The mammalian central nervous system maintains a delicate balance between neuronal excitation and inhibition. Conventional synaptic inhibition is mediated through the transient activity of postsynaptic γ-aminobutyric acid (GABA) at type A GABA (GABAA) receptors. A subset of GABAA receptors is also located outside of inhibitory synapses. These extrasynaptic receptors generate a tonic inhibitory conductance in response to low concentrations of extracellular GABA. Tonic inhibition broadly suppresses neuronal activity and regulates many vital processes such as sleep, consciousness and memory formation. This thesis examines the physiological effects of tonic inhibition at the cellular level and in the behaving animal. This thesis also explores whether gabapentin, a commonly used sedative, anxiolytic, and analgesic drug, enhances tonic GABAergic inhibition. I hypothesize that: (1) tonic GABAA receptor activity reduces the intrinsic excitability of neurons; (2) the activity of tonically active GABAA receptors in spinal pain pathways attenuates nociception; and (3) tonic inhibition can be upregulated by gabapentin. The results show that a tonic inhibitory current generated by α5 subunit-containing GABAA (α5GABAA) receptors reduces the excitability of hippocampal pyramidal neurons excitability by increasing the rheobase, but does not change the gain of action potential firing. A similar shunting inhibition is present in spinal cord lamina II neurons that is generated by δ subunit-containing GABAA receptors. The activity of these receptors in spinal nociceptive pathways reduces acute thermal nociception and may constrain central sensitization in a behavioural model of persistent pain. Finally, gabapentin increases a tonic inhibitory current in cultured hippocampal neurons independent from changes in the expression of α5GABAA receptors or in the concentration of GABAA receptor ligands. The results of this thesis demonstrate that tonically active GABAA receptors play an important role in the regulation of neuronal activity and nociception, and that tonic inhibition represents a novel target of therapeutic drugs.

Relatively few studies have examined the effects of nociception pe se on sympathetic nerve activity in awake healthy human subjects. Painful stimuli can produce differential responses from cutaneous and muscle postganglionic sympathetic neurones in the anaesthetised cat, and some animal and human studies suggest that nociceptive stimuli originating in different tissues may produce differential sympathetic effects- deep nociception causing vasodepressive and superficial nociception triggering an excitatory effect on cardiovascular state. It is important to understand how the sympathetic nervous system responds to nociception in healthy subjects in order to make more meaningful comparisons with the behaviour which occurs following damage to sympathetic pathways, e.g. nerve lesions (chronic regional pain syndromes) and spinal cord injury (autonomic dysreflexia (AD)). Additionally, it has been suggested that muscle spindles afferents may play a role in chronic pain, most notably the 'vicious cycle' of pain. While this has been investigated in animal studies, it has not been thoroughly investigated in healthy human subjects. Muscle spindle and sympathetic nerve activity from muscle and skin postganglionic neurones were directly recorded in healthy awake human subjects using microneurography; effector organ responses (blood pressure, heartrate, skin blood flow and sweat release) were recorded in both healthy and spinal cord injured subjects. Deep and superficial nociception was induced by intramuscular and subdermal injections of hypertonic saline given at unexpected times and in quasi-random order. Regardless of the origin of nociception (deep or superficial), general responses tended to be excitatory with increases seen in muscle and skin sympathetic nerve activity, heartrate, blood pressure and sweat release. A gender effect was noted regarding skin blood flow, with males largely showing decreases and females increases. No changes were noted in spindle firing rates and painful stimuli did not significantly increase effector organ responses in spinal cord injured subjects. Contrasting with previous studies, we did not see a differential sympathetic response or change in spindle firing rate to painful stimuli originating in different tissues. While it is believed that noxious stimuli trigger AD, we did not see exaggerated sympathetic responses in spinal cord injured subjects. More investigation is required regarding innocuous triggers of AD.

Migraine, a neurovascular disorder, is associated with disturbances in brain stem activity during attacks. Interictal persistence of these disturbances might increase vulnerability to recurrent attacks of migraine. To explore this possibility, effects of motion sickness and pain on migrainous symptoms and extracranial vascular reponses were investigated in 27 migraine sufferers in the headache-free interval, and 23 healthy age/sex matched controls. Symptoms of migraine and motion sickness are remarkably similar. As both maladies involve reflexes that relay in the brain stem, they most probably share the same neural circuitry. Furthermore, migraineurs are usually susceptible to motion sickness and, conversely, motion sickness-prone individuals commonly experience migraine. Participants in the present study were exposed to optokinetic stimulation (OKS), a well-established way of inducing symptoms of motion sickness in susceptible individuals. Sensitivity to painful stimulation of the head and hand was also explored. Head pain is a hallmark of a migraine attack and cutaneous allodynia has been observed elsewhere in the body during attacks. The trigeminal nerve is associated with head pain in migraine, and trigeminal activity evokes reflexes that relay in the brain stem. To stimulate the trigeminal nerve, ice was applied to the temple. To stimulate nociceptors elsewhere in the body the participant immersed their fingers and palm in ice-water. Procedures used in this study were physically stressful and probably psychologically stressful. The impact of stress in relation to the development of symptomatic and vascular responses, particularly anticipatory stress-responses, was explored. This research involved one central experiment that consisted of six experimental conditions. On separate occasions participants were exposed to optokinetic stimulation and painful stimulation of the head or limb, individually and in combination. In migraine sufferers, symptomatic responses were enhanced during all procedures involving OKS and during temple pain after OKS, in the presence of residual motion sickness. During trigeminal stimulation independent of OKS, headache initially developed followed by nausea as the procedure