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Stauber RE, Paar M, Balazs I, Horvath A, Feldbacher N, Posch A, Rainer F, Stadlbauer V, Oettl K. Effect of albumin infusion on oxidative albumin modification and albumin binding capacity in chronic liver failure. Basic Clin Pharmacol Toxicol 2024; 134:375-384. [PMID: 38093476 DOI: 10.1111/bcpt.13973] [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: 08/16/2023] [Revised: 11/27/2023] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Abstract
Oxidative albumin modification and impaired albumin binding function have been described both in chronic liver failure and for therapeutic albumin solutions. The aim of the present study was to evaluate the effect of albumin infusion on redox state and binding function of circulating albumin. We studied 20 patients with cirrhosis who routinely received albumin infusions for prevention of post-paracentesis circulatory dysfunction or treatment of hepatorenal syndrome. We measured albumin fractions by redox state of cysteine-34 and albumin binding properties using dansylsarcosine as site II ligand. Therapeutic albumin solutions showed high contents of human nonmercaptalbumin-1 and human nonmercaptalbumin-2, exceeding the respective values in our patients with decompensated cirrhosis. An initial protocol for the first nine patients sampled at baseline, 24 h and 48 h after albumin infusion revealed no significant changes of oxidized albumin species or albumin binding properties. However, a modified protocol for the remaining 11 patients sampled at baseline, <1 h after and 24 h after albumin infusion revealed short-lived changes of oxidized albumin species while no changes in albumin binding properties were observed. In conclusion, therapeutic albumin infusion transiently changed albumin redox state but did not improve binding function of circulating albumin in chronic liver failure.
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Affiliation(s)
- Rudolf E Stauber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
| | - Irina Balazs
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- CBmed Center of Biomarker Research in Medicine, Graz, Austria
| | - Angela Horvath
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- CBmed Center of Biomarker Research in Medicine, Graz, Austria
| | - Nicole Feldbacher
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- CBmed Center of Biomarker Research in Medicine, Graz, Austria
| | - Andreas Posch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Florian Rainer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Vanessa Stadlbauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- CBmed Center of Biomarker Research in Medicine, Graz, Austria
| | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center for Vascular Biology, Immunology and Inflammation, Medical University of Graz, Graz, Austria
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Boss K, Waterstradt K, Schnurr K, Paar M, Stolpe S, Ickerott P, Wieneke U, Spitthöver R, Oettl K, Kribben A. Binding and detoxification efficiency of albumin decline after haemodialysis. Nephrol Dial Transplant 2024; 39:215-221. [PMID: 37558390 PMCID: PMC10828194 DOI: 10.1093/ndt/gfad133] [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: 03/19/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Albumin, as the most abundant plasma protein, represents a target structure for both drug and physicochemical therapeutic approaches to eliminate uraemic toxins more efficiently. Potentially, this approach could reduce mortality of haemodialysis patients. However, little is known about albumin functional properties in these patients and its alteration by haemodialysis treatment. METHODS The binding and detoxification efficiency of albumin were assessed by electron paramagnetic resonance spectroscopy using a spin-labelled fatty acid. Binding efficiency (BE) reflects strength and amount of bound fatty acids under certain ethanol concentration. Detoxification efficiency (DTE) reflects the molecular flexibility of the patient's albumin molecule, thus the ability to change the conformation depending on ethanol concentration. Percentage of BE and DTE are depicted in relation to healthy individuals (100%). RESULTS Fifty-eight patients (59% male, median age 68 years, median time on haemodialysis 32 months) were included in the study. Before haemodialysis treatment, albumin binding and detoxification efficiency were substantially below healthy individuals [median BE 52% (interquartile range, IQR, 45%-59%); median DTE 38% (IQR 32-49%)]. After haemodialysis treatment, median BE and DTE significantly decreased [BE 28% (IQR 20-41%); DTE 11% (IQR 7%-27%; P < .001)]. BE and DTE decline after haemodialysis was not dependent on age, sex or treatment modalities, but was to a certain extent on the level of non-esterified fatty acids. CONCLUSION Albumin binding and detoxification efficiency of fatty acids in maintenance haemodialysis patients were substantially below those in healthy individuals and even declined after dialysis treatment. These findings might be helpful when considering new therapeutic approaches in maintenance haemodialysis patients.
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Affiliation(s)
- Kristina Boss
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | | | - Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Susanne Stolpe
- Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Philipp Ickerott
- Gemeinschaftspraxis für Nieren- und Hochdruckkrankheiten Essen-Steele, Essen, Germany
| | | | | | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Paar M, Cvirn G, Hoerl G, Reibnegger G, Sourij H, Sourij C, Kojzar H, Oettl K. Albumin of People with Diabetes Mellitus Is More Reduced at Low HbA1c. Int J Mol Sci 2023; 24:16256. [PMID: 38003446 PMCID: PMC10671031 DOI: 10.3390/ijms242216256] [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] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
Oxidative stress is involved in the development, progression, and complications of diabetes mellitus (DM). Oxidative modification of human serum albumin's cysteine-34 is a marker for oxidative stress-related pathological conditions. We aimed to evaluate the redox state of albumin in patients with DM to investigate possible correlations with age, diabetes duration, and disease control status. Plasma aliquots were collected from 52 participants (26 type 1 and 26 type 2 DM). Patients were divided into two groups according to their glycated hemoglobin levels less than or equal to and greater than 58 mmol/L. Albumin redox state was assessed with high-performance liquid chromatography by fractionating it into human mercaptalbumin (HMA) and human nonmercaptalbumin 1 and 2 (HNA1 and HNA2). Albumin redox fractions were differently related to the age of study participants. In age-matched T1DM and T2DM groups, the albumin redox state was essentially the same. Irreversibly oxidized HNA2 was positively correlated with diabetes duration, especially in the T1DM group. HNA was increased in people with an increased HbA1c (>58 mmol/mol). Our results support the hypothesis that oxidative stress plays a crucial role in DM pathogenesis and emphasize the importance of diabetes control on systemic oxidative burden.
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Affiliation(s)
- Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (M.P.); (G.C.); (G.H.); (G.R.)
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (M.P.); (G.C.); (G.H.); (G.R.)
| | - Gerd Hoerl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (M.P.); (G.C.); (G.H.); (G.R.)
| | - Gilbert Reibnegger
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (M.P.); (G.C.); (G.H.); (G.R.)
| | - Harald Sourij
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.K.)
| | - Caren Sourij
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria;
| | - Harald Kojzar
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria; (H.S.); (H.K.)
| | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria; (M.P.); (G.C.); (G.H.); (G.R.)
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Boss K, Paar M, Waterstradt K, Schnurr K, Ickerott P, Wieneke U, Spitthöver R, Oettl K, Kribben A. Albumin redox state of maintenance haemodialysis patients is positively altered after treatment. BMC Nephrol 2023; 24:273. [PMID: 37723426 PMCID: PMC10506191 DOI: 10.1186/s12882-023-03317-9] [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: 05/18/2023] [Accepted: 09/04/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND AND AIM Maintenance haemodialysis patients have increased morbidity and mortality which is mainly driven by an elevated inflammation level due to the uraemic milieu. A major part of this increased inflammation level is the degree of oxidative stress which can be assessed by albumin redox state (ARS). Aim of this study was to evaluate how the ARS is affected by a haemodialysis treatment and different dialyzer properties. METHODS ARS was determined before and after haemodialysis treatment by fractionating it into reduced human mercaptalbumin (HMA), reversibly oxidized human non-mercaptalbumin 1 (HNA-1), and irreversibly oxidized human non-mercaptalbumin 2 (HNA-2) by high-performance liquid chromatography. In healthy individuals, albumin circulates in the following proportions: HMA 70-80%, HNA-1 20-30% and HNA-2 2-5%. High flux (FX 100 [Fresenius Medical Care], BG 1.8 [Toray], Xevonta Hi 18 [B. Braun], CTA-2000 [Kawasumi]) and low flux FX10 [Fresenius Medical Care] dialyzers were used. RESULTS 58 patients (59% male, median age 68 years, median time on haemodialysis 32 month) were included in the study. Before haemodialysis treatment, HMA (median 55.9%, IQR 50.1-61.2%) was substantially lower than in healthy individuals. Accordingly, oxidized albumin fractions were above the level of healthy individuals (median HNA-1 38.5%, IQR 33.3-43.2%; median HNA-2 5.8%, IQR 5.1-6.7%). Before haemodialysis treatment HMA was significantly higher in patients usually treated with high flux membranes (p < 0.01). After haemodialysis treatment there was a significant increase of HMA and a decrease of HNA-1 and HNA-2 (p < 0.01). These effects were more pronounced in patients treated with high flux dialyzers (p < 0.01). There were no differences of ARS alteration with regard to the dialyzer´s sterilization mode or the presence of diabetes. CONCLUSION The study confirms that the ARS is positively altered by haemodialysis and shows for the first time that this effect depends on dialyzer properties.
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Affiliation(s)
- Kristina Boss
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.
| | - Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Philipp Ickerott
- Gemeinschaftspraxis für Nieren- und Hochdruckkrankheiten Essen-Steele, Essen, Germany
| | | | | | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany
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Paar M, Fengler VH, Reibnegger G, Schnurr K, Waterstradt K, Schwaminger SP, Stauber RE, Oettl K. Determination of binding characteristics as a measure for effective albumin using different methods. Biochim Biophys Acta Gen Subj 2023:130427. [PMID: 37454915 DOI: 10.1016/j.bbagen.2023.130427] [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: 06/29/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND & AIMS Transport functions of albumin are of clinical and pharmacological interest and are determined by albumin's properties like posttranslational modifications or bound ligands. Both are affected in pathological conditions and in therapeutic grade albumin solutions. The term effective albumin concentration was introduced as a measure of functionally intact albumin. Our aim was to evaluate the impact of ligands and modifications with different approaches as a measure of effective albumin. APPROACH & RESULTS We used a spin labelled fatty acid and dansylsarcosine to characterize binding properties of albumin i) prepared from plasma of patients and healthy control donors, ii) measured directly out of plasma, iii) research grade albumin, iv) in vitro modified albumin, and v) therapeutic infusion solutions before and after removal of stabilizers. Bilirubin is the main determinant for binding function in patients' albumin. In in vitro prepared albumin bound fatty acids correlated with impaired binding. Human nonmercaptalbumin1, not human nonmercaptalbumin2, showed reduced binding properties. Binding and transport function of therapeutic albumin was severely impaired and restored by filtration. Glycation of research grade albumin had no effect on the binding of dansylsarcosine and only a minor effect on fatty acid binding. CONCLUSIONS Our results suggest that effective albumin -in terms of binding properties- is primarily determined by bound ligands and only to a minor extent by posttranslational modifications. Characterizing albumin directly from plasma better reflects the physiological situation whereas in the case of therapeutic grade albumin stabilizers should be removed to make its binding properties accessible.
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Affiliation(s)
- Margret Paar
- Medical University of Graz, Otto Loewi Research Center, Division of Medicinal Chemistry, Neue Stiftingtalstrasse 6, 8010, Graz, Austria
| | - Vera H Fengler
- University of Graz, Institute of Molecular Biosciences, Humboldtstrasse 50, 8010, Graz, Austria
| | - Gilbert Reibnegger
- Medical University of Graz, Otto Loewi Research Center, Division of Medicinal Chemistry, Neue Stiftingtalstrasse 6, 8010, Graz, Austria
| | - Kerstin Schnurr
- MedInnovation GmbH, Wissenschaftsstandort Berlin-Adlershof (WISTA), Groß-Berliner Damm 151, 12487 Berlin, Germany
| | - Katja Waterstradt
- MedInnovation GmbH, Wissenschaftsstandort Berlin-Adlershof (WISTA), Groß-Berliner Damm 151, 12487 Berlin, Germany
| | - Sebastian P Schwaminger
- Medical University of Graz, Otto Loewi Research Center, Division of Medicinal Chemistry, Neue Stiftingtalstrasse 6, 8010, Graz, Austria; BioTechMed-Graz, Mozartgasse 12, 8010 Graz, Austria
| | - Rudolf E Stauber
- Medical University of Graz, Department of Internal Medicine, Division of Gastroenterology and Hepatology, Auenbruggerplatz 15, 8036 Graz, Austria
| | - Karl Oettl
- Medical University of Graz, Otto Loewi Research Center, Division of Medicinal Chemistry, Neue Stiftingtalstrasse 6, 8010, Graz, Austria.
