Alpha-Synuclein in Skin Nerve Fibers as a Biomarker for Alpha-Synucleinopathies

The common pathological features of synucleinopathies are abnormal aggregates of the synaptic protein alpha-synuclein (αSN) in the cytoplasm of neurons or glia. These abnormal aggregates appear several years before the onset of clinical manifestations, and so the early detection of αSN in body fluids or peripheral tissues (e.g., cerebrospinal fluid, colonic mucosa, salivary glands, and skin) is considered a potential tool for identifying synucleinopathies. Performing a skin biopsy is a practical option because it is a relatively noninvasive, safe, and reliable method to measure αSN deposition in the peripheral nervous system. Moreover, there is growing research interest in the use of cutaneous synuclein deposition as a biomarker for synucleinopathies. The aim of this study was to interpret the current data on cutaneous αSN deposition and present the current perspectives and future prospects.

Hyponatremia, Cognitive Function, and Mobility in an Outpatient Heart Failure Population

Background

The association of hyponatremia with cognitive impairment and mobility in heart failure (HF) patients is unknown. The purpose of this study was to determine if hyponatremia is associated with cognitive and mobility impairment as measured by simple, validated, and time-sensitive tests.

Material/Methods

This was a prospective study in patients with reduced and preserved ejection fraction (HFrEF, HFpEF) seen in outpatient HF clinics. Hyponatremia was defined as sodium level ≤136 mEq/L. Cognitive function was measured using the Montreal Cognitive Assessment (MoCA) tool, and mobility was measured with the Timed Up and Go test (TUG-t).

Results

A total of 121 patients were evaluated; 30% were hyponatremic (134±1.9 mEq/l, range 128–136 mEq/l). Overall, 92% of hyponatremic patients had cognitive impairment (MoCA <26) compared to 76% of the non-hyponatremic patients [relative risk 1.2 (confidence interval: 1.02–1.4, p=0.02)]. In regard to mobility, 72% of hyponatremic patients and 62% of non-hyponatremic patients (p=0.4) had TUG-t times that were considered to be worse than average. A total of 84% (N=76) of HFrEF and 71% (N=22) of HFpEF patients had cognitive impairment (p=0.86). HFrEF patients had significantly lower overall MoCA scores (21.2±3.7 vs. 23.3±3.6, p=0.006) and similar TUG-t times compared to HFpEF patients.

Conclusions

Most heart failure patients (HFrEF and HFpEF) seen in an ambulatory setting had impairment of cognitive function and mobility, with a higher prevalence among those with hyponatremia. Screening can be done using tests that can be administered in a clinical setting.

Effects of white and red wine on endothelial function in subjects with coronary artery disease

BACKGROUND

Levels of anti-oxidant polyphenols are higher in red than in white wine and are thought to contribute to the reduced cardiovascular risk associated with moderate consumption of wine observed in epidemiological studies.

AIM

To compare the acute effects of acute ingestion of white and red wine on endothelial function in subjects with coronary artery disease (CAD).

METHODS

Fourteen subjects with proven CAD were randomised to consume white and red wine with a light meal in a single blind cross-over study. Flow-mediated dilatation (FMD) of the brachial artery was measured using high-resolution ultrasonography. Endothelial function, lipid profile, plasma alcohol and polyphenols were measured at baseline, 60 and 360 min after wine consumption.

RESULTS

At baseline, FMD was similar (white wine 1.6 +/- 1.9%, red wine 1.8 +/- 1.7%). At 360 min after ingestion of wine there was no difference in FMD, which improved nearly threefold after both wines (white wine 4.7 +/- 2.2%, red wine 3.4 +/- 2.9%; P = 0.002). There was no detectable change in plasma polyphenol levels after either wine.

CONCLUSIONS

These data suggest that wine acutely improves endothelial function in patients with CAD. This improved endothelial function might contribute to a reduced risk of cardiovascular events.

Normal endothelial function after meals rich in olive or safflower oil previously used for deep frying

BACKGROUND AND AIM

Polyunsaturated fats are more susceptible to oxidation during heating than monounsaturated fats but their effects on endothelial function when heated are unknown. The aim of this study was to compare the effect of meals rich in heat-modified safflower and olive oils on postprandial flow-mediated endothelium-dependent dilation (EDD) in healthy men.