progressed. In contrast, symptoms barely developed in controls during any of the six procedures except for slight dizziness, self-motion and visual-illusion during conditions involving OKS, and slight nausea when the temple was painfully stimulated during OKS and during OKS alone. Trigeminal stimulation during OKS intensified nausea and headache in migraine sufferers compared to during OKS alone or limb pain during OKS. However, the remaining symptomatic ratings were not affected by temple pain during OKS, suggesting a specific association between nausea and head pain. It may be that these cardinal symptoms compound one another during a migraine attack. Enhanced symptomatic responses in migraine sufferers during the headache interval may indicate activation of hypersensitive neural pathways that mediate symptoms of motion sickness or migraine. Migraineurs found procedures generally more unpleasant, and ice-induced pain ratings more intense and unpleasant, than controls, which may further indicate hyperexcitable nociception in this group, or a difference in their criterion of discomfort. Vascular responses, particularly during OKS alone, and during painful stimulation independent of OKS, were greater in migraine sufferers than in controls. The added stress of painful stimulation during OKS appeared to boost facial blood flow in controls to approach levels obtained in migraine sufferers. Enhanced vasodilatation was observed in migraineurs prior to painful stimulation, presumably due to anticipatory anxiety. For both groups ipsilateral vascular responses were greater than contralateral responses when the hand was painfully stimulated. During limb pain before OKS asymmetry was minimal in migraine sufferers but more apparent in controls. An enhanced stress response in migraineurs may have drawn ipsilateral and contralateral responses closer together. The development of symptoms during the procedures of this study provides an insight into how symptoms might develop sequentially in a migraine attack. Once the headache is in motion, nausea and headache may mutually exacerbate one another. In turn, trigemino-vascular responses and stress appear to be associated with the migraine crisis. Given the interactive nature of symptomatic, vascular, and stress responses, it may be more effective to target multiple, rather than individual, symptoms, in prophylactic or acute chemical and psychological interventions.

Relatively few studies have examined the effects of nociception pe se on sympathetic nerve activity in awake healthy human subjects. Painful stimuli can produce differential responses from cutaneous and muscle postganglionic sympathetic neurones in the anaesthetised cat, and some animal and human studies suggest that nociceptive stimuli originating in different tissues may produce differential sympathetic effects- deep nociception causing vasodepressive and superficial nociception triggering an excitatory effect on cardiovascular state. It is important to understand how the sympathetic nervous system responds to nociception in healthy subjects in order to make more meaningful comparisons with the behaviour which occurs following damage to sympathetic pathways, e.g. nerve lesions (chronic regional pain syndromes) and spinal cord injury (autonomic dysreflexia (AD)). Additionally, it has been suggested that muscle spindles afferents may play a role in chronic pain, most notably the 'vicious cycle' of pain. While this has been investigated in animal studies, it has not been thoroughly investigated in healthy human subjects. Muscle spindle and sympathetic nerve activity from muscle and skin postganglionic neurones were directly recorded in healthy awake human subjects using microneurography; effector organ responses (blood pressure, heartrate, skin blood flow and sweat release) were recorded in both healthy and spinal cord injured subjects. Deep and superficial nociception was induced by intramuscular and subdermal injections of hypertonic saline given at unexpected times and in quasi-random order. Regardless of the origin of nociception (deep or superficial), general responses tended to be excitatory with increases seen in muscle and skin sympathetic nerve activity, heartrate, blood pressure and sweat release. A gender effect was noted regarding skin blood flow, with males largely showing decreases and females increases. No changes were noted in spindle firing rates and painful stimuli did not significantly increase effector organ responses in spinal cord injured subjects. Contrasting with previous studies, we did not see a differential sympathetic response or change in spindle firing rate to painful stimuli originating in different tissues. While it is believed that noxious stimuli trigger AD, we did not see exaggerated sympathetic responses in spinal cord injured subjects. More investigation is required regarding innocuous triggers of AD.

Made available in DSpace on 2015-05-14T12:59:41Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2581356 bytes, checksum: 263a53dd1bd0ffe8ccf75ad8984a3779 (MD5) Previous issue date: 2012-12-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Nerolidol, an acyclic sesquiterpene found as the major component in several essential oils, has antineoplastic, antimicrobial and antileishmanial activities, however its action in painful processes has never been studied. This study investigated the antinociceptive and anti-inflammatory activities of nerolidol in experimental pain and inflammation models in mice. On the pharmacological behavioral screening, the different doses tested by the nerolidol had psicodepressors behavioral changes such as decreased ambulation and analgesia. The LD50 could not be determined, since there were no deaths until the maximum dose of 2000 mg/kg. Motor coordination, evaluated through the rotarod test, was not altered in animals treated with nerolidol in any of the doses used. After, methods to evaluate the antinociceptive activity were used. Nerolidol reduced the number of acetic-acid induced abdominal contractions compared to the control group in all of the three doses tested. The formalin test, inhibited licking time both in the first phase (0 5 min) and in the second phase (15 30 min). Under the hot-plate test, nerolidol did not alter latency at any of the observed time-points. The mechanism of action of the antinociceptive property of nerolidol was assessed using the formalin test. The antinociception produced by nerolidol was significantly blocked in animals pre-treated with bicuculline (1 mg/kg, i.p.), indicating the involvement of GABAergic system. However, the effect of nerolidol was not reversed by the naloxone (non selective opioid antagonist, 5 mg/kg, s.c.) and glibenclamide (K +ATP channels bloker, 10 mg/kg, i.p.), demonstrating that at least directly, the nerolidol does not act