A long-acting LEAP2 analog reduces hepatic steatosis and inflammation and causes marked weight loss in mice

OBJECTIVE

The number of individuals affected by metabolic dysfunction associated fatty liver disease [1] is on the rise, yet hormonal contributors to the condition remain incompletely described and only a single FDA-approved treatment is available. Some studies suggest that the hormones ghrelin and LEAP2, which act as agonist and antagonist/inverse agonist, respectively, for the G protein coupled receptor GHSR, may influence the development of MAFLD. For instance, ghrelin increases hepatic fat whereas synthetic GHSR antagonists do the opposite. Also, hepatic steatosis is less prominent in standard chow-fed ghrelin-KO mice but more prominent in 42% high-fat diet-fed female LEAP2-KO mice.

METHODS

Here, we sought to determine the therapeutic potential of a long-acting LEAP2 analog (LA-LEAP2) to treat MAFLD in mice. LEAP2-KO and wild-type littermate mice were fed a Gubra-Amylin-NASH (GAN) diet for 10 or 40 wks, with some randomized to an additional 28 or 10 days of GAN diet, respectively, while treated with LA-LEAP2 vs Vehicle. Various metabolic parameters were followed and biochemical and histological assessments of MAFLD were made.

RESULTS

Among the most notable metabolic effects, daily LA-LEAP2 administration to both LEAP2-KO and wild-type littermates during the final 4 wks of a 14 wk-long GAN diet challenge markedly reduced liver weight, hepatic triglycerides, plasma ALT, hepatic microvesicular steatosis, hepatic lobular inflammation, NASH activity scores, and prevalence of higher-grade fibrosis. These changes were accompanied by prominent reductions in body weight, without effects on food intake, and reduced plasma total cholesterol. Daily LA-LEAP2 administration during the final 10 d of a 41.5 wk-long GAN diet challenge also reduced body weight, plasma ALT, and plasma total cholesterol in LEAP2-KO and wild-type littermates and prevalence of higher grade fibrosis in LEAP2-KO mice.

CONCLUSIONS

Administration of LA-LEAP2 to mice fed a MAFLD-prone diet markedly improves several facets of MAFLD, including hepatic steatosis, hepatic lobular inflammation, higher-grade hepatic fibrosis, and transaminitis. These changes are accompanied by prominent reductions in body weight and lowered plasma total cholesterol. Taken together, these data suggest that LEAP2 analogs such as LA-LEAP2 hold promise for the treatment of MAFLD and obesity.

Impact of Ghrelin on Islet Size in Nonpregnant and Pregnant Female Mice

Reducing ghrelin by ghrelin gene knockout (GKO), ghrelin-cell ablation, or high-fat diet feeding increases islet size and β-cell mass in male mice. Here we determined if reducing ghrelin also enlarges islets in females and if pregnancy-associated changes in islet size are related to reduced ghrelin. Islet size and β-cell mass were larger (P = .057 for β-cell mass) in female GKO mice. Pregnancy was associated with reduced ghrelin and increased liver-expressed antimicrobial peptide-2 (LEAP2; a ghrelin receptor antagonist) in wild-type mice. Ghrelin deletion and pregnancy each increased islet size (by ∼19.9-30.2% and ∼34.9-46.4%, respectively), percentage of large islets (>25 µm2×103, by ∼21.8-42% and ∼21.2-41.2%, respectively), and β-cell mass (by ∼15.7-23.8% and ∼65.2-76.8%, respectively). Neither islet cross-sectional area, β-cell cross-sectional area, nor β-cell mass correlated with plasma ghrelin, although all positively correlated with LEAP2 (P = .081 for islet cross-sectional area). In ad lib-fed mice, there was an effect of pregnancy, but not ghrelin deletion, to change (raise) plasma insulin without impacting blood glucose. Similarly, there was an effect of pregnancy, but not ghrelin deletion, to change (lower) blood glucose area under the curve during a glucose tolerance test. Thus, genetic deletion of ghrelin increases islet size and β-cell cross-sectional area in female mice, similar to males. Yet, despite pregnancy-associated reductions in ghrelin, other factors appear to govern islet enlargement and changes to insulin sensitivity and glucose tolerance in the setting of pregnancy. In the case of islet size and β-cell mass, one of those factors may be the pregnancy-associated increase in LEAP2.

The intersection between ghrelin, metabolism and circadian rhythms

Despite the growing popular interest in sleep and diet, many gaps exist in our scientific understanding of the interaction between circadian rhythms and metabolism. In this Review, we explore a promising, bidirectional role for ghrelin in mediating this interaction. Ghrelin both influences and is influenced by central and peripheral circadian systems. Specifically, we focus on how ghrelin impacts outputs of circadian rhythm, including neuronal activity, circulating growth hormone levels, locomotor activity and eating behaviour. We also consider the effects of circadian rhythms on ghrelin expression and the consequences of disrupted circadian patterns, such as shift work and jet lag, on ghrelin secretion. Our Review is aimed at both the casual reader interested in gaining more insight into the scientific context surrounding the trending topics of sleep and metabolism, as well as experienced scientists in the fields of ghrelin and circadian biology seeking inspiration and a comprehensive overview of how these fields are related.

