Knockdown of Notch Suppresses Epithelial-mesenchymal Transition and Induces Angiogenesis in Oral Submucous Fibrosis by Regulating TGF-β1

Oral submucous fibrosis (OSF) is a chronic disorder with a high malignant transformation rate. Epithelial-mesenchymal transition (EMT) and angiogenesis are key events in OSF. The Notch signaling plays an essential role in the pathogenesis of various fibrotic diseases, including OSF. Our study aimed to explore the effects of Notch on the EMT and angiogenesis processes during the development of OSF. The expression of Notch in OSF tissues versus normal buccal mucosa samples was compared. Arecoline was used to induce myofibroblast transdifferentiation of buccal mucosal fibroblasts (BMFs). Short hairpin RNA technique was used to knockdown Notch in BMFs. Pirfenidone and SRI-011381 were used to inhibit and activate the TGF-β1 signaling pathway in BMFs, respectively. The expression of Notch was markedly upregulated in OSF tissues and fibrotic BMFs. Knockdown of Notch significantly decreased the viability and promoted apoptosis in BMFs subjected to arecoline stimulation. Downregulation of Notch also significantly suppressed the EMT process, as shown by the reduction of N-cadherin and vimentin with concomitant upregulation of E-cadherin. In addition, knockdown of Notch upregulated VEGF and enhanced the angiogenic activity of fBMFs. Moreover, inhibition of TGF-β1 suppressed viability and EMT, promoted apoptosis, and induced angiogenesis of fBMFs, while activation of TGF-β1 significantly diminished the effects of Notch knockdown on fBMFs. Knockdown of Notch suppressed EMT and induced angiogenesis in OSF by regulating TGF-β1, suggesting that the Notch-TGF-β1 pathway may serve as a therapeutic intervention target for OSF.

Arecoline ameliorates hyperthyroid condition in mice under cold stress

Betel nut of Areca catechu is chewed by millions of people for increased capacity to work and stress reduction, but it contains arecoline that causes hypothyroidism. The aim is to investigate the role of arecoline on thyroid activity in cold stress in mice. Arecoline treatment (10 mg/kg body wt/day, for 7 d) caused a reduction in thyroid weight and ultrastructural degeneration of thyro-follicular cells with depletion of T₃ and T₄ levels compared with the control mice. Cold stress (4 °C for 2 h, twice daily, for 7 d) stimulated thyroid activity ultrastructurally with an elevation of T₃ and T₄ levels. Arecoline treatment in cold stress suppressed thyroid activity by showing reversed changes to those of cold stress. In contrast, TSH concentrations were consistently increased under all experimental conditions. The findings suggest that cold stress causes hyperthyroidism which arecoline can ameliorate in mice.

Arecoline cannot alter testicular dysfunction and pineal activation caused by noise in wistar rat

Millions of people consume betel nut for increased capacity to work and for stress reduction. The nut contains arecoline, which has multiple side effects on endocrine functions. Objective of the work is to investigate pineal-testicular responses to noise and after arecoline treatment in noise in rats. Noise exposure (100 dB, 6 h daily, 10 days) caused pineal stimulation ultrastructurally and at indoleamines level. Leydig cell dysfunction with fall of testosterone level and suppression of sex accessories were noticed. In contrast, pineal activity was inhibited and reproductive functions were stimulated after arecoline administration, confirmed from reversed changes to those of noise. Arecoline treatment in noise exposure showed same results as in noise both in pineal and in reproductive functions. It is concluded that noise causes testicular dysfunction probably by gonadotropin suppression induced by pineal melatonin in noise. Furthermore, arecoline cannot prevent it in noise in rats.

The pharmacology, toxicology and potential applications of arecoline: a review

CONTEXT

Arecoline is an effective constituent of Areca catechu L. (Arecaceae) with various pharmacological effects. However, investigations also revealed that long use of arecoline could arouse some oral diseases.

OBJECTIVE

The present review gathers the fragmented information available in the literature (before 1 October 2015) regarding pharmacology and toxicology of arecoline. We also discussed the potential developments and applications of arecoline in the future.

METHODS

All the available information regarding the arecoline is compiled from scientific databases, including Science Direct, PubMed, Web of Science, Scopus, etc.

