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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
771

Avaliação dos efeitos da inibição de cadeias inflamatórias e da suplementação exógena de CXCL12 na hematopoiese de modelos experimentais expostos a doses letais ou subletais de radiação gama / Assessment of the effects of inhibition of inflammatory cascades and exogenous supplementation of CXCL12 in hematopoiesis of experimental models exposed to sublethal and lethal doses of gamma radiation

Vieira, Daniel Perez 10 December 2007 (has links)
O presente estudo teve como objetivo avaliar o efeito da inibição das cadeias inflamatórias reguladas pela ação do interferon-gama (IFN-γ) e da enzima óxido nítrico sintase indutível (iNOS) no dano radioinduzido após exposição a dose letal (8 Gy) ou moderada a severa (4 Gy) nos tecidos hematopoiéticos (baço e medula) de modelos experimentais irradiados nestas doses. Grupos de camundongos isogênicos C57Bl/6j foram expostos à radiação correspondente a 4 ou 8 Gy em exposições de corpo inteiro em fonte panorâmica de 60Co. Da mesma forma, foram irradiados camundongos cuja expressão de IFN-γ ou iNOS é ausente ou indetectável. Outros grupos receberam via oral por toda a duração do experimento um inibidor atividade de iNOS, aminoguanidina, ou via intraperitoneal uma quimiocina primordial promotora da hematopoiese, CXCL12, até o quarto dia após a exposição. Outra divisão experimental recebeu os dois agentes concomitantemente. Os animais foram sacrificados nos dias 2º, 4º e 8º após a irradiação, e fragmentos dos baços e fêmures foram preservados para histologia. Os esplenócitos e células não aderentes da medula óssea femoral foram removidos e divididos, fornecendo alíquotas para posterior RT-PCR e suspensões celulares apropriadas para ensaios de citometria de fluxo específicos para a detecção da freqüência de populações CD34+. Nestes mesmos dias de experimento, alíquotas de sangue caudal foram coletadas para contagem de hemácias e plaquetas periféricas. Os resultados mostraram que a ausência da produção de interferon-gama no local irradiado aumenta a sobrevivência e a quantidade de células progenitoras hematopoiéticas e que a ausência de iNOS ou seu bloqueio funcional diminuem a extensão do dano radioinduzido nos tecidos hematopoiéticos. Além disso, foi possível observar que a suplementação com CXCL12 sintética aumenta a freqüência do fenótipo CD34+ P.chave: radiação ionizante; medula óssea; óxido nítrico; aminoguanidina nos baços dos modelos testados, e que seu efeito parece antagonizar com a inibição da produção de NO pela aminoguanidina. / This study aimed to evaluate the effect of inhibition of the inflammatory chains governed by the action of interferon-gamma (IFN-γ) and the enzyme inducible nitric oxide synthase (iNOS) in damage after radiation exposure to lethal dose (8 Gy) or moderate /severe dose (4 Gy) in hematopoietic tissues (spleen and bone marrow) of experimental models irradiated at these doses. Groups of isogenic C57Bl/6j mice were exposed to radiation (4 or 8 Gy) in whole-body exposures in a 60Co panoramic source. Similarly, were irradiated mice whose iNOS or IFN-γ expression was absent or undetectable. Other groups received orally in all days of experiments an inhibitor of iNOS activity, aminoguanidine, or CXCL12, a primordial chemokine known as an hematopoeisis promoter intraperitonially by days 0 to 4th after radiation events Another groups received the two agents concomitantly. The animals were sacrificed on days 2nd, 4th and 8th after irradiation, and fragments of the spleens and femurs were preserved for histology. Splenocytes and non-adherent cells from femoral bone marrow were removed and divided, providing aliquots for subsequent RT-PCR and cell suspensions suitable for flow cytometry experiments specific to the detection of the frequency of CD34+ cell populations. In same days of experiment, tail blood samples were collected for counting of peripheral red blood cells and platelets. The results showed that the absence of the production of interferon-gamma at the irradiated sites increases the survival and the amount of hematopoietic progenitor cells and that the absence of iNOS or its functional blockade reduces the extent of radioinduced damage in tested hematopoietic tissues. Furthermore, it was possible to observe that supplementing with synthetic CXCL12 increases the frequency of CD34+ Keywords: ionizing radiation, bone marrow, nitric oxide, aminoguanidine phenotype in the spleens of tested models, and that its effect seems to antagonize the inhibition of the production of NO by aminoguanidine.
772

Receptores vanilóides TRPV1 na retina. / Vanilloid TRPV1 receptors in the rat retina.

