Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study

BACKGROUND

No effective pharmacological or non-pharmacological interventions exist for patients with long COVID. We aimed to describe recovery 1 year after hospital discharge for COVID-19, identify factors associated with patient-perceived recovery, and identify potential therapeutic targets by describing the underlying inflammatory profiles of the previously described recovery clusters at 5 months after hospital discharge.

METHODS

The Post-hospitalisation COVID-19 study (PHOSP-COVID) is a prospective, longitudinal cohort study recruiting adults (aged ≥18 years) discharged from hospital with COVID-19 across the UK. Recovery was assessed using patient-reported outcome measures, physical performance, and organ function at 5 months and 1 year after hospital discharge, and stratified by both patient-perceived recovery and recovery cluster. Hierarchical logistic regression modelling was performed for patient-perceived recovery at 1 year. Cluster analysis was done using the clustering large applications k-medoids approach using clinical outcomes at 5 months. Inflammatory protein profiling was analysed from plasma at the 5-month visit. This study is registered on the ISRCTN Registry, ISRCTN10980107, and recruitment is ongoing.

FINDINGS

2320 participants discharged from hospital between March 7, 2020, and April 18, 2021, were assessed at 5 months after discharge and 807 (32·7%) participants completed both the 5-month and 1-year visits. 279 (35·6%) of these 807 patients were women and 505 (64·4%) were men, with a mean age of 58·7 (SD 12·5) years, and 224 (27·8%) had received invasive mechanical ventilation (WHO class 7-9). The proportion of patients reporting full recovery was unchanged between 5 months (501 [25·5%] of 1965) and 1 year (232 [28·9%] of 804). Factors associated with being less likely to report full recovery at 1 year were female sex (odds ratio 0·68 [95% CI 0·46-0·99]), obesity (0·50 [0·34-0·74]) and invasive mechanical ventilation (0·42 [0·23-0·76]). Cluster analysis (n=1636) corroborated the previously reported four clusters: very severe, severe, moderate with cognitive impairment, and mild, relating to the severity of physical health, mental health, and cognitive impairment at 5 months. We found increased inflammatory mediators of tissue damage and repair in both the very severe and the moderate with cognitive impairment clusters compared with the mild cluster, including IL-6 concentration, which was increased in both comparisons (n=626 participants). We found a substantial deficit in median EQ-5D-5L utility index from before COVID-19 (retrospective assessment; 0·88 [IQR 0·74-1·00]), at 5 months (0·74 [0·64-0·88]) to 1 year (0·75 [0·62-0·88]), with minimal improvements across all outcome measures at 1 year after discharge in the whole cohort and within each of the four clusters.

INTERPRETATION

The sequelae of a hospital admission with COVID-19 were substantial 1 year after discharge across a range of health domains, with the minority in our cohort feeling fully recovered. Patient-perceived health-related quality of life was reduced at 1 year compared with before hospital admission. Systematic inflammation and obesity are potential treatable traits that warrant further investigation in clinical trials.

FUNDING

UK Research and Innovation and National Institute for Health Research.

The lens of the eye: exposures in the UK medical sector and mechanistic studies of radiation effects

The recommendation from the International Commission on Radiological Protection that the occupational equivalent dose limit for the lens of the eye should be reduced to 20 mSv year(-1), averaged over 5 years with no year exceeding 50 mSv, has stimulated a discussion on the practicalities of implementation of this revised dose limit, and the most appropriate risk and protection framework to adopt. This brief paper provides an overview of some of the drivers behind the move to a lower recommended dose limit. The issue of implementation in the medical sector in the UK has been addressed through a small-scale survey of doses to the lens of the eye amongst interventional cardiologists and radiologists. In addition, a mechanistic study of early and late post-irradiation changes in the lens of the eye in in-vivo-exposed mice is outlined. Surveys and studies such as those described can contribute to a deeper understanding of fundamental and practical issues, and therefore contribute to a robust evidence base for ensuring adequate protection of the eye while avoiding undesirable restrictions to working practices.

Double deletion of orexigenic neuropeptide Y and dynorphin results in paradoxical obesity in mice

OBJECTIVE

Orexigenic neuropeptide Y (NPY) and dynorphin (DYN) regulate energy homeostasis. Single NPY or dynorphin deletion reduces food intake or increases fat loss. Future developments of obesity therapeutics involve targeting multiple pathways. We hypothesised that NPY and dynorphin regulate energy homeostasis independently, thus double NPY and dynorphin ablation would result in greater weight and/or fat loss than the absence of NPY or dynorphin alone.

DESIGN AND METHODS

We generated single and double NPY and dynorphin knockout mice (NPYΔ, DYNΔ, NPYDYNΔ) and compared body weight, adiposity, feeding behaviour, glucose homeostasis and brown adipose tissue uncoupling protein-1 (UCP-1) expression to wildtype counterparts.

RESULTS

Body weight and adiposity were significantly increased in NPYDYNΔ, but not in NPYΔ or DYNΔ. This was not due to increased food intake or altered UCP-1 expression, which were not significantly altered in double knockouts. NPYDYNΔ mice demonstrated increased body weight loss after a 24-h fast, with no effect on serum glucose levels after glucose injection.

CONCLUSIONS

Contrary to the predicted phenotype delineated from single knockouts, double NPY and dynorphin deletion resulted in heavier mice, with increased adiposity, despite no significant changes in food intake or UCP-1 activity. This indicates that combining long-term opioid antagonism with blockade of NPY-ergic systems may not produce anti-obesity effects.