RESULTS

Previous research demonstrated that arecoline is one of the major effective constituents in A. catechu. Additionally, arecoline has a wide spectrum of pharmacological activities including effects on nervous, cardiovascular, digestive and endocrine systems and anti-parasitic effects. What's more, arecoline is reported to be the primary toxic constituent of A. catechu, and the main toxic effects include oral submucous fibrosis (OSF), oral squamous cell carcinoma (OSCC) and genotoxicity.

CONCLUSION

Arecoline has great potential to be a therapeutic drug for various ailments. However, further investigations are needed in the future to reduce or eliminate its toxicities before developing into new drug.

Effects of isoarecolone, a nicotinic receptor agonist in rodent models of nicotine dependence

RATIONALE

The nicotinic receptor agonist, isoarecolone, has 'nicotine-like' subjective properties as detected by rats in a discrimination paradigm. However, isoarecolone lacks the intra-accumbens dopamine-releasing effects, a feature akin to most abused substances. In the five-choice serial reaction time task, isoarecolone can enhance attention and thus may be developed as a cognitive enhancer.

OBJECTIVE

The present experiments assess the dependence profile of isoarecolone in rodent models of nicotine dependence.

METHOD AND RESULTS

Tests for cross-substitution in which isoarecolone is substituted for nicotine [0.3 mg/kg/infusion (inf)] self-administration suggest isoarecolone to have nominal reinforcing properties (0.3 or 1.0 mg/kg/inf); intake of isoarecolone declined over three test sessions in which responding was no different from saline extinction, and behaviour was reinstated by re-presenting nicotine. In a model of nicotine-seeking behaviour, rats having been extinguished by removal of nicotine (0.03 mg/kg/inf) and associated cues, the presentation of priming doses of nicotine (0.1-0.4 mg/kg s.c.) with the cues robustly reinstated responding of nicotine-seeking behaviour. Tests with priming doses of isoarecolone (1-20 mg/kg s.c.) shown previously to generalise to nicotine in discrimination tests produced significant levels of reinstatement but the responses were significantly less compared to nicotine-induced reinstatement.

CONCLUSION

Overall, these results suggest that isoarecolone with its unique profile of behavioural activity should be further examined for treating chronic diseases that are characterised by attentional dysfunction.

Effects of arecoline in relaxing human umbilical vessels and inhibiting endothelial cell growth

This study investigated the effects of arecoline, an active ingredient of the areca nut, on the tone of human umbilical arteries and veins and on the eNOS expression and cell proliferation of human umbilical vein endothelial cells (HUVECs). We found that arecoline relaxes the human umbilical artery and vein rings in a concentration-dependent manner; the higher the concentration of arecoline, the greater the relaxation of the rings. However, the relaxation decreases after the endothelium was removed or pretreated with L-NAME, a nitric oxide synthase inhibitor. Moreover, arecoline increases in a dose-dependent way the cGMP levels of human umbilical arteries and veins. In HUVECs, arecoline also increases the eNOS expression. Therefore, the relaxant effects of arecoline on the umbilical artery and vein rings were endothelium-dependent through the NO-cGMP systems. In addition, arecoline at higher doses (100-1000 microM) inhibits endothelial cell proliferation; the exposure toarecoline (100-1000 microM) for 24 and 48 h induces G2/M cell cycle arrest of HUVECs. Our results indicate that arecoline would decrease vascular tone, in part mediated by NO. Higher doses of arecoline inhibit endothelial cell growth, which suggest that long-term use or high doses of areca nut might induce endothelial dysfunction and associated diseases.

Field evaluation of a coproantigen enzyme-linked immunosorbent assay for diagnosis of canine echinococcosis in a rural Andean village in Peru

One hundred and six dogs (61 males and 45 females) were examined for Echinococcus granulosus infection in a farming cooperative in the central highlands of Peru during November 1998. Canine echinococcosis was diagnosed using direct microscopic examinations of purged feces following arecoline purging and a coproantigen-detection enzyme-linked immunosorbent assay (ELISA) for E. granulosus. Mean age was 2 years with a range of 3 months to 9 years. The overall prevalence of canine echinococcosis using the ELISA test was 79% (84/106). Seventy-four dogs were successfully purged with arecoline. The frequency of canine echinococcosis was 82 (61/74) and 34% (25/74) by the coproantigen ELISA test and arecoline purging, respectively. The sensitivity and specificity of the coproantigen ELISA test was 88 and 95%, respectively. We found this assay to be especially advantageous in remote geographical areas. In future control programs against echinococcosis in Peru and other areas where E. granulosus is endemic the coproantigen ELISA should be used for the surveillance of the dog population.

