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Ramirez Bustamante CE, Agarwal N, Cox AR, Hartig SM, Lake JE, Balasubramanyam A. Adipose Tissue Dysfunction and Energy Balance Paradigms in People Living With HIV. Endocr Rev 2024; 45:190-209. [PMID: 37556371 PMCID: PMC10911955 DOI: 10.1210/endrev/bnad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 08/11/2023]
Abstract
Over the past 4 decades, the clinical care of people living with HIV (PLWH) evolved from treatment of acute opportunistic infections to the management of chronic, noncommunicable comorbidities. Concurrently, our understanding of adipose tissue function matured to acknowledge its important endocrine contributions to energy balance. PLWH experience changes in the mass and composition of adipose tissue depots before and after initiating antiretroviral therapy, including regional loss (lipoatrophy), gain (lipohypertrophy), or mixed lipodystrophy. These conditions may coexist with generalized obesity in PLWH and reflect disturbances of energy balance regulation caused by HIV persistence and antiretroviral therapy drugs. Adipocyte hypertrophy characterizes visceral and subcutaneous adipose tissue depot expansion, as well as ectopic lipid deposition that occurs diffusely in the liver, skeletal muscle, and heart. PLWH with excess visceral adipose tissue exhibit adipokine dysregulation coupled with increased insulin resistance, heightening their risk for cardiovascular disease above that of the HIV-negative population. However, conventional therapies are ineffective for the management of cardiometabolic risk in this patient population. Although the knowledge of complex cardiometabolic comorbidities in PLWH continues to expand, significant knowledge gaps remain. Ongoing studies aimed at understanding interorgan communication and energy balance provide insights into metabolic observations in PLWH and reveal potential therapeutic targets. Our review focuses on current knowledge and recent advances in HIV-associated adipose tissue dysfunction, highlights emerging adipokine paradigms, and describes critical mechanistic and clinical insights.
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Affiliation(s)
- Claudia E Ramirez Bustamante
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Neeti Agarwal
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Aaron R Cox
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sean M Hartig
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jordan E Lake
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at UTHealth, Houston, TX 77030, USA
| | - Ashok Balasubramanyam
- Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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Ziqubu K, Mazibuko-Mbeje SE, Mthembu SXH, Mabhida SE, Jack BU, Nyambuya TM, Nkambule BB, Basson AK, Tiano L, Dludla PV. Anti-Obesity Effects of Metformin: A Scoping Review Evaluating the Feasibility of Brown Adipose Tissue as a Therapeutic Target. Int J Mol Sci 2023; 24:ijms24032227. [PMID: 36768561 PMCID: PMC9917329 DOI: 10.3390/ijms24032227] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
Brown adipose tissue (BAT) is increasingly recognized as the major therapeutic target to promote energy expenditure and ameliorate diverse metabolic complications. There is a general interest in understanding the pleiotropic effects of metformin against metabolic complications. Major electronic databases and search engines such as PubMed/MEDLINE, Google Scholar, and the Cochrane library were used to retrieve and critically discuss evidence reporting on the impact of metformin on regulating BAT thermogenic activity to ameliorate complications linked with obesity. The summarized evidence suggests that metformin can reduce body weight, enhance insulin sensitivity, and improve glucose metabolism by promoting BAT thermogenic activity in preclinical models of obesity. Notably, this anti-diabetic agent can affect the expression of major thermogenic transcriptional factors such as uncoupling protein 1 (UCP1), nuclear respiratory factor 1 (NRF1), and peroxisome-proliferator-activated receptor gamma coactivator 1-alpha (PGC1-α) to improve BAT mitochondrial function and promote energy expenditure. Interestingly, vital molecular markers involved in glucose metabolism and energy regulation such as AMP-activated protein kinase (AMPK) and fibroblast growth factor 21 (FGF21) are similarly upregulated by metformin treatment in preclinical models of obesity. The current review also discusses the clinical relevance of BAT and thermogenesis as therapeutic targets. This review explored critical components including effective dosage and appropriate intervention period, consistent with the beneficial effects of metformin against obesity-associated complications.
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Affiliation(s)
- Khanyisani Ziqubu
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
- Department of Biochemistry, North-West University, Mmabatho 2745, South Africa
| | - Sithandiwe E. Mazibuko-Mbeje
- Department of Biochemistry, North-West University, Mmabatho 2745, South Africa
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60131 Ancona, Italy
- Correspondence: (S.E.M.-M.); (P.V.D.); Tel.: +27-21-938-0333 (P.V.D.)
| | - Sinenhlanhla X. H. Mthembu
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
- Department of Biochemistry, North-West University, Mmabatho 2745, South Africa
| | - Sihle E. Mabhida
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Babalwa U. Jack
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Tawanda M. Nyambuya
- Department of Health Sciences, Namibia University of Science and Technology, Windhoek 9000, Namibia
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Albertus K. Basson
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3880, South Africa
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, 60131 Ancona, Italy
| | - Phiwayinkosi V. Dludla
- Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg 7505, South Africa
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa 3880, South Africa
- Correspondence: (S.E.M.-M.); (P.V.D.); Tel.: +27-21-938-0333 (P.V.D.)
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Kolakowska A, El Alaoui F, Ben Alba H, Challal S, Carbonnelle E, Jaureguy F. Vaginal microbiota as an unusual cause of spondylodiscitis. Arch Gynecol Obstet 2022; 306:109-114. [PMID: 35435485 DOI: 10.1007/s00404-022-06432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/01/2022] [Indexed: 11/30/2022]
Abstract
The incidence of extra pelvic infections due to vaginal microflora bacteria has increased as growth media and methods of isolation have improved. However, bone infections seem to be still relatively rare, and little is known about their risk factors, clinical presentation, treatment and final outcome. We describe here a spondylodiscitis due to Gardnerella vaginalis, Atopobium vaginae, Peptostreptococcus indolicus and Prevotella amnii, anaerobic bacteria from vaginal microbiota. Our patient had no obvious predisposing factor and recovered after antibiotic treatment. To our knowledge, this case is the first reported spondylodiscitis caused by polymicrobial vaginal flora in a healthy, immunocompetent woman.