by these mechanisms. The treatment with nerolidol was able to reduce the paw edemas induced by carragenina. At the model of peritonitis induced by carraggenan, nerolidol decreased the influx of leukocytes and also the levels of TNF-α in the peritoneal fluid. Therefore, these results indicate that nerolidol has antinociceptive activity with possible participation of the GABAergic system. Besides, nerolidol has anti-inflammatory activity that may be attributed to inhibition pro-inflammatory cytokines production TNF-α. / O nerolidol, sesquiterpeno acíclico encontrado como constituinte majoritário em vários óleos essenciais, apresenta atividade antineoplásica, antimicrobiana e leishmanicida, porém sua ação em processos dolorosos nunca foi estudada. Este trabalho visa investigar a atividade antinociceptiva e anti-inflamatória do nerolidol em modelos experimentais de dor e inflamação em camundongos. Na triagem farmacológica comportamental, as diferentes doses testadas do nerolidol apresentaram alterações comportamentais psicodepressoras, tais como ambulação diminuída e analgesia. A DL50 não pôde ser determinada, uma vez que não se observaram mortes até a dose máxima de 2000 mg/kg. A coordenação motora, avaliada no teste do rota-rod, não foi alterada nos animais tratados com nerolidol em nenhuma das doses. Em seguida, metodologias foram realizadas para avaliar a atividade antinociceptiva. O nerolidol reduziu o número de contorções abdominais induzidas por ácido acético, quando comparado ao grupo controle nas três doses testadas. No teste da formalina, foi capaz de inibir o tempo de lambida tanto na primeira fase (0-5min) quanto na segunda fase (15-30 min). No teste da placa quente, o nerolidol não alterou a latência em nenhum dos tempos observados. O mecanismo de ação da propriedade antinociceptiva do nerolidol foi avaliado através do teste da formalina. A antinocicepção produzida pelo nerolidol foi significativamente bloqueada em animais pré-tratados com bicuculina (1 mg/kg, i.p.), indicando o envolvimento do sistema GABAérgico. O efeito antinociceptivo do nerolidol, contudo, não foi revertido pela naloxona (antagonista não seletivo dos receptores opioides, 5 mg/kg, s.c.) e pela glibenclamida (bloqueador dos canais de K+ATP, 10 mg/kg, i.p.), sugerindo que o nerolidol não atua por esses mecanismos. O tratamento com o nerolidol foi capaz de reduzir o edema de pata induzido por carragenina. No modelo da peritonite induzida por carragenina, o nerolidol diminuiu o influxo de leucócitos e também os níveis de TNF-α no lavado peritoneal. Sendo assim, esses resultados mostram que o nerolidol tem atividade antinociceptiva com possível participação do sistema GABAérgico Além disso, o nerolidol possui atividade anti-inflamatória que pode ser atribuída à inibição da produção da citocina pró-inflamatória TNF-α.

Fabaceae family is one of the largest botanical families and of wide geographic distribution. Erythrina genus is among the several genus of this family. Erythrina mulungu, popularly known as mulungu, is a native tree of the southeast and northeast of Brazil. In the herbal medicine is considered an excellent sedative to treat anxiety, nervous coughs, agitation psicomotory and insomnia, besides asthma, bronchitis, hepatitis, gengivite, hepatic and esplenics inflammations and fevers. This work had as aim accomplishes the phytochemical investigation of the crude ethanolic extract of the root of E. mulungu, and the pharmacological evaluation of the ethanolic extracts of the root bark, root, stem bark and stem. As result, it has been isolated two substances of the root of E. mulungu, that were identified by infrared, 1H and 13C NMR analyses as Quercitrin and Luteollin, obtained from the chloroformic and Ethyl Acetate phases, respectively. These substances had never been isolated before from this species. All of the tested crude extracts, as well as the chloroformic and ethyl acetate phases of the root exhibited a significantly inhibition of the contortions induced by acetic acid. In the hot plate test, any extract and/or phase presented antinociceptive effect, indicating that the tested extracts and phases don t have central analgesic action. In the first phase of the formalin test, no sample presented significant statistic effect, and in the second phase, all of the extracts and phases induced reduction of the time of latency. In the peritonitis test all of the extracts and the chloroformic phase reduced the number of cells significantly in the peritoneal washed. Finally, we can conclude that the two identified substances are valuable for literature, once this is the first time they were isolated of this species; and the pharmacological tests were showed promising antiinflammatory potential for Erythrina mulungu. / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A família Fabaceae é uma das maiores famílias botânicas e de ampla distribuição geográfica. O gênero Erythrina está dentre os vários gêneros desta família. Erythrina mulungu, popularmente conhecida como mulungu, é um arbusto nativo do sudeste e nordeste do Brasil. Na medicina herbária é considerada um excelente sedativo para tratar ansiedade, tosses nervosas, agitação psicomotora e insônia, além de asma, bronquite, hepatite, gengivite, inflamações hepáticas e esplênicas e febres. Este trabalho teve como objetivo realizar a investigação fitoquímica do extrato etanólico bruto da raiz de E. mulungu, com a avaliação farmacológica dos extratos etanólicos da casca da raiz, raiz, casca do caule e caule. Como resultado, foram isoladas duas substâncias da raiz de E. mulungu, que através de análises de infravermelho, RMN de 1H e 13C, e comparação com dados da literaura, foram identificadas como Quercitrina, proveniente da fase clorofórmica; e Luteolina, proveniente da fase Acetato de Etila, substâncias estas nunca relatadas antes na espécie. Todos os extratos brutos testados, assim como as fases clorofórmica e acetato de etila da raiz exibiram uma inibição significativa das contorções induzidas por ácido acético. Já no teste da placa quente, nenhum extrato e/ou fase apresentou efeito significante, indicando que as amostras testadas não têm ação analgésica central. Na primeira fase do ensaio de nocicepção induzida por formalina, nenhuma amostra apresentou resultado estatisticamente significante, e na segunda todos os extratos e fases induziram redução do tempo de latência. No ensaio de peritonite todos os extratos e a fase clorofórmica reduziram significativamente o número de células no lavado peritoneal. Sendo assim, pode-se concluir que as duas substâncias identificadas são de grande valia para literatura, uma vez que esta é a primeira vez em que foram isoladas desta espécie; e os testes farmacológicos se mostraram promissores no que diz respeito ao potencial anti-inflamatório para Erythrina mulungu.

