Formation of 13,14-dihydro-prostaglandin E1 during intravenous infusions of prostaglandin E1 in patients with peripheral arterial occlusive disease.

Formation of 13,14-dihydro-prostaglandin (PG) E1 during intravenous infusions of PGE1 in patients with peripheral arterial occlusive disease was investigated. Using both high performance liquid chromatography (h.p.l.c.) combined with radioimmunoassay and gas chromatography/triple stage quadrupole mass spectrometry (GC/MS/MS) basal levels of 13,14-dihydro-PGE1 were found to be close to or below the detection limits of the assay methods. Levels of the PGE1 metabolite increased significantly during the infusion periods and decreased after their end. Since 13,14-dihydro-PGE1, in contrast to its precursors 15-keto-PGE1 and 15-keto-13,14-dihydro-PGE1, is biologically active, its formation could contribute to the beneficial effects of PGE1 administered intravenously in patients with peripheral arterial occlusive disease.     

Regulation of agonist-induced prostaglandin E1 versus prostaglandin E2 production. A mass analysis.

Prostaglandin E1 (PGE1) and prostaglandin E2 (PGE2), derived by enzymatic oxidation of cellular dihomogammalinolenic acid (DHLA) and arachidonic acid (AA), respectively, have diverse and, at times, distinct biological actions. It has been suggested that PGE1 specifically inhibits a variety of inflammatory processes, and, in light of the potential therapeutic benefit of PGE1 and its fatty acid precursor in inflammatory disorders, there is growing interest in the biochemical mechanisms which determine the balance between PGE1 and PGE2 synthesis. Metabolic studies in this area have been hampered by the difficulties in measuring the extremely small masses of these prostaglandins which are generated in cell culture systems. We studied the regulation of PGE1 versus PGE2 synthesis using an essential fatty acid-deficient, PGE-producing, mouse fibrosarcoma cell line, EFD-1. Because EFD-1 cells contain no endogenous AA or DHLA, we were able to replete the cells with AA and DHLA of known specific activities; thus, the mass of both cellular AA and DHLA, and synthesized PGE1 and PGE2, could be accurately determined. The major finding of this study is that production of PGE2 was highly favored over production of PGE1 due to preferential incorporation of AA versus DHLA into, and release from, the total cellular phospholipid pool. Further, we correlated the selective release of AA versus DHLA from total cellular phospholipids with the selective incorporation of AA versus DHLA into specific phospholipid pools. In addition, we showed that conversion of DHLA to AA by delta 5 desaturase was enhanced by increasing the cellular mass of n-6 fatty acids and by increasing the cell proliferative activity. Together, these results indicate that the relative abundance of PGE2 versus PGE1 in vivo is not merely a function of the relative abundance of AA versus DHLA in tissues, but also relates to markedly different cellular metabolism of these two fatty acids.     

Endothelial function in patients with peripheral vascular disease: influence of prostaglandin E1

Peripheral arterial occlusive disease (PAOD) is characterized by atherosclerotic lesions in large vessels and disturbances on the microcirculatory level. In the local regulation of vascular tone and microvascular perfusion, vascular endothelium plays a key role. For many years prostaglandin E1 (PGE1) has been used for the treatment of PAOD. Because PGE1 has only moderate effects on blood flow other mechanisms may be relevant for the therapeutical efficacy. The aim of our pilot study was to evaluate endothelial function in patients with PAOD and to investigate the impact of PGE1 on endothelial-dependent vasodilation in peripheral vesselsIn 8 controls and in 8 patients with PAOD stage II, endothelial-dependent vascular responses of the femoral vessels to increasing doses of acetylcholine (30,60,90 microg/min) were determined by Doppler flow velocity measurements in the common femoral artery. Furthermore, vascular reactivity was evaluated before and immediately after intravenous infusion of 30 microg PGE1/30 min in patients. Endothelial-dependent vasodilation was significantly reduced in patients with PAOD compared to control subjects. Infusion of PGE1 neither increased blood flow in the common femoral artery nor endothelium-dependent vasodilation of peripheral resistance vessels as indicated by unchanged reaction to acetylcholine.In conclusion, endothelial function is impaired in patients with PAOD. Administration of PGE1 did not increase femoral artery blood flow or improve endothelial-dependent reactivity of peripheral resistance vessels in patients with PAOD. Therefore, beneficial effects of PGE1 in peripheral vascular disease cannot be attributed to an increase in blood supply or an improvement of endothelial-dependent vasodilation.     

Traumatic vasospastic disease in chain-saw operators.

