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Melnyk S, Bollag WB. Aquaporins in the Cornea. Int J Mol Sci 2024; 25:3748. [PMID: 38612559 PMCID: PMC11011575 DOI: 10.3390/ijms25073748] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
The cornea is an avascular, transparent tissue that allows light to enter the visual system. Accurate vision requires proper maintenance of the cornea's integrity and structure. Due to its exposure to the external environment, the cornea is prone to injury and must undergo proper wound healing to restore vision. Aquaporins (AQPs) are a family of water channels important for passive water transport and, in some family members, the transport of other small molecules; AQPs are expressed in all layers of the cornea. Although their functions as water channels are well established, the direct function of AQPs in the cornea is still being determined and is the focus of this review. AQPs, primarily AQP1, AQP3, and AQP5, have been found to play an important role in maintaining water homeostasis, the corneal structure in relation to proper hydration, and stress responses, as well as wound healing in all layers of the cornea. Due to their many functions in the cornea, the identification of drug targets that modulate the expression of AQPs in the cornea could be beneficial to promote corneal wound healing and restore proper function of this tissue crucial for vision.
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Affiliation(s)
- Samuel Melnyk
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Wendy B. Bollag
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
- Charlie Norwood Department of Veterans Affairs Medical Center, Augusta, GA 30904, USA
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Choudhary V, Choudhary M, Bollag WB. Exploring Skin Wound Healing Models and the Impact of Natural Lipids on the Healing Process. Int J Mol Sci 2024; 25:3790. [PMID: 38612601 PMCID: PMC11011291 DOI: 10.3390/ijms25073790] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Cutaneous wound healing is a complex biological process involving a series of well-coordinated events aimed at restoring skin integrity and function. Various experimental models have been developed to study the mechanisms underlying skin wound repair and to evaluate potential therapeutic interventions. This review explores the diverse array of skin wound healing models utilized in research, ranging from rodent excisional wounds to advanced tissue engineering constructs and microfluidic platforms. More importantly, the influence of lipids on the wound healing process is examined, emphasizing their role in enhancing barrier function restoration, modulating inflammation, promoting cell proliferation, and promoting remodeling. Lipids, such as phospholipids, sphingolipids, and ceramides, play crucial roles in membrane structure, cell signaling, and tissue repair. Understanding the interplay between lipids and the wound microenvironment provides valuable insights into the development of novel therapeutic strategies for promoting efficient wound healing and tissue regeneration. This review highlights the significance of investigating skin wound healing models and elucidating the intricate involvement of lipids in the healing process, offering potential avenues for improving clinical outcomes in wound management.
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Affiliation(s)
- Vivek Choudhary
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (V.C.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
| | - Mrunal Choudhary
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (V.C.)
| | - Wendy B. Bollag
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (V.C.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Dermatology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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Duchesne G, Xia D, Waller JL, Bollag WB, Mohammed A, Padala S, Kheda M, Taskar V, Weintraub NL, Young L, Baer SL. Risk factors and mortality in dialysis patients with abdominal aortic aneurysm: A retrospective cohort study. J Investig Med 2024; 72:287-293. [PMID: 38183213 DOI: 10.1177/10815589241226729] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
In the general population, abdominal aortic aneurysm (AAA) is synonymous with vascular disease and associated with increased mortality. Vascular disease is common in end-stage renal disease (ESRD) patients on dialysis, but there is limited information on AAA in this population. To address this issue, we queried the United States Renal Data System for risk factors associated with a diagnosis of AAA as well as the impact of AAA on ESRD patient survival. Incident dialysis patients from 2005 to 2014 with AAA and other clinical comorbidities were identified using ICD-9 and ICD-10 codes. Time to death was defined using the time from the start of dialysis to the date of death or to December 31, 2015. Cox proportional hazards (CPH) modeling was used to determine the adjusted hazard ratio (aHR) and 95% confidence intervals (CI) for death. From a total cohort of 820,826, we identified 21,631 subjects with a diagnosis of AAA. When compared to patients without AAA, AAA patients were older and more likely to be of white race and male gender, have a higher mean Charlson comorbidity index (CCI), have hypertension as the ESRD etiology, and use tobacco. Although a bivariate CPH model showed that AAA patients had an increased mortality risk compared to patients without the diagnosis, in the final CPH model, AAA patients had a decreased risk of mortality (aHR = 0.83, 95% CI 0.81-0.84) due to confounding with age. These results suggest that AAA is not associated with increased risk of death in ESRD patients after controlling for various demographic and clinical risk factors.
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Affiliation(s)
- Gabriela Duchesne
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Di Xia
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Mufaddal Kheda
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Varsha Taskar
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Neal L Weintraub
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
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Acree L, Day T, Groves MW, Waller JL, Bollag WB, Tran SY, Padala S, Baer SL. Deep neck space infections in end-stage renal disease patients: Prevalence and mortality. J Investig Med 2024; 72:220-232. [PMID: 38102746 DOI: 10.1177/10815589231222198] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Deep neck space infections (DNSI) are severe infections within the layers of neck fascia that are known to be associated with underlying immunocompromised states. Although uremia associated with kidney disease is known to cause immune system dysfunction, DNSI in patients with kidney disease has been poorly studied. This study investigated the prevalence of DNSI and the associated risk of mortality within the United States end-stage renal disease (ESRD) population, using a retrospective cohort study design and the United States Renal Data System database of patients (ages 18-100) who initiated dialysis therapy between 2005 and 2019. International Classification of Disease-9 and -10 codes were used to identify the diagnosis of DNSI and comorbid conditions. Of the 705,891 included patients, 2.2% had a diagnosis of DNSI. Variables associated with increased risk of DNSI were female sex, black compared to white race, catheter, or graft compared to arteriovenous fistula (AVF) access, autoimmune disease, chronic tonsillitis, diagnoses in the Charlson Comorbidity Index (CCI), tobacco use, and alcohol dependence. DNSI diagnosis was an independent risk factor for mortality, which was also associated with other comorbidity factors such as older age, catheter or graft compared to AVF access, comorbidities in the CCI, tobacco use, and alcohol dependence. Because of the increased mortality risk of DSNI in the ESRD population, health professionals should encourage good oral hygiene practices and smoking cessation, and they should closely monitor these patients to reduce poor outcomes.
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Affiliation(s)
- Lillian Acree
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Tyler Day
- Department of Dentistry, Dental College of Georgia, Augusta University, Augusta, GA, USA
| | - Michael W Groves
- Department of Otolaryngology - Head and Neck Surgery, Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Medicine Augusta University, Augusta, GA, USA
- Departments of Physiology, Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Sarah Y Tran
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
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Shah P, Hanson M, Waller JL, Tran S, Baer SL, Taskar V, Bollag WB. The Assessment of Infection Risk in Patients with Vitiligo Undergoing Dialysis for End-Stage Renal Disease: A Retrospective Cohort Study. Pathogens 2024; 13:94. [PMID: 38276167 PMCID: PMC10821439 DOI: 10.3390/pathogens13010094] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/16/2024] [Indexed: 01/27/2024] Open
Abstract
Vitiligo is an autoimmune condition that causes patchy skin depigmentation. Although the mechanism by which vitiligo induces immunocompromise is unclear, other related autoimmune diseases are known to predispose those affected to infection. Individuals with vitiligo exhibit epidermal barrier disruption, which could potentially increase their susceptibility to systemic infections; patients with renal disease also show a predisposition to infection. Nevertheless, there is little research addressing the risk of infection in dialysis patients with vitiligo in comparison to those without it. A retrospective analysis was performed on patients with end-stage renal disease (ESRD) in the United States Renal Data System who started dialysis between 2004 and 2019 to determine if ESRD patients with vitiligo are at an increased risk of bacteremia, cellulitis, conjunctivitis, herpes zoster, or septicemia. Multivariable logistic regression modeling indicated that female sex, black compared to white race, Hispanic ethnicity, hepatitis C infection, and tobacco use were associated with an enhanced risk of vitiligo, whereas increasing age and catheter, versus arteriovenous fistula, and access type were associated with a decreased risk. After controlling for demographics and clinical covariates, vitiligo was found to be significantly associated with an increased risk of bacteremia, cellulitis, and herpes zoster but not with conjunctivitis and septicemia.
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Affiliation(s)
- Pearl Shah
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
| | - Mitchell Hanson
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
| | - Jennifer L. Waller
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA;
| | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
| | - Stephanie L. Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
| | - Varsha Taskar
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
| | - Wendy B. Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (P.S.); (M.H.); (S.T.); (S.L.B.); (V.T.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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Acree L, Waller JL, Bollag WB, Healy WJ, Baer SL, Taskar V. Sleep apnea in end-stage renal disease patients: Impact on cardiovascular and neurological outcomes. J Postgrad Med 2024; 70:36-42. [PMID: 38197593 PMCID: PMC10947737 DOI: 10.4103/jpgm.jpgm_440_23] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/05/2023] [Accepted: 10/25/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Sleep apnea (SA) is an important comorbidity in end-stage renal disease (ESRD) patients. The association between SA and cardiac and neurological disease is known. This study investigates the relationship between SA and cardiovascular and cerebrovascular outcomes in the ESRD population. METHODS In a retrospective cohort study, the United States Renal Data System was queried to identify ESRD patients aged 18-100 years in whom hemodialysis had been initiated between 2005 and 2013. Diagnoses of SA and clinical comorbidities were determined from International Classification of Disease-9 codes. Demographic variables were obtained from Centers for Medicare and Medicaid Services Form-2728. Logistic regression was used to examine the association of SA with myocardial infarction (MI) or with stroke, controlling for demographic and clinical variables. RESULTS Of 858,131 subjects meeting the inclusion criteria, 587 had central SA, and 22,724 had obstructive SA. The SA cohort was younger, more likely to be male and Caucasian compared to the non-SA cohort. Patients with SA also had more tobacco and alcohol use, hypertension, heart failure, and diabetes. Central SA (aRR = 1.69, 95% CI = 1.28-2.23) and obstructive SA (aRR = 1.15, 95% CI = 1.09-1.21) were associated with an increased risk of stroke but not MI. CONCLUSION In the ESRD population, a diagnosis of central SA or obstructive SA increased the risk of stroke, but not MI. Early identification and treatment of SA in the ESRD population may help reduce the risk of stroke in these patients.
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Affiliation(s)
- L Acree
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - JL Waller
- Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - WB Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - WJ Healy
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - SL Baer
- Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - V Taskar
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
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Momin RI, Baer SL, Waller JL, Young L, Tran S, Taskar V, Bollag WB. Atopic Dermatitis and the Risk of Infection in End-Stage Renal Disease. Medicina (Kaunas) 2023; 59:2145. [PMID: 38138248 PMCID: PMC10744789 DOI: 10.3390/medicina59122145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Atopic dermatitis (AD), also known as eczema, is a common chronic inflammatory skin condition affecting 16.5 million adults in the United States. AD is characterized by an impaired epidermal barrier that can predispose individuals to infection. End-stage renal disease (ESRD) is also commonly complicated by infections due to chronic vascular access and immune-system dysfunction, possibly related to uremia. Multiple studies have reported that renal disease is a common comorbidity in adults with atopic dermatitis. The aim of this study was to determine whether AD is a risk factor for certain infections in patients with ESRD. Materials and Methods: Using the United States Renal Data System, a retrospective cohort analysis was conducted on adult ESRD patients initiating dialysis between 2004 and 2019 to investigate associations between infections and AD in this population. Results: Of 1,526,266 patients, 2290 were identified with AD (0.2%). Infectious outcomes of interest were bacteremia, septicemia, cellulitis, herpes zoster, and conjunctivitis. In all infectious outcomes except for conjunctivitis, patients with the infectious outcomes were more likely to carry a diagnosis of AD. After controlling for demographic and clinical covariates, AD was associated with an increased risk of cellulitis (adjusted relative risk (aRR) = 1.39, 95% confidence interval (CI) = 1.31-1.47) and herpes zoster (aRR = 1.67, CI = 1.44-1.94), but not with bacteremia (aRR = 0.96, CI = 0.89-1.05), septicemia (aRR = 1.02, CI = 0.98-1.08), or conjunctivitis (aRR = 0.97, CI = 0.740-1.34). Conclusions: Overall, after controlling for demographic and clinical covariates and adjusting for person-years-at-risk, AD was associated with an increased risk for some, but not all, infections within the population of patients with ESRD.
