Vascular changes, toxicants that Induce

OKT3, an immunosuppressive monoclonal antibody, can induce systemic vascular changes (leaky syndrome) and prerenal azotemia, presumably by stimulating the release of cytokines (e.g., tumor necrosis factor). These effects are seen more often in poorly hydrated patients. There is also evidence that OKT3 may induce a direct tubular toxicity, since significant numbers of patients developing renal insufficiency also exhibit enzymuria. 

Administration of imipramine plus serotonin to rats resulted in muscle changes which were consistent with the vascular theory of Duchenne dystrophy.21 However, other data suggest that the effect of the drugs on skeletal muscle were not due to the blockade of neuronal uptake of serotonin and subsequent vascular induced ischemia, but rather reflected a direct toxic effect on skeletal muscle.22... 

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