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Ma K, Yang J, Shao Y, Li P, Guo H, Wu J, Zhu Y, Zhang H, Zhang X, Du J, Li Y. Therapeutic and Prognostic Significance of Arachidonic Acid in Heart Failure. Circ Res 2022; 130:1056-1071. [PMID: 35255710 DOI: 10.1161/circresaha.121.320548] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Accurate prediction of death is an unmet need in patients with acute decompensated heart failure (HF). Arachidonic acid (AA) metabolites play an important role in the multiple pathophysiological processes. We aimed to develop an AA score to accurately predict mortality in patients with acute decompensated HF and explore the causal relationship between the AA predictors and HF. METHODS The serum AA metabolites was measured in patients with acute decompensated HF (discovery cohort n=419; validation cohort n=386) by mass spectroscopy. We assessed the prognostic importance of AA metabolites for 1-year death using Cox regression and machine learning approaches. An machine learning-based AA score for predicting 1-year death was created and validated. We explored the mechanisms using transcriptome and functional experiments in a mouse model of early ischemic cardiomyopathy. RESULTS Among the 27 AA metabolites, elevated 14,15-DHET/14,15-EET ratio was the strongest predictor of 1-year death (hazard ratio, 2.10, P=3.1×10-6). Machine learning-based AA score using a combination of the 14,15-DHET/14,15-EET ratio, 14,15-DHET, PGD2, and 9-HETE performed best (area under the curve [AUC]: 0.85). The machine learning-based AA score provided incremental information to predict mortality beyond BNP (B-type natriuretic peptide; ΔAUC: 0.19), clinical score (ΔAUC: 0.09), and preexisting ADHERE, Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients With Heart Failure, and Get With The Guidelines Heart Failure scores (ΔAUC: 0.17, 0.17, 0.15, respectively). In the validation cohort, the AA score accurately predicted mortality (AUC:0.81). False-negative and false-positive findings, as classified by the BNP threshold, were correctly reclassified by the AA score (46.2% of false-negative and 84.5% of false-positive). In a murine model, the expression and enzymatic activity of sEH (soluble epoxide hydrolase) increased after myocardial infarction. Genetic deletion of sEH improved HF and the blockade of 14,15-EET abolished this cardioprotection. We mechanistically revealed the beneficial effect of 14,15-EET by impairing the activation of monocytes/macrophages. CONCLUSIONS Our studies propose that the AA score predicts death in patients with acute decompensated HF and inhibiting sEH serves as a therapeutic target for treating HF. REGISTRATION URL: https://www. CLINICALTRIALS gov; Unique identifier: NCT04108182.
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Affiliation(s)
- Ke Ma
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Jie Yang
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Yihui Shao
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Ping Li
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Hongchang Guo
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Jianing Wu
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Yi Zhu
- Tianjin Key Laboratory of Metabolic Diseases, Collaborative Innovation Center of Tianjin for Medical Epigenetics, Center for Cardiovascular Diseases, Research Center of Basic Medical Sciences, Department of Physiology and Pathophysiology, Tianjin Medical University, China (Y.Z., X.Z.)
| | - Hui Zhang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University (H.Z.)
| | - Xu Zhang
- Tianjin Key Laboratory of Metabolic Diseases, Collaborative Innovation Center of Tianjin for Medical Epigenetics, Center for Cardiovascular Diseases, Research Center of Basic Medical Sciences, Department of Physiology and Pathophysiology, Tianjin Medical University, China (Y.Z., X.Z.)
| | - Jie Du
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
| | - Yulin Li
- Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, China (K.M., J.Y., Y.S., P.L., H.G., J.W., J.D., Y.L.)
