A. Abdel-Galil

Short-term aortic barodenervation diminishes α1-adrenoceptor reactivity in rat aortic smooth muscle

Our previous studies have shown that aortic baroreceptor denervation elicits acute increases in blood pressure and significant elevations of sympathetic activity and peripheral vascular resistance. This study investigated the short-term (3 and 48 h) effect of aortic barodenervation and associated sympathetic hyperactivity on the functional activity of alpha 1-adrenoceptors in rat aortic smooth muscle. Compared with sham operation, aortic barodenervation caused acute rises in blood pressure and heart rate and reductions in baroreflex sensitivity. Blood pressure and heart rate remained elevated when measured in conscious aortic barodenervated rats 3 h after surgery but subsided to sham-operated levels at 48 h; the baroreflex sensitivity, however, remained attenuated. Hexamethonium (0.5-4 mg/kg, i.v.) elicited significantly (P < 0.05) greater depressor responses in conscious aortic barodenervated rats than in sham-operated rats at both 3 and 48 h, suggesting a higher sympathetic activity in denervated rats. Exposure of aortic rings from aortic barodenervated and sham-operated rats to cumulative addition of phenylephrine (alpha 1-adrenoceptor agonist, 3 x 10(-8)-1 x 10(-4) M) resulted in concentration related contractile responses that were similar in the two groups of rats at 3 h in contrast to significantly (P < 0.05) smaller contractions in rings from denervated rats at 48 h. The maximum contraction developed (Emax) at 48 h showed approximately 50% reduction in rings from aortic barodenervated compared with sham-operated rats (239 +/- 16 vs. 558 +/- 15 mg tension/mg tissue). The pA2 value for prazosin (alpha 1-adrenoceptor antagonist) was not altered by aortic barodenervation at 3 h but showed significant (P < 0.05) increases, compared with sham-operated values, at 48 h. It is concluded that short-term aortic barodenervation results in an elevation of sympathetic activity that coincides with reduced responsiveness of aortic smooth muscle to alpha 1-adrenoceptor activation. The aortic barodenervation-induced alpha 1-adrenoceptor desensitization is not a result of decreased receptor affinity but may involve an alteration of receptor density or in the post-receptor activation events.

Pioglitazone abrogates cyclosporine-evoked hypertension via rectifying abnormalities in vascular endothelial function

In addition to insulin sensitization, the thiazolidenedione drug pioglitazone exhibits favorable circulatory effects. Here, we hypothesized that pioglitazone protects against the hypertension and related vascular derangements caused by the immunosuppressant drug cyclosporine (CSA). Compared with vehicle (olive oil)-treated rats, chronic treatment with CSA (20mg/kg/day s.c., for 14 days) increased blood pressure (BP), reduced the aortic protein expression of phosphorylated eNOS (p-eNOS), and impaired responsiveness of isolated aortas to endothelium-dependent vasorelaxations induced by carbachol. The effects of CSA on BP, aortic p-eNOS, and carbachol relaxations were abolished upon concurrent administration of pioglitazone (2.5mg/kg/day). Serum levels of adiponectin, an adipose tissue-derived adipokine, were not altered by CSA but showed significant elevations in rats treated with pioglitazone or pioglitazone plus CSA. The possibility that alterations in the antioxidant and/or lipid profile contributed to the CSA-pioglitazone BP interaction was investigated. Pioglitazone abrogated the oxidative (aortic superoxide dismutase), lipid peroxidation (aortic malondialdyde), and dyslipidemic (serum LDL levels and LDL/HDL ratio) effects of CSA. Histologically, CSA caused focal disruption in the endothelial lining of the aorta and this effect disappeared in rats co-treated with pioglitazone. Collectively, pioglitazone abrogates the hypertensive effect of CSA via ameliorating detrimental changes in vascular endothelial NOS/NO pathway and oxidative and lipid profiles caused by CSA.