Public Health England survey of eye lens doses in the UK medical sector

The ICRP has recently recommended that the occupational exposure limit for the lens of the eye be reduced to 20 mSv in a year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv. There has been concern amongst some groups of individuals, particularly interventional cardiologists and radiologists as well as relevant professional bodies, that implementation of these recommendations into UK law will adversely affect working patterns. However, despite a number of informative European studies, there is currently little UK dosimetry data available upon which judgements can effectively be based. In order to address this knowledge gap, Public Health England has carried out a small, targeted survey of UK lens doses to medical staff undertaking procedures likely to involve the highest levels of radiation exposure. Two out of a total of 61 individuals surveyed had projected annual doses which could be close to 20 mSv, measured outside lead glasses. Use of protective equipment was generally good; however, lead glasses were only used by 9 participants. The results of this survey suggest that compliance with the ICRP recommendations is likely to be possible for most individuals in the UK medical sector.

Subtle cardiovascular dysfunction in the unilateral 6-hydroxydopamine-lesioned rat

The present study evaluated whether the unilateral 6-hydroxydopamine (6-OHDA) model of Parkinson's disease produces autonomic deficits. Autonomic parameters were assessed by implanting a small radiofrequency telemetry device which measured heart rate variability (HRV), diurnal rhythms of heart rate (HR), core body temperature (cBT) and locomotor activity (LA). Rats then received 6-OHDA lesion or sham surgery. 6-OHDA lesioned rats exhibited head and body axis biases, defective sensorimotor function ("disengage" test), and prominent apomorphine rotation (all P < .05 versus controls). Diurnal rhythm of HR was lower for 6-OHDA lesioned rats (n = 8) versus controls (n = 6; P < .05). Whilst HR decreased similarly in both groups during the day, there was a greater decrease in HR for the 6-OHDA lesioned rats at night (by 38 b.p.m. relative to 17 b.p.m. for controls). LA and cBT did not differ between surgery groups. This study indicates the unilateral 6-OHDA model of PD shows subtle signs of cardiovascular autonomic dysfunction.

Neuropeptide Y knockout mice reveal a central role of NPY in the coordination of bone mass to body weight

Changes in whole body energy levels are closely linked to alterations in body weight and bone mass. Here, we show that hypothalamic signals contribute to the regulation of bone mass in a manner consistent with the central perception of energy status. Mice lacking neuropeptide Y (NPY), a well-known orexigenic factor whose hypothalamic expression is increased in fasting, have significantly increased bone mass in association with enhanced osteoblast activity and elevated expression of bone osteogenic transcription factors, Runx2 and Osterix. In contrast, wild type and NPY knockout (NPY (-/-)) mice in which NPY is specifically over expressed in the hypothalamus (AAV-NPY+) show a significant reduction in bone mass despite developing an obese phenotype. The AAV-NPY+ induced loss of bone mass is consistent with models known to mimic the central effects of fasting, which also show increased hypothalamic NPY levels. Thus these data indicate that, in addition to well characterized responses to body mass, skeletal tissue also responds to the perception of nutritional status by the hypothalamus independently of body weight. In addition, the reduction in bone mass by AAV NPY+ administration does not completely correct the high bone mass phenotype of NPY (-/-) mice, indicating the possibility that peripheral NPY may also be an important regulator of bone mass. Indeed, we demonstrate the expression of NPY specifically in osteoblasts. In conclusion, these data identifies NPY as a critical integrator of bone homeostatic signals; increasing bone mass during times of obesity when hypothalamic NPY expression levels are low and reducing bone formation to conserve energy under 'starving' conditions, when hypothalamic NPY expression levels are high.

Peripheral neuropeptide Y Y1 receptors regulate lipid oxidation and fat accretion

OBJECTIVE

Neuropeptide Y and its Y receptors are important players in the regulation of energy homeostasis. However, while their functions in feeding regulation are well recognized, functions in other critical aspects of energy homeostasis are largely unknown. To investigate the function of Y1 receptors in the regulation of energy homeostasis, we examined energy expenditure, physical activity, body composition, oxidative fuel selection and mitochondrial oxidative capacity in germline Y1(-/-) mice as well as in a conditional Y1-receptor-knockdown model in which Y1 receptors were knocked down in peripheral tissues of adult mice.

RESULTS

Germline Y1(-/-) mice of both genders not only exhibit a decreased respiratory exchange ratio, indicative of increased lipid oxidation, but interestingly also develop late-onset obesity. However, the increased lipid oxidation is a primary effect of Y1 deletion rather than secondary to increased adiposity, as young Y1(-/-) mice are lean and show the same effect. The mechanism behind this is likely because of increased liver and muscle protein levels of carnitine palmitoyltransferase-1 (CPT-1) and maximal activity of key enzymes involved in beta-oxidation; beta-hydroxyacyl CoA dehydrogenase (betaHAD) and medium-chain acyl-CoA dehydrogenase (MCAD), leading to increased mitochondrial capacity for fatty acid transport and oxidation. These effects are controlled by peripheral Y1-receptor signalling, as adult-onset conditional Y1 knockdown in peripheral tissues also leads to increased lipid oxidation, liver CPT-1 levels and betaHAD activity. Importantly, these mice are resistant to diet-induced obesity.

CONCLUSIONS

This work shows the primary function of peripheral Y1 receptors in the regulation of oxidative fuel selection and adiposity, opening up new avenues for anti-obesity treatments by targeting energy utilization in peripheral tissues rather than suppressing appetite by central effects.

Synergistic attenuation of obesity by Y2- and Y4-receptor double knockout in ob/ob mice

OBJECTIVE

Neuropeptide Y regulates numerous processes including food intake, body composition, and reproduction by at least five different Y receptors. We previously demonstrated a synergistic interaction between Y2 and Y4 receptors in reducing adiposity in chow- or fat-fed Y2Y4-receptor double-knockout mice. In the present study, we investigated whether this synergy could reduce the massive obesity of leptin-deficient ob/ob mice.

METHODS

Mice with germline deletions of Y2 and Y4 receptors were crossed onto the ob/ob strain. Body weight was measured weekly until 15-18 wk of age before decapitation for collection of trunk blood and tissues.

