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Wong A, Sun Q, Latif II, Karwi QG. Metabolic flux in macrophages in obesity and type-2 diabetes. JOURNAL OF PHARMACY & PHARMACEUTICAL SCIENCES : A PUBLICATION OF THE CANADIAN SOCIETY FOR PHARMACEUTICAL SCIENCES, SOCIETE CANADIENNE DES SCIENCES PHARMACEUTIQUES 2024; 27:13210. [PMID: 38988822 PMCID: PMC11233469 DOI: 10.3389/jpps.2024.13210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024]
Abstract
Recent literature extensively investigates the crucial role of energy metabolism in determining the inflammatory response and polarization status of macrophages. This rapidly expanding area of research highlights the importance of understanding the link between energy metabolism and macrophage function. The metabolic pathways in macrophages are intricate and interdependent, and they can affect the polarization of macrophages. Previous studies suggested that glucose flux through cytosolic glycolysis is necessary to trigger pro-inflammatory phenotypes of macrophages, and fatty acid oxidation is crucial to support anti-inflammatory responses. However, recent studies demonstrated that this understanding is oversimplified and that the metabolic control of macrophage polarization is highly complex and not fully understood yet. How the metabolic flux through different metabolic pathways (glycolysis, glucose oxidation, fatty acid oxidation, ketone oxidation, and amino acid oxidation) is altered by obesity- and type 2 diabetes (T2D)-associated insulin resistance is also not fully defined. This mini-review focuses on the impact of insulin resistance in obesity and T2D on the metabolic flux through the main metabolic pathways in macrophages, which might be linked to changes in their inflammatory responses. We closely evaluated the experimental studies and methodologies used in the published research and highlighted priority research areas for future investigations.
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Affiliation(s)
- Angela Wong
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Qiuyu Sun
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ismail Ibrahim Latif
- Department of Microbiology, College of Medicine, University of Diyala, Baqubaa, Diyala, Iraq
| | - Qutuba G Karwi
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, Saint John's, NL, Canada
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Jiménez-Osorio AS, Carreón-Torres E, Correa-Solís E, Ángel-García J, Arias-Rico J, Jiménez-Garza O, Morales-Castillejos L, Díaz-Zuleta HA, Baltazar-Tellez RM, Sánchez-Padilla ML, Flores-Chávez OR, Estrada-Luna D. Inflammation and Oxidative Stress Induced by Obesity, Gestational Diabetes, and Preeclampsia in Pregnancy: Role of High-Density Lipoproteins as Vectors for Bioactive Compounds. Antioxidants (Basel) 2023; 12:1894. [PMID: 37891973 PMCID: PMC10604737 DOI: 10.3390/antiox12101894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/05/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Inflammation and oxidative stress are essential components in a myriad of pathogenic entities that lead to metabolic and chronic diseases. Moreover, inflammation in its different phases is necessary for the initiation and maintenance of a healthy pregnancy. Therefore, an equilibrium between a necessary/pathologic level of inflammation and oxidative stress during pregnancy is needed to avoid disease development. High-density lipoproteins (HDL) are important for a healthy pregnancy and a good neonatal outcome. Their role in fetal development during challenging situations is vital for maintaining the equilibrium. However, in certain conditions, such as obesity, diabetes, and other cardiovascular diseases, it has been observed that HDL loses its protective properties, becoming dysfunctional. Bioactive compounds have been widely studied as mediators of inflammation and oxidative stress in different diseases, but their mechanisms of action are still unknown. Nonetheless, these agents, which are obtained from functional foods, increase the concentration of HDL, TRC, and antioxidant activity. Therefore, this review first summarizes several mechanisms of HDL participation in the equilibrium between inflammation and oxidative stress. Second, it gives an insight into how HDL may act as a vector for bioactive compounds. Third, it describes the relationships between the inflammation process in pregnancy and HDL activity. Consequently, different databases were used, including MEDLINE, PubMed, and Scopus, where scientific articles published in the English language up to 2023 were identified.
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Affiliation(s)
- Angélica Saraí Jiménez-Osorio
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Elizabeth Carreón-Torres
- Department of Molecular Biology, Instituto Nacional de Cardiología “Ignacio Chávez”, Juan Badiano 1, Sección XVI, Tlalpan, Mexico City 14080, Mexico;
| | - Emmanuel Correa-Solís
- Instituto de Farmacobiología, Universidad de la Cañada, Carretera Teotitlán-San Antonio Nanahuatipán Km 1.7 s/n., Paraje Titlacuatitla, Teotitlán de Flores Magón 68540, Oaxaca, Mexico;
| | - Julieta Ángel-García
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - José Arias-Rico
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Octavio Jiménez-Garza
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Lizbeth Morales-Castillejos
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Hugo Alexander Díaz-Zuleta
- Facultad de Ciencias de la Salud, Universidad de Ciencias Aplicadas y Ambientales, Cl. 222 #54-21, Bogotá 111166, Colombia;
| | - Rosa María Baltazar-Tellez
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - María Luisa Sánchez-Padilla
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Olga Rocío Flores-Chávez
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
| | - Diego Estrada-Luna
- Área Académica de Enfermería, Instituto de Ciencias de la Salud, Universidad Autónoma del Estado Hida go, Circuito Ex Hacienda La Concepción S/N, Carretera Pachuca-Actopan, San Agustín Tlaxiaca 42160, Hidalgo, Mexico; (A.S.J.-O.); (J.Á.-G.); (J.A.-R.); (O.J.-G.); (L.M.-C.); (R.M.B.-T.); (M.L.S.-P.); (O.R.F.-C.)
