A Abstinência ao Etanol (AE) é uma complicação de curta duração desenvolvida após a interrupção parcial ou total do consumo crônico de etanol. Alguns dos sintomas descritos incluem: aumento transitório da pressão arterial, alteração da resistência vascular periférica e alterações comportamentais; entretanto, os mecanismos envolvidos nessas respostas continuam elusivos. O objetivo desse estudo foi o de investigar os efeitos da abstinência ao etanol sobre o sistema renina-angiotensina-aldosterona (SRAA) e a função vascular. Ratos Wistar (250g) foram divididos em 3 grupos: Controle (CTR): os animais receberam água ad libitum por 23 dias; Etanol (EtOH): o tratamento crônico com etanol foi iniciado com uma solução de etanol 3% (vol./vol.), sendo gradualmente aumentada a cada três dias para 6% (4º dia) e 9% (7º dia em diante), mantendo-se esta concentração até o 21° dia; Abstinência ao Etanol (AE): os animais foram tratados da mesma maneira que o grupo EtOH até o 20º dia, neste dia a solução de etanol 9% foi retirada e retornada no dia seguinte (21º dia) por apenas 2h; após o término deste período, os animais receberam água até o dia do teste (23º dia), garantindo assim, o quadro de abstinência por 48h. Para avaliar o comportamento, os animais foram testados no Labirinto em Cruz Elevado (LCE). A pressão arterial foi medida por pletismografia de cauda. Foram avaliados os níveis plasmáticos de: a) etanol por cromatografia gasosa; b) corticosterona (CORT), angiotensina I e II (ANGI e II), vasopressina (AVP), ocitocina e peptídeo natriurético atrial (ANP) por radioimunoensaio; c) aldosterona (ALDO), renina (REN) e espécies reativas de oxigênio ao ácido tiobarbitúrico (TBARS) por ELISA; atividade plasmática da enzima conversora de angiotensina por fluorímetria; d) atividade da NAD(P)H-oxidase em aorta e leito mesentérico pelo método de quimioluminescência da lucigenina; d) de sódio (Na+ ) por fotometria de chama; e) osmolaridade foi medida pelo abaixamento do ponto de congelamento da água. Foi realizada avaliação da reatividade vascular em aorta isolada para angiotensina II (ANG II), fenilefrina, cloreto de potássio, acetilcolina e nitroprussiato de sódio (NPS). A abstinência ao etanol promoveu diminuição significativa da porcentagem de entrada e tempo despendido nos braços abertos do LCE; além disso, houve aumento da concentração plasmática de corticosterona. Em conjunto estes resultados mostram o efeito ansiogênico da abstinência ao etanol. A abstinência ao etanol também promoveu aumento da pressão arterial sistólica e média. Houve aumento do estresse oxidativo sistêmico e tecidual. Em relação ao balanço hidroeletrolítico, não foi encontrada nenhuma alteração induzida pela abstinência ao etanol. A abstinência ao etanol induziu alterações vasculares independentes de endotélio representada por diminuição da contração para ANG II, fenilefrina e KCl e aumento do relaxamento para o nitroprussiato de sódio. A partir destes resultados podemos concluir que a abstinência ao etanol induz ansiedade, estimula o SRAA, induz hipertensão e estresse oxidativo e altera a função vascular de maneira independente de endotélio. / Ethanol withdrawal is a short-term complication developed after partial or total interruption of chronic ethanol consumption. Some of the symptoms described include: transient increase in blood pressure, peripheral vascular resistance changes and behavioral changes, however, the mechanisms involved in these responses remain elusive. The aim of this study was to investigate the effects of ethanol withdrawal on the renin-angiotensin-aldosterone system (RAAS) and vascular function. With this purpose, male Wistar rats (250g) were divided into 3 groups: control (CTR): animals received water ad libitum for 23 days, ethanol (EtOH): chronic treatment with ethanol was started with an ethanol solution 3% (vol. / vol.) being gradually increased every three days to 6% (day 4) and 9% (day 7 onwards), being this concentration maintained until day 21; Ethanol abstinence (EA): animals were treated in the same way of the EtOH group until day 20. Then, ethanol solution 9% was removed and returned the next day (day 21) for 2h. After the end of this period, the animals received water until day 23, ensuring abstinence for 48 hours. Animals were tested on the Elevated Plus Maze (EPM). Blood pressure was measured by tail plethysmography. Plasma levels of: a) ethanol were determined by gas chromatography, b) corticosterone (CORT), angiotensin I and II (ANGI and II), vasopressin (AVP), oxytocin, and atrial natriuretic peptide (ANP) by radioimmunoassay; c ) aldosterone (ALDO), plasma activity of angiotensin converting enzyme by fluorimetry; renin (REN) and thiobarbituric acid reactive substances (TBARS) by ELISA; d) activity of NAD (P)H in the aorta and mesenteric arterial bed by lucigenin chemiluminescence assay; d) sodium (Na+ ) by photometry; e) osmolarity was measured by the lowering of the freezing point of water. Vascular reactivity of isolated aorta to angiotensin II (ANG II), phenylephrine, KCl, acetylcholine, and sodium nitroprusside (SNP) was evaluated. Abstinence to ethanol induced a significant reduction in the percentage of entries and time spent in the open arms of the EPM. Increased corticosterone plasma levels were also detected in animals from the EA group. Together these findings suggest that abstinence to ethanol induces an anxiogenic-like effect. Abstinence to ethanol induced an increase in plasma ANG II with no changes on ANG I, renin or aldosterone levels. The levels of ANG I and ANG II in the aorta and mesenteric arterial bed were not altered in animals from the EA group. Abstinence to ethanol also induced increase in systolic blood pressure and mean arterial blood pressure. Abstinence to ethanol increased systemic oxidative stress and the vascular generation of superoxide anion. No change in the fluid balance was detected in animals from the EA group. In endothelium-denuded, but not intact aortic rings, abstinence to ethanol decreased the contraction induced by ANG II, phenylephrine and KCl. Increased NPS-induced relaxation was also observed in rings from EA animals. We conclude that ethanol withdrawal: a) induces anxiety; b) stimulates the systemic RAAS; c) increases blood pressure; d) induces systemic and vascular oxidative stress; e) alters the vascular function in an endothelium-independent manner.

