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Zhang X, Schalkwijk CG, Wouters K. Immunometabolism and the modulation of immune responses and host defense: A role for methylglyoxal? Biochim Biophys Acta Mol Basis Dis 2022; 1868:166425. [DOI: 10.1016/j.bbadis.2022.166425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/14/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022]
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Alfarouk KO, Alqahtani SS, Alshahrani S, Morgenstern J, Supuran CT, Reshkin SJ. The possible role of methylglyoxal metabolism in cancer. J Enzyme Inhib Med Chem 2021; 36:2010-2015. [PMID: 34517737 PMCID: PMC8451662 DOI: 10.1080/14756366.2021.1972994] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Tumours reprogram their metabolism to acquire an evolutionary advantage over normal cells. However, not all such metabolic pathways support energy production. An example of these metabolic pathways is the Methylglyoxal (MG) one. This pathway helps maintain the redox state, and it might act as a phosphate sensor that monitors the intracellular phosphate levels. In this work, we discuss the biochemical step of the MG pathway and interrelate it with cancer.
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Affiliation(s)
- Khalid O Alfarouk
- Department of Evolutionary Pharmacology, and Tumor Metabolism, Hala Alfarouk Cancer Center, Khartoum, Sudan
| | - Saad S Alqahtani
- Pharmacy Practice Research Unit, Clinical Pharmacy Department, College of Pharmacy, Jazan University, Jazan, KSA
| | - Saeed Alshahrani
- Pharmacology and Toxicology Department, College of Pharmacy, Jazan University, Jazan, KSA
| | - Jakob Morgenstern
- Department of Internal Medicine I, Endocrinology and Metabolism, Heidelberg University, Germany
| | - Claudiu T Supuran
- Neurofarba Department, Universita Degli Studi di Firenze, Florence, Italy
| | - Stephan J Reshkin
- Department of Bioscience, Biotechnology and Biopharmaceutics, University of Bari, Bari, Italy
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Francisco FA, Saavedra LPJ, Junior MDF, Barra C, Matafome P, Mathias PCF, Gomes RM. Early AGEing and metabolic diseases: is perinatal exposure to glycotoxins programming for adult-life metabolic syndrome? Nutr Rev 2021; 79:13-24. [PMID: 32951053 DOI: 10.1093/nutrit/nuaa074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Perinatal early nutritional disorders are critical for the developmental origins of health and disease. Glycotoxins, or advanced glycation end-products, and their precursors such as the methylglyoxal, which are formed endogenously and commonly found in processed foods and infant formulas, may be associated with acute and long-term metabolic disorders. Besides general aspects of glycotoxins, such as their endogenous production, exogenous sources, and their role in the development of metabolic syndrome, we discuss in this review the sources of perinatal exposure to glycotoxins and their involvement in metabolic programming mechanisms. The role of perinatal glycotoxin exposure in the onset of insulin resistance, central nervous system development, cardiovascular diseases, and early aging also are discussed, as are possible interventions that may prevent or reduce such effects.
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Affiliation(s)
- Flávio A Francisco
- Department of Biotechnology, Genetics, and Cellular Biology, State University of Maringa, Maringa, PR, Brazil
| | - Lucas P J Saavedra
- Department of Biotechnology, Genetics, and Cellular Biology, State University of Maringa, Maringa, PR, Brazil
| | - Marcos D F Junior
- Department of Physiological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
| | - Cátia Barra
- Institute of Physiology and Coimbra Institute of Clinical and Biomedical Research, Faculty of Medicine, and the Center for Innovative Biotechnology and Biomedicine, University of Coimbra; and the Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Paulo Matafome
- Institute of Physiology and Coimbra Institute of Clinical and Biomedical Research, Faculty of Medicine, and the Center for Innovative Biotechnology and Biomedicine, University of Coimbra; and the Clinical Academic Center of Coimbra, Coimbra, Portugal
| | - Paulo C F Mathias
- Department of Biotechnology, Genetics, and Cellular Biology, State University of Maringa, Maringa, PR, Brazil
| | - Rodrigo M Gomes
- Department of Physiological Sciences, Federal University of Goiás, Goiânia, GO, Brazil
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Immune Dysfunction in Uremia 2020. Toxins (Basel) 2020; 12:toxins12070439. [PMID: 32635646 PMCID: PMC7404977 DOI: 10.3390/toxins12070439] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular disease and infections are major causes for the high incidence of morbidity and mortality of patients with chronic kidney disease. Both complications are directly or indirectly associated with disturbed functions or altered apoptotic rates of polymorphonuclear leukocytes, monocytes, lymphocytes, and dendritic cells. Normal responses of immune cells can be reduced, leading to infectious diseases or pre-activated/primed, giving rise to inflammation and subsequently to cardiovascular disease. This review summarizes the impact of kidney dysfunction on the immune system. Renal failure results in disturbed renal metabolic activities with reduced renin, erythropoietin, and vitamin D production, which adversely affects the immune system. Decreased kidney function also leads to reduced glomerular filtration and the retention of uremic toxins. A large number of uremic toxins with detrimental effects on immune cells have been identified. Besides small water-soluble and protein-bound compounds originating from the intestinal microbiome, several molecules in the middle molecular range, e.g., immunoglobulin light chains, retinol-binding protein, the neuropeptides Met-enkephalin and neuropeptide Y, endothelin-1, and the adipokines leptin and resistin, adversely affect immune cells. Posttranslational modifications such as carbamoylation, advanced glycation products, and oxidative modifications contribute to uremic toxicity. Furthermore, high-density lipoprotein from uremic patients has an altered protein profile and thereby loses its anti-inflammatory properties.
