Pharmacokinetics and Pharmacodynamics of Inorganic Nitrate in Heart Failure With Preserved Ejection Fraction.

RATIONALE: Nitrate-rich beetroot juice has been shown to improve exercise capacity in heart failure with preserved ejection fraction, but studies using pharmacological preparations of inorganic nitrate are lacking. OBJECTIVES: To determine (1) the dose-response effect of potassium nitrate (KNO3) on exercise capacity; (2) the population-specific pharmacokinetic and safety profile of KNO3 in heart failure with preserved ejection fraction. METHODS AND RESULTS: We randomized 12 subjects with heart failure with preserved ejection fraction to oral KNO3 (n=9) or potassium chloride (n=3). Subjects received 6 mmol twice daily during week 1, followed by 6 mmol thrice daily during week 2. Supine cycle ergometry was performed at baseline (visit 1) and after each week (visits 2 and 3). Quality of life was assessed with the Kansas City Cardiomyopathy Questionnaire. The primary efficacy outcome, peak O2-uptake, did not significantly improve (P=0.13). Exploratory outcomes included exercise duration and quality of life. Exercise duration increased significantly with KNO3 (visit 1: 9.87, 95% confidence interval [CI] 9.31-10.43 minutes; visit 2: 10.73, 95% CI 10.13-11.33 minute; visit 3: 11.61, 95% CI 11.05-12.17 minutes; P=0.002). Improvements in the Kansas City Cardiomyopathy Questionnaire total symptom (visit 1: 58.0, 95% CI 52.5-63.5; visit 2: 66.8, 95% CI 61.3-72.3; visit 3: 70.8, 95% CI 65.3-76.3; P=0.016) and functional status scores (visit 1: 62.2, 95% CI 58.5-66.0; visit 2: 68.6, 95% CI 64.9-72.3; visit 3: 71.1, 95% CI 67.3-74.8; P=0.01) were seen after KNO3. Pronounced elevations in trough levels of nitric oxide metabolites occurred with KNO3 (visit 2: 199.5, 95% CI 98.7-300.2 µmol/L; visit 3: 471.8, 95% CI 377.8-565.8 µmol/L) versus baseline (visit 1: 38.0, 95% CI 0.00-132.0 µmol/L; P<0.001). KNO3 did not lead to clinically significant hypotension or methemoglobinemia. After 6 mmol of KNO3, systolic blood pressure was reduced by a maximum of 17.9 (95% CI -28.3 to -7.6) mm Hg 3.75 hours later. Peak nitric oxide metabolites concentrations were 259.3 (95% CI 176.2-342.4) µmol/L 3.5 hours after ingestion, and the median half-life was 73.0 (interquartile range 33.4-232.0) minutes. CONCLUSIONS: KNO3 is potentially well tolerated and improves exercise duration and quality of life in heart failure with preserved ejection fraction. This study reinforces the efficacy of KNO3 and suggests that larger randomized trials are warranted. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02256345.

Nitrate promotes capsaicin accumulation in Capsicum chinense immobilized placentas.

In chili pepper's pods, placental tissue is responsible for the synthesis of capsaicinoids (CAPs), the compounds behind their typical hot flavor or pungency, which are synthesized from phenylalanine and branched amino acids. Placental tissue sections from Habanero peppers (Capsicum chinense Jacq.) were immobilized in a calcium alginate matrix and cultured in vitro, either continuously for 28 days or during two 14-day subculture periods. Immobilized placental tissue remained viable and metabolically active for up to 21 days, indicating its ability to interact with media components. CAPs contents abruptly decreased during the first 7 days in culture, probably due to structural damage to the placenta as revealed by scanning electron microcopy. CAPs levels remained low throughout the entire culture period, even though a slight recovery was noted in subcultured placentas. However, doubling the medium's nitrate content (from 40 to 80 mM) resulted in an important increment, reaching values similar to those of intact pod's placentas. These data suggest that isolated pepper placentas cultured in vitro remain metabolically active and are capable of metabolizing inorganic nitrogen sources, first into amino acids and, then, channeling them to CAP synthesis.

