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Chen J, Ye W. Molecular mechanisms underlying Tao-Hong-Si-Wu decoction treating hyperpigmentation based on network pharmacology, Mendelian randomization analysis, and experimental verification. PHARMACEUTICAL BIOLOGY 2024; 62:296-313. [PMID: 38555860 DOI: 10.1080/13880209.2024.2330609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/02/2024] [Indexed: 04/02/2024]
Abstract
CONTEXT Hyperpigmentation, a common skin condition marked by excessive melanin production, currently has limited effective treatment options. OBJECTIVE This study explores the effects of Tao-Hong-Si-Wu decoction (THSWD) on hyperpigmentation and to elucidate the underlying mechanisms. MATERIALS AND METHODS We employed network pharmacology, Mendelian randomization, and molecular docking to identify THSWD's hub targets and mechanisms against hyperpigmentation. The Cell Counting Kit-8 (CCK-8) assay determined suitable THSWD treatment concentrations for PIG1 cells. These cells were exposed to graded concentrations of THSWD-containing serum (2.5%, 5%, 10%, 15%, 20%, 30%, 40%, and 50%) and treated with α-MSH (100 nM) to induce an in vitro hyperpigmentation model. Assessments included melanin content, tyrosinase activity, and Western blotting. RESULTS ALB, IL6, and MAPK3 emerged as primary targets, while quercetin, apigenin, and luteolin were the core active ingredients. The CCK-8 assay indicated that concentrations between 2.5% and 20% were suitable for PIG1 cells, with a 50% cytotoxicity concentration (CC50) of 32.14%. THSWD treatment significantly reduced melanin content and tyrosinase activity in α-MSH-induced PIG1 cells, along with downregulating MC1R and MITF expression. THSWD increased ALB and p-MAPK3/MAPK3 levels and decreased IL6 expression in the model cells. DISCUSSION AND CONCLUSION THSWD mitigates hyperpigmentation by targeting ALB, IL6, and MAPK3. This study paves the way for clinical applications of THSWD as a novel treatment for hyperpigmentation and offers new targeted therapeutic strategies.
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Affiliation(s)
- Jun Chen
- Department of Geriatrics, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
| | - Wenyi Ye
- Department of Traditional Chinese Internal Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
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Jia Y, Yang F, Dong X, Zhou L, Long H. Association between nocturia and serum albumin in the U.S. adults from NHANES 2005-2012. PLoS One 2024; 19:e0308980. [PMID: 39146317 PMCID: PMC11326611 DOI: 10.1371/journal.pone.0308980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 08/03/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Nocturia, a prevalent chronic condition, impacts individuals' quality of life but remains underexplored. This study aimed to assess the association between serum albumin levels and nocturia. METHODS Based on the analysis of the National Health and Nutrition Examination Survey (NHANES) database (2005-2012), our study included a total of 6345 adults (≥20 years old). Nocturia was defined as ≥2 nocturnal voiding episodes. Logistic regression and smooth curve fitting analyzed the linear and nonlinear correlations between serum albumin and nocturia, with subgroup analysis. RESULTS Among 6345 participants, 1821 (28.7%) experienced nocturia. Logistic regression analysis revealed a linear negative correlation between serum albumin and nocturia risk (OR = 0.9549, 95% CI = 0.9280 ~ 0.9827, P = 0.002). Even after quartile division of serum albumin concentration, this correlation persisted within each group, and a smooth curve fitting validated the nonlinear negative correlation between the two. Subgroup analysis further demonstrated significant impacts of body mass index (BMI), alcohol consumption, and age on this association. CONCLUSION This cross-sectional study indicated that higher serum albumin levels were associated with a reduced risk of nocturia in U.S. adults aged 20 and older, highlighting the importance of serum albumin in the prevention and treatment of nocturia and providing clinical guidance.
