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Besteiro B, Marques da Cruz M, Alves C, Costa F, Nunes M, Dias DM, Barreira A, Calvão J, Mesquita M, Carvalho S, Pinho I, Carrola P, Ramos JP. The influence of carvedilol posology timing on clinically significant portal hypertension: insights from elastography measurements. Eur J Gastroenterol Hepatol 2024; 36:615-621. [PMID: 38477862 DOI: 10.1097/meg.0000000000002738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
BACKGROUND AND AIMS Carvedilol has emerged as the preferred β-blocker for treating portal hypertension. However, there is still a debate in dosing regimen, with a potential lower bioavailability in once-daily regimens. The aim of this study is to assess the acute effects of carvedilol posology in patients with clinically significant portal hypertension (CSPH), as a surrogate marker of bioavailability. METHODS In this experimental study, 34 patients with CSPH receiving carvedilol twice daily were asked to suppress the night dose of carvedilol, creating a standardized 24-hour dose interval. Spleen stiffness measurement (SSM) and liver stiffness measurement (LSM) by transient elastography (TE) were performed, with the exact interval between the last carvedilol administration and TE measurements consistently maintained at 24 hours and compared with values prior and under treatment. RESULTS Thirty-four patients were included, predominantly male (82.9%). SSM after suspending carvedilol for 24 hours [mean, 73.9kPa (SD, 17.0)] was significantly higher ( P < 0.001) than under treatment [mean, 56.3kPa (SD, 13.2)] and was not significantly different ( P = 0.908) from SSM prior to introduction of carvedilol [mean, 74.5kPa (SD, 12.4)]. Differences were also found in stratified analysis for carvedilol dosage, D'Amico classification stages, MELDNa scores, MELD3.0 scores, Child-Pugh class A and CSPH due to alcoholic cirrhosis. LSM after suspension was not significantly different from both under treatment and prior to treatment. CONCLUSION The differences in SSM after skipping one dose of carvedilol show both the importance of strict adherence to the prescribed dosing regimen to achieve the expected therapeutic benefits and the impact of twice daily prescription in bioavailability throughout the day.
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Affiliation(s)
- Bruno Besteiro
- Internal Medicine Department, Centro Hospitalar e Universitário de São João
- Faculty of Medicine, Oporto University, Centro Hospitalar e Universitário de São João, Oporto
| | - Manuel Marques da Cruz
- Unidade de Saúde Pública do Agrupamento de Centros de Saúde Marão e Douro Norte, ARS Norte, Vila Real
- Faculty of Medicine University of Porto, MEDCIDS and CINTESIS, Porto
| | - Cláudia Alves
- Internal Medicine Department, Hospital Distrital de Santarém, Santarém
| | - Fátima Costa
- Internal Medicine Department, Centro Hospitalar do Tâmega e Sousa, Penafiel
| | - Mariana Nunes
- Internal Medicine Department, Centro Hospitalar de Trás os Montes e Alto Douro, Vila Real
| | - Daniel Martinho Dias
- Faculty of Medicine University of Porto, MEDCIDS and CINTESIS, Porto
- Family Health Unit Ao Encontro da Saúde, ACES Santo Tirso, Trofa
| | - Ana Barreira
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Joana Calvão
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Mónica Mesquita
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Sónia Carvalho
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Inês Pinho
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Paulo Carrola
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - José Presa Ramos
- Liver Unit, Internal Medicine Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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Rao L, Bhardwaj BY, Chugh M, Sharma A, Shah R, Minocha N, Pandey P. Enhanced Efficacy of Carvedilol by Utilization of Solid Dispersion and Other Novel Strategies: A Review. Cardiovasc Hematol Disord Drug Targets 2023; 23:141-156. [PMID: 37953616 DOI: 10.2174/011871529x247622231101075854] [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: 02/28/2023] [Revised: 08/04/2023] [Accepted: 10/09/2023] [Indexed: 11/14/2023]
Abstract
Carvedilol is classified as a second class drug of Biopharmaceutical classification system (BCS), and it is an excellent beta blocker and vasodilating agent. It is used in a diverse range of disease states. Despite having tremendous advantages, the drug cannot be used effectively and productively due to aquaphobicity and poor bioavailability. To overcome this limitation, numerous novel approaches and tactics have been introduced over the past few years, such as Selfmicro emulsifying drug delivery systems (SMEDDS), nanoparticles, solid dispersions and liposomal drug delivery. The present review aims to accentuate the role of solid dispersion in improving the dissolution profile and aqua solubility of carvedilol and also to emphasize other novel formulations of carvedilol proposed to prevail the limitations of carvedilol. Solid dispersion and other novel approaches were found to play a significant role in overcoming the drawbacks of carvedilol, among which solid dispersion is the most feasible and effective approach being used worldwide. Reduced particle size, more wettability, and large surface area are obtained by the implementation of solid dispersion technique, hence improving carvedilol solubility and bioavailability.
