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1.
Genes Immun ; 18(2): 75-81, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28332559

RESUMO

The influenza A(H1N1)pdm09 vaccination campaign from 2009 to 2010 was associated with a sudden increase in the incidence of narcolepsy in several countries. Narcolepsy with cataplexy is strongly associated with the human leukocyte antigen (HLA) class II DQB1*06:02 allele, and protective associations with the DQB1*06:03 allele have been reported. Several non-HLA gene loci are also associated, such as common variants of the T-cell receptor-α (TRA), the purinergic receptor P2RY11, cathepsin H (CTSH) and TNFSF4/OX40L/CD252. In this retrospective multicenter study, we investigated if these predisposing gene loci were also involved in vaccination-associated narcolepsy. We compared HLA- along with single-nucleotide polymorphism genotypes for non-HLA regions between 42 Pandemrix-vaccinated narcolepsy cases and 1990 population-based controls. The class II gene loci associations supported previous findings. Nominal association (P-value<0.05) with TRA as well as suggestive (P-value<0.1) associations with P2RY11 and CTSH were found. These associations suggest a very strong gene-environment interaction, in which the influenza A(H1N1)pdm09 strain or Pandemrix vaccine can act as potent environmental triggers.


Assuntos
Interação Gene-Ambiente , Vacinas contra Influenza/efeitos adversos , Narcolepsia/induzido quimicamente , Narcolepsia/genética , Cadeias beta de HLA-DQ/genética , Humanos , Vírus da Influenza A Subtipo H1N1 , Estudos Retrospectivos
2.
Phys Chem Chem Phys ; 19(9): 6406-6415, 2017 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-28198894

RESUMO

Imidazole [C3H4N2] is ubiquitous in nature as an important biological building block of amino acids, purine nucleobases or antibiotics. In the present study, dissociative electron attachment to imidazole shows low energy shape resonances at 1.52 and 2.29 eV leading to the most abundant dehydrogenated anion [imidazole - H]- through dehydrogenation at the N1 position. All the other anions formed exhibit core excited resonances observed dominantly at similar electron energies of ∼7 and 11 eV, suggesting an initial formation through two temporary negative ion states. Among these anions, multiple dehydrogenation reactions are observed resulting in the loss of 2 up to 4 hydrogens, thus, leading to a complete dehydrogenation of the imidazole molecule, an interesting prototype of complex unimolecular decay induced by the attachment of a single electron. Additionally, the quantum chemical calculations reveal that these multiple dehydrogenation reactions are responsible for the remarkable one electron-induced gas-phase chemistry leading to the opening of the ring. The formation of the observed anions is likely driven by the high positive electron affinity of cyanocarbon molecules supported by quantum chemical calculations. The formation of H- showed additional resonance at about 5 eV and dipolar dissociation above ∼14 eV.


Assuntos
Elétrons , Hidrogênio/química , Imidazóis/química , Hidrogenação , Modelos Químicos
3.
J Intern Med ; 278(3): 264-76, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25683265

RESUMO

BACKGROUND: Type 1 narcolepsy is a neurological disorder characterized by excessive daytime sleepiness and cataplexy associated with the HLA allele DQB1*06:02. Genetic predisposition along with external triggering factors may drive autoimmune responses, ultimately leading to the selective loss of hypocretin-positive neurons. OBJECTIVE: The aim of this study was to investigate potential aetiological factors in Swedish cases of postvaccination (Pandemrix) narcolepsy defined by interferon-gamma (IFNγ) production from immune cells in response to molecularly defined targets. METHODS: Cellular reactivity defined by IFNγ production was examined in blood from 38 (HLA-DQB1*06:02(+) ) Pandemrix-vaccinated narcolepsy cases and 76 (23 HLA-DQB1*06:02(+) and 53 HLA-DQB1*06:02(-) ) control subjects, matched for age, sex and exposure, using a variety of different antigens: ß-haemolytic group A streptococcal (GAS) antigens (M5, M6 and streptodornase B), influenza (the pandemic A/H1N1/California/7/09 NYMC X-179A and A/H1N1/California/7/09 NYMC X-181 vaccine antigens, previous Flu-A and -B vaccine targets, A/H1N1/Brisbane/59/2007, A/H1N1/Solomon Islands/3/2006, A/H3N2/Uruguay/716/2007, A/H3N2/Wisconsin/67/2005, A/H5N1/Vietnam/1203/2004 and B/Malaysia/2506/2004), noninfluenza viral targets (CMVpp65, EBNA-1 and EBNA-3) and auto-antigens (hypocretin peptide, Tribbles homolog 2 peptide cocktail and extract from rat hypothalamus tissue). RESULTS: IFN-γ production was significantly increased in whole blood from narcolepsy cases in response to streptococcus serotype M6 (P = 0.0065) and streptodornase B protein (P = 0.0050). T-cell recognition of M6 and streptodornase B was confirmed at the single-cell level by intracellular cytokine (IL-2, IFNγ, tumour necrosis factor-alpha and IL-17) production after stimulation with synthetic M6 or streptodornase B peptides. Significantly, higher (P = 0.02) titres of serum antistreptolysin O were observed in narcolepsy cases, compared to vaccinated controls. CONCLUSION: ß-haemolytic GAS may be involved in triggering autoimmune responses in patients who developed narcolepsy symptoms after vaccination with Pandemrix in Sweden, characterized by a Streptococcus pyogenes M-type-specific IFN-γ cellular immune response.


