Diuretics are Similar to Losartan on Echocardiographic Target-Organ Damage in Stage I Hypertension. PREVER-Treatment Study / Diuréticos são Similares à Losartana na Avaliação Ecocardiográfica de Lesão a Órgãos-Alvo no Estágio I da Hipertensão. Estudo PREVER-Treatment

Abstract Blood pressure (BP)-lowering therapy improves left ventricular (LV) parameters of hypertensive target-organ damage in stage II hypertension, but whether there is a drug-class difference in echocardiographic parameters in stage I hypertension patients is less often studied. In the PREVER treatment study, where individuals with stage I hypertension were randomized for treatment with diuretics (chlorthalidone/amiloride) or losartan, 110 participants accepted to participate in a sub-study, where two-dimensional echocardiograms were performed at baseline and after 18 months of antihypertensive treatment. As in the general study, systolic BP reduction was similar with diuretics or with losartan. Echocardiographic parameters showed small but significant changes in both treatment groups, with a favorable LV remodeling with antihypertensive treatment for 18 months when target blood pressure was achieved either with chlorthalidone/amiloride or with losartan as the initial treatment strategy. In conclusion, even in stage I hypertension, blood pressure reduction is associated with improvement in echocardiographic parameters, either with diuretics or losartan as first-drug regimens.

Resumo A terapia de redução da pressão arterial (PA) melhora os parâmetros do ventrículo esquerdo (VE) na lesão a órgãos-alvo causada pela condição hipertensiva na hipertensão de estágio II; no entanto, se existem ou não diferenças relacionadas à classe de medicamentos nos parâmetros ecocardiográficos de pacientes com hipertensão estágio I é menos frequentemente estudado. No estudo PREVER-treatment, em que indivíduos com hipertensão estágio I foram randomizados para tratamento com diuréticos (clortalidona/amilorida) ou losartana, 110 participantes aceitaram participar de um subestudo, no qual foram realizados ecocardiogramas bidimensionais basais e após 18 meses de tratamento anti-hipertensivo. Como no estudo geral, a redução da PA sistólica foi semelhante com diuréticos ou com losartana. Os parâmetros ecocardiográficos mostraram pequenas mas significativas alterações em ambos os grupos de tratamento, com um remodelamento favorável do VE com tratamento anti-hipertensivo por 18 meses, quando a pressão arterial alvo foi atingida com clortalidona/amilorida ou com losartana como estratégia inicial de tratamento. Em conclusão, mesmo na hipertensão estágio I, a redução da pressão arterial está associada à melhora nos parâmetros ecocardiográficos tanto com o uso de diuréticos ou losartana como primeiro esquema de tratamento farmacológico.

Effect of Amiloride to Retinal Toxicity Induced by Tissue Plasminogen Activator

PURPOSE: The effects of amiloride on cellular toxicity caused by tissue plasminogen activator (tPA) in mouse primary retinal cells were investigated. METHODS: Primary retinal cell cultures were maintained using glial conditioned medium. Commercial tPA and L-arginine were added, and the level of cyclic guanosine monophosphate (cyclic-GMP) in the culture supernatant was assessed using an ELISA assay. We measured the cell viability of cultured retinal cells pretreated with three different concentrations of amiloride (1, 10, and 100 microm) in addition to commercial tPA or L-arginine treatment. RESULTS: After exposing the cultured mouse retinal cells to tPA plus L-arginine or L-arginine alone, cyclic-GMP concentrations were 61.9 +/- 5.1 pmole/mL and 63.1 +/- 6.1 pmole/mL, respectively. However, the control group had a significantly lower concentration of cyclic-GMP (37.2 +/- 3.4 pmole/mL, p < 0.01). The cyclic GMP-dissolved solution did not cause retinal cell death. In the control group and the group treated with 1 microm amiloride and tPA containing L-arginine, the cell viability was 43.7% and 44.5%, respectively. However, cell viability increased to 70.6% with 10 microm amiloride and 78.4% with 100 microm amiloride (p = 0.015). CONCLUSIONS: L-arginine increases intracellular cyclic-GMP and may give rise to retinal cells through this mechanism. In addition, amiloride in concentrations greater than 10 microm protects against L-arginine-induced retinal cell death.

