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Rumbus Z, Fekete K, Kelava L, Gardos B, Klonfar K, Keringer P, Pinter E, Pakai E, Garami A. Ammonium chloride-induced hypothermia is attenuated by transient receptor potential channel vanilloid-1, but augmented by ankyrin-1 in rodents. Life Sci 2024; 346:122633. [PMID: 38615746 DOI: 10.1016/j.lfs.2024.122633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/29/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
AIMS Systemic administration of ammonium chloride (NH4Cl), an acidifying agent used in human patients and experimental conditions, causes hypothermia in mice, however, the mechanisms of the thermoregulatory response to NH4Cl and whether it develops in other species remained unknown. MAIN METHODS We studied body temperature (Tb) changes in rats and mice induced by intraperitoneal administration of NH4Cl after blockade of transient receptor potential vanilloid-1 (TRPV1) or ankyrin-1 (TRPA1) channels. KEY FINDINGS In rats, NH4Cl decreased Tb by 0.4-0.8°C (p < 0.05). The NH4Cl-induced hypothermia also developed in Trpv1 knockout (Trpv1-/-) and wild-type (Trpv1+/+) mice, however, the Tb drop was exaggerated in Trpv1-/- mice compared to Trpv1+/+ controls with maximal decreases of 4.0 vs. 2.1°C, respectively (p < 0.05). Pharmacological blockade of TRPV1 channels with AMG 517 augmented the hypothermic response to NH4Cl in genetically unmodified mice and rats (p < 0.05 for both). In contrast, when NH4Cl was infused to mice genetically lacking the TRPA1 channel, the hypothermic response was significantly attenuated compared to wild-type controls with maximal mean Tb difference of 1.0°C between the genotypes (p = 0.008). Pretreatment of rats with a TRPA1 antagonist (A967079) also attenuated the NH4Cl-induced Tb drop with a maximal difference of 0.7°C between the pretreatment groups (p = 0.003). SIGNIFICANCE TRPV1 channels limit, whereas TRPA1 channels exaggerate the development of NH4Cl-induced hypothermia in rats and mice, but other mechanisms are also involved. Our results warrant for regular Tb control and careful consideration of NH4Cl treatment in patients with TRPA1 and TRPV1 channel dysfunctions.
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Affiliation(s)
- Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Kata Fekete
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Leonardo Kelava
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Bibor Gardos
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Krisztian Klonfar
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Patrik Keringer
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Erika Pinter
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Eszter Pakai
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs H-7624, Hungary.
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Ruzsics I, Matrai P, Hegyi P, Nemeth D, Tenk J, Csenkey A, Eross B, Varga G, Balasko M, Petervari E, Veres G, Sepp R, Rakonczay Z, Vincze A, Garami A, Rumbus Z. Noninvasive ventilation improves the outcome in patients with pneumonia-associated respiratory failure: systematic review and meta-analysis. J Infect Public Health 2022; 15:349-359. [DOI: 10.1016/j.jiph.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/29/2021] [Accepted: 02/09/2022] [Indexed: 11/29/2022] Open
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Keringer P, Furedi N, Gaszner B, Miko A, Pakai E, Fekete K, Olah E, Kelava L, Romanovsky AA, Rumbus Z, Garami A. The hyperthermic effect of central cholecystokinin is mediated by the cyclooxygenase-2 pathway. Am J Physiol Endocrinol Metab 2022; 322:E10-E23. [PMID: 34779255 DOI: 10.1152/ajpendo.00223.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cholecystokinin (CCK) increases core body temperature via CCK2 receptors when administered intracerebroventricularly (icv). The mechanisms of CCK-induced hyperthermia are unknown, and it is also unknown whether CCK contributes to the fever response to systemic inflammation. We studied the interaction between central CCK signaling and the cyclooxygenase (COX) pathway. Body temperature was measured in adult male Wistar rats pretreated with intraperitoneal infusion of the nonselective COX enzyme inhibitor metamizol (120 mg/kg) or a selective COX-2 inhibitor, meloxicam, or etoricoxib (10 mg/kg for both) and, 30 min later, treated with intracerebroventricular CCK (1.7 µg/kg). In separate experiments, CCK-induced neuronal activation (with and without COX inhibition) was studied in thermoregulation- and feeding-related nuclei with c-Fos immunohistochemistry. CCK increased body temperature by ∼0.4°C from 10 min postinfusion, which was attenuated by metamizol. CCK reduced the number of c-Fos-positive cells in the median preoptic area (by ∼70%) but increased it in the dorsal hypothalamic area and in the rostral raphe pallidus (by ∼50% in both); all these changes were completely blocked with metamizol. In contrast, CCK-induced satiety and neuronal activation in the ventromedial hypothalamus were not influenced by metamizol. CCK-induced hyperthermia was also completely blocked with both selective COX-2 inhibitors studied. Finally, the CCK2 receptor antagonist YM022 (10 µg/kg icv) attenuated the late phases of fever induced by bacterial lipopolysaccharide (10 µg/kg; intravenously). We conclude that centrally administered CCK causes hyperthermia through changes in the activity of "classical" thermoeffector pathways and that the activation of COX-2 is required for the development of this response.NEW & NOTEWORTHY An association between central cholecystokinin signaling and the cyclooxygenase-prostaglandin E pathway has been proposed but remained poorly understood. We show that the hyperthermic response to the central administration of cholecystokinin alters the neuronal activity within efferent thermoeffector pathways and that these effects are fully blocked by the inhibition of cyclooxygenase. We also show that the activation of cyclooxygenase-2 is required for the hyperthermic effect of cholecystokinin and that cholecystokinin is a modulator of endotoxin-induced fever.
