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Zhao N, Hua W, Liu Q, Wang Y, Liu Z, Jin S, Wang B, Pang Y, Qi J, Song Y. MALAT1 knockdown alleviates the pyroptosis of microglias in diabetic cerebral ischemia via regulating STAT1 mediated NLRP3 transcription. Mol Med 2023; 29:44. [PMID: 37013491 PMCID: PMC10069069 DOI: 10.1186/s10020-023-00637-2] [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: 04/12/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Dysregulated long non-coding RNAs participate in the development of diabetic cerebral ischemia. This study aimed to investigate the underlying mechanism of lncRNA MALAT1 in diabetic cerebral ischemia. METHOD Middle cerebral artery occlusion (MCAO) was performed to establish diabetic cerebral I/R in vivo. TTC and neurological deficits assessment were performed to assess cerebral ischemic injury. LDH was conducted to detect cytotoxicity. RT-qPCR and western blotting assays were applied to determine mRNA and protein expression. Flow cytometry was performed to detect the pyroptosis of BV2 cells. Immunofluorescence and FISH were conducted for subcellular localization of MALAT1 and STAT1. ELISA was performed to determine cytokine release. Dual luciferase reporter, RIP, and ChIP assays were used to validate the interaction between STAT1 and MALAT1/NLRP3. Diabetes aggravated cerebral injury in vivo and in vitro. Diabetic cerebral ischemia induced inflammatory response and inflammation-induced cell pyroptosis. RESULT MALAT1 was overexpressed in diabetic cerebral ischemia models in vivo and in vitro. However, knockdown of MALAT1 suppressed inflammatory response and the pyroptosis of BV2 cells. Moreover, MALAT1 interacted with STAT1 to transcriptionally activate NLRP3. Knockdown of STAT1 significantly reversed the effects of MALAT1. Furthermore, STAT1 promotes the MALAT1 transcription. MALAT1 interacts with STAT1 to promote the pyroptosis of microglias induced by diabetic cerebral ischemia through activating NLRP3 transcription. CONCLUSION Thus, knockdown of MALAT1 may be a potential promising therapy target for diabetic cerebral ischemia.
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Affiliation(s)
- Nan Zhao
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Wei Hua
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Qi Liu
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Yueying Wang
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Zhiyi Liu
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Sinan Jin
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Benshuai Wang
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Yuxin Pang
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China
| | - Jiping Qi
- Department of Pathology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China.
| | - Yuejia Song
- Department of Endocrinology, First Clinical Hospital, Harbin Medical University, No. 23 Post Street, Nangang District, Harbin, 150001, Heilongjiang, China.
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Miceli G, Basso MG, Rizzo G, Pintus C, Tuttolomondo A. The Role of the Coagulation System in Peripheral Arterial Disease: Interactions with the Arterial Wall and Its Vascular Microenvironment and Implications for Rational Therapies. Int J Mol Sci 2022; 23:ijms232314914. [PMID: 36499242 PMCID: PMC9739112 DOI: 10.3390/ijms232314914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
Peripheral artery disease (PAD) is a clinical manifestation of atherosclerotic disease with a large-scale impact on the economy and global health. Despite the role played by platelets in the process of atherogenesis being well recognized, evidence has been increasing on the contribution of the coagulation system to the atherosclerosis formation and PAD development, with important repercussions for the therapeutic approach. Histopathological analysis and some clinical studies conducted on atherosclerotic plaques testify to the existence of different types of plaques. Likely, the role of coagulation in each specific type of plaque can be an important determinant in the histopathological composition of atherosclerosis and in its future stability. In this review, we analyze the molecular contribution of inflammation and the coagulation system on PAD pathogenesis, focusing on molecular similarities and differences between atherogenesis in PAD and coronary artery disease (CAD) and discussing the possible implications for current therapeutic strategies and future perspectives accounting for molecular inflammatory and coagulation targets. Understanding the role of cross-talking between coagulation and inflammation in atherosclerosis genesis and progression could help in choosing the right patients for future dual pathway inhibition strategies, where an antiplatelet agent is combined with an anticoagulant, whose role, despite pathophysiological premises and trials' results, is still under debate.
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Affiliation(s)
- Giuseppe Miceli
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital Policlinico “P. Giaccone”, 90100 Palermo, Italy
- Correspondence: ; Tel.: +39-(091)-6552115; Fax: +39-(091)-6552142
| | - Maria Grazia Basso
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital Policlinico “P. Giaccone”, 90100 Palermo, Italy
| | - Giuliana Rizzo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital Policlinico “P. Giaccone”, 90100 Palermo, Italy
| | - Chiara Pintus
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital Policlinico “P. Giaccone”, 90100 Palermo, Italy
| | - Antonino Tuttolomondo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Università degli Studi di Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy
- Internal Medicine and Stroke Care Ward, University Hospital Policlinico “P. Giaccone”, 90100 Palermo, Italy
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Simonetta I, Riolo R, Todaro F, Tuttolomondo A. New Insights on Metabolic and Genetic Basis of Migraine: Novel Impact on Management and Therapeutical Approach. Int J Mol Sci 2022; 23:ijms23063018. [PMID: 35328439 PMCID: PMC8955051 DOI: 10.3390/ijms23063018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Migraine is a hereditary disease, usually one-sided, sometimes bilateral. It is characterized by moderate to severe pain, which worsens with physical activity and may be associated with nausea and vomiting, may be accompanied by photophobia and phonophobia. The disorder can occur at any time of the day and can last from 4 to 72 h, with and without aura. The pathogenic mechanism is unclear, but extensive preclinical and clinical studies are ongoing. According to electrophysiology and imaging studies, many brain areas are involved, such as cerebral cortex, thalamus, hypothalamus, and brainstem. The activation of the trigeminovascular system has a key role in the headache phase. There also appears to be a genetic basis behind the development of migraine. Numerous alterations have been identified, and in addition to the genetic cause, there is also a close association with the surrounding environment, as if on the one hand, the genetic alterations may be responsible for the onset of migraine, on the other, the environmental factors seem to be more strongly associated with exacerbations. This review is an analysis of neurophysiological mechanisms, neuropeptide activity, and genetic alterations that play a fundamental role in choosing the best therapeutic strategy. To date, the goal is to create a therapy that is as personalized as possible, and for this reason, steps forward have been made in the pharmacological field in order to identify new therapeutic strategies for both acute treatment and prophylaxis.
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Affiliation(s)
- Irene Simonetta
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant Excellence and Internal and Specialized Medicine (ProMISE) G. D’Alessandro, University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (I.S.); (R.R.); (F.T.)
- Molecular and Clinical Medicine PhD Programme, University of Palermo, P.zza delle Cliniche n.2, 90127 Palermo, Italy
| | - Renata Riolo
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant Excellence and Internal and Specialized Medicine (ProMISE) G. D’Alessandro, University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (I.S.); (R.R.); (F.T.)
| | - Federica Todaro
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant Excellence and Internal and Specialized Medicine (ProMISE) G. D’Alessandro, University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (I.S.); (R.R.); (F.T.)
| | - Antonino Tuttolomondo
- Internal Medicine and Stroke Care Ward, Department of Promoting Health, Maternal-Infant Excellence and Internal and Specialized Medicine (ProMISE) G. D’Alessandro, University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (I.S.); (R.R.); (F.T.)
- Molecular and Clinical Medicine PhD Programme, University of Palermo, P.zza delle Cliniche n.2, 90127 Palermo, Italy
- Correspondence:
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Di Chiara T, Del Cuore A, Daidone M, Scaglione S, Norrito RL, Puleo MG, Scaglione R, Pinto A, Tuttolomondo A. Pathogenetic Mechanisms of Hypertension-Brain-Induced Complications: Focus on Molecular Mediators. Int J Mol Sci 2022; 23:ijms23052445. [PMID: 35269587 PMCID: PMC8910319 DOI: 10.3390/ijms23052445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 02/06/2023] Open
Abstract
There is growing evidence that hypertension is the most important vascular risk factor for the development and progression of cardiovascular and cerebrovascular diseases. The brain is an early target of hypertension-induced organ damage and may manifest as stroke, subclinical cerebrovascular abnormalities and cognitive decline. The pathophysiological mechanisms of these harmful effects remain to be completely clarified. Hypertension is well known to alter the structure and function of cerebral blood vessels not only through its haemodynamics effects but also for its relationships with endothelial dysfunction, oxidative stress and inflammation. In the last several years, new possible mechanisms have been suggested to recognize the molecular basis of these pathological events. Accordingly, this review summarizes the factors involved in hypertension-induced brain complications, such as haemodynamic factors, endothelial dysfunction and oxidative stress, inflammation and intervention of innate immune system, with particular regard to the role of Toll-like receptors that have to be considered dominant components of the innate immune system. The complete definition of their prognostic role in the development and progression of hypertensive brain damage will be of great help in the identification of new markers of vascular damage and the implementation of innovative targeted therapeutic strategies.
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Maida CD, Daidone M, Pacinella G, Norrito RL, Pinto A, Tuttolomondo A. Diabetes and Ischemic Stroke: An Old and New Relationship an Overview of the Close Interaction between These Diseases. Int J Mol Sci 2022; 23:ijms23042397. [PMID: 35216512 PMCID: PMC8877605 DOI: 10.3390/ijms23042397] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 12/12/2022] Open
Abstract
Diabetes mellitus is a comprehensive expression to identify a condition of chronic hyperglycemia whose causes derive from different metabolic disorders characterized by altered insulin secretion or faulty insulin effect on its targets or often both mechanisms. Diabetes and atherosclerosis are, from the point of view of cardio- and cerebrovascular risk, two complementary diseases. Beyond shared aspects such as inflammation and oxidative stress, there are multiple molecular mechanisms by which they feed off each other: chronic hyperglycemia and advanced glycosylation end-products (AGE) promote ‘accelerated atherosclerosis’ through the induction of endothelial damage and cellular dysfunction. These diseases impact the vascular system and, therefore, the risk of developing cardio- and cerebrovascular events is now evident, but the observation of this significant correlation has its roots in past decades. Cerebrovascular complications make diabetic patients 2–6 times more susceptible to a stroke event and this risk is magnified in younger individuals and in patients with hypertension and complications in other vascular beds. In addition, when patients with diabetes and hyperglycemia experience an acute ischemic stroke, they are more likely to die or be severely disabled and less likely to benefit from the one FDA-approved therapy, intravenous tissue plasminogen activator. Experimental stroke models have revealed that chronic hyperglycemia leads to deficits in cerebrovascular structure and function that may explain some of the clinical observations. Increased edema, neovascularization, and protease expression as well as altered vascular reactivity and tone may be involved and point to potential therapeutic targets. Further study is needed to fully understand this complex disease state and the breadth of its manifestation in the cerebrovasculature.
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Affiliation(s)
- Carlo Domenico Maida
- Molecular and Clinical Medicine PhD Programme, University of Palermo, 90127 Palermo, Italy; (C.D.M.); (A.T.)
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
| | - Mario Daidone
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
- Correspondence:
| | - Gaetano Pacinella
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
| | - Rosario Luca Norrito
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
| | - Antonio Pinto
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
| | - Antonino Tuttolomondo
- Molecular and Clinical Medicine PhD Programme, University of Palermo, 90127 Palermo, Italy; (C.D.M.); (A.T.)
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro” (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy; (G.P.); (R.L.N.); (A.P.)
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Di Raimondo D, Musiari G, Rizzo G, Pirera E, Signorelli SS. New Insights in Prevention and Treatment of Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042475. [PMID: 35206661 PMCID: PMC8872199 DOI: 10.3390/ijerph19042475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Domenico Di Raimondo
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
- Correspondence: ; Tel.: +39-091-6552180
| | - Gaia Musiari
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Giuliana Rizzo
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Edoardo Pirera
- Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, Division of Internal Medicine and Stroke Care, University of Palermo, 90100 Palermo, Italy; (G.M.); (G.R.); (E.P.)
| | - Salvatore Santo Signorelli
- Medical Angiology Unit, Department of Clinic and Experimental Medicine, University of Catania, 95124 Catania, Italy;
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Daidone M, Cataldi M, Pinto A, Tuttolomondo A. Non-coding RNAs and other determinants of neuroinflammation and endothelial dysfunction: regulation of gene expression in the acute phase of ischemic stroke and possible therapeutic applications. Neural Regen Res 2021; 16:2154-2158. [PMID: 33818487 PMCID: PMC8354116 DOI: 10.4103/1673-5374.310607] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/15/2020] [Accepted: 12/22/2020] [Indexed: 12/15/2022] Open
Abstract
Ischemic stroke occurs under a variety of clinical conditions and has different pathogeneses, resulting in necrosis of brain parenchyma. Stroke pathogenesis is characterized by neuroinflammation and endothelial dysfunction. Some of the main processes triggered in the early stages of ischemic damage are the rapid activation of resident inflammatory cells (microglia, astrocytes and endothelial cells), inflammatory cytokines, and translocation of intercellular nuclear factors. Inflammation in stroke includes all the processes mentioned above, and it consists of either protective or detrimental effects concerning the "polarization" of these processes. This polarization comes out from the interaction of all the molecular pathways that regulate genome expression: the epigenetic factors. In recent years, new regulation mechanisms have been cleared, and these include non-coding RNAs, adenosine receptors, and the activity of mesenchymal stem/stromal cells and microglia. We reviewed how long non-coding RNA and microRNA have emerged as an essential mediator of some neurological diseases. We also clarified that their roles in cerebral ischemic injury may provide novel targets for the treatment of ischemic stroke. To date, we do not have adequate tools to control pathophysiological processes associated with stroke. Our goal is to review the role of non-coding RNAs and innate immune cells (such as microglia and mesenchymal stem/stromal cells) and the possible therapeutic effects of their modulation in patients with acute ischemic stroke. A better understanding of the mechanisms that influence the "polarization" of the inflammatory response after the acute event seems to be the way to change the natural history of the disease.
