Dose-dependent acute and sustained renal effects of the endothelin receptor antagonist avosentan in healthy subjects

Enjeu : L'incidence d'insuffisance rénale terminale augmente d'environ 5-6% par année dans nos régions. L'une des causes majeures d'insuffisance rénale est la néphropathie diabétique qui représente selon les pays entre 25 et 40% des néphropathies terminales. La progression de la néphropathie diabétique peut être ralentie de manière efficace par un bon contrôle du diabète et de l'hypertension artérielle et par le blocage du système rénine-angiotensine. Néanmoins, malgré l'application stricte de ces thérapies préventives, la néphropathie de bons nombres de patients diabétiques continue de progresser. Il est donc important de développer de nouvelles stratégies permettant de préserver la fonction rénale des patients diabétiques soit en améliorant le contrôle de la pression artérielle soit en diminuant la protéinurie. Contexte : Il existe un certain nombre d'évidences expérimentales que le blocage des récepteurs de l'endothéline pourrait avoir un effet positif sur le devenir de la néphropathie diabétique en diminuant de manière efficace la protéinurie même chez des animaux déjà traités efficacement avec un bloqueur du système rénine-angiotensine. Dans des études de phase 2 impliquant l'avosentan, un antagoniste des récepteurs de l'endothéline actuellement en cours de développement pour le traitement de la néphropathie diabétique, on a pu démontrer que cet antagoniste, prescrit à des doses oscillant entre 5 et 50 mg par jour per os, diminue la protéinurie d'environ 20-40% chez des patients déjà traités avec un IEC ou un antagoniste de l'angiotensine. Toutefois, une grande étude de phase III conduite avec ce médicament chez des patients diabétiques a du être interrompue précocement en raison de l'apparition d'oedèmes et d'une surcharge hydrosodée conduisant dans certains cas à une décompensation cardiaque aiguë. La rétention hydrosodée est un effet secondaire connu des antagonistes de l'endothéline déjà sur le marché. Toutefois, pour l'avosentan, on ne savait pas si des doses plus faibles du médicament avaient aussi un effet négative sur la balance hydrosodée. En outre, les mécanismes rénaux responsables de la rétention hydrosodée sont encore mal connus chez l'homme. C'est pourquoi, nous avons organisé et réalisé cette étude de pharmacologie clinique chez le volontaire sain posant 2 questions : 1) des doses faibles d'avosentan produisent-elles aussi une rétention hydrosodée chez l'homme ? et 2) quels sont les mécanismes rénaux pouvant expliquer la rétention hydrosodée ? Cette thèse est donc une étude clinique de phase I testant chez 23 volontaires sains les effets rénaux de différentes doses d'avosentan ou d'un placebo pour établir la courbe dose-réponse des effets rénaux de ce médicament. L'idée était également de définir quelle dose est sure et bien tolérée pour être utilisée dans une nouvelle étude de phase II. L'avosentan a été administré par voie orale une fois par jour pendant 8 jours à des doses de 0.5, 1.5, 5 et 50 mg. Les effets rénaux hémodynamiques et tubulaires ont été étudiés chez chaque sujet lors de la première administration (jour 1) et après une semaine de traitement (jour 8). Le médicament a induit une prise de poids dose-dépendante déjà présente à 5 mg et maximale à 50 mg (+ 0.8 kg au jour 8). Nous n'avons pas mesuré d'impact de l'avosentan sur l'hémodynamique rénale ni sur les électrolytes plasmatiques. En revanche, nous avons constaté une diminution dose-dépendante de la fraction d'excrétion de sodium (jusqu'à -8.7% avec avosentan 50 mg). Cette diminution était en rapport avec une augmentation dose-dépendante de la réabsorption proximale de sodium. Nous avons également constaté une baisse de la pression artérielle aux doses élevées et une hémodilution marquée par une baisse de l'hématocrite suggérant une rétention hydrique à la plus haute dose. Nos résultats suggèrent donc que l'avosentan induit une rétention sodée rénale dose-dépendante expliquée avant tout par une rétention du sodium au niveau du tubule proximal. Cet effet n'est pas observé à des doses plus basses que 5 mg chez le volontaire sain, suggérant que ce médicament devrait être évalué pour son activité réno-protectrice à des doses inférieures ou égales à 5 mg par jour. La raison pour laquelle les hautes doses produisent plus de rétention sodée est peut être liée à une perte de sélectivité pour les sous-types (A et B) de récepteurs à l'endothéline lorsque l'on administre des doses plus élevées que 5 mg. Perspectives : Les résultats de ce travail de thèse ont donc permis de caractériser les propriétés rénales d'un nouvel antagoniste des récepteurs de l'endothéline chez l'homme. Ces résultats ont aussi permis de guider le développement futur de ce médicament vers des doses plus faibles avec l'espoir de garder les effets bénéfiques sur la protéinurie tout en améliorant le profil de tolérance du médicament par l'utilisation de doses plus faibles. ANGLAIS The endothelin receptor antagonist avosentan may cause fluid overload at doses of 25 and 50 mg, but the actual mechanisms of this effect are unclear. We conducted a placebo-controlled study in 23 healthy subjects to assess the renal effects of avosentan and the dose dependency of these effects. Oral avosentan was administered once daily for 8 days at doses of 0.5, 1.5, 5, and 50 mg. The drug induced a dose-dependent median increase in body weight, most pronounced at 50 mg (0.8 kg on day 8). Avosentan did not affect renal hemodynamics or plasma electrolytes. A dose-dependent median reduction in the fractional renal excretion of sodium was found (up to 8.7% at avosentan 50 mg); this reduction was paralleled by a dose-related increase in proximal sodium reabsorption. It is suggested that avosentan dose-dependently induces sodium retention by the kidney, mainly through proximal tubular effects. The potential clinical benefits of avosentan should therefore be investigated at doses of ≤ 5 mg.

