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Böhm V, Lietz G, Olmedilla-Alonso B, Phelan D, Reboul E, Bánati D, Borel P, Corte-Real J, de Lera AR, Desmarchelier C, Dulinska-Litewka J, Landrier JF, Milisav I, Nolan J, Porrini M, Riso P, Roob JM, Valanou E, Wawrzyniak A, Winklhofer-Roob BM, Rühl R, Bohn T. From carotenoid intake to carotenoid blood and tissue concentrations - implications for dietary intake recommendations. Nutr Rev 2021; 79:544-573. [PMID: 32766681 PMCID: PMC8025354 DOI: 10.1093/nutrit/nuaa008] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [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] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
There is uncertainty regarding carotenoid intake recommendations, because positive and negative health effects have been found or are correlated with carotenoid intake and tissue levels (including blood, adipose tissue, and the macula), depending on the type of study (epidemiological vs intervention), the dose (physiological vs supraphysiological) and the matrix (foods vs supplements, isolated or used in combination). All these factors, combined with interindividual response variations (eg, depending on age, sex, disease state, genetic makeup), make the relationship between carotenoid intake and their blood/tissue concentrations often unclear and highly variable. Although blood total carotenoid concentrations <1000 nmol/L have been related to increased chronic disease risk, no dietary reference intakes (DRIs) exist. Although high total plasma/serum carotenoid concentrations of up to 7500 nmol/L are achievable after supplementation, a plateauing effect for higher doses and prolonged intake is apparent. In this review and position paper, the current knowledge on carotenoids in serum/plasma and tissues and their relationship to dietary intake and health status is summarized with the aim of proposing suggestions for a "normal," safe, and desirable range of concentrations that presumably are beneficial for health. Existing recommendations are likewise evaluated and practical dietary suggestions are included.
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Affiliation(s)
- Volker Böhm
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
| | - Georg Lietz
- Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Begoña Olmedilla-Alonso
- Institute of Food Science, Technology and Nutrition, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - David Phelan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | | | | | - Patrick Borel
- C2VN, INRAE, INSERM, Aix Marseille Univ, Marseille, France
| | - Joana Corte-Real
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Angel R de Lera
- Departmento de Química Orgánica, Centro De Investigaciones Biomédicas and Instituto de Investigación Biomédica de Vigo, Universidade de Vigo, Vigo, Spain
| | | | | | | | - Irina Milisav
- University of Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Health Sciences, Ljubljana, Slovenia and with University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - John Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, Waterford, Ireland
| | - Marisa Porrini
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Patrizia Riso
- Universitàdegli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milan, Italy
| | - Johannes M Roob
- Research Unit Chronic Inflammation in Nephrology, Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | | | - Agata Wawrzyniak
- Institute of Human Nutrition Sciences, Warsaw University of Life Sciences, Warsaw, Poland
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
| | - Ralph Rühl
- Paprika Bioanalytics BT, Debrecen, Hungary and with CISCAREX UG, Berlin, Germany
| | - Torsten Bohn
- Population Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
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Faustmann G, Tiran B, Trajanoski S, Obermayer-Pietsch B, Gruber HJ, Ribalta J, Roob JM, Winklhofer-Roob BM. Activation of nuclear factor-kappa B subunits c-Rel, p65 and p50 by plasma lipids and fatty acids across the menstrual cycle. Free Radic Biol Med 2020; 160:488-500. [PMID: 32846215 DOI: 10.1016/j.freeradbiomed.2020.08.012] [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: 04/11/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Abstract
This study focused on a comprehensive analysis of the canonical activation pathway of the redox-sensitive transcription factor nuclear factor-kappa B (NF-κB) in peripheral blood mononuclear cells, addressing c-Rel, p65 and p50 activation in 28 women at early (T1) and late follicular (T2) and mid (T3) and late luteal (T4) phase of the menstrual cycle, and possible relations with fasting plasma lipids and fatty acids. For the first time, strong inverse relations of c-Rel with apolipoprotein B were observed across the cycle, while those with LDL cholesterol, triglycerides as well as saturated (SFA), particularly C14-C22 SFA, monounsaturated (MUFA), and polyunsaturated fatty acids (PUFA) clustered at T2. In contrast, p65 was positively related to LDL cholesterol and total n-6 PUFA, while p50 did not show any relations. C-Rel was not directly associated with estradiol and progesterone, but data suggested an indirect C22:5n-3-mediated effect of progesterone. Strong positive relations between estradiol and individual SFA, MUFA and n-3 PUFA at T1 were confined to C18 fatty acids; C18:3n-3 was differentially associated with estradiol (positively) and progesterone (inversely). Given specific roles of c-Rel activation in immune tolerance, inhibition of c-Rel activation by higher plasma apolipoprotein B and individual fatty acid concentrations could have clinical implications for female fertility.
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Affiliation(s)
- Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, University of Graz, Graz, Austria; Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Beate Tiran
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Slave Trajanoski
- Core Facility Computational Bioanalytics, Center for Medical Research, Medical University of Graz, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Hans-Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Josep Ribalta
- Unitat de Recerca en Lípids i Arteriosclerosi, Departament de Medicina i Cirurgia, Universitat Rovira i Virgili and Institut d'Investigació Sanitària Pere Virgili, Reus, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Spain
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, University of Graz, Graz, Austria.
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Szostaczuk N, van Schothorst EM, Sánchez J, Priego T, Palou M, Bekkenkamp-Grovenstein M, Faustmann G, Obermayer-Pietsch B, Tiran B, Roob JM, Winklhofer-Roob BM, Keijer J, Palou A, Picó C. Identification of blood cell transcriptome-based biomarkers in adulthood predictive of increased risk to develop metabolic disorders using early life intervention rat models. FASEB J 2020; 34:9003-9017. [PMID: 32474969 DOI: 10.1096/fj.202000071rr] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/03/2020] [Accepted: 04/06/2020] [Indexed: 12/20/2022]
Abstract
Calorie restriction during gestation in rats has long-lasting adverse effects in the offspring. It induces metabolic syndrome-related alterations, which are partially reversed by leptin supplementation during lactation. We employed these conditions to identify transcript-based nutrient sensitive biomarkers in peripheral blood mononuclear cells (PBMCs) predictive of later adverse metabolic health. The best candidate was validated in humans. Transcriptome analysis of PBMCs from adult male Wistar rats of three experimental groups was performed: offspring of control dams (CON), and offspring of 20% calorie-restricted dams during gestation without (CR) and with leptin supplementation throughout lactation (CR-LEP). The expression of 401 genes was affected by gestational calorie restriction and reversed by leptin. The changes preceded metabolic syndrome-related phenotypic alterations. Of these genes, Npc1 mRNA levels were lower in CR vs CON, and normalized to CON in CR-LEP. In humans, NPC1 mRNA levels in peripheral blood cells (PBCs) were decreased in subjects with mildly impaired metabolic health compared to healthy subjects. Therefore, a set of potential transcript-based biomarkers indicative of a predisposition to metabolic syndrome-related alterations were identified, including NPC1, which was validated in humans. Low NPC1 transcript levels in PBCs are a candidate biomarker of increased risk for impaired metabolic health in humans.
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Affiliation(s)
- Nara Szostaczuk
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Juana Sánchez
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Teresa Priego
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain
| | - Mariona Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
| | | | - Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Graz, Austria.,Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Beate Tiran
- Clinical Institute of Medical and Clinical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Graz, Austria
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
| | - Catalina Picó
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Group of Nutrigenomics and Obesity), CIBER de Fisiopatología de la Obesidad y Nutrición (CIBERobn), University of the Balearic Islands, Palma de Mallorca, Spain.,Instituto de Investigación Sanitaria Illes Balears (IdISBa), Palma de Mallorca, Spain
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Faustmann G, Meinitzer A, Magnes C, Tiran B, Obermayer-Pietsch B, Gruber HJ, Ribalta J, Rock E, Roob JM, Winklhofer-Roob BM. Progesterone-associated arginine decline at luteal phase of menstrual cycle and associations with related amino acids and nuclear factor kB activation. PLoS One 2018; 13:e0200489. [PMID: 29990354 PMCID: PMC6039037 DOI: 10.1371/journal.pone.0200489] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 06/27/2018] [Indexed: 11/18/2022] Open
Abstract
Background/Objectives Given their role in female reproduction, the effects of progesterone on arginine and related amino acids, polyamines and NF-κB p65 activation were studied across the menstrual cycle. Methods Arginine, ornithine and citrulline as well as putrescine, spermidine, spermine, and N-acetyl-putrescine were determined in plasma, NF-κB p65 activation in peripheral blood mononuclear cells and progesterone in serum of 28 women at early (T1) and late follicular (T2) and mid (T3) and late (T4) luteal phase. Results Arginine and related amino acids declined from T1 and T2 to T3 and T4, while progesterone increased. At T3, arginine, ornithine, and citrulline were inversely related with progesterone. Changes (ΔT3-T2) in arginine, ornithine, and citrulline were inversely related with changes (ΔT3-T2) in progesterone. Ornithine and citrulline were positively related with arginine, as were changes (ΔT3-T2) in ornithine and citrulline with changes (ΔT3-T2) in arginine. At T2, NF-κB p65 activation was positively related with arginine. Polyamines did not change and were not related to progesterone. All results described were significant at P < 0.001. Conclusions This study for the first time provides data, at the plasma and PBMC level, supporting a proposed regulatory node of arginine and related amino acids, progesterone and NF-κB p65 at luteal phase of the menstrual cycle, aimed at successful preparation of pregnancy.