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Li CT, How SC, Chen ME, Lo CH, Chun MC, Chang CK, Chen WA, Wu JW, Wang SSS. Effects of glycation on human γd-crystallin proteins by different glycation-inducing agents. Int J Biol Macromol 2018; 118:442-451. [DOI: 10.1016/j.ijbiomac.2018.06.108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/17/2018] [Accepted: 06/22/2018] [Indexed: 01/22/2023]
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Islam S, Moinuddin, Mir AR, Raghav A, Habib S, Alam K, Ali A. Glycation, oxidation and glycoxidation of IgG: a biophysical, biochemical, immunological and hematological study. J Biomol Struct Dyn 2017; 36:2637-2653. [DOI: 10.1080/07391102.2017.1365770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Sidra Islam
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Moinuddin
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Abdul Rouf Mir
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
- Department of Biotechnology, Government Degree College, University of Kashmir, Baramulla 193101, Jammu and Kashmir, India
| | - Alok Raghav
- Rajiv Gandhi Centre for Diabetes and Endocrinology, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Safia Habib
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Khursheed Alam
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
| | - Asif Ali
- Department of Biochemistry, Jawarharlal Nehru Medical College, Faculty of Medicine, Aligarh Muslim University, Aligarh 202002, Uttar Pradesh, India
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Matafome P, Rodrigues T, Sena C, Seiça R. Methylglyoxal in Metabolic Disorders: Facts, Myths, and Promises. Med Res Rev 2016; 37:368-403. [DOI: 10.1002/med.21410] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/07/2016] [Accepted: 08/12/2016] [Indexed: 01/17/2023]
Affiliation(s)
- Paulo Matafome
- Laboratory of Physiology, Institute of Biomedical Imaging and Life Sciences (IBILI); Faculty of Medicine, University of Coimbra; 3000-548 Coimbra Portugal
- Department of Complementary Sciences; Coimbra Health School (ESTeSC); Instituto Politécnico de Coimbra; 3045-601 Coimbra Portugal
| | - Tiago Rodrigues
- Laboratory of Physiology, Institute of Biomedical Imaging and Life Sciences (IBILI); Faculty of Medicine, University of Coimbra; 3000-548 Coimbra Portugal
| | - Cristina Sena
- Laboratory of Physiology, Institute of Biomedical Imaging and Life Sciences (IBILI); Faculty of Medicine, University of Coimbra; 3000-548 Coimbra Portugal
| | - Raquel Seiça
- Laboratory of Physiology, Institute of Biomedical Imaging and Life Sciences (IBILI); Faculty of Medicine, University of Coimbra; 3000-548 Coimbra Portugal
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Huang Q, Chen Y, Gong N, Wang YX. Methylglyoxal mediates streptozotocin-induced diabetic neuropathic pain via activation of the peripheral TRPA1 and Nav1.8 channels. Metabolism 2016; 65:463-74. [PMID: 26975538 DOI: 10.1016/j.metabol.2015.12.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 12/02/2015] [Accepted: 12/12/2015] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Methylglyoxal is known to be associated with the development of nephropathy, retinopathy, and other complications in diabetes. The present study tested the hypothesis that endogenously increased levels of methylglyoxal in diabetes are causally associated with the induction of neuropathic pain. MATERIALS AND METHODS Streptozotocin- and methylglyoxal-induced pain models were established in rats, and the anti-nociceptive effects of the methylglyoxal scavenging agents, selective transient receptor potential channel ankyrin 1 (TRPA1) antagonist, and Nav1.8 antagonist were tested. RESULTS Systemic injection of streptozotocin in rats induced a prolonged increase in plasma methylglyoxal by approximately 60%, which was correlated with the progressive development of mechanical allodynia and thermal hyperalgesia. Local subcutaneous injection of methylglyoxal into the hindpaw produced dose-dependent and biphasic flinching nociceptive responses, which resembled formaldehyde (formalin)-induced nociception. The local methylglyoxal nociception was significantly blocked by co-injection into the hindpaw of the selective transient receptor potential channel ankyrin 1 (TRPA1) antagonist, A967079, and the Nav1.8 antagonist, A803467. Co-incubation with the methylglyoxal scavengers, aminoguanidine, d-arginine, and metformin, reduced the level of free methylglyoxal by more than 90%, and injection of their incubation solutions into the hindpaw produced negligible (3-17%) nociception. Like the clinically effective anti-diabetic neuropathic pain drug gabapentin, systemic injection of aminoguanidine, d-arginine, and metformin at doses that effectively inhibit paw-injected methylglyoxal-induced nociception significantly blocked streptozotocin-induced mechanical allodynia. CONCLUSION Endogenously increased methylglyoxal may mediate diabetic neuropathic pain via activation of both TRPA1 and Nav1.8 expressed on primary afferent sensory neurons, and injection of methylglyoxal into the hindpaw may serve as a simple and robust model for testing the anti-diabetic pain drugs.
