Cytomegalovirus and Toxoplasma gondii seroprevalence in a Brazilian liver transplant waiting

Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplantation. Disseminated toxoplasmosis after liver transplantation is a rare but fatal event. Serologic screening of the donor and the recipient is essential to prophylactic management, early diagnosis and therapeutic strategies to minimize the consequences of these infections. The aim of the present study was to determine the seroprevalence of CMV and Toxoplasma gondii (TG) in a Brazilian liver transplant waiting list (LTWL). Serological data were collected from 44 candidates on the LTWL between May 2003 and November 2004. Serological investigation of antibodies IgM and IgG against CMV (anti-CMV) and TG (anti-T. gondii) was performed using fluorometry commercial kits. IgG anti-CMV was positive in 37 patients (94.9 percent) out of 39 available results. There were not IgM anti-CMV positive results. Out of 36 analyzed patients, 22 (61.1 percent) presented positive IgG anti-T. gondii and none had positive IgM anti-T. gondii. The high CMV seroprevalence among our LTWL reinforces the need for appropriate protocols to avoid related complications, like reactivation and superinfection by CMV. Environmental and drug prophylactic strategies against primary infection and reactivation, as well as early diagnosis and treatment of toxoplasmosis complications, are essential for the good outcome of transplant patients.

Serologic profile in hepatitis B virus and hepatitis C virus in a Brazilian liver transplant waiting list.

UNLABELLED: Chronic viral hepatitis is currently the most common indication for liver transplantation (OLT). Knowing the serological profile of patients on the liver transplant waiting list (LTWL) is essential to manage prophylactic and therapeutic strategies pre- and post-OLT. The aim of this study was to determine the hepatitis B virus (HBV) and hepatitis C virus (HCV) serological profile on the LTWL. METHODS: Serological data were collected from 44 candidates included on the LTWL from May 2003 to November 2004. HBV and HCV serological profiles were performed by microenzyme immunoassay. RESULTS: Twenty-eight patients (66.7%) lacked HBV serological markers. Anti-HBs was detected in 9.5% and was positive for HBsAg, anti-HBc, IgM anti-HBc, or HbeAg in 4.8% of patients, probably related to reactivation of chronic infection. In 7.1% of patients, the markers demonstrated serological cure of infection. In HCV patients, 41.5% were positive. There was HBV and HCV co-infection in 12.2% of patients. CONCLUSION: HBV infection in 21.4% of the patients corroborates the need to use more efficient protocols for prophylactic and therapeutic management pre- and post-OLT. The high prevalence of HCV infection reinforces the need to follow adequate protocols to avoid related complications and guarantee rational and universal use of more efficient drugs.

Donor and recipient pretransplant conditioning with nonlethal radiation and antilymphocyte serum improves the graft survival in a rat small bowel transplant model.

BACKGROUND: Lymphoid tissue within the intestinal graft require immunomodulatory strategies to prevent graft versus host disease (GVHD) after transplant. Herein, we evaluate the potential advantage of donor-specific bone marrow infusions in donor and or recipient preconditioned with total body irradiation and or antilymphocyte serum (ALS) on the incidence of GVHD and rejection after small bowel transplantation. METHODS: Heterotopic SBTx was performed from DA to Lewis rats and distributed in nine groups: control group G0 (n=4) and G1 (n=6) without irradiation; recipients in G2 (n=4) were given 400 rd although in groups 3 (n=5), G4 (n=6), G6 (n=5), G7 (n=5), and G8 (n=6) with 250 rd. Donors in G5 (n=4) and G6 were given 250 rd of total body irradiation 2 hours before intestinal retrieval. Donors and recipients in G7 and donors in G8 additionally received ALS (day -5). G1, 2, 3, 5, 6, 7, and 8 were infused with UDBM and G4 with the same amount of TCDBM. Animals received tacrolimus for 15 days and accessed for rejection, GVHD and for chimerism analysis. RESULTS: High mortality due to GVHD was observed in G2, 3, and 4, and correlated with high levels of donor T cells in recipients blood. G0 and G1 showed early acute rejection with progression toward chronic rejection, in contrast to the preconditioned groups. High and low doses of total body irradiation resulted in allogeneic and in a mixed chimerism, respectively. Decrease in donor chimeric cells after 11 weeks in preconditioned groups was correlated with severe allograft rejection. CONCLUSION: Donor preconditioning with 250 rd and or ALS combined with recipient preconditioning and donor-specific bone marrow infusions prevented GVHD and resulted in a transient mixed chimerism with inhibition of allograft rejection after small bowel transplantation.

[(3)H]-girisopam, a novel selective benzodiazepine for the 2, 3-benzodiazepine binding site.