Ghrelin-responsive mediobasal hypothalamic neurons mediate exercise-associated food intake and exercise endurance

Previous studies have implicated the orexigenic hormone ghrelin as a mediator of exercise endurance and the feeding response postexercise. Specifically, plasma ghrelin levels nearly double in mice when they are subjected to an hour-long bout of high-intensity interval exercise (HIIE) using treadmills. Also, growth hormone secretagogue receptor-null (GHSR-null) mice exhibit decreased food intake following HIIE and diminished running distance (time until exhaustion) during a longer, stepwise exercise endurance protocol. To investigate whether ghrelin-responsive mediobasal hypothalamus (MBH) neurons mediate these effects, we stereotaxically delivered the inhibitory designer receptor exclusively activated by designer drugs virus AAV2-hSyn-DIO-hM4(Gi)-mCherry to the MBH of Ghsr-IRES-Cre mice, which express Cre recombinase directed by the Ghsr promoter. We found that chemogenetic inhibition of GHSR-expressing MBH neurons (upon delivery of clozapine-N-oxide) 1) suppressed food intake following HIIE, 2) reduced maximum running distance and raised blood glucose and blood lactate levels during an exercise endurance protocol, 3) reduced food intake following ghrelin administration, and 4) did not affect glucose tolerance. Further, HIIE increased MBH Ghsr expression. These results indicate that activation of ghrelin-responsive MBH neurons is required for the normal feeding response to HIIE and the usual amount of running exhibited during an exercise endurance protocol.

Ghrelin deletion and conditional ghrelin cell ablation increase pancreatic islet size in mice

Ghrelin exerts key effects on islet hormone secretion to regulate blood glucose levels. Here, we sought to determine whether ghrelin's effects on islets extend to the alteration of islet size and β cell mass. We demonstrate that reducing ghrelin - by ghrelin gene knockout (GKO), conditional ghrelin cell ablation, or high-fat diet (HFD) feeding - was associated with increased mean islet size (up to 62%), percentage of large islets (up to 854%), and β cell cross-sectional area (up to 51%). In GKO mice, these effects were more apparent in 10- to 12-week-old mice than in 4-week-old mice. Higher β cell numbers from decreased β cell apoptosis drove the increase in β cell cross-sectional area. Conditional ghrelin cell ablation in adult mice increased the β cell number per islet by 40% within 4 weeks. A negative correlation between islet size and plasma ghrelin in HFD-fed plus chow-fed WT mice, together with even larger islet sizes in HFD-fed GKO mice than in HFD-fed WT mice, suggests that reduced ghrelin was not solely responsible for diet-induced obesity-associated islet enlargement. Single-cell transcriptomics revealed changes in gene expression in several GKO islet cell types, including upregulation of Manf, Dnajc3, and Gnas expression in β cells, which supports decreased β cell apoptosis and/or increased β cell proliferation. These effects of ghrelin reduction on islet morphology might prove useful when designing new therapies for diabetes.

Effects of thermoneutrality on food intake, body weight, and body composition in a Prader-Willi syndrome mouse model

OBJECTIVE

Prader-Willi syndrome (PWS) is a multisystem genetic disorder. Unfortunately, none of several mouse models carrying PWS mutations emulates the entirety of the human PWS phenotype, including hyperphagia plus obesity.

METHODS

To determine whether housing at thermoneutrality (TN, 30 °C) permits the development of hyperphagia and obesity in the Snord116del PWS mouse model, the effects of housing three different ages of Snord116del and wild-type (WT) littermates at TN versus room temperature (RT, 22-24 °C) for 8 weeks were compared.

RESULTS

Snord116del mice born and maintained at TN exhibited lower body weight curves, lower percentage fat mass, and lower food intake than WT mice at RT. In 4- to 6-month-old high-fat diet-fed female mice, TN raised the Snord116del body weight curve closer to that of RT-housed WT mice although the TN-housed Snord116del mice did not gain more adiposity or exhibit greater food intake. In 6- to 8-month-old high-fat diet-fed male mice, body weight, adiposity, and food intake of TN-housed Snord116del mice remained far below levels in RT-housed WT mice. TN elicited hypotonia in Snord116del adults and exacerbated mortality of Snord116del newborns.

CONCLUSIONS

In none of three tested TN protocols were greater food intake, body weight, or adiposity induced in Snord116del mice compared with RT-housed WT mice.

