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Kahal H, Dimitriadis GK, Kyrou I, Ali A, Tahrani AA, Randeva H. A retrospective study assessing the effects of OSA in women with PCOS attending the weight management clinic. EJEA 2016. [DOI: 10.1530/endoabs.44.p185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Raine D, Begg G, Moore J, Taylor E, Buck R, Honarbakhsh S, Yew Ding W, Redfearn D, Opel A, Opel A, Thomas D, Prakash K, Thomas D, Khokhar A, Honarbakhsh S, Tairova S, Getman N, McAloon C, Honarbakhsh S, Shah M, Al-Lawati K, Al-Lawati K, Ensam B, Collins G, Akbar S, Merghani A, Furniss G, Yones E, Vijayashankar SS, Vijayashankar SS, Shariat H, Moss A, Yeoh A, Sadiq A, Taylor R, Edwards T, Nizam ud Din K, Langley P, Shepherd E, Murray S, Lord S, Bourke J, Plein S, Lip G, Tayebjee MH, Owen N, White S, O'Neill M, Hughes L, Carroll S, Moss-Morris R, Baker V, Kirkby C, Patel K, Robinson G, Antoniou S, Richmond L, Ullah W, Hunter R, Finlay M, Earley M, Whitbread M, Schilling R, Cooper R, Modi S, Somani R, Ng A, Hobson N, Caldwell J, Hadjivassilev S, Ang R, Finlay M, Dhinoja M, Earley M, Sporton S, Schilling R, Hunter R, Hadjivassilev S, Earley M, Lambiase P, Turley A, Child N, Linker N, Owens W, James S, Milner J, Tayebjee M, Sibley J, Griffiths A, Meredith T, Basher Y, Betts T, Rajappan K, Lambiase P, Lowe M, Hunter R, Schilling R, Finlay M, Rakhimbaeva G, Akramova N, Getman T, Hamborg T, O'Hare J, Randeva H, Osman F, Srinivasan N, Kirkby C, Firman E, Tobin L, Murphy C, Lowe M, Hunter R, Finlay M, Schilling R, Lambiase P, Mohan P, Salahia G, Lim H, Lim HS, Batchvarov V, Brennan P, Cox A, Muir A, Behr E, Hamill S, Laventure C, Newell S, Gordon B, Bashir K, Chuen J, Foster W, Yusuf S, Osman F, Hayat S, Panagopoulos D, Davies E, Tomlinson D, Haywood G, Mullan J, Kelland N, Horwood A, Connell N, Odams S, Maloney J, Shetty A, Kyriacou A, Sahu J, Lee J, Uzun O, Wong A, Ashtekar S, Uzun O, Wong A, Ashtekar S, Hashemi J, Gazor S, Redfearn D, Song A, Jenkins J, Glancy J, Wilson D, Sammut E, Diab I, Cripps T, Gill A, Abbas S, Enye J, Wahab A, Elshafie S, Ling K, Carey P, Chatterjee D, Timbrell S, Tufail W, Why H, Martos R, Thornley A, James S, Turley A, Bates M, Linker N, Hassan E, Quick J, Cowell R, Ho E. POSTERS (1)59MULTIPOLAR CONTACT MAPPING GUIDED ABLATION OF TEMPORALLY STABLE HIGH FREQUENCY AND COMPLEX FRACTIONATED ATRIAL ELECTROGRAM SITES IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION60INTRA-CARDIAC AND PERIPHERAL LEVELS OF BIOCHEMICAL MARKERS OF FIBROSES IN PATIENTS UNDERGOING CATHETER ABLATION FOR ATRIAL FIBRILATION61THE DON'T WAIT TO ANTICOAGULATE PROJECT (DWAC) BY THE WEST OF ENGLAND ACADEMIC HEALTH SCIENCE NETWORK (AHSN) OPTIMISES STROKE PREVENTION FOR PATIENTS WITH ATRIAL FIBRILLATION (AF) WITHIN PRIMARY CARE IN LINE WITH NICE CG180 IN THE WEST OF ENGLAND62ILLNESS AND TREATMENT REPRESENTATIONS, COPING AND DISTRESS: VICIOUS CYCLES OF EVERYDAY EXPERIENCES IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION63THE NEEDS OF THE ADOLESCENT LIVING WITH AN INHERITED CARDIAC CONDITION: THE PATIENTS' PERSPECTIVE64SAFETY AND EFFICACY OF PARAMEDIC TREATMENT OF REGULAR SUPRAVENTRICULAR TACHYCARDIA (PARA-SVT)65NATURAL PROGRESSION OF QRS DURATION FOLLOWING IMPLATABLE CARDIOVERTER DEFIBRILLATORS (ICD) - IMPLANTATION66COMPARISON OF EFFICACY OF VOLTAGE DIRECTED CAVOTRICUSPID ISTHMUS ABLATION USING MINI VS CONVENTIONAL ELETRODES67CRYOBALLOON ABLATION (CRYO) FOR ATRIAL FIBRILLATION (AF) CANNOT BE GUIDED BY TEMPERATURE END-POINTS ALONE68MODERATOR BAND ECTOPY UNMASKED BY ADENOSINE AS A CAUSE OF ECTOPIC TRIGGERED