Raynaud''s phenomenon is commonly induced in chain-saw operators by vibration; the hand guiding the tool is the more severely affected. The condition tends to persist after use of the chain-saw is stopped but compensation is rarely sought. Among 17 cases of Raynaud''s phenomenon in lumberjacks the condition was found to be related to use of the chain-saw in 14, 10 of whom had to give up their work in colder weather because the disease was so disabling. Two criteria essential to establish the condition as vibration-induced Raynaud''s phenomenon are the presence of symptoms for at least 2 years and a history of at least 1 year''s constant use of the chain-saw. Careful physical examination and simple tests of vascular function will provide objective evidence of permanent damage by which the patients may be classified and compensated.     

Characterization of prostaglandin E receptors in canine small intestine using [3H] prostaglandin E1 binding.

Prostaglandin E (PGE) receptors in canine small intestinal mucosal and muscle membrane preparations were labeled with [3H] PGE1. Saturable, high affinity binding of [3H] PGE1 was observed in both preparations. The density of binding sites (fmol/mg protein) was 39 for mucosal membranes and 60 for muscle membranes, with corresponding dissociation constants of 10.6 nM and 5.8 nM, respectively. [3H] PGE1 binding sites in both preparations showed stereospecificity and high affinity for natural PGE1 and PGE2, but not for I or F-type PGs. Synthetic PGEs such as misoprostol and enisoprost had lower affinity than PGE1 or PGE2. Several analogs of enisoprost bound weakly to the binding sites. A highly significant correlation (C.C. = 0.9) was demonstrated between mucosal and muscle binding potency for a series of enisoprost analogs. There was also a significant positive correlation between the receptor binding potency and rat diarrheagenic activity for these analogs. These results indicate that PGE receptors in canine intestinal mucosa and muscle can be directly studied with [3H] PGE1 binding. The mucosal and muscle PGE receptors may have similar ligand binding specificity. We speculate that these receptors are likely to be associated with the diarrheagenic activity of PGEs.     

Interaction of prostaglandin E1 with human high density lipoproteins

The assembly of cytochrome c oxidase subunits I-III was studied in vitro in isolated rat liver mitochondria pre-labeled with [35S]methionine. Individual subunits were immunoabsorbed with monospecific antibodies. Isolated heme a from rat liver mitochondria, when added to radiolabeled mitochondria, induced assembly of subunit I with subunits II and III. Assembly of these subunits was not observed in mitochondria incubated in the presence of heme b(hemin) or in the absence of heme. Quantitative analysis of immunoabsorbed, radiolabeled subunits suggests that the predominant effect of heme a is on the assembly of subunit I with subunit III.     

Ketanserin in the treatment of traumatic vasospastic disease.

The specific serotonin receptor blocker ketanserin was given orally to 12 patients with traumatic vasospastic disease in a double blind crossover study. The effect of treatment was assessed by measuring finger systolic pressure and rewarming time after cold provocation and by medical interview and diaries. Median (range) percentage change in finger systolic pressure after cooling was 50 (0-100)% after treatment with ketanserin compared with 0 (0-90)% after placebo. Median (range) rewarming time after cooling decreased from 320 (236-972)s with placebo to 160 (88-404)s after treatment with ketanserin. These changes were not significant. Ninety five percent confidence intervals for difference between the treatments, however, showed that finger systolic pressure may be 80% better and rewarming time 256 seconds faster after treatment with ketanserin than after placebo. The number of attacks did not differ significantly between the two treatments. Two patients had a feeling of warmth in their hands during treatment with ketanserin. The results suggest that orally administered ketanserin may improve digital circulation in patients with traumatic vasospastic disease, but larger numbers of patients are required to assess the true effect of treatment with ketanserin in this disease.     

A calcitonin-like action of prostaglandin E1

The pharmacological effects of PGE1 (6 and 9 days, 2-1,250 micrograms/kg per day subcutaneously) upon the growth and the bone resorption of mammals were studied using the proximal tibia and upper incisor of immature rats along with lead acetate as a time marker, and upon the serum calcium and inorganic phosphorus levels. The following results were obtained. 1. PGE1 hardly affected the body weight or the weight of organs of the rats but apparently inhibited the longitudinal growth of proximal tibia in a dose related manner. 2. PGE1 clearly inhibited not only the longitudinal growth (incisor growth) but also the appositional growth (dentin formation) of incisal dentin. 3. The grade of the inhibitory effect on the growth was in the order of bone growth greater than dentin formation greater than incisor growth. 4. The occurrence of osteoporosis due to a low calcium diet was inhibited by the simultaneous administration of PGE1, the mechanism being considered to be mainly due to the inhibitory effect on the bone resorption. 5. PGE1 lowered the level of serum calcium and the lowering effect was not observed in the thyro-parathyroidectomized rat. From the facts that the above effects were exactly the same as those of calcitonin (1), the possibility that the subcutaneous injection of PGE1 may induce a calcitonin-like action, a part of which may dependent on the calcitonin secretion is suggested.     

