Expression of active matrix metalloproteinase-9 as a likely contributor to the clinical failure of aclerastide in treatment of diabetic foot ulcers

Chronic wounds are a complication of diabetes. Treatment for diabetic foot ulcers is complex with little clinical recourse, resulting in 108,000 lower-limb amputations annually in the United States alone. Matrix metalloproteinases (MMPs) play important roles in the pathology and in the repair of chronic wounds. We previously identified active MMP-8 and MMP-9 in wounds of diabetic mice and determined that MMP-8 accelerates wound repair, while MMP-9 is the culprit for the diabetic wound being refractory to healing. Aclerastide, a peptide analog of angiotensin II, recently failed in phase III clinical trials for treatment of diabetic foot ulcers. We demonstrate herein that treatment of wounds of diabetic mice with aclerastide results in elevated levels of reactive oxygen species and of active MMP-9, which is likely an important contributor to the failure of aclerastide in clinical trials.

Fiesta as tradition, fiesta as change: ritual, alcohol and violence in a Mexican community

AIMS

To explore the traditional Mexican religious fiesta as a primary locus for community-based excessive drinking and violence against women. The research argues that the pattern of drinking and violence cannot be placed within explanations that tie a breakdown in social norms to drinking nor drinking to a breakdown in social norms.

DESIGN

The data were gathered over 14 continuous months of participant observation in 1995 and 1996, followed by two summer research projects in 1997 and 1998. The researcher documented the activities of the participants at each fiesta and followed-up each event with interviews of the parties involved in violent confrontations. In addition, life stories and archival data on violence were conducted and used to situate current findings against historical data.

SETTING

All data were collected in the community of Santa Maria Atzompa. Atzompa is a cabécera or municipal seat, for six colonias (large neighborhoods), and three ranchos (agriculturally based communities) and has a population of just over 5200. The main community of Atzompa, where most of the research was conducted, has a population of 2700+.

PARTICIPANTS

Over 1000 individuals participated in community religious fiestas that the researcher attended. More than half of these were men, and almost all the men present participated in the binge drinking.

MEASUREMENTS

Sixteen religious fiestas and 13 non-religious fiestas were documented through participant observation and photographs.

FINDINGS

In every religious-based fiesta, violence erupted and was directed primarily against women. Husband and wife abuse accounted for 10 of the 16 violent disruptions (63%) while male/male abuse accounted for six (38%).

CONCLUSIONS

The perpetuation of binge drinking and violence are part of a historic cycle of male dominance that dates back to the introduction of alcohol distillation during colonization by the Spaniards in the 16th century, compounded today by frustration over their inability to control the economic and political aspects of their households and community. Women's acquiescence to the violence is a form of mediation over male frustrations that allow women to continue in their roles as economic providers.

Offspring of streptozotocin diabetic rats: size changes in Langerhans islets with time after birth

It has been demonstrated that, in the diabetic rat, pregnancy and lactation are severely altered: in this study, we have measured the size of Langerhans islets of rat pups, the offspring of experimental diabetic mothers and nondiabetic controls. Diabetes was induced through streptozotocin administration (dose, 60 mg/kg body wt.). This drug was injected in every animal; their blood sugar was measured 1 week later (Haemo-Glukotest, Boehringer Mannheim), and they were then separated into three groups according to their fasting blood sugar levels: (a) severe diabetics (above 16.5 mM/l); (b) mild diabetics (6.5-16.5 mM/l); and (c) nondiabetic normals. They received insulin therapy (2-4 I.U./day) as the mild diabetics exhibited a slightly higher than normal fasting blood sugar, and the diabetic ones, above 15 mM/l. The areas of Langerhans islets of pups were measured 1 and 5 days after parturition; pancreas sections were dyed (haematoxylin-eosin) and morphometry was then performed using a digitalized magnetic tabloid connected to a Zeiss Morphomat 30 (Kontron). On the first day after parturition, the pancreas section areas in pups from mildly and severely diabetic mothers were smaller than those in neonates from nondiabetic controls (P < 0.001). The areas in neonates from severely diabetic mothers showed a more intense decrease than those from mildly diabetic animals (P < 0.01). On day 5 after delivery, the areas of Langerhans islets in offspring from normal mothers decreased and those in pups from diabetic mothers tended to normalize (P < 0.01), particularly those from the severely sick group (P < 0.01). We conclude that after parturition the offspring is no longer exposed to the high blood sugar levels found in both diabetic groups of mothers, thereby no hyperinsulinemia is needed; as time elapses, then, the area of their Langerhans islets tends to normalization.

Quantitation of insulin stores in Langerhans islets by combined immunohistochemistry and computerized microspectrophotometric analysis

Histology, size, and insulin content of Langerhans islets from normal and recent experimental hyperthyroid (REH) dogs were studied. Insulin localization in the islets was revealed by immunohistochemistry, and the remaining two variables were analyzed by computerized microspectrophotometry according to an original technique described here. Observed under the light microscope, the REH dog pancreas section shows larger than normal islets whose scarce beta-granules are mainly located near B-cell borders and grouped along capillaries. The brown areas occupied by insulin in Langerhans islets from REH and normal dogs (mean +/- SEM) are 5182 +/- 311 and 4236 +/- 287 microns2, the total mean insulin amount per respective islet section-as expressed in absorbance arbitrary units-is 1108 and 1846, and the light absorbances per such area units are 0.214 +/- 0.070 and 0.436 +/- 0.060, respectively. Measuring these variables in dog and human (large) pancreases by the conventional methods successfully used for small pancreases would have been technically impossible.

