A procyanidin type A trimer from cinnamon extract attenuates glial cell swelling and the reduction in glutamate uptake following ischemia-like injury in vitro

Dietary polyphenols exert neuroprotective effects in ischemic injury. The protective effects of a procyanidin type A trimer (trimer 1) isolated from a water soluble cinnamon extract (CE) were investigated on key features of ischemic injury, including cell swelling, increased free radical production, increased intracellular calcium ([Ca(2+)](i)), mitochondrial dysfunction, and the reduction in glutamate uptake. Astrocyte (glial) swelling is a major component of cytotoxic brain edema in ischemia and, along with vasogenic edema, may contribute to increased intracranial pressure, brain herniation, and additional ischemic injuries. C6 glial cultures were exposed to oxygen-glucose deprivation (OGD) for 5 h, and cell swelling was determined at 90 min after the end of OGD. OGD-induced increases in glial swelling were significantly blocked by trimer 1, but not by the major nonpolyphenol fractions of CE including cinnamaldehyde and coumarin. Increased free radical production, a contributing factor in cell swelling following ischemic injury, was also significantly reduced by trimer 1. Mitochondrial dysfunction, another key feature of ischemic injury, is hypothesized to contribute to glial swelling. Depolarization of the inner mitochondrial membrane potential (ΔΨ(m)) was assessed using a fluorescent dye (tetramethylrhodamine ethyl ester [TMRE]), and was significantly attenuated by trimer 1 as was OGD-induced increased [Ca(2+)](i). Taken together with our previous observation that blockers of [Ca(2+)](i) reduce cell swelling, our results indicate that trimer 1 may attenuate cell swelling by regulating [Ca(2+)](i). Trimer 1 also significantly attenuated the OGD-induced decrease in glutamate uptake. In addition, cyclosporin A, a blocker of the mitochondrial permeability pore (mPT), but not FK506 (that does not block the mPT), reduced the OGD-induced decline in glutamate uptake indicating a role of the mPT in such effects. Thus, the effects of trimer 1 in attenuating the reduction in glutamate uptake are likely mediated through their action on the mitochondria.

Clomifene citrate or low-dose FSH for the first-line treatment of infertile women with anovulation associated with polycystic ovary syndrome: a prospective randomized multinational study

BACKGROUND

Clomifene citrate (CC) is accepted as the first-line method for ovulation induction (OI) in patients with polycystic ovary syndrome (PCOS) associated with infertility owing to anovulation. Low-dose FSH has been reserved for women failing to conceive with CC. In this RCT, we tested the hypothesis that pregnancy rate (PR) and live birth rates (LBR) are higher after OI with low-dose FSH than with CC as first-line treatment.

METHODS

Infertile women (<40 years old) with PCOS-related anovulation, without prior OI treatment, attending 10 centres in Europe/South America were randomized to OI with either CC (50-150 mg/day for 5 days) or FSH (starting dose 50 IU) for up to three treatment cycles. The primary outcome was clinical PR.

RESULTS

Patients (n = 302) were randomized to OI with FSH (n = 132 women; 288 cycles) or CC (n = 123; 310 cycles). Per protocol analysis revealed that reproductive outcome was superior after OI with FSH than with CC with respect to PR per first cycle [30 versus 14.6%, respectively, 95% confidence interval (CI) 5.3-25.8, P = 0.003], PR per woman, (58 versus 44% of women, 95% CI 1.5-25.8, P = 0.03), LBR per woman (52 versus 39%, 95% CI 0.4-24.6, P = 0.04), cumulative PR (52.1 versus 41.2%, P = 0.021) and cumulative LBR (47.4 versus 36.9%, P = 0.031), within three cycles of OI.

CONCLUSIONS

Pregnancies and live births are achieved more effectively and faster after OI with low-dose FSH than with CC. This result has to be balanced by convenience and cost in favour of CC. FSH may be an appropriate first-line treatment for some women with PCOS and anovulatory infertility, particularly older patients.