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Affiliation(s)
- Qian Huang
- King's Laboratory, School of Pharmacy, Shanghai Jiao Tong University, China.
| | - Yuan Chen
- King's Laboratory, School of Pharmacy, Shanghai Jiao Tong University, China.
| | - Nian Gong
- King's Laboratory, School of Pharmacy, Shanghai Jiao Tong University, China.
| | - Yong-Xiang Wang
- King's Laboratory, School of Pharmacy, Shanghai Jiao Tong University, China.
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Methylglyoxal and Advanced Glycation End-Products Promote Cytokines Expression in Peritoneal Mesothelial Cells Via MAPK Signaling. Am J Med Sci 2015; 349:105-9. [DOI: 10.1097/maj.0000000000000394] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Role of methylglyoxal in Alzheimer's disease. BIOMED RESEARCH INTERNATIONAL 2014; 2014:238485. [PMID: 24734229 PMCID: PMC3966409 DOI: 10.1155/2014/238485] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Revised: 01/28/2014] [Accepted: 01/30/2014] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease is the most common and lethal neurodegenerative disorder. The major hallmarks of Alzheimer's disease are extracellular aggregation of amyloid β peptides and, the presence of intracellular neurofibrillary tangles formed by precipitation/aggregation of hyperphosphorylated tau protein. The etiology of Alzheimer's disease is multifactorial and a full understanding of its pathogenesis remains elusive. Some years ago, it has been suggested that glycation may contribute to both extensive protein cross-linking and oxidative stress in Alzheimer's disease. Glycation is an endogenous process that leads to the production of a class of compounds known as advanced glycation end products (AGEs). Interestingly, increased levels of AGEs have been observed in brains of Alzheimer's disease patients. Methylglyoxal, a reactive intermediate of cellular metabolism, is the most potent precursor of AGEs and is strictly correlated with an increase of oxidative stress in Alzheimer's disease. Many studies are showing that methylglyoxal and methylglyoxal-derived AGEs play a key role in the etiopathogenesis of Alzheimer's disease.
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Su Y, Qadri SM, Hossain M, Wu L, Liu L. Uncoupling of eNOS contributes to redox-sensitive leukocyte recruitment and microvascular leakage elicited by methylglyoxal. Biochem Pharmacol 2013; 86:1762-74. [PMID: 24144633 DOI: 10.1016/j.bcp.2013.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 10/10/2013] [Accepted: 10/11/2013] [Indexed: 01/03/2023]
Abstract
Elevated levels of the glycolysis metabolite methylglyoxal (MG) have been implicated in impaired leukocyte-endothelial interactions and vascular complications in diabetes, putative mechanisms of which remain elusive. Uncoupling of endothelial nitric oxide synthase (eNOS) was shown to be involved in endothelial dysfunction in diabetes. Whether MG contributes to these effects has not been elucidated. By using intravital microscopy in vivo, we demonstrate that MG-triggered reduction in leukocyte rolling velocity and increases in rolling flux, adhesion, emigration and microvascular permeability were significantly abated by scavenging reactive oxygen species (ROS). In murine cremaster muscle, MG treatment reduced tetrahydrobiopterin (BH4)/total biopterin ratio, increased arginase expression and stimulated ROS and superoxide production. The latter was significantly blunted by ROS scavengers Tempol (300μM) or MnTBAP (300μM), by BH4 supplementation (100μM) or by NOS inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME; 20μM). In these tissues and cultured murine and human primary endothelial cells, MG increased eNOS monomerization and decreased BH4/total biopterin ratio, effects that were significantly mitigated by supplementation of BH4 or its precursor sepiapterin but not by L-NAME or tetrahydroneopterin, indicative of MG-triggered eNOS uncoupling. MG treatment further decreased the expression of guanosine triphosphate cyclohydrolase I in murine primary endothelial cells. MG-induced leukocyte recruitment was significantly attenuated by supplementation of BH4 or sepiapterin or suppression of superoxide by L-NAME confirming the role of eNOS uncoupling in MG-elicited leukocyte recruitment. Together, our study uncovers eNOS uncoupling as a pivotal mechanism in MG-induced oxidative stress, microvascular hyperpermeability and leukocyte recruitment in vivo.
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Affiliation(s)
- Yang Su
- Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5
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Vlassara H, Striker GE. Advanced glycation endproducts in diabetes and diabetic complications. Endocrinol Metab Clin North Am 2013; 42:697-719. [PMID: 24286947 DOI: 10.1016/j.ecl.2013.07.005] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This review presents insights from studies of advanced glycation end products (AGEs) in humans and mice. Although the emphasis is on the effects of exogenous AGEs and the suppression of specific host defense mechanisms, AGEs are also formed intracellularly, where they may contribute to several normal intracellular functions. It is only when the overall levels of AGEs in the extracellular and the intracellular spaces exceeds the ability of the native antioxidant (and AGE) defenses that they pose a problem.
