Physical Activity, Inflammation, and Muscle Loss

Sarcopenia is the degenerative loss of skeletal muscle that occurs naturally in individuals as they age. Although many factors underlie sarcopenia, epidemio-logical and experimental evidence suggests that low-grade chronic inflammation is an important contributor to its progression. Still, few healthcare professionals have a clear understanding of the profound effects of cytokines on sarcopenia, or how these effects may be counteracted. Interestingly, mounting evidence suggests that along with good diet and vitamin supplementation, this muscle damage can be mitigated with regular physical activity. Without a doubt, exercise is an intervention that reliably counteracts the loss of muscle mass, strength, and power common in our increasingly aged, and pervasively sedentary, population.     

Sleep and Inflammation

Among adults in the United States, sleep durations appear to have decreased in recent years. Inadequate sleep and sleep deprivation cause numerous neurobe-havioral and physiological changes. A number of recent studies have reported associations between disrupted sleep/sleep deprivation and inflammatory responses, although the physiological mechanisms underlying these relationships remain unclear. Alterations in sleep due to lifestyle factors, the aging process, and disease states have all been associated with increases in a range of inflammatory markers. Several of these inflammatory processes have been associated with reduced health status (e.g., C-reactive protein and cardiovascular disease). Thus, maintaining adequate sleep duration and quality through good sleep habits and treatment of sleep disorders may reduce inflammatory processes associated with aging and increase the wellness phenotype.     

潜艇舱室环境中有害气体对肺组织的慢性损伤

在潜艇舱室复杂的气体环境下,有害气体可能刺激气管上皮细胞并损伤肺血管内皮细胞,引起肺组织慢性炎症反应以及氧化与抗氧化功能失衡。肺组织内氧自由基增多与炎症反应相互作用,引起血液和肺组织中超氧化物歧化酶（superoxide dismutase,SOD）、血管内皮素-1（endothelin-1,ET-1）和一氧化氮含量变化,并产生大量炎性细胞以及肿瘤坏死因子-α（ tumor necrosis factor-α, TNF-α ）、白介素一6（interleukin-6,IL-6）等炎性介质浸润肺组织。这些炎症反应可以导致气管壁的损伤修复过程反复发生,引起气管结构重塑,还可以损伤肺血管,使肺血管平滑肌增生,肺血管阻力增加,形成肺动脉高压,同时,长期炎症反应还可导致肺实质的纤维化,进一步影响肺功能。     

Second-Trimester Constituents of the Metabolic Syndrome and Pregnancy Outcome: An Observational Cohort Study

Background: Gestational diabetes mellitus (GDM) increases the risk of type 2 diabetes mellitus and cardiovascular disease (CVD) in women in later life. In the general population, metabolic syndrome (MetS) shows identical associations. The aim of this study was to evaluate the association between GDM, constituents of MetS and pregnancy outcomes. Methods: Of 2041 pregnant women undergoing an oral glucose tolerance test (OGTT) between 22 and 30 weeks of gestation, data were collected to evaluate the constituents of MetS. Odds ratios (ORs) were calculated to determine the associations between MetS and pregnancy outcomes. Results: GDM and obesity did not affect the risk of fetal growth abnormalities (SGA/LGA), preterm birth or preeclampsia (PE). Hypertension significantly increased the risk of SGA (OR—1.59), PE (OR—3.14), and preterm birth <37 weeks (OR—2.17) and <34 weeks (OR—2.96) and reduced the occurrence of LGA (OR—0.46). Dyslipidemia increased the risk of PE (OR—2.25), while proteinuria increased the risk of PE (OR—12.64) and preterm birth (OR—4.72). Having ≥2 constituents increased the risk of PE and preterm birth. Conclusions: Constituents of metabolic syndrome, rather than treating impaired glucose handling, increased the risk of preeclampsia, altered fetal growth and preterm birth. Obesity was not related to adverse outcomes.     

