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1.
Radiat Res ; 156(1): 53-60, 2001 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-11418073

RESUMO

Rectenwald, J. E., Pretus, H. A., Seeger, J. M., Huber, T. S., Mendenhall, N. P., Zlotecki, R. A., Palta, J. R., Li, Z. F., Hook, S. Y., Sarac, T. P., Welborn, M. B., Klingman, N. V., Abouhamze, Z. S. and Ozaki, C. K. External-Beam Radiation Therapy for Improved Dialysis Access Patency: Feasibility and Early Safety. Radiat. Res. 156, 53-60 (2001).Prosthetic dialysis access grafts fail secondary to neointimal hyperplasia at the venous anastomosis. We hypothesized that postoperative single-fraction external-beam radiation therapy to the venous anastomosis of hemodialysis grafts can be used safely in an effort to improve access patency. Dogs (n = 8) underwent placement of expanded polytetrafluoroethylene grafts from the right carotid artery to the left jugular vein. Five dogs received single-fraction external-beam photon irradiation (8 Gy) to the venous anastomosis after surgery. Controls were not irradiated. Shunt angiograms were completed 3 and 6 months postoperatively. Anastomoses, mid-graft, and the surrounding tissues were analyzed. Immunohistochemistry for smooth muscle cell alpha-actin, proliferating cellular nuclear antigen (PCNA), and apoptosis was performed. Incisions healed well, though all animals developed wound seromas. One control suffered graft thrombosis 4 months postoperatively. Angiography/histology confirmed severe neointimal hyperplasia at the venous anastomosis. The remaining seven dogs developed similar amounts of neointimal hyperplasia. PCNA studies showed no accelerated fibroproliferative response at irradiated anastomoses compared to controls. Skin incisions and soft tissues over irradiated anastomoses revealed no radiation-induced changes or increase in apoptosis. Thus we conclude that postoperative single-fraction external-beam irradiation of the venous anastomosis of a prosthetic arteriovenous graft that mimics the situation in humans is feasible and safe with regard to early wound healing.


Assuntos
Derivação Arteriovenosa Cirúrgica , Prótese Vascular , Oclusão de Enxerto Vascular/prevenção & controle , Túnica Íntima/efeitos da radiação , Grau de Desobstrução Vascular/efeitos da radiação , Actinas/metabolismo , Animais , Apoptose/efeitos da radiação , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Derivação Arteriovenosa Cirúrgica/instrumentação , Prótese Vascular/efeitos adversos , Artérias Carótidas/metabolismo , Artérias Carótidas/efeitos da radiação , Cães , Estudos de Viabilidade , Feminino , Oclusão de Enxerto Vascular/etiologia , Oclusão de Enxerto Vascular/patologia , Imuno-Histoquímica , Veias Jugulares/metabolismo , Veias Jugulares/efeitos da radiação , Politetrafluoretileno , Antígeno Nuclear de Célula em Proliferação/metabolismo , Diálise Renal/métodos , Pele/efeitos da radiação , Túnica Íntima/metabolismo , Túnica Íntima/patologia , Cicatrização/efeitos da radiação
2.
J Vasc Surg ; 32(3): 451-9; discussion 460-1, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10957651

