Radioimmunologische Bestimmung der Glykosidkonzentration im menschlichen Gewebe

Abstract

After extraction of myocardial and skeletal muscle biopsy and autopsy specimens tissue glycoside concentrations can be determined by radioimmunoassay. Total tissue extraction of digoxin and beta-methyl-digoxin varies between 87 and 95%, the variation coefficient for repeated determinations is 10.2%. Glycoside concentrations of left ventricular papillary muscle obtained after mitral valve replacement were 69.0 +/- 25.05 ng/g with a tissue to serum relation of 46.6 +/- 8.96:1 and a correlation coefficient of r = 0.8442. In autopsy left ventricular papillary muscle glycoside concentrations were 105.2 +/- 27.35 ng/g with an almost identical tissue to serum relation of 46.2 +/- 9.57:1 and a corresponding serum concentration of 2.3 +/- 0.63 ng/ml. In adults glycoside concentrations of autopsy specimens of the right ventricle were significantly lower by 28 to 30% than those of the left ventricle. Glycoside concentrations of skeletal muscle specimens (m. pectorialis major) were 14.7 +/- 10.35 ng/g with a tissue to serum relation of 9.7 +/- 3.00:1 (r = 0.8377), which corresponds to approximately 1/5 to 1/4 of the concentrations of the left ventricular myocardium.

Toxikologische und morphologische Befunde bei Digoxinvergiftung in forensischer Sicht

“…Eine quantitative Aussage war meist nur unter erheblichen Vorbehalten m6glich. Plasmawerten liegt (Brock, 1974;Haasis et al, 1977;Karjalainen et al, 1974). Seit dieser Zeit wird, falls erforderlich, die Glykosid-Therapie herzkranker Patienten mit Hilfe von Plasmaspiegelbestimmungen kontrolliert (Besch und Watanabe, 1975;Bodem und Gilfrich, 1973).…”

Digitalis in Chronic Renal Insufficiency

“…due to altered binding kinet ics of the receptor, or due to postrcceptor events. Indeed, diminished digoxin tissue/ plasma ratios in myocardium of uremic pa tients were found by some authors [38] but it is uncertain to what extent this reflects spe cific versus non-specific binding.…”

Reversal of Digitalis Effects by Specific Antibodies

“…A new approach to the therapy of digitalis intoxication was started by Butler and Chen (4), who were able to raise digoxin-specific antibodies in rabbits and to develop a sensitive and accurate radioimmunoassay for measure ments of digoxin in the nanogram range in biological fluids and tissues (2,9,19,21,41,42). The availability of digoxin-specific anti bodies suggested the possibility to neutralize effects of cardiac glycosides by virtue of their antigen-binding capacity, a technique which had already been shown to inhibit effects of steroid hormones (8), pyridoxal phosphate (53), histamine (11), serotonin (15), and chloramphenicol (22) on various tissues.…”