3501
|
Vidal A, Sun Y, Bhattacharya SK, Ahokas RA, Gerling IC, Weber KT. Calcium paradox of aldosteronism and the role of the parathyroid glands. Am J Physiol Heart Circ Physiol 2006; 290:H286-94. [PMID: 16373592 DOI: 10.1152/ajpheart.00535.2005] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The hypercalciuria and hypermagnesuria that accompany aldosteronism contribute to a fall in plasma ionized extracellular Ca2+ and Mg2+ concentrations ([Ca2+]o and [Mg2+]o). Despite these losses and the decline in extracellular levels of these cations, total intracellular and cytosolic free Ca2+ concentration ([Ca2+]i) is increased and oxidative stress is induced. This involves diverse tissues, including peripheral blood mononuclear cells (PBMC) and plasma. The accompanying elevation in plasma parathyroid hormone (PTH) and reduction in bone mineral density caused by aldosterone (Aldo)-1% NaCl treatment (AldoST) led us to hypothesize that Ca2+ loading and altered redox state are due to secondary hyperparathyroidism (SHPT). Therefore, we studied the effects of total parathyroidectomy (PTx). In rats receiving AldoST, without or with a Ca2+-supplemented diet and/or PTx, we monitored urinary Ca2+ and Mg2+ excretion; plasma [Ca2+]o, [Mg2+]o, and PTH; PBMC [Ca2+]i and H2O2 production; plasma α1-antiproteinase activity; total Ca2+ and Mg2+ in bone, myocardium, and rectus femoris; and gp91phox labeling in the heart. We found that 1) the hypercalciuria and hypermagnesuria and decline ( P < 0.05) in plasma [Ca2+]o and [Mg2+]o that occur with AldoST were not altered by the Ca2+-supplemented diet alone or with PTx; 2) the rise ( P < 0.05) in plasma PTH with AldoST, with or without the Ca2+-supplemented diet, was prevented by PTx; 3) increased ( P < 0.05) PBMC [Ca2+]i and H2O2 production, increased total Ca2+ in heart and skeletal muscle, and fall in bone Ca2+ and Mg2+ and plasma α1-antiproteinase activity with AldoST were abrogated ( P < 0.05) by PTx; and 4) gp91phox activation in right and left ventricles at 4 wk of AldoST was attenuated by PTx. AldoST is accompanied by SHPT, with parathyroid gland-derived calcitropic hormones being responsible for Ca2+ overload in diverse tissues and induction of oxidative stress. SHPT plays a permissive role in the proinflammatory vascular phenotype.
Collapse
Affiliation(s)
- Alex Vidal
- Division of Cardiovascular Diseases, Univ. of Tennessee Health Science Center, 920 Madison Ave., Memphis, TN 38163, USA
| | | | | | | | | | | |
Collapse
|
3502
|
Kashyap MK, Saxena SV, Khullar M, Sawhney H, Vasishta K. Role of anion gap and different electrolytes in hypertension during pregnancy (preeclampsia). Mol Cell Biochem 2006; 282:157-67. [PMID: 16317523 DOI: 10.1007/s11010-006-1739-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2005] [Accepted: 08/05/2005] [Indexed: 02/07/2023]
Abstract
The present study was designed to determine the changes in serum sodium, anion gap, different antioxidants and free radicals in preeclamptic patients and control subjects. Serum sodium, chloride, bicarbonate, calcium, potassium and magnesium were estimated and anion gap was determined in 100 proteinuric hypertensive and 100 normotensive pregnant women. Mean serum sodium, chloride and bicarbonate level (133.26 +/- 13.1, 104.97 +/- 11.37, and 22.01 +/- 4.66 mEq/l, respectively) were significantly higher in proteinuric hypertensive women as compared to controls (125.85 +/- 10.4, 101.90 +/- 6.3, 19.34 +/- 3.21 mEq/l, respectively) whereas anion gap level (6.28 +/- 16.147) was nonsignificantly higher in proteinuric hypertensive as compared to normotensive (4.61 +/- 11.84). Total serum sodium concentration increases in preeclamptic subjects, the exact distribution of serum sodium in various compartments of the body are not clear and correlation of serum sodium and anion gap with proteinuria is also not known. The levels of different antioxidants were decreased in preeclamptic patients as compared to the controls while the level of free radicals elevated in preeclamptic subjects as compared to controls. In our study, anion gap level was found to be rather non-significantly higher in proteinuric hypertensive women as compared to normotensive women.