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Affiliation(s)
- Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Christoph Magnes
- Institute for Biomedicine and Health Sciences, HEALTH, Joanneum Research Forschungsgesellschaft m.b.H., Graz, Austria
| | - Beate Tiran
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | | | - Hans-Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Josep Ribalta
- Unitat de Recerca de Lipids I Arteriosclerosi, Facultat de Medicina, Universitat Rovira I Virgili, Facultat Medicina i Ciències de la Salut, Reus, Spain
| | - Edmond Rock
- Unité de Nutrition Humaine, Centre Auvergne Rhône-Alpes, Institut National de la Recherche Agronomique, Saint-Gènes-Champanelle, France
| | - Johannes M. Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University, Graz, Austria
| | - Brigitte M. Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
- * E-mail:
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Winklhofer-Roob BM, Faustmann G, Roob JM. Low-density lipoprotein oxidation biomarkers in human health and disease and effects of bioactive compounds. Free Radic Biol Med 2017; 111:38-86. [PMID: 28456641 DOI: 10.1016/j.freeradbiomed.2017.04.345] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 02/07/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 12/14/2022]
Abstract
Based on the significance of oxidized low-density lipoprotein (LDL) in health and disease, this review focuses on human studies addressing oxidation of LDL, including three lines of biomarkers, (i) ex vivo LDL resistance to oxidation, a "challenge test" model, (ii) circulating oxidized LDL, indicating the "current in vivo status", and (iii) autoantibodies against oxidized LDL as fingerprints of an immune response to oxidized LDL, along with circulating oxysterols and 4-hydroxynonenal as biomarkers of lipid peroxidation. Lipid peroxidation and oxidized LDL are hallmarks in the development of various metabolic, cardiovascular and other diseases. Changes further occur across life stages from infancy to older age as well as in athletes and smokers. Given their responsiveness to targeted nutritional interventions, markers of LDL oxidation have been employed in a rapidly growing number of human studies for more than 2 decades. There is growing interest in foods, which, besides providing energy and nutrients, exert beneficial effects on human health, such as protection of DNA, proteins and lipids from oxidative damage. Any health claim, however, needs to be substantiated by supportive evidence derived from human studies, using reliable biomarkers to demonstrate such beneficial effects. A large body of evidence has accumulated, demonstrating protection of LDL from oxidation by bioactive food compounds, including vitamins, other micronutrients and secondary plant ingredients, which will facilitate the selection of oxidation biomarkers for future human intervention studies and health claim support.
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Affiliation(s)
- Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria.
| | - Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Austria; Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Austria
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Faustmann G, Tiran B, Maimari T, Kieslinger P, Obermayer-Pietsch B, Gruber HJ, Roob JM, Winklhofer-Roob BM. Circulating leptin and NF-κB activation in peripheral blood mononuclear cells across the menstrual cycle. Biofactors 2016; 42:376-87. [PMID: 27093900 DOI: 10.1002/biof.1281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/01/2016] [Accepted: 03/06/2016] [Indexed: 12/13/2022]
Abstract
Using the menstrual cycle as a model, this study focused on longitudinal changes and associations within a physiological network known to play a role in female fertility, including, as biologically active nodes, NF-κB, leptin and adiponectin, β-carotene, adipose tissue, and progesterone. In 28 women, leptin, adiponectin, β-carotene, and progesterone concentrations, NF-κB p65 and p50 activation in peripheral blood mononuclear cells (known to possess estrogen, progesterone and leptin receptors), total body fat (TBF) and subcutaneous adipose tissue (SAT) mass were determined at early (T1) and late follicular (T2) and mid (T3) and late (T4) luteal phase. Leptin and adiponectin concentrations were higher, while NF-κB p65 activation was lower at T3 compared with T1. NF-κB p65 activation was inversely related to leptin concentrations at T1, T3, and T4. β-Carotene was inversely related to leptin (T1,T2,T4) and SAT (T1,T3,T4). NF-κB p50 activation was inversely related to TBF (T4) and SAT (T3,T4), and leptin was positively related to TBF and SAT (T1-T4). Progesterone was inversely related to leptin (T2,T3), adiponectin (T3), TBF (T3,T4), and SAT (T2,T3,T4). By providing evidence of luteal phase-specific reduced NF-κB p65 activation in women under physiological conditions, this study bridges the gap between existing evidence of a Th1-Th2 immune response shift induced by reduced NF-κB p65 activation and a Th1-Th2 shift previously observed at luteal phase. For the first time, inverse regressions suggest inhibitory effects of leptin on NF-κB p65 activation at luteal phase, along with inhibitory effects of leptin as well as adiponectin on progesterone production in corpus luteum. © 2016 The Authors BioFactors published by Wiley Periodicals, Inc. on behalf of International Union of Biochemistry and Molecular Biology. 24(4):376-387, 2016.
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Affiliation(s)
- Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Universitätsplatz 2, 8010 Graz, Austria
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 27, 8036 Graz, Austria
| | - Beate Tiran
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Theopisti Maimari
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 27, 8036 Graz, Austria
| | - Petra Kieslinger
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Hans-Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 27, 8036 Graz, Austria
| | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Universitätsplatz 2, 8010 Graz, Austria
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Waris S, Winklhofer-Roob BM, Roob JM, Fuchs S, Sourij H, Rabbani N, Thornalley PJ. Increased DNA dicarbonyl glycation and oxidation markers in patients with type 2 diabetes and link to diabetic nephropathy. J Diabetes Res 2015; 2015:915486. [PMID: 25950009 PMCID: PMC4408631 DOI: 10.1155/2015/915486] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Revised: 03/14/2015] [Accepted: 03/23/2015] [Indexed: 02/07/2023] Open
Abstract
AIM The aim of this study was to assess the changes of markers of DNA damage by glycation and oxidation in patients with type 2 diabetes and the association with diabetic nephropathy. METHODOLOGY DNA oxidation and glycation adducts were analysed in plasma and urine by stable isotopic dilution analysis liquid chromatography-tandem mass spectrometry. DNA markers analysed were as follows: the oxidation adduct 7,8-dihydro-8-oxo-2'-deoxyguanosine (8-OxodG) and glycation adducts of glyoxal and methylglyoxal--imidazopurinones GdG, MGdG, and N2-(1,R/S-carboxyethyl)deoxyguanosine (CEdG). RESULTS Plasma 8-OxodG and GdG were increased 2-fold and 6-fold, respectively, in patients with type 2 diabetes, with respect to healthy volunteers. Median urinary excretion rates of 8-OxodG, GdG, MGdG, and CEdG were increased 28-fold, 10-fold, 2-fold, and 2-fold, respectively, in patients with type 2 diabetes with respect to healthy controls. In patients with type 2 diabetes, nephropathy was associated with increased plasma 8-OxodG and increased urinary GdG and CEdG. In a multiple logistic regression model for diabetic nephropathy, diabetic nephropathy was linked to systolic blood pressure and urinary CEdG. CONCLUSION DNA oxidative and glycation damage-derived nucleoside adducts are increased in plasma and urine of patients with type 2 diabetes and further increased in patients with diabetic nephropathy.
