Effect of vitamin D supplementation on reduction of cardiometabolic risk in patients with type 2 diabetes mellitus and dyslipidemia

Endothelial progenitor cells (EPCs) participate in endothelial regeneration. Previous studies link vitamin D deficiency, inflammatory cytokines, and cardiovascular disease (CVD) risk. This study evaluates the impact of vitamin D supplementation on EPCs, inflammatory markers, and glycemia in type 2 diabetes. This is prospective open-label randomized controlled study. Sixty-five patients with type 2 diabetes, dyslipidemia, HbA_1c below 9%, and vitamin D deficiency (below 30 ng/ml) attending the outpatient clinic between April and December 2015 were randomized to active vitamin D (60,000 IU of vitamin D orally once a week for 8 weeks, followed by once a month for 4 months) or control for 6 months. Data was analyzed with STATA 14. Demographics include median age 54 (range 48.5–60) years, median duration of diabetes 7 (4–12.5) years, mean BMI 26.86 ± 3.8 kg/m², mean HbA_1c 7.22±0.8%, and median vitamin D 13.42 (range 10.24–17.23) ng/ml; 50% were men. Vitamin D supplementation increased vitamin D levels in the active group compared to control (p < 0.01). EPCs decreased in both groups from baseline. There was no difference in change in EPCs, hsCRP, IL-6, IL-10, TNF-α, and HbA_1c or insulin resistance (HOMA-IR) between the active- and control-groups at the end of the study. Vitamin D supplementation did not alter EPCs or inflammatory markers, or improve glycemic control at the dose and duration investigated. Further studies are needed to study the long-term effects on markers of endothelial repair.     

Candesartan inhibits Toll-like receptor expression and activity both in vitro and in vivo

IntroductionToll-like receptors play an important role in the innate immune system and are found to be crucial in severe diseases like sepsis, atherosclerosis, and arthritis. TLR2 and TLR4 expression is upregulated in the inflammatory diseases. Angiotensin II in addition to stimulating vasoconstriction also induces an increase in ROS and a proinflammatory phenotype via AT₁R. Angiotensin II type-1 receptor blocker (ARB), widely used as an antihypertensive drug, has been reported to also have anti-inflammatory effects. Thus, we investigated whether an ARB exerts anti-inflammatory effects via inhibiting TLR2 and TLR4 expression.Methods and resultsMonocytes were isolated from healthy human volunteers and treated with the synthetic lipoprotein Pam3CSK4 or LPS in the absence or presence of candesartan. Pretreatment of human monocytes with candesartan significantly decreased Pam3CSK4 or LPS induced TLR2 and TLR4 expression of both mRNA and protein levels (P < 0.05 vs. control) along with decrease in the activity of NF-κB and the expression of IL-1β, IL-6, TNF-α, and MCP-1. Furthermore, candesartan treated mice show decreased TLR2 and TLR4 expression compared to vehicle control mice.ConclusionPam3CSK4 and LPS induced TLR2 and TLR4 expression at mRNA and protein levels are inhibited by candesartan both in vitro and in vivo. Thus, we define a novel pathway by which candesartan could induce anti-inflammatory effects.     

锌指蛋白A20抑制Toll样受体4介导的人单核细胞炎症反应的实验研究

目的:观察锌指蛋白A20过度表达对人单核细胞膜Toll样受体(TLR4),下游促炎因子肿瘤坏死因子-α(TNF-α)与白细胞介素(IL)-12,以及抗炎因子IL-10表达的影响,探讨锌指蛋白A20对单核细胞炎症反应的抑制作用及可能的调节机制。方法:Ficoll细胞分离液分离人外周血单核细胞,随机分为对照组、脂多糖(LPS)组、A20转染组与LPS+A20转染组。荧光显微镜检测GFP报告基因,免疫组织化学检测A20蛋白的表达,RT-PCR检测A20及TLR4的mRNA表达,流式细胞检测技术检测TLR4的蛋白表达,ELISA方法检测上清液TNF-α、IL-12及IL-10表达水平。结果:LPS刺激后,单核细胞TLR4和内源性A20的mRNA和蛋白、TNF-α、IL-12和IL-10表达较对照组均明显升高(均P<0.01);TNF-α/IL-10和IL-12/IL-10均明显高于对照组(均P<0.01);转染A20基因的单核细胞,在无LPS刺激的条件下,上述指标与对照组相比均差异无统计学意义;转染A20基因的单核细胞在LPS刺激后,TLR4mRNA和蛋白、TNF-α、IL-12的表达以及TNF-α/IL-10和IL-12/IL-10均显著低于LPS组,而IL-10的表达明显高于对照组和LPS组(均P<0.01)。结论:TLR4激活介导单核细胞的炎症反应,且正反馈调节其自身受体TLR4和内源性A20的表达;A20参与单核细胞TLR4激活所介导的炎症反应,其表达增加与TLR4表达的增加有关;单纯提高A20表达对未被激活的单核细胞TLR4及其信号通路影响不大;A20过表达可抑制TLR4激活所介导的单核细胞的炎症反应。     