Several members of the 2,3-benzodiazepine family, such as tofisopam (Grandaxin((R))) nerisopam (GYKI-52 322) [F. Andrási, K. Horváth, E. Sineger, P. Berzsenyi, J. Borsy, A. Kenessey, M. Tarr, T. Láng, J. Korösi, T. Hámori, Neuropharmacology of a new psychotropic 2, 3-benzodiazepine, Arzneim.-Forsch. Drug. Res., 37 (1987) 1119-1124.] [1] or girisopam (GYKI-51 189) [K. Horváth, F. Andrási, P. Berzsenyi, M. Pátfalusi, M. Patthy, G. Szabó, L. Sebestyén, J. Korösi, P. Botka, T. Hámori, T. Láng, A new psychoactive 5H-2, 3-benzodiazepine with a unique spectrum of activity, Arzneim.-Forsch. Drug. Res., 39 (1989) 894-899.] [2] proved anxiolytic in man and various animal models. Moreover, girisopam could also be characterized as an atypical neuroleptic agent. In spite of the structural similarity, their pharmacological profiles differ significantly from that of the 'classical' 1,4-benzodiazepines. Importantly, according to the data obtained so far these drugs do not have an addiction potential. The novel 2,3-benzodiazepine antagonist girisopam binds with high affinity (K(d)=10.3+/-1.21 nM) and limited capacity (B(max)=6.94+/-1.8 pmol/mg protein) to a single class of recognition sites in rat striatum [J.E. Horváth, J. Hudák, M. Palkovits, Zs. Lenkei, M.I.K. Fekete, P. Arányi, A novel specific binding site for homophthalazines (formerly 2, 3-benzodiazepines) in the rat brain, Eur. J. Pharmacol., 236 (1993) 151-153.]. This protocol describes the use of [(3)H]-girisopam as a specific radioligand for the 2,3-benzodiazepines receptor.

GYKI-46 903, a non-competitive antagonist for 5-HT3 receptors.

The effects of GYKI-46 903 ((+)endo-4-propionyloxy-6-(4-fluorophenyl)-1-azabicyclo [3.3.1]non-6-ene HCl), on 5-HT3 receptors have been studied and compared with ondansetron in peripheral organs in vitro and in vivo, and in a receptor binding assay in membranes prepared from rat cerebral cortex. GYKI-46 903 was found to be a non-competitive antagonist at 5-HT3 receptors present in non-stimulated longitudinal muscle strip of guinea-pig ileum (pD2' against serotonin = 5.54), and also in 5-methoxytryptamine-pretreated electrically stimulated ileal preparations (pD2' against serotonin = 5.26). On the contrary, ondansetron was found to be a competitive antagonist for 5-HT3 receptors; the pA2 value against serotonin was 7.40 in non-stimulated ileum, and it was 7.08 in electrically stimulated ileal preparation pretreated with 5-methoxytryptamine. In displacement studies, the pIC50 values of GYKI-46 903 and ondansetron against [3H]granisetron binding to rat cerebral cortex membranes were 6.91 and 8.58 respectively. GYKI-46 903, when administered by intravenous infusion, antagonized the decrease in heart rate evoked by serotonin (Bezold-Jarisch reflex) in anaesthetized rats, and the maximal reversal was less than 50%. This was in striking contrast with ondansetron, which, after intravenous injection, completely antagonized the serotonin-induced bradycardia with an ID50 value of 3.28 ug/kg. These data classify GYKI-46 903 as a non-competitive antagonist for 5-HT3 receptors.

Biochemical effect and kinetics of thrombin inhibition by GYKI-14766.

The tripeptide aldehyde GYKI-14766 (D-MePhe-Pro-Arg-H) synthesized by Bajusz et al. in 1975 is a specific, reversible thrombin inhibitor. It was found effective in vitro in clotting time assays as well as in vivo in thrombosis models. To study the biochemical effects of the inhibitor various experimental setups were applied. First we measured the binding of thrombin to platelets using 125J-thrombin. KD was 55 nM. Second, 125J-thrombin was displaced by thrombin or by a GYKI-14766-thrombin-complex with similar efficacy. However, the binding of thrombin to the platelets increased the intracellular free Ca2+ concentration, but the inhibitor-thrombin complex did not influence it. Analyzing the kinetics of the reactions involved we found that the formation of the GYKI-14766-thrombin complex was slower than the triggering of the platelet Ca2+ signal by thrombin.

Demonstration of the potassium channel opening activity of GYKI-12743 by 86Rb+ efflux studies.

It has been demonstrated that the novel antihypertensive compounds GYKI-12743 showed a potassium channel opening effect as studied in rabbit ear arteries with 86Rb+ as K+ marker. GYKI-12743 produced a concentration dependent 86Rb+ efflux in the same concentration range as the well-known K(+)-channel openers, pinacidil and cromakalim.