Collapse
Affiliation(s)
- Manoj Kumar Kashyap
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, PGIMER, Chandigarh, India.
| | | | | | | | | |
Collapse
|
3503
|
Kashyap MK, Yadav V, Sherawat BS, Jain S, Kumari S, Khullar M, Sharma PC, Nath R. Different antioxidants status, total antioxidant power and free radicals in essential hypertension. Mol Cell Biochem 2005; 277:89-99. [PMID: 16132719 DOI: 10.1007/s11010-005-5424-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2005] [Accepted: 04/13/2005] [Indexed: 02/07/2023]
Abstract
Hypertension is a multi-factorial process, prevalent in developed as well as in developing countries. Different antioxidants and free radicals play an important role in cardiovascular system. In present study, total antioxidant power in terms of FRAP (ferric reducing activity of plasma), free radicals and different antioxidants have been studied in essential hypertensives (n = 50) and normal subjects (n = 50). Levels of total cholesterol, low-density lipids-cholesterol, malonialdehyde, very low-density lipids (VLDL), uric acid, plasma homocysteine and low-density lipids (LDL), were significantly higher in hypertensives as compared to normotensive. HDL-cholesterol, SOD, GPx, reduced glutahione, total glutathione, oxidized glutathione, total thiols, protein thiols, non protein thiols, RNI, total antioxidant power, vitamin A, ascorbic acid and glutahione-S-transferase (GST) were decreased significantly in normotensive. We observed significantly low nitric oxide levels in hypertensive patients. No correlation was observed between severity of disease and plasma nitric oxide levels. There was a significant decrease in plasma FRAP value in essential hypertensives as compared to normotensive controls, which showed a negative correlation with diastolic blood pressure. In conclusion, our study revealed that there was a consistent significant difference between essential hypertensives versus controls with respect to most of the parameters. These complex changes are consistent in the view that essential hypertension is associated with an abnormal level of antioxidant status compared to normal response to oxidative stress or both.
Collapse
Affiliation(s)
- Manoj K Kashyap
- Department of Experimental Medicine and Biotechnology, PGIMER, Chandigarh, India.
| | | | | | | | | | | | | | | |
Collapse
|
3504
|
Abstract
Background—
Chronic, inappropriate (relative to dietary Na
+
) elevations in circulating aldosterone, such as occur in congestive heart failure, are accompanied by a proinflammatory vascular phenotype involving the coronary and systemic vasculature. An immunostimulatory state with activated peripheral blood mononuclear cells (PBMCs) precedes this phenotype and is induced by a fall in cytosolic free [Mg
2+
]
i
and subsequent Ca
2+
loading of these cells and transduced by oxidative/nitrosative stress.
Methods and Results—
We sought to further validate this hypothesis in rats with aldosterone/1%NaCl treatment (ALDOST) by using several interventions as cotreatment: a Mg
2+
-supplemented diet; amlodipine, a CCB; and
N
-acetylcysteine, an antioxidant. Blood samples were obtained at weeks 1 to 4 of ALDOST to monitor [Mg
2+
]
i
, [Ca
2+
]
I
, and H
2
O
2
production in PBMCs. Coronal ventricular sections were examined for invading inflammatory cells and 3-nitrotyrosine labeling, a marker of oxidative/nitrosative stress. In response to ALDOST and compared with untreated controls, we found an early and persistent reduction in [Mg
2+
]
i
with a subsequent rise in [Ca
2+
]
i
and H
2
O
2
production, each of which was either attenuated or abrogated by the Mg
2+
-supplemented diet and by
N
-acetylcysteine, whereas amlodipine prevented Ca
2+
loading and an altered redox state. Cotreatment with these interventions either markedly attenuated or prevented the appearance of the proinflammatory coronary vascular phenotype and the presence of 3-nitrotyrosine in invading inflammatory cells.
Conclusions—
We suggest that the immunostimulatory state that appears during aldosteronism and leads to a proinflammatory coronary vascular phenotype is induced by a fall in [Mg
2+
]
i
with Ca
2+
loading of PBMCs and is transduced by H
2
O
2
production in these cells.
Collapse
Affiliation(s)
- Robert A Ahokas
- Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, Tenn 38163, USA
| | | | | | | | | |
Collapse
|
3505
|
Abstract
Pancreatic cancer remains a major unsolved health problem, with conventional cancer treatments having little impact on disease course. Almost all patients who have pancreatic cancer develop metastases and die. The main risk factors are smoking, age, and some genetic disorders, although the primary causes are poorly understood. Advances in molecular biology have, however, greatly improved understanding of the pathogenesis of pancreatic cancer. Many patients have mutations of the K-ras oncogene, and various tumour-suppressor genes are also inactivated. Growth factors also play an important part. However, disease prognosis is extremely poor. Around 15-20% of patients have resectable disease, but only around 20% of these survive to 5 years. For locally advanced, unresectable, and metastatic disease, treatment is palliative, although fluorouracil chemoradiation for locally advanced and gemcitabine chemotherapy for metastatic disease can provide palliative benefits. Despite pancreatic cancer's resistance to currently available treatments, new methods are being investigated. Preoperative chemoradiation is being advocated, with seemingly sound reasoning, and a wider role for gemcitabine is being explored. However, new therapeutic strategies based on the molecular biology of pancreatic cancer seem to hold the greatest promise.
