Sirolimus causes relaxation of human vascular smooth muscle: a novel action of sirolimus mediated via ATP-sensitive potassium channels

Evaluation of the Effects of Bile on the Arterial Tonus in a Rabbit Model

Background:

Hepatic artery anastomosis is an essential part of live-donor liver transplantation, and during this anastomosis, an unusual contact between bile and vessel ends is observed. In this study, the effects of this nonphysiological contact in a rabbit model were evaluated.

Methods:

The study was designed in 2 steps—in vitro and in vivo. Three groups were established for the in vitro study. In the first group, vessels were incubated in Krebs solution with 5% bile for 1 minute. In the second group, vessels were kept in Krebs solution with 5% bile for 5 minutes. Vessels in the control group were kept in Krebs solution without bile. All groups were examined for responses to vasodilator and vasoconstrictor agents in organ bath system. The specimens were evaluated immunohistochemically and histopathologically. In the in vivo step, microvascular anastomosis was performed bilaterally. Right carotid artery was anastomosed during bile contamination as study group, and left carotid artery was anastomosed without bile contamination as control group. Blood flow indexes were measured.

Results:

The results of the in vitro study revealed decreased responses to contractile and relaxing agents in the first study group compared with that of the control group (P < 0.0001). There was no response obtained in the second study group. The Doppler ultrasound results revealed no difference between preoperative and postoperative flow indexes (P > 0.05). There was no postoperative spasm in the study group. However, there was significant vasospasm in the control group (P < 0.05).

Conclusions:

Vessels exposed to bile have decreased contractile and relaxing responses, and this effect increases with exposure duration.

The effects of immunosuppressants on vascular function, systemic oxidative stress and inflammation in rats

Immunosuppressants have been associated with increased cardiovascular disease risk. We determined the effects of calcineurin and mammalian target of rapamycin (mTOR) inhibitor administration on endothelial dysfunction and associated inflammation and oxidative stress in adult rats. Cyclosporine A (low and high dose), sirolimus, tacrolimus, everolimus and placebo were administered to 8-week-old male Wistar rats for 10 consecutive days. Aortic vascular endothelial and smooth muscle function were assessed ex vivo in organ baths. Maximal aortic contraction to noradrenaline in sirolimus-treated rats was significantly greater than cyclosporine groups, everolimus and placebo, whereas endothelial-dependent relaxation was significantly impaired with cyclosporine and tacrolimus compared with everolimus. Endothelial-independent relaxation was impaired in tacrolimus-treated rats compared with low dose cyclosporine, everolimus and sirolimus. Sirolimus was associated with a reduction in plasma interleukin (IL)-1β and tumour necrosis factor (TNF)-α and higher levels of catalase and total antioxidant status. In nontransplanted rats, vascular dysfunction was evident following administration of cyclosporine A, sirolimus and tacrolimus, whereas everolimus did not compromise aortic endothelial or smooth muscle function. At the doses administered in this model, the immunosuppressants exerted varying effects on vascular function.

Drug repositioning using in silico compound profiling

BACKGROUND

Drug repositioning is a current strategy to find new uses for existing drugs, patented or not, and for late-stage candidates that failed for lack of efficacy.

RESULTS

In silico profiling of several marketed drugs (methadone, rapamycin, saquinavir and telmisartan) was performed, exploiting a vast amount of published information. Similar compounds were assessed in terms of target-activity profiles for major drug-target families. In silico profiles were visualized within an interactive heat map and detailed analysis was performed associated with the accessible current knowledge.

CONCLUSION

Based on a basic principle assuming that similar molecules share similar target activity, new potential targets and, therefore, opportunities of potential new indications have been identified and discussed.

Posttransplantation therapeutic rapamycin concentration protects nitric oxide-related vascular endothelial function: comparative effects in rat thoracic aorta and coronary endothelial cell culture

OBJECTIVE

To investigate the potential effects of therapeutic dosages of the immunosuppression agent rapamycin on endothelial function with regard to nitric oxide (NO) synthesis in rat thoracic aorta in vivo and rat coronary endothelial cells in vitro.

MATERIALS AND METHODS

Male Wistar rats were injected with rapamycin, 1.5 mg/kg/d intraperitoneally for 14 days. After the rats were sacrificed, the thoracic aortas were suspended in organ chambers and evaluated for endothelium-dependent and endothelium-independent vascular responses.

RESULTS

Rapamycin administration resulted in increased relaxant responses to L-arginine and to greater concentrations of the calcium ionophore (A23187) in the aortas. However, potassium chloride, acetylcholine, sodium nitroprusside, and N(G)-nitro-L-arginine methyl ester responses remained unchanged. In addition, phenylephrine-induced contractions were significantly decreased in the aortas regardless of the presence of functional endothelium. In a series of in vitro experiments, isolated rat coronary endothelial cells were incubated with therapeutic concentrations of rapamycin (10 nmol/L). Nitrite accumulation in the supernatants revealed that rapamycin decreased nitrite release induced by interleukin-1beta but did not affect basal or A23187-stimulated nitrite levels. Western blot analysis demonstrated that rapamycin decreased inducible NO synthase protein expression in coronary endothelial cells.

CONCLUSION

Posttransplantation therapeutic concentrations of rapamycin not only preserve vascular endothelial function mediated by NO synthesis but possibly interact in vivo with adrenergic receptors in favor of vasodilatory mechanisms.

Immunosuppression in high-risk transplantation

PURPOSE OF REVIEW

Increasingly, transplant clinicians are faced with providing candidates with increased risks for poorer outcome with donor grafts that also carry higher risks of failure. Understanding the role of immunosuppressive management in these combinations of higher risks remains important for optimizing results.

RECENT FINDINGS

Few immunosuppressive protocols have been rigorously tested in the high-risk renal transplant setting. The two main risk categories accounted for in the trials are those ones that confer increased risks to renal function, usually carried by the donor organs, and those protocols defined by increased risk for immunological failure, mostly determined by recipient characteristics. The studied protocols generally involve reduction or avoidance of nephrotoxic drugs in the first case and use of lymphocyte-depleting agents in the case of increased immunological risk. In both scenarios, acceptable short-term results have been achieved. However, long-term results for high-risk transplants defined either by donor or recipient factors have yet to be reported.

SUMMARY

The lack of long-term data for optimizing the right immunosuppressive regimen for a given donor/recipient risk profile remains an ongoing challenge for researchers and clinicians alike.