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Harb I, Ashour H, Rashed LA, Mostafa A, Samir M, Aboulhoda BE, El-Hanbuli H, Rashwan E, Mahmoud H. Nicorandil mitigates amiodarone-induced pulmonary toxicity and fibrosis in association with the inhibition of lung TGF-β1/PI3K/Akt1-p/mTOR axis in rats. Clin Exp Pharmacol Physiol 2023; 50:96-106. [PMID: 36208078 DOI: 10.1111/1440-1681.13728] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/16/2022] [Accepted: 09/29/2022] [Indexed: 12/13/2022]
Abstract
The long-term side effect of the antiarrhythmic drug, amiodarone (AMIO), such as lung toxicity, remains a critical clinical issue. The previous knowledge denotes diverse antioxidant, anti-inflammatory, and antifibrotic properties of the anti-anginal drug, nicorandil (NI). Therefore, we aimed to investigate the possible protective effect of NI on pulmonary tissue remodelling following AMIO-induced lung toxicity. The included rats were assigned into four equal groups (n = 8): (1) control, (2) control group that received NI 10 mg kg-1 day-1 , (3) model group that received AMIO in a dose of 60 mg kg-1 day-1 , and (4) treated group (AMIO-NI) that were treated with AMIO plus NI as shown above. Drug administration continued for 10 weeks. AMIO resulted in deteriorated (p < 0.001) pulmonary functions accompanied by respiratory acidosis. AMIO showed an obvious histological injury score with intense collagen deposition, disturbed nitric oxide synthase enzymes (NOS/iNOS), and increased alpha smooth muscle actin expression. Furthermore, AMIO upregulated the transforming growth factor (TGF-β1)/phosphoinositide-3 kinase (PI3K)-Akt1-p/mammalian target of rapamycin (mTOR) axis, which determined the possible mechanism of AMIO on pulmonary remodelling. NI treatment significantly (p < 0.001) prevented the AMIO-induced lung toxicity, as well as inhibited the TGF-β1/PI3K/Akt1-p/mTOR axis in the lung tissue of rats. The results were confirmed by an in-vitro study. CONCLUSION: The current results revealed that NI was effective in preserving the lung structure and functions. Amelioration of the oxidative stress and modulation of TGF-β1/PI3K/Akt1-p/mTOR have been achieved. This study suggests NI administration as a preventive therapy from the serious pulmonary fibrosis side effect of AMIO.
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Affiliation(s)
- Inas Harb
- Department of Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hend Ashour
- Department of Physiology, Faculty of Medicine, KingKhalid University, Abha, Saudi Arabia.,Department of Physiology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Laila A Rashed
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Abeer Mostafa
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Mai Samir
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Basma Emad Aboulhoda
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Hala El-Hanbuli
- Department of Pathology, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Eman Rashwan
- Department of Physiology, Faculty of Medicine, Jouf University, Sakakah, Saudi Arabia.,Department of Physiology, Faculty of Medicine, Al-Azhar University, Assuit, Egypt
| | - Heba Mahmoud
- Department of Pharmacology, Faculty of Medicine, Cairo University, Giza, Egypt
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Ashour H, Elsayed MH, Elmorsy S, Harb IA. Hypothesis: The potential therapeutic role of nicorandil in COVID-19. Clin Exp Pharmacol Physiol 2020; 47:1791-1797. [PMID: 32881062 PMCID: PMC7436472 DOI: 10.1111/1440-1681.13395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/14/2020] [Accepted: 08/02/2020] [Indexed: 12/16/2022]
Abstract
At present, there is yet no specific antiviral treatment or immunization against the newly identified human severe acute respiratory syndrome virus (SARS‐CoV2) that results in a rapidly progressive pandemic coronavirus disease 2019 (COVID‐19). We believe in a crucial need for a clinical strategy to counteract this viral pandemic based on the known pathogenesis throughout the disease course. Evidence suggests that exaggerated patient's inflammatory response and oxidative stress are likely to aggravate the disease pathology. The resulting endothelial dysfunction further induces fibrosis and coagulopathy. These disturbances can generate severe acute respiratory distress syndrome (ARDS) that can progress into respiratory and circulatory failure. Nicorandil is an anti‐anginal vasodilator drug acts by increasing nitric oxide bioavailability and opening of the KATP channel. Recently, nicorandil has been recognized to possess multiple protective effects against tissue injury. Here, we address a possible modulatory role of nicorandil against COVID‐19 pathogenesis. We hypothesise nicorandil would be an effective form of adjuvant therapy against COVID‐19.
