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Biomedical subjects

D E Clarke

Publications and source records attributed to D E Clarke.

At least 55 records · Page 3Linked to original sources

Addressing emerging social needs of patients treated with new neuroleptics.

1. Clozapine and risperidone are revolutionary new neuroleptic drugs that appear to alleviate psychotic symptoms in many patients who are unresponsive to other neuroleptic medications. 2. Alleviation of negative symptoms, although beneficial in many ways, also may create fears, changes, and unknown challenges for both the patient and caregivers. 3. Thorough assessment and diligent community planning may assist patients in fulfilling the basic human need for love and belonging.

Adult↗

Characterization of the alpha-1 adrenoceptor subtype mediating [3H]-arachidonic acid release and calcium mobilization in Madin-Darby canine kidney cells.

The authors characterized the alpha-1 adrenoceptor subtype located on Madin-Darby canine kidney (MDCK) cells by measuring norepinephrine-mediated [3H]-arachidonic acid release and Ca++ mobilization in fura 2-loaded cells. In both assays, prazosin and chloroethylclonidine acted as unsurmountable antagonists, whereas 5-methyl-urapidil acted as a competitive antagonist with pA2 estimates of 7.3 (arachidonic acid assay) and 7.7 (Ca++ assay). Competitive antagonism toward arachidonic acid release was also obtained with the following alpha-1 adrenoceptor antagonists (pA2): (+)-niguldipine (7.6), 2-(2,6-dimethoxy-phenoxy-yethyl)aminomethyl-1,4-benzodioxane hydrochloride (WB 4101; 8.3), phentolamine (7.6) and oxymetazoline (6.4). Arachidonic acid release by norepinephrine was abolished in the absence of extracellular Ca++ and was antagonized by 1-[beta-[3-(4-methoxy-phenyl)propoxy]-4-methoxyphenethyl]-1H-imidazole hydrochloride (SK&F 96365) but was insensitive to antagonism by L-type Ca++ channel antagonists and La . Norepinephrine-mediated increases in intracellular Ca++ consisted of two distinct phases: a transient phase followed by a sustained plateau. The transient phase was resistant to EGTA, whereas the plateau phase was abolished by EGTA. Potassium chloride did not evoke a response in either assay. Northern blot analysis demonstrated that MDCK cells express alpha-1B adrenoceptor messenger RNA. It was concluded that typical alpha-1B adrenoceptors mediate responses to norepinephrine in MDCK cells and that these receptors couple to both intracellular Ca++ release and Ca++ influx by a voltage-independent mechanism. This influx pathway is insensitive to L-type Ca++ channel antagonists but is antagonized by the receptor-operated Ca++ channel antagonist SK&F 96365.

Adrenergic alpha-1 Receptor Antagonists↗

International Union of Pharmacology classification of receptors for 5-hydroxytryptamine (Serotonin).

It is evident that in the last decade or so, a vast amount of new information has become available concerning the various 5-HT receptor types and their characteristics. This derives from two main research approaches, operational pharmacology, using selective ligands (both agonists and antagonists), and, more recently, molecular biology. Although the scientific community continues to deliberate about the hierarchy of criteria for neurotransmitter receptor characterisation, there seems good agreement between the two approaches regarding 5-HT receptor classification. In addition, the information regarding transduction mechanisms and second messengers is also entirely consistent. Thus, on the basis of these essential criteria for receptor characterisation and classification, there are at least three main groups or classes of 5-HT receptor: 5-HT1, 5-HT2, and 5-HT3. Each group is not only operationally but also structurally distinct, with each receptor group having its own distinct transducing system. The more recently identified 5-HT4 receptor almost undoubtedly represents a fourth 5-HT receptor class on the basis of operational and transductional data, but this will only be definitively shown when the cDNA for the receptor has been cloned and the amino acid sequence of the protein is known. Although those 5-HT receptors that have been fully characterised and classified to date (and, hence, named with confidence) would seem to mediate the majority of the actions of 5-HT throughout the mammalian body, not all receptors for 5-HT are fully encompassed within our scheme of classification. These apparent anomalies must be recognised and need further study. They may or may not represent new groups of 5-HT receptor or subtypes of already known groups of 5-HT receptor. Even though the cDNAs for the 5-ht1E, 5-ht1F, 5-ht5, 5-ht6, and 5-ht7 receptors have been cloned and their amino acid sequence defined, more data are necessary concerning their operational and transductional characteristics before one can be confident of the suitability of their appellations. Therefore, it is important to rationalise in concert all of the available data from studies involving both operational approaches of the classical pharmacological type and those from molecular and cellular biology.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

Ethical dilemmas in the critically ill elderly.