Leonelli, Mauro 22 February 2011 (has links)
A expressão do receptor de potencial receptor transiente, vanilóide 1 (TRPV1) começa desde estágios pré-sinaptogênicos da retina. O bloqueio farmacológico desse receptor nesse período diminui a apoptose fisiológica, havendo possível envolvimento da sinalização de MAP quinases. Na retina do animal adulto, observamos que a expressão de TRPV1 é amplamente difundida, albergando neurônios, células endoteliais e células da microglia. A ativação dos receptores TRPV1 é potencialmente citotóxica, e os mecanismos que podem estar envolvidos incluem a liberação de glutamato, a excitotoxicidade e o estresse nitrosativo. Evidenciamos que a lesão prévia de células ganglionares sensibiliza o tecido retiniano à citotoxicidade mediada pela estimulação de TRPV1. Porém, o bloqueio de TRPV1, tanto in vivo quanto in vitro, não inibiu a morte de células ganglionares axotomizadas. Esses dados sugerem que o receptor TRPV1 participa da modulação de diversos processos fisiopatológicos na retina. / TRPV1 expression in the developing retina begins before retinal sinaptogenesis. TRPV1 blockade reduced the normal apoptosis in this period, and MAPK signaling seems to be involved in this process. In the adult retina, TRPV1 are expressed in neuronal, endothelial and microglial cells. The activation of those receptors is potentially cytotoxic, and glutamate release and further excitotoxicity and nitrosative stress might be also involved. Axotomized retinal ganglion cells were sensitized to TRPV1 citotoxicity, but TRPV1 antagonism, both in vitro and in vivo, did not reduce the loss of ganglion cell after axotomy. Our results suggest that TRPV1 receptors are involved in synaptic function and homeostatic control in the retina. Moreover, TRPV1 seems to be indirectly involved in cellular degeneration that follows the section of retinal ganglion cell axons.
773

Ação da molécula doadora de óxido nítrico S-Nitrosoglutationa (GSNO) na leishmaniose cutânea experimental. / Activity of the nitric oxide donor S-nitrosoglutathione (GSNO) on experimental cutaneous leishmaniasis.

