Inspiratory muscle training on quality of life and functional capacity after hospital discharge in patients submitted to coronary artery bypass grafting: A controlled clinical trial

INTRODUCTION

There is a gap in knowledge about functional capacity and quality of life in patients undergoing coronary artery bypass grafting (CABG) after hospital discharge and the contribution of inspiratory muscle training (IMT).

OBJECTIVE

To evaluate the influence of IMT on functional capacity and quality of life after hospital discharge of patients undergoing CABG.

METHODOLOGY

Clinical trial. In the preoperative period, patients assessed maximum inspiratory pressure (MIP), quality of life using the SF-36 and functional capacity using the Six-Minute Walk Test (6MWT). On the first postoperative day, they were randomized into: control group (CG) receiving routine assistance from the hospital; intervention group(IG) in addition to conventional physical therapy and submitted to an IMT protocol based on the glycemic threshold. Being reevaluated on the day of hospital discharge and post-discharge month.

RESULTS

41 patients were included. In the preoperative period of the MIP assessment of the CG, it was 104 ± 14 cmH2O already in GI it was 103 ± 19cmH2O (p = 0.78) CG at discharge 80 ± 13 cmH2O already in GI it was 92 ± 15cmH2O(p < 0.01), revaluation CG 91 ± 11 cmH2O versus 98 ± 12 cmH2O (p < 0.01) of the IG. In the 6MWT the preoperative of the GC group was 420 ± 70 m already in GI it was 429 ± 71 m (p = 0,89), CG at discharge 326 ± 79 m versus 373 ± 55 m and revaluation of the CG 377 ± 75 m and IG 410 ± 57 m (p < 0.01). Functional capacity, general health status, emotional aspects and limitations due to physical aspects were significant when the three moments were compared.

CONCLUSION

IMT increases functional capacity, inspiratory muscle strength and quality of life after discharge from patients undergoing CABG.

Impact of drains positioning on pulmonary function after coronary artery bypass grafting: an observational study

INTRODUCTION

Coronary artery bypass grafting (CABG) is a procedure associated with a decline in pulmonary function. Among the main causes is the presence of the drain that is usually positioned in the intercostal or subxiphoid region.

OBJECTIVE

To measure the interference of drains positioning on pulmonary function in patients undergoing CABG.

METHODS

Observational study that assessed preoperative pulmonary function through vital capacity (VC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and peak expiratory flow (PEF). These variables were evaluated in three different moments: in the presence of two drains, when removing one, and after removing all drains.

RESULTS

We evaluated 45 patients with a mean age of 62 ± 7 years with male prevalence of 29 (64%) individuals. The insertion of drains caused a decline in pulmonary function after surgery by reducing MIP by 48%, MEP by 11%, VC by 39%, and PEF by 6%.

CONCLUSION

This study has demonstrated that drains positioning after CABG surgery may produce weakness of the respiratory muscles, change ventilatory mechanics, and impair normal pulmonary function postoperatively.

Impact of early ambulation on functionality in patients undergoing valve replacement surgery

BACKGROUND

Cardiac surgery is a highly complex procedure that aims to increase and prolong the quality of life of patients. The role of physiotherapy in early mobilization after cardiac surgery has shown several benefits to the patient when he presents impairments in terms of functionality.

AIM

To evaluate the impact of early ambulation on the functionality of patients undergoing cardiac valve replacement surgery.

MATERIALS AND METHODS

Prospective cohort study in patients undergoing cardiac valve replacement surgery. Patients had their functionality assessed preoperatively using the Functional Independence Measurement (FIM) and Perme Intensive Care Unit (ICU) Mobility Score scales. At ICU discharge, they were divided into two groups: walking group (WG) and non-WG (NWG). At discharge, the two functional scales were reapplied in these patients. Pre- and postoperative values were assessed using the independent Student's t-test. It was considered statistically significant when P<0.05.

