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R Testa

Publications and source records attributed to R Testa.

At least 109 records · Page 6Linked to original sources

Pharmacological in vitro studies of the new 1,4-dihydropyridine calcium antagonist lercanidipine.

The present studies were undertaken to examine the in vitro calcium antagonistic properties of lercanidipine (CAS 132866-11-6, Rec 15/2375) in vascular and non-vascular tissues, as well as its binding profile and in particular its affinity to the calcium channel binding sites. Lercanidipine proved to be endowed with high affinity for the dihydropyridine subunit of the L-type calcium channel, where it was much more potent than on the other receptors tested. The nature of the interaction of lercanidipine with the calcium channel appears competitive, as evidenced by a progressive increase in the apparent Kd of the ligand with no change in Bmax. The performed functional in vitro studies in isolated vascular and cardiac tissues demonstrated that lercanidipine has a slower onset and offset of calcium antagonistic activity compared with other calcium antagonists. The time-course of inhibition of vascular smooth muscle contraction showed substantial differences after addition of lercanidipine with regard to the other calcium antagonists tested (nitrendipine and amlodipine). On repeated washing of rat aorta to remove the drugs from the preparation, the effects of nitrendipine disappeared rapidly. After amlodipine incubation, contractility of the tissue was still impaired after 6 h washout with the highest concentrations tested, but completely recovered in 1-3 h after washout of the lowest concentration. On the contrary, the preparations incubated with lercanidipine showed a decrease in contractility that reached the maximum 1 to 3 h after the removal of the compound from the bath at all the active concentrations tested. The functional calcium antagonistic activity of lercanidipine was also evaluated as relaxing potency against the tonic contractions induced by preincubation of rat aorta, bladder and colon with 80 mmol/l K+. In rat aorta, lercanidipine proved more potent than nitrendipine. Comparing the IC50 values evaluated after 3 h of contact time, lercanidipine resulted more active on the vascular tissue with potency ratios of 177 and 8.5 for aorta vs bladder and aorta vs colon, respectively. In contrast, nitrendipine showed about the same activity in the three tested tissues, and potency ratios of 2.0 and 0.8 for aorta vs bladder and aorta vs colon were calculated. In rat aortic strips maintained during the incubation with lercanidipine at different degrees of depolarization, the functional calcium antagonistic activity markedly increased by raising the tissue depolarization and the potency ratio between the IC50 values evaluated at 5 and 100 mmol/l K+ resulted 138. Nitrendipine provided very similar results, whereas nifedipine activity did not seem to be affected by raising the tissue depolarization. The negative inotropic effects of lercanidipine on normally and partially depolarized rabbit ventricular strips, as well as in guinea-pig atria, were negligible in comparison to its effects on vasculature. On the whole these characteristics suggest a slow onset of action and long duration of effects also after in vivo administration. In addition, the unique vascular selectivity of lercanidipine implies that the therapeutically desirable vasodilator activity is not or scarcely associated with a decrease in cardiac contractile force.

Adrenergic alpha-Agonists↗

Haemodynamic effects of lercanidipine in anaesthetized open-chest dogs.

In this study, the haemodynamic effects of lercanidipine (CAS 132866-11-6, Rec 15/2375) in anaesthetized open-chest dogs were investigated in comparison with nitrendipine. Intravenously administered lercanidipine induced a dose-related, long-lasting reduction in systemic and coronary vascular resistances, with concomitant decrease in arterial blood pressure and increase in coronary blood flow. The hypotensive ED25 was 6.1 micrograms/kg and 4.2 micrograms/kg (decrease of mean blood pressure and of total peripheral resistances, respectively) and the ED50 on coronary vasodilation, 4.8 micrograms/kg 7.8 micrograms/kg (increase of coronary blood flow and decrease in coronary vascular resistances, respectively). The time-course of the haemodynamic effects was investigated after administration of 5 micrograms/kg. A slow onset of haemodynamic vasodilation and long-lasting activity were observed, since peak effects on mean blood pressure and coronary blood flow occurred at 20 and 30 min after the administration, respectively, and the effects on systemic and coronary resistances were still significant at 30 and 150 min after administration, respectively. A reflex, non-dose-dependent increase in heart rate was observed after the administration of 10 and 30 micrograms/kg, which was absent with the 5 micrograms/kg dose. As far as cardiac contractility was concerned, the contractile index dP/dtmax and dP/dt/P were analyzed. In the dose-response study, dP/dtmax was practically not affected. In the time-course study, dP/dtmax was not modified after administration of 5 micrograms/kg, and dP/dt/P showed a slight but long-lasting increase. Haemodynamic investigation confirmed in vivo the high vascular selectivity of lercanidipine and a lack of sympathetic reflex activation at vasodilating doses.