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Agarwal B, Cañizares RB, Saliba F, Ballester MP, Tomescu DR, Martin D, Stadlbauer V, Wright G, Sheikh M, Morgan C, Alzola C, Lavin P, Green D, Kumar R, Sacleux SC, Schilcher G, Koball S, Tudor A, Minten J, Domenech G, Aragones JJ, Oettl K, Paar M, Waterstradt K, Bode-Boger SM, Ibáñez-Samaniego L, Gander A, Ramos C, Chivu A, Stange J, Lamprecht G, Sanchez M, Mookerjee RP, Davenport A, Davies N, Pavesi M, Andreola F, Albillos A, Cordingley J, Schmidt H, Carbonell-Asins JA, Arroyo V, Fernandez J, Mitzner S, Jalan R. Randomized, controlled clinical trial of the DIALIVE liver dialysis device versus standard of care in patients with acute-on- chronic liver failure. J Hepatol 2023; 79:79-92. [PMID: 37268222 DOI: 10.1016/j.jhep.2023.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/16/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND & AIMS Acute-on-chronic liver failure (ACLF) is characterized by severe systemic inflammation, multi-organ failure and high mortality rates. Its treatment is an urgent unmet need. DIALIVE is a novel liver dialysis device that aims to exchange dysfunctional albumin and remove damage- and pathogen-associated molecular patterns. This first-in-man randomized-controlled trial was performed with the primary aim of assessing the safety of DIALIVE in patients with ACLF, with secondary aims of evaluating its clinical effects, device performance and effect on pathophysiologically relevant biomarkers. METHODS Thirty-two patients with alcohol-related ACLF were included. Patients were treated with DIALIVE for up to 5 days and end points were assessed at Day 10. Safety was assessed in all patients (n = 32). The secondary aims were assessed in a pre-specified subgroup that had at least three treatment sessions with DIALIVE (n = 30). RESULTS There were no significant differences in 28-day mortality or occurrence of serious adverse events between the groups. Significant reduction in the severity of endotoxemia and improvement in albumin function was observed in the DIALIVE group, which translated into a significant reduction in the CLIF-C (Chronic Liver Failure consortium) organ failure (p = 0.018) and CLIF-C ACLF scores (p = 0.042) at Day 10. Time to resolution of ACLF was significantly faster in DIALIVE group (p = 0.036). Biomarkers of systemic inflammation such as IL-8 (p = 0.006), cell death [cytokeratin-18: M30 (p = 0.005) and M65 (p = 0.029)], endothelial function [asymmetric dimethylarginine (p = 0.002)] and, ligands for Toll-like receptor 4 (p = 0.030) and inflammasome (p = 0.002) improved significantly in the DIALIVE group. CONCLUSIONS These data indicate that DIALIVE appears to be safe and impacts positively on prognostic scores and pathophysiologically relevant biomarkers in patients with ACLF. Larger, adequately powered studies are warranted to further confirm its safety and efficacy. IMPACT AND IMPLICATIONS This is the first-in-man clinical trial which tested DIALIVE, a novel liver dialysis device for the treatment of cirrhosis and acute-on-chronic liver failure, a condition associated with severe inflammation, organ failures and a high risk of death. The study met the primary endpoint, confirming the safety of the DIALIVE system. Additionally, DIALIVE reduced inflammation and improved clinical parameters. However, it did not reduce mortality in this small study and further larger clinical trials are required to re-confirm its safety and to evaluate efficacy. CLINICAL TRIAL NUMBER NCT03065699.
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Affiliation(s)
- Banwari Agarwal
- Intensive Care Unit, Royal Free Hospital, London, UK; Institute for Liver & Digestive Health, University College London, London, UK
| | - Rafael Bañares Cañizares
- Department of Gastroenterology and Hepatology, Gregorio Marañón General University Hospital, Spain; Health Research Institute Gregorio Marañón, Department of Medicine Complutense University of Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain
| | - Faouzi Saliba
- AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, INSERM unit N° 1193, Université Paris-Saclay, France
| | - Maria Pilar Ballester
- INCLIVA Biomedical Research Institute, Hospital Clínico Universitario de Valencia, Spain; Digestive Disease Department, Hospital Clínico Universitario de Valencia, Spain
| | - Dana Rodica Tomescu
- Carol Davila University of Medicine and Pharmacy, Romania; Fundeni Clinical Institute Bucharest, Romania
| | - Daniel Martin
- Peninsula Medical School, University of Plymouth, UK
| | - Vanessa Stadlbauer
- Department of Internal Medicine, Division of Gastroenterology und Hepatology, Medical University of Graz, Austria
| | - Gavin Wright
- Basildon and Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, UK
| | - Mohammed Sheikh
- Institute for Liver & Digestive Health, University College London, London, UK
| | | | | | - Phillip Lavin
- Boston Biostatistics Research Foundation, Inc, Framingham MA, USA
| | | | | | - Sophie Caroline Sacleux
- AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, INSERM unit N° 1193, Université Paris-Saclay, France
| | - Gernot Schilcher
- Department of Internal Medicine, Division of Gastroenterology und Hepatology, Medical University of Graz, Austria
| | | | | | | | - Gema Domenech
- Medical Statistics Core Facility IDIBAPS - Hospital Clinic, Barcelona, USA
| | - Juan Jose Aragones
- Medical Statistics Core Facility IDIBAPS - Hospital Clinic, Barcelona, USA
| | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | | | | | - Luis Ibáñez-Samaniego
- Department of Gastroenterology and Hepatology, Gregorio Marañón General University Hospital, Spain; Health Research Institute Gregorio Marañón, Department of Medicine Complutense University of Madrid, Spain
| | - Amir Gander
- Tissue Access for Patient Benefit, Royal Free Hospital, UK
| | - Carolina Ramos
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, United Kingdom
| | - Alexandru Chivu
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, United Kingdom
| | - Jan Stange
- University Hospital Rostock, Germany; Fraunhofer IZI, Germany
| | - Georg Lamprecht
- Department of Medicine II, Division of Gastroenterology and Endocrinology, Rostock University, Medical Center, Rostock, Germany
| | | | | | - Andrew Davenport
- Institute for Liver & Digestive Health, University College London, London, UK
| | - Nathan Davies
- Institute for Liver & Digestive Health, University College London, London, UK
| | - Marco Pavesi
- European Foundation for the Study of Chronic Liver Failure (EF Clif), Barcelona, USA
| | - Fausto Andreola
- Institute for Liver & Digestive Health, University College London, London, UK
| | - Agustin Albillos
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Madrid, Spain; Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Madrid, Spain; Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS)
| | - Jeremy Cordingley
- Perioperative Medicine - Critical Care, St. Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Hartmut Schmidt
- Department of Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, 45147 Essen, Germany
| | | | - Vicente Arroyo
- European Foundation for the Study of Chronic Liver Failure (EF Clif), Barcelona, USA
| | | | - Steffen Mitzner
- Fraunhofer IZI, Germany; Department of Medicine II, Division of Gastroenterology and Endocrinology, Rostock University, Medical Center, Rostock, Germany
| | - Rajiv Jalan
- Institute for Liver & Digestive Health, University College London, London, UK; European Foundation for the Study of Chronic Liver Failure (EF Clif), Barcelona, USA.
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Paar M, Seifried K, Cvirn G, Buchmann A, Khalil M, Oettl K. Redox State of Human Serum Albumin in Multiple Sclerosis: A Pilot Study. Int J Mol Sci 2022; 23:ijms232415806. [PMID: 36555448 PMCID: PMC9779316 DOI: 10.3390/ijms232415806] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Like in many other pathologies, oxidative stress is involved in the development of neurodegenerative disorders. Human serum albumin (HSA) is the main protein in different body fluids including cerebrospinal fluid (CSF). By its redox state in terms of cysteine-34, albumin serves as marker for oxidative burden. We aimed to evaluate the redox state of HSA in patients with multiple sclerosis in serum and CSF in comparison to controls to identify possible correlations with disease activity and severity. Samples were stored at -70 °C until analysis by HPLC for the determination of albumin redox state in terms of the fractions of human mercaptalbumin (HMA), human nonmercaptalbumin1 (HNA1), and human nonmercaptalbumin2 (HNA2). Albumin in CSF showed significantly higher fractions of the reduced form HMA and decreased HNA1 and HNA2. There was no difference between albumin redox states in serum of patients and controls. In CSF of patients HNA2 showed a trend to higher fractions compared to controls. Albumin redox state in serum was associated with physical disability in remission while albumin redox state in CSF was related to disease activity. Thus, albumin redox state in serum and CSF of patients in relation to disease condition merits further investigation.
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Affiliation(s)
- Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Katharina Seifried
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Arabella Buchmann
- Department of Neurology, Medical University of Graz, 8036 Graz, Austria
| | - Michael Khalil
- Department of Neurology, Medical University of Graz, 8036 Graz, Austria
- Correspondence: (M.K.); (K.O.); Tel.: +43-(0)316-385-30313 (M.K.); +43-(0)316-385-72121 (K.O.)
| | - Karl Oettl
- Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
- Correspondence: (M.K.); (K.O.); Tel.: +43-(0)316-385-30313 (M.K.); +43-(0)316-385-72121 (K.O.)
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Boss K, Stettner M, Szepanowski F, Mausberg AK, Paar M, Pul R, Kleinschnitz C, Oettl K, Kribben A. Severe and long-lasting alteration of albumin redox state by plasmapheresis. Sci Rep 2022; 12:12165. [PMID: 35842435 PMCID: PMC9288533 DOI: 10.1038/s41598-022-16452-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 07/11/2022] [Indexed: 11/22/2022] Open
Abstract
Plasmapheresis (PE) is an established form of therapeutic apheresis (TA). Purpose of this longitudinal prospective single center study was to investigate the effect of PE on albumin redox state (ARS), as infusion of commercial albumin during PE may alter albumin oxidation which has an impact on its functional properties and oxidative stress level. 43 subjects with autoimmune-mediated neurological disorders were included. 20 subjects in the experimental group received five treatments of PE. 13 subjects received five treatments of immunoadsorption and 10 subjects received no TA as controls. ARS was determined before and after TA and 12 days after the last TA by fractionating it into human mercaptalbumin (HMA), human non-mercaptalbumin 1 (HNA-1), and human non-mercaptalbumin 2 (HNA-2) by high-performance liquid chromatography. Irreversibly oxidised HNA-2 increased over the course of five PE treatments from 2.8% (IQR 1.3–3.7%) to 13.6% (IQR 10.9–15.9) (P < 0.01) and remained elevated 12 days after the last PE procedure (7.7% IQR 7.1–10.5, P < 0.05). The study showed for the first time that PE exerts a severe and long-lasting alteration on ARS indicating a new adverse effect of PE, that may influence oxidative stress level.
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Affiliation(s)
- Kristina Boss
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany.
| | - Mark Stettner
- Department of Neurology and Center for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Fabian Szepanowski
- Department of Neurology and Center for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Anne K Mausberg
- Department of Neurology and Center for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Margret Paar
- Division of Physiological Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Refik Pul
- Department of Neurology and Center for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology and Center for Translational Neuro- and Behavioural Sciences (C-TNBS), University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Karl Oettl
- Division of Physiological Chemistry, Otto Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Andreas Kribben
- Department of Nephrology, University Hospital Essen, University Duisburg-Essen, 45147, Essen, Germany
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9
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Dahaba AA, Xiao Z, Zhu X, Oettl K, Dong H, Xiong L, Zelzer S, Zhao S, Reibnegger G. Cover Image, Volume 36, Issue 1. Fundam Clin Pharmacol 2022. [DOI: 10.1111/fcp.12762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Paar M, Fengler VH, Rosenberg DJ, Krebs A, Stauber RE, Oettl K, Hammel M. Albumin in patients with liver disease shows an altered conformation. Commun Biol 2021; 4:731. [PMID: 34127764 PMCID: PMC8203801 DOI: 10.1038/s42003-021-02269-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/27/2021] [Indexed: 12/14/2022] Open
Abstract
Human serum albumin (HSA) constitutes the primary transporter of fatty acids, bilirubin, and other plasma compounds. The binding, transport, and release of its cargos strongly depend on albumin conformation, which is affected by bound ligands induced by physiological and pathological conditions. HSA is both highly oxidized and heavily loaded with fatty acids and bilirubin in chronic liver disease. By employing small-angle X-ray scattering we show that HSA from the plasma of chronic liver disease patients undergoes a distinct opening compared to healthy donors. The extent of HSA opening correlates with clinically relevant variables, such as the model of end-stage liver disease score, bilirubin, and fatty acid levels. Although the mild oxidation of HSA in vitro does not alter overall structure, the alteration of patients’ HSA correlates with its redox state. This study connects clinical data with structural visualization of albumin dynamicity in solution and underlines the functional importance of albumin’s inherent flexibility. Paar et al. propose a SAXS-based approach to study conformations of human serum albumin (HSA) from patients with liver disease and a structural understanding of HSA dynamicity and its correlation with clinical variables are provided. Using it on real clinical samples, this study has concrete practical implications too.
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Affiliation(s)
- Margret Paar
- Division of Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Vera H Fengler
- Division of Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Graz, Austria
| | - Daniel J Rosenberg
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.,Graduate Group in Biophysics, University of California, Berkeley, CA, USA
| | - Angelika Krebs
- Science Technology Interface-Structural Biology, Center for Medical Research, Medical University of Graz, Graz, Austria
| | - Rudolf E Stauber
- Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Karl Oettl
- Division of Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Graz, Austria.
| | - Michal Hammel
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
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11
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Dahaba AA, Xiao Z, Zhu X, Oettl K, Dong H, Xiong L, Zelzer S, Zhao S, Reibnegger G. Location matters: Overlooked ethnic-geographic effect in China and Austria on propofol/cisatracurium sex differences among a population pharmacokinetic/pharmacodynamic (PopPK/PD) covariate analysis in men, women, and one transgender subject. Fundam Clin Pharmacol 2021; 36:182-198. [PMID: 34050969 DOI: 10.1111/fcp.12704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
A quick literature search using "sex/gender" vs. the commonly used hypnotic propofol or neuromuscular-blocking agent cisatracurium will reveal numerous contradictory sex difference publications depending on the ethnic-geographic location of where these studies were conducted. We induced anesthesia with cisatracurium besylate (GlaxoSmithKline) 100 μg kg-1 administered exactly 1 minute following propofol (AstraZeneca) 2 mg kg-1 . In 20 male and 20 female ethnic Han-Chinese test set patients (Xi'an China), and in similar ethnic white Austrian validation set patients (Graz Austria), we quantified propofol/cisatracurium pharmacodynamic parameters namely propofol onset time, lag time, plasma concentrations (Cp ) at loss-of-behavioral response (LOBR) using bispectral index (BIS); cisatracurium onset time, lag time, and Cp at T1 % (first twitch of train-of-four) complete twitch suppression using mechanomyography (MMG). Serial arterial blood samples were collected for population pharmacokinetic (PopPK) analysis of all demographic and biological covariates (region, sex, age, weight, and height) versus volumes of distribution and clearances pharmacokinetic parameters. In Chinese women (but not in white women), propofol Cp at LOBR was 33.60% lower than men and cisatracurium Cp at T1 % complete twitch suppression was 21.49% lower than men, a clear pharmacodynamic assertion. Region and weight were significant PopPK covariates. We demonstrated that sex differences are influenced by ethnic-geographic location as only in Chinese women (but not in white women) propofol Cp at LOBR and cisatracurium Cp at T1 % complete twitch suppression were lower than in men. When defining sex differences, ethnic-geographic location should be taken into consideration as a predictive factor for optimizing propofol/cisatracurium initial loading recommended dosages.
