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Choudhary MK, Bouquin H, Hytönen J, Koskela JK, Niemelä O, Nevalainen PI, Mustonen J, Pörsti I. Blood Haemoglobin Concentration Is Directly and Independently Related with Pulse Wave Velocity, a Measure of Large Artery Stiffness. J Clin Med 2023; 12:7623. [PMID: 38137695 PMCID: PMC10743951 DOI: 10.3390/jcm12247623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/20/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
High haemoglobin level has been associated with metabolic syndrome, elevated blood pressure (BP), and increased mortality risk. In this cross-sectional study, we investigated the association of blood haemoglobin with haemodynamics in 743 subjects, using whole-body impedance cardiography and pulse wave analysis. The participants were allocated to sex-stratified haemoglobin tertiles with mean values 135, 144, and 154 g/L, respectively. The mean age was similar in all tertiles, while body mass index was higher in the highest versus the lowest haemoglobin tertile. The highest haemoglobin tertile had the highest erythrocyte and leukocyte counts, plasma C-reactive protein, uric acid, renin activity, and aldosterone. The lipid profile was less favourable and insulin sensitivity lower in the highest versus the lowest haemoglobin tertile. Aortic BP, cardiac output, and systemic vascular resistance were similar in all tertiles, while the pulse wave velocity (PWV) was higher in the highest versus the lowest haemoglobin tertile. In linear regression analysis, age (Beta 0.478), mean aortic BP (Beta 0.178), uric acid (Beta 0.150), heart rate (Beta 0.148), and aldosterone-to-renin ratio (Beta 0.123) had the strongest associations with PWV (p < 0.001 for all). Additionally, haemoglobin concentration was an explanatory factory for PWV (Beta 0.070, p = 0.028). To conclude, blood haemoglobin concentration had a small direct and independent association with a measure of large artery stiffness.
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Affiliation(s)
- Manoj Kumar Choudhary
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Heidi Bouquin
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jere Hytönen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
| | - Jenni K. Koskela
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, 60220 Seinäjoki, Finland;
| | - Pasi I. Nevalainen
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Jukka Mustonen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
| | - Ilkka Pörsti
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (M.K.C.); (H.B.); (J.K.K.); (J.M.)
- Department of Internal Medicine, Tampere University Hospital, 33520 Tampere, Finland;
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Zhao L, Gao Y, Xu W, Li K, Liu L, Fan L. Factors influencing new-onset hypertension in elderly patients with obstructive sleep apnea: A multicenter cohort study. Clin Transl Sci 2023; 16:2507-2518. [PMID: 37969034 PMCID: PMC10719459 DOI: 10.1111/cts.13631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 11/17/2023] Open
Abstract
Investigating the influencing factors of new-onset hypertension in the elderly with obstructive sleep apnea (OSA). 450 Chinese older patients with OSA who were non-hypertensive at baseline were enrolled. All patients had undergone polysomnography monitoring in the multicenter study. The primary endpoint was incident hypertension. Kaplan-Meier survival analysis was performed, and multivariate Cox proportional hazards models were generated to determine the factors influencing new-onset hypertension. A total of 176 (39.1%) patients developed hypertension. The hypertension group had older age, higher hemoglobin (Hb) level and apnea-hypopnea index (AHI) values than the non-hypertension group (all p < 0.05). During the median 33-month follow-up period, multivariate Cox analysis showed age (hazard ratio (HR) = 1.039, 95% confidence interval (95% CI): 1.016-1.062), AHI (HR = 1.015, 95% CI: 1.007-1.023) and Hb level (HR = 1.016, 95% CI: 1.008-1.025) were independent predictors of new-onset hypertension. However, continuous positive airway pressure (CPAP; HR = 0.508, 95% CI: 0.271-0.951) reduced the risk of developing hypertension. Notably, the subgroup analysis demonstrated that the plasma glucose level (HR = 1.168, 95% CI: 1.029-1.326) was a risk factor for male patients. Besides length of time with the pulse oxygen saturation less than 90% (Tsat90; HR = 1.005, 95% CI: 1.003-1.007), body mass index (BMI; HR = 1.170, 95% CI: 1.043-1.311), and dyslipidemia (HR = 2.335, 95% CI: 1.144-4.766) had statistically significant effects on the incidence of hypertension in certain subgroups. Although this study lacked analysis of items such as living habits and medication, it did show age, AHI, Hb and CPAP affected the development of hypertension in elderly OSA patients. These findings suggested that targeted interventions in specific populations may be more effective in preventing hypertension.
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Affiliation(s)
- LiBo Zhao
- Cardiology Department of the Second Medical Center, National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina
| | - YingHui Gao
- Sleep CenterPeking University International HospitalBeijingChina
| | - WeiHao Xu
- Cardiology Department of Guangdong Provincial People's HospitalGuangzhouChina
| | - KaiLiang Li
- Health Service Department of the Guard Bureau of the General Office of the Central Committee of the Communist Party of ChinaBeijingChina
| | - Lin Liu
- Department of Pulmonary and Critical Care Medicine of the Second Medical Center, National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina
| | - Li Fan
- Cardiology Department of the Second Medical Center, National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijingChina
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Ha LX, Du YD, Qu XX, Wang JJ. Correlation Between Hemoglobin Levels and Polycystic Ovary Syndrome Metabolic Disorder. Diabetes Metab Syndr Obes 2023; 16:3019-3027. [PMID: 37794898 PMCID: PMC10545805 DOI: 10.2147/dmso.s430120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/14/2023] [Indexed: 10/06/2023] Open
Abstract
Objective The purpose of this study was to explore the relationship between hemoglobin levels and metabolic disorders in patients with PCOS. Methods A total of 573 patients were selected, based on the hemoglobin level; 342 patients with PCOS were divided into two groups as follows: Group A (normal Hb group, n = 269) and Group B (high Hb group, n = 73); 231 non-PCOS patients were divided into two groups as follows: Group C (normal Hb group, n = 199), and Group D (high Hb group, n = 32). The general information, glucose and lipid metabolism indicators, and uric acid levels of all patients were compiled for data analysis. Results (1) Hb, HGB concentration in mean red blood cells and RDW in PCOS patients were higher than those in non-PCOS patients, and MCV was lower than that in non-PCOS patients (P < 0.05); (2) Compared with Group A, patients in Group B had higher BMI, Hb, 2-hPG, FINS, 2-hINS, HOMA-IR, LDL-C, and uric acid levels while the QUICKI was lower; in Group C, the age, FSH, HDL-C, and LDL-C were higher, and AMH, BMI, T, TG, and uric acid level were lower (P<0.05); compared with Group D, AMH, BMI, FINS, HOMA-IR, TG, uric acid level increased, while age, FSH, and QUICKI decreased in Group B; and Hb and T decreased in Group C (P<0.05); (3) Pearson's correlation analysis indicated that Hb in PCOS patients was positively correlated with BMI, FPG, 2-hPG, FINS, 2-hINS, and HOMA-IR, and negatively correlated with the QUICKI (P<0.05); (4) Multi-factor logistic regression analysis suggested that the high Hb level in PCOS patients was an independent risk factor of IR (P<0.05). Conclusion Hb level in patients with PCOS was associated with BMI and glucose metabolism indicators; a high Hb level may be an independent risk factor for IR.
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Affiliation(s)
- Ling-Xia Ha
- Reproductive Medicine Center, General Hospital of Ningxia Medical University, Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Yu-Dong Du
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
- Department of Reproductive Medicine, Luoyang Maternal and Child Health Hospital, Luoyang, Henan, 471000, People’s Republic of China
| | - Xiao-Xiao Qu
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Jin-Juan Wang
- Ningxia Medical University, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
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Huang L, Song C, Liu Q, Liang X, Ren Y, Huang D, Guan X, An X, Liang X. The associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents: a prospective cohort study. Hypertens Res 2023; 46:2085-2099. [PMID: 37188752 DOI: 10.1038/s41440-023-01304-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023]
Abstract
Uncontrolled pediatric hypertension may increase the risk of hypertension in adulthood. Several studies have reported an association between hematological parameters and blood pressure (BP) levels. However, epidemiologic evidence of this association in children and adolescents remains scarce. This study aims to explore the associations between hematological parameters and the incidence of prehypertension and hypertension in children and adolescents. This longitudinal study was conducted with 1368 participants aged 6-8 years from baseline visit to follow-up visit. Compared with participants from the normal blood pressure (BP) group, participants from the elevated BP group had significantly higher baseline red blood cell (RBC) counts, hemoglobin (Hb) counts and hematocrit (Hct) levels (all P < 0.001). A multilevel linear mixed model was conducted to analyze the relationship between hematological parameters and BP levels. The results suggested that SBP, DBP and MAP increased significantly with a quartile increase of levels of hematological parameters (all P < 0.05). Furthermore, a multilevel mixed logistic regression model was used to analyze the risk of per interquartile range increase in hematological parameters on the incidence of prehypertension and hypertension. The risk of prehypertension and hypertension incidence increased by (1.34 (95%CIs: 1.20, 1.50)), (1.38 (95%CIs: 1.24,1.54)), (1.33 (95%CIs: 1.19,1.50)), (1.14 (95%CIs: 1.03,1.26)) fold with a one-quartile increase in levels of RBC, Hb, Hct and Fe, respectively (all P < 0.05). This longitudinal study showed that hematological parameters were positively associated with BP levels in healthy children and adolescents, which excluded the effect of antihypertensive drugs on BP levels that often appeared in adults.
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Affiliation(s)
- Lan Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Cui Song
- Department of Endocrinology and Genetic Metabolism disease, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Qin Liu
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaoyue Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Yanling Ren
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Daochao Huang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xianmin Guan
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xizhou An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China
| | - Xiaohua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, 400014, Chongqing, China.
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Kruczkowska W, Kciuk M, Pasieka Z, Kłosiński K, Płuciennik E, Elmer J, Waszczykowska K, Kołat D, Kałuzińska-Kołat Ż. The artificial oxygen carrier erythrocruorin-characteristics and potential significance in medicine. J Mol Med (Berl) 2023; 101:961-972. [PMID: 37460699 PMCID: PMC10400677 DOI: 10.1007/s00109-023-02350-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 07/04/2023] [Accepted: 07/07/2023] [Indexed: 08/05/2023]
Abstract
The diminishing supply and increasing costs of donated blood have motivated research into novel hemoglobin-based oxygen carriers (HBOCs) that can serve as red blood cell (RBC) substitutes. HBOCs are versatile agents that can be used in the treatment of hemorrhagic shock. However, many of the RBC substitutes that are based on mammalian hemoglobins have presented key limitations such as instability and toxicity. In contrast, erythrocruorins (Ecs) are other types of HBOCs that may not suffer these disadvantages. Ecs are giant metalloproteins found in annelids, crustaceans, and some other invertebrates. Thus far, the Ecs of Lumbricus terrestris (LtEc) and Arenicola marina (AmEc) are the most thoroughly studied. Based on data from preclinical transfusion studies, it was found that these compounds not only efficiently transport oxygen and have anti-inflammatory properties, but also can be modified to further increase their effectiveness. This literature review focuses on the structure, properties, and application of Ecs, as well as their advantages over other HBOCs. Development of methods for both the stabilization and purification of erythrocruorin could confer to enhanced access to artificial blood resources.
