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Bloch O, Kobi P, Ben Shimol A, Rotmensh A, Kagansky D, Zelnik-Yovel D, Yehudah GB, Cantrell D, Rapoport MJ. Severe and fatal COVID-19 is characterised by increased circulating glucagon like peptide 1 and procalcitonin modulated by type 2 diabetes. Diabetes Metab Res Rev 2023; 39:e3635. [PMID: 36960549 DOI: 10.1002/dmrr.3635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
AIMS Endotoxemia commonly occurs in severe and fatal COVID-19, suggesting that concomitant bacterial stimuli may amplify the innate immune response induced by SARS-CoV-2. We previously demonstrated that the endogenous glucagon like peptide 1 (GLP-1) system in conjunction with increased procalcitonin (PCT) is hyperactivated in patients with severe Gram-negative sepsis and modulated by type 2 diabetes (T2D). We aimed to determine the association of COVID-19 severity with endogenous GLP-1 activation upregulated by increased specific pro-inflammatory innate immune response in patients with and without T2D. MATERIALS AND METHODS Plasma levels of total GLP-1, IL-6, and PCT were estimated on admission and during hospitalisation in 61 patients (17 with T2D) with non-severe and severe COVID-19. RESULTS COVID-19 patients demonstrated ten-fold increase of IL-6 levels regardless of disease severity. Increased admission GLP-1 levels (p = 0.03) accompanied by two-fold increased PCT were found in severe as compared with non-severe patients. Moreover, GLP-1 and PCT levels were significantly increased in non-survived as compared with survived patients at admission (p = 0.01 and p = 0.001, respectively) and at 5 to 6 days of hospitalisation (p = 0.05). Both non-diabetic and T2D patients demonstrated a positive correlation between GLP-1 and PCT response (r = 0.33, p = 0.03, and r = 0.54, p = 0.03, respectively), but the intensity of this joint pro-inflammatory/GLP-1 response was modulated by T2D. In addition, hypoxaemia down-regulated GLP-1 response only in T2D patients with bilateral lung damage. CONCLUSIONS The persistent joint increase of endogenous GLP-1 and PCT in severe and fatal COVID-19 suggests a role of concomitant bacterial infection in disease exacerbation. Early elevation of endogenous GLP-1 may serve as a new biomarker of COVID-19 severity and fatal outcome.
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Affiliation(s)
- Olga Bloch
- Diabetes & Autoimmunity Research Laboratory, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Perl Kobi
- Department "C" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Ariel Ben Shimol
- Department "A" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Assaf Rotmensh
- Department "C" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Dana Kagansky
- Department "A" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Dana Zelnik-Yovel
- Department "C" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Gilad Ben Yehudah
- Laboratory of Microbiology, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Dror Cantrell
- Department "C" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Micha J Rapoport
- Diabetes & Autoimmunity Research Laboratory, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
- Department "C" of Internal Medicine, Yitzhak Shamir Medical Center, Sackler Medical School Tel Aviv University, Zerifin, Israel
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Mengesha B, Blatt A, Bloch O, Rapoport MJ. Low soluble dipeptidyl Peptidase-4 levels during acute myocardial infarction and decreased endogenous glucagon like Peptide-1 response are associated with adverse long-term cardiovascular outcome and mortality: A pilot study. Eur J Clin Invest 2023; 53:e13897. [PMID: 36345656 DOI: 10.1111/eci.13897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Bethlehem Mengesha
- Department of Cardiology, Shamir Medical Center, Be'er Yaakov, Israel.,Affiliated with Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Alex Blatt
- Cardiology Center, Kaplan Medical Center, Affiliated with Hebrew University of Jerusalem, Jerusalem, Israel
| | - Olga Bloch
- Affiliated with Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.,Immunology and Diabetes research laboratory, Shamir medical Center, Be'er Ya'akov, Israel
| | - Micha J Rapoport
- Affiliated with Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Israel.,Immunology and Diabetes research laboratory, Shamir medical Center, Be'er Ya'akov, Israel.,Department of Internal Medicine "C", Shamir Medical Center, Be'er Ya'akov, Israel
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Bloch O, Perl SH, Lazarovitch T, Zelnik-Yovel D, Love I, Mendel-Cohen L, Goltsman G, Flor H, Rapoport MJ. Hyper-Activation of Endogenous GLP-1 System to Gram-negative Sepsis Is Associated With Early Innate Immune Response and Modulated by Diabetes. Shock 2021; 55:796-805. [PMID: 33079891 DOI: 10.1097/shk.0000000000001683] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Culture-positive gram-negative sepsis induces greater magnitude of early innate immunity /inflammatory response compared with culture-negative sepsis. We previously demonstrated increased activation of anti-inflammatory Glucagon Like Peptide-1 (GLP-1) hormone in initial phase of sepsis more pronounced in diabetes patients. However, whether GLP-1 system is hyperactivated during the early innate immune response to gram-negative sepsis and modulated by diabetes remains unknown. OBJECTIVES Total and active GLP-1, soluble Dipeptidyl peptidase 4 (sDPP-4) enzyme, and innate immunity markers presepsin (sCD14) and procalcitonin (PCT) in plasma were determined by ELISA on admission and after 2 to 4 days in 37 adult patients with and without type 2 diabetes and gram-negative or culture-negative sepsis of different severity. RESULTS Severe but not non-severe sepsis was associated with markedly increased GLP-1 system response, which correlated with PCT and the organ dysfunction marker lactate. Culture-positive gram-negative bacteria but not culture-negative sepsis induced hyper-activation of GLP-1 system, which correlated with increased innate immune markers sCD14, PCT, and lactate. GLP-1 inhibitory enzyme sDPP-4 was down regulated by sepsis and correlated negatively with sCD14 in gram-negative sepsis. Diabetic patients demonstrated increased GLP-1 response but significantly weaker innate immune response to severe and gram-negative sepsis. CONCLUSIONS Early stage of gram-negative sepsis is characterized by endogenous GLP-1 system hyperactivity associated with over activation of innate immune response and organ dysfunction, which are modulated by diabetes. Total GLP-1 may be novel marker for rapid diagnosis of gram-negative sepsis and its severity.
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Affiliation(s)
- Olga Bloch
- Diabetes and Autoimmunity Research Laboratory, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Sivan H Perl
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Tsilia Lazarovitch
- Laboratory of Microbiology, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Dana Zelnik-Yovel
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Itamar Love
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Lior Mendel-Cohen
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Galina Goltsman
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Hadar Flor
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Micha J Rapoport
- Diabetes and Autoimmunity Research Laboratory, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
- Department 'C' of Internal Medicine, Yitzhak Shamir Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
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Elbaz-Greener G, Bloch O, Kumets I, Blatt A, Rapoport MJ. Endogenous glucagon-like peptide-1 system response is impaired during ST-elevation myocardial infarction in type 2 diabetes patients. Diabetes Obes Metab 2019; 21:194-198. [PMID: 30084185 DOI: 10.1111/dom.13490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 07/18/2018] [Accepted: 08/01/2018] [Indexed: 12/13/2022]
Abstract
We previously demonstrated increased glucagon-like peptide-1 (GLP-1) secretion during acute ST elevation myocardial infarction (STEMI) in non-diabetic (ND) patients. Whether the endogenous GLP-1 system response is different in patients with type 2 diabetes (T2D) during STEMI is unknown. Patients with STEMI (20 ND, 13 T2D) and 3 control groups (non-STEMI [14 ND, 13 T2D], stable angina pectoris [SAP] [8 ND, 10 T2D] patients and healthy subjects) (n = 25) were studied. Plasma levels of total and active GLP-1 and soluble dipeptidyl peptidase-4 (sDPP4) were estimated by enzyme-linked immunosorbent assay on admission and at 24 and 48 hours after percutaneous coronary intervention in all patients. Sharply elevated levels of total and active GLP-1 were found in ND STEMI patients at 24 h (P < 0.05 and P < 0.005, respectively), but not in T2D STEMI patients. All patients demonstrated decreased sDPP4 levels compared with healthy controls (P < 0.0005) accompanied by increased active/total GLP-1 ratio regardless of their ischemic state. These data demonstrate that T2D patients fail to further upregulate their endogenous GLP-1 system during STEMI. This may underlie their worse cardiovascular outcome.
