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Rutt LN, Liu M, Melamed E, Twardy S, Sturgill JL, Brenner LA, Hardesty J, Weinman SA, Tschann MM, Travers J, Welsh DA, Chichetto N, Crotty KM, Mackowiak B, Yeligar SM, Wyatt TA, McMahan RH, Choudry MA, Kovacs EJ, McCullough RL. Emerging concepts in alcohol, infection & immunity: A summary of the 2023 alcohol and immunology research interest group (AIRIG) meeting. Alcohol 2024; 118:9-16. [PMID: 38582261 PMCID: PMC11179971 DOI: 10.1016/j.alcohol.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/29/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
On December 8th 2023, the annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at the University of Colorado Anschutz Medical Campus in Aurora, Colorado. The 2023 meeting focused broadly on how acute and chronic alcohol exposure leads to immune dysregulation, and how this contributes to damage in multiple tissues and organs. These include impaired lung immunity, intestinal dysfunction, autoimmunity, the gut-Central Nervous System (CNS) axis, and end-organ damage. In addition, diverse areas of alcohol research covered multiple pathways behind alcohol-induced cellular dysfunction, including inflammasome activation, changes in miRNA expression, mitochondrial metabolism, gene regulation, and transcriptomics. Finally, the work presented at this meeting highlighted novel biomarkers and therapeutic interventions for patients suffering from alcohol-induced organ damage.
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Affiliation(s)
- Lauren N Rutt
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mengfei Liu
- Digestive Diseases, Yale School of Medicine, New Haven, CT, USA
| | - Esther Melamed
- Department of Neurology, The University of Texas at Austin, Austin, TX, USA
| | - Shannon Twardy
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jamie L Sturgill
- Department of Microbiology, Immunology, and Molecular Genetics, University of Kentucky, Lexington, KY, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research Education and Clinical Center, Rocky Mountain Regional Veterans Affairs (VA) Medical Center, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Psychiatry and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education, Aurora, CO, USA; Departments of Physical Medicine and Rehabilitation, Psychiatry, and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Josiah Hardesty
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, KY, USA
| | - Steven A Weinman
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, MO, USA
| | - Madison M Tschann
- Department of Surgery, Loyola University Chicago Health Sciences Campus, Maywood, IL, USA; Alcohol Research Program, Loyola University Chicago Health Sciences Campus, Maywood, IL, USA
| | - Jared Travers
- Division of Gastroenterology and Liver Disease, Case Western Reserve University, Cleveland, OH, USA; University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - David A Welsh
- Department of Medicine, Section of Pulmonary and Critical Care Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Natalie Chichetto
- Department of Epidemiology, College of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
| | - Kathryn M Crotty
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep, Emory University, Atlanta, GA, USA; Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Bryan Mackowiak
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, USA
| | - Samantha M Yeligar
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep, Emory University, Atlanta, GA, USA; Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Todd A Wyatt
- Pulmonary Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA; Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rachel H McMahan
- Division of GI Trauma and Endocrine Surgery, Department of Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mashkoor A Choudry
- Department of Surgery, Loyola University Chicago Health Sciences Campus, Maywood, IL, USA; Alcohol Research Program, Loyola University Chicago Health Sciences Campus, Maywood, IL, USA
| | - Elizabeth J Kovacs
- Division of GI Trauma and Endocrine Surgery, Department of Surgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Veterans Health Administration, Eastern Colorado Health Care System, Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Alcohol Research Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Rebecca L McCullough
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Alcohol Research Program, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
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Staller DW, Bennett RG, Mahato RI. Therapeutic perspectives on PDE4B inhibition in adipose tissue dysfunction and chronic liver injury. Expert Opin Ther Targets 2024:1-29. [PMID: 38878273 DOI: 10.1080/14728222.2024.2369590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Chronic liver disease (CLD) is a complex disease associated with profound dysfunction. Despite an incredible burden, the first and only pharmacotherapy for metabolic-associated steatohepatitis was only approved in March of this year, indicating a gap in the translation of preclinical studies. There is a body of preclinical work on the application of phosphodiesterase 4 inhibitors in CLD, none of these molecules have been successfully translated into clinical use. AREAS COVERED To design therapies to combat CLD, it is essential to consider the dysregulation of other tissues that contribute to its development and progression. As such, proper therapies must combat this throughout the body rather than focusing only on the liver. To detail this, literature characterizing the pathogenesis of CLD was pulled from PubMed, with a particular focus placed on the role of PDE4 in inflammation and metabolism. Then, the focus is shifted to detailing the available information on existing PDE4 inhibitors. EXPERT OPINION This review gives a brief overview of some of the pathologies of organ systems that are distinct from the liver but contribute to disease progression. The demonstrated efficacy of PDE4 inhibitors in other human inflammatory diseases should earn them further examination for the treatment of CLD.
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Affiliation(s)
- Dalton W Staller
- Department of Cellular & Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Robert G Bennett
- Department of Internal Medicine, Division of Diabetes Endocrinology and Metabolism, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, USA
- VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Ram I Mahato
- Department of Cellular & Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
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Finsterer J. Unexpected death in alcohol addiction requires extensive post-mortem assessment. Leg Med (Tokyo) 2024; 70:102467. [PMID: 38908213 DOI: 10.1016/j.legalmed.2024.102467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024]
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Liu X, Bishir M, Hodgkinson C, Goldman D, Chang SL. The mechanisms underlying alcohol-induced decreased splenic size: A network meta-analysis study. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:72-87. [PMID: 38059389 PMCID: PMC11161039 DOI: 10.1111/acer.15234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Organ weight change is widely accepted as a measure of toxicologic pathology. We and other groups have shown that excessive alcohol exposure leads to decreased spleen weight in rodents. This study explores the mechanisms underlying alcohol-induced splenic injury through a network meta-analysis. METHODS QIAGEN Ingenuity Pathway Analysis (IPA) and Mammalian Phenotype (MP) Ontology were used to identify alcohol-related molecules associated with the small spleen phenotype. Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) and IPA bioinformatics tools were then used to analyze the biologic processes and enriched signaling pathways engaging these molecules. In addition, the "downstream effects analysis" algorithm was used to quantify alcohol's effects. RESULTS IPA identified 623 molecules affected by alcohol and a Venn diagram revealed that 26 of these molecules overlapped with those associated with the MP Ontology of small spleen. The 26 molecules are TGFB1, CASP8, MTOR, ESR1, CXCR4, CAMK4, NFKBIA, DRD2, BCL2, FAS, PEBP1, TRAF2, ATM, IGHM, EDNRB, MDM2, GLRA1, PRF1, TLR7, IFNG, ALOX5, FOXO1, IL15, APOE, IKBKG, and RORA. Some of the 26 molecules were also associated with the MP Ontology of abnormal white pulp and red pulp morphology of the spleen, abnormal splenic cell ratio, decreased splenocyte number, abnormal spleen physiology, increased splenocyte apoptosis, and reduced splenocyte proliferation. STRING and IPA "Core Analysis" showed that these molecules were mainly involved in pathways related to cell apoptosis, proliferation, migration, and immune responses. IPA's "Molecular Activity Predictor" tool showed that concurrent effects of activation and inhibition of these molecules led to decreased spleen size by modulating apoptosis, proliferation, and migration of splenocytes. CONCLUSIONS Our network meta-analysis revealed that excessive alcohol exposure can damage the spleen through a variety of molecular mechanisms, thereby affecting immune function and human health. We found that alcohol-mediated splenic atrophy is largely mediated by increased apoptosis signaling, migration of cells, and inhibition of splenocyte proliferation.
