A hiperhomocisteinemia (HHcy) tem sido associada à disfunção endotelial, em decorrência do aumento de ânion superóxido (O2-) e redução da biodisponibilidade de óxido nítrico (NO), fatos estes que poderiam acarretar disfunção erétil. O objetivo deste trabalho foi estudar as consequências da HHcy sobre as respostas à endotelina-1 (ET-1) e fenilefrina (PhE) em corpos cavernosos de ratos, bem como os mecanismos envolvidos. Os animais foram divididos em dois grupos, os quais receberam água (controle) ou DL-homocisteina tiolactona (DL-HcyT, grupo HHcy), na dose de 1 g/Kg/dia, via oral por 15 dias. Análises morfológicas, de colágeno e expressão de -actina não revelaram macroalterações na estrutura de corpos cavernosos de ratos HHcy, sugerindo que alterações na funcionalidade destes tecidos não decorrem de modificações estruturais. A HHcy acarretou aumento dos níveis de O2- em corpos cavernosos de ratos, avaliados por microscopia confocal. A reatividade vascular foi avaliada para KCl, nitroprussiato de sódio (NPS), acetilcolina (ACh), ET-1, IRL-1620 e PhE. Não foram observadas alterações na reatividade vascular para KCl ou NPS. O relaxamento induzido por ACh foi reduzido em corpos cavernosos de ratos HHcy. A contração induzida por ET-1, via receptores ETA, mostrou-se aumentada em corpos cavernosos de ratos HHcy, sugerindo possível envolvimento de O2- basais em vias intracelulares, decorrentes da ativação de receptores ETA. Observou-se prejuízo do relaxamento induzido por ET-1 e IRL-1620 em corpos cavernosos de ratos HHcy, por ativação de receptores ETB. O prejuízo do relaxamento induzido por IRL-1620 foi decorrente da produção e/ou biodisponibilidade reduzida de NO. A expressão de RNAm para pré-pró-ET-1, enzima conversora de ET-1 e receptores ETA e ETB não foram alteradas em decorrência da HHcy. O Emax da PhE foi aumentado em corpos cavernosos de ratos HHcy, em decorrência de aumento nos níveis basais de O2- e redução de fatores moduladores negativos da contração, tal como peróxido de hidrogênio (H2O2), sugerindo possível prejuízo da enzima superóxido dismutase. A participação de metabólitos derivados da isoformas da enzima óxido nítrico sintase (NOS), eNOS, nNOS e iNOS que modulam negativamente a contração da PhE, mostraram-se importantes nesta resposta. Na HHcy, os metabólitos derivados principalmente da iNOS estão prejudicados, possivelmente por redução da atividade da NOS, processo de desacoplamento e/ou redução da biodisponibilidade de NO por interação com espécies reativas de oxigênio (ERO), formando peróxinitrito. A expressão de nitrotirosina, indicador da presença de peroxinitrito, não foi alterada em corpos cavernosos de ratos HHcy. As dosagens plasmáticas de nitrato mostraram redução dos níveis de NO em ratos HHcy, sendo sugestivo de redução de sua biodisponibilidade. A HHcy não alterou a expressão de RNAm para eNOS, nNOS e iNOS em corpos cavernosos de ratos. Os metabólitos da enzima cicloxigenase-1 (COX-1) e COX-2 participam modulando negativamente a contração da PhE e a HHcy não alterou esta modulação. Concluindo, a HHcy intermediária, por sua capacidade de aumentar os níveis basais de O2-, pode afetar a função vasoativa, contração e relaxamento, do peptídeo ET-1, bem como aumentar a resposta de contração à PhE em decorrência de prejuízo de H2O2 e redução de metabólitos derivados da iNOS em corpos cavernosos de ratos. / Hyperhomocysteinemia (HHcy) has been associated with endothelial dysfunction, due to the increase in superoxide anion (O2-) and reduced bioavailability of nitric oxide (NO), these facts could result in erectile dysfunction. The objective of this work was to study the consequences of HHcy on the responses to endothelin-1 (ET-1) and phenylephrine (PhE) in rat corpus cavernosum, as well as the mechanisms involved. The animals were divided into two groups, which received water (control) or DL-homocysteine thiolactone (DL-HcyT; HHcy group) at a dose of 1 g/kg/day for 15 days orally. Morphological analysis and collagen and expression of -actin revealed no considerable alterations in the structure of the corpus cavernosum of HHcy rats, suggesting that alterations in the