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1.
Pediatr Res ; 94(4): 1341-1348, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37179436

RESUMO

BACKGROUND: The study's objective is to evaluate if Molsidomine (MOL), an anti-oxidant, anti-inflammatory, and anti-apoptotic drug, is effective in treating hyperoxic lung injury (HLI). METHODS: The study consisted of four groups of neonatal rats characterized as the Control, Control+MOL, HLI, HLI + MOL groups. Near the end of the study, the lung tissue of the rats were evaluated with respect to apoptosis, histopathological damage, anti-oxidant and oxidant capacity as well as degree of inflammation. RESULTS: Compared to the HLI group, malondialdehyde and total oxidant status levels in lung tissue were notably reduced in the HLI + MOL group. Furthermore, mean superoxide dismutase, glutathione peroxidase, and glutathione activities/levels in lung tissue were significantly higher in the HLI + MOL group as compared to the HLI group. Tumor necrosis factor-α and interleukin-1ß elevations associated with hyperoxia were significantly reduced following MOL treatment. Median histopathological damage and mean alveolar macrophage numbers were found to be higher in the HLI and HLI + MOL groups when compared to the Control and Control+MOL groups. Both values were increased in the HLI group when compared to the HLI + MOL group. CONCLUSIONS: Our research is the first to demonstrate that bronchopulmonary dysplasia may be prevented through the protective characteristics of MOL, an anti-inflammatory, anti-oxidant, and anti-apoptotic drug. IMPACT: Molsidomine prophylaxis significantly decreased the level of oxidative stress markers. Molsidomine administration restored the activities of antioxidant enzymes. Molsidomine prophylaxis significantly reduced the levels of inflammatory cytokines. Molsidomine may provide a new and promising therapy for BPD in the future. Molsidomine prophylaxis decreased lung damage and macrophage infiltration in the tissue.


Assuntos
Hiperóxia , Lesão Pulmonar , Ratos , Animais , Lesão Pulmonar/tratamento farmacológico , Lesão Pulmonar/etiologia , Lesão Pulmonar/prevenção & controle , Antioxidantes/metabolismo , Molsidomina/farmacologia , Molsidomina/uso terapêutico , Animais Recém-Nascidos , Ratos Wistar , Hiperóxia/patologia , Pulmão , Estresse Oxidativo , Oxidantes/farmacologia , Anti-Inflamatórios/farmacologia
2.
Neurocrit Care ; 32(3): 742-754, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31418143

RESUMO

BACKGROUND: Patients with aneurysmal subarachnoid hemorrhage (aSAH) require close treatment in neuro intensive care units (NICUs). The treatments available to counteract secondary deterioration and delayed ischemic events remain restricted; moreover, available neuro-monitoring of comatose patients is undependable. In comatose patients, clinical signs are hidden, and timing interventions to prevent the evolution of a perfusion disorder in response to fixed ischemic brain damage remain a challenge for NICU teams. Consequently, comatose patients often suffer secondary brain infarctions. The outcomes for long-term intubated patients w/wo pupil dilatation are the worst, with only 10% surviving. We previously added two nitroxide (NO) donors to the standard treatment: continuous intravenous administration of Molsidomine in patients with mild-to-moderate aSAH and, if required as a supplement, intraventricular boluses of sodium nitroprusside (SNP) in high-risk patients to overcome the so-called NO-sink effect, which leads to vasospasm and perfusion disorders. NO boluses were guided by clinical status and promptly reversed recurrent episodes of delayed ischemic neurological deficit. In this study, we tried to translate this concept, the initiation of intraventricular NO application on top of continuous Molsidomine infusion, from awake to comatose patients who lack neurological-clinical monitoring but are primarily monitored using frequently applied transcranial Doppler (TCD). METHODS: In this observational, retrospective, nonrandomized feasibility study, 18 consecutive aSAH comatose/intubated patients (Hunt and Hess IV/V with/without pupil dilatation) whose poor clinical status precluded clinical monitoring received standard neuro-intensive care, frequent TCD monitoring, continuous intravenous Molsidomine plus intraventricular SNP boluses after TCD-confirmed macrospasm during the daytime and on a fixed nighttime schedule. RESULTS: Very likely associated with the application of SNP, which is a matter of further investigation, vasospasm-related TCD findings promptly and reliably reversed or substantially weakened (p < 0.0001) afterward. Delayed cerebral ischemia (DCI) occurred only during loose, low-dose or interrupted treatment (17% vs. an estimated 65% with secondary infarctions) in 17 responders. However, despite their worse initial condition, 29.4% of the responders survived (expected 10%) and four achieved Glasgow Outcome Scale Extended (GOSE) 8-6, modified Rankin Scale (mRS) 0-1 or National Institutes of Health Stroke Scale (NIHSS) 0-2. CONCLUSIONS: Even in comatose/intubated patients, TCD-guided dual-compartment administration of NO donors probably could reverse macrospasm and seems to be feasible. The number of DCI was much lower than expected in this specific subgroup, indicating that this treatment possibly provides a positive impact on outcomes. A randomized trial should verify or falsify our results.