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Affiliation(s)
- Rushan I. Momin
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Stephanie L. Baer
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
- Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA
| | - Jennifer L. Waller
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Lufei Young
- School of Nursing at UNC Charlotte, University of North Carolina Charlotte, Charlotte, NC 28223, USA
| | - Sarah Tran
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Varsha Taskar
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
| | - Wendy B. Bollag
- Medical College of Georgia, Augusta University, Augusta, GA 30912, USA; (R.I.M.); (S.L.B.); (J.L.W.); (S.T.); (V.T.)
- Charlie Norwood Department, Veterans Affairs Medical Center, Augusta, GA 30904, USA
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Siddiquee N, Waller JL, Baer SL, Mohammed A, Tran S, Padala S, Young L, Kheda M, Bollag WB. Association of psoriasis and stroke in end-stage renal disease patients. Am J Med Sci 2023; 366:413-420. [PMID: 37716600 DOI: 10.1016/j.amjms.2023.09.014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 08/18/2023] [Accepted: 09/07/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Previous research in the general population suggests that the inflammatory skin disease psoriasis is associated with an increased risk of vascular events, such as stroke. Thus, psoriasis may also represent a risk factor for stroke in end-stage renal disease (ESRD) patients. METHODS We queried the United States Renal Data System for incident dialysis patients between 2004 and 2015. Psoriasis was defined as having at least two international classification of disease (ICD)-9 or ICD-10 diagnosis codes. ICD codes were also used to query the outcome of interest, stroke, as well as other clinical risk factors. Logistic regression was used to examine the association of psoriasis and other risk factors with stroke. RESULTS Of 966,399 ESRD patients, we identified 89,700 (9.3%) subjects with stroke and 6,286 (0.7%) with psoriasis. Of these psoriasis patients, 796 (0.9%) also had a stroke. Psoriasis was associated with an increased risk of stroke in an unadjusted model [odds ratio (OR)=1.16; 95% confidence interval (CI)=1.08-1.25]. However, after controlling for demographic and clinical risk factors, the final adjusted model showed that psoriasis was not associated with stroke (OR=0.96, CI=0.88-1.04). Congestive heart failure [adjusted OR of 1.79 (CI=1.75-1.83)] was a confounder of the association of psoriasis with stroke. CONCLUSIONS Contrary to prior research in the general population, psoriasis in ESRD patients was not associated with the risk of stroke after controlling for various demographic and clinical parameters. Our finding emphasizes the importance of controlling for a variety of factors in population studies examining associations of diseases and risk factors.
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Affiliation(s)
- Naomi Siddiquee
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, USA
| | | | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA.
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Abstract
With its unique anatomical location facing both the external and internal environment, the skin has crucial functions, including shielding the body from damage caused by ultraviolet radiation and chemicals, preventing water loss, acting as a primary barrier against pathogens, participating in metabolic processes like vitamin D production and temperature control and relaying information to the body through sensory and proprioceptor nerves. Like all organ systems, skin is known to undergo multiple changes with aging. A better understanding of the mechanisms that mediate aging-related skin dysfunction may allow the creation of targeted therapeutics that have beneficial effects not only on aged skin but also on other organs and tissues that experience a loss of or decline in function with aging. The skin is the largest organ of the body and can contribute to serum inflammatory mediator levels. One alteration known to occur with age is an impairment of skin barrier function; since disruption of the barrier is known to induce inflammation, skin may be a major contributor to the sustained, sub-clinical systemic inflammation associated with aging. Such "inflamm-aging" may underlie many of the deleterious changes observed in aged individuals. This review explores the role of age-related skin changes, skin inflammation and inflamm-aging.
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Affiliation(s)
- Rashi Agrawal
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
| | - Anne Hu
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
| | - Wendy B. Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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10
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Toth E, Waller JL, Bollag WB, Siddiqui B, Mohammed A, Kheda M, Padala S, Young L, Baer SL, Tran S. Non-tuberculous mycobacterial infections in patients with end-stage renal disease: Prevalence, risk factors, and mortality. J Investig Med 2023; 71:707-715. [PMID: 36202430 DOI: 10.1136/jim-2022-002462] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 01/06/2023]
Abstract
Non-tuberculous mycobacterial (NTM) disease has increased in prevalence in the USA, however, little is known on NTM in the population with end-stage renal disease (ESRD). Thus, we investigated patients with ESRD to determine risk factors for NTM disease and mortality. We queried the United States Renal Data System from 2005 to 2015 using International Classification of Diseases (ICD)-9/ICD-10 codes to identify NTM and risk factors. Logistic regression was used to examine the association of risk factors with NTM and Cox proportional hazards modeling was used to assess the association of NTM with mortality. Of 1,068,634 included subjects, 3232 (0.3%) individuals were identified with any NTM diagnosis. Hemodialysis versus peritoneal dialysis (OR=0.10, 95% CI=0.08 to 0.13) was protective for NTM, whereas black (OR=1.27, 95% CI=1.18 to 1.37) or other race compared with white race (OR=1.39, 95% CI=1.21 to 1.59) increased the risk of NTM. HIV (OR=15.71, 95% CI=14.24 to 17.33), history of any transplant (OR=4.25, 95% CI=3.93 to 4.60), kidney transplant (OR=3.00, 95% CI=2.75 to 3.27), diabetes (OR=1.32, 95% CI=1.23 to 1.43), rheumatologic disease (OR=1.92, 95% CI=1.77 to 2.08), and liver disease (OR=2.09, 95% CI=1.91 to 2.30) were associated with increased risk for NTM diagnosis. In multivariable analysis, there was a significant increase in mortality with any NTM diagnosis (HR=1.83, 95% CI=1.76 to 1.91, p≤0.0001). Controlling for relevant demographic and clinical risk factors, there was an increased risk of mortality associated with any diagnosis of NTM. Early diagnosis and treatment of NTM infection may improve survival in patients with ESRD.
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Affiliation(s)
- Eszter Toth
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Jennifer L Waller
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia, Augusta, Georgia, USA
- Research, Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Budder Siddiqui
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Mufaddal Kheda
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Lufei Young
- College of Nursing, Augusta University, Augusta, Georgia, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Infection Control, Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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11
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Smaha K, Mixson A, Waller JL, Bollag WB, Taskar V, Padala SA, Baer SL, Healy WJ. Demographic and clinical risk factors for diagnosis of sleep disorders in ESRD patients. Am J Med Sci 2023; 366:270-277. [PMID: 37454928 DOI: 10.1016/j.amjms.2023.07.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/24/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Sleep disturbances in patients with end-stage renal disease (ESRD) are common and more prevalent than in the general population. This study aims to assess the demographic and clinical risk factors for the diagnosis of sleep disorders in ESRD patients. METHODS This study is a retrospective analysis of the United States Renal Data System (USRDS) to evaluate risk factors for the diagnosis of sleep disorders, including hypersomnolence, insomnia, restless leg syndrome (RLS), or obstructive or central sleep apnea (OSA/CSA). All ESRD subjects enrolled in the USRDS between 2004-2015 were eligible for inclusion. The risk factors analyzed were age, race, sex, ethnicity, access type, dialysis modality, and the Charlson Comorbidity Index (CCI). All statistical analysis was performed using SAS 9.4, and statistical significance was assessed using an alpha level of 0.05. Descriptive statistics on all variables overall and by each sleep diagnosis were determined. RESULTS Increasing age, black race, other race, and Hispanic ethnicity were associated with decreased risk of each sleep diagnosis while CCI was associated with increased risk. Females were at increased risk of RLS and insomnia while males were at increased risk of OSA/CSA. Catheter and graft access decreased risk of RLS but increased risk of insomnia compared to AVF access. Catheter access increased risk of OSA/CSA compared to graft access. Hemodialysis increased risk of OSA/CSA compared to peritoneal dialysis. CONCLUSIONS Some ESRD patients are at an increased risk for diagnosis of sleep disorders based on age, race, sex, comorbid health conditions, and dialysis modality.
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Affiliation(s)
- Katlyn Smaha
- Medical College of Georgia School of Medicine at Augusta University, Augusta, GA, USA
| | - Andrew Mixson
- Medical College of Georgia School of Medicine at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Population Health Sciences at Augusta University, Augusta, GA United States
| | - Wendy B Bollag
- Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Varsha Taskar
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Augusta University, Augusta, GA, USA
| | - Sandeep Anand Padala
- Division of Nephrology, Department of Medicine, Augusta University, Augusta, GA, USA
| | | | - William J Healy
- Medical College of Georgia School of Medicine at Augusta University, Augusta, GA, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Augusta University, Augusta, GA, USA.
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12
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Tran SY, Barry S, Waller JL, Bollag WB, Young L, Padala S, Baer SL. Risk factors and mortality in patients with listeriosis and end-stage renal disease. Am J Med Sci 2023; 366:263-269. [PMID: 37331513 DOI: 10.1016/j.amjms.2023.06.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/16/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND End-stage renal disease (ESRD) is a known immunocompromising status that predisposes patients to developing infections. Disease from Listeria monocytogenes may affect any host but tends to be more severe in the immunocompromised. METHODS We used a large population of patients with ESRD to identify risk factors for listeriosis and mortality. Patients with a diagnosis of Listeria and other risk factors for listeriosis were identified using claims data from the United States Renal Data System database from 2004-2015. Demographic parameters and risk factors associated with Listeria were modeled using logistic regression while association with mortality was assessed with Cox Proportional Hazards modeling. RESULTS A diagnosis of Listeria was identified in 291 (0.01%) of a total 1,071,712 patients with ESRD. Cardiovascular disease, connective tissue disease, upper gastrointestinal ulcerative disease, liver disease, diabetes, cancer, and human immunodeficiency virus were all associated with an increased risk of Listeria. Patients with Listeria had an increased risk of death relative to patients without Listeria (adjusted hazard ratio=1.79; 95% confidence interval 1.52-2.10). CONCLUSIONS Incidence of listeriosis in our study population was over 7 times higher than what has been reported for the general population. The independent association of a Listeria diagnosis with increased mortality is also consistent with the disease's high mortality in the general population. Due to limitations with diagnosis, providers should maintain high clinical suspicion for listeriosis when patients with ESRD present with a compatible clinical syndrome. Further prospective study may help precisely quantify the increased risk of listeriosis in patients with ESRD.
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Affiliation(s)
- Sarah Y Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
| | - Sauveur Barry
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
| | - Jennifer L Waller
- Department of Population Health Science, Medical College of Georgia at Augusta University, Augusta, GA, USA.
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA.
| | - Lufei Young
- College of Nursing at Augusta University, Augusta, GA, USA.
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA; Charlie Norwood VA Medical Center, Augusta, GA, USA.
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13
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Sigman B, Linder DF, Waller JL, Bollag WB, Baer SL, Tran S, Kheda M, Young L, Mohammed A, Isales CM, Siddiqui B. Hashimoto's thyroiditis and renal transplant rejection. J Endocrinol Invest 2023; 46:2125-2132. [PMID: 37012521 DOI: 10.1007/s40618-023-02065-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/09/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Hashimoto's thyroiditis (HT) is a common autoimmune thyroid disorder that can disrupt thyroid function and homeostasis. As HT results from a dysregulated immune system, we hypothesized that these patients might be more susceptible to transplant failure; however, literature on this association is limited. The purpose of this study is to examine the association of HT with the risk of renal transplant failure. METHODS We utilized the United States Renal Database System dataset collected from 2005 to 2014 and compared the time from first renal transplant to transplant failure in end-stage renal disease (ESRD) patients with a HT diagnosis to ESRD patients without a HT diagnosis that underwent renal transplant. RESULTS A total of 144 ESRD patients had International Classification of Disease-9 claim codes for HT prior to renal transplant, amongst a total cohort of 90,301 renal transplant patients aged 18-100 and meeting criteria. Patients with HT were significantly more likely to be female, white, and to have a diagnosis of cytomegalovirus compared to patients without. ESRD patients with a HT diagnosis that underwent renal transplant had a significantly increased risk of renal transplant failure compared to those ESRD renal transplant patients without an HT diagnosis. There was a significantly increased adjusted hazard ratio for graft failure in patients with a HT diagnosis compared to those without. CONCLUSION Thyroid health and HT may play a significant role in the development of the increased risk of renal transplant failure observed in this study. Additional studies are needed to investigate the underlying mechanisms for this association.
