Glucagon induces the hepatic expression of inflammatory markers in vitro and in vivo

Glucagon exerts multiple hepatic actions, including stimulation of glycogenolysis/gluconeogenesis. The liver plays a crucial role in chronic inflammation by synthesizing proinflammatory molecules, which are thought to contribute to insulin resistance and hyperglycaemia. Whether glucagon affects hepatic expression of proinflammatory cytokines and acute-phase reactants is unknown. Herein, we report a positive relationship between fasting glucagon levels and circulating interleukin (IL)-1β (r = 0.252, p = .042), IL-6 (r = 0.230, p = .026), fibrinogen (r = 0.193, p = .031), complement component 3 (r = 0.227, p = .024) and high sensitivity C-reactive protein (r = 0.230, p = .012) in individuals without diabetes. In CD1 mice, 4-week continuous treatment with glucagon induced a significant increase in circulating IL-1β (p = .02), and IL-6 (p = .001), which was countered by the contingent administration of the glucagon receptor antagonist, GRA-II. Consistent with these results, we detected a significant increase in the hepatic activation of inflammatory pathways, such as expression of NLRP3 (p < .02), and the phosphorylation of nuclear factor kappaB (NF-κB; p < .02) and STAT3 (p < .01). In HepG2 cells, we found that glucagon dose-dependently stimulated the expression of IL-1β (p < .002), IL-6 (p < .002), fibrinogen (p < .01), complement component 3 (p < .01) and C-reactive protein (p < .01), stimulated the activation of NLRP3 inflammasome (p < .01) and caspase-1 (p < .05), induced the phosphorylation of TRAF2 (p < .01), NF-κB (p < .01) and STAT3 (p < .01). Preincubating cells with GRA-II inhibited the ability of glucagon to induce an inflammatory response. Using HepaRG cells, we confirmed the dose-dependent ability of glucagon to stimulate the expression of NLRP3, the phosphorylation of NF-κB and STAT3, in the absence of GRA-II. These results suggest that glucagon has proinflammatory effects that may participate in the pathogenesis of hyperglycaemia and unfavourable cardiometabolic risk profile.

The Functional Polymorphism of DDAH2 rs9267551 Is an Independent Determinant of Arterial Stiffness

Background: The association of circulating asymmetric dimethylarginine (ADMA) levels with cardiovascular risk and arterial stiffness has been reportedly demonstrated, although the causal involvement of ADMA in the pathogenesis of these conditions is still debated. Dimethylaminohydrolase 2 (DDAH2) is the enzyme responsible for ADMA hydrolysis in the vasculature, and carriers of the polymorphism rs9267551 C in the 5′-UTR of DDAH2 have been reported to have higher DDAH2 expression and reduced levels of serum ADMA.

Approach and Results: We genotyped rs9267551 in 633 adults of European ancestry and measured their carotid–femoral pulse wave velocity (cfPWV), the gold-standard method to estimate arterial stiffness. cfPWV resulted significantly lower in rs9267551 C allele carriers (Δ = −1.12 m/s, P < 0.01) after correction for age, sex and BMI, and a univariate regression showed that the presence of rs9267551 C variant was negatively associated with cfPWV (β = −0.110, P < 0.01). In a multivariable regression model, subjects carrying the rs9267551 C allele manifested significantly lower cfPWV than GG carriers (β = −0.098, P = 0.01) independently from several potential confounders. We measured circulating ADMA levels in a subset of 344 subjects. A mediation analysis revealed that the effect of DDAH2 rs9267551 genotype on cfPWV was mediated by the variation in ADMA levels.

Conclusions: These evidences hint that the presence of rs9267551 C allele may explain, at least in part, a reduction in vessel rigidity as measured by cfPWV, and support the attribution of a causative role to ADMA in the pathogenesis of arterial stiffness.

Metabolites Profiling of Melanoma Interstitial Fluids Reveals Uridine Diphosphate as Potent Immune Modulator Capable of Limiting Tumor Growth

Tumor interstitial fluid (TIF) surrounds and perfuses tumors and collects ions, metabolites, proteins, and extracellular vesicles secreted by tumor and stromal cells. Specific metabolites, accumulated within the TIF, could induce metabolic alterations of immune cells and shape the tumor microenvironment. We deployed a metabolomic approach to analyze the composition of melanoma TIF and compared it to the plasma of C57BL6 mice, engrafted or not with B16-melanoma cells. Among the classes of metabolites analyzed, monophosphate and diphosphate nucleotides resulted enriched in TIF compared to plasma samples. The analysis of the effects exerted by guanosine diphosphate (GDP) and uridine diphosphate (UDP) on immune response revealed that GDP and UDP increased the percentage of CD4+CD25+FoxP3- and, on isolated CD4+ T-cells, induced the phosphorylation of ERK, STAT1, and STAT3; increased the activity of NF-κB subunits p65, p50, RelB, and p52; increased the expression of Th1/Th17 markers including IFNγ, IL17, T-bet, and RORγt; and reduced the expression of IL13, a Th2 marker. Finally, we observed that local administrations of UDP in B16-engrafted C57BL6 mice reduced tumor growth and necrotic areas. In addition, UDP-treated tumors showed a higher presence of MHCIIhi tumor-associated macrophage (TAM) and of CD3+CD8+ and CD3+CD4+ tumor-infiltrating T-lymphocytes (TILs), both markers of anti-tumor immune response. Consistent with this, intra-tumoral gene expression analysis revealed in UDP-treated tumors an increase in the expression of genes functionally linked to anti-tumor immune response. Our analysis revealed an important metabolite acting as mediator of immune response, which could potentially represent an additional tool to be used as an adjuvant in cancer immunotherapy.

The TRIB3 R84 variant is associated with increased left ventricular mass in a sample of 2426 White individuals

Background

Prior studies in animal models showed that increased cardiac expression of TRIB3 has a pathogenic role in inducing left ventricular mass (LVM). Whether alterations in TRIB3 expression or function have a pathogenic role in inducing LVM increase also in humans is still unsettled. In order to address this issue, we took advantage of a nonsynonymous TRIB3 Q84R polymorphism (rs2295490), a gain-of-function amino acid substitution impairing insulin signalling, and action in primary human endothelial cells which has been associated with insulin resistance, and early vascular atherosclerosis.

Methods

SNP rs2295490 was genotyped in 2426 White adults in whom LVM index (LVMI) was assessed by validated echocardiography-derived measures.

Results

After adjusting for age and sex, LVMI progressively and significantly increased from 108 to 113, to 125 g/m² in Q84Q, Q84R, and R84R individuals, respectively (Q84R vs. Q84Q, P = 0.03; R84R vs. Q84Q, P < 0.0001). The association between LVMI and the Q84R and R84R genotype remained significant after adjusting for blood pressure, smoking habit, fasting glucose levels, glucose tolerance status, anti-hypertensive treatments, and lipid-lowering therapy (Q84R vs. Q84Q, P = 0.01; R84R vs. Q84Q, P < 0.0001).

Conclusions

We found that the gain-of-function TRIB3 Q84R variant is significantly associated with left ventricular mass in a large sample of White nondiabetic individual of European ancestry.