Costa, Inez Silva Fernandes 01 December 2009 (has links)
Os protozoários do gênero Leishmania são os agentes etiológicos da leishmaniose cutânea e visceral. A infecção é transmitida por insetos hematófagos, nos quais os parasitos se desenvolvem sob a forma promastigota. Nos hospedeiros mamíferos, incluindo a espécie humana, as formas encontradas são as amastigotas que proliferam nos macrófagos; estas células podem controlar a infecção produzindo radicais derivados do oxigênio e do nitrogênio. O óxido nítrico (NO) é um dos mais potentes radicais com atividade leishmanicida. Existem várias moléculas já descritas que liberam NO em meio aquoso ou quando adicionadas a suspensões celulares. São chamadas de doadoras de NO. Algumas destas vêm sendo estudadas pelo seu potencial terapêutico no tratamento das leishmanioses cutâneas. A molécula S-nitrosoglutationa (GSNO) pertence a um grupo de moléculas conhecido com S-nitroso-tióis e é um doador de NO relativamente estável. A GSNO havia sido previamente testada em culturas de formas promastigotas de L. amazonensis e causou a morte do parasito. O possível uso da GSNO na terapia das leishmanioses cutâneas demanda o conhecimento de suas ações sobre as formas amastigotas encontradas nos hospedeiros mamíferos. Terapias complementares aos antimoniais usados no tratamento da leishmaniose cutânea são necessárias porque estes são apenas injetáveis, têm efeitos colaterais e ocorrem altos índices de desistência do tratamento. O objetivo do trabalho foi analisar o efeito da molécula GSNO nas culturas de células THP-1 (linhagem de monócitos humanos leucêmicos) infectadas com L.major e o efeito da sua administração tópica diretamente na lesão ulcerada leishmaniótica de camundongos infectados. Os experimentos com células THP-1 infectadas com L. major e tratadas com GSNO, mostram marcada redução do parasitismo intracelular, dose dependente, em comparação às culturas sem tratamento. O tratamento com GSNO foi testado em camundongos Balb/c 8 infectados com L. major e em camundongos C57BL/6 desprovidos do gene de IFN<font face=\"symbol\">g- (Knockout de IFN ou IFN-<font face=\"symbol\">g KO) infectados com L. braziliensis. Grupos de animais foram infectados no dorso e após 60 dias iniciou-se o tratamento tópico com GSNO diluída em PBS, em GEL F127 ou com os respectivos veículos, como controles; ainda, outros grupos foram tratados sistemicamente (via endovenosa) com o antibiótico com ação leishmanicida, anfotericina B, ou com anfotericina B associada à aplicação tópica de GSNO. Foram feitas duas medições semanais das lesões. Decorridos aproximadamente 60 dias após o início do tratamento, os animais foram sacrificados e retirados o linfonodo drenante (inguinal superficial) e a lesão para fazer a quantificação parasitária. O tratamento tópico da infecção por L.major com a molécula GSNO reduziu o tamanho da lesão cutânea, chegando a se observar fechamento da úlcera em alguns animais; a carga parasitária no linfonodo drenante e/ou na lesão também sofreu redução. Nos camundongos IFN-<font face=\"symbol\">g KO infectados por L. braziliensis, também ocorreu inibição da progressão da lesão pelo tratamento local com GSNO em comparação ao grupo não tratado. Como conclusão, conseguimos demonstrar que GSNO apresenta efeito leishmanicida sobre formas amastigotas de L. major em cultura celular e reduz a lesão cutânea causada por L.major ou por L. braziliensis em comparação aos grupos controle. / Protozoa of the genus Leishmania are the etiological agents of cutaneous and visceral leishmaniasis. The infection is transmitted by hematophagous insects in which the parasite multiplies and differentiates as promastigotes. In the mammalian hosts, including man, the parasite proliferates as amastigotes inside macrophages; production of reactive oxygen or nitrogen intermediates (ROI and RNI) by these cells can control the infection. Nitric oxide (NO) is a very toxic RNI active against leishmania. The are many molecules that liberate NO in solution or when added to cellular suspensions. They are collectively called NO donors. A few of them have been studied because of their potential therapeutic use in cutaneous leishmaniasis. The molecule S-nitrosoglutathione (GSNO) belongs to the S-nitroso-thiols and is a relatively stable NO donor. GSNO has been previously tested and caused the death of L. amazonensis promastigotes in liquid culture. A putative application of GSNO in the treatment of cutaneous leishmaniasis requires the understanding of its activities on amastigote forms which are the parasite forms found in the mammalian host. Because the classical leishmaniasis treatment relies on injectable antimonial drugs which have many side effects, many patients abandon the treatment. Therefore, additional therapy to accelerate the cure is needed as well as new drugs are much needed. The aim of the present work is to analyze the effect of the molecule GSNO in cultures of THP-1 cells (a leukemia human monocyte cell line) infected with Leishmania major as well as the effect of administering it topically into the lesion of infected mice. The experiments done on L. major-infected THP-1 cells showed marked dose-dependent reduction of parasitism when compared to untreated infected cells. The topical treatment with GSNO was done in BALB/c mice infected with L. major and in C57BL/6 mice deprived of the IFN-<font face=\"symbol\">g gene (IFN- <font face=\"symbol\">g KO) infected with L. braziliensis. Groups of mice were infected in the shaven dorsal skin and 60 days later the topical treatment with GSNO dissolved in PBS, in GEL F127 was started. Still other groups were treated systemically (i.v.) with Amphotericin B which is leishmanicidal or with Amphotericin B associated to topically applied GSNO. The lesions were measured twice a week. After 60 days the mice were killed and the draining lymph node and the lesion were removed for quantifying the parasite numbers. The topical treatment of L. major-induced ulcer with GSNO reduced the size of the ulcer leading in some mice to complete healing; the parasitic loads in the draining lymph node or in the lesion were also reduced. In L. braziliensis-infected IFN-<font face=\"symbol\">g KO mice, inhibition of lesion growth also occurred in the mice topically treated with GSNO in comparison to the untreated control group. In conclusion we showed that GSNO is leishmanicidal to L. major intracellular amastigotes and that the topical treatment reduces the size of the lesion caused in mice by L. major or by L. braziliensis in comparison to the control groups.
774

Tnf(alpha)-dependent and Tnf(alpha)-independent Activation of Macrophage Effector Function

