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Deng C, Pan J, Zhu H, Chen ZY. Effect of Gut Microbiota on Blood Cholesterol: A Review on Mechanisms. Foods 2023; 12:4308. [PMID: 38231771 DOI: 10.3390/foods12234308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 01/19/2024] Open
Abstract
The gut microbiota serves as a pivotal mediator between diet and human health. Emerging evidence has shown that the gut microbiota may play an important role in cholesterol metabolism. In this review, we delve into five possible mechanisms by which the gut microbiota may influence cholesterol metabolism: (1) the gut microbiota changes the ratio of free bile acids to conjugated bile acids, with the former being eliminated into feces and the latter being reabsorbed back into the liver; (2) the gut microbiota can ferment dietary fiber to produce short-chain fatty acids (SCFAs) which are absorbed and reach the liver where SCFAs inhibit cholesterol synthesis; (3) the gut microbiota can regulate the expression of some genes related to cholesterol metabolism through their metabolites; (4) the gut microbiota can convert cholesterol to coprostanol, with the latter having a very low absorption rate; and (5) the gut microbiota could reduce blood cholesterol by inhibiting the production of lipopolysaccharides (LPS), which increases cholesterol synthesis and raises blood cholesterol. In addition, this review will explore the natural constituents in foods with potential roles in cholesterol regulation, mainly through their interactions with the gut microbiota. These include polysaccharides, polyphenolic entities, polyunsaturated fatty acids, phytosterols, and dicaffeoylquinic acid. These findings will provide a scientific foundation for targeting hypercholesterolemia and cardiovascular diseases through the modulation of the gut microbiota.
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Affiliation(s)
- Chuanling Deng
- School of Food Science and Engineering/National Technical Center (Foshan) for Quality Control of Famous and Special Agricultural Products (CAQS-GAP-KZZX043), Foshan University, Foshan 528011, China
| | - Jingjin Pan
- School of Food Science and Engineering/National Technical Center (Foshan) for Quality Control of Famous and Special Agricultural Products (CAQS-GAP-KZZX043), Foshan University, Foshan 528011, China
| | - Hanyue Zhu
- School of Food Science and Engineering/National Technical Center (Foshan) for Quality Control of Famous and Special Agricultural Products (CAQS-GAP-KZZX043), Foshan University, Foshan 528011, China
| | - Zhen-Yu Chen
- School of Life Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China
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2
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Macpherson ME, Skarpengland T, Hov JR, Ranheim T, Vestad B, Dahl TB, Fraz MSA, Michelsen AE, Holven KB, Fevang B, Berge RK, Aukrust P, Halvorsen B, Jørgensen SF. Increased Plasma Levels of Triglyceride-Enriched Lipoproteins Associate with Systemic Inflammation, Lipopolysaccharides, and Gut Dysbiosis in Common Variable Immunodeficiency. J Clin Immunol 2023:10.1007/s10875-023-01475-x. [PMID: 36995502 DOI: 10.1007/s10875-023-01475-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Triglycerides (TG) and their major transport lipoprotein in the circulation (VLDL) appear to be related to inflammation. Patients with common variable immunodeficiency (CVID) have inflammatory complications associated with gut microbial dysbiosis. We hypothesized that CVID patients have disturbed TG/VLDL profiles associated with these clinical characteristics. METHODS We measured plasma concentrations of TGs, inflammatory markers, and lipopolysaccharide (LPS) in 95 CVID patients and 28 healthy controls. Additionally, in 40 CVID patients, we explored plasma lipoprotein profiling, fatty acid, gut microbial dysbiosis, and diet. RESULTS TG levels were increased in CVID patients as compared to healthy controls (1.36 ± 0.53 mmol/l versus 1.08 ± 0.56 [mean, SD], respectively, P = 0.008), particularly in the clinical subgroup "Complications," characterized by autoimmunity and organ-specific inflammation, compared to "Infection only" (1.41 mmol/l, 0.71[median, IQR] versus [1.02 mmol/l, 0.50], P = 0.021). Lipoprotein profile analyses showed increased levels of all sizes of VLDL particles in CVID patients compared to controls. TG levels correlated positively with CRP (rho = 0.256, P = 0.015), IL-6 (rho = 0.237, P = 0.021), IL-12 (rho = 0.265, P = 0.009), LPS (r = 0.654, P = 6.59 × 10-13), CVID-specific gut dysbiosis index (r = 0.315, P = 0.048), and inversely with a favorable fatty acid profile (docosahexaenoic acid [rho = - 0.369, P = 0.021] and linoleic acid [rho = - 0.375, P = 0.019]). TGs and VLDL lipids did not appear to be associated with diet and there were no differences in body mass index (BMI) between CVID patients and controls. CONCLUSION We found increased plasma levels of TGs and all sizes of VLDL particles, which were associated with systemic inflammation, LPS, and gut dysbiosis in CVID, but not diet or BMI.
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Affiliation(s)
- Magnhild E Macpherson
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tonje Skarpengland
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Johannes R Hov
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Gastroenterology, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway
| | - Trine Ranheim
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Beate Vestad
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Tuva B Dahl
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Mai S A Fraz
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Annika E Michelsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kirsten B Holven
- Department of Nutrition, Institute for Basic Medical Sciences, University of Oslo, Oslo, Norway
- Norwegian National Advisory Unit On Familial Hypercholesterolemia, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Børre Fevang
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Centre for Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - Rolf K Berge
- Department of Clinical Science, University of Bergen, N-5020, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, N-5021, Bergen, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente Halvorsen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Silje F Jørgensen
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway.
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Pienkos SM, Moore AR, Guan J, Levitt JE, Matthay MA, Baron RM, Conlon J, McAuley DF, O'Kane CM, Rogers AJ. Effect of total cholesterol and statin therapy on mortality in ARDS patients: a secondary analysis of the SAILS and HARP-2 trials. Crit Care 2023; 27:126. [PMID: 36978134 PMCID: PMC10053133 DOI: 10.1186/s13054-023-04387-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Two acute respiratory distress syndrome (ARDS) trials showed no benefit for statin therapy, though secondary analyses suggest inflammatory subphenotypes may have a differential response to simvastatin. Statin medications decrease cholesterol levels, and low cholesterol has been associated with increased mortality in critical illness. We hypothesized that patients with ARDS and sepsis with low cholesterol could be harmed by statins. METHODS Secondary analysis of patients with ARDS and sepsis from two multicenter trials. We measured total cholesterol from frozen plasma samples obtained at enrollment in Statins for Acutely Injured Lungs from Sepsis (SAILS) and Simvastatin in the Acute Respiratory Distress Syndrome (HARP-2) trials, which randomized subjects with ARDS to rosuvastatin versus placebo and simvastatin versus placebo, respectively, for up to 28 days. We compared the lowest cholesterol quartile (< 69 mg/dL in SAILS, < 44 mg/dL in HARP-2) versus all other quartiles for association with 60-day mortality and medication effect. Fisher's exact test, logistic regression, and Cox Proportional Hazards were used to assess mortality. RESULTS There were 678 subjects with cholesterol measured in SAILS and 509 subjects in HARP-2, of whom 384 had sepsis. Median cholesterol at enrollment was 97 mg/dL in both SAILS and HARP-2. Low cholesterol was associated with higher APACHE III and shock prevalence in SAILS, and higher Sequential Organ Failure Assessment score and vasopressor use in HARP-2. Importantly, the effect of statins differed in these trials. In SAILS, patients with low cholesterol who received rosuvastatin were more likely to die (odds ratio (OR) 2.23, 95% confidence interval (95% CI) 1.06-4.77, p = 0.02; interaction p = 0.02). In contrast, in HARP-2, low cholesterol patients had lower mortality if randomized to simvastatin, though this did not reach statistical significance in the smaller cohort (OR 0.44, 95% CI 0.17-1.07, p = 0.06; interaction p = 0.22). CONCLUSIONS Cholesterol levels are low in two cohorts with sepsis-related ARDS, and those in the lowest cholesterol quartile are sicker. Despite the very low levels of cholesterol, simvastatin therapy seems safe and may reduce mortality in this group, though rosuvastatin was associated with harm.
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Affiliation(s)
- Shaun M Pienkos
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, 300 Pasteur Dr H3143, Stanford, CA, 94305, USA
| | - Andrew R Moore
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, 300 Pasteur Dr H3143, Stanford, CA, 94305, USA
| | - Jiazhen Guan
- Division of Pulmonary & Critical Care, Brigham and Women's Hosp, 15 Francis Street, Boston, MA, 02115, USA
| | - Joseph E Levitt
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, 300 Pasteur Dr H3143, Stanford, CA, 94305, USA
| | - Michael A Matthay
- Department of Medicine, Cardiovascular Research Institute, University of California, 35 Medical Center Way, San Francisco, CA, 94143, USA
| | - Rebecca M Baron
- Division of Pulmonary & Critical Care, Brigham and Women's Hosp, 15 Francis Street, Boston, MA, 02115, USA
| | - John Conlon
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Daniel F McAuley
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, 97 Lisburn Road, Belfast, BT9 7BL, UK
- Regional Intensive Care Unit, Royal Victoria Hospital, 274 Grosvenor Rd, Belfast, BT12 6BA, UK
| | - Cecilia M O'Kane
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, 97 Lisburn Road, Belfast, BT9 7BL, UK
| | - Angela J Rogers
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University, 300 Pasteur Dr H3143, Stanford, CA, 94305, USA.
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Leung AKK, Xue YC, de Guzman A, Grzelkovski G, Kong HJ, Genga KR, Russell JA, Boyd JH, Francis GA, Walley KR. Modulation of vascular endothelial inflammatory response by proprotein convertase subtilisin-kexin type 9. Atherosclerosis 2022; 362:29-37. [PMID: 36207148 DOI: 10.1016/j.atherosclerosis.2022.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/15/2022] [Accepted: 09/14/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Endotoxins carried within LDL are cleared from the circulation via hepatic LDL receptor (LDLR)-mediated endocytosis. Proprotein convertase subtilisin-kexin type 9 (PCSK9) reduces this clearance by down-regulating LDLR density on hepatocytes. In addition to hepatocytes, vascular endothelial cells also express receptor targets of PCSK9, including LDLR. Therefore, we hypothesized that PCSK9 may regulate vascular endothelial cell uptake of lipopolysaccharide (LPS) and alter the vascular endothelial cell inflammatory response. METHODS AND RESULTS We found that LPS is internalized by human umbilical vein vascular endothelial cells (HUVECs) and LPS uptake dose-dependently increased with increasing LDL concentration. Intracellular LPS co-localized with LDL. PCSK9 and, separately, blocking antibodies against LDLR, dose-dependently decreased the vascular endothelial cell uptake of LPS and, furthermore, inhibition of endocytosis using Dynasore blocked LPS uptake. In contrast, blocking antibodies against TLR4 did not alter LPS uptake. PCSK9 decreased the LPS-induced proinflammatory response (IL-6 and IL-8 gene expression and protein secretion, and VCAM-1/ICAM-1 expression) in vascular endothelial cells. In addition, a decrease in PCSK9 and increase in LDLR, mediated by triciribine or siPCSK9, increased LPS uptake and the LPS-induced proinflammatory response. Similar results were also found in aortic vascular tissue from Pcsk9-/- mice after LPS injection. CONCLUSIONS Our data suggest that, similar to PCSK9 treatment in hepatocytes, PCSK9 reduces vascular endothelial cell uptake of LPS via LDLR-mediated endocytosis. Consequently, PCSK9 decreases the LPS-induced proinflammatory response in vascular endothelial cells. These results raise the possibility that PCSK9 inhibition may have additional effects on vascular endothelial inflammation via this alternative pathway, beyond the known effects of PCSK9 inhibition on LDL lowering and hepatic endotoxin clearance.
