Biomedical subjects
Publications and source records attributed to M Shannon.
Five cases are presented in which multiple doses of activated charcoal were given to infants 6 months of age or less, as treatment of theophylline overdose. This therapy was tolerated in all cases with apparent enhancement of theophylline elimination. Use of multiple dose activated charcoal appears to be a viable option in the treatment of young infants with theophylline poisoning.
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The affinities of a series of 1-(2,5-dimethoxyphenyl)-2-aminopropane (2,5-DMA) derivatives, most of which are hallucinogenic in man, and several related agents were determined for rat cortical serotonin (5-HT) binding sites. Competition assays were performed in which these agents were competed for the 5-HT2 binding of [3H]ketanserin, or the 5-HT1 binding of [3H]LSD (in the presence of ketanserin). The R(-)-isomers of DOI, DOM and DON (i.e. the 4-iodo, -methyl and -nitro derivatives of 2,5-DMA) were found to be more potent than their racemates and demonstrated selectivity for 5-HT2 sites. These same agents in competing for [3H]ketanserin binding resulted in Hill coefficients significantly less than unity; computer-assisted analysis indicated a two-state model better fit the data. In the presence of 10(-4) M Gpp(NH)p the competition curve for R(-)-DOI produced a Hill coefficient close to unity. These results are consistent with the hypothesis that certain derivatives of 2,5-DMA, in particular R(-)-DOI, may be potent and selective agonists at 5-HT2 binding sites, sites that may constitute a serotonin receptor that is regulated by a guanine nucleotide regulatory protein. Conversely, the interactions of these agents at 5-HT1 sites was with a lower affinity and a lack of stereoselectivity. Although DOI and DOM are amongst the most potent of these agents as hallucinogens, it is still too premature to draw any conclusions regarding a possible relationship between 5-HT binding and hallucinogenic potency.
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Computer-assisted quantitative analysis of radioligand binding to rat cortical S2 serotonin receptors indicates the existence of two affinity states of the same receptor population. Monophasic antagonist competition curves for [3H]ketanserin-labelled sites suggest a uniform population of receptors with one affinity state for antagonists. Biphasic competition curves of agonists suggest that agonists discriminate high- and low-agonist-affinity forms of the S2 receptors. The affinities of agonists for the high- and low-affinity states, and the apparent percentages of high agonist-affinity forms varies with different agonists. The guanine nucleotides GTP and guanyl-5'-imido-diphosphate [Gpp(NH)p], as well as divalent cations, modulate the proportion of the sites with high affinity for agonists as evidenced by their ability to shift the agonist competition curves for [3H]ketanserin-labelled S2 receptors. GTP and Gpp(NH)p effects appear to be agonist-specific, as they do not affect antagonist competition for [3H]ketanserin-labelled S2 receptors, or [3H]ketanserin binding to S2 receptors. ATP and ADP have little or no effect on the binding properties of S2 serotonin receptors, whereas GDP is less potent than GTP. The presence of these specific nucleotide effects are the first evidence suggesting involvement of a guanine nucleotide-binding protein in the mechanism of agonist interaction with the S2 serotonin receptor. In general, the binding properties of [3H]ketanserin-labelled S2 serotonin receptors strongly resemble those of adenylate-cyclase coupled receptors such as the beta-adrenergic, the alpha 2-receptor, and the D-2 dopamine receptor. This may indicate the S2 serotonin receptor is coupled to adenylate cyclase activity, through a GTP binding protein.
Many radiolabelled receptors coupled to intracellular adenylate cyclase activity have been found to be modulated by physiological modulators such as GTP (guanosine triphosphate) and Gpp(NH)p (guanosine-imido-diphosphate). In particular, the apparent affinity of agonists competing for the binding of 3H-antagonist-labelled receptors is reduced in the presence of GTP and Gpp(NH)p. We report herein the agonist-specific effects of GTP and Gpp(NH)p on rat brain cortical S2 serotonin receptors. The agonists serotonin, 5-methoxytryptamine, bufotenine, and tryptamine display threefold lower affinities for S2 serotonin receptors in the presence of 10(-4)M GTP or Gpp(NH)p than in the absence of the nucleotides. The antagonists spiperone, cinanserin, cyproheptadine and methysergide are unaffected by the guanine nucleotides. The Hill coefficients of the agonists increase from between 0.70-0.80 to 0.90-1.00 due to guanine nucleotides. ATP, ADP, and GDP have little or no effect. This pattern of guanine nucleotide effects has been found with receptors which are modulated by a guanine nucleotide regulatory protein and may indicate that the S2 serotonin receptor may be coupled to intracellular adenylate cyclase activity.
[3H]Ketanserin, a serotonin receptor antagonist, labelled high affinity, saturable sites in homogenates of porcine neurointermediate lobe tissue. Cinanserin, a potent and selective serotonin receptor antagonist, inhibited the specific binding of 5 X 10(-10)M [3H]ketanserin with a high affinity component representing 20% of the total binding. Prazosin, a potent and selective alpha 1 adrenergic antagonist, inhibited [3H]ketanserin binding with a high affinity component representing 60% of total binding. The prazosin-specific component was demonstrated to be distinct from the cinanserin-specific component. 10(-7)M cinanserin was co-incubated with [3H]ketanserin to eliminate the serotonergic component of the binding and allow pharmacological characterization of the remaining prazosin-specific component. The prazosin-specific binding of [3H]ketanserin binding closely resembled the results of experiments using [3H]prazosin to label alpha 1 receptors in neurointermediate lobe tissue homogenates. Ketanserin was found to be seven-fold more potent in inhibiting [3H]prazosin binding to alpha 1 adrenergic receptors in the neurointermediate lobe tissue than in brain tissue. This observation explains why low concentrations of [3H]ketanserin can selectively label serotonin receptors in the brain but will label both adrenergic and serotonin receptors in the neurointermediate lobe.
