Effect of Cydonia oblonga Mill. fruit and leaf extracts on blood pressure and blood rheology in renal hypertensive rats

Ethnopharmacological relevance

Quince, Cydonia oblonga Mill. (COM), is used in traditional Uyghur medicine to treat or prevent cardiovascular diseases. Uyghur people have greater longevity and lower blood pressure than other central Asian populations. We therefore tested COM fruit and leaf extracts on blood pressure and rheology in renal hypertensive rats (RHR).

Materials and methods

Two-kidney, one-clip (2K1C) renal hypertensive rats were divided randomly into eleven groups: sham, model, and model treated with daily doses of 80 and 160 mg/kg aqueous or ethanol extracts of COM fruit or leaves, or 25 mg/kg captopril (n=10 per group), given orally once daily for 8 weeks. Blood pressure was measured before treatment and every 2 weeks thereafter. Blood rheology was tested after 8 weeks.

Results

Model rats had higher blood pressure than sham 8 weeks after the procedure (systolic blood pressure 193±7 vs. 138±8 mmHg, p<0.05). Those treated with captopril had decreased blood pressure within 2 weeks but that did not return to the level found in the sham group at 8 weeks (167±7, p<0.05 vs. model). With the COM extracts, the effect on blood pressure was notable after 4 weeks. At 8 weeks blood pressure was similar with captopril and with 160 mg ethanol leaf extract (166±4, p<0.05 vs. model), the most effective of the extracts. Model rats had higher blood viscosity and lower erythrocyte deformability than sham. Captopril had little effect on blood rheology; whereas COM extracts reduced whole blood viscosity and improved erythrocyte deformability to levels approaching those found in sham.

Conclusions

COM extracts have antihypertensive activity in renal hypertensive rats. The additional effect on rheology, compared to captopril, may convey added interest. Further studies of these effects in man appear warranted.     

Prostaglandin E1 protects blood cell filterability from oxygen free radical-induced injury

Uncompensated increased production of oxygen free radicals (OFR) during cardio-pulmonary bypass (CPB) disturbs blood rheology and microcirculation. The effects of alprostadil (prostaglandin E₁:PGE₁) on OFR-induced blood injury were studied with hydrogen peroxide (H₂O₂) as a model substance. Forty blood samples of 500 mL were collected from 40 healthy blood donors. Each blood sample was divided into four groups: a control, a sample treated with PGE₁, a sample treated with H₂O₂, and a sample pretreated with PGE₁ before H₂O₂. A simple microfiltration method was utilized to assess red and white filtration rates. Blood cell counts, platelet count, hematocrit, and hemoglobin were measured by blood cell counter. All measurements were done at the start of the experiment and after 1, 2, 3, and 4 h in all blood samples.Treatment of blood with PGE₁ was found to provide slight protection of blood cells from the damaging effects of H₂O₂ with significant preservation of platelet count and blood cell filterability. These results indicate that the previously reported beneficial effects of PGE₁ on the disturbed microcirculation and blood cell filterability during CPB may be based on its capacity to reduce the response of the blood cells to the damaging effects of OFR. The results also indicate that the rheological beneficial effects of PGE₁ may be due to some direct cellular protection mechanisms in addition to its antiplatelet and antineutrophilic activities.     

Chronic groin sinus: an unusual complication of sterilisation clips

We report the case of a patient presenting with a chronic groin sinus secondary to a tubal ligation clip migration (Filshie clip) 21 years after the laparoscopic sterilisation took place. Our case report adds to the small number of cases describing tubal clip migration with resultant local sepsis. Although this is a rare complication, it should be borne in mind for women who have undergone tubal clip ligation and present with recurrent or chronic groin, perineal or peri-anal sepsis.     

Hydrodynamic function of the second-generation mitroflow pericardial bioprosthesis

BACKGROUND: The hydrodynamic function of the smaller size Mitroflow Synergy stented pericardial bioprostheses has been studied in an in vitro fresh tissue aortic root model and compared with previous studies of free-sewn bioprostheses. METHODS: Three valves of each of the sizes 19, 21, and 23 mm were sutured into fresh tissue aortic roots and tested in a pulsatile flow simulator using two different ventricular input impedance conditions. A high-speed camera was used to study the leaflet opening and closing configurations. Mean pressure difference as a function of root mean square forward flow, effective orifice area, regurgitant volumes, and total energy loss across the valves was measured. RESULTS: Mean pressure difference with respect to root mean square forward flow decreased as the valve size increased. Thus effective orifice area increased as the valve size increased. The open leaflet configuration images showed that all three sizes of Mitroflow valves had a large circular orifice with minimal open leaflet deformation. All valves closed competently with no visible leakage and no closed regurgitant volume. The Mitroflow valves showed better effective orifice areas compared with previously tested frame-mounted porcine bioprostheses but lower effective orifice areas compared with porcine stentless bioprostheses; however, the open leaflet bending deformation was better than for any of the previously tested bioprosthetic valves. CONCLUSIONS: The hydrodynamic function of the Mitroflow Synergy stented pericardial bioprosthesis shows potential for good in vivo hemodynamic performance. The good hemodynamic performance combined with relative ease of implantation technique makes the pericardial valve a good valve in the aortic position, particularly in older patients with small annuli.     

Effects of Cydonia oblonga Miller extracts on blood hemostasis,coagulation and fibrinolysis in mice,and experimental thrombosis in rats

Introduction

Cydonia oblonga Miller (COM) is traditionally used in Uyghur medicine for the prevention of cardiovascular disease. The present study is designed to explore the effects of COM extracts on models and markers of thrombosis and related biomarkers.

