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1.
J Virol ; 73(8): 6670-9, 1999 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-10400764

RESUMEN

Integration of retroviral cDNA involves coupled joining of the two ends of the viral genome at precisely spaced positions in the host cell DNA. Correct coupled joining is essential for viral replication, as shown, for example, by the finding that viral mutants defective in coupled joining are defective in integration and replication. To date, reactions with purified human immunodeficiency virus type 1 (HIV-1) integrase protein in vitro have supported mainly uncoupled joining of single cDNA ends. We have analyzed an activity stimulating coupled joining present in HIV-1 virions, which led to the finding that the HIV-1 nucleocapsid (NC) protein can stimulate coupled joining more than 1,000-fold under some conditions. The requirements for stimulating coupled joining were investigated in assays with mutant NC proteins, revealing that mutations in the zinc finger domains can influence stimulation of integration. These findings (i) provide a means for assembling more authentic integrase complexes for mechanistic studies, (ii) reveal a new activity of NC protein in vitro, (iii) indicate a possible role for NC in vivo, and (iv) provide a possible method for identifying a new class of inhibitors that disrupt coupled joining.


Asunto(s)
ADN Viral , Integrasa de VIH/metabolismo , VIH-1/genética , Proteínas de la Nucleocápside/metabolismo , Integración Viral , Secuencia de Aminoácidos , ADN Complementario , Humanos , Datos de Secuencia Molecular , Mutagénesis , Proteínas Virales/metabolismo , Virión
3.
J Virol ; 72(5): 4005-14, 1998 May.
Artículo en Inglés | MEDLINE | ID: mdl-9557688

RESUMEN

Integration of retroviral cDNA into host chromosomal DNA is an essential and distinctive step in viral replication. Despite considerable study, the host determinants of sites for integration have not been fully clarified. To investigate integration site selection in vivo, we used two approaches. (i) We have analyzed the host sequences flanking 61 human immunodeficiency virus type 1 (HIV-1) integration sites made by experimental infection and compared them to a library of 104 control sequences. (ii) We have also analyzed HIV-1 integration frequencies near several human repeated-sequence DNA families, using a repeat-specific PCR-based assay. At odds with previous reports from smaller-scale studies, we found no strong biases either for or against integration near repetitive sequences such as Alu or LINE-1 elements. We also did not find a clear bias for integration in transcription units as proposed previously, although transcription units were found somewhat more frequently near integration sites than near controls. However, we did find that centromeric alphoid repeats were selectively absent at integration sites. The repeat-specific PCR-based assay also indicated that alphoid repeats were disfavored for integration in vivo but not as naked DNA in vitro. Evidently the distinctive DNA organization at centromeres disfavors cDNA integration. We also found a weak consensus sequence for host DNA at integration sites, and assays of integration in vitro indicated that this sequence is favored as naked DNA, revealing in addition an influence of target primary sequence.


Asunto(s)
Centrómero , ADN Viral , VIH-1/genética , Secuencias Repetitivas de Ácidos Nucleicos , Integración Viral , Sitios de Unión , Clonación Molecular , Secuencia de Consenso , ADN Complementario , Biblioteca Genómica , Humanos , Análisis de Secuencia de ADN
4.
J Virol ; 71(8): 6225-9, 1997 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9223522

RESUMEN

The integrase (IN) protein of the human immunodeficiency virus mediates integration of the viral DNA into the cellular genome. In vitro, this reaction can be mimicked by using purified recombinant IN and model DNA substrates. IN mediates two reactions: an endonucleolytic cleavage at each 3' end of the proviral DNA (terminal cleavage) and the joining of the linear viral DNA to 5' phosphates in the target DNA (strand transfer). Previous investigators have shown that purified IN requires Mn2+ or Mg2+ to promote strand transfer in vitro, although Mg2+ is the likely metal cofactor in vivo. IN activity in the presence of Mg2+ in vitro requires high IN concentrations and low concentrations of salt. Here, we show that the viral nucleocapsid protein NCp7 allows efficient IN-mediated strand transfer in the presence of Mg2+ at low enzyme concentrations. This potentiating effect appears to be unique to NCp7, as other small DNA-binding proteins, while capable of stimulating integration in the presence of Mn2+, all failed to stimulate strand transfer in the presence of Mg2+.