The effects of varying the pH on the properties of S2 serotonin receptors labelled by [3H]-ketanserin were examined. Between pH 7.0 and 8.2 the agonist affinities, as determined by competition experiments, increased dramatically. Serotonin, 5-methoxytryptamine, tryptamine, bufotenine and quipazine, demonstrated 15,16,8,6 and 5-fold increases in apparent affinity between pH 7.0 and 8.2. On the other hand the antagonists, ketanserin, cinanserin, and spiperone demonstrated little or no affinity changes between pH 7.0 and 8.2. The largest shift in affinity for an antagonist occurred with spiperone, which displayed a two-fold shift. Although changing pH is a rather non-specific manipulation, the selective affect on agonist interaction with S2 receptors indicates further investigation of this pH effect may aid in discovering the difference in receptor interactions between serotonin agonists and antagonists.
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The effect of LiCl, NaCl, and KCl on serotonin competition for 3H-ketanserin binding to S2 serotonin receptors in homogenates of rat prefrontal cortex were investigated. LiCl was the most potent of the ionic modulators in lowering the apparent affinity of serotonin for the S2 serotonin receptor. A threshold effect was noted at 12 mM LiCl (a 60% change in IC50); at 120 mM LiCl a nine-fold shift in the serotonin IC50 was noted. 120 mM NaCl or KCl demonstrated similar effects as 12 mM LiCl in reducing serotonin's apparent affinity. These results indicated that monovalent cations modulate S2 serotonin receptor affinity for serotonin and that lithium ion is more potent than sodium or potassium.
[3H]Prazosin binding to alpha 1 receptors in homogenates of rat prefrontal cortical tissue and porcine pituitary neurointermediate lobe tissue was investigated. Competition curves produced by coincubating adrenergic agonists and antagonists with 0.5 nM [3H]prazosin and tissue revealed some anomalous binding properties. In the brain and pituitary tissue, agonist competition curves produced "shallow" slopes, with Hill coefficients significantly lower than unity. The IC50 of the agonists epinephrine, norepinephrine, and clonidine for inhibition of 0.5 nM [3H]prazosin binding were significantly lower in the porcine pituitary than in the rat brain. Most antagonists, such as prazosin, chlorpromazine, and piperoxan, produced "steep" competition curves with Hill coefficients close to unity, with two notable exceptions. WB-4101 and phentolamine produced competition curves with Hill coefficients significantly less than unity in the rat brain preparation. Ketanserin, an antagonist, displayed a sevenfold higher affinity for the alpha 1 sites in the pituitary tissue than in the brain tissue. These anomalies in the binding results may indicate the presence of an endogenous modulatory factor affecting agonist and antagonist affinities for the alpha 1 receptor.
[3H]Prazosin binding to alpha 1-adrenergic receptors was investigated in homogenates of tissue from the porcine pituitary neurointermediate lobe. Potent alpha 1-adrenergic antagonists such as prazosin, WB-4101, and phentolamine displayed high potency in competing for [3H]prazosin specific binding in pituitary tissue. Epinephrine and norepinephrine were the only neurotransmitters which displayed high potency in competing for [3H]prazosin binding sites. There was a strong correlation in the pharmacological properties of the alpha 1 sites in pituitary tissue and the alpha 1 sites detected by [3H]prazosin in rat brain tissue. Alpha-adrenergic agonists demonstrated significantly higher potency for the alpha 1-receptor sites in pituitary tissue than in brain tissue preparations. The antagonist ketanserin demonstrated significantly higher potency at alpha 1 sites in pituitary tissue than in brain tissue. This latter observation has important implications for investigators attempting to use [3H]ketanserin as a selective serotonin receptor ligand in pituitary tissue. The results of this study represent the first demonstration of alpha 1-receptors in mammalian neurointermediate lobe tissue.
72 patients severely immunocompromised by their underlying disease (marrow aplasia, acute leukaemia, or solid tumour) or by the treatment they were receiving, or both, were randomised to receive antifungal prophylaxis with either oral ketoconazole or conventional doses of oral amphotericin B and nystatin. All patients also had gut decontamination with non-absorbable antibiotics, skin antisepsis, sterile food, and oral cotrimoxazole. Protection against fungal infection was significantly superior with ketaconazole. When patients who had received allogeneic bone-marrow transplant were studied separately, there was no significant difference between the two treatments, probably because there was a fall-off in ketoconazole absorption from the end of the third week after the transplant. However, ketoconazole greatly reduced the likelihood of fungal infection in non-transplant patients.
Nine patients with acute leukaemia developed a complex syndrome of hypocalcaemia and hypomagnesaemia during treatment. These metabolic abnormalities developed rapidly in some patients and gave rise to acute symptoms. Immunoreactive parathormone concentrations in these patients were found to be either absolutely or inappropriately low. Hypomagnesaemia and the action of chemotherapeutic agents, especially adriamycin or cytarabine, or both may have contributed to the pathogenesis of this syndrome.
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