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The evaluation of therapeutic efficacy of hachimi-jio-gan (traditional Chinese medicine) to rat galactosemic cataract.

Hachimi-jio-gan (Rehmannia Eight Formula, pa-wei-ti-huang-wan or Bawei dihuang wan) is one of traditional Chinese medicines which has been used for treating various senile disease for a few hundred years. This drug was evaluated for its therapeutic efficacy to rat galactosemic cataract from the suppressive rate of variance of some biochemical parameters, whose variation with cataractogenesis or the advance of cataract have been reported already. The dose of 500mg of Hachimi-jio-gan/day/200g of rat body weight suppressed significantly the variations of hydration rate, Na/K ratios, and calcium ion level in the lens with the advance of galactosemic cataract, especially when the drug was administered by the pre- or concurrent-administration before or with 30% of galactose diet respectively. This drug also could delay the progressive rate of lens opacification. However, the drug had no effect to suppress the galactitol accumulation in the lens. From these results, we presume that a drug action of Hachimi-jio-gan may control the balance of sodium, potassium and calcium ions which are important in relation to the maintenance of lens transparency. Then, we realized, that this drug may have a prophylactic efficacy to diabetic cataract, though a more detail study should be needed to apply this drug to human cataract disease.

Animals↗

The prevention of biochemical changes in lens, retina, and nerve of galactosemic dogs by the aldose reductase inhibitor AL01576.

Normal eight month old beagle dogs were fed a diet of 30% galactose for a period of two weeks. One group of dogs was untreated while three other groups were orally dosed with 0.25, 1.0, and 5.0 mg/kg of the aldose reductase inhibitor (ARI), AL01576. No visible changes were observed in the lens but glutathione (GSH) and inositol were depleted while dulcitol was elevated. These biochemical changes closely parallel those found in the (two week) streptozotocin induced diabetic rat. In contrast with the diabetic rat model, retina and nerve inositol was not found to differ from normal in spite of significant dulcitol accumulation. Plasma AL01576 was found to be inversely correlated with lens dulcitol concentration. When plasma AL0P1576 concentration was greater than 1 microgram/mL (5 mg/kg), there was a 95% reduction in dulcitol concentration (relative to untreated), while concentrations of 0.2 to 0.2 mg/mL (1 mg/kg) of AL01576 resulted in a dulcitol reduction of at least 70%. Retina and nerve dulcitol concentrations of galactosemic dogs were similarly diminished by AL01576 treatment. The dog model exhibits a biochemical profile of change and responsiveness to ARI therapy similar to that observed in hyperglycemic rats. Changes in retina morphology in diabetic and galactosemic dogs has been shown to closely resemble those occurring in human diabetics; these early biochemical events may also parallel.

Administration, Oral↗

Diabetic-like corneal sensitivity loss in galactose-fed rats ameliorated with aldose reductase inhibitors.

This study investigated whether diabetic-like corneal sensory deficits occur in the galactose-fed rat model of diabetic ocular complications and if such deficits could be prevented using either of two structurally different aldose reductase (AR) inhibitors, CT-112 or AL-1576. S-D rats were randomly grouped to receive a diet of Purina chow with either 50% starch (n=25) or 50% D-galactose (n=65). Some of the galactosemic rats received either 0.25% CT-112 topically 3x daily (n=15) or 28 mg/kg body wt/day AL-1576 systemically (n=10). The control and untreated galactosemic rats in the CT-112 portion of the study received equivalent topical doses of the vehicle. Sensitivity measurements were made with a Cochet-Bonnet Aesthesiometer mounted on a micromanipulator. The filament was applied to the central corneal surface (mean pressure of 0.96 g/mm2) and viewed using a slit-lamp biomicroscope. Ten consecutive stimuli were conducted on each cornea and the average number of blink-responses was expressed as a percent of total stimuli effected. Mean initial corneal sensitivities were similar in all groups. Corneal sensitivity in the galactosemic rat was reduced (p<0.01) at each monthly measurement compared to control. Animals treated with CT-112 or AL-1576 showed a significant increase in the mean blink-response compared to untreated galactose-fed rats and did not differ significantly from controls towards the completion of the 7 month study. Animals treated with AL-1576 did not develop cataracts, whereas those treated topically with CT-112 and untreated galactose-fed rats developed bilateral nuclear cataracts within 3 weeks. This is the first study to demonstrate decreased corneal sensitivity in the galactose-fed rat model and its amelioration with AR inhibitors. Thus, aldose reductase, the first enzyme of the polyol pathway, may have an important role in the pathogenesis of decreased corneal sensitivity. The model could be useful for investigating the pathogenic mechanism(s) involved in reduced corneal sensitivity associated with diabetic keratopathy in humans.

