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Effect of trapidil, an antiplatelet and vasodilator agent on gentamicin-induced nephrotoxicity in rats.

This study was carried out to evaluate the effect of trapidil, an antiplatelet and vasodilator drug, on the nephrotoxicity by an aminoglycoside, gentamicin, in rats. Forty female Wistar rats were divided into six different groups. One group served as a control group and the other groups were treated as follows: gentamicin (50 mg kg(-1) twice daily)-treated, gentamicin plus trapidil (4 or 20 mg kg(-1) daily)-treated and only trapidil-treated (4 or 20 mg kg(-1) daily) groups. Serum urea, creatinine and nitrite/nitrate levels were measured. Moreover, histopathological as well as electron microscopic examinations were performed. At a lower dose (4 mg kg(-1)) trapidil did not prevent the development of renal tubular damage by gentamicin. However, a higher dose of trapidil (20 mg kg(-1)) inhibited the ability of gentamicin to increase the levels of creatinine and urea. Furthermore, both light and electron microscopic evaluation confirmed the nephroprotective effect of the higher dose of trapidil. The level of the stable nitric oxide (NO) metabolite, nitrite, was also increased by trapidil. In conclusion, trapidil at a higher dose may protect against gentamicin nephrotoxicity. The mechanism underlying trapidil nephroprotection is not known, but may result from the antagonism of platelet-derived growth factor (PDGF), vasodilatation, inhibition of trombosit aggregation, and/or NO release.

Animals↗

Trapidil in preventing restenosis after balloon angioplasty in the atherosclerotic rabbit.

Trapidil (triazolopyrimidine) possesses activity against platelet-derived growth factor-induced cellular proliferation in vitro and intimal proliferation in vivo. The objective of this study was to determine if trapidil could prevent restenosis in experimentally induced atherosclerotic rabbits. New Zealand White rabbits with preexisting iliac arterial lesions induced by balloon deendothelialization underwent balloon angioplasty. Arteriography was performed before, immediately after, and 4 weeks after the balloon dilatation. Tissue sections of the dilated arterial segment were also analyzed morphometrically. Seventeen rabbits were randomized to two groups: a control group (n = 8) and a trapidil-treated group (n = 9). The treatment group received 30 mg/kg s.c. trapidil twice daily. The angiographic luminal diameters before and after dilatation were similar. At the 4-week restudy, there was a significant preservation of luminal diameter in the trapidil group compared with the control group (1.27 +/- 0.20 vs. 0.94 +/- 0.48 mm, respectively; p less than 0.005). When luminal diameters immediately after dilatation were compared with diameters at the 4-week restudy (i.e., when the degree of restenosis was assessed), there was a greater luminal diameter reduction in the control group than in the trapidil group (0.70 +/- 0.44 vs. 0.30 +/- 0.25 mm, respectively; p = 0.005). By morphometric analyses, the luminal areas were also greater in the trapidil group than the control group (0.80 +/- 0.25 vs. 0.57 +/- 0.33 mm2, respectively; p = 0.03). Intimal thickness was significantly less for the trapidil group than for the control group (0.33 +/- 0.15 vs. 0.44 +/- 0.15 mm, respectively; p = 0.01), as well as medial thickness (0.09 +/- 0.03 vs. 0.11 +/- 0.03 mm, respectively; p = 0.01). In this study, trapidil significantly increased the luminal area and reduced the intimal thickness in the atherosclerotic rabbit iliac artery after balloon angioplasty.

Angioplasty, Balloon↗

Trapidil inhibits platelet-derived growth factor-stimulated mitogen-activated protein kinase cascade.

