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1.
In Vitro Cell Dev Biol Anim ; 44(10): 464-71, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18802738

RESUMO

Today there is a concern about the use of animal source proteins and peptides in cell culture applications due to potential contamination by adventitious infectious pathogens. Recombinant production of these proteins using a plant host provides a safe and cost effective alternative. In this paper, we tested the effect of rice-derived recombinant human lactoferrin (rhLF) on mammalian cell growth. The purified rhLF was partially (about 50%) iron-saturated (pis-rhLF). Chemical modification of pis-rhLF generated apo-rhLF (<10% iron saturation) or holo-rhLF (>90% iron saturation). All three forms of rhLF (pis, apo, holo) promoted growth of intestinal cells (HT-29) measured as [(3)H]-thymidine incorporation or viable cell count, but holo-rhLF was most effective. Holo-rhLF was further tested on hybridoma, osteoblast, and human embryonic kidney cells. Results showed that holo-rhLF promoted cell growth and reduced cell doubling time. The concentration of holo-rhLF in media was critical in promoting cell growth and each cell line had different concentration dependence with the most effective range from 5 to 200 mg/L. The effect of rhLF on antibody production was determined using a hybridoma cell line. Significantly, more antibodies were produced by cells grown with holo-rhLF than cells grown without holo-rhLF. We also compared the effect of holo-rhLF to that of human transferrin, a component commonly used in cell culture media as an iron source. Holo-rhLF was as effective as human transferrin in promoting cell growth and antibody production. Considering all the data obtained, we conclude that rhLF from rice is effective in promoting mammalian cell growth and increasing cell productivity.


Assuntos
Lactoferrina/farmacologia , Mamíferos/metabolismo , Oryza/química , Proteínas Recombinantes/farmacologia , Absorção/efeitos dos fármacos , Animais , Anticorpos Monoclonais/biossíntese , Contagem de Células , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Farinha , Células HT29 , Humanos , Hibridomas/citologia , Hibridomas/efeitos dos fármacos , Ferro/metabolismo , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Ratos , Timidina/metabolismo
2.
Regul Toxicol Pharmacol ; 52(2): 174-9, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18700160

RESUMO

Recombinant human holo-lactoferrin (holo-rhLF) was orally administered, via gavage, to Wistar rats at 1000, 500 and 100mg/kgbw/day for 28 days. The test article, holo-rhLF, was expressed in rice grain, extracted, purified and saturated with iron. During the 28-day period, animals were examined for evidence of toxicity. On day 29, the animals were exsanguinated, examined for gross pathology, and tissues preserved for histopathology. There were no deaths caused by holo-rhLF and in-life physical signs were generally normal. Although statistical differences were noted in some hematology, clinical chemistry and heart/body weight ratios, they were of questionable biological significance. A significantly greater total iron binding capacity (TIBC) was detected in the blood of male animals dosed with holo-rhLF. Serum was analyzed for the presence of IgG and IgE antibodies; demonstrating low levels of IgG antibodies to the human protein, but no increase in IgE antibodies. There was no increase in serum lactoferrin levels. The results of the 28-day oral administration demonstrate a lack of toxicity of holo-rhLF in rats. There were no treatment related, toxicologically relevant changes in clinical signs, growth, food consumption, hematology, clinical chemistry, organ weights or pathology. The no observed adverse effect level (NOAEL) is greater than 1000 mg/kg/day.