METHODS AND RESULTS

Flow-mediated EDD and glyceryltrinitrate-induced endothelium-independent dilation of the brachial artery were investigated in 14 subjects before and 4 hours after meals rich in olive oil and safflower oil used hourly for deep-frying for 8 hours in a double-blind crossover study design. There were high levels of lipid oxidation products (peroxides and carbonyls) in both heated oils. Plasma triglycerides were markedly increased at 4 hours after heated olive oil (1.26 +/- 0.43 vs 2.06 +/- 0.97 mmol/L) and heated safflower oil (1.44 +/- 0.63 vs 1.99 +/- 0.88 mmol/L). There was no change in EDD between fasting and postprandial studies and the response during the postprandial period was not significantly (p = 0.51) different between the meals (heated olive oil: 4.9 +/- 2.2% vs 4.9 +/- 2.5%; heated safflower oil: 5.1 +/- 3.1% vs 5.6 +/- 3.4%).

CONCLUSIONS

Meals rich in olive and safflower oils previously used for deep frying and containing high levels of lipid oxidation products increase postprandial serum triglycerides without affecting endothelial function. These findings suggest that relatively short-term use of these vegetable oils for frying may not adversely affect postprandial endothelial function when foods containing the heat-modified oils are consumed.

Vitamin C improves endothelial dysfunction in renal allograft recipients

BACKGROUND

Endothelial function is impaired in renal allograft recipients but the effects of antioxidant vitamin therapy on endothelial function in such patients is unknown.

METHODS

Thirteen renal allograft recipients were randomized to vitamin C or placebo in a double blind cross-over study design. Flow-mediated endothelium-dependent dilation and glyceryltrinitrate-induced endothelium-independent dilation of the brachial artery were assessed before and 2 h after oral administration of 2 g vitamin C or placebo.

RESULTS

Plasma vitamin C levels increased from 33.5+/-17.0 micromol/l to 98.8+/-60.2 micromol/l after treatment (P=0.0001). Endothelium-dependent dilation improved (from 1.6+/-2.6 to 4.5+/-2.5%) after vitamin C administration but was unchanged after placebo (1.9+/-1.5 to 1.8+/-2.5%; P=0.003 for vitamin C vs placebo). There was no significant change in endothelium-independent dilation in response to vitamin C. Vitamin C was also associated with a significant increase in the lag time in dilute serum oxidation (P=0.001).

CONCLUSIONS

Vitamin C acutely improves flow-mediated, endothelium-dependent dilation and increases the resistance of lipoproteins in dilute serum to oxidation in renal transplant recipients.

Improved coronary artery flow after coronary angioplasty in patients with unstable angina

BACKGROUND

Coronary artery flow is impaired after myocardial infarction but there is limited information regarding coronary flow in unstable angina.

AIM

To assess baseline coronary artery flow and the effects of coronary angioplasty on coronary flow in patients with unstable angina.

METHODS

Twenty-one patients with unstable angina with a culprit lesion suitable for coronary angioplasty were enrolled in the study. Coronary flow was assessed with the Thrombolysis In Myocardial Infarction (TIMI) grade and the Corrected TIMI Frame Count (CTFC) pre and post angioplasty.

RESULTS

Baseline flow was impaired in the culprit artery compared to the non culprit artery (42.0+/-28.1 vs 25.3+/-7.0 frames, p<0.02). Pre angioplasty coronary flow was TIMI grade 2 in 52% and TIMI grade 3 in 48% of patients. Post angioplasty flow improved with TIMI grade 2 flow in 5% and TIMI grade 3 in 95%. After angioplasty coronary flow improved from 42.0+/-28.1 frames to 21.6+/-16.3 (p=0.0001). The culprit coronary stenosis decreased from 74+/-9% pre angioplasty to 28+/-12% after intervention (p=0.0001).

CONCLUSIONS

Angioplasty and stenting of the culprit vessel restores normal coronary flow in most patients with unstable angina. This suggests that impaired flow in unstable angina is predominantly related to the culprit lesion residual stenosis.

Impaired endothelial function following a meal rich in used cooking fat

OBJECTIVES

The purpose of this study was to test the hypothesis that intake of used cooking fat is associated with impaired endothelial function.

BACKGROUND

Diets containing high levels of lipid oxidation products may accelerate atherogenesis, but the effect on endothelial function is unknown.

