Renal excretory responses of taurine-depleted rats to hypotonic and hypertonic saline infusion

Male Wistar-Kyoto rats were given either tap water (control) or 3% beta-alanine (taurine-depleted) for three weeks. To prepare for the kidney function studies, the animals were then implanted with femoral vessels and bladder catheters. Two days after surgery, each rat was given an intravenous infusion of saline at the rate of 50 microliter/min and urine samples were collected at specific time intervals. An isotonic saline solution (0.9% NaCl) was infused for determination of baseline parameters and was followed by the infusion of a hypotonic saline solution (0.45% NaCl). Two days later, the infusion protocol was repeated in the same animals; however, a hypertonic saline solution (1.8% NaCl) was substituted for the hypotonic saline solution. Renal excretion of fluid and sodium increased in the control, but not taurine-depleted, rats during the hypotonic saline infusion. Interestingly, diuretic and natriuretic responses were similar between the groups during hypertonic saline infusion. The results suggest that taurine-depletion in rats affects renal excretory responses to a hypotonic, but not a hypertonic, saline solution.

Evaluation of induction of CYP3A mRNA using the HepG2 cell line and reverse transcription-PCR

Cytochrome P-450 3A (CYP3A) is a drug-metabolizing enzyme dominant in the human liver. We have designed a useful method for evaluation of induction of CYP3A mRNA by various drugs using HepG2 cells known to retain liver-cellular functions. Using semi-quantitative reverse transcription-PCR (RT-PCR), we demonstrated that cultured HepG2 cells constitutively expressed CYP3A mRNA. This mRNA was expressed at high levels in culture for several days and was further induced by several drugs (e.g. rifampicin (RFP), dexamethasone). Treatment of HepG2 cells with RFP induced CYP3A mRNA in a dose- and time-dependent manner. Cells in culture for 48 h with 1 and 50 micromol/l RFP increased 2.7- and 5.0-fold in CYP3A mRNA expression in comparison with untreated controls, respectively. In contrast, no change in the amount of CYP3A mRNA was observed when the cells were treated with cimetidine which has been shown to inhibit CYP3A activity. Our method using a combination of HepG2 cells and RT-PCR allowed evaluation of the degree of induction of CYP3A mRNA both easily and rapidly.

Interaction of citrus juices with pranidipine, a new 1,4-dihydropyridine calcium antagonist, in healthy subjects

OBJECTIVES

The study was conducted to investigate whether oral co-administration with citrus juices significantly affects the pharmacokinetics and/or pharmacodynamics of pranidipine, a new 1,4-dihydropyridine calcium antagonist, in healthy male subjects. Grapefruit juice and orange juice, which were both commercially available, were used in this study.

METHODS

Sixteen healthy male Japanese subjects participated in this study and were divided into two groups for grapefruit juice and orange juice treatment. The study followed an open-labelled crossover design, comparing the effects of a single oral dose of 2 mg pranidipine taken together with 250 ml citrus juice or 250 ml water. Serum pharmacokinetics of pranidipine, adverse reactions, blood pressure, heart rate, 12-lead ECG, haematology, clinical chemistry and urinalysis were measured throughout the study.

RESULTS

For grapefruit juice, mean Cmax and AUC0-24 h were significantly higher than those of water (P=0.0003 and 0.0005, respectively, ANOVA) with the ratios of log transformed values being 1.50 and 1.74, respectively. There were no differences in tmax and t1/2 between the juice and water treatments. A significant increase in heart rate (P=0.0240, ANOVA with repeated measurements) was observed in the juice treatment whereas there were no significant differences in systolic and diastolic blood pressure between the two treatments. For orange juice, a small decrease in mean Cmax was observed compared with water (P=0.0218, ANOVA) with the ratio being 0.86, but there was no significant difference in AUC0-24h between the two treatments. No marked differences were observed in tmax and t1/2. Oral pranidipine administration with orange juice did not affect heart rate, systolic and diastolic blood pressures or other parameters for safety evaluation.

CONCLUSIONS

Oral co-administration with grapefruit juice and pranidipine was associated with increased bioavailability and changed the pharmacodynamics of pranidipine, particularly with regard to heart rate. Orange juice intake with pranidipine did not markedly affect the pharmacokinetics and no clinically significant changes were observed in the pharmacodynamics and safety evaluation.

Taurine improves angiotensin II-induced hypertrophy of cultured neonatal rat heart cells

The effect of taurine on angiotensin II-induced hypertrophy of cultured neonatal rat heart cells (myocytes and nonmyocytes) was examined. Angiotensin II (1-100 nM) alone caused an increase in the rate of protein synthesis and the surface area of myocytes without altering the rate of DNA synthesis or cell number. It also mediated an increase in DNA synthesis and in cell number of nonmyocytes. Exposure of the cells to taurine (20 mM) in the absence of angiotensin II had no effect on either hyperplastic growth or hypertrophy of the two types of cultured cardiac cells. However, myocytes pretreated with 20 mM taurine exhibited reduced responsiveness to angiotensin II. Following a 24 hr pretreatment with 20 mM taurine, the stimulation in protein synthesis by angiotensin II (1 nM) was significantly suppressed. Similarly, taurine treatment of nonmyocytes reduced the degree of angiotensin II-induced promotion of hyperplastic growth (DNA synthesis and cell number). Finally, taurine partially prevented the rise in [Ca2+]i mediated by angiotensin II in cardiac cells. The present results indicate that taurine is an effective inhibitor of angiotensin II action. The possibility that the beneficial effects of taurine in the treatment of heart failure might be related to its suppression of angiotensin II-mediated cellular responses is discussed.