老年慢性阻塞性肺疾病急性加重期患者IL-8、IL-6、TNF-α水平变化与肺功能的相关性研究

目的探讨老年慢性阻塞性肺疾病急性加重期(AECOPD)患者IL-8、IL-6、TNF-α水平变化和肺功能的相关性。方法选取我院收治的AECOPD患者78例。分别于患者急性加重期和稳定期检测其血清IL-8、IL-6、TNF-α水平以及肺功能。对比不同肺功能综合评估分级的患者IL-8、IL-6、TNF-α的水平,同时对比急性加重期和稳定期患者IL-8、IL-6、TNF-α和FEV1%预计值的检测结果,并分析IL-8、IL-6、TNF-α与FEV1%预计值的相关性。结果肺功能综合评估分级级别越高,其IL-8、IL-6和TNF-α的水平显著增高(p<0.05);COPD急性加重期及稳定期患者的IL-8、IL-6、TNF-α水平和FEV1%预计值水平均呈负相关(p<0.05)。结论老年AECOPD患者IL-8、IL-6和TNF-α水平和FEV1%预计值呈负相关,检测IL-8、IL-6和TNF-α的水平可反应出患者病情的严重程度,有助于临床评估患者的病情,指导临床治疗。     

IL和TNF—α与急性下呼吸道感染的关系

目的 探讨白细胞介素－2（IL－2），白细胞介素－6（IL－6），白细胞介素－8（IL－8）和肿瘤坏死因子－α（TNF－α）在急性呼吸道感染发病机制中的作用。方法 选择以急性呼吸道感染入院的30例患并按临床表现分为重症组和轻症组。采用放射免疫法（RIA）分别检测急性感染期和痊愈期血清IL－2，IL－6，IL－8和TNF－α水平，并以30例健康人血清中IL－2，IL－6，IL－8和TNF－α水平作为对照。结果 30例急性呼吸道感染患血清IL－6，IL－8和TNF－α水平显高于健康对照组（P＜0．01），并与病情的轻重有关，而IL－2水平明显低于对照组（P＜0．01），但轻症组和重症组间差异无显性（P＞0．05）。结论 血清IL－2，IL－6，IL－8和TNF－α可能与呼吸道急性感染时的发病机理，疾病的严重程度和预后有关。     

Maternal Obesity in Twin Pregnancy: The Role of Nutrition to Reduce Maternal and Fetal Complications

There are more and more obese mothers with twin gestations. For a long time before, the responses of lymphocytes and platelets in obese women can cause a low-grade inflammation. In addition, a proper control of gestational weight gain would improve the outcomes in mothers with high pre-gestational body mass index (BMI). In women with high pre-gestational BMI and twin pregnancy, our aims were to explore the biochemical and hematological parameters and to study the rate of obstetric adverse outcomes. This was an observational and retrospective study conducted in the Hospital Universitario La Paz (Madrid, Spain). We included 20 twin pregnancies as the lean group (BMI = 18.5–24.9 kg/m²), homogeneous in the maternal age and ethnicity, and having parity with other 20 twin pregnancies as the obese group (BMI ≥ 30 kg/m²). The maternal data and maternal, fetal, obstetric, and neonatal complications were collected from the medical records. In the first and third trimester of pregnancy, the biochemical and hematological parameters of the blood were assayed. In this cohort, gestational weight gain was significantly lower in the obese than lean group. In the first trimester, the hemoglobin levels in obese women (12.1 ± 0.8 g/dL) were lower than lean women (12.6 ± 0.7 g/dL; p-Value = 0.048). In addition, the tendency of glucose levels, TSH levels and platelets was to increase in obese compared to lean women. In the third trimester, the TSH levels were higher in obese (3.30 ± 1.60 mUI/L) than lean women (1.70 ± 1.00 mUI/L; p-Value = 0.009). Furthermore, there was a tendency for levels of platelets and lymphocytes to increase in obese compared to lean women. No significant differences were detected in the rate of maternal, fetal, obstetrical, and neonatal complications between the groups. The hemoglobin, platelets, lymphocytes and TSH levels need further investigation to understand potential subclinical inflammation in obese women. Furthermore, obese women with twin pregnancies should follow-up with a specialist nutritionist, to help them control their gestational weight gain with appropriate dietary measures.     

Effects of a Low Dose of Fish Oil on Inflammatory Markers of Brazilian HIV-Infected Adults on Antiretroviral Therapy: A Randomized,Parallel, Placebo-Controlled Trial

