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Ramalho NJD, Švecová O, Kula R, Šimurdová M, Šimurda J, Bébarová M. Aminophylline at clinically relevant concentrations affects inward rectifier potassium current in a dual way. Pflugers Arch 2022; 474:303-313. [PMID: 35084562 DOI: 10.1007/s00424-021-02646-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/26/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022]
Abstract
Bronchodilator aminophylline may induce atrial or less often ventricular arrhythmias. The mechanism of this proarrhythmic side effect has not been fully explained. Modifications of inward rectifier potassium (Kir) currents including IK1 are known to play an important role in arrhythmogenesis; however, no data on the aminophylline effect on these currents have been published. Hence, we tested the effect of aminophylline (3-100 µM) on IK1 in enzymatically isolated rat ventricular myocytes using the whole-cell patch-clamp technique. A dual steady-state effect of aminophylline was observed; either inhibition or activation was apparent in individual cells during the application of aminophylline at a given concentration. The smaller the magnitude of the control IK1, the more likely the activation of the current by aminophylline and vice versa. The effect was reversible; the relative changes at -50 and -110 mV did not differ. Using IK1 channel population model, the dual effect was explained by the interaction of aminophylline with two different channel populations, the first one being inhibited and the second one being activated. Considering various fractions of these two channel populations in individual cells, varying effects observed in the measured cells could be simulated. We propose that the dual aminophylline effect may be related to the direct and indirect effect of the drug on various Kir2.x subunits forming the homo- and heterotetrameric IK1 channels in a single cell. The observed IK1 changes induced by clinically relevant concentrations of aminophylline might contribute to arrhythmogenesis related to the use of this bronchodilator in clinical medicine.
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Affiliation(s)
- Nuno Jorge Dourado Ramalho
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Olga Švecová
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Roman Kula
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.,Department of Paediatric Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Brno, Masaryk University, Černopolní 9, 662 63, Brno, Czech Republic
| | - Milena Šimurdová
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Jiří Šimurda
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - Markéta Bébarová
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
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2
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Mohamed Sofian Z, Harun N, Mahat MM, Nor Hashim NA, Jones SA. Investigating how amine structure influences drug-amine ion-pair formation and uptake via the polyamine transporter in A549 lung cells. Eur J Pharm Biopharm 2021; 168:53-61. [PMID: 34455038 DOI: 10.1016/j.ejpb.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022]
Abstract
Transiently associating amines with therapeutic agents through the formation of ion-pairs has been established both in vitro and in vivo as an effective means to systemically direct drug delivery to the lung via the polyamine transport system (PTS). However, there remains a need to better understand the structural traits required for effective PTS uptake of drug ion-pairs. This study aimed to use a structurally related series of amine counterions to investigate how they influenced the stability of theophylline ion-pairs and their active uptake in A549 cells. Using ethylamine (mono-amine), ethylenediamine (di-amine), spermidine (tri-amine) and spermine (tetra-amine) as counterions the ion-pair affinity was shown to increase as the number of protonated amine groups in the counterion structure increased. The mono and diamines generated a single hydrogen bond and the weakest ion-pair affinities (pKFTIR: 1.32 ± 0.04 and 1.43 ± 0.02) whereas the polyamines produced two hydrogen bonds and thus the strongest ion-pair affinities (pKFTIR: 1.93 ± 0.05 and 1.96 ± 0.04). In A549 cells depleted of endogenous polyamines using α-difluoromethylornithine (DFMO), the spermine-theophylline uptake was significantly increased (p < 0.05) compared to non-amine depleted cells and this evidenced the active PTS sequestering of the ion-pair. The mono-amine and di-amine failed to enhance theophylline uptake in these A549 cells, but the tri-amine and tetra-amine both almost doubled the theophylline uptake into the cells when compared to the uptake of free drug. As the data indicated that polyamines with at least 3 amines were required to form ion-pairs that could enhance A549 cell uptake, it suggested that at least two amines were required to physically stabilise the ion-pair and one to interact with the PTS.
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Affiliation(s)
- Zarif Mohamed Sofian
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Insitute of Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK.
| | - Norsyifa Harun
- Centre for Drug Research, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
| | - Mohd Muzamir Mahat
- Faculty of Applied Sciences, Universiti Teknologi MARA, 40000 Shah Alam, Selangor, Malaysia
| | - Nikman Adli Nor Hashim
- Centre for Drug Research in Systems Biology, Structural Bioinformatics and Human Digital Imaging (CRYSTAL), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Stuart A Jones
- Insitute of Pharmaceutical Sciences, Faculty of Life Sciences & Medicine, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 9NH, UK
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Aralihond A, Shanta Z, Pullattayil A, Powell C. Treating acute severe asthma attacks in children: using aminophylline. Breathe (Sheff) 2020; 16:200081. [PMID: 33664832 PMCID: PMC7910032 DOI: 10.1183/20734735.0081-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/24/2020] [Indexed: 12/02/2022] Open
Abstract
Aminophylline does have a role in treating severe asthma attacks in children with asthma. Clinicians just need to be aware of the toxic side-effects of the drug and manage the drug carefully. https://bit.ly/3o7IJV1.