Anesthesia↗

[Usefulness of pirenzepine in the study of the upper digestive tract and the large intestine with double contrast media: comparison with scopolamine methylbromide].

The purpose of the present study is to assess the importance of pirenzepine, a selective M1 antimuscarinic drug, as hypotonic agent for diagnostic double-contrast studies of the upper gastrointestinal tract and for double-contrast barium enema studies of the large bowel. Pirenzepine and scopolamine methylbromide (SMB) (Buscopan) were compared in a single blind randomized trial. One hundred-thirty consecutive patients were enrolled in the study. Seventy of them underwent double-contrast studies of the stomach and duodenum and sixty double-contrast barium enema studies of the large bowel. Visceral distension and painting of stomach, duodenal bulb and large bowel and global quality of the images were blindly evaluated by 4 independent observers by means of a numerical score (1 to 4). Quantitative analysis of bowel distension was done measuring the maximum diameter of the transverse colon before and after drug administration. No differences were found in the diagnostic performance between the two drugs in the study of the duodenal bulb (2.8 +/- 0.8 vs 2.9 +/- 0.7, p = NS) and of the large bowel (3.0 +/- 0.6 vs 3.1 +/- 0.6, p = NS). Under SMB, slightly but significantly better results were obtained in the stomach (3.0 +/- 0.6 vs 2.7 +/- 0.6, p = 0.01). However, large bowel distension was slightly but significantly improved with Pirenzepine (68 +/- 12 vs 65 +/- 8 mm, p = 0.02). Heart rate and rhythm during the study were recorded by ECG. SMB induced tachycardia in all patients while pirenzepine did not. Moreover, after SMB, 3 patients exhibited faintness, some patients complained of visual accommodation defects, dryness of the mouth and dizziness. Under pirenzepine, no side-effects were reported. To conclude, pirenzepine gives good results in double contrast studies, as good as SMB but with no adverse effects; thus, it could be proposed as the hypotonic agent of choice in upper gastrointestinal and large bowel examinations.

Adult↗

Receptor binding profile of cyclazosin, a new alpha 1B-adrenoceptor antagonist.

The binding profile of cyclazosin, a new prazosin-related alpha 1-adrenoceptor antagonist, at alpha 1-, alpha 2-adrenoceptors, dopamine D2 and 5-HT1A receptors was compared to that of 5-methylurapidil, spiperone, risperidone and other prazosin-related ligands. In addition, cyclazosin was investigated at native and cloned alpha 1-adrenoceptor subtypes. Cyclazosin showed high specificity for alpha 1-adrenoceptors and a 10-15-fold selectivity for alpha 1B (alpha 1b)-adrenoceptors with respect to the alpha 1A (alpha 1a) subtype (pKi values of 9.23-9.57 and 8.18-8.41, respectively). However, it failed to discriminate between cloned alpha 1b and alpha 1d-adrenoceptors (pKi values of 9.23 and 9.28, respectively).

Adrenergic alpha-Antagonists↗

The alpha 1d-adrenoceptor subtype is involved in the noradrenaline-induced contractions of rat aorta.