RESULTS

One hundred and seventy patients were evaluated, 110 (65%) male, with a mean age of 48±2 years. In relation to Perme Score, the WG had a decrease of 11±2 and the NWG had a decrease of 13±2 (P=0.34). Regarding FIM, those who walked had a decrease of 27±3 against those who did not walk, which showed a reduction of 36±5, with a significance level of P<0.001.

CONCLUSION

Based on the FIM data found, patients undergoing cardiac valve replacement surgery who underwent early mobilization had less decrease of functionality compared to patients who did not ambulate.

RELEVANCE FOR PATIENTS

Based on this article, we can demonstrate that walking while still in the ICU environment favors less loss of functionality for patients after valve replacement surgery.

Nasal CPAP complications in very low birth weight preterm infants

BACKGROUND

Nasal trauma due to nasal CPAP (nCPAP) use is a commonly reported complication in infants under 1500 g of birth weight and 32 weeks of gestation. With the rise of nCPAP as the gold standard for non-invasive respiratory support, preventive measures should be considered.

OBJECTIVE

To assess the prevalence and risk factors of nasal injury in very low birth weight (VLBW) preterm infants with nCPAP.

METHODS

We retrospectively analyzed neonates hospitalized between 2012 and 2017, with less than 1500 g and 32 weeks of gestational age who received more than 12 hours of nCPAP. Demographic, antenatal and clinical data, along with information regarding respiratory support and nCPAP complications, were collected. We used Fischer's classification to grade nasal trauma.

RESULTS

A total of 135 infants were evaluated. Mean gestational age was 28 weeks (SD 2) and mean birth weight 1072 g (SD 239). Nasal trauma was reported in 65% of patients and it was of stage I, II and III in 49%, 16% and 1% of patients, respectively. The multivariate logistic regression revealed that the risk of trauma was greater in neonates with a longer duration of nCPAP ventilation (OR = 1.098, 95% CI: 1.055-1.142; p < 0.001) and in patients submitted to oxygen therapy (OR = 3.174, 95% CI: 1.014-9.929, p = 0.004). The median of days after nCPAP administration until the onset of an identifiable lesion was 4.

CONCLUSION

Nasal trauma is a frequent complication in VLBW preterm infants using nCPAP for long periods. Preventive measures in patients who are at greater risk of skin breakdown are of major clinical importance for a better outcome.

Repercussions of the COVID-19 Pandemic on the Care Practices of a Tertiary Hospital

Fundamento

Ainda não temos informações acerca do impacto da pandemia da COVID-19 sobre a atividade médica assistencial no Brasil.

Objetivo

Descrever as repercussões da pandemia da COVID-19 na rotina de atendimentos em um hospital terciário, referência regional em cardiologia e oncologia.

Métodos

Estudo de corte transversal. Foi realizado levantamento dos atendimentos no período de 23/03/2020 (fechamento do comércio local) até 23/04/2020 (P20) e comparado com o mesmo período em 2019 (P19).Resultados: Detectamos redução no número de consultas cardiológicas, teste ergométrico, Holter, monitorização ambulatorial da pressão arterial, eletrocardiograma e ecocardiograma (90%, 84%, 94%, 92%, 94% e 81%, respectivamente). Em relação à cirurgia cardíaca e cateterismo cardíaco, houve redução de 48% e 60%, respectivamente. Aumento no número de angioplastia transluminal coronária (33%) e de implante de marca-passo definitivo (29%). Houve 97 internamentos na UTI em P19, contra 78 em P20, redução de 20%. Diminuição dos atendimentos no pronto-socorro cardiológico (45%) e nos internamentos na enfermaria de cardiologia (36%). Houve diminuição nas consultas oncológicas de 30%. Sessões de quimioterapia reduziram de 1.944 para 1.066 (45%). Sessões de radioterapia diminuíram 19%.

