Soluble (1-->3)-beta-D-glucan purified from Candida albicans: biologic effects and distribution in blood and organs in rabbits

(1-->3)-beta-D-glucan is a ubiquitous constituent of fungi, and elevated plasma glucan levels are commonly present in patients with deep mycosis or fungemia. The pharmacokinetics, biologic effects, and distribution in blood and organs of iodine 125-labeled (1--> 3)-beta-D-glucan purified from Candida albicans organisms were analyzed in rabbits during the 24-hour period after intravenous administration of this constituent. The intravascular half-life of beta-glucan was 1.8 minutes in the low-dose group (9.3 micrograms/kg, n = 3) and 1.4 minutes in the high-dose group (222 micrograms/kg, n = 3), and the total body clearance was 1.12 +/- 0.30 ml/min and 1.17 +/- 0.16 ml/min (mean +/- SD), respectively (not significantly different). The serum concentration of (1-->3)-beta-D-glucan was also biologically determined by a test using coagulation factor G of the Japanese horse-shoe crab (G test). There was good correlation between the clearance of beta-glucan measured biologically and isotopically. During the 24-hour period of observation the rabbits remained well and beta-glucan failed to alter blood cell counts, tumor necrosis factor levels, or lipid metabolism. 125I-labeled beta-glucan associated with the blood cellular compartment initially was less than 3% (the majority in the platelets) and decreased further during the following 2-hour period. Over 97% of circulating 125I-labeled beta-glucan was associated with the cell-free plasma, and the majority of this glucan in plasma appeared not to be associated with lipoproteins. The liver contained more than 80% of the 125I-labeled beta-glucan detected in the six major organs analyzed.

Inadequate treatment with HMG-CoA reductase inhibitors by health care providers

PURPOSE

To determine if patients treated with HMG-CoA reductase inhibitors have their LDL cholesterol levels at or below the levels recommended by the National Cholesterol Education Program (NCEP) and if patients on these medications are monitored for potential toxicity.

PATIENTS AND METHODS

Ninety patients from the VA Medical Center in San Francisco were randomly selected in this retrospective analysis. All patients were taking a HMG-CoA reductase inhibitor as monotherapy for treatment of high blood cholesterol for a minimum of 1 year. Medical charts and laboratory and pharmacy computer databases were utilized to gather information regarding the patients' medical history, treatment history, relevant laboratory tests, and medication refill profile.

RESULTS

The majority of patients, 73%, were secondary prevention patients. Only 33% of the 90 subjects met the LDL cholesterol goal recommended by the NCEP. For the secondary prevention patients, only 24% met goal LDL. Even when the stringency of the NCEP guidelines was reduced by 20% (goal LDL < 120 mg/dL), 50% of the secondary prevention patients were still inadequately treated. Only 2 of the 90 patients were on maximal dosage regimens. Sixty-seven percent of patients had annual lipid panels and 49% had annual liver panels. Forty-five percent of patients followed by nonphysicians met goal LDL while only 29% and 31% of patients followed by attending physicians and residents/fellows met goal LDL, respectively. In addition, patients followed by nonphysicians were monitored more closely for efficacy and toxicity of the medications.

CONCLUSIONS

Based on the current NCEP recommendations, patients on monotherapy with HMG-CoA reductase inhibitors are often inadequately treated. Only 33% of the patients evaluated at our institution were at or below the NCEP recommended LDL cholesterol levels and less than half of the patients were adequately monitored for hepatotoxicity.

Hormonal basis for the gender difference in epidermal barrier formation in the fetal rat. Acceleration by estrogen and delay by testosterone

Previous studies have shown that ontogeny of the epidermal permeability barrier and lung occur in parallel in the fetal rat, and that pharmacologic agents, such as glucocorticoids and thyroid hormone, accelerate maturation at comparable developmental time points. Gender also influences lung maturation, i.e., males exhibit delayed development. Sex steroid hormones exert opposite effects on lung maturation, with estrogens accelerating and androgens inhibiting. In this study, we demonstrate that cutaneous barrier formation, measured as transepidermal water loss, is delayed in male fetal rats. Administration of estrogen to pregnant mothers accelerates fetal barrier development both morphologically and functionally. Competent barriers also form sooner in skin explants incubated in estrogen-supplemented media in vitro. In contrast, administration of dihydrotestosterone delays barrier formation both in vivo and in vitro. Finally, treatment of pregnant rats with the androgen antagonist flutamide eliminates the gender difference in barrier formation. These studies indicate that (a) estrogen accelerates and testosterone delays cutaneous barrier formation, (b) these hormones exert their effects directly on the skin, and (c) sex differences in rates of barrier development in vivo may be mediated by testosterone.