CD31+ Extracellular Vesicles From Patients With Type 2 Diabetes Shuttle a miRNA Signature Associated With Cardiovascular Complications

Innovative biomarkers are needed to improve the management of patients with type 2 diabetes mellitus (T2DM). Blood circulating miRNAs have been proposed as a potential tool to detect T2DM complications, but the lack of tissue specificity, among other reasons, has hampered their translation to clinical settings. Extracellular vesicle (EV)-shuttled miRNAs have been proposed as an alternative approach. Here, we adapted an immunomagnetic bead-based method to isolate plasma CD31⁺ EVs to harvest vesicles deriving from tissues relevant for T2DM complications. Surface marker characterization showed that CD31⁺ EVs were also positive for a range of markers typical of both platelets and activated endothelial cells. After characterization, we quantified 11 candidate miRNAs associated with vascular performance and shuttled by CD31⁺ EVs in a large (n = 218) cross-sectional cohort of patients categorized as having T2DM without complications, having T2DM with complications, and control subjects. We found that 10 of the tested miRNAs are affected by T2DM, while the signature composed by miR-146a, -320a, -422a, and -451a efficiently identified T2DM patients with complications. Furthermore, another CD31⁺ EV-shuttled miRNA signature, i.e., miR-155, -320a, -342-3p, -376, and -422a, detected T2DM patients with a previous major adverse cardiovascular event. Many of these miRNAs significantly correlate with clinical variables held to play a key role in the development of complications. In addition, we show that CD31⁺ EVs from patients with T2DM are able to promote the expression of selected inflammatory mRNAs, i.e., CCL2, IL-1α, and TNFα, when administered to endothelial cells in vitro. Overall, these data suggest that the miRNA cargo of plasma CD31⁺ EVs is largely affected by T2DM and related complications, encouraging further research to explore the diagnostic potential and the functional role of these alterations.

HDL (High-Density Lipoprotein) and ApoA-1 (Apolipoprotein A-1) Potentially Modulate Pancreatic α-Cell Glucagon Secretion

OBJECTIVE

Subjects with low levels of HDL (high-density lipoprotein) and ApoA-1 (apolipoprotein A-1) have increased risk to develop type 2 diabetes. HDL levels are an independent predictor of β-cell function and positively modulate it. Type 2 diabetes is characterized by defects in both β and α-cell function, but the effect of HDL and ApoA1 on α-cell function is unknown. Approach and Results: We observed a significant negative correlation (r=-0.422, P<0.0001) between HDL levels and fasting glucagon in a cohort of 132 Italian subjects. In a multivariable regression analysis including potential confounders such as age, sex, BMI, triglycerides, total cholesterol, fasting and 2-hour postload glucose, and fasting insulin, the association between HDL and fasting glucagon remained statistically significant (β=-0.318, P=0.006). CD1 mice treated with HDL or ApoA-1 for 3 consecutive days showed a 32% (P<0.001) and 23% (P<0.05) reduction, respectively, in glucagon levels following insulin-induced hypoglycemia, compared with controls. Treatment of pancreatic αTC1 clone 6 cells with HDL or ApoA-1 for 24 hours resulted in a significant reduction of glucagon expression (P<0.04) and secretion (P<0.01) after an hypoglycemic stimulus and increased Akt (RAC-alpha serine/threonine-protein kinase) and FoxO1 (forkhead/winged helix box gene, group O-1) phosphorylation. Pretreatment with Akt inhibitor VIII, PI3K (phosphatidylinositol 3-kinase) inhibitor LY294002, and HDL receptor SCARB-1 (scavenger receptor class B type 1) inhibitor BLT-1 (block lipid transport-1) restored αTC1 cell response to low glucose levels.

CONCLUSIONS

These results support the notion that HDL and ApoA-1 modulate glucagon expression and secretion by binding their cognate receptor SCARB-1, and activating the PI3K/Akt/FoxO1 signaling cascade in an in vitro α-cell model. Overall, these results raise the hypothesis that HDL and ApoA-1 may have a role in modulating glucagon secretion.

Association between Serum Mg2+ Concentrations and Cardiovascular Organ Damage in a Cohort of Adult Subjects

Magnesium (Mg²⁺) levels are associated with insulin resistance, hypertension, atherosclerosis, and type 2 diabetes (T2DM). We evaluated the clinical utility of physiological Mg²⁺ in assessing subclinical cardiovascular organ damage including increased carotid artery intima- media thickness (c-IMT) and left ventricular mass index (LVMI) in a cohort of well-characterized adult non-diabetic individuals. Age- and gender-adjusted correlations between Mg²⁺ and metabolic parameters showed that Mg²⁺ circulating levels were correlated negatively with body mass index (BMI), fasting glucose, and 2h-oral glucose tolerance test (OGTT) glucose. Similarly, Mg²⁺ levels were significantly and negatively related to c-IMT and LVMI. A multivariate regression analysis revealed that age (β = 0.440; p < 0.0001), BMI (β = 0.225; p < 0.0001), and Mg²⁺ concentration (β = −0.122; p < 0.01) were independently associated with c-IMT. Age (β = 0.244; p = 0.012), Mg²⁺ (β = −0.177; p = 0.019), and diastolic blood pressure (β = 0.184; p = 0.038) were significantly associated with LVMI in women, while age (β = 0.211; p = 0.019), Mg²⁺ (β = −0.171; p = 0.038) and the homeostasis model assessment index of insulin resistance (HOMA-IR) (β = −0.211; p = 0.041) were the sole variables associated with LVMI in men. In conclusion, our data support the hypothesis that the assessment of Mg²⁺ as part of the initial work-up might help unravel the presence of subclinical organ damage in subjects at increased risk of cardiovascular complications.

Are Circulating Mg2+ Levels Associated with Glucose Tolerance Profiles and Incident Type 2 Diabetes?

Magnesium (Mg²⁺) is an enzyme co-factor that plays a key role in many biochemical reactions, as well as in glucose metabolism. Clinical evidences have demonstrated that depletion of serum Mg²⁺ increases exponentially with the duration of type 2 diabetes mellitus (T2DM). Diabetes is associated with low Mg²⁺, and hypomagnesemia is associated with insulin resistance, inflammation, and increased risk for cardiovascular disease. In subjects at high risk of inflammation and insulin resistance, supplementation of Mg²⁺ alone ameliorates both phenotypes, slowing the development and progression of hepatic steatosis. We analyze the relationship between serum Mg²⁺ levels and the onset of T2DM in a large cohort of well-characterized adult white individuals participating in the CATAMERI study, who were reexamined after a mean follow-up of 5.6 ± 0.9 years. In our analysis we acquired a significant negative correlation between Mg²⁺ levels, fasting glucose, and 2h-post load glucose in subjects who underwent an OGTT. Moreover, Mg²⁺ levels correlated negatively with fasting insulin levels, and positively with the lipid profile. As for the detrimental effect of lower circulating Mg²⁺ levels, our data revealed a significant reduction of T2DM risk of about 20% for each 1 mg/dL increase of circulating Mg²⁺. The present results are consistent with the theory that Mg²⁺ supplementation could ameliorate insulin sensitivity reducing the risk to develop T2DM.