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Affiliation(s)
- Gabby Elbaz-Greener
- Intensive Coronary Care Unit, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Olga Bloch
- Diabetes Research Laboratory, Assaf Harofeh Medical Center Affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel
| | - Ilya Kumets
- Department "C" of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel
| | - Alex Blatt
- Intensive Coronary Care Unit, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Micha J Rapoport
- Diabetes Research Laboratory, Assaf Harofeh Medical Center Affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel
- Department "C" of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School, Tel Aviv University, Zerifin, Israel
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Dajani S, Abraham C, Huang J, Sperduto P, Sosman J, Chandra S, Robinson C, Acharya S, Helenowski I, Bloch O, Kruser T. Outcomes in BRAFV600e-Mutant Melanoma Brain Metastases Managed with Radiosurgery: A Multi-Institutional Assessment of Craniotomy Mitigation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.741] [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: 11/26/2022]
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Petras K, Helenowski I, Patel R, Lurain J, Tate M, Bloch O, Kruser T. Gamma knife stereotactic radiosurgery for brain metastases of primary gynecologic origin. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.190] [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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Perl SH, Bloch O, Zelnic-Yuval D, Love I, Mendel-Cohen L, Flor H, Rapoport MJ. Sepsis-induced activation of endogenous GLP-1 system is enhanced in type 2 diabetes. Diabetes Metab Res Rev 2018; 34:e2982. [PMID: 29334697 DOI: 10.1002/dmrr.2982] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 12/03/2017] [Accepted: 12/27/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND High levels of circulating GLP-1 are associated with severity of sepsis in critically ill nondiabetic patients. Whether patients with type 2 diabetes (T2D) display different activation of the endogenous GLP-1 system during sepsis and whether it is affected by diabetes-related metabolic parameters are not known. METHODS Serum levels of GLP-1 (total and active forms) and its inhibitor enzyme sDPP-4 were determined by ELISA on admission and after 2 to 4 days in 37 sepsis patients with (n = 13) and without T2D (n = 24) and compared to normal healthy controls (n = 25). Correlations between GLP-1 system activation and clinical, inflammatory, and diabetes-related metabolic parameters were performed. RESULTS A 5-fold (P < .001) and 2-fold (P < .05) increase in active and total GLP-1 levels, respectively, were found on admission as compared to controls. At 2 to 4 days from admission, the level of active GLP-1 forms in surviving patients were decreased significantly (P < .005), and positively correlated with inflammatory marker CRP (r = 0.33, P = .05). T2D survivors displayed a similar but more enhanced pattern of GLP-1 response than nondiabetic survivors. Nonsurvivors demonstrate an early extreme increase of both total and active GLP-1 forms, 9.5-fold and 5-fold, respectively (P < .05). The initial and late levels of circulating GLP-1 inhibitory enzyme sDPP-4 were twice lower in all studied groups (P < .001), compared with healthy controls. CONCLUSIONS Taken together, these data indicate that endogenous GLP-1 system is activated during sepsis. Patients with T2D display an enhanced and prolonged activation as compared to nondiabetic patients. Extreme early increased GLP-1 levels during sepsis indicate poor prognosis.
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Affiliation(s)
- Sivan H Perl
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Olga Bloch
- Diabetes Research Laboratory, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Dana Zelnic-Yuval
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Itamar Love
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Lior Mendel-Cohen
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Hadar Flor
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
| | - Micha J Rapoport
- Department 'C' of Internal Medicine, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
- Diabetes Research Laboratory, Assaf Harofeh Medical Center Affiliated to Sackler Medical School Tel Aviv University, Zerifin, Israel
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Refaat T, Gentile M, Dalal P, Gutiontov S, Helenowksi I, Lee P, Sathiaseelan V, Bendok B, Bloch O, Chandler J, Parsa A, Sejpal S, Marymont M, Kalapurakal J. Stereotactic Radiosurgery for Intracranial Meningiomas: A 15 Year Experience. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.710] [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: 11/16/2022]
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Bloch O, Broide E, Ben-Yehudah G, Cantrell D, Shirin H, Rapoport MJ. Nutrient induced type 2 and chemical induced type 1 experimental diabetes differently modulate gastric GLP-1 receptor expression. J Diabetes Res 2015; 2015:561353. [PMID: 25893200 PMCID: PMC4393893 DOI: 10.1155/2015/561353] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 02/24/2015] [Accepted: 03/03/2015] [Indexed: 01/09/2023] Open
Abstract
T2DM patients demonstrate reduced GLP-1 receptor (GLP-1R) expression in their gastric glands. Whether induced T2DM and T1DM differently affect the gastric GLP-1R expression is not known. This study assessed extrapancreatic GLP-1R system in glandular stomach of rodents with different types of experimental diabetes. T2DM and T1DM were induced in Psammomys obesus (PO) by high-energy (HE) diet and by streptozotocin (STZ) in Sprague Dawly (SD) rats, respectively. GLP-1R expression was determined in glandular stomach by RT PCR and immunohistomorphological analysis. The mRNA expression and cellular association of the GLP-1R in principal glands were similar in control PO and SD rats. However, nutrient and chemical induced diabetes resulted in opposite alterations of glandular GLP-1R expression. Diabetic PO demonstrated increased GLP-1R mRNA expression, intensity of cellular GLP-1R immunostaining, and frequency of GLP-1R positive cells in the neck area of principal glands compared with controls. In contrast, SD diabetic rats demonstrated decreased GLP-1 mRNA, cellular GLP-1R immunoreactivity, and frequency of GLP-1R immunoreactive cells in the neck area compared with controls. In conclusion, nutrient and chemical induced experimental diabetes result in distinct opposite alterations of GLP-1R expression in glandular stomach. These results suggest that induced T1DM and T2DM may differently modulate GLP-1R system in enteropancreatic axis.
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Affiliation(s)
- Olga Bloch
- Diabetes and Immunology Research Laboratory, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
| | - Efrat Broide
- Institute of Gastroenterology, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
| | - Gilad Ben-Yehudah
- Institute of Gastroenterology, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
| | - Dror Cantrell
- Department of Internal Medicine “C”, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
| | - Haim Shirin
- Institute of Gastroenterology, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
| | - Micha J. Rapoport
- Diabetes and Immunology Research Laboratory, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
- Department of Internal Medicine “C”, Assaf Harofeh Medical Center Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, 70300 Zerifin, Israel
- *Micha J. Rapoport:
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Ivan M, Safaee M, Oh T, Clark A, Sun M, Kim J, Bloch O, Jahangiri A, Aghi M, Parsa A. AI-15 * EPIDERMAL GROWTH FACTOR-LIKE MODULE CONTAINING MUCIN-LIKE HORMONE RECEPTOR 2 ROLE IN PREDICTING SURVIVAL IN INVASIVE GLIOMAS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou238.15] [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: 11/13/2022] Open
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Bloch O, Amit-Vazina M, Yona E, Molad Y, Rapoport MJ. Increased ERK and JNK activation and decreased ERK/JNK ratio are associated with long-term organ damage in patients with systemic lupus erythematosus. Rheumatology (Oxford) 2014; 53:1034-42. [PMID: 24501249 DOI: 10.1093/rheumatology/ket482] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The activities of two mitogen-activated protein kinases (MAPKs), extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK), correlate with disease severity in SLE patients. Whether they are also associated with long-term organ damage is unknown. The aim of the present work was to determine whether impaired expression and activity of ERK and JNK correlate with long-term damage in SLE. METHODS The expression of ERK and JNK and their phosphorylated active forms was determined by western blot analysis four times during the first year of follow-up in peripheral blood mononuclear cells from 36 SLE patients. A correlation analysis was performed between ERK and JNK expression and longterm organ damage estimated by the SLICC/ARC Damage Index (SDI) 4 years later. RESULTS Mean levels of ERK and JNK activities during the first year correlated with long-term organ damage severity (r = 0.38 and r = 0.35, respectively; P = 0.05). Overall JNK expression increased with the severity of chronic damage (P = 0.01; P = 0.05 for SDI score 2 and 3, respectively). In contrast, overall ERK expression significantly decreased in patients with maximal organ damage (SDI score 3) compared with patients with an SDI score of 2 (P = 0.03). The ERK/JNK ratio decreased by approximately 40% and 30% in patients with an SDI score of 3 as compared with patients without organ damage and healthy controls, respectively. CONCLUSION These results demonstrate that early activation of ERK and JNK along with decreased overall ERK expression and reduced ERK/JNK ratio may predict the severity of long-term organ damage in SLE patients.
