L-alanyl-glutamine pretreatment attenuates acute inflammatory response in children submitted to palatoplasty

Protective Effects Oncorneal Endothelium During Intracameral Irrigation Using N-(2)-l-alanyl-l-Glutamine

Corneal endothelial disease is a global sight-threatening disease, and corneal transplantation using donor corneas remains the sole therapeutic option. A previous work demonstrated that N (2)-alanyl-glutamine (Ala-Gln) protected against apoptosis and cellular stress, and maintained intestinal tissue integrity. In this pursuit, the present study aimed to examine the effect of Ala-Gln in the protection of the corneal endothelium and expand its range of potential clinical applications. Mice in the control group were intracamerally irrigated with Ringers lactate injection, whereas those in the experimental group were irrigated with Ringers lactate injection containing Ala-Gln. The mean intraocular pressure increased to 44 ± 3.5 mm Hg during intracameral irrigation (normal range 10.2 ± 0.4 mmHg). In vivo confocal microscopy results showed that the addition of Ala-Gln protected the morphology, structure, and density of the corneal endothelial cells. Optical Coherence Tomography (OCT) measurements showed that corneal thickness was not significantly different between the two groups, because of the immediate corneal edema after irrigation, but the addition of Ala-Gln obviously promoted the recovery of the corneal edema. Scanning electron microscopy indicated that the corneal endothelial cells were severely ruptured and exfoliated in the Ringer’s group accompanied with cellular edema, when compared with the Ala-Gln group. The intracameral irrigation using Ala-Gln protected the structure and expression of cytoskeleton and Na-K-ATPase, which exhibited a regular distribution and significantly increased expression in comparison to Ringer’s group. Furthermore, Ala-Gln maintained the mitochondrial morphology and increased the activity of mitochondria. Moreover, transmission electron microscopy showed that intracameral irrigation of Ala-Gln reversed the ultrastructural changes induced by the acute ocular hypertension in mice. Our study demonstrates that the intracameral irrigation of Ala-Gln effectively maintained the corneal endothelial pump function and barrier function by protecting the mitochondrial function and preventing the rearrangement of cytoskeleton in acute ocular hypertension in mice.

Protective effects of N(2)‑L‑alanyl‑L‑glutamine mediated by the JAK2/STAT3 signaling pathway on myocardial ischemia reperfusion

To explore the protective effect of N(2)-L-alanyl-L-glutamine (NLAG) on myocardial ischemia-reperfusion injury (IRI), and observe the influence of NLAG on the Janus activated kinase signal transducer 2 and activator of transcription 3 (JAK2/STAT3) signaling pathway‑associated molecules. Wistar rats were randomly divided into three groups: Sham, IRI and NLAG. In the IRI rat model, the cardiac hemodynamics, the maximum rate of left ventricular pressure (+dP/dtmax) and the left ventricular end‑diastolic pressure (LVDP) were recorded. Hematoxylin‑eosin and Masson staining were used to detect myocardial histological changes. The levels of plasma interleukin (IL)‑1β and ‑6, tumor necrosis factor (TNF)‑α, lactase dehydrogenase (LDH), troponin (cTn)I, creatine kinase (CK), heart type fatty acid binding protein (hFABP), malondialdehyde (MDA) and succinate dehydrogenase (SDH) were determined with ELISA. The protein expression levels of B‑cell lymphoma (Bcl)‑2, Bcl2‑associated X protein (Bax), Caspase‑3, JAK2, phosphorylated (p)‑JAK2, STAT3 and p‑STAT3 were detected by western blot analysis. The IRI model demonstrated notable myocardial injury; myocardial cells were arranged disorderly with some nuclei disappearing, and cardiac muscular fibers were degenerated. Following 60 min of reperfusion, LVDP, HR and +dP/dtmax were 31.3±4.53 mmHg, 239.17±8.45 beats/min and 615.17 mmHg/sec, respectively. Compared with the Sham group, the levels of LDH, cTnI, CK, hFABP release, inflammatory factors (IL‑1β, IL‑6 and TNF‑α) and oxygen free radical (MDA and SDH) levels were increased in the IRI group. In the NLAG group, myocardial injury was improved, the concentrations of LDH, cTnI, CK, hFABP, IL‑1β, IL‑6, TNF‑α, MDA were decreased, and SDH release was increased compared with the IRI group. In addition, NLAG significantly increased Bcl‑2, JAK2, p‑JAK2, STAT3 and p‑STAT3 protein expression, and decreased Bax protein expression compared with the IRI group. In conclusion, myocardial ischemia‑reperfusion can lead to myocardial cell apoptosis and myocardial injury and NLAG attenuates the IRI‑induced mitochondrial oxidative stress injury and apoptosis by activating the JAK2/STAT3 signaling pathway, thus exerting protective effects against IRI.

