Characterization of Parkinson's disease using blood-based biomarkers: A multicohort proteomic analysis

BACKGROUND

Parkinson's disease (PD) is a progressive neurodegenerative disease affecting about 5 million people worldwide with no disease-modifying therapies. We sought blood-based biomarkers in order to provide molecular characterization of individuals with PD for diagnostic confirmation and prediction of progression.

METHODS AND FINDINGS

In 141 plasma samples (96 PD, 45 neurologically normal control [NC] individuals; 45.4% female, mean age 70.0 years) from a longitudinally followed Discovery Cohort based at the University of Pennsylvania (UPenn), we measured levels of 1,129 proteins using an aptamer-based platform. We modeled protein plasma concentration (log10 of relative fluorescence units [RFUs]) as the effect of treatment group (PD versus NC), age at plasma collection, sex, and the levodopa equivalent daily dose (LEDD), deriving first-pass candidate protein biomarkers based on p-value for PD versus NC. These candidate proteins were then ranked by Stability Selection. We confirmed findings from our Discovery Cohort in a Replication Cohort of 317 individuals (215 PD, 102 NC; 47.9% female, mean age 66.7 years) from the multisite, longitudinally followed National Institute of Neurological Disorders and Stroke Parkinson's Disease Biomarker Program (PDBP) Cohort. Analytical approach in the Replication Cohort mirrored the approach in the Discovery Cohort: each protein plasma concentration (log10 of RFU) was modeled as the effect of group (PD versus NC), age at plasma collection, sex, clinical site, and batch. Of the top 10 proteins from the Discovery Cohort ranked by Stability Selection, four associations were replicated in the Replication Cohort. These blood-based biomarkers were bone sialoprotein (BSP, Discovery false discovery rate [FDR]-corrected p = 2.82 × 10-2, Replication FDR-corrected p = 1.03 × 10-4), osteomodulin (OMD, Discovery FDR-corrected p = 2.14 × 10-2, Replication FDR-corrected p = 9.14 × 10-5), aminoacylase-1 (ACY1, Discovery FDR-corrected p = 1.86 × 10-3, Replication FDR-corrected p = 2.18 × 10-2), and growth hormone receptor (GHR, Discovery FDR-corrected p = 3.49 × 10-4, Replication FDR-corrected p = 2.97 × 10-3). Measures of these proteins were not significantly affected by differences in sample handling, and they did not change comparing plasma samples from 10 PD participants sampled both on versus off dopaminergic medication. Plasma measures of OMD, ACY1, and GHR differed in PD versus NC but did not differ between individuals with amyotrophic lateral sclerosis (ALS, n = 59) versus NC. In the Discovery Cohort, individuals with baseline levels of GHR and ACY1 in the lowest tertile were more likely to progress to mild cognitive impairment (MCI) or dementia in Cox proportional hazards analyses adjusting for age, sex, and disease duration (hazard ratio [HR] 2.27 [95% CI 1.04-5.0, p = 0.04] for GHR, and HR 3.0 [95% CI 1.24-7.0, p = 0.014] for ACY1). GHR's association with cognitive decline was confirmed in the Replication Cohort (HR 3.6 [95% CI 1.20-11.1, p = 0.02]). The main limitations of this study were its reliance on the aptamer-based platform for protein measurement and limited follow-up time available for some cohorts.

CONCLUSIONS

In this study, we found that the blood-based biomarkers BSP, OMD, ACY1, and GHR robustly associated with PD across multiple clinical sites. Our findings suggest that biomarkers based on a peripheral blood sample may be developed for both disease characterization and prediction of future disease progression in PD.

Plasma EGF and cognitive decline in Parkinson's disease and Alzheimer's disease

Objective

Cognitive decline occurs in multiple neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD). Shared underlying mechanisms may exist and manifest as shared biomarker signatures. Previously, we nominated plasma epidermal growth factor (EGF) as a biomarker predicting cognitive decline in patients with established PD. Here, we investigate EGF as a predictive biomarker in prodromal PD, as well as AD.

Methods

A cohort of PD patients (n = 236) was recruited to replicate our finding that low baseline EGF levels predict future cognitive decline. Additionally, plasma EGF and cognitive outcome measures were obtained from individuals with normal cognition (NC, n = 58), amnestic mild cognitive impairment (AD‐MCI, n = 396), and Alzheimer's disease (AD, n = 112) in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort to investigate whether low EGF levels correlate with cognitive status and outcome in AD‐MCI and AD. Third, plasma EGF and cognitive measures were evaluated in the high‐risk asymptomatic Parkinson's Associated Risk Study (PARS) cohort (n = 165) to investigate the association of EGF and cognitive performance in a PD prodromal context.

