Histopathological alterations in the striatum caused by Karwinskia humboldtiana (Buckthorn) fruit in an experimental model of peripheral neuropathy.

The accidental ingestion of Karwinskia humboldtiana (Kh) fruit in humans and animals causes chronic or acute intoxication. Acute poisoning induces respiratory failure that progresses rapidly to death. Studies in animals intoxicated with Kh describe lesions in cerebral cortex, cerebellum, spinal cord, hippocampus and caudate nucleus. Kh intoxication in Wistar rats models the sub-lethal clinical phase observed in humans. Considering these reports, the present study analyzed the histopathological alterations within the striatum following experimental Kh intoxication. Twenty Wistar rats were divided into three groups (n =5) and were intoxicated with Kh fruit. A control group (n =5) was included. Animals were euthanized at several time points (48, 58 and 170 days post-intoxication). The brain was collected, divided and processed for conventional histology or electron microscopy. Sections were stained with hematoxylin and eosin, cresyl violet, Klüver-Barrera, and toluidine blue. Immunolabeling was performed for glial cells in the striatum, and the samples were analyzed with light microscopy. Morphometric and statistical analyses were performed. In control group, neurons, axon bundles and neuropil had a normal appearance. At 48 days, hyperchromic neurons with apparent decreased size were observed interspersed among the normal neurons. At 58 days, we observed an increased number of hyperchromic neurons and disorganization of the myelin sheath and neuropil. At 170 days, these alterations persisted in the paralysis group. In treated groups, we observed signs of gliosis and increased axonal diameters. This study is the first report that describes the histopathological alterations within the striatum caused by chronic intoxication with Kh fruit in the Wistar rat.

Intoxicación crónica con el fruto maduro de karwinskia humboldtiana en ratas wistar: daño renal / Chronic intoxication with ripe fruit of karwinskia humboldtiana in wistar rats: renal damage

Karwinskia humboldtiana (Kh) es un arbusto venenoso responsable de numerosos casos de intoxicación accidental en humanos. En la literatura se ha descrito a la intoxicación crónica con Kh como uno polineuropatía sin describir si existen o no alteraciones en órganos distintos al SNC y SNP como lo es el riñón. El objetivo de este estudio fue evaluar la morfología renal en un modelo de intoxicación crónica con Kh. Se utilizaron 32 ratas Wistar, se dividieron en cuatro grupos (n=8) en donde 5 ratas de cada grupo fueron intoxicadas y 3 fueron control no intoxicadas. A las ratas intoxicadas se les administraron por vía oral 3,5 g/kg del fruto seco y molido de Kh fraccionados en 5 dosis de 1,5; 0,5; 0,5; 0,5 y 0,5 g/kg los días 0, 3, 7, 10 y 14 respectivamente. Las ratas control solo recibieron agua. Cada grupo fue sacrificado a diferentes tiempos según la evolución de la parálisis. Se obtuvieron muestras de riñón, se procesaron hasta obtener bloques de parafina y resinas epóxicas, se obtuvieron cortes y se tiñeron y contrastaron para su observación al microscopio de luz y electrónico de transmisión (MET) respectivamente. A microscopia de luz identificamos congestión vascular, necrosis de los túbulos contorneados y fibrosis de la cápsula de renal, en la etapa de parálisis se realizo un conteo de los glomérulos afectados en las muestras tratadas con Kh, a MET además de los hallazgos previamente descritos se identificó la presencia de abundantes depósitos de matriz extracelular en la membrana basal de la cápsula renal y en la barrera de filtración de todos los grupos intoxicados, siendo más evidentes en el grupo de recuperación, lo que demuestra que la intoxicación crónica con Kh es una intoxicación sistémica y no exclusiva del SNC y SNP.

Karwinskia humboldtiana (Kh) is a poisonous shrub causing a number a accidental intoxications in humans. In previous studies, damage has been reported to Peripheral and Central Nervous System. Main intoxication sign is the presence of paralysis. However, no studies have been documented about damage to other organs like the kidney. The objective of this research is to evaluate kidney histology during chronic intoxication. Thirty two (32) Wistar rats were divided into 4 groups (n=8). For each group, 5 rats were intoxicated with Kh and 3 received water only as a control. Intoxicated rats received 3.5 g/Kg body weight of dry powder of Kh fruit, fractionated in 5 doses as follows 1.5, 0.5, 0.5, 0.5, 05 on days 0, 3, 7, 10 and 14 respectively. Control rats received water only. Each group was euthanized at different times during paralysis evolution. Samples of kidney were obtained and processed by routine technique until paraffin embedding for light microscopy studies, and in epoxy resins for transmission electron microscopy. Sections were obtained and stained with H&E, Masson's trichrome, and treated for PAS with diastase reaction to demonstrate basal membranes. At the light microscopic level we observed blood vessel congestion, tubular necrosis and fibrosis of renal capsule. Both at Light microscopy and electron microscopy, it was identified a thickening of the filtration barrier and of renal capsule, in all intoxicated animals, especially in the recovery group. These findings demonstrate that Kh causes a systemic intoxication and not only of the nervous system, as has been considered up to now.