IDIOPATHIC VF69EARLY CLINICAL EXPERIENCE WITH TARGETED SITE SELECTION FOR THE WiCS-LV ELECTRODE FOR CRT70DOES VECTOR MAPPING PRIOR TO IMPLANTABLE LOOP RECORDER INSERTION IMPROVE THE DETECTION OF ARRHYTHMIA?71THE ROLE OF SPECKLE TRACKING STRAIN IMAGING IN ASSESSING LEFT VENTRICULAR RESPONSE TO CARDIAC RESYNCHRONISATION THERAPY IN RESPONDERS AND NON-RESPONDERS72EVALUATING PATIENTS' EXPERIENCE AND SATISFACTION OF THE ATRIAL FIBRILLATION ABLATION PROCEDURE: A RETROSPECTIVE ANALYSIS73TROUBLESHOOTING LV LEAD IMPLANTATION - NOVEL “UNIRAIL TECHNIQUE”74SUBCLINICAL ATHEROSCELEROSIS AND COGNITIVE IMPAIRMENT75EFFECT OF LOZARTANE ON DEVELOPMENT OF THE ELECTRICAL INSTABILITY OF THE MYOCARDIUM76THE INTERPLAY BETWEEN BODY COMPOSITION AND LEFT VENTRICULAR REMODELLING IN CARDIAC RESYNCHRONISATION THERAPY77FAMILY SCREENING IN IDIOPATHIC VENTRICULAR FIBRILLATION78MANAGEMENT OF ATRIAL FIBRILLATION IN A LARGE TEACHING HOSPITAL79THE EFFECT OF LEFT VENTRICULAR LEAD POSITION ON SURVIVAL IN PATIENTS WITH BINVENTRICULAR PACEMAKRS/DEFIBRILLATORS80ACUTE DEVICE IMPLANT-RELATED COMPLICATIONS DO NOT INCREASE LATE MORTALITY81ABORTED CARIDAC ARREST AS THE SENTINEL PRESENTATION IN A COHORT OF PATIENTS WITH THE CONCEALED BRUGADA PHENOTYPE82POST-CARDIAC DEVICE IMPLANTATION MOBILISATION ADVICE: A NATIONAL SURVEY83DO RISK SCORES DEVELOPED TO PROTECT ONE-YEAR MORTALITY ACTUALLY HELP IN ACCURATELY SELECTING PATIENTS RECEIVING PRIMARY PREVENTION ICD?84ATRIAL TACHYCARDIA ARISING FROM THE NON-CORONARY AORTIC CUSP85THE EFFECT OF DIFFERENT ATRIAL FIBRILLATION ABLATION STRATEGIES ON SURFACE ECG P WAVE DURATION86PRESCRIBING DRONEDARONE: HOW IS IT DONE ACROSS THE UK AND IS IT SAFE?87A CASE OF WIDE COMPLEX TACHYCARDIA88TRANSITION TO DEDICATED DAY CASE DEVICES - SAFETY AND EFFICACY IN A LARGE VOLUME CENTRE89SEQUENTIAL REGIONAL DOMINANT FREQUENCY MAPPING DURING ATRIAL FIBRILLATION: A NOVEL TEQUNIQUE90ELECTIVE CARDIOVERSION ENERGY PROTOCOLS: A RETROSPECTIVE COMPARISON OF ESCALATION STRATEGIES91THE INCIDENCE OF CLINCALLY RELEVANT HAEMATOMAS WITH PERIOPERATIVE USE OF NEWER P2Y12 INHIBITORS AND INTERRUPTED NOAC THERAPY IN CARDIAC IMPLANTABLE ELECTRONIC DEVICE INSERTION92AN AUDIT OF THE OUTCOMES FOR CHEMICAL AND DIRECT CURRENT CARDIOVERSION FOR ATRIAL FIBRILLATION AT OUR DGH OVER A 3 YEAR DURATION93REAL LIFE ACUTE MANAGEMET OF HAEMODYNAMICALLY TOLERATED MONOMORPHIC VENTRICULAR TACHYCARDIA. ARE WE MAKING EVIDENCE BASED ON DECISIONS?94A SERVICE EVALUATION TO ASSESS THE EFFICACY AND SAFETY OF NOVEL ORAL ANTICOAGULANTS VERSUS WARFARIN FOR ELECTIVE CARDIVERSION IN PATIENTS WITH NON VALVULAR AF IN A NURSE LED CARDIOVERSION SERVICE95PICK UP RATE OF IMPLANTED LOOP RECORDER AT A DISTRICT HOSPITAL. Europace 2016. [DOI: 10.1093/europace/euw273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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McAloon C, Heining D, Atherton G, Anderson B, Randeva H, O’Hare P, Osman F. 55 Evaluation of Potential Clinical Response and Cardiovascular Outcomes Predictors in a Tertiary Cardiac Resynchronisation Therapy Implantation Centre. Heart 2016. [DOI: 10.1136/heartjnl-2016-309890.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Atherton G, McAloon CJ, Chohan B, Heining D, Anderson B, Barker J, Randeva H, Osman F. Safety and Cost-Effectiveness of Same-Day Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator Implantation. Am J Cardiol 2016; 117:1488-93. [PMID: 26993428 DOI: 10.1016/j.amjcard.2016.02.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Abstract
Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator (ICD) implantation improve morbidity and mortality in selected patients. Many centers still admit patients overnight. We evaluated the safety, feasibility, and cost savings of same-day CRT/ICD device implantation by performing a retrospective study of all consecutive elective CRT/ICD implants at a tertiary center from January 2009 to April 2013. All emergency and/or inpatient cases were excluded. Data were collected on baseline demographics, implantation indication, procedure details, complications (categorized as immediate [≤24 hours], short term [24 hours to 6 weeks], medium term [6 weeks to 4 months], and long term [>4 months]), and mortality (30 day and 1 year). Comparisons were made between those having planned same-day versus overnight stay procedures. A cost analysis was performed to evaluate cost savings of the same-day policy. A total of 491 devices were implanted during this period: 267 were elective (54 planned overnight, 213 planned same-day) of which 229 were CRT pacemakers or CRT defibrillators and 38 ICDs. There were 26 total overall complications (9.7%) with no significant differences between planned same-day versus planned overnight stay cohorts (9.4% vs 11.1%, p = 0.8) and specifically no differences in immediate, short-, medium-, and long-term complications at follow-up. The 30-day and 1-year mortality rates did not differ between the two groups. An overnight stay at our hospital costs $450 (£300); our cost saving during this period was $91,800 (£61,200). Same-day CRT/ICD implantation is safe, feasible, and associated with significant cost savings. It provides significant advantages for patients and health care providers, especially given the current financial climate.
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Davies J, Chen J, Pink R, Carter D, Saunders N, Sotiriadis G, Bai B, Pan Y, Howlett D, Payne A, Randeva H, Karteris E. Orexin receptors exert a neuroprotective effect in Alzheimer's disease (AD) via heterodimerization with GPR103. Sci Rep 2015; 5:12584. [PMID: 26223541 PMCID: PMC4519789 DOI: 10.1038/srep12584] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 05/29/2015] [Indexed: 12/22/2022] Open
Abstract
Orexins are neuropeptides that regulate the sleep-wake cycle and feeding behaviour. QRFP is a newly discovered neuropeptide which exerts similar orexigenic activity, thus playing an important role in energy homeostasis and regulation of appetite. The exact expression and signalling characteristics and physiological actions of QRFP and its receptor GPR103 are poorly understood. Alzheimer's disease (AD) patients experience increased nocturnal activity, excessive daytime sleepiness, and weight loss. We hypothesised therefore that orexins and QRFP might be implicated in the pathophysiology of AD. We report that the down-regulation of hippocampal orexin receptors (OXRs) and GPR103 particularly in the cornu ammonis (CA) subfield from AD patients suffering from early onset familial AD (EOFAD) and late onset familial AD (LOAD). Using an in vitro model we demonstrate that this downregulation is due to to Aβ-plaque formation and tau hyper-phosphorylation. Transcriptomics revealed a neuroprotective role for both orexins and QRFP. Finally we provide conclusive evidence using BRET and FRET that OXRs and GPR103 form functional hetero-dimers to exert their effects involving activation of ERK1/2. Pharmacological intervention directed at the orexigenic system may prove to be an attractive avenue towards the discovery of novel therapeutics for diseases such as AD and improving neuroprotective signalling pathways.
