Drug secretion systems in renal tubular cells: functional models and molecular identity

For the last several decades, functional characterization of renal drug handling has provided the conceptual framework of drug transport, especially drug secretion by the renal tubular cells. Functional models have been postulated for the two distinct groups of drugs with regard to their ionization characteristics at physiological pH (i.e., organic cations and organic anions). Organic cations are predicted to cross the basolateral membranes through a potential-sensitive uptake system along an inside-negative potential gradient, with secretion of organic cations into urine across apical membranes appearing to occur via a proton-organic cation antiport system. Organic anions are predicted to enter the cells against an electrical-potential gradient through basal membranes via an organic anion-dicarboxylic acid exchanger. Secretion of organic anions into urine across apical membranes is less well characterized, but the presence of an organic anion exchanger and a potential-driven transporter is hypothesized. Recent data obtained using molecular biology techniques have helped to elucidate molecular identity of each system postulated in these models. Novel drug transport proteins have also been discovered that were not part of the original organic cation/anion model, such as P-glycoprotein for hydrophobic neutral and cationic compounds. Moreover, the search for homologous genes of these transporters has led to the discovery of previously unknown transporter proteins, whose function has yet to be identified. Integral roles of these transport proteins in overall tubular handling of drugs remain to be determined. Received: 3 November 1998 / Revised: 8 February 1999 / Accepted: 12 February 1999     

Ionic mechanism of 4-aminopyridine action on leech neuropile glial cells

Extracellular 4-aminopyridine (4-AP), tetraethylammonium chloride (TEA) and quinine depolarized the neuropile glial cell membrane and decreased its input resistance. As 4-AP induced the most pronounced effects, we focused on the action of 4-AP and clarified the ionic mechanisms involved. 4-AP did not only block glial K+ channels, but also induced Na+ and Ca2+ influx via other than voltage-gated channels. The reversal potential of the 4-AP-induced current was -5 mV. Application of 5 mM Ni2+ or 0.1 mM d-tubocurarine reduced the 4-AP-induced depolarization and the associated decrease in input resistance. We therefore suggest that 4-AP mediates neuronal acetylcholine release, apparently by a presynaptic mechanism. Activation of glial nicotinic acetylcholine receptors contributes to the depolarization, the decrease in input resistance, and the 4-AP-induced inward current. Furthermore, the 4-AP-induced depolarization activates additional voltage-sensitive K+ and Cl- channels and 4-AP-induced Ca2+ influx could activate Ca2+-sensitive K+ and Cl- channels. Together these effects compensate and even exceed the 4-AP-mediated reduction in K+ conductance. Therefore, the 4-AP-induced depolarization was paralleled by a decreasing input resistance.     

P-Glycoprotein on astrocyte foot processes of unfixed isolated human brain capillaries

Sites of immunoreactive P-glycoprotein associated with human brain microvasculature were identified by labeling of unfixed isolated human brain capillaries, allowing visualization of the three-dimensional capillary structure by confocal microscopy. Capillaries isolated from human autopsy brain were dual-labeled with the MRK16 mouse monoclonal antibody (against human P-glycoprotein) and rabbit polyclonal antisera against the human brain microvascular glucose transporter (GLUT1), or glial fibrillary acidic protein (GFAP) on astrocyte foot processes. MRK16 and GLUT1 dual-labeling showed no signal overlap, identical to the staining pattern observed for dual-labeling with anti-GFAP and anti-GLUT1 antibodies: both GFAP and MRK16 labeling were discrete, discontinuous, and not co-localized with continuous GLUT1 labeling of capillary endothelium. In contrast, complete overlap of MRK16 and GFAP labeling demonstrated P-glycoprotein localization on astrocyte foot process remnants at the abluminal face of the brain microvasculature.     

联合内分泌治疗对前列腺和睾丸的影响

目的 探讨抑那通和缓退瘤联合治疗对正常前列腺,增生的前列腺（ＢＰＨ）和前列腺癌以及睾丸的作用。方法 对１６例接受联合内分泌治疗至少３个月且有治疗前后病理资料的前列腺癌患者的标本进行了系统的病理学检查。对内分泌治疗后的睾丸标本与同龄未接受治疗的进行对照研究。结果 １４例内分泌治疗后的前列腺标本２例未见残存癌灶,９例对治疗有明显的反应;３例对治疗反应差,治疗并未降低前列腺癌的病理分期。３例内分泌治疗后     

Mechanism of tolerance development to 2,5-dimethoxy-4-iodoamphetamine in rats: down-regulation of the 5-HT2A, but not 5-HT2C, receptor

  Rationale: Defining the mechanism of tolerance development to hallucinogenic drugs will help to explain their mechanism of action. Objectives: The present study was conducted to determine first, if tolerance develops to the discriminative stimulus (DS) properties of the hallucinogen, 2,5 dimethoxy-4-iodo-amphetamine (DOI) and second, the mechanism mediating tolerance. Methods: Rats were trained to discriminate 0.75 mg/kg DOI from saline on a concurrent VI-30-min schedule of reinforcement with a 15-min time-out for incorrect responses. To evaluate tolerance development, rats were assigned to one of four groups and treated with either chronic saline or chronic DOI. Prior to chronic treatment, two groups were tested for choice behavior following vehicle administration while the remaining two groups were tested following the administration of 0.375 mg/kg DOI. One group from each pre-test condition was injected with either saline or DOI (1 mg/kg) for 8 days. Twenty-four hours after the last chronic injection the pre-test treatments were replicated. Using receptor autoradiography, the density of 5-HT_2A and 5-HT_2C receptors was measured in independent groups of rats that had received identical treatment conditions. Results: Animals receiving chronic DOI showed a 60% decrease in DOI lever responding (from 100% to 40%) when tested on 0.375 mg/kg DOI, while animals receiving chronic saline showed no change in percent choice (100%) on the DOI lever. Significant changes in binding were observed in 5-HT_2A receptors but not 5-HT_2C receptors. The results of tests with antagonists were consistent with the changes in binding. Conclusions: These results suggest that behavioral tolerance to DOI reflects neuroadaptive changes in 5-HT_2A receptors. Received: 17 July 1998 / Final version: 19 January 1999     