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Affiliation(s)
- Sahar Waris
- Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry CV2 2DX, UK
| | - Brigitte M. Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center Graz, Institute of Molecular Biosciences, Karl Franzens University, 8010 Graz, Austria
| | - Johannes M. Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Sebastian Fuchs
- Human Nutrition & Metabolism Research and Training Center Graz, Institute of Molecular Biosciences, Karl Franzens University, 8010 Graz, Austria
| | - Harald Sourij
- Clinical Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Naila Rabbani
- Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry CV2 2DX, UK
- Warwick Systems Biology Centre, Senate House, University of Warwick, Coventry CV4 7AL, UK
- *Naila Rabbani:
| | - Paul J. Thornalley
- Warwick Medical School, Clinical Sciences Research Laboratories, University of Warwick, University Hospital, Coventry CV2 2DX, UK
- Warwick Systems Biology Centre, Senate House, University of Warwick, Coventry CV4 7AL, UK
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Siwy J, Schanstra JP, Argiles A, Bakker SJL, Beige J, Boucek P, Brand K, Delles C, Duranton F, Fernandez-Fernandez B, Jankowski ML, Al Khatib M, Kunt T, Lajer M, Lichtinghagen R, Lindhardt M, Maahs DM, Mischak H, Mullen W, Navis G, Noutsou M, Ortiz A, Persson F, Petrie JR, Roob JM, Rossing P, Ruggenenti P, Rychlik I, Serra AL, Snell-Bergeon J, Spasovski G, Stojceva-Taneva O, Trillini M, von der Leyen H, Winklhofer-Roob BM, Zürbig P, Jankowski J. Multicentre prospective validation of a urinary peptidome-based classifier for the diagnosis of type 2 diabetic nephropathy. Nephrol Dial Transplant 2014; 29:1563-70. [PMID: 24589724 DOI: 10.1093/ndt/gfu039] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetic nephropathy (DN) is one of the major late complications of diabetes. Treatment aimed at slowing down the progression of DN is available but methods for early and definitive detection of DN progression are currently lacking. The 'Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria trial' (PRIORITY) aims to evaluate the early detection of DN in patients with type 2 diabetes (T2D) using a urinary proteome-based classifier (CKD273). METHODS In this ancillary study of the recently initiated PRIORITY trial we aimed to validate for the first time the CKD273 classifier in a multicentre (9 different institutions providing samples from 165 T2D patients) prospective setting. In addition we also investigated the influence of sample containers, age and gender on the CKD273 classifier. RESULTS We observed a high consistency of the CKD273 classification scores across the different centres with areas under the curves ranging from 0.95 to 1.00. The classifier was independent of age (range tested 16-89 years) and gender. Furthermore, the use of different urine storage containers did not affect the classification scores. Analysis of the distribution of the individual peptides of the classifier over the nine different centres showed that fragments of blood-derived and extracellular matrix proteins were the most consistently found. CONCLUSION We provide for the first time validation of this urinary proteome-based classifier in a multicentre prospective setting and show the suitability of the CKD273 classifier to be used in the PRIORITY trial.
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Affiliation(s)
- Justyna Siwy
- Mosaiques Diagnostics GmbH, Hanover, Germany Charité-Universitaetsmedizin Berlin, Medizinische Klinik IV, Berlin, Germany
| | - Joost P Schanstra
- Mosaiques Diagnostics GmbH, Hanover, Germany Institut National de la Santé et de la Recherche Médicale (INSERM), U1048, Institut of Cardiovascular and Metabolic Disease, Toulouse, France Université Toulouse III Paul-Sabatier, Toulouse, France
| | - Angel Argiles
- RD Néphrologie, Montpellier, France Néphrologie Dialyse St Guilhem, Sète, France Service de Néphrologie, Dialyse Péritonéale et Transplantation, Montpellier, France
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Joachim Beige
- Department of Nephrology and KfH Renal Unit, Hospital St. Georg, Leipzig, Germany
| | - Petr Boucek
- Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Korbinian Brand
- Institut für Klinische Chemie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Christian Delles
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | - Thomas Kunt
- HealthPlus Diabetes & Endocrinology Center, Abu Dhabi, UAE
| | | | - Ralf Lichtinghagen
- Institut für Klinische Chemie, Medizinische Hochschule Hannover, Hannover, Germany
| | | | - David M Maahs
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - Harald Mischak
- Mosaiques Diagnostics GmbH, Hanover, Germany BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - William Mullen
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Gerjan Navis
- Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands Department of Clinical Pharmacology, University Medical Center Groningen, Groningen and University of Groningen, The Netherlands
| | - Marina Noutsou
- Diabetes Center, Second Department of Medicine, Athens University Medical School, Hippokration Hospital, Athens, Greece
| | - Alberto Ortiz
- IIS-Fundacion Jimenez Diaz/UAM/IRSIN and REDIREN, Madrid, Spain
| | | | - John R Petrie
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Johannes M Roob
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Peter Rossing
- Steno Diabetes Center, Gentofte, Denmark HEALTH, University of Aarhus, Aarhus, Denmark Faculty of Health, University of Copenhagen, Copenhagen, Denmark
| | - Piero Ruggenenti
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Clinical Research Center for Rare Diseases 'Aldo e Cele Daccò', Bergamo, Italy Unit of Nephrology and Dialysis, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Ivan Rychlik
- Second Department of Internal Medicine, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andreas L Serra
- Division of Nephrology, University Hospital, Zürich, Switzerland
| | - Janet Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, CO, USA
| | - Goce Spasovski
- Department of Nephrology, University of Skopje, Skopje, Macedonia
| | | | - Matias Trillini
- IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Clinical Research Center for Rare Diseases 'Aldo e Cele Daccò', Bergamo, Italy
| | | | - Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University of Graz, Graz, Austria
| | | | - Joachim Jankowski
- Charité-Universitaetsmedizin Berlin, Medizinische Klinik IV, Berlin, Germany
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Ribitsch W, Haditsch B, Otto R, Schilcher G, Quehenberger F, Roob JM, Rosenkranz AR. Effects of a pre-dialysis patient education program on the relative frequencies of dialysis modalities. Perit Dial Int 2013; 33:367-71. [PMID: 23547278 DOI: 10.3747/pdi.2011.00255] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Pre-dialysis education can guide the choice of the dialysis modality best tailored to meet the needs and preferences of individual patients with chronic kidney disease. METHODS In a retrospective single-center cohort study, we evaluated the impact of a pre-dialysis education program on the incidence rates of patients using hemodialysis (HD) and peritoneal dialysis (PD) in our unit. The frequency distribution of dialysis modalities between people attending our education program and people not attending the program (control group) was analyzed for the 4-year period 2004 - 2008. RESULTS From among all the incident chronic kidney disease 5D patients presenting during the 4-year period, we analyzed 227 who started dialysis either with an arteriovenous fistula or a PD catheter. In that cohort, 70 patients (30.8%) took part in the education program, and 157 (69.2%) did not receive structured pre-dialysis counseling. In the group receiving education, 38 patients (54.3%) started with PD, and 32 (45.7%), with HD. In the standard-care group not receiving education, 44 patients (28%) started with PD, and 113 (72%), with HD (p < 0.001). CONCLUSIONS Our multidisciplinary pre-dialysis program had a significant impact on the frequency distribution of dialysis modalities, increasing the proportion of patients initiating dialysis with PD.
