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OBJECTIVE: To examine the associations of maternal and child overweight status across multiple time-points with liver fat content in the offspring during young adulthood. DESIGN: Cohort study. SETTING: ELEMENT Cohort in Mexico City. POPULATION: Pregnant women with singleton births (n = 97). METHODS: We quantified hepatic triglyceride content (liver fat content) by proton magnetic resonance spectroscopy (1H MRS) and conventional T2-weighted MRIs (3T scanner) in 97 young adults from the ELEMENT birth cohort in Mexico City. Historical records of the cohort were used as a source of pregnancy, and childhood and adolescence anthropometric information, overweight and obesity (OWOB) were defined. Adjusted structural equation models were run to identify the association between OWOB in different life stages with liver fat content (log-transformed) in young adulthood. MAIN OUTCOME: Maternal OWOB at the time of delivery was directly and indirectly associated with the liver fat content in the offspring at young adulthood. RESULTS: Seventeen percent of the participants were classified as having NAFLD. We found a strong association of OWOB between all periods assessed. Maternal OWOB at time of delivery (ß = 1.97, 95% CI 1.28-3.05), and OWOB status in the offspring at young adulthood (ß = 3.17, 95% CI 2.10-4.77) were directly associated with the liver fat content in the offspring. Also, maternal OWOB was indirectly associated with liver fat content through offspring OWOB status. CONCLUSION: We found that maternal OWOB status is related to fatty liver content in the offspring as young adults, even after taking into account OWOB status and lifestyle factors in the offspring. TWEETABLE ABSTRACT: There was an association between pre-pregnancy overweight and the development of NAFLD in adult offspring.
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Enfermedad del Hígado Graso no Alcohólico/epidemiología , Obesidad/epidemiología , Complicaciones del Embarazo/epidemiología , Adolescente , Adulto , Peso al Nacer , Índice de Masa Corporal , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , México/epidemiología , Enfermedad del Hígado Graso no Alcohólico/etiología , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Triglicéridos/análisis , Adulto JovenRESUMEN
BACKGROUND: The relationship between gout medication use and cataract development is controversial. Moreover, limited clinical studies have evaluated this relationship. AIM: To assess the effects of colchicine, allopurinol and benzbromarone on the risk of cataract in patients with gout. DESIGN: Population-based nested case-control study. METHODS: We enrolled 7900 patients who had received a new diagnosis of cataract >3 years after gout diagnosis into the study group and 33 475 patients who did not receive a diagnosis of cataract into the control group by matching for age, sex and the year of gout diagnosis at a ratio of 1:1. We used World Health Organization's defined daily dose (DDD) as a measure to assess the dosage of colchicine, allopurinol and benzbromarone exposure. Logistic regression was used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the risk of cataract. RESULTS: The risk of cataract significantly increased in patients who received colchicine at a cumulative DDD of ≥66.5 (OR = 1.17, 95% CI = 1.01-1.36, P = 0.041). In the age-stratified analysis, patients with gout aged >60 years had a higher risk of cataract (OR = 1.27, 95% CI = 1.06-1.53, P = 0.011) than did patients aged <60 years. Allopurinol and benzbromarone had no association with cataract. CONCLUSIONS: In this population-based nested case-control study, we observed that colchicine use increased the risk of cataract in patients with gout, especially in those aged >60 years who received colchicine at a cumulative DDD of >66.5.
