Anticoagulation With an Inhibitor of Factors XIa and XIIa During Cardiopulmonary Bypass.

BACKGROUND: Exposure of blood to polyanionic artificial surfaces, for example, during cardiopulmonary bypass (CPB), induces a highly procoagulant condition requiring strong anticoagulation. Unfractionated heparin (UFH) is currently used during CPB but can lead to serious bleeding complications or development of a hypercoagulable state culminating in life-threatening thrombosis, highlighting the need for safer antithrombotics. Ixodes ricinus contact phase inhibitor (Ir-CPI) is a protein expressed by I. ricinus ticks, which specifically inhibits both factors XIIa and XIa, 2 factors contributing to thrombotic disease while playing a limited role in hemostasis. OBJECTIVES: This study assessed the antithrombotic activity of Ir-CPI in animal contact phase-initiated thrombosis models, including CPB. The safety of Ir-CPI also was evaluated. METHODS: The authors evaluated the antithrombotic activity of Ir-CPI by using in vitro catheter-induced clotting assays and rabbit experimental models of catheter occlusion and arteriovenous shunt. During CPB with cardiac surgery in sheep, the clinical applicability of Ir-CPI was investigated and its efficacy compared to that of UFH using an uncoated system suitable for adult therapy. Taking advantage of the similar hemostatic properties of pigs and humans, the authors performed pig liver bleeding assays to evaluate the safety of Ir-CPI. RESULTS: Ir-CPI prevented clotting in catheter and arteriovenous shunt rabbit models. During CPB, Ir-CPI was as efficient as UFH in preventing clot formation within the extracorporeal circuit and maintained physiological parameters during and post-surgery. Unlike UFH, Ir-CPI did not promote bleeding. CONCLUSIONS: Preclinical animal models used in this study showed that Ir-CPI is an effective and safe antithrombotic agent that provides a clinically relevant approach to thrombosis prevention in bypass systems, including highly thrombogenic CPB.

Advantageous safety profile of a dual selective alpha(2C) agonist/alpha(2A) antagonist antinociceptive agent.

A selective α2C -adrenoceptor (AR) agonist was developed for the treatment of neuropathic pain. The objective was to dissociate analgesic activity from cardiovascular and sedative side effects commonly observed with nonselective agents. A 2-amino-oxazoline derivative (compound A), identified as a dual α2C -AR agonist/α2A -AR antagonist in in vitro-binding assays, exhibited in vivo efficacy in rodent pain models. Its safety profile was compared with that of clonidine in six different in vivo models. Contrary to clonidine, compound A did not induce hypotension in pentobarbital-anesthetized rats, in conscious spontaneous hypertensive rats, or in telemetered dogs. Both agents induced similar dose-dependent decreases in heart rate in dogs and rats. In anesthetized pithed rats, clonidine showed dose-dependent hypertension and inhibited electrical nerve stimulation-induced tachycardia at doses close to its efficacious doses in the mouse formalin test, while compound A had much weaker vasoconstrictive and antichronotropic effects. Finally, in a mouse Irwin test, no sedation was observed with compound A at 30-fold its ED50 in the mouse formalin test, while sedative effects of clonidine started from three-fold its ED50 . These data confirm the advantageous safety profile of the new dual α2C -AR agonist/α2A -AR antagonist agent vs. the nonselective agonist clonidine.

Inhibitory effects of sigma-1 ligands on handling-induced tachycardia in conscious tethered rats.

We used conscious tethered Sprague-Dawley rats to evaluate the cardiovascular effects of four sigma-1 (σ1 ) agonists and five antagonists, given alone or in combination. All drugs were administered as a single intraperitoneal dose. The agonists were given at doses reported as efficacious in rodent cognition models, while the antagonists were administered at doses neutralizing agonist effects in vivo. Systolic blood pressure (SBP) and heart rate (HR) were continuously recorded for 20 min before and 60 min postadministration. Immediately after injection, a sudden, transitory increase in HR and SBP was noted in all animals, because of the stress induced by handling. For both parameters, a peak value (ΔHRmax and ΔSBPmax ) and an area under the curve of changes from baseline over the period 5-20 min postinjection (ΔHR_AUC5-20 min and ΔSBP_AUC5-20 min ) were calculated. Three of the four σ1 agonists (SKF-10,047, dehydroepiandrosterone (DHEAS), Compound 14) significantly reduced ΔHR_AUC5-20 min value without changing ΔHRmax , while the fourth one, SA-4503, had no significant effect. None of the antagonists (haloperidol, rimcazole, NE-100, and BD1047) reduced, and even one (progesterone) enhanced the stress-induced effects on HR. No changes in SBP were noted with any compound. When the antagonist NE-100 was administered just before SKF-10,047, it completely reversed the inhibitory effects of the σ1 agonist on HR increase. In conclusion, we demonstrated for the first time the involvement of σ1 receptors in the regulation of handling-induced tachycardia in the conscious rat. Although additional investigations are needed to fully understand this role, it might offer new therapeutic perspectives to σ1 ligands in the cardiovascular sphere.

Repeated assessment of cardiovascular and respiratory functions using combined telemetry and whole-body plethysmography in the rat.

INTRODUCTION: As the currently recommended laboratory techniques for assessing cardiovascular and respiratory functions are telemetry and plethysmography, we therefore combined both in a single rodent model. The purpose of the present work was to assess the potential influence of body growth on the recorded parameters, to verify the sensitivity of the system to detect well known pharmacological effects of reference drugs, and to determine their reproducibility over time. METHODS: Telemetry instrumented rats were enrolled in successive experiments over a total of 5 months. In each run, they were placed in individual plethysmography chambers for 6h, and received a single intraperitoneal injection of vehicle or test compound. Heart rate, blood pressure, body temperature and respiratory parameters were measured in real time. Six of these 16 rats were submitted 5 times at one month intervals to a vehicle injection, and six rats received theophylline (30 mg/kg) twice at 4 months interval. Nine other reference compounds were also tested at a single dose. RESULTS: Analysis of baseline data mainly showed correlations between body weight or age and heart rate, as well as tidal volume. In the five successive runs, handling-induced perturbations were noted in all the parameters during 60 to 90 min. The effects of the different reference drugs were consistent with data published in animals and man. The response to theophylline was qualitatively similar at 4 months interval. DISCUSSION: We established a combined model of telemetry and plethysmography in the conscious rat, allowing the reuse of the animals over several successive pharmacodynamic studies. Although a shift of some parameters, particularly heart rate and tidal volume, was noted with age and body weight, this can easily be managed by appropriate design measures. We showed that the combined system can detect negative or positive effects on both cardiovascular and respiratory functions with enough sensitivity.

Alkyne-quinuclidine derivatives as potent and selective muscarinic antagonists for the treatment of COPD.

SAR around alkyne-quinuclidine derivatives allowed the discovery of highly potent muscarinic antagonists displaying interesting preferential slow off-rates from the M3 receptor.

Potent anti-muscarinic activity in a novel series of quinuclidine derivatives.

The synthesis and biological evaluation of a novel family of M(3) muscarinic antagonists are described. A systematic modification of the substituents to a novel alkyne-quinuclidine scaffold yielded original compounds displaying potent in vitro anticholinergic properties.