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Affiliation(s)
- Lakshita Rao
- Department of Pharmaceutical Sciences, Gurugram University, Gurugram - 122018, Haryana, India
| | - Bigul Yogeshver Bhardwaj
- Institute of Pharmaceutical Sciences, Shoolini University, Solan - 173229, Himachal Pradesh, India
| | - Mahek Chugh
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak - 124001, Haryana, India
| | - Ashish Sharma
- Department of Pharmaceutical Sciences, Gurugram University, Gurugram - 122018, Haryana, India
| | - Rashmi Shah
- Department of Pharmaceutical Sciences, Maharshi Dayanand University, Rohtak - 124001, Haryana, India
| | - Neha Minocha
- Chitkara School of Pharmacy, Chitkara University, Baddi - 174103, Himachal Pradesh, India
| | - Parijat Pandey
- Department of Pharmaceutical Sciences, Gurugram University, Gurugram - 122018, Haryana, India
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Chen H, Zhang S, Hou R, Liu H. Gi-protein-coupled β 1-adrenergic receptor: re-understanding the selectivity of β 1-adrenergic receptor to G protein. Acta Biochim Biophys Sin (Shanghai) 2022; 54:1043-1048. [PMID: 35959878 PMCID: PMC9828293 DOI: 10.3724/abbs.2022096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
β 1-adrenergic receptor (β 1-AR), a member in the family of G-protein-coupled receptors, is a transmembrane receptor of great significance in the heart. Physiologically, catecholamines activate β 1-AR to initiate a positive chronotropic, inotropic, and dromotropic change. It is believed that β 1-AR couples to Gs protein and transmits the signal through second messenger cAMP. However, increasing research shows that β 1-AR can also bind with Gi protein in addition to Gs. When β 1-AR-Gi is biasedly activated, cardioprotective effects are introduced by the activated cGMP-protein kinase G (PKG) pathway and the transactivation of epidermal growth factor receptor (EGFR) pathway. The discovery of β 1-AR-Gi signaling makes us reconsider the selectivity of G protein with regard to β 1-AR, which also provides new ideas for the treatment of heart diseases. This review summarizes the discovery of β 1-AR-Gi pathway, including the evidence that supports β 1-AR's capability to couple Gi, details of the transduction process and functions of the β 1-AR-Gi signaling pathway.
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Affiliation(s)
- Hao Chen
- Department of Physiology & PathophysiologySchool of Basic Medical SciencesCapital Medical UniversityBeijing100069China
| | - Suli Zhang
- Department of Physiology & PathophysiologySchool of Basic Medical SciencesCapital Medical UniversityBeijing100069China,Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular DiseaseCapital Medical UniversityBeijing100069China
| | - Ruiqi Hou
- Department of Physiology & PathophysiologySchool of Basic Medical SciencesCapital Medical UniversityBeijing100069China
| | - Huirong Liu
- Department of Physiology & PathophysiologySchool of Basic Medical SciencesCapital Medical UniversityBeijing100069China,Beijing Key Laboratory of Metabolic Disorders Related Cardiovascular DiseaseCapital Medical UniversityBeijing100069China
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de Abreu ES, Nardelli MJ, Lima AMC, Cardoso JB, Osório FMF, Ferrari TCDA, Faria LC, Couto CA, Cançado GGL. Carvedilol as secondary prophylaxis for variceal bleeding in hepatosplenic schistosomiasis. Trans R Soc Trop Med Hyg 2022; 116:663-667. [DOI: 10.1093/trstmh/trab190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/24/2021] [Accepted: 12/21/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Upper variceal bleeding (UVB) is a possible complication of portal hypertension secondary to hepatosplenic schistosomiasis (HSS). Propranolol is a non-selective beta-blocker used as secondary prophylaxis for UVB, but no previous studies have addressed carvedilol effects in rebleeding prevention.