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Affiliation(s)
- Helen Vlassara
- Departments of Geriatrics and Medicine, Division of Experimental Diabetes and Aging, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, Annenberg Building, Box 1640, New York, NY 10029, USA.
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Abstract
Methylglyoxal (MG) is a highly reactive compound derived mainly from glucose and fructose metabolism. This metabolite has been implicated in diabetic complications as it is a strong AGE precursor. Furthermore, recent studies suggested a role for MG in insulin resistance and beta-cell dysfunction. Although several drugs have been developed in the recent years to scavenge MG and inhibit AGE formation, we are still far from having an effective strategy to prevent MG-induced mechanisms. This review summarizes the mechanisms of MG formation, detoxification, and action. Furthermore, we review the current knowledge about its implication on the pathophysiology and complications of obesity and diabetes.
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Affiliation(s)
- Paulo Matafome
- Laboratory of Physiology, Institute of Biomedical Research on Light and Image (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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Guerra B, Bolin A, Otton R. Carbonyl stress and a combination of astaxanthin/vitamin C induce biochemical changes in human neutrophils. Toxicol In Vitro 2012; 26:1181-90. [DOI: 10.1016/j.tiv.2012.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/15/2012] [Accepted: 06/22/2012] [Indexed: 10/28/2022]
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Tang YH, Xu SC, Wu P. Irritable bowel syndrome and food allergy. Shijie Huaren Xiaohua Zazhi 2012; 20:389-393. [DOI: 10.11569/wcjd.v20.i5.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Irritable bowel syndrome (IBS) is a kind of functional gastrointestinal disease characterized by abdominal pain or discomfort associated with changes in bowel habits. The alternating symptoms of IBS seriously affect the patients' quality of life. Some studies have found that food could cause or aggravate the symptoms of IBS possibly by inducing food allergy and food intolerance. However, the specific mechanisms have not been established yet. Currently there are "bacterial 'toxin' hypothesis", "immune or inflammatory response hypothesis" and "physical or chemical irritation hypothesis" explaining the role of food in the pathogenesis of IBS. It has been known that food factors play a very important role in the pathogenesis of IBS. This article reviews food allergy and the possible mechanisms, diagnosis and treatment of IBS caused by food.
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Lee S, Takahashi I, Matsuzaka M, Yamai K, Danjo K, Kumagai T, Umeda T, Itai K, Nakaji S. The relationship between serum selenium concentration and neutrophil function in peripheral blood. Biol Trace Elem Res 2011; 144:396-406. [PMID: 21691799 DOI: 10.1007/s12011-011-9108-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 06/01/2011] [Indexed: 02/07/2023]
Abstract
We evaluated the relationships between neutrophil-related functions and serum selenium (Se) concentration in the general population. We examined 800 subjects who had participated in the Iwaki Health Promotion Project in 2005 to determine the relationships between serum Se concentration and neutrophil-related functions such as the production capability of reactive oxygen species (ROS), phagocytic activity, and serum opsonic activity (SOA). In nonstimulated neutrophils, i.e., in neutrophils at their baseline condition before the application of the phagocytic stimulus, the serum Se concentration tends to be high and the ROS production tends to be low. With regard to SOA, there was a significant negative correlation between lucigenin-dependent chemiluminescence and serum Se concentration in both men and women. Moreover, in women, a significant negative correlation was observed between luminol-dependent chemiluminescence and serum Se concentration. These results suggest that subjects with a lower serum Se concentration may be exposed to a greater chronic oxidative stress due to neutrophil ROS production. In addition, the findings of our study suggest that women rather than men benefit more from Se against oxidative stress.
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Affiliation(s)
- Sangun Lee
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, Hirosaki, 036-8562, Aomori, Japan
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Sato J, Takahashi I, Umeda T, Matsuzaka M, Danjyo K, Tsuya R, Kida K, Takami H, Nakaji S. Effect of alcohol drinking and cigarette smoking on neutrophil functions in adults. LUMINESCENCE 2011; 26:557-64. [PMID: 21433278 DOI: 10.1002/bio.1270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 10/12/2010] [Accepted: 11/12/2010] [Indexed: 01/12/2023]
Abstract
In recent years, the effects of smoking and excessive alcohol consumption on immune function have been studied, due to a high prevalence of infection or cancer in heavy drinkers, and the combination of smoking and drinking was considered to be a carcinogenic risk. However, the effect of smoking and drinking on systemic immune function has yet to be clearly understood. In this study, we investigated neutrophil functions (reactive oxygen species (ROS) productive activity, phagocytic ability and serum opsonic activity) and their relationship with alcohol consumption or amount of smoking. In total there were 731 male and female adult subjects who participated in the Iwaki Health Promotion Project in 2005. Multiple regression analysis showed a trend of increased ROS production in male subjects and a statistically significant decrease was observed in phagocytic activity caused by smoking in female subjects. In other words, oxidative stress caused by smoking in male subjects may be involved in ROS production from neutrophils. Decreased phagocytic activity of neutrophils caused by smoking suggests that host defense functions were impaired in female subjects. A relationship between neutrophil functions and the amount of alcohol consumption was not observed.