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Affiliation(s)
- Weronika Kruczkowska
- Faculty of Biomedical Sciences, Medical University of Lodz, Zeligowskiego 7/9, 90-752, Lodz, Poland
| | - Mateusz Kciuk
- Department of Molecular Biotechnology and Genetics, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
- Doctoral School of Exact and Natural Sciences, University of Lodz, Banacha 12/16, 90-237, Lodz, Poland
| | - Zbigniew Pasieka
- Department of Experimental Surgery, Medical University of Lodz, Narutowicza 60, 90-136, Lodz, Poland
| | - Karol Kłosiński
- Department of Experimental Surgery, Medical University of Lodz, Narutowicza 60, 90-136, Lodz, Poland
| | - Elżbieta Płuciennik
- Department of Functional Genomics, Medical University of Lodz, Zeligowskiego 7/9, 90-752, Lodz, Poland
| | - Jacob Elmer
- Department of Chemical and Biological Engineering, Villanova University, Villanova, PA, USA
| | - Klaudia Waszczykowska
- Department of Functional Genomics, Medical University of Lodz, Zeligowskiego 7/9, 90-752, Lodz, Poland
| | - Damian Kołat
- Department of Experimental Surgery, Medical University of Lodz, Narutowicza 60, 90-136, Lodz, Poland
| | - Żaneta Kałuzińska-Kołat
- Department of Experimental Surgery, Medical University of Lodz, Narutowicza 60, 90-136, Lodz, Poland.
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Positive Association between Hemoglobin Concentration and Blood Pressure in Adults: A Cross-Sectional Study Based on Rafsanjan Cohort Study. Int J Hypertens 2023; 2023:6283711. [PMID: 36777237 PMCID: PMC9908348 DOI: 10.1155/2023/6283711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/26/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction Identification of factors associated with blood pressure (BP), including hemoglobin, can be used in diagnosing, controlling, and predicting the prognosis of patients. This study aims to investigate the cross-sectional association between hemoglobin concentration and BP in people aged 35-70 years in a cohort study of Rafsanjan, Iran. Method This cross-sectional study was conducted on 9398 urban and rural population of Rafsanjan adult cohort study as a part of the prospective epidemiological research studies in Iran (PERSIAN). Demographic information, medical history, history of smoking and alcohol intake, systolic and diastolic BP, and hemoglobin concentration were collected. A logistic regression test was performed to evaluate the relationship between hemoglobin concentration and BP in 4 unadjusted and adjusted models based on demographic indicators, clinical and laboratory findings using SPSS.24 software and SAS software version 9.2. Results The mean age of the participants was 49.78 ± 9.53 years, and 53.2% (5002 people) were women. Adjusted models 3 and 4 showed a positive association between BP and hemoglobin. For each unit increase in hemoglobin, the odds ratio (OR) of BP in the adjusted model 3 was 1.062 (95% CI: 1.005-1.121), and in the adjusted model 4, it was 1.090 (95% CI: 1.031-1.153). Conclusion Based on the results, the positive trend of BP and hemoglobin levels may indicate the need to pay more attention to these people as higher-risk groups for hypertension.
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Solhpour A, Kumar S, Koch MJ, Doré S. Impact of blood component transfusions, tranexamic acid and fluids on subarachnoid hemorrhage outcomes. BRAIN HEMORRHAGES 2022. [DOI: 10.1016/j.hest.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Integrating Health Data-Driven Machine Learning Algorithms to Evaluate Risk Factors of Early Stage Hypertension at Different Levels of HDL and LDL Cholesterol. Diagnostics (Basel) 2022; 12:diagnostics12081965. [PMID: 36010315 PMCID: PMC9407063 DOI: 10.3390/diagnostics12081965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose: Cardiovascular disease (CVD) is a major worldwide health burden. As the risk factors of CVD, hypertension, and hyperlipidemia are most mentioned. Early stage hypertension in the population with dyslipidemia is an important public health hazard. This study was the application of data-driven machine learning (ML), demonstrating complex relationships between risk factors and outcomes and promising predictive performance with vast amounts of medical data, aimed to investigate the association between dyslipidemia and the incidence of early stage hypertension in a large cohort with normal blood pressure at baseline. Methods: This study analyzed annual health screening data for 71,108 people from 2005 to 2017, including data for 27 risk-related indicators, sourced from the MJ Group, a major health screening center in Taiwan. We used five machine learning (ML) methods—stochastic gradient boosting (SGB), multivariate adaptive regression splines (MARS), least absolute shrinkage and selection operator regression (Lasso), ridge regression (Ridge), and gradient boosting with categorical features support (CatBoost)—to develop a multi-stage ML algorithm-based prediction scheme and then evaluate important risk factors at the early stage of hypertension, especially for groups with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels within or out of the reference range. Results: Age, body mass index, waist circumference, waist-to-hip ratio, fasting plasma glucose, and C-reactive protein (CRP) were associated with hypertension. The hemoglobin level was also a positive contributor to blood pressure elevation and it appeared among the top three important risk factors in all LDL-C/HDL-C groups; therefore, these variables may be important in affecting blood pressure in the early stage of hypertension. A residual contribution to blood pressure elevation was found in groups with increased LDL-C. This suggests that LDL-C levels are associated with CPR levels, and that the LDL-C level may be an important factor for predicting the development of hypertension. Conclusion: The five prediction models provided similar classifications of risk factors. The results of this study show that an increase in LDL-C is more important than the start of a drop in HDL-C in health screening of sub-healthy adults. The findings of this study should be of value to health awareness raising about hypertension and further discussion and follow-up research.
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Design, Synthesis, and Antisickling Investigation of a Nitric Oxide-Releasing Prodrug of 5HMF for the Treatment of Sickle Cell Disease. Biomolecules 2022; 12:biom12050696. [PMID: 35625623 PMCID: PMC9138457 DOI: 10.3390/biom12050696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 02/02/2023] Open
Abstract
5-hydroxyfurfural (5HMF), an allosteric effector of hemoglobin (Hb) with an ability to increase Hb affinity for oxygen has been studied extensively for its antisickling effect in vitro and in vivo, and in humans for the treatment of sickle cell disease (SCD). One of the downstream pathophysiologies of SCD is nitric oxide (NO) deficiency, therefore increasing NO (bio)availability is known to mitigate the severity of SCD symptoms. We report the synthesis of an NO-releasing prodrug of 5HMF (5HMF-NO), which in vivo, is expected to be bio-transformed into 5HMF and NO, with concomitant therapeutic activities. In vitro studies showed that when incubated with whole blood, 5HMF-NO releases NO, as anticipated. When incubated with sickle blood, 5HMF-NO formed Schiff base adduct with Hb, increased Hb affinity for oxygen, and prevented hypoxia-induced erythrocyte sickling, which at 1 mM concentration were 16%, 10% and 27%, respectively, compared to 21%, 18% and 21% for 5HMF. Crystal structures of 5HMF-NO with Hb showed 5HMF-NO bound to unliganded (deoxygenated) Hb, while the hydrolyzed product, 5HMF bound to liganded (carbonmonoxy-ligated) Hb. Our findings from this proof-of-concept study suggest that the incorporation of NO donor group to 5HMF and analogous molecules could be a novel beneficial strategy to treat SCD and warrants further detailed in vivo studies.
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Nitric oxide releasing nanoparticles reduce inflammation in a small animal model of ARDS. Pharmacotherapy 2022; 148:112705. [DOI: 10.1016/j.biopha.2022.112705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/20/2022]
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Ghosh T, Rehman T, Ahamed F. Relationship Between Hemoglobin and Blood Pressure Levels in the Context of Chronic Morbidity Among Older Adults Residing in a Developing Country: A Community-Level Comparative Cross-Sectional Study. Cureus 2021; 13:e19540. [PMID: 34934558 PMCID: PMC8667963 DOI: 10.7759/cureus.19540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/12/2022] Open
Abstract
Objectives: The objective of this study is to assess the association between hemoglobin (Hb) and blood pressure (BP) levels among community-dwelling older adults. Materials and Methods: This comparative cross-sectional study was conducted in April 2021 in West Bengal, India. Individuals who are receiving treatment for hypertension, or had a history of blood transfusion, or had a history of intake of iron and vitamins were excluded from the study. A total of 81 and 106 individuals were recruited in “Group 1” (no self-reported comorbidity) and “Group 2” (self-reported comorbidity present), respectively. Results: The mean (SD) age of the participants (n = 187) was 67.4 (7.4) years; 54% (n = 101) were males; and 45.4% (n = 85) were obese. We found a significant association of Hb level with systolic blood pressure (SBP) (r = 0.22, p = 0.04) and mean arterial pressure (MAP) (r = 0.22, p = 0.04) in “Group 1”. The quantum of increases in SBP, diastolic blood pressure (DBP), pulse pressure (PP), and MAP with one gram/dl change in Hb level were 3.24 (95% CI: -0.75 to 7.24) mmHg, 1.17 (95% CI: -0.84 to 3.20) mmHg, 2.06 (95% CI: -0.67 to 4.81) mmHg, and 1.87 (95% CI: -0.65 to 4.39) mmHg, respectively, in “Group 1” after adjustment for age, gender, and body mass index. The findings were inconsistent in “Group 2”, and the changes in Hb level were 0.5 (95% CI: -3.77 to 2.77) mmHg, 0.92 (95% CI: -0.72 to 2.75) mmHg, -1.42 (95% CI: -4.09 to 1.24) mmHg, and 0.45 (95% CI: -1.05 to 2.40) mmHg, respectively. Conclusion: Hb level has a positive correlation with SBP and MAP only in those without comorbidities.
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Affiliation(s)
- Tandra Ghosh
- Physiology, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
| | - Tanveer Rehman
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
| | - Farhad Ahamed
- Community Medicine and Family Medicine, All India Institute of Medical Sciences, Kalyani, Kalyani, IND
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Han B, Song M, Li L, Sun X, Lei Y. The Application of Nitric Oxide for Ocular Hypertension Treatment. Molecules 2021; 26:molecules26237306. [PMID: 34885889 PMCID: PMC8659272 DOI: 10.3390/molecules26237306] [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] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/18/2021] [Accepted: 11/25/2021] [Indexed: 12/21/2022] Open
Abstract
Despite of various therapeutic methods for treating ocular hypertension and glaucoma, it still remains the leading cause of irreversible blindness. Intraocular pressure (IOP) lowering is the most effective way to slow disease progression and prevent blindness. Among the ocular hypotensive drugs currently in use, only a couple act on the conventional outflow system, which is the main pathway for aqueous humor outflow and the major lesion site resulting in ocular hypertension. Nitric oxide (NO) is a commendable new class of glaucoma drugs that acts on the conventional outflow pathway. An increasing number of nitric oxide donors have been developed for glaucoma and ocular hypertension treatment. Here, we will review how NO lowers IOP and the types of nitric oxide donors that have been developed. And a brief analysis of the advantages and challenges associated with the application will be made. The literature used in this review is based on Pubmed database search using ‘nitric oxide’ and ‘glaucoma’ as key words.
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Schneider VM, Frank P, Fuchs SC, Ferrari R. Effects of recreational sports and combined training on blood pressure and glycated hemoglobin in middle-aged and older adults: A systematic review with meta-analysis. Exp Gerontol 2021; 154:111549. [PMID: 34509590 DOI: 10.1016/j.exger.2021.111549] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/21/2021] [Accepted: 09/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Combined resistance and aerobic training (CT) is the most suitable form of exercise training to simultaneously improve strength and cardiometabolic profile in middle-aged and older adults. Recreational sports (RS) emerge as an alternative to CT to improve these outcomes. We performed a meta-analysis on the effects of RS and CT on systolic blood pressure (SBP), diastolic blood pressure (DBP) and glycated hemoglobin (HbA1c) in middle-aged and older adults and to compare these exercise interventions to a non-exercising control group (CON). METHODS Search was conducted using the databases at PubMed, COCHRANE and SciELO between July and August 2020. Studies that included men and women aged ≥45 years, healthy or with values for SBP ≥130 mmHg or DBP ≥80 mmHg or with type 2 diabetes and performed RS or CT versus CON. RESULTS From 6017 records, 27 studies were included (9 RS and 18 CT). The analysis included 1411 participants with 55 ± 8 years. RS and CT were associated with reductions in SBP (RS: -7.2 mmHg, P = 0.03; CT: -3.6 mmHg, P < 0.001) and DBP (RS: -3.6 mmHg, P = 0.02; CT: -3.1 mmHg, P < 0.001) versus CON. Only CT was associated with a reduction in HbA1c versus CON (-0.47%; P < 0.001). CONCLUSIONS RS and CT are effective exercise interventions to improve BP in middle-aged and older adults. CT seems to be an excellent strategy to reduce HbA1c, and future studies are necessary to confirm the effectiveness of RS to improve HbA1c.
