1
|
Akintunde JK, Falomo IM, Akinbohun OM, Erinoso SO, Ugwor E, Folayan AD, Ateate AD. Naringin corrects renal failure related to Lesch-Nyhan disease in a rat model via NOS-cAMP-PKA and BDNF/TrkB pathways. J Biochem Mol Toxicol 2024; 38:e23558. [PMID: 37865952 DOI: 10.1002/jbt.23558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 09/11/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
This study explored the effect of naringin (NAR) on HGPRT1 deficiency and hyperuricemia through NOS-cAMP-PKA and BDNF/TrkB signaling pathways induced by caffeine (CAF) and KBrO3 in a rat model. Sixty-three adult male albino rats were randomly assigned into nine (n = 7) groups. Group I: control animals, Group II was treated with 100 mg/kg KBrO3 , Group III was treated with 250 mg/kg CAF, Group IV was treated with 100 mg/kg KBrO3 + 250 mg/kg CAF, Group V was administered with 100 mg/kg KBrO3 + 100 mg/kg haloperidol, Group VI was administered with 100 mg/kg KBrO3 + 50 mg/kg NAR, Group VII was administered with 500 mg/kg CAF + 50 mg/kg NAR, and Group VIII was administered with 100 mg/kg KBrO3 + 250 mg/kg CAF + 50 mg/kg NAR. Finally, group IX was treated with 50 mg/kg NAR. The exposure of rats to KBrO3 and CAF for 21 days induced renal dysfunction linked with Lesch-Nyhan disease. NAR obliterated renal dysfunction linked with Lesch-Nyhan disease by decreasing uric acid, renal malondialdehyde level, inhibiting the activities of arginase, and phosphodiesterase-51 (PDE-51) with corresponding upregulation of brain derived-neurotrophic factor and its receptor (BDNF-TrkB), Bcl11b, HGPRT1, and DARPP-32. Additionally, renal failure related to Lesch-Nyhan disease was remarkably corrected by NAR as shown by the reduced activities of AChE and enzymes of ATP hydrolysis (ATPase, AMPase, and ADA) with affiliated increase in the NO level. This study therefore validates NAR as nontoxic and effective chemotherapy against kidney-related Lesch-Nyhan disease by mitigating effects of toxic food additives and enzymes of ATP-hydrolysis via NOS-cAMP-PKA and BDNF/TrkB signaling pathways.
Collapse
Affiliation(s)
- Jacob K Akintunde
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Idowu M Falomo
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Oreoluwa M Akinbohun
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - S O Erinoso
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Emmanuel Ugwor
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - Adeniyi D Folayan
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| | - A D Ateate
- Molecular Toxicology and Biomedical Research Group, Department of Biochemistry, College of Biosciences, Federal University of Agriculture, Abeokuta, Nigeria
| |
Collapse
|
2
|
Baumgartner K, Doering And M, Mullins ME. Dexmedetomidine in the treatment of toxicologic conditions: a systematic review and review of the toxicology investigators consortium database. Clin Toxicol (Phila) 2022; 60:1356-1375. [PMID: 36346349 DOI: 10.1080/15563650.2022.2138761] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Dexmedetomidine is an alpha-2 adrenoceptor agonist which is widely used for sedation. Dexmedetomidine does not suppress the respiratory drive and produces a state of cooperative sedation; it may be associated with beneficial outcomes in the general critical care population. The role of dexmedetomidine in the treatment of toxicologic conditions (excluding alcohol withdrawal) is unclear. OBJECTIVES To critically assess and summarize the literature regarding the use of dexmedetomidine in toxicologic conditions other than alcohol withdrawal. METHODS We performed a systematic review of the medical literature to identify all existing evidence regarding the use of dexmedetomidine for toxicologic conditions. We excluded reviews and commentary, studies reporting exclusively on alcohol withdrawal, and studies reporting the use of dexmedetomidine to treat iatrogenic sedative withdrawal in the intensive care unit. We also performed a review of the Toxicology Investigators Consortium (ToxIC) database for patients treated with dexmedetomidine. RESULTS We identified 98 studies meeting inclusion criteria; 87 of these were case reports or case series, representing 99 unique cases. Eleven articles with other designs were identified, which included 138 patients treated with dexmedetomidine for toxicologic conditions. Ninety-three cases from the ToxIC registry met inclusion criteria. Common indications for dexmedetomidine included stimulant intoxication, sedative withdrawal, serotonin syndrome, antimuscarinic toxidrome, opioid withdrawal, and cannabinoid intoxication. Dexmedetomidine was usually administered by