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Evaluation of the endothelium of human donor corneas by induced dilation of intercellular spaces and trypan blue.

The endothelium of 30 pairs of human cadaver corneas was stained by trypan blue and the intercellular spaces were visualized by induced dilation prior to corneal culture. Trypan blue staining and induced dilation of intercellular spaces by 0.9% and 0.45% NaCl were found to be atraumatic. Only a fraction of damaged cells were stained by trypan blue. Endothelial cell losses in culture did not correlate with the number of trypan-blue stained cells, the post-mortem time, or donor age.

Adult↗

The induction of axial blisters in the chick embryo by trypan blue.

The hemorrhage, blister formation, and rumplessness observed in the chick embryo following treatment with trypan blue may be due to (1) increased ventricular blood pressure or (2) to necrosis and edema in the caudal region of the embryo by inhibiting nutrient utilization. To test the role of increased ventricular blood pressure in the induction of caudal blisters, primitive streak to 7-somite chick embryos were cut in half, separating the upper presumptive heart region from the lower presumptive trunk and tail regions. Each half was then explanted on media containing trypan blue for 24 hours. In intact embryos treated with 0.04 mM trypan blue the frequency of blisters in the posterior region was 80.8%. The blisters usually appeared on both sides of the neural tube, below or in the region of the last few somites. In transected embryos treated with trypan blue, the frequency of blisters in the posterior halves which had beating hearts was 2.6%. However, the frequency of blisters in the posterior halves which were not connected to beating hearts was 47.8%. In some cases the blisters were found in posterior halves in which the rump was not well developed or present at all. Thus, we may conclude that: (1) direct connection between the heart and the rump is not necessary for the induction of caudal blisters. (2) The presence of a well-differentiated rump is also not necessary for blister formation. We suggest that trypan blue acts directly on organs or structures found in the caudal region of the chick embryos.

Abnormalities, Drug-Induced↗

Trypan-blue- and endoillumination-assisted phacoemulsification in eyes with vitreous hemorrhage during combined cataract and vitreous surgery.

PURPOSE: To study the safety and usefulness of trypan blue application and conventional endoillumination for enhancing visualization during phacoemulsification and foldable intraocular lens implantation in cases of cataract with vitreous hemorrhage. METHODS: Ten eyes of 10 patients with cataract and coexisting vitreous hemorrhage underwent combined trypan-blue- and endoillumination-assisted phacoemulsification and foldable intraocular lens implantation with vitrectomy. In a two-step surgery, after staining the anterior capsule with trypan blue, continuous circular capsulorhexis was performed; then, phacoemulsification was performed using conventional endoillumination. Specular microscopy was performed before and 3 months after surgery on eyes that underwent trypan-blue- and endoillumination-assisted phacoemulsification and on control eyes that underwent standard phacoemulsification to evaluate the toxic effect of trypan blue on corneal endothelial cells. RESULTS: Trypan blue application improved visualization of the anterior capsule, and a complete capsulorhexis could be performed in all eyes. In all 10 eyes, endoillumination was required to visualize the lens structure, and phacoemulsification could be accomplished. Specular microscopy revealed that there was no significant difference in the level of corneal endothelial cell loss between the trypan-blue- and endoillumination-assisted phacoemulsification group and the control group. CONCLUSION: The described double visualization technique may assist phacoemulsification in selected cases of cataract with vitreous hemorrhage.

Aged↗

Digital image analysis of trypan blue and fluorescein staining of anterior lens capsules and intraocular lenses.

PURPOSE: To study the intensity of trypan blue and fluorescein staining over time in anterior lens capsules and various intraocular lens (IOL) materials. SETTING: Fritz Eye Associates, Geislingen, Germany. METHODS: Excised anterior lens capsules and IOLs were exposed to trypan blue 0.1% and fluorescein 2% solution to assess the time correlation of color saturation. A technique of color differentiation using red-green-blue analysis was used. RESULTS: In the anterior lens capsules, trypan blue saturation was 17% after 60 seconds and 71% after 24 hours; with fluorescein, there was no visible staining after 5 minutes and 17% saturation after 24 hours. Red and green light transmission was reduced with trypan blue and high with fluorescein. Blue light transmission was reduced with fluorescein. In poly(methyl methacrylate) and silicone IOLs, there was no to minimal staining and in acrylic IOLs, there was intense uptake of both dyes. CONCLUSIONS: The implications of this surgical technique are to use a short exposure time with trypan blue and avoid acrylic IOLs in cases of questionabale dye loss to the vitreous. Fluorescein should be used as a dye only when injected subcapsularly.

