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Meek PD, Vlasses PH, Sura ME, Walsh RE, Vermeulen LC. Cost-offset analysis of aprotinin in high-risk coronary artery bypass. Pharm Pract Manag Q 1999; 19:18-25. [PMID: 10558092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Aprotinin, a naturally occurring protease inhibitor derived from bovine lung, is used prophylactically to minimize the amount of perioperative blood loss in patients undergoing coronary artery bypass graft surgery who are at high risk for excessive bleeding. A retrospective multicenter evaluation of aprotinin use was performed in high-risk coronary artery bypass graft patients treated either with aprotinin or according to usual-care to assess (1) differences in demographic and medical history characteristics, and (2) clinical and economic outcomes associated with their care. This study suggests that in many cases, the cost of aprotinin is offset by reductions in overall cost. Additional study is required to better understand this potential. In other cases, however, a more conservative approach to aprotinin use appears to be warranted.
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Affiliation(s)
- P D Meek
- University of Wisconsin Hospital and Clinics, Center for Drug Policy and Clinical Economics, Madison 53706, USA
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2
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Namovic MT, Walsh RE, Goodfellow C, Harris RR, Carter GW, Bell RL. Pharmacological modulation of eosinophil influx into the lungs of Brown Norway rats. Eur J Pharmacol 1996; 315:81-8. [PMID: 8960868 DOI: 10.1016/s0014-2999(96)00590-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A model of lung inflammation was developed in Brown Norway rats. Intense lung eosinophilia was induced by a single intravenous injection of Sephadex G-200 particles. The eosinophilia observed was preceded by an increase in cysteinyl leukotrienes found in lung lavage fluids. Theophylline and albuterol were tested in the model and found to be inactive, while dexamethasone was effective. Zileuton, a specific leukotriene inhibitor, was found to effectively inhibit leukotriene formation and the influx of eosinophils into the lungs of these Sephadex-treated animals. Studies with specific leukotriene D4 antagonists of the cysLT1 type receptor indicate that this leukotriene receptor is probably not involved directly in the eosinophilic inflammation. This model appears to be useful in characterizing potential anti-inflammatory effects of inhibitors by evaluating their ability to prevent eosinophil influx into the lung.
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Affiliation(s)
- M T Namovic
- AP9 Immunosciences Research Area, Department 47 K, Abbott Laboratories, Abbott Park, IL 60064, USA
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3
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Hulkower KI, Pollock JS, Walsh RE, Huang R, Otis ER, Brooks CD, Bell RL. Leukotrienes do not regulate nitric oxide production in RAW 264.7 macrophages. Prostaglandins Leukot Essent Fatty Acids 1996; 55:145-9. [PMID: 8931110 DOI: 10.1016/s0952-3278(96)90089-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
RAW 264.7 macrophages respond to lipopolysaccharide (LPS) and interferon-gamma (IFN-gamma) by producing large amounts of nitric oxide (NO) and prostaglandin E2 (PGE2), with maximal production 18-24 h after treatment. Following stimulation with the calcium inophore A23187, cultures of RAW cells also produce modest amounts of leukotrienes. However, the capacity of these cells to produce leukotrienes is transient, beginning 2 h after vehicle or LPS/IFN-gamma treatment, peaking by 4-6 h and absent by 8 h. A-79175, (R(+) N-[3-[5-(4-Fluorophenoxy)-2-furanyl]-1-methyl-2-propynyl]-N-hydroxyurea) a specific inhibitor of 5-lipoxygenase (5-LO), abolished leukotriene production by RAW cells in a dose-dependent, non-cytotoxic fashion while having no effect on PGE2 or NO production. By contrast, nordihydroguaiaretic acid (NDGA) inhibited production of leukotrienes, PGE2 and NO only at doses that were cytotoxic to the RAW cells. Exogenous leukotriene B4 (LTB4) had no effect on either NO or PGE2 production. An inhibitor of NO production, L-N-5-(1-iminoethyl) ornithine HCl (NIO) also did not affect leukotriene or PGE2 production, while dexamethasone blocked PGE2 and NO production, but did not affect leukotriene production in these cells. Taken collectively, these results indicate that there is no interaction between the pathways for leukotriene and nitric oxide production in RAW 264.7 macrophages.