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Affiliation(s)
- Agnieszka Kolakowska
- Service de Maladies Infectieuses et Tropicales, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France.
| | - Fatma El Alaoui
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Heida Ben Alba
- Service de Rhumatologie, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Salima Challal
- Service de Rhumatologie, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France
| | - Etienne Carbonnelle
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France.,IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Paris, France
| | - Françoise Jaureguy
- Service de Microbiologie Clinique, Groupe Hospitalier Paris Seine Saint-Denis, AP-HP, Bobigny, France. .,IAME, UMR 1137, Université Paris 13, Sorbonne Paris Cité, Paris, France.
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Jurkowska K, Szymańska B, Knysz B, Piwowar A. Effect of Combined Antiretroviral Therapy on the Levels of Selected Parameters Reflecting Metabolic and Inflammatory Disturbances in HIV-Infected Patients. J Clin Med 2022; 11:jcm11061713. [PMID: 35330038 PMCID: PMC8954290 DOI: 10.3390/jcm11061713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 01/25/2023] Open
Abstract
Subjects infected with human immunodeficiency virus (HIV) treated with combined antiretroviral therapy (cART) show a greater predisposition to metabolic disturbances compared to the general population. The aim of the study was to assess the effect of cART on the level of selected parameters related to carbohydrate and lipid metabolism, cardiovascular diseases and inflammation in the plasma of HIV-infected patients against the uninfected. The levels of irisin (IRS), myostatin (MSTN), peptide YY (PYY), glucagon-like peptide-1 (GLP-1), dipeptidyl peptidase IV (DPP-4), fetuin A (FETU-A), pentraxin 3 (PTX 3), chemokine stromal cell-derived factor 1 (SDF-1), and regulated on activation normal T cell expressed and secreted (RANTES) in the plasma of HIV-infected patients and the control group were measured by immunoassay methods. HIV-infected patients were analyzed in terms of CD4+ T cells and CD8+ T cell count, HIV RNA viral load, and the type of therapeutic regimen containing either protease inhibitors (PIs) or integrase transfer inhibitors (INSTIs). The analysis of HIV-infected patients before and after cART against the control group showed statistically significant differences for the following parameters: IRS (p = 0.02), MSTN (p = 0.03), PYY (p = 0.03), GLP-1 (p = 0.03), PTX3 (p = 0.03), and RANTES (p = 0.02), but no significant differences were found for DPP-4, FETU-A, and SDF-1. Comparing the two applied therapeutic regimens, higher levels of all tested parameters were shown in HIV-infected patients treated with INSTIs compared to HIV-infected patients treated with PIs, but the differences were not statistically significant. The obtained results indicated significant changes in the expression of selected parameters in the course of HIV infection and cART. There is need for further research on the clinical usefulness of the selected parameters and for new information on the pathogenesis of HIV-related comorbidities to be provided. The obtained data may allow for better monitoring of the course of HIV infection and optimization of therapy in order to prevent the development of comorbidities as a result of long-term use of cART.
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Affiliation(s)
- Karolina Jurkowska
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.J.); (A.P.)
| | - Beata Szymańska
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.J.); (A.P.)
- Correspondence: ; Tel.: +48-71-784-0457
| | - Brygida Knysz
- Department of Infectious Diseases, Liver Diseases and Acquired Immune Deficiencies, Faculty of Medicine, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Agnieszka Piwowar
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, 50-556 Wroclaw, Poland; (K.J.); (A.P.)
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Varikasuvu SR, Pérez-López FR, Thangappazham B, Raj H, Vykunta A. Effect of metformin intervention on circulating irisin levels in polycystic ovary syndrome: a systematic review and collaborative meta-analysis. Gynecol Endocrinol 2022; 38:207-212. [PMID: 34779689 DOI: 10.1080/09513590.2021.1998439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Irisin is an adipo-myokine with potential implications in metabolic disorders such as polycystic ovary syndrome (PCOS). Despite of a strong evidence showing increased irisin level in PCOS, there is no conclusive evidence on the effect of metformin intervention on circulatory irisin in PCOS. AIM The aim of this meta-analysis was to compare the circulatory (serum/plasma) irisin levels before and after metformin intervention in subjects with PCOS. METHODS Relevant studies were retrieved by online database and manual searching. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) were obtained by a random-effects meta-analysis. A one-study leave-out sensitivity analysis was conducted to validate the overall obtained results. RESULTS A total of five observations were included in this meta-analysis. The results based on random effects meta-analysis indicated that irisin levels were significantly decreased after metformin intervention as compared to the baseline pretreatment levels in PCOS (SMD: -1.00, 95% CI: -1.60 to -0.41, Z: 3.29, p = .001). The sensitivity analysis leaving-out a particular observation at a time and repeating the meta-analysis validated the robustness of the overall finding suggesting the significant effect of metformin treatment on irisin levels in PCOS. CONCLUSION Circulating irisin levels were significantly decreased upon metformin intervention in PCOS patients. The higher pretreatment irisin levels in PCOS may recede once the altered metabolic state is restored upon metformin intervention. Well-designed randomized trials with large sample sizes are warranted to further substantiate the reported evidence reported and to establish the possible mechanisms.
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Affiliation(s)
- Seshadri Reddy Varikasuvu
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India
| | - Faustino R Pérez-López
- Department of Obstetrics and Gynecology, University of Zaragoza Faculty of Medicine, Zaragoza, Spain
| | | | - Hemanth Raj
- Department of Medicine, Mount Medical Centre, Chennai, Tamil Nadu, India
| | - Alekya Vykunta
- Heath Centre, Sri Venkateswara University, Tirupathi, Andhra Pradesh, India
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Gojanovich GS, Jacobson DL, Broadwell C, Karalius B, Kirmse B, Geffner ME, Jao J, Van Dyke RB, McFarland EJ, Silio M, Crain M, Gerschenson M. Associations of FGF21 and GDF15 with mitochondrial dysfunction in children living with perinatally-acquired HIV: A cross-sectional evaluation of pediatric AIDS clinical trials group 219/219C. PLoS One 2022; 16:e0261563. [PMID: 34972147 PMCID: PMC8719680 DOI: 10.1371/journal.pone.0261563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In persons living with HIV, mitochondrial disease (MD) is difficult to diagnose, as clinical signs are non-specific with inconsistent patterns. Fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15) are mitokines elevated in MD patients without HIV, and associated with cardiometabolic comorbidities in adults living with HIV. We assessed relationships of these biomarkers with MD in children living with perinatally-acquired HIV infection (CPHIV). SETTING Cross-sectional study of CPHIV from Pediatric ACTG 219/219C classified by Mitochondrial Disease Criteria (MDC) that defines scores 2-4 as "possible" MD. METHODS Each case with MDC equaling 4 (MDC4; n = 23) was matched to one randomly selected control displaying no MDC (MDC0; n = 23) based on calendar date. Unmatched cases with MDC equaling 3 (MDC3; n = 71) were also assessed. Plasma samples proximal to diagnoses were assayed by ELISA. Mitokine distributions were compared using Wilcoxon tests, Spearman correlations were calculated, and associations with MD status were assessed by conditional logistic regression. RESULTS Median FGF21 and GDF15 concentrations, respectively, were highest in MDC4 (143.9 and 1441.1 pg/mL), then MDC3 (104.0 and 726.5 pg/mL), and lowest in controls (89.4 and 484.7 pg/mL). Distributions of FGF21 (paired Wilcoxon rank sum p = 0.002) and GDF15 (paired Wilcoxon rank sum p<0.001) differed in MDC4 vs MDC0. Mitokine concentrations were correlated across all participants (r = 0.33; p<0.001). Unadjusted odds ratios of being MDC4 vs MDC0 were 5.2 [95% confidence interval (CI): 1.06-25.92] for FGF21 and 3.5 (95%CI: 1.19-10.25) for GDF15. Relationships persisted after covariate adjustments. CONCLUSION FGF21 and GDF15 levels may be useful biomarkers to screen for CPHIV with mitochondrial dysfunction.