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Affiliation(s)
- A. Aralihond
- Sidra Medicine, Doha, Qatar
- Weill Cornell Medical College, Doha, Qatar
| | | | | | - C.V.E. Powell
- Sidra Medicine, Doha, Qatar
- Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
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4
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Sofian ZM, Benaouda F, Wang JTW, Lu Y, Barlow DJ, Royall PG, Farag DB, Rahman KM, Al-Jamal KT, Forbes B, Jones SA. A Cyclodextrin-Stabilized Spermine-Tagged Drug Triplex that Targets Theophylline to the Lungs Selectively in Respiratory Emergency. ADVANCED THERAPEUTICS 2020; 3:2000153. [PMID: 33043128 PMCID: PMC7536984 DOI: 10.1002/adtp.202000153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/04/2020] [Indexed: 12/21/2022]
Abstract
Ion‐pairing a lifesaving drug such as theophylline with a targeting moiety could have a significant impact on medical emergencies such as status asthmaticus or COVID‐19 induced pneumomediastinum. However, to achieve rapid drug targeting in vivo the ion‐pair must be protected against breakdown before the entry into the target tissue. This study aims to investigate if inserting theophylline, when ion‐paired to the polyamine transporter substrate spermine, into a cyclodextrin (CD), to form a triplex, could direct the bronchodilator to the lungs selectively after intravenous administration. NMR demonstrates that upon the formation of the triplex spermine protruded from the CD cavity and this results in energy‐dependent uptake in A549 cells (1.8‐fold enhancement), which persists for more than 20 min. In vivo, the triplex produces a 2.4‐fold and 2.2‐fold increase in theophylline in the lungs 20 min after injection in rats and mice, respectively (p < 0.05). The lung targeting is selective with no increase in uptake into the brain or the heart where the side‐effects of theophylline are treatment‐limiting. Selectively doubling the concentration of theophylline in the lungs could improve the benefit‐risk ratio of this narrow therapeutic index medicine, which continues to be important in critical care.
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Affiliation(s)
- Zarif M Sofian
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK.,Department of Pharmaceutical Technology Faculty of Pharmacy Universiti Malaya Kuala Lumpur 50603 Malaysia
| | - Faiza Benaouda
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Julie Tzu-Wen Wang
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Yuan Lu
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - David J Barlow
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Paul G Royall
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Doaa B Farag
- Faculty of Pharmacy Misr International University Cairo 11431 Egypt
| | - Khondaker Miraz Rahman
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Khuloud T Al-Jamal
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Ben Forbes
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
| | - Stuart A Jones
- School of Cancer and Pharmaceutical Sciences Faculty of Life Sciences & Medicine King's College London Franklin-Wilkins Building, 150 Stamford Street London SE1 9NH UK
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Matera MG, Page CP, Calzetta L, Rogliani P, Cazzola M. Pharmacology and Therapeutics of Bronchodilators Revisited. Pharmacol Rev 2020; 72:218-252. [PMID: 31848208 DOI: 10.1124/pr.119.018150] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Bronchodilators remain the cornerstone of the treatment of airway disorders such as asthma and chronic obstructive pulmonary disease (COPD). There is therefore considerable interest in understanding how to optimize the use of our existing classes of bronchodilator and in identifying novel classes of bronchodilator drugs. However, new classes of bronchodilator have proved challenging to develop because many of these have no better efficacy than existing classes of bronchodilator and often have unacceptable safety profiles. Recent research has shown that optimization of bronchodilation occurs when both arms of the autonomic nervous system are affected through antagonism of muscarinic receptors to reduce the influence of parasympathetic innervation of the lung and through stimulation of β 2-adrenoceptors (β 2-ARs) on airway smooth muscle with β 2-AR-selective agonists to mimic the sympathetic influence on the lung. This is currently achieved by use of fixed-dose combinations of inhaled long-acting β 2-adrenoceptor agonists (LABAs) and long-acting muscarinic acetylcholine receptor antagonists (LAMAs). Due to the distinct mechanisms of action of LAMAs and LABAs, the additive/synergistic effects of using these drug classes together has been extensively investigated. More recently, so-called "triple inhalers" containing fixed-dose combinations of both classes of bronchodilator (dual bronchodilation) and an inhaled corticosteroid in the same inhaler have been developed. Furthermore, a number of so-called "bifunctional drugs" having two different primary pharmacological actions in the same molecule are under development. This review discusses recent advancements in knowledge on bronchodilators and bifunctional drugs for the treatment of asthma and COPD. SIGNIFICANCE STATEMENT: Since our last review in 2012, there has been considerable research to identify novel classes of bronchodilator drugs, to further understand how to optimize the use of the existing classes of bronchodilator, and to better understand the role of bifunctional drugs in the treatment of asthma and chronic obstructive pulmonary disease.