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Affiliation(s)
- Patrik Keringer
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nora Furedi
- Department of Anatomy, Research Group for Mood Disorders, Centre for Neuroscience, Medical School and Szentagothai Research Centre, University of Pécs, Pécs, Hungary
| | - Balazs Gaszner
- Department of Anatomy, Research Group for Mood Disorders, Centre for Neuroscience, Medical School and Szentagothai Research Centre, University of Pécs, Pécs, Hungary
| | - Alexandra Miko
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pécs, Pécs, Hungary
| | - Eszter Pakai
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Kata Fekete
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Emoke Olah
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Leonardo Kelava
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | | | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
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Olah E, Poto L, Rumbus Z, Pakai E, Romanovsky AA, Hegyi P, Garami A. POLAR Study Revisited: Therapeutic Hypothermia in Severe Brain Trauma Should Not Be Abandoned. J Neurotrauma 2021; 38:2772-2776. [PMID: 34002636 DOI: 10.1089/neu.2020.7509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The benefits of therapeutic hypothermia (TH) in severe traumatic brain injury (sTBI) have been long debated. In 2018, the POLAR study, a high-quality international trial, appeared to end the debate by showing that TH did not improve mortality in sTBI. However, the POLAR-based recommendation to abandon TH was challenged by different investigators. In our recent meta-analysis, we introduced the cooling index (COIN) to assess the extent of cooling and showed that TH is beneficial in sTBI, but only when the COIN is sufficiently high. In the present study, we calculated the COIN for the POLAR study and ran a new meta-analysis, which included the POLAR data and accounted for the cooling extent. The POLAR study targeted a high cooling extent (COIN of 276°C × h; calculated for 72 h), but the achieved cooling was much lower (COIN of 193°C × h)-because of deviations from the protocol. When the POLAR data were included in the COIN-based meta-analysis, TH had an overall effect of reducing death (odds rate of 0.686; p = 0.007). Among the subgroups with different COIN levels, the only significantly decreased odds rate (i.e., beneficial effect of TH) was observed in the subgroup with high COIN (0.470; p = 0.013). We conclude that, because of deviations from the targeted cooling protocol, the overall cooling extent was not sufficiently high in the POLAR study, thus masking the beneficial effects of TH. The current analysis shows that TH is beneficial in sTBI, but only when the COIN is high. Abandoning the use of TH in sTBI may be premature.
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Affiliation(s)
- Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Laszlo Poto
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Eszter Pakai
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | | | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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Toldi J, Nemeth D, Hegyi P, Molnar Z, Solymar M, Farkas N, Alizadeh H, Rumbus Z, Pakai E, Garami A. Macrophage migration inhibitory factor as a diagnostic and predictive biomarker in sepsis: meta-analysis of clinical trials. Sci Rep 2021; 11:8051. [PMID: 33850259 PMCID: PMC8044150 DOI: 10.1038/s41598-021-87613-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/31/2021] [Indexed: 12/29/2022] Open
Abstract
The hunt for useful sepsis biomarkers is ongoing. Macrophage migration inhibitory factor (MIF) was implicated as a biomarker in sepsis, but its diagnostic and prognostic value has remained unclear in human studies. Here, we aimed at clarifying the value of MIF as a sepsis biomarker with the meta-analysis of clinical trials. PubMed, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched until December 2019. From the included studies, blood MIF levels and indicators of disease severity were extracted in septic and control patient groups. Twenty-one eligible studies were identified, including data from 1876 subjects (of which 1206 had sepsis). In the septic patients, blood MIF levels were significantly higher than in healthy controls with a standardized mean difference (SMD) of 1.47 (95% confidence interval, CI: 0.96-1.97; p < 0.001) and also higher than in patient groups with nonseptic systemic inflammation (SMD = 0.94; CI: 0.51-1.38; p < 0.001). Markedly greater elevation in blood MIF level was found in the more severe forms of sepsis and in nonsurvivors than in less severe forms and in survivors with SMDs of 0.84 (CI: 0.45-1.24) and 0.75 (CI: 0.40-1.11), respectively (p < 0.001 for both). In conclusion, blood MIF level is more elevated in systemic inflammation caused by infection (i.e., sepsis) compared to noninfectious causes. In more severe forms of sepsis, including fatal outcome, MIF levels are higher than in less severe forms. These results suggest that MIF can be a valuable diagnostic and prognostic biomarker in sepsis given that well-designed clinical trials validate our findings.
