Post-Exercise Hypotension: An Alternative Management Strategy for Hypertension and Cardiovascular Disease?

Cardiovascular disease (CVD), including hypertension, is a leading cause of death worldwide and imposes an enormous burden on our societies [...].

Stability of Compounded Topical Nifedipine in Cream, Gel, and Ointment Bases.

The objective of this study was to investigate the stability of compounded nifedipine cream in gel and ointment formulations dispensed in white plastic and glass amber jars. Extemporaneously compounded nifedipine cream (Glaxal Base), gel (K-Y Jelly), and ointment (Aquaphor) in white plastic and glass amber jars were stored at 4°C, 23°C, and 40°C. We determined potency on days 0, 7, 14, 30, 60, and 90, and subsequently assigned beyond-use-dates based on United States Pharmacopeia recommendations, organoleptic properties, and pH changes. Nifedipine potency in cream and ointment stored in white plastic jars was within ±10% of initial for 90 days (excluding day 14 for cream). In glass amber jars, potency was outside the acceptable range by day 14 at 23°C but within range for 90 days at 4°C (excluding day 30). Nifedipine potency was maintained for 90 days in both jars at 23°C and 4°C (excluding day 30) and in white plastic jars at 40°C, but 60 days stored in glass amber jars. The pH of formulations was stable with changes of less than 1-unit pH. At 40°C, a significant decrease in apparent viscosity of cream was evident on day 90. There was a decrease in apparent viscosity and phase separation of the ointment at 40°C and an increase in apparent viscosity (difficult to mix) at 4°C on day 14 onwards. Significant organoleptic changes were observed by day 7 at 40°C (decrease in apparent viscosity and abnormal odor by day 90), day 30 at 4°C (thicker consistency), and day 90 at 23°C (abnormal odor). Storage in white plastic jars at 23°C is recommended for compounded topical nifedipine cream and ointment (for 90 days), and for gel (60 days).

Hemodynamic Assessment and In vivo Catabolism of Adenosine 5'-triphosphate in Doxorubicin or Isoproterenol-induced Cardiovascular Toxicity.

OBJECTIVE: Previous studies have shown that catabolism of adenosine 5'-triphosphate (ATP) in systemic blood is a potential surrogate biomarker for cardiovascular toxicity. We compared the acute toxicity of high doses of doxorubicin (DOX) and isoproterenol (ISO) on hemodynamics and ATP catabolism in the systemic circulation. METHODS: sprague Dawley (SD) rats (n = 8 - 11) were each given either a single dose of 30 mg/kg ISO, or a twice-daily dose of 10 mg/kg of DOX or 4 doses of normal saline (control) by subcutaneous injection. Blood samples were collected up to 6 hours for measuring concentrations of ATP and its catabolites. Hemodynamics was recorded continuously. The difference was considered significant at p < 0.05 (ANOVA). RESULTS: Mortality was 1/8, 5/11, and 0/11 for the DOX, ISO, and control groups, respectively. Systolic blood pressure was significantly lower in the DOX and ISO treated rats than in control measured at the last recorded time (76 ± 9 for DOX vs. 42 ± 8 for ISO vs. 103 ± 5 mmHg for control, p < 0.05 for all). Blood pressure fell gradually after the final injection for both DOX and control groups, but abruptly after ISO, followed by a rebound and then gradual decline till the end of the experiment. Heart rate was significantly higher after ISO, but there were no differences between the DOX and control rats (p > 0.05). RBC concentrations of ADP and AMP, and plasma concentrations of adenosine and uric acid were significantly higher in the ISO group. In contrast, hypoxanthine concentrations were significantly higher in the DOX treated group (p < 0.05). CONCLUSION: Acute cardiovascular toxicity induced by DOX and ISO may be measured by changes in hemodynamics and breakdown of ATP and adenosine in the systemic circulation, albeit a notable qualitative and quantitative difference was observed.

Stability of Compounded Diltiazem Hydrochloride in Cream, Ointment, and Gel Formulations for Topical Use.

