Avaliação comparativa da eficácia da terapia de reposição hormonal de baixa dose isolada ou associada à sinvastatina no perfil lipídico e lipoprotéico em mulheres sintomáticas e dislipidêmicas na pós-menopausa

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Avaliação da toxicidade reprodutiva da sinvastatina em Ratos machos adultos

Pós-graduação em Biologia Geral e Aplicada - IBB

Effect of Statins and Aerobic Physical Exercise on Liver Function in Dyslipidemic Rats - Morphometric Study

The present study was carried out to evaluate the effect of statins associated with physical exercise (PE) in liver cells in dyslipidemic rats through cariometry. The animals were divided into six groups: animals subjected to a hypercholesterolemic diet (HD), simvastatin, with (G1) and without (G2) physical exercise (PE); HD submitted (G3) or not (G4) to PE, and commercial food diet (F) with (G5) and without (G6) PE. Histological analysis of the liver was performed by staining the slides with hematoxylin and eosin. The cariometric study included measuring the major and minor diameters of the hepatocytes nuclei. The Shapiro-Wilk test was also performed. To determine the differences among the groups, the Kruskal-Wallis Test with Dunn's post-test were conducted. The significance level was set at 5%. No difference was found in the hepatocytes nuclei between G5 and G6. When these groups were related with G3 and G4, reduced nuclei were observed. There was no difference between G1 and G6. The comparison between G6 and G2 showed that the nuclei in G2 were smaller. No difference was detected between G5 and G1. Changes were observed in the nuclei shape in G2 in comparison to G1. Considering G2 and G3, a decrease in the size of nuclei was observed in G3. On the other hand, G2 showed changes in shape in the comparative analysis with G4. The size and shape of G1 nuclei were larger than G3 as well as changes in shape were observed when compared to G4. G4 showed smaller nuclei than G3. Therefore, F, associated or not with the practice of PE, does not alter the size and shape of the hepatocytes nuclei; HD combined with sedentarism influences changes in the morphometric parameters of hepatocytes; and the association of simvastatin and PE seems to protect the hepatocytes nuclei with regard to HD.

Influência da sinvastatina na reparação óssea de mandíbulas da ratas ovariectomizadas e nos níveis de colesterol sanguíneo

Pós-graduação em Biopatologia Bucal - ICT

Legumin from chickpea: hypolipidemic effect in the liver of hypercholesterolemic rats

Purpose – This paper aims to determine the effects of 11S globulin isolated from Chickpea (Cicer arietinum L.) on lipid metabolism in animals subjected to a hypercholesterolemic and hyperlipidemic diet and compared to the drug simvastatin. Design/methodology/approach – Thirty-six male Wistar rats, kept in individual cages and under appropriate conditions, were separated into groups that were fed a normal diet (STD) containing casein as protein source and according to AIN-93G; a high-cholesterol diet (HC), normal diet plus 1 per cent cholesterol and 0.5 per cent cholic acid and 20 per cent coconut oil; HC diet plus the isolated 11S globulin (300 mg/kg/day); and HC diet plus the simvastatin (50 mg/kg/day), both dissolved in saline and administered by gavage for 28 days. After this time, the animals were killed. Findings – The results indicated that the addition of 1 per cent cholesterol and 0.5 per cent cholic acid induced hypercholesterolemia in the animals without interfering with their weight gain. Analyses of total cholesterol (TC), HDL-cholesterol (HDL-C) and triglycerides (TG) in the plasma, and TC and TG in the liver were made. The results show that the protein isolated from chickpea, and given as a single daily dose, did not affect the levels of plasma TC and its fractions, although decreasing the TG levels. Unlike the simvastatin, the chickpea protein significantly reduced TC and TG in the liver relative to HC group. Originality/value – A single daily dose of 11S globulin from chickpea contributed as only as additional 2.8 per cent of dietary protein intake. These findings demonstrate that 11S chickpea protein acts as a functional agent in the lipid metabolism in addition to its nutritional properties.

