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Elzagallaai AA, Rieder MJ. In vitro testing for diagnosis of idiosyncratic adverse drug reactions: Implications for pathophysiology. Br J Clin Pharmacol 2015; 80:889-900. [PMID: 25199801 DOI: 10.1111/bcp.12505] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/31/2014] [Indexed: 12/19/2022] Open
Abstract
Idiosyncratic drug reactions (IDRs) represent a major health problem, as they are unpredictable, often severe and can be life threatening. The low incidence of IDRs makes their detection during drug development stages very difficult causing many post-marketing drug withdrawals and black box warnings. The fact that IDRs are always not predictable based on the drug's known pharmacology and have no clear dose-effect relationship with the culprit drug renders diagnosis of IDRs very challenging, if not impossible, without the aid of a reliable diagnostic test. The drug provocation test (DPT) is considered the gold standard for diagnosis of IDRs but it is not always safe to perform on patients. In vitro tests have the advantage of bearing no potential harm to patients. However, available in vitro tests are not commonly used clinically because of lack of validation and their complex and expensive procedures. This review discusses the current role of in vitro diagnostic testing for diagnosis of IDRs and gives a brief account of their technical and mechanistic aspects. Advantages, disadvantages and major challenges that prevent these tests from becoming mainstream diagnostic tools are also discussed here.
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Affiliation(s)
- Abdelbaset A Elzagallaai
- Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Michael J Rieder
- Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,CIHR-GSK Chair in Pediatric Clinical Pharmacology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Umasuthan N, Whang I, Revathy KS, Oh MJ, Jung SJ, Choi CY, Lee JH, Noh JK, Lee J. A teleostean angiotensinogen from Oplegnathus fasciatus responses to immune and injury challenges. FISH & SHELLFISH IMMUNOLOGY 2012; 32:922-928. [PMID: 22300787 DOI: 10.1016/j.fsi.2012.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/14/2012] [Accepted: 01/14/2012] [Indexed: 05/31/2023]
Abstract
Angiotensinogen (AGT) is the precursor of the renin-angiotensin system and contributes to osmoregulation, acute-phase and immune responses. A full-length cDNA of the AGT (2004 bp with a 1389 bp coding region) was isolated from rock bream (Rb), Oplegnathus fasciatus. The encoded polypeptide of 463 amino acids had a predicted molecular mass of 51.6 kDa. RbAGT possessed a deduced signal peptide of 22 residues upstream of a putative angiotensin I sequence ((23)NRVYVHPFHL(32)). RbAGT possessed a specific domain profile and a signature motif which are characteristics of the serpin family. Sequence homology and phylogenetic analysis indicated that RbAGT was evolutionarily closest to AGT of Rhabdosargus sarba. The mRNA expression profile of RbAGT was determined by quantitative RT-PCR and it demonstrated a constitutive and tissue-specific expression with the highest transcript level in the liver. Significantly up-regulated RbAGT expression was elicited by systemic injection of a lipopolysaccharide, rock bream iridovirus (RBIV) and bacteria (Edwardsiella tarda and Streptococcus iniae), revealing its pathogen inducibility. RbAGT manifested a down-regulated response to systemic injury, contemporaneously with two other serpins, protease nexin-1 (PN-1), and heparin cofactor II (HCII). In addition, a synchronized expression pattern was elicited by RbAGT and RbTNF-α in response to injury, suggesting that TNF-α might be a potential modulator of AGT transcription.
