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Comparative pharmacology of calcium antagonists.

OBJECTIVE: To compare clinically relevant pharmacokinetic, pharmacodynamic and toxico logical characteristics of calcium-modulating compounds used in ischemic heart disease. DATA SOURCES: A MEDLINE search (1990 pt B to 1991 pt A revised for 1993; 1991 pt B to 1992 revised for 1993; and January to May 1993) combining the search phrases 'calcium channel blockers', 'myocardial ischemia', 'pharmacodynamics' and 'pharmacokinetics', and a search in Compact Cambridge Drug Information Source vol-6 (revised 1992, fourth quarter) using the search phrase 'calcium antagonists' and medical subject headings (MeSH) 'pharmacokinetics' and 'pharmacodynamics' were used to obtain title and abstract information on available current literature. STUDY SELECTION: Review articles, proceedings and studies published in English and available within the University of Saskatchewan library system, as they appeared to relate closely to the objective, were obtained for closer evaluation. In addition, primary references were examined, and journal reprints were selected from the authors' files. DATA EXTRACTION: The focus was on studies and objective reviews that profiled one or more representative compounds in a manner suitable for deriving background and comparative information pertaining to the objective. Data from multiple studies, or from studies that employed multiple methodological approaches, were preferentially extracted and summarized for presentation. DATA SYNTHESIS: The role of calcium in cardiac and vascular smooth muscle physiology was reviewed, highlighting the major mechanisms responsible for maintaining calcium homeostasis in these cells. With a focus on verapamil, diltiazem and 1,4-dihydropyridines currently employed in the treatment of cardiovascular disorders, a general survey of their sites of action, tissue selective pharmacodynamics, pharmacokinetic properties and side effects was undertaken in a comparative context. CONCLUSIONS: Calcium antagonists are employed in the treatment of angina, certain cardiac arrhythmias and hypertension. They are a chemically and pharmacologically heterogeneous group of compounds that act principally to inhibit the influx of calcium across certain voltage-dependent membrane channels. Concepts pertaining to calcium mobilization in the pathophysiology of myocardial ischemia, particularly at the molecular level, have evolved remarkably over the past decade. The repertoire of agents having calcium-regulating properties has expanded in parallel. The task of integrating new knowledge in both of these areas requires further attention in order to determine optimal approaches to treatment.

Animals↗

Role of hexose monophosphate shunt in parathyroid hormone secretion.

The metabolism of labeled glucose by collagenase-dispersed bovine parathyroid cells was examined. When the medium calcium ion concentration was increased to 2.0 mM, the rate of 14CO2 release from [1-14C]glucose was increased 169 +/- 45% compared with the rate of 0.5 mM calcium. There was no significant change in the rate of 14CO2 release from [6-14C]glucose by this maneuver. The greatest increase in 14CO2 release and decrease in parathyroid hormone secretion occurred between medium calcium ion concentrations of 0.5-1.5 mM. This difference in the metabolism of glucose represents a true increase in hexose shunt activity because the incorporation of label from either [1-14C]- or [6-14C]glucose into parathyroid tissue lipids was equal. This suggests equilibration of label at the level of triose-phosphates. The increase in hexose shunt activity was not due to a calcium-mediated increase in glucose uptake because calcium changes did not affect 2-[3H]deoxyglucose transport by the cells. Phenazine methosulfate added to cells incubated at 0.5 mM calcium selectively increased hexose shunt activity in a dose-dependent manner (91 +/- 33% overall) and concomitantly inhibited parathyroid hormone secretion 65% overall at 0.5 mM calcium. The compound 6-aminonicotinamide inhibited hexose shunt activity but could not overcome the inhibition of hormone secretion at 2.0 mM calcium. A decrease in protein biosynthesis cannot fully explain the inhibition of hormone secretion by calcium or phenazine methosulfate because [3H]-leucine incorporation into total cell protein was not as affected as secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Modulation of human neutrophil function in vitro by gastrin.

