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Morin C, Cantin AM, Vézina FA, Fortin S. The Efficacy of MAG-DHA for Correcting AA/DHA Imbalance of Cystic Fibrosis Patients. Mar Drugs 2018; 16:md16060184. [PMID: 29861448 PMCID: PMC6025526 DOI: 10.3390/md16060184] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 05/16/2018] [Accepted: 05/25/2018] [Indexed: 11/22/2022] Open
Abstract
Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementations are thought to improve essential fatty acid deficiency (EFAD) as well as reduce inflammation in Cystic Fibrosis (CF), but their effectiveness in clinical studies remains unknown. The aim of the study was to determine how the medical food containing docosahexaenoic acid monoglyceride (MAG-DHA) influenced erythrocyte fatty acid profiles and the expression levels of inflammatory circulating mediators. We conducted a randomized, double blind, pilot trial including fifteen outpatients with Cystic Fibrosis, ages 18–48. The patients were divided into 2 groups and received MAG-DHA or a placebo (sunflower oil) for 60 days. Patients took 8 × 625 mg MAG-DHA softgels or 8 × 625 mg placebo softgels every day at bedtime for 60 days. Lipid analyses revealed that MAG-DHA increased docosahexaenoic acid (DHA) levels and decrease arachidonic acid (AA) ratio (AA/DHA) in erythrocytes of CF patients following 1 month of daily supplementation. Data also revealed a reduction in plasma human leukocyte elastase (pHLE) complexes and interleukin-6 (IL-6) expression levels in blood samples of MAG-DHA supplemented CF patients. This pilot study indicates that MAG-DHA supplementation corrects erythrocyte AA/DHA imbalance and may exert anti-inflammatory properties through the reduction of pHLE complexes and IL6 in blood samples of CF patients. Trial registration: Pro-resolving Effect of MAG-DHA in Cystic Fibrosis (PREMDIC), NCT02518672.
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Affiliation(s)
- Caroline Morin
- SCF Pharma, 235, route du Fleuve Ouest, Ste-Luce, QC G0K 1P0, Canada.
| | - André M Cantin
- Department of Medicine, Respiratory Division, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
| | - Félix-Antoine Vézina
- Department of Medicine, Respiratory Division, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada.
| | - Samuel Fortin
- SCF Pharma, 235, route du Fleuve Ouest, Ste-Luce, QC G0K 1P0, Canada.
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Ma DC, Yoon AJ, Faull KF, Desharnais R, Zemanick ET, Porter E. Cholesteryl esters are elevated in the lipid fraction of bronchoalveolar lavage fluid collected from pediatric cystic fibrosis patients. PLoS One 2015; 10:e0125326. [PMID: 25919295 PMCID: PMC4412572 DOI: 10.1371/journal.pone.0125326] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/11/2015] [Indexed: 01/12/2023] Open
Abstract
Background Host-derived lipids including cholesteryl esters (CEs) such as cholesteryl linoleate have emerged as important antibacterial effectors of innate immunity in the airways and cholesteryl linoleate has been found elevated in the context of inflammation. Cystic fibrosis (CF) patients suffer from chronic infection and severe inflammation in the airways. Here, we identified and quantified CEs in bronchoalveolar lavage fluid (BALF) from CF patients and non-CF disease controls, and tested whether CE concentrations are linked to the disease. Materials and Methods CEs in BALF from 6 pediatric subjects with CF and 7 pediatric subjects with non-CF chronic lung disease were quantified by mass spectral analysis using liquid chromatography coupled with tandem mass spectrometry and multiple reaction monitoring. BALFs were also examined for total lipid, total protein, albumin, and, as a marker for inflammation, human neutrophil peptide (HNP) 1–3 concentrations. Statistical analysis was conducted after log 10 transformation of the data. Results Total lipid/protein ratio was reduced in CF BALF (p = 0.018) but the concentrations of CEs, including cholesteryl linoleate, were elevated in the total lipid fraction in CF BALF compared to non-CF disease controls (p < 0.050). In addition, the concentrations of CEs and HNP1-3 correlated with one another (p < 0.050). Conclusions The data suggests that the lipid composition of BALF is altered in CF with less total lipid relative to protein but with increased CE concentrations in the lipid fraction, likely contributed by inflammation. Future longitudinal studies may reveal the suitability of CEs as a novel biomarker for CF disease activity which may provide new information on the lipid mediated pathophysiology of the disease.