METHODS

Flow-mediated endothelium-dependent dilation and glyceryl trinitrate-induced endothelium-independent dilation of the brachial artery were investigated in 10 men. Subjects had arterial studies before and 4 h after three test meals: 1) a meal (fat 64.4 g) rich in cooking fat that had been used for deep frying in a fast food restaurant; 2) the same meal (fat 64.4 g) rich in unused cooking fat, and 3) a corresponding low fat meal (fat 18.4 g) without added fat.

RESULTS

Endothelium-dependent dilation decreased between fasting and postprandial studies after the used fat meal (5.9 +/- 2.3% vs. 0.8 +/- 2.2%, p = 0.0003), but there was no significant change after the unused fat meal (5.3 +/- 2.1% vs. 6.0 +/- 2.5%) or low fat meal (5.3 +/- 2.3% vs. 5.4 +/- 3.3%). There was no significant difference in endothelium-independent dilation after any of the meals. Plasma free fatty acid concentration did not change significantly during any of the meals. The level of postprandial hypertriglyceridemia was not associated with change in endothelial function.

CONCLUSIONS

Ingestion of a meal rich in fat previously used for deep frying in a commercial fast food restaurant resulted in impaired arterial endothelial function. These findings suggest that intake of degradation products of heated fat contribute to endothelial dysfunction.

Retrieval analysis of aerosol-size distribution with simulated extinction measurements at SAGE III wavelengths

The retrieval of aerosol-size distribution from simulated aerosol-extinction-coefficient measurements of the new satellite instrument, the Stratospheric Aerosol and Gas Experiment (SAGE) III, is investigated. A detailed discussion on the aerosol-size-distribution information content of the SAGE III aerosol-extinction-coefficient measurement is provided. Results of the investigation indicate that unimodal as well as bimodal log-normal size distributions can be inferred. In addition, it is shown that a shape-constraint-free size distribution can be derived from SAGE III aerosol measurements by use of the randomized minimization search technique and the optimal estimation theory.

SAGE II aerosol data validation based on retrieved aerosol model size distribution from SAGE II aerosol measurements

This paper describes an investigation of the comprehensive aerosol correlative measurement experiments conducted between November 1984 and July 1986 for satellite measurement program of the Stratospheric Aerosol and Gas Experiment (SAGE II). The correlative sensors involved in the experiments consist of the NASA Ames Research Center impactor/laser probe, the University of Wyoming dustsonde, and the NASA Langley Research Center airborne 14-inch (36 cm) lidar system. The approach of the analysis is to compare the primary aerosol quantities measured by the ground-based instruments with the calculated ones based on the aerosol size distributions retrieved from the SAGE II aerosol extinction measurements. The analysis shows that the aerosol size distributions derived from the SAGE II observations agree qualitatively with the in situ measurements made by the impactor/laser probe. The SAGE II-derived vertical distributions of the ratio N0.15/N0.25 (where Nr is the cumulative aerosol concentration for particle radii greater than r, in micrometers) and the aerosol backscatter profiles at 0.532- and 0.6943-micrometer lidar wavelengths are shown to agree with the dustsonde and the 14-inch (36-cm) lidar observations, with the differences being within the respective uncertainties of the SAGE II and the other instruments.

Error analysis of DIAL measurements of ozone by a Shuttle excimer lidar

An error analysis of DIAL (differential absorption lidar) measurements of stratospheric ozone from the Space Shuttle is discussed. A transmitter system consisting of a KrF excimer laser pumping gas cells of H2 or D2 producing output wavelengths in the near UV is shown to be useful for the measurement of ozone in a 15-50-km altitude range.

Stratospheric Aerosol Effects from Soufriere Volcano as Measured by the SAGE Satellite System

During its April 1979 eruption series, Soufriere Volcano produced two major stratospheric plumes that the SAGE (Stratospheric Aerosol and Gas Experiment) satellite system tracked to West Africa and the North Atlantic Ocean. The total mass of these plumes, whose movement and dispersion are in agreement with those deduced from meteorological data and dispersion theory, was less than 0.5 percent of the global stratospheric aerosol burden; no significant temperature or climate perturbation is therefore expected.