RESUMO

OBJECTIVE: The purpose of this study was to determine long-term outcome in patients with infected prosthetic aortic grafts who were treated with extra-anatomic bypass grafting and aortic graft removal. METHODS: Between January 1989 and July 1999, 36 patients were treated for aortic graft infection with extra-anatomic bypass grafting and aortic graft removal. Extra-anatomic bypass graft types were axillofemoral femoral (5), axillofemoral (26; bilateral in 20), axillopopliteal (3; bilateral in 1) and axillofemoral/axillopopliteal (2). The mean follow-up was 32.3 +/- 4. 8 months. RESULTS: Four patients (11%) died in the postoperative period, and two patients died during follow-up as a direct consequence of extra-anatomic bypass grafting and aortic graft removal (one died 7 months after extra-anatomic bypass graft failure, one died 36 months after aortic stump disruption). One additional patient died 72 months after failure of a subsequent aortic reconstruction, so that the overall treatment-related mortality was 19%, whereas overall survival by means of life table analysis was 56% at 5 years. No amputations were required in the postoperative period, but four patients (11%) required amputation during follow-up. Twelve patients (35%) had extra-anatomic bypass graft failure during follow-up, and six patients underwent secondary aortic reconstruction (thoracobifemoral [2], iliofemoral [2], femorofemoral [2]). However, with the exclusion of patients undergoing axillopopliteal grafts (primary patency 0% at 7 months), only seven patients (25%) had extra-anatomic bypass graft failure, and only two patients required amputation (one after extra-anatomic bypass graft removal for infection, one after failure of a secondary aortic reconstruction). Furthermore, primary and secondary patency rates by means of life table analysis were 75% and 100% at 41 months for axillofemoral femoral grafts and 64% and 100% at 60 months for axillofemoral grafts. Only one patient required extra-anatomic bypass graft removal for recurrent infection, and only one late aortic stump disruption occurred. CONCLUSIONS: Staged extra-anatomic bypass grafting (with axillofemoral bypass graft) and aortic graft removal for treatment of aortic graft infection are associated with acceptable early and long-term outcomes and should remain a primary approach in selected patients with this grave problem.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Doenças da Aorta/cirurgia , Arteriopatias Oclusivas/cirurgia , Implante de Prótese Vascular/métodos , Prótese Vascular , Remoção de Dispositivo , Infecções Relacionadas à Prótese/cirurgia , Idoso , Artéria Axilar/cirurgia , Artéria Femoral/cirurgia , Seguimentos , Humanos , Artéria Ilíaca/cirurgia , Pessoa de Meia-Idade , Reoperação
3.
J Vasc Surg ; 30(3): 427-35, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10477635

RESUMO

PURPOSE: Aggressive attempts at limb salvage in patients with ischemic tissue loss are justified by favorable initial results in most patients. The identification of patients whose conditions will not benefit from attempted revascularization remains difficult. METHODS: This study was designed as a retrospective review of prospectively collected clinical data. The subjects were 210 consecutive patients who underwent infrainguinal vein bypass grafting for ischemic tissue loss in the setting of an academic medical center. Bypass grafting was to the popliteal artery in 56 patients, to the infrapopliteal arteries in 131 patients, and to the pedal arteries in 23 patients. The follow-up examination was complete in 209 of 210 patients. One hundred twenty-five patients underwent blinded review of duplex scan venous mapping and arteriography to determine simplified vein and run-off scores. The outcome measures were the influence of risk factors, venous conduit, and runoff on mortality, limb loss, and graft failure at the 6-month follow-up examination. RESULTS: One hundred seventy patients (81%) were alive and had limb salvage. Nineteen patients (9.1%) died, with need for a simultaneous inflow procedure and end-stage renal disease being most commonly associated with mortality. Thirty-three patients (15.8%) had undergone amputation: 18 after graft failure, and 15 for progressive tissue loss despite a patent graft. Amputation was significantly more common in patients with diabetes (P =.05) and with poor runoff scores (poor runoff, 44.4% vs good runoff, 7.4%; P <.01). Amputation despite a patent graft also correlated with runoff (poor runoff, 41.7% vs good runoff, 4.3%; P <.01). Twenty-five patients had graft failure without amputation, so that only 145 patients (69.4%) were alive, had limb salvage, and had a patent graft. Run-off score was the strongest predictor of outcome, with 70% of patients with poor run-off scores having death, amputation, or graft failure. CONCLUSION: Aggressive use of infrainguinal vein bypass grafting in patients with ischemic tissue loss results in a high rate of initial limb salvage but significant morbidity and mortality. Arteriographically determined runoff scores appear to potentially identify patients at high risk for a poor initial outcome and may provide a method of selecting patients for primary amputation.


Assuntos
Isquemia/cirurgia , Perna (Membro)/irrigação sanguínea , Veias/transplante , Amputação Cirúrgica , Angiografia , Artérias/cirurgia , Feminino , Seguimentos , Pé/irrigação sanguínea , Previsões , Sobrevivência de Enxerto , Humanos , Canal Inguinal/irrigação sanguínea , Falência Renal Crônica/complicações , Perna (Membro)/cirurgia , Masculino , Pessoa de Meia-Idade , Artéria Poplítea/cirurgia , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do Tratamento , Ultrassonografia Doppler Dupla
4.
Carbohydr Res ; 299(3): 203-8, 1997 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-9163899