Conclusão

A COVID-19 provocou redução considerável no número de consultas nos ambulatórios de cardiologia, oncologia e demais especialidades. Houve uma preocupante diminuição no número de cirurgias cardíacas e nas sessões de quimioterapia e radioterapia nas semanas iniciais da pandemia. A procura por atendimento no pronto-socorro cardiológico, assim como as internações na UTI e enfermaria cardiológicas, também reduziram, gerando preocupação acerca da evolução e prognóstico destes pacientes portadores de outras patologias, que não a COVID-19, nestes tempos de pandemia. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Impact of Lung Expansion Therapy Using Positive End-Expiratory Pressure in Mechanically Ventilated Patients Submitted to Coronary Artery Bypass Grafting

OBJECTIVE

To evaluate the impact of different levels of positive end-expiratory pressure (PEEP) on gas exchange in patients undergoing coronary artery bypass grafting (CABG).

METHODS

A randomized clinical trial was conducted with patients undergoing CABG surgery. Patients were randomized into three groups: Group 10, PEEP of 10 cmH2O; Group 12, PEEP of 12 cmH2O; and Group 15, PEEP of 15 cmH2O. After the randomization, all patients underwent gas analysis at three moments: (1) before lung expansion therapy (LET); (2) 30 minutes after LET; and (3) one hour after extubation.

RESULTS

Sixty-six patients were studied, of which 61.7% were men, with mean age of 64 ± 8.9 years. Patients allocated to Group 15 showed a significant improvement in gas exchange comparing pre- and post-expansion values (239±21 vs. 301±19, P<0,001) and the increase was maintained after extubation (278±26). Despite the use of high levels of PEEP, no significant hemodynamic change was evidenced.

CONCLUSION

It is concluded that high levels of PEEP (15 cmH2O) are beneficial for the improvement of gas exchange in patients undergoing CABG.

Effect of Different Levels of Peep on Oxygenation during Non-Invasive Ventilation in Patients Submitted to CABG Surgery: Randomized Clinical Trial

INTRODUCTION

During and after coronary artery bypass grafting, a decline in multifactor lung function is observed. Due to this fact, some patients may benefit from non-invasive ventilation after extubation targeting lung expansion and consequently improved oxygenation.

OBJECTIVE

To test the hypothesis that higher levels of positive end expiration pressure during non-invasive ventilation improves oxygenation in patients undergoing coronary artery bypass grafting.

METHODS

A randomized clinical trial was conducted at Instituto Nobre de Cardiologia in Feira de Santana. On the first day after surgery, the patients were randomized: Group PEEP 10, Group PEEP 12 and Group PEEP 15 who underwent non-invasive ventilation with positive end expiration pressure level. All patients were submitted to analysis blood pressure oxygen (PaO2), arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2).

RESULTS

Thirty patients were analyzed, 10 in each group, with 63.3% men with a mean age of 61.1±12.2 years. Mean pulmonary expansion pre-therapy PaO2 was generally 121.9±21.6 to 136.1±17.6 without statistical significance in the evaluation among the groups. This was also present in PaO2/FiO2 and SaO2. Statistical significance was only present in pre and post PEEP 15 when assessing the PaO2 and SaO2 (P=0.02).

CONCLUSION

Based on the findings of this study, non-invasive ventilation with PEEP 15 represented an improvement in oxygenation levels of patients undergoing coronary artery bypass grafting.

Análise do tempo de ventilação mecânica e internamento em pacientes submetidos a cirurgia cardíaca