Interest in the topical use of compounded diltiazem has increased. Published information on the stability of such products is scarce. The objective of this study was to investigate the stability of diltiazem hydrochloride compounded in cream (Glaxal Base), ointment (white petrolatum), and hydroxyethyl cellulose-based gel over 90 days at room (23°C), refrigerator (4°C), and elevated (40°C) temperatures, stored in white plastic and glass amber containers. Organoleptic properties, pH changes, and United States Pharmacopeia recommendations were used for assigning beyond-use-dates. The results showed that the currently recommended United States Pharmacopeia beyond-use date of 30 days is acceptable for diltiazem (2%) in Glaxal Base at 4°C and 23°C in either white plastic or glass amber jars. The cream, however, is not recommended for use if exposed to elevated temperatures (40°C) in white plastic jars but may be used within 7 days if stored in glass amber jars. A beyond-use date of 90 days for diltiazem (2%) hydroxyethyl cellulose-based gel, when maintained at 4°C or 23°C, in either white plastic or glass amber jars, is recommended. Gels exposed to elevated temperatures (40°C) should be used within14 and 30 days in glass amber and white plastic jars, respectively. Lastly, a BUD of 90 days for diltiazem (2%) ointment (white petrolatum) at 23°C stored in either jar type is acceptable. Ointment formulations exposed to elevated temperatures (40°C) may be used within 7 days in white plastic jars. Diltiazem (2%) in white petrolatum should not be stored at 4°C.

Drug-release Assessment of Compounded Topical Nifedipine and Diltiazem in Commonly Used Bases for Wound Healing.

The objective of this study was to determine release profiles of extemporaneously compounded nifedipine and diltiazem in commonly used bases in pharmacy practice. Release of nifedipine 0.2%, 2%, and 10% (w/w) from Glaxal Base, K-Y Jelly, and Aquaphor Healing Ointment, and of diltiazem 2% (w/w) from GlaxalBase, hydroxyethyl cellulose-based gel, and white petrolatum was quantified using the Franz-cell diffusion system. The cumulative release was determined at 0.5 hour, 1 hour, 1.5 hours, 2 hours, 3 hours, 4 hours, and 6 hours. Two-way ANOVA with Tukey's posthoc test was used for statistical analyses, with a P-value of <0.05 considered significant. At a 0.2% concentration, cumulative nifedipine release was highest from Glaxal Base. At 2% and 10% concentrations, nifedipine release was highest from K-Y Jelly, although this was only significantly different from Glaxal Base at 6 hours and 1.5 hours, 4 hours, 6 hours (P<0.05), respectively. Diltiazem release from Glaxal Base and white petrolatum was significantly lower than the gel (P<0.05). No significant difference in diltiazem release from Glaxal Base at 0.5 hour was observed versus white petrolatum (P>0.05). Nifedipine and diltiazem release both followed Higuchi's mathematical model with the highest coefficient of determination (R2) for all formulations. Of the bases studies, Glaxal Base is the recommended base for compounding topical nifedipine (0.2%). For higher concentrations of nifedipine (2% and10%), both Glaxal Base and K-Y Jelly are suitable options for base selection. A hydroxyethylcellulose-based gel is recommended for topical diltiazem (2%).

Compounded Topical Amitriptyline for Neuropathic Pain: In Vitro Release from Compounding Bases and Potential Correlation with Clinical Efficacy.