Assuntos
Aneurisma Roto/cirurgia , Isquemia Encefálica/prevenção & controle , Aneurisma Intracraniano/cirurgia , Molsidomina/uso terapêutico , Doadores de Óxido Nítrico/uso terapêutico , Nitroprussiato/uso terapêutico , Hemorragia Subaracnóidea/terapia , Vasoespasmo Intracraniano/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Isquemia Encefálica/tratamento farmacológico , Estudos de Viabilidade , Feminino , Humanos , Infusões Intravenosas , Infusões Intraventriculares , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura Espontânea , Vasoespasmo Intracraniano/tratamento farmacológico
3.
Biotech Histochem ; 93(3): 188-197, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29323543

RESUMO

We investigated the effect of molsidomine (MOL) on ischemia/reperfusion (I/R) injury. Rabbits were assigned to four groups: group 1, sham; group 2, I/R; group 3, MOL treatment for 4 days after I/R; group 4, MOL treatment for 1 day before I/R and 3 days after I/R. Retinal I/R was produced by elevating the intraocular pressure to 150 mm Hg for 60 min. Seven days after I/R, the eyes were enucleated. Retinal changes were examined using histochemistry. The levels of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) also were measured. We found a significant increase in the thickness of the outer nuclear layer of group 3 compared to the other groups. In groups 3 and 4, caspase-3 stained cells in the ganglion cell layer were decreased compared to group 2. We found a significant increase in caspase-3 stained cells in the inner nuclear layer (INL) of group 2 compared to the other groups. We found a significant increase in caspase-3 stained cells in group 3 compared to group 4 in the INL. The MDA level in group 2 was significantly higher than group 1 and MOL significantly decreased MDA levels in groups 3 and 4. We found that MOL protected the retina from I/R injury by enhancing antioxidative effects and inhibiting apoptosis of retinal cells.


Assuntos
Molsidomina/uso terapêutico , Traumatismo por Reperfusão/tratamento farmacológico , Retina/efeitos dos fármacos , Animais , Imuno-Histoquímica , Coelhos , Ratos , Padrões de Referência
4.
Biotech Histochem ; 92(1): 68-77, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28166419

RESUMO

We investigated the protective and therapeutic effects of molsidomine (MOL) in a rat model of whole brain radiotherapy (RT). Forty female rats were divided into five groups of eight: group 1, control; group 2, 15 Gy single dose RT (RT); group 3, 4 mg/kg MOL treated for 5 days (MOL); group 4, 4 mg/kg MOL for 5 days, 10 days after RT treatment (RT + MOL); group 5, 4 mg/kg MOL treatment for 5 days before RT treatment and for 5 days after RT treatment (MOL + RT). All rats were sacrificed on day 16. Neurodegenerative changes in the brain and tissue levels of oxidants and antioxidants were evaluated. The oxidative parameters were increased and antioxidant status was decreased in group RT compared to groups MOL + RT and RT + MOL. Histopathological examination showed that treatment with MOL after RT application and treatment with MOL before RT treatment decreased neuronal degeneration. No difference in neuronal appearance was found between groups RT + MOL and MOL + RT. MOL treatment protected the nervous system of rats and may be a treatment option for preventing RT induced neural injury.


Assuntos
Encéfalo/efeitos da radiação , Molsidomina/uso terapêutico , Lesões Experimentais por Radiação/prevenção & controle , Animais , Encéfalo/metabolismo , Feminino , Glutationa , Malondialdeído , Molsidomina/administração & dosagem , Radiação Ionizante , Protetores contra Radiação/administração & dosagem , Protetores contra Radiação/uso terapêutico , Ratos , Superóxido Dismutase
5.
Acta Physiol (Oxf) ; 220(3): 382-393, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28168814

RESUMO

AIM: Multiple interacting pathways contribute to progression of renal and cardiac damage in chronic kidney disease followed by chronic heart failure (renocardiac syndrome). We hypothesized that simultaneous pharmacological modulation of critical pathways implicated in renocardiac syndrome would effectively reduce fibrosis in and preserve function of heart and kidney. METHODS: Rats were subjected to subtotal nephrectomy followed 9 weeks later by coronary artery ligation. From week 11 until week 16, rats received vehicle or losartan, or a combination of the NF-kB inhibitor PDTC, the NO donor molsidomine and superoxide dismutase mimetic tempol, or a combination of all four of these plus metoprolol together. At week 16, renal and cardiac structure, function and gene expression were assessed. RESULTS: Individual and combined treatments were similarly effective in limiting cardiac fibrosis and further decline in systolic function. Combined treatment with all five drugs reduced renal fibrosis and CTGF gene expression more effectively than other strategies. Combining all five drugs reduced heart rate, inotropy and mean arterial pressure (MAP). CONCLUSION: Thus, in our model of chronic renocardiac syndrome, combined treatments similarly decreased cardiac fibrosis and stabilized systolic function as losartan alone, perhaps suggesting a dominant role for a single factor such as angiotensin II type 1 (AT1) receptor activation or inflammation in the network of aberrant systems in the heart. However, tubulointerstitial fibrosis was most effectively reduced by a five-drug regimen, pointing to additive effects of multiple pathophysiological pathways in the kidney.


