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Domingo P, Giralt M, Gavaldà-Navarro A, Blasco-Roset A, Delgado-Anglés A, Gallego-Escuredo JM, Gutiérrez MDM, Mateo MG, Cereijo R, Domingo JC, Villarroya F, Villarroya J. Adipose tissue aging partially accounts for fat alterations in HIV lipodystrophy. Adipocyte 2022; 11:143-152. [PMID: 35300561 PMCID: PMC8942446 DOI: 10.1080/21623945.2022.2042962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Lipodystrophy is a major disturbance in people living with HIV-1 (PLWH). Several systemic alterations in PLWH are reminiscent of those that occur in ageing. It is unknown whether the lipodystrophy in PLWH is the consequence of accelerated ageing in adipose tissue. We compared systemic and adipose tissue disturbances in PLWH with those in healthy elderly individuals (~80 y old). We observed similarly enhanced expression of inflammation-related genes and decreased autophagy in adipose tissues from elderly individuals and PLWH. Indications of repressed adipogenesis and mitochondrial dysfunction were found specifically in PLWH, whereas reduced telomere length and signs of senesce were specific to elderly individuals. We conclude that ageing of adipose tissue accounts only partially for the alterations in adipose tissues of PLWH.
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Affiliation(s)
- Pere Domingo
- Infectious Diseases Unit and Institut de Recerca Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Marta Giralt
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad Y Nutrición, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu Barcelona, Spain
| | - Aleix Gavaldà-Navarro
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad Y Nutrición, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu Barcelona, Spain
| | - Albert Blasco-Roset
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
| | - Alejandro Delgado-Anglés
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
| | - José Miguel Gallego-Escuredo
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
| | - Maria Del Mar Gutiérrez
- Infectious Diseases Unit and Institut de Recerca Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Maria Gracia Mateo
- Infectious Diseases Unit and Institut de Recerca Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Rubén Cereijo
- Infectious Diseases Unit and Institut de Recerca Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad Y Nutrición, Barcelona, Spain
| | - Joan Carles Domingo
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
| | - Francesc Villarroya
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad Y Nutrición, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu Barcelona, Spain
| | - Joan Villarroya
- Departament de Bioquímica I Biomedicina Molecular and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- Ciber Fisiopatología de la Obesidad Y Nutrición, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu Barcelona, Spain
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Díaz M, Gallego-Escuredo JM, López-Bermejo A, de Zegher F, Villarroya F, Ibáñez L. Low-Dose Spironolactone-Pioglitazone-Metformin Normalizes Circulating Fetuin-A Concentrations in Adolescent Girls with Polycystic Ovary Syndrome. Int J Endocrinol 2018; 2018:4192940. [PMID: 30123261 PMCID: PMC6079549 DOI: 10.1155/2018/4192940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 12/20/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Fetuin-A is a glycoprotein produced in the liver and related to metabolic syndrome; fetuin-A secretion is divergently regulated in different pathological conditions. In girls with polycystic ovary syndrome (PCOS), insulin sensitization results in a more favorable endocrine-metabolic outcome than oral contraception; we assessed whether those differences are underscored by changes in circulating fetuin-A. METHODS Fetuin-A concentration endocrine-metabolic markers and hepatovisceral fat were measured longitudinally in 35 PCOS girls [age, 16 yr; body mass index (BMI), 23 kg/m2] randomized to receive either oral contraception [ethinylestradiol-levonorgestrel (n = 18)] or a low-dose combination of spironolactone, pioglitazone, and metformin (SPIOMET, n = 17) over 12 months. Healthy adolescent girls (age- and BMI-matched) were used as controls (n = 25). RESULTS Pretreatment fetuin-A serum levels in PCOS girls were lower than those in controls. After 12 months on treatment, fetuin-A raised to control levels only in the SPIOMET subgroup (P = 0.009, versus oral contraception); this increase was paralleled by a healthier metabolic profile with less hepatic fat (by MRI); baseline serum fetuin-A as well as the changes over 12 months was inversely related to hepatic adiposity. CONCLUSIONS A low-dose combination of insulin sensitizers and an antiandrogen-but not oral contraception-normalizes fetuin-A levels in adolescent girls with PCOS. This trial is registered with ISRCTN29234515.
