Search PubMed⌕ Search

Biomedical subjects

D D Miller

Publications and source records attributed to D D Miller.

At least 73 records · Page 4Linked to original sources

Medetomidine analogs as alpha 2-adrenergic ligands. 3. Synthesis and biological evaluation of a new series of medetomidine analogs and their potential binding interactions with alpha 2-adrenoceptors involving a "methyl pocket".

The synthesis and the biological evaluation of a new series of medetomidine analogs are reported. The substitution pattern at the phenyl ring of the tetralin analogs had a distinct influence on the alpha 2-adrenoceptor binding affinity. 4-Methylindan analog 6 was the most potent alpha 2-adrenoceptor binding ligand among these 4-substituted imidazoles, and its alpha 2-adrenoceptor selectivity was greater than the 5-methyl tetralin analog 4c. Ligand-pharmacophore and receptor modeling were combined to rationalize alpha 2-adrenoceptor binding data of the imidazole analogs in terms of ligand-receptor interactions. The structure-activity relationships that were apparent from this and previous studies were qualitatively rationalized by the binding site models of the alpha 2-adrenoceptor. The benzylic methyl group of medetomidine or the naphthyl analog 2a was superimposable with the alpha-methyl group of (-)-alpha-methylnorepinephrine and fit into the proposed "methyl pocket" of the alpha 2-adrenoceptor defined by the residues Leu110, Leu169, Phe391, and Thr395.

Adrenergic alpha-Agonists↗

Relation between ambulatory electrocardiographic monitoring and myocardial perfusion imaging to detect coronary artery disease and myocardial ischemia: an ACIP ancillary study. The Asymptomatic Cardiac Ischemia Pilot (ACIP) Investigators.

OBJECTIVES: This study sought to explore the relation between markers of ischemia detected by ambulatory electrocardiographic (AECG) monitoring and stress myocardial perfusion single-photon emission computed tomography (SPECT). BACKGROUND: Stress myocardial SPECT and AECG monitoring are both utilized in evaluating patients with coronary artery disease. However, information is limited regarding the relation between the presence and extent of ischemia as detected by these two modalities. METHODS: This was an ancillary study of the Asymptomatic Cardiac Ischemia Pilot (ACIP) trial. One hundred six patients with previous coronary angiography underwent AECG monitoring and stress SPECT within a close temporal time period. The frequency and duration of ischemia as assessed by AECG monitoring and the total and ischemic stress-induced myocardial perfusion defect sizes as assessed by SPECT were quantified in separate core laboratories. Multivariate logistic regression and linear regression analysis were used to determine associations between AECG and SPECT abnormalities with regard to angiographic, demographic and treadmill exercise variables. RESULTS: Seventy-four percent of patients with significant (> or = 50%) coronary artery stenosis had SPECT abnormalities, whereas 61% had ischemia by AECG monitoring. The most important predictors of SPECT abnormalities were severity (p < 0.001) of coronary artery stenosis, followed by total exercise duration (p = 0.016) and patient age (p = 0.04). The only predictor of AECG abnormalities was the presence of ST segment depression on the initial exercise treadmill test (p = 0.021). Only a 50% concordance for normalcy or abnormalcy was observed between the SPECT and AECG results, and no relation was observed between the frequency or duration of AECG ischemia and the quantified total or ischemic myocardial perfusion defect size as assessed by SPECT. CONCLUSIONS: Ischemia as detected by AECG monitoring does not correlate with the presence and extent of ischemia as quantified by stress SPECT. Because these techniques appear to detect different pathophysiologic manifestations of ischemia, they may be complementary in more fully defining the functional significance of coronary artery disease and, in particular, which patients are at highest risk for adverse cardiac events.

Adult↗

The effect of antipsychotic medication on relative cerebral blood perfusion in schizophrenia: assessment with technetium-99m hexamethyl-propyleneamine oxime single photon emission computed tomography.

Functional neuroimaging studies in schizophrenia have often been confounded by various factors including medication status. To explore the effects of antipsychotic medications on relative regional cerebral perfusion, we scanned a group of 33 persons with schizophrenia twice, while receiving a stable dose of antipsychotic and after being off antipsychotics for 3 weeks, using technetium-99m hexamethyl-propyleneamine oxime single photon emission computed tomography (Tc-99m HMPAO-SPECT. We found that antipsychotic significantly increased the mean relative cerebral perfusion in the left basal ganglia. Additionally, patients receiving thiothixene (n = 9) had a significantly greater increase in relative cerebral perfusion in the basal ganglia than patients receiving haloperidol (n = 12). These findings indicate that antipsychotics lead to regional increases in cerebral perfusion and that antipsychotic status must be controlled for in functional neuroimaging studies. Functional neuroimaging techniques such as SPECT may be useful in furthering our understanding of the mechanism of antipsychotics.