Methods
A retrospective exploratory study of 57 patients with chronic HSS and index UVB treated with endoscopic variceal ligation and propranolol or carvedilol was conducted. The primary outcome was UVB-free time in the first 12 mo after the initial bleeding episode.
Results
Propranolol was used for secondary UVB prophylaxis in 43 (75.4%) participants (median dose 80 [interquartile range – IQR 60–80] mg/d) and carvedilol in 14 (24.6%) participants (median dose 12.5 [IQR 7.9–25.0] mg/d). During a 12-mo follow-up, rebleeding was observed in 13 (22.8%) patients, 9 (20.9%) of those treated with propranolol and 4 (28.6%) treated with carvedilol (p=0.715). Mean time from the beginning of drug prophylaxis to rebleeding was 6±3 mo and there was no difference between that for propranolol vs carvedilol subgroups. Portal vein thrombosis did not influence the bleeding recurrence in either subgroup.
Conclusion
Carvedilol may be equally effective as propranolol in preventing secondary UVB in HSS at 12-mo follow-up.
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Affiliation(s)
- Eliabe Silva de Abreu
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Mateus Jorge Nardelli
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - André Mourão Costa Lima
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Jaqueline Brito Cardoso
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Fernanda Maria Farage Osório
- Instituto Alfa de Gastroenterologia , Avenida Professor Alfredo Balena, 110-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Teresa Cristina de Abreu Ferrari
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
- Instituto Alfa de Gastroenterologia , Avenida Professor Alfredo Balena, 110-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Luciana Costa Faria
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
- Instituto Alfa de Gastroenterologia , Avenida Professor Alfredo Balena, 110-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Cláudia Alves Couto
- Faculdade de Medicina da Universidade Federal de Minas Gerais , Avenida Professor Alfredo Balena, 190-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
- Instituto Alfa de Gastroenterologia , Avenida Professor Alfredo Balena, 110-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
| | - Guilherme Grossi Lopes Cançado
- Instituto Alfa de Gastroenterologia , Avenida Professor Alfredo Balena, 110-Santa Efigěnia, Belo Horizonte, Minas Gerais 30310-100, Brazil
- Hospital da Polícia Militar de Minas Gerais , Rua Pacífico Mascarenhas, s/n-Santa Efigěnia, Belo Horizonte, Minas Gerais 30110-013, Brazil
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Hamed R, Seder BY, Bardaweel SK, Qawass H. Lipid-based formulations of microemulsion-loaded oleogels for the oral delivery of carvedilol. J DISPER SCI TECHNOL 2021. [DOI: 10.1080/01932691.2021.1964987] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rania Hamed
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Bayan Yaser Seder
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sanaa K. Bardaweel
- Department of Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Hala Qawass
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
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Abstract
Cirrhosis is the fifth leading cause of death in adults. Advanced cirrhosis can cause significant portal hypertension (PH), which is responsible for many of the complications observed in patients with cirrhosis, such as varices. If portal pressure exceeds a certain threshold, the patient is at risk of developing life-threatening bleeding from varices. Variceal bleeding has a high incidence among patients with liver cirrhosis and carries a high risk of mortality and morbidity. The management of variceal bleeding is complex, often requiring a multidisciplinary approach involving pharmacological, endoscopic, and radiologic interventions. In terms of management, three stages can be considered: primary prophylaxis, active bleeding, and secondary prophylaxis. The main goal of primary and secondary prophylaxis is to prevent variceal bleeding. However, active variceal bleeding is a medical emergency that requires swift intervention to stop the bleeding and achieve durable hemostasis. We describe the pathophysiology of cirrhosis and PH to contextualize the formation of gastric and esophageal varices. We also discuss the currently available treatments and compare how they fare in each stage of clinical management, with a special focus on drugs that can prevent bleeding or assist in achieving hemostasis.