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Affiliation(s)
- Junya Sato
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, Hirosaki, 036-8562 Aomori, Japan
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Mikami M, Takahashi I, Matsuzaka M, Danjo K, Yamai K, Inoue R, Iwane K, Umeda T, Nakaji S. The relationship between exhaled carbon monoxide and human neutrophil function in the Japanese general population. LUMINESCENCE 2011; 26:162-6. [PMID: 21681908 DOI: 10.1002/bio.1199] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Revised: 12/04/2009] [Accepted: 01/11/2010] [Indexed: 01/03/2023]
Abstract
We have evaluated the relationship between exhaled carbon monoxide (CO) level and neutrophil-related functions such as reactive oxygen species (ROS) production capability, phagocytic activity and serum opsonic activity in the general population. Serum opsonic activity was determined by measuring the effects of serum on neutrophil ROS production capability using lucigenin- and luminol-dependent chemiluminescence (LgCL, LmCL). LgCL is associated with the detection of O(2)(-) , whereas LmCL mainly detects H(2)O(2) and HOCl, which are higher reactive oxygen radicals. In females, exhaled CO level was found to have positive associations with ROS production capability and LgCL. However, the opposite tendency was seen between exhaled CO level and LmCL in both genders. This result suggests that neutrophil ROS production in females may have contributed to oxidative stress, which led to the increases in intrinsic CO and exhaled CO consequently. Such changes then may have inhibited the process of changing reactive oxygen radicals into higher oxidizing potential levels.
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Affiliation(s)
- Makoto Mikami
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, 036-8562 Aomori, Japan
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Koizumi K, Nakayama M, Zhu WJ, Ito S. Characteristic effects of methylglyoxal and its degraded product formate on viability of human histiocytes: A possible detoxification pathway of methylglyoxal. Biochem Biophys Res Commun 2011; 407:426-31. [DOI: 10.1016/j.bbrc.2011.03.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 03/09/2011] [Indexed: 11/29/2022]
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Dhar A, Dhar I, Desai KM, Wu L. Methylglyoxal scavengers attenuate endothelial dysfunction induced by methylglyoxal and high concentrations of glucose. Br J Pharmacol 2011; 161:1843-56. [PMID: 20825408 DOI: 10.1111/j.1476-5381.2010.01017.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND PURPOSE Endothelial dysfunction is a feature of hypertension and diabetes. Methylglyoxal (MG) is a reactive dicarbonyl metabolite of glucose and its levels are elevated in spontaneously hypertensive rats and in diabetic patients. We investigated if MG induces endothelial dysfunction and whether MG scavengers can prevent endothelial dysfunction induced by MG and high glucose concentrations. EXPERIMENTAL APPROACH Endothelium-dependent relaxation was studied in aortic rings from Sprague-Dawley rats. We also used cultured rat aortic and human umbilical vein endothelial cells. The MG was measured by HPLC and Western blotting and assay kits were used. KEY RESULTS Incubation of aortic rings with MG (30 µM) or high glucose (25 mM) attenuated endothelium-dependent, acetylcholine-induced relaxation, which was restored by two different MG scavengers, aminoguanidine (100 µM) and N-acetyl cysteine (NAC) (600 µM). Treatment of cultured endothelial cells with MG or high glucose increased cellular MG levels, effects prevented by aminoguanidine and NAC. In cultured endothelial cells, MG and high glucose reduced basal and bradykinin-stimulated nitric oxide (NO) production, cGMP levels, and serine-1177 phosphorylation and activity of endothelial NO synthase (eNOS), without affecting threonine-495 and Akt phosphorylation or total eNOS protein. These effects of MG and high glucose were attenuated by aminoguanidine or NAC. CONCLUSIONS AND IMPLICATIONS Our results show for the first time that MG reduced serine-1177 phosphorylation, activity of eNOS and NO production. MG caused endothelial dysfunction similar to that induced by high glucose. Specific and safe MG scavengers have potential to prevent endothelial dysfunction induced by MG and high glucose concentrations.
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Affiliation(s)
- Arti Dhar
- Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Desai KM, Chang T, Wang H, Banigesh A, Dhar A, Liu J, Untereiner A, Wu L. Oxidative stress and aging: is methylglyoxal the hidden enemy? Can J Physiol Pharmacol 2011; 88:273-84. [PMID: 20393592 DOI: 10.1139/y10-001] [Citation(s) in RCA: 146] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aging is a multifactorial process that involves changes at the cellular, tissue, organ and the whole body levels resulting in decreased functioning, development of diseases, and ultimately death. Oxidative stress is believed to be a very important factor in causing aging and age-related diseases. Oxidative stress is caused by an imbalance between oxidants such as reactive oxygen species (ROS) and antioxidants. ROS are produced from the mitochondrial electron transport chain and many oxidative reactions. Methylglyoxal (MG) is a highly reactive dicarbonyl metabolite formed during glucose, protein and fatty acid metabolism. MG levels are elevated in hyperglycemia and other conditions. An excess of MG formation can increase ROS production and cause oxidative stress. MG reacts with proteins, DNA and other biomolecules, and is a major precursor of advanced glycation end products (AGEs). AGEs are also associated with the aging process and age-related diseases such as cardiovascular complications of diabetes, neurodegenerative diseases and connective tissue disorders. AGEs also increase oxidative stress. In this review we discuss the potential role of MG in the aging process through increasing oxidative stress besides causing AGEs formation. Specific and effective scavengers and crosslink breakers of MG and AGEs are being developed and can become potential treatments to slow the aging process and prevent many diseases.