Trapidil, an antiplatelet drug, has been shown to reduce restenosis after angioplasty. It exerts its action, at least in part, by inhibiting vascular smooth muscle cell proliferation, antagonizing platelet-derived growth factor (PDGF). We examined its site of action on PDGF cellular signaling. Exposure of cultured rat vascular smooth muscle cells to increasing concentrations of trapidil for 18 hours resulted in a dose-dependent reduction in PDGF-BB-stimulated [3H] thymidine incorporation. Trapidil (400 microg/mL) increased PDGF beta-receptor protein by 28+/-8%, whereas PDGF-induced tyrosine phosphorylation of PDGF beta-receptor remained unchanged. PDGF-induced tyrosine phosphorylation of phospholipase Cgamma, the p85 regulatory subunit of phosphatidyl-inositol 3 kinase, Ras GTPase-activating protein, and an adaptor molecule Shc were also not altered. On the other hand, trapidil inhibited PDGF-stimulated mitogen-activated protein kinase (MAP kinase) activity by 35+/-7% at 10 minutes and by 32+/-10% at 6 hours. Activation of Raf-1, an upstream activator of MAP kinase, by PDGF was also attenuated by trapidil. Moreover, protein content of MAP kinase phosphatase-1, which inactivates MAP kinase, was elevated in trapidil-treated cells. These actions of trapidil may be mediated by cAMP. Thus, there was a 1.9-fold increase in cellular cAMP generation in trapidil-treated cells. The present results demonstrate that trapidil antagonizes PDGF-induced mitogenesis and MAP kinase activation in vascular smooth muscle cells, probably through cAMP.

Animals↗

The effects of trapidil on left ventricular function and platelet aggregation in patients with coronary artery disease subjected to pacing.

The effects of the intravenous administration of 100 mg of trapidil on systolic and diastolic left ventricular functions and coronary sinus blood flow, as well as on myocardial lactate metabolism and platelet aggregation, were investigated before and after pacing in 12 patients with coronary artery disease. Pacing without administration of trapidil provoked angina in 6 of these patients. During rest, trapidil decreased the mean blood pressure by an average of 5 mmHg (from 112 +/- 15 to 107 +/- 8 mmHg, p less than 0.05) and the left ventricular end-diastolic pressure by an average of 4 mmHg (from 10 +/- 3 to 6 +/- 2 mmHg, p less than 0.05). Trapidil also caused both the max dp/dt and the coronary sinus blood flow to increase slightly, although it had no significant effect on diastolic function, myocardial lactate metabolism, or platelet aggregation. During the pacing that followed trapidil administration, chest pain was not provoked in the same 6 patients who had previously experienced chest pain on pacing. The extent of ST-segment depression also improved from -1.6 +/- 0.3 to -0.9 +/- 0.7 mm (p less than 0.05) and there was a significant suppression of the production of myocardial lactate. When pacing was terminated, trapidil caused a decrease in left ventricular systolic pressure from 173 to 156 mmHg (p less than 0.05), and also caused a decrease of the left ventricular end-diastolic pressure, from 16 +/- 4 to 8 +/- 2 mmHg (p less than 0.05). Trapidil had no significant effect on platelet aggregation activity with either a 1 microM or a 2 microM dose of ADP (adenosine diphosphate). However, the beta-TG level was suppressed, decreasing from 119 +/- 14 to 99 +/- 19 ng/ml in the arterial blood (p less than 0.1) and from 114 +/- 9 to 103 +/- 17 ng/ml (p less than 0.1) in the coronary sinus blood. Reductions in the preload and afterload by trapidil were of far greater magnitude than either its coronary dilatory or positive chronotropic effects in patients with coronary artery disease. Thus trapidil, a new antianginal agent appears to inhibit the production of platelet derived growth factors and may, therefore, protect the arteries from atherosclerosis as it promotes beneficial systemic hemodynamics in patients with depressed ventricular function.

Aged↗

Antiproliferative effect of trapidil, a platelet-derived growth factor antagonist, on a glioma cell line in vitro.

Platelet-derived growth factor (PDGF) is produced by glioma cells. However, there is heterogeneity among glioma cell lines in the production of PDGF. It has been demonstrated that U251MG cells produce a PDGF-like molecule while U105MG cells do not. Trapidil, a specific antagonist of PDGF, competes for receptor binding with PDGF. Therefore, the inhibitory effect of trapidil on the proliferation of glioma cells was investigated in vitro using two glioma cell lines. At 100 micrograms/ml, trapidil significantly inhibited the proliferation of U251MG cells (which produce the PDGF-like molecule). At the same trapidil concentration, the proliferation of U105MG cells (which do not produce the PDGF-like molecule) was not inhibited. The inhibitory effect of trapidil was remarkable on Days 3 and 4 of culture. After 4 days of incubation, the proliferation of U251MG cells was 46% of the control preparation. Trapidil enhanced the antitumor effect of 3-[4-amino-2-methyl-5-pyrimidinyl)ethyl)-1-(2-chloroethyl)-1-nitrosourea (ACNU) against U251MG cells. The enhancing effect was highest on Days 4 and 6 of culture. After 6 days of incubation in the presence of 100 micrograms/ml trapidil and 1 microgram/ml ACNU, the proliferation of U251MG cells was 18% of the control preparation. These findings suggest that trapidil interrupts the autocrine loop at the PDGF and PDGF-receptor level and that combination therapy with trapidil and ACNU may be useful in the treatment of glioma.