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Affiliation(s)
- Vinícius M Schneider
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil
| | - Paula Frank
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil
| | - Sandra C Fuchs
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil.
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14
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Hemoglobin and hematocrit levels are positively associated with blood pressure in children and adolescents 10 to 18 years old. Sci Rep 2021; 11:19052. [PMID: 34561491 PMCID: PMC8463603 DOI: 10.1038/s41598-021-98472-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/08/2021] [Indexed: 02/08/2023] Open
Abstract
To investigate the associations between hemoglobin (Hb) concentration and hematocrit (Hct), and blood pressure (BP) in children and adolescents. The study population consisted of 7950 subjects total (4229 boys and 3721 girls) aged 10-18 years who participated in the Korea National Health and Nutrition Examination Surveys conducted between 2007 and 2017. The prevalence of hypertension was 19.19% (21.51% for boys and 16.5% for girls) among the study population, and the prevalence of obesity was 9.59% (10.5% for boys and 8.6% for girls). Hb count and Hct tended to increase with the degree of obesity and BP elevation. Systolic BP (SBP) and diastolic BP (DBP) positively correlated with Hb count and Hct in both sexes. Following multiple linear regression analysis, Hb count and Hct presented a positive association with SBP and DBP after adjusting for age, BMI SDS, alcohol consumption, smoking status, physical activity, rural residence, household income, diagnosis of T2DM, hypertension, and dyslipidemia. Hb count and Hct were positively associated with SBP and DBP in children and adolescents 10-18 years old.
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15
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Wen J, Zhang Q, Yang Q, Hu F. The levels of hemoglobin are positively associated with arterial stiffness in community-dwelling Chinese adults. Nutr Metab Cardiovasc Dis 2021; 31:2929-2934. [PMID: 34364772 DOI: 10.1016/j.numecd.2021.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 04/02/2021] [Accepted: 07/04/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS Hemoglobin (Hb) concentrations are known to be related to cardiovascular diseases. This study investigated the association between Hb levels and arterial stiffness, as assessed by measurement of the brachial-ankle pulse wave velocity (baPWV). METHODS AND RESULTS 3576 adults (2139 males and 1437 females) from the general Chinese population who had their physical check-ups in the health examination centers of Jiangmen Central Hospital were enrolled into the study. The anthropometrics and laboratory data as well as the baPWV and Hb levels were subsequently obtained. Age-adjusted partial correlation and multivariable stepwise linear regression analyses were used to evaluate the relationships between Hb and baPWV for men and women separately. In both sexes, Hb levels were positively associated with body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, glutamic-pyruvic transaminase, γ-glutamyltranspeptidase, uric acid and baPWV, but negatively correlated with the estimated glomerular filtration rate. Multivariable linear regression analysis showed that Hb was significantly and independently associated with arterial stiffness in men (β = 0.043, 95% CI 0.010-0.077, p < 0.05) and women (β = 0.035, 95% CI 0.001-0.069, P < 0.05), after adjustment for confounding factors. CONCLUSION The data indicate that high Hb concentration significantly correlate with increased baPWV in general Chinese population.
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Affiliation(s)
- Jianghua Wen
- Department of Health Examination, Jiangmen Central Hospital, Jiangmen, 529070, Guangdong, China
| | - Qinqin Zhang
- Department of Thyroid and Breast Surgery, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin 541002, Guangxi, China.
| | - Qiong Yang
- Department of Endocrinology, Guilin Medical University Affiliated Hospital, Guilin 541001, Guangxi, China.
| | - Fang Hu
- Department of Endocrinology, The Fifth Affiliated Hospital, Sun Yat-Sen University, 52 Meihua East Road, Zhuhai 519000, Guangdong, China
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16
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Karand JC, Reis K, Stephano PF, Gargurevich N, Zhou J, Desderius B, Fadhil S, Ladha Y, Rosengard R, Kowal DR, Peck RN. Sex-dependent correlates of arterial stiffness in Tanzanian adults. Trop Med Int Health 2021; 26:1494-1502. [PMID: 34478605 DOI: 10.1111/tmi.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Arterial stiffness is a known indicator for cardiovascular disease. However, the factors that lead to arterial stiffening have primarily been studied in participants from high-income countries. Here, we examine clinical and lifestyle metrics in relation to arterial stiffness in Tanzanian adults. METHODS We performed pulse wave velocity (PWV), the gold standard measure of arterial stiffness, on 808 Tanzanian adults (ages 18-65) enrolled in a longitudinal cohort studying trends in blood pressure. RESULTS As expected, PWV was strongly associated with age, blood pressure and sex. We controlled for these factors in our statistical analysis. Lifestyle metrics were compared across multiple PWV quantiles. We found that determinants of PWV varied by sex: in female participants, PWV was associated with common obesity metrics and menopause, while in male participants, PWV was associated with HIV status and duration of anti-retroviral therapy (ART). Further clinical and lifestyle factors such as marriage status and type of occupation were also significantly associated with PWV and moderated by sex. CONCLUSION Together, our data demonstrate the importance of studying sex-specific causal pathways for arterial stiffness and of including under-represented populations in these studies.
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Affiliation(s)
- Julie C Karand
- Fulbright U.S. Scholar Program, Washington, DC, USA.,University of Delaware, Newark, DE, USA
| | - Karl Reis
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
| | | | | | | | | | | | - Yumna Ladha
- Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Rachel Rosengard
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | | | - Robert N Peck
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
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17
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Kandhwal M, Behl T, Kumar A, Arora S. Understanding the Potential Role and Delivery Approaches of Nitric Oxide in Chronic Wound Healing Management. Curr Pharm Des 2021; 27:1999-2014. [PMID: 33106138 DOI: 10.2174/1381612826666201026152209] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
Nitric oxide (NO) is a promising pharmaceutical component that has vasodilator, anti-bacterial, and wound healing activities. Chronic ulcers are non-healing disorders that are generally associated with distortion of lower limbs. Among the severe consequence derivatives of these diseases are the problems of chronic wound progression. NO, which is categorized as the smallest gaseous neurotransmitter, has beneficial effects in different phases of chronic inflammation. The defensive mechanism of NO is found useful in several severe conditions, such as gestational healing, gastrointestinal healing, and diabetic healing. The current review presents an updated collection of literature about the role of NO in chronic ulcers due to the prevalence of diabetes, DPN, and diabetic foot ulcers, and because of the lack of available effective treatments to directly address the pathology contributing to these conditions, novel treatments are being sought. This review also collects information about deficiency of NO synthase in diabetic patients, leading to a lack of vascularization of the peripheral nerves, which causes diabetic neuropathy, and this could be treated with vasodilators such as nitric oxide. Apart from the pharmacological mechanism of NO, the article also reviewed and analyzed to elucidate the potential of transdermal delivery of NO for the treatment of chronic ulcers.
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Affiliation(s)
- Mimansa Kandhwal
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Arun Kumar
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Sandeep Arora
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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18
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Qian M, Zhou X, Gao B, Huang H, Yang C, Zeng T, Shen J, Hu J, Sun F, Li S, Huang X, Chen G. Red cell index: A novel biomarker for 3-month mortality in acute ischemic stroke patients treated with intravenous thrombolysis. Brain Behav 2021; 11:e02170. [PMID: 33943024 PMCID: PMC8213941 DOI: 10.1002/brb3.2170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 04/09/2021] [Accepted: 04/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The red cell index (RCI) was described as a biomarker for evaluating respiratory function in previous studies, but the relationship between RCI and stroke, remained a mystery. The present study aimed to probe the association between RCI at 24-hr and 3-month mortality and functional outcomes among acute ischemic stroke (AIS) patients treated with recombinant tissue plasminogen activator (r-tPA). METHODS A total of 217 AIS patients between January 2016 and January 2019 were recruited in this retrospective study. AIS patients were grouped in terms of RCI tertiles. Predictive factors were confirmed via multivariate logistic regression analysis. The receiver operating characteristic (ROC) was used to assess the ability of RCI in predicting mortality. In addition, the risk of 3-month all-cause mortality was evaluated by Cox proportional hazard model. RESULTS We grouped AIS patients into tertiles with the purpose of comparing clinical factors and RCI levels. Multivariate logistic regression analysis presented that RCI (odds ratio [OR] = 1.443, 95% confidence interval [CI] [1.167-1.786], p = 0.001) was an independent biomarker for 3-month all-cause mortality. The best cutoff value of RCI was 2.41 (area under the curve [AUC] = 0.639, 95% CI [0.501-0.778], p = .032), with a sensitivity of 40.9% and a specificity of 89.7%. Cox survival analysis demonstrated a positive significant correlation between RCI (hazard ratio [HR] = 1.332, 95% CI [1.148-1.545], p < .001) and mortality risk. CONCLUSION RCI, a potential predictor, was significantly associated with 3-month mortality in AIS patients with r-tPA.
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Affiliation(s)
- Meizi Qian
- Department of Anesthesia, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xinbo Zhou
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Beibei Gao
- Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Honghao Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Chenguang Yang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Tian Zeng
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jiamin Shen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jingyu Hu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Fangyue Sun
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shengqi Li
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xuerong Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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19
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Reis KG, Desderius B, Kingery J, Kirabo A, Makubi A, Myalla C, Lee MH, Kapiga S, Peck RN. Blood pressure, T cells, and mortality in people with HIV in Tanzania during the first 2 years of antiretroviral therapy. J Clin Hypertens (Greenwich) 2020; 22:1554-1562. [PMID: 32815636 PMCID: PMC7722134 DOI: 10.1111/jch.13975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/11/2020] [Accepted: 05/16/2020] [Indexed: 12/23/2022]
Abstract
Cardiovascular disease is now a leading cause of mortality in people with HIV (PWH). High blood pressure is the major driver of cardiovascular disease. Despite this, little is known about blood pressure in PWH during the early years of antiretroviral therapy (ART). In this prospective cohort study in Tanzania, the authors conducted unobserved blood pressure measurements at enrollment, 3, 6, 12, 18, and 24 months in 500 PWH initiating ART and 504 HIV-uninfected adults. The authors excluded measurements taken on antihypertensive medications. Although PWH had a significantly lower blood pressure before ART initiation, they had a significantly greater increase in blood pressure during the first 2 years of ART compared to HIV-uninfected controls. Blood pressure correlates in PWH differed from HIV-uninfected controls. In PWH, lower baseline CD4+ T-cell counts were associated with lower blood pressure, and greater increases in CD4+ T-cell counts on ART were associated with greater increases in blood pressure, both on average and within individuals. In addition, PWH with a systolic blood pressure (SBP) <90 mm Hg at the time of ART initiation had ~30% mortality in the following 3 months due to occult infections. These patients require careful investigation for occult infections, and those with tuberculosis may benefit from corticosteroids.