Influence of estrogen-progesterone sequential administration on pancreas cytology. Serum insulin and metabolic adjustments in female dogs

In bitches in anestrus, artificial endometrial sex cycles were induced. Estrus was induced by 17 beta-estradiol benzoate administration; matched untreated and vehicle-treated controls were studied. Early metadiestrus (6th day after appearance of metestrum cells in vaginal smears) was induced by the sequential administration of 17 beta-estradiol benzoate and progesterone: matched studies with only one hormone or vehicles were also carried out. In different groups of animals, blood sugar (BS), serum immunoreactive insulin (IRI) and serum free fatty acids (FFA) in the basal conditions and during glucose and insulin tests were studied. Insulin was immunocytolocalized in sections of pancreas from a part of these animals. Size and insulin content in Langerhans islets were measured by morphometric and cytospectrophotometric computerized analysis. Extra-pancreatic factors--space of distribution, t1/2 in blood stream--regulating serum IRI and BS levels were calculated. The hypoglycemic effect of insulin was enhanced by estrogenization, together with insulin accumulation in Langerhans islets. Progesterone treatment caused mild insulin resistance together with depletion of pancreatic insulin stores in the long run. Glucose tolerance of progesterone-injected bitches was improved after estrogen priming with greater space of distribution of glucose. Furthermore, a high basal serum FFA levels in bitches receiving the hormone sequence was observed. We may therefore conclude that the metabolic and endocrine changes induced in bitches by artificial sex cycles converge towards excellent BS homeostasis leads to the replenishing of pancreatic insulin stores, so that estrogen-progesterone administration in sequence appears to be, in this experimental condition, non-diabetogenic.

Prolactin release, oestrogens and proliferation of prolactin-secreting cells in the anterior pituitary gland of adult male rats

Relationships among the release of prolactin, the effect of oestrogens and the proliferation of prolactin-secreting cells were studied under several experimental conditions. Administration of sulpiride or oestradiol released prolactin and stimulated cell proliferation in the anterior pituitary gland of adult male rats. Clomiphene completely abolished the rise in cell proliferation, but did not interfere with the sulpiride-induced release of prolactin. Treatment with oestradiol plus sulpiride significantly increased serum prolactin concentrations and the mitotic index compared with the sum of the stimulation produced by both drugs separately. Bromocriptine abolished the stimulatory effect of oestradiol on the serum prolactin concentration and on cell proliferation. In oestradiol- and/or sulpiride-treated rats, 80% of the cells in mitoses were lactotrophs. The remaining 20% did not stain with antisera against any of the pituitary hormones. The number of prolactin-secreting cells in the anterior pituitary gland significantly increased after the administration of oestradiol or sulpiride. The results demonstrate that treatment with sulpiride and/or oestradiol increases the proliferation and the number of lactotrophs in the anterior pituitary gland of the rat.

Correlation between LH secretion in castrated rats with cellular proliferation and synthesis of DNA in the anterior pituitary gland

The relationship between the release of LH and the synthesis of DNA was studied in the anterior pituitary gland of castrated rats. Cell types were characterized immunocytochemically. Castration significantly (P less than 0.01) increased the concentration of LH in serum (1326%) and the incorporation of [3H]thymidine into pituitary DNA (72%). This was accompanied by an increment in the activity of the enzyme DNA polymerase-alpha (58%) and in the number of mitoses (from 2 +/- 0.1/mm2 in intact rats to 21 +/- 0.8/mm2 15 days after castration). Only 20% of the mitoses found in the pituitary gland of castrated rats were positively stained with the antiserum against the beta-subunit of LH. The other 80% did not stain either with LH antiserum or with antisera against the other pituitary hormones. There was a significant (P less than 0.01) increase in the number of LH cells in castrated rats (48%). All the changes produced in the anterior pituitary gland after castration were prevented by the administration of dihydrotestosterone. The results demonstrate that a stimulation of LH release is followed by an increase of DNA synthesis and cell proliferation of gonadotrophs in the anterior pituitary gland.