Assuntos
Narcolepsia/imunologia , Streptococcus agalactiae/imunologia , Estreptodornase e Estreptoquinase/imunologia , Adolescente , Adulto , Idoso , Antiestreptolisina/sangue , Criança , Feminino , Humanos , Interferon gama/biossíntese , Interferon gama/sangue , Masculino , Pessoa de Meia-Idade , Narcolepsia/epidemiologia , Fragmentos de Peptídeos/biossíntese , Fragmentos de Peptídeos/sangue , Sorotipagem , Streptococcus agalactiae/enzimologia , Suécia/epidemiologia
4.
Mult Scler Relat Disord ; 68: 104220, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36242804

RESUMO

BACKGROUND: The use of disease-modifying therapies (DMTs) in multiple sclerosis (MS) has been associated with reduced relapse rates and accumulation of disability. However, studies examining impact of DMT on risk of transition to secondary progressive MS (SPMS) leveraging population-based nationwide data are still rare. Here, we determine the population incidence of conversion to SPMS using two consecutive nation-wide cohorts, one immediately before and one after the introduction of DMT in Sweden. METHODS: We included two consecutive population cohorts of relapsing-remitting MS (RRMS) from the Swedish national MS register for the periods 1975-1994 (n = 2161), before DMT availability, and 1995-2011 (n = 3510), in which DMTs, mainly first generation DMT (injectables), became available and eventually were used by 70% of patients. We explored the risk of transition to SPMS as a calendar year function encompassing the two cohorts. In addition, we determined the incidence of transition to SPMS through age strata below and above 50 years in untreated and treated patient subgroups. RESULTS: The risk of conversion to SPMS (adjusted for current age, current time since onset, calendar year and sex) was significantly lower in the second compared with the first population cohort (hazard ratio 0.58; CI 0.48, 0.70). The risk of SPMS conversion per calendar year decreased by 2.6% annually (p < 0.001) after 1995. The risk of SPMS conversion increased with age until age 50. Thereafter, it was unchanged or decreased among those with early MS onset age (<35 years), but continued to increase with onset at higher age, with similar trends in treated and untreated subgroups. CONCLUSION: The incidence of SPMS conversion significantly decreased at the population level after introduction of first generation DMTs by 1995. DMT efficiency was confirmed by a downward turn of the annual trajectory of the risk of SPMS conversion after 1995. An onset age determined pattern of variable SPMS incidence in higher age appeared in both treated and untreated strata. While first generation DMT delayed conversion to SPMS, their long-term effect was only moderate.


Assuntos
Esclerose Múltipla Crônica Progressiva , Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Humanos , Pessoa de Meia-Idade , Adulto , Esclerose Múltipla Crônica Progressiva/tratamento farmacológico , Esclerose Múltipla Crônica Progressiva/epidemiologia , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Recidiva , Incidência , Progressão da Doença
5.
Nat Med ; 6(7): 797-801, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10888929

RESUMO

Huntington disease is an autosomal dominant neurodegenerative disease with no effective treatment. Minocycline is a tetracycline derivative with proven safety. After ischemia, minocycline inhibits caspase-1 and inducible nitric oxide synthetase upregulation, and reduces infarction. As caspase-1 and nitric oxide seem to play a role in Huntington disease, we evaluated the therapeutic efficacy of minocycline in the R6/2 mouse model of Huntington disease. We report that minocycline delays disease progression, inhibits caspase-1 and caspase-3 mRNA upregulation, and decreases inducible nitric oxide synthetase activity. In addition, effective pharmacotherapy in R6/2 mice requires caspase-1 and caspase-3 inhibition. This is the first demonstration of caspase-1 and caspase-3 transcriptional regulation in a Huntington disease model.


