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We conducted a quantitative structure-activity relationship study using a database of 158 quinolones previously tested against Mycobacterium avium-M. intracellulare complex in order to develop a model capable of predicting the activity of new quinolones against the M. avium-M. intracellulare complex in vitro. Topological indices were used as structural descriptors and were related to anti-M. avium-M. intracellulare complex activity by using the linear discriminant analysis (LDA) statistical technique. The discriminant equation thus obtained correctly classified 137 of the 158 quinolones, including 37 of a test group of 44 randomly chosen compounds. This model was then applied to 24 quinolones, including recently developed fluoroquinolones, whose MICs were subsequently determined in vitro by using the Alamar blue microplate assay; the biological results confirmed the model's predictions. The MICs of these 24 quinolones were then treated by multilinear regression (MLR) to establish a model capable of classifying them according to their in vitro activities. Using this model, a good correlation between measured and predicted MICs was found (r(2) = 0.88; r(2)(cv) [cross-validation correlation] = 0.82). Moxifloxacin, sparfloxacin, and gatifloxacin were the most potent against the M. avium- M. intracellulare complex, with MICs of 0.2, 0.4, and 0.9 microg/ml, respectively. Finally, virtual modifications of these three drugs were evaluated in LDA and MLR models in order to determine the importance of different substituents in their activity. We conclude that the combination of molecular-topology methods, LDA, and MLR provides an excellent tool for the design of new quinolone structures with enhanced activity.

As in vitro culture systems allowing to isolate Pneumocystis samples from patients or other mammal hosts are still not available, animal models have critical importance in Pneumocystis research. The parasite was reported in numerous mammals but P. carinii pneumonia (PCP) experimental models were essentially developed by using rats, mice, rabbits and ferrets. The rat treated with corticosteroids for 9-12 weeks is a useful PCP model. Like laboratory rats, conventional mice develop PCP after prolonged corticosteroid administration. The ferret (Mustela putorius furo) also develop PCP under corticosteroid regime. Whilst bronchoalveolar lavage (BAL) is really difficult to perform on live laboratory rodents, serial BAL sampling can be performed on live ferrets. Rabbits currently develop spontaneous PCP at weaning without corticosteroid administration. For this reason this model has been used for studying the host immune response as well as Pneumocystis-surfactant interactions. Pigs and horses also develop spontaneous PCP. Treated with corticosteroids, piglets develop extensive PCP and could be used as a non-rodent model. Pneumocystis was detected in many non-human primates. Primates could represent a source of parasites taxonomically related to P. carinii sp. f. hominis. Moreover, primates might be used as experimental hosts to human Pneumocystis. A marked variability of parasite levels among corticosteroid-treated animals and the fact that the origin of the parasite strain remains unknown, are important drawbacks of the corticosteroid-treated models. For these reasons, inoculated animal models of PCP were developed. The intratracheal inoculation of lung homogenates containing viable parasites in corticosteroid-treated non-latently infected rats resulted in extensive, reproducible Pneumocystis infections. Extensive PCP can be obtained within 5-7 weeks, whilst 9-12 weeks are needed in the classical model. The severe combined immunodeficiency (SCID) mouse inoculated by nasal route and the athymic nude rats intratracheally inoculated were used to test the infectivity of Pneumocystis samples coming from cultures or from different hosts. They were also used to test the anti-Pneumocystis activity of antimicrobial molecules.

The efficacy of most therapeutic and prophylactic protocols against Pneumocystis carinii pneumonia used in human patients has been tested in animal models, especially in the corticosteroid-treated rat. The advantages and drawbacks of this model have been examined in brief in Chapter 1 of this section. More recently, the nude rat, intratracheally inoculated with Pneumocystis, was used to test new anti-microbian molecules for their anti-Pneumocystis activity. In vitro systems, co-cultures of Pneumocystis with feeder cells as well as axenic cultures, were also used many times for drug screening. In this paper, the most used in vivo or in vitro drug screening systems are described. Moreover, as immunocompromised individuals, AIDS patients, especially, are often infected simultaneously by several infectious agents, a recent co-infection model is described.

