Transcranial Doppler assessment of cerebral flow velocity during cognitive tasks

BACKGROUND AND PURPOSE

The purpose of this study was to assess the ability of transcranial Doppler ultrasonography to detect selective circulatory changes during cognitive activity.

METHODS

We measured cerebral artery flow velocity in 21 normal volunteers by transcranial Doppler ultrasonography during rest followed by cerebral activation. Mean and peak systolic flow velocities of the anterior, middle, and posterior cerebral arteries were measured during the performance of a commercial video game. We also measured flow velocity of the anterior cerebral arteries in 18 subjects during a mental arithmetic task. Serial measurements of the right and left sides were made with a headband with two probes.

RESULTS

We observed a global increase in the flow velocity above baseline measurements during task performance. During the video game, both middle cerebral arteries (t = 2.6, p = 0.02 for the left; t = 3.3, p = 0.004 for the right) and the left posterior cerebral artery (t = 2.2, p = 0.004) had selective increase in mean flow velocity compared with the ipsilateral anterior cerebral artery. This selective activation was most prominent in the right middle cerebral artery, which had a greater degree of activation than the right posterior cerebral artery (t = 2.8, p = 0.013). We did not observe a statistically significant difference between the right and left middle cerebral arteries, but there was a trend toward a greater activation on the right for both the mean velocity (t = 1.7, p = 0.098) and the peak velocity (t = 1.9, p = 0.079).

CONCLUSIONS

Our preliminary investigation suggests that this noninvasive technique has the potential to correlate selective cerebral artery flow dynamics with cognitive activity.

A novel one-step purification of human alpha-thrombin after direct activation of crude prothrombin enriched from plasma

Crude prothrombin enriched from human plasma was directly activated to generate alpha-thrombin without prior exhaustive purification of the proenzyme using a combination of several different types of chromatographic techniques, as in all previously described methodologies. Activated thrombin was separated from other components in a single step by taking advantage of its highly specific affinity to heparin immobilized on a matrix support of Sepharose CL-6B. On the basis of the data presented herein, we have demonstrated the ease with which at least 25 mg of a highly purified enzyme (greater than 97% homogeneous by laser densitometry) can be obtained per litre of plasma. Our product exhibits a specific activity of at least 4000 National Institutes of Health units/mg and is stable after being freeze-dried for the purpose of long-term storage.

Passive Inhalation of Cocaine

Recent studies (1, 2) have shown that dermal absorption of cocaine can lead to low concentrations (<150 μg/L) of the cocaine metabolite benzoylecgonine in urine. An anecdotal report (3) suggests that children may exhibit positive urine cocaine metabolite tests after passive exposure to the vapor created by free-base cocaine smoking.

Antitumor agents. 120. New 4-substituted benzylamine and benzyl ether derivatives of 4'-O-demethylepipodophyllotoxin as potent inhibitors of human DNA topoisomerase II

A number of new 4'-O-demethylepipodophyllotoxin derivatives possessing various 4 beta-N- or 4 beta-O-benzyl groups have been synthesized and evaluated for their inhibitory activity against the human DNA topoisomerase II as well as for their activity in causing cellular protein-linked DNA breakage. The 4 beta-N-benzyl derivatives 9-22 are, in general, as active or more active than etoposide (1). The most active compounds are 14, 16, and 17, which are more than 2-fold more potent than 1. The results indicated that a basic unsubstituted 4 beta-benzylamino moiety is structurally required for the enhanced activity. Replacement of the benzyl nitrogen with oxygen gave compounds (23 and 24) which are inactive. The ability of these compounds to inhibit human DNA topoisomerase II and to cause protein-linked DNA breakage appears to have no direct correlation with cytotoxicity in KB cells.

