Possible Parkinson's Disease Induced by Chronic Manganese Supplement Ingestion.

OBJECTIVE: The objective is to report a case of possible neurotoxicity resulting from an incorrect dietary supplement for osteoporosis taken at a toxic dose. SUMMARY: The case study examined here is a 37-year-old African-American female who consumed excessive manganese over a period of years, resulting in Parkinson's disease (PD). This patient was referred to the pharmacist pharmacotherapy service by a neurology physician. PD has been shown in the medical literature to be caused by chronic exposure to high levels of manganese. It may be concluded that daily doses of manganese well above the upper limit of 9 mg per day were taken by this patient for an extended period of time, possibly causing PD via manganism. CONCLUSION: This case illustrates the unknown risks taken by patients who use excessive amounts of over-the-counter herbals and supplements and how pharmacists can assist patients and physicians in the proper use of these popular products. ABBREVIATIONS: AI = Adequate intake, EMS = Eosinophilia myalgia syndrome, MTM = Medication therapy management, UL = Tolerable upper limit.

[Osteoporosis correction in experiment].

Osteoporosis is simulated in rats by chronic administration of omeprazole or serotonin for 6 months; investigated bone status in the model of liver fibrosis and the administration of serotonin against liver fibrosis. The following experimental groups of rats: with bilateral ovariectomy, with bilateral ovariectomy and administration of omeprazole, with the introduction of serotonin, with serotonin administration and bilateral ovariectomy, with model of liver fibrosis, with liver fibrosis model and administration of serotonin were used. The content of Ca, P, alkaline phosphatase, albumin, serum creatinine, and the content of Ca, P, Mg andFe in the bone was determined. It was found that the administration of mesenchymal stromal cells reduces the severity of osteoporosis. The effects of alfacalcidol on experimental osteoporosis was investigated. Introduction of alfacalcidol in all experimental groups increased the bone formation.

Effect of transcutaneous electrical stimulation on nociception and edema induced by peripheral serotonin.

Transcutaneous electrical nerve stimulation (TENS) is defined as the application of an electrical current to the skin through surface electrodes for pain relief. Various theories have been proposed in order to explain the analgesic mechanism of TENS. Recent studies have demonstrated that part of this analgesia is mediated through neurotransmitters acting at peripheral sites. The aim of this study was to investigate the effects of low frequency (LF: 10 HZ) TENS and high frequency (HF: 130 HZ) TENS on hyperalgesia and edema when applied before the serotonin (5-HT) administered into the rat paw. LF and HF TENS were applied to the right paw for 20 min, and 5-HT was administered immediately after TENS. The Hargreaves method was used to measure nociception, while the hydroplethysmometer (Ugo Basile®) was used to measure edema. Neither HF nor LF TENS inhibited 5-HT-induced edema. However, LF TENS, but not HF TENS, completely reduced 5-HT-induced hyperalgesia. Pre-treatment of the paw with naltrexone, prior to application of TENS, (Nx: 50 µg; I.pl.) showed a complete blockade of the analgesic effect induced by low frequency TENS. Thus, our results confirmed the lack of an anti-inflammatory effect through the use of TENS as well as the participation of peripheral endogenous opioid receptors in LF TENS analgesia in addition to its central action.

[Inhibitory effect and acting mechanism of Tongxinluo on IL-1beta-mediated coronary intimal hyperplasia and 5-hydroxytryptamine-induced coronary vasospasm in small swine].