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Affiliation(s)
- K I Hulkower
- Abbott Laboratories, Immunosciences Research, Abbott Park, IL 60064-3500, USA
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4
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Tsai BS, Keith RH, Perkins WE, Walsh RE, Anglin CP, Collins PW, Gasiecki AW, Bauer RF, Jones PH, Gaginella TS. Preferential binding of the novel prostaglandin SC-46275 to canine gastric versus intestinal receptors. J Pharmacol Exp Ther 1995; 275:368-73. [PMID: 7562572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Prostaglandins (PGs) in the E-series exhibit potent gastric antisecretory activity, but can also cause diarrhea, which is mediated via PGE receptors. SC-46275, an omega-chain cyclopentenyl analog of the E-type PG enisoprost, was evaluated with other E-PGs for PGE receptor binding activity in gastric and intestinal tissues. SC-46275, enisoprost, misoprostol and PGE1 were first evaluated in enriched canine gastric parietal cells with [3H]misoprostol free acid binding and subsequently with [3H]PGE1 binding in canine intestinal tissues where misoprostol free acid had weak receptor binding activity. The receptor binding potency of SC-46275 (IC50, 0.013 mM) in enriched canine parietal cell preparations was found to be much greater than misoprostol and enisoprost (IC50, 10 and 8 nM), whereas PGE1 had the least potency (IC50, 37 nM). Similar relative potencies for these PGs were also obtained in the inhibition of histamine-stimulated acid secretion in enriched parietal cell preparations. In small intestinal mucosal and muscle membranes, the receptor binding potency of SC-46275 (IC50, 13 and 20 microM) was much less than misoprostol or enisoprost (IC50, 0.39-1.2 microM) and substantially less than PGE1 (IC50, 0.017 and 0.066 microM). This weak binding activity of SC-46275 in intestinal tissues is consistent with its reported weak diarrheagenic activity in the rat. These results suggest that SC-46275 binds preferentially to gastric vs. intestinal PGE receptors and is specific for the EP3 receptors.
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Affiliation(s)
- B S Tsai
- Department of Immunoinflammatory Diseases Research, Searle Research and Development, Skokie, Illinois, USA
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5
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Fretland DJ, Widomski DL, Anglin CP, Walsh RE, Levin S, Gasiecki AF, Collins PW. Mucosal protective activity of prostaglandin analogs in rodent colonic inflammation. Inflammation 1992; 16:623-9. [PMID: 1334049 DOI: 10.1007/bf00919345] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The mucosal protective prostaglandin analogs misoprostol, enisoprost, and SC-46275 (the 17E-18-cyclopentenyl analog of enisoprost) were tested in mouse and rat colitis induced by the intrarectal instillation of dilute acetic acid. Colitis was assessed by histology and colonic levels of myeloperoxidase (a neutrophil marker enzyme). When given as enemas 30 min ahead of colitis induction, 15(R)-15-methyl-PGE2 (arbaprostil) and 15(S)-15-methyl-PGE1 were inactive; however, misoprostol, enisoprost, and SC-46275 protected against colonic inflammation with ED50 values of 24, 12 and 1.3 micrograms/kg, respectively, in rats and 11, 5, and 1 micrograms/kg, respectively, in mice. These compounds may have utility in the medical management of human inflammatory bowel disease.
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Affiliation(s)
- D J Fretland
- Department of ImmunoInflammatory Diseases Research, Searle Research and Development, Skokie, Illinois 60077
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Affiliation(s)
- T S Gaginella
- Gastrointestinal Diseases Research, Searle Research and Development, Skokie, Illinois 60077
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Villani-Price D, Yang DC, Walsh RE, Fretland DJ, Keith RH, Kocan G, Kachur JF, Gaginella TS, Tsai BS. Multiple actions of the leukotriene B4 receptor antagonist SC-41930. J Pharmacol Exp Ther 1992; 260:187-91. [PMID: 1309871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
7-[3-(4-acetyl-3-methoxy-2-propylphenoxy)-propoxy]-3,4-dihydro-8- propyl-2H-1-benzopyran-2-carboxylic acid (SC-41930), a leukotriene B4 (LTB4) receptor antagonist with anti-inflammatory activity in animal models of colitis, was evaluated for effects on superoxide, LTB4 and prostaglandin E2 production. SC-41930 inhibited human neutrophil (PMN) superoxide generation maximally stimulated by f-Met-Leu-Phe (IC50 4 microM) and C5a (IC50 approximately 12 microM). Moreover, postreceptor stimulation of superoxide production by NaF (a G protein activator), but not by phorbol myristate acetate, was significantly inhibited by SC-41930, indicating that SC-41930 may act via attenuation of a G protein-mediated signal transduction. SC-41930 also inhibited A23187-stimulated LTB4 production (IC50 5.3 microM) in human PMN as well as LTB4 (IC50 2.1 microM) and prostaglandin E2 (IC50 2.9 microM) production in HL-60 cells. When coinjected intradermally (400 micrograms/site), SC-41930 inhibited A23187-stimulated increases in LTB4 levels in guinea pig skin. SC-41930 inhibited human synovial phospholipase A2 (IC50 72 microM), A23187-stimulated 5-hydroxy-eicosatetranoic acid production in human PMN (IC50 8.5 microM), and rat peritoneal leukotriene A4 hydrolase (IC50 20 microM), but not ram seminal vesical cyclooxygenase. The results suggest that the anti-inflammatory activity of SC-41930 could be attributed to postreceptor inhibition of inflammatory mediator production by PMN and other cells in addition to antagonism of PMN LTB4 receptors.