The pA2 value of several alpha 1-adrenoceptor antagonists on noradrenaline-induced contractions of rat aorta, and their affinity for the cloned alpha 1a-, alpha 1b- and alpha 1d-adrenoceptor subtypes were evaluated. Selective or moderately selective alpha 1d-, partially selective alpha 1b-, selective alpha 1a- and non subtype-selective alpha 1-adrenoceptors antagonists were included in the study. The potency of these compounds on rat aorta was well correlated with the affinity observed for the alpha 1d-adrenoceptor subtype. A poor correlation was found for the alpha 1b- and alpha 1a-subtypes. These results suggest that the alpha 1d-subtype plays a determining role in rat aorta contractions induced by noradrenaline.

Adrenergic alpha-Antagonists↗

Mediation of noradrenaline-induced contractions of rat aorta by the alpha 1B-adrenoceptor subtype.

1. The subtypes of alpha 1-adrenoceptor mediating contractions to exogenous noradrenaline (NA) in rat aorta have been examined in both biochemical and functional studies. 2. Incubation of rat aortic membranes with the irreversible alpha 1B-adrenoceptor antagonist, chloroethylclonidine (CEC: 10 microM) did not change the KD of [3H]-prazosin binding in comparison to untreated membranes, but reduced by 88% the total number of binding sites (Bmax). 3. Contractions of rat aortic strips to NA after CEC (50 microM for 30 min) incubation followed by repetitive washing, showed a marked shift in the potency of NA and a partial reduction in the maximum response. The residual contractions to NA after CEC incubation were not affected by prazosin (10 nM). 4. The competitive antagonists prazosin, terazosin, (R)-YM-12617, phentolamine, 5-methylurapidil and spiperone inhibited contractions to NA with estimated pA2 values of 9.85, 8.54, 9.34, 7.71, 7.64 and 8.41, respectively. 5. The affinity of the same antagonists for the alpha 1A- and alpha 1B- adrenoceptors was evaluated by utilizing membranes from rat hippocampus pretreated with CEC, and rat liver, respectively. 5-Methylurapidil and phentolamine were confirmed as selective for the alpha 1A-adrenoceptors, whereas spiperone was alpha 1B-selective. 6. A significant correlation was found between the pA2 values of the alpha 1-adrenoceptor antagonists tested and their affinity for the alpha 1B-adrenoceptor subtype, but not for the alpha 1A-subtype. 7. In conclusion, these findings indicate that in rat aorta most of the contraction is mediated by alpha 1B-adrenoceptors, and that the potency (pA2) of an antagonist in this tissue should be related to its antagonistic effect on this subtype of the alpha 1-adrenoceptor population.

Adrenergic alpha-Antagonists↗

Association of Hb S/Hb lepore and delta beta-thalassemia/Hb lepore in Sicilian patients: review of the presence of Hb lepore in Sicily.

The hemoglobin (Hb) lepore-Boston is a beta-globin structural variant, produced in a reduced amount and formed from the fusion of N-terminus delta-(residues 1-87) and C-terminus beta-chains (residues 116-146). This type of fusion protein is quite common in Southern Italy (Campania, Calabria, and Sicily). We report here the hematological and hemoglobin data on 96 unrelated Sicilians with Hb lepore trait. Particularly interesting are the subjects where Hb lepore occurs with Hb S or Sicilian type delta beta-thalassemia. In these individuals, striking features are clinical variability and different hematological pictures. These observations underscore the importance of thalassemia screening in these geographic areas, such as Southern Italy, principally Sicily, where the mutations in globin gene clusters are especially prevalent. Moreover, as from the second half of the last century, owing to high migratory flux from Sicily to Northern Europe, North and South America, and Australia, the Hb lepore, as well as other hemoglobin variants, have become prevalent, making the identification of the heterozygotes a problem of general interest.

Adolescent↗

Caffeine clearance in subjects with constitutional unconjugated hyperbilirubinemia.