Results

In both PD and AD‐MCI, low baseline plasma EGF predicted poorer long‐term cognitive outcomes. In asymptomatic individuals at highest risk for developing PD from the PARS cohort, low baseline plasma EGF associated with poorer performance in the visuospatial domain but not in other cognitive domains.

Interpretation

Low plasma EGF at baseline predicts cognitive decline in both AD and PD. Evidence for this signal may exist in prodromal stages of both diseases.

Plasma apolipoprotein A1 associates with age at onset and motor severity in early Parkinson's disease patients

BACKGROUND

Development of robust plasma-based biomarkers in Parkinson's disease (PD) could lead to new approaches for identifying those at risk for PD and developing novel therapies. Here, we validate plasma apolipoprotein A1 (ApoA1) as a correlate of age at onset and motor severity in PD.

METHODS

Plasma ApoA1 and high-density lipoprotein at baseline, 6 months, and 12 months were measured in 254 research volunteers (154 patients with PD and 100 normal controls) enrolled in the Parkinson's Progression Markers Initiative (PPMI) study.

RESULTS

Lower baseline plasma ApoA1 levels associate with an earlier age at PD onset in early-stage, drug-naïve PPMI PD patients (P = 0.023). Moreover, lower baseline ApoA1 levels trend toward association with worse motor severity in PPMI PD patients (p = 0.080). Over 12 months of follow-up, plasma ApoA1 levels do not predict motor decline in the PPMI PD cohort. Finally, a meta-analysis of five PD cohorts encompassing >1,000 patients confirms significant association of lower plasma ApoA1 with earlier age at PD onset (P < 0.001) and greater motor severity (P < 0.001).

CONCLUSIONS

Our results confirm the previously reported association of lower plasma ApoA1 levels with two clinical features suggesting poorer dopaminergic system integrity-earlier age at PD onset and greater motor severity-in early-stage, drug-naïve PD patients. This is the first report of a plasma-based biomarker evaluated in the PPMI study. Future investigations are warranted evaluating plasma ApoA1 as a longitudinal correlate of disease progression as well as investigating the potential of ApoA1 as a therapeutic target in PD.

Lower plasma apolipoprotein A1 levels are found in Parkinson's disease and associate with apolipoprotein A1 genotype

The discovery of novel plasma-based biomarkers could lead to new approaches in the treatment of Parkinson's disease (PD). Here, we explore the role of plasma apolipoprotein A1 (ApoA1) as a risk marker for PD and evaluate the influence of APOA1 promoter variation on plasma ApoA1 levels. Plasma ApoA1 and the single-nucleotide polymorphism, rs670, were assayed in a discovery cohort (cohort 1) of 301 PD patients, 80 normal controls (NCs), and 165 subjects with other neurodegenerative diseases, as well as a cohort (cohort 2) of 158 PD patients from a second clinical site. Additionally, rs670 was genotyped in a third cohort of 1,494 PD and 925 NC subjects from both clinical sites. Compared to both normal and disease controls, PD patients have lower plasma ApoA1 (P < 0.001 for both comparisons). Moreover, in PD patients, plasma ApoA1 levels are correlated with genotype at the APOA1 promoter polymorphism, rs670. Specifically, lower plasma ApoA1 levels were found in rs670 major allele (G) homozygotes in both cohort 1 (P = 0.009) and in a replication cohort (cohort 2; n = 158 PD patients; P = 0.024). Finally, evaluating rs670 genotype frequencies in 1,930 PD cases versus 997 NCs, the rs670 GG genotype shows a trend toward association (odds ratio: 1.1; P = 0.10) with PD. Our results are compatible with a model whereby circulating ApoA1 levels may be useful in risk-stratifying subjects for the development of PD, with higher ApoA1 levels suggesting relative protection. Future studies evaluating modulation of ApoA1 as a novel therapeutic strategy in PD are warranted. © 2014 International Parkinson and Movement Disorder Society.

Titer and product affect the distribution of gene expression after intraputaminal convection-enhanced delivery

BACKGROUND

The efficacy and safety of intracerebral gene therapy for brain disorders like Parkinson's disease depends on the appropriate distribution of gene expression.

OBJECTIVES

To assess whether the distribution of gene expression is affected by vector titer and protein type.

