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Chikezie PC, Ekechukwu CU. Acute patho-toxicological indicators of methaemoglobinemia. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Schalcher TR, Borges RS, Coleman MD, Batista Júnior J, Salgado CG, Vieira JLF, Romão PRT, Oliveira FR, Monteiro MC. Clinical oxidative stress during leprosy multidrug therapy: impact of dapsone oxidation. PLoS One 2014; 9:e85712. [PMID: 24465659 PMCID: PMC3899049 DOI: 10.1371/journal.pone.0085712] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 11/29/2013] [Indexed: 12/17/2022] Open
Abstract
This study aims to assess the oxidative stress in leprosy patients under multidrug therapy (MDT; dapsone, clofazimine and rifampicin), evaluating the nitric oxide (NO) concentration, catalase (CAT) and superoxide dismutase (SOD) activities, glutathione (GSH) levels, total antioxidant capacity, lipid peroxidation, and methemoglobin formation. For this, we analyzed 23 leprosy patients and 20 healthy individuals from the Amazon region, Brazil, aged between 20 and 45 years. Blood sampling enabled the evaluation of leprosy patients prior to starting multidrug therapy (called MDT 0) and until the third month of multidrug therapy (MDT 3). With regard to dapsone (DDS) plasma levels, we showed that there was no statistical difference in drug plasma levels between multibacillary (0.518±0.029 µg/mL) and paucibacillary (0.662±0.123 µg/mL) patients. The methemoglobin levels and numbers of Heinz bodies were significantly enhanced after the third MDT-supervised dose, but this treatment did not significantly change the lipid peroxidation and NO levels in these leprosy patients. In addition, CAT activity was significantly reduced in MDT-treated leprosy patients, while GSH content was increased in these patients. However, SOD and Trolox equivalent antioxidant capacity levels were similar in patients with and without treatment. These data suggest that MDT can reduce the activity of some antioxidant enzyme and influence ROS accumulation, which may induce hematological changes, such as methemoglobinemia in patients with leprosy. We also explored some redox mechanisms associated with DDS and its main oxidative metabolite DDS-NHOH and we explored the possible binding of DDS to the active site of CYP2C19 with the aid of molecular modeling software.
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Affiliation(s)
- Taysa Ribeiro Schalcher
- Laboratório de Microbiologia e Imunologia Clínica/UFPA and Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Pará/UFPA, Rua Augusto Corrêa, Belém, Brasil
| | - Rosivaldo S. Borges
- Laboratório de Microbiologia e Imunologia Clínica/UFPA and Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Pará/UFPA, Rua Augusto Corrêa, Belém, Brasil
| | - Michael D. Coleman
- Mechanisms of Drug Toxicity Group, Department of Pharmaceutical Sciences, Aston University, Aston Triangle, Birmingham, United Kingdom
| | - João Batista Júnior
- Centro Universitário do Distrito Federal - UDF, SEP/SUL EQ 704/904 - CONJ A, Brasília/DF, Brasil
| | - Claudio G. Salgado
- Laboratório de Dermato-Imunologia UFPA/MC, Marituba, Pará, and Programa de Pós-graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará/UFPA, Bairro Guamá, Belém, Brasil
| | - Jose Luiz F. Vieira
- Laboratório de Microbiologia e Imunologia Clínica/UFPA and Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Pará/UFPA, Rua Augusto Corrêa, Belém, Brasil
| | - Pedro R. T. Romão
- Programa de Pós-graduação em Ciências da Saúde. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil
| | - Fabio R. Oliveira
- Laboratório de Microbiologia e Imunologia Clínica/UFPA and Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Pará/UFPA, Rua Augusto Corrêa, Belém, Brasil
| | - Marta Chagas Monteiro
- Laboratório de Microbiologia e Imunologia Clínica/UFPA and Programa de Pós-graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Pará/UFPA, Rua Augusto Corrêa, Belém, Brasil
- * E-mail:
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Moraes NVD, Bergamaschi MM, Bianchi MDLP, Bragheto JB, Malfará WR, Queiroz RHC. L-arginine, a nitric oxide precursor, reduces dapsone-induced methemoglobinemia in rats. BRAZ J PHARM SCI 2012. [DOI: 10.1590/s1984-82502012000100010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Dapsone use is frequently associated to hematological side effects such as methemoglobinemia and hemolytic anemia, which are related to N-hydroxylation mediated by the P450 enzyme system. The aim of the present study was to evaluate the influence of L-arginine supplementation, a precursor for the synthesis of nitric oxide, as single or multiple dose regimens on dapsone-induced methemoglobinemia. Male Wistar rats were treated with L-arginine at 5, 15, 30, 60 and 180 mg/kg doses (p.o., gavage) in single or multiple dose regimens 2 hours prior to dapsone administration (40 mg/kg, i.p.). The effect of the nitric oxide synthase inhibitor L-NAME was investigated by treatment with multiple doses of 30 mg/kg (p.o., gavage) 2 hours before dapsone administration. Blood samples were collected 2 hours after dapsone administration. Erythrocytic methemoglobin levels were assayed by spectrophotometry. The results showed that multiple dose supplementations with 5 and 15 mg/kg L-arginine reduced dapsone-induced methemoglobin levels. This effect is mediated by nitric oxide formation, since the reduction in methemoglobin levels by L-arginine is blocked by simultaneous administration with L-NAME, a nitric oxide synthase inhibitor.
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