A functional variant of the dimethylarginine dimethylaminohydrolase-2 gene is associated with myocardial infarction in type 2 diabetic patients

Background

Myocardial infarction is the main mortality cause in patients with type 2 diabetes (T2DM). Endothelial dysfunction due to reduced bioavailability of nitric oxide (NO) is an early step of atherogenesis. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of NO synthesis, and it is metabolized by the enzymes dimethylarginine dimethylaminohydrolase (DDAH) 1 and 2. The functional variant rs9267551 C, in the promoter region of DDAH2, has been linked to increased DDAH2 expression, and lower ADMA plasma levels, and was associated with lower risk of coronary artery disease in large-scale genome-wide association studies (GWAS) performed in the general population. However, it is unknown whether this association holds true in T2DM patients. To address this issue, we investigated whether rs9267551 is associated with risk of myocardial infarction in two cohorts of T2DM patients.

Methods

SNP rs9267551 was genotyped in 1839 White T2DM patients from the Catanzaro Study (CZ, n = 1060) and the Gargano Heart Study-cross sectional design (GHS, n = 779). Cases were patients with a previous myocardial infarction, controls were asymptomatic patients with neither previous myocardial ischemia nor signs of it at resting and during a maximal symptom limited stress electrocardiogram.

Results

Carriers of allele rs9267551 C showed a dose dependent reduction in the risk of myocardial infarction [(CZ = OR 0.380, 95% CI 0.175–0.823, p = 0.014), (GHS = 0.497, 0.267–0.923, p = 0.027), (Pooled = 0.458, 0.283–0.739, p = 0.001)] which remained significant after adjusting for sex, age, BMI, smoking, HbA1c, total cholesterol HDL, and triglyceride levels [(CZ = 0.307, 0.106–0.885, p = 0.029), (GHS = 0.512, 0.270–0.970, p = 0.040), (Pooled = 0.458, 0.266–0.787, p = 0.005)].

Conclusions

We found that rs9267551 polymorphism is significantly associated with myocardial infarction in T2DM patients of European ancestry from two independent cohorts. It is possible that in subjects carrying the protective C allele less ADMA accumulates in endothelial cells causing vascular protection as a consequence of higher nitric oxide availability.

The polymorphism rs35767 at IGF1 locus is associated with serum urate levels

Previous studies suggested that the IGF-1/IGF-1 receptor signaling pathway may contribute to regulate uric acid levels. To confirm this hypothesis, we assessed the effects of the IGF-1-raising genetic variant rs35767 on urate levels in serum and urine, and we investigated IGF-1 ability to modulate the expression of transporters involved in reabsorption and secretion of uric acid in the kidney. The study population included 2794 adult Whites. 24-hour urinary uric acid concentration was available for 229 subjects. rs35767 polymorphism was screened using TaqMan genotyping assays. HEK293 (human embryonic kidney-293) cell line was treated with IGF-1 (1, 5, 10, 50 nM) for 24-hours, and differences in the expression of urate transporters were evaluated via Western Blot and real time rtPCR. Individuals carrying the IGF-1-raising allele (rs35767 T) exhibited significantly lower levels of serum urate according to both additive and recessive models, after correction for gender, age, BMI, glucose tolerance, glomerular filtration rate, and anti-hypertensive treatment. TT genotype carriers displayed higher uricosuria than C allele carriers did, after adjusting for confounders. Exposure of HEK293 cells to IGF-1 resulted in a dose-dependent increase of uric acid transporters deputed to uric acid excretion (MRP4, NPT1 and BCRP), and reduction of GLUT9 expression, the major mediator of uric acid reabsorption, both at mRNA and protein level. We observed a significant association between the functional polymorphism rs35767 near IGF1 with serum urate concentrations and we provide a mechanistic explanation supporting a causal role for IGF-1 in the regulation of uric acid homeostasis.

Short-term sustained hyperglycaemia fosters an archetypal senescence-associated secretory phenotype in endothelial cells and macrophages

Diabetic status is characterized by chronic low-grade inflammation and an increased burden of senescent cells. Recently, the senescence-associated secretory phenotype (SASP) has been suggested as a possible source of inflammatory factors in obesity-induced type 2 diabetes. However, while senescence is a known consequence of hyperglycaemia, evidences of SASP as a result of the glycaemic insult are missing. In addition, few data are available regarding which cell types are the main SASP-spreading cells in vivo. Adopting a four-pronged approach we demonstrated that: i) an archetypal SASP response that was at least partly attributable to endothelial cells and macrophages is induced in mouse kidney after in vivo exposure to sustained hyperglycaemia; ii) reproducing a similar condition in vitro in endothelial cells and macrophages, hyperglycaemic stimulus largely phenocopies the SASP acquired during replicative senescence; iii) in endothelial cells, hyperglycaemia-induced senescence and SASP could be prevented by SOD-1 overexpression; and iiii) ex vivo circulating angiogenic cells derived from peripheral blood mononuclear cells from diabetic patients displayed features consistent with the SASP. Overall, the present findings document a direct link between hyperglycaemia and the SASP in endothelial cells and macrophages, making the SASP a highly likely contributor to the fuelling of low-grade inflammation in diabetes.

Teneligliptin enhances the beneficial effects of GLP-1 in endothelial cells exposed to hyperglycemic conditions

High-glucose-induced oxidative stress contributes to cardiovascular endothelial damage in diabetes. Glucagon-like peptide 1 (GLP-1) is beneficial to endothelial cells, but its effects are diminished when cells are continuously exposed to high glucose. Teneligliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that prevents oxidative stress, apoptosis and the metabolic memory effect. We explored the potential additive effects of Teneligliptin and GLP-1 in hyperglycemia-damaged endothelial cells. Human umbilical vein endothelial cells (HUVECs) were exposed to normal-glucose (5 mmol/L) or high-glucose (HG, 25 mmol/L) for 21 days, or to HG for 14 days followed by normal-glucose for 7 days (HM). These cells were continually treated with Teneligliptin 3.0 μmol/L, alone or in combination with an acute dose of GLP-1 50 nmol/L. DPP-4 was upregulated under hyperglycemic conditions, but Teneligliptin reduced DPP-4 expression and activity. Simultaneous Teneligliptin and GLP-1 synergistically increased the antioxidant response and reduced ROS levels in HG- and HM-exposed HUVECs. Concurrent treatment also enhanced cell proliferation, reduced apoptotic gene expression and ameliorated endoplasmic reticulum stress in HG- and HM-exposed HUVECs. Thus, long-term Teneligliptin treatment reduced DPP-4 levels and activity in HUVECs exposed to chronic hyperglycemia. Moreover, Teneligliptin enhanced the beneficial effects of GLP-1 on oxidative stress, proliferation, apoptosis and endoplasmic reticulum homeostasis.