Effect of taurine depletion on angiotensin II-mediated modulation of myocardial function

Taurine depletion was induced by either incubation of isolated myocytes with 5 mM beta-alanine or feeding rats with water containing 3% beta-alanine. Hearts of taurine depleted rats exhibited an impairment in myocardial relaxation, associated with a decrease in Na(+)-Ca2+ exchanger activity. Exposure of the heart to angiotensin II, an activator of the Na(+)-Ca2+ exchanger, eliminated the relaxation defect. In agreement with the contractile results, taurine depletion prolonged the calcium transient, an effect which was partially eliminated by exposure to angiotensin II. Although peak systolic [Ca2+]i was modestly depressed in the taurine depleted myocyte, peak ventricular pressure was normal. This may be related to an elevation in pHi induced by taurine depletion. Angiotensin II had little effect on contractility of the taurine depleted heart, presumably because of two opposing effects, a reduction in pHi and an increase in [Ca2+]i. Thus, taurine depletion alters contractile function and ion transport and both of these effects are modulated by exposure of the heart to angiotensin II.

[Individualization of drug therapy and pharmacogenetics]

This brief review discusses the relationship between genetic polymorphism of drug metabolizing enzyme and drug's safety and efficacy. When elimination occurs via a single metabolic pathway, individual differences in metabolic rates can lead to large differences in drug and metabolite concentrations in the blood. Genetic polymorphism leads to subpopulation of patients with decreased, absent or even increased activities of certain reactions (e.g., CYP2C19, CYP2D6, CYP2C9, N-acetyltransferase, thiopurine methyltransferase polymorphism). The consequences of a genetic polymorphism include not only altered kinetics of specific drug substrate but idiosyncratic adverse drug reactions. Having these information will aid in determining dosage of certain medications to the patients with an inherited abnormality of drug metabolizing enzyme. Pharmacogenetics already has influenced therapeutics.

Evaluation of oral mucoadhesive microspheres in man on the basis of the pharmacokinetics of furosemide and riboflavin, compounds with limited gastrointestinal absorption sites

When sustained-release adhesive and non-adhesive microspheres which release the same drugs at similar rates are administered orally, drug absorption after administration of adhesive microspheres should, if the gastrointestinal residence of adhesive microspheres is prolonged as a result of mucoadhesion, be higher than that after administration of non-adhesive microspheres. The gastrointestinal transit of oral adhesive microspheres in man has been evaluated pharmacokinetically using furosemide and riboflavin, compounds with limited absorption sites in the upper small intestine. In a preliminary experiment with fasted rats it was confirmed that a higher percentage of the drug remained in the stomach and that plasma drug levels were higher when furosemide was administered in the form of adhesive rather than non-adhesive microspheres. Two kinds of sustained-release microsphere, adhesive and non-adhesive, containing furosemide and riboflavin in hard gelatin capsules were prepared and orally administered to 10 healthy fasted volunteers in a cross-over design. Areas under the plasma concentration-time curves (AUC) were 1.8 times larger for furosemide and urinary recovery was 2.4 times higher for riboflavin when adhesive microspheres rather than when non-adhesive microspheres were used. When adhesive microspheres containing riboflavin were administered to fed volunteers, urinary recovery was 2.1 times higher and mean residence time (MRT) was more prolonged than when the microspheres were administered to fasted volunteers. Adhesive microspheres were found to adhere to the gastric or intestinal mucosa with high affinity in man and rats, resulting in prolonged gastrointestinal residence.

The effect of Y-25510 injection on the serum levels of some cytokines in healthy adult volunteers

OBJECTIVE

Y-25510 was administered by means of an intravenous drip infusion to healthy adult male volunteers at a dose of 40, 80 or 160 mg in a single-dose study, and at a dose of 160 mg once a day for 7 days in a multiple-dose study.

RESULTS

Serum levels of interleukin (IL)-1beta, IL-6 and IL-10 were significantly increased, but there was no change in leukocyte and platelet counts. The peak serum concentration of IL-1beta was nearly maximum at the single doses of 40 and 80 mg, and at the multiple dose of 160 mg per day. The peak serum concentration of IL-6 increased in a dose-dependent manner at a dose of 40 mg or more. For the multiple-dose study, the serum level of IL-10, which remained unchanged in the placebo group, began to increase in the Y-25510 group following the maximum serum level of IL-1beta and IL-6. There were no clinically relevant differences in body temperature and blood pressure after the administration of Y-25510.

CONCLUSION

These findings that leukocyte and platelet counts never increased, despite the increment of the IL-1beta and IL-6 production after the administration of Y-25510, may be explained in part by the negative feedback mechanism induced by IL-10.

Effect of taurine on angiotensin II-induced hypertrophy of neonatal rat cardiac cells

The effect of taurine on angiotensin II-induced hypertrophy of cultured neonatal rat heart cells (myocytes and nonmyocytes) was examined. Angiotensin II (1-100 nM) alone caused an increase in the rate of protein synthesis of myocytes without changing the rate of DNA synthesis and cell number. It mediated increases in DNA synthesis and cell number in nonmyocytes. Furthermore, at the lower concentration of 1 nM, it induced c-fos and c-jun expression in both cultured myocytes and nonmyocytes. Exposure of the cells to taurine (20 mM) in the absence of angiotensin II had no effect on either hyperplastic growth or immediate early response gene expression by the two types of cultured cardiac cells. However, myocytes pretreated for 24 h with 20 mM taurine exhibited reduced responsiveness to angiotensin II (1 nM), resulting in lower levels of angiotensin II-mediated stimulation in protein synthesis, and immediate early response gene expression was attenuated. Similarly, taurine treatment of nonmyocytes reduced the degree of hyperplastic growth (DNA synthesis and cell number) and immediate early response gene expression stimulated by angiotensin II. Finally, taurine partially prevented the increase in intracellular free calcium [Ca2+]i mediated by angiotensin II in cardiac cells. Our results indicate that taurine is an effective inhibitor of angiotensin II action.