Data-driven assessment of the human ovarian reserve

Human ovarian physiology is still poorly understood, with the factors and mechanisms that control initiation of follicular recruitment and loss remaining particularly unclear. Conventional hypothesis-led studies provide new data, results and insights, but datasets from individual studies are often small, allowing only limited interpretation. Great power is afforded by the aggregation of data from multiple studies into single datasets. In this paper, we describe how modern computational analysis of these datasets provides important new insights into ovarian function and has generated hypotheses that are testable in the laboratory. Specifically, we can hypothesize that age is the most important factor for variations in individual ovarian non-growing follicle (NGF) populations, that anti-Müllerian hormone (AMH) levels generally rise and fall in childhood years before peaking in the mid-twenties, and that there are strong correlations between AMH levels and both NGF populations and rates of recruitment towards maturation, for age ranges before and after peak AMH levels.

Kisspeptin-10 is a potent stimulator of LH and increases pulse frequency in men

CONTEXT

Kisspeptins stimulate GnRH and thus gonadotropin secretion. Kisspeptin-10 is the minimal kisspeptin sequence with full intrinsic bioactivity, but it has not been studied in man.

OBJECTIVE

We investigated our hypothesis that kisspeptin-10 increases GnRH and thus LH pulse frequency.

DESIGN AND PARTICIPANTS

The dose response of kisspeptin-10 was investigated by administering iv bolus doses (0.01-3.0 μg/kg) and vehicle to healthy men. Effects on LH pulse frequency and size were determined by deconvolution analysis during infusion of kisspeptin-10 for up to 22.5 h.

RESULTS

Intravenous bolus kisspeptin-10 resulted in a rapid and dose-dependent rise in serum LH concentration, with maximal stimulation at 1 μg/kg (4.1 ± 0.4 to 12.4 ± 1.7 IU/liter at 30 min, P < 0.001, n = 6). Administration of 3 μg/kg elicited a reduced response vs. 1 μg/kg (P < 0.05). Infusion of kisspeptin-10 at 4 μg/kg · h for 22.5 h elicited an increase in LH from a mean of 5.4 ± 0.7 to 20.8 ± 4.9 IU/liter (n = 4; P < 0.05) and serum testosterone increased from 16.6 ± 2.4 to 24.0 ± 2.5 nmol/liter (P < 0.001). LH pulses were obscured at this high rate of secretion, but a lower dose infusion of kisspeptin-10 (1.5 μg/kg · h) increased mean LH from 5.2 ± 0.8 to 14.1 ± 1.7 IU/liter (n = 4; P < 0.01) and increased LH pulse frequency from 0.7 ± 0.1 to 1.0 ± 0.2 pulses/h (P < 0.05) and secretory burst mass from 3.9 ± 0.4 to 12.8 ± 2.6 IU/liter (P < 0.05).

CONCLUSIONS

Kisspeptin-10 boluses potently evoke LH secretion in men, and continuous infusion increases testosterone, LH pulse frequency, and pulse size. Kisspeptin analogues have therapeutic potential as regulators of LH and thus testosterone secretion.

The stability of sucrose monolaurate: Rate of formation of lauric acid

At concentrations below the critical micelle concentration, sucrose monolaurate hydrolyses to give lauric acid at first-order rates. At concentrations above the critical micelle concentration first-order kinetics are not obeyed. In systems buffered to pH values sufficiently high for the liberated lauric acid to ionize, the laurate ions appear to form mixed micelles with the ester and these carry negative charges. Coulombic repulsion of hydroxyl ions by these negative charges protects neighbouring ester molecules from attack and so reduces hydrolysis rates.

