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Clough GF, Frisbee JC. Understanding complex behaviours in the microcirculation: From blood flow to oxygenation. Exp Physiol 2020; 105:1429-1430. [DOI: 10.1113/ep088912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/08/2022]
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Clough GF, Chipperfield AJ, Thanaj M, Scorletti E, Calder PC, Byrne CD. Dysregulated Neurovascular Control Underlies Declining Microvascular Functionality in People With Non-alcoholic Fatty Liver Disease (NAFLD) at Risk of Liver Fibrosis. Front Physiol 2020; 11:551. [PMID: 32581841 PMCID: PMC7283580 DOI: 10.3389/fphys.2020.00551] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022] Open
Abstract
Background/Aims Increasing evidence shows that non-alcoholic fatty liver disease (NAFLD) is associated with dysregulation of microvascular perfusion independently of established cardio-metabolic risk factors. We investigated whether hepatic manifestations of NAFLD such as liver fibrosis and liver fat are associated with microvascular hemodynamics through dysregulation of neurovascular control. Methods Microvascular dilator (post-occlusive reactive hyperemia) and sympathetically mediated constrictor (deep inspiratory breath-hold) responses were measured at the forearm and finger, respectively, using laser Doppler fluximetry. Non-linear complexity-based analysis was used to assess the information content and variability of the resting blood flux (BF) signals, attributable to oscillatory flow-motion activity, and over multiple sampling frequencies. Results Measurements were made in 189 adults (113 men) with NAFLD, with (n = 65) and without (n = 124) type 2 diabetes mellitus (T2DM), age = 50.9 ± 11.7 years (mean ± SD). Microvascular dilator and constrictor capacity were both negatively associated with age (r = −0.178, p = 0.014, and r = −0.201, p = 0.007, respectively) and enhanced liver fibrosis (ELF) score (r = −0.155, p = 0.038 and r = −0.418, p < 0.0001, respectively). There was no association with measures of liver fat, obesity or T2DM. Lempel-Ziv complexity (LZC) and sample entropy (SE) of the BF signal measured at the two skin sites were associated negatively with age (p < 0.01 and p < 0.001) and positively with ELF score (p < 0.05 and p < 0.0001). In individuals with an ELF score ≥7.8 the influence of both neurogenic and respiratory flow-motion activity on LZC was up-rated (p < 0.0001). Conclusion Altered microvascular network functionality occurs in adults with NAFLD suggesting a mechanistic role for dysregulated neurovascular control in individuals at risk of severe liver fibrosis.
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Affiliation(s)
- Geraldine F Clough
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Andrew J Chipperfield
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Marjola Thanaj
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, United Kingdom
| | - Eleonora Scorletti
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom.,Department of Gastroenterology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Philip C Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
| | - Christopher D Byrne
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom
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Scorletti E, Afolabi PR, Miles EA, Smith DE, Almehmadi A, Alshathry A, Childs CE, Fabbro SD, Beavis J, Moyses HE, Clough GF, Sethi JK, Patel J, Wright M, Breen DJ, Peebles C, Darekar A, Aspinall R, Fowell AJ, Dowman JK, Nobili V, Targher G, Delzenne NM, Bindels LB, Calder PC, Byrne CD. Synbiotics Alter Fecal Microbiomes, But Not Liver Fat or Fibrosis, in a Randomized Trial of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology 2020; 158:1597-1610.e7. [PMID: 31987796 PMCID: PMC7613160 DOI: 10.1053/j.gastro.2020.01.031] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 12/05/2019] [Accepted: 01/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Dysbiosis of the intestinal microbiota has been associated with nonalcoholic fatty liver disease (NAFLD). We investigated whether administration of a synbiotic combination of probiotic and prebiotic agents affected liver fat content, biomarkers of liver fibrosis, and the composition of the fecal microbiome in patients with NAFLD. METHODS We performed a double-blind phase 2 trial of 104 patients with NAFLD in the United Kingdom. Participants (mean age, 50.8 ± 12.6 years; 65% men; 37% with diabetes) were randomly assigned to groups given the synbiotic agents (fructo-oligosaccharides, 4 g twice per day, plus Bifidobacterium animalis subspecies lactis BB-12; n = 55) or placebo (n = 49) for 10-14 months. Liver fat content was measured at the start and end of the study by magnetic resonance spectroscopy, and liver fibrosis was determined from a validated biomarker scoring system and vibration-controlled transient elastography. Fecal samples were collected at the start and end of the study, the fecal microbiome were analyzed by 16S ribosomal DNA sequencing. RESULTS Mean baseline and end-of-study magnetic resonance spectroscopy liver fat percentage values were 32.3% ± 24.8% and 28.5% ± 20.1% in the synbiotic group and 31.3% ± 22% and 25.2% ± 17.2% in the placebo group. In the unadjusted intention-to-treat analysis, we found no significant difference in liver fat reduction between groups (β = 2.8; 95% confidence interval, -2.2 to 7.8; P = .30). In a fully adjusted regression model (adjusted for baseline measurement of the outcome plus age, sex, weight difference, and baseline weight), only weight loss was associated with a significant decrease in liver fat (β = 2; 95% confidence interval, 1.5-2.6; P = .03). Fecal samples from patients who received the synbiotic had higher proportions of Bifidobacterium and Faecalibacterium species, and reductions in Oscillibacter and Alistipes species, compared with baseline; these changes were not observed in the placebo group. Changes in the composition of fecal microbiota were not associated with liver fat or markers of fibrosis. CONCLUSIONS In a randomized trial of patients with NAFLD, 1 year of administration of a synbiotic combination (probiotic and prebiotic) altered the fecal microbiome but did not reduce liver fat content or markers of liver fibrosis. (ClinicalTrials.gov, Number: NCT01680640).
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Affiliation(s)
- Eleonora Scorletti
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, Southampton, United Kingdom; Department of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Paul R. Afolabi
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Elizabeth A. Miles
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Debbie E. Smith
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Amal Almehmadi
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Albandri Alshathry
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Caroline E. Childs
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Stefania Del Fabbro
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Josh Beavis
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Helen E. Moyses
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
| | - Geraldine F. Clough
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jaswinder K. Sethi
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Janisha Patel
- Hepatology, Department of Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mark Wright
- Hepatology, Department of Medicine, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David J. Breen
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Charles Peebles
- Department of Radiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Angela Darekar
- Department of Medical Physics, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard Aspinall
- Department of Hepatology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Andrew J. Fowell
- Department of Hepatology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Joanna K. Dowman
- Department of Hepatology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
| | - Valerio Nobili
- Hepatology, Gastroenterology and Nutrition Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy,Department of Pediatric, University "La Sapienza", Rome, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Nathalie M. Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Laure B. Bindels
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université Catholique de Louvain, Brussels, Belgium
| | - Philip C. Calder
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK,Institute for Life Sciences, University of Southampton, Southampton, UK
| | - Christopher D. Byrne
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust, Southampton, UK
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Thanaj M, Chipperfield AJ, Clough GF. Attractor Reconstruction Analysis for Blood Flow Signals. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:2281-2284. [PMID: 31946355 DOI: 10.1109/embc.2019.8856856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Attractor reconstruction analysis has been previously used to determine changes in the shape and variability of fairly periodic signals such as arterial blood pressure signals and electroencephalogram signals, providing a two-dimensional attractor with features like density and symmetry. Since BF signals are fairly periodic and quasi-stationary, we set out to investigate whether attractor reconstruction method could be applied in signals derived from the microvascular perfusion. We describe the basis and the implementation of attractor reconstruction analysis of the microvascular blood flux (BF) signals recorded from the skin of 15 healthy male volunteers, age 29.2 ± 8.1y (mean ± SD). The efficacy of attractor reconstruction analysis (ARA) as a potential method of identifying changes in the microvascular function is evaluated in two haemodynamic steady states, at 33°C, and during warming at 43°C to generate a local thermal hyperaemia (LTH). Our findings show a significant drop of the maximal density derived from the ARA, during increased flow and that there was good discrimination of the blood flow signals between the two haemodynamic steady states, having good classification accuracy (80%). This study shows that ARA of BF signals can identify different microvascular functional states and thus has a potential for the clinical assessment and diagnosis of pathophysiological condition.
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Chipperfield AJ, Thanaj M, Clough GF. Multiscale, multidomain analysis of microvascular flow dynamics. Exp Physiol 2019; 105:1452-1458. [PMID: 31875329 DOI: 10.1113/ep087874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/23/2019] [Indexed: 12/17/2022]
Abstract
NEW FINDINGS What is the topic of this review? We describe a range of techniques in the time, frequency and information domains and their application alone and together for the analysis of blood flux signals acquired using laser Doppler fluximetry. What advances does it highlight? This review highlights the idea of using quantitative measures in different domains and scales to gain a better mechanistic understanding of the complex behaviours in the microcirculation. ABSTRACT To date, time- and frequency-domain metrics of signals acquired through laser Doppler fluximetry have been unable to provide consistent and robust measures of the changes that occur in the microcirculation in healthy individuals at rest or in response to a provocation, or in patient cohorts. Recent studies have shown that in many disease states, such as metabolic and cardiovascular disease, there appears to be a reduction in the adaptive capabilities of the microvascular network and a consequent reduction in physiological information content. Here, we introduce non-linear measures for assessing the information content of fluximetry signals and demonstrate how they can yield deeper understanding of network behaviour. In addition, we show how these methods may be adapted to accommodate the multiple time scales modulating blood flow and how they can be used in combination with time- and frequency-domain metrics to discriminate more effectively between the different mechanistic influences on network properties.
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Affiliation(s)
- A J Chipperfield
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - M Thanaj
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton, UK
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Nightingale AM, Leong CL, Burnish RA, Hassan SU, Zhang Y, Clough GF, Boutelle MG, Voegeli D, Niu X. Monitoring biomolecule concentrations in tissue using a wearable droplet microfluidic-based sensor. Nat Commun 2019; 10:2741. [PMID: 31227695 PMCID: PMC6588579 DOI: 10.1038/s41467-019-10401-y] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 05/07/2019] [Indexed: 01/02/2023] Open
Abstract
Knowing how biomarker levels vary within biological fluids over time can produce valuable insight into tissue physiology and pathology, and could inform personalised clinical treatment. We describe here a wearable sensor for monitoring biomolecule levels that combines continuous fluid sampling with in situ analysis using wet-chemical assays (with the specific assay interchangeable depending on the target biomolecule). The microfluidic device employs a droplet flow regime to maximise the temporal response of the device, using a screw-driven push-pull peristaltic micropump to robustly produce nanolitre-sized droplets. The fully integrated sensor is contained within a small (palm-sized) footprint, is fully autonomous, and features high measurement frequency (a measurement every few seconds) meaning deviations from steady-state levels are quickly detected. We demonstrate how the sensor can track perturbed glucose and lactate levels in dermal tissue with results in close agreement with standard off-line analysis and consistent with changes in peripheral blood levels.
