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Biomedical subjects

M Kakihana

Publications and source records attributed to M Kakihana.

At least 19 recordsLinked to original sources

Randomized, double-blind, placebo-controlled study of ascorbate on the preventive effect of nitrate tolerance in patients with congestive heart failure.

BACKGROUND: Reduced cGMP production caused by increased superoxide has been proposed as a mechanism of nitrate tolerance during continuous nitrate therapy. This study was designed to evaluate the effects of ascorbate, an antioxidant, on the development of nitrate tolerance during continuous nitrate therapy in patients with congestive heart failure. METHODS AND RESULTS: Twenty patients with congestive heart failure were randomized to receive intravenous infusion of nitroglycerin concomitantly with placebo (placebo group, n=10) or intravenous ascorbate (vitamin C group, n=10). After baseline measurements were obtained, dose titration was started by the infusion of nitroglycerin at a rate of 0.5 microg/kg per minute (titration period). Measurements of hemodynamic parameters and blood sampling were performed serially at 0, 6, 12, 18, and 24 hours after the titration period. At baseline, mean pulmonary artery pressure (MPAP, mm Hg), mean pulmonary capillary wedge pressure (PCWP, mm Hg), plasma vitamin E level (micromol/L), and platelet cGMP level (pmol/10[9] platelets) were comparable in the two groups (placebo group: MPAP, 48+/-6; PCWP, 24+/-4; cGMP, 0.76+/-0.12; vitamin E, 18.2+/-1.2; vitamin C: MPAP, 49+/-7; PCWP, 24+/-4; cGMP, 0.71+/-0.16; vitamin E, 18.6+/-1.3). In both groups, at 6 hours after the titration period, MPAP and PCWP were significantly decreased (placebo group: MPAP, 26+/-5; PCWP, 15+/-4; vitamin C: MPAP, 26+/-4; PCWP, 16+/-4), and platelet cGMP was significantly increased (placebo group: 2.42+/-0.24; vitamin C: 2.26+/-0.26). However, at 18 hours after titration, in the placebo group, MPAP (44+/-5) and PCWP (23+/-4) were increased, and platelet cGMP (0.85+/-0.20) and plasma vitamin E levels (12.4+/-1.4) were significantly decreased. In contrast, in the vitamin C group, MPAP (31+/-6), PCWP (17+/-5), platelet cGMP (2.49+/-0.23), and plasma vitamin E levels (17.6+/-1.4) were maintained for 18 hours after the titration period. CONCLUSIONS: These findings indicate that ascorbate, an antioxidant, may prevent the development of nitrate tolerance during continuous nitrate therapy in patients with congestive heart failure.

Aged

Randomized, double-blind, placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance.

OBJECTIVES: This study sought to evaluate the preventive effect of vitamin C, an antioxidant, on the development of nitrate tolerance. BACKGROUND: Decreased intracellular production of cyclic guanosine monophosphate (cGMP) is a mechanism of nitrate tolerance, and increased superoxide levels and reduced activation of guanylate cyclase have been observed in vitro. METHODS: In this double-blind, placebo-controlled study, 24 normal volunteers and 24 patients with ischemic heart disease (IHD) were randomized to receive either vitamin C (2 g three times daily [vitamin C group, n=12]) or placebo (placebo group, n=12). The vasodilator response to nitroglycerin was assessed with forearm plethysmography by measuring the change in FBF before and 5 min after sublingual administration of 0.3 mg of nitroglycerin. Blood samples were simultaneously obtained to measure platelet cGMP levels. FBF was measured, and blood sampling was performed serially at baseline (day 0), 3 days after administration of vitamin C or placebo (day 3) and 3 days after application of a 10-mg/24-h nitroglycerin tape concomitantly with oral vitamin C or placebo (day 6). RESULTS: There were no differences between the vitamin C and placebo groups in percent increases in FBF (%FBF) or platelet cGMP levels (%cGMP) after administration of sublingual nitroglycerin on day O (%FBF: normal volunteers 31+/-8 vs. 32+/-10; patients with IHD 32+/-9 vs. 32+/-8; %cGMP: normal volunteers 37+/-9 vs. 39+/-10; patients with IHD 38+/-10 vs. 39+/-10 [vitamin C group vs. placebo group]) or day 3 (%FBF: normal volunteers 32+/-9 vs. 33+/-9; patients with IHD 31+/-10 vs. 31+/-10; %cGMP: normal volunteers 36+/-8 vs. 37+/-9; patients with IHD 39+/-11 vs. 38+/-10 [vitamin C group vs. placebo group]). The %FBF and %cGMP in the placebo group were significantly lower on day 6 than in the vitamin C group (%FBF: normal volunteers 30+/-8 vs. 19 4, p < 0.01; patients with IHD 29+/-9 vs. 17+/-6, p < 0.01; %cGMP: normal volunteers 36 10 vs. 17+/-6, p < 0.01; patients with IHD 37+/-11 vs. 15+/-5, p < 0.01 [vitamin C group vs. placebo group]). CONCLUSIONS: These results indicate that combination therapy with vitamin C is potentially useful for preventing the development of nitrate tolerance.