Effects of Betel chewing on the central and autonomic nervous systems

Betel chewing has been claimed to produce a sense of well-being, euphoria, heightened alertness, sweating, salivation, a hot sensation in the body and increased capacity to work. Betel chewing also leads to habituation, addiction and withdrawal. However, the mechanisms underlying these effects remain poorly understood. Arecoline, the major alkaloid of Areca nut, has been extensively studied, and several effects of betel chewing are thought to be related to the actions of this parasympathomimetic constituent. However, betel chewing may produce complex reactions and interactions. In the presence of lime, arecoline and guvacoline in Areca nut are hydrolyzed into arecaidine and guvacine, respectively, which are strong inhibitors of GABA uptake. Piper betle flower or leaf contains aromatic phenolic compounds which have been found to stimulate the release of catecholamines in vitro. Thus, betel chewing may affect parasympathetic, GABAnergic and sympathetic functions. Betel chewing produces an increase in heart rate, blood pressure, sweating and body temperature. In addition, EEG shows widespread cortical desynchronization indicating a state of arousal. In autonomic function tests, both the sympathetic skin response and RR interval variation are affected. Betel chewing also increases plasma concentrations of norepinephrine and epinephrine. These results suggest that betel chewing mainly affects the central and autonomic nervous systems. Future studies should investigate both the acute and chronic effects of betel chewing. Such studies may further elucidate the psychoactive mechanisms responsible for the undiminished popularity of betel chewing since antiquity.

Effects of chewing betel nut (Areca catechu) on the symptoms of people with schizophrenia in Palau, Micronesia

BACKGROUND

Although millions of people with schizophrenia live in betel chewing regions, the effects of betel chewing on their symptoms are unknown. Betel nut alkaloids include potent muscarinic cholinomimetics: recent research suggests that these agents may be therapeutic in schizophrenia.

AIMS

To compare the primary and extrapyramidal symptom profiles and substance-using habits of betel chewing v. non-chewing people with schizophrenia.

METHOD

A cross-sectional study of 70 people with schizophrenia. Symptom ratings measured by the Positive and Negative Syndrome Scale (PANSS) and Extrapyramidal Symptom Rating Scale (ESRS), and demographic and substance-use data, were compared for 40 chewers and 30 non-chewers of betel nut.

RESULTS

Betel chewers with schizophrenia scored significantly lower on the positive (P = 0.001) and negative (P = 0.002) sub-scales of the PANSS than did non-chewers. There were no significant differences in extrapyramidal symptoms or tardive dyskinesia.

CONCLUSIONS

Betel chewing is associated with milder symptomatology and avoidance of more harmful recreational drugs. These initial results indicate that longitudinal research is merited.

Canine echinococcosis: an alternative for surveillance epidemiology

The essential activities for programmes of cystic echinococcosis control are the census of all dogs from the program and identification of parasitised animals. Currently, in South America evaluations and epidemiological surveillance are based on the administration of arecoline hydrobromide. This method has the disadvantage of increasing environmental pollution and risk for operators and owners of treated dogs. A genus-specific ELISA capture method has been employed for recently issued faeces and the confirmation of positive examination was performed by dog autopsies. Our work presents an alternative method based on collection of dry field-dispersed faeces, followed by serological diagnosis by Copro-ELISA and confirmation by Copro-Western blot. If Copro-ELISA were used to define positive samples of dry faeces, the Copro-Western blot assay would provide 70% sensitivity and 100% specificity. Global efficiency of the system using dry faeces would reach 76%, allowing epidemiological surveillance to be oriented to analysis of surface units instead of dog as measurement unit.

