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Williams MJ, Halabi CM, Patel HM, Joseph Z, McCommis K, Weinheimer C, Kovacs A, Lima F, Finck B, Malluche H, Hruska KA. In chronic kidney disease altered cardiac metabolism precedes cardiac hypertrophy. Am J Physiol Renal Physiol 2024; 326:F751-F767. [PMID: 38385175 DOI: 10.1152/ajprenal.00416.2023] [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: 12/22/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
Conduit arterial disease in chronic kidney disease (CKD) is an important cause of cardiac complications. Cardiac function in CKD has not been studied in the absence of arterial disease. In an Alport syndrome model bred not to have conduit arterial disease, mice at 225 days of life (dol) had CKD equivalent to humans with CKD stage 4-5. Parathyroid hormone (PTH) and FGF23 levels were one log order elevated, circulating sclerostin was elevated, and renal activin A was strongly induced. Aortic Ca levels were not increased, and vascular smooth muscle cell (VSMC) transdifferentiation was absent. The CKD mice were not hypertensive, and cardiac hypertrophy was absent. Freshly excised cardiac tissue respirometry (Oroboros) showed that ADP-stimulated O2 flux was diminished from 52 to 22 pmol/mg (P = 0.022). RNA-Seq of cardiac tissue from CKD mice revealed significantly decreased levels of cardiac mitochondrial oxidative phosphorylation genes. To examine the effect of activin A signaling, some Alport mice were treated with a monoclonal Ab to activin A or an isotype-matched IgG beginning at 75 days of life until euthanasia. Treatment with the activin A antibody (Ab) did not affect cardiac oxidative phosphorylation. However, the activin A antibody was active in the skeleton, disrupting the effect of CKD to stimulate osteoclast number, eroded surfaces, and the stimulation of osteoclast-driven remodeling. The data reported here show that cardiac mitochondrial respiration is impaired in CKD in the absence of conduit arterial disease. This is the first report of the direct effect of CKD on cardiac respiration.NEW & NOTEWORTHY Heart disease is an important morbidity of chronic kidney disease (CKD). Hypertension, vascular stiffness, and vascular calcification all contribute to cardiac pathophysiology. However, cardiac function in CKD devoid of vascular disease has not been studied. Here, in an animal model of human CKD without conduit arterial disease, we analyze cardiac respiration and discover that CKD directly impairs cardiac mitochondrial function by decreasing oxidative phosphorylation. Protection of cardiac oxidative phosphorylation may be a therapeutic target in CKD.
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Affiliation(s)
- Matthew J Williams
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Carmen M Halabi
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Hiral M Patel
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Zachary Joseph
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Kyle McCommis
- Geriatrics and Nutritional Science Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Carla Weinheimer
- Cardiology Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Attila Kovacs
- Cardiology Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Florence Lima
- Renal Division, Department of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Brian Finck
- Geriatrics and Nutritional Science Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Hartmut Malluche
- Renal Division, Department of Medicine, University of Kentucky, Lexington, Kentucky, United States
| | - Keith A Hruska
- Renal Division, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
- Renal Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri, United States
- Department of Cell Biology, Washington University in St. Louis, St. Louis, Missouri, United States
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Menta PR, Fernandes L, Prim J, De Oliveira E, Lima F, Galvão KN, Noyes N, Ballou MA, Machado VS. A randomized controlled trial evaluating the efficacy of systemic ceftiofur administration for metritis therapy in dairy cows and the effect of metritis cure on economically important outcomes. J Dairy Sci 2024:S0022-0302(24)00754-9. [PMID: 38642646 DOI: 10.3168/jds.2023-24406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/15/2024] [Indexed: 04/22/2024]
Abstract
The main objective of this study was to evaluate the effect of ceftiofur on metritis cure, milk yield, reproductive performance, and culling up to 300 DIM. The secondary objective was to evaluate the effect of metritis cure at 5 (ECURE) and 14 (LCURE) d after diagnosis on milk production, reproduction, and culling. A total of 422 Holstein cows diagnosed with metritis from 4 herds located in TX, CA, and FL were enrolled in a randomized clinical trial. Cows diagnosed with metritis (fetid, watery, reddish/brownish uterine discharge) were blocked by herd and parity and were randomly allocated to receive systemic administration of ceftiofur (CEF) or to remain untreated (CON). In addition, 399 non-metritic cows (NMET) were included for comparison purposes. Metritis cure was evaluated at 5 and 14 d after diagnosis and was defined as the absence of metritis clinical signs. Logistic regression models were fitted to the data to assess the effect of treatment on metritis cure. Milk yield was analyzed using a mixed linear model, while logistic regression, Cox proportional hazard and Kaplan-Meier survival analysis models were fitted to culling and reproduction data. Cows treated with CEF had 1.86 (95% CI: 1.22 - 2.81) and 1.68 (95% CI: 1.02 - 2.75) greater odds of being cured than CON cows at 5 and 14 d after diagnosis, respectively. No effect of CEF was observed for milk yield; however, NMET cows had greater milk yield compared with metritic cows (CEF = 36.0, 95% CI = 33.8 - 38.1; CON = 36.1, 95% CI = 33.9 - 38.2; NMET = 36.9 kg/d, 95% CI = 34.8 - 39.4). Likewise, no effect of CEF was observed on reproductive performance and culling. Nonetheless, the likelihood of conceiving for NMET cows was 1.72 (95% CI = 1.41 - 2.12) and 1.64 (95% CI = 1.33 - 2.00) times greater than for CEF and CON cows, respectively. Ceftiofur-treated and CON cows had 2.93 (95% CI = 1.90 - 4.51) and 2.37 (95% CI = 1.51 - 3.71) greater hazard of culling compared with NMET, respectively. Regardless of treatment, no differences between ECURE and LCURE were observed on milk yield, reproduction, and culling throughout the entire lactation, but cows that cured at 5 or 14 d after diagnosis had greater milk production in the first 60 DIM compared with cows that did not cure (NCURE). Cows in ECURE and LCURE also had a 1.59 (95% CI = 1.16 - 2.16) and 1.49 (95% CI = 1.08 - 2.05) greater hazard of pregnancy and 0.43 (95% CI = 0.26-0.71) and 0.56 (95% CI = 0.34-0.92) hazard of culling compared with NCURE. Ceftiofur therapy increased metritis cure, but benefits to productivity and longevity were not observed. Also, cows that fail to cure have impaired lactation performance, but no differences regarding timing of cure were observed.
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Affiliation(s)
- P R Menta
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - L Fernandes
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - J Prim
- Department of Large Animal Clinical Sciences, University of Florida, Gainesville 32610
| | - E De Oliveira
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616
| | - F Lima
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616
| | - K N Galvão
- Department of Large Animal Clinical Sciences, University of Florida, Gainesville 32610; D. H. Barron Reproductive and Perinatal Biology Research Program, University of Florida, Gainesville 32610
| | - N Noyes
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN 55108
| | - M A Ballou
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - V S Machado
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409.
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Schilling J, Rudy M, Lima F, Richards D, Sawaya P, Rao M. Chronic Shoulder Pain in a Patient Receiving Maintenance Dialysis: A Quiz. Am J Kidney Dis 2024; 83:A13-A16. [PMID: 38519245 DOI: 10.1053/j.ajkd.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 09/06/2023] [Accepted: 09/27/2023] [Indexed: 03/24/2024]
Affiliation(s)
| | - Mark Rudy
- University of Kentucky, Lexington, Kentucky
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Bonnín CM, Sánchez-Moreno J, Lima F, Roca X, Segú X, Montejo L, Solé B, Hidalgo-Mazzei D, Martin-Parra S, Martínez-Arán A, Vieta E, Torrent C, Rosa AR. Factors associated with the discrepancy between objective and subjective cognitive impairment in bipolar disorder. J Affect Disord 2024; 349:210-216. [PMID: 38190862 DOI: 10.1016/j.jad.2024.01.012] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/27/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
OBJECTIVE The aim of this study is to evaluate the discrepancy between objective cognitive measures and cognitive subjective complaints in a sample of euthymic patients with bipolar disorder (BD). METHODS One hundred and sixteen participants (83 euthymic patients with BD and 33 healthy controls) were enrolled for this study. Patients were assessed with a comprehensive neuropsychological battery and they also reported their subjective cognitive complaints with the Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA). The discrepancy between objective and subjective data was calculated using a novel methodology proposed in a previous study (Miskowiak, 2016). Statistical analyses included Pearson correlations and multiple linear regression. RESULTS Higher number of previous depressive episodes was identified as one variable associated with the global sensitivity composite score (Beta = 0.25; t = 2.1; p = 0.04) and with the verbal learning and memory sensitivity score (Beta = 0.26; t = 2.16; p = 0.03). That is, patients with more previous depressive episodes tend to over-report cognitive complaints. In contrast, higher number of previous hospitalizations was associated with stoicism in the global total score (Beta = -0.27; t = -2.24: p = 0.029) and in the domain of attention/processing speed (Beta = -0.34; t = -2.52; p = 0.016), indicating patients with more hospitalizations tend to report less cognitive complaints. DISCUSSION Our study identified some factors that might help to explain the discrepancy between objective and subjective cognitive measures in BD, including number of previous depressive episodes and number of previous hospitalizations. This highlights the need of the combined use of both types of cognitive measures to make an accurate assessment of cognitive dysfunctions and their effective treatment.
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Affiliation(s)
- C M Bonnín
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIBSANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Catalonia, Spain
| | - J Sánchez-Moreno
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - F Lima
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - X Roca
- Unitat de Conductes Addictives, Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Institut d'Investigació Biomèdica- Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - X Segú
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain
| | - L Montejo
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - B Solé
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - D Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - S Martin-Parra
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain
| | - A Martínez-Arán
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - E Vieta
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), c. Casanova, 143, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - C Torrent
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, c. Villarroel, 170, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), c. Villarroel, 170, 08036 Barcelona, Spain; Institute of Neurosciences (UBNeuro), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - A R Rosa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Pharmacology, Health Basic Science Institute, Universidade Federal do Rio Grande do Sul (UFRGS), Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil
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Menta PR, Prim J, de Oliveira E, Lima F, Galvão KN, Noyes N, Ballou MA, Machado VS. Predictive models for metritis cure using farm-collected data, metabolic and inflammation biomarkers, and hemogram variables measured at diagnosis. J Dairy Sci 2024:S0022-0302(24)00525-3. [PMID: 38428496 DOI: 10.3168/jds.2023-24452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/25/2024] [Indexed: 03/03/2024]
Abstract
Our objective was to evaluate the accuracy of predictive models for metritis spontaneous cure (SC) and cure among ceftiofur-treated cows using farm collected data only, and with the addition of hemogram variables and circulating concentration of metabolites, minerals, and biomarkers of inflammation measured at time of diagnosis. Data related to parity, calving related issues, body condition score (BCS), rectal temperature (RT), and days in milk (DIM) at metritis diagnosis were collected from a randomized clinical trial that included 412 metritic cows from 4 herds in TX, CA, and FL. Metritis was defined as the presence of red-brownish, watery, and fetid vaginal discharge, while cure was defined as the absence of metritis 14 d after initial diagnosis. Cows were randomly allocated to receive systemic ceftiofur therapy (2 subcutaneous doses of 6.6 mg/kg of ceftiofur crystalline-free acid on the day of diagnosis and 3 d later; CEF) or to remain untreated (CON). At enrollment (day of metritis diagnosis), blood samples were collected and submitted to cell blood count (CBC) and processed for the measurement of 13 minerals and biomarkers of metabolism and inflammation (BM). Univariable analysis to evaluate the association of farm collected data and blood assessed variables with metritis cure were performed, and variables with P ≤ 0.20 were offered to multivariable logistic regression models and retained if P ≤ 0.15. The area under the curve (AUC) for models predicting SC using farm data only and farm + BM, was 0.70 and 0.76 respectively. Cell blood count variables were not retained in the models for SC. For models predicting cure among CEF cows, the AUC was 0.75, 0.77, 0.80, and 0.80 for models using farm data only, farm + CBC, farm + BM, and farm + CBC + BM, respectively. Predictive models of metritis cure had fair accuracy, with SC models being less accurate than models predictive of cure among CEF cows. Additionally, adding BM variables marginally improved the accuracy of models using farm collected data, while CBC data did not improve the accuracy of predictive models.