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Affiliation(s)
- Janos Toldi
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Anesthesiology and Intensive Care, Medical School, University of Pecs, Pecs, Hungary
| | - David Nemeth
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Zsolt Molnar
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary.,Department of Anesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznan, Poland
| | - Margit Solymar
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Nelli Farkas
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Hussain Alizadeh
- Division of Hematology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Eszter Pakai
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
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Kelava L, Nemeth D, Hegyi P, Keringer P, Kovacs DK, Balasko M, Solymar M, Pakai E, Rumbus Z, Garami A. Dietary supplementation of transient receptor potential vanilloid-1 channel agonists reduces serum total cholesterol level: a meta-analysis of controlled human trials. Crit Rev Food Sci Nutr 2021; 62:7025-7035. [PMID: 33840333 DOI: 10.1080/10408398.2021.1910138] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 10/21/2022]
Abstract
Abnormal cholesterol level is a major risk factor in the development of atherosclerosis, which is a fundamental derangement in cardiovascular diseases. Any efforts should be undertaken to lower blood cholesterol levels. Among dietary interventions, capsaicinoid supplementation is also considered as a novel cholesterol-lowering approach, but human studies concluded contradictory results about its effectiveness. The present meta-analysis aimed at determining the effects of capsaicinoids on serum lipid profile in humans. We searched the PubMed, EMBASE, and CENTRAL databases from inception to February 2021. We included 10 controlled studies, which involved 398 participants. We found that dietary capsaicinoid supplementation alone or in combination with other substances significantly (p = 0.004 and 0.001, respectively) reduced serum total cholesterol level compared to controls with an overall standardized mean difference of -0.52 (95% confidence interval: -0.83, -0.21). Capsaicinoids also decreased low-density lipoprotein level significantly (p = 0.035), whereas no effect was observed on serum levels of high-density lipoprotein and triglycerides. Our findings provide novel quantitative evidence for the efficacy of dietary capsaicin supplementation in lowering serum total cholesterol and low-density lipoprotein levels in humans. To validate our conclusion, further randomized controlled trials in a diverse population of adult humans receiving dietary capsaicinoid supplementation are warranted.
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Affiliation(s)
- Leonardo Kelava
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - David Nemeth
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Szentagothai Research Centre, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Patrik Keringer
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Dora K Kovacs
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Margit Solymar
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Eszter Pakai
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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Keringer P, Farkas N, Gede N, Hegyi P, Rumbus Z, Lohinai Z, Solymar M, Ruksakiet K, Varga G, Garami A. Menthol can be safely applied to improve thermal perception during physical exercise: a meta-analysis of randomized controlled trials. Sci Rep 2020; 10:13636. [PMID: 32788718 PMCID: PMC7423903 DOI: 10.1038/s41598-020-70499-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/27/2020] [Indexed: 02/03/2023] Open
Abstract
Menthol is often used as a cold-mimicking substance to allegedly enhance performance during physical activity, however menthol-induced activation of cold-defence responses during exercise can intensify heat accumulation in the body. This meta-analysis aimed at studying the effects of menthol on thermal perception and thermophysiological homeostasis during exercise. PubMed, EMBASE, Cochrane Library, and Google Scholar databases were searched until May 2020. Menthol caused cooler thermal sensation by weighted mean difference (WMD) of - 1.65 (95% CI, - 2.96 to - 0.33) and tended to improve thermal comfort (WMD = 1.42; 95% CI, - 0.13 to 2.96) during physical exercise. However, there was no meaningful difference in sweat production (WMD = - 24.10 ml; 95% CI, - 139.59 to 91.39 ml), deep body temperature (WMD = 0.02 °C; 95% CI, - 0.11 to 0.15 °C), and heart rate (WMD = 2.67 bpm; 95% CI - 0.74 to 6.09 bpm) between the treatment groups. Menthol improved the performance time in certain subgroups, which are discussed. Our findings suggest that different factors, viz., external application, warmer environment, and higher body mass index can improve menthol's effects on endurance performance, however menthol does not compromise warmth-defence responses during exercise, thus it can be safely applied by athletes from the thermoregulation point of view.
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Affiliation(s)
- Patrik Keringer
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Szentagothai Research Centre, Medical School, University of Pecs, 7624, Pecs, Hungary
- Institute of Bioanalysis, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Noemi Gede
- Institute for Translational Medicine, Szentagothai Research Centre, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Szentagothai Research Centre, Medical School, University of Pecs, 7624, Pecs, Hungary
- Department of Translational Medicine, First Department of Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Zsolt Lohinai
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, 1088, Budapest, Hungary
| | - Margit Solymar
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary
| | - Kasidid Ruksakiet
- Department of Conservative Dentistry, Faculty of Dentistry, Semmelweis University, 1088, Budapest, Hungary
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, 1089, Budapest, Hungary
| | - Gabor Varga
- Department of Oral Biology, Faculty of Dentistry, Semmelweis University, 1089, Budapest, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, 7624, Pecs, Hungary.