Assuntos
Síndrome Cardiorrenal/tratamento farmacológico , Óxidos N-Cíclicos/uso terapêutico , Losartan/uso terapêutico , Metoprolol/uso terapêutico , Molsidomina/uso terapêutico , Pirrolidinas/uso terapêutico , Tiocarbamatos/uso terapêutico , Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Animais , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Vasos Coronários , Óxidos N-Cíclicos/farmacologia , Modelos Animais de Doenças , Avaliação Pré-Clínica de Medicamentos , Quimioterapia Combinada , Fibrose , Coração/efeitos dos fármacos , Rim/efeitos dos fármacos , Testes de Função Renal , Ligadura , Losartan/farmacologia , Masculino , Metoprolol/farmacologia , Molsidomina/farmacologia , NF-kappa B/antagonistas & inibidores , Nefrectomia , Doadores de Óxido Nítrico/farmacologia , Doadores de Óxido Nítrico/uso terapêutico , Pirrolidinas/farmacologia , Ratos Endogâmicos Lew , Marcadores de Spin , Simpatolíticos/farmacologia , Simpatolíticos/uso terapêutico , Tiocarbamatos/farmacologia
6.
Can J Physiol Pharmacol ; 95(2): 111-121, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27918857

RESUMO

Molsidomine is a well-known vasodilatating, antianginal drug. Despite earlier studies with its metabolites (3-morpholino-syndnonimine (SIN-1) and N-nitroso-N-morpholino-amino-acetonitrile (SIN-1A)), which indicated a potential favorable cardioprotective activity, a lot of controversy remains. The aim of our research was to compare molsidomine, SIN-1, SIN-1A, and lidocaine influence on arrhythmias and hemodynamic parameters in 2 experimental models in rats. In the Langendorff heart study, SIN-1A markedly elevated left ventricular systolic pressure, maximum rise and fall of the first pressure derivative, coronary flow, and myocardial oxygen consumption. In addition, SIN-1A more so than SIN-1 significantly lowered creatine kinase release. The antiarrhythmic action of SIN-1 was observed, while lidocaine significantly diminished ventricular arrhythmias duration in comparison with the control. In the ischemia-reperfusion-induced arrhythmias model, hypotensive action of molsidomine was observed as well as the reduction in pressure rate product. Molsidomine also prolonged ventricular tachycardia duration. On the other hand, no significant effects on hemodynamic parameters as well as on ventricular arrhythmias were found in any of the SIN-1 and SIN-1A groups. In conclusion, our research suggests a possible direct, cardioprotective action of SIN-1A. It seems worthwhile to further investigate molsidomine derivatives, especially SIN-1A, because of its potential use in invasive cardiology procedures such as percutaneous transluminal coronary angioplasty.


Assuntos
Arritmias Cardíacas/tratamento farmacológico , Hemodinâmica/efeitos dos fármacos , Molsidomina/análogos & derivados , Molsidomina/farmacologia , Nitrosaminas/farmacologia , Animais , Antiasmáticos/farmacologia , Arritmias Cardíacas/complicações , Arritmias Cardíacas/metabolismo , Creatina Quinase/metabolismo , Modelos Animais de Doenças , Preparação de Coração Isolado , Lidocaína/farmacologia , Lidocaína/uso terapêutico , Masculino , Molsidomina/uso terapêutico , Nitrosaminas/uso terapêutico , Ratos , Traumatismo por Reperfusão/complicações , Traumatismo por Reperfusão/tratamento farmacológico , Traumatismo por Reperfusão/metabolismo
7.
Indian J Pharmacol ; 48(5): 544-549, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27721541

RESUMO

BACKGROUND: Diabetes-induced oxidative stress and hypertension play a major role in the development of nephropathy. Hence, the present study was undertaken to evaluate the protective effects of molsidomine, a nitric oxide donor in streptozotocin (STZ)-induced diabetic nephropathy (DN) in rats. MATERIALS AND METHODS: Type 1 diabetes was induced through a single dose of STZ (52 mg/kg, i.p.) in male Wistar rats and then treated with molsidomine (5 and 10 mg/kg; p.o.) for 8 weeks. Physical parameters, vital and renal function test including blood glucose, albuminuria, blood urine nitrogen, serum creatinine, and kidney index were determined. Oxidative stress and lipid peroxidation were assessed in the kidney homogenate by means of antioxidant enzymes and malondialdehyde levels. RESULTS: DN rats exhibited a significant renal dysfunction with a reduction in body weight, excessive oxidative stress, and pathological changes. Molsidomine treatment significantly improved vital sign, renal functions, and oxidative stress in DN rats in a dose-dependent manner. The protective effect of molsidomine was also substantiated by pathological changes in the architect of the kidney. CONCLUSION: Molsidomine shows a significant beneficial effect in Type 1 DN in rats.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Nefropatias Diabéticas/tratamento farmacológico , Molsidomina/uso terapêutico , Doadores de Óxido Nítrico/uso terapêutico , Albuminúria/tratamento farmacológico , Animais , Anti-Hipertensivos/uso terapêutico , Antioxidantes/uso terapêutico , Glicemia/análise , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Experimental/urina , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 1/urina , Nefropatias Diabéticas/sangue , Nefropatias Diabéticas/patologia , Nefropatias Diabéticas/urina , Hipoglicemiantes/uso terapêutico , Rim/efeitos dos fármacos , Rim/patologia , Testes de Função Renal , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Estresse Oxidativo/efeitos dos fármacos , Ratos Wistar
8.
J Cardiovasc Pharmacol ; 68(5): 342-355, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27482866

