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Veras ASC, Batista VRG, Correia RR, de Almeida Tavares ME, Rubira RJG, Tavares ER, Giometti IC, Maranhão RC, Teixeira GR. Integrated aerobic exercise with LDE-docetaxel treatment: a novel approach to combat prostate cancer progression. Sci Rep 2024; 14:9626. [PMID: 38671015 PMCID: PMC11053171 DOI: 10.1038/s41598-024-60138-y] [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: 12/22/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
The variability in response to conventional prostate cancer (PC) therapies, coupled with the emergent issue of drug resistance, underscores the critical need for innovative treatment strategies. Aerobic physical exercise reduced incidence of several cancers, but the mechanism underlying these effects associated the nanoemulsion not fully understood. The application of a lipid nanoemulsion (LDE) delivery system for docetaxel (DTX), showing marked enhancement in therapeutic efficacy when combined with aerobic physical exercise. This novel intervention potentiates the antitumor activity of LDE-delivered DTX by augmenting nanoparticle internalization and inducing cell cycle arrest. Our findings reveal that this synergistic treatment not only significantly reduces prostate weight and mitigates adenocarcinoma proliferation but also attenuates anti-apoptotic BCL-2 protein expression. Concurrently, it elevates pro-apoptotic proteins and diminishes inflammatory markers. Metabolic profiling of the combined therapy group disclosed additional benefits, such as reduced lipid and plasma glucose levels. Collectively, our data illuminate the profound impact of integrating LDE-mediated DTX delivery with structured physical exercise, which together spearhead a dual-front assault on PC. This multimodal approach heralds a new paradigm in PC management, accentuating the promise of combined pharmacological and non-pharmacological interventions to elevate tumor suppressor protein activity and refine patient outcomes.
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Affiliation(s)
- Allice Santos Cruz Veras
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Victor Rogério Garcia Batista
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Rafael Ribeiro Correia
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Maria Eduarda de Almeida Tavares
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Rafael Jesus Gonçalves Rubira
- Department of Physics, School of Technology and Applied Sciences, São Paulo State University, Presidente Prudente, SP, Brazil
| | - Elaine Rufo Tavares
- Lipid Metabolism Laboratory, Heart Institute (INCOR), Medical School Hospital, University of São Paulo, (USP), Presidente Prudente, SP, Brazil
| | - Inês Cristina Giometti
- Postgraduate Animal Science Program, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Raul Cavalcante Maranhão
- Lipid Metabolism Laboratory, Heart Institute (INCOR), Medical School Hospital, University of São Paulo, (USP), Presidente Prudente, SP, Brazil
| | - Giovana Rampazzo Teixeira
- Multicenter Graduate Program in Physiological Sciences, SBFis, São Paulo State University (UNESP), Presidente Prudente, SP, Brazil.
- Department of Physical Education, São Paulo State University (UNESP), School of Technology and Sciences, Presidente Prudente, Street Roberto Simonsen, 305, Presidente Prudente, SP, 19060-900, Brazil.
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Marinho LL, Rached FH, Morikawa AT, Tavoni TM, Cardoso APT, Torres RVA, Assuncao AN, Serrano CV, Nomura CH, Maranhão RC. Safety and possible anti-inflammatory effect of paclitaxel associated with LDL-like nanoparticles (LDE) in patients with chronic coronary artery disease: a double-blind, placebo-controlled pilot study. Front Cardiovasc Med 2024; 11:1342832. [PMID: 38450375 PMCID: PMC10915057 DOI: 10.3389/fcvm.2024.1342832] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Studies in cholesterol-fed rabbits showed that anti-proliferative chemotherapeutic agents such as paclitaxel associated with solid lipid nanoparticles (LDE) have marked anti-atherosclerotic effects. In addition, association with LDE nearly abolishes paclitaxel toxicity. We investigated whether treatment with LDE-paclitaxel changes plaque progression by coronary CT angiography and is safe in patients with chronic coronary artery disease. Methods We conducted a prospective, randomized, double-blind, placebo-controlled pilot study in patients with multi-vessel chronic coronary artery disease. Patients were randomized to receive IV infusions of LDE-paclitaxel (paclitaxel dose: 175 mg/m2 body surface) or LDE alone (placebo group), administered every 3 weeks for 18 weeks. All participants received guideline-directed medical therapy. Clinical and laboratory safety evaluations were made at baseline and every 3 weeks until the end of the study. Analysis of inflammatory biomarkers and coronary CTA was also performed at baseline and 4 weeks after treatment. Results Forty patients aged 65.6 ± 8 years, 20 in LDE-paclitaxel and 20 in placebo group were enrolled. Among those, 58% had diabetes, 50% had myocardial infarction, and 91% were in use of statin and aspirin. Baseline demographics, risk factors, and laboratory results were not different between groups. In all patients, no clinical or laboratory toxicities were observed. From the baseline to the end of follow-up, there was a non-significant trend toward a decrease in IL-6 levels and hsCRP in the LDE-paclitaxel group (-16% and -28%, respectively), not observed in placebo. Regarding plaque progression analysis, variation in plaque parameter values was wide, and no difference between groups was observed. Conclusion In patients with multivessel chronic coronary artery disease and optimized medical therapy, LDE-paclitaxel was safe and showed clues of potential benefits in reducing inflammatory biomarkers. Clinical Trial Registration https://clinicaltrials.gov/study/NCT04148833, identifier (NCT04148833).
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Affiliation(s)
- Lucas Lage Marinho
- Lipid Metabolism Laboratory, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | - Fabiana Hanna Rached
- Department of Cardiopneumology, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | - Aleksandra Tiemi Morikawa
- Lipid Metabolism Laboratory, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | - Thauany Martins Tavoni
- Lipid Metabolism Laboratory, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | | | | | | | - Carlos Vicente Serrano
- Department of Cardiopneumology, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | - Cesar Higa Nomura
- Department of Radiology, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Lipid Metabolism Laboratory, Instituto do Coracao (InCor) Universidade de Sao Paulo, São Paulo, Brazil
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Avila-Tavares R, Gibran L, Brito LGO, Tavoni TM, Gonçalves MO, Baracat EC, Maranhão RC, Podgaec S. Pilot study of treatment of patients with deep infiltrative endometriosis with methotrexate carried in lipid nanoparticles. Arch Gynecol Obstet 2024; 309:659-667. [PMID: 37987824 DOI: 10.1007/s00404-023-07246-8] [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: 01/24/2023] [Accepted: 09/27/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Previously, lipid nanoparticles (LDE) injected in women with endometriosis were shown to concentrate in the lesions. Here, the safety and feasibility of LDE carrying methotrexate (MTX) to treat deep infiltrating endometriosis was tested. DESIGN Prospective pilot study. SETTING Perola Byington Hospital Reference for Women's Health. SUBJECTS Eleven volunteers (aged 30-47 years, BMI 26.15 ± 6.50 kg/m2) with endometriosis with visual analog scale pelvic pain scores (VAS) > 7 and rectosigmoid lesions were enrolled in the study. INTERVENTION Three patients were treated with LDE-MTX at single intravenous 25 mg/m2 dose of MTX and eight patients with two 25 mg/m2 doses with 1-week interval. MAIN OUTCOME MEASURES Clinical complaints, blood count, and biochemistry were analyzed before treatment and on days 90, 120, and 180 after LDE-MTX administration. Endometriotic lesions were evaluated by pelvic and transvaginal ultrasound (TVUS) before treatment and on days 30 and 180 after LDE-MTX administration. RESULTS No clinical complaints related with LDE-MTX treatment were reported by the patients, and no hematologic, renal, or hepatic toxicities were observed in the laboratorial exams. FSH, LH, TSH, free T4, anti-Müllerian hormone, and prolactin levels were also within normal ranges during the observation period. Scores for deep dyspareunia (p < 0.001), chronic pelvic pain (p = 0.008), and dyschezia (p = 0.025) were improved over the 180-day observation period. There was a non-significant trend for reduction of VAS scores for dysmenorrhea. Bowel lesions by TVUS were unchanged. No clear differences between the two dose levels in therapeutic responses were observed. CONCLUSION Results support the safety and feasibility of using LDE-MTX in women with deep infiltrating endometriosis as a novel and promising therapy for the disease. More prolonged treatment schemes should be tested in future placebo-controlled studies aiming to establish the usefulness of this novel nanomedicine approach.
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Affiliation(s)
- Roberta Avila-Tavares
- Gynecological Endoscopy Center of the Perola Byington Hospital Reference for Women's Health, São Paulo, Brazil.
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil.
| | - Luciano Gibran
- Gynecological Endoscopy Center of the Perola Byington Hospital Reference for Women's Health, São Paulo, Brazil
| | - Luiz Gustavo Oliveira Brito
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, Brazil
| | - Thauany Martins Tavoni
- Lipid Metabolism Laboratory, Heart Institute, University of Sao Paulo, São Paulo, Brazil
| | | | - Edmund Chada Baracat
- Department of Obstetrics and Gynecology, Medical School Hospital, University of Sao Paulo, São Paulo, Brazil
| | | | - Sergio Podgaec
- Department of Obstetrics and Gynecology, Medical School Hospital, University of Sao Paulo, São Paulo, Brazil
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Franco Fontes C, Silva Bidu N, Rodrigues Freitas F, Maranhão RC, Santos Monteiro ADS, David Couto R, Martins Netto E. Changes in serum amyloid A, plasma high-density lipoprotein cholesterol and apolipoprotein A-I as useful biomarkers for Mycobacterium tuberculosis infection. J Med Microbiol 2023; 72. [PMID: 37389586 DOI: 10.1099/jmm.0.001726] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
Introduction. In recent years, cholesterol has received interest in the study of infection due to evidence of a relationship between low plasma cholesterol levels and tuberculosis (TB).Hypothesis/Gap Statement. Plasma lipid profiles of serum amyloid A (SAA), apolipoprotein A-I and high-density lipoprotein cholesterol (HDL-C) are biomarkers associated with symptomatic TB patients.Objective. We aimed to evaluate plasma lipid profiles of apolipoprotein A-I, SAA and the size of HDL as biomarkers to diagnose symptomatic TB patients.Methodology. Patients with TB symptoms attending the Instituto Brasileiro para a Investigação da Tuberculose/Fundação José Silveira (IBIT/FJS) between September 2015 and August 2016 for diagnosis of TB were studied. From 129 patients, 97 were classified as pulmonary TB and 32 as negative-bacilloscopy (non-TB group). Medical history, fasting serum and plasma were obtained. Total cholesterol (TC), HDL-C, apolipoprotein A-I and SAA were measured by enzymatic or immunochemical reaction assays. HDL size was measured by laser light-scattering.Results. In TB patients, TC (147.0±37 vs. 168±44 mg dL-1), HDL-C (37±14 vs. 55±18 mg dL-1) and apolipoprotein A-I (102±41 vs. 156±47 mg dL-1) concentrations were lower (P<0.0001), while HDL particle size (10.16±1.02 vs. 9.62±0.67 nm) and SAA levels (280±36 vs. 19±8 mg L-1) were higher (P<0.0001). Using receiver-operating characteristic curve analysis for predicting TB, the cutoff values were <83.85 mg L-1 for SAA (sensitivity=96.88 %, specificity=78.43 %, P<0.0001), >44.50 mg dL-1 for HDL-C (sensitivity=75 %, specificity=72.16 %, P<0.001) and >118.5 mg dL-1 for apolipoprotein A-I (sensitivity=83.83 %, specificity=72.22 %, P<0.001).Conclusion. SAA, HDL-C and apolipoprotein A-I are associated with TB infection and could be used as laboratory biomarkers, especially in patients who are negative for alcohol-acid-resistant bacilli.
