Sex hormones regulate metainflammation in diet-induced obesity in mice

Men have a statistically higher risk of metabolic and cardiovascular disease than premenopausal women, but the mechanisms mediating these differences are elusive. Chronic inflammation during obesity contributes to disease risk and is significantly more robust in males. Prior work demonstrated that compared with obese males, obese females have reduced proinflammatory adipose tissue macrophages (ATMs). Given the paucity of data on how sex hormones contribute to macrophage responses in obesity, we sought to understand the role of sex hormones in promoting obesity-induced myeloid inflammation. We used gonadectomy, estrogen receptor-deficient alpha chimeras, and androgen-insensitive mice to model sex hormone deficiency. These models were evaluated in diet-induced obesity conditions (high-fat diet [HFD]) and in vitro myeloid assays. We found that ovariectomy increased weight gain and adiposity. Ovariectomized females had increased ATMs and bone marrow myeloid colonies compared with sham-gonadectomized females. In addition, castrated males exposed to HFD had improved glucose tolerance, insulin sensitivity, and adiposity with fewer Ly6chi monocytes and bone marrow myeloid colonies compared with sham-gonadectomized males, although local adipose inflammation was enhanced. Similar findings were observed in androgen-insensitive mice; however, these mice had fewer CD11c+ ATMs, implying a developmental role for androgens in myelopoiesis and adipose inflammation. We concluded that gonadectomy results in convergence of metabolic and inflammatory responses to HFD between the sexes, and that myeloid estrogen receptor alpha contributes minimally to diet-induced inflammatory responses, whereas loss of androgen-receptor signaling improves metabolic and inflammatory outcomes. These studies demonstrate that sex hormones play a critical role in sex differences in obesity, metabolic dysfunction, and myeloid inflammation.

Programming effects of maternal and gestational obesity on offspring metabolism and metabolic inflammation

With the increasing prevalence of obesity in women of reproductive age there is a need to understand the ramifications of this on offspring. The purpose of this study is to investigate the programming effects of maternal obesity during preconception and the preconception/gestational period on adiposity and adipose tissue inflammation in offspring using an animal model. Adult female C57Bl/6J mice were assigned either normal diet, high fat diet (HFD) prior to pregnancy, or HFD prior to and through pregnancy. Some offspring were maintained on normal diet while others started HFD later in life. Offspring were assessed for body composition and metabolic responses. Lipid storing tissues were evaluated for expansion and inflammation. Male offspring from the preconception group had the greatest weight gain, most subcutaneous adipose tissue, and largest liver mass when introduced to postnatal HFD. Male offspring of the preconception/gestation group had worsened glucose tolerance and an increase in resident (CD11c⁻) adipose tissue macrophages (ATMs) when exposed to postnatal HFD. Female offspring had no significant difference in any parameter between the diet treatment groups. In conclusion, this study demonstrates that prenatal and pregnancy windows have independent programming effects on offspring. Preconception exposure affects body composition and adiposity while gestation exposure affects metabolism and tissue immune cell phenotypes.

Natural Killer Cell Activity Unaffected by Ozonated Autohemotherapy in Patients with End-Stage Renal Disease on Maintenance Renal Replacement Therapy

Ozonotherapy is a complementary medical approach in the treatment of resistant infections, immune deficiency syndromes, orthopedic pathologies and vascular diseases. The criticism of this method is associated with potentially harmful effects of ozone on cells. The aim of this study was to investigate the influence of ozonated autohemotherapy (O3-AHT) on the cellular response of the immunologic system represented by cytotoxic activity of natural killer cells. 12 hemodialyzed patients (8 M, 4 F) aged 64.8±7.6 years with peripheral arterial disease as the main reason for the treatment with O3-AHT were examined in a prospective, placebo controlled, single blind study. They received 9 sessions of autohemotherapy without ozone exposure as a placebo-control and subsequent 9 sessions of O3-AHT. The procedures were performed 3 times a week, just before hemodialysis session. Ozone-oxygen gas mixture with ozone concentration of 50 μg/ml produced by ozone generator (ATO3, KrioMetrum, Poland) was used during O3-AHT. Natural killer cell activity was measured using lactate dehydrogenase release assay. There was no statistical difference between natural killer cell activity (%) at the baseline (16.78±8.07), after nine sessions of control autohemotherapy (15.98±6.67), and after nine sessions of O3-AHT (18.26±8.82). In conclusion, our findings showed that O3-AHT in a dose of 50 mg/mL does not have any significant influence on natural killer cell function in hemodialyzed patients.