METHODS

Four adult macaque monkeys seronegative for adeno-associated virus 5 (AAV5) received a 30-µl inoculation of a high- or a low-titer suspension of AAV5 encoding glial cell line-derived neurotrophic factor (GDNF) or green fluorescent protein (GFP) in the right and left ventral postcommissural putamen. The inoculations were conducted using convection-enhanced delivery and intraoperative MRI (IMRI).

RESULTS

IMRI confirmed targeting and infusion cloud irradiation from the catheter tip into the surrounding area. A postmortem analysis 6 weeks after surgery revealed GFP and GDNF expression ipsilateral to the injection site that had a titer-dependent distribution. GFP and GDNF expression was also observed in fibers in the substantia nigra (SN) pars reticulata (pr), demonstrating anterograde transport. Few GFP-positive neurons were present in the SN pars compacta (pc), possibly by direct retrograde transport of the vector. GDNF was present in many neurons of the SNpc and SNpr.

CONCLUSIONS

After controlling for target and infusate volume, the intracerebral distribution of the gene product was affected by the vector titer and product biology.

A monoclonal antibody-GDNF fusion protein is not neuroprotective and is associated with proliferative pancreatic lesions in parkinsonian monkeys

Glial cell line derived neurotrophic factor (GDNF) is a neurotrophic factor that has neuroprotective effects in animal models of Parkinson’s disease (PD) and has been proposed as a PD therapy. GDNF does not cross the blood brain barrier (BBB), and requires direct intracerebral delivery to be effective. Trojan horse technology, in which GDNF is coupled to a monoclonal antibody (mAb) against the human insulin receptor (HIR), has been proposed to allow GDNF BBB transport (ArmaGen Technologies Inc.). In this study we tested the feasibility of HIRMAb-GDNF to induce neuroprotection in parkinsonian monkeys, as well as its tolerability and safety. Adult rhesus macaques were assessed throughout the study with a clinical rating scale, a computerized fine motor skills task and general health evaluations. Following baseline measurements, the animals received a unilateral intracarotid artery MPTP injection. Seven days later the animals were evaluated, matched according to disability and blindly assigned to receive twice a week iv. treatments (vehicle, 1 or 5 mg/kg HIRmAb-GDNF) for a period of three months. HIRmAb-GDNF did not improve parkinsonian motor symptoms and induced a dose-dependent hypersensitivity reaction. Quantification of dopaminergic striatal optical density and stereological nigral cell counts did not demonstrate differences between treatment groups. Focal pancreatic acinar to ductular metaplasia (ADM) was noted in four of seven animals treated with 1 mg/kg HIRmAb-GDNF; two of four with ADM also had focal pancreatic intraepithelial neoplasia 1B (PanIN-1B) lesions. Minimal to mild, focal to multifocal, nonsuppurative myocarditis was noted in all animals in the 5 mg/kg treatment group. Our results demonstrate that HIRmAb-GDNF dosing in a monkey model of PD is not an effective neuroprotective strategy and may present serious health risks that should be considered when planning future use of the IR antibody as a carrier, or of any systemic treatment of a GDNF-containing molecule.

The PPAR-γ agonist pioglitazone modulates inflammation and induces neuroprotection in parkinsonian monkeys

BACKGROUND

Activation of the peroxisome proliferator-activated receptor gamma (PPAR-γ) has been proposed as a possible neuroprotective strategy to slow down the progression of early Parkinson's disease (PD). Here we report preclinical data on the use of the PPAR-γ agonist pioglitazone (Actos®; Takeda Pharmaceuticals Ltd.) in a paradigm resembling early PD in nonhuman primates.

METHODS

Rhesus monkeys that were trained to perform a battery of behavioral tests received a single intracarotid arterial injection of 20 ml of saline containing 3 mg of the dopaminergic neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Twenty-four hours later the monkeys were assessed using a clinical rating scale, matched accordingly to disability, randomly assigned to one of three groups [placebo (n = 5), 2.5 (n = 6) or 5 (n = 5) mg/kg of pioglitazone] and their treatments started. Three months after daily oral dosing, the animals were necropsied.