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Affiliation(s)
- Cleuber Franco Fontes
- The Graduate Program in Medicine and Health, School of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil
- Clinical Biochemistry Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Nadielle Silva Bidu
- Clinical Biochemistry Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil
- Postgraduate Course in Biotechnology in Health and Investigative Medicine, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Fatima Rodrigues Freitas
- Laboratory of Metabolism and Lipid, Heart Institute, Medical School Hospital, University of Sao Paulo, São Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Laboratory of Metabolism and Lipid, Heart Institute, Medical School Hospital, University of Sao Paulo, São Paulo, Brazil
- Faculty of Pharmacy, University of Sao Paulo, São Paulo, Brazil
| | - Adriano de Souza Santos Monteiro
- Postgraduate Course in Biotechnology in Health and Investigative Medicine, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
| | - Ricardo David Couto
- Clinical Biochemistry Laboratory, Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil
- Postgraduate Course in Biotechnology in Health and Investigative Medicine, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil
- The Graduate Program in Pharmacy, Faculty of Pharmacy, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Medicine, Centro Universitário de Tecnologia e Ciências (UniFTC), Salvador, Brazil
| | - Eduardo Martins Netto
- The Graduate Program in Medicine and Health, School of Medicine of Bahia, Federal University of Bahia, Salvador, Bahia, Brazil
- Instituto Brasileiro para Investigação da Tuberculose, José Silveira Foundation, Salvador, Bahia, Brazil
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Albuquerque CI, Tavares ER, Guido MC, Carvalho PO, Tavoni TM, Lopes NM, Silva BMDO, Jensen L, Stolf NAG, Maranhão RC. Treatment of rabbits with atherosclerosis induced by cholesterol feeding with daunorubicin associated to a lipid core nanoparticle (LDE). J Drug Deliv Sci Technol 2023. [DOI: 10.1016/j.jddst.2022.104067] [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: 12/12/2022]
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Streb AR, Braga PGS, de Melo RF, Botelho LJ, Maranhão RC, Del Duca GF. Effects of combined physical exercise on plasma lipid variables, paraoxonase 1 activity, and inflammation parameters in adults with obesity: a randomized clinical trial. J Endocrinol Invest 2022; 45:1991-1997. [PMID: 35713846 DOI: 10.1007/s40618-022-01833-3] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/31/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We aimed to investigate whether combined physical exercise may affect plasma lipid variables, paraoxonase 1 (PON1) activity, and inflammation parameters in adults with obesity. METHODS Thirty-six participants were recruited to complete the study protocol. The mean age was 37 ± 1 years, and the baseline body mass index was 33.0 ± 0.4 kg/m2. Participants were allocated to the control group (CG) and the exercise group (EG). The EG performed three weekly sessions of combined physical exercise for 16 weeks. Plasma lipid variables, PON1 activity, and inflammatory profile were determined before and after intervention. RESULTS Total cholesterol levels decreased in both groups, without intergroup difference (time p = 0.001). Non-high-density lipoprotein cholesterol (HDL-C) levels decreased in both groups (time p = 0.001); however, they were lower in the EG than in the CG (p = 0.038). The EG had increased HDL-C levels, but the CG had decreased HDL-C levels (time*group p = 0.011). PON1 activity was reduced in both groups (time, p = 0.001). The Castelli risk Index I and II reduced in the EG and increased in the CG (time*group, p = 0.008 and p = 0.011, respectively). The inflammatory markers were not modified. CONCLUSION Adults with obesity may benefit from regular practice of combined physical exercise training in many metabolic aspects that are related to protection against the development of cardiovascular disease.
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Affiliation(s)
- A R Streb
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Centro de Desportos-CDS, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil.
| | - P G S Braga
- Laboratório de Metabolismo e Lípides, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - R F de Melo
- Departamento de Análises Clínicas, Centro de Ciências da Saúde-CCS, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - L J Botelho
- Departamento de Saúde Pública, Centro de Ciências da Saúde-CCS, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil
| | - R C Maranhão
- Laboratório de Metabolismo e Lípides, Instituto do Coração, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, 05403-000, Brazil
| | - G F Del Duca
- Grupo de Estudo e Pesquisa em Exercício Físico e Doenças Crônicas Não Transmissíveis, Centro de Desportos-CDS, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, 88040-900, Brazil
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Guido MC, Lopes NDM, Albuquerque CI, Tavares ER, Jensen L, Carvalho PDO, Tavoni TM, Dias RR, Pereira LDV, Laurindo FRM, Maranhão RC. Treatment With Methotrexate Associated With Lipid Core Nanoparticles Prevents Aortic Dilation in a Murine Model of Marfan Syndrome. Front Cardiovasc Med 2022; 9:893774. [PMID: 35757348 PMCID: PMC9226570 DOI: 10.3389/fcvm.2022.893774] [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: 03/10/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
In Marfan syndrome (MFS), dilation, dissection, and rupture of the aorta occur. Inflammation can be involved in the pathogenicity of aortic defects and can thus be a therapeutic target for MFS. Previously, we showed that the formulation of methotrexate (MTX) associated with lipid nanoparticles (LDE) has potent anti-inflammatory effects without toxicity. To investigate whether LDEMTX treatment can prevent the development of aortic lesions in the MFS murine model. MgΔloxPneo MFS (n = 40) and wild-type (WT, n = 60) mice were allocated to 6 groups weekly injected with IP solutions of: (1) only LDE; (2) commercial MTX; (3) LDEMTX (dose = 1mg/kg) between 3rd and 6th months of life. After 12 weeks of treatments, animals were examined by echocardiography and euthanatized for morphometric and molecular studies. MFS mice treated with LDEMTX showed narrower lumens in the aortic arch, as well as in the ascending and descending aorta. LDEMTX reduced fibrosis and the number of dissections in MFS but not the number of elastic fiber disruptions. In MFS mice, LDEMTX treatment lowered protein expression of pro-inflammatory factors macrophages (CD68), T-lymphocytes (CD3), tumor necrosis factor-α (TNF-α), apoptotic factor cleaved-caspase 3, and type 1 collagen and lowered the protein expression of the transforming growth factor-β (TGF-β), extracellular signal-regulated kinases ½ (ERK1/2), and SMAD3. Protein expression of CD68 and CD3 had a positive correlation with an area of aortic lumen (r2 = 0.36; p < 0.001), suggesting the importance of inflammation in the causative mechanisms of aortic dilation. Enhanced adenosine availability by LDEMTX was suggested by higher aortic expression of an anti-adenosine A2a receptor (A2a) and lower adenosine deaminase expression. Commercial MTX had negligible effects. LDEMTX prevented the development of MFS-associated aortic defects and can thus be a candidate for testing in clinical studies.
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Affiliation(s)
- Maria Carolina Guido
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Natalia de Menezes Lopes
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Camila Inagaki Albuquerque
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Elaine Rufo Tavares
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Leonardo Jensen
- Laboratory of Hypertension, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Priscila de Oliveira Carvalho
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Thauany Martins Tavoni
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Ricardo Ribeiro Dias
- Department of Cardiovascular Surgery, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Lygia da Veiga Pereira
- Department of Genetics and Evolutionary Biology, Institute of Biosciences, University of São Paulo, São Paulo, Brazil
| | | | - Raul Cavalcante Maranhão
- Laboratory of Metabolism and Lipids, Heart Institute (InCor) of the Medical School Hospital, University of São Paulo, São Paulo, Brazil
- *Correspondence: Raul Cavalcante Maranhão
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Pereira ELR, Feio DCA, Tavares JPL, Morikawa NM, Deus DF, Vital CG, Tavares ER, Maranhão RC. Uptake of lipid core nanoparticles by fragments of tissues collected during cerebral tumor excision surgeries: hypotheses for use in drug targeting therapy. J Neurooncol 2022; 158:413-421. [PMID: 35612697 DOI: 10.1007/s11060-022-04028-1] [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: 03/25/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Malignant cerebral tumors have poor prognosis and the blood-brain barrier is a major hindrance for most drugs to reach those tumors. Lipid nanoparticles (LDE) that bind to lipoprotein receptors may carry anticancer drugs and penetrate the cells through those receptors that are overexpressed in gliomas. The aim was to investigate the in vivo uptake of LDE by human cerebral tumors. METHODS Twelve consecutive patients (4 with glioblastomas, 1 meduloblastoma, 1 primary lymphoma, 2 with non-cerebral metastases and 4 with benign tumors) scheduled for tumor excision surgery were injected intravenously, 12 h before surgery, with LDE labeled 14C-cholesterol oleate. Fragments of tumors and of normal head tissues (muscle, periosteum, dura mater) discarded by the surgeon were submitted to lipid extraction and radioactive counting. RESULTS Tumor LDE uptake (range: 10-283 d.p.m./g of tissue) was not lower than that of normal tissues (range: 20-263 d.p.m./g). Malignant tumor uptake was threefold greater than benign tumor uptake (140 ± 93 vs 46 ± 18 d.p.m./g, p < 0.05). Results show that LDE can concentrate in brain malignant tumors and may be used to carry drugs directed against those tumors. CONCLUSION As LDE was previously shown to markedly decrease drug toxicity this new therapeutic strategy should be tested in future trials.
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Affiliation(s)
- Edmundo Luís Rodrigues Pereira
- Servico de Cirurgia, Nucleo de Pesquisas em Neurooncologia, Hospital Universitario Joao de Barros Barreto, Universidade Federal do Para, Belem, Para, Brazil
| | | | - João Pojucan Lobo Tavares
- Servico de Cirurgia, Nucleo de Pesquisas em Neurooncologia, Hospital Universitario Joao de Barros Barreto, Universidade Federal do Para, Belem, Para, Brazil
| | - Natalia Megumi Morikawa
- Servico de Cirurgia, Nucleo de Pesquisas em Neurooncologia, Hospital Universitario Joao de Barros Barreto, Universidade Federal do Para, Belem, Para, Brazil
| | - Debora Fernandes Deus
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Carolina Graziani Vital
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Elaine Rufo Tavares
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil. .,Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, São Paulo, Brazil. .,Instituto Nacional de Ciencias e Tecnologia em Fluidos Complexos (INCT-FCx), São Paulo, São Paulo, Brazil. .,Laboratório de Metabolismo e Lípides, Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44, bloco 2, 1º subsolo, São Paulo, SP, Brazil.