functionality of these tissues are not based on structural modifications. The HHcy resulted in increased levels of O2- in corpus cavernosum of rats, assessed by confocal microscopy. Vascular reactivity was assessed for substances KCl, sodium nitroprusside (SNP), acetylcholine (ACh), ET-1, IRL-1620 and PhE. There were no changes in vascular reactivity to KCl or NPS. The relaxation induced by ACh was reduced in HHcy rat corpus cavernosum. The contraction induced by ET-1, by ETA receptors, was increased in corpus cavernosum of HHcy rats, suggesting possible involvement of basal O2- in intracellular pathways by activation of ETA receptors. There was prejudice to the relaxation to ET-1 and IRL-1620 in HHcy rat corpus cavernosum by activation of ETB receptors. The decreased IRL-1620-induced relaxation was due to the reduced production and/or bioavailability of NO.The expression of mRNA for pre-pro-ET-1, endothelin converting enzyme and ETA and ETB receptors were not altered in HHcy. The Emax of PhE was increased in HHcy rat corpus cavernosum, due to increase in basal levels of O2- and reducing negative modulators factors of the contraction, such as hydrogen peroxide (H2O2), suggesting possible loss of the enzyme superoxide dismutase (SOD). The participation of metabolites derived from eNOS, nNOS and iNOS, that modulate negatively PhE-induced contraction appear to be important in this response. In HHcy, these metabolites, derived primary from iNOS, are damaged, possibly by reducing the activity of NOS, the process of decoupling and/or reduced bioavailability of NO by interaction with reactive oxidative species (ROS) to form peroxynitrite. The expression of nitrotyrosine, inidicador the presence of peroxynitrite, was not altered in HHcy rat corpus cavernosum. Plasma levels of nitrate showed reduced levels of NO in HHcy rats, being suggestive of reduced bioavailability. The HHcy did not alter the expression of mRNA for eNOS, iNOS and nNOS in rat corpus cavernosum. The metabolites of the enzyme cyclooxygenase-1 (COX-1) and COX-2 participate negatively modulating the contraction of PhE and HHcy does not seem to change this modulation. In conclusion, intermediate HHcy, by its ability to increase basal levels of O2-, may affect the vasoactive function, contraction and relaxation of ET-1 peptide, as well as increase the contraction induced by PhE due to decrease of H2O2 and reduced of the metabolites derived from iNOS in rat corpus cavernosum.

A hiperhomocisteinemia (HHcy) tem sido associada à disfunção endotelial, em decorrência do aumento de ânion superóxido (O2-) e redução da biodisponibilidade de óxido nítrico (NO), fatos estes que poderiam acarretar disfunção erétil. O objetivo deste trabalho foi estudar as consequências da HHcy sobre as respostas à endotelina-1 (ET-1) e fenilefrina (PhE) em corpos cavernosos de ratos, bem como os mecanismos envolvidos. Os animais foram divididos em dois grupos, os quais receberam água (controle) ou DL-homocisteina tiolactona (DL-HcyT, grupo HHcy), na dose de 1 g/Kg/dia, via oral por 15 dias. Análises morfológicas, de colágeno e expressão de -actina não revelaram macroalterações na estrutura de corpos cavernosos de ratos HHcy, sugerindo que alterações na funcionalidade destes tecidos não decorrem de modificações estruturais. A HHcy acarretou aumento dos níveis de O2- em corpos cavernosos de ratos, avaliados por microscopia confocal. A reatividade vascular foi avaliada para KCl, nitroprussiato de sódio (NPS), acetilcolina (ACh), ET-1, IRL-1620 e PhE. Não foram observadas alterações na reatividade vascular para KCl ou NPS. O relaxamento induzido por ACh foi reduzido em corpos cavernosos de ratos HHcy. A contração induzida por ET-1, via receptores ETA, mostrou-se aumentada em corpos cavernosos de ratos HHcy, sugerindo possível envolvimento de O2- basais em vias intracelulares, decorrentes da ativação de receptores ETA. Observou-se prejuízo do relaxamento induzido por ET-1 e IRL-1620 em corpos cavernosos de ratos HHcy, por ativação de receptores ETB. O prejuízo do relaxamento induzido por IRL-1620 foi decorrente da produção e/ou biodisponibilidade reduzida de NO. A expressão