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Catarata/inducido químicamente , Colchicina/efectos adversos , Supresores de la Gota/efectos adversos , Gota/tratamiento farmacológico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Alopurinol/uso terapéutico , Benzbromarona/uso terapéutico , Estudios de Casos y Controles , Catarata/epidemiología , Colchicina/administración & dosificación , Bases de Datos Factuales , Femenino , Gota/complicaciones , Supresores de la Gota/administración & dosificación , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Factores de Riesgo , Taiwán , Adulto JovenRESUMEN
BACKGROUND: Identifying metabolomic profiles of children with asthma has the potential to increase understanding of asthma pathophysiology. OBJECTIVE: To identify differences in plasma metabolites between children with and without current asthma at mid-childhood. METHODS: We used untargeted mass spectrometry to measure plasma metabolites in 237 children (46 current asthma cases and 191 controls) in Project Viva, a birth cohort from eastern Massachusetts, USA. Current asthma was assessed at mid-childhood (mean age 8.0 years). The ability of a broad spectrum metabolic profile to distinguish between cases and controls was assessed using partial least squares discriminant analysis. We used logistic regression models to identify individual metabolites that were differentially abundant by case-control status. We tested significant metabolites for replication in 411 children from the VDAART clinical trial. RESULTS: There was no evidence of a systematic difference in the metabolome of children reporting current asthma vs. healthy controls according to partial least squares discriminant analysis. However, several metabolites were associated with odds of current asthma at a nominally significant threshold (P < .05), including a metabolite of nicotinamide (N1-Methyl-2-pyridone-5-carboxamide (Odds Ratio (OR) = 2.8 (95% CI 1.1-8.0)), a pyrimidine metabolite (5,6-dihydrothymine (OR = 0.4 (95% CI 0.2-0.9)), bile constituents (biliverdin (OR = 0.4 (95%CI 0.1-0.9), taurocholate (OR = 2.0 (95% CI 1.2-3.4)), two peptides likely derived from fibrinopeptide A (ORs from 1.6 to 1.7), and a gut microbiome metabolite (p-cresol sulphate OR = 0.5 (95% CI 0.2-0.9)). The associations for N1-Methyl-2-pyridone-5-carboxamide and p-cresol sulphate replicated in the independent VDAART population (one-sided P values = .03-.04). CONCLUSIONS AND CLINICAL RELEVANCE: Current asthma is nominally associated with altered levels of several metabolites, including metabolites in the nicotinamide pathway, and a bacterial metabolite derived from the gut microbiome.
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Asma/sangre , Biomarcadores/sangre , Metaboloma , Metabolómica , Asma/diagnóstico , Asma/inmunología , Estudios de Casos y Controles , Niño , Cromatografía Liquida , Femenino , Humanos , Masculino , Espectrometría de Masas , Metabolómica/métodos , Oportunidad RelativaRESUMEN
This study investigates relations of maternal N-3 and N-6 polyunsaturated fatty acids (PUFA) intake during pregnancy with offspring body mass index (BMI), height z-score and metabolic risk (fasting glucose, C-peptide, leptin, lipid profile) during peripuberty (8-14 years) among 236 mother-child pairs in Mexico. We used food frequency questionnaire data to quantify trimester-specific intake of N-3 alpha-linolenic acid, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA); N-6 linoleic acid and arachidonic acid (AA); and N-6:N-3 (AA:EPA+DHA), which accounts for the fact that the two PUFA families have opposing effects on physiology. Next, we used multivariable linear regression models that accounted for maternal education and parity, and child's age, sex and pubertal status, to examine associations of PUFA intake with the offspring outcomes. In models where BMI z-score was the outcome, we also adjusted for height z-score. We found that higher second trimester intake of EPA, DHA and AA were associated with lower offspring BMI and height z-score. For example, each 1-s.d. increment in second trimester EPA intake corresponded with 0.25 (95% CI: 0.03, 0.47) z-scores lower BMI and 0.20 (0.05, 0.36) z-scores lower height. Accounting for height z-score in models where BMI z-score was the outcome attenuated estimates [e.g., EPA: -0.16 (-0.37, 0.05)], suggesting that this relationship was driven by slower linear growth rather than excess adiposity. Maternal PUFA intake was not associated with the offspring metabolic biomarkers. Our findings suggest that higher PUFA intake during mid-pregnancy is associated with lower attained height in offspring during peripuberty. Additional research is needed to elucidate mechanisms and to confirm findings in other populations.