5HT antagonists attenuate MK801-impaired radial arm maze performance in rats

Glutamatergic hypofunction occurs in Alzheimer's disease (AD). MK801, a noncompetitive blocker of glutamate N-methyl-D-aspartate receptors, was used to disrupt the cognitive performance of rats trained on a delayed nonmatching to sample radial maze task. Drugs which act by blocking serotonin (5-HT) receptors were evaluated for their ability to reduce the cognitive impairment produced by MK801. Specifically, WAY-100635, a selective 5-HT1A receptor antagonist, buspirone, a 5-HT1A partial agonist, ritanserin, a 5-HT2 antagonist, and ondansetron, a 5-HT3 antagonist, were assessed. In addition, the muscarinic agonist arecoline was evaluated for its potential cognitive benefit in this model. It was found that WAY-100635 significantly reduced the cognitive impairment induced by MK801. Treatment with single doses of ritanserin, ondansetron, or arecoline in combination with MK801 did not result in a cognitive impairment, indicating that these drugs attenuated the MK801 impairment. The combination of buspirone and MK801 resulted in an inability of the animals to complete the task. These results suggest that interactions between 5-HT and glutamate may mediate the beneficial effects of reducing cognitive impairment and that 5-HT antagonists, especially selective 5-HT1A antagonists, may be useful in treating AD. Further, it is indicated that the MK801 model of cognitive impairment may add to the armamentarium of tools available to predict treatment efficacy in AD.

Potential role of muscarinic agonists in Alzheimer's disease

Alzheimer's disease (AD) is a common neurodegenerative disorder and a leading cause of death among the elderly. Recent advances in our understanding of the neurobiology of AD have provided scientific groundwork for the development of potentially more effective and less toxic treatment strategies for the disease. Some of the neuropathological hallmarks of AD include early and extensive degeneration of cortically projecting cholinergic neurons in the basal forebrain, and a reduced number of muscarinic acetylcholine receptors. Of note, neocortical muscarinic receptors of the M1 subtype are relatively preserved in the brains of patients with AD, whereas the presynaptic receptors, which are of the M2 subtype, are reduced in number. Therefore, activation of relatively intact postsynaptic mechanisms by muscarinic M1 receptor-specific agonists could theoretically be more efficacious in the treatment of AD compared with agents (e.g. acetylcholinesterase inhibitors) that predominantly act on dysfunctional presynaptic terminals. The administration of muscarinic agonists can demonstrably enhance cognition and significantly improve some of the disturbing behaviours in patients with AD. Recent advances in our knowledge of the molecular biology of muscarinic receptors, together with a better understanding of signal transduction pathways in AD, are likely to result in the development of receptor-specific muscarinic agonists that are more efficacious and less toxic. Moreover, preliminary evidence concerning the effects of muscarinic agonists on the processing of amyloid precursor protein and the formation of neurofibrillary tangles suggests that these agents might favourably alter the pathobiology of AD.

Differential response to the cholinergic agonist arecoline among different cognitive modalities in Alzheimer's disease

Nine patients with possible or probable dementia of the Alzheimer type were tested on nine cognitive tests prior to (two times) and during continuous intravenous administration of five different doses of the muscarinic cholinergic agonist arecoline (1, 4, 16, 28, and 40 mg/day). The present analysis examined whether improvement on cognitive testing for each patient during arecoline treatment was most likely to occur at the same dose for all tests or whether different test scores improved at different doses of arecoline. Results indicated there were significant differences among tests in the dose at which most patients showed improved cognitive performance. These differences may have therapeutic significance, as verbal ability tended to improve at low doses of arecoline, whereas attention and visuospatial ability tended to improve at higher doses of arecoline.

[Hydatidosis control in the province of Río Negro, Argentina: evaluation of the veterinary health care activities. 1]

BACKGROUND

Hydatidosis constitutes a serious Public Health problem in the Province of Rio Negro, Argentine. This situation has promoted the implementation of a Control Programme, carried out in 1979. The accumulated experience of 13 years works is presented in this study.

