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Braczko A, Harasim G, Kawecka A, Walczak I, Kapusta M, Narajczyk M, Stawarska K, Smoleński RT, Kutryb-Zając B. Blocking cholesterol formation and turnover improves cellular and mitochondria function in murine heart microvascular endothelial cells and cardiomyocytes. Front Physiol 2023; 14:1216267. [PMID: 37745244 PMCID: PMC10512729 DOI: 10.3389/fphys.2023.1216267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Background: Statins and proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) are cornerstones of therapy to prevent cardiovascular disease, acting by lowering lipid concentrations and only partially identified pleiotropic effects. This study aimed to analyze impacts of atorvastatin and synthetic peptide PCSK9i on bioenergetics and function of microvascular endothelial cells and cardiomyocytes. Methods: Mitochondrial function and abundance as well as intracellular nucleotides, membrane potential, cytoskeleton structure, and cell proliferation rate were evaluated in mouse heart microvascular endothelial cells (H5V) and cardiomyocytes (HL-1) under normal and hypoxia-mimicking conditions (CoCl2 exposure). Results: In normal conditions PCSK9i, unlike atorvastatin, enhanced mitochondrial respiratory parameters, increased nucleotide levels, prevented actin cytoskeleton disturbances and stimulated endothelial cell proliferation. Under hypoxia-mimicking conditions both atorvastatin and PCSK9i improved the mitochondrial respiration and membrane potential in both cell types. Conclusion: This study demonstrated that both treatments benefited the endothelial cell and cardiomyocyte bioenergetics, but the effects of PCSK9i were superior.
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Affiliation(s)
- Alicja Braczko
- Department of Biochemistry, Medical University of Gdansk, Gdańsk, Poland
| | - Gabriela Harasim
- Department of Biochemistry, Medical University of Gdansk, Gdańsk, Poland
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdansk, Gdańsk, Poland
| | - Iga Walczak
- Department of Biochemistry, Medical University of Gdansk, Gdańsk, Poland
| | | | | | - Klaudia Stawarska
- Department of Biochemistry, Medical University of Gdansk, Gdańsk, Poland
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Kutryb-Zając B, Kawecka A, Nasadiuk K, Braczko A, Stawarska K, Caiazzo E, Koszałka P, Cicala C. Drugs targeting adenosine signaling pathways: A current view. Biomed Pharmacother 2023; 165:115184. [PMID: 37506580 DOI: 10.1016/j.biopha.2023.115184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Adenosine is an endogenous nucleoside that regulates many physiological and pathological processes. It is derived from either the intracellular or extracellular dephosphorylation of adenosine triphosphate and interacts with cell-surface G-protein-coupled receptors. Adenosine plays a substantial role in protecting against cell damage in areas of increased tissue metabolism and preventing organ dysfunction in pathological states. Targeting adenosine metabolism and receptor signaling may be an effective therapeutic approach for human diseases, including cardiovascular and central nervous system disorders, rheumatoid arthritis, asthma, renal diseases, and cancer. Several lines of evidence have shown that many drugs exert their beneficial effects by modulating adenosine signaling pathways but this knowledge urgently needs to be summarized, and most importantly, actualized. The present review collects pharmaceuticals and pharmacological or diagnostic tools that target adenosine signaling in their primary or secondary mode of action. We overviewed FDA-approved drugs as well as those currently being studied in clinical trials. Among them are already used in clinic A2A adenosine receptor modulators like istradefylline or regadenoson, but also plenty of anti-platelet, anti-inflammatory, or immunosuppressive, and anti-cancer drugs. On the other hand, we investigated dozens of specific adenosine pathway regulators that are tested in clinical trials to treat human infectious and noninfectious diseases. In conclusion, targeting purinergic signaling represents a great therapeutic challenge. The actual knowledge of the involvement of adenosinergic signaling as part of the mechanism of action of old drugs has open a path not only for drug-repurposing but also for new therapeutic strategies.
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Affiliation(s)
- Barbara Kutryb-Zając
- Department of Biochemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland.