Renal excretory responses to saline load in the taurine-depleted and the taurine-supplemented rat

Taurine is found in high concentrations in mammalian cells. Despite recognition of its role as an organic osmolyte in the kidney, information regarding its effects on renal fluid and electrolyte excretion is sparse. Therefore, the objective of the first series of experiments was to determine the effects of taurine depletion on renal excretory responses to a saline load. To induce taurine depletion, male Wistar-Kyoto (WKY) rats were treated with tap water containing 3% beta-alanine for 3 weeks. Taurine depletion reduced the initial rates of fluid and sodium excretion after an intravenous saline load. This effect was attributed to taurine depletion since maintenance of the taurine-depleted rats on tap water for 2 days to remove the effects of beta-alanine yielded the same pattern as the taurine-depleted rats exposed to beta-alanine at the time of the experiment. Nonetheless, rats exposed to short-term beta-alanine treatment, which has no influence on kidney taurine content, demonstrated a larger (approximately 25%) natriuretic but not diuretic response to the isotonic saline load than either the control or taurine-depleted rats. These data suggest that beta-alanine-induced inhibition of tubular reabsorption of taurine may result in subsequent excretion of taurine with attendant natriuresis early in the course of beta-alanine treatment. We also tested the hypothesis that taurine potentiates the renal excretory responses to an isotonic saline load in WKY rats. Inclusion of taurine in the infusate significantly increased natriuresis and diuresis after a saline load. This effect was greater in animals fed a basal than a high NaCl diet. Our data support a role for taurine as a natriuretic and diuretic agent.

Ca2+ depletion facilitates taurine release in cultured rat astrocytes

Removal of external Ca2+ facilitated endogenous taurine release in cultured rat astrocytes. The stimulated release was not affected by furosemide, sucrose, tetrodotoxin and 3,4-dichlorobenzamil, but partially inhibited by nifedipine. Omission of external Na+ increased basal taurine release, and the effects of Na+ removal and Ca2+ depletion on the release were additive. The Na(+)-free condition did not affect Ca2+ paradox-induced cell death in astrocytes. These findings suggest that Ca2+ depletion facilitates taurine release in a mechanism independent of volume and the Na+ gradient and that the release is not involved in Ca2+ paradox-induced delayed cell toxicity in astrocytes.

Temporal changes in regional end-diastolic wall thickness early after reperfusion in acute anterior myocardial infarction: relation to myocardial viability and vascular damage

We investigated early temporal changes in end-diastolic wall thickness (EDWT) of the infarcted myocardium in 46 patients with reperfused anterior acute myocardial infarction in relation to myocardial viability. Two-dimensional echocardiography was performed on days 1 and 2 of acute myocardial infarction, and the EDWT of the anterior segment was measured in the short-axis view. Patients were divided into three groups on the basis of day 1 to day 2 ratio of EDWT: the ratio < or = 0.85 as group A (n = 13), >0.85 but < or = 1.15 as group B (n = 23), and >1.15 as group C (n = 1 0). Left ventricular functional improvement was significantly better in group B than in groups A and C. Substantial size of "no reflow" phenomenon was observed only in groups A (n = 9, 69%) and C (n = 6, 60%). The frequency of transient ST re-elevation after reperfusion was the highest in group C (70%), and left ventricular expansion was observed at day 2 only in group A. We conclude that changes in the EDWT of the infarct segment early after reperfusion, either decreases or increases, are related to irreversibly damaged myocardium. A decrease in EDWT and concomitant ventricular expansion may be related to impaired myocardial perfusion. An increase in EDWT after reperfusion may be caused by accelerated myocardial and microvascular damage after reperfusion.

Involvement of Na+-Ca2+ exchanger in reperfusion-induced delayed cell death of cultured rat astrocytes

In some cells, Ca2+ depletion induces an increase in intracellular Ca2+ ([Ca2+]i) after reperfusion with Ca2+-containing solution, but the mechanism for the reperfusion injury is not fully elucidated. Using an antisense strategy we studied the role of the Na+-Ca2+ exchanger in reperfusion injury in cultured rat astrocytes. When astrocytes were perfused in Ca2+-free medium for 15-60 min, a persistent increase in [Ca2+]i was observed immediately after reperfusion with Ca2+-containing medium, and the number of surviving cells decreased 3-5 days later. The increase in [Ca2+]i was enhanced by low extracellular Na+ ([Na+]0) during reperfusion and blocked by the inhibitors of the Na+-Ca2+ exchanger amiloride and 3, 4-dichlorobenzamil, but not by the Ca2+ channel antagonists nifedipine, Ca2+ and Ni2+. Treatment of astrocytes with antisense, but not sense, oligodeoxynucleotide to the Na+-Ca2+ exchanger decreased Na+-Ca2+ exchanger protein level and exchange activity. The antisense oligomer attenuated reperfusion-induced increase in [Ca2+]i and cell toxicity. The Na+-Ca2+ exchange inhibitors 3, 4-dichlorobenzamil and ascorbic acid protected astrocytes from reperfusion injury partially, while the stimulators sodium nitroprusside and 8-bromo-cyclic GMP and low [Na+]0 exacerbated the injury. Pretreatment of astrocytes with ouabain and monensin caused similar delayed glial cell death. These findings suggest that Ca2+ entry via the Na+-Ca2+ exchanger plays an important role in reperfusion-induced delayed glial cell death.

