Coronary inflammation by computed tomography pericoronary fat attenuation in young male anabolic androgenic steroid users

Background

The illicit use of anabolic androgenic steroids (AAS) has been associated with diminished cholesterol efflux mediated by HDL, remarkable decrease in high-density lipoprotein (HDL) plasma concentration and subclinical coronary artery disease (CAD). Inflammation is the key to the atherogenic process associated with atherosclerotic plaque vulnerability. The pericoronary mean fat attenuation (pFAM) has emerged as a marker of coronary inflammation and can predict future cardiovascular events, which is measurable from standard coronary computed tomography angiography (CCTA). However, whether AAS abuse has a role in pFAM in young male AAS users is unknown.

Purpose

The aim of this study was to evaluate whether AAS abuse could leads to higher pFAM and premature coronary inflammation in young male AAS users.

Methods

Twenty strength-trained AAS users (AASU) age 29±5 yr, 20 age-matched strength-trained AAS nonusers (AASNU), and 10 sedentary controls (SC) were enrolled in this study. Coronary inflammation was assessed by pFAM-CCTA in the right coronary artery (RCA), left anterior descending artery (LDA) and left circumflex coronary artery (Cx).

Results

pFAM in the RCA was significantly higher in AASU compared with AASNU and SC (−64.59±9.45 vs. −79.21±6.67 vs. −80.97±7,91 Hounsfield Units (HU), respectively, p<0.001]. Also, the pFAM in the LAD was higher in AASU compared with AASNU and SC (−72.83±7.21 vs. −79.41±6.72 vs. −80.97±7.72 HU, p=0.006). However, no difference to pFAM in the Cx between AASU, AASNU and SC (−74.30±5.85 vs. −79.77±7.13 vs. −78.19±5.82 HU, respectively, p=0.069) was found.

Conclusion

This study indicates that AAS abuse may be associated with higher pFAM and premature coronary inflammation in the RCA and LAD. The higher pFAM may be linked to early development of CAD in young AAS users.

Funding Acknowledgement

Type of funding sources: Other. Main funding source(s): Fundação Zerbini

SNPs from BCHE and DRD3 genes associated to cocaine abuse amongst violent individuals from Sao Paulo, Brazil

Violence and drug abuse are highly destructive phenomena found world-wide, especially in Brazil. They seem to rise proportionally to one another and possibly related. Additionally, genetics may also play a role in drug abuse. This study has focused on identifying the use of cocaine within postmortem cases arriving at the Institute of Legal Medicine of Sao Paulo as well as the presence of certain single nucleotide polymorphisms (SNPs) to better understand one's susceptibility to abuse the drug. Both hair and blood samples have been extracted through a simple methanol overnight incubation or a rapid dilute-and-shoot method, respectively. The samples were then analyzed using an UPLC-ESI-MS/MS and genotyped through RT-PCR. Statistical analyses were performed via SPSS software. From 105 postmortem cases, 53% and 51% of the cases shown to be positive for cocaine in hair and blood, respectively. Genetic wise, a significant difference has been observed for SNP rs4263329 from the BCHE gene with higher frequencies of the genotypes A/G and G/G seen in cocaine users (OR=8.91; 95%CI=1.58-50.21; p=0.01). Likewise, also SNP rs6280 from the DRD3 gene presented a significant association, with both genotypes T/C and C/C being more frequent in users (OR=4.96; 95% CI=1.07-23.02; p=0.04). To conclude, a rather high proportion of cocaine has been found, which may suggest a connotation between the use of the drug and risky/violent behaviors. Additionally, significant associations were also found within two SNPs related to cocaine use, however, due to several inherent limitations, these must be confirmed.

P4132Decreased myocardial native T1 times and impaired myocardial contractility in young anabolic androgenic steroids users

Background

Anabolic androgenic steroids (AAS) have been associated with several injuries on the cardiovascular system. AAS abuse may have a direct toxic effect on the myocardium that could lead to cardiac function and structure alterations. Clinical and forensic cases have been reported myocardial fibrosis in AAS users. Myocardial fibrosis increases the risk of heart failure and sudden death. However, recent studies did not show evidence of focal myocardial fibrosis and diffuse myocardial fibrosis in AAS users using T1-mapping techniques. Thus, it remains unclear the association between AAS and cardiac structure alterations.

