Saffron (Crocus sativus L.) extract attenuates chronic scopolamine-induced cognitive impairment, amyloid beta, and neurofibrillary tangles accumulation in rats

ETHNOPHARMACOLOGICAL RELEVANCE

Crocus sativus L. known as saffron, is a popular food condiment with a high aroma, deep colour, and long and thick threads (stigmas) cultivated in Iran, Morocco, Spain, Italy, China, Japan, France, Turkey, and India. In 'Ayurveda', saffron is acknowledged for its immunostimulant, aphrodisiac, cardiotonic, liver tonic, nervine tonic, carminative, diaphoretic, diuretic, emmenagogue, galactagogue, febrifuge, sedative, relaxant, and anxiolytic activities. The renowned Persian physician and philosopher, Avicenna, delineated saffron as an antidepressant, hypnotic, anti-inflammatory, hepatoprotective, bronchodilator, and aphrodisiac in his book, the Canon of Medicine. Within traditional Iranian Medicine (TIM), saffron is characterized as a mood elevator and a rejuvenator for the body and senses. Further, the ethnopharmacological evidence indicates that saffron has shown an effect against neurodegenerative disorders namely, dementia, Alzheimer's, and Parkinson's with its bioactive constituents i.e., carotenoids and apocarotenoids.

AIM

The present study aimed to investigate the potential of standardized (Kashmir Saffron, India) Crocus sativus extract (CSE) in chronic scopolamine-induced cognitive impairment, amyloid beta (Aβ) plaque, and neurofibrillary tangles (NFT) accumulation in rat brains by targeting AChE inhibition and scopolamine mechanistic effect.

METHODS

The experimental animals were divided into six groups: group 1: normal control, group 2: scopolamine, group 3,4 and 5 rivastigmine tartrate, CSE (p.o. 10 mg/kg, 15 mg/kg, and 20 mg/kg) respectively. Each treatment group received scopolamine after 20 min of dosing, till 4 weeks. The effects of different treatments on learning, acquisition, and reversal memory were performed using a Morris water maze test. In addition to behavioral assessments, biochemical parameters such as AChE, IL-6, and antioxidants were measured in isolated brains. Histological observations were also conducted to assess the presence of Aβ plaques and NFT. Furthermore, molecular docking was performed to explore the potential AChE inhibitory activity of the bioactive constituents of standardized CSE.

RESULTS

Scopolamine produces memory impairment, and its chronic administration forms Aβ plaque and NFT in rat brains. Supplementation with CSE in presence of scopolamine has shown remarkable effects on behavioural activity, special acquisition, and reversal memory. The CSE has also shown promising effects on AChE inhibition and antioxidant activity. The results of the docking study also indicate that trans-crocetin, i.e., a biologically active metabolite of Crocins, has strong AChE inhibitory activity, supported by an in vivo animal experiment.

CONCLUSION

Supplementation with CSE significantly attenuates the formation of Aβ plaque and NFT in the hippocampus at a dose of 20 mg/kg per day. In addition, CSE also counters scopolamine-induced neuroinflammation.

Novel pyrrole based CB2 agonists: New insights on CB2 receptor role in regulating neurotransmitters' tone

The cannabinoid system is one of the most investigated neuromodulatory systems because of its involvement in multiple pathologies such as cancer, inflammation, and psychiatric diseases. Recently, the CB2 receptor has gained increased attention considering its crucial role in modulating neuroinflammation in several pathological conditions like neurodegenerative diseases. Here we describe the rational design of pyrrole-based analogues, which led to a potent and pharmacokinetically suitable CB2 full agonist particularly effective in improving cognitive functions in a scopolamine-induced amnesia murine model. Therefore, we extended our study by investigating the interconnection between CB2 activation and neurotransmission in this experimental paradigm. To this purpose, we performed a MALDI imaging analysis on mice brains, observing that the administration of our lead compound was able to revert the effect of scopolamine on different neurotransmitter tones, such as acetylcholine, serotonin, and GABA, shedding light on important networks not fully explored, so far.

A Novel Tetrapeptide Ala-Phe-Phe-Pro (AFFP) Derived from Antarctic Krill Prevents Scopolamine-Induced Memory Disorder by Balancing Lipid Metabolism of Mice Hippocampus

Memory impairment is a serious problem with organismal aging and increased social pressure. The tetrapeptide Ala-Phe-Phe-Pro (AFFP) is a synthetic analogue of Antarctic krill derived from the memory-improving Antarctic krill peptide Ser-Ser-Asp-Ala-Phe-Phe-Pro-Phe-Arg (SSDAFFPFR) after digestion and absorption. The objective of this research was to assess the neuroprotective effects of AFFP by reducing oxidative stress and controlling lipid metabolism in the brains of mice with memory impairment caused by scopolamine. The 1H Nuclear magnetic resonance spectroscopy results showed that AFFP had three active hydrogen sites that could contribute to its antioxidant properties. The findings from in vivo tests demonstrated that AFFP greatly enhanced the mice's behavioral performance in the passive avoidance, novel object recognition, and eight-arm maze experiments. AFFP reduced oxidative stress by enhancing superoxide dismutase activity and malondialdehyde levels in mice serum, thereby decreasing reactive oxygen species level in the mice hippocampus. In addition, AFFP increased the unsaturated lipid content to balance the unsaturated lipid level against the neurotoxicity of the mice hippocampus. Our findings suggest that AFFP emerges as a potential dietary intervention for the prevention of memory impairment disorders.

Simultaneous UPLC Assay for Oxitropium Bromide and Formoterol Fumarate Dihydrate in Pressurized Metered Dose Inhaler Products for Chronic Obstructive Pulmonary Disease

BACKROUND

Oxitropium bromide (OB) and formoterol fumarate dihydrate (FFD) are inhaler molecules that are widely used in the treatment of chronic lung diseases.

OBJECTIVE

The goal of this work was to create a reversed phase-ultra performance liquid chromatography (RP-UPLC) technique for assay and identification of OB and FFD, as well as identification and estimate of its associated compounds in pressurized metered dose inhaler product (pMDI).

METHOD

Separation of oxitropium and formoterol peaks were enhanced on a C18 (50 × 2.1 mm × 1.7 μm) UPLC column with ethylene-bridged-hybrid technology, The mobile phase consists of buffer (0.07 M KH2PO4) and acetonitrile (80:20, v/v). The detector wavelength of 210 nm, flow rate of pump 0.6 mL/min, and oven temperature for column were set at 25°C. The injection volume was 10 μL. The method run time was 2 min. The mobile phase was used as the solvent.

RESULTS

Retention times (RTs) were 0.5 min for OB and 1.0 min for FFD. The assay analysis was linear range for all analytes within the range for concentrations 0.03-14.8 µg/mL of OB, 0.01-0.88 µg/mL of FFD. LOD values and LOQ values 0.009 and 0.026 µg/mL for OB and 0.003 and 0.009 µg/mL for FFD, respectively. Recoveries were obtained at 96.3% for OB and 97.2% for FFD. Precisions values were (as RSD, %) ≤1.5%.

CONCLUSIONS

With the UPLC method developed and validated according to the current ICH guidelines, it is possible to simultaneously detect OB and FFD of assay analysis in pMDI products accurately, precisely and selectively, independent of the matrix effect.

HIGHLIGHTS

The present method is the first method in the literature based on the UPLC method for this purpose. The UPLC method is a time-saving method, it provides a faster and cheaper technique than the high performance liquid chromatography (HPLC) method.

Effect of woohwangchungsimwon and donepezil co-treatment on cognitive function and serum metabolic profiles in a scopolamine-induced model of Alzheimer's disease

ETHNOPHARMACOLOGICAL RELEVANCE

Woohwangchungsimwon (WCW) is a traditional medicine used in East Asian countries to treat central nervous system disorders. Reported pharmacological properties include antioxidant effects, enhanced learning and memory, and protection against ischemic neuronal cell death, supporting its use in treating neurodegenerative diseases like Alzheimer's disease (AD).

AIM OF THE STUDY

The study aims to assess the effects of co-treatment with WCW and donepezil on cognitive functions and serum metabolic profiles in a scopolamine-induced AD model.

MATERIALS AND METHODS

Cell viability and reactive oxygen species (ROS) levels were measured in amyloid β-peptide25-35 (Aβ25-35)-induced SH-SY5Y cells. An AD model was established in ICR mice by intraperitoneal scopolamine administration. Animals underwent the step-through passive avoidance test (PAT) and Morris water maze (MWM) test. Hippocampal tissues were collected to examine specific protein expression. Serum metabolic profiles were analyzed using nuclear magnetic resonance (NMR) spectroscopy.

