Hepatoprotection by carotenoids in isoniazid-rifampicin induced hepatic injury in rats

This study evaluates the hepatoprotective effect of carotenoids against isoniazid (INH) and rifampicin (RIF). Thirty-six adult rats were divided into the following 4 groups: (1) control group treated with normal saline; (2) INH + RIF group treated with 50?mg·(kg body mass)-1·day-1 of INH and RIF each; (3) INH + RIF+ carotenoids group treated with 50?mg·(kg body mass)-1·day-1 of INH and RIF each and 10?mg·(kg body mass)-1·day-1 of carotenoids; and (4) carotenoids group treated with 10?mg·(kg body mass)-1·day-1 of carotenoids for 28?days intragastrically. Oxidative stress and antioxidant levels in liver and blood, liver histology and change in transaminases were measured in all the above-mentioned groups. There was an increase in lipid peroxidation with a reduction in thiols, catalase, and superoxide dismutase (SOD) in the liver and blood of rats accompanied by an increase in transaminases, bilirubin, and alkaline phosphatase. Treatment with carotenoids along with INH + RIF partially reversed lipid peroxidation, thiols, catalase, and SOD in the liver and blood of rats. Elevated levels of the enzymes in serum were also reversed partially by this treatment. The degree of necrosis, portal triaditis, and inflammation were also lowered in the carotenoids group. In conclusion, carotenoids supplementation in INH + RIF treated rats showed partial protection.     

Correlation of isonicotinic acid hydrazide infiltration across the blood-brain barrier to postnatal development in rats.

Changes in the isonicotinic acid hydrazide (INH) concentration in rat blood and brain were studied in correlation to postnatal development in groups of animals aged 21 and 42 days and 3 months. In the first part of the experiments, INH was administered intravenously to all the age groups in a dose of 100 mg/kg. In the second part, the dose was related to extracellular fluid volume, so that the 3-week-old rats were given 154 mg/kg, the 6-week-old animals 129 mg/kg and the 3-month-old animals 100 mg/kg. After a dose of 100 mg/kg, INH levels in the blood of 21-day-old rats were significantly lower than in 42-day-old and adult animals. The brain INH levels did not differ significantly. On relating the dose to the amount of extracellular fluid, there were no significant differences in the blood INH levels, but the levels in the brain of 21- and 42-day-old rats were significantly higher than in 3-month-old animals. Blood volume related to body weight and brain weight did not differ in the various age groups. The authors conclude that the blood-brain barrier for isonicotinic acid hydrazide alters in rats during postnatal development. In young animals (21- and 42-day-old), more INH infiltrates into the CNS than in adult animals.     

Nucleus anomaly test in Chinese hamster and in rat after treatment with isoniazid

Summary Nucleus anomaly test in Chinese hamsters and in rats treated with isoniazid (INH) was carried out according to a standard protocol in two different laboratories. These comprised both short-term studies, in which the tests were performed on animals killed 6, 12, 24, 36, or 48 h after the second of two consecutive doses of 5, 25, or 125 mg/kg INH given at an interval of 24 h, and long-term studies in animals treated with 25 mg/kg INH thrice weekly for 12 weeks. As a rule, each group consisted of at least four animals, and 1000 cells from each animal were examined. In one of the laboratories, a slight, but statistically significant increase in the incidence of nuclear anomalies was observed in two experiments on animals sacrificed 24 h after treatment; in the majority of cases, however, the investigations yielded negative results. Two out of three long-term studies revealed a slight, but statistically significant increase in the incidence of nuclear anomalies.     

Sulphadimidine Acetylation Test for Classification of Patients as Slow or Rapid Inactivators of Isoniazid

Sulphadimidine acetylation studies were undertaken in 103 patients, 52 of whom had been classified as slow and 51 as rapid inactivators of isoniazid by a standard microbiological assay method. Each patient received sulphadimidine by mouth in a dose of 44 mg./kg. body weight, and free and total sulphadimidine were estimated in blood and urine collected at six hours. The findings suggest that patients may be classified as slow inactivators of isoniazid if the proportion of acetylated sulphadimidine (total minus free) is (a) less than 25% in blood or (b) less than 70% in urine. The sulphadimidine test is easy to perform and the result is available the same day; urine specimens for the test can be stored at room temperature for over a week without any loss of drug.     