To investigate the behaviour of caffeine (CAF) in patients with Gilbert's Syndrome (GS), a combined oral loading test of caffeine and chenodeoxycholic acid was performed in 14 healthy subjects and 71 patients with GS. Indocyanine green (ICG) kinetics was tested in 50 subjects with GS and in all control subjects. Fasting serum bile acids (SBA) and clearance after CDCA loading were within normal range in normal and GS subjects. No significant difference in levels either of bilirubin or of SBA was observed in GS cases with normal (52 cases, 488 +/- 63 ml/min) or impaired (19 cases, 338 +/- 30 ml/min) caffeine clearance. Eleven GS cases showed altered ICG clearance. No correlation was found between bilirubin and bile acids, CAF or ICG. Fasting SBA were normal even in cases of CAF or ICG altered kinetics, thus excluding structural damage in unconjugated hyperbilirubinemia. CAF altered kinetics in 27% of GS cases may suggest multiple deficits in the hepatocellular metabolism, thus confirming the heterogeneity of this syndrome.

Adolescent↗

Biochemical scores could reflect histological activity in chronic hepatitis C.

Eighty-one patients with HCV positive chronic active hepatitis (CAH) were studied to correlate, in multivariate regression analysis, liver tests with the histological activity index (HAI). The median HAI value (9.4) divided the patients into two groups; 44 under the 9.4 value (moderate CAH) and 37 above (severe CAH). Multiple regression improved the significance of nine biochemical parameters related to HAI in univariate analysis, and backward stepwise analysis identified the combination of alanine-aminotransferase (ALT), gammaglobulins (gamma GL), gammaglutamyl transpeptidase (gamma GT) and prolyl-hydroxylase (PH) as the best relationship with HAI (R = 0.520, p < 0.0001). A biochemical activity index (BAI) calculated as: 2.304 + ALT x 0.013 + gamma GL x 1.76 + gamma GT x 0.008 + PH x 0.012 showed the higher significant difference between moderate (7.7 +/- 1.3) and severe (12.2 +/- 2) CAH (p < 0.0001). These results suggest that this BAI could be a pointer for checking activity of chronic liver diseases.

Adult↗

Characterization of alpha 1-adrenoceptor subtypes in prostate and prostatic urethra of rat, rabbit, dog and man.

The alpha 1-adrenoceptor subtypes present in the smooth muscle of urethra and prostate of different animal species, including man, were characterized by using receptor binding techniques. In prostatic urethra and prostate membranes, [3H]prazosin labelled a single population of alpha 1-adrenoceptors (Hill coefficient not different from unity) with a high affinity in the range 0.21-0.51 nM. The number of specific [3H]prazosin binding sites was partially affected by chloroethylclonidine only in human and rat prostate membranes, whereas this agent proved practically devoid of activity in rabbit and dog prostate membranes as well as in the prostatic urethra membranes of all the animal species examined. These findings indicate that in prostatic and urethral membranes the alpha 1-adrenoceptors mainly belong to the alpha 1A subtype. The binding results were confirmed by in vitro functional studies on noradrenaline-induced contractions of rabbit and dog urethral preparations. The agonist-induced contractions were practically unaffected by preincubation of both tissues with chloroethylclonidine, but were sensitive to nifedipine. We found, moreover, a good correlation between the potency of different selective and non-selective alpha 1-adrenoceptor antagonists (WB-4101, 5-methylurapidil, phentolamine, spiperone, prazosin and urapidil) tested against the noradrenaline-induced contractions of rabbit urethra and their affinity for the alpha 1A-adrenoceptor subtype, no correlation with the affinity for the alpha 1B subtype, and a lower correlation with the affinity for the alpha 1C-adrenoceptor subtype.

Adrenergic alpha-Antagonists↗

Affinity of different alpha 1-agonists and antagonists for the alpha 1-adrenoceptors of rabbit and rat liver membranes.