We present a new experimental model for the simultaneous evaluation of the activities of drugs against Pneumocystis carinii, Toxoplasma gondii, and Mycobacterium avium complex infections. Rats latently infected with P. carinii were challenged with the MO-1 strain of M. avium and then immunosuppressed with corticosteroids for 7 weeks. At week 5 the RH strain of T. gondii was intraperitoneally injected. Organs were examined for the three pathogens after death or killing of the animals at week 7. Without treatment, rats challenged with T. gondii died with pulmonary P. carinii infection and disseminated T. gondii and M. avium infections. In order to assess the value of the model for evaluation of the activities of drugs, we administered by oral gavage for 7 weeks drugs or combinations of drugs selected for their individual efficacies against at least one pathogen. We found that clarithromycin with sulfamethoxazole, clarithromycin with atovaquone, roxithromycin with sulfamethoxazole or dapsone, and rifabutin with atovaquone were effective against the three infections, whereas PS-15 with dapsone and trimethoprim with sulfamethoxazole were active against Toxoplasma and Pneumocystis infections only. This triple-infection rat model offers a new tool for the simultaneous evaluation of the activities of drugs against three of the major opportunistic infections occurring in immunosuppressed individuals.

Trimethoprim-sulfamethoxazole (TMP-SMX) is the first-line drug for prophylaxis and treatment of Pneumocystis carinii pneumonia (PCP) and for prophylaxis of toxoplasmosis in HIV-infected patients. Evidence indicating intolerance related to the dose of SMX led us to examine the efficacy of altered TMP-SMX ratios in a corticosteroid-treated rat model. Infections were assessed by counting P. carinii cysts in lung and by titration of Toxoplasma gondii burdens in tissue culture. For prophylaxis, the reference regimen of 20 mg/kg TMP plus 100 mg/kg SMX was effective. Reduced doses of SMX (5 and 20 mg/kg) effective against PCP were effective against toxoplasmosis, provided the TMP dose was increased to 100 mg/kg. For curative treatment, the reversed ratio of 100 mg/kg TMP plus 20 mg/kg SMX was not effective. These results may provide a basis for altering the TMP-SMX ratios in setting of prophylaxis for both infections, especially in HIV infected patients who often poorly tolerate sulfonamides.

Nitrite production by rat alveolar macrophages was studied to determine the role of L-arginine oxidation in the interaction between these cells and Pneumocystis carinii. Alveolar macrophages from rats obtained from two different breeders were used: rats from Janvier breeder had latent P. carinii infection, while those from Charles River breeder were bred in a germ-free environment. Pneumocystis carinii increased in vitro nitrite generation by unstimulated alveolar macrophages from Janvier rats only, and this was blocked by NG-monomethyl-L-arginine. Incubation of cells from Janvier and Charles River rats with lipopolysaccharide and/or interferon-gamma increased nitrite production to a similar extent. Pneumocystis carinii partially decreased nitrite release by activated alveolar macrophages, and this was still inhibited by NG-monomethyl-L-arginine. In the presence of P. carinii, superoxide dismutase used as a superoxide anion scavenger had no effect on nitrite production by activated cells. These results show that prior exposure to P. carinii leads to nitric oxide production by rat alveolar macrophages. Although the magnitude of this production seems to be moderate, it is of biological significance since cells of P. carinii-naive rats do not generate nitrite whereas those of latently infected rats do.

Artemisinin and its derivatives have been found effective in vivo against Plasmodium and in vitro against Toxoplasma gondii and Pneumocystis carinii. We tested the activity of artemether for prophylaxis and treatment in the rat model of concurrent T. gondii and P. carinii infection. Artemether at doses of 18 and 100 mg/kg administered (s.c.) in prophylaxis did not prevent toxoplasmosis or pneumocystosis, while trimethoprimsulfamethoxazole (reference treatment) was effective for prevention of both infections. Similar results were obtained in curative studies. These results do not support the use of artemether for prevention or treatment of toxoplasmosis or pneumocystosis.

Pneumocystis carinii is an opportunistic agent found in the lung of various mammals which often causes severe pneumonia in immunocompromised humans, especially in AIDS patients. In the past several years significant additions have been made to the collection of knowledge we have concerning the genetic diversity of P. carinii. These additions provide new understanding of Pneumocystis transmission and the effect of possible reservoirs of Pneumocystis in the various species. In this study, a 400-bp fragment of the thymidylate synthase (TS) gene of P. carinii has been amplified by PCR from 43 parasite isolates obtained from 4 mammalian host species: rat, mouse, rabbit and human. A probe selected from the TS gene sequence of rat-derived P. carinii was hybridized with the amplified products from rat- and mouse-derived P. carinii, but not with rabbit or human P. carinii DNA. Restriction profiles were performed on amplified fragments from all isolates, and the 4 nucleotide sequences of the TS gene fragment amplified from rat, mouse, rabbit and human P. carinii were determined. Differences were detected in the gene fragment in P. carinii isolates from the 4 host species; however no difference was revealed in P. carinii isolates within a single host species, whatever the host strain or its geographic origin. Thus, the sequence differences of the P. carinii TS gene appeared as host-species specific. A specific probe which recognized all human P. carinii isolates was defined.

