Inhibitory effects of tryptophan pyrolysis products on human platelet aggregation through inhibition of prostaglandin endoperoxide synthetase

Comparative Effects of α-, β-, and γ-Carbolines on Platelet Aggregation and Lipid Membranes

Cigarette smoking and alcohol consumption possibly affect platelet functions. To verify the hypothesis that some α-, β-, and γ-carboline components in cigarette smoke and alcoholic beverages may change platelet aggregability, their effects on human platelets were determined by aggregometry together with investigating their membrane effects by turbidimetry. Carbolines inhibited platelet aggregation induced by five agents with the potency being 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole > 3-amino-1-methyl-5H-pyrido[4,3-b]indole > 1-methyl-9H-pyrido[3,4-b]indole. The most potent 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole showed 50% aggregation-inhibitory concentrations of 6–172 μM. Both γ-carbolines interacted with phosphatidylcholine membranes to lower the lipid phase transition temperature with the potency correlating to the antiplatelet activity, suggesting that the interaction with platelet membranes to increase their fluidity underlies antiplatelet effects. Given their possible concentration and accumulation in platelets, γ- and β-carbolines would provide cigarette smokers and alcohol drinkers with reduced platelet aggregability, and they may be responsible for the occurrence of hemorrhagic diseases associated with heavy smoking and alcoholics.

Uremic bleeding: pathogenesis and therapy

BACKGROUND

We reviewed current understanding of the pathophysiology of the uremic bleeding diathesis and discuss accepted therapeutic interventions that minimize the risk of bleeding in the uremic patient.

METHODS

Computerized literature searches and references from previous publications, including articles describing original research and reviews pertaining to the pathophysiology of and clinical approach to uremic bleeding.

RESULTS

The most common hemorrhagic manifestations in uremia are prolonged bleeding from puncture sites; nasal, gastrointestinal and genitourinary bleeding; and subdural hematomas. The most useful clinical laboratory test to assess both bleeding risk and response to therapy is bleeding time. It correlates better with clinical bleeding complications than indices of azotemia (eg, blood urea nitrogen [BUN], creatinine) or in vitro platelet aggregation tests. A low hematocrit is also correlated with increased bleeding risk. Anemia plays an important role in the bleeding diathesis of uremia and its correction with red cell transfusions or human recombinant erythropoietin is critical. Anticoagulation during hemodialysis may transiently exacerbate the bleeding diathesis. Hemodialysis and peritoneal dialysis improve the hemostatic defect and renal transplantation totally corrects it. Cryoprecipitate has been largely replaced by desmopressin acetate, which acts promptly (in less than 1 hour) but has a short duration of action (hours) and exhibits tachyphylaxis. Conjugated estrogens are slower in the onset of action (about 6 hours) but their effect lasts for about 2 weeks.

CONCLUSIONS

The pathophysiology of the bleeding diathesis of uremia is complex and incompletely understood but useful clinical tests and therapies have evolved empirically. Broadly available dialysis and the advent of erythropoietin are likely to reduce the magnitude of this problem.

Inhibitory effects of carcinogenic tryptophan pyrolysis products on phytohemagglutinin-induced blast transformation of human lymphocytes

In order to evaluate the effect of carcinogenic heterocyclic amines on the stimulus-reaction system of human cells, we examined the effect of 5 kinds of carcinogenic heterocyclic amines including 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 2-amino-6-methyldipyrido[1,2-a:3',2'-d]imidazole (Glu-P-1), 2-amino-dipyrido[1,2-a:3',2'-d]imidazole (Glu-P-2), 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole (Trp-P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2) on human lymphocyte (4 x 10(5) cells/ml) blast transformation induced by 0.125% phytohemagglutinin (PHA). Both Trp-P-1 and Trp-P-2 exhibited an inhibitory effect on the lymphocyte proliferation stimulated by PHA at the final concentration of 1.0-5.0 and 1.0-10 microM, respectively. The concentrations of Trp-P-1 and Trp-P-2 causing 50% inhibition were 3.1 and 5.1 microM, respectively. However, the other carcinogenic heterocyclic amines examined did not show any inhibitory effect on lymphocyte mitogenesis even at a final concentration of 10 microM. Viabilities of lymphocytes were more than 90% (n = 3 x 5) when 5 kinds of carcinogenic heterocyclic amines (0.1 ml) were respectively added at the final concentration of 10 microM to the lymphocyte culture medium (4 x 10(5) cells/0.9 ml).

Carcinogenic tryptophan pyrolysis products in human lens

Mutagenic and carcinogenic tryptophan pyrolysis products, 3-amino-1,4-dimethyl-5H-pyrido-[4,3-b]indole (Trp-P-1) and 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2), have been identified in human cataractous lenses, but not in young bovine lenses. The amounts of Trp-P-1 and Trp-P-2 in senile cataractous lenses were 156.34 +/- 35.63 fmol (mean +/- S.D., n = 10) and 128.27 +/- 40.45 fmol (n = 10), respectively, while those of Trp-P-1 and Trp-P-2 in diabetic cataractous lenses were 158.29 +/- 40.06 fmol (n = 10) and 150.34 +/- 23.77 fmol (n = 10), respectively. In both senile and diabetic cataractous lenses, the concentrations of Trp-P-1 and Trp-P-2 in the insoluble protein fraction (fmol mg-1 protein) were significantly higher than those in the water-soluble protein fraction. Moreover, proteinase-K treatment of lens protein before extraction with methylene chloride significantly increased the recoveries of Trp-P-1 and Trp-P-2. These results clearly indicate that carcinogenic tryptophan pyrolysis products, gamma-carboline derivatives, are present in human cataractous lenses and that these fluorescent carcinogens are significantly concentrated in the insoluble lens proteins.

Carcinogenic tryptophan pyrolysis products potent inhibitors of type A monoamine oxidase and the platelet response to 5-hydroxytryptamine

The effects of carcinogenic heterocyclic amines and beta-carbolines on 5-hydroxytryptamine-induced human platelet aggregation, on the uptake of 5-hydroxytryptamine by platelets, and on human monoamine oxidase activity were investigated. Of the dietary carcinogens and beta-carbolines studied, carcinogenic tryptophan pyrolysis products had greater pharmacological activities than other heterocyclic amines. The carcinogenic tryptophan pyrolysis products, 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole and 3-amino-1-methyl-5H-pyrido[4,3-b]indole, which have been identified in the dialysis fluid of uraemic patients, were the most potent inhibitors of the aggregation response to 5-hydroxytryptamine, with IC50 (the concentrations causing 50% inhibition) values of 10 mumol/l and 50 mumol/l, respectively. 3-Amino-1,4-dimethyl-5H-pyrido[4,3-b]indole and 3-amino-1-methyl-5H-pyrido[4,3-b]indole by themselves did not induce platelet aggregation, although these dietary carcinogens structurally resemble 5-hydroxytryptamine. Kinetic analyses showed that 3-amino-1,4-dimethyl-5H-pyrido[4,3-b]indole and 3-amino-1-methyl-5H-pyrido[4,3-b]indole were potent competitive inhibitors of 5-hydroxytryptamine uptake by platelets with Ki 18 mumol/l and 42 mumol/l, respectively. Furthermore, carcinogenic tryptophan pyrolysates as well as beta-carbolines were found to be competitive selective inhibitors of monoamine oxidase 'type A'.