RESULTS

Co-treatment with WCW and donepezil increased cell viability and reduced ROS production in Aβ25-35-induced SH-SY5Y cells compared to that with donepezil treatment alone. Co-treatment improved cognitive functions and was comparable to donepezil treatment alone in the PAT and MWM tests. Pathways related to tyrosine, phenylalanine, and tryptophan biosynthesis, phenylalanine metabolism, and cysteine and methionine metabolism were altered by co-treatment. Levels of tyrosine and methionine, major serum metabolites in these pathways, were significantly reduced after co-treatment.

CONCLUSIONS

Co-treatment with WCW and donepezil shows promise as a therapeutic strategy for AD and is comparable to donepezil alone in improving cognitive function. Reduced tyrosine and methionine levels after co-treatment may enhance cognitive function by mitigating hypertyrosinemia and hyperhomocysteinemia, known risk factors for AD. The serum metabolic profiles obtained in this study can serve as a foundation for developing other bioactive compounds using a scopolamine-induced mouse model.

Characterization and Exploration of the Neuroprotective Potential of Oat-Protein-Derived Peptides in PC12 Cells and Scopolamine-Treated Zebrafish

Neurodegenerative disorders pose a substantial risk to human health, and oxidative stress, cholinergic dysfunction, and inflammation are the major contributors. The purpose of this study was to explore the neuroprotective effects of oat protein hydrolysate (OPH) and identify peptides with neuroprotective potential. This study is the first to isolate and identify OPH peptides with neuroprotective potential, including DFVADHPFLF (DF-10), HGQNFPIL (HL-8), and RDFPITWPW (RW-9), by screening via peptidomes and molecular-docking simulations. These peptides showed positive effects on the activity of antioxidant enzymes and thus reduced oxidative stress through regulation of Nrf2-keap1/HO-1 gene expression in vitro and in vivo. The peptides also significantly ameliorated scopolamine-induced cognitive impairment in the zebrafish model. This improvement was correlated with mitigation of MDA levels, AChE activity, and levels of inflammatory cytokines in the brains of zebrafish. Furthermore, these peptides significantly upregulated the mRNA expression of Bdnf, Nrf2, and Erg1 in the brains of zebrafish with neurodegenerative disorders. Collectively, oat peptides have potential for use as active components in nutraceutical applications for the prevention of neurodegenerative diseases.

Simultaneous determination of seven toxic components in ShenFuTuoDu capsules by HPLC-MS/MS

An accurate and reliable HPLC-MS/MS method has been established for the simultaneous determination of seven toxic components in the Chinese medicine ShenFuTuoDu capsules. The seven toxic components were separated on a Shimadzu Shim-pack GIST C18 column (3.0 mm×50 mm, 3.0 μm) with methanol and water (containing 0.1% formic acid) as the mobile phase by gradient elution. The flow rate was 0.5 mL•min-1. The column temperature was 25°C and the injection volume was 5μL. An ESI+ scan combined with MRM was adopted and the instrument parameters were as follows: ion source voltage, 5.5 kV; ion source temperature, 600oC; curtain gas, 68.95 kPa; atomized gas, 344.75 kPa; auxiliary gas, 344.75 kPa. The linear relationships of the seven components were good (R2>0.9937). The average recoveries were 95.2%-106.7% with RSD of 0.79%-5.27% (n=6). The seven toxic components of scopolamine, atropine, rhynchophylline, isorhynchophylline, benzoylaconine, benzoylmesaconine and benzoylhypaconine in six batches of ShenFuTuoDu capsules were 5.99-18.48μg•g-1, 6.36-14.79μg•g-1, 3.71-15.45μg•g-1, 7.90-15.08μg•g-1, 19.05-44.58μg•g-1, 117.38-248.26μg•g-1 and 19.74-79.49μg•g-1, respectively. Precision, stability and repeatability test RSDs were less than 7.17% (n=6). The method is suitable for the simultaneous determination of scopolamine, atropine, rhynchophylline, isorhynchophylline, benzoylaconine, benzoylmesaconine and benzoylhypaconine. It can be used for the quality control of ShenFuTuoDu capsules.

Transdermal scopolamine and urinary retention following urogynecologic surgery: a systematic review and meta-analysis

INTRODUCTION AND HYPOTHESIS

Both urogynecologic surgeries and transdermal scopolamine (TDS) patches are independently associated with postoperative urinary retention (POUR). It is unclear if the risk of POUR increases when these interventions are used in combination. This systematic review and meta-analysis aim to synthesize current evidence to optimize clinical management and outcomes for patients undergoing urogynecologic procedures.

METHODS

This systematic review was conducted in concordance with the PRISMA 2020 guidelines. MEDLINE, ClinicalTrials.gov, and Cochrane Library were searched. Publications were filtered by inclusion and exclusion criteria. Inclusion criteria required: (1) preoperative or perioperative application of TDS, (2) surgery indicated for stress urinary incontinence and/or pelvic organ prolapse, (3) results given for postoperative voiding trials, and (4) were available in English. Exclusion criteria included: (1) oral or parenteral formulations of scopolamine, (2) administration of alternative preoperative antiemetics, and (3) use of combination antiemetic therapy. Quality was assessed using the Joanna Briggs Institute Checklist. Publication bias was evaluated via the ROBINS-I assessment tool, and Egger regression and Begg and Mazumumdar rank correlation tests. A meta-analysis was conducted using Meta-Essentials Excel Workbook.

RESULTS

Four publications were identified which complied with inclusion and exclusion criteria. Included studies comprised 752 patients (237 experimental group, 515 control group). All were retrospective cohort studies conducted via chart review in America. Meta-analysis revealed a risk ratio (RR) of 2.35 with a confidence interval (CI) of 0.61 to 9.07, indicating a positive association between TDS and POUR, but without statistical significance.

CONCLUSIONS

Current evidence suggests that TDS application may be associated with increased risk of POUR following urogynecologic procedures. While research on this topic is greatly limited, this systematic review and meta-analysis highlights that alternative antiemetic therapy may be necessary for patients undergoing such interventions in effort to limit the risk of POUR.

Estrogenic and anti-amnesic potential of Millettia griffoniana Baill. (Fabaceae) ethanolic extract on scopolamine-induced memory impairment in ovariectomized Wistar rats

ETHNOPHARMACOLOGICAL RELEVANCE

Dementias including Alzheimer disease (AD) are three times higher in menopausal women than in men. Phytoestrogens, a group of plant-derived compounds are known to alleviate menopausal complaints including dementia. Millettia griffoniana Baill is a phytoestrogen-rich plant used to treat menopausal complaints and dementia.

AIM

Evaluating the estrogenic and neuroprotective potential of Millettia griffoniana on ovariectomized (OVX) rats.

MATERIALS AND METHODS

The in vitro safety of M. griffoniana ethanolic extract was assayed by MTT in human mammary epithelial (HMEC) and mouse neuronal (HT-22) cells and its lethal dose 50 (LD₅₀) was estimated following OECD 423 guidelines. For estrogenicity, in vitro the well known E-screen assay on MCF-7 cells was performed and in vivo four groups of OVX rats were treated either with 75, 150 and 300 mg/kg M. griffoniana extract doses or estradiol (1 mg/kg BW) for three days; and changes in uterine and vagina were analyzed. Then, for neuroprotective effect, Alzheimer-type dementia induction was achieved by scopolamine (1.5 mg/kg B.W., i.p.) injection four days/week and M. griffoniana extract as well as piracetam (standard) were administered daily for 2 weeks to evaluate the extract's neuroprotective potential. The endpoints were the assessment of learning and working memory, oxidative stress state (SOD, CAT, and MDA) in brain, acetylcholine esterase (AChE) activity and the histopathological changes in hippocampus.

RESULTS

No toxic effect was observed when incubating mammary (HMEC) and neuronal (HT-22) cells with M. griffoniana ethanol extract for 24 h and its LD₅₀ was found >2000 mg/kg. The extract also exhibited both in vitro and in vivo estrogenic activities, displayed by a significant (p < 0.01) increment in MCF-7 cells population in vitro and an increase in the epithelium height of the vagina and the wet weight of the uterus mainly with the 150 mg/kg BW extract dose compared to untreated OVX rats. The extract also reversed scopolamine-induced memory impairment in rat by improving learning, working and reference memory. This was associated with an increment in CAT and SOD expression, alongside a decrement in MDA content and AChE activity in hippocampus. Further, the extract reduced neuronal cell loss in hippocampal structures (CA1, CA3 and dentate gyrus). High Performance Liquid Chromatography coupled with Mass Spectrometry (HPLC-MS) spectra, revealed the presence of numerous phytoestrogens in M. griffoniana extract.