Metabolic approaches to enhance transdermal drug delivery. 1. Effect of lipid synthesis inhibitors

The intercellular domains of the stratum corneum, which contain a mixture of cholesterol, free fatty acids, and ceramides, mediate both the epidermal permeability barrier and the transdermal delivery of both lipophilic and hydrophilic molecules. Prior studies have shown that each of the three key lipid classes is required for normal barrier function. For example, selective inhibition of either cholesterol, fatty acid, or ceramide synthesis in the epidermis delays barrier recovery rates after barrier perturbation of hairless mouse skin in vivo. In this study, we investigated the potential of certain inhibitors of lipid synthesis to enhance the transdermal delivery of lidocaine or caffeine as a result of their capacity to perturb barrier homeostasis. After acetone disruption of the barrier, the extent of lidocaine delivery and the degree of altered barrier function paralleled each other. Moreover, the further alteration in barrier function produced by either the fatty acid synthesis inhibitor 5-(tetradecyloxy)-2-furancarboxylic acid (TOFA), the cholesterol synthesis inhibitor fluvastatin (FLU), or cholesterol sulfate (CS) resulted in a further increase in lidocaine absorption. Furthermore, coapplications of TOFA and CS together caused an additive increase in lidocaine uptake. Finally, a comparable increase in drug delivery occurred when the barrier was disrupted initially with DMSO instead of acetone; coapplications of TOFA and FLU together again delayed barrier recovery and increased drug delivery by about 8-fold vs delivery from a standard enhancing vehicle. Whereas these metabolic inhibitors also variably increased the octanol/water partitioning of the drugs studied (perhaps via complexion or pH alterations), physicochemical effects of the inhibitors alone did not alter drug uptake in intact skin; i.e., passive mechanisms alone cannot account for the net increase in drug delivery. Our results show that modulations of epidermal lipid biosynthesis, following application of conventional, chemical penetration enhancers, cause a further boost in drug delivery, attributable to the ability of these agents to alter both permeability barrier homeostasis and thermodynamics. This biochemical/metabolic approach provides a novel means to enhance transdermal drug delivery in conjunction with the concurrent or prior use of chemical enhancers.

Decreased epidermal lipid synthesis accounts for altered barrier function in aged mice

The epidermis of aged mice displays decreased stratum corneum (SC) lipid content and decreased extracellular bilayers, which result in impaired barrier recovery following the solvent treatment or tape stripping. We assessed the role of altered lipid synthesis as the cause of the abnormal barrier and lipid content in aged epidermis, both under basal conditions and in response to acute barrier perturbations. In aged epidermis ( > or = 18 months), synthesis of one of the three key lipid classes (cholesterol) is decreased under basal conditions, and sterologenesis fails to attain the levels reached in young epidermis following comparable acute perturbations. In contrast, fatty acid and sphingolipid synthesis in aged epidermis increase sufficiently to approach the levels attained in stimulated young epidermis. The abnormalities in sterologenesis in aged epidermis are paralleled by a decrease in activity of its rate-limiting enzyme, 3-hydroxy-3-methylglutaryl-coenzyme A reductase, under basal conditions, and enzyme activity also fails to increase as much as in young epidermis after barrier disruption. That defective lipid generation contributes to the barrier defect is shown directly by the ability of either a cholesterol-containing mixture of SC lipids or cholesterol alone to enhance barrier recovery. Finally, lipid-induced acceleration of barrier recovery in aged epidermis correlates with repletion of the extracellular spaces with normal lamellar structures. Thus, a deficiency in lipid synthesis, particularly in cholesterologenesis, accounts for the barrier abnormality in aged epidermis.

