Inflammation, endothelial injury, and the acute respiratory distress syndrome after out-of-hospital cardiac arrest

Background

Acute respiratory distress syndrome (ARDS) is often seen in patients resuscitated from out-of-hospital cardiac arrest (OHCA). We aim to test whether inflammatory or endothelial injury markers are associated with the development of ARDS in patients hospitalized after OHCA.

Methods

We conducted a prospective, cohort, pilot study at an urban academic medical center in 2019 that included a convenience sample of adults with non-traumatic OHCA. Blood and pulmonary edema fluid (PEF) were collected within 12 hours of hospital arrival. Samples were assayed for cytokines (interleukin [IL]-1, tumor necrosis factor-α [TNF-α], tumor necrosis factor receptor1 [TNFR1], IL-6), epithelial injury markers (pulmonary surfactant-associated protein D), endothelial injury markers (Angiopoietin-2 [Ang-2] and glycocalyx degradation products), and other proteins (matrix metallopeptidase-9 and myeloperoxidase). Patients were followed for 7 days for development of ARDS, as adjudicated by 3 blinded reviewers, and through hospital discharge for mortality and neurological outcome. We examined associations between biomarker concentrations and ARDS, hospital mortality, and neurological outcome using multivariable logistic regression. Latent phase analysis was used to identify distinct biological classes associated with outcomes.

Results

41 patients were enrolled. Mean age was 58 years, 29% were female, and 22% had a respiratory etiology for cardiac arrest. Seven patients (17%) developed ARDS within 7 days. There were no significant associations between individual biomarkers and development of ARDS in adjusted analyses, nor survival or neurologic status after adjusting for use of targeted temperature management (TTM) and initial cardiac arrest rhythm. Elevated Ang-2 and TNFR-1 were associated with decreased survival (RR = 0.6, 95% CI = 0.3-1.0; RR = 0.5, 95% CI = 0.3-0.9; respectively), and poor neurologic status at discharge (RR = 0.4, 95% CI = 0.2-0.8; RR = 0.4, 95% CI = 0.2-0.9) in unadjusted associations.

Conclusion

OHCA patients have markedly elevated plasma and pulmonary edema fluid biomarker concentrations, indicating widespread inflammation, epithelial injury, and endothelial activation. Biomarker concentrations were not associated with ARDS development, though several distinct biological phenotypes warrant further exploration. Latent phase analysis demonstrated that patients with low biomarker levels aside from TNF-α and TNFR-1 (Class 2) fared worse than other patients. Future research may benefit from considering other tools to predict and prevent development of ARDS in this population.

Distribution of natural radionuclides in NORM samples from North Abu Rusheid area, Egypt

The North Abu Rusheid area in Egypt is a well-known high background natural radiation area (HBNRA) due to the existence of naturally occurring radioactive materials (NORMs) in mylonitic rocks. In this study, 27 rock samples were selected for dose estimation studies. ²³⁸U and ²³²Th were measured using inductively coupled plasma mass spectrometry (ICP-MS) and ⁴⁰K was measured using sodium iodide (thallium) gamma-ray spectroscopy. The ranges of activity concentrations (Bq/kg) of ²³⁸U, ²³²Th and ⁴⁰K in the samples varied from 270 ± 2 to 2120 ± 29, 350 ± 2 to 1840 ± 27 and 20 ± 2 to 1390 ± 35 with mean values of 980 ± 349, 770 ± 351, and 640 ± 402 Bq/kg, respectively. The radiological hazard parameters were estimated from activity concentrations of ²³⁸U, ²³²Th and ⁴⁰K and compared to United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) values. The present study revealed that the hazard parameters were several times higher than the worldwide averages. The U/Th concentration ratio ranged from 0.7 to 3 and could be attributed to the presence of kasolite, uranothorite, zircon, and columbite in mylonitic rocks. From the radiological protection viewpoint, it is necessary to monitor natural radionuclides in these rocks prior to their use in residential and commercial construction materials.