Adult

Preventive effects of angiotensin-converting enzyme inhibitors on nitrate tolerance during continuous transdermal application of nitroglycerin in patients with chronic heart failure.

This study was designed to investigate the effect of angiotensin-converting enzyme (ACE) inhibitors with and without a sulfhydryl group on intracellular production of cGMP, forearm blood flow, and neurohormonal factors during continuous transdermal application of nitroglycerin in patients with chronic heart failure. Platelet cGMP level and forearm blood flow were measured before and 5 min after sublingual administration of nitroglycerin (NTG) in 20 patients with chronic heart failure during the following 4 phases: (1) baseline phase; (2) NTG phase (1 week after NTG tape 10 mg/day); (3) CPT phase (1 week after both captopril 37.5 mg/day and NTG tape 10 mg/day); and (4) ENL phase (1 week after both enalapril 5 mg/day and NTG tape 10 mg/day). The platelet GMP level before sublingual NTG and forearm blood flow were significantly higher during the 3 phases with NTG tape than during the control phase. The percent increases in platelet cGMP level and forearm blood flow after sublingual NTG were significantly lower during the NTG phase than during the baseline phase. In contrast, concomitant application of ACE inhibitors maintained the percent increase in platelet cGMP level and forearm blood flow. These results indicate that concomitant therapy with ACE inhibitors may be helpful in preventing the attenuation of intracellular cGMP production in patients with chronic heart failure during continuous transdermal application of NTG.

Administration, Cutaneous

[Randomized, double-blind, placebo-controlled study of supplemental vitamin E on attenuation of the development of nitrate tolerance].