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Affiliation(s)
- B Sigman
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - D F Linder
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - J L Waller
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - W B Bollag
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
- Charlie Norwood VA Medical Center, Augusta, GA, USA.
| | - S L Baer
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - S Tran
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - M Kheda
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
- Southwest Georgia Nephrology, Albany, GA, USA
| | - L Young
- College of Nursing at Augusta University, Augusta, GA, USA
| | - A Mohammed
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - C M Isales
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
| | - B Siddiqui
- Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA
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14
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Duchesne GA, Waller JL, Baer SL, Young L, Bollag WB. Pressure Ulcer Diagnosis Is Associated with Increased Mortality in Patients with End-Stage Renal Disease: A Retrospective Study. Life (Basel) 2023; 13:1713. [PMID: 37629570 PMCID: PMC10456114 DOI: 10.3390/life13081713] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Pressure ulcers are associated with multiple comorbidities and annually affect approximately 3 million Americans, directly accounting for approximately 60,000 deaths per year. Because patients with end-stage renal disease (ESRD) are known to present with unique factors which impair wound healing, pressure ulcers diagnosed in ESRD patients might independently increase the risk of mortality. To investigate the association between pressure ulcer diagnosis and mortality risk in the ESRD population, a retrospective analysis of the United States Renal Data System (USRDS) database was performed. The records of 1,526,366 dialysis patients who began therapy between 1 January 2005 and 31 December 2018 were included. Our analysis showed that the diagnosis of pressure ulcers in this population was independently associated with mortality even after controlling for confounding factors (p < 0.001). A Kaplan-Meier survival analysis demonstrated reduced survival in patients with a pressure ulcer diagnosis compared to those without a pressure ulcer diagnosis. These results establish pressure ulcers as a significant independent risk factor for mortality, as well as suggesting several comorbidities as potential risk factors for pressure ulcers in the ESRD population.
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Affiliation(s)
- Gabriela A. Duchesne
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (G.A.D.); (S.L.B.)
| | - Jennifer L. Waller
- Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA;
| | - Stephanie L. Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (G.A.D.); (S.L.B.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA 30912, USA
| | - Wendy B. Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (G.A.D.); (S.L.B.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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15
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Luo Y, Vivaldi Marrero E, Choudhary V, Bollag WB. Phosphatidylglycerol to Treat Chronic Skin Wounds in Diabetes. Pharmaceutics 2023; 15:1497. [PMID: 37242739 PMCID: PMC10222993 DOI: 10.3390/pharmaceutics15051497] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/02/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
This review proposes the use of dioleoylphosphatidylglycerol (DOPG) to enhance diabetic wound healing. Initially, the characteristics of diabetic wounds are examined, focusing on the epidermis. Hyperglycemia accompanying diabetes results in enhanced inflammation and oxidative stress in part through the generation of advanced glycation end-products (AGEs), in which glucose is conjugated to macromolecules. These AGEs activate inflammatory pathways; oxidative stress results from increased reactive oxygen species generation by mitochondria rendered dysfunctional by hyperglycemia. These factors work together to reduce the ability of keratinocytes to restore epidermal integrity, contributing to chronic diabetic wounds. DOPG has a pro-proliferative action on keratinocytes (through an unclear mechanism) and exerts an anti-inflammatory effect on keratinocytes and the innate immune system by inhibiting the activation of Toll-like receptors. DOPG has also been found to enhance macrophage mitochondrial function. Since these DOPG effects would be expected to counteract the increased oxidative stress (attributable in part to mitochondrial dysfunction), decreased keratinocyte proliferation, and enhanced inflammation that characterize chronic diabetic wounds, DOPG may be useful in stimulating wound healing. To date, efficacious therapies to promote the healing of chronic diabetic wounds are largely lacking; thus, DOPG may be added to the armamentarium of drugs to enhance diabetic wound healing.
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Affiliation(s)
- Yonghong Luo
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (Y.L.); (E.V.M.); (V.C.)
| | - Edymarie Vivaldi Marrero
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (Y.L.); (E.V.M.); (V.C.)
| | - Vivek Choudhary
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (Y.L.); (E.V.M.); (V.C.)
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, GA 30904, USA
| | - Wendy B. Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (Y.L.); (E.V.M.); (V.C.)
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, GA 30904, USA
- Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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16
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Spaulding SC, Choudhary V, Bollag WB. Phospholipase D mediates very low-density lipoprotein-induced aldosterone production, in part, via lipin-1. J Mol Endocrinol 2023; 70:e220196. [PMID: 36779781 DOI: 10.1530/jme-22-0196] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/13/2023] [Indexed: 02/14/2023]
Abstract
Aldosterone is considered to be a link between hypertension and obesity; obese individuals have high serum levels of very low-density lipoprotein (VLDL). VLDL has been shown to induce aldosterone production in multiple adrenal zona glomerulosa models, mediated in part by phospholipase D (PLD). PLD is an enzyme that hydrolyzes phosphatidylcholine to produce phosphatidic acid (PA), a lipid second messenger that can also be dephosphorylated by lipin to yield diacylglycerol (DAG), yet another lipid signal. However, it is unclear which of the two lipid second messengers, PA or DAG, underlies PLD's mediation of aldosterone production. We hypothesized that the key signal produced by PLD (indirectly) is DAG such that PLD mediates VLDL-induced aldosterone production via lipin-mediated metabolism of PA to DAG. To assess the role of lipin in VLDL-induced aldosterone production, lipin-1 was overexpressed (using an adenovirus) or inhibited (using propranolol) in HAC15 cells followed by treatment with or without VLDL. Lipin-1 overexpression enhanced the VLDL-stimulated increase in CYP11B2 expression (by 75%), and lipin-1 inhibition decreased the VLDL-stimulated increase in CYP11B2 expression (by 66%). Similarly, the VLDL-stimulated increase in aldosterone production was enhanced by lipin-1 overexpression (182%) and was decreased by lipin inhibition (80%). Our results are suggestive of DAG being the key lipid signal since manipulating lipin-1 levels/activity affects VLDL-stimulated steroidogenic gene expression and ultimately, aldosterone production. Our study warrants further investigation into VLDL-stimulated steroidogenic signaling pathways which may lead to the identification of novel therapeutic targets, such as lipin-1 and its downstream pathways, to potentially treat obesity-associated hypertension.
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Affiliation(s)
- Shinjini C Spaulding
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Vivek Choudhary
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
- Charlie Norwood VA Medical Center, Augusta, Georgia, USA
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17
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Siddiquee N, Waller JL, Baer SL, Mohammed A, Tran S, Siddiqui B, Padala S, Young L, Kheda M, Bollag WB. Association of psoriasis with myocardial infarction in end-stage renal disease patients. Am J Med Sci 2023; 365:329-336. [PMID: 36030899 DOI: 10.1016/j.amjms.2022.08.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/29/2022] [Accepted: 08/09/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Previous research in non-dialysis patients suggests that the inflammatory skin disease psoriasis is associated with an increased risk of severe vascular events like myocardial infarction (MI). Thus, we determined whether psoriasis represents a significant risk factor for MI in end-stage renal disease (ESRD) patients. METHODS We queried the United States Renal Data System for ESRD patients starting dialysis between 2004 and 2015. ICD-9 and ICD-10 codes were used to identify those with at least two diagnoses of psoriasis, a diagnosis of MI, and other clinical risk factors. Logistic regression was used to examine the association of psoriasis and various risk factors with MI. RESULTS Of a cohort of 1,062,693, we identified 6823 (0.6%) subjects with psoriasis and 181,960 (17.1%) with MI. Of the 6823 patients with psoriasis, 1671 (24%) developed an MI. Psoriasis was associated with an increased risk of MI in an unadjusted model [odds ratio (OR) = 1.34; confidence interval (CI) = 1.26-1.42]. However, after controlling for demographics, dialysis modality, access type, and various conditions related to the Charlson Comorbidity Index, psoriasis was not associated with MI (OR = 0.95, CI = 0.89-1.01). Confounders of the association of psoriasis with MI included congestive heart failure (OR = 5.26, CI = 5.17-5.36), pulmonary disease (OR = 1.25, CI = 1.23-1.26), and diabetes with complications (OR = 1.82, CI = 1.79-1.85). CONCLUSIONS Contrary to prior research in the general population, in the ESRD population psoriasis was not associated with an increased risk of MI after controlling for various demographic and clinical parameters. These data emphasize the importance of an integrated approach since comorbidities may influence the choice of therapy for psoriasis and outcomes.
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Affiliation(s)
- Naomi Siddiquee
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jennifer L Waller
- Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Stephanie L Baer
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Azeem Mohammed
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sarah Tran
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Budder Siddiqui
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sandeep Padala
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA, United States
| | | | - Wendy B Bollag
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, United States; Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States.
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18
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Prabu P, Acree L, Waller JL, Linder DF, Bollag WB, Mohammed A, Padala S, Healy W, Kheda M, Baer SL, Dillard T, Taskar V. Sleep apnea in end-stage renal disease patients: risk factors and mortality. J Investig Med 2023; 71:465-470. [PMID: 36945195 DOI: 10.1177/10815589231162541] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Sleep apnea (SA) is highly prevalent in the end-stage renal disease (ESRD) population. However, the impact of SA on mortality in ESRD is unclear. This study investigates the relationship between SA and mortality in ESRD. The United States Renal Data System was queried in a retrospective cohort study to identify ESRD patients aged 18-100 years who initiated hemodialysis between 2005 and 2013. Diagnoses of SA and comorbidities were determined from International Classification of Disease-9 codes and demographic variables from Centers for Medicare and Medicaid Services Form-2728. Cox proportional hazards models were used to examine the association of SA with mortality controlling for multiple variables. Of 858,131 subjects meeting inclusion criteria, 587 were found to have central SA (CSA) and 22,724 obstructive SA (OSA). The SA cohort was younger and more likely to be male and Caucasian compared to the non-SA cohort, with more diagnoses of tobacco and alcohol use, hypertension, heart failure, and diabetes. Both CSA (adjusted hazard ratio (aHR) = 1.42, 95% confidence interval (CI): 1.29-1.56) and OSA (aHR = 1.35, 95% CI: 1.32-1.37) were associated with increased mortality. Other variables associated with increased mortality included age, dialysis initiation with a catheter or graft, alcohol use, hypertension, and cardiovascular disease. Factors associated with decreased mortality included female sex, black race, Hispanic ethnicity, diagnosis of heart failure or diabetes, and an ESRD etiology of glomerulonephritis or polycystic kidney disease. Since a diagnosis of either OSA or CSA increases mortality risk, early identification of SA and therapy in this ESRD population may improve survival.
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Affiliation(s)
- Pranav Prabu
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Lillian Acree
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Jennifer L Waller
- Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Daniel F Linder
- Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Azeem Mohammed
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Sandeep Padala
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - William Healy
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Mufaddal Kheda
- Southwest Georgia Nephrology, Medical College of Georgia at Augusta University, Albany, GA, USA
| | - Stephanie L Baer
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Thomas Dillard
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Varsha Taskar
- Departments of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA
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19
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Fowler TE, Choudhary V, Melnyk S, Farsi M, Chang LY, Fortingo N, Chen X, Watsky MA, Bollag WB. Dioleoylphosphatidylglycerol Inhibits Heat Shock Protein B4 (HSPB4)-Induced Inflammatory Pathways In Vitro. Int J Mol Sci 2023; 24:5839. [PMID: 36982926 PMCID: PMC10059050 DOI: 10.3390/ijms24065839] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 03/22/2023] Open
Abstract
Our previous work shows that dioleoylphosphatidylglycerol (DOPG) accelerates corneal epithelial healing in vitro and in vivo by unknown mechanisms. Prior data demonstrate that DOPG inhibits toll-like receptor (TLR) activation and inflammation induced by microbial components (pathogen-associated molecular patterns, PAMPs) and by endogenous molecules upregulated in psoriatic skin, which act as danger-associated molecular patterns (DAMPs) to activate TLRs and promote inflammation. In the injured cornea, sterile inflammation can result from the release of the DAMP molecule, heat shock protein B4 (HSPB4), to contribute to delayed wound healing. Here, we show in vitro that DOPG inhibits TLR2 activation induced in response to HSPB4, as well as DAMPs that are elevated in diabetes, a disease that also slows corneal wound healing. Further, we show that the co-receptor, cluster of differentiation-14 (CD14), is necessary for PAMP/DAMP-induced activation of TLR2, as well as of TLR4. Finally, we simulated the high-glucose environment of diabetes to show that elevated glucose levels enhance TLR4 activation by a DAMP known to be upregulated in diabetes. Together, our results demonstrate the anti-inflammatory actions of DOPG and support further investigation into its development as a possible therapy for corneal injury, especially in diabetic patients at high risk of vision-threatening complications.