Assuntos
Caspase 1/biossíntese , Caspases/biossíntese , Doença de Huntington/tratamento farmacológico , Minociclina/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Caspase 3 , Modelos Animais de Doenças , Progressão da Doença , Ativação Enzimática/efeitos dos fármacos , Estudos de Avaliação como Assunto , Regulação da Expressão Gênica , Doença de Huntington/mortalidade , Camundongos , Camundongos Transgênicos , Óxido Nítrico Sintase/efeitos dos fármacos , Óxido Nítrico Sintase Tipo II , Transcrição Gênica
6.
Naunyn Schmiedebergs Arch Pharmacol ; 394(9): 1829-1867, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33991216

RESUMO

Manfred Göthert, who had served Naunyn-Schmiedeberg's Arch Pharmacol as Managing Editor from 1998 to 2005, deceased in June 2019. His scientific oeuvre encompasses more than 20 types of presynaptic receptors, mostly on serotoninergic and noradrenergic neurones. He was the first to identify presynaptic receptors for somatostatin and ACTH and described many presynaptic receptors, known from animal preparations, also in human tissue. In particular, he elucidated the pharmacology of presynaptic 5-HT receptors. A second field of interest included ligand-gated and voltage-dependent channels. The negative allosteric effect of anesthetics at peripheral nACh receptors is relevant for the peripheral clinical effects of these drugs and modified the Meyer-Overton hypothesis. The negative allosteric effect of ethanol at NMDA receptors in human brain tissue occurred at concentrations found in the range of clinical ethanol intoxication. Moreover, the inhibitory effect of gabapentinoids on P/Q Ca2+ channels and the subsequent decrease in AMPA-induced noradrenaline release may contribute to their clinical effect. Another ligand-gated ion channel, the 5-HT3 receptor, attracted the interest of Manfred Göthert from the whole animal via isolated preparations down to the cellular level. He contributed to that molecular study in which 5-HT3 receptor subtypes were disclosed. Finally, he found altered pharmacological properties of 5-HT receptor variants like the Arg219Leu 5-HT1A receptor (which was also shown to be associated with major depression) and the Phe124Cys 5-HT1B receptor (which may be related to sumatriptan-induced vasospasm). Manfred Göthert was a brilliant scientist and his papers have a major impact on today's pharmacology.


Assuntos
Receptores de Serotonina/metabolismo , Serotonina/metabolismo , Regulação Alostérica , Animais , História do Século XX , História do Século XXI , Humanos , Canais Iônicos de Abertura Ativada por Ligante/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Receptores Nicotínicos/metabolismo , Receptores de Serotonina/história , Serotonina/história
7.
J Am Chem Soc ; 132(37): 12899-905, 2010 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-20806920

RESUMO

We present herein the first indications for dimeric structures in cometal-free asymmetric conjugate addition reactions of dialkylzinc reagents with aldehydes. These are revealed by nonlinear effect (NLE) studies. A monomer-dimer equilibrium can be assumed which explains the increase of the ee value in the product over time. Also, DOSY NMR spectroscopic measurements indicate the existence of the catalyst as [LZnEt](n) complexes in solution. Additionally, the first X-ray structure of a zinc complex with a [2.2]paracyclophane ligand was determined. The structures of the zinc complexes are supported by DFT calculations of monomeric and dimeric species.

8.
J Exp Med ; 185(5): 933-40, 1997 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-9120399

RESUMO

To explore the role of the interleukin (IL)-1 beta converting enzyme (ICE) in neuronal apoptosis, we designed a mutant ICE gene (C285G) that acts as a dominant negative ICE inhibitor. Microinjection of the mutant ICE gene into embryonal chicken dorsal root ganglial neurons inhibits trophic factor withdrawal-induced apoptosis. Transgenic mice expressing the fused mutant ICE-lacZ gene under the control of the neuron specific enolase promoter appeared neurologically normal. These mice are deficient in processing pro-IL-1 beta, indicating that mutant ICEC285G blocks ICE function. Dorsal root ganglial neurons isolated from transgenic mice were resistant to trophic factor withdrawal-induced apoptosis. In addition, the neurons isolated from newborn ICE knockout mice are similarly resistant to trophic factor withdrawal-induced apoptosis. After permanent focal ischemia by middle cerebral artery occlusion, the mutant ICEC285G transgenic mice show significantly reduced brain injury as well as less behavioral deficits when compared to the wild-type controls. Since ICE is the only enzyme with IL-1 beta convertase activity in mice, our data indicates that the mutant ICEC285G inhibits ICE, and hence mature IL-1 beta production, and through this mechanism, at least in part, inhibits apoptosis. Our data suggest that genetic manipulation using ICE family dominant negative inhibitors can ameliorate the extent of ischemia-induced brain injury and preserve neurological function.