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Abstract
The prevalence of neonatal hypoxic-ischemic encephalopathy (HIE), a devastating neurological injury, is increasing; thus, effective treatments and preventions are urgently needed. The underlying pathology of HIE remains unclear; recent research has focused on elucidating key features of the disease. A variety of diseases can be alleviated by consuming a ketogenic diet (KD) despite differences in pathogenesis and features, given the common mechanisms of KD-induced effects. Dietary modification is the most translatable, cost-efficient, and safest approach to treat acute or chronic neurological disorders and reduces reliance on pharmaceutical treatments. Evidence suggests that the KD can exert beneficial effects in animal models and in humans with brain injuries. The efficacy of the KD in preventing neuronal damage, motor alterations, and cognitive decline varies. Moreover, the KD may provide an alternative source of energy, enhance mitochondrial function, and reduce the expression of inflammatory and apoptotic mediators. Thus, this diet has attracted interest as a potential therapy for HIE. This review examined the role of the KD in HIE treatment and described the mechanisms by which ketone bodies (KBs) exert effects under pathological conditions and protect against brain damage; the evidence supports the implementation of dietary interventions as a therapeutic strategy for HIE. Future research should aim to elucidate the underlying mechanisms of the KD in patients with HIE and determine whether the effect of the KD on clinical outcomes can be reproduced in humans.
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Affiliation(s)
- Yue Zhou
- Department of Pharmacy, Xindu District People's Hospital of Chengdu, 610500 Chengdu, China
| | - Luqiang Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, 610075 Chengdu, China
| | - Haichuan Wang
- Department of Paediatrics, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 610072 Chengdu, China
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Hughey CC, Puchalska P, Crawford PA. Integrating the contributions of mitochondrial oxidative metabolism to lipotoxicity and inflammation in NAFLD pathogenesis. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159209. [DOI: 10.1016/j.bbalip.2022.159209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/25/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
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Ketone Bodies and SIRT1, Synergic Epigenetic Regulators for Metabolic Health: A Narrative Review. Nutrients 2022; 14:nu14153145. [PMID: 35956321 PMCID: PMC9370141 DOI: 10.3390/nu14153145] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Ketone bodies (KBs) and Sirtuin-1 (SIRT1) have received increasing attention over the past two decades given their pivotal function in a variety of biological contexts, including transcriptional regulation, cell cycle progression, inflammation, metabolism, neurological and cardiovascular physiology, and cancer. As a consequence, the modulation of KBs and SIRT1 is considered a promising therapeutic option for many diseases. The direct regulation of gene expression can occur in vivo through histone modifications mediated by both SIRT1 and KBs during fasting or low-carbohydrate diets, and dietary metabolites may contribute to epigenetic regulation, leading to greater genomic plasticity. In this review, we provide an updated overview of the epigenetic interactions between KBs and SIRT1, with a particular glance at their central, synergistic roles for metabolic health.
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Acetoacetate is a trigger of NLRP3 inflammasome activation in bovine peripheral blood mononuclear cells. Vet Immunol Immunopathol 2021; 244:110370. [PMID: 34952251 DOI: 10.1016/j.vetimm.2021.110370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/21/2022]
Abstract
Repeat breeding, which is non-pregnancy following three or more breeding attempts, is a serious reproductive disorder in cattle. In the present study, metabolomic profiling was used to identify metabolites in the blood plasma of repeat breeder cows (RBCs) and non-RBCs. Metabolomic analysis showed that acetoacetate (AcAc), a ketone body, was detected in RBCs, but not in non-RBCs. In contrast, β-hydroxybutyrate (BHB) was at similar levels in both RBCs and non-RBCs. We hypothesized that an imbalance of AcAc and BHB induces abnormal inflammatory conditions, especially the NLRP3 inflammasome, which regulates sterile inflammation to control interleukin (IL)-1β secretion, and may be associated with repeat breeding in cattle. To investigate this hypothesis, blood samples were collected from both non-RBCs and RBCs on day 7 of the estrous cycle. The mRNA expression of IL1B in peripheral blood mononuclear cells (PBMCs) was observed to be higher in RBCs than in non-RBCs. To test the effects of AcAc and BHB on inflammatory responses, blood samples were collected from healthy cows and PBMCs were isolated. PBMCs were treated with AcAc and BHB to investigate the activation of the NLRP3 inflammasome (complex of NLRP3, ASC, and caspase-1) and IL-1β secretion. AcAc treatment resulted in higher protein and/or mRNA expression of NLRP3 and IL-1β in PBMCs. Moreover, AcAc increased the co-localization of NLRP3 and ASC and stimulated caspase-1 activation, indicating the formation of the platform of the NLRP3 inflammasome. Addition of specific NLRP3 inhibitor, MCC950, suppressed AcAc stimulation-induced IL-1β secretion. Contrary to the effects of AcAc, BHB treatment suppressed the activation of NLRP3 inflammasome and IL-1β secretion in response to AcAc and typical NLRP3 inflammasome triggers. These findings demonstrate that AcAc can potentially trigger NLRP3 inflammasome activation, resulting in IL-1β secretion, and that these inflammatory responses are suppressed by BHB in bovine PBMCs. In addition, the imbalance between AcAc and BHB with higher levels of IL-1β may be associated with repeat breeding in cattle.
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Puthanveetil P, Kong X, Bräse S, Voros G, Peer WA. Transcriptome analysis of two structurally related flavonoids; Apigenin and Chrysin revealed hypocholesterolemic and ketogenic effects in mouse embryonic fibroblasts. Eur J Pharmacol 2020; 893:173804. [PMID: 33347826 DOI: 10.1016/j.ejphar.2020.173804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 12/14/2022]
Abstract
There is no known single therapeutic drug for treating hypercholesterolemia that comes with negligible systemic side effects. In the current study, using next generation RNA sequencing approach in mouse embryonic fibroblasts we discovered that two structurally related flavonoid compounds. Apigenin and Chrysin exhibited moderate blocking ability of multiple transcripts that regulate rate limiting enzymes in the cholesterol biosynthesis pathway. The observed decrease in cholesterol biosynthesis pathway correlated well with an increase in transcripts involved in generation and trafficking of ketone bodies as evident by the upregulation of Bdh1 and Slc16a6 transcripts. The hypocholesterolemic potential of Apigenin and Chrysin at higher concentrations along with their ability to generate ketogenic substrate especially during embryonic stage is useful or detrimental for embryonic health is not clear and still debatable. Our study will serve as a steppingstone to further the investigation in whole animal studies and also in translating this knowledge to human studies.
