Hypomagnesemia in the intensive care unit: Choosing your gastrointestinal prophylaxis,a case report and review of the literature

We report a case of symptomatic hypomagnesaemia in medical intensive care unit that is strongly related to proton pump inhibitors (PPIs) and provide literature review. A 65-year-old male with severe gastroesophageal reflux on omeprazole 20 mg orally twice a day, who presented to the hospital with abdominal pain, nausea, diarrhea, and new onset seizures. On admission, his serum magnesium level was undetectable. Electrocardiogram showed a new right bundle branch block with a prolonged QT interval. The hypomagnesemia was corrected with aggressive magnesium supplementation and hypomagnesemia resolved only after the PPI was stopped. Neurologic and cardiac abnormalities were corrected. This is a life-threatening case of an undetectable magnesium level strongly associated with PPI use. In critically, ill patients with refractory hypomagnesemia, we advocate considering changing gastrointestinal prophylaxis from a PPI to a histamine-receptor blocker.     

The kiwi fruit peptide kissper displays anti‐inflammatory and anti‐oxidant effects in in‐vitro and ex‐vivo human intestinal models

Literature reports describe kiwi fruit as a food with significant effects on human health, including anti‐oxidant and anti‐inflammatory activity. Fresh fruit or raw kiwi fruit extracts have been used so far to investigate these effects, but the molecule(s) responsible for these health‐promoting activities have not yet been identified. Kissper is a kiwi fruit peptide displaying pore‐forming activity in synthetic lipid bilayers, the composition of which is similar to that found in intestinal cells. The objective of this study was to investigate the kissper influence on intestinal inflammation using cultured cells and ex‐vivo tissues from healthy subjects and Crohn's disease (CD) patients. The anti‐oxidant and anti‐inflammatory properties of kissper were tested on Caco‐2 cells and on the colonic mucosa from 23 patients with CD, by challenging with the lipopolysaccharide from Escherichia coli (EC‐LPS) and monitoring the appropriate markers by Western blot and immunofluorescence. EC‐LPS challenge determined an increase in the intracellular concentration of calcium and reactive oxygen species (ROS). The peptide kissper was highly effective in preventing the increase of LPS‐induced ROS levels in both the Caco‐2 cells and CD colonic mucosa. Moreover, it controls the calcium increase, p65‐nuclear factor (NF)‐kB induction and transglutaminase 2 (TG2) activation inflammatory response in Caco‐2 cells and CD colonic mucosa. Kissper efficiently counteracts the oxidative stress and inflammatory response in valuable model systems consisting of intestinal cells and CD colonic mucosa. This study reports the first evidence supporting a possible correlation between some beneficial effects of kiwi fruit and a specific protein molecule rather than generic nutrients.     

Emerging role of interleukin‐33 in autoimmune diseases

Interleukin‐33 (IL‐33) is a member of the IL‐1 cytokine family. It predominantly induces type 2 immune responses and thus is protective against atherosclerosis and nematode infections but contributes to allergic airway inflammation. Interleukin‐33 also plays a pivotal role in the development of many autoimmune diseases through mechanisms that are still not fully understood. In this review, we focus on the recent advances in understanding of the expression and function of IL‐33 in some autoimmune disorders, aiming to provide insight into its potential role in disease development.     

Well‐Defined Imidazolium ABA Triblock Copolymers as Ionic‐Liquid‐Containing Electroactive Membranes

Nitroxide‐mediated polymerization (NMP) affords the synthesis of well‐defined ABA triblock copolymers with polystyrene external blocks and a charged poly(1‐methyl‐3‐(4‐vinylbenzyl)­imidazolium bis(trifluoromethane sulfonyl)imide central block. Aqueous size‐exclusion chromatography (SEC) and ¹H NMR spectroscopy studies confirm the control of the composition and block lengths for both the central and external blocks. Dynamic mechanical analysis (DMA) reveals a room temperature modulus suitable for fabricating these triblock copolymers into electroactive devices in the presence of an added ionic liquid. Dielectric relaxation spectroscopy (DRS) elucidates the ion‐transport properties of the ABA triblock copolymers with varied compositions. The ionic conductivity in these single‐ion conductors exhibits Vogel–Fulcher–Tammann (VFT) and Arrhenius temperature dependences, and electrode polarization (EP) analysis determines the number density of simultaneously conducting ions and their mobility. The actuators derived from these triblock copolymer membranes experience similar actuation speeds at an applied voltage of 4 V DC, as compared with benchmark Nafion membranes. These tailorable ABA block copolymers are promising candidates for ionic‐polymer device applications.