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Affiliation(s)
- Hend Ashour
- Faculty of Medicine, Department of Physiology, King Khalid University, Abha, Saudi Arabia.,Faculty of Medicine, Department of Physiology, Kasr Alainy, Cairo University, Cairo, Egypt
| | - Mohamed H Elsayed
- Department of Pediatrics ICU, Al-Ahrar Teaching Hospital, Zagazig, Egypt.,Department of Pediatrics ICU, King Fahd Armed Forces Hospital, Khamis Mushait, Saudi Arabia
| | - Soha Elmorsy
- Faculty of Medicine, Department of Medical Pharmacology, Cairo University, Cairo, Egypt
| | - Inas A Harb
- Faculty of Medicine, Department of Medical Pharmacology, Cairo University, Cairo, Egypt
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Wajima Z, Shiga T, Imanaga K, Inoue T, Ogawa R. Effect of prophylactic bronchodilator treatment with i.v. carperitide on airway resistance and lung compliance after tracheal intubation. Br J Anaesth 2006; 96:660-4. [PMID: 16531446 DOI: 10.1093/bja/ael047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Lung resistance increases after induction of anaesthesia. We hypothesized that prophylactic bronchodilation with i.v. carperitide before tracheal intubation would decrease airway resistance and increase lung compliance after placement of the tracheal tube in both smokers and nonsmokers. METHODS Ninety-seven adults aged between 24 and 59 yr were randomized to receive i.v. normal saline (0.9% saline) (control) or carperitide, 0.2 microg kg(-1) min(-1) throughout the study. The 97 patients included smokers and nonsmokers. Thus the patients were allocated to one of the four groups: smokers who received normal saline (n=21), nonsmokers who received normal saline (n=27), smokers who received carperitide (n=19) or nonsmokers who received carperitide (n=30). Thirty minutes after starting normal saline or carperitide infusion, we administered thiamylal 5 mg kg(-1) and fentanyl 5 microg kg(-1) to induce general anaesthesia and vecuronium 0.3 mg kg(-1) for muscle relaxation. Continuous infusion of thiamylal 15 mg kg(-1) h(-1) followed anaesthetic induction. Mean airway resistance (R(awm)), expiratory airway resistance (R(awe)) and dynamic lung compliance (C(dyn)) were determined 4, 8, 12 and 16 min after tracheal intubation and compared between the four groups. RESULTS At 4 min after intubation, R(awm) and R(awe) were higher and C(dyn) lower in smokers than in nonsmokers in the control group. R(awm) and R(awe) were lower and C(dyn) higher in smokers in the carperitide group than in smokers in the control group. R(awm) and R(awe) were lower in nonsmokers in the carperitide group than in nonsmokers in the control group. CONCLUSIONS Marked bronchoconstriction occurred in the control groups (smokers and nonsmokers) 4 min after tracheal intubation. Prophylactic treatment with carperitide before induction of anaesthesia and tracheal intubation was advantageous, particularly in smokers.
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Affiliation(s)
- Z Wajima
- Department of Anaesthesia, Chiba-Hokusoh Hospital, Nippon Medical School 1715 Kamagari, Inba-mura, Inba-gun, Chiba 270-1694, Japan.
