Hypoadiponectinemia is associated with valvular inflammation and faster disease progression in patients with aortic stenosis

OBJECTIVES

Adiponectin is a protein secreted by adipocytes which has anti-inflammatory properties. The objective of this study was to examine the relationship between adiponectinemia and the hemodynamic progression of aortic stenosis (AS) as well as the degree of inflammation in the valve explanted at the time of aortic valve replacement (AVR).

METHODS

The plasma level of adiponectin was measured in 122 patients undergoing AVR. The explanted aortic valves were analyzed and the density of leukocytes (CD45+), T cells (CD3+) and blood vessels (von Willebrand factor positive; vWF+) was documented. Also, a subset of patients (n = 67) had ≥2 echocardiographic studies separated by at least 6 months, thereby allowing assessment of the rate of progression of stenosis during the preoperative period.

RESULTS

Patients with lower plasma levels of adiponectin (<5.4 μg/ml) had a faster progression rate of the mean transvalvular gradient before surgery than those with higher levels (9 ± 1 vs. 4 ± 1 mm Hg/year; p = 0.008). Moreover, these patients with hypoadiponectinemia had significantly more leukocytes (CD45+), T cells and blood vessels (vWF+) in their explanted valves compared to those with higher adiponectin levels.

CONCLUSION

These findings support the concept that adiponectin may play a protective role against the inflammatory process and progression of calcific AS.

Broad DNA repair responses in neural injury are associated with activation of the IL-6 pathway in cholesterol-fed rabbits

The importance of DNA repair in the pathogenic mechanism of Alzheimer's Disease (AD) is still poorly understood. Here, we report that a broad range of responses by DNA repair proteins plays a critical role in the regulation of inflammatory response in rabbits fed with cholesterol-rich diet, a model system for AD. We found accumulation of oxodG DNA adduct in the brain of rabbits fed with cholesterol-enriched diets compared to control diets, which subsequently induced a broad range of DNA repair protein activities. Also, the hippocampus was identified as the primary site of oxidative DNA damage and elevated OGG1 activity. In addition, a physical interaction between XPB and OGG1 may account for a potential mechanism involving these DNA repair responses. DNA repair proteins also impact activation of various signaling cascades, including Src in response to cholesterol oxidation. Furthermore, OGG1 deficient mice showed no IL-6 activation as seen in wt mice but a drastic increase of TNF-alpha, a pro-inflammatory cytokine. Thus, OGG1 may be associated with cytokine production induced by high cholesterol levels, impacting neurodegeneration. Together, our studies suggest that critical DNA repair proteins are associated with development of AD, and may serve as potential targets for the treatment of AD.

Lipid-mediated inflammation and degeneration of bioprosthetic heart valves

BACKGROUND

The durability of bioprosthetic valves is limited by structural valve degeneration (SVD) leading to bioprostheses (BPs) stenosis or regurgitation. We hypothesized that a lipid-mediated inflammatory mechanism is involved in the SVD of BPs.

MATERIAL AND METHODS

Eighteen Freestyle stentless BP valves were explanted for SVD at a mean time of 5.9 +/- 3 years after implantation and were analysed by immunohistochemistry and transmission electron microscopy (TEM).

RESULTS

The mean age of the patients was 65 +/- 8 years and there were 11 male and seven female patients. Two of the 18 BPs had macroscopic calcification, whereas the other valves had minimal or no macroscopic calcification. Tears at the commissures leading to regurgitation was present in 16 BPs. Immunohistochemistry showed the presence of oxidized low-density lipoprotein (ox-LDL) and glycosaminoglycans in the fibrosa layer of 13 BPs. Areas with ox-LDL were infiltrated by macrophages (CD68(+)) co-expressing the scavenger receptor CD36 and metalloproteinase-9 (MMP-9). Zymogram showed the active form of MMP-9 within explanted BPs. EM studies revealed the presence of lipid-laden cells featuring foam cells and fragmented collagen. Nonimplanted control BPs obtained from the manufacturer (n = 4) had no evidence of lipid accumulation, inflammatory cell infiltration or expression of MMP9 within the leaflets.

CONCLUSIONS

These results support the concept that lipid-mediated inflammatory mechanisms may contribute to the SVD of BPs. These findings suggest that modification of atherosclerotic risk factors with the use of behavioural or pharmacological interventions could help to reduce the incidence of SVD.