Background: The benefits of antiretroviral therapy for HIV-infected subjects have been limited by an increased risk of metabolic and cardiovascular diseases. The objective of this study was to assess the effects of a low dose of marine omega-3 fatty acids on inflammatory marker concentrations in HIV-infected subjects under antiretroviral therapy (ART). Methods: This was a randomized, parallel, placebo-controlled trial that investigated the effects of 3 g fish oil/day (540 mg of eicosapentaenoic acid—EPA plus 360 mg of docosahexaenoic acid—DHA) or 3 g soy oil/day (placebo) for 24 weeks in 83 male and non-pregnant female HIV-infected adults on ART. Results: There were no differences between groups for the measures at baseline. Multilevel analyses revealed no statistically significant relationship between the longitudinal changes in high sensitivity-C reactive protein (hs-CRP) (Wald Chi2 = 0.17, p = 0.918), fibrinogen (Wald Chi2 = 3.82, p = 0.148), and factor VIII (Wald Chi2 = 5.25, p = 0.073) with fish oil. No significant changes in interleukin-6 (IL6), interleukin-1 beta (IL1-beta) and tumor necrosis factor-alpha (TNF-alpha) serum concentrations were observed with fish oil supplements for 12 weeks. Conclusions: Compared to placebo, a low dose of 900 mg omega-3 fatty acids (EPA plus DHA) in fish oil capsules did not change hs-CRP, fibrinogen, factor VIII, IL6, IL1-beta and TNF-alpha serum concentrations in HIV-infected subjects on ART. Further investigations should consider the assessment of more sensitive inflammatory markers or higher doses to evaluate the effects of marine omega-3 fatty acids in this population. Registered at the Nederlands Trial Register, Identifier no. NTR1798.     

Enhancement of HIV-1 DNA vaccine immunogenicity by BCG-PSN,a novel adjuvant

Although the importance of DNA vaccines, especially as a priming immunization has been well established in numerous HIV vaccine studies, the immunogenictiy of DNA vaccines is generally moderate. Novel adjuvant is in urgent need for improving the immunogenicity of DNA vaccine. Polysaccharide and nucleic acid fraction extracted by hot phenol method from Mycobacterium bovis bacillus Calmette-Guérin, known as BCG-PSN, is a widely used immunomodulatory product in China clinical practice. In this study, we evaluated whether the BCG-PSN could serve as a novel adjuvant of DNA vaccine to trigger better cellular and humoral immune responses against the HIV-1 Env antigen in Balb/C mouse model. The BCG-PSN was mixed with 10 μg or 100 μg of pDRVI1.0gp145 (HIV-1 CN54 gp145 gene) DNA vaccine and intramuscularly immunized two or three times. We found that BCG-PSN could significantly improve the immunogenicity of DNA vaccine when co-administered with DNA vaccine. Further, at the same vaccination schedule, BCG-PSN co-immunization with 10 μg DNA vaccine could elicit cellular and humoral immune responses which were comparable to that induced by 100 μg DNA vaccine alone. Moreover, our results demonstrate that BCG-PSN can activate TLR signaling pathways and induce Th1-type cytokines secretion. These findings suggest that BCG-PSN can serve as a novel and effective adjuvant for DNA vaccination.     

An Overview of Obesity,Cholesterol, and Systemic Inflammation in Preeclampsia

Preeclampsia (PE), an inflammatory state during pregnancy, is a significant cause of maternal and fetal morbidity and mortality. Adverse outcomes associated with PE include hypertension, proteinuria, uterine/placental abnormalities, fetal growth restriction, and pre-term birth. Women with obesity have an increased risk of developing PE likely due to impaired placental development from altered metabolic homeostasis. Inflammatory cytokines from maternal adipose tissue and circulating cholesterol have been linked to systemic inflammation, hypertension, and other adverse outcomes associated with PE. This review will summarize the current knowledge on the role of nutrients, obesity, and cholesterol signaling in PE with an emphasis on findings from preclinical models.     

