Microbial Translocation and Gut Damage Are Associated With an Elevated Fast Score in Women Living With and Without HIV

Background

Steatohepatitis is common in persons living with HIV and may be associated with gut microbial translocation (MT). However, few studies have evaluated the gut-liver axis in persons living with HIV. In the Women's Interagency HIV Study, we examined the associations of HIV and circulating biomarkers linked to MT and gut damage using the FibroScan-aspartate aminotransferase (FAST) score, a noninvasive surrogate for steatohepatitis with advanced fibrosis.

Methods

Among 883 women with HIV and 354 without HIV, we used multivariable regression to examine the associations of HIV and serum biomarkers linked to MT and gut damage (kynurenine and tryptophan ratio, intestinal fatty acid-binding protein, soluble CD14, and soluble CD163) with a log-transformed FAST score after adjusting for key covariates. We used a path analysis and mediation models to determine the mediating effect of each biomarker on the association of HIV with FAST.

Results

HIV infection was associated with a 49% higher FAST score. MT biomarker levels were higher in women with HIV than women without HIV (P < .001 for each). MT biomarkers mediated 13% to 32% of the association of HIV and FAST score.

Conclusions

Biomarkers linked to MT and gut damage are associated with a higher FAST score and mediate the association of HIV with a higher FAST score. Our findings suggest that MT may be an important mechanism by which HIV increases the risk of steatohepatitis with advanced fibrosis.

Sex Hormones, the Stool Microbiome, and Subclinical Atherosclerosis in Women With and Without HIV

CONTEXT

Cardioprotective roles of endogenous estrogens may be particularly important in women with HIV, who have reduced estrogen exposure and elevated cardiovascular disease risk. The gut microbiome metabolically interacts with sex hormones, but little is known regarding possible impact on cardiovascular risk.

OBJECTIVE

To analyze potential interplay of sex hormones and gut microbiome in cardiovascular risk.

METHODS

Among 197 postmenopausal women in the Women's Interagency HIV Study, we measured 15 sex hormones in serum and assessed the gut microbiome in stool. Presence of carotid artery plaque was determined (B-mode ultrasound) in a subset (n = 134). We examined associations of (i) sex hormones and stool microbiome, (ii) sex hormones and plaque, and (iii) sex hormone-related stool microbiota and plaque, adjusting for potential confounders.

RESULTS

Participant median age was 58 years and the majority were living with HIV (81%). Sex hormones (estrogens, androgens, and adrenal precursors) were associated with stool microbiome diversity and specific species, similarly in women with and without HIV. Estrogens were associated with higher diversity, higher abundance of species from Alistipes, Collinsella, Erysipelotrichia, and Clostridia, and higher abundance of microbial β-glucuronidase and aryl-sulfatase orthologs, which are involved in hormone metabolism. Several hormones were associated with lower odds of carotid artery plaque, including dihydrotestosterone, 3α-diol-17G, estradiol, and estrone. Exploratory mediation analysis suggested that estrone-related species, particularly from Collinsella, may mediate the protective association of estrone with plaque.

CONCLUSION

Serum sex hormones are significant predictors of stool microbiome diversity and composition. The gut microbiome may play a role in estrogen-related cardiovascular protection.

The menopause-related gut microbiome: associations with metabolomics, inflammatory protein markers, and cardiometabolic health in women with HIV

OBJECTIVE

This study aimed to identify menopause-related gut microbial features, as well as their related metabolites and inflammatory protein markers, and link with cardiometabolic risk factors in women with and without HIV.

METHODS

In the Women's Interagency HIV Study, we performed shotgun metagenomic sequencing on 696 stool samples from 446 participants (67% women with HIV), and quantified plasma metabolomics and serum proteomics in a subset (~86%). We examined the associations of menopause (postmenopausal vs premenopausal) with gut microbial features in a cross-sectional repeated-measures design and further evaluated those features in relation to metabolites, proteins, and cardiometabolic risk factors.

