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Saleem Y, Darbari A, Sharma R, Vashisth A, Gupta A. Recent advancements in pediatric cardiopulmonary bypass technology for better outcomes of pediatric cardiac surgery. THE CARDIOTHORACIC SURGEON 2022. [DOI: 10.1186/s43057-022-00084-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Pediatric cardiac surgery is in itself very enigmatic and individualized. Presently, there has been a slew of new developments aimed primarily toward pediatric cardiopulmonary bypass for safer, patient-centered pediatric cardiac surgery. Still, lot of technological challenges need to be resolved, and their safer application in pediatric and neonate patients requires further refinement.
Main body of the abstract
Considering various significant yet unresolved issues of pediatric cardiac bypass, an exhaustive literature search was done on various internet databases with standard keywords. There are various new recent improvements; as the first oxygenator explicitly designed for neonatal patients; pediatric oxygenators with low prime volumes and surface areas that allow flows up to 2 L/min; pediatric oxygenators with integrated arterial filters; and miniature ultrafiltration devices that allow for high rates of ultrafiltrate removal. These advancements can significantly reduce cardiopulmonary bypass circuit surface areas and prime volumes. These advancements could reduce or eliminate the requirement for homologous red blood cells during or after surgery with reduction or eliminate bypass-related hemodilution, and inflammation. Because of the immaturity of the neonatal hemostatic system, conventional coagulation tests alone are insufficient to guide neonatal hemostatic therapy. Myocardial preservation techniques, safe temperature with duration are still debatable and yet to be fully explored.
Short conclusion
This review is based on Standards for Quality Improvement Reporting Excellence guidelines to provide a framework for reporting new knowledge to find better management strategy for pediatric cardiac cases.
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Proteomic profiling identifies key differences between inter-stage infants with single ventricle heart disease and healthy controls. Transl Res 2021; 229:24-37. [PMID: 33045409 PMCID: PMC8191179 DOI: 10.1016/j.trsl.2020.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 12/17/2022]
Abstract
Despite significant morbidity among infants with single ventricle heart disease (SVHD), clinical monitoring is limited by poor understanding of the underlying pathobiology. Proteomics can identify novel biomarkers and important pathways in complex disease. No prior study has evaluated whether the proteome of SVHD infants differs from healthy controls, how it shifts after stage 2 palliation, or whether differences can predict post-operative outcomes. We present a prospective cohort study of cardiovascular proteomic phenotyping in infants with SVHD undergoing stage 2 palliation. Twenty-nine pre-stage-2 SVHD infants and 25 healthy controls were enrolled. Outcomes included postoperative hypoxemia and endotracheal intubation time. Serum samples were drawn pre-operatively (systemic and pulmonary vein) and at 24 hours postoperation. Targeted cardiovascular proteomic analysis included 184 proteins. Partial least squares discriminant analysis distinguished cases from controls (Accuracy = 0.98, R2 = 0.93, Q2 = 0.81) with decreased inflammatory mediators and increased modulators of vascular tone. Partial least squares discriminant analysis also distinguished cases pre-operation vs. post-operation (Accuracy=0.98, R2=0.99, Q2 = 0.92) with postoperative increase in both inflammatory and vascular tone mediators. Pre-operation pulmonary vein tissue inhibitor of metalloproteinase-1 (1.8x-fold, p=1.6 × 10-4) and nidogen-1 (1.5x-fold, p=1.7 × 10-4) were higher in subjects with longer endotracheal intubation time. Postoperation matrix metalloproteinase 7 levels were higher in subjects with greater postoperative hypoxemia (1.5x-fold, P= 1.97 × 10-5). Proteomic analysis identifies significant changes among SVHD infants pre- and post-stage 2, and healthy controls. Tissue inhibitor of metalloproteinase-1, nidogen-1, and matrix metalloproteinase 7 levels are higher in SVHD cases with greater morbidity suggesting an important role for regulation of extracellular matrix production. Proteomic profiling may identify high-risk SVHD infants.