RESULTS

Male and female Y24ob triple mutants showed highly significant reductions in body weight and white adipose tissue mass compared with ob/ob mice. This reduction in body weight was not evident in Y2ob or Y4ob double mutants, and the effect on adiposity was significantly greater than that seen in Y2ob or Y4ob mice. These changes were associated with significant attenuation of the increased brown adipose tissue mass and small intestinal hypertrophy seen in ob/ob mice and with normalization of the low circulating free thyroxine concentrations seen in female ob/ob mice and the high circulating corticosterone concentrations seen in male ob/ob mice.

CONCLUSION

These data reveal a synergistic interaction between Y2 and Y4 receptors in attenuating the massive obesity of ob/ob mice, possibly mediated by stimulation of thyroid function and inhibition of intestinal nutrient absorption. Dual pharmacologic antagonism of Y2 and Y4 receptors could help people to attain and maintain a healthy weight.

PYY transgenic mice are protected against diet-induced and genetic obesity

The gut-derived hormone, peptide YY (PYY) reduces food intake and enhances satiety in both humans and animals. Obese individuals also have a deficiency in circulating peptide YY, although whether this is a cause or a consequence of obesity is unclear. Our aims were to determine whether peptide YY (PYY) over-expression may have therapeutic effects for the treatment of obesity by altering energy balance and glucose homeostasis. We generated PYY transgenic mice and measured body weight, food intake, temperature, adiposity, glucose tolerance, circulating hormone and lipid concentrations and hypothalamic neuropeptide levels (neuropeptide Y; proopiomelanocortin, and thyrotropin-releasing hormone) under chow and high-fat feeding and after crossing these mice onto the genetically obese leptin-deficient ob/ob mouse background. PYY transgenic mice were protected against diet-induced obesity in association with increased body temperature (indicative of increased thermogenesis) and sustained expression of thyrotropin-releasing hormone in the paraventricular nucleus of the hypothalamus. Moreover, PYY transgenic mice crossed onto the genetically obese ob/ob background had significantly decreased weight gain and adiposity, reduced serum triglyceride levels and improved glucose tolerance compared to ob/ob controls. There was no effect of PYY transgenic over expression on basal or fasting-induced food intake measured at 11-12 weeks of age. Together, these findings suggest that long-term administration of PYY, PYY-like compounds or agents that stimulate PYY synthesis in vivo can reduce excess adiposity and improve glucose tolerance, possibly via effects on the hypothalamo-pituitary-thyroid axis and thermogenesis.

Novel role of Y1 receptors in the coordinated regulation of bone and energy homeostasis

The importance of neuropeptide Y (NPY) and Y2 receptors in the regulation of bone and energy homeostasis has recently been demonstrated. However, the contributions of the other Y receptors are less clear. Here we show that Y1 receptors are expressed on osteoblastic cells. Moreover, bone and adipose tissue mass are elevated in Y1(-/-) mice with a generalized increase in bone formation on cortical and cancellous surfaces. Importantly, the inhibitory effects of NPY on bone marrow stromal cells in vitro are absent in cells derived from Y1(-/-) mice, indicating a direct action of NPY on bone cells via this Y receptor. Interestingly, in contrast to Y2 receptor or germ line Y1 receptor deletion, conditional deletion of hypothalamic Y1 receptors in adult mice did not alter bone homeostasis, food intake, or adiposity. Furthermore, deletion of both Y1 and Y2 receptors did not produce additive effects in bone or adiposity. Thus Y1 receptor pathways act powerfully to inhibit bone production and adiposity by nonhypothalamic pathways, with potentially direct effects on bone tissue through a single pathway with Y2 receptors.

Fasting inhibits the growth and reproductive axes via distinct Y2 and Y4 receptor-mediated pathways

Neuropeptide Y, a neuropeptide abundantly expressed in the brain, has been implicated in the regulation of the hypothalamo-pituitary-somatotropic axis and the hypothalamo-pituitary-gonadotropic axis. Elevated hypothalamic neuropeptide Y expression, such as that occurs during fasting, is known to inhibit both of these axes. However, it is not known which Y receptor(s) mediate these effects. Here we demonstrate, using Y receptor knockout mice, that Y2 and Y4 receptors are separately involved in the regulation of these axes. Fasting-induced inhibition of hypothalamic GHRH mRNA expression and reduction of circulating IGF-I levels were observed in wild-type and Y4(-/-) mice but not Y2(-/-) or Y2(-/-)Y4(-/-) mice. In contrast, fasting-induced reduction of GnRH expression in the medial preoptic area and testis testosterone content were abolished in the absence of Y4 receptors. Colocalization of Y2 receptors and GHRH in the arcuate nucleus (Arc) suggests that GHRH mRNA expression in this region might be directly regulated by Y2 receptors. Indeed, hypothalamic-specific deletion of Y2 receptors in conditional knockout mice prevented the fasting-induced reduction in Arc GHRH mRNA expression. On the other hand, fasting-induced decrease in GnRH mRNA expression in the medial preoptic area is more likely indirectly influenced by Y4 receptors because no Y4 receptors could be detected on GnRH neurons in this region. Together these data show that fasting inhibits the somatotropic axis via direct action on Y2 receptors in the Arc and indirectly inhibits the gonadotropic axis via Y4 receptors.