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Affiliation(s)
- Teresa E. Fowler
- Department of Ophthalmology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Vivek Choudhary
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
| | - Samuel Melnyk
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Mishma Farsi
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Luke Y. Chang
- Department of Ophthalmology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Nyemkuna Fortingo
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Xunsheng Chen
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Mitchell A. Watsky
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
| | - Wendy B. Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Cellular Biology and Anatomy, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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20
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Jung J, Waller JL, Tran S, Baer SL, Kheda M, Mohammed A, Padala S, Young L, Siddiqui B, Bollag WB. Cutaneous squamous cell carcinoma and mortality in end-stage renal disease. Am J Med Sci 2023; 365:249-257. [PMID: 36403674 DOI: 10.1016/j.amjms.2022.10.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/08/2022] [Accepted: 10/12/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND In the general population, cutaneous squamous cell carcinoma (cSCC) is associated with increased all-cause mortality. Transplant patients have been shown to have an increased risk of developing cSCC, and their cSCC is associated with an increased risk for mortality. In end-stage renal disease (ESRD) patients, there is extensive mortality and immune dysfunction. Because of this immune system dysfunction, we examined whether cSCC is associated with increased risk of all-cause mortality among ESRD patients, as well as the risk factors for cSCC. METHODS We analyzed ESRD patients in the United States Renal Data System from 2004-2014, excluding organ transplant recipients. We assessed mortality using a Cox Proportional Hazards (CPH) model to control for various demographic and clinical parameters, identified using international classification of diseases (ICD)-9 codes. RESULTS Of the 1,035,193 patients included, 624 (0.1%) were diagnosed with cSCC. The median survival time for those with cSCC was 3.91 years [95% confidence interval (CI) = 3.67-4.15], versus 2.92 years [95%CI = 2.92-2.93] for patients without cSCC. ESRD patients with cSCC were at lower risk of death [adjusted hazard ratio = 0.75; 95%CI = 0.69-0.82] compared to those without. Decreased risk of death was also associated with parameters such as black race, Hispanic ethnicity, tobacco dependence and actinic keratosis. Increased mortality risk was associated with increasing age, male sex, hemodialysis (versus peritoneal dialysis) and alcohol dependence. CONCLUSIONS Contrary to expectations, ESRD patients with a cSCC diagnosis showed reduced all-cause mortality risk relative to those without. The reason for this discrepancy remains unclear, suggesting the need for further study.
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Affiliation(s)
- Joo Jung
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jennifer L Waller
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sarah Tran
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Stephanie L Baer
- Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States
| | - Mufaddal Kheda
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Azeem Mohammed
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Sandeep Padala
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Lufei Young
- College of Nursing at Augusta University, Augusta, GA, United States
| | - Budder Siddiqui
- Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Wendy B Bollag
- Medical College of Georgia at Augusta University, Augusta, GA, United States; Charlie Norwood VA Medical Center, Augusta, GA, United States.
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21
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Bensreti H, Alhamad DW, Gonzalez AM, Pizarro-Mondesir M, Bollag WB, Isales CM, McGee-Lawrence ME. Update on the Role of Glucocorticoid Signaling in Osteoblasts and Bone Marrow Adipocytes During Aging. Curr Osteoporos Rep 2023; 21:32-44. [PMID: 36564571 PMCID: PMC9936962 DOI: 10.1007/s11914-022-00772-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW Bone marrow adipose tissue (BMAT) in the skeleton likely plays a variety of physiological and pathophysiological roles that are not yet fully understood. In elucidating the complex relationship between bone and BMAT, glucocorticoids (GCs) are positioned to play a key role, as they have been implicated in the differentiation of bone marrow mesenchymal stem cells (BMSCs) between osteogenic and adipogenic lineages. The purpose of this review is to illuminate aspects of both endogenous and exogenous GC signaling, including the influence of GC receptors, in mechanisms of bone aging including relationships to BMAT. RECENT FINDINGS Harmful effects of GCs on bone mass involve several cellular pathways and events that can include BMSC differentiation bias toward adipogenesis and the influence of mature BMAT on bone remodeling through crosstalk. Interestingly, BMAT involvement remains poorly explored in GC-induced osteoporosis and warrants further investigation. This review provides an update on the current understanding of the role of glucocorticoids in the biology of osteoblasts and bone marrow adipocytes (BMAds).
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Affiliation(s)
- Husam Bensreti
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Dima W Alhamad
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Alejandro Marrero Gonzalez
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Manuel Pizarro-Mondesir
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Meghan E McGee-Lawrence
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, USA.
- Department of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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22
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Fortingo N, Melnyk S, Sutton SH, Watsky MA, Bollag WB. Innate Immune System Activation, Inflammation and Corneal Wound Healing. Int J Mol Sci 2022; 23:ijms232314933. [PMID: 36499260 PMCID: PMC9740891 DOI: 10.3390/ijms232314933] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022] Open
Abstract
Corneal wounds resulting from injury, surgeries, or other intrusions not only cause pain, but also can predispose an individual to infection. While some inflammation may be beneficial to protect against microbial infection of wounds, the inflammatory process, if excessive, may delay corneal wound healing. An examination of the literature on the effect of inflammation on corneal wound healing suggests that manipulations that result in reductions in severe or chronic inflammation lead to better outcomes in terms of corneal clarity, thickness, and healing. However, some acute inflammation is necessary to allow efficient bacterial and fungal clearance and prevent corneal infection. This inflammation can be triggered by microbial components that activate the innate immune system through toll-like receptor (TLR) pathways. In particular, TLR2 and TLR4 activation leads to pro-inflammatory nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB) activation. Similarly, endogenous molecules released from disrupted cells, known as damage-associated molecular patterns (DAMPs), can also activate TLR2, TLR4 and NFκB, with the resultant inflammation worsening the outcome of corneal wound healing. In sterile keratitis without infection, inflammation can occur though TLRs to impact corneal wound healing and reduce corneal transparency. This review demonstrates the need for acute inflammation to prevent pathogenic infiltration, while supporting the idea that a reduction in chronic and/or excessive inflammation will allow for improved wound healing.
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Affiliation(s)
- Nyemkuna Fortingo
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
| | - Samuel Melnyk
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
| | - Sarah H. Sutton
- Department of Medical Illustration, Augusta University, Augusta, GA 30907, USA
| | - Mitchell A. Watsky
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
| | - Wendy B. Bollag
- Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
- James and Jean Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30907, USA
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Correspondence: ; Tel.: +61-(706)-721-0698
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23
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Morgan MC, Waller JL, Bollag WB, Baer SL, Tran S, Kheda MF, Young L, Padala S, Siddiqui B, Mohammed A. Association of intermittent versus continuous hemodialysis modalities with mortality in the setting of acute stroke among patients with end-stage renal disease. J Investig Med 2022; 70:1513-1519. [PMID: 35680177 DOI: 10.1136/jim-2022-002439] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2022] [Indexed: 11/03/2022]
Abstract
Patients with end-stage renal disease (ESRD) are 8-10 times more likely to suffer from a stroke compared with the general public. Despite this risk, there are minimal data elucidating which hemodialysis modality is best for patients with ESRD following a stroke, and guidelines for their management are lacking. We retrospectively queried the US Renal Data System administrative database for all-cause mortality in ESRD stroke patients who received either intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). Acute ischemic stroke and hemorrhagic stroke were identified using the International Classification of Diseases 9th Revision (ICD-9)/ICD-10 codes, and hemodialysis modality was determined using Healthcare Common Procedure Coding System (HCPCS) codes. Time to death from the first stroke diagnosis was the outcome of interest. Cox proportional hazards modeling was used, and associations were expressed as adjusted HRs. From the inclusion cohort of 87,910 patients, 92.9% of patients received IHD while 7.1% of patients received CRRT. After controlling for age, race, sex, ethnicity, and common stroke risk factors such as hypertension, diabetes, tobacco use, atrial fibrillation, and hyperlipidemia, those who were placed on CRRT within 7 days of a stroke had an increased risk of death compared with those placed on IHD (HR=1.28, 95% CI 1.25 to 1.32). It is possible that ESRD stroke patients who received CRRT are more critically ill. However, even when the cohort was limited to only those patients in the intensive care unit and additional risk factors for mortality were controlled for, CRRT was still associated with an increased risk of death (HR=1.32, 95% CI 1.27 to 1.37). Therefore, further prospective clinical trials are warranted to address these findings.
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Affiliation(s)
- Michael C Morgan
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Jennifer L Waller
- Department of Population Health Science, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA .,Research, Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.,Infection Control and Epidemiology, Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | | | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, Georgia, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Budder Siddiqui
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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24
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Agrawal R, Bollag WB. De(C1P)hering the Role of Ceramide-1-Phosphate Levels in Skin Wound Healing. J Lipid Res 2022; 63:100231. [PMID: 35595160 PMCID: PMC9254447 DOI: 10.1016/j.jlr.2022.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Rashi Agrawal
- Department of Physiology, Augusta University, Augusta, GA 30912, USA
| | - Wendy B Bollag
- Department of Physiology, Augusta University, Augusta, GA 30912, USA; Charlie Norwood VA Medical Center, Augusta, GA 30904, USA; Department of Dermatology, Augusta University, Augusta, GA 30912, USA; Department of Medicine, Augusta University, Augusta, GA 30912, USA.
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25
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Spaulding SC, Choudhary V, Kaddour‐Djebbar I, Bollag WB. Phospholipase D2 Loss Impairs Low Salt‐Induced Increases in Steroidogenic Gene Expression with No Effect on Serum Aldosterone Levels. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.0r861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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26
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Spaulding SC, Choudhary V, Choudhary M, Chen X, Bollag WB. Very Low‐Density Lipoprotein (VLDL) Signals Through Sphingosine‐1‐Phosphate Receptor 1, Upon Binding to VLDL Receptor, to Induce Aldosterone Synthesis and Secretion in Human Adrenocortical Cells. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r6078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Vivek Choudhary
- PhysiologyAugusta UniversityAugustaGA
- Augusta UniversityAugustaGA
| | | | - Xunsheng Chen
- PhysiologyAugusta UniversityAugustaGA
- Augusta UniversityAugustaGA
| | - Wendy B. Bollag
- PhysiologyAugusta UniversityAugustaGA
- Augusta UniversityAugustaGA
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27
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Irsik DL, Bollag WB, Isales CM. Kynurenine Infusion Disrupts Normal Blood Pressure Circadian Rhythms. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r5235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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28
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Ortiz-Lopez LI, Choudhary V, Bollag WB. Updated Perspectives on Keratinocytes and Psoriasis: Keratinocytes are More Than Innocent Bystanders. Psoriasis (Auckl) 2022; 12:73-87. [PMID: 35529056 PMCID: PMC9075909 DOI: 10.2147/ptt.s327310] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/08/2022] [Indexed: 02/02/2023]
Abstract
Psoriasis is a complex disease triggered by genetic, immunologic, and environmental stimuli. Many genes have been linked to psoriasis, like the psoriasis susceptibility genes, some of which are critical in keratinocyte biology and epidermal barrier function. Still, the exact pathogenesis of psoriasis is unknown. In the disease, the balance between the proliferative and differentiative processes of keratinocytes becomes altered. Multiple studies have highlighted the role of dysregulated immune cells in provoking the inflammatory responses seen in psoriasis. In addition to immune cells, accumulating evidence shows that keratinocytes are involved in psoriasis pathogenesis, as discussed in this review. Although certain immune cell-derived factors stimulate keratinocyte hyperproliferation, activated keratinocytes can also produce anti-microbial peptides, cytokines, and chemokines that can promote their proliferation, as well as recruit immune cells to help initiate and reinforce inflammatory feedback loops. Psoriatic keratinocytes also show intrinsic differences from normal keratinocytes even after removal from the in vivo inflammatory environment; thus, psoriatic keratinocytes have been found to exhibit abnormal calcium metabolism and possible epigenetic changes that contribute to psoriasis. The Koebner phenomenon, in which injury promotes the development of psoriatic lesions, also provides evidence for keratinocytes' contributions to disease pathogenesis. Furthermore, transgenic mouse studies have confirmed the importance of keratinocytes in the etiology of psoriasis. Finally, in addition to immune cells and keratinocytes, data in the literature support roles for other cell types, tissues, and systems in psoriasis development. These other contributors are all potential targets for therapies, suggesting the importance of a holistic approach when treating psoriasis.