O tecido adiposo perivascular (PVAT) da aorta torácica (AT) possui ação anticontrátil (AC). O PVAT da AT e das artérias mesentéricas de resistência (AM) possuem diferentes características. Na obesidade ocorre expansão do PVAT. Nós avaliamos a modulação da contração pelo PVAT da AT e AM em camundongos controles (CT) e obesos (OB) e a participação do sistema renina-angiotensina (SRA), por meio do tratamento com antagonista do receptor AT1 (BRA). PVAT da AT e AM apresentaram ação AC. Ação AC do PVAT das AM, mas não da TA, foi abolida no grupo OB. BRA resgatou a ação AC do PVAT das AM no grupo OB, que foi abolida pelo antagonismo do receptor AT2 e pela inibição da óxido nítrico (NO) sintase (NOS). Em AM, a expressão dos receptores AT1 e AT2 não foi modificada e da NOS endotelial foi aumentada em AM e reduzida no PVAT da AM no grupo OB. BRA aumentou a expressão da eNOS no PVAT das AM nos dois grupos. Assim, concluímos que a obesidade induz disfunção do PVAT de AM e há envolvimento do SRA. BRA corrige a função do PVAT de AM por mecanismo dependente do receptor AT2 e NO. / The perivascular adipose tissue (PVAT) of thoracic aorta (TA) has an anticontractile (AC) action. TA and resistance mesenteric arteries (MA) PVAT have different characteristics. Expansion of PVAT occurs in obesity. We evaluated the modulation of contraction by PVAT of TA and MA in control (CT) and obese (OB) mice and the participation of the renin-angiotensin system (RAS), by treating mice with AT1 receptor antagonist (ARB). PVAT of both TA and MA showed an AC action. The AC action of MA PVAT, but of TA PVAT, was abolished in the OB group. ARB recovered the AC action of MA PVAT in OB group, which was abolished by both AT2 receptor antagonism and nitric oxide (NO) synthase (NOS) inhibition. In MA, the expression of AT1 and AT2 receptors was not changed and the expression of eNOS was increased in MA and reduced in MA PVAT of OB group. ARB increased the expression of eNOS in MA PVAT in both CT and OB groups. In conclusion, obesity induced MA PVAT dysfunction, in which RAS is involved. ARB recovered the MA PVAT function by mechanisms that depend on the AT2 receptor and NO.

