Effects of fatty and lean fish intake on blood pressure in subjects with coronary heart disease using multiple medications

BACKGROUND: Intake of fish and long-chain n-3 fatty acids has been of wide interest due to their beneficial effects on cardiovascular risk factors and lower coronary heart disease (CHD) risk. AIM OF THE STUDY: The aim of this pilot study was to examine the effects of fatty fish and lean (white) fish on fatty acid composition of serum lipids and cardiovascular risk factors in subjects with CHD using multiple drugs for this condition. METHODS: The study was an 8-week controlled, parallel intervention. Inclusion criteria were myocardial infarction or unstable ischemic attack, age under 70 years, use of betablockers and presence of sinus rhythm. The subjects were randomized to one of the following groups: 4 meals/week fatty fish (n = 11), 4 meals/week lean fish (n = 12) and control diet including lean meat (n = 10). RESULTS: The mean (+/-SD) of reported fish meals per week was 4.3 +/- 0.4, 4.7 +/- 1.1 and 0.6 +/- 0.4 in the groups, respectively. The proportions of eicosapentaenoic and docosahexaenoic acids in serum lipids increased in the fatty fish group only (P < 0.05). Systolic and diastolic blood pressure levels decreased in the lean fish group (0 vs. 8 week: 3.5 +/- 3.2 and 4.6 +/- 3.6%, respectively, P < 0.05). Serum total triglyceride concentration did not significantly change. HDL cholesterol concentration change differed among groups but without significant post hoc differences. Apolipoprotein A-1 concentration decreased in the control group (0 vs. 8 week, P < 0.05). Coagulation factors, 25-hydroxy vitamin D, and heart rate variability (24 h Holter) did not change among the groups. CONCLUSIONS: Our results suggest that intake of lean fish at least four times per week could reduce blood pressure levels in CHD patients.     

The effects of fish oil and high or low linoleic acid intake on fatty acid composition of human peripheral blood mononuclear cells

Dietary intake of 18: 2n-6 and 18: 3n-3 may affect endogenous production and incorporation of n-3 long-chain PUFA (LCPUFA) from fish oils (FO). This double-blinded controlled 2 x 2-factorial 8-week intervention investigates the effects of high and low 18: 2n-6 intake in combination with FO-supplementation on tissue fatty acid composition. Healthy young men (n 64) were randomized to capsules with FO or olive oil (control) (4.4 (2.0-5.6) ml/d) and to either sunflower oil and margarine (S/B) or rapeseed oil and a butter spread (R/K) to provide a high or a low 18: 2n-6 intake. Diet was measured by 4-d weighed dietary records at baseline, during and 8 weeks after the intervention and tissue incorporation as fatty acid composition of peripheral blood mononuclear cells (PBMC). The fat intervention gave a mean difference in the 18: 2n-6 intake of 7.3 g/d (95 % CI 4.6, 10.0) and a similar 18: 3n-3 intake in the groups. The R/K groups had a 0.2 % fatty acid (FA%) (95 % CI 0.0, 0.4, P = 0.02) higher content of 22: 5n-3 in the PBMC, a tendency of slightly higher 20: 5n-3 (P = 0.06), but no more 22: 6n-3 (P = 0.83) than the S/B groups. FO effectively raised the PBMC content of all n-3 LCPUFA (P < 0.001). The fat intervention did not markedly influence the effect of FO; the mean PBMC content of n-3 LCPUFA was 10.3 (sem 0.3) FA% in the FO+S/B group and 10.6 (sem 0.2) FA% in the FO+R/K group. In conclusion, increasing the 18: 2n-6 intake did not have any pronounced effect on incorporation of n-3 LCPUFA in PBMC, either alone or with simultaneous FO supplementation.     