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Affiliation(s)
- Laura I Ortiz-Lopez
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA,Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA
| | - Vivek Choudhary
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA,Charlie Norwood VA Medical Center, Augusta, GA, 30904, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA,Charlie Norwood VA Medical Center, Augusta, GA, 30904, USA,Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA,Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, 30912, USA,Correspondence: Wendy B Bollag, Department of Physiology, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA, Tel +1 706 721-0698, Fax +1 706 721-7299, Email
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29
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Spaulding SC, Bollag WB. The role of lipid second messengers in aldosterone synthesis and secretion. J Lipid Res 2022; 63:100191. [PMID: 35278411 PMCID: PMC9020094 DOI: 10.1016/j.jlr.2022.100191] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Second messengers are small rapidly diffusing molecules or ions that relay signals between receptors and effector proteins to produce a physiological effect. Lipid messengers constitute one of the four major classes of second messengers. The hydrolysis of two main classes of lipids, glycerophospholipids and sphingolipids, generate parallel profiles of lipid second messengers: phosphatidic acid (PA), diacylglycerol (DAG), and lysophosphatidic acid versus ceramide, ceramide-1-phosphate, sphingosine, and sphingosine-1-phosphate, respectively. In this review, we examine the mechanisms by which these lipid second messengers modulate aldosterone production at multiple levels. Aldosterone is a mineralocorticoid hormone responsible for maintaining fluid volume, electrolyte balance, and blood pressure homeostasis. Primary aldosteronism is a frequent endocrine cause of secondary hypertension. A thorough understanding of the signaling events regulating aldosterone biosynthesis may lead to the identification of novel therapeutic targets. The cumulative evidence in this literature emphasizes the critical roles of PA, DAG, and sphingolipid metabolites in aldosterone synthesis and secretion. However, it also highlights the gaps in our knowledge, such as the preference for phospholipase D-generated PA or DAG, as well as the need for further investigation to elucidate the precise mechanisms by which these lipid second messengers regulate optimal aldosterone production.
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Affiliation(s)
- Shinjini C Spaulding
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, USA; Research Department, Charlie Norwood VA Medical Center, Augusta, GA, USA.
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30
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Aitkens L, Waller JL, Baer SL, Mohammed A, Tran S, Siddiqui B, Padala S, Young L, Kheda M, Bollag WB. Psoriasis and Pneumonia in the End-stage Renal Disease Population. Am J Med Sci 2022; 364:29-35. [DOI: 10.1016/j.amjms.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/21/2021] [Accepted: 03/08/2022] [Indexed: 12/01/2022]
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31
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Choudhary V, Ajebo E, Uaratanawong R, Spaulding SC, Hossack S, Chen X, Xu J, Choudhary M, Irsik DL, Isales CM, Bollag WB. Loss of Indoleamine-2,3-Dioxygenase-1 (IDO1) in Knockout Mice Does Not Affect the Development of Skin Lesions in the Imiquimod-Induced Mouse Model of Psoriasis. Int J Tryptophan Res 2022; 15:11786469221078191. [PMID: 35250276 PMCID: PMC8891896 DOI: 10.1177/11786469221078191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022] Open
Abstract
Indoleamine-2,3-dioxygenase (IDO) degrades the essential amino acid tryptophan resulting in tryptophan depletion and the accumulation of catabolites such as kynurenine. The expression/activity of IDO in various cells, including macrophages and dendritic cells, results in an inhibition of T-cell responses in a number of situations, such as toward allogeneic fetuses and tissue grafts. Psoriasis is an immune-mediated skin disease involving T cells; kynureninase and its generation of catabolites downstream of IDO are reported to play an important role in this disease. We hypothesized that mice lacking the IDO1 gene would exhibit a hyperactive immune response and an exacerbation of skin lesions in the imiquimod-induced mouse model of psoriasis. Littermate wild-type and IDO1-knockout mice were treated with imiquimod for 5 days, and the severity of psoriasiform skin lesions assessed using the psoriasis area and severity index (PASI), ear edema measured using a digital caliper, and thickness of the epidermis determined by histology. Expression of pro-inflammatory mediators and tryptophan-metabolizing enzymes was monitored using quantitative RT-PCR. Imiquimod increased ear edema, PASI scores, and epidermal thickness in both WT and IDO1 knockout mice; however, there were no differences observed between the 2 genotypes. There were also no differences in imiquimod’s induction of skin inflammatory mediators, indicating no effect of IDO1 gene loss in this psoriasis model. Although these data suggest a lack of involvement of IDO1 in psoriatic skin inflammation, other possible mechanisms, such as compensatory changes in other pathways and the involvement of the IDO2 isoform, must also be considered.
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Affiliation(s)
- Vivek Choudhary
- Charlie Norwood VA Medical Center, Augusta, GA, USA
- Department of Physiology, Medical College of Georgia at Augusta University, USA
| | - Etsubdenk Ajebo
- Department of Dermatology, Medical College of Georgia at Augusta University, USA
| | - Rawipan Uaratanawong
- Department of Physiology, Medical College of Georgia at Augusta University, USA
- Department of Medicine (Dermatology), Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | | | - Sarah Hossack
- Department of Physiology, Medical College of Georgia at Augusta University, USA
| | - Xunsheng Chen
- Charlie Norwood VA Medical Center, Augusta, GA, USA
- Department of Physiology, Medical College of Georgia at Augusta University, USA
| | - Jianrui Xu
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, USA
| | - Mrunal Choudhary
- Department of Physiology, Medical College of Georgia at Augusta University, USA
| | - Debra L Irsik
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, USA
| | - Carlos M Isales
- Departments of Medicine and of Neuroscience and Regenerative Medicine, Medical College of Georgia at Augusta University, USA
| | - Wendy B Bollag
- Charlie Norwood VA Medical Center, Augusta, GA, USA
- Departments of Physiology, of Dermatology and of Medicine, Medical College of Georgia at Augusta University, USA
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32
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Pierce JL, Sharma AK, Roberts RL, Yu K, Irsik DL, Choudhary V, Dorn JS, Bensreti H, Benson RD, Kaiser H, Khayrullin A, Davis C, Wehrle CJ, Johnson MH, Bollag WB, Hamrick MW, Shi X, Isales CM, McGee-Lawrence ME. The Glucocorticoid Receptor in Osterix-Expressing Cells Regulates Bone Mass, Bone Marrow Adipose Tissue, and Systemic Metabolism in Female Mice During Aging. J Bone Miner Res 2022; 37:285-302. [PMID: 34747055 PMCID: PMC9976194 DOI: 10.1002/jbmr.4468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/23/2021] [Accepted: 10/17/2021] [Indexed: 12/18/2022]
Abstract
Hallmarks of aging-associated osteoporosis include bone loss, bone marrow adipose tissue (BMAT) expansion, and impaired osteoblast function. Endogenous glucocorticoid levels increase with age, and elevated glucocorticoid signaling, associated with chronic stress and dysregulated metabolism, can have a deleterious effect on bone mass. Canonical glucocorticoid signaling through the glucocorticoid receptor (GR) was recently investigated as a mediator of osteoporosis during the stress of chronic caloric restriction. To address the role of the GR in an aging-associated osteoporotic phenotype, the current study utilized female GR conditional knockout (GR-CKO; GRfl/fl :Osx-Cre+) mice and control littermates on the C57BL/6 background aged to 21 months and studied in comparison to young (3- and 6-month-old) mice. GR deficiency in Osx-expressing cells led to low bone mass and BMAT accumulation that persisted with aging. Surprisingly, however, GR-CKO mice also exhibited alterations in muscle mass (reduced % lean mass and soleus fiber size), accompanied by reduced voluntary physical activity, and also exhibited higher whole-body metabolic rate and elevated blood pressure. Moreover, increased lipid storage was observed in GR-CKO osteoblastic cultures in a glucocorticoid-dependent fashion despite genetic deletion of the GR, and could be reversed via pharmacological inhibition of the mineralocorticoid receptor (MR). These findings provide evidence of a role for the GR (and possibly the MR) in facilitating healthy bone maintenance with aging in females. The effects of GR-deficient bone on whole-body physiology also demonstrate the importance of bone as an endocrine organ and suggest evidence for compensatory mechanisms that facilitate glucocorticoid signaling in the absence of osteoblastic GR function; these represent new avenues of research that may improve understanding of glucocorticoid signaling in bone toward the development of novel osteogenic agents. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Jessica L Pierce
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Anuj K Sharma
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Rachel L Roberts
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Kanglun Yu
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Debra L Irsik
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA.,Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Vivek Choudhary
- Department of Physiology, Augusta University, Augusta, GA, USA
| | - Jennifer S Dorn
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Husam Bensreti
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Reginald D Benson
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Helen Kaiser
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Andrew Khayrullin
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Colleen Davis
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Chase J Wehrle
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Maribeth H Johnson
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Wendy B Bollag
- Charlie Norwood VA Medical Center, Augusta, GA, USA.,Department of Physiology, Augusta University, Augusta, GA, USA
| | - Mark W Hamrick
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Xingming Shi
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Meghan E McGee-Lawrence
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA.,Department of Orthopaedic Surgery, Augusta University, Augusta, GA, USA
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33
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Downey MR, Taskar V, Linder DF, Baer SL, Waller JL, Bollag WB, Kheda M, Mohammed A, Padala S. Incidence and risk factors for mucormycosis in renal transplant patients. J Investig Med 2021; 70:396-401. [PMID: 34799422 DOI: 10.1136/jim-2021-001933] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Renal transplant patients are at increased risk for mucormycosis. Diabetes, neutropenia, deferoxamine therapy, and immunosuppressive medications have been associated with increased risk of mucormycosis in studies of solid organ transplant recipients. To focus on renal transplant patients, the US Renal Data System (USRDS) was queried to determine the incidence and risk factors for mucormycosis. METHODS All renal transplant patients in the USRDS from 1988 to 2015 were queried for a diagnosis of mucormycosis after the first transplant date using ICD-9 and ICD-10 codes. The International Classification of Diseases (ICD) codes, which currently exist in the ninth and tenth revisions, are a global system of classification used to code diagnoses, procedures, and symptoms. We defined proven mucormycosis by a histopathologic or fungal stain procedure code within 7 days of the diagnosis code. Logistic regression controlling for person-years at risk was used to examine demographic and clinical diagnosis risk factors for mucormycosis. RESULTS Of the 306,482 renal transplant patients, 222 (0.07%) had codes consistent with proven mucormycosis. The incidence of mucormycosis increased from 1990 to 2000 (peak 17.6 per 100,000 person-years) and subsequently demonstrated more variability. Hispanic ethnicity (OR=1.45), age 65 years or greater (OR=1.64), other or black race compared with white race (OR=1.96 and 1.74), cadaver or other donor type (OR=2.41), and receiving tacrolimus (OR=2.09) were associated with increased risk. Comorbidities associated with decreased risk of mucormycosis included female sex (OR=0.68), iron overload (OR=0.56), and receiving mycophenolate mofetil (OR=0.67) or azathioprine (OR=0.53). CONCLUSIONS In renal transplant patients, age, deceased donor graft transplant, tacrolimus administration, race other than white, and Hispanic ethnicity were associated with increased risk of mucormycosis. Unexpectedly, iron overload was protective. Mucormycosis is a rare infection in renal transplant patients which should be considered in patients with the above risk factors after more common infections have been ruled out.