Asunto(s)
Proteínas de la Cápside , Cápside/fisiología , ADN Viral/metabolismo , Productos del Gen gag/fisiología , VIH-1/genética , Integrasas/fisiología , Magnesio/farmacología , Proteínas Virales , Integración Viral , Proteínas de Unión al ADN/fisiología , Manganeso/farmacología , Productos del Gen gag del Virus de la Inmunodeficiencia Humana
5.
Cancer Res ; 55(14): 3211-7, 1995 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-7606743

RESUMEN

The possible intervention of nuclear proteins as cofactors of integrase-catalyzed integration of retroviral DNA into the host cell genome is not fully understood. Among various nuclear proteins, DNA topoisomerase II appears to be a plausible candidate. This hypothesis is supported by a series of evidence, including the fact that integration is markedly affected by the topology of the target DNA and mainly occurs in transcribed regions in which topoisomerase II is preferentially located. In an attempt to confirm the validity of this hypothesis, we have comparatively investigated the early stages of a recombinant Moloney murine leukemia virus (psi neo) in two related Chinese hamster cell lines (DC3F and R/DC3F) expressing different levels of both isoforms of topoisomerase II. R/DC3F is derived from the parental cell line DC3F and displays a resistant phenotype towards the usual anticancer topoisomerase II inhibitors (actinomycin D, doxorubicin, and taxol). Results show that the early stages of the retroviral cycle are markedly impaired in cells underexpressing topoisomerase II (R/DC3F). This alteration mimics Fv-1 restriction and is characterized by about a 6-fold decrease in viral DNA synthesis and total inhibition of viral genome integration. The specific impairment of integration in R/DC3F cells compared to DC3F cells is assessed by the absence of G418-resistant colonies upon viral infection and a lack of the viral genome in cellular nuclear DNA as detected by the PCR procedure. These features are observed in relevant infecting conditions leading, in both cell lines, to the same amount of linear viral DNA and to the occurrence of two long terminal repeats containing circular DNA in the nuclear fractions.


Asunto(s)
ADN-Topoisomerasas de Tipo II/metabolismo , Virus de la Leucemia Murina de Moloney/genética , Integración Viral , Células 3T3/fisiología , Células 3T3/virología , Animales , Secuencia de Bases , Línea Celular , Cricetinae , Cricetulus , ADN Viral/genética , Pulmón/enzimología , Pulmón/virología , Ratones , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , Transcripción Genética , Células Tumorales Cultivadas
6.
J Biol Chem ; 269(34): 21635-8, 1994 Aug 26.
Artículo en Inglés | MEDLINE | ID: mdl-8063805

RESUMEN

Integration of human immunodeficiency virus (HIV) DNA into the genome of host cells is an obligatory step in the replicative cycle of the virus. The overall process is carried out in vitro by a single viral protein, the integrase, which binds to short sequences located at the ends of viral DNA long terminal repeats (LTRs). These end sequences are highly conserved in all HIV genomes and are therefore attractive targets for selective DNA binding compounds. The integrase-binding site located in U3 LTR contains a purine motif, 5'-GGAAGGG-3' which can be selectively targeted by oligonucleotide-intercalator conjugates. Under neutral pH and physiological temperature, these conjugates readily form a stable complex with the viral DNA which involves a short DNA triplex. Triple-helix formation prevents the catalytic functions of the integrase in vitro which results in a sequence-specific inhibition of the U3 integration process.