血清炎症因子检测对早产的预测效果及机制

目的：探讨血清基质金属蛋白酶-3（MMP-3）、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）和核因子NF-κB水平对早产的预测效果。方法回顾性分析2010年1月至2013年1月广州市妇女儿童医疗中心收治的66例早产产妇临床资料,同时选取同期在该院正常分娩的66例产妇作为对照组。采用酶联免疫吸附试验（ELISA）检测两组孕妇的MMP-3、TNF-α、IL-6和核因子NF-κB水平。在观察组血清中加入核因子NF-κB抑制剂IkappaB-a后,再检测4种指标水平,并进行统计学分析。结果正常对照组血清TNF-α、MMP-3、IL-6和NF-κB浓度分别为（769．35±113．35） pg/mL、（87．45±52．33） ng/mL、（176．19±68．65）pg/mL和（3．09±1．21）mg/L;加入核因子NF-κB抑制剂IkappaB-a前,观察组血清TNF-α、MMP-3、IL-6和NF-κB浓度分别为（1332．35±346．65）pg/mL、（242．25±72．40）ng/mL、（521．00±105．14）pg/mL和（13．9±4．83）mg/L,两组各指标的水平差异均有统计学意义（t值分别为5．11、4．415、6．671和6．872,均P＜0．05）。加入核因子NF-κB抑制剂IkappaB-a后,观察组4项指标分别为（973．26±213．38）pg/mL、（128．33±78．29）ng/mL、（361．12±101．03）pg/mL 和（8．14±2．86）mg/L,与未加IkappaB-a时观察组各指标比较,差异均具有统计学意义（ t值分别为2．591、5．210、3．992和3．566,均P＜0．05）;与对照组各指标比较,差异也均具有统计学意义（t值分别为4．100、2．588、4．892、和4．456,均P＜0．05）。结论早产孕妇血清MMP-3、TNF-α、IL-6和核因子NF-κB水平明显增高,与早产关系密切,核因子NF-κB具有调控炎症反应的作用,可作为降低早产发生率的干预靶点。     

胰腺脂肪浸润对营养性肥胖大鼠糖代谢影响

目的 探讨胰腺脂肪浸润对营养性肥胖大鼠的胰岛功能及形态影响。方法 刚断乳SD雄性大鼠70只, 随机分为普通饲料组(N组)和高脂饲料组(F组), 18周后成功构建营养性肥胖大鼠模型34只, 将其按体重分为轻度肥胖组(A组, n=11)、中度肥胖组(B组, n=11)、重度肥胖组(C组, n=12)。测空腹胰岛素(FINS)、游离脂肪酸(FFA)、白介素-6(IL-6)、肿瘤坏死因子α(TNFα)、胰腺组织甘油三酯(TG)和胰腺组织病理改变等指标。 计算胰岛素抵抗指数(HOMA-IR)、胰岛素β细胞功能指数(HOMA-β)、早期胰岛素分泌功能指数(ΔI₃₀/ΔG₃₀)及胰岛素曲线下面积(0～120 min)。结果 C组大鼠胰腺TG含量比N组明显增高[(324.52±55.82)μmol/L vs(269.57±50.45)μmol/L, P<0.05)]。与N组相比, B组HOMA-IR显著升高[(2.27±0.31)vs(1.91±0.26), P<0.01];B、C组 的ΔI₃₀/ΔG₃₀明显降低[(8.90±2.23) vs(12.56±3.38), P<0.05;(7.41±2.00) vs(12.56±3.38), P<0.01]。结论 轻中度胰腺脂肪浸润可造成胰岛素早期分泌时相延迟, 出现胰岛素抵抗;而重度胰腺脂肪浸润可致胰岛β细胞损伤。     

Vitamin D Levels in Early and Middle Pregnancy and Preeclampsia,a Systematic Review and Meta-Analysis

Vitamin D (VitD) shows a beneficial role in placentation, the immune system, and angiogenesis, and thus, VitD status may link to the risk of preeclampsia. A meta-analysis was conducted to investigate the association between VitD status in early and middle pregnancy and the risk of preeclampsia. A total of 22 studies with 25,530 participants were included for analysis. Women with VitD insufficiency or deficiency had a higher preeclampsia rate compared to women with replete VitD levels (OR 1.58, 95% CI 1.39–1.79). Women with VitD deficiency had a higher preeclampsia rate compared to women with replete or insufficient VitD levels (OR 1.35, 95% CI 1.10–1.66). Women with insufficient VitD levels had a higher preeclampsia rate compared to women with replete VitD levels (OR 1.44, 95% CI 1.24–1.66). Women with deficient VitD levels had a higher preeclampsia rate compared to women with replete VitD levels (OR 1.50, 95% CI 1.05–2.14). Sensitivity analysis showed the results were stable after excluding any one of the included studies. In conclusion, our systematic review suggested that VitD insufficiency or deficiency was associated with an increased risk of preeclampsia.     