Assuntos
Ferro/metabolismo , Lactoferrina/toxicidade , Testes de Toxicidade/métodos , Administração Oral , Animais , Peso Corporal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Humanos , Imunoglobulina E/imunologia , Imunoglobulina G/imunologia , Lactoferrina/administração & dosagem , Masculino , Nível de Efeito Adverso não Observado , Tamanho do Órgão/efeitos dos fármacos , Oryza/metabolismo , Ratos , Ratos Wistar , Fatores Sexuais
3.
Allergy ; 63(7): 891-6, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18588555

RESUMO

BACKGROUND: The clinical relevance of immunoglobulin E (IgE) to plant glycans is a longstanding debate. We sought to evaluate their clinical reactivity using the human glycoprotein lactoferrin expressed in rice. METHODS: Allergic patients with IgE antibodies against plant glycans were analyzed for the presence of IgE against rice-produced lactoferrin. The potency of IgE to induce mediator release was assessed by basophil histamine release and skin prick tests (SPTs). Clinical relevance was evaluated by double-blind placebo-controlled oral challenge (DBPCOC). RESULTS: Twenty-four of 29 sera (82.7%) with IgE antibodies against plant glycans demonstrated IgE binding to transgenic lactoferrin. In three of five cases transgenic lactoferrin induced histamine release. Compared to a control major grass pollen allergen lactoferrin concentrations needed for biological activity of IgE were 5-6 orders of magnitude higher. Skin prick test and DBPCOC were negative in five patients with potential clinical reactivity that volunteered to undergo these in vivo challenges. CONCLUSIONS: Poor or no biological activity and lack of clinical relevance of IgE-binding plant glycans (five out of five) was demonstrated using human lactoferrin expressed in rice as a model.


Assuntos
Alérgenos/imunologia , Imunoglobulina E/imunologia , Polissacarídeos/imunologia , Adolescente , Teste de Degranulação de Basófilos , Proteínas de Transporte/genética , Proteínas de Transporte/imunologia , Criança , Método Duplo-Cego , Feminino , Liberação de Histamina , Humanos , Hipersensibilidade/imunologia , Imunoglobulina E/sangue , Lactoferrina , Masculino , Pessoa de Meia-Idade , Oryza/genética , Phleum/imunologia , Proteínas de Plantas/imunologia , Plantas Geneticamente Modificadas/genética , Pólen/imunologia , Teste de Radioalergoadsorção , Proteínas Recombinantes/genética , Proteínas Recombinantes/imunologia , Testes Cutâneos
4.
Regul Toxicol Pharmacol ; 51(2): 162-7, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18457910

RESUMO

Lactoferrin and lysozyme are important proteins of the human innate immune system. These proteins are found in breast milk and have been associated with improved infant health. Recombinant human apo-lactoferrin (apo-rhLF), 1800 and 180mg/kg bw/day, and recombinant human lysozyme (rhLZ), 360 and 36mg/kg bw/day, were orally administered to Wistar rats for 28 days. Apo-rhLF and rhLZ were expressed in rice grain, extracted, purified; the lactoferrin was iron desaturated. The animals were examined for evidence of toxicity; there were no deaths and in-life physical signs were normal. Transient differences in mean food consumption occurred in high dose apo-rhLF and low dose LZ females at week three. There were no biologically significant differences in hematological or clinical chemistry parameters. Necropsy results were normal and microscopic evaluation showed no treatment related changes in animals dosed with 1800mg/kg/day apo-rhLF or 360mg/kg/day rhLZ. The results of the 28-day oral administration demonstrate a lack of toxicity of apo-rhLF and rhLZ in rats. There were no treatment related, toxicologically relevant changes in clinical signs, growth, food consumption, hematology, clinical chemistry, organ weight and pathology. The no observed adverse effect level (NOAEL) is greater than 1800mg/kg/day for apo-rhLF and 360mg/kg/day for rhLZ.


Assuntos
Apoproteínas/toxicidade , Lactoferrina/toxicidade , Muramidase/toxicidade , Testes de Toxicidade , Administração Oral , Animais , Apoproteínas/administração & dosagem , Relação Dose-Resposta a Droga , Esquema de Medicação , Ingestão de Alimentos/efeitos dos fármacos , Feminino , Humanos , Lactoferrina/administração & dosagem , Masculino , Muramidase/administração & dosagem , Nível de Efeito Adverso não Observado , Oryza , Ratos , Ratos Wistar , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/toxicidade
5.
J Phys Chem B ; 111(24): 6703-12, 2007 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-17497912

