Valsartan prevents gefitinib-induced lung inflammation,oxidative stress,and alteration of plasma metabolites in rats

Gefitinib (GEF) is an inhibitor of the epidermal growth factor receptor, linked to higher risk of severe/fatal interstitial lung disease (ILD). This study was performed to determine the protective roles of an angiotensin-II type-1 receptor (AT1R) “valsartan (VAL)” in prevention of lung inflammation, oxidative stress and metabolites alteration induced by GEF. Four groups of male Wistar albino rats were received vehicle, VAL (30 mg/kg), GEF (30 mg/kg), or both for four weeks. Blood samples and lungs were harvested for plasma metabolites and histological analysis, respectively, and evaluation of inflammation and oxidative stress. GEF monotherapy showed a dense inflammation in lungs, and significantly increased tumor necrosis factor-α (P = 0.0349), interleukin-6 (P < 0.0001), chemokine ligand-3 (P = 0.0420), and interleukin-1β (P = 0.0377). GEF increased oxidative stress markers including glutathione, malondialdehyde, and catalase levels. Also, several plasma metabolites including butanoic acid, N-methylphenylethanolamine, oxalic acid, l-alanine, phosphoric acid, l-theorinine, pyroglutamic acid, and 2-bromosebacic acid were changed by GEF. The combination of VAL plus GEF reduced the inflammation and oxidative stress mediated by GEF monotherapy. In addition, the combination treatment returned plasma metabolites to the normal levels compared to GEF monotherapy. These findings revealed that VAL has a possible pulmonary protective role against pulmonary toxicity of GEF, which may lead to novel approaches for management of GEF-induced ILD.     

缬沙坦氢氯噻嗪对高血压合并心力衰竭患者Ang Ⅱ、NT-ProBNP及CTGF的作用分析

目的:探讨缬沙坦氢氯噻嗪对高血压合并心力衰竭患者血管紧张素Ⅱ(Ang Ⅱ)、氨基末端脑钠尿肽前体(NT-ProBNP)及结缔组织生长因子(CTGF)的作用。方法:选择2016年3月到2019年3月我院收治的高血压合并心力衰竭患者113例进行研究,以随机数表法分为观察组(n=57)和对照组(n=56)。对照组给予贝那普利治疗,观察组在对照组的基础上采用缬沙坦氢氯噻嗪治疗。比较两组患者的临床疗效、Ang Ⅱ、NT-ProBNP及CTGF、左心室射血分数(LVEF)、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)、收缩压(SBP)、舒张压(DBP)水平变化情况及并发症发生情况。结果:治疗后,两组总有效率分别为92.98%、73.21%,差异显著;治疗前,两组Ang Ⅱ、NT-ProBNP及CTGF水平无显著差异(P>0.05);治疗后,两组Ang Ⅱ、NT-ProBNP及CTGF水平均显著改善,且观察组均低于对照组(P<0.05);治疗前,两组心功能水平无显著差异(P>0.05);治疗后,两组心功能水平均显著改善,且观察组LVEF高于对照组,LVESd、LVEDd低于对照组(P<0.05);治疗前,两组血压水平无显著差异(P>0.05);治疗后,两组血压水平均显著改善,且观察组SBP、DBP水平显著低于对照组,差异显著(P<0.05);两组并发症总发生率分别为7.02%、10.71%,差异无显著差异(P>0.05)。结论:在高血压合并心力衰竭患者中应用缬沙坦氢氯噻嗪辅助治疗效果显著,可有效改善患者心功能、Ang Ⅱ、NT-ProBNP及CTGF水平。     

Antihypertensive drug Valsartan promotes dendritic spine density by altering AMPA receptor trafficking

Recent studies demonstrated that the antihypertensive drug Valsartan improved spatial and episodic memory in mouse models of Alzheimer’s Disease (AD) and human subjects with hypertension. However, the molecular mechanism by which Valsartan can regulate cognitive function is still unknown. Here, we investigated the effect of Valsartan on dendritic spine formation in primary hippocampal neurons, which is correlated with learning and memory. Interestingly, we found that Valsartan promotes spinogenesis in developing and mature neurons. In addition, we found that Valsartan increases the puncta number of PSD-95 and trends toward an increase in the puncta number of synaptophysin. Moreover, Valsartan increased the cell surface levels of AMPA receptors and selectively altered the levels of spinogenesis-related proteins, including CaMKIIα and phospho-CDK5. These data suggest that Valsartan may promote spinogenesis by enhancing AMPA receptor trafficking and synaptic plasticity signaling.     