Toll样受体4和单核细胞趋化蛋白1与急性冠状动脉综合征的相关性研究

目的探讨急性冠状动脉综合征(ACS)患者外周血单核细胞Toll样受体4(TLR4)和单核细胞趋化蛋白1(MCP-1)的表达及临床意义。方法入选对象包括ACS组患者50例:经临床及冠状动脉造影检查明确诊断[其中急性心肌梗死(AMI)25例,不稳定型心绞痛(UA)25例];稳定型心绞痛(SA)组患者13例;对照组患者30例:同期住院冠状动脉造影阴性且排除了冠心病诊断。采用流式细胞术检测外周血单核细胞上TLR4的表达,用酶联免疫吸附法检测血清中MCP-1的表达。结果 AMI、UA、SA组和对照组外周血单核细胞上TLR4的表达分别为76.56%±6.32%、73.70%±7.67%、63.20%±6.86%和54.20%±9.34%,ACS组显著高于SA组(P<0.05)和对照组(P<0.01),而SA组又高于对照组(P<0.05);AMI、UA、SA组和对照组血清中MCP-1的表达分别为(161.52±40.30)ng/L、(156.63±34.10)ng/L、(141.32±29.26)ng/L和(125.20±20.75)ng/L,ACS组显著高于SA组(P<0.05)和对照组(P<0.01),而SA组又高于对照组(P<0.05)。ACS组外周血单核细胞上TLR4表达与血清MCP-1水平呈正相关(r=0.876,P<0.01)。结论 TLR4介导的免疫炎症机制参与了冠心病的发生、发展,推测TLR4和MCP-1可能与动脉粥样硬化相关。     

The role of TLR2 in the inflammatory activation of mouse fibroblasts by human antiphospholipid antibodies

Antiphospholipid antibodies (APLAs) promote inflammatory and procoagulant responses in endothelial cells and monocytes. Previous studies have shown that MyD88, TRAF6, and NF-kappaB mediate cell activation by APLAs. These intermediates are also used by toll-like receptors (TLRs). We investigated the role of TLRs in the cellular response to APLAs. IgGs were isolated from the plasma of 5 patients with antiphospholipid syndrome along with immunopurified anti-beta2-glycoprotein 1 IgG from a sixth patient. Control IgG was obtained from a pool of healthy donor plasmas negative for APLAs. Wild-type mouse embryonic fibroblasts (EFs) and EFs deficient in TLR1, TLR2, TLR4, or TLR6 were incubated with APLAs, anti-beta2-glycoprotein 1 IgG, or control IgG. On incubation with the patient IgG, but not control IgG, a significant increase in mRNA levels of the inflammatory marker proteins MCP-1, ICAM-1, and IL-6 as well as IL-6 secretion was observed in wild-type EFs, whereas TLR2-deficient EFs did not respond. Responses in TLR1- and TLR6-deficient EFs were decreased and those in TLR4-deficient EFs comparable to those in wild-type EFs. Overexpression of human TLR2 in the TLR2-deficient EFs restituted the response to patient IgG. Our results imply that TLR2 plays a role in mouse fibroblast activation by APLAs.     

The inflammatory status score including IL-6, TNF-α, osteopontin,fractalkine, MCP-1 and adiponectin underlies whole-body insulin resistance and hyperglycemia in type 2 diabetes mellitus

A state of subclinical systemic inflammation is characteristically present in obesity/insulin resistance and type 2 diabetes mellitus (T2DM). The aim of the study was to develop an integrated measure of the circulating cytokines involved in the subclinical systemic inflammation and evaluate its relation with whole-body insulin sensitivity and glucose metabolism in T2DM. T2DM patients (n = 17, M/F 13/4, age = 55.0 ± 1.7 years, BMI = 33.5 ± 1.5 kg/m², HbA_1c = 7.7 ± 0.3 %) and normal glucose-tolerant (NGT) subjects (n = 15, M/F 7/8, age = 49.1 ± 2.5 years, BMI = 31.8 ± 1.2 kg/m², HbA_1c = 5.6 ± 0.1 %) were studied in a cross-sectional design. Whole-body insulin sensitivity was quantified by the euglycemic clamp. Beta-cell function [disposition index (DI)] was calculated using insulin and glucose values derived from an oral glucose tolerance test and the euglycemic clamp. Body fat mass was evaluated by dual-energy X-ray absorptiometry. Plasma cytokine [TNF-α, IL-6, MCP-1, osteopontin, fractalkine and adiponectin] values were divided into quintiles. A score ranging from 0 (lowest quintile) to 4 (highest quintile) was assigned. The inflammatory score (IS) was the sum of each cytokine score from which adiponectin score was subtracted in each study subject. Inflammatory cytokine levels were all higher in T2DM. IS was higher in T2DM as compared to NGT (10.0 ± 1.1 vs. 4.8 ± 0.8; p < 0.001). IS positively correlated with fasting plasma glucose (r = 0.638, p < 0.001), 1-h plasma glucose (r = 0.483, p = 0.005), 2-h plasma glucose (r = 0.611, p < 0.001) and HbA1c (r = 0.469, p = 0.007). IS was inversely correlated with insulin sensitivity (r = ?0.478, p = 0.006) and DI (r = ?0.523, p = 0.002). IS did not correlate with BMI and body fat mass. IS was an independent predictor of fasting plasma glucose and had a high sensibility and sensitivity to predict insulin resistance (M/I < 4). A state of subclinical inflammation defined and quantifiable by inflammatory score including TNF-α, IL-6, MCP-1, osteopontin, fractalkine and adiponectin is associated with both hyperglycemia and whole-body insulin resistance in T2DM.     