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Affiliation(s)
- Yangtao Jia
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Fangzheng Yang
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Xinke Dong
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Libin Zhou
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Huimin Long
- The Affiliated Lihuili Hospital of Ningbo University, Ningbo, Zhejiang, People's Republic of China
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Wei N, Liu C, Zhu H, Wang C, Zhou Y, Xiao Z, Du L, Song Y. Hypoalbuminemia contributes to ascites formation via sodium and water retention: Evidence from clinical date and albumin deficient mice. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167275. [PMID: 38844112 DOI: 10.1016/j.bbadis.2024.167275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 05/10/2024] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
Albumin infusions improve circulatory and renal function in patients with decompensated cirrhosis. However, there is no convincing evidence that hypoalbuminemia contributes to ascites formation in liver cirrhosis. The aim of our study is to determine the exact role of hypoalbuminemia in the formation of ascites caused by liver cirrhosis and its underlying mechanism. Clinical profiles of patients with liver cirrhosis retrospectively analyzed. The details of albumin involved in ascites formation were investigated in rat model and murine model. Statistical analysis demonstrated hypoalbuminemia was an independent risk factor for ascites formation in patients with liver cirrhosis (OR = 0.722, P < 0.001). In carbon tetrachloride (CCl4)-induced rat model of liver cirrhosis, a significant reduction in serum albumin was observed in rats with ascites (13.37 g/L) compared with rats without ascites (21.43 g/L, P < 0.001). In thioacetamide (TAA)-treated mice, ascites amount of heterozygous albumin (Alb+/-) mice (112.0 mg) was larger than that of wild-type (Alb+/+) mice (58.46 mg, P < 0.001). In CCl4-induced chronic liver injury, ascites amounts of Alb+/- or Alb+/+ mice were 80.00 mg or 48.46 mg (P = 0.001). Further study demonstrated 24-h urinary sodium excretion in Alb+/- mice was lower than that of Alb+/+ mice in TAA/CCl4-induce murine models of liver cirrhosis. Additionally, serum sodium concentration of Alb+/- mice was lower than that of Alb+/+ mice. In cirrhotic mice, higher level of antidiuretic hormone was observed in Alb+/- mice compared with the control; and renal aquaporin (AQP2) expression in Alb+/- mice was significantly higher than that of WT mice. These revealed hypoalbuminemia contributed to the occurrence of ascites in liver cirrhosis through sodium and water retention.
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Affiliation(s)
- Ning Wei
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chang Liu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Huifang Zhu
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chengbo Wang
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yangyang Zhou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhuanglong Xiao
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li Du
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yuhu Song
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Qiu X, Shen S, Lu D, Jiang N, Feng Y, Li J, Yang C, Xiang B. Predictive Efficacy of the Advanced Lung Cancer Inflammation Index in Hepatocellular Carcinoma After Hepatectomy. J Inflamm Res 2024; 17:5197-5210. [PMID: 39104905 PMCID: PMC11299648 DOI: 10.2147/jir.s468215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/16/2024] [Indexed: 08/07/2024] Open
Abstract
Background Hepatocellular carcinoma (HCC) presents a significant global health challenge due to its poor prognosis and high recurrence rates post-surgery. This study examines the predictive efficacy of the Advanced Lung Cancer Inflammation Index (ALI) in assessing the post-hepatectomy prognosis of patients with HCC. Methods A cohort comprising 1654 HCC patients who underwent hepatectomy at Guangxi Medical University Cancer Hospital from 2013 to 2019 was enrolled. Patients were stratified into two groups according to the median ALI level, and then subjected to propensity score matching (PSM) in a 1:1 ratio. Kaplan-Meier survival curves, the traditional Cox proportional hazards (CPH) model, and machine learning (ML) models were employed to analyze and evaluate ALI's prognostic significance. Furthermore, ALI's prognostic value in digestive system tumors was validated via analysis of the National Health and Nutrition Examination Survey (NHANES) database. Results After applying PSM, a final cohort of 1284 patients, categorized into high and low ALI groups, revealed a significantly reduced survival time in the low ALI cohort. Univariate and multivariate Cox analyses identified ALI, BCLC stage, CK19, Hepatitis B virus (HBV) DNA, lymph node metastasis, and microvascular invasion (MVI) as independent predictors of prognosis. Both traditional CPH and ML models incorporating ALI demonstrated excellent predictive accuracy, validated through calibration curves, time-dependent ROC curves, and decision curve analysis. Furthermore, the prognostic value of ALI in digestive tumors was confirmed in the NHANES database. Conclusion The ALI exhibits potential as a prognostic predictor in patients with HCC following hepatectomy, providing valuable insights into postoperative survival.