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Affiliation(s)
- Karl G. Reis
- Center for Global HealthWeill Cornell Medical CollegeNew YorkNYUSA
- Department of MedicineWeill Bugando School of MedicineMwanzaTanzania
| | - Bernard Desderius
- Department of MedicineWeill Bugando School of MedicineMwanzaTanzania
| | - Justin Kingery
- Center for Global HealthWeill Cornell Medical CollegeNew YorkNYUSA
- Department of MedicineWeill Bugando School of MedicineMwanzaTanzania
| | - Annet Kirabo
- Division of Clinical PharmacyVanderbilt University Medical CenterNashvilleTNUSA
- Department of Molecular Physiology and BiophysicsVanderbilt University Medical CenterNashvilleTNUSA
| | - Abel Makubi
- Department of MedicineWeill Bugando School of MedicineMwanzaTanzania
| | | | - Myung Hee Lee
- Center for Global HealthWeill Cornell Medical CollegeNew YorkNYUSA
| | - Saidi Kapiga
- Mwanza Intervention Trials Unit (MITU)MwanzaTanzania
| | - Robert N. Peck
- Center for Global HealthWeill Cornell Medical CollegeNew YorkNYUSA
- Department of MedicineWeill Bugando School of MedicineMwanzaTanzania
- Mwanza Intervention Trials Unit (MITU)MwanzaTanzania
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20
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The Impact of Beta Blockers on Survival in Heart Transplant Recipients: Insights from the Zabrze HTx Registry. Cardiol Res Pract 2020; 2020:5190248. [PMID: 32774914 PMCID: PMC7396039 DOI: 10.1155/2020/5190248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction The data assessing the impact of beta blocker (BB) medication on survival in patients after heart transplantation (HTx) are scarce and unequivocal; therefore, we investigated this population. Methods We retrospectively analyzed the HTx Zabrze Registry of 380 consecutive patients who survived the 30-day postoperative period. Results The percentage of patients from the entire cohort taking BBs was as follows: atenolol 24 (17%), bisoprolol 67 (49%), carvedilol 11 (8%), metoprolol 28 (20%), and nebivolol 8 (6%). The patients receiving BBs were older (56.94 ± 14.68 years vs. 52.70 ± 15.35 years, p=0.008) and experienced an onset of HTx earlier in years (11.65 ± 7.04 vs. 7.24 ± 5.78 p ≤ 0.001). They also had higher hematocrit (0.40 ± 0.05 vs. 0.39 ± 0.05, p=0.022) and red blood cells (4.63 (106/μl) ± 0.71 vs. 4.45 (106/μl) ± 0.68, p=0.015). Survival according to BB medication did not differ among the groups (p=0.655) (log-rank test). Univariate Cox proportional hazard regression analysis revealed that the following parameters were associated with unfavorable diagnosis: serum concentration of albumin (g/l) HR: 0.87, 95% CI (0.81–0.94), p=0.0004; fibrinogen (mg/dl) HR: 1.006, 95% CI (1.002–1.008), p=0.0017; and C-reactive protein (mg/l) HR: 1.014, 95% CI (1.004–1.023), p=0.0044. Conclusions The use of BBs in our cohort of patients after HTx was not associated with survival benefits.
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21
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Shi J, Yang Y, Cheng A, Xu G, He F. Metabolism of vascular smooth muscle cells in vascular diseases. Am J Physiol Heart Circ Physiol 2020; 319:H613-H631. [PMID: 32762559 DOI: 10.1152/ajpheart.00220.2020] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Vascular smooth muscle cells (VSMCs) are the fundamental component of the medial layer of arteries and are essential for arterial physiology and pathology. It is becoming increasingly clear that VSMCs can alter their metabolism to fulfill the bioenergetic and biosynthetic requirements. During vascular injury, VSMCs switch from a quiescent "contractile" phenotype to a highly migratory and proliferative "synthetic" phenotype. Recent studies have found that the phenotype switching of VSMCs is driven by a metabolic switch. Metabolic pathways, including aerobic glycolysis, fatty acid oxidation, and amino acid metabolism, have distinct, indispensable roles in normal and dysfunctional vasculature. VSMCs metabolism is also related to the metabolism of endothelial cells. In the present review, we present a brief overview of VSMCs metabolism and how it regulates the progression of several vascular diseases, including atherosclerosis, systemic hypertension, diabetes, pulmonary hypertension, vascular calcification, and aneurysms, and the effect of the risk factors for vascular disease (aging, cigarette smoking, and excessive alcohol drinking) on VSMC metabolism to clarify the role of VSMCs metabolism in the key pathological process.
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Affiliation(s)
- Jia Shi
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Yang
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anying Cheng
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Xu
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fan He
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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22
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Haselden WD, Kedarasetti RT, Drew PJ. Spatial and temporal patterns of nitric oxide diffusion and degradation drive emergent cerebrovascular dynamics. PLoS Comput Biol 2020; 16:e1008069. [PMID: 32716940 PMCID: PMC7410342 DOI: 10.1371/journal.pcbi.1008069] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 08/06/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023] Open
Abstract
Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in neurovascular coupling. NO produced by neurons diffuses into the smooth muscle surrounding cerebral arterioles, driving vasodilation. However, the rate of NO degradation in hemoglobin is orders of magnitude higher than in brain tissue, though how this might impact NO signaling dynamics is not completely understood. We used simulations to investigate how the spatial and temporal patterns of NO generation and degradation impacted dilation of a penetrating arteriole in cortex. We found that the spatial location of NO production and the size of the vessel both played an important role in determining its responsiveness to NO. The much higher rate of NO degradation and scavenging of NO in the blood relative to the tissue drove emergent vascular dynamics. Large vasodilation events could be followed by post-stimulus constrictions driven by the increased degradation of NO by the blood, and vasomotion-like 0.1-0.3 Hz oscillations could also be generated. We found that these dynamics could be enhanced by elevation of free hemoglobin in the plasma, which occurs in diseases such as malaria and sickle cell anemia, or following blood transfusions. Finally, we show that changes in blood flow during hypoxia or hyperoxia could be explained by altered NO degradation in the parenchyma. Our simulations suggest that many common vascular dynamics may be emergent phenomena generated by NO degradation by the blood or parenchyma.
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Affiliation(s)
- William Davis Haselden
- Neuroscience Graduate Program, MD/PhD Medical Scientist Training Program, Pennsylvania State University, University Park, Pennsylvania, United States of America
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Ravi Teja Kedarasetti
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - Patrick J. Drew
- Neuroscience Graduate Program, MD/PhD Medical Scientist Training Program, Pennsylvania State University, University Park, Pennsylvania, United States of America
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, Pennsylvania, United States of America
- Departments of Biomedical Engineering and Neurosurgery, Pennsylvania State University, University Park, Pennsylvania, United States of America
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23
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Munoz CJ, Pires IS, Baek JH, Buehler PW, Palmer AF, Cabrales P. Apohemoglobin-haptoglobin complex attenuates the pathobiology of circulating acellular hemoglobin and heme. Am J Physiol Heart Circ Physiol 2020; 318:H1296-H1307. [PMID: 32302494 DOI: 10.1152/ajpheart.00136.2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Haptoglobin (Hp) is the plasma protein that binds and clears cell-free hemoglobin (Hb), whereas apohemoglobin (apoHb, i.e., Hb devoid of heme) can bind heme. Therefore, the apoHb-Hp protein complex should facilitate holoHb-apoHb αβ-dimer exchange and apoHb-heme intercalation. Thus, we hypothesized that apoHb-Hp could facilitate both Hb and heme clearance, which, if not alleviated, could have severe microcirculatory consequences. In this study, we characterized apoHb-Hp and Hb/heme ligand interactions and assessed their in vivo consequences. Hb exchange and heme binding with the apoHb-Hp complex was studied with transfer assays using size-exclusion high-performance liquid chromatography coupled with UV-visible spectrophotometry. Exchange/transfer experiments were conducted in guinea pigs dosed with Hb or heme-albumin followed by a challenge with equimolar amounts of apoHb-Hp. Finally, systemic and microcirculatory parameters were studied in hamsters instrumented with a dorsal window chamber via intravital microscopy. In vitro and in vivo Hb exchange and heme transfer experiments demonstrated proof-of-concept Hb/heme ligand transfer to apoHb-Hp. Dosing with the apoHb-Hp complex reversed Hb- and heme-induced systemic hypertension and microvascular vasoconstriction, reduced microvascular blood flow, and diminished functional capillary density. Therefore, this study highlights the apoHb-Hp complex as a novel therapeutic strategy to attenuate the adverse systemic and microvascular responses to intravascular Hb and heme exposure.NEW & NOTEWORTHY This study highlights the apoHb-Hp complex as a novel therapeutic strategy to attenuate the adverse systemic and microvascular responses to intravascular Hb and heme exposure. In vitro and in vivo Hb exchange and heme transfer experiments demonstrated proof-of-concept Hb/heme ligand transfer to apoHb-Hp. The apoHb-Hp complex reverses Hb- and heme-induced systemic hypertension and microvascular vasoconstriction, preserves microvascular blood flow, and functional capillary density. In summary, the unique properties of the apoHb-Hp complex prevent adverse systemic and microvascular responses to Hb and heme-albumin exposure and introduce a novel therapeutic approach to facilitate simultaneous removal of extracellular Hb and heme.
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Affiliation(s)
- Carlos J Munoz
- Department of Bioengineering, University of California San Diego, La Jolla, California
| | - Ivan S Pires
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio
| | - Jin Hyen Baek
- Division of Blood Components and Devices, Office of Blood Research and Review, Laboratory of Biochemistry and Vascular Biology, Food and Drug Administration, Silver Spring, Maryland
| | - Paul W Buehler
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland.,The Center for Blood Oxygen Transport and Hemostasis, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Andre F Palmer
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio
| | - Pedro Cabrales
- Department of Bioengineering, University of California San Diego, La Jolla, California
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24
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Huang J, Ma J, Guo Y, Wang Y, Zhang Q, Zhong J, Jiang W, Li Y, Xu L. [Peripheral blood albumin level in significantly correlated with the severity of atherosclerosis in hypertensive patients]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:240-245. [PMID: 32376544 DOI: 10.12122/j.issn.1673-4254.2020.02.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate the relationship between peripheral blood albumin (Hb) level and the severity of arteriosclerosis in hypertensive patients. METHODS This retrospective analysis was conducted among 419 randomly selected patients with hypertension. The pulse wave velocity (ba-PWV) of the bilateral limbs was measured using an arteriosclerosis tester. According to the ba-PWV value (the higher value of the two sides), the hypertensive patients were divided into 4 groups, namely normal arterial group [S0 group, ba-PWV < 1400 cm/s; 49 cases (11.7%)], mild arteriosclerosis group [S1 group, ba-PWV of 1400-1800 cm/s; 190 cases (45.3%)], moderate arteriosclerosis group [S2 group, ba-PWV of 1800-2000 cm/s); 69 cases (16.5%)], and severe arteriosclerosis group [S3 group, ba-PWV > 2 000 cm/s; 111 cases (26.5 %)]. The clinical data of the patients were collected and multivariate logistic regression was used to analyze the risk factors of arteriosclerosis. RESULTS The patients' age, obesity, albumin, alanine aminotransferase (ALT), total bile acid, adenosine deaminase, urea nitrogen, serum creatinine, cystatin C, low-density lipoprotein, red blood cells, hemoglobin (Hb), fibrinogen, and FT3 all differed significantly between S0 group and the 3 arteriosclerosis groups (P < 0.05). Multivariate logistic regression analysis revealed that in hypertensive patients, age was an independent risk factor for severe arteriosclerosis (OR=1.094, 95% CI: 1.052-1.137, P < 0.05) and moderate arteriosclerosis (OR= 1.081, 95% CI: 1.039-1.125, P < 0.05); Hb was an independent risk factor for new-onset severe arteriosclerosis (OR= 1.025, 95% CI: 1.003-1.045, P < 0.05) and moderate arteriosclerosis (OR=1.035, 95% CI: 1.008-1.056, P < 0.05), and an increase of Hb levels by 1 standard deviation was associated with a doubled risk in hypertensive patients. CONCLUSIONS Peripheral Hb level is significantly correlated with the severity of arteriosclerosis and may serve as a new predictor for arteriosclerosis in hypertensive patients.