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Reed CR, McCoy CC, Nag U, Nixon AB, Otto J, Lawson JH, Lodge AJ, Turek JW, Tracy ET. Proteomic Analysis of Infants Undergoing Cardiopulmonary Bypass Using Contemporary Ontological Tools. J Surg Res 2019; 246:83-92. [PMID: 31562990 DOI: 10.1016/j.jss.2019.08.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/08/2019] [Accepted: 08/29/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Cardiopulmonary bypass (CPB) is essential for the repair of many congenital cardiac defects in infants but is associated with significant derangements in hemostasis and systemic inflammation. As a result, hemorrhagic complications and thrombosis are major challenges in the management of children requiring CPB or extracorporeal membrane oxygenation. Conventional clinical laboratory tests capture individual hemostatic derangements (low platelets, elevated fibrinogen) but fail to describe the complex, overlapping interactions among the various components of coagulation, including cellular interactions, contact activation, fibrinolysis, and inflammation. Given recent advances in analytic tools for identifying protein-protein interactions in the plasma proteome, we hypothesized that an unbiased proteomic analysis would help identify networks of interacting proteins for further investigation in pediatric CPB. MATERIALS AND METHODS Infants up to 1 y of age were enrolled. Plasma samples were collected at 0, 1, 4, and 24 h after CPB. Mass spectrometry was used to identify proteins undergoing changes in concentration after CPB, and STRING and ToppGene tools were used to identify biological networks. Two-dimensional difference gel electrophoresis identified changes in protein concentrations. Inflammatory markers were assessed by enzyme-linked immunosorbent assay at the same time points. RESULTS Ten infants with cardiac anomalies requiring surgery and CPB were enrolled; no major complications were recorded (median age, 127.5 d; interquartile range, 181.25 d). Using two-dimensional difference gel electrophoresis, >1400 individual protein spots were observed, and 89 proteins demonstrated change in concentration >30% with P < 0.02 when comparing 1, 4, or 24 h to baseline. Among protein spots with significant changes in concentration after CPB, 29 were identified with mass spectrometry (33%). In our interrogation of functional associations among these differentially expressed proteins, our results were dominated by the acute phase response, coagulation, and cell signaling functional categories. Among cytokines analyzed by enzyme-linked immunosorbent assay, IL-2, IL-8, and IL-10 were elevated at 4 h but normalized by 24 h, whereas IL-6 was persistently elevated. CONCLUSIONS Infants manifest a robust response to CPB that includes overlapping, complex pathways. Further investigation of interactions among immune, coagulation, and cell signaling systems may lead to novel therapeutics or biomarkers useful in the management of infants requiring CPB.
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Affiliation(s)
| | | | - Uttara Nag
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Andrew B Nixon
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - James Otto
- Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | | | - Andrew J Lodge
- Section of Pediatric Cardiac Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
| | - Joseph W Turek
- Section of Pediatric Cardiac Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina
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Wang G, Umstead TM, Hu S, Mikerov AN, Phelps DS, Floros J. Differential Effects of Human SP-A1 and SP-A2 on the BAL Proteome and Signaling Pathways in Response to Klebsiella pneumoniae and Ozone Exposure. Front Immunol 2019; 10:561. [PMID: 30972061 PMCID: PMC6443908 DOI: 10.3389/fimmu.2019.00561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 03/04/2019] [Indexed: 12/29/2022] Open
Abstract
Surfactant protein A (SP-A) plays critical roles in host defense, regulation of inflammation and surfactant metabolism in the lung. The human SP-A locus consists of two functional genes, SFTPA1 and SFTPA2 encoding surfactant proteins SP-A1 and SP-A2, respectively. Structural and functional differences exist between SP-A1 and SP-A2 in vitro and in vivo. Ozone is a major air pollutant with a negative impact on many biological processes. In this study we used humanized transgenic (hTG) SP-A1 and SP-A2 mice, and SP-A KO mice to study in vivo effects of SP-A1 and SP-A2 on the bronchoalveolar lavage (BAL) proteomic profile and associated signaling pathways in response to ozone or filtered air (FA) exposure and Klebsiella pneumoniae infection. The BAL samples were harvested 24 h after ozone (2 ppm for 3 h) or FA exposure and infection and analyzed by two-dimensional difference gel electrophoresis (2D-DIGE) and MALDI-ToF/ToF. We found: that (1) Ozone exposure, but not infection, is a major factor for increases in total BAL protein content. (2) A total of 36 proteins were identified, accounting for 89.62% of the BAL proteins resolved by the 2D-DIGE system. (3) The number of proteins in which levels were altered more than 25% following infection and FA exposure was: SP-A2 > SP-A1 > KO for male mice, and SP-A2 ≈ SP-A1 > KO for female mice. (4) The number of proteins with more than 25% increase/decrease after ozone exposure and infection was: SP-A2 > SP-A1 ≈ KO, with the majority being increases in male mice and decreases in female mice. (5) Eleven out of the 36 proteins, including annexin A5, glutathione S-transferase A4, SP-A1/SP-A2, and 14-3-3 zeta protein, exhibited significant differences among SP-A genotypes. The acute phase response (APR) that includes the NF-kB signaling pathway plays a critical role, followed by Nrf2-mediated oxidative response, and others. These associated with SP-A genotype, sex, and ozone-induced oxidative stress in response to infection. We concluded that human SP-A2 and SP-A1 exhibit differential genotype-and sex-dependent innate immune responses to microbial pathogens and/or ozone-induced oxidative stress by modulating proteomic patterns and signaling pathways in the lung.