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Affiliation(s)
- Adrian M Nightingale
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Chi Leng Leong
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, SO17 1BJ, UK
- Department of Bioengineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Rachel A Burnish
- Critical Care/ Anaesthesia and Perioperative Medicine Research Unit, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Sammer-Ul Hassan
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Yu Zhang
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, SO17 1BJ, UK
| | - Geraldine F Clough
- Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK
| | - Martyn G Boutelle
- Department of Bioengineering, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - David Voegeli
- Faculty of Environmental and Life Sciences, University of Southampton, Southampton, SO17 1BJ, UK
- Now at Department of Sport, Exercise & Health, University of Winchester, Winchester, SO22 4NR, UK
| | - Xize Niu
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, SO17 1BJ, UK.
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Baumann KY, Church MK, Clough GF, Quist SR, Schmelz M, Skov PS, Anderson CD, Tannert LK, Giménez-Arnau AM, Frischbutter S, Scheffel J, Maurer M. Skin microdialysis: methods, applications and future opportunities-an EAACI position paper. Clin Transl Allergy 2019; 9:24. [PMID: 31007896 PMCID: PMC6456961 DOI: 10.1186/s13601-019-0262-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 03/25/2019] [Indexed: 12/20/2022] Open
Abstract
Skin microdialysis (SMD) is a versatile sampling technique that can be used to recover soluble endogenous and exogenous molecules from the extracellular compartment of human skin. Due to its minimally invasive character, SMD can be applied in both clinical and preclinical settings. Despite being available since the 1990s, the technique has still not reached its full potential use as a tool to explore pathophysiological mechanisms of allergic and inflammatory reactions in the skin. Therefore, an EAACI Task Force on SMD was formed to disseminate knowledge about the technique and its many applications. This position paper from the task force provides an overview of the current use of SMD in the investigation of the pathogenesis of chronic inflammatory skin diseases, such as atopic dermatitis, chronic urticaria, psoriasis, and in studies of cutaneous events during type 1 hypersensitivity reactions. Furthermore, this paper covers drug hypersensitivity, UVB-induced- and neurogenic inflammation, and drug penetration investigated by SMD. The aim of this paper is to encourage the use of SMD and to make the technique easily accessible by providing an overview of methodology and applications, supported by standardized operating procedures for SMD in vivo and ex vivo.
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Affiliation(s)
- Katrine Y Baumann
- RefLab ApS, Copenhagen, Denmark.,2Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Martin K Church
- 3Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | | | - Sven Roy Quist
- 5Clinic of Dermatology, Otto-von-Guericke University, Magdeburg, Germany.,Skin Center MDZ, Mainz, Germany
| | - Martin Schmelz
- 7Department of Experimental Pain Research, CBTM, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Per Stahl Skov
- RefLab ApS, Copenhagen, Denmark.,8Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Center, Odense University Hospital, Odense, Denmark
| | - Chris D Anderson
- 9Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Line Kring Tannert
- 8Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Center, Odense University Hospital, Odense, Denmark
| | - Ana Maria Giménez-Arnau
- 10Department of Dermatology, Hospital del Mar, Institut Mar d'Investigacions Mèdiques, Universitat Autònoma, Barcelona, Spain
| | - Stefan Frischbutter
- 3Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Jörg Scheffel
- 3Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Marcus Maurer
- 3Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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Chipperfield AJ, Thanaj M, Scorletti E, Byrne CD, Clough GF. Multi-domain analysis of microvascular flow motion dynamics in NAFLD. Microcirculation 2019; 26:e12538. [PMID: 30803094 DOI: 10.1111/micc.12538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/22/2019] [Accepted: 02/20/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To determine whether analysis of microvascular network perfusion using complexity-based methods can discriminate between groups of individuals at an increased risk of developing CVD. METHODS Data were obtained from laser Doppler recordings of skin blood flux at the forearm in 50 participants with non-alcoholic fatty liver disease grouped for absence (n = 28) or presence (n = 14) of type 2 diabetes and use of calcium channel blocker medication (n = 8). Power spectral density was evaluated and Lempel-Ziv complexity determined to quantify signal information content at single and multiple time-scales to account for the different processes modulating network perfusion. RESULTS Complexity was associated with dilatory capacity and respiration and negatively with baseline blood flux and cardiac band power. The relationship between the modulators of flowmotion and complexity of blood flux is shown to change with time-scale improving discrimination between groups. Multiscale Lempel-Ziv achieved best classification accuracy of 86.1%. CONCLUSIONS Time and frequency domain measures alone are insufficient to discriminate between groups. As cardiovascular disease risk increases, the degree of complexity of the blood flux signal reduces, indicative of a reduced temporal activity and heterogeneous distribution of blood flow within the microvascular network sampled. Complexity-based methods, particularly multiscale variants, are shown to have good discriminatory capabilities.
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Affiliation(s)
- Andrew J Chipperfield
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
| | - Marjola Thanaj
- Faculty of Engineering and Physical Sciences, University of Southampton, Southampton, UK
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Thanaj M, Chipperfield AJ, Clough GF. Analysis of microvascular blood flow and oxygenation: Discrimination between two haemodynamic steady states using nonlinear measures and multiscale analysis. Comput Biol Med 2018; 102:157-167. [DOI: 10.1016/j.compbiomed.2018.09.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/07/2018] [Accepted: 09/24/2018] [Indexed: 11/16/2022]
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Manousopoulou A, Scorletti E, Smith DE, Teng J, Fotopoulos M, Roumeliotis TI, Clough GF, Calder PC, Byrne CD, Garbis SD. Marine omega-3 fatty acid supplementation in non-alcoholic fatty liver disease: Plasma proteomics in the randomized WELCOME* trial. Clin Nutr 2018; 38:1952-1955. [PMID: 30172659 DOI: 10.1016/j.clnu.2018.07.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 05/31/2018] [Accepted: 07/31/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is a liver condition characterised by liver fat accumulation and often considered to be the liver manifestation of metabolic syndrome. The aim of this study was to examine in patients with NAFLD the system-wide effects of treatment with docosahexaenoic acid + eicosapentaenoic acid (DHA + EPA) versus placebo on the plasma proteome. METHODS Plasma from patients that participated in a 15-18 months randomised, double-blind placebo-controlled trial testing the effects of 4 g DHA + EPA daily was analysed using depletion-free quantitative proteomics. RESULTS Bioinformatics interpretation of the proteomic analysis showed that DHA + EPA treatment affected pathways involving blood coagulation, immune/inflammatory response and cholesterol metabolism (p < 0.05). Two key proteins of cardiovascular risk, prothrombin and apolipoprotein B-100, were shown to decrease as a result of DHA + EPA supplementation [Prothrombin: Males DHA + EPA Mean iTRAQ log2ratio (SD) = -0.13 (0.20) p = 0.05, Females DHA + EPA Mean iTRAQ log2ratio (SD) = -0.48 (0.35) p = 0.03; Apo B-100: Males DHA + EPA Mean iTRAQ log2ratio (SD) = -0.24 (0.16) p = 0.01, Females DHA + EPA Mean iTRAQ log2ratio (SD) = -0.15 (0.05) p = 0.02]. CONCLUSIONS Plasma proteomics applied in a randomised, placebo-controlled trial showed that high dose DHA + EPA treatment in patients with NAFLD affects multiple pathways involved in chronic non-communicable diseases.
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Affiliation(s)
| | - Eleonora Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Debbie E Smith
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Jie Teng
- Institute for Life Sciences, University of Southampton, Southampton, UK; Tianjin Medical University - School of Pharmacy, Tianjin, China
| | | | - Theodoros I Roumeliotis
- Institute for Life Sciences, University of Southampton, Southampton, UK; Institute for Cancer Research, London, UK
| | - Geraldine F Clough
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Spiros D Garbis
- Institute for Life Sciences, University of Southampton, Southampton, UK; Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; Proteome Exploration Laboratory of the Beckman Institute, California Institute of Technology, Pasadena, CA, 91125, USA.
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Cooper LJ, Zeller-Plumhoff B, Clough GF, Ganapathisubramani B, Roose T. Using high resolution X-ray computed tomography to create an image based model of a lymph node. J Theor Biol 2018; 449:73-82. [PMID: 29678689 DOI: 10.1016/j.jtbi.2018.04.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/21/2018] [Accepted: 04/15/2018] [Indexed: 11/28/2022]
Abstract
Lymph nodes are an important part of the immune system. They filter the lymphatic fluid as it is transported from the tissues before being returned to the blood stream. The fluid flow through the nodes influences the behaviour of the immune cells that gather within the nodes and the structure of the node itself. Measuring the fluid flow in lymph nodes experimentally is challenging due to their small size and fragility. In this paper, we present high resolution X-ray computed tomography images of a murine lymph node. The impact of the resulting visualized structures on fluid transport are investigated using an image based model. The high contrast between different structures within the lymph node provided by phase contrast X-ray computed tomography reconstruction results in images that, when related to the permeability of the lymph node tissue, suggest an increased fluid velocity through the interstitial channels in the lymph node tissue. Fluid taking a direct path from the afferent to the efferent lymphatic vessel, through the centre of the node, moved faster than the fluid that flowed around the periphery of the lymph node. This is a possible mechanism for particles being moved into the cortex.
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Affiliation(s)
- L J Cooper
- Faculty of Engineering and the Environment, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK.
| | - B Zeller-Plumhoff
- Faculty of Engineering and the Environment, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | - B Ganapathisubramani
- Faculty of Engineering and the Environment, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
| | - T Roose
- Faculty of Engineering and the Environment, University of Southampton, Highfield Campus, Southampton SO17 1BJ, UK
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13
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Zeller-Plumhoff B, Daly KR, Clough GF, Schneider P, Roose T. Investigation of microvascular morphological measures for skeletal muscle tissue oxygenation by image-based modelling in three dimensions. J R Soc Interface 2018; 14:rsif.2017.0635. [PMID: 29021164 DOI: 10.1098/rsif.2017.0635] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 09/12/2017] [Indexed: 12/15/2022] Open
Abstract
The supply of oxygen in sufficient quantity is vital for the correct functioning of all organs in the human body, especially for skeletal muscle during exercise. Traditionally, microvascular oxygen supply capability is assessed by the analysis of morphological measures on transverse cross-sections of muscle, e.g. capillary density or capillary-to-fibre ratio. In this work, we investigate the relationship between microvascular structure and muscle tissue oxygenation in mice. Phase contrast imaging was performed using synchrotron radiation computed tomography (SR CT) to visualize red blood cells (RBCs) within the microvasculature in mouse soleus muscle. Image-based mathematical modelling of the oxygen diffusion from the RBCs into the muscle tissue was subsequently performed, as well as a morphometric analysis of the microvasculature. The mean tissue oxygenation was then compared with the morphological measures of the microvasculature. RBC volume fraction and spacing (mean distance of any point in tissue to the closest RBC) emerged as the best predictors for muscle tissue oxygenation, followed by length density (summed RBC length over muscle volume). The two-dimensional measures of capillary density and capillary-to-fibre ratio ranked last. We, therefore, conclude that, in order to assess the states of health of muscle tissue, it is advisable to rely on three-dimensional morphological measures rather than on the traditional two-dimensional measures.