Effects of short-term thyroxine treatment on pancreatic cytology and responses of blood sugar, serum insulin and serum free fatty acids to epinephrine infusion

The influence of short-term treatment with l-thyroxine on pancreatic histology and on the responses of glycemia, insulinemia and serum free fatty acids to a continuous l-epinephrine infusion in the absence or presence of alpha- and beta-adrenergic blockade was studied in male dogs. l-Epinephrine dosage: 0.06 microgram/kg body weight/min for 55 min. Two experimental groups were studied, one treated for 10 days with sodium l-thyroxine, one daily dose of 100 micrograms/kg body weight, the other of untreated controls. Three alternative treatments were applied to dogs of both groups: 1) no treatment; 2) alpha-adrenergic blockade with phentolamine (2.0 mg/kg body weight, 35 min before starting the l-epinephrine infusion); 3) beta-adrenergic blockade with propranolol (0.3 mg/kg body weight, 20 min before starting the l-epinephrine infusion). Body weight, rectal temperature, heart and respiratory rates were used as guidelines to assess experimental hyperthyroidism. Insulin immunocytolocalization was also studied in the Langerhans islets of T4-treated and control dogs. Body weight decreased and rectal temperature did not vary as a result of thyroxine administration which had no significant effect on respiratory and heart rate. The mean number of breaths from 0 to 120 min from the start of l-epinephrine infusion decreased in both T4-treated and control dogs submitted to propranolol blockage compared to non-blocked animals; phentolamine had no effect on the respiratory rate. Thyroxine treatment did not modify the number of heart beats, but phentolamine blockade had a different effect in T4-treated compared to control dogs whereas propranolol had similar effects in these two groups. Histological examination of the Langerhans islets of dogs submitted to short-term thyroxine treatment showed degranulation though no vacuolation. Most of the beta-granules contained in the B-cells of these islets were found near the cell membrane, thus forming a dark brown line after the immunochemical reaction. Since negative images of B-cell nuclei and vascular spaces were predominant in these specimens, the pancreas of T4-treated dogs presented a mesh structure. In dogs submitted to short-term thyroxine treatment, the hyperglycemic response to l-epinephrine was enhanced and prolonged as compared to untreated controls. In normal dogs, this response is mainly mediated by alpha-adrenergic receptors while beta-receptors hardly influence this response.(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of sulpiride on the adenohypophysis of castrated male rats. Immunocytochemistry and ultrastructural cytomorphometry

Previous studies have shown that N-[(1-ethyl-2-pyrrolidinyl)methyl] )-2-methoxy-5-sulfamoylbenzamide (sulpiride), a psychotrophic drug of clinical use, is a potent antidopaminergic agent, and acts on prolactin and gonadotroph secretions. Cytological changes caused by the effects of this drug were studied in castrated male rats treated with daily doses of sulpiride 5 mg/100 g body weight. Animals were sacrificed 2 months after treatment and their hypophyses processed for cytological and immunohistochemical studies. Cytomorphometry was carried out at the ultrastructural level. An immunocytochemical study was performed with peroxidase-labelled antibody to determine PRL, FSH and LH hormones in gland sections. The administration of sulpiride produced a decrease in granules of prolactin cells. Only the Golgi region showed a positive prolactin reaction and the cytomorphometric study indicated an increase of the area occupied by the endoplasmic reticulum and Golgi complex. In gonadotrophs, treatment with sulpiride decreased the vacuolatin caused by castration. The area occupied by the endoplasmic reticulum was smaller, whereas that occupied by secretion granules and lysosomes became larger. It is suggested that sulpiride treatment increased markedly the mammotroph activity and decreased the gonadotroph one, restoring the vacuolation of the endoplasmic reticulum vacuolation to normal.

Effect of estrogens on blood sugar, serum insulin and serum free fatty acids, and pancreas cytology in female dogs

We analyzed the changes in blood sugar (BS), serum immunoreactive insulin (IRI), circulating free fatty acids (FFA) and pancreatic cytology caused by estrogenization at low pharmacological dosage in female dogs. Vehicle-injected and untreated controls (anestrus) were studied as well. Neither mean basal BS nor basal serum IRI was modified by the treatments, while the mean basal serum FFA value was raised. Glucose tolerance was not modified by the estrogens while glucose y-mean was significantly raised. Hyperglycemia was higher for a longer time in estrogenized animals compared to both controls, while the profiles of hyperinsulinemia coincided. In the estrogen-treated bitches, the pancreatic B-cells contained scarse brown-stained granules near their vascular pole, as shown by an immunochemical method. In the peripheral part of the pancreas, near the acini, some solitary, poorly beta-granulated B-cells were present. During the IVGTT, serum FFA reached lower values for a longer time in the estrogenized bitches as compared to those found in both control groups. Insulin-induced hypoglycemia in the estrogenized animals coincided with the one evoked in the vehicle controls; in the semilog relationship of serum IRI and time, y-mean was lower than that observed in oil-injected controls, and insulin space was larger. The serum FFA levels of these estrogenized bitches, very high in the basal conditions, did not respond to insulin administration, and were above those found in untreated controls and also in vehicle-injected controls just at the beginning of the test. These results are discussed. We came to the conclusion that estrogenization causes some glucose intolerance in bitches while insulin sensitivity remains normal in the IVITT as studied measuring BS. The glucose intolerance is thought to be related to a reduction in glucose space and occurs despite the normality of the serum IRI response. The pancreas must have an intense secretory response in vivo as as to maintain normal IRI activity despite degranulation of the islets of Langerhans and poor islet hypertrophy and neoformation. The serum FFA changes are thought to contribute towards the tendency to adiposity in these animals.