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Affiliation(s)
- Werner Ribitsch
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
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10
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Faustmann G, Roob JM, Gruber H, Hafner‐Giessauf H, Grabher J, Tiran B, Winklhofer‐Roob BM. Activation of RelA (p65), but not of p50 dimers of nuclear factor kappa B (NF‐κB) is decreased in impaired renal function. FASEB J 2013. [DOI: 10.1096/fasebj.27.1_supplement.46.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gernot Faustmann
- Human Nutrition & Metabolism Research and Training CenterInstitute of Molecular BiosciencesKarl‐Franzens UniversityGrazAustria
| | - Johannes M. Roob
- Clinical Division of NephrologyDepartment of Internal MedicineMedical UniversityGrazAustria
| | - Hans‐Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical UniversityGrazAustria
| | | | - Johanna Grabher
- Clinical Division of NephrologyDepartment of Internal MedicineMedical UniversityGrazAustria
| | - Beate Tiran
- Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical UniversityGrazAustria
| | - Brigitte M. Winklhofer‐Roob
- Human Nutrition & Metabolism Research and Training CenterInstitute of Molecular BiosciencesKarl‐Franzens UniversityGrazAustria
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11
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Maahs DM, Siwy J, Argilés A, Cerna M, Delles C, Dominiczak AF, Gayrard N, Iphöfer A, Jänsch L, Jerums G, Medek K, Mischak H, Navis GJ, Roob JM, Rossing K, Rossing P, Rychlík I, Schiffer E, Schmieder RE, Wascher TC, Winklhofer-Roob BM, Zimmerli LU, Zürbig P, Snell-Bergeon JK. Urinary collagen fragments are significantly altered in diabetes: a link to pathophysiology. PLoS One 2010; 5. [PMID: 20927192 PMCID: PMC2946909 DOI: 10.1371/journal.pone.0013051] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 08/23/2010] [Indexed: 01/15/2023] Open
Abstract
Background The pathogenesis of diabetes mellitus (DM) is variable, comprising different inflammatory and immune responses. Proteome analysis holds the promise of delivering insight into the pathophysiological changes associated with diabetes. Recently, we identified and validated urinary proteomics biomarkers for diabetes. Based on these initial findings, we aimed to further validate urinary proteomics biomarkers specific for diabetes in general, and particularity associated with either type 1 (T1D) or type 2 diabetes (T2D). Methodology/Principal Findings Therefore, the low-molecular-weight urinary proteome of 902 subjects from 10 different centers, 315 controls and 587 patients with T1D (n = 299) or T2D (n = 288), was analyzed using capillary-electrophoresis mass-spectrometry. The 261 urinary biomarkers (100 were sequenced) previously discovered in 205 subjects were validated in an additional 697 subjects to distinguish DM subjects (n = 382) from control subjects (n = 315) with 94% (95% CI: 92–95) accuracy in this study. To identify biomarkers that differentiate T1D from T2D, a subset of normoalbuminuric patients with T1D (n = 68) and T2D (n = 42) was employed, enabling identification of 131 biomarker candidates (40 were sequenced) differentially regulated between T1D and T2D. These biomarkers distinguished T1D from T2D in an independent validation set of normoalbuminuric patients (n = 108) with 88% (95% CI: 81–94%) accuracy, and in patients with impaired renal function (n = 369) with 85% (95% CI: 81–88%) accuracy. Specific collagen fragments were associated with diabetes and type of diabetes indicating changes in collagen turnover and extracellular matrix as one hallmark of the molecular pathophysiology of diabetes. Additional biomarkers including inflammatory processes and pro-thrombotic alterations were observed. Conclusions/Significance These findings, based on the largest proteomic study performed to date on subjects with DM, validate the previously described biomarkers for DM, and pinpoint differences in the urinary proteome of T1D and T2D, indicating significant differences in extracellular matrix remodeling.
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Affiliation(s)
- David M Maahs
- Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, Aurora, Colorado, United States of America.
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12
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Kopriva-Altfahrt G, König P, Mündle M, Prischl F, Roob JM, Wiesholzer M, Vychytil A, Arneitz K, Karner A, Artes R, Wolf E, Auinger M, Pawlak A, Fraberger J, Hofbauer S, Galvan G, Salmhofer H, Pichler B, Wazel M, Gruber M, Thonhofer A, Hager A, Malajner S, Heiss S, Braunsteiner T, Zweiffler M, König P, Rudnicki M, Kogler R, Kohlhauser D, Wiesinger T, Kopriva-Altfahrt G, Moser E, Kotanko P, Loibner H, Nitz H, Miska HJ, Wenzel R, Wölfer M, Mündle M, Breuss H, Hölzl B, Prischi F, Schmekal B, Riener EM, Roob JM, Wonisch W, Vikydal R, Vychytil A, Frank B, Wieser C, Wiesholzer M, Pokorny K. Exit-site care in Austrian peritoneal dialysis centers -- a nationwide survey. Perit Dial Int 2009; 29:330-339. [PMID: 19458307] [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: 05/27/2023] Open
Abstract
BACKGROUND Catheter-associated infections markedly contribute to treatment failure in peritoneal dialysis (PD) patients. There is much controversy surrounding prophylactic strategies to prevent these infections. METHODS In this nationwide multicenter study we analyzed strategies to prevent catheter-associated infections as performed in Austrian PD centers in 2006. A questionnaire was sent to all 23 PD centers in Austria. RESULTS Ten different catheter models were used in the 332 patients being treated in the 23 Austrian PD centers. Systemic antibiotics prior to catheter placement were given by 17 of the 23 PD centers (glycopeptides, n = 7; cephalosporins, n = 10). Nasal swabs were taken preoperatively by 17 PD centers; nasal Staphylococcus aureus carriers were treated prophylactically with mupirocin cream in 15 of these centers. Dressing change was routinely performed in 318 of 332 chronic PD patients (nonocclusive film dressing, n = 58; gauze dressing, n = 260). Disinfectants for chronic exit-site care included povidone iodine (n = 155), sodium hypochlorite (n = 31), povidone iodine + sodium hypochlorite together (n = 102), and octenidine dihydrochloride/phenoxyethanol (n = 17). Water + non-disinfectant soap or 0.9% sodium chloride was administered as a cleansing agent to the exit site by 27 patients. Routine S. aureus screening (nasal and/or exit-site swabs) in chronic PD patients was performed in 12 PD centers; carriers were treated with mupirocin cream in 11 of these centers. Dialysis staff members were screened for S. aureus in 8 PD centers and spouses were screened for S. aureus in 5 PD centers. The overall exit-site infection rate was 1 episode/43.9 patient-months, tunnel infection rate was 1 episode/88.9 patient-months, and peritonitis rate was 1 episode/51.0 patient-months. Patients of centers that have installed a prophylaxis protocol for treating S. aureus carriers had lower mean infection rates compared with those not using such a protocol. CONCLUSION Various individual prophylactic strategies are used to prevent catheter-associated infections in Austrian PD centers. Infection rates are within the range reported in the literature. There is still scope for improvement in some centers (e.g., by establishing a prophylaxis protocol).
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13
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Kopriva–Altfahrt G, König P, Mündle M, Prischl F, Roob JM, Wiesholzer M, Vychytil A, Arneitz K, Karner A, Artes R, Wolf E, Auinger M, Pawlak A, Hietzing K, Fraberger J, Hofbauer S, Waldviertel L, Galvan G, Salmhofer H, Pichler B, Wazel M, Landeskliniken S, Gruber M, Thonhofer A, Hager A, Malajner S, Heiss S, Braunsteiner T, Zweifler M, König P, Rudnicki M, Nephrologie KAF, Kogler R, Kohlhauser D, Wiesinger T, Kopriva–Altfahrt G, Moser E, Kotanko P, Loibner H, Nitz H, Miska HJ, Wenzel R, Wölfler M, Mündle M, Breuss H, Hölzl B, Oberortner W, Prischl F, der Kreuzschwestern K, Schmekal B, Riener EM, Krankenhaus A, Roob JM, Wonisch W, Vikydal R, Vychytil A, Frank B, Wieser C, Wiesholzer M, Pokorny K. Exit-Site Care in Austrian Peritoneal Dialysis Centers — a Nationwide Survey. Perit Dial Int 2009. [DOI: 10.1177/089686080902900319] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Catheter-associated infections markedly contribute to treatment failure in peritoneal dialysis (PD) patients. There is much controversy surrounding prophylactic strategies to prevent these infections. Methods In this nationwide multicenter study we analyzed strategies to prevent catheter-associated infections as performed in Austrian PD centers in 2006. A questionnaire was sent to all 23 PD centers in Austria. Results Ten different catheter models were used in the 332 patients being treated in the 23 Austrian PD centers. Systemic antibiotics prior to catheter placement were given by 17 of the 23 PD centers (glycopeptides, n = 7; cephalosporins, n = 10). Nasal swabs were taken preoperatively by 17 PD centers; nasal Staphylococcus aureus carriers were treated prophylactically with mupirocin cream in 15 of these centers. Dressing change was routinely performed in 318 of 332 chronic PD patients (nonocclusive film dressing, n = 58; gauze dressing, n = 260). Disinfectants for chronic exit-site care included povidone iodine ( n = 155), sodium hypochlorite ( n = 31), povidone iodine + sodium hypochlorite together ( n = 102), and octenidine dihydrochloride/phenoxyethanol ( n = 17). Water+non-disinfectant soap or 0.9% sodium chloride was administered as a cleansing agent to the exit site by 27 patients. Routine S. aureus screening (nasal and/or exit-site swabs) in chronic PD patients was performed in 12 PD centers; carriers were treated with mupirocin cream in 11 of these centers. Dialysis staff members were screened for S. aureus in 8 PD centers and spouses were screened for S. aureus in 5 PD centers. The overall exit-site infection rate was 1 episode/43.9 patient-months, tunnel infection rate was 1 episode/88.9 patient-months, and peritonitis rate was 1 episode/51.0 patient-months. Patients of centers that have installed a prophylaxis protocol for treating S. aureus carriers had lower mean infection rates compared with those not using such a protocol. Conclusion Various individual prophylactic strategies are used to prevent catheter-associated infections in Austrian PD centers. Infection rates are within the range reported in the literature. There is still scope for improvement in some centers ( e.g., by establishing a prophylaxis protocol).