Animals↗

Mechanism of cardiovascular action of trapidil.

In anaesthetized, open-chest dogs N,N-diethyl-5-methyl[1,2,4]triazolo[1,5-alpha]pyrimidine-7-amine (trapidil) in doses of 0.3--3 mg/kg i.v. produced increases in coronary sinus outflow and heart rate and decreases in systemic blood pressure and coronary resistance in a dose-dependent manner. Trapidil produced an increase in myocardial oxygen consumption but virtually no change in coronary arteriovenous oxygen difference. At 1.8 mg/kg i.v. of the drug coronary resistance fell to half of the pre-drug value and coronary sinus outflow almost doubled, and so did myocardial oxygen consumption. In isolated, blood-perfused dog heart preparations, trapidil produced coronary vasodilator and positive inotropic and chronotropic effects. Theophylline produced similar effects. Trapidil was a more positive inotropic than positive chronotropic agent, and so was theophylline but to a lesser degree than trapidil. In producing vasodilator and positive inotropic effects trapidil was about 3 times more effective than theophylline. Trapidil and theophylline inhibited the cyclic AMP phosphodiesterase (PDE) activity in crude extracts prepared from the dog ventricular muscle. In this respect trapidil was nearly 3 times more potent than theophylline. It is suggested that PDE inhibition would be a fundamental mechanism of action of trapidil.

3',5'-Cyclic-AMP Phosphodiesterases↗

[Pharmacological properties of trapidil: comparison with other coronary vasodilators (author's transl)].

Effects of trapidil and other coronary vasodilators on retrograde blood flow in acute coronary-ligated dogs, isolated large and small coronary arteries of pig, platelet aggregation, biosynthesis of prostacyclin in isolated aortic rings and hyperlipemia in quails were investigated. Trapidil showed an increase in retrograde blood flow while dipyridamole, nifedipine, diltiazem and dilazep did not. Trapidil and nitroglycerin relaxed large coronary arteries, while dipyridamole, diltiazem, dilazep and adenosine relaxed small arteries. Trapidil, dipyridamole, diltiazem and aspirin protected against the secondary phase of ADP-induced platelet aggregation in guinea-pig platelet rich plasma more effectively than did nifedipine and dilazep. Trapidil and aspirin protected only against rabbit platelet aggregation as induced by arachidonic acid. Moreover, only trapidil protected against platelet aggregation as induced by prostaglandin G2-thromboxane A2 mixture. Trapidil and dipyridamole enhanced the platelet aggregation protection of prostacyclin. Trapidil also facilitated biosynthesis of prostacyclin more markedly than did the other drugs. Trapidil increased serum content of HDL cholesterol and significantly lowered serum content of triglyceride and the ratio of LDL cholesterol to HDL cholesterol in hyperlipemic quails. Dipyridamole, diltiazem, nifedipine and dilazep, however, showed little effect.

Animals↗

[The effects of treatment with trapidil compared to nifedipine on physical, emotional and cognitive exercise tolerance in patients with coronary heart disease].