RESUMO

Glucans are (1-->3)-beta-linked glucose polymers which have immune-stimulating capability. The extraction of water-insoluble (1-->3)-beta-D-glucan form Saccharomyces cerevisiae employs hydrochloric acid. Hydrochloric acid is difficult to employ in the large-scale pharmaceutical extraction of glucans due to its corrosive nature and toxicity. To address these concerns, we determined whether acetic, formic or phosphoric acid can be substituted for hydrochloric acid in the process for the isolation of (1-->3)-beta-D-glucan. The resulting microparticulate glucans were employed as the starting material for the production of (1-->3)-beta-D-glucan phosphate. 13C NMR analysis of the glucan phosphates derived from the acetic, formic or phosphoric acid-extracted microparticulate glucan show excellent correspondence to hydrochloric acid extracted glucan and laminarin, a (1-->3)-beta-D-glucan standard, indicating that the primary structure is not altered by the acid used for extraction. Glucan phosphate prepared from hydrochloric acid had a Mw of 7.2 x 10(4) g/mol, rmsz of 17.7 nm, of 1.50 and (eta) of 49.0 mL/g. Glucan phosphate prepared from acetic acid had a primary polymer peak with a Mw of 1.4 x 10(6) g/mol, rmsz of 23.6 nm, I of 1.93 and (eta) of 62.4 mL/g. Glucan phosphate prepared from formic acid had a main polymer peak with a Mw of 1.2 x 10(6) g/mol, rmsz 27.1 nm, I of 1.56 and (eta) of 89.0 mL/g. Glucan phosphate prepared from phosphoric acid had a primary polymer peak with a Mw of 6.6 x 10(5) g/mol, rmsz of 32.3 nm, I of 2.70 and (eta) of 91.3 mL/g. These data indicate that the molecular mass, size, polydispersity and intrinsic viscosity of the glucan phosphate obtained is influenced by the pKa of protic acid employed to extract the microparticulate glucan. However, the primary structure and side-chain branching are not substantially altered regardless of the acid employed.


Assuntos
Ácidos/química , Glucanos/isolamento & purificação , Saccharomyces cerevisiae/química , beta-Glucanas , Ácido Acético/química , Formiatos/química , Ácido Clorídrico/química , Espectroscopia de Ressonância Magnética , Peso Molecular , Oligossacarídeos/química , Fosfatos/análise , Ácidos Fosfóricos/química , Viscosidade
5.
J Chromatogr B Biomed Appl ; 666(2): 283-90, 1995 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-7633604

RESUMO

A major barrier to the development, preclinical and clinical application of natural carbohydrate biological response modifiers has been the difficulty involved in accurately characterizing carbohydrate polymers with molecular masses ranging from 10(4) to 10(7) g/mol. Herein, we employed size exclusion chromatography with multi-angle laser light scattering and differential viscometry to compare and contrast structural properties of the biological response modifiers Krestin, schizophyllan and glucan phosphate. Krestin, schizophyllan and glucan phosphate exhibit significant differences in molecular mass moments, molecular mass distribution, polymer sizes, intrinsic viscosity and perhaps their solution behaviour. This knowledge of precise physicochemical data is required for a better understanding of the properties and higher structure of complex carbohydrate biological response modifiers.


Assuntos
Cromatografia em Gel/métodos , Glucanos/análise , Fatores Imunológicos/análise , Proteoglicanas/análise , Sizofirano/análise , Lasers , Peso Molecular , Compostos Organofosforados/análise , Polímeros , Refratometria , Espalhamento de Radiação , Viscosidade
7.
Carbohydr Res ; 235: 247-57, 1992 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-1473107

RESUMO

This report describes a method for the solubilization of micro-particulate (1-->3)-beta-D-glucan. Insoluble glucan is dissolved in methyl sulfoxide and urea (8 M) and partially sulfated at 100 degrees. The resulting water-soluble product is called glucan sulfate. The conversion rate is 98%, and the preparation is endotoxin free as determined by the Limulus lysate procedure. Glucan sulfate is composed of 34.06% C, 6.15% H, 50.30% O, 5.69% S and 3.23% N, and has a repeating unit empirical formula of (C6H10O5)8.3 SO3NH4+.4 H2O, suggesting that, on the average, a sulfate group is substituted on every third glucose subunit along the polymer. Molecular weight averages, polydispersity, and intrinsic viscosity were determined by aqueous high-performance size-exclusion chromatography (HPSEC). Two polymer peaks were resolved. Peak 1 (Mw = 1.25 x 10(6) g/mol) represents < 1% of the total polymer mass. Peak 2 (Mw = 1.45 x 10(4) g/mol) comprises > 99% of polymers. 13C NMR spectroscopy confirmed the beta-(1-->3) interchain linkage. In solution, glucan sulfate polymers self-associate in a triple helix. Glucan sulfate stimulates murine bone marrow proliferation following intravenous administration. The ability to prepare a immunologically active, water-soluble (1-->3)-beta-D-glucan preparation will greatly enhance the clinical utility of this class of compounds.