TRH and NPY Interact to Regulate Dynamic Changes in Energy Balance in the Male Zebra Finch

In contrast to mammals, birds have a higher basal metabolic rate and undertake wide range of energy-demanding activities. As a consequence, food deprivation for birds, even for a short period, poses major energy challenge. The energy-regulating hypothalamic homeostatic mechanisms, although extensively studied in mammals, are far from clear in the case of birds. We focus on the interplay between neuropeptide Y (NPY) and thyrotropin-releasing hormone (TRH), 2 of the most important hypothalamic signaling agents, in modulating the energy balance in a bird model, the zebra finch, Taeniopygia guttata. TRH neurons were confined to a few nuclei in the preoptic area and hypothalamus, and fibers widely distributed. The majority of TRH neurons in the hypothalamic paraventricular nucleus (PVN) whose axons terminate in median eminence were contacted by NPY-containing axons. Compared to fed animals, fasting significantly reduced body weight, PVN pro-TRH messenger RNA (mRNA) and TRH immunoreactivity, but increased NPY mRNA and NPY immunoreactivity in the infundibular nucleus (IN, avian homologue of mammalian arcuate nucleus) and PVN. Refeeding for a short duration restored PVN pro-TRH and IN NPY mRNA, and PVN NPY innervation to fed levels. Compared to control tissues, treatment of the hypothalamic superfused slices with NPY or an NPY-Y1 receptor agonist significantly reduced TRH immunoreactivity, a response blocked by treatment with a Y1-receptor antagonist. We describe a detailed neuroanatomical map of TRH-equipped elements, identify new TRH-producing neuronal groups in the avian brain, and demonstrate rapid restoration of the fasting-induced suppression of PVN TRH following refeeding. We further show that NPY via Y1 receptors may regulate PVN TRH neurons to control energy balance in T. guttata.

Calcium-binding proteins typify the dopaminergic neuronal subtypes in the ventral tegmental area of zebra finch, Taeniopygia guttata

Calcium-binding proteins (CBPs) regulate neuronal function in midbrain dopamine (DA)-ergic neurons in mammals by buffering and sensing the intracellular Ca²⁺ , and vesicular release. In birds, the equivalent set of neurons are important in song learning, directed singing, courtship, and energy balance, yet the status of CBPs in these neurons is unknown. Herein, for the first time, we probe the nature of CBPs, namely, Calbindin-, Calretinin-, Parvalbumin-, and Secretagogin-expressing DA neurons in the ventral tegmental area (VTA) and substantia nigra (SN) in the midbrain of zebra finch, Taeniopygia guttata. qRT-PCR analysis of ventral midbrain tissue fragment revealed higher Calbindin- and Calretinin-mRNA levels compared to Parvalbumin and Secretagogin. Application of immunofluorescence showed CBP-immunoreactive (-i) neurons in VTA (anterior [VTAa], mid [VTAm], caudal [VTAc]), SN (compacta [SNc], and reticulata [SNr]). Compared to VTAa, higher Calbindin- and Parvalbumin-immunoreactivity (-ir), and lower Calretinin-ir were observed in VTAm and VTAc. Secretagogin-ir was highly localized to VTAa. In SN, Calbindin- and Calretinin-ir were higher in SNc, SNr was Parvalbumin enriched, and Secretagogin-ir was not detected. Weak, moderate, and intense tyrosine hydroxylase (TH)-i VTA neurons were demarcated as subtypes 1, 2, and 3, respectively. While subtype 1 TH-i neurons were neither Calbindin- nor Calretinin-i, ∼80 and ∼65% subtype 2 and ∼30 and ∼45% subtype 3 TH-i neurons co-expressed Calbindin and Calretinin, respectively. All TH-i neuronal subtypes co-expressed Parvalbumin with reciprocal relationship with TH-ir. We suggest that the CBPs may determine VTA DA neuronal heterogeneity and differentially regulate their activity in T. guttata.

EPIDEMIOLOGY AND SEASONAL VARIATION OF APPENDICITIS – A SINGLE CENTER RETROSPECTIVE STUDY FROM NORTH-EAST INDIA

Background. Acute appendicitis is the most common surgical emergency presenting in emergency department, and appendectomy is one of the most common surgeries. There is a wide variation in the incidence of acute appendicitis reported for different countries, different regions, race, sex, age and also seasons. Objective. The aim of this study was to understand the epidemiological trend and the seasonal variation of appendicitis in the northeast region of India. Methods. It was a retrospective hospital-based study conducted in Jan 2016 – Dec 2020 at a Tertiary Care Teaching Hospital in the northeast region of India. The patient data were obtained from the Medical Record Department of the hospital and the data regarding the weather was obtained from the Indian Meteorological Department (IMD) and the website www.worldweather.com. The statistical analysis was done using SPSS software version 24.0, and the seasonal variation was studied using Kruskal Wallis test. Results. Acute appendicitis affected both the sexes equally with a marginal higher incidence in males. It also had higher peak during the second and third decade of life in both the sexes. The incidence of acute appendicitis was high in the pre-monsoon and monsoon season with peak in the monsoon season. Conclusions. Acute appendicitis is more common during the pre-monsoon and monsoon season, a period known for humidity, high incidence of bacterial and viral infections.