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Affiliation(s)
- Alex K K Leung
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Yuan Chao Xue
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Antyrah de Guzman
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Guilherme Grzelkovski
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - HyeJin Julia Kong
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Kelly R Genga
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - James A Russell
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - John H Boyd
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Gordon A Francis
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Keith R Walley
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
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The effects of selenium supplementation on inflammatory markers in critically ill patients. SN APPLIED SCIENCES 2022; 4:326. [PMID: 36405547 PMCID: PMC9643959 DOI: 10.1007/s42452-022-05208-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract Low serum selenium (Se) levels have been shown in critical illness, which is associated with poor clinical outcomes and a higher mortality rate. Se plays an important role in inflammation and oxidative stress. Since the overproduction of inflammatory cytokines and increased oxidative stress is a major component of critical illnesses, its supplementation has been demonstrated to have promising effects on critically ill patients. This study aims to review the evidence regarding the effects of Se supplementation on inflammatory and oxidative markers in critically ill patients. The literature review highlights alterations of inflammatory markers, including procalcitonin, leukocyte count, albumin, prealbumin, C-reactive protein (CRP), inflammatory cytokines, and cholesterol following Se supplementation in critically ill patients. Besides, the antioxidant properties of Se due to its presence in the structure of several selenoenzymes have been reported. Article highlights Low serum Se level have been shown in critical illness, which is associated with poor clinical outcome and higher mortality rate. Se plays an important role in inflammation and oxidative stress. Se supplementation can have promising effects by alterations of inflammatory markers and its antioxidant properties for critically ill patients.
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Chagué C, Gautier T, Dal Zuffo L, Pais de Barros J, Wetzel A, Tarris G, Pallot G, Martin L, Valmary‐Degano S, Deckert V, Lagrost L, Daguindau E, Saas P. High-density lipoprotein infusion protects from acute graft-versus-host disease in experimental allogeneic hematopoietic cell transplantation. Am J Transplant 2022; 22:1350-1361. [PMID: 35038785 PMCID: PMC9306461 DOI: 10.1111/ajt.16960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 01/25/2023]
Abstract
Acute graft-versus-host disease (aGVHD) is a major limitation of the therapeutic potential of allogeneic hematopoietic cell transplantation. Lipopolysaccharides (LPS) derived from intestinal gram-negative bacteria are well-known aGVHD triggers and amplifiers. Here, we explored the LPS metabolism in aGVHD mouse models using an innovative quantification method. We demonstrated that systemic LPS accumulation after transplantation was due, at least partly, to a defect in its clearance through lipoprotein-mediated transport to the liver (i.e., the so-called reverse LPS transport). After transplantation, reduced circulating HDL concentration impaired LPS neutralization and elimination through biliary flux. Accordingly, HDL-deficient (Apoa1tm1Unc ) recipient mice developed exacerbated aGVHD. Repeated administration of HDL isolated from human plasma significantly decreased the mortality and the severity of aGVHD. While the potential role of HDL in scavenging circulating LPS was examined in this study, it appears that HDL plays a more direct immunomodulatory role by limiting or controlling aGVHD. Notably, HDL infusion mitigated liver aGVHD by diminishing immune infiltration (e.g., interferon-γ-secreting CD8+ T cells and non-resident macrophages), systemic and local inflammation (notably cholangitis). Hence, our results revealed the interest of HDL-based therapies in the prevention of aGVHD.
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Affiliation(s)
- Cécile Chagué
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance
| | - Thomas Gautier
- University Bourgogne Franche‐ComtéINSERMLNC UMR1231LabEX LipSTICDijonFrance
| | - Ludivine Dal Zuffo
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance
| | | | - Audrey Wetzel
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance
| | - Georges Tarris
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance,Service d’Anatomie et Cytologie PathologiquesCHU DijonDijonFrance
| | - Gaëtan Pallot
- University Bourgogne Franche‐ComtéINSERMLNC UMR1231LabEX LipSTICDijonFrance
| | - Laurent Martin
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance,Service d’Anatomie et Cytologie PathologiquesCHU DijonDijonFrance
| | | | - Valérie Deckert
- University Bourgogne Franche‐ComtéINSERMLNC UMR1231LabEX LipSTICDijonFrance
| | - Laurent Lagrost
- University Bourgogne Franche‐ComtéINSERMLNC UMR1231LabEX LipSTICDijonFrance
| | - Etienne Daguindau
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance,Service d’HématologieCHU BesançonBesançonFrance
| | - Philippe Saas
- University Bourgogne Franche‐ComtéINSERM, EFS BFCUMR1098 RIGHT Interactions Greffon‐Hôte‐Tumeur/Ingénierie Cellulaire et GéniqueLabEX LipSTICFHU INCREASEBesançonFrance
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Nguyen M, Gautier T, Reocreux G, Pallot G, Maquart G, Bahr PA, Tavernier A, Grober J, Masson D, Bouhemad B, Guinot PG. Increased Phospholipid Transfer Protein Activity Is Associated With Markers of Enhanced Lipopolysaccharide Clearance in Human During Cardiopulmonary Bypass. Front Cardiovasc Med 2021; 8:756269. [PMID: 34712716 PMCID: PMC8545915 DOI: 10.3389/fcvm.2021.756269] [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] [Received: 08/10/2021] [Accepted: 09/15/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction: Lipopolysaccharide (LPS) is a component of gram-negative bacteria, known for its ability to trigger inflammation. The main pathway of LPS clearance is the reverse lipopolysaccharide transport (RLT), with phospholipid transfer protein (PLTP) and lipoproteins playing central roles in this process in experimental animal models. To date, the relevance of this pathway has never been studied in humans. Cardiac surgery with cardiopulmonary bypass is known to favor LPS digestive translocation. Our objective was to determine whether pre-operative PLTP activity and triglyceride or cholesterol-rich lipoprotein concentrations were associated to LPS concentrations in patients undergoing cardiac surgery with cardiopulmonary bypass. Methods: A post-hoc analysis was conducted on plasma samples obtained from patients recruited in a randomized controlled trial.Total cholesterol, high density lipoprotein cholesterol (HDLc), low density lipoprotein cholesterol (LDLc), triglyceride and PLTP activity were measured before surgery. LPS concentration was measured by mass spectrometry before surgery, at the end of cardiopulmonary bypass and 24 h after admission to the intensive care unit. Results: High PLTP activity was associated with lower LPS concentration but not with inflammation nor post-operative complications. HDLc, LDLc and total cholesterol were not associated with LPS concentration but were lower in patients developing post-operative adverse events. HDLc was negatively associated with inflammation biomarkers (CRP, PCT). Triglyceride concentrations were positively correlated with LPS concentration, PCT and were higher in patients with post-operative complications. Conclusion: Our study supports the role of PLTP in LPS elimination and the relevance of RLT in human. PLTP activity, and not cholesterol rich lipoproteins pool size seemed to be the limiting factor for RLT. PLTP activity was not directly related to post-operative inflammation and adverse events, suggesting that LPS clearance is not the main driver of inflammation in our patients. However, HDLc was associated with lower inflammation and was associated with favorable outcomes, suggesting that HDL beneficial anti-inflammatory effects could be, at least in part independent of LPS clearance.
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Affiliation(s)
- Maxime Nguyen
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France.,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
| | - Thomas Gautier
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
| | - Guillaume Reocreux
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France
| | | | | | - Pierre-Alain Bahr
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France.,INSERM, LNC UMR1231, Dijon, France
| | | | - Jacques Grober
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France.,AgroSup, LNC UMR1231, Dijon, France
| | - David Masson
- University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
| | - Belaid Bouhemad
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France.,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
| | - Pierre-Grégoire Guinot
- Department of Anesthesiology and Intensive Care, Dijon University Hospital, Dijon, France.,University of Burgundy and Franche-Comté, LNC UMR1231, Dijon, France.,INSERM, LNC UMR1231, Dijon, France.,FCS Bourgogne-Franche Comté, LipSTIC LabEx, Dijon, France
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Hofmaenner DA, Kleyman A, Press A, Bauer M, Singer M. The Many Roles of Cholesterol in Sepsis: A Review. Am J Respir Crit Care Med 2021; 205:388-396. [PMID: 34715007 DOI: 10.1164/rccm.202105-1197tr] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE The biological functions of cholesterol are diverse, ranging from cell membrane integrity and signalling, immunity, to the synthesis of steroid and sex hormones, Vitamin D, bile acids and oxysterols. Multiple studies have demonstrated hypocholesterolemia in sepsis, the degree of which is an excellent prognosticator of poor outcomes. However, the clinical significance of hypocholesterolemia has been largely unrecognized. OBJECTIVES/METHODS We undertook a detailed review of the biological roles of cholesterol, the impact of sepsis, its reliability as a prognosticator in sepsis, and the potential utility of cholesterol as a treatment. MEASUREMENTS AND MAIN RESULTS Sepsis affects cholesterol synthesis, transport and metabolism. This likely impacts upon its biological functions including immunity, hormone and vitamin production, and cell membrane receptor sensitivity. Early preclinical studies show promise for cholesterol as a pleiotropic therapeutic agent. CONCLUSIONS Hypocholesterolemia is a frequent condition in sepsis and an important early prognosticator. Low plasma levels are associated with wider changes in cholesterol metabolism and its functional roles, and these appear to play a significant role in sepsis pathophysiology. The therapeutic impact of cholesterol elevation warrants further investigation.
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Affiliation(s)
- Daniel A Hofmaenner
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland.,University Hospital Zurich, Institute of Intensive Care Medicine, Zurich, Switzerland
| | - Anna Kleyman
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland
| | - Adrian Press
- Jena University Hospital Center for Sepsis Control and Care, 553346, Jena, Germany
| | - Michael Bauer
- University Hospital Jena, Dep. of Anesthesiology and Intensive Care Medicine, Jena, Germany
| | - Mervyn Singer
- University College London, 4919, Bloomsbury Inst of Intensive Care Medicine, London, United Kingdom of Great Britain and Northern Ireland;
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Outstanding Contributions of LAL Technology to Pharmaceutical and Medical Science: Review of Methods, Progress, Challenges, and Future Perspectives in Early Detection and Management of Bacterial Infections and Invasive Fungal Diseases. Biomedicines 2021; 9:biomedicines9050536. [PMID: 34064994 PMCID: PMC8150811 DOI: 10.3390/biomedicines9050536] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 02/07/2023] Open
Abstract
The blue blood of the horseshoe crab is a natural, irreplaceable, and precious resource that is highly valued by the biomedical industry. The Limulus amebocyte lysate (LAL) obtained from horseshoe crab blood cells functions as a surprisingly sophisticated sensing system that allows for the extremely sensitive detection of bacterial and fungal cell-wall components. Notably, LAL tests have markedly contributed to the quality control of pharmaceutical drugs and medical devices as successful alternatives to the rabbit pyrogen test. Furthermore, LAL-based endotoxin and (1→3)-β-D-glucan (β-glucan) assay techniques are expected to have optimal use as effective biomarkers, serving as adjuncts in the diagnosis of bacterial sepsis and fungal infections. The innovative β-glucan assay has substantially contributed to the early diagnosis and management of invasive fungal diseases; however, the clinical significance of the endotoxin assay remains unclear and is challenging to elucidate. Many obstacles need to be overcome to enhance the analytical sensitivity and clinical performance of the LAL assay in detecting circulating levels of endotoxin in human blood. Additionally, there are complex interactions between endotoxin molecules and blood components that are attributable to the unique physicochemical properties of lipopolysaccharide (LPS). In this regard, while exploring the potential of new LPS-sensing technologies, a novel platform for the ultrasensitive detection of blood endotoxin will enable a reappraisal of the LAL assay for the highly sensitive and reliable detection of endotoxemia.
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10
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Dusuel A, Deckert V, Pais de Barros JP, van Dongen K, Choubley H, Charron É, Le Guern N, Labbé J, Mandard S, Grober J, Lagrost L, Gautier T. Human cholesteryl ester transfer protein lacks lipopolysaccharide transfer activity, but worsens inflammation and sepsis outcomes in mice. J Lipid Res 2020; 62:100011. [PMID: 33500240 PMCID: PMC7859855 DOI: 10.1194/jlr.ra120000704] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 11/25/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Bacterial lipopolysaccharides (LPSs or endotoxins) can bind most proteins of the lipid transfer/LPS-binding protein (LT/LBP) family in host organisms. The LPS-bound LT/LBP proteins then trigger either an LPS-induced proinflammatory cascade or LPS binding to lipoproteins that are involved in endotoxin inactivation and detoxification. Cholesteryl ester transfer protein (CETP) is an LT/LBP member, but its impact on LPS metabolism and sepsis outcome is unclear. Here, we performed fluorescent LPS transfer assays to assess the ability of CETP to bind and transfer LPS. The effects of intravenous (iv) infusion of purified LPS or polymicrobial infection (cecal ligation and puncture [CLP]) were compared in transgenic mice expressing human CETP and wild-type mice naturally having no CETP activity. CETP displayed no LPS transfer activity in vitro, but it tended to reduce biliary excretion of LPS in vivo. The CETP expression in mice was associated with significantly lower basal plasma lipid levels and with higher mortality rates in both models of endotoxemia and sepsis. Furthermore, CETPTg plasma modified cytokine production of macrophages in vitro. In conclusion, despite having no direct LPS binding and transfer property, human CETP worsens sepsis outcomes in mice by altering the protective effects of plasma lipoproteins against endotoxemia, inflammation, and infection.
