Lidocaine inhibits potassium efflux and hemolysis in erythrocytes during oxidative stress in vitro

The impact of del Nido cardioplegia solution on blood morphology parameters

BACKGROUND

Crystalloid cardioplegic solutions are believed to reduce hemoglobin significantly and increase the transfusion rate. However, recent reports indicate that the del Nido cardioplegia may preserve blood morphology parameters.

METHODS

In "The del Nido versus cold blood cardioplegia in aortic valve Replacement" trial patients undergoing aortic valve replacement were randomized into the del Nido (DN) or cold blood cardioplegia (CB) group. For the subanalysis, patients who underwent blood transfusions were excluded from the study. Red blood cell (RBC) count, hemoglobin, white blood cell (WBC) count and platelet (PLT) count were measured before the surgery, 24-, 48-, and 96 hours postoperatively. Furthermore, percental variation in first-last measure was compared in groups. In addition, indexed normalized ratio (INR) and activated partial thromboplastin time (aPTT) were compared preoperatively and 24 hours after the surgery.

RESULTS

Eighteen (24%) patients from the del Nido group and 22 (29.3%) patients from the CB group received blood product transfusions (p = 0.560) and were excluded from further analysis. As such, 57 patients remained in DN group and 53 patients remained in CB group. No difference was found in RBC, hemoglobin, WBC, and platelet count in time intervals. Percental variation in first-last measure revealed higher fall in RBC (p = 0.0024) and hemoglobin (p = 0.0028) in the CB group. No difference was shown in preoperative and 24-hour postoperative INR and aPTT.

CONCLUSIONS

The del Nido cardioplegia does not decrease blood morphology parameters when compared to cold blood cardioplegia and may be used alternatively regardless of bleeding and coagulopathy risk.

Preliminary Study for the Preparation of Transmucosal or Transdermal Patches with Acyclovir and Lidocaine

The present study aimed to prepare and evaluate patches for the controlled release of lidocaine/acyclovir and the binary mixture between lidocaine: acyclovir in the oral cavity. Mucoside adhesive patches containing 12.5 mg/cm² lidocaine/acyclovir or binary mixture base were developed by a solvent casting method using sodium alginate, polyvinylpyrrolidone (PVP), glycerol (Gly), polyvinyl alcohol (PVA), and Span 80 (S). Binary mixtures between all components were prepared before the patches' formulation in order to be able to check the substance compatibility. All formulated patches were analyzed by FT-IR spectroscopy, UV-Vis analysis, thermogravimetry (TGA), and scanning electron microscopy (SEM). FT-IR and TGA analyses were also used to check compatibility between binary mixtures. The study establishes which membranes are indicated in the controlled release of lidocaine/acyclovir and those membranes that contain both active principles. Membranes based on alginate, PVP, and PVA can be used to release the active substance. Simultaneously, membranes with SPAN used as a gelling agent were excluded due to the interaction with the active substance. The following membranes composition have been chosen for lidocaine release: Alginate:Gly and Alginate:Gly:PVP. At the same time, the following membrane compositions were chosen for acyclovir membranes: Alginate:Gly:PVP and Alginate:PVA:Gly. Both active substances could be included to obtain a homogeneous distribution only in the membrane based on alginate, PVA, and Gly.

LC-ESI-MS/MS analysis of total oligomeric flavonoid fraction of Cyperus rotundus and its antioxidant, macromolecule damage protective and antihemolytic effects

In the present investigation, we identified the phytochemical constituents of total oligomeric flavonoid fraction (TOF) of Cyperus rotundus by LC-ESI-MS/MS and also demonstrated its antihemolytic effects against 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH) induced hemolysis of rat erythrocytes. Our results of TOF extract exhibited DPPH, metal chelating, ABTS, NO and hydroxyl radical scavenging activities with an IC50 values of 23.72±1.6, 52.45±2.88, 9.8±0.42, 6.5±0.33 and 120±6.83μg/ml respectively, whereas total antioxidant and reducing power activities were 194±12.5μg GAE/mg extract and 145±8.3μg AAE/mg extract. The extract showed potent inhibitory activity against AAPH induced plasmid DNA damage, protein oxidation and lipid peroxidation. The TOF extract mitigates AAPH induced hemolysis and exhibits ∼50% antihemolytic activity. TOF pretreatment also preserved morphology of erythrocytes as observed and measured by light microscope and atomic force microscope analysis. Furthermore, the TOF fraction effectively inhibited AAPH induced LDH release, ROS generation and lipid peroxidation. Taken together, our data demonstrate the antihemolytic activity of C. rotundus against AAPH induced oxidative stress of erythrocytes, and was associated with the decrease in oxidative stress, cellular damage and protection of macromolecules. In conclusion, the effects might be correlated with high content of flavonoids and polyphenols identified in C. rotundus. This suggests the clinical application of TOF fraction of C. rotundus against ROS induced cell death.