Assuntos
Apoptose/fisiologia , Sistema Nervoso Central/fisiologia , Cisteína Endopeptidases/genética , Inibidores de Cisteína Proteinase/genética , Mutação , Animais , Encéfalo/irrigação sanguínea , Encéfalo/patologia , Isquemia Encefálica/patologia , Isquemia Encefálica/fisiopatologia , Caspase 1 , Contagem de Células , Artérias Cerebrais/cirurgia , Embrião de Galinha , Nervo Facial/citologia , Gânglios Espinais/patologia , Gânglios Espinais/fisiologia , Lipopolissacarídeos/farmacologia , Camundongos , Camundongos Knockout , Camundongos Mutantes , Camundongos Transgênicos , Neurônios Motores/citologia , Fatores de Crescimento Neural/deficiência , Proteínas do Tecido Nervoso/deficiência , Neurônios/patologia , Neurônios/fisiologia , Processamento de Proteína Pós-Traducional
9.
Med Klin Intensivmed Notfmed ; 115(7): 573-584, 2020 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31197420

RESUMO

BACKGROUND: Treatment after cardiac arrest has become more complex and interdisciplinary over the last few years. Thus, the clinically active intensive and emergency care physician not only has to carry out the immediate care and acute diagnostics, but also has to prognosticate the neurological outcome. AIM: The different, most important steps are presented by leading experts in the area, taking into account the interdisciplinarity and the currently valid guidelines. MATERIALS AND METHODS: Attention was paid to a concise, practice-oriented presentation. RESULTS AND DISCUSSION: The practical guide contains all important steps from the acute care to the neurological prognosis generation that are relevant for the clinically active intensive care physician.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca , Hipotermia Induzida , Parada Cardíaca Extra-Hospitalar , Parada Cardíaca/terapia , Humanos , Parada Cardíaca Extra-Hospitalar/terapia , Prognóstico
10.
Med Klin Intensivmed Notfmed ; 115(4): 292-299, 2020 May.
Artigo em Alemão | MEDLINE | ID: mdl-31363800

RESUMO

Standard procedures and guidelines provide specific instructions for basic and advanced cardiac life support. Recommendations for the admission of patients from preclinical into clinical structures after successful cardiopulmonary resuscitation (CPR) are available, but only a few are detailed. In the presence of ST-elevation myocardial infarction after return of spontaneous circulation (ROSC), coronary angiography must be performed as soon as possible. However, acute management and consecutive diagnostic procedures after hospital admission are up to the doctor on duty, who can rely on standard internal hospital procedures at best. Despite the enormous progress and new findings in intensive care and emergency medicine, intra-hospital mortality, as well as long-term survival, after CPR remains low and depends on a wide variety of influencing factors. To optimize in-hospital acute care of successfully resuscitated patients, an interdisciplinary admission team, a so-called cardiac arrest receiving team (CART), has been implemented at the University Hospital of Freiburg, Germany. The aim of the CART is to provide primary care to resuscitated patients as quickly and in as standardized a manner as possible with predefined diagnostic and therapeutic pathways by a team with special expertise in the field of CPR and post-resuscitation management. Accordingly, clear criteria for procedures and the location of primary care (e.g. emergency room vs. cardiac catheter laboratory), the composition of the CART and concrete treatment measures were defined.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca Extra-Hospitalar , Angiografia Coronária , Alemanha , Humanos
11.
Transl Psychiatry ; 10(1): 39, 2020 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-32066685