The attenuation of intracellular production of cyclic guanosine monophosphate (cGMP) has been known as a mechanism of nitrate tolerance. A recent in vitro study have shown an increase in superoxide levels and a reduced activation of guanylate cyclase in tolerant vessels. We investigated the preventive effect of an antioxidant, vitamin E, on the development of nitrate tolerance. In this double-blind, placebo-controlled study, 24 normal volunteers and 24 patients with ischemic heart disease (IHD patients) were randomized to receive either vitamin E (200 mg t. i. d.; vitamin E group) or placebo (placebo group). Vasodilator response to nitroglycerin was assessed with forearm plethysmography by measuring the change in the forearm blood flow before and 5 min after sublingual administration of 0.3 mg nitroglycerin, and at the same time, blood samples were taken from veins to measure the platelet cGMP level. Measurements of the forearm blood flow and blood sampling were obtained serially at baseline (day 0), 3 days after taking vitamin E or placebo alone (day 3), and 3 days after application of a 10 mg/24 hr nitroglycerin tape concomitantly with oral vitamin E or placebo (day 6). The response of forearm blood flow (%FBF) and cGMP (%cGMP) after sublingual nitroglycerin on day 0(%FBF: normal volunteers 32 +/- 12% vs 31 +/- 11%, IHD patients 35 +/- 15% vs 34 +/- 15%; %cGMP: normal volunteers 38 +/- 10% vs 35 +/- 11%, IHD patients 37 +/- 11% vs 38 +/- 12%; vitamin E group as placebo group) and day 3(%FBF: normal volunteers 33 +/- 9% vs 32 +/- 12%, IHD patients 35 +/- 12% vs 33 +/- 13%, %cGMP: normal volunteers 38 +/- 10% vs 37 +/- 11%, IHD patients 36 +/- 14% vs 37 +/- 10%, vitamin E group vs placebo group) were not different between the two groups. On day 6 %FBF and %cGMP in the placebo group were significantly lower compared with day 0, and there were significant differences in them between the two groups (%FBF: normal volunteers 30 +/- 12% vs 17 +/- 9%, p < 0.01; IHD patients 28 +/- 14% vs 17 +/- 8%, p < 0.01; %cGMP: normal volunteers 35 +/- 11% vs 8 +/- 5%, p < 0.01; IHD patients 38 +/- 10% vs 12 +/- 4%, p < 0.01, vitamin E group vs placebo group). In conclusion, the combination therapy with vitamin E is potentially a useful method to prevent the development of nitrate tolerance.

Aged

The novel compound TDN-345 induces synthesis/secretion of nerve growth factor in C6-10A glioma cells.

A novel compound, TDN-345, not bearing catechol moiety, induced NGF synthesis/secretion in C6-10A glioma cells. Both intracellular and extracellular nerve growth factor (NGF) protein levels increased within 3 h and reached a maximum around 12 h after the addition of TDN-345. The induction of NGF synthesis/secretion by TDN-345 occurred in a concentration-dependent manner, beginning with about 0.1 microM and reaching a maximum at 10 microM. The ED50 was 0.88 microM. The induction was accompanied by an increase in NGF mRNA but not beta-actin mRNA. In a time-course study, the NGF mRNA level was found to reach a maximum 2-3 h after the addition of TDN-345 and then to return to control levels. The induction occurred dose-dependently. The catecholaminergic compound epinephrine, which induces NGF synthesis/secretion, increased the intracellular cyclic AMP content by more than 1000-times at 10 microM. In contrast, TDN-345 did not cause such a prominent increase in cAMP even at 100 microM. These results indicate that TDN-345 induces NGF synthesis/secretion by increasing NGF mRNA expression, and the action of TDN-345 clearly differs from that of epinephrine, as it does not seem to involve cAMP as a second messenger. The results of the present study suggest the existence of a signal transduction pathway for NGF synthesis/secretion which is not mediated by cAMP.

Animals

Randomized, double-blind, placebo-controlled study of supplemental vitamin E on attenuation of the development of nitrate tolerance.