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Affiliation(s)
- Julie Davies
- Biosciences, College of Health and Life Sciences, Brunel University, Uxbridge, UB8 3PH, UK
| | - Jing Chen
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- Neurobiology Institute, Jining Medical University, Jining, Shandong, 272067, P.R. China
| | - Ryan Pink
- Department of Biological and Medical Sciences, Oxford Brookes University, UK
| | - David Carter
- Department of Biological and Medical Sciences, Oxford Brookes University, UK
| | - Nigel Saunders
- Centre for Systems and Synthetic Biology, Brunel University, Uxbridge UB83PH, UK
| | - Georgios Sotiriadis
- Biosciences, College of Health and Life Sciences, Brunel University, Uxbridge, UB8 3PH, UK
| | - Bo Bai
- Neurobiology Institute, Jining Medical University, Jining, Shandong, 272067, P.R. China
| | - Yanyou Pan
- Neurobiology Institute, Jining Medical University, Jining, Shandong, 272067, P.R. China
| | - David Howlett
- Wolfson Centre for Age Related Diseases, King’s College London, London, SE11UL, UK
| | - Annette Payne
- Department of Computer Science, College of Engineering, Design and Physical Sciences, Brunel University, Uxbridge UB8 3PH, UK
| | - Harpal Randeva
- Division of Metabolic and Vascular Health, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK
| | - Emmanouil Karteris
- Biosciences, College of Health and Life Sciences, Brunel University, Uxbridge, UB8 3PH, UK
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Chambers AE, Stanley PF, Randeva H, Banerjee S. Microvesicle-mediated release of soluble LH/hCG receptor (LHCGR) from transfected cells and placenta explants. Reprod Biol Endocrinol 2011; 9:64. [PMID: 21575145 PMCID: PMC3112408 DOI: 10.1186/1477-7827-9-64] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 05/15/2011] [Indexed: 12/24/2022] Open
Abstract
Placental hCG and pitutary LH transduce signals in target tissues through a common receptor (LHCGR). We demonstrate that recombinant LHCGR proteins which include the hormone-binding domain are secreted from transfected cells and that natural LHCGR is also secreted from human placental explants. LHCGR recombinant proteins representing varying lengths of the N-terminal extracellular domain were expressed in Chinese Hamster Ovary cells in suspension culture. Secretion was minimal up to 72h but by 96h 24-37% of the LHCGR had been released into the culture medium. The secreted proteins were folded and sensitive to glycosidases suggesting N-linked glycosylation. Secretion was independent of recombinant size and was mediated via structurally defined membrane vesicles (50-150nm). Similarly cultured human early pregnancy placental explants also released LHCGR via microvesicles. These studies provide the first experimental evidence of the possible mechanistic basis of the secretion of LHCGR.
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Affiliation(s)
- Anne E Chambers
- Department of Clinical Biochemistry, Laboratory Medicine, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK
| | - Paul F Stanley
- Centre for Electron Microscopy Metallurgy and Materials Building, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Harpal Randeva
- Clinical Sciences Research Institute, Medical School Building, Gibbet Hill Campus, University of Warwick, Coventry, UK
| | - Subhasis Banerjee
- Department of Clinical Biochemistry, Laboratory Medicine, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK
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Abstract
BACKGROUND Review of the literature reveals considerable variability in the definitions and criteria used for reporting postoperative hypocalcemia. The lack of standardization prevents a meaningful comparison of results and performance locally with the national standard. It also prevents the pooling of data when performing meta-analysis, and may affect the comparison of research results. METHODS A literature review was performed to identify the different definitions used to define hypocalcemia in post-thyroidectomy patients. We analyzed the incidence of hypocalcemia in the same cohort of 202 post thyroidectomy patients using these definitions. RESULTS The reported hypocalcemia rates varied from 0% to 46% for the same cohort depending on the definition of hypocalcemia used. Only one-third of biochemically hypocalcemic patients requested calcium supplementation. CONCLUSION This study demonstrates the need for more uniformity and standardization in the definitions used for reporting hypocalcemia rates.
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Affiliation(s)
- Hisham M Mehanna
- Institute of Head and Neck Studies and Education, University Hospital, Coventry, United Kingdom.
