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Biomedical subjects

S Sabatini

Publications and source records attributed to S Sabatini.

At least 55 records · Page 3Linked to original sources
PubMed1994

Women, medicine and life in the Middle Ages (500-1500 AD).

The status of women in the Middle Ages was ambiguous, because although they had great responsibility and expertise in practical affairs they were viewed as chattel and inferior to men. They were skilled in cookery, often of highly spiced dishes using a variety of ingredients and flavorings, and they were taught the use of medicinal herbs. They were often skilled in simple first aid, though they were not allowed to practise outside the home. An important exception of this was Hildegarde von Bingen, whose Physica brought her great renown. In it she became the first woman to discuss plants in relation to their medicinal properties. For most people in the Middle Ages, treatment revolved around herbs and diet, together with faith and holy relics and the use of (forbidden) pagan incantation and ritual. Astrology was often a necessary adjunct to treatment. In Salerno, however, medicine had been practised from classical times, and medical training could last for 7 years or more. One of the greatest medieval medical texts is the Tacuinum Sanitatis, which describes in detail the 6 essentials for the preservation of man's health. Several vegetables and herbs are mentioned in connection with the kidneys, the picking and preparation of which are imbued with magic.

Europe↗
PubMed1994

Biochemistry and pathophysiology of vanadium.

The biochemistry and function of vanadate and its possible role in health as well as in disease remains one of the most fascinating stories in biology. This review has surveyed the pertinent literature regarding its effect in the normal kidney and other tissues. While inhibition of the Na(+)-K+ ATPase enzyme was the first described and perhaps the most widely studied, the element clearly has other actions. Speculation as to whether vanadate is a part of the pathogenesis of the 'uremic syndrome', acquired cystic kidney disease, depression, and bone disease should provoke the clinical investigator and the basic researcher alike to a myriad of new and intriguing experiments.

Animals↗
PubMed1994

The effect of parathyroid hormone and other metabolic factors on extrarenal acid buffering.

Parathyroid hormone (PTH) is an 84-amino acid, a polypeptide hormone which acts in many tissues. In the human there are many clinical examples of both primary and secondary PTH excess states; while deficiency states also occur, they are far less common. This manuscript reviews the effects of PTH on extrarenal acid buffering and discusses the possible mechanisms which are involved.

Acid-Base Equilibrium↗
PubMed1993

Effect of furosemide-induced hypokalemic metabolic alkalosis on renal transport enzymes.

Hypokalemic metabolic alkalosis is one of the most common complications of chronic furosemide administration. In this study we examined acid-base composition and ATPase enzyme activities in medullary thick ascending limb of Henle's loop (MTAL) and collecting tubule (CCT and MCT) after seven days of chronic furosemide therapy. All of the studies were conducted in adrenal intact (AI) rats or in adrenalectomized (ADX) glucocorticoid replete rats replaced with a physiological dose of aldosterone (Aldo). Furosemide (F) was administered to each rat by mini-osmotic pump. In the AI+F group, plasma Aldo was high and obvious metabolic alkalosis occurred (HCO3- = 37 +/- 2 mEq/liter vs. 22 +/- 2 mEq/liter in controls, P < 0.005); activities of H-K-ATPase, H-ATPase, and Na-K-ATPase were increased approximately twofold in both CCT and MCT. In the ADX+F group (HCO3- = 28 +/- 2 mEq/liter, P < 0.05 from control), H-ATPase activity was normal in CCT and it was slightly increased in MCT. CCT and MCT H-K-ATPase activities were markedly increased (approximately twofold). Na-K-ATPase activity was the same as control in CCT but it was increased in MCT. In ADX+F+Vanadate (V) group which also had normal Aldo levels, acid-base changes were modest (20 +/- 2 mEq/liter, NS from control); in CCT and MCT H-K-ATPase and Na-K-ATPase activities were markedly reduced, but H-ATPase activity in MCT was increased. In all three experimental groups Na-K-ATPase activity in MTAL was reduced fivefold. Hypokalemia developed in both intact and ADX animals receiving furosemide.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1993

Pathophysiology of and therapeutic strategies for hypertension in pregnancy.

Approximately 8% to 10% of pregnancies are complicated by hypertension. The disease, whether it first appears during gestation or was present prior to conception, puts both mother and baby at risk. The fetal risks include death in utero, poor growth, and prematurity. The risks to the mother are more difficult to assess, but intracranial bleeding is the most common cause of death. This review examines some of the physiological changes that occur in normal pregnancy and defines the hypertensive disorders of pregnancy. The recent data regarding pharmacologic and nonpharmacologic therapies for the treatment of hypertension in pregnancy are discussed, and comments as to the prophylaxis of preeclampsia are noted.