Myocardial protection by Ethyl-isopropyl amiloride, a specific NA[+] -H[+] exchange inhibitor, following hemorrhagic shock

Hemorrhagic shock and resuscitation is well known to result in myocardial dysfunction and injury. Stimulation of the Na[+] -H[+] exchanger plays an important role in the pathway of myocardial injury. The purpose of the present study was to examine the protective effects of blocking the cardiac Na[+] -H[+] exchange, using 100mM ethyl-isopropyl amiloride [EIPA], a specific Na[+] -H[+] exchanger blocker, on myocardial contractile function on ex vivo resuscitation of isolated rat heart following one hour of hemorrhagic shock. Sprague- Dawley rats were assigned to hemorrhage, hemorrhage + EIPA, sham hemorrhage and sham hemorrhage + EIPA groups. Rats were hemorrhaged for one hour. Hearts were harvested and ex vivo treated and resuscitated by perfused in the Langendorff System. Myocardial function was determined. The results showed that inhibition of the Na[+] -H[+] exchanger using EIPA improved the post-resuscitation myocardial contractile function. Blocking the Na[+] -H[+] exchanger using 100mM EIPA following 60 minutes of hemorrhagic shock improved myocardial function

Role of Ca2+ on uterine force stimulated by a glycoside from the root of Dalbergia saxatilis.

Uterine muscle contraction is dependent on external Ca2+ and Ca2+ release from cytoplasmic storage sites. In this study, the mechanism of Ca2+ mobilization in uterine muscle cells by glycoside, dalsaxini, isolated from the root of D. Saxatilis was investigated in the rat. Uterine muscle contractility stimulated by dalsaxin was concentration dependent (ED50 0.13 mg/ml) and was significantly attenuated (85%; P < 0.01) in Ca(2+)-free physiological solution and in solutions containing verapamil (0.06-0.48 mumol). The small transient contraction observed in Ca(2+)-free medium was further suppressed by caffeine (2 mmol) and completely abolished in solutions containing Lanthanum chloride [(La3+), 2 mmol]. Contractions stimulated by the glycoside were unaffected by amiloride (50-83 mumol) in Ca(2+)-free and Ca(2+)-containing media. Dalsaxin also altered the pattern of uterine contraction stimulated by high potassium depolarization from fast-phasic to a sustained but transient plateau. It is concluded that dalsaxin causes uterine muscle contraction by mobilizing external Ca2+ through predominantly a voltage-dependent Ca2+ channel.

Efecto de la amilorida y su derivado diclorobenzamil sobre la auricula aislada del acure (Cavia porcellus): interaccion con otras maniobras inotropicas / Effect of amiloride and dichlorobenzamil derivative in the guinea pig atria: interaction with other inotropic mechanisms

Se estudiaron los efectos cronotrópico e inotrópico de la Amilorida (AMI) y la dicloro-benzamil-Amilorida (DCB-AMI) sobre las aurículas aislada del acure, así como la interacción de estas drogas con la beta-metil-digoxina (BM_DIGO), la epinefrina y la disminución del potasio extracelular (de 4 a 1 mM). La AMI (1 mM) causa un efecto inotrópico positivo y cronotrópico negativo, independientes del sistema autonómico. La DCB-AMI causa um efecto bimodal sobre la fuerza de contracción: la aumenta a bajas dosis pero la disminuye a concentraciones mayores de 10(-6) M. También disminuye levemente la frecuencia sinusal. El efecto de la AMI sobre el automatismo sinusal no es alterado por la BM-DIGO. En cambio, la AMI ((10(-3 M) disminuye el efecto inotrópico positivo de la BM-DIGO e incrementa la dosis tóxica en preparaciones aisladas. La curva dosis-respuesta a la epinefrina no varía en presencia de AMI. Resultados similares se obtuvieron con DCB-AMI (2 x 10(-7 M). El incremento de contractilidad que se observa al disminuir la concentración extracelular de potasio a 1 mM no se altera en presencia de AMI. La actividad de la Na+/K+ ATPasa dependiente de Mg++ de la fracción microsomal obtenida del corazón del acure disminuye en 10 por ciento aproximadamente en presencia de AMI (1nM). Por otra parte, el efecto inhibitorio sobre la enzima obtenido con ouabaína no varía con esta droga. En conclusión, nuestros resultados sugieren múltiples efectos de la AMI y DCB-AMI sobre el corazón del acure. La inhibición del intercambiador Na+/Ca++ explica solo parte de ellos; el bloqueo de los canales lentos parece fundamental para explicar nuestras observaciones.