RESUMO

This study investigated the effects and associated underlying mechanisms of molsidomine, a nitric oxide (NO) donor, on cardiac electrical remodeling and ventricular tachycardias (VTs) induced by chronic isoprenaline (ISO) stimulation in rats. The rats were randomly divided into groups that were treated with saline (control group), ISO (ISO group), ISO + molsidomine (ISO + M group), and ISO + molsidomine + the soluble guanylate cyclase inhibitor 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, ISO + M + O group) for 14 days. An electrophysiological study was performed to assess cardiac repolarization, action potential duration restitution, and the induction of action potential duration alternans and VTs in vitro. The properties of the Ca transients, Ca handling-related proteins, and NO/guanosine 3'5'-cyclic monophosphate (cGMP)/protein kinase G (PKG) pathway were examined. Compared with the control group, chronic ISO stimulation prolonged the cardiac repolarization, decreased the Ca transient alternans and action potential duration alternans thresholds, and increased the maximum slope (Smax) of the action potential duration restitution curve and incidence of VTs in vitro. All these effects were attenuated by molsidomine treatment (P < 0.05). Moreover, molsidomine activated cGMP/PKG signaling and stabilized the expression of calcium handling-related proteins compared with the ISO group. However, the protective effects of molsidomine were partially inhibited by ODQ. Our results suggest that molsidomine stabilizes calcium handling and attenuates cardiac electrical remodeling and arrhythmogenesis in rats with chronic ß-adrenergic receptor activation. These effects are at least partially mediated by the activation of NO/cGMP/PKG pathway.


Assuntos
Arritmias Cardíacas/metabolismo , Proteínas Quinases Dependentes de GMP Cíclico/metabolismo , GMP Cíclico/metabolismo , Molsidomina/farmacologia , Óxido Nítrico/metabolismo , Receptores Adrenérgicos beta/metabolismo , Remodelação Ventricular/efeitos dos fármacos , Agonistas Adrenérgicos beta/farmacologia , Animais , Arritmias Cardíacas/prevenção & controle , Células Cultivadas , GMP Cíclico/antagonistas & inibidores , Proteínas Quinases Dependentes de GMP Cíclico/antagonistas & inibidores , Eletrocardiografia/efeitos dos fármacos , Masculino , Molsidomina/uso terapêutico , Óxido Nítrico/agonistas , Doadores de Óxido Nítrico/farmacologia , Doadores de Óxido Nítrico/uso terapêutico , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/fisiologia , Remodelação Ventricular/fisiologia
9.
J Neurosurg ; 124(1): 51-8, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26162034

RESUMO

OBJECT Delayed ischemic neurological deficits (DINDs) and cerebral vasospasm (CVS) are responsible fora poor outcome in patients with aneurysmal subarachnoid hemorrhage (SAH), most likely because of a decreased availability of nitric oxide (NO) in the cerebral microcirculation. In this study, the authors examined the effects of treatment with the NO donor molsidomine with regard to decreasing the incidence of spasm-related delayed brain infarctions and improving clinical outcome in patients with SAH. METHODS Seventy-four patients with spontaneous aneurysmal SAH were included in this post hoc analysis. Twenty-nine patients with SAH and proven CVS received molsidomine in addition to oral or intravenous nimodipine. Control groups consisted of 25 SAH patients with proven vasospasm and 20 SAH patients without. These patients received nimodipine therapy alone. Cranial computed tomography (CCT) before and after treatment was analyzed for CVS-related infarcts. A modified National Institutes of Health Stroke Scale (mNIHSS) and the modified Rankin Scale (mRS) were used to assess outcomes at a 3-month clinical follow-up. RESULTS Four of the 29 (13.8%) patients receiving molsidomine plus nimodipine and 22 of the 45 (48%) patients receiving nimodipine therapy alone developed vasospasm-associated brain infarcts (p < 0.01). Follow-up revealed a median mNIHSS score of 3.0 and a median mRS score of 2.5 in the molsidomine group compared with scores of 11.5 and 5.0, respectively, in the nimodipine group with CVS (p < 0.001). One patient in the molsidomine treatment group died, and 12 patients in the standard care group died (p < 0.01). CONCLUSIONS In this post hoc analysis, patients with CVS who were treated with intravenous molsidomine had a significant improvement in clinical outcome and less cerebral infarction. Molsidomine offers a promising therapeutic option in patients with severe SAH and CVS and should be assessed in a prospective study.