Dynorphin knockout reduces fat mass and increases weight loss during fasting in mice

Endogenous opioids, particularly dynorphins, have been implicated in regulation of energy balance, but it is not known how they mediate this in vivo. We investigated energy homeostasis in dynorphin knockout mice (Dyn(-/-) mice) and probed the interactions between dynorphins and the neuropeptide Y (NPY) system. Dyn(-/-) mice were no different from wild types with regards to body weight and basal and fasting-induced food intake, but fecal output was increased, suggesting decreased nutrient absorption, and they had significantly less white fat and lost more weight during a 24-h fast. The neuroendocrine and thermal responses to fasting were at least as pronounced in Dyn(-/-) as in wild types, and there was no stimulatory effect of dynorphin knockout on 24-h energy expenditure (kilocalories of heat produced) or physical activity. However, Dyn(-/-) mice showed increased circulating concentrations of 3,4-dihydroxyphenlacetic acid and 3,4-dihydroxyphenylglycol, suggesting increased activity of the sympathetic nervous system. The respiratory exchange ratio of male but not female Dyn(-/-) mice was reduced, demonstrating increased fat oxidation. Interestingly, expression of the orexigenic acting NPY in the hypothalamic arcuate nucleus was reduced in Dyn(-/-) mice. However, fasting-induced increases in pre-prodynorphin expression in the arcuate nucleus, the paraventricular nucleus, and the ventromedial hypothalamus but not the lateral hypothalamus were abolished by deletion of Y(1) but not Y(2) receptors. Therefore, ablation of dynorphins results in increases in fatty acid oxidation in male mice, reductions in adiposity, and increased weight loss during fasting, possibly via increases in sympathetic activity, decreases in intestinal nutrient absorption, and interactions with the NPYergic system.

Combined deletion of Y1, Y2, and Y4 receptors prevents hypothalamic neuropeptide Y overexpression-induced hyperinsulinemia despite persistence of hyperphagia and obesity

Neuropeptide Y (NPY) is a key regulator of energy homeostasis and is implicated in the development of obesity and type 2 diabetes. Whereas it is known that hypothalamic administration of exogenous NPY peptides leads to increased body weight gain, hyperphagia, and many hormonal and metabolic changes characteristic of an obesity syndrome, the Y receptor(s) mediating these effects is disputed and unclear. To investigate the role of different Y receptors in the NPY-induced obesity syndrome, we used recombinant adeno-associated viral vector to overexpress NPY in mice deficient of selective single or multiple Y receptors (including Y1, Y2, and Y4). Results from this study demonstrated that long-term hypothalamic overexpression of NPY lead to marked hyperphagia, hypogonadism, body weight gain, enhanced adipose tissue accumulation, hyperinsulinemia, and other hormonal changes characteristic of an obesity syndrome. NPY-induced hyperphagia, hypogonadism, and obesity syndrome persisted in all genotypes studied (Y1(-/-), Y2(-/-), Y2Y4(-/-), and Y1Y2Y4(-/-) mice). However, triple deletion of Y1, Y2, and Y4 receptors prevented NPY-induced hyperinsulinemia. These findings suggest that Y1, Y2, and Y4 receptors under this condition are not crucially involved in NPY's hyperphagic, hypogonadal, and obesogenic effects, but they are responsible for the central regulation of circulating insulin levels by NPY.

Distinct endocrine effects of chronic haloperidol or risperidone administration in male rats

Antipsychotic drugs have been used effectively for the treatment of schizophrenia symptoms, but they are often associated with metabolic side effects such as weight gain and endocrine disruptions. To investigate the possible mechanisms of antipsychotic-induced metabolic effects, we studied the impact of chronic administration of a typical antipsychotic drug (haloperidol) and an atypical antipsychotic (risperidone) to male rats on food intake, body weight, adiposity, and the circulating concentrations of hormones and metabolites that can influence energy homeostasis. Chronic (28days) haloperidol administration had no effect on food intake, weight gain or adiposity in male rats, whereas risperidone treatment resulted in a transient reduction in food intake and significantly reduced body weight gain compared to vehicle-treated control rats. Whereas neither antipsychotic had any effect on serum lipid profiles, glucose tolerance or the circulating concentrations of hormones controlled by the hypothalamo-pituitary-thyroid (free T4), -adrenal (corticosterone), -somatotropic (IGF-1), or -gonadotropic axes (testosterone), haloperidol increased circulating insulin levels and risperidone increased serum glucagon levels. This finding suggests that haloperidol or risperidone induce distinct metabolic effects. Since metabolic disorders such as obesity and type 2 diabetes mellitus represent serious health issues, understanding antipsychotic-induced endocrine and metabolic effects may ultimately allow better control of these side effects.

Peptide YY ablation in mice leads to the development of hyperinsulinaemia and obesity

AIMS/HYPOTHESIS

Obese people exhibit reduced circulating peptide YY (PYY) levels, but it is unclear whether this is a consequence or cause of obesity. We therefore investigated the effect of Pyy ablation on energy homeostasis.

METHODS

Body composition, i.p. glucose tolerance, food intake and hypothalamic neuropeptide expression were determined in Pyy knock-out and wild-type mice on a normal or high-fat diet.

RESULTS

Pyy knock-out significantly increased bodyweight and increased fat mass by 50% in aged females on a normal diet. Male chow-fed Pyy (-/-) mice were resistant to obesity but became significantly fatter and glucose-intolerant compared with wild-types when fed a high-fat diet. Pyy knock-out animals exhibited significantly elevated fasting or glucose-stimulated serum insulin concentrations vs wild-types, with no increase in basal or fasting-induced food intake. Pyy knock-out decreased or had no effect on neuropeptide Y expression in the arcuate nucleus of the hypothalamus, and significantly increased proopiomelanocortin expression in this region. Male but not female knock-outs exhibited significantly increased growth hormone-releasing hormone expression in the ventromedial hypothalamus and significantly elevated serum IGF-I and testosterone levels. This sex difference in activation of the hypothalamo-pituitary somatotrophic axis by Pyy ablation may contribute to the resistance of chow-fed male knock-outs to late-onset obesity.

CONCLUSIONS/INTERPRETATION

PYY signalling is important in the regulation of energy balance and glucose homeostasis, possibly via regulation of insulin release. Therefore reduced PYY levels may predispose to the development of obesity, particularly with ageing or under conditions of high-fat feeding.