Acrylic Resins↗

Anterior and posterior capsulorhexis in pediatric cataract surgery with or without trypan blue dye: randomized prospective clinical study.

PURPOSE: To evaluate the clinical efficacy of trypan blue 0.1% dye (Blurhex) in creating a complete anterior and posterior capsulorhexis during pediatric cataract surgery. SETTING: Tertiary eyecare center, Postgraduate Institute of Medical Education and Research, Chandigarh, India. METHODS: In a prospective randomized study, an anterior (ACCC) and posterior (PCCC) continuous curvilinear capsulorhexis were performed in pediatric patients. In Group 1 (n = 19), the ACCC and PCCC were created without use of trypan blue dye. In Group 2 (n = 23), intracameral trypan blue dye was used to stain the anterior and posterior capsules. RESULTS: In Group 1, 14 eyes (73.6%) had a complete ACCC and 10 (52.6%) had a complete PCCC. In Group 2, 21 eyes (91.3%) had a complete ACCC and 19 (82.6%) had a complete PCCC. CONCLUSION: In cases of pediatric cataract, staining the anterior and posterior capsules with trypan blue 0.1% allowed recognition of capsule flaps and facilitated the creation of complete ACCCs and PCCCs.

Capsulorhexis↗

Changes in blood-brain barrier permeability following neurotoxic lesions of rat brain can be visualised with trypan blue.

A simple method for measuring changes in blood-brain barrier (BBB) permeability following neurotoxic lesions is described. In the brains of animals perfused transcardially with a trypan blue solution at the time of sacrifice, the presence of trypan blue staining correlated with changes in BBB function seen with more traditional markers, such as albumin staining. Thus, trypan blue appears to be useful as a marker for changes in BBB permeability. We have used this method to show increases in BBB permeability in striatal lesions induced by three different neurotoxins: chronic systemic injection of 3-nitropropionic acid (3-NP) and intrastriatal injection of either quinolinic or kainic acid. Trypan blue staining was seen in all three types of lesion, with both the neuropil and some neurones being stained. In the kainic acid lesioned animals, trypan blue also stained hippocampal and cortical neurones which are known to degenerate. Our findings suggest that trypan blue makes a more sensitive marker than albumin for both BBB integrity changes and degenerating neurones. Furthermore, this method has the advantages over others of being quick, economic and compatible with most subsequent histological and immunocytochemical staining.

Albumins↗

Staining the anterior capsule with indocyanine green or trypan blue for capsulorhexis in eyes with white cataract.

AIM: To assess the efficacy and safety of indocyanine green (ICG) 0.5% and trypan blue 0.1% for anterior capsule staining in cases of white cataract. METHODS: This prospective study comprised 55 eyes of 55 patients with white cataract that had phacoemulsification with foldable intraocular lens implantation. ICG in 30 eyes and trypan blue in 25 eyes were used under air to stain the anterior lens capsule. The staining patterns and the ease of creating a continuous curvilinear capsulorhexis (CCC) were assessed; the intraoperative and postoperative complications were noted. The mean follow-up was 17.68+/-1.65 months. RESULT: Either ICG or trypan blue stained the anterior capsule uniformly. However, the staining provided by trypan blue was slightly superior. A CCC was successfully achieved in 25 eyes (100%) with trypan blue, and 29 eyes (96.7%) with ICG, respectively. There was no significant postoperative reaction in any eye. CONCLUSION: The use of vital dyes such as ICG and trypan blue guarantees a complete CCC and makes it possible to deliver the benefits of phacoemulsification in the patients with white cataract.

Aged↗

Trypan blue exclusion principle in the evaluation of fibroblast attachment in vitro using V79 cells on the conditioned root surface.

OBJECTIVE: Various studies have shown that the root surface condition may play an important role in wound healing. Root surface demineralization has been shown to promote the establishment of new connective tissue attachment. Various agents, including citric acid, ethylenediaminetetraacetic acid (EDTA), and tetracycline, have been used to try to achieve a root surface that is biocompatible with the adjacent periodontal cells. Traditional in vitro studies have used periodontal ligament fibroblasts and scanning electron microscopic studies to check the efficacy of these root-conditioning agents. The objective of this study was to assess the efficacy of trypan blue to evaluate fibroblast attachment in an in vitro model using V79 fibroblasts (embryonic Chinese hamster lung fibroblasts) on root specimens treated by citric acid, EDTA, and tetracycline. METHOD AND MATERIALS: Citric acid-, EDTA-, and tetracycline-treated root specimens were placed in cultures of V79 cells and in human periodontal ligament cells, which acted as a control. The treated root specimens were removed from the cultures after 4 weeks and immediately treated with 1% trypan blue. Trypan blue was selected because it can stain only nonvital tissues. RESULTS: The root specimens placed in V79 and human periodontal ligament cultures showed unstained areas, indicating the presence of vital cells, in contrast to the stained areas, which represented the areas devoid of cells. CONCLUSION: This in vitro screening model based on the trypan blue exclusion principle may be used for immediate evaluation of the efficacy of various root-conditioning agents. V79 cells may be used as an alternative to human periodontal ligament fibroblasts in the evaluation of the efficacy of root conditioning agents.