多重干预RAAS对大鼠慢性心功能不全心室重构及血钾的影响

目的探讨多重干预RAAS对大鼠慢性心功能不全心室重构及血钾的影响。方法实验采用缩窄大鼠腹主动脉法建立慢性压力负荷致心功能不全动物模型,选6周龄20只雌性SD大鼠,随机分4组(每组5只),B组(手术模型组)、C组(卡托普利组)、D组(卡托普利+缬沙坦组)、E组(卡托普利+缬沙坦+螺内酯组),另随机抽取5只同龄雌性SD大鼠假手术作为对照(A组)。给药8周后用Doppler超声心动图检测大鼠心脏结构和心功能各项参数的变化,放射免疫法测定血浆AngⅡ,ALDO浓度,并生化检测血钾水平。结果腹主动脉结扎后第9周,与A组比较,B组舒张末期室间隔厚度(IVSTD)、舒张末期左室后壁厚度(LVPWTD)、相对室壁厚度(RWT)、左室重量(LVM)、左室重量与体重比(LVM/BW)均显著提高(P<0.05);C、D、E组与B组相比,LVM,LVM/BW下降显著(P<0.05)。各药物干预组(C、D、E)血浆AngⅡ,ALDO水平明显低于B组(P<0.05),以联合应用螺内酯组明显。各药物干预组与A组和B组相比较,血钾水平差异无显著性(P>0.05)。结论联合应用卡托普利、缬沙坦及螺内酯多重干预RAAS能明显改善大鼠慢性心功能不全心室重构,对血钾无明显影响。     

Dinuclear copper(II) complexes with valsartan. Synthesis, characterization and cytotoxicity

Two novel dinuclear complexes involving the antihypertensive drug valsartan and copper(II) ion have been prepared in water and DMSO. The complex compositions were determined as: [Cu(vals)(H₂O)₃]₂.6H₂O and [Cu(vals)(H₂O)₂DMSO]₂.2H₂O. They were thoroughly characterized by elemental and thermal analysis, spectrophotometric titrations and UV-visible, diffuse reflectance, FTIR, Raman and EPR spectroscopies. No effect of the ligand on two tested osteoblastic cell lines in culture (one normal MC3T3E1 and one tumoral UMR106) was observed in concentrations up to 100 μM. Higher concentrations of Valsartan are required to induce cytotoxicity in both cell lines. The antiproliferative effect of the tested complex ([Cu(vals)(H₂O)₃]₂.6H₂O) in a dose-response manner, was higher in the UMR106 osteoblastic cell line than that of the MC3T3E1 normal line at concentrations ≥ 100 μM. Morphological alterations are in accordance with proliferative observations.     

硝苯地平联合缬沙坦治疗老年原发性高血压疗效分析

目的:探讨硝苯地平缓释片联合缬沙坦治疗老年原发性高血压的临床疗效。方法:将180例患者随机分入对照组与观察组,给予对照组86例患者硝苯地平缓释片口服降压;观察组94例患者接受硝苯地平缓释片联合缬沙坦治疗,比较两组患者治疗8周后血压、心率、脉压、肾功、尿酸、血钾及尿微量白蛋白的变化。结果:治疗后观察组患者收缩压、舒张压、脉压及心率均显著降低,治疗总有效率高于对照组,两组比较差异有统计学意义(P<0.01);观察组尿酸、尿微量白蛋白显著优于对照组(P<0.01),两组肾功、血钾比较差异无统计学意义(P>0.05)。结论:硝苯地平缓释片联合缬沙坦治疗老年原发性高血压,降压平稳,同时可显著降低尿酸及尿微量白蛋白,改善肾功能。     

Prediction of Pharmacokinetic Profile of Valsartan in Humans Based on in vitro Uptake‐Transport Data