Assuntos
Infarto Encefálico/prevenção & controle , Isquemia Encefálica/prevenção & controle , Molsidomina/uso terapêutico , Doenças do Sistema Nervoso/prevenção & controle , Hemorragia Subaracnóidea/cirurgia , Vasodilatadores/uso terapêutico , Vasoespasmo Intracraniano/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infarto Encefálico/etiologia , Isquemia Encefálica/etiologia , Quimioterapia Combinada , Feminino , Seguimentos , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/etiologia , Nimodipina/uso terapêutico , Estudos Prospectivos , Acidente Vascular Cerebral/epidemiologia , Hemorragia Subaracnóidea/complicações , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vasoespasmo Intracraniano/mortalidade , Adulto Jovem
10.
Xenotransplantation ; 22(5): 391-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26381495

RESUMO

BACKGROUND: Nitric oxide (NO) can reduce platelet adhesion and vascular resistance. Tempol can scavenge the reactive oxygen species (ROS) that induce tissue injury. As xenograft rejection attenuates endogenous NO production and generates ROS, we evaluated the potential effect of an NO donor (SIN-1, 3-morpholinosydnonimine) and tempol on hyperacute xenograft dysfunction using an ex vivo porcine lung perfusion model. METHODS: For the evaluation of von Willebrand factor (vWF) secretion, human endothelial cells were stimulated with thrombin. Porcine lungs were perfused with either fresh human whole blood (unmodified control group [n = 4]), SIN-1 (n = 4), or SIN and tempol (n = 4). RESULTS: SIN-1 and tempol significantly inhibited vWF secretion from endothelial cells in vitro. However, they did not suppress xenogeneic complement activation. In an ex vivo pulmonary perfusion model, SIN-1 improved pulmonary xenograft function by reducing pulmonary vascular resistance (PVR), inhibiting complement activation, and inhibiting thrombin generation. Combined treatment with tempol and SIN-1 potentiated PVR reduction, but slightly enhanced complement activation. CONCLUSIONS: An NO donor is expected to improve pulmonary xenograft function through inhibition of vWF secretion, vasoconstriction, thrombin generation, and indirectly through inhibition of complement activation. The additional effects of tempol on an NO donor were not considered significant in an ex vivo xenograft system.


Assuntos
Rejeição de Enxerto/prevenção & controle , Transplante de Pulmão , Doadores de Óxido Nítrico/uso terapêutico , Substâncias Protetoras/uso terapêutico , Transplante Heterólogo , Animais , Linhagem Celular , Óxidos N-Cíclicos/uso terapêutico , Quimioterapia Combinada , Humanos , Molsidomina/análogos & derivados , Molsidomina/uso terapêutico , Perfusão , Marcadores de Spin , Suínos , Resultado do Tratamento
11.
Atherosclerosis ; 240(2): 351-4, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25875387

RESUMO

OBJECTIVE: The MEDCOR trial is a double-blind, randomized study aiming at demonstrating the superiority of molsidomine (direct NO donor) over placebo, used as add-on treatments, on improving endothelial function (EF) after 12 months, in stable angina patients undergoing percutaneous coronary intervention. METHODS: EF was assessed by peripheral vasodilator response (i.e. Endoscore) using arterial tonometry and by several biomarkers, in terms of changes versus baseline after a one-year treatment. RESULTS: The change in Endoscore was +75 ± 130% in placebo group and +39 ± 145% in molsidomine group (p = 0.143). There was a decrease in sICAM-1 with molsidomine (-6%) and an increase with placebo (+6%). The MPO activity/antigen ratio slightly increased with placebo (+9%) and strongly decreased with molsidomine (-42%) (p = 0.020). CONCLUSION: The MEDCOR trial was not able to demonstrate significant differences between molsidomine and placebo for all parameters, except the MPO activity/antigen ratio which significantly decreased with molsidomine (p = 0.020 versus placebo).


Assuntos
Angina Estável/terapia , Doença da Artéria Coronariana/terapia , Endotélio Vascular/efeitos dos fármacos , Molsidomina/uso terapêutico , Doadores de Óxido Nítrico/uso terapêutico , Intervenção Coronária Percutânea , Vasodilatação/efeitos dos fármacos , Vasodilatadores/uso terapêutico , Idoso , Angina Estável/sangue , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Bélgica , Biomarcadores/sangue , Terapia Combinada , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/fisiopatologia , Método Duplo-Cego , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Molécula 1 de Adesão Intercelular/sangue , Masculino , Manometria , Pessoa de Meia-Idade , Molsidomina/efeitos adversos , Doadores de Óxido Nítrico/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Peroxidase/sangue , Fatores de Tempo , Resultado do Tratamento , Vasodilatadores/efeitos adversos
12.
Anesth Analg ; 118(4): 830-40, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24651238

