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Hempel P, Klein V, Michely A, Böll S, Rieg AD, Spillner J, Braunschweig T, von Stillfried S, Wagner N, Martin C, Tenbrock K, Verjans E. Amitriptyline inhibits bronchoconstriction and directly promotes dilatation of the airways. Respir Res 2023; 24:262. [PMID: 37907918 PMCID: PMC10617234 DOI: 10.1186/s12931-023-02580-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023] Open
Abstract
INTRODUCTION The standard therapy for bronchial asthma consists of combinations of acute (short-acting ß2-sympathomimetics) and, depending on the severity of disease, additional long-term treatment (including inhaled glucocorticoids, long-acting ß2-sympathomimetics, anticholinergics, anti-IL-4R antibodies). The antidepressant amitriptyline has been identified as a relevant down-regulator of immunological TH2-phenotype in asthma, acting-at least partially-through inhibition of acid sphingomyelinase (ASM), an enzyme involved in sphingolipid metabolism. Here, we investigated the non-immunological role of amitriptyline on acute bronchoconstriction, a main feature of airway hyperresponsiveness in asthmatic disease. METHODS After stimulation of precision cut lung slices (PCLS) from mice (wildtype and ASM-knockout), rats, guinea pigs and human lungs with mediators of bronchoconstriction (endogenous and exogenous acetylcholine, methacholine, serotonin, endothelin, histamine, thromboxane-receptor agonist U46619 and leukotriene LTD4, airway area was monitored in the absence of or with rising concentrations of amitriptyline. Airway dilatation was also investigated in rat PCLS by prior contraction induced by methacholine. As bronchodilators for maximal relaxation, we used IBMX (PDE inhibitor) and salbutamol (ß2-adrenergic agonist) and compared these effects with the impact of amitriptyline treatment. Isolated perfused lungs (IPL) of wildtype mice were treated with amitriptyline, administered via the vascular system (perfusate) or intratracheally as an inhalation. To this end, amitriptyline was nebulized via pariboy in-vivo and mice were ventilated with the flexiVent setup immediately after inhalation of amitriptyline with monitoring of lung function. RESULTS Our results show amitriptyline to be a potential inhibitor of bronchoconstriction, induced by exogenous or endogenous (EFS) acetylcholine, serotonin and histamine, in PCLS from various species. The effects of endothelin, thromboxane and leukotrienes could not be blocked. In acute bronchoconstriction, amitriptyline seems to act ASM-independent, because ASM-deficiency (Smdp1-/-) did not change the effect of acetylcholine on airway contraction. Systemic as well as inhaled amitriptyline ameliorated the resistance of IPL after acetylcholine provocation. With the flexiVent setup, we demonstrated that the acetylcholine-induced rise in central and tissue resistance was much more marked in untreated animals than in amitriptyline-treated ones. Additionally, we provide clear evidence that amitriptyline dilatates pre-contracted airways as effectively as a combination of typical bronchodilators such as IBMX and salbutamol. CONCLUSION Amitriptyline is a drug of high potential, which inhibits acute bronchoconstriction and induces bronchodilatation in pre-contracted airways. It could be one of the first therapeutic agents in asthmatic disease to have powerful effects on the TH2-allergic phenotype and on acute airway hyperresponsiveness with bronchoconstriction, especially when inhaled.
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Affiliation(s)
- Paulina Hempel
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Virag Klein
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Anna Michely
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Svenja Böll
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Annette D Rieg
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
- Department of Anaesthesiology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Jan Spillner
- Department of Thoracic and Cardiovascular Surgery, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Till Braunschweig
- Institute of Pathology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Saskia von Stillfried
- Institute of Pathology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Norbert Wagner
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Christian Martin
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany
| | - Klaus Tenbrock
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Eva Verjans
- Department of Pediatrics, Medical Faculty, RWTH Aachen, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
- Institute of Pharmacology and Toxicology, Medical Faculty, RWTH Aachen, University Hospital Aachen, Aachen, Germany.
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Mazereeuw G, Herrmann N, Bennett SAL, Swardfager W, Xu H, Valenzuela N, Fai S, Lanctôt KL. Platelet activating factors in depression and coronary artery disease: a potential biomarker related to inflammatory mechanisms and neurodegeneration. Neurosci Biobehav Rev 2013; 37:1611-21. [PMID: 23800745 DOI: 10.1016/j.neubiorev.2013.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/07/2013] [Accepted: 06/13/2013] [Indexed: 02/02/2023]
Abstract
The persistence of a depressive episode in coronary artery disease (CAD) patients not only heightens the risk of acute ischemic events, but it is also associated with accelerated cognitive decline. Antidepressant interventions for depression in CAD have only modest effects and novel approaches are limited by a poor understanding of etiological mechanisms. This review proposes that the platelet activating factor (PAF) family of lipids might be associated with the persistence of a depressive episode and related neurodegenerative pathology in CAD due to their association with leading etiological mechanisms for depression in CAD such as inflammation, oxidative and nitrosative stress, vascular endothelial dysfunction, and platelet reactivity. The evidence implicating PAFs in CAD, vascular pathology, and neurodegenerative processes is also presented. We also propose future directions for the investigation of PAFs as mediators of persistent depression. In summary, PAFs are implicated in leading mechanisms associated with depression in CAD. PAFs may therefore be associated with the persistence of depression in CAD and related to neurodegenerative and cognitive sequelae.
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Affiliation(s)
- Graham Mazereeuw
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Neural Regeneration Laboratory, Ottawa Institute of Systems Biology, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada; CIHR Training Program in Neurodegenerative Lipidomics, Canada
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Santos Martínez Martínez M, Colino Gandarillas CI, Lanao JM, Sánchez Navarro A. Influence of flow rate on the disposition of levofloxacin and netilmicin in the isolated rat lung. Eur J Pharm Sci 2005; 24:325-32. [PMID: 15734299 DOI: 10.1016/j.ejps.2004.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2004] [Revised: 11/01/2004] [Accepted: 11/22/2004] [Indexed: 10/25/2022]
Abstract
The objective of this study was to examine the influence of the rate at which the tissue is perfused on the disposition of levofloxacin and netilmicin in the pulmonary tissue, using an experimental model of the isolated rat lung. Analysis of the results was performed using two pharmacokinetic approaches. By stochastic analysis of outflow curves the corresponding statistical moments and derived distribution coefficient were calculated. Model-dependent analysis based on a three-compartment dispersion model was also applied to the outflow concentration data. A statistically significant decrease in the distribution coefficient was observed for both antibiotics when the flow rate was decreased. For levofloxacin this parameter takes values of 2.14 and 1.25 mL/g for 10 and 5 mL/min flow rates, respectively. In the case of netilmicin these values were 0.81 and 0.39 mL/g for the higher and lower flow rates, respectively. Model parameters related to the distribution process were also modified as a consequence of the flow rate decrease. Tissue flow rate seems to be a determinant factor on the distribution of levofloxacin and netilmicin in the isolated rat lung.
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Affiliation(s)
- María Santos Martínez Martínez
- Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Salamanca, Avda. Campo Charro s/n, 37007 Salamanca, Spain
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