RESULTS

Different overall gut microbial composition was observed by menopausal status in women with HIV only. We identified a range of gut microbial features that differed between postmenopausal and premenopausal women with HIV (but none in women without HIV), including abundance of 32 species and functional potentials involving 24 enzymatic reactions and lower β-glucuronidase bacterial gene ortholog. Specifically, highly abundant species Faecalibacterium prausnitzii , Bacteroides species CAG:98 , and Bifidobacterium adolescentis were depleted in postmenopausal versus premenopausal women with HIV. Menopause-depleted species (mainly Clostridia ) in women with HIV were positively associated with several glycerophospholipids, while negatively associated with imidazolepropionic acid and fibroblast growth factor 21. Mediation analysis suggested that menopause may decrease plasma phosphatidylcholine plasmalogen C36:1 and C36:2 levels via reducing abundance of species F. prausnitzii and Acetanaerobacterium elongatum in women with HIV. Furthermore, waist-to-hip ratio was associated with menopause-related microbes, metabolites, and fibroblast growth factor 21 in women with HIV.

CONCLUSIONS

Menopause was associated with a differential gut microbiome in women with HIV, related to metabolite and protein profiles that potentially contribute to elevated cardiometabolic risk.

Uncovering sperm metabolome to discover biomarkers for bull fertility

Background

Subfertility decreases the efficiency of the cattle industry because artificial insemination employs spermatozoa from a single bull to inseminate thousands of cows. Variation in bull fertility has been demonstrated even among those animals exhibiting normal sperm numbers, motility, and morphology. Despite advances in research, molecular and cellular mechanisms underlying the causes of low fertility in some bulls have not been fully elucidated. In this study, we investigated the metabolic profile of bull spermatozoa using non-targeted metabolomics. Statistical analysis and bioinformatic tools were employed to evaluate the metabolic profiles high and low fertility groups. Metabolic pathways associated with the sperm metabolome were also reported.

Results

A total of 22 distinct metabolites were detected in spermatozoa from bulls with high fertility (HF) or low fertility (LF) phenotype. The major metabolite classes of bovine sperm were organic acids/derivatives and fatty acids/conjugates. We demonstrated that the abundance ratios of five sperm metabolites were statistically different between HF and LF groups including gamma-aminobutyric acid (GABA), carbamate, benzoic acid, lactic acid, and palmitic acid. Metabolites with different abundances in HF and LF bulls had also VIP scores of greater than 1.5 and AUC- ROC curves of more than 80%. In addition, four metabolic pathways associated with differential metabolites namely alanine, aspartate and glutamate metabolism, β-alanine metabolism, glycolysis or gluconeogenesis, and pyruvate metabolism were also explored.

Conclusions

This is the first study aimed at ascertaining the metabolome of spermatozoa from bulls with different fertility phenotype using gas chromatography-mass spectrometry. We identified five metabolites in the two groups of sires and such molecules can be used, in the future, as key indicators of bull fertility.