Neuropeptide Y (NPY) Y4 receptor selective agonists based on NPY(32-36): development of an anorectic Y4 receptor selective agonist with picomolar affinity

We have previously shown [Cys-Trp-Arg-Nva-Arg-Tyr-NH(2)](2), 1, to be a moderately selective neuropeptide Y (NPY) Y(4) receptor agonist. Toward improving the selectivity and potency for Y(4) receptors, we studied the effects of dimerizing H-Trp-Arg-Nva-Arg-Tyr-NH(2) using various diamino-dicarboxylic acids containing either di-, tri-, or tetramethylene spacers. These parallel dimers, 2A, 2B, 3, 4A, and 4B, and the corresponding linear tandem dimer and trimer analogues, 5 and 6, had enhanced selectivity and affinity for Y(4) receptors compared to 1 (Table 1). Substitution of Trp and Nva with Tyr and Leu, respectively, as in 2,7-d/l-diaminosuberic acid derivatized dimer, 7, resulted in a superior Y(4) selective agonist with picomolar affinity. Intraperitoneal (ip) injection of 7 potently inhibited food intake in fasted mice. Moreover, 7 (ip) inhibited the food intake in wild-type mice and not in Y(4)(-/-) knock-out mice, confirming that the actions of 7 on food intake are not due to global effects, but specifically mediated Y(4) receptors.

Y2Y4 receptor double knockout protects against obesity due to a high-fat diet or Y1 receptor deficiency in mice

Neuropeptide Y receptors are critical regulators of energy homeostasis, but the functional interactions and relative contributions of Y receptors and the environment in this process are unknown. We measured the effects of an ad libitum diet of normal or high-fat food on energy balance in mice with single, double, or triple deficiencies of Y1, Y2, or Y4 receptors. Whereas wild-type mice developed diet-induced obesity, Y2Y4 double knockouts did not. In contrast, Y1 knockout or Y1Y2 or Y1Y4 receptor double knockout mice developed an exacerbated diet-induced obesity syndrome. Remarkably, the antiobesity effect of Y2Y4 deficiency was stronger than the obesogenic effect of Y1 deficiency, since Y1Y2Y4 triple knockouts did not develop obesity on the high-fat diet. Resistance to diet-induced obesity in Y2Y4 knockouts was associated with reduced food intake and improved glucose tolerance in the absence of changes in total physical activity. Fecal concentration of free fatty acids was significantly increased in Y2Y4 knockouts in association with a significantly reduced bile acid pool and marked alterations in intestinal morphology. In addition, hypothalamic proopiomelanocortin expression was decreased in diet-induced obesity (in both wild-type and Y1 receptor knockout mice) but not in obesity-resistant Y2Y4 receptor knockout mice fed a high-fat diet. Therefore, deletion of Y2 and Y4 receptors synergistically protects against diet-induced obesity, at least partially via changes in food intake and hypothalamic proopiomelanocortin expression.

Comparative productivity of irrigated short-term ryegrass (Lolium multiflorum) pasture receiving nitrogen, grown alone or in a mixture with white (Trifolium repens) and Persian (T. resupinatum) clovers

Dairy farms in subtropical Australia use irrigated, annually sown short-term ryegrass (Lolium multiflorum) or mixtures of short-term ryegrass and white (Trifolium repens) and Persian (shaftal) (T. resupinatum) clover during the winter–spring period in all-year-round milk production systems. A series of small plot cutting experiments was conducted in 3 dairying regions (tropical upland, north Queensland, and subtropical southeast Queensland and northern New South Wales) to determine the most effective rate and frequency of application of nitrogen (N) fertiliser. The experiments were not grazed, nor was harvested material returned to the plots, after sampling. Rates up to 100 kg N/ha.month (as urea or calcium ammonium nitrate) and up to 200 kg N/ha every 2 months (as urea) were applied to pure stands of ryegrass in 1991. In 1993 and 1994, urea, at rates up to 150 kg N/ha.month and to 200 kg N/ha every 2 months, was applied to pure stands of ryegrass; urea, at rates up to 50 kg N/ha.month, was also applied to ryegrass–clover mixtures. The results indicate that applications of 50–85 kg N/ha.month can be recommended for short-term ryegrass pastures throughout the subtropics and tropical uplands of eastern Australia, irrespective of soil type. At this rate, dry matter yields will reach about 90% of their potential, forage nitrogen concentration will be increased, there is minimal risk to stock from nitrate poisoning and there will be no substantial increase in soil N. The rate of N for ryegrass–clover pastures is slightly higher than for pure ryegrass but, at these rates, the clover component will be suppressed. However, increased ryegrass yields and higher forage nitrogen concentrations will compensate for the reduced clover component. At application rates up to 100 kg N/ha.month, build-up of NO3–-N and NH4+-N in soil was generally restricted to the surface layers (0–20 cm) of the soil, but there was a substantial increase throughout the soil profile at 150 kg N/ha.month. The build-up of NO3–-N and NH4+-N was greater and was found at lower rates on the lighter soil compared with heavy clays. Generally, most of the soil N was in the NO3–-N form and most was in the top 20 cm.

Selection for more persistent perennial ryegrass (Lolium perenne) cultivars for subtropical/warm temperate dairy regions of Australia