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Affiliation(s)
- Mario Daidone
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche n.2, Palermo, Italy
| | - Marco Cataldi
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche n.2, Palermo, Italy
| | - Antonio Pinto
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche n.2, Palermo, Italy
| | - Antonino Tuttolomondo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche n.2, Palermo, Italy
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Hassan EA, El-Khawas HM, H A, Alzahaby AA, Elbakry MMM, Shokri HM. Pre-micro RNA polymorphism detection in small versus large vessel disease in stroke Egyptian patients. Metab Brain Dis 2021; 36:1361-1367. [PMID: 33830413 DOI: 10.1007/s11011-021-00723-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/26/2021] [Indexed: 11/25/2022]
Abstract
Stroke is the main cause of adult disability and is responsible for around 11% of deaths all over the world. Ischemic stroke encompasses about 80-85% of total stroke cases. Several studies have shown the relation between microRNAs polymorphism and ischemic stroke. The aim of the study was to evaluate the influence of three common single nucleotide polymorphisms in pre-miRNAs (hsa-miR-146a/rs2910164, hsa-miR-196a2/rs11614913 and hsa-miR-499/rs3746444) on individual susceptibility to the risk of ischemic stroke subtypes in Egyptian population with 117 ischemic stroke patients. Results showed that hsa-miR-146a/rs2910164 was significantly associated with the risk of small vessel disease stroke in Egyptian population with no significant association between hsa-miR-196a2/rs11614913 and hsa-miR-499/rs3746444 with the risk of ischemic stroke. Therefore, it can be concluded that miR-146a/rs2910164 polymorphism is involved in the vulnerability to small vessel disease ischemic stroke risk in Egyptian population.
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Affiliation(s)
- Ekrami A Hassan
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, 11566, Egypt
| | - Hala M El-Khawas
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Afify H
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alaa A Alzahaby
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mustafa M M Elbakry
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, 11566, Egypt.
| | - Hossam M Shokri
- Neurology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Abstract
Stroke is the main cause of adult disability and is responsible for around 11% of deaths all over the world. Ischemic stroke encompasses about 80-85% of total stroke cases. Several studies have shown the relation between microRNAs polymorphism and ischemic stroke. The aim of the study was to evaluate the influence of three common single nucleotide polymorphisms in pre-miRNAs (hsa-miR-146a/rs2910164, hsa-miR-196a2/rs11614913 and hsa-miR-499/rs3746444) on individual susceptibility to the risk of ischemic stroke subtypes in Egyptian population with 117 ischemic stroke patients. Results showed that hsa-miR-146a/rs2910164 was significantly associated with the risk of small vessel disease stroke in Egyptian population with no significant association between hsa-miR-196a2/rs11614913 and hsa-miR-499/rs3746444 with the risk of ischemic stroke. Therefore, it can be concluded that miR-146a/rs2910164 polymorphism is involved in the vulnerability to small vessel disease ischemic stroke risk in Egyptian population.
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Ketogenic Diet, Physical Activity, and Hypertension-A Narrative Review. Nutrients 2021; 13:nu13082567. [PMID: 34444726 PMCID: PMC8398985 DOI: 10.3390/nu13082567] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 12/12/2022] Open
Abstract
Several studies link cardiovascular diseases (CVD) with unhealthy lifestyles (unhealthy dietary habits, alcohol consumption, smoking, and low levels of physical activity). Therefore, the strong need for CVD prevention may be pursued through an improved control of CVD risk factors (impaired lipid and glycemic profiles, high blood pressure, and obesity), which is achievable through an overall intervention aimed to favor a healthy lifestyle. Focusing on diet, different recommendations emphasize the need to increase or avoid consumption of entire classes of food, with only partly known and only partly foreseeable consequences on the overall level of health. In recent years, the ketogenic diet (KD) has been proposed to be an effective lifestyle intervention for metabolic syndrome, and although the beneficial effects on weight loss and glucose metabolism seems to be well established, the effects of a prolonged KD on the ability to perform different types of exercise and the influence of KD on blood pressure (BP) levels, both in normotensives and in hypertensives, are not so well understood. The objective of this review is to analyze, on the basis of current evidence, the relationship between KD, regular physical activity, and BP.
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Chiu EC, Chi FC, Chen PT. Investigation of the home-reablement program on rehabilitation outcomes for people with stroke: A pilot study. Medicine (Baltimore) 2021; 100:e26515. [PMID: 34190182 PMCID: PMC8257914 DOI: 10.1097/md.0000000000026515] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Reablement is 1 approach to conduct rehabilitation in the community (ie, home environment), which aims to enhance an individual's functional ability to perform everyday activities that individuals perceive as important. We investigated the effects of a home-reablement program on different rehabilitation outcomes in people with stroke. METHODS A single-blind randomized clinical trial was conducted. Twenty-six people with stroke were randomly assigned to the home-reablement group or control group. For 6 weeks, participants in the home-reablement group received training for activities of daily living (ADL) that they perceived as important but difficult to perform. Participants in the control group received conventional rehabilitation in the hospital. Outcome measures included the Fugl-Meyer Assessment for the upper-extremity (FMA-UE) and the Stroke Impact Scale 3.0 (SIS 3.0) subscales. RESULTS No statistically significant differences between the 2 groups were noticed in the FMA-UE and the SIS 3.0 subscales (P = .226-1.000). Small effect size (success rate difference = 0.12-0.25) were noticed in the FMA-UE and the 5 SIS 3.0 subscales. The home-reablement group exhibited a greater proportion of participants with scores greater than the minimal detectable change in the FMA-UE and the 6 SIS 3.0 subscales (ie, strength, ADL/instrumental ADL, mobility, emotion, memory, and participation). CONCLUSIONS People with stroke that underwent the 6-week home-reablement program showed potential for improving their motor function, ADL/instrumental ADL, emotion, memory, and activity participation.
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Affiliation(s)
- En-Chi Chiu
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Fang-Chi Chi
- Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- Taipei City Long-Term Care Management Center, Taipei, Taiwan
| | - Pei-Tsen Chen
- Department of Physical Medicine and Rehabilitation, Cardinal Tien Hospital, New Taipei City, Taiwan
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Liu X, Zhang Y, Chu J, Zheng J, Cheng X, Li X, Long J. Effect of probiotics on the nutritional status of severe stroke patients with nasal feeding that receive enteral nutrition: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e25657. [PMID: 33907128 PMCID: PMC8084017 DOI: 10.1097/md.0000000000025657] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/30/2021] [Accepted: 04/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Malnutrition is commonly observed after stroke and is closely associated with poor clinical outcomes. So, early nutrition support is particularly crucial for severe stroke patients. However, a significant number of critically ill patients are intolerant to enteral nutrition (EN). Probiotics have been widely used in malnutrition by various diseases and have a low incidence of enteral intolerance. So, we aim to elucidate the efficacy of probiotics in EN in improving the nutritional status and clinical prognosis of severe stroke patients with nasal feeding. METHOD Embase, PubMed, Sinomed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and Vip Journal Integration Platform were searched from inception to March 31, 2021. Randomized controlled trials that applied probiotics in patients with severe stroke were included. The data were extracted and the risk of bias was assessed independently by 2 evaluators. RESULTS Twenty-four studies comprising 2003 participants of randomized controlled trials were included. The result of pooled analyses showed that probiotics in EN were associated with better outcomes than EN alone on Glasgow Coma Scale score (mean difference [MD] = 1.03, 95% confidence intervals [CI]: 0.78-1.27; P < .00001), infection events (odds ratio [OR] = 0.25, 95% CI: 0.15-0.43; P < .00001), rate of intestinal flora dysbiosis (OR = 0.24, 95% CI: 0.12-0.48; P < .0001), gastrointestinal complications (OR = 0.25, 95% CI: 0.16-0.37, P < .00001), time to reach target nutrition (MD = -1.80, 95% CI: -2.42 to 1.18, P < .00001), prealbumin content (MD = 25.83, 95% CI: 13.68-37.99, P < .0001). CONCLUSION Our results demonstrated that probiotics supplementation might be an effective intervention for improving the clinical prognosis in severe stroke patients with nasal feeding, but no significant effect on increasing muscle circumference.
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Affiliation(s)
| | | | | | | | | | - Xinmin Li
- School of Basic Medical Science, Henan University of Chinese Medicine, Zhengzhou, China
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Simonetta I, Tuttolomondo A, Daidone M, Miceli S, Pinto A. Treatment of Anderson-Fabry Disease. Curr Pharm Des 2021; 26:5089-5099. [PMID: 32183665 DOI: 10.2174/1381612826666200317142412] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/10/2020] [Indexed: 12/25/2022]
Abstract
Fabry disease is an X-linked disorder of glycosphingolipid metabolism that results in progressive accumulation of neutral glycosphingolipids, predominantly globotriaosylsphingosine (Gb3) in lysosomes, as well as other cellular compartments of several tissues, causing multi-organ manifestations (acroparesthesias, hypohidrosis, angiokeratomas, signs and symptoms of cardiac, renal, cerebrovascular involvement). Pathogenic mutations lead to a deficiency of the lysosomal enzyme alpha-galactosidase A (GLA). In the presence of high clinical suspicion, a careful physical examination and specific laboratory tests are required. Finally, the diagnosis of Fabry's disease is confirmed by the demonstration of the absence of or reduced alpha-galactosidase A enzyme activity in hemizygous men and gene typing in heterozygous females. Measurement of the biomarkers Gb3 and Lyso Gb3 in biological specimens may facilitate diagnosis. The current treatment of Anderson-Fabry disease is represented by enzyme replacement therapy (ERT) and oral pharmacological chaperone. Future treatments are based on new strategic approaches such as stem cell-based therapy, pharmacological approaches chaperones, mRNA therapy, and viral gene therapy. This review outlines the current therapeutic approaches and emerging treatment strategies for Anderson-Fabry disease.
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Affiliation(s)
- Irene Simonetta
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy
| | - Antonino Tuttolomondo
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy
| | - Mario Daidone
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy
| | - Salvatore Miceli
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy
| | - Antonio Pinto
- U.O.C di Medicina Interna con Stroke Care, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), University of Palermo, Piazza delle Cliniche n.2, 90127 Palermo, Italy
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Wang Q, Zhao J, Chang H, Liu X, Zhu R. Association between lncRNA ANRIL genetic variants with the susceptibility to ischemic stroke: From a case-control study to meta-analysis. Medicine (Baltimore) 2021; 100:e25113. [PMID: 33725991 PMCID: PMC7982178 DOI: 10.1097/md.0000000000025113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/18/2021] [Accepted: 02/17/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Recent studies have reported that lncRNA (long noncoding RNAs) antisense non-coding RNA in the INK4 locus (ANRIL) plays important roles in the development of atherosclerosis through regulating cell apoptosis, proliferation, and adhesion. GWAS (genome-wide association studies) identified common genetic variants within ANRIL could confer risk of ischemic stroke (IS) in southern Sweden. METHODS We performed a case-control study, including 567 IS patients and 552 healthy controls from unrelated northern Chinese Han population, aiming to explore the association between lncRNA ANRIL rs2383207, rs4977574 polymorphisms and the risk of IS. Subsequently we implemented a meta-analysis to further assess the relationship of these variants and the disease. RESULTS In our case-control study, no significant associations were observed in all models between above 2 polymorphisms and IS. Next in our subgroup analysis, we detected significant association between GA genotype of rs4977574 and the increased risk of LAA-IS (large-artery atherosclerotic ischemic stroke), similar elevated risk also appeared in the GG + GA genotype under the dominant model (P = .048, OR = 1.385, 95% CIs 1.002-1.914; P = .040, OR = 1.378, 95% CIs 1.015-1.872, respectively). As for rs2383207, negative results were obtained under all models and subgroups. Our meta-analysis showed a significant association between rs4977574 polymorphism and IS risk in allele model (G vs A P = .002, OR = 1.137, 95% CIs 1.048-1.234); with respect to rs2383207 polymorphism, no significant association between that and the risk of IS was detected under the dominant model (GA + AA vs GG, P = .061, OR = 0.923, 95% CIs 0.849-1.004), or recessive model (AA vs GA + GG, P = .656, OR = 0.972, 95% CIs 0.858-1.101), or allele model (A vs G, P = .326, OR = 0.952, 95% CIs 0.863-1.050). Likewise, no significant association between rs2383207 and IS was found in different stoke subtypes (P > .05). CONCLUSIONS Our findings indicated G allele of lncRNA ANRIL rs4977574 could increase the risk of IS, and the variant may be associated with susceptibility to LAA-IS in Chinese Han population.