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Affiliation(s)
| | - Varsha Taskar
- Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Daniel F Linder
- Population Health Sciences, Augusta University, Augusta, GA, USA
| | - Stephanie L Baer
- Medicine, Medical College of Georgia, Augusta, Georgia, USA .,Hospital Epidemiology, Charlie Norwood VA Medical Center, Augusta, GA, USA
| | | | - Wendy B Bollag
- Medicine, Medical College of Georgia, Augusta, Georgia, USA.,Dermatology, Medical College of Georgia, Augusta, Georgia, USA.,Medicine, Charlie Norwood VA Medical Center, Augusta, GA, USA
| | - Mufaddal Kheda
- Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Azeem Mohammed
- Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Sandeep Padala
- Medicine, Medical College of Georgia, Augusta, Georgia, USA
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34
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Irsik DL, Bollag WB, Isales CM. Renal Contributions to Age-Related Changes in Mineral Metabolism. JBMR Plus 2021; 5:e10517. [PMID: 34693188 PMCID: PMC8520061 DOI: 10.1002/jbm4.10517] [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] [Received: 12/31/2020] [Revised: 04/28/2021] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
Aging results in a general decline in function in most systems. This is particularly true with respect to the skeleton and renal systems, impacting mineral homeostasis. Calcium and phosphate regulation requires tight coordination among the intestine, bone, parathyroid gland, and kidney. The role of the intestine is to absorb calcium and phosphate from the diet. The bone stores or releases calcium and phosphate depending on the body's needs. In response to low plasma ionized calcium concentration, the parathyroid gland produces parathyroid hormone, which modulates bone turnover. The kidney reabsorbs or excretes the minerals and serves as the final regulator of plasma concentration. Many hormones are involved in this process in addition to parathyroid hormone, including fibroblast growth factor 23 produced by the bone and calcitriol synthesized by the kidney. Sclerostin, calcitonin, osteoprotegerin, and receptor activator of nuclear factor‐κB ligand also contribute to tissue‐specific regulation. Changes in the function of organs due to aging or disease can perturb this balance. During aging, the intestine cannot absorb calcium efficiently due to decreased expression of key proteins. In the bone, the balance between bone formation and bone resorption tends toward the latter in older individuals. The kidney may not filter blood as efficiently in the later decades of life, and the expression of certain proteins necessary for mineral homeostasis declines with age. These changes often lead to dysregulation of organismal mineral homeostasis. This review will focus on how mineral homeostasis is impacted by aging with a particular emphasis on the kidney's role in this process. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Debra L Irsik
- Charlie Norwood VA Medical Center Augusta GA USA.,Department of Neuroscience and Regenerative Medicine Augusta University Augusta GA USA
| | - Wendy B Bollag
- Charlie Norwood VA Medical Center Augusta GA USA.,Department of Physiology Augusta University Augusta GA USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine Augusta University Augusta GA USA.,Division of Endocrinology, Department of Medicine Augusta University Augusta GA USA
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35
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Bollag WB. Down-Regulated Calcium-Sensing Receptor in Keratinocytes and Skin from Aged Mice and Humans Impairs Function. J Invest Dermatol 2021; 141:2558-2561. [PMID: 34688406 DOI: 10.1016/j.jid.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/14/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
The calcium-sensing receptor (CaSR) is important in the skin, contributing to several epidermal functions, including differentiation, water permeability barrier repair, and wound healing. Celli et al. (2021) show that CaSR levels are reduced in keratinocytes/skin from aged individuals, with resulting impairment of key functions. CaSR agonists can correct these defects, suggesting a possible therapy to combat aging-related delayed skin wound healing.
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Affiliation(s)
- Wendy B Bollag
- Charlie Norwood VA Medical Center, Augusta, Georgia, USA; Department of Physiology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA; Department of Dermatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA; Department of Medicine, Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
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36
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Vyavahare S, Kumar S, Cantu N, Kolhe R, Bollag WB, McGee-Lawrence ME, Hill WD, Hamrick MW, Isales CM, Fulzele S. Tryptophan-Kynurenine Pathway in COVID-19-Dependent Musculoskeletal Pathology: A Minireview. Mediators Inflamm 2021; 2021:2911578. [PMID: 34621138 PMCID: PMC8492288 DOI: 10.1155/2021/2911578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/09/2021] [Accepted: 09/21/2021] [Indexed: 12/28/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), affecting multiple organ systems, including the respiratory tract and lungs. Several studies have reported that the tryptophan-kynurenine pathway is altered in COVID-19 patients. The tryptophan-kynurenine pathway plays a vital role in regulating inflammation, metabolism, immune responses, and musculoskeletal system biology. In this minireview, we surmise the effects of the kynurenine pathway in COVID-19 patients and how this pathway might impact muscle and bone biology.
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Affiliation(s)
- Sagar Vyavahare
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Sandeep Kumar
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Nicholas Cantu
- Department of Medicine, Augusta University, Augusta, GA, USA
| | - Ravindra Kolhe
- Department of Pathology, Augusta University, Augusta, GA, USA
| | - Wendy B. Bollag
- Department of Physiology, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - Meghan E. McGee-Lawrence
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - William D. Hill
- Department of Pathology, Medical University of South Carolina, Charleston, SC, USA
| | - Mark W. Hamrick
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - Carlos M. Isales
- Department of Medicine, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
| | - Sadanand Fulzele
- Department of Cell Biology and Anatomy, Augusta University, Augusta, GA, USA
- Department of Medicine, Augusta University, Augusta, GA, USA
- Center for Healthy Aging, Augusta University, Augusta, GA, USA
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37
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Aitkens L, Winn M, Waller JL, Huber L, Baer SL, Mohammed A, Kheda M, Tran S, Siddiqui B, Padala S, Colombo RE, Bollag WB. Septic arthritis in the end-stage renal disease population. J Investig Med 2021; 70:383-390. [PMID: 34518317 DOI: 10.1136/jim-2021-001869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 11/04/2022]
Abstract
Septic arthritis is important to consider in any patient who presents with joint pain because it is a medical emergency with an 11% fatality rate. Diagnosis and treatment may improve prognosis; however, many patients do not regain full joint function. In patients with end-stage renal disease (ESRD), immune dysfunction due to uremia and chronic vascular access leads to increased risk of infection. We examined the incidence, risk factors and sequelae of septic arthritis in a cohort of hemodialysis patients. The US Renal Data System was queried for diagnoses of septic arthritis and selected sequelae using International Statistical Classification of Diseases and Related Health Problems-9 and Current Procedural Terminology-4 codes in patients who initiated hemodialysis between 2005 and 2010. Multivariable logistic regression was used to determine potential risk factors for septic arthritis and its sequelae. 7009 cases of septic arthritis were identified, an incidence of 514.8 per 100,000 persons per year. Of these patients, 2179 were diagnosed with a documented organism within 30 days prior to or 14 days after the septic arthritis diagnosis, with methicillin-resistant Staphylococcus aureus infections (57.4%) being the most common. Significant risk factors for septic arthritis included history of joint disease, immune compromise (diabetes, HIV, cirrhosis), bacteremia and urinary tract infection. One of the four sequelae examined (joint replacement, amputation, osteomyelitis, Clostridioides difficile infection) occurred in 25% of septic arthritis cases. The high incidence of septic arthritis and the potential for serious sequelae in patients with ESRD suggest that physicians treating individuals with ESRD and joint pain/inflammation should maintain a high clinical suspicion for septic arthritis.
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Affiliation(s)
- Lorry Aitkens
- Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Matthew Winn
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Lu Huber
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.,Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.,Charlie Norwood VA Medical Center, Augusta, Georgia, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | | | - Sarah Tran
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Budder Siddiqui
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sandeep Padala
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Rhonda E Colombo
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA .,Charlie Norwood VA Medical Center, Augusta, Georgia, USA.,Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
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38
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Jung J, Bollag WB. Phenformin: AMP(K)ed for Potential Repurposing. J Invest Dermatol 2021; 141:11-14. [PMID: 33342506 DOI: 10.1016/j.jid.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022]
Abstract
The results in the article by Zhou et al. (2020) demonstrate that the antidiabetic drug phenformin inhibits skin tumor growth and promotes keratinocyte differentiation, and an underlying mechanism is also defined. In this commentary, additional potential mechanisms through which phenformin may exert its antitumorigenic effect are described. Thus, the proposed repurposing of phenformin to treat skin cancer has merit.
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Affiliation(s)
- Joo Jung
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, USA; Charlie Norwood VA Medical Center, Augusta, Georgia, USA.
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39
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Gibson M, Yang N, Waller JL, Young L, Bollag WB, Kheda M, Mohammed A, Baer SL. Nocardiosis in renal transplant patients. J Investig Med 2021; 70:36-45. [PMID: 34426458 DOI: 10.1136/jim-2021-001783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/04/2022]
Abstract
Renal transplant patients are immunosuppressed and are at increased risk of opportunistic infections, including Nocardia infection. In renal transplant patients, information on the incidence and risk factors associated with nocardiosis is limited. To address the incidence and risk factors associated with nocardiosis in a large renal transplant population, we used the US Renal Data System (USRDS). Sequelae of allograft failure or rejection after infection were also examined. Demographics, clinical risk factors, Nocardia diagnosis, and allograft failure following Nocardia infection were queried in USRDS renal transplant patients using International Classification of Diseases, Ninth Revision (ICD-9) codes in billing claims and Centers for Medicare and Medicaid Services Form 2728. Generalized linear models were used to determine the risk factors associated with nocardiosis, and Cox proportional hazards models were used to examine the association of risk factors with graft failure among patients with Nocardia infection. Of 203,233 renal transplant recipients identified from 2001 to 2011, 657 (0.32%) were diagnosed with Nocardia infection. Pneumonia was the most frequent presentation (15.2%), followed by brain abscess (8.4%). Numerous factors associated with increased Nocardia infection included age >65 years (OR=2.10, 95% CI 1.71 to 2.59), history of transplant failure (OR=1.28, CI 1.02 to 1.60) or history of rejection (OR=4.83, CI 4.08 to 5.72), receipt of a deceased donor transplant (OR=1.23, CI 1.03 to 1.46), and treatment with basiliximab (OR=1.25, CI 1.00 to 1.55), cyclosporine (OR=1.30, CI 1.03 to 1.65), tacrolimus (OR=2.45, CI 2.00 to 3.00), or thymoglobulin (OR=1.89, CI 1.59 to 2.25). In patients with nocardiosis administration of antithymocyte globulin (HR=2.76), chronic obstructive pulmonary disease (HR=2.47), and presentation of Nocardia infection with brain abscess (HR=1.85) were associated with an increased risk of graft failure. This study provides new information to enhance early recognition and targeted treatment of nocardiosis in renal transplant patients.
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Affiliation(s)
- Maya Gibson
- Department of Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA
| | - Nianlan Yang
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia, USA.,Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer L Waller
- Department of Biostatistics and Epidemiology, Augusta University, Augusta, Georgia, USA
| | - Lufei Young
- College of Nursing, Augusta University, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Dermatology, Medical College of Georgia, Augusta, Georgia, USA
| | - Mufaddal Kheda
- Department of Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA
| | - Azeem Mohammed
- Department of Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA
| | - Stephanie L Baer
- Department of Medicine, Augusta University Medical College of Georgia, Augusta, Georgia, USA .,Infection Control and Epidemiology, Augusta VA Medical Center, Augusta, Georgia, USA
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40
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Schwade MJ, Tien L, Waller JL, Davis LS, Baer SL, Mohammed A, Young L, Kheda MF, Bollag WB. Treatment of psoriasis in end-stage renal disease patients is associated with decreased mortality: A retrospective cohort study. Am J Med Sci 2021; 362:24-33. [PMID: 33798461 DOI: 10.1016/j.amjms.2021.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/18/2021] [Accepted: 03/25/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Psoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk. METHODS A retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality. RESULTS A total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55). CONCLUSIONS These results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.
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Affiliation(s)
- Mark J Schwade
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Lillie Tien
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Jennifer L Waller
- Division of Biostatistics and Data Science, Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Loretta S Davis
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia; Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia; Charlie Norwood VA Medical Center, Augusta, Georgia
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, Georgia
| | | | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia; Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia; Charlie Norwood VA Medical Center, Augusta, Georgia; Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia.