Roles of adiponectin and oxidative stress in the regulation of membrane microviscosity of red blood cells in hypertensive men-an electron spin resonance study

This study was undertaken to investigate possible relationships among plasma adiponectin, 8-iso-prostaglandin F2α (8-iso-PG F2α: an index of oxidative stress), and membrane fluidity (a reciprocal value of microviscosity) in hypertensive and normotensive men using an electron spin resonance-method. The order parameter (S) for the spin-label agent (5-nitroxide stearate) in red blood cell (RBC) membranes was higher in hypertensive men than in normotensive men, indicating that membrane fluidity was decreased in hypertension. Plasma adiponectin and NO metabolites levels were lower in hypertensive men than in normotensive men. In contrast, plasma 8-iso-PG F2α levels were increased in hypertensive men compared with normotensive men. Plasma adiponectin concentration was correlated with plasma NO-metabolites, and inversely correlated with plasma 8-iso-PG F2α. The order parameter (S) of RBCs was inversely correlated with plasma adiponectin and plasma NO metabolite levels, and positively correlated with plasma 8-iso-PG F2α, suggesting that the reduced membrane fluidity of RBCs might be associated with hypoadiponectinemia, endothelial dysfunction, and increased oxidative stress. In a multivariate regression analysis, adiponectin and 8-iso-PG F2α were significant determinants of membrane fluidity of RBCs after adjustment for general risk factors. These results suggest that adiponectin and oxidative stress might have a close correlation with rheologic behavior and microcirculation in hypertension.

Protective effect of desloratadine against oxidative stress in human erythrocytes in vitro

Desloratadine (DCL) is a non-sedating antihistamine approved for the treatment of allergic rhinitis or chronic idiopathic urticaria. The objective of this study was to evaluate the potential protective effect of DCL against oxidative stress in human erythrocytes in vitro. Human erythrocytes were oxidized by a water-soluble radical generators-2,2' azobis (2-amidinopropane) hydrochloride (AAPH; 20, 50mM) or tert-butyl hydroperoxide (TBHP; 0.5mM) and the protective effects of DCL (2, 5, 7, 10 and 26μM) on selected oxidative stress markers were investigated. Erythrocytes were divided into aliquots. The first aliquot was incubated for 2h at 37°C with AAPH or TBHP. The other test aliquots were preincubated with selected concentrations of DCL for 30min and followed by AAPH or TBHP incubation for 2h. Malondialdehyde (MDA) content, catalase (CAT) and superoxide dismutase (SOD) activities, as well as hemolysis percentage (H) were measured in all erythrocyte samples. The influence of solvent (0.5% ethanol) on the parameters studied was also checked. Pretreatment with DCL (7, 10, 26μM) could prevent TBHP-induced increase in MDA formation in a concentration-dependent manner. DCL has no influence on CAT activity and it significantly enhanced SOD activity compared to AAPH treatment samples at 7, 10, 26μM. DCL (26μM) also reduced the hemolytic effect on erythrocytes when compared to the erythrocytes exposed to oxidants only. These results suggest a beneficial effect of DCL as an antioxidant, which might be an additional explanation of its therapeutic action.