Cyanosis by methemoglobinemia in tadpoles of Cochranella granulosa (Anura: Centrolenidae)

Tadpoles inhabit generally well oxygenated rivers and streams, nevertheless they were found in areas with limited oxygen availability inside the rivers. To assess this feature, I examined factors that influence centrolenid tadpole behaviour using Cochranella granulosa. The tadpoles were reared in well-oxygenated and hypoxic environments and their development, survivorship and growth were compared. The tadpoles in oxygenated water acquired a pale color, while tadpoles in hypoxic water grew faster and were bright red and more active. In the oxygenated water, the ammonium, which had its origin in the tadpoles’ urine and feces, was oxidized to nitrate. In contrast, in the hypoxic treatment, the nitrogen compounds remained mainly as ammonium. Presumably, the nitrate in oxygenated water was secondarily reduced to nitrite inside the long intestine coils, because all symptoms in the tadpoles point to methemoglobinemia, which can occur when the nitrite passes through the intestine wall into the bloodstream, transforming the hemoglobin into methemoglobin. This could be checked by a blood test where the percentage of methemoglobin was 2.3% in the blood of tadpoles reared in hypoxic condition, while there was a 19.3% level of methemoglobin in the blood of tadpoles reared in oxygenated water. Together with the elevated content of methemoglobin, the growth of the tadpoles was delayed in oxygenated water, which had high nitrate content. The study about quantitative food-uptake showed that the tadpoles benefit more from the food in hypoxic water, although they spent there more energy moving around than the tadpoles living in oxygenated but nitrate-charged water. Rev. Biol. Trop. 58 (4): 1467-1478. Epub 2010 December 01.

Los renacuajos por lo general viven en ríos y arroyos bien oxigenados, sin embargo, como han sido encontrados en áreas con disponibilidad de oxígeno limitada en los ríos, se estudió como influye este factor en su comportamiento. Renacuajos de Cochranella granulosa fueron criados en ambientes bien oxigenados y de hipoxia para comparar su desarrollo, supervivencia y crecimiento. En el agua que no fue cambiada durante al menos un mes, los renacuajos mostraron diferencias en su desarrollo cuando vivían en agua hipóxica u oxigenada. Los renacuajos en el agua aireada tenían un color pálido, mientras que en la hipóxica fueron más activos y de un color rojo brillante. En el agua hipóxica, el nitrógeno que se originó de la orina y las heces de los renacuajos se mantuvo principalmente en forma de amonio; en cambio, el amonio fue oxidado a nitrato en el agua aireada. Presumiblemente, el nitrato en el agua oxigenada se redujo secundariamente a nitrito dentro del intestino, ya que todos los síntomas en los renacuajos que vivían en esta agua apuntaron a una metahemoglobinemia, que se produce cuando el nitrito pasa a través de la pared del intestino a la corriente sanguínea transformando la hemoglobina en metahemoglobina. Esto pudo comprobarse mediante un análisis sanguíneo en donde el porcentaje de metahemoglobina fue del 2.3% en la sangre de los renacuajos criados en condición hipóxica y de un 19.3% de metahemoglobina en aquellos criados en agua aireada. En la misma forma en que la metahemoglobina aumenta en la sangre de los renacuajos que viven en agua oxigenada, su crecimiento disminuye en agua con alto contenido de nitrato. El estudio cuantitativo de la ingestión de nutrientes mostró que el crecimiento de los renacuajos se beneficia más de los alimentos en agua hipóxica, a pesar de que los renacuajos son más activos en sus movimientos que los que viven en agua oxigenada pero cargada de nitratos.

Cyanosis by methemoglobinemia in tadpoles of Cochranella granulosa (Anura: Centrolenidae).

Tadpoles inhabit generally well oxygenated rivers and streams, nevertheless they were found in areas with limited oxygen availability inside the rivers. To assess this feature, I examined factors that influence centrolenid tadpole behaviour using Cochranella granulosa. The tadpoles were reared in well-oxygenated and hypoxic environments and their development, survivorship and growth were compared. The tadpoles in oxygenated water acquired a pale color, while tadpoles in hypoxic water grew faster and were bright red and more active. In the oxygenated water, the ammonium, which had its origin in the tadpoles' urine and feces, was oxidized to nitrate. In contrast, in the hypoxic treatment, the nitrogen compounds remained mainly as ammonium. Presumably, the nitrate in oxygenated water was secondarily reduced to nitrite inside the long intestine coils, because all symptoms in the tadpoles point to methemoglobinemia, which can occur when the nitrite passes through the intestine wall into the bloodstream, transforming the hemoglobin into methemoglobin. This could be checked by a blood test where the percentage of methemoglobin was 2.3% in the blood of tadpoles reared in hypoxic condition, while there was a 19.3% level of methemoglobin in the blood of tadpoles reared in oxygenated water. Together with the elevated content of methemoglobin, the growth of the tadpoles was delayed in oxygenated water, which had high nitrate content. The study about quantitative food-uptake showed that the tadpoles benefit more from the food in hypoxic water, although they spent there more energy moving around than the tadpoles living in oxygenated but nitrate-charged water.