de RNAm para pré-pró-ET-1, enzima conversora de ET-1 e receptores ETA e ETB não foram alteradas em decorrência da HHcy. O Emax da PhE foi aumentado em corpos cavernosos de ratos HHcy, em decorrência de aumento nos níveis basais de O2- e redução de fatores moduladores negativos da contração, tal como peróxido de hidrogênio (H2O2), sugerindo possível prejuízo da enzima superóxido dismutase. A participação de metabólitos derivados da isoformas da enzima óxido nítrico sintase (NOS), eNOS, nNOS e iNOS que modulam negativamente a contração da PhE, mostraram-se importantes nesta resposta. Na HHcy, os metabólitos derivados principalmente da iNOS estão prejudicados, possivelmente por redução da atividade da NOS, processo de desacoplamento e/ou redução da biodisponibilidade de NO por interação com espécies reativas de oxigênio (ERO), formando peróxinitrito. A expressão de nitrotirosina, indicador da presença de peroxinitrito, não foi alterada em corpos cavernosos de ratos HHcy. As dosagens plasmáticas de nitrato mostraram redução dos níveis de NO em ratos HHcy, sendo sugestivo de redução de sua biodisponibilidade. A HHcy não alterou a expressão de RNAm para eNOS, nNOS e iNOS em corpos cavernosos de ratos. Os metabólitos da enzima cicloxigenase-1 (COX-1) e COX-2 participam modulando negativamente a contração da PhE e a HHcy não alterou esta modulação. Concluindo, a HHcy intermediária, por sua capacidade de aumentar os níveis basais de O2-, pode afetar a função vasoativa, contração e relaxamento, do peptídeo ET-1, bem como aumentar a resposta de contração à PhE em decorrência de prejuízo de H2O2 e redução de metabólitos derivados da iNOS em corpos cavernosos de ratos. / Hyperhomocysteinemia (HHcy) has been associated with endothelial dysfunction, due to the increase in superoxide anion (O2-) and reduced bioavailability of nitric oxide (NO), these facts could result in erectile dysfunction. The objective of this work was to study the consequences of HHcy on the responses to endothelin-1 (ET-1) and phenylephrine (PhE) in rat corpus cavernosum, as well as the mechanisms involved. The animals were divided into two groups, which received water (control) or DL-homocysteine thiolactone (DL-HcyT; HHcy group) at a dose of 1 g/kg/day for 15 days orally. Morphological analysis and collagen and expression of -actin revealed no considerable alterations in the structure of the corpus cavernosum of HHcy rats, suggesting that alterations in the functionality of these tissues are not based on structural modifications. The HHcy resulted in increased levels of O2- in corpus cavernosum of rats, assessed by confocal microscopy. Vascular reactivity was assessed for substances KCl, sodium nitroprusside (SNP), acetylcholine (ACh), ET-1, IRL-1620 and PhE. There were no changes in vascular reactivity to KCl or NPS. The relaxation induced by ACh was reduced in HHcy rat corpus cavernosum. The contraction induced by ET-1, by ETA receptors, was increased in corpus cavernosum of HHcy rats, suggesting possible involvement of basal O2- in intracellular pathways by activation of ETA receptors. There was prejudice to the relaxation to ET-1 and IRL-1620 in HHcy rat corpus cavernosum by activation of ETB receptors. The decreased IRL-1620-induced relaxation was due to the reduced production and/or bioavailability of NO.The expression of mRNA for pre-pro-ET-1, endothelin converting enzyme and ETA and ETB receptors were not altered in HHcy. The Emax of PhE was increased in HHcy rat corpus cavernosum, due to increase in basal levels of O2- and reducing negative modulators factors of the contraction, such as hydrogen peroxide (H2O2), suggesting possible loss of the enzyme superoxide dismutase (SOD). The participation of metabolites derived from eNOS, nNOS and iNOS, that modulate negatively PhE-induced contraction appear to be important in this response. In HHcy, these metabolites, derived primary from iNOS, are damaged, possibly by reducing the activity of NOS, the process of decoupling and/or reduced bioavailability of NO by interaction with reactive oxidative species (ROS) to form peroxynitrite. The expression of nitrotyrosine, inidicador