Oxidative stress and membrane fluidity of red blood cells in hypertensive and normotensive men: an electron spin resonance investigation

Recent evidence indicates that oxidative stress might actively participate in the pathophysiology of hypertension, atherosclerosis, and other cardiovascular diseases. The purpose of the present study was to assess the possible link between oxidative stress and membrane fluidity in hypertensive and normotensive men. We measured the membrane fluidity (a reciprocal value of membrane microviscosity) of red blood cells (RBCs) in hypertensive and normotensive men using an electron spin resonance (ESR) and spin-labeling method. Membrane fluidity of RBCs was decreased in hypertensive men compared with normotensive men. The levels of plasma 8-Iso-prostaglandin F2alpha (8-Iso-PG F2alpha : an index of oxidative stress) were significantly higher in hypertensive men than in normotensive men. In contrast, plasma nitric oxide (NO)-metabolite levels were significantly lower in hypertensive men than in normotensive men. In the overall analysis of hypertensive and normotensive men, plasma 8-Iso-PG F2alpha levels were inversely correlated with plasma NO-metabolites. Furthermore, the reduced membrane fluidity of RBCs was associated with increased plasma 8-Iso-PG F2alpha and decreased plasma NO-metabolite levels. In a multivariate regression analysis, plasma 8-Iso-PG F2alpha was found to be an independent determinant of membrane fluidity of RBCs. The results of the present study suggest that oxidative stress might have a close correlation with the rheologic behavior of RBCs and the microcirculation in hypertensive men.

Novel semiautomated method for assessing in vitro cellular antioxidant activity using the light-scattering properties of human erythrocytes

The novel method developed for screening cellular antioxidant activity relies on differences in light-scattering properties (turbidity) between intact and lysed human erythrocytes. AAPH, a peroxyl radical generator, was used to enhance lipid peroxidation. The consequent hemolysis triggered a loss of the light-scattering ability in the lysed erythrocytes. When an antioxidant was added, the area under the absorbance decay curve (AUC) was linearly proportional to the concentration of antioxidant compound. This erythrocyte cellular antioxidant activity (ERYCA) method was found to be relatively fast, sensitive, accurate, and repeatable, even when using erythrocytes from different donors and for different storage times. The method was used to assess the antioxidant capacity of pure phenolic compounds, fruit juices, stimulant beverages, and blood plasma and compared with ORAC values. The values resulting from the two methods did not correlate as the mechanisms involved were different.

Oxidative modulation of marcaine and lekoptin in H9C2 rat myoblasts

AIM

The cytotoxicity of marcaine was estimated in combination with a calcium channel blocker. In addition, the influence of marcaine and marcaine plus lekoptin on a model system using the H9C2 cardiac cell line was investigated.

METHODS

Cells were incubated for five hours with marcaine, lekoptin, or with both drugs simultaneously. Apoptotic cells were detected using the TUNEL assay and the alkaline comet assay. Mitochondrial cell function after drug uptake was examined using the MTT assay. The concentration of MDA (malondialdehyde) -- the final product of fatty-acid peroxidation, was quantified spectrophotometrically. The expression of glutathione S-transferase pi (GST-pi) was detected by immunofluorescence (IF) and Western blotting (WB) and inducible nitric oxide synthase (iNOS) was assessed by immunocytochemical staining (ABC).

RESULTS

Incubation with marcaine resulted in the highest number of apoptotic cells. After incubation with both marcaine and lekoptin, moderate damage to cells (54.2%+/-1.775% of DNA destruction) was observed. The highest levels of iNOS and GST-pi expression were observed in cells treated with marcaine and marcaine plus lekoptin. The characteristic nuclear GST-pi expression was observed in cells treated with both drugs.

CONCLUSION

Lekoptin stimulated cells to proliferate. Marcaine caused membrane damage and ultimately cell death.

Stycholysin II, a cytolysin from the sea anemone Stichodactyla helianthus promotes higher hemolysis in aged red blood cells

We have investigated the relationship between the status of red blood cells (RBCs) and their susceptibility to toxin sticholysin II (StII) hemolytic activity; we have evaluated this effect in different RBC ensembles, comprising young and old cells, and in cells partially damaged by their pre-exposition to a free radical source. Upon action of StII, young cell populations are less prone to hemolysis than the whole population, while old cell populations and peroxyl-oxidized red cells are lysed faster than the whole population. Cell K(+) content was higher in young cells and lower in both senescent cells and in peroxyl-damaged cells relative to whole cell population. The relevance of cell K(+) content in St II-induced lysis was shown when external Na(+) was partially replaced by K(+); under this condition, RBC lysed faster in the presence of St II but no difference was observed among young cells, whole cells population and peroxyl-damaged cells; only old cells lysed faster that the whole population, response that can be due to an enhanced St II-induced pore formation as supported by evaluation of St II irreversible binding to RBC. It is concluded that this factor and the amount of intracellular K(+) are the dominant parameters that modulate the resistance of RBC to St II-induced lysis.