Asunto(s)
Carbazoles/farmacología , VIH-1/efectos de los fármacos , Sustancias Intercalantes/farmacología , Oligonucleótidos/farmacología , Integración Viral/efectos de los fármacos , Secuencia de Bases , Sistema Libre de Células , ADN/metabolismo , ADN Nucleotidiltransferasas/metabolismo , ADN Viral/metabolismo , Duplicado del Terminal Largo de VIH/efectos de los fármacos , VIH-1/genética , VIH-1/crecimiento & desarrollo , Integrasas , Datos de Secuencia Molecular
7.
C R Acad Sci III ; 317(5): 430-6, 1994 May.
Artículo en Inglés | MEDLINE | ID: mdl-7994621

RESUMEN

Combinations of ddC with either the ribonucleotide reductase inhibitor hydroxyurea (HU) or with the natural nucleoside thymidine have been investigated on the cycle of a defective (psi neo) Moloney Leukemia Virus (MoMLV) using 3T3 fibroblasts as host cells. In this experimental model, ddC displayed very poor antiviral action which was obvious given an IC50 value close to 100 microM, i.e. an efficiency about thirty thousand fold lower than that of AZT. Both HU and thymidine alone resulted in significant inhibition of MoMLV replication with IC50 values of 40 microM and 100 microM respectively. The combination of ddC with 50 microM HU lowered the IC50 of ddC by a factor of 10. A similar but more pronounced effect was obtained by combining ddC and 100 microM thymidine, which decreases the IC50 value of ddC by a factor of 50. Combining 40 microM ddC and 100 microM thymidine resulted in the quite complete inhibition of viral replication. These results show that in cell types with strongly restricted ddC action, combination treatment with compounds known to ultimately decrease dCTP biosynthesis leads to the restoration of efficient antiviral activity.


Asunto(s)
Hidroxiurea/farmacología , Virus de la Leucemia Murina de Moloney/fisiología , Timidina/farmacología , Replicación Viral/efectos de los fármacos , Zalcitabina/farmacología , Células 3T3/virología , Animales , Sinergismo Farmacológico , Ratones , Transcripción Genética/efectos de los fármacos , Zidovudina/farmacología
8.
Biochem Pharmacol ; 47(10): 1821-6, 1994 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-8204098

RESUMEN

In search of potential inhibitors of integration of retroviral DNA into host cells genome, we have investigated the effect of the external DNA binder netropsin on the in vitro insertion of long terminal repeat (LTR) ends of Moloney murine leukemia virus (M.MuLV) as catalysed by integrase purified from baculovirus strain expression vector. In agreement with the preferential binding of netropsin to A+T rich sequences, footprinting experiments have shown that this drug selectively binds to the 5'-TTTCAT LTR end sequence which is included in the DNA binding site of integrase. This feature results in the potent inhibition of both reactions involved in the insertion process, namely, nucleolytic cleavage and strand transfer. The relation between netropsin binding to A+T rich region of M.MuLV LTR end and inhibition of insertion is strongly suggested from the inability of the drug to inhibit the insertion of HIV U3 LTR end which displays a G+C rich sequence. Selective inhibition of integration of viral DNA appears to be feasible using drugs recognizing LTR end sequences.


Asunto(s)
ADN Viral/metabolismo , Virus de la Leucemia Murina de Moloney/efectos de los fármacos , Netropsina/farmacología , Secuencias Repetitivas de Ácidos Nucleicos , Secuencia de Aminoácidos , Secuencia de Bases , ADN Nucleotidiltransferasas/antagonistas & inhibidores , ADN Nucleotidiltransferasas/aislamiento & purificación , Técnicas In Vitro , Integrasas , Datos de Secuencia Molecular , Virus de la Leucemia Murina de Moloney/enzimología , Virus de la Leucemia Murina de Moloney/genética , Netropsina/química
9.
Virology ; 200(1): 87-97, 1994 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-7510441