Antihypertensive Agents↗
PubMed1993

H-K-ATPase in distal renal tubular acidosis: urinary tract obstruction, lithium, and amiloride.

In previous studies we suggested that urinary tract obstruction and chronic administration of lithium or amiloride were models of "voltage-dependent" distal renal tubular acidosis (DRTA). Subsequently, differences among these three models suggested that the pathogenesis was far more complex than we originally proposed. A recent study showed that H-adenosinetriphosphatase (H-ATPase) activity was decreased in all three experimental models. In the current experiments we examined the effect of 24-h unilateral ureteral obstruction (UUO) and chronic administration of amiloride and lithium on collecting tubule H-K-ATPase, the other renal H-ATPase enzyme. In the obstructed kidney, cortical collecting tubule (CCT) H-K-ATPase activity was enhanced by 73 +/- 10.0%, whereas the enzyme activity in medullary collecting tubule (MCT) was decreased by 67 +/- 5.4%. In the normal contralateral kidney, activities of H-ATPase, H-K-ATPase, and Na-K-ATPase were increased by approximately 30% in both CCT and MCT. Following amiloride (3 mg.kg-1.day-1 x 3 days ip), rats had normal acid-base status, slight hyperkalemia, and markedly elevated plasma aldosterone levels. Both CCT and MCT H-K-ATPase activities in amiloride-treated rats were unchanged. After LiCl (4 meq.kg-1.day-1 x 3 days ip), rats developed mild metabolic acidosis and had normokalemia and normal aldosterone status. CCT H-K-ATPase activity in lithium-treated rats was decreased by 64 +/- 8.8%, whereas the enzyme activity in MCT remained unchanged. Lithium in vitro (30 meq/l) inhibited CCT, but not MCT, H-K-ATPase activity, whereas amiloride had no effect on the enzyme activity. (ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗
PubMed1993

Regulation of collecting tubule adenosine triphosphatases by aldosterone and potassium.

To examine the precise role of potassium and aldosterone on acid-base composition and on collecting tubule ATPases, glucocorticoid-replete adrenalectomized rats were replaced with zero, physiological, or pharmacological doses of aldosterone and were fed varying potassium diets to produce hypokalemia, normokalemia, or hyperkalemia. Radiochemical measurement of ATPase activities showed that collecting tubule H/K-ATPase changed inversely with potassium and not with aldosterone whereas H-ATPase changed directly with aldosterone but not with potassium. When both enzymes changed in the same direction, alterations in acid-base composition were profound; however, when these two acidifying enzymes changed in opposite directions or when only one enzyme changed, the effect on acid-base balance was modest. Serum bicarbonate was approximately 45 meq/liter when aldosterone was high and potassium was low; it was only 29 meq/liter when aldosterone was high but potassium was normal or when aldosterone was normal and potassium was low. Our observations may help explain the metabolic alkalosis of primary aldosteronism in which aldosterone excess and hypokalemia are combined and the metabolic acidosis of aldosterone deficiency in which hypoaldosteronism and hyperkalemia are paired. The present study also demonstrated that aldosterone plays the major role in controlling Na/K-ATPase activity in cortical collecting tubule. Hypokalemia stimulates Na/K-ATPase activity in the medullary collecting tubule; this stimulatory effect of hypokalemia supports the hypothesis that the enzyme is present on the apical membrane at this site.

Adenosine Triphosphatases↗
PubMed1993

Corticosterone metabolism and membrane transport.

The mammalian kidney metabolizes virtually all of the steroid hormones. Corticosterone receptors have been found in the cortical collecting tubule, and at least four metabolites of the hormone have been identified in rat renal tissue and urine. The biologic activity of these metabolites is not completely known. In this study, we examined the functional effects of three of the metabolites of corticosterone on membrane transport in toad and turtle bladders; we also analyzed the oxidoreductase pathways for corticosterone metabolism. In the toad bladder, maximal water flow (vasopressin- and cyclic AMP-stimulated) was unaffected by corticosterone, 11-dehydro-20-dihydrocorticosterone (metabolite I) and 11-dehydrocorticosterone (metabolite IV); maximal water flow was significantly inhibited by 20-dihydrocorticosterone (metabolite II). Sodium transport in the toad bladder was stimulated by corticosterone, 11-dehydrocorticosterone and 20-dihydrocorticosterone. Analysis of the oxidoreductase pathways in this tissue revealed that most of the corticosterone was oxidized to 11-dehydrocorticosterone, a biologically active compound; 11-dehydrocorticosterone was further metabolized to 11-dehydro-20-dihydrocorticosterone, a biologically inactive compound. Only 6% of the parent compound was converted to 20-dihydrocorticosterone. In the turtle bladder, none of the metabolites tested altered hydrogen ion secretion over the time period studied; no significant biotransformation of corticosterone occurred in this tissue. As the metabolites of corticosterone found in toad bladder are the same as those identified in mammalian tissues, our studies suggest that some of them may be important modulators of sodium and water transport in the distal nephron. Our data further suggest that these compounds are likely not involved in the regulation of urinary acidification.