Hypocholesterolaemic effect of rat-administered oral doses of the isolated 7S globulins from cowpeas and adzuki beans

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

Efeito da combinação de antibióticos e sinvastatina sobre microrganismos de interesse endodôntico e na expressão de marcadores odontoblásticos

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

Lovastatin protects mithochondrial and renal function in kidney ischemia-reperfusion in rats

PURPOSE: To investigate the effect of lovastatin on renal ischemia followed by reperfusion. METHODS: Thirty one Wistar rats submitted to left renal ischemia for 60 minutes followed by contralateral nephrectomy were divided into two groups: A (n = 17, control, no treatment), and B (n = 14, lovastatin 15 mg/kg/day p.o. ten days before ischemia). The animals were sacrificed at the end of ischemia, after 24 hours and at seven days after reperfusion. Survival, serum urea and creatinine levels and renal mitochondrial function were evaluated. RESULTS: Mortality was 29.4% in group A and 0.7% in group B. Urea and creatinine levels were increased in both groups, but the values were significantly lower in group B. Mitochondrial function showed decoupling in 83.4% of group A, as opposed to 38.4/% of group B. CONCLUSIONS: The result shows a protective action of renal function by lovastatin administered before ischemia/reperfusion. Since most of the mitochondrial fraction presented membranes with the ability to maintain ATP production in group B, stabilization of the mitochondrial membrane should be considered as part of the protective action of lovastatin on renal function in ischemia/reperfusion.

Potential Drug-Drug Interactions in Prescriptions to Patients over 45 Years of Age in Primary Care, Southern Brazil

Background: Few cross-sectional studies involving adults and elderly patients with major DDIs have been conducted in the primary care setting. The study aimed to investigate the prevalence of potential drug-drug interactions (DDIs) in patients treated in primary care. Methodology/Principal Findings: A cross-sectional study involving patients aged 45 years or older was conducted at 25 Basic Health Units in the city of Maringa (southern Brazil) from May to December 2010. The data were collected from prescriptions at the pharmacy of the health unit at the time of the delivery of medication to the patient. After delivery, the researcher checked the electronic medical records of the patient. A total of 827 patients were investigated (mean age: 64.1; mean number of medications: 4.4). DDIs were identified in the Micromedex (R) database. The prevalence of potential DDIs and major DDIs was 63.0% and 12.1%, respectively. In both the univariate and multivariate analyses, the number of drugs prescribed was significantly associated with potential DDIs, with an increasing risk from three to five drugs (OR = 4.74; 95% CI: 2.90-7.73) to six or more drugs (OR = 23.03; 95% CI: 10.42-50.91). Forty drugs accounted for 122 pairs of major DDIs, the most frequent of which involved simvastatin (23.8%), captopril/enalapril (16.4%) and fluoxetine (16.4%). Conclusions/Significance: This is the first large-scale study on primary care carried out in Latin America. Based on the findings, the estimated prevalence of potential DDIs was high, whereas clinically significant DDIs occurred in a smaller proportion. Exposing patients to a greater number of prescription drugs, especially three or more, proved to be a significant predictor of DDIs. Prescribers should be more aware of potential DDIs. Future studies should assess potential DDIs in primary care over a longer period of time.

SLCO1B1 haplotypes are not associated with atorvastatin-induced myalgia in Brazilian patients with familial hypercholesterolemia

Purpose Recent studies reported the association of SLCO1B1 haplotypes with the development of musculoskeletal side effects during simvastatin use. The aim was to evaluate the pharmacogenetic association of SLCO1B1 haplotypes with atorvastatin-induced myalgia in a sample of individuals on high-dose atorvastatin regimens. Methods One hundred and forty-three patients with familial hypercholesterolemia were followed for at least 12 months while receiving atorvastatin. Genotypes for the rs2306283 (c.A388G) and rs4149056 (c.T521C) polymorphisms were detected by high-resolution melting analysis. These markers form four distinct haplotypes (*1A, *1B, *5 and *15). Results During the follow-up period, 14 (9.8%) patients developed myalgia and 16 (11.2%) presented CK levels more than 3 times the upper limit of the normal range. No association of the SLCO1B1 rs2306283 and rs4149056 genotypes or haplotypes with the presence of myalgia or creatine kinase (CK) values was found. Presence of rs2306283 AG+GG genotypes was not associated with increased risks of myalgia or abnormal CK values (OR 2.08, 95% CI 0.62-7.00, p=0.24 and OR 0.51, 95% CI 0.21-1.26, p=0.15 respectively). The presence of rs4149056 TC+CC genotypes was also not associated with increased risk of myalgia or abnormal CK values (OR 2.24, 95% CI 0.47-10.72, p=0.31 and OR 1.51, 95% CI 0.57-3.96, p=0.41 respectively). Conclusions Our findings reaffirm that the SLCO1B1 genetic risk appears to be greater in those patients receiving simvastatin compared with those receiving atorvastatin. This suggests that the importance of SLCO1B1 haplotypes depends on the specific statin that has been used.