RESUMEN

We studied Moloney murine leukemia virus replication in newly infected Balb c/3T3 cells brought to the G0 phase by serum depletion. Using the polymerase chain reaction method, we showed that Moloney murine leukemia virus can be efficiently internalized in nonproliferating fibroblasts, although reverse transcription of the viral RNA in these cells remains incomplete. It seems likely that a lower availability of deoxyribonucleotides in G0-arrested cells is responsible for this premature termination of the reverse transcription step. Accordingly, the addition of high concentrations of nucleosides to the culture medium of nondividing cells simultaneously with infection enables them to complete the reverse transcription process, without re-initiating the cell cycle. Inhibition of reverse transcription by hydroxyurea confirms the dependence of this retroviral step on the intracellular nucleotide pool rather than on the precise arrest point of the host cell cycle. Furthermore, the pyrimidine nucleotide pool, and more particularly the cytidine pool, appears to play a central regulatory role in this step.


Asunto(s)
ADN Viral/biosíntesis , Virus de la Leucemia Murina de Moloney/crecimiento & desarrollo , Nucleósidos/farmacología , ADN Polimerasa Dirigida por ARN/metabolismo , Fase de Descanso del Ciclo Celular , Transcripción Genética/efectos de los fármacos , Animales , Secuencia de Bases , Citidina/metabolismo , Fibroblastos , Hidroxiurea/farmacología , Ratones , Ratones Endogámicos BALB C , Datos de Secuencia Molecular , Nucleótidos de Pirimidina/metabolismo , ADN Polimerasa Dirigida por ARN/efectos de los fármacos , Replicación Viral
10.
Biochemistry ; 33(14): 4187-96, 1994 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-8155634

RESUMEN

In an attempt to target short purine sequences in view of pharmacological application, we have synthesized three new TFO (triple-helix-forming oligonucleotide) conjugates in which an intercalating oxazolopyridocarbazole (OPC) chromophore is linked by a pentamethylene linker to a 7-mer oligonucleotide matching the polypurine/polypyrimidine sequence located in the HIV-1 U3 LTR end region. The TFO moiety of conjugates are 5'CCTTCCC, 5'GGGAAGG, and 5'GGGTTGG. Their ability to bind to double-stranded DNA targets was examined. This binding is demonstrated by a footprinting technique using DNase I as a cleaving agent. The complex involved intermolecular pyr-pur*pyr or pur-pur*pyr triple helix. Pyrimidine TFO-OPC binds in a pH-dependent manner, whereas the others do not. The formation of the complex has been investigated at neutral pH and increasing temperature. We observed that the protection due to the purine and mixed TFO-OPC was pH independent and remained identical up to 40 degrees C. To determine the position of the OPC chromophore, molecular modeling was undertaken on the purine-conjugate/target complex. It has been suggested that the complex involved the intercalation of the OPC at the triplex-duplex junction with a small unwinding at the next excluded site.


Asunto(s)
ADN Viral/química , Duplicado del Terminal Largo de VIH , VIH-1/genética , Sustancias Intercalantes/química , Conformación de Ácido Nucleico , Oligodesoxirribonucleótidos/química , Secuencia de Bases , Carbazoles/química , ADN Viral/efectos de los fármacos , Concentración de Iones de Hidrógeno , Modelos Moleculares , Datos de Secuencia Molecular , Temperatura
11.
Biochemistry ; 33(6): 1412-8, 1994 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-8312260

RESUMEN

In order to further characterize the binding of the hybrid molecule NetOPC [bis(pyrrolecarboxamide)-oxazolopyridocarbazole conjugate] to double-stranded DNA, we have performed a molecular modeling study to investigate the binding modes of the complexes possibly formed between NetOPC and synthetic polynucleotides poly [(dA-dT)]2, poly [(dA).d(T)], and poly [d(G-C)]2 and interpreted the results in the light of the experimentally determined binding parameters. In agreement with experimental data, the modeling study suggests that whatever was the binding mode of the complex formed, the complexation energy is markedly lower (thus favorable) for AT-containing polynucleotides than for poly d[(G-C)]2. With both poly [d(A).d(T)] and poly [d(A-T)]2, the most energetically favored complex has netropsin and OPC moieties bound simultaneously in the minor groove of DNA. The second favored complex exhibits the bimodal binding, i.e., intercalation of OPC and minor groove binding of the netropsin moiety. For both types of complex, the energy of complex formation is slightly lower with poly [d(A).d(T)]. The binding site sizes of the modeled complexes are about seven and four base pairs to the full groove and bimodal binding, respectively.