RESULTS

We observed significant improvements in clinical rating score (P = 0.02) in the animals treated with 5 mg/kg compared to placebo. Behavioral recovery was associated with preservation of nigrostriatal dopaminergic markers, observed as higher tyrosine hydroxylase (TH) putaminal optical density (P = 0.011), higher stereological cell counts of TH-ir (P = 0.02) and vesicular monoamine transporter-2 (VMAT-2)-ir nigral neurons (P = 0.006). Stereological cell counts of Nissl stained nigral neurons confirmed neuroprotection (P = 0.017). Pioglitazone-treated monkeys also showed a dose-dependent modulation of CD68-ir inflammatory cells, that was significantly decreased for 5 mg/kg treated animals compared to placebo (P = 0.018). A separate experiment to assess CSF penetration of pioglitazone revealed that 5 mg/kg p.o. induced consistently higher levels than 2.5 mg/kg and 7.5 mg/kg. p.o.

CONCLUSIONS

Our results indicate that oral administration of pioglitazone is neuroprotective when administered early after inducing a parkinsonian syndrome in rhesus monkeys and supports the concept that PPAR-γ is a viable target against neurodegeneration.

Can we prevent parkinson's disease?

Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects 1 million people in the United States. Although the cause of PD remains unknown, a number of factors that increase the risk of developing this disease have been identified. Other factors that may prevent or slow down PD development and progression have also been found. In this review, we describe current basic, clinical and epidemiological findings on risk and neuroprotective factors and discuss how they can affect PD.

Comparative efficacy of tricaine methanesulfonate and clove oil for use as anesthetics in red pacu (Piaractus brachypomus)

OBJECTIVE

To compare the anesthetic efficacy and physiologic changes associated with exposure to tricaine methanesulfonate and clove oil (100% eugenol).

ANIMALS

15 adult cultured red pacu (Piaractus brachypomus).

PROCEDURE

Fish were exposed to each of 6 anesthetic concentrations in a within-subjects complete crossover design. Stages of anesthesia and recovery were measured, and physiologic data were collected before and during anesthesia.

RESULTS

Interval to induction was more rapid and recovery more prolonged in fish exposed to eugenol, compared with those exposed to tricaine methanesulfonate. The margin of safety for eugenol was narrow, because at the highest concentration, most fish required resuscitation. Mixed venous-arterial PO2 consistently decreased with anesthesia, while PCO2 consistently increased with anesthesia in all fish regardless of anesthetic agent. The increase in PCO2 was accompanied by a decrease in pH, presumably secondary to respiratory acidosis. Anesthesia was associated with increased blood glucose, potassium, and sodium concentrations as well as Hct and hemoglobin. Fish anesthetized with eugenol were more likely to react to a hypodermic needle puncture than fish anesthetized with tricaine methanesulfonate.

CONCLUSIONS AND CLINICAL RELEVANCE

Anesthesia induced with tricaine methanesulfonate or eugenol contributes to hypoxemia, hypercapnia, respiratory acidosis, and hyperglycemia in red pacu. Similar to tricaine methanesulfonate, eugenol appears to be an effective immobilization compound, but eugenol is characterized by more rapid induction, prolonged recovery, and a narrow margin of safety. Care must be taken when using high concentrations of eugenol for induction, because ventilatory failure may occur rapidly. In addition, analgesic properties of eugenol are unknown.

Respiratory depressant and skeletal muscle relaxant effects of low-dose pancuronium bromide in spontaneously breathing, isoflurane-anesthetized dogs

OBJECTIVE

To assess and compare the respiratory depressant and skeletal muscle relaxant effects of two low doses of a nondepolarizing neuromuscular blocker, pancuronium bromide. To determine if a "low dose" of pancuronium bromide can produce selective skeletal muscle relaxation in extraocular muscles sufficient to perform intraocular surgery while sparing or minimizing depression of muscles of ventilation.

STUDY DESIGN

Blinded, randomized crossover, placebo controlled study.

ANIMALS

Six healthy, adult mongrel dogs weighing 20.8 +/- 1.9 kg.

METHODS

Spontaneously breathing, isoflurane-anesthetized dogs received 0.02 mg/kg pancuronium bromide, intravenously (i.v.), (high dose [HD]), 0.01 mg/kg pancuronium bromide, i.v., (low dose [LD]), or saline placebo i.v. in a blinded, randomized crossover study. Indices of patient ventilation including tidal volume (Vt), respiratory rate (RR), and minute ventilation (VE) were recorded throughout the study period. Serial arterial blood gas analyses were performed at timed intervals. Neuromuscular blockade of skeletal muscle was assessed at timed intervals with train-of-four stimulus/response ratios. Eye position scores, based on the degree of ocular rotation from a neutral gaze axis, were assigned by an ophthalmologist who was blinded to the treatment given.