Despite existing several pharmacological alternatives, it is growing the number of researchers interested in studying the pathophysiology and mediators of inflammation, because the drugs that are currently available on the market have limited efficiency and/ or have adverse effects that limit their use. Thus, it is necessary to continue the research in the search for more effective options. One alternative is the use of Punica granatum (pomegranate) that in the literature there are reports of the use of many of its parts in the treatment of infectious and inflammatory diseases. Considering the results obtained in previous studies on the actions of P. granatum and the need to increase the knowledge about their applications, this study aimed to evaluate the anti-nociceptive and anti-inflammatory potencial effects of ethanolic extract from fruits peels's Punica granatum (EEPG). Peels, from Maragogi-AL, were lyophilized, grinded, macerated in ethanol PA, filtered and the final product rotaevaporated, obtaining 65 g EEPG in which the phytochemical analysis revealed the presence of flavonoids, tannins and saponins. Toxicity tests were performed in vitro (MTT assay at doses of 1, 10 and 100 mg/ mL) and in vivo (acute toxicity test at doses of 500 and 1000 mg/ kg). To evaluate the antinociceptive activity were used as experimental models: writhing test induced by acetic acid, the hot plate test and formalin and glutamate-induced nociception. Anti-inflammatory activity evaluation was analyzed in the arthritis assay Freund agent-induced. To rule out a possible effect to alter the motor performance of the animals, the open field test was performed. Our results showed that the doses used showed no signs of toxicity in animals, with no death, change in weight or appetite, or change other parameters analyzed, whereas at the cellular level submaximal doses tested showed no cytotoxicity. EEPG treatment induced inhibition significantly and dependent-dose (ID50 = 7.9 ± 1.7 mg/ kg), the nociceptive action of acetic acid and Emax of 98.8 ± 1.2% was reached at the dose 100 mg/ kg. In the hot plate test no change in the latency time of the animals was observed. In the formalin test, the EEPG (100 mg/ kg, p.o.) did not inhibit the neurogenic phase (1st phase). However, the inflammatory phase (phase 2) was inhibited for 51.7%. For the induction of nociception induced by glutamate was observed that the EEPG possibly acts modulating negatively this pathway, either by antagonizing their actions receptor-mediated or inhibiting the L-arginine-nitric oxide pathway. In the arthritis assay, all doses tested were able to decrease inflammation in the paw from the 3rd day of treatment, extending to the end of it. Finally, in the open field test, it was possible to observe that no satisfactory change of analyzed motor parameters, rulling out a possible effect on this system. The results of this study not only support research on natural products, but also to search for new analgesic and anti-inflamatory drugs. Further studies are needed to define the mechanisms of action of the antinociceptive and anti-inflammatory activities of the fruits peel's of P. granatum, however, the results support the popular use of this plant. / Apesar das diversas alternativas farmacológicas existentes, é crescente o número de pesquisadores interessados em estudar os mediadores e a fisiopatologia da inflamação, pois os medicamentos que estão disponíveis no mercado apresentam eficácia limitada e/ou possuem efeitos adversos que restringem sua utilização. Sendo assim, é necessário que as pesquisas continuem na busca por opções mais eficazes. Uma das alternativas é a utilização de Punica granatum (romã) que na literatura há referência do uso de várias partes no tratamento de doenças infecciosas e inflamatórias. Diante dos resultados de estudos anteriores sobre as ações da P. granatum e a necessidade de aumentar o conhecimento sobre suas aplicações, este estudo experimental tem como objetivo avaliar o potencial antinociceptivo e anti-inflamatório do extrato etanólico da casca do fruto da Punica granatum (EEPG). As cascas, provenientes de Maragogi-AL, foram liofilizadas, trituradas, maceradas em etanol PA, filtradas e o produto final rotaevaporado, obtendo-se 65 g de EEPG que à análise fitoquímica constatou-se a presença de flavonoides, saponinas e taninos. Foram realizados ensaios de toxicidade in vitro (ensaio de MTT, nas doses de 1, 10 e 100 μg/mL) e in vivo (ensaio de toxicidade aguda, nas doses de 500 e 1000 mg/kg). Para avaliar a atividade antinociceptiva foram usados como modelos experimentais: ensaio de contorção abdominal induzido por ácido acético, teste da placa quente e nocicepção induzida por formalina e glutamato. A avaliação da atividade anti-inflamatória foi analisada no ensaio de artrite induzida por agente de Freund. Para descartar um possível efeito que alterasse a performance motora dos animais, foi realizado o teste do campo aberto. Os resultados mostraram que as doses utilizadas não demonstraram sinais de toxicidade nos animais, não havendo morte, alteração de peso ou apetite, nem alteração dos outros parâmetros analisados; enquanto que em nível celular as doses submáximas testadas não apresentaram citotoxicidade. O tratamento com EEPG induziu a inibição, de forma significativa e dose-dependente (DI50 = 7,9 ± 1,7 mg/kg) da ação nociceptiva do ácido acético e o Emax de 98,8 ± 1,2% foi alcançado na dose de 100 mg/kg. No ensaio de placa quente não foram observadas alterações no tempo de latência dos animais. No ensaio de formalina, o EEPG (100 mg/kg, v.o.) não inibiu a fase neurogênica (1ª fase). No entanto, a fase inflamatória (2ª fase) foi inibida em 51,7%. Na indução de nocicepção induzida por glutamato observou-se que o EEPG possivelmente age modulando negativamente esta via, seja por antagonizar suas ações via receptor ou inibição da via L-arginina-óxido nítrico. No ensaio de artrite, todas as doses testadas foram capazes de diminuir a inflamação na pata a partir do 3º dia de tratamento, prolongando-se até o final do mesmo. Por fim, no teste do campo aberto, foi possível obervar que não houve alteração satisfatória dos parâmetros motores analisados, descartando-se um possível efeito sobre esse sistema. Os resultados obtidos neste trabalho dão suporte não somente a pesquisa com produtos naturais, como também à pesquisa por novos fármacos analgésicos e anti-inflamatórios. Novos estudos são necessários para definição dos mecanismos de ação da atividade antinociceptiva e anti-inflamatória da casca do fruto da P. granatum, porém, os resultados obtidos dão suporte ao uso popular da planta.