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Affiliation(s)
- Xin Qiu
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Shuang Shen
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
| | - Donghong Lu
- Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China
| | - Nizhen Jiang
- Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
| | - Yifei Feng
- Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
| | - Jindu Li
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
| | - Chenglei Yang
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
| | - Bangde Xiang
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China
- Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Ministry of Education, Nanning, People’s Republic of China
- Guangxi Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor, Nanning, People’s Republic of China
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Xu Y, Yan Z, Li K, Liu L, Xu L. Association between nutrition-related indicators with the risk of chronic obstructive pulmonary disease and all-cause mortality in the elderly population: evidence from NHANES. Front Nutr 2024; 11:1380791. [PMID: 39081677 PMCID: PMC11286481 DOI: 10.3389/fnut.2024.1380791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Background This study aims to use six nutrition-related indicators to assess the relationship between nutritional status and the risk of COPD as well as the all-cause mortality rate, and to determine the most reliable predictive indicators. Methods Data from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2013 to 2018 were extracted. Nutritional status was evaluated using Controlling nutritional status (CONUT) score, Geriatric Nutritional Risk Index (GNRI), Advanced Lung Cancer Inflammation Index (ALI), Prognostic Nutritional Index (PNI), Triglycerides (TG) × Total Cholesterol (TC) × Body Weight (BW) Index (TCBI), and Albumin-to-Globulin Ratio (AGR) nutritional-related indicators. Multivariate weighted logistic and Cox regression models were employed to assess the correlation between the six nutritional-related indicators and the risk of COPD and as all-cause mortality. The restricted cubic spline tests were applied to explore potential nonlinear relationships, and ROC curves and C-index analyses were conducted to compare the predictive capabilities of different indicators. Stratified analysis and propensity score matching (PSM) to assess the robustness of the results. Results In this study, Lower ALI, lower GNRI, and higher CONUT scores were positively correlated with an increased risk of COPD (OR: 1.77, 95% CI: 1.10-2.84) (OR: 8.66, 95% CI: 2.95-25.5), and (OR: 5.11, 95% CI: 1.72-15.2), respectively. It was found that ALI and GNRI had a non-linear relationship with the risk of COPD. After propensity score matching (PSM), the associations between ALI, GNRI, CONUT scores, and COPD remained consistent. Lower ALI, PNI, and GNRI scores were positively associated with all-cause mortality in COPD patients (HR: 2.41, 95% CI: 1.10-5.27), (HR: 3.76, 95% CI: 1.89-7.48), and (HR: 4.55, 95% CI: 1.30-15.9), respectively, with GNRI displaying a non-linear relationship with all-cause mortality. ROC curve and C-index analyses indicated that ALI had the best predictive ability for both COPD risk and all-cause mortality. Conclusion ALI, GNRI, and CONUT scores are correlated with the risk of COPD, while ALI, PNI, and GNRI scores are associated with all-cause mortality in COPD patients. Compared to other nutritional scores, ALI may provide more effective predictive value for both risk and all-cause mortality.
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Affiliation(s)
- Yifeng Xu
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Zhaoqi Yan
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Keke Li
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Liangji Liu
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
| | - Lei Xu
- Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, China
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Huang Y, Wang X, Li Z, Yin X. A novel nutritional inflammation index for predicting mortality in acute ischemic stroke patients: insights into advanced lung cancer inflammation index from the Medical Information Mart for Intensive Care-IV database. Front Nutr 2024; 11:1408372. [PMID: 39036488 PMCID: PMC11257925 DOI: 10.3389/fnut.2024.1408372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/26/2024] [Indexed: 07/23/2024] Open
Abstract
Objective This investigation aimed to delineate the association between the advanced lung cancer inflammation index (ALI) and all-cause mortality (ACM) in individuals experiencing acute ischemic stroke (AIS). Methods Drawing on information from the Medical Information Mart for Intensive Care (MIMIC)-IV database, release 2.2, covering the years 2012 to 2019, this research assessed the advanced lung cancer inflammation index (ALI) by factoring in body mass index (BMI), serum albumin levels (ALB), and the neutrophil-to-lymphocyte ratio (NLR). Patients with AIS were identified using codes from the International Classification of Diseases (ICD). To address potential confounding factors, a 1:1 propensity score matching (PSM) method was utilized. The investigation identified the pivotal ALI level impacting patient survival using maximally selected rank statistics. It then examined the effects on short- and long-term ACM through multivariate Cox proportional hazards regression models and Kaplan-Meier (K-M) survival analysis. Additionally, restricted cubic spline (RCS) methods were applied to delve into the linear or nonlinear nature of the relationship between ALI and ACM, with further insights gained from interaction and subgroup analyses. Results The cohort comprised 838 AIS patients. Post-PSM, analysis involved 199 matched patient pairs. Adjusted Cox proportional hazard models indicated a significant association of low ALI (<10.38) with increased in-hospital ACM, both before (HR: 1.98; 95% CI: 1.36-2.88; p < 0.001) and after PSM (HR: 2.16; 95% CI: 1.32-3.52; p = 0.002). Associations of low ALI with elevated risk were consistent across ICU, 30 days, 90 days, and 1 year ACM pre- and post-PSM. Subsequent RCS analysis post-PSM underscored a negative nonlinear relationship between ALI and ACM over both short and long terms, without significant interaction effects across different subgroups for ACM. Conclusion In this retrospective cohort study, by utilizing a nationally representative sample of United States patients with AIS, our analysis elucidates a negative correlation between the ALI and ACM in individuals with AIS, underscoring the utility of ALI as a novel, efficacious, and accessible inflammatory biomarker for prognosticating ACM. These results carry profound implications for public health policy and practice. A deeper comprehension of these associations can empower public health practitioners and researchers to devise more targeted interventions and policies, aimed specifically at catering to the distinct needs of the AIS patient population, thereby enhancing their health outcomes. The further research in other races/ethnicity is urgent, particularly before applying these findings in clinical practice.
