Induction of chagasic-like arrhythmias in the isolated beating hearts of healthy rats perfused with Trypanosoma cruzi-conditioned medium.

Chagas' myocardiopathy, caused by the intracellular protozoan Trypanosoma cruzi, is characterized by microvascular alterations, heart failure and arrhythmias. Ischemia and arrythmogenesis have been attributed to proteins shed by the parasite, although this has not been fully demonstrated. The aim of the present investigation was to study the effect of substances shed by T. cruzi on ischemia/reperfusion-induced arrhythmias. We performed a triple ischemia-reperfusion (I/R) protocol whereby the isolated beating rat hearts were perfused with either Vero-control or Vero T. cruzi-infected conditioned medium during the different stages of ischemia and subsequently reperfused with Tyrode's solution. ECG and heart rate were recorded during the entire experiment. We observed that triple I/R-induced bradycardia was associated with the generation of auricular-ventricular blockade during ischemia and non-sustained nodal and ventricular tachycardia during reperfusion. Interestingly, perfusion with Vero-infected medium produced a delay in the reperfusion-induced recovery of heart rate, increased the frequency of tachycardic events and induced ventricular fibrillation. These results suggest that the presence of parasite-shed substances in conditioned media enhances the arrhythmogenic effects that occur during the I/R protocol.

Induction of chagasic-like arrhythmias in the isolated beating hearts of healthy rats perfused with Trypanosoma cruzi-conditioned medium

Chagas' myocardiopathy, caused by the intracellular protozoan Trypanosoma cruzi, is characterized by microvascular alterations, heart failure and arrhythmias. Ischemia and arrythmogenesis have been attributed to proteins shed by the parasite, although this has not been fully demonstrated. The aim of the present investigation was to study the effect of substances shed by T. cruzi on ischemia/reperfusion-induced arrhythmias. We performed a triple ischemia-reperfusion (I/R) protocol whereby the isolated beating rat hearts were perfused with either Vero-control or Vero T. cruzi-infected conditioned medium during the different stages of ischemia and subsequently reperfused with Tyrode's solution. ECG and heart rate were recorded during the entire experiment. We observed that triple I/R-induced bradycardia was associated with the generation of auricular-ventricular blockade during ischemia and non-sustained nodal and ventricular tachycardia during reperfusion. Interestingly, perfusion with Vero-infected medium produced a delay in the reperfusion-induced recovery of heart rate, increased the frequency of tachycardic events and induced ventricular fibrillation. These results suggest that the presence of parasite-shed substances in conditioned media enhances the arrhythmogenic effects that occur during the I/R protocol.

Trypanosoma cruzi infection induces up-regulation of cardiac muscarinic acetylcholine receptors in vivo and in vitro.

The pathogenesis of chagasic cardiomyopathy is not completely understood, but it has been correlated with parasympathetic denervation (neurogenic theory) and inflammatory activity (immunogenic theory) that could affect heart muscarinic acetylcholine receptor (mAChR) expression. In order to further understand whether neurogenic and/or immunogenic alterations are related to changes in mAChR expression, we studied two models of Trypanosoma cruzi infection: 1) in 3-week-old male Sprague Dawley rats chronically infected with T. cruzi and 2) isolated primary cardiomyocytes co-cultured with T. cruzi and peripheral blood mononuclear cells (PBMC). Using [3H]-quinuclidinylbenzilate ([3H]-QNB) binding assays, we evaluated mAChR expression in homogenates from selected cardiac regions, PBMC, and cultured cardiomyocytes. We also determined in vitro protein expression and pro-inflammatory cytokine expression in serum and cell culture medium by ELISA. Our results showed that: 1) mAChR were significantly (P < 0.05) up-regulated in right ventricular myocardium (means +/- SEM; control: 58.69 +/- 5.54, N = 29; Chagas: 72.29 +/- 5.79 fmol/mg, N = 34) and PBMC (control: 12.88 +/- 2.45, N = 18; Chagas: 20.22 +/- 1.82 fmol/mg, N = 19), as well as in cardiomyocyte transmembranes cultured with either PBMC/T. cruzi co-cultures (control: 24.33 +/- 3.83; Chagas: 43.62 +/- 5.08 fmol/mg, N = 7 for both) or their conditioned medium (control: 37.84 +/- 3.84, N = 4; Chagas: 54.38 +/- 6.28 fmol/mg, N = 20); 2) [(3)H]-leucine uptake was increased in cardiomyocytes co-cultured with PBMC/T. cruzi-conditioned medium (Chagas: 21,030 +/- 2321; control 10,940 +/- 2385 dpm, N = 7 for both; P < 0.05); 3) plasma IL-6 was increased in chagasic rats, IL-1beta, was increased in both plasma of chagasic rats and in the culture medium, and TNF-alpha level was decreased in the culture medium. In conclusion, our results suggest that cytokines are involved in the up-regulation of mAChR in chronic Chagas disease.