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Khrystyna Nasadiuk
- Department of Biochemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Klaudia Stawarska
- Department of Biochemistry, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Elisabetta Caiazzo
- Department of Pharmacy, School of Medicine, University of Naple Federico II, 80131 Naples, Italy
| | - Patrycja Koszałka
- Laboratory of Cell Biology and Immunology, Institute of Medical Biotechnology and Experimental Oncology, Intercollegiate Faculty of Biotechnology University of Gdańsk and Medical University of Gdańsk, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Carla Cicala
- Department of Pharmacy, School of Medicine, University of Naple Federico II, 80131 Naples, Italy
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Jedrzejewska A, Kawecka A, Braczko A, Romanowska-Kocejko M, Stawarska K, Deptuła M, Zawrzykraj M, Franczak M, Krol O, Harasim G, Walczak I, Pikuła M, Hellmann M, Kutryb-Zając B. Changes in Adenosine Deaminase Activity and Endothelial Dysfunction after Mild Coronavirus Disease-2019. Int J Mol Sci 2023; 24:13140. [PMID: 37685949 PMCID: PMC10487738 DOI: 10.3390/ijms241713140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
Endothelial cells are a preferential target for SARS-CoV-2 infection. Previously, we have reported that vascular adenosine deaminase 1 (ADA1) may serve as a biomarker of endothelial activation and vascular inflammation, while ADA2 plays a critical role in monocyte and macrophage function. In this study, we investigated the activities of circulating ADA isoenzymes in patients 8 weeks after mild COVID-19 and related them to the parameters of inflammation and microvascular/endothelial function. Post-COVID patients revealed microvascular dysfunction associated with the changes in circulating parameters of endothelial dysfunction and inflammatory activation. Interestingly, serum total ADA and ADA2 activities were diminished in post-COVID patients, while ADA1 remained unchanged in comparison to healthy controls without a prior diagnosis of SARS-CoV-2 infection. While serum ADA1 activity tended to positively correspond with the parameters of endothelial activation and inflammation, sICAM-1 and TNFα, serum ADA2 activity correlated with IL-10. Simultaneously, post-COVID patients had lower circulating levels of ADA1-anchoring protein, CD26, that may serve as an alternative receptor for virus binding. This suggests that after the infection CD26 is rather maintained in cell-attached form, enabling ADA1 complexing. This study points to the possible role of ADA isoenzymes in cardiovascular complications after mild COVID-19.
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Affiliation(s)
- Agata Jedrzejewska
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Marzena Romanowska-Kocejko
- Department of Cardiac Diagnostics, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.R.-K.); (M.H.)
| | - Klaudia Stawarska
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Milena Deptuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Division of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (M.P.)
| | - Małgorzata Zawrzykraj
- Division of Clinical Anatomy, Department of Anatomy, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Marika Franczak
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Oliwia Krol
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Gabriela Harasim
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Iga Walczak
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
| | - Michał Pikuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Division of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (M.P.)
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, 80-210 Gdansk, Poland; (M.R.-K.); (M.H.)
| | - Barbara Kutryb-Zając
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (A.J.); (A.K.); (A.B.); (K.S.); (M.F.); (O.K.); (G.H.); (I.W.)
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Kutryb-Zajac B, Kawecka A, Caratis F, Urbanowicz K, Braczko A, Furihata T, Karaszewski B, Smolenski RT, Rutkowska A. The impaired distribution of adenosine deaminase isoenzymes in multiple sclerosis plasma and cerebrospinal fluid. Front Mol Neurosci 2022; 15:998023. [PMID: 36204140 PMCID: PMC9530629 DOI: 10.3389/fnmol.2022.998023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adenosine deaminase (ADA) via two isoenzymes, ADA1 and ADA2, regulates intra- and extracellular adenosine concentrations by converting it to inosine. In the central nervous system (CNS), adenosine modulates the processes of neuroinflammation and demyelination that together play a critical role in the pathophysiology of multiple sclerosis (MS). Except for their catalytic activities, ADA isoenzymes display extra-enzymatic properties acting as an adhesion molecule or a growth factor. Aims This study aimed to explore the distribution and activity of ADA1 and ADA2 in the plasma and the CSF of MS patients as well as in the human brain microvascular endothelial cells (HBMEC), human brain vascular pericytes and human astrocytes. Methods and results The enzyme assay following reverse phase-high performance liquid chromatography (HPLC) analysis was used to detect the ADA1 and ADA2 activities and revealed an increased ratio of ADA1 to ADA2 in both the plasma and the CSF of MS patients. Plasma ADA1 activity was significantly induced in MS, while ADA2 was decreased in the CSF, but significance was not reached. The brain astrocytes, pericytes and endothelial cells revealed on their surface the activity of ADA1, with its basal level being five times higher in the endothelial cells than in the astrocytes or the pericytes. In turn, ADA2 activity was only observed in pericytes and endothelial cells. Stimulation of the cells with pro-inflammatory cytokines TNFα/IL17 for 18 h decreased intracellular nucleotide levels measured by HPLC only in pericytes. The treatment with TNFα/IL17 did not modulate cell-surface ATP and AMP hydrolysis nor adenosine deamination in pericytes or astrocytes. Whereas in endothelial cells it downregulated AMP hydrolysis and ADA2 activity and upregulated the ADA1, which reflects the ADA isoenzyme pattern observed here in the CSF of MS patients. Conclusion In this study, we determined the impaired distribution of both ADA isoenzymes in the plasma and the CSF of patients with MS. The increased ADA1 to ADA2 ratio in the CSF and plasma may translate to unfavorable phenotype that triggers ADA1-mediated pro-inflammatory mechanisms and decreases ADA2-dependent neuroprotective and growth-promoting effects in MS.