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Affiliation(s)
- Daniel C. Ma
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, United States of America
| | - Alexander J. Yoon
- Pasarow Mass Spectrometry Laboratory, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, United States of America
| | - Kym F. Faull
- Pasarow Mass Spectrometry Laboratory, David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, California, United States of America
| | - Robert Desharnais
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, United States of America
| | - Edith T. Zemanick
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Edith Porter
- Department of Biological Sciences, California State University Los Angeles, Los Angeles, California, United States of America
- * E-mail:
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Guerrera IC, Astarita G, Jais JP, Sands D, Nowakowska A, Colas J, Sermet-Gaudelus I, Schuerenberg M, Piomelli D, Edelman A, Ollero M. A novel lipidomic strategy reveals plasma phospholipid signatures associated with respiratory disease severity in cystic fibrosis patients. PLoS One 2009; 4:e7735. [PMID: 19893743 PMCID: PMC2768907 DOI: 10.1371/journal.pone.0007735] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Accepted: 10/14/2009] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to search for lipid signatures in blood plasma from cystic fibrosis (CF) patients using a novel MALDI-TOF-ClinProTools strategy, initially developed for protein analysis, and thin layer chromatography coupled to MALDI-TOF (TLC-MALDI). Samples from 33 CF patients and 18 healthy children were subjected to organic extraction and column chromatography separation of lipid classes. Extracts were analyzed by MALDI-TOF, ion signatures were compared by the ClinProTools software and by parallel statistical analyses. Relevant peaks were identified by LC-MSn. The ensemble of analyses provided 11 and 4 peaks differentially displayed in CF vs healthy and in mild vs severe patients respectively. Ten ions were significantly decreased in all patients, corresponding to 4 lysophosphatidylcholine (18:0, 18:2, 20:3, and 20:5) and 6 phosphatidylcholine (36:5, O-38:0, 38:4, 38:5, 38:6, and P-40:1) species. One sphingolipid, SM(d18:0), was significantly increased in all patients. Four PC forms (36:3, 36:5, 38:5, and 38:6) were consistently downregulated in severe vs mild patients. These observations were confirmed by TLC-MALDI. These results suggest that plasma phospholipid signatures may be able to discriminate mild and severe forms of CF, and show for the first time MALDI-TOF-ClinProTools as a suitable methodology for the search of lipid markers in CF.
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Affiliation(s)
- Ida Chiara Guerrera
- Plateau Proteome Necker, Université Paris Descartes, IFR94, Paris, France
- INSERM, U845, Université Paris Descartes, Faculté de Médecine, Paris, France
| | - Giuseppe Astarita
- University of California Irvine, Irvine, California, United States of America
| | - Jean-Philippe Jais
- Université Paris Descartes, Service de Biostastistiques et Bioinformatique du CHU Necker-Enfants-Malades, Paris, France
| | | | | | - Julien Colas
- INSERM, U845, Université Paris Descartes, Faculté de Médecine, Paris, France
| | | | | | - Daniele Piomelli
- University of California Irvine, Irvine, California, United States of America
| | - Aleksander Edelman
- Plateau Proteome Necker, Université Paris Descartes, IFR94, Paris, France
- INSERM, U845, Université Paris Descartes, Faculté de Médecine, Paris, France
| | - Mario Ollero
- INSERM, U845, Université Paris Descartes, Faculté de Médecine, Paris, France
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Van Biervliet S, Vanbillemont G, Van Biervliet JP, Declercq D, Robberecht E, Christophe A. Relation between Fatty Acid Composition and Clinical Status or Genotype in Cystic Fibrosis Patients. ANNALS OF NUTRITION AND METABOLISM 2008; 51:541-9. [DOI: 10.1159/000114208] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 09/04/2007] [Indexed: 11/19/2022]