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Affiliation(s)
- Aloïs Dusuel
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Valérie Deckert
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jean-Paul Pais de Barros
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Kevin van Dongen
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Hélène Choubley
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Émilie Charron
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Naig Le Guern
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jérôme Labbé
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Stéphane Mandard
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Jacques Grober
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France
| | - Laurent Lagrost
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France; University Hospital of Dijon, Dijon, France
| | - Thomas Gautier
- INSERM/University of Bourgogne Franche-Comté LNC UMR1231 and LipSTIC LabEx, UFR Sciences de Santé, Dijon, France.
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11
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Määttä AM, Salminen A, Pietiäinen M, Leskelä J, Palviainen T, Sattler W, Sinisalo J, Salomaa V, Kaprio J, Pussinen PJ. Endotoxemia is associated with an adverse metabolic profile. Innate Immun 2020; 27:3-14. [PMID: 33243051 PMCID: PMC7780360 DOI: 10.1177/1753425920971702] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Our aim was to analyze whether endotoxemia, i.e. translocation of LPS to circulation, is reflected in the serum metabolic profile in a general population and in participants with cardiometabolic disorders. We investigated three Finnish cohorts separately and in a meta-analysis (n = 7178), namely population-based FINRISK97, FinnTwin16 consisting of young adult twins, and Parogene, a random cohort of cardiac patients. Endotoxemia was determined as serum LPS activity and metabolome by an NMR platform. Potential effects of body mass index (BMI), smoking, metabolic syndrome (MetS), and coronary heart disease (CHD) status were considered. Endotoxemia was directly associated with concentrations of VLDL, IDL, LDL, and small HDL lipoproteins, VLDL particle diameter, total fatty acids (FA), glycoprotein acetyls (GlycA), aromatic and branched-chain amino acids, and Glc, and inversely associated with concentration of large HDL, diameters of LDL and HDL, as well as unsaturation degree of FAs. Some of these disadvantageous associations were significantly stronger in smokers and subjects with high BMI, but did not differ between participants with different CHD status. In participants with MetS, however, the associations of endotoxemia with FA parameters and GlycA were particularly strong. The metabolic profile in endotoxemia appears highly adverse, involving several inflammatory characters and risk factors for cardiometabolic disorders.
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Affiliation(s)
- Anne-Mari Määttä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Aino Salminen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Leskelä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Wolfgang Sattler
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Juha Sinisalo
- Department of Cardiology, Heart and Lung Center, Helsinki University Central Hospital, Helsinki, Finland
| | - Veikko Salomaa
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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12
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van den Boogert MA, Crunelle CL, Ali L, Larsen LE, Kuil SD, Levels JH, Schimmel AW, Konstantopoulou V, Guerin M, Kuivenhoven JA, Dallinga‐Thie GM, Stroes ES, Lefeber DJ, Holleboom AG. Reduced CETP glycosylation and activity in patients with homozygous B4GALT1 mutations. J Inherit Metab Dis 2020; 43:611-617. [PMID: 31800099 PMCID: PMC7318693 DOI: 10.1002/jimd.12200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 11/12/2019] [Accepted: 12/02/2019] [Indexed: 12/21/2022]
Abstract
The importance of protein glycosylation in regulating lipid metabolism is becoming increasingly apparent. We set out to further investigate this by studying the effects of defective glycosylation on plasma lipids in patients with B4GALT1-CDG, caused by a mutation in B4GALT1 with defective N-linked glycosylation. We studied plasma lipids, cholesteryl ester transfer protein (CETP) glyco-isoforms with isoelectric focusing followed by a western blot and CETP activity in three known B4GALT1-CDG patients and compared them with 11 age- and gender-matched, healthy controls. B4GALT1-CDG patients have significantly lowered non-high density lipoprotein cholesterol (HDL-c) and total cholesterol to HDL-c ratio compared with controls and larger HDL particles. Plasma CETP was hypoglycosylated and less active in B4GALT1-CDG patients compared to matched controls. Our study provides insight into the role of protein glycosylation in human lipoprotein homeostasis. The hypogalactosylated, hypo-active CETP found in patients with B4GALT1-CDG indicates a role of protein galactosylation in regulating plasma HDL and LDL. Patients with B4GALT1-CDG have large HDL particles probably due to hypogalactosylated, hypo-active CETP.
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Affiliation(s)
| | - Cleo L. Crunelle
- Vrije Universiteit BrusselUniversitair Ziekenhuis Brussel, Department of PsychiatryBrusselsBelgium
| | - Lubna Ali
- Department of Experimental Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Lars E. Larsen
- Department of Experimental Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Sacha D. Kuil
- Department of Laboratory Medicine, Laboratory of GeneticEndocrine and Metabolic Disease, Radboud University Nijmegen Medical CenterNijmegenThe Netherlands
| | - Johannes H.M. Levels
- Department of Experimental Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Alinda W.M. Schimmel
- Department of Experimental Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | | | - Maryse Guerin
- ICAN ‐ Institute of CardioMetabolism and NutritionHôpital de la PitiéParisFrance
| | - Jan Albert Kuivenhoven
- Department of Pediatrics, Section Molecular GeneticsUniversity Medical Center Groningen, University of GroningenThe Netherlands
| | - Geesje M. Dallinga‐Thie
- Department of Experimental Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Erik S.G. Stroes
- Department of Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Dirk J. Lefeber
- Department of Laboratory Medicine, Laboratory of GeneticEndocrine and Metabolic Disease, Radboud University Nijmegen Medical CenterNijmegenThe Netherlands
- Department of NeurologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
| | - Adriaan G. Holleboom
- Department of Vascular MedicineAmsterdam University Medical CentersAmsterdamThe Netherlands
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13
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Mecatti GC, Messias MCF, de Oliveira Carvalho P. Lipidomic profile and candidate biomarkers in septic patients. Lipids Health Dis 2020; 19:68. [PMID: 32284068 PMCID: PMC7155265 DOI: 10.1186/s12944-020-01246-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
Sepsis is a severe disease with a high mortality rate. Identification and treatment in the initial hours of the disease improve outcomes. Some biomarkers like procalcitonin and C-reactive protein are used for diagnosis and to access sepsis prognosis and they can help in clinical decision-making, but none has sufficient specificity or sensitivity to be routinely employed in clinical practice. This review seeks to evaluate lipid metabolism alterations in patients with sepsis and the possibility of using the respective metabolites as biomarkers of the disease. A search of the main electronic biomedical databases was conducted for the 20-year period ending in February 2020, focused on primary research articles on biomarkers in sepsis. The keywords included sepsis, septic shock, biomarker, metabolomic, lipidomic and lysophosphatidylcoline. . It concludes that altered lipid profiles, along with the progress of the disease should provide new insights, enabling a better understanding of the pathogenic mechanisms and making it possible to design new early diagnosis and therapeutic procedures for sepsis.
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Affiliation(s)
- Giovana Colozza Mecatti
- Laboratory of Multidisciplinary Research, São Francisco University, USF, São Francisco de Assis Avenue, 218, Bragança Paulista, SP, 12916-900, Brazil.
| | - Márcia Cristina Fernandes Messias
- Laboratory of Multidisciplinary Research, São Francisco University, USF, São Francisco de Assis Avenue, 218, Bragança Paulista, SP, 12916-900, Brazil
| | - Patrícia de Oliveira Carvalho
- Laboratory of Multidisciplinary Research, São Francisco University, USF, São Francisco de Assis Avenue, 218, Bragança Paulista, SP, 12916-900, Brazil
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14
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Leskelä J, Pietiäinen M, Safer A, Lehto M, Metso J, Malle E, Buggle F, Becher H, Sundvall J, Grau AJ, Pussinen PJ, Palm F. Serum lipopolysaccharide neutralizing capacity in ischemic stroke. PLoS One 2020; 15:e0228806. [PMID: 32084157 PMCID: PMC7034831 DOI: 10.1371/journal.pone.0228806] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 01/21/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Periodontitis is associated with increased serum lipopolysaccharide (LPS) activity, which may be one mechanism linking periodontitis with the risk of cardiovascular diseases. As LPS-carrying proteins including lipoproteins modify LPS-activity, we investigated the determinants of serum LPS-neutralizing capacity (LPS-NC) in ischemic stroke. The association of LPS-NC and Aggregatibacter actinomycetemcomitans, a major microbial biomarker in periodontitis, was also investigated. Materials and methods The assay to measure LPS-NC was set up by spiking serum samples with E. coli LPS. The LPS-NC, LPS-binding protein (LBP), soluble CD14 (sCD14), lipoprotein profiles, apo(lipoprotein) A-I, apoB, and phospholipid transfer protein (PLTP) activity, were determined in 98 ischemic stroke patients and 100 age- and sex-matched controls. Serum and saliva immune response to A. actinomycetemcomitans, its concentration in saliva, and serotype-distribution were examined. Results LPS-NC values ranged between 51–83% in the whole population. Although several of the LPS-NC determinants differed significantly between cases and controls (PLTP, sCD14, apoA-I, HDL-cholesterol), the levels did not (p = 0.056). The main determinants of LPS-NC were i) triglycerides (β = -0.68, p<0.001), and ii) HDL cholesterol (0.260, <0.001), LDL cholesterol (-0.265, <0.001), PLTP (-0.196, 0.011), and IgG against A. actinomycetemcomitans (0.174, 0.011). Saliva A. actinomycetemcomitans concentration was higher [log mean (95% CI), 4.39 (2.35–8.19) vs. 10.7 (5.45–21) genomes/ml, p = 0.023) and serotype D more frequent (4 vs. 0%, p = 0.043) in cases than controls. Serotypeablity or serotypes did not, however, relate to the LPS-NC. Conclusion Serum LPS-NC comprised low PLTP-activity, triglyceride and LDL cholesterol concentrations, as well as high HDL cholesterol and IgG against A. actinomycetemcomitans. The present findings let us to conclude that LPS-NC did not associate with stroke.
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Affiliation(s)
- Jaakko Leskelä
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Anton Safer
- Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Markku Lehto
- Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland
| | - Jari Metso
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Ernst Malle
- Division of Molecular Biology and Biochemistry, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Florian Buggle
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Heiko Becher
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg, Germany
- University Hospital Heidelberg, Institute of Global Health, Heidelberg, Germany
| | - Jouko Sundvall
- National Institute for Health and Welfare, Helsinki, Finland
| | - Armin J. Grau
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Pirkko J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Frederick Palm
- Department of Neurology, Helios Klinikum Schleswig, Schleswig, Germany
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15
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Reduced Proprotein convertase subtilisin/kexin 9 (PCSK9) function increases lipoteichoic acid clearance and improves outcomes in Gram positive septic shock patients. Sci Rep 2019; 9:10588. [PMID: 31332258 PMCID: PMC6646337 DOI: 10.1038/s41598-019-46745-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 06/27/2019] [Indexed: 01/01/2023] Open
Abstract
Previous studies have shown lipopolysaccharide from Gram-negative bacteria is cleared from the circulation via LDL receptors on hepatocytes, which are downregulated by PCSK9. Whether clearance of Gram positive bacterial lipoteichoic acid (LTA) shows similar dependence on PCSK9, and whether this is clinically relevant in Gram positive human sepsis, is unknown. We examined survival data from three cohorts of patients who had Gram positive septic shock (n = 170, n = 130, and n = 59) and found that patients who carried a PCSK9 loss-of-function (LOF) allele had significantly higher 28-day survival (73.8%) than those with no LOF alleles (52.8%) (p = 0.000038). Plasma clearance of LTA was also found to be increased in PCSK9 knockout mice compared to wildtype control mice (p = 0.002). In addition, hepatocytes pre-treated with recombinant wildtype PCSK9 showed a dose-dependent decrease in uptake of fluorescently-labeled LTA (p < 0.01). In comparison to wildtype PCSK9, hepatocytes pre-treated with 3 different LOF variants of recombinant PCSK9 showed an increase in LTA uptake. This study shows the clearance of LTA follows a similar route as lipopolysaccharide, which is dependent on hepatic LDL receptors. This has important implications in health as strategies aimed at inhibiting PCSK9 function may be an effective treatment option for both Gram-positive and negative sepsis.