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Affiliation(s)
- Kaushik M Desai
- Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
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Effect of Methylglyoxal Modification of Human α-Crystallin on the Structure, Stability and Chaperone Function. Protein J 2010; 29:551-6. [DOI: 10.1007/s10930-010-9289-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Campbell AK, Matthews SB, Vassel N, Cox CD, Naseem R, Chaichi J, Holland IB, Green J, Wann KT. Bacterial metabolic 'toxins': a new mechanism for lactose and food intolerance, and irritable bowel syndrome. Toxicology 2010; 278:268-76. [PMID: 20851732 DOI: 10.1016/j.tox.2010.09.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 08/18/2010] [Accepted: 09/05/2010] [Indexed: 10/19/2022]
Abstract
Lactose and food intolerance cause a wide range of gut and systemic symptoms, including gas, gut pain, diarrhoea or constipation, severe headaches, severe fatigue, loss of cognitive functions such as concentration, memory and reasoning, muscle and joint pain, heart palpitations, and a variety of allergies (Matthews and Campbell, 2000; Matthews et al., 2005; Waud et al., 2008). These can be explained by the production of toxic metabolites from gut bacteria, as a result of anaerobic digestion of carbohydrates and other foods, not absorbed in the small intestine. These metabolites include alcohols, diols such as butan 2,3 diol, ketones, acids, and aldehydes such as methylglyoxal (Campbell et al., 2005, 2009). These 'toxins' induce calcium signals in bacteria and affect their growth, thereby acting to modify the balance of microflora in the gut (Campbell et al., 2004, 2007a,b). These bacterial 'toxins' also affect signalling mechanisms in cells around the body, thereby explaining the wide range of symptoms in people with food intolerance. This new mechanism also explains the most common referral to gastroenterologists, irritable bowel syndrome (IBS), and the illness that afflicted Charles Darwin for 50 years (Campbell and Matthews, 2005a,b). We propose it will lead to a new understanding of the molecular mechanism of type 2 diabetes and some cancers.
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Affiliation(s)
- A K Campbell
- Welsh School of Pharmacy, Cardiff University, King Edward VII Avenue, Cardiff CF103NB, UK.
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Miyazawa N, Abe M, Souma T, Tanemoto M, Abe T, Nakayama M, Ito S. Methylglyoxal augments intracellular oxidative stress in human aortic endothelial cells. Free Radic Res 2009; 44:101-7. [DOI: 10.3109/10715760903321788] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Methylglyoxal contributes to the development of insulin resistance and salt sensitivity in Sprague-Dawley rats. J Hypertens 2009; 27:1664-71. [PMID: 19531965 DOI: 10.1097/hjh.0b013e32832c419a] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Methylglyoxal, a metabolite of the glycolysis pathway, may play an important role in the development of diabetes and hypertension, but the exact mechanism has not been fully elucidated. The present study was designed to investigate whether methylglyoxal could directly induce insulin resistance and salt sensitivity in Sprague-Dawley rats. METHODS Rats were allocated to four groups: control (normal drinking water), 1% methylglyoxal in drinking water, 1% methylglyoxal plus N-acetyl cysteine (NAC) (800 mg/kg per day), a methylglyoxal scavenger, or TM2002 (100 mg/kg per day), an advanced glycation endproducts (AGEs) inhibitor. After 4-week treatment insulin resistance was evaluated by an euglycemic hyperinsulinemic glucose clamp technique. In another set of rats, either a high-salt diet (4%) alone, standard rat chow with 1% methylglyoxal in drinking water or high-salt diet plus methylglyoxal was given for 4 weeks. Immunohistochemistry was performed to measure nitrotyrosine and methylglyoxal-induced AGEs, N-carboxyethyl-lysine (CEL) in the kidney. RESULTS Four-week treatment with NAC or TM2002 completely improved methylglyoxal-induced insulin resistance. Co-administration of methylglyoxal and high-salt diet significantly increased systolic blood pressure, urinary albumin excretion, urinary thiobarbituric acid-reactive substances excretion and the renal nitrotyrosine expression in the kidney (markers of oxidative stress) compared with methylglyoxal or high-salt diet alone. Renal CEL was significantly increased in methylglyoxal-treated rats compared with nonmethylglyoxal-treated rats. CONCLUSION These results indicate that methylglyoxal-induced insulin resistance and salt sensitivity at least in part by increasing oxidative stress and/or AGEs formation in Sprague-Dawley rats. The present study provides further evidence for methylglyoxal as one of the causative factors in the pathogenesis of insulin resistance and salt-sensitive hypertension.
