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Viele im klinischen Alltag verwendete volatile Anästhetika verursachen während der Narkose eine Vasodilatation. In dieser Hinsicht wäre es interessant, zu Untersuchen, ob volatile Anästhetika die Prostacyclinbildung in Endothelzellen beeinflussen können. Für diese Untersuchungen wurden primäre humane Endothelzellen aus der Nabelschnurvene (HUVEC) isoliert und in Zellkulturen kultiviert. Diese Zellen zeigen nach Zugabe von Histamin eine Dosis- und Zeitabhängige Prostacyclinbildung. Entscheidend für diese Prostacyclinbildung ist die Ca2+-Freisetzung aus intrazellulären Speichern. Die dosisabhängige Untersuchung von Halothan auf die Prostacyclinbildung zeigte eine signifikante Stimulation der Prostacyclinbildung von 33,8% bei einer klinisch relevanten Konzentration von 1 Vol.%. Diese stimulierende Wirkung von Halothan auf die Prostacyclinbildung könnte einen Beitrag zu der in vivo beobachteten vasodilatierenden Wirkung des Anästhetikums leisten. Eine ähnliche stimulierende Wirkung wurde auch für Isofluran beobachtet, obwohl der stimulierende Effekt auf die Prostacyclinbildung keine statistische Relevanz erreichte. Höhere supraklinische Konzentrationen der beiden Anästhetika hemmen allerdings signifikant die Prostacyclinbildung. Die Aktivierung der Proteinkinase C in den HUVEC Zellen hat keinen signifikanten Einfluss auf die Histamin-induzierte Prostacyclinbildung. Dieses Ergebnis macht eine stimulierende Wirkung der volatilen Anästhetika auf die Prostacyclinbildung mittels Proteinkinase C-Aktivierung unwahrscheinlich. Die Stimulation der NO-Signalweges mittels Natrium-Nitroprussid in den HUVEC Zellen verursachte eine signifikante Hemmung der Histamin-induzierten Prostacyclinbildung. Andererseits führte die Hemmung des NO-Signalwegs mit L-NAME nicht zu einer signifikanten Zunahme der Prostacyclinbildung. Eine mögliche Hemmung des NO-Signalwegs durch volatile Anästhetika kann daher in HUVEC Zellen nicht durch vermehrte Prostacyclinbildung kompensiert werden. / Many volatile anesthetics cause vasodilatiation during their clinical use.Theredore it is of interest to investigate the effect of volatile anesthetics on prostacyclin production in endothelial cells. Primary Human Umbilical Vein Endothelial Cells (HUVEC) were isolated ans cultivated in cell cultures. A dose and time dependent prostacyclin production was found in these cells. The release of Ca2+ from intracellular stores is essential for prostacyclin production. After application of Halothane a significant stimulation of prostacyclin production of 33.8% was found at clinically relevant concentrations of 1 Vol%. Isoflurane showed similar effects. However, increase of prostacyclin production after incubation with Isoflurane was not statistically relevant. High supraclinical concentrations of both anesthetics result in significant inhibition of prostacyclin production. Activation of protein-kinase-C in HUVECs was found to have no significant effect on histamine-induced prostacyclin production. Therefore, a stimulating effect of volatile anesthetics via protein-kinase-C activation is unlikely. Stimulation of th NO-pathway with sodium-nitroprussid resulted in significant inhibition of histamine-induced prostacyclin production in the HUVECs. Inhibition of the NO-pathway with L-NAME had no significant effect on prostacyclin production. In HUVECs, inhibition of the NO-pathway by volatile anesthetics cannot be compensated by increased prostacyclin production.