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Gentzsch M, Choudhury A, Chang XB, Pagano RE, Riordan JR. Misassembled mutant DeltaF508 CFTR in the distal secretory pathway alters cellular lipid trafficking. J Cell Sci 2007; 120:447-55. [PMID: 17213331 DOI: 10.1242/jcs.03350] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Most patients with cystic fibrosis (CF) have a single codon deletion (DeltaF508) in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) that impairs assembly of the multidomain glycoprotein. The mutant protein escapes endoplasmic reticulum (ER) quality control at low temperature, but is rapidly cleared from the distal secretory pathway and degraded in lysosomes. CF cells accumulate free cholesterol similar to Niemann-Pick disease type C cells. We show that this lipid alteration is caused by the presence of misassembled mutant CFTR proteins, including DeltaF508, in the distal secretory pathway rather than the absence of functional CFTR. By contrast, cholesterol distribution is not changed by either D572N CFTR, which does not mature even at low temperature, or G551D, which is processed normally but is inactive. On expression of the DeltaF508 mutant, cholesterol and glycosphingolipids accumulate in punctate endosomal structures and cholesterol esters are reduced, indicating a block in the translocation of cholesterol to the ER for esterification. This is overcome by Rab9 overexpression, resulting in clearance of accumulating intracellular cholesterol. Similar but less pronounced alterations in intracellular cholesterol distribution are observed on expression of a temperature-rescued mutant variant of the related ATP-binding cassette (ABC) protein multidrug resistance-associated protein 1 (MRP1). Thus, on escape from ER quality control, misassembled mutants of CFTR and MRP1 impair lipid homeostasis in endocytic compartments.
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Affiliation(s)
- Martina Gentzsch
- Department of Cell and Developmental Biology and Cystic Fibrosis Research Center, University of North Carolina, Chapel Hill, NC 27599, USA.
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Peretti N, Roy CC, Drouin E, Seidman E, Brochu P, Casimir G, Levy E. Abnormal intracellular lipid processing contributes to fat malabsorption in cystic fibrosis patients. Am J Physiol Gastrointest Liver Physiol 2006; 290:G609-15. [PMID: 16223944 DOI: 10.1152/ajpgi.00332.2005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A common feature of cystic fibrosis (CF) is the functional derangement of the exocrine pancreas, which affects output of pancreatic lipase. This condition results in severe dietary malabsorption due to the poor hydrolysis of triacylglycerol (TG) in the lumen of the small intestine. Despite the benefits of pancreatic enzyme supplements, patients with CF present with persistent intestinal fat malabsorption. The aim of the present investigation was to determine whether defects in the intracellular phase of lipid transport occur in this pathophysiology in addition to the known disturbed digestive processes. Our hypothesis was tested by incubating intestinal biopsies from six CF and six healthy subjects with radiolabeled lipid and protein precursors. Lipid esterification and secretion were markedly decreased by 22-31% and 38-42%, respectively, in CF samples, as noted by the low incorporation of [(14)C]palmitic acid into TGs, phospholipids, and cholesteryl esters in patients' duodenal explants and culture media compared with controls (100%). Accordingly, the output of TG-rich lipoproteins was substantially reduced (P < 0.05), and a similar trend was observed for high-density lipoproteins. Because intestinal lipoprotein assembly/secretion shows an absolute requirement for apolipoprotein (apo) B-48, radioactive labeling experiments were performed; these experiments demonstrated a significantly (P < 0.05) diminished synthesis of apoB-48 (40%) and apoA-I (30%). Given the critical role of microsomal triglyceride transfer protein in the formation of apoB-containing lipoproteins, its activity was determined and not found to be altered in CF intestinal tissue. Together, these results suggest that CF malabsorption may also be caused by defects in mucosal mechanisms leading to abnormal lipoprotein delivery into the blood circulation.