外周血单核细胞IL-12、IL-15、ISG15表达与老年冠心病并发肺部感染预后的关系

目的 检测白细胞介素-12(IL-12)、IL-15及干扰素刺激基因15(ISG15)在老年冠心病并发肺部感染患者外周血单核细胞(PBMCs)的表达及其与预后的关系。方法 收集2018年11月-2020年10月诸暨市中医医院收治的老年冠心病患者213例,根据患者是否并发肺部感染分为感染组115例和非感染组98例。记录两组入院后第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰流速(PEF);采用受试者工作特征(ROC)曲线评价外周血单核细胞IL-12、IL-15及ISG15对老年冠心病并发肺部感染预后的临床价值。结果 115例老年冠心病并发肺部感染患者共培养分离病原菌132株,其中革兰阴性菌97株(73.48%);感染组患者FEV1、FVC、PEF均低于非感染组(P<0.05),PMBCs中IL-12、IL-15及ISG15 mRNA水平均高于非感染组(P<0.05);预后不良组IL-12、IL-15及ISG15 mRNA均高于预后良好组(P<0.05); IL-12、IL-15及ISG15预测老年冠心病并发肺部感染患者预后不良的AUC分别为0.642、0.728和0.768,三者联合预测预后不良的AUC分别大于IL-12(Z=3.576,P<0.001)、IL-15(Z=2.770,P=0.006)。结论 外周血单核细胞中IL-12、IL-15及ISG15表达水平在老年冠心病并发肺部感染患者明显上调,此三者联合检测对患者的预后评估具有较好的应用价值。     

The effect of dietary protein intake on coronary heart disease risk

There is cumulative evidence that there is a relationship between diet and coronary heart disease (CHD) risk. The majority of studies have focused on the role of carbohydrate and fat on CHD risk; yet the role of protein has, until recently, been neglected. The effects of dietary protein on modulating CHD risk factors are still unclear. The aim of this review is to summarise available data from epidemiological and randomised control trials on the effects of animal and vegetable protein intake on markers of CHD risk; that is, obesity, hyperlipidaemia, glucose intolerance, diabetes and hypertension. Regarding the management of body weight, reviewed data suggest that there is no convincing evidence that higher protein (HP) diets enhance weight loss compared with low protein (LP) diets, but there is some evidence that HP diets may lead to better weight maintenance. Moreover, HP diets seem to have a more favourable effect on triglyceride levels than LP diets, but on the other hand, there is no convincing evidence that there is a significant beneficial effect on total and low‐density lipoprotein cholesterol levels. In the literature, there is also a concern that higher protein intakes may increase blood glucose levels and may aggravate glycaemic control. Currently, data suggest that HP diets may have a favourable effect on postprandial glucose and glycated haemoglobin levels, whereas there is no convincing evidence on their effects on fasting glucose and insulin levels. There has also been concern that higher protein intakes may increase arterial blood pressure because of higher levels of sodium in protein‐rich foods. The data we reviewed suggest that HP diets may be more beneficial in ameliorating hypertension than LP diets. Finally, the effect of a higher protein intake on kidney function has been debated.     

脑钠肽对血液透析患者心功能不全及／或高血容量负荷的诊断价值

目的 观察脑钠肽（BNP）对血液透析患者透析前后血浆浓度的变化并评价其对心功能不全及，或高血容量负荷的诊断价值。方法 检测66例维持性血液透析患者（MHD组）透析前后血浆BNP水平，同时应用彩色多普勒超声心动图测定透析前及透析后的心脏结构，测量下腔静脉宽度，记录当次透析脱水量。与健康对照者32例（健康对照组）进行比较。结果 （1）MHD组透析后及透析前BNP均较健康对照组显著增高，与透析前及透析后左室舒张末期内径、左室收缩期内径呈正相关（P〈0．05）。MHD组透析前与透析后血浆BNP的减少之比与透析前及透析后平均下腔静脉宽度的减少之比呈正相关（P〈0．01），与体重减少之比呈正相关（P〈0．05）。透析前存在慢性心功能不全者及左心扩大者，BNP水平显著增高。结论 血液透析患者血浆BNP水平较对照组显著增高。左室内径的增大、心功能的减退、高血容量负荷可导致血浆BNP的增高，透析后BNP水平下降。血浆BNP水平在一定程度上反映了血液透析患者心功能和／或体内血容量的变化，是一个无创和敏感的指标。     

