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Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references. Available also from UMI/Dissertation Abstracts International.

Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 200-211). Available also in a digital version from Dissertation Abstracts.

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Thesis (Ph. D.)--University of Wisconsin, 1951. / Typescript (carbon copy). eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves [82]-86).

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 5 uppsatser.

Orientador: Lea Rodrigues Simioni / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T12:36:33Z (GMT). No. of bitstreams: 1 Camargo_ThiagoMagalhaes_M.pdf: 3717453 bytes, checksum: 7f1985b88491433917e7fdf3c88dbfc7 (MD5) Previous issue date: 2010 / Resumo: A espécie Micrurus pyrrhocryptus, classificada anteriormente como subespécie da Micrurus frontalis, foi recentemente classificada como espécie plena baseada nas diferenças morfológicas. Esta serpente é especialmente encontrada no continente Sul Americano. No presente trabalho foram analisados os efeitos farmacológicos do veneno de M. pyrrhocryptus sob métodos para caracterização de efeitos neurotóxico e miotóxico em preparações biventer cervicis de pintainho (BCP) (0,5, 1, 5, 10, 20, 30 e 50 µg/mL, n=6 para cada concentração) e nervo frênicodiafragma de camundongo (NFD) (1, 5, 10, 20, 30 e 50 µg/mL, n=6 para cada concentração). Também foram realizados estudos sobre a capacidade de neutralização do antiveneno específico e comercial. O veneno induziu um irreversível bloqueio neuromuscular (pós-sináptico, como demonstrado pela resposta contrátil sob estímulo de alta frequência - 50 Hz, n=6 em NFD), tempo e concentração-dependente em ambas as preparações (10 µg/mL induziu 50% de bloqueio neuromuscular em 22±3 min vs 62±4 min em BCP e NFD respectivamente, n=6 para cada preparação); as contraturas em resposta a adição exógena de KCl (20 mM) não foram afetadas significativamente depois da incubação com o veneno, bem como, a determinação da atividade de CK quando comparados com os valores controle (25,8±1,75 U/L vs 24,3±2,2 U/L) ou também com o registro da resposta contrátil em preparações curarizadas (n=6). O veneno apresentou um baixo valor de atividade fosfolipásica quando comparado com o veneno de Crotalus durissus terrificus em 37ºC. Nos testes de neutralização, os antivenenos específico e comercial foram eficientes, contra o efeito bloqueador neuromuscular induzido pelo veneno, quando usados na concentração recomendada pelo fabricante (1,5 mg de veneno para 1,0 mL de antiveneno). A análise histológica mostrou apenas uma discreta alteração mesmo quando usado em alta concentração (50 µg/mL - n=5; 3,5±0,8% em mamífero e 4,3±1,5% em ave vs 1,2±0,5% em mamífero e 1,1±0,7% em ave do controle, ambos p<0,05 em relação ao controle), corroborando com as características de outros venenos de Micrurus. A razão da potência do veneno vs sensibilidade de receptores colinérgicos presentes no sítio extra juncional da preparação do músculo biventer, foi demonstrada quando usado em baixa concentração (0,5 µg/mL) aboliu totalmente em 30 min a contratura induzida pela adição ACh exógena (110 µM). O conjunto dos resultados indica que o veneno de M. pyrrhocryptus causa bloqueio pós-sináptico envolvendo os receptores nicotínicos, como as ?- neurotoxinas, sem determinar alteração significativa na membrana da fibra muscular / Abstract: Micrurus pyrrhocryptus, originally known as a Micrurus frontalis subspecies, was recently classified as a species based on selected morphological features. It can be found in the South America. Only two studies are apparently available on its venom effects. Herein, pharmacological approaches were used to characterize the neurotoxic and myotoxic effects of M. pyrrhocryptus venom in chick biventer cervicis (BC, 0.5, 1, 5, 10 and 50 µg/mL, n=6 for each concentration) and mouse phrenic nerve-diaphragm preparations (NFD, 1, 5, 10 and 50 µg/mL, n=6 for each concentration). In addition, studies on neutralization capacity of specific and commercial antivenom were performed. The venom induced an irreversible, time and concentrationdependent neuromuscular blockade (postsynaptic, as demonstrated by the high frequency twitch tension response - 50Hz, n=6 in NFD) in both preparations (10 µg/mL induced 50% neuromuscular blockade in 22±3 min vs 62±4 min in BC and NFD respectively, n=6 for each preparation); the contractures in response to exogenous KCl (20 mM) were not significant after venom incubation as well as the value of CK released when compared with control values (25.8±1.75 U/L vs 24.3±2.2 U/L) or also twitch tension record in curarized preparations (n=6). The venom showed a very low PLA2 activity when compared with c. d. terrificus venom at 37ºC. In neutralization test the specific and Brazilian commercial antielapidic serum were efficient when used in concentration recommended by the producer (1.5 of venom to 1.0 mL of antivenom). The histological analysis showed a mild myotoxic effect, even using high venom concentration (50 µg/mL - n=5, 3.5±0.8% in mammalian and 4.3±1.5% on avian vs 1.2±0.5% in mammalian and 1.1±0.7% in avian of control), corroborating characteristics of other Micrurus venoms). The ratio venom potency vs preparation sensitivity was shown when a concentration as low as 0.5 µg/mL totally abolished within only 30 min the contracture induced by the exogenously added ACh (110µM) to chick preparation. Altogether the results indicate that M. pyrrhocryptus venom has a postsynaptic blocking effect involving nicotinic receptors as does the ?-neurotoxins, and without any significant myotoxic effect / Mestrado / Mestre em Farmacologia

