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1.
Rapid Commun Mass Spectrom ; 35(14): e9116, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-33928691

RESUMO

RATIONALE: Narcissus cv. Hawera has been found to biosynthesize some Sceletium-type alkaloids with antidepressant and anxiolytic activities. This ornamental plant has been poorly studied as a source of bioactive alkaloids including some contraversive reports on in vitro and intact plants. In this study, a detailed GC-MS characterization of its alkaloid fractions is presented. METHODS: GC-MS was used for the identification of compounds in the alkaloid fractions. Both underivatized and silylated samples were analyzed simultaneously. Elevated plus maze and tail suspension tests were used to assay the anxiolytic and antidepressant activities. Ellman's and MTT-dye reduction assays were used to evaluate the acetylcholinesterase (AChE) inhibitory and cytotoxicity activities, respectively. RESULTS: Of the 29 alkaloids, 13 of Sceletium-type were detected. Two new alkaloids were identified as 2-oxo-mesembrine and 2-oxo-epi-mesembrenol. Lycorine was found as a major compound (43.5%) in the crude silylated methanol extract. After the elimination of lycorine by pre-crystallization, the major alkaloids were 40.8% 6-epi-mesembranol, 16.2% 6-epi-mesembrenol, and 13.8% sanguinine. This fraction showed anxiolytic and antidepressant-like activities as well as potent AChE inhibitory and antineoplastic activities. CONCLUSIONS: Silylation of the alkaloid fractions from Narcissus cv. Hawera provides better separation, structural information, and improved sensitivity for compounds with two and more hydroxyl groups. The lycorine-free alkaloid fraction shows a great potential for further pharmacological studies.


Assuntos
Alcaloides , Cromatografia Gasosa-Espectrometria de Massas/métodos , Narcissus/química , Extratos Vegetais/química , Aizoaceae , Alcaloides/análise , Alcaloides/farmacologia , Alcaloides/toxicidade , Amaryllidaceae , Animais , Ansiolíticos/análise , Ansiolíticos/farmacologia , Ansiolíticos/toxicidade , Comportamento Animal/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos ICR
2.
Metab Brain Dis ; 35(3): 527-538, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31997264

RESUMO

Diabetes mellitus type 2 (T2DM) is characterized by resistance of insulin receptors and/or inadequate insulin secretion resulting in metabolic and structural complications including vascular diseases, arterial hypertension and different behavioral alterations. We aimed to study the effects of the antihypertensive angiotensin AT1 receptor antagonist losartan on the T2DM-induced changes of exploratory behavior, anxiety, nociception and short term memory in normotensive Wistar and spontaneously hypertensive rats (SHRs). The experimental model of T2DM induced by a combination of high fat diet and streptozotocin, decreased exploratory activity and increased the level of carbonylated proteins in selected brain structures in both strains; as well it increased corticosterone level, pain threshold, anxiety-like behavior, and decline short term memory only in SHRs. Losartan treatment alleviated some of the T2DM- induced metabolic complications, abolished the T2DM-induced hypo activity, and normalized the corticosterone level, carbonylated proteins in brain, nociception and memory. Losartan did not exert effect on the anxiety behavior in both strains. We showed that T2DM exerted more pronounced negative effects on the rats with comorbid hypertension as compared to normotensive rats. Overall effects on the studied behavioral parameters are related to decreased exploration of the new environment, increased anxiety-like behavior, and decline in short-term memory. The systemic sub-chronic treatment with an angiotensin AT1 receptor antagonist losartan ameliorated most of these complications.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Encéfalo/efeitos dos fármacos , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 2/complicações , Comportamento Exploratório/efeitos dos fármacos , Secreção de Insulina/efeitos dos fármacos , Losartan/administração & dosagem , Animais , Encéfalo/metabolismo , Corticosterona/sangue , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Dieta Hiperlipídica , Resistência à Insulina , Memória/efeitos dos fármacos , Nociceptividade/efeitos dos fármacos , Ratos , Ratos Endogâmicos SHR , Ratos Wistar
3.
Cell Mol Neurobiol ; 36(6): 927-941, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26464042