Comparison of three methods for oxidative stress-induced potassium efflux measurement

The aim of the study was to compare the potassium efflux measurements (flame photometry (FP), specific electrode (SE) and atomic absorption photometry (AAP)) using a model of erythrocytes exposed to an oxidative stress in various conditions of osmolarity. Human erythrocytes were incubated in 3 different values of osmolarity and in the presence of 50mM AAPH, potassium efflux was measured by FP, SE and AAP at t=0 and every 30min for 2h. These methods were similar for the measurement of global potassium efflux. However, SE detected important amounts of potassium at the beginning of the experiment or in absence of AAPH in comparison with AAP and FP. It is noteworthy that these different methods of measurements were not altered by the osmolarity. FP and AAP make it possible to study the potassium efflux during oxidative stress while SE should be used only for global measurements.

Genistein abrogates pre-hemolytic and oxidative stress damage induced by 2,2′-Azobis (Amidinopropane)

The pre-hemolytic mechanism induced by free radicals initiated from water-soluble 2,2'-azobis (2-amidinopropane) hydrochloride (AAPH) and its reversal by genistein was investigated in human erythrocytes. The time course of K+ efflux compared to the occurrence of hemolysis suggests that AAPH-induced hemolysis occurs indirectly via pore formation and band 3 oxidation as expected. However, genistein inhibited hemolysis, LDH release and membrane protein oxidation but not K+ efflux. This indicated that erythrocyte protein oxidation possibly in the hydrophobic core plays a significant role in the membrane pre-hemolytic damage. Chemiluminescence (CL) analysis carried out in non-lysed erythrocytes treated with AAPH showed a dramatic increase in CL indicating both reduced levels of antioxidants and increased membrane lipid peroxide. The V0 value was also increased up to 6 times, denoting a high degree of membrane peroxidation very early in erythrocyte membrane damage. The whole process was inhibited by genistein in a dose-dependent manner. These results indicate that the genistein inhibited both hemolysis and pre-hemolytic damage and also hindered membrane lipid peroxide formation and protein oxidation. In addition, it is suggested that pre-hemolytic damage is mediated mainly by the oxidation of both phospholipid and protein located in the deeper hydrophobic region of the membrane.

Optimization of a model of red blood cells for the study of anti-oxidant drugs, in terms of concentration of oxidant and phosphate buffer

The aggression of erythrocytes by an oxidative stress induces hemolysis. This paper aims to valid a model of erythrocytes in terms of composition of the phosphate buffer solution and of concentration of a well-known oxidant, AAPH. Three compositions of phosphate buffer solution are mixed with three concentrations of oxidant. The influence of these two parameters on hemolysis is independently studied by a variance analysis and a Kruskal-Wallis test when ANOVA is not available. The hemolysis rate increases with time at fixed oxidant concentration, but is not influenced by the composition of the buffer solution. The highest hemolysis rate, 90%, was only measured within 2 h with the highest oxidant concentration. If we retain this concentration of oxidant, the lower concentration of the buffer can by eliminated by a significant less hemolysis and the highest concentration of the buffer can by chosen in regard of the better precision for a similar hemolysis compared to the mean buffer. We hope to study the effect of anti-oxidant agent with such a model of erythrocytes.