Aldehyde Reductase↗

Preventive effect of vitamin E-containing liposome instillation on cataract progression in 12-month-old rats fed a 25% galactose diet.

The preventive effect of vitamin E (Vit. E)-containing liposome instillation on cataract progression was examined in 12-month-old Wistar rats fed a 25% galactose diet. Vit. E-containing liposomes prepared with dipalmitoylphosphatidylcholine and dioleoylphosphatidylcholine (7:3 w/w) were instilled into both eyes twice a day. Lenses of galactose-fed rats showed suture accentuation at 6 months of feeding and opacities in the cortex and nuclei at 8 months. Two months of Vit. E-containing liposome instillation, starting at 6 months of galactose feeding, retarded this cataract progression. Lenses of galactose-fed rats had increased Vit. E, lipid peroxide (LPO), galactitol, and water contents and decreased reduced glutathione (GSH) content at 6 months of feeding; increased LPO, galactitol, and water contents and decreased GSH content at 8 months. Sera of galactose-fed rats had increased Vit. E and cholesterol concentrations at 6 months of feeding. The liposome instillation increased lens Vit. E content with attenuation of the increased lens LPO content and the decreased lens GSH content but did not affect the changes in lens galactitol and water contents and serum Vit. E and cholesterol concentrations. These results indicate that instilled Vit. E-containing liposomes retard cataract progression in 12-month-old rats fed a 25% galactose diet, mainly by the antioxidative and membrane-stabilizing actions of Vit. E contained in the liposomes.

1,2-Dipalmitoylphosphatidylcholine↗

Variability of creatinine excretion of normal, phenylketonuric and galactosemic children, and children treated with anticonvulsant drugs.

Creatinine per minute excretion rates in individual voidings varied as much as 300-500 percent of the 24-hour value for several children. Creatinine excretion rates were significantly more variable for children treated with anticonvulsant drugs than for normal children. Riboflavin-creatinine ratios determined on individual voidings were variable but adequate although total riboflavin was low. No time of day was found when creatinine excretion was representative of the 24-hour value. The creatinine height index when calculated from timed individual voidings during a 24-hour period varied for some children from 0.5 to more than 1.5 times published norms.

Body Height↗

Falsely normal value in fluorometric transferase screening of galactosemic blood. A cautionary note.

A blood sample from a galactosemic infant gave a normal result with the fluorescent screening test for galactose-1-phosphate uridyl transferase. The generation of fluorescence from this sample was found to be property of the plasma; the erythrocytes manifested no galactose-1-phosphate uridyl transferase activity. The plasma was found to contain a high level of isocitrate dehydrogenase, presumably a result of the infant's liver disease, and of isocitrate, presumably derived from citrate in the anticoagulant solution by action of aconitase derived from leukocytes which lysed during shipment. The oxidation of the isocitrate by the dehydrogenase apparently resulted in reduction of NADP to NADPH. False negative results have not been reported previously using the fluorescent transferase assay. They can be avoided in the future by using EDTA rather than citrate as an anticoagulant, particularly if blood samples are to be shipped at ambient temperature.

False Negative Reactions↗

Localization of neutral and acidic glycosphingolipids in rat lens.

Rat lens was found to contain several neutral and acidic glycosphingolipids in lens epithelia, cortex and nucleus, and showed developmental changes in their content and localization. TLC-immunostaining of gangliosides revealed the enrichment of some ganglio-series gangliosides (GM3, GM1, GD3 and GD1b) in lens epithelia and the presence of GM3 and GD3 in the lens nucleus. Immunohistochemical studies confirmed the distribution of GM3 and GM1 in anterior lens epithelial cells and the cortex, with expression decreasing toward the lens nucleus. Immunoreaction to GD3 was more intense in the lens nucleus than in epithelial cells. In contrast, the expression of neolacto-series glycosphingolipids was restricted to the lens nucleus. In order to investigate the pathological changes of glycosphingolipids in cataract, galactose-induced cataractous lenses were examined. However, no significant changes were observed in the content and composition of glycosphingolipids. In addition, Lewisx epitopes found in human cataractous lenses were not detected in the cataractous lenses of galactosaemic rats and hereditary cataractous Emory mice.

Aging↗

Prenatal exposure to high galactose adversely affects initial gonadal pool of germ cells in rats.