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Affiliation(s)
- D Villani-Price
- Gastrointestinal Diseases Research, Searle Research and Development, Skokie, Illinois
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Affiliation(s)
- R E Walsh
- Gastrointestinal Diseases Research, Searle Research and Development, Skokie, IL 60077
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Widomski DL, Walsh RE, Baron DA, Hidvegi MI, Fretland DJ, Collins PW, Gaginella TS. Effects of the prostaglandin analogue misoprostol on inflammatory mediator release by human monocytes. Agents Actions 1991; 34:30-1. [PMID: 1793047 DOI: 10.1007/bf01993229] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The effect of misoprostol (M) on IL-1 beta, TNF-alpha, and lipid mediator release (assessed by RIA) by adherent (assessed by electron microscopy) human monocytes were studied in vitro. Human monocytes stimulated with E. Coli-derived lipopolysaccharide showed an increase in both IL-1 beta and TNF-alpha release. Incubation of the monocytes with LPS and M (18 hrs.), resulted in a reduction of both IL-1 beta and TNF-alpha levels. Leukotriene B4 levels did not increase in response to LPS or M. LPS also caused an increase in thromboxane (TXB2). M decreased TXB2 levels. 6-keto PGF1 alpha (6KP). Incubation with LPS and M stimulated release. LPS caused an increase in PGE2 levels. M (100 microM) caused an increase in PGE2 levels, M (1 microM) had no effect on PGE2. These data suggest a possible immunomodulatory role for misoprostol in inflammatory diseases.
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Affiliation(s)
- D L Widomski
- Searle Research and Development, Skokie, IL 60077
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10
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Clapp NK, Henke MA, Hansard RM, Walsh RE, Widomski DL, Anglin CP, Fretland DJ, Gaginella TS. Inflammatory mediators in cotton-top tamarins (CTT) with acute and chronic colitis. Agents Actions 1991; 34:178-80. [PMID: 1665291 DOI: 10.1007/bf01993271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Spontaneous colitis in CTT's presents cytological characteristics similar to chronic ulcerative colitis in humans, e.g. inflammatory cell infiltrate and crypt abscesses. To better characterize CTT colitis as a potential model for human inflammatory bowel disease (IBD), inflammatory mediators identified in colonic tissue of human IBD patients and/or experimental colitis models were assayed. Inflammatory mediator changes in plasma and colon from tamarins with acute (n = 10) and chronic (n = 10) colitis (by mucosal biopsy) were assayed by RIAs. Similar inflammatory mediators were found in the CTT's with acute colitis. In the plasma, PAF and PGE2 levels were lower in acute colitis CTT's, no LTB4 was detected, and histamine levels were not different from chronic colitic animals. In the colon, myeloperoxidase and interleukin-1 beta were significantly higher in acute colitis, PGE2 and LTB4 were higher but not significantly, and PAF was not different from chronic CTT's. These data suggest that a combination of events are occurring in the pathogenesis of tamarin colitis that involves some of the same mediators that are found in the human disease and in other experimental models. The importance of these findings to human IBD remains for further investigation; however, the spontaneous primate model offers an exciting approximation of the disease development and merits further investigation for understanding the pathogenesis of human IBD as well as to aid in development of targeted therapeutics.
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Affiliation(s)
- N K Clapp
- Marmoset Research Center, Oak Ridge Associated Universities, TN 37831
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Fretland DJ, Widomski DL, Anglin CP, Walsh RE, Levin S, Gaginella TS. 6-trans-leukotriene B4 is a neutrophil chemotaxin in the guinea pig dermis. J Leukoc Biol 1991; 49:283-8. [PMID: 1847716 DOI: 10.1002/jlb.49.3.283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The products of the 5- and 12-lipoxygenase (5-LO, 12-LO) pathways of arachidonic acid metabolism are implicated as proinflammatory mediators in a number of disease states. 12(R)-hydroxyeicosatetraenoic acid [12(R)-HETE] is present in large quantities in human psoriatic lesional skin and can be further metabolized by 5-LO to 5(S), 12(R)-dihydroxy-(6E,8Z,10E,14Z)-eicosatetraenoic acid (6-trans-LTB4). Furthermore, leukotriene B4 (LTB4) and the sulfidopeptide leukotrienes (LTC4, LTD4) can be transformed to 6-trans-LTB4. When injected into the guinea pig dermis, 6-trans-LTB4 (1.0, 10.0, 20.0 micrograms/intradermal site) caused a significant (P less than 0.02) infiltration of polymorphonuclear leukocytes (PMN) at 4 hr as assessed by histology and the levels of the PMN marker enzyme myeloperoxidase. 6-trans-LTB4 is a more potent PMN chemoattractant than 12(R)-HETE in the guinea pig dermis but is far less potent than LTB4. Pharmacological interdiction of leukotriene production or receptor binding should take into account the proinflammatory activity of 6-trans-LTB4.