Clemons-miller, Annette R. 01 May 1998 (has links)
Tumor necrosis factor α (TNFα) is a pleiotropic cytokine that is predominantly produced by activated macrophages. The effects of TNFα are as diverse as the cells with which it interacts, e.g., stimulating fibroblast growth, exerting cytotoxic/cytostatic; activity against various human and murine cell lines, promoting inflammation through upregulation of endothelial adhesion molecules and IL-8 production. Yet TNFα is best known, and in fact was originally described, for its role in the bacterial-induced hemorrhagic necrosis of tumors and exacerbation of septic shock in which aberrant TNFα production leads to vascular collapse, cachexia, multiple organ failure, and ultimately death in as many as 100,000 people each year in the United States alone. LPS, a component of the outer cell wall of gram-negative bacteria, is the principal inducer of macrophage TNFα production. TNFα production can be enhanced by IFNγ which also induces upregulation of TNFα receptors allowing for the establishment of a TNFα autocrine loop. It has been hypothesized that autocrine TNFα stimulation plays a critical role in the induction of macrophage effector function, e.g., nitric oxide production. This dissertation represents efforts to evaluate the respective roles of the TNFα receptors in the induction of macrophage effector function, in addition to examining the mechanism by which autocrine TNFα exerts its effects on macrophages. Exploiting the species specificity of the murine TNFα receptor type 2 (TNF-R2), splenic macrophages were stimulated with human TNFα (which binds to TNF-R1 but not TNF-R2), in the presence of IFNγ. Human TNFα was effective in the induction of nitric oxide production, albeit at concentrations 12.5-fold greater than those required by murine TNFα to achieve the same result. Addition of anti-TNF-R1 completely inhibited the murine TNFα mediated induction of macrophage effector function. However, treatment with anti-TNF-R2 resulted in partial inhibition of macrophage activation. Taken together this data suggests that the primary TNFα mediated signals involved in macrophage activation are transduced through TNF-R1, although TNF-R2 appears to contribute to the intensity of the macrophage response. To evaluate the role of autocrine TNFα signaling in the induction of macrophage effector function, immortalized macrophages from normal C57Bl/6J mice (B6/J2) and C57Bl/6J mice containing gene targeted disruptions of the TNF-R1 and TNF-R2 genes (TRN) were stimulated under CD14-dependent and CD14-independent conditions. Although the B6/J2 and TRN clones mounted similar NO responses to LPS in the presence of serum, the TRN macrophages generated a weak nitric oxide response as compared to B6/J2 when stimulated with LPS under serum-free conditions. The involvement of TNFα autocrine stimulation in the CD14-independent activation was corroborated by the ability of soluble TNF-R1 to inhibit the response of B6/J2 macrophages to LPS in serum-free medium. CD14-independent LPS stimulation of TRN and B6/J2 resulted in equivalent levels of IL-1β, TNFα, and NOS gene expression, as determined by RT-PCR, and in release of equivalent amounts of biologically active TNFα. However, western blot analysis revealed that NOS protein production by TRN was as much as 50% less than that produced by B6/J2. These results indicate that autocrine TNFα stimulation contributes to the signaling pathways initiated by ligation of CD14-independent LPS receptors and may be involved in NOS post-transcriptional regulation.
775

Effects of Oxidized Low Density Lipoprotein on Nitric Oxide Production in Macrophages

Huang, Annong 01 December 1997 (has links)
The effects of oxidatively modified low density lipoprotein (oxLDL) on atherogenesis may be partly mediated by alterations in nitric oxide (NO) production by macrophages. A major goal of this study was to identify the lipid components in oxLDL modulating NO production. The effect of a water soluble antioxidants (N-acetylcysteine) and lipid soluble antioxidant (alpha-tocopherol) on NO production in macrophages was also determined. A second goal was to determine if the effects of oxLDL occurred at the transcriptional level. Human LDL was oxidized using an azo-initiator 2,2$\sp\prime$-azobis (2-amidinopropane) HCI (ABAP). OxLDL markedly decreased the production of NO in LPS stimulated RAW264.7 macrophages. This inhibition depended on the levels of LOOH formed in oxLDL and was not due to oxLDL cytotoxicity. In contrast, acetylated LDL (AcLDL) and native LDL showed only minor inhibition. Lipid hydroperoxides (LOOH) and lysophosphatidylcholine (lysoPC) are the primary products formed during LDL oxidation. 13-Hydroperoxyl octadecadienoic acid (13-HPODE) markedly inhibited NO production, whereas lysoPC showed only slight inhibition. Furthermore, the effects of 13-HPODE and lysoPC did not require their uptake in an AcLDL carrier. Pre-treatment of macrophages with alpha-tocopherol attenuated the inhibition due to oxLDL. Similarly, pre-treatment with N-acetylcysteine attenuated the inhibition caused by oxLDL or 13-HPODE. OxLDL was found to decrease iNOS protein and mRNA levels in RAW264.7 macrophages induced by LPS. The activation of NF-$\kappa$B was slightly suppressed after 45 minutes of treatment. 13-HPODE showed much stronger reduction of iNOS protein levels than lysoPC. These results suggest that oxLDL may inhibit NO production in macrophages at transcriptional level. 13-HPODE is likely to be the most important lipid component in oxLDL for the inhibitory effect. Antioxidants were found to preserve NO production in macrophages treated with either oxLDL or 13-HPODE. The physiological consequences of decreased NO production in macrophages caused by oxLDL are discussed with respect to atherosclerosis.
776