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Affiliation(s)
- P R Menta
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - J Prim
- Department of Large Animal Clinical Sciences, University of Florida, Gainesville 32610
| | - E de Oliveira
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616
| | - F Lima
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616
| | - K N Galvão
- Department of Large Animal Clinical Sciences, University of Florida, Gainesville 32610; D. H. Barron Reproductive and Perinatal Biology Research Program, University of Florida, Gainesville 32610
| | - N Noyes
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN 55108
| | - M A Ballou
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409
| | - V S Machado
- Department of Veterinary Sciences, Davis College of Agricultural Sciences and Natural Resources, Texas Tech University, Lubbock, TX 79409.
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Wiggs MP, Lee Y, Shimkus KL, O'Reilly CI, Lima F, Macias BR, Shirazi-Fard Y, Greene ES, Hord JM, Braby LA, Carroll CC, Lawler JM, Bloomfield SA, Fluckey JD. Combined effects of heavy ion exposure and simulated Lunar gravity on skeletal muscle. Life Sci Space Res (Amst) 2023; 37:39-49. [PMID: 37087178 DOI: 10.1016/j.lssr.2023.02.003] [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] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/04/2023] [Accepted: 02/19/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND The limitations to prolonged spaceflight include unloading-induced atrophy of the musculoskeletal system which may be enhanced by exposure to the space radiation environment. Previous results have concluded that partial gravity, comparable to the Lunar surface, may have detrimental effects on skeletal muscle. However, little is known if these outcomes are exacerbated by exposure to low-dose rate, high-energy radiation common to the space environment. Therefore, the present study sought to determine the impact of highly charge, high-energy (HZE) radiation on skeletal muscle when combined with partial weightbearing to simulate Lunar gravity. We hypothesized that partial unloading would compromise skeletal muscle and these effects would be exacerbated by radiation exposure. METHODS For month old female BALB/cByJ mice were -assigned to one of 2 groups; either full weight bearing (Cage Controls, CC) or partial weight bearing equal to 1/6th bodyweight (G/6). Both groups were then divided to receive either a single whole body absorbed dose of 0.5 Gy of 300 MeV 28Si ions (RAD) or a sham treatment (SHAM). Radiation exposure experiments were performed at the NASA Space Radiation Laboratory (NSRL) located at Brookhaven National Laboratory on Day 0, followed by 21 d of CC or G/6 loading. Muscles of the hind limb were used to measure protein synthesis and other histological measures. RESULTS Twenty-one days of Lunar gravity (G/6) resulted in lower soleus, plantaris, and gastrocnemius muscle mass. Radiation exposure did not further impact muscle mass. 28Si exposure in normal ambulatory animals (RAD+CC) did not impact gastrocnemius muscle mass when compared to SHAM+CC (p>0.05), but did affect the soleus, where mass was higher following radiation compared to SHAM (p<0.05). Mixed gastrocnemius muscle protein synthesis was lower in both unloading groups. Fiber type composition transitioned towards a faster isoform with partial unloading and was not further impacted by radiation. The combined effects of partial loading and radiation partially mitigated fiber cross-sectional area when compared to partial loading alone. Radiation and G/6 reduced the total number of myonuclei per fiber while leading to elevated BrdU content of skeletal muscle. Similarly, unloading and radiation resulted in higher collagen content of muscle when compared to controls, but the effects of combined exposure were not additive. CONCLUSIONS The results of this study confirm that partial weightbearing causes muscle atrophy, in part due to reductions of muscle protein synthesis in the soleus and gastrocnemius as well as reduced peripheral nuclei per fiber. Additionally, we present novel data illustrating 28Si exposure reduced nuclei in muscle fibers despite higher satellite cell fusion, but did not exacerbate muscle atrophy, CSA changes, or collagen content. In conclusion, both partial loading and HZE radiation can negatively impact muscle morphology.
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Affiliation(s)
- Michael P Wiggs
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States; Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, United States.
| | - Yang Lee
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Kevin L Shimkus
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Colleen I O'Reilly
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Florence Lima
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Brandon R Macias
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States; NASA Johnson Space Center, Houston, Texas, United States
| | - Yasaman Shirazi-Fard
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States; NASA Ames Research Center, Moffett Field, CA, United States
| | - Elizabeth S Greene
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Jeffrey M Hord
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Leslie A Braby
- Department of Nuclear Engineering, Texas A&M University, College Station, TX, United States
| | - Chad C Carroll
- Department of Physiology, Purdue University, West Lafayette, IN, United States
| | - John M Lawler
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - Susan A Bloomfield
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
| | - James D Fluckey
- Department of Health & Kinesiology, Texas A&M University, College Station, TX, United States
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Lima F, Monier-Faugere MC, Mawad H, David V, Malluche HH. FGF-23 and sclerostin in serum and bone of CKD patients. Clin Nephrol 2023; 99:209-218. [PMID: 36970967 DOI: 10.5414/cn111111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 03/29/2023] Open
Abstract
AIMS Renal osteodystrophy occurs in the early stages of chronic kidney disease (CKD) and progresses during loss of kidney function. Fibroblast growth factor (FGF)-23 and sclerostin, both produced by osteocytes, are increased in blood of patients with CKD. The aim of this study was to analyze the impact of decline in kidney function on FGF-23 and sclerostin protein expression in bone and to study their relationship with their serum levels and bone histomorphometry. MATERIALS AND METHODS 108 patients aged 25 - 81 years (mean ± SD: 56 ± 13 years) underwent anterior iliac crest biopsies after double-tetracycline labeling. Eleven patients were CKD-2, 16 were CKD-3, 9 were CKD-4 - 5, and 64 CKD-5D. Patients were on hemodialysis for 49 ± 117 months. 18 age-matched patients without CKD were included as controls. Immunostaining was performed on undecalcified bone sections to quantify FGF-23 and sclerostin expression. Bone sections were also evaluated by histomorphometry for bone turnover, mineralization, and volume. RESULTS FGF-23 expression in bone correlated positively with CKD stages (p < 0.001) increasing from 5.3- to 7.1-fold starting at CKD-2. No difference in FGF-23 expression was seen between trabecular and cortical bone. Sclerostin expression in bone correlated positively with CKD stages (p < 0.001) with an increase from 3.8- to 5.1-fold starting at CKD-2. This increase was progressive and significantly greater in cortical than cancellous bone. FGF-23 and sclerostin in blood and bone were strongly associated with bone turnover parameters. Expression of FGF-23 in cortical bone correlated positively with activation frequency (Ac.f) and bone formation rate (BFR/BS) (p < 0.05), while sclerostin correlated negatively with Ac.f, BFR/BS, and osteoblast and osteoclast numbers (p < 0.05). FGF-23 trabecular and cortical expressions correlated positively with cortical thickness (p < 0.001). Sclerostin bone expression correlated negatively with parameters of trabecular thickness and osteoid surface (p < 0.05). CONCLUSION These data show a progressive increase in FGF-23 and sclerostin in blood and bone associated with decrease in kidney function. The observed relationships between bone turnover and sclerostin or FGF-23 should be considered when treatment modalities are developed for management of turnover abnormalities in CKD patients.
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Malluche HH, Davenport DL, Lima F, Monier-Faugere MC. Prevalence of low bone formation in untreated patients with osteoporosis. PLoS One 2022; 17:e0271555. [PMID: 35853025 PMCID: PMC9295966 DOI: 10.1371/journal.pone.0271555] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/01/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Osteoporosis treatment usually starts with an antiresorber and switches to an anabolic agent if it fails. It is known that suppressing bone resorption also results in reduced bone formation. In addition, patients with prior treatment with antiresorbers may have reduced response to subsequent anabolic treatment. This study determined the prevalence of low bone formation in untreated osteoporosis patients to identify patients who may not be optimally treated under the current paradigm. METHODS This is a cross-sectional study of bone samples stored in the Kentucky Bone Registry. Included samples were from adult patients presenting for workup of osteoporosis. Exclusion criteria were other diseases or treatments affecting bone. Patients underwent iliac crest bone biopsies after tetracycline labeling for identification of bone formation. RESULTS 107 patients met study criteria, 92 White and 5 Black women and 10 White men. Forty percent of patients (43/107) had low bone formation/bone surface (BFR/BS < 0.56 mm3/cm2/yr). Clinical and serum parameters did not differ between formation groups, except for type II diabetes, which was found exclusively in the low formation group. CONCLUSIONS Starting treatment of osteoporotic patients with an antiresorber in all patients appears not optimal for a significant portion.
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Affiliation(s)
- Hartmut H. Malluche
- Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America
- * E-mail:
| | - Daniel L. Davenport
- Division of Healthcare Outcomes and Optimal Patient Services, Department of Surgery, University of Kentucky, Lexington, Kentucky, United States of America
| | - Florence Lima
- Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America
| | - Marie-Claude Monier-Faugere
- Division of Nephrology, Department of Medicine, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, United States of America
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El-Husseini A, Abdalbary M, Lima F, Issa M, Ahmed MT, Winkler M, Srour H, Davenport D, Wang G, Faugere MC, Malluche H. Low turnover renal osteodystrophy with abnormal bone quality and vascular calcification in patients with mild to moderate CKD. Kidney Int Rep 2022; 7:1016-1026. [PMID: 35570986 PMCID: PMC9091581 DOI: 10.1016/j.ekir.2022.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/06/2023] Open
Abstract
Introduction Limited information is available on renal osteodystrophy (ROD) and vascular calcification (VC) during early chronic kidney disease (CKD). This study was designed to evaluate ROD and VC in 32 patients with CKD stages II to IV. Methods Patients underwent dual-energy X-ray absorptiometry (DXA) for assessment of bone mineral density (BMD) and trabecular bone score (TBS), thoracic computed tomography for VC scoring using the Agatston method, and anterior iliac crest bone biopsy for mineralized bone histology, histomorphometry, and Fourier transform infrared spectroscopy (FTIR). Classical and novel bone markers were determined in the blood. Results Mean estimated glomerular filtration rate (eGFR) was 44 ± 16 ml/min per 1.73 m2. Of the patients, 84% had low bone turnover. In Whites, eGFR correlated negatively with the turnover parameter activation frequency (Ac.f) (r −0.48, P = 0.019) and with parameters of bone formation. Most patients had VC (>80%) which correlated positively with levels of phosphorus, c-terminal fibroblast growth factor-23, and activin. Aortic calcifications (ACs) correlated negatively with bone formation rate (BFR) and Ac.f (rho −0.62, −0.61, P < 0.001). TBS correlated negatively with coronary calcification (rho −0.42, P = 0.019) and AC (rho −0.57, P = 0.001). These relationships remained after adjustment of age. The mineral-to-matrix ratio, an FTIR metric reflecting bone quality, was negatively related to Ac.f and positively related to AC. Conclusion Low bone turnover and VC are predominant in early stages of CKD. This is the first study demonstrating mineral abnormalities indicating reduced bone quality in these stages of CKD.