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Affiliation(s)
- Guirong Wang
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States.,Department of Surgery, SUNY Upstate Medical University, Syracuse, NY, United States
| | - Todd M Umstead
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Sanmei Hu
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Anatoly N Mikerov
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - David S Phelps
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Joanna Floros
- Department of Pediatrics, Center for Host defense, Inflammation, and Lung Disease (CHILD) Research, The Pennsylvania State University College of Medicine, Hershey, PA, United States.,Department of Obstetrics and Gynecology, The Pennsylvania State University College of Medicine, Hershey, PA, United States
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Hepponstall M, Ignjatovic V, Binos S, Attard C, Karlaftis V, d’Udekem Y, Monagle P, Konstantinov IE. Cardiopulmonary bypass changes the plasma proteome in children undergoing tetralogy of Fallot repair. Perfusion 2015; 30:556-64. [DOI: 10.1177/0267659114566065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Cardiopulmonary bypass (CPB) can be associated with deleterious clinical effects. However, the impact of CPB on inflammatory, immunological and other homeostatic pathways remains poorly understood. We investigated the impact of CPB on the plasma proteome in children undergoing tetralogy of Fallot repair. Methods: Blood samples were taken from 20 children prior to and at the end of CPB and 6h, 12h and 24h after CPB. Plasma was analysed by liquid chromatography-mass spectrometry (LC-MS) in a label-free, untargeted approach. Data were analysed using Genedata software to identify peptides that were differentially expressed (p<0.01 above a false discovery rate). Proteins were identified from peptides that demonstrated differential expression. Results: The proteins that were found to be differentially expressed were haptoglobin isoform 1 preproprotein, isoform 2 of semaphorin-6C, vitamin D-binding protein, inter-alpha-trypsin inhibitor, ceruloplasmin, apolipoprotein B100 and fibrinogen alpha. Conclusion: CPB alters the plasma proteome with differences most apparent at 6h and 12h post CPB. There was a return to baseline with no proteins differentially regulated by 24h.
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Affiliation(s)
- M Hepponstall
- Murdoch Childrens Research Institute, Melbourne, Australia
- Cardiac Surgery Unit, Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Primary Industries, Bioscience Research Division, Melbourne, Australia
| | - V Ignjatovic
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - S Binos
- Department of Primary Industries, Bioscience Research Division, Melbourne, Australia
| | - C Attard
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - V Karlaftis
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Y d’Udekem
- Murdoch Childrens Research Institute, Melbourne, Australia
- Cardiac Surgery Unit, Royal Children’s Hospital, Melbourne, Australia
| | - P Monagle
- Murdoch Childrens Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - I E Konstantinov
- Murdoch Childrens Research Institute, Melbourne, Australia
- Cardiac Surgery Unit, Royal Children’s Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Hepponstall M, Konstantinov IE. Proteomics in paediatric cardiac surgery: is a personalised approach feasible? Proteomics Clin Appl 2014; 8:851-61. [PMID: 25244609 DOI: 10.1002/prca.201400054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/27/2014] [Accepted: 09/17/2014] [Indexed: 11/10/2022]
Abstract
The incidence of congenital cardiac abnormalities remains high. Paediatric patients with congenital cardiac defects often require surgery at a young age. The surgeries are often long and complex, rendering this population particularly vulnerable to the deleterious effects of cardiopulmonary bypass and cardiac surgery. The search for cardioprotective strategies is ongoing in an attempt to reduce the morbidity in this population. In the post-genomic era, it is apparent that simply determining the genomic sequences holds little diagnostic potential and means to determine progression of disease and response to treatment. The field of proteomics is expanding and application of proteomic techniques in the clinical setting holds great potential to advance our understanding of the proteomic changes involved in specific disease stages. This review will assess the application of proteomic techniques in the setting of paediatric cardiac surgery and highlight the need to obtain a clear understanding of the role of various proteins in children with cardiac conditions. The success and challenges of the available proteomic technology will be discussed as well as the future potential of proteomic methods for advancing our understanding of protein changes in children requiring cardiac surgery.