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de Macedo Ribeiro FRC, Ribeiro CHMA, Tavoni TM, Dos Santos Sarges E, Freitas FR, Stolf NAG, Kalil Filho R, Maranhão RC. Disturbances of the transfer of cholesterol to high-density lipoprotein (HDL) in patients with peripheral artery disease with or without type 2 diabetes mellitus. Vasc Med 2021; 26:602-607. [PMID: 34137646 DOI: 10.1177/1358863x211021142] [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: 11/16/2022]
Abstract
INTRODUCTION Low high-density lipoprotein (HDL)-cholesterol is frequent in patients with peripheral artery disease (PAD) and also in type 2 diabetes mellitus (T2DM), the major risk factor for PAD. The transfer of cholesterol from the other lipoproteins to HDL is an important aspect of HDL metabolism and function, and may contribute to atherogenic mechanisms that lead to PAD development. OBJECTIVE The aim of this study was to investigate the status of cholesterol transfers in patients with PAD without or with T2DM. METHODS Patients with PAD (n = 19), with PAD and T2DM (PAD + DM, n = 19), and healthy controls (n = 20), all paired for age, sex, and BMI were studied. Transfer of both forms of cholesterol, unesterified (UC) and esterified (EC), was performed by incubating plasma with a donor nanoemulsion containing radioactive UC and EC, followed by chemical precipitation and HDL radioactive counting. RESULTS Low-density lipoprotein (LDL)-cholesterol and triglycerides were similar in the three groups. Compared to controls, HDL-C was lower in PAD + DM (p < 0.05), but not in PAD. Transfer of UC was lower in PAD + DM than in PAD and controls (4.18 ± 1.17%, 5.13 ± 1.44%, 6.59 ± 1.25%, respectively, p < 0.001). EC transfer tended to be lower in PAD + DM than in controls (2.96 ± 0.60 vs 4.12 ± 0.89%, p = 0.05). Concentrations of cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT), both involved in HDL metabolism, were not different among the three groups. CONCLUSION Deficient cholesterol transfer to HDL may play a role in PAD pathogenesis. Since UC transfer to HDL was lower in PAD + DM compared to PAD alone, it is possible that defective HDL metabolism may contribute to the higher PAD incidence in patients with T2DM.Keywords.
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Affiliation(s)
| | | | - Thauany Martins Tavoni
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Erica Dos Santos Sarges
- Departamento de Ciencias Farmaceuticas, Instituto de Ciencias da Saude, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Fatima Rodrigues Freitas
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Noedir Antonio Groppo Stolf
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Roberto Kalil Filho
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Faculdade de Ciencias Farmaceuticas, Universidade de Sao Paulo, Sao Paulo, Brazil
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10
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de Souza RM, Maranhão RC, Tavares ER, Filippin-Monteiro FB, Nicodemo AC, Morikawa AT, Kanashiro EHY, Amato VS. Lipid nanoparticles for amphotericin delivery in the treatment of American tegumentary leishmaniasis. Drug Deliv Transl Res 2020; 10:403-412. [PMID: 31701487 DOI: 10.1007/s13346-019-00677-4] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Leishmaniasis occurs in the five continents and represents a serious public health challenge, but is still a neglected disease, and the current pharmacological weaponry is far from satisfactory. Triglyceride-rich nanoparticles mimicking chylomicrons (TGNP) behave metabolically like native chylomicrons when injected into the bloodstream. Previously we have shown that TGNP as vehicle to amphothericin B (AB) for treatment of fungi infection showed reduced renal toxicity and lower animal death rates compared to conventional AB. The aim of the current study was to test the tolerability and effectiveness of the TGNP-AB preparation in a murine model of Leishmania amazonensis infection. The in vitro assays determined the cytotoxicity of TGNP-AB, AB, and TGNP in macrophages and promastigote forms and the leishmanicidal activity in infected macrophages. The in vivo toxicity tests were performed in healthy mice with increasing doses of TGPN-AB and AB. Then, animals were treated with 2.5 mg/kg/day of AB, 17.5 mg/kg/day of TGNP-AB, or TGNP three times a week for 4 weeks. TGNP-AB formulation was less cytotoxic for macrophages than AB. TGNP-AB was more effective than AB against the promastigotes forms of the parasite and more effective in reducing the number of infected macrophages and the number of amastigotes forms per cell. TGNP-AB-treated animals showed lower hepatotoxicity. In addition, TGNP-AB group showed a marked reduction in lesion size on the paws and parasitic load. The TGNP-AB preparation attained excellent leishmanicidal activity with remarkable lower drug toxicity at very high doses that, due to the toxicity-buffering properties of the nanocarrier, become fully tolerable.
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Affiliation(s)
- Regina Maia de Souza
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Lipid Metabolism Laboratory, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil. .,Laboratório de Metabolismo e Lípides, Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Av. Dr. Enéas de Carvalho Aguiar, 44, bloco 2, 1° subsolo, São Paulo, SP, Brazil.
| | - Elaine Rufo Tavares
- Lipid Metabolism Laboratory, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | | | - Antônio Carlos Nicodemo
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Aleksandra Tiemi Morikawa
- Lipid Metabolism Laboratory, Heart Institute, Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Edite Hatsumi Yamashiro Kanashiro
- Laboratory of Seroepidemiology and Immunobiology, Tropical Medicine Institute, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Valdir Sabbaga Amato
- Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo, São Paulo, Brazil
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11
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Zanardo TÉC, Amorim FG, Taufner GH, Pereira RHA, Baiense IM, Destefani AC, Iwai LK, Maranhão RC, Nogueira BV. Decellularized Splenic Matrix as a Scaffold for Spleen Bioengineering. Front Bioeng Biotechnol 2020; 8:573461. [PMID: 33123515 PMCID: PMC7567156 DOI: 10.3389/fbioe.2020.573461] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/08/2020] [Indexed: 01/15/2023] Open
Abstract
The spleen is considered a non-essential organ. However, its importance is increasingly clear, given the serious disorders caused by its absence or dysfunction, e.g., greater susceptibility to infections, thromboembolism and cancer. Surgical techniques to preserve the spleen and maintain splenic function have become increasingly common. However, the morbidity and mortality associated with its absence and dysfunction are still high. We used the decellularization technique to obtain a viable splenic scaffold for recellularization in vitro and propose the idea of bioengineered spleen transplantation to the host. We observed the maintenance of important structural components such as white pulp, marginal zone and red pulp, in addition to the network of vascular ducts. The decellularized scaffold presents minimal residual DNA and SDS, which are essential to prevent immunogenic responses and transplantation failure. Also, the main components of the splenic matrix were preserved after decellularization, with retention of approximately 72% in the matrisomal protein content. The scaffold we developed was partially recellularized with stromal cells from the spleen of neonatal rats, demonstrating adhesion, proliferation and viability of cells. Therefore, the splenic scaffold is very promising for use in studies on spleen reconstruction and transplantation, with the aim of complete recovery of splenic function.
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Affiliation(s)
- Tadeu Ériton Caliman Zanardo
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
| | - Fernanda Gobbi Amorim
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Pharmaceutical Sciences Graduate Program, University of Vila Velha, Vila Velha, Brazil
| | - Gabriel Henrique Taufner
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
| | - Rayssa Helena Arruda Pereira
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
| | - Ian Manhoni Baiense
- Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
| | - Afrânio Côgo Destefani
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
| | - Leo Kei Iwai
- Laboratory of Proteomics and Mass Spectrometry-Special Laboratory of Applied Toxinology LETA/CETICS, Instituto Butantan, São Paulo, Brazil
| | | | - Breno Valentim Nogueira
- Biotechnology Graduate Program, Rede Nordeste de Biotecnologia (RENORBIO), Vitória, Brazil.,Tissue Engineering Core, Department of Morphology, Federal University of Espírito Santo, Vitória, Brazil
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12
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Salsoso R, Dalçóquio T, Furtado R, Franci A, Barbosa C, Genestreti P, Ferreira MRC, Strunz C, Baracioli L, Maranhão RC, Nicolau JC. IMPACT OF HIGH LIPOPROTEIN(A) LEVELS ON PLATELET AGGREGABILITY IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)30829-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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de Freitas MCP, Fernandez DGE, Cohen D, Figueiredo-Neto AM, Maranhão RC, Damasceno NRT. Oxidized and electronegative low-density lipoprotein as potential biomarkers of cardiovascular risk in obese adolescents. Clinics (Sao Paulo) 2018; 73:e189. [PMID: 30365817 PMCID: PMC6172975 DOI: 10.6061/clinics/2018/e189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 03/13/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To evaluate biomarkers associated with early cardiometabolic risk in obese adolescents. METHODS This cross-sectional study included 137 adolescents of both sexes aged 10 to 19 years divided into a normal weight group (NW) (n=69) and an obese group (OB) (n=68). RESULTS As expected, obesity showed positive associations with homeostatic model assessment for insulin resistance (HOMA-IR), triacylglycerol, insulin, plasma levels of non-esterified fatty acids, and cholesterol ester transfer protein activity and negative associations with plasma antioxidant levels. Plasma oxidized low-density lipoprotein (oxLDL) and electronegative low-density lipoprotein [LDL(-)] levels were significantly higher in the OB group. Higher tertiles of oxLDL were associated with increased values of body mass index; waist circumference; fatty mass percentage (%FM); and the atherogenic lipids non-high-density-lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B and triacylglycerol. Higher tertiles of LDL(-) were robustly associated with body mass index and waist circumference. Logistic regression models (odds ratios) confirmed that increased values of lipids and apolipoprotein B were associated with increased risk of oxLDL. For LDL(-), these associations were not significant, suggesting that another mechanism is involved in generating this particle in obese adolescents. CONCLUSIONS Obese adolescents showed increased plasma LDL(-) and oxLDL, and obese girls had more LDL(-) than obese boys. Therefore, oxLDL is strongly and independently associated with classical cardiovascular risk factors, while increased levels of LDL(-) were influenced by body mass index, waist circumference and demographic parameters in obese adolescents.