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Affiliation(s)
- Xiangqian Liu
- Institute of NeuroImmune Pharmacology, South Orange, New Jersey, USA
- Department of Histology and Embryology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Muhammed Bishir
- Institute of NeuroImmune Pharmacology, South Orange, New Jersey, USA
- Department of Biological Sciences, Seton Hall University, South Orange, New Jersey, USA
| | - Colin Hodgkinson
- Laboratory of Neurogenetics, NIAAA, NIH, Rockville, Maryland, USA
| | - David Goldman
- Laboratory of Neurogenetics, NIAAA, NIH, Rockville, Maryland, USA
| | - Sulie L Chang
- Institute of NeuroImmune Pharmacology, South Orange, New Jersey, USA
- Department of Biological Sciences, Seton Hall University, South Orange, New Jersey, USA
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Glaser EP, Stewart AN, Jagielo-Miller JE, Bailey CS, Prendergast MA, Gensel JC. Effects of Acute Ethanol Intoxication on Spinal Cord Injury Outcomes in Female Mice. J Neurotrauma 2023; 40:2541-2551. [PMID: 37350129 PMCID: PMC10698778 DOI: 10.1089/neu.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Abstract Approximately one in three traumatic spinal cord injuries (SCIs) occurs during or shortly after the consumption of alcohol. A small number of retrospective clinical studies report variable effects of alcohol intoxication on mortality, neurological recovery, and complications after SCI. Some of these studies demonstrate a protective effect of alcohol intoxication on SCI outcomes, whereas others show an increased complication risk. Pre-clinical studies in rat, ferret, and feline SCI models report a detrimental effect of ethanol intoxication on hemorrhage, motor recovery, and biochemical markers of tissue injury. However, no studies to date have investigated the neuropathological consequences of ethanol intoxication at the time of SCI or the reciprocal effect of SCI on ethanol metabolism. Therefore, we combined a pre-clinical mouse model of acute ethanol intoxication and experimental vertebral level T9 contusion SCI to investigate their interactive effects in female mice. We first investigated the effect of SCI on ethanol metabolism and found that T9 SCI does not alter ethanol metabolism. However, we did find that isoflurane anesthesia significantly slowed ethanol metabolism independent of SCI. We also determined how acute ethanol intoxication at the time of SCI alters locomotor recovery and lesion pathology. Using the Basso Mouse Scale (BMS) and CatWalk XT Gait Analysis System, we assessed locomotor recovery for 6 weeks after injury and observed that acute ethanol intoxication at the time of injury did not alter locomotor recovery. We also found no effect of ethanol intoxication on heat hyperalgesia development. There was, however, a detrimental effect of ethanol on tissue sparing after SCI. Therefore, we conclude that acute alcohol intoxication at the time of injury may contribute to the neuropathological consequences of SCI.
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Affiliation(s)
- Ethan P. Glaser
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Andrew N. Stewart
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Julia E. Jagielo-Miller
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Caleb S. Bailey
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Mark A. Prendergast
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - John C. Gensel
- Department of Physiology, Spinal Cord and Brain Injury Research Center, College of Medicine, University of Kentucky, Lexington, Kentucky, USA
- Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
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Jeong Y, Kim SH, Kang G, Yoon HJ, Kim YK, Ha A. Visual Impairment Risk After Alcohol Abstinence in Patients With Newly Diagnosed Open-Angle Glaucoma. JAMA Netw Open 2023; 6:e2338526. [PMID: 37856121 PMCID: PMC10587786 DOI: 10.1001/jamanetworkopen.2023.38526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Recent studies indicate that alcohol consumption is linked to increased intraocular pressure and higher prevalence of open-angle glaucoma (OAG). However, there is insufficient evidence to establish any correlation between alcohol abstinence and improved outcomes in patients with OAG. Objective To evaluate the association between alcohol consumption status (and its changes) and risk of incident severe visual impairment (VI) or blindness in patients with newly diagnosed OAG. Design, Setting, and Participants This retrospective, nationwide, population-based cohort study used the Korean National Health Insurance Service's claims and health examination database to enroll patients who were newly diagnosed with OAG between January 1, 2010, and December 31, 2011, and had been alcohol drinkers before their OAG diagnosis. The cohort was followed up until December 2020. The data were analyzed from February to December 2022. Exposures The patients were categorized into 2 groups based on their post-OAG diagnosis alcohol consumption status: sustainers and abstainers. The risks of severe VI or blindness were compared using weighted Cox proportional hazards regression models along with inverse probability of treatment weighting. Main Outcomes and Measures Incident severe VI or blindness. Results Among 13 643 patients with newly diagnosed OAG (mean [SD] age, 53.7 [11.9] years; 12 066 men [88.4%]) who were drinkers, 2866 (21.0%) quit drinking after the diagnosis. During 91 366 person-years of follow-up, patients abstaining from alcohol after their OAG diagnosis had a lower risk of severe VI or blindness than did those who had sustained drinking (adjusted hazard ratio [AHR] after inverse probability of treatment weighting, 0.63; 95% CI, 0.45-0.87). Among the sustained drinkers, both mild consumption (<105 g/wk; AHR, 1.52; 95% CI, 1.01-2.28) and moderate to heavy consumption (≥105 g/wk; AHR, 1.78; 95% CI, 1.11-2.86) after OAG diagnosis were associated with higher risk of severe VI or blindness relative to abstainers. Frequent drinking (≥4 d/wk) also was associated with a higher risk of severe VI or blindness (AHR, 2.56; 95% CI, 1.52-4.33) compared with abstinence. Conclusions and Relevance In this cohort study of patients with OAG who were drinkers, abstaining from alcohol after an OAG diagnosis was associated with lower risk of severe VI or blindness. These findings suggest that lifestyle interventions, such as alcohol abstinence, could be essential for patients with newly diagnosed OAG.
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Affiliation(s)
- Yoon Jeong
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
| | - Su Hwan Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Goneui Kang
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- EyeLight Data Science Lab, Seoul National University College of Medicine, Seoul, Korea
| | - Hyung-Jin Yoon
- Medical Bigdata Research Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
- EyeLight Data Science Lab, Seoul National University College of Medicine, Seoul, Korea
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Ahnul Ha
- Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea
- Department of Ophthalmology, Jeju National University College of Medicine, Jeju-si, Korea
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Stuart KV, Luben RN, Warwick AN, Madjedi KM, Patel PJ, Biradar MI, Sun Z, Chia MA, Pasquale LR, Wiggs JL, Kang JH, Kim J, Aschard H, Tran JH, Lentjes MAH, Foster PJ, Khawaja AP. The Association of Alcohol Consumption with Glaucoma and Related Traits: Findings from the UK Biobank. Ophthalmol Glaucoma 2023; 6:366-379. [PMID: 36481453 PMCID: PMC10239785 DOI: 10.1016/j.ogla.2022.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 05/12/2023]
Abstract
PURPOSE To examine the associations of alcohol consumption with glaucoma and related traits, to assess whether a genetic predisposition to glaucoma modified these associations, and to perform Mendelian randomization (MR) experiments to probe causal effects. DESIGN Cross-sectional observational and gene-environment interaction analyses in the UK Biobank. Two-sample MR experiments using summary statistics from large genetic consortia. PARTICIPANTS UK Biobank participants with data on intraocular pressure (IOP) (n = 109 097), OCT-derived macular inner retinal layer thickness measures (n = 46 236) and glaucoma status (n = 173 407). METHODS Participants were categorized according to self-reported drinking behaviors. Quantitative estimates of alcohol intake were derived from touchscreen questionnaires and food composition tables. We performed a 2-step analysis, first comparing categories of alcohol consumption (never, infrequent, regular, and former drinkers) before assessing for a dose-response effect in regular drinkers only. Multivariable linear, logistic, and restricted cubic spline regression, adjusted for key sociodemographic, medical, anthropometric, and lifestyle factors, were used to examine associations. We assessed whether any association was modified by a multitrait glaucoma polygenic risk score. The inverse-variance weighted method was used for the main MR analyses. MAIN OUTCOME MEASURES Intraocular pressure, macular retinal nerve fiber layer (mRNFL) thickness, macular ganglion cell-inner plexiform layer (mGCIPL) thickness, and prevalent glaucoma. RESULTS Compared with infrequent drinkers, regular drinkers had higher IOP (+0.17 mmHg; P < 0.001) and thinner mGCIPL (-0.17 μm; P = 0.049), whereas former drinkers had a higher prevalence of glaucoma (odds ratio, 1.53; P = 0.002). In regular drinkers, alcohol intake was adversely associated with all outcomes in a dose-dependent manner (all P < 0.001). Restricted cubic spline regression analyses suggested nonlinear associations, with apparent threshold effects at approximately 50 g (∼6 UK or 4 US alcoholic units)/week for mRNFL and mGCIPL thickness. Significantly stronger alcohol-IOP associations were observed in participants at higher genetic susceptibility to glaucoma (Pinteraction < 0.001). Mendelian randomization analyses provided evidence for a causal association with mGCIPL thickness. CONCLUSIONS Alcohol intake was consistently and adversely associated with glaucoma and related traits, and at levels below current United Kingdom (< 112 g/week) and United States (women, < 98 g/week; men, < 196 g/week) guidelines. Although we cannot infer causality definitively, these results will be of interest to people with or at risk of glaucoma and their advising physicians. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
| | - Robert N Luben
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Alasdair N Warwick
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Kian M Madjedi
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Calgary, Alberta, Canada
| | - Praveen J Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Mahantesh I Biradar
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Zihan Sun
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Mark A Chia
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jae H Kang
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jihye Kim
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Hugues Aschard
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts; Institut Pasteur, Université Paris Cité, Department of Computational Biology, Paris, France
| | - Jessica H Tran
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Pullen RL, Hammond L, Harris S. Systemic effects of excessive alcohol consumption. Nursing 2023; 53:29-36. [PMID: 36946634 DOI: 10.1097/01.nurse.0000920452.23534.ea] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
ABSTRACT This article presents priority nursing assessments and interventions that address the multicellular assault of excessive alcohol consumption on bodily organs and the impact on the patient's quality of life.