BACKGROUND: Topical amitriptyline has been described as having mixed clinical efficacy for neuropathic pain. A few case reports using higher concentrations of this compound found clinical benefit, but many of these studies did not describe the components used in formulating the amitriptyline preparations. OBJECTIVE: To generate reproducible clinical measures of the characteristics of amitriptyline diffusion from selected compounding bases, to support a scientific approach to base selection when compounding this drug for neuropathic pain. METHODS: Amitriptyline hydrochloride (1%, 5%, and 10%) was compounded with 3 proprietary compounding bases: Lipoderm base, Emollient Cream, and Mediflo 30 pluronic lecithin organogel (PLO) gel. In vitro release of the drug from each base and subsequent permeation across artificial human skin were investigated with the Franz diffusion system. Amitriptyline release mechanisms were determined with kinetic models. How quickly and to what extent the drug leaves each base to diffuse through the skin were characterized by determining steady-state flux, cumulative permeation, and lag times. RESULTS: Release of amitriptyline was significantly higher from the Mediflo PLO gel than from the Lipoderm base or Emollient Cream (p < 0.05). Mean cumulative drug release after 24 h, from the 10% formulation, was 23.9% (standard deviation [SD] 4.1%) for Lipoderm base, 41.8% (SD 3.1%) for Emollient Cream, and 53.2% (SD 7.7%) for Mediflo PLO gel. A high percentage of amitriptyline was retained in all 3 bases. Although amitriptyline release was highest with Mediflo PLO gel, this base resulted in significantly lower cumulative permeation relative to Lipoderm base and Emollient Cream (p < 0.05). There was a strong overall correlation between amitriptyline concentration, lag time, and flux. Higher concentrations were associated with significantly lower lag times and increased flux. The highest lag time and flux were observed for Mediflo PLO gel. CONCLUSION: These data indicate that the therapeutic effectiveness of compounded amitriptyline for neuropathic pain depends on its diffusion out of the compounding bases and penetration through the skin.

CONTEXTE: L'efficacité clinique de l'amitriptyline topique contre les douleurs neuropathiques a été décrite comme étant variable. Quelques rapports utilisant des concentrations plus élevées de cette base indiquent des avantages cliniques, mais bon nombre d'entre eux ne décrivent pas les composants des préparations d'amitriptyline. OBJECTIF: Établir des mesures cliniques reproductibles des caractéristiques de la diffusion de l'amitriptyline selon une approche scientifique de la sélection des bases pour la préparation de ce médicament contre les douleurs neuropathiques. MÉTHODES: Le chlorohydrate d'amitriptyline (1 %, 5 % et 10 %) a été mélangé à trois bases de préparations magistrales brevetées : la base Lipoderm, la crème émolliente et le gel Mediflo PLO 30. La libération in vitro du médicament de chaque base et la perméation qui s'en est suivie dans la peau humaine artificielle ont été étudiées à l'aide du système de diffusion Franz. La définition des mécanismes de libération de l'amitriptyline repose sur des modèles cinétiques. La rapidité et la durée de libération du médicament de chaque base pour se diffuser dans la peau ont été caractérisées par la détermination du flux constant, de la perméation cumulée et des temps de latence. RÉSULTATS: La libération de l'amitriptyline était sensiblement plus élevée quand le produit était mélangé au gel Mediflo PLO plutôt qu'à la base Lipoderm ou à la crème émolliente (p < 0,05). La libération cumulée du médicament, formule 10 %, après 24 h était de 23,9 % (écart type [É.T.] ± 4,1 %) avec la base Lipoderm; 41,8 % (É.T. ± 3,1 %) avec la crème émolliente et 53,2 % (É.T. ± 7,7 %) avec le gel Mediflo PLO. Les trois bases retenaient un pourcentage élevé d'amitriptyline. Bien que la libération d'amitriptyline était plus élevée en présence du gel Mediflo PLO, la perméation cumulée de cette base par rapport à celle de la base Lipoderm et de la crème émolliente était sensiblement moins élevée (p < 0,05). L'observation a révélé une forte corrélation générale entre la concentration d'amitriptyline, le temps de latence et le flux. Les concentrations plus élevées étaient associées à des temps de latence sensiblement moins élevés. C'est le gel Mediflo PLO qui a démontré une supériorité du temps de latence et du flux. CONCLUSION: Ces données indiquent que l'efficacité thérapeutique de la préparation d'amitriptyline contre les douleurs neuropathiques dépend de sa diffusion hors des bases dans les préparations magistrales et de sa pénétration dans la peau.