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Affiliation(s)
- B Zeller-Plumhoff
- Helmholtz-Zentrum für Material- und Küstenforschung, Geesthacht, Germany .,Bioengineering Research Group, Faculty of Engineering and the Environment, , University of Southampton, Southampton, UK
| | - K R Daly
- Bioengineering Research Group, Faculty of Engineering and the Environment, , University of Southampton, Southampton, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Schneider
- Bioengineering Research Group, Faculty of Engineering and the Environment, , University of Southampton, Southampton, UK
| | - T Roose
- Bioengineering Research Group, Faculty of Engineering and the Environment, , University of Southampton, Southampton, UK
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14
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Welsh JA, Scorletti E, Clough GF, Englyst NA, Byrne CD. Leukocyte extracellular vesicle concentration is inversely associated with liver fibrosis severity in NAFLD. J Leukoc Biol 2018; 104:631-639. [DOI: 10.1002/jlb.5a1217-501r] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 02/04/2018] [Accepted: 03/08/2018] [Indexed: 12/21/2022] Open
Affiliation(s)
- Joshua A. Welsh
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - Eleonora Scorletti
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - Geraldine F. Clough
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - Nicola A. Englyst
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - Christopher D. Byrne
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton United Kingdom
- National Institute for Health Research, Southampton Biomedical Research Centre; University Hospital Southampton NHS Foundation Trust; University of Southampton; Southampton United Kingdom
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15
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Clough GF, Kuliga KZ, Chipperfield AJ. Flow motion dynamics of microvascular blood flow and oxygenation: Evidence of adaptive changes in obesity and type 2 diabetes mellitus/insulin resistance. Microcirculation 2018; 24. [PMID: 27809397 DOI: 10.1111/micc.12331] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/31/2016] [Indexed: 11/29/2022]
Abstract
An altered spatial heterogeneity and temporal stability of network perfusion can give rise to a limited adaptive ability to meet metabolic demands. Derangement of local flow motion activity is associated with reduced microvascular blood flow and tissue oxygenation, and it has been suggested that changes in flow motion activity may provide an early indicator of declining, endothelial, neurogenic, and myogenic regulatory mechanisms and signal the onset and progression of microvascular pathophysiology. This short conference review article explores some of the evidence for altered flow motion dynamics of blood flux signals acquired using laser Doppler fluximetry in the skin in individuals at risk of developing or with cardiometabolic disease.
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Affiliation(s)
| | - Katarzyna Z Kuliga
- Faculty of Medicine, University of Southampton, Southampton, UK.,Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - Andrew J Chipperfield
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
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16
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Zeller-Plumhoff B, Roose T, Clough GF, Schneider P. Image-based modelling of skeletal muscle oxygenation. J R Soc Interface 2017; 14:rsif.2016.0992. [PMID: 28202595 DOI: 10.1098/rsif.2016.0992] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 01/25/2017] [Indexed: 12/12/2022] Open
Abstract
The supply of oxygen in sufficient quantity is vital for the correct functioning of all organs in the human body, in particular for skeletal muscle during exercise. Disease is often associated with both an inhibition of the microvascular supply capability and is thought to relate to changes in the structure of blood vessel networks. Different methods exist to investigate the influence of the microvascular structure on tissue oxygenation, varying over a range of application areas, i.e. biological in vivo and in vitro experiments, imaging and mathematical modelling. Ideally, all of these methods should be combined within the same framework in order to fully understand the processes involved. This review discusses the mathematical models of skeletal muscle oxygenation currently available that are based upon images taken of the muscle microvasculature in vivo and ex vivo Imaging systems suitable for capturing the blood vessel networks are discussed and respective contrasting methods presented. The review further informs the association between anatomical characteristics in health and disease. With this review we give the reader a tool to understand and establish the workflow of developing an image-based model of skeletal muscle oxygenation. Finally, we give an outlook for improvements needed for measurements and imaging techniques to adequately investigate the microvascular capability for oxygen exchange.
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Affiliation(s)
- B Zeller-Plumhoff
- Helmholtz-Zentrum für Material- und Küstenforschung, Geesthacht, Germany .,Bioengineering Research Group, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - T Roose
- Bioengineering Research Group, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Schneider
- Bioengineering Research Group, Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
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17
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Agra KF, Pontes IEA, da Silva JR, Figueiroa JN, Clough GF, Alves JGB. Impaired neurovascular reactivity in the microvasculature of pregnant women with preeclampsia. Microcirculation 2017; 24. [DOI: 10.1111/micc.12383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 05/08/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Karine Ferreira Agra
- Department of Mother and Child Health; Instituto de Medicina Integral Prof. Fernando Figueira-IMIP; Recife Brazil
| | | | - José Roberto da Silva
- Department of Mother and Child Health; Instituto de Medicina Integral Prof. Fernando Figueira-IMIP; Recife Brazil
| | - José Natal Figueiroa
- Department of Mother and Child Health; Instituto de Medicina Integral Prof. Fernando Figueira-IMIP; Recife Brazil
| | | | - João Guilherme Bezerra Alves
- Department of Mother and Child Health; Instituto de Medicina Integral Prof. Fernando Figueira-IMIP; Recife Brazil
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18
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Zeller-Plumhoff B, Roose T, Katsamenis OL, Mavrogordato MN, Torrens C, Schneider P, Clough GF. Phase contrast synchrotron radiation computed tomography of muscle spindles in the mouse soleus muscle. J Anat 2017; 230:859-865. [PMID: 28369928 DOI: 10.1111/joa.12606] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 12/29/2022] Open
Abstract
Muscle spindles are skeletal muscle sensory organs involved in the sensation of position and movement of the body. We have explored the capability of phase contrast computed tomography to visualise muscle spindles in murine skeletal muscle. In particular, we have validated the visualisation of nerve fibres through phase contrast computed tomography using light microscopy on stained histological sections. We further present the first three-dimensional visualisation of muscle spindles in mouse soleus skeletal muscle in conjunction with the neurovascular bundle associated with it.
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Affiliation(s)
- B Zeller-Plumhoff
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,Helmholtz-Zentrum für Material- und Küstenforschung, Geesthacht, Germany
| | - T Roose
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - O L Katsamenis
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,μ-VIS X-ray Imaging Centre, University of Southampton, Southampton, UK
| | - M N Mavrogordato
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK.,μ-VIS X-ray Imaging Centre, University of Southampton, Southampton, UK
| | - C Torrens
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Schneider
- Faculty of Engineering and the Environment, University of Southampton, Southampton, UK
| | - G F Clough
- Faculty of Medicine, University of Southampton, Southampton, UK
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19
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Kuliga KZ, Gush R, Clough GF, Chipperfield AJ. Time-dependent Behavior of Microvascular Blood Flow and Oxygenation: a Predictor of Functional Outcomes. IEEE Trans Biomed Eng 2017; 65:1049-1056. [DOI: 10.1109/tbme.2017.2737328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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Clough GF, McCormick KG, Scorletti E, Bhatia L, Calder PC, Griffin MJ, Byrne CD. Higher body fat percentage is associated with enhanced temperature perception in NAFLD: results from the randomised Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD with OMacor thErapy trial (WELCOME) trial. Diabetologia 2016; 59:1422-1429. [PMID: 27106721 DOI: 10.1007/s00125-016-3966-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/01/2016] [Indexed: 01/18/2023]
Abstract
AIMS/HYPOTHESIS The effect of n-3 fatty acid treatment on temperature perception as a sensory nerve function modality is uncertain. In patients with non-alcoholic fatty liver disease (NAFLD) both with and without type 2 diabetes, we: (1) tested whether 15-18 months' treatment with 4 g/day of docosahexaenoic plus eicosapentaenoic acid (DHA+EPA) improved hot (HPT) and cold (CPT) temperature perception thresholds and (2) explored factors associated with HPT and CPT, in a randomised, double-blind, placebo-controlled trial. METHODS The effect of treatment (n = 44) on HPT, CPT and temperature perception index (TPI: difference between HPT and CPT) was measured at the big toe in 90 individuals without neuropathy (type 2 diabetes; n = 30). Participants were randomised 1:1, using sequential numbering, by personnel independent from the trial team. All participants and all members of the research team were blinded to group assignment. Data were collected in the Southampton National Institute for Health Research Biomedical Research Centre. Treatment effects and the independence of associations were testing by regression modelling. RESULTS Mean ± SD age was 50.9 ± 10.6 years. In men (n = 53) and women (n = 37), HPTs (°C) were 46.1 ± 5.1 and 43.1 ± 6.4 (p = 0.02), CPTs (°C) were 22.7 ± 3.4 and 24.5 ± 3.6 (p = 0.07) and TPIs (°C) were 23.4 ± 7.4 and 18.7 ± 9.5 (p = 0.008), respectively. In univariate analyses, total body fat percentage (measured by dual-energy x-ray absorptiometry [DXA]) was associated with HPT (r = -0.36 p = 0.001), CPT (r = 0.35 p = 0.001) and TPI (r = 0.39 p = 0.0001). In multivariable-adjusted regression models, adjusting for age, sex and other potential confounders, only body fat percentage was independently associated with HPT, CPT or TPI (p = 0.006, p = 0.006 and p = 0.002, respectively). DHA+EPA treatment did not modify HPT, CPT or TPI (p = 0.93, p = 0.44 and p = 0.67, respectively). There were no important adverse effects or side effects reported. CONCLUSIONS/INTERPRETATION Higher body fat percentage is associated with enhanced temperature perception. There was no benefit of treatment with high-dose n-3 fatty acids on the thresholds to detect hot or cold stimuli. TRIAL REGISTRATION ClinicalTrials.gov NCT00760513 FUNDING: This work was supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Unit grant and by a Diabetes UK allied health research training fellowship awarded to KMcC (Diabetes UK. BDA 09/0003937).
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Affiliation(s)
- Geraldine F Clough
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Keith G McCormick
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - Eleonora Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lokpal Bhatia
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Michael J Griffin
- Institute of Sound and Vibration Research, University of Southampton, Southampton, UK
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, The Institute of Developmental Sciences (IDS), MP887, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, UK.
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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21
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Stead R, Musa MG, Bryant CL, Lanham SA, Johnston DA, Reynolds R, Torrens C, Fraser PA, Clough GF. Developmental conditioning of endothelium-derived hyperpolarizing factor-mediated vasorelaxation. J Hypertens 2016; 34:452-63; discussion 463. [PMID: 26682783 PMCID: PMC4732175 DOI: 10.1097/hjh.0000000000000833] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 10/26/2015] [Accepted: 11/20/2015] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The endothelium maintains vascular homeostasis through the release of endothelium-derived relaxing factors (EDRF) and endothelium-derived hyperpolarization (EDH). The balance in EDH : EDRF is disturbed in cardiovascular disease and may also be susceptible to developmental conditioning through exposure to an adverse uterine environment to predispose to later risk of hypertension and vascular disease. METHODS Developmentally conditioned changes in EDH : EDRF signalling pathways were investigated in cremaster arterioles (18-32 μm diameter) and third-order mesenteric arteries of adult male mice offspring of dams fed either a fat-rich (high fat, HF, 45% energy from fat) or control (C, 10% energy from fat) diet. After weaning, offspring either continued on high fat or were placed on control diets to give four dietary groups (C/C, HF/C, C/HF, and HF/HF) and studied at 15 weeks of age. RESULTS EDH via intermediate (IKCa) and small (SKca) conductance calcium-activated potassium channels contributed less than 10% to arteriolar acetylcholine-induced relaxation in in-situ conditioned HF/C offspring compared with ∼60% in C/C (P < 0.01). The conditioned reduction in EDH signalling in HF/C offspring was reversed in offspring exposed to a high-fat diet both before and after weaning (HF/HF, 55%, P < 0.01 vs. HF/C). EDH signalling was unaffected in arterioles from C/HF offspring. The changes in EDH : EDRF were associated with altered endothelial cell expression and localization of IKCa channels. CONCLUSION This is the first evidence that EDH-mediated microvascular relaxation is susceptible to an adverse developmental environment through down-regulation of the IKCa signalling pathway. Conditioned offspring exposed to a 'second hit' (HF/HF) exhibit adaptive vascular mechanisms to preserve dilator function.
