BACKGROUND: The purpose of this study was to independently evaluate the beneficial effects of a high dose of transamine administrated prior to CPB on the postoperative hematologic aspect and bleeding. MATERIALS AND METHODS: This study included randomly selected groups of 40 adult patients undergoing OHS with CPB. All patients were divided into 2 groups: transamine group (T-group, n=20) and placebo group (P-group, n=20). The T-group received a high-dose of transamine (10 g) before and during CPB. The P-group received normal saline at the same times and served as a control group. RESULTS: The results of comparative studies between the 2 groups in the same hematologic variables were summarized as follows. (1) During CPB, the fibrinogen concentrations and platelet counts were significantly lower in the P-group than in the T-group (p<0.01). (2) During CPB, production of D-dimer occurred in 18 patients (90%) in the P-group and did not occur in the T-group (0%) (p<0.0001). (3) At CPB-off, the % concentration of fibrinogen (70.2+/-3.9%) and the % platelet counts (72.4+/-4.5%) of the T-group were significantly higher than those (54.5+/-3.8%, 64.3+/-2.9%) of the P-group (p<0.01). (4) Postoperative values of PT (14.0+/-0.03 sec.) and aPTT (27.6+/-0.1 sec.) of the T-group were significantly lower than those (16.0+/-0.02sec., 30.1+/-0.1sec.) of the P-group (p<0.05). (5) Postoperative bleeding and requirement of whole blood and other blood products were significantly less in the T-group than in the P-group (p <0.05). (6) There were no significant hypercoagulability signs such as cerebral em bolism, myocardial infarction, pulmonary embolism, or any other neurological prob lems in either group. CONCLUSIONS: We concluded that a high dose of transamine administered prior to CPB prevents the activation of fibri nolytic system and has beneficial effects of reducing the postoperative bleeding t endency without apparent hypercoagulability signs.
Adult ; Cardiopulmonary Bypass* ; Fibrinogen ; Hemorrhage ; Humans ; Myocardial Infarction ; Platelet Count ; Pulmonary Embolism ; Sensitivity Training Groups ; Thrombophilia ; Tranexamic Acid* ; Tranylcypromine*

OBJECTIVE: Treatment for panic disorder (PD) have evolved, although there is still a strong unmet need for more effective and tolerable options. The present study summarizes and discusses recent evidence regarding the pharmacological and neuromodulatory treatment of PD. METHODS: MEDLINE, Cochrane Library, PsycINFO and Thomson Reuters’s Web of Science were searched for clinical trials published between 2010 and 2018. We included all prospective experimental studies including randomized controlled trials (RCT) and other clinical trials with more than 10 patients. RESULTS: Only 11 articles met the inclusion criteria, including 4 RCT, 3 open clinical trials and 5 comparative clinical trials. RCT demonstrated efficacy of transcranial magnetic stimulation (TMS) in only one of two trials. Neither pindolol nor d-fenfluramine were effective in blocking flumazenil-induced panic attacks. Augmentation with quetiapine was not superior to placebo. Open trials indicated that escitalopram, vortioxetine and TMS may be effective. Comparative trials did not demonstrate superiority from any drug, but confirmed tranylcypromine, paroxetine, clonazepam and alprazolam as effective options. CONCLUSION: The current study confirmed the efficacy of tranylcypromine, paroxetine, clonazepam, alprazolam and escitalopram. Vortioxetine and TMS, with duration of 4 or more weeks, also seems to be effective. Quetiapine, pindolol and d-fenfluramine were not considered effective compounds.
Alprazolam ; Citalopram ; Clonazepam ; Humans ; Panic Disorder ; Panic ; Paroxetine ; Pindolol ; Prospective Studies ; Quetiapine Fumarate ; Transcranial Magnetic Stimulation ; Tranylcypromine

Monoamine oxidase inhibitors (MAO-I) belong to the earliest drugs tried in Parkinson's disease (PD). They have been used with or without levodopa (L-DOPA). Non-selective MAO-I due to their side-effect/adverse reaction profile, like tranylcypromine have limited use in the treatment of depression in PD, while selective, reversible MAO-A inhibitors are recommended due to their easier clinical handling. For the treatment of akinesia and motor fluctuations selective irreversible MAO-B inhibitors selegiline and rasagiline are recommended. They are safe and well tolerated at the recommended daily doses. Their main differences are related to (1) metabolism, (2) interaction with CYP-enzymes and (3) quantitative properties at the molecular biological/genetic level. Rasagiline is more potent in clinical practise and has a hypothesis driven more favourable side effect/adverse reaction profile due to its metabolism to aminoindan. Both selegiline and rasagiline have a neuroprotective and neurorestaurative potential. A head-to head clinical trial would be of utmost interest from both the clinical outcome and a hypothesis-driven point of view. Selegiline is available as tablet and melting tablet for PD and as transdermal selegiline for depression, while rasagiline is marketed as tablet for PD. In general, the clinical use of MAO-I nowadays is underestimated. There should be more efforts to evaluate their clinical potency as antidepressants and antidementive drugs in addition to the final proof of their disease-modifying potential. In line with this are recent innovative developments of MAO-I plus inhibition of acetylcholine esterase for Alzheimer's disease as well as combined MAO-I and iron chelation for PD.
Acetylcholine ; Alzheimer Disease ; Antidepressive Agents ; Depression ; Freezing ; Handling (Psychology) ; Head ; Indans ; Iron ; Levodopa ; Moclobemide ; Monoamine Oxidase ; Monoamine Oxidase Inhibitors ; Parkinson Disease ; Phenelzine ; Selegiline ; Tranylcypromine