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Garami A, Shimansky YP, Rumbus Z, Vizin RCL, Farkas N, Hegyi J, Szakacs Z, Solymar M, Csenkey A, Chiche DA, Kapil R, Kyle DJ, Van Horn WD, Hegyi P, Romanovsky AA. Hyperthermia induced by transient receptor potential vanilloid-1 (TRPV1) antagonists in human clinical trials: Insights from mathematical modeling and meta-analysis. Pharmacol Ther 2020; 208:107474. [PMID: 31926897 DOI: 10.1016/j.pharmthera.2020.107474] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [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: 11/05/2019] [Accepted: 12/23/2019] [Indexed: 02/06/2023]
Abstract
Antagonists of the transient receptor potential vanilloid-1 (TRPV1) channel alter body temperature (Tb) in laboratory animals and humans: most cause hyperthermia; some produce hypothermia; and yet others have no effect. TRPV1 can be activated by capsaicin (CAP), protons (low pH), and heat. First-generation (polymodal) TRPV1 antagonists potently block all three TRPV1 activation modes. Second-generation (mode-selective) TRPV1 antagonists potently block channel activation by CAP, but exert different effects (e.g., potentiation, no effect, or low-potency inhibition) in the proton mode, heat mode, or both. Based on our earlier studies in rats, only one mode of TRPV1 activation - by protons - is involved in thermoregulatory responses to TRPV1 antagonists. In rats, compounds that potently block, potentiate, or have no effect on proton activation cause hyperthermia, hypothermia, or no effect on Tb, respectively. A Tb response occurs when a TRPV1 antagonist blocks (in case of hyperthermia) or potentiates (hypothermia) the tonic TRPV1 activation by protons somewhere in the trunk, perhaps in muscles, and - via the acido-antithermogenic and acido-antivasoconstrictor reflexes - modulates thermogenesis and skin vasoconstriction. In this work, we used a mathematical model to analyze Tb data from human clinical trials of TRPV1 antagonists. The analysis suggests that, in humans, the hyperthermic effect depends on the antagonist's potency to block TRPV1 activation not only by protons, but also by heat, while the CAP activation mode is uninvolved. Whereas in rats TRPV1 drives thermoeffectors by mediating pH signals from the trunk, but not Tb signals, our analysis suggests that TRPV1 mediates both pH and thermal signals driving thermoregulation in humans. Hence, in humans (but not in rats), TRPV1 is likely to serve as a thermosensor of the thermoregulation system. We also conducted a meta-analysis of Tb data from human trials and found that polymodal TRPV1 antagonists (ABT-102, AZD1386, and V116517) increase Tb, whereas the mode-selective blocker NEO6860 does not. Several strategies of harnessing the thermoregulatory effects of TRPV1 antagonists in humans are discussed.
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Affiliation(s)
- Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.
| | - Yury P Shimansky
- Department of Neurobiology, Barrow Neurological Institute, Dignity Health, Phoenix, AZ, USA
| | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Robson C L Vizin
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), Trauma Research, St. Joseph's Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA
| | - Nelli Farkas
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Judit Hegyi
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Zsolt Szakacs
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Margit Solymar
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Alexandra Csenkey
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | | | | | | | - Wade D Van Horn
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School and Szentagothai Research Centre, University of Pecs, Pecs, Hungary; Department of Translational Medicine, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andrej A Romanovsky
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), Trauma Research, St. Joseph's Hospital and Medical Center, Dignity Health, Phoenix, AZ, USA; School of Molecular Sciences, Arizona State University, Tempe, AZ, USA; Zharko Pharma Inc., Olympia, WA, USA.
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Csenkey A, Jozsa G, Gede N, Pakai E, Tinusz B, Rumbus Z, Lukacs A, Gyongyi Z, Hamar P, Sepp R, Romanovsky AA, Hegyi P, Vajda P, Garami A. Systemic antibiotic prophylaxis does not affect infectious complications in pediatric burn injury: A meta-analysis. PLoS One 2019; 14:e0223063. [PMID: 31553768 PMCID: PMC6760783 DOI: 10.1371/journal.pone.0223063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 09/12/2019] [Indexed: 12/30/2022] Open
Abstract
In pediatric burns the use of systemic antibiotic prophylaxis is a standard procedure in some burn centers, though its beneficial effect on the infectious complications is debated. The present meta-analysis aimed at determining whether systemic antibiotic prophylaxis prevents infectious complications in pediatric patients with burn injuries. We searched the PubMed, EMBASE, and Cochrane Library databases from inception to August 2019. We included 6 studies, in which event rates of infectious complications were reported in children with burn injuries receiving or not receiving systemic antibiotic prophylaxis. We found that the overall odds ratio (OR) of developing an infection (including local and systemic) was not different between the groups (OR = 1.35; 95% CI, 0.44, 4.18). The chances for systemic infectious complications alone were also not different between antibiotic-treated and non-treated patients (OR = 0.74; 95% CI, 0.38, 1.45). Based on the age, affected total body surface area, and country income level, we did not find any subgroup that benefited from the prophylaxis. Our findings provide quantitative evidence for the inefficacy of systemic antibiotic prophylaxis in preventing infections in pediatric burns. To validate our conclusion, multinational, randomized trials in a diverse population of children with burn injuries are warranted.
