Interleukin-4 inhibits the hypothalamic appetite control by modulating the insulin-AKT and JAK-STAT signaling in leptin mutant mice

Our previous research identified interleukin-4 (IL-4) as a key regulator of glucose/lipid metabolism, circulatory leptin levels, and insulin action, suggesting its potential as a therapeutic target for obesity and related complications. This study aimed to further elucidate the role of IL-4 in regulating hypothalamic appetite-controlling neuropeptides using leptin dysfunctional Leptin145E/145E mice as the experimental model. IL-4 significantly reduces body weight, food intake, and serum glucose levels. Our data demonstrated that IL-4 exhibits multiple functions in regulating hypothalamic appetite control, including downregulating orexigenic agouti-related peptide and neuropeptide Y levels, promoting expression of anorexigenic proopiomelanocortin, alleviating microenvironmental hypothalamic inflammation, enhancing leptin and insulin pathway, and attenuating insulin resistance. Furthermore, IL-4 promotes uncoupling protein 1 expression of white adipose tissue (WAT), suggesting its role in triggering WAT-beige switch. In summary, this study uncovers novel function of IL-4 in mediating food-intake behaviors and metabolic efficiency by regulating hypothalamic appetite-control and WAT browning activities. These findings support the therapeutic potential of targeting hypothalamic inflammation and reducing adiposity through IL-4 intervention for tackling the pandemic increasing prevalence of obesity and associated metabolic disorders.

Differential expression of GABAA receptor subunits δ and α6 mediates tonic inhibition in parvalbumin and somatostatin interneurons in the mouse hippocampus

Inhibitory γ-aminobutyric acid (GABA)-ergic interneurons mediate inhibition in neuronal circuitry and support normal brain function. Consequently, dysregulation of inhibition is implicated in various brain disorders. Parvalbumin (PV) and somatostatin (SST) interneurons, the two major types of GABAergic inhibitory interneurons in the hippocampus, exhibit distinct morpho-physiological properties and coordinate information processing and memory formation. However, the molecular mechanisms underlying the specialized properties of PV and SST interneurons remain unclear. This study aimed to compare the transcriptomic differences between these two classes of interneurons in the hippocampus using the ribosome tagging approach. The results revealed distinct expressions of genes such as voltage-gated ion channels and GABAA receptor subunits between PV and SST interneurons. Gabrd and Gabra6 were identified as contributors to the contrasting tonic GABAergic inhibition observed in PV and SST interneurons. Moreover, some of the differentially expressed genes were associated with schizophrenia and epilepsy. In conclusion, our results provide molecular insights into the distinct roles of PV and SST interneurons in health and disease.

Endoplasmic reticulum stress induces Alzheimer's disease-like phenotypes in the neuron derived from the induced pluripotent stem cell with D678H mutation on amyloid precursor protein

Alzheimer's disease (AD), a progressive neurodegenerative disorder, is mainly caused by the interaction of genetic and environmental factors. The impact of environmental factors on the genetic mutation in the amyloid precursor protein (APP) is not well characterized. We hypothesized that Endoplasmic Reticulum (ER) stress would promote disease for the patient carrying the APP D678H mutation. Therefore, we analyzed the impact of a familial AD mutation on amyloid precursor protein (APP D678H) under ER stress. Induced pluripotent stem cell (iPSC) from APP D678H mutant carrier was differentiated into neurons, which were then analyzed for AD-like changes. Immunocytochemistry and whole-cell patch-clamp recording revealed that the derived neurons on day 28 after differentiation showed neuronal markers and electrophysiological properties similar to those of mature neurons. However, the APP D678H mutant neurons did not have significant alterations in the levels of amyloid-β (Aβ) and phosphorylated tau (pTau) compared to its isogenic wild-type neuron. Only under ER stress, the neurons with the APP D678H mutation had more Aβ and pTau via immune detection assays. The higher level of Aβ in the APP D678H mutant neurons was probably due to the increased level of β-site APP cleaving enzyme (BACE1) and decreased level of Aβ degrading enzymes under ER stress. Increased Aβ and pTau under ER stress reduced the N-methyl-D-aspartate receptor (NMDAR) in Western blot analysis and altered electrophysiological properties in the mutant neurons. Our study provides evidence that the interaction between genetic mutation and ER stress would induce AD-like changes.