Changes in the expression of c-myc, RB and tyrosine-phosphorylated proteins during proliferation of NIH 3T3 cells induced by hyaluronic acid

We have shown that hyaluronic acid stimulates the proliferation of quiescent NIH 3T3 cells. We have shown that treatment of 1 mg/ml hyaluronic acid results in increase of tyrosine phosphorylation of two proteins, MW 124 kDa and 60 kDa as detected by anti-tyrosine antibodies by Western blot analysis. Maximum phosphorylation occurred within 2 h after addition of 1 mg/ml hyaluronic acid. Stimulation of proliferation was also accompanied by increase in c-Myc protein, which was inhibited by amlloride, an inhibitor of Na+/H+ antiporter and EGTA and increase in the steady state level of pRb, the RB gene product. These results suggest that the intracellular signal transduction pathways that mediate the stimulatory effects of hyaluronic acid on cellular proliferation are similar to those of growth factors.

Cardioprotective drugs decrease the Na+ background current

Cardiac dysfunctions such as myocardial functional failure and ventricular arrhythmia have been largely attributed to intracellular Ca2+ overload. One of the mechanisms of intracellular Ca2+ overload involves a rapid influx of Ca2+ via Na(+)-Ca2+ exchange during the reperfusion which utilizes the accumulation of Na+ in myocytes during ischemic cardiac arrest. Possible sources of the intracellular Na+ accumulation include Na+ channel, Na(+)-H+ exchange, Na(+)-Ca2+ exchange, and Na+ background current. In this study, we studied the role of the Na+ background current in intracellular Na+ accumulation during the cardiac arrest by measuring the Na+ background current in guinea pig ventricular myocytes with whole cell clamp method and evaluating the effects of cardioprotective drugs on the Na+ background current. The results were as follows: (1) The Na+ background inward current at -40 mV membrane potential was larger at Ca2+ free solution than 1.8 mM Ca2+ solution. (2) The Na+ background current was not affected by verapamil. (3) 2 microM O-(N, N-hexamethylene)-amiloride (HMA) decreased the Na+ background current at negative membrane potential. (4) The new cardioprotective drug, R 56865, decreased the Na+ background current. These results suggest that the Na+ background current plays a role in increasing the intracellular Na+ activity during high K+ cardioplegia and the blocking effect of myoprotective drugs, such as R 56865, on the Na+ background current may contribute to myocardial protection after cardioplegia.

Clearance de lítio como método da avaliaçäo do manuseio tubular de sódio em ratos acordados, estudados em gaiolas metabólicas / Lithium clearance like evaluation method of tubular handling of sodium in awake rats, studieds in metabolic cages

