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Vasodilator activity of endothelin-1 and endothelin-3: rapid development of cross-tachyphylaxis and dependence on the rate of endothelin administration.

In pentobarbital anesthetized cats, i.v. bolus injections of endothelin-1 (ET-1, 1 microgram) and ET-3 (3 micrograms) produced a rapidly appearing but short-lasting fall in aortic blood pressure followed in the case of ET-1 only by a small pressor response. When these peptides were administered repeatedly after 10- to 12-min intervals, there was a gradual attenuation of the hypotension that by the fourth injection was replaced by a monophasic pressor response. The i.v. infusion of ET-1 (0.3 microgram/min) or ET-3 (0.9 microgram/min) for 20 min produced sole systemic vasoconstriction. The decrease in blood pressure produced by an i.v. bolus injection of ET-1 and ET-3 was no longer observed 5 min after the end of the ET-1 or ET-3 infusion. In contrast, the hypotensive activity of bradykinin was not modified after the depressor responses to ET-1 and ET-3 had disappeared. Thus, the failure of i.v. bolus injections of ET-1 and ET-3 to lower blood pressure under these experimental conditions cannot be attributed to the development of tachyphylaxis to endogenous endothelium-derived relaxant factor, which is known to mediate the effects of bradykinin. These results suggest that ET-1 and ET-3 share a single vascular receptor for vasodilation, which becomes refractory upon repeated or maintained exposure to these peptides. Alternatively, this refractoriness may be due to depletion of an intracellular mediator(s) that is jointly used by the membrane binding sites of ET-1 and ET-3. Moreover, the present data suggest that the vasodilator activity of ETs depends on the rate of the peptide administration.

Animals↗

Persistence of the hypertriglyceridemic effect of tumor necrosis factor despite development of tachyphylaxis to its anorectic/cachectic effects in rats.

The administration of a single injection of tumor necrosis factor (TNF) produces a variety of acute and sustained biological effects, including hyperlipidemia, stimulation of hepatic lipogenesis, decreases in adipose tissue lipoprotein lipase activity, and anorexia with weight loss. Chronic administration of a fixed dose of TNF produces tachyphylaxis to the anorectic/cachectic effects of TNF. We now report that the hyperlipidemic effect of TNF persists during chronic TNF administration in the absence of any cachectic effect of TNF. Sprague-Dawley rats injected with TNF (250 micrograms/kg) show a significant decrease in weight over the next 24 h which can be accounted for by decreases in food and water intake accompanied by an increase in urine output. With subsequent daily injections of TNF, treated rats begin eating and rapidly regain weight. Hypertriglyceridemia persists for up to 10 days of daily injections of TNF. After three daily injections of TNF, no decreases were seen in lipoprotein lipase activity in a wide variety of tissues. De novo hepatic lipogenesis remained increased in TNF-treated animals after four daily injections, but by the fifth day hepatic lipogenesis returned to normal. After 5 days of TNF treatment the acute incorporation of labeled glycerol into serum triglycerides remained elevated. These data indicate that hyperlipidemia persists during multiple daily injections of TNF and that TNF induced hypertriglyceridemia is not inevitably linked to the syndrome of cachexia.

Animals↗

Development of drug tachyphylaxis in asthmatic patients treated with beta-adrenergic drugs.

The development of drug tolerance in two groups of asthmatics treated with beta-adrenergic bronchodilators was studied by respiratory function methods. During one-year treatment with conventional therapeutic doses of selective beta-2-receptor stimulant aerosols, none of the patients showed subsensitivity to the bronchodilatory effect of terbutaline. Dose-response curves were plotted upon the inhalation of salbutamol in two-week intervals in patients treated with betamimetics. There was no decrease in the airways beta-adrenergic receptor function as compared to the untreated control group. The results show that prolonged treatment with therapeutic doses of inhaled beta-adrenergic bronchodilators does not result in drug tachyphylaxis, which is in accord with the clinical experience that there is no loss of effect of the preparations during their continuous administration.