A gene delivery/recall system for neurons which utilizes ribonucleotide reductase-negative herpes simplex viruses

We present data which show that ribonucleotide (RR)-negative herpes simplex virus type-1 (HSV-1) is a useful vector for gene delivery into neuronal cells. For these studies we used hrR3, a genetically engineered HSV-1 mutant which has an in-frame insertion of the bacterial lacZ gene into the HSV gene that encodes the large subunit (ICP6) of RR. After infection of rat primary sympathetic neuronal cultures with hrR3, the ICP6::lacZ chimeric gene was expressed, as shown by blue staining of the cells upon exposure to X-Gal, a chromogenic beta-galactosidase substrate. When the infection was performed in the presence of acyclovir, hrR3 appeared to become "latent"; neither infectious virus nor beta-galactosidase activity was detectable in these neuronal cultures at 3 weeks after the acyclovir was removed. However, beta-galactosidase activity was inducible in the "latent" cultures by superinfection with ICP6 delta (a RR-negative deletion mutant) without resulting in the "reactivation" of hrR3 and without apparent cytopathic effects. In contrast, superinfection with ICP6 delta + 3.1, a virus derived by marker rescue of ICP6 delta, resulted in the expression of lacZ, the release of hrR3 into the culture medium, and cytopathic effects. The introduction of a foreign gene into neuronal cells by a RR-negative herpes simplex virus, and the subsequent induction of gene expression by another noncomplementing virus, may constitute a prototype gene delivery/recall system for neurons.

Menadione-induced DNA damage in a human tumor cell line

The nature and extent of menadione (MD)-induced DNA damage were explored using the human breast cancer cell line MCF-7. Concentration-dependent single-strand (ss) and double-strand (ds) DNA breaks were detected in MD-treated MCF-7 cells using the alkaline- and neutral-elution techniques, respectively. The repair of ss and ds DNA breaks was extensive but not complete after a 6-hr incubation in drug-free medium. Evidence was found for the production of DNA interstrand cross-links in MCF-7 cells treated with the bifunctional alkylating agent, mitomycin C, but not for cells treated with MD. Exposure of MCF-7 cells to etoposide (VP-16), mitoxantrone and camptothecin resulted in the detection of significant amounts of protein-linked DNA breaks, whereas none were found in MD-treated cells. These results support the proposition that MD-induced DNA damage is not likely to be mediated via topoisomerases, nor do significant amounts of protein-linked DNA form in MD-treated cells. Thus, MD serves as a good model for examination of the role of the quinone moiety in DNA damage in relation to redox cycling. Future studies directed at elucidation of the biochemical determinants mediating formation of reactive oxygen species effecting the MD-induced DNA damage are necessary and underway.

PAF and LTB4 biosynthesis in the human neutrophil: effects of putative inhibitors of phospholipase A2 and specific inhibitors of 5-lipoxygenase

The effect of several putative phospholipase A2 (PLA2) inhibitors on [3H]-acetate incorporation into platelet-activating factor (PAF) upon calcium ionophore A23187 stimulation of purified human neutrophils (PMN) were evaluated in vitro. PLA2 inhibitors such as p-bromophenacyl bromide (pBPB), ellagic acid, aristolochic acid and gossypol were without effect or only weakly inhibited PAF biosynthesis. Luffariellolide, a potent PLA2 inhibitor isolated from the marine sponge Luffariella sp., dose-dependently inhibited PAF production (IC50 = 5 microM). Due to the relationship between PAF and LTB4 biosynthesis, the effect of inhibiting LTB4 production on PAF biosynthesis was investigated. At concentrations which reduce LTB4 production by greater than 95%, Wy-50,295 tromethamine and A-64,077, specific 5-lipoxygenase (5-LO) inhibitors, did not significantly effect PAF production. In contrast, L-663,536, the 5-LO translocation inhibitor, was a potent inhibitor of PAF production (IC50 = 1 microM). This activity of L-663,536 may contribute to its pharmacological profile at higher doses. These data also suggest that PAF biosynthesis in human PMNs is not dependent on the formation or continued presence of leukotrienes.