Animals↗

Identification of tissue hypoxia in the livers of ascitic and hypoxia-induced broilers using trypan blue.

1. The perfusion of livers with the vital dye trypan blue was performed to test for evidence of tissue hypoxia in 3 groups of young broiler chickens, namely, ascitic, hypoxia-induced and controls. 2. Hepatocytes that stained with trypan blue were considered to be dead or dying before fixation and represented damaged cells. 3. The proportion of trypan blue-stained hepatocytes in the livers of ascitic birds was slightly less than half that observed in the hypoxia-induced birds but significantly more than the proportion of stained cells observed in control birds. 4. Liver damage in the ascitic birds was also assessed biochemically by an altered enzyme profile. 5. The study demonstrated that increased trypan blue uptake in the livers of ascitic birds reared at sea-level may be the consequence of hypoxia stress caused by reduced oxygen utilisation.

Animals↗

Trypan blue not toxic for retinal pigment epithelium in vitro.

PURPOSE: To investigate whether trypan blue has a toxic effect on cultured retinal pigment epithelial (retinal pigment epithelium) cells. DESIGN: Experimental study with a direct live/dead cell staining technique using fluorescent dyes. METHODS: Cultured human retinal pigment epithelium cells were exposed for 5 minutes to various concentrations of trypan blue (0.06%, 0.15%, 0.30%), and cell viability was confocally measured. RESULTS: No increased cell death was found in cultures incubated in any of the trypan blue concentrations used. CONCLUSION: These findings indicate that a short exposure of trypan blue does not have a toxic effect on cultured retinal pigment epithelium cells.

Cell Survival↗

Trypan blue: identification and teratogenic and oncogenic activities of its coloured constituents.

Three coloured substances frequently present as contaminants in commercial samples of trypan blue have been identified as those monoazo dyes in which 4-amino-3,3'-dimethyl-biphenyl, 4-amino-3,3'-dimethyl-4'-hydroxy-biphenyl or omicroc-tolidine are coupled to H-acid. These dyes have been synthesized and, together with purified samples of trypan blue, tested for teratogenic activity in mice and oncogenic activity in rats. Unpurified trypan blue was both teratogenic and oncogenic; purified trypan blue, was teratogenic but only weakly oncogenic; the monoazo dyes possessed neither activity. It is concluded that the main blue component of trypan blue is the teratogenic principle and that some as yet unidentified component of the purple fraction either is the main oncogenic principle or potentiates the action of the blue component.

Animals↗

A comparative study of the inhibitory effect of trypan blue on mouse erythrocyte and C3 binding receptors of peripheral blood mononuclear cells from healthy donors and patients suffering from chronic lymphocytic leukaemia.

Trypan blue has previously been shown to interact with the C3 receptor, but not with the Fc receptor. In the present work the effects of Trypan blue on mouse erythrocyte (ME) and C3 binding receptors of the peripheral blood mononuclear cells have been studied in healthy individuals and in patients with chronic lymphocytic leukemia (CLL). The resulting dose-response curves have been compared with each another. The results of statistical analysis indicate that there is no significant difference between the effects of trypan blue on the two receptors in healthy individuals. In contrast ME and C3 binding receptors differ significantly in trypan blue sensitivity in CLL patients. These data suggest that the two receptors are similar, or are situated on the cell membrane in such a way that the trypan blue bound to one of them inhibits the functioning of the other one too, but they are not the same. In the course of leukemic transformation, the trypan blue sensitivity of the ME binding receptor does not vary, whereas that of the C3 receptor is enhanced significantly.

Animals↗

Development of the skeleton in normal rats and in rats with trypan blue induced spina bifida.