Submitted by GABRIELA RONCADA HADDAD null (gabriela.haddad@yahoo.com) on 2017-09-10T22:08:03Z No. of bitstreams: 1 Tese Doutorado 27 jul 2017 - Gabriela.pdf: 1172239 bytes, checksum: d6ae9b8e2d02ba5890bf385b02539433 (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-09-12T16:46:39Z (GMT) No. of bitstreams: 1 haddad_gr_dr_bot.pdf: 1172239 bytes, checksum: d6ae9b8e2d02ba5890bf385b02539433 (MD5) / Made available in DSpace on 2017-09-12T16:46:39Z (GMT). No. of bitstreams: 1 haddad_gr_dr_bot.pdf: 1172239 bytes, checksum: d6ae9b8e2d02ba5890bf385b02539433 (MD5) Previous issue date: 2017-08-21 / Introdução: A influência do ácido retinoico (AR) sobre o coração é bastante relevante, ocorrendo durante a embriogênese, diferenciação e desenvolvimento cardíaco. Estudos experimentais mostram que o AR pode induzir hipertrofia excêntrica com melhora da função cardíaca em coração de ratos sadios, e também reduzir a hipertrofia, modulando o sistema renina angiotensina aldosterona (SRAA), em animais hipertensos. Pouco se sabe sobre os efeitos do AR em coração de humanos. Pacientes portadores de acne fazem uso de um tipo de AR que é o 13- cis-AR, também chamado de isotretinoína e por isso possibilitam o estudo do papel do AR em humanos. Estudo prévio mostrou que com 2 meses de uso do 13-cis-AR houve remodelação cardíaca. Entretanto, não se sabe sobre os mecanismos ou se essas alterações são reversíveis. Objetivos: Portanto, os objetivos desse trabalho foram de comparar a avaliação morfofuncional cardíaca e variáveis do SRAA entre pacientes em uso de isotretinoína com um grupo controle. Adicionalmente, avaliar se as alterações são reversíveis em pacientes em uso de isotretinoína. Casuística e Métodos: Foram estudados 35 adolescentes e adultos jovens, com idade entre 14 e 23 anos, do sexo masculino, sendo 20 deles em uso de isotretinoína oral, na dose de 0,5 mg/kg/dia a 0,75 mg/kg/dia, acompanhados no ambulatório de dermatologia do Hospital das Clínicas da Faculdade de Medicina de Botucatu (FMBUNESP), aos 6 meses de tratamento. Os outros 15 pacientes foram convidados na comunidade ou apresentavam acne leve com indicação apenas de tratamento tópico. Foram realizados avaliação morfofuncional e doppler tissular por meio de ecocardiografia transtorácica, dosagens bioquímicas de rotina e dosagens de componentes do SRAA renina, angiotensina I, angiotensina II, aldosterona, angiotensina 1-7 e alamandina. Essas variáveis foram comparadas nos grupos controle e isotretinoína pelo teste t de student ou Mann Whitnney. Os pacientes que receberam isotretinoína foram estudados antes do início do tratamento, com 6 meses de tratamento e 2 meses após o término do tratamento. Esses momentos foram comparados por meio do teste de Anova de 1 via de medidas repetidas. O nível de significância adotado foi de 5%. Resultados: Os pacientes do grupo controle e isotretinoína apresentaram a mesma idade, índice de massa corcoral, pressão arterial e frequência cardíaca. Dosagens bioquímicas habitualmente solicitadas durante o tratamento como enzimas hepáticas, função renal e triglicérides também foram semelhantes entre os grupos. Os dados morfológicos mostraram aumento do diâmetro diastólico do ventrículo esquerdo (DDVE) acompanhado de aumento do débito cardíaco e do fluxo transmitral avaliado por E/E’. Houve aumento do volume do átrio esquerdo (AE), no limite da significância e tendência ao aumento da massa do ventrículo esquerdo (VE) e com espessura relativa da parede semelhante entre os grupos. Sobre o SRAA houve redução da angiotensina II e da renina. Na avaliação ecocardiográfica apenas dos pacientes em uso de isotretinoína observou-se que houve redução do AE e do índice de massa do VE (IMVE) após 2 meses do término do tratamento. Embora não significativo, o comportamento de E/E’ também foi de redução após o tratamento. Discussão: O 13-cis-AR promove remodelação cardíaca, provavelmente induzida por hipervolemia, levando a um padrão de hipertrofia excêntrica com melhora da função. Essas alterações provavelmente levaram a menor ativação do SRAA visto pela redução da renina e angiotensina II. Esse perfil de remodelação e de bloqueio do SRAA é semelhante ao que ocorre no exercício físico. Nesse estudo foi possível apenas avaliar o grupo isotretinoína, quanto às variáveis ecocardiográficas antes, durante e após o tratamento. Observa-se que o término do estimulo com 13-cis-AR reduz algumas variáveis como átrio esquerdo e massa do VE. Portanto, em corações normais de adultos jovens, o AR atenuou o efeito de SRAA e promoveu remodelação cardíaca do tipo excêntrica, com melhora da função, compatível com sobrecarga volêmica e com caráter transitório. / Background: The influence of retinoic acid (RA) in the heart is very relevant, occurring during the embryogenesis, differentiation and cardiac development. Experimental studies shown that RA induces excentric hypertrophy, with improvement of cardiac function in heart of healthy rats. In addition, it was observed that RA regulates renin angiotensin aldosterone system (RAAS), a regulatory system involved in blood pressure, volume homeostasis and cardiac hypertrophy. There is a lack of information about the role of RA on cardiac remodeling in adult humans. Otherwise there are patients with Acne that uses 13- cis-RA, also called isotretinoin, and this population allow the investigation of cardiac remodeling and RA treatment. In fact, previously study shown that the use of 13-cis-RA, for acne, for 2 months induced cardiac remodeling, however, no one knows if these changes are persistent and reversible. Objectives: the objectives of these study is to compare the cardiac morphofunctional evaluation and RASS variables in patients using