We have studied the effects in vitro of gastrin-17 and gastrin-34, at concentrations from 10(-14) M to 10(-6) M, on several of the functions of peripheral blood human neutrophils, i.e. adherence to substrate, mobility (spontaneous and directed by a chemical gradient or chemotaxis), ingestion of inert particles (latex beads) and cells (Candida albicans) and superoxide anion production. Both gastrins inhibited several steps of the phagocytic process of human neutrophils, such as mobility and ingestion. By contrast, these peptides increased adherence and had no effect on superoxide anion production. In general, these effects were significant at peptide concentrations between 10(-12) M and 10(-8) M with a maximal effect at 10(-10) M. In addition, gastrin peptides induced a significant increase in intracellular cAMP levels at 30, 60 and 120 s. Moreover, the inhibitory effect of gastrin-17 on the ingestion capacity of neutrophils (latex bead phagocytosis) was similar to that obtained with EGTA, a well-known extracellular calcium chelating compound. Gastrin-17 was found to inhibit completely the stimulation of latex bead phagocytosis in neutrophils caused by the calcium ionophore A23187. These results suggest that gastrin is a negative modulator of the phagocytic process of human neutrophils, and that this effect might involve an increase in intracellular cAMP levels and a decrease in calcium entry into the cells.

Adult↗

Morphological changes after simultaneous administration of isoproterenol (ISO) and K+,MG2+-Aspartate (KMg-ASP) as a physiological Ca2+ antagonist.

Calcium antagonistic compounds including physiological ions of K and Mg are supposed to protect the heart against the deleterious effect of calcium overload. Pretreatment with K,Mg-aspartate in a single i.v. dose of 100 mg/kg was performed in dogs 5--10 min prior to isoproterenol chloride injection in a single dose of 7 mg/kh s.c. Administration of K,Mg-aspartate alone in the above-mentioned dose produced reversible changes of mitochondria after 2--6 hr. K,Mg-aspartate pretreatment applied prior to isoproterenol application revealed summarization of both K,Mg-aspartate and isoproterenol-produced changes after 2--6 h without significantly preventing hypoxic-like alterations. However, the final result after 24 h was good improvement of ultrastructure generally resembling metabolic regeneration and/or enhanced metabolic activity.

Animals↗

[Field study of workers with longterm exposure to calcium cyanamide (author's transl)].

"Kalkstickstoff" (calcium cyanamide) is extensively used as a fertilizer and a herbicide and also as a chemical intermediate. Its main compounds are calcium cyanamide (CaCN2) (60%) and calcium oxide (15%). In earlier times cauterized damages of the skin and the mucous membranes caused by the content of calcium oxide were common. A certain effect of CaCN2 is the reaction of intolerance after alcohol intake, which expresses as a so-called burning, a flush with redness and feeling of heat of the head, the neck and the upper part of the body often combined with tachycardia and dyspnea. Further health impairments, sometimes with fatal end, were reported repeatedly in the older literature. Convincing evidences for the causal connections between the exposure to CaCN2 and these damages are missed. They exclusively concerned farmers but not workers in the production of CaCN2. Except of the damages of the skin also diseases of the respiratory and gastrointestinal tract, the kidneys, the nervous and circulatory system as well as favoring of infectious complications and goitrogenic effects are in discussion. Furthermore it was suggested that CaCN2 causes a lack of reduced glutathione in the organism. On the occasion of establishing a preliminary MAC-value for CaCN2 in the F.R.G. an occupationally medical field study was performed on 65 workers of a calcium cyanamide factory with long-term exposure to CaCN2. The maximal CaCN2 concentration measured at the working places was 8.3 mg/m3. No signs of diseases or health impairments, which are possibly caused by CaCN2, were found with the medical examination in the above mentioned organs and organ systems. There also was no decrease of the glutathione content of the total blood detectable. With an alcohol load of 22 voluntary workers 1 till 7 hours after the working shift in 6 cases modest and in 7 cases weak flush reactions were observed. As result of the study an elevation of the MAC-value from 1 to at least 2.5 mg/m3 is proposed.

Adult↗

Voltage-dependent calcium currents in trigeminal chick neurons.