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Affiliation(s)
- M G Matera
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy (M.G.M.); Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom (C.P.P.); and Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (L.C., P.R., M.C.)
| | - C P Page
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy (M.G.M.); Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom (C.P.P.); and Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (L.C., P.R., M.C.)
| | - L Calzetta
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy (M.G.M.); Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom (C.P.P.); and Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (L.C., P.R., M.C.)
| | - P Rogliani
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy (M.G.M.); Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom (C.P.P.); and Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (L.C., P.R., M.C.)
| | - M Cazzola
- Unit of Pharmacology, Department of Experimental Medicine, University of Campania "Luigi Vanvitelli," Naples, Italy (M.G.M.); Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom (C.P.P.); and Unit of Respiratory Medicine, Department of Experimental Medicine, University of Rome "Tor Vergata," Rome, Italy (L.C., P.R., M.C.)
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Azmeh R, Greydanus DE, Agana MG, Dickson CA, Patel DR, Ischander MM, Lloyd RD. Update in Pediatric Asthma: Selected Issues. Dis Mon 2019; 66:100886. [PMID: 31570159 DOI: 10.1016/j.disamonth.2019.100886] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is a complex condition that affects 14% of the world's children and the approach to management includes both pharmacologic as well as non-pharmacologic strategies including attention to complex socioeconomic status phenomena. After an historical consideration of asthma, allergic and immunologic aspects of asthma in children and adolescents are presented. Concepts of socioeconomic aspects of asthma are considered along with environmental features and complications of asthma disparities. Also reviewed are links of asthma with mental health disorders, sleep disturbances and other comorbidities. A stepwise approach to asthma management is discussed that includes pharmacologic and non-pharmacologic strategies in the pediatric population. The role of immunotherapy and use of various immunomodulators are considered as well.
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Affiliation(s)
- Roua Azmeh
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Donald E Greydanus
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States.
| | - Marisha G Agana
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Cheryl A Dickson
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States; Health Equity and Community Affairs, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, United States
| | - Dilip R Patel
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Mariam M Ischander
- Department of Pediatric and Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States
| | - Robert D Lloyd
- Pacific Northwest University of Health Sciences College of Osteopathic Medicine, Yakima, Washington, United States
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7
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Liu Q, Wang W, Jing W. Indoor air pollution aggravates asthma in Chinese children and induces the changes in serum level of miR-155. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:22-30. [PMID: 30084260 DOI: 10.1080/09603123.2018.1506569] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/26/2018] [Indexed: 06/08/2023]
Abstract
Indoor air pollution is associated with childhood asthma but the molecular mechanism remains unclear. We aimed to explore the relationship between indoor air pollution and pediatric asthma, and the potential molecular mechanism. The serum level of miR-155 was measured by real-time qPCR in 180 Chinese children with asthma caused by air pollution (an asthma group). Meanwhile, 180 healthy subjects were selected as a control group. HCHO, NO2, and particles (PM10, PM2.5, and PM1) were measured. Univariate and multivariate logistic regression were analyzed to assess the relationship between air pollutants and asthma risk. A rank correlation test was used to explore the relationship between serum level of miR-155 and the level of PM2.5 or HCHO. Serum level of miR-155 was higher in the asthma group than the control group (p < 0.001). The history of childhood allergy, breastfeeding, environmental tobacco smoke, PM2.5, and HCHO were significantly different between two groups (p < 0.05). Serum level of miR-155 was closely associated with the levels of indoor PM2.5 and HCHO in the asthma group (p < 0.05) but not in the control group (p > 0.05). Indoor air pollution aggravates the asthma in Chinese children and induces the changes in the serum level of miR-155. Abbreviation: DEP: Diesel exhaust particles; PAHs: Polycyclic aromatic hydrocarbons; THBS1: thrombospondin 1; ISAAC: International Study of Asthma and Allergies in Childhood; PFTs: Pulmonary Function Tests; FEV1: The first second of forced expiration; EDTA, ethylenediaminetetraacetic acid; RT-qPCR, Reverse transcription quantitative real-time PCR; ETS: environmental tobacco smoke; PAEs: phthalate esters.
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Affiliation(s)
- Qingbin Liu
- a Department of Pediatric , Affiliated Hospital of Changchun University of Traditional Chinese Medicine , Changchun , China
| | - Wei Wang
- a Department of Pediatric , Affiliated Hospital of Changchun University of Traditional Chinese Medicine , Changchun , China
| | - Wei Jing
- a Department of Pediatric , Affiliated Hospital of Changchun University of Traditional Chinese Medicine , Changchun , China
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