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Chen S, Shen Y, Liu YH, Dai Y, Wu ZM, Wang XQ, Yang CD, Li LY, Liu JM, Zhang LP, Shen WF, Ji R, Lu L, Ding FH. Impact of glycemic control on the association of endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus. Cardiovasc Diabetol 2021; 20:64. [PMID: 33714276 PMCID: PMC7956110 DOI: 10.1186/s12933-021-01257-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/05/2021] [Indexed: 12/16/2022] Open
Abstract
Background We investigated whether glycemic control affects the relation between endothelial dysfunction and coronary artery disease in patients with type 2 diabetes mellitus (T2DM). Methods In 102 type 2 diabetic patients with stable angina, endothelial function was evaluated using brachial artery flow-mediated dilation (FMD) with high-resolution ultrasound, and significant stenosis of major epicardial coronary arteries (≥ 50% diameter narrowing) and degree of coronary atherosclerosis (Gensini score and SYNTAX score) were determined. The status of glycemic control was assessed by blood concentration of glycated hemoglobin (HbA1c). Results The prevalence of significant coronary artery stenosis (67.9% vs. 37.0%, P = 0.002) and degree of coronary atherosclerosis (Gensini score: 48.99 ± 48.88 vs. 15.07 ± 21.03, P < 0.001; SYNTAX score: 15.88 ± 16.36 vs. 7.28 ± 10.54, P = 0.003) were higher and FMD was lower (6.03 ± 2.08% vs. 6.94 ± 2.20%, P = 0.036) in diabetic patients with poor glycemic control (HbA1c ≥ 7.0%; n = 56) compared to those with good glycemic control (HbA1c < 7.0%; n = 46). Multivariate regression analysis revealed that tertile of FMD was an independent determinant of presence of significant coronary artery stenosis (OR = 0.227 95% CI 0.056–0.915, P = 0.037), Gensini score (β = − 0.470, P < 0.001) and SYNTAX score (β = − 0.349, P = 0.004) in diabetic patients with poor glycemic control but not for those with good glycemic control (P > 0.05). Conclusion Poor glycemic control negatively influences the association of endothelial dysfunction and coronary artery disease in T2DM patients.
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Affiliation(s)
- Shuai Chen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Ying Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Yong-Hua Liu
- Department of Cardiology, Bao Shan People's Hospital, Baoshan, Yunnan Province, China
| | - Yang Dai
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Zhi-Ming Wu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Xiao-Qun Wang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Chen-Die Yang
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Le-Ying Li
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Jing-Meng Liu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Li-Ping Zhang
- Department of Cardiology, Bao Shan People's Hospital, Baoshan, Yunnan Province, China
| | - Wei-Feng Shen
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China
| | - Ri Ji
- Department of Ultrasound, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Lin Lu
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China.
| | - Feng-Hua Ding
- Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin Road II, Shanghai, 200025, People's Republic of China.
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Genome-Wide Detection of m 6A-Associated Genetic Polymorphisms Associated with Ischemic Stroke. J Mol Neurosci 2021; 71:2107-2115. [PMID: 33580473 DOI: 10.1007/s12031-021-01805-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 01/28/2021] [Indexed: 12/16/2022]
Abstract
N6-Methyladenosine (m6A) methylation is the most abundant post-transcription modification in eukaryotes and plays a vital role in many pathological conditions including cerebral ischemia-reperfusion injury and vascular inflammation. Moreover, recent studies have reported that single-nucleotide polymorphisms (SNPs) can affect the m6A modification. Therefore, we investigated the relationship between m6A-SNPs and ischemic stroke (IS) risk through integrative analysis of an IS genome-wide association study and m6A-SNP list from the m6AVar database. Next, we performed eQTL and differential expression analysis to support these IS-associated m6A-SNPs. Finally, using the identified polymorphisms, a PPI network was constructed using the STRING database, and GO and pathway enrichment analyses were performed using the DAVID online tool. Accordingly, we identified 305 IS-associated SNPs that could affect m6A methylation. Next, 158 of these SNPs were determined to have eQTL signals on local genes. We further identified 84 local genes (containing a total of 87 SNPs) that were differentially expressed in IS patients. Finally, we identified several biological processes and pathways related to IS pathogenesis, such as "leukocyte migration" and "focal adhesion." In summary, our study detected dozens of m6A-SNPs as critical functional polymorphisms and novel genetic biomarkers for IS susceptibility and provided a new means of elucidating the biological mechanism underlying IS development.
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Filgueira TO, Castoldi A, Santos LER, de Amorim GJ, de Sousa Fernandes MS, Anastácio WDLDN, Campos EZ, Santos TM, Souto FO. The Relevance of a Physical Active Lifestyle and Physical Fitness on Immune Defense: Mitigating Disease Burden, With Focus on COVID-19 Consequences. Front Immunol 2021; 12:587146. [PMID: 33613573 PMCID: PMC7892446 DOI: 10.3389/fimmu.2021.587146] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/13/2021] [Indexed: 12/15/2022] Open
Abstract
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a fast spreading virus leading to the development of Coronavirus Disease-2019 (COVID-19). Severe and critical cases are characterized by damage to the respiratory system, endothelial inflammation, and multiple organ failure triggered by an excessive production of proinflammatory cytokines, culminating in the high number of deaths all over the world. Sedentarism induces worse, continuous, and progressive consequences to health. On the other hand, physical activity provides benefits to health and improves low-grade systemic inflammation. The aim of this review is to elucidate the effects of physical activity in physical fitness, immune defense, and its contribution to mitigate the severe inflammatory response mediated by SARS-CoV-2. Physical exercise is an effective therapeutic strategy to mitigate the consequences of SARS-CoV-2 infection. In this sense, studies have shown that acute physical exercise induces the production of myokines that are secreted in tissues and into the bloodstream, supporting its systemic modulatory effect. Therefore, maintaining physical activity influence balance the immune system and increases immune vigilance, and also might promote potent effects against the consequences of infectious diseases and chronic diseases associated with the development of severe forms of COVID-19. Protocols to maintain exercise practice are suggested and have been strongly established, such as home-based exercise (HBE) and outdoor-based exercise (OBE). In this regard, HBE might help to reduce levels of physical inactivity, bed rest, and sitting time, impacting on adherence to physical activity, promoting all the benefits related to exercise, and attracting patients in different stages of treatment for COVID-19. In parallel, OBE must improve health, but also prevent and mitigate COVID-19 severe outcomes in all populations. In conclusion, HBE or OBE models can be a potent strategy to mitigate the progress of infection, and a coadjutant therapy for COVID-19 at all ages and different chronic conditions.
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Affiliation(s)
| | - Angela Castoldi
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
| | - Lucas Eduardo R. Santos
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
- Pós Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Recife, Brazil
| | - Geraldo José de Amorim
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
- Serviço de Nefrologia do Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Brazil
| | - Matheus Santos de Sousa Fernandes
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
- Pós Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | - Tony Meireles Santos
- Pós Graduação em Educação Física, Universidade Federal de Pernambuco, Recife, Brazil
| | - Fabrício Oliveira Souto
- Keizo Asami Immunopathology Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
- Núcleo de Ciências da Vida, Centro Acadêmico do Agreste, Universidade Federal de Pernambuco, Caruaru, Brazil
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Blacher J, Gabet A, Vallée A, Ferrières J, Bruckert E, Farnier M, Olié V. Prevalence and management of hypercholesterolemia in France, the Esteban observational study. Medicine (Baltimore) 2020; 99:e23445. [PMID: 33327276 PMCID: PMC7738064 DOI: 10.1097/md.0000000000023445] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Hypercholesterolemia is a major risk factor for cardiovascular diseases. However, its management in everyday clinical practice is often suboptimal. The aims of the Esteban study were to estimate the prevalence of hypercholesterolemia and to describe its management in France in 2015.Esteban is a cross-sectional, publicly funded survey, representative of the French population. Data were collected using questionnaires and biological and clinical examinations in 3021 adults aged 18-74.The lipid-lowering treatments were obtained by matching the individual data of the subjects included in the Esteban survey with data from the Système national de données de santé. Hypercholesterolemia was defined as either a low density lipoprotein cholesterol value higher than the goal set in the European Society of Cardiology/European Atherosclerosis Society guidelines as a function of individual cardiovascular risk level, or at least 1 delivery of lipid-lowering treatment. Adherence was defined by the proportion of days covered by the lipid-lowering treatment in the 6 months preceding clinical examination. Prevalence of hypercholesterolemia in France was 23.3% (27.8% in men, 19.0% in women). Mean low density lipoprotein cholesterol was 3.38 mmol/l in French participants. Among them, 7.2% were treated (8.5% of men, 5.8% of women), while 16.1% of adults went untreated (19.3% of men, 13.2% of women). Only 29.7% of secondary prevention adults had a delivery of lipid-lowering treatments in the 6 months preceding clinical examination. Fewer than 1 in 3 treated adults were adherent, i.e. more than 80% of days covered by a treatment. This proportion reached 37.4% in the high-risk group, with no significant difference of adherence in people with or without a personal history of cardiovascular disease in this group.This study showed that hypercholesterolemia is a common metabolic disease in France, affecting 23.3% of the population. Lipid-lowering prescriptions diverged greatly from current recommendations, with less than a third of eligible patients being treated.
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Affiliation(s)
- Jacques Blacher
- Diagnosis and Therapeutic Center, Hotel Dieu; AP-HP; University Paris Descartes, Paris
| | | | - Alexandre Vallée
- Diagnosis and Therapeutic Center, Hotel Dieu; AP-HP; University Paris Descartes, Paris
| | - Jean Ferrières
- Cardiology Department; INSERM UMR 1027; Toulouse University Hospital; 30159 Toulouse
| | - Eric Bruckert
- Endocrinology, metabolism and cardiovascular prevention; E3 M Institut and cardiometabolic IHU (ICAN) Pitié Salpêtrière hospital, Paris
| | - Michel Farnier
- Point Médical and Cardiology Department, CHU Dijon-Bourgogne, Dijon, France
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Di Raimondo D, Rizzo G, Musiari G, Tuttolomondo A, Pinto A. Role of Regular Physical Activity in Neuroprotection against Acute Ischemia. Int J Mol Sci 2020; 21:ijms21239086. [PMID: 33260365 PMCID: PMC7731306 DOI: 10.3390/ijms21239086] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 12/12/2022] Open
Abstract
One of the major obstacles that prevents an effective therapeutic intervention against ischemic stroke is the lack of neuroprotective agents able to reduce neuronal damage; this results in frequent evolution towards a long-term disability with limited alternatives available to aid in recovery. Nevertheless, various treatment options have shown clinical efficacy. Neurotrophins such as brain-derived neurotrophic factor (BDNF), widely produced throughout the brain, but also in distant tissues such as the muscle, have demonstrated regenerative properties with the potential to restore damaged neural tissue. Neurotrophins play a significant role in both protection and recovery of function following neurological diseases such as ischemic stroke or traumatic brain injury. Unfortunately, the efficacy of exogenous administration of these neurotrophins is limited by rapid degradation with subsequent poor half-life and a lack of blood-brain-barrier permeability. Regular exercise seems to be a therapeutic approach able to induce the activation of several pathways related to the neurotrophins release. Exercise, furthermore, reduces the infarct volume in the ischemic brain and ameliorates motor function in animal models increasing astrocyte proliferation, inducing angiogenesis and reducing neuronal apoptosis and oxidative stress. One of the most critical issues is to identify the relationship between neurotrophins and myokines, newly discovered skeletal muscle-derived factors released during and after exercise able to exert several biological functions. Various myokines (e.g., Insulin-Like Growth Factor 1, Irisin) have recently shown their ability to protects against neuronal injury in cerebral ischemia models, suggesting that these substances may influence the degree of neuronal damage in part via inhibiting inflammatory signaling pathways. The aim of this narrative review is to examine the main experimental data available to date on the neuroprotective and anti-ischemic role of regular exercise, analyzing also the possible role played by neurotrophins and myokines.