Sinvastatina e lesão renal aguda isquêmica em ratos

OBJETIVOS: O estudo visou verificar a ação renoprotetora da sinvastatina em modelo animal de isquemia/reperfusão por 30 minutos. MÉTODOS: A isquemia foi obtida por meio do clampeamento dos pedículos renais bilaterais por 30 minutos, seguida de reperfusão. Ratos Wistar, machos foram usados pesando entre 250-300g, distribuídos nos seguintes grupos: SHAM (controle, sem clampeamento renal); Isquemia (isquemia renal por 30 minutos); Isquemia+Estatina (sinvastatina 0,5 mg/kg, via oral durante três dias). A função renal (clearance de creatinina, método de Jaffé), a osmolalidade urinária, os peróxidos urinários foram avaliados. RESULTADOS: Os resultados mostraram que a estatina melhorou a função renal, a osmolalidade urinária e reduziu a excreção de PU. CONCLUSÃO: Em síntese, o estudo confirmou o efeito renoprotetor da estatina, com ação antioxidante de proteção renal.

Amphotericin B nano-formulations : development, characterisation and suitability for oral administration

In der Form von Nanokapseln (AmB-HST), Nanoemulsion beziehungsweise multilamellaren Vesikeln (MLV) wurden drei Amphotericin-B-Formulierungen für die orale Applikation entwickelt, charakterisiert und verglichen. Die neuartige homogene Nanokapsel-Formulierung des hydrophoben Polyen-Antimykotikums Amphotericin B wurde in Analogie zu einem für Simvastatin und andere Arzneistoffe etablierten Prozess aus der Reinsubstanz, Lezithin und Gelatine mit Hilfe des HST-Verfahrens hergestellt. Photometrische Untersuchungen zeigten, dass das Endprodukt aus Monomeren aufgebaut ist. Mittels Mikroskopie ließen sich die Aggregate vor der Umhüllung mit Lezithin und Gelatine im Ausgangsmaterial als individuelle kugelförmige Arzneistoffpartikel darstellen. Strukturuntersuchungen mit dynamischer licht streuung (DLS) zeigten eine enge Größenverteilung der verkapselten Partikel von ca. 1 µm. Die Struktur der Hülle der HST-Partikel wurde erstmalig mit Neutronenstreuung unter Verwendung der Deuterium-basierten Lösungsmittel kontrastmethode aufgeklärt. Durch die teilweise Kontrastmaskierung des Partikelkerns bei der Neutronenstreuung konnte die Lezithin-Gelatine-Hülle als eine dünne, 5,64 ± 0.18 nm dicke Schicht aufgelöst werden, welche der biologischen Lipidmembran ähnlich, im Vergleich aber geringfügig größer ist. Dieses Resultat eröffnet Wege für die Optimierung der Formulierung von pharmazeutischen Nanopartikeln, z.B. durch Oberflächenmodifizierungen. Weitere Untersuchungen mittels Kleinwinkelneutronenstreuung unter Verwendung der D-Kontrastvariation deuten darauf hin, dass die Komponenten der Nanokapseln nicht den gleichen Masseschwerpunkt haben, sondern asymmetrisch aufgebaut sind und dass die stärker streuenden Domänen weiter außen liegen. Die Partikel sind im Vergleich zu Liposomen dichter. In-Vitro Freisetzungsstudien belegen das Solubilisierungsvermögen des HST-Systems, wonach die Freisetzung des Arzneistoffes aus der Formulierung zu allen gemessenen Zeitpunkten höher als diejenige der Reinsubstanz war. rnDie Nanoemulsion-Formulierung von Amphotericin B wurde mit einem Öl und Tensid system, jedoch mit unterschiedlichen Co-Solvenzien, erfolgreich entwickelt. Gemäß der Bestimmung der Löslichkeit in verschiedenen Hilfsstoffen erwies sich der Arzneistoff Amphotericin B als nicht-lipophil, gleichzeitig aber auch als nicht-hydrophil. Die zur Ermittlung der für die Emulsionsbildung notwendigen Hilfstoffkonzentrationen erstellten ternären Diagramme veranschaulichten, dass hohe Öl- und Tensidgehalte zu keiner Emulsionsbildung führten. Dementsprechend betrug der höchste Ölgehalt 10%. Die Tröpfchengröße wuchs mit zunehmender Tensidkonzentration, wobei die Co-Solventmenge der Propylenglykol-haltigen Nanoemulsion indirekt verringert wurde. Für die Transcutol®P-haltige Nanoemulsion hingegen wurde das Gegenteil beobachtet, nämlich eine Abnahme der Tröpfchengröße bei steigenden