Characterization of Collapsin Response Mediator Protein 2 in Colorectal Cancer Progression in Subjects with Diabetic Comorbidity

BACKGROUND

Common demographic risk factors are identified in colorectal cancer (CRC) and type 2 diabetes mellitus (DM), nevertheless, the molecular link and mechanism for CRC-DM comorbidity remain elusive. Dysregulated glycogen synthase kinase-3 beta under metabolic imbalance is suggested to accelerate CRC pathogenesis/progression via regulating collpasin response mediator protein-2 (CRMP2). Accordingly, roles of CRMP2 in CRC and CRC-DM patients were investigated for elucidating the molecular convergence of CRC and DM.

METHODS

CRMP2 profile in tumor tissues from CRC and CRC-DM patients was investigated to explore the link between CRC and DM etiology. Meanwhile, molecular mechanism of glucose to regulate CRMP2 profile and CRC characteristics was examined in vitro and in vivo.

RESULTS

CRMP2 was significantly lower in tumor lesions and associated with advanced tumor stage in CRC-DM patients. Physiological hyperglycemia suppressed CRMP2 expression/activity and augmented malignant characteristics of CRC cells. Hyperglycemia promotes actin de-polymerization, cytoskeleton flexibility and cell proliferation/metastasis by downregulating CRMP2 profile and thus contributes to CRC disease progression.

CONCLUSIONS

This study uncovers molecular evidence to substantiate and elucidate the link between CRC and T2DM, as well as characterizing the roles of CRMP2 in CRC-DM. Accordingly, altered metabolic adaptations are promising targets for anti-diabetic and cancer strategies.

Oxygenated Water Inhibits Adipogenesis and Attenuates Hepatic Steatosis in High-Fat Diet-Induced Obese Mice

The expansion of adipose tissue mass is the primary characteristic of the process of becoming obesity, which causes chronic adipose inflammation and is closely associated with type 2 diabetes mellitus (T2DM). Adipocyte hypertrophy restricts oxygen availability, leading to microenvironmental hypoxia and adipose dysfunction. This study aimed at investigating the effects of oxygenated water (OW) on adipocyte differentiation (adipogenesis) and the metabolic function of mature adipocytes. The effects of OW on adipogenesis and the metabolic function of mature adipocytes were examined. Meanwhile, the in vivo metabolic effects of long-term OW consumption on diet-induced obesity (DIO) mice were investigated. OW inhibited adipogenesis and lipid accumulation through down-regulating critical adipogenic transcription factors and lipogenic enzymes. While body weight, blood and adipose parameters were not significantly improved by long-term OW consumption, transient circulatory triglyceride-lowering and glucose tolerance-improving effects were identified. Notably, hepatic lipid contents were significantly reduced, indicating that the DIO-induced hepatic steatosis was attenuated, despite no improvements in fibrosis and lipid contents in adipose tissue being observed in the OW-drinking DIO mice. The study provides evidence regarding OW’s effects on adipogenesis and mature adipocytes, and the corresponding molecular mechanisms. OW exhibits transient triglyceride-lowering and glucose tolerance-improving activity as well as hepatic steatosis-attenuating functions.

Regulation of Adipogenesis and Lipid Deposits by Collapsin Response Mediator Protein 2

As emerging evidence suggesting neurodegenerative diseases and metabolic diseases have common pathogenesis, we hypothesized that the neurite outgrowth-controlling collapsin response mediator protein 2 (CRMP2) was involved in energy homeostasis. Therefore, putative roles of CRMP2 in adipocyte differentiation (adipogenesis) and lipid metabolism were explored and addressed in this study. CRMP2 expression profiles were in vitro and in vivo characterized during adipogenic process of 3T3-L1 pre-adipocytes and diet-induced obese (DIO) mice, respectively. Effects of CRMP2 on lipid metabolism and deposits were also analyzed. Our data revealed that CRMP2 expression pattern was coupled with adipogenic stages. CRMP2 overexpression inhibited cell proliferation at MCE phase, and significantly reduced lipid contents by down-regulating adipogenesis-driving transcription factors and lipid-synthesizing enzymes. Interestingly, GLUT4 translocation and the lipid droplets fusion were disturbed in CRMP2-silencing cells by affecting actin polymerization. Moreover, adipose CRMP2 was significantly increased in DIO mice, indicating CRMP2 is associated with obesity. Accordingly, CRMP2 exerts multiple functions in adipogenesis and lipid deposits through mediating cell proliferation, glucose/lipid metabolism and cytoskeleton dynamics. The present study identifies novel roles of CRMP2 in mediating adipogenesis and possible implication in metabolic disorders, as well as provides molecular evidence supporting the link of pathogenesis between neurodegenerative diseases and metabolic abnormalities.