Inflammageing and metaflammation: The yin and yang of type 2 diabetes

Type 2 diabetes mellitus (T2DM) is characterised by chronic low-grade inflammation, recently referred to as 'metaflammation', a relevant factor contributing to the development of both diabetes and its complications. Nonetheless, 'canonical' anti-inflammatory drugs do not yield satisfactory results in terms of prevention of diabetes progression and of cardiovascular events, suggesting that the causal mechanisms fostering metaflammation deserve further research to identify new druggable targets. Metaflammation resembles ageing-induced low-grade inflammation, previously referred to as inflammageing, in terms of clinical presentation and the molecular profile, pointing to a common aetiology for both conditions. Along with the mechanisms proposed to fuel inflammageing, here we dissect a plethora of pathological cascades triggered by gluco- and lipotoxicity, converging on candidate phenomena possibly explaining the enduring pro-inflammatory program observed in diabetic tissues, i.e. persistent immune-system stimulation, accumulation of senescent cells, epigenetic rearrangements, and alterations in microbiota composition. We discuss the possibility of harnessing these recent discoveries in future therapies for T2DM. Moreover, we review recent evidence regarding the ability of diets and physical exercise to modulate selected inflammatory pathways relevant for the diabetic pathology. Finally, we examine the latest findings showing putative anti-inflammatory mechanisms of anti-hyperglycaemic agents with proven efficacy against T2DM-induced cardiovascular complications, in order to gain insights into quickly translatable therapeutic approaches.

Hospital-acquired infections documented by repeated annual prevalence surveys over 15 years

OBJECTIVE

To estimate the benefits of iterative prevalence surveys in detecting trends of hospital-acquired infections (HAIs).

METHODS

On the basis of the French protocol for national prevalence studies, HAI data of 15 consecutive annual surveys performed at the same period by the same group of investigators was gathered in a single database to describe the trend of HAIs in a University Hospital over a 15-year period.

RESULTS

A total of 20,401 patients were included. Overall, the prevalence of patients presenting with at least one HAI acquired in our University Hospital was 5.1% [95% CI, 4.8-5.4%]. The prevalence of HAIs and antimicrobial drug use significantly decreased over time (P<0.01).

CONCLUSION

Despite limitations, repeated prevalence surveys can be a useful tool for promoting control measures to better prevent HAIs.

Plasma kisspeptin levels are associated with insulin secretion in nondiabetic individuals

To evaluate if plasma kisspeptin concentrations are associated with insulin secretion, as suggested by recent in vitro studies, independently of confounders. 261 nondiabetic subjects were stratified into tertiles according to kisspeptin values. Insulin secretion was assessed using indexes derived from oral glucose tolerance test (OGTT). After adjusting for age, gender, and BMI, subjects in the highest (tertile 3) kisspeptin group exhibited significantly lower values of insulinogenic index, corrected insulin response (CIR₃₀), and Stumvoll indexes for first-phase and second-phase insulin release as compared with low (tertile 1) or intermediate (tertile 2) kisspeptin groups. Univariate correlations between kisspeptin concentration and metabolic variables showed that kisspeptin concentration was significantly and positively correlated with age, blood pressure, and 2-h post-load glucose, and inversely correlated with BMI, and waist circumference. There was an inverse relationship between kisspeptin levels and OGTT-derived indexes of glucose-stimulated insulin secretion. A multivariable regression analysis in a model including all the variables significantly correlated with kisspeptin concentration showed thar age (β = -0.338, P<0.0001), BMI (β = 0.272, P<0.0001), 2-h post-load glucose (β = -0.229, P<0.0001), and kisspeptin (β = -0.105, P = 0.03) remained associated with insulinogenic index. These factors explained 34.6% of the variance of the insulinogenic index. In conclusion, kisspeptin concentrations are associated with insulin secretion independently of important determinants of glucose homeostasis such as gender, age, adiposity, 2-h post-load glucose, and insulin sensitivity.

Uric Acid Is Associated With Inflammatory Biomarkers and Induces Inflammation Via Activating the NF-κB Signaling Pathway in HepG2 Cells

Objective—

Serum uric acid (UA) has been associated with increased risk of cardiovascular and metabolic diseases. However, the causal mechanisms linking elevated UA levels to cardio-metabolic diseases are still unsettled. One potential explanation for how UA might contribute to cardio-metabolic disease might be its ability to induce systemic inflammation.

Approach and Results—

Herein, we report a positive relationship between serum UA and acute-phase reactants, such as high-sensitivity C-reactive protein, fibrinogen, ferritin, complement C3, and erythrocyte sedimentation rate, in a cohort of 2731 nondiabetic adults. The relationship remains significant after adjustment for several confounders, including age, sex, adiposity, anti-hypertensive treatments or diuretics use. To confirm the existence of a causal relationship, we examined the effect of UA on the expression of inflammatory biomarkers in human hepatoma HepG2 cells and characterized the signaling pathway by which UA acts. We show that UA stimulates the expression of C-reactive protein, fibrinogen, ferritin, and complement C3 in a dose-dependent fashion. The proinflammatory effects of UA were abrogated by benzbromarone, a specific inhibitor of UA transporters. Exposure of cells to UA resulted in activation of the IκB kinase/IκBα/NF-κB signaling pathway that was attenuated by benzbromarone. The effect of UA was completely blocked by the antioxidant N -acetylcysteine.

Conclusions—

These in vivo and in vitro data suggest that hyperuricemia might induce the expression of hepatic inflammatory molecules by activating the proinflammatory NF-κB signaling cascade. Because inflammation has an important pathogenetic role in metabolic and cardiovascular disease, our study may help understanding the mechanism by which hyperuricemia may contribute to organ damage.

Liraglutide prevents cognitive decline in a rat model of streptozotocin-induced diabetes independently from its peripheral metabolic effects

Diabetes has been identified as a risk factor for cognitive dysfunctions. Glucagone like peptide 1 (GLP-1) receptor agonists have neuroprotective effects in preclinical animal models. We evaluated the effects of GLP-1 receptor agonist, liraglutide (LIR), on cognitive decline associated with diabetes. Furthermore, we studied LIR effects against hippocampal neurodegeneration induced by streptozotocin (STZ), a well-validated animal model of diabetes and neurodegeneration associated with cognitive decline. Diabetes and/or cognitive decline were induced in Wistar rats by intraperitoneal or intracerebroventricular injection of STZ and then rats were treated with LIR (300μg/kg daily subcutaneously) for 6 weeks. Rats underwent behavioral tests: Morris water maze, passive avoidance, forced swimming (FST), open field, elevated plus maze, rotarod tests. Furthermore, LIR effects on hippocampal neurodegeneration and mTOR pathway (AKT, AMPK, ERK and p70S6K) were assessed. LIR improved learning and memory only in STZ-treated animals. Anxiolytic effects were observed in all LIR-treated groups but pro-depressant effects in CTRL rats were observed. At a cellular/molecular level, intracerebroventricular STZ induced hippocampal neurodegeneration accompanied by decreased phosphorylation of AMPK, AKT, ERK and p70S6K. LIR reduced hippocampal neuronal death and prevented the decreased phosphorylation of AKT and p70S6K; AMPK was hyper-phosphorylated in comparison to CTRL group, while LIR had no effects on ERK. LIR reduced animal endurance in the rotarod test and this effect might be also linked to a reduction in locomotor activity during only the last two minutes of the FST. LIR had protective effects on cognitive functions in addition to its effects on blood glucose levels. LIR effects in the brain also comprised anxiolytic and pro-depressant actions (although influenced by reduced endurance). Finally, LIR protected from diabetes-dependent hippocampal neurodegeneration likely through an effect on mTOR pathway.