Trypanosoma cruzi infection induces up-regulation of cardiac muscarinic acetylcholine receptors in vivo and in vitro

The pathogenesis of chagasic cardiomyopathy is not completely understood, but it has been correlated with parasympathetic denervation (neurogenic theory) and inflammatory activity (immunogenic theory) that could affect heart muscarinic acetylcholine receptor (mAChR) expression. In order to further understand whether neurogenic and/or immunogenic alterations are related to changes in mAChR expression, we studied two models of Trypanosoma cruzi infection: 1) in 3-week-old male Sprague Dawley rats chronically infected with T. cruzi and 2) isolated primary cardiomyocytes co-cultured with T. cruzi and peripheral blood mononuclear cells (PBMC). Using [³H]-quinuclidinylbenzilate ([³H]-QNB) binding assays, we evaluated mAChR expression in homogenates from selected cardiac regions, PBMC, and cultured cardiomyocytes. We also determined in vitro protein expression and pro-inflammatory cytokine expression in serum and cell culture medium by ELISA. Our results showed that: 1) mAChR were significantly (P < 0.05) up-regulated in right ventricular myocardium (means ± SEM; control: 58.69 ± 5.54, N = 29; Chagas: 72.29 ± 5.79 fmol/mg, N = 34) and PBMC (control: 12.88 ± 2.45, N = 18; Chagas: 20.22 ± 1.82 fmol/mg, N = 19), as well as in cardiomyocyte transmembranes cultured with either PBMC/T. cruzi co-cultures (control: 24.33 ± 3.83; Chagas: 43.62 ± 5.08 fmol/mg, N = 7 for both) or their conditioned medium (control: 37.84 ± 3.84, N = 4; Chagas: 54.38 ± 6.28 fmol/mg, N = 20); 2) [³H]-leucine uptake was increased in cardiomyocytes co-cultured with PBMC/T. cruzi-conditioned medium (Chagas: 21,030 ± 2321; control 10,940 ± 2385 dpm, N = 7 for both; P < 0.05); 3) plasma IL-6 was increased in chagasic rats, IL-1â, was increased in both plasma of chagasic rats and in the culture medium, and TNF-á level was decreased in the culture medium. In conclusion, our results suggest that cytokines are involved in the up-regulation of mAChR in chronic Chagas disease.

[Propofol-induced myocardial depression: possible role of atrial muscarinic cholinergic receptors]. / Depresión de la función mioc irdica inducida por propofol: posible participación del receptor colinérgico muscarínico auricular.

OBJECTIVE: To investigate the possible role of muscarinic cholinergic receptors (MCRs) in the depression of myocardial function induced by propofol, an intravenous anesthetic chemically unrelated to other drugs. Although adverse effects are rare, bradycardia has been reported and this can lead to cardiac arrest in some patients. The mechanism behind this effect is still unknown but a possible role for MCRs has been suggested. MATERIAL AND METHODS: The interaction of propofol with human atrial MCRs was determined by means of inhibition tests using [3H] quinuclidinyl benzilate ([3H] QNB). RESULTS: The displacement of [3H] QNB binding to human atrial MCRs by propofol was concentration dependent but the observed effect was not consistent with a model of simple competition between propofol and [3H] QNB. CONCLUSION: Propofol appears to have the ability to modify the activity of human atrial MCRs and this effect may be related to its ability to induce bradycardia.