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Affiliation(s)
- Michele Hepponstall
- Murdoch Childrens Research Institute, Melbourne, Australia; Cardiac Surgery Unit and Cardiology, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Phelps DS, Umstead TM, Floros J. Sex differences in the acute in vivo effects of different human SP-A variants on the mouse alveolar macrophage proteome. J Proteomics 2014; 108:427-44. [PMID: 24954098 DOI: 10.1016/j.jprot.2014.06.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 05/28/2014] [Accepted: 06/10/2014] [Indexed: 01/06/2023]
Abstract
UNLABELLED Surfactant protein A (SP-A) is involved in lung innate immunity. Humans have two SP-A genes, SFTPA1 and SFTPA2, each with several variants. We examined the in vivo effects of treatment with specific SP-A variants on the alveolar macrophage (AM) proteome from SP-A knockout (KO) mice. KO mice received either SP-A1, SP-A2, or both. AM were collected and their proteomes examined with 2D-DIGE. We identified 90 proteins and categorized them as related to actin/cytoskeleton, oxidative stress, protease balance/chaperones, regulation of inflammation, and regulatory/developmental processes. SP-A1 and SP-A2 had different effects on the AM proteome and these effects differed between sexes. In males more changes occurred in the oxidative stress, protease/chaperones, and inflammation groups with SP-A2 treatment than with SP-A1. In females most SP-A1-induced changes were in the actin/cytoskeletal and oxidative stress groups. We conclude that after acute SP-A1 and SP-A2 treatment, sex-specific differences were observed in the AM proteomes from KO mice, and that these sex differences differ in response to SP-A1 and SP-A2. Females are more responsive to SP-A1, whereas the gene-specific differences in males were minimal. These observations not only demonstrate the therapeutic potential of exogenous SP-A, but also illustrate sex- and gene-specific differences in the response to it. BIOLOGICAL SIGNIFICANCE This study shows that changes occur in the alveolar macrophage proteome in response to a single in vivo treatment with exogenous SP-A1 and/or SP-A2. We demonstrate that SP-A1 and SP-A2 have different effects on the AM proteome and that sex differences exist in the response to each SP-A1 and SP-A2 gene product. This study illustrates the potential of exogenous SP-A1 and SP-A2 treatment for the manipulation of macrophage function and indicates that the specific SP-A variant used for treatment may vary with sex and with the cellular functions being modified. The observed changes may contribute to sex differences in the incidence of some lung diseases.
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Affiliation(s)
- David S Phelps
- The Center for Host Defense, Inflammation, and Lung Disease (CHILD) Research, Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Todd M Umstead
- The Center for Host Defense, Inflammation, and Lung Disease (CHILD) Research, Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Joanna Floros
- The Center for Host Defense, Inflammation, and Lung Disease (CHILD) Research, Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA; Department of Obstetrics and Gynecology, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Hall R. Identification of Inflammatory Mediators and Their Modulation by Strategies for the Management of the Systemic Inflammatory Response During Cardiac Surgery. J Cardiothorac Vasc Anesth 2013; 27:983-1033. [DOI: 10.1053/j.jvca.2012.09.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Indexed: 12/21/2022]
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Undar A, Wang S, Krawiec C. Impact of a unique international conference on pediatric mechanical circulatory support and pediatric cardiopulmonary perfusion research. Artif Organs 2012; 36:943-50. [PMID: 23121202 DOI: 10.1111/j.1525-1594.2012.01563.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
There is no question that the International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion is a unique event that has had a significant impact on the treatment of neonatal, infantile, and pediatric cardiopulmonary patients around the globe since 2005. This annual event will continue as long as there is a need to fill the gap for underserved patient population. It will also continue to recognize promising young investigators based on their full manuscripts for young investigator awards.