Protective effect of taurine against reperfusion injury in cultured rat astrocytes

Reperfusion of cultured rat astrocytes with Ca(2+)-containing medium after exposure to Ca(2+)-free medium for a short time caused an increase in intracellular Ca2+ ([Ca2+]i), and delayed cell death (Ca2+ paradox-like injury). Exposure of astrocytes to Ca(2+)-free medium caused a marked release of taurine. Taurine (3-30 mM) reduced the reperfusion-induced increase in [Ca2+]i and attenuated the delayed glial cell death. Glycine, GABA and beta-alanine did not affect reperfusion-induced cell toxicity. The protective effect of taurine required addition at an early time during reperfusion. Ouabain and monensin mimicked reperfusion injury and their toxicity was also reduced by taurine. Taurine (3-30 mM) inhibited dose-dependently 45Ca2+ uptake stimulated by ouabain and monensin in astrocytes. These findings suggest that taurine has a protective effect against reperfusion injury via an inhibition of Na+/Ca2+ exchange activity in the reverse mode.

A missense mutation in the beta-myosin heavy chain gene in a Japanese patient with hypertrophic cardiomyopathy

A 55-year-old man had been previously admitted at the age of 44 because of chest pain on effort. He was diagnosed as hypertrophic obstructive cardiomyopathy with a left ventricular outflow pressure gradient of 65 mmHg. We analyzed the cardiac beta-myosin heavy chain gene in this patient using polymerase chain reaction-single strand conformation polymorphism analysis (PCR-SSCP analysis). PCR-SSCP analysis revealed a sequence variation within exon 16. A G-to-A transversion with replacement of Val by Met at codon 606 was confirmed by sequencing analysis. Previously, a 606Val-->Met mutation has been reported to give a benign prognosis because of the neutral charge substitution. However, there have been some premature deaths in this patient's kindred. Thus, despite the absence of a change in charge, this mutation may be malignant in some kindreds.

Hypoxic stress induces cardiac myocyte-derived interleukin-6

BACKGROUND

Hypoxic and ischemic stresses cause a series of well-documented changes in myocardial cells and tissues, including loss of contractility, changes in lipid and fatty acid metabolism, and irreversible membrane damage leading to eventual cellular death. Activated neutrophils are considered to be involved in this myocardial cellular injury. By stimulation of the neutrophils with chemotactic factors, canine neutrophils can be induced to adhere to isolated cardiac myocytes only if the myocytes have been previously exposed to cytokines such as tumor necrosis factor-alpha, interleukin (IL)-1, and IL-6.

METHODS AND RESULTS

To examine the possible involvement of IL-6 in ischemia-reperfusion injury, we used cultured rat neonatal cardiac myocytes to study the effects of hypoxic stress on the production of IL-6 by cardiac myocytes. Unstimulated cardiac myocytes (3 x 10(5) cells per dish) produced 320 pg IL-6 over 4 hours in vitro (ie, biological activity equal to 320 pg recombinant IL-6, as detected by bioassay using the MH-60.BSF2 cell line). The incubation of cardiac myocytes under hypoxic conditions for 4 hours induced significantly increased production of IL-6 compared with normoxic conditions (2.82 +/- 0.49 versus 1.64 +/- 0.18 U/mL, P < .05). Furthermore, reoxygenation for 2 hours after 2 hours of hypoxic stress significantly augmented the production of IL-6 by cardiac myocytes (4.34 +/- 0.52 U/mL, P < .05). These responses to hypoxia and reoxygenation were not observed in fibroblasts isolated from the same tissue. Although unstimulated cardiac myocytes lacked IL-6 mRNA expression detectable by Northern blot analysis, hypoxic stress induced the expression of IL-6 mRNA in the cardiac myocytes. Several pathophysiologically relevant factors also augmented IL-6 release from cultured cardiac myocytes, including IL-1 beta, ionomycin, and epinephrine.

CONCLUSIONS

Cardiac myocytes respond to hypoxic stress to augment the production of IL-6, and the IL-6 derived from cardiac myocytes may play an important role in the progression of myocardial dysfunction observed in cardiac ischemia-reperfusion injury.

Effect of taurine and methionine on sarcoplasmic reticular Ca2+ transport and phospholipid methyltransferase activity

Perfusion of rat hearts with buffer containing 300 microM L-methionine led to a decrease in Ca(2+)-induced Ca2+ release in sarcoplasmic reticulum (SR) but an increase in calcium-independent Ca2+ release from junctional SR. These effects of L-methionine were not altered by exposure of the hearts to high levels of extracellular taurine, but changes in the size of the intracellular taurine pool appear to modulate calcium transport in SR through two mechanisms. First, millimolar concentrations of taurine can directly promote release of calcium from 45Ca(2+)-loaded junctional SR vesicles. Second, taurine serves as an inhibitor of SR phospholipid methyltransferase, an enzyme that appears to be responsible for methionine-mediated loss in Ca(2+)-induced Ca2+ release activity and promotion of Ca(2+)-independent Ca2+ release. The data imply that modulation of the intracellular taurine pool may affect cellular calcium homeostasis and myocardial contractile function. This may be important in development of the cardiomyopathy linked to taurine deficiency.

[Metabolic and endocrinological responses to the infusion of a new intraoperative fluid]

A new intraoperative fluid, which is characterized by containing 10 mEq.l-1 of potassium, 140 mEq.l-1 sodium and 1% glucose, was infused into 18 healthy volunteers either at rate of 5, 10 ml.kg-1.h-1 (for 3 hours) or 15 ml.kg-1.h-1 (for 2 hours). Responding to increase in the infusion rate and volume, blood glucose and insulin (IRI) levels increased slightly but remained in the normal range. On the other hand, lipid metabolism was depressed markedly. Although concentrations of both potassium and sodium in serum remained unchanged, sodium and water balance (intake vs. outflow) became absolutely positive. Potassium balance was maintained at zero. Blood renin activity decreased gradually after the infusion was commenced and remained at a lower level for 3 hours after stopping infusion. Blood aldosterone and antidiuretic hormone levels also decreased but more gradually than the decrease of blood renin activity. Noteworthy change was not observed in the variables relating to hepatic and renal functions.