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Affiliation(s)
- Richard L Pullen
- At the Texas Tech University Health Sciences Center School of Nursing, Richard Pullen is a professor, Lori Hammond is an associate professor, and Shonna Harris is an assistant professor. Richard Pullen is also a member of the Nursing2023 editorial board
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Kumar V, Sethi B, Staller DW, Xin X, Ma J, Dong Y, Talmon GA, Mahato RI. Anti-miR-96 and Hh pathway inhibitor MDB5 synergistically ameliorate alcohol-associated liver injury in mice. Biomaterials 2023; 295:122049. [PMID: 36827892 PMCID: PMC9998370 DOI: 10.1016/j.biomaterials.2023.122049] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/19/2023]
Abstract
Alcohol-associated liver disease (ALD) and its complications are significant health problems worldwide. Several pathways in ALD are influenced by alcohol that drives inflammation, fatty acid metabolism, and fibrosis. Although miR-96 has become a key regulator in several liver diseases, its function in ALD remains unclear. In contrast, sonic hedgehog (SHH) signaling has a well-defined role in liver disease through influencing the activation of hepatic stellate cells (HSCs) and the inducement of liver fibrosis. In this study, we investigated the expression patterns of miR-96 and Hh molecules in mouse and human liver samples. We showed that miR-96 and Shh were upregulated in ethanol-fed mice. Furthermore, alcoholic hepatitis (AH) patient specimens also showed upregulated FOXO3a, TGF-β1, SHH, and GLI2 proteins. We then examined the effects of Hh inhibitor MDB5 and anti-miR-96 on inflammatory and extracellular matrix (ECM)-related genes. We identified FOXO3 and SMAD7 as direct target genes of miR-96. Inhibition of miR-96 decreased the expression of these genes in vitro in AML12 cells, HSC-T6 cells, and in vivo in ALD mice. Furthermore, MDB5 decreased HSCs activation and the expression of ECM-related genes, such as Gli1, Tgf-β1, and collagen. Lipid nanoparticles (LNPs) loaded with the combination of MDB5, and anti-miR-96 ameliorated ALD in mice. Our study demonstrated that this combination therapy could serve as a new therapeutic target for ALD.
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Affiliation(s)
- Virender Kumar
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Bharti Sethi
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Dalton W Staller
- Department of Cellular & Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Xiaofei Xin
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jingyi Ma
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yuxiang Dong
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Geoffrey A Talmon
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ram I Mahato
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE, USA; Department of Cellular & Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA.
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Nath P, Anand AC. Extrahepatic Manifestations in Alcoholic Liver Disease. J Clin Exp Hepatol 2022; 12:1371-1383. [PMID: 36157144 PMCID: PMC9499846 DOI: 10.1016/j.jceh.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/20/2022] [Indexed: 12/12/2022] Open
Abstract
Though liver is the most commonly affected organ in patients with chronic and excessive intake of alcohol, no organ is immune to toxic effects of alcohol and patients with alcohol-related liver disease (ALD) can suffer from a wide list of extrahepatic manifestations involving gastrointestinal tract, central and peripheral nervous systems, cardio vascular system, musculo-skeletal system, disruption of nutritional status, endocrinological abnormalities, hematological abnormalities and immune dysfunction. These extrahepatic organ involvements are usually overlooked by hepatologists and physicians who are mostly focused on managing life threatening complications of ALD. As a result, there is delayed diagnosis, delay in the initiation of appropriate treatment and late referral to other specialists. Some of these manifestations are of utmost clinical importance (e.g. delirium tremans and Wernicke's encephalopathy) because an early diagnosis and treatment can lead to full recovery while delayed or no treatment can result in death. On the other hand, several extrahepatic manifestations are of prognostic significance (such as alcoholic cardiomyopathy and malignancies) in which there is an increased risk of morbidity and mortality. Hence, a clear understanding and awareness of the extrahepatic manifestations of ALD is quintessential for proper management of these patients.
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Key Words
- ACE, Angiotensin-Converting-Enzyme
- ALD, Alcohol related Liver Disease
- AUD, Alcohol Use Disorder
- GAVE, Gastric Antral Vascular Ectasia
- GERD, Gastro-Esophageal Reflux Disease
- HCC, Hepatocellular Carcinoma
- HIV, Human Immunodeficiency Virus
- IARC, International Agency for Research on Cancer
- IL, Interleukin
- NERD, Non-Erosive Reflux Disease
- PPI, Proton Pump Inhibitors
- TNF, Tumour Necrosis Factor
- UGI, Upper Gastrointestinal
- WHO, World Health Organization
- alcohol use disorder
- alcohol withdrawal syndrome
- alcoholic cardiomyopathy
- alcoholic liver disease
- alcoholic myopathy
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Affiliation(s)
- Preetam Nath
- Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India
| | - Anil C. Anand
- Department of Gastroenterology & Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, 751024, India
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ERGİN EĞRİTAĞ H. The acute effect of thiamine on serum insulin levels and some biochemical parameters in excessive alcohol-consuming rats. MEHMET AKIF ERSOY ÜNIVERSITESI VETERINER FAKÜLTESI DERGISI 2022. [DOI: 10.24880/maeuvfd.1100674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
There are studies that present metabolic disorders in alcohol drinkers are associated with thiamine deficiency. Therefore, in the present study, it was aimed to investigate the effectiveness of thiamine in rats with binge drinking model. For this purpose, total 21 spraque dawley rats were divided into three equal groups as control, alcohol and thiamine+alcohol groups. The thiamine+ethanol group was given thiamine at a daily dose of 100 mg/kg by oral gavage, starting 2 days before the ethanol administration. Alcohol and thiamine+alcohol groups were given 3.45g/kg/day ethanol as 20%. At the end of the study, while serum total bile acid, total bilirubin and insulin levels increased in rats in the alcohol group compared to the rats in the control group; total protein and albumin levels decreased (P<0.05). In the thiamine + alcohol group, LDL-cholesterol, total cholesterol, bile acid levels and AST enzyme activity increased, while ALT enzyme activity and total protein levels decreased compared to the control group (P<0.05). There was no statistically significant result in the values in the thiamine+alcohol group compared to the alcohol group. It has been concluded that acutely administered thiamine supplementation had no effect on alcohol-induced biochemical parameter changes in binge-drinking animals. In this sense, studies with longer-term thiamine use are needed.