Adrenergic beta-Agonists↗

Effects of prednisolone on beta-adrenergic desensitization of normal peripheral lymphocytes: an in vitro model for steroid-controlled tachyphylaxis.

In vitro culture of human peripheral blood lymphocytes with the beta-adrenergic catecholamine isoproterenol for 24 hours, induced homologous beta-adrenergic desensitization, i.e. a large decrease in the number of beta-adrenergic binding sites and loss of the adenylate cyclase response to isoproterenol, without altering the effectiveness of prostaglandin E1 to stimulate the enzyme. Lymphocyte cultures pulsed for 24 hours with isoproterenol, washed free of the agent and cultured in hormone-free medium for 48 hours still showed marked suppression of the beta-adrenergic adenylate cyclase response and a lack of beta-receptors. When prednisolone was added to the isoproterenol-depleted resuspension medium of desensitized lymphocytes, however, the beta-adrenergic system recovered fully within 48 hours. Treatment of desensitized lymphocytes with prednisolone in the continuous presence of isoproterenol failed to restore beta-adrenergic responsiveness of the cells. The results are discussed with respect to the reconstituting effect of prednisolone on beta-adrenergic responsiveness in bronchial asthma after therapy induced tachyphylaxis.

Adenylyl Cyclases↗

[Testing the loss of efficacy (tachyphylaxis) during external steroid application].

The steroids fluprednylidene-21-acetate (FA) and betamethasone-17-valerate (BV) were tested in comparison to their inactive bases for loss of activity (tachyphylaxis) after 2 weeks of application. In the croton oil test, both steroids produced equal inhibition of the pustular inflammatory reaction. The vasoconstriction test after 14 days of use revealed a clear decrease in the blanching reaction - which was, however, not statistically significant in the case of BV.

Administration, Topical↗

Effects of verapamil on automaticity and conduction with particular reference to tachyphylaxis.

Verapamil delivered via the sinus node artery exerted a dose-related, exclusively negative chronotropic action at all concentrations studied. Perfusion through the AV node artery during AV junctional rhythm also caused a dose-related negative chronotropic response, but the concentrations required to depress this pacemaker were ten times higher than those required to depress sinus node automaticity. Verapamil administered into the AV node artery during sinus rhythm impaired AV conduction. His bundle electrograms demonstrated that depressed A-V conduction was exclusively located at the A-H level. In 5 out of 10 dogs verapamil (5 to 10 mg) delivered into the septal artery caused an abrupt onset of ventricular fibrillation without premonitory dysrhythmias. Verapamil (except at very high concentrations) did not alter the responsiveness of the sinus node and the AV junction to acetylcholine or norepinephrine, whether administered selectively into the sinus node artery or the AV node artery or released by neural stimulation. Serial injections of verapamil were associated with tachyphylaxis for the direct chronotropic and dromotropic properties of the drug.

Acetylcholine↗

Tachyphylaxis to d-amphetamine: a reexamination of the phenomenon.

Single or multiple injections of d-amphetamine (10(-3)--10(0) mg/kg) were administered to rats, after which steady-state blood levels of drug were determined. After single injections of d-amphetamine, there was a linear relationship between amount of administered drug and steady-state blood level of drug. After multiple injections of d-amphetamine, steady-state blood levels of drug conformed to the equation D = Doe--kappaepsilont. An attempt was made to relate steady-state blood levels of drug to steady-state responses (e.g., increase in blood pressure or heart rate). At steady-state, amphetamine-induced pressor responses were too small to be analyzed, but tachycardic responses were easily analyzed. It was found that steady-state heart rate responses were dose related to steady-state blood levels of drug. This was true regardless of whether d-amphetamine was administered once or repeatedly. The data indicate that, when tested in rats at sub-toxic doses, d-amphetamine does not evoke tachyphylaxis in relation to heart rate responses which are measured under steady-state conditions.

Animals↗

[Tachyphylaxis in continuous epidural anaesthesia with bupivacaine 0.125% and 0.25% (author's transl)].