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16
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Pietiäinen M, Liljestrand JM, Kopra E, Pussinen PJ. Mediators between oral dysbiosis and cardiovascular diseases. Eur J Oral Sci 2019; 126 Suppl 1:26-36. [PMID: 30178551 DOI: 10.1111/eos.12423] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 12/11/2022]
Abstract
Clinical periodontitis is associated with an increased risk for cardiovascular diseases (CVDs) through systemic inflammation as the etiopathogenic link. Whether the oral microbiota, especially its quality, quantity, serology, and virulence factors, plays a role in atherogenesis is not clarified. Patients with periodontitis are exposed to bacteria and their products, which have access to the circulation directly through inflamed oral tissues and indirectly (via saliva) through the gastrointestinal tract, resulting in systemic inflammatory and immunologic responses. Periodontitis is associated with persistent endotoxemia, which has been identified as a notable cardiometabolic risk factor. The serology of bacterial biomarkers for oral dysbiosis is associated with an increased risk for subclinical atherosclerosis, prevalent and future coronary artery disease, and incident and recurrent stroke. In addition to species-specific antibodies, the immunologic response includes persistent, cross-reactive, proatherogenic antibodies against host-derived antigens. Periodontitis may affect lipoprotein metabolism at all levels, and all lipoprotein classes are affected. Periodontitis or its bacterial signatures may be involved not only in increased storage of proatherogenic lipids but also in attenuation of the anti-atherogenic processes, thereby putatively increasing the net risk of atherosclerosis. In this review we summarize possible molecular mediators between the dysbiotic oral microbiota and atherosclerotic processes.
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Affiliation(s)
- Milla Pietiäinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - John M Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pirkko J Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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17
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Abraham S, Premnath A, Arunima PR, Kassim RM. Critical Appraisal of Bidirectional Relationship between Periodontitis and Hyperlipidemia. J Int Soc Prev Community Dent 2019; 9:112-118. [PMID: 31058060 PMCID: PMC6489519 DOI: 10.4103/jispcd.jispcd_316_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022] Open
Abstract
Periodontal disease and hyperlipidemia are both multifactorial disease with a high prevalence Worldwide. Cross-sectional and longitudinal prospective clinical studies show some evidence for a bidirectional relationship. Periodontitis and hyperlipidemia share some common risk factors and there exist a mechanistic link between both. Studies have found a positive response to periodontal therapy among hyperlipidemic patients, and statin use by hyperlipidemic patients has shown to influence the periodontal health. However, in spite of the rising prevalence of both diseases, many people remain unaware of their association with each other. Hence, this article summarizes the cyclic relationship between periodontal disease and hyperlipidemia.
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Affiliation(s)
- Seba Abraham
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Arya Premnath
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - P. R. Arunima
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
| | - Reejamol Mohammed Kassim
- Department of Periodontology, PMS College of Dental Science and Research, Thiruvananthapuram, Kerala, India
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18
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Blaurock-Möller N, Gröger M, Siwczak F, Dinger J, Schmerler D, Mosig AS, Kiehntopf M. CAAP48, a New Sepsis Biomarker, Induces Hepatic Dysfunction in an in vitro Liver-on-Chip Model. Front Immunol 2019; 10:273. [PMID: 30873161 PMCID: PMC6401602 DOI: 10.3389/fimmu.2019.00273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/31/2019] [Indexed: 12/13/2022] Open
Abstract
Sepsis is a leading cause of mortality in the critically ill, characterized by life-threatening organ dysfunctions due to dysregulation of the host response to infection. Using mass spectrometry, we identified a C-terminal fragment of alpha-1-antitrypsin, designated CAAP48, as a new sepsis biomarker that actively participates in the pathophysiology of sepsis. It is well-known that liver dysfunction is an early event in sepsis-associated multi-organ failure, thus we analyzed the pathophysiological function of CAAP48 in a microfluidic-supported in vitro liver-on-chip model. Hepatocytes were stimulated with synthetic CAAP48 and several control peptides. CAAP48-treatment resulted in an accumulation of the hepatocyte-specific intracellular enzymes aspartate- and alanine-transaminase and impaired the activity of the hepatic multidrug resistant-associated protein 2 and cytochrome P450 3A4. Moreover, CAAP48 reduced hepatic expression of the multidrug resistant-associated protein 2 and disrupted the endothelial structural integrity as demonstrated by reduced expression of VE-cadherin, F-actin and alteration of the tight junction protein zonula occludens-1, which resulted in a loss of the endothelial barrier function. Furthermore, CAAP48 induced the release of adhesion molecules and pro- and anti-inflammatory cytokines. Our results show that CAAP48 triggers inflammation-related endothelial barrier disruption as well as hepatocellular dysfunction in a liver-on-chip model emulating the pathophysiological conditions of inflammation. Besides its function as new sepsis biomarker, CAAP48 thus might play an important role in the development of liver dysfunction as a consequence of the dysregulated host immune-inflammatory response in sepsis.
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Affiliation(s)
- Nancy Blaurock-Möller
- Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena, Germany
| | - Marko Gröger
- Centre for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Fatina Siwczak
- Centre for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Julia Dinger
- Institute of Forensic Medicine, Jena University Hospital, Jena, Germany
| | - Diana Schmerler
- Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena, Germany
| | - Alexander S Mosig
- Centre for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Michael Kiehntopf
- Department of Clinical Chemistry and Laboratory Medicine, Jena University Hospital, Jena, Germany
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19
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Bermudes ACG, Delgado AF, de Carvalho WB. Author's response re. "Changes in lipid metabolism in pediatric patients with severe sepsis and septic shock". Nutrition 2018; 62:209. [PMID: 30935713 DOI: 10.1016/j.nut.2018.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 10/08/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Ana Carolina G Bermudes
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
| | - Artur F Delgado
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
| | - Werther B de Carvalho
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
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20
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van Loon NM, Ottenhoff R, Kooijman S, Moeton M, Scheij S, Roscam Abbing RL, Gijbels MJ, Levels JH, Sorrentino V, Berbée JF, Rensen PC, Zelcer N. Inactivation of the E3 Ubiquitin Ligase IDOL Attenuates Diet-Induced Obesity and Metabolic Dysfunction in Mice. Arterioscler Thromb Vasc Biol 2018; 38:1785-1795. [PMID: 29903737 PMCID: PMC6092113 DOI: 10.1161/atvbaha.118.311168] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 05/31/2018] [Indexed: 12/26/2022]
Abstract
Objective- The E3 ubiquitin ligase IDOL (inducible degrader of the LDLR [LDL (low-density lipoprotein) receptor]) is a post-transcriptional regulator of LDLR abundance. Model systems and human genetics support a role for IDOL in regulating circulating LDL levels. Whether IDOL plays a broader metabolic role and affects development of metabolic syndrome-associated comorbidities is unknown. Approach and Results- We studied WT (wild type) and Idol(-/-) (Idol-KO) mice in 2 models: physiological aging and diet-induced obesity. In both models, deletion of Idol protected mice from metabolic dysfunction. On a Western-type diet, Idol loss resulted in decreased circulating levels of cholesterol, triglycerides, glucose, and insulin. This was accompanied by protection from weight gain in short- and long-term dietary challenges, which could be attributed to reduced hepatosteatosis and fat mass in Idol-KO mice. Although feeding and intestinal fat uptake were unchanged in Idol-KO mice, their brown adipose tissue was protected from lipid accumulation and had elevated expression of UCP1 (uncoupling protein 1) and TH (tyrosine hydroxylase). Indirect calorimetry indicated a marked increase in locomotion and suggested a trend toward increased cumulative energy expenditure and fat oxidation. An increase in in vivo clearance of reconstituted lipoprotein particles in Idol-KO mice may sustain this energetic demand. In the BXD mouse genetic reference population, hepatic Idol expression correlates with multiple metabolic parameters, thus providing support for findings in the Idol-KO mice. Conclusions- Our study uncovers an unrecognized role for Idol in regulation of whole body metabolism in physiological aging and on a Western-type diet. These findings support Idol inhibition as a therapeutic strategy to target multiple metabolic syndrome-associated comorbidities.
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Affiliation(s)
- Nienke M. van Loon
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
| | - Roelof Ottenhoff
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
| | - Sander Kooijman
- Academic Medical Center, University of Amsterdam, The Netherlands; Division of Endocrinology, Department of Medicine, Einthoven Laboratory for Experimental Vascular and Regenerative Medicine, Leiden University Medical Center, The Netherlands (S.K., J.F.P.B., P.C.N.R.)
| | - Martina Moeton
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
| | - Saskia Scheij
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
| | | | - Marion J.J. Gijbels
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
- Department of Molecular Genetics (M.J.J.G.)
| | | | - Vincenzo Sorrentino
- CARIM, Maastricht University, The Netherlands; and Laboratory for Integrative and Systems Physiology, EPFL, Lausanne, Switzerland (V.S.)
| | - Jimmy F.P. Berbée
- Academic Medical Center, University of Amsterdam, The Netherlands; Division of Endocrinology, Department of Medicine, Einthoven Laboratory for Experimental Vascular and Regenerative Medicine, Leiden University Medical Center, The Netherlands (S.K., J.F.P.B., P.C.N.R.)
| | - Patrick C.N. Rensen
- Academic Medical Center, University of Amsterdam, The Netherlands; Division of Endocrinology, Department of Medicine, Einthoven Laboratory for Experimental Vascular and Regenerative Medicine, Leiden University Medical Center, The Netherlands (S.K., J.F.P.B., P.C.N.R.)
| | - Noam Zelcer
- From the Department of Medical Biochemistry (N.M.v.L., R.O., M.M., S.S., M.J.J.G., N.Z.)
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21
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Wegner A, Pavlovic D, Haußmann-Vopel S, Lehmann C. Impact of lipid modulation on the intestinal microcirculation in experimental sepsis. Microvasc Res 2018; 120:41-46. [PMID: 29859746 DOI: 10.1016/j.mvr.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 01/14/2023]
Abstract
It has been observed, that patients who were treated medically for dyslipoproteinemia had a potentially lower risk of complications during infection and sepsis, regarding both morbidity and mortality. Aim of this study in experimental sepsis was to elucidate the impact of lipid metabolism modulation by simvastatin, HDL, or bezafibrate, respectively, on the intestinal microcirculation which plays a crucial role in the development of multiple organ failure in sepsis. Experimental sepsis was induced in Lewis rats by intravenous lipopolysaccharide (LPS) administration. Animals were treated with simvastatin, HDL or bezafibrate. By means of intestinal intravital microscopy (IVM), the inflammatory response in the microcirculation was studied by leukocyte adherence assessment (LA) and functional capillary density (FCD) measurements. In addition, plasma levels of pro-inflammatory cytokines were determined. Bezafibrate treatment led to a reduction in leukocyte adherence, improved functional capillary density (FCD), and a reduction in interleukin-1α (IL-1α), tumour necrosis factor α (TNF-α) and granulocyte macrophage colony stimulating factors (GM-CSF) plasma levels in experimental sepsis. Contrary to this, the administration of HDL increased leukocyte adherence as well as the number of rolling leukocytes. Only IL-1α plasma levels were decreased by HDL. No significant changes were observed following simvastatin treatment. In summary, only bezafibrate showed anti-inflammatory effects in endotoxemia. This effect cannot be explained by the HDL-enhancing effect of the bezafibrate, since the direct administration of HDL showed opposite effects. Bezafibrate induced reduction of inflammation in sepsis should be investigated in further studies.