Compounded gabapentin for neuropathic pain: Stability and beyond-use date (BUD) in some commonly used bases.

OBJECTIVES: To investigate the stability and beyond-use date (BUD) of topical gabapentin in 3 commonly used bases. METHODS: Lipoderm cream, Versabase gel, and Emollient cream were used to compound gabapentin (10%). The products were stored in Ecolojars, kept at 25°C, 4°C, and 40°C, and samples were collected on different days (days 0, 14, 28, and 90). Potency, stability, and organoleptic changes were monitored. RESULTS: At 25°C and 40°C, the potency of gabapentin in Lipoderm cream significantly increased (P < 0.05) after 28 and 90 days, respectively. In contrast, gabapentin degraded in Emollient cream (P < 0.05). At 25°C, the organoleptic properties of the drug compounded with Lipoderm cream (25°C) remained consistent for up to 28 days but showed signs of physical changes in other bases. Gabapentin recrystallized from Versabase gel and Emollient cream within 14 days. CONCLUSION: Gabapentin compounded with Lipoderm cream for topical use was stable in Ecolojars for 28 days at 25°C. Under the same conditions, the drug was not stable in Versabase gel and Emollient cream. Based on our stability and potency data, the beyond-use date of currently dispensed gabapentin (10%) formulations with Lipoderm cream should not be extended beyond the currently assigned 30-day mark, even when refrigerated. It is unclear whether the stability of these formulations is improved if stored in air-tight containers.

ATP in red blood cells as biomarker for sepsis in humans.

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to an infection. Due to the lack of causative immune treatment, mortality of sepsis remains at a high level and represents one of the main disease burdens globally. Adenosine 5' triphosphate (ATP) levels in red blood cells (RBC) are modulated by various factors during sepsis, including a decrease in ATP production, an increase in ATP catabolism and alterations in ATP release. Therefore, we hypothesize that intracellular ATP levels in RBC can serve as potential biomarker for sepsis and support sepsis diagnosis. This will facilitate early treatment and could improve the outcome of this serious condition.

Adenosine 5'-Triphosphate Metabolism in Red Blood Cells as a Potential Biomarker for Post-Exercise Hypotension and a Drug Target for Cardiovascular Protection.

The importance of adenosine and ATP in regulating many biological functions has long been recognized, especially for their effects on the cardiovascular system, which may be used for management of hypertension and cardiometabolic diseases. In response to ischemia and cardiovascular injury, ATP is broken down to release adenosine. The effect of adenosine is very short lived because it is rapidly taken up by erythrocytes (RBCs), myocardial and endothelial cells, and also rapidly catabolized to oxypurine metabolites. Intracellular adenosine is phosphorylated back to adenine nucleotides via a salvage pathway. Extracellular and intracellular ATP is broken down rapidly to ADP and AMP, and finally to adenosine by 5′-nucleotidase. These metabolic events are known to occur in the myocardium, endothelium as well as in RBCs. Exercise has been shown to increase metabolism of ATP in RBCs, which may be an important mechanism for post-exercise hypotension and cardiovascular protection. The post-exercise effect was greater in hypertensive than in normotensive rats. The review summarizes current evidence in support of ATP metabolism in the RBC as a potential surrogate biomarker for cardiovascular protection and toxicities. It also discusses the opportunities, challenges, and obstacles of exploiting ATP metabolism in RBCs as a target for drug development and precision medicine.

Adenosine and Adenosine 5'-triphosphate Catabolism in Systemic Blood as a Potential Biomarker for Doxorubicin Cardiotoxicity in an Experimental Rat Model in vivo.