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Affiliation(s)
- Jianyu Huang
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Jun Ma
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yan Guo
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yao Wang
- Jiangxi Province Hospital of Integrated Chinese and Western Medicine, Nanchang, 330003, China
| | - Qunhui Zhang
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Junda Zhong
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Wencai Jiang
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Yanzhuo Li
- General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
| | - Lin Xu
- Guangdong Pharmaceutical University, Guangzhou 510006, China.,General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, China
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Navati MS, Lucas A, Liong C, Barros M, Jayadeva JT, Friedman JM, Cabrales P. Reducing Ischemia/Reperfusion Injury by the Targeted Delivery of Nitric Oxide from Magnetic-Field-Induced Localization of S-Nitrosothiol-Coated Paramagnetic Nanoparticles. ACS APPLIED BIO MATERIALS 2019; 2:2907-2919. [DOI: 10.1021/acsabm.9b00282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mahantesh S. Navati
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Alfredo Lucas
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Celine Liong
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Marcelo Barros
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
| | - Jyothishree Tholalu Jayadeva
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Joel M. Friedman
- Department of Albert Einstein College of Medicine Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, United States
| | - Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093, United States
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Xuan Y, Zuo J, Zheng S, Ji J, Qian Y. Association of Hemoglobin and Blood Pressure in a Chinese Community-Dwelling Population. Pulse (Basel) 2019; 6:154-160. [PMID: 31049315 DOI: 10.1159/000494735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/20/2018] [Indexed: 12/31/2022] Open
Abstract
This study investigated the relationship between hemoglobin (Hb) level and blood pressure in a Chinese community-dwelling population with normal glucose metabolism. Hb, fasting plasma glucose, glycated Hb A1c, hepatic and renal function, lipid, electrolytes, and anthropometric parameters were measured. Hb level was found to be positively correlated with systolic (SBP; r = 0.075, p < 0.001) and diastolic (DBP; r = 0.272, p < 0.001) blood pressure in the cohort. The relationship was not affected by age, BMI, serum creatinine (Cr), and low-density lipoprotein (LDL) in both males and females. Multivariate stepwise regression showed that age (β = 0.556, p < 0.001), BMI (β = 1.107, < 0.001), Hb (β = 0.082, p < 0.001), Cr (β = -0.032, p < 0.001), and LDL (β = 1.023, p < 0.001) were independent factors for SBP, and Hb (β = 0.168, p < 0.001), BMI (β = 0.519, p = 0.001), and LDL (β = 0.331, p < 0.001) for DBP. Hb level is positively associated with both SBP and DBP in a Chinese community-dwelling population with normal glucose metabolism.
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Affiliation(s)
- Yan Xuan
- Department of Geriatrics, Ruijin Hospital North, Shanghai Jiaotong University Medicine School, Shanghai, China
| | - Junli Zuo
- Department of Geriatrics, Ruijin Hospital North, Shanghai Jiaotong University Medicine School, Shanghai, China
| | - Shuping Zheng
- Jiading District Jiangqiao Community Health Service Center, Shanghai, China
| | - Jinbao Ji
- Jiading District Jiangqiao Community Health Service Center, Shanghai, China
| | - Yi Qian
- Department of Respiratory Medicine, Ruijin Hospital North, Shanghai Jiaotong University School of Medicine, Shanghai, China
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27
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Chen H, Xiong C, Shao X, Ning J, Gao P, Xiao H, Chen Y, Zou Z, Hong G, Li X, Shao M, Sheng J, Yang X, You X, Zou H. Lymphocyte To High-Density Lipoprotein Ratio As A New Indicator Of Inflammation And Metabolic Syndrome. Diabetes Metab Syndr Obes 2019; 12:2117-2123. [PMID: 31686883 PMCID: PMC6798814 DOI: 10.2147/dmso.s219363] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/01/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Metabolic syndrome (MetS), which is a global public health problem, is a state of chronic low-grade inflammation. This study looked at the changes in hematological parameters and the predictive value of the lymphocyte to high-density lipoprotein cholesterol (HDL-C) ratio (LHR) as a new index in subjects with and without MetS in coastal cities in southern China. PATIENTS AND METHODS In this cross-sectional study, there were 852 participants (n = 598 with MetS and n = 254 without MetS). MetS was defined in accordance with the National Cholesterol Education Program, Adult Treatment Panel III (NCEP-ATP III) criteria. RESULTS MetS was positively correlated with white blood cell count, total lymphocyte count, neutrophil count, red blood cell count, hematocrit, hemoglobin, and high-sensitivity C-reactive protein levels (p<0.05). In addition, there was a positive correlation between LHR and the number of metabolic risk factors for MetS. In a logistic regression analysis, LHR (odds ratio: 4.117; 95% CI: 2.766-6.309; p<0.001) was an independent predictor of MetS. When a receiver operating characteristic (ROC) curve analysis was used to assess the value of LHR for predicting MetS, the area under the curve yielded a cut-off value of 1.657, with a sensitivity of 65% and a specificity of 64% (p<0.0001). CONCLUSION In summary, MetS can involve changes in blood parameters, and LHR may be a useful marker of inflammation to assess the presence and severity of MetS.
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Affiliation(s)
- Haishan Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Chongxiang Xiong
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xiaofei Shao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Jing Ning
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Peichun Gao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hua Xiao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Yunying Chen
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Ziliang Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Guobao Hong
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xiaolin Li
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Mengjiao Shao
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Jieli Sheng
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xingyan Yang
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Xu You
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
| | - Hequn Zou
- Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, Guangzhou510630, People’s Republic of China
- Correspondence: Hequn Zou Department of Nephrology, The Third Affiliated Hospital, Southern Medical University, 183 Zhongshan West Avenue, Tianhe District, Guangzhou510630, People’s Republic of China Email
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Guo D, Zhu Z, Zhong C, Peng H, Xu T, Wang A, Peng Y, Xu T, Chen CS, Li Y, Ju Z, Chen J, Zhang Y, He J. Hemoglobin level and three-month clinical outcomes among ischemic stroke patients with elevated systolic blood pressure. J Neurol Sci 2018; 396:256-261. [PMID: 30530284 DOI: 10.1016/j.jns.2018.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 11/26/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Previous studies have reported that extreme low and high hemoglobin levels are positively associated with the risk of ischemic stroke. However, there are few reports on the relationship between hemoglobin at acute phase and clinical outcomes after ischemic stroke and the results of their association to date are inconsistent. We aimed to investigate the association between them in a large prospective cohort of ischemic stroke patients. METHODS Baseline hemoglobin levels were measured in 3881 patients with acute ischemic stroke. The primary outcome was defined as composite outcome of major disability and death (modified Rankin Scale score ≥ 3) at 3 months after stroke onset. Secondary outcomes were separately those of major disability and death. RESULTS Compared with the lowest quartile of hemoglobin, the multivariate adjusted odds ratios (95% confidence intervals) associated with the highest quartile were 1.38 (1.03-1.86), 1.49 (1.11-1.99), 0.79 (0.41-1.52) for primary outcome, major disability and death, respectively. Multiple-adjusted spline regression model showed linear associations of hemoglobin levels with primary outcome (P for linearity =0.037) and major disability (P for linearity =0.004). Subgroup analyses further confirmed the positive association between high hemoglobin and poor prognosis of ischemic stroke. CONCLUSIONS Elevated hemoglobin levels in the acute phase were associated with poor prognosis at 3 months after ischemic stroke. Further prospective studies from other samples of ischemic stroke patients are needed to validate our findings.
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Affiliation(s)
- Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Tian Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China; Department of Neurology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Yanbo Peng
- Department of Neurology, Affiliated Hospital of Hebei United University, Hebei, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Chung-Shiuan Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States
| | - Yongqiu Li
- Department of Neurology, Tangshan Worker's Hospital, Hebei, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, Jiangsu, China.
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, United States; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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Chen XT, Yang S, Yang YM, Zhao HL, Chen YC, Zhao XH, Wen JB, Tian YR, Yan WL, Shen C. Exploring the relationship of peripheral total bilirubin, red blood cell, and hemoglobin with blood pressure during childhood and adolescence. J Pediatr (Rio J) 2018; 94:532-538. [PMID: 29107800 DOI: 10.1016/j.jped.2017.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Total bilirubin is beneficial for protecting cardiovascular diseases in adults. The authors aimed to investigate the association of total bilirubin, red blood cell, and hemoglobin levels with the prevalence of high blood pressure in children and adolescents. METHODS A total of 3776 students (aged from 6 to 16 years old) were examined using cluster sampling. Pre-high blood pressure and high blood pressure were respectively defined as the point of 90th and 95th percentiles based on the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Both systolic and diastolic blood pressure were standardized into z-scores. RESULTS Peripheral total bilirubin, red blood cell and hemoglobin levels were significantly correlated with age, and also varied with gender. Peripheral total bilirubin was negatively correlated with systolic blood pressure in 6- and 9-year-old boys, whilst positively correlated with diastolic blood pressure in the 12-year-old boys and 13- to 15-year-old girls (p<0.05). Higher levels of red blood cell and hemoglobin were observed in pre-high blood pressure and high blood pressure students when compared with their normotensive peers (p<0.01). The increases in red blood cell and hemoglobin were significantly associated with high blood pressure after adjusting for confounding factors. The ORs (95% CI) of each of the increases were 2.44 (1.52-3.92) and 1.04 (1.03-1.06), respectively. No statistical association between total bilirubin and high blood pressure was observed (p>0.05). CONCLUSION Total bilirubin could be weakly correlated with both systolic and diastolic blood pressure, as correlations varied with age and gender in children and adolescents; in turn, the increased levels of red blood cell and hemoglobin are proposed to be positively associated with the prevalence of high blood pressure.
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Affiliation(s)
- Xiao-Tian Chen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Song Yang
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Ya-Ming Yang
- Center for Disease Control and Prevention of Yixing City, Yixing, China
| | - Hai-Long Zhao
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Yan-Chun Chen
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Xiang-Hai Zhao
- People's Hospital of Yixing City, Affiliated Yixing People's Hospital of Jiangsu University, Department of Cardiology, Yixing, China
| | - Jin-Bo Wen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Yuan-Rui Tian
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China
| | - Wei-Li Yan
- Children's Hospital of Fudan University, Department of Clinical Epidemiology, Shanghai, China
| | - Chong Shen
- Nanjing Medical University, School of Public Health, Department of Epidemiology, Nanjing, China.
