4-chloro-m-cresol-induced contractures of skeletal muscle specimen from patients at risk for malignant hyperthermia

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
F WapplerJ Schulte am Esch

Abstract

4-chloro-m-cresol (4-CmC), commonly used as preservative, has been shown to induce contractures in skeletal muscle specimens from individuals susceptible to malignant hyperthermia (MH). It has been suggested that a defect of the calcium release channel of the skeletal muscle sarcoplasmic reticulum (ryanodine receptor) in MH susceptible (MHS) patients could be responsible for this phenomenon. 4-CmC was found to be a potent activator of ryanodine receptor-mediated Ca2+ release. The aim of this study was to determine the in vitro effects of 4-CmC on muscle specimens from MHS and normal (MHN) patients, and whether contracture testing with different concentrations of 4-CmC could result in a more precise discrimination between MHS and MHN. In this prospective study muscle biopsies were obtained from 40 patients with clinical suspicion of MH. The patients were first classified by the in vitro contracture test (IVCT) according to the European MH protocol. After MH classification, surplus muscle specimens were subjected to the 4-CmC study. Cumulative administration of 4-CmC (25, 50, 75, 100, 150, and 200 mumol/l) produced contractures in a concentration-dependent manner. However, contractures developed significantly earlier and were gre...Continue Reading

Citations

Aug 6, 2000·British Journal of Anaesthesia·P M Hopkins
Jun 9, 1999·Anesthesiology·F WapplerJ Schulte am Esch
Mar 14, 2000·Acta Anaesthesiologica Scandinavica·M AnetsederN Roewer
Oct 9, 2003·Wiener klinische Wochenschrift·Fritz ZimprichJosef Zeitlhofer

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