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Adiposidad/fisiología , Estatura , Índice de Masa Corporal , Ácidos Grasos Omega-3/administración & dosificación , Ácidos Grasos Omega-6/administración & dosificación , Obesidad/prevención & control , Efectos Tardíos de la Exposición Prenatal/prevención & control , Adiposidad/efectos de los fármacos , Adolescente , Adulto , Niño , Femenino , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Obesidad/metabolismo , Embarazo , Estudios Prospectivos , Adulto JovenRESUMEN
BACKGROUND: Prenatal exposure to traffic pollution has been associated with faster infant weight gain, but implications for cardiometabolic health in later childhood are unknown. METHODS: Among 1418 children in Project Viva, a Boston-area pre-birth cohort, we assessed anthropometric and biochemical parameters of cardiometabolic health in early (median age 3.3 years) and mid- (median age 7.7 years) childhood. We used spatiotemporal models to estimate prenatal and early life residential PM2.5 and black carbon exposure as well as traffic density and roadway proximity. We performed linear regression analyses adjusted for sociodemographics. RESULTS: Children whose mothers lived close to a major roadway at the time of delivery had higher markers of adverse cardiometabolic risk in early and mid-childhood. For example, total fat mass was 2.1 kg (95%CI: 0.8, 3.5) higher in mid-childhood for children of mothers who lived <50 m vs. ≥200 m from a major roadway. Black carbon exposure and traffic density were generally not associated with cardiometabolic parameters, and PM2.5 exposure during the year prior was paradoxically associated with improved cardiometabolic profile. CONCLUSIONS: Infants whose mothers lived close to a major roadway at the time of delivery may be at later risk for adverse cardiometabolic health.
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Contaminantes Atmosféricos/efectos adversos , Contaminación del Aire/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Síndrome Metabólico/epidemiología , Contaminantes Atmosféricos/análisis , Biomarcadores/análisis , Boston , Niño , Preescolar , Estudios de Cohortes , Femenino , Humanos , Lactante , Masculino , Síndrome Metabólico/etiología , Embarazo , Efectos Tardíos de la Exposición Prenatal , Estudios Prospectivos , Análisis de RegresiónRESUMEN
OBJECTIVE: This study aims to investigate relations of serum leptin at age 4 with development of adiposity and linear growth during 3 years of follow-up among 75 Greek children and to identify serum metabolites associated with leptin at age 4 and to characterize their associations with adiposity gain and linear growth. METHODS: Linear regression models that accounted for maternal age, education and gestational weight gain and child's age and sex were used to examine associations of leptin and leptin-associated metabolites measured at age 4 with indicators of adiposity and linear growth at age 7. RESULTS: Each 1-unit increment in natural log-(ln)-transformed leptin corresponded with 0.33 (95% CI: 0.10, 0.55) units greater body mass index-for-age z-score gain during follow-up. Likewise, higher levels of the leptin-associated metabolites methylmalonyl-carnitine and glutaconyl-carnitine corresponded with 0.14 (95% CI: 0.01, 0.27) and 0.07 (95% CI: -0.01, 0.16) units higher body mass index-for-age z-score gain, respectively. These relationships did not differ by sex or baseline weight status and were independent of linear growth. CONCLUSIONS: These findings suggest that leptin, methylmalonyl-carnitine and possibly glutaconyl-carnitine are associated with weight gain during early childhood. Future studies are warranted to confirm these findings in other populations.
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In this review, we discuss the potential role of metabolomics to enhance understanding of obesity-related developmental origins of health and disease (DOHaD). We first provide an overview of common techniques and analytical approaches to help interested investigators dive into this relatively novel field. Next, we describe how metabolomics may capture exposures that are notoriously difficult to quantify, and help to further refine phenotypes associated with excess adiposity and related metabolic sequelae over the life course. Together, these data can ultimately help to elucidate mechanisms that underlie fetal metabolic programming. Finally, we review current gaps in knowledge and identify areas where the field of metabolomics is likely to provide insights into mechanisms linked to DOHaD in human populations.
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Metabolómica , Obesidad/etiología , Animales , Humanos , Obesidad/metabolismoRESUMEN
BACKGROUND/OBJECTIVES: Studies in adults indicate that dietary polyunsaturated fatty acid (PUFA) composition may play a role in development of adiposity. Because adipocyte quantity is established between late childhood and early adolescence, understanding the impact of PUFAs on weight gain during the school-age years is crucial to developing effective interventions. SUBJECTS/METHODS: We quantified N-3 and N-6 PUFAs in serum samples of 668 Colombian schoolchildren aged 5-12 years at the time of recruitment into a cohort study, using gas-liquid chromatography. Serum concentrations of N-3 (alpha-linolenic acid (ALA), eicosapentaenoic acid, docosahexaenoic acid) and N-6 PUFAs (linoleic acid, gamma-linolenic acid, dihomo-gamma-linolenic acid, arachidonic acid) were determined as percentage total fatty acids. Children's anthropometry was measured annually for a median of 30 months. We used mixed-effects models with restricted cubic splines to construct population body mass index-for-age z-score (BAZ) growth curves for age- and sex-specific quartiles of each PUFA. RESULTS: N-3 ALA was inversely related to BAZ gain after adjustment for sex, baseline age and weight status, as well as household socioeconomic level. Estimated BAZ change between 6 and 14 years among children in the highest quartile of ALA compared with those in the lowest quartile was 0.45 (95% confidence interval: 0.07, 0.83) lower (P-trend=0.006). CONCLUSIONS: N-3 ALA may be protective against weight gain in school-age children. Whether improvement in PUFA status reduces adiposity in pediatric populations deserves evaluation in randomized trials.