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Affiliation(s)
| | - Diana Gabriela Estevez Fernandez
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Danielle Cohen
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Raul Cavalcante Maranhão
- Laboratorio de Metabolismo de Lipides do Instituto do Coracao, Hospital das Clinicas, Faculdade de Medicina da Universidade de Sao Paulo, SP, BR
- Departamento de Analises Clinicas, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Nágila Raquel Teixeira Damasceno
- Departamento de Nutricao, Faculdade de Saude Publica da Universidade de Sao Paulo, Sao Paulo, SP, BR
- Programa de Interunidades em Nutricao Humana Aplicada, Faculdade de Ciencias Farmaceuticas da Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
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Pala D, Barbosa PO, Silva CT, de Souza MO, Freitas FR, Volp ACP, Maranhão RC, Freitas RND. Açai ( Euterpe oleracea Mart.) dietary intake affects plasma lipids, apolipoproteins, cholesteryl ester transfer to high-density lipoprotein and redox metabolism: A prospective study in women. Clin Nutr 2018; 37:618-623. [DOI: 10.1016/j.clnu.2017.02.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 07/14/2016] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
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15
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Freitas SCMP, Tavares ER, Silva BMO, Meneghini BC, Kalil-Filho R, Maranhão RC. Lipid core nanoparticles resembling low-density lipoprotein and regression of atherosclerotic lesions: effects of particle size. ACTA ACUST UNITED AC 2018. [PMID: 29513883 PMCID: PMC5912096 DOI: 10.1590/1414-431x20177090] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Particles are usually polydispersed and size is an important feature for lipid-based drug delivery systems in order to optimize cell-particle interactions as to pharmacologic action and toxicity. Lipid nanoparticles (LDE) with composition similar to that of low-density lipoprotein carrying paclitaxel were shown to markedly reduce atherosclerosis lesions induced in rabbits by cholesterol feeding. The aim of this study was to test whether two LDE fractions, one with small (20-60 nm) and the other with large (60-100 nm) particles, had different actions on the atherosclerotic lesions. The two LDE-paclitaxel fractions, prepared by microfluidization, were separated by density gradient ultracentrifugation and injected (4 mg/body weight, intravenously once a week) into two groups of rabbits previously fed cholesterol for 4 weeks. A group of cholesterol-fed animals injected with saline solution was used as control to assess lesion reduction with treatment. After the treatment period, the animals were euthanized for analysis. After treatment, both the small and large nanoparticle preparations of LDE-paclitaxel had equally strong anti-atherosclerosis action. Both reduced lesion extension in the aorta by roughly 50%, decreased the intima width by 75% and the macrophage presence in the intima by 50%. The two preparations also showed similar toxicity profile. In conclusion, within the 20-100 nm range, size is apparently not an important feature regarding the LDE nanoparticle system and perhaps other solid lipid-based systems.
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16
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Faludi AA, Izar MCDO, Saraiva JFK, Chacra APM, Bianco HT, Afiune A, Bertolami A, Pereira AC, Lottenberg AM, Sposito AC, Chagas ACP, Casella A, Simão AF, Alencar ACD, Caramelli B, Magalhães CC, Negrão CE, Ferreira CEDS, Scherr C, Feio CMA, Kovacs C, Araújo DBD, Magnoni D, Calderaro D, Gualandro DM, Mello EPD, Alexandre ERG, Sato EI, Moriguchi EH, Rached FH, Santos FCD, Cesena FHY, Fonseca FAH, Fonseca HARD, Xavier HT, Mota ICP, Giuliano IDCB, Issa JS, Diament J, Pesquero JB, Santos JED, Faria JR, Melo JXD, Kato JT, Torres KP, Bertolami MC, Assad MHV, Miname MH, Scartezini M, Forti NA, Coelho OR, Maranhão RC, Santos RDD, Alves RJ, Cassani RL, Betti RTB, Carvalho TD, Martinez TLDR, Giraldez VZR, Salgado W. ATUALIZAÇÃO DA DIRETRIZ BRASILEIRA DE DISLIPIDEMIAS E PREVENÇÃO DA ATEROSCLEROSE - 2017. Arq Bras Cardiol 2017; 109:1-76. [PMID: 28813069 DOI: 10.5935/abc.20170121] [Citation(s) in RCA: 173] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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17
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Fiorelli AI, Lourenço-Filho DD, Tavares ER, Carvalho PO, Marques AF, Gutierrez PS, Maranhão RC, Stolf NAG. Methotrexate associated to lipid core nanoparticles improves cardiac allograft vasculopathy and the inflammatory profile in a rabbit heart graft model. ACTA ACUST UNITED AC 2017; 50:e6225. [PMID: 28832763 PMCID: PMC5561808 DOI: 10.1590/1414-431x20176225] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 01/26/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022]
Abstract
Coronary allograft vasculopathy is an inflammatory-proliferative process that compromises the long-term success of heart transplantation and has no effective treatment. A lipid nanoemulsion (LDE) can carry chemotherapeutic agents in the circulation and concentrates them in the heart graft. The aim of the study was to investigate the effects of methotrexate (MTX) associated to LDE. Rabbits fed a 0.5% cholesterol diet and submitted to heterotopic heart transplantation were treated with cyclosporine A (10 mg·kg–1·day–1 orally) and allocated to treatment with intravenous LDE-MTX (4 mg/kg, weekly, n=10) or with weekly intravenous saline solution (control group, n=10), beginning on the day of surgery. Animals were euthanized 6 weeks later. Compared to controls, grafts of LDE-MTX treated rabbits showed 20% reduction of coronary stenosis, with a four-fold increase in vessel lumen and 80% reduction of macrophage staining in grafts. Necrosis was attenuated by LDE-MTX. Native hearts of both LDE-MTX and Control groups were apparently normal. Gene expression of lipoprotein receptors was significantly greater in grafts compared to native hearts. In LDE-MTX group, gene expression of the pro-inflammatory factors tumor necrosis factor-α, monocyte chemoattractant protein-1, interleukin-18, vascular cell adhesion molecule-1, and matrix metalloproteinase-12 was strongly diminished whereas expression of anti-inflammatory interleukin-10 increased. LDE-MTX promoted improvement of the cardiac allograft vasculopathy and diminished inflammation in heart grafts.
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Affiliation(s)
- A I Fiorelli
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - D D Lourenço-Filho
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - E R Tavares
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - P O Carvalho
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - A F Marques
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - P S Gutierrez
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - R C Maranhão
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.,Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, SP, Brasil
| | - N A G Stolf
- Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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de Oliveira WPC, Tavoni TM, Freitas FR, Silva BMO, Maranhão RC. Lipid transfers to HDL are diminished in long-term bedridden patients: association with low HDL-cholesterol and increased inflammatory markers. Lipids 2017; 52:703-709. [PMID: 28660528 DOI: 10.1007/s11745-017-4274-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 02/08/2017] [Accepted: 06/11/2017] [Indexed: 12/27/2022]
Abstract
Plasma lipids have been extensively studied in sedentary and in subjects practicing exercise training, but not in extreme inactivity as occurs in bedridden patients. This is important for the care of bedridden patients and understanding the overall plasma lipid regulation. Here, we investigated plasma lipids, lipid transfers to HDL and inflammatory markers in bedridden patients. Fasting blood samples were collected from 23 clinically stable bedridden patients under long-term care (>90 days) and 26 normolipidemic sedentary subjects, paired for age and gender. In vitro transfer of four lipids to HDL was performed by incubating plasma with donor nanoparticles containing radioactive lipids. Total (193 ± 36 vs 160 ± 43, p = 0.005), LDL (124 ± 3 vs 96 ± 33 p = 0.003) and HDL-cholesterol (45 ± 10 vs 36 ± 13, p = 0.008), apolipoprotein A-I (134 ± 20 vs 111 ± 24, p = 0.001) and oxidized LDL (53 ± 13 vs 43 ± 12, p = 0.011) were lower in bedridden patients, whereas triglycerides, apolipoprotein B, CETP and LCAT were equal in both groups. Transfers of all lipids, namely unesterified cholesterol, cholesterol esters, triglycerides and phospholipids, to HDL were lower in bedridden patients, probably due to their lower HDL-cholesterol levels. Concentrations of IL-1β, IL-6, IL-8, HGF and NGF were higher in bedridden patients compared to sedentary subjects. In conclusion, inactivity had great impact on HDL, by lowering HDL-cholesterol, apolipoprotein A-I and thereby cholesterol transfers to the lipoprotein, which suggests that inactivity may deteriorate HDL protection beyond the ordinary sedentary condition.
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Affiliation(s)
- Wilson Pascoalino Camargo de Oliveira
- Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil.,Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.,Suzano Auxiliary Hospital, Medical School Hospital, University of São Paulo, Suzano, Brazil
| | - Thauany Martins Tavoni
- Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil.,Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Fatima Rodrigues Freitas
- Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Bruna Miranda Oliveira Silva
- Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil
| | - Raul Cavalcante Maranhão
- Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital, University of São Paulo, São Paulo, Brazil. .,Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil. .,Instituto do Coração (InCor) do Hospital das Clínicas, FMUSP, Av. Dr. Enéas de Carvalho Aguiar, 44, 1º subsolo, São Paulo, SP, 05403-000, Brazil.
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Graziani SR, Vital CG, Morikawa AT, Fernandes HJ, Naime FDF, Fonseca ROD, Dias CAR, Almeida LRD, Neto RFA, Yamada KE, De Abreu MSSG, Pontes TC, D'Alvia T, Ferreira RS, Eyzaguirre Velasquez AR, Orias VU, Vanderlinde FG, de Almeida LM, Diniz PCB, Maranhão RC. Association of paclitaxel to lipid nanoparticles in the treatment of bone metastasis in patients with solid tumors. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21631] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21631 Background: Bone metastasis occurs in more than 65-90% patients with hormone-dependent solid tumors, as breast and prostate cancer, with slow evolution, being not responsive to standard chemotherapeutic agents, which restricts treatment options. Previously, we have shown that lipid nanoparticles resembling LDL-cholesterol-like are uptake in malignant tissues and capable of delivery anti-cancer drugs, after intravenous injection. The delivery of drug drastically reduced toxicity. The objective of this study was to evaluate the clinical responses to treatment with paclitaxel associated to nanoparticles, laboratory toxicity and pain scale in patients with breast and prostate carcinoma, previously treated with conventional schemes chemotherapy and not eligible for subsequent treatment. Methods: We included six patients with prostate carcinoma, and ten patients with breast carcinoma (age 68 ± 4 and 55 ± 7 years, respectively). All patients had advanced clinical staging IV at diagnosis (TNM-UICC classification). Treatment consisted in the combination of paclitaxel to lipid nanoparticles (dose: 175 mg/m2 body surface), intravenous, every 21 days, without premedications. Biochemistry determinations were performed before onset and every three weeks during treatment. To assess pain, we used the Verbal Analogue Scale (from zero to 10) and the use of opioids in the treatment period. Results: Total of 64 cycles were performed without clinical or laboratory toxicity. At the beginning of treatment the pain score was 8 (range 6-9), after six weeks it reduced to a mean of 6 (range 4-8) and after 18 weeks reduced to 4 (range 2-8). Six patients required 180 mg/day of morphine, but after 12 weeks the dose was reduced to 60 mg/day. Six patients progressed after three cycles requiring use of potent analgesic. Conclusions: The notable absence of toxicity and significant improvement in pain indicate paclitaxel associated to lipid nanoparticles as a promising option in chemotherapy regimens.