EFFECT OF DRUGS ON RAT BRAIN, CEREBROSPINAL FLUID AND BLOOD GABA CONTENT

Acute administration of GABA transaminase inhibitors to rats results in a dose-dependent increase in both brain and blood GABA content and administration of isonicotinic acid hydrazide (INH), at a dose which decreases the amount of brain GABA, also lowers blood levels of this amino acid. Chronic treatment (10 days) with INH (20mg/kg), y-acetylenic-GABA (10 mg/kg) or aminooxyacetic acid (AOAA) (10 mg/kg) results in a significant elevation in both rat brain and blood GABA concentrations. At the doses studied, only AOAA caused a significant elevation in CSF GABA content. Co-administration of pyridoxal phosphate (2 mg/kg) blocks the chronic INH-induced rise in blood GABA but does not affect the increase in brain content of this amino acid. Chronic administration of di-n-propylacetate (20 mg/kg) did not significantly alter brain, blood or CSF GABA levels. The results suggest that, under the proper conditions, changes in blood GABA levels after administration of inhibitors of GABA synthesis or degradation may be an indirect indicator of changes in the brain content of this amino acid. Blood GABA determinations may be useful for studying the biochemical effectiveness of GABA transaminase inhibitors in man.     

Protective Effects of Metallothionein on Isoniazid and Rifampicin-Induced Hepatotoxicity in Mice

Isoniazid (INH) and Rifampicin (RFP) are widely used in the world for the treatment of tuberculosis, but the hepatotoxicity is a major concern during clinical therapy. Previous studies showed that these drugs induced oxidative stress in liver, and several antioxidants abated this effect. Metallothionein (MT), a member of cysteine-rich protein, has been proposed as a potent antioxidant. This study attempts to determine whether endogenous expression of MT protects against INH and RFP-induced hepatic oxidative stress in mice. Wild type (MT+/+) and MT-null (MT−/−) mice were treated intragastrically with INH (150 mg/kg), RFP (300 mg/kg), or the combination (150 mg/kg INH +300 mg/kg RFP) for 21 days. The results showed that MT−/− mice were more sensitive than MT+/+ mice to INH and RFP-induced hepatic injuries as evidenced by hepatic histopathological alterations, increased serum AST levels and liver index, and hepatic oxidative stress as evidenced by the increase of MDA production and the change of liver antioxidant status. Furthermore, INH increased the protein expression of hepatic CYP2E1 and INH/RFP (alone or in combination) decreased the expression of hepatic CYP1A2. These findings clearly demonstrate that basal MT provides protection against INH and RFP-induced toxicity in hepatocytes. The CYP2E1 and CYP1A2 were involved in the pathogenesis of INH and RFP-induced hepatotoxicity.     

Treatment of chronic drug-resistant pulmonary tuberculosis with rifampin and ethambutol

Twenty patients with chronic pulmonary tuberculosis completed eight months of rifampin-ethambutol treatment. Half the patients received daily 600 mg. rifampin and 25 mg./kg. ethambutol for the first two months and subsequently 15 mg./kg. The others received the same dosage of ethambutol and 450 mg. rifampin daily. The average time of sputum conversion was seven weeks and 11 weeks in the two groups respectively. The patients tolerated these drug regimens well.Rifampin blood levels and urinary excretion were studied monthly during the therapy. They indicated that after a short period of treatment the elimination of this drug became faster owing to increased excretion of rifampin, and particularly of its desacetyl metabolite, in the bile. Liver damage resulted in a slower excretion rate. Rifampin should be taken on an empty stomach because simultaneous food intake reduces the peak blood concentration.     