RESUMO

Experimental data and theoretical notions are presented for 6-[1'-(6-mercapto-hexyl)-[4,4']bipyridinium]-hexane-1-thiol iodide (6V6) "wired" between a gold electrode surface and tip in an in situ scanning tunneling microscopy configuration. The viologen group can be used to "gate" charge transport across the molecular bridge through control of the electrochemical potential and consequently the redox state of the viologen moiety. This gating is theoretically considered within the framework of superexchange and coherent two-step notions for charge transport. It is shown here that the absence of a maximum in the Itunneling versus electrode potential relationship can be fitted by a "soft" gating concept. This arises from large configurational fluctuations of the molecular bridge linked to the gold contacts by flexible chains. This view is incorporated in a formalism that is well-suited for data analysis and reproduces in all important respects the 6V6 data for physically sound values of the appropriate parameters. This study demonstrates that fluctuations of isolated configurationally "soft" molecules can dominate charge transport patterns and that theoretical frameworks for compact monolayers may not be directly applied under such circumstances.

6.
Neuropathol Appl Neurobiol ; 33(2): 179-92, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17359359

RESUMO

Disruption of axonal transport may represent a final common pathway leading to neurological dysfunction in cerebral malaria (CM). Calpains are calcium (Ca2+)-activated cysteine proteases which have been implicated in axonal injury in neurological diseases of various aetiologies. In this study we examined the association between mu- and m-calpain, the specific inhibitor calpastatin, and axonal injury in post mortem brain tissue from patients who died from severe malaria. Calpains were associated with axons labelled for the beta-amyloid precursor protein that detects impaired axonal transport. Elevated levels of calpastatin were rarely observed in injured axons. There were increased numbers of neurones with mu-calpain in the nuclear compartment in severe malaria cases compared with non-neurological controls, and increased numbers of glia with nuclear mu-calpain in CM patients compared with non-CM malaria cases and non-neurological controls. There was marked redistribution of calpastatin in the sequestered Plasmodium falciparum-infected erythrocytes. Responses specific to malaria infection were ascertained following analysis of brain samples from fatal cases with acute axonal injury, HIV encephalitis, and progressive multifocal leucoencephalopathy. Our findings implicate a role for calpains in the modulation of disease progression in CM.


Assuntos
Transporte Axonal , Calpaína/metabolismo , Malária Falciparum/metabolismo , Malária Falciparum/patologia , Complexo AIDS Demência/metabolismo , Complexo AIDS Demência/patologia , Adulto , Idoso , Axônios/enzimologia , Axônios/patologia , Proteínas de Ligação ao Cálcio/metabolismo , Endotélio Vascular/enzimologia , Endotélio Vascular/patologia , Eritrócitos/parasitologia , Eritrócitos/patologia , Feminino , Humanos , Imuno-Histoquímica , Leucoencefalopatia Multifocal Progressiva/metabolismo , Leucoencefalopatia Multifocal Progressiva/patologia , Malária Falciparum/mortalidade , Masculino , Pessoa de Meia-Idade , Neuroglia/enzimologia , Neuroglia/patologia , Neurônios/enzimologia , Neurônios/patologia , Neurônios/ultraestrutura
7.
Trop Med Int Health ; 11(3): 279-87, 2006 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16553907