the presence of peroxynitrite, was not altered in HHcy rat corpus cavernosum. Plasma levels of nitrate showed reduced levels of NO in HHcy rats, being suggestive of reduced bioavailability. The HHcy did not alter the expression of mRNA for eNOS, iNOS and nNOS in rat corpus cavernosum. The metabolites of the enzyme cyclooxygenase-1 (COX-1) and COX-2 participate negatively modulating the contraction of PhE and HHcy does not seem to change this modulation. In conclusion, intermediate HHcy, by its ability to increase basal levels of O2-, may affect the vasoactive function, contraction and relaxation of ET-1 peptide, as well as increase the contraction induced by PhE due to decrease of H2O2 and reduced of the metabolites derived from iNOS in rat corpus cavernosum.

The mammalian Na+/H+ exchanger isoform 1 (NHE1) is a ubiquitously expressed membrane protein that regulates myocardial intracellular pH. Inhibition of NHE1 prevents hypertrophy and reduces ischemia-reperfusion (I/R) injury in animal models. To understand the regulation of NHE1 in the myocardium by phosphorylation we constructed adenoviruses, which express wild type or mutant cDNA for NHE1. Additionally, wild type and mutant NHE1 had mutations Leu163Phe/Gly174Ser, which increases NHE1 resistance to EMD87580 (NHE1 inhibitor) by 100-fold. This allowed measurement of exogenous NHE1 activity while inhibiting endogenous NHE1 activity. We examined the effects of a series of mutations of phosphorylation sites in the cytosolic domain of NHE1. Sustained intracellular acidosis and phenylephrine caused an ERK-dependent activation of NHE1 activity and phosphorylation levels. We demonstrated that amino acids Ser770 and Ser771 were essential for activation of NHE1 activity in isolated rat cardiomyocytes by sustained intracellular acidosis and phenylephrine. Furthermore, mutation of Ser770 and Ser771 to Ala prevented increased NHE1 phosphorylation by sustained intracellular acidosis and phenylephrine. This was found to occur in an ERK-dependent manner. Taken together, our results demonstrate that both sustained intracellular acidosis and phenylephrine rapidly activate the NHE1 protein in isolated cardiac cells via an ERK-dependent pathway that acts on the common amino acids Ser770 and Ser771 of the C-terminal tail of NHE1.

Background: In order to perform cataract surgery, adequate dilatation of the pupil is essential. This is traditionally achieved by preoperative topical mydriatic eye-drops, commonly cyclopentolate and phenylephrine. This routine has several disadvantages. First, the slow penetration through the cornea delays the onset of mydriasis. Second, the limited bioavailability of topically administered substances with significant systemic absorption may increase the risk for systemic side effects. Third, even if good mydriasis is achieved initially with topical mydriatics (TM), the effect tends to wear off during surgery. In relation to cataract surgery a transient postoperative corneal oedema is sometimes noted, indicating effects on the corneal endothelial pump function. These effects have been ascribed to ultrasonic or mechanical trauma from the phacoemulsification procedure. Corneal endothelial cell loss (ECL) is a commonly studied variable, not least because it is associated with the long-term risk for corneal decompensation. But, there has been a debate whether postoperative corneal swelling after phacoemulsification cataract surgery correlates to ECL. Aims: To evaluate an alternative mydriatic regimen for phacoemulsification cataract surgery: intracameral injection of mydriatics mixed with lidocaine (ICM). Additionally, to determine the correlation between early transient postoperative corneal oedema and permanent ECL after phacoemulsification cataract surgery. Methods: Pupil dilatation with ICM (150 µl of lidocaine 1%, phenylephrine 1.5%, and cyclopentolate 0.1%) was compared to TM (phenylephrine 10% and cyclopentolate 1%) prior to cataract surgery. Additionally, two ICM-groups were randomized to receive either 0.6 µg/ml epinephrine added to the irrigating balanced salt solution or no epinephrine in the irrigation solution. Furthermore, two