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      Effect of Bumetanide on Facial Nerve Regeneration in Rat Model

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          Abstract

          Objective

          We investigated the effects of bumetanide alone and in combination with dexamethasone on facial nerve regeneration in rats with facial paralysis.

          Study Design

          A prospective controlled animal study.

          Setting

          An animal laboratory.

          Subjects and Methods

          Facial paralysis was induced in 32 Wistar rats that we then divided into 4 groups: group 1, control; group 2, bumetanide; group 3, dexamethasone; group 4, bumetanide and dexamethasone. Electroneurography was performed 1, 2, and 4 weeks later, and nerve regeneration was evaluated by electron and light microscopy and Western blotting in week 4.

          Results

          Regarding the comparison between preoperative values and week 4, the latency difference in group 1 (1.25 milliseconds) was significantly higher than those of groups 2 to 4 (0.56, 0.34, and 0.10 milliseconds, respectively; P = .001). The latency increment in groups 2 and 3 was higher than that of group 4 ( P = .002 and P = .046) in week 4, whereas groups 2 and 3 did not differ significantly ( P = .291). Amplitude difference was not statistically significant from week 4 among all groups (all P > .05). The number of myelinated axons was significantly higher in all treatment groups than in the control group ( P = .001). Axon number and intensity were significantly higher in group 4 as compared with groups 2 and 3 ( P = .009, P = .005).

          Conclusion

          After primary neurorrhaphy, dexamethasone and bumetanide alone promoted nerve recovery based on electrophysiologic and histologic measures. Combination therapy was, however, superior.

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          Most cited references30

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          Nogo and axon regeneration.

          Nogo-A is one of several neurite growth inhibitory components present in oligodendrocytes and CNS myelin membranes. Nogo has a crucial role in restricting axonal regeneration and compensatory fibre growth in the injured adult mammalian CNS. Recent studies have shown that in vivo applications of Nogo neutralizing antibodies, peptides blocking the Nogo receptor subunit NgR, or blockers of the postreceptor components Rho-A and ROCK induce long-distance axonal regeneration and compensatory sprouting, accompanied by an impressive enhancement of functional recovery, in the rat and mouse spinal cord.
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            Is Open Access

            Effects of bumetanide on neurobehavioral function in children and adolescents with autism spectrum disorders

            In animal models of autism spectrum disorder (ASD), the NKCC1 chloride-importer inhibitor bumetanide restores physiological (Cl−)i levels, enhances GABAergic inhibition and attenuates electrical and behavioral symptoms of ASD. In an earlier phase 2 trial; bumetanide reduced the severity of ASD in children and adolescents (3–11 years old). Here we report the results of a multicenter phase 2B study primarily to assess dose/response and safety effects of bumetanide. Efficacy outcome measures included the Childhood Autism Rating Scale (CARS), the Social Responsive Scale (SRS) and the Clinical Global Impressions (CGI) Improvement scale (CGI-I). Eighty-eight patients with ASD spanning across the entire pediatric population (2–18 years old) were subdivided in four age groups and randomized to receive bumetanide (0.5, 1.0 or 2.0 mg twice daily) or placebo for 3 months. The mean CARS value was significantly improved in the completers group (P: 0.015). Also, 23 treated children had more than a six-point improvement in the CARS compared with only one placebo-treated individual. Bumetanide significantly improved CGI (P: 0.0043) and the SRS score by more than 10 points (P: 0.02). The most frequent adverse events were hypokalemia, increased urine elimination, loss of appetite, dehydration and asthenia. Hypokalemia occurred mainly at the beginning of the treatment at 1.0 and 2.0 mg twice-daily doses and improved gradually with oral potassium supplements. The frequency and incidence of adverse event were directly correlated with the dose of bumetanide. Therefore, bumetanide improves the core symptoms of ASD and presents a favorable benefit/risk ratio particularly at 1.0 mg twice daily.
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              Functional characterization of the neuronal-specific K-Cl cotransporter: implications for [K+]o regulation.

              Mark Payne (1997)
              The neuronal K-Cl cotransporter isoform (KCC2) was functionally expressed in human embryonic kidney (HEK-293) cell lines. Two stably transfected HEK-293 cell lines were prepared: one expressing an epitope-tagged KCC2 (KCC2-22T) and another expressing the unaltered KCC2 (KCC2-9). The KCC2-22T cells produced a glycoprotein of approximately 150 kDa that was absent from HEK-293 control cells. The 86Rb influx in both cell lines was significantly greater than untransfected control HEK-293 cells. The KCC2-9 cells displayed a constitutively active 86Rb influx that could be increased further by 1 mM N-ethylmaleimide (NEM) but not by cell swelling. Both furosemide [inhibition constant (Ki) approximately 25 microM] and bumetanide (Ki approximately 55 microM) inhibited the NEM-stimulated 86Rb influx in the KCC2-9 cells. This diuretic-sensitive 86Rb influx in the KCC2-9 cells, operationally defined as KCC2 mediated, required external Cl- but not external Na+ and exhibited a high apparent affinity for external Rb+(K+) [Michaelis constant (Km) = 5.2 +/- 0.9 (SE) mM; n = 5] but a low apparent affinity for external Cl- (Km > 50 mM). On the basis of thermodynamic considerations as well as the unique kinetic properties of the KCC2 isoform, it is hypothesized that KCC2 may serve a dual function in neurons: 1) the maintenance of low intracellular Cl- concentration so as to allow Cl- influx via ligand-gated Cl- channels and 2) the buffering of external K+ concentration ([K+]o) in the brain.
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                Author and article information

                Journal
                Otolaryngology–Head and Neck Surgery
                Otolaryngol Head Neck Surg
                SAGE Publications
                0194-5998
                1097-6817
                January 2021
                June 30 2020
                January 2021
                : 164
                : 1
                : 117-123
                Affiliations
                [1 ]Department of Otorhinolaryngology–Head and Neck Surgery, Ercis State Hospital, Van, Turkey
                [2 ]Department of Otorhinolaryngology–Head and Neck Surgery, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
                [3 ]Department of Neurology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
                [4 ]Department of Histology and Embryology, School of Medicine, Marmara University, Istanbul, Turkey
                [5 ]Department of Biophysics, School of Medicine, Marmara University, Istanbul, Turkey
                Article
                10.1177/0194599820937670
                32600218
                bd025376-723a-422d-8470-e0ac9f2fb0e8
                © 2021

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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