Depresión de la función miocárdica inducida por propofol: posible participación del receptor colinérgico muscarínico auricular / Propofol-induced myocardial depression: possible role of atrial muscarinic cholinergic receptors

OBJETIVO: Investigar la posible participación de la transmisión muscarínica en la depresión miocárdicainducida por propofol, anestésico intravenoso no relacionadoquímicamente con otras drogas. A pesar de que los efectos adversos son raros, se ha reportado la aparición de bradicardia, que puede llevar incluso a paro cardíaco en algunos pacientes. En la actualidad se desconoce elmecanismo de este efecto, pero se ha sugerido la posible participación de los receptores colinérgicos muscarínicos(RCMs).MATERIAL Y MÉTODOS: La interacción del propofol con RCMs de aurícula humana se determinó por ensayos deinhibición usando benzilato de [3H]-quinuclidinilo ([3H]- QNB).RESULTADOS: El propofol desplazó la unión de [3H]- QNB de los RCMs de aurícula humana, de maneradependiente de la concentración; no obstante, el efecto observado no fue consistente con un modelo de simplecompetición entre propofol y [3H]-QNB.CONCLUSIÓN: El propofol parece tener la capacidad de modificar la actividad de los RCMs de aurícula humana,siendo éste un efecto que podría estar relacionado con su capacidad de inducir bradicardia (AU)

OBJECTIVE: To investigate the possible role of muscarinic cholinergic receptors (MCRs) in the depression ofmyocardial function induced by propofol, an intravenous anesthetic chemically unrelated to other drugs. Althoughadverse effects are rare, bradycardia has been reported and this can lead to cardiac arrest in some patients. Themechanism behind this effect is still unknown but a possible role for MCRs has been suggested.MATERIAL AND METHODS: The interaction of propofol with human atrial MCRs was determined by means ofinhibition tests using [3H] quinuclidinyl benzilate ([3H] QNB).RESULTS: The displacement of [3H] QNB binding to human atrial MCRs by propofol was concentrationdependent but the observed effect was not consistent with a model of simple competition between propofol and [3H]QNB.CONCLUSION: Propofol appears to have the ability to modify the activity of human atrial MCRs and this effectmay be related to its ability to induce bradycardia (AU)

Prevención de la Enfermedad de Chagas a través de un taller educativo dirigido a docentes de educación primaria / Prevention of Chagas disease through an educational workshop aimed at teachers in primary education

Sabiendo que la Enfermedad de Chagas es endémica en Venezuela, que los principales factores de riesgo aún están presentes en el territorio nacional y que los programas preventivos se basas principalmente en la fumigación domiciliaria, se propuso un proyecto de prevención dirigido a docentes, basado en la información sobre el tema que permitiera abordar las generalidades de la infección y conocer los factores de riesgo. Para ello, se realizó una investigación de tipo causi experimental, para lo cual se elaboró un manual: "Aprende Chagas" y un material audiovisual con información básica sobre esta parasitosis, además del diseño, aplicación y evaluación de un taller educativo que constó de cinco sesiones de 90 minutos cada una, donde los docentes contribuyeron el conociemineto a través de videos, exposiciones, dramatizaciones, carteleras y juegos didácticos. La muestra fue no probalilística intencional y estuvo conformada por 27 docentes, a los cuales les fue aplicado un instrumento de evaluación antes y después de la actividad, y de acuerdo al nivel de conocimiento alcanzado fueron clasificados en cuatro categorías: excelente, bueno, regular y malo. Los resultados mostraron que el conocimiento del grupo sobre la enfermedad en general antes del taller fué; 51,8% en la categoría regular y 22,2% en la categoría malo. Posterior al desarrollo de las cinco sesiones, el grupo se distribuyó: 63% en la categoría excelente y 37% en la categoría bueno, sin registro en las categorías regular o malo, independientemente del grupo etario, sexo y condición socioeconómica. Demostrando que las estrategias implementadas para el abordaje de la Enfermedad de Chagas a través de este taller educativo, establecieron con éxito el proceso de enseñanza-aprendizaje, colocando a este modelo como una formula valida para la comprensión de este y otros temas de salud en la comunidad.