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Affiliation(s)
- Ashraf A Dahaba
- Department of Anaesthesiology and Intensive Care Medicine, Suez Canal University, Ismailia, Egypt
| | - Zhaoyang Xiao
- Department of Anesthesiology, Xijing Hospital of Fourth Military Medical University, Xi'an, Shanxi, China.,Department of Anesthesiology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaoling Zhu
- Department of Anesthesiology, Xijing Hospital of Fourth Military Medical University, Xi'an, Shanxi, China
| | - Karl Oettl
- Otto-Loewi Research Center for Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Hailong Dong
- Department of Anesthesiology, Xijing Hospital of Fourth Military Medical University, Xi'an, Shanxi, China
| | - Lize Xiong
- Department of Anesthesiology, Xijing Hospital of Fourth Military Medical University, Xi'an, Shanxi, China
| | - Sieglinde Zelzer
- Institute for Medical and Chemical Diagnostics, Medical University of Graz, Graz, Austria
| | - Shuiyu Zhao
- Shanghai Qiangshi Information Technology Co. Ltd, Shanghai, China
| | - Gilbert Reibnegger
- Otto-Loewi Research Center for Physiological Chemistry, Medical University of Graz, Graz, Austria
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12
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López-Vicario C, Checa A, Urdangarin A, Aguilar F, Alcaraz-Quiles J, Caraceni P, Amorós A, Pavesi M, Gómez-Cabrero D, Trebicka J, Oettl K, Moreau R, Planell N, Arroyo V, Wheelock CE, Clària J. Targeted lipidomics reveals extensive changes in circulating lipid mediators in patients with acutely decompensated cirrhosis. J Hepatol 2020; 73:817-828. [PMID: 32294533 DOI: 10.1016/j.jhep.2020.03.046] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/04/2020] [Accepted: 03/25/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Acute-on-chronic liver failure (ACLF) is a newly described syndrome, which develops in patients with acute decompensation of cirrhosis, and is characterized by intense systemic inflammation, multiple organ failures and high short-term mortality. The profile of circulating lipid mediators, which are endogenous signaling molecules that play a major role in inflammation and immunity, is poorly characterized in ACLF. METHODS In the current study, we assessed the profile of lipid mediators by liquid chromatography coupled to tandem mass spectrometry in plasma from patients with acute decompensation of cirrhosis, with (n = 119) and without (n = 127) ACLF, and from healthy controls (n = 18). Measurements were prospectively repeated in 191 patients with acute decompensation of cirrhosis during a 28-day follow-up period. RESULTS Fifty-nine lipid mediators (out of 100) were detected in plasma from cirrhotic patients, of which 16 were significantly associated with disease status. Among these, 11 lipid mediators distinguished patients at any stage from healthy controls, whereas 2 lipid mediators (LTE4 and 12-HHT, both derived from arachidonic acid) shaped a minimal plasma fingerprint that discriminated patients with ACLF from those without. Levels of LTE4 distinguished ACLF grade 3 from ACLF grades 1 and 2, followed the clinical course of the disease (increased with worsening and decreased with improvement) and positively correlated with markers of inflammation and non-apoptotic cell death. Moreover, LTE4 together with LXA5 (derived from eicosapentaenoic acid) and EKODE (derived from linoleic acid) were associated with short-term mortality. LXA5 and EKODE formed a signature associated with coagulation and liver failures. CONCLUSION Taken together, these findings uncover specific lipid mediator profiles associated with disease severity and prognosis in patients with acute decompensation of cirrhosis. LAY SUMMARY Acute-on-chronic liver failure (ACLF) is characterized by intense systemic inflammation, multiple organ failures and high short-term mortality. In the current study, we assessed the plasma lipid profile of 100 bioactive lipid mediators in healthy controls, patients with decompensated cirrhosis, and those who had developed ACLF. We identified lipid mediator signatures associated with inflammation and non-apoptotic cell death that discriminate disease severity and evolution, short-term mortality and organ failures.
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Affiliation(s)
- Cristina López-Vicario
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain; Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS and CIBERehd, Barcelona, Spain
| | - Antonio Checa
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | | | - Ferran Aguilar
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain
| | - José Alcaraz-Quiles
- Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS and CIBERehd, Barcelona, Spain
| | - Paolo Caraceni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alex Amorós
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain
| | - Marco Pavesi
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain
| | | | - Jonel Trebicka
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain; J.W. Goethe University Hospital, Frankfurt, Germany
| | - Karl Oettl
- Institute of Physiological Chemistry, Center of Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Richard Moreau
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain; Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), UMRS1149; Université Paris Diderot-Paris 7, Paris, France
| | - Núria Planell
- Translational Bioinformatics Unit, NavarraBiomed, Pamplona, Spain
| | - Vicente Arroyo
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain
| | - Craig E Wheelock
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - Joan Clària
- European Foundation for the Study of Chronic Liver Failure (EF-Clif) and Grifols Chair, Barcelona, Spain; Biochemistry and Molecular Genetics Service, Hospital Clínic-IDIBAPS and CIBERehd, Barcelona, Spain; Department of Biomedical Sciences, University of Barcelona, Barcelona, Spain.
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13
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Schwab C, Paar M, Fengler VH, Lindner E, Haas A, Ivastinovic D, Seidel G, Weger M, Wedrich A, Oettl K. Vitreous albumin redox state in open-angle glaucoma patients and controls: a pilot study. Int Ophthalmol 2020; 40:999-1006. [PMID: 31925660 DOI: 10.1007/s10792-019-01268-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Numerous studies suggest that reactive oxygen species play a crucial role in the development of glaucoma. Since glaucoma patients exhibit posterior vitreous detachment earlier than controls, it has been suggested that reactive oxygen species-increased in glaucoma-also affect the vitreous. In the present study we evaluated the influence of open-angle glaucoma oxidative stress on the redox state of vitreous albumin. METHODS Albumin redox states of the vitreous and plasma were evaluated in 22 subjects-11 open-angle glaucoma patients and 11 controls-matched for age, gender, and vitreous state. According to the redox state of cysteine-34, albumin can be separated into: human mercaptalbumin (the thiol form), human nonmercaptalbumin1 (a reversible modification due to mild oxidation), and human nonmercaptalbumin2 (an irreversible modification due to severe oxidation). RESULTS Albumin of both, the open-angle glaucoma group and the control group, was more oxidized in the vitreous compared to plasma. Furthermore, significantly higher human nonmercaptalbumin1 fractions were found in the vitreous of open-angle glaucoma patients compared to controls. No significant differences were found in the plasma albumin fractions between the groups. CONCLUSION Our results support the hypothesis that oxidative stress plays a crucial role in open-angle glaucoma and that reactive oxygen species in glaucomatous eyes may also affect the vitreous.
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Affiliation(s)
- Christoph Schwab
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Margret Paar
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria.
| | - Vera Heike Fengler
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
| | - Ewald Lindner
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Anton Haas
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Domagoj Ivastinovic
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Gerald Seidel
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Martin Weger
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Karl Oettl
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010, Graz, Austria
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14
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Schwab C, Paar M, Fengler VH, Ivastinovic D, Haas A, Seidel G, Glatz W, Malle EM, Weger M, Velikay-Parel M, Faustmann G, Wedrich A, Reibnegger G, Winklhofer-Roob B, Oettl K. Gender differences in albumin and ascorbic acid in the vitreous antioxidant system. Free Radic Biol Med 2020; 146:257-263. [PMID: 31705958 DOI: 10.1016/j.freeradbiomed.2019.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 11/04/2019] [Indexed: 11/21/2022]
Abstract
Ascorbic acid is present at high concentrations in the vitreous and plays a central role in vitreous redox chemistry. Albumin is the main protein in the vitreous with antioxidant properties and occurs in different oxidation states, which can be used as redox indicators, but have not been studied in the vitreous. This study, therefore, addressed the vitreous redox state of cysteine-34 of albumin in relation to the ascorbic acid content, which has been suggested to exert a main function in detoxifying reactive oxygen in the vitreous. A total of 58 vitreous samples obtained from patients undergoing vitrectomy were analyzed for (i) human mercaptalbumin (HMA), the reduced thiol form; (ii) human non-mercaptalbumin1 (HNA1), a reversible oxidative modification with a disulfide at cysteine-34; and (iii) human non-mercaptalbumin2 (HNA2), a non-reversibly (highly) oxidized form of albumin; as well as (iv) ascorbic acid concentrations, to study possible relations. In addition, blood samples were taken to compare albumin redox state between plasma and the vitreous. Vitreous albumin showed greater variability in the redox state of cysteine-34 and a shift to the oxidized fractions compared to plasma albumin (P < 0.001). A strong positive relation was observed between the vitreous ascorbic acid concentrations and the reversibly oxidized form, HNA1 (P < 0.001), and a negative relation with the reduced form, HMA. Positive relations between ascorbic acid and HNA1 in the vitreous were stronger in men than in women. In contrast to HMA and HNA1, there was a distinct gender difference noted for the irreversibly oxidized form, HNA2. While males showed a positive relation between the vitreous ascorbic acid concentrations and HNA2, there was no correlation found with HNA2 in females. Our results support the view that ascorbic acid, by decreasing either directly or indirectly the concentrations of molecular oxygen, generates hydrogen peroxide, and that thiols, including HMA, are acting as antioxidants. This study for the first time provides evidence that vitreous albumin can be used as a marker molecule for the appearance of reactive oxygen species in the vitreous of patients undergoing vitrectomy. Moreover, it can be shown that there are gender differences in vitreous ascorbic acid and albumin concentrations as well as in oxidation state of vitreous albumin.
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Affiliation(s)
- Christoph Schwab
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Margret Paar
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria.
| | - Vera Heike Fengler
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Domagoj Ivastinovic
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Anton Haas
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Gerald Seidel
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Wilfried Glatz
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Eva-Maria Malle
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Martin Weger
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Michaela Velikay-Parel
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Gernot Faustmann
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University of Graz, Auenbruggerplatz 4, 8036 Graz, Austria
| | - Gilbert Reibnegger
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
| | - Brigitte Winklhofer-Roob
- Human Nutrition & Metabolism Research and Training Center, Institute of Molecular Biosciences, University of Graz, Universitätsplatz 2, 8010 Graz, Austria
| | - Karl Oettl
- Physiological Chemistry, Otto-Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6, 8010 Graz, Austria
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15
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Clària J, Moreau R, Fenaille F, Amorós A, Junot C, Gronbaek H, Coenraad MJ, Pruvost A, Ghettas A, Chu-Van E, López-Vicario C, Oettl K, Caraceni P, Alessandria C, Trebicka J, Pavesi M, Deulofeu C, Albillos A, Gustot T, Welzel TM, Fernández J, Stauber RE, Saliba F, Butin N, Colsch B, Moreno C, Durand F, Nevens F, Bañares R, Benten D, Ginès P, Gerbes A, Jalan R, Angeli P, Bernardi M, Arroyo V. Orchestration of Tryptophan-Kynurenine Pathway, Acute Decompensation, and Acute-on-Chronic Liver Failure in Cirrhosis. Hepatology 2019; 69:1686-1701. [PMID: 30521097 DOI: 10.1002/hep.30363] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 10/22/2018] [Indexed: 12/12/2022]
Abstract
Systemic inflammation (SI) is involved in the pathogenesis of acute decompensation (AD) and acute-on-chronic liver failure (ACLF) in cirrhosis. In other diseases, SI activates tryptophan (Trp) degradation through the kynurenine pathway (KP), giving rise to metabolites that contribute to multiorgan/system damage and immunosuppression. In the current study, we aimed to characterize the KP in patients with cirrhosis, in whom this pathway is poorly known. The serum levels of Trp, key KP metabolites (kynurenine and kynurenic and quinolinic acids), and cytokines (SI markers) were measured at enrollment in 40 healthy subjects, 39 patients with compensated cirrhosis, 342 with AD (no ACLF) and 180 with ACLF, and repeated in 258 patients during the 28-day follow-up. Urine KP metabolites were measured in 50 patients with ACLF. Serum KP activity was normal in compensated cirrhosis, increased in AD and further increased in ACLF, in parallel with SI; it was remarkably higher in ACLF with kidney failure than in ACLF without kidney failure in the absence of differences in urine KP activity and fractional excretion of KP metabolites. The short-term course of AD and ACLF (worsening, improvement, stable) correlated closely with follow-up changes in serum KP activity. Among patients with AD at enrollment, those with the highest baseline KP activity developed ACLF during follow-up. Among patients who had ACLF at enrollment, those with immune suppression and the highest KP activity, both at baseline, developed nosocomial infections during follow-up. Finally, higher baseline KP activity independently predicted mortality in patients with AD and ACLF. Conclusion: Features of KP activation appear in patients with AD, culminate in patients with ACLF, and may be involved in the pathogenesis of ACLF, clinical course, and mortality.