Influence of CYP2D6 activity on pre-emptive analgesia by the N-methyl-D-aspartate antagonist dextromethorphan in a randomized controlled trial of acute pain.

BACKGROUND: There is some evidence that dextromethorphan (DM) is effective as a pre-emptive analgesic agent.  DM is mainly metabolized to dextrorphan (DOR) by CYP2D6 whose activity can be inhibited by pharmacologic intervention. OBJECTIVES: To investigate the efficacy of DM as a pre-emptive analgesic agent and describe the population pharmacokinetics in the presence of normal and poor CYP2D6 metabolism in acute post-operative pain. STUDY DESIGN: Double blind, randomized, placebo-controlled trial SETTING: Post-surgical analgesic consumption after knee ligament surgery, a setting of acute pain. METHODS: Forty patients were randomized to a single oral dose of 50 mg quinidine or placebo, administered 12 hours before 50 mg DM. Patients were genotyped for the major CYP2D6 and ABCB1 variants and phenotyped for CYP2D6 using urine DM/DOR metabolic ratios and blood samples for population pharmacokinetic modeling. RESULTS: Quinidine was effective in inhibiting CYP2D6 activity, with 2-fold reduction of DM to DOR biotransformation clearance, prolonged DM half-life, and increased DM systemic availability. Patients in the quinidine group required significantly less often NSAIDs than patients in the placebo group (35.3% vs. 75.0%, P = 0.022). The odds ratio for NSAID consumption in the placebo vs. quinidine group was 5.5 (95% confidence interval (CI) 1.3 - 22.7) at 48 hours after surgery. LIMITATIONS: While this study shows an impact of DM on pre-emptive analgesia and is mechanistically interesting, the findings need to be confirmed in larger trials. CONCLUSION: CYP2D6 inhibition by quinidine influenced the pre-emptive analgesic effectiveness of DM confirming that CYP2D6 phenotypic switch increases the neuromodulatory effect of oral dextromethorphan.

The effect of sub-lethal doses of Azadirachta indica (Meliaceae) oil on the midgut of Spodoptera frugiperda (Lepidoptera, Noctuidae)

The fall armyworm, Spodoptera frugiperda, is one of the major field pests for maize production. It is mainly controlled by means of synthetic, and more recently by resistant cultivar of maize expressing Bt toxins. The neem tree, Azadirachta indica, is a plant that can potentially control insects with the advantage of being food and environmental safe. The aim of this study was to assess the effect of neem oil on the development and survival of S. frugiperda caterpillars by assessing histological alterations caused on their midgut. Newly hatched caterpillars were submitted to three neem oil concentrations: 0.006; 0.05; 0.4%, which were added to their artificial diet. Ten 3rd instar caterpillars, taken from each treatment, were submitted to histological analysis. The alimentary canals from the specimens were fixed in Baker for 12 hours, desiccated and diaphanized in alcohol/xylol (1:1) and xylol. After placing the samples in paraffin, they were sliced in 8 µm sections and stained with hematoxylin-eosin stain. The neem oil added to the diet of S. frugiperda caused total mortality at dose of 0.4% whilst still in the first instars, prolonged the larval and pupal stages, and reduced the pupal weight. Histo-physiological alterations such as degeneration of the epithelial lining of the midgut and in the peritrophic matrix were found at all concentrations of neem oil.