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Índice de Masa Corporal , Dieta , Ácidos Grasos/sangre , Estado Nutricional , Obesidad Infantil/prevención & control , Aumento de Peso/efectos de los fármacos , Ácido alfa-Linolénico/sangre , Adiposidad/efectos de los fármacos , Niño , Preescolar , Estudios de Cohortes , Colombia , Grasas de la Dieta/sangre , Grasas de la Dieta/farmacología , Grasas de la Dieta/uso terapéutico , Ácidos Grasos/farmacología , Ácidos Grasos/uso terapéutico , Femenino , Humanos , Masculino , Obesidad Infantil/sangre , Ácido alfa-Linolénico/farmacología , Ácido alfa-Linolénico/uso terapéuticoRESUMEN
BACKGROUND AND AIMS: DNA methylation of repetitive elements may explain the relations between dietary intake, hyperhomocysteinemia, and cardiovascular disease risk. We investigated associations of methyl micronutrient intake and plasma total homocysteine with LINE-1 and Alu methylation in a cross-sectional study of 987 adults aged 45-84 y who participated in the Multi-Ethnic Study of Atherosclerosis (MESA) Stress Study. METHODS AND RESULTS: DNA methylation was estimated using pyrosequencing technology. A 120-item food frequency questionnaire was used to ascertain daily intake of folate, vitamin B12, vitamin B6, zinc, and methionine. Plasma total homocysteine was quantified using a fluorescence polarization immunoassay. Associations of micronutrient intake and homocysteine with LINE-1 and Alu methylation were examined using linear regression. Adjusted differences in %5-methylated cytosines (%5 mC) were examined by categories of predictors using multivariable linear regression models. Intake of methyl-donor micronutrients was not associated with DNA methylation. After adjustment for covariates, each 3 µmol/L increment of homocysteine corresponded with 0.06 (-0.01, 0.13) %5 mC higher LINE-1 methylation. Additionally, BMI was positively associated with LINE-1 methylation (P trend = 0.03). Participants with BMI ≥ 40 kg/m² had 0.35 (0.03, 0.67) %5 mC higher LINE-1 than those with normal BMI. We also observed a 0.10 (0.02, 0.19) %5 mC difference in Alu methylation per 10 cm of height. These associations did not differ by sex. CONCLUSION: Dietary intake of methyl-donor micronutrients was not associated with measures of DNA methylation in our sample. However, higher BMI was related to higher LINE-1 methylation, and height was positively associated with Alu methylation.