Biochemical effects of garlic protein on lipid metabolism in alcohol fed rats

Garlic protein is a very good hypolipidemic agent. In the present study the water soluble protein fraction of garlic was investigated for its effect on hyperlipidemia induced by alcohol (3.76 g/kg. body wt./day). The hypolipidemic action is mainly due to an increase in cholesterol degradation to bile acids and neutral sterols and mobilization of triacyl glycerols in treated rats. Garlic protein (500 mg./kg body wt./day) showed significant hypolipidemic action comparable with a standard dose of gugu-lipid (50 mg./kg. body wt./day).     

BIOCHEMICAL EFFECTS IN MAN and RAT OF THREE DRUGS WHICH CAN INCREASE BRAIN GABA CONTENT

Abstract— Brain amino acids were measured in rats given aminooxyacetic acid (AOAA) by mouth, and in rats given sodium dipropylacetate (DPA) both orally and by intraperitoneal injection. Brain GABA content was significantly elevated by AOAA doses of 10mg/kg/day, but not by 5mg/kg/day. Approximately 4 times as much AOAA is required by mouth as by parenteral injection to raise brain GABA content in the rat. DPA (400mg/kg) increased brain GABA and lowered brain aspartate content significantly 1 h after a single injection. However, DPA given orally (350 mg/kg/day) produced no alterations of any amino acids in rat brain.
Amino acids were measured in plasma and urine from patients treated orally with isonicotinic acid hydrazide (INH) or DPA, and from a volunteer who took AOAA. INH (10–21 mg/kg/day) increased concentrations of β -alanine and ornithine in plasma, as well as urinary excretion of β -alanine. DPA had no such effect. AOAA in oral doses ranging from 1.25 to 5.0 mg/kg/day increased plasma concentrations of β -alanine, ornithine, β -aminoisobutyric acid, proline and hydroxyproline, and produced massive urinary excretion of β -alanine, β -aminoisobutyric acid, and taurine.
Both INH and AOAA, given in doses practical for human use, inhibit the transamination of β -alanine and ornithine in liver, and may also inhibit the transamination of GABA in brain. In addition, AOAA interferes with the catabolism of β -aminoisobutyric acid, proline, and hydroxyproline. AOAA, in the lowest dose employed, appeared more effective than INH as an inhibitor of GABA aminotransferase in man, and might therefore be useful in the treatment of neurological diseases in which brain GABA is deficient.     

A Clinical Study of Isoniazid Inactivation

The rate of inactivation of isoniazid (INH) in a host organism varies widely, probably because of genetic factors. A simple chemical test was used to determine INH levels in 24 tuberculous patients three and six hours after oral administration of the drug. Results are expressed in terms of half-life values of free INH in the body. Seven of the 24 patients inactivated INH rapidly (half-life average: 64 minutes); the remaining 17 metabolized INH at a slower rate (half-life average: 186 minutes). The range of individual half-life values was 30 to 305 minutes. A provisional half-life limit of 110 minutes was used to define “fast inactivators”; 110-160 minutes, “mo$\tilde{d}$erate inactivators”; and over 160 minutes, “slow inactivators”. Although INH inactivation may not be directly related to therapeutic failure, the security margin of the treatment may be diminished in those patients who inactivate INH rapidly.     

Physiological studies of a hybrid between populations of Dactylis glomerata from contrasting climatic regions. II. Intra population variation