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Affiliation(s)
- Greg S. Gojanovich
- University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
| | - Denise L. Jacobson
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Carly Broadwell
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Brad Karalius
- Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Brian Kirmse
- University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Mitchell E. Geffner
- Keck School of Medicine of USC, Los Angeles, California, United States of America
| | - Jennifer Jao
- Northwestern Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Russell B. Van Dyke
- Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | | | - Margarita Silio
- Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Marilyn Crain
- University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Mariana Gerschenson
- University of Hawaii at Manoa, Honolulu, Hawaii, United States of America
- * E-mail:
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7
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The effect of metformin on body mass index and metabolic parameters in non-diabetic HIV-positive patients: a meta-analysis. J Diabetes Metab Disord 2021; 20:1901-1911. [PMID: 34900832 DOI: 10.1007/s40200-021-00869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
We sought to evaluate the effetc of metformin on body mass index (BMI) and metabolic parameters in HIV-positive patients. We performed a comprehensive search through five major indexing databases, using keywords ("metformin" OR "dimethylguanylguanidine" OR "biguanide" OR "Glucophage") AND ("HIV" OR "human immunodeficiency virus" OR "AIDS" OR "Acquired immunodeficiency syndrome"), and all possible combinations until January 15, 2021. We measured standardized mean differences (SMD) and 95% confidence intervals (CI) for each outcome. We finally included 12 RCTs (577 participants, 274 in the metformin group and 303 in the comparators). Metformin did not significantly change BMI index compared to various comparators. Metformin generally improve LDL levels (SMD = 0.29, 95% CI: - 1.00 1.57, P = 0.01), HDL levels (SMD = - 0.15, 95% CI: - 0.72 0.41, P = 0.001), triglycerides values (SMD = 0.46, 95% CI: - 0.36 1.27, P < 0.00001), fasting glucose (SMD = - 0.82, 95% CI: - 1.80 0.15, P < 0.00001), insulin 120 min (SMD = - 0.82, 95% CI: - 1.59-0.04, P = 0.02), and glucose 120 min (SMD = - 1.24, 95% CI: - 2.57 0.10, P < 0.0001), but worsened total cholesterol values (SMD = 1.24, 95% CI: - 0.98 3.46, P = 0.0001). Metformin is safe for weight loss in obese people; however, this drug may not be suitable for everyone, especially those who are not overweight. Nevertheless the body of evidences may suggest that metformin had promising impacts on metabolic parameters in patients with both HIV, it is still unknown that such surrogate changes will translate to long-standing clinical advantages. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-021-00869-1.
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Agarwal N, Iyer D, Saha P, Cox AR, Xia Y, Utay NS, Somasundaram A, Schubert U, Lake JE, Hartig SM, Balasubramanyam A. HIV-1 Viral Protein R Couples Metabolic Inflexibility With White Adipose Tissue Thermogenesis. Diabetes 2021; 70:2014-2025. [PMID: 34233931 PMCID: PMC8576429 DOI: 10.2337/db20-0888] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 06/29/2021] [Indexed: 11/13/2022]
Abstract
Persons living with HIV (PLWH) manifest chronic disorders of brown and white adipose tissues that lead to diabetes and metabolic syndrome. The mechanisms that link viral factors to defective adipose tissue function and abnormal energy balance in PLWH remain incompletely understood. Here, we explored how the HIV accessory protein viral protein R (Vpr) contributes to adaptive thermogenesis in two mouse models and human adipose tissues. Uncoupling protein 1 (UCP1) gene expression was strongly increased in subcutaneous white adipose tissue (WAT) biopsy specimens from PLWH and in subcutaneous WAT of the Vpr mice, with nearly equivalent mRNA copy number. Histology and functional studies confirmed beige transformation in subcutaneous but not visceral WAT in the Vpr mice. Measurements of energy balance indicated Vpr mice displayed metabolic inflexibility and could not shift efficiently from carbohydrate to fat metabolism during day-night cycles. Furthermore, Vpr mice showed a marked inability to defend body temperature when exposed to 4°C. Importantly, Vpr couples higher tissue catecholamine levels with UCP1 expression independent of β-adrenergic receptors. Our data reveal surprising deficits of adaptive thermogenesis that drive metabolic inefficiency in HIV-1 Vpr mouse models, providing an expanded role for viral factors in the pathogenesis of metabolic disorders in PLWH.