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Phelps DS, Umstead TM, Floros J. Sex differences in the response of the alveolar macrophage proteome to treatment with exogenous surfactant protein-A. Proteome Sci 2012; 10:44. [PMID: 22824420 PMCID: PMC3570446 DOI: 10.1186/1477-5956-10-44] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 06/29/2012] [Indexed: 01/12/2023] Open
Abstract
Background Male wild type (WT) C57BL/6 mice are less capable of clearing bacteria and surviving from bacterial pneumonia than females. However, if an oxidative stress (acute ozone exposure) occurs before infection, the advantage shifts to males who then survive at higher rates than females. We have previously demonstrated that survival in surfactant protein-A (SP-A) knockout (KO) mice compared to WT was significantly reduced. Because the alveolar macrophage (AM) is pivotal in host defense we hypothesized that SP-A and circulating sex hormones are responsible for these sex differences. We used 2D-DIGE to examine the relationship of sex and SP-A on the AM proteome. The role of SP-A was investigated by treating SP-A KO mice with exogenous SP-A for 6 and 18 hr and studying its effects on the AM proteome. Results We found: 1) less variance between KO males and females than between the WT counterparts by principal component analysis, indicating that SP-A plays a role in sex differences; 2) fewer changes in females when the total numbers of significantly changing protein spots or identified whole proteins in WT or 18 hr SP-A-treated males or females were compared to their respective KO groups; 3) more proteins with functions related to chaperones or protease balance and Nrf2-regulated proteins changed in response to SP-A in females than in males; and 4) the overall pattern of SP-A induced changes in actin-related proteins were similar in both sexes, although males had more significant changes. Conclusions Although there seems to be an interaction between sex and the effect of SP-A, it is unclear what the responsible mechanisms are. However, we found that several of the proteins that were expressed at significantly higher levels in females than in males in WT and/or in KO mice are known to interact with the estrogen receptor and may thus play a role in the SP-A/sex interaction. These include major vault protein, chaperonin subunit 2 (beta) (CCT2), and Rho GDP alpha dissociation inhibitor. We conclude that sex differences exist in the proteome of AM derived from male and female mice and that SP-A contributes to these sex differences.
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Affiliation(s)
- David S Phelps
- Center for Host defense, Inflammation, and Lung Disease(CHILD) Research and Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, 17033, USA.
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Krul ES, Lemke SL, Mukherjea R, Taylor ML, Goldstein DA, Su H, Liu P, Lawless A, Harris WS, Maki KC. Effects of duration of treatment and dosage of eicosapentaenoic acid and stearidonic acid on red blood cell eicosapentaenoic acid content. Prostaglandins Leukot Essent Fatty Acids 2012; 86:51-9. [PMID: 22064208 DOI: 10.1016/j.plefa.2011.10.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this randomized, controlled, parallel group study was to characterize the relationships between dosages of stearidonic acid (SDA) and eicosapentaenoic acid (EPA), and incorporation of EPA into red blood cell (RBC) membranes over time. METHODS Healthy subjects (n=131) received capsules with placebo (safflower oil), SDA (0.43, 1.3, 2.6, or 5.2 g/d) or EPA (0.44, 1.3, or 2.7 g/d) for 12 weeks. RBC fatty acids were analyzed biweekly. RESULTS RBC %EPA increased in all EPA and SDA groups (p<0.02 vs. control) except the 0.43 g/d SDA group (p=0.187). For theoretical intakes of EPA of 0.25, 0.5, and 0.89 g/d, the amounts of SDA needed to achieve equivalent RBC EPA enrichment were 0.61, 1.89, and 5.32 g/d (conversion efficiencies of 41%, 26%, and 17%), respectively. CONCLUSIONS SDA increased RBC %EPA in a dosage and time-dependent manner at intakes as low as 1.3 g/d.
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Affiliation(s)
- E S Krul
- Solae LLC, 4300 Duncan Avenue, St. Louis, MO 63110, USA.