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Affiliation(s)
- Barbara Kutryb-Zajac
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, Poland
- *Correspondence: Barbara Kutryb-Zajac,
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, Poland
| | - Fionä Caratis
- Department of Anatomy and Neurobiology, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdańsk, Gdańsk, Poland
| | - Tomomi Furihata
- Laboratory of Clinical Pharmacy and Experimental Therapeutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Japan
| | - Bartosz Karaszewski
- Department of Adult Neurology, Medical University of Gdańsk and University Clinical Center, Gdańsk, Poland
| | | | - Aleksandra Rutkowska
- Department of Anatomy and Neurobiology, Medical University of Gdańsk, Gdańsk, Poland
- Aleksandra Rutkowska,
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Jedrzejewska A, Braczko A, Kawecka A, Hellmann M, Siondalski P, Slominska E, Kutryb-Zajac B, Yacoub MH, Smolenski RT. Novel Targets for a Combination of Mechanical Unloading with Pharmacotherapy in Advanced Heart Failure. Int J Mol Sci 2022; 23:ijms23179886. [PMID: 36077285 PMCID: PMC9456495 DOI: 10.3390/ijms23179886] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 12/19/2022] Open
Abstract
LVAD therapy is an effective rescue in acute and especially chronic cardiac failure. In several scenarios, it provides a platform for regeneration and sustained myocardial recovery. While unloading seems to be a key element, pharmacotherapy may provide powerful tools to enhance effective cardiac regeneration. The synergy between LVAD support and medical agents may ensure satisfying outcomes on cardiomyocyte recovery followed by improved quality and quantity of patient life. This review summarizes the previous and contemporary strategies for combining LVAD with pharmacotherapy and proposes new therapeutic targets. Regulation of metabolic pathways, enhancing mitochondrial biogenesis and function, immunomodulating treatment, and stem-cell therapies represent therapeutic areas that require further experimental and clinical studies on their effectiveness in combination with mechanical unloading.
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Affiliation(s)
- Agata Jedrzejewska
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Marcin Hellmann
- Department of Cardiac Diagnostics, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdansk, Poland
| | - Piotr Siondalski
- Department of Cardiac Surgery, Medical University of Gdansk, Debinki 7 Street, 80-211 Gdansk, Poland
| | - Ewa Slominska
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
| | - Barbara Kutryb-Zajac
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
- Correspondence: (B.K.-Z.); (R.T.S.)
| | - Magdi H. Yacoub
- Heart Science Centre, Imperial College of London at Harefield Hospital, Harefield UB9 6JH, UK
| | - Ryszard T. Smolenski
- Department of Biochemistry, Medical University of Gdansk, Debinki 1 Street, 80-211 Gdansk, Poland
- Correspondence: (B.K.-Z.); (R.T.S.)