Secretagogin in the brain and pituitary of the catfish, Clarias batrachus: Molecular characterization and regulation by insulin

Secretagogin (scgn), is a novel hexa EF-hand, phylogenetically conserved calcium-binding protein. It serves as Ca²⁺ sensor and participates in Ca²⁺ -signaling and neuroendocrine regulation in mammals. However, its relevance in the brain of non-mammalian vertebrates has largely remained unexplored. To address this issue, we studied the cDNA encoding scgn, scgn mRNA expression, and distribution of scgn-equipped elements in the brain and pituitary of a teleost, Clarias batrachus (cb). The cbscgn cDNA consists of three transcripts (T) variants: T1 (2185 bp), T2 (2151 bp) and T3 (2060 bp). While 816 bp ORF in T1 and T2 encodes highly conserved six EF-hand 272 aa protein fully capable of Ca²⁺ -binding, 726-bp ORF in T3 encodes 242 aa protein. The T1 showed >90% and >70% identity with scgn of catfishes, and other teleosts and mammals, respectively. The T1-mRNA was widely expressed in the brain and pituitary, while the expression of T3 was restricted to the telencephalon. Application of the anti-scgn antiserum revealed a ∼32 kDa scgn-immunoreactive (scgn-i) band (known molecular weight of scgn) in the forebrain tissue, and immunohistochemically labeled neurons in the olfactory epithelium and bulb, telencephalon, preoptic area, hypothalamus, thalamus, and hindbrain. In the pituitary, scgn-i cells were seen in the pars distalis and intermedia. Insulin is reported to regulate scgn mRNA in the mammalian hippocampus, and feeding-related neuropeptides in the telencephalon of teleost. Intracranial injection of insulin significantly increased T1-mRNA expression and scgn-immunoreactivity in the telencephalon. We suggest that scgn may be an important player in the regulation of olfactory, neuroendocrine system, and energy balance functions in C. batrachus.

LEAP2 deletion in mice enhances ghrelin's actions as an orexigen and growth hormone secretagogue

Objective

The hormone liver-expressed antimicrobial peptide-2 (LEAP2) is a recently identified antagonist and an inverse agonist of the growth hormone secretagogue receptor (GHSR). GHSR's other well-known endogenous ligand, acyl-ghrelin, increases food intake, body weight, and GH secretion and is lowered in obesity but elevated upon fasting. In contrast, LEAP2 reduces acyl-ghrelin-induced food intake and GH secretion and is found elevated in obesity but lowered upon fasting. Thus, the plasma LEAP2/acyl-ghrelin molar ratio could be a key determinant modulating GHSR signaling in response to changes in body mass and feeding status. In particular, LEAP2 may serve to dampen acyl-ghrelin action in the setting of obesity, which is associated with ghrelin resistance. Here, we sought to determine the metabolic effects of genetic LEAP2 deletion.

Methods

We generated the first known LEAP2-KO mouse line. Food intake, GH secretion, and cellular activation (c-fos induction) in different brain regions following s.c. acyl-ghrelin administration in LEAP2-KO mice and wild-type littermates were determined. LEAP2-KO mice and wild-type littermates were submitted to a battery of tests (such as measurements of body weight, food intake, and body composition; indirect calorimetry, determination of locomotor activity, and meal patterning while housed in metabolic cages) over the course of 16 weeks of high-fat diet and/or standard chow feeding. Fat accumulation was assessed in hematoxylin & eosin-stained and oil red O-stained liver sections from these mice.

Results

LEAP2-KO mice were more sensitive to s.c. ghrelin. In particular, acyl-ghrelin acutely stimulated food intake at a dose of 0.5 mg/kg BW in standard chow-fed LEAP2-KO mice while a 2× higher dose was required by wild-type littermates. Also, acyl-ghrelin stimulated food intake at a dose of 1 mg/kg BW in high-fat diet-fed LEAP2-KO mice while not even a 10× higher dose was effective in wild-type littermates. Acyl-ghrelin induced a 90.9% higher plasma GH level and 77.2–119.7% higher numbers of c-fos-immunoreactive cells in the arcuate nucleus and olfactory bulb, respectively, in LEAP2-KO mice than in wild-type littermates. LEAP2 deletion raised body weight (by 15.0%), food intake (by 18.4%), lean mass (by 6.1%), hepatic fat (by 42.1%), and body length (by 1.7%) in females on long-term high-fat diet as compared to wild-type littermates. After only 4 weeks on the high-fat diet, female LEAP2-KO mice exhibited lower O₂ consumption (by 13%), heat production (by 9.5%), and locomotor activity (by 49%) than by wild-type littermates during the first part of the dark period. These genotype-dependent differences were not observed in high-fat diet-exposed males or female and male mice exposed for long term to standard chow diet.

Conclusions

LEAP2 deletion sensitizes lean and obese mice to the acute effects of administered acyl-ghrelin on food intake and GH secretion. LEAP2 deletion increases body weight in females chronically fed a high-fat diet as a result of lowered energy expenditure, reduced locomotor activity, and increased food intake. Furthermore, in female mice, LEAP2 deletion increases body length and exaggerates the hepatic fat accumulation normally associated with chronic high-fat diet feeding.

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A novel line of LEAP2-knockout mice was generated.

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LEAP2 deletion sensitizes mice to the GH secretory effects of administered ghrelin.

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LEAP2 deletion reduces ghrelin resistance in diet-induced obese mice.

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HFD-fed female LEAP2-KO mice eat more and gain more body weight and hepatic fat.

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HFD-fed female LEAP2-KO mice exhibit lowered energy expenditure and activity.