Introdução: Pacientes submetidos à cirurgia cardíaca (CC) necessitam de ventilação mecânica invasiva (VMI) após o procedimento cirúrgico, sendo que um tempo prolongado de VMI pode levar a um aumento do tempo de permanência na Unidade de Terapia Intensiva (UTI). Objetivo: Verificar se o tempo de VMI interfere no tempo de internação em UTI. Métodos: Foram analisados, prospectivamente, pacientes submetidos à CC e que permaneceram por um tempo inferior a 24 horas na VMI. Foram selecionados 69 pacientes, os quais foram admitidos na UTI e acompanhados até o momento da extubação. Com esse dado encontrou-se o tempo que permaneceram em VMI e, depois, quantos dias permaneceram internados na UTI até o momento da alta da unidade. Resultados: A maior parte dos pacientes submetidos à CC foi do sexo masculino (56,5%); a idade média foi de 55,93±14,29 anos; o tipo de cirurgia mais prevalente foi a revascularização miocárdica (71,0%); o tempo médio de circulação extracorpórea (CEC) foi de 65,05±20,06 minutos; o tempo médio de internação na UTI foi de 2,18±1,10 dias; o tempo de VMI foi de 7,32±2,66 horas. Não se verificou significância estatística entre essas duas últimas variáveis com um p=0,43. Conclusão: Pode-se concluir que não houve correlação entre o tempo de ventilação mecânica e tempo de internação em UTI em pacientes que não apresentaram complicações pós-operatórias imediatas e que permaneceram menos de 12 horas sob ventilação mecânica. 

Formation of alkali-soluble fluoride on the surface of human dental enamel after treatment with fluoridated gels: influence of the pH variation and of the treatment time

The aim of this study was to quantify, in vitro, the formation of CaF2 after the application of three fluoridated gels: one neutral, one acidulated and another highly acidulated, on a bovine enamel dental surface treated with a Dijkman's demineralizing solution (1990). 145 sections were utilized, obtained from 145 sound teeth and divided into seven groups: C (enamel without treatment); FN1 (enamel demineralized and treated with neutral gel for 1 minute); FN4 (enamel demineralized and treated with neutral gel for 4 minutes); FFA1 (enamel demineralized and treated with acidulated gel for 1 minute); FFA4 (enamel demineralized and treated with acidulated gel for 4 minutes); FAA1 (enamel demineralized and treated with highly acidulated gel for 1 minute) and FAA4 (enamel demineralized and treated with highly acidulated gel for 4 minutes). The formation of CaF2 was analyzed by SEM and chemically by Caslavska's method (1975). The average and standard deviations from the groups studied were respectively: C-0.63; 0.38; FN1-23.06; 16.52; FFA1-54.11; 49.00; FAA1-43.87; 32.66; FN4-34.92; 23.00; FFA4-67.91; 42.36; FAA4-56.03; 38.96. (Mann-Whitney non-parametric test). The time of application did not interfere in the CaF2 formation from the acidulated and highly-acidulated gels. A minor concentration of fluoride and amount of pH from highly-acidulated gel did not affect the higher formation from the CaF2 in relation to the acidulated gel in both cases when the application was evaluated.

Metabolic fate of glutamine in lymphocytes, macrophages and neutrophils

Eric Newsholme's laboratory was the first to show glutamine utilization by lymphocytes and macrophages. Recently, we have found that neutrophils also utilize glutamine. This amino acid has been shown to play a role in lymphocyte proliferation, cytokine production by lymphocytes and macrophages and phagocytosis and superoxide production by macrophages and neutrophils. Knowledge of the metabolic fate of glutamine in these cells is important for the understanding of the role and function of this amino acid in the maintenance of the proliferative, phagocytic and secretory capacities of these cells. Glutamine and glucose are poorly oxidized by these cells and might produce important precursors for DNA, RNA, protein and lipid synthesis. The high rate of glutamine utilization and its importance in such cells have raised the question as to the source of this glutamine, which, according to current evidence, appears to be muscle.

Treatment of malnutrition in Brazil: simple solutions to common problems

At the largest rehabilitation centre in Ceará, Brazil, the World Health Organization (WHO) guidelines for improved dietary management of severe malnutrition were implemented. Rates of weight gain increased fourfold, daily food costs were reduced, and staff time was saved. Implementation was achieved within 1 week, including training. Other centres are encouraged to adopt similar measures.