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Affiliation(s)
| | - Paul König
- Nephrology and Hypertensiology, University Hospital of Medicine IV, Medical University of Innsbruck, Austria
| | - Michael Mündle
- Division of Nephrology and Dialysis, Department of Medicine, Landeskrankenhaus Feldkirch, Austria
| | - Friedrich Prischl
- Division of Nephrology and Dialysis, Third Department of Medicine, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels, Austria
| | - Johannes M. Roob
- Clinical Division of Nephrology and Dialysis, Medical University of Graz, Austria
| | - Martin Wiesholzer
- Division of Nephrology and Dialysis, First Department of Medicine, A.ö. Krankenhaus St. Pölten
| | - Andreas Vychytil
- Division of Nephrology and Dialysis, Department of Medicine III, Medical University of Vienna, Austria
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14
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Sundl I, Roob JM, Meinitzer A, Tiran B, Khoschsorur G, Haditsch B, Holzer H, Winklhofer-Roob BM. Antioxidant status of patients on peritoneal dialysis: associations with inflammation and glycoxidative stress. Perit Dial Int 2009; 29:89-101. [PMID: 19164258] [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: 05/27/2023] Open
Abstract
BACKGROUND Patients on peritoneal dialysis (PD) frequently exhibit oxidant-antioxidant imbalance, advanced glycation end-product overload, and subclinical inflammation but the interrelations between these pathophysiological changes have not been fully elucidated. SUBJECTS AND METHODS To study possible associations, a cross-sectional study of antioxidant status, glycoxidative stress, and inflammation, using HPLC and ELISA methods, was undertaken in 37 PD patients and age- and sex-matched healthy controls. RESULTS Plasma ascorbate concentrations were low in patients not taking at least low-dose vitamin C supplements. In patients taking vitamin C supplements, there was a positive relation between ascorbate and pentosidine concentrations. Vitamin E and carotenoid concentrations were comparable between patients and controls, while lycopene and lutein/zeaxanthin concentrations were lower. Interleukin-6, C-reactive protein (CRP), and pentosidine concentrations were elevated in PD patients. beta-Cryptoxanthin, lycopene, and lutein/zeaxanthin concentrations were inversely related to interleukin-6 concentrations. beta-Cryptoxanthin concentrations were also inversely related to CRP concentrations. Pentosidine showed a low dialysate-to-plasma ratio, indicating low peritoneal clearance. Pentosidine concentrations increased with duration of PD therapy, while alpha- and beta-carotene concentrations decreased. Malondialdehyde concentrations were elevated compared to controls but remained within the normal range. Retinol concentrations decreased with PD therapy and were inversely related to interleukin-6 and CRP concentrations. CONCLUSIONS Low-dose vitamin C supplements and a carotenoid-rich diet should be recommended for PD patients to maintain normal antioxidant status and efficiently counteract the chronic inflammatory response, rather than high doses of vitamin C, which could play a role as a precursor of pentosidine.
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Affiliation(s)
- Isabella Sundl
- Human Nutrition & Metabolism Research and Training Center Graz, Institute of Molecular Sciences, Karl-Franzens University, Graz, Austria
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15
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Sundl I, Roob JM, Meinitzer A, Tiran B, Khoschsorur G, Haditsch B, Holzer H, Winklhofer–Roob BM. Antioxidant Status of Patients on Peritoneal Dialysis: Associations with Inflammation and Glycoxidative Stress. Perit Dial Int 2009. [DOI: 10.1177/089686080902900113] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Patients on peritoneal dialysis (PD) frequently exhibit oxidant–antioxidant imbalance, advanced glycation end-product overload, and subclinical inflammation but the interrelations between these pathophysiological changes have not been fully elucidated. Subjects and Methods To study possible associations, a cross-sectional study of antioxidant status, glycoxidative stress, and inflammation, using HPLC and ELISA methods, was undertaken in 37 PD patients and age- and sex-matched healthy controls. Results Plasma ascorbate concentrations were low in patients not taking at least low-dose vitamin C supplements. In patients taking vitamin C supplements, there was a positive relation between ascorbate and pentosidine concentrations. Vitamin E and carotenoid concentrations were comparable between patients and controls, while lycopene and lutein/zeaxanthin concentrations were lower. Interleukin-6, C-reactive protein (CRP), and pentosidine concentrations were elevated in PD patients. β–Cryptoxanthin, lycopene, and lutein/zeaxanthin concentrations were inversely related to interleukin-6 concentrations. β–Cryptoxanthin concentrations were also inversely related to CRP concentrations. Pentosidine showed a low dialysate-to-plasma ratio, indicating low peritoneal clearance. Pentosidine concentrations increased with duration of PD therapy, while α– and β–carotene concentrations decreased. Malondialdehyde concentrations were elevated compared to controls but remained within the normal range. Retinol concentrations decreased with PD therapy and were inversely related to interleukin-6 and CRP concentrations. Conclusions Low-dose vitamin C supplements and a carotenoid-rich diet should be recommended for PD patients to maintain normal antioxidant status and efficiently counteract the chronic inflammatory response, rather than high doses of vitamin C, which could play a role as a precursor of pentosidine.
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Affiliation(s)
- Isabella Sundl
- Human Nutrition & Metabolism Research and Training Center Graz, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
| | - Johannes M. Roob
- Division of Clinical Nephrology and Hemodialysis, Medical University, Graz, Austria
| | - Andreas Meinitzer
- Department of Internal Medicine, and Clinical Institute of Medical & Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Beate Tiran
- Department of Internal Medicine, and Clinical Institute of Medical & Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Gholamali Khoschsorur
- Department of Internal Medicine, and Clinical Institute of Medical & Chemical Laboratory Diagnostics, Medical University, Graz, Austria
| | - Bernd Haditsch
- Division of Clinical Nephrology and Hemodialysis, Medical University, Graz, Austria
| | - Herwig Holzer
- Division of Clinical Nephrology and Hemodialysis, Medical University, Graz, Austria
| | - Brigitte M. Winklhofer–Roob
- Human Nutrition & Metabolism Research and Training Center Graz, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
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16
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Meinitzer A, Puchinger M, Winklhofer-Roob BM, Rock E, Ribalta J, Roob JM, Sundl I, Halwachs-Baumann G, März W. Reference values for plasma concentrations of asymmetrical dimethylarginine (ADMA) and other arginine metabolites in men after validation of a chromatographic method. Clin Chim Acta 2007; 384:141-8. [PMID: 17689511 DOI: 10.1016/j.cca.2007.07.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2007] [Revised: 07/03/2007] [Accepted: 07/03/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND Owing to the growing number of reports in the literature on ADMA as a possibly useful marker of endothelial health, its use in the clinical laboratory is of increasing interest. Age dependency and the small, but statistically significant differences between healthy subjects and disease groups are difficult to interpret. Additionally, levels of ADMA in comparable patient groups of different studies vary widely, even when similar methods have been used. METHODS After analytical evaluation of a chromatographic method according to international guidelines, we analysed asymmetrical (ADMA) and symmetrical dimethyl arginine (SDMA), homo-arginine and arginine in EDTA plasma of 292 healthy males aged 20 to 75 years (y) who had passed strict inclusion/exclusion criteria. For statistical analysis, 4 age groups were formed. Group differences were identified with the non-parametric Kruskal-Wallis test. RESULTS Calibration curves were linear throughout the selected ranges; the standard deviation for the regression line, recovery, imprecision, and accuracy results were all highly satisfactory. The reference ranges of ADMA for the 4 age groups are presented as age (mean+/-SD of age group, y); number of subjects; median, 2.5th-97.5th percentile: group <35 y: 26.7+/-4.0 y; n=78; 0.58, 0.43-0.69 micromol/L; group 35-49 y: 41.6+/-4.0 y; n=93; 0.59, 0.45-0.73 micromol/L; group 50-65 y: 57.5+/-4.2 y; n=82; 0.61, 0.46-0.78 micromol/L; and group >65 y: 69.6+/-3.3 y; n=39; 0.64, 0.54-0.79 micromol/L. CONCLUSIONS Only highly precise methods are able to detect small differences between groups. The application of an evaluated method to a well defined group of healthy subjects should provide a basis for comparison of ADMA concentrations in different patient populations of future studies.