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Affiliation(s)
- Navaneethaiyer Umasuthan
- Department of Marine Life Sciences, School of Marine Biomedical Sciences, Jeju National University, Ara-Dong, Jeju Special Self-Governing Province, Republic of Korea
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Guo F, Chen XL, Wang F, Liang X, Sun YX, Wang YJ. Role of Angiotensin II Type 1 Receptor in Angiotensin II-Induced Cytokine Production in Macrophages. J Interferon Cytokine Res 2011; 31:351-61. [PMID: 21235392 DOI: 10.1089/jir.2010.0073] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Feng Guo
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xu-Lin Chen
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Fei Wang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Xun Liang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Ye-Xiang Sun
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
| | - Yong-Jie Wang
- Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, P.R. China
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Halici Z, Bilen H, Albayrak F, Uyanik A, Cetinkaya R, Suleyman H, Keles ON, Unal B. Does telmisartan prevent hepatic fibrosis in rats with alloxan-induced diabetes? Eur J Pharmacol 2009; 614:146-52. [DOI: 10.1016/j.ejphar.2009.04.042] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2008] [Revised: 04/15/2009] [Accepted: 04/20/2009] [Indexed: 12/28/2022]
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Palladino MA, Powell JD, Korah N, Hermo L. Expression and Localization of Hypoxia-Inducible Factor-1 Subunits in the Adult Rat Epididymis1. Biol Reprod 2004; 70:1121-30. [PMID: 14668208 DOI: 10.1095/biolreprod.103.023085] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The epididymal epithelium contributes to formation of a luminal fluid that is essential for the protection of spermatozoa from a variety of insults including changes in oxygen tension. A key regulator of the response to oxygen debt in many cells is hypoxia-inducible factor-1 (HIF-1). A transcription factor composed of alpha and beta subunits, HIF-1 activates genes that mediate oxygen homeostasis and cell survival pathways or trigger cell death responses. Previously we have shown that HIF-1alpha mRNA is expressed in the adult rat epididymis. Goals of this study were to determine whether HIF-1alpha protein is activated by ischemia in the rat epididymis, to determine whether epididymal HIF-1alpha mRNA expression is androgen dependent, and to identify epididymal cell types expressing HIF-1alpha and beta. Immunoblot analysis revealed that HIF-1alpha protein is primarily present in corpus and cauda of the normoxic epididymis and unaffected by ischemia, whereas HIF-1beta was detected equally in all regions and also unaffected by ischemia. HIF-1alpha mRNA expression in all regions was not affected by 15 days bilateral orchiectomy. Principal cells stained positive for HIF-1alpha by immunocytochemistry, with the epithelium of initial segment and caput epididymidis staining less intensely than corpus and cauda. HIF-1beta immunoreactivity was equally present in principal cells in all regions. Clear, narrow, and basal cells were unreactive for HIF-1alpha and beta. The presence of HIF-1 in normoxic epididymis and the regional distribution of HIF-1alpha suggests fundamental differences in how proximal and distal regions of the epididymis maintain oxygen homeostasis to protect the epithelium and spermatozoa from hypoxia.
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Affiliation(s)
- M A Palladino
- Department of Biology, Monmouth University, West Long Branch, New Jersey 07764, USA.
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Lam SY, Fung ML, Leung PS. Regulation of the angiotensin-converting enzyme activity by a time-course hypoxia in the carotid body. J Appl Physiol (1985) 2003; 96:809-13. [PMID: 14527966 DOI: 10.1152/japplphysiol.00684.2003] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chronic hypoxia activates a local angiotensin-generating system in the carotid body. Here, we test the hypothesis that the activity of the critical enzyme for this system, angiotensin-converting enzyme (ACE), in the carotid body is subject to regulation by a time-course hypoxia. Results from the carotid body assays showed that ACE activity was markedly increased under the hypoxic stress of 7-, 14-, 21-, and 28-day exposures. The changes in ACE activity of 7-day (15.00 vs. 30.95 x 10(-5) nmol.microg(-1).min(-1)), 14-day (8.73 vs. 30.25 x 10(-5) nmol.microg(-1).min(-1)), and 21-day (11.41 vs. 31.83 x 10(-5) nmol.microg(-1).min(-1)) hypoxia treatments were enhanced significantly. However, ACE activity in 28-day (13.18 vs. 24.53 x 10(-5) nmol.microg(-1).min(-1)) hypoxia treatment was observed to increase insignificantly when compared with results in the respective control groups. Captopril inhibited all rises in ACE activity in both the control and experimental groups. Results clearly indicate an activation of the enzymatic activity of ACE, the critical enzyme for determining the conversion of angiotensin I into the physiologically active angiotensin II, by chronic hypoxia in the carotid body. An increase in the ACE activity may increase the local production of angiotensin II in the carotid body and thus its agonist action at the AT1 receptor. This may be important in the modulation of cardiopulmonary adaptation in the hypoxic ventilatory response as well as for electrolyte and water homeostasis during chronic hypoxia.
