The APOA5-1131 T>C variant enhances the association between RBP4 and hypertriglyceridemia in diabetes

BACKGROUND AND AIM

Type 2 diabetic patients have an increased prevalence of hypertriglyceridemia. RBP4 has been associated with insulin resistance and hypertriglyceridemia in obesity, the metabolic syndrome and type 2 diabetes. APOA5 is proposed to be a genetic modulator of triglycerides. The aim of this study was to evaluate the relationship between RBP4 plasma levels and lipid disturbances and to determine the impact of the APOA5-1131 T>C variant on this relationship in type 2 diabetic patients.

METHODS AND RESULTS

A total of 165 type 2 diabetic patients were included in the study. RBP4 plasma levels and the APOA5-1131 T>C variant were determined and the complete lipid profile was assessed by sequential ultracentrifugation. RBP4 was positively correlated with triglyceride levels in plasma and with all the components of triglyceride-rich lipoproteins. Despite the fact that a statistically significant relationship between the APOA5 genetic variant and RBP4 plasma levels was not found, the hypertriglyceridemic effect of high RBP4 levels was enhanced by the presence of the APOA5-1131 T>C genetic variant. Correlation coefficients were 2-fold higher for TC carriers compared to TT carriers with regard to RBP4 plasma levels and all the components of triglyceride-rich lipoproteins. Those type 2 diabetic patients with high RBP4 plasma concentrations and who were TC carriers showed an increased incidence of hypertriglyceridemia (OR=7.46, P=0.010).

CONCLUSION

RBP4 is associated with hypertriglyceridemia in type 2 diabetic patients. The RBP4 effect is conditioned by the presence of the APOA5-1131 T>C genetic variant.

Retinol-binding protein 4 as a plasma biomarker of renal dysfunction and cardiovascular disease in type 2 diabetes

OBJECTIVE

The retinol-binding protein 4 (RBP4) has been linked to the insulin resistance state in obesity and type 2 diabetes in animal studies. Data in humans are controversial and their relationship with organ damage in diabetic patients is lacking. We studied the association of plasma RBP4 with organ complications in type 2 diabetic patients.

SETTING

Sant Joan University Hospital, Reus, Spain.

SUBJECTS

165 nonsmoker type 2 diabetic subjects according to American Diabetes Association criteria, aged 36-79 years, without proteinuria or severely decreased glomerular filtration rates (MDRD-GFR <30 mL min(-1) 1.73 m(-2)), were included in the study.

MAIN OUTCOME MEASURE

Plasma RBP4 concentrations were the primary outcome variable. Statistics were performed in relation to clinical and subclinical arteriosclerosis, renal function parameters and biochemical data.

RESULTS

Plasma RBP4 concentrations were positively correlated with serum creatinine levels (r = 0.322, P < 0.001) and inversely correlated with MDRD-GFR (r = -0.468, P = 0.009). Patients with moderately renal dysfunction (MDRD-GFR <60 mL min(-1) 1.73 m(-2)) had higher plasma RBP4 concentrations than those with normal to mildly decreased GFR (55.3 +/- 24.6 vs. 40.8 +/- 15.4, P <0.001). Patients in the top quartile of RBP4 concentrations had an increased adjusted odds ratio for moderately renal dysfunction compared with lower quartiles (4.68; 95% CI: 1.52-14.36, P = 0.007). The presence of microalbuminuria was not associated with RBP4. Plasma RBP4 concentrations were higher in those subjects with previous clinical arteriosclerosis than in event-free subjects (48.8 +/- 24.2 vs. 40.6 +/- 13.9, P = 0.045). The presence of retinopathy or polyneuropathy did not differ across RBP4 quartiles.

CONCLUSIONS

Plasma RBP4 concentration might be a biomarker of nephropathy and cardiovascular disease in type 2 diabetic subjects.

Fatty acid binding protein 4 is increased in metabolic syndrome and with thiazolidinedione treatment in diabetic patients

OBJECTIVE

To study the role of FABP4 in the plasma of type 2 diabetic (T2D) subjects with and without metabolic syndrome (MS) and the impact of thiazolidinedione (TZD) treatment.

METHODS AND RESULTS

FABP4 was analyzed in 274 individuals (169 T2D subjects and 105 controls). MS-T2D subjects had higher FABP4 levels than non-MS-T2D subjects and controls (53% and 76% increase, respectively, p<0.005). FABP4 levels in T2D subjects were positively correlated to the number of MS elements, obesity degree, adiponectin, triglycerides, lipoperoxides, C-reactive protein, age, systolic blood pressure and diabetes duration (p<0.05). Neither clinical or subclinical atherosclerosis, nor plasma levels of insulin, glucose or RBP4 were associated to FABP4. TZD-treated T2D subjects showed >30% higher FABP4 levels (p<0.05) than non-TZD-treated T2D. A subgroup study confirmed that TZD treatment prospectively increased FABP4 levels (p<0.05) along with an increase of peripheral blood mononuclear cell PPARgamma activity (p<0.05). Furthermore, in vitro studies showed that TZD treatment increased FABP4 mRNA, intracellular protein levels and extracellular secretion from human adipocytes.

CONCLUSIONS/INTERPRETATION

FABP4 plasma concentrations are increased with the early presence of MS components, as well as inflammation and oxidation markers in T2D subjects. TZD increases FABP4 plasma concentrations, reflecting PPARgamma activation. FABP4 plasma measurements could be useful in the management of T2D subjects.