Introdução: Estudos em animais e em humanos demonstram que o alto consumo de cafeína pode promover riscos e complicações obstétricas podendo resultar em eventos teratogênicos na prole, como alterações esqueléticas, retardo no crescimento intrauterino e baixo peso ao nascer e a partos prematuros. Embora a relação entre o consumo de cafeína durante a gravidez e seus efeitos tóxicos sobre o desenvolvimento embrionário venham sendo alvo de vários estudos, seus mecanismos ainda não estão totalmente esclarecidos. Objetivos: avaliar os efeitos da utilização crônica de cafeína no período gestacional e neonatal sobre o desenvolvimento da prole, reflexos motores, comportamentos, resposta nociceptiva, atividade e expressão em hipocampo da acetilcolinesterase e, atividade de ectonucleotidases em medula espinhal de ratos. Métodos: o ciclo estral das ratas com aproximadamente 90 dias (peso 200-300 g) foi avaliado por meio de esfregaço de lavado vaginal. Sendo a prenhez confirmada, as ratas foram divididas em 3 grupos experimentais: (1) controle; (2) cafeína; e (3) abstido de cafeína. As ratas controles recebiam somente água, as do grupo cafeína recebiam 0,3 g/L de solução de cafeína diluída em água e as abstidas recebiam a mesma solução até o 7º dia de vida pós-natal (P7) da prole, sendo após substituída por água. O dia do nascimento foi considerado P0, padronizou-se 8 machos por ninhada. O comportamento de endireitamento postural e resposta a geotáxia negativa foram avaliados do P1 até P14 e utilizados como parâmetros dos reflexos motores da prole. No final do tratamento (P14) foram avaliados: (1) o limiar nociceptivo, utilizando aparelho de tail-flick; (2) a atividade locomotora no campo aberto (3) a funcionalidade dos receptores de adenosina, por meio da administração de agonistas e antagonistas adenosinérgicos; (4) hidrólise de nucleotídeos em sinaptossomas de medula espinhal; e (5) a atividade e a expressão gênica da enzima acetilcolinesterase em hipocampo. Os dados foram expressos em Média+Erro Padrão da Média (EPM), e analisados utilizando ANOVA de uma via/Tukey e ANOVA de duas vias de medidas repetidas/Tukey de acordo com cada experimento, as diferenças foram consideradas significativas quando P<0,05. Resultados: os animais dos grupos cafeína e abstido apresentaram um atraso no desenvolvimento dos reflexos neurológicos ao longo dos 14 dias de vida quando comparados ao grupo controle. No campo aberto, os animais do grupo cafeína apresentaram diminuição no tempo total de locomoção e cruzamentos externos em relação ao controle. O grupo abstido aumentou cruzamentos internos e diminuiu rearing. No teste de tail-flick, não observou-se diferença entre os grupos. Apesar de não haver diferença entre os grupos na resposta nociceptiva basal no teste de tail-flick, quando avaliamos a funcionalidade dos receptores de adenosina do tipo A1, observou-se que o grupo cafeína teve sua resposta diminuída ao agonista adenosinérgico (CPA) e o grupo abstido apresentou este efeito parcialmente revertido, demonstrando não ser um efeito de longa duração. No entanto, não foram observadas diferenças entre os grupos nas atividades de NTPDases e de 5’nucleotidase. Adicionalmente, observamos uma diminuição significativa na atividade da acetilcolinesterase (AChE) em hipocampo dos animais cafeínados comparados aos controles sem diferenças em sua expressão gênica, sugerindo assim que a baixa atividade desta enzima esta relacionada a mudanças pós-traducionais. Conclusão: Nossos resultados demonstram que o uso de cafeína durante a gestação e lactação pode trazer prejuízos ao desenvolvimento da prole, salientando a importância da restrição de alimentos e preparações que contenham esta substancia durante estes períodos. / Introduction: Studies in animals and humans show that high consumption of caffeine can promote risks and obstetric complications may result in teratogenic events in the offspring, such as skeletal abnormalities, intrauterine growth retardation and low birth weight and premature births. Although the relationship between caffeine consumption during pregnancy and its toxic effects on embryonic development may be the target of several studies, its mechanisms are not fully understood. Objectives: the aim was to evaluate the effects of gestational chronic caffeine intake and neonatal offspring development, neurological reflexes, behavior, nociceptive response, acetylcholinesterase activity and expression in hippocampus and ectonucleotidases activity in spinal cord of rats. Methods: adult female Wistar rats were performed vaginal lavage to verify the estrous cycle. Mating was confirmed by sperm presence in vaginal smears. On the first day of pregnancy, rats were divided into three groups: (1) control, (2) caffeine and (3) washout. Control animals received only water; caffeine group received caffeine solution 0.3 g / L diluted with water and the washout group received the same caffeine solution until the 7th day (P7), which was replaced by water. The birth date was considered P0, animals were standardized at 8 male animals per group. The righting reflex (RR) and negative geotaxis (NG) behaviors were measured from P0 to P14 and were using as motor reflexes. At P14 were evaluated: (1) the nociceptive response by tail-flick latency (TFL); (2) locomotor activity by open field test (OF); (3) functionality of A1 adenosine receptors by agonist and an antagonist administration of DPCPX and CPA; (4) nucleotides and nucleoside hydrolysis by spinal cord synaptosomes and (5) acetylcholinesterase (AChE) activity and gene expression in hippocampus. Data were expressed as mean ± SEM and analyzed using one-way ANOVA / Tukey and repeated measures ANOVA/Tukey, values were considered significant if P<0.05. Results: caffeine and washout groups presented a delay in the development of neurological