RESUMO

BACKGROUND: Growing evidence indicates that patients with complex regional pain syndrome (CRPS) exhibit tissue abnormalities caused by microvascular dysfunction in the blood vessels of skin, muscle, and nerve. We tested whether topical combinations aimed at improving microvascular function would relieve allodynia in an animal model of CRPS. We hypothesized that topical administration of either α2-adrenergic (α2A) receptor agonists or nitric oxide (NO) donors given to increase arterial blood flow, combined with either phosphatidic acid (PA) or phosphodiesterase (PDE) inhibitors to increase capillary blood flow, would effectively reduce allodynia and signs of microvascular dysfunction in the animal model of chronic pain. METHODS: Mechanical allodynia was induced in the hindpaws of rats with chronic postischemia pain (CPIP). Allodynia was assessed before and after topical application of vehicle, single drugs or combinations of an α2A receptor agonist (apraclonidine) or an NO donor (linsidomine), with PA or PDE inhibitors (lisofylline, pentoxifylline). A topical combination of apraclonidine + lisofylline was also evaluated for its effects on a measure of microvascular function (postocclusive reactive hyperemia) and tissue oxidative capacity (formazan production by tetrazolium reduction) in CPIP rats. RESULTS: Each of the single topical drugs produced significant dose-dependent antiallodynic effects compared with vehicle in CPIP rats (N = 30), and the antiallodynic dose-response curves of either PA or PDE inhibitors were shifted 5- to 10-fold to the left when combined with nonanalgesic doses of α2A receptor agonists or NO donors (N = 28). The potent antiallodynic effects of ipsilateral treatment with combinations of α2A receptor agonists or NO donors with PA or PDE inhibitors were not reproduced by the same treatment of the contralateral hindpaw (N = 28). Topical combinations produced antiallodynic effects lasting up to 6 hours (N = 15) and were significantly enhanced by low-dose systemic pregabalin in early, but not late, CPIP rats (N = 18). An antiallodynic topical combination of apraclonidine + lisofylline was also found to effectively relieve depressed postocclusive reactive hyperemia in CPIP rats (N = 61) and to increase formazan production in postischemic tissues (skin and muscle) (N = 56). CONCLUSIONS: The present results support the hypothesis that allodynia in an animal model of CRPS is effectively relieved by topical combinations of α2A receptor agonists or NO donors with PA or PDE inhibitors. This suggests that topical treatments aimed at improving microvascular function by increasing both arterial and capillary blood flow produce effective analgesia for CRPS.


Assuntos
Capilares/efeitos dos fármacos , Dor Crônica/tratamento farmacológico , Dor Crônica/fisiopatologia , Isquemia/complicações , Administração Tópica , Agonistas de Receptores Adrenérgicos alfa 2/administração & dosagem , Agonistas de Receptores Adrenérgicos alfa 2/farmacologia , Animais , Química Farmacêutica , Clonidina/análogos & derivados , Clonidina/farmacologia , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Hiperalgesia/tratamento farmacológico , Hiperemia/fisiopatologia , Fluxometria por Laser-Doppler , Masculino , Molsidomina/análogos & derivados , Molsidomina/uso terapêutico , Doadores de Óxido Nítrico/administração & dosagem , Doadores de Óxido Nítrico/farmacologia , Pomadas , Medição da Dor/efeitos dos fármacos , Ácidos Fosfatídicos/farmacologia , Inibidores de Fosfodiesterase/farmacologia , Ratos , Ratos Long-Evans , Fluxo Sanguíneo Regional/efeitos dos fármacos
13.
Inflammation ; 37(4): 1167-78, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24526289

RESUMO

We aimed to investigate the preventive and treatment effect of molsidomine (MOL) on bleomycin (BLC)-induced lung injury in rats. Rats were assigned into groups as follows: control group; MOL group, 10 mg/kg MOL was continued orally for 29 day; BLC group, a single intratracheal injection of BLC (2.5 mg/kg), MOL+BLC-preventive group, 10 mg/kg MOL was administered 1 day before the intratracheal BLC injection and continued for 14 days; BLC+MOL-treatment group 10 mg/kg MOL was given on 14th day after the intratracheal BLC injection and continued until sacrifice. All animals were sacrificed on 29th day after BLC administration. The semiquantitative histopathological assessment, tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), total antioxidant status (TAS), total oxidant status (TOS), myeloperoxidase (MPO), and oxidative stress index (OSI) were measured. BLC-provoked histological changes were significantly detected compared to the control group. MOL restored these histological damages in different quantity in the treatment and preventive groups. BLC administration significantly decreased levels of GSH and TAS when compared to controls and these reductions was significantly ameliorated by MOL given prophylactic setting. However, therapeutic MOL administration significantly increased the TAS level decreased by BLC. The levels of MDA, MPO, and TOS were significantly increased with BLM, and these augmentations of MDA and TOS were significantly reduced by MOL given prophylactic setting. Furthermore, the OSI was higher in the BLC group, and this increase was reversed by the MOL administration before and after BLC treatment. In this study, both protective and therapeutic effects of MOL against BLC-induced lung fibrosis were demonstrated for the first time.


