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Zhang RH, Zhang XB, Lu YB, Hu YC, Chen XY, Yu DC, Shi JT, Yuan WH, Wang J, Zhou HY. Calcitonin gene-related peptide and brain-derived serotonin are related to bone loss in ovariectomized rats. Brain Res Bull 2021; 176:85-92. [PMID: 34418462 DOI: 10.1016/j.brainresbull.2021.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/05/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Postmenopausal osteoporosis (PMO) and osteoporotic fracture seriously impair human health in developed countries. The present study aims to explore whether sensory nerves, calcitonin gene-related peptide (CGRP), and brain-derived serotonin are related to bone loss in ovariectomized (OVX) rats. METHODS Female rats were grouped into the ovariectomized (OVX) and sham surgery (SHAM) groups. Immunocytochemistry, western blotting, and qPCR were performed to detect CGRP expression in the femurs. The expression levels of serotonin and CGRP in the spinal cord and brainstem were estimated using western blotting, immunofluorescence, and qPCR. ELISA was used to evaluate the serum biomarkers of bone formation and resorption. Bone mineral density was measured using dual-energy X-ray (DXA) analysis. Femur microstructure was imaged by Micro CT. P values less than 0.05 were considered statistically significant. RESULTS ELISA showed that serum bone alkaline phosphatase (BALP), tartrate-resistant acid phosphatase (TRAP), β-crosslaps, and β-ctx were increased in the OVX group. In the OVX group, in vivo bone mineral density, trabecular bone mineral density, bone volume fraction (BV/TV), and trabecular number (Tb. N) were significantly decreased, while trabecular spacing (Tb. Sp) and trabecular bone pattern factor (Tb. Pf) were markedly increased. In the OVX group, the expression levels of CGRP of the femur were significantly downregulated. In contrast, CGRP and serotonin expression was increased in the spinal cord of the OVX group. Serotonin expression was increased in the brainstem, brainstem nucleus raphe magnus (RMG), and nucleus raphe dorsalis (DRN). CONCLUSION Our results indicated that the activation of osteoclast triggered the release of CGRP from nociceptive sensory nerve fibers and transmitted this painful stimulus to the dorsal horn of the spinal cord to release increased CGRP. The descending serotonergic inhibitory system was activated by increased CGRP levels of the spinal cord and promoted serotonin release in the brainstem RMG, DRN, and the spinal cord, contributing to the decreased CGRP level in bone tissue, which revealed a novel mechanism of bone loss in PMO.
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Affiliation(s)
- Rui-Hao Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - Xiao-Bo Zhang
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - Yu-Bao Lu
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510000, PR China
| | - Yi-Cun Hu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - Xiang-Yi Chen
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - De-Chen Yu
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - Jin-Tao Shi
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Key Laboratory of Bone and Joint Disease Research of Gansu Province, Lanzhou, 730000, PR China
| | - Wen-Huan Yuan
- Baotou First Affiliated Hospital of Inner Mongolia University of Science and Technology, Baotou, 014000, PR China
| | - Jing Wang
- The People's Hospital of Baoan District, Shenzhen, 518000, PR China.
| | - Hai-Yu Zhou
- Department of Orthopedics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730000, PR China; Lanzhou Xigu District People's Hospital, Lanzhou, Gansu, 730000, PR China.
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Al-Dorzi HM, Tamim HM, Rishu AH, Aljumah A, Arabi YM. Intra-abdominal pressure and abdominal perfusion pressure in cirrhotic patients with septic shock. Ann Intensive Care 2012; 2 Suppl 1:S4. [PMID: 22873420 PMCID: PMC3390301 DOI: 10.1186/2110-5820-2-s1-s4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The importance of intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) in cirrhotic patients with septic shock is not well studied. We evaluated the relationship between IAP and APP and outcomes of cirrhotic septic patients, and assessed the ability of these measures compared to other common resuscitative endpoints to differentiate survivors from nonsurvivors. METHODS This study was a post hoc analysis of a randomized double-blind placebo-controlled trial in which mean arterial pressure (MAP), central venous oxygen saturation (ScvO2) and IAP were measured every 6 h in 61 cirrhotic septic patients admitted to the intensive care unit. APP was calculated as MAP - IAP. Intra-abdominal hypertension (IAH) was defined as mean IAP ≥ 12 mmHg, and abdominal hypoperfusion as mean APP < 60 mmHg. Measured outcomes included ICU and hospital mortality, need for renal replacement therapy (RRT) and ventilator- and vasopressor-free days. RESULTS IAH prevalence on the first ICU day was 82%, and incidence in the first 7 days was 97%. Compared to patients with normal IAP, IAH patients had significantly higher ICU mortality (74.0% vs. 27.3%, p = 0.005), required more RRT (78.0% vs. 45.5%, p = 0.06) and had lower ventilator- and vasopressor-free days. On a multivariate logistic regression analysis, IAH was an independent predictor of both ICU mortality (odds ratio (OR), 12.20; 95% confidence interval (CI), 1.92 to 77.31, p = 0.008) and need for RRT (OR, 6.78; 95% CI, 1.29 to 35.70, p = 0.02). Using receiver operating characteristic curves, IAP (area under the curve (AUC) = 0.74, p = 0.004), APP (AUC = 0.71, p = 0.01), Acute Physiology and Chronic Health Evaluation II score (AUC = 0.71, p = 0.02), but not MAP, differentiated survivors from nonsurvivors. CONCLUSIONS IAH is highly prevalent in cirrhotic patients with septic shock and is associated with increased ICU morbidity and mortality.
