Feasibility study of nonclinical safety assessments on homeopathic preparations using the example of protoanemonin in Pulsatilla pratensis L.

Homeopathy is a world-wide available form of complementary therapy, which has a tradition of 200years. Due to the long history of clinical use, i.e. reflected by the first edition of the Homeopathic Pharmacopoeia of the US of 1914, the conduct of toxicological studies is not required if the safety has been otherwise substantiated. The aim of this article is to establish a risk assessment procedure without full toxicological examination, using homeopathic preparations from Pulsatilla pratensis L. as an example. The literature review shows that protoanemonin is the most relevant constituent of these plants regarding potential toxicity. Based on structural alerts protoanemonin is classified as a Cramer class III compound with the threshold of toxicological concern (TTC) of 180µg/day in adults. Neither computer aided toxicology methods (Toxtree and Derek Nexus®) nor a literature search revealed any evidence of genotoxic, carcinogenic or teratogenic potential of protoanemonin. The protoanemonin exposure from a maximum daily dose of a typical homeopathic preparation of P. pratensis L. does not exceed the TTC. The presented method is transparent, reproducible and applicable to other homeopathic substances as a use-case scenario for computational toxicology in order to evaluate an approach for safety assessment of homeopathic medicinal products.

Ultrastructure of pre- and postcolostral enterocytes of the newborn calf.

Ten calves were used to elucidate the ultrastructure of enterocytes before and 24 h after colostral intake. Tissue samples were obtained from duodenum, jejunum (5 locations) and ileum. Protein A-gold technique was applied to immunoelectron-microscopically demonstrate colostral IgA. The prominent feature of the precolostral enterocytes are intracytoplasmic vacuoles. The frequency of vacuoles increases from cranial jejunum to ileum and from the villi bases to the tips. The appearance of absorptive vacuoles after colostral administration correlates with the incidence of precolostral empty vacuoles. Bovine IgA was detected in absorptive vacuoles and within the intestinal lumen of postcolostral calves. In addition to a diffuse IgA labelling of most vacuoles, a few corresponding enterocytic vacuoles labelled inhomogenously or negatively. This study demonstrates morphologically that the main site of colostral absorption is the middle-to-caudal region of the small intestine. Immunoelectron microscopy of IgA labelling provides indications of a selective IgA absorption in addition to pinocytosis.

Porous balloon delivery of low molecular weight heparin in the dog coronary artery.

UNLABELLED: The aim of this experimental study was to assess the safety of local delivery of low molecular weight heparin via a porous balloon in the canine coronary artery. In 16 mongrel dogs, percutaneous transluminal coronary angioplasty was performed. In addition, eight of the dogs were given 4 ml Clivarin (1500 IU) delivered locally into the coronary artery immediately after dilatation. The animals were killed after 3 or 14 days. In the animals with local administration, the results of histopathology after 3 days showed the findings to be heterogeneous with marked disruption of the internal elastic lamina in all animals, and varying degrees of medial haemorrhage, medial necrosis, perivascular haemorrhage and signs of myocardial necrosis. Similar changes, but of lesser severity, were present in the animals treated with balloon dilatation only. After 14 days, the severity of vascular and perivascular alterations (medial haemorrhage, perivascular haemorrhage, thrombus formation) was significantly lower in the local delivery group (P < 0.05), but disruption of the internal elastic lamina, as a marker of the initial trauma, was present in all the animals. The presence of residual intracoronary thrombus was only seen in the PTCA group without local delivery. CONCLUSIONS: In this safety study, both groups showed pronounced alterations in the vessel wall 3 days following percutaneous transluminal coronary angioplasty. This changed 14 days following percutaneous transluminal coronary angioplasty when intramural injection of Clivarin resulted in a marked decrease of residual thrombus and medial as well as perivascular haemorrhage. Although the additional vessel trauma by the drug delivery technique did not result in increased complications, a careful approach with this potentially harmful procedure is essential.

Individual and combined effects of verapamil or trandolapril on attenuating hypertensive glomerulopathic changes in the stroke-prone rat.