Collapse
Affiliation(s)
- Donghui Li
- Department of Gastrointestinal Medical Oncology, University of Texas, M D Anderson Cancer Center, 1515 Holcombe Boulevard, Box 426, Houston, TX 77030, USA
| | | | | | | |
Collapse
|
3506
|
Northcott CA, Watts SW. Low [Mg
2+
]
e
Enhances Arterial Spontaneous Tone via Phosphatidylinositol 3-Kinase in DOCA-Salt Hypertension. Hypertension 2004; 43:125-9. [PMID: 14638620 DOI: 10.1161/01.hyp.0000103631.68328.03] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Phosphatidylinositol 3-kinase (PI3K) has been implicated in low extracellular Mg
2+
concentration ( [Mg
2+
]
e
)–induced aortic contraction, and Mg
2+
deficiency has been associated with hypertension. Moreover, arterial PI3K activity is increased in hypertensive deoxycorticosterone (DOCA)-salt rats. We hypothesized that low [Mg
2+
]
e
activates PI3K, eliciting enhanced vascular contraction, PI3K activity, and norepinephrine (NE)-induced contraction. Spontaneous tone was monitored in endothelium-denuded aortic strips from sham and DOCA-salt rats exposed to low Mg
2+
(0.15 mmol/L), high Mg
2+
(4.8 mmol/L), or normal (1.17 mmol/L) physiologic salt solution (PSS) in isolated tissue baths. LY294002 (20 μmol/L), a PI3K inhibitor, or vehicle was added (30 minutes), followed by NE (10
−9
to 3 x10
−-5
mol/L). Low [Mg
2+
]
e
significantly enhanced tone in aortas from DOCA-salt and sham rats compared with normal PSS (DOCA-salt low [Mg
2+
]
e
, +51.5 +7.0 vs DOCA-salt normal PSS, +7.1 +1.4 % of initial phenylephrine [PE] contraction). LY294002 and incubation with high Mg
2+
PSS decreased tone in aortas from DOCA-salt rats (low [Mg
2+
]
e
LY294002, −-87.5 +8.8; normal PSS LY294002, −81.7 +13.7; and high [Mg
2+
]
e
, −31.2 +10.8 % of initial PE contraction). Low [Mg
2+
]
e
leftward-shifted NE-induced aortic contractions in sham and thus matched the shift observed with DOCA (−log EC
50
mol/L: sham PSS, −7.7 +0.1; DOCA-salt PSS, −8.2 +0.1; sham low [Mg
2+
]
e
, −8.2 +0.1; and DOCA-salt low [Mg
2+
]
e
, −8.1 +0.1). Moreover, this shift was inhibited by LY294002. In conclusion, low [Mg
2+
]
e
might activate PI3K, leading to enhanced tone and agonist-induced contraction observed in aortas from DOCA-salt hypertensive rats.