BACKGROUND: In rats, prenatal exposure to high concentrations of galactose may contribute to a condition that is equivalent to the premature ovarian failure (POF) component of human galactosaemia. We investigated if development of POF under experimental galactosaemia-like conditions was attributed to impaired germ cell migration. METHODS: Pregnant rats were fed pellets supplemented with, or without, 35% galactose from day 3 of conception continuing through parturition. Between days 12-15, embryos from one uterine horn were dissected out. Primordial germ cells (PGC) were histochemically localized and counted on the basis of binding of Dolichos biflorus agglutinin, a lectin specific for terminal N-acetylgalactosamine (GalNAc), to the surface glycoconjugate of the germ cells. The embryos from the other uterine horn were maintained until parturition. Liver activity of uridine diphosphate galactose 4-epimerase, the enzyme involved at multiple steps in the process of synthesis of GalNAc, was assayed in 1-2 day old female pups. RESULTS: The numbers of PGC at the day-specific sites on all days of examination were significantly lower (P </= 0.0003), and liver epimerase activity was significantly (P = 0.000001) reduced in the galactose-exposed group. CONCLUSION: Impaired germ cell migration leading to the development of gonads with deficient initial pools of germ cells may form the causal link between galactosaemia and POF.

Animals↗

Pathophysiology of impaired ovarian function in galactosaemia.

Classical galactosaemia is an inherited inborn error of the major galactose assimilation pathway, caused by galactose-1-phosphate uridyltransferase (GALT) deficiency. Many GALT mutations have been described, with different clinical consequences. In severe forms, newborns present with a life-threatening, acute toxic syndrome that rapidly regresses under a galactose-restricted diet. However, long-term complications, particularly cognitive and motor abnormalities, as well as hypergonadotrophic hypogonadism in female patients are still unavoidable. The pathogenesis of galactose-induced ovarian toxicity remains unclear but probably involves galactose itself and its metabolites such as galactitol and UDP-galactose. Possible mechanisms of ovarian damage include direct toxicity of galactose and metabolites, deficient galactosylation of glycoproteins and glycolipids, oxidative stress and activation of apoptosis. As there is no aetiological treatment, clinical management of ovarian failure in galactosaemic patients principally relies on hormonal replacement therapy to induce pubertal development and to prevent bone loss and other consequences of estrogen deprivation. Further investigations will be necessary to better understand the metabolic flux of galactose through its biochemical pathways and the mechanisms of these secondary complications. The aim of this article is to present an extensive review on the pathogenesis and clinical management of galactose-induced premature ovarian failure.

Animals↗

Brief report: Predictors of parenting stress among parents of children with biochemical genetic disorders.

OBJECTIVE: To examine predictors of parenting stress in parents whose children were diagnosed with a biochemical genetic disorder clinically or through newborn screening. METHODS: Parents of 263 children with biochemical genetic disorders (139 identified by newborn screening, 124 identified clinically) completed interviews focused on child health, medical service use, satisfaction with services, parenting stress, and family functioning. RESULTS: Multiple regression analyses suggested that child adaptive functioning, parental satisfaction with support, and difficulties parents experienced meeting their child's health care needs were associated with scores on the Parenting Stress Index (R2 =.51). CONCLUSIONS: Initiatives to improve child adaptive functioning and parental support as well as practical assistance to help parents meet their child's health needs may reduce parental stress and family disruption in this population.

Adult↗

Galactosaemia.

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Galactose↗

Use of the lactose-ethanol tolerance test in diabetes.

The standard lactose tolerance test involves measuring a patient's blood glucose after the ingestion of lactose. If the patient has lactase deficiency and is unable to hydrolyze lactose and absorb its monosaccharides, glucose and galactose, the blood glucose does not usually increase greater than 20 mg/100 ml. Since factors other than the absorption of glucose can cause an increase in the blood glucose of greater than 20 mg/100 ml in a diabetic, this test could be unreliable when it is performed on a diabetic. The present study was performed to determine whether the lactose-ethanol tolerance test could be used to diagnose lactoase deficiency in diabetics. This test involves measuring the blood galactase level, instead of the blood glucose, and the administration of ethyl alcohol to a subject prior to the test to delay the clearance of galactose from the circulation. The results indicate that the standard lactose tolerance test in which the blood glucose is measured is unreliable when performed on insulin-dependent diabetics, but that it can be reliable when performed on non-insulin-dependent diabetics. The lactose-ethanol tolerance test gave results in each type of diabetic which were qualitatively similar to those of nondiabetics. It was concluded that the latter test is a useful screening test for lactase deficiency in diabetics.