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Affiliation(s)
- Annette Wegner
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany.
| | - Dragan Pavlovic
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Sebastian Haußmann-Vopel
- Department of Anesthesia and Intensive Care Medicine, University of Greifswald, Ferdinand-Sauerbruch, 17475 Greifswald, Germany
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St, Halifax, NS B3H 4R2, Canada
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22
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Golucci APBS, Marson FAL, Ribeiro AF, Nogueira RJN. Lipid profile associated with the systemic inflammatory response syndrome and sepsis in critically ill patients. Nutrition 2018; 55-56:7-14. [PMID: 29960160 DOI: 10.1016/j.nut.2018.04.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/02/2018] [Accepted: 04/22/2018] [Indexed: 02/09/2023]
Abstract
OBJECTIVES Changes in lipid profiles occur in systemic inflammatory response syndrome (SIRS), whether due to sepsis or another cause. Hypocholesterolemia associated with hypertriacylglycerolemia can lead to disease severity and higher mortality. The aim of this systematic review was to describe the principal alterations in markers that participate in the alteration of the lipid profile. METHODS We reviewed articles focused on alterations in the lipid profile in SIRS, sepsis, or both that were indexed in the Scientific Electronic Library Online from 2000 to 2017. The descriptors used were SIRS; sepsis; lipid profile; and lipoproteins. We focused in particular on the relationships among SIRS, sepsis, and lipid profiles. RESULTS We included 29 studies that discussed decreased high-density lipoprotein (HDL), total cholesterol, and low-density lipoprotein, and elevated triacylglycerols concentrations in patients with SIRS, sepsis, or both. The variation in the lipid profile was proportional to the level of inflammation as evaluated by inflammatory markers, including C-reactive protein, interleukin-6 and interleukin-8, lipopolysaccharide-binding protein, and tumor necrosis factor. Additionally, there was a change in the composition of lipoproteins, especially HDL, triacylglycerols, and very low-density lipoprotein. HDL appears to be an inflammatory marker, as reduction of its levels reflects the intensity of the underlying inflammatory process. CONCLUSION Critically ill patients with SIRS, sepsis, or both presented with alterations in lipid metabolism.
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Affiliation(s)
| | - Fernando Augusto Lima Marson
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Department of Medical Genetics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Center for Research in Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Antônio Fernando Ribeiro
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil
| | - Roberto José Negrão Nogueira
- Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; Center for Research in Pediatrics, Faculty of Medical Sciences, University of Campinas, São Paulo, Brazil; São Leopoldo Mandic Faculty, São Paulo, Brazil.
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23
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Bermudes ACG, de Carvalho WB, Zamberlan P, Muramoto G, Maranhão RC, Delgado AF. Changes in lipid metabolism in pediatric patients with severe sepsis and septic shock. Nutrition 2017; 47:104-109. [PMID: 29429528 DOI: 10.1016/j.nut.2017.09.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/13/2017] [Accepted: 09/17/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Limited knowledge exists regarding the lipid profiles of critically ill pediatric patients with systemic inflammatory response syndrome. The aim of this study was to evaluate the relationship between the intensity of the inflammatory response and changes in the lipid profiles of critically ill pediatric patients admitted to a pediatric intensive care unit (PICU) with severe sepsis/septic shock. METHODS This was a prospective and observational study at a 15-bed PICU at a public university hospital. We analyzed the lipid profiles of 40 patients with severe sepsis/septic shock admitted to the PICU on the first and seventh days of hospitalization. C-reactive protein was used as a marker for systemic inflammation. Forty-two pediatric patients seen in the emergency department and without systemic inflammatory response syndrome were used to provide control values. RESULTS On day 1 of admission to the PICU, the patients had significantly lower levels of total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) as well as higher concentrations of triacylglycerols compared with the control group. There was a significant increase in the TC, HDL, LDL, and apolipoprotein levels from day 1 to day 7 of the study. CONCLUSIONS During severe sepsis/septic shock, we found lower serum levels of lipoproteins and apolipoproteins, and these were negatively correlated with C-reactive protein. As the inflammatory response improved, the levels of TC, HDL, LDL, and apolipoproteins increased, suggesting a direct relationship between changes in the lipid profiles and inflammation.
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Affiliation(s)
- Ana Carolina G Bermudes
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil.
| | - Werther B de Carvalho
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
| | - Patricia Zamberlan
- Division of Nutrition, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
| | - Giovana Muramoto
- Emergency Department, Hospital Universitário, São Paulo University, São Paulo, Brazil
| | - Raul C Maranhão
- Lipid Metabolism Laboratory, Heart Institute (InCor) of the Medical School Hospital, São Paulo University, São Paulo, Brazil
| | - Artur F Delgado
- Pediatric Critical Care Unit, Instituto da Criança da Faculdade de Medicina, São Paulo University, São Paulo, Brazil
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Abstract
Determination of LDL particle uptake into cells is a valuable technique in the field of cholesterol metabolism. This allows assessment of LDL uptake capacity in different adherent and non-adherent cells types, as well as the effect of cellular, genetic, or pharmacological perturbations on this process. Here, we detail a general procedure that describes the production of fluorescently-labeled LDL particles and quantitative and non-quantitative assays for determining cellular LDL uptake.
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Affiliation(s)
- Anke Loregger
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105AZ, The Netherlands.
| | - Jessica K Nelson
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105AZ, The Netherlands
| | - Noam Zelcer
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, Amsterdam, 1105AZ, The Netherlands.
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25
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Werners AH. Treatment of endotoxaemia and septicaemia in the equine patient. J Vet Pharmacol Ther 2016; 40:1-15. [PMID: 27452161 DOI: 10.1111/jvp.12329] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/02/2016] [Indexed: 12/27/2022]
Abstract
Endotoxins, constituents of the cell wall of gram-positive and gram-negative bacteria, regularly result in severe illness and death in horses. In endotoxaemia, these constituents are present in the systemic circulation; in septicaemia, whole microbes invade normally sterile parts of the body. Interaction of these endotoxins with pathogen recognition receptors leads to an inflammatory response that cannot always be sufficiently contained and hence needs direct treatment. Over the last decennia, our understanding of the pathophysiology of endotoxaemia and septicaemia has significantly increased. Based on improved understanding of the interaction between receptors and endotoxins as well as the subsequent downstream signalling pathways, new therapeutic targets have been identified in laboratory animal species and humans. Important species differences in the recognition of endotoxins and pathogens by their receptors as well as the inflammatory response to receptor activation hamper extrapolation of this information to the horse (and other species). Historically, horses with endotoxaemia and septicaemia have been treated mainly symptomatically and supportively. Based on the identified therapeutic targets, this review describes the current knowledge of the treatment for endotoxaemia and septicaemia in the horse with reference to the findings in other animal species and humans.
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Affiliation(s)
- A H Werners
- Department of Anatomy, Physiology and Pharmacology, School of Veterinary Medicine, St. George's University, True Blue Campus, St. George's, Grenada, West-Indies
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26
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Munford RS. Endotoxemia-menace, marker, or mistake? J Leukoc Biol 2016; 100:687-698. [PMID: 27418356 DOI: 10.1189/jlb.3ru0316-151r] [Citation(s) in RCA: 135] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 06/27/2016] [Indexed: 01/19/2023] Open
Abstract
Endotoxemia is in its scientific ascendancy. Never has blood-borne, Gram-negative bacterial endotoxin (LPS) been invoked in the pathogenesis of so many diseases-not only as a trigger for septic shock, once its most cited role, but also as a contributor to atherosclerosis, obesity, chronic fatigue, metabolic syndrome, and many other conditions. Finding elevated plasma endotoxin levels has been essential supporting evidence for each of these links, yet the assays used to detect and quantitate endotoxin have important limitations. This article describes several assays for endotoxin in plasma, reviews what they do and do not measure, and discusses why LPS heterogeneity, LPS trafficking pathways, and host LPS inactivation mechanisms should be considered when interpreting endotoxin assay results.
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Affiliation(s)
- Robert S Munford
- Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, 9000 Rockville Pike, Bethesda, MD, USA
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27
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CCC- and WASH-mediated endosomal sorting of LDLR is required for normal clearance of circulating LDL. Nat Commun 2016; 7:10961. [PMID: 26965651 PMCID: PMC4792963 DOI: 10.1038/ncomms10961] [Citation(s) in RCA: 138] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/04/2016] [Indexed: 12/21/2022] Open
Abstract
The low-density lipoprotein receptor (LDLR) plays a pivotal role in clearing atherogenic circulating low-density lipoprotein (LDL) cholesterol. Here we show that the COMMD/CCDC22/CCDC93 (CCC) and the Wiskott–Aldrich syndrome protein and SCAR homologue (WASH) complexes are both crucial for endosomal sorting of LDLR and for its function. We find that patients with X-linked intellectual disability caused by mutations in CCDC22 are hypercholesterolaemic, and that COMMD1-deficient dogs and liver-specific Commd1 knockout mice have elevated plasma LDL cholesterol levels. Furthermore, Commd1 depletion results in mislocalization of LDLR, accompanied by decreased LDL uptake. Increased total plasma cholesterol levels are also seen in hepatic COMMD9-deficient mice. Inactivation of the CCC-associated WASH complex causes LDLR mislocalization, increased lysosomal degradation of LDLR and impaired LDL uptake. Furthermore, a mutation in the WASH component KIAA0196 (strumpellin) is associated with hypercholesterolaemia in humans. Altogether, this study provides valuable insights into the mechanisms regulating cholesterol homeostasis and LDLR trafficking. Low density lipoprotein receptor (LDLR) is crucial for cholesterol homeostasis. Here, the authors show that components of the CCC-protein complex, CCDC22 and COMMD1, facilitate the endosomal sorting of LDLR and that mutations in these genes cause hypercholesterolemia in dogs and mice, providing new insights into regulation of cholesterol homeostasis.
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28
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Gröger M, Rennert K, Giszas B, Weiß E, Dinger J, Funke H, Kiehntopf M, Peters FT, Lupp A, Bauer M, Claus RA, Huber O, Mosig AS. Monocyte-induced recovery of inflammation-associated hepatocellular dysfunction in a biochip-based human liver model. Sci Rep 2016; 6:21868. [PMID: 26902749 PMCID: PMC4763209 DOI: 10.1038/srep21868] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/02/2016] [Indexed: 12/19/2022] Open
Abstract
Liver dysfunction is an early event in sepsis-related multi-organ failure. We here report the establishment and characterization of a microfluidically supported in vitro organoid model of the human liver sinusoid. The liver organoid is composed of vascular and hepatocyte cell layers integrating non-parenchymal cells closely reflecting tissue architecture and enables physiological cross-communication in a bio-inspired fashion. Inflammation-associated liver dysfunction was mimicked by stimulation with various agonists of toll-like receptors. TLR-stimulation induced the release of pro- and anti-inflammatory cytokines and diminished expression of endothelial VE-cadherin, hepatic MRP-2 transporter and apolipoprotein B (ApoB), resulting in an inflammation-related endothelial barrier disruption and hepatocellular dysfunction in the liver organoid. However, interaction of the liver organoid with human monocytes attenuated inflammation-related cell responses and restored MRP-2 transporter activity, ApoB expression and albumin/urea production. The cellular events observed in the liver organoid closely resembled pathophysiological responses in the well-established sepsis model of peritoneal contamination and infection (PCI) in mice and clinical observations in human sepsis. We therefore conclude that this human liver organoid model is a valuable tool to investigate sepsis-related liver dysfunction and subsequent immune cell-related tissue repair/remodeling processes.