Endotoxin and cytokines induce expression of leptin, the ob gene product, in hamsters

The expression of leptin, the ob gene product, is increased in adipose tissue in response to feeding and energy repletion, while leptin decreases food intake. Because adipose tissue gene expression is regulated by cytokines induced during infection and because infection is associated with anorexia, we tested whether induction of leptin might occur during the host response to infection. Administration of endotoxin (LPS), a model for gram negative infections, induces profound anorexia and weight loss in hamsters. In fasted adipose tissue to levels similar to fed control animals. There is a strong inverse correlation between mRNA levels of leptin and subsequent food intake. TNF and IL-1, mediators of the host response to LPS, also induced anorexia and increased levels of leptin in mRNA in adipose tissue. As assessed by immuknoprecipitation and Western blotting, circulating leptin protein is regulated by LPS and cytokines in parallel to regulation of adipose tissue leptin mRNA. Induction of leptin during the host response to infection may contribute to the anorexia of infection.

Optimization of physiological lipid mixtures for barrier repair

Three stratum corneum lipids, ceramides, cholesterol (CHOL), and free fatty acids (FA), are required for permeability barrier homeostasis. Recent studies have shown that application of one or two of these lipids to perturbed skin delays barrier recovery; only equimolar mixtures allow normal recovery. We asked here whether any physiological lipid mixtures improve barrier repair, as assessed by transepidermal water loss. Whereas an equimolar ratio of ceramides, CHOL, and FA (either the essential fatty acid, linoleic acid, or the nonessential FAs, palmitic or stearic acids) allows normal repair, further acceleration of barrier repair occurs as the ratio of any of these ingredients is increased up to 3-fold. Similar preliminary results were obtained in damaged human skin. Likewise, while acylceramides alone delay barrier recovery, acylceramides: CHOL mixtures within a specific range of molar rations dramatically improve barrier repair. Furthermore, glycosyl ceramides, sphingomyelin, and triglycerides substitute effectively for ceramides and FA, respectively, but neither phospholipids nor cholesterol esters substitute for FA and CHOL, respectively. These studies show the specific requirements of selected stratum corneum lipid mixtures for optimized barrier repair in murine skin, with further validation in human skin. Utilization of physiologic lipids according to these parameters could lead to new forms of topical therapy for dermatoses (e.g., psoriasis, atopic dermatitis, and irritant dermatitis) triggered by abnormal barrier function.

Oxidized lipids in the diet accelerate the development of fatty streaks in cholesterol-fed rabbits

Studies have indicated that oxidized lipoproteins may play a role in atherosclerosis. We have recently demonstrated that the levels of oxidized lipoproteins in the circulation can be directly correlated to the quantity of oxidized lipids in the diet. The present study tested the hypothesis that dietary oxidized lipids accelerate the development of atherosclerosis. For 12 to 14 weeks, 36 male New Zealand White rabbits were fed a low-cholesterol (0.25%) diet containing either 5% unoxidized corn oil (control diet) or 5% oxidized corn oil (oxidized-lipid diet). Serum cholesterol levels increased to a similar extent in both groups, with the majority of the cholesterol in the beta-migrating very low density lipoprotein (beta-VLDL) fraction. Beta-VLDL from control animals contained 3.86+/- 0.57 versus 9.07 +/- 2.14 nmol conjugated dienes per micromol cholesterol (P<.05) in rabbits fed the oxidized-lipid diet. No difference in oxidized lipid levels was detected in LDL. Most important, feeding a diet rich in oxidized-lipid resulted in a 100% increase in fatty streak lesions in the aorta. Additionally, rabbits that were fed the oxidized-lipid++ diet had a >100% increase in total cholesterol in the pulmonary artery that was primarily due to an increase in cholesteryl ester. Oxidized lipids are frequently present in the typical US diet, and our results suggest that consumption of these foods may be an important risk factor for atherosclerosis.

Parathyroid hormone-related protein is induced during lethal endotoxemia and contributes to endotoxin-induced mortality in rodents

BACKGROUND

Parathyroid hormone-related protein (PTHrP) is a ubiquitous and highly conserved vasoactive peptide whose role and regulation in normal physiology remain an enigma. Recently, we demonstrated that low-dose endotoxin (LPS) induces intrasplenic, but not systemic, levels of PTHrP; and that tumor necrosis factor, a pro-inflammatory cytokine, is the major mediator of this effect. We have therefore hypothesized that, with higher, lethal doses of endotoxin, PTHrP could be induced in multiple tissues to such a degree that it could contribute to the lethality of septic shock.