randomized ICM-groups, with or without cyclopentolate, were analyzed. The patients planned for cataract surgery were examined with ultrasonic pachymetry, specular microscope endothelial photography and Orbscan II slit-scan tomography pre- and postoperatively. Results: With ICM, mydriasis reached 95 ± 3% of its final value within 20 seconds. In the ICM-group, the pupils were smaller than in the TM-group (mean 6.7 ± 1.0 mm versus 7.7 ± 1.0 mm, P<.001), but did not contract intraoperatively as the TM pupils did. Conversely, with ICM the pupil sizes generally increased during the cataract procedures. This increase was significantly greater without epinephrine in the irrigating solution (13 ± 19% versus 4 ± 14%; p = 0.02). No significant differences in pupil sizes were observed between the patients who were given ICM with or without cyclopentolate. The central corneal swelling at the first postoperative day was strongly correlated to the central ECL at 3 months, R2 = 0.785, P < 0.001. Conclusions: ICM is a rapid and safe alternative to TM in phacoemulsification cataract surgery. An irrigating solution without epinephrine can safely be used with ICM. Cyclopentolate, administrated intracamerally, has no immediate additive mydriatic effect to intracameral lidocaine combined with phenylephrine. The degree of permanent corneal endothelial damage in cataract surgery is reflected in the degree of early postoperative corneal swelling.

No description available.

Abstract Knowledge of the effects of maternally administered vasopressors on human fetal and placental haemodynamics is sparse and limited to elective Caesarean deliveries in uncomplicated pregnancies. We hypothesized that, after short-term fetal hypoxaemia, which activates fetal cardiovascular compensatory mechanisms, treatment of maternal hypotension with ephedrine or phenylephrine results in divergent responses in fetal and placental haemodynamics. Chronically instrumented near-term sheep fetuses with either normal placental function or increased placental vascular resistance following placental embolization were exposed to two subsequent periods of decreased fetal oxygenation caused by maternal hypoxaemia and epidural-induced hypotension. The fetuses that underwent placental embolization were also chronically hypoxaemic. Fetal and placental haemodynamics were assessed by invasive techniques and by noninvasive Doppler ultrasonography. Our results show that umbilical artery blood flow velocity waveforms cannot be used to derive information of fetal cardiac function. Furthermore, the changes in placental volume blood flows and vascular resistances caused by maternal vasopressor treatment cannot be reliably recognized based on uterine and umbilical artery pulsatility index values. In response to acute hypoxaemia, a fetus with normal placental function redistributes its right ventricular cardiac output from the pulmonary to the systemic circulation and is able to increase its combined cardiac output, with a concomitant relative decrease in the net forward flow through the aortic isthmus. However, fetal haemodynamic responses to subsequent hypoxaemic insults may vary. Furthermore, the compensatory responses of fetuses with increased placental vascular resistance differ from those of normal fetuses. In these fetuses, repeated episodes of a further decrease in oxygenation lead to lactataemia. The effects of ephedrine on uteroplacental and umbilicoplacental circulations were more favourable than those of phenylephrine. Ephedrine restored the changes in fetal cardiovascular haemodynamics caused by maternal hypotension to the baseline conditions in both embolized and nonembolized fetuses. Phenylephrine did not reverse fetal pulmonary vasoconstriction or the relative decrease in the net forward flow through the aortic isthmus. Moreover, fetal left ventricular function was impaired by phenylephrine. Although no significant differences in fetal acid-base status were observed in fetuses with normal placental function, the lactate concentrations of the embolized fetuses increased further when maternal hypotension was treated with phenylephrine.