CONCLUSION

M. griffoniana ethanolic extract has estrogenic, anticholinesterase and antioxidant activities that could account for its anti-amnesic effects. These findings therefore sheds light on why this plant is commonly used in the therapy of menopausal complaints and dementia.

Modulation of the Gut Microbiota in Memory Impairment and Alzheimer's Disease via the Inhibition of the Parasympathetic Nervous System

The gut microbiota has been demonstrated to play a critical role in maintaining cognitive function via the gut-brain axis, which may be related to the parasympathetic nervous system (PNS). However, the exact mechanism remains to be determined. We investigated that patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) could exhibit an altered gut microbiota through the suppression of the PNS, compared to the healthy individuals, using the combined gut microbiota data from previous human studies. The hypothesis was validated in rats to suppress the PNS by scopolamine injections. The human fecal bacterial FASTA/Q files were selected and combined from four different AD studies (n = 410). All rats had a high-fat diet and treatments for six weeks. The MD rats had memory impairment by scopolamine injection (2 mg/kg body weight; MD, Control) or no memory impairment by saline injection. The scopolamine-injected rats had a donepezil intake as the positive group. In the optimal model generated from the XGboost analysis, Blautia luti, Pseudomonas mucidoiens, Escherichia marmotae, and Gemmiger formicillis showed a positive correlation with MCI while Escherichia fergusonii, Mycobacterium neglectum, and Lawsonibacter asaccharolyticus were positively correlated with AD in the participants with enterotype Bacteroides (ET-B, n = 369). The predominant bacteria in the AD group were negatively associated in the networking analysis with the bacteria in the healthy group of ET-B participants. From the animal study, the relative abundance of Bacteroides and Bilophilia was lower, and that of Escherichia, Blautia, and Clostridium was higher in the scopolamine-induced memory deficit (MD) group than in the normal group. These results suggest that MCI was associated with the PNS suppression and could progress to AD by exacerbating the gut dysbiosis. MCI increased Clostridium and Blautia, and its progression to AD elevated Escherichia and Pseudomonas. Therefore, the modulation of the PNS might be linked to an altered gut microbiota and brain function, potentially through the gut-brain axis.

Antihistamines for motion sickness

BACKGROUND

Motion sickness is a syndrome that occurs as a result of passive body movement in response to actual motion, or the illusion of motion when exposed to virtual and moving visual environments. The most common symptoms are nausea and vomiting. Antihistamines have been used in the management of motion sickness for decades, however studies have shown conflicting results regarding their efficacy.

OBJECTIVES

To assess the effectiveness of antihistamines in the prevention and treatment of motion sickness in adults and children.

SEARCH METHODS

The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials; Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 7 December 2021.

SELECTION CRITERIA

Randomised controlled trials (RCTs) in susceptible adults and children in whom motion sickness was induced under natural conditions such as air, sea and land transportation. We also included studies in which motion sickness was induced under experimental conditions (analysed separately). Antihistamines were included regardless of class, route or dosage and compared to no treatment, placebo or any other pharmacological or non-pharmacological interventions.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Our primary outcomes were 1) the proportion of susceptible participants who did not experience any motion sickness symptoms; 2) the proportion of susceptible participants who experienced a reduction or resolution of existing symptoms. Secondary outcomes were 1) physiological measures (heart rate, core temperature and gastric tachyarrhythmia (electrogastrography)) and 2) adverse effects (sedation, impaired cognition, blurred vision). We used GRADE to assess the certainty of the evidence for each outcome.

MAIN RESULTS

We included nine RCTs (658 participants). Studies were conducted across seven countries, with an overall age range of 16 to 55 years. Motion sickness was induced naturally in six studies and experimentally in four studies (rotating chair). All the naturally induced studies only evaluated first-generation antihistamines (cinnarizine and dimenhydrinate). Risk of bias across the studies varied, with mostly low risk for random sequence generation and allocation concealment, and mostly high risk for selective reporting. Only the experimentally induced studies measured physiological parameters and only the naturally induced studies evaluated adverse effects. There were no studies that clearly assessed the paediatric population. Antihistamines versus placebo or no treatment Antihistamines are probably more effective than placebo at preventing motion sickness symptoms under natural conditions (symptoms prevented: 25% placebo; 40% antihistamines) (risk ratio (RR) 1.81, 95% confidence interval (CI) 1.23 to 2.66; 3 studies; 240 participants) (moderate-certainty). The evidence is very uncertain about the effect of antihistamines on preventing motion sickness under experimental conditions (standardised mean difference (SMD) 0.32, 95% CI -0.18 to 0.83; 2 studies; 62 participants) (very low-certainty). No studies reported results on the resolution of existing motion sickness symptoms. Antihistamines may result in little or no difference in gastric tachyarrhythmia under experimental conditions (mean difference (MD) -2.2, 95% CI -11.71 to 7.31; 1 study; 42 participants) (low-certainty). No studies reported results for any other physiological measures. When compared to placebo, antihistamines may be more likely to cause sedation (sedation: 44% placebo; 66% antihistamines) (RR 1.51, 95% CI 1.12 to 2.02; 2 studies; 190 participants) (low-certainty); they may result in little or no difference in blurred vision (blurred vision: 12.5% placebo; 14% antihistamines) (RR 1.14, 95% CI 0.53 to 2.48; 2 studies; 190 participants) (low-certainty); and they may result in little or no difference in terms of impaired cognition (impaired cognition: 33% placebo; 29% antihistamines) (RR 0.89, 95% CI 0.58 to 1.38; 2 studies; 190 participants) (low-certainty). Antihistamines versus scopolamine The evidence is very uncertain about the effect of antihistamines on preventing motion sickness under natural conditions when compared to scopolamine (symptoms prevented: 81% scopolamine; 71% antihistamines) (RR 0.89, 95% CI 0.68 to 1.16; 2 studies; 71 participants) (very low-certainty). No studies were performed under experimental conditions. No studies reported results on the resolution of existing motion sickness symptoms. The evidence is very uncertain about the effect of antihistamines on heart rate under natural conditions (narrative report, 1 study; 20 participants; "No difference in pulse frequency"; very low-certainty). No studies reported results for any other physiological measures. When compared to scopolamine, the evidence is very uncertain about the effect of antihistamines on sedation (sedation: 21% scopolamine; 30% antihistamines) (RR 0.82, 95% CI 0.07 to 9.25; 2 studies; 90 participants) (very low-certainty) and on blurred vision (narrative report: not a significant difference; 1 study; 51 participants; very low-certainty). No studies evaluated impaired cognition. Antihistamines versus antiemetics Antihistamines may result in little or no difference in the prevention of motion sickness under experimental conditions (MD -0.20, 95% CI -10.91 to 10.51; 1 study; 42 participants) (low-certainty). The evidence is of low certainty due to imprecision as the sample size is small and the confidence interval crosses the line of no effect. No studies assessed the effects of antihistamines versus antiemetics under natural conditions. No studies reported results on the resolution of existing motion sickness symptoms. Antihistamines may result in little or no difference in gastric tachyarrhythmia (MD 4.56, 95% CI -3.49 to 12.61; 1 study; 42 participants) (low-certainty). No studies reported results for any other physiological measures. No studies evaluated sedation, impaired cognition or blurred vision. One study reported physiological data for this outcome, evaluating gastric tachyarrhythmia specifically. Antihistamines may result in little or no difference in gastric tachyarrhythmia (MD 4.56, 95% CI -3.49 to 12.61; 1 study; 42 participants; low-certainty evidence). This evidence is of low certainty due to imprecision as the sample size is small and the confidence interval crosses the line of no effect. Antihistamines versus acupuncture The evidence is very uncertain about the effects of antihistamines on the prevention of motion sickness under experimental conditions when compared to acupuncture (RR 1.32, 95% CI 1.12 to 1.57; 1 study; 100 participants) (very low-certainty). This study did not assess the prevention of motion sickness under natural conditions, nor the resolution of existing motion sickness symptoms. There was no study performed under natural conditions. Physiological measures and adverse effects were not reported.

