Changes of myocardial functions in acute hepatic porphyrias. Role of heme arginate administration

In three patients with attacks of acute intermittent porphyria we found markedly impaired functions of the left ventricle accompanied by ECG changes that returned to normal after administration of heme arginate or cytochrome C administration. In nine patients with other types of porphyria, and in one patient with acute intermittent porphyria not suffering an attack, no significant changes of left ventricle function were observed. The changes seen in patients with an acute attack may be ascribed to acute myocardial hypoxia resulting from defective biosynthesis of heme. We assume that the exogenous supply of heme may improve cellular hypoxia.

[Intracellular mechanisms of the effect of cytochrome C on various areas of the myocardium during the dynamic development of an experimental infarct]

The effectiveness of the drug was shown to depend on the number of reversibly damaged cells. The intracellular mechanisms of cytochrome C effect are thought to be related to both the possibility of its permeation through the changed cell membrane of a cardiomyocyte and the action of the drug directly on sarcolemma. Predominantly in the early periods of the study one could note a marked preservation of the ultrastructure of cardiomyocytes, a decrease of degradation of adenine nucleotides and cytochrome aa3 and in the long run limitation of the sizes of necrosis zone.

[Type-II alveolocytes in the treatment of the pulmonary form of oxygen poisoning (electron microscopic and morphometric research)]

The effect of cytochrome C, thymalin and their combination has been studied concerning morphofunctional state of alveolocytes of the II type (A II) in the lungs of 33 non-inbred white rats at the pulmonary form of oxygen poisoning. The phenomenon develops, when the animals are in pure oxygen under pressure of 0.25 MPa for 10 h. The ultrastructural stereological analysis demonstrates that after exposure of the mice in the barochamber, immediately after decompression and during the 1st and the 3d day in the animals not given the pharmacological preparations in the A II diffuse and local edema develops in hyaloplasm, certain changes develop in mitochondria and endoplasmic reticulum. Comparing to intact animals, a relative volume of the lamellar bodies decreases nearly two times, the volume of mitochondria increases by 1.5 times, amount of A II drops. While treating the pulmonary form of oxygen poisoning with cytochrome C or thymalin, in 3 days after beginning to administer the preparations, the relative volume of the lamellar bodies increase by 1.5 times in comparison with those in the group of untreated animals, and at the combined administration-by 2.5 times. This demonstrates stimulation of the pulmonary surfactant synthesis. When the preparations are applied together, by the 3d day the relative volume of mitochondria and amount of A II do not differ from the corresponding indices in intact animals.

[Effect of polypeptides isolated from the heart on the course of experimental myocardial infarct]

Polypeptides excreted from the heart have been shown to exert a positive influence on myocardial infarction caused by izadrin injection in experimental rats.

The effects of cytochrome C on the extent of myocardial infarction and regional function of the ischemic myocardium

The effects of cytochrome C, an electron carrier in the process of oxidative phosphorylation, on infarct size and regional left ventricular function after a coronary artery occlusion were investigated. Thus, in 30 dogs, 1 minute after left anterior descending coronary artery occlusion, 99mTc-labeled albumin microspheres (8 mCi) were injected into the left atrium for subsequent assessment of the hypoperfused zone, that is, the area at risk of infarction. Fifteen minutes after coronary artery occlusion, dogs were randomized into a control group (n = 15) and a cytochrome C-treated group (n = 15). The latter immediately received cytochrome C, 2.5 mg/kg intravenously. Six hours after coronary artery occlusion the dogs were sacrificed and their left ventricles were cut into 3 mm thick slices. Infarct size was determined by triphenyltetrazolium chloride staining and measured by planimetry. The same slices were then submitted to autoradiography and the hypoperfused zone was then measured by planimetry. The hypoperfused zone was 22 +/- 2% and 23 +/- 2% of the left ventricle in the control and treated groups, respectively (NS), indicating that the extent of myocardium at risk before treatment was similar. The extent of the hypoperfused zone which evolved to necrosis was 90 +/- 3% in the control group but only 50 +/- 7% in the treated group (p less than 0.001). Myocardial salvage in the treated group was paralleled by improvement in systolic wall thickness of the ischemic segment as measured by two-dimensional echocardiography. Thus, cytochrome C reduced the extent of myocardial necrosis by 44% and improved systolic function of the ischemic myocardium.

[Pharmacological activity of cytochrome C]

Cytochrome C (a single dose range of 1-200 mg/kg, intraperitoneally) does not possess the antihypoxic activity (altitude chamber, methemoglobinemia, circulatory hypoxia), decreases (in a dose of 50 mg/kg) diuresis in rats modifying diversely (depending on the dose used) the hypnotic effects of general anesthetics and the convulsant activity of corazol and arecoline.