In this study skeletal abnormalities in trypan blue induced axial dysraphic disorders were investigated and compared with the normal ontogenesis of the rat skeleton. The first appearance and developmental sequence of the cartilaginous and osseous structures in embryos and fetuses of normal dams were described and discussed in relation to the literature. Two main types of spina bifida were found in the offspring of trypan blue treated dams: open and occult spina bifida. Vertebral abnormalities in open spina bifida fetuses were most frequently present in the lower thoracic region and were always accompanied by rib malformations. In occult spina bifida on the contrary the abnormalities in the vertebral arches were mainly restricted to the sacral region. Both types of spina bifida were accompanied by hypoplastic tails. Apart from a delay in the onset and progress of ossification no other skeletal abnormalities were seen following trypan blue treatment. A human fetus with spina bifida was X-rayed and the vertebral abnormalities detected were very similar to those in rat fetuses.

Abnormalities, Drug-Induced↗

Double visualization using triamcinolone acetonide and trypan blue during stage 3 macular hole surgery.

PURPOSE: To study the usefulness of intravitreal injection of triamcinolone acetonide and trypan blue for facilitating visualization and dissection of the posterior vitreous cortex and internal limiting membrane (ILM) during vitrectomy in idiopathic stage 3 macular holes. METHODS: Pars plana vitrectomy was performed in 10 eyes of 10 patients with idiopathic stage 3 macular holes. After core vitrectomy had been performed, triamcinolone acetonide was injected over the posterior pole. After separation of the visualized posterior vitreous cortex, trypan blue was injected over the macular area. Excised specimens were examined by electron microscopy. RESULTS: Upon injection of triamcinolone acetonide, the posterior vitreous cortex and residual vitreous cortex could be visualized in all patients. The posterior vitreous cortex and residual vitreous cortex were completely removed. The ILM of the retina was stained faint blue and was successfully removed in all patients. Electron microscopy revealed that the triamcinolone-acetonide-visualized layer and the trypan-blue-stained layer had different histological features. No complications related to the use of triamcinolone acetonide and trypan blue were encountered. CONCLUSION: Double visualization of the posterior vitreous cortex and ILM using triamcinolone acetonide and trypan blue during vitrectomy may facilitate separation of the posterior vitreous cortex from the retina and removal of the ILM around the macular hole in patients with idiopathic stage 3 macular holes.

Aged↗

Safety testing of indocyanine green and trypan blue using retinal pigment epithelium and glial cell cultures.

PURPOSE: Indocyanine green (ICG) and trypan blue have been advocated as vital stains for use during macular surgery. The safety of these agents was tested using a cell culture model. METHODS: Human retinal pigment epithelium (RPE) and Müller cell lines were exposed to ICG over a range of concentrations up to 0.5%, and trypan blue up to 0.2%. Cells were exposed to each dye for 5, 15, or 30 minutes, rinsed, and incubated 24 hours. Cell viability was measured using a mitochondrial dehydrogenase-assay and fluorescent live-dead probe. Experiments were repeated using 0.5% and 1% ICG and 0.06% and 0.12% trypan blue, with follow-up at 0, 1, 5, and 15 days. ICG experiments were repeated in the presence of illumination from a xenon light-source channeled through a surgical endolight, and using reduced osmolarity solutions of 0.1%, 0.5%, and 1% (185 vs. 275 mOsM). RESULTS: There was no clear relationship between cell viability and the concentration of the agent or duration of follow-up, except in RPE cells exposed to 1% ICG. These showed a linear (R(2) 0.9952) decline in viability with time, with a significant reduction by day 15 (P = 0.016). RPE cells exposed to ICG and illumination were not significantly different from the negative control, but when illumination was combined with low osmolarity, viability was reduced (P = 0.0016). ICG and illumination reduced Müller cell viability (P < 0.0001 for both 185 and 275 mOsM). Müller cells incubated with 185 mOsM 1% ICG showed a significant reduction in viability (P < 0.0001) not seen with the 185 mOsM 0.5% or 0.1% solutions or in the low-osmolarity RPE groups. CONCLUSIONS: The combination of exposure to 0.5% ICG and the newer endoillumination light-sources can damage cultured Müller cells. Although the preparations of ICG most commonly used clinically did not produce significant damage, relatively small changes in ICG osmolarity and concentration did. This suggests that safety margins are not large. Trypan blue is safe in a cell culture model.

Cell Line↗

Evaluation of retinal damage induced by air/fluid exchange using a trypan blue inclusion test in rabbits.