The present study was carried out to investigate exercise test results and the outcome of the quality of life after administration of trapidil (CAS 15421-84-8, Rocornal) or nifedipine (CAS 21829-25-4) to patients with coronary heart disease. The characteristics of the life quality in combination with the results of exercise test are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select the best pharmacological approach in individual patients. In this prospective multicentre study, 144 patients with stable angina were enrolled in 6 centres. Due to protocol violations and drop-outs 116 patients were evaluated for tolerability; 101 patients were evaluated for efficacy. After baseline evaluation, consisting of an exercise test and a questioning investigating patients' anginal symptoms and several psychometric testings, the patients were randomly allocated to double-blind treatment for 12 weeks with either trapidil, 200 mg t.i.d. or nifedipine, 10 mg t.i.d. according to a parallel group design. After 6 and 12 weeks exercise tests and psychometric testings were repeated. Both trapidil and nifedipine prolonged exercise tolerance (trapidil 39.2% vs. nifedipine 33.3%) or increased the total exercise over baseline levels (trapidil 57.8% vs. nifedipine 61.2%). Using Mann-Whitney U-test the SB-S-rating scale and the physician's assessment revealed a comparable improvement of life quality (trapidil 69.4% vs. nifedipine 80.0%) under both treatments. In addition patient questioning showed a significant reduction in angina attacks and in nitroglycerin consumption. None of the characteristics of anginal symptoms or exercise test gave evidence for a significant difference between nifedipine and trapidil. Both drugs demonstrated similar safety profiles (adverse events (AEs) 12.7% for trapidil and 11.1% for nifedipine); four patients of the trapidil group and one of the nifedipine group discontinued the clinical trial because of AEs. The results of a baseline exercise test and rating questionnaires may offer useful information for selecting medical treatment in stable angina pectoris.

Aged↗

Concentration-dependent effect of trapidil on slow action potentials in cardiac muscle.

Trapidil, a coronary vasodilator and positive inotropic agent, was tested for its ability to affect the normal "fast" action potentials and the "slow" action potentials and contractions of isolated perfused chick hearts, and to affect the tissue cyclic AMP level. At 5 X 10(-3) M, trapidil completely blocked the fast Na+ channels in hearts perfused with normal Tyrode solution, since this dose abolished the action potential when verapamil (2 X 10(-6) M) was present to eliminate the inward slow current. To study effects on the slow channels, the fast Na+ channels were voltage-inactivated by partial depolarization to about -40 mV with an elevated (25 mM) K+-Tyrode solution, resulting in loss of excitability. At low concentrations (1 X 10(-4) - 1 X 10(-3) M), trapidil induced slow action potentials accompanied by contractions, even in the presence of a beta-adrenergic blocker. In contrast, at high concentrations (3 X 10(-3) - 1 X 10(-2) M), trapidil markedly depressed or blocked the isoproterenol-induced slow action potentials. Consistent with this dual action, in hearts perfused with normal Tyrode solution, trapidil exerted a small positive inotropic action at low doses and a considerable negative inotropic action at high doses, even though the intracellular cyclic AMP level was substantially elevated. That is, trapidil has actions similar to those of papaverine. It is concluded that trapidil blocks both fast Na+ channels and slow channels in cardiac muscle, the fast Na+ channels being more sensitive, and that low concentrations of trapidil induce slow channels by elevating the cyclic AMP level because of phosphodiesterase inhibition.

Action Potentials↗

Trapidil inhibits platelet-derived growth factor-induced migration via protein kinase A and RhoA/Rho-associated kinase in rat vascular smooth muscle cells.

Trapidil suppresses platelet-derived growth factor (PDGF)-induced vascular smooth muscle cell (VSMC) proliferation by inhibiting Raf-1/extracellular signal-regulated kinase (ERK) via cAMP/protein kinase A (PKA). We examined whether trapidil inhibits PDGF-induced VSMC migration and investigated its mechanisms of action. VSMC migration was inhibited to a similar extent by trapidil and forskolin. A PKA inhibitor N-(2-[p-bromocinnamylamino]ethyl)-5-isoquinolinesulfonamide (H89) blocked the inhibition by forskolin to a greater degree than that by trapidil. Trapidil but not forskolin suppressed PDGF-stimulated RhoA activation. In the presence of both H89 and (+)-(R)-trans-4-(1-aminoethyl)-N-(4-pyridyl)cyclohexanecarboxamide dihydrochloride monohydrate, an inhibitor of Rho-associated kinase (ROCK), trapidil and forskolin inhibited migration to a similar extent. Thus, in addition to cAMP/PKA activation, trapidil inhibits RhoA/ROCK activation, which may be important in trapidil's inhibitory effect on migration.

Amides↗

Trapidil-mediated inhibition of CNS remyelination results from reduced numbers and impaired differentiation of oligodendrocytes.