Purpose

The aim of this study was to evaluate cardiac structure by cardiovascular magnetic resonance (CMR) imaging with late-gadolinium enhancement (LGE), cardiac T1-mapping and extracellular volume measurements (ECV). Additionally, we also evaluated the cardiac contractility by CMR and echocardiography in young AAS users.

Methods

Twenty strength-trained AAS users (AASU) age 29±5 yr, 20 age-matched strength-trained AAS nonusers (AASNU), and 10 sedentary controls (SC) were enrolled. Cardiac structure was assessed by LGE, native T1-mapping and ECV. Cardiac contractility was evaluated as cardiac strain measured by CMR (feature tracking imaging technique) and echocardiography (speckle tracking technique).

Results

Global native T1 times [753 (683–870) vs 916 (815–1239) vs 1205 (825–1242) ms, respectively, p=0.03], and native T1 times at the left ventricle mid-ventricular slice [813 (695–1096) vs 922 (825–1095) vs 1140 (840–1322) ms, respectively, p=0.03] were lower in AASU compared with AASNU and SC. Mid-ventricular ECV was similar between AASU, AASNU and SC (22±6 vs 23±4 vs 24±4%, respectively, p=0.37). Focal myocardial fibrosis was found in 2 individuals (11%) of AASU. The mid anteroseptal and mid inferoseptal were the most affected segments. The total estimated mass of the LV mass was 1.25 g (0.65%). Three participants of SC showed focal myocardial fibrosis. The mid anterolateral, mid inferolateral and mid inferomedial were the most affected segments. The total estimated mass of the LV mass was 3.43 g (2.30%). In contrast, none of the AASNU had myocardial fibrosis. By CMR, AASU showed a lower medial radial strain (30±8 vs. 38±6%, p<0.01), medial circumferential strain (−17±3 vs −20±2%, p<0.01) and global longitudinal strain (−17±3 vs −20±3%, p<0.01) compared with AASNU. Echocardiography also demonstrated a lower 4CH longitudinal strain in AASU compared with AASNU (−15.5±3 vs −18.3±2%, p=0.03). Moreover, the AASU shower a higher left ventricle mass compared with AASNU and SC (185±20 vs 130±17 vs 112±14 g, respectively, p<0.01).

Conclusion

This study indicates that AAS abuse may be associated with decreased myocardial native T1 times, impaired myocardial contractility and focal myocardial fibrosis. These myocardial structural and functional alterations may be associated to unadapted cardiac hypertrophy in young AAS users.

Acknowledgement/Funding

Fundação de Amparo à Pesquisa do Estado de São Paulo [FAPESP], Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes).

Free-radical scavenging action of medicinal herbs from Ghana: Thonningia sanguinea on experimentally-induced liver injuries

The antioxidant action of medicinal herbs used in Ghana for treating various ailments was evaluated in vitro and in vivo. Five plants, Desmodium adscendens, Indigofera arrecta, Trema occidentalis, Caparis erythrocarpus, and Thonningia sanguinea were tested for their free radical scavenging action by their interaction with 1,1-diphenyl-2-picrylhydrazyl (DPPH). Of these five plants, only Thonningia sanguinea was found to scavenge the DPPH radical. Lipid peroxidation in liver microsomes induced by H2O2 was also inhibited by T. sanguinea. The hepatoprotective effect of T. sanguinea was studied on acute hepatitis induced in rats by a single dose of galactosamine (GalN, 400 mg/kg, IP) and in mice by carbon tetrachloride (CCl4, 25 microl/kg, IP). GalN induced hepatotoxicity in rats as evidenced by an increase in alanine aminotransferase (ALT) and glutathione (GSH) S-transferase activities in serum was significantly inhibited when T. sanguinea extract (5 ml/kg, IP) was given to rats 12 hr and 1 hr before GalN treatment. The activity of liver microsomal GSH S-transferase, which is known to be activated by oxidative stress, was increased by the GaIN treatment and this increase was blocked by T. sanguinea pretreatment. Similarly, T. sanguinea pretreatment also inhibited CCl4-induced hepatotoxicity in mice. These data indicate that T. sanguinea is a potent antioxidant and can offer protection against GalN- or CCl4-induced hepatotoxicity.