A high-quality genome sequence of Rosa chinensis to elucidate ornamental traits

Rose is the world's most important ornamental plant, with economic, cultural and symbolic value. Roses are cultivated worldwide and sold as garden roses, cut flowers and potted plants. Roses are outbred and can have various ploidy levels. Our objectives were to develop a high-quality reference genome sequence for the genus Rosa by sequencing a doubled haploid, combining long and short reads, and anchoring to a high-density genetic map, and to study the genome structure and genetic basis of major ornamental traits. We produced a doubled haploid rose line ('HapOB') from Rosa chinensis 'Old Blush' and generated a rose genome assembly anchored to seven pseudo-chromosomes (512 Mb with N50 of 3.4 Mb and 564 contigs). The length of 512 Mb represents 90.1-96.1% of the estimated haploid genome size of rose. Of the assembly, 95% is contained in only 196 contigs. The anchoring was validated using high-density diploid and tetraploid genetic maps. We delineated hallmark chromosomal features, including the pericentromeric regions, through annotation of transposable element families and positioned centromeric repeats using fluorescent in situ hybridization. The rose genome displays extensive synteny with the Fragaria vesca genome, and we delineated only two major rearrangements. Genetic diversity was analysed using resequencing data of seven diploid and one tetraploid Rosa species selected from various sections of the genus. Combining genetic and genomic approaches, we identified potential genetic regulators of key ornamental traits, including prickle density and the number of flower petals. A rose APETALA2/TOE homologue is proposed to be the major regulator of petal number in rose. This reference sequence is an important resource for studying polyploidization, meiosis and developmental processes, as we demonstrated for flower and prickle development. It will also accelerate breeding through the development of molecular markers linked to traits, the identification of the genes underlying them and the exploitation of synteny across Rosaceae.

A high-quality genome sequence of Rosa chinensis to elucidate ornamental traits

Rose is the world's most important ornamental plant, with economic, cultural and symbolic value. Roses are cultivated worldwide and sold as garden roses, cut flowers and potted plants. Roses are outbred and can have various ploidy levels. Our objectives were to develop a high-quality reference genome sequence for the genus Rosa by sequencing a doubled haploid, combining long and short reads, and anchoring to a high-density genetic map, and to study the genome structure and genetic basis of major ornamental traits. We produced a doubled haploid rose line ('HapOB') from Rosa chinensis 'Old Blush' and generated a rose genome assembly anchored to seven pseudo-chromosomes (512 Mb with N50 of 3.4 Mb and 564 contigs). The length of 512 Mb represents 90.1-96.1% of the estimated haploid genome size of rose. Of the assembly, 95% is contained in only 196 contigs. The anchoring was validated using high-density diploid and tetraploid genetic maps. We delineated hallmark chromosomal features, including the pericentromeric regions, through annotation of transposable element families and positioned centromeric repeats using fluorescent in situ hybridization. The rose genome displays extensive synteny with the Fragaria vesca genome, and we delineated only two major rearrangements. Genetic diversity was analysed using resequencing data of seven diploid and one tetraploid Rosa species selected from various sections of the genus. Combining genetic and genomic approaches, we identified potential genetic regulators of key ornamental traits, including prickle density and the number of flower petals. A rose APETALA2/TOE homologue is proposed to be the major regulator of petal number in rose. This reference sequence is an important resource for studying polyploidization, meiosis and developmental processes, as we demonstrated for flower and prickle development. It will also accelerate breeding through the development of molecular markers linked to traits, the identification of the genes underlying them and the exploitation of synteny across Rosaceae.

Detection of bleeding disorders in Lebanon: outcomes of a pilot programme

To promote management and awareness of bleeding disorders in Lebanon, a pilot programme was launched in 2009 by the Lebanese Hemophilia Association assisted by World Federation of Hemophilia. The aim of this study was to diagnose patients with bleeding disorders and to assess the potential challenges in implementing a screening programme. The pilot project was launched in 26 social health centres in the Bekaa valley. The study tools included the evaluation of the Tossetto Bleeding Score and the Pictorial Bleeding Assessment Chart (PBAC) for menstruation. Persons with a bleeding score higher than 2 and PBAC higher than 185 were eligible for further blood tests including the prothrombin time, partial thromboplastin time, complete blood count, bleeding time and von Willebrand ristocetin cofactor activity. 643 patients were enrolled, of whom 60.6% were women. Overall, 91 persons had an abnormal score. 50 eligible patients were tested: 32 had normal tests, nine new patients with severe Von Willebrand were discovered, 4 had VW:RiCo of 40, 3 prolonged APTT and 2 thrombocytopaenia. There was a clear correlation between the severity of the score and the willingness to perform the tests (P = 0.02). Women were reluctant to participate fully when investigators were men. The probability of adherence to the screening protocol is significantly increased when directed by women health care professional. For patients with milder forms, global screening programmes were neither feasible nor acceptable but those more severely affected have to be identified. Providers are crucial in preselecting patients with blood problems who are not coping well.