慢性乙型肝炎患者外周血单个核细胞中STING基因表达与HBV DNA载量的关系

目的观察慢性乙型肝炎(CHB)患者外周血单个核细胞干扰素刺激基因(STING)和I型干扰素(IFN)α、βmRNA的表达,及其与乙型肝炎病毒载量之间的关系。方法选择2016年2月—2017年2月在武汉大学人民医院感染科未经治疗的CHB患者88例(CHB组),以及同期进行体检的健康者74例(对照组),通过实时荧光定量PCR检测STING,IFN-α和IFN-βmRNA表达,用2~(-ΔΔCT)的方法计算相对表达量,并对计算结果进行统计学分析。结果CHB组患者外周血中STING,IFN-α和IFN-βmRNA的表达分别是健康对照组的2.95、3.14、2.01倍,两组间比较差异均有统计学意义(t值分别为-4.72,-3.41,-2.31,均P0.05);CHB患者STING相对表达量HBV DNA病毒载量≤10~(4 )IU/mL组分别是HBV DNA病毒载量10~4~10~(5 )IU/mL组、10~5~10~(6 )IU/mL组和10~(6 )IU/mL组的2.98、3.76、3.97倍,差异有统计学意义(P0.05);CHB组患者STING与IFN-α、IFN-βmR-NA表达呈正相关性(r值分别为0.475、0.503,均P0.05)。结论CHB患者体内STING表达升高,且STING高表达影响HBV复制。     

Fasting induces changes in peripheral blood mononuclear cell gene expression profiles related to increases in fatty acid beta-oxidation: functional role of peroxisome proliferator activated receptor alpha in human peripheral blood mononuclear cells

BACKGROUND: Peripheral blood mononuclear cells (PBMCs) are the only readily available cells in healthy humans. Various studies showed disease-characteristic gene expression patterns in PBMCs. However, little is known of nutritional effects on PBMC gene expression patterns. Fatty acids are nutrients that regulate gene expression by activating the nuclear receptor peroxisome proliferator-activated receptor alpha (PPARalpha). PBMCs express PPARalpha, making these cells interesting to study FA-dependent gene expression. OBJECTIVE: The aim of this study was to elucidate whether PBMC gene expression profiles also reflect nutrition-related metabolic changes. Furthermore, we focused on the specific role of PPARalpha in regulation of PBMC gene expression during fasting, when plasma free fatty acids are elevated. DESIGN: Four healthy male volunteers fasted for 48 h. PBMC RNA was hybridized on Affymetrix whole genome microarrays. To elucidate the role of PPARalpha, PBMCs of 9 blood donors were incubated with the specific PPARalpha ligand Wy14643. RESULTS: After 24 and 48 h of fasting, 1200 and 1386 genes were changed >1.4-fold, respectively. Many of those genes were involved in fatty acid beta-oxidation and are known PPARalpha target genes. Incubation of PBMCs with Wy14643 resulted in up-regulation of genes that were also up-regulated during fasting. CONCLUSIONS: We conclude that PBMC gene expression profiles reflect nutrition-related metabolic changes such as fasting and that part of the fasting-induced changes are likely regulated by PPARalpha.     

Distinct gene expression profiles in peripheral blood mononuclear cells from patients infected with vaccinia virus, yellow fever 17D virus, or upper respiratory infections

Gene expression in human peripheral blood mononuclear cells was systematically evaluated following smallpox and yellow fever vaccination, and naturally occurring upper respiratory infection (URI). All three infections were characterized by the induction of many interferon stimulated genes, as well as enhanced expression of genes involved in proteolysis and antigen presentation. Vaccinia infection was also characterized by a distinct expression signature composed of up-regulation of monocyte response genes, with repression of genes expressed by B and T-cells. In contrast, the yellow fever host response was characterized by a suppression of ribosomal and translation factors, distinguishing this infection from vaccinia and URI. No significant URI-specific signature was observed, perhaps reflecting greater heterogeneity in the study population and etiological agents. Taken together, these data suggest that specific host gene expression signatures may be identified that distinguish one or a small number of virus agents.     