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Broide E, Bloch O, Ben-Yehudah G, Cantrell D, Shirin H, Rapoport MJ. Reduced GLP-1R expression in gastric glands of patients with type 2 diabetes mellitus. J Clin Endocrinol Metab 2014; 99:E1691-5. [PMID: 24878048 DOI: 10.1210/jc.2014-1114] [Citation(s) in RCA: 11] [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: 02/13/2023]
Abstract
BACKGROUND The incretin effect is reduced in type 2 diabetes mellitus (T2DM) patients. Whether the impaired function of the enteropancreatic axis in these patients is due to defective GLP-1 receptor (GLP-1R) expression in extrapancreatic target organs is not known. AIMS AND METHODS To compare the GLP-1R expression and distribution in gastric mucosa biopsies of patients with (n =22) and without (n =22) T2DM referred for routine esophagogastroduodenoscopies. GLP-1R mRNA levels were estimated by real-time PCR. The intensity of GLP-1R immunostaining, frequency, and types of glandular cells bearing GLP-1R and their glandular distribution in different stomach mucosa regions were evaluated by immunohistochemical morphological semiquantitative and quantitative analysis. RESULTS Mean mRNA GLP-1R levels were significantly reduced in patients with T2DM compared with nondiabetic patients (P < .02). Immunohistochemical analysis revealed that the reduced GLP-1R expression in T2DM patients was due to a decreased intensity of immunostaining (P < .01). The number of glandular GLP-1R-bearing cells in both body and antrum mucosa was decreased in T2DM patients. Most notably, the frequency of GLP-1R immunoreactive acid-secreting parietal cells was reduced in the neck area of the gastric principal glands of T2DM patients (P < .01). No correlation was found between the reduced GLP-1R expression and clinical parameters including body mass index, age, glycosylated hemoglobin, and disease duration. CONCLUSION This is the first evidence of reduced GLP-1R expression in gastric glands of T2DM patients. These data demonstrate that the defective function of the incretin axis in T2DM may also result from decreased GLP-1R expression in its extrapancreatic target organs.
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Affiliation(s)
- E Broide
- Institute of Gastroenterology (E.B., G.B.-Y., H.S.), Diabetes and Immunology Research Laboratory (O.B, M.J.R.), and Department of Internal Medicine "C" (D.C., M.J.R), Assaf Harofeh Medical Center, Zerifin 70300, Israel; and Sackler Faculty of Medicine Tel Aviv University (E.B., O.B., G.B.-Y., D.C., H.S., M.J.R., Tel Aviv 69978, Israel
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Parsa AT, Bloch O, Crane C, Kaur R, Safae M. GLIOMAS PROMOTE INDUCTION OF B7-H1/PD-L1 EXPRESSION ON MONOCYTES: CLINICAL EVIDENCE OF AN IMMUNOSUPPRESSIVE MECHANISM THAT CAN BE TARGETED WITH ANTIBODY BLOCKADE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou208.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barish M, Weng L, D'Apuzzo M, Forman S, Brown C, Ben Horin I, Volovitz I, Ram Z, Chang A, Wainwright D, Dey M, Han Y, Lesniak M, Chow K, Yi J, Shaffer D, Gottschalk S, Clark A, Safaee M, Oh T, Ivan M, Kaur R, Sun M, Lu YJ, Ozawa T, James CD, Bloch O, Parsa A, Debinski W, Choi YA, Gibo DM, Dey M, Wainwright D, Chang A, Han Y, Lesniak M, Herold-Mende C, Mossemann J, Jungk C, Ahmadi R, Capper D, von Deimling A, Unterberg A, Beckhove P, Jiang H, Klein SR, Piya S, Vence L, Yung WKA, Sawaya R, Heimberger A, Conrad C, Lang F, Gomez-Manzano C, Fueyo J, Jung TY, Choi YD, Kim YH, Lee JJ, Kim HS, Kim JS, Kim SK, Jung S, Cho D, Kosaka A, Ohkuri T, Okada H, Erickson K, Malone C, Ha E, Soto H, Hickey M, Owens G, Liau L, Prins R, Minev B, Kruse C, Lee J, Dang X, Borboa A, Coimbra R, Baird A, Eliceiri B, Mathios D, Lim M, Ruzevick J, Nicholas S, Polanczyk M, Jackson C, Taube J, Burger P, Martin A, Xu H, Ochs K, Sahm F, Opitz CA, Lanz TV, Oezen I, Couraud PO, von Deimling A, Wick W, Platten M, Ohkuri T, Ghosh A, Kosaka A, Zhu J, Ikeura M, Watkins S, Sarkar S, Okada H, Pellegatta S, Pessina S, Cantini G, Kapetis D, Finocchiaro G, Avril T, Vauleon E, Hamlat A, Mosser J, Quillien V, Raychaudhuri B, Rayman P, Huang P, Grabowski M, Hamburdzumyan D, Finke J, Vogelbaum M, Renner D, Litterman A, Balgeman A, Jin F, Hanson L, Gamez J, Carlson B, Sarkaria J, Parney I, Ohlfest J, Pirko I, Pavelko K, Johnson A, Sims J, Grinshpun B, Feng Y, Amendolara B, Shen Y, Canoll P, Sims P, Bruce J, Lee SX, Wong E, Swanson K, Wainwright D, Chang A, Dey M, Balyasnikova I, Cheng Y, Han Y, Lesniak M, Wang F, Wei J, Xu S, Ling X, Yaghi N, Kong LY, Doucette T, Weinberg J, DeMonte F, Lang F, Prabhu S, Heimberger A, Wiencke J, Accomando W, Houseman EA, Nelson H, Wrensch M, Wiemels J, Zheng S, Hsuang G, Bracci P, Kelsey K. IMMUNOLOGY RESEARCH. Neuro Oncol 2013. [DOI: 10.1093/neuonc/not177] [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: 11/13/2022] Open
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Broide E, Bloch O, Ben-Yehudah G, Cantrell D, Shirin H, Rapoport MJ. GLP-1 receptor is expressed in human stomach mucosa: analysis of its cellular association and distribution within gastric glands. J Histochem Cytochem 2013; 61:649-58. [PMID: 23803499 DOI: 10.1369/0022155413497586] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The stomach is a target organ of the incretin hormone glucagon-like peptide-1 (GLP-1). However, the cellular expression and glandular distribution of its receptor (GLP-1R) in human gastric mucosa are not known. We determined the expression of GLP-1R in different regions of human stomach mucosa and its specific cellular association and distribution within gastric glands. Tissue samples from stomach body and antrum were obtained from 20 patients during routine esophagogastroduodenoscopy. mRNA encoding GLP-1R protein expression was evaluated by RT-PCR. Determination of cell types bearing GLP-1R, their localization, and their frequency in gastric glands in different gastric regions were estimated by immunohistochemical morphological analysis. Levels of GLP-1R mRNA were similar in body and antrum. GLP-1R immunoreactivity was found throughout the gastric mucosa in various types of glandular cells. The highest frequency of GLP-1R immunoreactive cells was found in the neck area of the principal glands in cells morphologically identified as parietal cells. GLP-1R immunostaining was also found on enteroendocrine-like cells in the pyloric glands. This study provides the first description of GLP-1R expression in human gastric glands and its specific cellular association. Our data suggest that GLP-1 may act directly on the gastric mucosa to modulate its complex functions.