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Affiliation(s)
- Silvia Regina Graziani
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | - Carolina Graziani Vital
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | - Aleksandra Tiemi Morikawa
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | | - Thiago D'Alvia
- Instituto do Câncer Dr. Arnaldo Vieira de Carvalho, São Paulo, Brazil
| | | | | | | | | | | | | | - Raul Cavalcante Maranhão
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
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Feio DCA, de Oliveira NCL, Pereira ELR, Morikawa AT, Muniz JAPC, Montenegro RC, Alves APNN, de Lima PDL, Maranhão RC, Burbano RR. Organic effects of associating paclitaxel with a lipid-based nanoparticle system on a nonhuman primate, Cebus apella. Int J Nanomedicine 2017; 12:3827-3837. [PMID: 28572727 PMCID: PMC5441669 DOI: 10.2147/ijn.s129153] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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] [Indexed: 12/16/2022] Open
Abstract
Lipid-based nanoparticle systems have been used as vehicles for chemotherapeutic agents in experimental cancer treatments. Those systems have generally been credited with attenuating the severe toxicity of chemotherapeutic agents. This study aimed to investigate the effects of associating paclitaxel (PTX) with a lipid-based nanoparticle system on a nonhuman primate, Cebus apella, documenting the toxicity as measured by serum biochemistry, which is a detailed analysis of blood and tissue. Eighteen C. apella were studied: three animals were treated with cholesterol-rich nanoemulsion (LDE) only, without PTX, administered intravenously every 3 weeks, during six treatment cycles; six animals were treated with PTX associated with LDE at the same administration scheme, three with lower (175 mg/m2) and three with higher (250 mg/m2) PTX doses; and six animals were treated with commercial PTX, three with the lower and three with the higher doses. In the LDE-PTX group, no clinical toxicity appeared, and the weight-food consumption curve was similar to that of the controls. Two animals treated with commercial PTX presented weight loss, nausea and vomiting, diarrhea, skin flaking, 70% loss of body hair, and decreased physical activity. The use of LDE as a carrier at both lower and higher doses reduced the toxicity of the drug in this species, which is closely related to human subjects. This was observed not only by clinical, biochemical, and hematological profiles but also by the histopathological analysis. The results of this study support the assumption that lipid-based nanoparticle systems used as drug carriers can serve as valuable tools to decrease the toxicity and increase the safety of chemotherapeutic agents.
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Affiliation(s)
| | | | | | | | | | | | | | - Patrícia Danielle Lima de Lima
- Molecular Biology Laboratory, Post Graduate Program of Amazon Parasitic Biology, Biological and Health Sciences Center, State University of Pará, Belem, Brazil
| | | | - Rommel Rodríguez Burbano
- Human Cytogenetics Laboratory, Institute of Biological Sciences, Federal University of Pará, Belem
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21
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Muramoto G, Figueiredo Delgado A, Correa de Souza E, Elias Gilio A, Brunow de Carvalho W, Cavalcante Maranhão R. Lipid profiles of children and adolescents with inflammatory response in a paediatric emergency department. Ann Med 2016; 48:323-9. [PMID: 27087567 DOI: 10.3109/07853890.2016.1171896] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND To compare the lipid profile between patients with and without inflammatory process in according nutritional status, gender and age. METHODS One hundred and twenty-four children and adolescents in the emergency department were separated into two groups according to the levels of C-reactive protein (CRP). Total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL), triglycerides (TG) and albumin in patients with CRP < 5 mg/L were compared with patients with CRP ≥ 5 mg/L. Nutritional status was assessed by anthropometric measurements. RESULTS Patients were mostly classified as well-nourished (76.5%) and had low levels of HDL (70%). There was no significant difference in lipid profile between the two groups of CRP. Linear regression analysis, however, it became clear that for each increase of 1 mg/L in the values of CRP expected an average reduction of 0.072 mg/dL of HDL, the 0.083 mg/dL of LDL, the 0.002 g/dL albumin and an average increase of 0.564 mg/dL of TG. CONCLUSIONS Patients with an inflammatory process exhibit changes in the serum levels of the lipids HDL, LDL and TG that are related to the degree of inflammation. These changes occurred regardless of nutritional status. Key Messages Lipoproteins are structures composed of lipids and proteins that transport fats in the circulation: HDL, LDL, IDL, VLDL and chylomicrons. Lipoproteins, especially HDL, undergo changes during the systemic inflammatory response and play an important role as a modulator of the inflammatory response. We believe this is a first study to show that inflammatory process modifies the serum levels of the lipoproteins and triglycerides independent of nutritional status, in paediatric patients.
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Affiliation(s)
- Giovana Muramoto
- a Pediatric Department , São Paulo University Medical School , São Paulo , Brazil
| | | | | | - Alfredo Elias Gilio
- a Pediatric Department , São Paulo University Medical School , São Paulo , Brazil
| | | | - Raul Cavalcante Maranhão
- b Lipid Metabolism Laboratory , Heart Institute, São Paulo University Medical School , São Paulo , Brazil
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22
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Santos MHH, de Lourdes Higuchi M, Tucci PJF, Garavelo SM, Reis MM, Antonio EL, Serra AJ, Maranhão RC. Previous exercise training increases levels of PPAR-α in long-term post-myocardial infarction in rats, which is correlated with better inflammatory response. Clinics (Sao Paulo) 2016; 71:163-8. [PMID: 27074178 PMCID: PMC4785847 DOI: 10.6061/clinics/2016(03)08] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/21/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE Exercise is a protective factor for cardiovascular morbidity and mortality, with unclear mechanisms. Changing the myocardial metabolism causes harmful consequences for heart function and exercise contributes to metabolic adjustment modulation. Peroxisome proliferator-activated receptors (PPARs) are also myocardium metabolism regulators capable of decreasing the inflammatory response. We hypothesized that PPAR-α is involved in the beneficial effects of previous exercise on myocardial infarction (MI) and cardiac function, changing the expression of metabolic and inflammatory response regulators and reducing myocardial apoptosis, which partially explains the better outcome. METHODS AND RESULTS Exercised rats engaged in swimming sessions for 60 min/day, 5 days/week, for 8 weeks. Both the exercised rats and sedentary rats were randomized to MI surgery and followed for 1 week (EI1 or SI1) or 4 weeks (EI4 or SI4) of healing or to sham groups. Echocardiography was employed to detect left ventricular function and the infarct size. Additionally, the TUNEL technique was used to assess apoptosis and immunohistochemistry was used to quantitatively analyze the PPAR-α, TNF-α and NF-κB antigens in the infarcted and non-infarcted myocardium. MI-related mortality was higher in SI4 than in EI4 (25% vs 12%), without a difference in MI size. SI4 exhibited a lower shortening fraction than EI4 did (24% vs 35%) and a higher apoptosis/area rate (3.97±0.61 vs 1.90±1.82) in infarcted areas (both p=0.001). Immunohistochemistry also revealed higher TNF-α levels in SI1 than in EI1 (9.59 vs 4.09, p<0.001) in infarcted areas. In non-infarcted areas, EI4 showed higher levels of TNF-α and positive correlations between PPAR-α and NF-κB (r=0.75, p=0.02), in contrast to SI4 (r=0.05, p=0.87). CONCLUSION Previously exercised animals had better long-term ventricular function post-MI, in addition to lower levels of local inflammatory markers and less myocardial apoptosis, which seemed to be related to the presence of PPAR-α.
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Affiliation(s)
- Marília Harumi Higuchi Santos
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (InCor), Laboratório de Patologia Cardíaca, São Paulo/, SP, Brazil
- E-mail:
| | - Maria de Lourdes Higuchi
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (InCor), Laboratório de Patologia Cardíaca, São Paulo/, SP, Brazil
| | | | - Shérrira M Garavelo
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (InCor), Laboratório de Patologia Cardíaca, São Paulo/, SP, Brazil
| | - Márcia M Reis
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (InCor), Laboratório de Patologia Cardíaca, São Paulo/, SP, Brazil
| | | | | | - Raul Cavalcante Maranhão
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Instituto do Coração (InCor), Laboratório de Patologia Cardíaca, São Paulo/, SP, Brazil
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23
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Segre CAW, Hueb W, Garcia RMR, Rezende PC, Favarato D, Strunz CMC, Sprandel MDCO, Roggério A, Carvalho ALDO, Maranhão RC, Ramires JAF, Kalil Filho R. Troponin in diabetic patients with and without chronic coronary artery disease. BMC Cardiovasc Disord 2015. [PMID: 26195004 PMCID: PMC4508806 DOI: 10.1186/s12872-015-0051-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [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] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cardiac-specific troponin detected with the new high-sensitivity assays can be chronically elevated in response to cardiovascular comorbidities and confer important prognostic information, in the absence of unstable coronary syndromes. Both diabetes mellitus and coronary artery disease are known predictors of troponin elevation. It is not known whether diabetic patients with coronary artery disease have different levels of troponin compared with diabetic patients with normal coronary arteries. To investigate this question, we determined the concentrations of a level 1 troponin assay in two groups of diabetic patients: those with multivessel coronary artery disease and those with angiographically normal coronary arteries. METHODS We studied 95 diabetic patients and compared troponin in serum samples from 50 patients with coronary artery disease (mean age = 63.7, 58 % male) with 45 controls with angiographically normal coronary arteries. Brain natriuretic peptide and the oxidative stress biomarkers myeloperoxidase, nitrotyrosine and oxidized LDL were also determined. RESULTS Diabetic patients with coronary artery disease had higher levels of troponin than did controls (median values, 12.0 pg/mL (95 % CI:10-16) vs 7.0 pg/mL (95 % CI: 5.9-8.5), respectively; p = 0.0001). The area under the ROC curve for the diagnosis of CAD was 0.712 with a sensitivity of 70 % and a specificity of 66 %. Plasma BNP levels and oxidative stress variables (myeloperoxidase, nitrotyrosine, and oxidized LDL) were not different between the two groups. In a multivariate analysis, gender (p = 0.04), serum glucose (0.03) and Troponin I (p = 0.01) had independent statistical significance. CONCLUSION Troponin elevation is related to the presence of chronic coronary artery disease in diabetic patients with multiple associated cardiovascular risk factors. Troponin may serve as a biomarker in this high-risk population. TRIAL REGISTRATION http://www.controlled-trials.com REGISTRATION NUMBER ISRCTN26970041.
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Affiliation(s)
- Carlos Alexandre Wainrober Segre
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Whady Hueb
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Rosa Maria Rahmi Garcia
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Paulo Cury Rezende
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Desiderio Favarato
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Celia Maria Cassaro Strunz
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Marília da Costa Oliveira Sprandel
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Alessandra Roggério
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Ana Luiza de Oliveira Carvalho
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Raul Cavalcante Maranhão
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - José Antonio Franchini Ramires
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
| | - Roberto Kalil Filho
- Department of Clinical Cardiology, Heart Institute (InCor) University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 44, AB, BL I, Sala 114, Cerqueira César, Sao Paulo, SP, 05403-000, Brazil.