The effect of N-3 PUFA rich diet upon macrophage and lymphocyte metabolism and function

A large body of evidence from experimental studies has documented that n-3 fatty acids can modify a variety of cell functions and disease states. As lymphocytes and macrophages are important cells for the development of the inflammatory and non-inflammatory immune response and are known to utilize high rates of glucose and glutamine, we have evaluated the effect of n-3 PUFA rich diet on the metabolisation of glucose and glutamine these cells, as well as the effect of one such diet upon the proliferative response of lymphocytes and the phagocytic capacity and hydrogen peroxide production by macrophages. The diet provoked an increase in the flux of glucose through the Krebs cycle in macrophages as well as a reduction in G6PDh and glutaminase activity in these cells. Lymphocytes from n-3 PUFA rich diet-fed rats showed a reduction in glucose and glutamine decarboxylation. Taken together the data show that, at least in part, the functional changes observed in macrophages and lymphocytes from n-3 PUFA-rich diet fed rats are related to the effect of this diet upon glucose and glutamine metabolism, leading to immunosuppression.

Variability of brain lithium levels during maintenance treatment: a magnetic resonance spectroscopy study

In vivo magnetic resonance spectroscopy (MRS) was used to determine the relationship between serum and brain lithium levels in bipolar patients (n=25). Over the broad range of serum lithium levels observed, the correlation (r=.68) with brain lithium levels was high. This correlation was much weaker (r=.39) when limited to only those patients with serum lithium levels in the range of 0.6-1.0 mmol/l. This variability may account for failure of lithium prophylaxis in some patients who have serum lithium levels in the therapeutic range.

Composition of fatty acids in the liver and lymphoid organs of rats fed fatty acid-rich diets

The composition of the fatty acids in the thymus, spleen and mesenteric lymph nodes was determined in rats fed polyunsaturated (UFC) or saturated (SFC) fatty acid-rich chow during 6 weeks or 14 months. The results indicated that the lipid composition of fatty acids in these tissues was modified by the type of fat given in the diets. Interestingly, the liver did not show any dietary induced change in the composition of fatty acids. The unsaturation index was raised in the lymphoid organs by UFC either after 6 weeks or 14 months. The ageing process itself increased the degree of unsaturation of fatty acids only in the spleen of the 3 groups. A high degree of unsaturation of fatty acids in the tissues may favour the occurrence of lipid peroxidation. It was noteworthy that a linoleic acid-rich diet (UFC) did not change the content of arachidonic acid in the tissues and so would therefore be unlikely to affect eicosanoid synthesis. As shown by previous studies, these fat-rich diets caused marked changes in the key enzyme activities of glucose and glutamine metabolism in the lymphoid organs, by as yet unknown mechanisms. The results reported here suggest that the effect of fat-rich diets on intermediary metabolism does not occur through eicosanoid synthesis and may be a consequence of the lipid peroxidative process or even alterations in the transcription of the enzymes of glycolysis and glutaminolysis.

Antioxidant enzyme activities in the lymphoid organs and muscles of rats fed fatty acids-rich diets subjected to prolonged physical exercise-training

Rats weighing 45-50 g were fed 3 diets for 8 wk: a balanced control diet (CD) consisting of 4% fat (polyunsaturated/saturated fatty acids [P/S] ratio 2.9/1) and two fat-rich diets: polyunsaturated (UD)--P/S 7.6/1 and saturated (SD) P/S 0.3/1. After 8 wk feeding on the respective diets, rats were subjected to swimming for 90 min at 30 degrees C daily, 5 d/wk for 8 wk. At the end of this period, the rats were killed and the lymphoid organs (LO--thymus, spleen, and mesenteric lymph nodes) and muscles (soleus and gastrocnemius) removed for the measurement of TBARs (Thiobarbituric Acid Reactant Substances) content and of the activities of antioxidant enzymes (CuZn- and Mn-Superoxide dismutase--SOD--, catalase, and glutathione peroxidase). To evaluate the changes in the sites of generation of reducing equivalents involved in the formation of free radicals, the activities of citrate synthase and glucose-6-phosphate dehydrogenase were measured. The exercise-training clearly modified the enzyme activities and TBARs content of the lymphoid organs and skeletal muscles, but this effect was dependent upon the diet given to the rats. However, fatty acid rich diets had presented a more pronounced effect on the studied aspects than did physical activity. Although one could expect a summatory effect of polyunsaturated fatty acid-rich diet and exercise-training, swimming increased the activities of CuZn- and Mn-SOD in almost all tissues from the elevated level promoted by fat-rich diets.