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Elementos Alu , Aterosclerosis/etiología , Metilación de ADN , Dieta/efectos adversos , Homocisteína/sangre , Hiperhomocisteinemia/etiología , Elementos de Nucleótido Esparcido Largo , Anciano , Anciano de 80 o más Años , Aterosclerosis/complicaciones , Aterosclerosis/epidemiología , Aterosclerosis/metabolismo , Biomarcadores/sangre , Estatura , Índice de Masa Corporal , Estudios Transversales , Femenino , Humanos , Hiperhomocisteinemia/complicaciones , Hiperhomocisteinemia/epidemiología , Hiperhomocisteinemia/metabolismo , Los Angeles/epidemiología , Masculino , Micronutrientes/deficiencia , Micronutrientes/metabolismo , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Obesidad Mórbida/complicaciones , Factores de RiesgoRESUMEN
BACKGROUND: Studies regarding the role of iron on linear growth have yielded heterogeneous results. Some trials indicate that iron supplementation of iron-replete infants leads to slower-length gain. However, little is known of the relation between iron status and linear growth in school-age children. METHODS: We quantified plasma ferritin, mean corpuscular volume (MCV), and hemoglobin in 2714 children aged 5-12 years at recruitment into a cohort study. Height was measured periodically for a median of 30 months. Height-for-age Z-scores (HAZ) were calculated using the World Health Organization growth reference. Mixed effects models with restricted cubic splines were used to construct population HAZ-for-age growth curves for sex- and age-specific quartiles of each iron status indicator. RESULTS: Ferritin and MCV were each inversely related to attained HAZ among boys after the adjustment for baseline age, baseline body mass index-for-age Z-score and socioeconomic status. There was a decreasing monotonic relation between quartiles of ferritin and estimated change in HAZ from ages 6 to 14 years (P trend=0.001); boys in the 4th quartile experienced a HAZ change that was 0.46 Z lower than that of boys in the 1st quartile (P=0.0006). Similarly, we observed smaller HAZ change among boys in the highest quartile of MCV in comparison with those in the 1st quartile (P trend=0.001). Hemoglobin was not related to linear growth in boys. None of the iron-status indicators were associated with linear growth in girls. CONCLUSIONS: Higher iron status, as indicated by ferritin and MCV, is related to slower linear growth in iron-replete school-age boys.
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Estatura , Desarrollo Infantil , Trastornos del Crecimiento/etiología , Hierro de la Dieta/efectos adversos , Estado Nutricional , Anemia Ferropénica/sangre , Anemia Ferropénica/epidemiología , Niño , Preescolar , Estudios de Cohortes , Colombia/epidemiología , Femenino , Estudios de Seguimiento , Alimentos Fortificados/efectos adversos , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/fisiopatología , Humanos , Sobrecarga de Hierro/sangre , Sobrecarga de Hierro/epidemiología , Sobrecarga de Hierro/etiología , Sobrecarga de Hierro/fisiopatología , Hierro de la Dieta/administración & dosificación , Estudios Longitudinales , Masculino , Política Nutricional , Prevalencia , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Caracteres SexualesAsunto(s)
Adenocarcinoma/patología , Neoplasias de los Bronquios/secundario , Neoplasias del Colon/patología , Adenocarcinoma/terapia , Adulto , Neoplasias de los Bronquios/terapia , Quimioradioterapia , Neoplasias del Colon/terapia , Procedimientos Quirúrgicos del Sistema Digestivo , Resultado Fatal , Femenino , Humanos , Metástasis de la NeoplasiaAsunto(s)
Enfermedades Pulmonares Parasitarias/diagnóstico , Enfermedades Cutáneas Parasitarias/diagnóstico , Strongyloides stercoralis , Estrongiloidiasis/diagnóstico , Anciano de 80 o más Años , Animales , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico por imagen , Masculino , Radiografía , Enfermedades Cutáneas Parasitarias/patología , Estrongiloidiasis/diagnóstico por imagen , Resultado del TratamientoAsunto(s)
Lipoma/diagnóstico por imagen , Quiste Mediastínico/congénito , Quiste Mediastínico/diagnóstico por imagen , Neoplasias del Timo/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto , Aorta Torácica/patología , Diagnóstico Diferencial , Humanos , Lipoma/complicaciones , Lipoma/patología , Lipoma/cirugía , Masculino , Quiste Mediastínico/complicaciones , Quiste Mediastínico/patología , Quiste Mediastínico/cirugía , Mediastino/patología , Mediastino/cirugía , Timectomía , Timo/patología , Neoplasias del Timo/complicaciones , Neoplasias del Timo/patología , Neoplasias del Timo/cirugíaRESUMEN