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Affiliation(s)
- Neeti Agarwal
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX
| | - Dinakar Iyer
- Department of Biology and Biochemistry, University of Houston, Houston, TX
| | - Pradip Saha
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX
| | - Aaron R Cox
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX
| | - Yan Xia
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
| | - Netanya S Utay
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, TX
| | - Anoma Somasundaram
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, TX
| | | | - Jordan E Lake
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School at the University of Texas Health Science Center, Houston, TX
| | - Sean M Hartig
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
| | - Ashok Balasubramanyam
- Division of Diabetes, Endocrinology, and Metabolism, Baylor College of Medicine, Houston, TX
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Dos Santos Trombeta JC, Junior RCV, Cavaglieri CR, Bonfante ILP, Prestes J, Tibana RA, Ghayomzadeh M, Souza VC, Seyedalinaghi S, Navalta JW, Voltarelli FA. Combined Physical Training Increases Plasma Brain-Derived Neurotropic Factor Levels, But Not Irisin in People Living with HIV/AIDS. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:1004-1017. [PMID: 34567363 PMCID: PMC8439702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study evaluated plasma levels of brain-derived neurotropic factor (BDNF), irisin, and lactate in people living with HIV/AIDS who completed a combined physical training program. Nineteen HIV+ participants (age: 39.60 ± 10.96 years; carrier time: 7.75 ± 7.88 years; time of ART: 6.41 ± 5.93 years) performed strength/aerobic training (combined physical training) in the same session for 8 weeks and levels of BDNF, irisin, and lactate were assessed. BDNF (pg/mL) was higher post-CPT (Pre: 1258.73 ± 372.30; Post: 1504.17 ± 322.30; p < 0.001). Irisin (ng/mL) showed no change (Pre: 115.61 ± 72.41; Post: 125.87 ± 81.14; p = 0.973). There was positive correlation between irisin and lactate (mmol/L) pre (r = 0.55, p = 0.04), and lactate values were higher in the group with the highest value of irisin (3.65 ± 0.69 × 2.82 ± 0.59, p = 0.02). Combined physical training results in increased basal BDNF in people living with HIV/AIDS, this finding suggests that increased concentration of BDNF may be associated with decreased chances of developing cognitive disorders or HIV-associated dementia. Further studies involving molecular mechanisms on this subject are necessary.
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Affiliation(s)
| | | | - Cláudia Regina Cavaglieri
- Laboratory of Exercise Physiology, School of Physical Education, University of Campinas, Campinas, SP, Brazil
| | - Ivan Luiz Padilha Bonfante
- Laboratory of Exercise Physiology, School of Physical Education, University of Campinas, Campinas, SP, Brazil
- Federal Institute of Education, Science and Technology of São Paulo, Hortolândia campus, Hortolândia, SP, Brazil
| | - Jonato Prestes
- Graduate Program in Physical Education, Faculty of Physical Education, Catholic University of Brasilia (UCB), Brasilia, Brazil
| | - Ramires Alsamir Tibana
- Graduate Program in Physical Education, Faculty of Physical Education, Catholic University of Brasilia (UCB), Brasilia, Brazil
| | - Morteza Ghayomzadeh
- Iranian Research center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
| | - Vinícius Carolino Souza
- Graduate Program in Physical Education, Faculty of Physical Education, Catholic University of Brasilia (UCB), Brasilia, Brazil
| | - Seyedahmad Seyedalinaghi
- Iranian Research center for HIV/AIDS (IRCHA), Tehran University of Medical Sciences, Tehran, Iran
| | - James W Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, USA
| | - Fabrício Azevedo Voltarelli
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso (UFMT), Cuiabá, MS, Brazil
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10
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Ghayomzadeh M, Earnest CP, Hackett D, SeyedAlinaghi S, Navalta JW, Gholami M, Hosseini Rouzbahani N, Mohraz M, Voltarelli FA. Combination of resistance and aerobic exercise for six months improves bone mass and physical function in HIV infected individuals: A randomized controlled trial. Scand J Med Sci Sports 2020; 31:720-732. [PMID: 33185897 DOI: 10.1111/sms.13871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/28/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023]
Abstract
To evaluate the effect of combined resistance and aerobic training (RT+AT) on regional bone mineral density (BMD) and physical performance in people living with HIV (PLWH). Forty PLWH (20 men and 20 women) were randomized into RT+AT group (n = 20; age = 38.3 ± 4.9) or non-exercise control group (n = 20; age = 37.9 ± 5.1). The RT+AT group was required to perform a nonlinear periodized resistance training program targeting large muscle groups followed by 20 min aerobic exercise at 65-80% of maximal heart rate. Participants in RT+AT performed three supervised sessions per week for 6-months, whereas participants in the control group were instructed to continue with their current lifestyle habits. The primary outcome was bone mineral density (lumbar spine (L2-L4), femoral neck, and distal 1/3 radius). Secondary outcomes included physical function, anthropometry, inflammatory markers, and growth factors. The RT+AT group demonstrated a significant increase in BMD at follow-up for the Lumbar spine (L2-L4), femoral neck, and 1/3 radius (all, P < .05), and There were no gender differences in the training response between men and women for any of the BMD regions. Similar findings were also observed for lean body mass, IGF1and Adiponectin (P < .001). We observed a decrease in percent body fat, fat mass, IL-6, TNF-α, and myostatin in the RT+AT group (P < .001). Finally, there was a significant increase in handgrip strength and gait speed for both women and men in the RT+AT group (P < .001). A combination of resistance and aerobic training appears to be a feasible and effective means for counteracting bone loss and improving various inflammatory markers, physical function, and growth hormones in PLWH.
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Affiliation(s)
- Morteza Ghayomzadeh
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia.,Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Conrad P Earnest
- Health and Kinesiology, Texas A&M University College Station, College Station, TX, USA
| | - Daniel Hackett
- Physical Activity, Lifestyle, Ageing and Wellbeing Faculty Research Group, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - James Wilfred Navalta
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV, USA
| | - Mohammad Gholami
- Department of Medical Microbiology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Negin Hosseini Rouzbahani
- Department of Medical Immunology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Mato Grosso, Cuiab'a, Brazil
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11
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Guo C, Zhao L, Li Y, Deng X, Yuan G. Relationship between FGF21 and drug or nondrug therapy of type 2 diabetes mellitus. J Cell Physiol 2020; 236:55-67. [PMID: 32583417 DOI: 10.1002/jcp.29879] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 01/06/2023]
Abstract
Sedentary and high-calorie diets are associated with increased risk of obesity and type 2 diabetes mellitus, while exercise and diet control are also important nondrug treatments for diabetes. Fibroblast growth factor 21 (FGF21) is an important cytokine, which is mainly expressed in liver, fat and muscle tissue responding to nutrition and exercise, and plays an important role in the improvement of glucose and lipid metabolism. Due to the increasing serum FGF21 level in obesity and diabetes, FGF21 can be used as a predictor or biomarker of diabetes. A variety of clinical antidiabetic drugs can reduce the content of FGF21, possibly for the improvement of FGF21 sensitivity. In this paper, we reviewed the interactions between FGF21 and nondrug therapy (diet and exercise) for diabetes and explored the potential value of the combined application of clinical antidiabetic drugs and FGF21.
