Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 283
Filtrar
1.
Molecules ; 26(15)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34361774

RESUMO

Polyphenols play a therapeutic role in vascular diseases, acting in inherent illness-associate conditions such as inflammation, diabetes, dyslipidemia, hypertension, and oxidative stress, as demonstrated by clinical trials and epidemiological surveys. The main polyphenol cardioprotective mechanisms rely on increased nitric oxide, decreased asymmetric dimethylarginine levels, upregulation of genes encoding antioxidant enzymes via the Nrf2-ARE pathway and anti-inflammatory action through the redox-sensitive transcription factor NF-κB and PPAR-γ receptor. However, poor polyphenol bioavailability and extensive metabolization restrict their applicability. Polyphenols carried by nanoparticles circumvent these limitations providing controlled release and better solubility, chemical protection, and target achievement. Nano-encapsulate polyphenols loaded in food grade polymers and lipids appear to be safe, gaining resistance in the enteric route for intestinal absorption, in which the mucoadhesiveness ensures their increased uptake, achieving high systemic levels in non-metabolized forms. Nano-capsules confer a gradual release to these compounds, as well as longer half-lives and cell and whole organism permanence, reinforcing their effectiveness, as demonstrated in pre-clinical trials, enabling their application as an adjuvant therapy against cardiovascular diseases. Polyphenol entrapment in nanoparticles should be encouraged in nutraceutical manufacturing for the fortification of foods and beverages. This study discusses pre-clinical trials evaluating how nano-encapsulate polyphenols following oral administration can aid in cardiovascular performance.


Assuntos
Antioxidantes/farmacologia , Cardiotônicos/farmacologia , Composição de Medicamentos/métodos , Hipertensão/tratamento farmacológico , Isquemia Miocárdica/tratamento farmacológico , Polifenóis/farmacologia , Elementos de Resposta Antioxidante , Antioxidantes/química , Antioxidantes/farmacocinética , Arginina/análogos & derivados , Arginina/antagonistas & inibidores , Arginina/metabolismo , Cardiotônicos/química , Cardiotônicos/farmacocinética , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/genética , Diabetes Mellitus/metabolismo , Diabetes Mellitus/fisiopatologia , Portadores de Fármacos , Dislipidemias/tratamento farmacológico , Dislipidemias/genética , Dislipidemias/metabolismo , Dislipidemias/fisiopatologia , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Hipertensão/genética , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Isquemia Miocárdica/genética , Isquemia Miocárdica/metabolismo , Isquemia Miocárdica/fisiopatologia , Fator 2 Relacionado a NF-E2/genética , Fator 2 Relacionado a NF-E2/metabolismo , Nanocápsulas/administração & dosagem , Nanocápsulas/química , Óxido Nítrico/antagonistas & inibidores , Óxido Nítrico/biossíntese , Estresse Oxidativo/efeitos dos fármacos , Polifenóis/química , Polifenóis/farmacocinética , Transdução de Sinais
2.
Molecules ; 26(5)2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33668802

RESUMO

The reactive adenosine derivative, adenosine 5'-O-[S-(4-hydroxy-2,3-dioxobutyl)]-thiophosphate (AMPS-HDB), contains a dicarbonyl group linked to the purine nucleotide at a position equivalent to the pyrophosphate region of NAD+. AMPS-HDB was used as a chemical label towards Candida boidinii formate dehydrogenase (CbFDH). AMPS-HDB reacts covalently with CbFDH, leading to complete inactivation of the enzyme activity. The inactivation kinetics of CbFDH fit the Kitz and Wilson model for time-dependent, irreversible inhibition (KD = 0.66 ± 0.15 mM, first order maximum rate constant k3 = 0.198 ± 0.06 min-1). NAD+ and NADH protects CbFDH from inactivation by AMPS-HDB, showing the specificity of the reaction. Molecular modelling studies revealed Arg174 as a candidate residue able to be modified by the dicarbonyl group of AMPS-HDB. Arg174 is a strictly conserved residue among FDHs and is located at the Rossmann fold, the common mononucleotide-binding motif of dehydrogenases. Arg174 was replaced by Asn, using site-directed mutagenesis. The mutant enzyme CbFDHArg174Asn was showed to be resistant to inactivation by AMPS-HDB, confirming that the guanidinium group of Arg174 is the target for AMPS-HDB. The CbFDHArg174Asn mutant enzyme exhibited substantial reduced affinity for NAD+ and lower thermostability. The results of the study underline the pivotal and multifunctional role of Arg174 in catalysis, coenzyme binding and structural stability of CbFDH.


Assuntos
Arginina/antagonistas & inibidores , Formiato Desidrogenases/antagonistas & inibidores , Fosfatos/farmacologia , Saccharomycetales/enzimologia , Arginina/genética , Arginina/metabolismo , Formiato Desidrogenases/genética , Formiato Desidrogenases/metabolismo , Modelos Moleculares , Estrutura Molecular , Mutagênese Sítio-Dirigida , Fosfatos/química
3.
Life Sci ; 264: 118674, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33129876

RESUMO

AIMS: Arginine depleting enzymes are found effective to treat arginine-auxotrophic cancers and therapy-resistant malignancies, alone or in combination with cytotoxic agents or immune checkpoint inhibitors. We aim to select and validate a long-lasting, safe and effective PEGylated and cobalt-chelated arginase conjugated at the selective cysteine residue as a therapeutic agent against cancers. MAIN METHODS: Exploring pharmacokinetic and pharmacodynamic properties of the three arginase conjugates with different PEG modality (20 kDa linear as A20L, 20 kDa branched as A20Y, and 40 kDa branched as A40Y) by cell-based and animal studies. KEY FINDINGS: Arginase conjugates showed comparable systemic half-lives, about 20 h in rats and mice. The extended half-life of PEGylated arginase was concurrent with the integrity of conjugates of which PEG and protein moieties remain attached in bloodstream for 72 h after drug administration. Arginase modified with a linear 20 kDa PEG (A20L) was chosen as the lead candidate (PT01). In vitro assays confirmed the very potent cytotoxicity of PT01 against cancer cell lines of breast, prostate, and pancreas origin. In MIA PaCa-2 pancreatic and PC-3 prostate tumor xenograft models, weekly infusion of the PT01 at 5 and 10 mg/kg induced significant tumor growth inhibition of 44-67%. All mice experienced dose-dependent but rapidly reversible weight loss following each weekly dose, suggesting tolerable toxicity. SIGNIFICANCE: These non-clinical data support PT01 as the lead candidate for clinical development that may benefit cancer patients by providing an alternative cytotoxic mechanism.