Three experiments were conducted in subtropical/warm temperate dairy regions of Australia to relate persistence of perennial ryegrass (Lolium perenne) to their response to temperature and defoliation. Experiment 1 was a small plot cutting study on a Krasnozem soil with 2 perennial ryegrass lines: LP31, a New Zealand Agriseeds Ltd experimental line; and Kangaroo Valley (KV), adapted to the south coast of New South Wales. They were defoliated at 1 (L) or 3 (3 L) leaves/tiller regrowth stage and at 20 or 60 mm stubble height. When defoliated at 3 L, LP31 was most productive (8839 v. 8481 kg DM/ha) and persistent (57 v. 49 plants/m2 surviving into the autumn of the second year) while the reverse was true at 1 L (5753 v. 6237 kg DM/ha and 27 and 54 plants/m2, respectively). In experiment 2, small plots were sown to 11 cultivars comprising the New Zealand Agriseeds Ltd experimental perennial ryegrass lines: F2 LP93045, F2 LP93026 (Dobson × Bronsyn), LP54, F2 LP92039 (Dobson × Jumbo), LP30 and the commercially available varieties: Bronsyn, Meridian, Dobson, Yatsyn1 and Impact. The plots were 'rotationally' grazed by Friesian heifers. Over the 25 months of this experiment Bronsyn was the most productive (7173 v. 5310 kg DM/ha) and persistent (17 v. 4 plants/m2 for Bronsyn and mean of the remainder, respectively) cultivar.In experiment 3, the 3 most persistent cultivars from experiment 2 (labelled 'Cas'), and 8 other cultivars, were grown as a mini-sward in a temperature-controlled glasshouse. The cultivars were grouped on the basis of persistence, origin and response to defoliation interval and temperature as follows: group 1 (persistent): Bronsyn, Bronsyn (Cas), F2 LP93026 (Dobson × Bronsyn) (Cas), Dobson; group 2 (persistent adaptive ecotype): Victorian; group 3 (not persistence): LP2551, Impact, F2 LP92039 (Cas); group 4: European. The treatments were 28/17°C (HT) or 21/10°C (LT) (day/night) temperature and 1 (1 L) or 3 (3 L) leaves/tiller defoliation interval. Yield (1.28 v. 0.77 g DM/plant) and water-soluble carbohydrate (WSC) content (127 v. 15 mg WSC/plant) were substantially higher in plants defoliated at 3 L compared with 1 L, respectively. The effect of temperature on yield was not significant but more WSC plant reserves accumulated (92 v. 60 mg/plant) at LT than HT. There was a significant (P<0.001) interaction between defoliation interval and cultivar group, with the cultivar, Victorian, being the highest yielding at a short defoliation interval (1.04 v. 0.71 g DM/plant for Victorian and the mean of the remaining cultivars, respectively) while group 1 cultivars (most persistent) were highest yielding at 3 L (1.45 v. 1.08 g DM/plant) and HT. In contrast, group 3 cultivars, were least productive at high temperatures, irrespective of defoliation interval.The results showed that the Australian adapted ecotypes Victorian and KV, which are not responsive to defoliation frequency, were only average yielding. In contrast, the newer cultivars such as Dobson and Bronsyn or crosses thereof are also persistent and are more productive but only when defoliated at an appropriate interval (3 leaves/tiller). In this group, growth was reduced at the higher temperature under frequent defoliation but promoted at infrequent defoliation. The more productive and persistent cultivars tended to have a higher content of WSC plant reserves.

Production and forage quality of prairie grass (Bromus willdenowii) in comparison to perennial ryegrass (Lolium perenne) and tall fescue (Festuca arundinacea) in subtropical dairy pastures

A grazing study was conducted, over a 3-year period (1997–99), on the subtropical north coast of New South Wales, Australia, to compare the yield of prairie grass (Bromus willdenowii cv. Matua), tall fescue (Festuca arundinacea cv. Vulcan) and perennial ryegrass (Lolium perenne cv. Yatsyn), on a well-drained red krasnozem soil at Wollongbar Agricultural Research Institute (WAI) and on a heavy clay soil at Casino. The effect of grazing interval (equivalent to the time taken to regrow 1.5, 2.5 or 4 leaves/tiller) in spring, and forage quality of prairie grass in winter and spring was also assessed. At both sites, the dry matter (DM) yields of prairie grass over the establishment year and in year 2 were significantly (P<0.001) higher than for the other 2 grass species (mean for 2 years over the 2 sites was 23.8, 8.9 and 7.7 t DM/ha for prairie grass, ryegrass and tall fescue, respectively). In year 3, there was no production of tall fescue or ryegrass at the WAI site while prairie grass produced 11.3 t DM/ha although this was obtained from natural seedling recruitment after the sward was sprayed with a herbicide in February of that year. At the Casino site, ryegrass and tall fescue still made substantial growth in year 3 (3.1 and 2.1 t DM/ha for ryegrass and tall fescue, respectively) but this was significantly below the yields of prairie grass (5.5 t DM/ha). More frequent grazing of prairie grass in spring (equivalent to 1.5 leaves/tiller of regrowth) led to significantly (P<0.05) less plants surviving summer and less seedling recruitment in the following autumn. The annual yield of the 1.5 leaf treatment was significantly (P<0.05) lower than the remaining treatments but only in the third year of the study. Analysis of prairie grass forage samples, taken in June (vegetative sward) and November (reproductive sward), gave magnesium values of less than 0.2% DM which is below the concentration found in ryegrass and that recommended for dairy cattle. The Ca : P and K : (Ca + Mg) ratios in prairie grass improved, as a forage for dairy cows, with regrowth time up to 5 leaves/tiller. Metabolisable energy remained constant with regrowth time in June at 10.8 MJ/kg DM but fell significantly in November from 10.7 MJ/kg DM, immediately post-grazing, to 9.2 MJ/kg DM at the 4.5 leaves/tiller stage of regrowth. In contrast to observations in ryegrass, the water-soluble carbohydrate content of forage samples of prairie grass taken in November showed a substantial increase with regrowth time to over 12% DM at the 3 leaves/tiller stage of regrowth. The high productivity and forage quality of prairie grass obtained over a 3-year period suggests this grass species could be a suitable temperate perennial grass for subtropical dairy pastures. An appropriately long grazing interval in spring seems critical to optimise plant survival over summer and for adequate seed set for seedling recruitment the following autumn. If summer weeds and/or grasses invade to a significant extent, the large seedbank of prairie grass provides the opportunity to spray out the pasture in summer and rely on seedling recruitment to establish a new sward in autumn. The forage quality of prairie grass in winter and spring is similar to perennial ryegrass but the magnesium levels are substantially lower and stock grazing this type of pasture for extended periods would need to be supplemented with this mineral.