Everolimus improves memory and learning while worsening depressive- and anxiety-like behavior in an animal model of depression

Everolimus (EVR) is an orally-administered rapamycin analog that selectively inhibits the mammalian target of rapamycin (mTOR) kinase (mainly mTORC1 and likely mTORC2) and the related signaling pathway. mTOR is a serine/threonine protein kinase regulating multiple important cellular functions; dysfunction of mTOR signaling has also been implicated in the pathophysiology of several neurological, neurodegenerative, developmental and cognitive disorders. EVR is widely used as an anti-neoplastic therapy and more recently in children with tuberous sclerosis complex (TSC). However, no clear correlation exists between EVR use and development of central side effects e.g. depression, anxiety or cognitive impairment. We studied the effects of a 3 weeks administration of EVR in mice chronically treated with betamethasone 21-phosphate disodium (BTM) as a model of depression and cognitive decline. EVR treatment had detrimental effects on depressive- and anxiety-like behavior while improving cognitive performance in both control (untreated) and BTM-treated mice. Such effects were accompanied by an increased hippocampal neurogenesis and synaptogenesis. Our results therefore might support the proposed pathological role of mTOR dysregulation in depressive disorders and confirm some previous data on the positive effects of mTOR inhibition in cognitive decline. We also show that EVR, possibly through mTOR inhibition, may be linked to the development of anxiety. The increased hippocampal neurogenesis by EVR might explain its ability to improve cognitive function or protect from cognitive decline. Our findings suggest some caution in the use of EVR, particularly in the developing brain; patients should be carefully monitored for their psychiatric/neurological profiles in any clinical situation where an mTOR inhibitor and in particular EVR is used e.g. cancer treatment, TSC or immunosuppression.

PHLPP phosphatases as a therapeutic target in insulin resistance-related diseases

INTRODUCTION

Pleckstrin homology domain leucine-rich repeat protein phosphatases (PHLPPs), originally identified as Akt kinase hydrophobic motif specific phosphatases, have subsequently been shown to regulate several molecules recurring within the insulin signaling pathway. This observation suggests that PHLPP phosphatases may have a clinically relevant role in the pathogenesis of insulin resistance-related diseases and may thus represent suitable targets for the treatment of these conditions.

AREAS COVERED

The literature pertaining to PHLPPs substrates is reviewed herein, along with information on the molecular players involved in regulating the activity and expression of PHLPP phosphatases. In the present review, knowledge of genetic variants in the genes that encode for PHLPP isozymes and the surrounding regulatory regions is also summarized. In addition, data from the studies addressing the role of PHLPPs in insulin resistance-related disorders and from those investigating the possibility to manipulate these phosphatases for therapeutic purposes are presented.

EXPERT OPINION

A number of issues should be resolved before PHLPPs are pursued as therapeutic targets including: the mechanisms regulating the specificity of PHLPP isozymes; the possibility of differentially regulating PHLPP family members and the possible impact of PHLPPs modulation on the risk of cancer.

Use of the Zung depression scale in patients with traumatic brain injury: 1 year post-injury

OBJECTIVE

The purpose of this study was to examine if the physical disabilities of patients with traumatic brain injury (TBI) would influence the assessment of depression when using the Zung depression scale.

METHOD

Patients with TBI (n=59) were assessed 1 year after injury for depression by both a psychiatrist and the use of the Zung depression scale.

RESULTS

By psychiatric evaluation, seven of 17 (41%) patients with severe TBI and one of 20 (5%) of the patients with moderate TBI were diagnosed with major depressive disorder. With the Zung depression scale, 10 of 17 (59%) patients with severe TBI met the cut-off (scored >55) for depression, whereas none of the patients with moderate (n=20) or mild (n=22) TBI did. The mean (SD) scores of the somatic scale were 2.91 (0.93), 2.49 (0.92) and 1.25 (0.43) for each group. The mean scores of the affective scale were 2.58 (0.90), 1.85 (0.79) and 1.24 (0.46). For patients with moderate (p<0.05) and severe (p<0.10) TBI, scores on the somatic items exceeded scores on their affective items. No difference in somatic and affective scale scores was noted for the patients with mild TBI.

CONCLUSION

The increased endorsement of somatic results may be the somatic difficulties associated with traumatic brain injury.

Human methadone self-administration: effects of diazepam pretreatment

The effect of diazepam on methadone self-administration was examined. Five methadone-maintained patients with a history of benzodiazepine abuse were recruited. Patients were stabilized on 80 mg of methadone per day. After stabilization patients participated in methadone self-administration sessions. During each session, 128 presses (fixed ratio 128) of 1 button delivered 10 ml of 0.054 mg/ml methadone solution. The same number of button presses on a 2nd button delivered 10 ml of vehicle. Forty-five min prior to the self-administration session, 0 (placebo), 5, 10, or 20 mg per 70 kg body weight diazepam was administered. Ratings of drug liking, goodness, strength, and high were collected 5, 30, 60, 90, and 150 min after the end of the self-administration session. Diazepam pretreatment significantly decreased the amount of methadone consumed. The 10- and 20-mg diazepam doses significantly increased reports of good, like, strong, and high.

Smoking cessation in women with cardiac risk: a comparative study of two theoretically based therapies

This gender-specific research study compares the relative effectiveness of two theory-based interventions targeting women who smoke. Women with coronary artery disease (CAD; n = 53) or CAD risk factors (n = 107) were randomly assigned to either coping-skills Relapse Prevention (RP) treatment or an educational/supportive treatment based on Health Belief Model (HBM) principles. RP was comparable, but not superior to HBM treatment, as indicated by the lack of differential smoking outcomes at 3 and 6 months. RP was more effective than HBM for women with low self-efficacy, as predicted. The presence of a smoking-related disease had a substantial effect on smoking status, in that the odds of being abstinent at 6 months were 2.2 times greater for non-diagnosed women when compared with CAD women. These findings indicate that more potent relapse prevention interventions are needed to increase cessation rates in women who smoke, especially those with established heart disease.

Context modulates effects of nicotine abstinence on human cooperative responding

The effects of ad libitum smoking, abstinence, and 0-, 2-, and 4-mg nicotine gum on human cooperative responding were examined. Participants were provided the opportunity to respond cooperatively or independently to episodes initiated by a computer-simulated other person. Participants could also initiate episodes that ostensibly provided the other person the opportunity to respond cooperatively or independently of the participant. Working cooperatively added points to both the participant's and other person's counters. Working independently added points only to the participant's counter. Results demonstrated that abstinence decreased cooperative responses during episodes initiated by the computer-stimulated other person. Relative to abstinence and placebo gum conditions, ad libitum smoking and administration of 2- and 4-mg nicotine gum increased these cooperative responses. No gender differences were observed. The number of cooperative episodes initiated by the participants was not affected significantly by the smoking or gum conditions. Nicotine increased reports of vigor and decreased abstinence-engendered reports of depression, anger, confusion, and tension. The difference in the effects of nicotine abstinence on the 2 classes of cooperative responding demonstrates that the social contingency mediates the behavioral effects of abstinence.