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Jablonska P, Mierzejewska P, Tomczyk M, Koszalka P, Franczak M, Kawecka A, Kutryb-Zajac B, Braczko A, Smolenski RT, Slominska EM. Differences in Extracellular NAD+ and NMN Metabolism on the Surface of Vascular Endothelial Cells. Biology 2022; 11:biology11050675. [PMID: 35625403 PMCID: PMC9137893 DOI: 10.3390/biology11050675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/15/2022] [Accepted: 04/25/2022] [Indexed: 12/04/2022]
Abstract
Simple Summary Nicotinamide adenine dinucleotide (NAD+) is a multifunctional metabolite involved in many key cellular processes. Outside the cell, NAD+ or its metabolites are important signaling molecules, related especially to calcium homeostasis, which controls the functioning of the heart. The cleavage of NAD+ or its precursor, nicotinamide mononucleotide (NMN), produces derivatives entering the cell to rebuild the intracellular NAD+ pool, which is important for cells with high energy turnover. Abnormalities in NAD+ and NMN metabolism can lead to cell aging and the development of cardiovascular diseases. In this study, we demonstrated that the extracellular metabolism of NAD+ and NMN is vastly different in the vascular endothelium obtained from different species and locations. This may have implications for strategies to modulate the NAD+ system and may cause difficulties for comparing the results of different reports. Abstract The disruption of the metabolism of extracellular NAD+ and NMN may affect related signaling cascades and pathologies, such as cardiovascular or respiratory system diseases. We aimed to study NAD+ and NMN hydrolysis on surface endothelial cells of diverse origins and with genetically modified nucleotide catabolism pathways. We tested lung endothelial cells isolated from C57BL/6 J wild-type (WT) and C57BL/6 J CD73 knockout (CD73 KO) mice, the transfected porcine iliac artery endothelial cell line (PIEC) with the human E5NT gene for CD73 (PIEC CD73), and a mock-transfected control (PIEC MOCK), as well as HMEC-1 and H5V cells. Substrate conversion into the product was followed by high-performance liquid chromatography (HPLC). We showed profound differences in extracellular NAD+ and NMN metabolism related to the vessel origin, species diversity, and type of culture. We also confirmed the involvement of CD38 and CD73 in NAD+ and NMN cleavage.
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Affiliation(s)
- Patrycja Jablonska
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Paulina Mierzejewska
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Marta Tomczyk
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Patrycja Koszalka
- Institute of Medical Biotechnology and Experimental Oncology, Intercollegiate Faculty of Biotechnology of University of Gdansk and Medical University of Gdansk, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Marika Franczak
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Ada Kawecka
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Barbara Kutryb-Zajac
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Alicja Braczko
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Ryszard T. Smolenski
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
| | - Ewa M. Slominska
- Department of Biochemistry, Medical University of Gdansk, 80-211 Gdansk, Poland; (P.J.); (P.M.); (M.T.); (M.F.); (A.K.); (B.K.-Z.); (A.B.); (R.T.S.)
- Correspondence:
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Dębska-ślizień A, Kawecka A, Wojnarowski K, Prajs J, Malgorzewicz S, Kunicka D, Zdrojewski Z, Lysiak-Szydłowska W, Lipiński J, Rutkowski B. Correlation between Plasma Carnitine, Muscle Carnitine and Glycogen Levels in Maintenance Hemodialysis Patients. Int J Artif Organs 2018. [DOI: 10.1177/039139880002300205] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chronic hemodialysis (HD) may lead to losses of carnitine from plasma and muscle. Plasma carnitine does not reflect the body content of carnitine. The purpose of this study was the evaluation of total and free plasma and muscle carnitine concentrations (TPC, FPC, TMC, FMC), muscle glycogen and the relationship between plasma and tissue carnitine content and the basic indices of lipid metabolism in HD patients. The studies were conducted in two groups: the first one consisted of 37 HD patients (19 F, 18 M), the second one served as the control and was composed of 29 (10 F, 19 M) patients with healthy kidneys. Tissue specimens in HD patients were taken during surgery on arterio-venous fistula from brachioradial muscle. Carnitine and glycogen measurements were performed using enzymatic methods according to Cederblad and Huijng respectively. Total cholesterol (CH), HDL-CH, and triglycerides were assayed by enzymatic commercial test system (Boehringer-Mannheim, Germany). To summarise, we found the following phenomena in our HD patients in comparison with the controls: 1) In plasma: similar TPC but decreased FPC levels and FPC/TPC ratio which may suggest free carnitine deficiency. 2) In muscle: significantly lower TMC and FMC levels but normal FMC/TMC ratio. 3) Negative correlation between TMC and FMC levels and duration of dialysis treatment. 4) No correlation between plasma and muscle carnitine concentration. 5) Significantly higher concentration of muscle glycogen which could be explained by the changes in the structure of muscle fibres in HD patients and/or lower physical activity. 6) A positive correlation between FPC/APC or FPC/TPC ratio and HDL-CH in HD patients which may suggest that an appropriate proportion between free and acylcarnitines may influence HDL-CH levels in that population. (Int J Artif Organs 2000; 23: 90–6)
