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Li A, Mu J, Huang M, Zhang Z, Liu J, Zhang M. Altered amygdala-related structural covariance and resting-state functional connectivity in end-stage renal disease patients. Metab Brain Dis 2018; 33:1471-1481. [PMID: 29869149 DOI: 10.1007/s11011-018-0254-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 05/21/2018] [Indexed: 02/07/2023]
Abstract
Depression and cognitive control deficits were frequently reported in concurrent end-stage renal disease (ESRD) patients. Neuroimaging studies indicated depression could be a risk factor for cognitive control deficits, and amygdala-related circuitry may play a critical role in this abnormal interaction. To investigate the potential relationship between depressive symptoms and cognitive control reduction in ESRD patients, T1-weighted and resting fMRI images were obtained in 29 ESRD patients and 29 healthy controls. Voxel-based morphometry (VBM), structural covariance (SC) analysis based on grey matter volume (GMV), and functional connectivity (FC) analysis were adopted. All subjects performed the Beck Depression Inventory (BDI) assessment and Stroop test. The patients also underwent blood biochemistry tests (urea, creatinine, phosphate, Ca2+, hematocrit, cystatin, hemoglobin). Compared with controls, GMV reductions were found mainly in the anterior cingulate cortex (ACC) and bilateral amygdala, and decreased SC was found between the amygdala and ACC in ESRD patients. This indicated that structural changes in the amygdala may be related to the GMV alterations in the ACC. Additionally, decreased FC between the amygdala and ACC was revealed in ESRD patients. Negative correlation was found between the FC of the amygdala-ACC and reaction delay during the Stroop test, but this correlation disappeared after controlling BDI. Stepwise regression analysis showed that the low level of hemoglobin was contributed to the reduced FC of the amygdala-ACC in ESRD patients. Our results demonstrated the abnormal interaction between depressive mood and cognitive control deficits in ESRD patients.
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Affiliation(s)
- Anmao Li
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, 710061, Shaanxi-Province, People's Republic of China
- Xi'an Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Junya Mu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, 710126, People's Republic of China
- Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, 710126, People's Republic of China
| | - Mingxia Huang
- Xi'an Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Zengjun Zhang
- Xi'an Children's Hospital, Xi'an, 710061, People's Republic of China
| | - Jixin Liu
- Center for Brain Imaging, School of Life Science and Technology, Xidian University, Xi'an, 710126, People's Republic of China.
- Engineering Research Center of Molecular and Neuro Imaging, Ministry of Education, Xi'an, 710126, People's Republic of China.
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, No. 277, West Yanta Road, Xi'an, 710061, Shaanxi-Province, People's Republic of China.
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Yi R, Sandhu J, Zhao S, Lam G, Loganathan D, Morrissey B. Detection of efaproxiral (RSR13) and its metabolites in equine by liquid chromatography tandem mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2014; 49:57-67. [PMID: 24446264 DOI: 10.1002/jms.3304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/01/2013] [Accepted: 11/04/2013] [Indexed: 06/03/2023]
Abstract
Efaproxiral (RSR 13) is an experimental synthetic allosteric modifier of haemoglobin (Hb) that acts by increasing the release of oxygen from Hb to the surrounding tissues. It has been shown to increase maximum oxygen uptake (VO(2max)) in a canine skeletal muscle model. The ability to increase maximal muscle oxygen uptake makes efaproxiral a potential performance-enhancing agent and is therefore prohibited by the World Anti-Doping Agency. In this study, a method for the detection and elimination of efaproxiral in equine plasma and urine after a 2.5 g intravenous administration of efaproxiral is described. Post administration plasma and urine samples were collected up to 120 h. Efaproxiral was detected up to 120 h in urine and up to 78 h in plasma. In plasma, the peak concentration was 42 µg/ml and detected at 5 min post administration. In urine, the peak concentration was 2.8 mg/ml and detected at 0-1 h post administration. A validated liquid chromatography tandem mass spectrometry method was used for the quantitation of efaproxiral in equine plasma and urine. The limit of detection of the method is 0.05 ng/ml in plasma and 0.1 ng/ml in urine. The method is highly sensitive and specific with good precision, accuracy and recovery. The manuscript also describes the systematic identification of efaproxiral metabolites detected in post administration equine urine samples. The metabolites were identified by use of enhanced mass spectra and enhanced product ion scans. Both positive and negative mode ionizations were utilized for metabolite identification and plausible fragmentation pathways were proposed for the phase 1 metabolite identified. In addition to free efaproxiral, one phase 1 metabolite and two phase 2 metabolites were identified in post administration urine.