Cocaine- and amphetamine-regulated transcript peptide- and dopamine-containing systems interact in the ventral tegmental area of the zebra finch, Taeniopygia guttata, during dynamic changes in energy status

The mesolimbic dopamine (DA)-pathway regulates food-reward, feeding-related behaviour and energy balance. Evidence underscores the importance of feeding-related neuropeptides in modulating activity of these DA neurons. The neuropeptide, CART, a crucial regulator of energy balance, modulates DA-release, and influences the activity of ventral tegmental area (VTA) DAergic neurons in the mammalian brain. Whether CART- and DA-containing systems interact at the level of VTA to regulate energy balance, however, is poorly understood. We explored the interaction between CART- and DA-containing systems in midbrain of the zebra finch, Taeniopygia guttata, an interesting model to study dynamic changes in energy balance due to higher BMR/daytime body temperature, and rapid responsiveness of the feeding-related neuropeptides to changes in energy state. Further, its midbrain DA-neurons share similarities with those in mammals. In the midbrain, tyrosine hydroxylase-immunoreactive (TH-i) neurons were seen in the substantia nigra (SN) and VTA [anterior (VTAa), mid (VTAm) and caudal (VTAc)]; those in VTA were smaller. In the VTA, CART-immunoreactive (CART-i)-fibers densely innervated TH-i neurons, and both CART-immunoreactivity (CART-ir) and TH-immunoreactivity (TH-ir) responded to energy status-dependent changes. Compared to fed and fasted birds, refeeding dramatically enhanced TH-ir and the percentage of TH-i neurons co-expressing FOS in the VTA. Increased prepro-CART-mRNA, CART-ir and a transient appearance of CART-i neurons was observed in VTAa of fasted, but not fed birds. To test the functional interaction between CART- and DA-containing systems, ex-vivo superfused midbrain-slices were treated with CART-peptide and changes in TH-ir analysed. Compared to control tissues, CART-treatment increased TH-ir in VTA but not SN. We propose that CART is a potential regulator of VTA DA-neurons and energy balance in T. guttata.

Disrupting the ghrelin-growth hormone axis limits ghrelin's orexigenic but not glucoregulatory actions

Objective

Acyl-ghrelin regulates eating, body weight, blood glucose, and GH secretion upon binding to its receptor GHSR (growth hormone secretagogue receptor; ghrelin receptor). GHSR is distributed in several brain regions and some peripheral cell-types including pituitary somatotrophs. The objective of the current study was to determine the functional significance of acyl-ghrelin's action on GHSR-expressing somatotrophs in mediating GH secretion and several of acyl-ghrelin's metabolic actions.

Methods

GH-IRES-Cre mice and loxP-flanked (floxed) GHSR mice were newly developed and then crossed to one another to generate mice that lacked GHSR selectively from somatotrophs. Following validation of mice with somatotroph-selective GHSR deletion, metabolic responses of these mice and control littermates were assessed following both acute and chronic acyl-ghrelin administration, a 24-h fast, and a prolonged 60% chronic caloric restriction protocol modeling starvation.

Results

In mice with somatotroph-selective GHSR deletion, a single peripheral injection of acyl-ghrelin failed to induce GH secretion or increase food intake, unlike wild-type and other littermate control groups. However, the usual acute blood glucose increase in response to the acyl-ghrelin bolus was preserved. Similarly, chronic s.c. acyl-ghrelin administration to mice with somatotroph-selective GHSR deletion failed to increase plasma GH, food intake, or body weight. Physiologically elevating plasma acyl-ghrelin via a 24-h fast also failed to raise plasma GH and resulted in a limited hyperphagic response upon food reintroduction in mice with somatotroph-selective GHSR deletion, although those mice nonetheless did not exhibit an exaggerated reduction in blood glucose. Physiologically elevating plasma acyl-ghrelin via a 15-day caloric restriction protocol which provided only 40% of usual daily calories failed to raise plasma GH in mice with somatotroph-selective GHSR deletion, although those mice did not exhibit life-threatening hypoglycemia.

Conclusions

These results reveal that direct engagement of GHSR-expressing somatotrophs is required for a peripheral ghrelin bolus to acutely stimulate GH secretion and the actions of chronic acyl-ghrelin delivery and physiological plasma acyl-ghrelin elevations to increase plasma GH. These results also suggest that actions of acyl-ghrelin to increase food intake and body weight are reliant on direct activation of GHSRs expressed on somatotrophs. Furthermore, these results suggest that the glucoregulatory actions of acyl-ghrelin – in particular, its actions to raise blood glucose when acutely administered, prevent small blood glucose drops following a 24-h fast, and avert life-threatening hypoglycemia during an acute-on-chronic caloric restriction protocol – do not depend on GHSR expression by somatotrophs.

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Mice with pituitary somatotroph-selective GHSR deletion were generated.

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Somatotroph-expressed GHSRs mediate GH secretion and food intake after acute ghrelin.

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Body weight effects of chronic ghrelin infusion require somatotroph-expressed GHSRs.

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Somatotroph-expressed GHSRs enable GH to increase upon chronic caloric restriction.

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Mice lacking somatotroph GHSRs maintain euglycemia upon chronic caloric restriction.