Mushroom compost was treated with nematicides and infested with Aphelenchoides composticola at the time of filling into growing containers. Yields of mushrooms from infested untreated control composts were reduced to 40–60% of yields from uninfested control compost. Yields from infested compost treated with fenamiphos emulsifiable concentrate (e.c.) at 10 or 20 mg a.i./kg, thiabendazole wettable powder at 40 or 60 mg a.i./kg or oxamyl granules at 20 mg a.i./kg were as high as from uninfested controls. Compost treated with granules of AC 64,475 up to 20 mg a.i./kg or ethoprophos or thionazin up to 80 mg a.i./kg gave yields significantly lower than uninfested controls. Numbers of nematodes rose to about 10⁶/20 g of compost in untreated compost and then fell, and a similar peak occurred in treatments in which yields were substantially reduced by nematode damage. Treatments which yielded as well as the uninfested controls held maximum nematode numbers down to about 10V20 g of compost but populations stayed at this level or tended to rise while numbers in untreated compost fell. Incorporation of fenamiphos in casing or its application to the surface of beds 3 wk after cropping began gave lower yields than the uninfested control but mushrooms were being produced late in the cropping cycle. Fenamiphos e.c. at 20 mg ai./kg incorporated in compost is considered a practical preventive measure for control of A. composticola.     

Sensitive liquid chromatographic technique to measure isoniazid in alveolar cells, bronchoalveolar lavage and plasma in HIV-infected patients

The need to monitor the effectiveness of antimicrobial drugs in treating opportunistic infections such as tuberculosis in HIV-infected patients requires the development of sensitive assays. A suitable HPLC method was developed to measure the concentration of isoniazid (INH) in plasma 1 h after a standard 300 mg dose and to detect the low levels typically found in alveolar cells obtained by bronchoalveolar lavage of subjects maintained on a standard regimen of the drug. Following extraction with a chloroform–butanol mixture, the INH was back-extracted into dilute acid which was subsequently analyzed by HPLC using a CN reversed-phase column and an acetonitrile–isopropanol based mobile phase. Another HPLC method was developed using direct injection and a polymer based column to measure minute concentrations of INH in the cell-free lavage. In both systems, detection of the drug was accomplished with a sealed coulometric detector (+0.6 V) capable of giving a consistent daily response without adjustment. When saline, cellular extracts and plasma from untreated subjects were spiked with various amounts of INH and analyzed, the lowest level of quantitation was 10, 25 and 100 ng/ml, respectively. Calibration curves showed good linearity when spiked concentrations were compared to peak areas (r=0.991, 0.993 and 0.998, respectively). Alveolar cell extracts and cell-free bronchoalveolar fluid from HIV-positive patients maintained on a standard INH regimen had detectable levels of INH 4 h after a 300 mg oral dose. The plasma INH at 1 h had a range of 0.3–7.1 μg/ml (n=50). Precision studies with plasma spiked at 0.1, 0.5, 1.0 and 5.0 μg/ml revealed within-run coefficients of variation (C.V.s) of 8.9, 7.2, 4.2 and 4.9%, respectively and analytical recoveries of 97, 108, 108 and 98%, respectively. The day-to-day C.V.s for the plasma method were 7.6, 4.9 and 3.8% at concentrations of 0.5, 1.0 and 3.0 μg/ml, respectively. The results suggest that this rugged HPLC technique can quantitate INH in 1 h plasma with good precision and can be used to estimate the very low INH concentrations found in alveolar cells and cell-free lavage recovered from patients undergoing anti-tuberculosis therapy.     

SUSTAINED DRUG-INDUCED ELEVATION OF BRAIN GABA IN THE RAT1

Abstract— The contents of GABA, homocarnosine, and β-alanine can be raised in rat brain for long periods of time by the continued administration of phenelzine, aminooxyacetic acid (AOAA), or isonicotinic acid hydrazide (INH). These 3 compounds apparently act by preferential inhibition of the enzyme GABA aminotransferase (GABA-T). Oral administration of phenelzine (20 mg/kg per day) caused a 25–50 per cent increase in GABA levels in rat brain, but produced appreciable toxic side effects. A similar increase in GABA levels in brain resulted from oral administration to rats of INH in a dosage of 60 mg/kg per day, without production of any obvious toxic effects. Simultaneous administration of large doses of pyridoxine did not abolish the GABA-elevating effect of INH. Brain GABA levels in the rat were increased by approx. 50 per cent by daily injections of AOAA (2.5 mg/kg per day). At this low dosage, AOAA injections in rats could be continued for at least 6 weeks without producing evident toxic effects. Oral administration of large amounts of GABA, on the other hand, failed to increase the content of GABA in the brains of rats not treated with GABA-T inhibitors, and failed to produce any further increase of brain GABA levels in rats treated with AOAA.     