AUTHORS' CONCLUSIONS

There is probably a reduction in the risk of developing motion sickness symptoms under naturally occurring conditions of motion when using first-generation antihistamines, in motion sickness-susceptible adults, compared to placebo. Antihistamines may be more likely to cause sedation when compared to placebo. No studies evaluated the treatment of existing motion sickness, and there are few data on the effect of antihistamines in children. The evidence for all other outcomes and comparisons (versus scopolamine, antiemetics and acupuncture) was of low or very low certainty and we are therefore uncertain about these effects of antihistamines.

Treatment for sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis

BACKGROUND

Motor neuron disease (MND), also known as amyotrophic lateral sclerosis (ALS), is a progressive neurodegenerative condition that may cause dysphagia, as well as limb weakness, dysarthria, emotional lability, and respiratory failure. Since normal salivary production is 0.5 L to 1.5 L daily, loss of salivary clearance due to dysphagia leads to salivary pooling and sialorrhea, often resulting in distress and inconvenience to people with MND. This is an update of a review first published in 2011.

OBJECTIVES

To assess the effects of treatments for sialorrhea in MND, including medications, radiotherapy and surgery.

SEARCH METHODS

On 27 August 2021, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, AMED, CINAHL, ClinicalTrials.gov and the WHO ICTRP. We checked the bibliographies of the identified randomized trials and contacted trial authors as needed. We contacted known experts in the field to identify further published and unpublished papers.

SELECTION CRITERIA

We included randomized controlled trials (RCTs) and quasi-RCTs, including cross-over trials, on any intervention for sialorrhea and related symptoms, compared with each other, placebo or no intervention, in people with ALS/MND.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane.

MAIN RESULTS

We identified four RCTs involving 110 participants with MND who were described as having intractable sialorrhea or bulbar dysfunction. A well-designed study of botulinum toxin B compared to placebo injected into the parotid and submandibular glands of 20 participants showed that botulinum toxin B may produce participant-reported improvement in sialorrhea, but the confidence interval (CI) was also consistent with no effect. Six of nine participants in the botulinum group and two of nine participants in the placebo group reported improvement (risk ratio (RR) 3.00, 95% CI 0.81 to 11.08; 1 RCT; 18 participants; low-certainty evidence). An objective measure indicated that botulinum toxin B probably reduced saliva production (in mL/5 min) at eight weeks compared to placebo (MD -0.50, 95% CI -1.07 to 0.07; 18 participants, moderate-certainty evidence). Botulinum toxin B may have little to no effect on quality of life, measured on the Schedule for Evaluation of Individual Quality of Life direct weighting scale (SEIQoL-DW; 0-100, higher values indicate better quality of life) (MD -2.50, 95% CI -17.34 to 12.34; 1 RCT; 17 participants; low-certainty evidence). The rate of adverse events may be similar with botulinum toxin B and placebo (20 participants; low-certainty evidence). Trialists did not consider any serious events to be related to treatment. A randomized pilot study of botulinum toxin A or radiotherapy in 20 participants, which was at high risk of bias, provided very low-certainty evidence on the primary outcome of the Drool Rating Scale (DRS; range 8 to 39 points, higher scores indicate worse drooling) at 12 weeks (effect size -4.8, 95% CI -10.59 to 0.92; P = 0.09; 1 RCT; 16 participants). Quality of life was not measured. Evidence for adverse events, measured immediately after treatment (RR 7.00, 95% CI 1.04 to 46.95; 20 participants), and after four weeks (when two people in each group had viscous saliva) was also very uncertain. A phase 2, randomized, placebo-controlled cross-over study of 20 mg dextromethorphan hydrobromide and 10 mg quinidine sulfate (DMQ) found that DMQ may produce a participant-reported improvement in sialorrhea, indicated by a slight improvement (decrease) in mean scores for the primary outcome, the Center for Neurologic Study Bulbar Function Scale (CNS-BFS). Mean total CNS-BFS (range 21 (no symptoms) to 112 (maximum symptoms)) was 53.45 (standard error (SE) 1.07) for the DMQ treatment period and 59.31 (SE 1.10) for the placebo period (mean difference) MD -5.85, 95% CI -8.77 to -2.93) with a slight decrease in the CNS-BFS sialorrhea subscale score (range 7 (no symptoms) to 35 (maximum symptoms)) compared to placebo (MD -1.52, 95% CI -2.52 to -0.52) (1 RCT; 60 participants; moderate-certainty evidence). The trial did not report an objective measure of saliva production or measure quality of life. The study was at an unclear risk of bias. Adverse events were similar to other trials of DMQ, and may occur at a similar rate as placebo (moderate-certainty evidence, 60 participants), with the most common side effects being constipation, diarrhea, nausea, and dizziness. Nausea and diarrhea on DMQ treatment resulted in one withdrawal. A randomized, double-blind, placebo-controlled cross-over study of scopolamine (hyoscine), administered using a skin patch, involved 10 randomized participants, of whom eight provided efficacy data. The participants were unrepresentative of clinic cohorts under routine clinical care as they had feeding tubes and tracheostomy ventilation, and the study was at high risk of bias. The trial provided very low-certainty evidence on sialorrhea in the short term (7 days' treatment, measured on the Amyotrophic Lateral Scelerosis Functional Rating Scale-Revised (ALSFRS-R) saliva item (P = 0.572)), and the amount of saliva production in the short term, as indicated by the weight of a cotton roll (P = 0.674), or daily oral suction volume (P = 0.69). Quality of life was not measured. Adverse events evidence was also very uncertain. One person treated with scopolamine had a dry mouth and one died of aspiration pneumonia considered unrelated to treatment.

AUTHORS' CONCLUSIONS

There is some low-certainty or moderate-certainty evidence for the use of botulinum toxin B injections to salivary glands and moderate-certainty evidence for the use of oral dextromethorphan with quinidine (DMQ) for the treatment of sialorrhea in MND. Evidence on radiotherapy versus botulinum toxin A injections, and scopolamine patches is too uncertain for any conclusions to be drawn. Further research is required on treatments for sialorrhea. Data are needed on the problem of sialorrhea in MND and its measurement, both by participant self-report measures and objective tests. These will allow the development of better RCTs.

Assessment of Cimetropium Bromide Use for the Detection of Gastric Neoplasms During Esophagogastroduodenoscopy

IMPORTANCE

Esophagogastroduodenoscopy (EGD) is a common procedure used to examine upper gastrointestinal diseases. Although cimetropium bromide and other antispasmodic agents are commonly administered as premedication to inhibit peristalsis during EGD examination, there are few data regarding the benefits of cimetropium bromide for the detection of gastric neoplasms.

OBJECTIVE

To investigate the association between the use of cimetropium bromide as premedication and gastric neoplasm detection rates during EGD examination.

DESIGN, SETTING, AND PARTICIPANTS

This propensity score-matched retrospective cohort study included 67 683 participants who received EGD screening at the Health Promotion Center of Seoul St. Mary's Hospital, The Catholic University of Korea, from January 2, 2010, to June 30, 2017. Data were analyzed from April 1 to December 30, 2021.

EXPOSURES

Participants were divided into 2 groups: those who received cimetropium bromide before EGD examination (intervention group) and those who did not (control group).

MAIN OUTCOMES AND MEASURES

Gastric neoplasm detection rates.

RESULTS

Among 67 683 participants, the mean (SD) age was 48.6 (10.8) years, and 36 517 participants (54.0%) were male; all participants were Asian (a racially homogenous population). Of those, 28 280 participants (41.8%; mean [SD] age, 50.3 [10.6] years; 57.8% male) received cimetropium bromide, and 39 403 participants (58.2%; mean [SD] age, 47.4 [10.8] years; 51.2% male) did not. Propensity score matching based on confounding variables yielded 41 670 matched participants (20 835 pairs). Detected lesions included 52 dysplasias (0.12%), 40 early cancers (0.10%), 7 advanced cancers (0.02%), and 3 lymphomas (0.01%). Gastric neoplasm detection rates were significantly higher in the intervention group (63 participants [0.30%]) vs the control group (39 participants [0.19%]; P = .02). A significant difference in the combined detection rate of dysplasia and early gastric cancer was found between those in the intervention group (57 participants [0.27%]) vs the control group (35 participants [0.17%]; P = .02). For small gastric lesions (<1 cm), those who received cimetropium bromide had higher detection rates (24 participants [0.12%]) than those who did not (11 participants [0.05%]; P = .03). Lesions in the gastric body were detected significantly more often in the intervention group (34 participants [0.16%]) vs the control group (15 participants [0.07%]; P = .007). In multivariate analyses involving all 67 683 participants, the use of cimetropium bromide was more likely to detect gastric neoplasms compared with nonuse (odds ratio, 1.42; 95% CI, 1.04-1.95; P = .03).