METHODS

The strategy used is that of the Primary Health Care; and community participation is a fundamental component of the programme as well as local planning and the approach of risk in the allocation of resources. The activities included the systematic dogs deparasitation with Praziquantel, carried out by health agents from the system rural hospitals (health promoters not professional staff); the surveillance of dogs rate of infection by means of diagnostic deparasitations made with hydrobromide or arecoline, educational talks at schools, the use of mass media, an the determination of ovine parasitism in studies carried out in the area abattoirs.

RESULTS

The information registered indicates that 1,86,156 dog deparasitations with Praziquantel were carried out with a consumption of 443,533 tablets and 11,178 deparasitations with hydrobromide and Arecoline. A continuous decrease of rates appears during the Period 1979-1992. So, dog Echinococcosis was reduced from 41.5% to 4.24% and ovine Hydatidosis from 61% to 12.7%. Consequently, Human Hydatidosis has decreased from an incidence rate of 64.11 x 100,000 in the age group of 0 to 10 years to and incidence rate of 4.46 x 100,000.

CONCLUSIONS

Finally, the results of the Programme are analyzed in the light of other global experiences of control; and the strategies that should be put into practice in the future with a view to a final limitation of the rate of transmission to man are analyzed.

Memory improvement without toxicity during chronic, low dose intravenous arecoline in Alzheimer's disease

Arecoline, a cholinergic agonist, administered at low doses by continuous intravenous infusion for up to 2 weeks, significantly and replicably improved memory in five of nine subjects with mild-moderate Alzheimer's disease. During dose finding, performance on a verbal memory task improved with an inverted U-shaped relation to dose. Six of nine subjects were classified as responders. During blinded, placebo-controlled, individualized optimal dosing for 5 days, verbal memory again improved in five of six responders but not in any non-responder. No adverse drug effects occurred. Arecoline, and possibly other cholinergic agonists, can safely improve memory in Alzheimer's disease at doses much lower than previously studied.

Effects of acute infusion of the muscarinic cholinergic agonist arecoline on verbal memory and visuo-spatial function in dementia of the Alzheimer type

1. Treatment of patients with dementia of the Alzheimer type (DAT) with arecoline, a muscarinic cholinergic receptor agonist, reportedly improves performance on a picture recognition memory task, but not on other memory measures. To examine further possible performance improvements following arecoline treatment, patients with DAT were treated with a 30 min intravenous infusion of arecoline (5 mg). 2. Psychometric testing was done at five time points (two before and three following the infusion). Patients were tested on a memory task (Buschke selective reminding) and a test of visuo-spatial performance (figure copying). 3. No net change from baseline was seen in mean scores following arecoline infusion. However, the changes in performance on the two tasks were correlated (p less than 0.02) over subjects at 10 min but not at 1.5 or 5.5 hr following the infusion. 4. This result suggests that although individual patients vary in their response to a given dose of arecoline, their responses are consistent across types of tasks. Thus the lack of a mean drug effect may be due to individual differences in response rather than to a lack of response.

Nicotine-induced tail-tremor and drug effects

Tail-tremor induced by repeated and daily administration (0.5 mg/kg SC x 6 times/day) of nicotine as well as effects of various drugs on this response were investigated in Wistar strain male rats. Daily administration of nicotine in doses of 0.5 mg/kg SC caused tail-tremors to appear beginning on the 3rd day. Tail-tremor induced by the first injection of each day gradually increased with the daily injections, however, the heightened effect of this first injection at the beginning of each day decreased during the day upon repeated administration of 6 times/day at 2-hr intervals. Basically, tail-tremor appeared about 5 min after SC administration of nicotine and reached a peak approximately 7-9 min after injection, declining to zero afterwards. Different drugs showed various effects on this response. While mecamylamine (0.5 and 1.0 mg/kg IP) abolished nicotine-induced tail-tremor, arecoline (0.5 and 1.0 mg/kg IP), atropine (2.5 and 5.0 mg/kg IP), scopolamine (1.0 and 2.0 mg/kg IP) and hexamethonium (0.5 and 1.0 mg/kg IP) showed no such effects. Furthermore, physostigmine (0.1 mg/kg IP) actually potentiated this action. These results suggest that tail-tremor induced by nicotine may be mediated through central nicotine receptor system.