Renal hemodynamic and natriuretic effects of concomitant Angiotensin-converting enzyme and neutral endopeptidase inhibition in men.

This double-blind placebo-controlled study was designed to investigate the acute and sustained hormonal, renal hemodynamic, and tubular effects of concomitant ACE and neutral endopeptidase (NEP) inhibition by omapatrilat, a vasopeptidase inhibitor, in men. Thirty-two normotensive subjects were randomized to receive a placebo, omapatrilat (40 or 80 mg), or the fosinopril/hydrochlorothiazide (FOS/HCTZ; 20 and 12.5 mg, respectively) fixed combination for 1 week. Blood pressure, renal hemodynamics, urinary electrolytes and atrial natriuretic peptide excretion, and several components of the renin-angiotensin system were measured for 6 hours on days 1 and 7 of drug administration. When compared with the placebo and the FOS/HCTZ combination, omapatrilat induced a significant decrease in plasma angiotensin II levels (P<0.001 versus placebo; P<0.05 versus FOS/HCTZ) and an increase in urinary atrial natriuretic peptide excretion (P<0.01). These hormonal effects were associated with a significant fall in blood pressure (P<0.01) and a marked renal vasodilatation, but with no significant changes in glomerular filtration rate. The FOS/HCTZ markedly increased urinary sodium excretion (P<0.001). The acute natriuretic response to FOS/HCTZ was significantly greater than that observed with omapatrilat (P<0.01). Over 1 week, however, the cumulative sodium excretion induced by both doses of omapatrilat (P<0.01 versus placebo) was at least as great as that induced by the dose of FOS/HCTZ (P=NS versus FOS/HCTZ). In conclusion, the results of the present study in normal subjects demonstrate that omapatrilat has favorable renal hemodynamic effects. Omapatrilat combines potent ACE inhibition with a sustained natriuresis, which explains its well-documented potent antihypertensive efficacy.

Effect of silicon and acibenzolar-s-methyl on colored cotton plants infested or not with Aphis gossypii Glover (Hemiptera, Aphididae)

Effect of silicon and acibenzolar-s-methyl on colored cotton plants infested or not with Aphis gossypii Glover (Hemiptera, Aphididae). The aphid Aphis gossypii is an insect pest that causes damage mainly at the beginning of the cotton plant development. The effect of resistance inductors silicon and acibenzolar-s-methyl (ASM) on the development of colored cotton plants were researched in the presence and absence of A. gossypii. Three colored cotton cultivars were sown in pots and individually infested with 25 apterous aphids, 13 days after the application of the inductors. Fifteen days after plant emergence, the silicon was applied at a dosage equivalent to 3 t/ha and acibenzolar-s-methyl in 0.2% solution of the product BION 500®. After 21 days of infestation the following parameters were evaluated: plant height, stem diameter, dry matter of aerial part and root, and total number of aphids replaced. It was verified that the plant height was reduced in the presence of aphids and all variables were negatively affected by the application of ASM. However, silicon did not affect plant development.

Liddle's syndrome caused by a novel missense mutation (P617L) of the epithelial sodium channel beta subunit.

OBJECTIVE: The aim of the study was to search for mutations of SCNN1B and SCNN1G in an Italian family with apparently dominant autosomal transmission of a clinical phenotype consistent with Liddle's syndrome. METHODS: Genetic analysis was performed in the proband, his relatives, and 100 control subjects. To determine the functional role of the mutation identified in the proband, we expressed the mutant or wild-type epithelial sodium channel in Xenopus laevis oocytes. RESULTS: A novel point mutation, causing an expected substitution of a leucine residue for the second proline residue of the conserved PY motif (PPP x Y) of the beta subunit was identified in the proband. The functional expression of the mutant epithelial sodium channel in X. laevis oocytes showed a three-fold increase in the amiloride-sensitive current as compared with that of the wild-type channel. CONCLUSION: This newly identified mutation adds to other missense mutations of the PY motif of the beta subunit of the epithelial sodium channel, thus confirming its crucial role in the regulation of the epithelial sodium channel. To our knowledge, this is the first report of Liddle's syndrome in the Italian population, confirmed by genetic and functional analysis, with the identification of a gain-of-function mutation not previously reported.