BACKGROUND: Previous studies have shown that metabolism of adenosine 5'-triphosphate (ATP) in systemic blood is a potential surrogate biomarker for cardiovascular toxicity. OBJECTIVE: To investigate the acute effect of high dose of doxorubicin (DOX) on adenosine and ATP catabolism in systemic blood in vivo. METHOD: Sprague Dawley (SD) rats were each given either 10 mg/kg of DOX (n = 8) or normal saline (1 mL/kg, n = 11) twice daily for 4 doses by subcutaneous (sc) injection. Blood samples were collected sequentially for up to 6 hours for measuring circulating concentrations of ATP, adenosine and their metabolites. Hemodynmic recording was obtained continuously after the last injection. The difference in response between groups was considered significant at p < 0.05 (t-test). RESULTS: Diastolic blood pressure (DBP) was significantly lower in the DOX treated rats than in the control before the final injection (87 ± 12 vs. 104 ± 11 mmHg, p < 0.05). Blood pressure fell gradually after the last injection and the decrease was significantly greater in the DOX treated group (p < 0.05). Plasma concentration of adenosine was significantly lower in the DOX treated group. In contrast, plasma concentrations of uric acid and hypoxanthine, as well as Red Blood Cell (RBC) concentrations of AMP, were significantly higher (p < 0.05). CONCLUSION: Acute cardiotoxicity induced by DOX may be measured by the increased breakdown of ATP to AMP in the RBC and also breakdown of adenosine to hypoxanthine and uric acid in plasma.

Metabolomics and Biomarkers for Drug Discovery.

Metabolomics and biomarkers are increasingly used in drug discovery and development, and are applied to personalized medicine. Progress in these research areas has increased our understanding of disease pathology and improved therapeutic strategies for many diseases with unmet challenges. Further advances will ultimately result in the development of better drugs and breakthrough therapies, which will benefit millions of patients suffering from chronic and life-threatening diseases worldwide.

Doxorubicin impairs cardiomyocyte viability by suppressing transcription factor EB expression and disrupting autophagy.

Doxorubicin (DOX) is an effective anti-cancer agent. However, DOX treatment increases patient susceptibility to dilated cardiomyopathy. DOX predisposes cardiomyocytes to insult by suppressing mitochondrial energy metabolism, altering calcium flux, and disrupting proteolysis and proteostasis. Prior studies have assessed the role of macroautophagy in DOX cardiotoxicity; however, limited studies have examined whether DOX mediates cardiac injury through dysfunctions in inter- and/or intra-lysosomal signaling events. Lysosomal signaling and function is governed by transcription factor EB (TFEB). In the present study, we hypothesized that DOX caused myocyte injury by impairing lysosomal function and signaling through negative regulation of TFEB. Indeed, we found that DOX repressed cellular TFEB expression, which was associated with impaired cathepsin proteolytic activity across in vivo, ex vivo, and in vitro models of DOX cardiotoxicity. Furthermore, we observed that loss of TFEB was associated with reduction in macroautophagy protein expression, inhibition of autophagic flux, impairments in lysosomal cathepsin B activity, and activation of cell death. Restoration and/or activation of TFEB in DOX-treated cardiomyocytes prevented DOX-induced suppression of cathepsin B activity, reduced DOX-mediated reactive oxygen species (ROS) overproduction, attenuated activation of caspase-3, and improved cellular viability. Collectively, loss of TFEB inhibits lysosomal autophagy, rendering cardiomyocytes susceptible to DOX-induced proteotoxicity and injury. Our data reveal a novel mechanism wherein DOX primes cardiomyocytes for cell death by depleting cellular TFEB.

Effect of Cardiovascular Injury on Catabolism of Adenosine and Adenosine 5-'Triphosphate in Systemic Blood in a Freely Moving Rat Model In Vivo.