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Abd ElRahim AY, Fouad R, Khairy M, Elsharkawy A, Fathalah W, Khatamish H, Khorshid O, Moussa M, Seyam M. Efficacy of carvedilol versus propranolol versus variceal band ligation for primary prevention of variceal bleeding. Hepatol Int 2017; 12:75-82. [PMID: 29185106 DOI: 10.1007/s12072-017-9835-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/02/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Band ligation and propranolol are the current therapies for primary prevention of variceal bleeding. Carvedilol is a rising nonselective beta-blocker used for reducing portal pressure with favorable outcome. The aim of this study to assess the efficacy of carvedilol, propranolol, and band ligation for primary prevention of variceal bleeding based on the effect of each regimen on progression of Child score and portal hypertensive gastropathy after 1 year. METHODS The study included 264 cirrhotic patients with medium/large-sized varices who were candidates for primary prophylaxis of variceal bleeding. Patients were randomly divided into three groups: group I: band ligation; group II: propranolol; group III: carvedilol. RESULTS Group I showed higher success rate of 75 %, followed by group III with 70.2 % and group II with 65.2 %. Risk of bleeding was comparable between the three groups, with group II carrying the highest rate of complications (34.7 %) followed by group III (14.2 %) and finally group I (5.7 %). After 1 year of follow-up, Child score did not improve in any of the studied groups, while portal hypertensive gastropathy significantly increased in group I but decreased in groups II and III. CONCLUSIONS Band ligation is the best treatment option for primary prevention of variceal bleeding with minimal complications. Carvedilol is a good pharmaceutical alternative medicine to propranolol with lesser side-effects. Progress of liver disease as represented by Child score is not affected by any of the primary variceal prophylactic regimens, although medical treatment reduces portal hypertensive gastropathy. Choice of treatment depends on patient will, compliance with treatment, and endoscopist competence.
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Affiliation(s)
- Ayman Yosry Abd ElRahim
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rabab Fouad
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marwa Khairy
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aisha Elsharkawy
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Waleed Fathalah
- Endemic Medicine Department and Hepatology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Haytham Khatamish
- Tropical Medicine Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Omayma Khorshid
- Pharmacology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Moussa
- Pathology Department, Theodor Bilharz Research Institute, Giza, Egypt
| | - Moataz Seyam
- Tropical Medicine Department, Theodor Bilharz Research Institute, Giza, Egypt
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Burza MA, Marschall HU, Napoleone L, Molinaro A. The 35-year odyssey of beta blockers in cirrhosis: any gender difference in sight? Pharmacol Res 2017; 119:20-26. [PMID: 28099882 DOI: 10.1016/j.phrs.2017.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2016] [Revised: 12/15/2016] [Accepted: 01/13/2017] [Indexed: 12/11/2022]
Abstract
Cirrhosis is the end-stage of chronic liver disease and leads to the development of portal hypertension and its complications such as esophagogastric varices. Non-selective beta blockers (NSBB) are the keystone for the treatment of portal hypertension since the 1980s and, over the decades, several studies have confirmed their beneficial effect on the prevention of variceal (re)bleeding. Pharmacological studies showed effects of gender, sex hormones, oral contraceptives, and pregnancy on cytochrome P450 (CYPs) enzymes that metabolise NSBB, suggesting that gender differences might exist in the effect of NSBB. In this review, we focused on the 35-year knowledge about the use of beta blockers in cirrhosis and potential gender differences. We specifically examined the role of NSBB in pre-primary, primary and secondary prophylaxis of variceal bleeding, compared two commonly used NSBB (i.e., Propranolol and Carvedilol), and present the current controversies about the window of treatment in advanced cirrhosis with a specific focus on gender differences in NSBB effects. NSBB are not currently recommended in pre-primary prophylaxis of varices mainly because of lack of proven efficacy. On the other hand, NSBB are strongly recommended in patient with cirrhosis as primary (as alternative to endoscopic band ligation, EBL) and secondary prophylaxis (in addition to EBL) of variceal bleeding. To date, no studies have focused specifically on the effect of gender on NSBB treatment. Data extrapolated from clinical studies show that gender was neither a risk factor for the development of varices nor associated with a different response to treatment in primary or secondary prophylaxis. According to the available guidelines, no different, gender-based treatment for portal hypertension is recommended.