Tensidkonzentrationen. Durch den Einschluss des Arzneistoffes wurde nicht die Viskosität der Formulierung, sondern die Tröpfchengröße beeinflusst. Der Wirkstoffeinschluss führte zu höheren Tröpfchengrößen. Mit zunehmender Propylenglykolkonzentration wurde der Wirkstoffgehalt erhöht, mit zunehmender Transcutol®P-Konzentration dagegen vermindert. UV/VIS-spektroskopische Analysen deuten darauf hin, dass in beiden Formulierungen Amphotericin B als Monomer vorliegt. Allerdings erwiesen sich die Formulierungen Caco-2-Zellen und humanen roten Blutkörperchen gegenüber als toxisch. Da die Kontrollproben eine höhere Toxizität als die wirkstoffhaltigen Formulierungen zeigten, ist die Toxizität nicht nur auf Amphotericin, sondern auch auf die Hilfsstoffe zurückzuführen. Die solubilisierte Wirkstoffmenge ist in beiden Formulierungen nicht ausreichend im Hinblick auf die eingesetzte Menge an Hilfsstoff nach WHO-Kriterien. Gemäß diesen Untersuchungen erscheinen die Emulsions-Formulierungen für die orale Gabe nicht geeignet. Dennoch sind Tierstudien notwendig, um den Effekt bei Tieren sowie die systemisch verfügbare Wirkstoffmenge zu ermitteln. Dies wird bestandskräftige Schlussfolgerungen bezüglich der Formulierung und Aussagen über mögliche Perspektiven erlauben. Nichtsdestotrotz sind die Präkonzentrate sehr stabil und können bei Raumtemperatur gelagert werden.rnDie multilamellar-vesikulären Formulierungen von Amphotericin B mit ungesättigten und gesättigten neutralen Phospholipiden und Cholesterin wurden erfolgreich entwickelt und enthielten nicht nur Vesikel, sondern auch zusätzliche Strukturen bei zunehmender Cholesterinkonzentration. Mittels Partikelgrößenanalyse wurden bei den Formulierungen mit gesättigten Lipiden Mikropartikel detektiert, was abhängig von der Alkylkettenlänge war. Mit dem ungesättigten Lipid (DOPC) konnten hingegen Nanopartikel mit hinreichender Verkapselung und Partikelgrößenverteilung gebildet werden. Die Ergebnisse der thermischen und FTIR-spektroskopischen Analyse, welche den Einfluss des Arzneistoffes ausschließen ließen, liefern den Nachweis für die mögliche, bereits in der Literatur beschriebene Einlagerung des Wirkstoffs in lipid- und/oder cholesterinreiche Membranen. Mit Hilfe eines linearen Saccharosedichtegradienten konnte die Formulierung in Vesikel und Wirkstoff-Lipid-Komplexe nach bimodaler Verteilung aufgetrennt werden, wobei der Arzneistoff stärker mit den Komplexen als mit den Vesikeln assoziiert ist. Bei den Kleinwinkelneutronenstreu-Experimenten wurde die Methode der Kontrastvariation mit Erfolg angewendet. Dabei konnte gezeigt werden, dass Cholesterol in situ einen Komplex mit Amphotericin B bildet. Diesen Sachverhalt legt unter anderem die beobachtete Differenz in der äquivalenten Streulängendichte der Wirkstoff-Lipid- und Wirkstoff-Lipid-Cholesterin-haltigen kleinen unilamellaren Vesikeln nahe. Das Vorkommen von Bragg-Peaks im Streuprofil weist auf Domänen hin und systematische Untersuchungen zeigten, dass die Anzahl der Domänen mit steigendem Cholesteringehalt zunimmt, ab einem bestimmten Grenzwert jedoch wieder abnimmt. Die Domänen treten vor allem nahe der Außenfläche der Modellmembran auf und bestätigen, dass der Wirkstoff in den Cholesterinreichen Membranen vertikal eingelagert ist. Die Formulierung war sowohl Caco-2-Zellen als auch humanen roten Blutkörperchen gegenüber nicht toxisch und erwies sich unter Berücksichtigung der Aufnahme in Caco-2-Zellen als vielversprechend für die orale Applikation. Die Formulierung zeigt sich somit aussichtsreich und könnte in Tabletten weiterverarbeitet werden. Ein Filmüberzug würde den Wirkstoff gegen die saure Umgebung im Magen schützen. Für die Bestimmung der systemischen Verfügbarkeit der Formulierung sind Tierstudien notwendig. Die entwickelten multilamellaren Formulierungen einschließlich der Wirkstoff-Cholesterin-Komplexe bieten somit gute Aussichten auf die mögliche medizinische Anwendung. rnrn