continuous infusion; bolus administration was reported in a minority of cases. Adverse effects were uncommon. The quality of evidence was generally low, given the preponderance of case reports, the rate of missing or poorly reported data, and the near-universal co-administration of other sedatives. TREATMENT OF STIMULANT POISONING Fifty-nine patients with stimulant poisoning were treated with dexmedetomidine. There was reasonably good evidence that dexmedetomidine was helpful in the treatment of stimulant poisoning. TREATMENT OF SEDATIVE WITHDRAWAL Twenty-two patients with sedative withdrawal were treated with dexmedetomidine. Several case reports of very high-quality suggested efficacy of dexmedetomidine for this indication, particularly for baclofen withdrawal. TREATMENT OF SEROTONIN SYNDROME Twenty-six patients with serotonin syndrome were treated with dexmedetomidine. This evidence was of lower quality due to missing clinical details, potential overdiagnosis of serotonin syndrome, and near-universal concomitant treatment with other sedatives. TREATMENT OF ANTIMUSCARINIC POISONING Forty-two patients with antimuscarinic poisoning were treated with dexmedetomidine. This evidence was of low quality and was limited by infrequent use of the preferred antidote, physostigmine. TREATMENT OF OPIOID WITHDRAWAL Forty-four patients with opioid withdrawal were treated with dexmedetomidine. This evidence was of low quality due to missing clinical details and near-universal concomitant treatment with other agents. The one high-quality trial reported the use of dexmedetomidine in ultra-rapid opioid detoxification, which is not indicated in modern practice. TREATMENT OF CANNABINOID INTOXICATION Five patients with cannabinoid intoxication were treated with dexmedetomidine. No definite conclusion can be drawn from the limited available evidence. DISCUSSION It is important to distinguish between the use of dexmedetomidine as a general sedative, which is likely to increase as the overall utilization of dexmedetomidine in critical care settings increases, and the use of dexmedetomidine as a specific pharmacologic treatment for a toxicologic condition. Well-established pharmacologic data from animal and human studies suggest dexmedetomidine counteracts stimulant-induced norepinephrine release. The mechanism by which dexmedetomidine treats sedative withdrawal is unclear. Some animal data show that dexmedetomidine may indirectly suppress serotonin release, which may suggest a role for dexmedetomidine in this condition. CONCLUSIONS There is a small and generally low-quality body of evidence which suggests that dexmedetomidine may be helpful in the treatment of certain toxicologic conditions, particularly stimulant intoxication and sedative withdrawal. Further high-quality research is needed to clarify the role of dexmedetomidine in patients with toxicologic conditions.
Collapse
Affiliation(s)
- Kevin Baumgartner
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michelle Doering And
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Michael E Mullins
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | -
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
3
|
Sampaio-Jorge F, Morales AP, Pereira R, Barth T, Ribeiro BG. Caffeine increases performance and leads to a cardioprotective effect during intense exercise in cyclists. Sci Rep 2021; 11:24327. [PMID: 34934054 PMCID: PMC8692308 DOI: 10.1038/s41598-021-03158-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022] Open
Abstract
The present study was designed to investigate the effects of different caffeine dietary strategies to compare the impact on athletic performance and cardiac autonomic response. The order of the supplementation was randomly assigned: placebo(4-day)-placebo(acute)/PP, placebo(4-day)-caffeine(acute)/PC and caffeine(4-day)-caffeine(acute)/CC. Fourteen male recreationally-trained cyclists ingested capsules containing either placebo or caffeine (6 mg kg-1) for 4 days. On day 5 (acute), capsules containing placebo or caffeine (6 mg kg-1) were ingested 60 min before completing a 16 km time-trial (simulated cycling). CC and PC showed improvements in time (CC vs PP, Δ - 39.3 s and PC vs PP, Δ - 43.4 s; P = 0.00; ƞ2 = 0.33) and in output power (CC vs PP, Δ 5.55 w and PC vs PP, Δ 6.17 w; P = 0.00; ƞ2 = 0.30). At the final of the time-trial, CC and PC exhibited greater parasympathetic modulation (vagal tone) when compared to the PP condition (P < 0.00; ƞ2 = 0.92). Our study provided evidence that acute caffeine intake (6 mg∙kg-1) increased performance (time-trial) and demonstrated a relevant cardioprotective effect, through increased vagal tone.