Karwinskia humboldtiana (buckthorn) fruit causes central nervous system damage during chronic intoxication in the rat.

Karwinskia humboldtiana fruit (Kh) causes a neurological disorder 3-4 weeks after ingestion, characterized by flaccid, symmetrical, ascending paralysis, similar to the Guillain-Barre syndrome. In this polyneuropathy the lesion (demyelization) in peripheral nerves has been described in several animal species, both in acute and in chronic intoxication. However, no reports exist about the presence of lesions in the Central Nervous System (CNS), in chronic intoxication. We considered it important to evaluate, with histological techniques, the possible presence of lesions in the brain, by using a model of chronic intoxication that reproduces the same stages present in the human intoxication, to better understanding of this pathological process. In our present work we fed the ground Kh fruit to Wistar rats and samples of brain, cerebellum, and pons were embedded in paraffin. Sections were stained with Hematoxylin & Eosin (HE) and special stains for nerve tissue. Histopathological changes were evaluated in the CNS through the different stages of the polyneuropathy and comparison to a control group. With this methodology, we found lesions in the motor pathway. This is the first report about the presence of neuronal damage caused by Kh in the Central Nervous System in chronic intoxication.

Bioequivalence of single 100-mg doses of two oral formulations of topiramate: an open-label, randomized-sequence, two-period crossover study in healthy adult male Mexican volunteers.

BACKGROUND: The proprietary form of topiramate is indicated in Mexico as an antiepileptic agent and in the prophylaxis of migraine headaches. However, before generic topiramate is placed on the market, pharmacokinetic studies investigating the bioequivalence of generic and branded formulations are needed. OBJECTIVE: The aim of this study was to compare the bioequivalence and tolerability of a generic (test) and a branded (reference) formulation of topiramate 100 mg in healthy Mexican volunteers. METHODS: This open-label, randomized-sequence, 2-period crossover study was conducted at Ipharma SA de CV, Monterrey, Mexico. Eligible subjects were healthy male Mexican volunteers aged 18 to 45 years. Participants were randomly assigned to receive 100 mg of the test or reference formulation, followed by a 3-week washout period and administration of the alternate formulation. Doses were administered after a 12-hour overnight fast. For analysis of pharmacokinetic properties, including C(max), AUC(0-t), and AUC(0-infinity), blood samples were obtained over a 144-hour period after dosing. The formulations were to be considered bioequivalent if calculations of a 90% CI for the ratio of the means of the measures for the test and reference formulations fell within bioequivalence limits, 80% to 125%, for logarithmic (log) transformation of C(max) and AUC, and if two 1-sided t tests showed P < 0.05. Tolerability was assessed using vital sign measurement (blood pressure, body temperature, heart rate, and respiratory rate), laboratory analysis (hematology, blood biochemistry, hepatic function, and urinalysis), and subject interview. RESULTS: Twenty-eight men (mean age, 22.21 years [range, 18-28 years]; mean weight, 75.04 kg [range, 62-96 kg]; mean height, 177 cm [range, 163-192 cm]) were enrolled in this study, and 28 (14 each randomized to receive the test or reference formulation first) completed it. No period or sequence effects were observed. The 90% CIs for the log-transformed C(max), AUC(0-t) and AUC(0-infinity) were 94.70 to 112.05, 98.88 to 105.16, and 98.80 to 105.28, respectively (all, P < 0.05). No adverse events were reported by the volunteers or found on clinical laboratory testing during the study. CONCLUSIONS: This study did not find any statistically significant differences in C(max) or AUC values between the test and reference formulations of oral topiramate 100 mg in this population of healthy adult male Mexican volunteers. On that basis, and according to both the rate and extent of absorption, the test and reference formulations met the regulatory criteria for bioequivalence. Both formulations were well tolerated.

An experimental model of peripheral neuropathy induced in rats by Karwinskia humboldtiana (buckthorn) fruit.

Intoxication by Karwinskia humboldtiana (buckthorn) fruit presents a neurological picture similar to that of Guillain-Barré syndrome. In this report, we describe an experimental animal model of peripheral neuropathy induced by buckthorn fruit. Four groups of Wistar rats received one oral dose of 1.5 g/kg followed by oral doses of 0.5 g/kg at days 3, 7, 10, and 14 of dried and ground buckthorn fruit in aqueous suspension. Rats were sacrificed at 24, 48, 58, and 112 days after initial dose. Treated animals developed progressive paralysis through 58 days, then completely recovered by 112 days. Sciatic nerves showed segmental demyelination and cellular infiltrates until 58 days after exposure and then remyelinating changes at 112 days. This experimental model for peripheral neuropathy is reproducible and easy to handle. Its manipulation is relatively innocuous and allows us to study reversible peripheral nerve damage. This model can be developed in other animal species and may be useful to test new therapies for peripheral neuropathy.