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Affiliation(s)
- Siu Yin Lam
- Department of Physiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
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Leung PS, Chappell MC. A local pancreatic renin-angiotensin system: endocrine and exocrine roles. Int J Biochem Cell Biol 2003; 35:838-46. [PMID: 12676170 DOI: 10.1016/s1357-2725(02)00179-6] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The renin-angiotensin system (RAS) is classically characterized as a circulating hormonal system primarily through the production of the physiologically active product angiotensin II (Ang II) that plays a crucial role in the regulation of blood pressure, fluid and electrolyte homeostasis. In addition to this circulating RAS, numerous tissues and organs have been recently demonstrated to exhibit their own RAS products and activities. Such an intrinsic RAS can modulate the specific local functions of their respective tissues and organs, frequently in a paracrine and autocrine manner. Recent findings from our laboratories and others have made a significant contribution on the expression, localization, regulation, and potential role of a local RAS in the pancreas. Although, it is quite intriguing that components of the local pancreatic RAS are responsive to various physiological and pathophysiological conditions, the crucial role of this system in regulating the exocrine and endocrine functions and ultimately the clinical relevance to pancreatic disease is still largely equivocal. Of particular interest in this context are the actions of pancreatic RAS on the growth, anti-proliferation and free radical generation in the pancreas. The aims of the current article focus on the emerging data on the local pancreatic RAS; its involvement in exocrine acinar and endocrine islet aspects, and the clinical significance in the pancreas are particularly addressed. The target for the local pancreatic RAS may provide a new insight into future management of various clinical conditions including islet transplants, diabetes mellitus, pancreatic cancer, pancreatitis and cystic fibrosis.
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Affiliation(s)
- Po Sing Leung
- Department of Physiology, Faculty of Medicine, Chinese University of Hong Kong, Shatin, N. T., Hong Kong, PR China.
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Abstract
Evidence exists for the presence of a functional angiotensin system in the carotid body, which can modulate the excitability of the carotid body chemoreceptors. In the present study, the effect of chronic hypoxia on the expression and localization of the angiotensinogen (AGT) and angiotensin-converting enzyme (ACE), the two critical components of an intrinsic angiotensin-generating system in the rat carotid body, are investigated by in situ hybridization histochemistry, semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) and Western blot analysis. In situ hybridization showed that the messenger RNA (mRNA) expression of AGT was localized within the type-I glomus cells of the carotid body, which was subjected to be upregulated under the stress of chronic hypoxia. RT-PCR further confirmed a significant increase in the expression of AGT mRNA by chronic hypoxia. Consistently, Western blot analysis demonstrated that chronic hypoxia could elicit the upregulation of AGT protein in chronically hypoxic carotid bodies when compared with their normoxic controls. On the other hand, there was a slight but significant increase in ACE mRNA expression during chronic hypoxia. This study suggests that chronic hypoxia can activate a local angiotensin-generating system in the carotid body, notably its obligatory component AGT. The activation of such an intrinsic, angiotensin-generating system in the carotid body during chronic hypoxia should be important in the modulation of cardiopulmonary adaptation in the hypoxic ventilatory response and the electrolyte as well as water homeostasis.
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Affiliation(s)
- Siu Yin Lam
- Department of Physiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong
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Abstract
INTRODUCTION The circulating renin-angiotensin system (RAS) plays a crucial role in the regulation of blood pressure, electrolytes, and fluid homeostasis. In contrast to the circulating RAS, the presence of an intrinsic RAS has been demonstrated in different tissues/organs, which may affect both local and global functions of a biologic system. Our previous studies provided solid evidence of the existence of a local RAS in rat pancreas. Our further investigation showed that such a pancreatic RAS could be activated by experimental models of chronic hypoxia and chemically induced pancreatitis. These previous findings formed the basis for the current study. METHODOLOGY Adult Sprague-Dawley rats were exposed to isobaric hypoxia (10% O2), and the effects on the circulating and pancreatic RAS were documented. RESULTS The current study shows that exposure of rats to isobaric hypoxia caused a time-dependent increase in plasma renin activity. The activation of circulating RAS by hypoxia was associated with a parallel upregulation of local RAS components, including the mRNA expression of angiotensinogen and angiotensin II receptor types I and II in the pancreas. CONCLUSION The upregulation of local pancreatic RAS, along with its counterpart circulating RAS, may be responsible for both physiologic and pathophysiologic aspects of a biologic system under chronic hypoxic stress.