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Affiliation(s)
- Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria.
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17
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Sundl I, Guardiola M, Khoschsorur G, Solà R, Vallvé JC, Godàs G, Masana L, Maritschnegg M, Meinitzer A, Cardinault N, Roob JM, Rock E, Winklhofer-Roob BM, Ribalta J. Increased concentrations of circulating vitamin E in carriers of the apolipoprotein A5 gene - 1131T>C variant and associations with plasma lipids and lipid peroxidation. J Lipid Res 2007; 48:2506-13. [PMID: 17693622 DOI: 10.1194/jlr.m700285-jlr200] [Citation(s) in RCA: 20] [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] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to investigate the effects of the apolipoprotein A5 (APOA5) 1131T>C gene variant on vitamin E status and lipid profile. The gene variant was determined in 297 healthy nonsmoking men aged 20-75 years and recruited in the VITAGE Project. Effects of the genotype on vitamin E in plasma, LDL, and buccal mucosa cells (BMC) as well as on cholesterol and triglyceride (TG) concentrations in plasma and apolipoprotein A-I (apoA-I), apoB, apoE, apoC-III, and plasma fatty acids were determined. Plasma malondialdehyde concentrations as a marker of in vivo lipid peroxidation were determined. C allele carriers showed significantly higher TG, VLDL, and LDL in plasma, higher cholesterol in VLDL and intermediate density lipoprotein, and higher plasma fatty acids. Plasma alpha-tocopherol (but not gamma-tocopherol, LDL alpha- and gamma-tocopherol, or BMC total vitamin E) was increased significantly in C allele carriers compared with homozygote T allele carriers (P = 0.02), but not after adjustment for cholesterol or TG. Plasma malondialdehyde concentrations did not differ between genotypes. In conclusion, higher plasma lipids in the TC+CC genotype are efficiently protected against lipid peroxidation by higher alpha-tocopherol concentrations. Lipid-standardized vitamin E should be used to reliably assess vitamin E status in genetic association studies.
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Affiliation(s)
- Isabella Sundl
- Human Nutrition and Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Graz, Austria
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Abstract
In addition to kidney transplantation, peritoneal dialysis (PD) and hemodialysis represent two options for renal replacement therapy in patients with end-stage renal disease (ESRD). Given that most patients are suitable for both types of dialysis and that many of them require lifelong therapy, differences in clinical outcome between these treatments are of major interest. Differences between the two dialysis treatments have been described in single clinical aspects (e.g., hyperkalemia, volume status, blood pressure control, cardiac complications), the relevance of which are reflected by mortality rates. Data available so far indicate that overall outcome of patients with ESRD is comparable in the two types of dialysis. However, there are significant differences in subgroups of patients, such as those with diabetes or coronary heart disease. In order to achieve the best possible survival and quality of life in ESRD, the optimal sequence of dialysis treatments during the course of renal replacement therapy, rather than a single type of treatment, has to be considered. The "integrated care concept" takes into account this sequence of dialysis treatments, suggesting that patients should start on PD but be transferred to hemodialysis as soon as PD is no longer adequate. This concept allows longer preservation of residual renal function, better early survival on dialysis and better short-term results of graft survival after kidney transplantation. Thus, if medically suitable, PD should be the first treatment option in patients with ESRD who need renal replacement therapy.
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Affiliation(s)
- Johannes M Roob
- Klinische Abteilung für Nephrologie und Hämodialyse, Medizinische Universität Graz, Graz, Austria.
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Winklhofer-Roob BM, Roob JM, Maritschnegg M, Sprinz G, Hiller D, Marktfelder E, Preinsberger M, Wuga S, Sundl I, Tiran B, Cardinault N, Ribalta J, Rock E. Does aging affect the response of vitamin E status to vitamin E depletion and supplementation? Ann N Y Acad Sci 2005; 1031:381-4. [PMID: 15753175 DOI: 10.1196/annals.1331.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A vitamin E depletion/supplementation study was conducted in 100 healthy 20-75-year-old volunteers. The responses of vitamin E status to 3-week dietary vitamin E restriction to approximately 25% of recommended intake and 2-month unrestricted dietary intake plus 800 IU/d of RRR-alpha-tocopherol were studied as a function of age. Plasma alpha-tocopherol concentrations were closely related to cholesterol concentrations, which increased with age (P < 0.001). Upon dietary restriction, plasma alpha-tocopherol concentrations decreased significantly (P < 0.001) but independently of age. Plasma alpha-tocopherol responses to supplementation increased significantly with age, but this effect disappeared after standardization for cholesterol. gamma-Tocopherol concentrations decreased to less than 30% of baseline.
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Affiliation(s)
- Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Schubertstrasse 1, A-8010 Graz, Austria.
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Winklhofer-Roob BM, Meinitzer A, Maritschnegg M, Roob JM, Khoschsorur G, Ribalta J, Sundl I, Wuga S, Wonisch W, Tiran B, Rock E. Effects of vitamin E depletion/repletion on biomarkers of oxidative stress in healthy aging. Ann N Y Acad Sci 2005; 1031:361-4. [PMID: 15753170 DOI: 10.1196/annals.1331.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The effects on ex vivo LDL resistance to oxidation and biomarkers of in vivo oxidative stress in response to 3-month dietary vitamin E restriction to 25% of recommended intake and 2-month unrestricted dietary intake and supplementation with 800 IU/d were studied in 100 healthy, nonsmoking 20-75-year-old volunteers. Significant changes in vitamin E status were associated with decreases and increases, respectively, in LDL resistance to oxidation in the depletion and supplementation period and with decreases in lipid peroxidation and oxidative DNA modification in the supplementation period. Healthy aging was not associated with enhanced susceptibility to oxidation in the depletion period.
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Affiliation(s)
- Brigitte M Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Schubertstrasse 1, A-8010 Graz, Austria.
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Brigelius-Flohé R, Roob JM, Tiran B, Wuga S, Ribalta J, Rock E, Winklhofer-Roob BM. The Effect of Age on Vitamin E Status, Metabolism, and Function: Metabolism as Assessed by Labeled Tocopherols. Ann N Y Acad Sci 2004; 1031:40-3. [PMID: 15753132 DOI: 10.1196/annals.1331.004] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The effects of age on vitamin E metabolism were studied in 97 healthy 20-75-year-old male nonsmoking Austrian volunteers of the VITAGE project. After a single oral intake of 30 mg d(6)-RRR-alpha- and d(2)-RRR-gamma-tocopheryl acetate, blood and 24-hour urine was collected. Deuterated tocopherols in plasma and deuterated urinary metabolites were analyzed by GC-MS. A first evaluation revealed a similar uptake of d(6)-alpha- and d(2)-gamma-tocopherol during the first 6 hours, and then d(2)-gamma-tocopherol started to decrease. Urinary d(2)-gamma- carboxyethyl hydroxychroman metabolites (CEHCs) exceeded those of d(6)-alpha-CEHCs by about 10 times. There was no effect of age. Thus, there might be no need for a higher vitamin E intake for healthy elderly nonsmoking men.
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Affiliation(s)
- Regina Brigelius-Flohé
- German Institute of Human Nutrition, Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, D-14558 Nuthetal, Germany.