A new prostaglandin - prostaglandin X (later renamed prostacyclin or prostaglandin I₂ (PGI₂)), was discovered by Moncada, Gryglewski, Bunting and Vane in 1976. This unstable substance was shown to be produced by vascular tissue and to be a vasodilator and the most potent endogenous inhibitor of platelet aggregation known. Because of its properties, it appeared that a lack of it may be related to the development and or maintenance of hypertension, a disorder featuring vasoconstriction and an increased tendency to arterial thrombosis. The present studies aimed to investigate this possibility using a rat model. A bioassay for prostacyclin was first perfected. This consisted of a modification of the method used by Moncada, Higgs and Vane (1977): PGI₂ released by rat aortic strips, during incubation in tris buffer, was measured by assessing the ability of the incubate to inhibit adenosine diphosphate induced aggregation of human platelets, as compared to the inhibitory effect of standard prostacyclin sodium salt. The specificity of the assay for the detection of PGI₂ was tested. The abil ity of hypertensive rat aorta to release prostacycl in was investigated in two studies. The first compared aortas of Wistar rats of the New Zealand genetically hypertensive strain (GH) with those of matched normotensive Wistar controls. In the second study, hypertension was induced by wrappi ng the ri ght kidney with surgical silk and removing the contralateral kidney. Ten weeks later, aortic generation of prostacyclin by these animals was compared with that of matched sham controls which had received identical surgical manipulation but for the application of silk to the right kidney. Contrary to expectation, in both forms of hypertension, aortas of the rats with elevated pressure produced consistently more prostacyclin than those of matched controls. In order to discover more about the relationship between elevated pressure and elevated PGI₂ production, the effect of pressure reduction with hypotensive agents on the ability of GH rat aortas to produce prostacyclin, was investigated. After pressure had been controlled within normal range for one week (achieved by oral administration of furosemide, dihydralazine and reserpine for one month), aortic PGI₂ was reduced in comparison with matched GH controls. However, the reduction was not consistent and statistical significance was not reached. Because it was subsequently reported by other workers, that some of the hypotensive agents which had been employed may effect prostaglandin levels per se, no conclusions could be drawn from this study as to any possible direct relationships between pressure and aortic prostacyclin generating capacity. A further means of reducing elevated pressure (which had no inherent effect on prostaglandin levels) was thus sought. A mechanical method was eventually selected, application of a silver clip to the aortas of GH rats, just below the diaphragm, producing an immediate reduction in pressure distal to the constriction. Eighteen hours with later, PGI₂ production by these distal aortas those of matched sham GH controls and was was compared found to be consistently reduced. These results indicate that the ability to produce PGI₂ may be influenced by prior local pressure changes and that the increased capacity of hypertensive rat aortas to generate prostacyclin may be related to the increased mechanical transmural stress consequent on elevated pressure. Since haemostatic balance must be influenced not only by vascular PGI₂ generation but also by platelet sensitivity to PGI₂, the response of GH platelets to the anti-aggregatory effect of prostacyc1in was also investigated. As it had been shown by Sinzinger, Si1berbauer, Horsch and Gall (1981) that intra-arterial infusion of PGI₂ in humans decreased platelet sensitivity to the substance, the possibility existed that platelet sensitivity in hypertension might be reduced. This hypothesis was, however, invalidated as the sensitivity of GH platelets to the anti-aggregatory effect of PGI₂ was almost identical to that of normotensive controls. The shortcomings of the methodology and the possible importance of these findings in the hypertensive animal are discussed. The idea that elevated PGI₂ in hypertension may play a protective role both with respect to platelet aggregation and in attenuating further pressure rises is considered. It is finally suggested that it will be possible to draw more accurate conclusions as to the meaning of the increased PGI₂ generation in hypertension (both in relation to vascular tone and platelet function) only when details of production of, and sensitivity to, thromboxane A₂ are known. Thromboxane A₂ (TXA₂) is a vasoconstrictor and promotor of aggregation (Hamberg, Svensson and Samuelson, 1975) and it may be that, despite elevated vascular PGI₂ generation, the TXA₂/PGI₂ balance is still tipped in favour of vasoconstriction and platelet aggregation in hypertension.

by Ho Wai Chan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (p. [254]-271). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstract in Chinese.