Mechanism of Interleukin-4 Reducing Lipid Deposit by Regulating Hormone-Sensitive Lipase

Accumulating evidence indicates that inflammation participates in the pathophysiological progress from insulin resistance, obesity, metabolic abnormalities, and type 2 diabetes mellitus. Our previous study reveals that interleukin-4 (IL-4) inhibits adipogenesis and promotes lipolysis to decrease lipid deposits by enhancing the activity of hormone sensitive lipase (HSL). The present study further dissects and characterizes the molecular mechanism of IL-4 in regulating HSL expression and lipolytic activity in the terminal differentiated 3T3-L1 mature adipocytes. Our results showed that IL-4 increased cAMP which then enhanced PKA activity and subsequent phosphorylation of HSL and perilipin. The phosphorylated HSL (p-HSL) translocated from cytoplasm to the surface of lipid droplets and exhibited lipolytic function. After being phosphorylated, p-perilipin also facilitated lipolysis through interacting with p-HSL. The in vitro findings were further verified by in vivo study in which IL-4 exhibited pro-lipolytic activity and enhanced HSL activity. In summary, the net outcome of IL-4 treatment is to reduce lipid storage by promoting lipolysis through enhancing HSL activity via cAMP/PKA pathway, the major route leading to lipolysis.

Distribution of Cytotoxic T Lymphocyte-Associated Antigen-4 Promoter Polymorphisms in Taiwanese Patients with Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is associated with chronic inflammation, suggesting the metabolic abnormalities are originated from or exacerbated by cytokine overproduction. Cytokines and counter-regulatory molecules are crucial in keeping the balance of immune responses and, therefore, are potential candidates involved in T2DM etiology, development and complications. Our previous reports identify several significant associations between the genotypes of cytokine genes and T2DM and/or the clinical lipid parameters, which strongly suggest the participation of immune-regulatory molecules in lipid metabolism. The aim of this study is to determine the distribution of gene encoding cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), a T-cell negative regulator, in T2DM patients and health subjects. Genomic DNA was extracted from 287 Taiwanese T2DM patients and 278 ethnic- and age- matched healthy subjects, and two CTLA-4 polymorphisms (-318 C/T and +49 A/G) were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Intriguingly, CTLA-4 -318 genotype was associated with circulatory triglycerides in T2DM subjects (P=0.019) although no significant association between CTLA-4 -318 (P=0.119) and +49 (P=0.2) genotypes with T2DM was identified. In addition, CTLA-4 +49 genotype was significantly associated with the ratio between total cholesterol and high-density lipoprotein (P=0.004) in control subjects. Our results suggest that CTLA-4 may be involved in lipid metabolism and affect T2DM disease progression and/or the development of diabetic complications although this gene does not represent a major risk factor for T2DM.

Role of PARL-PINK1-Parkin pathway in adipocyte differentiation

OBJECTIVE

Adipogenesis determines the number of adipocytes which is increased when individuals become obese. Mitochondria undergo remarkable morphological and functional changes during adipogenesis. PTEN-induced kinase 1 (PINK1) is pivotal to maintain mitochondrial homeostasis in neural cells. The present study aimed at investigating effects of PINK1 on adipogenesis and energy metabolism.

METHODS

Expression of presenilin associated rhomboid-like protein (PARL), PINK1 and Parkin, as well as the interaction among these proteins was temporally examined during adipogenesis. In addition, the alterations of mitochondrial mass and the energy metabolism were also analyzed.

RESULTS

Adipogenic process can be dissected into 3 stages according to the participation of PARL-PINK1-Parkin system. (1) When pre-adipocytes are switched to differentiation, f-PINK1 is subjected to PARL cleavage to generate s-PINK1 at the early stage of differentiation (0-4day). Mitochondrial mass is increased for generating ambient energy to meet the demands for cellular remodeling. (2) At the second stage (5-6day), s-PINK1 persistently accumulates in mitochondria and translocates into cytoplasm to mediate Parkin degradation. Mitochondria are fragmented to reduce their mass. (3) At the late stage (7-8day), only residual autophagy activity is remained when excess mitochondria have been eliminated. This mitochondria clearance maintains energy consumption of mature adipocytes at the minimal levels for storing energy. PARL silencing aborts adipogenesis by inhibiting PPARγ expression and the finely-orchestrated events.

CONCLUSIONS

Our findings reveal the sequential adipogenic events directed by PARL-PINK1-Parkin system, add more evidence supporting the convergence of pathogenesis leading to neurodegenerative and metabolic diseases, and provide substantial information for developing novel therapeutic strategies by manipulating adipogenesis.