Mice carrying ubiquitin-specific protease 2 (Usp2) gene inactivation maintain normal sodium balance and blood pressure.

Ubiquitylation plays an important role in the control of Na⁺ homeostasis by the kidney. It is well established that the epithelial Na⁺ channel ENaC is regulated by the ubiquitin-protein ligase NEDD4-2, limiting ENaC cell surface expression and activity. Ubiquitylation can be reversed by the action of deubiquitylating enzymes (DUBs). One such DUB, USP2-45, was identified previously as an aldosterone-induced protein in the kidney and is also a circadian output gene. In heterologous expression systems, USP2-45 binds to ENaC, deubiquitylates it, and enhances channel density and activity at the cell surface. Because the role of USP2-45 in renal Na⁺ transport had not been studied in vivo, we investigated here the effect of Usp2 gene inactivation in this process. We demonstrate first that USP2-45 protein has a rhythmic expression with a peak at ZT12. Usp2-KO mice did not show any differences from wild-type littermates with respect to the diurnal control of Na⁺ or K⁺ urinary excretion and plasma levels either on a standard diet or after acute and chronic changes to low- and high-Na⁺ diets, respectively. Moreover, they had similar aldosterone levels on either a low- or high-Na⁺ diet. Blood pressure measurements using telemetry did not reveal variations compared with control mice. Usp2-KO mice did not display alterations in expression of genes involved in sodium homeostasis or the ubiquitin system, as evidenced by transcriptome analysis in the kidney. Our data suggest that USP2 does not play a primary role in the control of Na⁺ balance or blood pressure.

Licorice-induced hypertension and common variants of genes regulating renal sodium reabsorption.

AIM: To study if gene alterations affecting renal sodium reabsorption associate with susceptibility to licorice-induced hypertension.METHODS: Finnish subjects (n = 30) with a previously documented incident of licorice-induced hypertension were recruited for the study using a newspaper announcement. Their previous clinical and family histories as well as serum electrolyte levels were examined. DNA samples from all individuals were screened for variants of the genes encoding 11beta-hydroxysteroid dehydrogenase type 2 (11betaHSD2) and alpha-, beta-, and gamma-subunits of the epithelial sodium channel (ENaC).RESULTS: Upon licorice predisposition, the patients had a mean blood pressure of 201/118 mmHg. Circulating potassium, renin, and aldosterone levels were low. No significant DNA variations were identified in the 11betaHSD2 gene. Four subjects were heterozygous for beta- and gammaENaC variants previously shown to be associated with hypertension. Furthermore, a novel G insertion (2004-2005insG) in the SCNN1A gene encoding the alphaENaC was identified in two subjects. The frequency of these ENaC variants was significantly higher in subjects with licorice-induced hypertension (6/30 i.e. 20%) than in blood donors (11/301 i.e. 3.7%, P = 0.002).CONCLUSIONS: Defects of the 11betaHSD2 gene do not constitute a likely cause for licorice-induced hypertension. Variants of the ENaC subunits may render some individuals sensitive to licorice-induced metabolic alterations and hypertension.

Avaliação da atividade "in vivo" da fosfatase ácida e do crescimento de progênies de pupunheira cultivadas em duas doses de nitrogênio e fósforo

O presente trabalho, realizado em janeiro de 1995, visou avaliar a atividade da enzima fosfatase ácida em folhas de quatro progênies de pupunheira (Bactris gasipaes Kunth), cultivadas em duas doses de nitrogênio e duas de fósforo. Para tanto, utilizou-se a porção média da segunda folha mais jovem de perfilhos de palmeiras com quatro anos de idade. As plantas analisadas representam parcelas submetidas a duas doses de nitrogênio (N1 = 0, N2 = 400 kg ha-1 ano-1 de N) e duas doses de fósforo (P1 = 0, P2 = 200 kg ha-1 ano-1 de P2O5). A dose de potássio foi 200 kg ha-1 ano-1 de K2O. Análises dos elementos no solo e nas folhas foram efetuadas e correlações foram estimadas entre as características avaliadas e o crescimento e a produção de palmito dos quatro tratamentos. Foram observados valores médios de atividade da fosfatase ácida de 8,35; 4,58; 10,84, e 11,05 µmol h-1 g-1, para os tratamentos N2P2, N2P1, N1P2 e N1P1, respectivamente. Houve diferenças significativas de atividade entre doses de nitrogênio (10,95 e 6,47 µmol h-1 g-1, para N1 e N2, respectivamente) e entre progênies (variando de 6,18 (G3) a 10,10 (G1) µmol h-1 g-1), indicando que esses dois fatores devem ser levados em conta em estudos dessa natureza. A atividade da fosfatase ácida apresentou correlação negativa com as características que avaliam o crescimento (biomassa aérea e radicular) e a produção de palmito (peso e diâmetro) das plantas estudadas, não se correlacionando com os teores de fósforo no solo ou no tecido foliar.