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Affiliation(s)
- Marta Díaz
- Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - José Miguel Gallego-Escuredo
- Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
- Institut de Recerca Biomèdica de Lleida, Lleida, Spain
| | - Abel López-Bermejo
- Department of Pediatrics, Dr. Josep Trueta Hospital, Girona Institute for Biomedical Research, 17007 Girona, Spain
| | - Francis de Zegher
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - Francesc Villarroya
- Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
- Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - Lourdes Ibáñez
- Endocrinology, Institut Pediàtric Hospital Sant Joan de Déu, University of Barcelona, Esplugues, 08950 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
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Domingo P, Fernández I, Gallego-Escuredo JM, Torres F, Gutierrez MDM, Mateo MG, Villarroya J, Giralt M, Vidal F, Villarroya F, Domingo JC. Effects of docosahexanoic acid on metabolic and fat parameters in HIV-infected patients on cART: A randomized, double-blind, placebo-controlled study. Clin Nutr 2017. [PMID: 28648475 DOI: 10.1016/j.clnu.2017.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Hypertriglyceridemia is common in HIV-infected patients. Polyunsaturated fatty acids reduce fasting serum triglyceride (TG) levels in HIV-infected patients. It is not known whether docosahexanoic acid (DHA) supplementation can reduce hypertriglyceridemia and modify fat distribution in HIV-infected patients. METHODS We conducted a randomized, double-blind, placebo-controlled trial with 84 antiretroviral-treated patients who had fasting TG levels from 2.26 to 5.65 mmol/l and were randomized to receive DHA or placebo for 48 weeks. TG levels were assessed at baseline, week 4 and every 12 weeks. Body composition was assessed at baseline and at week 48. Registered under ClinicalTrials.gov Identifier no. NCT02005900. RESULTS Patients receiving DHA had a 43.9% median decline in fasting TG levels at week 4 (IQR: -31% to -56%), compared with -2.9% (-18.6% to 16.5%) in the placebo group (P < 0.0001). DHA levels and decrease in TG at week 4 in the DHA arm correlated significantly (r = 0.7110, P < 0.0001). The median reduction in TG levels in the DHA arm was -43.7% (-32.4% to -57.5%), and in the placebo arm +2.9% (-21.3% to +30.1%) at week 12. The difference remained statistically significant at week 48 (P = 0.0253). LDL cholesterol levels significantly increased at week 4 by 7.1% (IQR: -4.8% to +35.3%) in the DHA arm but not in the placebo group. No significant changes were observed in HDL cholesterol, insulin, and HOMA-IR during the study. Limb fat significantly increased in both arms, without statistically significant differences between groups (P = 0.3889). DHA was well tolerated; only 3 patients experienced treatment-limiting toxicity. CONCLUSIONS Supplementation with DHA reduced fasting TG levels in antiretroviral-treated HIV-infected patients with mild hypertriglyceridemia. DHA was well tolerated with minor GI symptoms. Peripheral fat significantly increased in the DHA group but did not increase significantly compared with placebo.
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Affiliation(s)
- Pere Domingo
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Infectious Diseases Department, Hospital Arnau de Vilanova, Universitat de Lleida, Institut de Recerca Biomèdica de LLeida (IRBLleida), Lleida, Spain.
| | - Irene Fernández
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - José Miguel Gallego-Escuredo
- Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain
| | - Ferran Torres
- Biostatistics and Data Management Core Facility, IDIBAPS, Hospital Clinic, Barcelona, Spain; Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ma Del Mar Gutierrez
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ma Gracia Mateo
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Joan Villarroya
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain
| | - Marta Giralt
- Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain
| | - Francesc Vidal
- Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitari Joan XXIII, IISPV, Universitat Rovira i Virgili, Tarragona, Spain
| | - Francesc Villarroya
- Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain
| | - Joan Carles Domingo
- Department of Biochemistry and Molecular Biology, Institute of Biomedicine (IBUB), University of Barcelona, Barcelona, Spain; CIBER Fisiopatologia de la Obesidad y Nutrición, Barcelona, Spain
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Díaz M, Gallego-Escuredo JM, de Zegher F, Villarroya F, Ibáñez L. Effects of ethinylestradiol-cyproterone acetate vs. pioglitazone-flutamide-metformin on plasma FGF21 levels in adolescent girls with androgen excess. Diabetes Metab 2015; 42:196-9. [PMID: 26546387 DOI: 10.1016/j.diabet.2015.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/25/2015] [Accepted: 10/04/2015] [Indexed: 01/23/2023]
Affiliation(s)
- M Díaz
- Endocrinology, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - J M Gallego-Escuredo
- Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - F de Zegher
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium
| | - F Villarroya
- Department of Biochemistry and Molecular Biology, and Institute of Biomedicine, University of Barcelona, 08028 Barcelona, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain
| | - L Ibáñez
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain.
