Expression of adrenomedullin in adipose tissue of lean and obese women

OBJECTIVE: Adrenomedullin (AM), a potent vasodilatator and antioxidative peptide, was shown recently to be expressed by adipose tissue. The aim of our study was to investigate the precise localization of AM within human adipose tissue, and to examine AM regulation in obesity. DESIGN: Subcutaneous (SC) and omental (OM) adipose tissues from 9 lean and 13 obese women were profiled for AM expression changes. Preadipocytes from human adipose tissue were isolated and differentiated under defined adipogenic conditions. METHODS: AM expression was analyzed by immunohistochemistry, in situ hybridization and quantitative RT-PCR. RESULTS: A strong AM expression was observed in vessel walls, stromal cell clusters and isolated stromal cells, some of them being CD 68 positive, whereas mature adipocytes were not labeled. Calcitonin receptor-like receptor and receptor activity-modifying proteins (RAMP) 2 and RAMP 3 were expressed in vessel walls. In vitro, preadipocytes of early differentiation stages spontaneously secreted AM. No difference in AM localization was found between SC and OM adipose tissue. AM levels in SC tissue did not differ between lean and obese subjects. By contrast, AM levels in OM tissue were significantly higher in obese as compared with lean women. Moreover, we found a positive relationship between OM AM and tumor necrosis factor alpha mRNA levels and AM-immunoreactive area in OM tissue followed the features of the metabolic syndrome. CONCLUSION: Stromal cells from human adipose tissue, including macrophages, produce AM. Its synthesis increased in the OM territory during obesity and paralleled the features of the metabolic syndrome. Therefore, AM should be considered as a new member of the adipokine family.     

Complex basilar artery fenestration aneurysm successfully treated with single flow diverter using novel “crossing flow diverter technique” – A rare case report and review of literature

Basilar artery fenestration aneurysms are very rare and endovascular management of large and complex aneurysms is extremely challenging. Most of these type of cases are managed with stent assisted coiling, dual flow diverters (FD) and single FD with additional coiling of aneurysm and occlusion of one of the vertebral artery. Here, we report a case of large complex basilar artery fenestration aneurysm successfully treated with single FD using novel technique called “crossing flow diverter technique” without any additional coiling of aneurysm or occlusion of vertebral artery. Using this technique cost of procedure and procedural complexity inherent with other above mentioned techniques can be significantly reduced.     

Helicobacter pylori stimulates inducible nitric oxide synthase expression and activity in a murine macrophage cell line

BACKGROUND & AIMS: Helicobacter pylori uniquely colonizes the human stomach and produces gastric mucosal inflammation. High-output nitric oxide production by inducible nitric oxide synthase (iNOS) is associated with immune activation and tissue injury. Because mononuclear cells comprise a major part of the cellular inflammatory response to H. pylori infection, the ability of H. pylori to induce iNOS in macrophages was assessed. METHODS: H. pylori preparations were added to RAW 264.7 murine macrophages, and iNOS expression was assessed by Northern blot analysis, enzyme activity assay, and NO2- release. RESULTS: Both whole H. pylori and French press lysates induced concentration-dependent NO2- production, with peak levels 20-fold above control. These findings were paralleled by marked increases in iNOS messenger RNA and enzyme activity levels. iNOS expression was synergistically increased with interferon gamma, indicating that the H. pylori effect can be amplified by other macrophage-activating factors. Studies of lipopolysaccharide (LPS) content and polymyxin B inhibition of LPS suggested that the H. pylori effect was attributable to both LPS- dependent and -independent mechanisms. CONCLUSIONS: iNOS expression in macrophages is activated by highly stable H. pylori products and may play an important role in the pathogenesis of H. pylori-associated gastric mucosal disease. (Gastroenterology 1996 Dec;111(6):1524-33)     

Anti‐inflammatory effects of exendin‐4, a glucagon‐like peptide‐1 analog,on human peripheral lymphocytes in patients with type 2 diabetes

Aims/Introduction

Type 2 diabetes is characterized by dysregulation of immunity, oxidative stress and reduced incretin effects. Experimental studies suggest that glucagon‐like peptide (GLP‐1) might have immunomodulating effects. We hypothesize that GLP‐1 receptor agonist, exendin‐4, might reduce inflammatory response in type 2 diabetes.

Materials and Methods

Using peripheral blood mononuclear cells (PBMC) sampled from 10 type 2 diabetes and 10 sex‐ and age‐matched control subjects and supernatants from PBMC culture, the expression of phospho‐mitogen activated protein kinase (MAPK) signaling pathways in CD4+ T helper lymphocytes and monocytes was analyzed using flow cytometry. Cytokines/chemokines and superoxide anion before and after treatment with exendin‐4 were measured by cytometric bead array and chemiluminesence assay, respectively.

Results

Compared with control subjects, PBMC from type 2 diabetes patients showed activated MAPK (P38, c‐Jun NH2‐terminal protein kinase and extracellular signal‐regulated kinase) signaling pathway, elevated superoxide anion, increased pro‐inflammatory cytokines (tumor necrosis factor‐α, interleukin‐1β, interleukin‐6) and chemokines (CCL5/regulated on activation normal T‐cell expressed and secreted and CXCL10/interferon‐γ‐induced protein 10). These changes were attenuated by exendin‐4, possibly through the suppression of p38 MAPK.