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12
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Rani R, Hemavathy V. Counselling to promote self-esteem -pilot analysis. CARDIOMETRY 2022. [DOI: 10.18137/cardiometry.2022.22.429434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Alcohol is not able to control the drinking habit due to both physical and emotional dependence on alcohol. Counseling aims to address the underlying causes of alcoholism. Alcohol is classified as a ‘brain disease’. Counseling services are therefore an important factor in recovering from addiction and promoting self-esteem. Self-esteemis a reflection of human understanding and a sense of human worth. Counseling is a method that helps to use a problem-solving process to promote self-esteem. This study aims to determine the effectiveness of counseling, promote self-esteem, and link self-esteem with demographic variability. Post-counseling study methodology after counseling, in the Study group, 8.33% of alcohol dependents had a low score, 50% alcohol dependence had a moderate level of the score and 41.67% was a high score. Among the control group, 41.67% of alcohol dependents had a low score, 58.33% received a moderate level and none of them achieved a high score. Therefore, counseling provides professional support, advice, and recommended addiction services.
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Jakhete N, Abutaleb A, Shetty K. Transplant in acute alcoholic hepatitis: a relative contraindication. Curr Opin Organ Transplant 2022; 27:93-97. [PMID: 35166269 DOI: 10.1097/mot.0000000000000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to provide a critical analysis of liver transplantation for alcoholic hepatitis, with an emphasis on barriers to long-term success in current implementation strategies across the United States. RECENT FINDINGS Alcohol-associated liver disease is the most rapidly increasing indication for liver transplantation in the USA. Its most severe form, acute alcoholic hepatitis, has a rising incidence particularly in the young, and is associated with a high mortality risk. Although excellent outcomes following liver transplantation for alcoholic hepatitis can be achieved, several barriers limit its routine use. These constraints include risk of allograft dysfunction, the recognition of alcohol use disorder as a multisystem disease and ethical considerations. SUMMARY Although liver transplantation is an important option in a carefully selected group of candidates, it should not be considered the standard of care in this condition. Consistency, transparency and consensus are necessary to formulate and implement policy changes at the national level. Following liver transplantation, wraparound services are important for relapse prevention, and to ensure long-term success and survival in this challenging group of patients.
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Affiliation(s)
- Neha Jakhete
- Division of Gastroenterology & Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Dahiya DS, Kichloo A, Singh J, Singh G, Wani F, Shaka H. Declining Inpatient Mortality Despite Increasing Thirty-Day Readmissions of Alcoholic Hepatitis in the United States From 2010 to 2018. Gastroenterology Res 2022; 14:334-339. [PMID: 35059067 PMCID: PMC8734495 DOI: 10.14740/gr1473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/11/2021] [Indexed: 11/11/2022] Open
Abstract
Background Alcoholic hepatitis (AH) readmissions are commonly secondary to relapse to alcohol use after discharge from the hospital. Methods This retrospective interrupted trend study analyzed the National Readmissions Database (NRD) from 2010 to 2018 to identify 30-day readmissions of AH using the International Classification of Diseases (ICD)-9 and ICD-10 codes (571.1 and K70.1). Individuals < 18 years, elective and traumatic readmissions were excluded. The biodemographic characteristics and hospitalization trends were highlighted over an 8-year time frame. A multivariate regression analysis was used to calculate the risk-adjusted odds of trends for all-cause 30-day readmissions, AH-specific readmissions, inpatient mortality, mean length of stay (LOS), and mean total hospital charge (THC) after adjusting for age, gender, grouped Charlson Comorbidity Index (CCI), type of insurance, mean household income, and hospital characteristics. P-values ≤ 0.05 were considered statistically significant. Results We noted an increasing trend for total 30-day readmissions of AH from 1,839 in 2010 to 3,784 in 2018 (P-trend < 0.001). Males made up a majority of the population; however, gender distribution was not statistically significant. Additionally, 30-day AH readmissions had an increasing comorbidity burden with time. The 30-day all-cause readmission rate increased from 18.8% in 2010 to 24.4% in 2018 and AH-specific readmission rate from 2.9% in 2010 to 3.9% in 2018 without a statistically significant trend. However, we noted a declining risk-adjusted trend of inpatient mortality for 30-day readmissions of AH from 8.7% in 2010 to 7.4% in 2018 (P-trend = 0.022). Furthermore, the total LOS attributable to 30-day readmissions of AH increased by 132.5% from 11,275 days in 2010 to 26,220 days in 2018 and the attributable THC increased by 160.9% to over $67 million in 2018. Conclusions For 30-day AH readmissions, inpatient mortality declined to 7.4% in 2018, while the total number of hospitalizations, LOS and THC increased from 2010 to 2018.
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Affiliation(s)
| | - Asim Kichloo
- Central Michigan University College of Medicine, Saginaw, MI, US.,Samaritan Medical Center, Watertown, NY, US
| | | | - Gurdeep Singh
- Our Lady of Lourdes Memorial Hospital, Binghamton, NY, US
| | - Farah Wani
- Samaritan Medical Center, Watertown, NY, US
| | - Hafeez Shaka
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, US
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15
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Stuart KV, Madjedi K, Luben RN, Chua SY, Warwick AN, Chia M, Pasquale LR, Wiggs JL, Kang JH, Hysi PG, Tran JH, Foster PJ, Khawaja AP. Alcohol, intraocular pressure and open-angle glaucoma: A systematic review and meta-analysis. Ophthalmology 2022; 129:637-652. [PMID: 35101531 PMCID: PMC9126073 DOI: 10.1016/j.ophtha.2022.01.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 01/11/2023] Open
Abstract
Topic This systematic review and meta-analysis summarizes the existing evidence for the association of alcohol use with intraocular pressure (IOP) and open-angle glaucoma (OAG). Clinical Relevance Understanding and quantifying these associations may aid clinical guidelines or treatment strategies and shed light on disease pathogenesis. The role of alcohol, a modifiable factor, in determining IOP and OAG risk also may be of interest from an individual or public health perspective. Methods The study protocol was preregistered in the Open Science Framework Registries (https://osf.io/z7yeg). Eligible articles (as of May 14, 2021) from 3 databases (PubMed, Embase, Scopus) were independently screened and quality assessed by 2 reviewers. All case-control, cross-sectional, and cohort studies reporting a quantitative effect estimate and 95% confidence interval (CI) for the association between alcohol use and either IOP or OAG were included. The evidence for the associations with both IOP and OAG was qualitatively summarized. Effect estimates for the association with OAG were pooled using random effects meta-analysis. Studies not meeting formal inclusion criteria for systematic review, but with pertinent results, were also appraised and discussed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Results Thirty-four studies were included in the systematic review. Evidence from 10 studies reporting an association with IOP suggests that habitual alcohol use is associated with higher IOP and prevalence of ocular hypertension (IOP > 21 mmHg), although absolute effect sizes were small. Eleven of 26 studies, comprising 173 058 participants, that tested for an association with OAG met inclusion criteria for meta-analysis. Pooled effect estimates indicated a positive association between any use of alcohol and OAG (1.18; 95% confidence interval [CI], 1.02–1.36; P = 0.03; I2 = 40.5%), with similar estimates for both prevalent and incident OAG. The overall GRADE certainty of evidence was very low. Conclusions Although this meta-analysis suggests a harmful association between alcohol use and OAG, our results should be interpreted cautiously given the weakness and heterogeneity of the underlying evidence base, the small absolute effect size, and the borderline statistical significance. Nonetheless, these findings may be clinically relevant, and future research should focus on improving the quality of evidence.
