Interleukin-18 produced by peripheral blood cells is increased in Alzheimer's disease and correlates with cognitive impairment

A body of evidence indicates that inflammation plays a pivotal role in AD pathogenesis. IL-18 is a pro-inflammatory cytokine produced in the brain, emerging to be implicated in AD. Although no differences in circulating IL-18 levels were measured between AD patients and controls, a significant increased production of IL-18 was obtained from stimulated blood mononuclear cells of AD patients. This was true particularly in AD subjects carrying the C/C genotype at the -607 position of IL-18 gene promoter. Furthermore, a significant correlation between IL-18 production and cognitive decline was observed in AD patients. Overall, these data indicate that IL-18-related inflammatory pathways, probably also in virtue of polymorphic IL-18 gene influence, are exacerbated in AD patients, and that this cytokine may indeed participate in pathogenic processes leading to dementia.     

Atrial natriuretic peptide induces postprandial lipid oxidation in humans

OBJECTIVE—Atrial natriuretic peptide (ANP) regulates arterial blood pressure. In addition, ANP has recently been shown to promote human adipose tissue lipolysis through cGMP-mediated hormone-sensitive lipase activation. We hypothesized that ANP increases postprandial free fatty acid (FFA) availability and energy expenditure while decreasing arterial blood pressure.RESEARCH DESIGN AND METHODS—We infused human ANP (25 ng · kg⁻¹ · min⁻¹) in 12 men (age 32 ± 0.8 years, BMI 23.3 ± 0.4 kg/m²) before, during, and 2 h after ingestion of a standardized high-fat test meal in a randomized, double-blind, cross-over fashion. Cardiovascular changes were monitored by continuous electrocardiogram and beat-by-beat blood pressure recordings. Metabolism was monitored through venous blood sampling, intramuscular and subcutaneous abdominal adipose tissue microdialysis, and indirect calorimetry.RESULTS—ANP infusion decreased mean arterial blood pressure by 4 mmHg during the postprandial phase (P < 0.01 vs. placebo). At the same time, ANP induced lipolysis systemically (P < 0.05 vs. placebo) and locally in subcutaneous abdominal adipose tissue (P < 0.0001 vs. placebo), leading to a 50% increase in venous glycerol (P < 0.01) and FFA (P < 0.05) concentrations compared with placebo. The increase in FFA availability with ANP was paralleled by a 15% increase in lipid oxidation rates (P < 0.05 vs. placebo), driving a substantial increase in postprandial energy expenditure (P < 0.05 vs. placebo).CONCLUSIONS—Our data identify the ANP system as a novel pathway regulating postprandial lipid oxidation, energy expenditure, and concomitantly arterial blood pressure. The findings could have therapeutic implications.A modest mismatch between energy intake and expenditure elicits major changes in body weight over years. Total daily energy expenditure comprises resting metabolic rate, physical activity, and postprandial thermogenesis. Measures that increase postprandial thermogenesis could prevent or treat obesity. Pharmacological strategies to augment energy expenditure have been unsuccessful because of side effects (1). Manipulation of adrenergic transmission is associated with increased thermogenesis, blood pressure elevations, and other cardiac side effects (2). Atrial natriuretic peptide (ANP) has recently been shown to promote adipose tissue lipolysis through cGMP-mediated, hormone-sensitive lipase activation (3). ANP-mediated lipolysis has only been observed in primates such as macaques and humans but not in other species (4). ANP increases circulating free fatty acid (FFA) levels in human subjects (5–8). Previous studies with adrenergic agonists suggested that increased circulating FFA concentrations can drive an increase in energy expenditure (9). In our earlier studies, ANP-mediated lipolysis did not alter energy expenditure in the fasted state, whereas lipid oxidation rate increased slightly (6,8). We now tested the hypothesis that ANP augments postprandial FFA availability, lipid oxidation, and energy expenditure while concomitantly decreasing blood pressure in healthy young men.     

Long-term outcome of bilateral pallidal deep brain stimulation for primary cervical dystonia

Ten patients with severe cervical dystonia (CD) unresponsive to medical treatment underwent bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) and were followed for 31.9 +/- 20.9 months. At last follow-up, the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) severity score improved by 54.8%, the TWSTRS disability score improved by 59.1%, and the TWSTRS pain score improved by 50.4%. Bilateral GPi DBS is an effective long-term therapy in patients with CD.     

早产儿代谢性骨病

目前早产儿营养管理明显改善,如早期肠内外营养的建立、母乳强化剂的使用、配方奶营养成分的改变及临床技能的进步等,使早产儿代谢性骨病的发生率有所降低.