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Affiliation(s)
- Prasanth Puthanveetil
- Department of Pharmacology, College of Graduate Studies, Midwestern University, Downers Grove, IL, USA.
| | - Xiaoli Kong
- Department of Mathematics and Statistics, Loyola University Chicago, Chicago, IL, USA.
| | - Stefan Bräse
- Institute of Biological and Chemical Systems (IBCS), Karlsruhe Institute of Technology (KIT), Hermann von Helmholtz Platz 1, 76344, Eggenstein Leopoldshafen, Germany.
| | - Gabor Voros
- Department of Cardiovascular Diseases, University Hospital Gasthuisberg, Catholic University Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Wendy Ann Peer
- Department of Environmental Science and Technology, College of Agricultural and Natural Resources, University of Maryland, MD, USA.
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Kapustin RV, Chepanov SV, Babakov VN, Rogovskaya NY, Kopteeva EV, Alekseenkova EN, Arzhanova ON. Maternal serum leptin, adiponectin, resistin and monocyte chemoattractant protein-1 levels in different types of diabetes mellitus. Eur J Obstet Gynecol Reprod Biol 2020; 254:284-291. [PMID: 33039836 DOI: 10.1016/j.ejogrb.2020.09.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Evaluation of serum concentration of leptin, adiponectin, resistin, and MCP-1 in pregnant patients with different types of diabetes mellitus (DM) considering preconception planning and method of DM correction in 11-14th and 30-34th weeks of pregnancy. STUDY DESIGN Longitudinal, prospective study included 130 pregnant women divided into the following comparison groups: type 1 DM (T1DM, n = 40), type 2 DM (T2DM, n = 35), GDM (n = 40), and the control group (n = 15). The ELISA method defined the levels of leptin, resistin, adiponectin, and MCP-1 concentration in serum, which was assessed in 11-14th and 30-34th weeks of pregnancy. Statistical analysis was accomplished using SPSS 23.0 and "Prism 8-GraphPad" software. RESULTS The leptin level in the 1st trimester was the highest in T2DM insulin group compared to the control due to gestational age, hence in the 3rd trimester in all groups its serum concentrations appeared higher than in healthy patients (p = 0.0001). In the 1st trimester leptin levels directly correlated with women's BMI, newborns' weight and macrosomia rate, in the 3rd trimester - with OGTT levels, HbA1c, gestational hypertension, and preeclampsia rates. Resistin levels in the 1st and 3rd trimesters were increased in almost all DM groups compared to the control group (p = 0.0001). The study established direct positive correlation between resistin and HbA1c, birth weight, and preeclampsia. In the 1st trimester, adiponectin demonstrated the lowest levels in T2DM insulin compared to T1DM and the control group (p = 0.0001) while in the 3rd trimester, adiponectin levels declined alongside gestational age in DM patients and all the groups compared to the control group (p < 0.05). Adiponectin negatively correlated with BMI, OGTT levels, and preeclampsia rate. MCP-1 levels in T2DM appeared higher than in T1DM patients and the control group in the 1st trimester, whereas in the 3rd trimester MCP-1 declined, correlating with BMI, preeclampsia and OGTT levels. CONCLUSION High rate of adverse perinatal outcomes in diabetic pregnancy might be developed due to more severe metabolic failures and further disturbances of adipokines expression.
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Affiliation(s)
- Roman V Kapustin
- Department of Obstetrics, Division of Maternal-Fetal Medicine, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, 3 Mendeleevskaya Line, St. Petersburg, 199034, Russia; Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, St. Petersburg State University, 7-9 Universitetskaya Emb., St. Petersburg, 199034, Russia.
| | - Sergey V Chepanov
- Department of Immunology and Intercellular Interactions, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, 3 Mendeleevskaya Line, St. Petersburg, 199034, Russia
| | - Vladimir N Babakov
- Research Institute of Hygiene, Occupational Pathology and Human Ecology FMBA, Kuzmolovsky, Vsevolozhsky District, Leningrad Reg., 188663, Russia
| | - Nadezhda Y Rogovskaya
- Research Institute of Hygiene, Occupational Pathology and Human Ecology FMBA, Kuzmolovsky, Vsevolozhsky District, Leningrad Reg., 188663, Russia
| | - Ekaterina V Kopteeva
- Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, St. Petersburg State University, 7-9 Universitetskaya Emb., St. Petersburg, 199034, Russia
| | - Elena N Alekseenkova
- Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, St. Petersburg State University, 7-9 Universitetskaya Emb., St. Petersburg, 199034, Russia
| | - Olga N Arzhanova
- Department of Obstetrics, Division of Maternal-Fetal Medicine, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductive Medicine, 3 Mendeleevskaya Line, St. Petersburg, 199034, Russia; Department of Obstetrics, Gynecology and Reproduction, Faculty of Medicine, St. Petersburg State University, 7-9 Universitetskaya Emb., St. Petersburg, 199034, Russia
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Pocate-Cheriet K, Santulli P, Kateb F, Bourdon M, Maignien C, Batteux F, Chouzenoux S, Patrat C, Wolf JP, Bertho G, Chapron C. The follicular fluid metabolome differs according to the endometriosis phenotype. Reprod Biomed Online 2020; 41:1023-1037. [PMID: 33046374 DOI: 10.1016/j.rbmo.2020.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 12/11/2022]
Abstract
RESEARCH QUESTION Is there a follicular fluid-specific metabolic profile in deep infiltrating endometriosis (DIE) depending on the presence of an associated ovarian endometrioma (OMA) that could lead to the identification of biomarkers for diagnosis and prognosis of the disease? DESIGN In this prospective cohort study, proton nuclear magnetic resonance (1H-NMR) experiments were carried out on 50 follicular fluid samples from patients presenting with DIE, associated or not associated with an OMA, and 29 follicular fluid samples from patients with infertility caused by a tubal obstruction. RESULTS Concentrations of glucose, citrate, creatine and amino acids such as tyrosine and alanine were lower in women with DIE than control participants, whereas concentrations of lactate, pyruvate, lipids and ketone bodies were higher. Metabolic analysis revealed enhanced concentrations of glycerol and ketone bodies in patients with OMA, indicative of an activation of lipolysis followed by beta-oxidation. Concentrations of lactate and pyruvate were increased in patients without OMA, whereas the concentration of glucose was decreased, highlighting activation of the anaerobic glycolysis pathway. Differences in concentrations of amino acids such as threonine and glutamine were also statistically relevant in discriminating between the presence or absence of OMA. CONCLUSIONS Results indicate a mitochondrial dysregulation in endometriosis phenotypes, with a modified balance between anaerobic glycolysis and beta-oxidation in OMA phenotypes that could affect the fertility of women with endometriosis. As the composition of the follicular fluid has been shown to be correlated with oocyte development and outcome of implantation after fertilization, these findings may help explain the high level of infertility in these patients.