OBJECTIVE: To observe the inhibitory effect of Tongxinluo (TXL) on coronary vaso spasm in small swine in vivo, and to investigate its possible acting mechanism. METHODS: The model of coronary atherosclerosis in 16 male small swines was established by left thoracotomy after anesthesia, isolated the sections of left anterio-descending branch and proximal end of rotator branch with similar outer diameter, and encapsulated them with paper-towel holding 2.5 microg interleukin-1beta. Two weeks later, the condition of coronary vasospasm induced by catheter intra-coronary injection of 5-hydroxytryptamine (5-HT, 10 microg/kg) was observed through coronary artery contrast examination. The 12 swines with successfully formed coronary vaso spasm were randomly divided into 2 groups, the TXL group and the control group. They were fed with special diet, but TXL 1 g/(kg d) was administered additionally to the TXL group for 4 weeks. The observation on coronary vasospasm was repeated 1 week after discontinuation of TXL treatment, then the animals were sacrificed, their vascular sections enclosed with IL-1beta was taken to conduct the pathologic examination and to detect the expressions of Rho kinase mRNA and its substrate myosin- binding subunit phosphorylation (MBS-P) by RT-PCR and Western blot method. RESULTS: Coronary artery contrast showed that local coronary stenosis occurred in the 12 model swines to different extents (20% - 30%, and vascular spasm on them could be induced by 5-HT. At the time of repeating examination, 11 vascular sections in the control group still maintain their positive spasm reaction to 5-HT, but only 2 in the TXL group did so, the reaction turned to negative in 1 and 10 in the two groups respectively. Pathological examination showed that different degrees of macrophage aggregation could be found in both groups. The degree of lumen stricture and endometrial hyperplasia in the TXL group was obviously attenuated than those in the control group. The expressions of Rho kinase mRNA and MBS-P in the control group were up-regulated obviously. As compared with those in the control group, they were inhibited significantly in the TXL group, as (71.5 +/- 2.4) vs (98.2 +/- 7.7)% and 16,633 +/- 1,390 vs 25,818 +/- 4,745, respectively (all P < 0.05). CONCLUSION: TXL could obviously inhibit the coronary intimal hyperplasia mediated by IL-1beta and coronary vasospasm induced by 5-HT, one of its mechanisms is possibly the inhibition on the intracellular Rho kinase mRNA expression in the IL-1beta enclosed vascular section to decrease the level of MBS-P.

Antinociceptive and anti-inflammatory effects of Thespesia populnea bark extract.

The ethanolic extract of Thespesia populnea bark (TPE) was investigated for anti-inflammatory and analgesic activity at the doses (p.o.) of 100, 200 and 400mg/kg body weight. For evaluation of inflammation carrageenan-, histamine- and serotonin-induced paw edema served as acute models and formaldehyde-induced arthritis served as a chronic model in rats. The acetic acid-induced writhing response and formalin-induced paw licking time in the early and late phases of mice were used to assess analgesic activity. The higher doses of TPE (200 and 400mg/kg, p.o.) were inhibiting carrageenan, histamine and serotonin-induced paw edema as well as formaldehyde-induced arthritis successfully. In addition, TPE (200 and 400mg/kg, p.o.) significantly attenuated the writhing responses induced by an intraperitoneal injection of acetic acid and late phase of pain response induced by an subplantar injection of formalin in mice. Furthermore, our phytochemical studies indicated that the ethanolic extract of bark contains alkaloids, carbohydrates, protein, tannins, phenols, flavonoids, gums and mucilage, saponins and terpenes. From acute oral toxicity studies (OECD-423 guidelines), no mortality was observed even at highest dose of TPE (2000mg/kg, p.o.).

Anti-inflammatory activity of creatine supplementation in endothelial cells in vitro.

1 Creatine (CR) supplementation augments muscle strength in skeletal muscle cells by increasing intracellular energy pools. However, the effect of CR supplementation on endothelial cells remains to be clarified. 2 In this study, we investigated whether CR supplementation had any anti-inflammatory activity against human pulmonary endothelial cells in culture. 3 We confirmed that supplementation with 0.5 mM CR significantly increased both intracellular CR and phosphocreatine (PC) through a CR transporter while keeping intracellular ATP levels constant independent of CR supplementation and a CR transporter antagonist. 4 In the assay system of endothelial permeability, supplementation with 5 mM CR significantly suppressed the endothelial permeability induced by serotonin and H(2)O(2). 5 In cell adhesion experiments, supplementation with 5 mM CR significantly suppressed neutrophil adhesion to endothelial cells. 6 In the measurement of adhesion molecules, CR supplementation with more than 0.5 mM CR significantly inhibited the expressions of ICAM-1 and E-selectin on endothelial cells, and the inhibition was significantly suppressed by an adenosine A(2A) receptor antagonist. 7 The present study suggests that CR supplementation has anti-inflammatory activities against endothelial cells.

Anti-allergic actions of the leaves of Castanea crenata and isolation of an active component responsible for the inhibition of mast cell degranulation.

The anti-allergic actions of the leaves of Castanea crenata (Fagaceae) were studied. The water extract demonstrated potent anti-allergic actions in in vivo and in vitro experiments. The oral or intraperitoneal administration of the extract (100 or 200 mg/kg) caused a significant inhibition of the 48 hr-PCA (up to 90%) and the vascular permeability induced by histamine or serotonin in rats (about 80%). The anaphylactic release of beta-hexosaminidase from RBL-2H3 cells was also significantly inhibited by the extract in a dose-dependent manner with an IC50 value of 230 microg/ml. The activity-guided fractionation of the extract, based on the determination of inhibitory effect upon the release of beta-hexosaminidase, led to the isolation of quercetin as an active principle responsible for the inhibition of degranulation.