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Chen X, Yang S, Yang Y, Zhao H, Chen Y, Zhao X, Wen J, Tian Y, Yan W, Shen C. Exploring the relationship of peripheral total bilirubin, red blood cell, and hemoglobin with blood pressure during childhood and adolescence. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Enawgaw B, Adane N, Terefe B, Asrie F, Melku M. A comparative cross-sectional study of some hematological parameters of hypertensive and normotensive individuals at the university of Gondar hospital, Northwest Ethiopia. BMC HEMATOLOGY 2017; 17:21. [PMID: 29209503 PMCID: PMC5704458 DOI: 10.1186/s12878-017-0093-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022]
Abstract
Background Hypertension is a major health problem worldwide. It can lead to cardiovascular disease and also leads to functional disturbances including hematological parameters. The abnormalities of haematological parameters may enhance an end-organ damage. Therefore, the aim of this study was to assess some hematological parameters of hypertensive individuals in comparison with normotensive individuals at University of Gondar hospital, northwest Ethiopia. Methods A cross sectional comparative study was conducted from October to November 2015 on a total of 126 hypertensive and 126 normotensive individuals at University of Gondar Hospital. All participants after taking informed consent were interviewed for detailed history and 3 ml of blood was collected for hematological test analysis. Independent t-test and the Mann Whitney u-test were used to find out significant difference and Pearson’s and Spearman’s correlation were used for correlation test. P values less than 0.05 was considered the level of significance. Result From a total of 252 study subjects, about 67.5% were females. The mean age of study subjects was 50.3 ± 11 years for hypertensive individuals and 49.8 ± 11.6 years for normotensive individuals with range of 18–65 years. In the present study, the median (IQR) value of WBC, RBC, Hgb, HCT, MCV and the mean value of MCHC, RDW, MPV and PDW were significantly higher in hypertensive group compared to apparently healthy normotensive groups. Additionally, WBC, RBC, Hgb, HCT and PLT showed statistically significant positive correlations with blood pressure indices. Platelet count and MCH did not show statistically significant difference between the two groups. Conclusion Hypertension has impact on hematological parameters. In this study, the mean and median values of haematological parameters in hypertensive individuals were significantly different compared to apparently healthy normotensive individuals. Hence, hematological parameters can be used to monitor the prognosis of the disease and manage hypertensive related complications, and it is important to assess hematological parameters for hypertensive individuals which may help to prevent complications associated hematological disorders. Electronic supplementary material The online version of this article (doi: 10.1186/s12878-017-0093-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bamlaku Enawgaw
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigist Adane
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Betelihem Terefe
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikir Asrie
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- Department of Hematology & Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Emamian M, Hasanian SM, Tayefi M, Bijari M, Movahedian Far F, Shafiee M, Avan A, Heidari-Bakavoli A, Moohebati M, Ebrahimi M, Darroudi S, Zamani P, Azarpazhooh MR, Nematy M, Safarian M, Ferns GA, Esmaeili H, Parizadeh MR, Ghayour-Mobarhan M. Association of hematocrit with blood pressure and hypertension. J Clin Lab Anal 2017; 31. [PMID: 28105697 DOI: 10.1002/jcla.22124] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 12/01/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertension (HTN) is a risk factor for stroke, renal failure, and cardiovascular disease. The association between biochemical and hematological parameters with high blood pressure may provide a more precise approach to risk prediction conferred by HTN in these patients. OBJECTIVE The aim of current study was to explore whether biochemical and hematological parameters are associated with HTN in a cohort study with a 7-year follow-up. MATERIALS AND METHODS A total of 9808 individuals were enrolled and recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorders (MASHAD) cohort study, and biochemical and hematological factors were measured in all subjects. Univariate and multivariate logistic regression analysis were performed to determine the association of biochemical and hematological parameters with HTN. RESULTS Several biochemical parameters including fasting plasma glucose (FBG), serum high-sensitivity C-reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and uric acid were increased in hypertensive participants. In contrast, serum high-density lipoprotein cholesterol (HDL-C) was lower in hypertensive individuals. Furthermore, we demonstrated that hematological parameters including white blood cell (WBC) count, red blood cell (RBC) count, hemoglobin (HGB), hematocrit (HCT), and mean corpuscular hemoglobin (MCH) were higher in the hypertensive group compared to the control group. But mean corpuscular volume (MCV), and red cell distribution width (RDW), were decreased in the hypertensive group. Furthermore, our results strongly suggested that among these parameters, hematocrit was the independent risk factor for hypertension in the population. CONCLUSION We demonstrated the association of altered biochemical and hematological factors with hypertension supporting the value of emerging markers for early prediction of high blood pressure in prone individuals.
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Affiliation(s)
- Marzieh Emamian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mahdi Hasanian
- Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Microanatomy Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Moniba Bijari
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Faeze Movahedian Far
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Shafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Heidari-Bakavoli
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Moohebati
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ebrahimi
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sousan Darroudi
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Zamani
- Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Nematy
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, UK
| | - Habibollah Esmaeili
- Department of Biostatistics & Epidemiology, School of Health, Management & Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biochemistry, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Sustained Nitric Oxide-Releasing Nanoparticles Interfere with Methicillin-Resistant Staphylococcus aureus Adhesion and Biofilm Formation in a Rat Central Venous Catheter Model. Antimicrob Agents Chemother 2016; 61:AAC.02020-16. [PMID: 27821454 DOI: 10.1128/aac.02020-16] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 11/01/2016] [Indexed: 12/22/2022] Open
Abstract
Staphylococcus aureus is frequently isolated in the setting of infections of indwelling medical devices, which are mediated by the microbe's ability to form biofilms on a variety of surfaces. Biofilm-embedded bacteria are more resistant to antimicrobial agents than their planktonic counterparts and often cause chronic infections and sepsis, particularly in patients with prolonged hospitalizations. In this study, we demonstrate that sustained nitric oxide-releasing nanoparticles (NO-np) interfere with S. aureus adhesion and prevent biofilm formation on a rat central venous catheter (CVC) model of infection. Confocal and scanning electron microscopy showed that NO-np-treated staphylococcal biofilms displayed considerably reduced thicknesses and bacterial numbers compared to those of control biofilms in vitro and in vivo, respectively. Although both phenotypes, planktonic and biofilm-associated staphylococci, of multiple clinical strains were susceptible to NO-np, bacteria within biofilms were more resistant to killing than their planktonic counterparts. Furthermore, chitosan, a biopolymer found in the exoskeleton of crustaceans and structurally integrated into the nanoparticles, seems to add considerable antimicrobial activity to the technology. Our findings suggest promising development and translational potential of NO-np for use as a prophylactic or therapeutic against bacterial biofilms on CVCs and other medical devices.
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Kim NH, Lee JM, Kim HC, Lee JY, Yeom H, Lee JH, Suh I. Cross-sectional and longitudinal association between hemoglobin concentration and hypertension: A population-based cohort study. Medicine (Baltimore) 2016; 95:e5041. [PMID: 27741113 PMCID: PMC5072940 DOI: 10.1097/md.0000000000005041] [Citation(s) in RCA: 10] [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] [Indexed: 01/19/2023] Open
Abstract
We investigated the cross-sectional and longitudinal associations between hemoglobin concentration and hypertension in a Korean population.Between 2006 and 2013, we examined 4899 participants with mean age of 56.6 years (range 35-88 years) from a rural community. We excluded 298 participants with a history of myocardial infarction or stroke and 264 participants with very low hemoglobin levels (men: <13.3 g/dL; women: <11.6 g/dL). Finally, we performed a cross-sectional analysis on 1629 men and 2708 women. Longitudinal associations were evaluated in 654 men and 1099 women, after excluding 2584 people with hypertension at baseline and those who did not participate in follow-up examinations. Hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive treatment.The mean hemoglobin level was significantly higher in people with hypertension than in those without hypertension (P = 0.002 for men, P = 0.006 for women). On cross-sectional analysis, the odds ratio (95% confidence interval) for hypertension per 1 standard deviation increase in hemoglobin concentration (1.2 g/dL) was 1.11 (1.05-1.18) before adjustment and 1.20 (1.09-1.32) after adjusting for age, sex, body mass index, kidney markers, lifestyle factors, and comorbidities. On longitudinal analysis, the relative risk (95% confidence interval) for incident hypertension per 1 standard deviation increase in hemoglobin concentration was 1.09 (0.96-1.23) before adjustment and 0.91 (0.78-1.08) after adjusting for age, sex, body mass index, lifestyle factors, baseline blood pressure, baseline comorbidities, and baseline kidney markers.This study suggests that hemoglobin per se does not cause hypertension development.
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Affiliation(s)
- Na Hyun Kim
- Department of Public Health, Yonsei University Graduate School
| | | | - Hyeon Chang Kim
- Department of Preventive Medicine
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea
- Correspondence: Hyeon Chang Kim, Department of Preventive Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea (e-mail: )
| | | | | | - Jung Hyun Lee
- Department of Public Health, Yonsei University Graduate School
| | - Il Suh
- Department of Preventive Medicine
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DeMarino C, Schwab A, Pleet M, Mathiesen A, Friedman J, El-Hage N, Kashanchi F. Biodegradable Nanoparticles for Delivery of Therapeutics in CNS Infection. J Neuroimmune Pharmacol 2016; 12:31-50. [PMID: 27372507 DOI: 10.1007/s11481-016-9692-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/12/2016] [Indexed: 12/18/2022]
Abstract
Despite the significant advances in neurological medicine, it remains difficult to treat ailments directly involving the brain. The blood brain barrier (BBB) is a tightly regulated, selectively permeable barrier that restricts access from the blood into the brain extracellular fluid (BEF). Many conditions such as tumors or infections in the brain are difficult to treat due to the fact that drugs and other therapeutic agents are unable to easily pass through this relatively impermeable barrier. Human Immunodeficiency Virus (HIV) presents a particular problem as it is able to remain dormant in the brain for years protected from antiretroviral drugs by the BBB. The development of nanoscale carriers over the past few decades has made possible the delivery of therapies with the potential to overcome membrane barriers and provide specific, targeted delivery. This review seeks to provide a comprehensive overview of the various aspects of nanoparticle formulation and their applications in improving the delivery efficiency of drugs, specifically antiretroviral therapeutics to the brain to treat HIV.
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Affiliation(s)
- Catherine DeMarino
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, USA
| | - Angela Schwab
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, USA
| | - Michelle Pleet
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, USA
| | - Allison Mathiesen
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, USA
| | - Joel Friedman
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Nazira El-Hage
- Department of Immunology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Fatah Kashanchi
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, USA.
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Brant F, Miranda AS, Esper L, Gualdrón-López M, Cisalpino D, de Souza DDG, Rachid MA, Tanowitz HB, Teixeira MM, Teixeira AL, Machado FS. Suppressor of cytokine signaling 2 modulates the immune response profile and development of experimental cerebral malaria. Brain Behav Immun 2016; 54:73-85. [PMID: 26765997 DOI: 10.1016/j.bbi.2016.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 12/23/2015] [Accepted: 01/04/2016] [Indexed: 11/18/2022] Open
Abstract
Plasmodium falciparum infection results in severe malaria in humans, affecting various organs, including the liver, spleen and brain, and resulting in high morbidity and mortality. The Plasmodium berghei ANKA (PbA) infection in mice closely recapitulates many aspects of human cerebral malaria (CM); thus, this model has been used to investigate the pathogenesis of CM. Suppressor of cytokine signaling 2 (SOCS2), an intracellular protein induced by cytokines and hormones, modulates the immune response, neural development, neurogenesis and neurotrophic pathways. However, the role of SOCS2 during CM remains unknown. SOCS2 knockout (SOCS2(-/-)) mice infected with PbA show an initial resistance to infection with reduced parasitemia and production of TNF, TGF-β, IL-12 and IL-17 in the brain. Interestingly, in the late phase of infection, SOCS2(-/-) mice display increased parasitemia and reduced Treg cell infiltration, associated with enhanced levels of Th1 and Th17 cells and related cytokines IL-17, IL-6, and TGF-β in the brain. A significant reduction in protective neurotrophic factors, such as glial cell line-derived neurotrophic factor (GDNF) and brain-derived neurotrophic factor (BDNF), was also observed. Moreover, the molecular alterations in the brain of infected SOCS2(-/-) mice were associated with anxiety-related behaviors and cognition impairment. Mechanistically, these results revealed enhanced nitric oxide (NO) production in PbA-infected SOCS2(-/-) mice, and the inhibition of NO synthesis through l-NAME led to a marked decrease in survival, the disruption of parasitemia control and more pronounced anxiety-like behavior. Treatment with l-NAME also shifted the levels of Th1, Th7 and Treg cells in the brains of infected SOCS2(-/-) mice to the background levels observed in infected WT, with remarkable exception of increased CD8(+)IFN(+) T cells and inflammatory monocytes. These results indicate that SOCS2 plays a dual role during PbA infection, being detrimental in the control of the parasite replication but crucial in the regulation of the immune response and production of neurotrophic factors. Here, we provided strong evidence of a critical relationship between SOCS2 and NO in the orchestration of the immune response and development of CM during PbA infection.
