Increase in plasma levels of adenosine and adenine nucleotides after intravenous infusion of buflomedil in humans

The Human Platelet as an Innate Immune Cell: Interactions Between Activated Platelets and the Complement System

Platelets play an essential role in maintaining homeostasis in the circulatory system after an injury by forming a platelet thrombus, but they also occupy a central node in the intravascular innate immune system. This concept is supported by their extensive interactions with immune cells and the cascade systems of the blood. In this review we discuss the close relationship between platelets and the complement system and the role of these interactions during thromboinflammation. Platelets are protected from complement-mediated damage by soluble and membrane-expressed complement regulators, but they bind several complement components on their surfaces and trigger complement activation in the fluid phase. Furthermore, localized complement activation may enhance the procoagulant responses of platelets through the generation of procoagulant microparticles by insertion of sublytic amounts of C5b9 into the platelet membrane. We also highlight the role of post-translational protein modifications in regulating the complement system and the critical role of platelets in driving these reactions. In particular, modification of disulfide bonds by thiol isomerases and protein phosphorylation by extracellular kinases have emerged as important mechanisms to fine-tune complement activity in the platelet microenvironment. Lastly, we describe disorders with perturbed complement activation where part of the clinical presentation includes uncontrolled platelet activation that results in thrombocytopenia, and illustrate how complement-targeting drugs are alleviating the prothrombotic phenotype in these patients. Based on these clinical observations, we discuss the role of limited complement activation in enhancing platelet activation and consider how these drugs may provide opportunities for further dissecting the complex interactions between complement and platelets.

Adenosine and chronic ischemia of the lower limbs

Adenosine is an endogenous nucleoside with multiple biological properties which plays a central role in the pathophysiology of tissue ischemia. Adenosine signals an imbalance between oxygen demand and supply, and it initiates responses to redress such a discrepancy. Besides its vasodilating properties, adenosine possesses anti-platelet and anti-neutrophil activities and provides cytoprotection. Adenosine is presumably the main mediator of the preconditioning phenomenon. During ischemia of the lower limbs, adenosine plays a physiological role by inducing vasodilatation and by preventing microcirculatory failure. Exercise training prolongs claudication distance possibly by inducing pulse increases of adenosine and consequently skeletal muscle preconditioning. Moreover, the adenosine increase which follows the administration of some drugs, such as buflomedil and propionylcarnitine, opens new perspectives in the management of leg ischemia. In fact, the concept arises of an ischemic (exercise-dependent) or pharmacologic preconditioning in the treatment of patients with claudication.

The Latest Advance in Hair Regeneration Therapy Using Proteins Secreted by Adipose-Derived Stem Cells

Introduction:

Adipose-derived stem cells (ADSCs) that can be harvested from fat cells are one of the latest breakthroughs in the aesthetic field. In addition, basic studies have reported that ADSC conditioned medium (ADSC-CM) promotes skin and hair regeneration. We validate our novel approach, known as hair regenerative therapy, for hair growth treatment using ADSC-CM.

Materials and Methods:

ADSCs were cultured and expanded in hypoxic culture conditions, and ADSC-CM was collected. ADSC-CM includes various cytokines and growth factors that influence hair regrowth, to which we added buflomedyl, cysteine, coenzyme Q10, and vitamins. Protein solution from ADSC-CM was applied 4 to 6 times every 3 to 5 weeks by mesotherapy techniques such as nappage and papule injections. Satisfactory results of hair regenerative therapy in 12 women and 13 men were determined with a visual analog scale.

Results:

All patients experienced increased hair growth from the treatments with ADSC-CM. Four treatment sessions performed within 3 to 4 months provided especially good results. Scores on the visual analog scale increased with treatment frequency. Statistical significance was determined by Friedman's 2-way analysis of variance (P < .01) and Wilcoxon's signed rank test (P < .01).

Discussion:

ADSCs secrete cytokines, such as keratinocyte growth factor, vascular endotheliatl growth factor, platelet-derived growth factor, hepatocyte growth factor. Those cytokines and growth factor are very important for hair growth. Our new therapy with ADSC-CM does not require specialized facilities, such as a cell-processing center, and can be a valuable treatment.

Human plasma ATP concentration

BACKGROUND

Human plasma ATP concentration is reported in many studies as roughly 1000 nmol/L. The present study tested the hypothesis that the measured plasma ATP concentration is lower if ATP release from formed blood elements is inhibited during blood sample processing. A second hypothesis was that pretreatment with aspirin to inhibit platelets would reduce the measured plasma concentration of ATP.