Effect of dietary vitamin E supplementation on macrophage metabolism during ageing. Study in rats fed fat-rich diets during ageing

The effect of dietary vitamin E supplementation upon macrophage metabolism and function was examined in aged rats fed a balanced or a polyunsaturated-rich diet. The following parameters were studied: number of cells in the intraperitoneal cavity, maximal activity of hexokinase, citrate synthase, glucose-6-phosphate dehydrogenase, glutathione peroxidase and phosphate-dependent glutaminase. The consumption of glucose and the production of lactate, hydrogen peroxide and thiobarbituric reactive substances were measured in control ONCO-BCG injected rats. The results indicated that vitamin E has no significant effect on the values of the parameters studied in the macrophages of rats fed a balanced diet both for 3 (mature) or 17 months (aged). This antioxidant did not provoke any response on the changes caused by ageing the animals. However, several of the metabolic and functional alterations in macrophage induced by the polyunsaturated-rich diets were reversed by the inclusion of vitamin E in the diet. These changes were associated with macrophage migration capacity, citrate synthase and glucose-6-phosphate dehydrogenase activities and the content of lipid peroxides. The findings suggest that vitamin E has a beneficial effect for macrophage metabolism and function, but the effects are confined to particular circumstances.

Effect of a polyunsaturated fatty acid-rich diet on macrophage and lymphocyte metabolism of diabetic rats

Diabetic subjects present high susceptibility to infections but the mechanisms involved are not fully known. Macrophages and lymphocytes utilize glucose and glutamine at high rates and these metabolites are important for the function of these cells. The present study examines the activities of key metabolic enzymes in macrophages and lymphocytes obtained from alloxan-diabetic Wistar rats (10 weeks old, 7 rats each group). Since the enteral diet was enriched with omega-6 polyunsaturated fatty acids (PUFA), the effect of these fatty acids was also investigated in the same animals. Diabetes caused a marked decrease of hexokinase activity (48%; 274.23 +/- 18.43 vs 143.29 +/- 10.35 units for control vs diabetic rats) in macrophages and of citrate synthase and glucose-6-phosphate dehydrogenase activities (70%; 321.76 +/- 9.18 vs 96.25 +/- 5.43 units for citrate synthase and 89.43 +/- 2.33 vs 23.13 +/- 1.09 units for G6PDh for control vs diabetic rats) in mesenteric lymph node lymphocytes. A PUFA-rich diet given for 6 weeks enhanced hexokinase activities by 30% (274.23 +/- 18.43 vs 342.48 +/- 15.39, balanced vs PUFA-rich diets for normal and 143.29 +/- 10.35 vs 189.67 +/- 9.57 for diabetic rats) and reduced citrate synthase activities by 43% (30.31 +/- 1.73 vs 17.42 +/- 0.95, balanced vs PUFA-rich diets for normal and 29.34 +/- 1.23 vs 16.73 +/- 1.02 for diabetic rats) in macrophages, and reduced (< 50%; 59.67 +/- 3.45 vs 48.87 +/- 3.37 for hexokinase and 321.76 +/- 2.33 vs 161.66 +/- 9.97 for citrate synthase, balanced vs PUFA-rich diets) the activities of both enzymes in lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolic and functional changes in macrophages of rats fed polyunsaturated or saturated fatty acid rich-diets during ageing

Previous reports from our laboratory showed that rats fed a polyunsaturated fatty acid-rich diet (UC), during an acute intervals, present important changes in macrophage metabolism and function, while a saturated fatty acid diet (SC) did not induce significant changes (10). In this study, two important questions were addressed: 1. the persistence of the changes induced by the UC and 2. the effect of a SC offered during ageing. The maximal activities of hexokinase, glucose-6-phosphate dehydrogenase, glutaminase, citrate synthase and glutathione peroxidase and the total content of lipid peroxides were measured in resident and inflammatory macrophages of rats fed control chow (CC), UC or SC during 14 months. Intraperitoneal cell migration by thioglycollate injection and the phagocytosis capacity were also evaluated. The results indicate that: 1) the changes caused by UC are exacerbated during ageing, and 2) the SC, given during a prolonged period of time, also caused important alterations of macrophage metabolism and function.