Elderly people in the United States often receive treatment through an enormous array of medical technology when they become critically ill. Some, or all, such interventions may be unwanted, and patients have the right to be informed about what prospects lie ahead. CPR, with survival rates of 2% to 20%, rarely has the effect for which it was intended, as studies over the last two decades have repeatedly demonstrated. Although it is not clear that elderly people are at higher risk for poor outcomes of CPR, it is clear most of them do not possess sufficient knowledge about either CPR or its usual outcome to make an informed choice. Ideally, an individual should choose his or her own resuscitation status, but evidence exists indicating surrogates more often than not make this decision. This is unfortunate, because both surrogates and physicians are poor judges of patients' resuscitation preferences. Advance directives, especially when coupled with effective physician-patient communication, will aid elderly persons in making decisions about life support. We encourage all physicians who care for the elderly to avert many of tomorrow's ethical dilemmas by communicating with their healthy patients today.

Aged↗

Pharmacological analyses of endo-6-methoxy-8-methyl-8-azabicyclo[3.2.1]oct-3-yl-2,3-dihydro-2-oxo-1 H- benzimidazole-1-carboxylate hydrochloride (DAU 6285) at the 5-hydroxytryptamine4 receptor in the tunica muscularis mucosae of rat esophagus and ileum of guinea pig: role of endogenous 5-hydroxytryptamine.

Functional estimates of affinity for endo-6-methoxy-8-methyl-8- azabicyclo[3.2.1]oct-3-yl-2,3-dihydro-2-oxo-1H-benzimidazole-1-carboxyla te hydrochloride (DAU 6285) were made at the 5-hydroxytryptamine4 (5-HT4) receptor in isolated preparations of rat esophageal tunica muscularis mucosae (TMM) and guinea pig ileum. In the TMM, relaxation of carbachol-induced contracture by 5-HT4 receptor agonism of longitudinal muscle was recorded. Estimated pA2 values for DAU 6285 of 6.9 to 7.2 were tissue, time (1-3 hr equilibration) and agonist-independent. However, DAU 6285 increased the maximal response to 5-HT and 5-methoxytryptamine in the TMM and augmented the contractile tone to carbachol. These effects were not observed in guinea pig ileum, suggesting a tissue-dependent mechanism. [3a-Tropanyl]-1H-indole-3-carboxylic acid ester (tropisetron) and 2-methoxy-4-amino-5-chloro-benzoic acid 2-(diethylamino)ethyl ester (SDZ 205-557), two other 5-HT4 receptor antagonists, mimicked the effects of DAU 6285. Mechanistic experiments suggest agonism by endogenous 5-HT, within the isolated TMM, to explain the effects of 5-HT4 receptor antagonists. Pretreatment of rats with parachlorophenylalanine to deplete endogenous 5-HT, prevented the effect of DAU 6285 on the maximal response to 5-HT and carbachol-induced tone. In conclusion, DAU 6285 acts as a silent, competitive antagonist at 5-HT4 receptors in rat TMM and guinea pig ileum. However, in the TMM, endogenously released 5-HT confounds interpretation. The TMM, as a quantitative assay system for 5-HT4 receptor agonists and antagonists may be improved by pretreating rats with parachlorophenylalanine.

Animals↗

Characterization of angiotensin receptors mediating the neuromodulatory effects of angiotensin in the vas deferens of the rabbit.

The objective of the present study was to characterize receptors mediating the neuromodulatory effects of angiotensin in the prostatic vas deferens (VD) of the rabbit by using losartan (DuP 753) and PD 123177, two nonpeptide ligands interacting preferentially at the AT1 and AT2 sites, respectively. Field stimulation of the VD (3 Hz, 1 msec pulse duration, 50 V for 10 sec) resulted in a biphasic contractile response, consisting of an initial phasic component (Phase 1) and a late tonic component (Phase 2). Desensitization of purinoceptors with alpha-beta methylene ATP (3 microM) abolished completely both components of the biphasic response. Angiotensin-II (A-II) and angiotensin-III (A-III) produced a concentration-dependent potentiation of Phase 2, with A-II being approximately 10-fold more potent than A-III. Losartan (0.03, 0.3 and 3 microM) produced parallel, concentration-dependent dextral shifts of the concentration effect curve to A-II without altering the maximum response (Schild analysis: slope = 1.18, pA2 = 8.5). In a separate series of experiments, field stimulation of the VD (0.1 Hz, 1 msec pulse duration, 80 V) resulted in a monophasic twitch response (Phase 1), which was also abolished by desensitization of purinoceptors. Both A-II and A-III produced a concentration-dependent inhibition of the Phase 1, with A-III being as potent as A-II but producing a significantly greater maximum response. Losartan (0.1 and 0.01 microM) antagonized the inhibitory effects of A-II and A-III in an unsurmountable manner.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗

Benzimidazolone derivatives act as 5-HT4 receptor ligands in rat oesophagus.

Three benzimidazolone derivatives have been evaluated in the tunica muscularis mucosae preparation of the rat oesophagus for activity at the 5-HT4 receptor. BIMU 1 (endo-N-(8-methyl-8-azabicyclo-[3.2.1]oct-3-yl)-2,3-dihydro-3-ethyl-2-ox o- 1H-benzimidazole-1-carboxamide HCl) and BIMU 8 (endo-N-(8-methyl-8-azabicyclo[3.2.1]oct-3-yl)-2,3-dihydro-(1-methyl)eth yl- 2-oxo-1H-benzimidazole-1-carboxamide HCl) acted as potent but partial agonists relative to 5-HT whereas DAU 6215 (N-(endo-8-methyl-8-azabicyclo[3.2.1]oct-3-yl)2,3-dihydro-2-oxo-1H- benzimidazole-1-carboxamide HCl) behaved as a competitive antagonist with a pA2 of 6.5. The pEC50 values for BIMU 1 and BIMU 8 were 8.0 and 7.9, respectively, compared with 8.2 for 5-HT. Intrinsic activity values were 0.7 and 0.9, respectively. BIMU 1 and BIMU 8 are the most potent synthetic agonists so far tested in rat oesophagus, and DAU 6215 exhibits an equivalent affinity to ICS 205 930 at the 5-HT4 receptor.

Animals↗

5-Hydroxytryptamine stimulates cyclic AMP formation in the tunica muscularis mucosae of the rat oesophagus via 5-HT4 receptors.

The nature of 5-HT4 receptor coupling in the tunica muscularis mucosae of the rat oesophagus has been studied. 5-HT and renzapride stimulated cyclic AMP formation concentration dependently, with -log EC50 values of 7.1 and 6.8, respectively. Renzapride, relative to 5-HT, acted as a partial agonist. Tropisetron (ICS 205 930) and a novel 5-HT4 antagonist, SDZ 205 557, inhibited 5-HT-induced cyclic AMP production competitively, with pA2 estimates of 6.7 and 7.7, respectively. These data are consistent with the hypothesis that 5-HT4 receptors mediate relaxation of the smooth muscle cells of the tunica muscularis mucosae of rat oesophagus via activation of adenylyl cyclase.

Adenine↗

Slow off-rate of prazosin accounts for deviations from competitive antagonism in the isolated perfused kidney of rat.

1. The kinetics of the interaction of prazosin with noradrenaline, administered by bolus injection and infusion, was examined in the isolated perfused rat kidney. 2. Prazosin (1-30 nM) competitively antagonized vasoconstrictor responses to infusion of noradrenaline (pA2 = 9.51) whereas antagonism toward bolus injections of noradrenaline deviated from competition. 3. In the presence of prazosin, responses to bolus injection of noradrenaline became biphasic whereas the kinetics of the responses to infusions of noradrenaline were unchanged. 4. In contrast, phentolamine (30-300 nM) competitively antagonized responses to bolus injection of noradrenaline without altering response kinetics and in coperfusion studies with prazosin, prevented prazosin from inducing biphasic responses to bolus injection of noradrenaline. 5. It is concluded that prazosin acts as a pseudoirreversible antagonist toward vasoconstrictor responses to bolus injections noradrenaline (non-steady state conditions) whereas steady state conditions and competitive kinetics are observed with infused noradrenaline.

Animals↗

Evidence for a noradrenergic innervation to alpha 1A-adrenoceptors in rat kidney.