Adult↗

The life course of schizophrenia: age and symptom dimensions.

The life course of schizophrenia has eluded description for several reasons, including fluctuations in diagnostic criteria over the past century, and dramatic changes in treatment and expectations of the mentally ill. This study compared symptoms within a group of patients spanning ages 14 through 73. The three symptom dimensions (psychotic, disorganized and negative) were examined separately in relation to age. Using a multivariate analysis, the effects of age, sex and institutional status were found to have main effects for symptom severity with no interaction effects. The effect of age was significant in the negative direction for positive and disorganized symptoms. Age was specifically associated with decreased hallucinations, delusions, bizarre behavior and inappropriate affect. There was no age effect for formal thought disorder, nor was there an age effect for negative symptoms. Institutionalization was associated with greater symptom severity in all dimensions. Male gender was associated with greater severity of negative symptoms. We conclude that psychotic and disorganized symptoms are likely to be of lesser severity in older patients with schizophrenia, while negative symptoms tend to persist. Clinically, these findings suggest that medications targeting negative symptoms may confer the greatest benefit in treating the older patient with schizophrenia.

Adolescent↗

Synthesis and evaluation of trimetoquinol derivatives: novel thromboxane A2/prostaglandin H2 antagonists with diminished beta-adrenergic agonist activity.

Trimetoquinol (TMQ, 1) is a unique catecholamine with a strong stereodependence for agonism at beta-adrenergic (S > > R) and antagonism at thromboxane A2/prostaglandin H2 (TP; R > > S) receptors. Our laboratory has reported the effects of N-alkylation and modification of the trisubstituted benzyl group in these receptor systems. For iodinated derivative 5, maintaining potency in TP receptor systems (112%) was coupled with maintaining limited potency in beta-adrenergic receptor systems (34% for beta 1 and 47% for beta 2). In this study, several diverse TMQ derivatives were prepared to probe for binding interactions specific to a particular receptor system. Planar amidine 2, which was designed to explore the importance of TMQ's chiral center, showed a dramatic loss of potency (< 1%) in each receptor system. Likewise, the homologation of a previously described N-benzyl derivative (3) to the N-phenylethyl derivative 4 also showed reduced potency (< 3%) in both receptor systems. However, modification of the trimethoxybenzyl group of TMQ to a 4-hydroxy-3-nitrobenzyl group (7) provided a unique lead for TMQ derivatives with significant potency in TP receptor systems (91%) and reduced potency in beta-adrenergic receptor systems (4% for beta 1 and 19% for beta 2).

Adrenergic beta-Agonists↗

In vivo role of glucocorticoids in barotrauma vascular repair and fibrosis.

To determine the important repair events leading to vascular collagen accumulation following barotrauma, in vivo changes were assessed during dexamethasone (DEX) treatment, as well as physiological healing. Hypercholesterolemic rabbits underwent bilateral iliac artery endothelial denudation, followed by angioplasty. Messenger ribonucleic acid (RNA) (procollagen types I, III and transforming growth factor [TGF]beta1), and bio-histometric composition of iliac arteries of animals treated with DEX (2, 7 and 7 days; 1 mg/kg1/day1), were compared to that in controls 2, 7 and 30 days after angioplasty. Type I and III procollagen mRNA transcripts were up-regulated following injury in either group. Similarly, TGFbeta1 mRNA levels were also elevated; however, treatment with DEX led to down-regulation at day 30 post-angioplasty. Linear regression and correlation of the densitometric ratios of procollagen alpha1(I) and TGFbeta1 mRNA during repair were observed significantly in either group (DEX-treated, r2= 0.84; non-treated, r2=0.79). Biochemically derived total vascular RNA concentration decreased transiently (7 days), with DEX-treatment (P = 0.003). Arterial lumen cross-sectional area was reduced between days 2 and 30 (P=<0.02), accompanied by an increase in fibrillar collagen concentration in both groups of animals post-angioplasty. These results suggest that during barotrauma repair, administration of DEX (approximately 1 week), does not affect vascular intimal hyperplasia or fibrosis, and that despite treatment, significant production of type I procollagen mRNA continues, influencing subsequent collagen deposition. The data also confirm a strong correlation between TGFbeta1 and type I procollagen mRNA expression, and modestly with type III procollagen during post-angioplasty repair.