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24
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Graziani SR, Vital CG, Van Eyll BM, Morikawa AT, Fristachi CE, Nosralla M, Peres Neto A, Maranhão RC. Preliminary results of patients with advanced ovarian carcinoma treated with paclitaxel associated to nanoemulsions. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.e16539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Silvia Regina Graziani
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | - Carolina Graziani Vital
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | | | - Aleksandra Tiemi Morikawa
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
| | | | | | | | - Raul Cavalcante Maranhão
- Heart Institute (INCOR-HCFMUSP) of the Medical School and Pharmacy School of the University of São Paulo, São Paulo, Brazil
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25
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Maranhão RC, Carvalho PO, Strunz CC, Pileggi F. Lipoprotein (a): structure, pathophysiology and clinical implications. Arq Bras Cardiol 2015; 103:76-84. [PMID: 25120086 PMCID: PMC4126764 DOI: 10.5935/abc.20140101] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Accepted: 10/01/2013] [Indexed: 11/20/2022] Open
Abstract
The chemical structure of lipoprotein (a) is similar to that of LDL, from which it
differs due to the presence of apolipoprotein (a) bound to apo B100 via one disulfide
bridge. Lipoprotein (a) is synthesized in the liver and its plasma concentration,
which can be determined by use of monoclonal antibody-based methods, ranges from <
1 mg to > 1,000 mg/dL. Lipoprotein (a) levels over 20-30 mg/dL are associated with
a two-fold risk of developing coronary artery disease. Usually, black subjects have
higher lipoprotein (a) levels that, differently from Caucasians and Orientals, are
not related to coronary artery disease. However, the risk of black subjects must be
considered. Sex and age have little influence on lipoprotein (a) levels. Lipoprotein
(a) homology with plasminogen might lead to interference with the fibrinolytic
cascade, accounting for an atherogenic mechanism of that lipoprotein. Nevertheless,
direct deposition of lipoprotein (a) on arterial wall is also a possible mechanism,
lipoprotein (a) being more prone to oxidation than LDL. Most prospective studies have
confirmed lipoprotein (a) as a predisposing factor to atherosclerosis. Statin
treatment does not lower lipoprotein (a) levels, differently from niacin and
ezetimibe, which tend to reduce lipoprotein (a), although confirmation of ezetimibe
effects is pending. The reduction in lipoprotein (a) concentrations has not been
demonstrated to reduce the risk for coronary artery disease. Whenever higher
lipoprotein (a) concentrations are found, and in the absence of more effective and
well-tolerated drugs, a more strict and vigorous control of the other coronary artery
disease risk factors should be sought.
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Affiliation(s)
- Raul Cavalcante Maranhão
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Priscila Oliveira Carvalho
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Celia Cassaro Strunz
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fulvio Pileggi
- Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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26
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Ladeira RT, Baracioli LM, Faulin TES, Abdalla DSP, Seydell TM, Maranhão RC, Mendonça BB, Strunz CC, Castro ID, Nicolau JC. Unrecognized diabetes and myocardial necrosis: predictors of hyperglycemia in myocardial infarction. Arq Bras Cardiol 2013; 100:404-411. [PMID: 23598457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 12/17/2012] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Hyperglycemia in the acute phase of myocardial infarction is an important prognostic factor. However, its pathophysiology is not fully understood. OBJECTIVE To analyze simultaneously the correlation between hyperglycemia and biochemical markers related to stress, glucose and lipid metabolism, coagulation, inflammation, and myocardial necrosis. METHODS Eighty patients with acute myocardial infarction were prospectively included. The following parameters were analyzed: blood glucose; stress hormones (cortisol and norepinephrine); glucose metabolism factors [glycated hemoglobin (HbA1c); insulin]; lipoproteins (total cholesterol, LDL, HDL, minimally modified electronegative LDL, and adiponectin); glycerides (triglycerides, VLDL and fatty acids); coagulation factors (factor VII, fibrinogen, plasminogen activator inhibitor-1); inflammation (high-sensitivity C reactive protein); and myocardial necrosis (CK-MB and troponin). Continuous variables were converted into degrees of relevance using fuzzy logic. RESULTS Significant correlation was observed between hyperglycemia and glucose metabolism (p < 0.001), lipoproteins (p = 0.03), and necrosis factors (p = 0.03). In the multivariate analysis, only glucose metabolism (OR = 4.3; CI = 2.1-68.9; and p < 0.001) and myocardial necrosis (OR = 22.5; CI = 2-253; and p = 0.012) showed independent and significant correlation. For the analysis of the influence of history of diabetes mellitus, a regression model including only patients without diabetes mellitus was developed, and the results did not change. Finally, in the model adjusted for age, gender, and clinical variables (history of diabetes mellitus, hypertension and dyslipidemia), three variables maintained a significant and independent association with hyperglycemia: glucose metabolism (OR = 24.1; CI = 4.8-122.1; and p < 0.001), myocardial necrosis (OR = 21.9; CI = 1.3-360.9; and p = 0.03), and history of DM (OR = 27; CI = 3.7-195.7; and p = 0.001). CONCLUSION Glucose metabolism and myocardial necrosis markers were the best predictors of hyperglycemia in patients with acute myocardial infarction.
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Affiliation(s)
- Renata Teixeira Ladeira
- Instituto do Coração (InCor) – Hospital da Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil.
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27
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Vinagre JC, Vinagre CG, Pozzi FS, Slywitch E, Maranhão RC. Metabolism of triglyceride-rich lipoproteins and transfer of lipids to high-density lipoproteins (HDL) in vegan and omnivore subjects. Nutr Metab Cardiovasc Dis 2013; 23:61-67. [PMID: 21937206 DOI: 10.1016/j.numecd.2011.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 02/25/2011] [Accepted: 02/28/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Vegan diet excludes all foodstuffs of animal origin and leads to cholesterol lowering and possibly reduction of cardiovascular disease risk. The aim was to investigate whether vegan diet improves the metabolic pathway of triglyceride-rich lipoproteins, consisting in lipoprotein lipolysis and removal from circulation of the resulting remnants and to verify whether the diet alters HDL metabolism by changing lipid transfers to this lipoprotein. METHODS AND RESULTS 21 vegan and 29 omnivores eutrophic and normolipidemic subjects were intravenously injected triglyceride-rich emulsions labeled with (14)C-cholesterol oleate and (3)H-triolein: fractional clearance rates (FCR, in min(-1)) were calculated from samples collected during 60 min for radioactive counting. Lipid transfer to HDL was assayed by incubating plasma samples with a donor nanoemulsion labeled with radioactive lipids; % lipids transferred to HDL were quantified in supernatant after chemical precipitation of non-HDL fractions and nanoemulsion. Serum LDL cholesterol was lower in vegans than in omnivores (2.1 ± 0.8, 2.7 ± 0.7 mmol/L, respectively, p < 0,05), but HDL cholesterol and triglycerides were equal. Cholesteryl ester FCR was greater in vegans than in omnivores (0.016 ± 0.012, 0.003 ± 0.003, p < 0.01), whereas triglyceride FCR was equal (0.024 ± 0.014, 0.030 ± 0.016, N.S.). Cholesteryl ester transfer to HDL was lower in vegans than in omnivores (2.7 ± 0.6, 3.5 ± 1.5%, p < 0,05). Free-cholesterol, triglyceride and phospholipid transfer were equal, as well as HDL size. CONCLUSION Remnant removal from circulation, estimated by cholesteryl oleate FCR was faster in vegans, but the lipolysis process, estimated by triglyceride FCR was equal. Increased removal of atherogenic remnants and diminution of cholesteryl ester transfer may favor atherosclerosis prevention by vegan diet.
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Affiliation(s)
- J C Vinagre
- Lipid Metabolism Laboratory, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
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28
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Ladeira RT, Baracioli LM, Faulin TES, Abdalla DSP, Seydell TM, Maranhão RC, Mendonça BB, Strunz CC, Castro ID, Nicolau JC. Unrecognized Diabetes and Myocardial Necrosis: Predictors of Hyperglycemia in Myocardial Infarction. Arq Bras Cardiol 2013. [DOI: 10.5935/abc.20130087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Pires LA, Hegg R, Freitas FR, Tavares ER, Almeida CP, Baracat EC, Maranhão RC. Effect of neoadjuvant chemotherapy on low-density lipoprotein (LDL) receptor and LDL receptor-related protein 1 (LRP-1) receptor in locally advanced breast cancer. Braz J Med Biol Res 2012; 45:557-64. [PMID: 22570085 PMCID: PMC3854302 DOI: 10.1590/s0100-879x2012007500068] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [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: 08/06/2011] [Accepted: 03/26/2012] [Indexed: 11/22/2022] Open
Abstract
Low-density lipoprotein (LDL) receptors are overexpressed in most neoplastic cell lines and provide a mechanism for the internalization and concentration of drug-laden nanoemulsions that bind to these receptors. The aim of the present study was to determine whether the administration of standard chemotherapeutic schemes can alter the expression of LDL and LDL receptor-related protein 1 (LRP-1) receptors in breast carcinoma. Fragments of tumoral and normal breast tissue from 16 consecutive volunteer women with breast cancer in stage II or III were obtained from biopsies before the beginning of neoadjuvant chemotherapy and after chemotherapy, from fragments excised during mastectomy. Tissues were analyzed by immunohistochemistry for both receptors. Because complete response to treatment was achieved in 4 patients, only the tumors from 12 were analyzed. Before chemotherapy, there was overexpression of LDL receptor in the tumoral tissue compared to normal breast tissue in 8 of these patients. LRP-1 receptor overexpression was observed in tumors of 4 patients. After chemotherapy, expression of both receptors decreased in the tumors of 6 patients, increased in 4 and was unchanged in 2. Nonetheless, even when chemotherapy reduced receptors expression, the expression was still above normal. The fact that chemotherapy does not impair LDL receptors expression supports the use of drug carrier systems that target neoplastic cells by the LDL receptor endocytic pathway in patients on conventional chemotherapy.
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Affiliation(s)
- L A Pires
- Laboratório de Metabolismo de Lípides, Instituto do Coração, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo, Brasil
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Abstract
Os benefícios da prática regular do exercício físico estão claramente estabelecidos na literatura. Entretanto, a escolha do tipo de exercício ideal pode ser mais salutar para indivíduos com doenças específicas e patologias associadas. O propósito desta revisão foi verificar se o treinamento resistido (TR) exerce alguma alteração no colesterol da lipoproteína de baixa densidade (LDL-C). Foram observadas grandes diferenças na literatura, dificultando uma conclusão em relação aos benefícios do TR nesta revisão. No entanto, foi visto que o TR pode ser promissor na redução dos níveis de LDL-C, principalmente em homens e mulheres adultos, em pacientes com diabetes mellitus tipo 1 e tipo 2 e em mulheres pré-menopausa, não mostrando diferenças na população idosa. Os autores concluem que o TR é uma boa opção de exercício físico para indivíduos, principalmente quando o treinamento aeróbio (TA) é contraindicado.
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31
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Dantas SA, Ficker ES, Vinagre CGC, Ianni BM, Maranhão RC, Mady C. Metabolism of a lipid nanoemulsion resembling low-density lipoprotein in patients with grade iii obesity. Clinics (Sao Paulo) 2010; 65:23-7. [PMID: 20126342 PMCID: PMC2815278 DOI: 10.1590/s1807-59322010000100005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 10/11/2009] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Obesity increases triglyceride levels and decreases high-density lipoprotein concentrations in plasma. Artificial emulsions resembling lipidic plasma lipoprotein structures have been used to evaluate low-density lipoprotein metabolism. In grade III obesity, low density lipoprotein metabolism is poorly understood. OBJECTIVE To evaluate the kinetics with which a cholesterol-rich emulsion (called a low-density emulsion) binds to low-density lipoprotein receptors in a group of patients with grade III obesity by the fractional clearance rate. METHODS A low-density emulsion was labeled with [(14)C]-cholesterol ester and [(3)H]-triglycerides and injected intravenously into ten normolipidemic non-diabetic patients with grade III obesity [body mass index higher than 40 kg/m(2)] and into ten non-obese healthy controls. Blood samples were collected over 24 hours to determine the plasma decay curve and to calculate the fractional clearance rate. RESULTS There was no difference regarding plasma levels of total cholesterol or low-density lipoprotein cholesterol between the two groups. The fractional clearance rate of triglycerides was 0.086 +/- 0.044 in the obese group and 0.122 +/- 0.026 in the controls (p = 0.040), and the fractional clearance rate of cholesterol ester (h(-1)) was 0.052 +/- 0.021 in the obese subjects and 0.058 +/- 0.015 (p = 0.971) in the controls. CONCLUSION Grade III obese subjects exhibited normal low-density lipoprotein removal from plasma as tested by the nanoemulsion method, but triglyceride removal was slower.