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Alen Coutinho I, Lopes M, Lima F, Ventura C, Rabadão E, Alfaro T, da Cunha J, Regateiro F. Concomitant allergic bronchopulmonary aspergillosis and eosinophilic granulomatosis with polyangiitis after Aspergillus niger infection. Pulmonology 2022; 28:231-234. [DOI: 10.1016/j.pulmoe.2021.12.004] [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] [Received: 12/03/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 10/18/2022] Open
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Malluche HH, Chen J, Lima F, Liu LJ, Monier-Faugere MC, Pienkowski D. Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years. JBMR Plus 2021; 5:e10549. [PMID: 34761151 PMCID: PMC8567493 DOI: 10.1002/jbm4.10549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/26/2021] [Accepted: 08/17/2021] [Indexed: 11/09/2022] Open
Abstract
Oral bisphosphonates are the primary medication for osteoporosis, but concerns exist regarding potential bone-quality changes or low-energy fractures. This cross-sectional study used artificial intelligence methods to analyze relationships among bisphosphonate treatment duration, a wide variety of bone-quality parameters, and low-energy fractures. Fourier transform infrared spectroscopy and histomorphometry quantified bone-quality parameters in 67 osteoporotic women treated with oral bisphosphonates for 1 to 14 years. Artificial intelligence methods established two models relating bisphosphonate treatment duration to bone-quality changes and to low-energy clinical fractures. The model relating bisphosphonate treatment duration to bone quality demonstrated optimal performance when treatment durations of 1 to 8 years were separated from treatment durations of 9 to 14 years. This may be due to a change in relationship of bone-quality parameters with treatment duration. This model also showed that the effects of bisphosphonate treatment duration were most highly correlated with changes in means and standard deviations of infrared spectroscopically derived mineral and matrix parameters and histomorphometric bone turnover parameters. A second model related treatment duration to bone fracture in all 22 patients who fractured while on treatment with bisphosphonates for more than 8 years. This second model showed that bisphosphonate treatment duration, not hip bone mineral density (BMD), was the most strongly correlated parameter to these low-energy bone fractures. Application of artificial intelligence enabled analysis of large quantities of structural, cellular, mineral, and matrix bone-quality parameters to determine relationships with long-term oral bisphosphonate treatment and fracture. Infrared spectroscopy provides clinically relevant bone-quality information of which bone mineral purity is among the most relevant. Nine or more years of bisphosphonate treatment was associated with abnormal bone mineral purity, matrix abnormalities, and low-energy fractures. These data justify limiting bisphosphonate treatment duration to 8 years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Hartmut H Malluche
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - Jin Chen
- Division of Biomedical Informatics, Department of Internal Medicine University of Kentucky Lexington KY USA.,Department of Computer Science University of Kentucky Lexington KY USA
| | - Florence Lima
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - Lucas J Liu
- Department of Computer Science University of Kentucky Lexington KY USA
| | - Marie-Claude Monier-Faugere
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - David Pienkowski
- F. Joseph Halcomb III, MD Department of Biomedical Engineering University of Kentucky Lexington KY USA
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Borba-Junior IT, Moraes CRP, Lima F, Barbosa MS, Annichino-Bizzacchi JM, Mansour E, Velloso LA, Costa FTM, Orsi FA, Paula EV. AVALIAÇÃO DA INTEGRIDADE DA BARREIRA ENDOTELIAL E SUA RELAÇÃO COM AS MANIFESTAÇÕES CLÍNICAS E LABORATORIAIS NA COVID-19. Hematol Transfus Cell Ther 2021. [PMCID: PMC8530677 DOI: 10.1016/j.htct.2021.10.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objetivos Os mecanismos fisiopatológicos que determinam a gravidade da Covid-19 estão associados a ativação da hemostasia e da imunidade inata, em um processo coletivamente referido como imunotrombose, e que envolve ativação plaquetária, geração de NETs (do inglês, Nucleo extracelular traps), expressão de fator tecidual, ativação do complemento e ativação endotelial. Um elemento importante da ativação endotelial é a quebra da barreira endotelial (BE), que ocorre para facilitar o acesso de leucócitos aos tecidos, onde contribuem para erradicação dos patógenos. No entanto, a avaliação da integridade da BE é desafiadora, exigindo o uso de modelos celulares. O objetivo desse estudo foi avaliar o efeito do soro de pacientes com Covid-19 sobre a integridade da BE em monocamadas de células endoteliais, e sua correlação com características clínicas da doença. Materiais e métodos A população do estudo consistiu em 30 pacientes com Covid-19 que apresentavam comprometimento pulmonar confirmado por tomografia de tórax, e necessidade de internação hospitalar por hipoxemia e 30 controles saudáveis pareados por sexo e idade. Os pacientes recrutados fizeram parte de um estudo clínico (REBEC: U1111-1250-1843), e as amostras utilizadas nesta avaliação foram obtidas no momento da internação, antes de qualquer intervenção. Monocamadas de células endoteliais de duas fontes (HUVECs: células de cordão umbilical; HULECs: células endoteliais pulmonares) foram estimuladas com soro de pacientes e indivíduos saudáveis (diluição 15% em meio de cultura) e a integridade da BE foi avaliada por um sensor de impedância celular (ECIS; Eletric Cell-substrate Impedance Sensing System) continuamente por 36 horas. Biomarcadores de gravidade e relacionados à ativação da hemostasia foram avaliados por kits comerciais. Dados clínicos foram obtidos a partir dos prontuários digitais. Resultados O soro de pacientes com Covid-19 induziu quebra de BE significativamente mais acentuada que o de indivíduos saudáveis em HUVECs nos tempos 15 min (p < 0,01); 30 min (p ≤ 0,001); 1h (p ≤ 0,0001); 2h (p ≤ 0,0001); 3h (p ≤ 0,0001); 4h (p ≤ 0,01) e 5h (p ≤ 0,05). Estes resultados foram confirmados no modelo de células endoteliais pulmonares (HULECs). A magnitude da quebra apresentou correlação significativa com desfechos clínicos relevantes como tempo de internação total (RS até 0.57) e tempo de UTI (RS = 0,47). Em relação a biomarcadores de interesse na Covid-19, a quebra da BE apresentou correlação significativa com neutrofilia, relação neutrófilo/linfócito, fator de Von Willebrand, fatores IX e XI, fibrinogênio, D-dímero e uPAR (Receptor de Uroquinase). Discussão Através de um método considerado padrão-ouro para avaliação in vitro da integridade da BE nós demonstramos que componentes presentes no soro de pacientes com Covid-19 são capazes de promover a quebra da BE, e que a magnitude deste processo está relacionada à gravidade desta doença. A correlação com outros marcadores inflamatórios corrobora a conexão entre os mecanismos envolvidos na imunotrombose em pacientes com Covid-19. Conclusão nossos resultados apontam a quebra da BE como um alvo terapêutico atrativo nestes pacientes.
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Moraes CRP, Lima F, Borba-Junior IT, Barbosa MS, Huber SC, Mansour E, Annichino-Bizzacchi JM, Velloso LA, Orsi FA, Paula EV. AVALIAÇÃO DOS NÍVEIS CIRCULANTES DE MEDIADORES DA INTEGRIDADE DA BARREIRA ENDOTELIAL NA COVID-19 E SUA RELAÇÃO COM A ATIVAÇÃO DA HEMOSTASIA. Hematol Transfus Cell Ther 2021. [PMCID: PMC8530648 DOI: 10.1016/j.htct.2021.10.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objetivos a imunotrombose consiste no processo que envolve a ativação concomitante da imunidade inata, hemostasia e endotélio como parte da resposta a patógenos, e vem sendo colocada no centro da fisiopatologia da Covid-19. Um elemento menos explorado da imunotrombose é a ruptura da barreira endotelial (BE), que permite o acesso dos leucócitos aos tecidos inflamados. Entre os reguladores da integridade da BE destacam-se as vias que envolvem a angiopoietina (Ang) 1 e 2 e seu receptor Tie2, e a via do VEGF-A/VE-caderina (VEC). Além deste papel, foi recentemente demonstrado que a ativação da via Ang/Tie2 inibe a ativação endotelial e a expressão de fator tecidual, estabilizando o endotélio no estado quiescente. Neste estudo determinamos os níveis circulantes de mediadores da integridade da BE na Covid-19, e exploramos sua associação com a gravidade da doença, assim como com a ativação da hemostasia através de um painel abrangente de biomarcadores. Materiais e métodos as amostras foram obtidas de 30 pacientes internados por Covid-19 devido à hipoxemia e achados tomográficos típicos, e recrutados para um estudo clínico (REBEC: U1111-1250-1843). As amostras foram coletadas em até 24h do diagnóstico, antes de qualquer intervenção terapêutica. Os níveis de reguladores da BE foram medidos por métodos imunológicos (Elisa ou multiplex), e o de biomarcadores da hemostasia por kits comerciais específicos. Um grupo de 30 indivíduos saudáveis pareados por idade e sexo foram utilizados como controle. Dados clínicos e laboratoriais foram obtidos dos prontuários digitais. Resultados o tempo médio de internação foi de 12,9 ± 9,8 dias, e 12 pacientes (40%) necessitaram de UTI. O dímero D médio foi de 3.609 ± 14.440 ng/mL. Os níveis circulantes de todos reguladores da integridade da BE encontraram-se aumentados em pacientes, quando comparado com controles (Ang1: 463.2 ± 194.6 vs 237.4 ± 104.9 pg/mL, p < 0.0001; Ang2: 1.926 (1.275-3.134) vs 1.215 (9-1.444) pg/mL, p < 0.0001; Tie2: 10.753 ± 2.377 vs 8.603 ± 1.851 pg/mL, p < 0.0001 e VEGF-A: 94.7 (73.4-116.0) vs 45.9 (39.7-57.0), p < 0.0001. Além disso, os níveis de alguns destes reguladores se associaram significativamente a desfechos de relevância clínica, a saber: (i) extensão da lesão pulmonar na tomografia: Ang2 e VEGF-A; (ii) tempo de internação em UTI: VEGF-A. Interessantemente, observamos correlações consistentes e significativas entre os níveis de reguladores da BE a proteínas envolvidas na ativação da hemostasia (fibrinogênio, VWF: Ag, uPAR, PAI-1 e P-selectina). Discussão o interesse no estudo de reguladores da integridade da BE na Covid-19 já se justifica pelo fato de a doença envolver tanto o comprometimento da barreira alvéolo-capilar quanto a ativação da angiogênese, como demonstrado por outros autores. Nossos resultados reforçam a relevância destas vias através da associação observada com desfechos clínicos. Além disso, os resultados mostram pela primeira vez uma associação entre mediadores da integridade da BE e um painel amplo de biomarcadores da ativação da hemostasia, sugerindo um crosstalk entre estas vias na Covid-19, como demonstrado recentemente no contexto da sepse. Conclusões nossos resultados apontam que a via Ang/Tie2 deve ser considerada um alvo terapêutico atrativo na Covid-19, por representar um elemento central da imunotrombose nestes pacientes.