Asunto(s)
Carbazoles/química , Carbazoles/metabolismo , Sustancias Intercalantes/metabolismo , Modelos Moleculares , Netropsina/análogos & derivados , Polidesoxirribonucleótidos/metabolismo , Sitios de Unión , Fenómenos Químicos , Química Física , Dicroismo Circular , Simulación por Computador , Transferencia de Energía , Sustancias Intercalantes/química , Estructura Molecular , Netropsina/química , Netropsina/metabolismo , Poli dA-dT/metabolismo , Relación Estructura-Actividad
12.
Arch Biochem Biophys ; 305(2): 606-10, 1993 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8373200

RESUMEN

An obligatory step in retroviral growth is the integration of a DNA copy of the viral RNA into the genomic DNA of the host. Recombinant human immunodeficiency virus type I (HIV-1) integrase (IN) expressed in Escherichia coli efficiently catalyzes the overall in vitro integration reaction, namely the processing of the LTR ends and the strand transfer reaction. Using the 3' end of synthetic oligonucleotides which match the termini of the HIV-1 U5 LTR as substrate and supercoiled pSP65 DNA as target, we have investigated the effect of the polyanionic drug suramin on the catalytic activity of the IN protein. It was found that at stoichiometric suramin to protein ratios, suramin displays a strong inhibitory effect on both the processing and strand transfer reactions. This inhibitory effect is related to the decrease of IN protein binding efficiency to the LTR end DNA fragment.


Asunto(s)
ADN Viral/metabolismo , Suramina/farmacología , Integración Viral/efectos de los fármacos , Secuencia de Bases , ADN Nucleotidiltransferasas/metabolismo , Duplicado del Terminal Largo de VIH , Técnicas In Vitro , Integrasas , Datos de Secuencia Molecular , Oligodesoxirribonucleótidos/química
13.
Biochem Biophys Res Commun ; 192(3): 1409-14, 1993 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-8389550

RESUMEN

Retroviral growth requires as an obligatory step the integration of a DNA copy of the viral RNA into the genomic DNA of the host. Recombinant human immunodeficiency virus type I (HIV-1) integrase (IN) expressed in Escherichia coli efficiently catalyzes the overall in vitro integration reaction, namely, the processing of the LTR ends and the strand transfer reaction. Using the 3' end of synthetic oligonucleotides which match the termini of the HIV-I U5 LTR as substrate and supercoiled pSP65 DNA as target, we have measured the effect of various topoisomerase inhibitors on the functional activity of the IN protein. Among the various drugs tested, the antitumor drug 2N-Methyl, 9-hydroxyellipticinium (NMHE) displays a marked inhibitory effect on the IN-catalyzed U5 insertion. This effect is related to the DNA binding properties of the drug rather than to a selective effect on the IN protein or the DNA-IN protein complex.