Angioplasty↗

The interactive effects of cocaine/gender on immune function in mice. An observation of in vivo acute cocaine exposure.

The present experiments used a mouse model including both sexes to study the impact of acute cocaine exposure on the function of four major immunocompetent cell types (T, B cells, NK, and macrophages). Cocaine hydrochloride, 5 mg or 40 mg/kg, was administrated by i.p. injection to C57BL/6 mice. Thymocytes and splenocytes were obtained 24 h after injection. Acute in vivo cocaine exposure inhibited the proliferation of T lymphocytes in response to Con-A in both thymocytes and splenocytes. However, the attenuated IL-2 production was only seen in thymocytes. These effects on T cells were greater in male mice than in female mice. The function of macrophages was also impaired by acute cocaine exposure; however, the impact was greater in female than in male mice. In conclusion, the effects of acute cocaine exposure altered the functions of immunocompetent cells and the effects varied with gender.

Animals↗

Beta-adrenergic receptor and platelet inhibitory activities of a new series of trimetoquinol and related benzazepine analogs.

1. A series of dimethoxy and methylenedioxy analogs of trimetoquinol (TMQ) and structurally related 7-membered ring benzazepines (BA) were evaluated for their pharmacological effects in beta-adrenergic (atria, trachea) and thromboxane A2/prostaglandin H2 receptor systems (aorta, platelets). 2. Results show that both the 6,7-dihydroxy (catechol) moiety of trimetoquinol and an intact tetrahydroisoquinoline nucleus are essential for maintaining potent beta-stimulating and antithromboxane A2 activities. 3. By contrast, ring enlargement, as in the BA analogs, or masking of the catechol with dimethoxy or methylenedioxy functional groups enhanced the potency of inhibitors on thromboxane A2-independent activation of human platelets induced by bacterial phospholipase C (PLC). 4. The selective blockade of this pathway by these compounds suggests that they may represent a new and novel class of antiplatelet drugs.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

Effect of antipsychotics on regional cerebral blood flow measured with positron emission tomography.

Positron Emission Tomography (PET) imaging of regional cerebral blood flow (rCBF) provides an in vivo method for studying brain function. We used [15O]H20 PET to assess the effect of antipsychotic medications on rCBF in 17 subjects with schizophrenia. Each subject was scanned while receiving antipsychotic medication, and after having been withdrawn from antipsychotic medication for a 3-week period. The two scans were subtracted from one another, using a within subjects design, and the areas of difference were identified using the Montreal method. Subjects treated with antipsychotic medication had significantly higher rCBF in the left basal ganglia and left fusiform gyrus compared with the "off-medication" condition. Significantly higher relative rCBF in the anterior cingulate, left dorsolateral and inferior frontal cortex, and left and right cerebellum was observed when off antipsychotic medication. Upregulation of dopamine D2 receptors may lead to a regional increase of blood flow and metabolism in the basal ganglia, which may explain recently reported anatomical enlargement in these regions.

Adolescent↗

Human fatty acid ethyl ester synthase-III gene: genomic organization, nucleotide sequencing and chromosomal localization.

The complete gene for human fatty acid ethyl ester Synthase-III (FAEES-III) was isolated from a human genomic lambda phage library for functional and structural determination. The gene spans approximately 3.3 kb which includes 791 base pairs of the 5' and 124 base pairs of the 3' flanking regions. The gene is comprised of seven exons and is interrupted by six introns. Several transcription regulatory sequences were identified in the promoter region. Primer extension experiments demonstrated the existence of two possible transcription initiation sites at nucleotide -29 and 32 position, 5' to the start of the translation. In addition to a TATA box at position-29 relative to the transcription initiation site and two Spl GGGCGG recognition sequences at nucleotide positions -42 to -37 and -50 to -45, the promoter contains a sequence motif matching the transcription activating factor AP-1. We also found an A + T rich region between nucleotide -505 and -390 which contained twenty-two AAAAT tandem repeats. The gene for FAEES-III was localized to human chromosome 11 by hybridizing the genomic fragment Xh01 to Chinese hamster/human somatic cell hybrid panels. These data extend our knowledge of non-oxidative alcohol metabolism and permit linkage analyses between this pathway and alcohol-related phenotypes.