Contrasting nitrate adsorption in Andisols of two coffee plantations in Costa Rica.

Fertilizer use in coffee plantations is a suspected cause of rising ground water nitrate concentrations in the ground water-dependent Central Valley of Costa Rica. Nitrate adsorption was evaluated beneath two coffee (Coffea arabica L.) plantations in the Central Valley. Previous work at one site had identified unsaturated zone nitrate retardation relative to a tritium tracer. Differences in nitrate adsorption were assessed in cores to 4 m depth in Andisols at this and one other plantation using differences in KCl- and water-extractable nitrate as an index. Significant adsorption was confirmed at the site of the previous tracer test, but not at the second site. Anion exchange capacity, X-ray diffraction data, extractable Al and Si, and soil pH in NaF corroborated that differences in adsorption characteristics were related to subtle differences in clay mineralogy. Soils at the site with significant nitrate adsorption showed an Al-rich allophane clay content compared with a more weathered, Si-rich allophane and halloysite clay mineral content at the site with negligible adsorption. At the site with significant nitrate adsorption, nitrate occupied less than 10% of the total anion adsorption capacity, suggesting that adsorption may provide long-term potential for mitigation or delay of nitrate leaching. Evaluation of nitrate sorption potential of soil at local and landscape scales would be useful in development of nitrogen management practices to reduce nitrate leaching to ground water.

Influence of photoperiod on the uptake of nitrogen and phosphorus in the water by Eichhornia crassipes and Salvinia auriculata.

The main goal of this research was to quantify the concentrations of total and ammonium N, nitrate, total and soluble P in the water in the presence of Eichhornia crassipes and Salvinia auriculata, which were submitted to two different photoperiods in a 24 hours incubation period in the laboratory. The macrophytes were incubated in plastic vials of approximately 1.5 litters, with a previously prepared solution with NH4NO3, NH4Cl, and KH2PO4. Eichhornia crassipes showed the highest average rate of reduction of all the nutrients analysed in relation to Salvinia auriculata. The largest photoperiod reflected in a higher average rate of reduction of nutrients, in both plants. Therefore, we may expect that in some periods of the year (e.g. summer), the aquatic macrophytes would show higher growth rates and higher rates of nitrogen and phosphorus absorption. These results are important for the implementation and management of wastewater treatment systems in tropical areas using aquatic macrophytes.

Efficacy of a dentifrice containing 5 per cent potassium nitrate and 1500 PPM sodium monofluorophosphate in a precipitated calcium carbonate base on dentinal hypersensitivity / Eficácia do dentifrício contendo 5 por cento de nitrato de potássio e 1500 ppm de monofluorofosfato de sódio na base do carbonato de cálcio na hipersensibilidade dentinária

The effect on dentinal hypersensitivity from the use of a dentifrice containing 5.0 per cent potassium nitrate, 1500 ppm sodium monofluorophosphate in a precipitated calcium carbonate (PCC) base over an eight-week period was compared to a placebo dentifrice without potassium nitrate. A total of forty-eight subjects were entered into the study and stratified into two balanced groups according to their baseline mean thermal (air blast) and tactile (Yeaple Probe) sensitivity scores. The two groups were randomly assigned to use either the potassium nitrate/PCC dentifrice or a placebo dentifrice without potassium nitrate. The two groups were well balanced with regard to their mean baseline thermal tactile sensitivity scores, sex and age...