BACKGROUND: The attenuation of intracellular production of cGMP has been known to be a mechanism of nitrate tolerance. A recent in vitro study showed an increase in superoxide levels and a reduced activation of guanylate cyclase in tolerant vessels. We investigated the preventive effect of an antioxidant, vitamin E, on the development of nitrate tolerance. METHODS AND RESULTS: In this double-blind, placebo-controlled study, 24 normal volunteers and 24 patients with ischemic heart disease (IHD patients) were randomized to receive either vitamin E (200 mg TID vitamin E group) or placebo (placebo group). Vasodilator response to nitroglycerin was assessed with forearm plethysmography by measurement of the change in the forearm blood flow before and 5 minutes after sublingual administration of 0.3 mg nitroglycerin, and at the same time, blood samples were taken from veins to measure the platelet cGMP level. Measurements of the forearm blood flow and blood sampling were obtained serially at baseline (day 0), 3 days after vitamin E or placebo alone was taken (day 3), and 3 days after application of a 10-mg/24-h nitroglycerin tape concomitantly with oral vitamin E or placebo (day 6). The responses of forearm blood flow (%FBF) and cGMP (%cGMP) after sublingual nitroglycerin on day 0 (%FBF: normal volunteers, 32+/-12 versus 31+/-11; IHD patients, 35+/-15 versus 34+/-15; %cGMP: normal volunteers, 38+/-10 versus 35+/-11; IHD patients, 37+/-11 versus 38+/-12, vitamin E group versus placebo group) and day 3 (%FBF: normal volunteers, 33+/-9 versus 32+/-12; IHD patients, 35+/-12 versus 33+/-13; %cGMP: normal volunteers, 38+/-10 versus 37+/-11; IHD patients, 36+/-14 versus 37+/-10, vitamin E group versus placebo group) were not different between the two groups. On day 6, %FBF and %cGMP in the placebo group were significantly lower compared with day 0, and there were significant differences in them between the two groups (%FBF: normal volunteers, 30+/-12 versus 17+/-9, P<.01; IHD patients, 28+/-14 versus 17+/-8, P<.01; %cGMP: normal volunteers, 35+/-11 versus 8+/-5, P<.01; IHD patients, 38+/-10 versus 12+/-4, P<.01, vitamin E group versus placebo group). CONCLUSIONS: These results indicate that the combination therapy with vitamin E is potentially a useful method to prevent the development of nitrate tolerance.

Administration, Oral

Effects of enalapril during continuous nitrate therapy: analysis of diameter of coronary arteries and platelet cyclic guanosine monophosphate.

To investigate the effects of enalapril, an angiotensin-converting enzyme inhibitor, on nitrate tolerance during continuous nitrate therapy, coronary artery diameters and platelet cyclic guanosine monophosphate (cGMP) levels were measured before and 2 minutes after intracoronary injection of nitroglycerin 200 microg in 60 patients with coronary artery disease and were compared among 20 patients treated with nitrates (nitrate group), 20 patients treated with both nitrates and enalapril (enalapril group), and 20 untreated patients (control group). The percent increase in platelet cGMP and coronary dilatation in the nitrate group was significantly less than in the control group, but the percent increase in the enalapril group was significantly greater than that in the nitrate group. These results indicate that enalapril may be helpful as concomitant therapy to maintain the effect of nitrates during continuous nitrate therapy.

Aged

Hydroxyapatite ceramics with selected sintering additives.

Several sintering additives for hydroxyapatite (HA) have been tested in order to enhance its sinterability without decomposing the HA and/or decreasing bioactivity and biocompatibility, additionally providing a weak interface for HA ceramics. The ion species of sintering additives were selected from those in the mineral constituents of hard tissues and bioactive glasses. After investigation of phase diagrams in the CaO-P2O5-additive systems, and analysis of physiochemical properties of the additives, several sintering aids for HA have been chosen. Subsequently, densification, phase composition, grain growth and fracture behaviour of HA containing 5 wt% of each additive, sintered at 1000-1100 degrees C, have been studied. H3BO3, CaCl2, KCl, KH2PO4, (KPO3)n and Na2Si2O5 did not enhance densification of HA. K2CO2, Na2CO3, KF and sodium phosphates improved the densification significantly. Expect for KCl and some sodium phosphates, all the additives caused formation of large quantities of undesired beta-tricalcium phosphate or CaO; therefore, they are not appropriate for HA. In the case of sodium phosphate additives, it was possible to avoid formation of CaO or beta-tricalcium phosphate by control of the additive quantity and chemical composition. beta-NaCaPO4 has been found to be an effective sintering agent which causes neither decomposition of HA nor formation of other undesired phases.

Biocompatible Materials

Relation of a decrease in arterial compliance to ST segment depression on exercise electrocardiograms in patients with hypertension.