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Gallego-Escuredo JM, Gómez-Ambrosi J, Catalan V, Domingo P, Giralt M, Frühbeck G, Villarroya F. Opposite alterations in FGF21 and FGF19 levels and disturbed expression of the receptor machinery for endocrine FGFs in obese patients. Int J Obes (Lond) 2014; 39:121-9. [PMID: 24813368 DOI: 10.1038/ijo.2014.76] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/08/2014] [Accepted: 04/30/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Fibroblast growth factor (FGF)-21, and possibly FGF19, protect against type 2 diabetes mellitus (T2DM) and obesity in rodents. We investigated the circulating levels of FGF21 and FGF19 in obese patients with varying degrees of abnormal glucose homeostasis, and we determined gene expression for FGF receptors (FGFR1-4) and the co-receptor β-Klotho, in liver and adipose tissues. SUBJECTS AND METHODS We analyzed 35 lean healthy (71% men) and 61 obese patients (49% men, median body mass index (BMI): 40.5 kg m(-2), interquartile range: 34.7-46.2). Among obese patients, 36 were normoglycemic, 15 showed impaired glucose tolerance and 10 had T2DM. Biopsies from liver and visceral and subcutaneous fat from a subset of obese patients and controls were analyzed. FGF19 and FGF21 levels were measured using enzyme-linked immunosorbent assay, and tissue mRNA and protein levels by reverse transcription-polymerase chain reaction and immunoblotting. RESULTS FGF21 serum levels were significantly increased in obese patients compared with controls (P<0.001), whereas FGF19 levels were decreased (P < 0.001). FGF21 levels were positively correlated with homeostasis model assessment of insulin resistance (P = 0.0002, r = 0.37) and insulin (P = 0.001, r = 0.32), whereas FGF19 levels were negatively correlated (P = 0.007, r = -0.27; P=0.003, r = -0.28; respectively). After adjusting for BMI, the correlations of FGF21 and FGF19 levels with indicators of abnormal glucose homeostasis were not significant. In obese patients, the hepatic expression of FGF21 was increased. (P = 0.04). β-Klotho transcript levels in visceral fat (P = 0.002) and β-Klotho protein levels in subcutaneous (P = 0.03) and visceral fat (P = 0.04) were significantly reduced in obese patients, whereas hepatic levels for β-Klotho (P = 0.03), FGFR1 (P = 0.04) and FGFR3 (P = 0.001) transcripts were significantly increased. CONCLUSIONS Obesity is characterized by reciprocal alterations in FGF19 (decrease) and FGF21 (increase) levels. Although worsened in diabetic obese patients, obesity itself appears as the predominant determinant of the abnormalities in FGF21 and FGF19 levels. Opposite changes in β-Klotho expression in fat and liver indicate potential tissue-specific alterations in the responsiveness to endocrine FGFs in obesity.