Valoración de la eficacia de los nitratos (transdermicos y por vía oral) en el manejo del paciente con contusión miocardia / Nitrates in the managemente of patients with myocardial contusions

El trauma torácico es una condición que frecuentemente se acompaña de daño miocárdico, este último pasa desapercibido en etapas tempranas y no se diagnostican sus complicaciones. Las anormalidades miocárdicas por trauma se atribuyen a una reducción del flujo coronario. Dos agentes vasodilatadores coronarios, nitroglicerina y dinitrato de isosorbida, pueden mejorar la isquemia miocárdica resultante. Para comparar la eficacia y seguridad entre dos nitratos y placebo en la contusión miocárdica resultante. Para comparar la eficacia y seguridad entre dos nitratos y placebo en la contusión miocárdica por trauma torácico, se relizó un estudio comparativo, prospectivo, ciego simple. Los sujetos se asignaron aleatoriamente a: a) nitroglicerina transdérmica, b) dinitrato de isosorbida y c) placebo. Los medicamentos se administraron durante 5 días. Se incluyeron 12 pacientes en cada grupo. Las 4 enzimas medidas estuvieron altas al inicio, la fracción MB se normalizó más rápido en el grupo de nitroglicerina. La creatinfosfocinasa y la deshidrogenasa láctica se correlacionaron significativamente con la calificación de severidad del daño, no así la fracción MB. La normalización electrocardiográfica fue más completa con nitroglicerina. Los dispositivos transdérmicos de nitroglicerina demostraron ser efectivos en la recuperación de alteraciones electrocardiográficas por contusión miocárdica.

Kinetic studies of nitrite uptake by Aspergillus nidulans.

1. In the filamentous mold Aspergillus nidulans, net nitrite uptake is inducible by nitrate and nitrite, is probably different from the nitrate uptake system and is partially repressed by ammonium. 2. The concentration dependence of net nitrite uptake by the biA1 facA303 strain of A. nidulans shows a saturation kinetics with an apparent Km value of 0.64 mM. 3. Strains of A. nidulans carrying the nihA1 and nihA1 chlA14 mutations considerably reduced the affinity of the nitrite uptake system for the substrate when nitrite concentrations ranging from 2.5 mM to 10.0 mM were tested (apparent Km values of 5.9 mM and 23.6 mM, respectively). 4. These results suggest that the toxic effect of nitrite on A. nidulans is due to enhanced nitrite uptake by nihA strains when high concentrations are present in the medium.

Kinetic studies of nitrite uptake by Aspergillus nidulans

1. In the filamentous mold Aspergillus nidulans, net nitrite uptake is inducible by nitrate and nitrite, is probably different from the nitrate uptake system and is partially repressed by ammonium. 2. The concentration dependence of net nitrite uptake by the biA1 facA303 strain of A. nidulans shows a saturation kinetics with an apparent Km value of 0.64 mM. 3. Strains of A. nidulans carrying the nihA1 and nihA1 chlA14 mutations considerably reduced the affinity of the nitrite uptake system for the substrate when nitrite concentrations ranging from 2.5 mM to 10.0 mM were tested (apparent Km values of 5.9 mM and 23.6 mM, respectively). 4. These results suggest that the toxic effect of nitrite on A. nidulans is due to enhanced nitrite uptake by nihA strains when high concentrations are present in the medium

Farmacologia dos nitratos / Pharmacology of nitrates

Os nitratos säo drogas utilizadas nas afecçoes cardiovasculares, desde o século passado. Quimicamente säo ésteres de ácido nìtrico (HNO) ou nitroso (HNO) apresentando as ligaçöes C-O-N. Estes fármacos atuam promovendo vasodilataçöes periférica e coronária, levando deste modo a um aumento da oferta e a uma diminuiçäo do consumo de O. Assim, apresentam grande aplicaçäo na terapia da angina. Os mecanismos de açäo dos nitratos ainda näo se encontram totalmente esclarecidos, necessitando-se assim de novos estudos que visem ampliar o grau de conhecimento sobre a farmacodinâmica destes compostos, desta forma tornando seu uso mais eficaz na terapia cardiovascular

Nitrate as a precursor of the in-vivo formation of N-nitrosomorpholine in the stomach of guinea-pigs.

Reduction of nitrates to nitrites and formation of the carcinogen N-nitrosomorpholine (NMOR) was investigated in the stomach of guinea-pigs. A semisynthetic diet with nitrate plus morpholine was administered intragastrically after a 24-h fast; after treatment, the animals were killed and stomach nitrite contents were determined 6, 12, 18, 24 and 30 min after the treatment using a colorimetric method. NMOR content was determined 18 min after treatment with nitrate plus morpholine using gas chromatography-thermal energy analysis. Reduction of nitrates to nitrites in the stomach was observed that was sufficient to synthesize NMOR in guinea-pigs under the conditions of this experiment.