In membranes prepared from rabbit liver, competition with [3H]prazosin by different alpha 1-agonists and antagonists revealed different affinities in comparison to the results obtained on rat liver membranes, and showed a good correlation with the affinity of the same compounds for the cloned alpha 1c-adrenoceptor subtype. The potencies observed on rat liver membranes were well correlated with the affinity observed for the cloned alpha 1b-adrenoceptors. These results confirm that rabbit and rat liver membranes preparations can be utilized to evaluate the affinity of compounds for these alpha 1-adrenergic subtypes.

Adrenergic alpha-Agonists↗

Residual coronary reserve despite decreased resting blood flow in patients with critical coronary lesions. A study by technetium-99m human albumin microsphere myocardial scintigraphy.

BACKGROUND: Experimental data demonstrate the persistence of a transmural vasodilator reserve in the face of depressed resting myocardial perfusion. The present study was designed to determine whether resting myocardial hypoperfusion indicates exhausted coronary reserve (CR). METHODS AND RESULTS: Fifteen patients with stable angina, isolated left anterior descending coronary artery (LAD) stenosis, and no previous myocardial infarction were evaluated by means of 99mTc human albumin microsphere scintigraphy. Regional myocardial perfusion and CR were assessed at baseline and after LAD papaverine (10-12 mg) by means of two microsphere injections in the left ventricle and compared with five normal subjects. Two 300-second scans were obtained with a mobile gamma camera positioned in the 70 degrees left anterior oblique projection; actual microsphere distribution after papaverine was obtained by image subtraction. The two arterial input functions (basal and papaverine) were measured from the first-pass time-activity curves and validated with the reference arterial sample technique. From the comparison of circumferential profile analysis between patients and normal subjects, nine patients (group 1A) showed perfusion defects at rest (reduction of percent radioactivity below 2 SD of normal subjects) in the LAD territory, and the other six (group 1B) showed homogeneous perfusion. CR (papaverine/resting perfusion) was 3.8 +/- 0.2 and 1.51 +/- 0.27 in normal subjects and in ischemic patients, respectively (p < 0.01). Despite resting hypoperfusion, group 1A showed a papaverine-recruitable CR similar to that of group 1B (1.57 +/- 0.33 and 1.43 +/- 0.16, respectively, p = NS). CONCLUSIONS: In patients with stable angina pectoris, isolated LAD stenosis, and no previous myocardial infarction, microsphere scintigraphy disclosed a high incidence of resting perfusion defects; in those patients, a residual CR was observed despite decreased resting blood flow.

Adult↗

Myocardial blood flow distribution in patients with ischemic heart disease or dilated cardiomyopathy undergoing heart transplantation.

BACKGROUND: The present investigation was designed to obtain an absolute measurement of myocardial blood flow and of its transmural distribution in ischemic heart disease and idiopathic dilated cardiomyopathy and to provide a reference standard for cardiac imaging in nuclear cardiology. METHODS AND RESULTS: Regional myocardial blood flow and its transmural distribution were estimated by the reference microsphere method in eight patients with idiopathic dilated cardiomyopathy (n = 4) or ischemic heart disease (n = 4) during heart transplant procedure. Before aortic clamping, 99mTc-labeled human albumin microspheres were injected into the left atrium while arterial blood was sampled from the aorta at a constant rate. No complications were observed during or after the procedure. From the excised heart, myocardial slices for gamma camera imaging and well counting analysis were obtained. Myocardial blood flow was assessed by a well counter, correlated with the extent of fibrosis expressed as collagen per total tissue proteins obtained from 4-hydroxyproline and glycine as determined by high-performance liquid chromatography. Microsphere distribution, as seen by gamma camera images in a different slice, was correlated with the extent of fibrosis assessed by histological analysis of the same myocardial specimen. Mean transmural myocardial blood flow was 0.49 +/- 0.17 and 0.38 +/- 0.15 mL.min-1 x g-1 in idiopathic dilated cardiomyopathy and ischemic heart disease, respectively (P < .01). Endocardial-to-epicardial flow ratio was lower in ischemic heart disease than in idiopathic dilated cardiomyopathy patients (0.99 +/- 0.33 versus 1.16 +/- 0.30, P < .05). Mean myocardial fibrosis was 9 +/- 6% in idiopathic dilated cardiomyopathy and 25 +/- 28% in ischemic heart disease. In both groups, no correlation was found between myocardial blood flow values and the extent of fibrosis. In ischemic heart disease, regional myocardial blood flow was not significantly affected by the severity of coronary stenosis (< or = 70% or > 70%) either in the endocardium (0.44 +/- 0.24 versus 0.36 +/- 0.16 mL.min-1 x g-1, P = NS) or in the epicardium (0.50 +/- 0.33 versus 0.38 +/- 0.33 mL.min-1 x g-1, P = NS). By gamma camera imaging, transmural microsphere distribution appeared more homogeneous in idiopathic dilated cardiomyopathy than in ischemic heart disease (mean coefficient variation, 18% and 27%, respectively; P < .02); the severity of perfusion impairment did not correlate with the extent of fibrosis evaluated by histological criteria. CONCLUSIONS: Heart transplant surgery offers a valuable model to assess absolute myocardial perfusion in human heart failure. Myocardial blood flow is markedly depressed in failing hearts of both ischemic heart disease and idiopathic dilated cardiomyopathy patients; a different transmural myocardial blood flow distribution is observed in ischemic heart disease than in idiopathic dilated cardiomyopathy, with prevalent endocardial perfusion in the latter but not the former condition. In patients with end-stage heart failure, myocardial blood flow appears to be similarly impaired in fibrotic and viable regions. Mechanisms other than myocardial fibrosis and coronary lesions appear to operate in determining myocardial blood flow impairment in heart failure.