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Affiliation(s)
- Yongwei Huang
- Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Xiaoyi Wang
- Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Zongping Li
- Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Xiaoshuang Yin
- Department of Immunology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
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Prasetiyo PD, Baskoro BA, Hariyanto TI. The role of nutrition-based index in predicting survival of breast cancer patients: A systematic review and meta-analysis. Heliyon 2024; 10:e23541. [PMID: 38169970 PMCID: PMC10758813 DOI: 10.1016/j.heliyon.2023.e23541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Background Prognostic nutritional index (PNI) and Controlling Nutritional Status (CONUT) are two model that incorporates the role of inflammation and nutrition factors to predict the progression of tumor. The primary objective of this investigation is to examine the ability of PNI and CONUT score for predicting the survival in breast cancer patients. Methods A comprehensive search was conducted on the Cochrane Library, Scopus, Europe PMC, and Medline databases up until August 14th, 2023, utilizing a combination of relevant keywords. This review incorporates literature that examines the relationship between PNI, CONUT, and survival in breast cancer. We employed random-effect models to analyze the hazard ratio (HR) and present the outcomes together with their corresponding 95 % confidence intervals (CI). Results A total of sixteen studies were incorporated. The results of our meta-analysis indicated that high PNI was associated with better overall survival (OS) (HR 0.38; 95%CI: 0.28-0.51, p < 0.00001, I2 = 32 %), but not disease-free survival (DFS) (HR 0.60; 95%CI: 0.33-1.10, p = 0.10, I2 = 78 %) than low PNI in breast cancer patients. Meta-analysis also indicated that high CONUT was associated with worse OS (HR 1.66; 95%CI: 1.21-2.28, p = 0.002, I2 = 78 %) and worse DFS (HR 2.09; 95%CI: 1.60-2.73, p < 0.00001, I2 = 41 %) in breast cancer patients. Conclusions This study suggests the prognostic role of both PNI and CONUT score for predicting survival in breast cancer patients.
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Affiliation(s)
- Patricia Diana Prasetiyo
- Department of Pathology, Faculty of Medicine, Pelita Harapan University, Tangerang, Banten, 15811, Indonesia
| | - Bernard Agung Baskoro
- Division of Surgical Oncology, Department of Surgery, Faculty of Medicine, Pelita Harapan University, Karawaci, Tangerang, 15811, Indonesia
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Yao J, Chen X, Meng F, Cao H, Shu X. Combined influence of nutritional and inflammatory status and depressive symptoms on mortality among US cancer survivors: Findings from the NHANES. Brain Behav Immun 2024; 115:109-117. [PMID: 37820973 DOI: 10.1016/j.bbi.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/26/2023] [Accepted: 10/07/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Inflammation and nutrition and depression are interrelated, and both are related to changes in mortality rates. We investigated the association of nutritional and inflammation index or depressive symptoms with the risk of all-cause mortality or cause-specific mortality among cancer survivors. METHODS A prospective cohort of a nationally representative sample of cancer survivors, aged 40 years or older (n = 2331; weighted population, 15 248 255; 67.6 ± 11.0 years; 50.6 % males), were recruited from the US National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Advanced lung cancer inflammation index (ALI) reflected inflammation and nutritional status and Patient Health Questionnaire 9 (PHQ-9) demonstrated depressive symptoms. The independent and joint associations of ALI and PHQ-9 score with mortality outcomes were examined among cancer survivors and Cox regression analysis based on weights was used to calculate the relative risk. RESULTS We identified 605 all-cause deaths (cancer, 204; non-cancer, 401) over a median of 6.2 years of follow-up (15,385 person-years; interquartile range, 3.3-9.8 years). High ALI was observed to be consistently associated with lower risks of all-cause (hazard ratio [HR], 0.516; 95 % CI, 0.400-0.667) and non-cancer (HR, 0.414; 95 % CI, 0.291-0.588) mortality compared with low ALI in a series of adjusted models. Meanwhile, lower PHQ-9 score (0-4) was associated with lower risks of all-cause (HR, 0.686; 95 % CI, 0.521-0.903) and non-cancer (HR, 0.686; 95 % CI, 0.474-0.992) mortality compared with higher PHQ-9 score (≥10). Furthermore, joint analyses showed that high ALI was associated with a decreased risk of death among cancer survivors who were not depressive. Specifically, survivors with high ALI but not depressive symptoms had the lowest overall (HR, 0.404; 95 % CI, 0.228-0.715) risks. CONCLUSION In this cohort study, we observed impact of nutritional and inflammatory status and depressive symptoms on mortality among cancer survivors, with the lowest risks of death from both all causes and non-cancer being noted among the combination of high level ALI with no depression.