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Filippatos T, Randeva H, Derdemezis C, Elisaf M, Mikhailidis D. Visfatin/PBEF and Atherosclerosis-Related Diseases. Curr Vasc Pharmacol 2010; 8:12-28. [DOI: 10.2174/157016110790226679] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Accepted: 12/19/2008] [Indexed: 11/22/2022]
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Abstract
OBJECTIVE Observations of elevated circulating concentrations of visfatin (PBEF/Nampt) in obesity and diabetes suggest that this recently described adipokine is involved in the regulation of body weight and metabolism. We examined in humans whether visfatin is found in cerebrospinal fluid (CSF) and, if so, how CSF visfatin concentrations relate to adiposity and metabolic parameters. RESEARCH DESIGN AND METHODS We measured visfatin concentrations in the plasma and CSF of 38 subjects (18 men and 20 women; age 19-80 years) with a wide range of body weight (BMI 16.24-38.10 kg/m2). In addition, anthropometric parameters and endocrine markers were assessed. Bivariate correlation coefficients were determined and stepwise multiple regression analyses were performed to detect associations of CSF and plasma visfatin levels with relevant parameters. RESULTS Plasma visfatin levels increased with rising BMI (P < 0.0001) and body fat mass (P < 0.0001). In contrast, CSF visfatin levels decreased with increasing plasma visfatin concentrations (P < 0.03), BMI (P < 0.001), body fat mass (P < 0.0001), and insulin resistance (P < 0.05). Body fat was the only factor independently associated with CSF visfatin, explaining 58% of the variation of CSF visfatin levels (P < 0.0001). Neither plasma (P > 0.13) nor CSF (P > 0.61) visfatin concentrations differed between men and women. CONCLUSIONS Our data indicate that visfatin concentrations in human CSF decrease with rising body fat, supporting the assumption that visfatin transport across the blood-brain barrier is impaired in obesity and that central nervous visfatin insufficiency or resistance are linked to pathogenetic mechanisms of obesity.
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Affiliation(s)
- Manfred Hallschmid
- Department of Neuroendocrinology, University of Luebeck, Luebeck, Germany.
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Mehanna HM, Abdelrahim A, Sankar S, Randeva H, Lehnert H. Setting up a minimally invasive, endoscopically assisted parathyroidectomy service in the UK on a shoe-string: how we do it. Clin Otolaryngol 2009; 33:491-4. [PMID: 18983389 DOI: 10.1111/j.1749-4486.2008.01793.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H M Mehanna
- Institute of Head and Neck Studies and Education, University Hospital, Coventry, UK.
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Abstract
The concept that oxidative stress contributes to the development of human preeclampsia has never been tested in genetically-defined animal models. Homozygous deletion of catechol-O-methyl transferase (Comt-/-) in pregnant mice leads to human preeclampsia-like symptoms (high blood pressure, albuminurea and preterm birth) resulting from extensive vasculo-endothelial pathology, primarily at the utero-fetal interface where maternal cardiac output is dramatically increased during pregnancy. Comt converts estradiol to 2-methoxyestradiol 2 (2ME2) which counters angiogenesis by depleting hypoxia inducible factor-1 alpha (HIF-1 alpha) at late pregnancy. We propose that in wild type (Comt++) pregnant mice, 2ME2 destabilizes HIF-1 alpha by inhibiting mitochondrial superoxide dismutase (MnSOD). Thus, 2ME2 acts as a pro-oxidant, disrupting redox-regulated signaling which blocks angiogenesis in wild type (WT) animals in physiological pregnancy. Further, we suggest that a lack of this inhibition under normoxic conditions in mutant animals (Comt-/-) stabilises HIF-1 alpha by inactivating prolyl hydroxlases (PHD). We predict that a lack of inhibition of MnSOD, leading to persistent accumulation of HIF-1 alpha, would trigger inflammatory infiltration and endothelial damage in mutant animals. Critical tests of this hypothesis would be to recreate preeclampsia symptoms by inducing oxidative stress in WT animals or to ameliorate by treating mutant mice with Mn-SOD-catalase mimetics or activators of PHD.