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Affiliation(s)
- Efrat Broide
- Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel
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Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Zhou T, Meng X, Xu B, Wei S, Chen X, De Witt Hamer PC, Robles SG, Zwinderman AH, Duffau H, Berger MS, Gonzalez JDSR, Alberto OV, Patricia HM, Chaichana K, Pendleton C, Chambless L, Nathan J, Camara-Quintana J, Li G, Harsh G, Thompson R, Lim M, Quinones-Hinojosa A, Oppenlander ME, Wolf A, Porter R, Nakaji P, Smith KA, Spetzler RF, Sanai N, Kim JH, Clark AJ, Jahangiri A, Sughrue ME, McDermott MW, Aghi MK, Chen C, Kasper E, Warnke P, Park CK, Lee SH, Song SW, Kim JW, Kim TM, Yamaguchi F, Omura T, Ten H, Ishii Y, Kojima T, Takahashi H, Teramoto A, Pereira EA, Livermore J, Ansorge O, Bojanic S, Meng X, Xu B, Chen X, Wei S, Zhou T, Tong H, Yu X, Zhou D, Hou Y, Zhou Z, Zhang J, Fabiano AJ, Rigual N, Munich S, Fenstermaker RA, Chen X, Meng X, Zhang J, Wang F, Zhao Y, Xu BN, Kim EH, Oh MC, Lee EJ, Kim SH, Kim YH, Kim CY, Kim YH, Han JH, Park CK, Kim SK, Paek SH, Wang KC, Kim DG, Jung HW, Chen X, Meng X, Wang F, Zhao Y, Xu BN, Krex D, Lindner C, Juratli T, Raue C, Schackert G, Valdes PA, Kim A, Leblond F, Conde OM, Harris BT, Paulsen KD, Wilson BC, Roberts DW, Krex D, Juratli T, Lindner C, Raue C, Schackert G, Occhiogrosso G, Cascardi P, Blagia M, De Tommasi A, Gelinas-Phaneuf N, Choudhury N, Al-Habib A, Cabral A, Nadeau E, Vincent M, Pazos V, Debergue P, DiRaddo R, Del Maestro RF, Guha-Thakurta N, Prabhu SS, Schulder M, Zavarella S, Nardi D, Schaffer S, Ruge MI, Grau S, Fuetsch M, Kickingereder P, Hamisch C, Treuer H, Voges J, Sturm V, Choy W, Yew A, Spasic M, Nagasawa D, Kim W, Yang I, Quigley MR, Hobbs J, Bhatia S, Cohen ZR, Shimon I, Hadani M, Carapella CM, Oppido PA, Vidiri A, Telera S, Pompili A, Villani V, Fabi A, Pace A, Cahill D, Wang M, Won M, Aldape K, Maywald R, Hegi M, Mehta M, Gilbert M, Sulman E, Vogelbaum M, Narayana A, Kunnakkat SD, Parker E, Gruber D, Gruber M, Knopp E, Zagzag D, Golfinos J, Dziurzynski K, Blas-Boria D, Suki D, Cahill D, Prabhu S, Puduvalli V, Levine N, Bloch O, Han SJ, Kaur G, Aghi MK, McDermott MW, Berger MS, Parsa AT, Quigley MR, Fukui O, Chew B, Bhatia S, DePowell JJ, Sanders-Taylor C, Guarnaschelli J, McPherson C, Sheth SA, Snuderl M, Kwon CS, Wirth D, Yaroslavsky A, Curry WT, Vogelbaum MA, Wang M, Hadjipanayis CG, Won M, Mehta MP, Gilbert MR, Megyesi JF, Macdonald D, Wang B, Pierre GHS, Hoover JM, Goerss SJ, Kaufmann TJ, Meyer FB, Parney IF, Guthikonda B, Thakur J, Khan I, Ahmed O, Shorter C, Wilson J, Welsh J, Cuellar H, Jeroudi M. SURGICAL THERAPIES. Neuro Oncol 2011; 13:iii154-iii163. [PMCID: PMC3222965 DOI: 10.1093/neuonc/nor164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
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Rachmiel M, Bloch O, Shaul AA, Ben-Yehudah G, Bistritzer Z, Weintrob N, Ofan R, Rapoport MJ. Young patients with both type 1 diabetes mellitus and asthma have a unique IL-12 and IL-18 secretory pattern. Pediatr Diabetes 2011; 12:596-603. [PMID: 21418456 DOI: 10.1111/j.1399-5448.2010.00751.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The expression of the regulatory cytokines interleukin (IL)-12 and IL-18 in patients with both Th1- and Th2-mediated diseases, type 1 diabetes mellitus (T1DM) and asthma, is unknown. OBJECTIVE To investigate the in vivo and in vitro IL-12 and IL-18 secretion patterns in patients with both T1DM and asthma. METHODS Peripheral blood mononuclear cells (PBMC) were collected from 44 patients. Mean age 19.4 ± 4.7 yr (10.5-28 yr), divided into four paired groups: T1DM and asthma, asthma only, T1DM only, and healthy controls. T-cell proliferative response was assessed. IL-12 and IL-18 serum levels and expression by PBMC following in vitro stimulation by lipopolysaccharide (LPS) were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS Patients with T1DM and asthma had higher serum levels of both IL-12 and IL-18 compared to controls: 146.2 ± 69.2 and 109.7 ± 34.6 pg/mL, p = 0.038 and 436.1 ± 117.9, 320.2 ± 99.1 pg/mL, p = 0.028, respectively. Stimulated IL-12 secretion was significantly lower in these patients compared to those with one disease only: 809 ± 426.4, 2111.6 ± 2214.3, 3188.1 ± 2692.9 pg/mL and after 48 h: 956.3 ± 489.3, 2429.8 ± 2394.6, 3874.5 ± 2820.3 pg/mL, respectively, p < 0.03 for all. The IL-18/IL-12 serum ratio was also significantly higher in patients with both diseases compared to those with asthma only, p = 0.017. CONCLUSION Patients with both T1DM and asthma display a different pattern of IL-12 and IL-18 expression compared to patients with one disease only and controls.
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Affiliation(s)
- Marianna Rachmiel
- Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel.