RESUMO

OBJECTIVES: To create a new tetanus score and compare it with the Phillips and Dakar scores. METHODS: We used prospectively acquired data from consecutive patients admitted to the Hospital for Tropical Diseases, Ho Chi Minh City, to create the Tetanus Severity Score (TSS) with multivariate logistic regression. We compared the new score with Phillips and Dakar scores by means of resubstituted and prospective data, assessing performance in terms of sensitivity, specificity and area under receiver operator characteristic curves. RESULTS: Resubstitution testing yielded a sensitivity of 77% (298/385) and a specificity of 82% (1,183/1,437) for the TSS; 89% (342/385) and 20% (281/1,437) for the Phillips score; and 13% (49/385) and 98% (1,415/1,437) for the Dakar score. The TSS showed greatest discrimination with 0.89 area under the receiver operator characteristic curve (95% CI 0.88-0.90); this was 0.74 for the Dakar score and (95% CI 0.71-0.77) and 0.66 for the Phillips score (95% CI 0.63-0.70; P values <0.001). Prospective testing showed 65% (13/20) sensitivity and 91% (210/230) specificity for the TSS; 80% (16/20) and 51% (118/230) for the Phillips score; and 25% (5/20) and 96% (221/230) for the Dakar score. The TSS achieved the greatest area under TSS of 0.89 (95% CI 0.82-0.96), significantly greater than the Phillips score [0.74 (0.6-0.88), P = 0.049] but not the Dakar score [0.80, (0.71-0.90), P = 0.090]. CONCLUSIONS: The TSS is the first prospectively developed classification scheme for tetanus and should be adopted to aid clinical triage and management and as a basis for clinical research.


Assuntos
Índice de Gravidade de Doença , Tétano/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Tétano/mortalidade , Vietnã/epidemiologia
9.
Eye (Lond) ; 18(4): 389-92, 2004 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15069436

RESUMO

PURPOSE: To describe the presentation of cytomegalovirus retinitis (CMVR) in a series of infants. METHODS: Immunocompromised infants with either HIV or systemic cytomegalovirus (CMV) were examined for CMVR. Ocular involvement was recorded and monitored by digital imaging. RESULTS: Five infants were detected to have CMVR. All the infants demonstrated changes within the macula. One infant progressed from a fine granular pattern to fulminant CMVR. CONCLUSION: Infants under a year with CMVR have a predilection for the disease to present at the macula, in contrast to the presentation in adults, which tends to involve more peripheral parts of the retina.


Assuntos
Retinite por Citomegalovirus/patologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Infecções Oportunistas Relacionadas com a AIDS/virologia , Retinite por Citomegalovirus/imunologia , Retinite por Citomegalovirus/virologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Lactente , Recém-Nascido , Macula Lutea/patologia , Masculino , Carga Viral
10.
Lancet ; 362(9380): 295-6, 2003 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-12892962

RESUMO

In animals, high doses of intramuscular artemether and artemotil have been shown to cause an unusual pattern of selective damage to certain brainstem nuclei, especially those implicated in hearing and balance. We aimed to investigate whether a similar pattern arises in human adults. We examined the brainstems of adults who died after treatment with high dose artemether or quinine for severe falciparum malaria for evidence of a pattern of selective neuronal damage. Neuropathological findings were similar in recipients of quinine (n=15) and artemether (n=6; total artemether doses received 4-44 mg/kg). No evidence was recorded for artemether-induced neurotoxic effects.


Assuntos
Antimaláricos/efeitos adversos , Artemisininas/efeitos adversos , Encefalopatias/induzido quimicamente , Encefalopatias/patologia , Malária Falciparum/tratamento farmacológico , Sesquiterpenos/efeitos adversos , Adulto , Antimaláricos/uso terapêutico , Artemeter , Artemisininas/uso terapêutico , Tronco Encefálico/efeitos dos fármacos , Tronco Encefálico/patologia , Feminino , Humanos , Malária Falciparum/patologia , Masculino , Quinina/efeitos adversos , Quinina/uso terapêutico , Sesquiterpenos/uso terapêutico
11.
J Infect Dis ; 184(11): 1369-73, 2001 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-11709777