The pulmonary toxicity of antineoplastic drugs may be either direct or mediated by hypersensitivity. The aim of this study was to determine whether the mechanism by which cyclophosphamide (CY) damages the lung is direct and immediate or is the result of delayed immune toxicity. Pulmonary and immune changes following intraperitoneal injection of either CY (50 mg/kg) or NaCl (0.9%) in rats were assessed repeatedly over a period of 31 days by semi-quantitative histological studies, by measuring the pulmonary water/body weight ratio, dry lung weight/body weight ratio, heart weight and by assessing the transfer of [125I]-albumin in lung tissue. Lung damage was delayed and greatest at 11 (D11) and 14 (D14) days after CY injection. The pulmonary lesions were: (i) an infiltration of lymphocytes, plasma cells and histiocytes surrounding blood vessels and small airways, (ii) an alveolitis composed of macrophages, lymphocytes, a few neutrophils and a lymphoid infiltration of alveolar septa. Pulmonary water/body weight and dry lung weight/body weight ratios also increased and peaked at D11-D14 in CY-treated rats. No significant increase in [125I]-albumin in lung tissue or in heart weight was observed. It can be concluded that the mechanism by which CY induces a lymphoid lung infiltration is not direct and immediate but is the result of a delayed immune toxicity.

There are now three methods to evaluate treatments of pneumocystosis: (1) the animal model, using adult rats under corticosteroids; the intensity of infection is assessed on pulmonary appositions and can then be evaluated after administration of a potential treatment compared with a reference; (2) the in vitro propagation of P. carinii observed from rat lung extracts cultured on cell lines; this method, however, is limited by the difficulties encountered in quantifying the parasitic types; (3) the inhibition by the drugs tested of enzymes involved in folate synthesis is a method that is still under evaluation. The animal model remains the reference method.

The time course of the respiratory consequences of alpha-naphthyl thiourea (ANTU)-induced lung oedema was studied in adult albino rats, up to 6 h after the injection of 5 mg/kg ANTU. Control rats were injected with olive oil (ANTU solvent). After 6 h, pulmonary extravascular water increased by 50% in ANTU-treated rats and the volume of the pleural effusion reached 3.4 +/- 0.1 ml (mean +/- s.e. mean). The most striking point is the absence of hypoxaemia in the ANTU-treated rats: PaO2 = 103 +/- 1.5 Torr vs 100 +/- 1 Torr in the control rats. The non-decreased PaO2 can be related to the patency of the alveolar airspaces. The predominant location of the oedema in the lung interstitium is caused by a specific lymphatic drainage pathway towards the pleura in the rat which prevents alveolar flooding. Histological findings support this hypothesis. PaCO2 is unaltered: 32 +/- 1 Torr in ANTU rats vs 33.5 +/- 1 Torr in control rats. A slight downward shift of arterial pH is found in ANTU rats: (7.440 +/- 0.010 vs 7.475 +/- 0.010, P less than 0.01). Concomittently (HCO3-)a decreases in ANTU-treated rats (22.2 +/- 1.2 mmol l-1 vs 24.8 +/- 0.6 mmol l-1, P less than 0.01). The absence of hypoxaemia is common with normobaric oxygen (02) and ANTU-induced lung oedema in the rat. A comparison is made between 02 and ANTU toxicity, as for respiratory events and histological features.

Respiratory frequency (f), tidal volume (VT) and minute ventilation (VE) were measured in restrained awake rats using a volumetric body plethysmograph excluding the head. An arterial catheter was then implanted and ventilatory measurements performed again two or three days later. Arterial blood gases and acid-base status were measured before entry in the plethysmograph (control values) and after, accompanying each ventilatory measurement. The pattern of ventilation (VT and VE) was significantly correlated with the respiratory status, particularly with PaCO2 (P less than 0.001). A ventilatory (VE, VT, f) and respiratory (PaO2, PaCO2, pH) steady state was obtained from the fifteenth minute to the end of the observation period. The present preparation is a stable experimental model providing respiratory and ventilatory data in the awake rat.