Damaged spermatogenic cells induce inflammatory gene expression in mouse Sertoli cells through the activation of Toll-like receptors 2 and 4

Testicular inflammation, including noninfectious inflammatory responses in the testis, may impair male fertility. Mechanisms underlying the initiation of noninfectious testicular inflammation are poorly understood. In the current study, we demonstrate that damaged spermatogenic cell products (DSCPs) induce expression of various inflammatory mediators, including TNF-α, IL-1β, IL-6, and macrophage chemotactic protein 1 (MCP-1), in Sertoli cells. Notably, the DSCP-induced inflammatory gene expression was significantly reduced by knockout Toll-like receptor (TLR)2 or TLR4, and abolished by double knockout TLR2 and TLR4 (TLR2^−/−TLR4^−/−). MCP-1 secreted by Sertoli cells after stimulation with DSCPs promotes macrophage migration. We also provide evidence that busulfan-induced spermatogenic cell damages in vivo upregulate TNF-α and MCP-1 expression in Sertoli cells, and facilitate macrophage infiltration into the testis in wild-type mice. These phenomena were not observed in TLR2^−/−TLR4^−/− mice. Data indicate that DSCPs induce inflammatory gene expression in Sertoli cells via the activation of TLR2 and TLR4, which may initiate noninfectious inflammatory responses in the testis. The results provide novel insights into the mechanisms underlying damaged spermatogenic cell-induced testicular inflammation.     

CCDC80对巨噬细胞源性泡沫细胞炎症因子表达的影响及机制

目的 探讨卷曲螺旋结合域蛋白80(CCDC80)对THP-1 巨噬细胞源性泡沫细胞炎症因子表达的影响及相关分子机制.方法 体外培养的THP-1 细胞用佛波酯(160 nmol/L)处理,诱导分化为巨噬细胞,然后使用氧化型低密度脂蛋白(50 mg/L)处理使其荷脂形成泡沫细胞,并进行常规细胞体外培养.ELISA 检测细胞...     

间断人工重力在模拟失重所致胸主动脉炎症反应中的对抗作用

目的 观察模拟失重大鼠胸主动脉炎症反应变化以及间断人工重力对抗模拟失重所致变化的作用.方法 采用尾部悬吊方法建立模拟失重大鼠模型,将45只雄性Sprague-Dawley大鼠随机分为3组,每组15只(n=15).即对照(CON)组、4周尾部悬吊(HU)组和1 h/d间断人工重力(IAG)组.建模成功后,分离大鼠胸主动脉...     

变形链球菌对EAhy926细胞Toll样受体2和4及白细胞介素6和8表达的影响

目的 观察变形链球菌对EAhy926细胞Toll样受体2和4的表达及炎性细胞因子白细胞介素6和8分泌的影响,初步探讨Toll样受体表达与细胞因子产生之间的关系.方法 变形链球菌作用于EAhy926细胞,RT-PCR法检测EAhy926细胞Toll样受体2和4及白细胞介素6和8的mRNA表达;流式细胞术检测EAhy926细胞表面Toll样受体2和4的表达;细胞生物活性法和ELISA分别检测EAhy926细胞白细胞介素6和8的分泌;抗体阻断实验观察Toll样受体2和4的表达与白细胞介素6和8产生间的关系.结果 将变形链球菌作用于EAhy926细胞6 h,Toll样受体2和4的mRNA表达与加入的细菌量呈一定的剂量依赖关系,以细菌与细胞作用比例为100:1时,Toll样受体2和4的mRNA表达量最高(P<0.05).变形链球菌能诱导EAhy926细胞(100:1)Toll样受体2和4的mRNA和蛋白水平表达增强,在6 h达到高峰,12 h后又逐渐下降(P<0.01).结论 变形链球菌可上调EAhy926细胞Toll样受体2和4的表达,促进炎性细胞因子白细胞介素6和8的产生;白细胞介素6和8的产生与Toll样受体2和4的表达上调密切相关.     