RESUMO

Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by developmental delay, impaired communication, motor deficits and ataxia, intellectual disabilities, microcephaly, and seizures. The genetic cause of AS is the loss of expression of UBE3A (ubiquitin protein ligase E6-AP) in the brain, typically due to a deletion of the maternal 15q11-q13 region. Previous studies have been performed using a mouse model with a deletion of a single exon of Ube3a. Since three splice variants of Ube3a exist, this has led to a lack of consistent reports and the theory that perhaps not all mouse studies were assessing the effects of an absence of all functional UBE3A. Herein, we report the generation and functional characterization of a novel model of Angelman syndrome by deleting the entire Ube3a gene in the rat. We validated that this resulted in the first comprehensive gene deletion rodent model. Ultrasonic vocalizations from newborn Ube3am-/p+ were reduced in the maternal inherited deletion group with no observable change in the Ube3am+/p- paternal transmission cohort. We also discovered Ube3am-/p+ exhibited delayed reflex development, motor deficits in rearing and fine motor skills, aberrant social communication, and impaired touchscreen learning and memory in young adults. These behavioral deficits were large in effect size and easily apparent in the larger rodent species. Low social communication was detected using a playback task that is unique to rats. Structural imaging illustrated decreased brain volume in Ube3am-/p+ and a variety of intriguing neuroanatomical phenotypes while Ube3am+/p- did not exhibit altered neuroanatomy. Our report identifies, for the first time, unique AS relevant functional phenotypes and anatomical markers as preclinical outcomes to test various strategies for gene and molecular therapies in AS.


Assuntos
Síndrome de Angelman , Deficiência Intelectual , Síndrome de Angelman/genética , Animais , Deleção de Genes , Deficiência Intelectual/genética , Memória , Ratos , Ubiquitina-Proteína Ligases/genética
12.
Med Klin Intensivmed Notfmed ; 114(3): 246-251, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29556681

RESUMO

BACKGROUND: Administration of selenium, a trace element with antioxidative properties, has been shown to be beneficial in critically ill patients. OBJECTIVE: In this retrospective study, we analyzed the influence of selenium treatment on the outcome of patients after cardiopulmonary resuscitation (CPR) following cardiac arrest. PATIENTS AND METHODS: We retrospectively analyzed selenium plasma levels, neurological performance by Cerebral Performance Categories (CPC), and survival to discharge of 28 resuscitated patients receiving selenium treatment of any cause 24, 48, or 72 h after CPR. All patients received a 1000 µg selenium bolus, followed by a 1000 µg continuous intravenous infusion during a 24 h period. Results were compared to matched controls of resuscitated patients without selenium administration within the first 72 h after CPR. RESULTS: There were clearly distinct time courses of selenium plasma levels between the selenium and the control groups, and between the selenium groups depending on the timepoint of selenium administration after cardiac arrest. Patients receiving selenium within the first 48 h-and especially those with selenium administration within the first 24 h after CPR-showed significantly better neurological outcome, reflected by CPC, and significantly higher survival compared to controls. CONCLUSION: This small observational study gives an indication of a possible improvement in neurological outcome and survival rate with early selenium treatment in patients after CPR.


Assuntos
Reanimação Cardiopulmonar , Parada Cardíaca , Selênio , Idoso , Doenças do Sistema Nervoso Central/prevenção & controle , Feminino , Parada Cardíaca/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Selênio/uso terapêutico , Taxa de Sobrevida , Resultado do Tratamento
13.
Anaesthesist ; 57(12): 1155-60, 2008 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-18958431

RESUMO

INTRODUCTION: Time course, time necessary to achieve the target temperature and stable maintenance, as well as a controlled rewarming period are important factors influencing the outcome of patients after successful cardiopulmonary resuscitation. METHODS: After successful cardiopulmonary resuscitation a total of 49 patients were cooled via an endovascular or external cooling device to a target temperature of 33 degrees C. Relevant cooling parameters, such as time between admission and initiation of cooling, achievement of target temperature and stable maintenance of cooling therapy, were compared between both groups. RESULTS: In the endovascular cooling group the target temperature was reached significantly faster (154 +/- 97 min vs. 268 +/- 95 min, p = 0.0002) and showed stable and controlled maintenance of cooling therapy (deviation from target temperature: 0.189 +/- 0.23 degrees C vs 0.596 +/- 0.61 degrees C, p = 0.00006). The rewarming phase was better controlled and length of ICU stay was shorter in the group with endovascular cooling (8.8 +/- 3 vs. 12.9 +/- 6 days). CONCLUSION: Endovascular cooling offers the possibility to reach the target temperature significantly faster and a stable maintenance of therapeutic hypothermia. It is capable of a more controlled rewarming period and shortens the length of ICU stay.