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Yu D, Tang Z, Li B, Yu J, Li W, Liu Z, Tian C. Resveratrol against Cardiac Fibrosis: Research Progress in Experimental Animal Models. Molecules 2021; 26:6860. [PMID: 34833952 PMCID: PMC8621031 DOI: 10.3390/molecules26226860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Cardiac fibrosis is a heterogeneous disease, which is characterized by abundant proliferation of interstitial collagen, disordered arrangement, collagen network reconstruction, increased cardiac stiffness, and decreased systolic and diastolic functions, consequently developing into cardiac insufficiency. With several factors participating in and regulating the occurrence and development of cardiac fibrosis, a complex molecular mechanism underlies the disease. Moreover, cardiac fibrosis is closely related to hypertension, myocardial infarction, viral myocarditis, atherosclerosis, and diabetes, which can lead to serious complications such as heart failure, arrhythmia, and sudden cardiac death, thus seriously threatening human life and health. Resveratrol, with the chemical name 3,5,4'-trihydroxy-trans-stilbene, is a polyphenol abundantly present in grapes and red wine. It is known to prevent the occurrence and development of cardiovascular diseases. In addition, it may resist cardiac fibrosis through a variety of growth factors, cytokines, and several cell signaling pathways, thus exerting a protective effect on the heart.
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Affiliation(s)
- Dongmin Yu
- Department of Breast Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China;
- Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China;
| | - Zhixian Tang
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China; (Z.T.); (J.Y.); (W.L.)
| | - Ben Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China;
| | - Junjian Yu
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China; (Z.T.); (J.Y.); (W.L.)
| | - Wentong Li
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China; (Z.T.); (J.Y.); (W.L.)
| | - Ziyou Liu
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China; (Z.T.); (J.Y.); (W.L.)
| | - Chengnan Tian
- Department of Cardiothoracic Surgery, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China; (Z.T.); (J.Y.); (W.L.)
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Chen Y, Du Y, Sun C, Tan W. Lactate is Associated with Increased 30-Day Mortality in Critically Ill Patients with Alcohol Use Disorder. Int J Gen Med 2021; 14:2741-2749. [PMID: 34194237 PMCID: PMC8236836 DOI: 10.2147/ijgm.s314821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 05/28/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the predictive value of lactate for prognosis in critically ill patients with AUD. Methods A retrospective cohort study was performed using data extracted from a freely accessible critical care database (MIMIC-III). We studied all patients with AUD from the database for whom lactate was available. The clinical outcomes were 30-day mortality. Analyses included LOWESS curve fitting, logistic multivariate regression model, receiver operating characteristic (ROC) analysis and subgroup analysis. Results A total of 1296 eligible critically ill patients with AUD were included and there were 223 non-survivors (17.2%). The non-survivors had a higher lactate than the survivors (p < 0.001). A nonlinear relationship between lactate and 30-day mortality was observed. Multivariate logistic regression indicated lactate could be an independent risk factors to predict the prognosis of critically ill patients with AUD. According to ROC curve analysis, the area under the curve predicted by lactate for 30-day mortality was 0.672 (95% CI, 0.634 to 0.711). Subgroup analysis did not find obvious interaction in most subgroups. Conclusion High lactate was associated with increased mortality in critically ill patients with AUD.
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Affiliation(s)
- Yu Chen
- Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China
| | - Yuanyuan Du
- Nursing School, Peking University, Beijing, People's Republic of China
| | - Cheng Sun
- Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China
| | - Wenliang Tan
- Department of Cardiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, People's Republic of China
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Yuan J, Che S, Zhang L, Ruan Z. Reparative Effects of Ethanol-Induced Intestinal Barrier Injury by Flavonoid Luteolin via MAPK/NF-κB/MLCK and Nrf2 Signaling Pathways. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:4101-4110. [PMID: 33749262 DOI: 10.1021/acs.jafc.1c00199] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Luteolin, a dietary flavonoid, has gained increasing interest as an intestinal protectant. This study aimed to evaluate the reparative effect of luteolin against ethanol-induced intestinal barrier damage in a Caco-2 cell monolayer model and the potential mechanisms. Luteolin attenuated ethanol-induced intestinal barrier injury, by increasing transepithelial monolayer resistance (TEER, 27.75 ± 14.75% of the ethanol group, p < 0.01), reducing Lucifer yellow flux (13.21 ± 1.23% of ethanol group, p < 0.01), and upregulating the expression of tight junction (TJ) proteins zonulin occludin-1 (ZO-1), occludin, and claudin-1 (37.963 ± 8.62%, 17.69 ± 7.35%, and 29.40 ± 8.08% of the ethanol group, respectively, p < 0.01). Further mechanistic studies showed that luteolin suppressed myosin light chain 2 (MLC) phosphorylation, myosin light chain kinase (MLCK) activation, nuclear factor kappa-B (NF-κB) nuclear translocation, and mitogen-activated-protein-kinase (MAPK) phosphorylation. Moreover, luteolin also acted as antioxidants indirectly by upregulating antioxidant-responsive-element (ARE) and nuclear factor (erythroid-derived 2)-like 2 (Nrf2) nuclear translocation to relieve ethanol-induced oxidative damage and TJ dysfunction. The results of the study indicate that luteolin may play an effective role in relieving intestinal barrier damage, and this effect is at least partially due to its indirect antioxidant capacity.
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Affiliation(s)
- Jinwen Yuan
- State Key Laboratory of Food Science and Technology, Nanchang Key Laboratory of Fruits and Vegetables Nutrition and Processing, Institute of Nutrition and School of Food Science, Nanchang University, Nanchang 330047, China
| | - Siyan Che
- State Key Laboratory of Food Science and Technology, Nanchang Key Laboratory of Fruits and Vegetables Nutrition and Processing, Institute of Nutrition and School of Food Science, Nanchang University, Nanchang 330047, China
| | - Li Zhang
- State Key Laboratory of Food Science and Technology, Nanchang Key Laboratory of Fruits and Vegetables Nutrition and Processing, Institute of Nutrition and School of Food Science, Nanchang University, Nanchang 330047, China
| | - Zheng Ruan
- State Key Laboratory of Food Science and Technology, Nanchang Key Laboratory of Fruits and Vegetables Nutrition and Processing, Institute of Nutrition and School of Food Science, Nanchang University, Nanchang 330047, China
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Carrino D, Branca JJV, Becatti M, Paternostro F, Morucci G, Gulisano M, Di Cesare Mannelli L, Pacini A. Alcohol-Induced Blood-Brain Barrier Impairment: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2683. [PMID: 33799986 PMCID: PMC7967408 DOI: 10.3390/ijerph18052683] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 12/16/2022]
Abstract
In recent years, alcohol abuse has dramatically grown with deleterious consequence for people's health and, in turn, for health care costs. It has been demonstrated, in humans and animals, that alcohol intoxication induces neuroinflammation and neurodegeneration thus leading to brain impairments. Furthermore, it has been shown that alcohol consumption is able to impair the blood-brain barrier (BBB), but the molecular mechanisms underlining this detrimental effect have not been fully elucidated. For this reason, in this study we investigated the effects of alcohol exposure on a rat brain endothelial (RBE4) cell line, as an in vitro-validated model of brain microvascular endothelial cells. To assess whether alcohol caused a concentration-related response, the cells were treated at different times with increasing concentrations (10-1713 mM) of ethyl alcohol (EtOH). Microscopic and molecular techniques, such as cell viability assay, immunofluorescence and Western blotting, were used to examine the mechanisms involved in alcohol-induced brain endothelial cell alterations including tight junction distribution, apoptosis, and reactive oxygen species production. Our findings clearly demonstrate that alcohol causes the formation of gaps between cells by tight junction disassembly, triggered by the endoplasmic reticulum and oxidative stress, highlighted by GRP78 chaperone upregulation and increase in reactive oxygen species production, respectively. The results from this study shed light on the mechanisms underlying alcohol-induced blood-brain barrier dysfunction and a better understanding of these processes will allow us to take advantage of developing new therapeutic strategies in order to prevent the deleterious effects of alcohol.