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Zhang N, Zhang L, Wang Q, Zhao J, Liu J, Wang G. Cerebrovascular risk factors associated with ischemic stroke in a young non-diabetic and non-hypertensive population: a retrospective case-control study. BMC Neurol 2020; 20:424. [PMID: 33225904 PMCID: PMC7681954 DOI: 10.1186/s12883-020-02005-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/17/2020] [Indexed: 02/08/2023] Open
Abstract
Background Globally, rates of ischemic stroke (IS) have been rising among young adults. This study was designed to identify risk factors associated with IS incidence in young adults unaffected by hypertension or diabetes. Methods This was a retrospective case-control study of early-onset IS patients without diabetes and hypertension. Control patients were matched with healthy individuals based upon sex, age (±2 years), and BMI (±3 kg/m2) at a 1:3 ratio. Sociodemographic, clinical, and risk factor-related data pertaining to these patients was collected. The association between these risk factors and IS incidence was then assessed using conditional logistic regression models. Results We recruited 60 IS patients and 180 controls with mean ages of 44.37 ± 4.68 and 44.31 ± 4.71 years, respectively, for this study. Relative to controls, IS patients had significantly higher total cholesterol (TG), homocysteine (HCY), white blood cell (WBC), absolute neutrophil count (ANC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) levels, and significantly lower high-density lipoprotein cholesterol (HDL-C) and triglyceride cholesterol (TC), free triiodothyronine (FT3), and free thyroxine (FT4) levels (all P < 0.05). After controlling for potential confounding factors, HCY and ANC were found to be significantly positively associated with IS incidence (OR 1.518, 95%CI 1.165–1.977, P = 0.002 and OR 2.418, 95%CI 1.061–5.511, P = 0.036, respectively), whereas HDL-C and FT3 levels were negatively correlated with IS incidence (OR 0.001, 95%CI 0.000–0.083, P = 0.003 and OR 0.053, 95%CI 0.008–0.326, P = 0.002, respectively). Conclusions In young non-diabetic and non-hypertensive patients, lower HDL-C and FT3 levels and higher HCY and ANC levels may be associated with an elevated risk of IS. Additional prospective studies of large patient cohorts will be essential to validate these findings.
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Affiliation(s)
- Nan Zhang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Lin Zhang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Qiu Wang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jingwei Zhao
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China
| | - Jia Liu
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China.
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, China.
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Lin K, Chen L, Wang Y, Xu Y, Wang G, Li H, Pan Y, Ma L, He S. Endovascular treatment of cerebrovascular stenosis with stent for patients with ischemic cerebrovascular disease. Medicine (Baltimore) 2020; 99:e23313. [PMID: 33217866 PMCID: PMC7676544 DOI: 10.1097/md.0000000000023313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate the therapeutic effect of cerebrovascular stent implantation in southwest Chinese patients with ischemic cerebrovascular disease and underlying risk factors for stent restenosis.We made a retrospectively analysis of occurring risk, cerebrovascular lesion, stent implantation, complication treatment, and prognosis of 54 patients with ischemic cerebrovascular disease in our department.A total of 85 stents were implanted into 54 patients, involving 44 of the internal carotid artery system, 34 of the vertebral-basal artery system and 7 of the subclavian artery system. All patients with stenosis were reduced by >70%, with all stenosis complete reduction in 5 (9%) patients and reduction of over 90% in 25 (46%) patients. A total of 50 patients were followed up for 28.5 (21-35) months. The stents in 42 patients exhibited satisfactory shape and location while restenosis occurred in 8 patients. Univariate analysis revealed that hyperlipidemia, hyperuricemia, surgery duration, and total length of hospital stay are significantly correlated with stent restenosis, and hyperlipidemia and hyperuricemia were proven to be independent risk factors for restenosis using logistic regression analysis.Cerebrovascular stent implantation and balloon inflation surgery can assist in abating angiostenosis and improving blood supplement effectively in patients with ischemic cerebrovascular disease. Besides, an overall evaluation, strict care, and regular check-up in perioperative period may reduce the occurrence of complications. Finally, several clinical parameters may need to be highly focused on in surgery for better prognosis.
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Affiliation(s)
- Kailong Lin
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Liusheng Chen
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Yang Wang
- Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University
| | - Yeqiang Xu
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Guanliang Wang
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Hongfang Li
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Yicheng Pan
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Lichun Ma
- Department of neurology, The 75th Group Army Hospital of People's Liberation Army of China, Dali, Yunnan
| | - Siyi He
- Department of cardiovascular surgery, General Hospital of Western Theater Command, Chengdu, Sichuan, China
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Ryu CS, Bae J, Kim IJ, Kim J, Oh SH, Kim OJ, Kim NK. MPG and NPRL3 Polymorphisms are Associated with Ischemic Stroke Susceptibility and Post-Stroke Mortality. Diagnostics (Basel) 2020; 10:diagnostics10110947. [PMID: 33202874 PMCID: PMC7696846 DOI: 10.3390/diagnostics10110947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/16/2020] [Accepted: 11/12/2020] [Indexed: 01/04/2023] Open
Abstract
Ischemic stroke is a complicated disease which is affected by environmental factors and genetic factors. In this field, various studies using whole-exome sequencing (WES) have focused on novel and linkage variants in diverse diseases. Thus, we have investigated the various novel variants, which focused on their linkages to each other, in ischemic stroke. Specifically, we analyzed the N-methylpurine DNA glycosylase (MPG) gene, which plays an initiating role in DNA repair, and the nitrogen permease regulator-like 3 (NPRL3) gene, which is involved in regulating the mammalian target of rapamycin pathway. We took blood samples of 519 ischemic stroke patients and 417 controls. Genetic polymorphisms were detected by polymerase chain reaction (PCR), real-time PCR, and restriction fragment length polymorphism (RFLP) analysis. We found that two NPRL3 polymorphisms (rs2541618 C>T and rs75187722 G>A), as well as the MPG rs2562162 C>T polymorphism, were significantly associated with ischemic stroke. In Cox proportional hazard regression models, the MPG rs2562162 was associated with the survival of small-vessel disease patients in ischemic stroke. Our study showed that NPRL3 and MPG polymorphisms are associated with ischemic stroke prevalence and ischemic stroke survival. Taken together, these findings suggest that NPRL3 and MPG genotypes may be useful clinical biomarkers for ischemic stroke development and prognosis.
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Affiliation(s)
- Chang Soo Ryu
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea;
| | - Jinkun Bae
- Department of Emergency Medicine, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Korea;
| | - In Jai Kim
- Department of Internal Medicine, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Korea;
| | - Jinkwon Kim
- Department of Neurology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Korea; (J.K.); (S.H.O.)
| | - Seung Hun Oh
- Department of Neurology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Korea; (J.K.); (S.H.O.)
| | - Ok Joon Kim
- Department of Neurology, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam 13496, Korea; (J.K.); (S.H.O.)
- Correspondence: (O.J.K.); (N.K.K.)
| | - Nam Keun Kim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea;
- Correspondence: (O.J.K.); (N.K.K.)
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Giordano M, Trotta MC, Ciarambino T, D’Amico M, Galdiero M, Schettini F, Paternosto D, Salzillo M, Alfano R, Andreone V, Malatino LS, Biolo G, Paolisso G, Adinolfi LE. Circulating MiRNA-195-5p and -451a in Diabetic Patients with Transient and Acute Ischemic Stroke in the Emergency Department. Int J Mol Sci 2020; 21:E7615. [PMID: 33076256 PMCID: PMC7593949 DOI: 10.3390/ijms21207615] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 12/18/2022] Open
Abstract
(1) Background: Circulating micro-RNAs (miRNAs) modulate the expression of molecules in diabetes. We evaluated the expression of serum miRNA-195-5p and -451a in diabetic patients with ischemic stroke and correlated them with two markers of brain tissue integrity. (2) Methods: Seventy-eight subjects with acute ischemic stroke (AIS) or transient ischemic attack (TIA) (40 with diabetes) were enrolled. Serum miRNA levels, brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor A (VEGF-A) were assessed at admission and 24 and 72 h after a post-ischemic stroke, and were compared to 20 controls. (3) Results: Both circulating miRNAs were two-fold up-regulated in diabetic AIS and TIA patients compared to non-diabetics. Their levels progressively decreased at 24 and 72 h in both AIS and TIA patients. Interestingly, in the non-diabetic TIA group, both circulating miRNAs, although higher than the controls, tended to achieve a complete decay after 72 h. Furthermore, miRNA-195-5p and miRNA-451a levels inversely correlated with both BDNF and VEGF-A serum levels. (4) Conclusions: These data show a different profile of both micro-RNAs in diabetic versus non-diabetic patients after acute ischemic stroke, suggesting their pivotal role in cerebrovascular ischemic attack.
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Affiliation(s)
- Mauro Giordano
- Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.G.); (F.S.); (G.P.); (L.E.A.)
| | - Maria Consiglia Trotta
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.G.); (R.A.)
| | - Tiziana Ciarambino
- Department of Internal Medicine, Hospital of Marcianise, ASL, 81025 Caserta, Italy;
| | - Michele D’Amico
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.G.); (R.A.)
| | - Marilena Galdiero
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.G.); (R.A.)
| | - Federico Schettini
- Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.G.); (F.S.); (G.P.); (L.E.A.)
| | - Diego Paternosto
- Department of Emergency Medicine, AORN Sant’Anna e San Sebastiano,81100 Caserta, Italy; (D.P.); (M.S.); (V.A.)
| | - Marta Salzillo
- Department of Emergency Medicine, AORN Sant’Anna e San Sebastiano,81100 Caserta, Italy; (D.P.); (M.S.); (V.A.)
| | - Roberto Alfano
- Department of Experimental Medicine, Division of Pharmacology, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.C.T.); (M.G.); (R.A.)
| | - Vincenzo Andreone
- Department of Emergency Medicine, AORN Sant’Anna e San Sebastiano,81100 Caserta, Italy; (D.P.); (M.S.); (V.A.)
| | | | - Gianni Biolo
- Department of Medical and Surgical Sciences, University of Trieste, 34100 Trieste, Italy;
| | - Giuseppe Paolisso
- Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.G.); (F.S.); (G.P.); (L.E.A.)
| | - Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.G.); (F.S.); (G.P.); (L.E.A.)
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Di Raimondo D, Musiari G, Benfante A, Battaglia S, Rizzo G, Tuttolomondo A, Scichilone N, Pinto A. Prevalence of Arterial Hypertension and Characteristics of Nocturnal Blood Pressure Profile of Asthma Patients According to Therapy and Severity of the Disease: The BADA Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186925. [PMID: 32971927 PMCID: PMC7557609 DOI: 10.3390/ijerph17186925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND several studies report an increased risk for asthmatic subjects to develop arterial hypertension and the relationship between these two diseases, frequently co-existing, still has some unclear aspects. METHODS The BADA (blood pressure levels, clinical features and markers of subclinical cardiovascular damage of asthma patients) study is aimed to evaluate the prevalence of the cardiovascular comorbidities of asthma and their impact on the clinical outcome. The main exclusion criteria were the presence of other respiratory diseases, current smoking, any contraindication to ambulatory blood pressure monitoring (ABPM). RESULTS The overall percentage of asthmatics having also hypertension was 75% (30 patients) vs. 45% (18 patients) of the control group (p: 0.012). Reduced level of FEV1 (but not inhaled steroid therapy) was associated to newly-diagnosed hypertension (p: 0.0002), higher day SBP levels (p: 0.003), higher day DBP levels (p: 0.03), higher 24 h-SBP levels (p: 0.005) and higher 24h-DBP levels (p: 0.03). The regression analysis performed taking into account sex, age, diabetes, fasting glucose, and body mass index confirms the independent role played by asthma: odds ratio (OR): 3.66 (CI: 1.29-11.1). CONCLUSIONS hypertension is highly prevalent in asthma; the use of ABPM has allowed the detection of a considerable number of unrecognized hypertensives.
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Affiliation(s)
- Domenico Di Raimondo
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (G.M.); (G.R.); (A.T.); (A.P.)
- Correspondence: ; Tel.: +39-091-655-2180
| | - Gaia Musiari
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (G.M.); (G.R.); (A.T.); (A.P.)
| | - Alida Benfante
- Division of Respiratory Diseases, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (A.B.); (S.B.); (N.S.)
| | - Salvatore Battaglia
- Division of Respiratory Diseases, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (A.B.); (S.B.); (N.S.)
| | - Giuliana Rizzo
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (G.M.); (G.R.); (A.T.); (A.P.)
| | - Antonino Tuttolomondo
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (G.M.); (G.R.); (A.T.); (A.P.)
| | - Nicola Scichilone
- Division of Respiratory Diseases, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (A.B.); (S.B.); (N.S.)
| | - Antonio Pinto
- Division of Internal Medicine and Stroke Care, Department of Promoting Health, Maternal-Infant, Excellence and Internal and Specialized Medicine (Promise) G. D’Alessandro, University of Palermo, 90133 Palermo, Italy; (G.M.); (G.R.); (A.T.); (A.P.)