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Affiliation(s)
- Jiazhen Yao
- Department of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou 215123, China
| | - Xiaohong Chen
- Department of Anesthesiology, Tumor Hospital Affiliated to Nantong University, Nantong 226361, China; Department of Anesthesiology, Nantong Tumor Hospital, Nantong 226361, China
| | - Fang Meng
- National Key Laboratory of Immunity and Inflammation, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, China; State Key Laboratory of Medical Molecular Biology, Suzhou Institute of Systems Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Suzhou 215123, China
| | - Hanzhong Cao
- Department of Anesthesiology, Tumor Hospital Affiliated to Nantong University, Nantong 226361, China; Department of Anesthesiology, Nantong Tumor Hospital, Nantong 226361, China.
| | - Xiaochen Shu
- Department of Epidemiology, School of Public Health, Suzhou Medical College of Soochow University, Suzhou 215123, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, Jiangsu 215123, China.
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Valera RJ, Sarmiento-Cobos M, Montorfano L, Khan M, Lo Menzo E, Szomstein S, Rosenthal RJ. Predictors and outcomes of acute kidney injury after bariatric surgery: analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Surg Obes Relat Dis 2023; 19:1302-1307. [PMID: 37468336 DOI: 10.1016/j.soard.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Acute kidney injury (AKI) after surgery increases long-term risk of kidney dysfunction. The major risk factor for AKI after bariatric surgery is having preoperative renal insufficiency. Little is known about the outcomes and risk factors for developing AKI in patients undergoing bariatric surgery with normal renal function. OBJECTIVE We aimed to describe factors that may increase risk of AKI after primary bariatric surgery in patients without history of kidney disease. SETTING Academic hospital, United States. METHODS We performed a retrospective analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry for patients aged ≥18 years undergoing laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass (LRYGB) from 2015 to 2019. Patients with diagnosis of chronic kidney disease were excluded. The primary outcome was incidence of AKI. Secondary outcomes included 30-day complications, readmissions, reoperations, and mortality. Univariate and multivariate analyses were performed to identify differences between patients with and without AKI. RESULTS A total of 747,926 patients were included in our analysis (laparoscopic sleeve gastrectomy = 73.1%, LRYGB = 26.8%). Mean age was 44.40 ± 11.94 years, with female predominance (79.7%). AKI occurred in 446 patients (.05%). Patients with postoperative AKI had higher rates of complications, readmissions, reoperations, and mortality. Significant predictors of AKI were male sex, history of venous thromboembolism, hypertension, limitation for ambulation, and LRYGB. High albumin levels and White race were protective factors. CONCLUSIONS New-onset AKI was associated with adverse 30-day outcomes in patients undergoing bariatric surgery. Male sex, venous thromboembolism, hypertension, limited ambulation, and LRYGB were independent predictors of AKI. Prospective studies are needed to better describe these results.
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Affiliation(s)
- Roberto J Valera
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Mauricio Sarmiento-Cobos
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Lisandro Montorfano
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Mustafa Khan
- Department of General Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | - Emanuele Lo Menzo
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Samuel Szomstein
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida
| | - Raul J Rosenthal
- Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
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Tanrıkulu AB, Kaya H, Çatak Z. Elevated C-reactive protein/albumin ratio in patients with methamphetamine use disorder. Int J Psychiatry Clin Pract 2023; 27:351-358. [PMID: 37477597 DOI: 10.1080/13651501.2023.2237557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/09/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Methamphetamine use disorder causes significant crises, which have individual, familial, and social consequences. Identifying inflammatory biomarkers for methamphetamine use disorder may be useful for following the inflammatory status of patients in clinical assessment. In this study, we aimed to investigate whether neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), C-reactive protein/albumin ratio (CAR) and neutrophil/albumin ratio (NAR) levels can be used as inflammatory biomarkers in methamphetamine use disorder. METHODS The sample comprised 139 treatment-seeking participants who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for methamphetamine use disorder and 139 sociodemographically matched controls. Only hospitalised patients were included. An independent sample t-test, Pearson's correlation test, and binominal logistic regression analysis were performed. RESULTS CAR (p = 0.016) and NAR (p = 0.048) levels were significantly higher in individuals with methamphetamine use disorder when compared with healthy controls. The CAR level was found to be a significant predictor of group membership in regression analysis for methamphetamine use disorder. CONCLUSION CAR may be a potential inflammatory biomarker for patients with methamphetamine use disorder. CAR as a relatively easier-to-measure biomarker could be beneficial to follow the inflammatory status and treatment response of patients.