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Qin A, Lima F, Bell S, Kalemkerian G, Schneider B, Ramnath N, Lew M, Rao A, Frankel T. P57.03 Cellular Engagement and Interaction in the Tumor Microenvironment (TME) Predicts Response to ICI in Metastatic NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.575] [Citation(s) in RCA: 1] [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: 11/16/2022]
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Lima F, Moraes CRP, Barbosa MS, Borba-Júnior IT, Mansour E, Velloso LA, Paula EV. AVALIAÇÃO DOS NÍVEIS DE MARCADORES DA VIA HEME/HEMOPEXINA/HEME-OXIGENASE 1 E SUA ASSOCIAÇÃO COM PARÂMETROS CLÍNICOS E LABORATORIAIS NA COVID-19. Hematol Transfus Cell Ther 2021. [PMCID: PMC8530620 DOI: 10.1016/j.htct.2021.10.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objetivos Material e métodos Resultados Discussão Conclusão
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Lima F, Kennedy K, Parulkar A, Sheikh W, Sharma E, Chu A. Hospital readmissions after catheter ablation for atrial fibrillation among patients with heart failure in the United States. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0443] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Catheter ablation for atrial fibrillation may improve quality of life and long-term mortality among patients with heart failure.
Purpose
The rates of hospital readmission after catheter ablation for atrial fibrillation among patients with an established diagnosis of heart failure are largely unknown. We aimed to assess the rates and causes of 30-day readmission among patients with heart failure undergoing catheter ablation vs. medical therapy for atrial fibrillation in the United States.
Methods
The 2016 Nationwide Readmissions Database was screened for patients with diagnosis of heart failure and atrial fibrillation using the 10th Revision of International Classification of Diseases codes. Patients undergoing catheter ablation for atrial fibrillation were grouped separately from those treated medically for atrial fibrillation. Thirty-day readmissions were assessed for both groups.
Results
The analytical cohort included 749,776 (national estimate of 1,421,673) patients with heart failure and atrial fibrillation. This included 2,204 patients that underwent catheter ablation. Patients treated with catheter ablation had lower 30-day readmissions compared to the medical therapy group (16.8% vs 20.1%, p<0.001). Fifty-five percent of all readmissions among the catheter ablation cohort were related to cardiac events. Heart failure exacerbation (40%) and arrhythmia (36%) were the most common cardiac causes for readmission after catheter ablation (Figure).
Conclusions
In a contemporary nationwide analysis of patients with heart failure and atrial fibrillation, compared to medical therapy those treated with catheter ablation for atrial fibrillation had fewer 30-day readmissions after index hospital discharge. The most common cause for readmission among patients treated with catheter ablation was heart failure exacerbation and arrhythmia.
Causes of readmission
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- F Lima
- Brown University, Providence, United States of America
| | - K Kennedy
- St. Luke's Mid America Heart Institute, Kansas City, United States of America
| | - A Parulkar
- Brown University, Providence, United States of America
| | - W Sheikh
- Brown University, Providence, United States of America
| | - E Sharma
- Brown University, Providence, United States of America
| | - A Chu
- Brown University, Providence, United States of America
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Sharma E, Sheikh W, Parulkar A, Lima F, Wu M, Chu A. Implications of pacemaker implantation after TAVR: insights from the Nationwide Readmissions Database. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0720] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Conduction disturbances after transcatheter aortic valve replacement (TAVR) requiring permanent pacemaker (PPM) implantation are a well-known procedural complication. Data on the effect of post-TAVR PPM implantation on 30-day readmissions is scarce.
Methods
The Nationwide Readmissions Database (NRD) is a nationally representative sample of all US hospitalizations, representing over 35 million discharges. The 2016 NRD was used to identify patients who underwent TAVR and PPM implantation from January to November 2016. Propensity matching was used to balance baseline clinical characteristics.
Results
Of the 44,607 patients who underwent TAVR, 4,878 (10.9%) required permanent pacemaker implantation during their index hospitalization. Patients requiring PPM during their index admission for TAVR had a higher crude median length of stay (LOS) (5d vs. 3d, p<0.001), median cost of index admission ($61,604 vs. $45,513, p<0.001) and rate of 30-day readmission (14.5% vs 11.2%, p<0.001). After 2:1 propensity matching, PPM patients still had a higher median LOS (5d vs. 3d, p<0.001), median cost of index admission ($61,902 vs. $41,162, p<0.001), and rate of 30-day readmission (13.8% vs 11.1%, p=0.003). Patients who received PPM were more likely to be older (81.1 vs 80.3, OR 1.01, CI 1.01–1.02), diabetic (OR 1.27, 1.13–1.44), obese (OR 1.22, 1.05–1.43), and have right (OR 4.35, 3.72–5.09) or left (OR 1.80, 1.51–2.15) bundle branch blocks on multivariate analysis. Causes of readmission in patients with and without PPM were predominantly non-cardiac (62.9% vs 68.0%). Heart failure was the most common cause of readmission for both groups (18.4% vs 14.6%). Median cost of readmissions ($8716 vs $8250, p=0.34) and LOS (4d vs 4d, p=1) were not significantly different during readmissions.
Conclusions
Based on a nationally representative sample, 10.9% of patients undergoing TAVR required PPM implantation during the index hospitalization. Age, diabetes, obesity, and right or left bundle branch blocks were significant predictors of PPM implantation. PPM implantation resulted in significantly higher LOS, costs, and 30-day readmissions on propensity-matched analysis.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Sharma
- Brown University, Providence, United States of America
| | - W Sheikh
- Brown University, Providence, United States of America
| | - A Parulkar
- Brown University, Providence, United States of America
| | - F Lima
- Brown University, Providence, United States of America
| | - M Wu
- Brown University, Providence, United States of America
| | - A Chu
- Brown University, Providence, United States of America
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Hughes-Austin JM, Katz R, Semba RD, Kritchevsky SB, Bauer DC, Sarnak MJ, Ginsberg C, Shlipak MG, Lima F, Malluche HH, Ix JH. Biomarkers of Bone Turnover Identify Subsets of Chronic Kidney Disease Patients at Higher Risk for Fracture. J Clin Endocrinol Metab 2020; 105:5849341. [PMID: 32474604 PMCID: PMC7340189 DOI: 10.1210/clinem/dgaa317] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/22/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND We sought to identify biomarkers that indicate low turnover on bone histomorphometry in chronic kidney disease (CKD) patients, and subsequently determined whether this panel identified differential risk for fractures in community-dwelling older adults. METHODS Among CKD patients who underwent iliac crest bone biopsies and histomorphometry, we evaluated candidate biomarkers to differentiate low turnover from other bone disease. We applied this biomarker panel to 641 participants in the Health Aging and Body Composition Study (Health ABC) study with estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2 who were followed for fracture. Cox proportional hazards models evaluated the association of bone mineral density (BMD) with fracture risk and determined whether biomarker-defined low bone turnover modified fracture risk at any level of BMD. RESULTS In 39 CKD patients age 64 ± 13 years, 85% female, with mean eGFR 37 ± 14 mL/min/1.73 m2 who underwent bone biopsy, lower fibroblast growth factor (FGF)-23, higher ɑ-Klotho, and lower parathyroid hormone (PTH) indicated low bone turnover in accordance with bone histomorphometry parameters (individual area under the curve = 0.62, 0.73, and 0.55 respectively; sensitivity = 22%, specificity = 100%). In Health ABC, 641 participants with CKD were age 75 ± 3 years , 49% female, with mean eGFR 48 ± 10 mL/min/1.73 m2. For every SD lower hip BMD at baseline, there was an 8-fold higher fracture risk in individuals with biomarker-defined low turnover (hazard ratio 8.10 [95% CI, 3.40-19.30]) vs a 2-fold higher risk in the remaining individuals (hazard ratio 2.28 [95% CI, 1.69-3.08]) (Pinteraction = .082). CONCLUSIONS In CKD patients who underwent bone biopsy, lower FGF-23, higher ɑ-Klotho, and lower PTH together had high specificity for identifying low bone turnover. When applied to older individuals with CKD, BMD was more strongly associated with fracture risk in those with biomarker-defined low turnover.
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Affiliation(s)
- Jan M Hughes-Austin
- Department of Orthopaedic Surgery, School of Medicine, University of California, San Diego, La Jolla, California
- Correspondence and Reprint Requests: Jan Hughes-Austin, PT, PhD, Department of Orthopaedic Surgery, University of California, San Diego, 9500 Gilman Drive, Mail Code 0863, La Jolla, CA 92093. E-mail:
| | - Ronit Katz
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | - Richard D Semba
- Department of Ophthalmology, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Stephen B Kritchevsky
- Department of Gerontology and Geriatric Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Douglas C Bauer
- Division of General Internal Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Mark J Sarnak
- Division of Nephrology, School of Medicine,Tufts University, Boston, Massachusetts
| | - Charles Ginsberg
- Division of Nephrology-Hypertension, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Michael G Shlipak
- Division of General Internal Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Florence Lima
- Division of Nephrology, Bone and Mineral Metabolism, Department of Medicine, University of Kentucky, Lexington, Kentucky
| | - Hartmut H Malluche
- Division of Nephrology, Bone and Mineral Metabolism, Department of Medicine, University of Kentucky, Lexington, Kentucky
| | - Joachim H Ix
- Division of Nephrology-Hypertension, Department of Medicine, School of Medicine, University of California, San Diego, La Jolla, California
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
- Division of Preventive Medicine, Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, California
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Maibam A, Rao M, Lia Castellanos A, Lima F, Stivers T, Holleman D, Thornton A. 320. UK-HOPS (HIV Osteoporosis Prevention and Screening)-Gaps in the Care of HIV Patients with Bone Disease. Open Forum Infect Dis 2019. [PMCID: PMC6809595 DOI: 10.1093/ofid/ofz360.393] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background With increasing life expectancy among people living with Human Immunodeficiency Virus (HIV), long-term complications such as osteoporosis/osteopenia and fractures are frequently seen. Although screening guidelines exist for bone disease in the HIV population, quantitative and qualitative gaps exist in screening and prevention. Bone disease in HIV is multifactorial, and FRAX may not accurately predict fracture risk. The aim of our study is to describe diagnostic features of bone disease and estimate the population at risk, and evaluate the frequency of screening, referral and treatment in patients attending an HIV Clinic. Methods We performed a retrospective analysis of 1220 patients with HIV infection ≥40 years of age who attended the HIV clinic under the Ryan White program, during January 2016 to December 2018, at University of Kentucky. We obtained demographic details (Table 1), comorbidities, laboratory testing, bone mineral density (BMD) testing and specialty bone clinic referral data from electronic health records, applying ICD -10 and CPT codes. We estimated the frequency of BMD measurement and prevalence of risk factors for bone disease specific to this population. Results BMD testing was performed in only 158 (13%) patients (CMS targets 60% for testing at-risk populations). Of these patients, 76 (48%) had osteopenia and 59 (37%) had osteoporosis; 22 (14%) received treatment (Figure 1). Seven patients with osteoporosis/osteopenia and fracture had bone biopsy, with low bone turnover in four (57%). Potential risk factors for secondary osteoporosis are presented in Table 2; at least one factor was present in 98% of patients. Fracture prevalence was likely underestimated because the ICD-10 /CPT coding was available only in 23 (2%) patients. Conclusion Bone disease is under-recognized and undertreated, and targeted screening programs are needed for earlier diagnosis and management in this population. Bisphosphonates may not be optimal first-line therapy for all HIV patients with bone loss. In addition to stress or fragility fractures and worsening osteoporosis, metabolic bone work-up should be performed in patients with secondary osteoporosis related to CKD, renal phosphate loss, prior bisphosphonate/Tenofovir/glucocorticoid treatment. ![]()
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Disclosures All authors: No reported disclosures.