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Affiliation(s)
- Khaled Pocate-Cheriet
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Service d'Histologie-Embryologie-Biologie de la Reproduction, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France.
| | - Pietro Santulli
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France
| | - Fatiha Kateb
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Laboratoire de Chimie et Biochimie Pharmacologiques et Toxicologiques, UMR 8601-CNRS, Université de Paris, Campus Saint-Germain-des-Prés, Paris, France
| | - Mathilde Bourdon
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France
| | - Chloé Maignien
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France
| | - Frédéric Batteux
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France; Service d'Immunologie Biologique, Paris, France
| | - Sandrine Chouzenoux
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France
| | - Catherine Patrat
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Service d'Histologie-Embryologie-Biologie de la Reproduction, Paris, France
| | - Jean Philippe Wolf
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Service d'Histologie-Embryologie-Biologie de la Reproduction, Paris, France
| | - Gildas Bertho
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Laboratoire de Chimie et Biochimie Pharmacologiques et Toxicologiques, UMR 8601-CNRS, Université de Paris, Campus Saint-Germain-des-Prés, Paris, France
| | - Charles Chapron
- Université de Paris, Faculté de Médecine, Paris, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Cochin (HUPC), Centre Hospitalier Paris Centre, Paris, France; Département "Développement, Reproduction et Cancer", Institut Cochin, INSERM U1016, Université de Paris, Paris, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France
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Maignien C, Santulli P, Kateb F, Caradeuc C, Marcellin L, Pocate-Cheriet K, Bourdon M, Chouzenoux S, Batteux F, Bertho G, Chapron C. Endometriosis phenotypes are associated with specific serum metabolic profiles determined by proton-nuclear magnetic resonance. Reprod Biomed Online 2020; 41:640-652. [PMID: 32839101 DOI: 10.1016/j.rbmo.2020.06.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/16/2020] [Accepted: 06/29/2020] [Indexed: 12/18/2022]
Abstract
RESEARCH QUESTION What is the correlation between serum metabolic profile and endometriosis phenotype? DESIGN A pilot study nestled in a prospective cohort study at a university hospital, including 46 patients with painful endometriosis who underwent surgery and 21 controls who did not have macroscopic endometriotic lesions. Endometriosis was strictly classified into two groups of 23 patients each: endometrioma (OMA) and deep infiltrating endometriosis (DIE). Serum samples were collected before surgery for metabolomic profiling based on proton-nuclear magnetic resonance spectroscopy in combination with statistical approaches. Comparative identification of the metabolites in the serum from endometriosis patients and from controls was carried out, including an analysis according to endometriosis phenotype. RESULTS The serum metabolic profiles of the endometriosis patients revealed significantly lower concentrations of several amino acids compared with the controls, whereas the concentrations of free fatty acids and ketone bodies were significantly higher. The OMA and the DIE phenotypes each had a specific metabolic profile, with higher concentrations of two ketone bodies in the OMA group, and higher concentrations of free fatty acids and lipids in the DIE group. CONCLUSION Proton-nuclear magnetic resonance-based metabolomics of serum samples were found to have ample potential for identifying metabolic changes associated with endometriosis phenotypes. This information may improve our understanding of the pathogenesis of endometriosis.
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Affiliation(s)
- Chloé Maignien
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction (Professor Chapron), 123 boulevard de Port-Royal, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
| | - Pietro Santulli
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction (Professor Chapron), 123 boulevard de Port-Royal, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France.