Asunto(s)
Amsacrina/farmacología , Antineoplásicos/farmacología , Antivirales/farmacología , ADN Nucleotidiltransferasas/metabolismo , VIH-1/enzimología , Secuencia de Bases , Camptotecina/farmacología , Carbazoles/farmacología , ADN Nucleotidiltransferasas/antagonistas & inhibidores , ADN Nucleotidiltransferasas/genética , Elipticinas/farmacología , Escherichia coli/genética , Etopósido/farmacología , Duplicado del Terminal Largo de VIH , VIH-1/genética , Integrasas , Cinética , Datos de Secuencia Molecular , Netropsina/farmacología , Oligodesoxirribonucleótidos/síntesis química , Plásmidos , Proteínas Recombinantes/antagonistas & inhibidores , Proteínas Recombinantes/metabolismo , Especificidad por Sustrato , Inhibidores de Topoisomerasa I , Inhibidores de Topoisomerasa II
14.
Arch Biochem Biophys ; 300(2): 756-60, 1993 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-8434953

RESUMEN

An obligatory step of retroviral growth is the integration of a DNA copy of the viral RNA into the genomic DNA of the host. Recombinant human immunodeficiency virus type I (HIV-1) integrase (IN) expressed in Escherichia coli efficiently catalyzes the overall in vitro integration reaction, namely, the processing of the long terminal repeat (LTR) ends and the strand transfer reaction. Using the 3' end of synthetic oligonucleotides which match the termini of HIV-1 LTRs as substrate and supercoiled pSP65 DNA as the target, we describe an assay that is suitable for the enzymatic analysis of the integration and for testing candidate inhibitors of HIV IN protein.


Asunto(s)
ADN Nucleotidiltransferasas/metabolismo , ADN Viral/metabolismo , Duplicado del Terminal Largo de VIH , VIH-1/genética , Integración Viral , Secuencia de Bases , ADN Nucleotidiltransferasas/genética , ADN Nucleotidiltransferasas/aislamiento & purificación , ADN Viral/genética , Escherichia coli/genética , VIH-1/enzimología , VIH-1/crecimiento & desarrollo , Integrasas , Cinética , Datos de Secuencia Molecular , Oligodesoxirribonucleótidos , Plásmidos , Proteínas Recombinantes/aislamiento & purificación , Proteínas Recombinantes/metabolismo
15.
Biochemistry ; 30(6): 1642-50, 1991 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-1847070

RESUMEN

We have investigated some properties related to interaction with DNA and recognition of AT-rich sequences of netropsin-oxazolopyridocarbazole (Net-OPC) (Mrani et al., 1990), which is a hybrid groove-binder-intercalator. The hybrid molecule Net-OPC binds to poly[d(A-T)] at two different sites with Kapp values close to 7 x 10(6) and 6 x 10(8) M-1 (100 mM NaCl, pH 7.0). Data obtained from melting experiments are in agreement with these values and indicate that Net-OPC displays a higher binding constant to poly[d(A-T)] than does netropsin. On the basis of viscometric and energy transfer data, the binding of Net-OPC to poly[d(A-T)] is suggested to involve both intercalation and external binding of the OPC chromophore. In contrast, on poly[d(G-C)], Net-OPC binds to a single type of site composed of two base pairs in which the OPC chromophore appears to be mainly intercalated. The binding constant of Net-OPC to poly[d(G-C)] was found to be about 350-fold lower than that of the high-affinity binding site in poly[d(A-T)]. As evidenced by footprinting data, Net-OPC selectively recognizes TTAA and CTT sequences and strongly protects the 10-bp AT-rich DNA region 3'-TTAAGAACTT-5' containing the EcoRI site. The binding of Net-OPC to this sequence results in a strong and selective inhibition of the activity of the restriction endonuclease EcoRI on the plasmid pBR322 as substrate. The extent of inhibition of the rate constant of the first strand break catalyzed by the enzyme is about 100-fold higher than the one observed in the presence of netropsin under similar experimental conditions.


