A comparison between haemodynamic effects of vasopressin analogues

The effect of fat emulsion on hemodynamics following treatment with propranolol and clonidine in anesthetized rats

OBJECTIVES

There is evidence indicating that intravenous fatty emulsion (IFE) is beneficial in restoring circulatory function in certain types of drug overdose. The authors investigated the hemodynamic effects of IFE compared to epinephrine in rats treated with propranolol and clonidine.

METHODS

Anesthetized male Sprague-Dawley rats were instrumented for measurement of hemodynamics. Rats were randomly assigned to one of six groups (n = 6-8), and each received a clonidine infusion (150 μg/kg) or an equivalent volume of normal saline (0.9% NaCl) over 1 hour. Each rat then received normal saline (1.0 mL/kg) or propranolol (15 to 20 mg/kg). Thereafter, each rat received a dose of IFE (20% solution; 1.0 mL/kg) or epinephrine (2.0 μg/kg) or an equivalent volume of normal saline (1.0 mL/kg).

RESULTS

Propranolol alone or with clonidine significantly (p < 0.05) reduced a number of hemodynamic parameters (mean arterial pressure, 37% to 70%; heart rate, 30% to 51%; cardiac contractility [dP/dtmax], 50% to 67%; and abdominal aortic blood flow, 50% to 83%), while increasing PR intervals (65% to 85%) and QTc intervals (26% to 64%). Saline and epinephrine treatment after propranolol and clonidine combined resulted in no survivors in saline and two out of six in epinephrine group. IFE resulted in significant survival (seven out of eight) for 30 minutes in rats treated with propranolol alone, and propranolol combined with clonidine (seven out of eight).

CONCLUSIONS

These data demonstrate that IFE is effective for resuscitating rats overdosed on propranolol combined with clonidine. The effect of IFF is unlikely due to a direct positive inotropic or chronotropic action on the myocardium. IFE is also more effective than epinephrine treatment in this paradigm.

Alteration in hemodynamic effects of interleukin 2 after treatment with indomethacin in anesthetized rats

The cardiovascular effects of interleukin 2 (IL2), were investigated in animals pretreated with indomethacin. Bolus intravenous administration of IL2 alone caused a significant reduction in cardiac output over time. Pretreatment with indomethacin significantly accentuated the reduction in cardiac output produced by IL2. The administration of IL2 or indomethacin alone or combined had no significant effects on dP/dt, heart rate or plasma troponin levels. As well, administration of either compound alone or combined had limited effects on mean circulatory filling pressure and arterial blood pressure. Injection of IL2 alone significantly increased resistance to venous return and arterial resistance at 3h post injections. Pretreatment with indomethacin caused IL2 to produce a significantly greater increase in arterial resistance and resistance to venous return. Administration of IL2 and indomethacin combined also produced significant reduction in stroke volume than IL2 or indomethacin alone. The injection of IL2 or indomethacin alone or combined had no significant impact on blood volume. Acute administration of IL2 appears to have no negative inotropic or chronotropic effects and its impact in reducing cardiac output is the result of an increase in vascular resistance. It seems that activation of prostanoids, possibly prostacyclin, has an acute beneficial effect in attenuating the initial negative effects of IL2 on cardiac output.

Design and synthesis of potent, highly selective vasopressin hypotensive agonists

We report here the solid-phase synthesis and vasodepressor potencies of a new lead vasopressin (VP) hypotensive peptide [1(beta-mercapto-beta,beta-pentamethylenepropionic acid)-2-0-ethyl-D-tyrosine, 3-arginine, 4-valine, 7-lysine, 9-ethylenediamine] lysine vasopressin, d(CH(2))(5)[D-Tyr(Et)(2), Arg(3), Val(4), Lys(7), Eda(9)]LVP (C) and 21 analogues of C with single modifications at positions 9 (1-13), 6 (14), 2 (16-20) and combined modifications at positions 6 and 10 (15) and 2 and 10 (21). Peptides 1-13 have the following replacements for the Eda residue at position 9 in C: (1) Gly-NH(2); (2) Gly-NH-CH(3); (3) Ala-NH(2); (4) Ala-NH-CH(3), (5) Val-NH(2); (6) Cha-NH(2); (7) Thr-NH(2); (8) Phe-NH(2); (9) Tyr-NH(2); (10) Orn-NH(2); (11) Lys-NH(2); (12) D-Lys-NH(2); (13) Arg-NH(2). Peptide 14 has the Cys residue at position 6 replaced by Pen. Peptide 15 is the retro-Tyr(10) analogue of peptide 14. Peptides 16-20 have the D-Tyr(Et) residue at position 2 in C replaced by the following substituents: D-Trp (16); D-2-Nal (17); D-Tyr(Bu(t))(18); D-Tyr(Pr(n)) (19); D-Tyr(Pr(i)) (20). Peptide 21 is the retro-Tyr(10) analogue of peptide 20. C and peptides 1-21 were evaluated for agonistic and antagonistic activities in in vivo vasopressor (V(1a)-receptor), antidiuretic (V(2)-receptor), and in in vitro (no Mg(2+)) oxytocic (OT-receptor) assays in the rat, and, like the original hypotensive peptide, d(CH(2))(5)[D-Tyr(Et)(2), Arg(3), Val(4)]AVP (A) (Manning et al., J. Peptide Science 1999, 5:472-490), were found to exhibit no or negligible activities in these assays. Vasodepressor potencies were determined in anesthetized male rats with baseline mean arterial blood pressure (BP) maintained at 100-120 mmHg. The effective dose (ED), in microg/100 g i.v., the dose required to produce a vasodepressor response of 5 cm(2) area under the vasodepressor response curve (AUC) during the 5-min period following the injection of the test peptide, was determined. The EDs measure the vasodepressor potencies of the hypotensive peptides C and 1-21 relative to that of A (ED = 4.66 microg/100 g) and to each other. The following ED values in microg/100 g were obtained for C and for peptides 1-21; C 0.53; (1) 2.41; (2) 1.13; (3) 1.62; (4) 0.80; (5) 1.83; (6) 1.56; (7) 2.12, (8) 2.58; (9) 1.40; (10) 0.88; (11) 0.90; (12) 0.85; (13) 0.68; (14) 0.99; (15) 1.05; (16) 0.66; (17) 0.54; (18) 0.33; (19) 0.18; (20) 0.15; (21) 0.14. All of the hypotensive peptides reported here are more potent than A. Peptides 20 and 21 exhibit a striking 30-fold enhancement in vasodepressor potencies relative to A. With a vasodepressor ED = 0.14, peptide 21 is the most potent VP vasodepressor agonist reported to date. Because it contains a retro-Tyr(10) residue, it is a promising new radioiodinatable ligand for the putative VP vasodilating receptor. Some of these new hypotensive peptides may be of value as research tools for studies on the complex cardiovascular actions of VP and may lead to the development of a new class of antihypertensive agents.