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Phung AS, Bannenberg G, Vigor C, Reversat G, Oger C, Roumain M, Galano JM, Durand T, Muccioli GG, Ismail A, Wang SC. Chemical Compositional Changes in Over-Oxidized Fish Oils. Foods 2020; 9:foods9101501. [PMID: 33092165 PMCID: PMC7590219 DOI: 10.3390/foods9101501] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023] Open
Abstract
A recent study has reported that the administration during gestation of a highly rancid hoki liver oil, obtained by oxidation through sustained exposure to oxygen gas and incident light for 30 days, causes newborn mortality in rats. This effect was attributed to lipid hydroperoxides formed in the omega-3 long-chain polyunsaturated fatty acid-rich oil, while other chemical changes in the damaged oil were overlooked. In the present study, the oxidation condition employed to damage the hoki liver oil was replicated, and the extreme rancidity was confirmed. A detailed analysis of temporal chemical changes resulting from the sustained oxidative challenge involved measures of eicosapentaenoic acid/docosahexaenoic acid (EPA/DHA) omega-3 oil oxidative quality (peroxide value, para-anisidine value, total oxidation number, acid value, oligomers, antioxidant content, and induction time) as well as changes in fatty acid content, volatiles, isoprostanoids, and oxysterols. The chemical description was extended to refined anchovy oil, which is a more representative ingredient oil used in omega-3 finished products. The present study also analyzed the effects of a different oxidation method involving thermal exposure in the dark in contact with air, which is an oxidation condition that is more relevant to retail products. The two oils had different susceptibility to the oxidation conditions, resulting in distinct chemical oxidation signatures that were determined primarily by antioxidant protection as well as specific methodological aspects of the applied oxidative conditions. Unique isoprostanoids and oxysterols were formed in the over-oxidized fish oils, which are discussed in light of their potential biological activities.
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Affiliation(s)
- Austin S. Phung
- Department of Chemistry, University of California, Davis, CA 95616, USA;
| | - Gerard Bannenberg
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT 84105, USA;
- Correspondence: (G.B.); (S.C.W.)
| | - Claire Vigor
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, 34093 Montpellier, France; (C.V.); (G.R.); (C.O.); (J.-M.G.); (T.D.)
| | - Guillaume Reversat
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, 34093 Montpellier, France; (C.V.); (G.R.); (C.O.); (J.-M.G.); (T.D.)
| | - Camille Oger
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, 34093 Montpellier, France; (C.V.); (G.R.); (C.O.); (J.-M.G.); (T.D.)
| | - Martin Roumain
- Louvain Drug Research Institute, Université Catholique de Louvain, 1200 Brussels, Belgium; (M.R.); (G.G.M.)
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, 34093 Montpellier, France; (C.V.); (G.R.); (C.O.); (J.-M.G.); (T.D.)
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université de Montpellier, ENSCM, 34093 Montpellier, France; (C.V.); (G.R.); (C.O.); (J.-M.G.); (T.D.)
| | - Giulio G. Muccioli
- Louvain Drug Research Institute, Université Catholique de Louvain, 1200 Brussels, Belgium; (M.R.); (G.G.M.)
| | - Adam Ismail
- Global Organization for EPA and DHA Omega-3s (GOED), Salt Lake City, UT 84105, USA;
| | - Selina C. Wang
- Department of Food Science and Technology, University of California, Davis, CA 95616, USA
- Correspondence: (G.B.); (S.C.W.)
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Roy J, Galano JM, Durand T, Le Guennec JY, Lee JCY. Physiological role of reactive oxygen species as promoters of natural defenses. FASEB J 2017; 31:3729-3745. [PMID: 28592639 DOI: 10.1096/fj.201700170r] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/22/2017] [Indexed: 02/06/2023]
Abstract
It has been 60 yr since the discovery of reactive oxygen species (ROS) in biology and the beginning of the scientific community's attempt to understand the impact of the unpaired electron of ROS molecules in biological pathways, which was eventually noted to be toxic. Several studies have shown that the presence of ROS is essential in triggering or acting as a secondary factor for numerous pathologies, including metabolic and genetic diseases; however, it was demonstrated that chronic treatment with antioxidants failed to show efficacy and positive effects in the prevention of diseases or health complications that result from oxidative stress. On the contrary, such treatment has been shown to sometimes even worsen the disease. Because of the permanent presence of ROS in organisms, elaborate mechanisms to adapt with these reactive molecules and to use them without necessarily blocking or preventing their actions have been studied. There is now a large body of evidence that shows that living organisms have conformed to the presence of ROS and, in retrospect, have adapted to the bioactive molecules that are generated by ROS on proteins, lipids, and DNA. In addition, ROS have undergone a shift from being molecules that invoked oxidative damage in regulating signaling pathways that impinged on normal physiological and redox responses. Working in this direction, this review unlocks a new conception about the involvement of cellular oxidants in the maintenance of redox homeostasis in redox regulation of normal physiological functions, and an explanation for its essential role in numerous pathophysiological states is noted.-Roy, J., Galano, J.-M., Durand, T., Le Guennec, J.-Y., Lee, J. C.-Y. Physiological role of reactive oxygen species as promoters of natural defenses.