Asunto(s)
Carbazoles/química , ADN Bacteriano/metabolismo , Netropsina/análogos & derivados , Plásmidos , Poli dA-dT/química , Polidesoxirribonucleótidos/química , Secuencia de Bases , Carbazoles/síntesis química , Carbazoles/metabolismo , Enzimas de Restricción del ADN , ADN Bacteriano/genética , Escherichia coli/genética , Radicales Libres , Hidróxidos , Radical Hidroxilo , Cinética , Matemática , Datos de Secuencia Molecular , Estructura Molecular , Netropsina/síntesis química , Netropsina/química , Netropsina/metabolismo , Desnaturalización de Ácido Nucleico , Análisis de Regresión
16.
Ann Fr Anesth Reanim ; 6(6): 528-32, 1987.
Artículo en Francés | MEDLINE | ID: mdl-3481679

RESUMEN

Thirty-six patients were anaesthetized for a maxillofacial surgical procedure. Ventilation was controlled by a ventilator (Kontron ABT 4100) with a semi-closed circle system. The flow of fresh gases was 1,200 ml.min-1. The vaporizer for the halogenated anaesthetic agent was placed out of the circle before the ventilator. Halothane was used for maintenance of anaesthesia and isoflurane for induced hypotension in orthognathic surgery. The inspired concentration of the halogenated agent was monitored by an analyser. A linear correlation between the delivered and the inhaled concentration of halogenated agent was established, the latter never reaching the delivered concentration. Monitoring the inspired oxygen concentration was required, so as to maintain a constant value. Carbon dioxide absorption by soda lime was also studied. The known advantages were: substantial economies in nitrous oxide and halogenated agents, prevention of contamination of the operating theatre, humidification and warning of the inspired gases. The use of such a system with the vaporizer out of the circle was safe, all the more so as the concentration of inhaled halogenated agents could be predicted.


Asunto(s)
Anestesia por Inhalación/instrumentación , Halotano/administración & dosificación , Isoflurano/administración & dosificación , Adulto , Humanos , Persona de Mediana Edad , Intercambio Gaseoso Pulmonar , Ventiladores Mecánicos
17.
Can Anaesth Soc J ; 33(3 Pt 1): 308-14, 1986 May.
Artículo en Inglés | MEDLINE | ID: mdl-3719431

RESUMEN

The potential for inducing hypotension during fentanyl anaesthesia by administering either diltiazem (n = 7) or sodium nitroprusside (n = 7) was investigated during total hip arthroplasty. Haemodynamic variables were obtained in the lateral position before, during and after administration of the hypotensive agent. Diltiazem 0.15 mg X kg-1 given as an IV bolus followed by a 12.5 +/- 3 micrograms X kg-1 X min-1 continuous infusion decreased mean arterial pressure (MAP) from 77 +/- 11 mmHg to 63 +/- 16 mmHg (p less than 0.05) while other haemodynamic parameters showed only minor and insignificant changes. Hypotension continued for at least 30 min after the cessation of diltiazem. With sodium nitroprusside MAP decreased immediately from 81 +/- 11 mmHg to 59 +/- 9 mmHg (p less than 0.01) and rapidly returned to its control value after cessation of the infusion. CI and Qs/Qt rose significantly (p less than 0.05) while the systemic vascular resistance index (SVRI) (p less than 0.01) and pulmonary vascular resistance index (PVRI) (p less than 0.05) fell significantly. The haemodynamic profile was significantly different between hypotensive agents for MAP (p less than 0.02), heart rate (HR) (p less than 0.01), SVRI (p less than 0.05), and PVRI (p less than 0.05). HR was lower with diltiazem than with nitroprusside. A bradycardia less than 50 beats/min was observed in five patients in the diltiazem group. MAP, SVRI and PVRI were lower with nitroprusside than with diltiazem. Diltiazem can induce and maintain moderate hypotension without tachycardia and decreased cardiac output in humans during fentanyl anaesthesia but the modulation of the level of arterial pressure and the depression of atrioventricular conduction are unpredictable.


Asunto(s)
Anestesia , Benzazepinas/farmacología , Diltiazem/farmacología , Fentanilo , Ferricianuros/farmacología , Prótesis de Cadera , Hipotensión Controlada , Nitroprusiato/farmacología , Anciano , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Masculino , Persona de Mediana Edad , Medicación Preanestésica , Factores de Tiempo
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