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Affiliation(s)
- Joan Clària
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain.,Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Richard Moreau
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain.,Inserm, Centre de Recherche sur l'Inflammation, Université Paris Diderot-Paris, Département Hospitalo-Universitaire UNITY; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris; Laboratoire d'Excellence Inflamex, ComUE Sorbonne Paris Cité, Paris, France
| | - François Fenaille
- CEA, INRA, Université Paris Saclay, Laboratoire d'Etude du Métabolisme des Médicaments, MetaboHUB-Paris, Gif-Sur-Yvette, France
| | - Alex Amorós
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain
| | - Christophe Junot
- CEA, INRA, Université Paris Saclay, Laboratoire d'Etude du Métabolisme des Médicaments, MetaboHUB-Paris, Gif-Sur-Yvette, France
| | - Henning Gronbaek
- Department of Hepatology & Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Alain Pruvost
- CEA, INRA Université Paris Saclay, Service de Pharmacologie et Immunoanalyse, Plateforme SMArt-MS, Gif-sur-Yvette, France
| | - Aurélie Ghettas
- CEA, INRA Université Paris Saclay, Service de Pharmacologie et Immunoanalyse, Plateforme SMArt-MS, Gif-sur-Yvette, France
| | - Emeline Chu-Van
- CEA, INRA, Université Paris Saclay, Laboratoire d'Etude du Métabolisme des Médicaments, MetaboHUB-Paris, Gif-Sur-Yvette, France
| | | | - Karl Oettl
- Medical University of Graz, Graz, Austria
| | - Paolo Caraceni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Alessandria
- Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital, Torino, Italy
| | - Jonel Trebicka
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain.,Department of Internal Medicine I, University of Bonn, Bonn, Germany.,J.W. Goethe University Hospital, Frankfurt, Germany
| | - Marco Pavesi
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain
| | - Carme Deulofeu
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain
| | | | - Thierry Gustot
- CUB Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Javier Fernández
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain.,Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | | | - Faouzi Saliba
- Hôpital Paul Brousse, Université Paris-Sud, Villejuif, France
| | - Noémie Butin
- CEA, INRA, Université Paris Saclay, Laboratoire d'Etude du Métabolisme des Médicaments, MetaboHUB-Paris, Gif-Sur-Yvette, France
| | - Benoit Colsch
- CEA, INRA, Université Paris Saclay, Laboratoire d'Etude du Métabolisme des Médicaments, MetaboHUB-Paris, Gif-Sur-Yvette, France
| | - Christophe Moreno
- CUB Hopital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - François Durand
- Inserm, Centre de Recherche sur l'Inflammation, Université Paris Diderot-Paris, Département Hospitalo-Universitaire UNITY; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris; Laboratoire d'Excellence Inflamex, ComUE Sorbonne Paris Cité, Paris, France
| | | | - Rafael Bañares
- Facultad de Medicina, Universidad Complutense, Madrid, Spain
| | | | - Pere Ginès
- Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Alexander Gerbes
- Department of Medicine II, University Hospital LMU Munich, Liver Center Munich, Munich, Germany
| | - Rajiv Jalan
- Liver Failure Group, Institute for Liver Disease Health, University College London, Royal Free Hospital, London, United Kingdom
| | - Paolo Angeli
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain.,Unit of Internal Medicine and Hepatology, Department of Medicine, DIMED, University of Padova, Padoa, Italy
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Vicente Arroyo
- European Foundation for the Study of Chronic Liver Failure Consortium and Grifols Chair, Barcelona, Spain
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16
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Trebicka J, Amoros A, Pitarch C, Titos E, Alcaraz-Quiles J, Schierwagen R, Deulofeu C, Fernandez-Gomez J, Piano S, Caraceni P, Oettl K, Sola E, Laleman W, McNaughtan J, Mookerjee RP, Coenraad MJ, Welzel T, Steib C, Garcia R, Gustot T, Rodriguez Gandia MA, Bañares R, Albillos A, Zeuzem S, Vargas V, Saliba F, Nevens F, Alessandria C, de Gottardi A, Zoller H, Ginès P, Sauerbruch T, Gerbes A, Stauber RE, Bernardi M, Angeli P, Pavesi M, Moreau R, Clària J, Jalan R, Arroyo V. Addressing Profiles of Systemic Inflammation Across the Different Clinical Phenotypes of Acutely Decompensated Cirrhosis. Front Immunol 2019; 10:476. [PMID: 30941129 PMCID: PMC6434999 DOI: 10.3389/fimmu.2019.00476] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/21/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Patients with acutely decompensated cirrhosis (AD) may or may not develop acute-on-chronic liver failure (ACLF). ACLF is characterized by high-grade systemic inflammation, organ failures (OF) and high short-term mortality. Although patients with AD cirrhosis exhibit distinct clinical phenotypes at baseline, they have low short-term mortality, unless ACLF develops during follow-up. Because little is known about the association of profile of systemic inflammation with clinical phenotypes of patients with AD cirrhosis, we aimed to investigate a battery of markers of systemic inflammation in these patients. Methods: Upon hospital admission baseline plasma levels of 15 markers (cytokines, chemokines, and oxidized albumin) were measured in 40 healthy controls, 39 compensated cirrhosis, 342 AD cirrhosis, and 161 ACLF. According to EASL-CLIF criteria, AD cirrhosis was divided into three distinct clinical phenotypes (AD-1: Creatinine<1.5, no HE, no OF; AD-2: creatinine 1.5-2, and or HE grade I/II, no OF; AD-3: Creatinine<1.5, no HE, non-renal OF). Results: Most markers were slightly abnormal in compensated cirrhosis, but markedly increased in AD. Patients with ACLF exhibited the largest number of abnormal markers, indicating "full-blown" systemic inflammation (all markers). AD-patients exhibited distinct systemic inflammation profiles across three different clinical phenotypes. In each phenotype, activation of systemic inflammation was only partial (30% of the markers). Mortality related to each clinical AD-phenotype was significantly lower than mortality associated with ACLF (p < 0.0001 by gray test). Among AD-patients baseline systemic inflammation (especially IL-8, IL-6, IL-1ra, HNA2 independently associated) was more intense in those who had poor 28-day outcomes (ACLF, death) than those who did not experience these outcomes. Conclusions: Although AD-patients exhibit distinct profiles of systemic inflammation depending on their clinical phenotypes, all these patients have only partial activation of systemic inflammation. However, those with the most extended baseline systemic inflammation had the highest the risk of ACLF development and death.
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Affiliation(s)
- Jonel Trebicka
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.,Department of Internal Medicine I, University of Bonn, Bonn, Germany.,Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.,Department of Mechanical Biology, Institute for Bioengineering of Catalonia, Barcelona, Spain.,J.W. Goethe University Hospital, Frankfurt, Germany
| | - Alex Amoros
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
| | - Carla Pitarch
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
| | - Esther Titos
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - José Alcaraz-Quiles
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Robert Schierwagen
- Department of Internal Medicine I, University of Bonn, Bonn, Germany.,J.W. Goethe University Hospital, Frankfurt, Germany
| | - Carmen Deulofeu
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
| | | | - Salvatore Piano
- Unit of Internal Medicine and Hepatology, Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Paolo Caraceni
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Karl Oettl
- Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Elsa Sola
- Liver Unit, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Wim Laleman
- University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | | | | | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, Netherlands
| | - Tania Welzel
- J.W. Goethe University Hospital, Frankfurt, Germany
| | - Christian Steib
- Department of Medicine II, Liver Center Munich, University Hospital LMU Munich, Munich, Germany
| | - Rita Garcia
- Department of Digestive Diseases and CIBERehd, Facultad de Medicina, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | - Thierry Gustot
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Rafael Bañares
- Department of Digestive Diseases and CIBERehd, Facultad de Medicina, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, Spain
| | | | | | | | - Faouzi Saliba
- Hôpital Paul Brousse, Université Paris-Sud, Villejuif, France
| | - Frederic Nevens
- University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Carlo Alessandria
- Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital, Torino, Italy
| | | | - Heinz Zoller
- Department of Hepatology and Gastroenterology, University Clinic Innsbruck, Innsbruck, Austria
| | - Pere Ginès
- Liver Unit, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Tilman Sauerbruch
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | - Alexander Gerbes
- Department of Medicine II, Liver Center Munich, University Hospital LMU Munich, Munich, Germany
| | - Rudolf E Stauber
- Department of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Angeli
- Unit of Internal Medicine and Hepatology, Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Marco Pavesi
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
| | - Richard Moreau
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.,Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), UMRS1149, Paris, France.,Université Paris Diderot-Paris 7, Département Hospitalo-Universitaire (DHU) UNITY, Paris, France.,Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Paris, France.,Laboratoire d'Excellence Inflamex, ComUE Sorbonne Paris Cité, Paris, France
| | - Joan Clària
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain.,Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | | | - Vicente Arroyo
- European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
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17
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Alcaraz-Quiles J, Casulleras M, Oettl K, Titos E, Flores-Costa R, Duran-Güell M, López-Vicario C, Pavesi M, Stauber RE, Arroyo V, Clària J. Oxidized Albumin Triggers a Cytokine Storm in Leukocytes Through P38 Mitogen-Activated Protein Kinase: Role in Systemic Inflammation in Decompensated Cirrhosis. Hepatology 2018; 68:1937-1952. [PMID: 30070728 DOI: 10.1002/hep.30135] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [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: 01/12/2018] [Revised: 04/22/2018] [Accepted: 05/20/2018] [Indexed: 12/22/2022]
Abstract
Decompensated cirrhosis is characterized by exuberant systemic inflammation. Although the inducers of this feature remain unknown, the presence of circulating forms of oxidized albumin, namely human nonmercaptalbumin 1 (HNA1) and HNA2, is a common finding in cirrhosis. The aim of this study was to explore the ability of these oxidized albumin forms to induce systemic inflammation by triggering the activation of peripheral leukocytes. We observed significantly higher plasma levels of HNA1 and HNA2 in patients with cirrhosis (n = 256) compared to healthy volunteers (n = 48), which gradually increased during the course from compensated to decompensated to acute-on-chronic liver failure. Plasma HNA1 and HNA2 levels significantly correlated with inflammatory markers (i.e., interleukin-6 [IL-6], IL-1β, tumor necrosis factor-alpha [TNF-α] and IL-8) in patients with cirrhosis. To directly test the inflammatory effects of HNA1 and HNA2 on leukocytes, these oxidized albumin forms were prepared ex vivo and their posttranslational modifications monitored by liquid chromatography (LC)-quadrupole time-of-flight/mass spectrometry (MS). HNA1, but not HNA2, increased IL-1β, IL-6, and TNF-α mRNA and protein expression in leukocytes from both healthy volunteers and patients with cirrhosis. Moreover, HNA1 up-regulated the expression of eicosanoid-generating enzymes (i.e., cyclooxygenase-2 [COX-2] and microsomal prostaglandin E [PGE] synthase 1) and the production of inflammatory eicosanoids (PGE2 , PGF2α , thromboxane B2 , and leukotriene B4 ), as determined by LC-electrospray ionization-MS/MS. The inflammatory response to HNA1 was more pronounced in peripheral blood mononuclear cells (PBMCs) and marginal in polymorphonuclear neutrophils. Kinome analysis of PBMCs revealed that HNA1 induced the phosphorylation of p38 mitogen-activated protein kinase, the inhibition of which blocked HNA1-induced cytokine and COX-2 induction. Conclusion: HNA1 triggers an inflammatory response in PBMCs, providing a rationale for its removal and replacement by reduced albumin in the prevention of systemic inflammation in patients with advanced liver disease.
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Affiliation(s)
- José Alcaraz-Quiles
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Mireia Casulleras
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Karl Oettl
- Institute of Physiological Chemistry, Center of Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Esther Titos
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Roger Flores-Costa
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Marta Duran-Güell
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Cristina López-Vicario
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Marco Pavesi
- European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain
| | - Rudolf E Stauber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Vicente Arroyo
- European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain
| | - Joan Clària
- Department of Biochemistry and Molecular Genetics, Hospital Clínic-IDIBAPS, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.,European Foundation for the Study of Chronic Liver Failure (EF-CLIF), Barcelona, Spain.,Department of Biomedical Sciences, University of Barcelona, Barcelona, Spain
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18
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Paar M, Rossmann C, Nusshold C, Wagner T, Schlagenhauf A, Leschnik B, Oettl K, Koestenberger M, Cvirn G, Hallström S. Anticoagulant action of low, physiologic, and high albumin levels in whole blood. PLoS One 2017; 12:e0182997. [PMID: 28800610 PMCID: PMC5553770 DOI: 10.1371/journal.pone.0182997] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/27/2017] [Indexed: 01/01/2023] Open
Abstract
Albumin is the most abundant plasma protein. Critical illness is often associated with altered, predominately decreased, serum albumin levels. This hypoalbuminaemia is usually corrected by administration of exogenous albumin. This study aimed to track the concentration-dependent influence of albumin on blood coagulation in vitro. Whole blood (WB) samples from 25 volunteers were prepared to contain low (19.3 ± 7.7 g/L), physiological (45.2 ± 7.8 g/L), and high (67.5 ± 18.1 g/L) levels of albumin. Haemostatic profiling was performed using a platelet function analyzer (PFA) 200, impedance aggregometry, a Cone and Platelet analyzer (CPA), calibrated automated thrombogram, and thrombelastometry (TEM). Platelet aggregation-associated ATP release was assessed via HPLC analysis. In the low albumin group, when compared to the physiological albumin group, we found: i) shortened PFA 200-derived closure times indicating increased primary haemostasis; ii) increased impedance aggregometry-derived amplitudes, slopes, ATP release, as well as CPA-derived average size indicating improved platelet aggregation; iii) increased TEM-derived maximum clot firmness and alpha angles indicating enhanced clot formation. TEM measurements indicated impaired clot formation in the high albumin group compared with the physiological albumin group. Thus, albumin exerted significant anticoagulant action. Therefore, low albumin levels, often present in cancer or critically ill patients, might contribute to the frequently occurring venous thromboembolism.