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Furnari F, Fenton T, Nathanson D, de Alberquerque CP, Kuga D, Wanami A, Dang J, Yang H, Tanaka K, Gao L, Oba-Shinjo S, Uno M, Inda MDM, Bachoo R, James CD, DePinho R, Vandenberg S, Zhou H, Marie S, Mischel P, Cavenee W, Szerlip N, Pedraza A, Huse J, Mikkelsen T, Brennan C, Szerlip N, Castellani RJ, Ivanova S, Gerzanich VV, Simard JM, Ito M, See W, Mukherjee J, Ohba S, Tan IL, Pieper RO, Lukiw WJ, Culicchia F, Pogue A, Bhattacharjee S, Zhao Y, Proescholdt MA, Merrill M, Storr EM, Lohmeier A, Brawanski A, Abraham S, Jensen R, Khatua S, Gopal U, Du J, He F, Golub T, Isaacs JS, Dietrich J, Kalogirou-Valtis Y, Ly I, Scadden D, Proschel C, Mayer-Proschel M, Rempel SA, Schultz CR, Golembieski W, Brodie C, Mathew LK, Skuli N, Mucaj V, Imtiyaz HZ, Venneti S, Lal P, Zhang Z, Davuluri RV, Koch C, Evans S, Simon MC, Ranganathan P, Clark P, Salamat S, Kuo JS, Kalejta RF, Bhattacharjee B, Renzette N, Moser RP, Kowalik TF, McFarland BC, Ma JY, Langford CP, Gillespie GY, Yu H, Zheng Y, Nozell SE, Huszar D, Benveniste EN, Lawrence JE, Cook NJ, Rovin RA, Winn RJ, Godlewski JA, Ogawa D, Bronisz A, Lawler S, Chiocca EA, Lee SX, Wong ET, Swanson KD, Liu KW, Feng H, Bachoo R, Kazlauskas A, Smith EM, Symes K, Hamilton RL, Nagane M, Nishikawa R, Hu B, Cheng SY, Silber J, Jacobsen A, Ozawa T, Harinath G, Brennan CW, Holland EC, Sander C, Huse JT, Sengupta R, Dubuc A, Ward S, Yang L, Northcott P, Kroll K, Taylor M, Wechsler-Reya R, Rubin J, Chu WT, Lee HT, Huang FJ, Aldape K, Yao J, Steeg PS, Lu Z, Xie K, Huang S, Sim H, Agudelo-Garcia PA, Hu B, Viapiano MS, Hu B, Agudelo-Garcia PA, Saldivar J, Sim H, Dolan C, Mora M, Nuovo G, Cole S, Viapiano MS, Stegh AH, Ryu MJ, Liu Y, Du J, Zhong X, Marwaha S, Li H, Wang J, Salamat S, Chang Q, Zhang J, Ng HK, Yang L, Poon WS, Zhou L, Pang JC, Chan A, Didier S, Kwiatkowska A, Ennis M, Fortin S, Rushing E, Eschbacher J, Tran N, Symons M, Roldan G, McIntyre JB, Easaw J, Magliocco A, Wykosky J, Cavenee W, Furnari F, Lu D, Mreich E, Chung S, Teo C, Wheeler H, McDonald KL, Lawn S, Forsyth P, Sonabend AM, Lei L, Kennedy B, Soderquist C, Guarnieri P, Leung R, Yun J, Sisti J, Castelli M, Bruce S, Bruce R, Ludwig T, Rosenfeld S, Bruce JN, Canoll P, Lamszus K, Schulte A, Gunther HS, Riethdorf S, Phillips HS, Westphal M, Siegal T, Zrihan D, Granit A, Lavon I, Singh M, Chandra J, Ogawa D, Nakashima H, Godlewski J, Chiocca AE, Kapoor GS, Poptani H, Ittyerah R, O'Rourke DM, Sadraei NH, Burgett M, Ahluwalia M, Tipps R, Khosla D, Weil R, Nowacki A, Prayson R, Shi T, Gladson C, Moeckel S, Meyer K, Bosserhoff A, Spang R, Leukel P, Vollmann A, Jachnick B, Stangl C, Proescholdt M, Bogdahn U, Hau P, Kaur G, Sun M, Kaur R, Bloch O, Jian B, Parsa AT, Hossain A, Shinojima N, Gumin J, Feng G, Lang FF, Li L, Yang CR, Chakraborty S, Hatanpaa K, Chauncey S, Jiwani A, Habib A, Nguyen T, Nakashima H, Chiocca EA, Munson J, Machaidze R, Kaluzova M, Bellamkonda R, Hadjipanayis CG, Zhang Y, McFarland B, Bredel M, Benveniste EN, Lee SH, Zerrouqi A, Khwaja F, Devi NS, Van Meir EG, Haseley A, Boone S, Wojton J, Yu L, Kaur B, Wojton JA, Naduparambil J, Denton N, Chakravarti A, Kaur B, Conrad CA, Wang X, Sheng X, Nilsson C, Marshall AG, Emmett MR, Hu Y, Mark L, Zhou YHZ, Dhruv H, McDonough W, Tran N, Armstrong B, Tuncali S, Eschbacher J, Kislin K, Berens M, Plas D, Gallo C, Stringer K, Kendler A, McPherson C, Castelli MA, Ellis JA, Assanah M, Bruce JN, Canoll P, Ogden A, Liang J, Piao Y, deGroot JF, Gordon N, Patel D, Chakravarti A, Palanichamy K, Hervey-Jumper S, Wang A, He X, Zhu T, Heth J, Muraszko K, Fan X, Nakashima H, Nguyen T, Chiocca EA, Liu WM, Huang P, Rani S, Stettner MR, Jerry S, Dai Q, Kappes J, Tipps R, Gladson CL, Chakravarty D, Pedraza A, Koul D, Alfred Yung WK, Brennan CW, Jensen SA, Luciano J, Calvert A, Nagpal V, Stegh A, Kang SH, Yu MO, Lee MG, Chi SG, Chung YG, Cooper MK, Valadez JG, Grover VK, Kouri FM, Chin L, Stegh AH, Ahluwalia MS, Khosla D, Weil RJ, McGraw M, Huang P, Prayson R, Nowacki A, Barnett GH, Gladson C, Kang C, Zou J, Lan F, Yue X, Shi Z, Zhang K, Han L, Pu P, Seaman BF, Tran ND, McDonough W, Dhruv H, Kislin K, Berens M, Battiste JD, Sirasanagandla S, Maher EA, Bachoo R, Sugiarto S, Persson A, Munoz EG, Waldhuber M, Vandenberg S, Stallcup W, Philips J, Berger MS, Bergers G, Weiss WA, Petritsch C. CELL BIOLOGY AND SIGNALING. Neuro Oncol 2011; 13:iii10-iii25. [PMCID: PMC3199169 DOI: 10.1093/neuonc/nor148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023] Open
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Rapoport MJ, Bloch O, Amit-Vasina M, Yona E, Molad Y. Constitutive abnormal expression of RasGRP-1 isoforms and low expression of PARP-1 in patients with systemic lupus erythematosus. Lupus 2011; 20:1501-9. [PMID: 21976405 DOI: 10.1177/0961203311418790] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Defective expression of Ras guanil releasing protein-1 (RasGRP-1) and increased apoptosis have been reported in lymphocytes from SLE patients. Whether these aberrations are correlated and linked to disease activity has not been elucidated. METHODS Expression of normal 90 kDa RasGRP-1, its most prevalent 86 kDa isoform and full PARP-1 116 kDa and its cleavage fragment 84 kDa were determined in whole protein lysates of peripheral blood mononuclear cells (PBMC) in correlation with mitogen activated protein kinase (MAPK) activity and SLE clinical status in a large group of SLE patients during 1 year follow-up. RESULTS Expression of normal 90 kDa RasGRP-1 was comparable in patients and controls. However, SLE patients demonstrated a constitutively increased 86 kDa/90 kDA ratio (p < 0.01) and decreased full poly (ADP-ribose) polymerase protein-1 (PARP-1) expression (p < 0.002) compared with controls who were disease-independent. A remission in disease activity was associated with decreased RasGRP-1 expression. Expression of 84 kDa PARP-1 cleavage fragment was found in 15% of patients but in none of the controls. In addition, expression of PARP-1 correlated positively with normal 90 kDa RasGRP-1 expression and negatively with the RasGRP-1 86 kDa/90 kDA ratio. CONCLUSIONS These data suggest that constitutive aberrant expression of PARP-1 and RasGRP-1 ratio may act in concert to impair survival of lymphocytes in SLE patients.
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Bloch K, Bloch O, Tarasenko I, Lazard D, Rapoport M, Vardi P. A strategy for the engineering of insulin producing cells with a broad spectrum of defense properties. Biomaterials 2010; 32:1816-25. [PMID: 21144579 DOI: 10.1016/j.biomaterials.2010.11.018] [Citation(s) in RCA: 11] [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] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 11/01/2010] [Indexed: 11/26/2022]
Abstract
Insulin-producing pancreatic beta cells are known to be extremely susceptible to the oxidative stress and hypoxia generated following islet transplantation in diabetic patients. We hereby present a novel in vivo selection strategy based on the isolation of insulin-producing cells with enhanced protection after repeated rounds of encapsulation and xenotransplantation. Rat insulinoma INS-1 cells were encapsulated in alginate macrobeads and transplanted in the peritoneal cavity of mice. After 2 days the beads were retrieved and cells were recovered from alginate and propagated in vitro until submitted to a second round of encapsulation and transplantation. Three days later, the surviving cells, named INS-1m2, were isolated from the alginate beads and their protection and functional activity examined. Compared to parental INS-1 cells, the selected INS-1m2 cells were more resistant to hydrogen peroxide, nitric oxide, alloxan and hypoxia. This enhanced protection of the selected cells correlated with the increased level of catalase and poly (ADP-ribose) polymerase expression. Although selected cells expressed more insulin than parental cells, no change in their insulin response to glucose was observed. We conclude that the in vivo selection strategy is a powerful tool for the engineering of insulin producing cells with a broad spectrum of defense properties.
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Affiliation(s)
- Konstantin Bloch
- Diabetes and Obesity Research Laboratory, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel-Aviv University, Beilinson Campus, Petah Tikva 49100, Israel.