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Affiliation(s)
- Alexandra Csenkey
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Department of Paediatrics, Surgical Division, University of Pecs, Pecs, Hungary
| | - Gergo Jozsa
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Department of Paediatrics, Surgical Division, University of Pecs, Pecs, Hungary
| | - Noemi Gede
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Eszter Pakai
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Benedek Tinusz
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Anita Lukacs
- Department of Public Health, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Zoltan Gyongyi
- Department of Public Health Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Hamar
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Robert Sepp
- Second Department of Internal Medicine and Cardiology Centre, University Szeged, Szeged, Hungary
| | - Andrej A. Romanovsky
- Thermoregulation and Systemic Inflammation Laboratory (FeverLab), Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, United States of America
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Vajda
- Department of Paediatrics, Surgical Division, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Department of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- * E-mail:
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10
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Keringer P, Rumbus Z. The interaction between neurokinin-1 receptors and cyclooxygenase-2 in fever genesis. Temperature (Austin) 2019; 6:4-6. [PMID: 30906808 PMCID: PMC6422470 DOI: 10.1080/23328940.2019.1567247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Patrik Keringer
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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11
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Olah E, Poto L, Hegyi P, Szabo I, Hartmann P, Solymar M, Petervari E, Balasko M, Habon T, Rumbus Z, Tenk J, Rostas I, Weinberg J, Romanovsky AA, Garami A. Therapeutic Whole-Body Hypothermia Reduces Death in Severe Traumatic Brain Injury if the Cooling Index Is Sufficiently High: Meta-Analyses of the Effect of Single Cooling Parameters and Their Integrated Measure. J Neurotrauma 2018; 35:2407-2417. [PMID: 29681213 DOI: 10.1089/neu.2018.5649] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Laszlo Poto
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
- Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences - University of Szeged, Szeged, Hungary
| | - Imre Szabo
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Petra Hartmann
- Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Margit Solymar
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Erika Petervari
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Tamas Habon
- Department of Cardiology and Angiology, First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Judit Tenk
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Ildiko Rostas
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Jordan Weinberg
- Trauma Research, St. Joseph's Hospital and Medical Center, Phoenix, Arizona
| | | | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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12
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Rumbus Z, Garami A. Fever, hypothermia, and mortality in sepsis: Comment on: Rumbus Z, Matics R, Hegyi P, Zsiboras C, Szabo I, Illes A, Petervari E, Balasko M, Marta K, Miko A, Parniczky A, Tenk J, Rostas I, Solymar M, Garami A. Fever is associated with reduced, hypothermia with increased mortality in septic patients: a meta-analysis of clinical trials. PLoS One. 2017;12(1):e0170152. DOI: 10.1371/journal.pone.0170152. Temperature (Austin) 2018; 6:101-103. [PMID: 31286020 PMCID: PMC6601416 DOI: 10.1080/23328940.2018.1516100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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13
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Rumbus Z, Toth E, Poto L, Vincze A, Veres G, Czako L, Olah E, Marta K, Miko A, Rakonczay Z, Balla Z, Kaszaki J, Foldesi I, Maleth J, Hegyi P, Garami A. Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis: A Translational Study of Their Noxious Combination. Front Physiol 2018; 9:1360. [PMID: 30327613 PMCID: PMC6174522 DOI: 10.3389/fphys.2018.01360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relationship between blood pH and AP in animal models. PubMed, EMBASE, and Cochrane Controlled Trials Registry databases were searched from inception to January 2017. Human studies reporting systemic pH status and outcomes (mortality rate, severity scores, and length of hospital stay) of patient groups with AP were included in the analyses. We developed a new mouse model of chronic metabolic acidosis (MA) and induced mild or severe AP in the mice. Besides laboratory blood testing, the extent of pancreatic edema, necrosis, and leukocyte infiltration were assessed in tissue sections of the mice. Thirteen studies reported sufficient data in patient groups with AP (n = 2,311). Meta-analysis revealed markedly higher mortality, elevated severity scores, and longer hospital stay in AP patients with lower blood pH or base excess (P < 0.001 for all studied outcomes). Meta-regression analysis showed significant negative correlation between blood pH and mortality in severe AP. In our mouse model, pre-existing MA deteriorated the pancreatic damage in mild and severe AP and, vice versa, severe AP further decreased the blood pH of mice with MA. In conclusion, MA worsens the outcome of AP, while severe AP augments the decrease of blood pH. The discovery of this vicious metabolic cycle opens up new therapeutic possibilities in AP.
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Affiliation(s)
- Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Emese Toth
- Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Laszlo Poto
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Aron Vincze
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Gabor Veres
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Laszlo Czako
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Katalin Marta
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Alexandra Miko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Zoltan Rakonczay
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Zsolt Balla
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Jozsef Kaszaki
- Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Imre Foldesi
- Department of Laboratory Medicine, University of Szeged, Szeged, Hungary
| | - Jozsef Maleth
- First Department of Medicine, University of Szeged, Szeged, Hungary.,Momentum Epithel Cell Signaling and Secretion Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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14
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Szabó IL, Mátics R, Hegyi P, Garami A, Illés A, Sarlós P, Bajor J, Szűcs A, Mosztbacher D, Márta K, Szemes K, Csekő K, Kővári B, Rumbus Z, Vincze Á. PPIs Prevent Aspirin-Induced Gastrointestinal Bleeding Better than H2RAs. A Systematic Review and Meta-analysis. J Gastrointestin Liver Dis 2018; 26:395-402. [PMID: 29253055 DOI: 10.15403/jgld.2014.1121.264.hra] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Aspirin is one of the most widely used medication for its analgesic and anti-platelet properties and thus a major cause for gastrointestinal (GI) bleeding. This study compared the preventive effect of histamine-2 receptor antagonists (H2RAs) and proton-pump inhibitors (PPIs) against chronic low-dose aspirin (LDA)-related GI bleeding and ulcer formation. METHODS Electronic databases of Pubmed, Embase and Cochrane Central Register of Controlled Trials were searched for human observations (randomised controlled trials and observational studies) comparing the long term effects of PPIs and H2RAs treatment in the prevention of GI bleeding or ulcer formation in patients on chronic LDA treatment listed up till September 30, 2016. Two independent authors searched databases using PICO questions (aspirin, H2RA, PPI, GI bleeding or ulcer), and reviewed abstracts and articles for comprehensive studies keeping adequate study quality. Data of weighted odds ratios were statistically evaluated using Comprehensive Metaanalysis (Biostat, Inc., Engelwood, MJ, USA), potential bias was checked. RESULTS Nine studies for GI bleeding and eight studies for ulcer formation were found meeting inclusion criteria, altogether 1,879 patients were included into review. The H2RAs prevented less effectively LDA-related GI bleeding (OR= 2.102, 95% CI: 1.008-4.385, p<0.048) and ulcer formation (OR= 2.257, 95% CI: 1.277-3.989, p<0.005) than PPIs. CONCLUSION The meta-analysis showed that H2RAs were less effective in the prevention of LDA-related GI bleeding and ulcer formation suggesting the preferable usage of PPIs in case of tolerance.