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Affiliation(s)
- Chang Guo
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Li Zhao
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Yanyan Li
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Xia Deng
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
| | - Guoyue Yuan
- Department of Endocrinology, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China
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12
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Relationship of HIV Status and Fatigue, Cardiorespiratory Fitness, Myokines, and Physical Activity. J Assoc Nurses AIDS Care 2020; 30:392-404. [PMID: 31241504 DOI: 10.1097/jnc.0000000000000022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
People living with HIV (PLWH) experience high rates of fatigue, which can be improved with physical activity. We examined relationships between HIV infection, fatigue, cardiorespiratory fitness, physical activity, and myokines. Twenty PLWH and 20 HIV-uninfected adults completed a fatigue assessment, a maximal cardiometabolic exercise test, serum measures of myokines, and wore an accelerometer for 7 days. Measures were completed at baseline, 3 months, and 6 months. At baseline, PLWH had more fatigue (4.7 ± 2.6 vs. 2.8 ± 2.5, p = .01) and higher peak ventilatory efficiency (VE/VCO2; 33 ± 5.5 vs. 30.2 ± 2.5; p = .06). Half of PLWH engaged in at least one 10-minute bout of physical activity in the previous week, compared with control subjects (65%). Over time, HIV infection and fibroblast growth factor 21 were associated with fatigue (p < .05). People living with HIV have more fatigue and a higher ventilatory efficiency; expression of fibroblast growth factor 21 may underpin this relationship.
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13
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Fibroblast Growth Factor 21 Is Elevated in HIV and Associated With Interleukin-6. J Acquir Immune Defic Syndr 2020; 83:e30-e33. [PMID: 31913998 DOI: 10.1097/qai.0000000000002285] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Kolakowska A, Maresca AF, Collins IJ, Cailhol J. Update on Adverse Effects of HIV Integrase Inhibitors. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2019; 11:372-387. [PMID: 33380904 PMCID: PMC7758219 DOI: 10.1007/s40506-019-00203-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE OF REVIEW The goal of this paper is to provide an up-to-date review of adverse events related to the class of integrase strand transfer inhibitors (INSTIs), which became the class of choice in few years. We sought answers specifically to issues pertaining to neuropsychiatric adverse events, as well as weight gain, which were the two most important categories of adverse events raised in recent studies based on real-life experience. The primary focus of this paper is on adults with a brief summary on pregnant women and children/adolescents. RECENT FINDINGS Dolutegravir (DTG) bears the heaviest burden of neuropsychiatric side effects. Weight gain was reported with all INSTIs, although there are methodological caveats in the analyses and the findings need to be interpreted with caution.Moreover, due to recent findings on neural tube defects in infants exposed to dolutegravir during their peri-conception period, its use is not recommended for women of childbearing age without proper birth control method, while raltegravir remains the only drug which may be prescribed without caution. Given the importance of cognitive and metabolic co-morbidities in people living with HIV in regard to their quality of life, future research needs to focus on long-term effects of INSTIs in relation to these adverse events. Pharmacogenetics seems to be a promising tool. Safety during pregnancy is also another important issue to further clarify. SUMMARY INSTIs are a generally well-tolerated class of antiretrovirals (ARV), and has a higher antiviral potency compared to other classes of ARV.Clinicians and patients need however to be aware of some red flags when starting with and monitoring patients on INSTIs.All INSTIs can lead to mild increases in creatinine levels, usually without clinical significance, but caution is needed in patients with low eGFR (<30ml/min), when using other nephrotoxic drugs, such as as tenofovir disoproxil.Neuro-psychiatric (NP) effects are to be monitored with INSTIs, especially with DTG (though reports are at times contradictory); clinicians might want to avoid DTG for patients with history of severe NP symptoms, until clarity is provided.Weight gain was reported with all INSTIs, especially with DTG, with possible differential effects according to sex and ethnicity (female and non-white patients being at increased risk). This is worrying since patients from African descent are at higher risk of cardio-vascular events and increased body mass index (BMI) can cause further increase metabolic risk. There is possibly an additional effect of tenofovir alafenamide (TAF) on weight increase.Discrepancies between clinical trials - with low rates of adverse events - and reports from real-life settings might be due partly to under-representation of some groups of patients in clinical trials, and/or the short duration of follow-up, since some adverse effects may only occur after prolonged exposure.Preliminary data on safety of bictegravir (BIC), from clinical trials and non-trial settings, are very reassuring and seem to show lower rates of adverse events compared to DTG.Elvitegravir/cobicistat (EVG/cobi) need to be used with caution in patients with other co-morbidities given potential for polypharmacy, as it is the case for aging patients, because of the high potential of drug-drug interactions due to effects of the cobicistat booster.We are awaiting the release of cabotegravir (CAB), which could represent a good option for patients struggling with adherence, despite injection site reactions.Pharmacogenetics is a promising way to explore adverse effects occurrence in the INSTI class.