Vascular inflammatory response to hyperoxia (FIO2 greater than 0.98) was studied in awake jugular and carotid catheterized rats. Simultaneous i.v. injection of 125I albumin (125I A), 99mTc polymorphonuclear cells (99mTc PMN) and 51Cr red blood cells (51Cr RBC) allowed to study both the macromolecule exchange through vascular endothelium and the leukocyte uptake by several organs (liver, lungs, spleen) with respect to radiolabelled red blood cells, as an intravascular reference. Rats were exposed to O2 for 24, 38 and 45 h. They were anesthetized and killed by exanguination 15 to 120 min following the tracer injection. After 45 h exposure, the plasmatic 125I A half-life decreased significantly (158 +/- 42 min for the control; 106 +/- 34 min for the exposed animals). The ratio 125I A/51Cr RBC varied significantly in the lung. The iodinated albumin exchange through lung vascular endothelium was altered at the 24th h, with a significant difference reached by the 45th h. At the same time, the pulmonary decreasing curve of 99mTc/51Cr RBC ratio versus time was not not modified. In our experimental conditions, there was no detectable variation in the lung uptake and vascular transit of PMN cells. The discussion of the results must be related with the technics used in the present work when the albumin exchange increased.

We studied the time course of the respiratory events in awake guinea-pigs catheterized with a chronic arterial cannula, exposed to 100% O2 during 48 hr and after air return breathing. 2. The oxygen toxicity has a pulmonary and respiratory expression: clinical, histological and biochemical data show that death is related to the asphyxia generated by acute pulmonary edema. 3. The O2 toxicity respiratory effects show striking differences in rats and guinea-pigs; the differences belong to a specific and particular lymphatic system in the rat. 4. Rat and guinea pig offer two different models of pulmonary edema, (the first is characterized by absence of arterial hypoxemia) and in consequence two different models of lung oxygen toxicity.

1. 288 arterial blood samples were obtained at successive times, through indwelling catheters, from conscious rats subjected to selective dietary potassium restriction for up to 5 weeks. 2. In control rats with unrestricted access to potassium [HCO-3]a = 25.4 mmol/l, pHa = 7.47, PaCO2 = 34 mmHg, PaO2 = 94 mmHg and [K+]a = 4.3 mmol/l were steady and within the range of values reported in conscious rats. Five weeks of isolated potassium restriction resulted in significant hypokalaemia ([K+]a = 2.15 mmol/l) and metabolic alkalosis ([HCO-3]a = 34.1 mmol/1, pH 7.57). This alkalosis, due mostly to H+ transfer into cells, was accompanied by a significant increase in PaCO2 to 36.4 mmHg and decrease in PaO2 to 88 mmHg, contrary to previous reports in man and dog. The administration of neutral sodium phosphate in addition to potassium restriction enhanced both the alkalosis ([HCO-3]a = 42.3 mmol/l, pH 7.61) and its respiratory compensation (PaCO2 = 40.8, PaO2 = 82 mmHg), without altering the PaCO2: [HCO-3]a relationship. 3. The opposite variations of PaCO2 and PaO2 were significantly correlated to the increase in plasma bicarbonate concentration and described best by crossed sigmoid curves. The equations of both curves were calculated; their point of inflection occurred at the same bicarbonate concentration (36 mmol/l). The maximum intensity of respiratory compensation (0.62 mmHg PaCO2 for each mmol [HCO-3]a/l) observed at this point fell within the range of values yielded by previous estimations.

The vascular sequestration of polymorphonuclear leukocytes (PMN) may be responsible for endothelial injury leading to lung oedema, which occurs when rats are exposed to pure normobaric oxygen. Indeed, marginated PMN in close contact with the endothelium are able to damage the latter when activated. In the present work, marginated leukocytes were recovered by lavage through the pulmonary artery in isolated rat lung and the leukocyte differential count in blood and in the lung perfusion liquid (perfusate) was studied. Following 55 h of hyperoxia, a rise in the PMN count and lymphocytopenia were observed in the blood and in the perfusate. Moreover, the relatively greater increase in the PMN concentration in the perfusate than in the blood suggested a strengthening of their margination along the endothelium. A clear protective effect was noted during hyperoxia provided previous injection of endotoxin (1.5 mg X kg-1 intraperitoneally) had been performed. Indeed, after 65 h of hyperoxia, none of these rats (Endo/O2) died and there was no pleural effusion. The lymphocyte count was maintained within the normal limit and the number of PMN in the lung perfusion fluid and in blood was reduced. Results of this study suggest an essential role of the marginated PMN in lung oxygen toxicity.

