45 resultados para allopurinol


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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The medullary sponge kidney is rare in children and may present it self with hematuria and nephrolithiasis. We report a case of medullary sponge kidney in a child with nephrolithiasis, hypercalciuria, hyperuricosuria and prolonged treatment which avoided the recurrence of nephrolithiasis.

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Background and Objectives - Allopurinol is a drug which inhibits the formation of noxious renal free radicals. The aim of this study was to evaluate the protecting renal effects of allopurinol in ischemic kidneys of dogs. Methods - Sixteen dogs were anesthetized with sodium pentobarbital and submitted to extracellular volume expansion (1.4 ml.kg-1.min-1), to mechanic ventilation with air, to right nephrectomy and to left renal artery clamping. Changes which might occur in renal morphology and function after 30 min of total ischemia and posterior reperfusion were studied in Group 1 (G1), in addition to the action of allopurinol (50 mg.kg-1) on those kidneys, when administered 24 h before the experiment and 1 h before the ischemic procedure in Group 2 (G2). The following parameters: heart rate, inferior vena cava pressure, mean blood pressure, PAH clearance (PAH(c)), renal blood flow (RBF), renal vascular resistance (RVR), creatinine clearance (Cr(c)), filtration fraction, urine output, plasma and urine osmolality, osmolar clearance, free water, sodium and potassium clearance, urine and fractional sodium and potassium excretion, hematocrit, rectal temperature, and left kidney histology were evaluated in four moments: M1 control, and M2, M3, M4 obtained immediately, 15 and 30 min after unclamping of the left renal artery. In G2, M1, M2, M3 and M4 were obtained 45, 90, 105, and 120 min after the second allopurinol dose. Results - Both groups showed the highest values for PAH(c), RBF, and Cr(c), and the lowest values for RVR in M1. Animals were tachycardiac since the beginning of the experiment both in G1 and in G2. The other parameters were not changed. Left kidney histological evaluation showed alterations compatible with acute tubular necrosis in both experimental groups. Conclusions - Alterations found in renal hemodynamics were compatible with the release of vasoconstrictor substances due to renal ischemia. Allopurinol was not effective in preventing renal alterations caused by ischemia and reperfusion.

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Aiming to assess the efficacy of the treatment, to verify the occurrence of possible disease relapses and to search for the presence of parasites after the treatment, seven dogs naturally infected by Leishmania sp., were submitted to a treatment with meglumine antimoniate and allopurinol. For this, lymph node and bone marrow aspiration biopsies were carried out at seven moments. After the end of the six-month observation period all dogs were submitted to euthanasia. Then, spleen and liver imprints and in vitro cultures were carried out to search for amastigote forms of the parasite. All animals presented remission of the symptoms and during all the observation period no dog presented relapse of the disease, although amastigote forms of the parasite were observed in two of the animals at the end of the experiment. Thus, it was possible to conclude that the treatment promotes clinical healing but it does not eliminate the parasites completely.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Leukogram and neutrophil oxidative metabolism from dogs with visceral leishmaniasis (VL) were compared before and after treatment with meglumine antimoniate (AM) and with an association of meglumine antimoniate and allopurinol (AMA). The results obtained demonstrated that neutrophils of dogs with VL do not lose their capacity of reducing NBT and that oxidative metabolism has been more active in the majority of the cases. After treatment with AM and AMA, dogs with VL presented a redution of neutrophils oxidative metabolism, suggesting that this decrease was related with the decrease in the number of parasites and a probable inhibitor effect of these drugs on neutrophils oxidative metabolism.

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Abstract Background Hypoxanthine-guanine phosphoribosyltransferase (HGPRT) (EC 2.4.2.8) is a central enzyme in the purine recycling pathway. Parasitic protozoa of the order Kinetoplastida cannot synthesize purines de novo and use the salvage pathway to synthesize purine bases, making this an attractive target for antiparasitic drug design. Results The glycosomal HGPRT from Leishmania tarentolae in a catalytically active form purified and co-crystallized with a guanosine monophosphate (GMP) in the active site. The dimeric structure of HGPRT has been solved by molecular replacement and refined against data extending to 2.1 Å resolution. The structure reveals the contacts of the active site residues with GMP. Conclusion Comparative analysis of the active sites of Leishmania and human HGPRT revealed subtle differences in the position of the ligand and its interaction with the active site residues, which could be responsible for the different reactivities of the enzymes to allopurinol reported in the literature. The solution and analysis of the structure of Leishmania HGPRT may contribute to further investigations leading to a full understanding of this important enzyme family in protozoan parasites.

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Clinical gout has rarely been described after pediatric renal transplantation (RTx), although asymptomatic hyperuricemia is common in these patients. We describe three male pediatric patients who presented with gouty arthritis 7-8.5 years following RTx. Since receiving allopurinol, all patients had been free of gouty symptoms. To prevent severe bone marrow depletion, the dosage of azathioprine, an immunosupressant drug, was reduced by 50% to prevent interaction with allopurinol. Because atypical presentation of gout can occur, a high index of suspicion is needed to allow appropriate diagnosis of this disease in patients with skeletal pain after RTx.

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Recent publications have shown that certain human leukocyte antigen (HLA) alleles are strongly associated with hypersensitivity to particular drugs. As HLA molecules are a critical element in T-cell stimulation, it is no surprise that particular HLA alleles have a direct functional role in the pathogenesis of drug hypersensitivity. In this context, a direct interaction of the relevant drug with HLA molecules as described by the p-i concept appears to be more relevant than presentation of hapten-modified peptides. In some HLA-associated drug hypersensitivity reactions, the presence of a risk allele is a necessary but incomplete factor for disease development. In carbamazepine and HLA-B*15:02, certain T-cell receptor (TCR) repertoires are required for immune activation. This additional requirement may be one of the 'missing links' in explaining why most individuals carrying this allele can tolerate the drug. In contrast, abacavir generates polyclonal T-cell response by interacting specifically with HLA-B*57:01 molecules. T cell stimulation may be due to presentation of abacavir or of altered peptides. While the presence of HLA-B*58:01 allele substantially increases the risk of allopurinol hypersensitivity, it is not an absolute requirement, suggesting that other factors also play an important role. In summary, drug hypersensitivity is the end result of a drug interaction with certain HLA molecules and TCRs, the sum of which determines whether the ensuing immune response is going to be harmful or not.