Adult↗

Corneal transport of circulating glutathione in normal and galactosemic guinea pigs.

PURPOSE: To study synthesis and transport of glutathione (GSH) in guinea-pig cornea and to determine the effect of galactose feeding and growth on transport. METHODS: Steady-state level and maximal rate of synthesis of GSH (GSH-SR) were determined in guinea pigs fed 50% galactose diet for 10 days and in controls. By using a model of in situ eye perfusion, corneal transport of [35S]GSH (4 nM) and [14C]sucrose was measured as a function of time (1-10 min) in normal guinea pigs under gamma-glutamyltranspeptidase (GGT)-inhibited and uninhibited conditions. The unidirectional constant of GSH uptake was determined as a function of GSH concentration in the perfusate. The effect of galactose feeding on corneal uptake of tracer GSH was determined in control and 10-day galactose-fed guinea pigs. Levels of GSH and uptake of GSH also were measured in corneas from three different age groups: 10 days, 4 weeks, and 9 months. RESULTS: The mean GSH level (nmol/ mg protein) in corneas of control guinea pigs was 47.6, which decreased to 36.4 (p<0.05) in 10-day galactose-fed animals. The GSH-SR was not significantly different in the two groups (1.98 vs. 2.27 nmol/min/mg protein, respectively; p = NS). Corneal uptake of tracer [35S]GSH (4 nM) was linear up to 10 min and was several-fold higher than that of the impermeable marker [14C]sucrose. The unidirectional rate constant (corrected for sucrose) for GSH was 4.03+/-0.21x10(-3)/min. GSH uptake in normal guinea pigs occurred by a saturable process with a Km of 24+/-4 microM and Vmax of 92+/-14 pmol/min/g and was significantly inhibited by GSH and GSH monoethyl ester at 60 microM concentrations. Corneal uptake of tracer GSH in galactose-fed guinea pigs showed a dramatic decrease (almost to that of sucrose) as compared with control guinea pigs. GSH uptake was similar in corneas of 10-day and 4-week-old guinea pigs, whereas that in 9-month-old guinea pigs showed a significant (approximately 80%) decrease in uptake. CONCLUSION: Cellular uptake of GSH by the cornea in the young, adult guinea pigs is carrier mediated via mechanism(s) that can be dissociated from the transpeptidation pathway. The reduced availability of circulating GSH may be an important factor in the development of corneal pathology associated with aging and corneal hydration due to relative GSH deficiency.

Aging↗

Relationship between hepatic blood flow and tissue lipid peroxidation in the early postburn period.

OBJECTIVES: To determine the effect of a body burn on effective or nutrient liver blood flow and the relationship between blood flow and oxidant-induced lipid peroxidation. DESIGN: Anesthetized sheep were given a 40% of total body surface, third-degree burn, after which animals were fluid resuscitated to return ventricular filling pressures and cardiac output to baseline values. Animals, for the 6-hr study period, were resuscitated with lactated Ringer's solution alone or lactated Ringer's solution plus 1500 mL of 5% hydroxyethyl starch or lactated Ringer's solution plus hydroxyethyl starch on which was complexed the iron chelator deferoxamine to prevent oxidant release. Effective liver blood flow was measured using the galactose infusion technique. Liver tissue lipid peroxidation was monitored using malondialdehyde content. RESULTS: We found that effective liver blood flow was decreased by 50% in the 4- to 5-hr postburn period, even when animals were resuscitated to baseline cardiac output values with lactated Ringer's solution. Tissue malondialdehyde content increased in the group treated with lactated Ringer's solution from a control value of 110 +/- 7 to 202 +/- 59 nmol/g of tissue. Resuscitation with hydroxyethyl starch restored postburn effective liver blood flow to control values, but malondialdehyde content was still increased two-fold. Resuscitation with hydroxyethyl starch and deferoxamine resulted in an increase in effective liver blood flow postburn to a value 80% above controls. In addition, lipid peroxidation was prevented. CONCLUSIONS: Effective liver blood flow is markedly decreased after burn injury, even with apparently adequate volume resuscitation, when using lactated Ringer's solution. Liver lipid peroxidation persists even when effective liver blood flow is maintained, indicating that the oxidant process is not solely related to blood flow. Infusion of the antioxidant deferoxamine during resuscitation not only prevents the lipid peroxidation, most likely by a nonblood-flow-related process, but also results in an increase in blood flow above normal rates, suggesting that postburn liver oxygen needs exceed normal values.

Animals↗