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Silva F, Louro R, Cortezzi W, Torres M, Lima F, Sartoretto S, Correa R, Arantes E, Caetano D, Romanach M. Cemento-ossifying fibroma: prototype guided surgical approach for treatment of major lesions. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.744] [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: 10/26/2022]
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Faria S, Lima F, Pereira L. Association between the control of inhibitory and a directed listening, contributing to the promotion of a differential prognosis. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Faria
- Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil
| | - F Lima
- Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil
| | - L Pereira
- Escola Paulista de Medicina, Universidade Federal de São Paulo, Brasil
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Oliveira J, Duarte A, Santos C, Pessoa L, Filho CM, Lima J, Carvalho D, Xavier T, Figueiredo E, Giovanetti M, Almeida B, Goes J, Lima F, Alcantara L, Siqueira I. Prevalence of Zika, dengue and Chikungunya virus infection in pregnant women and surveillance of congenital Zika infection in Salvador, Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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23
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Rosário MD, Jesus P, Farias D, Novaes M, Moura D, Lima F, Santos C, Giovanetti M, Alcantara L, Siqueira I. Neurological complications associated with arboviruses during Zika outbreak in Salvador, Bahia-Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3534] [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: 10/28/2022] Open
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24
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Marques S, Cabreira G, Correa N, Lima F, Mackoski F, Ferreira L, Silva E. Sanitary parasitological evaluation in military dogs from the Military Brigade of the state of Rio Grande do Sul, Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4129] [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] Open
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25
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Linhas R, Lima F, Coutinho D, Almeida J, Neves S, Oliveira A, Ladeira I, Lima R, Campainha S, Guimarães M. Role of the impulse oscillometry in the evaluation of tracheal stenosis. Pulmonology 2018; 24:224-230. [PMID: 29627402 DOI: 10.1016/j.pulmoe.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 11/26/2017] [Accepted: 12/11/2017] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Tracheal stenosis is a rare and challenging disease. Bronchoscopy is the gold standard for diagnosis and assessment but brings inherent risks. Spirometry is commonly used to access obstructions but is not always feasible due to patient related factors. We therefore considered impulse oscillometry (IOS) as a non-invasive method to quantify airway obstruction and its potential use for diagnosis and follow-up of tracheal stenosis. MATERIALS AND METHODS Patients with confirmed tracheal stenosis were recruited between January 1st, 2015 and December 31st, 2016. Before bronchoscopy, all subjects underwent IOS and spirometry; for patients submitted to interventional bronchoscopy the same techniques were also performed after the procedure. We assessed the correlation between IOS measurements and airway narrowing as well as between IOS and spirometry values. RESULTS Twenty-one patients were included. Tracheal narrowing was inversely correlated with X5% (r -0.442, p 0.045) and positively correlated with FEV1/PEF (r 0.467, p 0.033). The stenosis length was inversely correlated with PEF and PEF% (r -0.729, p=0.001 and r -0.707, p=0.002, respectively). There was a strong correlation between spirometric and IOS values. We did not find any significant differences between pre- and post-intervention IOS values for patients assessed after interventional bronchoscopy. CONCLUSIONS Our study showed a weak correlation between X5% and tracheal narrowing making it unclear whether IOS can be used for physiological assessment of patients with tracheal stenosis. Stenosis length correlated with PEF making it a potential predictor of successful surgical approach. The correlation between IOS and spirometric values makes IOS a potential alternative in patients with suspected tracheal stenosis who are not able to perform spirometry. Larger scale studies should clarify the role of IOS in this pathology.
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Affiliation(s)
- R Linhas
- Department of Pulmonology, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal.
| | - F Lima
- Department of Pulmonology, Centro Hospitalar Vila Nova de Gaia/Espinho, EPE, Portugal
| | - D Coutinho
- Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - J Almeida
- Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - S Neves
- Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - A Oliveira
- Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - I Ladeira
- Respiratory Physiopathology Laboratory, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - R Lima
- Respiratory Physiopathology Laboratory, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - S Campainha
- Bronchoscopy Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
| | - M Guimarães
- Respiratory Physiopathology Laboratory, Centro Hospitalar de Vila Nova de Gaia/Espinho, EPE, Portugal
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Luna EB, Janini MER, Lima F, Pontes RRA, Guedes FR, Geller M, da Silva LE, Motta AT, Cunha KS. Craniomaxillofacial morphology alterations in children, adolescents and adults with neurofibromatosis 1: A cone beam computed tomography analysis of a Brazilian sample. Med Oral Patol Oral Cir Bucal 2018; 23:e168-e179. [PMID: 29476678 PMCID: PMC5911357 DOI: 10.4317/medoral.22155] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Oral manifestations are common in neurofibromatosis 1 (NF1), and include jaws and teeth alterations. Our aim was to investigate the craniomaxillofacial morphology of Brazilian children, adolescents and adults with NF1 using cone beam computed tomography. MATERIAL AND METHODS This study was conducted with 36 Brazilian individuals with NF1 with ages ranging from 4 to 75. The participants were submitted to anamnesis, extra and intraoral exam and cephalometric analysis using cone beam computed tomography. Height of the NF1 individuals was compared to the length of jaws and skull base. The results of the cephalometric measurements of the NF1 group were compared with a control group paired by age, gender and skin color. RESULTS Individuals with NF1 had lower maxillary length (p<0.0001), lower mandibular length (p<0.0001), lower skull base length (p<0.0001). In children and adolescents, the mandible was more posteriorly positioned (p=0.01), when compared with the control group. There was no association between jaws and skull base length with the height of the individuals with NF1. CONCLUSIONS Brazilian children, adolescents and adults with NF1 have short mandible, maxilla and skull base. Moreover, children and adolescents present mandibular retrusion.
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Affiliation(s)
- E-B Luna
- School of Medicine, Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Av. Marquês do Paraná, 303, 4o andar, sala 01, Centro, Niterói, RJ, Brazil, Zip code: 24033-900,
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Duarte R, Lönnroth K, Carvalho C, Lima F, Carvalho ACC, Muñoz-Torrico M, Centis R. Tuberculosis, social determinants and co-morbidities (including HIV). Pulmonology 2017; 24:115-119. [PMID: 29275968 DOI: 10.1016/j.rppnen.2017.11.003] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/12/2017] [Indexed: 11/26/2022] Open
Abstract
The risk of exposure, progression to active tuberculosis (TB) and then to cure is a process affected by several risk factors. Along with well known risk factors such as human immunodeficiency virus (HIV), use of immunosuppressive drugs and being of young age, emerging risk factors such socio-economic and behavioral aspects play a significant role in increasing the susceptibility to infection, and unsuccessful treatment outcomes. This paper summarizes the effects of these socio-economic determinants and co-morbidities (including HIV) on TB infection and disease.
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Affiliation(s)
- R Duarte
- Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Departamento de Pneumologia, Vila Nova de Gaia, Portugal; ISPUP-EPIUnit, Universidade do Porto, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.
| | - K Lönnroth
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County, Sweden
| | - C Carvalho
- Serviço de Doenças Infecciosas, Centro Hospitalar São João, Porto, Portugal
| | - F Lima
- Centro Hospitalar Vila Nova de Gaia/Espinho EPE, Departamento de Pneumologia, Vila Nova de Gaia, Portugal
| | - A C C Carvalho
- Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - M Muñoz-Torrico
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias, Mexico
| | - R Centis
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Institute, IRCCS Tradate, Italy
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El-Husseini A, Wang K, Edon A, Saxon D, Lima F, Sloan D, Sawaya BP. Value of Intraoperative Parathyroid Hormone Assay during Parathyroidectomy in Dialysis and Renal Transplant Patients with Secondary and Tertiary Hyperparathyroidism. Nephron Clin Pract 2017; 138:119-128. [PMID: 29131092 DOI: 10.1159/000482016] [Citation(s) in RCA: 11] [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] [Received: 06/26/2017] [Accepted: 10/05/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In dialysis and renal transplant patients with secondary and tertiary hyperparathyroidism (HPT), the value of intraoperative parathyroid hormone (ioPTH) during parathyroidectomy (PTX) and its association with long-term PTH levels are unknown. The present study aims at evaluating the relationship of ioPTH with long-term PTH levels post-PTX in dialysis and renal transplant patients in a single-center study. METHODS The ioPTH was measured in 57 dialysis patients (33 females and 24 males) and 18 renal transplant recipients (12 males and 6 females) who underwent PTX from 2005 to 2015 for refractory HPT. Near-total PTX was performed in 56 patients and total PTX with autotransplantation in 20 patients. The PTH monitoring included 3 samples: pre-intubation, 10- and 20-min (pre-ioPTH, 10-ioPTH, and 20-ioPTH) post parathyroid gland excision. Patients were followed up for up to 5 years. RESULTS In the dialysis group, the median (25th-75th percentile) pre-, 10-, and 20-ioPTH levels were 1,447 pg/mL (938-2,176), 143 pg/mL (78-244) and 112 pg/mL (59-153) respectively. In the renal transplant group, pre-, 10-, and 20-ioPTH levels were 273 pg/mL (180-403), 42 pg/mL (25-72), and 34 pg/mL (23-45) respectively. All patients in the transplant group had a functional kidney transplant at the time of PTX with a median serum creatinine of 1.3 mg/dL (1.2-1.7) and estimated glomerular filtration rate of 55 mL/min (40-60). The median time between renal transplant and PTX surgeries was 22 months (7-81). The last median follow-up PTH level was 66 pg/mL (15-201) in the dialysis group and 54 pg/mL (17-72) in the transplant group (p = 0.438). The mean time for last PTH post-PTX was 2.3 ± 2.0 years. In both groups, there was no significant difference between 20-ioPTH and any-time post-PTX PTH levels (p = 0.6 and p = 0.9). Nineteen patients (25%) were readmitted within 90 days because of hypocalcemia. One patient in the dialysis group was readmitted for post-PTX hematoma evacuation. No patient required repeat PTX because of recurrent HPT that was refractory to medical therapy. Only one dialysis patient required repeat PTX because the first procedure failed. CONCLUSIONS The 20-ioPTH is a good indicator of long-term PTH levels in dialysis and renal transplant patients. Hypocalcemia is a common complication, particularly in dialysis patients, and it is the main reason for readmission after PTX. Hypoparathyroidism is a potential concern after PTX in dialysis patients.