| | - Fatiha Kateb
- Laboratoire de Chimie et Biochimie Pharmacologiques et Toxicologiques, UMR 8601-CNRS, Université de Paris, Campus Saint-Germain-des-Prés, 45 Rue des Saint-Pères, Paris 75006, France
| | - Cédric Caradeuc
- Laboratoire de Chimie et Biochimie Pharmacologiques et Toxicologiques, UMR 8601-CNRS, Université de Paris, Campus Saint-Germain-des-Prés, 45 Rue des Saint-Pères, Paris 75006, France
| | - Louis Marcellin
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction (Professor Chapron), 123 boulevard de Port-Royal, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
| | - Khaled Pocate-Cheriet
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Service d'Histologie-Embryologie-Biologie de la Reproduction (Professor Patrat), 123 Boulevard de Port-Royal, Paris 75014, France
| | - Mathilde Bourdon
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction (Professor Chapron), 123 boulevard de Port-Royal, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
| | - Sandrine Chouzenoux
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
| | - Frédéric Batteux
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Service d'Immunologie Biologique (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
| | - Gildas Bertho
- Laboratoire de Chimie et Biochimie Pharmacologiques et Toxicologiques, UMR 8601-CNRS, Université de Paris, Campus Saint-Germain-des-Prés, 45 Rue des Saint-Pères, Paris 75006, France
| | - Charles Chapron
- Université de Paris, Faculté de Medecine, 15 Rue de L'ecole de Médecine, Paris 75006, France; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre (HUPC), Centre Hospitalier Universitaire (CHU) Cochin, 27 Rue du Faubourg Saint Jacques, Paris 75014, France; Département de Gynécologie Obstétrique II et Médecine de la Reproduction (Professor Chapron), 123 boulevard de Port-Royal, Paris 75014, France; Département 'Développement, Reproduction et Cancer', Institut Cochin, Inserm u1016 (Professor Batteux), 27 Rue du Faubourg Saint Jacques, Paris 75014, France
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11
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Yang H, Shan W, Zhu F, Wu J, Wang Q. Ketone Bodies in Neurological Diseases: Focus on Neuroprotection and Underlying Mechanisms. Front Neurol 2019; 10:585. [PMID: 31244753 PMCID: PMC6581710 DOI: 10.3389/fneur.2019.00585] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/17/2019] [Indexed: 12/14/2022] Open
Abstract
There is growing evidence that ketone bodies, which are derived from fatty acid oxidation and usually produced in fasting state or on high-fat diets have broad neuroprotective effects. Although the mechanisms underlying the neuroprotective effects of ketone bodies have not yet been fully elucidated, studies in recent years provided abundant shreds of evidence that ketone bodies exert neuroprotective effects through possible mechanisms of anti-oxidative stress, maintaining energy supply, modulating the activity of deacetylation and inflammatory responses. Based on the neuroprotective effects, the ketogenic diet has been used in the treatment of several neurological diseases such as refractory epilepsy, Parkinson's disease, Alzheimer's disease, and traumatic brain injury. The ketogenic diet has great potential clinically, which should be further explored in future studies. It is necessary to specify the roles of components in ketone bodies and their therapeutic targets and related pathways to optimize the strategy and efficacy of ketogenic diet therapy in the future.
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Affiliation(s)
- Huajun Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Wei Shan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fei Zhu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China
| | - Jianping Wu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Qun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Clinical Medicine of Neurological Diseases, Beijing, China.,Beijing Institute for Brain Disorders, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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12
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Bellos I, Fitrou G, Pergialiotis V, Perrea DN, Daskalakis G. Serum levels of adipokines in gestational diabetes: a systematic review. J Endocrinol Invest 2019; 42:621-631. [PMID: 30392100 DOI: 10.1007/s40618-018-0973-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the difference of serum levels of 10 adipokines (apelin, chemerin, fatty acid-binding protein-4, fibroblast growth factor-21, monocyte chemoattractant protein-1, nesfatin-1, omentin-1, resistin, vaspin, and visfatin) among women with gestational diabetes and healthy pregnant controls. MATERIALS AND METHODS Literature search was conducted using the Medline (1966-2018), Scopus (2004-2018), Cochrane Central Register of Controlled Trials (CENTRAL) (1999-2018), Clinicaltrials.gov (2008-2018) and Google Scholar (2004-2018) databases, along with the reference list of the included studies. RESULTS Ninety-one studies were included in the present review, with a total number of 11,074 pregnant women. A meta-analysis was not conducted due to the high inter-study heterogeneity. Current evidence suggests that fatty acid-binding protein-4 levels are significantly increased in pregnancies complicated with gestational diabetes, while no association of serum apelin and monocyte chemoattractant protein-1 with the disease can be supported. Data regarding the rest adipokines are conflicting, since the available studies did not unanimously indicate a significant change of their levels in gestational diabetes. CONCLUSIONS The findings of the present systematic review suggest the promising role of fatty acid-binding protein-4 in the prediction of gestational diabetes, while inconsistent evidence exists regarding the rest novel adipokines. Future cohorts are needed to assess their predictive efficacy and fully elucidate their contribution in the disease.
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Affiliation(s)
- I Bellos
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, 15Β, Ag. Thoma str., 115 27, Athens, Greece.
| | - G Fitrou
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, 15Β, Ag. Thoma str., 115 27, Athens, Greece
| | - V Pergialiotis
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, 15Β, Ag. Thoma str., 115 27, Athens, Greece
| | - D N Perrea
- Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, 15Β, Ag. Thoma str., 115 27, Athens, Greece
| | - G Daskalakis
- First Department of Obstetrics and Gynecology, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
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13
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Puchalska P, Martin SE, Huang X, Lengfeld JE, Daniel B, Graham MJ, Han X, Nagy L, Patti GJ, Crawford PA. Hepatocyte-Macrophage Acetoacetate Shuttle Protects against Tissue Fibrosis. Cell Metab 2019; 29:383-398.e7. [PMID: 30449686 PMCID: PMC6559243 DOI: 10.1016/j.cmet.2018.10.015] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/20/2018] [Accepted: 10/24/2018] [Indexed: 12/12/2022]
Abstract
Metabolic plasticity has been linked to polarized macrophage function, but mechanisms connecting specific fuels to tissue macrophage function remain unresolved. Here we apply a stable isotope tracing, mass spectrometry-based untargeted metabolomics approach to reveal the metabolome penetrated by hepatocyte-derived glucose and ketone bodies. In both classically and alternatively polarized macrophages, [13C]acetoacetate (AcAc) labeled ∼200 chemical features, but its reduced form D-[13C]β-hydroxybutyrate (D-βOHB) labeled almost none. [13C]glucose labeled ∼500 features, and while unlabeled AcAc competed with only ∼15% of them, the vast majority required the mitochondrial enzyme succinyl-coenzyme A-oxoacid transferase (SCOT). AcAc carbon labeled metabolites within the cytoplasmic glycosaminoglycan pathway, which regulates tissue fibrogenesis. Accordingly, livers of mice lacking SCOT in macrophages were predisposed to accelerated fibrogenesis. Exogenous AcAc, but not D-βOHB, ameliorated diet-induced hepatic fibrosis. These data support a hepatocyte-macrophage ketone shuttle that segregates AcAc from D-βOHB, coordinating the fibrogenic response to hepatic injury via mitochondrial metabolism in tissue macrophages.