Ischaemia/reperfusion (I/R) lung injury using University of Wisconsin solution (UW) as perfusate has not been well studied. Isolated rat lungs were challenged with various periods of ischaemia and/or reperfusion. Haemodynamics, lung weight gain (LWG), capillary filtration coefficient (K(fc)), tissue pathology, the concentrations of cytokines in the perfusate, and mRNAs for the various cytokines in the lung tissues were measured. I/R induced a permeability type of pulmonary oedema, as reflected by increases in LWG and K(fc). LWG and K(fc) in the I(45)R(60)(UW) group (45 min of ischaemia followed by 60 min of reperfusion with UW) were only 2% and 5% respectively of those in the I(45)R(60)(NS) group (where NS is normal saline). LWG and K(fc) in the UW group had both increased by 180 min, to values similar to those in the I(45)R(60)(NS) group. However, these findings show that UW was remarkably effective at preventing LWG after 60 min of reperfusion, and was more than 3-fold more effective than NS in delaying LWG. For longer ischaemic times only, or the same period of ischaemia followed by longer reperfusion periods, greater lung injury occurred. I/R lung injury also induced increased concentrations of tumour necrosis factor-alpha (TNF-alpha), interleukin 1 and interleukin 6 in the perfusate, and increased the mRNAs for these cytokines in lung tissue. A significant correlation was obtained between TNF-alpha concentration and LWG. TNF-alpha production in the I(45)R(60)(UW) group was only 7% of that in the I(45)R(60)(NS) group. However, TNF-alpha mRNA expression in the I(45)R(60)(UW) group was 80% of that in the I(45)R(60)(NS) group. This indicates that transcription/translation do not correlate well with cytokine production, and also suggests that one reason for the effectiveness of UW in delaying LWG may be because it delays TNF-alpha production. In summary, ischaemia or I/R caused a permeability-type pulmonary oedema that was associated with leucocyte infiltration and the up-regulation of various cytokines, regardless of the perfusion fluid. Except for pulmonary hypertension, less severe I/R lung injury and delayed cytokine production in lungs perfused with UW, the pattern of injury associated with I/R challenge was similar to that in lungs perfused with NS. We propose that more or long-acting protective agents are required as additives in order to modify UW to produce an optimal preservation solution.
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Adenosina/farmacología , Alopurinol/farmacología , Citocinas/metabolismo , Glutatión/farmacología , Insulina/farmacología , Pulmón/irrigación sanguínea , Soluciones Preservantes de Órganos/farmacología , Rafinosa/farmacología , Daño por Reperfusión/metabolismo , Regulación hacia Arriba/efectos de los fármacos , Animales , Citocinas/genética , Hemodinámica/efectos de los fármacos , Pulmón/patología , Masculino , Tamaño de los Órganos/efectos de los fármacos , Reacción en Cadena de la Polimerasa/métodos , Edema Pulmonar/metabolismo , Edema Pulmonar/patología , Edema Pulmonar/prevención & control , ARN Mensajero/genética , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/fisiopatología , Daño por Reperfusión/prevención & controlRESUMEN
A simplified pore-to-pore hopping model for the two-phase diffusion problem is developed for the analysis of the pulsed gradient spin echo (PGSE) attenuation of water diffusion in the condensed cell suspension systems. In this model, the two phases inside and outside the cells are treated as two different kinds of pores, and the spin-bearing molecules perform hopping diffusion between them. The size and the orientations of those two respective pores are considered, and then the diffraction pattern of the PGSE attenuation may be well simulated. Nevertheless, the intensity of the characteristic peak decreases with increasing membrane permeability, from which the exchange time may be estimated. We then analyze the experimental 1H PGSE results of the erythrocytes suspension system. The water-residence lifetime in the erythrocyte is obtained to be 10 ms, which is the same as that estimated from the two-region approximation. Furthermore, the PGSE attenuation curve of addition of p-Chloromercuribenzenesulfonate (p-CMBS) is also discussed. It predicts that the alignment of erythrocytes will become normal to the magnetic field direction after the addition of p-CMBS, and inspection using a light microscope confirms that result.