Alveolar epithelial type II cells activate alveolar macrophages and mitigate P. Aeruginosa infection

Although alveolar epithelial type II cells (AECII) perform substantial roles in the maintenance of alveolar integrity, the extent of their contributions to immune defense is poorly understood. Here, we demonstrate that AECII activates alveolar macrophages (AM) functions, such as phagocytosis using a conditioned medium from AECII infected by P. aeruginosa. AECII-derived chemokine MCP-1, a monocyte chemoattractant protein, was identified as a main factor in enhancing AM function. We proposed that the enhanced immune potency of AECII may play a critical role in alleviation of bacterial propagation and pneumonia. The ability of phagocytosis and superoxide release by AM was reduced by MCP-1 neutralizing antibodies. Furthermore, MCP-1(-/-) mice showed an increased bacterial burden under PAO1 and PAK infection vs. wt littermates. AM from MCP-1(-/-) mice also demonstrated less superoxide and impaired phagocytosis over the controls. In addition, AECII conditioned medium increased the host defense of airway in MCP-1(-/-) mice through the activation of AM function. Mechanistically, we found that Lyn mediated NFkappaB activation led to increased gene expression and secretion of MCP-1. Consequently Lyn(-/-) mice had reduced MCP-1 secretion and resulted in a decrease in superoxide and phagocytosis by AM. Collectively, our data indicate that AECII may serve as an immune booster for fighting bacterial infections, particularly in severe immunocompromised conditions.

Cholesterol-rich membrane rafts and Lyn are involved in phagocytosis during Pseudomonas aeruginosa infection

The mechanism of phagocytosis of pathogens remains to be fully characterized. We report a novel phagocytosis pathway for Pseudomonas aeruginosa, which is initiated by cholesterol-rich membrane rafts and is dependent on Lyn, primarily an immune regulator with both positive and negative roles. Blocking of Lyn or blocking of cholesterol synthesis significantly inhibited phagocytosis by alveolar macrophages. We found that Lyn, via Src homology 2 and 3 domains, bound to and then activated PI3K and Akt to regulate intracellular routing of the engulfed P. aeruginosa. Further analysis indicates that Lyn and raft components entered in phagosomes and late lysosomes. Finally, respiratory burst was dependent on Lyn and membrane rafts, as confirmed by small interfering RNA and dominant-negative strategies. Our investigations demonstrate that Lyn along with membrane rafts plays a fundamental role in phagocytosis by alveolar macrophages during infection.

Src kinase Lyn is crucial for Pseudomonas aeruginosa internalization into lung cells

Lyn is an important B cell signaling kinase of the Src tyrosine kinase family with a broad range of functions from cytoskeletal changes to induction of apoptosis. However, the role of Lyn in infectious diseases is not clear. Here, we demonstrate that Lyn activation by phosphorylation significantly impacted invasion of an alveolar epithelial cell line, primary lung cells, and rat lungs by Pseudomonas aeruginosa (PA), a common opportunistic lung pathogen affecting individuals with deficient lung immunity. Our results indicate that activation of Lyn and its interaction with rafts and TLR2, played an important role in the initial stages of PA interaction with host cells. The role of Lyn was further evaluated using the pharmacologic Src-specific inhibitor PP2, a dominant negative mutant, and finally confirmed with Lyn-deficient (Lyn(-/-)) bone marrow-derived mast cells. Inhibition of Lyn's function by above approaches prevented PA internalization. Moreover, blocking of Lyn also affected downstream events: induction of inflammatory cytokines and apoptosis. This report brings out a new role of Lyn in infectious diseases and indicates potential new targets for prevention and treatment of infections.

Short-term treatment with mycophenolic acid and tacrolimus is tolerogenic for INS-1 cell clone transplantation and the deleterious effects of the drugs are limited: in vivo and in vitro studies

One of the major requirements for a successful and life-lasting organ transplant is the access to safe, least toxic and permanent tolerance-inducing drugs. In this study we wished to evaluate the effects of tolerogenic doses of the immunosuppressive drugs mycophenolic acid (MPA) and tacrolimus (Tac) on clonal beta-cell lines, both in vivo and in vitro. Here we demonstrate that combined administration of low-dose MPA and Tac for 23 days induced permanent tolerance in an allogeneic beta-cell line transplant in Wistar rat liver through the portal vein. This short-term treatment of tolerogenic doses of the two drugs was deleterious to the survival of the transplanted cells but a small percentage of the cells could resist the effect and become fully active when the drugs were removed. The surviving cells, retrieved from growth in vivo, did not exhibit increased resistance in comparison to the original cells when tested in vitro at two glucose concentrations, 10 and 20 mM. The presence of a small percentage of resistant cells at the two glucose concentrations was also detected in the in vitro study after a continuous 8-day treatment demonstrating that the in vivo resistance was not related to micro-environmental protection but possibly to a phenotypic cell state that is yet to be determined.

Inhibition of the interaction between lipoproteins and amphotericin B by some delivery systems

Amphotericin B (AmB) is a potent antifungal agent used to treat patients with systemic mycoses. The clinical usefulness of the drug is limited by its high toxicity and several new less toxic formulations of AmB have been recently developed. In order to understand the mechanism of the decreases of toxicity caused by various new delivery systems, we have investigated by uv-visible spectroscopy the interaction of two of these formulations with human blood lipoproteins. The results were compared with those obtained with the commonly used pharmaceutical form of AmB (Fungizone). This study shows that AmB-lipoprotein interaction is hindered when the drug is in a monomeric form and/or when it is included in phospholipid-surfactant micelles. In an in vivo study on mice it is shown here that AmB monomerized by surfactant is less toxic to animals than the same concentration of Fungizone, where the polyene is strongly aggregated. It may be concluded from the present study that the AmB species which is responsible for the in vivo toxicity is a complex of the antibiotic with the low density and the very low density blood lipoproteins and that hindering of this complex formation results in a decrease of AmB toxicity.