Based on the results in 105 patients under continual thoracic epidural analgesia differences in the dose response relationship of bolusinjections are found. While under bupivacaine 0.25% a decrease of the effectivity of additional bolusinjections can be stated, the dose response relationship does not change under bupivacaine 0.125%. Moreover the effectivity of bupivacaine 0.25% increases after an interruption of the local anaesthetic infusion. The pH-value of bupivacaine 0.25% was 6.0 and that of bupivacaine 0.125% 6.3. Even so the differences of the pH-values between the two solutions are rather small, a possible key to the problem of the dose response relationship, concerning tachyphylaxis, can be suggested. But further investigations have to show, whether the use of local anaesthetic solutions, being stable at pH-values of 7 to 8, makes the continuous epidural analgesia easier to handle for postoperative pain relief.

Aged↗

Tachyphylaxis and phase II block development during infusion of succinylcholine in children.

Contraction of the adductor of the thumb in response to ulnar nerve stimulation during continuous infusion of succinylcholine (SCh) was evaluated in 22 children anesthetized with halothane (1% to 1.5%) and N2O/O2. Twitch rates of 0.1 Hz were used to evaluate the force of contraction. Train-of-four stimulation (2 Hz for 2 seconds) was used to differentiate between phase I and phase II block. Tachyphylaxis to the effects of SCh occurred in 23 +/- 2 minutes in all children at a mean (+/- SE) dose of 3.0 +/- 0.4 mg/kg of SCh. In 21 of the 22 children, phase II block, as defined by a train-of-four ratio less than 50%, occurred in 29 +/- 5 minutes after 4.1 +/- 0.6 mg/kg of SCh. A mean dose of 10.3 +/- 0.6 mg/kg of SCh administered in a span of 71 +/- 5 minutes produced a mean train-of-four ratio of 12 +/- 5%. The recovery from phase II block after 10.3 +/- 0.6 mg/kg of SCh to train-of-four ratios of 50% and 75% was 16 +/- 3 minutes and 41 +/- 5 minutes, respectively. Caution should be used when more than 3 mg/kg of SCh is infused intravenously; adequate neuromuscular monitoring should be available and ample time should be given for spontaneous recovery.

Adolescent↗

5-Hydroxytryptamine-induced tachyphylaxis of the molluscan heart and concomitant desensitization of adenylate cyclase.

High concentrations of 5-hydroxytryptamine (5HT) first excite the isolated ventricle of Mercenaria mercenaria and then specifically desensitize it to further additions of the neuropeptide. This 5HT-induced tachyphylaxis is paralleled by a 5HT-specific desensitization of the myocardial adenylate cyclase and a decrease in intracellular cyclic AMP. However, FMRF-NH2, a cardioexcitatory tetrapeptide, can still increase contractility, cyclic AMP, and the adenylate cyclase activity of a tachyphylactic ventricle. These results are consistent with the hypothesis that 5HT augments molluscan myocardial contractility by elevating intracellular cyclic AMP.

Adenylyl Cyclases↗

Tachyphylaxis and sensitization to nicotine-induced tachycardiac and pressor effects after nicotine infusions.

This work examined the effects of nicotine on mean arterial pressure and heart rate in non-anesthetized spinal rats. Nicotine (200 mg/kg) was administered as a single bolus, as infusions lasting 7.5, 15 or 30 min, and as a post-infusion bolus. A nicotine bolus increased pressure and rate. These effects were less marked as the rate of infusion decreased. The infusions affected differentially the effects of a subsequent bolus. Thus, while tachycardia was decreased, the blood pressure rise was increased. An initial transient bradycardia was observed after bolus administration, but not during infusions; this effect was unchanged after post-infusion boluses. Pharmacological analysis indicated that tachycardia and bradycardia were predominantly due to ganglionic stimulation, while adrenal and sympathetic nerve catecholamine release played a major role in the pressor response. These results indicate that slow nicotine infusions do not induce tachyphylaxis for all of the cardiovascular effects of a subsequent bolus, and that development of acute tolerance appears to depend on the mechanism of action of the response.