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Affiliation(s)
- Patrycja Puchalska
- Division of Molecular Medicine, Department of Medicine, University of Minnesota, 401 East River Parkway, MMC 194, Minneapolis, MN 55455, USA; Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA
| | - Shannon E Martin
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Pathobiology Graduate Program, Brown University, Providence, RI 02912, USA
| | - Xiaojing Huang
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Department of Chemistry, Washington University, St. Louis, MO 63110, USA; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Justin E Lengfeld
- Division of Molecular Medicine, Department of Medicine, University of Minnesota, 401 East River Parkway, MMC 194, Minneapolis, MN 55455, USA
| | - Bence Daniel
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, FL 33701, USA
| | | | - Xianlin Han
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Barshop Institute for Longevity and Aging Studies, Department of Medicine, Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Laszlo Nagy
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, FL 33701, USA; Department of Biological Chemistry, Johns Hopkins University School of Medicine, Johns Hopkins All Children's Hospital, Saint Petersburg, FL 33701, USA
| | - Gary J Patti
- Department of Chemistry, Washington University, St. Louis, MO 63110, USA
| | - Peter A Crawford
- Division of Molecular Medicine, Department of Medicine, University of Minnesota, 401 East River Parkway, MMC 194, Minneapolis, MN 55455, USA; Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA; Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis, MN 55455, USA.
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14
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Huang SY, Yu B, He X, Chen Y. Intrapartum Results on Differing Degrees of Ketonuria in Nulliparous Women with Gestational Diabetes Mellitus during Spontaneous Labor. Int J Endocrinol 2019; 2019:7207012. [PMID: 31827509 PMCID: PMC6885219 DOI: 10.1155/2019/7207012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/26/2019] [Indexed: 12/21/2022] Open
Abstract
To compare intrapartum results associated with differing degrees of ketonuria in nulliparous women with gestational diabetes mellitus (GDM), we implemented a retrospective cohort study comparing clinical characteristics among differing degrees of ketonuria and the duration and distribution of ketonuria at different stages of labor. We also analyzed adverse maternal and neonatal outcomes for each group. A total of 570 GDM deliveries were included; of these, 238 had negative ketonuria (41.8%), 180 had moderate ketonuria (31.6%), and 152 had ketosis (26.6%). The proportion of patients with a family history of diabetes significantly increased as the degree of ketonuria increased (P < 0.001). Moreover, a significantly lower level of HOMA-IR (the insulin resistance index) was observed for the Negative group (P < 0.001). The triglyceride (TG) level was significantly higher in the Ketosis group (P < 0.001), and the total cholesterol (TC) levels significantly increased as the degree of ketonuria progressed (P < 0.001). There were also higher maternal blood sugar levels and a significantly higher proportion of oxytocin augmentation in ketonuria cases (P < 0.001). Over three-fourths of patients (75.6%) had a ketonuria duration of ≤2 hours in the Moderate group, 61.2% had a ketonuria duration of between 3 and 4 h in the Ketosis group, and most of the ketonuria cases resolved in the first stage of labor. As the degree of ketonuria progressed, we observed a significantly higher number of cases with fetal heart rate pattern III (FHR pattern III), meconium-stained amniotic fluid III (MSAF III), postpartum hemorrhages, prolonged labor, neonatal hypoglycemia, an umbilical cord arterial pH of <7.2, low Apgar scores, increased neonatal intensive care admissions, augmented forceps-assisted deliveries, and conversions to cesarean sections. The results showed that ketonuria is common during the intrapartum period and that the risk of adverse maternal and neonatal outcomes may increase when complicated with ketonuria.
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Affiliation(s)
- Shi-Yun Huang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Bo Yu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Xin He
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Yi Chen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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15
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Price S, Nankervis A, Permezel M, Prendergast L, Sumithran P, Proietto J. Health consequences for mother and baby of substantial pre-conception weight loss in obese women: study protocol for a randomized controlled trial. Trials 2018; 19:248. [PMID: 29690917 PMCID: PMC5926510 DOI: 10.1186/s13063-018-2615-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 03/28/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Current guidelines for the management of obesity in women planning pregnancy suggest lifestyle modification before conception. However, there is little evidence that lifestyle modification alters pregnancy outcomes. Bariatric surgery results in significant weight loss. This appears to reduce the risk of adverse pregnancy outcomes for the mother but may increase the risk of adverse outcomes for the infant. In order to reduce the risks of obesity-related adverse pregnancy outcomes for both mother and offspring, alternative approaches to the management of obesity in women planning pregnancy are needed. METHODS/DESIGN This study, a two-arm, parallel group, randomized control trial, will be conducted at the Metabolic Disorders Centre, University of Melbourne. This trial will recruit 164 women aged 18-38 years with a body mass index of 30-55 kg/m2 who plan to conceive in the next 6-12 months. Women will be randomized to one of two 12-week interventions (Group A and Group B). Group A will aim for modest weight loss (MWL; ≤ 3% body weight) using a hypocaloric diet. Group B will aim for substantial weight loss (SWL; 10-15% body weight) using a modified very low energy diet (VLED) program. All participants will be asked to comply with National Health and Medical Research Council (NHMRC) guidelines for exercise and will be provided with standard pre-pregnancy advice according to Royal Australian and New Zealand College of Obstetrics and Gynaecology guidelines. All participants will then be observed for the subsequent 12 months. If pregnancy occurs within the 12-month follow-up period, data on weight and metabolic status of the mother, and pregnancy outcomes of mother and offspring will be recorded. The primary outcome is maternal fasting plasma glucose at 26-28 weeks' gestation, given that this is known to correlate with pregnancy outcomes. Time to conception, live birth rate, gestational weight gain, and a composite of adverse pregnancy outcomes for mother and baby will comprise the secondary outcomes. DISCUSSION There is increasing emphasis on obese women losing weight before conception. To date, no randomized controlled trial has demonstrated an effective means of weight loss that results in improved pregnancy outcomes for both mother and baby. This study intends to determine if substantial pre-conception weight loss, achieved using a VLED, improves pregnancy outcomes for mother and baby when compared with standard care. This research will potentially change clinical care of an obese woman planning pregnancy. TRIAL REGISTRATION ANZCTR, 12,614,001,160,628 . Registered on 5 November 2014.