RESUMO

Dengue is an increasingly important cause of morbidity and mortality in the tropics, but vaccine development has been impeded by a poor understanding of disease pathogenesis and, in particular, of immunologic enhancement. In a large case-control study of Vietnamese patients with dengue hemorrhagic fever (DHF), variation at the HLA-A locus was significantly associated with susceptibility to DHF (P=.02), and specific HLA-A susceptibility and resistance alleles were identified. HLA-A-specific epitopes were predicted from binding motifs, and ELISPOT analyses of patients with DHF revealed high frequencies of circulating CD8 T lymphocytes that recognized both serotype-specific and -cross-reactive dengue virus epitopes. Thus, strong CD8 T cell responses are induced by natural dengue virus infection, and HLA class I genetic variation is a risk factor for DHF. These genetic and immunologic data support both protective and pathogenic roles for dengue virus-specific CD8 T cell responses in severe disease. The potentially pathogenic role of serotype-cross-reactive CD8 T cells poses yet another obstacle to successful dengue vaccine development.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Antígenos HLA-A/genética , Dengue Grave/genética , Dengue Grave/imunologia , Adolescente , Adulto , Antígenos Virais/imunologia , Estudos de Casos e Controles , Células Cultivadas , Criança , Pré-Escolar , Vírus da Dengue/imunologia , Epitopos/imunologia , Feminino , Predisposição Genética para Doença , Variação Genética , Humanos , Interferon gama/biossíntese , Ativação Linfocitária , Complexo Principal de Histocompatibilidade , Masculino , Polimorfismo Genético
12.
J Org Chem ; 66(21): 6926-31, 2001 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-11597211

RESUMO

A range of dihydroisoquinolinium salts containing alcohol, ether, and acetal functionalities in the nitrogen substituent has been prepared and tested as asymmetric epoxidation catalysts, providing ee's of up to ca. 60%.

13.
Clin Infect Dis ; 32(2): 243-53, 2001 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-11170914

RESUMO

Dengue shock syndrome (DSS) is a potentially lethal complication of dengue virus infection associated with hypotension and leakage of plasma water into the extravascular space. To determine whether the underlying pathophysiology of DSS is distinct from that in milder forms of the disease, we assessed microvascular permeability, by use of strain gauge plethysmography, in Vietnamese children with DSS (n=19), or dengue hemorrhagic fever (DHF) without shock (n=16), and in healthy control children (n=15). At admission and after fluid resuscitation, the mean coefficient of microvascular permeability (K(f)) for the patients with dengue was approximately 50% higher than that for the control patients (P=.02). There was no significant difference in K(f) between the 2 groups of patients with dengue; this suggests the same underlying pathophysiology. We hypothesize that in patients with DSS, the fluctuations in K(f) are larger than those in patients with DHF, which leads to short-lived peaks of markedly increased microvascular permeability and consequent hemodynamic shock.


Assuntos
Microcirculação/fisiopatologia , Dengue Grave/fisiopatologia , Adolescente , Capilares/fisiopatologia , Permeabilidade Capilar , Criança , Pré-Escolar , Feminino , Hidratação , Humanos , Masculino , Pletismografia , Ressuscitação , Dengue Grave/terapia
14.
Neuropathol Appl Neurobiol ; 27(6): 421-33, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11903925

RESUMO

Immunohistochemical techniques have been used to investigate specific patterns of potentially reversible cellular injury, DNA damage, and apoptosis in the brainstems of Vietnamese patients who died of severe Plasmodium falciparum malaria. The degree and pattern of neuronal and glial stress responses were compared between patients with cerebral and non-cerebral malaria (CM), and appropriate non-malaria infected controls. The following markers were examined: (i) heat shock protein 70 (HSP70), for reversible injury; (ii) heme oxygenase-1, for oxidative stress; (iii & iv) two DNA-repair proteins, poly(ADP) ribose polymerase (PARP) and DNA-dependent protein kinase catalytic subunit; (v) poly(ADP) ribose, an end-product of PARP activity; and (vi) caspase-3-active, for apoptosis. Stress responses were found in a range of cell types as reflected by the widespread expression of HSP70. Oxidative stress predominated in the vicinity of vessels and haemorrhages. Some degree of DNA damage was found in the majority of malaria patients, but the distribution and frequency of the damage was much less than that observed in controls with irreversible neuronal injury. Similarly, caspase-3-active expression, as a measure of apoptosis, was no higher in the majority of malaria patients than the negative control cases, although 40% of CM cases expressed caspase-3-active in a small number of neurones of the pontine nuclei or within swollen axons of the pontocerebellar and corticospinal tracts. In conclusion, cells within the brainstem of all patients who died from severe malaria showed staining patterns indicative of considerable stress response and reversible neuronal injury. There was no evidence for a specific pattern of widespread irreversible cell damage in those patients with cerebral malaria.


