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Biomedical subjects

D Steinberg

Publications and source records attributed to D Steinberg.

At least 37 records · Page 2Linked to original sources

[Effects of non-depolarizing muscle relaxants on the duration of mivacurium].

The interaction between Mivacurium and several muscle relaxants results in a slow recovery. We have previously described that small doses of d-tubocurarine prolong the duration of two successful administrations of Mivacurium. The present investigation was designed to uncover if such an effect could be observed after other neuro-muscular blocking drugs were administered, and if so, its consistency during the different methods of their use. Patients (n = 224) were anesthetized with Enflurane and randomly assigned to two control groups which received 100 micrograms/Kg-1 Mivacurium as a bolus or primed. Other groups received: Rocuronium (60 micrograms/Kg-1), Vecuronium (10 micrograms/Kg-1), Atracurium (60 micrograms/Kg-1), d-tubocurarine (50 micrograms/Kg-1) or Pancuronium (8 micrograms/Kg-1) before, after or as a mixture with 90 micrograms/Kg-1 of Mivacurium. The clinical effect was monitored by electromyography and the results show that all these agents prolong the duration of Mivacurium, the last three in a statistically significant fashion independently of the mode of administration. Current hypothesis are reviewed, but no definitive clues are obtained to explain the present results. Our conclusions must be considered as further research on the interaction between non-depolarizing muscle relaxants and a base for new theories on interactions.

Analysis of Variance↗

Scavenger receptor class B type I as a receptor for oxidized low density lipoprotein.

Scavenger receptor class B type I (SR-BI) has been established as the primary mediator of the selective transfer of lipids from HDL to mammalian cells. In addition to its role in cholesterol metabolism, SR-BI has been shown to bind apoptotic cells and thus could in theory also function as a scavenger receptor. We now show that SR-BI binds oxidized LDL (OxLDL) with high affinity (K(d) of 4.0 +/- 0.5 microg/ml) and mediates internalization and degradation to an extent comparable to that of other scavenger receptors, when normalized to binding activity. The best competitors for OxLDL binding to SR-BI were oxidized lipoproteins, whereas native or acetylated lipoproteins only competed for a small fraction of OxLDL binding. Both the isolated lipids and the isolated protein from OxLDL bound with high affinity to SR-BI and showed partial reciprocal competition. Monoclonal antibody EO6, an antibody against oxidized phospholipids, and 1-palmitoyl-2-(5-oxovaleroyl) phosphatidylcholine (POVPC) both competed effectively with intact OxLDL and with isolated lipids from OxLDL for SR-BI binding.Together, these results demonstrate a potential function of SR-BI, in addition to its role in selective uptake of lipids, to mediate internalization of OxLDL by macrophages and suggest a central role for oxidized phospholipids in this process.

Antibodies, Monoclonal↗

The oxidative modification hypothesis of atherogenesis: an overview.

The literature relating lipid and lipoprotein oxidation to atherosclerosis has expanded enormously in recent years. Papers on the "oxidative modification hypothesis" of atherogenesis have ranged from the most basic studies of the chemistry and enzymology of LDL oxidation, through studies of the biological effects of oxidized LDL on cultured cells, and on to in vivo studies of the effects of antioxidants on atherosclerosis in animals and humans. The data in support of this theory are mounting but many key questions remain unanswered. For example, while it is generally agreed that LDL undergoes oxidation and that oxidized LDL is present in arterial lesions, it is still not known how and where LDL gets oxidized in vivo nor which of its many biological effects demonstrable in vitro are relevant to atherogenesis in vivo. This brief review is not intended to be comprehensive but rather to offer a perspective and a context for this Forum. We discuss the strengths and weaknesses of each line of evidence, try to identify areas in which further research is needed, assess the relevance of the hypothesis to the human disease, and point to some of the potential targets for therapy.

Animals↗

The binding of oxidized low density lipoprotein to mouse CD36 is mediated in part by oxidized phospholipids that are associated with both the lipid and protein moieties of the lipoprotein.