Enhanced endothelial nitric oxide activity contributes to the reduced responsiveness of vascular α1-adrenoceptors following aortic barodenervation

We have recently shown that short-term aortic barodenervation diminishes constrictor responses to activation of alpha1-adrenoceptors in rat aortic smooth muscle. This study investigated the potential role of vascular endothelium and its derived vasoactive substances, nitric oxide and prostaglandins, in the reduced alpha1-adrenoceptor responsiveness after aortic barodenervation. Exposure of isolated aortic rings from aortic barodenervated and sham-operated rats 48 h after surgery to cumulative addition of phenylephrine (alpha1-adrenoceptor agonist, 3 x 10(-8) - 1 X 10(-4) M) resulted in concentration-related contractions that were significantly (P < 0.05) smaller in rings of denervated rats. Removal of the endothelium increased phenylephrine-mediated contractions in rings obtained from aortic barodenervated rats to near sham-operated levels as demonstrated by the similar contractile responses and slopes of the regression lines of the concentration-response curves. Pretreatment with indomethacin (cyclooxygenase inhibitor, 1 x 10[-5] M) had no effect on contractile responses to phenylephrine in rings from both groups of rats. In contrast, N(G)-nitro-L-arginine (nitric oxide synthase inhibitor, 3 x 10[-5] M) elevated basal vascular tone and significantly (P < 0.05) increased alpha1-adrenoceptor responsiveness, effects that were more evident in rings from denervated compared with sham-operated rats. N(G)-nitro-L-arginine produced significantly (P < 0.05) greater increases in the slopes of the regression lines (136.1 +/- 22% vs. 73.0 +/- 8.6% mg tension/mg tissue/log molar concentration) and maximum contractile response (Emax) to phenylephrine (161.2 +/- 8.2% vs. 76.7 +/- 6.1%) in rings from denervated compared with sham-operated rats suggesting an enhanced nitric oxide activity in aortas of denervated rats. This notion is further supported by the finding that cumulative i.v. administration of N(G)-nitro-L-arginine (1, 2, 4 and 8 mg/kg) elicited significantly (P < 0.05) greater pressor responses in conscious barodenervated compared with sham-operated rats. These results suggest that the endothelium plays a major role in the reduced constrictor responses to alpha1-adrenoceptor activation that occurs shortly after aortic barodenervation. This effect of the endothelium appears to involve, at least in part, enhancement of endothelial nitric oxide activity.

Co-administration of α-lipoic acid and cyclosporine aggravates colon ulceration of acetic acid-induced ulcerative colitis via facilitation of NO/COX-2/miR-210 cascade

In this work, α-lipoic acid and cyclosporine demonstrated significant protection against acetic acid-induced ulcerative colitis in rats. We proposed that α-lipoic acid and cyclosporine co-administration might modulate their individual effects. Induction of ulcerative colitis in rats was performed by intra-rectal acetic acid (5% v/v) administration for 3 consecutive days. Effects of individual or combined used of α-lipoic acid (35 mg/kg ip) or cyclosporine (5mg/kg sc) for 6 days starting 2 days prior to acetic acid were assessed. Acetic acid caused colon ulceration, bloody diarrhea and weight loss. Histologically, there was mucosal atrophy and inflammatory cells infiltration in submucosa, associated with depletion of colon reduced glutathione, superoxide dismutase and catalase activities and elevated colon malondialdehyde, serum C-reactive protein (C-RP) and tumor necrosis factor-α (TNF-α). Colon gene expression of cyclooxygenase-2 and miR-210 was also elevated. These devastating effects of acetic acid were abolished upon concurrent administration of α-lipoic acid. Alternatively, cyclosporine caused partial protection against acetic acid-induced ulcerative colitis. Cyclosporine did not restore colon reduced glutathione, catalase activity, serum C-RP or TNF-α. Unexpectedly, co-administration of α-lipoic acid and cyclosporine aggravated colon ulceration. Concomitant use of α-lipoic acid and cyclosporine significantly increased nitric oxide production, cyclooxygenase-2 and miR-210 gene expression compared to all other studied groups. The current findings suggest that facilitation of nitric oxide/cyclooxygenase-2/miR-210 cascade constitutes, at least partially, the cellular mechanism by which concurrent use of α-lipoic acid and cyclosporine aggravates colon damage. Collectively, the present work highlights the probable risk of using α-lipoic acid/cyclosporine combination in ulcerative colitis patients.

PPARγ dependence of cyclosporine-isoprenaline renovascular interaction: roles of nitric oxide synthase and heme oxygenase.