K+ depletion of two kinds was induced in two groups of rats by selective dietary restriction for up to 5 weeks. Complete metabolic studies for H+, K+, Na+ and Cl- were carried out daily during weeks 1, 3 and 5. In control rats of group A (receiving K+ with sodium chloride), plasma pH (7.47) and HCO3- (25 mmol/l), as well TA (titratable acid)--HCO3- and NH+4 urinary excretion rates, were stable, while balances were nil for K+ and slightly positive for Cl-. In K+-deprived rats of group A receiving sodium chloride, a progressive metabolic alkalosis developed (plasma pH reached 7.57 and HCO3- 35.8 mmol/l by 5 weeks), and TA--HCO3- and NH+4 urinary excretion rates were not different from controls. Plasma K+ fell progressively from 4.20 to 2.20 mmol/l, with negative K+ balance. Balances for Na+ and H2O were highly positive and plasma renin activity and aldosterone decreased by week 5. Hypochloraemia developed with positive Cl- balance. In control rats of group B (receiving K+ with neutral sodium phosphate), a slight metabolic alkalosis developed, and TA--HCO3- excretion rate was increased compared with control rats of group A.(ABSTRACT TRUNCATED AT 250 WORDS)

Rat exposure to pure normobaric oxygen induces a specific non alveolar pulmonary edema which leads to massive pleural exudate. This does not induce hypoxemia, and is characterized by both hypovolemia and arterial hypotension with hypothermia. Histological findings shed some light on these special aspects of oxygen toxicity. In the Rat, this toxicity results from hemodynamic changes rather than from pulmonary lesions.

Inducers of cytochrome P450-linked mono-oxygenases increase the normobaric oxygen tolerance of the adult rat. Pulmonary inducers, as 3-methylcholanthrene and beta-naphthoflavone permit the rat survival and simultaneously a decrease of pulmonary edema. Phenobarbital, an hepatic inducer had lesser effects both on survival rate and on pulmonary and lymphoïd oxygen toxicity.

Rats were pretreated with various inducers of cytochrome P-450 before being exposed to pure normobaric oxygen (O2) in order to determine whether the inducers interfere with toxicity. The pulmonary and liver inducers beta-naphthoflavone (beta NF) and 3-methylcholanthrene (3MC) increased the survival rate and decreased the amount of pleural and lung fluid accumulation in adult rats exposed to oxygen. Phenobarbital (PB), which is essentially active in the hepatic microsomal cytochrome P-450, was less effective in counteracting oxygen toxicity. After 7 days of exposure to oxygen, none of the untreated rats survived, whereas 40, 73, and 90% survival was observed in rats treated with PB, 3MC, and beta NF, respectively. After 60 h of O2 exposure, significantly less pleural and lung fluid accumulation was observed in beta NF- and 3MC-treated rats than in untreated or PB-treated rats (p less than 0.001). Both beta NF and 3MC prevented the increase of lung peroxidation (assessed by measuring of malondialdehyde) and that of hydrogen peroxide production by lung microsomes induced by O2 exposure. These protective effects are associated with a large increase in the components of the pulmonary cytochrome P-450 system and its peroxidase activity and with an increased response to hyperoxia by lung antioxidant enzyme activities. In contrast, in control rats, the activities of the antioxidant enzymes were not increased, and both the quantity and the peroxidase activity of cytochrome P-450 were significantly decreased by O2 exposure. We conclude that in the rat, pretreatment by inducers of pulmonary cytochrome P-450 results in marked protection against O2 toxicity and an increase of antioxidant enzyme response to hyperoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

Pneumocystis carinii (P.c.) pneumonia was induced in 40 rats by a prolonged corticosteroid treatment (group 1); 40 healthy rats of equal weight constituted the control group (group 2); 9 rats received the same corticosteroid treatment as group 1, together with trimethoprim-sulfamethoxazole (TMP-SFZ) in order to prevent P.c. multiplication (group 3). We could distinguish the respiratory effects induced by corticosteroids from those caused by P.c. pneumonia (group 3 vs group 1). For six weeks the blood leukocyte count, the weight of the spleen and the thymus and the pulmonary status were monitored. Blood gases and acid-base status were measured in conscious rats. There was no pulmonary oedema. The infected P.c. rats had a low PaCO2 and a slight disturbance of blood oxygenation, exemplified by A-aDO2 of 30 mmHg, compared with 17.5 mmHg in control rats and 17 mmHg in TMP-SFZ treated rats. P.c. infected rats had a lymphocyte depletion induced by corticosteroids. They did not exhibit respiratory distress. P.c. pneumonia alone in rats did not cause frank hypoxemia.