Concurrent changes in photoperiod-induced seasonal phenotypes and hypothalamic CART peptide-containing systems in night-migratory redheaded buntings

This study tested the hypothesis whether hypothalamic cocaine-and amphetamine-regulated transcript (CART)-containing systems were involved in photoperiod-induced responses associated with spring migration (hyperphagia and weight gain) and reproduction (gonadal maturation) in migratory songbirds. We specifically chose CART to examine neural mechanism(s) underlying photoperiod-induced responses, since it is a potent anorectic neuropeptide and involved in the regulation of changes in the body mass and reproduction in mammals. We first studied the distribution of CART-immunoreactivity in the hypothalamus of migratory redheaded buntings (Emberiza bruniceps). CART-immunoreactive neurons were found extensively distributed in the preoptic, lateral hypothalamic (LHN), anterior hypothalamic (AN), suprachiasmatic (SCN), paraventricular (PVN), dorsomedialis hypothalami (DMN), inferior hypothalamic (IH), and infundibular (IN) nuclei. Then, we correlated hypothalamic CART-immunoreactivity in buntings with photostimulated seasonal states, particularly winter non-migratory/non-breeding (NMB) state under short days, and spring premigratory/pre-breeding (PMB) and migratory/breeding (MB) states under long days. There were significantly increased CART-immunoreactive cells, and percent fluorescent area of CART-immunoreactivity was significantly increased in all mapped hypothalamic areas, except the SCN, PVN, AN, and DMN in photostimulated PMB and MB states, as compared to the non-stimulated NMB state. In particular, CART was richly expressed in the medial preoptic nucleus, LHN, IH and IN during MB state in which buntings showed reduced food intake and increased night-time activity. These results suggest that changes in the activity of the CART-containing system in different brain regions were associated with heightened energy needs of the photoperiod-induced seasonal responses during spring migration and reproduction in migratory songbirds.

MODERN APPROACHES IN MANAGEMENT OF CHILDREN WITH CHRONIC HEPATITIS B IN REMISSION OF ACUTE LYMPHOBLASTIC LEUKEMIA

The aim of the study is to assess the effectivity of the drug «Betargin» in complex management of patients with chronic hepatitis B (CHB) in remission of acute lymphoblastic leukemia (ALL). The research had shown the results of treatment of 41 children with CHB in remission of ALL aged from 3 to 17 years old, who were on dispensary observation in Vinnytsia Regional Children's Clinical Infectious Diseases Hospital during 2013-2017 years. Patients were devided into the following groups: the comparison group (group A), which included 18 children with CHB in remission of ALL, who received basis therapy; the main group (group B) which consisted of 23 patients with CHB in remission of ALL, who got betaine arginine complex («Betargin») in addition to basis therapy. The control group was formed out of 30 healthy children. Determination of effectivity of the proposed treatment regimen was performed by studying the indicators of cholestasis, cytolysis, hepatocellular insufficiency, and lipid metabolism. To assess the liver's fibrosis level and necroinflammatory activity we used the determination of the level of plasma osteopontin in the serum using the enzyme-linked immunosorbent assay (ELISA) method: Human Osteopontin Quantikine (RDD systems, Dos Too, Minneapolis, MS, USA). The verification of the diagnosis of CHB was based on the detection of specific markers of HBV-infection in blood using ELISA and PCR analysis. During our scientific research we established that using betaine arginine complex in management of CHB in remission of ALL led to considerable improvement of children's general condition, namely due to reducing (p<0,05) the incidence of asthenovegetative (8.6% against 33.3% in the comparison group), dyspeptic (13.1% against 38.8%) as well as pain syndromes (4.3% against 11%) and hepatomegaly (13.1% against 38.8%). The activity of ALT in the main group was in 1.6 times less (p<0,05) than in comparison group at the end of the course of treatment. «Betargin» has an antifibrotic effect which is confirmed by a decrease in the level of plasma osteopontin up to 104,92 ng/ml against 178,15 ng/ml in the comparison group (p<0,05).

Impact of COVID-19 pandemic and lockdown on the state of mental health services in the private sector in India

BACKGROUND

No information is available about the impact of lockdown and COVID-19 pandemic on the mental health services in the private practice in India.

AIM

The current study is aimed to assess the impact of the COVID-19 pandemic and lockdown on the state of Mental Health Services in the Private Sector in India.

MATERIALS AND METHODS

An online survey was carried out using the Survey Monkey platform during the period of 1^st to 15^th May 2020 among the members of the Indian Psychiatric Society.

RESULTS

Three hundred and ninety six responses were analysed. There was a reduction in revenue generation by about 70%. All kinds of services, including outpatient services, inpatient services, psychotherapy services, consultation-liaison, and electroconvulsive therapy (ECT) services, were severely affected. One-third of the participants were using the teleservices during the pandemic. The most common problem faced in running the services included modifying the psychological treatment to maintain social distancing, and managing the staff. Besides providing clinical care to the patients, the majority of the mental health professionals reported that they were involved in increasing awareness about the mental health consequences of pandemic and the lockdown and addressing myths related to the spread of infection.

CONCLUSION

The pandemic and the lockdown have markedly impacted mental health services in the private sector. ECT services, inpatient services, psychotherapy services and outpatient services are the most affected. However, the COVID-19 pandemic and lockdown have led to the expansion of teleconsultation services.