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Molad Y, Amit-Vasina M, Bloch O, Yona E, Rapoport MJ. Increased ERK and JNK activities correlate with disease activity in patients with systemic lupus erythematosus. Ann Rheum Dis 2010; 69:175-80. [PMID: 19158114 DOI: 10.1136/ard.2008.102780] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Aberrant signalling along the p21ras/MAP kinase pathway has been demonstrated in systemic lupus erythematosus (SLE). OBJECTIVE To determine whether expression and activity of the MAP kinases ERK and JNK reflect disease activity in patients with SLE. METHODS Blood samples of 42 outpatients with SLE were prospectively collected during four consecutive visits. The control group included 20 healthy subjects. Disease activity was assessed using the SLE Disease Activity Index (SLEDAI). Expression of total ERK and JNK kinases and their active forms (pERK and pJNK) was determined in whole protein lysates of peripheral blood mononuclear cells. RESULTS The mean levels of the active kinases pERK and pJNK were significantly increased in patients with active disease (SLEDAI 4-20) as compared with patients with inactive disease (SLEDAI 0-3), p = 0.04, as well as with healthy controls, p = 0.03 and p = 0.003 for pERK and pJNK, respectively. The percentage of activated forms of ERK and JNK of the total expression of these MAP kinases was also gradually increased, reaching 50% for pERK and >40% for pJNK in patients with SLE with moderate-to-severe disease (SLEDAI 7-20), p = 0.005, p = 0.005 and p = 0.02, p = 0.05 as compared with controls and inactive patients, respectively. A decrease of more than three SLEDAI points was associated with a significant reduction in the expression of both total and activated forms of ERK and JNK, p = 0.03, p = 0.01, respectively. CONCLUSIONS The results show that ERK and JNK activity reflects disease activity in patients with SLE. These MAP kinases may serve as additional tools for the evaluation of disease activity and management of these patients.
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Affiliation(s)
- Y Molad
- Rheumatology Unit, Beilinson Hospital, Rabin Medical Centre, Petah Tikva, Israel
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Broide E, Scapa E, Bloch O, Shapiro M, Kimchi NA, Ben-Yehudah G, Rapoport MJ. Evidence for aberrant regulation of MAP kinase signal transduction pathway in peripheral blood mononuclear cells in patients with active celiac disease. Dig Dis Sci 2009; 54:1270-5. [PMID: 18787952 DOI: 10.1007/s10620-008-0480-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 07/24/2008] [Indexed: 12/09/2022]
Abstract
BACKGROUND Aberrant signaling via the p21/mitogen-activated proteins (MAP) kinase pathway has been described in lymphocytes of patients with various autoimmune diseases. There is little published data about the intracellular mediators and signals that regulate expression and activity of transcription factors and their effect on celiac disease induction and progression. AIM To investigate the possible involvement of MAP kinase pathway in peripheral blood mononuclear cells (PBMC) in celiac disease and its correlation with disease activity. METHODS Expression of the total and activated forms of two MAP kinases [extracellular response kinase (ERK) and c-Jun amino terminal kinase (JNK)] were studied by Western blots in PBMC of 17 untreated and 19 treated celiac patients, and 17 controls. Seven of these untreated celiac patients were studies before and after 6 months of gluten-free diet. RESULTS Phosphorylated ERK of active celiac disease patients was significantly lower compared with controls (P < 0.01) and was increased towards normal after 6 month of gluten-free diet (P < 0.01). Phosphorylated JNK was increased significantly in the untreated celiac group (P < 0.01) and normalized towards the control level after 6 months of gluten-free diet (P < 0.04). CONCLUSIONS Aberrant MAP-kinase pathway activity is associated with active celiac disease (CD). Further studies should examine the potential role of this aberration in pathogenesis of CD.
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Affiliation(s)
- E Broide
- Institute of Gastroenterology and Liver Diseases, Assaf Harofeh Medical Center Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Ewart HS, Bloch O, Girouard GS, Kralovec J, Barrow CJ, Ben-Yehudah G, Suárez ER, Rapoport MJ. Stimulation of cytokine production in human peripheral blood mononuclear cells by an aqueous Chlorella extract. Planta Med 2007; 73:762-8. [PMID: 17611933 DOI: 10.1055/s-2007-981544] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
CPE is an aqueous extract of the edible micro alga Chlorella pyrenoidosa, which has been shown to have immunostimulatory effects in vivo. In the present study, CPE was evaluated for an ability to stimulate cytokine production by human peripheral blood mononuclear cells (PBMC). PBMC from healthy individuals were treated ex vivo for 24 hours with 1, 10 and 100 microg/mL CPE. This resulted in a marked increase in the level of IL-10, a regulatory cytokine, and strong stimulation of the T-helper-1 (Th1) cell cytokines, IFN-gamma and TNF-alpha. In contrast, stimulation of representative T-helper-2 (Th2) cell cytokines, IL-4 and IL-13, was minor. CPE (1, 10 or 100 microg/mL) did not cause a proliferation of human PBMC suggesting that enhanced secretion of cytokines was not secondary to an increase in cell number. We conclude that CPE stimulation of human PBMC induces a Th1-patterned cytokine response and a strong anti-inflammatory regulatory cytokine response, observations that await confirmation in vivo.
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Rachmiel M, Bloch O, Bistritzer Z, Weintrob N, Ofan R, Bloch K, Vardi P, Rapoport MJ. Clinical characteristics and diabetes associated autoantibodies in patients with both type 1 diabetes mellitus and asthma. J Pediatr Endocrinol Metab 2006; 19:1001-6. [PMID: 16995585 DOI: 10.1515/jpem.2006.19.8.1001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Type 1 diabetes mellitus (DM1) and asthma are mediated by opposite arms of the cellular immune system, namely T helper (Th)1 and Th2 CD4+ cells, respectively. It is not known whether their coexistence affects their clinical manifestations. METHODS The number of asthma exacerbations, frequency of hypoglycemic events, HbA1c levels, diabetes associated autoantibody status and diabetes associated late complications were determined in three paired groups of patients (n = 11) matched by gender and age: DM1 and asthma, asthma only, and DM1 only. RESULTS Patients with both diseases had a higher prevalence of hypoglycemic events per month compared to patients with DM1 only: 5.67 +/- 4.27 vs 1.45 +/- 2.06, respectively (p = 0.008). The co-existence of the two diseases did not modify the remaining clinical and laboratory parameters. CONCLUSION Patients with both DM1 and asthma have similar clinical characteristics to patients with only one of these diseases apart from a higher rate of hypoglycemic events compared to patients with DM1 without asthma.
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Affiliation(s)
- M Rachmiel
- Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel
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Rachmiel M, Bloch O, Bistritzer T, Weintrob N, Ofan R, Koren-Morag N, Rapoport MJ. TH1/TH2 cytokine balance in patients with both type 1 diabetes mellitus and asthma. Cytokine 2006; 34:170-6. [PMID: 16765604 DOI: 10.1016/j.cyto.2006.04.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Revised: 04/09/2006] [Accepted: 04/25/2006] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE T1DM and asthma are mediated by opposite arms of the cellular immune system namely T helper (Th)1 and Th2 CD4(+) cells, respectively. Our aim was to characterize the Th1/Th2 cytokine balance in patients with both T1DM and asthma. METHODS Forty-four patients, mean age 19 years were matched by gender and age, to 4 paired groups: T1DM and asthma, asthma only, T1DM only and healthy controls. Peripheral blood mononuclear cells (PBMC) were stimulated in vitro with disease-specific recombinant antigens; glutamic acid decarboxylase and house dust mite (Der p1 antigen) for T1DM and asthma, respectively, and non-specific mitogens; phytohemaglutinin (PHA), tetanus toxin and anti-CD3 mAb. ELISPOT and ELISA technique were used to determine INF-gamma, IL-2, IL-4, IL-13 and IL-10 expression. RESULTS Patients with T1DM and asthma demonstrated a similar cytokine pattern but lower Th1/Th2 ratio compared to patients with T1DM only. The Th2 cytokines response to Der p1 was enhanced in patients with both diseases compared to controls. The IL-10 overall secretion was higher in patients with both diseases compared to one disease only. CONCLUSION The Th1 and Th2 secretory pattern of patients with T1DM and asthma combines features of both diseases suggesting a unique Th1/Th2 balance.