Prognosis of patients with severe congestive heart failure referred to the cardiac transplant program. Osaka University Cardiac Transplant Program

In any program for cardiac transplantation, appropriate recipient selection is critically important. The purpose of this study is to evaluate the prognosis of 42 patients with severe cardiac dysfunction who were referred to the Patient Referral Committee of the Osaka University Cardiac Transplant Program from August 1990 to July 1993. All of the patient profiles and clinical data were presented and discussed in the Committee Conference. The Committee classified the patients into three groups according to the following criteria: Class A; 14 patients judged to have a medical indication for heart transplantation, Class B; 7 patients with possible indications which required reevaluation for a definite indication after further intensive medical treatments, and Class C; 21 patients who did not have indications for heart transplantation or who required further clinical examinations and/or medical treatments before a final judgment. Twelve of the 14 Class A patients had a history of NYHA functional class IV and ejection fractions were 25% or less in all of the patients but one (18.5 +/- 1.7%). Six patients in Class A had a history of ventricular tachycardia. The one-year survival rate of Class A patients was 60%, and only 28% survived for 28 months. One patient underwent successful heart transplantation in the United States. If we assume that this patient would have died within a year without heart transplantation, the estimated one-year survival rate would fall to 48%, which is comparable to the survival rate of patients who have been accepted for transplant, but are being treated medically, in Western countries.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of the angiotensin II receptor antagonist, TCV-116, on blood pressure and the renin-angiotensin system in healthy subjects

TCV-116 is a new, nonpeptide, angiotensin II type-1 receptor antagonist that acts as a specific inhibitor of the renin-angiotensin system. In this study, 36 healthy male volunteers were administered single and repeated oral doses of TCV-116 to investigate its effects on blood pressure and heart rate, and to evaluate the safety and pharmacokinetics of the drug. At single doses of 2.5 mg and greater, TCV-116 significantly lowered blood pressure even in normotensive subjects. This hypotensive effect was maintained during repeated administration on a once-daily regimen over an 8-day period. Serum concentration of M-1, an active metabolite of TCV-116, increased in a dose-dependent manner, reaching a peak 3 to 4 hours after administration. An amount of M-1 equivalent to approximately 10% of the administered dose of TCV-116 was excreted in the urine during the first 24 hours following administration. No accumulation of M-1 was observed in subjects receiving repeated administration of TCV-116. No adverse effects were observed except for mild headache in three subjects. These results suggest that the renin-angiotensin system plays a role in the regulation of blood pressure, even in normotensive subjects, and that TCV-116 may prove to be useful in the treatment of hypertension.

Usefulness of taurine in chronic congestive heart failure and its prospective application

We compared the effect of oral administration of taurine (3 g/day) and coenzyme Q10 (CoQ10) (30 mg/day) in 17 patients with congestive heart failure secondary to ischemic or idiopathic dilated cardiomyopathy, whose ejection fraction assessed by echocardiography was less than 50%. The changes in echocardiographic parameters produced by 6 weeks of treatment were evaluated in a double-blind fashion. In the taurine-treated group significant treatment effect was observed on systolic left ventricular function after 6 weeks. Such an effect was not observed in the CoQ10-treated group.

6-Deoxy-D-talan and 6-deoxy-L-talan. Novel serotype-specific polysaccharide antigens from Actinobacillus actinomycetemcomitans

Serotype-specific polysaccharide antigens from Actinobacillus actinomycetemcomitans ATCC 29523 (serotype a) and NCTC 9710 (serotype c) were extracted from whole cells by autoclaving and purified by ion-exchange chromatography and gel filtration. Analysis of component sugars by gas-liquid chromatography-mass spectrometry, high performance liquid chromatography, and NMR together with optical rotation data showed that the serotype a antigen was composed solely of 6-deoxy-D-talose, whereas the serotype c antigen consisted of 6-deoxy-L-talose. Structural analysis indicated that both of these antigens were composed of closely related repeating units, -3)-6-deoxy-alpha-D-Talp-(1-2)-6-deoxy-alpha-D-Talp-(1-(sero type a) and -3)-6-deoxy-alpha-L-Talp-(1-2)-6-deoxy-alpha-L-Talp-(1-(sero type c). 1H and 13C NMR analysis showed that both of these serotype antigens contained one acetyl group/2 sugar residues. These acetyl groups localized at the O-2 position of 3-linked 6-deoxy-D-talose (serotype a) or O-4 position of 3-linked 6-deoxy-L-talose residues (serotype c), respectively. These results coupled with our previous findings on the serotype b antigen (Amano, K., Nishihara, T., Shibuya, N., Noguchi, T., and Koga, T. (1989) Infect. Immun. 57, 2942-2946) showed that the serotype antigens from A. actinomycetemcomitans are a group of novel polysaccharides with structural features closely related biosynthetically.

Phase I study on human monoclonal antibody against cytomegalovirus: pharmacokinetics and immunogenicity

MAb C23, a human immunoglobulin G1 (IgG1) monoclonal antibody (MAb) against cytomegalovirus, was administered to 20 healthy volunteers. Sixteen of them received a single infusion of a dose ranging from 5 to 80 mg. The plasma clearance curves fit a two-compartment model, with half-lives of 31.0 +/- 23.6 h in the diffusion phase and 24.2 +/- 5.8 days in the equilibration phase. The plasma after administration had the virus neutralization activities that were equivalent to the plasma MAb C23 levels. The remaining four subjects, who received three infusions of 60, 20, and 20 mg at 1-week intervals, showed pharmacokinetics that were very consistent with those of the single infusion. No antibody response against MAb C23 was observed in any of the subjects at any time, when monitored for approximately 60 days after the single infusion or the third infusion of the three repeated doses. None of the 20 subjects showed any treatment-related clinical signs or changes. These results suggest that a human IgG MAb has the same pharmacokinetic characteristics as those of natural human serum IgG, and that it is not immunogenetic and is safe in humans.