Assuntos
Parada Cardíaca/terapia , Hipotermia Induzida , Idoso , Vasos Sanguíneos/fisiologia , Temperatura Corporal , Reanimação Cardiopulmonar , Cuidados Críticos , Feminino , Humanos , Hipotermia Induzida/instrumentação , Masculino , Pessoa de Meia-Idade , Reaquecimento
14.
Med Klin Intensivmed Notfmed ; 113(8): 658-663, 2018 11.
Artigo em Alemão | MEDLINE | ID: mdl-28842732

RESUMO

BACKGROUND: During the last decade target temperature management has become an integral part of postresuscitation care. Within recent years there was a strong debate about the optimal target temperature, which might have effects on the preclinical induction of hypothermia. The present investigation focuses on the use of mild therapeutic hypothermia by emergency services in the state of Baden-Württemberg (Germany) and compares it to results of a prior study in 2008. METHODS: Between April and August 2014 a questionnaire was sent to all senior emergency physicians of emergency services in Baden Württemberg. The survey period was April to August of 2014. Parts of the questionnaire were similar to a previous one in 2008, to ensure comparability to the former data; other parts were added to set new focuses. The data were analyzed in anonymized form. RESULTS: The response rate was 72.4% (97/134). Of the 97 sites which responded to the questionnaire significantly more use preclinical hypothermia, compared to 2008 (72.2% [70/97] vs. 41.7%); 62.9% (44/70) declare cooling resuscitated patients routinely (vs. 17.7% in 2008). Cold infusions (85.7%), icepacks (64.3%), passive cooling (37.1%), nasal cooling (2.9%) and cooling caps (1.4%) are used (multiple naming was possible). Sites that did not use mild therapeutic hypothermia stated the following reasons: lack of equipment, short transport time and missing data for the intervention. Four sites reported on complications with therapeutic hypothermia. CONCLUSION: The present investigation shows an increased use of preclinical cooling after cardiopulmonary resuscitation as compared to 2008. Therefore, recent discussions concerning the optimal target temperature in postresuscitation care did not result in a waiving of preclinical therapeutic strategies in Baden-Württemberg. The emergency services sites/locations estimated the complication rates of mild therapeutic hypothermia as very low. Lack of equipment seems to be the main reason to refuse the preclinical use of therapeutic hypothermia. In conclusion, preclinical mild therapeutic hypothermia has become an integral part in the standard care of resuscitated patients in Baden-Württemberg.


Assuntos
Reanimação Cardiopulmonar , Serviços Médicos de Emergência , Parada Cardíaca , Hipotermia Induzida , Alemanha , Parada Cardíaca/terapia , Humanos
15.
J Clin Invest ; 60(6): 1362-6, 1977 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-915002

RESUMO

Pyrimidine nucleotides, detectable in normal erythrocytes only in trace quantities if at all, were found to comprise 7-80% of the intracellular nucleotide pools in nine subjects with severe lead over-burden. Blood lead concentrations ranged from approximately equal to 200- to 400-microgram/dl packed cells, and the greatest accumulations of pyrimidine-containing nucleotides occurred in the two subjects with the highest blood lead levels. Most of the patients had mild or moderate anemia and moderate basophilic stippling evident in Wright's-stained peripheral smears. Pyrimidine nucleotidase activities were inhibited to 13-28% of the mean activity in normal control erythrocytes and even more so (5-15%) when compared to specimens with increased reticulocytes and young cells. Reticulocytosis was absent in two subjects and modest to moderate in the remainder, but erythrocyte assays revealed the substantial elevations in populations of young mean cell age. Inappropriately low reticulocyttial elevations in glucose-6-phosphate dehydrogenase expected in populations of young mean cell age. Inappropriately low reticulocyte responses may reflect hematopoietic suppressive effects of lead at a variety of metabolic loci.


Assuntos
Eritrócitos/enzimologia , Glucosefosfato Desidrogenase/sangue , Intoxicação por Chumbo/enzimologia , Nucleotidases/deficiência , Nucleotídeos de Pirimidina/metabolismo , Contagem de Células , Feminino , Hemoglobinas/análise , Humanos , Chumbo/sangue , Chumbo/urina , Masculino , Nucleotidases/sangue , Reticulócitos
16.
J Clin Invest ; 58(4): 926-32, 1976 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-965496

RESUMO

Lead intoxication is accompanied by an acquired deficiency of erythrocyte pryimidine-specific, 5'-nucleotidase. Genetically determined deficiency of this enzyme is associated with chronic hemolysis, marked basophilic stippling of erythrocytes on stained blood films, and unique intraerythrocytic accumulations of pyrimidine-containing nucleotides. The present report documents that lead-induced deficiency when sufficiently severe gives rise to findings similar to the hereditary disorder. Whereas pyrimidine-containing nucleotides are virutally absent in the erythrocytes of normal and reticulocyte-rich blood, 12% of erythrocyte nucloetides in the blood of a patient with lead intoxication contained cytidine. Nucleotidase activity was about 25% that in normal erythrocytes and 15% or less of that expected in comparable reticulocyte-rich blood. The distribution of nucleotidase activity in patient erythrocytes is unknown, and much more severe deficiency could have been present in subsets of the cell populations analyzed. The findings indicate that the hemolytic anemia and increased basophilic stippling characteristic of certain cases of lead intoxication may share a common etiology with essentially identical features of the genetically determined disorder.