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Affiliation(s)
- Maria Antonella Burza
- Department of Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hanns-Ulrich Marschall
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Laura Napoleone
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Antonio Molinaro
- Department of Molecular and Clinical Medicine, Wallenberg Laboratory, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Yoshihara D, Kugita M, Sasaki M, Horie S, Nakanishi K, Abe T, Aukema HM, Yamaguchi T, Nagao S. Telmisartan ameliorates fibrocystic liver disease in an orthologous rat model of human autosomal recessive polycystic kidney disease. PLoS One 2013; 8:e81480. [PMID: 24324698 PMCID: PMC3855683 DOI: 10.1371/journal.pone.0081480] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/19/2013] [Indexed: 01/13/2023] Open
Abstract
Human autosomal recessive polycystic kidney disease (ARPKD) produces kidneys which are massively enlarged due to multiple cysts, hypertension, and congenital hepatic fibrosis characterized by dilated bile ducts and portal hypertension. The PCK rat is an orthologous model of human ARPKD with numerous fluid-filled cysts caused by stimulated cellular proliferation in the renal tubules and hepatic bile duct epithelia, with interstitial fibrosis developed in the liver. We previously reported that a peroxisome proliferator activated receptor (PPAR)-γ full agonist ameliorated kidney and liver disease in PCK rats. Telmisartan is an angiotensin receptor blocker (ARB) used widely as an antihypertensive drug and shows partial PPAR-γ agonist activity. It also has nephroprotective activity in diabetes and renal injury and prevents the effects of drug-induced hepatotoxicity and hepatic fibrosis. In the present study, we determined whether telmisartan ameliorates progression of polycystic kidney and fibrocystic liver disease in PCK rats. Five male and 5 female PCK and normal control (+/+) rats were orally administered 3 mg/kg telmisartan or vehicle every day from 4 to 20 weeks of age. Treatment with telmisartan decreased blood pressure in both PCK and +/+ rats. Blood levels of aspartate amino transferase, alanine amino transferase and urea nitrogen were unaffected by telmisartan treatment. There was no effect on kidney disease progression, but liver weight relative to body weight, liver cystic area, hepatic fibrosis index, expression levels of Ki67 and TGF-β, and the number of Ki67- and TGF-β-positive interstitial cells in the liver were significantly decreased in telmisartan-treated PCK rats. Therefore, telmisartan ameliorates congenital hepatic fibrosis in ARPKD, possibly through the inhibition of signaling cascades responsible for cellular proliferation and interstitial fibrosis in PCK rats. The present results support the potential therapeutic use of ARBs for the treatment of fibrocystic liver disease in ARPKD patients.
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Affiliation(s)
- Daisuke Yoshihara
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Masanori Kugita
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Mai Sasaki
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
| | - Shigeo Horie
- Department of Urology, Juntendo University, Graduate School of Medicine, Bunkyou, Tokyo, Japan
| | - Koichi Nakanishi
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Wakayama, Japan
| | - Takaaki Abe
- Division of Medical Science, Tohoku University Graduate School of Biomedical Engineering, Sendai, Miyagi, Japan
| | - Harold M. Aukema
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tamio Yamaguchi
- Department of Human Nutritional Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shizuko Nagao
- Education and Research Center of Animal Models for Human Diseases, Fujita Health University, Toyoake, Aichi, Japan
- * E-mail:
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Arias N, Méndez M, Arias J, Arias JL. Brain metabolism and spatial memory are affected by portal hypertension. Metab Brain Dis 2012; 27:183-91. [PMID: 22314871 DOI: 10.1007/s11011-012-9276-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 01/19/2012] [Indexed: 11/24/2022]
Abstract
Portal hypertension is a major complication of cirrhosis that frequently leads to a neuropsychiatric disorder that affects cognition. The present study was undertaken in order to compare the performance of sham-operated rats (SHAM) and portal hypertension rats (PH) in reference memory tasks in the Morris water maze (MWM). Two groups of animals were used: SHAM group (n=12) was used as a control group and PH group (n=12) by the triple portal vein ligation method was used as an animal model of early evolutive phase of PH. The portal pressure was measured in the splenic parenchyma. Our work shows that spatial learning in the MWM is not impaired in PH group although this group showed a one-day delay in the task acquisition compared to the SHAM group. We assessed the brain metabolic activity of the animals by means of cytochrome c-oxidase (COx) histochemistry. Significant changes were found in the CA3, dentate gyrus, basolateral, medial, lateral and central amygdala, showing lower COx activity in the PH group as compared to the SHAM group in all cases. We found no changes in metabolic activity in prefrontal cortex and CA1 area between groups. In fact, different neural networks were shown according to the execution level of the subjects. The early PH evolution induced changes in brain metabolic activity without biggest alterations in spatial memory.
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Affiliation(s)
- Natalia Arias
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Asturias, Spain
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