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Affiliation(s)
- Margret Paar
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Christine Rossmann
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Christoph Nusshold
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, Graz, Austria
| | | | - Bettina Leschnik
- Department of Pediatrics, Medical University of Graz, Graz, Austria
| | - Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | | | - Gerhard Cvirn
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
- * E-mail:
| | - Seth Hallström
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
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19
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Tran US, Berger N, Arendasy ME, Greitemeyer T, Himmelbauer M, Hutzler F, Kraft HG, Oettl K, Papousek I, Vitouch O, Voracek M. Unto the third generation: evidence for strong familial aggregation of physicians, psychologists, and psychotherapists among first-year medical and psychology students in a nationwide Austrian cohort census. BMC Med Educ 2017; 17:81. [PMID: 28468682 PMCID: PMC5415715 DOI: 10.1186/s12909-017-0921-4] [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] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 04/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Medical students present higher numbers of physician relatives than expectable from the total population prevalence of physicians. Evidence for such a familial aggregation effect of physicians has emerged in investigations from the Anglo-American, Scandinavian, and German-speaking areas. In particular, past data from Austria suggest a familial aggregation of the medical, as well as of the psychological and psychotherapeutic, professions among medical and psychology undergraduates alike. Here, we extend prior related studies by examining (1) the extent to which familial aggregation effects apply to the whole nation-wide student census of all relevant (eight) public universities in Austria; (2) whether effects are comparable for medical and psychology students; (3) and whether these effects generalize to relatives of three interrelated health professions (medicine, psychology, and psychotherapy). METHODS We investigated the familial aggregation of physicians, psychologists, and psychotherapists, based on an entire cohort census of first-year medical and psychology students (n = 881 and 920) in Austria with generalized linear mixed models. RESULTS For both disciplines, we found strong familial aggregation of physicians, psychologists, and psychotherapists. As compared with previous results, directionally opposite time trends within disciplines emerged: familial aggregation of physicians among medical students has decreased, whilst familial aggregation of psychologists among psychology students has increased. Further, there were sex-of-relative effects (i.e., more male than female physician relatives), but no substantial sex-of-student effects (i.e., male and female students overall reported similar numbers of relatives for all three professions of interest). In addition, there were age-benefit effects, i.e., students with a relative in the medical or the psychotherapeutic profession were younger than students without, thus suggesting earlier career decisions. CONCLUSIONS The familial aggregation of physicians, psychologists, and psychotherapists is high among medical and psychology undergraduates in Austria. Discussed are implications of these findings (e.g., gender equity, feminization of the medical field, ideas for curricular implementation and student counselling), study limitations, and avenues for future research.
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Affiliation(s)
- Ulrich S. Tran
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | - Nina Berger
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
| | | | | | - Monika Himmelbauer
- Department of Medical Education, Medical University of Vienna, Vienna, Austria
| | - Florian Hutzler
- Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Hans-Georg Kraft
- Division of Cell Genetics, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Ilona Papousek
- Department of Psychology, University of Graz, Graz, Austria
| | - Oliver Vitouch
- Department of Psychology, University of Klagenfurt, Klagenfurt, Austria
| | - Martin Voracek
- Department of Basic Psychological Research and Research Methods, School of Psychology, University of Vienna, Vienna, Austria
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20
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Schwab C, Glatz W, Schmidt B, Lindner E, Oettl K, Riedl R, Wedrich A, Ivastinovic D, Velikay-Parel M, Mossboeck G. Prevalence of posterior vitreous detachment in glaucoma patients and controls. Acta Ophthalmol 2017; 95:276-280. [PMID: 27966831 DOI: 10.1111/aos.13339] [Citation(s) in RCA: 9] [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: 07/04/2016] [Accepted: 10/21/2016] [Indexed: 01/09/2023]
Abstract
PURPOSE To evaluate the impact of oxidative stress - present in glaucoma - on the vitreous. We therefore compare the presence of early and late stages of posterior vitreous detachment (PVD) between patients with glaucoma and controls. METHODS The vitreous state was evaluated by the combination of optical coherence tomography and ultrasound. The main outcome was the vitreous state classified into 'no PVD', 'initial PVD' and 'advanced PVD'. RESULTS We evaluated the vitreous state in 48 patients with glaucoma (age: mean 66.5 ± 11.9 years; visual field deviation: mean 10.4 ± 6.8 dB) and compared the results with 101 previously investigated controls (age: mean 73.6 ± 9.3 years). After one-to-one matching on age and sex, ordinal logistic regression revealed that patients with glaucoma were significantly more likely to exhibit advanced PVD stages compared to non-glaucoma patients (OR 2.60, 95% confidence interval: 1.06-6.36, p = 0.037). CONCLUSION Our results suggest that the presence or absence of PVD might be a valuable hint for diagnosing glaucoma - however, further research is needed to determine whether PVD can be used to supplement current glaucoma screening guidelines.
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Affiliation(s)
- Christoph Schwab
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
| | - Wilfried Glatz
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
| | - Bernd Schmidt
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
| | - Ewald Lindner
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
| | - Karl Oettl
- Institute of Physiological Chemistry; Medical University of Graz; Graz Austria
| | - Regina Riedl
- Institute for Medical Informatics, Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Andreas Wedrich
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
| | | | | | - Georg Mossboeck
- Departement of Ophthalmology; Medical University of Graz; Graz Austria
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21
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Clària J, Stauber RE, Coenraad MJ, Moreau R, Jalan R, Pavesi M, Amorós À, Titos E, Alcaraz-Quiles J, Oettl K, Morales-Ruiz M, Angeli P, Domenicali M, Alessandria C, Gerbes A, Wendon J, Nevens F, Trebicka J, Laleman W, Saliba F, Welzel TM, Albillos A, Gustot T, Benten D, Durand F, Ginès P, Bernardi M, Arroyo V. Systemic inflammation in decompensated cirrhosis: Characterization and role in acute-on-chronic liver failure. Hepatology 2016; 64:1249-64. [PMID: 27483394 DOI: 10.1002/hep.28740] [Citation(s) in RCA: 472] [Impact Index Per Article: 59.0] [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] [Received: 03/15/2016] [Accepted: 07/27/2016] [Indexed: 12/12/2022]
Abstract
UNLABELLED Acute-on-chronic liver failure (ACLF) in cirrhosis is characterized by acute decompensation (AD), organ failure(s), and high short-term mortality. Recently, we have proposed (systemic inflammation [SI] hypothesis) that ACLF is the expression of an acute exacerbation of the SI already present in decompensated cirrhosis. This study was aimed at testing this hypothesis and included 522 patients with decompensated cirrhosis (237 with ACLF) and 40 healthy subjects. SI was assessed by measuring 29 cytokines and the redox state of circulating albumin (HNA2), a marker of systemic oxidative stress. Systemic circulatory dysfunction (SCD) was estimated by plasma renin (PRC) and copeptin (PCC) concentrations. Measurements were performed at enrollment (baseline) in all patients and sequentially during hospitalization in 255. The main findings of this study were: (1) Patients with AD without ACLF showed very high baseline levels of inflammatory cytokines, HNA2, PRC, and PCC. Patients with ACLF showed significantly higher levels of these markers than those without ACLF; (2) different cytokine profiles were identified according to the type of ACLF precipitating event (active alcoholism/acute alcoholic hepatitis, bacterial infection, and others); (3) severity of SI and frequency and severity of ACLF at enrollment were strongly associated. The course of SI and the course of ACLF (improvement, no change, or worsening) during hospitalization and short-term mortality were also strongly associated; and (4) the strength of association of ACLF with SI was higher than with SCD. CONCLUSION These data support SI as the primary driver of ACLF in cirrhosis. (Hepatology 2016;64:1249-1264).
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Affiliation(s)
- Joan Clària
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Rudolf E Stauber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Minneke J Coenraad
- Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Richard Moreau
- Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), UMRS1149; Université Paris Diderot-Paris 7, Département Hospitalo-Universitaire (DHU) UNITY; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Laboratoire d'Excellence Inflamex, ComUE Sorbonne Paris Cité, Paris, France
| | - Rajiv Jalan
- Liver Failure Group, Institute for Liver Disease Health, University College London, Royal Free Hospital, London, United Kingdom
| | - Marco Pavesi
- EF-CLIF and EASL-CLIF Consortium, Barcelona, Spain
| | - Àlex Amorós
- EF-CLIF and EASL-CLIF Consortium, Barcelona, Spain
| | - Esther Titos
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - José Alcaraz-Quiles
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Manuel Morales-Ruiz
- Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Paolo Angeli
- Unit of Internal Medicine and Hepatology, Department of Medicine, DIMED, University of Padova, Padova, Italy
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlo Alessandria
- Division of Gastroenterology and Hepatology, San Giovanni Battista Hospital, Torino, Italy
| | - Alexander Gerbes
- Department of Medicine II, University Hospital LMU Munich, Liver Center Munich, Munich, Germany
| | | | - Frederik Nevens
- University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Jonel Trebicka
- Department of Internal Medicine I, University of Bonn, Bonn, Germany
| | - Wim Laleman
- University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Faouzi Saliba
- Hôpital Paul Brousse, Université Paris-Sud, Villejuif, France
| | | | | | - Thierry Gustot
- Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Daniel Benten
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - François Durand
- Inserm, U1149, Centre de Recherche sur l'Inflammation (CRI), UMRS1149; Université Paris Diderot-Paris 7, Département Hospitalo-Universitaire (DHU) UNITY; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Laboratoire d'Excellence Inflamex, ComUE Sorbonne Paris Cité, Paris, France
| | - Pere Ginès
- Liver Unit, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain.
| | - Mauro Bernardi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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22
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Abstract
Oxidative stress occurs when free radicals and other reactive species overwhelm the availability of antioxidants. Reactive oxygen species (ROS), reactive nitrogen species, and their counterpart antioxidant agents are essential for physiological signaling and host defense, as well as for the evolution and persistence of inflammation. When their normal steady state is disturbed, imbalances between oxidants and antioxidants may provoke pathological reactions causing a range of nonrespiratory and respiratory diseases, particularly chronic obstructive pulmonary disease (COPD). In the respiratory system, ROS may be either exogenous from more or less inhalative gaseous or particulate agents such as air pollutants, cigarette smoke, ambient high-altitude hypoxia, and some occupational dusts, or endogenously generated in the context of defense mechanisms against such infectious pathogens as bacteria, viruses, or fungi. ROS may also damage body tissues depending on the amount and duration of exposure and may further act as triggers for enzymatically generated ROS released from respiratory, immune, and inflammatory cells. This paper focuses on the general relevance of free radicals for the development and progression of both COPD and pulmonary emphysema as well as novel perspectives on therapeutic options. Unfortunately, current treatment options do not suffice to prevent chronic airway inflammation and are not yet able to substantially alter the course of COPD. Effective therapeutic antioxidant measures are urgently needed to control and mitigate local as well as systemic oxygen bursts in COPD and other respiratory diseases. In addition to current therapeutic prospects and aspects of genomic medicine, trending research topics in COPD are presented.
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Affiliation(s)
- Wolfgang Domej
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Wilfried Renner
- Clinical Institute of Medical and Chemical Diagnostics, Medical University of Graz, Graz, Austria
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23
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Oettl K, Birner-Gruenberger R, Spindelboeck W, Stueger HP, Dorn L, Stadlbauer V, Putz-Bankuti C, Krisper P, Graziadei I, Vogel W, Lackner C, Stauber RE. Oxidative albumin damage in chronic liver failure: relation to albumin binding capacity, liver dysfunction and survival. J Hepatol 2013; 59:978-83. [PMID: 23811308 DOI: 10.1016/j.jhep.2013.06.013] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [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: 08/20/2012] [Revised: 06/05/2013] [Accepted: 06/13/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Impaired binding function of albumin has been demonstrated in end-stage liver disease. This and other functional disturbances of albumin may be related to oxidative stress which is believed to play an important role in the pathogenesis of liver failure as well as sepsis. The aim of the present study was to relate oxidative modification of albumin to loss of albumin binding function in advanced chronic liver failure and in sepsis. METHODS Patients with decompensated cirrhosis or sepsis and healthy controls were investigated. Three fractions of albumin were separated by chromatography according to the redox state of cysteine-34: non-oxidized human mercaptalbumin, reversibly oxidized human non-mercaptalbumin-1, and irreversibly oxidized human non-mercaptalbumin-2 (HNA2). Binding properties of albumin site II were measured using dansylsarcosine as a ligand. RESULTS Both in cirrhotic and septic patients, fractions of oxidized albumin were increased and binding capacity for dansylsarcosine was decreased. Mass spectroscopy confirmed specific oxidation of cysteine-34. In cirrhotic patients, dansylsarcosine binding correlated strongly with liver function parameters and moderately with HNA2. Baseline levels of HNA2 accurately predicted 30-day and 90-day survival in cirrhotic patients and this was confirmed in an external validation cohort. CONCLUSIONS Our results suggest that oxidative damage impairs binding properties of albumin. In advanced liver disease, reduced binding capacity of albumin site II is mainly related to impaired liver function. The plasma level of HNA2 is closely related to survival and may represent a novel biomarker for liver failure.