Erythrocytes and proinflammatory mediators in wound drainage.

BACKGROUND AND OBJECTIVES: Retransfusion of shed blood collected after operation has become popular, but recent reports of side effects led to a search for possible causes. MATERIALS AND METHODS: In a randomized study of 28 patients undergoing total hip arthroplasty, shed blood was collected in Solcotrans, Orth-Evac, and ordinary Redon drainage. Osmotic fragility was measured and electron-microscopic pictures of erythrocytes from selective samples were taken. Serotonin, prostaglandin E2 (PGE2), and histamine were measured with enzyme-linked immunosorbent assays. RESULTS: Higher osmotic fragility of erythrocytes collected with Solcotrans appeared to be due to ACD which was used only with that system. Serotonin concentrations did not differ significantly. However, there was a great increase in histamine (Solcotrans 477.7, Orth-Evac 344.0, Redon drainage 453.1 nmol/ml) and PGE2 (Solcotrans 1,908.3, Orth-Evac 1,225.0, Redon drainage 2,666.7 microgram/ml) in shed blood compared with venous blood (histamine 9.5 nmol/l, PGE2 4.2 microgram/ml). CONCLUSION: Unwashed wound drainage blood collected after operation contains levels of proinflammatory mediators that can account for the reported side effects.

5-Hydroxytryptamine-induced vasoconstriction after cerebral hematoma in piglets.

Subarachnoid hematoma produces cerebral vasoconstriction that may lead to death or permanent disability. After hematoma, enhanced pial arteriolar responses to vasoconstrictor agents have been reported in newborn pigs. The present study was designed to address the hypothesis that 5-hydroxytryptamine (5-HT) constricts piglet pial arterioles, and hematoma augments this constriction. Piglets (1-3 d old) anesthetized with ketamine and acepromazine received either 3 mL of artificial cerebrospinal fluid (control) or autologous nonheparinized blood (hematoma) injected onto the cortical surface. Four days after injection, closed cranial windows were implanted over the injected area under alpha-chloralose anesthesia. Vascular reactivity to 5-HT was examined. In control piglets, topical application of 5-HT (10(-9), 10(-7), and 10(-5) M) induced very mild, dose-dependent constriction of pial arterioles (-6 +/- 1, -10 +/- 2, and -12 +/- 4%, respectively). These constrictions were substantially augmented in piglets with hematoma (-12 +/- 2, -19 +/- 1, and -30 +/- 2%, respectively). After topical application of 5-HT, cerebrospinal fluid samples were collected from under the window to determine the effects of 5-HT on the levels of 6-keto-prostaglandin F1 alpha and thromboxane B2. The baseline levels of 6-keto-prostaglandin F1 alpha and thromboxane B2 before 5-HT were 1791 +/- 387 and 434 +/- 74 pg/mL, respectively, in the control. 5-HT application had no significant effects on these prostanoid levels (levels at the highest concentration of 5-HT had a corresponding value of 1175 +/- 301 and 288 +/- 74 pg/mL for 6-keto-prostaglandin F1 alpha and thromboxane B2, respectively). However, indomethacin (5 mg/kg, i.v.) treatment of the control piglets potentiated the constriction in response to 5-HT (-11 +/- 1, -15 +/- 2, and -24 +/- 3%, respectively) sufficiently to produce constriction similar to that in the hematoma group. 5-HT has little effect on normal pial arterioles of newborn piglets but is a more potent cerebral vasoconstrictor in conjunction with cerebral hematoma.

Effects of nitric oxide synthesis inhibition on methamphetamine-induced dopaminergic and serotonergic neurotoxicity in the rat brain.

We examined effects of nitric oxide (NO.) synthesis inhibition on methamphetamine (MA)-induced dopaminergic and serotonergic neurotoxicity. The toxic dose of MA (5 mg/kg, sc, x4) significantly decreased contents of dopamine (DA), dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the striatum (ST), and significantly decreased contents of serotonin (5-HT) in the ST, nucleus accumbens (NA) and medial frontal contex (MFC). Coadministration with a NO. synthase inhibitor, N omega-nitro-L-arginine methyl ester (LNAME) (30 mg/kg, i.p., x2), reduced the MA-induced decreases in contents of DA, DOPAC and HVA in the ST, but not reduced the MA-induced decreases in contents of 5-HT in the ST, NA and MFC. These findings suggest that the MA-induced dopaminergic, but not serotonergic neurotoxicity, may be related to the neural process such as NO. formation caused by the activation of postsynaptic DA receptor.