MATERIALS AND METHODS

Northern blot analysis was used to measure PTHrP mRNA levels in vital organs of rats after administration of a near lethal dose (5 mg/250 g) of LPS (or vehicle alone). Plasma levels of PTHrP were also measured by immunoradiometric assay. The ability of the immunoglobulin fraction of two different PTHrP(1-34) antisera to protect from LPS-induced lethality was also studied in mice using survival analysis.

RESULTS

In response to a near-lethal dose of endotoxin, PTHrP mRNA levels increased acutely in every vital organ examined (spleen, lung, heart, kidney, and liver). Circulating levels of PTHrP also increased, peaking 2 hr after administration of high-dose endotoxin. Passive immunization of mice with anti-PTHrP(1-34) antibody 6 hr prior to administration of a lethal dose of LPS protected mice from endotoxin-induced death (p < 0.00005).

CONCLUSIONS

These results suggest that PTHrP belongs to the cascade of pro-inflammatory cytokines induced during lethal endotoxemia that is responsible for the toxic effects of LPS.

Barrier disruption stimulates interleukin-1 alpha expression and release from a pre-formed pool in murine epidermis

Previous studies have shown that barrier disruption increases epidermal mRNA levels of interleukin-1 alpha (IL-1 alpha). We used immunohistochemistry to examine IL-1 alpha expression in hairless mouse skin under basal conditions and following barrier abrogation. In untreated mice, IL-1 alpha was present in the dermis and nucleated epidermal layers in a diffuse, generalized pattern. In essential fatty acid deficient mice IL-1 alpha was present in all epidermal layers and the dermis, with prominent staining in the stratum corneum. After acute barrier disruption with tape-stripping, IL-1 alpha increased in the epidermis and dermis within 10 min, remained elevated at 2 and 4 h, and decreased to near basal levels by 24 h. Moreover, intense, perinuclear, basal cell staining appeared at 10 min, persisting until 4 h after barrier disruption. Since the increase in IL-1 alpha immunostaining after acute barrier abrogation precedes the increase in mRNA, we hypothesized that the IL-1 alpha might derive from a pre-formed pool. Prolonged occlusion of normal skin, a treatment that specifically reduces epidermal mRNA levels of IL-1 alpha, decreased basal immunostaining for IL-1 alpha and blunted the increase in IL-1 alpha usually seen following barrier disruption. Moreover, tape-stripping of skin, maintained ex vivo at 4 degrees C, resulted in increased IL-1 alpha immunostaining within the upper nucleated epidermal layers, as well as release of mature IL-1 alpha into the medium, as measured by Western blotting and enzyme-linked immunosorbent assay. In addition, the stratum corneum attached to the tape contained IL-1 alpha. These studies show that acute barrier disruption induces both the immediate release and dispersion of IL-1 alpha from a pre-formed, epidermal pool, as well as increased IL-1 alpha synthesis; both mechanisms are consistent with a role for IL-1 alpha in the regulation of proinflammatory and homeostatic processes in the skin.

Epidermal barrier ontogenesis: maturation in serum-free media and acceleration by glucocorticoids and thyroid hormone but not selected growth factors

Because the cutaneous permeability barrier develops late in gestation, prematurity may result in increased morbidity and mortality due to barrier incompetence. The purpose of the present study was to develop an in vitro model of barrier ontogenesis in order to identify those factors critical for fetal barrier formation. Skin explants from gestational day 17 fetal rats (term is 22 days) were incubated in hormone- and serum-free media. After 4 d in culture, a multi-layered stratum corneum (SC) developed that demonstrated a membrane pattern of fluorescence using the hydrophobic probe, nile red, and the deposition of mature lamellar unit structures throughout the SC interstices, ultrastructurally. Transepidermal water loss rates declined during explant culture such that after 4 d a competent barrier was present. Similarly, lanthanum permeation studies showed tracer penetration into all cell layers in 2-d explants, whereas it did not penetrate above the stratum granulosum in 4-d explants. Thus, the chronology of epidermal development in the explants precisely mirrored that observed in utero. Treatment with either 10 nM dexamethasone or 10 nM triiodothyronine accelerated SC development and barrier formation by 2 d. These results indicate that (i) the late events of fetal epidermal development progress in vitro under serum- and growth factor-free conditions, culminating in the formation of a functional barrier, and (ii) both dexamethasone and triiodothyronine accelerate barrier development.