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Affiliation(s)
- Karl Oettl
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria.
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24
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Dahaba AA, Suljevic I, Oettl K, Xiao Z, Dong H, Xiong L, Reibnegger G. Influence of acute normovolemic hemodilution on the pharmacokinetics of Cisatracurium Besylate. Minerva Anestesiol 2013; 79:1238-1247. [PMID: 23698546] [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: 06/02/2023]
Abstract
BACKGROUND Acute normovolemic hemodilution (ANH) is an efficacious blood conservation strategy for avoiding or reducing allogeneic blood transfusion. In a previous publication, on a different cohort of patients, we demonstrated that cisatracurium's potency and duration of action were not influenced by ANH, but we could not establish which role, if any, pharmacokinetics played. METHODS Forty patients were randomly allocated to the ANH or control groups. Patients received cisatracurium single 100 µg kg-1 bolus dose, serial arterial blood samples were collected and assayed for pharmacokinetic analysis. RESULTS Central and steady state apparent volumes of distribution (V1, Vdss) and slope factor (γ) were larger, effect-compartment concentration at 50% neuromuscular block was lower in the ANH (90.8±41.6 mL kg-1, 159.1±39.2 mL kg-1, 6.0±0.9 and 136.4±29.1 ng·mL-1) compared with the control group (65.5±26.1 mL kg-1, 134.8±31.8 mL kg-1, 5.5±0.8 and 158.5±26.0 ng·mL-1) respectively. Elimination half-life (t1/2 β) and mean residence time (MRT) were longer in the ANH (37.2±20.9, 23.5±13.2 min) than the control group (26.8±9.8, 16.9±6.2 min), albeit not statistically significant (P=0.051, P=0.051). There were no significant differences in distribution half-life (t1/2 α), effect-compartment equilibration rate-constant (keo), central and total clearances (Clc, Cl) between the ANH (2.4±1.2 min, 0.070±0.013 min-1, 6.1±1.9 mL kg-1 min-1 and 7.7±2.3 mL kg-1 min-1) and control group (1.9±1.2 min, 0.063±0.008 min-1, 7.0±1.8 mL kg-1 min-1 and 8.5±2.1 mL kg-1 min-1) respectively. CONCLUSION ANH altered some pharmacokinetic parameters such as significantly larger volumes of distribution. Other parameters such as elimination half-life were considerably longer albeit not statistically significant.
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Affiliation(s)
- A A Dahaba
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria -
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25
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Abstract
Abstract
We describe the impact of dihydroneopterin on the formation of superoxide radicals. As radical source ferrous iron in air-saturated aequeous solution was used. Detection of superoxide was achieved using reduction of nitroblue tetrazolium to formazan. Dihydroneopterin decreases formazan formation when high concentrations of ferrous iron are used which induce a rapid superoxide formation within minutes. On the other hand, when low concentrations of ferrous iron are used, addition of dihydroneopterin to the assay mixture leads to an increase ir. formazan formation for several hours of incubation. We therefore conclude that the radical promoting activity of dihydroneopterin is physiologically more relevant compared to its radical scavenging properties.
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Affiliation(s)
- Karl Oettl
- Institute for Medical Chernisty and Pregl-Laboratory, Karl-Franzens-University Graz, Harrachgasse 21111, A· 8010 Graz, Austria
| | - Joachim Greilberger
- Institute for Medical Chernisty and Pregl-Laboratory, Karl-Franzens-University Graz, Harrachgasse 21111, A· 8010 Graz, Austria
| | - Gilbert Reibnegger
- Institute for Medical Chernisty and Pregl-Laboratory, Karl-Franzens-University Graz, Harrachgasse 21111, A· 8010 Graz, Austria
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26
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Stauber RE, Spindelboeck W, Haas J, Putz-Bankuti C, Stadlbauer V, Lackner C, Oettl K. Human Nonmercaptalbumin-2: A Novel Prognostic Marker in Chronic Liver Failure. Ther Apher Dial 2013; 18:74-8. [DOI: 10.1111/1744-9987.12024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Rudolf E. Stauber
- Division of Gastroenterology and Hepatology; Department of Internal Medicine; Medical University of Graz; Graz Austria
| | - Walter Spindelboeck
- Division of Gastroenterology and Hepatology; Department of Internal Medicine; Medical University of Graz; Graz Austria
| | - Josef Haas
- Department of Gynecology and Obstetrics; Medical University of Graz; Graz Austria
| | - Csilla Putz-Bankuti
- Division of Gastroenterology and Hepatology; Department of Internal Medicine; Medical University of Graz; Graz Austria
| | - Vanessa Stadlbauer
- Division of Gastroenterology and Hepatology; Department of Internal Medicine; Medical University of Graz; Graz Austria
| | - Carolin Lackner
- Institute of Pathology; Medical University of Graz; Graz Austria
| | - Karl Oettl
- Institute of Physiological Chemistry; Center of Physiological Medicine; Medical University of Graz; Graz Austria
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27
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Abstract
Summary
Dihydroneopterin has recently been shown to either promote or decrease formation of free radicals or radicalmediated reactions, depending on the conditions. We report here the scavenging activity of dihydroneopterin on nitrogen centered radicals. Diphenylpicrylhydrazyl (DPPH) and tl. e radical cation of 2,2' -azino-di-[3- ethylbenzthiazoline sulphonate] (ABTS) were used. Dihydroneopterin showed scavenging properties against either compound. In the case of DPPH radical scavenging by dihydroneopterin was comparable with trolox. In the ABTS system, dihydroneopterin had an even better capacity of radical scavenging as compared to trolox .
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Affiliation(s)
- Karl Oettl
- Institute for Medical Chemistry and Pregl-Laboratory,Kari-Franzens-University Graz, Harrachgasse 2111,A-8010 Graz, Austria
| | - Joachim Greilberger
- Institute for Medical Chemistry and Pregl-Laboratory,Kari-Franzens-University Graz, Harrachgasse 2111,A-8010 Graz, Austria
| | - Gilbert Reibnegger
- Institute for Medical Chemistry and Pregl-Laboratory,Kari-Franzens-University Graz, Harrachgasse 2111,A-8010 Graz, Austria
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28
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Schippinger G, Fankhauser F, Oettl K, Spirk S, Hofmann P. Does single intramuscular application of autologous conditioned plasma influence systemic circulating growth factors? J Sports Sci Med 2012; 11:551-556. [PMID: 24149367 PMCID: PMC3737941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 05/04/2012] [Indexed: 06/02/2023]
Abstract
Platelet-rich plasma (PRP) has been employed to treat sports injuries to possibly accelerate healing and regeneration. This method offers some potential, especially for athletes. Growth factors are generally prohibited by the World Anti Doping Agency with exception to PRP which may induce adverse effects. The aim of this study was to evaluate any systemic increase of growth factors such as Insulin Like Growth Factor-1, Endothelial Growth Factors, Platelet-Derived Growth Factors, Fibroblast Growth Factors, Vascular-Endothelial Growth Factor and Transforming Growth Factors after local intramuscular administration of PRP in young, healthy male subjects keeping in mind adverse treatment effects. Enriched plasma from centrifuged blood samples was injected into the gluteus muscle. Venous blood was collected and serum prepared before as well as 0.5, 3 and 24 hours after PRP administration. Growth factors were analyzed using ELISA test kits. No significant systemic increase of growth factor levels was found after PRP injection except TGF-β2. For that reason the PRP method may be applied for muscle injury treatment in elite athletes although further studies are necessary to clarify the response to the unspecific increased TGF-β2 blood levels, which could increase the risk for local fibrosis. Key pointsMuscle injuryAutologous conditioned plasmaSystemic circulating growth factorsDoping.
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29
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Leber B, Stadlbauer V, Stiegler P, Stanzer S, Mayrhauser U, Koestenbauer S, Leopold B, Sereinigg M, Puntschart A, Stojakovic T, Tscheliessnigg KH, Oettl K. Effect of oxidative stress and endotoxin on human serum albumin in brain-dead organ donors. Transl Res 2012; 159:487-96. [PMID: 22633100 DOI: 10.1016/j.trsl.2011.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2011] [Revised: 12/15/2011] [Accepted: 12/16/2011] [Indexed: 12/12/2022]
Abstract
Albumin, among other molecules, binds and detoxifies endotoxin in healthy people. Oxidative stress leads to protein oxidation and thus to the impaired binding properties of albumin. This property, in combination with increased gut permeability, leads to the appearance of endotoxin in the systemic circulation and to impaired organ function. We hypothesize that these processes occur in the serum of brain-dead organ donors. Endotoxin was determined with an adapted Limulus amoebocyte lysate assay. The albumin fractions and binding capacity were determined by high-performance liquid chromatography (HPLC). FlowCytomix (eBioscience, San Diego, Calif) was used to determine the cytokine levels. Carbonylated proteins (CPs) and myeloperoxidase (MPO) were measured by an enzyme-linked immunosorbent assay (ELISA). Eighty-four brain-dead organ donors were enrolled and categorized by the duration of intensive care unit (ICU) stay. The albumin-binding capacity for dansylsarcosine was reduced in brain-dead patients compared with controls. Endotoxin positivity in 16.7% of donors was associated with decreased binding capacity in donors and worse survival of recipients. The CP and MPO levels of organ donors were significantly higher than in healthy controls. The durations of ICU stay increased albumin oxidation. In addition, interleukin-6 (IL-6), IL-8, IL-10, and IL-1β levels were increased in patients, whereas the interferon-γ (IFN-γ) levels were within the normal range. We conclude that oxidative stress and systemic endotoxemia are present in brain-dead organ donors, which might affect recipient survival. High endotoxin levels might be caused by increased gut permeability and decreased binding capacity of albumin influenced not just by higher albumin oxidation.
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Affiliation(s)
- Bettina Leber
- Division of Transplantation Surgery, Medical University of Graz, Graz, Austria
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30
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Schippinger G, Oettl K, Fankhauser F, Spirk S, Domej W, Hofmann P. Influence of Intramuscular Application of Autologous Conditioned Plasma on Systemic Circulating IGF-1. J Sports Sci Med 2011; 10:439-444. [PMID: 24150615 PMCID: PMC3737820] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 05/23/2011] [Indexed: 06/02/2023]
Abstract
Platelet-rich plasma (PRP) to increase levels of platelets and growth factors has been used for the treatment of sports injuries suggesting to improve healing and regeneration. This method offers some potential especially for elite athletes. However, the insulin like growth factor-1 (IGF-1) is prohibited by the World Anti Doping Agency and, in addition, there may be a possible link between increased levels of IGF-1 and cancer risk. Aim of the study was to evaluate a systemic increase of IGF-1 after local intramuscular administration of PRP in young healthy moderately trained male subjects. Blood samples were drawn and PRP preparation was performed by means of centrifugation. Enriched plasma was injected into the gluteus muscle. Venous blood was collected and serum prepared before as well as after 0.5, 3 and 24 hours after PRP administration. IGF-1 analysis was performed applying an ELISA test kit. No significant systemic increase of mean IGF-1 was found after the PRP injection. Only one subject showed an increase after 24 h, but all IGF-1 values were found within reference limits. We conclude that a single intramuscular application of PRP does not significantly increase systemic IGF-1 levels. Therefore, a single application of PRP is safe with respect to systemic IGF-1 response and cancer risk and this should be allowed for treatment of muscle injuries in elite athletes. Key pointsThere is no increase of systemic IGF-1 levels after a single local intramuscular administration of PRP.Professional athletes and non-athletes alike can benefit from such a treatment option for muscle injuries and related sports injuries without an increased risk of cancer.More studies are warranted to provide definitive evidence to guide surgeon's decision making regarding the appropriate use for PRP products.
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Affiliation(s)
- Gert Schippinger
- Human Performance Research Graz, University of Graz and Medical University of Graz ; Sportchirurgie Plus Graz
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31
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Abstract
PURPOSE To investigate the redox state of human serum albumin concerning cysteine-34 as a possible systemic redox marker in patients with different eye diseases with and without complications and with consideration of possible effects of age. METHODS Cataract (CAT), glaucoma, age-related macular degeneration (AMD), diabetes mellitus (DM), diabetic retinopathy and hypertension were the pathologies investigated. Albumin redox state concerning cysteine-34 was measured by high-performance liquid chromatography with fluorescence detection. The separation gives three fractions: the fully reduced form containing a thiol group, the disulphide form and a higher oxidized form. Statistical analysis was done by Student's t-test, analysis of variance and stepwise regression analysis. RESULTS Albumin as a systemic marker for oxidative stress was shifted to a more oxidized state by DM. An even stronger shift to the oxidized form was observed in patients with proliferative diabetic retinopathy. Notably, these effects were independent from age. In contrast, CAT and AMD had no influence on serum albumin redox state. CONCLUSION Serum albumin is not shifted to more oxidized forms by localized oxidative stress, but it is in systemic diseases like DM.
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Affiliation(s)
- Karl Oettl
- Institute of Physiological Chemistry, Center for Physiological Medicine, Medical University of Graz, Austria.