Assuntos
Medula Óssea/efeitos dos fármacos , Divisão Celular/efeitos dos fármacos , Glucanos/isolamento & purificação , Fatores Imunológicos/isolamento & purificação , Saccharomyces cerevisiae/química , Animais , Células da Medula Óssea , Configuração de Carboidratos , Ciclo Celular/efeitos dos fármacos , Células Cultivadas , Cromatografia Líquida de Alta Pressão , Glucanos/farmacologia , Fatores Imunológicos/farmacologia , Espectroscopia de Ressonância Magnética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Peso Molecular , Timidina/metabolismo , Viscosidade
8.
Dev Biol Stand ; 77: 129-36, 1992.
Artigo em Inglês | MEDLINE | ID: mdl-1426653

RESUMO

A major barrier to the understanding, development and utilization of natural product complex carbohydrate immunomodulators has been the lack of standardization during pre-clinical efficacy and safety testing. In addition, it has been our experience that no single assay system or model is adequate for assessing preclinical efficacy and safety of these agents. To address these important issues, our laboratory group has developed a sequential multi-assay protocol for the preclinical evaluation of natural product complex carbohydrate immunomodulators. This sequential multi-assay screening protocol is divided into four phases: 1) physiochemical characterization of the carbohydrate polymer; 2) evaluation of immune stimulatory activity; 3) assessing in vivo anti-microbial activity and anti-tumor efficacy and 4) preclinical safety evaluation. This sequential protocol provides an effective, reproducible and rational approach to the preclinical assessment of complex carbohydrate immunomodulators that, in our experience, is predictive of clinical safety and efficacy.


Assuntos
Adjuvantes Imunológicos/farmacologia , Avaliação Pré-Clínica de Medicamentos/métodos , Glucanos/farmacologia , Adjuvantes Imunológicos/uso terapêutico , Algoritmos , Animais , Medula Óssea/efeitos dos fármacos , Glucanos/uso terapêutico , Infecções/terapia , Células Matadoras Naturais/efeitos dos fármacos , Ativação Linfocitária/efeitos dos fármacos , Ativação de Macrófagos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos AKR/imunologia , Camundongos Endogâmicos C57BL/imunologia , Neoplasias Experimentais/terapia , Baço/citologia , Baço/efeitos dos fármacos , Baço/imunologia
9.
Immunopharmacology ; 22(3): 139-55, 1991.
Artigo em Inglês | MEDLINE | ID: mdl-1774155

RESUMO

This report describes the development, characterization and preclinical efficacy evaluation of water soluble glucan sulfate. Glucan sulfate was derived from insoluble beta-1,3-D-glucan isolated from Saccharomyces cerevisiae. The proposed repeating unit empirical formula of glucan sulfate is [(C6H10O5)5.3H2SO4]n. Two polymer peaks were resolved by aqueous high-performance size exclusion chromatography (HPSEC) with on-line multi-angle laser light scattering (MALLS) photometry and differential viscometry. Peak 1 (MW = 1219697 Da) represents approximately 1% of the total polymers, while peak 2 (MW = 8884 Da) accounts for approximately 99% of polymers. 13C-NMR spectroscopy suggests that glucan sulfate polymer strands may be partially cross-linked. Glucan sulfate (250 mg/kg, i.v.) increased (P less than 0.01) macrophage vascular clearance of 131I-reticuloendothelial emulsion by 42% (P less than 0.01) and in vitro bone marrow proliferation by 46% (P less than 0.05). Glucan sulfate (250 mg/kg, i.v.) increased (P less than 0.05) median survival time of C57B1/6J mice with syngeneic melanoma B16 or sarcoma M5076. In addition, glucan sulfate immunoprophylaxis increased resistance of mice to challenge with Escherichia coli, Candida albicans or Mouse Hepatitis Virus strain A-59. We concluded that: (1) insoluble beta-1,3-D-glucan can be converted to a water soluble sulfated form; (2) glucan sulfate activates macrophages and stimulates bone marrow; (3) glucan sulfate exerts antitumor therapeutic activity, and (4) glucan sulfate immunoprophylaxis will modify the course of experimental infectious disease.