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Affiliation(s)
- Agnieszka Kolakowska
- Infectious and Tropical Diseases Department, Avicenne University Hospital, Bobigny, France
| | - Anaenza Freire Maresca
- Infectious and Tropical Diseases Department, Avicenne University Hospital, Bobigny, France
| | - Intira Jeannie Collins
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, 90 High Holborn, 2nd Floor, London, WC1V 6LJ UK
| | - Johann Cailhol
- Infectious and Tropical Diseases Department, Avicenne University Hospital, Bobigny, France
- Infectious and Tropical Diseases Department, Avicenne University Hospital and Paris 13 University, Bobigny, France
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Al-Amrani A, AbdelKarim M, AlZabin M, Alzoghaibi M. Low expression of brown and beige fat genes in subcutaneous tissues in obese patients. Arch Med Sci 2019; 15:1113-1122. [PMID: 31572455 PMCID: PMC6764296 DOI: 10.5114/aoms.2018.76684] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/20/2018] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The molecular mechanisms behind obesity pathogenesis remain largely undefined. Impairment in the browning process of subcutaneous tissues proposed to contribute to obesity pathogenesis. In the current study, we aimed to assess whether the expression of brown fat genes in subcutaneous tissues in obese patients is altered as compared to non-obese patients. MATERIAL AND METHODS Participants were recruited from patients undergoing general surgeries. At the same site of surgery, biopsies were taken from the abdominal subcutaneous tissues from each participant, along with a venous blood sample. The expression of BAT genes was measured using a real-time PCR method. Serum FGF21 was measured using an ELISA kit, and the serum blood lipid profile was measured using the Dimension VistaTM 1500 System. RESULTS A total of 58 surgical patients was involved. A low expression of BAT genes was observed in the groups with higher body mass index (BMI) (< 30 kg/m2) as compared to the groups with lower BMI (> 30 kg/m2). The expression of CIDEA and CITED1 was significantly higher in the patients with normal weight as compared to obese (p = 0.01 and p = 0.02, respectively). A significant negative correlation was found between the expression of BAT genes and BMI in patients with BMI < 35 kg/m2. However, the strongest negative correlation was observed in the expression of CIDEA (r = -0.5, p = 0.004), followed by TBX1 (r = -0.4, p = 0.01), CITED1, and ZIC1 (r = -0.4, p = 0.03). Whereas the correlation of UCP1 with BMI remained insignificant (r = -0.29, p = 0.08). When including patients with BMI > 35 kg/m2, the correlation decreased and became insignificant (p = 0.08). No significant correlation was found between the expression of BAT genes and blood lipid profiles (p > 0.05). Serum FGF21 was positively and significantly correlated to the expression of UCP1 (r = 0.56, p = 0.02) and TBX1 (r = 0.62, p = 0.01), however, this correlation was missing in patients with severe obesity. CONCLUSIONS Our data suggested that brown and beige genes expression in abdominal subcutaneous tissues is dysregulated in patients with obesity. Further studies are needed to investigate the role of browning of subcutaneous tissues in regulating body weight and metabolism in human.
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Affiliation(s)
- Aishah Al-Amrani
- PhD student, Department of Physiology, Faculty of Medicine King Saud University, Riyadh, Saudi Arabia
- Faculty of Applied Medical Sciences, Tabuk University, Tabuk, Saudi Arabia
| | - Mouaadh AbdelKarim
- Department of Physiopathology of Inflammatory Bone Diseases, University of the Littoral, Boulogne sur Mer, France
| | | | - Mohammad Alzoghaibi
- Department of Physiology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
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16
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Moreno-Perez O, Reyes-Garcia R, Muñoz-Torres M, Merino E, Boix V, Reus S, Giner L, Alfayate R, Garcia-Fontana B, Sanchez-Paya J, Picó A, Portilla J. High Irisin levels in nondiabetic HIV-infected males are associated with insulin resistance, nonalcoholic fatty liver disease, and subclinical atherosclerosis. Clin Endocrinol (Oxf) 2018; 89:414-423. [PMID: 29947044 DOI: 10.1111/cen.13800] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 06/24/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE HIV infection is associated with an increased risk of cardiovascular disease. Irisin is a miokyne secreted by skeletal muscle, which may influence insulin homeostasis, nonalcoholic fatty liver disease (NAFLD) and atherosclerosis. Our objective was to evaluate the relationships between serum irisin, insulin homeostasis, NAFLD and subclinical atherosclerosis in HIV-infected males. DESIGN Cross-sectional study in a cohort of HIV-infected patients. PATIENTS Inclusion criteria: men older than 18 years; antiretroviral therapy (ART) -naïve or on effective ART (<50 HIV-1 RNA copies/mL) without changes in the previous 6 months; no diabetes or hepatitis C. MEASUREMENTS Irisin was measured by enzymatic immunoassay (Phoenix Pharmaceuticals), insulin sensitivity by homeostasis model assessment of insulin resistance (HOMA-IR), as well as the 2-hour continuous infusion of glucose with model assessment (CIGMA-HOMA). Hepatic steatosis was measured by 1-H magnetic resonance spectroscopy, subclinical atherosclerosis by evaluation of carotid intima-media thickness (C-IMT), measured by Ultrasonography. RESULTS Eight nine men (age 42.0 ± 8.3 years, duration of HIV infection 7.9 ± 5.6 years, CD4 count 547 ± 279 cells/mL) were included. Circulating irisin was positively related to HOMA-IR and CIGMA-HOMA, hepatic triglyceride content, and to VAT/SAT ratio. Higher irisin concentrations were associated with higher C-IMT, although this association did not persist in multivariate analysis. Lipodystrophy and a higher baseline PAI-1 concentration were independently associated with C-IMT. CONCLUSIONS In male HIV patients without diabetes, higher irisin concentrations are positively associated with insulin resistance, NAFLD and subclinical atherosclerosis. However, waist-hip-ratio is the main determinant of insulin resistance, and PAI-1 and lipodystrophy were the strongest determinants of IMT in this population.
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Affiliation(s)
- Oscar Moreno-Perez
- Endocrinology and Nutrition Service, University General Hospital of Alicante, Alicante, Spain
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Rebeca Reyes-Garcia
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
- Endocrinology Service, Complejo Hospitalario Torrecardenas, Almeria, Spain
| | - Manuel Muñoz-Torres
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | - Esperanza Merino
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Vicente Boix
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Sergio Reus
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Livia Giner
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
| | - Rocío Alfayate
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Hormone Laboratory, University General Hospital of Alicante, Alicante, Spain
| | - Beatriz Garcia-Fontana
- Bone Metabolism Unit (RETICEF), UGC Endocrinología y Nutrición, Complejo Hospitalario Universitario de Granada, Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | - Jose Sanchez-Paya
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Preventive Medicine Department, University General Hospital of Alicante, Alicante, Spain
| | - Antonio Picó
- Endocrinology and Nutrition Service, University General Hospital of Alicante, Alicante, Spain
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
| | - Joaquín Portilla
- Department of Clinical Medicine, University Miguel Hernandez, Alicante, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - FISABIO), Alicante, Spain
- Infectious Disease Unit, University General Hospital of Alicante, Alicante, Spain
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Reciprocal Effects of Antiretroviral Drugs Used To Treat HIV Infection on the Fibroblast Growth Factor 21/β-Klotho System. Antimicrob Agents Chemother 2018; 62:AAC.00029-18. [PMID: 29661866 PMCID: PMC5971578 DOI: 10.1128/aac.00029-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/05/2018] [Indexed: 01/01/2023] Open
Abstract
Following antiretroviral therapy, HIV-infected patients show increased circulating levels of the antidiabetic hormone fibroblast growth factor 21 (FGF21). In contrast, the expression of the FGF21-obligatory coreceptor β-Klotho (KLB) is reduced in target tissues. This situation is comparable to the FGF21 resistance status observed in obesity and type 2 diabetes. Here, we performed the first systematic study of the effects of distinct members of different antiretroviral drug classes on the FGF21/KLB system in human hepatic, adipose, and skeletal muscle cells. Most protease inhibitors and the nonnucleoside reverse transcriptase inhibitor efavirenz induced FGF21 gene expression. Neither nucleoside reverse transcriptase inhibitors nor the viral entry inhibitor maraviroc had any effect. Among the integrase inhibitors, elvitegravir significantly induced FGF21 expression, whereas raltegravir had minor effects only in adipose cells. In human hepatocytes and adipocytes, known target cells of FGF21 action, efavirenz, elvitegravir, and the lopinavir-ritonavir combination exerted inhibitory effects on KLB gene expression. Drug treatments that elicited FGF21 induction/KLB repression were those found to induce endoplasmic reticulum (ER) stress and oxidative stress. Notably, the pharmacological agents thapsigargin and tunicamycin, which induce these stress pathways, mimicked the effects of drug treatments. Moreover, pharmacological inhibitors of either ER or oxidative stress significantly impaired lopinavir–ritonavir-induced regulation of FGF21, but not KLB. In conclusion, the present in vitro screen study identifies the antiretroviral drugs that affect FGF21/KLB expression in human cells. The present results could have important implications for the management of comorbidities resulting from side effects of specific antiretroviral drugs for the treatment of HIV-infected patients.