There is growing evidence that CD36 has an important physiological function in the uptake of oxidized low density lipoprotein (OxLDL) by macrophages. However, the ligand specificity and the nature of the ligands on OxLDL that mediate the binding to CD36 remain ill defined. Results from recent studies suggested that some of the macrophage scavenger receptors involved in the uptake of OxLDL recognized both the lipid and the protein moieties of OxLDL, but there was no conclusive direct evidence for this. The present studies were undertaken to test whether a single, well characterized OxLDL receptor, CD36, could bind both the lipid and protein moieties of OxLDL. COS-7 cells transiently transfected with mouse CD36 cDNA bound intact OxLDL with high affinity. This binding was very effectively inhibited ( approximately 50%) both by the reconstituted apoB from OxLDL and by microemulsions prepared from OxLDL lipids. The specific binding of both moieties to CD36 was further confirmed by direct ligand binding analysis and by demonstrating reciprocal inhibition, i.e. apoB from OxLDL inhibited the binding of the OxLDL lipids and vice versa. Furthermore, a monoclonal mouse antibody that recognizes oxidation-specific epitopes in OxLDL inhibited the binding of intact OxLDL and also that of its purified protein and lipid moieties to CD36. This antibody recognizes the phospholipid 1-palmitoyl 2-(5'-oxovaleroyl) phosphatidylcholine. This model of an oxidized phospholipid was also an effective competitor for the CD36 binding of both the resolubilized apoB and the lipid microemulsions from OxLDL. Our results demonstrate that oxidized phospholipids in the lipid phase or covalently attached to apoB serve as ligands for recognition by CD36 and, at least in part, mediate the high affinity binding of OxLDL to macrophages.

Animals↗

Surface expression and rapid internalization of macrosialin (mouse CD68) on elicited mouse peritoneal macrophages.

Macrosialin, the mouse homolog of human CD68, is a heavily glycosylated transmembrane protein found almost exclusively in macrophages. Its function remains uncertain. It has a high affinity for oxidized low-density lipoprotein (LDL) in ligand blots and antibodies against the human homolog, CD68, inhibit the binding of oxidized LDL to a human monocyte-derived cell line (THP-1). However, there is still controversy as to whether macrosialin, found predominantly in late endosomes, is expressed at all on the plasma membrane. The present studies, done in thioglycollate-elicited peritoneal macrophages, confirm that macrosialin is predominantly intracellular but show clearly that 10-15% of it is expressed on the cell surface. Exchange with intracellular pools occurs at an extremely high rate. The results are compatible with a surface function, including internalization of bound ligands or adhesion to surfaces.

Animals↗

Protective effect of Copalite surface coating on mercury release from dental amalgam following treatment with carbamide peroxide.

The effect of Copalite coating on mercury release from dental amalgam following treatment with 10%, 20%, 30% and 40% carbamide peroxide was assessed in vitro, using a cold-vapour atomic absorption Mercury Analyzer System. Eighty samples of dental amalgam were automatically mixed in a dental amalgamator and condensed into silicon embedding molds. Forty amalgam samples were coated with three uniform layers of Copalite intermediary varnish and the other 40 samples were left uncoated. The coated and non-coated amalgam samples were exposed for 24 h to 10%, 20%, 30% or 40% carbamide peroxide preparations and compared with samples exposed to phosphate buffer. In the non-coated samples a significant increase of mercury concentration in solution was found following exposure to all carbamide peroxide preparations tested. Mercury concentration was directly related to carbamide peroxide concentration. In the Copalite-coated samples, significantly lower concentrations of mercury in solution were found as compared to the non-coated samples (P < 0.01). In conclusion, exposure of amalgam restorations to 10%-40% carbamide peroxide-based bleaching agents increased the mercury release. Pre-coating of the external amalgam surfaces with Copalite significantly reduced the release of mercury.

Analysis of Variance↗

Human scavenger receptor B1 is involved in recognition of apoptotic thymocytes by thymic nurse cells.