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Affiliation(s)
- Sarah Price
- Department of Medicine, University of Melbourne, Heidelberg Repatriation Hospital, Waterdale Rd., Heidelberg, VIC, 3081, Australia
| | - Alison Nankervis
- Diabetes Service, University of Melbourne, Royal Women's Hospital, Flemington Rd., Parkville, VIC, 3050, Australia.,Department of Medicine, University of Melbourne, Royal Melbourne Hospital, Grattan St.,, Parkville, VIC, 3083, Australia
| | - Michael Permezel
- Department of Obstetrics and Gynaecology, University of Melbourne, Mercy Hospital for Women, Studley Rd.,, Heidelberg, VIC, 3050, Australia
| | - Luke Prendergast
- Department of Mathematics and Statistics, LaTrobe University, Kingsbury Drive, Bundoora, VIC, 3081, Australia
| | - Priya Sumithran
- Department of Medicine, University of Melbourne, Heidelberg Repatriation Hospital, Waterdale Rd., Heidelberg, VIC, 3081, Australia
| | - Joseph Proietto
- Department of Medicine, University of Melbourne, Heidelberg Repatriation Hospital, Waterdale Rd., Heidelberg, VIC, 3081, Australia.
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16
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Bronisz A, Ozorowski M, Hagner-Derengowska M. Pregnancy Ketonemia and Development of the Fetal Central Nervous System. Int J Endocrinol 2018; 2018:1242901. [PMID: 29971100 PMCID: PMC6008755 DOI: 10.1155/2018/1242901] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 05/06/2018] [Accepted: 05/15/2018] [Indexed: 12/12/2022] Open
Abstract
Glucose is the major source of energy for the human brain which in turn uses ketone bodies as a supplement for energy deficit in glucose cell deficiency conditions. Pregnancy complicated by gestational diabetes is a condition associated with significantly increased risk of ketonemia development. The data available proves a changing influence of ketones on the central nervous system during fetal life and in adults as well. Ketone bodies freely pass through the placenta. They can affect fetal growth and organ damage development, especially the central nervous system. As agreed in the current recommendation of the diabetes associations, it is not obligatory for the attending doctor to conduct a routine inspection of ketone bodies during diabetes treatment in pregnancy. This article is a literature review of ketones' effect on the central nervous system and an attempt to initiate discussion whether we should consider including ketonemia assessment into the standard care package for pregnant women with diabetes and begin some research on the explanation of its influence on fetal development.
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Affiliation(s)
- Agata Bronisz
- Endocrinology and Diabetology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
| | - Mateusz Ozorowski
- Endocrinology and Diabetology, Faculty of Medicine, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
| | - Magdalena Hagner-Derengowska
- Clinical Neuropsychology, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 9 Skłodowskiej-Curie Street, 85-094 Bydgoszcz, Poland
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17
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Wolf A, Mulier KE, Muratore SL, Beilman GJ. D-β-Hydroxybutyrate and melatonin for treatment of porcine hemorrhagic shock and injury: a melatonin dose-ranging study. BMC Res Notes 2017; 10:649. [PMID: 29187245 PMCID: PMC5707828 DOI: 10.1186/s13104-017-2975-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/22/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Treatment with a combination of D-β-hydroxybutyrate (BHB) and melatonin (M) improves survival in hemorrhagic shock models. Our objective was to find the most effective melatonin concentration in combination with 4 molar BHB (4 M BHB). Survival and markers of organ injury were analyzed in pigs exposed to pulmonary contusion, liver crush injury, and hemorrhagic shock and treated with lactated Ringer's solution; 4 M BHB/43 mM M; 4 M BHB/20 mM M; 4 M BHB/10 mM M; 4 M BHB/4.3 mM M; or 4 M BHB/0.43 mM M. This work is an extension of a previously published research study. RESULTS Survival was highest in pigs receiving 4 M BHB/43 mM M (13/14), followed by lactated Ringer's solution (11/16) and BHB/M with decreased melatonin concentrations (4 M BHB/20 mM M 3/6, 4 M BHB/10 mM M 2/6, 4 M BHB/4.3 mM M 3/6, 4 M BHB/0.43 mM M 1/6, p = 0.011). High mortality was associated with increases in serum lactate, higher liver and muscle injury markers and decreases in PaO2:FiO2 ratios. Our study indicates that treatment with 4 M BHB and melatonin concentrations below 43 mM lack the survival benefit observed from 4 M BHB/43 mM melatonin in pigs experiencing hemorrhagic shock and polytrauma.
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Affiliation(s)
- Andrea Wolf
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Kristine E. Mulier
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Sydne L. Muratore
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Gregory J. Beilman
- Department of Surgery, University of Minnesota, 420 Delaware St SE, Minneapolis, MN 55455 USA
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18
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Abstract
Ketone body metabolism is a central node in physiological homeostasis. In this review, we discuss how ketones serve discrete fine-tuning metabolic roles that optimize organ and organism performance in varying nutrient states and protect from inflammation and injury in multiple organ systems. Traditionally viewed as metabolic substrates enlisted only in carbohydrate restriction, observations underscore the importance of ketone bodies as vital metabolic and signaling mediators when carbohydrates are abundant. Complementing a repertoire of known therapeutic options for diseases of the nervous system, prospective roles for ketone bodies in cancer have arisen, as have intriguing protective roles in heart and liver, opening therapeutic options in obesity-related and cardiovascular disease. Controversies in ketone metabolism and signaling are discussed to reconcile classical dogma with contemporary observations.
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Affiliation(s)
- Patrycja Puchalska
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA
| | - Peter A Crawford
- Center for Metabolic Origins of Disease, Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL 32827, USA.