State of mental health services in various training centers in India during the lockdown and COVID-19 pandemic

BACKGROUND

There is some information from different developed coutries that mental health services have been badly affected by the COVID-19 pandemic. Little information is available from India.

AIM

The aim of this study was to evaluate the impact of lockdown and COVID-19 pandemic on mental health services in India's various training centers.

MATERIALS AND METHODS

In an online survey, information was collected from various training centers of India through E-mail or WhatsApp.

RESULTS

Responses were received from 109 institutes. The majority of the responses were received from state-funded government medical colleges and private medical colleges. Since the lockdown and COVID-19 pandemic, brain stimulation treatments have completed stopped. Other, most affected services included electroconvulsive therapy, inpatient services, outpatient services, and psychotherapy services. However, there was an expansion of teleconsultations services because of the lockdown and the COVID-19 pandemic. In three-fourth of the centers mental health services were being provided to the patients with COVID-19 infection. In most of the institutes, mental health professionals were involved at different levels in the COVID-19 responsibilities. These included providing helpline services to the general public, screening people in quarantine for mental health issues, providing clinical care to COVID-19 patients, screening health care workers (HCWs) for mental health issues, and training the HCWs.

CONCLUSION

COVID-19 pandemic and lockdown have led to the collapse of regular mental health services. The present study also shows that mental health professionals are playing a significant role in addressing the prevailing psychiatric morbidity, specifically related to the COVID-19 related issues, and taking care of the HCWs.

Comparison of two multifraction radiotherapy schedules in management of painful bone metastases: A single institution prospective study

Background

Metastatic disease of bone is a common complication of most of the advanced malignancies. The majority of patients with bone metastases (BM) experience pain during their disease course and pain control can significantly improve their quality of life. Radiotherapy (RT) is an important modality in the management of BM and different schedules are followed worldwide.

Aim

The aim of this study was to compare two multi-fractionated RT regimens (30Gy in 10 fractions and 20Gy in 5 fractions) with respect to the patient's performance, response and pain score in palliative management of painful BM.

Methods

This prospective observational study was undertaken between October 2015 and September 2017 at a government medical college in central India. Two fractionation regimens (30 Gy/10 fractions and 20 Gy/5 fractions) were used to treat 50 patients with painful BM (n = 25 in each arm). Patients were treated on telecobalt machine and response assessment done in terms of complete/partial/intermediate response and pain progression. Assessment was performed at one, two and three months post treatment. Statistical analysis was done using Fisher's exact test, student t-test and Chi-square test. A value of P < 0.05 was considered significant.

Results

There were 9 males (36%) and 16 females (64%) in arm A, and 15 males (60%) and 10 females (40%) in arm B. The median age was 47.50 years (range 28-81 years) in arm A and 54 years (range 34-85 years) in arm B. There was no statistically significant difference between the two groups in terms of pain palliation at a 1 month (p = 0.73), 2 month (p = 0.75) or 3 month (p = 0.71) follow up. In addition, the mean performance scores at the end of 3^rd month in the 2 arms did not show any statistically significant difference (p = 0.51).

Conclusion

A shorter treatment schedule (5 fractions) was equally efficacious as the standard schedule (10 fractions) in our setting. With the advantage of shorter overall treatment time and avoidance of re-irradiation, this schedule may be favourable for high volume centres.

Thyrotropin-releasing hormone (TRH) in the brain and pituitary of the teleost, Clarias batrachus and its role in regulation of hypophysiotropic dopamine neurons

Thyrotropin-releasing hormone (TRH) regulates the hypothalamic-pituitary-thyroid axis in mammals and also regulates prolactin secretion, directly or indirectly via tuberoinfundibular dopamine neurons. Although TRH is abundantly expressed in teleost brain and believed to mediate neuronal communication, empirical evidence is lacking. We analyzed pro-TRH-mRNA expression, mapped TRH-immunoreactive elements in the brain and pituitary, and explored its role in regulation of hypophysiotropic dopamine (DA) neurons in the catfish, Clarias batrachus. Partial pro-TRH transcript from C. batrachus transcriptome showed six TRH progenitors repeats. Quantitative real-time polymerase chain reaction (qRT-PCR) identified pro-TRH transcript in a number of different brain regions and immunofluorescence showed TRH-immunoreactive cells/fibers in the olfactory bulb, telencephalon, preoptic area (POA), hypothalamus, midbrain, hindbrain, and spinal cord. In the pituitary, TRH-immunoreactive fibers were seen in the neurohypophysis, proximal pars distalis, and pars intermedia but not rostral pars distalis. In POA, distinct TRH-immunoreactive cells/fibers were seen in nucleus preopticus periventricularis anterior (NPPa) that demonstrated a significant increase in TRH-immunoreactivity when collected during preparatory and prespawning phases, reaching a peak in the spawning phase. Although tyrosine hydroxylase (TH)-immunoreactive neurons in NPPa are hypophysiotropic, none of the TRH-immunoreactive neurons in NPPa accumulated neuronal tracer DiI following implants into the pituitary. However, 87 ± 1.6% NPPa TH-immunoreactive neurons were surrounded by TRH-immunoreactive axons that were seen in close proximity to the somata. Superfused POA slices treated with TRH (0.5-2 μM) significantly reduced TH concentration in tissue homogenates and the percent TH-immunoreactive area in the NPPa. We suggest that TRH in the brain of C. batrachus regulates a range of physiological functions but in particular, serves as a potential regulator of hypophysiotropic DA neurons and reproduction.