Assuntos
Tronco Encefálico/patologia , Proteínas de Ligação a DNA , Malária Cerebral/patologia , Adulto , Apoptose , Tronco Encefálico/enzimologia , Tronco Encefálico/parasitologia , Caspase 3 , Caspases/análise , Causas de Morte , Proteína Quinase Ativada por DNA , Feminino , Proteínas de Choque Térmico HSP70/análise , Heme Oxigenase (Desciclizante)/análise , Heme Oxigenase-1 , Humanos , Malária Cerebral/metabolismo , Masculino , Proteínas de Membrana , Pessoa de Meia-Idade , Neuroglia/patologia , Proteínas Nucleares , Poli Adenosina Difosfato Ribose/análise , Poli(ADP-Ribose) Polimerases/análise , Proteínas Serina-Treonina Quinases/análise , Vietnã
15.
Nature ; 408(6808): 67-9, 2000 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-11081506

RESUMO

So-called bottom-up fabrication methods aim to assemble and integrate molecular components exhibiting specific functions into electronic devices that are orders of magnitude smaller than can be fabricated by lithographic techniques. Fundamental to the success of the bottom-up approach is the ability to control electron transport across molecular components. Organic molecules containing redox centres-chemical species whose oxidation number, and hence electronic structure, can be changed reversibly-support resonant tunnelling and display promising functional behaviour when sandwiched as molecular layers between electrical contacts, but their integration into more complex assemblies remains challenging. For this reason, functionalized metal nanoparticles have attracted much interest: they exhibit single-electron characteristics (such as quantized capacitance charging) and can be organized through simple self-assembly methods into well ordered structures, with the nanoparticles at controlled locations. Here we report scanning tunnelling microscopy measurements showing that organic molecules containing redox centres can be used to attach metal nanoparticles to electrode surfaces and so control the electron transport between them. Our system consists of gold nanoclusters a few nanometres across and functionalized with polymethylene chains that carry a central, reversibly reducible bipyridinium moiety. We expect that the ability to electronically contact metal nanoparticles via redox-active molecules, and to alter profoundly their tunnelling properties by charge injection into these molecules, can form the basis for a range of nanoscale electronic switches.