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Wang J, Li J, Li M, Hou L, Zhu P, Du X, Zhou M, Zhu C. Association between dynamic obesity and mortality in patients with first-ever ischemic stroke: A hospital-based prospective study. Medicine (Baltimore) 2020; 99:e22243. [PMID: 32957370 PMCID: PMC7505300 DOI: 10.1097/md.0000000000022243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/08/2020] [Accepted: 08/18/2020] [Indexed: 02/05/2023] Open
Abstract
Although obesity is an established risk factor of primary stroke, the association between obesity and post-stroke mortality remains unclear. The aim of this study was to investigate the association between dynamic obesity status and mortality in survivors of their first stroke in China.Of 775 patients with first-ever ischemic stroke included in a longitudinal study, 754 patients were included in this study and categorized into 4 categories of body mass index (BMI) (underweight, normal weight, overweight, and obese) and 2 categories of waist circumference (WC) (normal WC and abdominal obesity) according to standard Chinese criteria. The mortality information and obesity status were obtained via telephone follow-up every 3 months, beginning in 2010 through 2016. Time-dependent Cox proportional hazards models were used to estimate the unadjusted and adjusted hazard ratios (HRs) for the relationship between all-cause mortality and dynamic obesity status.Of 754 patients, 60.87% were male, and the overall mean age was 61.45 years. After adjusting for possible confounders, significant inverse associations were identified between BMI and WC and all-cause mortality. Compared with those with normal BMI or WC, those with abdominal obesity or overweight had a significantly lower risk of all-cause mortality (HR and 95% confidence intervals [CIs]: .521 [.303-.897] and 0.545 [.352-.845], respectively), whereas patients with underweight had the highest risk and those with obesity had lower risk of mortality, though it was not statistically significant (1.241 [.691-2.226] and .486 [.192-1.231], respectively).Overweight and abdominal obesity were paradoxically associated with reduced risk of mortality in patients who survived their first-ever ischemic stroke in China. Future prospective studies must look at evaluating the role of obesity in different stroke subtypes and devise appropriate weight-management strategies for optimal prognoses in secondary prevention in these survivors.
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Affiliation(s)
- Ju Wang
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing
| | - Jijie Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
- Institution of West China Second University Hospital, Sichuan University
| | - Mier Li
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
| | - Lisha Hou
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
| | - Ping Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
| | - Xudong Du
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
| | - Muke Zhou
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Cairong Zhu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan
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Alizaei Yousefabadi H, Niyazi A, Alaee S, Fathi M, Mohammad Rahimi GR. Anti-Inflammatory Effects of Exercise on Metabolic Syndrome Patients: A Systematic Review and Meta-Analysis. Biol Res Nurs 2020; 23:280-292. [PMID: 32938197 DOI: 10.1177/1099800420958068] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Increments in inflammatory indicators and low levels of physical activity are correlated to the expansion of the metabolic syndrome (MetS). OBJECTIVE The purpose of this study was to establish if exercise training ameliorates inflammatory status in MetS patients. DATA SOURCES PubMed, CINAHL, and Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched. STUDY SELECTION Twenty randomized controlled trials (RCTs) of exercise-training impact on inflammatory markers (tumor necrosis factor (TNF) α, C-reactive protein (CRP), interleukin (IL) 6, IL-8, IL-10, and IL-18) with concurrent control groups were included in this analysis. RESULTS Results demonstrated an overall significant decrease in serum levels of TNF-α (mean difference (MD): -1.21 pg/ml; 95% confidence interval (CI): -1.77, -0.66), CRP (MD: -0.52 mg/l; 95% CI: -0.79, -0.25), IL-8 (MD: -1.31 pg/ml; 95% CI: -2.57, -0.06), and a significant increase in IL-10 (MD: 0.48 pg/ml; 95% CI: 0.10, 0.86). But exercise training did not change the level of IL-6 (MD: -0.69 pg/ml; 95% CI: -1.53, 0.14) and IL-18 (MD: -53.01 pg/ml; 95% CI: -166.64, 60.62). CONCLUSION Exercise training improves TNF-α, CRP, IL-8, and IL-10 levels in patients with MetS. For some variables, isolated aerobic exercise, and combined aerobic and resistance exercise appears to be optimal. Future research is needed to clarify the mechanisms underlying exercise training's effect on this population's inflammatory markers. More studies are required to confirm these findings.
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Affiliation(s)
| | | | - Sahar Alaee
- Department of Physical Education, 201566Neyshabour Branch, Islamic Azad University, Neyshabour, Iran
| | - Mehrdad Fathi
- Department of Exercise Physiology, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
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Lavados PM, Mazzon E, Rojo A, Brunser AM, Olavarría VV. Pre-stroke adherence to a Mediterranean diet pattern is associated with lower acute ischemic stroke severity: a cross-sectional analysis of a prospective hospital-register study. BMC Neurol 2020; 20:252. [PMID: 32576150 PMCID: PMC7310482 DOI: 10.1186/s12883-020-01824-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 06/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background High adherence to a Mediterranean Diet is associated with reduced incidence and mortality of acute ischemic stroke (AIS) but may also be associated with severity. Our purpose was to investigate the association of adherence to a Mediterranean diet and severity in a prospective hospital register of AIS patients. Methods We included AIS patients admitted from February 2017 to July 2019. All were assessed by a neurologist with a standard stroke protocol, including NIHSS. Adherence to Mediterranean diet was prospectively measured by the 14-point Mediterranean Diet Adherence Screener (MEDAS) and defined as low (0–6 points) or high (7–14 points). Demographic and clinical characteristics were compared by group with univariate analysis. A Generalized Linear Model (GLM) was used to investigate the association of admission NIHSS as a continuous ordinal variable and an ordinal logistic regression (OLR) analysis to determine the independent association of the NIHSS quartiles with adherence to Mediterranean diet. Results Three hundred sixty-eight patients were included, mean age 68.3 (17.7), 158 (42.9%) females. The median NIHSS score was 3 (IQR 1–9) and the median MEDAS score was 6 (IQR 4.5–8). Patients with high MEDAS scores had significantly lower; admission NIHSS scores, sedentary lifestyle, body mass index, total and LDL cholesterol levels, but higher alcohol consumption. After adjustments, high adherence to Mediterranean diet remained independently associated with lower stroke severity both in the GLM (β coefficient = − 0.19, p = 0.01) and in the OLR model (OR for lower NIHSS quartiles 0.6 (95% CI 0.37–0.98, p = 0.04). Conclusions Higher pre-stroke adherence to a Mediterranean diet is independently associated with lower AIS severity.
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Affiliation(s)
- Pablo M Lavados
- Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Unidad de Neurología Vascular, Servicio de Neurología, Santiago, Chile
| | - Enrico Mazzon
- Departamento de Neurología y Psiquiatría y Departamento de Paciente Critico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Unidad de Neurología Vascular, Servicio de Neurología, Avenida Vitacura 5951, Vitacura, 7650568, Santiago, Chile
| | - Alexis Rojo
- Servicio de Neurología, Hospital Clínico Herminda Martin de Chillán, Servicio de Salud Ñuble, Chillán, Chile
| | - Alejandro M Brunser
- Departamento de Neurología y Psiquiatría y Departamento de Urgencia, Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Clínica Alemana, Unidad de Neurología Vascular, Servicio de Neurología, Santiago, Chile
| | - Verónica V Olavarría
- Departamento de Neurología y Psiquiatría y Departamento de Paciente Critico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Unidad de Neurología Vascular, Servicio de Neurología, Avenida Vitacura 5951, Vitacura, 7650568, Santiago, Chile.
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Alfieri DF, Lehmann MF, Flauzino T, de Araújo MCM, Pivoto N, Tirolla RM, Simão ANC, Maes M, Reiche EMV. Immune-Inflammatory, Metabolic, Oxidative, and Nitrosative Stress Biomarkers Predict Acute Ischemic Stroke and Short-Term Outcome. Neurotox Res 2020; 38:330-343. [PMID: 32415527 DOI: 10.1007/s12640-020-00221-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/15/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
Immune-inflammatory, metabolic, oxidative, and nitrosative stress (IMO&NS) pathways and, consequently, neurotoxicity are involved in acute ischemic stroke (IS). The simultaneous assessment of multiple IMO&NS biomarkers may be useful to predict IS and its prognosis. The aim of this study was to identify the IMO&NS biomarkers, which predict short-term IS outcome. The study included 176 IS patients and 176 healthy controls. Modified Rankin scale (mRS) was applied within 8 h after IS (baseline) and 3 months later (endpoint). Blood samples were obtained within 24 h after hospital admission. IS was associated with increased white blood cell (WBC) counts, high sensitivity C-reactive protein (hsCRP), interleukin (IL-6), lipid hydroperoxides (LOOHs), nitric oxide metabolites (NOx), homocysteine, ferritin, erythrocyte sedimentation rate (ESR), glucose, insulin, and lowered iron, 25-hydroxyvitamin D [25(OH)D], total cholesterol, and high-density lipoprotein (HDL) cholesterol. We found that 89.4% of the IS patients may be correctly classified using the cumulative effects of male sex, systolic blood pressure (SBP), glucose, NOx, LOOH, 25(OH)D, IL-6, and WBC with sensitivity of 86.2% and specificity of 93.0%. Moreover, increased baseline disability (mRS ≥ 3) was associated with increased ferritin, IL-6, hsCRP, WBC, ESR, and glucose. We found that 25.0% of the variance in the 3-month endpoint (mRS) was explained by the regression on glucose, ESR, age (all positively), and HDL-cholesterol, and 25(OH)D (both negatively). These results show that the cumulative effects of IMO&NS biomarkers are associated with IS and predict a poor outcome at 3-month follow-up.
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Affiliation(s)
- Daniela Frizon Alfieri
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Marcio Francisco Lehmann
- Department of Clinical Surgery, Health Sciences Center, Neurosurgery Service of the University Hospital, State University of Londrina, Londrina, Paraná, Brazil
| | - Tamires Flauzino
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Nicolas Pivoto
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Rafaele Maria Tirolla
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Andrea Name Colado Simão
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, 86.038-440, Brazil
| | - Michael Maes
- Department Psychiatry, Chulalongkorn University, Bangkok, Thailand
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Edna Maria Vissoci Reiche
- Laboratory of Research in Applied Immunology, Health Sciences Center, State University of Londrina, Londrina, Paraná, Brazil.
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, State University of Londrina, Av. Robert Koch, 60, Londrina, Paraná, 86.038-440, Brazil.
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Farbod M, Eizadi M, Rashidi M, Mirakhori Z. Effects of Aerobic Training With No Caloric Restriction on Serum Resistin and Lipid Profile in Inactive Overweight Women. INTERNATIONAL JOURNAL OF BASIC SCIENCE IN MEDICINE 2020. [DOI: 10.34172/ijbsm.2020.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Obesity is a major risk factor for inflammation and cardiovascular diseases. We tried to assess whether 12 weeks of aerobic exercises affect serum resistin level and lipid profile in overweight females or not. Methods: For this purpose, 32 non-trained adult females with the mean age of 38 ± 7 years old and body mass index (BMI) of 32 ± 3 kg/m2 were randomly assigned to aerobic exercise (n=16) and control (n=16) groups. Twelve weeks of aerobic exercise program including 3 sessions weekly at 60-75% of maximum heart rate was considered. Fasting serum resistin level, lipid profile (total cholesterol [TC], low-density lipoprotein [LDL] and high-density lipoprotein [HDL] cholesterol, and triglyceride [TG]), and anthropometric indexes were measured and compared between the two groups before and after training. Results: Serum resistin, lipid profile markers, and anthropometrical indexes were not significantly different at baseline between the two groups (P>0.05). TG, TC, LDL, and serum resistin did not change significantly after the intervention in the exercise group (P>0.05). However, a significant increase in HDL (exercise: 46.3 ± 9.6 vs. 51.4 ± 8.5, P=0.011; control: 45.8 ± 7.9 vs. 46.8 ± 6.9 P=0.326) and a significant decrease in LDL/HDL ratio (exercise: 2.94 ± 0.12 vs. 2.47 ± 0.19, P=0.019; control: 3.14 ± 0.23 vs. 3.18 ± 0.63, P=0.265) were observed after the intervention. Other variables in the control group remained unchanged. Conclusion: Aerobic exercises had no impacts on the inflammatory profile but could improve lipid profile with an emphasis on HDL in adult obese women.
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Affiliation(s)
- Maryam Farbod
- Master of Science, Department of Physical Education and Sports Sciences, Parand Branch, Islamic Azad University, Tehran, Iran
| | - Mojtaba Eizadi
- Assistant Professor, Department of Exercise Physiology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Mohammad Rashidi
- Assistant Professor, Department of Exercise Physiology, Semnan Branch, Islamic Azad University, Semnan, Iran
| | - Zahra Mirakhori
- Assistant Professor, Department of Physical Education and Sport Sciences, Amirkabir University of Technology, Tehran, Iran
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Ninomiya I, Kanazawa M, Uemura M, Onodera O. Elevated serum pentraxin 3 levels might predict the diagnosis of branch atheromatous disease at a very early stage. Eur J Neurol 2020; 27:1279-1284. [PMID: 32250504 DOI: 10.1111/ene.14249] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Branch atheromatous disease (BAD) is one of the stroke subtypes caused by occlusion at the origin of a deep penetrating artery of the brain and is associated with a microatheroma or a junctional plaque. Patients with BAD often develop progressive worsening of neurologic deficits, although these patients often present minor stroke with clinical characteristics of lacunar syndrome at the onset. Pentraxin 3 (PTX3) is known to be a key molecule involved in the pathogenesis of atherosclerosis. Although a high level of serum PTX3 is observed in patients with acute coronary syndrome, there are no reports on PTX3 levels in patients with BAD. This study aimed to investigate whether serum PTX3 levels can distinguish BAD from other stroke subtypes. METHODS We investigated 93 patients with ischaemic stroke. Serum PTX3 levels on admission were measured using enzyme-linked immunosorbent assay in patients with BAD and those with other stroke subtypes (each n ≥ 20). RESULTS The median PTX3 levels in patients with BAD (4840 pg/mL) were higher than those with other subtypes of stroke (3397 pg/mL in lacunar stroke, 1298 pg/mL in large-artery atherosclerosis, 1470 pg/mL in cardioaortic embolism and 1006 pg/mL in control) (all P < 0.01). CONCLUSION Our results suggest that elevated serum PTX3 levels might predict the diagnosis of BAD at a very early stage.