isotretinoin and in control group. Additionally, evaluate if these changes are reversible in isotretinoin group. Casuistic and Methods: Study1: 35 young men, between 14 to 23 years, 20 in use of 13-cis-RA, in the dose of 0,5 mg/kg/day to 0,75 mg/kg/day, from dermatology clinic of São Paulo State University (FMB-UNESP), at 6 months of treatment. The others 15 patients had mild acne only with topic treatment. Morphofunctional evaluation, tissular Doppler, Biochemical evaluation, dosage of RAAS components were performed. Results were compared in isotretinoin and control group by t student or Mann Whitnney tests. Study 2: Only the isotretinoin group were evaluated before beginning of treatment (initial moment - M0), after 6 months of treatment (final moment - M1) and two months after finishing the medication (M2). This results were compared by One way pared Anova. The statistically significant level was set at 5%. Results: control and isotretinoin group presents similar age, body mass index, blood pressure and heart rate. Biochemical evaluation was also similar. The present study showed that young patients receiving 13-cis-RA for Acne treatment presented left ventricle and atrium chamber enlargement and increase in cardiac output and in mitral flows. There was a trend toward higher ventricular mass with preserved relative wall thickness. RAAS showed decreased in angiotensin II and renin. Considering only patients that received isotretinoin, it was observed that cardiac atrium size and flows returned to baseline 2 months after the end of treatment and cardiac structures such as ventricle mass and thickness reduced. Discussion: 13-cis-RA promotes cardiac remodeling, probably induced by hypervolemia, taking to a pattern of eccentric hypertrophy, with improvement of function. It is possible that hypervolemia or a direct effect of 13-cis-RA, reduces renin and angiotensin II. The remodeling phenotype described is compatible with cardiac remodeling induced by physical activity, marked by hypervolemia, excentric hypertrophy and increased cardiac output. In the isotretinoin group, the end of treatment reduces left atrium size and left ventricle mass. Therefore, in normal hearts of young adults, RA reduces the effect of RAAS and promotes eccentric cardiac remodeling, with improvement of function, compatible with volume overload and with transitory character.

O mecanismo mais importante para a homeostase do K+ é o controle da secreção de K+ no néfron distal. O objetivo deste trabalho foi avaliar em animais submetidos à depleção de K+ por sete dias, a expressão de AT1R da ATRAP e algumas vias de sinalização como as WNK1, KS-WNK1 e WNK4. Estes animais apresentaram menor ganho de peso corporal, hipertrofia renal, isostenúria, e redução da FE de Na+ e K+, com aumento de Ang II, sem alterar a aldosterona. Verificamos aumento da expressão de AT1R mais acentuado em lisado celular e o aumento de ATRAP foram iguais nas frações de lisado total, membranas total e apical. Não detectamos variação nos níveis de RNAm dessas proteínas. A depleção de K+ induziu a fosforilação de c-Src, ERK1/2 e p38, bem como aumento dos RNAm de WNK1 e WNK4, e redução do RNAm de KS-WNK1. Considerando nossos resultados, a depleção aumenta a ação da Ang II, provavelmente devido à hiperexpressão de AT1R, sem diminuir a expressão de ATRAP. A hiperexpressão de WNK1 e WNK4, associada à redução da KS-WNK1. / The most important mechanism for the K+ homeostasis on varying the content of this ion in the diet is the control of K+ secretion in the distal nephron. Since angiotensin II (Ang II) is an important modulator of K+ secretion, the aim of this study was to evaluate, in animals subjected to K+ depletion for seven days, the expression level of angiotensin type 1 receptor (AT1R) and the AT1R-associated protein (ATRAP). Moreover, it was intended to evaluate the possible activation of some signaling pathways triggered by Ang II via AT1R. We also looked for evaluate the expression of ion transporters and \'\'with no lysine kinases\'\' (WNKs) WNK1, KS-WNK1 and WNK4 in these animals, since some of the effects of angiotensin II in the distal tubular segments are mediated by these kinases. The animals subjected to K+ depletion have showed lower body weight gain, renal hypertrophy, marked polyuria, isosthenuria, and significant reduction in FE Na+ and K+, and increased plasmatic Ang II levels, without changing the aldosterone levels. We found that the expression of ATRAP and AT1R is increased in all cell fractions analyzed, with the highest rise in the AT1R in total cell lysate and ATRAP increase was not significant in the apical membrane. We did not detect changes in mRNA levels of these proteins, suggesting no changes in the transcription rate. The mRNA levels of Na+/H+ exchanger isoform 3 (NHE3) and Cl-/Formate (CFEX), abundant in proximal tubuleswere not altered as well. Regarding signaling pathways, K+ depletion induced c-Src, ERK1/2 and p38 phosphorylation, as well as a significant increase in WNK1 and WNK4 mRNA , and reduced KS- WNK1 mRNA. Considering our results, K+ depletion increases Ang II action in renal tissue, probably due to the overexpression of AT1R, and that effect is not associated to the decreased expression of ATRAP. However, the total cell lysate AT1R increasing, was greater than that of ATRAP. The overexpression of WNK1 and WNK4 associated with (to) the reduction of KS - WNK1 appears to be important for K+ secretion inhibition in K+-depleted animals. The inhibitory activity of WNK4 on ROMK channels depends on its dephosphorylation, which depends on the activation of c-Src. The activation of c-Src was evidenced by the increase in K+ -depleted animals phosphorylation.

Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....

O mecanismo mais importante para a homeostase do K+ é o controle da secreção de K+ no néfron distal. O objetivo deste trabalho foi avaliar em animais submetidos à depleção de K+ por sete dias, a expressão de AT1R da ATRAP e algumas vias de sinalização como as WNK1, KS-WNK1 e WNK4. Estes animais apresentaram menor ganho de peso corporal, hipertrofia renal, isostenúria, e redução da FE de Na+ e K+, com aumento de Ang II, sem alterar a aldosterona. Verificamos aumento da expressão de AT1R mais acentuado em lisado celular e o aumento de ATRAP foram iguais nas frações de lisado total, membranas total e apical. Não detectamos variação nos níveis de RNAm dessas proteínas. A depleção de K+ induziu a fosforilação de c-Src, ERK1/2 e p38, bem como aumento dos RNAm de WNK1 e WNK4, e redução do RNAm de KS-WNK1. Considerando nossos resultados, a depleção aumenta a ação da Ang II, provavelmente devido à hiperexpressão de AT1R, sem diminuir a expressão de ATRAP. A hiperexpressão de WNK1 e WNK4, associada à redução da KS-WNK1. / The most important mechanism for the K+ homeostasis on varying the content of this ion in the diet is the control of K+ secretion in the distal nephron. Since angiotensin II (Ang II) is an important modulator of K+ secretion, the aim of this study was to evaluate, in animals subjected to K+ depletion for seven days, the expression level of angiotensin type 1 receptor (AT1R) and the AT1R-associated protein (ATRAP). Moreover, it was intended to evaluate the possible activation of some signaling pathways triggered by Ang II via AT1R. We also looked for evaluate the expression of ion transporters and \'\'with no lysine kinases\'\' (WNKs) WNK1, KS-WNK1 and WNK4 in these animals, since some of the effects of angiotensin II in the distal tubular segments are mediated by these kinases. The animals subjected to K+ depletion have showed lower body weight gain, renal hypertrophy, marked polyuria, isosthenuria, and significant reduction in FE Na+ and K+, and increased plasmatic Ang II levels, without changing the aldosterone levels. We found that the expression of ATRAP and AT1R is increased in all cell fractions analyzed, with the highest rise in the AT1R in total cell lysate and ATRAP increase was not significant in the apical membrane. We did not detect changes in mRNA levels of these proteins, suggesting no changes in the transcription rate. The mRNA levels of Na+/H+ exchanger isoform 3 (NHE3) and Cl-/Formate (CFEX), abundant in proximal tubuleswere not altered as well. Regarding signaling pathways, K+ depletion induced c-Src, ERK1/2 and p38 phosphorylation, as well as a significant increase in WNK1 and WNK4 mRNA , and reduced KS- WNK1 mRNA. Considering our results, K+ depletion increases Ang II action in renal tissue, probably due to the overexpression of AT1R, and that effect is not associated to the decreased expression of ATRAP. However, the total cell lysate AT1R increasing, was greater than that of ATRAP. The overexpression of WNK1 and WNK4 associated with (to) the reduction of KS - WNK1 appears to be important for K+ secretion inhibition in K+-depleted animals. The inhibitory activity of WNK4 on ROMK channels depends on its dephosphorylation, which depends on the activation of c-Src. The activation of c-Src was evidenced by the increase in K+ -depleted animals phosphorylation.

Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....