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Affiliation(s)
- Jérôme Roy
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal and Montreal Diabetes Research Center, Department of Nutrition, Université de Montréal, Montreal, Québec, Canada; .,Centre National de la Recherche Scientifique Unité Mixte de Recherche 9214, Inserm Unité 1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles, Université de Montpellier, Montpellier, France
| | - Jean-Marie Galano
- Institut des Biomolécules Max Mousseron, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5247, École Nationale Supérieure de Chimie de Montpellier, Université de Montpellier, Montpellier, France
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron, Centre National de la Recherche Scientifique Unité Mixte de Recherche 5247, École Nationale Supérieure de Chimie de Montpellier, Université de Montpellier, Montpellier, France
| | - Jean-Yves Le Guennec
- Centre National de la Recherche Scientifique Unité Mixte de Recherche 9214, Inserm Unité 1046 Physiologie et Médecine Expérimentale du Cœur et des Muscles, Université de Montpellier, Montpellier, France
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Chafer-Pericas C, Cernada M, Rahkonen L, Stefanovic V, Andersson S, Vento M. Preliminary case control study to establish the correlation between novel peroxidation biomarkers in cord serum and the severity of hypoxic ischemic encephalopathy. Free Radic Biol Med 2016; 97:244-249. [PMID: 27296840 DOI: 10.1016/j.freeradbiomed.2016.06.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/01/2016] [Accepted: 06/09/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Hypoxic-ischemic encephalopathy (HIE) has deleterious neurological consequences. To identify patients at risk of neuronal damage deserving implementation of neuroprotective strategies clinicians have relied on prenatal sentinel events, postnatal clinical assessment (Apgar score), and blood gas analysis. This feasibility study aimed to assess if lipid peroxidation byproducts associated with neuronal damage correlated with cord blood metabolic acidemia in patients with HIE. POPULATION AND METHODS This is a case/control study in which cases were newborn infants with severe acidemia (pH<7.00; base excess ≥12mmol/L) while control babies exhibited normal gases (pH=7.20-7.40; base excess=-4 to +4mmol/L) in the first cord blood analysis performed immediately after birth. Concomitantly, lipid peroxidation byproducts were determined using ultra performance liquid chromatography coupled to mass spectrometry in the same cord blood sample. RESULTS A total of 19 controls and 20 cases were recruited. No differences in gestational characteristics were present. However, cases exhibited profound metabolic alterations as compared to controls (Cases vs. CONTROL pH=6.90±0.1 vs. 7.33±0.03; base excess=-15±3 vs. -1±2mmol/L), 85% were admitted to the NICU, and 50% developed symptoms of HIE. 8-iso-15(R)-PGF2α (P=0.01) and total isoprostanes (P=0.045) presented statistically significant differences between cases and control groups and correlated with level of HIE. CONCLUSIONS The 8-iso-15(R)-PGF2α and isoprostanes reflecting oxidative damage are significantly increased in severe postnatal acidemia. Follow up studies with adequate power are necessary to confirm if these biomarkers measured in cord blood serum could be predictive of neonatal encephalopathy.
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Affiliation(s)
| | - María Cernada
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain
| | - Leena Rahkonen
- Department of Obstetrics and Gynecology, Fetomaternal Medical Center, Helsinki University Hospital, Finland
| | - Vedran Stefanovic
- Department of Obstetrics and Gynecology, Fetomaternal Medical Center, Helsinki University Hospital, Finland
| | - Sture Andersson
- Children׳s Hospital, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Máximo Vento
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain; Division of Neonatology, University & Polytechnic Hospital La Fe, Valencia, Spain.