Induction of breast and lung neoplastic lesions in mice by alpha-ecdysone

Alpha ecdysone is naturally present in the leaves of some plants, including the carcinogenic plant bracken fern (Pteris aquilina). Feeding mice with alpha-ecdysone at a dose level of 3 ppm/25 g body weight, 2 times per week for 22 months induced a significant increase in the body weight of the animals. Breast and lung tumors developed in the experimental mice. Other pathological changes such as fibrocystic disease of the breast and bronchocentric granulomas appeared in these animals. The results of this study proved that alpha-ecdysone may be one of the active carcinogens in bracken fern plant which was responsible for induction of tumors in different animals investigated by previous authors.

Insights into Populus XIP aquaporins: evolutionary expansion, protein functionality, and environmental regulation

A novel category of major intrinsic proteins which share weak similarities with previously identified aquaporin subfamilies was recently identified in land plants, and named X (for unrecognized) intrinsic proteins (XIPs). Because XIPs are still ranked as uncharacterized proteins, their further molecular characterization is required. Herein, a systematic fine-scale analysis of XIP sequences found in flowering plant databases revealed that XIPs are found in at least five groups. The phylogenetic relationship of these five groups with the phylogenetic organization of angiosperms revealed an original pattern of evolution for the XIP subfamily through distinct angiosperm taxon-specific clades. Of all flowering plant having XIPs, the genus Populus encompasses the broadest panel and the highest polymorphism of XIP isoforms, with nine PtXIP sequences distributed within three XIP groups. Comprehensive PtXIP gene expression patterns showed that only two isoforms (PtXIP2;1 and PtXIP3;2) were transcribed in vegetative tissues. However, their patterns are contrasted, PtXIP2;1 was ubiquitously accumulated whereas PtXIP3;2 was predominantly detected in wood and to a lesser extent in roots. Furthermore, only PtXIP2;1 exhibited a differential expression in leaves and stems of drought-, salicylic acid-, or wounding-challenged plants. Unexpectedly, the PtXIPs displayed different abilities to alter water transport upon expression in Xenopus laevis oocytes. PtXIP2;1 and PtXIP3;3 transported water while other PtXIPs did not.

Oxidant alterations in CD16 expression are cytoskeletal induced

Oxidative stress during reperfusion of ischemia is associated with a phenotypic change in circulating monocytes from CD14++CD16- to a proinflammatory CD14+CD16+ subpopulation resulting in altered immunity and development of organ failure. However, the mechanism responsible remains unknown. We hypothesize that this phenotypic change, modeled by hydrogen peroxide exposure in vitro, is due to oxidative-induced intracellular calcium flux and distinct cytoskeletal and lipid raft changes. Peripheral blood monocytes obtained from healthy volunteers underwent 100 mM H2O2 exposure for 0 to 24 h. Selected cells were pretreated with 2 microM cytochalasin D, 1 microM lactrunculin A, or 30 microM 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid for 30 min. Cells underwent fluorescence-activated cell sorter for CD14, CD16, and cytokine expression. Cellular and lipid raft CD16 expression was determined by immunoblot and confocal microscopy. H2O2 exposed monocytes underwent a rapid time-dependent increase in the surface expression of CD16 from 12.81% +/- 3.53% to 37.12% +/- 7.61% at 24 h (P = 0.001). Total cellular CD16 was not changed by H2O2, but an increase in lipid raft and decrease in intracellular CD16 expression were seen after H2O2 exposure. This increase in CD16 expression was associated with a 27% increase in intracellular TNF-alpha, an alteration in actin polymerization, and the formation of raft macrodomains. These changes induced by H2O2 were inhibited by inhibition of actin polymerization (cytochalasin D and lactrunculin A) and intracellular calcium flux [1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid]. This study provides the first evidence that phenotypic alterations induced by oxidative stress during reperfusion may occur as a result of changes in cytoskeletal architecture due to calcium flux that result in lipid raft alterations rather than solely from demargination and/or production of bone marrow-derived CD16+ monocytes.

Identification of a pollen-specific sucrose transporter-like protein NtSUT3 from tobacco

Pollen cells are symplasmically isolated during maturation and germination. Pollen therefore needs to take up nutrients via membrane carriers. Physiological measurements on pollen indicate sucrose transport in the pollen tube. A cDNA encoding a pollen-specific sucrose transporter-like protein NtSUT3 was isolated from a tobacco pollen cDNA library. NtSUT3 expression is detected only in pollen and is restricted to late pollen development, pollen germination and pollen tube growth. Altogether these data indicate that pollen is supplied not only with glucose, but also with sucrose through a specific sucrose transporter. The respective contribution of each transport pathway may change during pollen tube growth.