Assuntos
Anemia Hemolítica/etiologia , Basófilos , Eritrócitos/enzimologia , Intoxicação por Chumbo/complicações , Nucleotidases/deficiência , Nucleotídeos de Pirimidina/sangue , Adulto , Citidina/análise , Eritrócitos/metabolismo , Humanos , Chumbo/sangue , Masculino , Nucleotidases/metabolismo
17.
J Clin Invest ; 54(4): 866-79, 1974 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-4372252

RESUMO

A severe deficiency of a red cell pyrimidine 5'-nucleotidase was found to be associated with hereditary hemolytic anemia in four members of three kindreds. The syndrome was characterized by marked increases above normal in red cell basophilic stippling, total nucleotides, and GSH and by a fairly severe deficiency of ribosephosphate pyrophosphokinase (EC 2.7.6.1.). Patient erythrocytes uniquely contained large amounts of pyrimidine 5'-ribonucleotides. In earlier studies, these were erroneously considered to be adenosine phosphates, since all previous investigations of the nucleotides of human red cells and reticulocytes have shown 97% or more to contain adenine. Total nucleotides in patient cells were present in amounts 3-6 times greater than normal, and approximately 80% contained pyrimidine. The ultraviolet spectral curves of deproteinized red cell extracts exhibited a shift in maximum absorbance from the usual 256-257 nm to approximately 266-270 nm, and absorbance at 250, 270, 280, and 290 nm, expressed as a ratio of that at 260 nm, differed greatly from normal. The spectral characteristics of extracts provide the basis of a readily performed screening procedure, which does not require enzyme assay. The nucleotidase activity in deficient red cells assayed less than 14%, and usually less than 10%, of normal and much less in terms of reticulocyte-rich blood, where it was consistently found to be increased. The enzyme has a pH optimum of 7.5-8.0, is inhibited by EDTA, and does not utilize purine 5'-ribonucleotides or beta-glycerophosphate as substrates. While comparatively few family members have been available thus far for study, initial data are compatible with an autosomal, recessive mode of transmission of the deficiency. The pyrimidine 5'-ribonucleotides are presumably derived from RNA degradation and, not being diffusible, accumulate when the enzyme catalyzing their dephosphorylation is deficient. It is postulated that the prominent basophilic stippling results from retarded ribosomal RNA degradation secondary to accumulation of degradation products, namely pyrimidine 5'-ribonucleotides. Ribosephosphate pyrophosphokinase deficiency is considered to be an epiphenomenon. The mechanism responsible for increased red cell GSH is unknown.


Assuntos
Anemia Hemolítica Congênita/enzimologia , Eritrócitos/enzimologia , N-Glicosil Hidrolases/deficiência , Trifosfato de Adenosina/sangue , Adulto , Anemia Hemolítica Congênita/sangue , Anemia Hemolítica Congênita/genética , Anemia Hemolítica Congênita/patologia , Basófilos/patologia , Nucleotídeos de Citosina/sangue , Feminino , Humanos , N-Glicosil Hidrolases/sangue , Fosfoglicerato Quinase/sangue , Fosfotransferases/sangue , Erros Inatos do Metabolismo da Purina-Pirimidina/enzimologia , Nucleotídeos de Pirimidina/sangue , Pirimidinas , Nucleotídeos de Uracila/sangue
18.
J Clin Invest ; 103(3): 347-54, 1999 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-9927495

RESUMO

Increased Ca2+ influx through activated N-methyl-D-aspartate (NMDA) receptors and voltage-dependent Ca2+ channels (VDCC) is a major determinant of cell injury following brain ischemia. The activity of these channels is modulated by dynamic changes in the actin cytoskeleton, which may occur, in part, through the actions of the actin filament-severing protein gelsolin. We show that gelsolin-null neurons have enhanced cell death and rapid, sustained elevation of Ca2+ levels following glucose/oxygen deprivation, as well as augmented cytosolic Ca2+ levels in nerve terminals following depolarization in vitro. Moreover, major increases in infarct size are seen in gelsolin-null mice after reversible middle cerebral artery occlusion, compared with controls. In addition, treatment with cytochalasin D, a fungal toxin that depolymerizes actin filaments, reduced the infarct size of both gelsolin-null and control mice to the same final volume. Hence, enhancement or mimicry of gelsolin activity may be neuroprotective during stroke.