The aim of this study was to evaluate a physiologically based pharmacokinetic (PBPK) model for predicting PK profiles in humans based on a model refined in rats and humans in vitro uptake‐transport data using valsartan as a probe substrate. Valsartan is eliminated unchanged, mostly through biliary excretion, both in humans and rats. It was, therefore, chosen as model compound to predict in vivo elimination based on in vitro hepatic uptake‐transport data using a fully mechanistic PBPK model. Plated rat and human hepatocytes, and cell lines overexpressing human OATP1B1 and OATP1B3 were used for in vitro uptake experiments. A mechanistic two‐compartment model was used to derive the active and passive transport parameters, namely uptake Michaelis–Menten parameters (V_max and K_m,u) together with passive diffusion (P_dif). These transport parameters were then used as input in a whole body physiologically based pharmacokinetic (PBPK) model. The uptake rate of valsartan was higher for rat hepatocytes (K_m,u=28.4±3.7 μM , V_max=1320±180 pmol/mg/min, and P_dif =1.21±0.42 μl/mg/min) compared to human hepatocytes (K_m,u=44.4±14.6 μM , V_max=304±85 pmol/mg/min, and P_dif=0.724±0.271 μl/mg/min). OATP1B1 and ‐1B3 parameters were correlated to human hepatocyte data, using experimentally established relative activity factors (RAF). Resulting PBPK simulations were compared for plasma‐ (humans and rats) and bile‐ (rats) concentration–time profiles following iv bolus administration of valsartan. Plasma clearances (CL_P) for rats and humans were predicted within twofold relative to predictions based on respective in vitro data. The simulations were extended to simulate the impact of either OATP1B1 or ‐1B3 inhibition on plasma profile. The limited data set indicates that the mechanistic model allowed for accurate evaluation of in vitro transport data; and the resulting hepatic uptake transport kinetic parameters enabled the prediction of in vivo PK profiles and plasma clearances, using PBPK modelling. Moreover, the interspecies difference in elimination rate observed in vivo was correctly reflected in the transport parameters determined in vitro.     

缬沙坦联合吲达帕胺治疗高血压的效果观察

目的:探讨缬沙坦和吲达帕胺治疗高血压的临床效果,为临床治疗提供可借鉴的方法。方法:选取2012年4月-2014年1月在我院接受治疗的87例高血压患者的临床资料,根据治疗方式的不同将所选患者分为缬沙坦组、吲达帕胺组和联合用药组,每组27例。缬沙坦组患者采用口服缬沙坦单药治疗,吲达帕胺组患者采用口服吲达帕胺单药治疗,联合用药组采用缬沙坦+吲达帕胺缓释片治疗。观察三组患者治疗前后的血压变化、治疗总有效率及不良反应的发生情况。结果:治疗后,三组患者的血压均不同程度降低(P0.05);联合用药组患者血压下降幅度明显高于缬沙坦单药治疗组和吲达帕胺单药治疗组,差异具有统计学意义(P0.05)。联合用药组患者治疗的总有效率明显高于缬沙坦单药治疗组和吲达帕胺单药治疗组,差异具有统计学意义(P0.05)。三组患者不良反应的发生率无显著差异(P0.05)。结论:缬沙坦胶囊与吲哒帕胺缓释片联合应用治疗高血压具有显著的临床意义,能够有效的控制患者的血压,值得推广采用。     

缬沙坦联合通心络胶囊对糖尿病心肌病患者血清肌钙蛋白及SOD水平的影响

目的:探讨缬沙坦联合通心络胶囊对糖尿病心肌病患者血清肌钙蛋白,SOD及生活质量的影响。方法:收集我院就诊或住院治疗的60例糖尿病心肌病患者,随机分为实验组和对照组,每组30例。对照组患者给予缬沙坦口服治疗,实验组患者在此基础上给予通心络治疗。检测并比较两组患者治疗前后血清cTnI、生活质量、SOD、运动耐量的变化情况。结果:与治疗前相比,两组患者治疗后血清cTnI和生活质量评分均下降,而SOD和运动耐量水平均升高,差异具有统计学意义(P0.05);与对照组相比,实验组患者治疗后血清cTnI和生活质量评分较低,而SOD和运动耐量水平较高,差异具有统计学意义(P0.05)。结论:缬沙坦联合通心络胶囊能够降低糖尿病心肌病患者cTnI、生活质量评分,升高其SOD以及运动耐量水平,对临床具有指导意义。     

缬沙坦对糖尿病大鼠心肌保护作用以及氧化应激的影响

目的:探讨缬沙坦对糖尿病大鼠心肌的保护作用及氧化应激影响。方法:以链脲佐菌素建立糖尿病大鼠模型,缬沙坦干预治疗12周后,采用ELISA法检测血清中8脱氧鸟酐(8-OHd G)含量、超氧化物歧化酶(SOD)活性,PCR测定心肌NADPH氧化酶亚型NOX2m RNA、p47phox m RNA表达,采用原位末端标记法(TUNEL)检测心肌细胞凋亡。结果:糖尿病大鼠经缬沙坦干预治疗后,8-OHd G含量,NOX2和p47phox m RNA表达均显著降低(P0.05),SOD活性升高(P0.01),心肌细胞凋亡指数显著降低(P0.05)。结论:高血糖导致糖尿病大鼠氧化应激增强和心肌细胞凋亡增加,缬沙坦可降低糖尿病大鼠氧化应激反应及减少心肌细胞凋亡,因而对心肌有一定的保护作用。