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Affiliation(s)
- Imre L Szabó
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary.
| | - Robert Mátics
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Peter Hegyi
- First Department of Medicine, Division of Gastroenterology; Institute for Translational Medicine, University of Pécs, Pécs; Hungarian Academy of Sciences - University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary
| | - Andras Garami
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Anita Illés
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Patricia Sarlós
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Judit Bajor
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Akos Szűcs
- First Department of Surgery, Semmelweis University, Budapest, Hungary
| | | | - Katalin Márta
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Kata Szemes
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Kata Csekő
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Balint Kővári
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
| | - Zoltan Rumbus
- Institute for Translational Medicine, University of Pécs, Pécs, Hungary
| | - Áron Vincze
- First Department of Medicine, Division of Gastroenterology, Szekszárd, Hungary
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15
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Pakai E, Tekus V, Zsiboras C, Rumbus Z, Olah E, Keringer P, Khidhir N, Matics R, Deres L, Ordog K, Szentes N, Pohoczky K, Kemeny A, Hegyi P, Pinter E, Garami A. The Neurokinin-1 Receptor Contributes to the Early Phase of Lipopolysaccharide-Induced Fever via Stimulation of Peripheral Cyclooxygenase-2 Protein Expression in Mice. Front Immunol 2018; 9:166. [PMID: 29459872 PMCID: PMC5807668 DOI: 10.3389/fimmu.2018.00166] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 11/17/2017] [Accepted: 01/18/2018] [Indexed: 12/20/2022] Open
Abstract
Neurokinin (NK) signaling is involved in various inflammatory processes. A common manifestation of systemic inflammation is fever, which is usually induced in animal models with the administration of bacterial lipopolysaccharide (LPS). A role for the NK1 receptor was shown in LPS-induced fever, but the underlying mechanisms of how the NK1 receptor contributes to febrile response, especially in the early phase, have remained unknown. We administered LPS (120 µg/kg, intraperitoneally) to mice with the Tacr1 gene, i.e., the gene encoding the NK1 receptor, either present (Tacr1+/+ ) or absent (Tacr1-/- ) and measured their thermoregulatory responses, serum cytokine levels, tissue cyclooxygenase-2 (COX-2) expression, and prostaglandin (PG) E2 concentration. We found that the LPS-induced febrile response was attenuated in Tacr1-/- compared to their Tacr1+/+ littermates starting from 40 min postinfusion. The febrigenic effect of intracerebroventricularly administered PGE2 was not suppressed in the Tacr1-/- mice. Serum concentration of pyrogenic cytokines did not differ between Tacr1-/- and Tacr1+/+ at 40 min post-LPS infusion. Administration of LPS resulted in amplification of COX-2 mRNA expression in the lungs, liver, and brain of the mice, which was statistically indistinguishable between the genotypes. In contrast, the LPS-induced augmentation of COX-2 protein expression was attenuated in the lungs and tended to be suppressed in the liver of Tacr1-/- mice compared with Tacr1+/+ mice. The Tacr1+/+ mice responded to LPS with a significant surge of PGE2 production in the lungs, whereas Tacr1-/- mice did not. In conclusion, the NK1 receptor is necessary for normal fever genesis. Our results suggest that the NK1 receptor contributes to the early phase of LPS-induced fever by enhancing COX-2 protein expression in the periphery. These findings advance the understanding of the crosstalk between NK signaling and the "cytokine-COX-2-prostaglandin E2" axis in systemic inflammation, thereby open up the possibilities for new therapeutic approaches.
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Affiliation(s)
- Eszter Pakai
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences - University of Szeged, Szeged, Hungary
| | - Valeria Tekus
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Pecs, Hungary.,Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Csaba Zsiboras
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Patrik Keringer
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Nora Khidhir
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Robert Matics
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Laszlo Deres
- Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary.,First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Katalin Ordog
- Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary.,First Department of Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Nikolett Szentes
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Pecs, Hungary.,Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Krisztina Pohoczky
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Pecs, Hungary.,Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Agnes Kemeny
- Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary.,Department of Medical Biology, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences - University of Szeged, Szeged, Hungary.,First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Erika Pinter
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pecs, Pecs, Hungary.,Janos Szentagothai Research Centre, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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16
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Rumbus Z, Matics R, Hegyi P, Zsiboras C, Szabo I, Illes A, Petervari E, Balasko M, Marta K, Miko A, Parniczky A, Tenk J, Rostas I, Solymar M, Garami A. Fever Is Associated with Reduced, Hypothermia with Increased Mortality in Septic Patients: A Meta-Analysis of Clinical Trials. PLoS One 2017; 12:e0170152. [PMID: 28081244 PMCID: PMC5230786 DOI: 10.1371/journal.pone.0170152] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 12/29/2016] [Indexed: 12/29/2022] Open
Abstract
Background Sepsis is usually accompanied by changes of body temperature (Tb), but whether fever and hypothermia predict mortality equally or differently is not fully clarified. We aimed to find an association between Tb and mortality in septic patients with meta-analysis of clinical trials. Methods We searched the PubMed, EMBASE, and Cochrane Controlled Trials Registry databases (from inception to February 2016). Human studies reporting Tb and mortality of patients with sepsis were included in the analyses. Average Tb with SEM and mortality rate of septic patient groups were extracted by two authors independently. Results Forty-two studies reported Tb and mortality ratios in septic patients (n = 10,834). Pearson correlation analysis revealed weak negative linear correlation (R2 = 0.2794) between Tb and mortality. With forest plot analysis, we found a 22.2% (CI, 19.2–25.5) mortality rate in septic patients with fever (Tb > 38.0°C), which was higher, 31.2% (CI, 25.7–37.3), in normothermic patients, and it was the highest, 47.3% (CI, 38.9–55.7), in hypothermic patients (Tb < 36.0°C). Meta-regression analysis showed strong negative linear correlation between Tb and mortality rate (regression coefficient: -0.4318; P < 0.001). Mean Tb of the patients was higher in the lowest mortality quartile than in the highest: 38.1°C (CI, 37.9–38.4) vs 37.1°C (CI, 36.7–37.4). Conclusions Deep Tb shows negative correlation with the clinical outcome in sepsis. Fever predicts lower, while hypothermia higher mortality rates compared with normal Tb. Septic patients with the lowest (< 25%) chance of mortality have higher Tb than those with the highest chance (> 75%).