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41
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Schwade MJ, Waller JL, Mohammed A, Young L, Kheda M, Nahman NS, Baer SL, Bollag WB. Morbidity and Mortality of Spinal Epidural Abscess in End-Stage Renal Disease Patients: A Case-Control Study. Am J Med Sci 2021; 361:485-490. [PMID: 33637307 DOI: 10.1016/j.amjms.2020.10.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/25/2020] [Accepted: 10/22/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Spinal epidural abscess (SEA) is an uncommon and highly morbid infection of the epidural space. End-stage renal disease (ESRD) patients are known to be at increased risk of developing SEA; however, there are no studies that have described the risk factors and outcomes of SEA in ESRD patients utilizing the United States Renal Data System (USRDS). METHODS To determine risk factors, morbidity, and mortality associated with SEA in ESRD patients, a retrospective case-control study was conducted using the USRDS. ESRD patients diagnosed with SEA between 2005 and 2010 were identified, and logistic regression was performed to examine correlates of SEA, as well as risk factors associated with mortality in SEA-ESRD patients. RESULTS The prevalence of SEA amongst ESRD patients was 0.39% (n = 1,697). Patients with SEA were more likely to be male [adjusted Odds Ratio (OR) = 1.22], black (OR = 1.19), diabetic (OR = 1.26), with catheter access (OR = 1.29), and less likely to be ≥65 years old (OR = 0.64). Osteomyelitis, bacteremia/septicemia, MRSA, and endocarditis were all significantly associated with increased risk of SEA (OR = 1.54-5.14). Age ≥65 years (HR = 1.45), urinary tract infections (HR = 1.26), decubitus ulcers (HR=1.37), and post-SEA paraplegia (HR = 1.25) were significantly associated with mortality among those with SEA. CONCLUSIONS As described in previous literature, risk factors for SEA included infections, diabetes, and indwelling catheters. Additionally, clinicians should be aware of the risk factors for mortality in SEA-ESRD patients. As the largest study of SEA to date, our report identifies important risk factors for SEA in ESRD patients, and novel data regarding their mortality-associated risk factors.
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Affiliation(s)
- Mark J Schwade
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA
| | - Jennifer L Waller
- Department of Population Health Sciences, Medical College of Georgia at Augusta University, Augusta, GA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA
| | - Lufei Young
- Department of Physiological and Technological Nursing, Augusta University, Augusta, GA
| | | | - N Stanley Nahman
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA
| | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA; Charlie Norwood VA Medical Center, Augusta, GA
| | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA; Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA; Charlie Norwood VA Medical Center, Augusta, GA.
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42
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Fernung LP, Davis LS, Bollag WB. 13609 Nail degradation and decomposition secondary to extended use of cuticle remover cosmetic solutions. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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43
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Bollag WB, Gonzales JN. Phosphatidylglycerol and surfactant: A potential treatment for COVID-19? Med Hypotheses 2020; 144:110277. [PMID: 33254581 PMCID: PMC7493731 DOI: 10.1016/j.mehy.2020.110277] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/11/2020] [Accepted: 09/12/2020] [Indexed: 01/08/2023]
Abstract
A hypothesis concerning the potential utility of surfactant supplementation for the treatment of critically ill patients with COVID-19 is proposed, along with a brief summary of the data in the literature supporting this idea. It is thought that surfactant, which is already approved by the Food and Drug Administration for intratracheal administration to treat neonatal respiratory distress syndrome in pre-term infants, could benefit COVID-19-infected individuals by: (1) restoring surfactant damaged by lung infection and/or decreased due to the virus-induced death of the type II pneumocytes that produce it and (2) reducing surface tension to decrease the work of breathing and limit pulmonary edema. In addition, a constituent of surfactant, phosphatidylglycerol, could mitigate COVID-19-induced lung pathology by: (3) decreasing excessive innate immune system stimulation via its inhibition of toll-like receptor-2 and -4 activation by microbial components and cellular proteins released by damaged cells, thereby limiting inflammation and the resultant pulmonary edema, and (4) possibly blocking spread of the viral infection to non-infected cells in the lung. Therefore, it is suggested that surfactant preparations containing phosphatidylglycerol be tested for their ability to improve lung function in critically ill patients with COVID-19.
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Affiliation(s)
- Wendy B Bollag
- Charlie Norwood VA Medical Center, Augusta, GA 30904, United States; Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States; Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States; Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States.
| | - Joyce N Gonzales
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, United States
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Anaya JM, Bollag WB, Hamrick MW, Isales CM. The Role of Tryptophan Metabolites in Musculoskeletal Stem Cell Aging. Int J Mol Sci 2020; 21:ijms21186670. [PMID: 32933099 PMCID: PMC7555967 DOI: 10.3390/ijms21186670] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 12/16/2022] Open
Abstract
Although aging is considered a normal process, there are cellular and molecular changes that occur with aging that may be detrimental to health. Osteoporosis is one of the most common age-related degenerative diseases, and its progression correlates with aging and decreased capacity for stem cell differentiation and proliferation in both men and women. Tryptophan metabolism through the kynurenine pathway appears to be a key factor in promoting bone-aging phenotypes, promoting bone breakdown and interfering with stem cell function and osteogenesis; however, little data is available on the impact of tryptophan metabolites downstream of kynurenine. Here we review available data on the impact of these tryptophan breakdown products on the body in general and, when available, the existing evidence of their impact on bone. A number of tryptophan metabolites (e.g., 3-hydroxykynurenine (3HKYN), kynurenic acid (KYNA) and anthranilic acid (AA)) have a detrimental effect on bone, decreasing bone mineral density (BMD) and increasing fracture risk. Other metabolites (e.g., 3-hydroxyAA, xanthurenic acid (XA), picolinic acid (PIA), quinolinic acid (QA), and NAD+) promote an increase in bone mineral density and are associated with lower fracture risk. Furthermore, the effects of other tryptophan breakdown products (e.g., serotonin) are complex, with either anabolic or catabolic actions on bone depending on their source. The mechanisms involved in the cellular actions of these tryptophan metabolites on bone are not yet fully known and will require further research as they are potential therapeutic targets. The current review is meant as a brief overview of existing English language literature on tryptophan and its metabolites and their effects on stem cells and musculoskeletal systems. The search terms used for a Medline database search were: kynurenine, mesenchymal stem cells, bone loss, tryptophan metabolism, aging, and oxidative stress.
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Affiliation(s)
- Jordan Marcano Anaya
- Universidad Central Del Caribe Laurel, Av. Sta. Juanita, Bayamón PR 00960, Puerto Rico;
| | - Wendy B. Bollag
- Department of Physiology, Augusta University and Charlie Norwood VA Medical Center, Augusta, GA 30912, USA;
| | - Mark W. Hamrick
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA 30912, USA;
| | - Carlos M. Isales
- Departments of Medicine, Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +706-721-0692
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Bollag WB, Olala LO, Xie D, Lu X, Qin H, Choudhary V, Patel R, Bogorad D, Estes A, Watsky M. Dioleoylphosphatidylglycerol Accelerates Corneal Epithelial Wound Healing. Invest Ophthalmol Vis Sci 2020; 61:29. [PMID: 32186673 PMCID: PMC7401755 DOI: 10.1167/iovs.61.3.29] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose In contact with the external environment, the cornea can easily be injured. Although corneal wounds generally heal rapidly, the pain and increased risk of infection associated with a damaged cornea, as well as the impaired healing observed in some individuals, emphasize the need for novel treatments to accelerate corneal healing. We previously demonstrated in epidermal keratinocytes that the glycerol channel aquaporin-3 (AQP3) interacts with phospholipase D2 (PLD2) to produce the signaling phospholipid phosphatidylglycerol (PG), which has been shown to accelerate skin wound healing in vivo. We hypothesized that the same signaling pathway might be operational in corneal epithelial cells. Methods We used co-immunoprecipitation, immunohistochemistry, scratch wound healing assays in vitro, and corneal epithelial wound healing assays in vivo to determine the role of the AQP3/PLD2/PG signaling pathway in corneal epithelium. Results AQP3 was present in human corneas in situ, and AQP3 and PLD2 were co-immunoprecipitated from corneal epithelial cell lysates. The two proteins could also be co-immunoprecipitated from insect cells simultaneously infected with AQP3- and PLD2-expressing baculoviruses, suggesting a likely direct interaction. A particular PG, dioleoylphosphatidylglycerol (DOPG), enhanced scratch wound healing of a corneal epithelial monolayer in vitro. DOPG also accelerated corneal epithelial wound healing in vivo, both in wild-type mice and in a mouse model exhibiting impaired corneal wound healing (AQP3 knockout mice). Conclusions These results indicate the importance of the AQP3/PLD2/PG signaling pathway in corneal epithelial cells and suggest the possibility of developing DOPG as a pharmacologic therapy to enhance corneal wound healing in patients.
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Han J, Waller JL, Colombo RE, Spearman V, Young L, Kheda MF, Mohammed A, Bollag WB, Nahman NS, Baer SL. Incidence and risk factors for HPV-associated cancers in women with end-stage renal disease. J Investig Med 2020; 68:1002-1010. [PMID: 32503931 DOI: 10.1136/jim-2019-001262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 11/04/2022]
Abstract
Human papillomavirus (HPV) causes the majority of cervical, anal/rectal, and oropharyngeal cancers in women. End-stage renal disease (ESRD) is also associated with an increased risk of malignancy, but the incidence of and risk factors for HPV-associated cancers in US dialysis patients are not defined. We queried the US Renal Data System for women with HPV-associated cancers and assessed for incidence of cancer diagnosis and association of risk factors. From 2005 to 2011, a total of 1032 female patients with ESRD had 1040 HPV-associated cancer diagnoses. Patients had a mean age of 65 years, were mostly white (63%), and on hemodialysis (92%). Cervical cancer (54%) was the most common, followed by anal/rectal (34%), and oropharyngeal (12%). The incidence of HPV-associated cancers in patients with ESRD increased yearly, with up to a 16-fold increased incidence compared with the general population. Major risk factors associated with the development of any HPV-associated cancer included smoking (adjusted relative risk=1.89), alcohol use (1.87), HIV (2.21), and herpes infection (2.02). Smoking, HIV, and herpes infection were prominent risk factors for cervical cancer. The incidence of HPV-associated cancers in women with ESRD is rising annually and is overall higher than in women of the general population. Tobacco use is a universal risk factor. For cervical cancer, the presence of HIV and herpes are important comorbidities. Recognizing risk factors associated with these cancers may improve diagnosis and facilitate survival. The role of HPV vaccination in at-risk dialysis patients remains to be defined but warrants further study.
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Affiliation(s)
- Joan Han
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Jennifer L Waller
- Department of Population Health Sciences, Medical College of Georgia, Augusta, Georgia, USA
| | - Rhonda E Colombo
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Vanessa Spearman
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Lufei Young
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Mufaddal F Kheda
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Azeem Mohammed
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA
| | - Wendy B Bollag
- Department of Dermatology, Medical College of Georgia, Augusta, Georgia, USA
| | | | - Stephanie L Baer
- Department of Medicine, Medical College of Georgia, Augusta, Georgia, USA .,Infection Control and Epidemiology, Augusta VA Medical Center, Augusta, Georgia, USA
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Elmansi AM, Hussein KA, Herrero SM, Periyasamy-Thandavan S, Aguilar-Pérez A, Kondrikova G, Kondrikov D, Eisa NH, Pierce JL, Kaiser H, Ding KH, Walker AL, Jiang X, Bollag WB, Elsalanty M, Zhong Q, Shi XM, Su Y, Johnson M, Hunter M, Reitman C, Volkman BF, Hamrick MW, Isales CM, Fulzele S, McGee-Lawrence ME, Hill WD. Age-related increase of kynurenine enhances miR29b-1-5p to decrease both CXCL12 signaling and the epigenetic enzyme Hdac3 in bone marrow stromal cells. Bone Rep 2020; 12:100270. [PMID: 32395570 PMCID: PMC7210406 DOI: 10.1016/j.bonr.2020.100270] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Received: 03/09/2020] [Accepted: 04/06/2020] [Indexed: 12/14/2022] Open
Abstract
Mechanisms leading to age-related reductions in bone formation and subsequent osteoporosis are still incompletely understood. We recently demonstrated that kynurenine (KYN), a tryptophan metabolite, accumulates in serum of aged mice and induces bone loss. Here, we report on novel mechanisms underlying KYN's detrimental effect on bone aging. We show that KYN is increased with aging in murine bone marrow mesenchymal stem cells (BMSCs). KYN reduces bone formation via modulating levels of CXCL12 and its receptors as well as histone deacetylase 3 (Hdac3). BMSCs responded to KYN by significantly decreasing mRNA expression levels of CXCL12 and its cognate receptors, CXCR4 and ACKR3, as well as downregulating osteogenic gene RUNX2 expression, resulting in a significant inhibition in BMSCs osteogenic differentiation. KYN's effects on these targets occur by increasing regulatory miRNAs that target osteogenesis, specifically miR29b-1-5p. Thus, KYN significantly upregulated the anti-osteogenic miRNA miR29b-1-5p in BMSCs, mimicking the up-regulation of miR-29b-1-5p in human and murine BMSCs with age. Direct inhibition of miR29b-1-5p by antagomirs rescued CXCL12 protein levels downregulated by KYN, while a miR29b-1-5p mimic further decreased CXCL12 levels. KYN also significantly downregulated mRNA levels of Hdac3, a target of miR-29b-1-5p, as well as its cofactor NCoR1. KYN is a ligand for the aryl hydrocarbon receptor (AhR). We hypothesized that AhR mediates KYN's effects in BMSCs. Indeed, AhR inhibitors (CH-223191 and 3',4'-dimethoxyflavone [DMF]) partially rescued secreted CXCL12 protein levels in BMSCs treated with KYN. Importantly, we found that treatment with CXCL12, or transfection with an miR29b-1-5p antagomir, downregulated the AhR mRNA level, while transfection with miR29b-1-5p mimic significantly upregulated its level. Further, CXCL12 treatment downregulated IDO, an enzyme responsible for generating KYN. Our findings reveal novel molecular pathways involved in KYN's age-associated effects in the bone microenvironment that may be useful translational targets for treating osteoporosis.
