RESUMEN

We found that substance P (SP) and calcitonin gene-related peptide (CGRP) (0.3-1 microM) increased, in a concentration-dependent manner, the basal secretion of interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF alpha) from cultured lymphocyte-enriched mononuclear cells isolated from human peripheral blood. SP and CGRP (0.1 microM) synergistically increased basal TNF alpha secretion. Dynorphin A((1-17)) (0.1-1 microM) did not modify basal cytokine secretion. Lipopolysaccharide (10 ng/ml)-induced cytokine secretion and [(3)H]thymidine uptake were not altered by any neuropeptide (at 0.1 microM). Thus, SP and CGRP stimulate the production of pro-inflammatory cytokines from lymphocytes only at high concentrations, similar to those reached during tissue damage.

Asunto(s)

Péptido Relacionado con Gen de Calcitonina/farmacología , Interleucina-1/metabolismo , Interleucina-6/metabolismo , Leucocitos Mononucleares/efectos de los fármacos , Sustancia P/farmacología , Factor de Necrosis Tumoral alfa/metabolismo , Adulto , Células Cultivadas/efectos de los fármacos , Células Cultivadas/metabolismo , Relación Dosis-Respuesta a Droga , Sinergismo Farmacológico , Dinorfinas/farmacología , Humanos , Leucocitos Mononucleares/metabolismo , Lipopolisacáridos/farmacología , Activación de Linfocitos/efectos de los fármacos , Fitohemaglutininas/farmacología , Acetato de Tetradecanoilforbol/farmacología

RESUMEN

Substance P and glutamate are present in primary afferent C-fibers and play important roles in persistent inflammatory and neuropathic pain. In the present study, we have examined whether activation of different glutamate receptor subtypes modulates the release of substance P evoked by the C-fiber selective stimulant capsaicin (1 microM) from rat trigeminal nucleus slices. The selective NMDA glutamate receptor agonist L-CCG-IV (1-10 microM) enhanced capsaicin-evoked substance P release about 100%. This facilitatory effect was blocked by 0.3 microM MK-801, a selective NMDA receptor antagonist. The metabotropic glutamate receptor agonists L-AP4 (group III) and DHPG (group I) (30-100 microM) inhibited capsaicin-evoked substance P release by approximately 60%. These inhibitory effects were blocked by the selective metabotropic glutamate receptor antagonist (+/-)-MCPG (5 microM). On the other hand, AMPA and kainate (0.1-10 microM), did not significantly affect capsaicin-evoked substance P release. Thus, substance P release from non-myelinated primary afferents, and possibly nociception, may be under the functional antagonistic control of some metabotropic and ionotropic glutamate receptor subtypes.

Asunto(s)

Capsaicina/farmacología , Fibras Nerviosas/efectos de los fármacos , Receptores de Glutamato/efectos de los fármacos , Sustancia P/metabolismo , Núcleos del Trigémino/efectos de los fármacos , Vías Aferentes/efectos de los fármacos , Animales , Benzoatos/farmacología , Maleato de Dizocilpina/farmacología , Agonistas de Aminoácidos Excitadores/farmacología , Antagonistas de Aminoácidos Excitadores/farmacología , Glicina/análogos & derivados , Glicina/farmacología , Ácido Kaínico/farmacología , Masculino , Metoxihidroxifenilglicol/análogos & derivados , Metoxihidroxifenilglicol/farmacología , Fibras Nerviosas/metabolismo , Nociceptores/fisiología , Propionatos/farmacología , Ratas , Ratas Sprague-Dawley , Receptores de Glutamato Metabotrópico/agonistas , Receptores de Glutamato Metabotrópico/antagonistas & inhibidores , Receptores de N-Metil-D-Aspartato/agonistas , Receptores de N-Metil-D-Aspartato/antagonistas & inhibidores , Núcleos del Trigémino/metabolismo , Ácido alfa-Amino-3-hidroxi-5-metil-4-isoxazol Propiónico/farmacología

RESUMEN

Spinal epidural I abscess is an uncommon disease. The medical literature emphasizes the importance of its timely recognition and treatment. Three patients admitted in our hospital are presented. None of them was diagnosed on ambulatory bases. All of them were admitted because of spinal ache and two of them also had fever. Magnetic resonance imaging yielded the correct diagnosis in all cases and was very effective in delineating the extent of the lesion. We used antimicrobial therapy directed against the bacteria identified by cultures as well as surgical drainage in all cases. The three patients had a good outcome and no neurologic sequela. Early recognition, proper microbiologic diagnosis and surgical drainage are the main criteria for the current management of spinal epidural abscess.

Asunto(s)

Absceso/diagnóstico , Absceso/terapia , Enfermedades de la Columna Vertebral/diagnóstico , Enfermedades de la Columna Vertebral/terapia , Infecciones Estafilocócicas/diagnóstico , Infecciones Estafilocócicas/terapia , Anciano , Drenaje , Espacio Epidural/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad

RESUMEN

Spinal epidural I abscess is an uncommon disease. The medical literature emphasizes the importance of its timely recognition and treatment. Three patients admitted in our hospital are presented. None of them was diagnosed on ambulatory bases. All of them were admitted because of spinal ache and two of them also had fever. Magnetic resonance imaging yielded the correct diagnosis in all cases and was very effective in delineating the extent of the lesion. We used antimicrobial therapy directed against the bacteria identified by cultures as well as surgical drainage in all cases. The three patients had a good outcome and no neurologic sequela. Early recognition, proper microbiologic diagnosis and surgical drainage are the main criteria for the current management of spinal epidural abscess.