Conclusions

These results suggest that exendin‐4 might downregulate pro‐inflammatory responses and reduce oxidative stress by suppressing MAPK signaling pathways in type 2 diabetes.     

糖化血红蛋白A1c浓度与心血管疾病及全因死亡率增加相关——糖化血红蛋白A1c浓度与冠心病事件、心血管事件、全因死亡率之间的相关性如何？

设计：队列研究（欧洲前瞻性癌症调查研究．诺福克地区组（EPIC—Norfolk）），平均随访时间为6年。     

中指和无名指伸肌腱疲劳性损伤19例

1一般资料 1.1对象1998-01/2004-06收集中指和无名指伸肌腱疲劳性损伤19(男10,女9)例,26指,年龄18～24岁,均为学员,且连续从事高强度军事训练2 wk. 累及中指5例、无名指7例、中指无名指均累及7例,食指和小指均未累及. 发病至就诊时间3 d～4 wk,由于指伸肌腱的疲劳性损伤目前缺乏统一的诊断标准,我们主要根据病史和临床表现做出诊断[1];但我们诊治的均在高强度的军事训练中发病,手指的伸展功能出现障碍,因此诊断不难.     

钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗大鼠慢性心力衰竭

目的:观察肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植对慢性心力衰竭大鼠心功能的影响。方法:实验于2004-07/2005-12在北京医科大学生物化学系实验室完成。选取4周龄清洁级雄性SD大鼠作为骨髓供体。雌性SD大鼠作为细胞移植、基因治疗受体,随机数字表法分为4组:肌浆网钙离子ATP酶2a基因治疗组(n=7)、骨髓干细胞移植治疗组(n=7)、肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植组(n=8)、腺病毒空载体对照组(n=7)。结扎左冠状动脉制作急性心肌梗死后慢性心力衰竭大鼠模型,每组进行相应的基因治疗和细胞移植。治疗后21d,采用苏木精-伊红染色和MASSON染色评价心脏形态及结构变化,组织多普勒评价各组心功能。并检测肌浆网钙离子ATP酶2a基因和蛋白在宿主心脏的表达。结果:29只雌性大鼠均进入结果分析。①与腺病毒空载体对照组大鼠相比,骨髓干细胞移植治疗组和肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗组大鼠心室腔明显减小。MASSON染色显示,肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗组大鼠蓝色的胶原纤维染色区域减少,红色的肌纤维染色区域增多。②肌浆网钙离子ATP酶2a基因治疗组、骨髓干细胞移植治疗组和肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗组大鼠左室前壁、室间隔收缩及舒张期纵向峰值速度均较腺病毒空载体对照组显著升高[左室前壁:(0.58±0.03),(0.67±0.02),(0.78±0.05),(0.31±0.02)cm/s;(0.81±0.04),(1.26±0.04),(1.39±0.05),(0.40±0.01)cm/s;室间隔:(0.60±0.05),(1.00±0.08),(1.33±0.04),(0.40±0.01)cm/s;(0.70±0.04),(1.28±0.05),(1.57±0.03),(0.44±0.03)cm/s,P<0.001]。与肌浆网钙离子ATP酶2a基因治疗组相比,肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗组大鼠左室前壁、室间隔收缩及舒张期纵向峰值速度升高(P<0.001)。③肌浆网钙离子ATP酶2a基因治疗组和肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植治疗组心肌内肌浆网钙离子ATP酶2amRNA表达强度明显高于骨髓干细胞移植治疗组和腺病毒空载体对照组。结论:肌浆网钙离子ATP酶2a基因修饰的骨髓干细胞移植能显著改善慢性缺血性心力衰竭大鼠心脏的收缩和舒张功能。     

Oral sodium phenylbutyrate therapy in homozygous beta thalassemia: a clinical trial

Butyrate analogues have been shown to increase fetal hemoglobin (HbF) production in vitro and in vivo. Sodium phenylbutyrate (SPB), an oral agent used to treat individuals with urea-cycle disorders, has been shown to increase HbF in nonanemic individuals and in individuals with sickle cell disease. We have treated eleven patients with homozygous beta thalassemia (three transfusion dependent) and one sickle-beta- thalassemia patient with 20 g/d (forty 500-mg tablets) of SPB for 41 to 460 days. All patients showed an increase in the percent of F reticulocytes associated with treatment, but only four patients responded by increasing their Hb levels by greater than 1 g/dL (mean increase, 2.1 g/dL; range, 1.2 to 2.8 g/dL). None of the transfusion- dependent thalassemia subjects responded. Increase in Hb was associated with an increase in red blood cell number (mean increase, 0.62 x 10(12)/L), and mean corpuscular volume (mean increase, 6 fL). Changes in percent HbF, absolute HbF levels, or alpha- to non-alpha-globin ratios as measured by levels of mRNA and globin protein in peripheral blood did not correlate with response to treatment. Response to treatment was not associated with the type of beta-globin mutation, but baseline erythropoietin levels of greater than 120 mU/mL was seen in all responders and only two of eight nonresponders to SPB. Compliance with treatment was greater than 90% as measured by pill counts. Side effects of the drug included weight gain and/or edema caused by increase salt load in 2/12, transient epigastric discomfort in 7/12, and abnormal body odor in 3/12 subjects. Two splenectomized patients who were not on prophylactic antibiotics developed sepsis while on treatment. We conclude that SPB increases Hb in some patients with thalassemia, but the precise mechanism of action is unknown.