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Jenniskens K, Janssen PA. Newborn outcomes in british columbia after caesarean section for non-reassuring fetal status. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2015; 37:207-213. [PMID: 26001867 DOI: 10.1016/s1701-2163(15)30306-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the incidence in British Columbia of severe morbidity in neonates delivered by Caesarean section for non-reassuring fetal status, and to examine the accuracy of Apgar score and umbilical cord gas values in predicting severe neonatal morbidity. METHODS We assessed rates of hypoxic ischemic encephalopathy, NICU admission, and ventilator days, individually and as a composite outcome with neonatal death, among a total of 8466 term singletons delivered by Caesarean section for non-reassuring fetal status between January 1, 2007, and December 31, 2011. We calculated the predictive accuracy of Apgar scores and umbilical cord blood gas values using the area under the receiver operating characteristic (ROC) curve and the sensitivity and specificity for each outcome. RESULTS The incidence of Apgar score at one minute < 4 was 8.0%, and for Apgar score at five minutes < 4 it was 0.6%. The incidence of umbilical cord pH < 7.10 was 6.5%, and for base-excess < -12 it was 2.9%. Apgar score at one minute < 7 had the greatest predictive accuracy for the composite outcome (81% for both sensitivity and specificity). The area under the ROC curve for Apgar score at one minute and at five minutes, umbilical cord pH, and base-excess was 0.87, 0.86, 0.76, and 0.78, respectively. CONCLUSION The incidence of abnormal Apgar score and abnormal umbilical cord gas values is very low among neonates in British Columbia delivered by Caesarean section for non-reassuring fetal status. Apgar score at one minute < 7 is a good predictor of severe neonatal morbidity. Electronic fetal monitoring remains a non-specific method for detection of fetal compromise in the intrapartum period.
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Affiliation(s)
- Kevin Jenniskens
- Radboud University Nijmegen Medical Centre, Institute for Health Sciences, Nijmegen, The Netherlands; School of Population and Public Health, University of British Columbia, Vancouver BC
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, Vancouver BC; Child and Family Research Institute, Vancouver BC
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Kaandorp JJ, Benders MJNL, Schuit E, Rademaker CMA, Oudijk MA, Porath MM, Oetomo SB, Wouters MGAJ, van Elburg RM, Franssen MTM, Bos AF, de Haan TR, Boon J, de Boer IP, Rijnders RJP, Jacobs CJWFM, Scheepers LHCJ, Gavilanes DAW, Bloemenkamp KWM, Rijken M, van Meir CA, von Lindern JS, Huisjes AJM, Bakker SCMJER, Mol BWJ, Visser GHA, Van Bel F, Derks JB. Maternal allopurinol administration during suspected fetal hypoxia: a novel neuroprotective intervention? A multicentre randomised placebo controlled trial. Arch Dis Child Fetal Neonatal Ed 2015; 100:F216-23. [PMID: 25512466 DOI: 10.1136/archdischild-2014-306769] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 11/17/2014] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine whether maternal allopurinol treatment during suspected fetal hypoxia would reduce the release of biomarkers associated with neonatal brain damage. DESIGN A randomised double-blind placebo controlled multicentre trial. PATIENTS We studied women in labour at term with clinical indices of fetal hypoxia, prompting immediate delivery. SETTING Delivery rooms of 11 Dutch hospitals. INTERVENTION When immediate delivery was foreseen based on suspected fetal hypoxia, women were allocated to receive allopurinol 500 mg intravenous (ALLO) or placebo intravenous (CONT). MAIN OUTCOME MEASURES Primary endpoint was the difference in cord S100ß, a tissue-specific biomarker for brain damage. RESULTS 222 women were randomised to receive allopurinol (ALLO, n=111) or placebo (CONT, n=111). Cord S100ß was not significantly different between the two groups: 44.5 pg/mL (IQR 20.2-71.4) in the ALLO group versus 54.9 pg/mL (IQR 26.8-94.7) in the CONT group (difference in median -7.69 (95% CI -24.9 to 9.52)). Post hoc subgroup analysis showed a potential treatment effect of allopurinol on the proportion of infants with a cord S100ß value above the 75th percentile in girls (ALLO n=5 (12%) vs CONT n=10 (31%); risk ratio (RR) 0.37 (95% CI 0.14 to 0.99)) but not in boys (ALLO n=18 (32%) vs CONT n=15 (25%); RR 1.4 (95% CI 0.84 to 2.3)). Also, cord neuroketal levels were significantly lower in girls treated with allopurinol as compared with placebo treated girls: 18.0 pg/mL (95% CI 12.1 to 26.9) in the ALLO group versus 32.2 pg/mL (95% CI 22.7 to 45.7) in the CONT group (geometric mean difference -16.4 (95% CI -24.6 to -1.64)). CONCLUSIONS Maternal treatment with allopurinol during fetal hypoxia did not significantly lower neuronal damage markers in cord blood. Post hoc analysis revealed a potential beneficial treatment effect in girls. TRIAL REGISTRATION NUMBER NCT00189007, Dutch Trial Register NTR1383.