RESUMO

Over the last 10 years, accumulated experimental and clinical evidence has supported the idea that AT1 receptor subtype is involved in epilepsy. Recently, we have shown that the selective AT1 receptor antagonist losartan attenuates epileptogenesis and exerts neuroprotection in the CA1 area of the hippocampus in epileptic Wistar rats. This study aimed to verify the efficacy of long-term treatment with losartan (10 mg/kg) after kainate-induced status epilepticus (SE) on seizure activity, behavioral and biochemical changes, and neuronal damage in a model of co-morbid hypertension and epilepsy. Spontaneous seizures were video- and EEG-monitored in spontaneously hypertensive rats (SHRs) for a 16-week period after SE. The behavior was analyzed by open field, elevated plus maze, sugar preference test, and forced swim test. The levels of serotonin in the hippocampus and neuronal loss were estimated by HPLC and hematoxylin and eosin staining, respectively. The AT1 receptor antagonism delayed the onset of seizures and alleviated their frequency and duration during and after discontinuation of treatment. Losartan showed neuroprotection mostly in the CA3 area of the hippocampus and the septo-temporal hilus of the dentate gyrus in SHRs. However, the AT1 receptor antagonist did not exert a substantial influence on concomitant with epilepsy behavioral changes and decreased 5-HT levels in the hippocampus. Our results suggest that the antihypertensive therapy with an AT1 receptor blocker might be effective against seizure activity and neuronal damage in a co-morbid hypertension and epilepsy.


Assuntos
Comportamento Animal/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipertensão/fisiopatologia , Losartan/farmacologia , Neurônios/efeitos dos fármacos , Convulsões/tratamento farmacológico , Animais , Modelos Animais de Doenças , Hipertensão/complicações , Losartan/administração & dosagem , Masculino , Ratos , Ratos Endogâmicos SHR , Convulsões/complicações , Convulsões/fisiopatologia , Estado Epiléptico/induzido quimicamente
4.
Epilepsy Behav ; 51: 1-12, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26245156

RESUMO

Our previous studies revealed that Angiotensin (Ang) II has anticonvulsant effects in acute seizure models. However, data on its role in experimental models of epilepsy are missing. In the present study, we tested whether posttreatment with Ang II after kainate (KA)-induced status epilepticus (SE) can affect epileptogenesis, concomitant behavioral changes, and brain damage. The Wistar rats were intracerebroventricularly infused via osmotic mini-pumps with Ang II (1.52µg/µl/day for 28days) after SE. Spontaneous motor seizures (SMS) were video-recorded for up to three months. Locomotor activity, anxiety, and depression-like behavior were evaluated during the last week of drug infusion, while spatial memory was assessed during the 3rd month after SE. Angiotensin II decreased the latency for onset of the first SMS and increased the frequency of SMS two months after SE. The continuous peptide infusion exacerbated the KA-induced hyperactivity and caused depression-like behavior. The reduced anxiety of KA-treated rats was alleviated by Ang II exposure. The KA-induced deficit in the hippocampal-dependent spatial memory was not influenced by Ang II. However, Ang II partially prevented the neuronal damage in the hippocampus, specifically in the CA1 area. The role of AT1 and AT2 receptor activation in the effects of the octapeptide is discussed.


Assuntos
Angiotensina II/farmacologia , Anticonvulsivantes/farmacologia , Comportamento Animal/efeitos dos fármacos , Região CA1 Hipocampal/efeitos dos fármacos , Ritmo Circadiano/efeitos dos fármacos , Ácido Caínico/farmacologia , Fármacos Neuroprotetores/farmacologia , Memória Espacial/efeitos dos fármacos , Estado Epiléptico/tratamento farmacológico , Angiotensina II/administração & dosagem , Animais , Anticonvulsivantes/administração & dosagem , Região CA1 Hipocampal/patologia , Modelos Animais de Doenças , Infusões Intraventriculares , Ácido Caínico/toxicidade , Masculino , Fármacos Neuroprotetores/administração & dosagem , Ratos , Ratos Wistar , Estado Epiléptico/induzido quimicamente
5.
Pharmacol Biochem Behav ; 127: 27-36, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25456349