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Affiliation(s)
- Rong Yi
- Maxxam Analytics, 8577 Commerce Court, Burnaby, BC, V5A 4N5, Canada
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Morabito D, Hemphill JC, Erickson V, Holcroft JJ, Derugin N, Knudson MM, Manley GT, Lee SK. Small-volume Resuscitation with HBOC-201: Effects on Cardiovascular Parameters and Brain Tissue Oxygen Tension in an Out-of-hospital Model of Hemorrhage in Swine. Acad Emerg Med 2002. [DOI: 10.1197/aemj.9.10.969] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Morgan TJ, Koch D, Morris D, Clague A, Purdie DM. Reduced red cell 2,3-diphosphoglycerate concentrations in critical illness without decreased in vivo P50. Anaesth Intensive Care 2001; 29:479-83. [PMID: 11669427 DOI: 10.1177/0310057x0102900505] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated whether red cell 2,3-diphosphoglycerate (2,3-DPG) concentrations are reduced in critical illness, whether acidaemia, hypophosphataemia or anaemia influence 2,3-DPG, and whether there is any net effect on in vivo P50. Twenty healthy, non-smoking, male volunteers were compared with 20 male intensive care patients with APACHE 2 scores >20 on the preceding day. Those transfused in this time were excluded. Venous red cell 2,3-DPG concentrations were measured in both groups. In the patient group, routine multichannel biochemical profile and arterial blood gas analysis were also performed and in vivo P50 calculated. The mean 2,3-DPG concentration was significantly lower in the patient group than in the controls (4.2+/-1.3 mmol/l vs 4.9+/-0.5 mmol/l, P=0.016). The patients were well oxygenated (lowest arterial PO2=75 mm Hg) and showed a tendency to acidaemia (median pH 7.37, range 7.06 to 7.48) and anaemia (median haemoglobin concentration 113 g/l, range 89 to 154 g/l). By linear regression of patient data, pH had a significant effect on 2,3-DPG concentrations (r=0.6, P=0.011). Haemoglobin and phosphate concentrations did not, but there were few abnormal phosphate values. There was no correlation between 2,3-DPG concentrations and in vivo P50 (r2 < or = 0.08). We conclude that 2,3-DPG concentrations were reduced in a broad group of critically ill patients. Although this would normally reduce the P50, the reduction was primarily linked with acidaemia, which increases the P50. Overall, there was no net effect on the P50 and thus no affinity-related decrease in tissue oxygenation.
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Affiliation(s)
- T J Morgan
- Intensive Care Facility, Royal Brisbane Hospital, Queensland
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Breidbach A, Catlin DH. RSR13, a potential athletic performance enhancement agent: detection in urine by gas chromatography/mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2001; 15:2379-2382. [PMID: 11746905 DOI: 10.1002/rcm.523] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
RSR13 (2-[4-[[(3,5-dimethylanilino)carbonyl]methyl]phenoxyl]-2-methylpropionic acid) is a synthetic allosteric modifier of hemoglobin that is currently in a phase III clinical trial as a radio-enhancing agent. RSR13 has been shown to increase maximum oxygen uptake (VO(2max)) in a canine skeletal model, which makes it a potential performance-enhancing agent for endurance athletes, since VO(2max) is an index of aerobic capacity. In this study we present a method for the detection of RSR13-bis-TMS in human urine by gas chromatography/electron impact ionization mass spectrometry (GC/EI-MS) suitable for doping control laboratories. The presence of RSR13 is detected by monitoring the ions m/z 485 ([M](+.)) and 470 ([M - CH3](+)). The limit of detection (LOD) is less than 2 ng/mL in urine. Urine samples collected from clinical trial subjects immediately prior to receiving an infusion of RSR13 showed no evidence of RSR13, whereas post-infusion urine samples contained up to 1181 microg/mL. A urine sample collected 36 h after administration of a small dose (10 mg/kg) and diluted 100-fold showed a signal 80 times higher than the LOD. Urine samples obtained from 100 randomly selected athletes in our routine testing program did not show any traces of RSR13. Sport authorities may wish to add RSR13 to the list of prohibited substances.