Carcinoid tumor of the spleen: report of a case

Carcinoid tumors are uncommon tumors of the neuroendocrine system. They grow slowly and may remain silent for years before presenting with carcinoid syndrome. A diagnosis of asymptomatic carcinoid tumor is difficult. Wide resection of the primary tumor and metastatic lesions is the first choice of treatment. Primary carcinoid is sometimes distributed throughout the entire body, but it is rare in the spleen. We herein present a rare case of a symptomless carcinoid tumor that predominantly invaded the spleen with liver metastasis.

Accurate assessment of tissue expansion in the lower face and anterior neck by a simple measurement technique

A simple, precise method of clinical estimation for the accurate assessment of tissue expansion in the lower face and anterior neck is described using fixed anatomical reference points. The method makes it possible to select the most suitable size of tissue expander and to decide the optimal timing of operation. By recording the baseline data before expansion and repeating measurements as expansion proceeds, the discrepancy of the expectation between the surgeon and patient concerning the postoperative result can also be minimised.

Use of the scalp as a donor site for large burn wound coverage: review of 150 patients

The characteristics of rapid wound healing and multiple harvest capacity make the scalp an important donor site when dealing with large and deep burn wounds. This paper reports the results of a retrospective analysis of 150 patients treated for large burn wounds. The findings indicated that bleeding during graft skin harvest could be limited to 50 ml by intradermal injection of epinephrine (1:2,000,000), high-concentration epinephrine-soaked gauze compression (1:20,000), and temporary porcine skin coverage. Use of a scalp graft also carried a low risk of complications, with only four (2.7%) major complications including three cases (2.0%) of visible alopecia and one case (0.7%) of hair transplantation. There were no hypertrophic scars, even in the patient who had the largest number (11) of repeat harvests.

Necrotizing soft tissue infections. Surgical or conservative treatment?

BACKGROUND

Both surgeons and dermatologists are increasingly challenged with the prompt diagnosis and management of severe soft tissue infections. Although early surgical intervention appears to be for life-saving in many patients, especially those diagnosed as necrotizing fasciitis, some patients recover well with only conservative treatment. Because most of these infections have similar initial clinical presentations, there remains a need to find reliable clinical and/or laboratory parameters that can predict the prognosis and to accordingly judge the necessity and timing of operation.

METHODS

We conducted a retrospective study of case records of patients with necrotizing soft tissue infections. The clinical presentation, laboratory findings, management, and therapeutic outcome of 34 cases with necrotizing soft tissue infections were reviewed.

RESULTS

These infections were potentially life-threatening, with an overall mortality of 26.5%. Shock on admission was an extremely grave sign associated with a poor prognosis (P < 0.05). In this grave condition, most (80%) patients died regardless of the choice of treatment. Coagulation parameters, including platelet counts, prothrombin time (PT), and partial thromboplastin time (PTT), were available in 21 patients, of whom 16 had at least one abnormality at their initial presentation. In these 16 patients, those who underwent surgery had a significantly higher survival rate than those who were treated conservatively (P < 0.05). Prolonged PT was significantly associated with a higher mortality (P < 0.05). Surgery did seem to correct coagulopathies. However, in patients presenting with substantial alteration of all three coagulation parameters, there was no significant difference between medical treatment and surgical intervention in terms of mortality. In such cases, mortality was high (75%). On the other hand, the prognoses of patients who presented with normal coagulation profiles were rather good. Most of them recovered well despite the therapeutic option. Surgical treatment did not seem to increase additional benefits on chances of survival. Extent of tissue plane involvement, bacteriology, and site of infection had no significant influence on patients' survival.

CONCLUSIONS

A comprehensive, well-organized, universal approach, regardless of classification, is essential for all suspected cases of necrotizing soft tissue infections. Prompt diagnostic studies are needed, and platelet counts, PT, and PTT are readily available parameters that provide substantial information on diagnosis and treatment, thus avoiding an unwarranted loss of life or unnecessary operative sequelae. Early diagnosis and, in most cases, prompt radical surgical, intervention remain the cornerstone of successful management in these infections.

Continuous antegrade warm blood cardioplegia attenuates augmented coronary endothelium-dependent contraction after cardiac global ischemia and reperfusion

BACKGROUND

Experiments were designed to evaluate the effect of warm blood cardioplegia on endothelium-dependent contraction of the coronary endothelium after cardiac global ischemia and reperfusion.