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Permeabilidad de la Membrana Celular/fisiología , Difusión , Modelos Biológicos , 4-Cloromercuribencenosulfonato/farmacología , Transporte Biológico , Polaridad Celular/efectos de los fármacos , Simulación por Computador , Eritrocitos/química , Eritrocitos/citología , Eritrocitos/metabolismo , Humanos , Espectroscopía de Resonancia Magnética , Magnetismo , Microscopía , Agua/metabolismoRESUMEN
The choice of an intravenous solution for the attenuation of ischaemia/reperfusion (I/R) lung injury is still a difficult one. Although 10% (w/v) pentastarch has been used in ICU settings, its use in I/R lung injury has not been well explored. We hypothesized that this synthetic colloid substance, which maintains colloid osmotic pressure and potentially 'seals' capillary leaks, in combination with an anti-inflammatory agent (i.e. dexamethasone), would ameliorate I/R lung injury. After 60 min of lung ischaemia in an isolated rat lung model, lungs were reperfused for 60 min in a closed circulating system with one of the following solutions: (1) NS (0.9% normal saline), (2) NS+Dex (dexamethasone), (3) NS+Penta (pentastarch), or (4) NS+Penta+Dex. Haemodynamic changes, lung weight gain (LWG), capillary filtration coefficient (K(fc)) and lung pathology were analysed. Results showed significantly lower values of K(fc) and LWG in pentastarch- or dexamethasone-perfused groups as compared with those in the NS group. Dexamethasone as an additive to NS+Penta further decreased K(fc) and LWG. Histopathological studies showed similar decreases in injury profiles. We conclude that reperfusion with dexamethasone and pentastarch can attenuate I/R lung injury, and that dexamethasone and pentastarch have additive effects. Our data thus suggest that the combination of a colloid substance with 'sealing effects' and an anti-inflammatory agent may provide a better reperfusion solution for patients with I/R lung injury or for lungs stored for transplant.
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Antiinflamatorios/uso terapéutico , Dexametasona/uso terapéutico , Derivados de Hidroxietil Almidón/uso terapéutico , Enfermedades Pulmonares/tratamiento farmacológico , Sustitutos del Plasma/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Animales , Antiinflamatorios/farmacología , Permeabilidad Capilar/efectos de los fármacos , Dexametasona/farmacología , Sinergismo Farmacológico , Quimioterapia Combinada , Hemodinámica , Derivados de Hidroxietil Almidón/análogos & derivados , Enfermedades Pulmonares/fisiopatología , Masculino , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/fisiopatología , Aumento de Peso/efectos de los fármacosRESUMEN
Experimental interventions that reduce ischaemia/reperfusion (I/R) lung injury can be used to improve the properties of preservation solutions. We attempted to increase the attenuation of I/R injury by University of Wisconsin solution (UW) by adding an antibody against tumour necrosis factor-alpha (TNF-alpha), to neutralize TNF-alpha, and/or by adding 3-deaza-adenosine (c3-Ado), to inhibit leucocyte adhesion and the biosynthesis of ICAM-1 (intercellular cell-adhesion molecule 1). We examined I/R injury using an isolated rat lung model. Six different solutions were perfused individually, followed by evaluation of I/R injury: (1) 0.9% NaCl (normal saline; NS), (2) NS+anti-TNF-alpha antibody, (3) UW alone, (4) UW+anti-TNF-alpha, (5) UW+c3-Ado and (6) UW+anti-TNF-alpha+c3-Ado. Haemodynamic changes, lung weight gain, capillary filtration coefficient, TNF-alpha levels and lung pathology were analysed in order to evaluate I/R injury. Compared with lungs perfused with NS, lungs treated with NS+anti-TNF-alpha showed less I/R injury. The addition of anti-TNF-alpha and/or c3-Ado to UW reduced I/R injury compared with unmodified UW. Among the six solutions tested, UW containing anti-TNF-alpha antibody reduced I/R injury to the greatest extent. We conclude that addition of anti-TNF-alpha antibody or c3-Ado protects against I/R lung injury when using UW. Further investigation of the improved properties of modified UWs would be beneficial with regard to lung transplantation research.