<p>Tulbaghia violacea Harv. (Alliaceae) is a small bulbous herb which belongs to the family, Alliaceae, most commonly associated with onions and garlic. In South Africa (SA), this&nbsp / herb has been traditionally used in the treatment of various ailments, including fever, colds, asthma, paralysis, hypertension (HTN) and stomach problems. The aim of this study&nbsp / was to evaluate the effect of methanol leaf extracts (MLE) of T. violacea on the blood pressure (BP) and heart rate (HR) in anaesthetized male spontaneously hypertensive rats / &nbsp / and to find out the mechanism(s) by which it acts. The MLE of T. violacea (5 - 150 mg/kg), angiotensin I (ang I, 3.1 - 100 &mu / g/kg), captopril (10 mg/kg), angiotensin II (ang II, 3.1 - 50&nbsp / g/kg), losartan (30 mg/kg), phenylephrine (0.01 &ndash / 0.16 mg/kg), prazosin (1 mg/kg), dobutamine (0.2 &ndash / 10.0 &mu / g/kg), propranolol (0.1 - 12.8 mg/kg), muscarine (0.16 -10 &mu / g/kg),&nbsp / and atropine (0.02 - 20.48 mg/kg) were administered intravenously into male spontaneously hypertensive rats (SHR) weighing between 300 g and 350 g and aged less than 5&nbsp / months. The MLE of T. violacea and/or the standard drugs were infused alone, simultaneously, or separately into each animal. The BP and HR were measured via a pressure&nbsp / transducer connecting the femoral artery and the Powerlab. The vehicle (0.2 mls of a mixture of dimethylsulfoxide and normal saline), T. violacea (60 mg/kg) and captopril (10&nbsp / mg/kg) were injected intraperitoneally into some SHR for 21 days to investigate the chronic effect of these agents on plasma levels of aldosterone. The mean change, the mean&nbsp / of the individual percentage changes and the percentage difference (in mean) observed with each intervention was calculated and statistically analyzed using the Student&rsquo / s t test&nbsp / for significant difference (p &lt / 0.05). The Microsoft Excel software was used for statistical analysis. T. violacea significantly (p &lt / 0.05) reduced the systolic, diastolic, and mean&nbsp / arterial BP / and HR dose-dependently. In a dose-dependent manner, ang I, ang II, phenylephrine significantly (p &lt / 0.05) increased the BP, while propranolol, muscarine and&nbsp / atropine reduced the BP. The increases in BP due to dobutamine were not dose-dependent. In a dose dependent manner, phenylephrine and propranolol reduced the HR, while dobutamine increased the HR. The effect of ang I, ang II, muscarine and atropine on HR were not dose-dependent / with both increases as well as decreases observed with ang&nbsp / I, and II and atropine, while decreases were seen with muscarine. Captopril produced&nbsp / significant (p &lt / 0.05) reduction in BP which were not associated with any change in HR. The co-infusion of ang I with the MLE produced significant (p &lt / 0.05) reduction in BP, which were not associated with significant changes in HR. The co-infusion of ang II with the&nbsp / MLE did not produce any significant changes in BP or HR when compared to the infusion of the standard drug alone. The co-infusion of phenylephrine with the MLE did not&nbsp / produce any significant change in BP or HR when compared to the values obtained with the infusion of the standard drug alone, in both the absence and presence of prazosin.&nbsp / The co-infusion of dobutamine with T. violacea produced siginificant (p &lt / 0.05) increases in DBP which were associated with significant (p &lt / 0.05) reductions in HR, when&nbsp / compared to the values obtained with the infusion of the standard drug alone. Theco-infusion of atropine with the MLE did not produce any significant change in BP or HR when&nbsp / compared to the values obtained with the infusion of atropine alone. However, the infusion of T. violacea, 20 minutes after pre-treating animals with atropine (5.12 mg/kg) lead to&nbsp / dose dependent significant (p &lt / 0.05) increases in BP, which were associated with dose-dependent increases in HR. The chronic treatment of animals with T. violacea or&nbsp / captropril produced (a) signicant (p &lt / 0.05) reductions in the plasma levels of aldosterone when compared to the values obtained in the vehicle-treated group, (b) produced&nbsp / signifiant (p &lt / 0.05) reduction in BP in the captopril treated group when compared to the vehicle-treated, (c) did not produce any signficant change in BP in the T. violacea-treated&nbsp / group when compared to the vehicle-treated group and (d) did not produce any signifiant change in HR or body weight in any of the groups. The result obtained in this study&nbsp / suggests that T. violacea reduced BP and HR in the SHR. Secondly, the BP and HR reducing effect of the MLE may involve a) the inhibition of the ACE, b) the inhibition of the &beta / 1&nbsp / adrenoceptors, c) the stimulation of the muscarinic receptors and d) the reduction of the levels of aldosternone in plasma. The results also&nbsp / suggest that the MLE may not act&nbsp / through the angiotensin II receptors or the &alpha / 1 adrenergic receptors.&nbsp / </p>