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Affiliation(s)
- I Ninomiya
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - M Kanazawa
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - M Uemura
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
| | - O Onodera
- Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan
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31
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Brown J, Park YJ, Lee JY, Chase TN, Koga M, Borlongan CV. Bone Marrow-Derived NCS-01 Cells Advance a Novel Cell-Based Therapy for Stroke. Int J Mol Sci 2020; 21:ijms21082845. [PMID: 32325813 PMCID: PMC7215343 DOI: 10.3390/ijms21082845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 12/14/2022] Open
Abstract
Human mesenchymal stem cells have been explored for their application in cell-based therapies targeting stroke. Identifying cell lines that stand as safe, accessible, and effective for transplantation, while optimizing dosage, timing, and method of delivery remain critical translational steps towards clinical trials. Preclinical studies using bone marrow-derived NCS-01 cells show the cells' ability to confer functional recovery in ischemic stroke. Coculturing primary rat cortical cells or human neural progenitor cells with NCS-01 cells protects against oxygen-glucose deprivation. In the rodent middle cerebral artery occlusion model, intracarotid artery administration of NCS-01 cells demonstrate greater efficacy than other mesenchymal stem cells (MSCs) at improving motor and neurological function, as well as reducing infarct volume and peri-infarct cell loss. NCS-01 cells secrete therapeutic factors, including basic fibroblast growth factor and interleukin-6, while also demonstrating a potentially novel mechanism of extending filopodia towards the site of injury. In this review, we discuss recent preclinical advancements using in vitro and in vivo ischemia models that support the transplantation of NCS-01 in human stroke trials. These results, coupled with the recommendations put forth by the consortium of Stem cell Therapeutics as an Emerging Paradigm for Stroke (STEPS), highlight a framework for conducting preclinical research with the ultimate goal of initiating clinical trials.
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Affiliation(s)
- John Brown
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, FL 33612, USA; (J.B.); (Y.J.P.); (J.-Y.L.)
| | - You Jeong Park
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, FL 33612, USA; (J.B.); (Y.J.P.); (J.-Y.L.)
| | - Jea-Young Lee
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, FL 33612, USA; (J.B.); (Y.J.P.); (J.-Y.L.)
| | - Thomas N. Chase
- KM Pharmaceutical Consulting LLC, Washington, DC 20006, USA; (T.N.C.); (M.K.)
| | - Minako Koga
- KM Pharmaceutical Consulting LLC, Washington, DC 20006, USA; (T.N.C.); (M.K.)
| | - Cesar V. Borlongan
- Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida College of Medicine, Tampa, FL 33612, USA; (J.B.); (Y.J.P.); (J.-Y.L.)
- Correspondence: ; Tel.: +1-813-974-3988
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Genc Tapar G, Elcik D, Dogan A, Altunel E, Inanc MT, Alcali B, Boylug S, Oguzhan A, Topsakal R, Ergin A, Kalay N. An investigation of the relationship between arterial aortic stiffness and coronary slow flow that was detected during coronary angiography. Echocardiography 2020; 37:528-535. [DOI: 10.1111/echo.14643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/04/2020] [Accepted: 03/08/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Deniz Elcik
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | - Ali Dogan
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | - Ebru Altunel
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | | | - Bilal Alcali
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | - Sibel Boylug
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | | | - Ramazan Topsakal
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | - Ali Ergin
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
| | - Nihat Kalay
- Department of Cardiology Erciyes University Medicine Faculty Kayseri Turkey
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Wojciechowska-Kulik A, Blus E, Kowalczyk Z, Baj Z, Majewska E. The Effect of Noninvasive Bariatric Surgery on the Levels of Certain Adipokines and Atherosclerosis Risk Factors in Patients with Metabolic Syndrome. J Am Coll Nutr 2019; 39:481-487. [DOI: 10.1080/07315724.2019.1695017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
| | - Edyta Blus
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
| | | | - Zbigniew Baj
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
| | - Ewa Majewska
- Department of Pathophysiology and Clinical Immunology, Medical University of Lodz, Lodz, Poland
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Araujo ZT, Mendonça KM, Souza BM, Santos TZ, Chaves GS, Andriolo BN, Nogueira PA. Pulmonary rehabilitation for people with chronic obstructive pulmonary disease: A protocol for an overview of Cochrane reviews. Medicine (Baltimore) 2019; 98:e17129. [PMID: 31567952 PMCID: PMC6756730 DOI: 10.1097/md.0000000000017129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 08/19/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) is an indispensable component in the nonpharmacological management of patients with chronic obstructive pulmonary disease (COPD) with significant improvements in quality of life and exercise capacity. It is strongly supported by systematic reviews (SR) as part of the treatment of these patients. However, it is not known which PR components are essential, such as duration, ideal locations, type and intensity of training, degree of supervision, adherence, cost-effectiveness challenge, and how long the program effects last. This overview aims to evaluate and describe different pulmonary rehabilitation interventions for individuals with COPD. METHODS Only systematic reviews of randomized controlled trials (RCTs) published in the Cochrane Database of Systematic Reviews will be included. The following results were analyzed: health-related quality of life, functional capacity, mortality, dyspnea, cost-effectiveness, and adverse events. The risk of bias will be assessed by the Risk of Bias in Systematic Reviews (ROBIS). The methodological quality will be analyzed through the Assessment of Multiple Systematic Reviews (AMSTAR-2). We will use the evaluations of the Classification of Recommendations, Evaluation, Development and Evaluation (GRADE) of the authors of the included systematic reviews. The screening of systematic reviews, eligibility evaluation, data extraction, methodological quality, and quality of evidence will be performed in pairs by independent reviewers. The results that have been reported in the included reviews will be summarized in an "Overview of Reviews" table. The main conclusions about the effects of the interventions studied in the included reviews will be summarized and organized in clinically meaningful categories. RESULTS The article in this overview will be submitted for publication in a peer-reviewed journal. The results will also be included in a doctoral thesis and disclosed in medical conferences. CONCLUSIONS We expect to compile evidence from multiple systematic reviews of pulmonary rehabilitation in people with COPD in an accessible and useful document. REGISTRATION NUMBER PROSPERO CRD42019111564.
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Affiliation(s)
| | - Karla M.P.P. Mendonça
- Postgraduate Course in Physiotherapy of the Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Tacito Z.M. Santos
- Laboratory of evaluation and respiratory intervention, Department of Physiotherapy
| | | | - Brenda N.G. Andriolo
- Cochrane Brazil, Center for Evidence-Based Health Studies and Technology Assessment in Health, São Paulo
| | - Patricia A.M.S. Nogueira
- Laboratory of measures and evaluation in health, Postgraduate Course in Physiotherapy of the Federal University of Rio Grande do Norte, Natal, Brazil
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Chen L, Geng L, Chen J, Yan Y, Yang L, Zhao J, Sun Q, He J, Bai L, Wang X. Effects of Urinary Kallidinogenase on NIHSS score, mRS score, and fasting glucose levels in acute ischemic stroke patients with abnormal glucose metabolism: A prospective cohort study. Medicine (Baltimore) 2019; 98:e17008. [PMID: 31464958 PMCID: PMC6736392 DOI: 10.1097/md.0000000000017008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Urinary kallidinogenase may assist recovery acute ischemic stroke. This study evaluated the effect of urinary kallidinogenase on National Institute of Health Stroke Scale (NIHSS) score, modified Rankin scale (mRS) score, and fasting glucose levels in patients with acute ischemic stroke (AIS) combined with diabetes mellitus and impaired fasting glucose.Patients with AIS and abnormal glucose metabolism were enrolled in this prospective cohort study and divided into 2 groups. The human urinary kallidinogenase (HUK) group were treated with urinary kallidinogenase and standard treatment; the control group received standard treatment. NIHSS scores, mRS scores, and fasting blood glucose were evaluated and compared.A total of 113 patients were included: 58 in the HUK group and 55 in the control group. NIHSS scores decreased with treatment in both groups (time effect P < .05), but were lower in the HUK group (main effect P = .026). The mRS score decreased in both groups from 10 until 90 days after treatment (time effect P < .05); the 2 groups were similar (main effect, P = .130). Blood glucose levels decreased in both groups 10 days after treatment (time effect, P < .05), but there was no significant treatment effect (main effect, P = .635). Multivariate analysis showed blood uric acid >420 μmol/L (odds ratio [OR]: 0.053, 95% confidence interval [CI]: 0.008-0.350; P = .002) and application of HUK (OR: 0.217, 95% CI: 0.049-0.954; P = .043) were associated with 90% NIHSS recovery. Baseline NIHSS score was independently associated with poor curative effect.Urinary kallidinogenase with conventional therapy significantly improved NIHSS scores in patients with AIS. Urinary kallidinogenase also showed a trend toward lower fasting blood glucose levels, although the level did not reach significance.
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Affiliation(s)
- Lei Chen
- Department of Neurology, The Second Hospital of Hebei Medical University
- Department of Neurology, The first hospital of Shijiazhuang, Shijiazhuang
| | - Lianxia Geng
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Junmin Chen
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Yan Yan
- Department of Neurology, Xingtai People's Hospital, Xingtai, China
| | - Lan Yang
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Jing Zhao
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Qian Sun
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Junna He
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Lin Bai
- Department of Neurology, The Second Hospital of Hebei Medical University
| | - Xiaopeng Wang
- Department of Neurology, The Second Hospital of Hebei Medical University
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Hasegawa N, Fujie S, Horii N, Uchida M, Toyama Y, Inoue K, Sanada K, Hamaoka T, Iemitsu M. Aging-induced elevation in circulating complement C1q level is associated with arterial stiffness. Exp Gerontol 2019; 124:110650. [PMID: 31279001 DOI: 10.1016/j.exger.2019.110650] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/18/2019] [Accepted: 06/30/2019] [Indexed: 10/26/2022]
Abstract
Inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) are candidate blood biomarkers of cardiovascular disease (CVD). However, no consensus has been reached on the relationships between aging-induced secretion of cytokines and CVD risk. Complement C1q (C1q) secretion increases with aging, and C1q induces proliferation of vascular smooth muscle cells. Therefore, the secretion of C1q with aging may be a risk factor of CVD and reflect arterial stiffening and blood pressures. This study aimed to clarify whether aging-induced increase in serum C1q, TNF-α, and IL-6 levels are associated with arterial stiffness. One hundred twenty-seven healthy subjects participated in this study. Serum C1q, TNF-α, and IL-6 levels and carotid-femoral pulse wave velocity (cfPWV; arterial stiffness index) in middle-aged and older subjects (≥40 years) were significantly increased as compared with those in young subjects (<40 years; P < 0.05). The serum C1q, TNF-α, and IL-6 levels positively correlated with cfPWV (P < 0.05). Furthermore, C1q level contributed independently to the cfPWV variation after adjustment for 11 confounders. Moreover, serum C1q level is associated with cfPWV regardless of sex, but these relationships with TNF-α or IL-6 differed between sex. Importantly, cfPWV gradually increased from the age of 30 years, with simultaneous increase in circulating C1q level. However, TNF-α and IL-6 levels increased after age 50 years, later than the increase in C1q. These results suggest that serum C1q level may reflect the elevation of arterial stiffness that occurs with advancing age and has a potential as a novel biomarker of arterial stiffness.
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Affiliation(s)
- Natsuki Hasegawa
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Shumpei Fujie
- Faculty of Sport and Health Sciences, University of Tsukuba, Tsukuba City, Ibaraki, Japan; Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Naoki Horii
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan; Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Masataka Uchida
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Yuta Toyama
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Kenichiro Inoue
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Kiyoshi Sanada
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan
| | - Takafumi Hamaoka
- Department of Sports Medicine for Health Promotion, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Motoyuki Iemitsu
- Faculty of Sport and Health Science, Ritsumeikan University, Kusatsu City, Shiga, Japan.