Assuntos
Antineoplásicos/síntese química , Arginase/síntese química , Arginina/deficiência , Engenharia Química/métodos , Desenho de Fármacos , Polietilenoglicóis/síntese química , Animais , Antineoplásicos/administração & dosagem , Arginase/administração & dosagem , Arginina/antagonistas & inibidores , Relação Dose-Resposta a Droga , Humanos , Isoenzimas/administração & dosagem , Isoenzimas/síntese química , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Polietilenoglicóis/administração & dosagem , Estrutura Secundária de Proteína , Ratos , Ratos Sprague-Dawley , Resultado do Tratamento , Ensaios Antitumorais Modelo de Xenoenxerto/métodos
4.
J Insect Physiol ; 126: 104100, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32822690

RESUMO

The immune system of Rhodnius prolixus comprehends the synthesis of different effectors that modulate the intestinal microbiota population and the life cycle of the parasite Trypanosoma cruzi inside the vector midgut. One of these immune responses is the production of reactive nitrogen species (RNS) derived by the action of nitric oxide synthase (NOS). Therefore, we investigated the effects of L-arginine, the substrate for nitric oxide (NO) production and Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME), an inhibitor of NOS, added in the insect blood meal. We analyzed the impact of these treatments on the immune responses and development of intestinal bacteria and parasites on R. prolixus nymphs. The L-arginine treatment in R. prolixus nymphs induced a higher NOS gene expression in the fat body and increased NO production, but reduced catalase and antimicrobial activities in the midgut. As expected, L-NAME treatment reduced NOS gene expression in the fat body. In addition, L-NAME treatment diminished catalase activity in the hemolymph and posterior midgut reduced phenoloxidase activity in the anterior midgut and increased the antimicrobial activity in the hemolymph. Both treatments caused a reduction in the cultivatable intestinal microbiota, especially in insects treated with L-NAME. However, T. cruzi development in the insect's digestive tract was suppressed after L-arginine treatment and the opposite was observed with L-NAME, which resulted in higher parasite counts. Therefore, we conclude that induction and inhibition of NOS and NO production are associated with other R. prolixus humoral immune responses, such as catalase, phenoloxidase, and antibacterial activities in different insect organs. These alterations reflect on intestinal microbiota and T. cruzi development.


Assuntos
Microbioma Gastrointestinal/efeitos dos fármacos , Sistema Imunitário/efeitos dos fármacos , Óxido Nítrico , Rhodnius , Trypanosoma cruzi/efeitos dos fármacos , Animais , Arginina/antagonistas & inibidores , Arginina/farmacologia , Catalase/efeitos dos fármacos , Catalase/metabolismo , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/microbiologia , Expressão Gênica/efeitos dos fármacos , Genes de Insetos , Hemolinfa/efeitos dos fármacos , Hemolinfa/imunologia , Hemolinfa/metabolismo , Imunidade Humoral/efeitos dos fármacos , Insetos Vetores/imunologia , Insetos Vetores/microbiologia , Insetos Vetores/parasitologia , Monofenol Mono-Oxigenase/efeitos dos fármacos , Monofenol Mono-Oxigenase/metabolismo , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/metabolismo , Óxido Nítrico/farmacologia , Óxido Nítrico Sintase/genética , Óxido Nítrico Sintase/metabolismo , Rhodnius/imunologia , Rhodnius/microbiologia , Rhodnius/parasitologia
5.
Clin Cancer Res ; 26(16): 4402-4413, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32409304

RESUMO

PURPOSE: Many rare ovarian cancer subtypes, such as small-cell carcinoma of the ovary, hypercalcemic type (SCCOHT), have poor prognosis due to their aggressive nature and resistance to standard platinum- and taxane-based chemotherapy. The development of effective therapeutics has been hindered by the rarity of such tumors. We sought to identify targetable vulnerabilities in rare ovarian cancer subtypes. EXPERIMENTAL DESIGN: We compared the global proteomic landscape of six cases each of endometrioid ovarian cancer (ENOC), clear cell ovarian cancer (CCOC), and SCCOHT to the most common subtype, high-grade serous ovarian cancer (HGSC), to identify potential therapeutic targets. IHC of tissue microarrays was used as validation of arginosuccinate synthase (ASS1) deficiency. The efficacy of arginine-depriving therapeutic ADI-PEG20 was assessed in vitro using cell lines and patient-derived xenograft mouse models representing SCCOHT. RESULTS: Global proteomic analysis identified low ASS1 expression in ENOC, CCOC, and SCCOHT compared with HGSC. Low ASS1 levels were validated through IHC in large patient cohorts. The lowest levels of ASS1 were observed in SCCOHT, where ASS1 was absent in 12 of 31 cases, and expressed in less than 5% of the tumor cells in 9 of 31 cases. ASS1-deficient ovarian cancer cells were sensitive to ADI-PEG20 treatment regardless of subtype in vitro. Furthermore, in two cell line mouse xenograft models and one patient-derived mouse xenograft model of SCCOHT, once-a-week treatment with ADI-PEG20 (30 mg/kg and 15 mg/kg) inhibited tumor growth in vivo. CONCLUSIONS: Preclinical in vitro and in vivo studies identified ADI-PEG20 as a potential therapy for patients with rare ovarian cancers, including SCCOHT.