The inhibitory effects of prostaglandin E1 on guinea-pig ureter.

Prostaglandin E1 (PGE1) hyperpolarized the smooth muscle cells of guinea-pig ureter in normal Krebs solution and was without effect on ureters depolarized in KCl Krebs, PGE1 inhibited both electrically induced contractions and K+-induced contractures of the ureters. Conditions that favored greater tension development by the ureters, namely, high [K+] or high [Ca-2+] reduced the inhibitory effects of PGE1 on the K+-induced contractures. Depolarization of guinea-pig ureter with KCl Krebs led to an increase in radio-calcium content of the tissue over a 30 min loading period. This increase in the tissue's radio-calcium content was further increased by PGE1 but not by theophylline, PGE1 was found to have no effect on either total calcium content or the calcium efflux from the tissue. It is suggested that PGE1 exerts its inhibitory action by increasing calcium sequestration at the inner surface of the cell membrane.     

Pancreatic secretion in rats treated with intra-aortic prostaglandin E1

The effects from one dose of PGE1 on the endocrine pancreatic secretions have been studied in rat. The dose is injected i.a. very near the pancreas in the abdominal aorta at the level of the caeliac artery. Glycemia, insulinemia and glucagonemia are studied after i.v. glucose injection in: a) normal rats; b) rats free from their endogenous rate of PGs by previous treatment with indomethacin i.p. and c) with an excessive rate of PGE1. The treatment with PGE1 produces an inhibitory effect on the insulinic response to glucose, as well as hyperglycemia and hyperglucagonemia. In the cases without the endogenous rat of PGs the insulinic secretion as a response to glucose is greatly improved.     

Plasma prostaglandin E2 level in Kawasaki disease

Plasma levels of prostaglandin E2 and prostaglandin F2 alpha were determined in 15 patients in the acute and recovery stages of Kawasaki disease, 10 patients with anaphylactoid purpura, 16 with bacterial and viral infections and 10 healthy children. Plasma levels of prostaglandin E2 were markedly increased in the acute stage of Kawasaki disease, and these levels were decreased in the recovery stage. The prostaglandin F2 alpha/prostaglandin E2 ratio in the acute stage of Kawasaki disease was markedly decreased. Plasma levels of prostaglandin E2 in patients with anaphylactoid purpura, bacterial and viral infections were within the normal range. In Kawasaki disease which is associated with systemic vasculitis with a severe inflammatory reaction, prostaglandin E2 is considered to be more selectively produced and released than prostaglandin F2 alpha, suggesting that prostaglandin E2 plays an important role in the immunological and inflammatory reaction.     

Regulation of prostaglandin E synthases: effects of siRNA-mediated inhibition of microsomal prostaglandin E synthase-1

Prostaglandin E2 (PGE2) is a key mediator involved in several inflammatory conditions. In this study, we investigated the expression and regulation of the terminal PGE2 synthesizing enzyme prostaglandin E synthases (mPGES-1, mPGES-2 and cPGES) in gingival fibroblasts stimulated with pro-inflammatory cytokines. We used siRNA knockdown of mPGES-1 to elucidate the impact of mPGES-1 inhibition on mPGES-2 and cPGES expression, as well as on PGE2 production. The cytokines TNFalpha and IL-1beta increased protein expression and activity of mPGES-1, accompanied by increased COX-2 expression and PGE2 production. The isoenzymes mPGES-2 and cPGES, constitutively expressed at mRNA and protein levels, were unaffected by the pro-inflammatory cytokines. We show for the first time that treatment with mPGES-1 siRNA down-regulated the cytokine-induced mPGES-1 protein expression and activity. Interestingly, mPGES-1 siRNA did not affect the cytokine-stimulated PGE2 production, whereas PGF(2alpha) levels were enhanced. Neither mPGES-2 nor cPGES expression was affected by siRNA silencing of mPGES-1. Dexamethasone and MK-886 both inhibited the cytokine-induced mPGES-1 expression while mPGES-2 and cPGES expression remained unaffected. In conclusion, mPGES-1 siRNA down-regulates mPGES-1 expression, and neither mPGES-2 nor cPGES substituted for mPGES-1 in a knockdown setting in gingival fibroblasts. Moreover, mPGES-1 siRNA did not affect PGE2 levels, whereas PGF(2alpha) increased, suggesting a compensatory pathway of PGE2 synthesis when mPGES-1 is knocked down.     