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Phelps DS, Umstead TM, Quintero OA, Yengo CM, Floros J. In vivo rescue of alveolar macrophages from SP-A knockout mice with exogenous SP-A nearly restores a wild type intracellular proteome; actin involvement. Proteome Sci 2011; 9:67. [PMID: 22035134 PMCID: PMC3219558 DOI: 10.1186/1477-5956-9-67] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Accepted: 10/28/2011] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Mice lacking surfactant protein-A (SP-A-/-; knockout; KO) exhibit increased vulnerability to infection and injury. Although many bronchoalveolar lavage (BAL) protein differences between KO and wild-type (WT) are rapidly reversed in KO after infection, their clinical course is still compromised. We studied the impact of SP-A on the alveolar macrophage (AM) proteome under basal conditions. Male SP-A KO mice were SP-A-treated (5 micrograms/mouse) and sacrificed in 6 or 18 hr. The AM proteomes of KO, SP-A-treated KO, and WT mice were studied by 2D-DIGE coupled with MALDI-ToF/ToF and AM actin distribution was examined by phalloidon staining. RESULTS We observed: a) significant differences from KO in WT or exogenous SP-A-treated in 45 of 76 identified proteins (both increases and decreases). These included actin-related/cytoskeletal proteins (involved in motility, phagocytosis, endocytosis), proteins of intracellular signaling, cell differentiation/regulation, regulation of inflammation, protease/chaperone function, and proteins related to Nrf2-mediated oxidative stress response pathway; b) SP-A-induced changes causing the AM proteome of the KO to resemble that of WT; and c) that SP-A treatment altered cell size and F-actin distribution. CONCLUSIONS These differences are likely to enhance AM function. The observations show for the first time that acute in vivo SP-A treatment of KO mice, under basal or unstimulated conditions, affects the expression of multiple AM proteins, alters F-actin distribution, and can restore much of the WT phenotype. We postulate that the SP-A-mediated expression profile of the AM places it in a state of "readiness" to successfully conduct its innate immune functions and ensure lung health.
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Affiliation(s)
- David S Phelps
- Center for Host defense, Inflammation, and Lung Disease (CHILD) Research and Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA 17033, USA.
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Plasma proteomic alterations in non-human primates and humans after chronic alcohol self-administration. Int J Neuropsychopharmacol 2011; 14:899-911. [PMID: 21303580 PMCID: PMC3107900 DOI: 10.1017/s1461145711000046] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective diagnostics of excessive alcohol use are valuable tools in the identification and monitoring of subjects with alcohol use disorders. A number of potential biomarkers of alcohol intake have been proposed, but none have reached widespread clinical usage, often due to limited diagnostic sensitivity and specificity. In order to identify novel potential biomarkers, we performed proteomic biomarker target discovery in plasma samples from non-human primates that chronically self-administer high levels of ethanol. Two-dimensional difference in-gel electrophoresis (2D-DIGE) was used to quantify plasma proteins from within-subject samples collected before exposure to ethanol and after 3 months of excessive ethanol self-administration. Highly abundant plasma proteins were depleted from plasma samples to increase proteomic coverage. Altered plasma levels of serum amyloid A4 (SAA4), retinol-binding protein, inter-alpha inhibitor H4, clusterin, and fibronectin, identified by 2D-DIGE analysis, were confirmed in unmanipulated, whole plasma from these animals by immunoblotting. Examination of these target plasma proteins in human subjects with excessive alcohol consumption (and control subjects) revealed increased levels of SAA4 and clusterin and decreased levels of fibronectin compared to controls. These proteins not only serve as targets for further development as biomarker candidates or components of biomarker panels, but also add to the growing understanding of dysregulated immune function and lipoprotein metabolism with chronic, excessive alcohol consumption.
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Qiu F, Talor J, Zahn J, Pauliks L, Kunselman AR, Palanzo D, Baer L, Woitas K, Wise R, McCoach R, Weaver B, Carney E, Haines N, Uluer MC, Aran K, Sasso LA, Alkan-Bozkaya T, Akcevin A, Guan Y, Wang S, Aĝirbaşli M, Clark JB, Myers JL, Ündar A. Translational Research in Pediatric Extracorporeal Life Support Systems and Cardiopulmonary Bypass Procedures: 2011 Update. World J Pediatr Congenit Heart Surg 2011; 2:476-81. [DOI: 10.1177/2150135111402226] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular research center with a multidisciplinary research team with the goal to improve the outcomes for children undergoing cardiac surgery with cardiopulmonary bypass (CPB) and extracorporeal life support (ECLS). Due to the variety of commercially available pediatric CPB and ECLS devices, both in vitro and in vivo translational research have been conducted to achieve the optimal choice for our patients. By now, every component being used in our clinical settings in Penn State Hershey has been selected based on the results of our translational research. The objective of this review is to summarize our translational research in Penn State Hershey Pediatric Cardiovascular Research Center and to share the latest results with all the interested centers.