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37
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Ren L, Wang K, Shen H, Xu Y, Wang J, Chen R. Effects of continuous positive airway pressure (CPAP) therapy on neurological and functional rehabilitation in Basal Ganglia Stroke patients with obstructive sleep apnea: A prospective multicenter study. Medicine (Baltimore) 2019; 98:e16344. [PMID: 31305423 PMCID: PMC6641828 DOI: 10.1097/md.0000000000016344] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Obstructive sleep apnea (OSA) adversely affects neurological recovery. This study aimed to determine the impact of continuous positive airway pressure (CPAP) and/or rehabilitation in basal ganglia stroke patients with OSA.A prospective controlled trial was conducted in 2015-2018. The subjects received routine rehabilitation training for up to 2 years and were assigned to the intervention and control groups treated with CPAP or without, respectively. Then, treatment effects on sleep parameters, motor function, stroke severity, daily life activities, cognitive function, and psychological states were assessed at different time points.At 6 months, the CPAP group showed significantly lower mean apnea-hypopnea index (AHI), percentage of time with SpO2 at <90% (TS90%), micro-arousal index, and percentages of time in non-rapid eye movement (non-REM) stages 1-2 and REM stage in total sleeping time compared with the control group, and significantly higher mean minimum of peripheral oxygen saturation (L-SaO2%) and percentage of time in stage 3 (P < .001) sleep. The CPAP group showed significant improvements in average the National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment scale (FMA), Barthel index (BI), Minimental state examination (MMSE), Hamilton anxiety scale (HAMA) and Hamilton depression rating scale for depression (HRSD) scores at different times versus the control group, respectively (P < .05). However, no difference in body mass index (BMI) management was observed (P > .05). Repeated-measures ANOVA revealed significant interactions between the two groups for change in FMA, MMSE, BI, HAMA, and HRSD scores from admission to 24 months (P < .001), but no significant was found for BMI (P = .582).Basal ganglia stroke patients with OSA tend to have significantly greater sleeping, neurological and functional recovery after CPAP, and rehabilitation over 2 years.
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Affiliation(s)
- Lei Ren
- Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu
- Department of Respiratory Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jingan Geriatric Hospital)
| | - Kai Wang
- Department of Neurological Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jingan Geriatric Hospital), Shanghai, China
| | - Honghua Shen
- Department of Respiratory Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jingan Geriatric Hospital)
| | - Yiming Xu
- Department of Respiratory Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jingan Geriatric Hospital)
| | - Jing Wang
- Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu
| | - Rui Chen
- Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu
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Arnao V, Tuttolomondo A, Daidone M, Pinto A. Lipoproteins in Atherosclerosis Process. Curr Med Chem 2019; 26:1525-1543. [PMID: 31096892 DOI: 10.2174/0929867326666190516103953] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/17/2017] [Accepted: 12/10/2017] [Indexed: 01/15/2023]
Abstract
BACKGROUND Dyslipidaemias is a recognized risk factor for atherosclerosis, however, new evidence brought to light by trials investigating therapies to enhance HDLcholesterol have suggested an increased atherosclerotic risk when HDL-C is high. RESULTS Several studies highlight the central role in atherosclerotic disease of dysfunctional lipoproteins; oxidised LDL-cholesterol is an important feature, according to "oxidation hypothesis", of atherosclerotic lesion, however, there is today a growing interest for dysfunctional HDL-cholesterol. The target of our paper is to review the functions of modified and dysfunctional lipoproteins in atherogenesis. CONCLUSION Taking into account the central role recognized to dysfunctional lipoproteins, measurements of functional features of lipoproteins, instead of conventional routine serum evaluation of lipoproteins, could offer a valid contribution in experimental studies as in clinical practice to stratify atherosclerotic risk.
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Affiliation(s)
- Valentina Arnao
- BioNeC Dipartimento di BioMedicina Sperimentale e Neuroscienze Cliniche, Universita degli Studi di Palermo, Palermo, Italy.,PhD School of: Medicina Clinica e Scienze del Comportamento-Biomedical Department of Internal and Specialistic Medicine. (Di.Bi.M.I.S), University of Palermo, Palermo, Italy
| | - Antonino Tuttolomondo
- Internal Medicine and Stroke Care Ward, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, (PROMISE), University of Palermo, Palermo, Italy
| | - Mario Daidone
- Internal Medicine and Stroke Care Ward, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, (PROMISE), University of Palermo, Palermo, Italy
| | - Antonio Pinto
- Internal Medicine and Stroke Care Ward, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties, (PROMISE), University of Palermo, Palermo, Italy
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Yuede CM, Timson BF, Hettinger JC, Yuede KM, Edwards HM, Lawson JE, Zimmerman SD, Cirrito JR. Interactions between stress and physical activity on Alzheimer's disease pathology. Neurobiol Stress 2018; 8:158-171. [PMID: 29888311 PMCID: PMC5991353 DOI: 10.1016/j.ynstr.2018.02.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 02/20/2018] [Indexed: 12/14/2022] Open
Abstract
Physical activity and stress are both environmental modifiers of Alzheimer's disease (AD) risk. Animal studies of physical activity in AD models have largely reported positive results, however benefits are not always observed in either cognitive or pathological outcomes and inconsistencies among findings remain. Studies using forced exercise may increase stress and mitigate some of the benefit of physical activity in AD models, while voluntary exercise regimens may not achieve optimal intensity to provide robust benefit. We evaluated the findings of studies of voluntary and forced exercise regimens in AD mouse models to determine the influence of stress, or the intensity of exercise needed to outweigh the negative effects of stress on AD measures. In addition, we show that chronic physical activity in a mouse model of AD can prevent the effects of acute restraint stress on Aβ levels in the hippocampus. Stress and physical activity have many overlapping and divergent effects on the body and some of the possible mechanisms through which physical activity may protect against stress-induced risk factors for AD are discussed. While the physiological effects of acute stress and acute exercise overlap, chronic effects of physical activity appear to directly oppose the effects of chronic stress on risk factors for AD. Further study is needed to identify optimal parameters for intensity, duration and frequency of physical activity to counterbalance effects of stress on the development and progression of AD.
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Affiliation(s)
- Carla M Yuede
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA.,Department of Psychiatry, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Benjamin F Timson
- Biomedical Science Department, Missouri State University, Springfield, MO, USA
| | - Jane C Hettinger
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Kayla M Yuede
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Hannah M Edwards
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Justin E Lawson
- Biomedical Science Department, Missouri State University, Springfield, MO, USA
| | - Scott D Zimmerman
- Biomedical Science Department, Missouri State University, Springfield, MO, USA
| | - John R Cirrito
- Department of Neurology, Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
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Silveira LS, Pimentel GD, Souza CO, Biondo LA, Teixeira AAS, Lima EA, Batatinha HAP, Rosa Neto JC, Lira FS. Effect of an acute moderate-exercise session on metabolic and inflammatory profile of PPAR-α knockout mice. Cell Biochem Funct 2017; 35:510-517. [DOI: 10.1002/cbf.3308] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 06/23/2017] [Accepted: 09/17/2017] [Indexed: 11/05/2022]
Affiliation(s)
- Loreana S. Silveira
- Exercise and Immunometabolism Research Group, Department of Physical Education; Universidade Estadual Paulista; Presidente Prudente SP Brazil
| | - Gustavo D. Pimentel
- Clinical and Sports Nutrition Research Laboratory (Labince); Nutrition Faculty (FANUT)-Federal University of Goiás (UFG); Goiânia GO Brazil
| | - Camila O. Souza
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - Luana A. Biondo
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - Alexandre Abílio S. Teixeira
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - Edson A. Lima
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - Helena A. P. Batatinha
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - José C. Rosa Neto
- Immunometabolism Research Group, Institute of Biomedical Sciences; University of São Paulo (USP); São Paulo SP Brazil
| | - Fábio S. Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education; Universidade Estadual Paulista; Presidente Prudente SP Brazil
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Di Raimondo D, Miceli G, Musiari G, Tuttolomondo A, Pinto A. New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:300. [PMID: 28856140 DOI: 10.21037/atm.2017.07.30] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Exercise training prevents the onset and the development of many chronic diseases, acting as an effective tool both for primary and for secondary prevention. Various mechanisms that may be the effectors of these beneficial effects have been proposed during the past decades: some of these are well recognized, others less. Muscular myokines, released during and after muscular contraction, have been proposed as key mediators of the systemic effects of the exercise. Nevertheless the availability of an impressive amount of evidence regarding the systemic effects of muscle-derived factors, few studies have examined key issues: (I) if skeletal muscle cells themselves are the main source of cytokine during exercise; (II) if the release of myokines into the systemic circulation reach an adequate concentration to provide significant effects in tissues far from skeletal muscle; (III) what may be the role carried out by muscular cytokine regarding the well-known benefits induced by regular exercise, first of all the anti-inflammatory effect of exercise. Furthermore, a greater part of our knowledge regarding myokines derives from the muscle of healthy subjects. This knowledge may not necessarily be transferred per se to subjects with chronic diseases implicating a direct or indirect muscular dysfunction and/or a chronic state of inflammation with persistent immune-inflammatory activation (and therefore increased circulating levels of some cytokines): cachexia, sarcopenia due to multiple factors, disability caused by neurological damage, chronic congestive heart failure (CHF) or coronary artery disease (CAD). A key point of future studies is to ascertain how is modified the muscular release of myokines in different categories of unhealthy subjects, both at baseline and after rehabilitation. The purpose of this review is to discuss the main findings on the role of myokines as putative mediators of the therapeutic benefits obtained through regular exercise in the context of secondary cardiovascular prevention.
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Affiliation(s)
- Domenico Di Raimondo
- Dipartimento Biomedico di Medicina interna e Specialistica, University of PALERMO, Palermo, Italy
| | - Giuseppe Miceli
- Dipartimento Biomedico di Medicina interna e Specialistica, University of PALERMO, Palermo, Italy
| | - Gaia Musiari
- Dipartimento Biomedico di Medicina interna e Specialistica, University of PALERMO, Palermo, Italy
| | - Antonino Tuttolomondo
- Dipartimento Biomedico di Medicina interna e Specialistica, University of PALERMO, Palermo, Italy
| | - Antonio Pinto
- Dipartimento Biomedico di Medicina interna e Specialistica, University of PALERMO, Palermo, Italy
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Abdolali B, Mojtaba E, Shahram S, Heshmatollah P, Mohammadali S. Adiponectin/TNF-α Ratio Following a Selected Aerobic Training in Sedentary Adult Obese Men. AVICENNA JOURNAL OF MEDICAL BIOCHEMISTRY 2017. [DOI: 10.15171/ajmb.2017.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Based on clinical studies, low adiponectin and high tumor necrosis factor alpha (TNF-α) are associated with obesity and related diseases such as type 2 diabetes and insulin resistance. Objectives: In this study, we aimed to investigate the effect of an aerobic training program on adiponectin, TNF-α, and adiponectin/TNF-α ratio in adult obese men. Patients and Methods: For this purpose, 24 sedentary adult obese men matched for age (38 ± 3.23 years) and body mass index (31.94 ± 3.26 kg/m2 ) were selected and divided into exercise (aerobic training) and control groups. Exercise subjects participated in an aerobic exercise training intervention for 12 weeks (3 times/week) and the control group did not participate in aerobic intervention. Anthropometric and biochemical data including fasting serum adiponectin, TNF-α, and adiponectin/TNF-α ratio were measured before and after aerobic training for each participant in each group. Data were analyzed by both independent and paired sample t test. Results: Compared to pre-training, fasting serum adiponectin decreased significantly (P = .019), but serum TNF-α was not changed by aerobic training (P = .057). A significant increase was observed in adiponectin/TNF-α ratio in exercise subjects after aerobic training (P = .008). Conclusions: Based on these data, we conclude that aerobic training intervention is associated with improved inflammatory profile in obese subjects.
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Affiliation(s)
- Banaeifar Abdolali
- Assistant Professor of Exercise Physiology, South Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Eizadi Mojtaba
- Assistant Professor of Exercise Physiology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Sohaily Shahram
- Assistant Professor of Exercise Physiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Parsyan Heshmatollah
- Assistant Professor of Exercise Physiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Sayedhossainii Mohammadali
- Master of Sciences of Physical Education and Sport Sciences, Parand Branch, Islamic Azad University, Tehran, Iran
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Euteneuer F, Dannehl K, del Rey A, Engler H, Schedlowski M, Rief W. Immunological effects of behavioral activation with exercise in major depression: an exploratory randomized controlled trial. Transl Psychiatry 2017; 7:e1132. [PMID: 28509904 PMCID: PMC5534946 DOI: 10.1038/tp.2017.76] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/07/2017] [Accepted: 02/28/2017] [Indexed: 12/17/2022] Open
Abstract
Major depression (MD) is associated with peripheral inflammation and increased cardiovascular risk. Regular physical exercise can have anti-inflammatory effects. The present study examined whether behavioral activation with exercise affects inflammatory processes in MD. Ninety-eight patients with MD were randomly assigned to cognitive-behavioral therapy (CBT) emphasizing exercise during behavioral activation (CBT-E), CBT with pleasurable low-energy activities as an active control condition (CBT-C) or a passive waiting list control group (WL). Plasma levels of C-reactive protein (CRP), interleukin (IL)-6, IL-10, lipopolysaccharide (LPS)-stimulated IL-6 production, and blood immune cell counts were analyzed at baseline and weeks 8 (post-behavioral activation) and 16 (post-treatment). Thirty non-depressed age- and sex-matched controls were included to examine potential immunological alterations in MD at baseline. Patients with MD exhibited higher levels of CRP, higher neutrophil and monocyte counts, lower IL-10 levels and reduced LPS-stimulated IL-6 production compared to controls (P<0.001-0.045). Multilevel modeling indicated that CBT-E was associated with increased anti-inflammatory IL-10 at weeks 8 and 16 compared to CBT-C and WL (P=0.004-0.018). CBT-E did not significantly affect other immunological makers in the total sample. A subgroup analysis including patients with potentially higher cardiovascular risk (CRP ⩾1 μg ml-1) indicated that CRP was reduced in CBT-E compared to CBT-C (P<0.007) and marginally reduced compared to WL (P<0.085) after week 16. The present findings provide new insights into immunological effects of behavioral treatments against depression. Behavioral activation in conjunction with exercise may have the potential to reverse, in part, immunological alterations in MD.