Catha edulis, a plant that has amphetamine effects

The chewing of fresh leaves of the khat bush (Catha edulis) is common in certain countries of East Africa and the Arab peninsula, because this material has a stimulating effect. During the last decade, important progress has been made in understanding the pharmacology of this drug. Its actions are mainly due to the alkaloid cathinone, a substance that can be called a natural amphetamine.     

Hypertension in the elderly: Age- and disease-related complications and therapeutic implications

Summary Effective treatment of hypertension in the elderly requires an understanding of both the progressive course of the disease and the impact of aging on the cardiovascular system, including physiological, genetic, lifestyle, and environmental factors. Review of the literature that has attempted to define the impact of an aging process on cardiovascular structure and function reveals a diversity of findings and interpretations. However, in general, normotensive elderly subjects exhibit the heart and vascular characteristics of muted hypertension, including many features of younger hypertensive patients: cardiac hypertrophy, diminution in resting left ventricular early diastolic filling rate, increased arterial stiffness and aortic impedance, diminution in the baroreceptor reflex, a diminished response to catecholamines and diminished renal blood flow, and an increase in peripheral vascular resistance (PVR). Treatment of elderly hypertensives is more challenging because of the greater likelihood of the presence of concomitant diseases, most importantly, coronary and peripheral atherosclerosis, renal dysfunction, and diabetes mellitus. Isolated systolic hypertension (ISH), the most common form of hypertension in the elderly, has also been clearly shown to be an important predictor of cardiovascular morbidity and mortality, including coronary artery disease, congestive heart failure, and stroke. Treatment of ISH has been shown to lower systolic pressure safely and effectively in the elderly. By reducing PVR, and possibly the arterial stiffness, and thus the early reflected pulse waves, vasodilators, including calcium antagonists, may lower these three components of arterial impedance, and hence lower the arterial load on the heart. The cardiac hypertrophy and reduced left ventricular filling rate associated with hypertension in older individuals can also be ameliorated, to some extent, by calcium channel blockers.Proceedings of a symposium held in Atlanta, Georgia on March 2, 1991.     

Study of a new oral beta-adrenergic drug,clenbuterol, in patients with chronic bronchitis

Summary In a double-blind, placebo-controlled, incomplete cross-over study the bronchodilator, cardiovascular, respiratory and metabolic effects of 3 different oral doses of clenbuterol were studied in 12 patients suffering from partly reversible airways obstruction due to chronic bronchitis. The ventilatory response to oral clenbuterol or placebo was assessed by measurement of specific airway resistance (sRaw) to detect changes in central airways, and of flow at 85% of vital capacity ( _{85% VC}) to detect change in peripheral airways. Clenbuterol 20, 30 and 40 µg produced a significant decrease in sRaw between 15 and 480 min after administration. Its effect on the large airways was not related to the dose. Clenbuterol 30 and 40 µg caused a significant increase in _{85% VC} between 60 and 480 min after administration. After 20 µg a significant improvement in _{85% VC} was found between 120 and 240 min. The over-all effect of 30 µg on the small airways was significantly more pronounced than that of 20 µg and was more sustained than that of 40 µg 120 min after administration. No significant changes in heart rate, ECG or blood pressure were noted. Decreases in PaO₂ and O₂-saturation after clenbuterol were not related to dose. Slight falls in PaO₂ and O₂-saturation were also observed after placebo. These observations are briefly discussed. There was negligible lipid mobilization after either the placebo or bronchodilator. A slight but insignificant rise in blood glucose was observed after both 30 and 40 µg of clenbuterol.     

Progressive-ratio performance maintained by drug infusions: Comparison of cocaine,diethylpropion, chlorphentermine,and fenfluramine

Cocaine, diethylpropion, chlorphentermine, and fenfluramine were compared on a drug-maintained progressive-ratio procedure in baboons. Intravenous infusions of drug were contingent on completion of a fixed-ratio response requirement (fixed number of lever-press responses) with a 3-h time-out period following each infusion. Prior to testing each dose of drug, stable self-infusion performance was first established with 0.4 mg/kg cocaine when the fixed-ratio requirement was 160. Subsequently, a test dose of drug was substituted for the standard dose of cocaine. If the dose of drug maintained a criterion level of self-infusion performance (six or more infusions per day for 2 days), the ratio requirement was systematically increased every day until the breaking point at which the self-infusion performance fell below a criterion level (one or zero infusionsper day). Fenfluramine did not maintain criterion self-infusion performance at any dose tested (0.02–5.0 mg/kg). The dose ranges of the other drugs that maintained maximum breaking points were 1.0–5.6 mg/kg for chlorphentermine, 1.0–3.0 mg/kg for diethylpropion, and 0.1–0.4 mg/kg for cocaine. Within-animal comparison of the maximum breaking points indicated that cocaine maintained the highest breaking points, followed in order by diethylpropion, chlorphentermine, and fenfluramine. The rank ordering of these drugs with the breaking point measure corresponds well with both the results of other animal experiments on measurement of reinforcing efficacy of these drugs and with the clinical information about the human subjective effects and abuse of these drugs.