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Alterations in vitamin A/retinoic acid homeostasis in diet-induced obesity and insulin resistance. Proc Nutr Soc 2017; 76:597-602. [PMID: 28651670 DOI: 10.1017/s0029665117001069] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Vitamin A is an essential micronutrient for life and the phytochemical β-carotene, also known as pro-vitamin A, is an important dietary source of this vitamin. Vitamin A (retinol) is the parent compound of all bioactive retinoids but it is retinoic acid (RA) that is the active metabolite of vitamin A. The plasma concentration of retinol is maintained in a narrow range and its normal biological activities strictly regulated since excessive intake can lead to toxicity and thus also be detrimental to life. The present review will give an overview of how vitamin A homeostasis is maintained and move on to focus on the link between circulating vitamin A and metabolic disease states. Finally, we will examine how pharmacological or genetic alterations in vitamin A homeostasis and RA-signalling can influence body fat and blood glucose levels including a novel link to the liver secreted hormone fibroblast growth factor 21, an important metabolic regulator.
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Trombeta JCDS, Prestes J, Nascimento DDC, Tibana RA, Pereira GB, Lima TDR, Fraga GA, Vieira-Junior RC, Voltarelli FA. New insights into the effects of irisin levels in HIV-infected subjects: correlation with adiposity, fat-free mass, and strength parameters. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:382-390. [PMID: 28658348 PMCID: PMC10118935 DOI: 10.1590/2359-3997000000270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 02/01/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patients infected with the human immunodeficiency virus (HIV) have an increased risk of metabolic disorders and alterations on irisin levels. Therefore, the purpose of the current investigation was to quantify the circulating irisin concentration in HIV-infected subjects under highly active antiretroviral therapy and to determine possible correlations between irisin levels with fat mass, fat-free mass, body mass index (BMI), and muscle strength. SUBJECTS AND METHODS Cross-sectional study of 10 men (36.7 ± 11.3 years) and 10 women (42.5 ± 10.3 years) infected with HIV, recruited from the Specialized Service Center in the State Center of Reference for High and Medium Complexity. Blood samples were collected to determine plasma irisin levels, glucose, HDL, total cholesterol, triglycerides, and LDL. Body composition (fat mass, fat-free mass) and anthropometrics (body mass index; BMI) were measured by bioelectrical impedance. Muscle strength was assessed using a mechanic hand dynamometer and one maximum repetition tests. RESULTS Irisin levels correlated positively with fat mass (r = 0.67; p = 0.001) and BMI (r = 0.48; p = 0.036). In contrast, there was an inverse correlation between irisin levels and fat-free mass (r = -0.41; p = 0.008) and five strength parameters: right hand grip (r = -0.46; p = 0.044); left hand grip (r = -0.50; p = 0.027), relative hand grip (r = -0.79; p = 0.001), bench press (r = -0.58; p = 0.009), leg press (r = -0.40; p = 0.085), and biceps curl (r = -0.059; p = 0.009). CONCLUSION Irisin levels correlated positively with body fat and negatively with fat-free mass and strength parameters in HIV-infected patients. Female patients infected with HIV receiving highly active antiretroviral therapy have higher levels of irisin compared with men in a similar circumstance.
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Affiliation(s)
| | - Jonato Prestes
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília (UCB), Brasília, DF. Brasil
| | - Dahan da Cunha Nascimento
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília (UCB), Brasília, DF. Brasil
| | - Ramires Alsamir Tibana
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília (UCB), Brasília, DF. Brasil
| | - Guilherme Borges Pereira
- Programa de Pós-Graduação em Educação Física, Universidade Católica de Brasília (UCB), Brasília, DF. Brasil
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Thyagarajan B, Foster MT. Beiging of white adipose tissue as a therapeutic strategy for weight loss in humans. Horm Mol Biol Clin Investig 2017; 31:/j/hmbci.ahead-of-print/hmbci-2017-0016/hmbci-2017-0016.xml. [PMID: 28672737 DOI: 10.1515/hmbci-2017-0016] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 04/18/2017] [Indexed: 12/16/2022]
Abstract
An imbalance between energy intake and expenditure leads to obesity. Adiposity associated with obesity progressively causes inflammation, type 2 diabetes, hypertension, hyperlipidemia and cardiovascular disease. Excessive dietary intake of fat results in its accumulation and storage in the white adipose tissue (WAT), whereas energy expenditure by fat utilization and oxidation predominately occurs in the brown adipose tissue (BAT). Recently, the presence of a third type of fat, referred to as beige or brite (brown in white), has been recognized in certain kinds of WAT depots. It has been suggested that WAT can undergo the process of browning in response to stimuli that induce and enhance the expression of thermogenes characteristic of those typically associated with brown fat. The resultant beige or brite cells enhance energy expenditure by reducing lipids stored within adipose tissue. This has created significant excitement towards the development of a promising strategy to induce browning/beiging in WAT to combat the growing epidemic of obesity. This review systematically describes differential locations and functions of WAT and BAT, mechanisms of beiging of WAT and a concise analysis of drug molecules and natural products that activate the browning phenomenon in vitro and in vivo. This review also discusses potential approaches for targeting WAT with compounds for site-specific beiging induction. Overall, there are numerous mechanisms that govern browning of WAT. There are a variety of newly identified targets whereby potential molecules can promote beiging of WAT and thereby combat obesity.