Matching under nonindependent variable-ratio schedules of drug reinforcement

Response-contingent deliveries of oral pentobarbital maintained responding of 3 rhesus monkeys during daily 3-hr sessions. Deliveries of pentobarbital were arranged under nonindependent concurrent variable-ratio variable-ratio schedules. Responses to either schedule counted toward completion of both variable-ratio schedule requirements. This schedule is similar in some respects to conventional concurrent variable-interval variable-interval schedules, in which passage of time counts toward completion of the interval value on both schedules. Restricted nonindependent concurrent variable-ratio variable-ratio schedules were also studied. On that schedule, when a drug delivery was assigned to one spout, it had to be collected before responses on the opposite spout again counted toward completion of the schedule requirements. Relative reinforcer magnitude was varied by changing the drug concentration on one schedule while keeping the drug concentration constant on the other variable-ratio schedule. Under both types of concurrent variable-ratio schedules, the relative rate of responding corresponded to the relative drug intake. Unlike earlier studies of concurrent variable-interval variable-interval intravenous cocaine reinforcement, preference was proportionate to concentration, and exclusive preferences did not develop. The relationship between relative rate of responding and relative drug intake was well described by the generalized matching law.

Effects of acute and chronic doses of naltrexone on ethanol self-administration in rhesus monkeys

The effects of acute and chronic administration of intramuscular naltrexone (0.1, 0.3, 1.0, and 3.0 mg/kg) on oral ethanol (8%) self-administration were examined. Naltrexone (1.0 mg/kg) effects on the self-administration of ethanol concentrations ranging from 0.5 to 8% (w/v) were also investigated. Rhesus monkeys with substantial histories of drug and ethanol drinking served as subjects. During daily 3-hr sessions, monkeys were presented with ethanol solutions, concurrently available with water, under fixed-ratio reinforcement schedules. Naltrexone decreased the consumption of ethanol (g/kg). Biphasic temporal effects were observed within sessions. Naltrexone dose-dependently decreased the number of ethanol deliveries by a maximum of 56% (n = 18; 3 monkeys x 6 sessions) during the first hour of the session. During the second and third hours, however, ethanol intake recovered such that maximum decreases over the 3-hr session were approximately 27% (n = 18), and the mean decrease was 16% (n = 18). Often marked tolerance was observed, such that the effects of acute naltrexone administration were greater than effects after chronic administration. The self-administration of low ethanol concentrations (< or =2% w/v) was increased in several monkeys, by up to 340%, after naltrexone pretreatment. In summary, the effects of naltrexone on ethanol self-administration, in drug- and alcohol-experienced rhesus monkeys, are not characterized by unitary decreases in measures of ethanol self-administration. Rather, differential naltrexone effects were a function of experimental parameters, including the dose and number of naltrexone injections, the ethanol concentration, and the time point of measurement.

Effects of nicotine on methadone self-administration in humans

The effects of nicotine abstinence, ad libitum smoking, and 0, 2, and 4 mg nicotine gum on methadone self-administration were investigated. Five methadone-maintained patients with a history of smoking (18-30 cigarettes/day) were recruited as subjects. Upon arrival expired carbon monoxide levels were measured to confirm self-reported abstinence of 10-12 h. At 30 min prior to the methadone self-administration session, two response options were concurrently available. When a 64-button press requirement (FR64) was completed, 10 ml of 0.054 mg/ml methadone solution, or vehicle, was delivered. Immediately following, and 30, 60, 90, and 120 min after the self-administration session, expired carbon monoxide levels and typical symptoms of nicotine withdrawal were assessed. Relative to abstinence, subjects consumed more methadone following the 4-mg nicotine gum and ad libitum smoking conditions. Ratings of cigarette craving were significantly less following ad libitum smoking or administration of 4-mg nicotine gum, than following abstinence. Implications for understanding opioid and nicotine interactions are discussed.

Human ethanol self-administration. I: The interaction between response requirement and ethanol dose

The effects of work requirement on human ethanol self-administration were systematically examined. Healthy volunteers with a history of moderate alcohol consumption (12 to 16 drinks per week) were recruited as subjects. Four subjects self-administered 4, 8 or 16% w/v ethanol solution contingent upon completion of a fixed-ratio (FR) response requirement. The ratio requirements were FR 32, FR 64 and FR 128 responses. Ethanol consumption at lower doses decreased with increases in FR. Ethanol consumption at the high dose was greatest across all ratio requirements and was unchanged by increases in the ratio requirement, indicating greater relative reinforcing effects of the high dose of ethanol. Ethanol consumption was sensitive to unit price with 53-82% of the variance explained by the unit price analysis.

Human methadone self-administration: effects of dose and ratio requirement

The effects of response requirement and small doses of methadone on human oral self-administration of methadone were examined. Three methadone maintenance patients stabilized at a dose of 80mg methadone per day were recruited as subjects. Completing a response requirement, fixed ratio (FR) of 32, 64 or 128 responses (FR32, FR64, FR128) on one button dispensed 10ml of drug solution. Completing the equivalent response requirement on a second concurrently available response button dispensed 10ml of vehicle. The opportunity to respond was unavailable until the drug or vehicle had been consumed. Each 10ml of drug solution contained methadone doses of 0.027, 0.054 or 0.108mg/ml. The frequency of deliveries was limited so that subjects could not ingest more than 54mg of methadone; the difference between the 80mg daily methadone dose and the methadone consumed in session was administered 30min post-session. At FR64 and FR128 the frequency of deliveries decreased, at the 0.054 and 0.027mg/ml doses, relative to the frequency of deliveries at FR32. The amount of methadone consumed increased with increases in methadone dose and decreased with increases in FR size. These results demonstrate the reinforcing effects of small unit doses of methadone. This procedure provides a sensitive baseline for examining effects of other pharmacological interventions on methadone ingestion in humans.

Behavioral treatment of cocaine-dependent pregnant women and TB-exposed patients

Health-compromised drug-dependent patients require specialized treatment that addresses both drug use and health risks. This preliminary study examines the efficacy of a contingency management procedure (shaping) on decreasing cocaine use and increasing compliance with the prescribed treatment regimens in two health-compromised cocaine-dependent populations: (i) tuberculin (TB) exposed patients (n = 5) and (ii) pregnant women (n = 7). A multiple-baseline across-subjects design was used. There were no contingencies on cocaine use during baseline. During the contingent phase, patients received a monetary reinforcer for (a) successive decreases in the quantity of cocaine and (b) cocaine-free samples. They received a weekly reinforcer if all samples per week met criteria for (a) or (b). During the contingent phase, there was a significant decrease in cocaine metabolite levels and an increase in cocaine-free samples in both populations, with a more robust effect in the TB-exposed group. There was an increase in compliance with prenatal visits among the pregnant women during the contingent phase. Implications for health care are discussed.

Effects of nicotine on cooperative responding among abstinent male smokers

The effects of nicotine on human cooperative responding in abstinent male smokers were examined. During episodes occurring at random times through a session, concurrently available cooperative and independent responses were maintained by points exchangeable for money. Cooperative responses simultaneously added points to counters marked "Your Earnings" and "Other's Earnings" only if the subject's and another person's responses ostensibly coincided. Independent responses added points only to the counter marked "Your Earnings". After the first daily session abstinent subjects smoked ad libitum, received either 0, 2 or 4mg nicotine gum or abstained from smoking. Increases from this first session in time allocated to the cooperative response option, proportion of cooperative responses and cooperative response rate were significantly greater following ad libitum smoking or acute administration of 4mg nicotine. No effects of nicotine abstinence were observed on independent response rate. These results suggest effects on sociability may maintain nicotine use and increase relapse risk in abstinent smokers.