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Affiliation(s)
- J M Gallego-Escuredo
- 1] Department of Biochemistry and Molecular Biology and Institute of Biomedicina, University of Barcelona, Barcelona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain
| | - J Gómez-Ambrosi
- 1] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain [2] Clínica Universidad de Navarra, Pamplona, Spain
| | - V Catalan
- 1] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain [2] Clínica Universidad de Navarra, Pamplona, Spain
| | - P Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Giralt
- 1] Department of Biochemistry and Molecular Biology and Institute of Biomedicina, University of Barcelona, Barcelona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain
| | - G Frühbeck
- 1] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain [2] Clínica Universidad de Navarra, Pamplona, Spain
| | - F Villarroya
- 1] Department of Biochemistry and Molecular Biology and Institute of Biomedicina, University of Barcelona, Barcelona, Spain [2] CIBER Fisiopatología de la Obesidad y Nutrición, Nutrición, Spain
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Domingo P, Gutierrez MDM, Gallego-Escuredo JM, Torres F, Mateo GM, Villarroya J, de los Santos I, Domingo JC, Villarroya F, Rio LD, Estrada V, Giralt M. Effects of switching from stavudine to raltegravir on subcutaneous adipose tissue in HIV-infected patients with HIV/HAART-associated lipodystrophy syndrome (HALS). A clinical and molecular study. PLoS One 2014; 9:e89088. [PMID: 24586518 PMCID: PMC3935839 DOI: 10.1371/journal.pone.0089088] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 01/16/2014] [Indexed: 11/18/2022] Open
Abstract
HIV-1/HAART-associated lipodystrophy syndrome (HALS) has been associated with exposure to stavudine (d4T) through mitochondrial dysfunction. We performed a 48-week study to assess the effects of switching from d4T to raltegravir (RAL) on metabolic and fat molecular parameters of patients with HALS. Forty-two patients with HALS and a median exposure to d4T > 7 years were switched to RAL and followed for 48 weeks. Fasting metabolic tests, HIV RNA, CD4 cell count, and fat measured by DEXA were obtained at baseline and week 48. mtDNA and gene transcripts for PPAR gamma, adiponectin, cytochrome b, Cox IV, TNF alpha, MCP-1 and CD68 were assessed in paired subcutaneous fat tissue biopsies. Lipid parameters, fasting glucose, insulin, and HOMA-IR did not change significantly. Whole body fat (P = 0.0027) and limb fat mass (P<0.0001) increased from baseline. Trunk/limb fat ratio (P = 0.0022), fat mass ratio (P = 0.0020), fat mass index (P = 0.0011) and percent leg fat normalized to BMI (P<0.0001) improved after 48 weeks. Relative abundance of mtDNA, expression of PPAR gamma, adiponectin, Cyt b, and MCP-1 genes increased, whereas Cox IV, TNF alpha, and CD68 did not change significantly from baseline. Switching from d4T to RAL in patients with HALS is associated with an increase in limb fat mass and an improvement in markers of adipocyte differentiation and mitochondrial function in SAT.
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Affiliation(s)
- Pere Domingo
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail:
| | - María del Mar Gutierrez
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Miguel Gallego-Escuredo
- Department of Biochemistry and Molecular Biology and Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Fisiopatología de la Obesidad y Nutrición, Centros de Investigación Biomédica en Red (CIBER), Santiago de Compostela, Spain
| | - Ferran Torres
- Biostatistics and Data Management Platform, Institut d′Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gracia María Mateo
- Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Villarroya
- Department of Biochemistry and Molecular Biology and Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Institut de Recerca del Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Fisiopatología de la Obesidad y Nutrición, Centros de Investigación Biomédica en Red (CIBER), Santiago de Compostela, Spain
| | | | - Joan Carles Domingo
- Department of Biochemistry and Molecular Biology and Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Fisiopatología de la Obesidad y Nutrición, Centros de Investigación Biomédica en Red (CIBER), Santiago de Compostela, Spain
| | - Francesc Villarroya
- Department of Biochemistry and Molecular Biology and Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Fisiopatología de la Obesidad y Nutrición, Centros de Investigación Biomédica en Red (CIBER), Santiago de Compostela, Spain
| | | | - Vicente Estrada
- Infectious Diseases Unit, Hospital Clínico de San Carlos, Madrid, Spain
| | - Marta Giralt
- Department of Biochemistry and Molecular Biology and Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Institute of Biomedicine, University of Barcelona, Barcelona, Spain
- Fisiopatología de la Obesidad y Nutrición, Centros de Investigación Biomédica en Red (CIBER), Santiago de Compostela, Spain