Effects of an oxidative stress on human hemoglobin: a multiwavelength visible spectrometry study

This study was carried out to investigate hemoglobin behavior and the role of cell membrane during oxidative stress of human red blood cells induced by a water-soluble radical initiator, 2,2'-azobis(amidino-propane) hydrochloride (AAPH) and compare the observed data to the one obtained with purified human haemoglobin solution. The different forms of hemoglobin were identified and quantified by multiwavelength visible spectrometry using multiple linear regression analysis. Hemolysis was quantified by the Drabkin method. Oxidative stress on purified hemoglobin solutions induced an early formation of Hb(+). In intact erythrocytes, no modified form of haemoglobin was found. Only the hemoglobin released by hemolysis in the extracellular medium was notified in the same way as purified haemoglobin. Thus, the cell membrane appears to protect intraerythrocytic hemoglobin toward an extracellular oxidative stress. Oxidative stress-induced by hemolysis does not seem to be due to changes in intraerythrocytic hemoglobin forms.

Lidocaine has better antioxidant potential than ropivacaine and bupivacaine: in vitro comparison in a model of human erythrocytes submitted to an oxidative stress

BACKGROUND

Local anesthetic agents may exert antioxidant properties in various models. The aim of this work was to compare the antioxidant properties of lidocaine, bupivacaine and ropivacaine using an in vitro model of human erythrocytes submitted to an oxidative stress.

METHODS

Blood was obtained from healthy volunteers. After separation, erythrocytes were suspended in phosphate buffer. Oxidative stress was induced by incubation with 2,2'-azobis (2-amidinopropane) hydrochloride (AAPH). (1) Effects of four different concentrations (50, 100, 300 and 600 microg ml(-1)) of lidocaine, bupivacaine and ropivacaine were studied in absence or presence of AAPH (20 mM). Potassium efflux was assessed by flame photometry. (2) Effects of 50 and 600 microg ml(-1) of lidocaine, bupivacaine and ropivacaine on AAPH (50 mM) induced hemolysis were also studied. (3) The oxygen radical absorbing capacity of lidocaine, bupivacaine and ropivacaine at the four concentrations was evaluated by the analysis of the allophycocyanin fluorescence.

RESULTS

In absence of AAPH, neither extracellular potassium nor hemolysis was noted. AAPH (20 mM) induced a significant increase in extracellular potassium that was reduced by all local anesthetic agents, with greater effects for lidocaine. AAPH-induced hemolysis was significantly decreased by all the local anesthetic agents at higher concentration, but only by lidocaine at 50 microg ml(-1). Finally, none of the local anesthetic agents modified the allophycocyanin fluorescence.

CONCLUSION

In this model, lidocaine was proved more effective than bupivacaine and ropivacaine in protecting human erythrocytes submitted to an oxidative challenge. This was not due to a free radical scavenging effect.

The effect of local anesthetics and amitriptyline on peroxidation in vivo in an inflammatory rat model: preliminary reports

We studied the inhibition of peroxidation by local anesthetics in an inflammatory animal model. Inflammatory lipid peroxidation was assessed by the thiobarbituric assay in plasma from rats injected or not injected with carrageenan (Carra) and killed 1, 2, 4, 6, 12, and 24 h thereafter. Thiobarbituric acid reactive substances (TBARS) values in inflammatory animals were maximal 6 h after Carra administration. This result, in accordance with the evolution of paw edema width during time, supports that TBARS reflect the intensity of inflammation. Local anesthetics (bupivacaine, lidocaine, ropivacaine, or bupivacaine-loaded microspheres) or amitriptyline were injected in clinically relevant concentrations as a sciatic nerve block or intraperitoneally in inflamed animals. Ropivacaine did not exhibit any protective effect on Carra-induced lipid peroxidation in rats. With all the other drugs administered as a sciatic nerve block, the maximal TBARS increase was not observed at 6 h. Our conclusion is that bupivacaine (plain or encapsulated), lidocaine, and amitriptyline in clinically relevant concentrations administered via the sciatic nerve showed antioxidant properties toward lipid peroxidation induced by Carra inflammation. Intraperitoneal injection of those drugs gave the same effect as nerve block; this result suggests that their mechanism of action is not strictly limited to the nerve. IMPLICATIONS. We investigated the antioxidant effects of local anesthetics and amitriptyline in an inflammatory rat model. Amitriptyline exhibits antioxidant properties per se, whereas lidocaine and bupivacaine (plain or encapsulated) seem to inhibit the peroxidation process. This may have future application in limiting toxic oxygen metabolite production during the inflammatory process.