[Malocclusion: dental or skeletal?]

This article presents a simple rapid and practical method, based both on clinical and radiographic examinations, which the dentist can use to the patient's advantage in differentiating dental from skeletal malocclusion.

Lactate threshold and onset of blood lactate accumulation during incremental exercise after dietary modifications

This study was designed to clarify the effects of dietary modifications on the lactate threshold (LT) and on the onset of blood lactate accumulation (OBLA) during progressive incremental exercise. Six healthy males volunteered for the study. Informed consent was obtained from every participant. The following protocol was administered to each subject on three occasions: a 48-h period of mixed dieting (53% carbohydrates, 30% lipids, 17% proteins) preceding the first exercise test, immediately followed by a 48-h period of either a carbohydrate-rich (68% CHO, 23% lipids, 9% proteins) or a fat-rich (19% CHO, 57% lipids, 26% proteins) iso-caloric diet leading to the second exercise and separated from the third test by a 12-days period. Exercise tests were conducted on an electrically-braked ergocycle, and consisted of a progressive incremental maximal exercise. Respiratory parameters were continuously monitored by an automated open circuit sampling system. Exercise blood lactate (LA), free fatty acids (FFA), glucose levels and acid-base balance were determined from venous blood samples obtained through an indwelling brachial catheter. Peak lactate values, workload and performance time were not significantly altered by imposed diets. Furthermore, dietary modifications had no significant effect on LT, OBLA fixed at 4 mmol and ventilatory threshold. Increased pH and FFA mobilization were observed with fat-rich diet, while CHO-rich diet markedly increased the respiratory exchange ratio (R). It is concluded that LT and OBLA are not significantly altered by fat or CHO enrichment of diets.

Exercise-induced blood prolactin variations in trained adult males: a thermic stress more than an osmotic stress

Blood prolactin (PRL) variations have been linked to temperature and osmotic changes in several species. The latter factors are here explored to better understand blood PRL responses frequently induced during physical exercise. Since body heat generated by exercise can lead to marked body fluid shifts, it was postulated that PRL changes observed during exercise could be associated with variations in body temperature and/or blood osmolality (OSM). A wide range (38.5-40.5 degrees C) of rectal temperatures (Tr; used here to appreciate core temperatures) were theoretically selected and randomly assigned as targets to male runners. Measured by thermistor probe, target Tr were obtained by a combination of factors: (a) increases heat production by treadmill running, and (b) decreases heat losses by appropriate clothing (decreases evaporation) in warmed (decreases radiation) and hypoventilated (decreases convection) laboratory conditions. For each subject, target Tr was attained not prior to 30 min after initiation of running, and had to be maintained for at least 10 min, for a mean (+/- SD) running time of 52.6 +/- 10.0 min. In a first protocol, hypohydration was provoked in 26 runners (23.9 +/- 4.7 years) by total restriction of water intake. In a second protocol (10 different runners: 22.3 +/- 3.3 years), euhydration was maintained by water intake (20 ml/kg body weight). Venous blood was sampled at rest before and immediately after the run. PRL was assayed by RIA; OSM was measured by freezing point depression; sodium was analyzed by flame photometry. At rest, before the heat-producing exercise, mean PRL values were 9.4 +/- 3.4 ng/ml for both eu/hypohydrated groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Prolactinemia in exercising male athletes

8 male collegial athletes were submitted at random to three (55, 70 and 85% of VO2 max) ergocycle exercises of 20-min duration. Venous blood samples were obtained before, during and after ergocycling sessions by antecubital catheterization. Serum prolactin was measured by RIA using specific antiserum. The exercise treatments induced a blood prolactin response proportional to the intensity of the work loads.

Polyglycerophosphatide metabolism in Escherichia coli

When Escherichia coli B cells were labelled with [14-C] glycerol and chased, there was a marked sparing of the phosphatidyl moiety compared to the nonacylated glycerol moiety of phosphatidylglycerol. When energy-depleted cells were restored to an energy-rich medium there resulted a conversion of 32-P-labelled cardiolipin to phosphatidylglycerol, a lack of phosphatidic acid accumulation and no loss in total polyglycerophosphatide counts. In cell-free extracts, phosphatidic acid produced from 32-P-labelled cardiolipin by the action of Escherichia coli phosphalipase D, was readily recycled to form poly-glycerophosphatide. In the presence of glycerol, such extracts displayed traansphosphatidylase activity by degrading cardiolipin to phosphatidyglycerol mainly. The results as a whole indicate that the enzyme synthesizing cardiolipin together with cardiolipin-hydrolyzing phospholipase D constitute a cycle which is normally involved in the turnover of polyglycerophosphatides in Escherichia coli.