Blood Loss During Pediatric Operations

The gravimetric method of measuring blood loss was used during all types of pediatric operations at The Montreal Children''s Hospital. Results of 1787 such measurements indicated that the method is of value in the management of transfusion. Grading blood loss as minor, moderate or severe, in terms of its relation to total blood volume or body weight is a procedure of practical value. Operations were grouped into those that usually led to a loss of less than 10% of the blood volume (7.5 ml./kg.), those with a loss usually between 10% and 14% and those with blood loss usually over 14% (10.5 ml./kg.), in order that appropriate plans for transfusion could be made to reduce the incidence of serious hypovolemia without fear of cardiovascular overloading. Blood loss at operation (adenotonsillectomy) was noted to vary considerably among surgeons but was fairly constant for each surgeon and seemed to be independent of the surgeon''s experience. Two alleged hemostatic agents, adrenochrome carbazone (Statimo) and estrogenic substances (Premarin), were not effective in reducing the amount of blood lost during adenotonsillectomy. The importance of calculation of approximate equivalent amounts of blood at various ages of childhood is emphasized.     

Antihyperglycemic activity of Tarralin™, an ethanolic extract of Artemisia dracunculus L.

The studies reported here were undertaken to examine the antihyperglycemic activity of an ethanolic extract of Artemisia dracunculus L., called Tarralin in diabetic and non-diabetic animals. In genetically diabetic KK-A(gamma) mice, Tarralin treatment by gavage (500 mg/kg body wt./day for 7 days) lowered elevated blood glucose levels by 24% from 479+/-25 to 352+/-16 mg/dl relative to control animals. In comparison, treatment with the known antidiabetic drugs, troglitazone (30 mg/kg body wt./day) and metformin (300 mg/kg body wt./day), decreased blood glucose concentrations by 28% and 41%, respectively. Blood insulin concentrations were reduced in the KK-A(gamma) mice by 33% with Tarralin, 48% with troglitazone and 52% with metformin. In (STZ)-induced diabetic mice, Tarralin treatment, (500 mg/kg body wt./day for 7 days), also significantly lowered blood glucose concentrations, by 20%, from 429+/-41 to 376+/-58 mg/dl relative to control. As a possible mechanism, Tarralin was shown to significantly decrease phosphoenolpyruvate carboxykinase (PEPCK) mRNA expression by 28% in STZ-induced diabetic rats. In non-diabetic animals, treatment with Tarralin did not significantly alter PEPCK expression, blood glucose or insulin concentrations. The extract was also shown to increase the binding of glucagon-like peptide (GLP-1) to its receptor in vitro. These results indicate that Tarralin has antihyperglycemic activity and a potential role in the management of diabetic states.     

Lack of liver injury in Wistar rats treated with the combination of isoniazid and rifampicin

Isoniazid (INH) can cause serious idiosyncratic liver injury. An animal model would greatly facilitate mechanistic studies, but it is essential that the mechanism in the model be similar to the liver injury that can occur in humans. We attempted to replicate a previous study in which Wistar rats treated with INH and rifampicin (RMP) developed liver injury, which was promising because of its delayed onset similar to the liver injury that can occur in humans. Wistar rats were treated with either a high dose of INH (150 mg/kg/day) or a combination of INH and RMP (75 mg/kg/day and 50 mg/kg/day, respectively) for up to 4 weeks. However, we did not observe any liver injury or evidence of an inflammatory infiltrate as had been reported; rather, we observed an increase in CTLA4-positive cells in the cervical lymph nodes as well as a decrease in serum CXCL1 and MCP-1. In short, we were unable to reproduce a previously reported model of delayed onset INH-induced liver injury in Wistar rats.     