METHODS

Blood was sampled from the antecubital vein in 20 healthy individuals 30 and 60 min after ingestion of aspirin (325 mg) or placebo. Aliquots of each blood sample were added to the usual EDTA/saline solution to inhibit ATP catabolism, or to a new stabilizing solution designed to both stop ATP catabolism and inhibit ATP release from blood elements. The stabilizing solution contained NaCl, EDTA, tricine buffer, KCl, nitrobenzylthioinosine, forskolin, and isobutylmethylxanthine. Plasma ATP was measured with the luciferin-luciferase assay with standard additions in each sample to determine ATP content. Hemoglobin concentration was used as an index of sample hemolysis, and the plasma ATP concentration was corrected for the hemolysis component.

RESULTS

Aspirin pretreatment had no effect on plasma ATP concentrations. However, use of the stabilizing solution resulted in mean (SD) ATP concentrations 8-fold lower than the use of EDTA alone [28 (16) vs 236 (201) nmol/L; P <0.001].

CONCLUSION

When precautions are taken to inhibit ATP release from blood elements during sample preparation, human venous plasma ATP concentration is much lower than previously reported.

Cyclic GMP-dependent relaxation of isolated rat renal glomeruli induced by extracellular ATP

The relaxing effect of extracellular ATP on renal glomeruli has been investigated by applying ATP and its analogues to suspensions of angiotensin II-precontracted rat renal glomeruli. Based on changes of glomerular [3H]inulin space (GIS) the relaxation of glomeruli was analysed in the presence of agonists: ATP, ADP, AMP, UTP, 2-methylthio-ATP (P2Y agonist), beta,gamma-methylene-ATP (P2X agonist) and adenosine. ATP, 2-methylthio-ATP, ADP and UTP induced concentration-dependent relaxation whereas AMP, beta,gamma-methylene-ATP and adenosine had no effect. The rank order of relaxation potency was 2-methylthio-ATP > ATP > ADP > UTP. An inhibitor of constitutive nitric oxide synthase (NOS), Nomega-nitro-L-arginine (NNA) prevented the ATP-induced increased accumulation of L-citrulline and the relaxation effect of ATP. An inhibitor of the neuronal isoform of NOS, 7-nitroindazole, had no effect on the relaxation effect of ATP. The relaxing effect of ATP was prevented in the presence of inhibitors of cyclic guanylyl cyclase: methylene blue (MB) and the more specific inhibitor 1H-[1,2,4]oxadiazolo-[4,3-a]quinoxalin-1-one (ODQ). ATP stimulated an accumulation of cGMP that was diminished in the presence of MB. We indicated that extracellular ATP may relax the glomeruli via activation of P2Y receptors with the subsequent activation of the endothelial isoform of nitric oxide synthase and soluble guanylyl cyclase. We suggest that, based on the described mechanism, extracellular ATP may increase the filtration surface which, in turn, may influence the glomerular filtration rate.

Assessment of collateral perfusion: a pharmacodynamic study with buflomedil hydrochloride

The aim of the study was to assess the influence of Buflomedil hydrochloride on collateral function. Ten patients with isolated superficial femoral occlusions were investigated twice by duplex sonography with measurement sites at the common femoral artery (CF) and the popliteal artery (PA). After the second scan 200 mg of Buflomedil hydrochloride were infused; the infusion was followed by a third duplex examination. Endpoints assessed included the arterial diameter (D(CF), D(PA)), the systolic peak velocity (Vmax), the mean velocity of the maximum envelope (Vmean m.e.), the intensity weighted time average mean velocity (Vmean i.w.), the maximum reverse flow velocity (Vrev), the end-diastolic velocity (Venddiast), the calculated volume flow (Q), the pulsatility and the resistance indices (PI, RI), and PI and RI based segmental damping factors (DF(PI), DF(RI)). For the CF measurement site the infusion of Buflomedil hydrochloride resulted in a significant reduction in Vrev and PI (p<0.05), whereas trends in the opposite direction (increase) were observed for both measures of Vmean and for Q (0.1<p<0.05). No significant changes were reported for the PA measurement site. DF(PI) numerically decreased (0.1<p<0.05). The pattern of changes suggest that Buflomedil hydrochloride induces collateral vasodilation and thus improves collateral function.