Regrowth of prairie grass (Bromus willdenowii Kunth) and perennial ryegrass (Lolium perenne L.) in response to temperature and defoliation

This glasshouse study was undertaken to determine the effect of temperature and defoliation on the regrowth of prairie grass (Bromus willdenowii Kunth cv. Matua) in comparison with perennial ryegrass (Lolium perenne L. cv. Dobson). Individual plants of prairie grass and perennial ryegrass were grown in 2 mini-swards with one half as prairie grass and the other as ryegrass. From H0 (13 weeks after sowing) to the completion of the experiment at H3, one sward was maintained at a day/night temperature of 18/10˚C and the other at 25/15˚C. From H0 to H1, prairie grass was defoliated 4 times at the time taken to regrow 1 new leaf per tiller (1-leaf stage), 2 times at the 2-leaf stage, or once at the 4-leaf stage to 60, 90, or 120 mm stubble height. Similarly, ryegrass was defoliated 3 times at the 1- leaf stage, once at the 1-leaf stage then once at the 2-leaf stage, or once at the 3-leaf stage to 30, 60, or 90 mm stubble height. Plants were subsequently harvested at H1, H2, and H3, being the commencement, mid-point, and completion of the full regrowth cycle (4- and 3-leaf stage for prairie grass and ryegrass, respectively). Prairie grass was more adversely affected by frequent defoliation than ryegrass. The combination of high temperature and frequent defoliation reduced growth rates by 66 v. 54%, stubble dry matter (DM) by 50 v. 11%, root DM by 62 v. 45%, and stubble water-soluble carbohydrate (WSC) by 52 v. 21% for prairie grass and ryegrass, respectively. In contrast, ryegrass was more affected by defoliation height than prairie grass, particularly at the higher temperature. Close defoliation and high temperature reduced growth rate by 35 v. 25%, root DM by 18 v. 0%, and stubble WSC by 84% v. 36% for ryegrass and prairie grass, respectively. The number of tillers per plant was reduced by close defoliation, more so at the high temperature in ryegrass but not in prairie grass. Defoliating prairie grass to 90 mm stubble height at the 4-leaf per tiller stage compared with the 1-leaf per tiller led to maximum restoration of stubble WSC reserves as well as maximising leaf and root growth. The higher stubble WSC and greater root DM of prairie grass, together with its ability to maintain growth rates and tillering under high temperature, are attributes which explain why prairie grass appears to be more productive and persistent than ryegrass in a subtropical environment.

Fluticasone propionate attenuates ozone-induced rhinitis and mucous cell metaplasia in rat nasal airway epithelium

Ozone (O3) is the principal oxidant pollutant in photochemical smog. Repeated exposures to O3 induces inflammation and mucous cell metaplasia in the nasal airways of laboratory animals. Our study was designed to determine the efficacy of a topical anti-inflammatory corticosteroid in preventing O3-induced rhinitis and mucous cell metaplasia in rat nasal epithelium. Male F344 rats were exposed to filtered air (0 ppm O3; air-controls) or 0.5 ppm O3, 8 h/day, for 3 or 5 days. Immediately before and after each exposure, rats received an intranasal instillation (50 microl/nasal passage) of a topical corticosteroid, fluticasone propionate (FP; 25 microg/nasal passage) or its vehicle only (0.01% ethanol in saline). Rats were killed 2 h after the third exposure (3-day exposure) or 3 days after the fifth exposure (5-day exposure) and nasal tissues were processed for light microscopy. Numeric densities of epithelial cells and neutrophils, and the amount of intraepithelial mucosubstances (IM) in the epithelium lining the maxilloturbinates were morphometrically determined. There were no significant differences in any measured parameter in air-exposed rats instilled with FP compared with air-exposed rats instilled with vehicle. Vehicle-treated rats exposed to ozone had neutrophilic rhinitis with 3.3- and 1.6-fold more intraepithelial neutrophils (3-day and 5-day exposure, respectively) and marked mucous cell metaplasia (5-day exposure only) with numerous mucous cells and approximately 60 times more IM in the nasal transitional epithelium compared with vehicle-treated air-controls. FP-treated rats exposed to ozone had minimal nasal inflammation (1.3-fold more intraepithelial neutrophils only after 3-day exposure) and minimal mucous cell metaplasia (5-fold more IM only after 5-day exposure) compared with vehicle-instilled, air-exposed rats. Results of this study indicate that FP-treatment is effective in attenuating not only O3-induced rhinitis (30-60% reduction) but also O3-induced mucous cell metaplasia (85% reduction) in rat nasal transitional epithelium. The cellular and molecular mechanisms involved in FP-induced attenuation of O3-induced nasal lesions remain to be determined.

Nutrients in ryegrass (Lolium spp.), white clover (Trifolium repens) and kikuyu (Pennisetum clandestinum) pastures in relation to season and stage of regrowth in a subtropical environment