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Affiliation(s)
- F Euteneuer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany,Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Gutenbergstraße 18, Marburg 35032, Germany. E-mail:
| | - K Dannehl
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
| | - A del Rey
- Research Group Immunophysiology, Institute of Physiology and Pathophysiology, Philipps University of Marburg, Marburg, Germany
| | - H Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - M Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Clinic Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - W Rief
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
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Bird SR, Hawley JA. Update on the effects of physical activity on insulin sensitivity in humans. BMJ Open Sport Exerc Med 2017; 2:e000143. [PMID: 28879026 PMCID: PMC5569266 DOI: 10.1136/bmjsem-2016-000143] [Citation(s) in RCA: 289] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/04/2023] Open
Abstract
PURPOSE AND METHODS This review presents established knowledge on the effects of physical activity (PA) on whole-body insulin sensitivity (SI) and summarises the findings of recent (2013-2016) studies. DISCUSSION AND CONCLUSIONS Recent studies provide further evidence to support the notion that regular PA reduces the risk of insulin resistance, metabolic syndrome and type 2 diabetes, and SI improves when individuals comply with exercise and/or PA guidelines. Many studies indicate a dose response, with higher energy expenditures and higher exercise intensities, including high intensity interval training (HIIT), producing greater benefits on whole-body SI, although these findings are not unanimous. Aerobic exercise interventions can improve SI without an associated increase in cardiorespiratory fitness as measured by maximal or peak oxygen consumption. Both aerobic and resistance exercise can induce improvements in glycaemic regulation, with some suggestions that exercise regimens including both may be more efficacious than either exercise mode alone. Some studies report exercise-induced benefits to SI that are independent of habitual diet and weight loss, while others indicate an association with fat reduction, hence the debate over the relative importance of PA and weight loss continues. During exercise, muscle contraction stimulated improvements in SI are associated with increases in AMPK activity, which deactivates TCB1D1, promoting GLUT4 translocation to the cell membrane and thereby increasing glucose uptake. Postexercise, increases in Akt deactivate TCB1D4 and thereby increase GLUT4 translocation to the cell membrane. The reduction in intramuscular saturated fatty acids and concomitant reductions in ceramides, but not diacylglycerols, provide a potential link between intramuscular lipid content and SI. Increased skeletal muscle capillarisation provides another independent adaptation through which SI is improved, as does enhanced β cell activity. Recent studies are combining exercise interventions with dietary and feeding manipulations to investigate the potential for augmenting the exercise-induced improvements in SI and glycaemic control.
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Affiliation(s)
- Stephen R Bird
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - John A Hawley
- Mary MaKillop Institute for Health Research, Centre for Exercise and Nutrition, Australian Catholic University, Melbourne, Victoria, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Faleiros CM, Francescato HD, Papoti M, Chaves L, Silva CG, Costa RS, Coimbra TM. Effects of previous physical training on adriamycin nephropathy and its relationship with endothelial lesions and angiogenesis in the renal cortex. Life Sci 2017; 169:43-51. [DOI: 10.1016/j.lfs.2016.11.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/10/2016] [Accepted: 11/19/2016] [Indexed: 10/20/2022]
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Eizadi M, Sohaily S, Khorshidi D, Samarikhalaj H. Effect of Aerobic Training Program on Serum C-reactive Protein Levels. AVICENNA JOURNAL OF MEDICAL BIOCHEMISTRY 2016. [DOI: 10.17795/ajmb-33294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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47
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Donaire-Gonzalez D, Gimeno-Santos E, Balcells E, de Batlle J, Ramon MA, Rodriguez E, Farrero E, Benet M, Guerra S, Sauleda J, Ferrer A, Ferrer J, Barberà JA, Rodriguez-Roisin R, Gea J, Agustí A, Antó JM, Garcia-Aymerich J. Benefits of physical activity on COPD hospitalisation depend on intensity. Eur Respir J 2015; 46:1281-9. [PMID: 26206873 DOI: 10.1183/13993003.01699-2014] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 05/28/2015] [Indexed: 11/05/2022]
Abstract
The present study aims to disentangle the independent effects of the quantity and the intensity of physical activity on the risk reduction of chronic obstructive pulmonary disease (COPD) hospitalisations.177 patients from the Phenotype Characterization and Course of COPD (PAC-COPD) cohort (mean±sd age 71±8 years, forced expiratory volume in 1 s 52±16% predicted) wore the SenseWear Pro 2 Armband accelerometer (BodyMedia, Pittsburgh, PA, USA) for eight consecutive days, providing data on quantity (steps per day, physically active days and daily active time) and intensity (average metabolic equivalent tasks) of physical activity. Information on COPD hospitalisations during follow-up (2.5±0.8 years) was obtained from validated centralised datasets. During follow-up 67 (38%) patients were hospitalised. There was an interaction between quantity and intensity of physical activity in their effects on COPD hospitalisation risk. After adjusting for potential confounders in the Cox regression model, the risk of COPD hospitalisation was reduced by 20% (hazard ratio (HR) 0.79, 95% CI 0.67-0.93; p=0.005) for every additional 1000 daily steps at low average intensity. A greater quantity of daily steps at high average intensity did not influence the risk of COPD hospitalisations (HR 1.01, p=0.919). Similar results were found for the other measures of quantity of physical activity. Greater quantity of low-intensity physical activity reduces the risk of COPD hospitalisation, but high-intensity physical activity does not produce any risk reduction.
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Affiliation(s)
- David Donaire-Gonzalez
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Physical Activity and Sports Sciences Department, Fundació Blanquerna, Barcelona, Spain
| | - Elena Gimeno-Santos
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Eva Balcells
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain
| | - Jordi de Batlle
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC), Lyon, France
| | - Maria A Ramon
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Esther Rodriguez
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eva Farrero
- Department of Pneumology, Hospital Universitari de Bellvitge, Barcelona, Spain Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Marta Benet
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - Stefano Guerra
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
| | - Jaume Sauleda
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Son Espases, Palma de Mallorca, Spain Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Antoni Ferrer
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain
| | - Jaume Ferrer
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Department of Pneumology, Hospital Universitari Vall d'Hebron, Barcelona, Spain Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan A Barberà
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Robert Rodriguez-Roisin
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Gea
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain Department of Pneumology, Hospital del Mar IMIM, Barcelona, Spain
| | - Alvar Agustí
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain Servei de Pneumologia (Thorax Institute), Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Josep M Antó
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Judith Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
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Liu Y, Liu SX, Cai Y, Xie KL, Zhang WL, Zheng F. Effects of combined aerobic and resistance training on the glycolipid metabolism and inflammation levels in type 2 diabetes mellitus. J Phys Ther Sci 2015; 27:2365-71. [PMID: 26311110 PMCID: PMC4540883 DOI: 10.1589/jpts.27.2365] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/18/2015] [Indexed: 12/26/2022] Open
Abstract
[Purpose] To investigate the effects of combined aerobic and resistance training on glycolipid metabolism and inflammation levels in type 2 diabetes mellitus patients. [Subjects and Methods] Forty-two diabetes patients were randomized to the conventional therapy group (n = 20) or intensive therapy group (n = 22). The control group contained 20 healthy people. The conventional therapy group received routine drug therapy and diet control, while the intensive therapy group additionally underwent combined aerobic and resistance training for 12 weeks. The oral glucose tolerance test and cardiopulmonary exercise testing were performed. Toll-like receptor 4 and NF-κBp65 protein and mRNA expressions were determined by qPCR and western blotting. ELISA was used to determine the expression levels of interleukin-18, interleukin-33, pentraxin-related protein 3, and human cartilage glycoprotein 39. [Results] After exercise training, the intensive therapy group had significantly lower postprandial blood glucose, postprandial insulin, and glycated hemoglobin level and insulin resistance index than the conventional therapy group. The intensive therapy group had significantly lower toll-like receptor 4 and NF-κBp65 protein and mRNA expressions, and serum interleukin-18 levels but significantly higher serum interleukin-33 levels. [Conclusion] Combined aerobic and resistance training can improve glycolipid metabolism and reduce low-grade inflammation in patients with diabetes mellitus patients.
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Affiliation(s)
- Yuan Liu
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
| | - Sui-xin Liu
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
| | - Ying Cai
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
| | - Kang-ling Xie
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
| | - Wen-liang Zhang
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
| | - Fan Zheng
- Cardiac Rehabilitation Center, Department of
Rehabilitation, Xiangya Hospital, Central South University, China
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Loprinzi PD, Walker JF. Combined association of physical activity and diet with C-reactive protein among smokers. J Diabetes Metab Disord 2015; 14:51. [PMID: 26106588 PMCID: PMC4477475 DOI: 10.1186/s40200-015-0181-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 06/14/2015] [Indexed: 01/08/2023]
Abstract
Background In the general population, both physical activity and dietary behavior are independently associated with less systemic inflammation, with this relationship less examined among smokers. To our knowledge, no study has examined the combined association of both physical activity and dietary behavior on systemic inflammation among daily smokers, which was the purpose of this study. Methods Data from the 2003–2006 NHANES were employed. 810 adult smokers provided C-reactive protein data (CRP; a marker of inflammation), and sufficient physical activity (accelerometry) and dietary data (healthy eating index). Results The fully adjusted model showed that participants meeting physical activity guidelines and eating a healthy diet (β = −0.34, p = 0.03) had lower CRP levels when compared to those not engaging in these health behaviors, but only having one health behavior was not a significant predictor of CRP (β = −0.19, p = 0.14). Conclusions Smokers engaging in regular physical activity while consuming a healthy diet demonstrate lower CRP levels than their counterparts. When taken together, these behaviors may mitigate inflammation associated with various chronic diseases, which is of particular importance as very few smokers successfully quit smoking.
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Affiliation(s)
- Paul D Loprinzi
- Department of Health, Exercise Science, and Recreation Management, Center for Health Behavior Research, School of Applied Sciences, The University of Mississippi, 215 Turner Center, University, MS 38677 USA
| | - Jerome F Walker
- Department of Respiratory Therapy, Bellarmine University, Louisville, KY USA
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Morettini M, Storm F, Sacchetti M, Cappozzo A, Mazzà C. Effects of walking on low-grade inflammation and their implications for Type 2 Diabetes. Prev Med Rep 2015; 2:538-47. [PMID: 26844115 PMCID: PMC4721345 DOI: 10.1016/j.pmedr.2015.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective Inflammatory cytokines released by hypertrophic adipocytes contribute to low-grade inflammation, a characteristic of Type 2 Diabetes. Skeletal muscle contraction during physical activity stimulates the secretion of anti-inflammatory cytokines able to counteract this inflammatory status. The aim of this study was to review the evidence of the effectiveness of walking as a physical activity intervention to reduce inflammation. The interplay between adipose tissue and skeletal muscle contributions was also investigated. Method A structured literature review of papers available up to December 2014 was carried out within the PubMed, Scopus and ISI Web of Science databases using the keywords “walking” and “inflammation” in order to identify the studies involving healthy subjects and subjects diagnosed with, or at increased risk of, Type 2 Diabetes. Results Thirty-two studies were reviewed, five investigating the acute effects of walking and twenty-seven its chronic effects (n = 21 interventional and n = 6 observational). Acute effects of walking bouts led to an increase of interleukin-6 in one study, although without any increase in the concentration of the anti-inflammatory marker interleukin-1 receptor antagonist. Eight interventional studies showed a significant reduction of inflammation. A reduction in tumour necrosis factor-α concentration was often associated with an adiposity reduction. The observational studies showed that individuals who walk more present a lower inflammatory status. Conclusion There is no consensus regarding the efficacy of walking in the reduction of low-grade systemic inflammation, even though a relationship cannot be excluded. In each walking bout, no anti-inflammatory effect due to the IL-6-stimulated myokine cascade can be demonstrated. Efficacy of walking in the reduction of inflammation is controversial. Walking efficacy in reducing inflammation is mediated by duration and intensity. People accustomed to regular walking have lower inflammatory marker concentrations. No anti-inflammatory effect mediated by muscular IL-6 can be demonstrated.
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Affiliation(s)
- Micaela Morettini
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Rome, Italy
| | - Fabio Storm
- Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome"Foro Italico", Rome, Italy
| | - Aurelio Cappozzo
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome"Foro Italico", Rome, Italy
| | - Claudia Mazzà
- Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK
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