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Affiliation(s)
- Simone Alves Dantas
- Unidade Clínica de Miocardiopatias - Instituto do Coração - Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo,São Paulo/SP,Brazil.
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Puk CG, Bocchi EA, Lo Prete AC, Ferreira SMA, Stolf NAG, Maranhão RC. Transfer of Cholesterol and Other Lipids From a Lipid Nanoemulsion to High-density Lipoprotein in Heart Transplant Patients. J Heart Lung Transplant 2009; 28:1075-80. [DOI: 10.1016/j.healun.2009.05.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 05/15/2009] [Accepted: 05/17/2009] [Indexed: 11/30/2022] Open
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Oliveira TV, Maniero F, Maranhão RC. L 001 Changes in the Functional Properties of High-Density Lipoprotein (HDL) and the Cholesteryl Esters and Phospholipids Transfer Proteins Activities in Hamsters Submitted to Hiperlipidemic Diet. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71767-2] [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: 10/20/2022]
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Silva JL, Vinagre CGC, Morikawa AT, Alves MJN, Maranhão RC. L 028 The Effects of Resistance Training on Low-density Lipoprotein Metabolism. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71794-5] [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: 11/16/2022]
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Gagliardi ACM, Pavão BL, Barbeiro DF, Maranhão RC, Souza HP, Santos RD. L 020 Correlations Between Food Intake, Lipid Profile and Inflammation in Patients with Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71786-6] [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: 10/20/2022]
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36
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Casella Filho A, Cesena FHY, Trombetta IC, Denardi CAS, Dourado PMM, Silva VM, Negrão CE, Maranhão RC, Luz PL, Chagas ACP. L 008 Functional Characteristics of Plasma Lipoproteins From Patients with Metabolic Syndrome are Modulated by Changes in Their Size and Composition After Short-term Exercise. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71774-x] [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: 10/20/2022]
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Gagliardi ACM, Pavão BL, Barbeiro DF, Maranhão RC, Souza HP, Santos RD. L 021 Consumption of Margarine and Butter and Lipid Profiles and Inflammatory of Patients with Metabolic Syndrome. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71787-8] [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: 10/20/2022]
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38
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De Lima JJ, Latrilha MDC, Toffoletto O, Ianhez LE, Krieger EM, Maranhão RC. Plasma kinetics of chylomicron-like emulsion in renal transplant patients receiving cyclosporin-based immunosuppression. Clin Cardiol 2009; 21:411-3. [PMID: 9631270 PMCID: PMC6655711 DOI: 10.1002/clc.4960210608] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Atherosclerotic cardiovascular disease is prevalent among renal transplant patients. Increase in serum total cholesterol, low-density lipoprotein, and very low-density lipoprotein is common in those patients. Alterations in chylomicron metabolism, however, are also related to atherogenesis and were not studied in renal transplant. HYPOTHESIS The aim of this study was to evaluate chylomicron metabolism in renal transplant recipients receiving cyclosporin-based immunosuppression. We determined the plasma kinetics of triglyceride-rich emulsions labeled with [3H]triolein and [14C]cholesteryl oleate that are known to mimic the chylomicron metabolism when injected into the blood stream. METHODS Fourteen renal transplant recipients with normal renal function (10 men, 4 women, aged 40 +/- 6.1 years) and 17 age- and gender-matched healthy controls received bolus injections of the chylomicron-like emulsion. Plasma samples were then taken at regular intervals during 60 min. Disappearance curves of the labels and the respective fractional clearance rates (FCR) were calculated in order to measure lipolysis and chylomicron remnant removal from the plasma. RESULTS Fasting serum lipid levels did not differ in the two groups. The difference between Median FCR of [3H]triolein emulsion in renal transplant patients and that obtained in the controls (0.07 vs. 0.11 min-1, NS) was not statistically significant. Median FCR of [14C]cholesteryl oleate also did not differ between the groups (patients: 0.044; controls: 0.046, NS). CONCLUSION These results indicate that neither chylomicron lipolysis nor remnant removal are affected in stable renal transplant patients treated with cyclosporin-based immunosuppression.
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Affiliation(s)
- J J De Lima
- Hypertension Unit, Hospital das Clínicas, São Paulo University Medical School, Brazil
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Feitosa-Filho GS, Seydell TDM, Feitosa ACR, Maranhão RC, Ramires JAF. Transferências lipídicas para HDL em diabéticos tipo 2: associações com microalbuminúria, estatina e insulina. Arq Bras Cardiol 2009; 92:94-106. [DOI: 10.1590/s0066-782x2009000200005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Accepted: 03/04/2008] [Indexed: 11/21/2022] Open
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Feitosa ACR, Maranhão RC, Feitosa Filho GS, Wajchenberg BL. Transferência de lípides para a lipoproteína de alta densidade (HDl) em mulheres com diabetes melito tipo 1. ACTA ACUST UNITED AC 2009; 53:95-101. [DOI: 10.1590/s0004-27302009000100014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Accepted: 11/17/2008] [Indexed: 11/21/2022]
Abstract
INTRODUÇÃO: Os portadores de diabetes melito tipo 1 (DM1) possuem aumentado risco de doença cardiovascular e, ainda assim, podem apresentar perfil lipídico normal. Para esclarecer se os níveis normais de HDL podem ocultar defeitos na função, foram estudados a transferência de lípides para a HDL em DM1. MÉTODOS: Vinte e uma mulheres jovens portadoras de DM1 foram comparadas com 21 mulheres não-diabéticas. Nanoemulsões foram usadas como doadoras de lípides para HDL: uma marcada com ³H-triglicérides e 14C-colesterol livre e outra com ³H-éster de colesterol e 14C-fosfolípides. Após 1 hora de incubação com amostras de plasma, seguida por precipitação química, o sobrenadante, contendo HDL, teve a radioatividade contada. RESULTADOS: Nenhuma diferença foi encontrada nas transferências dos ésteres de colesterol, triglicérides, colesterol livre e fosfolípides para as HDL. CONCLUSÃO: A transferência de lípides para a HDL não está afetada em portadoras de DM1. Isso sugere que a doença não altera a composição de lipoproteínas e a ação de proteínas de transferência.
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Daminelli EN, Spada C, Treitinger A, Oliveira TV, Latrilha MDC, Maranhão RC. Alterations in lipid transfer to High-Density Lipoprotein (HDL) and activity of paraoxonase-1 in HIV+ patients. Rev Inst Med Trop Sao Paulo 2008; 50:223-7. [DOI: 10.1590/s0036-46652008000400007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 07/15/2008] [Indexed: 11/22/2022] Open
Abstract
HIV+ patients often develop alterations of the plasma lipids that may implicate in development of premature coronary artery disease. High-density lipoprotein (HDL) has an important role in preventing atherogenesis and the aim of this study was to investigate aspects of HDL function in HIV+ patients. HIV+ patients (n = 48) and healthy control subjects (n = 45) of both sexes with similar age were studied. Twenty-five were not being treated with antiretroviral agents, 13 were under reverse transcriptase inhibitor nucleosidic and non-nucleosidic (NRTI+NNRTI) and 10 were under NRTI + protease inhibitors (NRTI+PI) treatment. Paraoxonase 1 (PON1) activity and the transfer of free and esterified cholesterol, tryglicerides and phospholipids from a lipidic nanoemulsion to HDL were analyzed. In comparison with healthy controls, HIV+ patients presented low PON-1 activity and diminished transfer of free cholesterol and tryglicerides. In contrast, phospholipid transfer was increased in those patients, whereas the transfer of cholesteryl esters was unchanged. NRTI+NNRTI increases the transfer of cholesteryl esters and triglycerides but in NRTI+PI there was no difference in respect to non-treated HIV+ patients. HDL from HIV+ patients has smaller antioxidant properties, as shown by lower PON-1 activity, and the transfer of lipids to this lipoprotein fraction is also altered, suggesting that HDL function is defective in those patients.
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Affiliation(s)
| | - Celso Spada
- Federal University of Santa Catarina, Brazil
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Hosni JJ, Vinagre CG, Mady C, Maranhão RC. Lipolysis of emulsion models of triglyceride-rich lipoproteins is altered in male patients with abdominal aorta aneurysm. Braz J Med Biol Res 2008; 40:305-7. [PMID: 17334526 DOI: 10.1590/s0100-879x2007000300004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Accepted: 01/12/2007] [Indexed: 05/14/2023] Open
Abstract
Disorders of the lipid metabolism may play a role in the genesis of abdominal aorta aneurysm. The present study examined the intravascular catabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation in patients with abdominal aorta aneurysm. Thirteen male patients (72 +/- 5 years) with abdominal aorta aneurysm with normal plasma lipid profile and 13 healthy male control subjects (73 +/- 5 years) participated in the study. The method of chylomicron-like emulsions was used to evaluate this metabolism. The emulsion labeled with 14C-cholesteryl oleate and (3)H-triolein was injected intravenously in both groups. Blood samples were taken at regular intervals over 60 min to determine the decay curves. The fractional clearance rate (FCR) of the radioactive labels was calculated by compartmental analysis. The FCR of the emulsion with (3)H-triolein was smaller in the aortic aneurysm patients than in controls (0.025 +/- 0.017 vs 0.039 +/- 0.019 min-1; P < 0.05), but the FCR of 14C-cholesteryl oleate of both groups did not differ. In conclusion, as indicated by the triglyceride FCR, chylomicron lipolysis is diminished in male patients with aortic aneurysm, whereas the remnant removal which is traced by the cholesteryl oleate FCR is not altered. The results suggest that defects in the chylomicron metabolism may represent a risk factor for development of abdominal aortic aneurysm.