In a previous study, we described the inhibitory effects of the growth factor-antagonist, trapidil, on spontaneously occurring oligodendrocyte remyelination in the rat spinal cord following lysolecithin-induced demyelination [30]. The objective of the present study was to further investigate the mechanisms of trapidil-mediated impairment of remyelination and thus obtain greater insight into the steps at which growth factors may be involved in remyelination. To this end, an ultrastructural analysis of the cellular composition of lesions from control and trapidil-treated animals was undertaken. Demyelination was created in the dorsal funiculus of 6-week-old female rats by the injection of 1.0 microliter of 1% lysolecithin. The animals received daily intraperitoneal injections of trapidil (80 mg/kg) or saline for 21 days, beginning on the day of lesion induction. Quantitative electron microscopic examination of lesions from both groups of animals showed that trapidil-treated lesions had reduced numbers of oligodendrocytes (P = 0.02) with a higher relative proportion of immature phenotypes, but increased numbers of microglia (P = 0.0009) and dystrophic axons (P0.02). In addition, the numbers of myelin lamellae around remyelinated axons were fewer in trapidil-treated animals. These results suggest that trapidil-mediated impairment of CNS remyelination is due to a blockage of growth factor-mediated proliferation and/or recruitment of remyelinating cells. Furthermore, the presence of oligodendrocytes with a more immature phenotype and the decreased thickness of the myelin sheaths of remyelination in the trapidil-treated animals indicate an impairment of growth factor-mediated differentiation.

Animals↗

Effect of trapidil in ischemia/reperfusion injury of peripheral nerves.

OBJECTIVE: Ischemia plays an important role in the development of pathological changes in nerve tissue, and restoration of blood flow results in injury (ischemia/reperfusion [I/R] injury) mediated by toxic oxygen free radicals. Trapidil is currently used as a coronary artery vasodilating agent and is also used for the prevention of ischemic symptoms of cerebral vasospasm. The purpose of this study was to determine the effects of trapidil on I/R injury and the ischemic tolerance of rat peripheral nerves. METHODS: Preischemia or prereperfusion administration of trapidil (8 mg/kg) was evaluated in the rat sciatic nerve I/R injury model. Nerve tissue samples from the I/R injury site were assayed for malondialdehyde (MDA), nitrites, and nitrates, as markers of I/R injury, and pathological changes were evaluated by electron microscopy. RESULTS: I/R resulted in an increase in MDA levels, which remained elevated for 2 weeks in control nerves. Rats that received trapidil before ischemia exhibited decreased MDA levels, and rats that received trapidil after the standard 3 hours of ischemia demonstrated increased tolerance to reperfusion, as reflected in significantly decreased MDA levels. Nitrite and nitrate levels in trapidil-treated rats were significantly higher than those in control animals. Histological evaluations of the sciatic nerve segments demonstrated that preischemia and postischemia trapidil treatments had a sparing effect against the myelin damage and axonal edema that are consistently noted in untreated ischemic reperfused nerves. CONCLUSION: The results confirm that pretreatment with trapidil before the ischemic insult or before reperfusion provides marked protection against I/R injury in peripheral nerves.

Animals↗

Trapidil enhances the slowly activating delayed rectifier potassium current and suppresses the transient inward current induced by catecholamine in Guinea pig ventricular myocytes.

We examined the electrophysiological effects of trapidil on the ionic currents influencing the repolarization and on the transient inward current (ITi) that can cause triggered arrhythmia using the whole-cell patch-clamp technique in guinea pig ventricular myocytes. Trapidil shortened the action potential duration (APD) and increased the delayed rectifier potassium current (IK) in a concentration-dependent manner. The effect of trapidil on the rapidly and slowly activating components of IK (IKr and IKs, respectively) was studied by the envelope of tails test. Trapidil failed to affect IKr and selectively enhanced IKs. Trapidil increased the amplitude of the L-type Ca2+ current (ICa,L), with an acceleration of its inactivation, whereas isoproterenol, a beta-adrenoceptor agonist, increased the amplitude of the ICa,L in a different manner. Isoproterenol activated ITi; however, trapidil not only failed to facilitate ITi but also suppressed isoproterenol-induced ITi. The inhibitory effect of trapidil on isoproterenol-induced ITi is at least partly via a reduction of Ca2+ overload through an acceleration of ICa,L inactivation and/or a sarcoplasmic reticulum (SR) Ca channel modulation. These results suggest that trapidil does not prolong the QT interval and has an antiarrhythmic effect on arrhythmias elicited by triggered activity secondary to Ca2+ overload at much higher concentrations than clinical concentration.