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Jahangir A, Terzic A. K(ATP) channel therapeutics at the bedside. J Mol Cell Cardiol 2005; 39:99-112. [PMID: 15953614 PMCID: PMC2743392 DOI: 10.1016/j.yjmcc.2005.04.006] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Revised: 03/17/2005] [Accepted: 04/26/2005] [Indexed: 11/22/2022]
Abstract
The family of potassium channel openers regroups drugs that share the property of activating adenosine triphosphate-sensitive potassium (K(ATP)) channels, metabolic sensors responsible for adjusting membrane potential-dependent functions to match cellular energetic demands. K(ATP) channels, widely represented in metabolically-active tissue, are heteromultimers composed of an inwardly rectifying potassium channel pore and a regulatory sulfonylurea receptor subunit, the site of action of potassium channel opening drugs that promote channel activity by antagonizing ATP-induced pore inhibition. The activity of K(ATP) channels is critical in the cardiovascular adaptive response to stress, maintenance of neuronal electrical stability, and hormonal homeostasis. Thereby, K(ATP) channel openers have a unique therapeutic spectrum, ranging from applications in myopreservation and vasodilatation in patients with heart or vascular disease to potential clinical use as bronchodilators, bladder relaxants, islet cell protector, antiepileptics and promoters of hair growth. While the current experience in practice with potassium channel openers remains limited, multitude of ongoing investigations aims at defining the benefit of this emerging family of therapeutics in diverse disease conditions associated with metabolic distress.
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Affiliation(s)
- A Jahangir
- Division of Cardiovascular Diseases, Departmentof Medicine, Mayo Clinic College of Medicine, Guggenheim 7, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Wajima Z, Shiga T, Yoshikawa T, Ogura A, Imanaga K, Inoue T, Ogawa R. Intravenous alprostadil, an analog of prostaglandin E1, prevents thiamylal-fentanyl-induced bronchoconstriction in humans. Anesth Analg 2003; 97:456-460. [PMID: 12873934 DOI: 10.1213/01.ane.0000068884.53810.9c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
UNLABELLED Prostaglandin (PG) E(1) relaxes airway smooth muscle in animals. However, no clinical data have been published on the bronchorelaxant effects of IV alprostadil, an analog of PGE(1). We have described experimental thiamylal-fentanyl-induced bronchoconstriction in humans; we now report the effect of IV alprostadil on thiamylal-fentanyl-induced bronchoconstriction. Thirty-two patients were allocated randomly to a control group (n = 16) and alprostadil group (n = 16). Anesthesia was induced with thiamylal 5 mg/kg and vecuronium 0.3 mg/kg and maintained with a continuous infusion of thiamylal 15 mg. kg(-1). h(-1). The lungs of the patients were ventilated with 50% nitrous oxide in oxygen. Twenty minutes after the induction of anesthesia, patients in the control group were given a continuous infusion of normal saline 20 mL/h, and those in the alprostadil group received a continuous infusion of alprostadil 0.2 micro g. kg(-1). min(-1) (20 mL/h), both for 60 min. Both groups were then given fentanyl 5 micro g/kg. Systolic and diastolic arterial blood pressure, heart rate, mean airway resistance (Rawm), expiratory airway resistance (Rawe), and dynamic lung compliance (Cdyn) were measured at the baseline, just before the fentanyl injection (T30), at three consecutive 6-min intervals after fentanyl injection (T36, T42, and T48), and 30 min after fentanyl injection (T60). Baseline Rawm, Rawe, and Cdyn values were comparable between groups. In the control group, both Rawm and Rawe were significantly increased at T36-60, and Cdyn was significantly decreased at T36-60 compared with the baseline. Patients given alprostadil showed no change in Rawm, Rawe, or Cdyn at T36-60. Thus, IV alprostadil seems to have a bronchodilator effect in humans. IMPLICATIONS IV alprostadil, an analog of prostaglandin E(1), prevents thiamylal-fentanyl-induced bronchoconstriction in humans. This finding suggests that IV alprostadil has a bronchodilator effect.
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Affiliation(s)
- Zen'ichiro Wajima
- *Department of Anesthesia, Chiba Hokusoh Hospital, Chiba, Japan; †Department of Anesthesia, Tama-Nagayama Hospital; ‡Department of Anesthesiology, Nippon Medical School; §Department of Anesthesiology, Tokyo Jikeikai Medical School, Tokyo, Japan; and ∥Center for Anesthesiology Research, The Cleveland Clinic Foundation, Ohio
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