reflexes over the 14 days of life when compared to the control group. In the open field, caffeine group showed a decrease in the total time of locomotion and outer crossing in relation to control. The washout group presented increase in inner crossing and decrease in rearing behavior. In the tail-flick test, no difference was observed between groups. Although there is no difference between the groups in baseline nociceptive response in the tail-flick test, when evaluating the functionality of A1 adenosine receptors, caffeine group presented a decreased response to adenosinergic agonists (CPA) and the washout group presented partially reversed of this effect, demonstrating it is not a long duration effect. However, no differences were observed between groups in the activities of NTPDase and 5'nucleotidase. Additionally, we observed a significant decrease in the activity of acetylcholinesterase in hippocampus of caffeine group compared to controls without differences in their gene expression, suggesting that the low activity of this enzyme is related to post-translational changes. Conclusion: Our results demonstrate that caffeine intake during pregnancy and lactation can bring harm to the offspring developing. Therefore, it becomes increasingly important restriction of food and caffeine-containing preparations during the embryonic period.

OLIVEIRA, Jefferson Soares de. Múltiplas proteínas estão envolvidas nas atividades antiinflamatória e antinociceptiva do látex da planta medicinal Calotropis procera (AIT.) R. Br. 2009. 101 f. Dissertação (Mestrado em Bioquímica) - Universidade Federal do Ceará, Fortaleza-CE, 2009. / Submitted by Eric Santiago (erichhcl@gmail.com) on 2016-05-25T13:19:57Z No. of bitstreams: 1 2009_dis_jsoliveira.pdf: 2272072 bytes, checksum: 0182fc53b1ceb0d4a37902cd816bcd13 (MD5) / Approved for entry into archive by José Jairo Viana de Sousa (jairo@ufc.br) on 2016-07-05T20:11:29Z (GMT) No. of bitstreams: 1 2009_dis_jsoliveira.pdf: 2272072 bytes, checksum: 0182fc53b1ceb0d4a37902cd816bcd13 (MD5) / Made available in DSpace on 2016-07-05T20:11:29Z (GMT). No. of bitstreams: 1 2009_dis_jsoliveira.pdf: 2272072 bytes, checksum: 0182fc53b1ceb0d4a37902cd816bcd13 (MD5) Previous issue date: 2009 / Latex is a general term used to describe fluid exudates from plants after mechanical injury. Latex from Calotropis procera is well known for its medicinal properties mainly in Indian traditional medicine. Moreover, it has been experimentally shown that it exhibits interesting biological activities such as anti-inflammation. However its latex has been reported to induce proinflammatory responses. In the present work, (1) the latex was fractionated to segregate pro- and anti-inflammatory activities; (2) assays were carried out to characterize the mechanism of action of active fractions and (3) attempts were done to identify molecules involved in anti-inflammatory and antinociceptive activities. First, the latex was collected in distilled water (1:1; v/v) and submitted to centrifugation and dialysis steps to obtain three different fractions (FD, PL and B). These fractions were evaluated to pro- and anti-inflammatory activities using peritonitis model in rats. FD, constituted by compounds with molecular mass lower than 8,000 Da, did not exhibited anti-inflammatory activity, however induced intense neutrophil migration into peritoneal cavity of rats. The inflammation induced by FD was time and dose dependent. Moreover, it was seen that previous injection of Dexamethasone, Thalidomide and Meclizine in animals inhibited FD inflammatory responses suggesting that inflammation triggered by this fraction occurs through histamine and TNF-α release. Peptides, present in FD as shown in electrophoresis, should be involved in inflammation responses displayed by FD since such activity was diminished after 24 hour pronase treatment. Fractions PL, and B did not induce inflammatory response when injected into peritoneal cavity of animals, however intravenous injection displayed strong anti-inflammatory activity against inflammation induced by carrageenan. The anti-inflammatory activity promoted by B seems to be related to PL proteins present in B. PL fraction inhibited neutrophil migration trigged by FD. PL anti-inflammatory activity ought to be related to proteins since such activity was completely abolished after heat or pronase treatment and it still remained after acetone precipitation. Three protein sub-fractions (PI, PII and PIII) were recovered after PL chromatography on ion-exchange column (CM-Sepharose Fast flow) at pH 5.0. In spite of the fact that PI, PII e PIII were seen to be different by electrophoresis they were equally able to inhibit neutrophil migration induced by carrageenan in rats as well as abdominal writhes stimulated by acetic acid in mice. Intravital microscopy assay revealed that, PI, PII and PIII inhibit both leucocyte rolling and adhesion in mice mesenteric tissues. In addition, PI was able to induce nitric oxid production and inflammation induced by FD. These results show that multiples proteins in PL display anti-inflammatory activity and they act at different pathway of inflammation. Several experiments were performed aiming to detect the anti-inflammatory activity of PL when it was administered by oral route however, we did not obtain success. This is the first report which confirms the presence of pro- and anti-inflammatory activities and it shows that such activities are displayed by compounds suitable to be fractionated on the basis of their molecular size. In addition, these results show that anti-inflammatory and antinociceptive activities are displayed by proteins present in the latex / A planta Calotropis procera, pertencente à família Apocinaceae, tem como uma de suas principais características a produção constitutiva de