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Affiliation(s)
- Marko Gröger
- Institute of Biochemistry II, Jena University Hospital, 07743 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Knut Rennert
- Institute of Biochemistry II, Jena University Hospital, 07743 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Benjamin Giszas
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena 07747 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Elisabeth Weiß
- Institute of Biochemistry II, Jena University Hospital, 07743 Jena, Germany
| | - Julia Dinger
- Institute of Forensic Medicine, Jena University Hospital, 07743 Jena, Germany
| | - Harald Funke
- Molecular Hemostaseology, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Michael Kiehntopf
- Institute of Clinical Chemistry and Laboratory Diagnostics, Jena University Hospital, 07747 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Frank T Peters
- Institute of Forensic Medicine, Jena University Hospital, 07743 Jena, Germany
| | - Amelie Lupp
- Institute of Pharmacology and Toxicology, Jena University Hospital, Jena, Germany
| | - Michael Bauer
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena 07747 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Ralf A Claus
- Department of Anesthesiology and Intensive Care, Jena University Hospital, Jena 07747 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Otmar Huber
- Institute of Biochemistry II, Jena University Hospital, 07743 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
| | - Alexander S Mosig
- Institute of Biochemistry II, Jena University Hospital, 07743 Jena, Germany.,Center for Sepsis Control and Care, Jena University Hospital, Jena, 07747 Jena, Germany
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29
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Ruiz-Núñez B, Dijck-Brouwer DAJ, Muskiet FAJ. The relation of saturated fatty acids with low-grade inflammation and cardiovascular disease. J Nutr Biochem 2016; 36:1-20. [PMID: 27692243 DOI: 10.1016/j.jnutbio.2015.12.007] [Citation(s) in RCA: 128] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 12/03/2015] [Accepted: 12/16/2015] [Indexed: 12/15/2022]
Abstract
The mantra that dietary (saturated) fat must be minimized to reduce cardiovascular disease (CVD) risk has dominated nutritional guidelines for decades. Parallel to decreasing intakes of fat and saturated fatty acids (SFA), there have been increases in carbohydrate and sugar intakes, overweight, obesity and type 2 diabetes mellitus. The "lipid hypothesis" coined the concept that fat, especially SFA, raises blood low-density lipoprotein-cholesterol and thereby CVD risk. In view of current controversies regarding their adequate intakes and effects, this review aims to summarize research regarding this heterogenic group of fatty acids and the mechanisms relating them to (chronic) systemic low-grade inflammation, insulin resistance, metabolic syndrome and notably CVD. The intimate relationship between inflammation and metabolism, including glucose, fat and cholesterol metabolism, revealed that the dyslipidemia in Western societies, notably increased triglycerides, "small dense" low-density lipoprotein and "dysfunctional" high-density lipoprotein, is influenced by many unfavorable lifestyle factors. Dietary SFA is only one of these, not necessarily the most important, in healthy, insulin-sensitive people. The environment provides us not only with many other proinflammatory stimuli than SFA but also with many antiinflammatory counterparts. Resolution of the conflict between our self-designed environment and ancient genome may rather rely on returning to the proinflammatory/antiinflammatory balance of the Paleolithic era in consonance with the 21st century culture. Accordingly, dietary guidelines might reconsider recommendations for SFA replacement and investigate diet in a broader context, together with nondietary lifestyle factors. This should be a clear priority, opposed to the reductionist approach of studying the effects of single nutrients, such as SFA.
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Affiliation(s)
- Begoña Ruiz-Núñez
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - D A Janneke Dijck-Brouwer
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frits A J Muskiet
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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30
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Chen Z, Jin H, Hou Y, Wang B, Chen C, Yang Z, Ding D, Zuo Y, Ren S. Activated P2X7 receptor upregulates the expression levels of NALP3 in P388D1 murine macrophage‑like cells. Mol Med Rep 2014; 11:1542-6. [PMID: 25351950 DOI: 10.3892/mmr.2014.2776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 10/01/2014] [Indexed: 11/06/2022] Open
Abstract
The aims of the current study were to systematically analyze the regulation of the expression of NALP3 by the P2X7 receptor in P388D1 murine macrophage‑like cells, and to investigate the association between the P2X7 receptor and the NALP3 at the molecular level. Cell culture, RNA transfection, adenosine triphosphate (ATP)‑induced expression of NALP3, reverse transcription polymerase chain reaction and western blotting were used to explore the association between the P2X7 receptor and NALP3‑encoding gene in P388D1 murine macrophage‑like cells at the molecular level. The ATP‑activated P2X7 receptor can induce the upregulation of NALP3 expression at the gene and protein levels in P388D1 cells. These results demonstrated that the activation of P2X7 increases the expression levels of NALP3 in P388D1 murine macrophage‑like cells.
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Affiliation(s)
- Zhe Chen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Hongfei Jin
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Yahui Hou
- Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Bo Wang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Chunlin Chen
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Ziyi Yang
- Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Dongbing Ding
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
| | - Yunfei Zuo
- Department of Clinical Biochemistry, Dalian Medical University, Dalian, Liaoning 116044, P.R. China
| | - Shuangyi Ren
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116023, P.R. China
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31
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Serum lipid profile, cytokine production, and clinical outcome in patients with severe sepsis. J Crit Care 2014; 29:723-7. [DOI: 10.1016/j.jcrc.2014.04.018] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 03/28/2014] [Accepted: 04/21/2014] [Indexed: 02/04/2023]
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32
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Ruiz-Núñez B, Kuipers RS, Luxwolda MF, De Graaf DJ, Breeuwsma BB, Dijck-Brouwer DJ, Muskiet FA. Saturated fatty acid (SFA) status and SFA intake exhibit different relations with serum total cholesterol and lipoprotein cholesterol: a mechanistic explanation centered around lifestyle-induced low-grade inflammation. J Nutr Biochem 2014; 25:304-12. [DOI: 10.1016/j.jnutbio.2013.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 11/08/2013] [Accepted: 11/10/2013] [Indexed: 12/21/2022]
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Cheng J, Wei Z, Liu X, Li X, Yuan Z, Zheng J, Chen X, Xiao G, Li X. The role of intestinal mucosa injury induced by intra-abdominal hypertension in the development of abdominal compartment syndrome and multiple organ dysfunction syndrome. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2013; 17:R283. [PMID: 24321230 PMCID: PMC4057115 DOI: 10.1186/cc13146] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 11/26/2013] [Indexed: 12/19/2022]
Abstract
Introduction Abdominal distension is common in critical illness. There is a growing recognition that intra-abdominal hypertension (IAH) may complicate nonsurgical critical illness as well as after abdominal surgery. However, the pathophysiological basis of the injury to the intestinal mucosal barrier and its influence on the onset of abdominal compartment syndrome (ACS) and multiorgan dysfunction syndrome (MODS) remain unclear. We measured intestinal microcirculatory blood flow (MBF) during periods of raised intra-abdominal pressure (IAP) and examined how this influenced intestinal permeability, systemic endotoxin release, and histopathological changes. Methods To test different grades of IAH to the injury of intestinal mucosa, 96 New Zealand white rabbits aged 5 to 6 months were exposed to increased IAP under nitrogen pneumoperitoneum of 15 mmHg or 25 mmHg for 2, 4 or 6 hours. MBF was measured using a laser Doppler probe placed against the jejunal mucosa through a small laparotomy. Fluorescein isothiocyanate (FITC)-conjugated dextran was administered by gavage. Intestinal injury and permeability were measured using assays for serum FITC-dextran and endotoxin, respectively, after each increase in IAP. Structural injury to the intestinal mucosa at different levels of IAH was confirmed by light and transmission electron microscopy. Results MBF reduced from baseline by 40% when IAP was 15 mmHg for 2 hours. This doubled to 81% when IAP was 25 mmHg for 6 hours. Each indicator of intestinal injury increased significantly, proportionately with IAP elevation and exposure time. Baseline serum FITC-dextran was 9.30 (± SD 6.00) μg/ml, rising to 46.89 (±13.43) μg/ml after 15 mmHg IAP for 4 hours (P <0.01), and 284.59 (± 45.18) μg/ml after 25 mmHg IAP for 6 hours (P <0.01). Endotoxin levels showed the same pattern. After prolonged exposure to increased IAP, microscopy showed erosion and necrosis of jejunal villi, mitochondria swelling and discontinuous intracellular tight junctions. Conclusions Intra-abdominal hypertension can significantly reduce MBF in the intestinal mucosa, increase intestinal permeability, result in endotoxemia, and lead to irreversible damage to the mitochondria and necrosis of the gut mucosa. The dysfunction of the intestinal mucosal barrier may be one of the important initial factors responsible for the onset of ACS and MODS.
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Rensing KL, de Jager SC, Stroes ES, Vos M, Twickler MT, Dallinga-Thie GM, de Vries CJ, Kuiper J, Bot I, von der Thüsen JH. Akt2/LDLr double knockout mice display impaired glucose tolerance and develop more complex atherosclerotic plaques than LDLr knockout mice. Cardiovasc Res 2013; 101:277-87. [DOI: 10.1093/cvr/cvt252] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
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Chen X, Wang Y, Luo H, Luo Z, Liu L, Xu W, Zhang T, Yang N, Long X, Zhu N, Xie H, Liu J. Ulinastatin reduces urinary sepsis‑related inflammation by upregulating IL‑10 and downregulating TNF‑α levels. Mol Med Rep 2013; 8:29-34. [PMID: 23685622 DOI: 10.3892/mmr.2013.1480] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 04/09/2013] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to determine the efficacy of ulinastatin (UTI) for the treatment of sepsis and to investigate the associated molecular mechanisms. Twenty‑four male rabbits were randomly divided into 4 groups, the normal, sham, sepsis model and UTI groups, each containing 6 rabbits. Serum levels of interleukin (IL)‑10 and tumor necrosis factor‑α (TNF‑α) were measured by enzyme‑linked immunosorbent assay (ELISA). Liver, kidney and lung tissues were stained with hematoxylin and eosin (H&E) 36 h after sacrifice and morphological changes were observed under an optical microscope. The expression levels of IL‑10 and TNF‑α proteins in rabbit kidney tissue in each group were determined by immunohistochemical detection and western blot analysis. ELISA results indicated that, compared with the sepsis model, IL‑10 levels were significantly higher in the UTI treatment group (183.91±11.521 pg/ml) at 36 h (P=0.000), while serum TNF‑α concentration decreased significantly in the UTI treatment group (31.637±2.770 pg/ml; P=0.000). Results of western blot analysis were consistent with the immunohistochemistry, indicating that UTI upregulates IL‑10 and downregulates TNF‑α levels. In the current study, UTI was demonstrated to effectively treat urinary sepsis and alleviate the inflammatory response in tissues. These effects were mediated by the upregulation of IL‑10 and downregulation of TNF‑α levels.
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Affiliation(s)
- Xian Chen
- Department of Urology, The Second Affiliated Hospital of University of South China, Hengyang, Hunan 421001, PR China
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Strang AC, Bisoendial RJ, Kootte RS, Schulte DM, Dallinga-Thie GM, Levels JHM, Kok M, Vos K, Tas SW, Tietge UJF, Müller N, Laudes M, Gerlag DM, Stroes ESG, Tak PP. Pro-atherogenic lipid changes and decreased hepatic LDL receptor expression by tocilizumab in rheumatoid arthritis. Atherosclerosis 2013; 229:174-81. [PMID: 23746537 DOI: 10.1016/j.atherosclerosis.2013.04.031] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 04/05/2013] [Accepted: 04/19/2013] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Blocking the interleukin-6 pathway by tocilizumab (TCZ) has been associated with changes in the lipoprotein profile, which could adversely impact cardiovascular (CV) risk in patients with rheumatoid arthritis (RA). In the present study, we addressed the effect of TCZ on lipoproteins in both fasting and non-fasting state in RA patients and tested the effect of TCZ on LDL receptor (LDLr) expression in vitro. METHODS Twenty patients with active RA and an inadequate response to TNF blockers received monthly TCZ intravenously. On week 0, 1 and 6 blood was drawn before and after an oral fat load, the lipid profiles and HDL antioxidative capacity were measured. Effects of TCZ on LDLr expression in transfected HepG2 cells were subjected. RESULTS After 6 weeks of TCZ, total cholesterol increased by 22% (4.8 ± 0.9 to 5.9 ± 1.3 mmol/L; p < 0.001), LDLc by 22% (3.0 ± 0.6 to 3.6 ± 0.8 mmol/L; p < 0.001) and HDLc by 17% (1.4 ± 0.4 to 1.7 ± 0.7 mmol/L; p < 0.016). Fasting triglycerides (TG) increased by 48% (1.0 ± 0.4 to 1.4 ± 0.8 mmol/L; p = 0.011), whereas postprandial incremental area under the curve TG increased by 62% (p = 0.002). Lipid changes were unrelated to the change in disease activity or inflammatory markers. No difference in HDL antioxidative capacity was found. In vitro, LDLr expression in cultured liver cells was significantly decreased following TCZ incubation (P < 0.001). CONCLUSIONS TCZ adversely impacts on both LDLc as well as fasting and postprandial TG in patients with RA. The changes in hepatic LDLr expression following TCZ imply that adverse lipid changes may be a direct hepatic effect of TCZ. The net effect of TCZ on CV-morbidity has to be confirmed in future clinical trials.