慢性阻塞性肺疾病前驱性呼吸衰竭患者细胞因子的改变

目的　探讨慢性阻塞性肺疾病 (COPD)前驱性呼吸衰竭 (前驱呼衰 )患者细胞因子谱特征 ,并评价界定COPD前驱呼衰的临床意义。方法　随机选取健康对照者、COPD尚未达前驱呼衰患者、COPD前驱呼衰患者各 30例 ,用双抗体夹心酶联免疫吸附法 (ELISA)测定其外周血单个核细胞经植物血凝素刺激培养后的白细胞介素 4 (IL - 4 )、白细胞介素 8(IL - 8)、γ干扰素 (IFN -γ)的水平。结果　在正常对照、COPD未达前驱呼衰和COPD前驱呼衰三组人群中 ,IL - 8水平依次显著升高 ,其中后组与前两组相比较 ,P均 <0 .0 1,前两组比较P =0 .0 2 1;IFN -γ水平依次显著升高 ,其中后组与前两组相比较 ,P均 <0 .0 1,前两组比较亦为P <0 .0 1;IL - 4水平在三组人群中无统计学差异。结论　 (1)IL - 8和IFN -γ在COPD气道炎症的发生发展和气流阻塞中起着重要作用 ,可作为判断病情严重程度的指标。 (2 )界定COPD前驱呼衰阶段具有一定的临床意义 ,加强上述指标的监测有助于及时判断病情并采取措施。     

Expressions of interferon-stimulated genes in peripheral blood mononuclear cells from patients with secondary syphilis

BackgroundSyphilis is a sexually transmitted disease that threatens human health worldwide. However, the immune regulation cascade caused by treponemia pallidum (TP) infection remains still largely unclear.MethodsTo investigate the expression of ISGs in secondary syphilis (SS), we recruited 64 patients with SS and equal number of healthy participants to obtain their peripheral blood mononuclear cells (PBMCs). qRT-PCR was performed to estimate the expression of interferon-stimulated genes (ISGs) including CXCL10, OAS3, OAS1, MX1, IFIT3, IFIT2, IFI6 and AIM2. Receiver-operating characteristic (ROC) analysis was adapted to diagnostic value of these genes to distinguish healthy controls and patients with SS.ResultsISGs including CXCL10, OAS3, OAS1, MX1, IFIT3, IFIT2, IFI6 and AIM2 were all upregulated in PBMCs of patients with SS. Area under the ROC curve (AUC) of the 8 ISGs were all more than 0.5. IFIT3 exhibited the highest diagnostic value, followed by AIM2, IFIT2 and CXCL10, according to the Yoden Index.ConclusionISGs including CXCL10, OAS3, OAS1, MX1, IFIT3, IFIT2, IFI6 and AIM2 were upregulated in patients with SS and they have diagnostic value for syphilis.     