Collapse
Affiliation(s)
- Felipe Sampaio-Jorge
- Higher Institutes of Education of CENSA (ISECENSA), Campos dos Goytacazes, Rio de Janeiro, 28030-260, Brazil.
- Macaé Sports Secretary, City Government of Macaé (PMM), Macaé, Rio de Janeiro, 27913-080, Brazil.
- Laboratory Research and Innovation in Sports Sciences, Federal University of Rio de Janeiro (UFRJ), Macaé Campus, 50, Aluízio da Silva Gomes, Granja Dos Cavaleiros, Rio de Janeiro, 27930-560, Brazil.
| | - Anderson Pontes Morales
- Higher Institutes of Education of CENSA (ISECENSA), Campos dos Goytacazes, Rio de Janeiro, 28030-260, Brazil
- Macaé Sports Secretary, City Government of Macaé (PMM), Macaé, Rio de Janeiro, 27913-080, Brazil
- Laboratory Research and Innovation in Sports Sciences, Federal University of Rio de Janeiro (UFRJ), Macaé Campus, 50, Aluízio da Silva Gomes, Granja Dos Cavaleiros, Rio de Janeiro, 27930-560, Brazil
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro (UFRJ), Macaé, Rio de Janeiro, 21941-590, Brazil
| | - Rafael Pereira
- Integrative Physiology Research Center, State University of Southwest Bahia (UESB), Jequié, BA, 45210-506, Brazil
| | - Thiago Barth
- Laboratory of Bioactive Products, Federal University of Rio de Janeiro (UFRJ), Macaé, Rio de Janeiro, 27933-378, Brazil
| | - Beatriz Gonçalves Ribeiro
- Laboratory Research and Innovation in Sports Sciences, Federal University of Rio de Janeiro (UFRJ), Macaé Campus, 50, Aluízio da Silva Gomes, Granja Dos Cavaleiros, Rio de Janeiro, 27930-560, Brazil
- Postgraduate Program in Nutrition, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro (UFRJ), Macaé, Rio de Janeiro, 21941-590, Brazil
| |
Collapse
|
4
|
Effect of Dexmedetomidine Combined with Ropivacaine on Cognitive Dysfunction and Inflammatory Response in Patients Undergoing Craniocerebral Surgery. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4968300. [PMID: 34888381 PMCID: PMC8651389 DOI: 10.1155/2021/4968300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022]
Abstract
Objective To study the effects of dexmedetomidine in combination with ropivacaine in patients undergoing craniocerebral surgery and their efficiency on cognitive function and inflammatory response of patients. Methods 100 patients undergoing craniocerebral surgery in our hospital from November 2018 to September 2020 were randomly selected and divided into a control group and an experimental group by drawing lots, with 50 cases in each group. Patients in the control group received routine anesthesia, while those in the experimental group received 1 μg/kg of dexmedetomidine combined with 0.5% of ropivacaine for anesthesia to compare the anesthesia onset time, analgesic time, postoperative awake time, Social Disability Screening Schedule (SDSS) cognitive function score after waking, visual analogue scale (VAS) pain score, Ramsay sedation score, incidence of adverse reactions, postoperative inflammatory factor expression levels, and changes in heart rate, oxygen saturation, and blood pressure at T0, T1, T2, T3, and T4 between the two groups. Results The anesthesia onset time, SDSS cognitive function score after waking, VAS pain score, Ramsay sedation score, incidence of adverse reactions, and postoperative inflammatory factor expression levels in the experimental group were significantly lower than those in the control group (P < 0.05). The analgesic time and postoperative awake time in the experimental group were significantly longer than those in the control group, with statistical significance (P < 0.05). There were no statistically significant differences in the changes of heart rate, oxygen saturation, and blood pressure at T0, T1, T2, T3, and T4 between the two groups (P > 0.05). Conclusion Dexmedetomidine combined with ropivacaine has high application value in craniocerebral surgery.