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Affiliation(s)
- Aart C Strang
- Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands.
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Kallio KAE, Hyvärinen K, Kovanen PT, Jauhiainen M, Pussinen PJ. Very low density lipoproteins derived from periodontitis patients facilitate macrophage activation via lipopolysaccharide function. Metabolism 2013; 62:661-8. [PMID: 23218923 DOI: 10.1016/j.metabol.2012.09.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 09/05/2012] [Accepted: 09/20/2012] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Periodontitis, a chronic oral infection caused mainly by gram-negative bacteria, induces endotoxemia and associates with the risk for atherosclerosis. We investigated the effect of periodontal treatment on proatherogenic properties of very low density lipoproteins (VLDL). METHODS VLDL were isolated from 30 systemically healthy periodontitis patients before (pre-treatment) and 3 months after treatment (post-treatment). The mass compositions were analyzed, and VLDL-induced changes in cellular cholesterol content and expression of selected genes of human THP-1 macrophages were measured. RESULTS Periodontal treatment decreased the local inflammation in the periodontium, but did not have a significant effect on C-reactive protein (CRP) levels, VLDL composition, or VLDL potential to induce cholesterol uptake or gene expression by the macrophages. Incubation of macrophages in the presence of VLDL resulted in more than twofold increase in their cellular cholesterol content. Uptake of VLDL with ensuing macrophage cholesterol accumulation correlated positively with VLDL-associated lipopolysaccharide (LPS) activity (r=0.436, P=.016) and apolipoprotein E content (r=0.374, P=.046). Pre-treatment VLDL derived from the patients with high CRP levels displayed higher LPS activity than that of VLDL derived from patients with low CRP (above vs. below median, P=.007). In addition, pre-treatment VLDL isolated from patients with high systemic inflammation induced higher relative mRNA expression of CD14, TNF-α, MCP-1, and IL-6 in the macrophages. CONCLUSION Inflammation and endotoxemia induced by severe periodontitis may increase VLDL-dependent macrophage activation and cellular cholesterol accumulation, and thereby atherogenesis.
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Affiliation(s)
- K A Elisa Kallio
- Institute of Dentistry, University of Helsinki, Helsinki, Finland.
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Kumaraswamy SB, Linder A, Åkesson P, Dahlbäck B. Decreased plasma concentrations of apolipoprotein M in sepsis and systemic inflammatory response syndromes. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2012; 16:R60. [PMID: 22512779 PMCID: PMC3681389 DOI: 10.1186/cc11305] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 03/22/2012] [Accepted: 04/18/2012] [Indexed: 12/14/2022]
Abstract
Introduction Apolipoprotein M (apoM) is present in 5% of high-density lipoprotein (HDL) particles in plasma. It is a carrier of sphingosine-1-phosphate (S1P), which is important for vascular barrier protection. The aim was to determine the plasma concentrations of apoM during sepsis and systemic inflammatory response syndrome (SIRS) and correlate them to levels of apolipoprotein A-I (apoA1), apolipoprotein B (apoB), HDL-, and low-density lipoprotein (LDL)-cholesterol. Methods Plasma samples from patients with (1), severe sepsis with shock (n = 26); (2), severe sepsis without shock (n = 44); (3), sepsis (n = 100); (4), infections without SIRS (n = 43); and (5) SIRS without infection (n = 20) were analyzed. The concentrations of apoM, apoA1, and apoB were measured with enzyme-linked immunosorbent assays (ELISAs). Total, HDL-, and LDL-cholesterol concentrations were measured with a commercial HDL/LDL cholesterol test. Results ApoM concentrations correlated negatively to acute-phase markers. Thus, apoM behaved as a negative acute-phase protein. Decreased values were observed in all patient groups (P < 0.0001), with the most drastic decreases observed in the severely sick patients. ApoM levels correlated strongly to those of apoA1, apoB, HDL, and LDL cholesterol. The HDL and LDL cholesterol levels were low in all patient groups, as compared with controls (P < 0.0001), in particular, HDL cholesterol. ApoA1 and apoB concentrations were low only in the more severely affected patients. Conclusions During sepsis and SIRS, the plasma concentrations of apoM decrease dramatically, the degree of decrease reflecting the severity of the disease. As a carrier for barrier-protective S1P in HDL, the decrease in apoM could contribute to the increased vascular leakage observed in sepsis and SIRS.
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Affiliation(s)
- Sunil B Kumaraswamy
- Department of Laboratory Medicine, Division of Clinical Chemistry, Lund University, Skåne University Hospital, Entrance 46, Malmö, SE-20502, Sweden
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Lombardo E, van Roomen CPAA, van Puijvelde GH, Ottenhoff R, van Eijk M, Aten J, Kuiper J, Overkleeft HS, Groen AK, Verhoeven AJ, Aerts JMFG, Bietrix F. Correction of liver steatosis by a hydrophobic iminosugar modulating glycosphingolipids metabolism. PLoS One 2012; 7:e38520. [PMID: 23056165 PMCID: PMC3466229 DOI: 10.1371/journal.pone.0038520] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 05/05/2012] [Indexed: 02/07/2023] Open
Abstract
The iminosugar N-(5′-adamantane-1′-yl-methoxy)-pentyl-1-deoxynoijirimycin (AMP-DNM), an inhibitor of glycosphingolipid (GSL) biosynthesis is known to ameliorate diabetes, insulin sensitivity and to prevent liver steatosis in ob/ob mice. Thus far the effect of GSL synthesis inhibition on pre-existing NASH has not yet been assessed. To investigate it, LDLR(−/−) mice were kept on a western-type diet for 12 weeks to induce NASH. Next, the diet was continued for 6 weeks in presence or not of AMP-DNM in the diet. AMP-DNM treated mice showed less liver steatosis, inflammation and fibrosis. Induction of fatty acid beta-oxydation was observed, as well as a reduction of plasma lipids. Our study demonstrates that AMP-DNM treatment is able to significantly correct pre-existing NASH, suggesting that inhibiting GSL synthesis may represent a novel strategy for the treatment of this pathology.
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Affiliation(s)
- Elisa Lombardo
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Cindy P. A. A. van Roomen
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Gijs H. van Puijvelde
- Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | - Roelof Ottenhoff
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marco van Eijk
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan Aten
- Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Johan Kuiper
- Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research (LACDR), Leiden University, Leiden, The Netherlands
| | - Herman S. Overkleeft
- Division of Biopharmaceutics, Leiden Institute of Chemistry, Leiden University, Leiden, The Netherlands
| | - Albert K. Groen
- Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands
| | - Arthur J. Verhoeven
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Johannes M. F. G. Aerts
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
| | - Florence Bietrix
- Departments of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Holleboom AG, Karlsson H, Lin RS, Beres TM, Sierts JA, Herman DS, Stroes ES, Aerts JM, Kastelein JJ, Motazacker MM, Dallinga-Thie GM, Levels JH, Zwinderman AH, Seidman JG, Seidman CE, Ljunggren S, Lefeber DJ, Morava E, Wevers RA, Fritz TA, Tabak LA, Lindahl M, Hovingh GK, Kuivenhoven JA. Heterozygosity for a loss-of-function mutation in GALNT2 improves plasma triglyceride clearance in man. Cell Metab 2011; 14:811-8. [PMID: 22152306 PMCID: PMC3523677 DOI: 10.1016/j.cmet.2011.11.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 08/15/2011] [Accepted: 11/13/2011] [Indexed: 01/31/2023]
Abstract
Genome-wide association studies have identified GALNT2 as a candidate gene in lipid metabolism, but it is not known how the encoded enzyme ppGalNAc-T2, which contributes to the initiation of mucin-type O-linked glycosylation, mediates this effect. In two probands with elevated plasma high-density lipoprotein cholesterol and reduced triglycerides, we identified a mutation in GALNT2. It is shown that carriers have improved postprandial triglyceride clearance, which is likely attributable to attenuated glycosylation of apolipoprotein (apo) C-III, as observed in their plasma. This protein inhibits lipoprotein lipase (LPL), which hydrolyses plasma triglycerides. We show that an apoC-III-based peptide is a substrate for ppGalNAc-T2 while its glycosylation by the mutant enzyme is impaired. In addition, neuraminidase treatment of apoC-III which removes the sialic acids from its glycan chain decreases its potential to inhibit LPL. Combined, these data suggest that ppGalNAc-T2 can affect lipid metabolism through apoC-III glycosylation, thereby establishing GALNT2 as a lipid-modifying gene.
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Affiliation(s)
- Adriaan G. Holleboom
- Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Helen Karlsson
- Center of Occupational and Environmental Medicine, County Council of Östergötland, Linköping S-581 85, Sweden
- Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping S-581 85, Sweden
| | - Ruei-Shiuan Lin
- Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Thomas M. Beres
- Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jeroen A. Sierts
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Daniel S. Herman
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Erik S.G. Stroes
- Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Johannes M. Aerts
- Department of Medical Biochemistry, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - John J.P. Kastelein
- Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Mohammad M. Motazacker
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Geesje M. Dallinga-Thie
- Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Johannes H.M. Levels
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Aeilko H. Zwinderman
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | | | | | - Stefan Ljunggren
- Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping S-581 85, Sweden
| | - Dirk J. Lefeber
- Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
- Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
| | - Eva Morava
- Institute for Genetic and Metabolic Disease, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
- Department of Pediatrics, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
| | - Ron A. Wevers
- Department of Laboratory Medicine, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University Nijmegen Medical Center, Nijmegen 6525GA, The Netherlands
| | | | - Lawrence A. Tabak
- Section on Biological Chemistry, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mats Lindahl
- Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine, Linköping University, Linköping S-581 85, Sweden
| | - G. Kees Hovingh
- Department of Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
| | - Jan Albert Kuivenhoven
- Department of Experimental Vascular Medicine, Academic Medical Center, Amsterdam 1105AZ, The Netherlands
- Department of Pathology and Medical Biology, University Medical Center Groningen, University of Groningen, Groningen 9713AV, The Netherlands
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Moore EE. Claude H. Organ, Jr. memorial lecture: splanchnic hypoperfusion provokes acute lung injury via a 5-lipoxygenase-dependent mechanism. Am J Surg 2011; 200:681-9. [PMID: 21146002 DOI: 10.1016/j.amjsurg.2010.05.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 05/31/2010] [Accepted: 05/31/2010] [Indexed: 01/01/2023]
Abstract
Postinjury multiple organ failure (MOF) is the net result of a dysfunctional immune response to injury characterized by a hyperactive innate system and a suppressed adaptive system. Acute lung injury (ALI) is the first clinical manifestation of organ failure, followed by renal and hepatic dysfunction. Circulatory shock is integral in the early pathogenesis of MOF, and the gut has been invoked as the motor of MOF. Mesenteric lymph is recognized as the mechanistic link between splanchnic ischemia/reperfusion and distant organ dysfunction, but the specific mediators remain to be defined. Current evidence suggests the lipid fraction of postshock mesenteric lymph is central in the etiology of ALI. Specifically, our recent work suggests that intestinal phospholipase A2 generated arachidonic acid and its subsequent 5-lipoxygenase products are essential in the pathogenesis of ALI. Proteins conveyed via postshock mesenteric lymph also may have an important role. Elucidating these mediators and the timing of their participation in pulmonary inflammation is critical in translating our current knowledge to new therapeutic strategies at the bedside.
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Affiliation(s)
- Ernest E Moore
- Department of Surgery, University of Colorado Denver, Denver, CO 80204, USA.