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Uriarte SM, Jog NR, Luerman GC, Bhimani S, Ward RA, McLeish KR. Counterregulation of clathrin-mediated endocytosis by the actin and microtubular cytoskeleton in human neutrophils. Am J Physiol Cell Physiol 2009; 296:C857-67. [PMID: 19176760 DOI: 10.1152/ajpcell.00454.2008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
We have recently reported that disruption of the actin cytoskeleton enhanced N-formylmethionyl-leucyl-phenylalanine (fMLP)-stimulated granule exocytosis in human neutrophils but decreased plasma membrane expression of complement receptor 1 (CR1), a marker of secretory vesicles. The present study was initiated to determine if reduced CR1 expression was due to fMLP-stimulated endocytosis, to determine the mechanism of this endocytosis, and to examine its impact on neutrophil functional responses. Stimulation of neutrophils with fMLP or ionomycin in the presence of latrunculin A resulted in the uptake of Alexa fluor 488-labeled albumin and transferrin and reduced plasma membrane expression of CR1. These effects were prevented by preincubation of the cells with sucrose, chlorpromazine, or monodansylcadaverine (MDC), inhibitors of clathrin-mediated endocytosis. Sucrose, chlorpromazine, and MDC also significantly inhibited fMLP- and ionomycin-stimulated specific and azurophil granule exocytosis. Disruption of microtubules with nocodazole inhibited endocytosis and azurophil granule exocytosis stimulated by fMLP in the presence of latrunculin A. Pharmacological inhibition of phosphatidylinositol 3-kinase, ERK1/2, and PKC significantly reduced fMLP-stimulated transferrin uptake in the presence of latrunculin A. Blockade of clathrin-mediated endocytosis had no significant effect on fMLP-stimulated phosphorylation of ERK1/2 in neutrophils pretreated with latrunculin A. From these data, we conclude that the actin cytoskeleton functions to limit microtubule-dependent, clathrin-mediated endocytosis in stimulated human neutrophils. The limitation of clathrin-mediated endocytosis by actin regulates the extent of both specific and azurophilic granule exocytosis.
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Affiliation(s)
- Silvia M Uriarte
- Department of Medicine, University of Louisville, Louisville, KY, USA.
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Abstract
Methylglyoxal (MG) is a reactive dicarbonyl intermediate of the glycolytic pathway. Increased oxidative stress is associated with conditions of increased MG, such as diabetes mellitus. Increased oxidative stress is due to an increase in highly reactive by-products of metabolic pathways, the so-called reactive oxygen species, such as superoxide anion, hydroxyl radical, hydrogen peroxide, nitric oxide and peroxynitrite. These reactive species react with a variety of proteins, enzymes, lipids, DNA and other molecules and disrupt their normal function. Oxidative stress causes many pathological changes that lead to vascular complications of diabetes mellitus, hypertension, neurodegenerative diseases and aging. In this review we summarize the correlation of elevated MG and various reactive oxygen species, and the enzymes that produce them or take part in their disposal, such as antioxidant enzymes and cofactors. The findings reported in various studies reviewed have started filling in gaps in our knowledge that will ultimately provide us with a clear picture of how the whole process that causes cellular dysfunction is initiated.
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Affiliation(s)
- Kaushik M Desai
- Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Attenuation of hypertension development by scavenging methylglyoxal in fructose-treated rats. J Hypertens 2008; 26:765-72. [PMID: 18327087 DOI: 10.1097/hjh.0b013e3282f4a13c] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Methylglyoxal is a reactive dicarbonyl intermediate of metabolism produced in the body. It reacts with certain proteins and forms damaging advanced glycation endproducts (AGEs) such as N epsilon-carboxyethyl-lysine (CEL) and N epsilon-carboxymethyl-lysine (CML). Increased methylglyoxal levels are found in diabetes mellitus and associated with hypertension development in the spontaneously hypertensive rats (SHR). The purpose of this study was to investigate whether increased endogenous formation of methylglyoxal and methylglyoxal-induced AGEs caused hypertension development in normotensive Sprague Dawley rats. METHODS The rats were fed chronically for 16 weeks with fructose, a known precursor of methylglyoxal formation. One group of rats was cotreated with fructose and metformin, an AGEs formation inhibitor. Methylglyoxal and reduced glutathione (GSH) were measured by high performance liquid chromatography, whereas hydrogen peroxide was measured by a dicholorofluorescin assay. Immunohistochemistry was performed for endothelial nitric oxide synthase (eNOS), CEL and CML. RESULTS Fructose-fed rats had elevated blood pressure, serum methylglyoxal and triglycerides and reduced serum levels of GSH. Methylglyoxal, hydrogen peroxide and CEL were increased in the aorta, whereas eNOS was reduced. CEL and CML were also increased in the mesenteric artery endothelium along with media/lumen ratio, signifying structural remodelling. All the harmful changes in fructose-fed rats were attenuated in metformin and fructose cotreated rats. CONCLUSION Increased methylglyoxal, AGEs, oxidative stress and reduced eNOS along with structural remodeling of the vessel wall in the aorta and mesenteric artery likely play a role in the pathogenesis of hypertension.