Multiple-dose arecoline infusions in Alzheimer's disease

Twelve patients with dementia of the Alzheimer type received two-hour infusions of placebo and the muscarinic cholinergic agonist arecoline hydrobromide at rates of 1, 2, and 4 mg/h in a double-blind, randomized fashion. These infusions resulted in dose-dependent physiologic and neuroendocrine effects consistent with central cholinergic stimulation. Infusions were generally well tolerated. No statistically significant improvement in performance on most cognitive tasks assessing knowledge memory and episodic learning and memory was observed at any dose, although marginal improvement in picture recognition ability and in ratings of word-finding were observed at the lower doses. Psychomotor activation and slightly improved affect were reliably observed at the lower doses, whereas increasing psychomotor retardation was observed at the highest dose. The data support a role for central cholinergic modulation of some aspects of cognition, behavior, and affect in this population. The apparent greater behavioral sensitivity of patients with Alzheimer's disease in comparison with subject populations previously studied, as well as the altered dose responsiveness, merit further study in relationship to normal aging.

Protection against hypoxia-induced lethality in mice: a comparison of the effects of hypothermia and drugs

The role of hypothermia in the antihypoxic effects of drugs was examined in the present experiments. The effects of environmentally induced hypothermia and drugs were tested by exposing mice to 100% nitrogen gas for 80 sec and counting the number of survivors. In a series of 68 vehicle control groups, the mean of mice surviving the test was 8.6% (SEM = 1.4). Hypothermia induced by lowering the ambient temperature or by isolating mice for a brief period increased the number surviving hypoxia, and the per cent of animals surviving was linearly related to body temperature. When the effects of drugs were compared to that of hypothermia, several drugs were found which protected mice from hypoxia to a greater extent than hypothermia alone. Active substances included the anticonvulsant drugs phenobarbital, phenytoin, carbamazepine and diazepam, but not primidone. Physostigmine and the muscarinic agonist oxotremorine also caused significant protection, while the effects of nicotine could be completely accounted for by hypothermia. Arecoline had a biphasic, time-dependent effect that may be explained by a combination of muscarinic and nicotinic actions. The effects of the muscarinic agonists are centrally mediated, since they could be blocked by low doses of scopolamine HCl, but not by the quaternary analog scopolamine methyl nitrate. Furthermore, the antihypoxic effect of physostigmine was not mimicked by the peripherally acting acetylcholinesterase inhibitor, neostigmine. These results suggest that some drugs do have protective effects against hypoxia which are independent of drug-induced hypothermia and that these effects may be mediated through the CNS.

Population dynamics in echinococcosis and cysticercosis: biological parameters of Echinococcus granulosus in dogs and sheep

The numerical distributions of Echinococcus granulosus in an experimental dog population are described. At all dose rates of protoscoleces from 10 to 175000 the distribution of worms was over-dispersed. Host age had no effect. There was a direct proportionality between the infective-stage density and rate of infection, and between the latter and the index of clumping. The worm burdens were significantly higher in the proximal than distal portions of the small intestine. Lengths of the 3- and 4-segmented worms increased from 4 to 10 and 4 to 8 weeks of age, respectively. Thereafter apolysis was asynchronous and could not be determined. Eggs were first detected in the faeces at 6 weeks and the mean age at oogenesis was 7.26 weeks. Retarded growth of the whole population of worms was observed in some dogs. For the first few infections, worm burdens varied widely in the same dog, but by the 6th infection 50% of the dog population had developed a relative insusceptibility to infection. Growth or oogenesis of the worms were not affected. A short-acting immune response was artificially induced in some dogs following the parenteral injection of activated embryos of E. granulosus, Taenia hydatigena, T. ovis, T. multiceps, T. pisiformis and T. serialis. The response affected either the number of worms established, growth or oogenesis or all three parameters. There was a strong positive correlation between numbers and lengths of worms in dogs with acquired and induced immunity, indicating that no 'crowding' effects were involved. In sheep populations the mean number of cysts which established was directly proportional to the number of eggs given, implying that there was no negative feedback mechanism operating at this stage of the life-cycle. The distribution of the larval population in sheep was over-dispersed and the index of clumping increased with the size of the egg dose from 25 to 2500 eggs. Protoscoleces were first observed in cysts at 2 years and the proportion producing them increased with age, with an estimate of 50% of cysts containing protoscoleces at 6.29 years. No deaths were observed in dogs or sheep even when high parasite burdens were present, implying that E. granulosus does not regulate the population of its hosts.

