Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tonin is an enzyme of the serine protease family present in different rat tissues which releases angiotensin II (AII) directly from angiotensinogen and the tetradecapeptide renin substrate and from angiotensin I (AI). Tonin potentiates the effect of norepinephrine (NE) in the rat mesenteric artery preparation and in the aortic strips from normal and hypertensive rats. In rabbit aortic and mesenteric artery strips tonin potentiates the effect of NE, almost doubling its response. A similar effect was observed on the KCl and AII-induced contraction. This tonin-induced potentiation is reversible and long-lasting, persisting for 1 to 2 hours after being added into the tissue bath. In 75% of the vascular strips assayed, tonin elicited a contraction with a short latency period and with a maximum tension ranging from a few milligrams to over 1 g. To clarify the mechanisms of tonin effect on vascular smooth muscle, a variety of agents have been used. Neither indomethacin, saralasin, nor alpha- or beta-adrenergic blockers changed the direct contraction or the potentiation induced to NE. Db-cAMP and theophylline blocked the potentiation to the response to NE. A Ca2+-free medium, La3+, and verapamil produced a 75% inhibition of the direct tonin-induced contraction. Papaverine, isoproterenol, and theophylline relaxed the same contraction. Enzymatic inactivation of tonin blocked completely the direct contraction but not the potentiation to NE. These experiments suggest that the vasoactive effect of tonin may be mediated by the release of intracellular-bound calcium, an effect dependent on a proteolytic effect of tonin, and by increasing the cellular permeability to calcium, which is not of a proteolytic effect. It is suggested that tonin remains attached to the vascular strips by mechanisms as yet not clarified.
Hypertension
PMID:Effects of tonin, an angiotensin II-forming enzyme, on vascular smooth muscle in the normal rabbit. 626 53

The effects of age, atherosclerosis, hypertension, and hypercholesterolemia on vascular function of the coronary circulation were studied by subselective intracoronary infusions of acetylcholine, which releases endothelium-derived relaxing factor, and papaverine, which directly relaxes vascular smooth muscle, in normal patients (n = 18; no risk factors for coronary artery disease), in patients with evidence of early atherosclerosis but normal cholesterol levels and normal blood pressure (n = 12), in patients with hypertension without left ventricular hypertrophy (n = 12), and in patients with hypercholesterolemia (n = 20). Papaverine-induced maximal increases in coronary blood flow were significantly greater in normals, but no differences were noted between the groups of patients with early atherosclerosis, with hypertension, and with hypercholesterolemia. The capacity of the coronary system to increase blood flow in response to acetylcholine was similar in normal and normocholesterolemic patients with epicardial atherosclerosis and/or hypertension but was significantly impaired in patients with hypercholesterolemia, irrespective of evidence of epicardial atherosclerotic lesions. Age (r = -0.62, P < 0.0001) and total serum cholesterol levels (r = -0.70; P < 0.0001) were the only significant independent predictors of a blunted coronary blood flow response to acetylcholine. Thus, hypercholesterolemia and advanced age selectively impair endothelium-mediated relaxation of the coronary microvasculature in response to acetylcholine, whereas endothelial dysfunction is restricted to epicardial arteries in age-matched normocholesterolemic patients with evidence of coronary atherosclerosis and/or hypertension.
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PMID:Endothelium-mediated coronary blood flow modulation in humans. Effects of age, atherosclerosis, hypercholesterolemia, and hypertension. 834 4

Considerable interest exists in using endovascular techniques for assessing the renal circulation. The vasomotor response of the renal circulation in patients with hypertension and severe atherosclerotic renal artery stenosis was evaluated. Sixteen patients (5 men and 11 women) with a mean age of 73.2+/-7.1 years (range, 59-82 years) underwent noninvasive renal duplex ultrasonography and endovascular flow wire evaluation. The flow wire was positioned in the main renal artery distal to the stenosis and used to examine the reactivity of the renal circulation in response to intra-arterial papaverine before and after percutaneous revascularization. Resistive index was computed as (MPV - EDV)/MPV, where MPV is the maximum peak velocity and EDV is the end-diastolic velocity. Renal flow reserve was defined as the ratio of peak hyperemic response to baseline flow. Intervention was technically successful in 18/18 arteries. Heart rate (69+/-11 vs. 65+/-10 beats/min; P=NS) and systolic blood pressure (168+/-19 vs. 163+/-24 mm Hg; P=NS) remained constant following injection of intrarenal papaverine, while diastolic blood pressure decreased (77+/-13 vs. 65+/-11 mm Hg; P<0.006). Papaverine injection resulted in significant increases in average peak velocity (APV; 148% of baseline; P=0.0003), MPV (146% of baseline; P=0.001), and EDV (161% of baseline; P=0.0026), but had no effect on the endovascular resistive index (0.81+/-0.12 vs. 0.84+/-0.08; P=NS). Renal artery stenting produced no effect on APV or EDV, but a small increase in MPV (123% of baseline; P<0.05). In contrast, renal stenting resulted in a significant increase in the endovascular resistive index (0.77+/-012 vs. 0.84+/-0.08; P=0.003), pulsatility index (1.84+/-0.61 vs. 2.23+/-0.70; P<0.014), and renal flow reserve (1.49+/-0.44 vs. 1.86+/-0.73; P<0.0071). A correlation was found between the noninvasive and endovascular measures diastolic/systolic ratio (r=0.73; P<0.0009) and resistive index (r=0.63; P<0.0053). Patients with atherosclerotic renal artery stenosis have preserved vasomotor response to papaverine, as well as marked increases in renal flow and resistive index following successful renal artery stenting. Endovascular flow wire measurements are safe, easy to perform, and correlate well with noninvasive Doppler measurements.
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PMID:Correlation between noninvasive and endovascular Doppler in patients with atherosclerotic renal artery stenosis: a pilot study. 1650

Subarachnoid hemorrhage is associated with a number of cerebral insults as a result of cerebral vasospasm. Various pharmacological and non-pharmacological techniques are used for relief of cerebral vasospasm. Papaverine, either intraarterially or intracisternally, is advocated for management of vasospasm; however, its use is associated with a number of complications. The case of a patient with an anterior communicating artery aneurysm, who received intracisternal papaverine by instillation after aneurysm clipping, is reported. It was associated with hypertension and tachycardia that was not responsive to usual treatment.
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PMID:Association of acute onset hypertension and tachycardia following intracisternal papaverine administration during intracranial aneurysm surgery: a case report and review of the literature. 2149 75

The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA), which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient's main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.
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PMID:The new technique of using the epigastric arteries in renal transplantation with multiple renal arteries. 2353 46