Histological evidence for rescue of radiation dermatitis in an ultraviolet model system

Rescue of acute radiation dermatitis has already been shown feasible with cytochrome c(Sci. Rep. Res. Inst. Tohoku Univ.-C 29: 1, 1982). Interest in the probable reduction of inflammatory sequelae led to histological studies in an ultraviolet model system in the rabbit. The relative dermal thickness in the field of ultraviolet irradiation was 1.70 +/- 0.30 (5) in the untreated control and 1.31 +/- 0.07 (5) in the cytochrome c group respectively (p less than 0.05). Usefulness of the principle cannot be overemphasized in the strategies of radiotherapy, and in the treatment and/or prevention of actinic radiation dermatitis.

[Clinical death-cap (Amanita phalloides) poisoning: prognostic factors and therapeutic measures. Analysis of 205 cases]

205 cases of clinical poisoning with the mushroom Amanita phalloides (death cap) in the period 1971 to 1980 have been studied retrospectively. The lethality was 22.4%. Age and latency between the ingestion of the mushrooms and the first clinical symptoms were of prognostic significance. The death rate was 51.3% in children below 10 years of age but only 16.5% in patients older than 10 years. The average latency period was 10.3 hours for the fatal cases and 12.6 hours for the surviving patients. Country, year, sex and time of hospitalization did not influence lethality. Prognostic relevance could also be attributed to the thromboplastin time (Quick). 84% of the patients with values below 10% died, while all patients with minimal values of more than 40% survived. The correlation with the outcome was weaker for the serum transaminases and nil for creatinine. The patients underwent on the average 8 therapeutic measures, but up to 20 therapies could be administered to the same patient. Eight of the 30 recorded treatments involved general support, 7 toxin elimination and the remaining 14 could be classified as pharmacotherapy. With the aid of multiple regression analysis taking into account age, latency period and the effects of all the other measures, penicillin and hyperbaric oxygenation were found to contribute independently to a higher survival rate. As compared to penicillin, the combination of penicillin with silybin was associated with still further increased survival. On the other hand, several measures, including exchange transfusion, thiocytic acid, sulfamethoxazole, plasma expanders, haemodialysis, treatment of the hemorrhagic diathesis and THAM/sodium bicarbonate were administered more often to patients who did not survive. For the remaining 20 therapeutic measures our analysis revealed neither a positive nor a negative correlation with the clinical outcome.

[Oxidative phosphorylation of Krebs cycle substrates in experimental treatment of enterocolitis with cytochrome c]

After administration of exogenous cytochrome c into rats with enterocolitis, caused by salmonellae, tissue respiration and oxidative phosphorylation in presence of succinic, alpha-ketoglutaric, pyruvic and oxaloacetic acids were increased in the liver tissue. Treatment with cytochrome c produced a positive effect on the general state of an organism, led to disappearance of macroscopic alterations in mucosa of small intestine. The data obtained suggest that cytochrome c possesses the positive therapeutic effects in enterocolitis caused by salmonellae.

[Experimental basis for the therapy of Amanita phalloides poisoning]

The experimental basis for the treatment of death-cap poisoning is reviewed. The available data suggest penicillin and silymarin as the antidotes most likely to be effective. Measures to increase the elimination of the toxins appear to be warranted.

[Cytochrome content in the liver of rabbits in chronic carbon tetrachloride poisoning after perenteral administration of exogenous cytochrome C]

Administration of exogenous cytochrome C to rats poisoned with CCl4 prevented reduction of the cytochrome C content in the homogenates, and of cytochromes a+a3, b and c+c1 in the hepatic mitochondria; it also promoted the normalization of the histostructure of the organ.

Antagonistic effects against single lethal doses of Amanita phalloides

Agents with antagonistic effects against phalloidin or alpha-amanitin were tested in mice against lethal doses of an extract from the whole mushroom Amanita phalloides. The following categories of agents reduced lethality after the extract. First, agents protecting only against phalloidin such as rifampicin, phenylbutazone and antamanide. Second, silymarin and prednisolone which display both antiamatoxic and marked (silymarin) or moderate (prednisolone) anti-phallotoxic acitivty. Thioctic acid displayed some activity when tested against mid-lethal doses of the extract. Cytochrome c, a chemical with curative potencies against alpha-amanitin did not reduce the lethality of the exact. All of the effective agents acted only when applied prior to the poisoning. The pattern or protective activity would indicate that in mice death after single doses of Amanita phalloides may follow a qualitatively particular couse which is difficult to ascribe to phallo- or amatoxic effects alone.