La enfermedad de chagas induce una supersensibilidad colinergica muscarinica en ventrículo derecho de ratas chagásicas sprague dawley / Chagas's disease induce a muscarinie cholinergic supersensibility in right ventricle of chagas rats spargue dawley

La Enfermedad de Chagas constituye un problema de salud pública en Venezuela, cuyas alteraciones están representadas fundamentalmente por el desarrollo de miocardiopatías incapacitantes. En la actualidad, las causas de las miocardiopatías no son realmente conocidasy tampoco existe tratamiento; sin embargo, dentro de la teoria neurogénica se ha postulado que el Sistema Colinérgico est  involúcrado en su desarrollo. Con el fin de dilucidar el estado de Receptor Colinérgico Muscarínico (RCM) en ésta enfermedad, se establecieron dos grupos de animales: Control (ratas sanas) y Experimental (ratas con Enfermedad de Chagas en etapa crónica), posteriormente las ratas fueron sacrificadas, disecando en corazón Ventrículo Izquierdo (VI), Ventrículo Derecho (VD), Tabique Interventricular (TIV), Aurícula (Au) y en el encéfalo Tronco Encefálico (TE). Se determinó la cantidad de proteínas mediante el método de Lowry, la densidad de RCM y los efectos de agonistas (Carbacol) y antagonistas selectivos (Pirenzepina, Metoctramina, 4-DAMP y Tropicamida) por medio de ensayos de radioligandos usando [³H]-QNB como marcador radioactivo. Los resultados mostraron en TE una disminución significativa de la cantidad de proteínas en ratas con Enfermedad de Chagas; en VD se encontró una supersensibilidad significativa del RCM en ratas Chagásicas, mientras que en TIV, VI y Au no se observaron diferencias significativas entre ambos grupos. En las curvas de desplazamiento de [³H]-QNB por agonistas y antagonistas selectivos, no se encontraron diferencias significativas en el perfil de desplazamiento y en los valores de CI50, al comparar los dos grupos. En conclusión la expresión de proteínas y del RCM se encuentran alteradas en TE y VD, respectivamente.

Ciclofosfamida induce miocardiopatia en ratas inoculadas con trypanosoma cruzi / Ciclophosphamide induce myocardiopathy in rats inoculated with trypanosoma cruzi

La enfermedad de Chagas constituye un problema de salud pública en Venezuela, cuya principal consecuencia es el desarrollo de una Miocardiopatía Chagásica Crónica (MCHC). Las causas no son bien conocidas y en la actualidad no existe tratamiento específico, ni modelos animales que sustentes investigaciones para comprender su patogenia. Este trabajo plantea un modelo animal basado en el uso de Ciclofosfamida (CF). Para este fin se utilizaron 41 ratas Spargue Dawley de tres semanas de edad divididas en 4 grupos: Control (CC; n=12), Control Ciclofosfamida (CCF n=9), Control T. cruzi (TC; n=6) y Experimental Ciclofosfamida-T. cruzi (CFTC n=14). Los grupos TC y CFTC fueron inoculados con 100 parásitos/gr. de tripomastigotos de la cepa YBM. CF y CFTC fueron tratados con FC a razón de 29 mg/kg, 2 veces por semans 5 veces. La parasitemia fue valorada cada semana utilizando un hemocitometro. Posteriormente se realizaron estudios electrocardiogr ficos (EKG), bajo anestesia con Pentobarbital 40 mg/kg de peso con el fin de valorar la funcionalidad card¡aca y la respuesta vagal a la Felinefrina (1 mg/kg). Los resultados reflejaron qye: la CF en combinación con T. cruzi produce una parasitemia significativamente mayor y más prolongada, aumenta el número de trastornos electyrocardiogr ficos tales como: extrasístoles, bajo Voltaje del complejo QRS y RR variable, falta de onda "S", y PR y QT prolongados. La CF por si sola produce una respuesta bradicardizante inducida por FE más prolongada. En conclusión, la CF induce una MChC en rtas infectadas con T.cruzi.

Pharmacological doses of Zn2+ induce a muscarinic cholinergic supersensitivity.