látex. Este fluido é amplamente utilizado na medicina popular, principalmente da Índia, por apresentar diversas propriedades curativas. Na literatura, o produto da extração do látex íntegro com solvente aquoso e/ou orgânico desta planta é citado por apresentar atividade antinociceptiva e antiinflamatória. Por outro lado, a mesma preparação do látex também é relatada por induzir processos inflamatórios. O presente trabalho teve como objetivo fracionar o látex da planta Calotropis procera para separar as atividades pró- e antiinflamatória; caracterizar estes mecanismos e avançar na identificação das moléculas envolvidas na atividade antiinflamatória e antinociceptiva. O látex coletado em água destilada (1:1; v/v) foi submetido às etapas de centrifugação e diálise e três frações foram obtidas (FD, PL e B) e inicialmente avaliadas quanto à presença de atividade pró- e antiinflamatória, utilizando o modelo de peritonite em ratos. A fração FD, rica em compostos de massa molecular inferior a 8.000 Da, não se mostrou antiinflamatória quando administrada por via endovenosa nos animais. Por outro lado, uma forte atividade pró-inflamatória foi observada quando esta foi injetada na cavidade peritoneal de ratos. A resposta inflamatória induzida por FD foi dependente de tempo e dose e parece estar relacionada com a presença de peptídeos detectados na fração, já que esta atividade foi diminuída quando a fração foi tratada com pronase durante 24 horas antes de sua administração nos ratos. A inflamação induzida por FD foi inibida por Dexametasona, Talidomida e Meclizina sugerindo um processo inflamatório induzido por vias de liberação de histamina e TNF-α. A fração PL, rica em proteínas, e a fração borracha (B) não foram pró-inflamatórias e apresentaram forte atividade antiinflamatória por via endovenosa. A atividade promovida por B parece estar relacionada à presença de proteínas pertencentes à fração PL, como observado em ensaio de detecção imunológica. PL inibiu o processo inflamatório induzido por FD. A atividade antiinflamatória promovida pela fração PL parece ser um evento promovido pela ação de proteínas, visto que a atividade antiinflamatória da fração foi perdida após aquecimento ou tratamento com pronase, e permaneceu ativa após precipitação com acetona. Três novas sub-frações (PI, PII e PIII) foram obtidas após aplicação da fração PL em coluna de troca iônica (CM-Sepharose Fast Flow) em pH 5,0. As sub-frações, distintas entre si, como observado através de eletroforese em gel de poliacrilamida, foram igualmente capazes de reverter a inflamação induzida por carragenina no modelo de peritonite em ratos, bem como reduzir as contorções abdominais induzidas por ácido acético, evidenciando o envolvimento de múltiplas proteínas na resposta antiinflamatória e antinociceptiva produzida pela fração PL. Ensaio de microscopia intravital revelou que PI, PII e PIII inibem o rolamento e a adesão leucocitária no mesentério de camundongos. Somente PI induziu intensa produção de óxido nítrico em ratos além de ter sido a única sub-fração capaz de reverter a resposta pró-inflamatória promovida pela fração FD, evidenciando diferentes mecanismos antiinflamatórios promovidos por diferentes proteínas do látex. A atividade antiinflamatória não foi observada quando a fração PL foi administrada por via oral nos animais. Este é o primeiro trabalho que confirma a presença de duas atividades antagonistas no látex de C. procera e que estas são promovidas por moléculas distintas passíveis de serem separadas com base em seu tamanho molecular. O conjunto de resultados aqui apresentados mostra que a atividade antiinflamatória e antinociceptiva do látex foram promovidas por moléculas protéicas

BASE TEÓRICA: O alívio da dor é um direito do ser humano. Entretanto, atualmente a dor ainda é subidentificada e subtratada nas unidades de terapia Intensiva (UTI). O consenso para manejo de dor em pacientes adultos de UTI recomenda a avaliação rotineira de dor em todos os pacientes internados. O padrão-ouro para avaliação de dor, é o autorrelato de dor. Entretanto diversos pacientes internados em UTI não conseguem reportar verbalmente a dor, por variados motivos entre eles podemos destacar o uso de ventilação mecânica ou distúrbios de consciência. Nestes casos é recomendada a avaliação de dor através de instrumentos comportamentais. Segundo consenso são recomendados o uso das escalas Behavioral Pain Scale (BPS) ou o Critical-Care Pain Observation Tool (CPOT), instrumentos estes que até o presente ainda não encontravam-se validados para uso no Brasil. Em suma CPOT e BPS são instrumentos compostos por 4 categorias de comportamentos de dor: expressão facial, movimentos corporais, simetria com a ventilação mecânica (paciente entubado) ou vocalização (paciente extubado) e tensão muscular. Nos estudos prévios, durante o processo de desenvolvimento e validação de ambas as escalas, a validade discriminante foi testada somente por meio de procedimentos dolorosos, procedimentos estes que podem ter efeitos fisiológicos secundários como tosse e assincronia com o ventilador. Dependendo do contexto estes comportamentos podem facilmente ser confundidos com comportamentos de dor. Assim mostra-se a importância em verificar a validade discriminante de ambas as escalas com uso de estímulo específico de vias nociceptivas de dor, como a algometria de pressão. OBJETIVOS: Traduzir, adaptar e validar as escalas CPOT e BPS para uso no Brasil. Secundariamente verificar as variáveis que predizem a pontuação das escalas CPOT e BPS após estímulo nociceptivo padronizado (por meio da algometria de pressão). MÉTODO: Estudo de coorte prospectivo, realizado em um hospital universitário da região Sul do Brasil. O processo de tradução consistiu da tradução da versão original do inglês para o português, síntese da tradução e