Assuntos
Argininossuccinato Sintase/genética , Carcinoma de Células Pequenas/tratamento farmacológico , Hidrolases/farmacologia , Neoplasias Ovarianas/tratamento farmacológico , Polietilenoglicóis/farmacologia , Animais , Arginina/antagonistas & inibidores , Arginina/genética , Argininossuccinato Sintase/deficiência , Carcinoma de Células Pequenas/genética , Carcinoma de Células Pequenas/patologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Feminino , Humanos , Camundongos , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Ovário/metabolismo , Ovário/patologia , Proteína Relacionada ao Hormônio Paratireóideo/genética , Proteína Relacionada ao Hormônio Paratireóideo/imunologia , Proteômica , Ensaios Antitumorais Modelo de Xenoenxerto
6.
Appl Microbiol Biotechnol ; 104(9): 3921-3934, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32144472

RESUMO

L-Arginine (L-Arg) depletion has attracted great attention in cancer therapy. Although two types of arginine-depleting enzymes, arginine deiminase (ADI) and human arginase I, are undergoing clinical trials, random site of PEGylation, low efficacy of heavy metal as co-factor, and immunogenicity limit the performance of these drugs and cause difficulty in a homogeneous production. Here we screened ten catalytic metal ions and have successfully produced a site-specific mono-PEGylated human arginase I mutant by conjugating the Cys45 residue to PEG-maleimide to minimize the decrease in activity and produce a homogeneous product. The catalytic efficiency trend of metal ion-enriched human arginase I mutant (HAI) was Co2+ > Ni2+ ≫ Mn2+. The overall kcat/KM values of Co-HAI and Ni-HAI were higher than Mn-HAI by ~ 8.7- and ~ 5.2-folds, respectively. Moreover, the results of enzyme kinetics and circular dichroism spectrometry demonstrated that the 20 or 40 kDa linear and branched PEG attached on the HAI surface did not affect the enzyme activity and the protein secondary structures. In vitro studies showed that both Co-HAI-PEG20L and Ni-HAI-PEG20L inhibited the growth of eight types of cancer cell lines. The pharmacodynamic study in mice demonstrated that the i.p. administration of Co-HAI-PEG20L at 13 mg/kg and Ni-HAI-PEG20L at 15 mg/kg was able to maintain a L-Arg level below its detection limit for over 120 h after one injection. The body weights of mice could return to normal levels within 5 days after injection, showing that the doses were well-tolerated. Therefore, both the Ni-HAI-PEG20L and Co-HAI-PEG20L are promising candidates for cancer therapy. KEY POINTS: • Mono-PEGylation applied on human arginase I mutant (HAI) successfully. • The catalytic efficiency of Co- and Ni-enriched HAI was higher than the wild type. • At least eight types of cancer cell lines were inhibited by Co- and Ni-HAI-PEG20L. • Co- and Ni-HAI-PEG20L were able to achieve weekly depletion of L-Arg. Graphical abstract.


Assuntos
Arginase/genética , Arginase/uso terapêutico , Arginina/antagonistas & inibidores , Neoplasias/tratamento farmacológico , Engenharia de Proteínas , Animais , Linhagem Celular Tumoral , Humanos , Íons , Metais , Camundongos , Camundongos Endogâmicos BALB C , Mutação , Estrutura Secundária de Proteína
7.
Sci Rep ; 8(1): 12096, 2018 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-30108309

RESUMO

Tumors deficient in the urea cycle enzymes argininosuccinate synthase-1 (ASS1) and ornithine transcarbamylase (OTC) are unable to synthesize arginine and can be targeted using arginine-deprivation therapy. Here, we show that colorectal cancers (CRCs) display negligible expression of OTC and, in subset of cases, ASS1 proteins. CRC cells fail to grow in arginine-free medium and dietary arginine deprivation slows growth of cancer cells implanted into immunocompromised mice. Moreover, we report that clinically-formulated arginine-degrading enzymes are effective anticancer drugs in CRC. Pegylated arginine deiminase (ADI-PEG20), which degrades arginine to citrulline and ammonia, affects growth of ASS1-negative cells, whereas recombinant human arginase-1 (rhArg1peg5000), which degrades arginine into urea and ornithine, is effective against a broad spectrum of OTC-negative CRC cell lines. This reflects the inability of CRC cells to recycle citrulline and ornithine into the urea cycle. Finally, we show that arginase antagonizes chemotherapeutic drugs oxaliplatin and 5-fluorouracil (5-FU), whereas ADI-PEG20 synergizes with oxaliplatin in ASS1-negative cell lines and appears to interact with 5-fluorouracil independently of ASS1 status. Overall, we conclude that CRC is amenable to arginine-deprivation therapy, but we warrant caution when combining arginine deprivation with standard chemotherapy.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Arginina/antagonistas & inibidores , Argininossuccinato Sintase/metabolismo , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Idoso , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Arginase/farmacologia , Arginase/uso terapêutico , Arginina/metabolismo , Linhagem Celular Tumoral , Colo/patologia , Neoplasias Colorretais/mortalidade , Interações Medicamentosas , Sinergismo Farmacológico , Estudos de Viabilidade , Feminino , Fluoruracila/farmacologia , Fluoruracila/uso terapêutico , Seguimentos , Humanos , Hidrolases/farmacologia , Hidrolases/uso terapêutico , Concentração Inibidora 50 , Estimativa de Kaplan-Meier , Masculino , Camundongos , Ornitina Carbamoiltransferase/metabolismo , Oxaliplatina/farmacologia , Oxaliplatina/uso terapêutico , Polietilenoglicóis/farmacologia , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes/farmacologia , Proteínas Recombinantes/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Ureia/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto
8.
Curr Pharm Des ; 24(17): 1873-1878, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29938614