Interaction of taurine with methionine: inhibition of myocardial phospholipid methyltransferase

Perfusion of isolated, working rat heart with buffer containing 300 microM methionine in the presence of 2.5 U/L insulin led to a 15% decrease in cardiac work and a four-fold decrease in sarcolemmal Na(+)-Ca2+ exchange activity. These effects of methionine were largely prevented by inclusion of 10 mM taurine in the buffer supplemented with methionine and insulin. Taurine also reduced the extent of 3H-methyl group incorporation from radioactive methionine into myocardial phospholipids by approximately 45%. Assays of sarcolemmal phospholipid methyltransferase activity at catalytic sites I, II, and III revealed that taurine inhibited N-methylation activity approximately 30%. The data imply that the ability of taurine to modulate myocardial contraction and calcium transport may be related to taurine-mediated inhibition of phospholipid N-methylation.

Plasma endothelin levels during myocardial ischemia and reperfusion

Endothelin, an endothelium-derived vasoconstrictive peptide, has a strong potency of coronary artery constriction. However, the role of endogeneous endothelin under pathophysiological conditions has not yet been known. In this study, we examined plasma endothelin concentration in dogs with myocardial ischemia and reperfusion. Anesthetized open-chest dogs underwent either 45 minutes occlusion of the left anterior descending coronary artery followed by 3 hours reperfusion, or 4-10 hours of continuous occlusion. Plasma concentration of endothelin from the central vein was measured by the highly sensitive enzyme-immunoassay. Plasma endothelin concentration increased 2.2-fold with the peak level at 60 minutes after release of the ligated artery, but occlusion per se caused no remarkable change. These data suggest that reperfusion of the occluded artery might be needed to increase the plasma concentration of endothelin in case of myocardial infarction.

Taurine modulates ion influx through cardiac Ca2+ channels

The effects of taurine on the inward Ca2+ current (ICa) were investigated by means of the whole-cell voltage-clamp technique in isolated single guinea pig ventricular myocytes. ICa were elicited by 200-ms test pulses from a conditioning holding potential of -45 mV to various test potentials at a rate of 0.5 Hz. Taurine (10-20 mM) had different effects on ICa, depending on the extracellular Ca2+ concentration [( Ca]o). A small stimulatory effect of taurine was found in low [Ca]o (0.8 mM), and a small inhibitory effect was found in high [Ca]o (3.6 mM). Taurine had no significant effect on ICa in normal [Ca]o (1.8 mM). Such dual effects on ICa may explain the various effects reported for taurine especially its dual inotropic actions on cardiac muscle depending upon [Ca]o. Thus, taurine acts in a manner to keep ICa relatively constant. Taurine increased the resting potential irrespective of [Ca]o, suggesting that, in addition, taurine increased K+ conductance and/or ion exchange systems such as the Na/Ca and Na/K exchange.

The effect of taurine on age-related immune decline in mice: the effect of taurine on T cell and B cell proliferative response under costimulation with ionomycin and phorbol myristate acetate

Proliferative responses to the costimulation with phorbol-12-myristate-13-acetate (PMA) and suboptimal doses of ionomycin in the purified T and B cells from old mice were lower than those from young mice. The degree of the age-related decline was more significant in T cells than in B cells. Taurine, a sulfur containing amino acid, augmented the proliferative responses of T cells from both young and old mice. The augmentation of the proliferative response by taurine was more marked in old T cells than in young ones. The concentration of intracellular free calcium ion ([Ca2+]i) was significantly lower in the old T cells under the stimulation with PMA and ionomycin than that in the young ones. In the presence of taurine, the concentration of [Ca2+]i in the old T cell significantly increased under the stimulation. The results indicate that taurine improved the proliferative response of old T cells by the restoration of the increment of the concentration of [Ca2+]i under the stimulation.

Taurine deficiency and doxorubicin: interaction with the cardiac sarcolemmal calcium pump

An anticancer drug, doxorubicin, and a naturally occurring beta-amino acid, taurine, exert opposing actions on myocardial calcium content and lipid peroxidation. Thus, we tested the hypothesis that the two agents may interact to modify cardiac calcium metabolism and indices of lipid peroxidation. Cardiac taurine levels were reduced by half in rats given tap water containing a beta-amino transport inhibitor, beta-alanine. Taurine deficiency was associated with an increased susceptibility of the heart to doxorubicin-mediated calcium accumulation, a phenomenon commonly associated with doxorubicin cardiotoxicity. Taurine deficiency also predisposed the heart to enhanced formation of malondialdehyde caused by doxorubicin administration. While increases in malondialdehyde levels are often associated with lipid peroxidation, the failure of doxorubicin to cause changes in oxidized glutathione content makes peroxidative mechanisms a less likely explanation for the potentiation of doxorubicin-mediated myocardial calcium accumulation in taurine-deficient rats. A more likely possibility is the interaction between taurine deficiency and doxorubicin to inhibit the sarcolemmal calcium pump. The data also suggest that the interaction between doxorubicin and taurine deficiency does not involve alterations in the pharmacokinetics of doxorubicin or the cardiotoxic metabolite, doxorubicinol. It is concluded that reduction in sarcolemmal calcium pump activity by taurine deficiency may contribute to myocardial calcium accumulation in hearts whose calcium homeostasis has been compromised by doxorubicin.