Effects of ethanol on human free-operant cooperative responding

The effects of ethanol (0.5, 0.75 and 1.00 g/kg) on human cooperative behavior were examined. Ethanol or placebo was administered 30 min before the second of five trials. During the first of two alternating schedule components, button presses were maintained by a random interval (RI) 60-s schedule of point additions to a counter marked 'Your Earnings'. During the second, Choice, component a concurrent RI 60-s schedule maintained button presses on two manipulanda. Subjects randomly assigned to the social group were instructed that they were paired with another person and could earn points working with or independently of this person. Working together, the cooperative response, simultaneously produced points on counters marked 'Other's Earnings' and 'Your Earnings'. Working independently, the independent response produced points only on the counter marked 'Your Earnings'. The other person was fictitious. The instructions for the non-social group did not mention another subject and the counter marked 'Other's Earnings' was not visible but schedule contingencies were identical to those for the social instruction group. For the social instructions group, 1.00 g/kg ethanol increased the proportion of cooperative responses and time allocated the cooperative option. For the non-social instruction group, time allocated to the topographically identical but non-social equivalent of the cooperative response decreased at the same dose. No significant between-group effects were observed following acute administration of 0.50 and 0.75 g/kg ethanol. These results suggest that the instructions established a functionally distinct social, cooperative, response which was differentially affected by ethanol.

Acute and chronic alcohol tolerance in humans: effects of dose and consecutive days of exposure

Male social drinkers received doses of either 0.75 or 1.0 g/kg body weight of alcohol over 5 consecutive days. The beverage was divided into three equal drinks, and subjects performed an eye-hand coordination motor task after each drink. The breath alcohol concentration (BAC) was assessed at each performance measurement period. Performance was also assessed when the BAC level on the descending limb of the BAC curve was similar to each of the three BAC measurements on the ascending curve. Each group developed chronic tolerance (comparing the daily postalcohol performance with the daily prealcohol performance) by the 4th day of exposure. The development of a degree of acute tolerance (assessed by comparing the performance on the ascending and descending limbs of the BAC curve) was not observed consistently in the 1.0 g/kg dose group, but was seen in more than half of the subjects in the 0.75 g/kg dose group by the 4th and 5th day of exposure.

Compliance with tuberculosis treatment in methadone-maintained patients: behavioral interventions

Tuberculosis has increased dramatically in the United States. Noncompliance with treatment is high. The purpose of this investigation was to achieve compliance with prophylactic TB treatment and simultaneously decrease drug use in a high-risk group of intravenous drug users. Two studies were conducted. Study 1: Subjects were 9 chronic opiate users who tested positive for tuberculosis and were placed on isoniazid (INH) and methadone. Methadone was dispensed contingent upon INH ingestion throughout. A within-subject, A-B design with contingency management interventions on drug use was implemented.

RESULTS

Compliance with INH was 100% in 8 patients. Cocaine use remained high. Study 2: Two patients, meeting same criteria as Study 1, participated in a within-subject A-B multiple baseline design. Methadone was dispensed contingent upon INH ingestion throughout. Successive decreases in cocaine use were reinforced in the contingent phase.

RESULTS

Compliance with INH was high. During contingency, both patients had over 40% cocaine-free urine samples compared with 0% at baseline. This investigation serves as a model for achieving compliance with TB treatment in opiate users.

Triazolam and ethanol effects on human matching-to-sample performance vary as a function of pattern size and discriminability

The effects of placebo, triazolam (2.0, 4.0 and 8.0 micrograms/kg) and ethanol (0.25, 0.5, 1.0 g/kg) on perceptual-motor performance were examined using a visual pattern matching-to-sample procedure in which pattern size and comparison stimulus discriminability were systematically varied. Baseline response rates and accuracy increased as the discriminability of the comparison stimuli increased. At the highest dose, both drugs decreased response accuracy. This disruption of accuracy was attenuated by increasing the discriminability of non-matching stimuli. Triazolam produced dose-related decreases in response rate while ethanol produced only slight decreases at the highest baseline rates of responding. Thus, triazolam produced response rate slowing at relatively lower doses than ethanol.

Acute effects of marijuana smoking on aggressive, escape and point-maintained responding of male drug users

Aggressive, escape and point-maintained operant responding of male marijuana smokers were measured during six 25-min sessions conducted over an 8-h experimental day. Aggressive responding ostensibly subtracted points exchangeable for money from another subject. Escape responding protected the subject's counter from point subtractions initiated by the other subject for some period of time. Aggressive and escape responding were engendered by subtracting points from the subjects and maintained by initiation of intervals free of point subtractions. Point subtractions presented to the subjects were attributed to other persons. Subjects earned points exchangeable for money on a third response option. Subjects participated in one session prior to smoking and five sessions after smoking. Subjects smoked placebo or three different potencies of active marijuana cigarettes. Marijuana smoking effects on escape responding were not significant and depended upon the frequency of provocation. Point-maintained responding was decreased after marijuana smoking. Aggressive responding was increased for the first hour after smoking and returned to placebo levels later in the day. These effects of marijuana smoking on aggressive responding are discussed in terms of subject characteristics, particularly drug use history.

Effects of response requirement and alcohol on human aggressive responding

Nine men participated in two experiments to determine the effects of increased response requirement and alcohol administration on free-operant aggressive responding. Two response buttons (A and B) were available. Pressing Button A was maintained by a fixed-ratio 100 schedule of point presentation. Subjects were instructed that completion of each fixed-ratio 10 on Button B resulted in the subtraction of a point from a fictitious second subject. Button B presses were defined as aggressive because they ostensibly resulted in the presentation of an aversive stimulus to another person. Aggressive responses were engendered by a random-time schedule of point loss and were maintained by initiation of intervals free of point loss. Instructions attributed these point losses to Button B presses of the fictitious other subject. In Experiment 1, increasing the ratio requirement on Button B decreased the number of ratios completed in 4 of 5 subjects. In Experiment 2, the effects of placebo and three alcohol doses (0.125, 0.25, and 0.375 g/kg) were determined when Button B presses were maintained at ratio values of 20, 40 and 80. Three subjects who reduced aggressive responding with increasing fixed-ratio values reduced aggressive responding further at higher alcohol doses. One subject who did not reduce aggressive responding with increasing fixed-ratio values increased aggressive responding at the highest alcohol dose. The results of this study support suggestions that alcohol alters aggressive behavior by reducing the control of competing contingencies.

Effects of triazolam on human aggressive, escape and point-maintained responding

Placebo and triazolam (0.125, 0.25 and 0.5 mg/70 kg of body weight) were administered to male subjects under double-blind conditions prior to experimental sessions which provided three operant response options. These options were: 1) responding maintained by the presentation of points exchangeable for money, 2) responding which ostensibly resulted in the subtraction of points from a fictitious person was termed aggressive since this responding resulted in the delivery of an aversive stimulus to another person, and 3) responding which ostensibly protected the subject's point counter from subtractions initiated by the other person and was termed escape. Aggressive and escape responding were initiated by subtracting points from the subject. Point subtractions were attributed to the other person. Aggressive and escape responding were maintained by initiation of provocation-free intervals (PFI), during which no further point subtractions were presented. Triazolam produced dose-dependent decreases in point-maintained and escape responding. The effects of triazolam on aggressive responding varied across subjects.