RESUMO

Recently, we have shown that the blockade of AT1 receptor might be useful as an adjuvant treatment strategy for the prevention of oxidative stress and neurotoxicity caused by status epilepticus (SE) in rats. The purpose of the present study was to further assess the efficacy of long-term treatment with losartan (10mg/kg), the selective AT1 receptor antagonist, during kainate (KA)-induced epileptogenesis in Wistar rats. Losartan treatment started after onset of SE and continued for 4weeks. The rats were video- and EEG-recorded for 3months. Locomotor activity, anxiety and depressive-like behavior were evaluated 9weeks after SE, when all rats had developed chronic epileptic state. Neuronal damage in hippocampus was analyzed by hematoxylin while serotonin (5-HT) levels in hippocampus by HPLC. AT1 receptor antagonism increased the latent seizure-free period and decreased the frequency of spontaneous motor seizures. Losartan positively affected epilepsy-provoked behavioral changes, including impulsivity, low anxiety level and depression in a phase-dependent manner and restored the changes in diurnal fluctuation of motor activity. Losartan exerted neuroprotection selectively in the CA1 area of the hippocampus in the KA-treated rats and lowered the 5-HT levels both in normal and abnormal conditions. Our findings suggest that the AT1 receptor antagonist exerts disease-modifying effects during KA-induced epileptogenesis and neuronal damage in CA1 hippocampal area, attenuated some of the behavioral changes and restored diurnal variability in locomotor activity.


Assuntos
Anticonvulsivantes/uso terapêutico , Epilepsia do Lobo Temporal/induzido quimicamente , Epilepsia do Lobo Temporal/tratamento farmacológico , Ácido Caínico/toxicidade , Losartan/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Animais , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Resultado do Tratamento
6.
Epilepsy Behav ; 31: 198-208, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24440891

RESUMO

Melatonin is involved in the control of circadian and seasonal rhythmicity, possesses potent antioxidant activity, and exerts a neuroprotective and anticonvulsant effect. Spontaneously hypertensive rats (SHRs) are widely accepted as an experimental model of essential hypertension with hyperactivity, deficient sustained attention, and alterations in circadian autonomic profiles. The purpose of the present study was to determine whether melatonin treatment during epileptogenesis can prevent the deleterious consequences of status epilepticus (SE) in SHRs in the kainate (KA) model of temporal lobe of epilepsy (TLE). Spontaneous recurrent seizures (SRSs) were EEG- and video-recorded during and after the treatment protocol. Melatonin (10mg/kg diluted in drinking water, 8weeks) increased the seizure-latent period, decreased the frequency of SRSs, and attenuated the circadian rhythm of seizure activity in SHRs. However, melatonin was unable to affect the disturbed diurnal rhythms and behavioral changes associated with epilepsy, including the decreased anxiety level, depression, and impaired spatial memory. Melatonin reduced neuronal damage specifically in the CA1 area of the hippocampus and piriform cortex and decreased hippocampal serotonin (5-HT) levels both in control and epileptic SHRs. Although long-term melatonin treatment after SE shows a potential to attenuate seizure activity and neuronal loss, it is unable to restore epilepsy-associated behavioral abnormalities in SHRs.


Assuntos
Antioxidantes/uso terapêutico , Comportamento Animal/efeitos dos fármacos , Encéfalo/patologia , Epilepsia do Lobo Temporal/tratamento farmacológico , Epilepsia do Lobo Temporal/fisiopatologia , Melatonina/uso terapêutico , Animais , Antioxidantes/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Ritmo Circadiano/efeitos dos fármacos , Modelos Animais de Doenças , Epilepsia do Lobo Temporal/induzido quimicamente , Comportamento Exploratório/efeitos dos fármacos , Preferências Alimentares/efeitos dos fármacos , Ácido Caínico/toxicidade , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Melatonina/farmacologia , Ratos , Ratos Endogâmicos SHR , Serotonina/metabolismo , Natação/psicologia , Fatores de Tempo
7.
Epilepsy Behav ; 27(1): 174-87, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23435277

RESUMO

Melatonin is a potent antioxidant which showed anticonvulsant activities both in experimental and clinical studies. In the present study, we examined the effect of melatonin treatment (10mg/kg/day, diluted in drinking water, 8 weeks) during epileptogenesis on the consequences of a kainate (KA)-induced status epilepticus (SE) in rats. Melatonin increased the latency in the appearance of spontaneous recurrent seizures (SRSs) and decreased their frequency only during the treatment period. The behavioral alterations associated with hyperactivity, depression-like behavior during the light phase, and deficits in hippocampus-dependent working memory were positively affected by melatonin treatment in rats with epilepsy. Melatonin reduced the neuronal damage in the CA1 area of the hippocampus and piriform cortex and recovered the decrease of hippocampal serotonin (5-HT) level in rats with epilepsy. Taken together, long-term melatonin treatment after SE was unable to suppress the development of epileptogenesis. However, it showed a potential in reducing some of the deleterious alterations that develop during the chronic epileptic state in a diurnal phase-dependent mode.