Assuntos
Glucanos/uso terapêutico , Fatores Imunológicos/uso terapêutico , Saccharomyces cerevisiae/química , Animais , Infecções por Escherichia coli/prevenção & controle , Glucanos/química , Glucanos/farmacologia , Fatores Imunológicos/química , Fatores Imunológicos/farmacologia , Espectroscopia de Ressonância Magnética , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Peso Molecular , Neoplasias Experimentais/tratamento farmacológico
10.
Carbohydr Res ; 219: 203-13, 1991 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-1804535

RESUMO

This report describes a method for the solubilization of a micro-particulate beta-D-glucan. Insoluble glucan is dissolved in methyl sulfoxide and urea (8M) and partially phosphorylated at 100 degrees. The resulting water-soluble product is called glucan phosphate. The conversion rate is 70%, and the preparation is endotoxin free as determined by the Limulus lysate procedure. Glucan phosphate is composed of 34.66% C, 6.29% H, 42.83% O, and 2.23% P and has a repeating-unit empirical formula of (C6H10O5)7.PO3H2, indicating a phosphate group substitution on every seventh glucose subunit. Molecular-weight averages, polydispersity, and intrinsic viscosity were determined by aqueous high-performance size-exclusion chromatography (s.e.c.) with on-line, multi-angle laser light scattering (m.a.l.l.s.) photometry and differential viscometry (d.v.). Two polymer peaks were resolved. Peak 1 (Mw = 3.57 x 10(6) daltons), represents approximately 2% of the total polymers, while peak 2 (Mw = 1.10 x 10(5) daltons) comprises approximately 98% of polymers. 13C- and 31P-n.m.r. spectroscopy confirmed the beta-1,3 interchain linkage and the presence of a phosphate group. In solution, glucan phosphate polymers self-associate in a triple-helical arrangement. The ability to prepare a immunologically active, non-toxic, water-soluble beta-D-glucan preparation will greatly enhance the clinical utility of this class of compounds.


Assuntos
Composição de Medicamentos/métodos , Glucanos/química , Fatores Imunológicos/química , Conformação Molecular , Saccharomyces cerevisiae/química , Estudos de Avaliação como Assunto , Glucanos/imunologia , Fosforilação , Solubilidade , Fosfatos Açúcares/síntese química
11.
J Pharmacol Exp Ther ; 257(1): 500-10, 1991 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-1902259

RESUMO

Herein we describe the isolation, physicochemical characterization and preclinical evaluation of a water-soluble biologic response modifier extracted from Sclerotium glucanicum. Alkaline extraction of insoluble S. glucanicum exopolymers produced a soluble scleroglucan composed of a triple-helical beta-1,3-linked glucopyranose backbone with single beta-1,6-linked glucopyranosyl branches every third subunit. Scleroglucan has a weight average molecular mass of 1.56 x 10(6) Da, a weight average root mean square distance from the center of gravity of the molecule to its farthest elements of 51.8 nm, a polydispersity (weight-average molecular mass/number average molecular mass) of 1.83 and intrinsic viscosity of 3.081 dl/g. Scleroglucan (250 mg/kg, intravenously) stimulated in vivo murine macrophage phagocytic activity (66%, P less than .001) and increased in vitro macrophage tumor cytotoxicity against syngeneic tumor targets by 124% (P less than .05). Scleroglucan enhanced (P less than .001) murine bone marrow proliferation in a biphasic manner by up to 328%. Scleroglucan therapy increased survival of mice challenged with syngeneic lymphoma, melanoma or adenocarcinoma. AKR/J mice bearing syngeneic lymphoma (1 x 10(3) cells, intraperitoneally) demonstrated increased (P less than .001) long-term survival (100% vs. 0%, greater than 64 days). C57Bl/6J mice bearing syngeneic melanoma B16 (5 x 10(5) cells, subcutaneously) demonstrated increased long-term survival (64% vs. 0%, P less than .05). C57Bl/6J mice bearing syngeneic adenocarcinoma BW10232 (1 x 10(5) cells, subcutaneously) demonstrated increased (P less than .05) median survival time. In addition, scleroglucan prophylaxis increased resistance of mice to challenge with Staphylococcus aureus, Candida albicans and mouse hepatitis virus A-59. Scleroglucan did not induce toxicity or hepatomegaly. We conclude that: 1) a branched, water-soluble beta-1,3-linked scleroglucan biologic response modifier can be extracted from S. glucanicum; 2) scleroglucan will stimulate immunity, modify experimental neoplastic disease and increase resistance to microbial challenge; and 3) scleroglucan shows promise as an immunopotentiating drug.