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Affiliation(s)
- Donatello Carrino
- Department Experimental and Clinical Medicine, Anatomy and Histology Section, University of Firenze, 50134 Firenze, Italy; (D.C.); (J.J.V.B.); (F.P.); (M.G.)
| | - Jacopo Junio Valerio Branca
- Department Experimental and Clinical Medicine, Anatomy and Histology Section, University of Firenze, 50134 Firenze, Italy; (D.C.); (J.J.V.B.); (F.P.); (M.G.)
| | - Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Firenze, 50134 Firenze, Italy;
| | - Ferdinando Paternostro
- Department Experimental and Clinical Medicine, Anatomy and Histology Section, University of Firenze, 50134 Firenze, Italy; (D.C.); (J.J.V.B.); (F.P.); (M.G.)
| | - Gabriele Morucci
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy;
| | - Massimo Gulisano
- Department Experimental and Clinical Medicine, Anatomy and Histology Section, University of Firenze, 50134 Firenze, Italy; (D.C.); (J.J.V.B.); (F.P.); (M.G.)
| | - Lorenzo Di Cesare Mannelli
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), Pharmacology and Toxicology Section, University of Firenze, 50139 Firenze, Italy;
| | - Alessandra Pacini
- Department Experimental and Clinical Medicine, Anatomy and Histology Section, University of Firenze, 50134 Firenze, Italy; (D.C.); (J.J.V.B.); (F.P.); (M.G.)
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Moreb NA, Albandary A, Jaiswal S, Jaiswal AK. Fruits and Vegetables in the Management of Underlying Conditions for COVID-19 High-Risk Groups. Foods 2021; 10:389. [PMID: 33578926 PMCID: PMC7916708 DOI: 10.3390/foods10020389] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 12/21/2022] Open
Abstract
SARS-CoV-2 or COVID-19 is a novel coronavirus, which is the cause of the current pandemic with 107,411,561 infections and 2,351,195 death worldwide so far. There are multiple symptoms that are linked with the infection of COVID-19 such as coughing, shortness of breath, congestion together with fatigue, fever, loss of taste or smell, headaches, diarrhea, vomiting, and loss of appetite. The lack of or early stage of development of a cure for COVID-19 illness, there is need for insuring the best possible position of health to be able to fight the virus naturally through a robust immune system to limit severe complication. In this article, we have discussed the role of fruits and vegetables consumption to boost the immune system and major emphasis has been given to high risk group. We have taken into consideration a number of underlying conditions such as people with cardiovascular diseases, obesity, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, hemoglobin disorder such as sickle cell disease, weakened immune system due to organ transplant. Furthermore, factors to improve the immune system, risks associated with quarantine and lifestyle and food handling during COVID-19 has been discussed.
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Affiliation(s)
- Nora A. Moreb
- School of Food Science and Environmental Health, College of Sciences and Health, Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland; (N.A.M.); (A.A.); (S.J.)
| | - Ahmed Albandary
- School of Food Science and Environmental Health, College of Sciences and Health, Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland; (N.A.M.); (A.A.); (S.J.)
| | - Swarna Jaiswal
- School of Food Science and Environmental Health, College of Sciences and Health, Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland; (N.A.M.); (A.A.); (S.J.)
- Environmental Sustainability and Health Institute (ESHI), Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland
| | - Amit K. Jaiswal
- School of Food Science and Environmental Health, College of Sciences and Health, Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland; (N.A.M.); (A.A.); (S.J.)
- Environmental Sustainability and Health Institute (ESHI), Technological University Dublin—City Campus, Grangegorman, 7 Dublin, Ireland
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Nowak AJ, Relja B. The Impact of Acute or Chronic Alcohol Intake on the NF-κB Signaling Pathway in Alcohol-Related Liver Disease. Int J Mol Sci 2020; 21:ijms21249407. [PMID: 33321885 PMCID: PMC7764163 DOI: 10.3390/ijms21249407] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 02/06/2023] Open
Abstract
Ethanol misuse is frequently associated with a multitude of profound medical conditions, contributing to health-, individual- and social-related damage. A particularly dangerous threat from this classification is coined as alcoholic liver disease (ALD), a liver condition caused by prolonged alcohol overconsumption, involving several pathological stages induced by alcohol metabolic byproducts and sustained cellular intoxication. Molecular, pathological mechanisms of ALD principally root in the innate immunity system and are especially associated with enhanced functionality of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway. NF-κB is an interesting and convoluted DNA transcription regulator, promoting both anti-inflammatory and pro-inflammatory gene expression. Thus, the abundancy of studies in recent years underlines the importance of NF-κB in inflammatory responses and the mechanistic stimulation of inner molecular motifs within the factor components. Hereby, in the following review, we would like to put emphasis on the correlation between the NF-κB inflammation signaling pathway and ALD progression. We will provide the reader with the current knowledge regarding the chronic and acute alcohol consumption patterns, the molecular mechanisms of ALD development, the involvement of the NF-κB pathway and its enzymatic regulators. Therefore, we review various experimental in vitro and in vivo studies regarding the research on ALD, including the recent active compound treatments and the genetic modification approach. Furthermore, our investigation covers a few human studies.
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Affiliation(s)
- Aleksander J. Nowak
- Experimental Radiology, University Clinic for Radiology and Nuclear Medicine, Leipziger Strasse 44, 39120 Magdeburg, Germany;
- Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
| | - Borna Relja
- Experimental Radiology, University Clinic for Radiology and Nuclear Medicine, Leipziger Strasse 44, 39120 Magdeburg, Germany;
- Medical Faculty, Otto-von-Guericke-University Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
- Correspondence: ; Tel.: +49-(0)391-6728242; Fax: +49-(0)391-6728248
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23
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Fernández-Solà J. The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy. Nutrients 2020; 12:nu12020572. [PMID: 32098364 PMCID: PMC7071520 DOI: 10.3390/nu12020572] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 02/07/2023] Open
Abstract
Alcoholic-dilated Cardiomyopathy (ACM) is the most prevalent form of ethanol-induced heart damage. Ethanol induces ACM in a dose-dependent manner, independently of nutrition, vitamin, or electrolyte disturbances. It has synergistic effects with other heart risk factors. ACM produces a progressive reduction in myocardial contractility and heart chamber dilatation, leading to heart failure episodes and arrhythmias. Pathologically, ethanol induces myocytolysis, apoptosis, and necrosis of myocytes, with repair mechanisms causing hypertrophy and interstitial fibrosis. Myocyte ethanol targets include changes in membrane composition, receptors, ion channels, intracellular [Ca2+] transients, and structural proteins, and disrupt sarcomere contractility. Cardiac remodeling tries to compensate for this damage, establishing a balance between aggression and defense mechanisms. The final process of ACM is the result of dosage and individual predisposition. The ACM prognosis depends on the degree of persistent ethanol intake. Abstinence is the preferred goal, although controlled drinking may still improve cardiac function. New strategies are addressed to decrease myocyte hypertrophy and interstitial fibrosis and try to improve myocyte regeneration, minimizing ethanol-related cardiac damage. Growth factors and cardiomyokines are relevant molecules that may modify this process. Cardiac transplantation is the final measure in end-stage ACM but is limited to those subjects able to achieve abstinence.