Hydatid disease: research and control in Turkana, IV. The pilot control programme

A pilot programme to control hydatid disease in north-west Turkana district was started in October 1983 with an intensive educational campaign. This was followed by control and treatment of the dog population to reduce the prevalence of Echinococcus granulosus, thereby reducing the infective pressure on man. Surveillance is by mass annual sero-epidemiological and ultrascan surveys of the nomadic Turkana within the control region and by arecoline purging of the dogs. Some of the recent advances in research on hydatid disease in subject areas such as immunodiagnosis, chemotherapy and epidemiology have been incorporated into the present programme, and their relevance to this and other similar programmes is discussed.

Chemotherapy of cognitive disorders in geriatric subjects

Many of the neurochemical changes associated with aging brain, particularly lower choline acetyltransferase and higher monoamine oxidase, occur with greater severity in senile dementia, Alzheimer's type (SDAT). These alterations correlate with neuropathologic indices, e.g., the number of senile plaques and tangles. Although many different treatment techniques have been used, most have been unsuccessful. No strong data have supported the use of stimulants, Gerovital H3, or hyperbaric oxygen. Among the vasodilators, cyclandelate and hydergine may be of value in some but not most patients. Much recent work has focused on techniques to increase acetylcholine brain concentrations. To date, precursors, such as choline, seem to have very limited value. Postsynaptic treatments, e.g., physostigmine, hold more hope for future benefit, if longer acting oral preparations are developed. Other compounds, such as ACTH, vasopressin, and piracetam, may have some value but need better definition and treatment indications. Recent discoveries on the influences of lecithin on membrane fluidity and receptor binding, may affect the focus of future pharmacologic investigation.

Effect of cholinergic agents in Huntington's disease: a reappraisal

The effects of centrally and peripherally active anti-cholinergic agents were investigated in four patients with Huntington's disease. Scopolamine reduced chorea, increased incoordination, induced sedation, and produced confusion. Benztropine produced similar but milder effects. A peripheral anticholinergic, glycopyrrolate, had no effect. These results, combined with previous studies, indicate that cholinergic agonists and antagonists that produce sedation may reduce chorea without improving coordination, and suggest that this antichoreic action is independent of their cholinergic actions.

Measurement of cholinergic drug effects on memory in Alzheimer's disease

Double-blind, placebo-controlled investigations of scopolamine, physostigmine, arecoline, and tetrahydroaminoacridine (THA) in normal adults and in dementia of the Alzheimer-type (DAT) were reviewed to determine the relative sensitivity of various assessment procedures in the measurement of drug effects. In normal adults, word list learning techniques have been most widely employed and have been sensitive to drug effects. In DAT, a wide variety of assessment procedures have been employed. Based on the limited number of possible comparisons across studies, two procedures appear to be useful: word list learning tasks that generate an index of intrusion errors, and visual recognition tasks. The lack of standardized assessments limits the ability of investigators to replicate studies, to compare relative efficacy of various drugs, or to address a number of other questions that are fundamental to the development of effective cholinergic treatments for DAT.

Physostigmine and arecoline: effects of intravenous infusions in Alzheimer presenile dementia

Physostigmine (0.25 mg-1 mg), arecoline (2 and 4 mg) and saline were administered intravenously over 30 minutes in a randomized double blind design to 11 patients with a clinical diagnosis of Alzheimer presenile dementia. Significant improvement was seen on a picture recognition test with physostigmine 0.375 mg and arecholine 4 mg. A trend towards improvement was also seen with physostigmine 0.25 mg and 0.75 mg, and arecholine 2 mg. For the majority of the patients improvement was only slight but in two patients it was clear cut and consistent.