前列腺素E1改善高糖联合肿瘤坏死因子α损伤肾小球系膜细胞株细胞及机制研究

目的 观察前列腺素E1（PGG）对高糖联合TNF-α诱导的大鼠肾小球系膜细胞株（HBZY-1）损伤的影响及机制.方法 将HBZY-1细胞分为正糖（NG）组、高糖＋TNF-α（HT）组、高糖＋ TNF-α＋不同浓度PGE1（HTP1～5）组,采用MTT法测定细胞增殖,ELISA与RT-PCR法测定细胞上清液中单核细胞趋化蛋白1（MCP-1）、转化生长因子-β1（TGF-β1）以及白介素-6（IL-6）蛋白含量及mRNA表达,细胞免疫荧光法测定核因子-κB p65（NF-κB p65）核转位.结果 高糖联合TNF-α促进HBZY-1增殖,增加MCP-1、TGF-β1蛋白与mRNA,以及IL-6mRNA的表达（P＜0.05）,同时促进NF-κBp65的核转位;1 ng/ml的PGE1可抑制上述作用（P＜0.05）.结论 PGE1通过抑制NF-κB通路来抑制高糖联合TNF-α诱导的HBZY-1增殖,降低MCP-1、TGF-β1蛋白与基因,以及IL-6基因表达.     

IL-1β, IL-6, KC and MCP-1 are elevated in synovial fluid from haemophilic mice with experimentally induced haemarthrosis

Summary.  The hallmark of haemophilia is the joint morbidity resulting from haemarthrosis that accounts for the majority of the bleeds. The exact mechanisms underlying changes are not fully elucidated. Cytokines are speculated to be involved in the progression and in vitro studies have confirmed the presence of elevated levels of cytokines in synovial tissue and cartilage from patients with haemophilic synovitis. In this study, the presence of selected cytokines in synovial fluid from haemophilia A mice with experimentally induced haemarthroses treated with rFVIII, rFVIIa and an rFVIIa analogue were investigated. Ten cytokines previously shown to be involved in arthritic syndromes were evaluated. Interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-10, IL-17, Tumor Necrosis Factor-alpha (TNF- α), keratinocyte-derived chemokine (KC), Regulated upon Activation, Normal T cell Expressed and Secreted (RANTES) and monocyte chemotactic protein-1 (MCP-1) were included. In this article, we demonstrate, for the first time, that bleeding in knee joints of haemophilia A mice resulted in correlated increased levels of the pro-inflammatory cytokines: IL-1β, IL-6, KC and the MCP-1 in synovial fluid. These results suggest an important role of MCP-1 in the recruitment of monocytes and furthermore that the inflamed synovium releases IL-1β, IL-6 and KC, which in turn might contribute to further progression of the inflammatory process.     

Effect of weight loss on cytokine messenger RNA expression in peripheral blood mononuclear cells of obese subjects with the metabolic syndrome

Inflammation is associated with obesity, the metabolic syndrome, and diabetes. No data are available on the effect of weight reduction on the gene expression of cytokines in immune cells in obesity and the metabolic syndrome. We assessed how long-term weight loss affects expression of cytokines in peripheral blood mononuclear cells (PBMCs) in individuals with impaired glucose metabolism and the metabolic syndrome. Data from 34 subjects randomized to either a weight reduction or a control group for a 33-week period were analyzed. The messenger RNA (mRNA) expression of interleukins (ILs) in PBMCs was measured using real-time polymerase chain reaction. Measures of insulin and glucose metabolism (intravenous and oral glucose tolerance tests), body composition, and circulating adipokines and inflammatory markers were also assessed. Weight reduction resulted in a decrease in the mRNA expression of IL-1beta (IL1B), IL-1 receptor antagonist, and tumor necrosis factor alpha (P < .001) and an increase in expression of IL-6 (IL6) and IL-8 (P < .01). The increase in IL6 expression was associated with a decrease in fasting glycemia (r = -0.53, P < .01). Interestingly, the decrease in IL1B expression was correlated with an increase in insulin sensitivity index (r = -0.68, P < .01). In general, a decrease in circulating levels of adipokines and inflammatory markers was also observed after weight loss. Weight loss altered gene expression of cytokines related to inflammation and the immune response in PBMCs. Changes in IL6 mRNA expression were associated with changes in fasting glycemia. The decrease in IL-1 receptor antagonist expression after weight loss and the strong correlation between the decrease in IL1B expression and the increase in insulin sensitivity suggest a contribution of these genes to insulin-resistant states found in obesity and the metabolic syndrome.