[Perspectives in the treatment of allergy to latex: immunotherapy]

At present, allergy to latex is an important problem due to the severity of the symptomatology that it produces and the risk groups involved. Complete avoidance of latex is practically impossible, which is why in recent years there has been intense work on standardizing an extract in order not only to improve its clinical diagnosis but also to be able to offer a therapeutic alternative other than avoidance, such as immunotherapy. Since 1998, timely approaches to immunotherapy with latex have been published, with oral desensitization (three patients), subcutaneous (one patient) and sublingual (one patient). In every case there was an evident clinical improvement. At present, subcutaneous immunotherapy with latex, although efficient, is a high risk treatment. Sublingual immunotherapy with latex has recently been commercialized in Spain and we know of its efficacy through the results of an open test on 26 adult patients. The safety expectations are shown to be better than those for subcutaneous immunotherapy.

Human securin interacts with p53 and modulates p53-mediated transcriptional activity and apoptosis

The gene PTTG1 (encoding the pituitary tumor-transforming 1 protein) is overexpressed in several different tumor types, is tumorigenic in vivo and shows transcriptional activity. The PTTG1 protein is cell-cycle regulated and was identified as the human securin (a category of proteins involved in the regulation of sister-chromatid separation) on the basis of biochemical similarities with the Pds1p protein of budding yeast and the Cut2p protein of fission yeast. To unravel the function of human securin in oncogenesis, we carried out a phage-display screening to identify proteins that interact with securin. Notably, we isolated the p53 tumor suppressor. Pull-down and co-immunoprecipitation assays demonstrated that p53 interacts specifically with securin both in vitro and in vivo. This interaction blocks the specific binding of p53 to DNA and inhibits its transcriptional activity. Securin also inhibits the ability of p53 to induce cell death. Moreover, we observed that transfection of H1299 cells with securin induced an accumulation of G2 cells that compensated for the loss of G2 cells caused by transfection with p53. We demonstrated the physiological relevance of this interaction in PTTG1-deficient human tumor cells (PTTG1(-/-)): both apoptotic and transactivating functions of p53 were potentiated in these cells compared to parental cells. We propose that the oncogenic effect of increased expression of securin may result from modulation of p53 functions.

Description of an enzyme-linked immunosorbent assay for the detection of protein tyrosine kinase

A solid immunoassay for the detection of protein tyrosine kinases has been developed. It is based on the binding of the synthetic polypeptide poly(Glu.Na,Tyr) 4:1 to microELISA wells, where the phosphorylation reaction takes place in the presence of ATP and enzyme. The phosphorylated tyrosine residues produced in the reaction are finally detected, in the same well, by means of an ELISA using monoclonal antiphosphotyrosine antibody, peroxidase-labeled goat anti-mouse IgG antibody, and substrate. The amount of protein tyrosine kinase activity present in the sample is proportional to the color at 492 nm developed in each well.

[The evaluation of heterosexual transmission of the human immunodeficiency virus by nucleic acid amplification technics]

Heterosexual couples of individuals infected by HIV represent a group of high risk of virus infection. We have investigated the presence of fragments of the HIV genome with a new nucleic acid amplification technique (PCR or polymerase chain reaction) in lymphocytes from 33 seronegative couples with anti-HIV antibodies, most of which were heroin addicts. 12 of the 33 couples (36%) had positive PCR for a gag HIV amplimer in the absence of antibodies. 4 of them (12%) also showed reactivity for sequences from an env amplimer. A control group of 7 patients with AIDS and 4 seropositive couples showed reactivity to gag and env in all. It is concluded that silent HIV infection may frequently develop in heterosexual couples of infected individuals.

Soluble class I antigens in serum and CSF of patients with varicella-zoster virus meningitis

Soluble class I antigens (sHLA) are secreted by lymphocytes upon activation in vitro. The intrathecal synthesis (ITS) of these molecules has been studied in patients with the varicella-zoster virus (VZV) meningitis. In this paper we describe a sHLA index IH = (CSF sHLA/serum sHLA): (CSF albumin/serum albumin) which is expected to increase only when sHLA is synthesised within the central nervous system (CNS). The IH is elevated in the first week of meningitis, when antibody synthesis is still low, and decreases thereafter. We think IH is an index of early lymphocyte activation within the CNS. The relation of these findings with previous in vitro studies is also discussed.

Detection of soluble class I molecules (non HLA-A or HLA-B) in serum, spleen membranes and lymphocytes in culture

Soluble major histocompatibility complex class I molecules (sHLA) present in human serum can be resolved by gel filtration into two different peaks with an apparent molecular mass of about 200 kDa (30% of the total) and 50-60 kDa (60%-70%). The serological analysis of the peaks shows that A or B specificities can only be detected in the 200 kDa peak while both are recognized by the monomorphic W6/32 monoclonal antibody (mAb) and anti-beta 2-microglobulin mAb. Such sHLA (non HLA-A or -B) molecules are released from human spleen membranes upon incubation at 37 degrees C and have been purified by affinity chromatography with mAb W6/32 bound to Sepharose. The molecular mass analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis of the sHLA (non HLA-A or -B) and of the classical HLA-A or -B antigens still bound to the membranes and purified from the same membranes after detergent solubilization does not show a significant difference, indicating that sHLA do not represent proteolytic fragments of the classical HLA-A or -B antigens. The presence of sHLA (non HLA-A or -B) has also been detected in the supernatants of lymphocyte cultures and increases dramatically upon stimulation by mitogens. The effect of pokeweed mitogen, phytohemagglutinin, Staphylococcus aureus Cowan strain and phorbol 12-myristate 13-acetate on the secretion of sHLA has been studied. The molecular mass of the secreted sHLA (detected using [14C]leucine) is compared with the classical transmembrane proteins.