Collapse
Affiliation(s)
- Carrie A Northcott
- Department of Pharmacology and To-icology, Michigan State University, B445 Life Science Bldg, East Lansing, MI 48823, USA. taetscar @msu.edu
| | | |
Collapse
|
3507
|
Ahokas RA, Warrington KJ, Gerling IC, Sun Y, Wodi LA, Herring PA, Lu L, Bhattacharya SK, Postlethwaite AE, Weber KT. Aldosteronism and peripheral blood mononuclear cell activation: a neuroendocrine-immune interface. Circ Res 2003; 93:e124-35. [PMID: 14576195 PMCID: PMC2896314 DOI: 10.1161/01.res.0000102404.81461.25] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Aldosteronism eventuates in a proinflammatory/fibrogenic vascular phenotype of the heart and systemic organs. It remains uncertain whether peripheral blood mononuclear cells (PBMCs) are activated before tissue invasion by monocytes/macrophages and lymphocytes, as is the case for responsible pathogenic mechanisms. Uninephrectomized rats treated for 4 weeks with dietary 1% NaCl and aldosterone (ALDOST, 0.75 microg/h) with or without spironolactone (Spi, 100 mg/kg per daily gavage) were compared with unoperated/untreated and uninephrectomized/salt-treated controls. Before intramural coronary vascular lesions appeared at week 4 of ALDOST, we found (1) a reduction of PBMC cytosolic free [Mg2+]i, together with intracellular Mg2+ and Ca2+ loading, whereas plasma and cardiac tissue Mg2+ were no different from controls; (2) increased H2O2 production by monocytes and lymphocytes together with upregulated PBMC gene expression of oxidative stress-inducible tyrosine phosphatase and Mn2+-superoxide dismutase and the presence of 3-nitrotyrosine in CD4+ and ED-1-positive inflammatory cells that had invaded intramural coronary arteries; (3) B-cell activation, including transcription of immunoglobulins, intracellular adhesion molecule-1, and CC and CXC chemokines and their receptors; (4) expansion of B lymphocyte subset and myosin heavy chain class II-expressing lymphocytes; and (5) autoreactivity with gene expression for antibodies to acetylcholine receptors and a downregulation of RT-6.2, which is in keeping with cell activation and associated with autoimmunity. Spi cotreatment attenuated the rise in intracellular Ca2+, the appearance of oxidative/nitrosative stress in PBMCs and invading inflammatory cells, and alterations in PBMC transcriptome. Thus, aldosteronism is associated with an activation of circulating immune cells induced by iterations in PBMC divalent cations and transduced by oxidative/nitrosative stress. ALDO receptor antagonism modulates this neuroendocrine-immune interface. The full text of this article is available online at http://www.circresaha.org.
Collapse
Affiliation(s)
- Robert A. Ahokas
- Department of Obstetrics & Gynecology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Kenneth J. Warrington
- Division of Connective Tissue Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Ivan C. Gerling
- Division of Endocrinology, Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Yao Sun
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Linus A. Wodi
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Paula A. Herring
- Division of Connective Tissue Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Li Lu
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Syamal K. Bhattacharya
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Arnold E. Postlethwaite
- Division of Connective Tissue Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Karl T. Weber
- Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee
| |
Collapse
|
3508
|
Touyz RM, Pu Q, He G, Chen X, Yao G, Neves MF, Viel E. Effects of low dietary magnesium intake on development of hypertension in stroke-prone spontaneously hypertensive rats: role of reactive oxygen species. J Hypertens 2002; 20:2221-32. [PMID: 12409961 DOI: 10.1097/00004872-200211000-00022] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To investigate whether low dietary Mg2+ intake influences the development of hypertension in stroke-prone spontaneously hypertensive rats (spSHRs) and whether these effects are associated with vascular functional and structural changes, and to assess the role of reactive oxygen species and the activation of vascular mitogen-activated protein (MAP) kinases in these processes. METHODS Six-week-old male spSHRs (n = 18) were divided into three groups: control (normal chow, 0.21% Mg2+ ), low Mg2+ group (Mg2+ -free diet), and high Mg2+ group (Mg2+ -rich diet, 0.75%). Systolic blood pressure (SBP) was assessed weekly for 16 weeks. In a second series of experiments, 6-week-old spSHRs (n = 18) were divided into three groups and studied weekly for 7 weeks: control group, low Mg2+ group, and low Mg2+ group receiving the superoxide dismutase mimetic, tempol (1 mmol/l). RESULTS The low Mg2+ diet caused an initial decrease in SBP followed, 5 weeks later, by an exacerbated development of hypertension. This was associated with a transient reduction in the plasma concentrations of substances associated with the thiobarbituric acid reaction (markers of oxidative stress), which increased rapidly 2 weeks later. In the low Mg2+ group, acetylcholine-induced vasodilatation was decreased compared with that in controls ( P<0.05). The media : lumen ratio was greater in rats receiving a low Mg2+ diet than in those fed a high Mg2+ diet ( P<0.05). Mg2+ depletion was associated with increased vascular superoxide anion compared with that in Mg2+ -supplemented rats (1.2 0.24 compared with 0.65 0.1 nmol/min per mg). Phosphorylation of MAP kinases was increased two- to threefold in Mg2+ -deficient rats. Tempol prevented the progression of hypertension and normalized the vascular changes in rats fed a low Mg2+ diet. CONCLUSIONS Chronic Mg2+ deficiency leads to development of severe hypertension, endothelial dysfunction and vascular remodelling. These processes are associated with oxidative stress and upregulation of redox-dependent MAP kinases. Tempol normalized vascular changes and attenuated the development of hypertension. Our findings suggest that reactive oxygen species play an important part in vascular processes that are associated with progression of hypertension in Mg2+ -deficient spSHRs.
