High blood pressure. Causes, symptoms, treatments

Selective reduction of radiotracer trapping by deuterium substitution: comparison of carbon-11-L-deprenyl and carbon-11-deprenyl-D2 for MAO B mapping.


Alcohol consumption and hepatitis C virus (HCV) infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. Traditionally, HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population. However, the presence of advanced alcoholic liver disease (ALD) or intravenous drug use (IDU) may have confounded the results of previous studies, and the real prevalence of HCV infection in alcoholic patients without ALD or prior IDU has been shown to be lower. Due to the toxic combined effect of HCV and alcohol, patients with HCV infection should be screened for excessive ethanol intake. Patients starting treatment for HCV infection should be specifically advised to stop or reduce alcohol consumption because of its potential impact on treatment efficacy and adherence and may benefit from additional support during antiviral therapy. This recommendation might be extended to all currently recommended drugs for HCV treatment. Patients with alcohol dependence and HCV infection, can be treated with acamprosate, nalmefene, topiramate, and disulfiram, although baclofen is the only drug specifically tested for this purpose in patients with ALD and/or HCV infection.

Abacavir is metabolized primarily by two enzymes: alcohol dehydrogenase and gluconyl transferase. Under normal conditions, alcohol is hepatically cleared via alcohol dehydrogenase to acetaldehyde, and subsequently by acetaldehyde dehydrogenase (ACD) to acetic acid. Disulfiram acts as an ACD blocker. Abacavir may also act as an inhibitor of alcohol dehydrogenase, which raises the possibility of disulfiram-like reactions (if complete inhibition occurs) or reduced alcohol tolerance (if partial inhibition occurs) occurring with abacavir therapy.

The effect of three drugs, parachlorophenylalanine, nialamide and disulfiram, drugs known by their action on the two sleep phases, slow wave sleep and I-REM-sleep, have been studied and tested by their effect on the motor circadian rhythm : PCPA and disulfiram reduce the amplitude of the rhythm by two opposed mechanisms : PCPA increases the motor activity, especially the day-time activity, disulfiram reduces the motor activity, especially the night-time activity. The former reduces the serotonine content, the latter the noradrenaline content of the central nervous system. Nialamide (5 or 10 mg/1000 g) is without any action of the rhythm. Both doses increase very much the motor activity ; but the central excitatory state undergoes the normal circadian rhythm. This monoaminoxydase inhibitor is without any action on the circadian rhythm.

MVA-B was safe and well tolerated. A minor, but significant, increase in the T cell responses targeting vaccine inserts of Gag was observed [a median of 290, 403 and 435 spot-forming-cells/10(6) PBMCs at baseline, after two vaccinations and after three vaccinations, respectively; P = 0.02 and P = 0.04]. After interruption of cART, a modest delay in the rebound of the plasma viral load in participants receiving vaccine but not disulfiram was observed compared with placebo recipients (P = 0.01). The dynamics of the viral load rebound did not change in patients receiving MVA-B/disulfiram. No changes in the proviral reservoir were observed after disulfiram treatment.

This article describes the pharmacologic properties and clinical usefulness of acamprosate for the treatment of alcohol dependence.

Highly active antiretroviral therapy (HAART) can reduce plasma HIV-1 levels to below the detection limit. However, due to the latent reservoir in resting CD4(+) cells, HAART is not curative. Elimination of this reservoir is critical to curing HIV-1 infection. Agents that reactivate latent HIV-1 through nonspecific T cell activation are toxic. Here we demonstrate in a primary CD4(+) T cell model that the FDA-approved drug disulfiram reactivates latent HIV-1 without global T cell activation. The extent to which disulfiram reactivates latent HIV-1 in patient cells is unclear, but the drug alone or in combination may be useful in future eradication strategies.

1. Administration to rats of a monoamine oxidase inhibitor (for example tranylcypromine: Tcp) followed by L-tryptophan increases the rate of synthesis and release of 5-hydroxytryptamine (5-HT) and results in a series of behavioural changes, some of which can be recorded on activity meters or scored. Various putative 5-HT agonists and the releasing drugs, fenfluramine and p-chloroamphetamine, also produce these changes. 2. A supersensitive behavioural response was produced by specific lesioning or p-chlorophenylalanine pretreatment and lesioning and sectioning experiments suggested several of the behaviours to be either hind-brain or spinally mediated. 3. A role for dopamine and GABA in the behaviour was demonstrated, but depletion of brain noradrenaline by specific lesioning or administration of disulfiram did not influence the behavioural changes. 4. The behaviour produced by administration of Tcp/L-tryptophan or 5-methoxy N,N-dimethyl tryptamine was inhibited by the suggested 5-HT antagonists, methysergide, methergoline and (--)-propranolol, but not by cinanserin, mianserin and cyproheptadine, other putative antagonists. In contrast, all the antagonists inhibited the behaviour when it was produced by injection of the agonist, quipazine. 5. The possible reasons for these differences is discussed in the light of the receptor binding characteristics of the drugs and the possible existence of different 5-HT receptor populations.