153 Sperm metabolomic landscape associated with bull fertility

Sub-fertility fertility in bulls decreases the efficiency and profitability of cattle production because AI allows a single bull to inseminate thousands of cows. In recent decades, there has been a general decline in fertility of bulls, even among those exhibiting normal sperm motility and morphology. Despite advances in technology and knowledge, molecular, cellular and physiological mechanisms underlying the causes of low fertility in bulls are currently unclear. Therefore, the objective of this study was to identify sperm metabolites associated with fertility in Holstein bulls. The metabolome of sperm from 10 mature bulls with high fertility (HF, n=5) and low fertility (LF, n=5) was identified by gas chromatography coupled to mass spectrometry. Bull fertility was based on the sire conception rates deviating from the average. Statistical analysis was performed by using MetaboAnalyst 3.0 (http://www.metaboanalyst.ca/). A total of 22 metabolites were detected and categorized according to their major chemical classes, including amino acids, peptides/analogues, carbohydrates/carbohydrate conjugates, fatty acids, steroids/steroid derivatives, keto acids and derivatives, carboxylic acids, and other organic and inorganic compounds. Organic acids and derivatives as well as fatty acids were the major compounds in bull spermatozoa. Seven organic acids and derivatives were detected, including benzoic acid, carbonate, carbamate dimethyl, carbamate trimethyl, lactic acid, oxalic acid, and urea. Five fatty acids were identified including oleic acid, oleanitrile, nonanoic acid, and palmitic acid. Oleic acid, phosphoric acid, phosphine, carbamate trimethyl, and glycerol were the most abundant metabolites in bull sperm, whereas benzoic acid, acetic acid, l-serine, carbamate, and 2-ketobutyric acid were the least predominant metabolites present in bull sperm. Multivariate analysis (partial least squares-discriminant analysis) of the sperm metabolome showed a clear separation between HF and LF bulls. Variable importance in projection (VIP) score demonstrated that metabolites with VIP &gt;1.5 were gamma-aminobutyric acid (VIP=2.01), carbamate trimethyl (VIP=1.88), benzoic acid (VIP=1.86), and lactic acid (VIP=1.81). Abundance ratios of gamma-aminobutyric acid, carbamate trimethyl, benzoic acid, and lactic acid was greater in HF bulls compared with LF animals. According to univariate analysis, abundance ratios of gamma-aminobutyric acid (P=0.03) and carbamate trimethyl (P=0.047) were greater in HF than in LF bulls. Gamma-aminobutyric acid was positively correlated with carbamate trimethyl (r=0.94; P&lt;0.0001) and benzoic acid (r=0.74; P=0.0139). Benzoic acid was positively correlated with carbamate trimethyl (r=0.75; P=0.0107) and carbamate dimethyl (r=0.68; P=0.0274). The identified metabolites can serve as potential markers to evaluate semen quality and predict bull fertility.

100 PROTEOME OF BULL SPERMATOZOA

The reproductive performance of a herd is the biggest factor affecting production and product quality of livestock. Thus, a decline of male fertility represents a dramatic economic loss in beef and dairy industries. Caused by molecular defects in the spermatozoa, uncompensatory infertility is a current challenge for the cattle industry, because even with normal sperm morphology, motility, and number, fertility of bulls is still sub-par. Thus, the objective of this study was to determine the global proteome of spermatozoa collected from bulls with different fertility and study the proteins playing a role in uncompensatory infertility. We performed difference gel electrophoresis (2D-DIGE) using cryopreserved sperm from a total of 6 bulls. Spermatozoa were thawed, purified by percoll gradient, and washed in PBS solution. For each bull, a pellet of 100 million sperm cells was resuspended in the 2D-DIGE labeling buffer, and the total protein was quantified. Cell lysates were separately labeled with CyDye DIGE Fluor dyes (and reciprocally with different dyes) and multiplexed in pairs on 3 gels. The samples were focused according to their isoelectric point through an Immobiline DryStrip, pH4-7, using a IPGphor 2, followed by separation on 12.5% sodium dodecyl sulfate-polyacrylamide gel electrophoresis gels (21.5–200 kDa) using a DALTsix. The resulting gels were scanned, and their topographic digital maps were used for algorithmic spot matching, background normalization, spot differences quantification, and elimination of artifacts (DeCyder 2-D Differential Analysis Software, GE Healthcare Life Sciences, Piscataway, NJ, USA). The results showed between 2600 and 2800 proteins with high confidence. Compared to the high-fertile bulls, 30 proteins were increased, and 27 were decreased in the low-fertility bulls within a 2-fold range. The largest significant increase and decrease were 3.97- and 2.4-fold, respectively. The identification of these differentially represented proteins is in progress. However, our results provided a panoramic view of sperm proteome from bulls of different fertility and thus paved the way for research on mechanisms of uncompensatory bull infertility.

Comparison of the effect of insulin hypoglycemia and clonidine on secretion of growth hormone, cortisol and beta-endorphin in children and adolescents

Plasma beta-endorphin, human growth hormone (hGH) and cortisol were measured concomitantly during insulin hypoglycemia (0.1 u/kg i.v.) or clonidine administration (0.075 mg/m2 orally) in children with idiopathic short stature. Whereas hypoglycemia raised plasma beta-endorphin levels, clonidine slightly decreased beta-endorphin in six subjects and had no effect in four. Cortisol levels increased following hypoglycemia and decreased markedly after clonidine. hGH increased to greater than 20 ng/ml in all but one subject. The findings are interpreted as further evidence that the hGH stimulation of clonidine is not stress-mediated.