We previously showed that cyclosporine (CSA) impairs renal vasodilations caused by β-adrenoceptor activation. This study investigated whether the peroxisome proliferator-activated receptor gamma (PPARγ) and related nitric oxide synthase (NOS)/heme oxygenase (HO) signaling mediates the CSA-β-adrenoceptor interaction. The vasodilatory response elicited by a bolus injection of isoprenaline (1 μmole) in phenylephrine-preconstricted perfused kidneys of rats was reduced after prior infusion of zinc protoporphyrin IX (ZnPP, HO inhibitor) or GW9662 (PPARγ antagonist), suggesting the involvement of PPARγ and HO-derived CO in the isoprenaline response. In contrast, the inhibition of NOS activity by NG-nitro-l-arginine methyl ester had no effect on isoprenaline responses. CSA (5 μM) significantly attenuated isoprenaline vasodilations, an effect that was abolished in the presence of GW9662 and accentuated by ZnPP. Also, supplementation with the PPARγ agonist pioglitazone or with l-arginine or hemin, substrates for NOS and HO, respectively, eliminated the unfavorable effect of CSA on isoprenaline vasodilations. The protection conferred by pioglitazone against CSA-evoked attenuation of isoprenaline vasodilations was maintained in NG-nitro-l-arginine methyl ester-treated kidneys and disappeared after treatment with ZnPP or GW9662. In conclusion, the activation of the HO/CO/PPARγ cascade is probably the cellular mechanism that underlies the beneficial effect of pioglitazone on the CSA-isoprenaline interaction. Further, the facilitation of the HO/CO or NOS/NO pathway seems to offset this harmful effect of CSA.

Modulation by Central MAPKs/PI3K/sGc of the TNF-α/iNOS-dependent Hypotension and Compromised Cardiac Autonomic Control in Endotoxic Rats.

Abstract: Reduced blood pressure (BP) and cardiac autonomic activity are early manifestations of endotoxemia. We investigated whether these effects are modulated by central mitogen-activated protein kinases (MAPKs) and related phosphoinositide-3-kinase (PI3K)/soluble guanylate cyclase (sGC) signaling in conscious rats. The effect of pharmacologic inhibition of these molecular substrates on BP, heart rate (HR), and heart rate variability (HRV) responses evoked by intravascular lipopolysaccharide (LPS) (10 mg/kg) were assessed. LPS (1) lowered BP (2) increased HR, (3) reduced time [SD of beat-to-beat intervals (SDNN), and root mean square of successive differences in R-R intervals (rMSSD)], and frequency domain indices of HRV (total power and spectral bands of low and high-frequency), and (4) elevated serum tumor necrosis factor-&agr; (TNF-&agr;) and interleukin-6 (IL-6) levels. The inhibition of TNF-&agr; (pentoxifylline) or inducible nitric oxide synthase (iNOS, aminoguanidine) abolished hemodynamic, HRV, and inflammatory actions of LPS. Intracisternal (i.c.) injection of ODQ (sGC inhibitor), wortmannin (PI3K inhibitor), and SP600125 (MAPKJNK inhibitor) mitigated the hypotensive and tachycardic actions of LPS but failed to affect associated decreases in HRV. MAPKp38 inhibition by i.c. SB203580 produced exactly opposite effects. None of the LPS effects was altered after i.c. PD98059 (MAPKERK1/2 inhibitor). Overall, central MAPKs/PI3K/sGC pathways variably contribute to the TNF-&agr;/iNOS-dependent reductions in BP and HRV seen during endotoxic shock.

Cyclosporine counteracts endotoxemia-evoked reductions in blood pressure and cardiac autonomic dysfunction via central sGC/MAPKs signaling in rats