Action Potentials↗

Protective effects of trapidil in ischemia-reperfusion injury due to testicular torsion and detorsion: an experimental study.

OBJECTIVE: We aimed to detect the preventive effects of trapidil in ischemia-reperfusion (IR) injury due to testicular torsion and detorsion. METHODS: Forty prepubertal albino rats were used. In the IR group, torsion was created by rotating the left testis over 2 h, and detorsion was done by untwisting the testis. Bilateral orchiectomies were performed after 4 h. In study group, 2-h torsion was performed and trapidil was administered as a single dose 1 h before detorsion. Bilateral orchiectomies were performed after 4 h. In the sham group, a sham operation was done. In the sham plus trapidil group, a sham operation was done and trapidil was administered as a single dose. Testicular tissue malondialdehyde (MDA), nitric oxide (NO) and total sulfhydryl (T-SH) levels were determined for each group. The grades of interstitial injury were determined in histopathologic examination. RESULTS: The NO and MDA levels in the IR group were significantly higher than the study, sham and sham plus trapidil groups in the left testis (P<0.05, P<0.001 and P<0.001, respectively). A statistical difference was not found among study, sham and sham plus trapidil groups in the left testis in NO and MDA levels (P>0.05). The T-SH level in the study group was significantly higher than in the IR, sham and sham plus trapidil groups in left testis P<0.05). In the IR group (left testis), grade 1 interstitial injury was 30% (3/10), grade 2 injury was 60% (6/10) and grade 3 injury was 10% (1/10). In the study group (left testis), grade 1 interstitial injury was 30% (3/10) and there was no injury in 70% (7/10). CONCLUSION: Trapidil decreased free oxygen radical formation in testicular torsion and detorsion, and attenuated histopathological damage in the ipsilateral twisted testis.

Animals↗

Double-blind randomized multicenter study on the efficacy of trapidil versus isosorbide dinitrate in stable angina pectoris.

BACKGROUND: Trapidil is an inhibitor of phosphodiesterase I-IV with resulting positive lusitropic, vasodilating, and antiplatelet effects. HYPOTHESIS: This study was undertaken to compare the antianginal efficacy of trapidil with that of isosorbide dinitrate (ISDN) in patients with stable angina pectoris. METHODS: We studied 95 patients with stable angina pectoris who were randomized into a double-blind parallel group study with either oral trapidil or ISDN. After a 1-week run-in period and a 2-week wash-out phase, the patients received either trapidil 200 mg t.i.d. (n = 48) or ISDN 20 mg t.i.d. (n = 47) for 12 weeks. All antianginal medication, except sublingual glyceryl trinitrate (GTN), was discontinued during the study. Patients underwent an exercise electrocardiogram on an ergometer bicycle according to a modified Bruce protocol before and at 6 and 12 weeks during treatment. RESULTS: The workload capacity increased from 583 +/- 281 W.min before treatment to 833 +/- 444 W.min after 12 weeks of treatment in the trapidil group (p < 0.01) and from 555 +/- 276 W.min to 827 +/- 361 W.min in the ISDN group (p < 0.01). The anginal attacks per week as well as the use of GTN decreased significantly in both groups. After 12 weeks of therapy, the cumulative ST-segment depression during exercise decreased by 67% in the trapidil patients and by 23% in the ISDN patients. Compared with baseline, the double product at the 75 W level was reduced in both groups after 12 weeks of treatment. Blood pressure and heart rate at rest remained nearly unchanged. Overall, no statistical difference was found between the two study groups. The tolerability was good. CONCLUSION: Oral trapidil therapy is safe and effective in stable angina pectoris and is equivalent to standard therapy with ISDN.

Administration, Oral↗

The mechanism of growth-regulation of glioma cells by trapidil.