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Affiliation(s)
- Amr El-Husseini
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA.,Division of Nephrology, Mansoura University, Mansoura, Egypt
| | - Kevin Wang
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA
| | - Annick Edon
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA
| | - David Saxon
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA
| | - Florence Lima
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA
| | - David Sloan
- Section of Endocrine Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - B Peter Sawaya
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky, USA
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Mousinho F, Mendes T, Sousa E Santos P, Azevedo AP, Mousinho G, Malcata C, Viegas E, Madureira B, Falcão F, Gomes AP, Lima F. Bisoprolol-induced thrombocytopenia: A case report. J Clin Pharm Ther 2017; 43:280-283. [PMID: 28868658 DOI: 10.1111/jcpt.12614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/07/2017] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Thrombocytopenia, not associated with bone marrow primary disease, is a common clinical problem. The possibility of drug-induced thrombocytopenia must be considered, especially in hospitalized patients. Drugs can cause thrombocytopenia by several mechanisms including direct bone marrow or other organ toxicity, and immune reactions. CASE DESCRIPTION We describe a patient presenting with thrombocytopenia likely related to bisoprolol. WHAT IS NEW AND CONCLUSION We report a case of bisoprolol-induced thrombocytopenia which resolved with drug discontinuation and steroid therapy. We review the mechanisms involved in drug-induced immune thrombocytopenia.
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Affiliation(s)
- F Mousinho
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - T Mendes
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - P Sousa E Santos
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - A P Azevedo
- Clinical Pathology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.,Centre for Toxicogenomics and Human Health Genetics, Oncology and Human Toxicology, Universidade Nova de Lisboa, Lisboa, Portugal.,NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal.,Instituto Superior de Ciências da Saúde Egas Moniz, Monte da Caparica, Portugal
| | - G Mousinho
- ImunoHemotherappy Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - C Malcata
- Portuguese Institute of Blood and Transplantation, Centro de Sangue e da Transplantação de Lisboa, Lisboa, Portugal
| | - E Viegas
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - B Madureira
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - F Falcão
- Pharmaceutical Services, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - A P Gomes
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - F Lima
- Hematology Department, Hospital São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
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Lima F, Swift JM, Greene ES, Allen MR, Cunningham DA, Braby LA, Bloomfield SA. Exposure to Low-Dose X-Ray Radiation Alters Bone Progenitor Cells and Bone Microarchitecture. Radiat Res 2017; 188:433-442. [PMID: 28771086 DOI: 10.1667/rr14414.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Exposure to high-dose ionizing radiation during medical treatment exerts well-documented deleterious effects on bone health, reducing bone density and contributing to bone growth retardation in young patients and spontaneous fracture in postmenopausal women. However, the majority of human radiation exposures occur in a much lower dose range than that used in the radiation oncology clinic. Furthermore, very few studies have examined the effects of low-dose ionizing radiation on bone integrity and results have been inconsistent. In this study, mice were irradiated with a total-body dose of 0.17, 0.5 or 1 Gy to quantify the early (day 3 postirradiation) and delayed (day 21 postirradiation) effects of radiation on bone microarchitecture and bone marrow stromal cells (BMSCs). Female BALBc mice (4 months old) were divided into four groups: irradiated (0.17, 0.5 and 1 Gy) and sham-irradiated controls (0 Gy). Micro-computed tomography analysis of distal femur trabecular bone from animals at day 21 after exposure to 1 Gy of X-ray radiation revealed a 21% smaller bone volume (BV/TV), 22% decrease in trabecular numbers (Tb.N) and 9% greater trabecular separation (Tb.Sp) compared to sham-irradiated controls (P < 0.05). We evaluated the differentiation capacity of bone marrow stromal cells harvested at days 3 and 21 postirradiation into osteoblast and adipocyte cells. Osteoblast and adipocyte differentiation was decreased when cells were harvested at day 3 postirradiation but enhanced in cells isolated at day 21 postirradiation, suggesting a compensatory recovery process. Osteoclast differentiation was increased in 1 Gy irradiated BMSCs harvested at day 3 postirradiation, but not in those harvested at day 21 postirradiation, compared to controls. This study provides evidence of an early, radiation-induced decrease in osteoblast activity and numbers, as well as a later recovery effect after exposure to 1 Gy of X-rays, whereas osteoclastogenesis was enhanced. A better understanding of the effects of radiation on osteoprogenitor cell populations could lead to more effective therapeutic interventions that protect bone integrity for individuals exposed to low-dose ionizing radiation.
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Affiliation(s)
- Florence Lima
- a Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky 40536
| | - Joshua M Swift
- b Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843
| | - Elisabeth S Greene
- b Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843
| | - Matthew R Allen
- e Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - David A Cunningham
- b Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843
| | - Leslie A Braby
- c Department of Nuclear Engineering, Texas A&M University, College Station, Texas 77843
| | - Susan A Bloomfield
- b Department of Health and Kinesiology, Texas A&M University, College Station, Texas 77843.,d Department of Nutrition and Food Science, Texas A&M University, College Station, Texas 77843
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Dias Aguiar M, Garcia Tavares B, M Tsutsui J, Baptista C Lopes B, B Viana Cruz C, Nicolau J, Prado Viana E, T Oliveira M, Soeiro A, Ribeiro E, Lemos P, R Porter T, Lima F, Kalil Filho R, Mathias Jr W. P4646Effect of sonothrombolysis on recanalization rates, ventricular remodeling and mechanics. Results of a single center, randomized trial in patients with first acute ST elevation myocardial infarction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4646] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Silva S, Espada E, Melo J, Lima M, Ionita A, Carda J, Andrade J, Neves M, Cabral R, Mendes T, Gaspar C, Alves D, Pina F, Botelho de Sousa A, Coelho H, Montalvão A, Vitória H, Lima F, Coutinho J, Lúcio P, Guimarães J, Ribeiro M, Gomes da Silva M, Raposo J. PORTUGUESE REAL-LIFE EXPERIENCE WITH IBRUTINIB OUTSIDE CLINICAL TRIALS - A MULTICENTER ANALYSIS. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Silva
- Serviço de Hematologia e Transplantação de Medula; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Lisbon Portugal
| | - E. Espada
- Serviço de Hematologia e Transplantação de Medula; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Lisbon Portugal
| | - J.A. Melo
- Serviço de Hematologia e Transplantação de Medula; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Lisbon Portugal
| | - M.P. Lima
- Departamento de Hematologia; Instituto Português de Oncologia de Lisboa Francisco Gentil; Lisbon Portugal
| | - A. Ionita
- Departamento de Hematologia; Instituto Português de Oncologia de Lisboa Francisco Gentil; Lisbon Portugal
| | - J.P. Carda
- Serviço de Hematologia Clínica; Centro Hospitalar e Universitário de Coimbra; Coimbra Portugal
| | - J. Andrade
- Serviço de Hematologia Clínica; Centro Hospitalar de São João; Porto Portugal
| | - M. Neves
- Unidade de Hemato-oncologia; Fundação Champalimaud; Lisbon Portugal
| | - R. Cabral
- Serviço de Hematologia Clínica; Hospital Geral de Santo António, Centro Hospitalar do Porto; Porto Portugal
| | - T. Mendes
- Serviço de Hematologia, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - C. Gaspar
- Serviço de Hematologia; Hospital Santo António dos Capuchos, Centro Hospitalar Lisboa Central; Lisbon Portugal
| | - D. Alves
- Hematologia Clínica; Hospital Lusíadas Lisboa; Lisbon Portugal
| | - F. Pina
- Serviço de Hematologia; Hospital do Espírito Santo de Évora; Évora Portugal
| | - A. Botelho de Sousa
- Serviço de Hematologia; Hospital Santo António dos Capuchos, Centro Hospitalar Lisboa Central; Lisbon Portugal
| | - H. Coelho
- Serviço de Hematologia, Centro Hospitalar de Vila Nova de Gaia; Vila Nova de Gaia Portugal
| | - A. Montalvão
- Hematologia Clínica; Unidade Local de Saúde do Baixo Alentejo; Beja Portugal
| | - H. Vitória
- Hematologia; Centro Hospitalar Tondela - Viseu; Tondela Portugal
| | - F. Lima
- Serviço de Hematologia, Hospital de São Francisco Xavier, Centro Hospitalar de Lisboa Ocidental; Lisbon Portugal
| | - J. Coutinho
- Serviço de Hematologia Clínica; Hospital Geral de Santo António, Centro Hospitalar do Porto; Porto Portugal
| | - P. Lúcio
- Unidade de Hemato-oncologia; Fundação Champalimaud; Lisbon Portugal
| | - J.E. Guimarães
- Serviço de Hematologia Clínica; Centro Hospitalar de São João; Porto Portugal
| | - M.L. Ribeiro
- Serviço de Hematologia Clínica; Centro Hospitalar e Universitário de Coimbra; Coimbra Portugal
| | - M. Gomes da Silva
- Departamento de Hematologia; Instituto Português de Oncologia de Lisboa Francisco Gentil; Lisbon Portugal
| | - J. Raposo
- Serviço de Hematologia e Transplantação de Medula; Hospital de Santa Maria, Centro Hospitalar Lisboa Norte; Lisbon Portugal
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OReilly CL, Deaver JW, Wiggs MP, Lima F, Swift JM, Greene ES, Bloomfield SA, Fluckey JD. Partial or Complete Unloading of Skeletal Muscle Leads to Specific Alterations of Anabolic Signal Transduction. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000519050.26430.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Lima F, Cardoso T, Bonnin C, Martinez-Aran A, Vieta E, Rosa A. Concordance and Discrepancy Between Subjective and Objective Cognitive Assessment in Bipolar Disorder: What is Influencing this Discrepancy? Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionEvidence has shown that some patients with bipolar disorder have a relatively accurate sense of their cognitive abilities, whereas others may overreported or underreported cognitive difficulties, which causes a discrepancy in this measures.ObjectivesTo investigate concordance and discrepancy between subjective and objective cognitive measures, as well as to identify factors that could influence this discrepancy.MethodsPatients who met DSM IV-TR criteria for bipolar disorder in partial or full remission (HDRS-17 score ≤ 12; YMRS score ≤ 7) were recruited from outpatient clinic at Barcelona and Porto Alegre. Objective cognitive assessment was performed by the Letter-Number Sequencing (LNS-WAIS III). Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA) was used as a subjective cognitive measure.ResultsWere included 179 patients. We found a concordance between COBRA and LNS in 62 cases, and discrepancy in 117 cases (Fig. 1). The incongruent group (COBRA–and LNS + ) have less years of study (8.10 ± 4.01) than the incongruent group (COBRA+ and LNS–) (13.44 ± 4.05, P = 0.001), and than congruent group (COBRA–and NLS–) (13.75 ± 4.04, P = 0.003). Finally, the congruent group (COBRA+ and LNS + ) was the group with higher functioning impairment.ConclusionsA few number of false-negative cases were detected, suggesting that COBRA can be used as a screening instrument. A special attention should be provided for subjects with a few years of study, because possibly these subjects presents more difficulty in express its cognitive difficulties.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mousinho F, Sousa e Santos P, Viegas E, Madureira B, Gomes A, Falcão F, Lima F. Azacitidine in the Treatment of Myelodysplastic Syndromes: Retrospective Analysis. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30231-x] [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: 11/30/2022]
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Sampaio F, Costa W, Gallo C, Lima F, Abidu-Figueiredo M. P-01-025 The rhesus monkey (macaca mulatta) penis as an experimental model for sexual medicine studies. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.03.162] [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: 10/19/2022]
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Macias BR, Lima F, Swift JM, Shirazi-Fard Y, Greene ES, Allen MR, Fluckey J, Hogan HA, Braby L, Wang S, Bloomfield SA. Simulating the Lunar Environment: Partial Weightbearing and High-LET Radiation-Induce Bone Loss and Increase Sclerostin-Positive Osteocytes. Radiat Res 2016; 186:254-63. [PMID: 27538114 DOI: 10.1667/rr13579.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Exploration missions to the Moon or Mars will expose astronauts to galactic cosmic radiation and low gravitational fields. Exposure to reduced weightbearing and radiation independently result in bone loss. However, no data exist regarding the skeletal consequences of combining low-dose, high-linear energy transfer (LET) radiation and partial weightbearing. We hypothesized that simulated galactic cosmic radiation would exacerbate bone loss in animals held at one-sixth body weight (G/6) without radiation exposure. Female BALB/cByJ four-month-old mice were randomly assigned to one of the following treatment groups: 1 gravity (1G) control; 1G with radiation; G/6 control; and G/6 with radiation. Mice were exposed to either silicon-28 or X-ray radiation. (28)Si radiation (300 MeV/nucleon) was administered at acute doses of 0 (sham), 0.17 and 0.5 Gy, or in three fractionated doses of 0.17 Gy each over seven days. X radiation (250 kV) was administered at acute doses of 0 (sham), 0.17, 0.5 and 1 Gy, or in three fractionated doses of 0.33 Gy each over 14 days. Bones were harvested 21 days after the first exposure. Acute 1 Gy X-ray irradiation during G/6, and acute or fractionated 0.5 Gy (28)Si irradiation during 1G resulted in significantly lower cancellous mass [percentage bone volume/total volume (%BV/TV), by microcomputed tomography]. In addition, G/6 significantly reduced %BV/TV compared to 1G controls. When acute X-ray irradiation was combined with G/6, distal femur %BV/TV was significantly lower compared to G/6 control. Fractionated X-ray irradiation during G/6 protected against radiation-induced losses in %BV/TV and trabecular number, while fractionated (28)Si irradiation during 1G exacerbated the effects compared to single-dose exposure. Impaired bone formation capacity, measured by percentage mineralizing surface, can partially explain the lower cortical bone thickness. Moreover, both partial weightbearing and (28)Si-ion exposure contribute to a higher proportion of sclerostin-positive osteocytes in cortical bone. Taken together, these data suggest that partial weightbearing and low-dose, high-LET radiation negatively impact maintenance of bone mass by lowering bone formation and increasing bone resorption. The impaired bone formation response is associated with sclerostin-induced suppression of Wnt signaling. Therefore, exposure to low-dose, high-LET radiation during long-duration spaceflight missions may reduce bone formation capacity, decrease cancellous bone mass and increase bone resorption. Future countermeasure strategies should aim to restore mechanical loads on bone to those experienced in one gravity. Moreover, low-doses of high-LET radiation during long-duration spaceflight should be limited or countermeasure strategies employed to mitigate bone loss.