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Affiliation(s)
- Fatima Brant
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Aline S Miranda
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lisia Esper
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Melisa Gualdrón-López
- Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniel Cisalpino
- Department of Microbiology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danielle da Gloria de Souza
- Department of Microbiology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Milene Alvarenga Rachid
- Department of Pathology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Herbert B Tanowitz
- Department of Pathology and Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mauro Martins Teixeira
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Antônio Lucio Teixeira
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fabiana Simão Machado
- Program in Health Sciences: Infectious Diseases and Tropical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil; Department of Biochemistry and Immunology, Institute of Biological Science, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
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Sustained Nitric Oxide-Releasing Nanoparticles Induce Cell Death in Candida albicans Yeast and Hyphal Cells, Preventing Biofilm Formation In Vitro and in a Rodent Central Venous Catheter Model. Antimicrob Agents Chemother 2016; 60:2185-94. [PMID: 26810653 DOI: 10.1128/aac.02659-15] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 01/19/2016] [Indexed: 01/01/2023] Open
Abstract
Candida albicansis a leading nosocomial pathogen. Today, candidal biofilms are a significant cause of catheter infections, and such infections are becoming increasingly responsible for the failure of medical-implanted devices.C. albicansforms biofilms in which fungal cells are encased in an autoproduced extracellular polysaccharide matrix. Consequently, the enclosed fungi are protected from antimicrobial agents and host cells, providing a unique niche conducive to robust microbial growth and a harbor for recurring infections. Here we demonstrate that a recently developed platform comprised of nanoparticles that release therapeutic levels of nitric oxide (NO-np) inhibits candidal biofilm formation, destroys the extracellular polysaccharide matrices of mature fungal biofilms, and hinders biofilm development on surface biomaterials such as the lumen of catheters. We found NO-np to decrease both the metabolic activity of biofilms and the cell viability ofC. albicansin vitroandin vivo Furthermore, flow cytometric analysis found NO-np to induce apoptosis in biofilm yeast cellsin vitro Moreover, NO-np behave synergistically when used in combination with established antifungal drug therapies. Here we propose NO-np as a novel treatment modality, especially in combination with standard antifungals, for the prevention and/or remediation of fungal biofilms on central venous catheters and other medical devices.
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Abstract
Harnessing the impressive therapeutic potential of nitric oxide (NO) remains an ongoing challenge. This paper describes several of the current strategies both with respect to the underlying chemistry and physics and to the applications where they have shown promise. Included in this overview are molecular systems such as NONOates that release NO through chemical reactions and delivery vehicles such as nanoparticles that can generate, store, transport and deliver NO and related bioactive forms of NO such as nitrosothiols. Although there has been much positive movement, it is clear that we are only at the early stages of knowing how to precisely produce, transport and deliver to targeted sites therapeutic levels of NO and related molecules.
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Affiliation(s)
- Hongying Liang
- Department of Physiology & Biophysics, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA
| | - Parimala Nacharaju
- Department of Physiology & Biophysics, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA
| | - Adam Friedman
- Department of Dermatology, George Washington School of Medicine & Health Sciences, NW, Washington, DC 20037, USA
| | - Joel M Friedman
- Department of Physiology & Biophysics, Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY 10461, USA
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Xu GG, Deshpande TM, Ghatge MS, Mehta AY, Omar ASM, Ahmed MH, Venitz J, Abdulmalik O, Zhang Y, Safo MK. Design, Synthesis, and Investigation of Novel Nitric Oxide (NO)-Releasing Prodrugs as Drug Candidates for the Treatment of Ischemic Disorders: Insights into NO-Releasing Prodrug Biotransformation and Hemoglobin-NO Biochemistry. Biochemistry 2015; 54:7178-92. [PMID: 26582149 DOI: 10.1021/acs.biochem.5b01074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We have developed novel nitric oxide (NO)-releasing prodrugs of efaproxiral (RSR13) for their potential therapeutic applications in a variety of diseases with underlying ischemia. RSR13 is an allosteric effector of hemoglobin (Hb) that decreases the protein's affinity for oxygen, thereby increasing tissue oxygenation. NO, because of its vasodilatory property, in the form of ester prodrugs has been found to be useful in managing several cardiovascular diseases by increasing blood flow and oxygenation in ischemic tissues. We synthesized three NO-donor ester derivatives of RSR13 (DD-1, DD-2, and DD-3) by attaching the NO-releasing moieties nitrooxyethyl, nitrooxypropyl, and 1-(pyrrolidin-1-yl)diazen-1-ium-1,2-diolate, respectively, to the carboxylate of RSR13. In vitro studies demonstrated that the compounds released NO in a time-dependent manner upon being incubated with l-cysteine (1.8-9.3%) or human serum (2.3-52.5%) and also reduced the affinity of Hb for oxygen in whole blood (ΔP50 of 4.9-21.7 mmHg vs ΔP50 of 25.4-32.1 mmHg for RSR13). Crystallographic studies showed RSR13, the hydrolysis product of the reaction between DD-1 and deoxygenated Hb, bound to the central water cavity of Hb. Also, the hydrolysis product, NO, was observed exclusively bound to the two α hemes, the first such HbNO structure to be reported, capturing the previously proposed physiological bis-ligated nitrosylHb species. Finally, nitrate was observed bound to βHis97. Ultraperformance liquid chromatography-mass spectrometry analysis of the compounds incubated with matrices used for the various studies demonstrated the presence of the predicted reaction products. Our findings, beyond the potential therapeutic application, provide valuable insights into the biotransformation of NO-releasing prodrugs and their mechanism of action and into hemoglobin-NO biochemistry at the molecular level.
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Affiliation(s)
| | | | | | | | - Abdel Sattar M Omar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University , Alsulaymanyah, Jeddah 21589, Saudi Arabia.,Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Al-Azhar University , Cairo 11884, Egypt
| | | | | | - Osheiza Abdulmalik
- Division of Hematology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania 19104, United States
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Yu SH, Hu J, Ercole F, Truong NP, Davis TP, Whittaker MR, Quinn JF. Transformation of RAFT Polymer End Groups into Nitric Oxide Donor Moieties: En Route to Biochemically Active Nanostructures. ACS Macro Lett 2015; 4:1278-1282. [PMID: 35614828 DOI: 10.1021/acsmacrolett.5b00733] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Polymers with a terminal S-nitrosothiol moiety were synthesized by modifying the thiocarbonylthio end group formed by reversible addition-fragmentation chain transfer polymerization. Specifically, benzodithioate-terminated poly[oligo(ethylene glycol) methyl ether methacrylate] (POEGMA) was first synthesized by polymerizing OEGMA in the presence of 4-cyano-4-(phenylcarbonothioylthio)pentanoic acid. Sequential treatment with hydrazine hydrate and a stoichiometric amount of nitrous acid resulted in the formation of S-nitrosothiol-terminated polymers. A similar approach was applied to block copolymers of POEGMA incorporating a domain of poly[(N,N-diisopropylamino)ethyl methacrylate], thus, enabling the preparation of pH responsive nitric oxide (NO)-releasing micelles. The micelles possessed substantially modified S-nitrosothiol loss kinetics compared to the hydrophilic homopolymer analogue. Moreover, thiol-triggered degradation of the S-nitrosothiol was significantly slower when the S-nitrosothiol was embedded in a micellar structure. These results demonstrate that it is possible to incorporate nitric oxide donor moieties directly onto a polymer chain end, enabling simple synthesis of biochemically active nanostructures.
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Affiliation(s)
- Sul Hwa Yu
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Jinming Hu
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Francesca Ercole
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Nghia P. Truong
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - Thomas P. Davis
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
- Department
of Chemistry, University of Warwick, Coventry, ULCV4 7AL, United Kingdom
| | - Michael R. Whittaker
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
| | - John F. Quinn
- ARC
Centre of Excellence in Convergent Bio-Nano Science and Technology, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC 3052, Australia
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Senthil S, Krishndasa SN. Pre-Hypertension in Apparently Healthy Young Adults: Incidence and Influence of Haemoglobin Level. J Clin Diagn Res 2015; 9:CC10-2. [PMID: 26675286 DOI: 10.7860/jcdr/2015/14970.6847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 09/14/2015] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Prehypertension is a precursor of clinical hypertension and consequently of the cardiovascular disease. Recent studies have found positive correlation between Haemoglobin Level (Hb) and Blood Pressure (BP). But the presumed association between Hb and BP has not been investigated in healthy young adults. AIM This study aimed to estimate the incidence of prehypertension and the influence of Hb level on BP in healthy young adults. MATERIALS AND METHODS This was a cross-sectional study done in 84 apparently healthy undergraduate medical students aged between 18-23 years, of either sex. In study subjects, BP and haemoglobin content was measured. Prehypertension was defined as BP levels of 120 to 139/80 to 89 mm Hg. Statistical analysis was done by unpaired t-test and Pearson correlation Coefficient tests. RESULTS Incidence of prehypertension was 50%. In 24% of the study subjects both systolic and diastolic BP was in prehypertensive state. In another 26% of study subjects only systolic BP was above normal. There was positive correlation between systolic BP and Hb level (p = 0.0015). CONCLUSION High incidence of prehypertension especially systolic prehypertension prevails inapparently healthy medical undergraduate students. In them, positive correlation between Hb and systolic BP persists.
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Affiliation(s)
- Sunandha Senthil
- MBBS Student, Kasturba Medical College, Manipal University Mangalore , Karnataka, India
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Abstract
Blood transfusions are used to treat reduced O2-carrying capacity consequent to anemia. In many cases anemia is caused by a major blood loss, which also creates a state of hypovolemia. Whereas O2 transport capacity is restored by increasing levels of circulating Hb, transfusion does not resolve the hypoperfusion, the hypoxia and the inflammatory cascades initiated during the anemia and hypovolemia. This explains why blood transfusion is not always an effective treatment and why transfusion of stored blood has been associated with increased morbidity and mortality, especially in patient populations receiving multiple transfusions. Epidemiologic data indicate that adverse events after transfusion are relatively common, having a great impact on the patients outcome and on the costs of public health. In this chapter, we explain why classical transfusion strategies target the reversal of hypoxia only, but do not address the inflammatory cascades initiated during anemic states and the importance of the flow and vascular endothelium interactions. We also establish the relation between red blood cells storage lesions, limited NO bioavailability and transfusion-associated adverse events. Lastly, we explain the potential use of long-lived sources of bioactive NO to reverse the hypoxic inflammatory cascades, promote a sustained increase in tissue perfusion and thereby allow transfusions to achieve their intended goal. The underlying premise is that adverse effects associated with transfusions are intimately linked to vascular dysfunction. Understanding of these mechanisms would lead to novel transfusion medicine strategies to preserve red cell function and to correct for functional changes induced by hemoglobinopathies that affect cell structure and function.
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Quinn JF, Whittaker MR, Davis TP. Delivering nitric oxide with nanoparticles. J Control Release 2015; 205:190-205. [DOI: 10.1016/j.jconrel.2015.02.007] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/30/2015] [Accepted: 02/04/2015] [Indexed: 11/15/2022]
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Roche CJ, Talwar A, Palmer AF, Cabrales P, Gerfen G, Friedman JM. Evaluating the capacity to generate and preserve nitric oxide bioactivity in highly purified earthworm erythrocruorin: a giant polymeric hemoglobin with potential blood substitute properties. J Biol Chem 2014; 290:99-117. [PMID: 25371199 PMCID: PMC4281771 DOI: 10.1074/jbc.m114.583260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The giant extracellular hemoglobin (erythrocruorin) from the earth worm (Lumbricus terrestris) has shown promise as a potential hemoglobin-based oxygen carrier (HBOC) in in vivo animal studies. An important beneficial characteristic of this hemoglobin (LtHb) is the large number of heme-based oxygen transport sites that helps overcome issues of osmotic stress when attempting to provide enough material for efficient oxygen delivery. A potentially important additional property is the capacity of the HBOC either to generate nitric oxide (NO) or to preserve NO bioactivity to compensate for decreased levels of NO in the circulation. The present study compares the NO-generating and NO bioactivity-preserving capability of LtHb with that of human adult hemoglobin (HbA) through several reactions including the nitrite reductase, reductive nitrosylation, and still controversial nitrite anhydrase reactions. An assignment of a heme-bound dinitrogen trioxide as the stable intermediate associated with the nitrite anhydrase reaction in both LtHb and HbA is supported based on functional and EPR spectroscopic studies. The role of the redox potential as a factor contributing to the NO-generating activity of these two proteins is evaluated. The results show that LtHb undergoes the same reactions as HbA and that the reduced efficacy for these reactions for LtHb relative to HbA is consistent with the much higher redox potential of LtHb. Evidence of functional heterogeneity in LtHb is explained in terms of the large difference in the redox potential of the isolated subunits.