RESULTS

VT and VE in HD dogs decreased by 82% from baseline after administration of pancuronium bromide. Similarly, Vt and VE in LD dogs decreased 40% and 55%, respectively. Decreased ventilation in HD dogs corresponded with significant (P< .05) neuromuscular blockade, as indicated by train-of-four ratio less than 75% between 0 and 60 minutes. Eye position scores in HD and LD dogs were suitable for intraocular surgery between 0 and 60 minutes. Eye position scores in five of six control dogs were unsuitable for intraocular surgery at any time period.

CONCLUSIONS

LD dogs experienced only transient, mild to moderate respiratory depression compared with HD dogs, which experienced prolonged, moderate to severe respiratory depression. Both LD and HD dogs acquired and maintained eye position scores suitable for intraocular surgery between 0 to 60 minutes. A "low dose" of pancuronium bromide, which would provide adequate extraocular muscle relaxation while minimizing ventilatory depression, was not identified.

CLINICAL RELEVANCE

All patients receiving any dose of neuromuscular blocking agents should be closely monitored and receive ventilatory assistance as needed.

General principles of anesthesia and sedation in food animals

Minimal-risk anesthesia practice demands that fundamental physiologic and pharmacologic principles be applied to the specific medical and surgical needs of individual patients. In developing an anesthesia plan for a patient, health status must be assessed and considered along with other extrinsic factors such as the physical setting in which the anesthetic procedure will be performed, the availability of equipment and supplies, and the academic and technical training and abilities of participating personnel. This article reviews considerations for developing anesthesia protocols for ruminant and swine species.

Effects of clenbuterol hydrochloride on pulmonary gas exchange and hemodynamics in anesthetized horses

We evaluated the effects of clenbuterol HCl (0.8 micrograms/kg, of body weight, IV), a beta 2 agonist, on ventilation-perfusion matching and hemodynamic variables in anesthetized (by IV route), laterally recumbent horses. The multiple inert gas elimination technique was used to assess pulmonary gas exchange. Clenbuterol HCl induced a decrease in arterial oxygen tension (from 57.0 +/- 1.8 to 49.3 +/- 1.2 mm of Hg; mean +/- SEM) as a result of increased shunt fraction (from 6.6 +/- 2.1 to 14.4 +/- 3.1%) and ventilation to regions with high ventilation-perfusion ratios. In contrast, no changes in these variables were found in horses given sterile water. In horses given clenbuterol HCl, O2 consumption increased from 2.23 +/- 0.18 to 2.70 +/- 0.14 ml.min-1.kg-1, and respiratory exchange ratio decreased from 0.80 +/- 0.02 to 0.72 +/- 0.01. Respiratory exchange ratio and O2 consumption were not significantly modified in sterile water-treated (control) horses. Clenbuterol HCl administration was associated with increased cardiac index (from 57.4 +/- 4.0 to 84.2 +/- 6.3 ml.min-1.kg-1), decreased total peripheral vascular resistance (from 108.3 +/- 9.3 to 47.6 +/- 2.8 mm of Hg.s.kg.ml-1), and decreased pulmonary vascular resistance (from 31.3 +/- 3.8 to 13.6 +/- 0.7 mm of Hg.s.kg.ml-1). Our findings indicated that clenbuterol HCl may potentiate hypoxemia as a result of increased shunt fraction in horses anesthetized by the IV route, and caused changes in hemodynamic variables that were consistent with its ability to stimulate beta 2-adrenergic receptors.

Parasympathetic influence on the arrhythmogenicity of graded dobutamine infusions in halothane-anesthetized horses

We investigated the influence of parasympathetic tone on the arrhythmogenicity of graded dobutamine infusions in horses anesthetized under clinical conditions. Six horses were used in 9 trials. Two consecutive series of graded dobutamine infusions were given IV; each continuous graded dobutamine infusion was administered for 20 minutes. The dobutamine infusion dosage (5, 10, 15, and 20 micrograms/kg of body weight/min) was increased at 5-minute intervals. Isovolumetric saline solution vehicle (v) or atropine (A; 0.04 mg/kg) was administered IV, or bilateral vagotomy (VG) was performed as a treatment before the second series of dobutamine infusions. Treatment was not administered prior to the first dobutamine infusion. Significant interaction between treatment and dosage of dobutamine infusion existed for differences from baseline for mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, heart rate, and cardiac index at dosages of 5 and 10 micrograms of dobutamine/kg/min, given IV and for heart rate at dosage of 15 micrograms of dobutamine/kg/min, given IV. Results for group-V horses were different from those for group-A and group-VG horses, but were not different between group-A and group-VG horses in all aforementioned cases, except for heart rate and cardiac index at dosage of 5 micrograms of dobutamine/kg/min, given IV. Normal sinus rhythm, second-degree atrioventricular block, and bradyarrhythmias predominated during low dobutamine infusion rates during the first infusion series (nontreated horses) and in group-V horses during the second infusion series. Only tachyarrhythmias were observed during the second infusion series in the horses of the A and VG groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Duration of etomidate-induced adrenocortical suppression during surgery in dogs