The presence of action potentials, when sodium and potassium currents were blocked, has been investigated in trigeminal ganglion neurons, using the patch-clamp technique. In this conditions, inward currents, sensitive to the external application of cadmium, were detected. Activation and inactivation properties were investigated, as well as the behaviour of the current in the presence of extracellular Barium. The properties of these inward currents in trigeminal neurons are correlated to high threshold voltage-dependent calcium channels.

Action Potentials↗

Calcium requirements for barium stimulation of enkephalin and vasoactive intestinal peptide biosynthesis in adrenomedullary chromaffin cells.

The divalent cation barium was used to study the role of calcium in coupling neuropeptide secretion and biosynthesis following secretagogue stimulation of bovine chromaffin cells. Barium chloride (0.1-2.5 mM) stimulated in a dose-dependent manner the secretion of met-enkephalin (up to 20% of intracellular peptide content) and increased the total amount (cell plus medium content) of met-enkephalin and vasoactive intestinal polypeptide (VIP) 2- to 3-fold after 72 hours. A greater than six-fold increase in proenkephalin mRNA (mRNA(enk)) was observed by 24 hours following barium stimulation. The voltage-sensitive calcium channel blocker D600 inhibited the barium-stimulated secretion of enkephalin and blocked the stimulation of VIP biosynthesis and mRNA(enk). Reducing calcium in the medium resulted in an enhancement of barium-stimulated release of both peptides, but blocked the induction of their biosynthesis. The data indicate that calcium targets involved in secretion can be activated by barium or calcium while calcium targets involved in biosynthesis specifically require calcium. It is therefore proposed that pathways leading to peptide secretion and biosynthesis in the adrenal diverge just after secretagogue-stimulated calcium influx.

Adrenal Medulla↗

The effect of cholinergic agonists on coronary flow rate and oxygen consumption in isolated perfused rat heart.

The metabolic and circulatory consequences of activation of the muscarinic receptor(s) were investigated by local administration of acetylcholine and its three analogues (bethanechol, carbachol and methacholine) into beating and KCl-arrested perfused rat hearts. Acetylcholine and the three other choline esters caused vasoconstriction in both types of preparations and this vasoconstriction was accompanied by a decrease in oxygen consumption. In most cases the dose-response curves were biphasic and changes in coronary flow paralleled those in oxygen consumption. Both phenomena were abolished by administration of atropine and either removal of calcium or infusion of verapamil but were unaffected by addition of the adrenergic alpha-blocker, prazosin, and the adrenergic beta-blocker, propranolol. Infusions of low concentrations of the cholinergic agonists were accompanied by increases in the myocardial phosphorylation state ratio [( ATP]free/[ADP]free[Pi]) which correlated with the simultaneous decreases in oxygen consumption and coronary flow. It is suggested that muscarinic receptors responsible for vasoconstriction in perfused rat heart are located not only on coronary vessels but also on the cardiac muscle cells. Activation of the former receptors induces vasoconstriction by direct action on the vascular smooth muscle while activation of the latter receptors induces vasoconstriction indirectly by decreasing cardiac work and increasing the myocardial [ATP]free/[ADP]free[Pi] ratio. The results also show that stimulation of muscarinic receptor(s) and the consequent metabolic and vasoregulatory responses are coupled to calcium movements.

Animals↗

Characterization of intracellular calcium oscillations induced by extracellular nucleotides in HEp-2 cells.

The effect of extracellular nucleotides on the cytosolic calcium concentration of fluo-3-loaded HEp-2 cells was examined using confocal microscopy. Extracellular ATP and UTP at micromolar concentration induced cytosolic calcium oscillations in 42-66% of the cells. Oscillations were usually sinusoid and their frequency depended only slightly on agonist concentration. Oscillations developed in calcium-free medium but were diminished by depletion of intracellular calcium stores with thapsigargin, indicating periodic calcium release from internal stores. Inhibition of phospholipase C with U73122 prevented the development of oscillations, while ryanodine did not abolish the response to extracellular nucleotides. Activation of protein kinase C with 4beta-phorbol 12-myristate 13-acetate also prevented the development of oscillations. These results indicate that extracellular nucleotides induce periodic calcium release from inositol 1,4,5-trisphosphate-sensitive pools in HEp-2 cells and that the inhibitory effect of protein kinase C on the phosphatidylinositol signaling pathway can contribute to the development of intracellular calcium oscillations.