Decreased arterial compliance (ACo) and increased arterial resistance are the major alterations of arterial function in patients with hypertension. The influence of decreased ACo on the heart was investigated in patients with hypertension. Patients with a systolic blood pressure of > 140 mmHg, a diastolic blood pressure of > 90 mmHg, or both, who had normal coronary arteriograms were enrolled. These patients were divided into two groups according to the value of ACo: Group I, patients with ACo > or = 0.9 ml/mmHg (n = 15); and Group II, patients with ACo < 0.9 ml/mmHg (n = 13). There were no significant differences in arterial resistance, age, gender, and body surface area between the groups. Echocardiographic, hemodynamic, and exercise stress test variables were compared between the groups. There were no differences between the groups in left ventricular (LV) wall thickness and volume, cardiac output, LV end-diastolic pressure, and LV ejection fraction. However, pulse pressure was higher in Group II than in Group I. Ergometer exercise stress testing revealed that, although exercise duration and the peak rate-pressure product were similar in the two groups, ST segment depression of > or = 1.0 mm on the exercise electrocardiograms was induced more frequently in Group II than in Group I (92% vs. 27%, p < 0.001). Thus, the decrease in ACo in patients with hypertension may not significantly affect LV wall thickness, volume, or ejection fraction; however, it may increase pulse pressure and may adversely affect coronary circulation, as suggested by the ST segment depression on exercise electrocardiograms.

Arteries

Processing and mechanical properties of hydroxyapatite reinforced with hydroxyapatite whiskers.

Hydrothermally synthesized HAp fine crystals/HAp whiskers mixtures have been used for the preparation of HAp/0-30% (whiskers) composites. The composites have been fabricated by pressureless sintering and hot-pressing. The best mechanical properties and the highest densities have been achieved for composites hot pressed at 1000 degrees C (2 h, 30 MPa in flowing Ar). Their density was in the range of 90-97% of the theoretical density. Fracture toughness (Klc) of the composites reflected their microstructure and had the value of 1.4 MPa m1/2 (as compared with Klc = 1.0 MPa m1/2 for the non-reinforced HAp matrix). Compressive prestressing of the HAp matrix and crack deflection (both derived from the residual stress field) contributed to the increase of fracture toughness. Other toughening mechanisms have not been observed. HAp/HAp (whiskers) composites exhibited improved toughness without degradation of biocompatibility, because the HAp whiskers acted both as a reinforcement and as a biocompatible phase. Problems related to biocompatibility and mechanical properties of available HAp-based composites were also discussed.

Biocompatible Materials

Alterations in left ventricular wall stress and coronary circulation in patients with isolated systolic hypertension.

OBJECTIVES: To study the alterations in cardiac function and coronary circulation in patients with isolated systolic hypertension (ISH). PATIENTS: Ten patients with a history of ISH were studied and findings were compared with those of seven normotensive subjects. All of the patients had angiographically normal coronary arteries. They underwent cardiac catheterization, and haemodynamic variables and coronary flow velocity were measured. All of the patients also underwent treadmill exercise testing. MAIN OUTCOME MEASURES: Left ventricular mass was evaluated by echocardiography. The coronary flow velocity data were obtained by using the intracoronary Doppler catheter technique. ST-segment depression was observed on the exercise electrocardiogram. RESULTS: Systemic vascular resistance did not differ, whereas total arterial compliance was decreased in the ISH patients versus the controls (P < 0.001). The left ventricular mass of the ISH patients was increased slightly, but their left ventricular systolic wall stress was greater than that of the controls (P < 0.01). The coronary flow reserve ratio and the ratio of diastolic to total coronary flow were decreased in the ISH patients versus the controls (P < 0.01). ST-segment depression on the exercise electrocardiogram was frequently observed in the hypertensive patients (80 versus 0% in control subjects, P < 0.01). CONCLUSIONS: Patients with ISH were characterized haemodynamically by a decrease in arterial compliance. They showed an increase in left ventricular systolic wall stress and also showed decreases in coronary flow reserve ratio and in the relative diastolic coronary flow. Such alterations observed in patients with ISH are detrimental to the heart and may contribute to a reduced exercise capacity and the induction of subendocardial ischaemia during exercise.

Adult

Chronically decreased aortic distensibility causes deterioration of coronary perfusion during increased left ventricular contraction.