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Affiliation(s)
- Noël Peretti
- Departments of Nutrition, CHU Ste-Justine, Université de Montréal, Québec, Canada
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Peretti N, Marcil V, Drouin E, Levy E. Mechanisms of lipid malabsorption in Cystic Fibrosis: the impact of essential fatty acids deficiency. Nutr Metab (Lond) 2005; 2:11. [PMID: 15869703 PMCID: PMC1134666 DOI: 10.1186/1743-7075-2-11] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2005] [Accepted: 05/03/2005] [Indexed: 12/26/2022] Open
Abstract
Transport mechanisms, whereby alimentary lipids are digested and packaged into small emulsion particles that enter intestinal cells to be translocated to the plasma in the form of chylomicrons, are impaired in cystic fibrosis. The purpose of this paper is to focus on defects that are related to intraluminal and intracellular events in this life-limiting genetic disorder. Specific evidence is presented to highlight the relationship between fat malabsorption and essential fatty acid deficiency commonly found in patients with cystic fibrosis that are often related to the genotype. Given the interdependency of pulmonary disease, pancreatic insufficiency and nutritional status, greater attention should be paid to the optimal correction of fat malabsorption and essential fatty acid deficiency in order to improve the quality of life and extend the life span of patients with cystic fibrosis.
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Affiliation(s)
- N Peretti
- Department of Nutrition, CHU-Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - V Marcil
- Department of Nutrition, CHU-Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - E Drouin
- Department of Pediatrics, CHU-Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
| | - E Levy
- Department of Nutrition, CHU-Sainte-Justine, Université de Montréal, Montréal, Québec, Canada
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Levy E, Delvin E, Peretti N, Bouchard G, Seidman E. Combined effects of EFA deficiency and tumor necrosis factor-alpha on circulating lipoproteins in rats. Lipids 2003; 38:595-602. [PMID: 12934668 DOI: 10.1007/s11745-003-1103-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Both tumor necrosis factor-alpha (TNF-alpha) and EFA deficiency (EFAD) have been established as causes of marked perturbations in lipid and lipoprotein metabolism. Excessive levels of circulating TNF-alpha can coexist with EFAD in various clinical disorders such as cystic fibrosis and type I diabetes. The present study therefore aimed to investigate their combined effects on lipid profile and lipoprotein composition by administering TNF-alpha to EFAD rats. Lipoprotein lipase (LPL), the rate-limiting enzyme in TG catabolism, was also measured in epididymal adipose tissue. EFAD, after a 4-wk period, induced significant increases in plasma TG (80%, P < 0.001), total cholesterol (TC, 27%, P < 0.025), and HDL-cholesterol (HDL-C, 62%). Two hours after the administration of TNF-alpha, a further rise in TG (43%, P < 0.05) was noted in controls, but not EFAD animals. TC and HDL-C were unaffected by TNF-alpha treatment. In addition, TNF-alpha modified lipoprotein-lipid composition. VLDL and HDL2 derived from EFAD rats were depleted in apolipoprotein (apo) E and apo A-II, and enriched in apo A-I 2 h after TNF-alpha administration. Finally, TNF-alpha decreased adipose tissue LPL activity in both control and EFAD animals. The TNF-alpha-induced inhibition was more marked in EFAD rats. The present results demonstrated that TNF-alpha can amplify or antagonize the effects of EFAD on lipid profile, lipoprotein composition, and LPL activity. These data also suggest that the host's nutritional status is a determining factor for the modulating effect of TNF-alpha on lipid metabolism.
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Affiliation(s)
- Emile Levy
- Department of Nutrition, Centre de Recherche, Hôpital Ste-Justine, Université de Montréal, Montréal, Québec, Canada, H3T 1C5.