Deranged alpha-adrenergic regulation of growth hormone secretion in poorly controlled diabetes: reversal of the exaggerated response to clonidine after continuous subcutaneous insulin infusion

Elevated plasma growth hormone (GH) and peripheral catecholamine levels are frequently observed in poorly controlled, insulin-dependent diabetes. Since the alpha adrenergic system plays an important role in hypothalamic regulation of GH secretion, we tested the hypothesis that altered central adrenergic activity contributes to the increased GH concentrations in diabetes. Clonidine, an alpha-adrenergic agonist, was administered to nine poorly controlled, young diabetic patients (age 12-19 yr) before and after 1 wk of continuous subcutaneous insulin infusion pump therapy. As expected, continuous subcutaneous insulin infusion lowered mean 24-h plasma glucose (from 203 +/- 21 to 112 +/- 7 mg/dl, p less than 0.01) and GH (from 17.7 +/- 2.1 to 9.2 +/- 1.2 ng/ml, p less than 0.01) to values observed in normal controls. In the diabetic patients during conventional treatment, both the peak plasma GH level postclonidine (48.3 +/- 8.7 ng/ml) and the incremental area under the GH response curve (3.23 +/- 0.58 mg X min/ml) were significantly increased above normal control values (25.2 +/- 2.1 ng/ml, p less than 0.05 and 1.63 +/- 0.11 mg X min/ml, p less than 0.0025, respectively). In contrast, the GH response to clonidine was indistinguishable from normal after only 1 wk of intensified insulin treatment. Our findings support the contention that metabolic control of diabetes influences hypothalamic regulation of GH secretion and suggests that such alterations are related, at least in part, to changes in central alpha-adrenergic activity.

Plasma growth hormone response to oral clonidine as compared to insulin hypoglycemia in obese children and adolescents

The response of plasma growth hormone (hGH) to a single oral dose of clonidine (0.15 mg/m2) was compared with that obtained with insulin hypoglycemia (ITT) induced by administration of double the usual dose (0.2 U/kg i.v.) in 13 obese subjects aged 5-17 years (7 males, 6 females) with a subscapular skinfold greater than 20 mm and a weight greater than 2 SD of the median. Six healthy subjects (3 males, 3 females), aged 8-14 years who served as controls received the usual dose of 0.1 U/kg i.v. in the ITT. Clonidine induced an increase of more than 10 ng/ml in the plasma hGH levels in 10 (4 males, 6 females) of the 13 obese subjects and in all of the healthy controls, with peak levels ranging from 14.3 to 31.0 ng/ml (m +/- SD 21.0 +/- 5.2 ng/ml); the ITT elicited a similar rise in only 6 of the 13 subjects and 3 of the healthy controls, with peak levels ranging from 9.8 to 20.0 ng/ml (m +/- SD 14.4 +/- 4.5 ng/ml). Clonidine decreased plasma insulin levels in all the obese female subjects (by a mean of 65%) whereas in the obese males the insulin pattern was variable. There was no change in blood glucose levels following the administration of clonidine; during the ITT all subjects showed a decrease to less than 50 mg/dl. Blood pressure decreased by a mean of 20 mmHg during the clonidine test. This study demonstrates that clonidine is a more effective hGH stimulus than insulin induced hypoglycemia in normal and in obese children and that the lower hGH secretion of the obese is confirmed by the clonidine test.

Dietary adjustment during self-blood-glucose monitoring in pregnant women with insulin-dependent diabetes mellitus

The interaction between the daily distribution of carbohydrates and frequent self-blood-glucose monitoring (SBGM) was studied in 13 pregnant women who had had diabetes for 4 to 19 years. Before and during SBGM, data were obtained on dietary history, daily blood glucose levels, and HbA1C. Optimal control was found with 3 main meals and 5 snacks. The total daily caloric intake decreased without change in the proportions of protein, fat, and carbohydrate. Consumption of starch increased, and that of simple sugars decreased. Although no changes were made in the daily amount of insulin, the women's diabetic control improved significantly.