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Affiliation(s)
- J J Hosni
- Laboratório de Metabolismo de Lípides, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Enéas C. Aguiar 44, 05403-000 São Paulo, SP, Brazil
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Filippin FB, Souza LC, Maranhão RC. Amphotericin B associated with triglyceride-rich nanoemulsion: stability studies and in vitro antifungal activity. QUIM NOVA 2008. [DOI: 10.1590/s0100-40422008000300024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Abstract
Low-density lipoprotein (LDL) pathway in systemic lupus erythematosus (SLE) patients taking chloroquine diphosphate (CDP) was evaluated through the kinetic behavior of a radioactive cholesterol-rich nanoemulsion (LDE) that resembles the LDL lipidic structure. LDE was labeled with (14)C-cholesteryl ester ((14)C-CE), then IV injected in inactive female SLE patients: 10 taking CDP (CDP), 10 without therapy (NO THERAPY); and 10 normal subjects (CONTROL). Groups were age-matched and followed rigorous selection criteria of conditions that interfere in the lipid profile. Blood samples were collected in pre-established intervals after infusion for radioactivity measurement. Fasting lipoproteins were determined in the beginning of kinetic studies. Fractional clearance rate (FCR) of (14)C-CE was significantly different in the three groups (P = 0.03). In fact, a greater FCR of (14)C-CE was observed in CDP compared to NO THERAPY (0.076 +/- 0.037 versus 0.046 +/- 0.021 h(-1); P < 0.05) and to CONTROL (0.0516 +/- 0.0125 h(-1); P < 0.05). Accordingly, a significant lower total and LDL cholesterol were observed in CDP (156 +/- 16 and 88 +/- 16 mg/dl) compared to NO THERAPY (174 +/- 15 and 108 +/- 17 mg/dl; P < 0.05) and to CONTROL (200 +/- 24 and 118 +/- 23 mg/dl; P < 0.05). In contrast, no difference in (FCR) of (14)C-CE of NO THERAPY and CONTROL groups was observed. This is the first in vivo demonstration that LDE removal by LDL receptor from plasma is increased in SLE patients taking CDP with a consequent beneficial decrease in LDL-c levels.
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Affiliation(s)
- J C Sachet
- Rheumatology Division and Lipid Metabolism Laboratory, Heart Institute (InCor), Medical School Hospital and Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Mello APQ, de Oliveira AS, Parra Abdalla DS, Maranhão RC, dos Santos Filho RD, Damasceno NRT. L 018 Electronegative low density lipoprotein (LDL-) is inversely associated to HDL-cholesterol. ATHEROSCLEROSIS SUPP 2007. [DOI: 10.1016/s1567-5688(07)71962-1] [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: 11/28/2022]
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46
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Rangel CM, Grinberg M, Maranhão RC, Ventura LI. [Aortic stenosis and coronary disease. Analysis of risk factors]. Arq Bras Cardiol 2006; 87:115-20. [PMID: 16951828 DOI: 10.1590/s0066-782x2006001500008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 03/17/2006] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze clinical laboratorial aspects of the presence of coronary disease in patients with aortic stenosis and evaluate the influence of risk factors in the development of obstructive coronary disease. METHODS We studied 65 patients who had severe aortic stenosis with an indication for surgery, ages 51 to 85 years, 40 of them women. The coronary angiography assessment resulted in two groups: 26 (40%) with obstructive coronary disease and 39 (60%) with no coronary artery lesion. Personal antecedents for coronary disease (smoking, dyslipidemia, diabetes mellitus, arterial hypertension, family antecedents, sedentarism, and alcoholism) were analyzed. Additionally, the following assessments were made: electrocardiogram, echocardiogram with Doppler, and laboratory tests (blood glucose, total cholesterol and fractions, triglycerides, Apo-A1 and B, fibrinogen, lipoprotein (a) and fraction of triglycerides and cholesterol removal in both groups. RESULTS In the age analysis, the group with obstructive coronary disease belonged to an older age range with statistical significance (p<0.0001). Signs of ischemia of the anterior wall identified on the electrocardiogram showed a significant relationship with the obstruction of an anterior interventricular artery (p<0.002). The univariate analysis showed a significant difference between the groups regarding averages of the aortic (p= 0.041), HDL (p=0.042), and fibrinogen (p=0.047) gradients. The group with coronary disease presented an average gradient and HDL level lower than the group without obstructive coronary disease. For the fibrinogen variable, the average in the group with no coronary disease was lower compared to that of the coronariopathy group. The multivariate logistic regression analysis showed fibrinogen levels as an independent variable for coronary disease (p<0.039). CONCLUSION Fibrinogen was an independent risk factor for the association between obstructive coronary disease and aortic stenosis.
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Abstract
OBJECTIVE To investigate whether increasing body mass index (BMI) produces increasingly intense disturbances in the metabolism of chylomicrons, the lipoproteins that carry the dietary lipids absorbed by the intestine in the circulation. SUBJECTS Four groups of 10 normolipidemic nondiabetic women at the normal (BMI<25 kg/m(2)), preobese (BMI 25-30), obese (BMI 30-40) and morbid obese (BMI>40). METHODS Chylomicron metabolism was studied using the method of triglyceride-rich emulsions that mimic chylomicrons. The chylomicron-like emulsion doubly labeled with (3)H-triolein (TO) and (14)C-cholesteryl-oleate (CO) was intravenously injected to calculate the plasma fractional clearance rates (FCR, in min(-1)) by a compartmental analysis model. FCR-TO mirrors both the lipolysis from lipoprotein lipase that the emulsion suffers while still in the circulation, and the triglycerides portion that is not broken down and is removed from the plasma together with the remnant particles. Lipolysis index is calculated subtracting CO from TO areas under the curve. RESULTS FCR-TO did not differ among the four groups. The lipolysis index was positively correlated with BMI (r=0.310; P=0.05). On the other hand, FCR-CO progressively diminished from the normal to the morbid obese group (0.069+/-0.01; 0.064+/-0.01; 0.031+/-0.003; 0.029+/-0.005 min(-1), respectively, P=0.003) and there was a negative correlation between FCR-CO and BMI (r=-0.388; P=0.01). CONCLUSION In obesity, the capacity to break down chylomicron triglycerides by lipoprotein lipase in vivo increases, but the ability of the organism to remove the resulting chylomicron remnants particles progressively diminishes as the BMI rises. Remnant accumulation most likely predisposes to coronary artery disease development.
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Affiliation(s)
- M R M Oliveira
- Faculty of Pharmaceutical Sciences, and Heart Institute of the Medical School Hospital (INCOR-HCFMUSP), University of São Paulo (USP), São Paulo, Brazil
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48
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Uint L, Sposito A, Brandizzi LIV, Yoshida VM, Maranhão RC, Luz PLD. Cellular cholesterol efflux mediated by HDL isolated from subjects with low HDL levels and coronary artery disease. Arq Bras Cardiol 2003; 81:39-41, 35-8. [PMID: 12908071 DOI: 10.1590/s0066-782x2003000900003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
OBJECTIVE The aim of this study was to verify whether HDL particles isolated from patients with coronary artery disease (CAD) and low HDL-C had diminished ability to promote cholesterol efflux from cultured cells compared with HDL isolated from subjects without CAD and with normal HDL-C. METHODS Smooth muscle cells isolated from human aortas cultured and radiolabeled with H-cholesterol were loaded with cholesterol and incubated with increasing concentrations of HDL isolated from 13 CAD patients with low HDL-C (CAD group) or from 5 controls without CAD (C group). Efflux of cellular cholesterol was measured by cellular depletion of radiolabeled cholesterol and by the appearance of H-cholesterol into experimental medium expressed as a percentage of total labeled cholesterol. RESULTS Cholesterol efflux increased with the amount of HDL present in the medium, and no difference was found between groups at various HDL protein concentrations: efflux was 28 +/- 6.3% (C) and 25.5 +/- 8.9% (CAD) with 25 microg/mL; 34 +/- 4.3% (C) and 31.9 +/- 6.6% (CD) with 50 micro g/mL and 39.5 +/- 3.5% (C) and 37.1 +/- 4.4% (CAD) with 100 micro g/mL, HDL. CONCLUSION Because the HDL fraction of CAD patients with low HDL-C have normal ability to extract cholesterol from cells of the vessel wall, it is suggested that low HDL-C atherogenicity should be ascribed to diminished concentrations of HDL particles rather than to the qualitative properties of the HDL fraction.
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Affiliation(s)
- Luciana Uint
- Heart Institute (InCor), University of São Paulo Medical School, Brazil.
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Oliveira MRM, Maranhão RC. Plasma kinetics of a chylomicron-like emulsion in normolipidemic obese women after a short-period weight loss by energy-restricted diet. Metabolism 2002; 51:1097-103. [PMID: 12200752 DOI: 10.1053/meta.2002.34698] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chylomicrons carry dietary fats in the bloodstream for storage in body tissues, and thus play an important role in obesity. The 2-step chylomicron metabolism consists of lipolysis by lipoprotein lipase (LPL) on vessel walls and hepatic uptake of triglyceride-depleted remnants. A triglyceride-rich emulsion that mimics chylomicrons, labeled with [9,10-(3)H]glycerol-trioleate (TG) and [1-(14)C] cholesteryl-oleate (CE) was intravenously injected into 14 obese women with body mass index between 30 and 40 kg/m(2) (age, 30 to 40 years), before and after a 2-month energy-restricted diet and into non-obese controls for determination of radioactive lipid plasma kinetics. TG kinetics evaluates lipolysis, whereas CE kinetics evaluates remnant removal. The emulsion TG fractional clearance rate (FCR, in min(-1)) was similar in obese women and their controls (0.126 +/- 0.065; controls, 0.111 +/- 0.031), but the CE-FCR was pronouncedly reduced in the obese subjects (0.028 +/- 0.014; controls, 0.070 +/- 0.009 min(-1); P <.0001). After the energy-restricted diet, TG-FCR was reduced in the obese women (0.075 +/- 0.044 min(-1); P <.05), but CE-FCR was unchanged (0.032 +/- 0.025 min(-1)). Therefore, the lipolysis of the chylomicron-like emulsion is normal in obese women, but remnant removal from the plasma is diminished. After active weight loss by an energy-restricted diet, the remnant removal was unchanged but lipolysis was diminished, possibly due to adaptative changes in LPL activity.
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Affiliation(s)
- M R M Oliveira
- Faculty of Pharmaceutical Sciences, and Heart Institute of the Medical School Hospital (INCOR-HCFMUSP), University of São Paulo, Brazil
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Abstract
Low density lipoprotein (LDL) plasma concentration is increased in the elderly. In this group, the incidence of coronary artery disease (CAD) is greater and LDL remains an important risk factor for CAD development. In this study, the plasma kinetics of a cholesterol-rich emulsion that binds to LDL receptors was studied in 10-subject groups of the elderly (70 +/- 4 yr), middle-aged (42 +/- 5 yr) and young (23 +/- 2 yr). All were normolipidemic, nonobese, nondiabetic subjects who did not have CAD. The emulsion was labeled with 14C-cholesteryl oleate and injected intravenously into the subjects. Blood samples were drawn at regular intervals over 24 h to determine the plasma decay curve of the emulsion radioactive label and to estimate its plasma fractional clearance rate (FCR, in h(-1)). FCR of the emulsion label was smaller in elderly compared to young subjects (0.032 +/- 0.035 and 0.071 +/- 0.049 h(-1), respectively; mean +/- SD, P< 0.05). FCR of the middle-aged subjects (0.050 +/- 0.071 h(-1)) was intermediate between the values of the elderly and young subjects, although not statistically different from them. A negative correlation was found betweeen the emulsion FCR and subjects' age (r = -0.47, P = 0.008). We conclude that aging is accompanied by progressively diminished clearance of the emulsion cholesterol esters and, by analogy, of the native LDL.
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Affiliation(s)
- L B Pinto
- The Heart Institute, Medical School Hospital (InCor-HCFMUSP), São Paulo, Brazil
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