Treatment of Renal Colic by Prostaglandin Synthetase Inhibitors and Avafortan (Analgesic Antispasmodic)

El-Sherif, A.E.; Foda, R.; Norlén, Lars; Yahia, Hani

doi:10.1111/j.1464-410x.1990.tb07190.x

Cited by 15 publications

(6 citation statements)

References 9 publications

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“…However, spontaneous and regular contractions of ureteral strips have also been reported. It may be hypothesized that anoxia may have provoked spontaneous ureteral activity in some cases, as it occurred more often in abnormal or damaged ureters [4].…”

Section: Discussionmentioning

confidence: 99%

“…The most effective mode of administration is the intravenous route, but in 55% of cases, side effects occur. However, since these drugs also decrease the renal blood flow, they may induce renal failure, especially in obstructed kidneys [4,5].…”

mentioning

confidence: 99%

“…One family of drugs used in the treatment of ureteral colics is the prostaglandin synthetase inhibitor [4]. These drugs not only relieve the pain but also facilitate stone passage [5].…”

mentioning

confidence: 99%

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Characterization of cyclic nucleotide phosphodiesterase isoenzymes in the human ureter and their functional role in vitro

Taher

Schulz‐Knappe²,

Meyer

et al. 1994

World J Urol

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Summary. An increase in cyclic nucleotide monophosphate levels is suggested to play a prominent role in mediating smooth-muscle relaxation. Cyclic nucleotide phosphodiesterase (PDE) influences smooth-muscle tone by decreasing the level of cyclic nucleotides. At present, five different families of isoenzymes of PDE exist that show a distinct species-and organ-specific distribution. Our study was done to evaluate the existence of specific PDE isoenzymes and its functional role in human ureteral tissue. Normal ureteral tissue was homogenized and centrifuged and the supernatant fraction was separated using anioin-exchange diethylaminoethyl (DEAE)-Sephacel chromatography. A PDE assay was then performed and the peak fractions were added to different specific PDE activators and inhibitors. In vitro, longitudinal ureteral strips were precontracted and different selective and nonselective PDE inhibitors were added incremently. Three different PDE isoenzymes were characterized: PDE I (calmodulin-sensitive), PDE II (cGMP-stimulated), and PDE IV (cAMP-specific). All PDE inhibitors relaxed the strips dose-dependently, with the 50% effective concentrations (ECs0) being 30 gM for papaverine, 40 ~tM for zaprinast, 25 gM for quazinone, and 0.1 gM for rolipram. The ureter-relaxing effect of the PDE IV inhibitor at low concentrations, combined with its low-level effect on the systemic circulatory parameters, may open the possibility of using selective PDE IV-inhibitors in the treatment of ureteral colics or for ureteral stone passage.The incidence of urinary-tract stone disease in Germany is estimated to be 0.1%, with the prevalence for primary stones being 4%-5%. In the case of an uncomplicated renal or ureteral stone, the application of intravenous analgesics is the most useful means of relieving the pain [1,2]. With respect to the potential beneficial effect of ureteral relaxation on stone passage, some spasmolytic agents such as phentolamine and orciprenaline have been shown to dilate the ureteral lumen at the level of an artifi-

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Characterization of cyclic nucleotide phosphodiesterase isoenzymes in the human ureter and their functional role in vitro

Taher

Schulz‐Knappe²,

Meyer

et al. 1994

World J Urol

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“…The use of synthetic prostaglandin inhibitors, such as nonsteroidal anti-inflammatory drugs (NSAIDs), is considered nowadays the best and most effective way of treating patients who suffer from renal colics [4,6,7]. Nevertheless, NSAIDs exert undesirable side effects on the excretory tract: Perlmutter et al [8] demonstrated that the use of NSAIDs in subjects with acute obstruction of the excretory tract greatly reduces PRF, which remains low for a long period of time.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Effects of Desmopressin in Acute Ureteral Obstruction

et al. 1999

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Objective: To evaluate the effects of desmopressin on pressure values inside the pelvis and ureter of the rat following acute obstruction. Materials and Methods: By means of a microsurgical technique, 24 male Wistar rats were submitted to ureteral obstruction; pressure inside the ureter was recorded using a cannula and a micrometric glass column. In the treatment group (14 animals) 6 mg/kg of desmopressin were administered 30 min before the beginning of the experiment. Results: Rats pretreated with desmopressin showed a statistically significant reduction in mean intraureteral pressure following acute obstruction (p = 0.05). Conclusions: In Wistar rats desmopressin demonstrated a powerful antidiuretic effect, reducing the intraureteral pressure. The experimental model is useful for a better understanding of physiopathology of renal colic and acute obstruction.

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“…One family of drugs in the treatment of ure teral colics are prostaglandin synthase inhibitors [ 10], These drugs do not only relieve pain, but also facilitate stone passage [11], The most effective route of adminis tration is the intravenous, but in 55% of the cases side effects were reported. However, since these drugs also decrease renal blood flow, they may induce renal failure, especially in obstructed kidneys [ 12,13], The aim of our study was to analyze the PDE isoen zymes present in the human ureter and to evaluate the functional effects of isoenzyme-specific inhibitors in this tissue in vitro.…”

Section: Introductionmentioning

confidence: 99%

Phosphodiesterase Isoenzymes in Human Ureteral Smooth Muscle: Identification, Characterization, and Functional Effects of Various Phosphodiesterase Inhibitors in vitro

Stief

Taher²,

Truß³

et al. 1995

Urol Int

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Phosphodiesterases (PDE) are key enzymes regulating intracellular cyclic nucleotide metabolism and, thus, contraction and relaxation of the muscle. At present, five different families of isoenzymes of PDE exist that show a distinct species-specific and organ-specific distribution. The aim of the present study was to analyze the PDE isoenzymes present in the human ureter and to evaluate the functional effects of isoenzyme-specific inhibitors in this tissue. Normal ureteral tissue was obtained during radical nephrectomies, homogenized, centrifuged, and the supernatant fraction was separated using DEAE-Sephacel anion-exchange chromatography. PDE assay was then performed and the isoenzymes characterized on the basis of their kinetic characteristics and their sensitivity to allosteric modulators and inhibitors. In vitro, longitudinal ureteral strips as well as ureteral rings were precontracted, and different selective and nonselective PDE inhibitors were added incrementally. Three different PDE isoenzymes were identified: PDE I (Ca/calmodulin-stimulated), PDE II (cyclic guanosine monophosphate-stimulated), and PDE IV (cyclic adenosine monophosphate-specific). All PDE inhibitors relaxed the strips dose-depen-dently with an EC50 of 30 µM for papaverine, 40 µM for zaprinast, 25 µM for quazinone, and 0.1 µM for rolipram. The existence of three different PDE isoenzymes was shown in this study. The ureter-relaxing effect of the PDE IV inhibitor at low concentrations, combined with its low effect on the systemic circulatory parameters, may open a possibility of using selective PDE IV inhibitors in the treatment of ureteral colics or ureteral stones.

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Treatment of Renal Colic by Prostaglandin Synthetase Inhibitors and Avafortan (Analgesic Antispasmodic)

Cited by 15 publications

References 9 publications

Characterization of cyclic nucleotide phosphodiesterase isoenzymes in the human ureter and their functional role in vitro

Characterization of cyclic nucleotide phosphodiesterase isoenzymes in the human ureter and their functional role in vitro

Evaluation of the Effects of Desmopressin in Acute Ureteral Obstruction

Phosphodiesterase Isoenzymes in Human Ureteral Smooth Muscle: Identification, Characterization, and Functional Effects of Various Phosphodiesterase Inhibitors in vitro

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