Animals↗
PubMed1992

The effect of pregnancy on renal function: physiology and pathophysiology.

Marked changes in renal function occur with pregnancy. We present a summary of these changes in this review and give insight into possible mechanisms if they are known. Controversies exist regarding the therapy of pregnancy-induced hypertension and asymptomatic and recurrent bacteriuria. The current views on these topics are given. Specific renal diseases are summarized, including transplantation, and optimum management strategies and maternal and fetal prognosis during pregnancy are given.

Antihypertensive Agents↗
PubMed1992

Vanadate causes hypokalemic distal renal tubular acidosis.

Considerable evidence supports the presence of an H(+)-K(+)-ATPase along the mammalian nephron. Inhibition of this enzyme might be expected to reduce acid excretion while increasing potassium excretion, thus causing hypokalemic distal renal tubular acidosis (RTA). In this study we administered vanadate at a dose of 5 mg/kg ip for 10 days to rats. These animals developed hypokalemic distal RTA with a blood pH of 7.22 +/- 0.01, a plasma bicarbonate of 15.2 +/- 0.6 meq/l, and a plasma potassium of 3.28 +/- 0.06 meq/l. The vanadate-treated animals had a urine pH of 6.70 +/- 0.09, a value significantly higher than NH4Cl-treated animals with the same degree of acidemia (urine pH = 5.25 +/- 0.04). When cortical collecting tubules (CCT) from these animals were microdissected and H(+)-K(+)-ATPase was measured, it was decreased by approximately 75% (P less than 0.001); but H(+)-ATPase was no different from control. In medullary collecting tubule, H(+)-K(+)-ATPase was also decreased but less than in CCT. Muscle potassium concentration in the vanadate-treated animals was significantly lower than in controls. These results demonstrate that vanadate causes hypokalemic distal RTA in association with inhibition of collecting tubule H(+)-K(+)-ATPase activity.

Acidosis↗
PubMed1992

Effect of lithium and amiloride on collecting tubule transport enzymes.

In humans and animals, the administration of Li or amiloride results in a defect in urinary acidification. Both agents are thought to cause this by a voltage-dependent mechanism in the distal nephron. This study was designed to determine the effects of chronic Li and amiloride administration on the two main transport enzymes in rat nephron collecting tubule, the Na-K-adenosine triphosphatase (ATPase) and the H(+)-ATPase. We also examined the effects of both agents on these enzymes in vitro. Amiloride administration resulted in a decrease in Na-K-ATPase and H(+)-ATPase activities in cortical collecting tubule and medullary collecting tubule. Therapeutic concentrations of amiloride in vitro inhibited Na-K-ATPase activity, but only in cortical collecting tubule. The effects of Li administration were different; it decreased Na-K-ATPase and H(+)-ATPase in both cortical collecting tubule and medullary collecting tubule. In cortical collecting tubule, the inhibitory effect on H(+)-ATPase activity was seen in vitro at a Li concentration similar to that found in urine. In contrast to the effect of Li on the H(+)-ATPase, in vitro Li stimulated Na-K-ATPase activity. These results suggest that the mechanism of action whereby these two agents result in distal renal tubular acidosis in humans and animals are different. In the collecting tubule, amiloride appears to act solely through a voltage-dependent mechanism by inhibiting cortical collecting tubule Na-K-ATPase. Li, by contrast, appears to have an additional effect in the cortical collecting tubule to inhibit the H(+)-ATPase. The biochemical differences seen with these drugs may explain the more severe acidemia universally found in animals after chronic Li administration.

Amiloride↗
PubMed1991

Calcium transport and extracellular pH in epithelial membranes.