外周血内脂素水平检测对冠状动脉粥样硬化性心脏病的临床应用价值

目的 检测冠状动脉粥样硬化性心脏病(冠心病)患者外周血内脂素水平,探讨内脂素水平与冠心病病变程度的关系.方法 收集2011年1-6月住院并行冠状动脉造影检查确诊为冠心病的患者220例(冠心病组),其中稳定型心绞痛74例(稳定型心绞痛组),不稳定型心绞痛60例(不稳定型心绞痛组),急性心肌梗死86例(心肌梗死组),选取健康体检的冠状动脉造影正常者20例作为对照组.采用全自动生化仪检测各组血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等相关生化指标.采用酶联免疫吸附双抗体夹心法检测血清内脂素水平.比较各组血清生化指标与内脂素水平,分析血清内脂素水平与各生化指标的相关性.结果 冠心病组血清内脂素水平为(34.07±5.51)μg/L,显著高于对照组的(13.22±3.17)μg/L(P＜0.05).不同类型冠心病组血清TC、LDL-C与对照组比较差异无统计学意义(P＞0.05).稳定型心绞痛组、不稳定型心绞痛组、心肌梗死组血清TG、HDL-C、内脂素水平[(1.44±0.27) mmol/L、(1.16±0.12) mmol/L、(21.36±3.35)μg/L,(1.84±0.32) mmol/L、(1.01±0.08) mmol/L、(27.78±447)μg/L,(2.31±0.34) mmol/L、(0.93±0.06) mmol/L、(33.14±5.66)μg/L]与对照组[(0.93±0.25)mmol/L、( 1.48±0.24) mmol/L、( 13.22±3.17)μg/L]比较差异有统计学意义(P＜0.05或＜0.01).不稳定型心绞痛组和心肌梗死组血清TG、Gensini积分、血清内脂素水平明显高于稳定型心绞痛组,血清HDL-C明显低于稳定型心绞痛组,差异有统计学意义(P＜0.05).心肌梗死组Gensini积分、血清内脂素水平明显高于不稳定型心绞痛组,血清HDL-C明显低于不稳定型心绞痛组,差异有统计学意义(P＜0.05).Spearman相关分析显示冠心病组的血清内脂紊水平与TG和Gensini积分呈正相关(P＜0.05或＜ 0.01),与HDL-C呈负相关(P＜ 0.01),与TC和LDL-C无相关性(P＞0.05).结论 外周血内脂素水平的升高可能是冠心病的一个危险因素,其水平的变化可以较好地反映冠状动脉病变的严重程度.     

冠心病患者外周血脑钠肽及单核细胞趋化蛋白-1的变化及其临床意义

目的 观察不同类型冠心病患者外周血脑钠肽(BNP)及单核细胞趋化蛋白-1(MCP-1)的水平变化,探讨BNP、MCP-1与冠心病发生、发展的关系. 方法 选择74例人院时初步诊断为冠心病且入院后行冠状动脉造影的患者,其中最后诊断为急性心肌梗死(AMI)20例(AMI组),不稳定型心绞痛(UA)18例(UA组),稳定型心绞痛(SA)19例(SA组),17例经冠状动脉造影证实为无冠心病者作为对照组.采用ELISA法测定各组外周血BNP、MCP-1水平. 结果 (1)AMI组、UA组MCP-1、BNP水平均显著高于SA组和对照组.(2)AMI组BNP水平明显高于UA组,而MCP-1水平与UA组比较差异无统计学意义.(3)AMI组和UA组患者冠状动脉狭窄积分与BNP水平呈正相关(r=0.716,P＜0.01),而与MCP-1水平无相关性,并且BNP水平与MCP-1水平呈正相关(r=0.625,P＜0.01). 结论 冠心病患者外周血BNP、MCP-1水平升高.AMI、UA患者BNP与MCP-1水平升高可能提示斑块不稳定.AMI、UA患者BNP与MCP-1水平明显相关提示两者可能通过不同的方面反映了斑块的不稳定性.联合检测BNP、MCP-1水平,对冠心病患者进行危险分层,能更有效地预测急性冠状动脉事件的发生.     

Peripheral blood mononuclear cell fatty acid composition and inflammatory mediator production in adult Crohn's disease

BACKGROUND & AIMS: Crohn's disease (CD) is associated with nutritional deficiencies, altered plasma concentrations of polyunsaturated fatty acids (PUFA) and an anti-inflammatory response to fish oil that contains n-3 PUFA. This suggests that, in CD, immune cells may have altered n-3 PUFA composition with functional consequences. The aim of this study is to investigate n-3 and n-6 PUFA composition and synthetic function of peripheral blood mononuclear cells (PBMC) in the basal state. METHODS: A case control study of 52 adult CD patients and healthy, age- and sex-matched controls. Composition of PBMC and plasma phospholipids were measured by gas chromatography and production of tumour necrosis factor-alpha, prostaglandin E2 (PGE2) and interferon-gamma (IFN-gamma) by PBMC were measured by ELISA. RESULTS: CD was associated with higher concentrations of eicosapentaenoic acid and other n-3 PUFA, and lower arachidonic acid (AA) (n-6 PUFA) in PBMC. This was not explained by differences in dietary fat intake. Lower rates of production of PGE2 and IFN-gamma by PBMC were noted in quiescent and active CD, respectively, compared to controls. CONCLUSIONS: CD is associated with a greater availability, and not a deficiency, of n-3 PUFA in PBMC, but lower concentrations of AA, and lower rates of production of PGE2 and IFN-gamma, compared to healthy controls.     