Summary. On the subtropical north coast of New South Wales, Australia, kikuyu grass (Pennisetum clandestinum), biennial ryegrass (Lolium multiflorum) and mixed perennial ryegrass (Lolium perenne)–white clover (Trifolium repens) pastures grazed by dairy cows were plucked pregrazing to simulated grazing height, every 2 weeks for 2 years to determine seasonal changes in various nutrients and in sacco organic matter and nitrogen (N) degradability. Changes in nutrients during regrowth were determined in the ryegrass component of a mixed perennial ryegrass–white clover pasture by sequentially cutting pasture at 3- or 4-day intervals to 5 cm stubble height and non-structural carbohydrates in kikuyu by cutting at 4-day intervals in February–March. There was a significant effect of season on water-soluble carbohydrate (WSC) and crude protein (CP) content of perennial ryegrass with regrowth time, resulting in an 8-fold fall in the CP : WSC ratio from the 1 to 3 leaves/tiller stage of regrowth in mid winter, a 2-fold difference in mid spring but with no discernible difference in late spring. The metabolisable energy (ME) values for biennial ryegrass exceeded 11.9 MJ/kg dry matter (DM) from July to September and then fell markedly to <10 MJ/kg DM in November, coinciding with reproductive development. In perennial ryegrass–white clover pastures, mean ME was above 11 MJ/kg DM from May to September, but fell to < 9 MJ/kg DM in December while in kikuyu, the mean ME, over the recognised growing season, was 8.5 MJ/kg DM but in winter it was 9.5 MJ/kg DM. Fibre content in all pasture types showed a significant seasonal trend with the content of acid detergent fibre (ADF) in biennial ryegrass at 17% from May to August while the mean neutral detergent fibre (NDF) content was 37%. In perennial ryegrass–white clover, the mean ADF was <21% from May to August. The NDF content of kikuyu grass was about 60% during the growing season but 40% in winter. The calcium (Ca) : phosphorus (P) ratio in perennial ryegrass rose from <1 : 1 at the 1 leaf/tiller stage to 2.2 : 1 at the 3 leaves/tiller stage of regrowth due to a simultaneous fall in P and a rise in Ca. A fall in potassium (K) and a rise in magnesium (Mg) and Ca content in perennial ryegrass gave a very significant linear fall in K/(Mg + Ca), on a percentage basis, from 8 at the 1 leaf/tiller stage of regrowth, to 2.5 at the 3 leaves/tiller stage of regrowth. In kikuyu, the level of P changed significantly with season falling as the species became dormant. A fall in P and a rise in Ca content resulted in a high Ca : P ratio (2.5 : 1) in spring. The findings of this study give some insight into the reason why the content of various nutrients change in pasture and the implication of this for providing a balanced diet to dairy cows. A knowledge of these changes should provide the opportunity to balance nutrients in pasture by adjusting time of grazing and/or providing supplements of appropriate quality.

Variation in the response of Lolium genotypes to defoliation

A glasshouse study was undertaken to determine the effect of defoliation frequency (three times at one leaf stage or once at three leaf stage of the regrowth cycle) and height (20, 50 or 120 mm) on regrowth, plant water soluble carbohydrate (WSC) reserves and root growth of seven Lolium perenne and two Lolium multiflorum cultivars. The sensitivity to defoliation was in decreasing order: biennial, PI perennials (cv. Ellett, AN2327, LP30, LP31), P2 perennials (cv. Kangaroo Valley, Yatsyn, Pacific). The effect of frequent, compared to infrequent, defoliation was to suppress regrowth by l00%, 95% and 80%; stubble WSC (mg/plant) by 97, 89 and 81%; root DM (g/plant) by 76, 60 and 6%, for biennial, P1 and P2, respectively. The effect of defoliation height accentuated this response, with biennials defoliated frequently at 20 mm stubble height all dying. Under defoliation conditions producing optimal yield, the yield was positively related to sensitivity to defoliation, giving regrowths of 2.90, 2.68, 1.53 g DM per plant for biennial, P1 and P2 plants, respectively. In view of the marked defoliation by cultivar interaction, response to defoliation should be considered as a possible selection criterion in any evaluation process.

Estimating mass of temperate and tropical pastures in the subtropics

The feasibility of estimating, with acceptable precision, temperate and tropical pasture mass in a subtropical environment was evaluated. For the tropical grasses kikuyu (Pennisetum clandestinum) and setaria (Setaria ancepts), 3 different pasture meters were calibrated against 1 of 3 dry matter (DM) estimates. Temperate pastures (predominantly Lolium perenne and Trifolium repens) were evaluated using the Ellinbank rising plate meter (RPMl) calibrated against DM to ground level. A single regression equation was developed for syegrass-white clover pasture from data pooled within season over first- and second-year swards. The s.e. of estimate (s.e.e.) for assessing tropical grass pasture mass using RPMl was similar to that for a heavier Ellinbank meter and substantially lower than that for the electronic pasture probe. Using RPMl, separate regression equations were required for early (November-February) and late (March-May) season determinations for both kikuyu and setaria. The regression equations were based on calibrations against shoot DM (>5 cm stubble height for kikuyu and 6 cm for setaria) and are only applicable to well-managed and highly utilised pastures. Calibrations of all pasture meters over all months to green DM (senescent leaf and stem removed) gave a lower s.e.e. than total DM (kikuyu 138 v. 177 kg DM/ha, n = 171; setaria 211 v. 224 kg DM/ha, n = 177) whilst shoot DM gave a more substantial reduction in s.e.e. (kikuyu 95 v. 147 kg DM/ha; setaria 140 v. 193 kg DM/ha).

Management of Lolium perenne/Trifolium repens pastures in the subtropics. I. Effect of defoliation interval, seeding rate and application of N and lime

This plot cut study, conducted on the subtropical north coast of New South Wales, evaluated the effect of defoliation interval, seeding rate and application of nitrogen and lime on production and survival over summer of a Lolium perenne/Trifolium repens pasture. There was a 117% or 12 781 kg DM/ha difference in DM yield between the worst and best treatment combinations over the 17 month period of the study. The best treatment combination for yield also gave the highest rate of ryegrass survival and lowest levels of 'summer grass' ingression over the first summer. Defoliation at 4 weeks or 'when ready' (before onset of senescence, 'lodging' or rust), compared to at 2 weeks, increased DM yield by 18 and 32% in year 1 and 41 and 59% in year 2 respectively. The larger difference in year 2 was primarily due to a greater ingression of 'summer grass' (winter dormant) and a lower survival of ryegrass plants over the first summer in the most frequently cut plots. The lower root DM in summer at the more frequent cutting interval may have been one factor responsible for the defoliation effect. DM yields of a 'clover dominant' sward (nil N except at sowing and 8 kg ryegrass/ha; clover = 53%) was 85% in year 1 and 50% in year 2 (up to August) of that of a 'ryegrass dominant' sward (100 kg urea ha-1 mo-1 and 35 kg ryegrass/ha; clover = 8%). The lower yield of the 'clover dominant' pasture in year 2 was partly due to a greater level of 'summer grass' infestation. Application of N increased plant survival over summer, but under grazing, many plants may have been lost through sod pulling by stock, as roots were more restricted to the surface. Application of lime increased DM yield in both years.