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Akhlaghi F, Ashley J, Keogh A, Brown K. Cyclosporine plasma unbound fraction in heart and lung transplantation recipients. Ther Drug Monit 1999; 21:8-16. [PMID: 10051049 DOI: 10.1097/00007691-199902000-00003] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To investigate the variability in the unbound fraction (fu) of cyclosporine in recipients of heart, heart-lung, and lung transplantation, cyclosporine fu was determined ex vivo in plasma by equilibrium dialysis. In a retrospective study, 260 samples of plasma (one to seven per patient) were obtained from 89 heart (86%), lung (9%), and heart-lung (5%) transplant patients. The unbound fraction (x100) of cyclosporine ranged from 0.52% to 3.94%, with an overall mean of 1.53%+/-0.375% (SD). The mean percentage unbound for individual patients ranged from 0.71% to 1.98%, giving a 2.8-fold interpatient variation. In heart transplant recipients (66 patients), the values of fu were significantly lower (p < 0.01) during more severe rejection episodes, which required antirejection treatment (endomycardial biopsy result of grade 3a and higher) than in the absence of rejection (grade 0) or during grade la rejections. The value of fu did not vary with organ transplanted (p = 0.35) or etiology of organ failure (p = 0.32). Cyclosporine fu was negatively correlated with the age of the patient (r = -0.18, p < 0.05). Correlations were not observed between fu and blood biochemical and cytologic indices. However, fu was significantly lower (p < 0.01) in hypercholesterolemic transplant recipients (1.37+/-0.52%) than in normocholesterolemic patients (1.60+/-0.63%). Administration of simvastatin resulted in a significant increase in the mean fu from 1.40+/-0.09%) to 1.82+/-0.13% (paired t test, n = 13; p < 0.01). In patients who received ketoconazole, fu was not different from controls. These findings suggest that the level of cyclosporine fu may be an important determinant of immunosuppressive activity of cyclosporine. Moreover, the variation in fu could be strongly related to the concentration of serum lipoproteins; interpretation of the results of cyclosporine monitoring thus requires consideration of the lipidemic status of the patient.
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Affiliation(s)
- F Akhlaghi
- Department of Pharmacy, University of Sydney, Australia
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Affiliation(s)
- A Christophe
- Department of Endocrinology and Metabolic Diseases, University of Ghent, University Hospital, Belgium
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Lagrost L. Regulation of cholesteryl ester transfer protein (CETP) activity: review of in vitro and in vivo studies. BIOCHIMICA ET BIOPHYSICA ACTA 1994; 1215:209-36. [PMID: 7811705 DOI: 10.1016/0005-2760(94)90047-7] [Citation(s) in RCA: 133] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- L Lagrost
- Laboratoire de Biochimie des Lipoprotéines, INSERM CJF 93-10, Faculté de Médecine, Dijon, France
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Slesinski MJ, Gloninger MF, Costantino JP, Orenstein DM. Lipid levels in adults with cystic fibrosis. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1994; 94:402-8. [PMID: 8144807 DOI: 10.1016/0002-8223(94)90095-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To examine the hypothesis that an energy-dense, high-fat diet, which is necessary to maintain weight in adults with cystic fibrosis, does not result in high serum cholesterol levels. DESIGN Dietary, anthropometric, and biochemical data were correlated. SETTING A cystic fibrosis center in Pittsburgh, Pa. SUBJECTS Thirty-one adults with cystic fibrosis, 50 obligate carriers of the cystic fibrosis gene, and 26 controls who did not have cystic fibrosis. MAIN OUTCOME MEASURES Adults with cystic fibrosis had a lower mean serum cholesterol level and higher mean intakes of energy and fat than controls. STATISTICAL ANALYSES PERFORMED Student's t test was used to determine the statistical significance between two means. Univariate correlation coefficients were determined to measure the relative intensity of association between two variables. RESULTS Mean total serum cholesterol levels in men with cystic fibrosis was 3.1 mmol/L vs 4.7 mmol/L in male controls (P < .001). Mean total serum cholesterol levels in women with cystic fibrosis was 3.2 mmol/L vs 4.3 mmol/L in female controls (P < .001). Three adults with cystic fibrosis and no signs of pancreatic insufficiency had serum cholesterol levels in the high normal range. Carriers had serum lipid levels in the same range as the controls. CONCLUSIONS/APPLICATIONS The findings indicate that a high-energy, high-fat diet does not raise serum lipid levels in those patients with cystic fibrosis and pancreatic insufficiency. However, those individuals with cystic fibrosis and normal pancreatic function may be at the same risk as the general population for developing high serum lipid levels. They should have their serum lipid levels monitored and be given appropriate dietary recommendations.
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Affiliation(s)
- M J Slesinski
- Department of Epidemiology, University of Pittsburgh, PA
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