Metabolic asymmetries in asymptomatic HIV-1 seropositive subjects: relationship to disease onset and MRI findings

Fifteen male homosexual subjects (mean age 31.6 +/- 7.2 yr) who were asymptomatic, but HIV-1 seropositive (HIV+) were compared to 15 male age-matched HIV-1 seronegative (HIV-) subjects using resting PET/FDG studies and MR scans. Mean cerebral metabolic rates for glucose (mg/100 g/min) in the HIV+ and HIV- subjects were 7.7 +/- 1.7 and 7.0 +/- 2.1, (p = 0.44), respectively. An index of regional metabolic asymmetry for the whole brain was 5.8% +/- 3.2% in the HIV+ and 2.7% +/- 2.3% in the HIV- (p = 0.002), and the difference was most prominent in the prefrontal area. Significant asymmetries were found in 10/15 HIV+ subjects, primarily in prefrontal (7/15) and premotor (4/15) regions. MRI scans showed no abnormalities on clinical or quantitative evaluation in HIV+ subjects. Upon follow-up of HIV+ subjects over 18-40 mo, seven became symptomatic, of which two died. There was no relationship between the presence of PET scan abnormalities and earlier onset of symptomatic disease.

Direct analysis of the disulfide content of proteins: methods for monitoring the stability and refolding process of cystine-containing proteins

So far, the cystine (disulfide) content of proteins has been routinely determined by indirect methods, i.e., cystines are first converted to more stable half-cystines prior to analysis. We present a study which demonstrates that the cystine content can be directly and accurately analyzed at low picomole to femtomole levels. The method involves (a) the employment of a vacuum during sample hydrolysis which permits quantitative recovery of cystine, and (b) the dabsyl chloride precolumn derivatization method which yields stable DABS-cystine that is subsequently analyzed by HPLC. Direct analysis of the cystine residue is important in numerous areas of protein research. It allows, by a single analysis, simultaneous determination of the sulfhydryl (cysteine, as S-carboxymethyl derivative) and disulfide (cystine) contents. The technique can be used to follow the refolding process of fully reduced, cystine-containing proteins. Direct analysis of the cystine content also serves to monitor the extent of inactivation of cystine-containing proteins caused by alkaline pH and heat treatments. In this mode of protein inactivation, cystines are selectively destroyed and converted to lanthionine and lysinoalanine. Both the decrease of cystine and the recoveries of lanthionine and lysinoalanine can be simultaneously evaluated by the proposed method. Examples of these applications are presented here.

Preclinical evaluation of a new potent immunosuppressive agent, rapamycin

Since individual immunosuppressive agents display pleiotropic arrays of nonimmunologic toxic complications when used at therapeutic concentrations, synergistic drug combinations proffer an attractive strategy. RAPA is a good candidate for this enterprise, because of its unique action to inhibit lymphokine signal transduction. Initial in vivo and in vitro studies using the rigorous pharmacologic tool, the median effect analysis, document a synergistic relation between RAPA and CsA in rodent and canine models. These preclinical findings compel careful Phase I trials, in order to assess the safety and synergistic efficacy of RAPA in combination drug regimens with other immunosuppressive agents.

Deciphering the structural elements of hirudin C-terminal peptide that bind to the fibrinogen recognition site of alpha-thrombin

The C-terminal peptide of a hirudin acts as an anticoagulant by binding specifically to a noncatalytic (fibrinogen recognition) site of thrombin. This binding has been shown to shield five spatially distant lysines of the thrombin B-chain (Lys21, Lys65, Lys77, Lys106, and Lys107). It was also demonstrated that modification of the sequence of the hirudin C-terminal peptide invariably diminished its anticoagulant activity. The major object of this study is to investigate how the decreased activity of the modified hirudin C-terminal peptide is reflected by the change of its binding properties to these five lysines of thrombin. A synthetic peptide representing the last 12 C-terminal amino acids of hirudin (Hir54-65) was (1) truncated from both its N-terminal and its C-terminal ends, or (2) substituted with Gly along residues 57-62, or (3) chemically modified to add (sulfation at Tyr63) or abolish (Asp and Glu modification with carbodiimide/glycinamide) its negatively charged side chains. The binding characteristics of these peptides to thrombin were investigated by chemical methods, and their corresponding anticoagulant activities were studied. Our results demonstrated the following: (1) the anticoagulant activities of hirudin C-terminal peptides were quantitatively related to their abilities to shield the five identified lysines of thrombin. The most potent peptide was sulfated Hir54-65 (S-Hir54-65) with an average binding affinity to the five lysines of 120 nM. A heptapeptide (Hir54-60) also displayed anticoagulant activity and thrombin binding ability at micromolar concentrations. (2) All active hirudin C-terminal peptides regardless of their sizes and potencies were shown to be capable of shielding the five lysines of thrombin.(ABSTRACT TRUNCATED AT 250 WORDS)