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Affiliation(s)
- Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Robert Matics
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
- Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences - University of Szeged, Szeged, Hungary
| | - Csaba Zsiboras
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Imre Szabo
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Anita Illes
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Erika Petervari
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Marta Balasko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Katalin Marta
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Alexandra Miko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andrea Parniczky
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Judit Tenk
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Ildiko Rostas
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Margit Solymar
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
- * E-mail:
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17
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Ivic I, Solymar M, Pakai E, Rumbus Z, Pinter E, Koller A, Garami A. Transient Receptor Potential Vanilloid-1 Channels Contribute to the Regulation of Acid- and Base-Induced Vasomotor Responses. J Vasc Res 2016; 53:279-290. [PMID: 27923234 DOI: 10.1159/000452414] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/08/2016] [Indexed: 11/19/2022] Open
Abstract
pH changes can influence local blood flow, but the mechanisms of how acids and bases affect vascular tone is not fully clarified. Transient receptor potential vanilloid-1 (TRPV1) channels are expressed in vessels and can be activated by pH alterations. Thus, we hypothesized that TRPV1 channels are involved in the mediation of vascular responses to acid-base changes. Vasomotor responses to HCl, NaOH, and capsaicin were measured in isolated murine carotid and tail skin arteries. The function of TRPV1 was blocked by either of three approaches: Trpv1 gene disruption, pharmacological blockade with a TRPV1 antagonist (BCTC), and functional impairment of mainly neural TRPV1 channels (desensitization). In each artery type of control mice, HCl caused relaxation but NaOH contraction, and both responses were augmented after genetic or pharmacological TRPV1 blockade. In arteries of TRPV1-desensitized mice, HCl-induced relaxation did not differ from controls, whereas NaOH-induced contraction was augmented. All three types of TRPV1 blockade had more pronounced effects in carotid than in tail skin arteries. We conclude that TRPV1 channels limit the vasomotor responses to changes in pH. While base-induced arterial contraction is regulated primarily by neural TRPV1 channels, acid-induced arterial relaxation is modulated by TRPV1 channels located on nonneural vascular structures.
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Affiliation(s)
- Ivan Ivic
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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Benkó R, Undi S, Wolf M, Magyar K, Tóvölgyi Z, Rumbus Z, Barthó L. P2 purinoceptors account for the non-nitrergic NANC relaxation in the rat ileum. Naunyn Schmiedebergs Arch Pharmacol 2006; 373:319-24. [PMID: 16721556 DOI: 10.1007/s00210-006-0070-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Accepted: 04/12/2006] [Indexed: 11/27/2022]
Abstract
The transmitters involved in the non-nitrergic component of the non-adrenergic, non-cholinergic (NANC) inhibitory response of the rat small intestinal longitudinal muscle to electrical field stimulation of its nerves is a matter of controversy. The present study is the first one to utilise a combination of a nitric oxide synthase inhibitor and a P(2) purinoceptor antagonist for studying this response. We found that the P(2) purinoceptor antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (PPADS; 5x10(-5) M) abolished the non-nitrergic NANC relaxation to electrical field stimulation (10 Hz). PPADS alone provided a significant, moderate inhibitory action. PPADS specifically inhibited relaxations due to exogenous adenosine 5'-triphosphate (ATP) or alpha,beta-methylene ATP. The guanylate cyclase blocker 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10(-6) M) did not add to the inhibitory action of N(G)-nitro-L-arginine on field stimulation-induced relaxation. ODQ abolished the relaxant effect of the nitric oxide donors nitroglycerin or sodium nitroprusside. These data indicate that: (1) nitric oxide and ATP fully account for the field stimulation-induced relaxation in the rat ileal strip under the experimental conditions of this study, and (2) no ODQ-sensitive guanylate cyclase-mediated mechanism is involved in the non-nitrergic component of the NANC relaxation.