Screening of antioxidant action of various molds and protection of Monascus anka against experimentally induced liver injuries of rats

Antioxidant action of various molds, which are traditionally used for the production of foods or alcoholic beverages in Japan, was studied in vitro and in vivo. Antioxidant action was evaluated by scavenging stable free radical 1,1-diphenyl-2-picrylhydrazyl (DPPH) and lipid peroxidation of rat liver microsomes. Among 40 molds, 16 species showed the DPPH scavenging action, and the molds that can scavenge the DPPH radical inhibited lipid peroxidation. The mold with the strongest action, Monascus anka, was chosen for the investigation of a protective action against liver injury of rats. When galactosamine (GalN, 400 mg/kg) or GalN plus lipopolysaccharide (LPS, 0.5 microg/kg) was given intraperitoneally to rats (Sprague-Dawley), aspartate aminotransferase (AST) and glutathione (GSH) S-transferase (GST) activities in serum were significantly increased. However, such hepatotoxicities seen in the increase in serum enzyme levels were depressed when the extract prepared from M. anka was given 1 and 15 h before the toxic insultant. Liver microsomal GST activity, which is known to be activated by oxidative stress, was increased by GalN or GaIN plus LPS treatment and the increase was also inhibited by pretreatment with the extract. Pathomorphological changes in the liver caused by GalN treatment also were prevented by the mold extract. These results indicate that the extract of M. anka has radical scavenging action and ameliorates chemically induced hepatotoxicity.

Protective effect of the mold Monascus anka against acetaminophen-induced liver toxicity in rats

Antioxidant and hepatoprotective actions of the mold Monascus anka (also called Beni-Koji in Japan) against acetaminophen (AAP)-induced liver toxicity were investigated. Serum aspartate aminotransferase and glutathione S-transferase (GST) activities increased by AAP (180 mg/kg, i.p.) treatment were depressed when the Beni-Koji preparation (4 ml/kg, i.p.) was given 15 and 1 hr before AAP administration. The decrease in liver cytosolic GST activity by AAP, reflecting the release of the enzyme into serum, was also blocked by the mold. Cytochrome P450 activity was inhibited by the Beni-Koji preparation. These results suggest that M. anka prevents AAP-induced liver toxicity by both antioxidant action and the inhibition of AAP metabolism.

Acetaminophen-derived activation of liver microsomal glutathione S-transferase of rats

Effect of acetaminophen on glutathione (GSH) S-transferase and related drug metabolizing enzymes was studied in vivo. Rats were given acetaminophen (250 mg/kg, i.p.) 24 hr after the treatment with 3-methylcholanthrene (25 mg/kg, i.p.) and killed by decapitation at indicated times. Liver microsomal GSH S-transferase activity was increased to 331%, 193% and 158% of the control level at 3, 6 and 12 hr, respectively, after the administration of acetaminophen, while GSH content in the liver was markedly decreased at 3 and 6 hr. The increase in the transferase activity was not recovered by the treatment with dithiothreitol. Microsomal GSH peroxidase activity was significantly enhanced at 3 hr. Cytosolic GSH S-transferase and aniline hydroxylase in microsomes were gradually decreased with the increase in the time after administration of acetaminophen. Vmax values of both GSH S-transferase and GSH peroxidase activities in microsomes were increased at 3 hr. Two Km values were obtained for the peroxidase in the control, while only one was observed after the acetaminophen treatment. These results indicate that acetaminophen is converted via cytochrome P-450 to the reactive intermediate N-acetyl-p-benzoquinone imine, which binds to microsomal GSH S-transferase, resulting in the activation of the enzyme.