Collapse
Affiliation(s)
- Rhian M Touyz
- Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montreal, University of Montreal, Canada.
| | | | | | | | | | | | | |
Collapse
|
3509
|
Chakraborti S, Chakraborti T, Mandal M, Mandal A, Das S, Ghosh S. Protective role of magnesium in cardiovascular diseases: a review. Mol Cell Biochem 2002; 238:163-79. [PMID: 12349904 DOI: 10.1023/a:1019998702946] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A considerable number of experimental, epidemiological and clinical studies are now available which point to an important role of Mg2+ in the etiology of cardiovascular pathology. In human subjects, hypomagnesemia is often associated with an imbalance of electrolytes such as Na+, K+ and Ca2+. Abnormal dietary deficiency of Mg2+ as well as abnormalities in Mg2+ metabolism play important roles in different types of heart diseases such as ischemic heart disease, congestive heart failure, sudden cardiac death, atheroscelerosis, a number of cardiac arrhythmias and ventricular complications in diabetes mellitus. Mg2+ deficiency results in progressive vasoconstriction of the coronary vessels leading to a marked reduction in oxygen and nutrient delivery to the cardiac myocytes. Numerous experimental and clinical data have suggested that Mg2+ deficiency can induce elevation of intracellular Ca2+ concentrations, formation of oxygen radicals, proinflammatory agents and growth factors and changes in membrane perrmeability and transport processes in cardiac cells. The opposing effects of Mg2+ and Ca2+ on myocardial contractility may be due to the competition between Mg2+ and Ca2+ for the same binding sites on key myocardial contractile proteins such as troponin C, myosin and actin. Stimulants, for example, catecholamines can evoke marked Mg2+ efflux which appears to be associated with a concomitant increase in the force of contraction of the heart. It has been suggested that Mg2+ efflux may be linked to the Ca2+ signalling pathway. Depletion of Mg2+ by alcohol in cardiac cells causes an increase in intracellular Ca2+, leading to coronary artery vasospasm, arrhythmias, ischemic damage and cardiac failure. Hypomagnesemia is commonly associated with hypokalemia and occurs in patients with hypertension or myocardial infarction as well as in chronic alcoholism. The inability of the senescent myocardium to respond to ischemic stress could be due to several reasons. Mg2+ supplemented K+ cardioplegia modulates Ca2+ accumulation and is directly involved in the mechanisms leading to enhanced post ischemic functional recovery in the aged myocardium following ischemia. While many of these mechanisms remain controversial and in some cases speculative, the beneficial effects related to consequences of Mg2+ supplementation are apparent. Further research are needed for the incorporation of these findings toward the development of novel myocardial protective role of Mg2+ to reduce morbidity and mortality of patients suffering from a variety of cardiac diseases.
Collapse
Affiliation(s)
- Sajal Chakraborti
- Department of Biochemistry and Biophysics, University of Kalyani, Kalyani, West Bengal, India.
| | | | | | | | | | | |
Collapse
|
3510
|
Kisters K, Hausberg M, Kosch M. Effect of oral magnesium supplementation on blood pressure, platelet aggregation and calcium handling in deoxycorticosterone acetate-induced hypertension in rats. J Hypertens 2001; 19:161-2. [PMID: 11204298 DOI: 10.1097/00004872-200101000-00023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
3511
|
Whitworth JA. Effect of oral magnesium supplementation on blood pressure in deoxycorticosterone acetate-induced hypertension in rats. J Hypertens 2000; 18:1877. [PMID: 11132614 DOI: 10.1097/00004872-200018120-00024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
3512
|
Venook AP, Stagg RJ, Lewis BJ. Regional chemotherapy for colorectal cancer metastatic to the liver. Clin Cancer Res 1990; 17:635-7. [PMID: 3079322 DOI: 10.1158/1078-0432.ccr-10-3074] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Regionally directed therapies, especially hepatic intra-arterial chemotherapy, have produced encouraging results against liver metastases from colorectal cancer. An implanted system allows treatment to be administered in the outpatient setting. Intra-arterial floxuridine has been shown to produce an increased response rate and prolonged time to progression of intrahepatic tumor compared to conventional treatment, but whether or not survival is prolonged has not yet been determined. Hepatobiliary toxicity from floxuridine limits the duration of therapy. Other experimental methods of regional therapy include chemoembolization, chemofiltration and mechanical alterations in hepatic arterial flow rate.
Collapse
Affiliation(s)
- A P Venook
- Cancer Research Institute, University of California, San Francisco 94143
| | | | | |
Collapse
|