Acyltransferases↗

Moderate alcohol feeding attenuates postinjury vascular cell proliferation in rabbit angioplasty model.

Our studies in the cholesterol-fed rabbit model indicate that moderate alcohol consumption reduces the risk of restenosis by preventing low-density lipoprotein (LDL) oxidation. Eighteen hypercholesterolemic rabbits underwent arterial injury by Fogerty balloon endothelial denudation of iliac arteries. Two weeks later, balloon angioplasty of atherogenic or atherosclerotic arterial segments was performed. Nine rabbits (control) received water ad lib, whereas nine rabbits (moderate alcohol treated) received an average of 2.5 ml alcohol per 500 ml water daily, from the day of feeding hypercholesterolemic diet until they were killed, 10 weeks later. There was a 26% increase in lumen size of the moderate alcohol-treated group compared with the control group. The percentage neointima formation (NI) values of the moderate alcohol-treated and control groups were 77 +/- 2.1 and 61 +/- 1.9, respectively (p < 0.001). The lumen/neointima (L/NI) ratio of the moderate alcohol-treated group was 0.71 +/- 0.07 compared with the control group, 0.33 +/- 0.04 (p < 0.001). The number of foam cells in the moderate alcohol-treated group was threefold less than the control group [i.e., 1.4 +/- 0.4 and 3.9 +/- 0.8, respectively (p = 0.005)]. The arterial lesion malondialdehyde (MDA) values of the control and the moderate alcohol-treated groups were 13.6 +/- 2.8 and 4.4 +/- 0.5 (p = 0.004), respectively. By radioimmunoassay, the moderate alcohol-treated group had less macrophage chemotactic protein-1 (MCP-1; 3,277 cpm/microg protein) and platelet-derived growth factor (PDGF; 2,261 cpm/microg protein) compared with the controls (MCP-1, 4,529 cpm/microg protein; PDGF, 3,583 cpm/microg protein). Thus we conclude that low concentrations of alcohol reduce neointimal formation, and the extent of lipid oxidation, the number of foam cells in the neointimal area and may decrease the expression of MCP-1 and PDGF by reducing LDL oxidation in an animal model of postangioplasty restenosis.

Angioplasty, Balloon↗

Cost implications of selective preoperative risk screening in the care of candidates for peripheral vascular operations.

The preoperative identification that patients are at high risk for adverse postoperative outcomes is the first step toward preventing costly in-hospital complications. The economic implications of noninvasive screening strategies in the care of patients undergoing peripheral vascular operations must be clarified. A decision model was developed from the peer-reviewed literature on patients undergoing preoperative screening by means of dipyridamole myocardial perfusion imaging, dobutamine echocardiography, or cardiac catheterization before vascular operations (n = 23 studies). Routine versus selective screening strategies were compared for patients with an intermediate likelihood of having coronary artery disease on the basis of clinical history of coronary disease or typical symptoms. Median costs (1994 US dollars) of preoperative screening strategies were derived with two microcosting approaches: adjusted Medicare charges (top-down approach) and a bottom-up approach with Duke University Center direct cost estimate data. In-hospital cost was 11% higher for preoperative screening by means of routine cardiac catheterization ($27,760) than for routine pharmacologic stress imaging ($24,826, P = 0.001). The total cost of a do-nothing strategy, that is, no preoperative testing, was 5.9% less than that of routine preoperative pharmacologic stress imaging and 15.9% lower than that of cardiac catheterization (P = 0.001). Selective screening among patients with a history of coronary disease or typical angina resulted in further reduction of the cost of care to a level comparable with that of a do-nothing strategy (52.5% reduction in cost with pharmacologic stress imaging, P > 0.20). Use of noninvasive testing for preoperative risk stratification was cost effective for patients 60 to 80 years of age. Cost per life saved ranged from $33,338 to $21,790. However, coronary revascularization after an abnormal noninvasive test was cost effective only for patients older than 70 years. In this economic decision model, substantial cost savings were predicted when selective noninvasive stress imaging was added to preoperative screening for patients about to undergo vascular operations. With a selective screening approach, the economic impact of initial diagnostic testing may be minimized without compromising patient outcomes.

Decision Trees↗

PET perfusion and vasodilator function after angioplasty for acute myocardial infarction.