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Affiliation(s)
- Ali Baran Tanrıkulu
- Psychiatry, Elazığ Mental Health and Diseases Hospital, Turkey Elazığ, Turkey
| | - Hilal Kaya
- Psychiatry, Elazığ Mental Health and Diseases Hospital, Turkey Elazığ, Turkey
| | - Zekiye Çatak
- Department of Biochemistry, Health Sciences University Elazığ Fethi Sekin City Hospital, Central Laboratory, Elazig, Turkey
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11
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Trebicka J, Garcia-Tsao G. Controversies regarding albumin therapy in cirrhosis. Hepatology 2023:01515467-990000000-00524. [PMID: 37540192 DOI: 10.1097/hep.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/26/2023] [Indexed: 08/05/2023]
Abstract
Albumin is the most abundant protein in the human body and is synthetized exclusively by the liver. Therefore, serum albumin levels are reduced in acute and/or chronic liver disease. In cirrhosis, low levels of albumin predict the outcome. In advanced cirrhosis, the quality of albumin is decreased due to high oxidative stress and a proinflammatory state. Therefore, the administration of i.v. albumin would seem to be of pathophysiological relevance and benefit. Yet, the questions that remain are who, when, how much, and how often. While albumin infusion is recommended after large-volume paracentesis, at diagnosis of spontaneous bacterial peritonitis, in acute kidney injury, and in hepatorenal syndrome, the amount and schedule of albumin to be administered require refinement, particularly given complications related to volume overload that have become increasingly apparent. Other indications for albumin such as infections other than spontaneous bacterial peritonitis, hyponatremia, HE, prevention of poor outcomes in hospitalized, and in outpatients with cirrhosis are still debated. The results of studies in these settings are either negative, controversial, or inconclusive. This sheds some doubts regarding the use of albumin as a "one size fits all" strategy. The indication and patient selection are crucial and not always intuitive. The amount and frequency also seem to play a role in the success or failure of albumin. This review will critically discuss the evidence and underline areas where there are indications for albumin use and others where evidence is still insufficient and will have to await the development/results of randomized controlled trials.
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Affiliation(s)
- Jonel Trebicka
- Department of Internal Medicine B, University of Münster, Münster, Germany
- European Foundation for Study of Chronic Liver Failure, EASL-CLIF-Consortium, Barcelona, Spain
- Department of Gastroenterology and Hepatology, University of Southern Denmark, Odense, Denmark
| | - Guadalupe Garcia-Tsao
- Digestive Diseases Section, Department of Medicine, Yale University, New Haven, Connecticut, USA
- Digestive Diseases Section, Department of Medicine, VA-CT Healthcare System, West Haven, Connecticut, USA
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12
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Effective albumin – A novel paradigm in the management of decompensated liver cirrhosis. J Transl Int Med 2023; 11:11-14. [DOI: 10.2478/jtim-2022-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
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13
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Duran-Güell M, Garrabou G, Flores-Costa R, Casulleras M, López-Vicario C, Zhang IW, Cantó-Santos J, Contreras BJ, Sánchez-Rodríguez MB, Romero-Grimaldo B, Horrillo R, Costa M, Arroyo V, Clària J. Essential role for albumin in preserving liver cells from TNFα-induced mitochondrial injury. FASEB J 2023; 37:e22817. [PMID: 36809676 DOI: 10.1096/fj.202201526r] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
Cytokine-induced inflammation and mitochondrial oxidative stress are key drivers of liver tissue injury. Here, we describe experiments modeling hepatic inflammatory conditions in which plasma leakage leads to large amounts of albumin to reach the interstitium and parenchymal surfaces to explore whether this protein plays a role in preserving hepatocyte mitochondria against the damaging actions of the cytotoxic cytokine tumor necrosis factor alpha (TNFα). Hepatocytes and precision-cut liver slices were cultured in the absence or presence of albumin in the cell media and then exposed to mitochondrial injury with the cytokine TNFα. The homeostatic role of albumin was also investigated in a mouse model of TNFα-mediated liver injury induced by lipopolysaccharide and D-galactosamine (LPS/D-gal). Mitochondrial ultrastructure, oxygen consumption, ATP and reactive oxygen species (ROS) generation, fatty acid β-oxidation (FAO), and metabolic fluxes were assessed by transmission electron microscopy (TEM), high-resolution respirometry, luminescence-fluorimetric-colorimetric assays and NADH/FADH2 production from various substrates, respectively. TEM analysis revealed that in the absence of albumin, hepatocytes were more susceptible to the damaging actions of TNFα and showed more round-shaped mitochondria with less intact cristae than hepatocytes cultured with albumin. In the presence of albumin in the cell media, hepatocytes also showed reduced mitochondrial ROS generation and FAO. The mitochondria protective actions of albumin against TNFα damage were associated with the restoration of a breakpoint between isocitrate and α-ketoglutarate in the tricarboxylic acid cycle and the upregulation of the antioxidant activating transcription factor 3 (ATF3). The involvement of ATF3 and its downstream targets was confirmed in vivo in mice with LPS/D-gal-induced liver injury, which showed increased hepatic glutathione levels, indicating a reduction in oxidative stress after albumin administration. These findings reveal that the albumin molecule is required for the effective protection of liver cells from mitochondrial oxidative stress induced by TNFα. These findings emphasize the importance of maintaining the albumin levels in the interstitial fluid within the normal range to protect the tissues against inflammatory injury in patients with recurrent hypoalbuminemia.