Mechanisms of H2O2-induced oxidative stress in endothelial cells

Coyle, Christian Hannon 01 January 2004 (has links)
Development of an in vitro model for the early stages of cardiovascular disease is a current necessity. Cardiovascular disease is the leading cause of death in the United States and throughout the world. Oxidative stress and reactive oxygen species have been implicated in cardiovascular disease development. An in vitro model of these processes will improve our understanding of cardiovascular disease development and allow for the development of additional treatments. Atherosclerosis is an inflammatory disease and increased levels of H2O2 are associated with inflammation. The model focuses on H2O2-induced oxidative stress under static and shear conditions. Previous studies have documented increased O2.- and increased cytotoxicity in smooth muscle cells exposed to H2O2. Under static culture, endothelial cells exposed to H2O2, exhibited increased O2.- over basal levels via NOS and NAPDH oxidase pathways. Increased O2.- was attenuated by MnSOD adenoviral-mediated upregulation and endothelial cell exposure to Tiron. This suggests NOS and NADPH oxidase as sources of increased O2.- under H2O2-induced oxidative stress. Endothelial cell cytotoxicity was increased with H2O2 exposure. The increase in cytotoxicity was diminished upon exposure to Tiron or L-NAME. Under shear conditions (8.2 dynes/cm2), endothelial cells exposed to H2O2 exhibited increased O2.- compared to control via an L-NAME (specific inhibitor NOS) and Apocynin (NADPH oxidase inhibitor) inhibitable mechanism. This suggests NOS and NADPH oxidase as sources of increased O2.- under H2O2-induced oxidative stress. The increased O2.- was attenuated with MnSOD adenoviral-mediated upregulation and endothelial cell exposure to Tiron (an O2.-scavenger). Endothelial cell attachment under shear with exposure to H2O2 was improved with MnSOD adenoviral-mediated upregulation as observed by decreased loss of the endothelial cell monolayer compared with H2O2 exposed endothelial cells. Endothelial cells exposed to H2O2 exhibit increased O2.-, suggesting that H2O2-induced oxidative stress may be a reasonable model for atherosclerosis. NOS and NADPH oxidase co-inhibition under shear and static culture demonstrated that NOS and NADPH oxidase inhibition is non-additive under static culture, yet additive under shear. Co-inhibition results suggest a complex relationship between the two enzymes that requires additional experimentation to deconvolve.
777

RAPID NO• MEASURES IN RAT NUCLEUS ACCUMBENS AND FRONTAL CORTEX FOLLOWING NASAL ADMINISTRATION OF NITROGLYCERIN

Scott, Victoria A. 01 January 2019 (has links)
Nitric Oxide (NO) is a powerful endogenous free radical that has numerous biological functions including vasodilation and serves as a post synaptic second messenger in the central nervous system (CNS). Numerous studies implicate NO• involvement in CNS disorders such as schizophrenia and drug abuse. These studies address the direct in vivo determination of an FDA-approved NO• donor (nitroglycerin) on extracellular levels of NO• in the frontal cortex and core of the nucleus accumbens in a lightly anesthetized rat. State-of-the-art in vivo amperometric recording techniques coupled with a novel 4-channel low noise pre-amplifier system and new generation microelectrode arrays (MEAs) will be used to record extracellular levels of NO• at 100Hz before and during nasal administration of either placebo (1) or nitroglycerin. This studies will determine the feasibility of measuring NO• in the CNS while administering the NO• donor nasally and determine the amplitude and kinetic time course effects of a nasally delivered NO• donor in two rat brain areas, the frontal cortex and core of the nucleus accumbens.
778