Genetics of insulin dependent diabetes mellitus in Israel: population and family study

The association between insulin dependent diabetes mellitus (IDDM) and the HLA system was studied in two groups of Jewish patients: 50 Ashkenazim and 42 non-Ashkenazim. The pattern of association of HLA-A and B locus antigens was somewhat different from that observed in European Caucasian patients. HLA-B8 had a higher frequency; B15 and Cw3 were rare in the population studied and were less frequent in IDDM patients than in controls. On the other hand, the frequency of A26, B18, and Bw38 was increased in Ashkenazi patients, but not in non-Ashkenazim, who in turn showed an increase for Bw51. Although the association between IDDM and HLA-A and B locus antigens shows a marked variability in different populations, the association with HLA-DR3 and DR4 is constant feature. There was a typical excess of DR3/DR4 heterozygotes in both patient groups. This heterozygote type carries the highest relative risk, followed by DR4/DR4 homozygotes. These data can well be interpreted by a model of two different HLA-linked susceptibility genes, one associated with DR3 and the other one with DR4, that interact so that different genotypes are associated with different levels of penetrance. This model received further support from studies in 15 multiple case families where there is an excess of affected sib pairs sharing two DR antigens.

Self-montoring of blood glucose during pregnancy in women with juvenile Diabeters

Eight pregnant patients with insulin-dependent juvenile diabetes were persuaded to start self-monitoring of blood glucose between the 10th to the 20th week of gestation. One patient with two children discontinued this effort after a short period. Four patients are still on a regimen of self-monitoring during their pregnancy, and three have delivered normal infants. The latter three patients were all able to achieve almost normal blood glucose levels during the pregnancies. These observations, in addition to those of others, lead to the conclusion that self-monitoring of blood glucose can be an useful tool in the management of diabetes, particularly in pregnant women, who have a high degree of motivation to achieve good Control.

Infantile methemoglobinemia caused by food additives

A small outbreak of toxic methemoglobinemia occurred among infants in a pediatric ward. Investigation revealed that the most likely source of toxicity was an approved fat preservative which had been added to a soybean infant formula by the manufacturer. This fat preservative contained three phenolic compounds having highly effective antioxygenic properties (butylated hydroxyanisole, butylated hydroxytoluene and propyl gallate). The outbreak ceased when the offending agents were eliminated from the food preparation. It is emphasized that the approval of chemicals for use in the food industry through toxicity studies does not necessarily guarantee against the hazards of toxicity, especially during infancy.

Folate nutrition and growth in infancy

The effect of suboptimal folate nutrtion on the growing infant was studied in a population of infants fed a diet based on boiled, pasteurised cows' milk. One group of infants received a daily supplement of 1 mg folic acid from age 2 months, while the other group received a placebo. The infants were seen at bimonthly intervals. In the supplemented group the red cell folate level had increased to twice its pretreatment value by 4 months, and remained at this high level to the end of the first year. Hb concentration and incidence of anaemia were similar in both groups. The incidence of infection in the two groups did not differ. Weights and lengths attained at 6 months, and the rate of gain from 2 to 6 months were higher in infants whose folate levels were above the median value than in those below it. In the second half of the first year the differences between the two groups were no longer evident.

Oral clonidine as a growth hormone stimulation test

A single oral dose of 0.15 mg/m2 of clonidine was given to eighteen healthy children and adolescents and to seven patients with hypopituitarism. In healthy subjects there was a pronounced increase in plasma growth hormone from 4.9 +/- 1.3 ng/ml (+/- SEM) to 34.4 +/- 4.5 ng/ml. In the patients with hypopituitarism there was no change in growth-hormone concentrations. Clonidine induced a slight increase in blood glucose in healthy subjects and a slight decrease in patients with hypopituitarism. During the test systolic blood-pressure decreased by a mean of 20 mm Hg in the healthy subjects and by 25 mm Hg in the patients with hypopituitarism. The only side-effect observed was drowsiness. Oral administration of clonidine, a well-tolerated drug, seems to be a simple test for of GH reserves in children and adolescents.