Assuntos
Bleomicina/química , Molsidomina/uso terapêutico , Fibrose Pulmonar/induzido quimicamente , Animais , Antibióticos Antineoplásicos/química , Antioxidantes/metabolismo , Lavagem Broncoalveolar , Catalase/metabolismo , Feminino , Glutationa/metabolismo , Glutationa Peroxidase/metabolismo , Inflamação , Malondialdeído/metabolismo , Doadores de Óxido Nítrico/uso terapêutico , Estresse Oxidativo , Peroxidase/metabolismo , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico
14.
J Cardiovasc Transl Res ; 7(2): 226-31, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24142804

RESUMO

The effects of molsidomine (a direct nitric oxide donor) on the endothelial dysfunction have never been evaluated using reactive hyperemia peripheral arterial tonometry (RH-PAT). The objective of the MEDCOR double-blind trial will be to demonstrate the superiority of molsidomine (Coruno® 16 mg, once daily) over placebo, on improving the endothelial function (Endoscore by RH-PAT) after 12 months of treatment in stable angina patients undergoing elective percutaneous coronary intervention (PCI). Study design will take care of the real-life situation, in which patients are being offered PCI and stent placement (drug-eluting or bare metal), but also gold standard medical therapy (beta-blockers, statins, angiotensin-converting enzyme inhibitors (ACEIs), and/or calcium antagonists). Demonstrating clinical and statistical superiority of the study drug over placebo will be a real challenge. Therefore, a sequential approach has been designed with a pilot phase aiming at recruiting 50 patients. Upon evaluation of the results by an independent data steering committee, a larger sample size phase will eventually be considered.


Assuntos
Angina Estável/terapia , Vasos Coronários/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Molsidomina/uso terapêutico , Doadores de Óxido Nítrico/uso terapêutico , Intervenção Coronária Percutânea , Projetos de Pesquisa , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Bélgica , Protocolos Clínicos , Vasos Coronários/fisiopatologia , Método Duplo-Cego , Quimioterapia Combinada , Endotélio Vascular/fisiopatologia , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Projetos Piloto , Stents , Fatores de Tempo , Resultado do Tratamento
15.
Ann Noninvasive Electrocardiol ; 17(3): 286-90, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22816550

RESUMO

BACKGROUND: Myocardial ischemia during coronary spasm may generate malignant ventricular arrhythmias. The J-wave pattern was suggested to be a marker of a disorder associated with life-threatening arrhythmias. RESULTS: We report the case of a patient with vasospastic angina and J-wave pattern in inferior and lateral leads associated with polymorphic ventricular tachycardia which was effectively treated only with quinidine-vasodilating drugs were not able to prevent the arrhythmia although they were effective in preventing ischemic events. CONCLUSION: The J-wave pattern in inferolateral leads may be a sign of electrical vulnerability to lethal ventricular arrhythmia in patients suffering from vasospastic angina--quinidine can effectively prevent such arrhythmias in these patients.


Assuntos
Angina Pectoris Variante/terapia , Fibrilação Atrial/diagnóstico , Flutter Atrial/diagnóstico , Desfibriladores Implantáveis , Quinidina/uso terapêutico , Taquicardia Ventricular/terapia , Angina Pectoris Variante/complicações , Angina Pectoris Variante/diagnóstico , Fibrilação Atrial/etiologia , Fibrilação Atrial/cirurgia , Flutter Atrial/etiologia , Flutter Atrial/cirurgia , Ablação por Cateter/métodos , Terapia Combinada , Quimioterapia Combinada , Eletrocardiografia/métodos , Eletrocardiografia Ambulatorial/métodos , Teste de Esforço/métodos , Seguimentos , Humanos , Isossorbida/uso terapêutico , Masculino , Pessoa de Meia-Idade , Molsidomina/uso terapêutico , Medição de Risco , Índice de Gravidade de Doença , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico , Resultado do Tratamento , Verapamil/uso terapêutico
16.
Stem Cells ; 30(2): 197-209, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22084027

RESUMO

Satellite cells are myogenic precursors that proliferate, activate, and differentiate on muscle injury to sustain the regenerative capacity of adult skeletal muscle; in this process, they self-renew through the return to quiescence of the cycling progeny. This mechanism, while efficient in physiological conditions does not prevent exhaustion of satellite cells in pathologies such as muscular dystrophy where numerous rounds of damage occur. Here, we describe a key role of nitric oxide, an important signaling molecule in adult skeletal muscle, on satellite cells maintenance, studied ex vivo on isolated myofibers and in vivo using the α-sarcoglycan null mouse model of dystrophy and a cardiotoxin-induced model of repetitive damage. Nitric oxide stimulated satellite cells proliferation in a pathway dependent on cGMP generation. Furthermore, it increased the number of Pax7(+)/Myf5(-) cells in a cGMP-independent pathway requiring enhanced expression of Vangl2, a member of the planar cell polarity pathway involved in the Wnt noncanonical pathway. The enhanced self-renewal ability of satellite cells induced by nitric oxide is sufficient to delay the reduction of the satellite cell pool during repetitive acute and chronic damages, favoring muscle regeneration; in the α-sarcoglycan null dystrophic mouse, it also slowed disease progression persistently. These results identify nitric oxide as a key messenger in satellite cells maintenance, expand the significance of the Vangl2-dependent Wnt noncanonical pathway in myogenesis, and indicate novel strategies to optimize nitric oxide-based therapies for muscular dystrophy.