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Affiliation(s)
- Hasan M Al-Dorzi
- Department of Intensive Care Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426, Saudi Arabia
| | - Hani M Tamim
- Department of Epidemiology and Biostatistics, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426, Saudi Arabia
| | - Asgar H Rishu
- Department of Intensive Care Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426, Saudi Arabia
| | - Abdulrahman Aljumah
- Department of Hepatobiliary Sciences and Liver Transplantation, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426, Saudi Arabia
| | - Yaseen M Arabi
- Department of Intensive Care Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, 11426, Saudi Arabia
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Núñez Martínez Ó, Merino Rodríguez B, Díaz Sánchez A, Matilla Peña A, Clemente Ricote G. [Optimization of ascitic fluid culture in spontaneous bacterial peritonitis]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:315-321. [PMID: 21530006 DOI: 10.1016/j.gastrohep.2011.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Revised: 02/13/2011] [Accepted: 02/16/2011] [Indexed: 05/30/2023]
Abstract
INTRODUCTION AND AIMS Spontaneous bacterial peritonitis (SBP) is ascitic fluid (AF) infection in the absence of an intraperitoneal source of infection in patients with liver disease and portal hypertension. The aim of this study was to evaluate the yield of microbiological cultures to optimize their collection and systematic implementation in routine clinical practice. METHODS We analyzed two cohorts: the first consisted of retrospective data from the clinical records of 156 consecutive episodes of SBP from January 2003 to December 2005 (group R), and the second was composed of data collected prospectively from October 2007 to October 2008, consisting of 79 episodes (group P), with systematic inoculation of 10 cc of AF in each blood culture bottle. RESULTS No significant differences were demonstrated in baseline epidemiological or clinical characteristics among episodes, except the more frequent presence of alcoholic liver disease and the incidence of tense ascites, paralytic ileus and kidney failure at diagnosis in group P. Microbiological isolation in AF was achieved in 12.2% of the episodes in group R compared with 53.2% in group P (p = 0.001) and 8.5 and 26.6% (p = 0.001) in blood culture, respectively. Microbiological isolation was achieved in 65.8% of episodes in group P versus 19.2% in group R (OR 8; 95% CI: 4.4-14.9; p = 0.001). The most frequently isolated organism in AF in group P was Escherichia coli (42.9%). CONCLUSIONS Optimizing the diagnostic procedure in cirrhotic patients with ascites significantly increases diagnostic microbiologic performance.
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Affiliation(s)
- Óscar Núñez Martínez
- Unidad de Digestivo, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España.
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Merino Rodríguez B, Núñez Martínez Ó, Díaz Sánchez A, Matilla Peña A, Clemente Ricote G. Peritonitis bacteriana espontánea en pacientes con cirrosis mayores de 65 años. Med Clin (Barc) 2009; 133:167-72. [DOI: 10.1016/j.medcli.2008.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2008] [Accepted: 12/18/2008] [Indexed: 10/20/2022]
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Merino Rodríguez B, Núñez Martínez Ó, Díaz Sánchez A, Fernández Yunquera A, Pajares Díaz JA, Matilla Peña A, Rincón Rodríguez D, Bañares Cañizares R, Clemente Ricote G. Valor pronóstico de un episodio de peritonitis bacteriana espontánea en pacientes cirróticos en la práctica clínica. GASTROENTEROLOGIA Y HEPATOLOGIA 2008; 31:560-5. [DOI: 10.1157/13128294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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