19.
Crit Care Med ; 28(5): 1353-62, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10834678

RESUMO

OBJECTIVE: To describe and compare the effects of dopamine and epinephrine in various doses on renal hemodynamics and oxygen transport in patients with severe malaria and severe sepsis. DESIGN: Prospective, controlled, crossover trial. SETTING: The intensive care unit of an infectious diseases hospital in Viet Nam. PATIENTS: Fourteen patients with severe falciparum malaria and five with severe sepsis. INTERVENTIONS: In an open, crossover design, we observed the effects on renal and systemic hemodynamics and oxygen transport of separate stepped infusions of epinephrine and dopamine. We measured renal blood flow (RBF) and cardiac output by the thermodilution method using fluoroscopically guided catheters. Creatinine clearance at each time point was calculated from the renal plasma flow and the renal arteriovenous difference in plasma creatinine. MEASUREMENTS AND MAIN RESULTS: Dopamine at a "renal" dose (2.5 microg/kg/min) was associated with a mean (95% confidence interval) fractional increase in the absolute renal blood flow index (RBFI) of 37% (13% to 61%) and in RBF as a fraction of cardiac output (RBF/CO) of 35% (10% to 59%; p = .007 and p = .014, respectively). The consequent 39% (14% to 64%) increase in renal oxygen supply (p = .002) was accompanied by a 32% (20% to 44%) decrease in the renal oxygen extraction ratio (p = .0003), leading to no net change in renal oxygen consumption. At higher doses (10 microg/kg/min), both RBF and RBF/CO were not significantly different from baseline values and decreased further as the dose was reduced again. There was no obvious explanation for this hysteresis. There was no change in renal oxygen consumption throughout the study. Because lactic acidosis developed, epinephrine was only given to eight of the 19 patients, and the full stepped epinephrine infusion was given to four patients. Epinephrine infusion was associated, both in absolute terms and when compared with dopamine, with a significant increase in renal vascular resistance (p = .0008 and .0005, respectively), a decrease in RBF/CO (p = .002 and .03), and a compensatory increase in the renal oxygen extraction ratio (p = .005 and .0001). RBFI and renal oxygen consumption remained constant throughout the epinephrine infusion profile. Neither epinephrine nor dopamine significantly affected creatinine clearance or urine output. Twelve patients (63%) were in established renal failure (plasma creatinine, >3 mg/dL) at the time of the study, although the presence or absence of renal failure did not significantly influence the effects of the study drugs. However, overall, the presence of renal failure was associated with a lower mean renal oxygen consumption, a lower mean renal oxygen consumption as a fraction of systemic oxygen consumption, and a higher mean renal vascular resistance. CONCLUSION: Although dopamine increased and epinephrine decreased fractional renal blood flow, there was no evidence that either drug produced either a beneficial or a deleterious effect on renal oxygen metabolism or function at any of the doses investigated.


Assuntos
Cardiotônicos/administração & dosagem , Dopamina/administração & dosagem , Epinefrina/administração & dosagem , Hemodinâmica/efeitos dos fármacos , Rim/irrigação sanguínea , Malária Falciparum/tratamento farmacológico , Choque Séptico/tratamento farmacológico , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Velocidade do Fluxo Sanguíneo/fisiologia , Débito Cardíaco/efeitos dos fármacos , Débito Cardíaco/fisiologia , Cuidados Críticos , Relação Dose-Resposta a Droga , Feminino , Hemodinâmica/fisiologia , Humanos , Infusões Intravenosas , Testes de Função Renal , Malária Falciparum/fisiopatologia , Masculino , Pessoa de Meia-Idade , Consumo de Oxigênio/efeitos dos fármacos , Consumo de Oxigênio/fisiologia , Estudos Prospectivos , Choque Séptico/fisiopatologia
20.
Clin Sci (Lond) ; 98(2): 211-6, 2000 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-10657278

RESUMO

During studies of the pathogenesis of dengue shock syndrome, a condition largely confined to childhood and characterized by a systemic increase in vascular permeability, we observed that healthy controls, age-matched to children with dengue shock syndrome, gave high values of filtration capacity (K(f)), a factor describing vascular permeability. We hypothesized that K(f) might be age dependent. Calf K(f) was studied in 89 healthy Vietnamese subjects aged 5 to 77 years. The K(f) was highest in the youngest children [7. 53 (1.96-15.46) K(f)U; median (range); where the units of K(f), K(f)U=ml.min(-1).100 ml(-1).mmHg(-1)]. Values were 3- to 4-fold lower towards the end of the second decade [4.69 (1.91-7.06) K(f)U]. Young mammals are known to have a larger microvascular surface area per unit volume of skeletal muscle than adults. During development the proportion of developing vessels is greater. Moreover, the novel microvessels are known to be more permeable to water and plasma proteins than when mature. These factors may explain why children more readily develop hypovolaemic shock than adults in dengue haemorrhagic fever and other conditions characterized by increased microvascular permeability.


Assuntos
Envelhecimento/fisiologia , Permeabilidade Capilar/fisiologia , Choque/etiologia , Adolescente , Adulto , Idoso , Capilares/fisiologia , Criança , Pré-Escolar , Dengue/fisiopatologia , Suscetibilidade a Doenças , Feminino , Humanos , Masculino , Microcirculação , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Choque/fisiopatologia
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