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Affiliation(s)
- Feng Qiu
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Jonathan Talor
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Jeffrey Zahn
- Department of Bioengineering, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Linda Pauliks
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Allen R. Kunselman
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - David Palanzo
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Larry Baer
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Karl Woitas
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Robert Wise
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Robert McCoach
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Bonnie Weaver
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Elizabeth Carney
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Nikkole Haines
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Mehmet C. Uluer
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Kiana Aran
- Department of Bioengineering, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Lawrance A. Sasso
- Department of Bioengineering, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | | | - Atif Akcevin
- Department of Cardiovascular Surgery, American Hospital, Istanbul, Turkey
| | - Yulong Guan
- Department of Cardiopulmonary Bypass, The Fuwai Hospital, Beijing, China
| | - Shigang Wang
- Department of Cardiopulmonary Bypass, The Fuwai Hospital, Beijing, China
| | | | - J. Brian Clark
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - John L. Myers
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
| | - Akif Ündar
- Penn State Hershey Pediatric Cardiovascular Research Center, Departments of Pediatrics, Surgery, Bioengineering, Public Health Sciences, and Comparative Medicine, Penn State Hershey College of Medicine, Penn State Hershey Children’s Hospital, Hershey, PA, USA
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15
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Abstract
There have been a number of recent developments in the practice of anesthesia and intensive care aimed at improving outcome in terms of reducing both morbidity and mortality, as well as other less-defined factors, such as quality of service provision. Significant advances have been made in airway devices such as pediatric tracheal tube designs, Microcuff(®) tracheal tubes, and new laryngoscopes. Noninvasive monitoring devices, including continuous hemoglobin analysis and near infrared spectrometry, are being increasingly used in pediatric anesthesia. Other, 'scaled-down' versions from adult anesthesia care, however, have not universally been shown to result in improved safety and outcomes in pediatric anesthesia.
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Affiliation(s)
- Shane Campbell
- Department of Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
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16
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Abstract
This current review describes how components of the cardiopulmonary bypass (CPB) circuit are selected and examines the benefits of pulsatile perfusion for use during CPB. Pulsatile flow generates significantly greater surplus hemodynamic energy (SHE) than nonpulsatile flow; higher SHE values have been associated with better microcirculation perfusion, lower rates of systemic inflammatory response, and better vital organ protection. Pulsatile perfusion may have a positive effect on clinical outcomes, play a role in preserving homeostasis, and help to decrease morbidity associated with CPB.
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Affiliation(s)
- Jonathan J. Talor
- Penn State Hershey Pediatric Cardiovascular Research Center and Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Penn State Children’s Hospital, Hershey, PA, USA
| | - Akif Ündar
- Penn State Hershey Pediatric Cardiovascular Research Center and Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Penn State Children’s Hospital, Hershey, PA, USA
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17
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Multi-modal proteomic analysis of retinal protein expression alterations in a rat model of diabetic retinopathy. PLoS One 2011; 6:e16271. [PMID: 21249158 PMCID: PMC3020973 DOI: 10.1371/journal.pone.0016271] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 12/09/2010] [Indexed: 01/14/2023] Open
Abstract
Background As a leading cause of adult blindness, diabetic retinopathy is a prevalent and profound complication of diabetes. We have previously reported duration-dependent changes in retinal vascular permeability, apoptosis, and mRNA expression with diabetes in a rat model system. The aim of this study was to identify retinal proteomic alterations associated with functional dysregulation of the diabetic retina to better understand diabetic retinopathy pathogenesis and that could be used as surrogate endpoints in preclinical drug testing studies. Methodology/Principal Findings A multi-modal proteomic approach of antibody (Luminex)-, electrophoresis (DIGE)-, and LC-MS (iTRAQ)-based quantitation methods was used to maximize coverage of the retinal proteome. Transcriptomic profiling through microarray analysis was included to identify additional targets and assess potential regulation of protein expression changes at the mRNA level. The proteomic approaches proved complementary, with limited overlap in proteomic coverage. Alterations in pro-inflammatory, signaling and crystallin family proteins were confirmed by orthogonal methods in multiple independent animal cohorts. In an independent experiment, insulin replacement therapy normalized the expression of some proteins (Dbi, Anxa5) while other proteins (Cp, Cryba3, Lgals3, Stat3) were only partially normalized and Fgf2 and Crybb2 expression remained elevated. Conclusions/Significance These results expand the understanding of the changes in retinal protein expression occurring with diabetes and their responsiveness to normalization of blood glucose through insulin therapy. These proteins, especially those not normalized by insulin therapy, may also be useful in preclinical drug development studies.
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