Trapidil is a PDGF antagonist that can inhibit the proliferation of the PDGF-producing glioma cells, U251MG. As the mechanism of growth-regulation by trapidil remains unclear, we studied its effect on the growth of U251MG cells. We performed a cell cycle analysis and examined the intracellular transduction pathway and oncogene expression in serum-stimulated glioma cells with or without trapidil. After the serum starvation for 3 days, glioma cell proliferation was stimulated by the addition of serum. Cell cycle analysis showed that cell cycle perturbations induced by trapidil included a decreased transition rate from G0-G1 to S phase, suggesting that some metabolic event is required for progress through the G0-G1 phase and that this event is sensitive to trapidil. Internal signal transduction mechanisms are central in the molecular control of cell growth. One such regulator is the protein kinase C(PKC) system and the c-fos gene is likely to be a direct target of intracellular signal transduction pathways. Therefore, we hypothesize that the intracellular PKC activity and c-fos expression of the trapidil-treated cells are suppressed. We posit that trapidil affects the intracellular signal transduction pathway PKC activity and c-fos expression in cells stimulated with serum containing growth factors.

Blotting, Northern↗

Trapidil is as effective as isosorbide-dinitrate for treating stable angina pectoris: a multinational, multicenter, double-blind, randomized study.

OBJECTIVE: Nitrates have long been used in the treatment of stable angina pectoris. We set out to show that trapidil, a triazolo-pyrimidine with a mode of action different from that of nitrates, is not inferior to isosorbide-dinitrate (ISDN) in the treatment of this clinical syndrome. PATIENTS AND METHODS: We studied the efficacy of 200 mg trapidil (t.i.d.) vs. ISDN (20 mg b.i.d.) in patients with chronic stable angina treated for 12 weeks. The therapeutic effect was measured in terms of responder rate as change in total exercise time (TET) by at least 60 seconds using the bicycle ergometer test. RESULTS: A total of 648 patients were included in the study. Responder rates in the Per- Protocol (PP) population (n = 529) were 50.4% (n = 133) in the trapidil group and 52.5% (n = 139) in the ISDN group (p = 0.233). As the lower non-inferiority limit (-15%) was clearly excluded from the 95% CI (pp: -10.6%, +6.4%; ITT -9.7%, 5.7%), non-inferiority of trapidil compared to ISDN can be concluded. Trapidil 200 mg t.i.d. combined with short-acting NTG prn as rescue medication over 12 weeks in subjects with chronic stable angina pectoris proved to have similar effects on TET and on other clinical endpoints as ISDN 20 mg b.i.d. The secondary efficacy analyses did not reveal any clinically relevant differences between treatment groups, and were not in conflict with the non-inferiority claim. Patients in the ISDN group had significantly more headache (34.1%; n = 110) compared to those taking trapidil (19.3%, n = 62; p <0.0001). CONCLUSIONS: Overall results of this study show that both drugs are equally effective and safe for the short-term treatment of patients with chronic stable angina pectoris and that trapidil can be considered as therapeutically equivalent to ISDN.

Adult↗

Inhibitory effect of Trapidil on the proliferation of bovine corneal fibroblasts in vitro.

BACKGROUND: In order to develop new strategies for the pharmacological modulation of posttraumatic and postsurgical wound healing of the corneal stroma, the effect of Trapidil, a competitive platelet-derived growth factor (PDGF) antagonist, on the proliferation of cultured bovine stromal fibroblasts (BSF) was investigated. METHODS: BSF, obtained from explant cultures, were seeded at a cell density of 100/mm2. The effect of various concentrations of Trapidil on cell viability and cell proliferation was determined using three different culture conditions: (1) serum-free medium (WM/F12), (2) serum-containing medium (WM/F12 + 10% FCS), and (3) serum-free medium + 50 ng/ml PDGF-BB. Trapidil was added in concentrations ranging from 100 micrograms/ml to 400 micrograms/ml. Cell numbers were determined 2 and 5 days after addition of Trapidil, using a computer-based cell-counting system. Cell viability was evaluated morphologically and by means of a repopulation assay. RESULTS: Addition of Trapidil (100-400 micrograms/ml) led to a significant, dose-dependent inhibition of both serum- and PDGF-BB-induced proliferation of BSF. In contrast, treatment of quiescent BSF, cultured in serum-free medium, did not result in a significant reduction of cell number. No cytotoxic effects were observed. CONCLUSION: The results of the present study demonstrate an inhibitory effect of Trapidil on the proliferation of BSF. It can be assumed that application of Trapidil might be a useful tool in the prevention of corneal complications after trauma (e.g., scarring, astigmatism and--with respect to photorefractive procedures--formation of haze and regression of the refractive effect).

Animals↗