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Sundl I, Resch U, Bergmann AR, Roob JM, Winklhofer-Roob BM. The Decrease in γ-Tocopherol in Plasma and Lipoprotein Fractions Levels Off within Two Days of Vitamin E Supplementation. Ann N Y Acad Sci 2004; 1031:378-80. [PMID: 15753174 DOI: 10.1196/annals.1331.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The effects of vitamin E supplementation on alpha- and gamma-tocopherol concentrations were studied in plasma and lipoprotein fractions of five healthy volunteers taking 1000 IU/day of RRR alpha-tocopherol for 4 days. Although plasma alpha-tocopherol increased, gamma-tocopherol decreased. Compared with baseline, gamma-/alpha-tocopherol ratios decreased from 48 h onward (P < 0.001). They all leveled off within 48 h. From 12 h onward, gamma-/alpha-tocopherol ratios were higher in VLDL and IDL than in LDL and HDL, indicating that gamma-tocopherol is better maintained in triglyceride-rich lipoprotein fractions. These data suggest that vitamin E supplementation exceeding 2 days does not further decrease gamma-tocopherol concentrations.
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Affiliation(s)
- Isabella Sundl
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, Karl-Franzens University, Schubertstrasse 1, A-8010 Graz, Austria
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Winklhofer-Roob BM, Rock E, Ribalta J, Shmerling DH, Roob JM. Effects of vitamin E and carotenoid status on oxidative stress in health and disease. Evidence obtained from human intervention studies. Mol Aspects Med 2003; 24:391-402. [PMID: 14585310 DOI: 10.1016/s0098-2997(03)00035-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Vitamin E and carotenoids are known to act as antioxidants both in vitro and in vivo. In this review we present a series of studies in healthy subjects and in patients who exhibit either acute or chronic oxidative stress. In the EU-Commission funded VITAGE project we investigated the status and effects of vitamin E and carotenoids on oxidative stress in 300 healthy volunteers. Depletion studies limiting dietary vitamin E or carotenoid intake to approximately 25% of the dietary reference intakes and subsequent repletion by supplementation with either large doses of vitamin E or intermediate doses of carotenoids showed significant changes in ex vivo LDL oxidizability, total plasma peroxide concentrations and urinary 8-oxo-7,8-dihydro-2(')-deoxyguanosine excretion. Patients on chronic hemodialysis present with oxidative stress in the presence of normal vitamin E but impaired vitamin C status and, due to anemia, need to be treated with parenteral iron. We studied the effects of a single oral dose of vitamin E taken 6 h prior to intravenous infusion of 100 mg iron, which exceeded the iron-binding capacity of transferrin. Vitamin E significantly reduced and in combination with a single dose of vitamin C completely abrogated acute oxidative stress induced by the iron load. Patients with cystic fibrosis are exposed to chronic oxidative stress due to an overproduction of reactive oxygen species as a result of neutrophil-dominated lung inflammation and impaired antioxidant status. Biochemical vitamin E and carotenoid deficiencies could be fully corrected even in the presence of fat malabsorption using intermediate doses of either RRR alpha-tocopherol or all-rac alpha-tocopheryl acetate and water-miscible all-trans beta-carotene. Long-term supplementation reduced ex vivo LDL oxidizability, in vivo lipid peroxidation and lung inflammation.
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Abstract
Does cigarette smoking increase vitamin E utilization in vivo? A trial was carried out in 6 smokers and 5 nonsmokers of comparable ages and serum lipids. Subjects consumed 75 mg each d(3)-RRR and d(6)-all rac-alpha-tocopheryl acetates (natural and synthetic vitamin E, respectively) daily for 7 d with a standardized breakfast. Fasting blood samples were drawn on days -7, -6, -5, -4, -3, -2, -1, 0, 1, 2, 3, 4, 5, 6, 7, 9, 14, 21 (negative days indicate supplementation). In both groups, plasma d(3)-alpha-tocopherol concentrations were approximately double of d(6)-alpha-tocopherol. At day 0, the %d(3) alpha-tocopherols (d(3)-alpha-tocopherol/total-alpha-tocopherol x 100) were similar in both smokers and nonsmokers. Subsequently, there was a trend toward a faster exponential disappearance of the plasma %d(3) alpha-tocopherol in smokers compared with nonsmokers (0.30 +/- 0.04 compared with 0.24 +/- 0.05, p =.0565). The calculated %d(3) half-lives were 55.6 +/- 7.4 h in smokers and 72.1 +/- 17.3 h in nonsmokers (p =.0630). By day 21, the %d(3) in smokers had decreased to 1.4% +/- 0.3% while it was 2.2% +/- 0.7% (p =.0418) in the nonsmokers. These data suggest that smoking increases plasma vitamin E disappearance, but further studies are needed to confirm this finding and to assess its cause.
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Affiliation(s)
- M G Traber
- Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, CA, USA.
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Roob JM, Rabold T, Hayn M, Khoschsorur G, Resch U, Holzer H, Winklhofer-Roob BM. Ex vivo low-density lipoprotein oxidizability and in vivo lipid peroxidation in patients on CAPD. Kidney Int 2001. [DOI: 10.1046/j.1523-1755.2001.07832.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Roob JM, Rabold T, Hayn M, Khoschsorur G, Resch U, Holzer H, Winklhofer-Roob BM. Ex vivo low-density lipoprotein oxidizability and in vivo lipid peroxidation in patients on CAPD. Kidney Int Suppl 2001; 78:S128-36. [PMID: 11168998 DOI: 10.1046/j.1523-1755.2001.59780128.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Chronic renal failure is associated with accelerated atherosclerosis and a high incidence of cardiovascular disease. Oxidative modification of low-density lipoprotein (LDL) is considered a key event in atherogenesis. METHODS We studied the ex vivo oxidizability of LDL exposed to Cu2+ ions (lag time, rate of propagation, maximum conjugated diene formation) and its relationship with LDL density, fatty acids, and antioxidants, along with plasma malondialdehyde (MDA) and autoantibodies against Cu2+-, MDA-, and hypochlorous acid-modified LDL and plasma antioxidants in 17 continuous ambulatory peritoneal dialysis (CAPD) patients and 21 healthy control subjects. RESULTS LDL alpha- and gamma-tocopherol and total polyunsaturated fatty acid (PUFA) concentrations were significantly higher in the CAPD patients. LDL density was shifted to small, dense LDL. LDL oxidizability was comparable to that of healthy subjects. Lag time correlated positively with LDL alpha-tocopherol and inversely with both total PUFA concentrations and density; the rate of oxidation and LDL density correlated positively with total PUFA and total fatty acid concentrations, respectively. Ratios of autoantibody titers against oxidized to native LDL did not differ between the two groups. While plasma alpha- and gamma-tocopherol concentrations and tocopherol to cholesterol ratios were significantly higher, vitamin C concentrations were very low in the CAPD patients. MDA concentrations were 1.7 times higher than in healthy subjects. CONCLUSIONS (1) Ex vivo LDL oxidizability is normal in CAPD patients as a result of efficient protection by LDL-associated lipophilic antioxidants, although the LDL composition is altered toward high oxidizability; and (2) the plasma antioxidant screen is insufficient due to impaired vitamin C status.
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Affiliation(s)
- J M Roob
- Division of Clinical Nephrology and Hemodialysis, Department of Internal Medicine, Institute of Molecular Biology, Biochemistry, and Microbiology, Karl-Franzens University of Graz, Graz, Austria
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Roob JM, Khoschsorur G, Tiran A, Horina JH, Holzer H, Winklhofer-Roob BM. Vitamin E attenuates oxidative stress induced by intravenous iron in patients on hemodialysis. J Am Soc Nephrol 2000; 11:539-549. [PMID: 10703678 DOI: 10.1681/asn.v113539] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Intravenous iron application to anemic patients on hemodialysis leads to an "oversaturation" of transferrin. As a result, non-transferrin-bound, redox-active iron might induce lipid peroxidation. To test the hypothesis that vitamin E attenuates lipid peroxidation in patients receiving 100 mg of iron(III) hydroxide sucrose complex intravenously during a hemodialysis session, 22 patients were investigated in a randomized cross-over design, either with or without a single oral dose of 1200 IU of all-rac-alpha-tocopheryl acetate taken 6 h before the hemodialysis session. Blood was drawn before and 30, 60, 90, 135, and 180 min after the start of the iron infusion, and areas under the curve (AUC0-180 min) of ratios of plasma malondialdehyde (MDA) to cholesterol and plasma total peroxides to cholesterol (two markers of lipid peroxidation) were determined as the outcome variables. At baseline of the session without vitamin E supplementation, plasma alpha-tocopherol concentrations (27.6 +/- 1.8 micromol/L) and ratios of alpha-tocopherol to cholesterol (5.88 +/- 1.09 mmol/mol) were normal, plasma MDA concentrations were above normal (1.20 +/- 0.28 micromol/ L), and bleomycin-detectable iron (BDI), indicating the presence of redox-active iron, was not detectable. Upon iron infusion, BDI and MDA concentrations increased significantly (P < 0.001). BDI concentrations explained the increase over baseline in MDA concentrations (MDA = 1.29 +/- 0.075 x BDI). Vitamin E supplementation, leading to a 68% increase in plasma alpha-tocopherol concentrations, significantly reduced the AUC0-180 min of MDA to cholesterol (P = 0.004) and peroxides to cholesterol (P = 0.002). These data demonstrate that a single oral dose of vitamin E attenuates lipid peroxidation in patients on hemodialysis receiving intravenous iron. Given that intravenous iron is applied repeatedly to patients on hemodialysis, this therapeutic approach may protect against oxidative stress-related degenerative disease in the long term.