Collapse
|
5
|
Adachi K, Beppu S, Terashima M, Fukuda T, Tomizawa J, Shimizu M, Yamazaki H. Pharmacokinetics of caffeine self-administered in overdose in a Japanese patient admitted to hospital. J Pharm Health Care Sci 2021; 7:36. [PMID: 34602096 PMCID: PMC8489039 DOI: 10.1186/s40780-021-00220-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022] Open
Abstract
Background Caffeine (0.1 g) is used as a central nervous system stimulant and as a nontoxic phenotyping probe for cytochrome P450 1A2. However, an increasing number of suicide attempts by caffeine overdose have been recently reported. Case presentation A 25-year-old woman (body weight, 43 kg) who intentionally took an overdose of 5.9 g caffeine as a suicide attempt was emergently admitted to Kyoto Medical Center. The plasma concentrations of caffeine and its primary metabolite, N-demethylated paraxanthine, in the current case were 100 and 7.3 μg/mL, 81 and 9.9 μg/mL, 63 and 12 μg/mL, and 21 and 14 μg/mL, at 12, 20, 30, and 56 h after oral overdose, respectively. The observed apparent terminal elimination half-life of caffeine during days 1 and 2 of hospitalization was 27 h, which is several times longer than the reported normal value. This finding implied nonlinearity of caffeine pharmacokinetics over such a wide dose range, which could affect the accuracy of values simulated by a simplified physiologically based pharmacokinetic model founded on a normal dose of 100 mg. Low serum potassium levels (2.9 and 3.5 mM) on days 1 and 2 may have been caused by the caffeine overdose in the current case. Conclusions The patient underwent infusion with bicarbonate Ringer’s solution and potassium chloride and was discharged on the third day of hospitalization despite taking a potentially lethal dose of caffeine. The virtual plasma exposures of caffeine estimated using the current simplified PBPK model were higher than the measured values. The present results based on drug monitoring data and additional pharmacokinetic predictions could serve as a useful guide in cases of caffeine overdose.
Collapse
Affiliation(s)
- Koichiro Adachi
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan.,Kyoto Medical Center, Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan.,Himeji Medical Center, Himeji, Hyogo, 670-8520, Japan
| | - Satoru Beppu
- Kyoto Medical Center, Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | - Mariko Terashima
- Kyoto Medical Center, Fukakusa Mukaihata-cho, Fushimi-ku, Kyoto, 612-8555, Japan
| | | | - Jun Tomizawa
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan
| | - Makiko Shimizu
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan
| | - Hiroshi Yamazaki
- Laboratory of Drug Metabolism and Pharmacokinetics, Showa Pharmaceutical University, 3-3165 Higashi-tamagawa Gakuen, Machida, Tokyo, 194-8543, Japan.
| |
Collapse
|
6
|
Grémain V, Chevillard L, Saussereau E, Schnell G, Mégarbane B. Massive suicidal ingestion of caffeine: a case report with investigation of the cardiovascular effect/concentration relationships. Clin Toxicol (Phila) 2021; 59:937-941. [PMID: 33688777 DOI: 10.1080/15563650.2021.1891243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Caffeine poisoning may cause life-threatening arrhythmias and hemodynamic failure. We aimed to investigate the toxicokinetics (TK), toxicodynamics (TD) and TK/TD relationships of caffeine in a case of poisoning. CASE REPORT A 47-year-old male ingested pure anhydrous caffeine powder (70 g) in a suicide attempt. He developed agitation, tachycardia, and two episodes of ventricular fibrillation treated with defibrillation and tracheal intubation. He was successfully managed using intravenous infusions of esmolol and norepinephrine. METHODS We modelled the time-course of plasma caffeine concentration (TK study using online liquid chromatography-tandem mass spectrometry), the time-course of blood lactate concentration and infusion rates of esmolol and norepinephrine (TD studies) and the TK/TD relationships. RESULTS Caffeine TK was of first-order peaking at 258 mg/L with an elimination half-life of 46.2 h and clearance of 2.2 L/h. Caffeine-related effects on blood lactate (peak, 10 mmol/L at 1.25 h postingestion) were described by a Bateman-type equation (formation rate, 0.05 mmol/mg.h; elimination rate, 0.9 mmol/mg.h). Esmolol and norepinephrine infusion rates to reverse caffeine-related cardiovascular effects (peaks at 51-h postingestion) fitted well with a sigmoidal Emax model (EC50, 180.0 and 225.9 mg/L, respectively; Hill coefficient, 10.0). CONCLUSION Massive caffeine ingestion is characterized by prolonged caffeine elimination. TK/TD relationships are helpful to quantify caffeine-related catecholaminergic effects.
Collapse
Affiliation(s)
- Vincent Grémain
- Medical and Surgical Intensive Care Unit, General Hospital, Le Havre, France
| | | | | | - Guillaume Schnell
- Medical and Surgical Intensive Care Unit, General Hospital, Le Havre, France
| | - Bruno Mégarbane
- INSERM UMRS-1144, University of Paris, Paris, France.,Department of Medical and Toxicological Critical Care, Federation of Toxicology APHP, Lariboisière Hospital, Paris, France
| |
Collapse
|