布地奈德对哮喘大鼠肺组织病理改变及TRAF2表达的影响

【目的】 观察哮喘大鼠肺组织病理改变和TRAF2表达的水平,探讨布地奈德治疗哮喘的可能作用机制。 【方法】 采用大鼠哮喘模型,随机分成哮喘组、对照组和布地奈德组,HE染色观察肺组织炎性改变,免疫组织化学法检测肺组织TRAF2的表达。 【结果】 哮喘组大鼠的毛发、体重、活动度等一般情况改变和肺组织炎性改变较对照组有显著变化,布地奈德能明显减轻上述改变。哮喘组(0.317±0.041 OD值)支气管壁TRAF2的光密度值显著高于对照组(0.220±0.057 OD值)(P＜0.01);布地奈德组支气管壁(0.236±0.033 OD值)TRAF2的光密度值显著低于哮喘组(P＜0.01),与对照组相比差异无统计学意义(P>0.05),但肺组织中其表达水平却显著高于哮喘组。 【结论】 哮喘大鼠TRAF2的表达水平增强,它可能参与了哮喘的气道炎症过程;布地奈德能减轻气道炎症,其机制可能是部分通过TRAF2途经。     

Racial, Ethnic, and Economic Disparities in the Prevalence of Pregnancy Complications

Objectives Our objective was to use maternal self-reported data to estimate the prevalence of urinary tract infections, placenta disorders, and preterm rupture of the membranes (PROM) and to explore the association between these complications and race, ethnicity, and economic status. Methods We used data for the years 2000–2002 from the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing survey of women with a recent live birth, to examine the prevalence of and hospitalizations for self-reported urinary tract infections, placenta disorders, and PROM and to investigate differences by maternal race, Hispanic ethnicity, and economic status. Prevalence and hospitalizations were calculated as a percent of the represented population using SUDAAN to account for the sampling design. Results Urinary tract infections were commonly reported, occurring in more than 17% of women during their pregnancy. Placenta disorders and PROM were each reported by approximately 6% of women. Poverty and race had independent effects on each of the pregnancy complications examined. Fewer than half of the women who experienced these pregnancy complications were hospitalized. Conclusions Pregnancy complications are common and not adequately measured by hospitalizations alone. Both more research and improved surveillance are needed to understand the effect of pregnancy complications on women’s health and the reasons for the increased risk among poor or black women.     

孕中期血清脂联素及胰岛素与子痫前期的相关性研究

目的 探讨孕中期血清脂联素(APN)及胰岛素水平与子痫前期(PE)的相关性.方法 随机选择2009年7月至2010年7月在本院接受产前检查的300例单胎孕妇为研究对象,对其妊娠经过及妊娠结局进行随诊.其中,31例孕晚期时发展为PE,被纳入PE组.对PE组患者按照PE病情分度,将重度子痫前期(SPE)患者纳入SPE组(n-18),轻度子痫前期(MPE)患者,纳入MPE组(n-13),将同时纳入研究孕晚期仍正常的单胎妊娠妇女30例纳入对照组.于24～28孕周时,对SPE组、MPE组和对照组受试者采用放射免疫法(RIA)测定血清APN、胰岛素及其他相关指标,并进行相关分析.SPE组、MPE组与对照组,SPE组与MPE组孕妇年龄、孕龄及孕前体重指数(BMI)比较,差异无统计学意义(P＞0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书).结果 ①SPE组、MPE组与对照组血清APN水平呈上升趋势,SPE组较对照组明显降低,差异有统计学意义(P＜0.01);SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).②3组孕妇孕中期空腹血糖(FBG),总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇( LDLC)和高密度脂蛋白胆固醇(HDLC)水平比较,差异均无统计学意义(P＞0.05).③3组孕妇的血清胰岛素比较,SPE组较对照组明显升高,差异有统计学意义(P＜0.01),SPE组与MPE组、MPE组与对照组比较,差异无统计学意义(P＞0.05).④SPE组血清APN与胰岛素呈负相关(r=-0.50,P＜0.01),其他两组血清APN与胰岛素无相关性(r=0.33,r=-0.02;P＞0.05).SPE组血清APN与收缩压、舒张压呈负相关(r=-0.97,r=-0.94;P＜0.01),与TG呈负相关(r=-0.63,P＜0.01),与HDLC 呈正相关(r=0.54,P＜0.05),与TC和LDLC无相关关系(r=0.03,r=0.18;P＞0.05).SPE组血清胰岛素与收缩压呈正相关(r=0.90,P＜0.05),与TC和TG呈正相关(r=0.59,r=0.73;P＜0.01).MPE 组血清APN与TG呈负相关(r=-0.71,P＜0.01),血清胰岛素与TG呈正相关(r=0.58,P＜0.05).结论 孕中期血清低APN及高胰岛素血症与PE密切相关.