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Affiliation(s)
- Joaquim Fernández-Solà
- Alcohol Unit, Internal Medicine Department, Hospital Clínic, Institut de Recerca August Pi i Sunyer (IDIBAPS), University of Barcelona, 08007 Catalunya, Spain;
- Fisiopatología de la Obesidad y la Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Santos German IJ, Pomini KT, Bighetti ACC, Andreo JC, Reis CHB, Shinohara AL, Rosa Júnior GM, Teixeira DDB, Rosso MPDO, Buchaim DV, Buchaim RL. Evaluation of the Use of an Inorganic Bone Matrix in the Repair of Bone Defects in Rats Submitted to Experimental Alcoholism. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E695. [PMID: 32033088 PMCID: PMC7040897 DOI: 10.3390/ma13030695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 01/21/2020] [Accepted: 01/27/2020] [Indexed: 12/16/2022]
Abstract
To assess the effects of chronic alcoholism on the repair of bone defects associated with xenograft. Forty male rats were distributed in: control group (CG, n = 20) and experimental group (EG, n = 20), which received 25% ethanol ad libitum after a period of adaptation. After 90 days of liquid diet, the rats were submitted to 5.0-mm bilateral craniotomy on the parietal bones, subdividing into groups: CCG (control group that received only water with liquid diet and the defect was filled with blood clot), BCG (control group that received only water with liquid diet and the defect was filled with biomaterial), CEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with blood clot), and BEG (alcoholic group that received only ethanol solution 25% v/v with liquid diet and the defect was filled with biomaterial). In the analysis of body mass, the drunk animals presented the lowest averages in relation to non-drunk animals during the experimental period. Histomorphologically all groups presented bone formation restricted to the defect margins at 60 days, with bone islets adjacent to the BCG biomaterial particles. CEG showed significant difference compared to BEG only at 40 days (17.42 ± 2.78 vs. 9.59 ± 4.59, respectively). In the birefringence analysis, in early periods all groups showed red-orange birefringence turning greenish-yellow at the end of the experiment. The results provided that, regardless of clinical condition, i.e., alcoholic or non-alcoholic, in the final period of the experiment, the process of bone defect recomposition was similar with the use of xenograft or only clot.
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Affiliation(s)
- Iris Jasmin Santos German
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
- Department of Dentistry, Faculty of Health Science, Universidad Iberoamericana (UNIBE), Santo Domingo 10203, Dominican Republic
- Mother and Teacher Pontifical Catholic University (PUCMM), Santo Domingo 10203, Dominican Republic
| | - Karina Torres Pomini
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
| | - Ana Carolina Cestari Bighetti
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
| | - Jesus Carlos Andreo
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
| | - Carlos Henrique Bertoni Reis
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília, São Paulo 17525-902, Brazil; (C.H.B.R.); (D.d.B.T.); (D.V.B.)
| | - André Luis Shinohara
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
| | - Geraldo Marco Rosa Júnior
- University of the Ninth of July (UNINOVE), Bauru, São Paulo 17011-102, Brazil;
- University of the Sacred Heart (USC), Bauru, São Paulo 17011-160, Brazil
| | - Daniel de Bortoli Teixeira
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília, São Paulo 17525-902, Brazil; (C.H.B.R.); (D.d.B.T.); (D.V.B.)
| | - Marcelie Priscila de Oliveira Rosso
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília, São Paulo 17525-902, Brazil; (C.H.B.R.); (D.d.B.T.); (D.V.B.)
- Medical School, University Center of Adamantina (UniFAI), Adamantina, São Paulo 17800-000, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences (Anatomy), Bauru School of Dentistry, University of São Paulo (USP), Bauru, São Paulo 17012-901, Brazil; (I.J.S.G.); (K.T.P.); (A.C.C.B.); (J.C.A.); (A.L.S.); (M.P.d.O.R.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marília, São Paulo 17525-902, Brazil; (C.H.B.R.); (D.d.B.T.); (D.V.B.)
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Pohanka M. Antidotes Against Methanol Poisoning: A Review. Mini Rev Med Chem 2019; 19:1126-1133. [PMID: 30864518 DOI: 10.2174/1389557519666190312150407] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/20/2019] [Accepted: 03/06/2019] [Indexed: 12/12/2022]
Abstract
Methanol is the simplest alcohol. Compared to ethanol that is fully detoxified by metabolism. Methanol gets activated in toxic products by the enzymes, alcohol dehydrogenase and aldehyde dehydrogenase. Paradoxically, the same enzymes convert ethanol to harmless acetic acid. This review is focused on a discussion and overview of the literature devoted to methanol toxicology and antidotal therapy. Regarding the antidotal therapy, three main approaches are presented in the text: 1) ethanol as a competitive inhibitor in alcohol dehydrogenase; 2) use of drugs like fomepizole inhibiting alcohol dehydrogenase; 3) tetrahydrofolic acid and its analogues reacting with the formate as a final product of methanol metabolism. All the types of antidotal therapies are described and how they protect from toxic sequelae of methanol is explained.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, Hradec Kralove CZ-50001, Czech Republic
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Gupta NM, Lindenauer PK, Yu PC, Imrey PB, Haessler S, Deshpande A, Higgins TL, Rothberg MB. Association Between Alcohol Use Disorders and Outcomes of Patients Hospitalized With Community-Acquired Pneumonia. JAMA Netw Open 2019; 2:e195172. [PMID: 31173120 PMCID: PMC6563577 DOI: 10.1001/jamanetworkopen.2019.5172] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE Patients with alcohol use disorder (AUD) are at elevated risk of developing pneumonia, but few studies have assessed the outcomes of pneumonia in patients with AUD. OBJECTIVES To compare the causes, treatment, and outcomes of pneumonia in patients with and without AUD and to understand the associations of comorbid illnesses, alcohol withdrawal, and any residual effects due to alcohol itself with patient outcomes. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted of 137 496 patients 18 years or older with pneumonia who were admitted to 177 US hospitals participating in the Premier Healthcare Database from July 1, 2010, to June 30, 2015. Statistical analysis was conducted from October 27, 2017, to August 20, 2018. EXPOSURE Alcohol use disorders identified from International Classification of Diseases, Ninth Revision, Clinical Modification codes. MAIN OUTCOMES AND MEASURES Pneumonia cause, antibiotic treatment, inpatient mortality, clinical deterioration, length of stay, and cost. Associations of AUD with these variables were studied using generalized linear mixed models. RESULTS Of 137 496 patients with community-acquired pneumonia (70 358 women and 67 138 men; mean [SD] age, 69.5 [16.2] years), 3.5% had an AUD. Patients with an AUD were younger than those without an AUD (median age, 58.0 vs 73.0 years; P < .001), more often male (77.3% vs 47.8%; P < .001), and more often had principal diagnoses of aspiration pneumonia (10.9% vs 9.8%; P < .001), sepsis (38.6% vs 30.7%; P < .001), or respiratory failure (9.3% vs 5.5%; P < .001). Their cultures more often grew Streptococcus pneumoniae (43.7% vs 25.5%; P < .001) and less frequently grew organisms resistant to guideline-recommended antibiotics (25.0% vs 43.7%; P < .001). Patients with an AUD were treated more often with piperacillin-tazobactam (26.2% vs 22.5%; P < .001) but equally as often with anti-methicillin-resistant Staphylococcus aureus agents (32.9% vs 31.8%; P = .11) compared with patients without AUDs. When adjusted for demographic characteristics and insurance, AUD was associated with higher mortality (odds ratio, 1.40; 95% CI, 1.25-1.56), length of stay (risk-adjusted geometric mean ratio, 1.24; 95% CI, 1.20-1.27), and costs (risk-adjusted geometric mean ratio, 1.33; 95% CI, 1.28-1.38). After additional adjustment for differences in comorbidities and risk factors for resistant organisms, AUD was no longer associated with mortality but remained associated with late mechanical ventilation (odds ratio, 1.28; 95% CI, 1.12-1.46), length of stay (risk-adjusted geometric mean ratio, 1.04; 95% CI, 1.01-1.06), and costs (risk-adjusted geometric mean ratio, 1.06; 95% CI, 1.03-1.09). Models segregating patients undergoing alcohol withdrawal showed that poorer outcomes among patients with AUD were confined to the subgroup undergoing alcohol withdrawal. CONCLUSIONS AND RELEVANCE This study suggests that, compared with hospitalized patients with community-acquired pneumonia but without AUD, those with AUD less often harbor resistant organisms. The higher age-adjusted risk of death among patients with AUD appears to be largely attributable to differences in comorbidities, whereas greater use of health care resources may be attributable to alcohol withdrawal.