OBJECTIVES: This study investigated the long-term effects of decreased aortic distensibility on the heart in relation to coronary perfusion. BACKGROUND: Aortic distensibility is decreased in patients with atherosclerosis and hypertension and in the elderly. However, the effect of a long-term decrease in aortic distensibility on coronary perfusion has not been fully investigated. METHODS: Twelve anesthetized dogs underwent thoracotomy and were allocated to two groups: Group I included six control dogs with a normal aorta; Group II included six dogs with decreased aortic distensibility produced by banding the descending aorta. After 4 to 6 weeks, the dogs had a second operation to measure coronary artery flow and transmural flow distribution. Because the effect of decreased aortic distensibility on coronary perfusion may be affected by ventricular contractility, measurements were performed at baseline and during increased ventricular contraction induced by isoproterenol infusion. RESULTS: At baseline, arterial compliance was reduced by 35% in Group II, but there was no change in total mean arterial resistance. Hemodynamic variables, regional wall motion and coronary flow were also similar in both groups. However, during isoproterenol infusion, coronary flow increased more in Group II than in Group I (p < 0.01), and the coronary flow reserve ratio (maximal peak hyperemic flow divided by rest flow) decreased more in Group II than in Group I (mean [+/- SD] 1.9 +/- 0.4 vs. 2.4 +/- 0.3, p < 0.05). Moreover, although the transmural flow distribution was similar in the two groups at baseline, during isoproterenol infusion the endocardial flow increased less in Group II than in Group I (p < 0.05), and the endocardial/epicardial flow ratio was significantly decreased in Group II compared with Group I (mean [+/- SD] 0.70 +/- 0.18 vs. 0.99 +/- 0.22, p < 0.05). The subendocardial electrocardiogram showed ST segment elevation during isoproterenol infusion in Group II (p < 0.05) but not in Group I. CONCLUSIONS: These results demonstrate that during increased ventricular contraction, chronically decreased aortic distensibility contributes to a further decrease in the coronary flow reserve ratio, impairs endocardial blood flow and may induce subendocardial ischemia even in the absence of coronary artery stenosis.

Animals

Characterization of C6-10A glioma cells highly responsive to beta-adrenergic receptor agonist-induced NGF synthesis/secretion.

A subline of rat C6 glioma cells, C6-10A cells, in which epinephrine can induce nerve growth factor (NGF) synthesis/secretion, was isolated. C6-10A cells have retained their sensitivity to epinephrine for more than 2 years in a medium containing 0.5% fetal calf serum (FCS) but easily lose it in 10% FCS. C6-10A cells are S-100- and glial fibrillary acidic protein-positive, and the doubling time is about 60 h in the medium containing 0.5% FCS and about 20 h in 10% FCS. Epinephrine induced NGF synthesis/secretion prominently in serum-free cultures of C6-10A cells and in cultures with a high cell density, but not in serum-containing cultures. The induction did not occur with parent C6 cells under the appropriate conditions in C6-10A cells. NGF secretion was induced by catecholaminergic compounds in the following order isoproterenol > epinephrine = norepinephrine >> dopamine. The induction caused by epinephrine was blocked by propranolol (beta-blocker) but not by phentolamine (alpha-blocker). Various compounds that activate the adenylate cyclase system also induced NGF synthesis/secretion. These results indicate that C6-10A cells are astrocytes that are highly responsive to beta-adrenergic receptor agonists, which stimulate NGF synthesis/secretion via receptors coupled with adenylate cyclase machinery. These cells may be a useful aid in studying the mechanism of NGF synthesis/secretion.

1-Methyl-3-isobutylxanthine

Coronary circulation in dogs with an experimental decrease in aortic compliance.