Plasma cortisol concentrations were compared in canine surgical patients given etomidate (2 mg/kg of body weight, IV) or thiopental sodium (12 mg/kg, IV) for anesthetic induction. Blood samples to determine plasma concentrations of etomidate were obtained at 0, 5, 10, 15, and 30 minutes and 1, 2, 3, 4, 5, 6, 8, 12, and 24 hours after induction. Adrenocortical function was evaluated before surgery by use of adrenocorticotropic hormone stimulation tests. Dogs in both induction groups had high plasma cortisol concentrations after induction. Dogs given thiopental had a significant increase (P less than 0.05) in plasma cortisol concentration from baseline at 2, 3, 4, 5, 6, 8, and 12 hours after induction. Dogs given etomidate had a significant increase (P less than 0.05) in plasma cortisol concentration from baseline at 5, 6, and 8 hours after induction. A comparison of plasma cortisol concentrations determined at 2, 3, 4, 5, and 6 hours after induction with thiopental or etomidate revealed a higher (P less than 0.05) concentration in dogs given thiopental. The disposition of etomidate was best described by a 2-compartment model, with a redistribution half-life of 0.12 +/- 0.04 minute and a terminal half-life of 1.70 +/- 0.27 minute. Plasma cortisol concentrations did not correlate with plasma etomidate concentrations. We conclude that, compared with thiopental, a single bolus injection of etomidate reduces the adrenocortical response to anesthesia and surgery from 2 to 6 hours after induction. Because cortisol concentrations were significantly higher than baseline, and because cardiopulmonary function is maintained after a single bolus injection of etomidate, it can be considered a safe induction agent in dogs.

Heart rate spectral analysis of fasting-induced bradycardia of cattle

The autonomic mechanisms of fasting-induced bradycardia of cattle were studied using heart rate spectral analysis. This was performed on digitized, lead II, surface electrocardiograms from conscious, fed, and 48-h-fasted adult cows. Fasting resulted in a significant (P less than 0.05) decrease in resting heart rate and a significant (P = 0.0041) increase in low frequency (0-90 mHz) power spectral area. Administration of atropine sulfate (0.02 mg/kg iv) in either the fed or fasted state resulted in a significant (P less than 0.001) decrease in both low-frequency and high-frequency (100-400 mHz) power spectral areas. Significant (P less than 0.05) increases in serum total bilirubin, inorganic phosphorus, and total protein were associated with fasting. Significant decreases were seen in fasting serum aspartate aminotransferase and potassium values. Manual evacuation of the rumen of seven steers with chronic rumen fistulae resulted in a mean percent decrease in heart rate of 22 +/- 0.9% (mean +/- SE). These results indicate that in normal cattle a decrease in ruminorecticular fill results in a reflex slowing of the heart rate, due predominantly to an increase in parasympathetic tone.

Simultaneous evaluation of left ventricular end-systolic pressure-volume ratio and time constant of isovolumic pressure decline in dogs exposed to equivalent MAC halothane and isoflurane

The effects of 1.5, 2.0, and 2.5 MAC halothane (N = 8) and isoflurane (N = 6) upon systolic performance and isovolumic relaxation were evaluated in open chest dogs. Left ventricular internal volume was determined using piezoelectric crystals. Left ventricular end-systolic pressure-volume points were determined for a series of normal sinus beats during transient venae caval occlusions. The slope of the line formed by those points is a load-independent inotropic index (EES). Left ventricular pressure points during isovolumic relaxation were plotted for computing the time constant of isovolumic pressure decline (T). Both drugs dose-dependently decreased mean arterial blood pressure with no change in heart rate, end-diastolic pressure, or end-diastolic volume. Increasing halothane concentration decreased the values of EES, the maximum rate of rise of left ventricular pressure (dP/dtMAX), and systolic ejection fraction (SEF). Total systemic resistance was unchanged by halothane. Increasing isoflurane concentration decreased EES and dP/dtMAX. The EES was significantly larger (P less than 0.05) with 2.5 MAC isoflurane than 2.5 MAC halothane. The SEF was unchanged by increasing isoflurane. Total systemic vascular resistance was decreased by increasing isoflurane. Isovolumic relaxation was prolonged and became more load-dependent with increasing halothane concentration. Isoflurane did not alter T, but the load-dependency of T was increased by 2.5 MAC isoflurane. There were no differences in T or its load-dependency between drug groups. These results indicate that both anesthetics evoke load-independent negative inotropic effects. Systolic ejection fraction is maintained during isoflurane anesthesia by decreased systemic vascular resistance and less pronounced negative inotropic effects than equivalent MAC halothane.(ABSTRACT TRUNCATED AT 250 WORDS)