UNLABELLED: The aims of this study were to validate invasive coronary Doppler flows against noninvasive PET assessments of myocardial perfusion and to examine the timing and degree of regional coronary vasodilator reserve recovery in patients who are successfully reperfused with primary angioplasty (PTCA) for acute myocardial infarction. METHODS: PTCA was performed in 21 consecutive patients with acute myocardial infarction; the final diameter stenosis was 25% +/- 7%. After restoration of TIMI Grade 3 flow, all patients underwent quantitative coronary angiography and distal Doppler coronary blood flow studies (basal and after adenosine-induced hyperemia) in the infarct and noninfarct vessels. Regional myocardial perfusion and vasodilator function were quantitated after intravenous adenosine infusion PET in all patients at 26 +/- 9 hr after acute PTCA. These were repeated in 17 patients 9 +/- 3 days later. RESULTS: Post-PTCA resting coronary flow was 35 +/- 15 ml/min in the infarct-related vessels and 50 +/- 24 ml/min during peak hyperemia (p < 0.05). Coronary flow reserve (CFR) was 1.48 +/- 0.34 and 2.08 +/- 0.62 in the infarct and noninfarct vessels, respectively (p < 0.001). Early (< 36 hr) PET myocardial perfusion reserves (MPR) in the infarct and noninfarct regions were 1.59 +/- 0.33 and 2.03 +/- 0.62 (p < 0.01). Doppler CFR and PET MPR were correlated in the infarct (r = 0.61, p < 0.01) and noninfarct (r = 0.77, p < 0.0001) regions. Follow-up PET studies demonstrated improved MPR in both infarct and noninfarct regions (1.93 +/- 0.52 versus 2.54 +/- 0.97, p < 0.01). The improvement in coronary vasodilator function from the time of acute PTCA to follow-up PET in the infarct region was significant (p = 0.005). CONCLUSION: After successful mechanical revascularization by PTCA after acute myocardial infarction, intracoronary Doppler blood flows and noninvasive PET regional myocardial perfusion are correlated within the wide range of reperfusion blood flows observed in patients with contrast angiographic TIMI Grade 3 flow. Serial PET studies demonstrated a trend towards continued improvement in the vasodilator response in infarct-related myocardial regions after the restoration of blood flow by PTCA. PET offers the potential for accurate noninvasive serial assessment of reperfusion blood flow after primary angioplasty for acute myocardial infarction.

Angioplasty, Balloon, Coronary↗

Assessment of blood flow distal to coronary artery stenoses. Correlations between myocardial positron emission tomography and poststenotic intracoronary Doppler flow reserve.

BACKGROUND: Previous studies have correlated quantitative coronary angiographic stenosis severity with positron emission tomography (PET) myocardial perfusion and proximal measurements of intracoronary flow velocities in normal and diseased coronary arteries. The aim of this study was to correlate regional myocardial blood flow (RMBF) derived from [15O]H2O PET with directly measured poststenotic intracoronary Doppler flow velocity data acquired under basal conditions and dipyridamole-induced hyperemia. METHODS AND RESULTS: Eleven consecutive patients 53 +/- 13 years old with ischemic chest pain and isolated proximal left coronary artery stenoses (left anterior descending, 9; left circumflex, 2; mean, 59 +/- 23% diameter stenosis) underwent [15O]H2O myocardial PET and intracoronary Doppler flow velocity studies within 1 week. PET RMBF (mL.g-1.min-1) and myocardial perfusion reserve (MPR) were calculated in poststenotic and normal reference vascular beds. Poststenotic Doppler average peak flow velocities (APV; cm/s) and coronary flow velocity reserve (CFR) were compared with corresponding PET data and quantitative angiographic lesional parameters. PET RMBF and Doppler APV were linearly correlated (r = .60; P < .001), as were poststenotic PET MPR and Doppler CFR (r = .76; P < .0002). Relative coronary flow velocity and MPR ratios between poststenotic and angiographically normal vascular beds were comparably reduced (0.83 +/- 0.25 versus 0.86 +/- 0.21, respectively; P = NS). CONCLUSIONS: Intracoronary Doppler flow velocities acquired distal to isolated left coronary artery stenoses correlated with [15O]H2O PET regional myocardial perfusion and are useful for assessment of the physiological significance of coronary stenoses in humans.

Adult↗

Synthesis of chiral 1-(2'-amino-2'-carboxyethyl)-1,4-dihydro-6,7-quinoxaline-2,3-diones: alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate receptor agonists and antagonists.