Beta-nerve growth factor as a mediator of the acute phase response in vivo

Nerve growth factor (NGF) is increased during inflammation and stress. Stress-induced increases in specific serum proteins, such as serum amyloid A (SAA) and serum triglyceride (TG) levels, are part of the acute phase response which is mediated by cytokines. We now report the effect of systemic administration of beta-NGF on levels of serum lipids and SAA. Beta-NGF induced a rapid and sustained increase in serum TG and free fatty acid (FFA) in a dose dependent manner, while decreasing serum cholesterol levels in rats. Additionally, beta-NGF increased hepatic mRNA levels and serum concentrations of SAA at 16 hours in mice. Thus, beta-NGF joins the list of cytokines and growth factors that can mediate the acute phase response.

Endotoxin, TNF, and IL-1 decrease cholesterol 7 alpha-hydroxylase mRNA levels and activity

Endotoxin (LPS) and cytokines increase cholesterol synthesis and the secretion of lipoproteins by the liver in rodents resulting in hypercholesterolemia. Cholesterol 7 alpha-hydroxylase (CAH) is the rate-limiting enzyme in the conversion of cholesterol to bile acids in the liver, the major regulated pathway by which cholesterol is eliminated from the body. Decreases in CAH would increase the quantity of cholesterol available for lipoprotein production. In the present study, we demonstrate that LPS, TNF, or IL-1 administration to Syrian hamsters produces a marked decrease in the levels of CAH mRNA in the liver. This marked decrease occurred even when the basal level of CAH expression was increased by feeding the bile acid sequestrant, colestipol. Additionally, a marked decrease was also observed when the animals were fed a cholesterol-enriched diet. Moreover, the decrease in CAH mRNA occurred very rapidly (decreased 66% by 90 min after LPS administration) and required relatively small doses of LPS (100 ng/100 g body weight). Lastly, the decrease in mRNA levels was accompanied by a decrease in CAH activity. This decrease in CAH could contribute to the increase in hepatic lipoprotein production induced by LPS and cytokines. CAH can be added to the growing list of proteins that regulate lipid metabolism and that are altered during the acute phase response.

Oxidized lipids in the diet are incorporated by the liver into very low density lipoprotein in rats

Previous studies have shown that the quantity of oxidized lipids in the diet directly correlates with the level of oxidized chylomicrons in mesenteric lymph and the level of oxidized lipids in endogenous lipoproteins such as very low density lipoprotein (VLDL) and low density lipoprotein (LDL). The aim of the present study was to determine whether oxidized fatty acids in the diet are delivered via chylomicrons to the liver and whether these lipids are repackaged and secreted in VLDL. In these experiments, oxidized [14C]linoleic acid was utilized as a marker for oxidized dietary fats. When we determined the metabolism of nonoxidized and oxidized [14C]linoleic acid-labeled chylomicrons, we found that hepatic uptake was similar with 13.57 +/- 0.84% of nonoxidized and 13.40 +/- 0.96% of oxidized linoleic acid delivered to the liver 30 min after chylomicron administration. Additionally, uptake by the extrahepatic tissues was also similar. When the hepatic secretion of VLDL was determined in an in vitro perfusion system after the administration of nonoxidized and oxidized linoleic acid-labeled chylomicrons to intact animals, we found that oxidized linoleic acid was utilized for the formation and secretion of VLDL. After the administration of labeled nonoxidized and oxidized linoleic acid, 0.86 +/- 0.07% and 0.70 +/- 0.09% of the administered label was found in the liver perfusate at 2 h, respectively. The presence of oxidized linoleic acid in oxidized VLDL was confirmed by demonstrating the presence of hydroperoxide-derived hydroxy octadecanoic acid. Thus, our findings demonstrate that oxidized dietary lipids are delivered to the liver via chylomicrons where they are utilized for synthesis of endogenous lipoproteins such as VLDL.