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Affiliation(s)
- A Breidbach
- UCLA Olympic Analytical Laboratory, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA 90025, USA
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Doppenberg EM, Rice MR, Alessandri B, Qian Y, Di X, Bullock R. Reducing hemoglobin oxygen affinity does not increase hydroxyl radicals after acute subdural hematoma in the rat. J Neurotrauma 1999; 16:123-33. [PMID: 10098957 DOI: 10.1089/neu.1999.16.123] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Extensive evidence is available to show the importance of ischemia after severe human head injury. We have previously shown that pharmacologically increasing the release of oxygen in brain tissue where the local oxygen pressure is low reduces infarct size in animal models. To study the possible negative effects of this strategy, we tested the effect of an allosteric modifier of hemoglobin (RSR13) on free radical production in the rat acute subdural hematoma (ASDH) model, both under normoxic as well as under hyperoxic, normobaric conditions. When compared to baseline, induction of ASDH resulted in a significant increase (p < 0.05) in 2,3-DHBA (2,3 dihydroxybenzoic acid, produced from salicylate after attack by hydroxyl radicals) at 30 and 60 min postinduction, both for the control group (39% and 91%) as well as the RSR13-treated group (41% and 62%). The 2,5-DHBA also increased significantly (p < 0.05) in the drug-treated animals at the 30- and 60-min time points when compared to baseline (49% and 77%). At all time points, except the 30-min, the increase in 2,3-DHBA was less marked in the RSR13 animals than in the control group. Similarly, the 2,5-DHBA increase after ASDH was lower at all time points except for the 30-min time point in the RSR13-treated group. These results indicate that enhanced tissue oxygen release by the allosteric modifier of hemoglobin RSR13 does not increase hydroxyl radical production after ASDH. Clinical trials are needed to test this compound in humans after severe head injury.
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Affiliation(s)
- E M Doppenberg
- Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0631, USA
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Doppenberg EM, Zauner A, Watson JC, Bullock R. Determination of the ischemic threshold for brain oxygen tension. ACTA NEUROCHIRURGICA. SUPPLEMENT 1998; 71:166-9. [PMID: 9779174 DOI: 10.1007/978-3-7091-6475-4_48] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Measuring brain tissue oxygenation is now possible due to major advances in the technical development of Clark-electrodes and fiberoptic systems. However, to make this technique clinically useful for both nurses and medical staff, the ischemic threshold for brain tissue oxygen tension (brain pO2) must be determined. Three end points were used for determination of the critical brain pO2 value. 1) Infarct determination after permanent middle cerebral artery occlusion in a feline model. 2) Threshold analysis using the schemic threshold for cerebral blood flow (CBF) as a "gold standard" in severely head injury patients. 3) Outcome analysis in severely head injured patients. Brain pO2 dropped to 19 +/- 6 mm Hg and 23 +/- 6, 4 to 5 hours after MCA occlusion in the cat (n = 12). In severely head injured patients, a brain pO2 < or = 19 mm Hg was correlated with poor outcome (n = 24). The ischemic threshold for (r)CBF of 18 ml/100 g/min corresponded to a brain pO2 of 22 mm Hg, in the same patients. By using the above mentioned end points as a reference, we found the critical value for brain pO2 to be in between 19 and 23 mm Hg. Clearly, the difference between our threshold value and the lower critical brain pO2 level found by other groups using the Licox system, needs to be clarified in a comparison study before a uniform threshold for brain pO2 can be determined.
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Affiliation(s)
- E M Doppenberg
- Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA
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Papassotiriou I, Kister J, Griffon N, Stamoulakatou A, Abraham DJ, Marden MC, Loukopoulos D, Poyart C. Modulating the oxygen affinity of human fetal haemoglobin with synthetic allosteric modulators. Br J Haematol 1998; 102:1165-71. [PMID: 9753039 DOI: 10.1046/j.1365-2141.1998.00886.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Improving the delivery of oxygen to the tissues by decreasing the oxygen affinity of haemoglobin has been a major aim of several laboratories over recent years because this may reduce the consequences of anaemia and/or improve tissue oxygenation in cases of decreased blood perfusion. Within the same context, lowering the oxygen affinity may prove valuable in the application of native or recombinant haemoglobin solutions as a blood substitute. The shift of the oxygen equilibrium curve to the right is obtained by various modulators. Among them, the bezafibrate derivatives are considered as a most interesting group. These principles are of the utmost importance in thalassaemia and other haemoglobinopathies where the beneficial effects of the compensatory synthesis of fetal haemoglobin are diminished by the increased oxygen affinity of this pigment. In this paper we present the results of a study initiated to determine whether a potent oxygen affinity modifier, RSR-4, could satisfactorily decrease the oxygen affinity of fetal haemoglobin, thus improving tissue oxygenation. The experiments were carried out on whole blood and on purified haemoglobin solutions and showed that the effector markedly decreased the oxygen affinity of HbF (from 18.7 to 3.73 mmHg in whole blood). At the same time the cooperativity index (n50) and the oxygen saturation levels remained within normal limits under the conditions of the main experiment. These observations have important implications for the potential application of oxygen affinity modifiers in vivo.
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Affiliation(s)
- I Papassotiriou
- Haematology Laboratory, Aghia Sophia Children's Hospital, Athens, Greece
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