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Affiliation(s)
- Marta Duran-Güell
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain
| | - Glòria Garrabou
- Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences, Internal Medicine Department, University of Barcelona, Hospital Clínic, Barcelona, Spain.,CIBERer, Barcelona, Spain
| | - Roger Flores-Costa
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain
| | - Mireia Casulleras
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain
| | - Cristina López-Vicario
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain.,CIBERehd, Barcelona, Spain
| | - Ingrid W Zhang
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain
| | - Judith Cantó-Santos
- Muscle Research and Mitochondrial Function Laboratory, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences, Internal Medicine Department, University of Barcelona, Hospital Clínic, Barcelona, Spain.,CIBERer, Barcelona, Spain
| | - Bryan J Contreras
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | | | - Berta Romero-Grimaldo
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | | | | | - Vicente Arroyo
- Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain
| | - Joan Clària
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Grifols Chair, European Foundation for the Study of Chronic Liver Failure (EF CLIF), Barcelona, Spain.,CIBERehd, Barcelona, Spain.,Department of Biomedical Sciences, University of Barcelona, Barcelona, Spain
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14
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Rohrer L, Yunce M, Montine TJ, Shan H. Plasma Exchange in Alzheimer's Disease. Transfus Med Rev 2023; 37:10-15. [PMID: 36357257 DOI: 10.1016/j.tmrv.2022.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/25/2022] [Accepted: 09/01/2022] [Indexed: 11/09/2022]
Abstract
Therapeutic plasma exchange (TPE) has traditionally been used to selectively remove pathologic contents including autoantibodies, abnormal proteins, immune complexes, or toxins from a patient's plasma. In addition to the removal of molecular contributors to disease, fluid replacement and infusion of beneficial plasma constituents including albumin can be tapered based on the pathophysiologic mechanisms of the offending disease. This treatment modality has shown efficacy in symptomatic relief and slowing of disease progression for various neurologic, immunologic, and hematologic diseases. This review outlines the rationale for TPE in the treatment of Alzheimer's Disease (AD) through a potential mechanism leveraging the concentration gradient of amyloid β peptides and the infusion of albumin, and critically reviews the clinical evidence for treatment of AD using TPE and albumin replacement. This review also highlights potential sources of bias that must be considered in conjunction with the evidence of efficacy for the use of TPE in AD.
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Affiliation(s)
- Lucas Rohrer
- San Francisco, School of Medicine, University of California, San Francisco, CA, USA.
| | - Muharrem Yunce
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | - Hua Shan
- Department of Pathology, Stanford University, Stanford, CA, USA
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15
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Li J, Guo L. Association between sleep duration and albumin in US adults: a cross-sectional study of NHANES 2015-2018. BMC Public Health 2022; 22:1102. [PMID: 35655296 PMCID: PMC9161202 DOI: 10.1186/s12889-022-13524-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Albumin has multiple functions and is used in the clinical assessment of liver function, kidney function and nutritional status. However, few epidemiological studies have evaluated the association between sleep duration and albumin. Therefore, we carried out a cross-sectional study to address this issue. The aim of the study was to investigate the association between sleep duration and albumin in American adults based on the NHANES (National Health and Nutrition Examination Survey). METHODS A total of 9,973 participants aged [Formula: see text] 20 years were included in this study from NHANES 2015-2018. Weighted data were calculated according to analytical guidelines. Linear regression models and smooth curve fitting were used to assess and describe the relationship between sleep duration and albumin. The inflection point was determined by a two-step recursive method. Moreover, univariate and stratified analyses were performed. RESULTS There was an inverted U-shaped association between sleep duration and albumin levels. Albumin levels were highest when the sleep duration was 7.5 h. Compared to 7-8 h of sleep, short sleep duration was linked to lower albumin levels [sleep duration [Formula: see text] 5 h: β [Formula: see text]-1.00, 95% CI (-1.26, -0.74), P < 0.0001]. Compared to 7-8 h of sleep, long sleep duration was related to lower albumin levels [sleep duration [Formula: see text] 9 h: β [Formula: see text] -0.48, 95% CI (-0.68, -0.27), P < 0.0001]. CONCLUSIONS Sleep duration had an inverted U-shaped relationship with albumin, with short or long sleep duration associated with significantly lower albumin levels.