RESUMO

PURPOSE: The purpose of this study was to determine the relationship between Kinesin like protein 6 (KIF6) gene Trp719Arg and major cardiovascular events (MACEs) risk in subjects who received statin therapy. METHODS: PubMed, EmBase, and the Cochrane Library were searched from inception through September 2017. The selected studies evaluated the association of Trp719Arg with MACEs in individuals who received statins. Relative risk (RR) and 95% confidence interval (CI) were used to evaluate the effect of statin therapy on MACEs in subjects carrying polymorphisms, and the odds ratio (OR) and 95% CI were used to evaluate the relationship between Trp719Arg and MACE risk in individuals who received statins, using the random-effects model. RESULTS: Seven studies were included (N=48,885). Overall, we found that statin therapy significantly reduced the risk for MACEs in subjects carrying ArgArg (RR: 0.79; 95% CI: 0.69-0.90; P=0.001), ArgTrp (RR: 0.71; 95% CI: 0.60 -0.83; P<0.001), ArgArg+ArgTrp (RR: 0.71; 95% CI: 0.63 -0.81; P<0.001), and TrpTrp (RR: 0.79; 95% CI: 0.73-0.85; P<0.001). Furthermore, there was no significant difference between subjects carrying ArgArg and those carrying TrpTrp (OR: 1.11; 95% CI: 0.92-1.34; P=0.265). However, ArgTrp (OR: 1.29; 95% CI: 1.07-1.55; P=0.007) and ArgArg+ArgTrp (OR: 1.26; 95% CI: 1.05-1.51; P=0.012) were associated with an increased risk for MACEs when compared with TrpTrp. CONCLUSIONS: Statin therapy significantly reduced the risk for MACEs in subjects carrier specific KIF6 gene Trp719Arg polymorphisms. Further, subjects carrying ArgTrp or ArgArg+ArgTrp had a greater incidence of MACEs as compared with TrpTrp when they received statins.


Assuntos
Arginina/antagonistas & inibidores , Doenças Cardiovasculares/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Cinesinas/antagonistas & inibidores , Arginina/genética , Doenças Cardiovasculares/genética , Variação Genética/efeitos dos fármacos , Variação Genética/genética , Humanos , Cinesinas/genética , Polimorfismo Genético/efeitos dos fármacos , Polimorfismo Genético/genética , Fatores de Risco
9.
Indian J Dent Res ; 28(4): 450-456, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28836539

RESUMO

BACKGROUND: Dentin hypersensitivity results when patent tubules are exposed to pain-inducing external stimuli. AIM: This study aims to compare the effects of two desensitizing dentifrices containing NovaMin and arginine on dentinal tubule occlusion with and without citric acid challenge in vitro using confocal laser scanning microscopy (CLSM). MATERIALS AND METHODS: Forty dentin discs were randomly divided into Groups I and II containing twenty specimens each, treated with NovaMin and arginine-containing dentifrices, respectively. Groups I and II were divided into subgroups A and B where IA and IIA underwent CLSM analysis to determine the percentage of tubule occlusion while IB and IIB underwent 0.3% citric acid challenge and CLSM analysis. A novel grading system was devised to categorize tubule occlusion. RESULTS: In Group II, the percentage of occluded tubules was highest for IIA (72.25% ± 10.57%) and least for IIB (42.55% ± 8.65%) having statistical significance (P < 0.0005). In Group I, the difference between IA (49.9% ± 12.96%) and IB (43.15% ± 12.43%) was statistically insignificant (P = 0.249). On the comparison between IB and IIB statistically indifferent result was obtained (P = 0.901), whereas the difference between IA and IIA was statistically significant (P < 0.001). The results of grading system were for IA 50% of samples belonged to Grade 2, for IIA 60% - Grade 3, and for IB 70% and for IIB 90% - Grade 2. CONCLUSION: Dentinal tubule occlusion with arginine-containing dentifrice was significantly higher than NovaMin. However, it could not resist citric acid challenge as effectively as NovaMin. The effects of NovaMin were more sustainable as compared to arginine-containing dentifrice, thus proving to be a better desensitizing agent.


Assuntos
Arginina/antagonistas & inibidores , Ácido Cítrico/farmacologia , Dentifrícios , Dessensibilizantes Dentinários/antagonistas & inibidores , Dentina/efeitos dos fármacos , Vidro , Arginina/uso terapêutico , Dentina/ultraestrutura , Dessensibilizantes Dentinários/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Microscopia Confocal , Distribuição Aleatória
10.
Food Chem ; 217: 602-609, 2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-27664677

RESUMO

The antiglycative activity of hydroxytyrosol (HT) and olive leaf extract (OLE) was investigated in wheat-flour biscuits. Quercetin (QE) and gallic acid (GA) were used as reference of antiglycative activity of phenolic compounds. HT, OLE, QE and GA were added in the range of 0.25-0.75% (w/w). Samples were compared against a control recipe baked at 180°C/20min. HT biscuit was able to inhibit efficiently the formation of hydroxymethylfurfural (HMF) and 3-deoxyglucosone (3-DG), as well as reduced the formation of overall free fluorescent AGEs and pentosidine. The inhibition of the 3-DG and HMF formation was directly and significantly correlated under controlled baking conditions. However, samples formulated with OLE exerted similar antiglycative capacity against pentosidine and Nε-carboxyethyl-lysine, although the amount of HT in the biscuit was 100-fold lower than the biscuit formulated with HT. Methylglyoxal, 3-DG, and glyoxal were the predominant 1,2-dicarbonyl compounds after baking but only 3-DG was significantly reduced by HT.