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Affiliation(s)
- Joepe J Kaandorp
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
| | - Ewoud Schuit
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Carin M A Rademaker
- Department of Clinical Pharmacy, University Medical Center, Utrecht, The Netherlands
| | - Martijn A Oudijk
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
| | - Martina M Porath
- Department of Perinatology, Maxima Medical Center, Veldhoven, The Netherlands
| | | | | | - Ruurd M van Elburg
- Department of Perinatology, VU Medical Center, Amsterdam, The Netherlands Danone Research, Wageningen, The Netherlands
| | - Maureen T M Franssen
- Department of Perinatology, University Medical Center, Groningen, The Netherlands
| | - Arie F Bos
- Department of Perinatology, University Medical Center, Groningen, The Netherlands
| | - Timo R de Haan
- Department of Perinatology, Academic Medical Center, Amsterdam, The Netherlands
| | - Janine Boon
- Department of Perinatology, Diakonessenhuis, Utrecht, The Netherlands
| | - Inge P de Boer
- Department of Perinatology, Diakonessenhuis, Utrecht, The Netherlands
| | - Robbert J P Rijnders
- Department of Perinatology, Jeroen Bosch Medical Center, Den Bosch, The Netherlands
| | | | | | - Danilo A W Gavilanes
- Department of Perinatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kitty W M Bloemenkamp
- Department of Perinatology, Leids University Medical Center, Leiden, The Netherlands
| | - Monique Rijken
- Department of Perinatology, Leids University Medical Center, Leiden, The Netherlands
| | - Claudia A van Meir
- Department of Perinatology, Groene Hart Hospital, Gouda, The Netherlands
| | | | | | | | - Ben W J Mol
- Department of Perinatology, University Medical Center, Groningen, The Netherlands
| | - Gerard H A Visser
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
| | - Frank Van Bel
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
| | - Jan B Derks
- Department of Perinatology, University Medical Center, Utrecht, The Netherlands
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Kaandorp JJ, Derks JB, Oudijk MA, Torrance HL, Harmsen MG, Nikkels PGJ, van Bel F, Visser GHA, Giussani DA. Antenatal allopurinol reduces hippocampal brain damage after acute birth asphyxia in late gestation fetal sheep. Reprod Sci 2013; 21:251-9. [PMID: 23793473 DOI: 10.1177/1933719113493516] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Free radical-induced reperfusion injury is a recognized cause of brain damage in the newborn after birth asphyxia. The xanthine oxidase inhibitor allopurinol reduces free radical synthesis and crosses the placenta easily. Therefore, allopurinol is a promising therapeutic candidate. This study tested the hypothesis that maternal treatment with allopurinol during fetal asphyxia limits ischemia-reperfusion (I/R) damage to the fetal brain in ovine pregnancy. The I/R challenge was induced by 5 repeated measured compressions of the umbilical cord, each lasting 10 minutes, in chronically instrumented fetal sheep at 0.8 of gestation. Relative to control fetal brains, the I/R challenge induced significant neuronal damage in the fetal hippocampal cornu ammonis zones 3 and 4. Maternal treatment with allopurinol during the I/R challenge restored the fetal neuronal damage toward control scores. Maternal treatment with allopurinol offers potential neuroprotection to the fetal brain in the clinical management of perinatal asphyxia.