Secretory phospholipase A2 activity is required for permeability barrier homeostasis

The extracellular bilayers which mediate the epidermal permeability barrier are enriched in ceramides, free fatty acids, and cholesterol. Yet, the epidermal lamellar body, the source of these lipids, is enriched in a more polar mixture; i.e., glucosylceramides and phospholipids, which it delivers to the stratum corneum (SC) interstices. Whereas the extracellular processing of glucosylceramides to ceramides has been shown to be required for barrier homeostasis, the requirement for phospholipid degradation to free fatty acids is not yet established. In this study, we ascertained that topical applications of two chemically unrelated inhibitors of secretory phospholipase A2 (PLA2), bromphenacyl bromide and MJ-33, produced a progressive perturbation in barrier function in intact murine skin, first appearing at 5 d, preceded by the development of epidermal hyperplasia. Moreover, the defect in barrier homeostasis could be reversed by topical co-applications of the nonessential fatty acid, and of palmitic acid, but not by linoleic acid, both products of phospholipid catabolism. Furthermore, the barrier abnormality was accompanied by a reduction in free fatty acid levels in the stratum corneum, while phospholipid levels remained unchanged. These biochemical alterations were accompanied by the appearance of immature, incompletely processed lamellar body-derived membranes in the SC interstices, and depletion of histochemically detectable neutral lipid. Both the abnormalities and the epidermal hyperplasia were reversed by co-applications of palmitic acid (but not linoleic acid) with either inhibitor. These results demonstrate that processing of phospholipids to nonessential free fatty acids, by a yet-to-be-identified extracellular phospholipase, is required for the maintenance of barrier homeostasis in intact skin. Furthermore, our studies show that the barrier abnormalities induced by the PLA2 inhibitors are due to a failure to generate free fatty acids rather than to phospholipid accumulation.

Cutaneous permeability barrier repair following various types of insults: kinetics and effects of occlusion

Previous studies have shown that acute disruption of the cutaneous permeability barrier by acetone results in an initial rapid phase of repair followed by a later, slower phase. In the present study, we demonstrate that manipulations which disrupt the barrier by other mechanisms, such as tape stripping or detergent treatment, have a similar pattern of barrier repair. In all three models, the return of lipid to the stratum corneum parallels the normalization of barrier function, and occlusion immediately after disrupting the barrier blocks both the return of lipid and the normalization of function. Moreover, occlusion beginning 6-8 h following barrier disruption blocks the late, slower phase of repair, indicating that the late phase can be inhibited independently of the initial phase. Lastly, both severe and relatively minor perturbations of the barrier elicit a repair response with a similar kinetic pattern. In summary, the present study demonstrates that barrier repair responses are similar regardless of the etiology or extent of barrier disruption.

Regulation of lipid metabolism by cytokines during host defense

Lipid metabolism is extensively regulated during the host response to infection. As with other aspects of the host response, these events are mediated by cytokines, including tumor necrosis factor, interleukin 1 (IL-1), IL-6, and the interferons. Cytokines can decrease lipoprotein lipase and increase lipolysis in cultured fat cells. In vivo, many cytokines increase serum triglycerides by increasing very-low-density lipoprotein production. Interferons increase triglycerides predominantly by decreasing lipoprotein lipase activity and triglyceride clearance. These changes in lipid metabolism do not cause cachexia. Rather, they represent part of the host defense, as lipoproteins scavenge infectious particles such as endotoxin.

Topical stratum corneum lipids accelerate barrier repair after tape stripping, solvent treatment and some but not all types of detergent treatment