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Affiliation(s)
- A. Dębska-ślizień
- Department of Nephrology, Medical University of Gdańsk, Gdańsk - Poland
| | - A. Kawecka
- Department of Surgery and Medical University of Gdańsk, Gdańsk - Poland
| | - K. Wojnarowski
- Department of Nephrology, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Prajs
- Department of Surgery and Medical University of Gdańsk, Gdańsk - Poland
| | - S. Malgorzewicz
- Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk - Poland
| | - D. Kunicka
- Department of Clinical Nutrition, Medical University of Gdańsk, Gdańsk - Poland
| | - Z. Zdrojewski
- Department of Nephrology, Medical University of Gdańsk, Gdańsk - Poland
| | | | | | - B. Rutkowski
- Department of Nephrology, Medical University of Gdańsk, Gdańsk - Poland
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Kawecka A, DȨbska-Ślizien A, Korejwo G, Prajs J, Król E, Rutkowski B, Lasek J, Gwoździewicz J. Evaluation of Gore-Tex Graft Patency in Hemodialysis Access. J Vasc Access 2018. [DOI: 10.1177/112972980300400203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim The purpose of this retrospective study was to analyze the patency and complications of Gore-Tex grafts used in hemodialysis (HD) access. Methods In the last 16 years, 1649 surgical procedures were performed on 655 patients to ensure and maintain permanent HD access. The study group consisted of 64 HD patients on whom 81 vascular synthetic PTFE Goretex grafts were performed. There were 28 males and 36 females, 3 of them were children (4.7%). Mean age was 54.2 years (range 15–77). Two types of Gore-Tex prosthesis were used: Diastat and Stretch. All grafts were implanted in the upper extremities. Kaplan-Meier survival curves were calculated to determine primary and secondary patency. Log-rank analysis was used to determine differences between curves. Results Primary and secondary patency at 12 months was 52.5% and 67.5%, and at 18 months respectively 41.5% and 58.2%. The Diastat graft had a lower primary and secondary patency compared with the Stretch graft (respectively p = 0.02 and p = 0.008). Factors such as gender, coexisting diabetes and hypertension did not determine graft patency. Thrombosis was one of the most frequent complications. The remaining complications included stenosis, pseudoaneurysms, infection, steal syndrome and seroma. Conclusion On the basis of our experience Stretch grafts appear a better option for creating vascular access for HD than Diastat grafts.
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Affiliation(s)
- A. Kawecka
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - A. DȨbska-Ślizien
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - G. Korejwo
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Prajs
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - E. Król
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - B. Rutkowski
- Department of Nephrology, Transplantology and Internal Disease, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Lasek
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
| | - J. Gwoździewicz
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk - Poland
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Witkowski Z, Lasek J, Wujtewicz M, Stasiak M, Marks W, Kawecka A. Pericardiodiaphragmatic rupture and cardiac herniation after multiple blunt trauma: diagnostic and therapeutic difficulties. J Thorac Cardiovasc Surg 2006; 130:e1-2. [PMID: 16307985 DOI: 10.1016/j.jtcvs.2005.07.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2005] [Accepted: 07/19/2005] [Indexed: 10/25/2022]
Affiliation(s)
- Z Witkowski
- Department of Trauma Surgery, Medical University of Gdańsk, Gdańsk, Poland.
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Kawecka A, Korejwo G, Prajs J, Król E, Lasek J, Gwozdziewicz J. Evaluation of Gore-Tex graft patency in hemodialysis access. J Vasc Access 2003; 4:45-9. [PMID: 17642059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
AIM The purpose of this retrospective study was to analyze the patency and complications of Gore-Tex grafts used in hemodialysis (HD) access. METHODS In the last 16 years, 1649 surgical procedures were performed on 655 patients to ensure and maintain permanent HD access. The study group consisted of 64 HD patients on whom 81 vascular synthetic PTFE Gore-tex grafts were performed. There were 28 males and 36 females, 3 of them were children (4.7%). Mean age was 54.2 years (range 15-77). Two types of Gore-Tex prosthesis were used: Diastat and Stretch. All grafts were implanted in the upper extremities. Kaplan-Meier survival curves were calculated to determine primary and secondary patency. Log-rank analysis was used to determine differences between curves. RESULTS Primary and secondary patency at 12 months was 52.5% and 67.5%, and at 18 months respectively 41.5% and 58.2%. The Diastat graft had a lower primary and secondary patency compared with the Stretch graft (respectively p = 0.02 and p = 0.008). Factors such as gender, coexisting diabetes and hypertension did not determine graft patency. Thrombosis was one of the most frequent complications. The remaining complications included stenosis, pseudoaneurysms, infection, steal syndrome and seroma. CONCLUSION On the basis of our experience Stretch grafts appear a better option for creating vascular access for HD than Diastat grafts.