La sclérodermie systémique (ScS) est une maladie qui peut engager le pronostic vital des malades de façon très rapide. La pathogénie de la maladie reste encore obscure mais est liée aux atteintes vasculaires probablement en lien avec la fibrose cutanée. La thérapeutique de cette maladie est difficile. Aucun traitement étiologique n'existe et la prise en charge est plutôt axée sur les traitements des différentes atteintes. La iontophorèse cutanée est un dispositif qui permet la diffusion de molécules en solution à travers la peau grâce à une stimulation électrique de manière non invasive. Cette technique a été utilisée initialement comme test physiologique. Notre objectif est d'évaluer et de développer la iontophorèse thérapeutique, notamment avec des molécules vasodilatatrices, pour pouvoir l'utiliser dans des applications thérapeutiques telles que la pris en charge des ulcérations digitales (ou troubles trophiques cutanés) de la ScS. Trois parties ont été développées. La première partie consiste en l'association de deux molécules vasodilatatrices (une per os, le sildenafil, et en iontophorèse, le nitroprussiate de sodium (SNP), en étudiant la tolérance de l'association et son effet sur le flux vasculaire cutané chez le volontaire sain (étude INFLUX-VS). La deuxième partie correspond à un screening de molécules ayant une action vasodilatatrice et étant délivrées en iontophorèse chez le rat : l'étude INFLUX-RAT conclue à l'obtention d'une vasodilatation cutanée chez le rat avec les analogues de la prostacycline. La troisième partie correspond à l'évaluation chez le volontaire sain de la iontophorèse des analogues de la prostacycline : l'étude INFLUX-IT-VS conclue à une dilatation du flux sanguin cutané avec le tréprostinil et avec une bonne tolérance cutanée et systémique. La dernière partie correspond aux avancées parallèles des travaux tant dans le domaine de la reproductibilité des techniques d'acquisition des signaux du flux sanguin cutané que les études réalisées avec les patients sclérodermiques à qui on pourrait espérer un jour voir proposer une iontophorèse thérapeutique. / Systemic scleroderma (ScS) is a rare disease that may be associated with a poor prognosis. The pathogenesis of the disease remains still unclear but comprises vascular abnormalities related to skin fibrosis. ScS disease treatment is difficult. No etiologic therapy is available and patient's management is rather centred on the treatments of the different organs failure symptoms. Skin iontophoresis is a non invasive technique, which allows a transcutaneous diffusion of molecules in solution thanks to an electrical stimulation. This technique was initially used as physiological test. Our objective is to test and to develop therapeutic iontophoresis, in particular with molecules possessing vasodilator properties. The final objective is to use it in therapeutic applications such as the treatment of ScS digital ulcerations. Three parts will be developed in the present work. The first part describes the association of two vasodilatator drugs (sildenafil used per os, associated with sodium nitroprusside used through cathodal iontophoresis. We studied the safety of the association and its effect on the skin vascular flow in healthy volunteers (INFLUX-VS study). The second part describes the screening of vasodilatator drugs delivered through cutaneous iontophoresis in rats (INFLUX-RAT study). The aim of the study was to select the more potent drugs in term of maximal rat skin vasodilatation. The more potent drugs were prostacyclins analogues. The third part describes the iontophoresis of prostacyclins analogues in healthy volunteers: the INFLUX-IT-VS study. The more potent cutaneous vasodilatation was observed with treprostinil, with a good skin and systemic tolerance. The last part decribes the reproducibility of the techniques used to quantify skin blood flow along with studies using these techniques in scleroderma patients. These are required to enable a reproducible evaluation of the effect of skin iontophoresis in patients with scleroderma

Ulm, Univ. Diss., 2006.

Abstract Primary intracerebral hemorrhage (ICH) comprises 10–15% of all strokes. Arterial hypertension and warfarin use are well documented risk factors for ICH, but aspirin use also seems to predispose to ICH. The annual incidence of primary ICH in western populations is 12–31 / 100,000. Mortality is high: 14–52% during the first month and 14–80% during the first year after ICH. The size and location of the hemorrhage, a midline shift in head computed tomography, intraventricular spread of the hemorrhage, level of consciousness on admission, and high blood glucose independently predict mortality. For a risk factor study, 98 consecutive patients admitted into the Department of Neurology, Oulu University Hospital, because of ICH between January 1993 and September 1995 were compared with 206 control subjects drawn from a population register. Thromboxane and prostacyclin biosynthesis were measured from serial urine samples of 43 patients. For outcome studies, all subjects (n = 208) with incident ICH during the study period in the population of Northern Ostrobothnia, Finland, were identified. Untreated hypertension was the main modifiable risk factor for ICH. Use of aspirin appeared to be a significant risk factor for ICH in the subjects with a history of epistaxis. Enhanced thromboxane and prostacyclin biosynthesis were observed in the acute phase and 3 months after ICH. Regular use of aspirin preceding ICH doubled the 3-month mortality rate compared with nonusers of aspirin/warfarin. Aspirin use also associated with early hematoma growth. Patients with ICH showed increased long-term mortality up to 7 years after ICH compared to controls. No excess mortality was observed among those with good recovery at 3 months, but those who were severely disabled at 3 months after ICH showed marked excess mortality.

Mitochondrial coupling factor-6 (CF-6) is a component of the ATP synthase complex essential for energy transduction. CF-6, which is localized to the surface of endothelial cells (ECs) and released by shear stress, has been implicated as an endogenous vasoconstrictor. Previous methods of obtaining CF-6 through purification and recombinant methods were laborious and inefficient. Here, we describe the chemical synthesis of human CF-6, (33-108)-NH2, its C-terminal fragment (55-108)-NH2, which is termed pCF-6; the rat CF-6, (33-108)-NH2, its C-terminal fragment pCF-6, (55-108)-NH2; and two N-terminal fragments of the rat pro-coupling factor-6, (24-52)-NH2 and (33-52)-NH2. Biological activities of each peptide were initially screened with bioassays and verified by in vivo studies. Accordingly, intravenous administration of CF-6, pCF-6, rat CF-6, and rat pCF-6 produced a modest but statistically significant increase in blood pressure and heart rate in urethane anesthetized rats, whereas the N-terminal rat pro-coupling factor-6, (24-52)-NH2 and (33-52)-NH2 caused no significant pressor response. Thus, the biologically active site probably resides at the C-terminal portion of CF-6 peptides.