Coronary angiographic features within 48 hours from onset of non-Q wave myocardial infarction with R wave regression and no ST segment depression

The clinical features of acute non-Q wave myocardial infarction (NQMI) with R wave regression and no ST segment depression are distinct from those of acute Q wave myocardial infarction (QMI). NQMI patients showed ST segment elevation at admission, and significantly earlier regression of the ST segment elevation and appearance of coronary T waves were observed compared to QMI patients. In addition to the significantly lower level of mean peak serum creatine kinase activity and the significantly lower incidence of pump failure during the acute phase, the incidences of in-hospital mortality and multivessel disease were significantly lower in the NQMI patients. With respect to acute-phase coronary angiographic features within 48 h after the onset, the rate of spontaneous opening of infarct-related vessels was significantly higher in the NQMI patients. Thirteen of the 19 NQMI patients responded to urokinase infusion. These facts suggest that transient, intermittent or incomplete obstruction may favor this type of NQMI over QMI, and that thrombus might be an important factor in the pathogenesis of this type of NQMI.

Protective effect of taurine against doxorubicin-induced cardiotoxicity in perfused chick hearts

The ability of taurine to protect the isolated heart against doxorubicin cardiotoxicity was examined. Chick hearts perfused for 20 min with medium containing 17 microM doxorubicin exhibited a decrease in contractility, an increase in resting tension and a dramatic depletion in tissue high energy phosphate content. Addition of 20 mM taurine to the perfusate attenuated the increase in resting tension and the decrease in myocardial adenosine triphosphate content induced by doxorubicin. The present study confirms our previous in vivo observations that taurine partially prevents doxorubicin-induced cardiotoxicity.

Specific removal of IgE by therapeutic immunoadsorption system

A therapeutic immunoadsorption system was developed that can remove IgE effectively and specifically from the plasma of patients with an allergy or other hyper-IgE syndrome. The immunoadsorbent (IA) consists of immunoaffinity purified anti-IgE antibody (a-IgE ab) immobilized on controlled pore glass beads (50 nm pore size). Adsorption isotherms for IgE, which were reduced by the Freundlich adsorption equation, were obtained with IA that immobilized various amounts of a-IgE ab. An optimum amount of a-IgE ab to be immobilized was selected. IA worked sufficiently in a wide range of IgE concentrations. Clinical treatment requires an amount of 41 mg of IgE to be removed from a patient's plasma for 3 h. An IA for clinical use was designed to contain 10 g of the support binding 325 mg or more of the antibody. In fact, our study in vitro simulating a clinical case showed that serum IgE was removed by IA, as expected: the level decreased from 11,000 to 3000 U/ml after a 3 h perfusion (1 U = 2.3 ng). A very small amount of a-IgE ab (goat IgG) was found to be detached from IA by flowing plasma; the average level was 20 ng/ml, which seems to be safe. However, we installed the second column in a circuit that adsorbs a-IgE ab leaked into plasma, because the amounts of a-IgE ab infused into the patient must be minimized. The second column contained IgE immobilized on the same support, since IgE as a ligand adsorbed more a-IgE ab than did anti-goat IgG antibody. This is an effective and safe therapeutic immunoadsorption system and has been subjected to clinical tests.

Clinical performance of Bjork-Shiley mechanical heart valves: a perspective on outlet strut fractures in the 60 degrees and 70 degrees convexo-concave disc models

The convexo-concave disc model of Bjork-Shiley mechanical heart valve is a significant improvement over the spherical disc model and compares favourably to other valves, including bioprostheses, with respect to hemodynamics, thromboembolism, anticoagulant related hemorrhage and prosthetic endocarditis. A small number of the 60 degrees and 70 degrees welded outlet strut Bjork-Shiley convexo-concave valves are at risk of sudden structural failure. The risk is constant or decreasing with time. Elective explanation is not recommended. The integral outlet monostrut 70 degrees Bjork-Shiley convexo-concave valve demonstrates further improvements in design and durability, and is recommended for use in patients who are appropriate candidates for mechanical cardiac prostheses.

Clinical results of pericardial xenograft valves: the Ionescu-Shiley and Hancock valves

Between 1979 and 1985, 552 Ionescu-Shiley valves were implanted in 511 patients. The Hancock valve was implanted in 122 patients (129 valves) between 1982 and 1983. Sixty percent of procedures were isolated aortic valve replacements. In the Ionescu series, 59% of these were 19 or 21 mm valves while only 15% of the Hancock valves were of this size. For isolated mitral valve replacement, 76% of Ionescu-Shiley valves were 25 to 27 mm, compared to 36% of the Hancock valves. Patient age, sex, prior operations, concomitant surgery (usually coronary bypass), operative mortality and late deaths were similar for both valves. A mean follow-up of 38 months was obtained for each valve population (99% complete) representing a cumulative 1497 patient-years for the Ionescu-Shiley valve and 375.4 patient-years for the Hancock valve. Actuarial survival for the former was 73 +/- 4% at 72 months, and 65 +/- 14% for Hancock valves at 60 months. The frequency of major events during follow-up (thromboembolism, anticoagulant related hemorrhage, bland perivalvular leak and prosthetic valve endocarditis) were similar, but the frequency of primary tissue valve failure was markedly different for the two valves (1.1% per patient-year for Ionescu-Shiley valves and 5.9% for the Hancock valve). The mean interval to replacement of an Ionescu mitral prosthesis was significantly shorter (23.4 months) than for replacement of an aortic prosthesis (42 months) while the mean interval to replacement of an Ionescu aortic and/or a Hancock aortic or mitral were all similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Five-year follow-up of Hancock pericardial valves: management of premature failure