1. Experiments were undertaken to characterize the alpha 1-adrenoceptor subtype mediating vasoconstrictor responses to periarterial noradrenergic nerve stimulation (PNS) in the isolated perfused kidney of the rat. 2. Vasoconstrictor responses to nerve stimulation were inhibited by prazosin (10 nM), 5-methyl-urapidil (30 nM), and nitrendipine (1 microM) but were resistant to inhibition by chloroethylclonidine (100 microM). 3. 5-Methyl-urapidil (30 nM), chloroethylclonidine (100 microM) and nitrendipine (1 microM) did not inhibit the neuronal release of tritium from nerves loaded with [3H]-noradrenaline. 4. The results suggest that renovascular alpha 1A-adrenoceptors receive a noradrenergic innervation and that the innervated receptors are coupled to dihydropyridine-sensitive calcium channels.

Adrenergic alpha-Antagonists↗

Evidence for a noradrenergic innervation to "atypical" beta adrenoceptors (or putative beta-3 adrenoceptors) in the ileum of guinea pig.

Indirect evidence suggests that beta-1 adrenoceptors in the guinea pig ileum are innervated but it has not been determined whether "atypical" beta adrenoceptors also receive a postganglionic sympathetic innervation. To answer this question, experiments were undertaken using electrical stimulation of para-arterial sympathetic neurons to evoke relaxation in isolated segments of guinea pig ileum. Tension was developed in the ileal segments by either transmural electrical field stimulation to evoke the cholinergic "twitch" response, or by histamine to produce a steady-state contracture. Para-arterial sympathetic nerve stimulation evoked a frequency-dependent inhibition of the twitch response which was blocked by guanethidine and restored by dexamphetamine, indicating typical noradrenergic transmission. In preparations contracted with histamine and pretreated with benextramine to block alpha adrenoceptors, para-arterial sympathetic nerve stimulation evoked frequency-dependent relaxations which were reduced in magnitude but not abolished by the following beta adrenoceptor antagonists: bromoacetylalprenololmenthane (1 microM) or a combination of ICI 118,551 (0.3 microM) and CGP 20712A (0.1 microM). Remaining responses were blocked by compounds exhibiting affinity for atypical beta adrenoceptors, (-)-alprenolol (3 microM) and nadolol (300 microM), as well as the agonist (-)-isoproterenol (10 microM; to saturate the atypical beta adrenoceptor). However, relaxations to papaverine were unaffected by these treatments. Experiments revealed that potential cotransmitters (ATP, neuropeptide Y and somatostatin) do not appear to play a detectable role in relaxations produced by para-arterial sympathetic nerve stimulation. The results demonstrate, for the first time, that atypical beta adrenoceptors in guinea pig ileum receive a noradrenergic innervation.

Adenosine Triphosphate↗

5-Hydroxytryptamine4 receptors mediate relaxation of the rat oesophageal tunica muscularis mucosae.

The present study was designed to characterize an "atypical" 5-hydroxytryptamine (5-HT) receptor mediating relaxation of the rat oesophageal tunica muscularis mucosae. All experiments were performed under equilibrium conditions, using pargyline to inhibit the oxidative deamination of indoleamines, and cocaine and corticosterone to inhibit neuronal and extraneuronal uptake. Under these conditions 5-HT (0.3-1000 nmol/l) produced a concentration-dependent relaxation of carbachol-induced tension. The concentration-effect curve to 5-HT was unaffected by potent antagonists for 5-HT1, 5-HT2, 5-HT3 and so called 5-HT1P receptors (metergoline, methysergide, ketanserin, ondansetron, N-acetyl-5-hydroxytryptophyl-5-hydroxytryptophan amide), but was antagonized competitively by ICS 205-930 (pA2 = 6.7). Responses to 5-HT were mimicked by other indoleamines and substituted benzamides with the following order of potency: 5-HT greater than or equal to 5-methoxytryptamine greater than cisapride = alpha-methyl-5-HT = (S)-zacopride = renzapride greater than (RS)-zacopride greater than 5-carboxamido-tryptamine = metoclopramide = (R)-zacopride greater than tryptamine greater than 2-methyl-5-HT. ICS 205-930 afforded similar pA2 values (6.0-6.7) against each agonist, indicating a common site of action. Concentration-effect curves to 5-HT were not affected by tetrodotoxin or indomethacin, suggesting that 5-HT-induced relaxation of the tunica muscularis mucosae was mediated via a post-junctional receptor, independent of endogenous prostanoids. The pharmacological profile of the 5-HT receptor in the rat oesophageal tunica muscularis mucosae correlates well with the 5-HT4 receptor characterized recently in both the CNS and gastro-intestinal tract.

Animals↗