Positron emission tomographic studies during serial word-reading by normal and dyslexic adults

Positron-emission tomography (PET) was used to study regional cerebral metabolic activity during oral reading in right-handed adult males with, and without a childhood and family history of developmental dyslexia. Significant group differences in normalized regional metabolic values were revealed in prefrontal cortex and in the lingual (inferior) region of the occipital lobe. Lingual values were bilaterally higher for dyslexic than normal readers. In contrast to the asymmetry observed in prefrontal and lingual regions in nondyslexic subjects during reading, the dyslexic pattern was more symmetric. These results demonstrate that individuals who suffered from familial developmental dyslexia as children, activate different brain regions during reading as adults, as compared to individuals without such childhood history.

Stability of hirudin, a thrombin-specific inhibitor. The structure of alkaline-inactivated hirudin

Hirudin is a 65-amino acid polypeptide with three disulfide linkages. It is stable under extreme pH (1.47-12.9), high temperature (95 degrees C), and in the presence of denaturants (6 M guanidinium chloride or 8 M urea). The thrombin inhibitory activity of hirudin remains unaffected even after cleavage of an internal peptide bond (Lys36-Asn37). One condition which effectively and irreversibly inactivates hirudin is the combination of elevated temperature and alkaline pH. Structural analysis reveals that inactivation is a consequence of base-catalyzed beta-elimination of the disulfide bonds. The reaction leads to the conversion of hirudin to a mixture of highly heterogeneous polymers (from monomer to heptamer) which are intra- and intermolecularly cross-linked by cystine (20%), lanthionine (50%), and lysinoalanine (30%).

FK506 and rapamycin: novel pharmacological probes of the immune response

The immune system is an intricate network of circuitry which is incompletely understood. Novel tools are needed to unravel the relevance of even the smallest components of this network. While the clinical potential of FK506 and rapamycin as selective immunosuppressants is the major reason for their current importance, preclinical studies described here by Joseph Chang and colleagues have already suggested several provocative ideas which may revise our biochemical concepts of T-cell activation. With the combination of molecular and cellular studies, the insights gained with FK506/rapamycin may lead to a better understanding of the biochemical circuits that are involved in the immune response. Ultimately, studies may lead to the identification of an endogenous immunosuppressive ligand that mimics FK506 or rapamycin.

Structural and functional conservation of histidinol dehydrogenase between plants and microbes

The partial amino acid sequence of histidinol dehydrogenase (L-histidinol:NAD+ oxidoreductase, EC 1.1.1.23) from cabbage was determined from peptide fragments of the purified protein. The relative positions of these peptides were deduced by aligning their sequences with the sequence of the HIS4C gene product of Saccharomyces cerevisiae. cDNA encoding histidinol dehydrogenase was then amplified from a library using a polymerase chain reaction primed with degenerate oligonucleotide pools of known position and orientation. By using this amplified fragment as a probe, an apparently full-length cDNA clone was isolated that is predicted to encode a proenzyme having a putative 31-amino acid chloroplast transit peptide and a mature molecular mass of 47.5 kDa. The predicted protein sequence was 51% identical to the yeast enzyme and 49% identical to the Escherichia coli enzyme. Expression of the cDNA clone in an E. coli his operon deletion strain rendered the mutant able to grow in the presence of histidinol.

