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Kilicaslan B, Akinci SB, Saricaoglu F, Yılbas SO, Ozkaya BA. Effects of coenzyme Q10 in a propofol infusion syndrome model of rabbits. ASIAN BIOMED 2023; 17:173-184. [PMID: 37860674 PMCID: PMC10584382 DOI: 10.2478/abm-2023-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
Background Coenzyme Q (CoQ) might be the main site of interaction with propofol on the mitochondrial respiratory chain in the propofol infusion syndrome (PRIS) because of the structural similarity between coenzyme Q10 (CoQ10) and propofol. Aim To investigate the effects of CoQ10 on survival and organ injury in a PRIS model in rabbits. Methods Sixteen male New Zealand white rabbits were divided into 4 groups: (1) propofol infusion group, (2) propofol infusion and CoQ10, 100 mg/kg was administered intravenously, (3) sevoflurane inhalation was administered, and (4) sevoflurane inhalation and CoQ10, 100 mg/kg intravenously, was administered. Arterial blood gas and biochemical analyses were repeated every 2 h and every 12 h, respectively. Animals that were alive on the 24th hour after anesthesia induction were euthanized. The organ damages were investigated under light and transmission electron microscopy (TEM). Results The propofol infusion group had the highest troponin T levels when compared with the other three groups at the 12th hour. The propofol + CoQ10 group had lower troponin T levels when compared with the propofol and sevoflurane groups (P < 0.05). Administration of CoQ10 decreased total liver injury scores and total organ injury scores both in the propofol and sevoflurane groups. The propofol and sevoflurane organ toxicities were attenuated with CoQ10 in liver, gallbladder, urinary bladder, and spleen. Conclusion The addition of CoQ10 to propofol and sevoflurane anesthesia prevented the propofol-associated increase in troponin T levels at the 12th hour of infusion and decreased anesthetic-induced total liver and organ injury scores.
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Affiliation(s)
- Banu Kilicaslan
- Department of Anesthesiology and Intensive Care, Hacettepe University, Ankara06230, Turkey
| | - Seda B Akinci
- Department of Anesthesiology and Intensive Care, Hacettepe University, Ankara06230, Turkey
| | - Fatma Saricaoglu
- Department of Anesthesiology and Intensive Care, Hacettepe University, Ankara06230, Turkey
| | - Savas O Yılbas
- Department of Anesthesiology and Intensive Care, Hacettepe University, Ankara06230, Turkey
| | - Burcu A Ozkaya
- Department of Anesthesiology and Intensive Care, Hacettepe University, Ankara06230, Turkey
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Rasul A, Imran Khan M, Ur Rehman M, Abbas G, Aslam N, Ahmad S, Abbas K, Akhtar Shah P, Iqbal M, Ahmed Al Subari AM, Shaheer T, Shah S. In vitro Characterization and Release Studies of Combined Nonionic Surfactant-Based Vesicles for the Prolonged Delivery of an Immunosuppressant Model Drug. Int J Nanomedicine 2020; 15:7937-7949. [PMID: 33116510 PMCID: PMC7569247 DOI: 10.2147/ijn.s268846] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background Cyclosporine A (CsA) is an exceptional immunosuppressant used for the treatment of immune disorders. Niosomal vesicles are promising drug carriers that are formed by self-association of nonionic surfactants and cholesterol in an aqueous phase. The objective of the study was to formulate combined nonionic surfactant based vesicles and to evaluate their in vitro characterization, release studies and in vivo studies. Materials and Methods Five niosomal formulations (F7 to F11) were prepared using the thin film hydration method. The molar ratio of cholesterol and non-ionic surfactant taken was 1:1. In formulation F10, the combination of surfactants Span 20 and Brij 35 was used. The niosomes were characterized by zeta sizer and SEM for particle size analysis, in vitro drug release and stability studies. The pharmacokinetic studies were conducted on healthy albino rabbits. Results The size of niosome was found in the range of 427.1 nm to 972.3 nm. SEM image of optimized formulations F10 exhibit the spherical nature of niosomal vesicles. DSC thermograms of niosomal formulations exhibited a broadened endothermic peak. The stability study exhibited that all formulations are stable and negligible change of vesicle size and entrapment was observed with time. The percentage drug release was significantly higher as compared to CsA plain dispersion for all niosomal formulations at pH 1.2 and 7.4. The release kinetic behavior showed that all preparations were best described by zero order and can release active ingredient in a sustained manner. The pharmacokinetic data showed the test formulation (F10) possessed greater bioavailability as compared to the reference formulation (CsA aqueous dispersion). Conclusion The formulation F10 demonstrated a comparatively more delayed rate of release with enhanced dissolution as compared to a single surfactant scheme. The F10 formulation can be a remarkable nanotechnology for prolonged delivery of CsA orally with improved dissolution profile and bioavailability.