This study compared whether activation of muscle ergoreceptor afferents caused by isometric muscle contraction, activation of baroreceptor afferents induced by i.v. infusion of phenylephrine, or baroreceptor afferent inactivation, caused by carotid artery occlusion, elicit similar patterns of c-Fos induction in brainstem areas. Adult cats were anesthetized with α-chloralose, and in each case, the experimental intervention caused an increase in the arterial blood pressure. There were two sets of control experiments: in both, animals underwent the same surgical procedures but then either remained at rest for the entire study, or the tibial nerve was stimulated, as in the contraction group, following muscle paralysis with tubocurarine. Following the procedures, animals rested for 90 min to allow neuronal expression of c-Fos. Control cats showed very little c-Fos immunoreactivity (c-Fos-ir) in the brainstem. Muscle contraction induced c-Fos-ir expression mainly in the nucleus tractus solitarius, lateral reticular nucleus, lateral tegmental field, vestibular nucleus, subretrofacial nucleus, spinal trigeminal tract and in a lateral region of the periaqueductal grey (P 0.5-1.0). The majority of the c-Fos-ir was found in brainstem areas contralateral to the contracted muscle. In addition, muscle contraction induced c-Fos-ir in the dorsal horns of spinal segments L6-S1 on the ipsilateral side of the spinal cord. Phenylephrine infusion caused c-Fos-ir expression in the nucleus tractus solitarius, spinal trigeminal tract, solitary tract, and dorsal motor nucleus of the vagus. No c-Fos-ir was apparent in the periaqueductal grey. Carotid occlusions induced c-Fos-ir expression in the area postrema, nucleus tractus solitarius, solitary tract, and spinal trigeminal tract. Expression was bilateral. Areas that exhibited c-Fos-ir correspond to sites previously reported to release various neuropeptides in response to muscle contraction or carotid occlusions. These results indicate that the exercise pressor reflex and baroreflex activate similar, but not completely identical, sites in the brainstem.

Cocaine- and amphetamine-regulated transcript (CART) was first identified in the rat striatum where levels were upregulated following cocaine or amphetamine administration. A dense plexus of CART-immunoreactive fibers is noted in the nucleus of the solitary tract (NTS). Results from tract-tracing and immunohistochemical studies suggest that the dense network of CARTp-fibers in the NTS may arise from nodose ganglia. The present study was undertaken to evaluate the hypothesis that CARTp may alter baroreceptor function in rats. Rats were intravenously administered phenylephrine every 10 min to elicit a baroreflex. CARTp (0.1- 3 nmol) by intracisternal or bilateral intra-NTS microinjection consistently attenuated the phenylephrineinduced bradycardia. In contrast, CARTp antibody potentiated the bradycardia produced from phenylephrine. Microinjection of saline, normal rabbit serum, or concomitant injection of CARTp and CART antibody into the NTS caused no significant change of phenylephrineinduced baroreflex. The result suggests that CARTp released from primary afferents may modulate baroreflex.

PEREIRA, A.C. Mecanismos celulares que influenciam a sinalização por 1-adrenoceptores na carótida contra-lateral à lesão por cateter balão. 2009. 127 f. Tese (Doutorado) - Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, 2009. Em artérias carótidas de ratos, a lesão provocada pela angioplastia por cateter balão resulta em resposta neurocompensatória na carótida contra-lateral à lesão, com aumento da inervação contendo substância P e CGRP (peptídeo relacionado ao gene da calcitonina), além de alteração de reatividade a agonistas vasoconstritores. O objetivo deste trabalho foi estudar os mecanismos relacionados à alteração de reatividade à fenilefrina (Phe) na carótida contra-lateral à lesão, 1, 2, 4 e 15 dias após a lesão. A análise histológica mostrou que a carótida contra-lateral à lesão é semelhante ao controle. Na artéria ipsi-lateral a camada endotelial estava ausente e, aos 15 dias após a lesão observou-se a presença da neoíntima. Curvas concentração-resposta para Phe (contração) foram realizadas em anéis isolados de carótidas contra-laterais e controles, 1, 2, 4 e 15 dias após a lesão. No quarto dia após a lesão, observou-se aumento no efeito máximo (Emax) da Phe na artéria contralateral em relação ao controle. Para avaliar