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19
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Abstract
Diabetic ketoacidosis (DKA) is a serious medical and obstetrical emergency previously considered typical of type 1 diabetes but now reported also in type 2 and GDM patients. Although it is a fairly rare condition, DKA in pregnancy can compromise both fetus and mother. Metabolic changes occurring during pregnancy predispose to DKA in fact it can develop even in setting of normoglycemia. This article will provide the reader with information regarding the pathophysiology underlying DKA, in particular euglycemic DKA, and will provide information regarding all possible effects of ketones on the fetus.
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Affiliation(s)
| | - Silvia Burlina
- a Department of Medicine , DIMED, University of Padova , Italy
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20
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Wajid N, Naseem R, Anwar SS, Awan SJ, Ali M, Javed S, Ali F. The effect of gestational diabetes on proliferation capacity and viability of human umbilical cord-derived stromal cells. Cell Tissue Bank 2014; 16:389-97. [DOI: 10.1007/s10561-014-9483-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/11/2014] [Indexed: 01/01/2023]
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21
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Vicente GC, Correia-Santos AM, Suzuki A, Chagas MA, Boaventura GT. Maternal use of a diet rich omega-3 from flaxseed improves aortic remodeling but not the biochemical parameters of female offspring of diabetic rats. EUR J LIPID SCI TECH 2014. [DOI: 10.1002/ejlt.201400210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- Gabriela Câmara Vicente
- Federal Fluminense University (UFF); Postgraduate Program in Medical Sciences; Niterói-RJ Brazil
| | | | - Akemi Suzuki
- Federal Fluminense University (UFF); Postgraduate Program in Medical Sciences; Niterói-RJ Brazil
| | - Maurício Alves Chagas
- Federal Fluminense University (UFF); Laboratory of Cellular and Extracellular Biomorphology; Niterói-RJ Brazil
| | - Gilson Teles Boaventura
- Federal Fluminense University (UFF); Postgraduate Program in Medical Sciences; Niterói-RJ Brazil
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22
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Ota K, Yamagishi SI, Kim M, Dambaeva S, Gilman-Sachs A, Beaman K, Kwak-Kim J. Elevation of soluble form of receptor for advanced glycation end products (sRAGE) in recurrent pregnancy losses (RPL): possible participation of RAGE in RPL. Fertil Steril 2014; 102:782-9. [PMID: 25044082 DOI: 10.1016/j.fertnstert.2014.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 06/03/2014] [Accepted: 06/03/2014] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine whether the soluble receptor for advanced glycation end products (sRAGE) and immune inflammatory markers are associated with recurrent pregnancy losses (RPL). DESIGN Prospective case-control study. SETTING University clinic. PATIENT(S) A total of 93 women (age 35.8±4.6 years) were enrolled including 63 women with three or more recurrent pregnancy losses (RPL), and age-matched fertile controls with a history of at least one live birth and no history of pregnancy losses (n=30). INTERVENTION(S) Peripheral blood collection. MAIN OUTCOME MEASURE(S) Assessment of anthropometric, metabolic, and inflammatory immune variables. RESULT(S) Levels of sRAGE were statistically significantly higher in RPL patients than in control patients (1,528.9±704.5 vs. 1,149.9±447.4 pg/mL). In the multivariate analysis, the levels of insulin, plasminogen activator inhibitor-1, the resistance index of the uterine radial artery, and the ratio of tumor necrosis factor-α/interleukin-10 producing T helper cells were statistically significantly associated with the serum sRAGE level. CONCLUSION(S) Elevated levels of serum sRAGE are associated with RPL. The soluble receptor for advanced glycation end products might contribute to RPL by reducing uterine blood flow and subsequently causing ischemia in the fetus via inflammatory and thrombotic reactions.
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Affiliation(s)
- Kuniaki Ota
- Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, Illinois; Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Sho-ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Michael Kim
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Svetlana Dambaeva
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Alice Gilman-Sachs
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Kenneth Beaman
- Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois
| | - Joanne Kwak-Kim
- Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, Vernon Hills, Illinois; Department of Microbiology and Immunology, Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, Illinois.
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23
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Xu J, Ye J, Wu Y, Zhang H, Luo Q, Han C, Ye X, Wang H, He J, Huang H, Liu Y, Dong M. Reduced fetal telomere length in gestational diabetes. PLoS One 2014; 9:e86161. [PMID: 24465936 PMCID: PMC3899117 DOI: 10.1371/journal.pone.0086161] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 12/05/2013] [Indexed: 11/18/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is an important complication of pregnancy that poses significant threats to women and their offspring. Telomere length shortens as cellular damage increases and is associated with metabolic diseases. Telomere length in fetal leucocytes was determined in 82 infants of women with GDM (N = 82) and 65 normal pregnant women (N = 65). Women with preeclampsia (N = 45) and gestational hypertension (N = 23) were also studied. In the GDM group, telomere length was significantly shorter than normal pregnancy (P = 0.028), but there were no significant differences in fetal telomere length between preeclampsia and normal pregnancy (P = 0.841) and between gestational hypertension and normal pregnancy (P = 0.561). Regression analysis revealed that fetal telomere length was significantly associated with intrauterine exposure to GDM (P = 0.027 after adjustment for maternal age, gestational age at delivery, birth weight and fetal gender). Shortened telomere length may increase the risk of metabolic diseases in adulthood of GDM offspring.
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Affiliation(s)
- Jian Xu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Junyi Ye
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yanting Wu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Hong Zhang
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Qiong Luo
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Cong Han
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xiaoqun Ye
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Hanzhi Wang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jing He
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Hefeng Huang
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Yun Liu
- Institutes of Biomedical Sciences, Fudan University, Shanghai, China
- Key Laboratory of Molecular Medicine, The Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University, Shanghai, China
- * E-mail: (MD); (YL)
| | - Minyue Dong
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
- Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University, Hangzhou, Zhejiang Province, China
- * E-mail: (MD); (YL)
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