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Affiliation(s)
- Joepe J Kaandorp
- 1Perinatal Center, University Medical Center, Utrecht, the Netherlands
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Chen JX, O’Mara PW, Poole SD, Brown N, Ehinger NJ, Slaughter JC, Paria BC, Aschner JL, Reese J. Isoprostanes as physiological mediators of transition to newborn life: novel mechanisms regulating patency of the term and preterm ductus arteriosus. Pediatr Res 2012; 72:122-8. [PMID: 22565502 PMCID: PMC3586272 DOI: 10.1038/pr.2012.58] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Increased oxygen tension at birth regulates physiologic events that are essential to postnatal survival, but the accompanying oxidative stress may also generate isoprostanes. We hypothesized that isoprostanes regulate ductus arteriosus (DA) function during postnatal vascular transition. METHODS Isoprostanes were measured by gas chromatography-mass spectrometry. DA tone was assessed by pressure myography. Gene expression was measured by quantitative PCR. RESULTS Oxygen exposure was associated with increased 8-iso-prostaglandin (PG)F2α in newborn mouse lungs. Both 8-iso-PGE2 and 8-iso-PGF2α induced concentration-dependent constriction of the isolated term DA, which was reversed by the thromboxane A2 (TxA2) receptor antagonist SQ29548. SQ29548 pretreatment unmasked an isoprostane-induced DA dilation mediated by the EP4 PG receptor. Exposure of the preterm DA to 8-iso-PGE2 caused unexpected DA relaxation that was reversed by EP4 antagonism. In contrast, exposure to 8-iso-PGF2α caused preterm DA constriction via TxA2 receptor activation. Further investigation revealed the predominance of the TxA2 receptor at term, whereas the EP4 receptor was expressed and functionally active from mid-gestation onward. CONCLUSION This study identifies a novel physiological role for isoprostanes during postnatal vascular transition and provide evidence that oxidative stress may act on membrane lipids to produce vasoactive mediators that stimulate physiological DA closure at birth or induce pathological patency of the preterm DA.
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Affiliation(s)
- Jian-Xiong Chen
- Department of Pharmacology and Toxicology, University of Mississippi Medical Center, Jackson, Mississippi
| | - Patrick W. O’Mara
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Stanley D. Poole
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Naoko Brown
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Noah J. Ehinger
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - James C. Slaughter
- Department of Biostatistics, Vanderbilt University, Nashville, Tennessee
| | - Bibhash C. Paria
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Judy L. Aschner
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
| | - Jeff Reese
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee;,Department of Cell and Developmental Biology, Vanderbilt University, Nashville, Tennessee
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Mestan K, Matoba N, Arguelles L, Harvey C, Ernst LM, Farrow K, Wang X. Cord blood 8-isoprostane in the preterm infant. Early Hum Dev 2012; 88:683-9. [PMID: 22425039 PMCID: PMC3380152 DOI: 10.1016/j.earlhumdev.2012.02.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 12/29/2011] [Accepted: 02/13/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cord blood 8-isoprostane (8-IP) is a marker of lipid peroxidation in the peripartum period. The independent association with degree of prematurity is not well-described. OBJECTIVE To identify patterns of lipid peroxidation among early, moderate and late preterm infants, and to understand how cord blood 8-IP varies with gestational age (GA) and related covariates. STUDY DESIGN Mother-infant pairs from 237 preterm births were studied as part of a longitudinal birth cohort study. GA subgroups were defined as extremely (≤28w), moderately (29-33w), and late (34-36w) preterm. Cord blood 8-IP was measured using EIA. Elevated 8-IP (4th quartile) was the primary outcome for multivariate logistic regression models, which were adjusted for maternal age/race, multiple gestation and infant gender, as well as other relevant covariates. RESULTS Elevated 8-IP was associated with extremely preterm birth (OR=4.31; 95% CI=1.90, 9.76), and was inversely associated with increasing GA (OR=0.88; 95% CI=0.80, 0.97). Elevated 8-IP was also associated with decreasing birth weight (BW), clinical chorioamnionitis, fetal inflammatory response of the placenta (FIR), and signs of perinatal depression. The GA on 8-IP association appeared to be modified by several maternal disease and fetal-infant factors. Lastly, the indirect associations between log-transformed 8-IP, GA and BW appeared to be most prominent for GA<30w and for BW<2000g. CONCLUSION Lipid peroxidation in preterm birth, and the relative influence of accompanying peripartum factors, varies according to degree of prematurity. These findings have important implications for the developmental regulation of antioxidant defense and its impact on neonatal outcomes.
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Affiliation(s)
- Karen Mestan
- Department of Pediatrics, Division of Neonatology, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, United States.