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Affiliation(s)
| | | | | | | | | | - M R Allen
- g Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | | | - H A Hogan
- b Biomedical Engineering.,c Mechanical Engineering
| | | | - Suojin Wang
- f Statistics, Texas A&M University, College Station, Texas, 77843 and
| | - S A Bloomfield
- a Health and Kinesiology.,d Intercollegiate Faculty of Nutrition
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Tavares M, de Lima C, Fernandes W, Martinelli V, de Lucena M, Lima F, Telles A, Brandão L, de Melo Júnior M. Tumour necrosis factor-alpha (-308G/A) promoter polymorphism is associated with ulcerative colitis in Brazilian patients. Int J Immunogenet 2016; 43:376-382. [DOI: 10.1111/iji.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/13/2016] [Accepted: 07/28/2016] [Indexed: 01/26/2023]
Affiliation(s)
- M. Tavares
- Laboratory of Immunopathology Keizo Asami; Federal University of Pernambuco; Recife Brazil
| | - C. de Lima
- Laboratory of Immunopathology Keizo Asami and Department of Genetics; Federal University of Pernambuco; Recife Brazil
| | - W. Fernandes
- Master in Pathology; Federal University of Pernambuco; Recife Brazil
| | - V. Martinelli
- Department of Gastroenterology; University Hospital; Federal University of Pernambuco; Recife Brazil
| | - M. de Lucena
- Maurílio Toscano de Lucena; Department of Proctology; Barão de Lucena Hospital; Recife Brazil
| | - F. Lima
- Department of Surgery; University Hospital; Federal University of Pernambuco; Recife Brazil
| | - A. Telles
- Department of Pathology; Federal University of Pernambuco; Recife Brazil
| | - L. Brandão
- Department of Pathology; Federal University of Pernambuco; Recife Brazil
| | - M. de Melo Júnior
- Department of Pathology; Federal University of Pernambuco; Recife Brazil
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Stewart J, Ellerbrock R, Schlafer D, Lima F, Canisso I. Histologic features of accessory sex glands throughout equine development. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.06.050] [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: 10/21/2022]
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Ellerbrock R, Canisso I, Feijo L, Lima F, Shipley C, Kline K. Diagnosis and effects of urine contamination in cooled-extended stallion semen. Theriogenology 2016; 85:1219-24. [DOI: 10.1016/j.theriogenology.2015.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/05/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
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Nascimento O, Eduardo Davidovich E, Lima F, Pupe C, Bittar C, Yuki N, Vidal C. Contact heat evoked potentials (CHEPs) in painful autoimmune neuropathy (pain). J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.046] [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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Ritchie LE, Taddeo SS, Weeks BR, Lima F, Bloomfield SA, Azcarate-Peril MA, Zwart SR, Smith SM, Turner ND. Space Environmental Factor Impacts upon Murine Colon Microbiota and Mucosal Homeostasis. PLoS One 2015; 10:e0125792. [PMID: 26083373 PMCID: PMC4470690 DOI: 10.1371/journal.pone.0125792] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/26/2015] [Indexed: 01/01/2023] Open
Abstract
Astronaut intestinal health may be impacted by microgravity, radiation, and diet. The aim of this study was to characterize how high and low linear energy transfer (LET) radiation, microgravity, and elevated dietary iron affect colon microbiota (determined by 16S rDNA pyrosequencing) and colon function. Three independent experiments were conducted to achieve these goals: 1) fractionated low LET γ radiation (137Cs, 3 Gy, RAD), high Fe diet (IRON) (650 mg/kg diet), and a combination of low LET γ radiation and high Fe diet (IRON+RAD) in male Sprague-Dawley rats; 2) high LET 38Si particle exposure (0.050 Gy), 1/6 G partial weight bearing (PWB), and a combination of high LET38Si particle exposure and PWB in female BalbC/ByJ mice; and 3) 13 d spaceflight in female C57BL/6 mice. Low LET radiation, IRON and spaceflight increased Bacteroidetes and decreased Firmicutes. RAD and IRON+RAD increased Lactobacillales and lowered Clostridiales compared to the control (CON) and IRON treatments. Low LET radiation, IRON, and spaceflight did not significantly affect diversity or richness, or elevate pathogenic genera. Spaceflight increased Clostridiales and decreased Lactobacillales, and similar trends were observed in the experiment using a ground-based model of microgravity, suggesting altered gravity may affect colonic microbiota. Although we noted no differences in colon epithelial injury or inflammation, spaceflight elevated TGFβ gene expression. Microbiota and mucosal characterization in these models is a first step in understanding the impact of the space environment on intestinal health.
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Affiliation(s)
- Lauren E. Ritchie
- Intercollegiate Faculty of Genetics, Texas A&M University, College Station, Texas, United States of America
| | - Stella S. Taddeo
- Nutrition & Food Science Department, Texas A&M University, College Station, Texas, United States of America
| | - Brad R. Weeks
- Department of Veterinary Pathobiology, Texas A&M University, College Station, Texas, United States of America
| | - Florence Lima
- Division of Nephrology, Department of Medicine, University of Kentucky, Lexington, Kentucky, United States of America
| | - Susan A. Bloomfield
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, United States of America
| | - M. Andrea Azcarate-Peril
- Department of Cell Biology and Physiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Sara R. Zwart
- Human Health and Performance Directorate, NASA Lyndon B. Johnson Space Center, Houston, Texas, United States of America
| | - Scott M. Smith
- Human Health and Performance Directorate, NASA Lyndon B. Johnson Space Center, Houston, Texas, United States of America
| | - Nancy D. Turner
- Intercollegiate Faculty of Genetics, Texas A&M University, College Station, Texas, United States of America
- Nutrition & Food Science Department, Texas A&M University, College Station, Texas, United States of America
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Abstract
OBJECTIVE Phenotypic plasticity of vascular smooth muscle cells (VSMCs) contributes to cardiovascular disease. Chondrocyte-like transformation of VSMCs associates with vascular calcification and underlies the formation of aortic cartilaginous metaplasia induced in mice by genetic loss of matrix Gla protein (MGP). Previous microarray analysis identified a dramatic downregulation of Wnt16 in calcified MGP-null aortae, suggesting an antagonistic role for Wnt16 in the chondrogenic transformation of VSMCs. APPROACH AND RESULTS Wnt16 is significantly downregulated in MGP-null aortae, before the histological appearance of cartilaginous metaplasia, and in primary MGP-null VSMCs. In contrast, intrinsic TGFβ is activated in MGP-null VSMCs and is necessary for spontaneous chondrogenesis of these cells in high-density micromass cultures. TGFβ3-induced chondrogenic transformation in wild-type VSMCs associates with Smad2/3-dependent Wnt16 downregulation, but Wnt16 does not suppress TGFβ3-induced Smad activation. In addition, TGFβ3 inhibits Notch signaling in wild-type VSMCs, and this pathway is downregulated in MGP-null aortae. Exogenous Wnt16 stimulates Notch activity and attenuates TGFβ3-induced downregulation of Notch in wild-type VSMCs, prevents chondrogenesis in MGP-null and TGFβ3-treated wild-type VSMCs, and stabilizes expression of contractile markers of differentiated VSMCs. CONCLUSIONS We describe a novel TGFβ-Wnt16-Notch signaling conduit in the chondrocyte-like transformation of VSMCs and identify endogenous TGFβ activity in MGP-null VSMCs as a critical mediator of chondrogenesis. Our proposed model suggests that the activated TGFβ pathway inhibits expression of Wnt16, which is a positive regulator of Notch signaling and a stabilizer of VSMC phenotype. These data advance the comprehensive mechanistic understanding of VSMC transformation and may identify a novel potential therapeutic target in vascular calcification.
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Affiliation(s)
- Kelly E Beazley
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore
| | - Dmitry Nurminsky
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore
| | - Florence Lima
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore
| | - Chintan Gandhi
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore
| | - Maria V Nurminskaya
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore.