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Affiliation(s)
- Camille J Roche
- From the Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461
| | - Abhinav Talwar
- From the Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, Herricks High School, New Hyde Park, New York 11040
| | - Andre F Palmer
- William G. Lawrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, Ohio 43210, and
| | - Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093-0412
| | - Gary Gerfen
- From the Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461
| | - Joel M Friedman
- From the Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461,
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Fens MH, Larkin SK, Oronsky B, Scicinski J, Morris CR, Kuypers FA. The capacity of red blood cells to reduce nitrite determines nitric oxide generation under hypoxic conditions. PLoS One 2014; 9:e101626. [PMID: 25007272 PMCID: PMC4090171 DOI: 10.1371/journal.pone.0101626] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 06/09/2014] [Indexed: 01/11/2023] Open
Abstract
Nitric oxide (NO) is a key regulator of vascular tone. Endothelial nitric oxide synthase (eNOS) is responsible for NO generation under normoxic conditions. Under hypoxia however, eNOS is inactive and red blood cells (RBC) provide an alternative NO generation pathway from nitrite to regulate hypoxic vasodilation. While nitrite reductase activity of hemoglobin is well acknowledged, little is known about generation of NO by intact RBC with physiological hemoglobin concentrations. We aimed to develop and apply a new approach to provide insights in the ability of RBC to convert nitrite into NO under hypoxic conditions. We established a novel experimental setup to evaluate nitrite uptake and the release of NO from RBC into the gas-phase under different conditions. NO measurements were similar to well-established clinical measurements of exhaled NO. Nitrite uptake was rapid, and after an initial lag phase NO release from RBC was constant in time under hypoxic conditions. The presence of oxygen greatly reduced NO release, whereas inhibition of eNOS and xanthine oxidoreductase (XOR) did not affect NO release. A decreased pH increased NO release under hypoxic conditions. Hypothermia lowered NO release, while hyperthermia increased NO release. Whereas fetal hemoglobin did not alter NO release compared to adult hemoglobin, sickle RBC showed an increased ability to release NO. Under all conditions nitrite uptake by RBC was similar. This study shows that nitrite uptake into RBC is rapid and release of NO into the gas-phase continues for prolonged periods of time under hypoxic conditions. Changes in the RBC environment such as pH, temperature or hemoglobin type, affect NO release.
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Affiliation(s)
- Marcel H. Fens
- Children's Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Sandra K. Larkin
- Children's Hospital Oakland Research Institute, Oakland, California, United States of America
| | - Bryan Oronsky
- RadioRx, Inc., Mountain View, California, United States of America
| | - Jan Scicinski
- RadioRx, Inc., Mountain View, California, United States of America
| | - Claudia R. Morris
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Frans A. Kuypers
- Children's Hospital Oakland Research Institute, Oakland, California, United States of America
- * E-mail:
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Zhong Q, Xu J, Long Y, Deng Y, Hu J, Li X, Qiu X. Interaction of body mass index and hemoglobin concentration on blood pressure among pregnant women in Guangxi, China. BMC Public Health 2014; 14:474. [PMID: 24885822 PMCID: PMC4030466 DOI: 10.1186/1471-2458-14-474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 05/06/2014] [Indexed: 11/23/2022] Open
Abstract
Background Body mass index (BMI) and hemoglobin (Hb) are positively associated with hypertensive disorders among pregnant women. The aim of this study was to estimate a potential interaction between high BMI and high Hb concentrations on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in pregnancy. Methods We recruited 4497 single-birth women aged 18–43 years who received routine antenatal care at three hospitals of Guigang, Guangxi, China, from December 2007 to January 2011. Of 4497 participants, 3472 women were in the first trimester, with following up, 2986 women and 2261 women were left in the second and third trimester, respectively. Clinical data were derived from medical records of each woman. We used multivariable linear regression, by trimesters of pregnancy, to evaluate the associations of high BMI and high Hb concentrations with SBP and DBP according to cross-sectional design. Results In multivariable analyses, BMI was positively associated with SBP throughout all trimesters, but the corresponding association for Hb concentrations only in the first trimester, whereas both BMI and Hb concentrations were positively associated with DBP in the first and third trimesters. After full adjustment for confounding, the average differences in SBP and DBP comparing women with high BMI and high Hb to those with non-high BMI and non-high Hb were 2.9 mmHg (95% CI: 0.8 to 5.0 mmHg) and 3.9 mmHg (95% CI: 1.5 to 6.3 mmHg) in the first trimester, 2.6 mmHg (95% CI: 0.4 to 4.8 mmHg) and 1.5 mmHg (95% CI: -1.3 to 4.3 mmHg) in the second trimester, and 4.8 mmHg (95% CI: 2.3 to 7.4 mmHg) and 5.7 mmHg (95% CI: 3.2 to 8.3 mmHg) in the third trimester, respectively. With respect to the interaction, significant combined effects between high BMI and high Hb were confirmed on SBP (P = 0.02) and DBP (P = 0.004) in the third trimester, and the amount of interaction on SBP and DBP were 2.0 mmHg (95% CI: 0.1 to 3.9 mmHg) and 2.3 mmHg (95% CI: 0.4 to 4.3 mmHg), respectively. Conclusion Our findings suggest that high BMI and high Hb concentrations may have a synergistic effect on blood pressure in late stage of pregnancy.
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Affiliation(s)
| | | | | | | | | | | | - Xiaoqiang Qiu
- Department of Epidemiology, Guangxi Medical University School of Public Health, 22 Shuangyong Road, Nanning, Guangxi 530021, China.
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Ren L, Gu B, Du Y, Wu X, Liu X, Wang H, Jiang L, Guo Y, Wang J. Hemoglobin in normal range, the lower the better?-Evidence from a study from Chinese community-dwelling participants. J Thorac Dis 2014; 6:477-82. [PMID: 24822106 DOI: 10.3978/j.issn.2072-1439.2014.02.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 02/26/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine the association between hemoglobin (Hb) levels and cardiovascular risk factors in a large community-dwelling cohort. METHODS A total of 4,186 women and 4,851 men were enrolled in the study. Data on personal history, physical examination and biochemical parameters were collected. Subjects were categorized by gender and divided into different group according to the level of Hb or blood pressure, and the association between Hb levels and cardiovascular risk factors was examined using Pearson's correlation analysis. RESULTS In both men and women even with normal Hb level, tertiles of Hb levels were positively associated with body mass index (BMI), total-cholesterol (TC), triglyceride (TG), uric acid (UA), diastolic blood pressures (DBP) and fasting plasma glucose (FPG) (all P=0.000 in men and women). Furthermore, significantly increased incidence of hyperuricemia (P=0.000 both in men and women) and obesity (P=0.000 both in men and women) were observed with the gradually increased Hb level. In addition, Pearson's correlation analysis revealed obvious correlation between Hb level and various cardiovascular risk factors including blood pressure and UA. Binary logistic regression analysis further demonstrated that the level of Hb was an important risk factor for elevated blood pressure (OR =1.216; 95% CI: 1.138-1.293, P=0.000 in men; OR =1.287; 95% CI: 1.229-1.363, P=0.000 in women). CONCLUSIONS Increasing Hb levels, even in subjects with normal level were associated with increasing prevalence of cardiovascular risk factors, suggesting that a slightly low Hb level might be beneficial to Chinese community-dwelling individuals.
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Affiliation(s)
- Lianxiang Ren
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Bing Gu
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Yixing Du
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Xin Wu
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Xinjian Liu
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Hui Wang
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Li Jiang
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Yan Guo
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
| | - Junhong Wang
- 1 Department of Medical Examination Center, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China ; 2 Department of Laboratory Medicine, 3 Department of Neurology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 4 Department of Clinical Laboratory Medicine, BenQ Medical Center, Nanjing 210019, China ; 5 Department of Pathogen Biology, Nanjing Medical University, Nanjing 210029, China ; 6 Department of Gerontology, 7 Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China ; 8 Department of Laboratory Medicine, Jiangsu Shengze Hospital, Wujiang 215228, China
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PUSPITANINGRUM RINI, MANTOLINI KURNIANUZTIR, RUSDI, SADIKIN MOHAMAD. Comparison of Hemoglobins from Various Subjects Living in Hypoxia. HAYATI JOURNAL OF BIOSCIENCES 2013. [DOI: 10.4308/hjb.20.3.99] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
The development of oxygen (O2)-carrying blood substitutes has evolved from the goal of replicating blood O2 transport properties to that of preserving microvascular and organ function, reducing the inherent or potential toxicity of the material used to carry O2, and treating pathologies initiated by anemia and hypoxia. Furthermore, the emphasis has shifted from blood replacement fluid to "O2 therapeutics" that restore tissue oxygenation to specific tissues regions. This review covers the different alternatives, potential and limitations of hemoglobin-based O2 carriers (HBOCs) and perfluorocarbon-based O2 carriers (PFCOCs), with emphasis on the physiologic conditions disturbed in the situation that they will be used. It describes how concepts learned from plasma expanders without O2-carrying capacity can be applied to maintain O2 delivery and summarizes the microvascular responses due to HBOCs and PFCOCs. This review also presents alternative applications of HBOCs and PFCOCs namely: 1) How HBOC O2 affinity can be engineered to target O2 delivery to hypoxic tissues; and 2) How the high gas solubility of PFCOCs provides new opportunities for carrying, dissolving, and delivering gases with biological activity. It is concluded that the development of current blood substitutes has amplified their applications horizon by devising therapeutic functions for O2 carriers requiring limited O2 delivery capacity restoration. Conversely, full, blood-like O2-carrying capacity reestablishment awaits the control of O2 carrier toxicity.
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Affiliation(s)
- Pedro Cabrales
- Department of Bioengineering, University of California, San Diego, La Jolla, California 92093-0412, USA.
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Roche CJ, Cassera MB, Dantsker D, Hirsch RE, Friedman JM. Generating S-nitrosothiols from hemoglobin: mechanisms, conformational dependence, and physiological relevance. J Biol Chem 2013; 288:22408-25. [PMID: 23775069 DOI: 10.1074/jbc.m113.482679] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In vitro, ferrous deoxy-hemes in hemoglobin (Hb) react with nitrite to generate nitric oxide (NO) through a nitrite reductase reaction. In vivo studies indicate Hb with nitrite can be a source of NO bioactivity. The nitrite reductase reaction does not appear to account fully for this activity because free NO is short lived especially within the red blood cell. Thus, the exporting of NO bioactivity both out of the RBC and over a large distance requires an additional mechanism. A nitrite anhydrase (NA) reaction in which N2O3, a potent S-nitrosating agent, is produced through the reaction of NO with ferric heme-bound nitrite has been proposed (Basu, S., Grubina, R., Huang, J., Conradie, J., Huang, Z., Jeffers, A., Jiang, A., He, X., Azarov, I., Seibert, R., Mehta, A., Patel, R., King, S. B., Hogg, N., Ghosh, A., Gladwin, M. T., and Kim-Shapiro, D. B. (2007) Nat. Chem. Biol. 3, 785-794) as a possible mechanism. Legitimate concerns, including physiological relevance and the nature of the mechanism, have been raised concerning the NA reaction. This study addresses these concerns demonstrating NO and nitrite with ferric hemes under near physiological conditions yield an intermediate having the properties of the purported NA heme-bound N2O3 intermediate. The results indicate that ferric heme sites, traditionally viewed as a source of potential toxicity, can be functionally significant, especially for partially oxygenated/partially met-R state Hb that arises from the NO dioxygenation reaction. In the presence of low levels of nitrite and either NO or a suitable reductant such as L-cysteine, these ferric heme sites can function as a generator for the formation of S-nitrosothiols such as S-nitrosoglutathione and, as such, should be considered as a source of RBC-derived and exportable bioactive NO.
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Affiliation(s)
- Camille J Roche
- Department of Physiology and Biophysics, Albert Einstein College of Medicine, Bronx, New York 10461, USA
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