Animals↗

Angiotensin II and norepinephrine after indomethacin in isolated perfused canine kidneys. Tachyphylaxis vs. modulator effect of prostaglandins.

High levels of radioimmunoassayable PGE2 were measured in the perfusate of isolated kidneys. Indomethacin inhibited PGE2 release in this system. Small reductions in the pressor effects of norepinephrine (NE) were associated with increasing perfusate levels of PGE2; a large increase in the pressor effect of NE followed additions of indomethacin and reductions in perfusate PGE2 levels. A marked reduction in pressor responsiveness to angiotensin II (AII) was measured in the isolated kidney which could not be prevented or reversed by indomethacin. It is believed that tachyphylaxis was responsible for the marked reduction in pressor responsiveness to AII and that this is independent of alterations in prostaglandin metabolism. However prostaglandins appeared to modulate the pressor effects of AII as they did NE in the isolated perfused kidney.

Angiotensin II↗

Lorazepam in childhood status epilepticus and serial seizures: effectiveness and tachyphylaxis.

We report our experience with 300 consecutive parenteral doses of lorazepam (LOR) for status epilepticus (SE) or serial seizures in 77 children and young adults. The median dose for SE in children less than 12 years old was 0.10 mg/kg. LOR stopped the SE in 79% and diminished the intensity of SE in an additional 4%. Prior acute or chronic anticonvulsant use (excepting chronic benzodiazepines) did not alter effectiveness or increase side effects. Duration of freedom from seizures following acute therapy was independent of LOR dosage. In patients requiring sequential doses, LOR becomes progressively less effective. Side effects were few and, when present, always associated with a single or first dose in a series. LOR is a safe and effective acute anticonvulsant agent for in-hospital control of SE in the pediatric age group. Tachyphylaxis of anticonvulsant action occurs when serial doses are used.

Adolescent↗

Induction and maintenance of monocyte cytotoxicity during treatment with liposomes containing muramyl tripeptide despite tachyphylaxis to the cytokine response.

Monocyte-mediated cytotoxicity (determined in a 72-h111In release assay) and the circulating levels of tumor necrosis factor alpha (TNF-alpha), interleukin (IL) 1beta, IL-6, IFN-gamma, C-reactive protein, and beta2-microglobulin were determined in 14 melanoma patients treated with multilamellar vesicle liposomes containing muramyl tripeptide phosphatidylethanolamine, 4 mg twice a week for 12 weeks. Monocyte-mediated cytotoxicity increased 24 h after the first infusion in 9 of 14 patients and had reached maximum levels (mean, 44% +/- 8) in all patients by the sixth week; similar values were observed at the 12th week. Once increased in vivo, peripheral blood monocyte cytotoxicity was not susceptible to any further increase after a subsequent in vitro incubation of the monocytes with liposomes. However, the peripheral blood monocytes which were not cytotoxic in vivo were activated by in vitro incubation with liposomes and not by medium. TNF-alpha and IL-6 peaked 2 h after the first infusion and returned to baseline values at 24 h; they were not significantly increased by subsequent treatments. The induction of fever in patients, observed 2 h after the first infusion, correlated with TNF-alpha and IL-6 levels. Similarly, C-reactive protein levels also increased at 24 h, but only after the first dose. No increase in beta2-microglobulin and IL-1beta levels was observed, and IFN-gamma was never detected in serum. Two patients experienced stable disease lasting 7 and 12 months, and 12 patients progressed. These results show that multilamellar vesicle muramyl tripeptide phosphatidylethanolamine administration activates monocyte cytotoxicity and cytokine production (TNF-alpha, IL-6). Chronic treatment with multilamellar vesicle muramyl tripeptide phosphatidylethanolamine results in tachyphylaxis in terms of cytokine secretion but not cytotoxicity. There was no difference between the maximum cytotoxicity levels obtained in vivo and those obtained in vitro using the same agent. A better understanding of immunoregulation is required for a rational application of this and related immunotherapies.

Acetylmuramyl-Alanyl-Isoglutamine↗