Materials and methods

20, 40, 80 mg/kg/day COM aqueous extracts and 5 mg/kg/day aspirin, orally for 14 days were compared to untreated controls in mice on bleeding and clotting times, using the tail cutting and glass slide methods and for death rates in collagen–epinephrine pulmonary thrombosis, thrombolysis in vitro and euglobulin lysis time (ELT). In rats, common carotid artery FeCl₃-induced thrombus and inferior vena cava thrombosis occlusion time, plasma concentrations of thromboxane B₂ (TXB₂) and 6-keto-prostaglandine F₁α (6-keto-PGF1α) were measured.

Results and conclusion

Compared to controls, COM extracts dose-dependently prolonged bleeding by 2.17, 2.78 and 3.63 times, vs. aspirin 2.58, and the clotting time by 1.44, 2.47 and 2.48 times, vs. aspirin 1.91. COM reduced pulmonary embolus mortality by 27, 40 and 53%, vs. 47% for aspirin. COM dose-dependently increased thrombolysis by 45, 55 and 63%, vs. 56% for aspirin, and shortened ELT to 71, 61 and 43%, vs. 43% for aspirin. In rats, venous occlusion time was prolonged. Arterial and venous thrombus weights were dose-dependently reduced in COM groups. TXB₂ decreased and 6-keto-PGF1α increased with COM and aspirin, with an association between 6-keto-PGF1α/TXB2 and arterial or venous thrombus weight for all products, and for occlusion time with COM but not for aspirin.

Conclusion

We confirm the experimental effects of COM on hemostasis and thrombosis. Further exploration of putative clinical effects appear justified.     

Aneurysmal rupture of the costo-cervical trunk in a patient with neurofibromatosis type 1: A case report

INTRODUCTION

Rupture of blood vessels associated with neurofibromatosis type 1 (NF-1) is a rare but life threatening complication. We report the first case of an aneurysmal rupture from the costocervical trunk in a NF-1 patient treated by endovascular embolisation.

PRESENTATION OF CASE

A 43 year-old gentleman with a past medical history of NF-1 presented with sudden onset left sided neck swelling. A computed tomography (CT) revealed a large cervical haematoma, which was causing airway compromise, requiring the patient to be intubated. Percutaneous embolisation of the bleeding vessel from the costo-cervical trunk was performed with successful haemostasis and no immediate complications. A repeat CT scan showed a reduction in the original cervical haematoma. However, six days post embolisation, the patient arrested with complete whiteout of the left hemithorax.

DISCUSSION

CT angiography is the gold standard for diagnosis of an aneurysmal rupture in NF-1 patients, and percutaneous embolisation is the preferred modality in patients who are haemodynamically stable due to arterial fragility and high intra operative mortality rates. The increasing haemothorax could be explained by the original cervical haematoma draining down into the pleural space, or the possibility of a new second bleed.

CONCLUSION

This is the first reported episode of bleeding from the costocervical trunk in NF-1 patients. Ruptured aneurysms require urgent CT angiography, if haemodynamically stable, and further input from the vascular surgeons and vascular radiologists.     

Effect of Cydonia oblonga Mill. leaf extracts or captopril on blood pressure and related biomarkers in renal hypertensive rats

Ethnopharmacological relevance

Cydonia oblonga Mill. (COM) is used in traditional Uyghur medicine to treat or prevent cardiovascular disease. In a previous study COM leaf extracts were found to be active in renal hypertensive rats (RHR). The present study tests the dose-dependence of the effect of ethanol leaf extracts on hypertension and on biomarkers associated with blood pressure control, such as angiotensin-II (AII), plasma renin activity (PRA), apelin-12 (A), endothelin (ET) and nitric oxide (NO), compared to captopril.

Methods

Two-kidney one-clip (2K1C) Goldblatt model rats were divided randomly into six groups: sham, model, captopril 25 mg/kg, COM leaf extract 80, 160 and 320 mg/kg (n=10 each). Drugs were administered orally daily for eight weeks. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before treatment and every 2 weeks. Blood and kidney samples were collected after the last treatment to measure AII, PRA, A, ET and NO.

Results

RHR had increased blood pressure, AII, A, PRA, ET and decreased NO. Treatment with captopril reduced blood pressure, AII, A, PRA, and ET, though not quite to normal values. COM leaf extracts significantly and dose-dependently reduced blood pressure, AII, A, RA and ET, whereas NO was increased. The highest dose of COM had the same effects as captopril.

Conclusion

The effects of COM extracts on blood pressure and biomarkers were dose-dependent and at the highest dose similar to those of captopril. This suggests an action of COM on the renin–angiotensin system, which could explain its antihypertensive effect.     

Neutralization of kinin-releasing enzymes from viperid venoms by antivenom IgG fragments

The activities of kinin-releasing enzymes in the venoms of Vipera xanthina xanthina, V. lebetina obtusa, V. aspis aspis, V. lebetina schweizeri, V. ammodytes ammodytes and V. berus berus were determined using a specific radioimmunoassay for kinin. The kinin-releasing activities of all the viperid venoms measured in vitro were neutralized, to varying extents, by two commercially available monospecific antivenoms in the form of F(ab′)₂ (Zagreb) and Fab (TAb) immunoglobin fragments, indicating a high degree of cross-neutralization of those enzymes.