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Affiliation(s)
- Rita Benkó
- Department of Pharmacology and Pharmacotherapy, Division of Pharmacodynamics, University Medical School of Pécs, Szigeti u. 12, H-7643, Pécs, Hungary
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Benko R, Lazar Z, Undi S, Illenyi L, Antal A, Horvath OP, Rumbus Z, Wolf M, Maggi CA, Bartho L. Inhibition of nitric oxide synthesis blocks the inhibitory response to capsaicin in intestinal circular muscle preparations from different species. Life Sci 2005; 76:2773-82. [PMID: 15808879 DOI: 10.1016/j.lfs.2004.07.033] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 06/07/2004] [Accepted: 07/22/2004] [Indexed: 10/25/2022]
Abstract
Moderate concentrations of the sensory stimulant drug capsaicin caused relaxation in human and animal intestinal circular muscle preparations (guinea-pig proximal, mouse distal colon, human small intestine and appendix) in vitro. With the exception of the guinea-pig colon, the nitric oxide (NO) synthase inhibitor N(G)-nitro-L-arginine (L-NOARG; 10(-4) M) strongly inhibited the relaxant effect of capsaicin. Tetrodotoxin, an inhibitor of voltage-sensitive Na+ channels failed to significantly reduce the inhibitory effect of capsaicin in the guinea-pig colon, human ileum and appendix; it caused an approximately 50% reduction in the mouse colon. The relaxant effect of capsaicin was strongly reduced in colonic preparations from transient receptor potential vanilloid type (TRPV1) receptor knockout mice as compared to their wildtype controls. It is concluded that nitric oxide, possibly of sensory origin, is involved in the relaxant action of capsaicin in the circular muscle of the mouse and human intestine.
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Affiliation(s)
- Rita Benko
- Department of Pharmacology and Pharmacotherapy, University Medical School of Pecs, Szigeti ut 12, H-7643 Pecs, Hungary
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Lázár Z, Benkó R, Bölcskei K, Rumbus Z, Wolf M, Holzer P, Maggi CA, Barthó L. Actions of endothelin and corticotropin releasing factor in the guinea-pig ileum: no evidence for an interaction with capsaicin-sensitive neurons. Neuropeptides 2003; 37:220-32. [PMID: 12906840 DOI: 10.1016/s0143-4179(03)00048-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/25/2022]
Abstract
Both endothelins and corticotropin releasing factor (CRF) appear in capsaicin-sensitive neurons. We have investigated the effects of human endothelin-1 (ET-1) and CRF in the guinea-pig ileum longitudinal and circular preparations and sought for ways of specific antagonism. With the aid of tachyphylaxis to capsaicin (i.e., rendering capsaicin-sensitive neurons functionally impaired) it was tested if these neurons played a mediating role in the effects of ET-1 or CRF. We also tried to find out whether endogenous endothelin or CRF plays a role in the excitatory and inhibitory effects of capsaicin in the ileum. In preparations at basal tone, both exogenous ET-1 (1-100 nM) and CRF (3-100 nM) caused contraction. These responses were not influenced by capsaicin tachyphylaxis. The contractile effect of ET-1 was not affected by tetrodotoxin (1 microM), atropine (1 microM), methysergide (100 nM), chloropyramine (100 nM) or SR140333 (100 nM) but was significantly inhibited or even abolished by the receptor antagonist BQ123 (3 microM) or BQ788 (3 microM). CRF caused contraction that was fully sensitive to tetrodotoxin (1 microM), tachyphylaxis to CRF or to atropine (1 microM) plus the tachykinin NK1 receptor antagonist SR140333 (200 nM). Atropine alone had a weak inhibitory effect on the contractile action of CRF. Neither the antagonist BQ123 (3 microM) nor CRF tachyphylaxis inhibited the contractile action of capsaicin (2 microM), even in the presence of a mixture of GR82334 (3 microM) and SR142801 (100 nM), for blocking tachykinin NK1 and NK3 receptors, respectively--a treatment that by itself significantly reduced the effect of capsaicin. Exogenous ET-1 (0.3-5 nM), but not CRF (30-100 nM), caused relaxation of the atropine-treated, histamine-precontracted ileum. This effect of ET-1 was significantly inhibited or abolished by BQ123 (10 microM), or BQ788 (3 microM), but was not influenced by capsaicin tachyphylaxis. Likewise, relaxation of the atropine-treated, histamine-precontracted ileum in response to capsaicin was not influenced by the endothelin receptor antagonist BQ788 (3 microM) or BQ788 (3 microM) plus BQ123 (3 microM). Apamin (300 nM) was also without effect on the capsaicin-induced relaxation. In circular muscle strips ET-1 inhibited the indomethacin-induced spontaneous activity. This effect was abolished by BQ123 (3 microM) or BQ788 (3 microM). CRF caused a stimulation of the circular muscle. This stimulatory effect was not influenced by atropine (1 microM) alone, but was inhibited by atropine plus tachykinin NK1 and NK2 receptor antagonists (SR140333 (200 nM) and SR48968 (200 nM)) and also by tetrodotoxin (1 microM). It is concluded that capsaicin-sensitive neurons do not play a role in the effects of exogenous ET-1 or CRF in the guinea-pig ileum. ET-1 can both contract and relax the ileal longitudinal smooth muscle directly, probably via both ETA and ETB receptors. CRF acts by specifically stimulating excitatory (but not inhibitory) neurons of the myenteric plexus. Neither endogenous ET-1 nor CRF seems to play a role in the excitatory or inhibitory effects of capsaicin.
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Affiliation(s)
- Zs Lázár
- Department of Pharmacology and Pharmacotherapy, University Medical School of Pécs, Szigeti út 12, H-7643 Pécs, Hungary
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