Regulation of a plant plasma membrane sucrose transporter by phosphorylation

The protein phosphatase inhibitor okadaic acid (OA) either provided directly to sugar beet (Beta vulgaris L.) leaf discs or infiltrated in the leaf blade rapidly inhibited sucrose uptake. Methyl okadaic acid, a biologically inactive analogue of OA, had only a marginal effect on uptake. OA inhibited proton-motive force-driven uptake of sucrose into plasma membrane vesicles, without affecting their proton permeability. OA did not significantly affect the amount of sucrose transporters present in the vesicles, as estimated by ELISA with specific antibodies. It is concluded that OA directly inhibits the activity of a H+-sucrose cotransporter of the plant plasma membrane, likely by maintaining it in a phosphorylated form.

Cutting, ageing and expression of plant membrane transporters

The activity and the expression of sucrose, hexose and amino acid transporters were studied with fresh, cut or aged tissues and plasma membrane vesicles (PMV) of mature sugar beet (Beta vulgaris L.) leaves. Cutting and ageing both induced an increase of the transcripts coding for sucrose transporters and hexose transporters. No significant effect could be detected on the amino acid transporter transcripts with the probe used (aap1). A polyclonal serum directed against the Arabidopsis thaliana sucrose transporter (AtSUC1) reacted with a 42 kDa band of the sugar beet PMV, confirming previous biochemical identification of this band as a sucrose transporter. ELISA assays run with microsomal fractions and PMV using the AtSUC1 sucrose transporter probe indicated that ageing, and to a lesser extent cutting, increased the amount of sucrose transporter present in the plasma membrane. However, while cutting strongly stimulated proton-motive force driven uptake of sucrose in PMV, ageing only resulted in a slight stimulation. These data give evidence for transcriptional, post-transcriptional and post-translational controls of the activity of the sucrose transporter by mechanical treatments. Proton-motive force driven uptake of 3-O-methylglucose and valine in PMV was strongly stimulated in PMV from aged tissues, although previous data had shown that cutting did not affect theses processes. Therefore, the plant cells possess various levels of control mechanisms that allow them to regulate fluxes of the main assimilates across the plasma membrane when their natural environment is directly or indirectly altered.

Transcriptional and post-translational control of the plant plasma membrane H(+)-ATPase by mechanical treatments

The activity of the plant plasma membrane (PM) H(+)-ATPase was studied with fresh, cut or aged tissues of sugar beet (Beta vulgaris L.) leaves. The rate of acidification of the medium by tissue samples was strongly stimulated by ageing, but unaffected by cutting. The proton-pumping activity and the specific activity of the vanadate-sensitive ATPase of purified PM vesicles prepared from aged tissues were much higher than that of fresh tissues, whereas cutting had no effect. Yet, both ageing and cutting increased the amount of PM H(+)-ATPase detected by enzyme-linked immunosorbent assays. Likewise, both ageing and cutting increased the levels of pma4 and pma2 ATPase transcripts, as assayed with the corresponding probes from Nicotiana plumbaginifolia. Ageing increases, within a few hours, the levels of the transcripts, the translation and the activity of several PM H(+)-ATPase families. Cutting, which represents a milder mechanical stress, only increases the levels of the transcripts and their translation, without detectable effect on the activity at the biochemical or physiological level, which suggests a post-translational control of this activity. Thus, upon mechanical stress, the activity of the H(+)-ATPase, a key enzyme of the plant PM is rapidly and tightly regulated by transcriptional and post-translational controls.

Postprandial free fatty acids stimulate activity of human corticosteroid binding globulin

The effect of postprandial variation of free fatty acids (FFA) on serum corticosteroid binding globulin (CBG) properties and cortisol (hydrocortisone) concentrations were explored in 11 women (20-30 yr) during 8 h after an oral load of tallow (26% C16:0, 18% C18:0, and 43% C18:1), oleic-sunflower (oleic-SF; 73% C18:1), sunflower (SF; 67% C18:2), and mixed oil (MO; 39% C18:1 and 48% C18:2). Serum FFA increased little after SF and MO but more than doubled in the late postprandial period (6 and 8 h) after oleic-SF (due to monounsaturated FFA) or tallow (due to saturated and monounsaturated FFA). CBG concentrations remained unchanged, but in relation with the postprandial elevation of serum FFA, CBG binding activity was increased after tallow or oleic-SF as a result of a combined two- to threefold increase in affinity constant and a 50% reduction in binding sites. Immunological and in vitro binding studies showed the changes in CBG behavior to be conformational and to be mediated mainly by monounsaturated FFA, especially C18:1. The modifications of CBG properties were associated with sustained high concentrations of cortisol (suppression of midday decrease) 6 and 8 h after tallow or oleic-SF. Thus dietary FFA may have an impact on bioavailability of glucocorticoids.