Assuntos
Glucanos/isolamento & purificação , Fatores Imunológicos/isolamento & purificação , Animais , Medula Óssea/efeitos dos fármacos , Candidíase/tratamento farmacológico , Candidíase/patologia , Glucanos/química , Glucanos/uso terapêutico , Fatores Imunológicos/química , Fatores Imunológicos/uso terapêutico , Controle de Infecções , Espectroscopia de Ressonância Magnética , Masculino , Camundongos , Camundongos Endogâmicos AKR , Camundongos Endogâmicos C57BL , Conformação Molecular , Peso Molecular , Neoplasias Experimentais/tratamento farmacológico , Fagocitose/efeitos dos fármacos , Viscosidade
12.
Ann Surg ; 211(5): 605-12; discussion 612-3, 1990 May.
Artigo em Inglês | MEDLINE | ID: mdl-2111126

RESUMO

Host immunosuppression after trauma contributes to septic morbidity. The macrophage is a key element in the host immune response. This study evaluated glucan, a macrophage stimulant, in a prospective, randomized, double-blind study of 38 trauma patients undergoing surgery. Glucan (21 patients), 50 mg/m2, or placebo (17 patients) was given intravenously daily for 7 days. Delayed hypersensitivity skin testing was performed on days 1 and 7 after trauma. Serum interleukin-1 (IL-1) and tumor necrosis factor (TNF) were assayed after trauma. While the total mortality rate was significantly less in the glucan group (0% versus 29%) (p less than 0.05), the mortality rate from sepsis was not statistically different (0% versus 17.6%). Glucan therapy significantly decreased septic morbidity (9.5% versus 49%; p less than 0.05). Serum IL-1 had a greater increase in glucan patients on day 3 after trauma (143.4 +/- 19.3% versus 78.6 +/- 11.7%; p less than 0.05), but there was no difference thereafter. Serum TNF did not vary between groups. Early increase in IL-1 correlated with subsequent skin test conversion to positive. Neither serum IL-1 nor TNF was a reliable indicator of future sepsis. Further clinical trials are indicated to evaluate biologic response modifiers that activate macrophages in the trauma patient.


Assuntos
Glucanos/uso terapêutico , Ativação de Macrófagos/efeitos dos fármacos , Ferimentos e Lesões/imunologia , Adulto , Método Duplo-Cego , Feminino , Glucanos/administração & dosagem , Glucanos/farmacologia , Humanos , Controle de Infecções , Interleucina-1/análise , Masculino , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Testes Cutâneos , Fator de Necrose Tumoral alfa/análise , Infecção dos Ferimentos/prevenção & controle , Ferimentos e Lesões/complicações
13.
Ann Ophthalmol ; 22(1): 30-4, 1990 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-2155571

RESUMO

We systematically observed the effects of lipoxygenase enzyme products (5-, 8-, 9-, 12-, and 15-HETE and leukotrienes (LT) C4, D4, and B4) on the external ocular inflammatory process in rabbits. Our results, using 1 and 10 micrograms enzymatic preparations topically applied to the conjunctiva, were consistent with the potent chemotactic activity of 12-HETE and LTB4. Modulation of the inflammatory process can be accomplished better, as a result of our findings, by inhibition of both the lipoxygenase and cyclooxygenase pathways.


Assuntos
Olho/imunologia , Ácidos Hidroxieicosatetraenoicos/fisiologia , Leucotrienos/fisiologia , Lipoxigenase/metabolismo , Animais , Ácidos Araquidônicos/metabolismo , Cromatografia Líquida de Alta Pressão , Túnica Conjuntiva/imunologia , Túnica Conjuntiva/metabolismo , Olho/efeitos dos fármacos , Ácidos Hidroxieicosatetraenoicos/farmacologia , Inflamação/etiologia , Leucotrieno B4/biossíntese , Leucotrieno B4/farmacologia , Leucotrieno B4/fisiologia , Leucotrienos/biossíntese , Leucotrienos/farmacologia , Oxigênio/metabolismo , Coelhos , SRS-A/biossíntese , SRS-A/farmacologia , SRS-A/fisiologia
14.
J Trauma ; 29(8): 1152-6; discussion 1156-7, 1989 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-2760956

RESUMO

Prostaglandin E2 (PGE2) derived from macrophages following trauma may contribute to trauma-induced immunosuppression. This study evaluated the effect of glucan, a macrophage-activating agent, on macrophage PGE2 release in a murine trauma model. ICR/HSD mice were administered D5W, glucan pre-trauma, or glucan post-trauma, and subjected to hindlimb crush and amputation injury. Splenic macrophages were isolated 24 hours following trauma, cultured (24 hrs), and macrophage PGE2 levels were determined. In-vitro marrow proliferation was assessed as a measure of immune function. Crush-amputation injury increased (184%) macrophage PGE2 release. In contrast, glucan administration (pre or post) reduced PGE2 levels in macrophage supernatants (71% and 85%, respectively). A 52% decrease in in-vitro bone marrow proliferation was observed following trauma. Glucan pre- or post-trauma eliminated the suppression of bone marrow proliferation. In conclusion, macrophage-activating immunomodulators may exert beneficial effects following trauma by: 1) reducing macrophage PGE2 synthesis and release; and 2) reducing traumatic suppression of bone marrow proliferation.