A comparison of biphasic insulin aspart and insulin glargine administered with oral antidiabetic drugs in type 2 diabetes mellitus--a systematic review and meta-analysis

OBJECTIVE

It is uncertain whether the addition of biphasic insulin analogues to oral antidiabetic drugs (OADs) is as effective and safe as basal insulin in patients with type 2 diabetes mellitus (T2DM). We performed a systematic review to compare glycaemic control and selected clinical outcomes in T2DM patients inadequately controlled with OADs whose treatment was intensified by adding biphasic insulin aspart (BIAsp 30) or insulin glargine (IGlar).

METHODS

The analysis included randomised controlled trials (RCTs) identified by a systematic literature search in medical databases (MEDLINE, EMBASE, The Cochrane Library and other sources) up to March 2013. Studies met the inclusion criteria if they compared BIAsp 30 vs. IGlar added to at least one OAD in T2DM patients. Trials applying different OADs in both treatment arms were also included. Results were presented as weighted mean difference (WMD) or odds ratio (OR) with a 95% confidence interval (CI).

RESULTS

Five trials, including a total number of 1758 patients followed up from 24 to 28 weeks, were identified. Quantitative synthesis demonstrated that BIAsp 30 reduced HbA1c level more efficiently than IGlar [5 RCTs; WMD (95% CI): -0.21% (-0.35%, -0.08%)]. Differences were observed in favour of BIAsp for lower mean prandial glucose increment [3 RCTs; WMD (95% CI): -14.70 mg/dl (-20.09, -9.31)]; no difference was observed for fasting plasma glucose [3 RCTs; WMD (95% CI): 7.09 mg/dl (-15.76, 29.94)]. We found no evidence for higher risk of overall [2 RCTs; 63% vs. 51%; OR = 1.77 (0.91; 3.44)] and severe hypoglycaemic episodes [4 RCTs; 0.98% vs. 1.12%; OR (95% CI) = 0.88 (0.31, 2.53)] in the BIAsp 30 group as compared with IGlar group. Twice-daily administration of BIAsp 30 resulted in larger weight gain [2 RCTs; WMD (95% CI) = 1.78 kg (1.04; 2.52)].

CONCLUSIONS

BIAsp 30 added to OAD therapy results in a better glycaemic control as compared with IGlar in T2DM patients. BIAsp 30 use is associated with slightly larger weight gain but no rise in risk of severe hypoglycaemic episodes.

Sensitivity of natural killer cells to activation in the process of ageing is related to the oxidative and inflammatory status of the elderly

The role of the innate immunity during human ageing is not well understood. The aim of the study was to estimate reactivity of NK (natural killer) cells in the very old (mean age 91 years) and old subjects (mean age 78 years) compared to young individuals (mean age 26 years) in respect to the indices of the oxidative stress (telomere length of NK cells, serum content of -H groups), serum total antioxidant status and serum concentrations of interleukin 6 and tumor necrosis factor-α (TNF-α). The activation state of NK cells, reflected by telomerase activity and intracellular interferon γ (IFNγ) content, was also measured. We found that length of telomeres in NK cells and serum concentration of -SH groups decreased both in the old and the oldest subjects as compared to young individuals. The oldest seniors, on the contrary to the old ones, revealed similar level of serum antioxidant status as the young subjects. The serum level of IL-6, not detectable in the young subjects, did not differ in the oldest and old seniors. TNF-α serum concentrations progressively increased with age. After stimulation, NK cells of both old groups showed higher intracellular levels of IFNγ than young subjects. IL-2-activated NK cells of the oldest seniors showed the highest increase of telomerase activity as compared to the other age groups. Serum level of IL-6 correlated positively with activation markers of NK cells. Moreover, in seniors but not in young subjects, the number of active, IFNγ-expressing NK cells, correlated positively with the serum content of the -SH groups. These findings indicate that sensitivity of NK cells to activation is maintained during ageing and this phenomenon may be related to the oxidative and inflammatory status of the elderly.

Successful ageing of nonagenarians is related to the sensitivity of NK cells to activation

NK cells are a component of innate immunity which activity significantly correlates with health status. The aim of our study was to estimate a status of NK (natural killer) cells in the very old (mean age 92+/-2 ys) and old subjects (mean age 78+/-5 ys) as compared to a control group of young individuals (mean age 25+/-4 ys). NK cells were characterized by measurement of their cytotoxic activity, expression of intracellular interferon gamma, telomere length and telomerase activity in resting and activated cells. The results revealed that the oldest seniors did not differ from the other age groups in the number of NK cells and NK cytotoxic activity, however, they displayed the shortest telomeres and the lowest telomerase activity. Surprisingly, activated NK cells of the very old, similarly to the old subjects, were able to significantly increase intracellular level of IFNgamma. Moreover, activated with IL-2 NK cells of the old and oldest seniors showed increased telomerase activity. The results of our study suggest that the functional status of NK cells and their sensitivity to activation is well preserved until very advanced age and may contribute to longevity and successful ageing.