Binding of HDL to basolateral membranes of the renal cortex. Evidence for two components in the HDL-membrane association

The binding of porcine 125I-HDL to purified basolateral membrane fractions isolated from pig kidney cortex displays two categories of sites, one with high affinity ((Kd = (3.0 +/- 0.7) x 10(-9) M) and low capacity (Bmax = 52 +/- 32 ng/mg proteins) another with low affinity (Kd = (5.3 +/- 0.7) x 10(-8) M) but a higher capacity (Bmax = 795 +/- 115 ng/mg proteins). Binding was competitively inhibited to the same extent by unlabeled HDL from swine, human or rat, demonstrating an absence of species specificity. Porcine LDL partially competed for binding even in the presence of 30 mM EDTA which prevents apo B/E specific binding. Membrane proteins solubilized with CHAPS were analyzed by electrophoresis followed by ligand blotting using porcine 125I-HDL and 125I-apoAI-HDL to show that HDL bound to two proteins of respective molecular masses 120 +/- 2 and 95 +/- 9 kDa. 125I-apoAI associated mostly with the 95 kDa protein. A 100-fold excess of unlabeled HDL greatly decreased binding to the 95 kDa protein but less to the 120 kDa protein. We conclude that part of HDL binding occurs through the lipid moiety, while another is the result of a specific interaction between apoAI and a membrane protein of 95 kDa.

Effect of cutting on solute uptake by plasma membrane vesicles from sugar beet (Beta vulgaris L.) leaves

The uptake of sucrose, 3-O-methylglucose (3-O-MeG), and valine were studied in discs and in purified plasma membrane vesicles (PMV) prepared from sugar beet (Beta vulgaris L.) exporting leaves. The uptake capacities of freshly excised leaf discs were compared with the uptake in discs that had been floated for 12 h on a simple medium (aging) and with discs excised from leaves that had been cut from the plant 12 h before the experiments (cutting). After cutting, sucrose uptake amounted to twice the uptake measured in fresh discs, whereas the uptake of 3-O-MeG and valine remained unaffected. In aged leaf discs, there was a general stimulation of uptake, which represented 400, 300, and 400% of the uptake measured in fresh discs for sucrose, 3-O-MeG, and valine, respectively. Sucrose uptake in fresh discs was sensitive to N-ethylmaleimide (NEM), to p-chloromercuribenzenesulfonic acid (PCMBS), and to mersalyl acid (MA). Although cutting induced the appearance of a sucrose uptake system that is poorly sensitive to NEM but sensitive to PCMBS and MA, aging induced the development of an uptake system that is sensitive to NEM but poorly sensitive to PCMBS and MA. Autoradiographs of discs fed with [14C]sucrose show that cutting resulted in an increase of vein labeling with little effect in the mesophyll, whereas aging induced an increase of labeling located mainly in the mesophyll. The data show that cutting is sufficient to induce dramatic and selective changes in the uptake properties of leaf tissues and that the effects of cutting and aging on the uptake of organic solutes are clearly different. Parallel experiments were run with purified PMV prepared from fresh and cut leaves. The uptake of sugars and amino acids was studied after imposition of an artificial proton motive force (pmf). Comparison of the uptake properties of PMV and of leaf tissues indicate that the recovery of the sucrose uptake system in PMV is better than the recovery of the hexose and of the valine uptake systems. As observed with the leaf discs, cutting induced a 2-fold increase of the initial rate of sucrose uptake in PMV but did not affect the uptake of valine and 3-O-MeG. Cutting induced an increase of both Vmax and Km of the sucrose transport system in PMV. Measurements of the pmf imposed on the vesicles indicated that the increase of sucrose uptake induced by cutting was not due to a better integrity of the vesicles. Hexoses did not compete with sucrose for uptake in PMV from fresh and cut leaves, and maltose was a stronger inhibitor of sucrose uptake in PMV from cut leaves than in PMV from fresh leaves. The sensitivity of sucrose uptake to NEM, PCMBS, and MA in PMV from fresh and cut leaves paralleled that described above for the corresponding leaf discs. These data show that (a) the changes induced by cutting on sucrose uptake by leaf discs are due to membrane phenomena and not to the metabolism of sucrose; (b) the study of sucrose uptake with PMB gives a good account of the physiological situation; and (c) the specific effects induced by cutting on the sucrose uptake system are not lost during the preparation of the PMV.