Exosomes in renal cell carcinoma: challenges and opportunities

Renal cell carcinoma (RCC) is the most common type of kidney cancer that accounts for approximately 2-3% of adult malignancies. Among the primary treatment methods for this type of cancer are surgery and targeted treatment. Still, due to less than optimal effectiveness, there are problems such as advanced distant metastasis, delayed diagnosis, and drug resistance that continue to plague patients. In recent years, therapeutic advances have increased life expectancy and effective treatment in renal cell carcinoma patients. One of these methods is the use of stem cells. Although the therapeutic effects of stem cells, especially mesenchymal stem cells, are still impressive, today, extracellular vesicles (EVs) as carrying molecules and various mediators in intercellular communications, having a central role in tumorigenesis, metastasis, immune evasion, and drug response, and on the other hand, due to its low immunogenicity and strong regulatory properties of the immune system, has received much attention from researchers and doctors. Despite the increasing interest in exosomes as the most versatile type of EVs, the heterogeneity of their efficacy presents challenges and, on the other hand, exciting opportunities for diagnostic and clinical interventions.In the upcoming article, we will review the various aspects of exosomes' effects in the prevention, treatment, and progress of renal cell carcinoma and also ways to optimize them to strengthen their positive sides.

Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019: results from the Global Burden of Disease Study 2019

BACKGROUND

The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories.

METHODS

In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4-B97.6, J09-J15.8, J16-J16.9, J20-J21.9, J91.0, P23.0-P23.4, and U04-U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors.

FINDINGS

Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18-1·42) male deaths and 1·20 million (1·07-1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16-1·18) and 1·31 times (95% UI 1·23-1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4-131·1]) and deaths (100·0% [83·4-115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (-70·7% [-77·2 to -61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7-61·8] in males and 56·4% [40·7-65·1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6-35·5] for males and PAF 25·8% [16·3-35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4-25·2) in those aged 15-49 years, 30·5% (24·1-36·9) in those aged 50-69 years, and 21·9% (16·8-27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5-27·9) in those aged 15-49 years and 18·2% (12·5-24·5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2-15·8) of LRI deaths.

INTERPRETATION

The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities.

FUNDING

Bill & Melinda Gates Foundation.

Molecular detection of fowl adenovirus 7 from slaughtered broiler chickens in Iran: the first report

Background

Fowl adenoviruses (FAdVs) are responsible for a variety of clinical symptoms, with an increasing significance in the poultry industry throughout the world. Typical diseases caused by FAdVs include inclusion body hepatitis (IBH), hepatitis-hydropericardium syndrome (HHS), gizzard erosion (GE), respiratory disease, and hemorrhage in muscles and organs.

Aims

During 2020, broiler chickens from the north of Iran showed ecchymotic and petechial hemorrhages in thigh and breast muscles at the slaughterhouse. Hemorrhages were observed in 10% to 60% (with an average of 20-30%) of chicks per flock. To find out the etiology of these lesions, the present study was conducted.

Methods

Different environmental factors were investigated, and FAdV, infectious bursal disease virus (IBDV), and chicken infectious anemia virus (CIAV) were detected using molecular assays.

Results

Among the viruses tested, FAdV was detected by polymerase chain reaction (PCR), and sequence analysis clustered the virus into species E, serotype 7.

Conclusion

This is the first report on FAdV-7 existence among poultry in Iran. Effective screening of the chicks at slaughtering age should be performed from the whole country.

Kidney injury in COVID-19 patients, drug development and their renal complications: Review study

Since December 2019, the world was encountered a new disease called coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although SARS-CoV-2 initially causes lung damage, it also affects many other organs, including the kidneys, and on average, 5–23% of people with COVID-19 develop the symptoms of acute kidney injury (AKI), including elevated blood creatinine and urea, hematuria, proteinuria, and histopathological damages. The exact mechanism is unknown, but the researchers believe that SARS-CoV-2 directly and indirectly affects the kidneys. The direct pathway is by binding the virus to ACE2 receptor in the kidney, damage to cells, the renin-angiotensin system disturbances, activating coagulation pathways, and damaging the renal vascular endothelium. The initial evidence from studying the kidney tissue in postmortem patients is more in favor of the direct pathway. The indirect pathway is created by increased cytokines and cytokine storm, sepsis, circulatory disturbances, hypoxemia, as well as using the nephrotoxic drugs. Using renal tissue biopsy and autopsy in the patients with COVID-19, recent studies found evidence for a predominant indirect pathway in AKI induction by SARS-CoV-2. Besides, some studies showed that the degree of acute tubular injury (ATI) in autopsies from COVID-19 victims is milder compared to AKI degree. We review the mechanism of AKI induction and the renal side effects of the most common drugs used to treat COVID-19 after the overview of the latest findings on SARS-CoV-2 pathogenicity.

Diagnosis of poult enteritis complex (PEC) and molecular detection of avian coronaviruses in some commercial turkey flocks in Iran

BACKGROUND

Enteritis syndromes, also known as poult enteritis complex (PEC) with diverse etiologies, can affect turkey production. An avian coronavirus (AvCoV), turkey coronavirus (TCoV), is one of the most important viral causes of PEC in turkeys.

AIMS

In the present study, the occurrence of PEC and the presence of AvCoV in some commercial turkey flocks were investigated.

METHODS

PEC was diagnosed based on the history, clinical, and necropsy findings. A reverse transcriptase-polymerase chain reaction (RT-PCR) targeting the AvCoV nucleoprotein (N) gene was applied to detect the virus in the tissue samples. Cloacal swabs were collected from 11 flocks without a known history of PEC.

RESULTS

PEC was diagnosed in six (16.2%) out of 37 investigated turkey flocks. The daily mortality rate in affected flocks ranged from 0.2 to 1.2%. Samples from 8 flocks out of 18 (44.4%) were positive for AvCoV. Four PEC affected flocks were positive for AvCoV. Seven positive samples were sequenced and phylogenetic analysis revealed the close relationship with previously characterized avian infectious bronchitis viruses (IBV).

CONCLUSION

The results suggested that PEC should be considered as a significant syndrome in the Iranian turkey industry. According to this preliminary study, it was shown that avian coronavirus infection is prevalent in commercial turkey farms of Iran. However, no causative association could be concluded between PEC occurrence and AvCoV infection in turkey flocks.

Volume 25, Issue 1 (March 2021) Physiol Pharmacol 2021, 25(1): 1-6 | Back to browse issues page 10.32598/ppj.25.1.10 XML Print Download citation: BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks Send citation to: Mendeley Zotero RefWorks Najafi H, Zarei R, Alimoradian A, Asafari M, Mohammadi M, Samadi F, et al . A review on humane endpoints in animal experimentation for biomedical research. Physiol Pharmacol. 2021; 25 (1) :1-6 URL: http://ppj.phypha.ir/article-1-1606-en.html A review on humane endpoints in animal experimentation for biomedical research

Introduction: The use of animals in experiments and their role in the development of medical sciences are undeniable. Humane endpoints terminate pain and distress in laboratory animals, which are experimented in painful procedures and an involuntary manner. This study was going to review studies published in this area to assist researchers in developing their approach. Methods: Articles used in this review study were obtained from relevant databases including Pubmed, Scopus, Science Direct, OVID, SID, Magiran and Google scholar. Results: “Humane endpoints” or killing the animal humanely means the point at which an experimental animal’s pain and/or distress is terminated. This pain and distress are not necessarily accompanied by clinical symptoms and it can also be recognized by biochemical, physiological and molecular biomarkers testing. Conclusion: Regarding the extensive use of laboratory animals, the aim is not only to take care of animals but also to develop knowledge and prevent unintentional animal suffering and death. Increasing awareness of ethical issues regarding research animal use needs scientific information and designing experiments, which are terminated immediately after achieving main goals. Otherwise, it threatens the life of animal and leads to the animal suffering.

The emergence of Q1 genotype of avian infectious bronchitis virus in Iran, 2019: the first report

BACKGROUND

Avian infectious bronchitis (IB) is an infectious viral disease of chickens. The effective protection of chickens against many different infectious bronchitis virus (IBV) variants is not achieved unless the circulating genotypes in the region are identified and the cross-protection of the potential of vaccines in use is assessed.

AIMS

In a monitoring program of IBVs, a new genotype was identified in the north of Iran, 2019. This work was conducted to isolate and characterize this new IBV genotype.

METHODS

Tracheal tissues were collected from chickens showing signs of respiratory involvement. Specimens were homogenized and inoculated to the allantoic fluid of embryonated specific pathogen-free (SPF) eggs. Infectious bronchitis virus was detected using real time-polymerase chain reaction (RT-PCR). The hypervariable region of the IBV S1 gene was amplified for sequencing.

RESULTS

Positive samples were phylogenetically analyzed, and both positive isolates were clustered with Q1 IBV strains.

CONCLUSION

This is the first report of the Q1 outbreak in Iran. More investigations are needed to find the role of Q1 IBV in the respiratory disease complex of chickens.

Molecular Detection of Gamma Coronaviruses in Bird Parks of Iran

Gamma Coronaviruses (GCoVs) are distributed worldwide, affecting a wide range of bird species, the beluga whale, and bottlenose dolphins. Because of the limited proofreading capability in the viral encoded polymerase, they emerge genetically diverse. There has been no molecular surveillance data to describe the epidemiology of GCOVs in avian species. The present study was conducted to detect GCOVs in Tehran birds’ parks, 2015. Cloacal swabs (267 samples) from eight different bird species ((Chickens (Gallus gallus), Pheasant (Phasianus colchicus), Turkey (Meleagris gallopavo), Partridge (Perdix perdix), Quail (Coturnix coturnix), Duck (Anas platyrhynchos), Goose (Anserini),and Guinea fowl (Numididae)) were collected, the viral RNA was extracted, the RT-PCR was performed using QIAGEN one step RT-PCR kit and the primers targeting “3'-UTR” and “Nucleocapsid” genes. The detection rate was approximately 8.99%. GCOVs were detected in the chicken, quail, pheasant, turkey, and the partridge with different prevalence rates. Phylogenetic tree based on partial nucleotide sequences of the N gene clustered the samples into two groups. It is the first report of GCOVs in non-commercial birds in Iran. According to our results, GCOVs are circulating in different avian species, and further studies are needed to isolate these viruses and evaluate their pathogenesis.

Stem Cell Therapy Ameliorates Ischemia-reperfusion Induced Kidney Injury After 24 Hours Reperfusion

INTRODUCTION

The mortality rate in patients with acute kidney injury (AKI) is high. The aim of this study was to evaluate the efficacy of treatment with adipose-derived mesenchymal stem cells (AD-MSC) in renal ischemia-reperfusion (I/R) model in rats.

METHODS

In this study 28 male Wistar rats were divided into four groups of control, sham, I/R24h+PBS, and I/R24h+AD-MSC. Blocking the renal arteries for 45 minutes induced renal I/R and then reperfusion was conducted for 24 hours. Parameters including urine volume, osmolarity, plasma creatinine (Crp), and blood urea nitrogen (BUN) were evaluated and values of creatinine clearance (CCr), absolute sodium excretion (UNaV°), fractional excretion of sodium (FENa), absolute potassium excretion (UKV°) and fractional excretion of potassium (FEK) were calculated. The right kidney was removed to measure the malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP), as well as the left kidney for histological evaluation.

RESULTS

I/R caused a significant increase in Crp, BUN, UNaV°, FENa, FEK, MDA, and tissue damages. In addition, the values of CCr, urine osmolarity, and FRAP level decreased significantly (P < .05). Following AD-MSC treatment, values of FENa, Crp, FEK, MDA, and tissue damages decreased significantly, while urine osmolarity increased significantly in the I/R24h + AD-MSC group compared to the I/R24h + PBS group. Furthermore, FRAP values increased significantly (P < .001).

CONCLUSION

Treatment with AD-MSC reduced tissue damage and oxidative stress while increasing antioxidant activity. In addition, it improved kidney function after 45 min ischemia and 24 h reperfusion.

Piperine pretreatment attenuates renal ischemia-reperfusion induced liver injury

Background

Remote organ injury is one of the complications which are developed following ischemia-reperfusion induced acute kidney injury (AKI), dramatically increasing its mortality rate. The aim of the present study was to investigate the effect of piperine pretreatment on liver dysfunction following ischemia-reperfusion induced AKI.

Materials and methods

Acute kidney injury was induced by 30 min-bilateral renal ischemia followed by 24 h of reperfusion. To investigate liver damages, the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) enzymes were measured in plasma. In order to study oxidative stress, malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP) levels were measured. Furthermore, the expression of intercellular adhesion molecule-1 (ICAM-1) mRNA along with infiltration of leukocytes in the liver tissue was measured for inflammation assessment. Histopathological damages were studied through measuring the extent of cellular fibrosis, sinusoidal dilatation, and vascular congestion in liver tissue.

Results

Following acute kidney injury, AST, ALT, and ALP levels in plasma, MDA level and ICAM-1 expression in the liver tissue, infiltration of leukocytes into the interstitium, and hepatic histopathologic damages increased significantly, while FRAP decreased. Pretreatment with piperine at 10 and 20 mg/kg body weight was able to improve these damages, such that some of them reached its value in the sham group, though piperine in the 20 mg/kg was more effective.

Conclusions

The results of this study suggest that ischemia-reperfusion induced AKI result in hepatic damages, and pretreatment with piperine can prevent development of these damages through its antioxidant and anti-inflammatory properties.

Protective effect of piperine in ischemia-reperfusion induced acute kidney injury through inhibition of inflammation and oxidative stress

Background and aim

Renal ischemia-reperfusion is associated with inflammation and oxidative stress. As a major compound in black pepper, piperine has anti-inflammatory and anti-oxidative properties. In present study, the protective effects of oral administration of piperine in renal ischemia-reperfusion (IR) induced acute kidney injuries (AKI) were investigated.

Experimental procedure

Male Wistar rats received piperine (10 or 20 mg/kg.bw) or vehicle for 10 days. The artery and vein of both kidneys were then clamped for 30 min, followed by a 24-h reperfusion period. Concentrations of creatinine and urea-nitrogen in descending aorta blood were measured, and malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) levels were measured in kidney tissue to evaluate the oxidative stress. Inflammation was evaluated by measuring the TNF-α and ICAM-1 mRNA expression levels in renal cortical tissue using Real Time PCR method and counting leukocytes infiltration to interstitium. Further measured were tissue damages in H & E stained sections.

Results

Renal IR reduced FRAP, while increasing the plasma concentrations of creatinine and urea-nitrogen, tissue MDA level, TNF-α and ICAM-1 mRNA expressions, leukocyte infiltration and histopathologic injuries. Piperine administration significantly reduced the plasma concentrations of creatinine and urea-nitrogen, expression of pro-inflammatory factors, oxidative stress and renal histopathologic injuries. It is to be noted that 20 mg/kg dose was more effective.

Conclusion

Our results suggest piperine protects the kidney against ischemia-reperfusion induced acute kidney injuries by its anti-inflammatory and anti-oxidative properties.

•

Renal ischemia-reperfusion increased the inflammation and oxidative stress parameters.

•

Ischemia-reperfusion increased histopathological damages and functional parameters.

•

Piperine pretreatment significantly reduced the inflammation and oxidative stress.

•

Piperine administration ameliorated renal function and histopathologic damages.

Reduction of cisplatin-induced renal and hepatic side effects in rat through antioxidative and anti-inflammatory properties of Malva sylvestris L. extract

BACKGROUND

Cisplatin is widely used in the chemotherapy of solid organ cancers. However, its application is associated with serious side effects in various organs including the kidneys and liver.

OBJECTIVES

The aim of this study was to investigate the effects of mallow extract on the side effects of cisplatin in the kidneys and liver.

METHODS

Hydroalcoholic extract of mallow, at doses of 200, 400, and 600 mg/kg BW, was administered to the animals for seven days intraperitoneally (ip). Animals in the Cis + Mallow group received a dose of cisplatin (8 mg/kg, ip) on the third day. Renal and hepatic functional disturbances were evaluated by measuring concentrations of creatinine, urea-nitrogen, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in the plasma. In order to assess oxidative stress, malondialdehyde (MDA) and ferric reducing antioxidant power (FRAP) levels were measured in the kidney tissue. Then, degree of mRNA expressions of TNF-α and ICAM-1 were measured to examine renal inflammation. Hematoxylin and Eosin (H & E) staining of kidney and liver tissues was performed to study tissue damage and leukocyte infiltration.

RESULTS

Cisplatin increased levels of plasma creatinine, urea-nitrogen, AST, and ALT; levels of tissue damage and leukocytes infiltration in the kidneys and liver; and MDA level and expression of pro-inflammatory factors in the kidney tissue. Meanwhile, it decreased FRAP level in the kidney tissue. Pretreatment by mallow extract resulted in significant improvement in all measured variables although 200-mg and 400-mg doses yielded better results.

CONCLUSION

Results showed that mallow supplement protects the kidneys and liver against side effects of cisplatin, and reduces the resultant oxidative stress and inflammation.

Anti-inflammatory and protective effects of saffron extract in ischaemia/reperfusion-induced acute kidney injury

AIM

Inflammation is one of the major challenges in the management of ischaemia/reperfusion (I/R)-induced acute kidney injury. Our aim was to assess the anti-inflammatory and protective effects of saffron extract against I/R-induced renal disturbances.

METHODS

A total of 35 male Wistar rats were randomly divided into five groups (n = 7) as sham, I/R and three groups of I/R that were pretreated with different doses of saffron extract (5 mg/kg, 10 mg/kg, or 20 mg/kg) intraperitoneally. The I/R-induced renal inflammation was assessed by measuring leukocyte infiltration and mRNA expression levels of intercellular adhesion molecule-1 and tumour necrotic factor-alpha. For the assessment of oxidative stress, thiobarbituric acid reactive species and antioxidant capacity of kidneys were measured in the right kidneys. In addition, plasma creatinine and urea-nitrogen concentrations were determined for renal functional disturbances. Statistical analysis was performed using one-way analysis of variance using the Duncan post hoc test.

RESULTS

The I/R increased all of the measured parameters, except for the tissue level of ferric reducing/antioxidant power, which decreased. Pretreatment with saffron extract in all doses significantly reduced the severity of these disturbances in such a way that there were no significant differences between the FRAP level and urea-nitrogen concentrations between the sham and all three saffron extract-treated groups. However, the saffron extract could decrease the plasma creatinine concentration, malondialdehyde level, tumour necrotic factor-alpha and intercellular adhesion molecule-1 expression and leukocyte infiltration in a dose-dependent manner.

CONCLUSION

The present study showed anti-inflammatory, anti-oxidative and protective effects for the hydro-ethanolic extract of saffron in I/R-induced acute kidney injury.

Protective effect of Malva sylvestris L. extract in ischemia-reperfusion induced acute kidney and remote liver injury

Mallow (Malva sylvestris L.) has had medicinal and therapeutic uses in addition to its oral consumption. The present study was conducted to examine the protective effect of Malva sylvestris L. extract on ischemia-reperfusion-induced kidney injury and remote organ injuries in the liver. Before ischemia-reperfusion, rats in the different groups received intraperitoneal normal saline or mallow extract at the doses of 200, 400 or 600 mg/kg of body weight. After 30-minutes of bilateral renal ischemia followed by 24-hours of reperfusion, tissue damage in the kidney and liver samples were determined through studying H&E-stained slides under a light microscope. The degree of leukocyte infiltration and tissue mRNA expressions of TNF- and ICAM-1 were then measured to examine the degree of renal inflammation. The renal tissue MDA and FRAP levels were measured for determining the amount of oxidative stress. Plasma concentrations of creatinine, urea, ALT and ALP were also measured. Ischemia-reperfusion led to a significant increase in plasma concentrations of creatinine, urea, ALT and ALP, and renal tissue MDA, and a significant decrease in renal tissue FRAP. The expression of pro-inflammatory factors in the kidney tissue, the level of leukocyte infiltration and the amount of tissue damage in the kidney and liver also increased. Pretreatment by mallow extract led to a significant improvement in all the variables measured. The 200- and 400-mg doses yielded better results in most parameters compared to the 600-mg dose. The findings showed that mallow extract protects the kidney against ischemia-reperfusion and reduces remote organ injury in the liver.

Antioxidant activity of omega-3 derivatives and their delivery via nanocages and nanocones: DFT and experimental in vivo investigation

The antioxidant properties of omega-3 were investigated via experimental in vivo and theoretical methods. For experimental evaluation, oxidative stress was induced by 30 min bilateral renal ischemia and 24 h of reperfusion in male Sprague Dawley rats. The oxidative stress was evaluated through measuring malondialdehyde (MDA) and ferric reducing/antioxidant power (FRAP) levels in renal tissue. In theoretical methods, the reaction enthalpies of antioxidant mechanisms of omega-3 were calculated and the effects of NHMe, OMe, OH, Cl, and Me substituents on its antioxidant activity were investigated. Moreover, the omega-3 delivery potential by carbon and boron nitride nanocages and naocones were evaluated. The experimental results showed that omega-3 administration decreases MDA and increases FRAP levels after their changes by ischemia/reperfusion. Theoretical results indicated that NHMe and OMe substituents can significantly improve the antioxidant activity of omega-3. Also, boron nitride nanocone (BNNC) has higher |∆E_ad| values, so it has higher potential for omega-3 delivery. Taken together, the new findings presented here indicate that omega-3 has anti-oxidative properties and NHMe and OMe substituents can improve its antioxidant activity. Moreover, adsorption of omega-3 on the surface of the studied nanostructures was exothermic, and BNNC with higher |∆Ead| values has higher potential for omega-3 delivery. Graphical abstract The interaction and adsorption of BNNC with omega-3 is exothermic and experimentally possible from the energetic viewpoint, so the BNNC with higher |∆E_ad| and |∆G_ad| values has higher potential for omega-3 delivery.

Pathogenicity characteristics of an Iranian variant-2 (IS-1494) like infectious bronchitis virus in experimentally infected SPF chickens

Avian infectious bronchitis (IB) is a major cause of economic loss to the poultry industry. IB virus primarily affects respiratory tract, but strains differ in their tropism for such other target organs as kidneys and alimentary tract. The objective of this study was to estimate the pathogenicity of an Iranian IB virus (IBV) variant (variant-2) which is one of the most prevalent isolates circulating in Iranian poultry farms. SPF chickens were intranasally inoculated with 104 EID50/0.1 ml of the virus. Sera, fecal swabs, and different tissue samples were collected on different days post infection. Clinical signs, gross pathology, and histological changes were recorded. The amount of virus genome was quantified in different tissues and feces using quantitative real-time PCR assay. The highest viral loads were detected in the feces and cecal tonsils. Real-time PCR results demonstrated variant-2 tropism for respiratory tract, digestive system and renal tissue that is due to its epitheliotropic nature. This is the first pathogenicity study of Iranian variant-2 virus. Based on histology observations and clinical signs this isolate was classified as a nephropathogenic IBV. Further knowledge of IBV pathogenesis permits to perform more effective prevention practice.

Physalis alkekengi and Alhagi maurorum ameliorate the side effect of cisplatin-induced nephrotoxicity

Cisplatin is frequently being used for the treatment of different tumors, although the application of this agent is associated with nephrotoxicity. Here, we explored the antioxidant and anti-inflammatory activities of Physalis alkekengi and Alhagi maurorum; 400 mg kg(-1) per day P. alkekengi and 100 mg kg(-1) per day A. maurorum were administered in rats, orally for 10 days after a single dose of 7 mg kg(-1) intraperitoneal cisplatin. The concentrations of creatinine, urea-nitrogen, and relative and absolute excretion of sodium/potassium were evaluated before/after therapy. Levels of malondialdehyde (MDA) and ferric-reducing antioxidant power (FRAP) were measured to assess the oxidative stress induced by cisplatin. Moreover, tissues sections were used for histological analyses and evaluation of the degree of tissue damage. Cisplatin increased serum levels of creatinine and urea-nitrogen, relative/absolute excretion of sodium/potassium, and MDA, whereas decreased FRAP level. Interestingly, P. alkekengi or A. maurorum were able to reduce the level of the renal function markers as well as the levels of sodium/potassium. This effect was more pronounced by P. alkekengi. Moreover, cisplatin induced pathological damage in kidney, whereas treatment with these agents improved this condition. Our findings demonstrate the potential therapeutic impact of P. alkekengi and A. maurorum for improving cisplatin-induced nephrotoxicity, supporting further investigations on the novel potential clinical application of these agents for patients being treated with cisplatin to ameliorate cisplatin-induced nephrotoxicity.

Protective effect of crocin on gentamicin-induced nephrotoxicity in rats

OBJECTIVES

Gentamicin is used for the treatment of Gram-negative bacterial infections. However, gentamicin administration is limited because of nephrotoxicity. The aim of the present study was to evaluate the protective effect of crocin against gentamicin-induced nephrotoxicity in rats.

MATERIALS AND METHODS

Thirty two male Wistar rats received gentamicin (100 mg/kg, IP), with or without crocin (100 mg/kg, IP) for seven consecutive days. Plasma creatinine and urea-nitrogen concentrations, oxidative stress and histopathological changes of kidney tissues were monitored.

RESULTS

Administration of gentamicin resulted in significant increases in plasma creatinine and urea-nitrogen concentrations and renal tissue malondialdehyde (MDA) level, and a decrease in the renal tissue ferric reducing/antioxidant power (FRAP) level. Crocin decreased plasma creatinine and urea-nitrogen concentrations and tissue MDA level, but increased the level of tissue FRAP. In addition, gentamicin led to cellular damages including glomerular atrophy, cellular desquamation, tubular necrosis and fibrosis, epithelial oedema of proximal tubules, perivascular edema, vascular congestion and intra-tubular proteinaceous casts, all of which were partially recovered by crocin.

CONCLUSION

Crocin has protective effects against functional disturbances, oxidative stress and tissue damages induced by gentamicin.

Therapeutic effects of curcumin on the functional disturbances and oxidative stress induced by renal ischemia/reperfusion in rats

OBJECTIVE

Curcumin has anti-inflammatory and antioxidative properties. The objective of this study was to investigate the therapeutic effects of curcumin on functional disturbances, oxidative stress, and leukocyte infiltration induced by renal ischemia/reperfusion (I/R).

MATERIALS AND METHODS

Animals were randomly divided into 9 groups. The groups with 24-h reperfusion consisted of sham-24h, I/R-24h, and three I/R groups treated with curcumin at 10, 20, or 30 mg kg(-1), i.p. after the ischemic period. The 72-h reperfusion groups also included Sham-72h, I/R-72h, I/R treated with curcumin at single dose of 20 mg kg(-1), i.p., and I/R group which received three doses of curcumin at 20 mg kg(-1), i.p., consecutively. Renal functional injury was assessed by measuring serum creatinine and urea-nitrogen concentrations. Oxidative stress was evaluated by assessment tissue malondialdehyde (MDA) and the ferric reducing/antioxidant power (FRAP) levels. Moreover, renal tissue leukocyte infiltration was measured by histopathology examination.

RESULTS

Ischemia/reperfusion resulted in a significant increase in serum concentration of creatinine, urea-nitrogen, tissue MDA level, and leukocytes infiltration as well as reduced FRAP level. Treatment with curcumin in 24-h reperfusion groups could only lead to a significant change in the levels of MDA and FRAP. However, in 72-h reperfusion groups, curcumin was able to correct all functional disturbances, oxidative stress, and leukocytes infiltration with more effectiveness in groups that received three doses of curcumin.

CONCLUSION

The administration of curcumin during 72-h reperfusion following 30 minutes of ischemia can decrease renal oxidative stress and leukocytes infiltration as well as improve kidney function. However, during first 24-h reperfusion, curcumin only decreased oxidative stress.

Protective effects of Tribulus terrestris L extract against acute kidney injury induced by reperfusion injury in rats

INTRODUCTION

This study aimed to investigate the protective effect of aerial parts of the Tribulus terrestris L extract on acute kidney injury (AKI) induced by ischemia for 30 minutes and reperfusion for 24 hours in rats.

MATERIALS AND METHODS

Ten male Sprague-Dawley rats in the AKI and 10 in the Tribulus terrestris groups received the extract solvent and extract of the plant (11 mg/kg), respectively, for 13 days (oral administration). On day 14, ischemia for 30 minutes and reperfusion for 24 hours were induced on the rats. In the last 6 hours of the reperfusion period (24 hours), urine samples were collected in metabolic cages. At the end of this period, blood samples were also taken to determine plasma urea nitrogen, creatinine, and electrolyte concentrations. The kidney tissues were collected for measuring the level of oxidative stress and histological studies. They were compared with the sham operation group and a control group with normal diet and no operation.

RESULTS

In the Tribulus terrestris group, the increase in plasma creatinine and urea nitrogen concentrations was significantly less following reperfusion, and their values reached the same level as that in the sham group. Creatinine clearance and urine osmolarity in the Tribulus terrestris group was higher in comparison with the AKI group, whereas sodium absolute excretion, fractional excretion of potassium, oxidative stress, and cellular damages were less.

CONCLUSIONS

Oral administration of Tribulus terrestris extract for 2 weeks can decrease kidney functional disturbance, oxidative stress, and cellular damages following reperfusion injury in rats.

Calcium dobesilate for prevention of gentamicin-induced nephrotoxicity in rats

INTRODUCTION

Calcium dobesilate is an antioxidant drug and this study is aimed to investigate the effects of calcium dobesilate on gentamicin-induced nephrotoxicity.

MATERIAL AND METHODS

This experimental study was conducted on 40 male Sprague-Dawley rats. The rats were randomly divided into the following 5 groups: control, sham, gentamicin (100 mg/kg/d, intraperitoneal), gentamicin and calcium dobesilate (50 mg/kg body weight), gentamicin and calcium dobesilate (50 mg/kg body weight). Treatment was provided once a day in a 7-day period. At the end of the 7th day, plasma and urine samples were taken and the concentrations of creatinine, urea nitrogen, sodium, potassium, and osmolarity were measured in both samples. The level of oxidative stress in the left kidney tissue samples was also assessed by measuring malondialdehyde and ferric reducing antioxidant power.

RESULTS

Calcium dobesilate intake with both doses led to a significant decrease in the elevated concentration of creatinine, urea nitrogen, and fractional excretion of sodium by gentamicin, and an increase in creatinine clearance and absolute excretion of potassium as compared to the gentamicin group. Furthermore, calcium dobesilate decreased tissue malondialdehyde and increased tissue ferric reducing antioxidant power at both doses, in comparison to those in the gentamicin group.

CONCLUSIONS

Calcium dobesilate is capable of protecting rats against gentamicin-induced nephrotoxicity. This protective effect of calcium dobesilate is probably dependent on its antioxidant properties.

Protective effects of Rosa canina L fruit extracts on renal disturbances induced by reperfusion injury in rats

INTRODUCTION

This study aimed to investigate the effects of Rosa canina L fruit extracts on histological damages, oxidative stress, and functional disturbances induced by bilateral renal ischemia and reperfusion.

MATERIALS AND METHODS

Ischemia and reperfusion were induced on the kidneys of anesthetized male Sprague-Dawley rats. The rats in the reperfusion and Rosa canina groups were administered extract solvent and Rosa canina extract, respectively. In addition, in the sham group, surgery was done without ischemia. In the last 6 hours of the reperfusion period, urine sample were collected using metabolic cage and at the end of this period, blood samples were taken from the descending aorta. The kidney tissues were collected and subjected to microscopic study for histological damages, while oxidative stress was measured by determining malondialdehyde and ferric reducing/antioxidant power levels.

RESULTS

The comparison between the reperfusion and sham groups indicated reductions in creatinine clearance, absolute excretion of potassium, urine osmilarity, and increase in absolute excretion of sodium in the reperfusion group. These changes were less pronounced with Rosa canina fruit extract. In addition, blood creatinine and urea concentrations which increased in the reperfusion group, were significantly lower in the Rosa canina group. In this group, the degree of histological damages and the level of malondialdehyde were lower than the reperfusion group, while ferric reducing/antioxidant power level was significantly higher.

CONCLUSIONS

The findings of this study showed that Rosa canina fruit extract possesses protective effects against kidney function disturbances, oxidative stress, and histological damages.

Textile Softeners on Cotton Dyed with Direct Dyes: Reflectance and Fastness Assessments

In this research, cotton fabrics scoured with nonionic detergent were dyed with four different direct dyes (Thiazole, Disazo, Trisazo and Polyazo). The dyed fabrics were then treated with anionic, cationic, nonionic, micro and macro emulsion silicone softeners. CIELAB color coordinates (L∗, a∗, b∗, C∗ and h) were measured with reflectance spectrophotometer. The lightness (L∗ value) for samples dyed with disazo and polyazo direct dyes (orange and red dyes) showed an increase after treatment with all the mentioned softeners, while it was decreased for thiazole and trisazo dyed fabrics treated with anionic, cationic, micro and macro emulsion silicone softeners. The wash and light fastness properties of samples were measured according to ISO 105-CO5 and Daylight ISO 105-BO1. The washing fastness properties of some direct dyed samples were decreased after treatment with softeners. In the case of light fastness properties, it was decreased for most of the samples.

Grape seed extract for reduction of renal disturbances following reperfusion in rats

INTRODUCTION

Proanthocyanidines in grape seed extract (GSE) possess a wide array of pharmacological and biological actions, including anti-inflammatory, antioxidant, free radical scavenging, and vasodilatory properties as well as inhibition of phospholipase A2, cyclooxygenase, and lipooxygenase enzymes. The aim of this study was to examine the effects of the oral administration of GSE on renal disturbances due to reperfusion injury in rats.

MATERIALS AND METHODS

Thirty-two male Sprague-Dawley rats were divided into 4 groups. They received a standard diet for two eeks. During this period, one group also received normal saline and GSE (50 mg/kg) daily. At the beginning of day 14, the rats in 2 groups underwent surgery and bilateral renal ischemia, and one group had sham operation. Urine and blood samples were taken and the kidneys were removed for histologic and enzyme studies. The control group did not receive any solutions and did not have surgery.

RESULTS

The increased amount of plasma creatinine concentration induced by reperfusion injury was improved by GSE administration. In addition, urine osmolality increased in the GSE group in comparison with the reperfusion injury only group. The degrees of histological damages and oxidative stress that had increased following reperfusion injury were also significantly lower with GSE administration.

CONCLUSIONS

Oral supplementation of GSE for 2 weeks may decrease histologic damages and oxidative stress, and as a result, may reduce kidney function disturbances following reperfusion injury.

DFT/B3LYP Study of the Substituent Effects on the Reaction Enthalpies of the Antioxidant Mechanisms of Sesamol Derivatives in the Gas phase and water

In this paper, the study of various ortho and meta–substituted Sesamol derivatives is presented. The reaction enthalpies related to three antioxidant action mechanisms HAT, SET–PT, and SPLET for substituted Sesamols, have been calculated using the DFT/B3LYP method in gas phase and water. Calculated results show that electron-withdrawing substituents increase the bond dissociation enthalpy (BDE), ionization potential (IP), and electron transfer enthalpy (ETE), while electron-donating ones cause a rise in the proton dissociation enthalpy (PDE) and proton affinity (PA). In the ortho position, substituents show a larger effect on reaction enthalpies than in the meta position. In comparison with the gas phase, water attenuates the substituent effect on all reaction enthalpies. In the gas phase, BDEs are lower than PAs and IPs, i.e., HAT represents the thermodynamically preferred pathway. On the other hand, the SPLET mechanism represents the thermodynamically favored process in water. Results show that calculated enthalpies can be successfully correlated with Hammett constants (σm) of the substituted Sesamols. Furthermore, calculated IP and PA values for substituted Sesamols show linear dependence on the energy of the highest occupied molecular orbital (EHOMO).

Oral omega-3 fatty acid for reduction of kidney dysfunction induced by reperfusion injury in rats

INTRODUCTION

The aim of this study was to examine the effects of oral administration of omega-3 fatty acid on kidney functional disturbances, histological damages, and oxidative stress due to reperfusion injury.

MATERIALS AND METHODS

Male Sprague Dawley rats received a standard diet for 2 weeks. Through gavage, the rats in acute kidney failure and omega-3 groups received 4 mL normal saline or omega-3 fatty acid (0.4 g/kg) daily. After 2 weeks, the rats underwent surgery and renal ischemia on both sides. During the last 6 hours, the rats were transferred to the metabolic cage for urine sampling. At the end of the period, blood samples were obtained from the aorta and the kidneys were removed for hematoxylin-eosin staining, histological analysis, and oxidative stress measurement. The sham group also received normal saline, but the operation was done without renal ischemia, whereas the control group did not received any substances or operation.

RESULTS

The decrease in glomerular filtration rate induced by reperfusion was relatively improved by omega-3 administration, which resulted in the decrease in plasma urea and creatinine concentrations. In addition, the relative excretion of sodium and potassium, and urine flow rate decreased in the omega-3 group as compared with the acute kidney failure group. The degrees of histologic damages and oxidative stress that had increased following reperfusion injury were also significantly lowered by omega-3 administration.

CONCLUSIONS

Preventive oral administration of omega-3 supplement may decrease histological damages, oxidative stress, and kidney dysfunction following reperfusion injury.

Lung function reference values in Iranian adolescents

There is insufficient information about reference values for pulmonary volumes for Iranian populations. A study of lung function parameters was made on 302 non-smoking healthy Iranian students (152 male and 150 female). Lung function measures correlated strongly with height but not with body mass index. There were significant differences between some of the measured parameters and American Thoracic Society reference values for Caucasians (P < 0.05). Of note is the high functional residual capacity (110% higher) and low inspirational capacity (86% lower) in males compared with the reference values.

Glucokinase and glucose homeostasis: proven concepts and new ideas

The enzyme GK (glucokinase), which phosphorylates glucose to form glucose 6-phosphate, serves as the glucose sensor of insulin-producing beta-cells. GK has thermodynamic, kinetic, regulatory and molecular genetic characteristics that are ideal for its glucose sensor function and allow it to control glycolytic flux of the beta-cells as indicated by control-, elasticity- and response-coefficients close to or larger than 1.0. GK operates in tandem with the K(+) and Ca(2+) channels of the beta-cell membrane, resulting in a threshold for glucose-stimulated insulin release of approx. 5 mM, which is the set point of glucose homoeostasis for most laboratory animals and humans. Point mutations of GK cause 'glucokinase disease' in humans, which includes hypo- and hyper-glycaemia syndromes resulting from activating or inactivating mutations respectively. GK is allosterically activated by pharmacological agents (called GK activators), which lower blood glucose in normal animals and animal models of T2DM. On the basis of crystallographic studies that identified a ligand-free 'super-open' and a liganded closed structure of GK, on thermostability studies using glucose or mannoheptulose as ligands and studies showing that mannoheptulose alone or combined with GK activators induces expression of GK in pancreatic islets and partially preserves insulin secretory competency, a new hypothesis was developed that GK may function as a metabolic switch per se without involvement of enhanced glucose metabolism. Current research has the goal to find molecular targets of this putative 'GK-switch'. The case of GK research illustrates how basic science may culminate in therapeutic advances of human medicine.

Glucose regulation of glutaminolysis and its role in insulin secretion

Leucine or the nonmetabolized leucine analog +/- 2-amino-2-norbornane-carboxylic acid (BCH) (both at 10 mmol/l) induced biphasic insulin secretion in the presence of 2 mmol/l glutamine (Q2) in cultured mouse islets pretreated for 40 min without glucose but with Q2 present. The beta-cell response consisted of an initial peak of 20- to 25-fold above basal and a less marked secondary phase. However, BCH produced only a delayed response, while leucine was totally ineffective when islets were pretreated with 25 mmol/l glucose plus Q2. With Q2, 10 mmol/l BCH or leucine caused a nearly threefold increase, a twofold increase, or had no effect on cytosolic Ca2+ levels in islets pretreated for 40 min with 0, 5, or 15 mmol/l glucose, respectively. Thus, pretreatment of islets with high glucose inhibited BCH- and leucine-induced cytosolic Ca2+ changes and insulin release. Glucose decreased glutamine oxidation in cultured rat islets when BCH was present at 10 mmol/l, but not in its absence, with a lowest effective level of approximately 0.1 mmol/l, a maximum of 18-30 mmol/l, and an inhibitory concentration, 50%, of approximately 3 mmol/l. The data are consistent with the hypothesis that glucose inhibits glutaminolysis in pancreatic beta-cells in a concentration-dependent manner and hence blocks leucine-stimulated insulin secretion. We postulate that in the basal interprandial state, glutaminolysis of beta-cells is partly turned on because glutamate dehydrogenase (GDH) is activated by a decreased P-potential due to partial fuel depletion and sensitization to endogenous activators such as leucine. Additionally, it may contribute significantly to basal insulin release, which is known to be responsible for about half of the insulin released daily. The data explain "leucine-hypersensitivity" of beta-cells during hypoglycemia and contribute to the elucidation of the GDH-linked syndrome of hyperinsulinism associated with elevated serum ammonia levels. Thus, understanding the precise regulation and role of beta-cell glutaminolysis is probably central to our concept of normal blood glucose control.

An unusual combination of cardiovascular surgical disorders

A 53-year-year-old man presented with aortic regurgitation, subvalvular and supravalvular aortic stenoses, and aneurysms involving the ascending aorta, the arch, and the innominate, right subclavian, and left common carotid arteries. Surgery consisted of resection of the obstructive lesions, replacement of the aortic valve, graft replacement of the ascending aorta, and the arch resection of innominate and subclavian artery aneurysms and reconstruction with a side limb to which the right carotid artery was anastomosed. The patient has remained asymptomatic with full employment.

Experience with antegrade bihemispheric cerebral perfusion in aortic arch operations

BACKGROUND

Various techniques have been used for cerebral protection in aortic arch operations. Antegrade cerebral perfusion has lost its popularity to hypothermic circulatory arrest to overcome the so-called cluttered operative field. Hypothermic circulatory arrest has its own problems of coagulopathy, time constraints, and prolongation of cardiopulmonary bypass time.

METHODS

Since June 1986 we have used antegrade bihemispheric cerebral perfusion with moderate hypothermia in 20 patients with aortic arch disease. Twelve patients had aneurysm, 7 had dissection, and 1 had traumatic tear. Five patients had had previous sternotomy for ascending aortic replacement. In addition to arch reconstruction, 7 patients had aortic valve replacement or repair, 2 patients had Bentall procedure, and 3 had selective innominate reconstruction. The mean cerebral perfusion time was 51+/-29 minutes. In 7 patients the cerebral perfusion time was between 60 and 120 minutes.

RESULTS

There was no in-hospital or 30-day mortality. The blood product requirements were significantly less with moderate hypothermia. One patient suffered cerebrovascular accident (5%). None of the 7 patients with cerebral perfusion times of 60 to 120 minutes had any neurologic deficits. These results are superior to those reported for hypothermic circulatory arrest with or without retrograde cerebral perfusion.

CONCLUSIONS

Antegrade bihemispheric cerebral perfusion is an optimal adjunct for cerebral protection during aortic arch operations.

How to do it: aortic and mitral valve replacement through aortotomy

Combined replacement of the aortic and mitral values is a relatively common operation. Occasionally it is feasible to replace the mitral value through the aortic root. This remarkable approach eliminates the need for a second atrial incision, and in reoperation it avoids extensive dissection and release of adhesions. Injury to the heart is minimized and the incidence of perioperative bleeding is reduced. The exposure is excellent and the operation is performed safely and expeditiously.

Thoracic aortic operations: management of maldistribution of arterial flow during cardiopulmonary bypass

On three occasions during operations for aortic aneurysm involving the ascending aorta it was noted that upon the release of the aortic clamp the grafted segment remained collapsed, indicating very little or no flow reaching the lumen of the reconstructed aorta. This was promptly and successfully remedied in 2 patients by perfusing the graft directly with a pediatric arterial catheter attached to a pump head while the femoral arterial line maintained systemic arterial inflow. This simple, safe, and highly effective technique adds to the surgeon's repertoire to manage yet another intriguing intraoperative development during thoracic aortic operations.

Regulation of insulin preRNA splicing by glucose

Glucose tightly regulates the synthesis and secretion of insulin by beta cells in the pancreatic islets of Langerhans. To investigate whether glucose regulates insulin synthesis at the level of insulin RNA splicing, we developed a method to detect and quantify a small amount of RNA by using the branched DNA (bDNA) signal-amplification technique. This assay is both sensitive and highly specific: mouse insulin II mRNA can be detected from a single beta cell (betaTC3 cells or mouse islets), whereas 1 million non-insulin-producing alpha cells (alphaTC1.6 cells) give no signal. By using intron and exon sequences, oligonucleotide probes were designed to distinguish the various unspliced and partially spliced insulin preRNAs from mature insulin mRNA. Insulin RNA splicing rates were estimated from the rate of disappearance of insulin preRNA signal from beta cells treated with actinomycin D to block transcription. We found that the two introns in mouse insulin II are not spliced with the same efficiency. Intron 2 is spliced out more efficiently than intron 1. As a result, some mRNA retaining intron 1 enters the cytoplasm, making up approximately 2-10% of insulin mRNA in the cell. This partially spliced cytoplasmic mRNA is quite stable, with a half-life similar to the completely spliced form. When islets grown in high glucose are shifted to low glucose medium, the level of insulin preRNA and the rate of splicing fall significantly. We conclude that glucose stimulates insulin gene transcription and insulin preRNA splicing. Previous estimates of insulin transcription rates based on insulin preRNA levels that did not consider the rate of splicing may have underestimated the effect of glucose on insulin gene transcription.

Measurement and modeling of glucose-6-phosphatase in pancreatic islets

In the beta-cells of the pancreas, glucose phosphorylation carried out by glucokinase is the rate-controlling step in glycolysis, and the kinetic characteristics of glucokinase govern to a high degree the dose-response relationship between glucose and insulin release. Because glucose-6-phosphatase (G-6-Pase) opposes the action of glucokinase, it may have a regulatory role in the release of insulin in response to glucose if the enzyme is present in the beta-cells. A number of researchers have reported finding high levels of G-6-Pase in islets, but quantitation of its activity remains controversial, mainly because of difficulties in solubilizing a particulate enzyme. Therefore a method developed to measure functional glucose phosphorylation activity in intact brain was applied (Chi, M. M.-Y., M. E. Pusateri, J. G. Carter, B. J. Norris, D. B. McDougal, Jr., and O. H. Lowry. Anal. Biochem. 161: 508-513, 1987), and the rates of accumulation and disappearance of 2-deoxyglucose 6-phosphate (DG-6-P) in freshly harvested islets were determined as a measure of glucose cycling. Islets were incubated in the presence of 30 mM 2-deoxyglucose (DG) for 60 min, and subsequently the incubation medium was replaced with medium containing no DG, but instead high levels of mannoheptulose as a blocker of phosphorylation. The content of DG-6-P in the islets was measured at strategic times during the protocol. As predicted by a mathematical model, DG-6-P accumulated in the presence of DG and decayed after its washout. Both of these results are consistent with islets containing dephosphorylation activity for this substrate. The kinetic curves were fit using a mathematical model, and the maximal G-6-Pase activity was estimated to be 0.13 +/- 0.005 micromol x g(-1) x min(-1). However, when the physiological effect of this amount of G-6-Pase activity was assessed by use of a model of glycolysis, it was found that the impact on glucose cycling and usage was insignificant. It was concluded that normal islets do contain measurable activity for dephosphorylating glucose 6-phosphate but that this enzymatic reaction does not play a role in glucose metabolism and sensing by the normal beta-cell.

Effect of a glucokinase inhibitor on energy production and insulin release in pancreatic islets

Glucokinase has exclusively high control strength on glucose usage in the pancreatic beta-cell. However, glucokinase also has extraordinarily high control strength on insulin secretion, which is linked to the phosphate potential, [ATP]/([ADP][Pi]) (F.M. Matschinsky, Y.Liang, P. Kesavan, L. Wang, P. Froguel, G. Velho, D. Cohen, M.A. Permutt, Y. Tanizawa, T.L. Jetton, K. Niswender, and M.A. Magnuson. J. Clin. Invest. 92: 2092-2098, 1993). We propose that the ATP produced via the tricarboxylic acid cycle is approximately constant, irrespective of the glucose level. Furthermore, the component of ATP production that is derived from glycolysis and glycolytically derived NADH, which is shuttled into the mitochondria, is a critical signal controlling the ionic events leading to insulin secretion, as suggested previously (M. J. MacDonald. Diabetes 39: 1461-1466, 1990 and I.D. Dukes, M.S. McIntyre, R.J. Mertz, L.H. Philipson, M.W. Roe, B. Spencer, and J.F. Worley III. J. Biol. Chem. 269: 10979-10982, 1994). To test this hypothesis, glucose usage, oxidation, and insulin secretion were measured in cultured rat islets over a wide range of concentrations of glucose and mannoheptulose, an inhibitor of glucokinase. These data were fit to a mathematical model that predicts that glucokinase will govern the rate of glucose usage and ATP production and will also have a strong, but not complete, control over the rate of glucose oxidation, the phosphate potential, and insulin release. Mannoheptulose caused an inhibition of all three fluxes. The estimates of the mechanistic parameters of the model [maximal velocity (Vmax) and Michaelis constant for glucokinase, Vmax for hexokinase and glucose transport, and the inhibition constant of mannoheptulose to glucokinase] were similar to those obtained in vitro. Thus the data are consistent with a model in which the primary importance of glycolysis in transducing the glucose signal into changes of the phosphate potential imparts to glucokinase a high control strength on glucose-induced insulin secretion.

Declining risk of reoperative valvular surgery

One hundred eleven patients underwent their second to fifth open heart operation, excluding isolated coronary revascularization. The procedures included repeat, single and multiple valve replacements, concomitant redo valve surgery, plus aortic root, and/or aortic arch reconstruction with or without coronary bypass graft. Six patients had heart transplantation as the final procedure. The article is based on the analysis of the experience of one surgeon with particular emphasis on technical considerations and factors enhancing outcome. There were two deaths for an early (hospital--30 days) mortality of 1.8%. There were three sternal wound complications. Two patients suffered cerebrovascular accident (one with permanent residual deficit), and one patient required reoperation for tamponade. The text contains a relatively detailed description of the technical maneuvers applied for several different categories of procedures used.