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Mukhopadhyay S, Ghosh A, Kar M. Methylglyoxal increase in uremia with special reference to snakebite-mediated acute renal failure. Clin Chim Acta 2008; 391:13-7. [DOI: 10.1016/j.cca.2008.01.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2007] [Revised: 01/01/2008] [Accepted: 01/14/2008] [Indexed: 10/22/2022]
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Cohen G, Raupachova J, Wimmer T, Deicher R, Hörl WH. The uraemic retention solute para-hydroxy-hippuric acid attenuates apoptosis of polymorphonuclear leukocytes from healthy subjects but not from haemodialysis patients. Nephrol Dial Transplant 2008; 23:2512-9. [PMID: 18319358 DOI: 10.1093/ndt/gfn098] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Disturbed polymorphonuclear leukocyte (PMNL) apoptosis contributes to the dysregulation of the non-specific immune system in uraemia. Intracellular Ca(2+) modulates PMNL apoptotic cell death. We investigated the effect of para-hydroxy-hippuric acid (PHA), an erythrocyte plasma membrane Ca(2+)-ATPase inhibitor accumulating in uraemic sera, and of cyclopiazonic acid (CPA), an inhibitor of the sarko/endoplasmatic Ca(2+)-ATPase, on PMNL apoptosis. METHODS Apoptosis of PMNLs from healthy subjects and from haemodialysis (HD) patients was assessed after incubation for 20 h by evaluating morphological features under the fluorescence microscope and by measuring the DNA content and caspase activities by flow cytometry. The intracellular calcium concentration ([Ca(2+)](i)) was determined by measurement of fura-2 fluorescence using the 340/ 380 nm dual wavelength excitation. RESULTS Spontaneous apoptosis of PMNLs from healthy subjects and from HD patients did not differ. PHA significantly attenuated, while CPA increased, the apoptotic cell death of PMNLs from healthy subjects. The PHA effect was not observed with PMNLs from HD patients, irrespective of whether the blood was drawn before or after HD treatment. Baseline [Ca(2+)](i) was increased in PMNLs obtained from HD patients before dialysis but reversed after dialysis. The PHA effects were not mediated via [Ca(2+)](i). The chemotactic peptide N-formyl-L-methionyl-L-leucyl-L-phenylalanine (fMLP) induced a [Ca(2+)](i) increase and reduced PMNL survival. Extracellular Ca(2+) did not affect CPA- and fMLP-induced apoptosis. CONCLUSIONS PHA, without affecting [Ca(2+)](i), attenuates apoptosis of healthy but not of uraemic PMNLs. CPA and fMLP enhance PMNL apoptosis independently of Ca(2+) influx.
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Affiliation(s)
- Gerald Cohen
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Austria.
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KIM HY, OI Y, KIM M, YOKOZAWA T. Protective Effect of Lipoic Acid against Methylglyoxal-Induced Oxidative Stress in LLC-PK1 Cells. J Nutr Sci Vitaminol (Tokyo) 2008; 54:99-104. [DOI: 10.3177/jnsv.54.99] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Campbell AK, Naseem R, Holland IB, Matthews SB, Wann KT. Methylglyoxal and other carbohydrate metabolites induce lanthanum-sensitive Ca2+ transients and inhibit growth in E. coli. Arch Biochem Biophys 2007; 468:107-13. [DOI: 10.1016/j.abb.2007.09.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Revised: 09/07/2007] [Accepted: 09/09/2007] [Indexed: 01/10/2023]
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Wu L. Is methylglyoxal a causative factor for hypertension development?This paper is one of a selection of papers published in this Special Issue, entitled Young Investigator's Forum. Can J Physiol Pharmacol 2006; 84:129-39. [PMID: 16845897 DOI: 10.1139/y05-137] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Hypertension is a life-threatening disease that is associated with increased cardiovascular risks. Causes and mechanisms for hypertension development remain poorly understood. Methylglyoxal (MG), a highly reactive molecule, is a metabolite of sugar. Increased circulation and tissue levels of MG have been documented not only in diabetes but also in hypertension. Many recent studies also link MG-induced vascular damage to the pathogenic process of hypertension. As such, an etiological role of MG in hypertension development is proposed.
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Affiliation(s)
- Lingyun Wu
- Department of Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
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Abstract
Kidney dysfunction leads to disturbed renal metabolic activities and to impaired glomerular filtration, resulting in the retention of toxic solutes affecting all organs of the body. Cardiovascular disease (CVD) and infections are the main causes for the increased occurrence of morbidity and mortality among patients with chronic kidney disease (CKD). Both complications are directly or indirectly linked to a compromised immune defense. The specific coordinated roles of polymorphonuclear leukocytes (PMNLs), monocytes/macrophages, lymphocytes and antigen-presenting cells (APCs) in maintaining an efficient immune response are affected. Their normal response can be impaired, giving rise to infectious diseases or pre-activated/primed, leading to inflammation and consequently to CVD. Whereas the coordinated removal via apoptosis of activated immune cells is crucial for the resolution of inflammation, inappropriately high apoptotic rates lead to a diminished immune response. In uremia, the balance between pro- and anti-inflammatory and between pro- and anti-apoptotic factors is disturbed. This review summarizes the interrelated parameters interfering with the immune response in uremia, with a special focus on the non-specific immune response and the role of uremic toxins.
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Affiliation(s)
- Gerald Cohen
- Abteilung für Nephrologie und Dialyse, Univ.-Klinik für Innere Medizin III, Währinger Gürtel 18-20, Wien A-1090, Austria.
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