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Lasio G, Guerrero M, Goetz W, Lima F, Baulch JE. Effect of varying dose-per-pulse and average dose rate in X-ray beam irradiation on cultured cell survival. Radiat Environ Biophys 2014; 53:671-676. [PMID: 25169705 DOI: 10.1007/s00411-014-0565-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 08/18/2014] [Indexed: 06/03/2023]
Abstract
Characterizing the biological effects of flattening filter-free (FFF) X-ray beams from linear accelerators is of importance, due to their increasing clinical availability. The purpose of this work is to determine whether in vitro cell survival is affected by the higher dose-per-pulse present in FFF beams in comparison with flattened X-ray beams. A Varian TrueBeam(®) linear accelerator was used to irradiate the T98G, V79-4 and U87-MG cell lines with a single fraction of 5 Gy or 10 Gy doses of X-rays. Beams with energies of 6 MegaVolt (MV), 6 MV FFF and 10 MV FFF were used, with doses-per-pulse as measured at the monitor chamber of 0.28, 0.78 and 1.31 mGy/pulse for 6 MV, 6 MV FFF and 10 MV FFF, respectively. The dose delivered to each Petri dish was verified by means of ionization chamber measurements. No statistically significant effects on survival fraction were observed for any of the cell lines considered, either as a function of dose-per-pulse, average dose rate or total dose delivered. Biological effects of higher instantaneous rates should not be excluded on the basis of in vitro experimental results such as the ones presented in this work. The next step toward an assessment of the biological impact of FFF beams will require in vivo studies.
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Affiliation(s)
- G Lasio
- Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, USA
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Swift JM, Lima F, Macias BR, Allen MR, Greene ES, Shirazi-Fard Y, Kupke JS, Hogan HA, Bloomfield SA. Partial weight bearing does not prevent musculoskeletal losses associated with disuse. Med Sci Sports Exerc 2014; 45:2052-60. [PMID: 23657172 DOI: 10.1249/mss.0b013e318299c614] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to investigate whether partial weight-bearing activity, at either one-sixth or one-third of body mass, blunts the deleterious effects of simulated microgravity (0G) after 21 d on muscle mass and quantitative/qualitative measures of bone. METHODS Using a novel, previously validated partial weight-bearing suspension device, mice were subjected to 16% (G/3, i.e., simulated lunar gravity) or 33% (G/6, i.e., simulated Martian gravity) weight bearing for 21 d. One gravity control (1G, i.e., Earth gravity) and tail-suspended mice (0G, i.e., simulated microgravity) served as controls to compare the effects of simulated lunar and Martian gravity to both Earth and microgravity. RESULTS Simulated microgravity (0G) resulted in an 8% reduction in body mass and a 28% lower total plantarflexor muscle mass (for both, P < 0.01) as compared with 1G controls, but one-sixth and one-third partial weight-bearing activity attenuated losses. Relative to 1G controls, trabecular bone volume fraction (-9% to -13%) and trabecular thickness (-10% to -14%) were significantly lower in all groups (P < 0.01). In addition, cancellous and cortical bone formation rates (BFR) were lower in all reduced weight-bearing groups compared with 1G controls (-46% to -57%, trabecular BFR; -73% to -85%, cortical BFR; P < 0.001). Animals experiencing one-third but not one-sixth weight bearing exhibited attenuated deficits in femoral neck mechanical strength associated with 0G. CONCLUSION These results suggest that partial weight bearing (up to 33% of body mass) is not sufficient to protect against bone loss observed with simulated 0 g but does mitigate reductions in soleus mass in skeletally mature female mice.
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Affiliation(s)
- Joshua M Swift
- 1Department of Health and Kinesiology, Texas A&M University, College Station, TX; 2Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN; 3Department of Biomedical Engineering, Texas A&M University, College Station, TX; 4Department of Mechanical Engineering, Texas A&M University, College Station, TX; and 5Department of Nutrition and Food Science, Texas A&M University, College Station, TX
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Perandini L, Gualano B, Pinto A, Lima F, Bonfá E, Borba E, Roschel H, Mello S. THU0056 Acute Aerobic Exercise Induces Increases on Plasma Levels of α-Melanocyte Stimulating Hormone in Patients with Active Systemic Lupus Erythematosus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5206] [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: 11/03/2022]
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Lima F, Ding D, Goetz W, Yang AJ, Baulch JE. High LET (56)Fe ion irradiation induces tissue-specific changes in DNA methylation in the mouse. Environ Mol Mutagen 2014; 55:266-77. [PMID: 24723241 DOI: 10.1002/em.21832] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 07/12/2013] [Accepted: 11/15/2013] [Indexed: 05/15/2023]
Abstract
DNA methylation is an epigenetic mechanism that drives phenotype and that can be altered by environmental exposures including radiation. The majority of human radiation exposures occur in a relatively low dose range; however, the biological response to low dose radiation is poorly understood. Based on previous observations, we hypothesized that in vivo changes in DNA methylation would be observed in mice following exposure to doses of high linear energy transfer (LET) (56) Fe ion radiation between 10 and 100 cGy. We evaluated the DNA methylation status of genes for which expression can be regulated by methylation and that play significant roles in radiation responses or carcinogenic processes including apoptosis, metastasis, cell cycle regulation, and DNA repair (DAPK1, EVL, 14.3.3, p16, MGMT, and IGFBP3). We also evaluated DNA methylation of repeat elements in the genome that are typically highly methylated. No changes in liver DNA methylation were observed. Although no change in DNA methylation was observed for the repeat elements in the lungs of these same mice, significant changes were observed for the genes of interest as a direct effect and a delayed effect of irradiation 1, 7, 30, and 120 days post exposure. At delayed times, differences in methylation profiles among genes were observed. DNA methylation profiles also significantly differed based on dose, with the lowest dose frequently affecting the largest change. The results of this study are the first to demonstrate in vivo high LET radiation-induced changes in DNA methylation that are tissue and locus specific, and dose and time dependent.
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Affiliation(s)
- Florence Lima
- Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, Kentucky
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Beazley KE, Reckard S, Nurminsky D, Lima F, Nurminskaya M. Two sides of MGP null arterial disease: chondrogenic lesions dependent on transglutaminase 2 and elastin fragmentation associated with induction of adipsin. J Biol Chem 2013; 288:31400-8. [PMID: 24036114 PMCID: PMC3829453 DOI: 10.1074/jbc.m113.495556] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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: 06/20/2013] [Revised: 09/02/2013] [Indexed: 01/04/2023] Open
Abstract
Mutations in matrix Gla protein (MGP) have been correlated with vascular calcification. In the mouse model, MGP null vascular disease presents as calcifying cartilaginous lesions and mineral deposition along elastin lamellae (elastocalcinosis). Here we examined the mechanisms underlying both of these manifestations. Genetic ablation of enzyme transglutaminase 2 (TG2) in Mgp(-/-) mice dramatically reduced the size of cartilaginous lesions in the aortic media, attenuated calcium accrual more than 2-fold, and doubled longevity as compared with control Mgp(-/-) animals. Nonetheless, the Mgp(-/-);Tgm2(-/-) mice still died prematurely as compared with wild-type and retained the elastocalcinosis phenotype. This pathology in Mgp(-/-) animals was developmentally preceded by extensive fragmentation of elastic lamellae and associated with elevated serine elastase activity in aortic tissue and vascular smooth muscle cells. Systematic gene expression analysis followed by an immunoprecipitation study identified adipsin as the major elastase that is induced in the Mgp(-/-) vascular smooth muscle even in the TG2 null background. These results reveal a central role for TG2 in chondrogenic transformation of vascular smooth muscle and implicate adipsin in elastin fragmentation and ensuing elastocalcinosis. The importance of elastin calcification in MGP null vascular disease is highlighted by significant residual vascular calcification and mortality in Mgp(-/-);Tgm2(-/-) mice with reduced cartilaginous lesions. Our studies identify two potential therapeutic targets in vascular calcification associated with MGP dysfunction and emphasize the need for a comprehensive approach to this multifaceted disorder.
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Affiliation(s)
- Kelly E. Beazley
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Steven Reckard
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Dmitry Nurminsky
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Florence Lima
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
| | - Maria Nurminskaya
- From the Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland 21201
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Beazley KE, Lima F, Borras T, Nurminskaya M. Attenuation of chondrogenic transformation in vascular smooth muscle by dietary quercetin in the MGP-deficient mouse model. PLoS One 2013; 8:e76210. [PMID: 24098781 PMCID: PMC3786963 DOI: 10.1371/journal.pone.0076210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/21/2013] [Indexed: 12/30/2022] Open
Abstract
RATIONALE Cartilaginous metaplasia of vascular smooth muscle (VSM) is characteristic for arterial calcification in diabetes and uremia and in the background of genetic alterations in matrix Gla protein (MGP). A better understanding of the molecular details of this process is critical for the development of novel therapeutic approaches to VSM transformation and arterial calcification. OBJECTIVE This study aimed to identify the effects of bioflavonoid quercetin on chondrogenic transformation and calcification of VSM in the MGP-null mouse model and upon TGF-β3 stimulation in vitro, and to characterize the associated alterations in cell signaling. METHODS AND RESULTS Molecular analysis revealed activation of β-catenin signaling in cartilaginous metaplasia in Mgp-/- aortae in vivo and during chondrogenic transformation of VSMCs in vitro. Quercetin intercepted chondrogenic transformation of VSM and blocked activation of β-catenin both in vivo and in vitro. Although dietary quercetin drastically attenuated calcifying cartilaginous metaplasia in Mgp-/- animals, approximately one-half of total vascular calcium mineral remained as depositions along elastic lamellae. CONCLUSION Quercetin is potent in preventing VSM chondrogenic transformation caused by diverse stimuli. Combined with the demonstrated efficiency of dietary quercetin in preventing ectopic chondrogenesis in the MGP-null vasculature, these findings indicate a potentially broad therapeutic applicability of this safe for human consumption bioflavonoid in the therapy of cardiovascular conditions linked to cartilaginous metaplasia of VSM. Elastocalcinosis is a major component of MGP-null vascular disease and is controlled by a mechanism different from chondrogenic transformation of VSM and not sensitive to quercetin.
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Affiliation(s)
- Kelly E. Beazley
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Florence Lima
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Teresa Borras
- Department of Ophthalmology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Maria Nurminskaya
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America
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Deasey S, Nurminsky D, Shanmugasundaram S, Lima F, Nurminskaya M. Transglutaminase 2 as a novel activator of LRP6/β-catenin signaling. Cell Signal 2013; 25:2646-51. [PMID: 23993960 DOI: 10.1016/j.cellsig.2013.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/24/2013] [Indexed: 11/15/2022]
Abstract
The β-catenin signaling axis is critical for normal embryonic development and tissue homeostasis in adults. We have previously shown that extracellular enzyme transglutaminase 2 (TG2) activates β-catenin signaling in vascular smooth muscle cells (VSMCs). In this study, we provide several lines of evidence that TG2 functions as an activating ligand of the LRP5/6 receptors. Specifically, we show that TG2 synergizes with LRP6 in the activation of β-catenin-dependent gene expression in Cos-7 cells. Interfering with the LRP5/6 receptors attenuates TG2-induced activation of β-catenin in Cos-7 cells. Further, we show that TG2 binds directly to the extracellular domain of LRP6, which is also able to act as a substrate for TG2-mediated protein cross-linking. Furthermore, inhibitors of TG2 protein cross-linking quench the observed TG2-induced β-catenin activation, implicating protein cross-linking as a novel regulatory mechanism for this pathway. Together, our findings identify and characterize a new activating ligand of the LRP5/6 receptors and uncover a novel activity of TG2 as an agonist of β-catenin signaling, contributing to the understanding of diverse developmental events and pathological conditions in which transglutaminase and β-catenin signaling are implicated.
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Affiliation(s)
- S Deasey
- Dept. of Biochemistry and Molecular Biology, University of Maryland School of Medicine, Baltimore, MD 21201, United States
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