PURPOSE: To investigate whether retina damaged in the process of air/fluid exchange could be visualized in situ using trypan blue staining. METHODS: Vitrectomy and air/fluid exchange with continuous air infusion for various periods of time was performed in adult pigmented rabbits, followed by injection of 0.4% trypan blue solution into the vitreous cavity. Retinal staining was evaluated intraoperatively under the operating microscope and by light microscopy after enucleation. RESULTS: Intraoperative examination showed localized trypan blue staining of areas of the retina opposite the infusion cannula. Light microscopy of the same areas revealed intranuclear trypan blue inclusion in the retina. CONCLUSION: Trypan blue staining allows for the immediate in situ evaluation of damage to the retina associated with air/fluid exchange and continuous air infusion in rabbit eyes.

Air↗

Alkaline ribonuclease activity increase in rat kidney cortex and liver after trypan blue and other azo dyes administration.

Acid azo dyes, most of them naphtholdisulfonic acid derivatives, were given intraperitoneally to rats and their effect on "alkaline" ribonuclease activity was studied in total homogenates of kidney cortex and liver. Acid treatment was used to release bound enzyme activity. Several of the dyes, including trypan blue, increased RNase activity in both organs 3 days after administration of single doses, while others, like Evans blue, were inactive. Activity was apparently bound to the sulfonic substitution in the 3, 6 positions in the naphthalene rings, substitutions in the benzidine rings being not critical. All of the active and most of the inactive compounds were taken up by tubule cells of kidney cortex and by reticular and parenchymal cells of liver. While the effect on both liver and kidney was obtained 1 day after trypan blue administration, RNase remained increased for only about 3 days in the first organ, and for at least a month in the second. However, repeated trypan blue doses increased liver enzyme activity for at least 9 days. Serum RNase activity was decreased after trypan blue administration. Ethionine administration together with trypan blue markedly blocked the effect of the dye on liver RNase activity; simultaneously given methionine partially reversed the action of the antimetabolite. This suggests that de novo synthesis of RNase is induced in liver by trypan blue. The action of ethionine on the kidney RNase response to trypan blue was less marked although significant; in view of the possible kidney uptake of the plasma enzyme, interpretation of this finding must be postponed. Results are discussed with reference to the mechanism of the structural specificity of the compounds used, cytological localization of the dyes and their mechanism of action on liver and kidney RNase.

Animals↗

Cytotoxicity as measured by trypan blue as a potentially confounding variable in the in vitro alkaline elution/rat hepatocyte assay.

Rat hepatocytes treated in vitro with A2RA, an angiotensin II receptor antagonist, displayed an increased level of DNA-strand breaks as determined by alkaline elution, without an appreciable increase in cytotoxicity as determined by a trypan blue dye exclusion assay at harvest. The alkaline elution profile appeared to have two components: a rapidly eluting component detected in the first fraction collected (often associated with DNA from dead or dying cells), followed by a more slowly eluting component detected in the subsequent fractions. Further analysis of hepatocytes treated with A2RA by pulsed-field gel electrophoresis and neutral elution revealed significant levels of DNA double-strand breaks. Electron microscopy (EM) showed pronounced damage to mitochondria; although cell blebbing was seen using both EM and light microscopy, the plasma and nuclear membranes appeared intact when examined by EM. Cellular ATP levels decreased precipitously with increasing doses of A2RA, falling to less than 10% of control values at a dose of 0.213 mM A2RA, a concentration showing 100% relative viability by trypan blue at harvest. Thus, whereas in our experience trypan blue dye exclusion accurately reflects cytotoxicity induced by the majority of test agents, in this rather unusual case, trypan blue did not accurately reflect compound-induced cytotoxicity at harvest since there was no concurrent loss of membrane integrity. However, when hepatocytes treated with A2RA were incubated for either 3 h or 20 h in the absence of compound, a sharp, dose-dependent decline in viability was observed using trypan blue dye exclusion. Together with the initial, dose-dependent drop in the alkaline elution curve, these data suggest that the observed DNA double-strand breaks arose as a consequence of endonucleolytic DNA degradation associated with cytotoxicity, rather than by a direct compound-DNA interaction. Since DNA double-strand breaks behave under alkaline denaturing conditions as two single-strand breaks and can therefore produce increases in the alkaline-elution slope values, a necessary criteria for a valid positive result in this assay is that cytotoxicity by trypan blue dye exclusion will not be greater than 30%. Our data, however, indicate that interpretation of the elution assay as a test for genotoxicity can still be confounded by the failure of the trypan blue dye exclusion assay to reflect cytotoxicity in the unusual instance when there is no concurrent, immediate loss of membrane integrity.

Angiotensin Receptor Antagonists↗