Etablir le diagnostic d'une réaction d'hypersensibilité aiguë (RHA) peropératoire est difficile du fait de l'incidence supérieure des diagnostiques différentiels. Les facteurs de risques en sont mal établis. Il n'existe pas de signe clinique fiable aidant à un diagnostic rapide. Alors que 25% des explorations immunologiques classiques ne mettent pas en évidence un mécanisme IgE-médié, des études animales et humaines suggèrent un rôle des IgG dans ces RHA non caractérisées. Ce travail s'est basé sur deux cohortes de patients : la première pour étudier des phénotypes en lien avec l'apparition d'un bronchospasme, la seconde pour analyser des marqueurs diagnostiques au bloc opératoire et explorer un mécanisme alternatif impliquant les IgG. La survenue d'un bronchospasme au cours d'une RHA peropératoire n'est pas associée à un antécédent d'asthme mais au curare comme agent étiologique. La mise en évidence de la valeur diagnostique d'une hypocapnie inférieure à 20 mmHg dans le caractère sévère de la RHA devrait aider les cliniciens à l'établissement rapide du diagnostic. La présence d'IgG spécifiques anti-curares était associée à la survenue d'une RHA sévère suggérant une participation des IgG à la gravité de la RHA en association avec les IgE. En fonction du curare administré, le mécanisme de la RHA semble différent : implication d'anticorps (IgE et/ou IgG) dans 90% pour succinylcholine et rocuronium mais uniquement 50% pour atracurium suggérant une importante contribution de l'histamino-libération dans ces réactions. L'ensemble de ces travaux devraient permettre d'améliorer les performances diagnostiques en temps réel et à distance lors de la survenue d'une RHA peropératoire. / Diagnosis of intra-anesthetic acute hypersensitivity reactions (AHR) is challenging because of elevated incidences of differential diagnoses. Risk factors remain mostly unknown and there is no reliable clinical sign to help physicians in establishing a rapid diagnosis. In 25% of cases, immunologic exploration cannot identify the culprit agent through the exploration of the IgE-mediated pathway. Several animal and human studies suggest a role of IgG in the physiopathology of anaphylaxis, which could explain these uncharacterized AHR. This PhD has focused on two cohorts of patients: the first cohort allowed the exploration of phenotypic links in relation to bronchospasm occurrence; the second cohort analyzed clinical markers of severe AHR and the alternative pathway involving IgG against neuromuscular blocking agents (NMBA). Analysis of risk factors identified a NMBA as the culprit agent of the intra-anesthetic AHR to be the only factor statistically associated with bronchospasm. We propose that a hypocapnia below 20 mmHg may be a novel and useful tool for physicians for the rapid diagnosis of severe intra-anesthetic AHR. Among the second cohort of patients, NMBA-specific IgG were identified and associated with clinical severity, suggesting that they may participate in the severity of NMBA-AHR in association with IgE. The chemical structure of a given NMBA may dictate the mechanism of anaphylaxis to this particular NMBA: an IgE/IgG-pathway for succinylcholine and rocuronium, whereas atracurium may be rather linked to spontaneous histamine release mechanisms. Altogether, our results might improve diagnosis efficacy at the time of the AHR and during immunologic explorations.