METHOD

Dogs (n = 12 in each group) were exposed to extracorporeal circulation with the body temperature at 37 degrees C (group 1) or 28 degrees C (groups 2 and 3). The ascending aorta was crossclamped for 120 minutes while continuous infusion of warm blood cardioplegec solution (group 1) or intermittent infusion of cold (4 degrees C) crystalloid cardioplegic solution (group 2) was performed via the coronary arteries through the aortic root. Cardioplegic solution was not used in group 3 animals. The heart was then allowed to function for 60 minutes of reperfusion. Reperfused (groups 1, 2, and 3) and control (group 4) coronary arteries were then harvested for study.

RESULTS

Perfusate hypoxia caused endothelium-dependent contraction in the arteries of all four groups that could be attenuated by NG-monomethyl-L-arginine (L-NMMA) or L-NMMA plus D-arginine, but not by L-NMMA plus L-arginine or endothelin receptor A and B antagonist PD 145065. The endothelium-dependent contraction results in groups 2 and 3 (75% +/- 4% and 80% +/- 5%, respectively) were significantly greater than those in groups 1 and 4 (15% +/- 3% and 18% +/- 5%, respectively). Scanning electron microscope studies showed that platelet adhesion and aggregation, areas of microthrombi, disruption of endothelial cells, and separation of the intercellular junction could be found in coronary segments from groups 2 and 3, but not in vessels from groups 1 and 4.

CONCLUSION

These experiments suggest that global ischemia and reperfusion enhances hypoxia-mediated endothelium-dependent contraction of the coronary endothelium and damages the ultrastructure. These kinds of changes can be prevented by continuous antegrade infusion of warm blood cardioplegic solution during global ischemia.

Chronic volar dislocation of the metacarpophalangeal joint of the thumb: a case report and review of the literature

A 61-year-old man sustained a chronic volar dislocation of the metacarpophalangeal joint of the thumb. He did not present for treatment until he experienced recently progressive joint pain 2 year after injury. Arthrodesis of the metacarpophalangeal joint was performed to correct the deformity of the thumb because of its extensive tissue scarring and erosion of the articular cartilage of the metacarpal head. Six weeks of splint immobilization followed by a physiotherapy program allowed the patient to resume his daily activities with his right hand.

Intramuscular cavernous hemangioma of the masseter muscle

Intramuscular hemangioma is relatively uncommon and frequently misdiagnosed, and even rarer in the head and neck region. The masseter muscle is the most frequent site for such hemangioma in the head and neck. A retrospective chart-review of intramuscular hemangioma in Keelung Chang Gung Memorial Hospital from 1983 through 1992 revealed the incidence of masseter muscle hemangioma is approximately 8% of all intramuscular hemangioma. Because of the rarity of these tumors, their vague presentations, inaccurate preoperative diagnosis and inappropriate surgical planning are common problems. This paper described five hemangiomas involving the masseter muscle with a review of the current literature on masseter muscle hemangioma.

Facial plaque-type blue nevus and its reconstruction

Blue nevi rarely appear in a plaque form. Because of their rarity and unusual clinical appearance, these nevi may present a diagnostic problem. We described a large plaque-type blue nevus measuring about 9 x 6 cm on the right cheek of a 22-year-old man. It was characterized by several dark-blue macules and papules with intervening areas of faint blue discoloration. Excision of this unusual plaque-type blue nevus with reconstruction using tissue expander was performed successfully. A 6-year postoperative follow-up revealed satisfactory results.

Plaque-type blue nevus on the face: a variant of Ota's nevus?

We describe a plaque-type blue nevus that had been present since birth on the right cheek of a 22-year-old man. It was characterized by several dark blue macules and papules with intervening areas of faint blue discoloration. Histologic examination showed a common blue nevus and a mongolian spot-like dermal melanocytosis in the dark blue and intervening faint blue pigmentary lesions, respectively.

Buttock augmentation with silicone prosthesis--a case report

A 18-year-old male patient presented with small, flat buttock due to gluteus maximus contracture which caused psychological problem. Bilateral gluteal augmentation was achieved with tissue expanders followed by permanent silicone prosthesis replacement. A two year postoperative follow up revealed no capsular contracture of the prosthesis and no limitation of the patient's activities. The improved contour has improved the patient's outlook on his body image or confidence in his body image.

Midfoot replantation: case report

The replantation of lower extremity amputations is uncommon. Foot replantation is quite rare because of the severity of the primary injury and its rare occurrence compared with lower leg and upper extremity amputations. A successful replantation in a young woman of a foot amputation at the talo-navicular-calcaneal area is reported with a 1-year postoperative follow-up revealing adequate restoration of foot function.