CONCLUSIONS AND RELEVANCE

In this study, the use of cimetropium bromide as premedication was significantly associated with increased gastric neoplasm detection rates during EGD screening, and lesions in the gastric body were detected more frequently among those who received cimetropium bromide compared with those who did not. These findings suggest that cimetropium bromide may be considered as premedication before EGD examination among individuals with no contraindications.

[Efficacy and safety of tiotropium Respimat in the treatment of chronic obstructive pulmonary disease: systematic review]

Objective: To evaluate the efficacy and safety of tiotropium Respimat in the treatment of chronic obstructive pulmonary disease (COPD) according to the Cochrane systematic evaluation. Methods: The Cochrane Library, PubMed, EMbase, CNKI, VIP and CBM, Wanfang Data were searched(from the foundation date to Jan. 2016) for the randomized controlled trials (RCTs) of tiotropium Respimat in the treatment of patients with COPD. Two reviewers independently retrieved the RCTs according to the inclusion and exclusion criteria, assessed the methodological quality of the included trials.and performed statistical analysis on the data using RevMan 5.3 software. Results: Totally 11 RCTs on efficacy were finally included.The results of the combined analysis showed that FEV(1) was significantly improved in the tiotropium Respimat group than that in the placebo group[MD=0.12, 95%CI(0.10-0.14), P<0.000 01], while FEV(1) was similar between the tiotropium Respimat group and the tiotropium HandiHaler group[5 μg: MD=0.00, 95%CI(-0.04-0.04), P=0.94; 2.5 μg: MD=-0.04, 95%CI(-0.10-0.01), P=0.12; 10 μg: MD=0.02, 95%CI(-0.06-0.09), P=0.66]. FVC was significantly improved in the tiotropium Respimat group than that in the placebo group[MD=0.18, 95%CI(0.09-0.28), P=0.0002], while FVC was similar between the tiotropium Respimat group and the HandiHaler group[2.5 μg: MD=-0.06, 95%CI(-0.16-0.04), P=0.24; 5 μg: MD=-0.00, 95%CI(-0.08-0.08), P=1.00; 10 μg: MD=0.02, 95%CI(-0.14-0.19), P=0.78]. The risk of acute exacerbations was lower in the tiotropium Respimat group (5 μg / kg) than in the placebo group [OR=0.72, 95%CI(0.60-0.86), P=0.000 3]. It was similar in the tiotropium Respimat group (5 μg) and the HandiHaler group[OR=1.01, 95%CI(0.94-1.09), P=0.71]. The SGRQ total score of the tiotropium Respimat group (5 μg) was significantly different from that of the placebo group[MD=-3.6, 95%CI(-3.88--3.32), P<0.000 01]. C(max, ss) and AUC(0-6 h, ss) were also similar between the tiotropium Respimat group and the HandiHaler group[MD=0.2, 95%CI(-5.1-5.5), P=0.94]; MD=-1.01, 95%CI(-11.78-9.77), P=0.85]. Nine RCTs were included in the evaluation of the incident rates of adverse drug reactions(ADR). There was no significant difference between the tiotropium Respimat group HandiHaler group and the placebo group[RR=0.95, 95%CI(0.89-1.00), P=0.05], [OR=1.07, 95%CI(1.00-1.16), P=0.06]. Conclusions: The efficacy and safety of tiotropium Respimat was similar to tiotropium HandiHaler in the treatment of COPD. They can effectively improve the pulmonary function and clinical symptoms of patients. But the long-term efficacy and safety of tiotropium Respimat still need to be confirmed by higher quality and larger RCTs with long-term follow-up.

[HPLC Fingerprint of Anisodus tanguticus Root]

OBJECTIVE

To establish an HPLC fingerprint of Anisodus tanguticus root for its quality control.

METHODS

The analysis was carried out on a Ultimate AQ C18 (250 mm x 4.6 mm, 5 μm) column with the gradient elution of acetonitrile and KH2PO4 buffer soution, whose pH was adjusted to 3.0 with phosphoric acid. The flow rate, column temperature, detection wavelength and injection volume was 1.0 mL/min, 30 degrees C, 210 nm and 10 μL separately. The similarity evaluation and principal component analysis were used to analyze HPLC fingerprint of Anisodus tanguticus root.

RESULTS

HPLC fingerprint of Anisodus tanguticus root was established with 15 common peaks by determining 18 batches of Anisodus tanguticus root samples. Four characteristic peaks, anisodine, scopolamine, anisodamine and anisodamine, were confirmed by comparing their retention time and UV spectrum with standard reference substances. The simiarities of 18 batches of Anisodus tanguticus root were between -0.891 and 0.987. Comprehensive evaluation scores of 18 batches of Anisodus tanguticus root were between -0.85 and 0.89 by principal component analysis.

CONCLUSION

The established HPLC fingerprint has good precision, repeatability and stability, which can provide more comprehensive information for identification and quality control of Anisodus tanguticus root.

[Effects of (-), (+)clausenamide on anisodine-induced acetylcholine decrease and associated memory deficits in the mouse brain]

The effect of a new cognition enhancer clausenamide on regional acetylcholine (ACh) levels and anisodine-induced ACh decrease were examined in mice of memory deficits. In the mean time, the effect of (-)clausenamide on ACh was compared with that of (+)clausenamide. Animal amnesia model was induced by i.p. anisodine, brain acetylcholine content was measured by high performance liquid chromatography with electrochemical detection. It was found that single administration of (-)clausenamide or (+)clausenamide(10, 20, 50 mg.kg-1, ig) showed no effect on the ACh level in the frontal cortex, hippocampus and striatum in normal condition. However, pretreatment with (-)clausenamide (10, 20, 50 mg.kg-1, ig) significantly ameliorated the reduction of ACh in these regions induced by anisodine (10 mg.kg-1, i.p.) in a dose-dependent manner. In the meantime, (-) clausenamide ameliorate anisodine-induced memory deficits in step-through test in mice. In contrast, (+)clausenamide showed no effect on these sides. The results indicate that there is significant difference between the actions of (-)clausenamide and (+)clausenamide; The protective action of (-)clausenamide against anisodine-induced amnesia is due to its ability to reverse ACh reduction.

[Cooperative activity of motor and frontal cortex neurons in trained cats systemically administered M-cholinoreceptor blockers]

It was shown previously that peripherally administered antagonists of the central 1 M-cholinoreceptors led to a selective impairment of bar-pressing response in a food-reinforced operant conditioned task but did not alter contextual behavior and functions such as motivation, perception, and locomotion. To obtain information about the central mechanisms of the conditioning impairment, we recorded simultaneously the extracellular multiunit activity from the frontal and motor neocortical areas of five cats trained to acquisition criteria in a food-reinforced operant conditioning task. Multiunit recordings were performed drur 1) normal conditioning; 2) conditioning during subcutaneous administration of muscarinic antagonists scopolamine (0.03 mg/kg), trihexyphenidyl (1 mg/kg), and methylscopolamine (0.03 mg/kg). Autocorrelation analysis showed that scopolamine and trihexyphenidyl but not methylscopolamine led to a significant increase in the tendency of cortical cells to fire in a cyclic way (i.e., the shift of the firing pattern from a single-spike discharge to burst, rhythmic, or rhythmic-burst discharge) both in the motor and frontal areas. Cross-correlation analysis showed that the bursting and rhythmic-bursting cells synchronized their activity within and (in a number of cases) between the cortical areas. These changes in the neuronal activity within the motor cortex and frontal cortex were accompanied by a significant decrease in the functional connectivity both inside and between the cortical areas in parallel with selective impairment of the conditioned response.