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Affiliation(s)
- Rebecca Stead
- Vascular Research Group
- Rebecca Stead and Moji G. Musa contributed equally to the writing of this article
| | - Moji G. Musa
- Vascular Research Group
- Rebecca Stead and Moji G. Musa contributed equally to the writing of this article
| | | | - Stuart A. Lanham
- Bone and Joint Research Group, Institute of Developmental Sciences
| | - David A. Johnston
- Faculty of Medicine, Biomedical Imaging Unit, University of Southampton, Southampton
| | | | | | - Paul A. Fraser
- Cardiovascular Division, BHF Centre of Research Excellence, School of Medicine, King's College London, London, United Kingdom
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Hanson MA, Cooper C, Aihie Sayer A, Eendebak RJ, Clough GF, Beard JR. Developmental aspects of a life course approach to healthy ageing. J Physiol 2016; 594:2147-60. [PMID: 26518329 DOI: 10.1113/jp270579] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/30/2015] [Indexed: 12/23/2022] Open
Abstract
We examine the mechanistic basis and wider implications of adopting a developmental perspective on human ageing. Previous models of ageing have concentrated on its genetic basis, or the detrimental effects of accumulated damage, but also have raised issues about whether ageing can be viewed as adaptive itself, or is a consequence of other adaptive processes, for example if maintenance and repair processes in the period up to reproduction are traded off against later decline in function. A life course model places ageing in the context of the attainment of peak capacity for a body system, starting in early development when plasticity permits changes in structure and function induced by a range of environmental stimuli, followed by a period of decline, the rate of which depends on the peak attained as well as the later life conditions. Such path dependency in the rate of ageing may offer new insights into its modification. Focusing on musculoskeletal and cardiovascular function, we discuss this model and the possible underlying mechanisms, including endothelial function, oxidative stress, stem cells and nutritional factors such as vitamin D status. Epigenetic changes induced during developmental plasticity, and immune function may provide a common mechanistic process underlying a life course model of ageing. The life course trajectory differs in high and low resource settings. New insights into the developmental components of the life course model of ageing may lead to the design of biomarkers of later chronic disease risk and to new interventions to promote healthy ageing, with important implications for public health.
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Affiliation(s)
- M A Hanson
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,NIHR Nutrition Biomedical Research Centre, University Hospital Southampton, UK
| | - C Cooper
- NIHR Nutrition Biomedical Research Centre, University Hospital Southampton, UK.,MRC Lifecourse Epidemiology Unit, University Hospital Southampton, UK
| | - A Aihie Sayer
- NIHR Nutrition Biomedical Research Centre, University Hospital Southampton, UK.,MRC Lifecourse Epidemiology Unit, University Hospital Southampton, UK
| | - R J Eendebak
- Andrology Research Unit, Centre for Endocrinology and Diabetes, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Old St Mary's Building, Hathersage Road, Manchester, UK
| | - G F Clough
- Institute of Developmental Sciences, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - J R Beard
- Department of Ageing and Lifecourse, World Health Organization, 20 Avenue Appia, 1211, Geneva 27, Switzerland
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Bhatia L, Scorletti E, Curzen N, Clough GF, Calder PC, Byrne CD. Improvement in non-alcoholic fatty liver disease severity is associated with a reduction in carotid intima-media thickness progression. Atherosclerosis 2015; 246:13-20. [PMID: 26748347 DOI: 10.1016/j.atherosclerosis.2015.12.028] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIMS n-3 polyunsaturated fatty acid (PUFA) treatment may decrease liver fat in non-alcoholic fatty liver disease (NAFLD), but uncertainty exists whether this treatment also decreases cardiovascular disease (CVD) risk in NAFLD. We tested whether 15-18 months n-3 PUFA [docosahexaenoic acid (DHA) and eicosapentaenoic acid] (Omacor/Lovaza, 4 g/day) vs placebo decreased carotid intima-media thickness (CIMT) progression, a surrogate marker of CVD risk. We also evaluated if improvement in markers of NAFLD severity was associated with decreased CIMT progression over time. METHODS In a pre-specified sub-study of the WELCOME (Wessex Evaluation of fatty Liver and Cardiovascular markers in NAFLD with OMacor thErapy) trial (NCT00760513), CIMT was measured using B-mode ultrasound while NAFLD severity was assessed by measuring liver fat percentage (magnetic resonance spectroscopy) and hepatic necro-inflammation (serum cytokeratin-18 (CK-18) concentration), at baseline and end of study. RESULTS 92 patients (age 51.5 ± 10.7 years, 57.6% men) completed the study. In the treatment group (n = 45), CIMT progressed by 0.012 mm (IQR 0.005-0.020 mm) compared to 0.015 mm (IQR 0.007-0.025 mm) in the placebo group (n = 47) (p = 0.17). Reduced CIMT progression in the entire cohort was independently associated with decreased liver fat (standardized β-coefficient 0.32, p = 0.005), reduced CK-18 levels (standardized β-coefficient 0.22, p = 0.04) and antihypertensive usage (standardized β-coefficient -0.31, p = 0.009) in multivariable regression analysis after adjusting for all potential confounders. Decreased weight (standardized β-coefficient 0.30, p < 0.001) and increased DHA tissue enrichment during the 18-month study (standardized β-coefficient -0.19, p = 0.027) were both independently associated with decreased liver fat, but not with CK-18. CONCLUSION Improvement in two markers of NAFLD severity is independently associated with reduced CIMT progression.
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Affiliation(s)
- Lokpal Bhatia
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; Wessex Cardiac Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Eleonora Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Nicholas Curzen
- National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; Wessex Cardiac Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Geraldine F Clough
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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24
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Patel HP, White MC, Westbury L, Syddall HE, Stephens PJ, Clough GF, Cooper C, Sayer AA. Skeletal muscle morphology in sarcopenia defined using the EWGSOP criteria: findings from the Hertfordshire Sarcopenia Study (HSS). BMC Geriatr 2015; 15:171. [PMID: 26678672 PMCID: PMC4683975 DOI: 10.1186/s12877-015-0171-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/10/2015] [Indexed: 01/06/2023] Open
Abstract
Background Sarcopenia is defined as the loss of muscle mass and function with age and is associated with decline in mobility, frailty, falls and mortality. There is considerable interest in understanding the underlying mechanisms. Our aim was to characterise muscle morphology changes associated with sarcopenia among community dwelling older men. Methods One hundred and five men aged 68–76 years were recruited to the Hertfordshire Sarcopenia Study (HSS) for detailed characterisation of muscle including measures of muscle mass, strength and function. Muscle tissue was obtained from a biopsy of the vastus lateralis for 99 men and was processed for immunohistochemical studies to determine myofibre distribution and area, capillarisation and satellite cell (SC) density. Results Six (6 %) men had sarcopenia as defined by the European Working Group on Sarcopenia in Older People (EWGSOP) criteria. These men had lower SC density (1.7 cells/mm2 vs 3.8 cells/mm2, p = 0.06) and lower SC/fibre ratio (0.02 vs 0.06, p = 0.06) than men without sarcopenia. Although men with sarcopenia tended to have smaller myofibres and lower capillary to fibre ratio, these relationships were not statistically significant. Conclusion We have shown that there may be altered muscle morphology parameters in older men with sarcopenia. These results have the potential to help identify cell and molecular targets for therapeutic intervention. This work now requires extension to larger studies which also include women.
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Affiliation(s)
- H P Patel
- Academic Geriatric Medicine, University of Southampton, University Hospital Southampton FoundationTrust (UHSFT), Tremona Road, Southampton, SO16 6YD, UK. .,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK. .,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and UHSFT, Tremona Road, Southampton, SO16 6YD, UK.
| | - M C White
- Academic Geriatric Medicine, University of Southampton, University Hospital Southampton FoundationTrust (UHSFT), Tremona Road, Southampton, SO16 6YD, UK
| | - L Westbury
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK
| | - H E Syddall
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK
| | - P J Stephens
- Academic Geriatric Medicine, University of Southampton, University Hospital Southampton FoundationTrust (UHSFT), Tremona Road, Southampton, SO16 6YD, UK
| | - G F Clough
- Institute for Developmental Sciences, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK
| | - C Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and UHSFT, Tremona Road, Southampton, SO16 6YD, UK.,National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - A A Sayer
- Academic Geriatric Medicine, University of Southampton, University Hospital Southampton FoundationTrust (UHSFT), Tremona Road, Southampton, SO16 6YD, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK.,National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and UHSFT, Tremona Road, Southampton, SO16 6YD, UK.,National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care: Wessex, Academic Geriatric Medicine, University of Southampton, UHSFT, Tremona Road, Southampton, SO16 6YD, UK.,Newcastle University Institute for Ageing and Institute of Health & Society, Newcastle University, Newcastle, UK
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Scorletti E, West AL, Bhatia L, Hoile SP, McCormick KG, Burdge GC, Lillycrop KA, Clough GF, Calder PC, Byrne CD. Treating liver fat and serum triglyceride levels in NAFLD, effects of PNPLA3 and TM6SF2 genotypes: Results from the WELCOME trial. J Hepatol 2015; 63:1476-83. [PMID: 26272871 DOI: 10.1016/j.jhep.2015.07.036] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND & AIMS Genetic variation in both patatin-like phospholipase domain-containing protein-3 (PNPLA3) (I148M) and the transmembrane 6 superfamily member 2 protein (TM6SF2) (E167K) influences severity of liver disease, and serum triglyceride concentrations in non-alcoholic fatty liver disease (NAFLD), but whether either genotype influences the responses to treatments is uncertain. METHODS One hundred three patients with NAFLD were randomised to omega-3 fatty acids (DHA+EPA) or placebo for 15-18months in a double blind placebo controlled trial. Erythrocyte enrichment with DHA and EPA was measured by gas chromatography. PNPLA3 and TM6SF2 genotypes were measured by PCR technologies. Multivariable linear regression and analysis of covariance were undertaken to test the effect of genotypes on omega-3 fatty acid enrichment, end of study liver fat percentage and serum triglyceride concentrations. All models were adjusted for baseline measurements of each respective outcome. RESULTS Fifty-five men and 40 women (Genotypes PNPLA3 I148M, 148I/I=41, 148I/M=43, 148M/M=11; TM6SF2 E167K 167E/E=78, 167E/K+167K/K=17 participants) (mean ± SD age, 51 ± 11 years) completed the trial. Adjusting for baseline measurement, measured covariates and confounders, PNPLA3 148M/M variant was independently associated with percentage of DHA enrichment (B coefficient -1.02 (95% CI -1.97, -0.07), p=0.036) but not percentage of EPA enrichment (B coefficient -0.31 (95% CI -1.38, 0.75), p=0.56). This genotype was also independently associated with end of study liver fat percentage (B coefficient 9.5 (95% CI 2.53, 16.39), p=0.008), but not end of study triglyceride concentration (B coefficient -0.11 (95% CI -0.64, 0.42), p=0.68). CONCLUSIONS PNPLA3 148M/M variant influences the changes in liver fat and DHA tissue enrichment during the trial but not the change in serum triglyceride concentration.