Assuntos
Amputação Traumática/imunologia , Síndrome de Esmagamento/imunologia , Dinoprostona/biossíntese , Ativação de Macrófagos , Choque Traumático/imunologia , Amputação Traumática/patologia , Animais , Medula Óssea/efeitos dos fármacos , Medula Óssea/imunologia , Medula Óssea/patologia , Divisão Celular/efeitos dos fármacos , Separação Celular , Síndrome de Esmagamento/patologia , Dinoprostona/análise , Glucanos/farmacologia , Ativação de Macrófagos/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Masculino , Camundongos , Camundongos Endogâmicos ICR , Radioimunoensaio , Baço/efeitos dos fármacos , Baço/imunologia , Baço/patologia , Estimulação Química
15.
Int J Immunopharmacol ; 11(4): 403-10, 1989.
Artigo em Inglês | MEDLINE | ID: mdl-2506140

RESUMO

Trypanosoma cruzi, the causative agent of Chagas' disease, infects humans and animals in tropical, subtropical and some temperature regions of the western hemisphere. At present, there is no effective vaccine for T. cruzi infection. Glucan, a beta-1,3 polyglucose biological response modifier, possesses significant adjuvant activity. The present study investigated the adjuvant activity of particulate glucan when combined with a vaccine of glutaraldehyde-killed T. cruzi culture forms. ICR/HSD mice (20 g) were injected s.c. with glutaraldehyde-killed T. cruzi on days 21, 14 and 7 prior to challenge with 50 T. cruzi blood forms. Particulate glucan (1 mg/mouse) was administered s.c. either alone or in conjunction with T. cruzi vaccine. Isovolumetric dextrose served as control. Dextrose, glucan or T. cruzi vaccine as single treatment regimens showed 100% mortality with 20.5, 21.4 and 21.6 day median survival times, respectively. In contrast, glucan administered with T. cruzi vaccine showed an 85% (P less than 0.01) survival at 275 days post-challenge. In addition, the number of T. cruzi observed in the blood of glucan--T. cruzi immunized mice was lower than the appropriate controls. However, immunized mice which survived at 275 days were positive for the presence of T. cruzi by xenodiagnosis. Histopathologic evaluation of glucan--T. cruzi mice revealed no parasites or cardiac pathology, but a mild splenic hyperplasia and inflammation of skeletal muscle were noted. In subsequent studies, mice were immunized with the same regimen of glucan--T. cruzi and challenged with 500 or 5000 T. cruzi. Glucan significantly (P less than 0.05) increased survival as denoted by 60% and 50% survival in the glucan-T. cruzi group vs 0% in controls.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Adjuvantes Imunológicos , Doença de Chagas/prevenção & controle , Glucanos/farmacologia , Animais , Doença de Chagas/imunologia , Doença de Chagas/parasitologia , Imunização , Masculino , Camundongos , Camundongos Endogâmicos ICR , Músculos/parasitologia , Trypanosoma cruzi/imunologia
16.
Surgery ; 104(2): 224-30, 1988 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-3261048