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Affiliation(s)
- A Kawecka
- Department of Trauma Surgery, Medical University of Gdansk, Gdansk - Poland
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Kawecka A, Wojnarowski K, Prajs J, Malgorzewicz S, Kunicka D, Zdrojewski Z, Lipiński J, Rutkowski B. Correlation between plasma carnitine, muscle carnitine and glycogen levels in maintenance hemodialysis patients. Int J Artif Organs 2000; 23:90-6. [PMID: 10741803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Chronic hemodialysis (HD) may lead to losses of carnitine from plasma and muscle. Plasma carnitine does not reflect the body content of carnitine. The purpose of this study was the evaluation of total and free plasma and muscle carnitine concentrations (TPC, FPC, TMC, FMC), muscle glycogen and the relationship between plasma and tissue carnitine content and the basic indices of lipid metabolism in HD patients. The studies were conducted in two groups: the first one consisted of 37 HD patients (19 F, 18 M), the second one served as the control and was composed of 29 (10 F, 19 M) patients with healthy kidneys. Tissue specimens in HD patients were taken during surgery on arterio-venous fistula from brachioradial muscle. Carnitine and glycogen measurements were performed using enzymatic methods according to Cederblad and Huijng respectively. Total cholesterol (CH), HDL-CH, and triglycerides were assayed by enzymatic commercial test system (Boehringer-Mannheim, Germany). To summarise, we found the following phenomena in our HD patients in comparison with the controls: 1) In plasma: similar TPC but decreased FPC levels and FPC/TPC ratio which may suggest free carnitine deficiency. 2) In muscle: significantly lower TMC and FMC levels but normal FMC/ITMC ratio. 3) Negative correlation between TMC and FMC levels and duration of dialysis treatment. 4) No correlation between plasma and muscle camitine concentration. 5) Significantly higher concentration of muscle glycogen which could be explained by the changes in the structure of muscle fibres in HD patients and/or lower physical activity. 6) A positive correlation between FPC/APC or FPC/TPC ratio and HDL-CH in HD patients which may suggest that an appropriate proportion between free and acylcarnitines may influence HDL-CH levels in that population.
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Kawecka A, Prajs J, Lipiński J, Białko M. [Thrombotic complications of arterio-venous fistulas in chronically hemodialysed patients]. Wiad Lek 1997; 50 Suppl 1 Pt 2:60-64. [PMID: 9424928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Treatment by means of repeated haemodialysis has been accepted as the basic method of renal substitution treatment in our country. Thrombosis has been found as the most frequent local complication in arterio-venous (A-V) fistulas. The purpose of this study has been to analyse the frequency of thrombosis in relation to the type of A-V fistula and occurrence of early thrombosis (within 24 postoperative hours). Studies have been based in 186 patients (31 children) in whom 545 A-V surgical procedures have been performed to create and maintain permanent vascular access for haemodialysis. The mean age of the patients was 37 years. Thrombosis has been detected in 41.5% of fistulas and has been found as the main cause of 49.4% secondary procedures. Most frequently they have been observed in A-V fistulas using PTFE prosthesis. Rare complications have been found in brachio-basilic and brachio-cephalic fistulas. Early thrombosis has been observed in 4.5% of A-V fistulas. The causes of early thrombosis and within 30 postoperative days have been discussed in detail. In these complications thrombectomy (60.5%) and thrombectomy combined with creating new anastomosis (31.9%) have been performed most frequently. It has concluded that the condition of anastomosed vessels is the most important factor influencing early thrombosis.
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Affiliation(s)
- A Kawecka
- Katedry i Kliniki Chirurgii Urazowej Akademii Medycznej w Gdańsku
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