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Affiliation(s)
- Akhtar Rasul
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Imran Khan
- Riphah Institute of Pharmaceutical Sciences, Riphah International University, Lahore Campus, Lahore, Pakistan
| | - Mujeeb Ur Rehman
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Ghulam Abbas
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Nosheen Aslam
- Department of Biochemistry, Government College University, Faisalabad, Pakistan
| | - Shabbir Ahmad
- Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macau, People's Republic of China
| | - Khizar Abbas
- Department of Pharmacognosy, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | | - Muhammad Iqbal
- Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | | | - Talal Shaheer
- Department of Pharmacognosy, Xian Jiaotong University, Xian, People's Republic of China
| | - Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
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Liu YH, Qiu DJ, Jia L, Tan JT, Kang JM, Xie T, Xu HM. Depth of anesthesia measured by bispectral index and postoperative mortality: A meta-analysis of observational studies. J Clin Anesth 2019; 56:119-125. [DOI: 10.1016/j.jclinane.2019.01.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 11/25/2022]
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Herminghaus A, Buitenhuis AJ, Schulz J, Vollmer C, Scheeren TWL, Bauer I, Picker O, Truse R. Propofol improves colonic but impairs hepatic mitochondrial function in tissue homogenates from healthy rats. Eur J Pharmacol 2019; 853:364-370. [PMID: 31009637 DOI: 10.1016/j.ejphar.2019.04.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 11/24/2022]
Abstract
Evidence suggests that propofol infusion syndrome (PRIS) is caused by an altered mitochondrial function. The aim of this study was to examine the effects of propofol and the vehicle MCT on mitochondrial function in hepatic and colonic tissue. Mitochondrial oxygen consumption was determined in colon and liver homogenates after incubation with buffer (control), propofol (50, 75, 100, 500 μM) or the carrier substances DMSO and MCT. State 2 (substrate-dependent) and state 3 (ADP-dependent respiration) were assessed. RCI (respiratory control index) - an indicator for coupling between electron transport chain system (ETS) and oxidative phosphorylation (OXPHOS) and ADP/O ratio - a parameter for efficacy of OXPHOS were calculated. Data were presented as % of control. In hepatic mitochondria, 500 μM propofol reduced RCI formulation-independently (propofol/MCT 500 μM: complex I: 66.3 ± 8.7%*, complex II: 75.5 ± 9.2%*; propofol/DMSO 500 μM: complex I: 29.1 ± 8.8%*, complex II: 49.3 ± 15.5%*). 75 μM Propofol/MCT reduced ADP/O for complex I (73.5 ± 27.3%*). DMSO did not affect hepatic mitochondria whereas MCT reduced RCI for complex II (87.2 ± 9.8%*) and ADP/O for complex I (93.7 ± 31.7%*). In colon 50 μM Propofol/MCT increased RCI for complex I and II (complex I: 127.2 ± 10.7%*, complex II: 136.8 ± 33.9%*) and 100 μM Propofol/MCT for complex I (131.4 ± 18.7%*). 500 μM Propofol/DMSO increased ADP/O for complex I (139.4 ± 41.4%*). DMSO did not affect RCI but increased ADP/O for both complexes (complex I: 119.9 ± 25.8%*, complex II: 110.2 ± 14.2%*). MCT increased RCI for complex I (123.0 ± 31.6%*). In hepatic mitochondria propofol uncoupled ETS from OXPHOS formulation-independently and propofol/MCT reduced efficacy of OXPHOS. In colonic mitochondria, propofol/MCT strengthened the coupling and propofol/DMSO enhanced the efficacy of OXPHOS.
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Affiliation(s)
- Anna Herminghaus
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - A Johannes Buitenhuis
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - Jan Schulz
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - Christian Vollmer
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - Thomas W L Scheeren
- Department of Anaesthesiology, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, the Netherlands.
| | - Inge Bauer
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - Olaf Picker
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
| | - Richard Truse
- Department of Anaesthesiology, University of Duesseldorf, Moorenstrasse 5, 40225, Duesseldorf, Germany.
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Schroeppel TJ, Clement LP, Barnard DL, Guererro W, Ferguson MD, Sharpe JP, Magnotti LJ, Croce MA, Fabian TC. Propofol Infusion Syndrome: Efficacy of a Prospective Screening Protocol. Am Surg 2018. [DOI: 10.1177/000313481808400848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Propofol infusion syndrome (PIS) is a potentially lethal complication of propofol marked by rhabdomyolysis, metabolic acidosis, and cardiac arrhythmias or collapse. The objective of this study was to determine the effectiveness of a prospective screening protocol to prevent PIS. All trauma patients admitted who received propofol as a continuous infusion were prospectively screened from November 1, 2013 to December 31, 2015. Variables studied included demographics, injury severity, laboratory values, infusion rates, and mortality. Serum creatine phosphokinase (CPK) and lactate were drawn daily. Propofol was stopped for a positive screen defined as an increase in CPK to greater than 5000 IU/L or lactate greater than 4 mmol/L. Positive and negative cohorts were compared. Two hundred and twenty-five patients met the inclusion criteria and 12 patients (5.3%) had propofol stopped because of elevated CPK. No differences were identified in demographics, transfusions, injury severity, hospital length of stay, or propofol dose. The positive screened group had longer intensive care unit length of stay (20 vs 13 days; P = 0.002) and increased vent days (14.5 vs 10 days; P = 0.008). Max serum osmolality (334 vs 305 mosm/kg; P = 0.049) and max serum CPK (6782 vs 1058 IU/L; P < 0.0001) were higher in the positive cohort. No cases of PIS occurred, and mortality (16.7 vs 15.5%; P = 0.999) was not different between the cohorts. The screening protocol was effective in eliminating PIS. Serial CPK evaluations provided an effective screening tool and serum lactate can be dropped from screening.
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Affiliation(s)
- Thomas J. Schroeppel
- Departments of Surgery, University of Colorado Health-Memorial Hospital, Colorado Springs, Colorado
| | - L. Paige Clement
- Departments of Pharmacy, University of Colorado Health-Memorial Hospital, Colorado Springs, Colorado
| | - Danielle L. Barnard
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Whitney Guererro
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Margaret D. Ferguson
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - John P. Sharpe
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Louis J. Magnotti
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Martin A. Croce
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Timothy C. Fabian
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee
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Zorrilla-Vaca A, Healy RJ, Wu CL, Grant MC. Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies. Can J Anaesth 2017; 64:597-607. [DOI: 10.1007/s12630-017-0872-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 12/12/2016] [Accepted: 03/21/2017] [Indexed: 11/28/2022] Open
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