Comparison of organ doses and image quality between CT and flat panel XperCT scans in wrist and inner ear examinations.

The aim of this study was to evaluate and compare organ doses delivered to patients in wrist and petrous bone examinations using a multislice spiral computed tomography (CT) and a C-arm cone-beam CT equipped with a flat-panel detector (XperCT). For this purpose, doses to the target organ, i.e. wrist or petrous bone, together with those to the most radiosensitive nearby organs, i.e. thyroid and eye lens, were measured and compared. Furthermore, image quality was compared for both imaging systems and different acquisition modes using a Catphan phantom. Results show that both systems guarantee adequate accuracy for diagnostic purposes for wrist and petrous bone examinations. Compared with the CT scanner, the XperCT system slightly reduces the dose to target organs and shortens the overall duration of the wrist examination. In addition, using the XperCT enables a reduction of the dose to the eye lens during head scans (skull base and ear examinations).

Avaliação do crescimento de plantas de milho em função de doses de potássio e estresse hídrico

Este trabalho teve por objetivo estudar o efeito de variações nas doses de potássio e nos níveis de estresse hídrico sobre o ajustamento osmótico e crescimento de plantas de milho (Zea mays L.). Para tanto, instalou-se um experimento em vasos que continham 40 dm³ de Terra Roxa Estruturada Latossólica textura média argilosa, em casa de vegetação telada do Departamento de Ciência do Solo, Campus de Botucatu, UNESP/SP, de dezembro de 1994 a fevereiro de 1995. O delineamento experimental utilizado foi o de blocos ao acaso em esquema fatorial (2 x 3 x 3). Os tratamentos consistiram da aplicação de duas doses (35 e 130 mg dm-3) de potássio na forma de KCl e três condições de estresse hídrico, sendo plantas sem estresse (S0) e plantas que sofreram estresse hídrico moderado (S1) ou intenso (S2), 44 dias após a emergência. O crescimento das plantas foi avaliado em três épocas, aos 55, 69 e 83 dias da emergência. Da análise geral dos resultados pôde-se inferir que as folhas das plantas de milho se ajustaram osmoticamente com relação as doses de potássio, em condições de estresse hídrico moderado. Não houve efeito dos estresses hídricos na acumulação de K, Ca e Mg nas folhas; no entanto, a maior dose de K aplicado ao solo proporcionou, em todas as épocas, maior teor deste nutriente e menores de Ca e de Mg nas folhas. Os níveis de estresse utilizados não influíram na área foliar, mas o maior teor de água no solo aumentou a produção de matéria seca das partes e, principalmente, da planta toda, mostrando ser esta última a melhor característica para avaliação do déficit de água na planta. A maior dose de K proporcionou maior área foliar e produção de matéria seca às partes e à planta toda; no entanto, não influenciou o comportamento de nenhum índice fisiológico estudado. O maior teor de água no solo mostrou menores valores de área foliar específica (AFE), razão de área foliar (RAF) e razão de massa foliar (RMF). A adição de potássio não melhorou o crescimento da cultura, quando o fornecimento de água foi limitado. No entanto, as plantas mais bem nutridas em potássio produziram mais massa, independentemente dos níveis de água utilizados, indicando melhor produção de matéria seca destas plantas.