Assuntos
Depressores do Sistema Nervoso Central/uso terapêutico , Depressão/prevenção & controle , Hipercinese/prevenção & controle , Melatonina/uso terapêutico , Estado Epiléptico/complicações , Análise de Variância , Animais , Cromatografia Líquida de Alta Pressão , Depressão/etiologia , Eletroencefalografia , Agonistas de Aminoácidos Excitatórios/toxicidade , Comportamento Exploratório/efeitos dos fármacos , Hipocampo/efeitos dos fármacos , Hipocampo/metabolismo , Hipocampo/patologia , Hipercinese/etiologia , Ácido Caínico/toxicidade , Estimativa de Kaplan-Meier , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Neurônios/patologia , Ratos , Ratos Wistar , Serotonina/metabolismo , Estado Epiléptico/induzido quimicamente , Estado Epiléptico/tratamento farmacológico , Sacarose/administração & dosagem , Natação , Fatores de Tempo
8.
Folia Med (Plovdiv) ; 55(3-4): 63-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24712284

RESUMO

UNLABELLED: The renin-angiotensin system plays a crucial role in the regulation of cardiovascular function and maintenance of water-electrolyte balance. The two major receptor types of the system, AT1 and AT2, have different, often opposite effects on these functions. AIM: To elucidate the impact of long-term treatment with selective angiotensin receptor antagonists and an agonist on water-salt balance in normotensive Wistar and spontaneously hypertensive rats (SHRs). MATERIALS AND METHODS: 12-week-old male Wistar rats and SHRs were individually housed in metabolic cages and 24-h food and water intake and urine and electrolyte excretion were measured. Urinary sodium (UNa), potassium (UK) and chlorine (UCl) were determined by a flame photometer. Losartan, a selective AT1 receptor antagonist, was administered in the Wistar rats and SHRs at a dose of 10 mg/kg/day subcutaneously (sc). Wistar rats were also given the AT2 receptor antagonist, PD123319, subcutaneously at a dose of 10 mg/kg/ day. CGP 42112A, an AT2 receptor agonist, was administered intracerebroventricularly in Wistar rats at a dose of 12 microg/rat/day. The drugs were infused continuously for 14 days through osmotic minipumps. RESULTS: Losartan selectively increased sodium excretion in both rat strains and decreased weight gain in SHRs. PD123319 increased potassium excretion and decreased weight gain in Wistar rats. CGP 42112A increased food and water intake, urine output and UNa+ and UK+ excretion and decreased weight gain in normotensive Wistar rats. CONCLUSIONS: Chronic treatment with selective angiotensin receptor ligands modifies water-salt balance in rats through changes both in renal excretory function and ingestive behaviors.


Assuntos
Antagonistas de Receptores de Angiotensina/farmacologia , Receptores de Angiotensina/agonistas , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Animais , Peso Corporal/efeitos dos fármacos , Ingestão de Líquidos/efeitos dos fármacos , Ingestão de Alimentos/efeitos dos fármacos , Masculino , Oligopeptídeos/farmacologia , Ratos , Ratos Endogâmicos SHR , Ratos Wistar
9.
Folia Med (Plovdiv) ; 53(2): 69-73, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21797110