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Affiliation(s)
- Niyati M. Gupta
- Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter K. Lindenauer
- Institute for Healthcare Delivery and Population Science, Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
| | - Pei-Chun Yu
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter B. Imrey
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Mellon Center for MS Treatment and Research, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Sarah Haessler
- Division of Infectious Diseases, Department of Medicine, University of Massachusetts Medical School-Baystate, Springfield
| | - Abhishek Deshpande
- Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - Michael B. Rothberg
- Center for Value-Based Care Research, Medicine Institute, Cleveland Clinic, Cleveland, Ohio
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Role of HIF-1α in Alcohol-Mediated Multiple Organ Dysfunction. Biomolecules 2018; 8:biom8040170. [PMID: 30544759 PMCID: PMC6316086 DOI: 10.3390/biom8040170] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 11/30/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022] Open
Abstract
Excess alcohol consumption is a global crisis contributing to over 3 million alcohol-related deaths per year worldwide and economic costs exceeding $200 billion dollars, which include productivity losses, healthcare, and other effects (e.g., property damages). Both clinical and experimental models have shown that excessive alcohol consumption results in multiple organ injury. Although alcohol metabolism occurs primarily in the liver, alcohol exposure can lead to pathophysiological conditions in multiple organs and tissues, including the brain, lungs, adipose, liver, and intestines. Understanding the mechanisms by which alcohol-mediated organ dysfunction occurs could help to identify new therapeutic approaches to mitigate the detrimental effects of alcohol misuse. Hypoxia-inducible factor (HIF)-1 is a transcription factor comprised of HIF-1α and HIF-1β subunits that play a critical role in alcohol-mediated organ dysfunction. This review provides a comprehensive analysis of recent studies examining the relationship between HIF-1α and alcohol consumption as it relates to multiple organ injury and potential therapies to mitigate alcohol’s effects.
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Femoral neck fractures after internal fixation of trochanteric fractures with implants in situ in adults: A systematic review. Injury 2018; 49:2121-2131. [PMID: 30526921 DOI: 10.1016/j.injury.2018.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Femoral neck fractures (FNF) after internal fixation of trochanteric fractures (AIFTF) with the implant in situ (WIIS) are uncommon. Publications of FNFAIFTFWIIS are rare. The purpose of this systematic review of the literature is to report on the frequency, risk factors, mechanisms, clinical presentation, diagnostic and therapeutic modalities, outcomes and the eventual prevention of this complication. MATERIALS AND METHODS A comprehensive review of the literature was undertaken using the PRISMA guidelines with no language restriction. Case reports of FNFAIFTFWIIS and series of trochanteric fractures (TF) with this complication in adults published between inception of journals to May 2018 were eligible for inclusion. Cases with fractures in pathological bone, undergoing treatment with hip replacement, or after partial or total implant removal were excluded. Relevant information was divided in two parts. Part I included the analysis of cases of FNFAIFTFWIIS, with the objective of establishing the eventual risk factors, mechanisms, diagnostic, treatment modalities, and outcomes. Part II analyzed series of TFs with implants in situ which included cases of FNFs for assessing the incidence of FNFs in this condition. RESULTS Overall 77 publications with 104 cases of FNFAIFTFWIIS met the inclusion criteria. The median incidence of this complication was 0,43%. The mean age was 80 years (range, 42-96).The prevalent factors for FNFAIFTFWIIS were osteoporosis, and the presence of the implant in the femoral neck and head. A short nail or screw with the tip far from the subchondral bone was of influence as a stress riser factor, but not prevalent because in two thirds of the cases the FNF occurred when the implant was introduced up to the subchondral bone. Other risk factors analysed included varus reduction or nonunion of the TF, and the breakage of the hip screw, which modify the forces exerted over the femoral neck, and may contribute to the FNF. The FNFs were spontaneous, i.e. not related to trauma or fall, in more than two thirds of the cases. CONCLUSION The etiology of FNFAIFTFWII should be considered multifactorial. The frequency seems low. Although a subchondral positioning of the hip screw might diminish the incidence of FNFS, a correct surgical technique does not preclude a FNFAIFTFWIIS, and in fact the incidence of this complication was higher in these correctly treated patients. FNFAIFTFWIIS is a fragility fracture and adequate management of systemic osteoporosis should be targeted as a main factor of prevention.
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Wu C, Wu D, Liu Y, Zhong Y. Genetic polymorphism in cytochrome P450 2E1 and alcoholic pancreatitis sus-ceptibility: a meta-analysis. Hippokratia 2018; 22:60-67. [PMID: 31217677 PMCID: PMC6548521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The association between cytochrome P450 2E1 (CYP2E1) polymorphism and the risk of alcoholic pancreatitis is contentious. This meta-analysis aimed to demonstrate the association between CYP2E1 RsaI/PstI, or DraI polymorphisms and the susceptibility of alcoholic pancreatitis. MATERIALS AND METHODS We searched for sources and background in Pubmed, Medline, Web of science and CNKI (Chinese national knowledge infrastructure), using the following keywords: "cytochrome P450 2E1" or "CYP2E1", "polymorphism" or "genotype", in combination with "alcoholic pancreatitis". All meta-analyses were performed with Stata 12.0. Subgroup analyses on ethnicity and type of alcoholic pancreatitis were conducted as well. Results: Eleven articles, which met the inclusion criteria, included 595 patients with alcoholic pancreatitis, and 1767 controls. For the general population, our analysis suggested no obvious association between CYP2E1 RsaI/PstI or DraI polymorphisms and the risk of alcoholic pancreatitis. However, in the non-Asian subgroup, significant associations were found between the risk for alcoholic pancreatitis and CYP2E1 RsaI/PstI polymorphism [dominant model: odds ratio (OR) =1.92, 95 % confidence interval (CI): 1.25-2.95, p =0.003; allelic contrast model: OR =1.99, 95 % CI: 1.35-2.92, p <0.001. There was not a significant association found within the Asian group. Meanwhile, the susceptibilities of chronic alcoholic pancreatitis were significantly increased for dominant and allelic contrast models of CYP2E1 RsaI/PstI polymorphism [OR =1.62, 95 % CI: 1.12-2.34; p =0.011; OR =1.62, 95 % CI: 1.17-2.24, p = 0.004, respectively] but not for acute alcoholic pancreatitis for all population. CONCLUSIONS CYP2E1 RsaI/PstI polymorphism may increase the risk of alcoholic pancreatitis in the non-Asian population. Additionally, the CYP2E1 RsaI/PstI polymorphism may increase the susceptibility for chronic alcoholic pancreatitis for all population. HIPPOKRATIA 2018, 22(2): 60-67.
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Affiliation(s)
- C Wu
- ICU Center of the Second Xiangya Hospital, Central South University, Changsha, China
| | - D Wu
- ICU Center of the Second Xiangya Hospital, Central South University, Changsha, China
| | - Y Liu
- Hematological department of the Third Xiangya Hospital, Central South University, Changsha, China
| | - Y Zhong
- ICU Center of the Second Xiangya Hospital, Central South University, Changsha, China
- Hematological department of the Third Xiangya Hospital, Central South University, Changsha, China
- Department of Surgery of University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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