Mechanisms underlying the protective effects of myricetin and quercetin following oxygen-glucose deprivation-induced cell swelling and the reduction in glutamate uptake in glial cells

The protective effects of the flavonoid polyphenols, myricetin and quercetin, were investigated on key features of ischemic injury in cultures including cell swelling and the reduction in glutamate uptake. C6 glial cells were exposed to oxygen-glucose deprivation (OGD) for 5 h and cell swelling was determined 90 min after the end of OGD. OGD-induced swelling was significantly blocked by both quercetin and myricetin although higher concentrations were required for quercetin. OGD-induced free radical production, a contributing factor in cell swelling, was significantly reduced by both myricetin and quercetin. However, depolarization of the inner mitochondrial membrane potential (ΔΨ(m)), the blockade of which generally reduces swelling, was significantly diminished by myricetin, but not quercetin. This indicated that quercetin could reduce swelling despite its inability to prevent depolarization of ΔΨ(m) possibly through other signaling pathways. Increased intracellular calcium ([Ca²+](i)) is an important characteristic of ischemic injury and is implicated in swelling. Both myricetin and quercetin attenuated the increase in [Ca²+](i). Further, a reduction in [Ca²+](i), through the use of nifedipine, nimodipine, verapamil, dantrolene, or BAPTA-AM, significantly reduced OGD-induced cell swelling indicating that one possible mechanism by which such flavonoids attenuate cell swelling may be through regulating [Ca²+](i). OGD-induced decrease in glutamate uptake was attenuated by myricetin, but not quercetin. Cyclosporin A, a blocker of the mitochondrial permeability transition (mPT) pore, but not FK506 (that does not block the mPT), attenuated the decline in glutamate uptake after OGD, indicating the involvement of the mPT in glutamate uptake. Our results indicated that while blockade of ΔΨ(m) may be sufficient to reduce swelling, it may not be a necessary factor, and that flavonoids reduce cell swelling by regulating [Ca²+](i). The differential effects of myricetin and quercetin on OGD-induced reduction on glutamate uptake may be due to their differential effects on mitochondria.

IMMUNOLOGIC STUDY OF STRAINS OF BACILLUS PFEIFFERI ISOLATED FROM A CASE OF MENINGITIS

Five strains of Bacillus pfeifferi were isolated from a case of meningitis. These strains came from the spinal fluid, blood, nose, throat, and nasopharynx. Immunologic reactions show no definite relations between these strains, although those from the nose, throat, and nasopharynx might be presumed to be related to one another. It is also presumable that the spinal fluid strain was derived from the upper air passages, and that the blood was invaded from the meninges. In spite of immunologic differences, it is believed that the five strains were genetically related. The variations in these five strains from a single case are as great as those which have been found by others for strains from different cases, or individuals. As determined by immunologic reactions, the number of so called strains of Bacillus pfeifferi is apparently limited only by the number of cultures which have been or might be isolated. It is inconceivable that under the designation Bacillus pfeifferi is included a heterogeneous mixture of innumerable distinct races of bacteria; there must be some biological relation which cannot be established by agglutination, complement fixation, or opsonin reactions. The variations which have been noted, may be an indication of a degree of instability which may have some bearing upon questions relating to the epidemiology of Bacillus pfeifferi infections and to the serum therapy of influenzal meningitis. The strain variations which have been shown to exist by immunologic methods do not support the theory of the etiological relationn of Bacillus pfeifferi to epidemic influenza, unless it can be shown that such variations are due to instability of the organism. The fact that the incidence of meningeal involvement was only slightly increased during the last pandemic is also evidence against the causal relation of the organism to the pandemic disease.

Cinnamon extract regulates plasma levels of adipose-derived factors and expression of multiple genes related to carbohydrate metabolism and lipogenesis in adipose tissue of fructose-fed rats

