to assess the biological plausibility of claims that power-frequency fields caused leukemia and breast cancer. The issue continues with two teratology studies and one immunology study. The section of the issue covering in vitro studies begins with an overview of the efforts NIEHS made to replicate a wide range of reported effects of power-frequency fields and continues with four papers reporting the absence of effects of power-frequency fields on the expression of stress-response genes and oncogenes. Other reports of in vitro studies and studies of mechanisms cover cytotoxicity, gap junction intracellular communication, calcium ion transport across the plasma membrane, and intracellular electric fields.


Assuntos
Neoplasias da Mama/etiologia , Defesa do Consumidor , Campos Eletromagnéticos/efeitos adversos , Exposição Ambiental/efeitos adversos , Leucemia/etiologia , Animais , Testes de Carcinogenicidade , Relação Dose-Resposta à Radiação , Instalação Elétrica , Feminino , Programas Governamentais/legislação & jurisprudência , Humanos , Masculino , Testes de Mutagenicidade , Educação de Pacientes como Assunto/organização & administração , Apoio à Pesquisa como Assunto/organização & administração , Estados Unidos
19.
Int J Radiat Biol ; 76(4): 523-32, 2000 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10815633

RESUMO

PURPOSE: This report summarizes our experiences on the protective effect of angiotensin-converting enzyme (ACE) inhibitors, especially captopril and an angiotensin II type 1 receptor blocker on radiation-induced pulmonary injury. METHOD: In the first series of experiments, adult male Sprague Dawley rats were given a single dose of either 20 or 30 Gy of gamma rays to a 35 cm2 right hemithorax port, whilst shielding the left, contralateral, lung. Perfusion scans and autopsies were performed at intervals up to 12 months post-radiation. Three different ACE inhibitors, penicillamine and pentoxifylline were given as radiation protectors and their activity compared. A model of irradiation for total bone marrow transplant (BMT) was used for the second group of experiments. Male WAC/Rij/MCW rats received total-body irradiation and a regimen of cyclophosphamide (CTX) in preparation for bone marrow transplant. The modifiers were two ACE inhibitors, captopril and enalapril, and L-158,809, an angiotensin II (A II) type 1 receptor blocker. All drugs were administered in the rats' drinking water and all were well-tolerated. RESULTS: In the irradiated rats, pulmonary damage progressed from the presence of blebs and detachment from basement membranes of endothelial cells a few days after injury, to severe arteritis and interstitial collagen deposition at 3 months, and then on to severe pneumonitis and extensive pulmonary fibrosis at 6 months. Marked increase of hydroxyproline was also found in the lungs at 6 months. These morphological changes were associated with significant decrease of ACE and plasminogen activator activity (PLA) and a marked increase of prostaglandins (PG12) and thromboxane (Txa2), substances considered as indicators of endothelial pulmonary damage. ACE inhibitors captopril, CL 24817, enalapril and CGS 13945 prevented the markers of endothelial dysfunction. Captopril and CL 24817, which contain a sulphydryl (-SH) radical in their moiety and the AII type 1 receptor blocker, L-158,809, were the most efficient in protecting the lung parenchyma from the inflammatory response and subsequent fibrosis. Penicillamine, an SH-containing compound with weak ACE inhibitory activity was also a strong antifibrotic agent but showed only modest anti-inflammatory properties. Additionally, in the irradiated rats, captopril also reduced the incidence of squamous cell skin carcinomas and subcutaneous sarcomas consequent to the highest doses of radiation. CONCLUSION: ACE inhibitors and one AII type 1 receptor blocker were effective in protecting lungs from radiation-induced pneumonitis and the development of lung fibrosis in two models of rat radiation injury. In the first series of experiments (unilateral irradiation), those ACE inhibitors containing a sulphydryl radical were more effective than those without it. This observation led to the question of whether this protective effect is related to inhibition of AII synthesis or rather to some of the collateral pharmacologic properties of these drugs, such as anti-oxidation or protease inhibition. The AII receptor blocker, however, was shown to be equally effective, if not better, in its antifibrotic capacity than any ACE inhibitor with or without an SH radical, reaffirming the role of AII in modulation of collagen synthesis.


Assuntos
Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Fibrose Pulmonar/prevenção & controle , Lesões Experimentais por Radiação/prevenção & controle , Pneumonite por Radiação/prevenção & controle , Animais , Transplante de Medula Óssea , Masculino , Ratos , Ratos Sprague-Dawley
20.
Int J Radiat Oncol Biol Phys ; 47(2): 481-8, 2000 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-10802376

RESUMO

PURPOSE: We evaluate whether magnetic resonance imaging (MRI) with blood oxygenation level-dependent (BOLD) contrast correctly predicts the relative effects of tumor-oxygenating agents on hypoxic fraction in BA1112 rhabdomyosarcomas in WAG/Rij rats. METHODS AND MATERIALS: The response of ten tumors to carbogen (95% O(2)/5% CO(2)), a perfluorocarbon emulsion (PFC), and the combination of PFC + carbogen was studied with high spectral and spatial resolution MR imaging of the water resonance at 4.7 Tesla. Decreases in MR signal linewidth indicate increases in tumor blood oxygen levels. RESULTS: Average MR signal linewidth was decreased 2.0% by carbogen, 2.5% by PFC + air, and 4.9% by PFC + carbogen. PFC + carbogen caused a larger linewidth decrease than either treatment alone (p < 0.04 by ANOVA). Maps of pixels responding to treatment indicate that combining PFC with carbogen significantly enlarges the area of the tumor in which oxygen levels are increased (p < 0.01 by ANOVA). CONCLUSION: MRI predicts that PFC + carbogen will increase radiosensitivity more than either treatment alone; this agrees with the known effects of these treatments on hypoxic fraction. Utilizing MRI to choose the treatment that maximizes the size and extent of increases in tumor oxygenation could reduce hypoxic fraction.


Assuntos
Dióxido de Carbono/uso terapêutico , Fluorocarbonos/uso terapêutico , Imageamento por Ressonância Magnética/métodos , Oxigênio/sangue , Oxigênio/uso terapêutico , Radiossensibilizantes/uso terapêutico , Rabdomiossarcoma/sangue , Animais , Pressão Sanguínea/efeitos dos fármacos , Hipóxia Celular/efeitos dos fármacos , Transplante de Neoplasias , Radiobiologia , Ratos , Rabdomiossarcoma/fisiopatologia , Células Tumorais Cultivadas
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