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Majed BH, Khalil RA. Molecular mechanisms regulating the vascular prostacyclin pathways and their adaptation during pregnancy and in the newborn. Pharmacol Rev 2012; 64:540-82. [PMID: 22679221 DOI: 10.1124/pr.111.004770] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Prostacyclin (PGI(2)) is a member of the prostanoid group of eicosanoids that regulate homeostasis, hemostasis, smooth muscle function and inflammation. Prostanoids are derived from arachidonic acid by the sequential actions of phospholipase A(2), cyclooxygenase (COX), and specific prostaglandin (PG) synthases. There are two major COX enzymes, COX1 and COX2, that differ in structure, tissue distribution, subcellular localization, and function. COX1 is largely constitutively expressed, whereas COX2 is induced at sites of inflammation and vascular injury. PGI(2) is produced by endothelial cells and influences many cardiovascular processes. PGI(2) acts mainly on the prostacyclin (IP) receptor, but because of receptor homology, PGI(2) analogs such as iloprost may act on other prostanoid receptors with variable affinities. PGI(2)/IP interaction stimulates G protein-coupled increase in cAMP and protein kinase A, resulting in decreased [Ca(2+)](i), and could also cause inhibition of Rho kinase, leading to vascular smooth muscle relaxation. In addition, PGI(2) intracrine signaling may target nuclear peroxisome proliferator-activated receptors and regulate gene transcription. PGI(2) counteracts the vasoconstrictor and platelet aggregation effects of thromboxane A(2) (TXA(2)), and both prostanoids create an important balance in cardiovascular homeostasis. The PGI(2)/TXA(2) balance is particularly critical in the regulation of maternal and fetal vascular function during pregnancy and in the newborn. A decrease in PGI(2)/TXA(2) ratio in the maternal, fetal, and neonatal circulation may contribute to preeclampsia, intrauterine growth restriction, and persistent pulmonary hypertension of the newborn (PPHN), respectively. On the other hand, increased PGI(2) activity may contribute to patent ductus arteriosus (PDA) and intraventricular hemorrhage in premature newborns. These observations have raised interest in the use of COX inhibitors and PGI(2) analogs in the management of pregnancy-associated and neonatal vascular disorders. The use of aspirin to decrease TXA(2) synthesis has shown little benefit in preeclampsia, whereas indomethacin and ibuprofen are used effectively to close PDA in the premature newborn. PGI(2) analogs have been used effectively in primary pulmonary hypertension in adults and have shown promise in PPHN. Careful examination of PGI(2) metabolism and the complex interplay with other prostanoids will help design specific modulators of the PGI(2)-dependent pathways for the management of pregnancy-related and neonatal vascular disorders.
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Affiliation(s)
- Batoule H Majed
- Harvard Medical School, Brigham and Women's Hospital, Division of Vascular Surgery, 75 Francis St., Boston, MA 02115, USA
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Khaw KS, Wang CC, Ngan Kee WD, Tam WH, Ng FF, Critchley LAH, Rogers MS. Supplementary oxygen for emergency Caesarean section under regional anaesthesia. Br J Anaesth 2008; 102:90-6. [PMID: 19011261 DOI: 10.1093/bja/aen321] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. METHODS We recruited 131 women having emergency CS under regional anaesthesia. Either 21% (air group) or 60% oxygen (oxygen group) was administered using a Venturi-type facemask until delivery. We compared the oxygen exposure duration, umbilical arterial (UA) and venous (UV) blood gases and oxygen content, and plasma concentration of 8-isoprostane. Subanalysis was performed according to whether or not fetal compromise was considered present. RESULTS Data from 125 patients were analysed. For the oxygen group vs the air group, there were greater values for UA PO(2) [mean 2.2 (SD 0.5) vs 1.9 (0.6) kPa, P=0.01], UA O(2) content [6.6 (2.5) vs 4.9 (2.8) ml dl(-1), P=0.006], UV PO(2) [3.8 (0.8) vs 3.2 (0.8) kPa, P<0.0001], and UV O(2) content [12.9 (3.5) vs 10.4 (3.8) ml dl(-1), P=0.001]. There was no difference between the groups in maternal, UA, or UV 8-isoprostane concentration. Apgar scores and UA pH were similar between the groups. Similar changes were observed regardless of whether fetal compromise was considered present (n=37) or not (n=88). CONCLUSIONS Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.
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Affiliation(s)
- K S Khaw
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China.