Effect of 4 beta-arylamino derivatives of 4'-O-demethylepipodophyllotoxin on human DNA topoisomerase II, tubulin polymerization, KB cells, and their resistant variants

Six 4 beta-arylamino derivatives of 4'-O-demethylepipodophyllotoxin were examined for inhibitory activity against human DNA topoisomerase II and tubulin polymerization, their ability to generate protein-linked DNA breaks in cells, and their cytotoxicity toward the KB cell line and its VP-16- and vincristine-resistant variants. Five of these derivatives were 5- to 10-fold more potent than VP-16 as inhibitors of DNA topoisomerase II in vitro, and all of these derivatives could generate the same amount of or more protein-linked DNA breaks in cells than VP-16 at 1-20 microMs. Tubulin polymerization was inhibited by these compounds to different degrees in the order: podophyllotoxin greater than W73 greater than W87 greater than NPF greater than NPC greater than W68 greater than W38 greater than VP-16. These analogues were cytotoxic not only to KB cells but also to their VP-16-resistant and vincristine-resistant variants which showed decreased cellular uptake of VP-16 and a decrease in DNA topoisomerase II content or overexpression of MDR1 phenotype. These characteristics may cause these derivatives to have different spectrums of antitumor activity.

Evaluation of antirheumatic drugs for their effect in vitro on purified human synovial fluid phospholipase A2

Agents used to treat rheumatoid arthritis were examined for their ability to modify synovial fluid phospholipase A2 (SF-PLA2) activity. Nonsteroidal or steroidal antiinflammatory drugs and disease modifying agents exhibited little or no PLA2 modulatory activity. The exceptions include weak inhibition displayed by the cyclooxygenase inhibitors, indomethacin (IC50 = 144.8 microM) and sulindac sulfide (30.2 microM) and a 5-lipoxygenase translocation inhibitor, MK-886 (IC50 = 50 microM). Cyclosporine potentiated acylhydrolysis (EC50 = 1.5 microM) whereas the other immunomodulators examined demonstrated no significant effect on SF-PLA2 activity. Our data show that there are no selective PLA2 inhibitors currently used in the treatment of human arthritic disease and the viability of this novel approach remains to be tested.

Autoregulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury

Two groups of patients who developed orthostatic hypotension (OH) after spinal cord injury (SCI) were studied. In the first group all patients (4 females and 6 males) were asymptomatic, whereas in the second group (1 female and 9 males) all had clinical manifestations of hypotension. All but 3 patients were tetraplegic, and these patients were paraplegic above the T6 level. For this study blood pressure (BP), heart rate and cerebral blood flow (CBF) velocity were measured simultaneously on a tilt table at 0, 30, 60, and 80 degrees. Cerebral blood flow in the middle cerebral artery was measured bilaterally utilising the transcranial Doppler technique. In asymptomatic patients the mean baseline (0 degrees) BP (110 +/- 16/70 +/- 77 mm Hg systolic/diastolic) was not significantly different from the BP (106 +/- 16/68 +/- 11 mm Hg) of symptomatic patients. The mean maximal change in BP during tilting in the asymptomatic group (-23 +/- 10/10 +/- 7 mm Hg) was also not significantly different when compared to the symptomatic group (-29 +/- 13/11 +/- 6 mm Hg). CBF in the symptomatic group during the hypotensive reaction at 80 degrees was 32.5 +/- 5 cm/sec, while at the same body position in the asymptomatic group it was 40.9 +/- 8 cm/sec (significant at the p less than 0.02). In addition, CBF decreased in the symptomatic group at 80 degrees to 55.5 +/- 9.6% of baseline, while in the asymptomatic group the fall was 69.3 +/- 7.2% (p less than 0.001). Our data suggest that autoregulation of CBF rather than systemic BP plays a dominant role in the adaptation to OH in patients with SCI.

Production, properties, and thrombin inhibitory mechanism of hirudin amino-terminal core fragments