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Affiliation(s)
- Subhasis Banerjee
- Clinical Sciences Research Institute, Medical School Building, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK
| | - Harpal Randeva
- Clinical Sciences Research Institute, Medical School Building, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK
| | - Anne E Chambers
- Clinical Sciences Research Institute, Medical School Building, Gibbet Hill Campus, University of Warwick, Coventry CV4 7AL, UK
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Abstract
AIMS Maternal leptin affects placental growth hormone (GH), whereas ghrelin, a natural ligand of the growth-hormone-secretagogue receptor, modulates GH action. Both hormones may affect fetal growth, and dysregulation in diabetes may lead to fetal growth disturbances. The aim was to investigate changes in maternal ghrelin during pregnancy with diabetes and to establish reference leptin levels. METHODS Twelve healthy non-diabetic (ND) and 12 pregnant women with Type 1 diabetes (T1DM) were recruited. Age and body mass index (BMI) [ND: age 29.9 +/- 4.7 years (mean +/- sd), BMI 25.2 +/- 3.7 kg/m2; T1DM: age 31 +/- 5.5 years, BMI 27 +/- 3.1 kg/m2] were similar in the groups. HbA1c in T1DM was 6.2 +/- 1.1% at 20 weeks, 6.3 +/- 1.1% at 30 weeks' gestation and 7.8 +/- 2.1% postpartum. Fasting plasma ghrelin, total leptin, free leptin (FL) and soluble leptin receptor (sOB-R) levels were measured at 20 and 30 weeks' gestation and postpartum and determined by radioimmunoassay. RESULTS All pregnancies resulted in full-term singleton births with no differences in birth weight between groups [T1DM: 3.4 +/- 0.56 kg (mean +/- SE); ND: 3.6 +/- 0.3 kg, P = NS]. Ghrelin levels were lower in T1DM when corrected for age and mothers' weight (T1DM: 458 +/- 36 pg/ml and 432.9 +/- 26.6 pg/ml; ND: 562 +/- 52 pg/ml and 515.8 +/- 63 pg/ml at 20 and 30 weeks, respectively, P < 0.05). T1DM mothers had higher levels of sOB-R and FL levels declined at 30 weeks' gestation in T1DM (P = 0.04) but not in ND. CONCLUSION In a population of pregnant women with expected changes in leptin levels as previously reported, ghrelin levels were lower in T1DM pregnancies at 20 and 30 weeks. This may have implications for fetal development and requires further study in diabetes, particularly in pregnancies that result in macrosomia.
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Affiliation(s)
- K Kos
- The Warwickshire Institute for the Study of Diabetes, Endocrinology & Metabolism (WISDEM), Coventry, UK
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Heutling D, Schulz H, Nickel I, Kleinstein J, Kaltwasser P, Westphal S, Mittermayer F, Wolzt M, Krzyzanowska K, Randeva H, Schernthaner G, Lehnert H. Asymmetrical dimethylarginine, inflammatory and metabolic parameters in women with polycystic ovary syndrome before and after metformin treatment. J Clin Endocrinol Metab 2008; 93:82-90. [PMID: 17986642 DOI: 10.1210/jc.2007-0842] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
CONTEXT Insulin resistance plays a significant role in the pathogenesis of the polycystic ovary syndrome (PCOS) and represents a link to the unfavorable cardiovascular risk profile frequently found in affected patients. The endogenous nitric oxide synthase inhibitor asymmetrical dimethyl-L-arginine (ADMA) is associated with atherosclerosis and represents an independent marker for cardiovascular morbidity and mortality. OBJECTIVE We investigated ADMA levels among other cardiovascular, metabolic, and hormonal parameters in women with PCOS and the effects of metformin treatment on these parameters. DESIGN A cross-sectional study and clinical trial were performed. PATIENTS AND PARTICIPANTS Women with PCOS (n = 83) compared with a control group of healthy women (n = 39) were studied. INTERVENTIONS In a subgroup of patients with PCOS (n = 21), the effect of metformin was assessed after 6 months of treatment. MAIN OUTCOME MEASURES ADMA, intima media thickness (IMT), metabolic and hormonal parameters, and markers of inflammation were investigated. RESULTS ADMA levels were significantly higher in the PCOS group compared with controls (0.57 +/- 0.15 vs. 0.50 +/- 0.11; P = 0.024). Androgens, C-reactive protein, fasting C-peptide, area under the curve (AUC) insulin, AUC glucose, homeostatic assessment of insulin resistance, fasting insulin, glycosylated hemoglobin, cholesterol, low-density lipoprotein cholesterol, triglycerides, and IMT were significantly higher in women with PCOS compared with controls. In PCOS patients ADMA was found to be positively correlated with body mass index (BMI), waist to hip ratio, parameters of insulin sensitivity, hyperandrogenemia (free testosterone, free androgen index), and IMT. Treatment with metformin ameliorated hyperandrogenemia and decreased ADMA levels (0.53 +/- 0.06 vs. 0.46 +/- 0.09, P = 0.013). Decrease in ADMA levels subsequent to metformin treatment did not correlate with change in BMI or metabolic parameters. CONCLUSIONS ADMA amd parameters of insulin sensitivity are elevated in women with PCOS and the degree of insulin resistance confers the greatest influence on ADMA level. Metformin treatment led to improvement of hormonal and metabolic parameters and decreased ADMA levels possibly independent of BMI and metabolic changes.