OBJECTIVES: This study was designed to investigate the effects of decreased aortic compliance on the coronary circulation. BACKGROUND: A decrease in aortic compliance due to arteriosclerosis is observed in patients with coronary artery disease. However, the effects of decreased aortic compliance on the coronary circulation have not yet been investigated sufficiently. METHODS: Hemodynamics, subendocardial electrocardiogram (ECG), myocardial segmental length and myocardial blood flow were investigated in six dogs with aortic bandaging (bandaged group) and five dogs with a sham operation (control group) at rest and during pacing 4 weeks after surgery. RESULTS: Aortic compliance in the bandaged group was less than that in the control group (0.24 +/- 0.20 vs. 0.50 +/- 0.22 ml/mm Hg, p < 0.05). Pulse pressure and the tension-time index were significantly greater in the bandaged group than in the control group, but systemic vascular resistance was not altered significantly. The subendocardial/subepicardial flow ratio was lower in the bandaged group than in the control group (0.95 +/- 0.31 vs. 1.57 +/- 0.26, p < 0.05). In the region supplied by the left circumflex artery with a stenosis that was adjusted to eliminate reactive hyperemia, rapid atrial pacing (heart rate 200 beats/min) further decreased endocardial flow and the endocardial/epicardial flow ratio in the bandaged group. Moreover, both the reduction of segmental shortening and the ST elevation on the subendocardial ECG in the left circumflex-supplied region during pacing were greater in the bandaged group. CONCLUSIONS: These results indicate that decreased aortic compliance greatly increases the risk of subendocardial ischemia in the presence of coronary stenosis.

Animals

Platelet cyclic GMP. A potentially useful indicator to evaluate the effects of nitroglycerin and nitrate tolerance.

BACKGROUND: The present study was designed to investigate the intracellular production of cyclic GMP (cGMP) in platelets in response to nitroglycerin and to determine the potential clinical value of platelet cGMP as an indicator of the effects of nitroglycerin and nitrate tolerance. METHODS AND RESULTS: Platelet cGMP levels and the diameters of the coronary arteries before and 2 minutes after intracoronary injection of 200 micrograms nitroglycerin were measured in 15 patients who had previously received nitrates (nitrates group) and in 16 who had not received any nitrates (no-nitrates group). Platelet cGMP levels increased significantly after nitroglycerin injection in the two groups, but plasma cGMP levels and plasma atrial natriuretic peptide levels did not change. The percent increase in platelet cGMP levels and the percent dilatation of the left anterior descending (LAD) and left circumflex (LCx) coronary arteries after nitroglycerin injection were higher in the no-nitrates group than in the nitrates group (platelet cGMP levels: artery, 74.2 +/- 18.3% versus 11.5 +/- 4.2%, P < .01; vein, 73.6 +/- 22.9% versus 9.0 +/- 3.1%, P < .01; coronary dilatation: LAD, 46.7 +/- 6.0% versus 9.9 +/- 2.5%, P < .01, LCx, 51.2 +/- 8.7% versus 6.1 +/- 3.0%, P < .01). The percent increase in platelet cGMP levels was significantly correlated with the percent dilatation of the coronary arteries (LAD: r = .90, P < .01; LCx: r = .92, P < .01) in the no-nitrates group and not in the nitrates group. CONCLUSIONS: These results indicate that platelet cGMP can be used as an indicator for in situ evaluation of nitroglycerin effects and that patients who have received nitrates develop nitrate tolerance, which affects intracellular production of cGMP and vasodilation in the response to nitroglycerin.

Atrial Natriuretic Factor

Decreased aortic compliance aggravates subendocardial ischaemia in dogs with stenosed coronary artery.