Influence of chronic ethanol consumption on the muscarinic cholinergic control of rat pancreatic acinar cells

There are a number of hypothetical explanations for the actions of ethanol on the exocrine pancreas; among them, the cholinergic hypothesis has received special attention. According to this hypothesis, chronic alcohol consumption induces alterations in the control of exocrine pancreatic function resulting in cholinergic hyperstimulation of pancreatic acinar cells and their muscarinic receptors. Our aim was to investigate the cholinergic control of pancreatic enzyme secretion and the number and affinity of muscarinic receptors in the pancreatic acinar cells of rats subjected to chronic ethanol ingestion. We also investigated whether a high-fibre diet modifies the actions of ethanol on these aspects of the exocrine pancreatic function. Four groups of rats received either a standard or a high fibre diet, and either water or 20% (v/v) ethanol. After 6 months of treatment, isolated pancreatic acini were used for the determination of carbachol-stimulated amylase secretion and for the analysis of muscarinic receptors, using 1-[N-methyl-3H]scopolamine as a radioligand. Neither chronic ethanol intake nor a high fibre diet caused any apparent alteration in pancreatic histology, neither did them modify plasmatic amylase levels. Chronic alcoholization resulted in a significant increase in the amylase released from pancreatic acini in response to carbachol stimulation, but it did not affect either the number or the affinity of pancreatic acinar muscarinic receptors. The actions of ethanol are not significantly modified by the simultaneous consumption of a high fibre diet.

[Improving memory effects of eel oil capsule on memory obstruction of mice hurt by anisodine]

The effects of eel oil capsule on memory obstruction of mice were observed in step-down test, step-through test, Y-maze test and Japanese labyrinth test. The results indicated that the eel oil capsule treating group with dosages of 0.234, 0.702 and 2.106 g/kg markedly enhance the acquirement, strengthing and reappearance of memory, having the functions of improving brain memory hurt by Anisodine.

Effects of clausenamide on anisodine-induced acetylcholine decrease and memory deficits in the mouse brain

OBJECTIVES

To study the action mechanism of a new cognition enhancer clausenamide and the effect of clausenamide on regional acetylcholine (ACh) levels, and to examine anisodine-induced ACh decrease in mice of memory deficits, and to compare the effect of (-)clausenamide on ACh with that of (+)clausenamide.

METHODS

Animal amnesia model was induced by i.p. anisodine and brain ACh content was measured by high performance liquid chromatography with electrochemical detection.

RESULTS

Single administration of (-)clausenamide or (+)clausenamide (10, 20, 50 mg/kg, i.g.) had no effect on the ACh level in the frontal cortex, hippocampus and striatum. However, pretreatment with (-)clausenamide (10, 20, 50 mg/kg, i.g.) significantly ameliorated the reduction of ACh induced by anisodine (10 mg/kg, i.p.) in a dose-dependent manner. Physostigmine (0.2 mg/kg, s.c.), as a cholinesterase inhibitor significantly increased the ACh levels and reversed the anisodine-induced ACh decrease. In contrast, (+)clausenamide had no effect on ACh decrease in all examined brain regions. (-)Clausenamide ameliorated anisodine-induced memory deficits in step-through test in mice.

CONCLUSION

There is significant difference in the action of (-)clausenamide and (+)clausenamide. The protective action of (-)clausenamide against anisodine-induced amnesia is due to its ability to reverse the ACh reduction.

[Studies on improving the ability of learning and memories of yangshoudan]

OBJECTIVE

To observe the effects of Yangshoudan(YSD) on the ability of learning and memories in experimental animals.

METHODS

The tests of darkness-avoidance response in normal young mice and rats, aged mice, as well as in model mice with dysmnesia induced by anisodine, model rats with dysmnesia induced by scopolamine hydrobromide and with orientation disturbance induced by pentobarbital sodium.

RESULTS

In normal young mice and rats, the error times in five minutes in learning and memories tests was reduced (P < 0.01-0.05) by YSD, while in dysmnesia groups the error times in five minutes also reduced (P < 0.01-0.05) and the incubation period of memories could be shortened by YSD. In orientation disturbance mice, the averages and percentages of correct response times increased by YSD.

CONCLUSIONS

YSD could improve the memory ability both in normal and dysmnesia which either induced by drugs or due to age. This indicates primarily that YSD has the effects of improving the ability of learning and memories and of antidementia.

Effect of inhaled prostaglandin D2 in normal and atopic subjects, and of pretreatment with leukotriene D4

BACKGROUND

Prostaglandin (PG) D2 is a potent bronchoconstrictor mediator and is found, together with leukotriene (LT) D4, in bronchoalveolar lavage fluid during the early response to allergen challenge in asthmatic subjects. The potency of PGD2 has not been established in normal and atopic non-asthmatic subjects, nor has the contribution of cholinergic mechanisms to PGD2 induced bronchoconstriction in normal subjects. Mediators released simultaneously may interact, so the effect of pre-inhalation of LTD4 on PGD2 responsiveness was investigated.

METHODS

Six normal and six atopic non-asthmatic subjects performed histamine and PGD2 challenges on separate occasions. Eight normal subjects performed PGD2 challenges immediately before and 45 minutes after inhalation of 200 micrograms oxitropium bromide or placebo. Bronchial responsiveness to PGD2 was established in six normal subjects immediately after pretreatment with saline or non-bronchoconstricting doses of methacholine or LTD4 (challenge 1), and again at six hours (challenge 2). All studies were performed in a double blind, randomised, crossover fashion.

RESULTS

PGD2 was 25-fold and 18-fold more potent as a bronchoconstrictor than histamine in atopic non-asthmatic and normal subjects, respectively. Responsiveness (PC35sGaw) to histamine and PGD2 correlated significantly (r = 0.917, n = 12, p < 0.001). Oxitropium bromide in a dose of 200 micrograms inhibited PGD2 induced bronchoconstriction by 37.5%, although in two of these subjects no inhibition was seen. Pre-inhalation of LTD4 and methacholine shifted the dose-response curve of PGD2 to the left by 4.6-fold and 2.4-fold, respectively.

CONCLUSIONS

PGD2 is a potent bronchoconstrictor in normal subjects, which is partly mediated by cholinergic mechanisms in some subjects. No significant interaction was found between LTD4 and PGD2 in six normal subjects.

[Clinical and experimental studies on zhikang oral liquid in treatment of hypophrenia]

The effect of Zhikang Oral Liquid (ZK) on 50 cases of hypophrenia children was observed and a control group of 20 cases was set. Results showed that the total effective rate of ZK group was 82%, it was significantly higher than that of control group (P < 0.01). Animal experiment revealed that ZK could improve the hypomnesia in learning caused by anisodine, poor memory retention caused by sodium nitrite and memory hypo-reproducibility caused by 40% alcohol. The results of clinical and experimental studies suggested that ZK could promote the intelligence development of child and improve the memory.

Ventricular, but not atrial, M2-muscarinic receptors increase in the canine pacing-overdrive model of heart failure

OBJECTIVE

To investigate the effects of heart failure induced by chronic rapid ventricular pacing (six weeks) on canine atrial and ventricular muscarinic receptors.

DESIGN

Dogs (n = 4) were fitted with a bipolar pacing electrode connected to a Medtronic pacemaker set at 240 stimuli/min. Pacing was maintained for six weeks. Tissue samples obtained from the left atrium and ventral wall of the left ventricle were frozen at -70 degrees C. Control tissue was obtained from normal dogs (n = 6) following anesthesia and thoracotomy. M2-muscarinic receptors were characterized and quantified in tissue micropunches using the hydrophilic ligand [3H] N-methyl-scopolamine (NMS).

MAIN RESULTS

Cardiac tissue bound [3H] NMS with the specificity of an M2 subtype. Tachycardia-induced heart failure did not affect atrial muscarinic receptors but signify left ventricular myocytes (control 160.0 +/- 10.0 fmol/mg protein versus heart failure 245.0 +/- 25.0 fmol/mg protein; P < 0.01).

CONCLUSIONS

Canine ventricular muscarinic receptors display a specificity for the M2 subtype. In contrast to previous work, tachycardia-induced heart failure was accompanied by an increase (+ 53%) in ventricular, but not atrial, M2 receptors compared with normal dogs.

[Manufacture of computer-based testing and analyzing system for measuring step-through performance]

The computer-Based Testing and Analysing System for measuring Step-Through (avoiding darkness) performance (CTASS) has been developed. The system is based on the infrared beams which transfer actions of mice inside the boxes into signals of voltage. The signals are fed into the computer through A/D converter to computer for software processing. The functions which have been realized include, but not limited to: signal sampling and data curve displaying; intelligent identification and elimination of jamming signal; auto-calculation of number of errors (No) in all channels, latent period (LP) of entering into the light chamber, total time of mice staying in the light chamber (safty place Tl) and dark chamber (error place Td); hardcopy of screen graphics and resulting output by various printers. The CATSS system was applied to test normal mice and the cognition-deficient mice induced by anisodine, a M-Cholinergic antagonist at a dose of 1-10 mg/kg i.p. The data collected by the system were compared and proved to be consistent with those acquired by manual labour. The system has produced refined and accurate information refined to a maximum extent and guaranteed scientifically sound experimental results. It is foreseable that introducing the computer into pharmacological researches will update and advance their methodology.