BACKGROUND: Previous studies have shown that catabolism of adenosine 5'-triphosphate (ATP) in red blood cell (RBC) may be a key factor for cardiovascular protection and maintaining cardiovascular homeostasis. OBJECTIVE: To investigate the effect of cardiovascular injury on adenosine and ATP catabolism in systemic blood using a freely moving rat model in vivo. METHOD: After acclimatized to the experimental environment, Sprague Dawley (SD) rats were each given either isoproterenol (30 mg/kg) or saline (1 mL/kg) by subcutaneous (sc) injection. Blood samples were collected sequentially for up to 6 hours for measurement of red blood cell (RBC) concentrations of adenine nucleotides and plasma concentrations of adenosine and its oxypurine metabolites. RESULTS: We have found isoproterenol induced 50% mortality under the experimental condition. Plasma concentrations of adenosine (ADO) and uric acid (UA) and red blood cell (RBC) concentrations of adenosine 5'-diphosphate (ADP) and adenosine 5'-monophosphate (AMP) in RBC were significantly higher in the isoproterenol treated rats (p < 0.05 for all the comparison). On the other hand, plasma concentrations of hypoxanthine (HYP) were higher in the control group (p < 0.05), but there was no statistically significant changes in ATP concentrations in the RBC (p > 0.05). CONCLUSION: Cardiovascular injury induced by isoproterenol resulted in breakdown of ATP to ADP and AMP in the RBC and also breakdown of ADO to UA in plasma and other tissues.

Thyroid hormone (levothyroxine) replacement via the respiratory route by inhalation: in vitro exploratory studies.

OBJECTIVES: To conduct proof of principle studies that will enable development of noninvasive (respiratory) delivery systems for levothyroxine (T4). METHODS: Preformulation (solubility, stability), formulation and biopharmaceutical (in vitro absorption, transport, gene expression) studies were conducted. Calu-3 cell line was used for permeation studies. RESULTS: Solubility profiles of T4 were established in aqueous (PBS, HBSS, isotonic saline) and non-aqueous solvents (PEG 400, PEG 600, propylene glycol, glycerine). Transport of the compound across Calu-3 cells suggested involvement of active transport systems. This correlated with expression of thyroxine transporters (MCT8, MCT10, OATP1A2, LAT1 and LAT2) in the cell line. Diffusion characteristics showed significant absorption with no detection of T4 metabolite (triiodothyronine). Formulation studies revealed that stable formulations could be prepared using a combination of aqueous and non-aqueous solvents. CONCLUSIONS: Results of the studies indicated that T4 can be absorbed effectively from the respiratory mucosa. Factors affecting stability such as pH and temperature should be taken into account during formulation development of this compound for the respiratory route.

A Pilot Study to Assess Adenosine 5'-triphosphate Metabolism in Red Blood Cells as a Drug Target for Potential Cardiovascular Protection.

OBJECTIVE: To study the effect of exercise preconditioning on adenosine 5'triphosphate (ATP) metabolism in red blood cells and cardiovascular protection against injury induced by isoproterenol in vivo. METHODS: Male Sprague Dawley rats (SDR) were each exercised on a treadmill for 15 minutes at 10 m/min and 10% grade (n = 7) (LowEx), or 14 m/min and 22% grade (n = 8) (VigEx). Two hours after the exercise, each rat received a single dose of isoproterenol (30 mg/kg) by subcutaneous (sc) injection. Two separate groups of SDR were used as control: One received no exercise (n = 10) (NoEx) and the other received no exercise and no isoproterenol (n = 11) (NoIso). Serial blood samples were collected over 5 hours for measurement of ATP and its catabolites by a validated HPLC. Hemodynamic recording was collected continuously for the duration of the experiment. Data were analysed using ANOVA and t-tests and difference considered significant at p < 0.05. RESULTS: Exercise pre-conditioning (both LowEx and VigEx) reduced mortality after isoproterenol from 50% to < 30% (p > 0.05). It attenuated the rebound in blood pressure significantly (p < 0.05 between NoEx vs VigEx), attenuated the increase of RBC adenosine 5'-monophosphate (AMP) concentrations induced by isoproterenol, and also decreased the breakdown of ATP to AMP in the RBC (p < 0.05 vs NoEx). CONCLUSION: Exercise pre-conditioning decreased the blood pressure rebound and also breakdown of ATP in RBC after isoproterenol which may be exploited further as a drug target for cardiovascular protection and prevention.

Diltiazem reduces mortality and breakdown of ATP in red blood cell induced by isoproterenol in a freely moving rat model in vivo.