se o aumento no Emax da Phe estava relacionado à mobilização de cálcio induzida por esse agonista, foi usada solução de Krebs sem cálcio, contendo ou não EGTA e curvas concentração resposta para CaCl2. Observamos que a mobilização de cálcio intracelular induzido pela Phe na contra-lateral não estava alterada em relação ao controle, mas o influxo de cálcio estava reduzido. Este resultado foi confirmado em usando anéis de carótida marcados com Fluo-3AM em microscópio confocal. Na presença de inibidores específicos, observou-se que a isoforma endotelial da enzima óxido nítrico sintase, canais para potássio dependentes de cálcio, prostanóides derivados da COX-2, ânion superóxido e junções do tipo Gap estão envolvidos na redução do influxo de cálcio na contra-lateral. No entanto, não há participação de óxido nítrico, guanilato ciclase ou da Ca-ATPase do retículo. Ânion superóxido, COX-2 e junções do tipo Gap também participam do aumento de Emax da Phe na carótida contra-lateral à lesão. Os resultados sugerem ainda que ânions superóxido promovem aumento da atividade de Rho-kinase na artéria contra-lateral em relação ao controle, conforme observado em curvas de relaxamento com Y-27632 (inibidor de Rho-quinase), após pré-contração com Phe. A potência para Phe e para CaCl2 na contra-lateral foi semelhante ao controle, assim como o relaxamento induzido pela acetilcolina e a contração desencadeada pelo KCl. Os resultados obtidos neste trabalho indicam que a resposta neurocompensatória ao cateter balão resulta em alterações na sinalização celular que interferem na reatividade à Phe na carótida contra-lateral à lesão. Estas alterações são dependentes do endotélio, desencadeadas, provavelmente, por um estresse oxidativo causado por ânions superóxido e sugerem a existência de mecanismos compensatórios para manter o tônus vascular. / In rat carotid arteries, balloon catheter injury results in neurocompensatory response in contralateral carotid, leading to increased levels of substance P and CGRP (calcitonin gene-related peptide), beside alterations in reactiveness to vasoconstrictor agonists. The aim of this work was to study the mechanisms involved in alterations in phenylephrine (Phe) responsiveness in contralateral carotid, 1, 2, 4 and 15 days after injury. Histological analysis showed that contralateral carotid was similar to control. Endothelium was absent in ipsilateral arteries, but 15 days after lesion it was observed the neointima. Concentration-response curves to Phe (contraction) were performed in isolated carotid rings, control and contralateral, 1, 2, 4 and 15 days after lesion. In the fourth day after lesion, it was observed increase in maximum effect (Emax) to Phe in contralateral compared to control arteries. In order to verify if the increase in Emax to Phe was related to calcium mobilization by this agonist, it was used free-calcium Krebs solution containing or not EGTA, and concentration-response curves to CaCl2. It was observed that intracellular calcium mobilization by Phe was similar to control, but calcium influx was reduced in contralateral. Confocal microscopy, using carotid rings loaded with Fluo-3AM, was also utilized to corroborate this result. In presence of specific inhibitors, it was observed that endothelial isoform of nitric oxide synthase, calcium-activated potassium channels, prostanoids from COX-2, superoxide anions and Gap-junctions are involved on reduction of Phe-induced calcium influx. However, neither nitric oxide, guanylate cyclase nor sarcoendoplasmic reticulum Ca-ATPase participate in this response. Superoxide anions, COX-2 and Gap-junctions also play a role on increased Emax to Phe in contralateral carotid. Futhermore, superoxide anions promote increase in Rho-kinase activity in contralateral carotid compared to control, as it was observed in relaxation curves with Y-27632 (Rho-kinase inhibitor), after Phe pre-contraction. Phe and CaCl2 potency in contralateral were similar to control, like acetylcholine relaxation and KCl-induced contraction. Results obtained in this work indicate that the neurocompensatory response to balloon catheter injury leads to alterations in the signaling pathway downstream alpha1-adrenoceptor activation in contralateral carotid. These alterations are endothelium dependent and, probably, triggered by oxidative stress due to superoxide anions. Taken together, data suggest the existence of compensatory mechanisms to maintain the vascular tonus.