[Reproduction of "passive" avoidance in rats by administering pharmacologic agents]

In experiments on rats learned to passive avoidance reaction in one trial with subsequent administration of electroconvulsive shock (two hours after learning), the influence of different factors on the retrieval of the lost reaction was tested after three days. The greatest restoring capacity was exhibited by a non-specific reminding agent, the bell, gamma-amino-butyric acid (200 mg/kg) and etimizol (1.5 mg/kg). In animals with a preserved reaction, a number of pharmacological agents impaired retrieval of the habit (caffeine 5 mg/kg, carbocholine 0.01 mg/kg and metamizil 0.5 mg/kg). Optimal conditions for the restoration of the lost reaction were formed by etimizol and gamma-aminobutyric acid. Cholinergic mechanisms play a certain role in the functioning of the retrieval apparatus.

[The use of direct and indirect parasympathomimetics in poisonings with tricyclic antidepressive agents]

The use of cholinesterase inhibitors in poisonings with potentially lethal doses of tricyclic antidepressive drugs seems to be indicated on account of clinical experiences and own experimental investigations on animals. An uncritical use of these substances which have considerable side-effects must be warned of. A mixed intoxication with several drugs effecting on the central nervous system is only a relative indication for the use of indirect parasympathicomimetics of the cholinesterase type. They should be used only then, when the picture of poisoning is unequivocally determined by the thymoleptics. When cholinesterase inhibitors are used the physostigmine salicylate should be preferred, since at present it is sufficiently accessible to the central nervous system and with the slightest peripheral effects as the only representative of this group of substances, above all with regard to the gastrointestinal motility. Later investigations shall show, whether also other groups of substances which develop an antagonistic effect to the tricyclic antidepressive drugs may be of use in the treatment of the acute poisoning.

Treatment of Huntington disease with a cholinergic agonist

The involuntary movements of Huntington disease may be related to cholinergic hypofunction in the striatum. For this reason, the effect of a direct cholinergic agonist, arecoline, was studied in six patients with this disorder. Rather than improving the chorea, arecoline tended to exacerbate the choreic movements. Arecoline did produce significant alterations of blood pressure, heart rate, and body temperature, probably by central cholinergic stimulation.

Activity of uredofos, niclosamide, bunamidine hydrochloride, and arecoline hydrobromide against Mesocestoides corti in experimentally infected dogs

Uredofos, niclosamide, bunamidine hydrochloride, and arecoline hydrobromide were given at various doses to dogs experimentally infected with Mesocestoides corti. The highest efficacies were obtained with bunamidine hydrochloride and uredofos. Variable results were obtained with arecoline hydrobromide and niclosamide.

[Effect of M- and N-cholinomimetics on the activity of an epileptogenic focus in the hippocampus of rabbits of different ages]

Experiments have been made on adult, 16-20 and 6-10 day old rabbits with electrodes chronically implanted into the left and right dorsal hippocamp. Solutions of arecoline (M-cholinomimetic) and nicotine (N-cholinomimetic) were administered into the penicillin epileptogenic focus of the hippocamp. Large doses of arecoline (10 mg) and nicotine (0.5 mg) did not affect the epileptiform discharges in the EEG, but inhibited the fits in adult and 16-20 day old rabbits...

[Committee on anthelmintics. Residual group]

A number of the older and a few recent anthelmintics are enumerated or briefly discussed. Moreover some attention is paid to anthelmintics, used for nematodes and trematodes which have a limited effect on cestodes.

Comparative value of arecoline hydrobromide and bunamidine hydrochloride for the treatment of Echinococcus granulosus in dogs

A controlled trial involving 122 dogs experimentally infected with Echinococcus granulosus was carried out to compare the efficiency of arecoline hydrobromide and bunamidine hydrochloride. A single treatment with arecoline hydrobromide at a dose rate of 4 mg/kg or with bunamidine hydrochloride at 50 mg/kg gave a similar degree of efficiency against young worms. At these dose rates, worms were still present in almost half the dogs at autopsy.

Surveillance of Echinococcus granulosus in dogs with arecoline hydrobromide

Arecoline hydrobromide has been used for almost half a century for the treatment of Echinococcus granulosus in dogs. Trials in New Zealand showed that it had real limitations for this purpose. Its main value lies in its use as a diagnostic agent for detecting infections in dogs on a group basis. The data so obtained can be used in educating dog owners as well as for providing base-line data and an index of progress in a continuing control programme. The drug's limitations for treatment and value as a diagnostic agent in a field trial are assessed.