Hirudin, a thrombin-specific inhibitor, comprises a compact amino-terminal core domain (residues 1-52) and a disordered acidic carboxyl-terminal tail (residues 53-65). An array of core fragments were prepared from intact recombinant hirudin by deletion of various lengths of its carboxyl-terminal tail on selective enzymatic cleavage. Hir1-56 and Hir1-53 were produced by pepsin digestion at Phe56-Glu57 and Asp53-Gly54. Hir1-52 was generated by Asp-N cleavage at Asn52-Asp53. Hir1-49 was prepared by cleavage of Gln49-Ser50 by chymotrypsin, elastase, and thermolysin. In addition, Hir1-62 (containing part of the carboxyl-terminal tail) was derived from Hir1-65 by selective removal of the three carboxyl-terminal amino acids using carboxypeptidase A. Hirudin amino-terminal core fragments were stable at extreme pH (1.47 and 12.6), high temperature (95 degrees C), and resistant to attack by various proteinases. For instance, following 24-h incubation with an equal weight of pepsin, the covalent structure of Hir1-52 remained intact and its anticoagulant activity unaffected. Unlike intact hirudin (Hir1-65) the inhibitory potency of which is a consequence of concerted binding of its amino-terminal and carboxyl-terminal domains to the active site and the fibrinogen recognition site of thrombin, the core fragments block only the active site of thrombin with binding constants of 19 nM (Hir1-56), 35 nM (Hir1-52), and 72 nM (Hir1-49). As an anticoagulant Hir1-56 is about 2-, 4-, and 30-fold more potent (on a molar basis) than Hir1-52, Hir1-49, and Hir1-43, respectively. Hir1-56 was also about 15-fold more effective than the most potent carboxyl-terminal fragment of hirudin, sulfated-Hir54-65, although they bind to independent sites on thrombin. The potential advantages of hirudin core fragments as antithrombotic agents are discussed in this report.

On the dermal absorption of cocaine

A 5-mg dose of cocaine free base applied to the volar forearm skin surface of a volunteer resulted in a maximal urinary benzoylecgonine concentration of 55 ng/mL at 48 h, using discrete urine specimens. A total of 58 micrograms of benzoylecgonine, representing 1.2% of the dose, was excreted in the 96-h urine. An identical trial using 5 mg of cocaine hydrochloride resulted in a maximal urinary benzoylecgonine concentration of 15 ng/mL at 24 h. We conclude that dermal absorption of cocaine represents a minor, but significant route of exposure to this drug that needs to be considered when interpreting low-level urine drug testing results.

Evidence that arginine-129 and arginine-145 are located within the heparin binding site of human antithrombin III

Arginyl residues of human antithrombin III have been implicated to involve in the heparin binding site [Jorgensen, A. M., Borders, C. L., & Fish, W. W. (1985) Biochem, J. 231, 59-63]. We have performed chemical modification of antithrombin with (p-hydroxyphenyl)glyoxal (HPG) in order to determine the locations of these arginine residues. Antithrombin was modified with 12 mM HPG in the absence and presence of heparin (2-fold by weight to antithrombin). In the absence of heparin, about 3-4 mol of arginines/mol of antithrombin were modified within 60 min, and the modification led to the loss of 95% of the inhibitor's heparin cofactor activity as well as heparin-induced fluorescence enhancement and 50% of its progressive inhibitory activity. In the presence of heparin, the extent of modification was diminished by 30% and modified antithrombin retained approximately 70% of its heparin cofactor activity. Peptide mapping and subsequent sequence analysis revealed that selective HPG modification occurred at Arg129 and Arg145 and that their modifications were protected upon binding of heparin to antithrombin. We conclude that Arg129 and Arg145 are situated within the heparin binding site of human antithrombin III.

Transcranial Doppler ultrasonography of the middle cerebral artery in the hemodynamic assessment of internal carotid artery stenosis

We performed transcranial Doppler ultrasonography of the middle cerebral arteries in 43 patients who underwent cerebral angiography. Twelve patients had normal arteriograms, 18 had internal carotid artery stenosis, and 13 had complete occlusion. Parameters measured included: flow velocity (mean, maximum, and peak systolic), flow acceleration, systolic-to-diastolic ratio, and pulsatility index. Patients with 75% to 100% stenosis had lower average ipsilateral flow acceleration and mean velocity than did normal subjects. Correlation analysis revealed an inverse relationship between degree of stenosis and ipsilateral flow acceleration, as well as ipsilateral mean velocity. These correlations were no longer significant when we excluded normals, however. There was a linear relationship between right and left velocity values for both normal subjects and patients with occlusion but not for patients with stenosis. This technique has potential for the reliable assessment of the hemodynamic effect of carotid stenosis on intracranial circulation.