Assuntos
GMP Cíclico/metabolismo , Músculo Esquelético/fisiologia , Proteínas do Tecido Nervoso/metabolismo , Óxido Nítrico/fisiologia , Regeneração , Células Satélites de Músculo Esquelético/fisiologia , Animais , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Camundongos , Camundongos da Linhagem 129 , Molsidomina/farmacologia , Molsidomina/uso terapêutico , Desenvolvimento Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/embriologia , Distrofias Musculares/tratamento farmacológico , Distrofias Musculares/patologia , Proteínas do Tecido Nervoso/genética , Óxido Nítrico/farmacologia , Doadores de Óxido Nítrico/farmacologia , Doadores de Óxido Nítrico/uso terapêutico , Células Satélites de Músculo Esquelético/efeitos dos fármacos , Células Satélites de Músculo Esquelético/metabolismo , Transdução de Sinais
18.
Clin Sci (Lond) ; 120(6): 251-61, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20919993

RESUMO

In the present study, we hypothesized that postcon (postconditioning) confers cardioprotection in vivo by reducing the production of ONOO- (peroxynitrite) and nitro-oxidative stress subsequent to the inhibition of the iNOS (inducible NO synthase). Patients with AMI (acute myocardial infarct) were randomly assigned to undergo percutaneous coronary intervention without (control) or with ischaemic postcon by three episodes of 30-s inflation and 30-s deflation of the angioplasty balloon. Animal models of MI/R (myocardial ischaemia/reperfusion) injury were induced in rats by occluding the left coronary artery for 40 min followed by 4-h reperfusion. Rats were randomized to receive vehicle, postcon (three cycles of 10-s reperfusion and 10-s coronary re-occlusion preceding full reperfusion), the selective iNOS inhibitor 1400W or postcon plus 3-morpholinosydnonimine (an ONOO- donor). Postcon in patients reduced iNOS activity in white blood cells, decreased plasma nitrotyrosine, a fingerprint of ONOO- and an index of nitro-oxidative stress, and improved cardiac function (P<0.01 compared with control). In rats, postcon reduced post-ischaemic myocardial iNOS activity and nitrotyrosine formation, reduced myocardial infarct size (all P<0.05 compared with control) and improved cardiac function. Administration of 1400W resembled, whereas 3-morpholinosydnonimine abolished, the effects of postcon. In conclusion, reduction in ONOO--induced nitro-oxidative stress subsequent to the inhibition of iNOS represents a major mechanism whereby postcon confers cardioprotection in vivo.


Assuntos
Pós-Condicionamento Isquêmico/métodos , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Idoso , Angioplastia Coronária com Balão/métodos , Animais , Apoptose , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Contagem de Leucócitos , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Molsidomina/análogos & derivados , Molsidomina/uso terapêutico , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Infarto do Miocárdio/terapia , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Óxido Nítrico Sintase Tipo II/sangue , Estresse Oxidativo/fisiologia , Ratos , Ratos Sprague-Dawley , Resultado do Tratamento , Tirosina/análogos & derivados , Tirosina/sangue , Função Ventricular Esquerda/fisiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-19744535

RESUMO

Nitric oxide (NO) is considered as an intracellular messenger in the brain. Its involvement in learning and memory processes has been proposed. The present study was designed to investigate the effects of the NO-releasing derivative of ferulic acid NCX 2057 on rats' recognition memory. For this purpose the object recognition task was selected. Post-training treatment with NCX 2057 (10 mg/kg, i.p.) and with the reference compound, the NO donor molsidomine (4 mg/kg, i.p.), antagonized extinction of recognition memory in the normal rat. Conversely, animals treated with the parent compound ferulic acid (1.9, 6.2 and 18.7 mg/kg, i.p.) failed to do so. In addition, NCX 2057 (3 and 10 mg/kg, i.p) reversed the scopolamine (0.2 mg/kg, s.c.)-induced performance deficits in this recognition memory task. These results indicate that this novel NO donor may modulate different aspects of recognition memory and suggest that an interaction between the nitrergic and cholinergic system is relevant to cognition.


Assuntos
Butanos/uso terapêutico , Ácidos Cumáricos/uso terapêutico , Sequestradores de Radicais Livres/uso terapêutico , Transtornos da Memória/tratamento farmacológico , Nitrocompostos/uso terapêutico , Reconhecimento Psicológico/efeitos dos fármacos , Análise de Variância , Animais , Comportamento Animal/efeitos dos fármacos , Butanos/farmacologia , Ácidos Cumáricos/farmacologia , Modelos Animais de Doenças , Interações Medicamentosas , Sequestradores de Radicais Livres/farmacologia , Masculino , Transtornos da Memória/induzido quimicamente , Molsidomina/farmacologia , Molsidomina/uso terapêutico , Testes Neuropsicológicos , Doadores de Óxido Nítrico/farmacologia , Doadores de Óxido Nítrico/uso terapêutico , Nitrocompostos/farmacologia , Ratos , Ratos Wistar , Tempo de Reação/efeitos dos fármacos , Escopolamina
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