To investigate the effect of monoamine oxidase inhibitor tranylcypromine (TCP) on the differentiation of human U251 glioma cells, we treated U251 cells with TCP and/or 100 nmol/L histone deacetylase inhibitor trychostatin A (TSA). The differentiation of U251 cells was observed with inverted microscopy. The cell proliferation and cell cycle distribution were determined by MTT assay and flow cytometry, respectively. Apoptosis was observed by Hoechst 33258 staining. The levels of differentiation-related genes were assessed by real-time PCR and Western blotting. TCP-induced differentiation was characterized by typical morphological changes, inhibition of cellular proliferation, accumulation of cells in the G1 phase of the cell cycle, decreased expression of the pluripotency transcription factors Oct4 and Sox2, and increased expression of glial fibrillary acid protein (GFAP). The combination of TCP and TSA treatment also triggered an over-expression of GFAP. These findings suggest that TCP may induce differentiation of U251 glioma cells, and the differentiation process may be promoted by histone deacetylase inhibitor TSA.
Brain Neoplasms ; pathology ; Cell Line, Tumor ; Cell Transformation, Neoplastic ; drug effects ; Glioma ; pathology ; Histone Deacetylase Inhibitors ; pharmacology ; Humans ; Hydroxamic Acids ; pharmacology ; Monoamine Oxidase Inhibitors ; pharmacology ; Tranylcypromine ; pharmacology

Mitochondrial permeability transition has been shown to be involved in neuronal cell death. Mitochondrial monoamine oxidase (MAO)-B is considered to play a part in the progress of nigrostriatal cell death. The present study examined the effect of MAO inhibitors against the toxicity of 1-methyl-4-phenylpyridinium (MPP+) in relation to the mitochondrial permeability transition. Chlorgyline (a selective inhibitor of MAO-A), deprenyl (a selective inhibitor of MAO-B) and tranylcypromine (non-selective inhibitor of MAO) all prevented cell viability loss, cytochrome c release, caspase-3 activation, formation of reactive oxygen species and depletion of GSH in differentiated PC12 cells treated with 500 micrometer MPP+. The MAO inhibitors at 10 micrometer revealed a maximal inhibitory effect and beyond this concentration the inhibitory effect declined. On the basis of concentration, the inhibitory potency was tranylcypromine, deprenyl and chlorgyline order. The results suggest that chlorgyline, deprenyl and tranylcypromine attenuate the toxicity of MPP+ against PC12 cells by suppressing the mitochondrial permeability transition that seems to be mediated by oxidative stress.
1-Methyl-4-phenylpyridinium* ; Animals ; Caspase 3 ; Cell Death ; Cell Survival ; Clorgyline ; Cytochromes c ; Monoamine Oxidase Inhibitors* ; Monoamine Oxidase* ; Neurons ; Oxidative Stress ; PC12 Cells ; Permeability* ; Reactive Oxygen Species ; Selegiline ; Tranylcypromine

AIMTo study the metabolic kinetics of MN9202 in Beagle dog liver microsome.

METHODSBeagle dog liver microsomes were prepared by using ultracentrifuge method. After incubating 0.4 micromol x L(-1) MN9202 with 1 g x L(-1) microsomes for 30 min at 37 degrees C, the reaction was terminated by adding 0.5 mL alkalization. The RP-HPLC was used to determine the drug in the incubation mixture. The Michaelis-Menten parameters Km, and Vmax in Beagle dog liver microsomes were initially estimated by analyzing Lineweave-Brurk plot. Various selective CYP inhibitors were used to investigate their inhibitory effect on the metabolism of MN9202.

RESULTSThe Km, Vmax and CLint of MN9202 were (22.6 +/- 8.0) micromol x L(-1), (0.54 +/- 0.17) micromol x g(-1) x min(-1) and (0.0242 +/- 0.0009) L x g(-1) x min(-1), respectively. The metabolism of MN9202 was significantly inhibited by ketoconazole (Ket) and troleandomycin (Tro) in Beagle dog liver microsomes. Tranylcypromine (Tra) could inhibit the metabolism of drug as well. While other inhibitors showed little inhibitory effect on the metabolism of MN9202.

CONCLUSIONIt was shown that CYP3A and CYP2C19 were involved in MN9202 metabolism. The inhibitors of human CYP3A and CYP2C19 may have potential interaction with MN9202, and this can reduce the metabolism rate and increase the toxicity of MN9202.

Animals ; Aryl Hydrocarbon Hydroxylases ; antagonists & inhibitors ; Calcium Channel Blockers ; metabolism ; pharmacokinetics ; Cytochrome P-450 CYP2C19 ; Cytochrome P-450 CYP3A Inhibitors ; Dihydropyridines ; metabolism ; pharmacokinetics ; Dogs ; Ketoconazole ; pharmacology ; Microsomes, Liver ; metabolism ; Mixed Function Oxygenases ; antagonists & inhibitors ; Nitrobenzenes ; metabolism ; pharmacokinetics ; Tranylcypromine ; pharmacology ; Troleandomycin ; pharmacology