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Affiliation(s)
- Dennis Heutling
- Department of Endocrinology and Metabolism, Otto-von-Guericke-University, D-39120 Magdeburg, Germany
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Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women in the reproductive age and is a major cause of anovulation, hyperandrogenism and infertility. Since obesity and insulin resistance are predominant features of women with PCOS, a variety of metabolic disturbances are associated. There is a marked increase in the risk of developing type-2 diabetes in these patients and a majority of women with PCOS will subsequently harbour an enhanced cardiovascular risk.
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Affiliation(s)
- D Heutling
- 1. Medizinische Klinik, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
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Markovic D, Papadopoulou N, Teli T, Randeva H, Levine MA, Hillhouse EW, Grammatopoulos DK. Differential responses of corticotropin-releasing hormone receptor type 1 variants to protein kinase C phosphorylation. J Pharmacol Exp Ther 2006; 319:1032-42. [PMID: 16956982 DOI: 10.1124/jpet.106.107441] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Corticotropin-releasing hormone (CRH) regulates diverse biological functions in mammals, through activation of two types of specific G protein-coupled receptors that are expressed as multiple mRNA spliced variants. In most cells, the type 1alpha CRH receptor (CRH-R1alpha) preferentially activates the G(s)-adenylyl cyclase signaling cascade. CRH-R1alpha-mediated signaling activity is impaired by insertion of 29 amino acids in the first intracellular loop, a sequence modification that is characteristic of the human-specific CRH-R1beta variant. In various tissues, CRH signaling events are regulated by protein kinase C (PKC). The CRH receptors contain multiple putative PKC phosphorylation sites that represent potential targets. To investigate this, we expressed recombinant CRH-R1alpha or CRH-R1beta in human embryonic kidney 293 cells and analyzed signaling events after PKC activation. Agonist (oxytocin) or phorbol 12-myristate 13-acetate-induced activation of PKC led to phosphorylation of both CRH-R1 variants. However, CRH-R1alpha and CRH-R1beta exhibited different functional responses to PKC-induced phosphorylation, with only the CRH-R1beta susceptible to cAMP signaling desensitization. This was associated with a significant decrease of accessible CRH-R1beta receptors expressed on the cell surface. Both CRH-R1 variants were susceptible to homologous desensitization and internalization following treatment with CRH; however, PKC activation increased internalization of CRH-R1beta but not CRH-R1alpha in a beta-arrestin-independent manner. Our findings indicate that CRH-R1alpha and -R1beta exhibit differential responses to PKC-induced phosphorylation, and this might represent an important mechanism for functional regulation of CRH signaling in target cells.
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Affiliation(s)
- Danijela Markovic
- Endocrinology and Metabolism, Division of Clinical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Mottershead M, Karteris E, Barclay JY, Suortamo S, Newbold M, Randeva H, Nwokolo CU. Immunohistochemical and quantitative mRNA assessment of ghrelin expression in gastric and oesophageal adenocarcinoma. J Clin Pathol 2006; 60:405-9. [PMID: 16751299 PMCID: PMC2001112 DOI: 10.1136/jcp.2006.038356] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Ghrelin is an orexigenic gut peptide produced predominantly by the stomach. Gastric mucosal ghrelin production could be compromised by an infiltrating adenocarcinoma. AIMS To assess the expression of ghrelin mRNA and peptide in oesophagogastric adenocarcinomas and adjacent non-neoplastic mucosa. METHODS 10 gastric and 22 oesophageal adenocarcinoma archival samples were randomly selected from a database. The presence of ghrelin-positive cells was assessed in cancer and corresponding non-neoplastic mucosa by immunohistochemistry. Quantitative reverse transcriptase polymerase chain reaction (PCR) for ghrelin mRNA was also performed on 24 gastric and 8 oesophageal adenocarcinoma specimens and adjacent non-neoplastic mucosa. RESULTS Immunohistochemistry and reverse transcriptase PCR confirm a negligible expression of ghrelin in adenocarcinoma specimens. By contrast, non-neoplastic gastric mucosa was rich in ghrelin-positive cells and ghrelin mRNA. The number (median and range) of ghrelin-positive cells per 2 mm section of non-neoplastic mucosa was 73 (45-215) in the corpus; this was significantly higher than in cardia mucosa (9 (0-64), p<0.001) and antral mucosa (5 (0-14), p<0.001). CONCLUSIONS Gastric and oesophageal adenocarcinomas have no ghrelin-producing cells. The highest level of ghrelin expression was noted in the non-neoplastic mucosa of the gastric corpus. Disruption of the gastric ghrelin-producing mechanism may occur during oesophagogastric malignancy.