<p>Tulbaghia violacea Harv. (Alliaceae) is a small bulbous herb which belongs to the family, Alliaceae, most commonly associated with onions and garlic. In South Africa (SA), this&nbsp / herb has been traditionally used in the treatment of various ailments, including fever, colds, asthma, paralysis, hypertension (HTN) and stomach problems. The aim of this study&nbsp / was to evaluate the effect of methanol leaf extracts (MLE) of T. violacea on the blood pressure (BP) and heart rate (HR) in anaesthetized male spontaneously hypertensive rats / &nbsp / and to find out the mechanism(s) by which it acts. The MLE of T. violacea (5 - 150 mg/kg), angiotensin I (ang I, 3.1 - 100 &mu / g/kg), captopril (10 mg/kg), angiotensin II (ang II, 3.1 - 50&nbsp / g/kg), losartan (30 mg/kg), phenylephrine (0.01 &ndash / 0.16 mg/kg), prazosin (1 mg/kg), dobutamine (0.2 &ndash / 10.0 &mu / g/kg), propranolol (0.1 - 12.8 mg/kg), muscarine (0.16 -10 &mu / g/kg),&nbsp / and atropine (0.02 - 20.48 mg/kg) were administered intravenously into male spontaneously hypertensive rats (SHR) weighing between 300 g and 350 g and aged less than 5&nbsp / months. The MLE of T. violacea and/or the standard drugs were infused alone, simultaneously, or separately into each animal. The BP and HR were measured via a pressure&nbsp / transducer connecting the femoral artery and the Powerlab. The vehicle (0.2 mls of a mixture of dimethylsulfoxide and normal saline), T. violacea (60 mg/kg) and captopril (10&nbsp / mg/kg) were injected intraperitoneally into some SHR for 21 days to investigate the chronic effect of these agents on plasma levels of aldosterone. The mean change, the mean&nbsp / of the individual percentage changes and the percentage difference (in mean) observed with each intervention was calculated and statistically analyzed using the Student&rsquo / s t test&nbsp / for significant difference (p &lt / 0.05). The Microsoft Excel software was used for statistical analysis. T. violacea significantly (p &lt / 0.05) reduced the systolic, diastolic, and mean&nbsp / arterial BP / and HR dose-dependently. In a dose-dependent manner, ang I, ang II, phenylephrine significantly (p &lt / 0.05) increased the BP, while propranolol, muscarine and&nbsp / atropine reduced the BP. The increases in BP due to dobutamine were not dose-dependent. In a dose dependent manner, phenylephrine and propranolol reduced the HR, while dobutamine increased the HR. The effect of ang I, ang II, muscarine and atropine on HR were not dose-dependent / with both increases as well as decreases observed with ang&nbsp / I, and II and atropine, while decreases were seen with muscarine. Captopril produced&nbsp / significant (p &lt / 0.05) reduction in BP which were not associated with any change in HR. The co-infusion of ang I with the MLE produced significant (p &lt / 0.05) reduction in BP, which were not associated with significant changes in HR. The co-infusion of ang II with the&nbsp / MLE did not produce any significant changes in BP or HR when compared to the infusion of the standard drug alone. The co-infusion of phenylephrine with the MLE did not&nbsp / produce any significant change in BP or HR when compared to the values obtained with the infusion of the standard drug alone, in both the absence and presence of prazosin.&nbsp / The co-infusion of dobutamine with T. violacea produced siginificant (p &lt / 0.05) increases in DBP which were associated with significant (p &lt / 0.05) reductions in HR, when&nbsp / compared to the values obtained with the infusion of the standard drug alone. Theco-infusion of atropine with the MLE did not produce any significant change in BP or HR when&nbsp / compared to the values obtained with the infusion of atropine alone. However, the infusion of T. violacea, 20 minutes after pre-treating animals with atropine (5.12 mg/kg) lead to&nbsp / dose dependent significant (p &lt / 0.05) increases in BP, which were associated with dose-dependent increases in HR. The chronic treatment of animals with T. violacea or&nbsp / captropril produced (a) signicant (p &lt / 0.05) reductions in the plasma levels of aldosterone when compared to the values obtained in the vehicle-treated group, (b) produced&nbsp / signifiant (p &lt / 0.05) reduction in BP in the captopril treated group when compared to the vehicle-treated, (c) did not produce any signficant change in BP in the T. violacea-treated&nbsp / group when compared to the vehicle-treated group and (d) did not produce any signifiant change in HR or body weight in any of the groups. The result obtained in this study&nbsp / suggests that T. violacea reduced BP and HR in the SHR. Secondly, the BP and HR reducing effect of the MLE may involve a) the inhibition of the ACE, b) the inhibition of the &beta / 1&nbsp / adrenoceptors, c) the stimulation of the muscarinic receptors and d) the reduction of the levels of aldosternone in plasma. The results also&nbsp / suggest that the MLE may not act&nbsp / through the angiotensin II receptors or the &alpha / 1 adrenergic receptors.&nbsp / </p>

Le système cardiovasculaire est composé d'un cœur qui pompe régulièrement le sang à travers des artères afin d'alimenter tous les tissus corporels en oxygène et nutriments qui leur sont nécessaires. Une caractéristique particulière de ce système est son aspect fermé, où le sang fait un cycle constant commençant par le ventricule gauche, allant vers tous les tissus corporels, revenant vers le cœur et le ventricule droit, étant propulsé vers la circulation pulmonaire en retournant au ventricule gauche. L'insuffisance cardiaque est alors une incapacité du cœur à effectuer sa tâche de pomper le sang efficacement. Une série d'ajustements sont alors enclenchés pour rétablir un débit sanguin adéquat; cette réponse systémique est principalement menée par le système rénine-angiotensine-aldostérone ainsi que par le système adrénergique. À court terme, le flot sanguin est rétabli et le métabolisme corporel continue comme si rien n'était, de telle sorte que, souvent ce stade passe inaperçu et les individus qui en sont affectés sont