The goal of this study was to evaluate the effect of chronic Zn2+ administration (1 mg/kg/day for 1 month) in Sprague-Dawley rats (n = 11) on motility and rearing behaviors (number of events/10 min measured in motility cage), on memory (percentage of failures using a foot-shock double T maze), on the number of muscarinic receptors (using [(3)H]-QNB as a marker) and on the cholinacetyltransferase (Chat) activity (determined by Fonnun's method) in various brain areas (striatum, hippocampus and frontal cortex), as compared with saline-treated rats (n = 10). Our results showed that Zn2+ induced a decrease in rearing (control: 24.6 +/- 3; Zn2+: 15.91 +/- 2.19) and in locomotor activity (control: 37 +/- 3.79; Zn2+: 25 +/- 4.37), a decrease in failures during memory trials (control: 26.12 +/- 5.6; Zn2+: 5.33 +/- 2.71) and an increase in muscarinic receptor density (fmol/mg) in the striatum (control: 539 +/- 6.18; Zn2+: 720 +/- 14.69), hippocampus (control: 396 +/- 7.41; Zn 2+: 458 +/- 5.05) and frontal cortex (control: 506 +/- 10.28; Zn2+: 716 +/- 16.54). Chat activity (pmol/mg/min) was decreased only in the striatum (control: 4240 +/- 158; Zn2+: 2311 +/- 69). We conclude that Zn 2+ induces a cholinergic functional supersensitivity which is related to receptor upregulation.

Partial characterization of endogenous modulators of muscarinic acetylcholine receptors in human frontal cortex.

A soluble fraction from human frontal cortex with molecular weight less than 10 kD was tested for the presence of endogenous substances capable of modulating the [3H]-QNB binding to crude P1 + P2 fractions from the same region. The soluble fraction was able to decrease [3H]-QNB binding in a dose-response manner with an IC50 of about 30 micrograms/ml. The effect appeared to be noncompetitive in nature, since Bmax but not Kd was significantly affected; however, in some specimens a biphasic profile, with an initial inhibition of 88-90% of [3H]-QNB binding and 50-60% ulterior binding recuperation was also found. The modulator appeared to have a molecular weight less than 10,000 Daltons and was heat and trypsin resistant. These results point out the existence of an endogenous factor, which could be heterogeneous in regard to its molecular nature or to its action sites.

Diversity of nicotinic acetylcholine receptors in rat hippocampal neurons. IV. Regulation by external Ca++ of alpha-bungarotoxin-sensitive receptor function and of rectification induced by internal Mg++.

Applying the whole-cell mode of the patch-clamp technique to cultured hippocampal neurons, we demonstrated that extracellular Ca++ modulates the activation and inactivation of type IA nicotinic currents, ie., the currents subserved by alpha-bungarotoxin (alpha-BGT)-sensitive, alpha-7-containing nicotinic acetylcholine receptors (nAChRs). The rundown profile of acetylcholine (ACh)-induced type IA currents that were obtained using patch pipettes filled with F(-)-based internal solution had two components: the first component of rundown was counteracted by a more physiological internal solution containing an organic anion (malate or aspartate), suggesting energy dependence; the second component exhibited dependence on concentration of CaCl2 added to the external solution ([Ca++]o), with rundown minimized at 0.32 mM. The inward rectification of Ach-elicited type IA currents, induced by intracellular Mg++ was augmented by lowering [Ca++]o (from 2 to 0.32 mM). Moreover, extracellular Ca++ (0.01-10 mM) acted in a concentration-dependent manner (IC50 = 0.26 mM) to decrease the cooperativity induced by ACh (nH was reduced from 2.7 to 1). Extracellular Ca++ (EC50 = 0.1 mM) also increased the efficacy of ACh, but exposure to [Ca++]o from 1 to 32 mM decreased the efficacy of ACh and inactivated the alpha-BGT-sensitive nAChRs (IC50 = 11 mM). In conclusion, Ca++ regulates agonist efficacy and cooperativity at the alpha-BGT-sensitive neuronal nAChR, modulates rundown and counteracts Mg++ -dependent inward rectification of type IA currents. It is suggested that the regulation by Ca++ of the alpha-BGT-sensitive nAChR activity could modulate many neuronal functions.