[Memory-improving effect of aqueous extract of Astragalus membranaceus (Fisch.) Bge]

The study shows that the aqueous extract of Astragulus membranaceus (AMWE) can improve the anisodine-induced impairment on memory acquisition as well as the alcohol-elicited deficit of memory retrieval (number of errors were reduced and latent period was prolonged) in step down, and can also prolong the gasping duration of mice after decapitation at doses of 50g/kg (ig) for 7 days.

[Physical exercise tolerance in chronic obstructive emphysematous bronchitis and coronary heart disease under antiobstructive therapy]

19 consecutive patients (18 men, one woman, mean age 61.4 [49-73]years) with chronic obstructive airways disease (bronchitis and emphysema) together with angiographically confirmed coronary heart disease were studied to investigate their cardiopulmonary exercise tolerance and the effects of bronchodilators on their myocardial ischaemia. Because they were receiving drug therapy for angina or because they had previously undergone aortocoronary bypass operation or balloon dilatation, the patients were symptom-free. In three cases slight ischaemia was demonstrable during maximal exertion. Aerobic and anaerobic exercise capacity was determined by spiroergometry after inhalation of salbutamol (S, 0.2 mg) alone or in combination with oxitropium bromide (O, 0.2 mg). The supplementary effect of oral theophylline (T, 15 mg/kg.day) was studied in 13 patients. In terms of maximal aerobic exercise tolerance the following improvements were noted: energy output (watts): S: + 6.3%; S and O: + 12.3% (P < 0.05); S, O and T: + 14.0% (P < 0.01). Oxygen uptake (ml/min): S: + 8.2% (P < 0.05); S and O: + 18.2% (P < 0.01); S, O and T: + 35.4% (P < 0.01). Maximum exercise capacity was not significantly improved, although maximum oxygen uptake was significantly increased by the two-drug combination by 16.9% (P < 0.05) and by the three-drug combination by 19.2% (P < 0.05). Maximum minute volume and tidal volume rose significantly, though respiratory rate was unchanged. Heart rate and blood pressure remained practically unaffected by the treatment, both at rest and during exertion. There was no evidence of significant aggravation of ventricular arrhythmias or of ischaemia during ergometric testing.

Hm1 muscarinic cholinergic receptor internalization requires a domain in the third cytoplasmic loop

Selected regions of the Hm1 muscarinic cholinergic receptor were mutated to analyze the molecular mechanisms of agonist-induced receptor internalization (or sequestration). The wild-type and mutant Hm1 genes were expressed, using pSG5, in U293 human kidney cells. Whereas surface receptor density measured with the polar tracer N-[3H]methylscopolamine was rapidly reduced by carbachol exposure, total receptor content measured with [3H]quinuclidinyl benzilate did not decline for at least 24 h, indicating the absence of extensive receptor down-regulation in U293 cells. Carbachol stimulation of phosphatidylinositol turnover paralleled receptor internalization, both with EC50 values of 10-20 microM. Furthermore, a D71N point mutation that prevented receptor activation also abolished carbachol-induced receptor internalization, indicating that receptor activation (but not necessarily second messenger stimulation) was required for internalization. Truncation of the COOH-terminal tail (K447 trunc) and point mutations of several potential Ser and Thr phosphorylation sites to Ala failed to affect receptor activation and internalization. In contrast, partial deletions of the third intracellular loop (i3) (Tyr208-Thr366) resulted in receptor mutants deficient in agonist-induced receptor internalization/sequestration. Various deletions caused either complete loss of internalization (d 232-358) or impaired internalization, ranging from 10 to 30% over 2 h, whereas wild-type Hm1 internalized to approximately 50%. Whereas the reason for the observed differences among the deficient deletion mutants remains unclear, the initial rate of N-[3H]methylscopolamine binding loss from the cell surface was much slower than that of wild-type Hm1 in each case. The deletion of only one single domain, 284-292 (SMESLTSSE), in the middle of i3 was consistently associated with impaired internalization. Domain 284-292 is partially conserved among closely related muscarinic receptors, whereas most of the remainder of i3 is not (except for the i3 membrane junctions), and similar Ser- and Thr-rich regions are present in many other G protein-coupled receptors. We propose that a small receptor domain in the middle of the i3 loop of Hm1 is involved in agonist-induced receptor internalization.

Evaluation of an infrared light absorption method for objective assessment of oral mucosal dryness

The aim of this study was to evaluate an infrared light absorption (ILA) method for registration of dryness of the oral mucosa. Measurements were performed in the buccal and in the lip mucosa immediately before and every 30 min after submucosal injection of 1.0 ml methylscopolamine nitrate in nine healthy subjects. For comparison, a dental mirror sliding friction test was used. About 1.5 h after injection the ILA method showed statistically significant (P less than 0.01) decreases of values in both the buccal and the lip mucosa. However, in the individual subjects the deviations from initial values showed only slight agreement when measured with the ILA method and the mirror friction test. Thus, the ILA method does not seem to be suitable for registration of individual variations in oral mucosal dryness.

Characterization of muscarinic receptors in dog tracheal smooth muscle cells

1. The tritiated muscarinic antagonist N-methyl scopolamine, [3H]-NMS, was used to characterize the muscarinic receptors associated with the intact dog tracheal smooth muscle cells. Based on receptor binding assays, the intact tracheal smooth muscle cells had specific, saturable, high-affinity binding sites for [3H]-NMS. 2. Specific binding was cell concentration- and time-dependent. The specific binding of [3H]-NMS was increased linearly with increasing cell concentrations. The equilibrium for association of [3H]-NMS with the muscarinic receptors was attained within 30 min at 37 degrees C. 3. Binding was saturable with respect to [3H]-NMS concentrations. Analysis of binding isotherms yielded an apparent equilibrium dissociation constant (KD) of 320 +/- 20 pM and a maximum receptor density (Bmax) of 13.7 +/- 1.4 fmole per 5 x 10(4) cells. The Hill coefficient for [3H]-NMS binding was 1.00 +/- 0.01. The association (K1) and dissociation (K-1) rate constants were determined to be (1.19 +/- 0.23) x 10(8) M-1 min-1 and 0.034 +/- 0.09 min-1, respectively. KD, calculated from the ratio of K-1 and K1, was 286 +/- 65 pM; this value is close to the value of KD calculated from Scatchard plots of binding isotherms. 4. The non-selective muscarinic antagonist atropine and M1 selective antagonist pirenzepine did not reveal any selectivity of these muscarinic receptors. Pirenzepine competed with [3H]-NMS for a single binding site with a Ki value of (6.02 +/- 0.69) x 10(-7) M which is close to the value of M2 or M3 receptors, indicating that the M1 receptor subtype did not exist in the intact tracheal smooth muscle cells. 5. Competition with cardioselective antagonist (M2), methoctramine; smooth muscle selective antagonists (M3), hexahydrodifenidol and hexahydrosiladifenidol; as well as carbachol, were best fit by a two-binding site model. The results suggest that both M2 and M3 receptor subtypes exist at the cell surface of tracheal smooth muscle cells.

Evaluation of some electrical methods for objective assessment of oral mucosal dryness

The aim of this study was to evaluate different electrical methods (resistance, capacitance and polarization resistance) for clinical and objective registration of dryness of the oral mucosa. Measurements were performed in the buccal and in the lip mucosa before and every 30 min after injection of 1.0 ml methylscopolamine nitrate submucosally in the labial sulcus in 10 healthy subjects. For comparison, a dental mirror sliding test was used. About 1 h after injection, all three methods showed statistically significant decreases of values in the buccal as well as the lip mucosa except for polarization resistance, which showed such a difference only in the buccal mucosa. The deviations from initial values in the individual subject showed no agreement between measurements with the electrical instruments and oral mucosal dryness assessed with the mirror test. Neither was there any agreement between values registered with the three electrical methods. It seems that these electrical methods are not suitable for registration of individual variations in oral mucosal dryness.