Hemodynamic and respiratory responses in halothane-anesthetized horses exposed to positive end-expiratory pressure alone and with dobutamine

The influence of positive end-expiratory pressure (PEEP) on the alveolar-arterial O2 tension difference [P(A-a)O2], physiologic right-to-left shunt fraction, physiologic dead space-to-tidal volume ratio, and hemodynamic variables was studied in halothane-anesthetized horses maintained in dorsal recumbency during controlled ventilation. Dobutamine was used to minimize the adverse cardiovascular consequences of PEEP. Six adult horses were anesthetized, using xylazine (2.2 mg/kg of body weight, IM), guaifenesin (50 mg/kg, IV), thiamylal Na (4.4 mg/kg, IV), and halothane (1.5 to 2% inspired) in 100% O2. Mechanical ventilation was controlled to maintain arterial eucapnia for at least 45 minutes during base-line measurements. Hemodynamic and respiratory variables were determined every 15 minutes during equilibration. Each horse was subjected to 4 randomized treatments: 5 cm of H2O PEEP, 10 cm of H2O PEEP, 5 cm of H2O PEEP plus dobutamine (1 microgram/kg/min), and 10 cm of H2O PEEP plus dobutamine (1 microgram/kg/min). Each treatment lasted 15 minutes and immediately followed its predecessor. Although the magnitude of PEEP was randomized with and without dobutamine, PEEP without dobutamine always preceded PEEP with dobutamine. Differences in hemodynamic or respiratory variables among base-line measurements, 5 cm of H2O PEEP, or 10 cm of H2O PEEP were not significant (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of etomidate on adrenocortical function in canine surgical patients

Adrenocortical function in canine surgical patients given etomidate at 1 of 2 dosages (1.5 mg/kg of body weight or 3 mg/kg, IV) was evaluated and compared with that of dogs given thiopental (12 mg/kg, IV). The adrenocortical function was evaluated by use of adrenocorticotropic hormone (ACTH) stimulation tests and determination of plasma cortisol concentrations at 0 minute (base line) and 60 minutes after ACTH administration. At 24 hours before administration of either drug (ie, induction of anesthesia), each dog had an increase in plasma cortisol concentration when given ACTH. The ACTH stimulation tests were repeated 2 hours after induction of anesthesia. Dogs given thiopental had base-line plasma cortisol concentrations greater than preinduction base-line values, but did not increase plasma cortisol in response to ACTH stimulation. Postinduction ACTH stimulation tests in dogs given etomidate at either dose indicated base-line and 60-minute plasma cortisol concentrations that were not different from preinduction base-line values. Therefore, adrenocortical function was suppressed 2 and 3 hours after the administration of etomidate in canine surgical patients.

Dobutamine-induced augmentation of cardiac output does not enhance respiratory gas exchange in anesthetized recumbent healthy horses

The influence of pharmacologic enhancement of cardiac output on the alveolar-to-arterial oxygen tension (difference (P[A-a]O2), physiologic right-to-left shunt fraction (Qs/Qt), and physiologic dead space-to-tidal volume ratio (VD/VT) ws studied in halothane-anesthetized horses in left lateral, right lateral, and dorsal recumbencies. Adult horses were anesthetized, using xylazine (2.2 mg/kg, IM), guaifenesin (50 mg/kg, IV), thiamylal (4.4 mg/kg, IV), and halothane (1.5% to 2% inspired) in 100% O2. Mechanical ventilation was controlled to maintain arterial eucapnia (PaCO2) 35 to 45 mm of Hg) for a period lasting at least 1 hour. Dobutamine was administered at dosages of 1, 3, and 5 micrograms/kg/min, IV, on a randomized basis. The P(A-a)O2, Qs/Qt, and VD/VT were calculated during equilibration and after each dobutamine infusion was given. The P(A-a)O2 and Qs/Qt were significantly (P less than 0.05) greater and VD/VT tended to be greater in horses in dorsal recumbency, compared with those values in horses in left lateral or right lateral recumbency. Cardiac output was similar in all horses, regardless of body position (recumbency). The qualitative relationship between horses in the 3 recumbent positions were not altered by dobutamine. Cardiac output was significantly (P less than 0.05) increased by 3 or 5 micrograms of dobutamine/kg/min in all horses, whereas P(A-a)O2, Qs/Qt, and VD/VT were not significantly altered by dobutamine. The results of the present study failed to substantiate our clinical observations of decreased P(A-a)O2 and Qs/Qt in anesthetized compromised horses given dobutamine.