A Comparison of Exhaled Breath Nitric Oxide Between Old and Young Individuals

Gordon, Robert L. 30 March 2004 (has links)
BACKGROUND: Older individuals suffer from higher rates of pulmonary infections than younger individuals. In addition, older individuals have increased morbidity and mortality due to pulmonary infections when compared to younger individuals. The physiological and immunological reasons for these aforementioned differences are not clear. Recently, non-invasive markers of the lung's physiologic and immunologic status have been recognized. This study employs one of these non-invasive markers, exhaled nitric oxide, in an attempt to determine how the airways may change with age, predisposing older individuals to pulmonary diseases and poorer outcomes as compared to younger individuals. METHODS: Exhaled nitric oxide measurements were obtained from a group of 25 older subjects (61 to 79 years old, median 72 years old) and a group of 23 younger subjects (21 to 30 years old, median 24 years old) that were non-smokers with no history of pulmonary disease, no recent respiratory infections, and no history of environmental allergies. A focused history and physical exam along with spirometry were used to confirm the normal pulmonary status of each subject. Exhaled nitric oxide was measured following the American Thoracic Society recommendations using the Sievers Nitric Oxide Analyzer 280i. The exhaled nitric oxide values for the old and young groups were compared using the Wilcoxon Rank Sum test. RESULTS: For the older subjects, the median exhaled NO concentration was 36.9 ppb. For the younger subjects, the median exhaled NO concentration was 18.7 ppb. These exhaled NO concentrations are significantly different (p = 0.0011). CONCLUSIONS: The exhaled NO concentrations are significantly higher in older individuals than in younger individuals. The reasons for this difference along with the significance are unclear and further studies will be necessary to further evaluate these issues.
779

Reductive Activation of Nitric Oxide and Nitrosobenzene at a Dinickel(II) Dihydride Complex and New Pyrazole-Based Diiron Compounds

Ferretti, Eleonora 17 September 2018 (has links)
No description available.
780

Modulation of arterial stiffness by angiotensin receptors and nitric oxide in the insulin resistance syndrome

Brillante, Divina Graciela, Clinical School - St George Hospital, Faculty of Medicine, UNSW January 2008 (has links)
The insulin resistance syndrome [INSR] is associated with increased cardiovascular risk and affects up to 25% of the Australian population. The mechanism underlying the relationship between the INSR and increased cardiovascular risk is controversial. We postulated that perturbations in the renin-angiotensin system [RAS] and endothelium-derived NO may be implicated in the development of early vascular changes in the INSR. Repeated measurements of arterial stiffness [using digital photoplethysmography] and haemodynamic parameters in response to vasoactive medications were used to demonstrate the functional expression of angiotensin II [Ang II] receptors and NO synthase [NOS]. Ang II acts via two main receptor sub-types: the Ang II type 1 [AT1] and Ang II type 2 [AT2] receptors. The AT1 receptor is central to the development of arterial stiffness and endothelial dysfunction. The role of AT2 receptors in humans is controversial but is postulated to counter-act AT1 receptor mediated effects in diseased vascular beds. We demonstrated increased AT1 and AT2 receptor-mediated effects in small to medium-sized arteries of subjects with early INSR [Chapter 6]. In addition, functional expression of AT2 receptors in adult insulin resistant humans [Chapter 5], but not in healthy volunteers [Chapter 4] was demonstrated. AT1 receptor blockade in subjects with early INSR resulted in improvements in vascular function, with a consequent functional down-regulation of AT2 receptors [Chapter 7]. Functional NOS expression was demonstrated to be increased in subjects with early INSR compared with healthy controls [Chapter 6]. This was postulated to be a homeostatic response to counteract early vascular changes in subjects with early INSR. AT1 receptor blockade in these subjects reduced functional NOS expression [Chapter 8]. In conclusion, patients with early INSR represent a model of early disease where early intervention may be able to reverse the process incited by the initial exposure to multiple cardiovascular risk factors. Early vascular changes in these individuals are mediated at least in part, by increased AT1 receptor activity and/or expression, and may be detected by changes in arterial stiffness indices and non-invasive vascular reactivity studies. There is a compensatory increase in AT2 receptor and NOS expression/activity to counter-act these vascular changes.

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