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Affiliation(s)
- Marianna Rachmiel
- Department of Pediatrics, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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Bloch K, Vorobeychik M, Yavrians K, Azarov D, Bloch O, Vardi P. Improved activity of streptozotocin-selected insulinoma cells following microencapsulation and transplantation into diabetic mice. Cell Biol Int 2006; 30:138-43. [PMID: 16448824 DOI: 10.1016/j.cellbi.2005.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2004] [Revised: 08/29/2005] [Accepted: 08/30/2005] [Indexed: 11/20/2022]
Abstract
We have recently shown that repeated streptozotocin (STZ) treatment induces the selection of insulinoma cells (RINmS) with both improved resistance to diabetogenic toxins and functional activity, compared to parental RINm cells. The aim of the present study was to estimate the potential of RINmS cells to maintain their engineered characteristics during in vivo hyperglycemic conditions. It was found that microencapsulation and transplantation into diabetic mice preserved a three-fold higher level of insulin content in selected RINmS cells when compared to the parental ones. Retrieval of transplanted encapsulated cells from the peritoneal cavity of diabetic mice had a significantly higher insulin content and a more intense insulin response to secretogogues in selected RINmS cells when compared to retrieved RINm cells. In conclusion, our results show that RINmS cells do not lose their improved functional characteristics after encapsulation and transplantation into diabetic mice.
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Affiliation(s)
- K Bloch
- Diabetes and Obesity Research Laboratory, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Beilinson Campus, Petah Tikva 49100, Israel
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Rapoport MJ, Sharabi A, Aharoni D, Bloch O, Zinger H, Dayan M, Mozes E. Amelioration of SLE-like manifestations in (NZBxNZW)F1 mice following treatment with a peptide based on the complementarity determining region 1 of an autoantibody is associated with a down-regulation of apoptosis and of the pro-apoptotic factor JNK kinase. Clin Immunol 2005; 117:262-70. [PMID: 16257268 DOI: 10.1016/j.clim.2005.09.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2005] [Revised: 08/11/2005] [Accepted: 09/13/2005] [Indexed: 01/11/2023]
Abstract
Treatment with peptides based on the complementarity determining regions (CDR) of murine and human monoclonal anti-DNA antibodies that bear the common idiotype, 16/6 Id, ameliorates disease manifestations of mice with either induced or spontaneous SLE. Aberrant expression and function of the p21Ras/MAP kinase pathway are associated with active SLE. Therefore, we examined the effect of treatment with a CDR1-based peptide of a human autoantibody (hCDR1) on the p21Ras pathway and SLE manifestations of SLE-prone (NZBxNZW)F1 mice. Untreated SLE-afflicted mice demonstrated increased expression of p21Ras and the phosphorylated active form of its down-stream element JNK kinase in conjunction with reduced hSOS and unchanged p120GAP, as compared to healthy controls. Amelioration of SLE manifestations following treatment with hCDR1 was associated with a diminished expression of phosphorylated JNK kinase, mainly in the T cell population that also exhibited reduced rates of apoptosis. Thus, hCDR1 therapy ameliorates SLE, at least in part, via down-regulation of the activity of the pro-apoptotic JNK kinase.
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Affiliation(s)
- Micha J Rapoport
- Department C of Internal Medicine, Assaf Harofeh Medical Center, Zerifin 70300, Israel
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Bendet N, Scapa E, Cohen O, Bloch O, Aharoni D, Ramot Y, Weiss M, Halevi A, Rapoport MJ. Enhanced glucose-dependent glucagon-like peptide-1 and insulin secretion in Crohn patients with terminal ileum disease is unrelated to disease activity or ileal resection. Scand J Gastroenterol 2004; 39:650-6. [PMID: 15370686 DOI: 10.1080/00365520410004839] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Enhanced secretion of glucagon-like peptide-1 (GLP-1) has been reported in patients with Crohn disease (CD). However, the correlation between the enteropancreatic axis and the activity of CD remains unclear. METHODS Plasma glucose, insulin, GLP-1 levels and insulin sensitivity were determined before and after oral glucose tolerance tests in 13 patients with CD of the terminal ileum, in 13 patients after resection of the terminal ileum and in 7 healthy controls. Basal and stimulated insulin sensitivities were determined using the homeostasis model assessment (HOMA) and the insulin sensitivity index (ISI) methods, respectively. RESULTS Basal and stimulated glucose levels were comparable in patients and controls. The peak stimulated GLP-1 secretion was significantly higher in the patient group compared to controls: 12.2 +/- 1.24 pM/L and 8.1 +/- 1.72 pM/L, respectively, P=0.03. This was associated with 52% increased overall insulin secretion in the patients' group as compared to controls (P=0.007) and a higher peak insulin response: 63.5 +/- 9.69 mU/L and 41.5 +/- 6.85 mU/L for patients and controls, respectively, P=0.04. Operated patients had similar GLP-1 levels but higher peak and overall insulin secretions compared with those in non-operated patients (P=0.01). Fasting and stimulated insulin sensitivities were reduced only in patients with ileal resection as compared to controls: P=0.01 and P=0.05, respectively. No correlation was found between the CD activity index and GLP-1 or insulin secretion. CONCLUSIONS CD of the terminal ileum is associated with enhanced glucose-dependent GLP-1 secretion, which is unrelated to disease activity or ileal resection.
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Affiliation(s)
- N Bendet
- Division of Surgery, Institute of Gastroenterology, Assaf Harofeh Medical Center, Tel-Aviv University, Israel
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29
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Abstract
Metabolic, genetic and environmental factors very likely play an important role in the development of skin lesions in diabetes mellitus. While these lesions are involved in secondary diabetes complications, various diabetogenic genotoxic agents may induce direct skin damage. In the present study we examined the potential of known diabetogenic agents (streptozotocin (STZ) and alloxan (AL)), with different mechanisms of action, for induction of direct injury in an immortal human keratinocyte HaCat cell line. In contrast to STZ, which induces alkylation of DNA, a genotoxic effect of AL is achieved through reactive oxygen species. We found that HaCat cells are highly sensitive to STZ, but not to AL. At a concentration of 10mM STZ, cell viability decreased to 32 +/-13% of control (P<0.05), as compared to 82 +/-14% with 10mM of AL. Cells treated with 10 and 20mM STZ showed a significant increase in apoptosis (3.9- and 6.7-fold), but not in necrosis, compared to naive cells (P<0.05). In contrast to STZ, no increase in apoptotic and necrotic cell death was observed after AL treatment. Pretreatment with non-metabolizable 3-O-methyl glucose (3-OMG), which can blockade glucose transporter, or with poly(ADP-ribose) polymerase inhibitors (nicotinamide or 3-aminobenzamide), did not protect keratinocytes from STZ injury. Our results show that STZ, but not AL, is highly toxic to the HaCat cell line. Unlike insulin-producing cells, STZ-induced injury of immortal human keratinocyte HaCat cells is independent of the glucose transporters as well as of the activation of poly(ADP-ribose) polymerase.
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Affiliation(s)
- Avikam Harel
- The Pediatric Dermatology Unit and The Gino Stock Dermatophysiology Laboratory, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 64239, Tel Aviv, Israel.