Cervicothoracic (stellate) ganglion block in conscious horses

Seven adult horses were used to compare the cardiovascular and respiratory effects of unilateral (right side) and bilateral cervicothoracic ganglion (CTG) blockade. An 18-gauge, 25-cm needle was placed midventrally between articulations of the 1st and 2nd ribs from a cranial and paratracheal site. One gram of lidocaine HCl in aqueous solution (100 ml) was used to infiltrate the CTG. Cervicothoracic sympathetic blockade was characterized by Horner's syndrome, increased skin temperature and profuse sweating over the face, neck, and thoracic limb. Comparison of base-line data with data obtained during unilateral and bilateral CTG blockades indicated a significant (P less than 0.05) decrease in respiratory rate, significant (P less than 0.05) increases in arterial oxygen, and carbon dioxide tensions, and a significant increase in subcutaneous temperature at the neck and shoulder. Systolic, diastolic, and mean aortic blood pressures, pulse pressure, rectal temperature, arterial pH, bicarbonate, PVC, and total solid concentration did not change significantly from base-line values. Arterial O2 tension was significantly (P less than 0.05) less in horses with bilateral CTG blockade than in horses with unilateral CTG blockade. In 4 horses without cervicothoracic sympathetic blockade that were given lidocaine (1 g in 100 ml) in the right cervicothoracic region, cardiovascular and respiratory values did not change significantly from base-line values. The nonsedated healthy horse tolerated unilateral CTG blockade well. Bilateral and unilateral injections of 100 ml of 1% lidocaine into the CTG at intervals of less than 2 hours induced bilateral recurrent nerve paralysis and airway obstruction.

Hemodynamic responses in halothane-anesthetized horses given infusions of dopamine or dobutamine

The hemodynamic changes induced by constant infusions of dopamine or dobutamine (each 3, 5, and 10 micrograms/kg/min) were observed in halothane-anesthetized horses. Left ventricular dp/dt and cardiac output were increased in horses given dobutamine at dosage of 3 micrograms/kg/min and in those given either of the drugs at dosages of 5 and 10 micrograms/kg/min. Concomitant increases in systemic arterial blood pressure occurred at lower infusion dosage rates of dobutamine than those of dopamine and were modulated by dosage-related changes in peripheral vascular resistance that were different between the 2 drugs. Total peripheral vascular resistance was unchanged by the 3 micrograms/kg/min dosage of dopamine, significantly (P less than 0.05) decreased at the 5 micrograms/kg/min dosage of dopamine, and returned to base line in horses when given the largest dosage. Dobutamine had no effect on total peripheral vascular resistance. Heart rate was significantly (P less than 0.05) decreased by the 2 smaller dosages of dobutamine, but returned to base line at the 10 micrograms/kg/min dosage. Heart rates did not change significantly in response to dopamine over the range of the dosages. Sinus tachycardia with atrioventricular conduction block was noted in some horses given either of the drugs. The results of the present study indicate that the hemodynamic responses in horses given dopamine or dobutamine infusions are similar to those in other species, and are the net result of the different adrenergic pharmacologic profiles of the 2 drugs combined with autonomic nervous system reflexes.

Polysome Formation in Light-sensitive Common Purslane Seeds

Common purslane (Portulaca oleracea L.) seeds show light-controlled dormancy. Ribosome profiles from dark-incubated seeds consist of 22 to 26% polysomes. Light induces germination and stimulates polysome formation during the 12-hour lag period preceding radicle protrusion. Polysome levels increase to 29, 35, and 41% with exposure to 3, 6, and 9 hours of light, respectively. Although polysomes form on imbibition in the dark, 6 hours of light stimulates a significant increase in polysome formation which is probably related to early stages of radicle elongation.