INTRODUÇÃO: Existem poucos estudos na literatura sobre o efeito de drogas no posicionamento vertical das pálpebras. Esse assunto é importante na análise da dinâmica palpebral, principalmente em afecções como a blefaroptose. O objetivo deste estudo é determinar a ação de uma gota do colírio de fenilefrina a 10% sobre as pálpebras superior e inferior de indivíduos normais e portadores de blefaroptose adquirida involucional e verificar a ocorrência de alterações no posicionamento das pálpebras superior e inferior do olho contralateral. MÉTODOS: Realizou-se um estudo clínico, prospectivo e aberto com indivíduos normais e pacientes com blefaroptose adquirida involucional, que foram submetidos à instilação de uma gota do colírio de fenilefrina a 10% em um dos olhos. Todos os indivíduos foram filmados antes e após a instilação da medicação (3, 10, 15, 30, 45 e 60 minutos). As imagens foram submetidas ao processamento digital e editadas para análise das medidas palpebrais. Foi traçada uma linha horizontal a partir do canto medial em direção ao canto externo. Considerouse como altura da pálpebra superior a distância entre o ponto mais alto da margem palpebral superior e a linha horizontal traçada. A altura palpebral inferior foi avaliada como a distância entre o ponto mais baixo da margem palpebral inferior e a referida linha. RESULTADOS: Foram incluídos na pesquisa 70 indivíduos normais e 40 portadores de blefaroptose adquirida involucional. Em relação à blefaroptose, a maioria apresentava quadro bilateral (92,5%) e grau mínimo (45%). Em relação à resposta ao colírio de fenilefrina a 10%, a medida antes da instilação da medicação diferiu significativamente dos demais momentos (p< 0,001), com elevação média da pálpebra superior de 0,92 mm e retração de 0,40 mm na altura palpebral inferior em todos os grupos estudados. Em relação ao olho contralateral, observou-se queda da pálpebra superior em praticamente todos os momentos estudados, com o menor nível aos 3 minutos (queda média de 0,66 mm). A pálpebra inferior contralateral mostrou uma elevação média de 0,35 mm. CONCLUSÕES: A instilação de uma gota do colírio de fenilefrina a 10% em olhos de indivíduos normais e pacientes portadores de blefaroptose adquirida involucional altera a posição das pálpebras superior e inferior do olho testado, como também das pálpebras do olho contralateral / INTRODUCTION: There are few studies in the literature on the effect of drugs on the vertical positioning of the eyelids. This issue is important in the analysis of the eyelid dynamics mainly in disorders such as blepharoptosis. The aim of this study is to determine the action of a single drop of 10% phenylephrine on the upper and lower eyelids of healthy subjects and patients with acquired involutional blepharoptosis and observe the occurrence of changes in the positioning of the upper and lower eyelids of the contralateral eye. METHOD: A prospective clinical trial was done with healthy subjects and patients with acquired involutional blepharoptosis. The patients were submitted to the instillation of a single drop of 10% phenylephrine in one eye. All subjects were filmed before and after instillation of medication (3, 10, 15, 30, 45 and 60 minutes). The images were submitted to digital processing and edited to analyze lid measurements. A horizontal line was drawn from the medial canthus toward the outer. The upper eyelid height was measured as the distance between the highest point of the upper eyelid margin and the horizontal line drawn. The lower eyelid height was the distance between the lowest point of the margin lower eyelid and the drawn line. RESULTS: Seventy healthy subjects and 40 patients with acquired involutional blepharoptosis were included. Most patients had bilateral (92,5%) and mild blepharoptosis (45%). After 10% phenylephrine instillation, upper lid height showed a mean elevation of 0,92 mm, which was significantly different at all time measurements (p< 0,001). The lower eyelid height changed with a mean retraction of 0,40 mm. In the contralateral eye was observed a fall of upper eyelid in all most all times studied, with the lowest level observed at 3 minutes (with average fall of 0,66 mm). The contralateral lower eyelid showed an average elevation of 0,35 mm. CONCLUSION: Instillation of a single drop of 10% phenylephrine altered the position of upper and lower eyelids on the tested eye, as well as of the contralateral eye on both groups, healthy subjects and patients with acquired involutional blepharoptosis