The durability and function of bovine pericardial valves are dependent upon design, preservation, patient factors (age, sex), and site of valve implantation. In 1983, a shelf recall of all Hancock bovine pericardial valves (HPV) was instituted by the manufacturer. This report represents the results of an organized 5-year follow-up in a hospital Prosthetic Valve Registry of 129 HPV implanted in 122 patients (79 males, 43 females) between May 1982 and April 1985 using echo Doppler and careful clinical evaluation. Mean age was 56 +/- 15 years. There were 81 AVR, 33 MVR, 7 DVR, and 1 TVR. Concomitant coronary bypass was performed in 38 patients (31%). Surgery was on a redo basis in 25 patients (20%), urgent in 14 (11%), and for SBE in 8 patients (7%). There were seven hospital deaths (5.7%). Mean follow-up was 44 months (maximum 66 months) for 114 patients (99% complete), representing 417 patient years. There have been 20 late deaths (18%), of which 7 were directly valve related. Linearized frequency of major events (per pt-yr) was: thromboembolism, 1.6%; anticoagulant related hemorrhage, 0.8% (1 late death); prosthetic valve endocarditis 1.3%; primary tissue failure, 5.8%. Patient symptomatology was a more accurate predictor of bioprosthetic failure requiring reoperation than echo Doppler studies, which were completed in 74 of 97 patients examined during scheduled follow-up visits. Twenty-four of the 96 patients (25%) have required re-replacement at a mean interval of 44 months (27-59 months) from initial implantation. This was due to vertical shear starting at the top of the strut anchoring commissural attachments in every case.(ABSTRACT TRUNCATED AT 250 WORDS)

Cellular oncogene expression in the idiopathic cardiomyopathic hamster heart during the growing process

The expression of various proto-oncogenes was evaluated in the Syrian hamster with hereditary idiopathic cardiomyopathy. mRNA from the heart and aorta of controls (BIO-RB) and cardiomyopathic hamsters (UM-X7.1 strain, BIO 14.6 line) was tested using RNA hybridization techniques. Of the 19 different v-oncogene probes used in the study, only the v-myc probe revealed a substantially greater expression of oncogene in the 30th day of cardiomyopathic hamster heart than in control hamster heart. The amplified expression of c-myc was also observed in the heart of 1-year-old, but not of 7-day-old cardiomyopathic hamster. Overexpression of c-myc, otherwise associated with the regulation of cell differentiation or rapid growth, may relate to the pathological state or pathogenesis of the hereditary cardiomyopathy.

Taurine prevention of calcium paradox-related damage in cardiac muscle. Its regulatory action on intracellular cation contents

The present study was designed to investigate in chick heart whether oral pretreatment with taurine or taurine added directly to the perfusate has any effect upon calcium paradox-induced heart failure. In both protocols, taurine significantly reduced the mechanical dysfunction resulting from the calcium paradox. Taurine pretreatment partially inhibited the excess accumulation of calcium in the myocardium that occurs upon calcium repletion, and microscopy revealed almost normal structure. This protective effect of taurine was accompanied by (a) reduction of the gain of sodium content that occurs during calcium depletion, and (b) reduction of the late gain in calcium that occurs during calcium repletion. It is proposed that taurine plays a role in the regulation of calcium homeostasis and membrane stabilization.

Mechanism of the protective action of taurine against isoprenaline induced myocardial damage

The effect of the sulphur amino acid, taurine, on the biochemical changes induced by a toxic dose of isoprenaline was examined in chick hearts. Isoprenaline treatment (80 and 240 mg.kg-1 subcutaneously twice a day for four days) caused a dose dependent increase in heart to body weight ratio. Isoprenaline administration induced a substantial accumulation of calcium and caused a profound decrease of adenosine triphosphate content and creatine phosphokinase activity in the myocardium. A pronounced increase in lipoperoxide and decrease in phospholipid and reduced glutathione concentrations were also seen. Oral administration of taurine (200 mg.kg-1 for seven days) partially protected against these changes induced by isoprenaline. It is suggested that the beneficial effect of taurine may be due in part to inhibition of lipoperoxide formation and calcium accumulation and to protection against the deterioration of membrane phospholipids.

Protective effect of taurine on the irregular beating pattern of cultured myocardial cells induced by high and low extracellular calcium ion

Abnormal beating patterns were induced in spontaneously contracting cultured embryonic mouse myocardial cells either by elevating or by lowering extracellular calcium. At low calcium (0.4 mM), the number of beating cells and beating rate decreased while the number of arrhythmic cells increased. By contrast, at high calcium (20 mM), the number of beating cells decreased while beating rate and the number of arrhythmic cells increased. Addition of taurine (20 mM) to the medium attenuated the response to varying calcium; the taurine effect appeared to be specific since neither taurine analog tested (beta-alanine nor glycine) provided much protection against these abnormalities. The protective effect of taurine also appeared to differ from that of verapamil, which was effective only in decreasing beating rate in the high calcium condition. Uptake of 14C-taurine by the cells was higher at both low and high extracellular calcium when compared to the normal calcium (2 mM) concentration. The results raise the possibility that the protective effect of taurine on beating abnormalities caused by low or high calcium is related to taurine uptake.

Reduction of doxorubicin-induced cardiotoxicity in mice by taurine

The effect of taurine on doxorubicin-induced cardiotoxicity was examined in mice. A single intraperitoneal injection of doxorubicin (15 mg/kg) produced a significant elevation of calcium and lipoperoxide content at 72 hr, as well as a significant depletion of creatine phosphokinase, glutamic oxaloacetic transaminase and lactate dehydrogenase activities at 48 hr and glutathione peroxidase activity at 24 hr in the myocardium. These results suggest that a substantial myocardial damage had occurred. All biochemical alterations except depletion of glutathione peroxidase, were markedly attenuated by the combined oral and intraperitoneal administration of taurine. Taurine significantly improved the survival rate of the mice treated with doxorubicin. These results demonstrate that taurine antagonized doxorubicin-induced cardiotoxicity.