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Affiliation(s)
- Eleonora Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
| | - Annette L West
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lokpal Bhatia
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Samuel P Hoile
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Keith G McCormick
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Graham C Burdge
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Karen A Lillycrop
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Geraldine F Clough
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Philip C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Christopher D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
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McCormick KG, Scorletti E, Bhatia L, Calder PC, Griffin MJ, Clough GF, Byrne CD. Impact of high dose n-3 polyunsaturated fatty acid treatment on measures of microvascular function and vibration perception in non-alcoholic fatty liver disease: results from the randomised WELCOME trial. Diabetologia 2015; 58:1916-25. [PMID: 26021488 DOI: 10.1007/s00125-015-3628-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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] [Received: 03/12/2015] [Accepted: 04/29/2015] [Indexed: 12/20/2022]
Abstract
AIMS/HYPOTHESIS The effect of n-3 fatty acid treatment on vibration perception thresholds (VPTs) and cutaneous microvascular reactivity is not known. We tested whether: (1) a 15-18 month treatment with high dose (4 g/day) docosahexaenoic (DHA) plus eicosapentaenoic (EPA) acid improved VPT and microvascular reactivity in patients with non-alcoholic fatty liver disease; and (2) there are associations between VPT, microvascular reactivity and metabolic variables. METHODS In the completed single centre, randomised, parallel group, placebo controlled Wessex Evaluation of fatty Liver and Cardiovascular markers in non-alcoholic fatty liver disease with OMacor thErapy (WELCOME) trial, we tested the effect of DHA+EPA on VPT at 125 Hz (big toe) and the cutaneous hyperaemic response (forearm) to arterial occlusion (ratio of maximum to resting blood flux [MF/RF]). Allocation and dispensing was carried out by an independent research pharmacist; all participants and research team members were blinded to group assignment. RESULTS In all, 51 and 49 patients were randomised to placebo and DHA+EPA, respectively (mean age 51.4 years). Of these, 32 had type 2 diabetes. Forty-six (placebo) and 47 (DHA+EPA) patients completed the study; there were no important adverse (or unexpected) effects or side effects. In multivariable-adjusted regression models (intention-to-treat analyses), DHA+EPA treatment was associated with an increase in VPT (β coefficient 1.49 [95% CI 0.04, 2.94], p = 0.04). For VPT, the adjusted mean differences (95% CIs) in the placebo and DHA+EPA treatment groups were -0.725 (-1.71, 0.25) and 0.767 (-0.21, 1.75) m/s(2), respectively. With DHA+EPA treatment, there was no change in MF/RF (β coefficient 0.07 [95% CI -0.56, 0.70], p = 0.84), the adjusted mean differences (95% CIs) in the placebo and DHA+EPA treatment groups were -0.549 (-1.03, -0.07) and -0.295 (-0.77, 0.18) respectively. VPT was independently associated with age (β coefficient 0.019 [95% CI 0.010, 0.029], p < 0.0001) and MF/RF (β coefficient -0.074 [95% CI -0.132, -0.016], p = 0.013), but not with diabetes (p = 0.38). CONCLUSIONS/INTERPRETATION High dose n-3 fatty acid treatment did not improve measures of microvascular function or vibration perception. Ageing and microvascular reactivity are associated with a measure of peripheral nerve function. TRIAL REGISTRATION ClinicalTrials.gov NCT00760513. FUNDING The study was funded by the National Institute for Health Research UK and Diabetes UK.
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Affiliation(s)
- Keith G McCormick
- Human Development and Health Academic Unit, Faculty of Medicine, University Hospital Southampton, MP887, IDS Building, Tremona Road, Southampton, SO166YD, UK
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Pontes IEA, Afra KF, Silva JR, Borges PSN, Clough GF, Alves JGB. Microvascular reactivity in women with gestational diabetes mellitus studied during pregnancy. Diabetol Metab Syndr 2015; 7:27. [PMID: 26056535 PMCID: PMC4459465 DOI: 10.1186/s13098-015-0017-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 03/03/2015] [Indexed: 01/11/2023] Open
Abstract
AIM To compare microvascular reactivity assessed in the skin using laser Doppler fluximetry (LDF) in women with gestational diabetes mellitus (GDM) and gestational age-matched control during pregnancy. METHODS 110 pregnant women at ~33 weeks gestation participated in the study. Skin microvascular reactivity was evaluated by LDF, at rest, during the response to brief arterial occlusion (post occlusive hyperaemic response) and during sympathetically mediated vasoconstrictor response to deep inspiratory breath hold. RESULTS No statistically significant differences were found in the microvascular variables studied (resting and maximum rate flux, post-ischaemic reactive hyperaemia and deep inspiratory breath holds) between +GDM and -GDM groups women. In women with GDM there was a negative correlation between resting flux and the response to the oral glucose tolerance test (OGTT), r = -0.282 (p = 0.037). There was also a negative correlation between the response to the OGTT and the sympathetically mediated constrictor response to inspiratory breath holds (r = -.298, p = .030) but not in women with GDM (r = .102, r = .468). CONCLUSION Attenuated microvascular reactivity as an early marker of endothelial dysfunction is not present in women with GDM when assessed during pregnancy.
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Affiliation(s)
- Isabelle EA Pontes
- />Mother and Child Unit, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Rua dos Coelhos, 300, 50070-550 Boa Vista Recife, Pernambuco Brazil
| | - Karine F Afra
- />Mother and Child Unit, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Rua dos Coelhos, 300, 50070-550 Boa Vista Recife, Pernambuco Brazil
| | - José R Silva
- />Mother and Child Unit, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Rua dos Coelhos, 300, 50070-550 Boa Vista Recife, Pernambuco Brazil
| | - Paulo SN Borges
- />Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - João GB Alves
- />Mother and Child Unit, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Rua dos Coelhos, 300, 50070-550 Boa Vista Recife, Pernambuco Brazil
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Scorletti E, Bhatia L, McCormick KG, Clough GF, Nash K, Hodson L, Moyses HE, Calder PC, Byrne CD. Effects of purified eicosapentaenoic and docosahexaenoic acids in nonalcoholic fatty liver disease: results from the Welcome* study. Hepatology 2014; 60:1211-21. [PMID: 25043514 DOI: 10.1002/hep.27289] [Citation(s) in RCA: 231] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/05/2014] [Accepted: 06/21/2014] [Indexed: 02/06/2023]
Abstract
There is no licensed treatment for non-alcoholic fatty liver disease (NAFLD), a condition that increases risk of chronic liver disease, type 2 diabetes and cardiovascular disease. We tested whether 15-18 months treatment with docosahexaenoic acid (DHA) plus eicosapentaenoic acid (EPA) (Omacor/Lovaza) (4 g/day) decreased liver fat and improved two histologically-validated liver fibrosis biomarker scores (primary outcomes). Patients with NAFLD were randomised in a double blind placebo-controlled trial [DHA+EPA(n=51), placebo(n=52)]. We quantified liver fat percentage (%) by magnetic resonance spectroscopy in three liver zones. We measured liver fibrosis using two validated scores. We tested adherence to the intervention (Omacor group) and contamination (with DHA and EPA) (placebo group) by measuring erythrocyte percentage DHA and EPA enrichment (gas chromatography). We undertook multivariable linear regression to test effects of: a) DHA+EPA treatment (ITT analyses) and b) erythrocyte DHA and EPA enrichment (secondary analysis). Median (IQR) baseline and end of study liver fat% were 21.7 (19.3) and 19.7 (18.0) (placebo), and 23.0 (36.2) and 16.3 (22.0), (DHA+EPA). In the fully adjusted regression model there was a trend towards improvement in liver fat% with DHA+EPA treatment (β=-3.64 (95%CI -8.0,0.8); p=0.1) but there was evidence of contamination in the placebo group and variable adherence to the intervention in the Omacor group. Further regression analysis showed that DHA enrichment was independently associated with a decrease in liver fat% (for each 1% enrichment, β=-1.70 (95%CI -2.9,-0.5); p=0.007). No improvement in the fibrosis scores occurred. Conclusion. Erythrocyte DHA enrichment with DHA+EPA treatment is linearly associated with decreased liver fat%. Substantial decreases in liver fat% can be achieved with high percentage erythrocyte DHA enrichment in NAFLD. (Hepatology 2014;).