novamente tradução (back translation) para o inglês, e após a avaliação das versões por um comitê de juízes. Duas enfermeiras treinadas para avaliação dos pacientes por meios das escalas CPOT e BPS versão para uso no Brasil, realizaram as seguintes avaliações: a) durante repouso, b) após estímulo nociceptivo padrão com uso da algometria de pressão (ENPAP) com pressão máxima de 14 kgf/cm2, c) durante mudança de decúbito, d) 15 minutos após mudança de decúbito. RESULTADOS: Foram triados 1019 pacientes, 844 excluídos por não preencherem os critérios de inclusão, 175 incluídos para avaliação e 7 excluídos durante o protocolo por necessidade de uso endovenosos de sedativo ou analgésico. O total de 168 pacientes clínico-cirúrgicos adultos e não comunicativos verbalmente internados em UTI foram incluídos no estudo. Confiabilidade interobservador de ambas escalas, durante todas as avaliações foi suportado por Kappa >0,7 entre as 2 enfermeiras, cegadas uma para a avaliação da outra. Validade discriminante suportada por pontuação maior das escalas CPOT e BPS durante ENPAP e mudança de decúbito quando comparadas ao repouso (p<0,001). Análise adicional foi realizada para verificar variáveis á predizer o escore das escalas CPOT e BPS, e foi verificado que a pontuação da Escala de Coma de Glasgow (Glasgow) é um preditor de ambas escalas, mostrando que quanto maior a pontuação do Glasgow maior a pontuação nas escalas CPOT e BPS. CONCLUSÃO: As versões para uso no Brasil das escalas CPOT e BPS mostraram boa confiabilidade e validade para uso em pacientes não comunicativos verbalmente internados nas UTIs do Brasil. Algometria de pressão, um método de estimulação específico das vias nociceptivas de dor parece ser um estímulo padronizado que melhora a avaliação da acurácia das escalas CPOT e BPS. Da mesma forma, mostra-se de importância a realização de estudos adicionais para verificar os benefícios do uso concomitante da escala de Glasgow com o CPOT e BPS, principalmente com vistas a diferenciação de pontos de corte das escalas CPOT e BPS considerando as diferenças no nível de consciência. / BACKGROUND: Pain relief is a Human right. However, currently unrelieved pain is very common in Intensive Care Unit (ICU) patients. The clinical practice guidelines for the management of pain in adult ICU patients recommends that pain be routinely monitored in all patients. The gold standard to evaluate pain is the self-reporting of pain. However, in the ICU a lot of patients cannot report their pain, because of mechanical ventilation and disturbances in consciousness. In these cases, pain assessment is recommend with the use of behavioral pain tolls. The guideline recommends the use of the Behavioral Pain Scale (BPS) or the Critical-Care Pain Observation Tool (CPOT), but there is a lack of translating and validating studies to use CPOT and BPS in Brazilian settings. In brief, CPOT and BPS are composed of 4 categories of distinct pain behaviors: facial expressions, body movements, synchrony with the ventilator (intubated patients) or vocalization (extubated patients) and muscle tension. The discriminant validity of both tools was tested with painful procedures, these procedures can induce other secondary physiological effects, such as coughing and asynchrony with the ventilator. Depending on the context these behaviors can easily be confused with pain behaviors. Thus, it is important to verify the discriminant validity of both scales with the use of specific stimuli of nociceptive pain pathways, such as pressure algometry. OBJECTIVE: Translate, culturally adapt, and validate a Brazilian Portuguese version of the CPOT and BPS. Secondarily to verify the variables that predict the scoring of the CPOT and BPS scales after standardized nociceptive stimuli (through pressure algometry). METHODS: A prospective cohort study, in a University hospital in the South of Brazil. The translation process consisted of an initial translation into Brazilian Portuguese, translation synthesis, back-translation into English, then an evaluation by a committee of experts. Two trained nurses used the CPOT and the BPS Brazilian Portuguese versions for the following assessments: a) rest at baseline, b) after standardized nociceptive stimulation by pressure algometry (SNSPA) with a maximum pressure of 14 kgf/cm2, c) during change of position and d) 15 minutes after change of position . RESULTS: A total of 1019 ICU patients were screened, 844 excluded, 175 patients included for assessment, seven excluded during protocol because of the requirement IV infusion of analgesic or sedative agents, and 168 medical-surgical adult non-verbal communicative intensive care unit patients were included in data analysis. Inter-rater reliability of CPOT and BPS scores during all assessments was supported by high weighted Kappa > 0.7 for all assessments between the two nurses blinded of each other’s scores. Discriminant validation was supported with higher CPOT and BPS scores during SNSPA or change of position in comparison to rest (p<0.001). An additional analysis was carried out to predict CPOT and BPS scores, and it was seen that the Glasgow Coma Scale (GCS) was a significant predictor of both tools, as a result than higher GCS, higher were the CPOT and BPS scores. CONCLUSION: The use of the CPOT and BPS Brazilian versions showed good reliability and validity in non-verbal critically ill patients in Brazil. Pressure algometry, a specific nociceptive way of stimulation appears to be a standardized approach to improve the measurement of the accuracy of the CPOT and the BPS. Similarly, it is important to carry out studies to verify the benefits of concomitant use of the GCS with the CPOT and BPS scale, especially with a view to differentiating cut-off points of the CPOT and BPS scales for different levels of consciousness.