asymptomatiques. Cependant, le cœur doit alors fournir un effort constant supérieur et si la cause n'est pas résolue, la condition cardiaque se dégradera encore plus. Si tel est le cas, pour s'ajuster à cette nouvelle réalité, le cœur, comme tout muscle, deviendra plus massif et changera de conformation afin de répondre à sa nouvelle charge de travail. Cette transformation cardiaque est communément connue sous le terme de remodelage. Par contre, le remodelage cardiaque est délétère à long terme et entrave encore plus le cœur à bien effectuer sa tâche. Au fur et à mesure que la fonction cardiaque décline, les systèmes compensatoires persistent et s'intensifient; il y a alors établissement d'un cercle vicieux destructeur qui ne peut être renversé que par une transplantation cardiaque. Entre temps, des thérapies inhibant le système rénine-angiotensine-aldostérone et le système adrénergique se sont avérés très efficaces pour prolonger la survie, diminuer la mortalité, réduire les hospitalisations ainsi que soulager la symptomatologie associée à l'insuffisance cardiaque. Par contre, ces régimes thérapeutiques ne semblent pas induire une réponse positive chez tous les patients, de sorte que certains n'en retirent pas de bénéfices tangibles, tandis que d'autres éprouvent plusieurs difficultés à les tolérer. Suite à des analyses rétrospectives, surtout en comparant la réponse thérapeutique entre des populations de diverses ethnies, les variations génétiques, particulièrement les polymorphismes ayant le potentiel de moduler le mécanisme d'action de la pharmacothérapie, furent proposés comme responsables de cette variabilité dans la réponse aux médicaments. Certains ont aussi proposé que certains polymorphismes pourraient être considérés comme des facteurs de risque prédisposant à l'insuffisance cardiaque ou coupables de moduler sa progression en tant que facteurs aggravants ou atténuants. Avec de telles hypothèses proposées, plusieurs associations génétiques furent étudiées en commençant par des gènes directement impliqués dans la pathogénèse de cette maladie. Dans le cadre de cette thèse, nous allons revoir les diverses données disponibles dans la littérature au sujet de l'influence que peuvent avoir les divers polymorphismes impliqués dans la prédisposition, la progression et la pharmacogénétique de l'insuffisance cardiaque. / The cardiovascular system is composed of a heart that regularly pumps blood through the arteries in order to meet the peripheral tissues' demand for oxygen and nutrients. One particularity of this system is its closed aspect where the blood constantly travels in a circular fashion: starting from the left ventricle it is thrusted towards the body tissues, returns to the right side of the heart, is propelled through the pulmonary circulation by the right ventricle and returns again to its starting point, the left ventricle. Heart failure is then the incapacity of the heart to perform its task of appropriately pumping blood. A series of adjustments are then put in place in order to restore an adequate blood flow; this systemic response is mainly lead by the renin-angiotensin-aldosterone and the adrenergic systems. In the short term, the proper blood flow is re-established and the body's metabolism is mainly not affected. This initial stage goes frequently unnoticed and the affected individuals are essentially asymptomatic. However, the heart now needs to deliver a constantly elevated effort and if the precipitating cause is not resolved, the cardiac condition will degrade even further. If this is the case, to adjust itself to this new state, as would any muscle, the heart will become more massive and change its conformation in order to respond to this new workload. This transformation of the heart is commonly referred to as remodelling. However, in the long run, this cardiac remodelling is detrimental and hinders even further the ability of the heart to effectively perform its task. As the cardiac function declines, the compensatory systems persist and intensify; a destructive vicious cycle is then established which will ultimately lead to a heart transplantation or death. In the meantime, therapies inhibiting the renin-angiotensin-aldosterone and the adrenergic systems were found to be very effective in prolonging lifespan, diminishing mortality, reducing hospitalisations and relieving some of the symptomatology associated with heart failure. However, these therapeutic strategies do not seem to induce a positive response in all, thus some patients do not derive any tangible benefits, whereas others experience many difficulties in tolerating them. Following retrospective analysis, especially when comparing the therapeutic response between different ethnic populations, the genetic variations, particularly polymorphisms having the potential to modulate the mechanism of action of pharmacotherapy, were put forward as culprits of this variability in response to medications. Furthermore, some researchers have also suggested that certain polymorphisms might be considered as risk factors predisposing towards heart failure or capable of modulating its progression, whether they act as aggravating or attenuation factors. With such hypothesis, many genetic associations were studied, many starting with genes directly implicated in the pathogenesis of this disease. Within the framework of this thesis, we will review the current data available in the literature as it pertains to the influence that various polymorphisms can have on the predisposition, the progression and the pharmacogenetics of heart failure.