Recognition and uptake of apoptotic cells by neighboring phagocytes is essential for the clearance of dying cells without accompanying inflammation or tissue damage. In the thymus, many apoptotic cells are generated in the process of negative selection, and both thymic macrophages (professional phagocytes) and nursing thymic epithelial cells (nursing TEC; nonprofessional phagocytes) recognize and ingest them. However the receptors responsible for this recognition and uptake have not been identified. In the present study, we have established a human nursing TEC line and examined the expression of several genes of the scavenger receptor family considered to be potential receptors for apoptotic cells. Human scavenger receptor-B1 (hSR-B1)/CLA-1, previously shown to recognize apoptotic cells, was strongly expressed in nursing TEC, whereas there was little or no expression of the other scavenger receptors tested: scavenger receptor class A, CD36, or CD68. Suppression of hSR-B1/CLA-1 expression using antisense oligonucleotides decreased the binding of apoptotic thymocytes to nursing TEC by more than 40%. These results indicate that hSR-B1/CLA-1 may play a major role in the clearance of apoptotic cells in the thymus, mediating the recognition and ingestion of apoptotic thymocytes by nursing TEC.

Animals↗

Mercury release from dental amalgam after treatment with 10% carbamide peroxide in vitro.

OBJECTIVES: The effect of 10% carbamide peroxide on mercury release from dental amalgams was assessed in vitro by using a cold-vapor atomic absorption Mercury Analyzer System. STUDY DESIGN: Samples of 4 commercial brands of dental amalgam, Megaloy (Dentsply/Caulk, Milford, Del), Mega+ (CFPM, Aulnaye, France), Nongama 2 (Silmet, Or Yehuda, Israel), and Valiant Ph.D. (Dentsply/Caulk, Milford, Del), were treated for 48 hours with 10% carbamide peroxide and compared with samples treated with phosphate buffer. RESULTS: Amalgam specimens exposed for 48 hours to 10% carbamide peroxide showed significantly higher concentrations of mercury in solution as compared with specimens treated with phosphate buffer (P <.001). Megaloy and Valiant Ph.D. yielded significantly higher mercury concentrations in solution than Mega+ and Nongama 2 (P <.001). Mega+ yielded significantly higher mercury concentrations in solution than Nongama 2 (P <.05). No significant differences were found in mercury concentrations in solution between Megaloy and Valiant Ph.D. CONCLUSIONS: Treatment with 10% carbamide peroxide bleaching agents caused an increase in mercury release from amalgam restorations, possibly increasing exposure of patients to its adverse effects. Amalgam brands differed in the amounts of mercury release after bleaching with carbamide peroxide.

Carbamide Peroxide↗

Is there a potential therapeutic role for vitamin E or other antioxidants in atherosclerosis?

In-vitro studies and animal model studies provide an ever-growing body of evidence, direct and indirect, that oxidation of low-density lipoprotein and/or related oxidative mechanisms play a role in atherogenesis. However, two recent, very large, carefully conducted clinical intervention trials using adequate doses of vitamin E demonstrated no effect on a composite end-point of non-fatal infarction, stroke or death from cardiovascular causes. Why the unexpected negative results? Possibly because the animal intervention evidence on which these trials were based deals primarily with very early lesions (fatty streaks). That evidence does not necessarily provide a basis for predicting what antioxidant intervention will do in patients with advanced lesions, particularly when the end-points used relate to unstable plaques and fatal thrombosis, events for which we have no adequate animal models. Nor does it necessarily follow that the same antioxidants used successfully in animals will be effective in humans. The strength of the evidence for the oxidative modification hypothesis is such that negative clinical trials with one particular antioxidant, in patients with very advanced coronary heart disease and lasting only 3-5 years, should not be taken as refutation of the hypothesis. Perhaps different kinds of human trials are needed, trials in which the development of new lesions is measured, in order to test whether antioxidants can decrease the rate of initiation and early progression of atherosclerosis as they do in animals. The answer to the title query is 'Probably, but it is too soon to say'.

Animals↗

Polymerase chain reaction-based method for quantifying recruitment of monocytes to mouse atherosclerotic lesions in vivo: enhancement by tumor necrosis factor-alpha and interleukin-1 beta.