Reporting of Randomized Controlled Trials in Cleft Lip and Palate: A 10-Year Review

Objectives

Reviews of the quality of reporting of randomized controlled trials (RCTs) have recently been conducted in different surgical specialties. In this review of RCTs relating to cleft lip, cleft palate, and cleft lip and palate (CL/P), we investigate the quality of reporting against the Consolidated Standards of Reporting Trials (CONSORT) checklist.

Design

A systematic review of CL/P RCTs published from 2004 to 2013, with the included articles scored against the CONSORT checklist.

Patients, Participants

The literature search identified 174 articles. Studies were selected for participants with CL/P who were involved in an RCT with prospective data collection and reported in a full journal article. A total of 6352 participants were included from 65 CUP RCTs during the study period.

Main Outcome Measures

The methodological quality of RCTs was assessed using the CONSORT checklist and Jadad scale.

Results

The mean CONSORT score was 15.8, and the mean Jadad score was 3.3. There was a significant positive correlation between the CONSORT and Jadad score ( P < .0001, ρ = .47). The only significant correlation showed that with an increasing number of authors, both the CONSORT and the Jadad score increased.

Conclusion

This analysis has shown that that there are deficiencies in the transparent reporting of factors such as randomization implementation, blinding, and participant flow. Interventions, outcomes, and the interpretation of results are well presented. We would recommend that RCTs are conceived and undertaken using the CONSORT checklist and reported in a clear and reproducible manner.

Plasma arginine levels and blood glucose control in very preterm infants receiving 2 different parenteral nutrition regimens

BACKGROUND

Improving parenteral nutrition (PN) amino acid (AA) intake in very preterm infants is associated with less hyperglycemia. AAs stimulate newborn insulin secretion with arginine, demonstrating a specific effect. We hypothesized that low arginine levels would be associated with increased insulin-treated hyperglycemia and higher mean daily blood glucose levels in very preterm infants.

METHODS

We performed a secondary analysis on previous study data comparing high-protein/calorie PN (HPC-PN) and control groups in infants <29 weeks' gestation. Infants were substratified (within original groups) according to high (highARG) and low (lowARG) plasma arginine levels on days 8-10 using a reference population-derived threshold for high/low arginine (57 µmol/L). Daily protein, arginine, carbohydrate intake, mean daily blood glucose, and insulin treatment data from the first 15 days of life were collected.

RESULTS

Control group infants (n = 60) were stratified into lowARG (n = 41) and highARG (n = 19) groups. There were no differences in basic demographic data or carbohydrate intake. LowARG infants had higher mean daily blood glucose levels ( P .05) and a trend to more insulin treatment on days 610. HPC-PN group infants (n = 55) were stratified into lowARG (n = 33) and highARG (n = 22) GROUPS. LowARG infants had lower gestation and birth weight and were sicker than highARG infants. There were no differences in carbohydrate intake. LowARG infants had higher mean daily blood glucose levels (p .01) and more insulin treatment (p .01) on days 15 and 610. Insulin-treated hyperglycemia was also associated with low plasma glutamine levels.

CONCLUSION

Low plasma arginine levels (≤57 µmol/L) in very preterm infants are associated with poorer blood glucose control.