Previous studies have demonstrated differences in the progression to glomerulosclerosis with the use of calcium channel blockers (CCB). The results with angiotensin-converting enzyme (ACE) inhibitors are more consistent. Moreover, only two studies have examined the combined effects of these drug classes on the development of glomerulosclerosis. The aim of the study presented here was to test the hypothesis that nonhypotensive doses of the combination (VT) of a nondihydropyridine CCB, verapamil (V), and an ACE-inhibitor, trandolapril (T), will slow the development of glomerulosclerosis better than either agent alone in stroke-prone spontaneously hypertensive rats (SHRSP). SHRSP were randomized to treatment in one of three groups with nonhypotensive doses of these agents; a fourth group served as control (C). The control rats developed significant increases in proteinuria compared with the other groups (C, 190 +/- 35 mg.kg-1.d-1 versus VT, 19 +/- 12 mg.kg-1.d-1; P < 0.05). This finding correlated with the degree of glomerulosclerosis (mean severity grading for C, 3.31 +/- 0.21 versus VT, 1.6 +/- 0.51; P < 0.05). Moreover, there was no significant reduction in arterial pressure between these groups (C, 282 +/- 5 versus VT, 259 +/- 13 mm Hg; P = 0.12). Despite persisting hypertension, the rise in proteinuria was also attenuated in both the V group (57 +/- 21 mg.kg-1.d-1) and the T group (43 +/- 24 mg.kg-1.d-1). However, compared with the control rats, kidney morphology was unchanged. Lastly, creatinine clearance was better preserved in the VT group compared with the control group (C, 0.57 +/- 0.01 versus VT, 0.74 +/- 0.06 mL.min-1.100 g-1; P < 0.05). It was concluded that the combination of nonhypotensive doses of VT attenuates the rise in proteinuria and progression to glomerulosclerosis. This study supports the concept that VT may have effects on the glomerulus that are independent of blood pressure reduction.

Immunoelectron microscopical demonstration of the absorption of colostral IgG by small intestinal enterocytes in newborn rats.

The protein A-gold technique was used in the cranial, transitional and caudal segments of the small intestine of 12 newborn rats to demonstrate the process of absorption of gold-labelled IgG through the enterocytes. The observation of the attachment of labelled IgG molecules to the wall of coated vesicles suggested a receptor-mediated transport of colostral IgG in the cranial segment of the small intestine. However, intracellular micropinocytotic transport predominated in the transitional and caudal segments of the small intestine. There was no evidence for paracellular transport. Lysosomal structures in the enterocytes did not appear to impede the absorptive activity during the absorption period, which lasted 20 days.

An immunoelectron microscopic investigation of colostral IgG absorption across the intestine of newborn calves.

The protein A-gold was used to examine the transport of colostral IgG from the lumen of the gut to the circulation in four newborn calves and one 24-hour-old calf. The absorptive enterocytes of the duodenum, jejunum and ileum were investigated five to 60 minutes after administering colostrum, and 24 hours after birth. In the newborn calves, an intracellular micropinocytotic transport of IgG molecules was dominant throughout the entire small intestine. The amount transported increased from the duodenum to the ileum. In addition, evidence of a selective, receptor-mediated transport of IgG during the first few hours of life was provided by the presence of bovine clathrin at the microvillous membrane of the duodenal and jejunal enterocytes, indicating the existence of specialised vesicles for transport, the so-called 'coated' vesicles. No sign of paracellular transport was detected. Intestinal closure was interpreted as a multifactorial event comprising the replacement of the fetal intestinal epithelial cells by more mature populations, the initial cessation of transport at the basal and lateral cell membrane of the absorptive enterocytes, and an increase in intracellular proteolytic activity by lysosomes.

Clinical, histological and ultrastructural characteristics of a spontaneous corneal opacity in Sprague-Dawley rats.

The eyes of 200 rats (Mol:SPRD, Moellegaard Ltd., Skensvet, Denmark), 8 weeks of age and of both sexes, were examined routinely with a photo-slitlamp microscope (Zeiss) and opthalmoscope (Heine) 3-4 times in the course of four different 12-week toxicity studies. The animals were kept under constant lighting conditions at a room temperature of 20 +/- 2 degrees C and 55 +/- 5% humidity on a standard diet. More than 70% of the animals were found to have more or less prominent corneal opacities already at the beginning of the study. These were morphologically characterized as meshwork-like alterations of the deeper corneal epithelium, mostly located in the central and nasal region. The temporal, upper and lower periphery remained always unaffected. Male animals were more frequently and more intensively affected than the females. The occurrence of the opacity was totally independent of the treatment scheme (controls and drug dosages, respectively), showing a slight increase in density in some of the animals of all groups and remaining stable in others. Regression was rarely observed. Light and electron microscopical investigations demonstrated focal degenerations of the basal epithelial cell layer as well as alterations of its basement membrane. The lesion was not associated with inflammation or irritation. Therefore, we considered that a genetically determined metabolic disorder of the basal epithelial cells might have led to the impairment of basement membrane synthesis. Further screenings performed in conjunction with the breeder evidenced that these opacities are probably caused by a spontaneous mutation with a complex, not X-linked genetic background.