Metabolic changes induced by w-3 polyunsaturated fatty acid rich-diet (w-3 PUFA) on the thymus, spleen and mesenteric lymph nodes of adult rats

The maximal activity of key enzymes of glycolysis, pentose phosphate pathway, TCA cycle and glutaminolysis were measured in the immune tissues of rats fed w-3 PUFA during 6 weeks. Total lipid peroxidation and glutathione peroxidase activity were also measured. The hexokinase activity was enhanced 4-fold in the spleen and thymus, doubled in the liver and was diminished in mesenteric lymph nodes (35%). Citrate synthase activity was decreased in the spleen and lymph nodes and increased in the thymus. G-6-PDH activity was increased 2-fold in the spleen and mesenteric lymph nodes and by 20% in the thymus whereas it was reduced (66%) in the liver. Glutathione peroxidase activity and total lipid peroxides increased in all tissues of rats fed w-3 PUFA. The results presented here suggest that w-3 PUFA, by causing important metabolic changes in the immune tissues and lipid peroxidation may lead to changes of immune function.

Effect of polyunsaturated (PUFA n-6) and saturated fatty acids-rich diets on macrophage metabolism and function

Previous reports of our laboratory have shown that PUFA (n-6)-rich diets cause important changes of the metabolism of the immune tissues. In this study, alterations of macrophage metabolism and function were examined in rats fed polyunsaturated (UC) or saturated (SC) fatty acids-rich diets during 6 weeks. The UC group decreased intraperitoneal cell migration and macrophage phagocytosis. These changes were related to modifications of macrophage metabolism. The UC group showed also increased G-6-PDh in inflammatory macrophages. These findings suggest that pentose-phosphate pathway is not the unique metabolic factor to control phagocytosis. PUFA-rich diet reduced glutaminase activity. Therefore, this amino acid might be one of the possible metabolic reasons for the impaired macrophage function observed.

Polyunsaturated and saturated fatty acids-rich diets and immune tissues. 2. Maximal activities of key enzymes of glutaminolysis, glycolysis, pentose-phosphate-pathway and Krebs cycle in thymus, spleen and mesenteric lymph nodes

It has been widely reported that polyunsaturated fatty acids (PU-FA n-6) in the diet lead to immunosuppression. In the present study, the activity of key enzymes several metabolic pathways were measured in the immune tissues of rats fed polyunsaturated (UC) or saturated fatty (SC) acids-rich diets. The following enzyme activities were measured: hexokinase, citrate synthase, glucose-6-phosphate dehydrogenase, glutaminase and malic enzyme. The metabolism of immune tissues was markedly changed by the fat content of the diet. However, UC diet determined more significant metabolic changes than SC diet.

Polyunsaturated and saturated fatty acids-rich diets and immune tissues. 1. Fresh weight, DNA content, percentage of lipids and rate of lipogenesis from 3H2O in thymus, spleen and mesenteric lymph nodes

It has been widely reported that polyunsaturated fatty acids-rich diets (PUFA n-6) cause immunodeficiency. In this study, fresh weight, DNA and lipid content and rate of lipogenesis from 3H2O of thymus, spleen, mesenteric lymph nodes and liver were assessed in rats fed polyunsaturated (UC) or saturated (SC) fatty acids-rich chows. The results obtained indicate that both types of fatty acids caused similar increment of lipid content in the immune tissues. The rate of lipogenesis was decreased only in the thymus of (UC) rats and liver of both experimental groups as compared to control rats. The results of fresh weight and DNA content was decreased only by (UC) diet.