Evaluation of a new device for measuring oral mucosal surface friction

For the objective measurement of oral mucosal dryness or moisture, a device registering oral mucosal surface slide friction has been developed. Two prototypes, Probe I and Probe II, have been tested. Probe I was constructed for initial testing of the method and was based on easily accessible electrical components. Probe I was computerized and developed for more accurate registration and also for easy handling. Reliability and validity tests were carried out on Probe I as well as on Probe II. In repeated in vitro measurements, the probes showed good reproducibility. Validity was assessed on healthy subjects injected with methylscopolamine nitrate submucosally in the labial sulcus. All subjects experienced a pronounced oral mucosal dryness within half an hour. Registration with the surface slide friction device showed maximum friction values 1-2 h after injection. These reliability and validity tests gave good results for both Probe I and Probe II, but Probe II had several practical advantages over Probe I. Both probes were considerably more sensitive to changes of the oral mucosal surface than the previously used simple friction test using the back of a mouth mirror.

Cholecystokinin-induced regulation of muscarinic receptor on dispersed pancreatic acini

We have examined the effect of cholecystokinin octapeptide (CCK-8) on the ability of carbamylcholine (carbachol) to inhibit binding of 3H-N-methylscopolamine (3H-NMS) to muscarinic receptors on dispersed acini from rat pancreas. Carbachol bound to muscarinic receptors on rat dispersed pancreatic acini with two different Kd values. EC50 value for the stimulation of amylase secretion by carbachol was well compatible to the calculated Kd value of high affinity binding site of carbachol, suggesting that high affinity binding sites were mainly involved in the secretory response. Simultaneous addition of CCK-8 decreased the ability of carbachol to inhibit binding of 3H-NMS to acini due to an apparent disappearance of high affinity binding site of carbachol. The effective range of concentrations of CCK-8 for such a receptor regulation, as well as the time course of CCK-8 effect, were in good agreement with those for the restriction of carbachol-induced amylase secretion by CCK-8. These findings suggest that the restriction of carbachol-stimulated amylase secretion by CCK-8 is mainly a result of the disappearance of high affinity binding site of muscarinic receptor as a result of CCK-8 administration.

Carbachol-induced down-regulation of receptors for pancreatic secretagogues

Pancreatic acini possess a high affinity class of cholinergic receptors and a low affinity class of cholinergic receptors. Carbachol occupation of high affinity cholinergic receptors produces a reduction in binding of [3H]N-methylscopolamine. First incubating acini with carbachol caused a complete loss of high affinity cholinergic receptors with no change in the number or affinity of low affinity cholinergic receptors. Carbachol occupation of low affinity cholinergic receptors appears to produce a reduction in binding of 125I-CCK-8 and 125I-[Tyr4]bombesin. Acini possess two classes of CCK receptors. One class has a high affinity for CCK-8; the other class has a low affinity for CCK-8. First incubating acini with carbachol caused a 60% decrease in the number of high affinity CCK receptors with no change in the number of low affinity receptors or the affinities of either class of receptors for CCK-8. Acini possess a single class of bombesin receptors and first incubating acini with carbachol caused a 40% decrease in the number of bombesin receptors with no change in their affinity for bombesin.

Muscarinic cholinoceptors in the human heart: demonstration, subclassification, and distribution

In human atrial and ventricular myocardium, the muscarinic cholinoceptor (M-cholinoceptor) populations were characterized by means of radioligand binding (with [N-methyl-3H]-scopolamine ([3H]-NMS) as the ligand) and functional experiments (negative inotropic effect of carbachol on isolated electrically driven right atrial and left papillary muscle preparations). (1) Binding of [3H]-NMS to human atrial and ventricular membranes was rapid, reversible and saturable (KD-values: 0.5-1.0 nmol/l). The maximal number of [3H]-NMS binding sites, however, was approximately 2.5-fold higher in right and left atrial membranes (200-250 fmol [3H]-NMS specifically bound/mg protein) than in right and left ventricular membranes (80-100 fmol/mg protein). (2) M-cholinoceptor antagonists inhibited [3H]-NMS binding to right atrial and left ventricular membranes with steep, monophasic competition curves indicating interaction with a single class of binding sites. In both tissues the order of potency was: atropine greater than AF-DX 116 greater than hexahydrosiladifenidol (HHSiD) greater than pirenzepine. (3) On isolated electrically driven right atrial and left papillary muscle preparations (with force of contraction enhanced by 10(-5) mol/l isoprenaline), carbachol (10(-8)-10(-4) mol/l) caused concentration-dependent decreases in force of contraction; the pD2-value for carbachol was 6.65 +/- 0.09 (n = 8, atria) and 6.62 +/- 0.08 (n = 10, papillary muscles). In both tissues M-cholinoceptor antagonists antagonized the negative inotropic effect of carbachol with an order of potency: atropine greater than AF-DX 116 greater than HHSiD greater than pirenzepine, identical to that obtained in radioligand binding experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Urography with spasmolytics

The effects of glucagon (1 mg i.v.) and hyoscine butylbromide (Buscopan 20 mg i.v.) and placebo on the visualization of the pyelocalyceal systems and ureters was compared in a routine urography with abdominal compression in a double-blind, randomized trial comprising 189 kidneys and ureters. The visualization of the ureters in the supine position was highly significantly better than in the prone. In the prone position the ureteral visualization with Buscopan was marginally significantly better than with placebo or glucagon. Otherwise, neither Buscopan nor glucagon improved the pyeloureteral visualization. However, with glucagon the pyelocalyceal visualization was highly significantly poorer than with placebo, and marginally significantly poorer than with Buscopan.

Differential regulation of human cardiac beta-adrenergic and muscarinic receptors by chronic beta-adrenoceptor antagonist treatment

In patients undergoing coronary artery bypass grafting chronic beta 1-adrenoceptor antagonist treatment increased right atrial beta 1-adrenoceptor number, did not affect beta 2-adrenoceptor number and decreased muscarinic M2-receptor number. Concomitantly, the M2-receptor-mediated negative inotropic effect of carbachol was reduced, while the beta 1-adrenoceptor-mediated positive inotropic effect of noradrenaline was not altered. The beta 2- adrenoceptor mediated positive inotropic effect of procaterol, however, was markedly enhanced. We conclude that chronic beta 1-adrenoceptor antagonist treatment increases beta 1-adrenoceptor number, sensitizes beta 2-adrenoceptor function and desensitizes M2-receptor function in the human heart.

Autonomic control of the diurnal variation in arterial blood pressure and heart rate in spontaneously hypertensive and Wistar-Kyoto rats

The relative influences of sympathetic and parasympathetic neural modulation on mean arterial pressure (MAP) and heart rate (HR), and their respective variabilities, were studied in young spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY). An on-line computerized system was used for continuous intra-arterial measurements of MAP and HR in unrestrained rats. In addition, the autonomic nervous control of MAP and HR was studied in ageing SHR and WKY. Both WKY and SHR showed diurnal rhythms with regard to MAP and HR. The MAP variability was higher in SHR than in WKY during both daytime (inactive) and night-time (active), and did not change in response to either beta 1-adrenoceptor- or cholinergic blockade. Structural vascular changes, with a resultant increase in reactivity, may explain the elevated MAP variability in SHR. HR variability was clearly reduced in SHR; this was not influenced by vagal blockade, whereas HR variability was significantly reduced in WKY. This pattern is suggested to be due to a reduced tonic vagal discharge in SHR, as part of a persistent, mild defence reaction. The initial reduction in vagal activity will in turn eliminate vagally mediated tachycardias. Furthermore, administration beta 1-blockade to SHR of different ages caused a greater fall in MAP and HR than in WKY, indicating an increased dependence upon the sympathetic nervous system in SHR with age.

Induction of oral cancer by 7,12-dimethylbenz[a]anthracene in rats with liver cirrhosis

The effects of carbon tetrachloride-induced liver cirrhosis and xerostomia on oral carcinogenesis were studied in rats given the lipid-soluble carcinogen 7,12-dimethylbenz-[a]anthracene (DMBA). The first carcinoma was detected after only 1 month of DMBA applications. After a further 8 months 85% of the animals had developed one or more squamous cell carcinomas. The latency period for DMBA-induced oral cancer in cirrhotic rats with xerostomia was markedly reduced in comparison with previous findings from xerostomic rats without liver cirrhosis. The results support earlier epidemiologic studies indicating a relationship between liver cirrhosis and oral cancer.