We reported earlier that dietary cinnamon extract (CE) improves systemic insulin sensitivity and dyslipidemia by enhancing insulin signaling. In the present study, we have examined the effects of CE on several biomarkers including plasma levels of adipose-derived adipokines, and the potential molecular mechanisms of CE in epididymal adipose tissue (EAT). In Wistar rats fed a high-fructose diet (HFD) to induce insulin resistance, supplementation with a CE (Cinnulin PF, 50 mg/kg daily) for 8 weeks reduced blood glucose, plasma insulin, triglycerides, total cholesterol, chylomicron-apoB48, VLDL-apoB100, and soluble CD36. CE also inhibited plasma retinol binding protein 4 (RBP4) and fatty acid binding protein 4 (FABP4) levels. CE-induced increases in plasma adiponectin were not significant. CE did not affect food intake, bodyweight, and EAT weight. In EAT, there were increases in the insulin receptor ( IR) and IR substrate 2 ( IRS2) mRNA, but CE-induced increases in mRNA expression of IRS1, phosphoinositide-3-kinase, AKT1, glucose transporters 1 and 4 , and glycogen synthase 1 expression and decreased trends in mRNA expression of glycogen synthase kinase 3beta were not statistically significant. CE also enhanced the mRNA levels of ADIPOQ, and inhibited sterol regulatory element binding protein-1c mRNA levels. mRNA and protein levels of fatty acid synthase and FABP4 were inhibited by CE and RBP4, and CD36 protein levels were also decreased by CE. These results suggest that CE effectively ameliorates circulating levels of adipokines partially mediated via regulation of the expression of multiple genes involved in insulin sensitivity and lipogenesis in the EAT.

The forkhead transcription factor FOXL2 is expressed in somatic cells of the human ovary prior to follicle formation

Interactions between germ cells and surrounding somatic cells are central to ovarian development as well as later function. Disruption of these interactions arising from abnormalities in either cell type can lead to premature ovarian failure (POF). The forkhead transcription factor FOXL2 is a candidate POF factor, and mutations in the FOXL2 gene are associated with syndromic and non-syndromic ovarian failure. Foxl2-deficient mice display major defects in primordial follicle activation with consequent follicle loss, and earlier roles in gonadal development and sex determination have also been suggested. However, despite its importance no data presently exist on its expression in the developing human ovary. Expression of FOXL2 mRNA was demonstrated in the human fetal ovary between 8 and 19 weeks gestation, thus from soon after sex determination to primordial follicle development. Expression in the ovary was higher after 14 weeks than at earlier gestation weeks and was very low in the fetal testis at all ages examined. Immunolocalization revealed FOXL2 expression to be confined to somatic cells, both adjacent to germ cells and those located in the developing ovarian stroma. These cells are the site of action of oocyte-derived activin signalling, but in vitro treatment of human fetal ovaries with activin failed to reveal any regulation of FOXL2 transcription by this pathway. In summary, the expression of FOXL2 in somatic cells of the developing human ovary before and during follicle formation supports a conserved and continuing role for this factor in somatic/germ cell interactions from the earliest stages of human ovarian development.

Cumulus gene expression as a predictor of human oocyte fertilisation, embryo development and competence to establish a pregnancy

The close relationship between cumulus cell function and oocyte developmental competence indicates that analysis of cumulus gene expression is a potential non-invasive method to aid embryo selection and IVF outcome. Cumulus was isolated from 674 oocytes from 75 women undergoing ICSI and gene expression analysed by quantitative RT-PCR. Cumulus expression of cyclooxygenase 2 (PTGS2) was higher with mature oocytes, whereas brain-derived neurotrophic factor (BDNF) was lower when fertilisation was normal. Expression levels of gremlin (GREM1) and BDNF were weak positive and negative predictors of embryo quality respectively. Ranking of GREM1 expression within cohorts of oocytes showed that oocytes associated with the highest GREM1 expression were more likely to be transferred or cryopreserved than discarded (49 vs 33%, P<0.02), although the clinical pregnancy rate was not significantly different. This study demonstrates both the feasibility and difficulties of this method of analysis in the largest such group studied thus far. Novel relationships between BDNF expression and fertilisation were identified, and the potential value of GREM1 expression as a marker of embryo quality supports the further assessment of GREM1 analysis in the context of embryo selection.