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Affiliation(s)
- Ahmed M Elmansi
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29403, United States of America.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America
| | - Khaled A Hussein
- Department of Oral Surgery and Medicine, National Research Centre, Cairo, Egypt
| | | | | | - Alexandra Aguilar-Pérez
- Department of Anatomy and Cell Biology, Indiana University School of Medicine in Indianapolis, IN, United States of America.,Department of Cellular and Molecular Biology, School of Medicine, Universidad Central del Caribe, Bayamon 00956, Puerto Rico.,Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Galina Kondrikova
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29403, United States of America.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America
| | - Dmitry Kondrikov
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29403, United States of America.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America
| | - Nada H Eisa
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29403, United States of America.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America.,Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Jessica L Pierce
- Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Helen Kaiser
- Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Ke-Hong Ding
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Aisha L Walker
- Department of Medicine, Vascular Medicine Institute, University of Pittsburg School of Medicine, Pittsburg, PA 15261, United States of America
| | - Xue Jiang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wendy B Bollag
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America.,Charlie Norwood Veterans Affairs Medical Center, Augusta, GA 30904, United States of America.,Department of Physiology, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Mohammed Elsalanty
- Department of Oral Biology, Dental College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Qing Zhong
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Xing-Ming Shi
- Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Yun Su
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Maribeth Johnson
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Department of Population Health Science, Augusta University, Augusta, GA 30912, United States of America
| | - Monte Hunter
- Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America
| | - Charles Reitman
- Orthopaedics and Physical Medicine Department, Medical University of South Carolina, Charleston, SC 29403, United States of America
| | - Brian F Volkman
- Biochemistry Department, Medical College of Wisconsin, Milwaukee, WI 53226, United States of America
| | - Mark W Hamrick
- Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America
| | - Carlos M Isales
- Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America.,Division of Endocrinology, Diabetes and Metabolism, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America
| | - Sadanand Fulzele
- Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America
| | - Meghan E McGee-Lawrence
- Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Department of Orthopaedic Surgery, Medical College of Georgia, Aueusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America
| | - William D Hill
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC 29403, United States of America.,Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America.,Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, United States of America.,Center for Healthy Aging, Medical College of Georgia, Augusta University, Augusta, GA, 30912, United States of America.,Charlie Norwood Veterans Affairs Medical Center, Augusta, GA 30904, United States of America
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Choudhary V, Griffith S, Chen X, Bollag WB. Pathogen-Associated Molecular Pattern-Induced TLR2 and TLR4 Activation Increases Keratinocyte Production of Inflammatory Mediators and is Inhibited by Phosphatidylglycerol. Mol Pharmacol 2020; 97:324-335. [PMID: 32173651 PMCID: PMC7174787 DOI: 10.1124/mol.119.118166] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/25/2020] [Indexed: 12/15/2022] Open
Abstract
Skin serves not only as a protective barrier to microbial entry into the body but also as an immune organ. The outer layer, the epidermis, is composed predominantly of keratinocytes, which can be stimulated to produce proinflammatory mediators. Although some inflammation is useful to defend against infection, excessive or persistent inflammation can lead to the development of inflammatory skin diseases, such as psoriasis, a common skin disorder affecting approximately 2% of the US population. We have previously found that phosphatidylglycerol (PG) derived from soy can inhibit inflammation in a contact irritant ear edema mouse model. Here, we investigated the ability of soy PG to inhibit inflammatory mediator expression in response to activators of the pattern recognition receptors, toll-like receptor-2 (TLR2) and -4 (TLR4). We found that in epidermal keratinocytes, soy PG inhibited TLR2 and TLR4 activation and inflammatory mediator expression in response to a synthetic triacylated lipopeptide and lipopolysaccharide, respectively, as well as an endogenous danger-associated molecular pattern. However, at higher concentrations, soy PG alone enhanced the expression of some proinflammatory cytokines, suggesting a narrow therapeutic window for this lipid. Dioleoylphosphatidylglycerol (DOPG), but not dioleoylphosphatidylcholine, exerted a similar inhibitory effect, completely blocking keratinocyte inflammatory mediator expression induced by TLR2 and TLR4 activators as well as NFκB activation in a macrophage cell line (RAW264.7); however, DOPG was not itself proinflammatory even at high concentrations. Furthermore, DOPG had no effect on NFκB activation in response to a TLR7/8 agonist. Our results suggest that DOPG could be used to inhibit excessive skin inflammation. SIGNIFICANCE STATEMENT: Although inflammation is beneficial for clearing an infection, in some cases, the infection can be excessive and/or become chronic, thereby resulting in considerable tissue damage and pathological conditions. We show here that the phospholipid phosphatidylglycerol can inhibit the activation of toll-like receptors 2 and 4 of the innate immune system as well as the downstream inflammatory mediator expression in response to microbial component-mimicking agents in epidermal keratinocytes that form the physical barrier of the skin.
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Affiliation(s)
- Vivek Choudhary
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, Georgia (V.C., W.B.B.); and Departments of Physiology (V.C., S.G., X.C., W.B.B.) and Dermatology (W.B.B.), Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Shantelle Griffith
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, Georgia (V.C., W.B.B.); and Departments of Physiology (V.C., S.G., X.C., W.B.B.) and Dermatology (W.B.B.), Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Xunsheng Chen
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, Georgia (V.C., W.B.B.); and Departments of Physiology (V.C., S.G., X.C., W.B.B.) and Dermatology (W.B.B.), Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Wendy B Bollag
- Charlie Norwood VA Medical Center, One Freedom Way, Augusta, Georgia (V.C., W.B.B.); and Departments of Physiology (V.C., S.G., X.C., W.B.B.) and Dermatology (W.B.B.), Medical College of Georgia at Augusta University, Augusta, Georgia
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49
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Ding K, McGee-Lawrence ME, Kaiser H, Sharma AK, Pierce JL, Irsik DL, Bollag WB, Xu J, Zhong Q, Hill W, Shi XM, Fulzele S, Kennedy EJ, Elsalanty M, Hamrick MW, Isales CM. Picolinic acid, a tryptophan oxidation product, does not impact bone mineral density but increases marrow adiposity. Exp Gerontol 2020; 133:110885. [PMID: 32088397 PMCID: PMC7065047 DOI: 10.1016/j.exger.2020.110885] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022]
Abstract
Tryptophan is an essential amino acid catabolized initially to kynurenine (kyn), an immunomodulatory metabolite that we have previously shown to promote bone loss. Kyn levels increase with aging and have also been associated with neurodegenerative disorders. Picolinic acid (PA) is another tryptophan metabolite downstream of kyn. However, in contrast to kyn, PA is reported to be neuroprotective and further, to promote osteogenesis in vitro. Thus, we hypothesized that PA might be osteoprotective in vivo. In an IACUC-approved protocol, we fed PA to aged (23-month-old) C57BL/6 mice for eight weeks. In an effort to determine potential interactions of PA with dietary protein we also fed PA in a low-protein diet (8%). The mice were divided into four groups: Control (18% dietary protein), +PA (700 ppm); Low-protein (8%), +PA (700 ppm). The PA feedings had no impact on mouse weight, body composition or bone density. At sacrifice bone and stem cells were collected for analysis, including μCT and RT-qPCR. Addition of PA to the diet had no impact on trabecular bone parameters. However, marrow adiposity was significantly increased in PA-fed mice, and in bone marrow stromal cells isolated from these mice increases in the expression of the lipid storage genes, Plin1 and Cidec, were observed. Thus, as a downstream metabolite of kyn, PA no longer showed kyn's detrimental effects on bone but instead appears to impact energy balance.
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Affiliation(s)
- Kehong Ding
- Center for Healthy Aging, Augusta University, United States of America; Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America
| | - Meghan E McGee-Lawrence
- Center for Healthy Aging, Augusta University, United States of America; Department of Orthopaedic Surgery, Augusta University, United States of America; Department of Cellular Biology and Anatomy, Augusta University, United States of America
| | - Helen Kaiser
- Department of Cellular Biology and Anatomy, Augusta University, United States of America
| | - Anuj K Sharma
- Department of Cellular Biology and Anatomy, Augusta University, United States of America
| | - Jessica L Pierce
- Department of Cellular Biology and Anatomy, Augusta University, United States of America
| | - Debra L Irsik
- Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America
| | - Wendy B Bollag
- Center for Healthy Aging, Augusta University, United States of America; Department of Medicine, Augusta University, United States of America; Department of Physiology, Augusta University, United States of America; Charlie Norwood VA Medical Center, Augusta, GA 30912, United States of America
| | - Jianrui Xu
- Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America
| | - Qing Zhong
- Center for Healthy Aging, Augusta University, United States of America; Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America
| | - William Hill
- Center for Healthy Aging, Augusta University, United States of America; Department of Pathology and Laboratory Medicine, Medical University of South Carolina, United States of America; Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC 29403, United States of America
| | - Xing-Ming Shi
- Center for Healthy Aging, Augusta University, United States of America; Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America; Department of Orthopaedic Surgery, Augusta University, United States of America
| | - Sadanand Fulzele
- Center for Healthy Aging, Augusta University, United States of America; Department of Orthopaedic Surgery, Augusta University, United States of America
| | - Eileen J Kennedy
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia College of Pharmacy, Athens, GA 30602, United States of America
| | - Mohammed Elsalanty
- Center for Healthy Aging, Augusta University, United States of America; Department of Oral Biology, Augusta University, United States of America
| | - Mark W Hamrick
- Center for Healthy Aging, Augusta University, United States of America; Department of Orthopaedic Surgery, Augusta University, United States of America; Department of Cellular Biology and Anatomy, Augusta University, United States of America
| | - Carlos M Isales
- Center for Healthy Aging, Augusta University, United States of America; Department of Medicine, Augusta University, United States of America; Department of Neuroscience and Regenerative Medicine, Augusta University, United States of America; Department of Orthopaedic Surgery, Augusta University, United States of America; Department of Cellular Biology and Anatomy, Augusta University, United States of America.
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50
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Abstract
The skin is essential for terrestrial life. It is responsible for regulating water permeability and functions as a mechanical barrier that protects against environmental insults such as microbial infection, ultraviolet light, injury, and heat and cold, which could damage the cells of the body and compromise survival of the organism. This barrier is provided by the outer layer, the epidermis, which is composed predominantly of keratinocytes; keratinocytes undergo a program of differentiation to form the stratum corneum comprising the cornified squame "bricks" and lipid "mortar." Dysregulation of this differentiation program can result in skin diseases, including psoriasis and nonmelanoma skin cancers, among others. Accumulating evidence in the literature indicates that the water-, glycerol-, and hydrogen peroxide-transporting channel aquaporin-3 (AQP3) plays a key role in various processes involved in keratinocyte function, and abnormalities in this channel have been observed in several human skin diseases. Here, we discuss the data linking AQP3 to keratinocyte proliferation, migration, differentiation, and survival as well as its role in skin properties and functions like hydration, water retention, wound healing, and barrier repair. We also discuss the mechanisms regulating AQP3 levels, localization, and function and the anomalies in AQP3 that are associated with various skin diseases.
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Affiliation(s)
- Wendy B Bollag
- Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia.,Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia.,Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia.,Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Lorry Aitkens
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Joseph White
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Kelly A Hyndman
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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