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21
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Morrice N, Mcilroy GD, Tammireddy SR, Reekie J, Shearer KD, Doherty MK, Delibegović M, Whitfield PD, Mody N. Elevated Fibroblast growth factor 21 (FGF21) in obese, insulin resistant states is normalised by the synthetic retinoid Fenretinide in mice. Sci Rep 2017; 7:43782. [PMID: 28256636 PMCID: PMC5335663 DOI: 10.1038/srep43782] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/30/2017] [Indexed: 01/06/2023] Open
Abstract
Fibroblast growth factor 21 (FGF21) has emerged as an important beneficial regulator of glucose and lipid homeostasis but its levels are also abnormally increased in insulin-resistant states in rodents and humans. The synthetic retinoid Fenretinide inhibits obesity and improves glucose homeostasis in mice and has pleotropic effects on cellular pathways. To identify Fenretinide target genes, we performed unbiased RNA-seq analysis in liver from mice fed high-fat diet ± Fenretinide. Strikingly, Fgf21 was the most downregulated hepatic gene. Fenretinide normalised elevated levels of FGF21 in both high-fat diet-induced obese mice and in genetically obese-diabetic Leprdbmice. Moreover, Fenretinide-mediated suppression of FGF21 was independent of body weight loss or improved hepatic insulin sensitivity and importantly does not induce unhealthy metabolic complications. In mice which have substantially decreased endogenous retinoic acid biosynthesis, Fgf21 expression was increased, whereas acute pharmacological retinoid treatment decreased FGF21 levels. The repression of FGF21 levels by Fenretinide occurs by reduced binding of RARα and Pol-II at the Fgf21 promoter. We therefore establish Fgf21 as a novel gene target of Fenretinide signalling via a retinoid-dependent mechanism. These results may be of nutritional and therapeutic importance for the treatment of obesity and type-2 diabetes.
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Affiliation(s)
- Nicola Morrice
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK.,Centre for Genome Enabled Biology and Medicine, University of Aberdeen, 23 St Machar Drive, Old Aberdeen, Aberdeen, Scotland AB24 3UU, UK
| | - George D Mcilroy
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK
| | - Seshu R Tammireddy
- Lipidomics Research Facility, Department of Diabetes and Cardiovascular Science, University of Highlands and Islands, Old Perth Road, Inverness, Scotland IV2 3JH, UK
| | - Jennifer Reekie
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK
| | - Kirsty D Shearer
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK
| | - Mary K Doherty
- Lipidomics Research Facility, Department of Diabetes and Cardiovascular Science, University of Highlands and Islands, Old Perth Road, Inverness, Scotland IV2 3JH, UK
| | - Mirela Delibegović
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK
| | - Phillip D Whitfield
- Lipidomics Research Facility, Department of Diabetes and Cardiovascular Science, University of Highlands and Islands, Old Perth Road, Inverness, Scotland IV2 3JH, UK
| | - Nimesh Mody
- Institute of Medical Sciences, College of Life Sciences and Medicine, University of Aberdeen, Foresterhill Health Campus, Aberdeen, Scotland AB25 2ZD, UK
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22
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So WY, Leung PS. Fibroblast Growth Factor 21 As an Emerging Therapeutic Target for Type 2 Diabetes Mellitus. Med Res Rev 2016; 36:672-704. [PMID: 27031294 DOI: 10.1002/med.21390] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 12/13/2015] [Accepted: 02/15/2016] [Indexed: 12/19/2022]
Abstract
Fibroblast growth factor (FGF) 21 is a distinctive member of the FGF family that functions as an endocrine factor. It is expressed predominantly in the liver, but is also found in adipose tissue and the pancreas. Pharmacological studies have shown that FGF21 normalizes glucose and lipid homeostasis, thereby preventing the development of metabolic disorders, such as obesity and diabetes. Despite growing evidence for the therapeutic potential of FGF21, paradoxical increases of FGF21 in different disease conditions point to the existence of FGF21 resistance. In this review, we give a critical appraisal of recent advances in the understanding of the regulation of FGF21 production under various physiological conditions, its antidiabetic actions, and the clinical implications. We also discuss recent preclinical and clinical trials using engineered FGF21 analogs in the management of diabetes, as well as the potential side effects of FGF21 therapy.
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Affiliation(s)
- Wing Yan So
- School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Po Sing Leung
- School of Biomedical Sciences, Faculty of Medicine, the Chinese University of Hong Kong, Shatin, Hong Kong, China
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23
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Kim KH, Lee MS. FGF21 as a mediator of adaptive responses to stress and metabolic benefits of anti-diabetic drugs. J Endocrinol 2015; 226:R1-16. [PMID: 26116622 DOI: 10.1530/joe-15-0160] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Most hormones secreted from specific organs of the body in response to diverse stimuli contribute to the homeostasis of the whole organism. Fibroblast growth factor 21 (FGF21), a hormone induced by a variety of environmental or metabolic stimuli, plays a crucial role in the adaptive response to these stressful conditions. In addition to its role as a stress hormone, FGF21 appears to function as a mediator of the therapeutic effects of currently available drugs and those under development for treatment of metabolic diseases. In this review, we highlight molecular mechanisms and the functional importance of FGF21 induction in response to diverse stress conditions such as changes of nutritional status, cold exposure, and exercise. In addition, we describe recent findings regarding the role of FGF21 in the pathogenesis and treatment of diabetes associated with obesity, liver diseases, pancreatitis, muscle atrophy, atherosclerosis, cardiac hypertrophy, and diabetic nephropathy. Finally, we discuss the current understanding of the actions of FGF21 as a crucial regulator mediating beneficial metabolic effects of therapeutic agents such as metformin, glucagon/glucagon-like peptide 1 analogues, thiazolidinedione, sirtuin 1 activators, and lipoic acid.
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Affiliation(s)
- Kook Hwan Kim
- Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
| | - Myung-Shik Lee
- Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea
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