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Affiliation(s)
- Jingxian Li
- Nanjing University of Chinese Medicine, Nanjing, 210029, China.
- Jining NO.1 People's Hospital, Jining, 272000, China.
| | - Lizhong Guo
- Nanjing University of Chinese Medicine, Nanjing, 210029, China
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16
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Abstract
PURPOSE OF REVIEW Albumin has been used primarily as a plasma expander, since it leads to an increase in the circulating blood volume. Current generally recommended indications for albumin therapy in cirrhotic patients are the prevention of circulatory dysfunction after large-volume paracentesis, the prevention of hepatorenal syndrome (HRS) in patients with spontaneous bacterial peritonitis (SBP), and the management of HRS in combination with vasoconstrictors. Yet, new indications for albumin have been tested in the recent years and are outlined in this short review. RECENT FINDINGS New data show that albumin both supports the circulation and reduces systemic inflammation. In addition, to its oncotic function, it acts as an antioxidant, radical scavenger, and immune modulator. These nononcotic properties explain why long-term albumin administration in patients with decompensated cirrhosis may be useful in the prevention of associated complications (acute-on-chronic liver failure, infections). New data show that long-term albumin therapy in patients with cirrhosis and ascites improves survival, prevents complications, simplifies ascites management, and lowers hospitalization rates. The so-called disease-modifying effects of long-term albumin therapy may have a favorable effect on the course of the disease. Nevertheless, the optimal dosage and administration intervals have not yet been finally defined. SUMMARY Albumin therapy is effective in the indications already recommended by the guidelines. A possible extension of the indication for albumin administration in non-SBP infections and as long-term therapy is promising, but should be confirmed by further studies.
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Affiliation(s)
- Jonel Trebicka
- European Foundation for Study of Chronic Liver Failure, EF-Clif, Barcelona, Spain
- Translational Hepatology, Internal Medicine I, Goethe University Frankfurt, Frankfurt, Germany
- University of Southern Denmark, Odense, Denmark
- Institute of Bioengineering Catalunya, Barcelona, Spain
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Jagdish RK, Maras JS, Sarin SK. Albumin in Advanced Liver Diseases: The Good and Bad of a Drug! Hepatology 2021; 74:2848-2862. [PMID: 33772846 DOI: 10.1002/hep.31836] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 02/13/2021] [Accepted: 03/17/2021] [Indexed: 12/13/2022]
Abstract
Human serum albumin is the most abundant plasma protein, and it regulates diverse body functions. In patients with advanced and decompensated cirrhosis, serum albumin levels are low because of a reduction in the hepatocyte mass due to disease per se and multiple therapeutic interventions. Because of their oncotic and nononcotic properties, administration of human albumin solutions (HAS) have been found to be beneficial in patients undergoing large-volume paracentesis or who have hepatorenal syndrome or spontaneous bacterial peritonitis. Albumin also improves the functionality of the immune cells and mitigates the severity and risk of infections in advanced cirrhosis. Its long-term administration can modify the course of decompensated cirrhosis patients by reducing the onset of new complications, improving the quality of life, and probably providing survival benefits. There is, however, a need to rationalize the dose, duration, and frequency of albumin therapy in different liver diseases and stages of cirrhosis. In patients with acute-on-chronic liver failure, potentially toxic oxidized isoforms of albumin increase substantially, especially human nonmercaptalbumin and 2, and nitrosoalbumin. The role of administration of HAS in such patients is unclear. Determining whether removal of the pathological and dysfunctional albumin forms in these patients by "albumin dialysis" is helpful, requires additional studies. Use of albumin is not without adverse events. These mainly include allergic and transfusion reactions, volume overload, antibody formation and coagulation derangements. Considering their cost, limited availability, need for a health care setting for their administration, and potential adverse effects, judicious use of HAS in liver diseases is advocated. There is a need for new albumin molecules and economic alternatives in hepatologic practice.
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Affiliation(s)
- Rakesh Kumar Jagdish
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Jaswinder Singh Maras
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
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