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Affiliation(s)
- Marcus Mottershead
- Department of Gastroenterology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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Abstract
The specific blockade of endocannabinoids at the level of the cannabinoid receptor 1 (CB (1) receptor) is a new therapeutic option to reduce body weight and manage cardiovascular risk. Although clinical trials are underway to document the safety and efficacy of this approach, much is still unknown about this endogenous system. Endocannabinoids and their receptors are expressed in the central nervous system as well as in the periphery and regulate the central neural circuits for food uptake and peripheral metabolic circuits. Within the context of food uptake, the stimulation of the CB (1) receptor with Delta (9)-tetrahydrocannabinol (Delta (9)-THC) enhances food consumption, while its blockade with receptor antagonists is an emerging relevant therapeutic means to reduce body weight. Rimonabant is the first of a new class of drugs that interferes with the endocannabinoid system by blocking the CB (1) receptor. In recent clinical studies, a substantial reduction in body weight and waist circumference was associated with an improvement of the cardiovascular risk profile. In particular, increased HDL cholesterol, decreased serum triglycerides and improved insulin sensitivity were observed. Further research will serve to establish the role of these compounds in cardiovascular risk management.
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Affiliation(s)
- P Bramlage
- Institute for Clinical Pharmacology, Technical University, Dresden, Germany
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68
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Karteris E, Randeva H, Hillhouse E. Corticotropin Releasing Factor (CRF) Peptide Family and their Receptors: Divergent Actions Influencing Human Physiology. Curr Genomics 2004. [DOI: 10.2174/1389202043348968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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69
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Abstract
Corticotropin-releasing hormone (CRH) and related peptides (urocortins, sauvagine, urotensin) play a central role in the co-ordination of autonomic, behavioural, cardiovascular, immune and endocrine responses to stressful stimuli. Their actions are mediated through activation of two types of G-protein-coupled receptors encoded by separate genes. In this review we focus on the diverse structural and functional characteristics of the family of CRH-like peptides and their receptors.
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Affiliation(s)
- E W Hillhouse
- Molecular Medicine Research Centre, Department of Biological Sciences, University of Warwick, Coventry CV4 7AL, UK.
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Karteris E, Grammatopoulos D, Randeva H, Hillhouse EW. Signal transduction characteristics of the corticotropin-releasing hormone receptors in the feto-placental unit. J Clin Endocrinol Metab 2000; 85:1989-96. [PMID: 10843186 DOI: 10.1210/jcem.85.5.6590] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Placentally derived CRH plays a major role in the mechanisms controlling human pregnancy and parturition. In this study, we sought to investigate the signal transduction mechanisms of CRH Type-1 receptors in the feto-placental unit. To clarify the signal transduction components in placenta and fetal membranes, we investigated the expression of G proteins and adenylate cyclase. Using the nonhydrolysable photoreactive analog [alpha-32P] GTP-azidoanilide and peptide antisera raised against G protein alpha-subunits, we studied coupling of CRH receptors to G proteins in both placental and fetal membranes. Treatment of placental membranes with human CRH (100 nM) increased the labeling of Gq, Go, and Gz but not Gi and Gs. Treatment of fetal membranes with human CRH (100 nM) increased the labeling of Go and Gq but not Gi, Gs, and Gz. These results were supported by experiments that showed that CRH failed to activate adenylate cyclase in these tissues, but induced an increase in inositol phosphates instead. These findings provide new insights into the components of the signal transduction machinery in both fetal and placental membranes and suggest that CRH Type-1 receptors can couple to different G proteins in different tissues. The physiological significance of these observations remains to be elucidated.
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Affiliation(s)
- E Karteris
- The Sir Quinton Hazel Research Centre for Molecular Medicine, Department of Biological Sciences, University of Warwick, Coventry, United Kingdom
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