Benzodiazepine-induced impairment of matching-to-sample performance in humans

The effects of benzodiazepines on a visual pattern matching-to-sample (MTS) task were examined in nine healthy male volunteers. The MTS task employed randomly generated checkerboard-like stimuli presented on a video display. The sample and two comparison stimuli were simultaneously presented. Nonmatching comparison stimuli were randomly generated to be 3.125, 6.25, 12.5, 25.0, 37.5, or 50.0 percent different from the sample. Subjects responded on left or right button manipulanda to identify the matching comparison stimulus. The nonmatching stimulus condition was maintained constant for a 60-sec component and the percentage difference of the nonmatching stimuli was systematically varied across multiple components. The effects of triazolam (2.25-9.0 micrograms/kg) and lorazepam (7.5-45 micrograms/kg) were examined in a within-subjects, double-blind, placebo-controlled study. Under placebo conditions, response rates and accuracy were a positive function of the nonmatching stimulus discriminability. Triazolam produced dose-related decreases in response rate at nonmatching stimulus conditions greater than or equal to 25%. Only the 9.0 micrograms/kg dose of triazolam decreased accuracy and this occurred across all nonmatching stimulus conditions. Lorazepam effects were qualitatively similar but less robust than those of triazolam.

The effects of codeine on human aggressive responding

Ten healthy male research subjects received placebo, 25, 50 and 75 mg/70 kg of codeine in a controlled laboratory setting. During each session subjects had two response options. The non-aggressive response option was maintained by points exchangeable for ten cents. The aggressive response option ostensibly subtracted a point from the subject's fictitious partner. Aggressive responding was engendered by point subtractions attributed to a fictitious partner. Codeine did not significantly alter the frequency of monetarily reinforced, nonaggressive, responding. Aggressive responding was significantly increased at the 50 mg/70 kg dose of codeine. The frequency of aggressive responses during the placebo sessions preceding administration of the first codeine dose were significantly and positively correlated with scores on the Buss-Durkee Hostility Scale. Aggressive responding increased for four of five subjects scoring below the median on the Buss-Durkee Hostility Scale at the 50 mg/70 kg dose; while administration of 50 mg/70 kg increased aggressive responding of one subject who scored above the median. Aggressive responding for both groups of subjects was unaffected by the 75 mg/70 kg dose.

Human aggressive responses maintained by avoidance or escape from point loss

During 50-min sessions, 6 male human subjects could press either Button A or Button B available as nonreversible options. Button A presses were nonaggressive responses and earned points according to a fixed-ratio 100 schedule. Prior to the experiment subjects were instructed that every 10 (fixed-ratio 10) Button B presses (aggressive responses) subtracted a point from a fictitious 2nd subject. A random-time schedule of point loss was used to engender aggressive responding. The instructions attributed these point losses to the Button B presses of the subject's fictitious partner. Aggressive responding either escaped or avoided point loss by initiating an interval free of point loss. The duration of the interval was varied systematically across sessions. Avoidance contingencies maintained a high rate of aggressive responding over 30 sessions in the absence of point loss. Escape contingencies also maintained aggressive responding across sessions, with rates of aggressive responding corresponding to rates of point loss.

Effects of acute administration of diazepam and d-amphetamine on aggressive and escape responding of normal male subjects

Normal males participated in sessions providing two operant response options and were administered either diazepam (study I and II) or d-amphetamine (study II). The acute effects of diazepam on human aggressive responding, which ostensibly subtracted points from another person, were determined in study I. Study II was conducted to determine the extent to which social context and response consequence influenced diazepam (study I) and d-amphetamine (previous research) effects on aggressive responding. In study II, the other response option was escape responding which protected the subject's counter from point losses. Aggressive and escape responding were engendered by subtracting points from the subject's counter, and maintained by initiation of intervals free of point loss. Point subtractions were attributed to the other person (study I) or to a machine (study II). Responding to accumulate points exchangeable for money was available in both studies. Acute diazepam administration decreased aggressive responding in most subjects (study I), slightly increased escape responding (study II), and decreased responding to accumulate points. In study II, d-amphetamine increased both escape responding and responding to accumulate points. The effects of d-amphetamine and diazepam were altered by the instructed source of point loss.

Predictability of repeated challenge: effects on cardiovascular activity in the type A (coronary prone) behavior pattern

Fifty-two healthy young adults classified either as Type A (coronary prone) or Type B were randomly assigned to a vigilance task during which observing responses produced targets according to either a predictable (i.e., fixed-interval 90-sec) or a nonpredictable (i.e., random-interval 90-sec) reinforcement schedule. During the task, blood volume pulse, interbeat interval, masseter (EMG) activity, and blood pressure were monitored. Transient peripheral vasomotor constriction and heart rate increases were initiated within an 8- to 12-sec period following target detection with the predictable schedule, with subjects evincing greater responsivity than their nonpredictable schedule counterparts. Type A subjects assigned to the random-schedule evinced significantly shorter heart rate and blood volume pulse response durations than did Type B subjects. Longer postevent EMG elevations were evidenced by subjects assigned to the predictable schedule. No significant blood pressure differences were found among the groups. The impact of challenge-contingent behavior on cardiovascular responsivity and the relevance of attentional processes to this relationship and to cardiovascular risk are discussed.

Effects of secobarbital on human aggressive and non-aggressive responding

This study examined the effects of secobarbital on human aggressive responding in a controlled laboratory setting. Sixty minutes prior to experimental sessions, male subjects were administered either placebo or 50, 100 or 200 mg per 70 kg of body weight doses of secobarbital double-blind. During these sessions, subjects could press a button to accumulate points exchangeable for money (non-aggressive response) or press another button ostensibly to subtract points from a fictitious person (aggressive response). Aggressive responding was occasioned by subtracting points from the subject. Subjects were instructed that points were subtracted by another person. Aggressive responding was maintained by contingent presentation of periods free of point subtractions, i.e., provocations. Acute secobarbital administration produced dose-dependent decreases in non-aggressive responding, and increases in aggressive responding.

Human schedule-induced cardiovascular response

Sixty-six students were randomly assigned to a vigilance task during which observing responses produced targets according to either a fixed-interval or random-interval 90-sec schedule. During the task, interbeat interval, masseter (EMG) activity, blood pressure and digital blood volume pulse were monitored. Vasoconstriction was initiated within a 4 to 6-sec period following target detection for the majority of subjects assigned to each schedule. Vasomotor tone returned to prechange levels approximately 16 sec after target detection. Transient heart rate increases also occurred during the post-event period, but were more prevalent with subjects in the fixed than in the random-interval group. Post-event masseter activity was exhibited infrequently and only by subjects assigned to the fixed-interval group. The involvement of cardiovascular responsiveness with human schedule-induced behavior and the implications of this involvement for arousal theories of schedule-induced behavior are discussed.

Insight and adherence to medication in chronic schizophrenics

Chronic schizophrenics are well-known for the tendency to not take medication. Clinical observation and studies indicate that insight plays a significant role in medication adherence. This study investigated the roles of insight and perceived benefits from medication by patients. Those patients who had insight, perceived benefits from medication and also perceived a relation between the 2 were more likely to take medication than those who did not have insight nor perceive benefits. A speculative model and possible methods of increasing medication adherence are suggested.