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Adenosina , Alopurinol , Glutatión , Insulina , Soluciones Preservantes de Órganos , Rafinosa , Daño por Reperfusión/prevención & control , Tubercidina , Factor de Necrosis Tumoral alfa/inmunología , Adenosina/química , Alopurinol/química , Animales , Anticuerpos Monoclonales , Glutatión/química , Hemodinámica , Insulina/química , Pulmón/irrigación sanguínea , Pulmón/patología , Trasplante de Pulmón , Masculino , Técnicas de Cultivo de Órganos , Preservación de Órganos/métodos , Soluciones Preservantes de Órganos/química , Tamaño de los Órganos , Rafinosa/química , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/patologíaRESUMEN
Current methods of preserving lung tissue for transplantation are inadequate. In this study, we tested whether the combination of hypothermia plus prostaglandin E(1) (PGE(1)) treatment would have synergistic attenuation on ischemia-reperfusion (I/R) lung injury. Isolated rat lung experiments with ischemia for 1 h then reperfusion for 1 h, were conducted using six different perfusates: (1) University of Wisconsin solution (UW) at 30 degrees C (n = 5), (2) UW at 22 degrees C (n = 5), (3) UW at 10 degrees C (n = 4), (4) UW+PGE(1) at 30 degrees C (n = 4), (5) UW+PGE(1) at 22 degrees C (n = 4), and (6) UW+PGE(1) at 10 degrees C (n = 4). Hemodynamic changes, lung weight gain, capillary filtration coefficients, and lung pathology were analyzed to evaluate the I/R injury. Compared with 30 degrees C UW, animals treated with 22 degrees C UW and 10 degrees C UW had less I/R lung injury, with the groups receiving 22 degrees C UW showing superior results to group receiving 10 degrees C UW. The addition of PGE(1) to UW solution produced more attenuation of I/R injury than did UW alone. Among the six groups, 10 degrees C UW+PGE(1) produced the most reduction of I/R injury. This study has shown that hypothermia can attenuate I/R injury with the optimal flushing temperature being near 22 degrees C. PGE(1) also has a protective effect on I/R. Furthermore, hypothermia and PGE(1) have synergistic attenuation of I/R lung injury. We propose that pulmonary artery flushed with cooling UW+PGE(1) might improve lung preservation and improve results in lung transplantation.
Asunto(s)
Alprostadil/farmacología , Hipotermia Inducida , Pulmón/patología , Preservación de Órganos , Daño por Reperfusión/patología , Vasodilatadores/farmacología , Adenosina , Alopurinol , Animales , Permeabilidad Capilar , Glutatión , Insulina , Pulmón/irrigación sanguínea , Masculino , Soluciones Preservantes de Órganos , Tamaño de los Órganos , Circulación Pulmonar/efectos de los fármacos , Presión Esfenoidal Pulmonar , Rafinosa , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/prevención & control , Resistencia VascularRESUMEN
1. An intervention to reduce ischaemia-reperfusion lung injury will be an important advance in transplant medicine. Although the mechanisms associated with producing ischaemia-reperfusion endothelial injury have not been completely elucidated, many of the injury mediators have been studied in detail. While no single pharmacological therapy is likely to be totally effective in eliminating this complex injury, we have developed a mixture of agents that are known to block pathways involved in producing ischaemia-reperfusion-associated lung vascular injury.2. The present study modified University of Wisconsin solution (UW) by adding one of the protective agents prostaglandin E1 (PGE1), dexamethasone (Dex) or dibutyryl cAMP (Bt2-cAMP), or a combination of these, to the perfusate of rat lungs exposed to 4 h of cold ischaemia followed by 1 h of reperfusion. Nine modified UW solutions were studied: (1) UW+Dex, (2) UW+PGE1, (3) UW+Bt2-cAMP, (4) UW+Dexx3, (5) UW+PGE1x3, (6) UW+Bt2-cAMPx3, (7) UW+Dex+PGE1, (8) UW+Dex+Bt2-cAMP, (9) UW+PGE1+Bt2-cAMP. These solutions were utilized in individual experiments to assess haemodynamic changes, lung weight gain, the capillary filtration coefficient (Kfc) and pathology in all lungs.3. The results indicate that lung weight gain and Kfc values were significantly lower than with UW alone in groups 1, 2 and 3, which contained only one additional protective agent. In groups 4, 5 and 6, which contain three times the concentration of each protective agent, both Kfc and lung weight gain were similar to those measured in groups 1, 2 and 3, i.e. lungs were protected but the protection was not dose dependent. In groups 7, 8 and 9, which contained two protective agents, lung weight gain and Kfc were greatly reduced compared with UW alone. Histopathological studies showed similar decreases in the injury profiles of lungs.4. Although UW contains several antioxidant protective agents such as allopurinol and glutathione, it did not provide effective protection in our ischaemia-reperfusion lung injury model. UW modified with an additive of PGE1, Dex or Bt2-cAMP attenuated ischaemia-reperfusion injury. Furthermore, UW containing two of these protective agents augmented the protection. Among the modified solutions, it appears that UW+PGE1+Bt2-cAMP protects the lungs to a greater extent than all other solutions used in our study. We suggest that preservation solutions containing PGE1-Bt2-cAMP will provide additional protective effects to organs stored for transplantation.