Assuntos
Álcool Feniletílico/análogos & derivados , Extratos Vegetais/farmacologia , Folhas de Planta/química , Arginina/análogos & derivados , Arginina/análise , Arginina/antagonistas & inibidores , Cromatografia Líquida , Desoxiglucose/análogos & derivados , Desoxiglucose/análise , Desoxiglucose/antagonistas & inibidores , Farinha/análise , Manipulação de Alimentos , Furaldeído/análogos & derivados , Furaldeído/análise , Furaldeído/antagonistas & inibidores , Ácido Gálico/farmacologia , Produtos Finais de Glicação Avançada/análise , Produtos Finais de Glicação Avançada/antagonistas & inibidores , Lisina/análogos & derivados , Lisina/análise , Lisina/antagonistas & inibidores , Reação de Maillard/efeitos dos fármacos , Olea/química , Álcool Feniletílico/farmacologia , Aldeído Pirúvico/análise , Aldeído Pirúvico/antagonistas & inibidores , Quercetina/farmacologia , Espectrometria de Massas em Tandem , Triticum/química
11.
Pharmacol Rep ; 68(6): 1319-1325, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27701056

RESUMO

BACKGROUND: Cyclosporine A (CsA)-induced nephrotoxicity is a challenging problem complicating its chronic use in a large array of autoimmune diseases, as well as in organ transplantation. A considerable body of evidence points to the involvement of nitric oxide (NO) and its endogenous synthesis inhibitor, asymmetric dimethylarginine (ADMA), in CsA-induced renal and cardiovascular adverse effects. In this study, the potential of the third generation ß-blocker, nebivolol, to modify the NO/ADMA system is hypothesized to play a role in protection against CsA-induced renal injury and endothelial dysfunction. METHODS: Both in vivo and in vitro studies were carried out on 36 male Wistar rats randomly divided into three groups; normal control, CsA (30mg/kg/day)-treated or CsA+nebivolol (30mg/kg and 1mg/kg daily, respectively)-treated groups. After four weeks, blood pressure, lipid profile, renal functions, renal oxidative status, NO, inducible NO synthase and ADMA were assessed. In vitro evaluation of vascular relaxant responses of norepinephrine pre-contracted aortic rings to acetylcholine (ACh) and sodium nitroprusside were evaluated. RESULTS: Concurrent nebivolol treatment significantly attenuated CsA-induced hypertension, impairment of renal functions, oxidative stress and restored the balance in renal NO system with lowering of the elevated ADMA. This was associated with favourable effects on lipid profile. Nebivolol treatment also abrogated the CsA-induced impairment of relaxant responses of aortic rings to ACh. CONCLUSIONS: Nebivolol possesses multifaceted actions that make it advantageous to combat the CsA-induced toxic effects on renal and endothelial functions.


Assuntos
Injúria Renal Aguda/prevenção & controle , Arginina/análogos & derivados , Ciclosporina/toxicidade , Endotélio Vascular/efeitos dos fármacos , Nebivolol/uso terapêutico , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/metabolismo , Agonistas de Receptores Adrenérgicos beta 1/farmacologia , Agonistas de Receptores Adrenérgicos beta 1/uso terapêutico , Animais , Arginina/antagonistas & inibidores , Arginina/metabolismo , Relação Dose-Resposta a Droga , Endotélio Vascular/metabolismo , Imunossupressores/toxicidade , Masculino , Nebivolol/farmacologia , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/metabolismo , Técnicas de Cultura de Órgãos , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Ratos , Ratos Wistar
12.
J Biol Regul Homeost Agents ; 30(3): 713-726, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27655488

RESUMO

Osteoporosis is a metabolic multifaceted disorder, characterized by insufficient bone strength. It has been recently shown that advanced glycation end products (AGEs) play a role in senile osteoporosis, through bone cell impairment and altered biomechanical properties. Pentosidine (PENT), a wellcharacterized AGE, is also considered a biomarker of bone fracture. Adequate responses to various hormones, such as 1,25-dihydroxyvitamin D3, are prerequisites for optimal osteoblasts functioning. Vitamin K2 is known to enhance in vitro and in vitro vitamin D-induced bone formation. The aim of the study was to assess the effects of Vitamins D3 and K2 and PENT on in vitro osteoblast activity, to convey a possible translational clinical message. Ex vivo human osteoblasts cultured, for 3 weeks, with vitamin D3 and vitamin K2 were exposed to PENT, a well-known advanced glycoxidation end product for the last 72 hours. Experiments with PENT alone were also carried out. Gene expression of specific markers of bone osteoblast maturation [alkaline phosphatase, ALP; collagen I, COL Iα1; and osteocalcin (bone-Gla-protein) BGP] was measured, together with the receptor activator of nuclear factor kappa-B ligand/osteoproteregin (RANKL/OPG) ratio to assess bone remodeling. Expression of RAGE, a well-characterized receptor of AGEs, was also assessed. PENT+vitamins slightly inhibited ALP secretion while not affecting gene expression, indicating hampered osteoblast functional activity. PENT+vitamins up-regulated collagen gene expression, while protein secretion was unchanged. Intracellular collagen levels were partially decreased, and a significant reduction in BGP gene expression and intracellular protein concentration were both reported after PENT exposure. The RANKL/OPG ratio was increased, favouring bone reabsorption. RAGE gene expression significantly decreased. These results were confirmed by a lower mineralization rate. We provided in vitro evidence that glycoxidation might interfere with the maturation of osteoblasts, leading to morphological modifications, cellular malfunctioning, and inhibition of the calcification process. However, these processes may be all partially counterbalanced by vitamins D3 and K2. Therefore, detrimental AGE accumulation in bone might be attenuated and/or reversed by the presence or supplementation of vitamins D3 and K2.