RESUMO

UNLABELLED: Accumulated evidence has shown that renin-angiotensin system has a pivotal role in stress responses. AIM: to assess the participation of AT1 receptor in stress-induced modulation of motor activity, nociception and seizure susceptibility in male Wistar rats. MATERIAL AND METHODS: AT1 receptor antagonist losartan was administered subcutaneously to rats for 10 days at a dose of 10 mg/kg either alone or as a pretreatment before chronic restraint stress applied for 10 days. Locomotor and exploratory activity (open field test), the nociception (paw-pressure test) and the seizure susceptibility (pentylenetetrazol seizure test) were analysed. RESULTS: Chronic restraint stress decreased motor activity and increased anxiety-like behaviour (grooming) while losartan pretreatment alleviated anxiety-like behaviour. Chronic restraint stress had an antinociceptive effect in paw-pressure test and losartan pretreatment abolished stress-induced antinociception. Both chronic restraint stress and losartan showed anticonvulsant activity in pentylenetetrazol seizure test. However, drug pretreatment attenuated this effect in chronically-stressed rats. CONCLUSIONS: Our findings suggest that the AT1 receptor is involved in the mechanism of stress-induced changes in anxiety-like behaviour, nociception and seizure susceptibility in rats.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/administração & dosagem , Losartan/administração & dosagem , Atividade Motora/efeitos dos fármacos , Convulsões/tratamento farmacológico , Animais , Modelos Animais de Doenças , Progressão da Doença , Relação Dose-Resposta a Droga , Masculino , Pentilenotetrazol/toxicidade , Ratos , Ratos Wistar , Restrição Física , Convulsões/induzido quimicamente , Convulsões/fisiopatologia
10.
Epilepsy Behav ; 20(2): 277-85, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21277833

RESUMO

The purpose of this study was to explore whether the kainate (KA) model of temporal lobe epilepsy (TLE) can be used as a model of comorbid epilepsy and depression to study diurnal behavioral variations in rats. Development of chronic epilepsy was confirmed by the detection of spontaneous motor seizures (SMS) with video monitoring (24 hours/3-5 months after status epilepticus [SE]). KA-treated spontaneously hypertensive rats (SHRs) exhibited higher seizure frequency than Wistar rats during the light phase in the fourth and fifth months after SE. Although epileptic Wistar rats showed depression-like behavior and reduced anxiety mostly during the light phase, there were no diurnal variations in depression-like patterns in SHRs. Anxiety levels of control and epileptic SHRs were similar. Decreases in serotonin, tryptophan, and dopamine concentrations in the hippocampus were detected in epileptic Wistar rats compared with naive controls. However, monoamine levels of epileptic SHRs were close to those of their controls. Wistar rats and SHRs develop stable depression-like behavior during the chronic epileptic phase with strain-dependent diurnal differences.


Assuntos
Transtornos Cronobiológicos/etiologia , Ritmo Circadiano/fisiologia , Depressão/etiologia , Epilepsia do Lobo Temporal/complicações , Análise de Variância , Animais , Aprendizagem da Esquiva/efeitos dos fármacos , Comportamento Animal/efeitos dos fármacos , Pressão Sanguínea/efeitos dos fármacos , Catecolaminas/metabolismo , Cromatografia Líquida de Alta Pressão/métodos , Ritmo Circadiano/efeitos dos fármacos , Modelos Animais de Doenças , Epilepsia do Lobo Temporal/induzido quimicamente , Reação de Fuga/efeitos dos fármacos , Hipocampo/metabolismo , Ácido Caínico/efeitos adversos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Ratos , Ratos Endogâmicos SHR , Ratos Wistar , Estatísticas não Paramétricas , Sacarose/metabolismo , Natação/psicologia , Fatores de Tempo
11.
Epilepsy Behav ; 17(1): 23-32, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20006556

RESUMO

Attention deficit hyperactivity disorder (ADHD) can coexist with epilepsy. Spontaneously hypertensive rats (SHRs) are considered to model ADHD with overactivity, impulsiveness, deficient sustained attention, and alterations in circadian autonomic profiles. The present study explored spontaneous recurrent seizures (SRSs) and behavioral diurnal activity rhythms in normotensive Wistar rats and SHRs in the kainate model of epilepsy. Rats were video monitored (24 h/3 months) to detect SRSs. SHRs manifested a lower seizure frequency during the light phase in the 8th and 10th weeks and a lower frequency of SRSs during the night phase accompanied by attenuated responses in hyperexcitability tests. Both epileptic strains were hyperactive, with lower anxiety levels, and their diurnal rhythms were abolished. Epileptic Wistar rats and SHRs exhibited less exploration during the dark phase. This study suggests that SHRs may be useful in modeling some aspects (particularly hypertension-related diurnal rhythm disturbance) of behavior associated with epilepsy.