Os autores estudaram o clearance de lítio (CLi), em ratos acordados näo restritos, em gaiolas metabólicas individuais. Os resultados do presente trabalho foram obtidos utilizando-se de fórmulas matemáticas definidas a partir dos conceitos básicos do manuseio tubular renal de lítio (Li), dentre os quais: 1) a absorçäo de Li no túbulo proximal é proporcional àquela de água e sódio (Na); 2) näo ocorre absorçäo ou secreçäo de Li em segmentos do nefro distais ao túbulo proximal; nessas condiçöes, o CLi seria um marcador da reabsorçäo proximal de sódio e água. Esses resultados mostraram uma rebsorçäo de Na pelo túbulo proximal de 77,1 ñ 1,04%, comparável aos valores aceitos classicamente na literatura. O valor verificado para a reabsorçäo distal (ou "pós-proximal") de sódio foi de 99,5 ñ 0,03%. Para sensibilizar o CLi como marcador tubular proximal, foi empregada a amilorida para bloquear eventual reabsorçäo distal de lítio. Os resultados do grupo I (controle) foram comparados àqueles do grupo que recebeu amilorida (Amd - grupo II) e näo mostraram diferenças significativas na reabsorçäo proximal de sódio entre os dois grupos (controle 77,1 ñ 1,04% vs. amilorida 75,5 ñ 1,70%). Porém, o efeito natriurético observado no grupo II fica evidente quando se compara a reabsorçäo distal deste íon, com a do grupo I (amilorida 98,2 ñ 0,11%vs. controle 99,5 ñ 0,03%, p < 0,001). Este último dado mostra a açäo farmacológica da droga nos segmentos distais do nefro, sem contudo alterar o CLi, validando esta técnica para o estudo de funçäo tubular proximal neste modelo

Ca2+ induced down-regulation of epithelial amiloride-sensitive channels reconstituted into planar lipid bilayers

Multichannel experiments were carried out to investigate the Ca2+ - induced down-regulation of epithelial Na+ channels reconstituted into planar lipid bilayer membranes. Reconstitution was achueved by fusion of vesiculated apical membrane fragments to solvent-free planar lipid bilayers. We found that the presence of micromolar concentrations of Ca2+ on the side to which the vesicles were added substantially lowered the channel-mediated current. The inhibition was strongly influenced by pH. At pH 8.0 all the current was blocked by 1 mM calcium, whereas at pH 7.1 the inhibition was about 80%. The blocking kinetics was clearly voltage-dependent. The mechanism of blocking cannot be explained either in terms of interations with a single site, or by a model in which two blocking sites are assumed.

Differential antagonism by amiloride and pirenzepine of the muscarinic receptors of rat tracheal smooth muscle

Amiloride (AM) is a well known potassium sparing diuretic. The effects of AM at the cellular level include blockade of Na+/H+ exchange in several tissues and inhibition of passive sodium flux in epithelial cells. In this study we have explored the interactions of amiloride with muscarinic receptors, using isolated rat tracheal rings and compared its effects to those of the muscarinic receptor subtype-selective antagonist pirenzepine (PZ). The results obtained demonstrate the ability of AM (100 uM to 1mM) to inhibit the ACh induced rat tracheall contractions. The inhibition resulted in the reduction of the Emax values of ACh in this preparation, and the apparent Ki for AM was of 478 uM. This effect was also observed in a sodium-free choline medium, indicating that it is independent from sodium transport mechanisms sensitive to AM. In contrast to AM, PZ displayed a surmountable type of antagonism with a pA2 value of 6.52. The results demonstrate a differential antagonism by AM and PZ of the muscarinic receptors present in the smooth muscle of the rat trachea

Acute effect of amiloride and urinary magnesium excretion in dogs

La administración intravenosa de amilorida aumentó la excrección de Na y redujo la excreción de K. Estos cambios fueron debidos, principalmente, a modificaciones en las concentraciones urinarias de estos iones ya que la diuresis prácticamente no se modificó. No hubo cambios en la concentración plasmática de Mg ni en su excreción urinaria. De estos resultados concluimos que, en perros no sometidos a una sobrecarga de Mg, el transporte de Mg en los segmentos distales, donde actúa la amilorida, no es alterado por este diurético. El cambio en la diferencia de potencial eléctrico transepitelial provocado por la amilorida no afectaría el transporte de Mg, el cual no estaría relacionado con el transporte de Na