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Affiliation(s)
- Eleonora Scorletti
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
- National Institute for Health Research Southampton Biomedical Research Center (in Nutrition) and Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust; Southampton UK
| | - Lokpal Bhatia
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
- National Institute for Health Research Southampton Biomedical Research Center (in Nutrition) and Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust; Southampton UK
| | - Keith G. McCormick
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
| | - Geraldine F. Clough
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
| | - Kathryn Nash
- Hepatology; University Hospital Southampton, NHS Foundation Trust; Southampton UK
| | - Leanne Hodson
- Oxford Center for Diabetes; Endocrinology and Metabolism (OCDEM), University of Oxford; Oxford UK
| | - Helen E. Moyses
- National Institute for Health Research Southampton Biomedical Research Center (in Nutrition) and Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust; Southampton UK
| | - Philip C. Calder
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
- National Institute for Health Research Southampton Biomedical Research Center (in Nutrition) and Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust; Southampton UK
| | - Christopher D. Byrne
- Human Development and Health Academic Unit; Faculty of Medicine, University of Southampton; Southampton UK
- National Institute for Health Research Southampton Biomedical Research Center (in Nutrition) and Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton National Health Service (NHS) Foundation Trust; Southampton UK
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Kuliga KZ, McDonald EF, Gush R, Michel C, Chipperfield AJ, Clough GF. Dynamics of Microvascular Blood Flow and Oxygenation Measured Simultaneously in Human Skin. Microcirculation 2014; 21:562-73. [DOI: 10.1111/micc.12136] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 03/27/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Katarzyna Z. Kuliga
- Human Development & Health; Faculty of Medicine; University of Southampton; Southampton UK
| | - Erin F. McDonald
- Human Development & Health; Faculty of Medicine; University of Southampton; Southampton UK
| | | | - Charles Michel
- Department of Bioengineering; Imperial College London; London UK
| | | | - Geraldine F. Clough
- Human Development & Health; Faculty of Medicine; University of Southampton; Southampton UK
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Valletta JJ, Chipperfield AJ, Clough GF, Byrne CD. Daily energy expenditure, cardiorespiratory fitness and glycaemic control in people with type 1 diabetes. PLoS One 2014; 9:e97534. [PMID: 24826899 PMCID: PMC4020853 DOI: 10.1371/journal.pone.0097534] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/21/2014] [Indexed: 12/20/2022] Open
Abstract
Objective Encouraging daily physical activity improves cardiorespiratory fitness and many cardiovascular risk factors. However, increasing physical activity often creates a challenge for people with type 1 diabetes, because of difficulties maintaining euglycemia in the face of altered food intake and adjustments to insulin doses. Our aim was to examine the triangular relationship between glucose control measured by continuous glucose monitoring system (CGMS), objective measures of total daily energy expenditure (TEE) recorded by a multi-sensory monitoring device, and cardiorespiratory fitness (CRF), in free-living subjects with type 1 diabetes. Research Design and Methods Twenty-three individuals (12 women) with type 1 diabetes who were free from micro- and macrovascular complications were recruited. TEE and glucose control were monitored simultaneously for up to 12 days, using a multi-sensory device and CGMS respectively. CRF was recorded as V02 max from a maximal treadmill test with the Bruce protocol. Results Subjects (mean±SD) were aged 37±11 years, with BMI = 26.5±5.1 kg.m−2, HbA1c = 7.7±1.3% (61±14 mmol/mol) and V02 max (ml.min−1.kg−1) = 39.9±8.4 (range 22.4 – 58.6). TEE (36.3±5.5 kcal.kg−1.day−1) was strongly associated with CRF(39.9±8.4 ml.min−1.kg−1) independently of sex (r = 0.63, p<0.01). However, neither TEE (r = −0.20, p = 0.36) nor CRF (r = −0.20, p = 0.39; adjusted for sex), were significantly associated with mean glycaemia measured by CGMS. Conclusion Higher levels of energy expenditure (due to a more active lifestyle) are associated with increased cardiorespiratory fitness, but not necessarily better glycaemic control. Since increased levels of energy expenditure and good glycaemic control are both needed to protect against diabetes-related complications our data suggest they need to be achieved independently.
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Affiliation(s)
- John Joseph Valletta
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- Bioengineering Science, Faculty of Engineering and the Environment, University of Southampton, Southampton, United Kingdom
| | - Andrew J. Chipperfield
- Bioengineering Science, Faculty of Engineering and the Environment, University of Southampton, Southampton, United Kingdom
- * E-mail:
| | - Geraldine F. Clough
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Christopher D. Byrne
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Scorletti E, Bhatia L, McCormick KG, Clough GF, Nash K, Calder PC, Byrne CD. Design and rationale of the WELCOME trial: A randomised, placebo controlled study to test the efficacy of purified long chainomega-3 fatty acid treatment in non-alcoholic fatty liver disease [corrected]. Contemp Clin Trials 2014; 37:301-11. [PMID: 24556343 DOI: 10.1016/j.cct.2014.02.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 01/28/2014] [Accepted: 02/05/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) represents a range of liver conditions from simple fatty liver to progressive end stage liver disease requiring liver transplantation. NAFLD is common in the population and in certain sub groups (e.g. type 2 diabetes) up to 70% of patients may be affected. NAFLD is not only a cause of end stage liver disease and hepatocellular carcinoma, but is also an independent risk factor for type 2 diabetes and cardiovascular disease. Consequently, effective treatments for NAFLD are urgently needed. OBJECTIVES The WELCOME study is testing the hypothesis that treatment with high dose purified long chain omega-3 fatty acids will have a beneficial effect on a) liver fat percentage and b) two histologically validated algorithmically-derived biomarker scores for liver fibrosis. DESIGN In a randomised double blind placebo controlled trial, 103 participants with NAFLD were randomised to 15-18months treatment with either 4g/day purified long chain omega-3 fatty acids (Omacor) or 4g/day olive oil as placebo. Erythrocyte percentage DHA and EPA enrichment (a validated proxy for hepatic enrichment) was determined by gas chromatography. Liver fat percentage was measured in three discrete liver zones by magnetic resonance spectroscopy (MRS). We also measured body fat distribution, physical activity and a range of cardiometabolic risk factors. METHODS Recruitment started in January 2010 and ended in June 2011. We identified 178 potential participants, and randomised 103 participants who met the inclusion criteria. The WELCOME study was approved by the local ethics committee (REC: 08/H0502/165; www.clinicalTrials.gov registration number NCT00760513).
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Affiliation(s)
- E Scorletti
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - L Bhatia
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - K G McCormick
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - G F Clough
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - K Nash
- Hepatology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - P C Calder
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C D Byrne
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK; National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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He D, Nguyen HC, Hayes-Gill BR, Zhu Y, Crowe JA, Gill C, Clough GF, Morgan SP. Laser doppler blood flow imaging using a CMOS imaging sensor with on-chip signal processing. Sensors (Basel) 2013; 13:12632-47. [PMID: 24051525 PMCID: PMC3821350 DOI: 10.3390/s130912632] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/06/2013] [Accepted: 09/09/2013] [Indexed: 11/16/2022]
Abstract
The first fully integrated 2D CMOS imaging sensor with on-chip signal processing for applications in laser Doppler blood flow (LDBF) imaging has been designed and tested. To obtain a space efficient design over 64 × 64 pixels means that standard processing electronics used off-chip cannot be implemented. Therefore the analog signal processing at each pixel is a tailored design for LDBF signals with balanced optimization for signal-to-noise ratio and silicon area. This custom made sensor offers key advantages over conventional sensors, viz. the analog signal processing at the pixel level carries out signal normalization; the AC amplification in combination with an anti-aliasing filter allows analog-to-digital conversion with a low number of bits; low resource implementation of the digital processor enables on-chip processing and the data bottleneck that exists between the detector and processing electronics has been overcome. The sensor demonstrates good agreement with simulation at each design stage. The measured optical performance of the sensor is demonstrated using modulated light signals and in vivo blood flow experiments. Images showing blood flow changes with arterial occlusion and an inflammatory response to a histamine skin-prick demonstrate that the sensor array is capable of detecting blood flow signals from tissue.
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Affiliation(s)
- Diwei He
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
| | - Hoang C. Nguyen
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
| | - Barrie R. Hayes-Gill
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
| | - Yiqun Zhu
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
| | - John A. Crowe
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
| | - Cally Gill
- School of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK; E-Mails: (C.G.); (G.F.C.)
| | - Geraldine F. Clough
- School of Medicine, University of Southampton, University Road, Southampton SO17 1BJ, UK; E-Mails: (C.G.); (G.F.C.)
| | - Stephen P. Morgan
- Electrical Systems and Optics Research Division, Faculty of Engineering, University of Nottingham, University Park, Nottingham NG7 2RD, UK; E-Mails: (D.H.); (H.C.N.); (B.R.H.-G.); (Y.Z.); (J.A.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +44-115-9515-570; Fax: +44-115-9515-616
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Clough GF, Stenken JA, Church MK. High Molecular Weight Targets and Treatments Using Microdialysis. Microdialysis in Drug Development 2013. [DOI: 10.1007/978-1-4614-4815-0_13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Winter CD, Clough GF, Pringle AK, Church MK. Outcome following severe traumatic brain injury TBI correlates with serum S100B but not brain extracellular fluid S100B: An intracerebral microdialysis study. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/wjns.2013.32013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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He D, Nguyen HC, Hayes-Gill BR, Zhu Y, Crowe JA, Clough GF, Gill CA, Morgan SP. 64×64 pixel smart sensor array for laser Doppler blood flow imaging. Opt Lett 2012; 37:3060-3062. [PMID: 22859085 DOI: 10.1364/ol.37.003060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
What is believed to be the first fully integrated two-dimensional complementary metal oxide semiconductor (CMOS) imaging array for laser Doppler blood flow imaging is demonstrated. The sensor has 64×64 pixels and includes both analog and digital on-chip processing electronics. This offers several potential advantages over commercial sensors as the processing is tailored to the signals of interest and the data bottleneck that exists between the sensor and processing electronics is overcome. To obtain a space efficient design over 64×64 pixels means that standard processing electronics used off-chip cannot be implemented. Images of both simulated blood flow responses and a blood flow occlusion test demonstrate the capability.
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Affiliation(s)
- D He
- Faculty of Engineering, University of Nottingham, University Park, Nottingham, UK
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Abstract
This spotlight issue of Microcirculation contains four state-of-the-art review articles on the role of microRNAs (miRNAs), a class of endogenous, highly conserved, small, non-coding RNAs that regulate gene expression at the post transcriptional level, and can act as key regulators of cellular mechanisms within the microcirculation. The expert reviews address issues, such as the role of miRNAs in determining endothelial cell differentiation and lineage commitment, the physiological role of miRNAs as critical modulators of endothelial cell proliferation, apoptosis and in angiogenesis, and their aberrant expression in different vascular disorders. The reviews also explore the prognostic value of miRNAs in cardiovascular disease and how they may serve both as a therapeutic target and clinical biomarker in the future. This cutting edge edition of the journal Microcirculation highlights the progress that has been made in this new and challenging research area.
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L'Esperance VS, Cox SE, Simpson D, Gill C, Makani J, Soka D, Mgaya J, Kirkham FJ, Clough GF. Peripheral vascular response to inspiratory breath hold in paediatric homozygous sickle cell disease. Exp Physiol 2012; 98:49-56. [PMID: 22660812 PMCID: PMC4463767 DOI: 10.1113/expphysiol.2011.064055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
New Findings • What is the central question of this study? Autonomic nervous dysfunction is implicated in complications of sickle cell anaemia (SCA). In healthy adults, a deep inspiratory breath hold (IBH) elicits rapid transient SNS- mediated vasoconstriction detectable using Laser Doppler Flux (LDF) assessment of the finger-tip cutaneous micovasculature. • What is the main finding and its importance? We demonstrate significantly increased resting peripheral blood flow and sympathetic activity in African children with SCA compared to sibling controls and increased sympathetic stimulation in response to vasoprovocation with DIG. This study is the first to observe an inverse association between resting peripheral blood flow and haemoglobin oxygen saturation (SpO2). These phenomena may be an adaptive response to the hypoxic exposure in SCA. There is increasing evidence that autonomic dysfunction in adults with homozygous sickle cell (haemoglobin SS) disease is associated with enhanced autonomic nervous system-mediated control of microvascular perfusion. However, it is unclear whether such differences are detectable in children with SS disease. We studied 65 children with SS disease [38 boys; median age 7.2 (interquartile range 5.1–10.6) years] and 20 control children without symptoms of SS disease [8 boys; 8.7 (5.5–10.8) years] and recorded mean arterial blood pressure (ABP) and daytime haemoglobin oxygen saturation (). Cutaneous blood flux at rest (RBF) and during the sympathetically activated vasoconstrictor response to inspiratory breath hold (IBH) were measured in the finger pulp of the non-dominant hand using laser Doppler fluximetry. Local factors mediating flow motion were assessed by power spectral density analysis of the oscillatory components of the laser Doppler signal. The RBF measured across the two study groups was negatively associated with age (r=−0.25, P < 0.0001), ABP (r=−0.27, P= 0.02) and daytime (r=−0.30, P= 0.005). Children with SS disease had a higher RBF (P= 0.005) and enhanced vasoconstrictor response to IBH (P= 0.002) compared with control children. In children with SS disease, higher RBF was associated with an increase in the sympathetic interval (r=−0.28, P= 0.022). The SS disease status, daytime and age explained 22% of the variance in vasoconstrictor response to IBH (P < 0.0001). Our findings suggest that blood flow and blood flow responses in the skin of young African children with SS disease differ from those of healthy control children, with increased resting peripheral blood flow and increased sympathetic stimulation from a young age in SS disease. They further suggest that the laser Doppler flowmetry technique with inspiratory breath hold manoeuvre appears to be robust for use in young children with SS disease, to explore interactions between , ABP and autonomic function with clinical complications, e.g. skin ulceration.
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Affiliation(s)
- Veline S L'Esperance
- Vascular Research Group, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Abstract
BACKGROUND Constant moderate intensity physical exertion in humid environments at altitude poses a considerable challenge to maintaining euglycaemia with Type 1 diabetes. Blood glucose concentrations and energy expenditure were continuously recorded in a person trekking at altitude in a tropical climate to quantify changes in glucose concentrations in relation to energy expenditure. CASE REPORT Blood glucose concentrations and energy expenditure were continuously monitored with a Guardian® real-time continuous glucose monitoring system (CGMS) and a SenseWear® Pro3 armband (BodyMedia Inc., USA), in a 27-year-old woman with Type 1 diabetes, during her climb up Mount Kinabalu in Borneo (c. 4095 m). Comparative control data from the same person was collected in the UK (temperate climate at sea level) and Singapore (tropical climate at sea level). Maximum physical effort during the climb was < 60% VO(2MAX) (maximal oxygen consumption). Mean daily calorific intakes were 2300 kcal (UK), 2370 kcal (Singapore) and 2274 kcal (Mount Kinabalu), and mean daily insulin doses were 54 U (UK), 40 U (Singapore) and 47 U (Mount Kinabalu). Despite markedly increased energy expenditure during the climb [4202 kcal (Mount Kinabalu) vs. 2948 kcal (UK) and 2662 kcal (Singapore)], mean blood glucose was considerably higher during the trek up Mount Kinabalu [13.2 ± 5.9 mmol/l, vs. 7.9 ± 3.8 mmol/l (UK) and 8.6 ± 4.0 mmol/l (Singapore)]. CONCLUSION Marked unexpected hyperglycaemia occurred while trekking on Mount Kinabalu, despite similar calorie consumption and insulin doses to control conditions. Because of the risk of unexpected hyperglycaemia in these conditions, we recommend that patients embarking on similar activity holidays undertake frequent blood glucose monitoring.
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Affiliation(s)
- J J Valletta
- The Institute of Developmental Sciences, Endocrinology and Metabolism Unit, School of Medicine School of Engineering Sciences, University of Southampton, Southampton, UK.
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Kelsall CJ, Hoile SP, Irvine NA, Masoodi M, Torrens C, Lillycrop KA, Calder PC, Clough GF, Hanson MA, Burdge GC. Vascular dysfunction induced in offspring by maternal dietary fat involves altered arterial polyunsaturated fatty acid biosynthesis. PLoS One 2012; 7:e34492. [PMID: 22509311 PMCID: PMC3317992 DOI: 10.1371/journal.pone.0034492] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/01/2012] [Indexed: 12/26/2022] Open
Abstract
Nutrition during development affects risk of future cardiovascular disease. Relatively little is known about whether the amount and type of fat in the maternal diet affect vascular function in the offspring. To investigate this, pregnant and lactating rats were fed either 7%(w/w) or 21%(w/w) fat enriched in either 18:2n-6, trans fatty acids, saturated fatty acids, or fish oil. Their offspring were fed 4%(w/w) soybean oil from weaning until day 77. Type and amount of maternal dietary fat altered acetylcholine (ACh)-mediated vaso-relaxation in offspring aortae and mesenteric arteries, contingent on sex. Amount, but not type, of maternal dietary fat altered phenylephrine (Pe)-induced vasoconstriction in these arteries. Maternal 21% fat diet decreased 20:4n-6 concentration in offspring aortae. We investigated the role of Δ6 and Δ5 desaturases, showing that their inhibition in aortae and mesenteric arteries reduced vasoconstriction, but not vaso-relaxation, and the synthesis of specific pro-constriction eicosanoids. Removal of the aortic endothelium did not alter the effect of inhibition of Δ6 and Δ5 desaturases on Pe-mediated vasoconstriction. Thus arterial smooth muscle 20:4n-6 biosynthesis de novo appears to be important for Pe-mediated vasoconstriction. Next we studied genes encoding these desaturases, finding that maternal 21% fat reduced Fads2 mRNA expression and increased Fads1 in offspring aortae, indicating dysregulation of 20:4n-6 biosynthesis. Methylation at CpG -394 bp 5' to the Fads2 transcription start site predicted its expression. This locus was hypermethylated in offspring of dams fed 21% fat. Pe treatment of aortae for 10 minutes increased Fads2, but not Fads1, mRNA expression (76%; P<0.05). This suggests that Fads2 may be an immediate early gene in the response of aortae to Pe. Thus both amount and type of maternal dietary fat induce altered regulation of vascular tone in offspring though differential effects on vaso-relaxation, and persistent changes in vasoconstriction via epigenetic processes controlling arterial polyunsaturated fatty acid biosynthesis.
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MESH Headings
- Acetylcholine/pharmacology
- Adrenergic alpha-1 Receptor Agonists/pharmacology
- Animals
- Aorta, Thoracic/drug effects
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/physiopathology
- Arteries/drug effects
- Arteries/metabolism
- Arteries/physiopathology
- Delta-5 Fatty Acid Desaturase
- Dietary Fats/adverse effects
- Fatty Acids, Unsaturated/biosynthesis
- Fatty Acids, Unsaturated/blood
- Female
- Gene Expression Regulation, Enzymologic/drug effects
- Male
- Mesenteric Arteries/drug effects
- Mesenteric Arteries/metabolism
- Mesenteric Arteries/physiopathology
- Mothers
- Muscarinic Agonists/pharmacology
- Phenylephrine/pharmacology
- Pregnancy
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Rats
- Rats, Wistar
- Receptors, Adrenergic, alpha-1/metabolism
- Receptors, Muscarinic/metabolism
- Stearoyl-CoA Desaturase/genetics
- Vasoconstriction/drug effects
- Vasodilation/drug effects
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Affiliation(s)
- Christopher J. Kelsall
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Samuel P. Hoile
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Nicola A. Irvine
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Mojgan Masoodi
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, United Kingdom
| | - Christopher Torrens
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Karen A. Lillycrop
- Faculty of Natural and Environmental Sciences, University of Southampton, Hampshire, United Kingdom
| | - Philip C. Calder
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Geraldine F. Clough
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Mark A. Hanson
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
| | - Graham C. Burdge
- Academic Unit of Human Development and Health, Faculty of Medicine, University of Southampton, Hampshire, United Kingdom
- * E-mail:
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Gill C, Parkinson E, Church MK, Skipp P, Scott D, White AJ, O'Connor CD, Clough GF. A qualitative and quantitative proteomic study of human microdialysate and the cutaneous response to injury. AAPS J 2011; 13:309-17. [PMID: 21494910 DOI: 10.1208/s12248-011-9269-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/07/2011] [Indexed: 01/16/2023]
Abstract
The extracellular fluid space is the site of intercellular communication and represents an important source of mediators that can shed light on the parenchymal environment. Sampling of this compartment using continuous microdialysis allows assessment of the temporal changes in extracellular mediators involved in tissue homeostasis and disease processes. However, novel biomarker identification is limited by the current need to utilize specific, targeted molecular assays. The aim of our study was to explore the use of qualitative and quantitative proteomic approaches to define the protein content of dermal dialysate. Timed dermal dialysate samples were collected from healthy human volunteers for 5 h following probe insertion, using a 3,000-kDa MWCO membrane perfused at a rate of 3 μl/min. Dialysate proteins were identified using GeLC-MS/MS and iTRAQ approaches and functions assigned according to the Gene Ontology classification system. More than 80 proteins (size range 11-516 kDa) originating from both extracellular and intracellular fluid space were identified using the qualitative approach of GeLC-MS/MS. Quantitative iTRAQ data were obtained for 27 proteins with relative change ratios between consecutive timed samples showing changes of >1.5-fold. Interstitial proteins can be identified and measured using shotgun proteomic techniques and changes detected during the acute inflammatory response. Our findings provide a platform from which to explore novel protein biomarkers and their modulation in health and disease.
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Affiliation(s)
- Carolyn Gill
- Centre for Proteomic Research, School of Biological Sciences, University of Southampton, UK
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Clough GF, L'Esperance V, Turzyniecka M, Walter L, Chipperfield AJ, Gamble J, Krentz AJ, Byrne CD. Functional dilator capacity is independently associated with insulin sensitivity and age in central obesity and is not improved by high dose statin treatment. Microcirculation 2011; 18:74-84. [PMID: 21166928 DOI: 10.1111/j.1549-8719.2010.00070.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To test the hypothesis that: (i) functional microvascular dilator capacity is independently associated with insulin sensitivity and age in individuals with central adiposity at risk of cardiovascular disease (CVD); and (ii) functional microvascular dilator capacity is improved by high dose statin treatment. METHODS Functional dilator capacity (measured as change in laser Doppler blood flux from baseline during post occlusive reactive hyperemia [peak flux%resting flux; PF%RF] and flowmotion (power spectral density [PSD] analysis)) were assessed in 40 people with central adiposity and one or more other CVD risk factors. Measurements were made at rest and during acute hyperinsulinaemia before and six months after high dose atorvastatin (40 mg daily) or placebo. RESULTS Insulin-induced change in PF%RF was independently associated with insulin sensitivity (M/I) (r = 0.46 p = 0.02) and age (r = -0.46 p = 0.02), which together explained almost half of the variance in PF%RF (adjusted r² = 0.37, p = 0.008). Whilst atorvastatin decreased LDL cholesterol by 51% (p < 0.001), PF%RF and flowmotion remained unchanged. CONCLUSIONS Insulin sensitivity and age are independently associated with an insulin-induced change in functional microvascular dilator capacity in individuals with central adiposity at risk of CVD. Dilator capacity is not improved by six months high dose statin treatment.
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Affiliation(s)
- Geraldine F Clough
- Institute of Developmental Sciences, School of Medicine, University of Southampton, Southampton General Hospital (MP 887), Southampton, UK.
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Bruce KD, Cagampang FR, Argenton M, Zhang J, Ethirajan PL, Burdge GC, Bateman AC, Clough GF, Poston L, Hanson MA, McConnell JM, Byrne CD. Maternal high-fat feeding primes steatohepatitis in adult mice offspring, involving mitochondrial dysfunction and altered lipogenesis gene expression. Hepatology 2009; 50:1796-808. [PMID: 19816994 DOI: 10.1002/hep.23205] [Citation(s) in RCA: 326] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
UNLABELLED Nonalcoholic fatty liver disease (NAFLD) describes an increasingly prevalent spectrum of liver disorders associated with obesity and metabolic syndrome. It is uncertain why steatosis occurs in some individuals, whereas nonalcoholic steatohepatitis (NASH) occurs in others. We have generated a novel mouse model to test our hypothesis: that maternal fat intake contributes to the development of NAFLD in adult offspring. Female mice were fed either a high-fat (HF) or control chow (C) diet before and during gestation and lactation. Resulting offspring were fed either a C or a HF diet after weaning, to generate four offspring groups; HF/HF, HF/C, C/HF, C/C. At 15 weeks of age, liver histology was normal in both the C/C and HF/C offspring. Kleiner scoring showed that although the C/HF offspring developed nonalcoholic fatty liver, the HF/HF offspring developed NASH. At 30 weeks, histological analysis and Kleiner scoring showed that both the HF/C and C/HF groups had NAFLD, whereas the HF/HF had a more severe form of NASH. Therefore, exposure to a HF diet in utero and during lactation contributes toward NAFLD progression. We investigated the mechanisms by which this developmental priming is mediated. At 15 weeks of age, hepatic mitochondrial electron transport chain (ETC) enzyme complex activity (I, II/III, and IV) was reduced in both groups of offspring from HF-fed mothers (HF/C and HF/HF). In addition, measurement of hepatic gene expression indicated that lipogenesis, oxidative stress, and inflammatory pathways were up-regulated in the 15-week-old HF/C and HF/HF offspring. CONCLUSION Maternal fat intake contributes toward the NAFLD progression in adult offspring, which is mediated through impaired hepatic mitochondrial metabolism and up-regulated hepatic lipogenesis.
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Affiliation(s)
- Kimberley D Bruce
- Institute of Developmental Sciences, University of Southampton, Southampton General Hospital, Southampton, UK.
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Stenken JA, Church MK, Gill CA, Clough GF. How minimally invasive is microdialysis sampling? A cautionary note for cytokine collection in human skin and other clinical studies. AAPS J 2009; 12:73-8. [PMID: 19950008 DOI: 10.1208/s12248-009-9163-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 11/16/2009] [Indexed: 01/05/2023]
Abstract
It is common to refer to microdialysis as a minimally invasive procedure, likening it to insertion of an artificial capillary. While a comparison of this type allows the process to be easily visualized by those outside the field, it tends to provide a false impression of the localized perturbation of the tissue space that is caused by catheter insertion. With the increased acceptance of microdialysis sampling as a viable in vivo sampling method, many researchers have begun to use the technique to explore inflammatory and immune-mediated diseases in the skin and other organs. Unfortunately, many of the molecules of interest, particularly chemokines and cytokines, are known to be generated during the inflammatory response to wounding and the subsequent cellular events leading to wound repair. With more than 11,000 reports citing the use of microdialysis sampling, only a few researchers have sought to assess the tissue damage that is incurred by probe insertion. For this reason, caution is warranted when collecting these molecules and inferring a role for them in clinical disease states. This commentary seeks to remind the research community of the confounding effects that signaling molecules related to the wounding response will have on clinical studies. Proper controls must be incorporated into all studies in order to assess whether or not particular molecules are truly related to the disease state under investigation or have been generated as part of the tissue response to the wound incurred by microdialysis catheter implantation.
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Affiliation(s)
- Julie A Stenken
- Department of Chemistry and Biochemistry, University of Arkansas, Fayetteville, Arkansas 72701, USA.
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Avery MR, Voegeli D, Byrne CD, Simpson DM, Clough GF. Age and Cigarette Smoking are Independently Associated with the Cutaneous Vascular Response to Local Warming. Microcirculation 2009; 16:725-34. [DOI: 10.3109/10739680903199194] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Turzyniecka M, Wild SH, Krentz AJ, Chipperfield AJ, Gamble J, Clough GF, Byrne CD. Skeletal muscle microvascular exchange capacity is associated with hyperglycaemia in subjects with central obesity. Diabet Med 2009; 26:1112-9. [PMID: 19929989 DOI: 10.1111/j.1464-5491.2009.02822.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 01/08/2023]
Abstract
AIMS Poor glycaemic control is associated with increased risk of microvascular disease in various organs including the eye and kidney, but the relationship between glycated haemoglobin (HbA(1c)) and microvascular function in skeletal muscle has not been described. We tested the association between HbA(1c) and a measure of microvascular exchange capacity (K(f)) in skeletal muscle in people with central obesity at risk of developing Type 2 diabetes. METHODS Microvascular function was measured in 28 women and 19 men [mean (+/- sd) age 51 +/- 9 years] with central obesity who did not have diabetes. We estimated insulin sensitivity by hyperinsulinaemic-euglycaemic clamp, visceral and total fatness by magnetic resonance imaging, fitness (VO(2) max by treadmill testing), physical activity energy expenditure [metabolic equivalents of tasks (METS) by use of the SenseWear Pro armband] and skeletal muscle microvascular exchange capacity (K(f)) by venous occlusion plethysmography. RESULTS In regression modelling, age, sex and fasting plasma glucose accounted for 30.5% of the variance in HbA(1c) (r(2) = 0.31, P = 0.001). Adding K(f) to this model explained an additional 26.5% of the variance in HbA(1c) (r(2) = 0.57, P = 0.0001 and K(f) was strongly and independently associated with HbA(1c) (standardized B coefficient -0.45 (95% confidence interval -0.19, -0.06), P = 0.001). CONCLUSIONS We found a strong negative independent association between a measure of skeletal muscle microvascular exchange capacity (K(f)) and HbA(1c). K(f) was associated with almost as much of the variance in HbA(1c) as fasting plasma glucose.
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Affiliation(s)
- M Turzyniecka
- School of Medicine, University of Southampton, Southampton, UK
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47
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Affiliation(s)
- Geraldine F Clough
- Institute ofDevelopmental Sciences, School of Medicine, University of Southampton, Southampton SO16 6YD, UK.
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Clough GF, Turzyniecka M, Walter L, Krentz AJ, Wild SH, Chipperfield AJ, Gamble J, Byrne CD. Muscle microvascular dysfunction in central obesity is related to muscle insulin insensitivity but is not reversed by high-dose statin treatment. Diabetes 2009; 58:1185-91. [PMID: 19208914 PMCID: PMC2671046 DOI: 10.2337/db08-1688] [Citation(s) in RCA: 19] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To test the hypotheses that decreased insulin-mediated glucose disposal in muscle is associated with a reduced muscle microvascular exchange capacity (Kf) and that 6 months of high-dose statin therapy would improve microvascular function in people with central obesity. RESEARCH DESIGN AND METHODS We assessed skeletal muscle microvascular function, visceral fat mass, physical activity levels, fitness, and insulin sensitivity in skeletal muscle in 22 female and 17 male volunteers with central obesity whose age (mean +/- SD) was 51 +/- 9 years. We tested the effect of atorvastatin (40 mg daily) on muscle microvascular function in a randomized, double-blind, placebo-controlled trial lasting 6 months. RESULTS Kf was negatively associated with a measure of glycemia (A1C; r = -0.44, P = 0.006) and positively associated with insulin sensitivity (the ratio of insulin-stimulated glucose effectiveness, or M value, to the mean insulin concentration, or I value; r = 0.39, P = 0.02). In regression modeling, A1C, visceral fat mass, and M:I explained 38% of the variance in Kf (in a linear regression model with Kf as the outcome [R2 = 0.38, P = 0.005]). M:I was associated with Kf independently of visceral fat mass (B coefficient 3.13 [95% CI 0.22-6.02], P = 0.036). Although 6 months' treatment with atorvastatin decreased LDL cholesterol by 51% (P < 0.001) and plasma high-sensitivity C-reactive protein by 75% (P = 0.02), microvascular function was unchanged. CONCLUSIONS Decreased insulin-mediated glucose uptake in skeletal muscle is associated with impaired muscle microvascular exchange capacity (Kf), independently of visceral fat mass. Muscle microvascular function is not improved by 6 months of high-dose statin treatment, despite marked statin-mediated improvements in lipid metabolism and decreased inflammation.
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Affiliation(s)
| | | | - Lara Walter
- School of Medicine, University of Southampton, Southampton, U.K.; the
| | - Andrew J. Krentz
- School of Medicine, University of Southampton, Southampton, U.K.; the
| | - Sarah H. Wild
- Public Health Sciences, University of Edinburgh, Edinburgh, U.K.; the
| | | | | | - Christopher D. Byrne
- School of Medicine, University of Southampton, Southampton, U.K.; the
- Corresponding author: Christopher D. Byrne,
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Wetherell JR, Armstrong SJ, Read RW, Clough GF. VX Penetration Following Percutaneous Poisoning: A Dermal Microdialysis Study in the Guinea Pig. Toxicol Mech Methods 2008; 18:313-21. [DOI: 10.1080/15376510701884944] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Rodford JL, Torrens C, Siow RCM, Mann GE, Hanson MA, Clough GF. Endothelial dysfunction and reduced antioxidant protection in an animal model of the developmental origins of cardiovascular disease. J Physiol 2008; 586:4709-20. [PMID: 18669533 DOI: 10.1113/jphysiol.2008.156976] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Endothelial dysfunction underlies cardiovascular disease (CVD) in humans and is reported in animal models of developmental origins of such disease. We have investigated whether impaired antioxidant defences and NO generation underlie the genesis of endothelial dysfunction and operate as part of the normal processes of developmental plasticity regulating the induction of phenotype in the offspring. Female Wistar rats were fed either a control (C, 18% protein) or protein-restricted (PR, 9% protein) diet throughout pregnancy. Dams and pups were returned to standard laboratory chow post partum. In male offspring, PR resulted in a reduced endothelial responsiveness to acetylcholine (P < 0.05) in resistance arteries, with vascular remodelling evident from a reduction in smooth muscle content. mRNA expression of endothelial NO synthase (eNOS) was increased (P < 0.05) but there was no change in mRNA levels of manganese superoxide dismutase (MnSOD) or glutamate cysteine ligase (GCL) expression. Interestingly, expression of the antioxidant enzyme haem oxygenase-1 (HO-1) was reduced in the liver (P < 0.05). Female PR offspring also showed a reduced endothelial responsiveness but exhibited no changes in expression of eNOS, iNOS, soluble guanylate cyclase (sGC) or antioxidant genes. Thus, in this model of the developmental origins of CVD, the structure and function of resistance arteries in offspring is altered in complex ways which cannot simply be explained by attenuation in vascular eNOS or in antioxidant protection afforded by GCL or MnSOD. The dysfunction in male offspring may partially be counteracted by an up-regulation of eNOS expression; however, PR does lead to reduced HO-1 expression in these offspring, which may affect both their growth and vascular function. Our findings have established that PR induces significant phenotypic changes in male offspring that may be indicative of an adaptive response during development.
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Affiliation(s)
- Joanne L Rodford
- Institute of Developmental Sciences, University of Southampton, Southampton, UK
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