Assuntos
Encéfalo/metabolismo , Transtornos Cerebrovasculares/metabolismo , Gelsolina/metabolismo , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/patologia , Canais de Cálcio/metabolismo , Morte Celular/efeitos dos fármacos , Transtornos Cerebrovasculares/tratamento farmacológico , Transtornos Cerebrovasculares/patologia , Citocalasina D/farmacologia , Citocalasina D/uso terapêutico , Citoesqueleto/metabolismo , Citoesqueleto/patologia , Camundongos , Neurônios/metabolismo , Neurônios/patologia , Inibidores da Síntese de Ácido Nucleico/farmacologia , Inibidores da Síntese de Ácido Nucleico/uso terapêutico , Receptores de N-Metil-D-Aspartato/metabolismo
19.
Toxicol In Vitro ; 21(8): 1402-8, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17590309

RESUMO

INTRODUCTION: Patients with end-stage renal disease suffer from increased genomic damage and cancer incidence. One possible reason is the accumulation of uremic toxins such as homocysteine (Hcy). Elevated Hcy levels--usually indicative of cardiovascular events--correlated with the genomic damage in cross-sectional studies. Therefore we investigated the genotoxic effects of Hcy in vitro. METHODS: To analyse the genomic damage, micronucleus tests and the comet-assay were performed in L5178Y and HL60 cells. Additionally, the influence of Hcy on cell cycle progression, DNA-cytosine-methylation, oxidative stress levels and on the cellular glutathione content were determined. RESULTS: Low millimolar concentrations of Hcy-induced micronuclei in both cell lines but did not enhance the DNA damage observed with the comet-assay. Cell cycle progression was inhibited in S-phase, while DNA-cytosine-methylation remained unchanged. Furthermore, Hcy protected cells challenged with H(2)O(2) from oxidative stress. This was accompanied by an increased cellular glutathione level. CONCLUSION: Since the genotoxic effect was limited to high Hcy concentrations, a contribution of Hcy to the enhanced genomic damage in end-stage renal disease patients would only be conceivable upon local Hcy accumulation. Whether the detected antioxidant capacity of Hcy is relevant for any situation in patients remains to be elucidated.


Assuntos
Antioxidantes/toxicidade , Homocisteína/toxicidade , Mutagênicos/toxicidade , Animais , Ciclo Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Citosina/metabolismo , Metilação de DNA , Camundongos , Estresse Oxidativo
20.
Neuropharmacology ; 113(Pt A): 354-366, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27765626

RESUMO

Nicotine is the primary addictive component of tobacco products and its complex stimulus effects are readily discriminated by human and non-human animals. Previous research with rodents directly investigating the nature of the nicotine stimulus has been limited to males. The current study began to address this significant gap in the literature by training female and male rats to discriminate 0.4 mg/kg nicotine from saline in the discriminated goal-tracking task. In this task, access to sucrose was intermittently available on nicotine session. On interspersed saline session, sucrose was not available. Both sexes acquired the discrimination as evidenced by increased head entries into sucrose receptacle (goal-tracking) evoked by nicotine; the nicotine generalization curves were also similar between females and males. The pharmacological profile of the nicotine stimulus was assessed using substitution and targeted combination tests with the following ligands: sazetidine-A, PHA-543613, PNU-120596, bupropion, nornicotine, and cytisine. For females and males, nornicotine fully substituted for the nicotine stimulus, whereas sazetidine-A, bupropion, and cytisine all evoked partial substitution. Female and male rats responded in a similar manner to interaction tests where a combination of 1 mg/kg of sazetidine-A plus nicotine or nornicotine shifted the nicotine dose-effect curve to the left. The combination of sazetidine-A plus bupropion or cytisine failed to do so. These findings begin to fill a significant gap the in scientific literature by studying the nature of the nicotine stimulus and response to therapeutically interesting combinations using a model that includes both sexes.


Assuntos
Azetidinas/farmacologia , Aprendizagem por Discriminação/efeitos dos fármacos , Objetivos , Nicotina/farmacologia , Agonistas Nicotínicos/farmacologia , Piridinas/farmacologia , Animais , Aprendizagem por Discriminação/fisiologia , Feminino , Ligantes , Masculino , Ratos , Ratos Sprague-Dawley , Fatores Sexuais
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