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Araújo-Vilar D, Victoria B, González-Méndez B, Barreiro F, Fernández-Rodríguez B, Cereijo R, Gallego-Escuredo JM, Villarroya F, Pañeda-Menéndez A. Histological and molecular features of lipomatous and nonlipomatous adipose tissue in familial partial lipodystrophy caused by LMNA mutations. Clin Endocrinol (Oxf) 2012; 76:816-24. [PMID: 21883346 DOI: 10.1111/j.1365-2265.2011.04208.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Type 2 familial partial lipodystrophy (FPLD2) is a rare adipose tissue (AT) disease caused by mutations in LMNA, in which lipomas appear occasionally. In this study, we aimed to histologically characterize FPLD2-associated lipomatosis and study the expression of genes and proteins involved in cell cycle control, mitochondrial function, inflammation and adipogenesis. DESIGN AND PATIENTS One lipoma and perilipoma fat from each of four subjects with FPLD2 and 10 control subjects were analysed by optical microscopy. The presence of inflammatory cells was evaluated by immunohistochemistry. Real-time RT-PCR and Western blot were used to evaluate gene and protein levels. RESULTS Adipocytes from lipodystrophic patients were significantly larger than those of controls, in both the lipomas and perilipoma fat. Lipodystrophic AT exhibited CD68(+) macrophages and CD3(+) lymphocytes infiltration. TP53 expression was reduced in all types of lipomas. At protein level, C/EBPβ, p53 and pRb were severely disturbed in both lipodystrophic lipomas and perilipoma fat coming from lipoatrophic areas, whereas the expression of CEBPα was normal. Mitochondrial function genes were less expressed in lipoatrophic fat. In both lipomas and perilipoma fat from lipoatrophic areas, the expression of adipogenes was lower than controls. CONCLUSIONS Even in lipomas, the adipogenic machinery is impaired in lipodystrophic fat coming from lipoatrophic regions in FPLD2, although the histological phenotype is near-normal, exhibiting low-grade inflammatory features. Our results suggest that the p53 pathway and some adipogenic proteins, such as CEBPα, could contribute to the maintenance of this near normal phenotype in the remnant AT present in these patients.
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Affiliation(s)
- D Araújo-Vilar
- Thyroid and Metabolic Diseases Unit (U.E.T.eM.), Department of Medicine, University of Santiago de Compostela, Spain.
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Negredo E, Massanella M, Puig J, Pérez-Alvarez N, Gallego-Escuredo JM, Villarroya J, Villarroya F, Moltó J, Santos JR, Clotet B, Blanco J. Nadir CD4 T cell count as predictor and high CD4 T cell intrinsic apoptosis as final mechanism of poor CD4 T cell recovery in virologically suppressed HIV-infected patients: clinical implications. Clin Infect Dis 2010; 50:1300-8. [PMID: 20367229 DOI: 10.1086/651689] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although antiretroviral therapy improves immune response, some human immunodeficiency virus-infected patients present unsatisfactory CD4 T cell recovery despite achieving viral suppression, resulting in increased morbidity and mortality. METHODS Cross-sectional, case-control study to characterize the mechanism and to identify predictive factors of poor immune response. We included 230 patients who were receiving highly active antiretroviral therapy and who had a viral load <50 copies/mL for >2 years; 95 were "discordant" (case patients; CD4 T cell count always <350 cells/microL), and 135 were "concordant" (control subjects). Activation markers, CD4 T cell death (necrosis, intrinsic apoptosis, and extrinsic apoptosis), and caspase-3 were measured. Clinical parameters, particularly antiretroviral combinations, were correlated with immune recovery. RESULTS Discordant patients showed higher levels of activation markers, mainly in CD4 T cells (p < .001), and higher rates of spontaneous cell death (P < .001). Rates of activation and rates of CD4 T cell death (mainly by intrinsic apoptosis) were the best predictive factors for immune recovery, along with nadir CD4 T cell count. Patients who were receiving a protease inhibitor-based regimen were more likely to be discordant and showed higher rates of activation (P= .011), higher rates of CD4 T cell death (P = .033), and a lower nadir CD4 T cell count (P < .001). Multivariate analysis, however, ruled out any effect of protease inhibitors on immune recovery. No differences were observed between the use of tenofovir-emtricitabine (Truvada) and the use of abacavir-lamivudine (Kivexa). CONCLUSIONS CD4 T cell apoptosis by the intrinsic pathway represents the determinant mechanism of the unsatisfactory immune recovery and should be targeted to manage therapy for discordant patients. The predictive value of low nadir CD4 T cell count for a poor immune recovery led us to consider starting antiretroviral therapy earlier. No differences were observed among antiretrovirals in terms of immune recovery.
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Affiliation(s)
- Eugènia Negredo
- Lluita contra SIDA Foundation, Institut de Recerca en Ciències de Salut Germans Trias i Pujol, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain.
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