Calcium plays a pivotal role in cell adhesion, ATPase function, and in membrane permeability. The molecular mechanism for these diverse actions include: hormonal factors, activation of intracellular mediators, and physical factors such as ionic mobility and pH. To further examine the effects of one physical factor, pH, we designed studies examining Ca transport in the isolated turtle bladder epithelium. This tissue is a high-resistance epithelium which reabsorbs Na and secretes H+. The turtle has only rudimentary parathyroid tissue, the gland does not respond to a lowered plasma Ca, and cyclic AMP is not a primary intracellular mediator. In a series of in vitro experiments, we examined Ca metabolism under conditions simulating metabolic acidosis and alkalosis. Acidosis markedly inhibited the mucosa-to-serosa Ca flux, while alkalosis stimulated it. The effect of acidosis on the mucosa-to-serosa Ca flux was independent of Na transport. Changing serosal pH had no effect on the serosa-to-mucosa Ca flux or on proton secretion. Total tissue Ca concentration, measured using atomic absorption spectrometry, was identical when the extracellular pH varied from 5.4 to 8.4. When epithelial cells were isolated and Ca uptake was measured over a wide pH range, a linear increase in uptake was seen as pH was increased from 4.4 to 8.4. In separated turtle bladder epithelial cells ATP-dependent Ca transport, in the mitochondrial-rich cells, was 4- to 5-fold higher than activity found in the granular cells. The mitochondrial-rich cells comprise approximately 20% of the total epithelial surface and are thought to be the cells primarily involved in proton secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1991

Characterization of the N-ethylmaleimide-sensitive ATPase in rat cortical and medullary collecting tubule.

Hydrogen ion secretion in the kidney is thought to be mediated in part by an N-ethylmaleimide (NEM)-sensitive proton-translocating adenosine triphosphatase (ATPase). This enzyme has been found throughout the nephron, but it has not been completely characterized enzymatically in the rat collecting duct. In the present study we characterized the NEM-sensitive ATPase from microdissected cortical (CCT) and medullary (MCT) collecting tubules of the rat nephron. At optimum conditions, NEM-sensitive ATPase activity was the same in both tubule segments: activity was 275.6 +/- 18.6 pmol/mm/h in the CCT and 280.3 +/- 35.2 pmol/mm/h in the MCT (n = 23, NS). ATP sensitivity was greater in CCT than in MCT, and in the former guanosine triphosphate was able to partially support enzyme activity. Maximal enzyme inhibition with NEM occurred at a lower concentration in CCT as compared to MCT. At pH 7.0 in MCT enzyme activity was approximately one half that seen at pH 7.4; in MCT and CCT, the pH optimum was 7.4. The temperature optimum in both segments was between 37 and 42 degrees C. Enzyme activity in CCT and MCT was linear to 30 min and proportional to tubule length. These results demonstrate that there are important differences in the NEM-sensitive ATPase isolated from two segments of rat collecting duct, and raise the possibility that enzyme heterogeneity may exist.

Adenosine Triphosphatases↗
PubMed1990

Enzyme activity in obstructive uropathy: basis for salt wastage and the acidification defect.

Unilateral ureteral obstruction results in marked changes in renal function throughout the nephron, including impaired acid and potassium secretion and salt wastage. The nephron site believed responsible for the acidification defect is the collecting duct. It has been presumed, although not demonstrated, that the cellular mechanism for the acidification defect is both a decrease in transepithelial voltage and a decrease in activity of the proton pump located at the luminal membrane. The mechanism for the abnormalities in sodium handling are thought due to alterations in Na-K ATPase activity. Our laboratory has recently mapped the profile of the N-ethylmaleimide (NEM)-sensitive ATPase and Na-K ATPase in microdissected rat nephron, documenting their presence throughout much of the nephron. In animals with acute unilateral ureteral obstruction for 18 to 24 hours, we measured NEM-sensitive ATPase and Na-K ATPase activities in several nephron sites. In all nephron segments Na-K ATPase activity was markedly decreased. In the medullary collecting duct, NEM-sensitive ATPase activity was also markedly reduced in animals with acute ureteral obstruction; in the cortical collecting duct, activity fell significantly, but to a lesser degree than was observed in the medullary collecting duct. NEM-sensitive ATPase activity was unchanged from control in the proximal convoluted tubule and in the medullary thick ascending limb; in the cortical thick ascending limb enzyme activity increased. These results demonstrate a change in both Na-K ATPase and NEM-sensitive ATPase activities as a direct consequence of a defect known to result in salt wastage and an acidification defect in humans and animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphatases↗