Garlic extract induces intestinal P-glycoprotein, but exhibits no effect on intestinal and hepatic CYP3A4 in humans

Garlic extracts have been shown to decrease drug exposure for saquinavir, a P-glycoprotein and cytochrome P450 3A4 substrate. In order to explore the underlying mechanisms and to study the effects of garlic on pre-systemic drug elimination, healthy volunteers were administered garlic extract for 21 days. Prior to and at the end of this period, expression of duodenal P-glycoprotein and cytochrome P450 3A4 protein were assayed and normalized to villin, while hepatic cytochrome P450 3A4 function and simvastatin, pravastatin and saquinavir pharmacokinetics were also evaluated. Ingestion of garlic extract increased expression of duodenal P-glycoprotein to 131% (95% CI, 105-163%), without increasing the expression of cytochrome P450 3A4 which amounted to 87% (95% CI, 67-112%), relative to baseline in both cases. For the erythromycin breath test performed, the average result was 96% (95% CI, 83-112%). Ingestion of garlic extract had no effect on drug and metabolite AUCs following a single dose of simvastatin or pravastatin, although the average area under the plasma concentration curve (AUC) of saquinavir decreased to 85% (95% CI, 66-109%), and changes in intestinal P-glycoprotein expression negatively correlated with this change. In conclusion, garlic extract induces intestinal expression of P-glycoprotein independent of cytochrome P450 3A4 in human intestine and liver.

[Perspectives in the treatment of subarachnoid-hemorrhage-induced cerebral vasospasm]

Cerebral vasospasm is still the most important cause of death and disability after rupture of intracranial aneurysms. The therapeutic strategies in the treatment of subarachnoid hemorrhage induced vasospasm vasospasm include four groups: 1) prevention of vasospasm; 2) reversion of vasospasm; 3) improvement of cerebral perfusion; and 4) neuroprotection and rescue therapies. Recent experimental studies allowed the design of phase II clinical studies which demonstrated positive results with medications and compounds such as statins (simvastatin and pravastatin) and endothelin-1 receptor antagonists (clasozentan). Moreover, experimental and clinical evidences showed the advantages of early cerebrospinal fluid drainage, intrathecal administration of NO-donors, effects of Ca2+ protein kinase inhibitor (Fasudil) and catecholamines on the cerebral vessels. This review article summarizes the stage of investigation of these medications and therapeutic strategies which will be relevant in the treatment of cerebral vasospasm.

Genome profiling of sterol synthesis shows convergent evolution in parasites and guides chemotherapeutic attack

Sterols are an essential class of lipids in eukaryotes, where they serve as structural components of membranes and play important roles as signaling molecules. Sterols are also of high pharmacological significance: cholesterol-lowering drugs are blockbusters in human health, and inhibitors of ergosterol biosynthesis are widely used as antifungals. Inhibitors of ergosterol synthesis are also being developed for Chagas's disease, caused by Trypanosoma cruzi. Here we develop an in silico pipeline to globally evaluate sterol metabolism and perform comparative genomics. We generate a library of hidden Markov model-based profiles for 42 sterol biosynthetic enzymes, which allows expressing the genomic makeup of a given species as a numerical vector. Hierarchical clustering of these vectors functionally groups eukaryote proteomes and reveals convergent evolution, in particular metabolic reduction in obligate endoparasites. We experimentally explore sterol metabolism by testing a set of sterol biosynthesis inhibitors against trypanosomatids, Plasmodium falciparum, Giardia, and mammalian cells, and by quantifying the expression levels of sterol biosynthetic genes during the different life stages of T. cruzi and Trypanosoma brucei. The phenotypic data correlate with genomic makeup for simvastatin, which showed activity against trypanosomatids. Other findings, such as the activity of terbinafine against Giardia, are not in agreement with the genotypic profile.