Abstract The immunosuppressant drug cyclosporine A (CSA) improves survivability in endotoxemia and offsets associated loss in vascular reactivity and hypotension. We tested the hypothesis that central phosphoinositide‐3‐kinase (PI3K)/soluble guanylate cyclase (sGC)/mitogen activated protein kinases (MAPKs) cascade modulates the CSA counteraction of endotoxic hypotension and cardiac autonomic dysfunction. The effects of pharmacologic inhibition of these molecular substrates in central pools on CSA interaction with cardiovascular responses evoked by lipopolysaccharide (LPS) were evaluated in conscious rats. CSA (10 mg/kg) reversed the LPS‐evoked (i) hypotension and tachycardia, (ii) decreases in time and spectral measures of heart rate variability (HRV), and (iii) increases in serum TNF&agr; and IL‐6. These CSA effects disappeared after intracisternal (i.c.) administration of ODQ (sGC inhibitor) but not wortmannin (PI3K inhibitor). When used alone, ODQ or wortmannin abolished the LPS‐evoked hypotension and tachycardia, but had no effect on the concomitant reductions in HRV. We also report that the reversal by CSA of LPS hypotension disappeared after treatment with i.c SB203580 (MAPKp38 inhibitor) or PD98059 (MAPKERK inhibitor), in contrast to little effect for SP600125 (MAPKJNK inhibitor). Alternatively, the CSA amelioration of LPS‐evoked reductions in HRV was abolished in presence of SP600125 or PD98059, but not SB203580. The single exposure to SP600125 reduced the decreases in blood pressure, but not HRV, caused by LPS whereas SB203580 produced the exact opposite effects. Together, while central sGC/MAPKs circuits modulate the CSA counteraction of endotoxic manifestations, the recruitment of individual MAPKs into this interaction depends on the nature of the cardiovascular response.

Role of PPARγ/Nitric Oxide Synthase Signaling in the Cyclosporine-induced Attenuation of Endothelium-dependent Renovascular Vasodilation

Evidence from our laboratory and others suggests a negative effect for cyclosporine A (CSA) on renovascular reactivity. This study investigated the role of peroxisome proliferator-activated receptor gamma (PPARγ)/nitric oxide synthase (NOS) signaling in the CSA-induced attenuation of endothelium-dependent vasodilations in phenylephrine-preconstricted perfused kidneys of rats. Bolus injection of carbachol (4 μmoL) reduced the renal perfusion pressure with a peak depressor effect observed at 2 minutes. CSA (5 μM) infusion significantly attenuated the vasodilatory action of carbachol. The specificity of this interaction was verified by the lack of effect of CSA on renal vasodilation caused by papaverine (50 nmol). The carbachol-induced renal vasodilations were also reduced after infusion of NG-nitro-l-arginine methyl ester (l-NAME, NOS inhibitor, 100 μM) or 2-chloro-5-nitro-N-phenylbenzamide (GW9662, PPARγ antagonist, 1 μM). The attenuation of carbachol vasodilation by CSA was abolished in presence of l-arginine or l-NAME in contrast to no effect for GW9662. Pioglitazone (PPARγ agonist, 10 μM) abolished the CSA-induced attenuation of carbachol responses, an effect that was not manifest in presence of GW9662 or l-NAME. These findings suggest that PPARγ act tonically to facilitate renovascular dilatory response to endothelial muscarinic receptor activation. More importantly, NOS signaling downstream of PPARγ mediates, at least partly, the inhibitory effect of CSA on carbachol vasodilations.

Activation of central GABAB receptors offsets the cyclosporine counteraction of endotoxic cardiovascular outcomes in conscious rats

We have previously shown that cyclosporine (CSA) counteracts cardiovascular manifestations induced by endotoxemia (lipopolysaccharide, LPS) such as hypotension and cardiac autonomic dysfunction in conscious rats. In this study, we investigated whether the facilitation of central γ‐amino butyric acid (GABA) neurotransmission blunts these favorable influences of CSA. The LPS‐CSA interaction was determined in the absence and presence of drugs that activate GABAA or GABAB receptors or elevate synaptic GABA levels in the central nervous system. The consequent i.v. administration of CSA (10 mg/kg) blunted the LPS‐evoked hypotension, tachycardia, and reductions in time‐ and frequency‐domain indices of heart rate variability (measures of cardiac autonomic control) evoked by LPS (10 mg/kg i.v.). The ability of CSA to reverse the LPS effects disappeared in rats treated intracisternally (i.c.) with baclofen (selective GABAB agonist, 2 μg/rat) but not muscimol (selective GABAA agonist, 1 μg/rat), indicating a preferential compromising action for central GABAB receptors on the advantageous effects of CSA. Moreover, the improvement by CSA of LPS‐evoked cardiovascular derangements was also eliminated after concurrent i.c. administration of vigabatrin (GABA transaminase inhibitor, 200 μg/rat) or tiagabine (GABA reuptake inhibitor, 100 μg/rat). These results demonstrate that the activation of central GABAB receptors either directly via baclofen or indirectly following interventions that boost GABA levels in central synapses counterbalances the rectifying action of CSA on endotoxemia.