OBJECTIVES: The existence of decreased aortic compliance due to arteriosclerosis has been documented in patients with coronary artery disease. The aim of this study was to investigate the effects of decreased aortic compliance on coronary artery disease. METHODS: To simulate coronary artery disease, a fixed stenosis was made in the left circumflex coronary artery in dogs. Ten anaesthetised open chest dogs were used. Aortic compliance was decreased by banding the thoracic aorta with adjustable plastic rings. The level of coronary stenosis was adjusted to reduce the baseline flow by no more than 10% but enough to eliminate reactive hyperaemia induced by a 10 s occlusion. Measurements of haemodynamics, regional myocardial segment length, subendocardial ECG, and myocardial tissue PO2 were performed at five stages (initial control stage, rest and pacing stages without aortic banding, and rest and pacing stages with the aortic banding). RESULTS: Haemodynamic variables were not changed at any stage, except for increased pulse pressure secondary to the aortic banding. During pacing with aortic banding, subendocardial PO2 (Endo) levels were decreased, and subepicardial PO2 (Epi) levels were increased, compared to those without the aortic banding [Endo: 43.2(SD 9.8) v 36.8(10.0) mm Hg, p < 0.05; Epi: 34.0(11.5) v 44.4(7.9) mm Hg, p < 0.05]. ST elevation on the subendocardial ECG was greater, and myocardial segment shortening was less with the aortic bandage during pacing. CONCLUSIONS: When the work of the heart is increased, a decrease in aortic compliance tends to compromise ischaemic myocardium further in the presence of an induced stenosis of a major coronary artery.

Animals

Cytokine regulation of nerve growth factor-mediated cholinergic neurotrophic activity synthesized by astrocytes and fibroblasts.

The neurotrophic activity of astrocytes and fibroblasts and its regulation by various cytokines were investigated. Astrocyte conditioned medium (ACM) enhanced the survival of neurons and the proliferation of astrocytes in embryonic cortical cultures grown in serum-free defined medium. However, these results were not affected by acidic fibroblast growth factor, interleukin-1 beta (IL-1 beta), tumor necrosis factor-alpha (TNF alpha), and transforming growth factor-beta 1. In contrast, ACM induced choline acetyltransferase expression in septal cholinergic neurons via nerve growth factor (NGF)-dependent and -independent mechanisms. However, neither acidic nor basic fibroblast growth factor is involved in this biological activity in ACM. The cytokines listed above mainly stimulate NGF-mediated cholinergic neurotrophic activity in ACM. A combination of IL-1 beta and TNF alpha significantly enhanced choline acetyltransferase activity in septal neurons co-cultured with astrocytes, and this effect was found to be mediated by NGF produced by activated astrocytes. Effects of astrocytes on GABAergic neurons were also examined. ACM was found to increase glutamate decarboxylase activity in neuronal cultures from septum in the presence of Ara-C. However, the cytokines did not enhance this activity in ACM. Moreover, a combination of IL-1 beta and TNF alpha had no effect on glutamate decarboxylase activity in septal neurons co-cultured with astrocytes. In a final set of experiments, cholinergic neurotrophic activity in skin-derived fibroblast conditioned medium (FCM) was examined. FCM was found to possess biological activity similar to that of ACM on septal neurons grown in serum-free defined medium with Ara-C. The cytokines also enhanced NGF-mediated cholinergic neurotrophic activity in FCM. Astrocytes and fibroblasts were found to possess NGF-type and non-NGF-type cholinergic neurotrophic activity, and various cytokines were found to regulate the NGF-type cholinergic neurotrophic activity in both types of cells. NGF produced by astrocytes and fibroblasts that are activated by cytokines is likely to be important for development and regeneration of NGF-sensitive neurons in the central and peripheral nervous systems.

Animals

Recombinant human basic fibroblast growth factor (rhbFGF) induces secretion of nerve growth factor (NGF) in cultured rat astroglial cells.

Recombinant human basic fibroblast growth factor (rhbFGF) was found to induce secretion of nerve growth factor (NGF) in cultured astrocytes from rat brain. The induction was concentration dependent; a maximum increase of 2-fold was observed at concentrations of 3-10 ng/ml or rhbFGF. When rhbFGF was added to the astrocytes, the induction occurred within 8 h and leveled off after 12 h. Antiserum against rhbFGF completely blocked the induction. Maximum induction occurred under serum-free culture conditions and in cultures with a high cell density. These results suggest that rhbFGF may exert a neurotrophic effect on the central nervous system through the induction of NGF secretion by astrocytes.

Animals