Assuntos
Arginina/análogos & derivados , Colecalciferol/farmacologia , Lisina/análogos & derivados , Osteoblastos/efeitos dos fármacos , Vitamina K 2/farmacologia , Fosfatase Alcalina/biossíntese , Fosfatase Alcalina/genética , Antígenos de Neoplasias/biossíntese , Antígenos de Neoplasias/genética , Arginina/antagonistas & inibidores , Arginina/toxicidade , Remodelação Óssea/efeitos dos fármacos , Células Cultivadas , Colágeno Tipo I/biossíntese , Colágeno Tipo I/genética , Cadeia alfa 1 do Colágeno Tipo I , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Lisina/antagonistas & inibidores , Lisina/toxicidade , Proteínas Quinases Ativadas por Mitógeno/biossíntese , Proteínas Quinases Ativadas por Mitógeno/genética , Osteoblastos/metabolismo , Osteocalcina/biossíntese , Osteocalcina/genética , Osteogênese/efeitos dos fármacos , Osteoprotegerina/biossíntese , Osteoprotegerina/genética , Ligante RANK/biossíntese , Ligante RANK/genética , RNA Mensageiro/biossíntese , RNA Mensageiro/genética
13.
Lipids Health Dis ; 14: 161, 2015 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-26645467

RESUMO

BACKGROUND: In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia. METHODS: This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of <100 mg/dl. RESULTS: The statin treatment by pitavastatin was well tolerated in all of the patients without any significant adverse events and the average dose of pitavastatin was 1.0 ± 0.0 mg daily after treatment. After the 12-months treatment period, LDL-C was significantly lower in the diet-plus-statin therapy group compared with the diet therapy group (diet vs diet-plus-statin: LDL-C, 126 ± 5 vs 83 ± 4 mg/dL, P < 0.001). On the other hand, the diet-plus-statin therapy did not significantly reduce albuminuria or delay the decline in eGFR compared with the diet therapy, and there was no relationship between the change in LDL-C and the change in eGFR or albuminuria. However, diet therapy as well as diet-plus-statin therapy exerted similar lowering effects on the pentosidine levels (diet therapy group, baseline vs 12 months: 40 ± 4 vs 24 ± 3 ng/mL, P = 0.001; diet-plus-statin therapy, 46 ± 7 vs 34 ± 6 ng/mL, P = 0.008). Furthermore, the results of multivariate regression analysis indicated that the change in pentosidine was a significant contributor to the change in eGFR (ß = -0.536, P = 0.011). CONCLUSIONS: Although statin add-on therapy did not show additive renal protective effects, the diet therapy as well as the diet-plus-statin therapy could contribute to the reduction in plasma pentosidine in CKD patients with albuminuria and dyslipidemia.


Assuntos
Albuminúria/tratamento farmacológico , Anticolesterolemiantes/uso terapêutico , Dieta/métodos , Dislipidemias/tratamento farmacológico , Quinolinas/uso terapêutico , Insuficiência Renal Crônica/tratamento farmacológico , Idoso , Albuminúria/sangue , Albuminúria/dietoterapia , Albuminúria/patologia , Arginina/análogos & derivados , Arginina/antagonistas & inibidores , Arginina/sangue , HDL-Colesterol/sangue , LDL-Colesterol/antagonistas & inibidores , LDL-Colesterol/sangue , Dislipidemias/sangue , Dislipidemias/dietoterapia , Dislipidemias/patologia , Feminino , Taxa de Filtração Glomerular , Produtos Finais de Glicação Avançada/antagonistas & inibidores , Produtos Finais de Glicação Avançada/sangue , Humanos , Lisina/análogos & derivados , Lisina/antagonistas & inibidores , Lisina/sangue , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo/efeitos dos fármacos , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/dietoterapia , Insuficiência Renal Crônica/patologia , Triglicerídeos/sangue , Rigidez Vascular/efeitos dos fármacos
14.
Curr Med Chem ; 22(24): 2871-901, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26112145

RESUMO

Asymmetric dimethylarginine (ADMA) is a competitive endogenous inhibitor of nitric oxide synthase with a key role in the pathophysiology of endothelial dysfunction, in the progression of atherosclerosis and in cardiovascular diseases. Statins, renin-angiotensin-aldosterone system inhibitors, blood glucose lowering agents, insulin sensitizers, beta-blockers, estrogen replacement therapy, antioxidants, complex B vitamins, L-arginine and acetylsalicylic acid have been evaluated for their ability to reduce ADMA levels or inhibit its actions. Despite the major beneficial effects of these agents in cardiovascular disease, research has shown that their favorable actions are only partially mediated by reducing ADMA levels or by bypassing its effect in nitric oxide synthesis. Novel therapeutic approaches targeting selectively ADMA are encouraging, but have only been tested in vitro or in animal studies and further research is needed in order to conclude on how therapeutic strategies modulating ADMA actions can affect atherosclerosis progression and cardiovascular diseases.


Assuntos
Arginina/análogos & derivados , Doença de Alzheimer/metabolismo , Animais , Arginina/antagonistas & inibidores , Arginina/metabolismo , Doenças Cardiovasculares/metabolismo , Diabetes Mellitus/metabolismo , Feminino , Humanos , Hipercolesterolemia/metabolismo , Neoplasias/metabolismo , Pré-Eclâmpsia/metabolismo , Gravidez , Insuficiência Renal Crônica/metabolismo
15.
PLoS One ; 10(1): e0116929, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25581376