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Abstract
OBJECT Intraoperative image guidance provides real-time three-dimensional visualization and has been successfully applied in many posterior spinal procedures. The feasibility of applying these techniques to anterior spinal surgery has not been studied systematically because the anterior spine, in contrast to the posterior spine, lacks distinct anatomical landmarks for registration. The authors sought to evaluate the practicality of performing stereotaxy in the anterior spine in a cadaveric model. METHODS Unilateral C4-L4 pedicle screws were placed posteriorly in three cadaveric specimens to serve as unknown markers within each vertebral body. The specimens then underwent computerized tomography (CT) scanning, and the CT data were transferred to an optical tracking system. The anterior surface of the spine was registered for use with the stereotactic system by using a paired point-matching technique. Attached to a surgical drill, K-wires were placed under stereotactic guidance in a tip-to-tip orientation with the posterior pedicle screws. A second postoperative CT scan was obtained, and accuracy was determined by measuring the distance between the tips of the K-wire and pedicle screw. The K-wires were placed tip to tip with pedicle screw markers in 57 vertebral levels. The mean registration error was 1.47+/-0.04 mm, and when combined with the universal instrument registration error of 0.7 mm yielded an overall registration error of 2.17+/-0.04 mm. The mean tip-to-tip distance for all K-wires placed was 2.46+/-0.23 mm. The difference between the mean tip-to-tip distance and overall registration error was not statistically significant (p > 0.05), indicating that the K-wires were placed within the expected range of error. CONCLUSIONS The results of this study confirmed the feasibility of performing anterior stereotactic procedures throughout the spine. The accuracy of the findings in this study indicates that anterior stereotaxy should be applicable in clinical practice.
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Affiliation(s)
- L T Holly
- Division of Neurosurgery, University of California at Los Angeles Medical Center, USA
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31
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Abstract
OBJECT In recent studies some authors have indicated that 20% of patients have at least one ectatic vertebral artery (VA) that, based on previous criteria in which preoperative computerized tomography (CT) and standard intraoperative fluoroscopic techniques were used. may prevent the safe placement of C1-2 transarticular screws. The authors conducted this study to determine whether frameless stereotaxy would improve the accuracy of C1-2 transarticular screw placement in healthy patients, particularly those whom previous criteria would have excluded. METHODS The authors assessed the accuracy of frameless stereotaxy for C1-2 transarticular screw placement in 17 cadaveric cervical spines. Preoperatively obtained CT scans of the C-2 vertebra were registered on a stereotactic workstation. The dimensions of the C-2 pars articularis were measured on the workstation, and a 3.5-mm screw was stereotactically placed if the height and width of the pars interarticularis was greater than 4 mm. The specimens were evaluated with postoperative CT scanning and visual inspection. Screw placement was considered acceptable if the screw was contained within the C-2 pars interarticularis, traversed the C 1-2 joint, and the screw tip was shown to be within the anterior cortex of the C-1 lateral mass. Transarticular screws were accurately placed in 16 cadaveric specimens, and only one specimen (5.9%) was excluded because of anomalous VA anatomy. In contrast, a total of four specimens (23.5%) showed significant narrowing of the C-2 pars interarticularis due to vascular anatomy that would have precluded atlantoaxial transarticular screw placement had previous nonimage-guided criteria been used. CONCLUSIONS Frameless stereotaxy provides precise image guidance that improves the safety of C1-2 transarticular screw placement and potentially allows this procedure to be performed in patients previously excluded because of the inaccuracy of nonimage-guided techniques.
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Affiliation(s)
- O Bloch
- University of California at Los Angeles Medical Center, Los Angeles, California, USA
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Kim KD, Johnson JP, Bloch O, Masciopinto JE, Saracen MJ, Villablanca JP. New software applications for interchangeable instrumentation in spinal stereotaxis. Stud Health Technol Inform 1999; 62:179-80. [PMID: 10538351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Computer image-guided surgery has been widely accepted because it allows the surgeon to track an instrument through unvisualized critical structures of a patient in real-time, thus minimizing the risk of injury. Current spinal and cranial image-guided surgery is, however, limited by the lack of surgical instruments and software applications that would allow rapid interchange of useful instruments to perform the procedures. Most image-guided systems utilize a single standard probe or a few pre-defined instruments that are not necessarily useful for performing the actual surgical procedure. Present image-guided technology for screw placement in spinal surgery utilizes the standard probe only to confirm the entry point location and view the planned trajectory of the screw. The surgeon then resumes the procedure using standard surgical instruments to drill, tap and place screws without the benefit of image guidance. Our clinical laboratory experience with spinal image-guided surgery indicates that there is potential for error between each of these procedural steps of screw placement. Despite accurately locating an entry point, any deviation in the trajectory during drilling of a pilot hole, tapping or screw placement may result in significant errors in screw placement and potential neurovascular injury. We have developed custom software applications and universal hardware adaptation devices for spinal image-guided surgery that allow the use of standard instruments for intraoperative guidance. Utilizing universal dynamic registration hardware and software, standard surgical instruments are adapted for real-time image guided surgery. An array of light emitting diodes can be attached to essentially any rigid instrument with a definable tip and then calibrated to the system for intraoperative use. Laboratory tests using a cadaveric model indicate a difference in accuracy of less than 1.0 mm between the standard probe and a dynamically registered custom instrument and an absolute mean error of less than 2.0 mm for the image-guided system which is clinically insignificant in most cases. This technology is a significant step forward as it allows the surgeon to use a full array of instruments with image guidance and will ultimately make spinal and intracranial surgery safer and more accurate.
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Affiliation(s)
- K D Kim
- Department of Neurosurgery (KDK), School of Medicine, University of California, Davis, USA
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Kim KD, Johnson JP, Masciopinto JE, Bloch O, Saracen MJ, Villablanca JP. Universal calibration of surgical instruments for spinal stereotaxy. Neurosurgery 1999; 44:173-7; discussion 177-8. [PMID: 9894978 DOI: 10.1097/00006123-199901000-00105] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/25/2022] Open
Abstract
PURPOSE To describe new software applications and interchangeable instrumentation enabling the use of standard surgical instruments with image-guided systems for stereotactic spinal procedures. CONCEPT The ability to adapt essentially any surgical instrument for stereotactic procedures will improve the safety and accuracy of image-guided spinal surgery. RATIONALE Using universal dynamic registration hardware and software, standard surgical instruments are adapted for real-time image-guided surgery. The Radionics Optical Tracking System (Radionics, Inc., Burlington, MA) has custom software applications and universal hardware adaptation devices for spinal stereotaxy that allows the use of standard instruments for intraoperative guidance. An array of light-emitting diodes can be attached to essentially any rigid instrument with a definable tip and can then be calibrated to the system for intraoperative use. Stereotactic guidance of a drill, tap, and screwdriver may improve screw placement accuracy in spinal surgery because every step of the procedure can be monitored in real time. DISCUSSION Most stereotactic systems have only a standard probe or limited instruments for localization, targeting, and tracking a procedure. The surgeon then resumes the operation using standard surgical instruments without the benefit of image guidance for the key steps of the procedure. Because each surgical step for screw placement in the spine has a potential for error, use of multiple instruments that can be interchanged for real-time image-guided spinal surgery may increase the accuracy and safety of spinal instrumentation procedures. These techniques can also be applied to intracranial image-guided surgery.
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Affiliation(s)
- K D Kim
- Division of Neurosurgery, School of Medicine, University of California, Los Angeles, USA
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Jacq J, Bloch O. Reduction eletrochimique de l'oxygene en eau oxygenee. Etablissement de l'equation de la courbe de polarisation: application au calcul des parametres thermodynamiques et cinetiques des etapes elementaires. Electrochim Acta 1970. [DOI: 10.1016/0013-4686(70)85030-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Desmarquest J, Bloch O. Électrode rédox à hydrazine: Étude de la réduction du chlorure cuivrique. Electrochim Acta 1968. [DOI: 10.1016/0013-4686(68)80040-4] [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: 10/18/2022]
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Jacq J, Bloch O. Formation d'eau oxygenee au cours de la reduction electrochimique de l'oxygene en milieu alcalin sur differentes cathodes. Electrochim Acta 1964. [DOI: 10.1016/0013-4686(64)80028-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bloch O. Specificity of the Lesion of Experimental Mumps. Am J Pathol 1937; 13:939-944. [PMID: 19970359 PMCID: PMC1911152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Bloch O. A Clinical Lecture on the Antiseptic Treatment of Wounds: Delivered at the Kgl. Frederik's Hospital, Copenhagen. West J Med 1902; 2:1825-8. [DOI: 10.1136/bmj.2.2189.1825] [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: 11/04/2022]
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Clo�z S, Bloch O. Zur Bestimmung des Wassergehalts der Kartoffelst�rke. Anal Bioanal Chem 1874. [DOI: 10.1007/bf01302349] [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: 11/30/2022]
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