Crescimento e absorção de fósforo em plantas de Eucalyptus grandis associadas a fungos micorrízicos em diferentes doses de fósforo e potenciais de água do solo

Avaliaram-se a produção de parte aérea (MS), a absorção (CP) e a eficiência de utilização de fósforo (EUP) por plantas de Eucalyptus grandis inoculadas com Glomus etunicatum (Ge) e, ou, Pisolithus tinctorius (Pt), em diferentes combinações entre doses de P e potenciais hídricos do solo (ψ), utilizando-se técnica de raízes subdivididas em vasos geminados, em casa de vegetação. Um dos vasos do conjunto geminado continha os tratamentos em arranjo fatorial de duas doses de P (P60 e P120, correspondentes a adições de 60 e 120 mg dm-3 de solo), três ψ (-10, -40 e -300 kPa) e quatro tratamentos com inóculos fúngicos (não inoculado, Ge, Pt, Ge + Pt). Outro vaso do conjunto continha 4,5 litros de solução nutritiva, sem P. Independentemente da dose de P adicionada, a colonização por Ge foi reduzida com a diminuição do ψ. Quanto à colonização por Pt, observou-se ausência de resposta a ψ em P60 e aumento em P120. A colonização ectomicorrízica foi reduzida quando Pt foi inoculado concomitantemente a Ge. Aumentos do CP, em função do incremento do ψ, foram observados em P60 e P120. No entanto, MS e EUP responderam positivamente à elevação de ψ apenas em P120. A inoculação isolada com Ge não apresentou efeito sobre as plantas, nas combinações entre ψ e P. A colonização por Pt apresentou efeitos diferenciados sobre as plantas, dependendo das condições de ψ e P no solo. Na combinação P60 e -300 kPa, correspondente à situação de menor disponibilidade de P, observou-se efeito deletério da colonização por Pt, isolada ou concomitantemente com Ge, sobre a EUP das plantas. Efeitos positivos da inoculação isolada com Pt sobre o CP foram observados nas combinações entre P120 e ψ de -10 kPa e -40 kPa, embora apenas na segunda situação este maior CP tenha sido acompanhado de incremento da MS.

Produção de micélio externo por fungos micorrízicos arbusculares e crescimento da soja em função de doses de fósforo

Em uma associação entre duas espécies de fungos micorrízicos arbusculares (FMAs) (Glomus intraradices ou Gigaspora margarita) e soja (Glycine max L. Merrill cv. IAC-8), avaliaram-se a produção de massa de material seco da parte aérea (MSPA), a massa de material seco de vagens (MSV), a colonização radicular, a concentração de N, P, K, Ca, Mg, S, Cu, Fe, Mn e Zn na parte aérea e vagens, além das estimativas do comprimento de micélio externo ativo (MEA) e micélio externo total (MET). As plantas receberam cinco doses de fósforo (0, 25, 50, 100 e 200 mg kg-1) e as avaliações foram feitas em quatro épocas (15, 30, 60 e 90 dias). A inoculação da soja com G. margarita resultou em redução transitória de crescimento aos 60 dias, enquanto aumentos na MSPA devidos à inoculação com os FMAs foram mais evidentes aos 90 dias. A colonização radicular, a produção de MEA e de MET apresentaram relação negativa com o incremento das doses de P nos tratamentos com FMAs. A menor produção de MEA e a fase de crescimento lento mais prolongada observadas no tratamento com G. margarita podem ter colaborado para a redução do crescimento das plantas aos 60 dias. O comprimento de MEA produzido por G. intraradices aumentou com o tempo e diminuiu com o aumento das doses de P. Esses efeitos foram menos evidentes para G. margarita. As concentrações de Fe e Mn nas vagens aos 90 dias foram menores nos tratamentos inoculados com FMAs nas menores doses de P, nas quais foi observada maior colonização radicular.

Efeito de doses de inoculante turfoso na fixação biológica do nitrogênio pela cultura da soja

A inoculação e a reinoculação da soja [Glycine max (L.) Merrill] são essenciais para garantir a maximização do processo de fixação biológica do N2. A maioria dos inoculantes comercializados para a soja no País utiliza, como veículo, a turfa, mas existem controvérsias sobre a dose a ser recomendada, especialmente em condições desfavoráveis ou em áreas já inoculadas. Assim, para a região central do Brasil, tem sido recomendado usar 1.000 g de inoculante/50 kg de sementes, com solução açucarada como adesivo. Neste estudo, porém, constatou-se que a dose máxima de turfa aderida às sementes está entre 500 g e 600 g de inoculante/50 kg. O uso de doses superiores resultará, portanto, em acúmulo na semeadora, dificultando o plantio. Em condições de casa de vegetação, em vasos esterilizados, a dose de 250 g foi suficiente para garantir boa nodulação e fixação, mas, em vasos com solo não esterilizado e em campo, os melhores resultados foram obtidos com a dose de 500 g. Em geral, a reinoculação com 500 g de inoculante turfoso (10(8) células/g) e solução açucarada como adesivo incrementou, em campo, o rendimento e o N total dos grãos.