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Greco A, Minghetti L, Puopolo M, Pietrobon B, Franzoi M, Chiandetti L, Suppiej A. Plasma levels of 15-F(2t)-isoprostane in newborn infants are affected by mode of delivery. Clin Biochem 2007; 40:1420-2. [PMID: 17949702 DOI: 10.1016/j.clinbiochem.2007.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 08/28/2007] [Accepted: 09/12/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate how the mode of delivery affects the level oxidative stress in newborns. DESIGN AND METHODS 15-F(2t)-isoprostane, as index of oxidative stress, was measured in umbilical cord plasma samples from 37 infants born after vaginal delivery or caesarian section, using specific immuno-affinity extraction and immunoassay. RESULTS 15-F(2t)-isoprostane levels were higher in infants born after vaginal delivery (n=18) compared to those delivered by elective caesarian section (n=19). CONCLUSIONS 15-F(2t)-isoprostane is a sensitive biomarker of fetal oxidative stress during labor.
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Affiliation(s)
- Anita Greco
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, Viale Regina Elena, 299-00161 Rome, Italy.
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Wang CC, Chu KO, Chong WS, Li WY, Pang CP, Shum ASW, Lau TK, Rogers MS. Tea epigallocatechin-3-gallate increases 8-isoprostane level and induces caudal regression in developing rat embryos. Free Radic Biol Med 2007; 43:519-27. [PMID: 17640562 DOI: 10.1016/j.freeradbiomed.2007.04.034] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2007] [Revised: 04/26/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022]
Abstract
Tea is the most common beverage after water. Concerns have been raised about the safety of tea during pregnancy, especially for embryo development. We aimed at studying the effects of active tea components on developing embryos by in vitro rat embryo culture. Rat embryos during early organogenesis were cultivated in serum supplemented with one of the tea catechins. Developmental hallmarks and malformations (Mal) in the developing embryos were compared and evaluated by a standard morphological scoring system. The embryotoxicity of each tea catechin was classified according to the European Center for the Validation of Alternative Methods. Cell viability was assessed by supervital dye staining, apoptosis by TUNEL assay, and peroxidation by the 8-isoprostane EIA method. We found that (+)-catechin had the least effect on developing embryos (Mal(50)=715.1 mg/L; IC50(Mal)=435 mg/L), whereas (-)-epigallocatechin gallate had the most adverse effect (Mal(50)=54.2 mg/L; IC50(Mal)=45.8 mg/L). The major malformation in affected embryos included caudal retardation with abnormal axial flexion and delayed hind-limb formation. All catechins were classified as nonembryotoxic except (-)-epigallocatechin gallate, which was classified as weakly embryotoxic. With (-)-epigallocatechin gallate, increased numbers of nonviable and apoptotic cells in the malformed embryos were associated with increased embryo 8-isoprostane.
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Affiliation(s)
- Chi Chiu Wang
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Shatin, New Territories, Hong Kong.
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Chu CY, Xiao X, Zhou XG, Lau TK, Rogers MS, Fok TF, Law LK, Pang CP, Wang CC. Metabolomic and bioinformatic analyses in asphyxiated neonates. Clin Biochem 2006; 39:203-9. [PMID: 16460720 DOI: 10.1016/j.clinbiochem.2006.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2005] [Revised: 12/06/2005] [Accepted: 01/02/2006] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We tested the application of bioinformatic algorithms in studying the metabolomic profiles of neonatal urine samples with clinical evidence of severe asphyxia at birth and subsequent neurodevelopmental handicap. DESIGN AND METHODS The clinical outcomes of 256 newborns that required direct admission to neonatal intensive care unit for respiratory support or did not require direct admission were studied. Urinary metabolite profiles were measured by high throughput mass spectrometry and analyzed by bioinformatic methods. RESULTS We found a positive relationship between suppressed biochemical networks involved in macromolecular synthesis and birth asphyxia associated with significant neonatal oxidative stress and morbidity. The metabolomic discriminators between good neonatal outcome and poor neonatal outcome were established using hierarchical clustering analysis. Concentrations of eight urinary organic acids in distinct biochemical pathways were elevated and significantly associated with the prognosis of neurodevelopmental handicap with high sensitivity and specificity: ethylmalonate, 3-hydroxy-3-methylglutarate, 2-hydroxy-glutarate and 2-oxo-glutarate were associated with good neonatal outcome, whereas glutarate, methylmalonate, 3-hydroxy-butyrate and orotate were associated with poor outcome. CONCLUSIONS The data demonstrated the potential application of bioinformatics methods in this metabolomic study and proved its clinical relevance.
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Affiliation(s)
- Ching Yan Chu
- Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Hong Kong
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