RESUMO

Although the macrophage is important to wound healing, research has focused on its relationship to fibroblast and collagen synthesis. This study was designed to assess effects of enhanced macrophage function on early wound healing, before established collagen synthesis. Sprague-Dawley rats had dorsal incisions after one of three treatment regimens: (1) saline solution, 0.5 ml administered intravenously, (2) intravenous glucan, a macrophage stimulant, 20 mg; (3) topical glucan, 20 mg. Intravenous therapy was administered 24 hours before and after incision. Breaking strength was significantly increased (p less than 0.01) by both intravenous glucan (49.8 +/- 5.5 gm) and topical glucan (59.7 +/- 5.6 gm) on the fourth day after incision, compared with controls (22.0 +/- 2.6 gm). Similar results occurred on the seventh day after incision. Although formalin fixation significantly enhanced breaking strength in fresh control wounds (22.0 +/- 2.6 vs 39.5 +/- 2.2 gm), no increase occurred in wounds treated with intravenous glucan (49.8 +/- 5.0 vs 55.3 +/- 6.4 gm), indicating maximal cross-linking of collagen. Collagen synthesis, reflected by tritiated proline uptake, was no different in control versus glucan groups. Supernatants from control or glucan-activated macrophages were injected intraperitoneally or applied topically in the rat model. Activated supernatant, both intraperitoneal and topical, resulted in increased breaking strength on the fourth day after incision. Formalin fixation did not increase breaking strength in the activated supernatant groups. We conclude that enhanced macrophage function increases early wound breaking strength. This effect appears unrelated to collagen synthesis but may be related to increased cross-linking of collagen. Similar effects are seen with activated macrophage secretory products administered intraperitoneally or topically.


Assuntos
Glucanos/farmacologia , Macrófagos/fisiologia , Cicatrização , Administração Tópica , Aminoácidos/metabolismo , Animais , Reagentes de Ligações Cruzadas , Formaldeído/farmacologia , Glucanos/administração & dosagem , Infusões Intravenosas , Interleucina-1/biossíntese , Masculino , Prolina/metabolismo , Ratos , Ratos Endogâmicos , Resistência à Tração/efeitos dos fármacos , Cicatrização/efeitos dos fármacos
17.
Am J Physiol ; 255(1 Pt 2): R46-51, 1988 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-3394844

RESUMO

Experiments were performed on conscious, chronically instrumented rats to determine the role of arginine vasopressin (AVP) on the systemic and regional hemodynamic effects of 48-h water deprivation. Arterial and venous catheters as well as pulsed Doppler flow probes were implanted in rats to measure cardiac output (CO), mesenteric blood flow (MBF), renal blood flow (RBF), or hindquarter blood flow (HQBF). After adequate recovery from surgey, euhydrated animals were administered a specific V1-vasopressinergic antagonist [d(CH2)5Tyr(Me)AVP, 10 micrograms/kg iv], a combined V1, V2-antagonist [d(CH2)5DTyr(Et)VAVP, 30 micrograms/kg iv], or saline vehicle (100 microliter/100 g). Neither antagonist was associated with any change in mean arterial blood pressure (MABP), heart rate (HR), systemic or regional flow or vascular resistance. All animals were subsequently water deprived for 48 h, at which time the experiments were repeated. Dehydration was associated with an increase in plasma AVP levels, hematocrit, and MABP but with a decrease in HR. Administration of either the combined V1, V2-antagonist or vehicle had no effect on any systemic or regional hemodynamic variables measured after 48-h dehydration. In contrast, although MABP, CO, MBF, and RBF were unaffected, V1-antagonism resulted in elevated HR, increased HQBF, and decreased hindquarter vascular resistance. In conclusion, AVP does not have a major effect on systemic hemodynamics in the dehydrated rat. However, certain beds may be affected by the relatively moderate levels of plasma AVP elicited during dehydration.


Assuntos
Arginina Vasopressina/fisiologia , Privação de Água , Animais , Arginina Vasopressina/antagonistas & inibidores , Pressão Sanguínea , Desidratação/sangue , Frequência Cardíaca , Hemodinâmica , Membro Posterior/irrigação sanguínea , Rim/irrigação sanguínea , Masculino , Ratos , Ratos Endogâmicos , Fluxo Sanguíneo Regional , Circulação Esplâncnica , Resistência Vascular
18.
Prostaglandins ; 30(4): 591-8, 1985 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-3936118

RESUMO

To determine whether agents which inhibit cytochrome P-450 enzymes also inhibit lipoxygenase, the effects of metyrapone and SKF 525-A were assessed on soybean lipoxygenase using a spectrophotometric technique which allows for measurement of both the rate and magnitude of product formation. Both SKF 525-A and metyrapone inhibited the rate of product formation and the final amount of product formed in 5 min incubations SKF 525-A was 5 to 5 times more potent than metyrapone, with the IC50 for SKF 525-A 40 microM and for metyrapone between 150 and 200 microM as determined by the total product formation in 5 minutes. Analysis of the reduced product by HPLC confirmed that the substances monitored were those generated by the 15-lipoxygenase enzyme.


Assuntos
Inibidores de Lipoxigenase , Metirapona/farmacologia , Plantas/enzimologia , Proadifeno/farmacologia , Cromatografia Líquida de Alta Pressão , Cinética , Glycine max/enzimologia
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