Assuntos
Sintomas Comportamentais/etiologia , Ritmo Circadiano/fisiologia , Ácido Caínico , Estado Epiléptico/induzido quimicamente , Estado Epiléptico/complicações , Adaptação Ocular/efeitos dos fármacos , Adaptação Ocular/fisiologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Modelos Animais de Doenças , Comportamento Exploratório/fisiologia , Frequência Cardíaca/efeitos dos fármacos , Hipocampo/patologia , Ácido Caínico/farmacologia , Masculino , Aprendizagem em Labirinto/fisiologia , Células Piramidais/efeitos dos fármacos , Células Piramidais/patologia , Ratos , Ratos Endogâmicos SHR , Ratos Wistar , Tempo de Reação/efeitos dos fármacos , Tempo de Reação/fisiologia , Recidiva , Estatísticas não Paramétricas , Estado Epiléptico/patologia
12.
J Exp Ther Oncol ; 7(4): 263-73, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19227006

RESUMO

Prompted by a recent report of the possible carcinogenic effect of shiftwork focusing on the disruption of circadian rhythms, we review studies involving shifts in schedule implemented at varying intervals in unicells, insects and mammals, including humans. Results indicate the desirability to account for a broader-than-circadian view. They also suggest the possibility of optimizing schedule shifts by selecting intervals between consecutive shifts associated with potential side-effects such as an increase in cancer risk. Toward this goal, marker rhythmometry is most desirable. The monitoring of blood pressure and heart rate present the added benefit of assessing cardiovascular disease risks resulting not only from an elevated blood pressure but also from abnormal variability in blood pressure and/or heart rate of normotensive as well as hypertensive subjects.


Assuntos
Neoplasias/diagnóstico , Tolerância ao Trabalho Programado , Animais , Pressão Sanguínea , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/patologia , Ritmo Circadiano/fisiologia , Frequência Cardíaca , Humanos , Hipertensão/diagnóstico , Hipertensão/patologia , Camundongos , Camundongos Endogâmicos BALB C , Neoplasias/patologia , Risco , Fatores de Tempo
13.
Biomed Pharmacother ; 58 Suppl 1: S99-106, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15754846

RESUMO

A 26-year-old white woman had an ablated sino-atrial node and ventricular pacemaker as an unusual feature of a pheochromocytoma-compatible history. Her status quo included, on three occasions, elevated 24-hour urinary epinephrine and metanephrine excretion. She monitored her blood pressure (BP) and heart rate (HR) at 15- to 60-minute intervals over several days, with interruptions, before and after the institution of 10 mg phenoxybenzamine per os every 12 hours (between 7:30 and 8:00 and between 19:30 and 20:00), with continued monitoring over several months. Her data were summarized for consecutive 3-day intervals by sphygmochron. Circadian parameters and original data are compared with gender- and age-specified reference values, yielding also non-parametric endpoints, such as the percentage time elevation, the extent of excess, and the timing of excess, that all can be acceptable for some days but unacceptable for other days. In her broader time structure, or chronome, cosinor analyses revealed a prominent and statistically significant circadian rhythm in BP and HR before and during the 12-hourly therapy. The 12-hour component of BP was more prominent during therapy than prior to it. A statistically significant decreasing trend occurred before therapy, and recurred during treatment. Chronomically interpreted monitoring revealed: 1) the persistence of a statistically significant circadian rhythm during 12-hourly phenoxybenzamine treatment; 2) days-long changes in BP MESOR, the duration of which could not be previously determined based on spotchecks; 3) changes in the circadian amplitude of BP, which can be either very small or very large, compatible with the diagnosis of intermittent circadian hyper-amplitude-tension (CHAT); and 4) a very wide range of BP and HR values, so that occasional (casual) measurements fail to convey the dynamics that may underlie this infrequently found clinical condition of an elevated catecholamine excretion compatible with a pheochromocytoma. All findings support the need for long-term monitoring of BP and HR that may account for controversy in earlier publications.


Assuntos
Ritmo Circadiano/fisiologia , Esquema de Medicação , Fenoxibenzamina/uso terapêutico , Feocromocitoma/fisiopatologia , Adulto , Pressão Sanguínea/efeitos dos fármacos , Determinação da Pressão Arterial , Epinefrina/sangue , Epinefrina/urina , Reações Falso-Negativas , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Metanefrina/urina , Métodos , Fenoxibenzamina/administração & dosagem , Feocromocitoma/complicações , Feocromocitoma/metabolismo , Síncope/complicações , Taquicardia/complicações , Fatores de Tempo
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