Characteristics of prostaglandin E1 interaction with components of biological membranes

To estimate the connection between physico-chemical characteristics and biological activity of prostaglandins the interaction of prostaglandin E1 with biological membrane lipids was studied. It is shown that as a result of prostaglandin interaction with phosphatidylcholine a complex is formed that behaves as an individual component and occupies in the surface layer twice as large area than the complex with prostaglandin F2 alpha. The prostaglandin E1 film collapses earlier than F2 alpha. Both facts indicate that the first is more friable. A difference in morphology of prostaglandin monolayers was revealed by electron microscopy. When studying the catalytic activity of peroxidase incorporated in prostaglandin E1 and F2 alpha monolayers some differences were also revealed. In the second case oxidation with methylblue located under the monolayer proceeds more actively. The results obtained point to the connection between the regulatory function of prostaglandins and their chemical structure. Molecular rearrangements of the monolayer caused by prostaglandin incorporation were recorded.     

Cervical ripening with intravaginal prostaglandin E2 gel.

We describe a technique of administering prostaglandin E2 (PGE2) in a viscous cellulose gel into the vagina to ripen the unfavourable cervix in patients requiring induction of labour. A total of 168 primigravidae were studied, of whom 102 received 2 mg PGE2 in 2% gel and 66 received 5 mg PGE2 in 4% gel. In the latter group, the state of the cervix was significantly improved in 58 patients (87.9%), while 32 (48.5%) had started labour before planned induction. There were no maternal or fetal side effects or complications.     

Metabolism of prostaglandin E1 and of glutathione conjugate of prostaglandin A1 (GSH-prostaglandin A1) by prostaglandin 9-ketoreductase from rabbit kidney.

Rabbit kidney prostaglandin 9-ketoreductase was found to metabolize the glutathione conjugate of prostaglandin A1 (GSH-prostaglandin A1). Apparent Km (GSH-prostaglandin A1) 13 microM and apparent Km (prostaglandin E1) 200 microM. The cytosolic preparation was subjected to gelfiltration and isoelectric focusing, which revealed that metabolism of prostaglandin E1 and GSH-prostaglandin A1 occurs by means of the same fractions. Furthermore, prostaglandin E1 and GSH-prostaglandin A1 are competitive inhibitors of the enzyme, when GSH-prostaglandin A1 and prostaglandin E1 are tested as substrates, respectively. It si concluded, that GSH-prostaglandin A1 is a much better substrate for prostaglandin 9-ketoreductase from rabbit kidney than is prostaglandin E1.     

Inducing labour with vaginally administered prostaglandin E2.

In 50 consecutive pregnant women at a 125-bed community hospital with 1000 deliveries annually, labour was induced with prostaglandin E2 administered intravaginally. There were no stillbirths or neonatal deaths, and complications in the mothers were few. In nine women (18%) oxytocin was subsequently administered because of a failure of labour to progress; in spite of this, cesarean section was required in two (4%) of the patients. The overall cesarean section rate was 6%. Prostaglandins have been used routinely to induce labour in the United Kingdom for several years. This noninvasive method is safe, effective and well received by women in a community hospital setting, including those wanting "natural childbirth".     

Microglia-specific expression of microsomal prostaglandin E2 synthase-1 contributes to lipopolysaccharide-induced prostaglandin E2 production

Microsomal prostaglandin E2 synthase (mPGES)-1 is an inducible protein recently shown to be an important enzyme in inflammatory prostaglandin E2 (PGE2) production in some peripheral inflammatory lesions. However, in inflammatory sites in the brain, the induction of mPGES-1 is poorly understood. In this study, we demonstrated the expression of mPGES-1 in the brain parenchyma in a lipopolysaccharide (LPS)-induced inflammation model. A local injection of LPS into the rat substantia nigra led to the induction of mPGES-1 in activated microglia. In neuron-glial mixed cultures, mPGES-1 was co-induced with cyclooxygenase-2 (COX-2) specifically in microglia, but not in astrocytes, oligodendrocytes or neurons. In microglia-enriched cultures, the induction of mPGES-1, the activity of PGES and the production of PGE2 were preceded by the induction of mPGES-1 mRNA and almost completely inhibited by the synthetic glucocorticoid dexamethasone. The induction of mPGES-1 and production of PGE2 were also either attenuated or absent in microglia treated with mPGES-1 antisense oligonucleotide or microglia from mPGES-1 knockout (KO) mice, respectively, suggesting the necessity of mPGES-1 for microglial PGE2 production. These results suggest that the activation of microglia contributes to PGE2 production through the concerted de novo synthesis of mPGES-1 and COX-2 at sites of inflammation of the brain parenchyma.