RESUMO

Accumulating evidence has demonstrated the importance of alternative splicing in various physiological processes, including the development of different diseases. CDC-like kinases (CLKs) and serine-arginine protein kinases (SRPKs) are components of the splicing machinery that are crucial for exon selection. The discovery of small molecule inhibitors against these kinases is of significant value, not only to delineate the molecular mechanisms of splicing, but also to identify potential therapeutic opportunities. Here we describe a series of small molecules that inhibit CLKs and SRPKs and thereby modulate pre-mRNA splicing. Treatment with these small molecules (Cpd-1, Cpd-2, or Cpd-3) significantly reduced the levels of endogenous phosphorylated SR proteins and caused enlargement of nuclear speckles in MDA-MB-468 cells. Additionally, the compounds resulted in splicing alterations of RPS6KB1 (S6K), and subsequent depletion of S6K protein. Interestingly, the activity of compounds selective for CLKs was well correlated with the activity for modulating S6K splicing as well as growth inhibition of cancer cells. A comprehensive mRNA sequencing approach revealed that the inhibitors induced splicing alterations and protein depletion for multiple genes, including those involved in growth and survival pathways such as S6K, EGFR, EIF3D, and PARP. Fluorescence pulse-chase labeling analyses demonstrated that isoforms with premature termination codons generated after treatment with the CLK inhibitors were degraded much faster than canonical mRNAs. Taken together, these results suggest that CLK inhibitors exhibit growth suppression and apoptosis induction through splicing alterations in genes involved in growth and survival. These small molecule inhibitors may be valuable tools for elucidating the molecular machinery of splicing and for the potential development of a novel class of antitumor agents.


Assuntos
Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Inibidores de Proteínas Quinases/farmacologia , Proteínas Serina-Treonina Quinases/antagonistas & inibidores , Proteínas Tirosina Quinases/antagonistas & inibidores , Splicing de RNA/efeitos dos fármacos , RNA Mensageiro/genética , Bibliotecas de Moléculas Pequenas/farmacologia , Apoptose/genética , Arginina/antagonistas & inibidores , Arginina/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/genética , Células HCT116 , Humanos , Proteínas Nucleares/antagonistas & inibidores , Proteínas Nucleares/metabolismo , Fosforilação/efeitos dos fármacos , Fosforilação/genética , Isoformas de Proteínas/antagonistas & inibidores , Isoformas de Proteínas/metabolismo , Proteínas Serina-Treonina Quinases/metabolismo , Proteínas Tirosina Quinases/metabolismo , Precursores de RNA/genética , Precursores de RNA/metabolismo , Splicing de RNA/genética , Proteínas de Ligação a RNA/metabolismo
17.
Eur J Nutr ; 53(3): 813-21, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24100601

RESUMO

BACKGROUND AND AIMS: Nitric oxide (NO) and vasoactive intestinal polypeptide (VIP) are important intestinal neurotransmitters that coexist in the gut enteric nervous system and play an important role in intestinal physiology (e.g., absorption, motility, fluid secretion and smooth muscle relaxation). It is also known that cold exposure alters several aspects of gastrointestinal physiology and induces hyperphagia to meet increased metabolic demands, but there are no data regarding NO and VIP involvement in intestinal response during acclimation to cold. The objective of this study was to determine the influence of long-term L-arginine supplementation on the expression of the three isoforms of nitric oxide synthase (NOS) and VIP in small intestine of rats acclimated to room temperature or cold. METHODS: Animals (six per group) acclimated to room temperature (22 ± 1 °C) and cold (4 ± 1 °C), respectively, were treated with 2.25% L-arginine, a substrate for NOSs, or with 0.01% N(ω)-nitro-L-arginine methyl ester, an inhibitor of NOSs, for 45 days. The topographical distribution of VIP and NOSs expression in small intestine was studied by immunohistochemistry, and ImageJ software was used for semiquantitative densitometric analysis of their immunoexpression. RESULTS: Long-term dietary L-arginine supplementation increases VIP and NOSs immunoexpression at room temperature while at cold increases the endothelial NOS, inducible NOS and VIP but decrease neuronal NOS in rat small intestine. CONCLUSION: Our results demonstrate that long-term dietary L-arginine supplementation modulates NOSs and VIP immunoexpression in rat small intestine with respect to ambient temperature, pointing out the eNOS as a predominant NOS isoform with an immunoexpression pattern similar to VIP.


Assuntos
Arginina/metabolismo , Suplementos Nutricionais , Mucosa Intestinal/metabolismo , Intestino Delgado/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Regulação para Cima , Peptídeo Intestinal Vasoativo/agonistas , Adaptação Fisiológica/efeitos dos fármacos , Animais , Arginina/antagonistas & inibidores , Temperatura Baixa/efeitos adversos , Cruzamentos Genéticos , Enterócitos/citologia , Enterócitos/efeitos dos fármacos , Enterócitos/metabolismo , Inibidores Enzimáticos/farmacologia , Imuno-Histoquímica , Células Intersticiais de Cajal/citologia , Células Intersticiais de Cajal/efeitos dos fármacos , Células Intersticiais de Cajal/metabolismo , Mucosa Intestinal/citologia , Mucosa Intestinal/efeitos dos fármacos , Intestino Delgado/citologia , Intestino Delgado/efeitos dos fármacos , Masculino , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico Sintase Tipo I/antagonistas & inibidores , Óxido Nítrico Sintase Tipo I/metabolismo , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/química , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III/antagonistas & inibidores , Óxido Nítrico Sintase Tipo III/química , Ratos , Regulação para Cima/efeitos dos fármacos , Peptídeo Intestinal Vasoativo/metabolismo
18.
Curr Pharm Des ; 20(14): 2448-55, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23844812

RESUMO

Cardiorenal syndrome (CRS) is a condition in which there is a complex interrelationship between cardiovascular disease (CVD) and chronic kidney disease (CKD). Impairment of one organ could accelerate pathological processes in the other, which in turn accelerates the progression of failure of both. Although clinical studies hint at a specific bidirectional interaction between cardiovascular system and kidney, insight into the pathogenesis of CRS remains unknown. One possible factor that could explain this link is endothelial dysfunction (ED). ED is not only involved in initiation and progression of atherosclerosis, but also contributes to progression of renal injury. Asymmetric dimethylarginine (ADMA) is an endogenous NO synthase inhibitor found in the plasma and cells. Plasma ADMA levels are increased in CKD patients and known to be an independent biomarker and predictor for future cardiovascular events as well as the progression of CKD. These findings indicate that accumulated ADMA-mediated ED may play important roles in CRS in CKD patients. In this review, we discuss the roles of ADMA in the development of ED, especially focusing on its roles in CRS.