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Affiliation(s)
- D J Fretland
- Gastrointestinal Diseases Research, G.D. Searle and Co., Skokie, Illinois 60077
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Fretland DJ, Widomski DL, Zemaitis JM, Walsh RE, Levin S, Djuric SW, Shone RL, Tsai BS, Gaginella TS. Inflammation of guinea pig dermis. Effects of leukotriene B4 receptor antagonist, SC-41930. Inflammation 1990; 14:727-39. [PMID: 1965311 DOI: 10.1007/bf00916375] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Neutrophil (PMNL) infiltration is a prominent feature of human psoriasis. Psoriatic skin lesions contain abnormally high amounts of leukotriene B4 (LTB4), itself a potent PMNL chemoattractant both in vivo and in vitro. SC-41930 (7-[3-(4-acetyl-3-methoxy-2-propylphenoxy)-propoxy]-3,4-dihydro-8- propyl-2H-1-benzopyran-2-carboxylic acid), an orally active LTB4 receptor antagonist, was tested topically in models of skin inflammation induced by 200 nmol of the calcium ionophore A23187 or 200 micrograms phorbol-12-myristate-13-acetate (PMA) applied topically to the guinea pig ear as assessed by ear weight, levels of the PMNL marker enzyme myeloperoxidase (MPO), and histological examination (PMA model) at 4 and 18 h respectively. When coapplied topically with A23187 or PMA, SC-41930 significantly inhibited epidermal inflammation with ED50 values of 0.6 and 4 mg, respectively. SC-41930 treatment also was associated with lowered dermal LTB4 levels in both models. The PMA-induced skin inflammation model also was assessed histologically and revealed acanthosis, edema, PMNL infiltration, and rete ridge prominence as long as 96 h after a single application that was completely inhibited by SC-41930 topical coapplication. Furthermore, oral treatment (40 mg/kg) significantly reduced edema and inflammatory cell infiltration in both models. These models possess many of the characteristics of human psoriasis, and agents such as SC-41930 that demonstrate activity in these models may well have therapeutic utility in the treatment of human psoriasis.
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Affiliation(s)
- D J Fretland
- Department of Gastrointestinal Diseases, Searle Research and Development, Skokie, Illinois
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Walsh RE, Bonnet JD, Kroening PM, Peterson RF, Brindley GV. Primary malignant pulmonary tumors in the older patient. Clin Geriatr Med 1985; 1:423-31. [PMID: 3006904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The incidence of lung cancer, the most common visceral malignancy, is increasing in the elderly patient. Careful preoperative preparation and postoperative care will allow some of these patients to have surgical resections. Radiotherapy and chemotherapy offer benefits for those patients who cannot have a curative surgical resection.
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Brindley GV, Walsh RE, Schnarr WT, Allen GW, Mendenhall MK, Ahlgren EW. Pulmonary resection in patients with impaired pulmonary function. Surg Clin North Am 1982; 62:199-214. [PMID: 7071689 DOI: 10.1016/s0039-6109(16)42679-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Spivey CG, Walsh RE, Perez-Guerra F, Harkleroad LE. Central airway obstruction. Report of seven cases. JAMA 1973; 226:1186-9. [PMID: 4800496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Walsh RE, Michaelson ED, Harkleroad LE, Zighelboim A, Sackner MA. Upper airway obstruction in obese patients with sleep disturbance and somnolence. Ann Intern Med 1972; 76:185-92. [PMID: 5009589 DOI: 10.7326/0003-4819-76-2-185] [Citation(s) in RCA: 81] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Perez-Guerra F, Walsh RE, Sagel SS. Bronchiolitis obliterans and tracheal stenosis. Late complications of inhalation burn. JAMA 1971; 218:1568-70. [PMID: 5171144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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20
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Rosen RA, Dalinka MK, Gralino BJ, Goldenberg DB, Walsh RE. The roentgenographic findings in alpha-1 antitrypsin deficiency (AAD). Radiology 1970; 95:25-8. [PMID: 5417043 DOI: 10.1148/95.1.25] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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