High-Latitude Stratospheric Aerosols Measured by the SAM II Satellite System in 1978 and 1979

Results of the first year of data collection by the SAM (Stratospheric Aerosol Measurement) II satellite system are presented. Almost 10,000 profiles of stratospheric aerosol extinction in the Arctic and Antarctic regions are used to construct plots of weekly averaged aerosol extinction versus altitude and time and stratospheric optical depth versus time. Corresponding temperature fields are presented. These data show striking similarities in the aerosol behavior for corresponding seasons. Wintertime polar stratospheric clouds that are strongly correlated with temperature are documented. They are much more prevalent in the Antarctic stratosphere during the cold austral winter and increase the stratospheric optical depths by as much as an order of magnitude for a period of about 2 months. These clouds might represent a sink for stratospheric water vapor and must be considered in the radiative budget for this region and time.

Characterization of Aerosols from Eruptions of Mount St. Helens

Measurements of mass concentration and size distribution of aerosols from eruptions of Mount St. Helens as well as morphological and elemental analyses were obtained between 7 April and 7 August 1980. In situ measurements were made in early phreatic and later, minor phreatomagmatic eruption clouds near the vent of the volcano and in plumes injected into the stratosphere from the major eruptions of 18 and 25 May. The phreatic aerosol was characterized by an essentially monomodal size distribution dominated by silicate particles larger than 10 micrometers in diameter. The phreatomagmatic eruption cloud was multimodal; the large size mode consisted of silicate particles and the small size modes were made up of mixtures of sulfuric acid and silicate particles. The stratospheric aerosol from the main eruption exhibited a characteristic narrow single mode with particles less than 1 micrometer in diameter and nearly all of the mass made up of sulfuric acid droplets.

Methodology for error analysis and simulation of lidar aerosol measurements

We present a methodology for objective and automated determination of the uncertainty in aerosol measurements made by lidar. The methodology is based on standard error-propagation procedures, a large data base on atmospheric behavior, and considerable experience in processing lidar data. It yields algebraic expressions for probable error as a function of the atmospheric, background lighting, and lidar parameters. This error includes contributions from (1) lidar signal; (2) molecular density; (3) atmospheric transmission; and (4) lidar calibration. The validity of the algebraic error expressions is tested by performing simulated measurements and analyses, in which random errors of appropriate size are injected at appropriate steps. As an example, the methodology is applied to a new airborne lidar system used for measurements of the stratospheric aerosol. It is shown that for stratospheric measurements below about 25 km, molecular density uncertainties are the dominant source of error for wavelengths shorter than about 1.1 microm during nonvolcanic conditions. Because the influence of molecular scattering (relative to particulate scattering) decreases with increasing wavelength, stratospheric measurements with a Nd:YAG lidar can thus be more accurate than those made with a ruby lidar, provided that a suitable detector is used.

Inversion of stratospheric aerosol and gaseous constituents from spacecraft solar extinction data in the 0.38-1.0-microm wavelength region

Inversion techniques for the retrieval of stratospheric aerosol, ozone, neutral density, and nitrogen dioxide vertical profiles from numerically simulated spacecraft solar extinction measurements have been analyzed. The analysis is applied toward the space flight mission of the Stratospheric Aerosol and Gas Experiment (SAGE), which will be flown on the Applications Explorer Mission B (AEM-B) spacecraft. The instrument has four radiometric channels located at selected intervals in the 0.38-1.0-,microm wavelength range. The expected retrieval accuracies are deterrrined from inverting simulated data with various experimental errors included. The results from this analysis assuming a horizontally homogeneous atmosphere indicate that aerosol, ozone, and neutral density vertical profiles can be retrieved to an accuracy better than 10% with about 1-km vertical resolution over most of the stratosphere. The results also show that nitrogen dioxide can be inverted to an accuracy of about 25% in the 25-38-km altitude ange. In addition, the effects of horizontally inhomogeneous distributions of aerosol and ozone on the retrieval accuracies are analyzed based on a simple inhomogeneous model of the atmosphere and found that there is only a small perturbation on the inversion accuracies.

Dustsonde and lidar measurements of stratospheric aerosols: a comparison

On two nights in mid-September 1972, comparative measurements of stratospheric aerosol profiles, utilizing backscattered ruby laser light and direct in situ sampling were conducted over Laramie, Wyoming. The lidar backscattering and the particle number density profiles correlated well when the measured atmospheric molecular density profile was used to calculate the Rayleigh profile used in the lidar data reduction. The backscattered signal at 20 km was approximately 18% above Rayleigh and corresponded to a measured concentration of about one particle per cm(3) with diameters greater than 0.30 microm. Based on these initial comparative experiments, the ground-based lidar coupled with temperature soundings appears to be a possible method for determining the relative aerosol profile under present stratospheric loading conditions.