外周血单核细胞表达Nod样受体蛋白炎症小体与冠状动脉病变程度的相关性

目的探讨Nod样受体蛋白(NLRP3)炎症小体对冠状动脉病变程度的预测价值,为NLRP3的临床应用提供依据。方法以行选择性冠状动脉造影检查的428例住院患者为研究对象,分离人外周血单个核细胞,以免疫印迹法(Western blotting)定量测定NLRP3水平,测定甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、载脂蛋白A1(Apo A1)和载脂蛋白B(Apo B)水平。根据冠脉造影结果,采用Gensini评分系统进行定量评分,将研究对象分为正常组(157例)、轻度病变组(137例)、中度病变组(70例)和重度病变组(64例),观察冠状动脉病变严重程度与NLRP3水平的关系。结果 NLRP3表达水平随冠状动脉病变严重程度增加而升高,HDL水平随冠状动脉病变严重程度增加而降低,差异均有统计学意义(F值分别为35.431和4.812,P0.01)。4组间TG、TC、LDL、Apo A1和Apo B水平差异均无统计学意义(P0.05)。对NLRP3与Gensini评分值进行偏相关分析(偏相关系数为0.347)及逐步回归分析(回归系数为0.408),均有统计学意义(P0.01)。结论 NLRP3的表达能够预测动脉粥样硬化病变严重程度。     

杂色曲霉素对人外周血单个核细胞表面HLA-Ⅰ分子表达的影响

目的探讨杂色曲霉素(ST)对体外培养的人外周血单个核细胞表面(HPBMc)HLAⅠ分子表达的影响。方法采用流式细胞定量术(FCM)和免疫印迹(Westernblot)分析方法,研究不同浓度ST(0.125、0.25、0.5、1和2mgL)处理后人外周血单个核细胞表面HLAⅠ分子表达的变化。结果FCM定量分析结果表明,经不同浓度ST处理24小时后,与对照组相比,各组细胞HLAⅠ的平均荧光强度均降低,以较高浓度(0.5、1和2mgL)ST处理组降低更明显(P<0.05)。在0.125mgL到2mgL的浓度范围内,随ST处理浓度的升高,HLAⅠ荧光指数逐渐降低,两者呈明显的负相关(r=-0.841,P<0.01)。免疫印迹结果也表明,随ST浓度的增高,HLAⅠ分子降低越明显。结论提示在0.125mgL到2mgL的浓度范围内,ST抑制人外周血单个核细胞表面HLAⅠ分子的表达呈现出负的剂量-反应关系。     

军团菌体外刺激对人PBMC TLR2 mRNA表达影响

目的探讨嗜肺军团菌活菌刺激对人外周血单个核细胞(PBMC)表达TLR2 mRNA的影响。方法采用不同浓度的嗜肺军团菌活菌悬液刺激体外培养的健康人PBMC,收集细胞运用RT-PCR方法测定TLR2 mRNA的表达水平。结果析因分析结果显示,时间的主效应有统计学意义(F=26.06,P<0.05);时间与浓度的交互作用有统计学意义(F=11.39,P<0.05);24 h时,MOI 1、MOI 10刺激组TLR2 mRNA的表达量均高于对照组(P<0.05),呈现随菌液浓度升高表达量也逐渐升高,48 h时,各组之间TLR2 mRNA的表达量差异虽无统计学意义(P>0.05),但表达量随浓度升高呈现下降趋势,72 h时,各组之间TLR2 mRNA的表达量差异有统计学意义(P<0.05),但随菌液浓度升高表达量反而降低。结论用军团菌体外刺激人PBMC,其TLR2 mRNA的表达在一定范围内呈一定的时效与量效关系,可为今后的研究提供有益的时间和剂量参考。