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32
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Stadlbauer V, Leber B, Stiegler P, Stanzer S, Mayrhauser U, Köstenbauer S, Sereinigg M, Puntschart A, Stojakovic T, Tscheliessnigg K, Oettl K. Interactions of endotoxin, albumin function, albumin binding capacity and oxidative stress in brain-dead organ donors. Crit Care 2011. [PMCID: PMC3068453 DOI: 10.1186/cc9944] [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: 11/21/2022] Open
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33
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Oettl K, Stadlbauer V, Krisper P, Stauber RE. Effect of Extracorporeal Liver Support by Molecular Adsorbents Recirculating System and Prometheus on Redox State of Albumin in Acute-on-Chronic Liver Failure. Ther Apher Dial 2009; 13:431-6. [DOI: 10.1111/j.1744-9987.2009.00762.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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34
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Marsche G, Frank S, Hrzenjak A, Holzer M, Dirnberger S, Wadsack C, Scharnagl H, Stojakovic T, Heinemann A, Oettl K. Plasma-advanced oxidation protein products are potent high-density lipoprotein receptor antagonists in vivo. Circ Res 2009; 104:750-7. [PMID: 19179658 DOI: 10.1161/circresaha.108.193169] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Advanced oxidation protein products (AOPPs) are carried by oxidized plasma proteins, especially albumin and accumulate in subjects with renal disease and coronary artery disease. AOPPs represent an excellent novel marker of oxidative stress and their roles in the development of cardiovascular disease might be of great importance. Here, we show that in vitro-generated AOPP-albumin binds with high affinity to the high-density lipoprotein (HDL) receptor scavenger receptor class B type I (SR-BI). Already an equimolar concentration of AOPP-albumin to HDL blocked HDL association to SR-BI and effectively inhibited SR-BI-mediated cholesterol ester (CE) uptake. Interestingly, albumin extensively modified by advanced glycation end products (AGE-albumin), which is an established SR-BI ligand known to accumulate in renal disease, only weakly interfered with HDL binding to SR-BI. Furthermore, AOPP-albumin administration increased the plasma half-life of [3H]CE-HDL in control mice 1.6-fold (P=0.01) and 8-fold (P=0.0003) in mice infected with adenoviral vectors encoding human SR-BI. Moreover, albumin isolated from hemodialysis patients, but not albumin isolated from healthy controls, markedly inhibited SR-BI-mediated HDL-CE transfer in vitro dependent on the AOPP content of albumin. These results indicate that AOPP-albumin effectively blocks SR-BI in vitro and in vivo. Thus, depressed plasma clearance of HDL-cholesterol may contribute to the abnormal composition of HDL and the high cardiovascular risk observed in patients with chronic renal failure.
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Affiliation(s)
- Gunther Marsche
- Center of Theoretical-Clinical Medicine II, Medical University Graz, Universitätsplatz 4, 8010 Graz, Austria.
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35
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Greilberger J, Koidl C, Greilberger M, Lamprecht M, Schroecksnadel K, Leblhuber F, Fuchs D, Oettl K. Malondialdehyde, carbonyl proteins and albumin-disulphide as useful oxidative markers in mild cognitive impairment and Alzheimer's disease. Free Radic Res 2008; 42:633-8. [PMID: 18654878 DOI: 10.1080/10715760802255764] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The question arises as to whether oxidative stress has a primary role in neurodegeneration or is a secondary end-stage epiphenomenon. The aim of the present study was to determine oxidative stress parameters like malondialdehyde (MDA), carbonyl proteins (CP) and Albumin-disulphide (Alb-SSR) and relate these parameters to the immune parameter neopterin, folic acid and vitamin B12 as vitamins and homocysteine in patients with neuro-degenerative diseases (NDD), namely mild cognitive impairment (MCI) and Alzheimer's disease (AD) compared to an aged matched control group. MDA, CP and Alb-SSR were significantly increased in the NDD group compared to controls, but not vitamin B12, folic acid and neopterin. Significant correlations were found between CP and Alb-SSR, CP and MDA and between MDA and Alb-SSR including patients with NDD and the control group. These results support the hypothesis that oxidative damage to lipids and proteins is an important early event in the pathogenesis of neurodegenerative diseases.
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Affiliation(s)
- J Greilberger
- Institute of Physiological Chemistry, Center for Physiological Medicine, Medical University of Graz,8010 Graz, Austria.
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36
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Mueller TF, Raeder J, Oettl K, Zitta S, Klausmann G, Estelberger W, Luyckx VA, Reibnegger G. Cystatin C does not detect acute changes in glomerular filtration rate in early diabetic nephropathy. Ren Fail 2008; 30:21-9. [PMID: 18197539 DOI: 10.1080/08860220701741916] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND The measurement of renal functional reserve (acute change in glomerular filtration rate [GFR] after protein load) allows the detection of sub-clinical renal dysfunction and has prognostic implications in diabetes. Our aim was to test cystatin C as an index of GFR and renal functional reserve. METHODS GFR was measured by C(Sinistrin) at baseline and after protein load in 28 diabetic patients with serum creatinine <1.2 mg/dL. The C(Sinistrin) was compared with cystatin C, serum creatinine, creatinine clearance, and Cockcroft-Gault formula. RESULTS Baseline C(Sinistrin) ranged from 67-172 mL/min. Regression analysis showed an overall low relationship between C(Sinistrin) and the indirect markers of GFR. The highest correlation with C(Sinistrin) was obtained for cystatin C clearance (R(2) = 0.58, r = 0.76, p < 0.001), the 1/serum cystatin C (R(2) = 0.58, r = 0.76, p < 0.001), and serum cystatin C (R(2) = 0.52, r = 0.72, p < 0.001). Renal functional reserve was preserved in 6 of 28 patients. There was no significant change in cystatin C in response to protein load. CONCLUSION Wide variation in baseline GFR emphasizes the need for the early detection of renal dysfunction. Cystatin C correlated best with C(Sinistrin) at baseline, but did not detect renal functional reserve.
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Affiliation(s)
- Thomas F Mueller
- Department of Medicine, Division of Nephrology and Transplantation Immunology, University of Alberta, Edmonton, Canada.
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37
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Lamprecht M, Greilberger JF, Schwaberger G, Hofmann P, Oettl K. Single bouts of exercise affect albumin redox state and carbonyl groups on plasma protein of trained men in a workload-dependent manner. J Appl Physiol (1985) 2008; 104:1611-7. [PMID: 18420715 DOI: 10.1152/japplphysiol.01325.2007] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study was to investigate the effect of single bouts of exercise at three different intensities on the redox state of human serum albumin (HSA) and on carbonyl groups on protein (CP) concentrations in plasma. Trained men [n = 44, maximal oxygen consumption (Vo(2max)): 55 +/- 5 ml.kg(-1).min(-1), nonsmokers, 34 +/- 5 years of age] from a homogenous population, volunteers from a police special forces unit, were randomly assigned to perform on a cycle ergometer either at 70% (n = 14), 75% (n = 14), or 80% (n = 16) of Vo(2max) for 40 min. Blood was collected before exercise, immediately after the exercise test (IE), and 30 min after each test (30M) and 30 h after each test (30H). The reduced fraction of HSA, human mercaptalbumin (HMA), decreased at all three exercise intensities IE and 30M, returning to preexercise values by 30H (P < 0.05). HMA was primarily oxidized to its reversible fraction human nonmercaptalbumin 1 (HNA1). CP concentrations increased at 75% of Vo(2max) IE and 30M with a tendency (P < 0.1) and at 80% Vo(2max) IE and 30M significantly, returning to preexercise concentrations by 30H (P < 0.01). These results indicate that the HSA redox system in plasma is activated after a single bout of cycle ergometer exercise at 70% Vo(2max) and 40 min duration. The extent of the HSA modification increased with exercise intensity. Oxidative protein damage, as indicated by CP, was only significantly increased at 80% Vo(2max) intensity in this homogenous cohort of trained men.
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Affiliation(s)
- Manfred Lamprecht
- Inst. of Physiological Chemistry, Harrachgasse 21/II, Medical Univ. of Graz, 8010 Graz, Austria.
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38
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Lamprecht M, Oettl K, Schwaberger G, Hofmann P, Greilberger JF. Several indicators of oxidative stress, immunity, and illness improved in trained men consuming an encapsulated juice powder concentrate for 28 weeks. J Nutr 2007; 137:2737-41. [PMID: 18029492 DOI: 10.1093/jn/137.12.2737] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [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: 11/15/2022] Open
Abstract
Phytonutrients from plant foods provide numerous antioxidants. We hypothesized that supplementation for 28 wk with a commercially available encapsulated juice powder concentrate (JPC) could influence indicators of oxidative stress, immunity, and illness. Trained men (n = 41; 34 +/- 5 y; maximum oxygen uptake = 55 +/- 7 mL x kg(-1) x min(-1)) from a homogenous police Special Forces unit were randomly assigned in a double blind manner to either JPC (n = 21) or placebo (n = 20). We used multiple 7-d food records to assess dietary intake and found inadequate mean daily fruit and vegetable consumption (3.2 +/- 1.2 servings). The group physician documented all duty days lost due to illness. We collected plasma at baseline and study wk 4, 8, 16, and 28 for analysis of carbonyl groups on protein (CP) and TNFalpha. Over the 28-wk investigation, CP was lower in the JPC group, with both a treatment and a time x treatment interaction (P < 0.05). Concentrations of both CP and TNFalpha at 16 and 28 wk were lower in the JPC than in the placebo group (P < 0.001). TNFalpha increased during the first 8 wk followed by a decrease in both groups for the following 20 wk (P < 0.001). Over the final 20 wk of the study, the placebo group tended to have more days of illness than the JPC group (P = 0.068). These data suggest beneficial JPC effects with regard to reduction of duty days lost due to illness and reduction of CP and TNFalpha concentrations in this group of trained men over 28 wk.
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Lamprecht M, Oettl K, Schwaberger G, Hofmann P, Pittner R, Greilberger J. Powdered Fruit and Vegetable Juice Concentrates Attenuate Carbonyl Proteins and TNF-alpha in Trained Men. Med Sci Sports Exerc 2007. [DOI: 10.1249/01.mss.0000273583.42742.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Oettl K, Stauber RE. Physiological and pathological changes in the redox state of human serum albumin critically influence its binding properties. Br J Pharmacol 2007; 151:580-90. [PMID: 17471184 PMCID: PMC2013999 DOI: 10.1038/sj.bjp.0707251] [Citation(s) in RCA: 252] [Impact Index Per Article: 14.8] [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: 02/07/2023] Open
Abstract
Binding and transport of a number of endogenous and exogenous compounds is an important function of the main plasma protein, albumin. In vivo and in vitro, albumin may be oxidatively modified in different ways with different agents at different sites. These modifications have various consequences on the physiological functions of albumin. Diabetes mellitus, liver diseases and nephropathy are just a few examples of disorders in which oxidative stress is involved and altered albumin functions have been described. This review is focussed on the consequences of oxidative modification on the binding properties of albumin. These range from no effect to decreased or increased binding affinities depending on the ligand under investigation and the type of modification. Indicators for modification include glycosylation, disulphide formation or the content of carbonyl groups. The redox state of albumin can affect the binding properties in several ways, including altered conformation and consequently altered affinities at binding sites and altered binding when the binding reaction itself is redox sensitive. The physiological or pathophysiological concentrations of different oxidatively modified albumin molecules vary over a wide range and are crucial in assessing the clinical relevance of altered ligand binding properties of a particularly modified albumin species in various disease conditions.
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Affiliation(s)
- K Oettl
- Institute of Physiological Chemistry, Center of Physiological Medicine, Medical University of Graz, Graz, Austria.
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Dahaba AA, Perelman SI, Moskowitz DM, Bennett HL, Shander A, Oettl K, Reibnegger G, Metzler H. Influence of acute normovolaemic haemodilution on the dose-response relationship, time-course of action and pharmacokinetics of rocuronium bromide. Br J Anaesth 2006; 97:482-8. [PMID: 16873389 DOI: 10.1093/bja/ael207] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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: 11/12/2022] Open
Abstract
BACKGROUND Acute normovolaemic haemodilution (ANH) is an effective strategy for avoiding or reducing allogeneic blood transfusion. We aimed to study its effect on the pharmacological profile of rocuronium. METHODS In two study centres, 28 patients undergoing major surgery with ANH were matched with 28 control patients. In the dose-response groups, using the mechanomyograph, neuromuscular block of six consecutive incremental doses of rocuronium 50 microg kg(-1), followed by 300 microg kg(-1), was evaluated. In the pharmacokinetics groups, serial arterial blood samples were withdrawn for rocuronium assay after a single dose of rocuronium 600 microg kg(-1). RESULTS ANH resulted in a shift to the left of rocuronium dose-response curve. Rocuronium effective dose(95) (ED(95)) was 26% lower (P<0.05) in the ANH group [283.4 (92.0) microg kg(-1)] compared with the control group [383.5 (127.3) microg kg(-1)]. Times from administration of last incremental dose until 25% of first response of train-of-four (TOF) recovery (Dur(25)) and 0.8 TOF ratio recovery (Dur(0.8)) were 28% longer in the ANH group [39.9 (8.4), 66.7 (14.2) min] compared with the control group [31.1 (6.6), 52.1 (15.8) min] (P<0.01, P<0.05), respectively. Volume of distribution was higher (P<0.01), central clearance was lower (P<0.05) and terminal elimination half-life was longer (P<0.0001) in the ANH group [234.97 (47.11) ml kg(-1), 4.70 (0.94) ml kg(-1) min(-1), 77.29 (12.25) min] compared with the control group [181.22 (35.73) ml kg(-1), 5.71 (1.29) ml kg(-1) min(-1), 56.86 (10.05) min, respectively]. CONCLUSION ANH resulted in prolongation of rocuronium time-course of action, thus careful monitoring of neuromuscular block is recommended in patients who undergo ANH.