Hepatoprotective effect of tocopherol against isoniazid and rifampicin induced hepatotoxicity in albino rabbits

Antitubercular drug induced hepatotoxicity is a major hurdle for an effective treatment of tuberculosis. The present study was undertaken to assess the hepatoprotective potential of tocopherol (50 mg/kg and 100 mg/kg, ip) and to compare it with cimetidine (120 mg/kg, ip). Hepatotoxicity was produced by giving isoniazid (INH, 50 mg/kg, po) and rifampicin (RMP, 100 mg/kg, po) combination to albino rabbits for 7 days. Assessment of liver injury was done by estimating levels of alanine transaminase (ALT) and argininosuccinic acid lyase (ASAL) in serum and by histopathological examination of liver. Results revealed that pretreatment with high dose of tocopherol (100 mg/kg) prevented both biochemical as well as histopathological evidence of hepatic damage induced by INH and RMP combination. Moreover, tocopherol (100 mg/kg) was found to be a more effective hepatoprotective agent as compared to cimetidine.     

The rate of breakdown of methyl methanesulphonate, dimethyl sulphate and N-methyl-N-nitrosourea in the rat

1. The rates of decomposition of methyl methanesulphonate, dimethyl sulphate and N-methyl-N-nitrosourea in the rat were measured. 2. Dimethyl sulphate is no longer detectable in the blood of the rat 3min. after an intravenous dose (75mg./kg. body wt.). Methyl methanesulphonate is only just detectable in the blood 1(1/2)hr. after an intravenous dose (100mg./kg. body wt.). N-Methyl-N-nitrosourea is no longer detectable in the blood 15min. after an intravenous dose (100mg./kg. body wt.). 3. The exhalation of (14)CO(2) after an intragastric dose of N[(14)C]-methyl-N-nitrosourea (100mg./kg. body wt.) is appreciably slower than after an intravenous dose, from which it is estimated that the lifetime in the rat is 2-3hr.     

Blood,Urine, and Breath Levels After Rapid Intravenous Infusion of Ethanol

A re-evaluation of alcohol as an intravenous anaesthetic provided an opportunity of studying the changes in venous blood, urine, and breath levels under controlled conditions. Twelve volunteer patients were given 0·8 g./kg. in 8% w/v solution over four to six minutes. Despite standardization of technique there was a great variation in the peak urinary concentration and also some variation in the time at which urinary level exceeded that of blood, but this latter always occurred within 30 minutes of infusion. From one hour after infusion there was a constant mean rate of decline of both venous and urinary concentrations. While urinary/venous blood ratios varied greatly they remained fairly constant in each individual patient. The average ratio (1·35) was similar to that of other published papers. With a modification of gearing (58:1 to 67:1) the standard Ethanographe gave good correlation of breath with venous blood concentrations at low levels when patients were able to operate the machine themselves. At high levels, however, with a two-minute period of rebreathing in the unconscious patient, the correlation was poor.     

Prophylactic antibiotics in neonates with umbilical artery catheter placement: a prospective study of 137 patients

To analyze the risk of cannula sepsis from indwelling umbilical arterial catheters and the indication for prophylactic antibiotics, 137 catheterized neonates with respiratory distress were prospectively placed into either antibiotic-treated (penicillin 50,000U/kg/day and kanamycin 15 mg./kg./day) or non-treated groups. Although bacteria were frequently isolated from blood and catheter tip cultures obtained upon removal of the catheter, especially among non-antibiotic treated infants, these isolates were predominantly non-pathogens and probably skin flora. Corresponding peripheral blood cultures were usually sterile. No cases of cannula-associated sepsis occurred among treated and non-treated newborns. The risk of bacteriologically proven sepsis resulting from an indwelling umbilical artery catheter appears insufficient to justify prophylactic antibiotics.