Assuntos
Arginina/análogos & derivados , Síndrome Cardiorrenal/metabolismo , Óxido Nítrico Sintase/antagonistas & inibidores , Animais , Arginina/antagonistas & inibidores , Arginina/fisiologia , Síndrome Cardiorrenal/tratamento farmacológico , Fármacos Cardiovasculares/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Sistemas de Liberação de Medicamentos/tendências , Humanos , Óxido Nítrico Sintase/metabolismo
19.
Spinal Cord ; 51(9): 663-7, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23797570

RESUMO

OBJECTIVES: The aim of this study was to investigate the pharmacological effects of long-term oral tadalafil treatment on the corpus cavernosum function in rats subjected to experimental spinal cord transection (SCT). METHODS: Thirty young adult, male Sprague­Dawley rats were randomly divided into five groups (n» 6, each), as follows: (1) Control,(2) Control surgery (Sham), (3) Tadalafil (Td), (4) Experimental SCT, and (5) SCT + Tadalafil (SCT + Td). SCT rat model: after removal of T8-T9 spinal processes and laminates, a full-thickness scalpel incision was made in the spinal cord. SCT + Td rat model:rats subjected to SCT were given tadalafil (5mg kg(-1), p.o.) for 4 weeks. Next, the penile cavernous tissues obtained by en blocexcision were trimmed free of the surrounding tissue to isolate cavernosal smooth muscle strips, which were then transferred into the isolated organ baths to investigate isometric tension changes in response to various bioactive agents and electrical field stimulation (EFS). RESULTS: The relaxation response to acetylcholine at 0.01 mM concentration was significantly less in the SCT group compared with other groups. EFS-induced relaxation in the basal and precontracted cavernous tissue preparations was greater in the SCT + Td group than in the SCT group. CONCLUSION: This study demonstrated that long-term tadalafil administration preserves relaxation responses probably by affecting through the nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) pathway in SCT-applied rats. This treatment strategy might preserve the erectile process and prevent the SCT-induced permanent damage in the cavernosal tissue.


Assuntos
Carbolinas/uso terapêutico , Disfunção Erétil/tratamento farmacológico , Pênis/fisiopatologia , Inibidores da Fosfodiesterase 5/uso terapêutico , Traumatismos da Medula Espinal/fisiopatologia , Acetilcolina/farmacologia , Animais , Arginina/antagonistas & inibidores , Arginina/farmacologia , Relação Dose-Resposta a Droga , Estimulação Elétrica , Inibidores Enzimáticos/farmacologia , Disfunção Erétil/etiologia , Disfunção Erétil/fisiopatologia , Técnicas In Vitro , Contração Isométrica/efeitos dos fármacos , Masculino , Contração Muscular/efeitos dos fármacos , Relaxamento Muscular/efeitos dos fármacos , NG-Nitroarginina Metil Éster/farmacologia , Óxido Nítrico/fisiologia , Óxido Nítrico Sintase/antagonistas & inibidores , Ratos , Ratos Wistar , Traumatismos da Medula Espinal/complicações , Tadalafila , Vasodilatadores/farmacologia
20.
Stroke ; 44(8): 2128-33, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23788583

RESUMO

BACKGROUND AND PURPOSE: In the German Multicenter Erythropoietin (EPO) Stroke Trial, patients not receiving thrombolysis most likely benefited from EPO on clinical recovery, whereas a combination of rtPA and EPO was associated with increased mortality. We investigated whether the combination of rtPA and EPO increased release of the endogenous NO synthase inhibitor asymmetric dimethylarginine (ADMA), and thereby potentially deteriorated ischemic stroke outcome, as suggested from experimental data. METHODS: ADMA was determined in serum samples from 90 patients of the German Multicenter EPO Stroke Trial taken at days 1 (within 6 hours after symptom onset), 2, 3, 4, and 7 after stroke using high-performance liquid chromatography-tandem mass spectrometry. ADMA was analyzed for the different treatment groups (EPO, n=25; placebo, n=30; rtPA+placebo, n=18; EPO+rtPA, n=17). Clinical outcome was expressed as difference between National Institutes of Health Stroke Scale at baseline and 90 days. RESULTS: ADMA levels significantly increased during the observation time in EPO, EPO+rtPA, and placebo groups (P<0.05). A treatment effect on ADMA levels was revealed by repeated measures ANOVA only in the rtPA+placebo group (P=0.027). Here, ADMA levels were decreased compared with the placebo group (P<0.05). Both the EPO and the rtPA+placebo groups in the Hannover subgroup of the EPO trial had better outcome than the placebo group (P<0.05). CONCLUSIONS: Our data underscore the potential benefit of EPO in ischemic stroke. The hypothesis from experimental data, that EPO treatment increases ADMA in stroke patients, was disproved. Further studies are needed to clarify whether decreased ADMA might contribute to therapeutic rtPA effects.


Assuntos
Arginina/análogos & derivados , Quimioterapia Combinada/efeitos adversos , Eritropoetina/efeitos adversos , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/metabolismo , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tecidual/efeitos adversos , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Arginina/antagonistas & inibidores , Arginina/biossíntese , Arginina/metabolismo , Método Duplo-Cego , Eritropoetina/administração & dosagem , Eritropoetina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Acidente Vascular Cerebral/mortalidade , Terapia Trombolítica/efeitos adversos , Ativador de Plasminogênio Tecidual/administração & dosagem , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA