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Gadd G, Åberg D, Wall A, Zetterberg H, Blennow K, Jood K, Jern C, Isgaard J, Svensson J, Åberg ND. A Nonlinear Relation between Body Mass Index and Long-Term Poststroke Functional Outcome-The Importance of Insulin Resistance, Inflammation, and Insulin-like Growth Factor-Binding Protein-1. Int J Mol Sci 2024; 25:4931. [PMID: 38732147 DOI: 10.3390/ijms25094931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
Both high serum insulin-like growth factor-binding protein-1 (s-IGFBP-1) and insulin resistance (IR) are associated with poor functional outcome poststroke, whereas overweight body mass index (BMI; 25-30) is related to fewer deaths and favorable functional outcome in a phenomenon labeled "the obesity paradox". Furthermore, IGFBP-1 is inversely related to BMI, in contrast to the linear relation between IR and BMI. Here, we investigated s-IGFBP-1 and IR concerning BMI and 7-year poststroke functional outcome. We included 451 stroke patients from the Sahlgrenska Study on Ischemic Stroke (SAHLSIS) with baseline measurements of s-IGFBP1, homeostasis model assessment of IR (HOMA-IR), BMI (categories: normal-weight (8.5-25), overweight (25-30), and obesity (>30)), and high-sensitivity C-reactive protein (hs-CRP) as a measure of general inflammation. Associations with poor functional outcome (modified Rankin scale [mRS] score: 3-6) after 7 years were evaluated using multivariable binary logistic regression, with overweight as reference due to the nonlinear relationship. Both normal-weight (odds-ratio [OR] 2.32, 95% confidence interval [CI] 1.30-4.14) and obese (OR 2.25, 95% CI 1.08-4.71) patients had an increased risk of poor functional outcome, driven by deaths only in the normal-weight. In normal-weight, s-IGFBP-1 modestly attenuated (8.3%) this association. In the obese, the association was instead attenuated by HOMA-IR (22.4%) and hs-CRP (10.4%). Thus, a nonlinear relation between BMI and poor 7-year functional outcome was differently attenuated in the normal-weight and the obese.
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Affiliation(s)
- Gustaf Gadd
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Daniel Åberg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Specialist Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Alexander Wall
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Närhälsan, Region Västra Götaland, 411 04 Gothenburg, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 431 41 Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53707, USA
- UK Dementia Research Institute, University College London (UCL), London WC1E 6BT, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 431 41 Mölndal, Sweden
- Paris Brain Institute, ICM, Pitié-Salpêtrière Hospital, Sorbonne University, 75005 Paris, France
- Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, Department of Neurology, Institute on Aging and Brain Disorders, University of Science and Technology of China and First Affiliated Hospital of USTC, Hefei 230001, China
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Neurology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Christina Jern
- Institute of Biomedicine, Department of Laboratory Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Genetics and Genomics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Specialist Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Internal Medicine, Skaraborg Central Hospital, 549 49 Skövde, Sweden
| | - N David Åberg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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Walser M, Karlsson L, Motalleb R, Isgaard J, Kuhn HG, Åberg ND. Brain tissue haemoglobin expression in saline-perfused vs non-perfused rodents. Heliyon 2024; 10:e23343. [PMID: 38163098 PMCID: PMC10755301 DOI: 10.1016/j.heliyon.2023.e23343] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/22/2022] [Revised: 08/22/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
Haemoglobin beta (Hbb) and delta-aminolevulinate synthase 2 (Alas2) messenger RNA (mRNA) is mainly found in immature red blood cells, reticulocytes, and not in mature erythrocytes. However, these are also expressed in other tissues such as brain cells, mostly neurons. Therefore, exact quantification of neural tissue homogenates may be confounded by remaining blood in the brain vasculature that may give falsely high values of Hbb/Alas2 expression. To investigate and compare the contribution of local Hbb/Alas2 expression, we investigated mRNA expression locally in the hippocampus and prefrontal cortex, in post-sacrifice saline-perfused and non-perfused mice and rats. Although there was a higher level of Hbb/Alas2 transcripts in the non-perfused animals, there was a significant mRNA expression in perfused brains that could at most partially be explained by remaining blood. Finally, we suggest that saline-perfusion should be recommended for quantification of brain Hbb/Alas2 transcripts in homogenates.
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Affiliation(s)
- Marion Walser
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Clinical Chemistry, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Karlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sweden
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Reza Motalleb
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Specialist Medicine, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - H Georg Kuhn
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Sweden
- Institute for Public Health, Charité – Universitätsmedizin Berlin, Germany
| | - N. David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Acute Medicine and Geriatrics, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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Åberg D, Gadd G, Jood K, Redfors P, Stanne TM, Isgaard J, Blennow K, Zetterberg H, Jern C, Åberg ND, Svensson J. Serum IGFBP-1 Concentration as a Predictor of Outcome after Ischemic Stroke-A Prospective Observational Study. Int J Mol Sci 2023; 24:ijms24119120. [PMID: 37298072 DOI: 10.3390/ijms24119120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023] Open
Abstract
Insulin-like growth factor-binding protein-1 (IGFBP-1) regulates insulin-like growth factor-I (IGF-I) bioactivity, and is a central player in normal growth, metabolism, and stroke recovery. However, the role of serum IGFBP-1 (s-IGFBP-1) after ischemic stroke is unclear. We determined whether s-IGFBP-1 is predictive of poststroke outcome. The study population comprised patients (n = 470) and controls (n = 471) from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Functional outcome was evaluated after 3 months, 2, and 7 years using the modified Rankin Scale (mRS). Survival was followed for a minimum of 7 years or until death. S-IGFBP-1 was increased after 3 months (p < 0.01), but not in the acute phase after stroke, compared with the controls. Higher acute s-IGFBP-1 was associated with poor functional outcome (mRS score > 2) after 7 years [fully adjusted odds ratio (OR) per log increase 2.9, 95% confidence interval (CI): 1.4-5.9]. Moreover, higher s-IGFBP-1 after 3 months was associated with a risk of poor functional outcome after 2 and 7 years (fully adjusted: OR 3.4, 95% CI: 1.4-8.5 and OR 5.7, 95% CI: 2.5-12.8, respectively) and with increased mortality risk (fully adjusted: HR 2.0, 95% CI: 1.1-3.7). Thus, high acute s-IGFBP-1 was only associated with poor functional outcome after 7 years, whereas s-IGFBP-1 after 3 months was an independent predictor of poor long-term functional outcome and poststroke mortality.
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Affiliation(s)
- Daniel Åberg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 5, 413 45 Gothenburg, Sweden
- Region Västra Götaland, Department of Specialist Medicine, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Gustaf Gadd
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 5, 413 45 Gothenburg, Sweden
- Region Västra Götaland, Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Neurology, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Petra Redfors
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Neurology, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Tara M Stanne
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 5, 413 45 Gothenburg, Sweden
- Region Västra Götaland, Department of Specialist Medicine, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Kaj Blennow
- Region Västra Götaland, Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 431 80 Mölndal, Sweden
| | - Henrik Zetterberg
- Region Västra Götaland, Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 431 80 Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 431 80 Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
- UK Dementia Research Institute, University College London (UCL), London WC1E 6BT, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53706-1380, USA
| | - Christina Jern
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Region Västra Götaland, Department of Genetics and Genomics, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - N David Åberg
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 5, 413 45 Gothenburg, Sweden
- Region Västra Götaland, Department of Acute Medicine and Geriatrics, Sahlgrenska University Hospital, Blå Stråket 5, 413 45 Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Blå Stråket 5, 413 45 Gothenburg, Sweden
- Region Västra Götaland, Department of Internal Medicine, Skaraborg Central Hospital, 541 42 Skövde, Sweden
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Wall A, Anger O, Jood K, Blomstrand C, Andreasson U, Blennow K, Zetterberg H, Isgaard J, Jern C, Åberg ND, Svensson J. Circulating granulocyte colony-stimulating factor and functional outcome after ischemic stroke: an observational study. Neurol Res 2021; 43:1013-1022. [PMID: 34253146 DOI: 10.1080/01616412.2021.1948766] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 10/20/2022]
Abstract
Objectives: While granulocyte colony-stimulating factor (G-CSF) has shown beneficial effects in experimental ischemic stroke (IS), these effects have not been reproduced clinically. Small-to-medium-sized observational studies have reported varying associations for G-CSF with stroke severity and post-stroke functional outcome, prompting their investigation in a larger study.Methods: Endogenous serum G-CSF (S-GCSF) was measured in the acute phase and after 3 months in patients with IS (N = 435; 36% females; mean age, 57 years) from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Stroke severity was scored according to the National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) assessed functional outcomes at 3-month and 2-year post-stroke. Correlation and logistic regression analyses with confounder adjustments assessed the relationships.Results: The acute S-GCSF level was 23% higher than at 3-month post-stroke (p < 0.001). Acute G-CSF correlated weakly with stroke severity quintiles (r = 0.12, p = 0.013) and with high-sensitivity C-reactive protein (r = 0.29, p < 0.001). The association between S-GCSF (as quintiles, q) and poor functional outcome at 3 months (mRS 3-6; S-GCSF-q5 vs. S-GCSF-q1, age- and sex-adjusted odds ratio: 4.27, 95% confidence interval: 1.82-9.99; p = 0.001) withstood adjustment for cardiovascular risk factors and stroke subtype, but not additional correction for stroke severity. Post-stroke changes in S-GSCF and absolute 3-month S-GCSF were not associated with 3-month or 2-year functional outcomes.Discussion: Early post-stroke S-GCSF is increased in severe IS and associated with 3-month poor functional outcomes. The change in S-GCSF and the 3-month S-GCSF appear to be less-important, and S-GCSF likely reflects inflammation in large infarctions.
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Affiliation(s)
- Alexander Wall
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics (Su/Sahlgrenska), Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Olof Anger
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Christian Blomstrand
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Stroke Centre West, Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Ulf Andreasson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, UCL, Gower St., London, UK
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics (Su/Sahlgrenska), Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Jern
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Clinical Pathology and Genetics, Institute of Biomedicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Acute Medicine and Geriatrics (Su/Sahlgrenska), Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at the University of Gothenburg, Sweden
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D'Assante R, Arcopinto M, Rengo G, Salzano A, Walser M, Gambino G, Monti MG, Bencivenga L, Marra AM, Åberg DN, De Vincentiis C, Ballotta A, Bossone E, Isgaard J, Cittadini A. Myocardial expression of somatotropic axis, adrenergic signalling, and calcium handling genes in heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. ESC Heart Fail 2021; 8:1681-1686. [PMID: 33512777 PMCID: PMC8006736 DOI: 10.1002/ehf2.13067] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 03/13/2020] [Revised: 09/17/2020] [Accepted: 09/25/2020] [Indexed: 12/28/2022] Open
Abstract
Aims Limited data are available regarding cardiac expression of molecules involved in heart failure (HF) pathophysiology. The majority of the studies have focused on end‐stage HF with reduced ejection fraction (HFrEF) without comparison with healthy subjects, while no data are available with regard to HF with preserved ejection fraction (HFpEF). HFpEF is a condition whose multiple pathophysiological mechanisms are still not fully defined, with many proposed hypotheses remaining speculative due to limited access to human heart tissue. This study aimed at evaluating cardiac expression levels of key genes of interest in human biopsy samples from patients affected with HFrEF and HFpEF in order to possibly point out distinct phenotypes. Methods and results Total RNA was extracted from left ventricular cardiac biopsies collected from stable patients with HFrEF (n = 6) and HFpEF (n = 7) and healthy subjects (n = 9) undergoing elective cardiac surgery for valvular replacement, mitral valvuloplasty, aortic surgery, or coronary artery bypass. Real‐time PCR was performed to evaluate the mRNA expression levels of genes involved in somatotropic axis regulation [IGF‐1, IGF‐1 receptor (IGF‐1R), and GH receptor (GHR)], in adrenergic signalling (GRK2, GRK5, ADRB1, and ADRB2), in myocardial calcium handling (SERCA2), and in TNF‐α. Patients with HFrEF and HFpEF showed reduced serum IGF‐1 circulating levels when compared with controls (102 ± 35.6, 138 ± 11.5, and 160 ± 13.2 ng/mL, P < 0.001, respectively). At myocardial level, HFrEF showed significant decreased GHR and increased IGF‐1R expressions when compared with HFpEF and controls (0.54 ± 0.27, 0.94 ± 0.25, and 0.84 ± 0.2, P < 0.05 and 1.52 ± 0.9, 1.06 ± 0.21, and 0.72 ± 0.12, P < 0.05, respectively), while no differences in the local expression of IGF‐1 mRNA were detected among the groups (0.80 ± 0.45, 0.97 ± 0.18, and 0.63 ± 0.23, P = 0.09, respectively). With regard to calcium handling and adrenergic signalling, HFrEF displayed significant decreased levels of SERCA2 (0.19 ± 0.39, 0.82 ± 0.15, and 0.87 ± 0.32, P < 0.01) and increased levels of GRK2 (3.45 ± 2.94, 0.93 ± 0.12, and 0.80 ± 0.14, P < 0.01) and GRK5 (1.32 ± 0.70, 0.71 ± 0.14, and 0.77 ± 0.15, P < 0.05), while no significant difference was found in ADRB1 (0.66 ± 0.4, 0.83 ± 0.3, and 0.86 ± 0.4) and ADRB2 mRNA expression (0.65 ± 0.3, 0.66 ± 0.2, and 0.68 ± 0.1) when compared with HFpEF and controls. Finally, no changes in the local expression of TNF‐α were detected among groups. Conclusions Heart failure with reduced ejection fraction and HFpEF patients with stable clinical condition display a distinct molecular milieu of genes involved in somatotropic axis regulation, calcium handling, and adrenergic derangement at a myocardial level. The unique opportunity to compare these results with a control group, as reference population, may contribute to better understand HF pathophysiology and to identify novel potential therapeutic targets that could be modulated to improve ventricular function in patients with HF.
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Affiliation(s)
- Roberta D'Assante
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - Michele Arcopinto
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy.,Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB) - IRCCS - Scientific Institute of Telese Terme, Telese Terme, Italy
| | - Andrea Salzano
- IRCCS SDN, Diagnostic and Nuclear Research Institute, Naples, Italy
| | - Marion Walser
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Giuseppina Gambino
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - Maria Gaia Monti
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - Leonardo Bencivenga
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - Alberto M Marra
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
| | - David N Åberg
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Carlo De Vincentiis
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Andrea Ballotta
- Department of Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - Eduardo Bossone
- Division of Cardiology, A. Cardarelli Hospital, Naples, Italy
| | - Jörgen Isgaard
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Antonio Cittadini
- Department of Translational Medical Sciences, Federico II University of Naples, Via Pansini 5, Naples, 80138, Italy
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6
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Karason K, Bobbio E, Polte C, Bollano E, Peterson M, Cittadini A, Caidahl K, Hjalmarson Å, Bengtsson BÅ, Ekelund J, Swedberg K, Isgaard J. Effect of growth hormone treatment on circulating levels of NT-proBNP in patients with ischemic heart failure. Growth Horm IGF Res 2020; 55:101359. [PMID: 33099227 DOI: 10.1016/j.ghir.2020.101359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/11/2020] [Revised: 09/21/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
AIMS Growth hormone (GH) therapy in heart failure (HF) is controversial. We investigated the cardiovascular effects of GH in patients with chronic HF due to ischemic heart disease. METHODS In a double-blind, placebo-controlled trial, we randomly assigned 37 patients (mean age 66 years; 95% male) with ischemic HF (ejection fraction [EF] < 40%) to a 9-month treatment with either recombinant human GH (1.4 mg every other day) or placebo, with subsequent 3-month treatment-free follow-up. The primary outcome was change in left ventricular (LV) end-systolic volume measured by cardiac magnetic resonance (CMR). Secondary outcomes comprised changes in cardiac structure and EF. Prespecified tertiary outcomes included changes in New York Heat Association (NYHA) functional class and quality of life (QoL), as well as levels of insulin-like growth factor-1 (IGF-1) and N-terminal pro-brain natriuretic peptide (NT-proBNP). RESULTS No changes in cardiac structure or systolic function were identified in either treatment group; nor did GH treatment affect QoL or functional class. In the GH group, circulating levels of IGF-1 doubled from baseline (+105%; p < 0.001) and NT-proBNP levels halved (-48%; p < 0.001) during the treatment period, with subsequently a partial return of both towards baseline levels. No changes in IGF-1 or NT-proBNP were observed in the placebo group at any time during the study. CONCLUSION In patients with chronic ischemic HF, nine months of GH treatment was associated with significant increases in levels of IGF-1 and reductions in levels of NT-proBNP, but did not affect cardiac structure, systolic function or functional capacity.
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Affiliation(s)
- Kristjan Karason
- Departments of Cardiology and Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Emanuele Bobbio
- Departments of Cardiology and Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christian Polte
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Departments of Clinical Physiology and Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Entela Bollano
- Departments of Cardiology and Transplantation, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Peterson
- Department of Medicine, Lidköping Hospital, Lidköping, Sweden
| | - Antonio Cittadini
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Kenneth Caidahl
- Department of Molecular Medicine and Surgery, Karolinska Institute (KI), Stockholm, Sweden
| | - Åke Hjalmarson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Bengt-Åke Bengtsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Ekelund
- Centre of Registers Västra Götaland, Gothenburg, Sweden
| | - Karl Swedberg
- National Heart and Lung Institute, Imperial College, London, UK
| | - Jörgen Isgaard
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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7
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Ekstrand E, Esposito D, Ragnarsson O, Isgaard J, Johannsson G. Metabolic Effects of Cortisone Acetate vs Hydrocortisone in Patients With Secondary Adrenal Insufficiency. J Endocr Soc 2020; 4:bvaa160. [PMID: 33241171 PMCID: PMC7671249 DOI: 10.1210/jendso/bvaa160] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Indexed: 01/01/2023] Open
Abstract
Context Pharmacokinetic properties of cortisone acetate (CA) and hydrocortisone (HC) differ because CA needs to be converted into cortisol to become active. Objective This work analyzed the metabolic consequences of switching CA to an equivalent daily dose of HC in patients with secondary adrenal insufficiency (SAI). Design This was a post hoc analysis from a prospective study including individuals with hypopituitarism receiving growth hormone replacement. Data were collected before and after a switch from CA to an equivalent dose of HC (switch group). Two control groups were included: patients continuing CA replacement (CA control group) and adrenal-sufficient hypopituitary patients (AS control group). Results The analysis included 229 patients: 105, 31, and 93 in the switch, CA control, and AS control groups, respectively. After the change from CA to HC, increases in mean body weight (1.2 kg; P < .05), waist circumference (2.9 cm; P < .001), body fat measured by dual-energy x-ray absorptiometry (1.3 kg; P < .001), and glycated hemoglobin (0.3%; P < .05) were recorded in the switch group. The increase in mean waist circumference was greater than in the AS control group (0.9 cm; P < .05). Mean body fat increased in the switch group but not in the CA control group (–0.7 kg; P < .05). Conclusions A switch from CA to an equivalent dose of HC was associated with a worsened metabolic profile, suggesting that HC has a more powerful metabolic action than CA based on the assumption that 20 mg HC equals 25 mg CA.
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Affiliation(s)
- Elise Ekstrand
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Primary Care Facility Kusten, Ytterby, Sweden
| | - Daniela Esposito
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Oskar Ragnarsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gudmundur Johannsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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8
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Åberg ND, Wall A, Anger O, Jood K, Andreasson U, Blennow K, Zetterberg H, Isgaard J, Jern C, Svensson J. Circulating levels of vascular endothelial growth factor and post-stroke long-term functional outcome. Acta Neurol Scand 2020; 141:405-414. [PMID: 31919840 DOI: 10.1111/ane.13219] [Citation(s) in RCA: 5] [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: 10/11/2019] [Revised: 12/23/2019] [Accepted: 01/05/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Vascular endothelial growth factor (VEGF) acts in angiogenesis and neuroprotection, although the beneficial effects on experimental ischemic stroke (IS) have not been replicated in clinical studies. We investigated serum VEGF (s-VEGF) in the acute stage (baseline) and 3 months post-stroke in relation to stroke severity and functional outcome. METHODS The s-VEGF and serum high-sensitivity C-reactive protein (hs-CRP) concentrations were measured in patients enrolled in the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) at the acute time-point (median 4 days, N = 492, 36% female; mean age, 57 years) and at 3 months post-stroke (N = 469). Baseline stroke severity was classified according to the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes (3 months and 2 years) were evaluated using the modified Rankin Scale (mRS), dichotomized into good (mRS 0-2), and poor (mRS 3-6) outcomes. Multivariable logistic regression analyses were adjusted for covariates. RESULTS The baseline s-VEGF did not correlate with stroke severity but correlated moderately with hs-CRP (r = .17, P < .001). The baseline s-VEGF was 39.8% higher in total anterior cerebral infarctions than in lacunar cerebral infarctions. In binary logistic regression analysis, associations with 3-month functional outcome were non-significant. However, an association between the 3-month s-VEGF and poor 2-year outcome withstood adjustments for age, sex, cardiovascular covariates, and stroke severity (per 10-fold increase in s-VEGF, odds ratio [OR], 2.56, 95% confidence interval [CI] 1.12-5.82) or hs-CRP (OR 2.53, CI 1.15-5.55). CONCLUSIONS High 3-month s-VEGF is independently associated with poor 2-year functional outcome but not with 3-month outcome.
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Affiliation(s)
- N. David Åberg
- Department of Internal Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
| | - Alexander Wall
- Department of Internal Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
| | - Olof Anger
- Department of Internal Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
| | - Katarina Jood
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
- Department for Clinical Neuroscience Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Ulf Andreasson
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Mölndal Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Mölndal Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Mölndal Sweden
- Department of Laboratory Medicine Institute of Biomedicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Neurodegenerative Disease UCL Institute of Neurology London UK
- UK Dementia Research Institute at UCL London UK
| | - Jörgen Isgaard
- Department of Internal Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
| | - Christina Jern
- Department of Laboratory Medicine Institute of Biomedicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Clinical Genetics and Genomics Sahlgrenska University Hospital Gothenburg Sweden
| | - Johan Svensson
- Department of Internal Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden
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9
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Åberg ND, Gadd G, Åberg D, Hällgren P, Blomstrand C, Jood K, Nilsson M, Walker FR, Svensson J, Jern C, Isgaard J. Relationship between Levels of Pre-Stroke Physical Activity and Post-Stroke Serum Insulin-Like Growth Factor I. Biomedicines 2020; 8:biomedicines8030052. [PMID: 32143318 PMCID: PMC7148508 DOI: 10.3390/biomedicines8030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 01/31/2020] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/18/2022] Open
Abstract
Physical activity (PA) and insulin-like growth factor I (IGF-I) have beneficial effects for patients who have suffered an ischemic stroke (stroke). However, the relationship between the levels of PA and IGF-I after stroke has not been explored in detail. We investigated the pre-stroke PA level in relation to the post-stroke serum IGF-I (s-IGF-I) level, at baseline and at 3 months after the index stroke, and calculated the change that occurred between these two time-points (ΔIGF-I). Patients (N = 380; 63.4% males; mean age, 54.7 years) with data on 1-year leisure-time pre-stroke PA and post-stroke s-IGF-I levels were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS). Pre-stroke, leisure-time PA was self-reported as PA1–4, with PA1 representing sedentary and PA2–4 indicating progressively higher PA levels. Associations between s-IGF-I and PA were evaluated by multiple linear regressions with PA1 as the reference and adjustments being made for sex, age, history of previous stroke or myocardial infarctions, cardiovascular risk factors, and stroke severity. PA correlated with baseline s-IGF-I and ΔIGF-I, but not with the 3-month s-IGF-I. In the linear regressions, there were corresponding associations that remained as a tendency (baseline s-IGF-I, p = 0.06) or as a significant effect (ΔIGF-I, p = 0.03) after all the adjustments. Specifically, for each unit of PA, ΔIGF-I increased by 9.7 (95% CI 1,1−18.4) ng/mL after full adjustment. This supports the notion that pre-stroke PA is independently related to ΔIGF-I.
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Affiliation(s)
- N. David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
- Correspondence: ; Tel.: +46-31-342-8422
| | - Gustaf Gadd
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Daniel Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Peter Hällgren
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg SE-41345, Sweden;
| | - Christian Blomstrand
- Department for Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (C.B.); (K.J.)
| | - Katarina Jood
- Department for Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; (C.B.); (K.J.)
| | - Michael Nilsson
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Fredrick R. Walker
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
- Hunter Medical Research Institute, Lot 1, Kookaburra Cct, New Lambton Heights, NSW 2305, Australia
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
| | - Christina Jern
- Department of Laboratory Medicine, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden;
- Department of Clinical genetics and genomics, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, SE-41345 Gothenburg, Sweden; (G.G.); (D.Å.); (J.S.); (J.I.)
- School of Biomedical Sciences and Pharmacy and the Priority Research Centre for Stroke and Brain Injury, the University of Newcastle, University Dr, Callaghan, NSW 2308, Australia; (M.N.); (F.R.W.)
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10
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Walser M, Svensson J, Karlsson L, Motalleb R, Åberg M, Kuhn HG, Isgaard J, Åberg ND. Growth Hormone and Neuronal Hemoglobin in the Brain-Roles in Neuroprotection and Neurodegenerative Diseases. Front Endocrinol (Lausanne) 2020; 11:606089. [PMID: 33488521 PMCID: PMC7821093 DOI: 10.3389/fendo.2020.606089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
In recent years, evidence for hemoglobin (Hb) synthesis in both animal and human brains has been accumulating. While circulating Hb originating from cerebral hemorrhage or other conditions is toxic, there is also substantial production of neuronal Hb, which is influenced by conditions such as ischemia and regulated by growth hormone (GH), insulin-like growth factor-I (IGF-I), and other growth factors. In this review, we discuss the possible functions of circulating and brain Hb, mainly the neuronal form, with respect to the neuroprotective activities of GH and IGF-I against ischemia and neurodegenerative diseases. The molecular pathways that link Hb to the GH/IGF-I system are also reviewed, although the limited number of reports on this topic suggests a need for further studies. In summary, GH and/or IGF-I appear to be significant determinants of systemic and local brain Hb concentrations through mediating responses to oxygen and metabolic demand, as part of the neuroprotective effects exerted by GH and IGF-I. The nature and quantity of the latter deserve further exploration in specific experiments.
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Affiliation(s)
- Marion Walser
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- *Correspondence: Marion Walser,
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lars Karlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Reza Motalleb
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Maria Åberg
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Public Health and Community Medicine at University of Gothenburg, Gothenburg, Sweden
| | - H Georg Kuhn
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Institute for Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
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11
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Åberg D, Åberg ND, Jood K, Holmegaard L, Redfors P, Blomstrand C, Isgaard J, Jern C, Svensson J. Homeostasis model assessment of insulin resistance and outcome of ischemic stroke in non-diabetic patients - a prospective observational study. BMC Neurol 2019; 19:177. [PMID: 31345181 PMCID: PMC6657049 DOI: 10.1186/s12883-019-1406-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/28/2018] [Accepted: 07/19/2019] [Indexed: 12/18/2022] Open
Abstract
Background Insulin resistance (IR) in relation to diabetes is a risk factor for ischemic stroke (IS), whereas less is known about non-diabetic IR and outcome after IS. Methods In non-diabetic IS (n = 441) and controls (n = 560) from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS), IR was investigated in relation to IS severity and functional outcome. IR was evaluated acutely and after 3 months using the Homeostasis model assessment of IR (HOMA-IR). Stroke severity was assessed by the National Institutes of Health Stroke Scale (NIHSS). Functional outcome was evaluated using the modified Rankin Scale (mRS) after 3 months, 2 and 7 years. Associations were evaluated by logistic regression. Results Higher acute and 3-month HOMA-IR was observed in IS compared to the controls (both p < 0.001) and in severe compared to mild IS (both p < 0.05). High acute HOMA-IR was associated with poor outcome (mRS 3–6) after 3 months and 7 years [crude Odds ratios (ORs), 95% confidence intervals (CIs) 1.50, 1.07–2.11 and 1.59, 1.11–2.30, respectively], but not after 2 years. These associations lost significance after adjustment for all covariates including initial stroke severity. In the largest IS subtype (cryptogenic stroke), acute HOMA-IR was associated with poor outcome after 2 years also after adjustment for age and stroke severity (OR 2.86, 95% CI 1.01–8.12). Conclusions In non-diabetic IS patients, HOMA-IR was elevated and related to stroke severity, but after adjustment for IS severity, the associations between HOMR-IR and poor outcome lost significance. This could suggest that elevated IR mostly is a part of the acute IS morbidity. However, in the subgroup of cryptogenic stroke, the associations with poor outcome withstood correction for stroke severity.
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Affiliation(s)
- Daniel Åberg
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. .,Department of Internal Medicine, Sahlgrenska University Hospital, University of Gothenburg, Blå stråket 5, SE-413 45, Göteborg, Sweden.
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Center of Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lukas Holmegaard
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petra Redfors
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christian Blomstrand
- Center of Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christina Jern
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Pathology and Clinical Genetics, Institute of Biomedicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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12
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Åberg ND, Åberg D, Lagging C, Holmegaard L, Redfors P, Jood K, Nilsson M, Åberg M, Blomstrand C, Svensson J, Jern C, Isgaard J. Association Between Levels of Serum Insulin-like Growth Factor I and Functional Recovery, Mortality, and Recurrent Stroke at a 7-year Follow-up. Exp Clin Endocrinol Diabetes 2019; 128:303-310. [PMID: 31261410 DOI: 10.1055/a-0833-8313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/26/2022]
Abstract
BACKGROUND The association of serum insulin-like growth factor I (s-IGF-I) with favorable outcome after ischemic stroke (IS) beyond 2 years is unknown. We investigated whether the levels of s-IGF-I 3 months post-stroke were associated with functional recovery up to 7 years after IS, considering also mortality and recurrent strokes. METHODS Patients (N=324; 65% males; mean age, 55 years) with s-IGF-I levels assessed 3 months after the index IS were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The modified Rankin Scale (mRS) was used to evaluate outcomes at 3 months, 2 and 7 years after IS, and recovery was defined as an improvement, no change, or deterioration in the shifts of mRS score. Baseline stroke severity was determined using the National Institutes of Health Stroke Scale (NIHSS). RESULTS The mRS score distributions were better in the above-median s-IGF-I group (>146.7 ng/ml). The s-IGF-I level was not associated with recurrent stroke (N=79) or death (N=44), although it correlated with recovery (r=0.12, P=0.035). In the regression analysis, s-IGF-I associated with recovery between 3 months and 7 years (but not between 2 and 7 years). The associations did not withstand adjustment for age and sex. For comparison, the corresponding associations between 3 months and 2 years withstood all adjustments. CONCLUSION The association for s-IGF-I with long-term post-stroke recovery persists after 7 years, which is also reflected in the mRS score distributions at all time-points. The effects are however modest, and not driven by mortality or recurrent stroke.
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Affiliation(s)
- N David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Center of Brain Repair and Rehabilitation, The Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Daniel Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Lagging
- Department of Clinical Pathology and Genetics, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lukas Holmegaard
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petra Redfors
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Michael Nilsson
- Center of Brain Repair and Rehabilitation, The Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Maria Åberg
- Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christian Blomstrand
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christina Jern
- Department of Clinical Pathology and Genetics, Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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13
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Walser M, Oscarsson J, Åberg MAI, Svensson J, Isgaard J, Åberg ND. Effects of peripheral administration of GH and IGF-I on gene expression in the hippocampus of hypophysectomised rats. Neuro Endocrinol Lett 2019; 39:525-531. [PMID: 30860684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/16/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Growth hormone (GH) increases insulin-like growth factor I (IGF-I) production and both hormones affect hippocampal plasticity. We have previously shown that Hbb and Alas2 in the rat hippocampus were robustly regulated by GH-infusions for six days, whereas other transcripts were weakly affected. Here, we explored the effects of prolonged GH administration on transcripts linked to neuroprotection and investigated whether serum IGF-I administration may exert similar effects. DESIGN Hypophysectomised female rats were infused with GH or IGF-I for 19 days. Hbb, Alas2 and seven additional GH- and IGF-I-related transcripts were quantified by Q-RT-PCR in rat hippocampus. RESULTS Three transcripts, Hbb, Alas2, and Alox15 were increased by both GH and IGF-I administration. The other transcripts were marginally affected. CONCLUSION The 19-day GH-infusion induced similar effects as those reported after 6-day GH treatment, with the addition of the regulation of transcript Alox15. IGF-I induced altered gene expression in relation to its effect on weight gain. This study underlines that there is an entity of transcripts involved in neuroprotection and vascular tone that is regulated by both systemic GH and IGF-I. For other transcripts, the longer duration of this study did not significantly enhance the marginal effects of GH administration seen previously.
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Affiliation(s)
- Marion Walser
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | | | - Maria A I Åberg
- Department of Primary Health Care, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - N David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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14
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Lillicrap T, Garcia-Esperon C, Walker FR, Ong LK, Nilsson M, Spratt N, Levi CR, Parsons M, Isgaard J, Bivard A. Growth Hormone Deficiency Is Frequent After Recent Stroke. Front Neurol 2018; 9:713. [PMID: 30237782 PMCID: PMC6135914 DOI: 10.3389/fneur.2018.00713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/06/2018] [Indexed: 12/27/2022] Open
Abstract
Introduction: The incidence of pituitary dysfunction after severe ischemic stroke is unknown, however given the increasing attention to pituitary dysfunction after neurological injuries such as traumatic brain injury, this may represent a novel area of research in stroke. Methods: We perform an arginine and human growth hormone releasing hormone challenge on ischemic stroke patients within a week of symptom onset. Results: Over the study period, 13 patients were successfully tested within a week of stroke (baseline NIHSS 10, range 7-16). Overall, 9(69%) patients had a poor response, with 7(54%) of these patients meeting the criteria for had human growth hormone deficiency. Other measures of pituitary function were within normal ranges. Conclusion: After major ischemic stroke, low GH levels are common and may play a role in stroke recovery.
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Affiliation(s)
- Thomas Lillicrap
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
| | - Carlos Garcia-Esperon
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
| | | | - Lin Kooi Ong
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
| | - Michael Nilsson
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
| | - Neil Spratt
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
| | - Christopher R. Levi
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
| | - Mark Parsons
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
| | - Jörgen Isgaard
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Andrew Bivard
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, NSW, Australia
- Hunter Medical Research Institute, University of NewcastleNewcastle, NSW, Australia
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15
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Åberg ND, Åberg D, Jood K, Nilsson M, Blomstrand C, Kuhn HG, Svensson J, Jern C, Isgaard J. Altered levels of circulating insulin-like growth factor I (IGF-I) following ischemic stroke are associated with outcome - a prospective observational study. BMC Neurol 2018; 18:106. [PMID: 30081862 PMCID: PMC6091156 DOI: 10.1186/s12883-018-1107-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/08/2018] [Accepted: 07/22/2018] [Indexed: 01/12/2023] Open
Abstract
Background Insulin-like growth factor I (IGF-I) has neuroprotective effects in experimental ischemic stroke (IS). However, in patients who have suffered IS, various associations between the levels of serum IGF-I (s-IGF-I) and clinical outcome have been reported, probably reflecting differences in sampling time-points and follow-up periods. Since changes in the levels of post-stroke s-IGF-I have not been extensively explored, we investigated whether decreases in the levels of s-IGF-I between the acute time-point (median, 4 days) and 3 months (ΔIGF-I, further transformed into ΔIGF-I-quintiles, ΔIGF-I-q) are associated with IS severity and outcome. Methods In the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS) conducted in Gothenburg, Sweden, patients with IS who had s-IGF-I measurements available were included (N = 354; 65% males; mean age, 55 years). Baseline stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and converted into NIHSS-quintiles (NIHSS-q). Outcomes were assessed using the modified Rankin Scale (mRS) at 3 months and 2 years. Results In general, the levels of s-IGF-I decreased (positive ΔIGF-I), except for those patients with the most severe NIHSS-q. After correction for sex and age, the 3rd ΔIGF-I-q showed the strongest association to mRS 0–2 [Odds Ratio (OR) 5.11, 95% confidence interval (CI) 2.18–11.9], and after 2 years, the 5th ΔIGF-I-q (OR 3.63, 95% CI 1.40–9.38) showed the strongest association to mRS 0–2. The associations remained significant after multivariate correction for diabetes, smoking, hypertension, and hyperlipidemia after 3 months, but were not significant (p = 0.057) after 2 years. The 3-month associations withstood additional correction for baseline stroke severity (p = 0.035), whereas the 2-year associations were further attenuated (p = 0.31). Conclusions Changes in the levels of s-IGF-I are associated primarily with temporally near 3-month outcomes, while associations with long-term 2-year outcomes are weakened and attenuated by other factors. The significance of the change in post-stroke s-IGF-I is compatible with a positive role for IGF-I in IS recovery. However, the exact mechanisms are unknown and probably reflects combinations of multiple peripheral and central actions. Electronic supplementary material The online version of this article (10.1186/s12883-018-1107-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N David Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
| | - Daniel Åberg
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden
| | - Katarina Jood
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Michael Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
| | - Christian Blomstrand
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - H Georg Kuhn
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden
| | - Christina Jern
- Institute of Biomedicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Clinical Genetics, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden
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16
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Ong LK, Chow WZ, TeBay C, Kluge M, Pietrogrande G, Zalewska K, Crock P, Åberg ND, Bivard A, Johnson SJ, Walker FR, Nilsson M, Isgaard J. Growth Hormone Improves Cognitive Function After Experimental Stroke. Stroke 2018; 49:1257-1266. [PMID: 29636425 DOI: 10.1161/strokeaha.117.020557] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 12/21/2017] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive impairment is a common outcome for stroke survivors. Growth hormone (GH) could represent a potential therapeutic option as this peptide hormone has been shown to improve cognition in various clinical conditions. In this study, we evaluated the effects of peripheral administration of GH at 48 hours poststroke for 28 days on cognitive function and the underlying mechanisms. METHODS Experimental stroke was induced by photothrombotic occlusion in young adult mice. We assessed the associative memory cognitive domain using mouse touchscreen platform for paired-associate learning task. We also evaluated neural tissue loss, neurotrophic factors, and markers of neuroplasticity and cerebrovascular remodeling using biochemical and histology analyses. RESULTS Our results show that GH-treated stroked mice made a significant improvement on the paired-associate learning task relative to non-GH-treated mice at the end of the study. Furthermore, we observed reduction of neural tissue loss in GH-treated stroked mice. We identified that GH treatment resulted in significantly higher levels of neurotrophic factors (IGF-1 [insulin-like growth factor-1] and VEGF [vascular endothelial growth factor]) in both the circulatory and peri-infarct regions. GH treatment in stroked mice not only promoted protein levels and density of presynaptic marker (SYN-1 [synapsin-1]) and marker of myelination (MBP [myelin basic protein]) but also increased the density and area coverage of 2 major vasculature markers (CD31 and collagen-IV), within the peri-infarct region. CONCLUSIONS These findings provide compelling preclinical evidence for the usage of GH as a potential therapeutic tool in the recovery phase of patients after stroke.
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Affiliation(s)
- Lin Kooi Ong
- From the Priority Research Centre for Stroke and Brain Injury (L.K.O., F.R.W., M.N., J.I.) .,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.).,National Health and Medical Research Council Centre of Research Excellence Stroke Rehabilitation and Brain Recovery, Australia (F.R.W., M.N., L.K.O.)
| | - Wei Zhen Chow
- School of Biomedical Sciences and Pharmacy (W.Z.C., C.T., M.K., G.P., K.Z.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Clifford TeBay
- School of Biomedical Sciences and Pharmacy (W.Z.C., C.T., M.K., G.P., K.Z.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Murielle Kluge
- School of Biomedical Sciences and Pharmacy (W.Z.C., C.T., M.K., G.P., K.Z.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Giovanni Pietrogrande
- School of Biomedical Sciences and Pharmacy (W.Z.C., C.T., M.K., G.P., K.Z.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Katarzyna Zalewska
- School of Biomedical Sciences and Pharmacy (W.Z.C., C.T., M.K., G.P., K.Z.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Patricia Crock
- Department of Paediatric Endocrinology and Diabetes, Priority Research Centre Grow Up Well, John Hunter Children's Hospital (P.C.)
| | - N David Åberg
- Sahlgrenska University Hospital, University of Gothenburg, Sweden (N.D.A.)
| | - Andrew Bivard
- Department of Neurology, John Hunter Hospital (A.B.), University of Newcastle, Australia.,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Sarah J Johnson
- School of Electrical Engineering and Computing (S.J.J.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.)
| | - Frederick R Walker
- From the Priority Research Centre for Stroke and Brain Injury (L.K.O., F.R.W., M.N., J.I.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.).,National Health and Medical Research Council Centre of Research Excellence Stroke Rehabilitation and Brain Recovery, Australia (F.R.W., M.N., L.K.O.)
| | - Michael Nilsson
- From the Priority Research Centre for Stroke and Brain Injury (L.K.O., F.R.W., M.N., J.I.).,Hunter Medical Research Institute, Australia (L.K.O., A.B., F.R.W., M.N., W.Z.C., C.T., M.K., G.P., K.Z., S.J.J.).,National Health and Medical Research Council Centre of Research Excellence Stroke Rehabilitation and Brain Recovery, Australia (F.R.W., M.N., L.K.O.)
| | - Jörgen Isgaard
- From the Priority Research Centre for Stroke and Brain Injury (L.K.O., F.R.W., M.N., J.I.) .,Centre for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology and Department of Internal Medicine (J.I.)
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17
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Walser M, Schiöler L, Oscarsson J, Åberg MAI, Wickelgren R, Svensson J, Isgaard J, Åberg ND. Mode of GH administration and gene expression in the female rat brain. J Endocrinol 2017; 233:187-196. [PMID: 28275169 DOI: 10.1530/joe-16-0656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 02/24/2017] [Accepted: 03/08/2017] [Indexed: 11/08/2022]
Abstract
The endogenous secretion of growth hormone (GH) is sexually dimorphic in rats with females having a more even and males a more pulsatile secretion and low trough levels. The mode of GH administration, mimicking the sexually dimorphic secretion, has different systemic effects. In the brains of male rats, we have previously found that the mode of GH administration differently affects neuron-haemoglobin beta (Hbb) expression whereas effects on other transcripts were moderate. The different modes of GH administration could have different effects on brain transcripts in female rats. Hypophysectomised female rats were given GH either as injections twice daily or as continuous infusion and GH-responsive transcripts were assessed by quantitative reverse transcription polymerase chain reaction in the hippocampus and parietal cortex (cortex). The different modes of GH-administration markedly increased Hbb and 5'-aminolevulinate synthase 2 (Alas2) in both brain regions. As other effects were relatively moderate, a mixed model analysis (MMA) was used to investigate general effects of the treatments. In the hippocampus, MMA showed that GH-infusion suppressed glia- and neuron-related transcript expression levels, whereas GH-injections increased expression levels. In the cortex, GH-infusion instead increased neuron-related transcripts, whereas GH-injections had no significant effect. Interestingly, this contrasts to previous results obtained from male rat cortex where GH-infusion generally decreased expression levels. In conclusion, the results indicate that there is a small but significant difference in response to mode of GH administration in the hippocampus as compared to the cortex. For both modes of GH administration, there was a robust effect on Hbb and Alas2.
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Affiliation(s)
- Marion Walser
- Department of Internal MedicineInstitute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Linus Schiöler
- Department for Public Health and Community MedicineThe Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | | | - Maria A I Åberg
- Department of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ruth Wickelgren
- Department of Clinical Chemistry and Transfusion MedicineThe Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal MedicineInstitute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Department of Internal MedicineInstitute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - N David Åberg
- Department of Internal MedicineInstitute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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18
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Affiliation(s)
- Jörgen Isgaard
- Department of Internal Medicine and Nutrition, Sahlgrenska Academy at the University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Antonio Cittadini
- Department of Translational Medical Science, Federico II University, Naples, Italy
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19
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Åberg D, Johansson P, Isgaard J, Wallin A, Johansson JO, Andreasson U, Blennow K, Zetterberg H, Åberg ND, Svensson J. Increased Cerebrospinal Fluid Level of Insulin-like Growth Factor-II in Male Patients with Alzheimer's Disease. J Alzheimers Dis 2016; 48:637-46. [PMID: 26402100 DOI: 10.3233/jad-150351] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Insulin-like growth factor-II (IGF-II) is important for brain development. Although IGF-II is abundant also in adult life, little is known of the role of IGF-II in Alzheimer's disease (AD). OBJECTIVE AND METHODS This was a cross-sectional study of 60 consecutive patients under primary evaluation of cognitive impairment and 20 healthy controls. The patients had AD dementia or mild cognitive impairment (MCI) diagnosed with AD dementia upon follow-up (n = 32), stable MCI (SMCI, n = 13), or other dementias (n = 15). IGF-II, IGF-binding protein-1 (IGFBP-1), and IGFBP-2 were analyzed in serum and cerebrospinal fluid (CSF). RESULTS Levels of IGF-II, IGFBP-1, and IGFBP-2 were similar in all groups in the total study population. Gender-specific analyses showed that in men (n = 40), CSF IGF-II level was higher in AD compared to SMCI and controls (p < 0.01 and p < 0.05, respectively). Furthermore, CSF IGFBP-2 level was increased in AD men versus SMCI men (p < 0.01) and tended to be increased versus control men (p = 0.09). There were no between-group differences in women (n = 40). In the total study population (n = 80) as well as in men (n = 40), CSF levels of IGF-II and IGFBP-2 correlated positively with CSF levels of the AD biomarkers total-tau and phosphorylated tau protein. CONCLUSION In men, but not women, in the early stages of AD, CSF IGF-II level was elevated, and CSF IGFBP-2 level tended to be increased, compared to healthy controls.
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Affiliation(s)
- Daniel Åberg
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Per Johansson
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Neuropsychiatry, Skaraborg Hospital, Falköping, Sweden
| | - Jörgen Isgaard
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, NSW, Australia
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Jan-Ove Johansson
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,UCL Institute of Neurology, Queen Square, London, UK
| | - N David Åberg
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Endocrinology, Skaraborg Hospital, Skövde, Sweden
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20
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Stanne TM, Åberg ND, Nilsson S, Jood K, Blomstrand C, Andreasson U, Blennow K, Zetterberg H, Isgaard J, Svensson J, Jern C. Low Circulating Acute Brain-Derived Neurotrophic Factor Levels Are Associated With Poor Long-Term Functional Outcome After Ischemic Stroke. Stroke 2016; 47:1943-5. [PMID: 27301948 DOI: 10.1161/strokeaha.115.012383] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [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: 12/15/2015] [Accepted: 05/03/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Brain-derived neurotrophic factor (BDNF) plays important roles in brain plasticity and repair, and it influences stroke outcomes in animal models. Circulating BDNF concentrations are lowered in patients with traumatic brain injury, and low BDNF predicts poor recovery after this injury. We sought to investigate whether circulating concentrations of BDNF are altered in the acute phase of ischemic stroke and whether they are associated with short- or long-term functional outcome. METHODS Serum concentrations of BDNF were measured in the Sahlgrenska Academy Study on Ischemic Stroke. The main outcomes were modified Rankin Scale (mRS) good (mRS score of 0-2) versus poor (mRS score of 3-6) at 3 months and 2 years after stroke, and good (mRS score of 0-2) versus poor (mRS score of 3-5) at 7 years after stroke. RESULTS Acute concentrations of BDNF were significantly lower in ischemic stroke cases (n=491) compared with controls (n=513). BDNF concentrations were not significantly associated with 3-month outcome. However, patients with BDNF in the lowest tertile had an increased risk of experiencing a poor outcome both at 2-year and 7-year follow-up, and these associations were independent of vascular risk factors and stroke severity (odds ratio, 2.6; confidence intervals, 1.4-4.9; P=0.002 and odds ratio, 2.1; confidence intervals, 1.1-3.9; P=0.028, respectively). CONCLUSIONS Circulating concentrations of BDNF protein are lowered in the acute phase of ischemic stroke, and low levels are associated with poor long-term functional outcome. Further studies are necessary to confirm these associations and to determine the predictive value of BDNF in stroke outcomes.
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Affiliation(s)
- Tara M Stanne
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.).
| | - N David Åberg
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Staffan Nilsson
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Katarina Jood
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Christian Blomstrand
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Ulf Andreasson
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Kaj Blennow
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Henrik Zetterberg
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Jörgen Isgaard
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Johan Svensson
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
| | - Christina Jern
- From the Department of Medical and Clinical Genetics (T.M.S., C.J.), Department of Internal Medicine (NDÅ, J.I., J.S.), Center of Brain Repair and Rehabilitation (N.D.Å., C.B.), Department for Clinical Neuroscience and Rehabilitation (K.J., C.B.), Department of Psychiatry and Neurochemistry (U.A., K.B., H.Z.), The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; Chalmers University of Technology, Mathematical Sciences, Gothenburg, Sweden (S.N.); and UCL Institute of Neurology, London, United Kingdom (H.Z.)
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Chan JYH, Chan SHH, Cosci F, Gardiner DM, Gollasch M, Gwinn M, Isgaard J, Kalantar-Zadeh K, Patrinos GP, Rubinstein I, Schmid M, Sherman M, Simon HU, Stratakis CA, Tanner M, Zaenker KS. Welcome to Biomedicine Hub. Biomed Hub 2016; 1:1-2. [PMID: 31988886 PMCID: PMC6945968 DOI: 10.1159/000446335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Affiliation(s)
- Jörgen Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, University of Gothenburg, Gröna Stråket 8, Gothenburg, SE-413 45, Sweden.
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Åberg ND, Stanne TM, Jood K, Schiöler L, Blomstrand C, Andreasson U, Blennow K, Zetterberg H, Isgaard J, Jern C, Svensson J. Serum erythropoietin and outcome after ischaemic stroke: a prospective study. BMJ Open 2016; 6:e009827. [PMID: 26916692 PMCID: PMC4769431 DOI: 10.1136/bmjopen-2015-009827] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Erythropoietin (EPO), which is inversely associated with blood haemoglobin (Hb), exerts neuroprotective effects in experimental ischaemic stroke (IS). However, clinical treatment trials have so far been negative. Here, in patients with IS, we analysed whether serum EPO is associated with (1) initial stroke severity, (2) recovery and (3) functional outcome. DESIGN Prospective. Controls available at baseline. SETTING A Swedish hospital-initiated study with outpatient follow-up after 3 months. PARTICIPANTS Patients (n=600; 64% males, mean age 56 years, controls n=600) were included from the Sahlgrenska Academy Study on IS (SAHLSIS). PRIMARY AND SECONDARY OUTCOME MEASURES In addition to EPO and Hb, initial stroke severity was assessed by the Scandinavian Stroke Scale (SSS) and compared with SSS after 3 months (follow-up) as a measure of recovery. Functional outcome was evaluated using the modified Rankin Scale (mRS) at follow-up. Serum EPO and SSS were divided into quintiles in the multivariate regression analyses. RESULTS Serum EPO was 21% and 31% higher than in controls at the acute phase of IS and follow-up, respectively. In patients, acute serum EPO was 19.5% higher in severe versus mild IS. The highest acute EPO quintile adjusted for sex, age and Hb was associated with worse stroke severity quintile (OR 1.70, 95% CI 1.00 to 2.87), better stroke recovery quintile (OR 1.93, CI 1.09 to 3.41) and unfavourable mRS 3-6 (OR 2.59, CI 1.15 to 5.80). However, the fourth quintile of EPO increase (from acute to follow-up) was associated with favourable mRS 0-2 (OR 3.42, CI 1.46 to 8.03). Only the last association withstood full adjustment. CONCLUSIONS The crude associations between EPO and worse stroke severity and outcome lost significance after multivariate modelling. However, in patients in whom EPO increased, the association with favourable outcome remained after adjustment for multiple covariates.
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Affiliation(s)
- N David Åberg
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center of Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tara M Stanne
- Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Katarina Jood
- Department for Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linus Schiöler
- Department of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christian Blomstrand
- Center of Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department for Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulf Andreasson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- UCL Institute of Neurology, London, UK
| | - Jörgen Isgaard
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Medicine and Public Health, University of Newcastle, New South Wales, Australia
| | - Christina Jern
- Department of Medical and Clinical Genetics, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Yang Y, Landin-Wilhelmsen K, Zetterberg H, Oleröd G, Isgaard J, Wikkelsö C. Serum IGF-1 is higher in patients with idiopathic normal pressure hydrocephalus than in the population. Growth Horm IGF Res 2015; 25:269-273. [PMID: 26572963 DOI: 10.1016/j.ghir.2015.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 07/07/2015] [Revised: 09/21/2015] [Accepted: 10/17/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hypopituitarism has been reported in patients with idiopathic normal pressure hydrocephalus (iNPH), which could enhance characteristic symptoms like impaired wakefulness, gait, body balance, and subcortical cognitive deterioration. PURPOSE To compare basal serum levels of pituitary and sex hormones and serum insulin-like growth factor-1 (S-IGF-1) in patients with iNPH and an age-matched control population, and to correlate the preoperative hormone levels with symptoms and signs pre-operatively and three months after surgery. METHODS A cross-sectional case control design was used. Patients diagnosed with iNPH, n=108 (65 men and 43 women, mean age 72.3 years), were consecutively included during 2006-2011 at Sahlgrenska University Hospital, Gothenburg, Sweden. S-TSH, S-free T4, S-FSH, S-LH, S-prolactin, plasma ACTH, S-testosterone, S-oestradiol and S-IGF-1 were examined. Symptoms and signs were scored using the iNPH scale score. Population controls, n=146, were recruited from the WHO MONICA project, Gothenburg in 2008. RESULTS Men and women with iNPH had higher S-IGF-1 than controls (p<0.001). Women with iNPH had lower S-TSH (p=0.016) than controls, but the frequency of levothyroxine substitution was similar. Among men, a higher level of S-IGF-1 was associated with milder symptoms, while higher levels of S-FSH and S-LH were associated with more severe symptoms. CONCLUSIONS Patients with iNPH did not have lower levels of pituitary or sex hormones but presented with higher levels of S-IGF-1, compared with healthy, age-matched controls. Higher S-IGF-1 in men was related to milder mental and physical symptoms and signs.
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Affiliation(s)
- Y Yang
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden..
| | - K Landin-Wilhelmsen
- Section for Endocrinology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gröna stråket 8, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden.
| | - H Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden.
| | - G Oleröd
- Department of Clinical Chemistry and Transfusion Medicine, Institute of Biomedicine, Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 1 G, S-413 45 Gothenburg, Sweden.
| | - J Isgaard
- Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Guldhedsgatan 10, S-413 46 Gothenburg, Sweden.
| | - C Wikkelsö
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 11, Box 430, SE-405 30 Gothenburg, Sweden..
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25
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Jones KA, Zouikr I, Patience M, Clarkson AN, Isgaard J, Johnson SJ, Spratt N, Nilsson M, Walker FR. Chronic stress exacerbates neuronal loss associated with secondary neurodegeneration and suppresses microglial-like cells following focal motor cortex ischemia in the mouse. Brain Behav Immun 2015; 48:57-67. [PMID: 25749481 DOI: 10.1016/j.bbi.2015.02.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [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: 12/31/2014] [Revised: 02/06/2015] [Accepted: 02/16/2015] [Indexed: 12/26/2022] Open
Abstract
Post-stroke patients describe suffering from persistent and unremitting levels of distress. Using an experimental model of focal cortical ischemia in adult male C57BL/6 mice, we examined whether exposure to chronic stress could modify the development of secondary thalamic neurodegeneration (STND), which is commonly reported to be associated with impaired functional recovery. We were particularly focused on the modulatory role of microglia-like cells, as several clinical studies have linked microglial activation to the development of STND. One month following the induction of cortical ischemia we identified that numbers of microglial-like cells, as well as putative markers of microglial structural reorganization (Iba-1), complement processing (CD11b), phagocytosis (CD68), and antigen presentation (MHC-II) were all significantly elevated in response to occlusion. We further identified that these changes co-occurred with a decrease in the numbers of mature neurons within the thalamus. Occluded animals that were also exposed to chronic stress exhibited significantly lower levels of Iba-1 positive cells and a reduced expression of Iba-1 and CD11b compared to the 'occlusion-alone' group. Interestingly, the dampened expression of microglial/monocyte markers observed in stressed animals was associated with significant additional loss of neurons. These findings indicate that the process of STND can be negatively modified, potentially in a microglial dependent manner, by exposure to chronic stress.
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Affiliation(s)
- Kimberley A Jones
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health Research, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Ihssane Zouikr
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health Research, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Madeleine Patience
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health Research, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Andrew N Clarkson
- Department of Anatomy and the Brain Health Research Center, Dunedin 9054, New Zealand; Centre for Translational Physiology, University of Otago Wellington, Dunedin 9054, New Zealand; Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Jörgen Isgaard
- University of Newcastle, Australia; Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, SE-413 45 Gothenburg, Sweden
| | - Sarah J Johnson
- School of Electrical Engineering and Computer Science, University of Newcastle, Callaghan, NSW, Australia
| | - Neil Spratt
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health Research, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Michael Nilsson
- University of Newcastle, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Frederick R Walker
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia; Centre for Translational Neuroscience and Mental Health Research, Australia; Hunter Medical Research Institute, Newcastle, NSW, Australia.
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Abstract
In this review, the importance of growth hormone (GH) for the maintenance of normal cardiac function in adult life is discussed. Physiological effects of GH and underlying mechanisms for interactions between GH and insulin-like growth factor I (IGF-I) and the cardiovascular system are covered as well as the cardiac dysfunction caused both by GH excess (acromegaly) and by GH deficiency in adult hypopituitary patients. In both acromegaly and adult GH deficiency, there is also increased cardiovascular morbidity and mortality possibly linked to aberrations in GH status. Finally, the status of the GH/IGF-I system in relation to heart failure and the potential of GH as a therapeutic tool in the treatment of heart failure are reviewed in this article.
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Affiliation(s)
- Jörgen Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 8, 413 45, Göteborg, Sweden,
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Patience MJ, Zouikr I, Jones K, Clarkson AN, Isgaard J, Johnson SJ, Walker FR, Nilsson M. Photothrombotic Stroke Induces Persistent Ipsilateral and Contralateral Astrogliosis in Key Cognitive Control Nuclei. Neurochem Res 2014; 40:362-71. [DOI: 10.1007/s11064-014-1487-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/22/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
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Walser M, Schiöler L, Oscarsson J, Aberg MAI, Svensson J, Aberg ND, Isgaard J. Different modes of GH administration influence gene expression in the male rat brain. J Endocrinol 2014; 222:181-90. [PMID: 24872576 DOI: 10.1530/joe-14-0223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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] [Indexed: 02/06/2023]
Abstract
The endogenous secretion pattern in males of GH is episodic in rats and in humans, whereas GH administration is usually even. Different types of GH administration have different effects on body mass, longitudinal bone growth, and liver metabolism in rodents, whereas possible effects on brain plasticity have not been investigated. In this study, GH was administered as a continuous infusion or as two daily injections in hypophysectomized male rats. Thirteen transcripts previously known to respond to GH in the hippocampus and parietal cortex (cortex) were assessed by RT-PCR. To investigate the effects of type of GH administration on several transcripts with different variations, and categories of transcripts (neuron-, glia-, and GH-related), a mixed model analysis was applied. Accordingly, GH injections increased overall transcript abundance more than GH infusions (21% in the hippocampus, P<0.001 and 10% in the cortex, P=0.09). Specifically, GH infusions and injections robustly increased neuronal hemoglobin beta (Hbb) expression significantly (1.8- to 3.6-fold), and GH injections were more effective than GH infusions in increasing Hbb in the cortex (41%, P=0.02), whereas a 23% difference in the hippocampus was not significant. Also cortical connexin 43 was higher in the group with GH injections than in those with GH infusions (26%, P<0.007). Also, there were differences between GH injections and infusions in GH-related transcripts of the cortex (23%, P=0.04) and glia-related transcripts of the hippocampus (15%, P=0.02). Thus, with the exception of Hbb there is a moderate difference in responsiveness to different modes of GH administration.
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Affiliation(s)
- Marion Walser
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Linus Schiöler
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jan Oscarsson
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria A I Aberg
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenLaboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Svensson
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - N David Aberg
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenLaboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jörgen Isgaard
- Laboratory of Experimental EndocrinologyDepartment of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Blå Stråket 5, SE-413 45 Gothenburg, SwedenDepartment for Public Health and Community MedicineThe Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenAstraZeneca R&DSE-431 83 Mölndal, Gothenburg, SwedenInstitute for Neuroscience and PhysiologyThe Sahlgrenska Academy, Center for Brain Repair and RehabilitationDepartment of Primary Health CareInstitute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Aberg ND, Olsson S, Aberg D, Jood K, Stanne TM, Nilsson M, Blomstrand C, Svensson J, Isgaard J, Jern C. Genetic variation at the IGF1 locus shows association with post-stroke outcome and to circulating IGF1. Eur J Endocrinol 2013; 169:759-65. [PMID: 24005314 DOI: 10.1530/eje-13-0486] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [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: 11/08/2022]
Abstract
OBJECTIVE In humans, serum IGF1 (s-IGF1) is associated with outcome after ischemic stroke (IS). Therefore variation at the IGF1 locus could also associate with both IS and s-IGF1. We investigated whether genetic variation at the IGF1 locus is associated with i) s-IGF1, ii) IS occurrence, iii) IS severity, and iv) post-stroke outcome. DESIGN/METHODS Patients (n=844; 66% males, mean age 56 years) and community controls (n=668) were included from the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). Post-stroke outcome was evaluated with the modified Rankin Scale at 3 and 24 months after index stroke, and baseline stroke severity with the Scandinavian Stroke Scale. s-IGF1 was determined in patients and after random selection in 40 of the controls. RESULTS Eleven single nucleotide polymorphisms (SNPs) were selected in the IGF1 gene. In healthy controls the major allele of rs7136446 was associated with higher s-IGF1, whereas in patients no such association was found. No SNP was associated with IS, nor with stroke severity. After multivariate correction for presence of diabetes, smoking, and hypertension, the major allele of rs7136446 was associated with favorable functional outcome 24-months post-stroke (odds ratio 1.46; 95% CI 1.09-1.96). CONCLUSION Variation in rs7136446 of the IGF1 gene associates with post-stroke outcome in relatively young IS patients. Also, rs7136446 associates with s-IGF1 in controls but not in IS, which indicates that IS perturbs a normal genetic impact on s-IGF1 levels.
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Affiliation(s)
- N David Aberg
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, The Sahlgrenska Academy, Sahlgrenska University Hospital
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Johansson P, Åberg D, Johansson JO, Mattsson N, Hansson O, Ahrén B, Isgaard J, Åberg ND, Blennow K, Zetterberg H, Wallin A, Svensson J. Serum but not cerebrospinal fluid levels of insulin-like growth factor-I (IGF-I) and IGF-binding protein-3 (IGFBP-3) are increased in Alzheimer's disease. Psychoneuroendocrinology 2013; 38:1729-37. [PMID: 23473966 DOI: 10.1016/j.psyneuen.2013.02.006] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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: 10/25/2012] [Revised: 02/05/2013] [Accepted: 02/05/2013] [Indexed: 01/21/2023]
Abstract
BACKGROUND Although insulin-like growth factor-I (IGF-I) is of importance for the adult function of the central nervous system (CNS), little is known of the significance of IGF-I in cerebrospinal fluid (CSF) in relation to Alzheimer's disease (AD). METHODS A cross-sectional study of 60 consecutive patients under primary evaluation of cognitive impairment and 20 healthy controls. The patients had AD dementia or mild cognitive impairment (MCI) diagnosed with AD dementia upon follow-up (n=32), stable MCI (SMCI, n=13), or other dementias (n=15). IGF-I, IGF-binding protein-3 (IGFBP-3), and insulin were measured in serum and CSF. RESULTS Serum IGF-I level was increased in AD patients and in patients with other dementias compared to healthy controls (P=0.01 and P<0.05, respectively). Serum IGFBP-3 concentration was increased in AD and SMCI patients compared to controls (P=0.001 and P<0.05, respectively). CSF levels of IGF-I and IGFBP-3 as well as serum and CSF levels of insulin were similar in all study groups. In the total study population (n=80), serum levels of IGF-I and IGFBP-3 correlated negatively with CSF β-amyloid₁₋₄₂ (Aβ₁₋₄₂) level (r=-0.29, P=0.01 and r=-0.27, P=0.02, respectively) and in the AD patients (n=32), the increased CSF/serum IGF-I ratio correlated positively with the CSF level of phosphorylated tau protein (P-tau; r=0.42, P=0.02). CONCLUSION Patients with AD as well as other dementias had high levels of IGF-I in serum but not in CSF. In AD patients, the IGF-I system was associated with biomarkers of AD disease status.
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Affiliation(s)
- Per Johansson
- Department of Neuropsychiatry, Skaraborg Hospital, SE-521 85 Falköping, Sweden; Department of Internal Medicine, Sahlgrenska Academy, University of Gothenburg, SE-413 45 Gothenburg, Sweden
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Abstract
Although ghrelin was initially associated with regulation of appetite, the cardiovascular system has also been recognized as a potentially important target for its effects. Moreover, experimental and a limited number of clinical studies suggest a potential role for ghrelin in the treatment of congestive heart failure. So far, reported cardiovascular effects of growth hormone secretagogues and/or ghrelin include lowering of peripheral resistance, either direct at the vascular level and/or by modulating sympathetic nervous activity. Other observed effects indicate possible improvement of contractility and cardioprotective and anti-inflammatory effects both in vivo and in vitro. Taken together, these results offer an interesting perspective on the future where further studies aiming at evaluating a role of growth hormone secretagogues and ghrelin in the treatment of cardiovascular disease are warranted.
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Affiliation(s)
- Jörgen Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, SE- 413 45 Gothenburg, Sweden.
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Walser M, Samà MT, Wickelgren R, Aberg M, Bohlooly-Y M, Olsson B, Törnell J, Isgaard J, Aberg ND. Local overexpression of GH and GH/IGF1 effects in the adult mouse hippocampus. J Endocrinol 2012; 215:257-68. [PMID: 22917932 DOI: 10.1530/joe-12-0077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
GH therapy improves hippocampal functions mainly via circulating IGF1. However, the roles of local GH and IGF1 expression are not well understood. We investigated whether transgenic (TG) overexpression in the adult brain of bovine GH (bGH) under the control of the glial fibrillary acidic protein (GFAP) promoter affected cellular proliferation and the expression of transcripts known to be induced by systemic GH in the hippocampus. Cellular proliferation was examined by 5-bromo-2'-deoxyuridine immunohistochemistry. Quantitative PCR and western blots were performed. Although robustly expressed, bGH-Tg did not increase either cell proliferation or survival. However, bGH-Tg modestly increased Igf1 and Gfap mRNAs, whereas other GH-associated transcripts were unaffected, i.e. the GH receptor (Ghr), IGF1 receptor (Igf1r), 2',3'-cyclic nucleotide 3'-phosphodiesterase (Cnp), ionotropic glutamate receptor 2a (Nr2a (Grin2a)), opioid receptor delta (Dor), synapse-associated protein 90/postsynaptic density-95-associated protein (Sapap2 (Dlgap2)), haemoglobin beta (Hbb) and glutamine synthetase (Gs (Glul)). However, IGF1R was correlated with the expression of Dor, Nr2a, Sapap2, Gs and Gfap. In summary, although local bGH expression was robust, it activated local IGF1 very modestly, which is probably the reason for the low response of previous GH-associated response parameters. This would, in turn, indicate that hippocampal GH is less important than endocrine GH. However, as most transcripts were correlated with the expression of IGF1R, there is still a possibility for endogenous circulating or local GH to act via IGF1R signalling. Possible reasons for the relative bio-inactivity of bGH include the bell-shaped dose-response curve and cell-specific expression of bGH.
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Affiliation(s)
- Marion Walser
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gröna Stråket Göteborg, Sweden
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Cittadini A, Napoli R, Monti MG, Rea D, Longobardi S, Netti PA, Walser M, Samà M, Aimaretti G, Isgaard J, Saccà L. Metformin prevents the development of chronic heart failure in the SHHF rat model. Diabetes 2012; 61:944-53. [PMID: 22344560 PMCID: PMC3314362 DOI: 10.2337/db11-1132] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Insulin resistance is a recently identified mechanism involved in the pathophysiology of chronic heart failure (CHF). We investigated the effects of two insulin-sensitizing drugs (metformin and rosiglitazone) in a genetic model of spontaneously hypertensive, insulin-resistant rats (SHHF). Thirty SHHF rats were randomized into three treatment groups as follows: 1) metformin (100 mg/kg per day), 2) rosiglitazone (2 mg/kg per day), and 3) no drug. Ten Sprague-Dawley rats served as normal controls. At the end of the treatment period (12 months), the cardiac phenotype was characterized by histology, echocardiography, and isolated perfused heart studies. Metformin attenuated left ventricular (LV) remodeling, as shown by reduced LV volumes, wall stress, perivascular fibrosis, and cardiac lipid accumulation. Metformin improved both systolic and diastolic indices as well as myocardial mechanical efficiency, as shown by improved ability to convert metabolic energy into mechanical work. Metformin induced a marked activation of AMP-activated protein kinase, endothelial nitric oxide synthase, and vascular endothelial growth factor and reduced tumor necrosis factor-α expression and myocyte apoptosis. Rosiglitazone did not affect LV remodeling, increased perivascular fibrosis, and promoted further cardiac lipid accumulation. In conclusion, long-term treatment with metformin, but not with rosiglitazone, prevents the development of severe CHF in the SHHF model by a wide-spectrum interaction that involves molecular, structural, functional, and metabolic-energetic mechanisms.
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Affiliation(s)
- Antonio Cittadini
- Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy
| | - Raffaele Napoli
- Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy
| | - Maria Gaia Monti
- Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy
| | - Domenica Rea
- Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy
| | | | - Paolo Antonio Netti
- Interdisciplinary Research Centre on Biomaterials, University Federico II, Naples, Italy
- Center for Advanced Biomaterial for Health Care, Interdisciplinary Research Centre on Biomaterials, Italian Institute of Technology, Naples, Italy
| | - Marion Walser
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Mariateresa Samà
- Department of Clinical and Experimental Medicine, University A. Avogadro, Novara, Italy
| | - Gianluca Aimaretti
- Department of Clinical and Experimental Medicine, University A. Avogadro, Novara, Italy
| | - Jörgen Isgaard
- Department of Internal Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Luigi Saccà
- Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University Federico II, Naples, Italy
- Corresponding author: Luigi Saccà,
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Åberg D, Jood K, Blomstrand C, Jern C, Nilsson M, Isgaard J, Aberg ND. Serum IGF-I levels correlate to improvement of functional outcome after ischemic stroke. J Clin Endocrinol Metab 2011; 96:E1055-64. [PMID: 21508132 DOI: 10.1210/jc.2010-2802] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT AND OBJECTIVE GH has positive cognitive effects when given to GH-IGF-I-deficient patients. GH and IGF-I exert both neuroprotective and regenerative effects on experimental stroke. We investigated whether the endogenous serum IGF-I (s-IGF-I) levels correlated with recovery of functional independence in patients who had suffered an ischemic stroke. SUBJECTS AND METHODS The s-IGF-I levels were measured in 407 patients (260 males, 147 females) with mean age of 55 (range, 18-69) yr and 40 randomly selected matched controls who were previously included in the Sahlgrenska Academy Study on Ischemic Stroke. Serum samples were collected on two occasions: acutely at 1-10 d (median, 4 d) after stroke and 3 months after the stroke. Recovery after ischemic stroke was evaluated using the modified Rankin scale 3 and 24 months after the stroke, and the Scandinavian Stroke Scale was used for assessments during the acute stage and 3 months after the stroke. RESULTS The s-IGF-I levels were higher in the acute stage than after 3 months and compared with the controls (P < 0.001 and P < 0.01, respectively), and the s-IGF-I levels were progressively lower in the elderly patients. The levels of s-IGF-I in the acute phase and after 3 months both positively correlated with improvement in the modified Rankin scale scores between 3 and 24 months (P = 0.001; r = 0.174, and P < 0.001; r = 0.24, respectively). CONCLUSION A high s-IGF-I during the rehabilitation phase of stroke correlates to better recovery of long-term function.
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Affiliation(s)
- Daniel Åberg
- Laboratory of Experimental Endocrinology, Sahlgrenska University Hospital, The SahlgrenskaAcademy at University of Gothenburg, SE-413 45 Göteborg, Sweden.
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Abstract
Although initially associated with regulation of appetite, the cardiovascular system has also been recognized as a potentially important target for ghrelin. Moreover, a limited number of clinical studies suggest a role for ghrelin in the treatment of congestive heart failure. So far reported cardiovascular effects of growth hormone secretagogues and/or ghrelin include lowering of peripheral resistance, either direct at the vascular level and/or by modulating sympathetic nervous activity. Other observed effects indicate possible improvement of contractility and cardioprotective effects both in vivo and in vitro.Taken together, these results offer an interesting perspective on the future where further studies aiming at evaluating a role of GHS and ghrelin in the treatment of cardiovascular disease are warranted.
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Affiliation(s)
- Jörgen Isgaard
- Department of Internal Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gröna Stråket 8, Gothenburg, Sweden.
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Granata R, Isgaard J, Alloatti G, Ghigo E. Cardiovascular actions of the ghrelin gene-derived peptides and growth hormone-releasing hormone. Exp Biol Med (Maywood) 2011; 236:505-514. [DOI: 10.1258/ebm.2011.010365] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
In 1976, small peptide growth hormone secretagogues (GHSs) were discovered and found to promote growth hormone (GH) release from the pituitary. The GHS receptor (GHS-R) was subsequently cloned, and its endogenous ligand ghrelin was later isolated from the stomach. Ghrelin is a 28-amino acid peptide, whose acylation is essential for binding to GHS-R type 1a and for the endocrine functions, including stimulation of GH secretion and subsequent food intake. Unacylated ghrelin, the other ghrelin form, although devoid of GHS-R binding is an active peptide, sharing many peripheral effects with acylated ghrelin (AG). The ghrelin system is broadly expressed in myocardial tissues, where it exerts different functions. Indeed, ghrelin inhibits cardiomyocyte and endothelial cell apoptosis, and improves left ventricular (LV) function during ischemia–reperfusion (I/R) injury. In rats with heart failure (HF), ghrelin improves LV dysfunction and attenuates the development of cardiac cachexia. Similarly, ghrelin exerts vasodilatory effects in humans, improves cardiac function and decreases systemic vascular resistance in patients with chronic HF. Obestatin is a recently identified ghrelin gene peptide. The physiological role of obestatin and its binding to the putative GPR39 receptor are still unclear, although protective effects have been demonstrated in the pancreas and heart. Similarly to AG, the hypothalamic peptide growth hormone-releasing hormone (GHRH) stimulates GH release from the pituitary, through binding to the GHRH-receptor. Besides its proliferative effects in different cell types, at the cardiovascular level GHRH inhibits cardiomyocyte apoptosis, and reduces infarct size in both isolated rat heart after I/R and in vivo after myocardial infarction. Therefore, both ghrelin and GHRH exert cardioprotective effects, which make them candidate targets for therapeutic intervention in cardiovascular dysfunctions.
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Affiliation(s)
- Riccarda Granata
- Laboratory of Molecular and Cellular Endocrinology, Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Corso Dogliotti, 14-10126 Turin, Italy
| | - Jörgen Isgaard
- Department of Internal Medicine, The Sahlgrenska Academy at the University of Gothenburg, 413 46 Gothenburg, Sweden
| | - Giuseppe Alloatti
- Department of Animal and Human Biology, University of Turin, 10123 Turin, Italy
| | - Ezio Ghigo
- Laboratory of Molecular and Cellular Endocrinology, Division of Endocrinology, Diabetology and Metabolism, Department of Internal Medicine, University of Turin, Corso Dogliotti, 14-10126 Turin, Italy
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Walser M, Hansén A, Svensson PA, Jernås M, Oscarsson J, Isgaard J, Åberg ND. Peripheral administration of bovine GH regulates the expression of cerebrocortical beta-globin, GABAB receptor 1, and the Lissencephaly-1 protein (LIS-1) in adult hypophysectomized rats. Growth Horm IGF Res 2011; 21:16-24. [PMID: 21212011 DOI: 10.1016/j.ghir.2010.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [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: 07/17/2010] [Revised: 11/17/2010] [Accepted: 11/27/2010] [Indexed: 11/20/2022]
Abstract
Growth hormone (GH) therapy substantially improves several cognitive functions in hypopituitary experimental animals and in humans. Although a number of biochemical correlates to these effects have been characterized, there are no comprehensive analysis available examining effects of GH on the brain. Hypophysectomized female rats were given replacement therapy with cortisol and thyroxine (=hx). Subcutaneous infusions of bovine GH (bGH, henceforth designated GH) were supplied in osmotic minipumps for 6 days (=hx+GH). To evaluate whether GH normalized specific transcript expression levels in cerebral cortex, pituitary-intact rats were used as normal controls. DNA microarrays (Affymetrix) of cerebrocortical samples showed that 24 transcripts were changed by more than 1.5-fold by GH treatment in addition to being normalized by GH treatment. The expression of three selected highly regulated transcripts was confirmed by quantitative real-time polymerase chain reaction analysis. These were the GABAB receptor 1, Lissencephaly-1 protein (LIS-1), and hemoglobin b or beta-globin. A similar regulation was found for hemoglobin b also in the hippocampus. Both the GABAB receptor 1 and hemoglobin b may have importance for the previously described neuroprotective and perhaps cognitive potential of GH treatment. Altogether, these results show that short term GH treatment affects a number of transcripts in cerebral cortex with various biological functions. These transcripts represent potential novel mechanisms by which GH can interact with the brain.
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Affiliation(s)
- Marion Walser
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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David Aberg N, Lind J, Isgaard J, Georg Kuhn H. Peripheral growth hormone induces cell proliferation in the intact adult rat brain. Growth Horm IGF Res 2010; 20:264-269. [PMID: 20106687 DOI: 10.1016/j.ghir.2009.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [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: 08/24/2009] [Revised: 11/23/2009] [Accepted: 12/16/2009] [Indexed: 01/17/2023]
Abstract
Growth hormone (GH) and insulin-like growth factor I (IGF-I) increase cell genesis in several regions of the brains of GH-IGF-I-deficient hypophysectomized rats. However, it is not known to what degree GH treatment stimulates adult cell genesis in pituitary-intact rodents. We investigated the effect of peripheral administration of bovine growth hormone (bGH) on cellular proliferation in various regions of the brains of normal adult female rats. To monitor cell division, bromodeoxyuridine (BrdU) was administered daily for 5 days. We studied the two areas of ongoing neurogenesis, the subventricular zone (SVZ) and the dentate gyrus (DG) of the hippocampus, as well as the corpus callosum, striatum, and the parietal and piriform cortices. After bGH treatment, the numbers of BrdU-positive cells increased 2.0- to 2.5-fold in all the brain regions, with the exception of the SVZ, in which there was no increase in the numbers of BrdU-positive cells. The present study shows for the first time that peripheral bGH administration increases the generation of new brain cells in normal adult female rats. Thus, bGH may stimulate cellular proliferation not only under GH-deficiency, but also under physiologic conditions. These findings have important implications for GH treatment strategies for patients who have normal or near-normal circulating levels of GH or IGF-I.
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Affiliation(s)
- N David Aberg
- Center of Brain Research and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
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Abstract
Substantial evidence supports a role for the growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis in regulation of normal cardiac growth, structure and function. Moreover, experimental data suggest beneficial effects of GH and IGF-1 on contractility and peripheral resistance in rats with impaired cardiac function. An increased Ca(++) responsiveness is one possible underlying cause for the improvement in contractility, although effects of GH and IGF-1 on apoptosis may also play a more long term role for cardiomyocyte survival. Until recently, studies regarding GH treatment in heart failure were limited to case reports where administration dramatically improved cardiac function. In a small non-blind study of 7 patients with idiopathic dilated cardiomyopathy and congestive heart failure (CHF) without GH deficiency who received treatment with recombinant GH (somatropin) for 3 months, considerable improvement of cardiac function was reported. More recent studies have demonstrated beneficial effects in patients with CHF due to both ischaemic and idiopathic dilated cardiomyopathy, with improvements in haemodynamics when somatropin was added both as a maintenance therapy and as a short term infusion. So far, 2 placebo-controlled studies with somatropin as adjunctive therapy in patients with CHF have been reported, although neither study could confirm previously reported improvement in systolic function and lowering of wall stress. In summary, it is clear that further placebo-controlled clinical trials are mandatory to verify positive effects and to monitor long term safety when somatropin is administered as an agent in the treatment of CHF.
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Affiliation(s)
- J Isgaard
- Research Center for Endocrinology and Metabolism, Göteborg, Sweden.
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Barlind A, Karlsson N, Åberg ND, Björk-Eriksson T, Blomgren K, Isgaard J. The growth hormone secretagogue hexarelin increases cell proliferation in neurogenic regions of the mouse hippocampus. Growth Horm IGF Res 2010; 20:49-54. [PMID: 19800825 DOI: 10.1016/j.ghir.2009.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 07/09/2009] [Revised: 08/27/2009] [Accepted: 09/04/2009] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Radiation therapy (RT) to the brain is often used in the treatment of children with different types of malignant diseases affecting the brain. However, RT in childhood may also have severe side effects including impaired brain maturation and intellectual development. For childhood cancer survivors these adverse effects of RT can cause lifelong disability and suffering. Therefore, there is an unmet need to limit late effects after RT. Precursor cells in the subgranular zone of the dentate gyrus (DG) in the hippocampus are particularly sensitive to irradiation (IR). This may be of significance as newly generated neurons in the DG are important for memory and learning. GH secretagogues (GHS) have previously been shown to promote neurogenesis and to have neuroprotective effects. In addition, several parts of the brain, including the hippocampus, have been shown to express the GHS receptor 1a (GHS-R1a). The aim of this study was to evaluate the potential effect of the GHS hexarelin on proliferation and survival of progenitor cells in the hippocampus after brain IR in a mouse model. DESIGN In the present study, 10-day-old male mice received 6Gy cranial IR. Non-irradiated sham animals were used as controls. We treated one group of irradiated and one sham group with hexarelin (100microg/kg/day) for 28days and used immunohistochemical labeling of bromo-deoxy uridine (BrdU) and phospho-histone H3 of the granular cell layer of the DG to evaluate proliferation and cell survival after IR at postnatal day ten. RESULTS Our results show that hexarelin significantly increased the number of BrdU-positive cells in the granule cell layer by approximately 50% compared to controls. CONCLUSION The increased number of BrdU-positive cells in the granule cell layer suggests a partial restoration in the pool of proliferating cells by hexarelin after IR.
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Affiliation(s)
- Anna Barlind
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
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Barlind A, Karlsson N, Björk-Eriksson T, Isgaard J, Blomgren K. Decreased cytogenesis in the granule cell layer of the hippocampus and impaired place learning after irradiation of the young mouse brain evaluated using the IntelliCage platform. Exp Brain Res 2009; 201:781-7. [DOI: 10.1007/s00221-009-2095-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Accepted: 11/10/2009] [Indexed: 01/27/2023]
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Abstract
IGF-I is expressed in virtually every tissue of the body, but with much higher expression in the liver than in any other tissue. Studies using mice with liver-specific IGF-I knockout have demonstrated that liver-derived IGF-I, constituting a major part of circulating IGF-I, is an important endocrine factor involved in a variety of physiological and pathological processes. Detailed studies comparing the impact of liver-derived IGF-I and local bone-derived IGF-I demonstrate that both sources of IGF-I can stimulate longitudinal bone growth. We propose here that liver-derived circulating IGF-I and local bone-derived IGF-I to some extent have overlapping growth-promoting effects and might have the capacity to replace each other (= redundancy) in the maintenance of normal longitudinal bone growth. Importantly, and in contrast to the regulation of longitudinal bone growth, locally derived IGF-I cannot replace (= lack of redundancy) liver-derived IGF-I for the regulation of a large number of other parameters including GH secretion, cortical bone mass, kidney size, prostate size, peripheral vascular resistance, spatial memory, sodium retention, insulin sensitivity, liver size, sexually dimorphic liver functions, and progression of some tumors. It is clear that a major role of liver-derived IGF-I is to regulate GH secretion and that some, but not all, of the phenotypes in the liver-specific IGF-I knockout mice are indirect, mediated via the elevated GH levels. All of the described multiple endocrine effects of liver-derived IGF-I should be considered in the development of possible novel treatment strategies aimed at increasing or reducing endocrine IGF-I activity.
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Affiliation(s)
- Claes Ohlsson
- Division of Endocrinology, Institute of Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
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Aberg ND, Johansson I, Aberg MAI, Lind J, Johansson UE, Cooper-Kuhn CM, Kuhn HG, Isgaard J. Peripheral administration of GH induces cell proliferation in the brain of adult hypophysectomized rats. J Endocrinol 2009; 201:141-50. [PMID: 19171566 DOI: 10.1677/joe-08-0495] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
IGF-I treatment has been shown to enhance cell genesis in the brains of adult GH- and IGF-I-deficient rodents; however, the influence of GH therapy remains poorly understood. The present study investigated the effects of peripheral recombinant bovine GH (bGH) on cellular proliferation and survival in the neurogenic regions (subventricular zone (SVZ), and dentate gyrus of the hippocampus), as well as the corpus callosum, striatum, parietal cortex, and piriform cortex. Hypopituitarism was induced in female rats by hypophysectomy, and the rats were supplemented with thyroxine and cortisone acetate. Subsequently, the rats received daily s.c. injections of bGH for either 6 or 28 days respectively. Following 5 days of peripheral bGH administration, the number of bromodeoxyuridine (BrdU)-positive cells was increased in the hippocampus, striatum, parietal cortex, and piriform cortex after 6 and 28 days. In the SVZ, however, BrdU-positive cells increased only after 28 days of bGH treatment. No significant change was observed in the corpus callosum. In the hippocampus, after 28 days of bGH treatment, the number of BrdU/NeuN-positive cells was increased proportionally to increase the number of BrdU-positive cells. (3)H-thymidine incorporation in vitro revealed that 24 h of bGH exposure was sufficient to increase cell proliferation in adult hippocampal progenitor cells. This study shows for the first time that 1) peripheral bGH treatment increased the number of newborn cells in the adult brain and 2) bGH exerted a direct proliferative effect on neuronal progenitor cells in vitro.
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Affiliation(s)
- N David Aberg
- Center of Brain Research and Rehabilitation, Institute of Physiology and Neuroscience, University of Gothenburg, Gothenburg, Sweden
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Abstract
Apart from promoting GH secretion and to regulate appetite and metabolism, it has become increasingly clear that GH secretagogues (GHS) and ghrelin exert a number of effects on the cardiovascular system. The main cardiovascular actions of GHS are possible inotropic effects, vasodilation, reported cardioprotective effects against ischemia, and in vitro effects on cardiomyocytes involving cell proliferation and anti-apoptotic actions. An interesting and intriguing feature of the cardiovascular effects of GHS is that they may be exerted directly on the heart and vasculature rather than being mediated by growth hormone. Evidence to suggest this is the finding of GHS binding sites on cardiomyocytes and the fact that some of the effects of GHS can be expressed also in the absence of GH. Taken together, these results offer an interesting perspective on the future where further studies aiming at evaluating a role of GHS and ghrelin in the treatment of cardiovascular disease are warranted.
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Affiliation(s)
- Jörgen Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, Sahlgrenska Academy, Göteborg, Sweden.
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Johansson I, Destefanis S, Aberg ND, Aberg MAI, Blomgren K, Zhu C, Ghè C, Granata R, Ghigo E, Muccioli G, Eriksson PS, Isgaard J. Proliferative and protective effects of growth hormone secretagogues on adult rat hippocampal progenitor cells. Endocrinology 2008; 149:2191-9. [PMID: 18218693 DOI: 10.1210/en.2007-0733] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Progenitor cells in the subgranular zone of the hippocampus may be of significance for functional recovery after various injuries because they have a regenerative potential to form new neuronal cells. The hippocampus has been shown to express the GH secretagogue (GHS) receptor 1a, and recent studies suggest GHS to both promote neurogenesis and have neuroprotective effects. The aim of the present study was to investigate whether GHS could stimulate cellular proliferation and exert cell protective effects in adult rat hippocampal progenitor (AHP) cells. Both hexarelin and ghrelin stimulated increased incorporation of (3)H-thymidine, indicating an increased cell proliferation. Furthermore, hexarelin, but not ghrelin, showed protection against growth factor deprivation-induced apoptosis, as measured by annexin V binding and caspase-3 activity and also against necrosis, as measured by lactate dehydrogenase release. Hexarelin activated the MAPK and the phosphatidylinositol 3-kinase/Akt pathways, whereas ghrelin activated only the MAPK pathway. AHP cells did not express the GHS receptor 1a, but binding studies could show specific binding of both hexarelin and ghrelin, suggesting effects to be mediated by an alternative GHS receptor subtype. In conclusion, our results suggest a differential effect of hexarelin and ghrelin in AHP cells. We have demonstrated stimulation of (3)H-thymidine incorporation with both hexarelin and ghrelin. Hexarelin, but not ghrelin, also showed a significant inhibition of apoptosis and necrosis. These results suggest a novel cell protective and proliferative role for GHS in the central nervous system.
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Affiliation(s)
- Inger Johansson
- Laboratory of Experimental Endocrinology, Sahlgrenska Academy, University of Göteborg, SE-413 45 Göteborg, Sweden.
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Nygren A, Sunnegårdh J, Albertsson-Wikland K, Berggren H, Isgaard J. Relative cardiac expression of growth hormone receptor and insulin-like growth factor-I mRNA in congenital heart disease. J Endocrinol Invest 2008; 31:196-200. [PMID: 18401200 DOI: 10.1007/bf03345590] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
GH may exert direct growth-promoting and metabolic actions on target tissues, but most of its effects are mediated by circulating (endocrine) or local (auto-/paracrine) IGF-I. The GH/IGF-I system has an important role in cardiac development and in maintaining the structure and function of the heart. A subgroup of children with pronounced heart defects will eventually need transplants, owing to congestive heart failure. Since the symptoms are often severe and may progress while waiting for surgery, it is necessary to develop supportive medical treatment. GH has been proposed as a therapeutic agent in adults with heart failure, but to date studies are lacking on children and more information is necessary. We have examined the expression of IGF-I mRNA and GH-receptor (GH-R) mRNA in children undergoing surgery for congenital heart disease. Eighteen children scheduled for open-heart surgery were included in the study. Right auricular biopsies were taken at the time of venous catheterization preceding cardiac bypass. The specimens were analysed using realtime PCR. We were able to show expression of both IGF-I mRNA and GH-R mRNA in the pediatric heart. The relative expressions were intercorrelated (r=0.75, p<0.001). GH-R mRNA correlated positively to standardized weight (r=0.65, p=0.004), body mass index (BMI) (r=0.59, p=0.01), and standardized BMI (r=0.59, p=0.01). IGF-I mRNA only correlated to BMI (r=0.50, p=0.04). This is the first study displaying cardiac expression of IGF-I mRNA and GH-R mRNA in children with congenital heart disease, although further studies are needed to define a role for GH in the treatment of these patients.
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Affiliation(s)
- A Nygren
- Department of Pediatrics, Institute for Health of Women and Children at Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
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Affiliation(s)
- O G Isaksson
- Department of Physiology, University of Gothenburg, Sweden
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Aberg ND, Johansson UE, Aberg MAI, Hellström NAK, Lind J, Bull C, Isgaard J, Anderson MF, Oscarsson J, Eriksson PS. Peripheral infusion of insulin-like growth factor-I increases the number of newborn oligodendrocytes in the cerebral cortex of adult hypophysectomized rats. Endocrinology 2007; 148:3765-72. [PMID: 17510237 DOI: 10.1210/en.2006-1556] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have previously shown that recombinant human (rh) IGF-I induces cell proliferation and neurogenesis in the hippocampus of hypophysectomized rats. In the current investigation, we determined the effects of rhIGF-I on proliferation and differentiation in the cerebral cortex. Adult hypophysectomized rats were injected with bromodeoxyuridine (BrdU) to label newborn cells (once a day for the first 5 d), and rhIGF-I was administered peripherally for 6 or 20 d. In the cerebral cortex, the number of BrdU-labeled cells increased after 20 d but not after 6 d of rhIGF-I infusion. This suggests that rhIGF-I enhances the survival of newborn cells in the cerebral cortex. Using BrdU labeling combined with the oligodendrocyte-specific markers myelin basic protein and 2',3'-cyclic nucleotide 3'-phosphodiesterase, we demonstrated an increase in oligodendrogenesis in the cerebral cortex. The total amount of myelin basic protein and 2',3'-cyclic nucleotide 3'-phosphodiesterase was also increased on Western blots of homogenates of the cerebral cortex, confirming the immunohistochemical findings. Also, we observed an increase in the number of capillary-associated BrdU-positive cells, although total capillary area was not increased. rhIGF-I treatment did not affect cortical astrogliogenesis and neurogenesis was not observed. The ability of rhIGF-I to induce cortical oligodendrogenesis may have implications for the regenerative potential of the cortex.
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Affiliation(s)
- N David Aberg
- Department of Internal Medicine, Research Center of Endocrinology and Metabolism, Sahlgrenska University Hospital, Göteborg University, Gröna Stråket 8, SE-413 45 Göteborg, Sweden.
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Svensson J, Tivesten A, Sjögren K, Isaksson O, Bergström G, Mohan S, Mölne J, Isgaard J, Ohlsson C. Liver-derived IGF-I regulates kidney size, sodium reabsorption, and renal IGF-II expression. J Endocrinol 2007; 193:359-66. [PMID: 17535874 DOI: 10.1677/joe-07-0024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The GH/-IGF-I axis is important for kidney size and function and may also be involved in the development of renal failure. In this study, the role of liver-derived endocrine IGF-I for kidney size and function was investigated in mice with adult liver-specific IGF-I inactivation (LI-IGF-I(-/-) mice). These mice have an 80-85% reduction of serum IGF-I level and compensatory increased GH secretion. Seven-month-old as well as 24-month-old LI-IGF-I(-/-) mice had decreased kidney weight. Glomerular filtration rate, assessed using creatinine clearance as well as creatinine clearance corrected for body weight, was unchanged. The 24-h urine excretion of sodium and potassium was increased in the LI-IGF-I(-/-) mice. In the 24-month-old mice, there was no between-group difference in kidney morphology. Microarray and real-time PCR (RT-PCR) analyses showed a high renal expression of IGF-II in the control mice, whereas in the LI-IGF-I(-/-) mice, there was a tissue-specific decrease in the renal IGF-II mRNA levels (-79%, P < 0.001 vs controls using RT-PCR). In conclusion, deficiency of circulating liver-derived IGF-I in mice results, despite an increase in GH secretion, in a global symmetrical decrease in kidney size, increased urinary sodium and potassium excretion, and a clear down regulation of renal IGF-II expression. However, the LI-IGF-I(-/-) mice did not develop kidney failure or nephrosclerosis. One may speculate that liver-derived endocrine IGF-I induces renal IGF-II expression, resulting in symmetrical renal growth.
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Affiliation(s)
- Johan Svensson
- Department of Internal Medicine, Sahlgrenska University Hospital, Gröna Stråket 8, SE-413 45 Göteborg, Sweden
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Isgaard J, Aberg D, Nilsson M. Protective and regenerative effects of the GH/IGF-I axis on the brain. MINERVA ENDOCRINOL 2007; 32:103-13. [PMID: 17557036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Apart from regulating somatic growth and metabolism, evidence suggest that the GH/ IGF-I axis is involved in the regulation of brain growth, development and myelination. Moreover, growth hormone (GH) and particularly IGF-I have been attributed neuroprotective effects in different in vitro and in vivo experimental models. In addition, both GH and IGF-I affect cognition and biochemistry in the adult brain. Some of the effects of GH are suggested to be mediated by circulating IGF-I, while other effects may be due to locally produced IGF-I within the brain. It is also possible that GH may act directly on the central nervous system (CNS) without involving IGF-I (either circulating or locally). Plasticity in the CNS may be viewed as changes in the functional interplay between the major cell types neurons, astrocytes and oligodendrocytes. GH and IGF-I affect all these cell types in several aspects. Apart from neuroprotective effects of GH and IGF-I in different experimental models of CNS injury, IGF-I has been found to increase progenitor cell proliferation and new neurons, oligodendrocytes, and blood vessels in the dentate gyrus of the hippocampus. In the adult cerebral cortex, it appears that only oligodendrogenesis is affected. The increase of IGF-I on endothelial cell phenotype may explain the increase in cerebral arteriole density observed after GH treatment. In the present review, different aspects of the GH/IGF-I axis effects on the brain will be discussed with particular emphasis on neuroprotection, regeneration and brain plasticity. Moreover, recent findings describing neuroprotective effects and effects on synaptic plasticity by GH secretagogues will be reviewed.
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Affiliation(s)
- J Isgaard
- Laboratory of Experimental Endocrinology, Department of Internal Medicine, University of Göteborg, Göteborg, Sweden.
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