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Affiliation(s)
- A A Dahaba
- Department of Anaesthesiology and Intensive Care Medicine, Graz Medical University, Graz, Austria.
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Schmoelzer I, de Campo A, Pressl H, Stelzl H, Dittrich P, Oettl K, Wascher TC. Biphasic insulin aspart compared to biphasic human insulin reduces postprandial hyperlipidemia in patients with Type 2 diabetes. Exp Clin Endocrinol Diabetes 2005; 113:176-81. [PMID: 15789278 DOI: 10.1055/s-2005-837521] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 10/25/2022]
Abstract
BACKGROUND Premixed insulin analogues reduce postprandial hyperglycemia in patients with Type 2 diabetes in comparison to premixed regular insulin. Insulin also plays an important role in the regulation of postprandial lipid metabolism. It is known that increased levels of postprandial insulin reduce postprandial hyperlipemia but, on the other hand, no information exists with regard to the possible effect of insulin analogues in comparison to human insulin. MATERIALS AND METHODS 12 subjects (3 men; age 59 +/- 5 years; BMI 30.5 +/- 5.9 kg/m2, duration of diabetes 9 +/- 1 years, HbA1c 8.33 +/- 1.1 %) already on therapy with premixed insulin were treated either with biphasic human insulin (BHI30) or with biphasic insulin aspart (BIAsp30) (1.3 IU fast acting insulin/12 g KH) in the setting of a standardized test meal. Serum levels of glucose, insulin, C-peptide and triglycerides as well as retinylpalmitate in plasma and chylomicron remnants were determined before and up to 8 hours after the meal. RESULTS As was to be expected, therapy with BIAsp30 reduced the maximum increase of postprandial glucose from 7.10 +/- 2.00 mmol/l to 5.27 +/- 1.83 mmo/l (p = 0.007) compared to BHI30 insulin. In the same way, the maximum increase of triglycerides (from 2.33 +/- 1.03 to 1.65 +/- 0.69 mmol/l, p = 0.014) was reduced. The AUC 0 - 8 for triglycerides was not significantly influenced (34.20 +/- 19.86 vs. 31.46 +/- 16.21 mmol x 8 h/l) but the incremental area over baseline (AOB 0 - 8) was significantly reduced from 8.02 +/- 4.35 to 6.12 +/- 3.94 mmol x 8 h/l (p = 0.024). CONCLUSIONS Compared to conventional human premixed insulin the prandial therapy with biphasic insulin aspart results not only in an improvement of glucose tolerance but also in a significant reduction of postprandial hyperlipemia.
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Affiliation(s)
- I Schmoelzer
- Diabetic Angiopathy Research Group, Department of Internal Medicine, University of Graz, Graz, Austria
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Lamprecht M, Oettl K, Schwaberger G, Hofmann P, Greilberger J. Supplementation With Mixed Fruit And Vegetable Juice Concentrates Attenuates Oxidative Stress Markers In Trained Athletes. Med Sci Sports Exerc 2005. [DOI: 10.1249/00005768-200505001-00242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Oettl K, Payerl D, Zitta S, Müller T, Estelberger W, Reibnegger G. Quantitative analysis of sinistrin in serum with high-performance liquid chromatography for renal function testing. Anal Biochem 2005; 331:183-8. [PMID: 15246012 DOI: 10.1016/j.ab.2004.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2004] [Indexed: 11/28/2022]
Abstract
Sinistrin, as inulin, is widely used as a marker for renal function testing. A reliable and accurate method with a simple sample preparation for the quantitative determination of sinistrin would be of advantage. We developed a high-performance liquid chromatography (HPLC)-based method with electrochemical detection for the quantitative measurement of sinistrin in serum and plasma. Sample preparation is easy and includes enzymatic removal of glucose, deproteinization, acid hydrolysis of sinistrin, and HPLC separation of fructose. The recovery of sinistrin from serum is the same as that from water and is near 100%. The method presented has a linear range up to 500 mg/L. The results from our method are in agreement with a fully enzymatic quantification (regression coefficient 1.01, coefficient of variation 0.97). Sinistrin concentrations in aqueous solutions can be measured down to 2mg/L with a coefficient of variation of 5.7%. Quantification in serum is primarily limited by its physiological fructose content. The sensitivity of the described method is sufficient for its use in renal function testing. We describe a method for quantification of sinistrin which allows accurate measurements especially at low concentrations and low sample volumes. This laboratory method may be used for obtaining sinistrin pharmacokinetics in renal function testing.
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Affiliation(s)
- Karl Oettl
- Institute of Medical Chemistry and Pregl Laboratory, Medical University Graz, Graz A-8010, Austria.
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Oettl K, Greilberger J, Dikalov S, Reibnegger G. Interference of 7,8-dihydroneopterin with peroxynitrite-mediated reactions. Biochem Biophys Res Commun 2004; 321:379-85. [PMID: 15358187 DOI: 10.1016/j.bbrc.2004.06.157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2004] [Indexed: 11/18/2022]
Abstract
By in vitro studies 7,8-dihydroneopterin, which is secreted by macrophages stimulated by interferon-gamma, was reported to be a radical scavenger as well as a prooxidative agent depending on the experimental settings. In this study, we investigated the interference of 7,8-dihydroneopterin with peroxynitrite mediated reactions by different analytical procedures. Luminol chemiluminescence and oxidation of the spin probe 1-hydroxy-2,2,6,6-tetramethyl-4-oxo-piperidine induced by peroxynitrite were inhibited by 7,8-dihydroneopterin. On the other hand, we found that 7,8-dihydroneopterin very efficiently inhibits nitration of tyrosine by peroxynitrite. Hydroxylation, however, was rather enhanced than inhibited, suggesting that 7,8-dihydroneopterin reacts in quite different manner with the intermediates generated from peroxynitrite. We provide the first evidence that a pterin radical is formed from a dihydropterin using EPR spectroscopy and 2,2,4-trimethyl-2H-imidazole-1-oxide as a spin trap. We conclude that 7,8-dihydroneopterin while being a weak scavenger of superoxide acts as a very efficient inhibitor of tyrosine nitration induced by peroxynitrite.
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Affiliation(s)
- Karl Oettl
- Institute for Physiological Chemistry, Medical University Graz, Harrachgasse 21/II, A-8010 Graz, Austria.
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Abstract
Human macrophages stimulated with interferon-gamma generate neopterin and 7,8-dihydroneopterin which interfere with reactive species involved in LDL oxidation. While neopterin was found to have pro-oxidative effects on copper-mediated LDL oxidation, the influence of 7,8-dihydroneopterin is more complex. This study provides detailed information that 7,8-dihydroneopterin reveals both pro-oxidative and anti-oxidative effects on copper mediated LDL oxidation. 7,8-dihydroneopterin inhibited the oxidation of native LDL effectively monitored by (i) formation of conjugated dienes, (ii) relative electrophoretic mobility (EM) and (iii) specific oxidized epitopes. Using minimally oxidized LDL (mi-LDL) or moderately oxidized LDL (mo-LDL) 7,8-dihydroneopterin changed its antioxidative behavior to a strongly pro-oxidative. Incubation of 7,8-dihydroneopterin with native LDL, mi-LDL or mo-LDL in the absence of copper ions showed that formation of conjugated dienes was more increased in mo-LDL than in mi-LDL while no diene formation was observed with native LDL. We suggest that 7,8-dihydroneopterin is a modulator for LDL oxidation in the presence of copper ions depending on the "oxidative status" of this lipoprotein.
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Affiliation(s)
- Joachim Greilberger
- Institute for Medical Chemistry and Pregl-Labratory, University of Graz, Harrachgasse 21/2, A-8010, Graz, Austria.
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Abstract
Despite the health-promoting effects of physical activity, exercise enhances the formation of free radicals and other reactive species in animals and humans. Numerous techniques have been established to investigate the diverse modifications of biomolecules by oxidative stress. These analytical procedures include different methods, ranging from simple photometric assays to a combination of chromatographic methods with mass spectrometry. We summarize briefly those analytical techniques of oxidative damage to biomolecules that have been applied to the investigation of oxidative stress during exercise.
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Affiliation(s)
- Manfred Lamprecht
- Institute of Physiological Chemistry, Medical University Graz, Graz, Austria.
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Mayer B, Zitta S, Greilberger J, Holzer H, Reibnegger G, Hermetter A, Oettl K. Effect of hemodialysis on the antioxidative properties of serum. Biochim Biophys Acta 2003; 1638:267-72. [PMID: 12878328 DOI: 10.1016/s0925-4439(03)00093-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In patients with chronic renal failure undergoing regular hemodialysis (HD), oxidative stress is involved in the development of dialysis-related pathologies. The aim of the study was to measure the effect of HD treatment on the general antioxidative status of serum with special consideration of the specific oxidizability of lipids and proteins. Indicators for the oxidative/antioxidative status of plasma were monitored at the beginning and at the end of a dialysis session on the arterial and venous side of the dialyzer. A decrease in the antioxidant status was accompanied by an increased oxidizability of proteins as well as lipids during HD treatment. During the first passage of the dialyzer, the lag time of lipid oxidation decreased from 114.0+/-19.8 to 81.5+/-18.9 min, the lag time of protein oxidation decreased from 105.0+/-24.6 to 72.9+/-21.3 min and the total antioxidative status decreased from 518+/-24 to 252+/-124 microM trolox equivalents. The carbonyl content of serum proteins was high in patients with end stage renal disease (ESRD) (3.9+/-1.1 vs. 0.9+/-0.1 nmol/mg in controls) but did not change significantly during dialysis procedure. Our data demonstrate that the susceptibility of serum lipids and proteins to oxidative modification is severely increased by HD treatment.
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Affiliation(s)
- Birgit Mayer
- Department of Biochemistry, Technical University Graz, Graz, Austria
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Oettl K, Höfler G, Ness GC, Sattler W, Malle E. An apparent decrease in cholesterol biosynthesis in peroxisomal-defective Chinese hamster ovary cells is related to impaired mitochondrial oxidation. Biochem Biophys Res Commun 2003; 305:957-63. [PMID: 12767923 DOI: 10.1016/s0006-291x(03)00855-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 12/01/2022]
Abstract
Recent data suggest that impaired mitochondrial activities in Zellweger fibroblasts are related to defective peroxisome biogenesis and vice versa. To investigate the contribution of functional mitochondria to cholesterol biosynthesis, radioactive precursor molecules that form acetyl-CoA via beta-oxidation-independent (pyruvate) or -dependent (palmitate and octanoate) pathways were used. Production of both 14C-labeled cholesterol and 14C-labeled CO(2) from these radioactive tracers was significantly impaired in peroxisomal-defective ZR-82 Chinese hamster ovary cells in comparison to controls. In contrast, cholesterol synthesis from acetate--a tracer directly converted to acetyl-CoA without the involvement of mitochondrial activities--was threefold higher in ZR-82 cells than in controls. Pathways further contributing to cellular cholesterol homeostasis, i.e., receptor-mediated binding of exogenous lipoprotein-associated cholesterol as well as intracellular mobilization of cholesteryl ester deposits were similar in ZR-82 and controls. From these findings, we propose that peroxisomal dysfunction in ZR-82 cells is tightly coupled to impaired mitochondrial activities, e.g., defective mitochondrial beta-oxidation and formation of acetyl-CoA from short chain fatty acids resulting in a decreased rate of CO(2) production, and an apparent decrease in cholesterol biosynthesis. Actually, cholesterol biosynthesis from acetate is increased in the peroxisomal-defective cells. This explains previous conflicting conclusions.
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Affiliation(s)
- Karl Oettl
- Institute of Medical Biochemistry and Molecular Biology, Karl-Franzens University Graz, Harrachgasse 21, Graz A-8010, Austria
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Abstract
BACKGROUND Single-sample techniques are widely used for determination of renal clearance by elimination kinetics of radiolabelled marker substances. Frequently, however, formulae for transforming single-time measurement values into estimates of kinetic function, such as renal clearance, are being established exclusively by data reduction methods and are devoid of any physiological meaning. METHODS Using 11 subjects with normal or impaired renal function, we compared one such method using (99m)Tc-labelled mercaptoacetyltriglycine ((99m)Tc-MAG(3)) for single-sample determination of tubular extraction rates with a more elaborate computer-based system identification technique. This latter method yields measures for glomerular filtration rate as well as effective renal plasma flow based on elimination kinetics of sinistrin and p-aminohippuric acid. RESULTS When applying the single-sample technique, two of the 11 estimated values for tubular extraction rate were negative, indicating an erroneous analysis of kinetic behaviour. This single-sample method failure was not caused by the marker, but rather by the specific mathematical procedure used for the evaluation. Importantly, evaluation of the same experimental data with a conventional two-sample technique would eliminate the principal mathematical defect and produce physiologically reasonable results, without requiring additional effort. CONCLUSIONS Our study does not criticize the (99m)Tc-MAG(3) technique per se. Rather, these findings indicate that usage of single-sample techniques for determination of inherently kinetic phenomena may produce incorrect results. Therefore, despite their obvious practical advantages, such simplified methods should be performed with great caution.
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Affiliation(s)
- Sabine Zitta
- Department of Internal Medicine, Division of Nephrology, Institute of Medical Chemistry and Pregl Laboratory, Karl-Franzens-University of Graz, Graz, Austria
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