The critical role of monocyte recruitment in atherogenesis has been appreciated for some time. However, until recently, there have been no sufficiently sensitive methods for measuring rates of monocyte recruitment to the arterial wall in vivo. We have developed a novel highly sensitive method, based on the polymerase chain reaction, for quantitatively tracking DNA-marked monocytes and have adapted it for use in mice. We use the uniquely male gene, SRY:, on the Y chromosome as a gene marker. We transfuse monocytes from a male donor into a congenic female mouse, euthanize the mouse after 24 to 48 hours, and then quantify the arterial uptake of monocytes by quantitative polymerase chain reaction. This study describes the techniques used and their sensitivity and reproducibility and demonstrates the approach by assessing the effects of cytokines. In control low density lipoprotein receptor-negative mice, monocyte recruitment decreased slightly but significantly as lesions progressed. Intraperitoneal injection of a combination of tumor necrosis factor-alpha and interleukin-1 beta more than doubled the rate of monocyte recruitment into developing lesions. However, the response to the cytokines was much greater in younger mice with less advanced lesions than in older animals with more advanced lesions.

Animals↗

The interactions of human neutrophils with the constituents of an experimental dental biofilm.

Despite the antibacterial properties of neutrophils, their ability to prevent colonization of the dental biofilm by pathogenic bacteria is limited. The present study examined the ability of human neutrophils to attach to an experimental dental biofilm and tested their antibacterial functions following adhesion. Neutrophil adhesion was greatest to hydroxyapatite (HA) in the absence of biofilm. Among the biofilms, glucosyltransferase or fructosyltransferase adsorbed onto saliva-coated HA showed the highest adhesion of cells. The adhesion of neutrophils was directly related to their initial concentration in the solution and to the duration of incubation. Plasma was found to reduce neutrophil attachment significantly, while stimulation of the cells had no effect. Stimulation of attached neutrophils induced superoxide secretion with levels significantly lower than that secreted by suspended cells. The presence of neutrophils on the biofilm reduced the number and the viability of Streptococcus mutans attached to the beads. The present findings suggest that neutrophils are able to attach to dental biofilms and that the attached neutrophils retained their antibacterial activity.

Adult↗

Oxidized phospholipids, linked to apolipoprotein B of oxidized LDL, are ligands for macrophage scavenger receptors.

Previous studies have shown that macrophage receptors for oxidized LDL (OxLDL) recognize both the lipid and protein moieties, and that a monoclonal antibody against OxLDL, EO6, also recognizes both species. The present studies show directly that during LDL oxidation phospholipids become covalently attached to apolipoprotein B (apoB). After exhaustive extraction of lipids, apoB of native LDL contained 4 +/- 3 moles of phosphorus/mole protein. In contrast, apoB of OxLDL contained approximately 75 moles of phosphorus/mole protein. Saponification of this apoB released phosphorus, choline, and saturated fatty acids in a molar ratio of 1.0:0.98:0.84. When LDL was reductively methylated prior to oxidation, the amount of phospholipid covalently bound was reduced by about 80%, indicating that the phospholipids attach at lysine epsilon amino groups. Progressive decreases in the phospholipid associated with apoB of OxLDL decreased the ability of the protein to compete for binding to macrophage scavenger receptors and decreased its reactivity with antibody EO6. We postulate that some oxidized phospholipids containing fatty acid aldehydes at the sn-2 position bind to lysine residues of apoB while others remain unreacted within the lipid phase. This would account for the interchangeability of lipid and apolipoprotein of OxLDL with respect to receptor binding and antibody recognition.

Animals↗

Preventing coronary artery disease by lowering cholesterol levels: fifty years from bench to bedside.

In the more than 50 years since the founding of the National Heart, Lung, and Blood Institute and the American Heart Association, medical science has moved from an era in which hypercholesterolemia, as it is now defined, was not believed to be abnormal to one in which controlling hypercholesterolemia is known to reduce not only coronary artery disease morbidity and mortality but also total mortality. While the efforts and successes of many researchers involved in this evolution are impressive, atherosclerosis is still a major cause of death and disability in many developed nations, mostly in the form of myocardial infarction and stroke, and is an increasing cause of morbidity and mortality in developing nations. Many questions about the detailed pathogenesis of the disease remain. Elucidating the roles of high-density lipoprotein, other lipoproteins, and homocysteine, as well as the roles of cytokines and growth factors, will permit better understanding and treatment of atherosclerosis. With continuing support for research and encouragement of physicians and patients to follow recommended preventive regimens, further progress can be made against this major cause of death.

Angiography↗