Recently discovered 6,7-disubstituted quinoxaline-2,3-diones, 1, have been found to antagonize specific binding and functional responses to both alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) and kainic acid. Although a variety of studies have analyzed the activity of quinoxaline-2,3-diones with various substitutions at positions 6 and 7, there is little information regarding the effects of N-substitution. A racemic mixture of 1-(2'-amino-2'-carboxyethyl)-1,4-dihydroquinoxaline-2, 3-dione (QXAA, 2, R1 = R2 = H) has been synthesized from 1 (R1 = R2 = H). This compound inhibited specific [3H]AMPA binding but not [3H]kainate binding. IC50 values for QXAA, AMPA, and DNQX were 0.69, 0.012, and 0.74 microM, respectively. The R- and S-enantiomers were prepared by asymmetric synthesis. The S-isomer (2b) was 160-fold more potent in binding assays than the R-isomer (2d), with IC50 values of 0.23 and 38 microM, respectively. Both enantiomers were agonists in a functional assay, with the S-isomer having an EC50 value of 3 microM while that for the R-isomer was greater than 1 mM. Methyl substitutions at positions 6 and 7 (2a and 2c) resulted in antagonist compounds characterized by the S- and R-isomers being nearly equipotent, with IC50 values of 51 and 22 microM in the binding assay and EC50 values of 290 and 300 microM in the functional assay. AMPA had an EC50 value of 11 microM and DNQX an EC50 value of 30 microM in the functional assay. Analogs of quinoxalinediones with side chains other than an amino acid moiety on the nitrogen did not show good binding activities.

Animals↗

Interleukin-2 receptor-specific fusion toxin inhibits barotrauma-induced arterial atherosclerosis.

Immunocytochemical analyses of human plaques and experimental arterial lesions have implicated activated lymphocytes and monocytes in the pathogenesis of atherosclerosis, as demonstrated by the expression of interleukin-2 (IL-2) membrane receptors and major histocompatibility complex class II epitopes. The objective is to determine if targeting these cells with an IL-2 receptor-specific chimeric toxin, DAB486-IL-2, can inhibit experimental post-angioplasty vascular neointimal thickening. Twenty-two atherogenically modeled rabbits were treated in vivo with DAB486-IL-2 (0.1 mg/kg per day i.v.; n = 11) or placebo (n = 11) for 10 days following aortic balloon angioplasty (4 atm x 30 s each x 2 dilatations). In vitro 3H-leucine incorporation studies of mononuclear leukocyte and vascular smooth muscle cell protein synthesis inhibition by DAB486-IL-2 were also performed. Angioplasty sites were examined for evidence of hyperproliferative atherosclerotic narrowing by quantitative angiography and histomorphometry of neointimal cross-sectional area at baseline and 6 weeks after injury. In vitro Concanavalin-A stimulated rabbit mononuclear leukocyte protein synthesis was 50% inhibited by DAB486-IL-2 at a concentration (IC50) of 6 x 10(-11) M. Rabbit vascular smooth muscle cells were approximately 150-fold less sensitive to DAB486-IL-2 (IC50 = 10(-8) M). In vivo studies showed no change in angioplasty site angiographic minimum luminal diameter at 6 weeks in DAB486-IL-2 treated animals (from 2.96 +/- 0.52 to 2.96 +/- 0.48 mm; percent cross-sectional area reduction = 1 +/- 10%; P = N.S.). In control animals, luminal diameter decreased from 2.79 +/- 0.4 to 2.32 +/- 0.52 mm at 6 weeks, and percent cross-sectional area was reduced by 34 +/- 14% (P < 0.01 vs. placebo). Quantitative histomorphometric angioplasty segmental intimal cross-sectional area reduction of treated and placebo vessels also differed significantly (19 +/- 16% vs. 31 +/- 21%; P < 0.05). DAB486-IL-2 caused no adverse effects on animal survival, weight or hepatic transaminase levels. We conclude that post-angioplasty administration of the chimeric toxin DAB486-IL-2 inhibits angiographic narrowing and neointimal thickening in the atherogenic rabbit model. Although this IL-2 receptor-specific molecule was cytotoxic in vitro for activated mononuclear leukocytes and vascular smooth muscle cells, systemic toxicity did not occur in vivo at a dose comparable to that evaluated in clinical trials of this agent. Potential anti-proliferative effects of this chimeric toxin may be mediated by direct local inhibition of leukocyte-mediated inflammation, or through the indirect modification of vascular cell mitogenesis and cytokine release.

Angioplasty, Balloon↗