The benefit of calcium channel blockers for cardiovascular prevention against heart attack and stroke has not been firmly supported. We investigated the possible cardiovascular protective effect of diltiazem (DTZ) against injury induced by isoproterenol using a freely moving rat model in vivo. Sprague Dawley rats were injected subcutaneously (sc) with either 5 or 10 mg/kg of DTZ, or saline as control, twice daily for five doses. One hour after the last injection, a single dose of isoproterenol (30 mg/kg) was injected sc to each rat. Blood samples were collected serially for 6 h for measurement of adenine nucleotides (ATP, ADP and AMP) in red blood cell (RBC) by a validated HPLC. The study has shown isoproterenol induced 50% mortality and also increased RBC concentrations of AMP from 0.04 ± 0.02 to 0.29 ± 0.21 mM at the end of the experiment (p < 0.05). Treatment with 10 mg/kg of DTZ reduced mortality from 50% to <20% and attenuated the increase of RBC concentrations of AMP from +0.25 ± 0.22 in the control rats to +0.072 ± 0.092 mM (p < 0.05). The study concluded that 10 mg/kg of DTZ reduced mortality and breakdown of ATP induced by isoproterenol in rats.

Effect of acute exercise on cardiovascular hemodynamic and red blood cell concentrations of purine nucleotides in hypertensive compared with normotensives rats.

OBJECTIVE: The mechanisms of exercise-induced health benefits are complex and not fully understood. This study investigated the effects of exercise and hypertension on cardiovascular hemodynamic responses and red blood cell (RBC) concentrations of purine nucleotides using normotensive and hypertensive rat models in vivo. METHODS: Sprague Dawley rats (SDRs) and spontaneously hypertensive rats (SHRs) were exercised on a treadmill for 15 min at a speed of 10 m/min and 5% grade. Blood samples were obtained from each rat before, during, and after exercise for measurement of adenosine 5'-triphosphate (ATP) and guanosine 5'-triphosphate (GTP) concentrations in RBCs by a validated high-performance liquid chromatography assay. They were returned to a restrainer after exercise, and hemodynamic recording collected continuously up to 6 h. Two separate groups (SDRs and SHRs) without exercise were used as controls. Biomarker data were compared between SDRs and SHRs using analysis of variance and t test and difference considered significant at p < 0.05. RESULTS: The study has demonstrated for the first time a difference in the postexercise effect between SDRs and SHRs. The 15 min of exercise significantly increased systolic blood pressure (SBP) (129 ± 16 to 162 ± 26 mmHg) and heart rate (HR) (416 ± 29 to 491 ± 26 bpm) in SDRs (p < 0.05), but not in SHRs. The postexercise hemodynamic effects were more profound in SHRs. SBP and diastolic blood pressure (DBP) also fell significantly in the control group of SHRs (SBP 184 ± 14 to 152 ± 29 mmHg and DBP 149 ± 9 to 120 ± 14 mmHg, p < 0.05 for both) towards the end of the experiment but not in the SDR group. The RBC concentrations of ATP and GTP increased after exercise in both SDRs and SHRs which were significantly correlated with the postexercise hemodynamic effect (p < 0.05). CONCLUSION: SHRs were more tolerant to increases in HR and SBP induced by exercise, and have more profound postexercise hemodynamic effects than SDRs. The hemodynamic effects were linked closely with RBC concentrations of ATP and GTP in both SDRs and SHRs.

Cytoprotective potential of anti-ischemic drugs against chemotherapy-induced cardiotoxicity in H9c2 myoblast cell line.