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Affiliation(s)
- Johannes M Roob
- Division of Clinical Nephrology and Hemodialysis, Department of Internal Medicine, Karl-Franzens University of Graz, Austria
| | | | - Andreas Tiran
- Department of Laboratory Medicine II, Karl-Franzens University of Graz, Austria
| | - Jörg H Horina
- Division of Clinical Nephrology and Hemodialysis, Department of Internal Medicine, Karl-Franzens University of Graz, Austria
| | - Herwig Holzer
- Division of Clinical Nephrology and Hemodialysis, Department of Internal Medicine, Karl-Franzens University of Graz, Austria
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Abstract
OBJECTIVE To investigate how extracorporal cholesterol lowering therapy affects circulating leptin levels in patients with ravenous hunger after treatment and permanent weight gain. DESIGN A case report. SUBJECT 51 y old caucasian male patient with moderate chronic renal failure. MEASUREMENTS Serum Leptin concentration (RIA, Linco Research Inc, St. Louis, MO, USA), total cholesterol, low density lipoprotein cholesterol, blood glucose levels, calorie intake by food records. RESULTS During treatment total cholesterol was reduced by 50%. Serum Leptin levels showed a 42% reduction at the end of treatment, that by far exceeds the physiological diurnal variation. Calorie intake was significantly increased on days of treatment. CONCLUSION We conclude that this artificial reduction in circulating leptin plays an important role in the pathogenesis of ravenous hunger and weight gain under extracorporal cholesterol lowering therapy in this case.
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Affiliation(s)
- G C Leitner
- Division of Nephrology, Karl-Franzens University, Graz, Austria.
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Ziouzenkova O, Winklhofer-Roob BM, Puhl H, Roob JM, Esterbauer H. Lack of correlation between the alpha-tocopherol content of plasma and LDL, but high correlations for gamma-tocopherol and carotenoids. J Lipid Res 1996; 37:1936-46. [PMID: 8895059] [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: 02/02/2023] Open
Abstract
In 59 healthy human subjects (37 male and 22 female) the concentrations of the lipid-soluble antioxidants alpha- and gamma-tocopherol, alpha- and beta-carotene, lycopene, cryptoxanthin, canthaxanthin, and lutein + zeaxanthin were determined in plasma (mumol/L) and in isolated low density lipoproteins (LDL) (mumol/mmol cholesterol). Plasma alpha-tocopherol concentrations were significantly correlated with plasma total cholesterol concentrations (r2 = 0.51, P < 0.0001) yet not with the LDL alpha-tocopherol content (r2 = 0.05, ns). Plasma gamma-tocopherol concentrations were weakly correlated with plasma total cholesterol (r2 = 0.12, P < 0.003) and both absolute and cholesterol standardized plasma gamma-tocopherol concentrations correlated strongly with the LDL gamma-tocopherol content (r2 = 0.58 and r2 = 0.72, respectively). In contrast, carotenoid concentrations did not correlate with cholesterol concentrations, but their LDL content correlated significantly with the respective plasma concentrations (r2 = 0.67 to 0.92, all P < 0.0001). In a subgroup of study subjects (n = 13) the distribution of vitamin E and carotenoids among LDL was calculated. The proportion of plasma alpha- and gamma-tocopherol found in LDL was 48 +/- 7 (range, 36-61%) and 41 +/- 7%, respectively, suggesting that LDL was in most of these subjects not the main carrier for these antioxidants. The lipophilic carotenoids, however, were predominantly carried by LDL (e.g., beta-carotene: 87 +/- 10%), whereas the proportion of the more polar ones carried by LDL was much smaller (e.g., lutein + zeaxanthin: 36 +/- 6%). The results of this study show that plasma alpha-tocopherol concentrations are not predictive for the alpha-tocopherol content of LDL in nonsupplemented individuals. This finding could have implications in interpreting the cause of the inverse relationship between plasma alpha-tocopherol and risk of atherosclerosis.
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Affiliation(s)
- O Ziouzenkova
- Institute of Biochemistry, University of Graz, Austria
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Affiliation(s)
- D Schneditz
- Department of Physiology, Karl Franzens University Graz, Austria
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Horina JH, Wirnsberger G, Horn S, Roob JM, Ratschek M, Holzer H, Pogglitsch H, Krejs GJ. Long-term follow-up of a patient with lecithin cholesterol acyltransferase deficiency syndrome after kidney transplantation. Transplantation 1993; 56:233-6. [PMID: 8333054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J H Horina
- Department of Medicine, Karl Franzens University Graz, Austria
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Horina JH, Schmid CR, Roob JM, Winkler HM, Samitz MA, Hammer HF, Pogglitsch H, Krejs GJ. Bone marrow changes following treatment of renal anemia with erythropoietin. Kidney Int 1991; 40:917-22. [PMID: 1762296 DOI: 10.1038/ki.1991.294] [Citation(s) in RCA: 18] [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] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In 14 severely anemic patients with end-stage renal disease and chronic hemodialysis the effect of recombinant human erythropoietin (EPO) on hemopoiesis was investigated. Bone marrow biopsies were taken before and after four and 26 months of treatment with EPO to evaluate quantitative and qualitative changes of histomorphology. EPO induced normalization of maturation and an increase in cell mass of the erythropoietic line in all patients. The number of megakaryocyte also increased significantly with EPO treatment (P less than 0.01). At the time of the third bone marrow biopsy (26 months) erythropoiesis was normal. Megakaryopoiesis remained unchanged compared to the second biopsy (4 months). No cytomorphologic abnormalities or other evidence for malignant disorder could be detected in any of the patients. Hematocrit increased from a mean of 19 to 31 percent at the second evaluation (P less than 0.001). Platelet count had risen by a mean of 30,000 at four months (P less than 0.05) and slightly decreased at 26 months. These observations suggest great safety of long-term treatment with recombinant human erythropoietin, and demonstrate efficacy in correcting reduced and immature erythropoiesis in chronically hemodialyzed patients. EPO also stimulates human megakaryopoiesis.
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Affiliation(s)
- J H Horina
- Department of Medicine, Karl Franzens University, Graz, Austria
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Roob JM, Schneditz D, Haas GM, Horina JH, Pogglitsch H. [Continuous measurement of blood volume changes in hemodialysis using an ultrasound method]. Wien Klin Wochenschr 1990; 102:131-6. [PMID: 2181783] [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: 12/30/2022]
Abstract
Haemodialysis treatment comprises the removal of surplus body water, mainly by ultrafiltration. Frequent complications, such as hypotension, are believed to be related to an imbalance between blood volume reduction, based upon ultrafiltration, and vascular refilling. The control of fluid balance can be achieved by the measurement of blood volume changes. A new method of determining total blood protein concentration by ultrasonic means facilitates continuous monitoring of blood volume changes during haemodialysis. Blood volume monitoring was undertaken during 38 haemodialysis treatments (19 patients) in order to achieve a better adjustment of the patient's estimated dry weight. The relative change in blood volume was registered in 11 patients who were first ultrafiltrated to their estimated dry weight. In a following session the ultrafiltration was increased by 10%. The relative change in blood volume, normalized to the change in total body water, increased significantly from 1.16 +/- 1.11% (normal ultrafiltration) to 1.67 +/- 0.8% (normal ultrafiltration + 10%) (p less than 0.05). Thus, normalized blood volume reduction may serve as an approximation to adjust the patient's dry weight.
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Affiliation(s)
- J M Roob
- Medizinische Universitätsklinik, Karl-Franzens-Universität, Graz
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