Topical acetone treatment extracts lipids from the stratum corneum, and disrupts the permeability barrier, resulting in a homeostatic response in the viable epidermis that ultimately repairs the barrier. Recently, we have developed an optimal lipid mixture (cholesterol, ceramide, palmitate and linoleate 4.3:2.3:1:1.08) that, when applied topically, accelerates barrier repair following extensive disruption of the barrier by acetone. The present study determined if topical treatment with this optimal lipid mixture would have beneficial effects following disruption of the barrier by petroleum ether, tape stripping, or by detergent treatment. Also, we determined if barrier repair was accelerated after moderate disturbances of barrier function. Following moderate or extensive disruption of the barrier by acetone or petroleum ether (solvents), or tape stripping (mechanical), application of the optimal lipid mixture accelerated barrier repair. Additionally, following barrier disruption with N-laurosarcosine free acid or dodecylbenzensulphuric acid (detergents), the optimal lipid mixture similarly accelerated barrier repair. However, following disruption of the barrier with different detergents, sodium dodecyl sulphate and ammonium lauryl sulphosuccinate, the optimal lipid mixture did not improve barrier recovery. Thus, the optimal lipid mixture is capable of accelerating barrier repair following disruption of the barrier by solvent treatment or tape stripping (mechanical), and by certain detergents such as Sarkosyl and dodecylbenzensulphuric acid. The ability of the optimal lipid mixture to accelerate barrier repair after both moderate and extensive degrees of barrier disruption suggests a potential clinical use for this approach.

Effects of endotoxin on lipid metabolism

Endotoxin, via cytokines, induces marked changes in lipid metabolism which are now considered part of the acute phase response. The endotoxin induced hyperlipidemia may represent a nonspecific immune response that can decrease the toxicity of a variety of harmful biological and chemical agents and serve to redistribute nutrients to cells important in host defense. The endotoxin induced changes in lipid metabolism may therefore be beneficial.

Keratinocyte growth factor increases fatty acid mobilization and hepatic triglyceride secretion in rats

Keratinocyte growth factor (KGF) is a member of the fibroblast growth factor family that was originally identified as a keratinocyte mitogen after isolation from a lung fibroblast cell line. In this study, we demonstrate that administration of KGF to mice and rats elevates serum lipid levels. In rats, 1 h after KGF administration, serum triglyceride and FFA levels were increased, with peak values at 2 h (1.9-fold increase). The increase in serum triglyceride levels was sustained for at least 16 h. Serum cholesterol levels were also increased, but the effect was delayed beginning at 4 h, with peak values at 16 h (1.27-fold increase). KGF did not decrease the clearance of triglyceride-rich lipoproteins, but increased hepatic triglyceride secretion. KGF stimulated lipolysis, but not hepatic de novo fatty acid synthesis, and the increased delivery of FFA to the liver plays a crucial role in the KGF-induced hypertriglyceridemia. Neither alpha- nor beta-adrenergic receptor antagonists affected the hypertriglyceridemia induced by KGF, indicating that endogenous catecholamines are not involved in mediating KGF-induced hypertriglyceridemia. These results demonstrate that KGF induces hypertriglyceridemia by increasing hepatic triglyceride secretion, with the fatty acids provided by lipolysis making a major contribution. Thus, KGF could modulate lipid metabolism in vivo.

Lipoteichoic acid stimulates lipolysis and hepatic triglyceride secretion in rats in vivo

The host response to infection is frequently accompanied by changes in lipid metabolism. Previous studies have shown that endotoxin (LPS), a component of the cell wall of gram-negative bacteria, increases serum lipid levels. In this study, we demonstrate that lipoteichoic acid (LTA), a component of the cell membrane of gram-positive bacteria, also increases serum lipid levels in rats in a dose-dependent manner (0.1-300 micrograms/200 g body weight). Serum triglyceride levels increased within 2 h after LTA administration with peak values at 4 h (2-fold increase). Serum cholesterol levels also increased but the effect was delayed occurring at 16 h and was relatively small (1.2-fold increase). LTA (10 micrograms/200 g BW) did not decrease adipose tissue lipoprotein lipase activity or the clearance of triglyceride-rich lipoproteins. Rather, the LTA-induced hypertriglyceridemia is due to an increase in hepatic triglyceride secretion. LTA stimulates both hepatic de novo fatty acid synthesis and lipolysis. The increased delivery of free fatty acids to the liver plays a major role in the LTA-induced hypertriglyceridemia. Pretreatment with phentolamine, an alpha-adrenergic receptor antagonist, and alprenolol, a beta-adrenergic receptor antagonist, or phentolamine alone significantly suppressed the hypertriglyceridemia induced by LTA. These adrenergic inhibitors had no significant effect on the increase in lipolysis. These results indicate that catecholamines are involved in mediating the LTA-induced increase in hepatic triglyceride secretion via alpha-adrenergic receptors. These changes in lipid metabolism may play an important role in the organism's response to gram-positive infection.