To investigate potential prevention or attenuation of anti- cancer drug induced cardiotoxicity using anti-ischemic drugs, a rat myoblast (H9c2) cell line was used as our in vitro cardiac model. Irinotecan and doxorubicin were found to be cytotoxic for the H9c2 cell line with IC50 of 30.69 ± 6.20 and 20.94 ± 6.05 mmol L-1, respectively. 5-Flurouracil and cladribine were not cytotoxic and thus IC50 could not be calculated. When 100 mmol L-1 doxorubicin was incubated for 72 hours with 50 mmol L-1 diltiazem, 100 mmol L-1 dexrazoxane and 100 mmol L-1 losartan, respectively, there was a 58.7 ± 10.2, 52.2 ± 11.7 and 44.7 ± 5.4 % reduction in cell death. When 200 mmol L-1 irinotecan was incubated for 72 hours with 100 mmol L-1 dexrazoxane, losartan and diltiazem, respectively, a 27.7 ± 6.9, 25.6 ± 5.1, and 19.1 ± 2.3 % reduction in cell death was observed. Our data suggests that losartan and diltiazem were as effective as dexrazoxane in protecting the cells against irinotecan- and doxorubicin-induced cell toxicity. These findings offer potential uses of anti- -ischemic drugs for ablation of cytotoxicity in response to mitochondrial injury, thereby improving patient outcomes and reducing health-care costs.

Comparing pharmacokinetics and metabolism of diltiazem in normotensive Sprague Dawley and Wistar Kyoto rats vs. spontaneously hypertensive rats in vivo.

BACKGROUND: In order to identify a suitable rodent model for preclinical study of calcium antagonists, the pharmacokinetics and metabolism of one of the prototypes diltiazem (DTZ) in normotensive Sprague Dawley (SDR) was compared with Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) following 5 mg/kg twice daily for five doses given by subcutaneous injection. METHODS: Pharmacokinetic data were analyzed by standard procedures assuming a one-compartment model with first-order input using Rstrips(®), and differences between the groups were considered significant when p<0.05. RESULTS: Plasma concentrations of DTZ were higher in the SHR than the normotensive SDR and WKY rats, although the differences did not reach statistical significance (p>0.05). Plasma concentrations of the active metabolites N-desmethyl DTZ (MA), deacetyl DTZ (M1) and deacetyl N-desmethyl DTZ (M2) were significantly higher in the SHR and WKY rats than the SDR, which was attributed to higher DTZ concentrations and also genetic factors. CONCLUSIONS: Although the differences were mainly quantitative and very small, the study has shown for the first time that the metabolism profiles of DTZ in SHR and WKY rats were closer to humans than SDR, and they may be more preferable rat models to study pharmacokinetic and metabolism studies of DTZ or similar agents.

Exercise improves hemodynamic profiles and increases red blood cell concentrations of purine nucleotides in a rodent model.

OBJECTIVE: To study the effect of exercise on hemodynamic profiles and red blood cell (RBC) concentrations of adenosine-5'-triphosphate (ATP). METHODS: Male Sprague-Dawley (SD) rats (n = 9) were exercised on a treadmill for 15 min at a speed of 10 m/min with a 5% gradient after an hour settling down in a restrainer. Blood samples were collected via an indwelling carotid artery catheter using a 'Stopping Solution' from each rat before, during and after exercise. Hemodynamic recordings were collected continuously throughout the experiment. Concentrations of ATP and other purine nucleotides in the RBCs were determined by a validated high-performance liquid chromatography (HPLC) assay. A control group (n = 12) was treated the same way except without the exercise. Data between groups were analyzed by analysis of variance (ANOVA) and Student's t-test, and differences were considered significant when p < 0.05. RESULTS: Exercise increased systolic blood pressure (SBP; 141±23 vs. 132±17 mmHg) and heart rate (HR; 420±33 vs. 397±41 bpm), but decreased diastolic blood pressure (DBP; 105±18 vs. 110±14 mmHg). This was followed by a postexercise condition when SBP, DBP, and HR were decreased for the remainder of the experiment. RBC concentrations of ATP and guanosine-5'-triphosphate (GTP) increased significantly during exercise and continued to increase for 5 hours postexercise (1.5±0.75 vs. 0.96 vs. 0.36 mM for ATP; and 0.14±0.061 vs. 0.058±0.030 mM) (p < 0.05). CONCLUSION: Exercise increased RBC ATP concentrations in a rodent model, which was correlated with the decrease in BP and HR postexercise.