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Grion CMC, Cardoso LTQ, Perazolo TF, Garcia AS, Barbosa DS, Morimoto HK, Matsuo T, Carrilho AJF. Lipoproteins and CETP levels as risk factors for severe sepsis in hospitalized patients. Eur J Clin Invest 2010; 40:330-8. [PMID: 20486994 DOI: 10.1111/j.1365-2362.2010.02269.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The magnitude of lipoprotein level reduction during the acute-phase response may be associated with the severity and mortality of sepsis. However, it remains to be determined whether low lipoprotein levels can be considered a risk factor for developing sepsis. We aimed to investigate lipoprotein levels as risk factors for sepsis in hospitalized patients, and also describe sequential changes in lipoprotein and cholesterol ester transfer protein (CETP) levels during sepsis. DESIGN This is a prospective cohort study and case-control analysis from selected hospitalized patients. Blood samples were collected at admission, and participants were monitored for severe sepsis. Total cholesterol, high density lipoprotein (HDL), low density lipoprotein, and triglyceride levels were compared between sepsis cases and controls. Cholesterol, apolipoprotein, phospholipid and CETP concentrations were monitored in the case group. RESULTS Of 1719 enrolled patients, 51 developed severe sepsis and were paired with 71 controls by age, gender, presence of infection at admission and chronic disease. HDL cholesterol level at admission was a risk factor for severe sepsis (OR = 0.969; 95% CI: 0.944-0.995). Mean CETP levels diminished between hospital admission and day 3 of sepsis. The magnitude of this variation (Delta CETP) was more pronounced in non-survivors (0.78 +/- 1.08 microg mL(-1)) than that in survivors (0.02 +/- 0.58 microg mL(-1), P = 0.01). CONCLUSIONS HDL cholesterol may have a protective effect against sepsis. Each 1 mg dL(-1) increase in HDL decreased the odds of severe sepsis by 3% during hospitalization. The reduction of plasma CETP was associated with mortality.
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Bietrix F, Lombardo E, van Roomen CPAA, Ottenhoff R, Vos M, Rensen PCN, Verhoeven AJ, Aerts JM, Groen AK. Inhibition of glycosphingolipid synthesis induces a profound reduction of plasma cholesterol and inhibits atherosclerosis development in APOE*3 Leiden and low-density lipoprotein receptor-/- mice. Arterioscler Thromb Vasc Biol 2010; 30:931-7. [PMID: 20167657 DOI: 10.1161/atvbaha.109.201673] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The iminosugar N-(5'-adamantane-1'-yl-methoxy)-pentyl-1-deoxynoijirimycin (AMP-DNM), an inhibitor of the enzyme glucosylceramide synthase catalyzing glycosphingolipid (GSL) biosynthesis, ameliorates diabetes and reduces liver steatosis in ob/ob mice. Because an accumulation of sphingolipids, including sphingomyelin and GSLs, has been reported in atherosclerotic lesions in animal models and in humans, the objective of this study was to determine whether AMP-DNM also exerts beneficial effects on the development of atherosclerosis. METHODS AND RESULTS APOE*3 Leiden mice, maintained on a high-cholesterol diet, were treated for up to 18 weeks with AMP-DNM. The iminosugar prevented hyperlipidemia, generated a less atherogenic lipid profile, and induced a dramatic reduction in the development of atherosclerotic lesions. At the highest dose, no lesions were detectable. The effect of AMP-DNM was associated with a decrease in liver cholesterol, an increase in bile secretion, and enhanced excretion of cholesterol in the feces. Similar effects of AMP-DNM were observed in mice deficient for the low-density lipoprotein receptor. CONCLUSION By lowering plasma cholesterol, the iminosugar AMP-DNM dramatically reduces the development of atherosclerosis in APOE*3 Leiden and low-density lipoprotein receptor -/- mice. Thus, targeting GSL synthesis may be a new treatment modality to prevent cardiovascular disease.
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Affiliation(s)
- Florence Bietrix
- Department of Medical Biochemistry, Academic Medical Center, University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, the Netherlands
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Efficacy and safety of a phospholipid emulsion (GR270773) in Gram-negative severe sepsis: Results of a phase II multicenter, randomized, placebo-controlled, dose-finding clinical trial. Crit Care Med 2009; 37:2929-38. [DOI: 10.1097/ccm.0b013e3181b0266c] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Depke M, Steil L, Domanska G, Völker U, Schütt C, Kiank C. Altered hepatic mRNA expression of immune response and apoptosis-associated genes after acute and chronic psychological stress in mice. Mol Immunol 2009; 46:3018-28. [PMID: 19592098 DOI: 10.1016/j.molimm.2009.06.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 06/16/2009] [Indexed: 01/16/2023]
Abstract
Using a combination of transcriptional profiling and Ingenuity Pathway Analysis (IPA, www.ingenuity.com) we investigated acute and chronic psychological stress induced alterations of hepatic gene expression of BALB/c mice. Already after a 2-h single stress session, up-regulation of several LPS and glucocorticoid-sensitive immune response genes and markers related to oxidative stress and apoptotic processes were observed. Support for the existence of oxidative stress was gained by measuring increased protein carbonylation, but no alterations of immune responsiveness or cell death were measured in mice after acute stress compared to the control group. When animals were repeatedly stressed during 4.5-days, we found reduced transcription of antigen presentation molecules, altered mRNA levels of immune cell signaling mediators and persisting high expression of apoptosis-related genes. These alterations were associated with a measurable immune suppression characterized by a reduced ability to clear experimental Salmonella typhimurium infection from the liver and a heightened hepatocyte apoptosis. Moreover, genes associated with anti-oxidative functions and regenerative processes were induced in the hepatic tissue of chronically stressed mice. These findings indicate that modulation of the immune response and of apoptosis-related genes is initiated already during a single acute stress exposure. However, immune suppression will only manifest in repeatedly stressed mice which additionally show induction of protective and liver regenerative genes to prevent further hepatocyte damage.
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Affiliation(s)
- Maren Depke
- Interfaculty Institute of Genetics and Functional Genomics, Ernst-Moritz-Arndt-University Greifswald, Germany
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Yildiz B, Ucar B, Akşit A, Aydogdu SD, Colak O, Colak E. Diagnostic values of lipid and lipoprotein levels in late onset neonatal sepsis. ACTA ACUST UNITED AC 2009; 41:263-7. [DOI: 10.1080/00365540902767056] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Beigneux AP, Franssen R, Bensadoun A, Gin P, Melford K, Peter J, Walzem RL, Weinstein MM, Davies BSJ, Kuivenhoven JA, Kastelein JJP, Fong LG, Dallinga-Thie GM, Young SG. Chylomicronemia with a mutant GPIHBP1 (Q115P) that cannot bind lipoprotein lipase. Arterioscler Thromb Vasc Biol 2009; 29:956-62. [PMID: 19304573 DOI: 10.1161/atvbaha.109.186577] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE GPIHBP1 is an endothelial cell protein that binds lipoprotein lipase (LPL) and chylomicrons. Because GPIHBP1 deficiency causes chylomicronemia in mice, we sought to determine whether some cases of chylomicronemia in humans could be attributable to defective GPIHBP1 proteins. METHODS AND RESULTS Patients with severe hypertriglyceridemia (n=60, with plasma triglycerides above the 95th percentile for age and gender) were screened for mutations in GPIHBP1. A homozygous GPIHBP1 mutation (c.344A>C) that changed a highly conserved glutamine at residue 115 to a proline (p.Q115P) was identified in a 33-year-old male with lifelong chylomicronemia. The patient had failure-to-thrive as a child but had no history of pancreatitis. He had no mutations in LPL, APOA5, or APOC2. The Q115P substitution did not affect the ability of GPIHBP1 to reach the cell surface. However, unlike wild-type GPIHBP1, GPIHBP1-Q115P lacked the ability to bind LPL or chylomicrons (d < 1.006 g/mL lipoproteins from Gpihbp1(-/-) mice). Mouse GPIHBP1 with the corresponding mutation (Q114P) also could not bind LPL. CONCLUSIONS A homozygous missense mutation in GPIHBP1 (Q115P) was identified in a patient with chylomicronemia. The mutation eliminated the ability of GPIHBP1 to bind LPL and chylomicrons, strongly suggesting that it caused the patient's chylomicronemia.
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Affiliation(s)
- Anne P Beigneux
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Kallio KAE, Buhlin K, Jauhiainen M, Keva R, Tuomainen AM, Klinge B, Gustafsson A, Pussinen PJ. Lipopolysaccharide associates with pro-atherogenic lipoproteins in periodontitis patients. Innate Immun 2009; 14:247-53. [PMID: 18669610 DOI: 10.1177/1753425908095130] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Periodontitis patients are known to suffer from endotoxemia, which may be among the major risk factors for atherosclerosis. In health, lipopolysaccharide (LPS) is mainly carried with high density lipoprotein (HDL) particles. Shift of LPS toward lipoproteins with lower densities may result in less effective endotoxin scavenging. Our aim was to determine plasma LPS activity and lipoprotein-distribution before and after treatment in periodontitis patients. PATIENTS AND METHODS Very low and intermediate density (VLDL-IDL), low density (LDL), HDL 2, HDL3, and lipoprotein-deficient plasma (LPDP) were isolated by sequential ultracentrifugation. Patients included 34 subjects aged 53.5 +/- 8.3 years, before and 6 months after periodontal treatment. RESULTS The mean LPS distribution decreased among lipoprotein classes as follows: VLDL-IDL 41.3 +/- 12.1%, LPDP 25.0 +/- 7.0%, HDL3 13.1 +/- 5.2%, LDL 11.5 +/- 3.7%, and HDL2 9.2 +/- 2.8%. Plasma and VLDL-IDL-associated LPS correlated positively, and LDL- and HDL-associated LPS negatively with clinical periodontal parameters and plasma cytokine concentrations. Mean plasma LPS activity increased after periodontal treatment from 44.0 +/- 17.0 to 55.7 +/- 24.2 EU/ml (P = 0.006). No significant changes were found in LPS lipoprotein distribution and lipoprotein compositions after the treatment. CONCLUSIONS Endotoxemia increases with severity of periodontitis. In periodontitis, LPS associates preferentially with the pro-atherogenic VLDL-IDL fraction. Periodontal treatment has only minor effects on plasma LPS activity or distribution, which reflects persistence of the disease.
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Affiliation(s)
- K A Elisa Kallio
- Institute of Dentistry, University of Helsinki, and Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Helsinki, Finland.
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Abstract
PURPOSE OF REVIEW The intention of this article is to review endotoxin, host response to endotoxin, clinical significance of endotoxemia, past failed therapies targeting endotoxin, current therapeutic efforts in this area and the authors' opinion on the future of such therapy. RECENT FINDINGS Endotoxin or lipopolysaccharide is implicated in the activation of cytokine release with the potential to lead to severe sepsis. Therapies targeting endotoxin are very appealing and remain a matter of study and debate. Antiendotoxin antibody studies did not show consistent benefit to warrant its approval for use. Lipid A analog, phospholipid emulsion, and ethyl pyruvate are currently being evaluated for potential clinical use. Polymyxin B as an antiendotoxin strategy has an unacceptable toxicity profile for routine use as an intravenous agent and its use in plasmapheris is too cumbersome. Curcumin and lipopolysaccharide binding peptides, although having a potentially desirable effect on ameliorating endotoxin toxicity, remain to be shown effective in clinical trials. The development of a vaccine against endotoxin carries promise. SUMMARY The benefits of therapies targeting endotoxin remain to be elucidated. Clinical trials targeting populations with documented endotoxemia are more likely to provide an adequate test of this therapeutic approach. Prophylaxis of high-risk populations should also be considered.
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Nur77 modulates hepatic lipid metabolism through suppression of SREBP1c activity. Biochem Biophys Res Commun 2007; 366:910-6. [PMID: 18086558 DOI: 10.1016/j.bbrc.2007.12.039] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2007] [Accepted: 12/04/2007] [Indexed: 11/22/2022]
Abstract
NR4A nuclear receptors are induced in the liver upon fasting and regulate hepatic gluconeogenesis. Here, we studied the role of nuclear receptor Nur77 (NR4A1) in hepatic lipid metabolism. We generated mice expressing hepatic Nur77 using adenoviral vectors, and demonstrate that these mice exhibit a modulation of the plasma lipid profile and a reduction in hepatic triglyceride. Expression analysis of >25 key genes involved in lipid metabolism revealed that Nur77 inhibits SREBP1c expression. This results in decreased SREBP1c activity as is illustrated by reduced expression of its target genes stearoyl-coA desaturase-1, mitochondrial glycerol-3-phosphate acyltransferase, fatty acid synthase and the LDL receptor, and provides a mechanism for the physiological changes observed in response to Nur77. Expression of LXR target genes Abcg5 and Abcg8 is reduced by Nur77, and may suggest involvement of LXR in the inhibitory action of Nur77 on SREBP1c expression. Taken together, our study demonstrates that Nur77 modulates hepatic lipid metabolism through suppression of SREBP1c activity.
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