Adenosine Triphosphate↗

Long-lasting decrease in the crayfish giant motoneuron soma excitability induced by Ca2+ influx.

After a single Ca-dependent action-potential or a 300 ms clamp pulse to 0 mV in the motor giant somata of the crayfish abdominal nerve cord, a decrease in input resistance, an afterhyperpolarisation and a shortening of the test action potentials were observed during 10-15 min. These effects were due to a novel type of long-lasting outward current, triggered by a single influx of Ca2+, resistant to TEA+ and blocked by Ba2+.

Action Potentials↗

Calcium lysosomes in rachitic and vitamin D3 replete chick duodenal absorptive cells.

Calcium-containing lysomes were described in a previous communication in this series (Davis et al., 1979). Their potential role in intestinal calcium uptake and transcellular transports was hypothesized. To further this notion, the effects of a rachitogenic diet and vitamin D3 repletion were investigated. Intestinal absorptive cells from chicks maintained on a vitamin D deficient diet were characterized by decreased numbers of supranuclear calcium lysosomes. In contrast, intestinal cells from chicks given vitamin D3 (cholecalciferol) subsequent to the rachitogenic diet showed numerous large compound supranuclear calcium lysosomes. Since other steroid hormones are known to effect lysosomes, it is tempting to speculate that vitamin D, itself a steroid hormone, may activate lysosomes which themselves might be involved in calcium homeostatic mechanisms.

Animals↗

Removal of PCR inhibitors from soil DNA by chemical flocculation.

Extracting high-purity DNA directly from soil has become essential for the study of microorganisms in environmental samples. However, many soils contain compounds that inhibit enzymes involved in manipulating DNA. In this study, chemical flocculation using multivalent cations was investigated as a potential method for eliminating soil-based inhibitors during the extraction process. The addition of AlNH(4)(SO(4))(2) during extraction significantly reduced the co-purification of PCR inhibitors with minimal loss of DNA yield.

Alum Compounds↗

The stabilities of calcium arsenates at 23+/-1 degrees C.

The stabilities of calcium arsenate compounds were established by analysis of suspensions made with varying molar Ca/As ratios. Solution chemistry analyses determined the concentrations of calcium and arsenic and pH. The phases that were shown to form in order of descending pH were Ca(4)(OH)(2)(AsO(4))(2).4H(2)O, Ca(5)(AsO(4))(3)OH (arsenate-apatite), Ca(3)(AsO(4))(2).3 23H(2)O, Ca(3)(AsO(4))(2).4 14H(2)O, Ca(5)H(2)(AsO(4))(4).9H(2)O - ferrarisite, Ca(5)H(2)(AsO(4))(4).9H(2)O - guerinite and CaHAsO(4).H(2)O. The analytical concentrations of calcium and arsenic and pH were used in estimating solubility products. The estimated values were then refined through the comparison of the analytical data with calculated K(sp) values using the computer program PhreeqC. From the refined solubility products, the free energies of formation of the calcium arsenate hydrates were calculated as follows: Ca(4)(OH)(2)(AsO(4))(2).4H(2)O (-4941 kJ/mol), Ca(5)(AsO(4))(3)OH (-5087 kJ/mol), Ca(3)(AsO(4))(2).3 23H(2)O (-3945 kJ/mol), Ca(3)(AsO(4))(2).4 14H(2)O (-4085 kJ/mol), Ca(5)H(2)(AsO(4))(4).9H(2)O - ferrarisite (-7808 kJ/mol), Ca(5)H(2)(AsO(4))(4).9H(2)O - guerinite (-7803 kJ/mol), and CaHAsO(4).H(2)O (-1533 kJ/mol). Unlike other solubility studies on arsenate immobilization, this study was the first to consider the complete array of calcium arsenate hydrates that can form and to use the associated ions, CaAsO(4)(-), CaHAsO(4)(0) and CaH(2)AsO(4)(+) in determining their solubility products.

Journal Article↗