Adult↗

[Effects of insular hormones on the secretion of atrial natriuretic factor].

Aim of this study was to verify the existence of a correlation between the insular hormones and the atrial natriuretic factor (ANF). We studied 70 subjects (20 control, 20 obese, 20 non insulin-dependent diabetic obese, 10 insulin-dependent diabetic subjects) submitted to a glucagon test (1 mg i.v.). Blood samples were collected at -15, 0, 3, 6, 12, 15, 30, 60, 120, 150 minutes to assay insulin, C-peptide, serum electrolytes and ANF levels. The results to point out are: the ANF basal values are significantly higher (p < 0.01) in non insulin-dependent obese patients than in controls; the obese subjects also present a significant difference (p < 0.05). After glucagon injection no variations have been found in the ANF values until the 15th minute; then the controls, the obese and, above all, the non insulin-dependent diabetic obese subjects showed a significant increase of the ANF values between 60' and 90' (basal values 38 +/- 4 ng/ml; 90' values 85 +/- 7 ng ml). As these high values appear only after the induction of hyperinsulinism in our experiment and are not present in the type-1 diabetic subjects, it's probable that insulin, rather than glucagon, stimulates, directly or indirectly, the ANF secretion. If this hypothesis is confirmed, the correlation between insulin and ANF should deserve attention from a therapeutic point of view in subjects with glycometabolic imbalance.

Adolescent↗

[ANP changes induced by varying TSH].

Aim of our study was estimating if TSH could influence the timing of ANP release. About it we observed 70 male subjects: 40 were euthyroid patients aged 42 +/- 5 years (group A); 20 patients treated by thyroxine in doses sufficient for inhibiting TSH release, aged 45 +/- 7 years (group B). A third group (C) was composed by 10 subjects with high basal levels of serum T3 and T4 with no thyrostatic therapy, aged 40 +/- 9 years. These subjects underwent a TRH test estimating at -30', 0', 30', 60', 120' plasma concentrations of TSH, ANP, T3, T4. In reply to physiological stimulus induced on patients of group A we observed a significant increase of TSH values (max at 60') and ANP levels (max at 120'). No significant variations occurred during the TRH test in T3 and T4 concentrations. In groups B and C no important modifications were observed neither in TSH nor in ANP plasma levels. ANP secretion seems to be dependent from the secretory condition of hypothalamus-pituitary-thyroid axis both in physiological and pathological conditions.

Adult↗