Cinnamon extract attenuates TNF-alpha-induced intestinal lipoprotein ApoB48 overproduction by regulating inflammatory, insulin, and lipoprotein pathways in enterocytes

We have previously reported that the obesity-associated proinflammatory cytokine, TNF-alpha, stimulates the overproduction of intestinal apolipoprotein (apo) B48 containing lipoproteins. In the current study, we have evaluated whether a water-soluble cinnamon extract [CE (Cinnulin PF)] attenuates the dyslipidemia induced by TNF-alpha in Triton WR-1339 treated hamsters, and whether CE inhibits the oversecrection of apoB48-induced by TNF-alpha in enterocytes in a 35S labeling study. In vivo, oral treatment of Cinnulin PF (50 mg per kg BW), inhibited the postprandial overproduction of apoB48-containing lipoproteins and serum triglyceride levels. In ex vivo 35S labeling studies, CE (10 and 20 microg/ml) inhibited the oversecretion of apoB48 induced by TNF-alpha treated enterocytes into the media. To determine the molecular mechanisms, TNF-alpha treated primary enterocytes isolated from chow-fed hamsters, were incubated with CE (10 microg/ml), and the expression of the inflammatory factor genes, IL1-beta, IL-6, and TNF-alpha, insulin signaling pathway genes, insulin receptor (IR), IRS1, IRS2, phosphatidylinositol 3-kinase (PI3-K), Akt1 and phosphatase and tensin homology (PTEN), as well as the key regulators of lipid metabolism, cluster of differentiation (CD)36, microsomal triglyceride transfer protein (MTTP), and sterol regulatory element binding protein (SREBP)-1c were evaluated. Quantitative real-time PCR assays showed that CE treatment decreased the mRNA expression of IL-1beta, IL-6 and TNF-alpha, improved the mRNA expression of IR, IRS1, IRS2, PI3K and Akt1, inhibited CD36, MTTP, and PTEN, and enhanced the impaired SREBP-1c expression in TNF-alpha treated enterocytes. These data suggest that a water extract of cinnamon reverses TNF-alpha-induced overproduction of intestinal apoB48 by regulating gene expression involving inflammatory, insulin, and lipoprotein signaling pathways. In conclusion, Cinulin PF improves inflammation related intestinal dyslipidemia.

Trace elements and cardiovascular diseases

Evidence linking marginal intakes of the trace elements, chromium, copper, zinc and selenium, with abnormal lipid metabolism and ultimately cardiovascular diseases is accumulating from both animal and human studies. Chromium supplementation of normal adult men, as well as diabetics, has been reported to increase high density lipoprotein cholesterol and decrease triglycerides and total cholesterol. Subjects with the highest total cholesterol and triglycerides usually respond the most to supplemental chromium. Improvements in lipid metabolism, as well as those in glucose metabolism, appear to be related to improvements in insulin efficiency due likely to increased receptor number. Animal studies also indicate that improvements in serum cholesterol, aortic lipids and plaque formations due to supplemental chromium are associated with decreased circulating insulin. Insufficient dietary copper also leads to elevated lipid levels and impaired heart function. Animal studies indicate an obvious degradation of the heart muscles. Zinc appears to function in cardiovascular diseases primarily via its antagonism with copper. Selenium may also affect cardiovascular diseases since selenium is postulated to be involved in platelet aggregation. These data demonstrate that the trace elements, chromium, copper, and selenium, have beneficial effects on risk factors associated with cardiovascular diseases suggesting that a decreased risk of cardiovascular disease may be achieved by adequate intake of trace elements.

Fertility preservation techniques: laboratory and clinical progress and current issues

Human fertility is dependent on maturation of germ cells through meiosis and their association with supporting cells, which in the female are also the source of sex steroids. These processes are sensitive to both chemotherapy and radiotherapy thus can be damaged by anti-cancer treatments. The uterus is also sensitive to radiotherapy. Our understanding of and the ability to manipulate fertility has increased together with survival rates from many cancers, particularly those affecting children, younger men, and women. The growth of interest in fertility preservation for cancer patients is a natural union of these two fields. Sperm banking has been available for many years, and is a recognized and evidence-based option for men that should be available to all. Options for women and pre-pubertal boys and girls are, however, more experimental, other than for women of committing oocytes to fertilization and cryopreservation as embryos. This Focus Issue of Reproduction aims to address the current status of some of the clinical and laboratory aspects of this burgeoning subspecialty to highlight not only areas of progress but also areas of uncertainty where future developments are required to allow the provision of accurate information, and safe and effective treatments.