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Affiliation(s)
- Siu Po Ip
- Department of Physiology and School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong
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Ip SP, Chan YW, Che CT, Leung PS. Effect of chronic hypoxia on glutathione status and membrane integrity in the pancreas. Pancreatology 2002; 2:34-9. [PMID: 12120004 DOI: 10.1159/000049446] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Our recent study has shown that chronic hypoxia could upregulate significantly a local renin-angiotensin system in the pancreas. The activation of such a local renin-angiotensin system may provide an alternate mechanism that leads to the generation of reactive radical species in the pancreas during chronically hypoxic exposure. The present study aims at elucidating the antioxidant status in the pancreas during varying degrees of chronic hypoxia. METHODS Sprague-Dawley rats were exposed to an isobaric hypoxic (10% oxygen) chamber for a period up to 28 days. The glutathione status and membrane integrity of the pancreas were studied with a time course of chronic hypoxia (3, 7, 14, 21 and 28 days). The effect of chronic hypoxia on changes of oxidative states in the pancreas was assessed based on the measurements of glutathione, malondialdehyde, alpha-amylase and DNA fragmentation using biochemical assays. RESULTS Pancreatic glutathione was decreased drastically after 3-day hypoxia and its level was almost completely recovered after 7-day hypoxia. Malondialdehyde was not affected while DNA fragmentation was increased significantly in a time-dependent manner during the course of chronic hypoxia. Membrane integrity of the pancreatic cells was improved, as evidenced by the decrease of plasma alpha-amylase during the time-course study of chronic hypoxia. CONCLUSION Pancreatic glutathione was depleted only in the early period of chronic hypoxia followed by a rapid recovery, suggesting that adaptive response of the pancreas may occur during chronic hypoxia. The enhancement of glutathione-dependent antioxidant capacity during chronic hypoxia prevented oxidative damage to the membrane of the pancreatic cells.
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Affiliation(s)
- S P Ip
- School of Chinese Medicine, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR
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Abstract
Previous studies have shown the existence of functional angiotensin II receptors in rat carotid body, which directly alters the carotid chemoreceptor afferent nerve activity. Moreover, chronic hypoxia could result in an enhanced sensitivity of chemoreceptor afferent activity via an AT(1) receptor-mediated calcium signaling in the carotid body. In the present study, the localization and expression of angiotensinogen, the obligatory component for an intrinsic, angiotensin-generating system, were investigated by in situ hybridization histochemistry, immunohistochemistry, RT-PCR, Western blot and Northern blot analysis. In situ hybridization showed the expression of angiotensinogen within the glomus cells of the carotid body. Double immunostaining of angiotensinogen and tyrosine hydroxylase, an immunohistochemical marker for type I glomus cells, elucidated that angiotensinogen protein was specifically localized to the lobules of type I cells. Consistently, RT-PCR and Western blot analysis confirmed the expression of angiotensinogen mRNA and protein, respectively. On the other hand, renin mRNA was not detected using RT-PCR and Northern blot analysis whereas angiotensin-converting enzyme (ACE) mRNA was detected in the carotid body. These data suggest that a locally generated angiotensin system is operated in the carotid body, which might be linked to a renin-independent biosynthetic pathway. Such an intrinsic, angiotensin-generating system and its local regulation by chronic hypoxia should be important in the modulation of cardiopulmonary adaptation in the hypoxic ventilatory response and the electrolyte as well as water homeostasis.
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Affiliation(s)
- Siu Yin Lam
- Department of Physiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, PR China
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Santos CF, Oliveira EB, Salgado MCO, Greene AS. Molecular cloning and sequencing of the cDNA for rat mesenteric arterial bed elastase-2, an angiotensin II-forming enzyme. J Cardiovasc Pharmacol 2002; 39:628-35. [PMID: 11973405 DOI: 10.1097/00005344-200205000-00002] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 28.5-kD protein expressed in rat mesenteric arterial bed (MAB) perfusate with angiotensin II-forming ability was previously characterized. This protein, a member of the elastase-2 family of enzymes, seems to be the only representative of this family of proteases to be secreted outside the digestive tract and implicated in the generation of angiotensin II. The cloning and sequencing of the cDNA for the rat MAB elastase-2 by using reverse transcription polymerase chain reaction are reported. The sequence of this cDNA was found to be identical to the sequence of the rat pancreatic elastase-2; the cDNA is 909 nucleotides in length plus a poly (A) tail and encodes a preproenzyme of 271 amino acids. Analysis of the putative amino acids in the extended angiotensin I binding site of the rat MAB elastase-2 reveals features that could explain the dipeptidyl carboxypeptidase-like activity required for efficient conversion of angiotensin I to angiotensin II. Additionally, the sequence reveals structural features that could contribute to the lack of activity of this enzyme toward angiotensin II. Rat MAB elastase-2 was expressed in mesenteric arteries and lung but not in aorta. These results may also indicate that rat MAB elastase-2 is expressed in resistance vessels but not in conduit vessels.
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Affiliation(s)
- Carlos F Santos
- University of São Paulo, School of Medicine of Ribeirão Preto, Department of Pharmacology, Brazil
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