Transient receptor potential vanilloid 6 (TRPV6) in the mouse brain: Distribution and estrous cycle-related changes in the hypothalamus

Transient receptor potential vanilloid (TRPV) subfamily of cationic channels have emerged as novel players in neural regulation. Unlike other members of TRPV subfamily, TRPV5 and TRPV6 are highly Ca²⁺-selective. Although TRPV5/TRPV6 transcripts are expressed in mouse brain, understanding the full functional spectrum of these ion channels in the brain is however limited due to the lack of information on their neuroanatomical distribution. We have studied TRPV6 in mouse brain in further detail. In the hypothalamus, while Western blot analysis using TRPV6 specific antiserum showed a distinct ∼95 kDa band corresponding to the molecular weight of TRPV6, transcripts for TRPV6 were detected with RT-PCR. TRPV6-immunoreactive cells/fibers were observed in vascular organ of the lamina terminalis, olfactory bulb, amygdala, hippocampus, septohypothalamic, supraoptic, arcuate (ARC), dorsomedial, and subincertal nuclei. TRPV6-immunoreactive cells/fibers were also observed in the brainstem and cerebellum. Estrogen has emerged as a potential regulator of TRPV6 in peripheral tissues. TRPV6 gene promoter contains estrogen-response element, estrogen activates TRPV6 via estrogen receptor alpha (ERα), and ERα-expressing ARC neurons in mediobasal hypothalamus (MBH) serve as primary site for estradiol feedback. Using double immunofluorescence, co-expression of TRPV6 and ERα was observed in several ARC neurons. MBH of mice during different phases of estrous cycle were subjected to Western blot analysis of TRPV6. Compared to proestrus, a significant reduction (P<0.01) in intensity of TRPV6-immunoreactive band was observed in MBH during metestrus and diestrus phases. While the wide distribution of TRPV6-expressing elements in the brain suggests its role in a range of CNS functions, the ion channel may serve as novel component of the neural pathway mediating effects of estradiol in MBH.

Role of Isotocin in the Regulation of the Hypophysiotropic Dopamine Neurones in the Preoptic Area of the Catfish, Clarias batrachus

Dopamine (DA) has emerged as a potent inhibitory neuromodulator of luteinsing hormone (LH) secretion and reproduction in teleosts. The DA neurones located in the anterior subdivision of nucleus preopticus periventricularis (NPPa) in the preoptic area (POA) innervate the pituitary gland and regulate LH cells. Although a reduction in the inhibitory DAergic tone is crucial for stimulatory action of gonadotrophin-releasing hormone (GnRH) on LH cells, the role of other hypothalamic factors is suggested but not fully understood. Nonapeptide, isotocin (IST) has emerged as a likely candidate that may also influence the LH cell function. IST neurones reside in the nucleus preopticus and innervate LH cells. While IST treatment dramatically elevated LH secretion, the IST levels in brain peaked during spawning. In a pilot study on the catfish, Clarias batrachus, we observed a dense network of IST-immunoreactive (IST-IR) fibres in the NPPa, the region known to harbour hypophysiotropic DA neurones. Application of the double immunofluorescence method showed a dense IST-IR fibre network around the tyrosine hydroxylase-immunoreactive (TH-IR) neurones in the NPPa region. A great majority of the TH-IR neurones in the NPPa were contacted by IST-IR fibres during the spawning phase. The NPPa therefore appears to be a site for the intense interaction of DA and IST. IST-IR fibre innervation in NPPa showed reproduction phase-dependent changes. The percent fluorescent area of IST-IR fibres showed a gradual increase from the resting through prespawning phases (resting: 7.5 ± 1.04; preparatory: 8.6 ± 0.8; prespawning: 15.5 ± 1.4), reaching a peak in the spawning phase (28 ± 2.3; P < 0.001). Compared to the spawning phase, a drastic reduction in IST-IR fibres in the NPPa was observed during the postspawning phase (8.4 ± 0.9; P < 0.001). Superfused slices of the POA of C. batrachus treated with IST peptide resulted in a significant reduction in TH immunoreactivity in the NPPa (Control: 45.3 ± 4.2; IST peptide, 5 μm: 29.4 ± 4.7; P < 0.05). We suggest that the intense interaction between IST and DA in the NPPa, most probably of an inhibitory nature, may be critical for the regulation of LH cells and reproduction in teleosts.

Role of membrane cholesterol and lipid peroxidation in regulating the Na+/K+-ATPase activity in schizophrenia

BACKGROUND

Na⁺/K⁺-ATPase (NKA) activity is compromised in several neuropsychiatric disorders. Oxidative stress and membrane lipid composition play important roles in regulating NKA activity.

AIMS

The present study was undertaken to evaluate the effects of oxidative stress-induced membrane lipid damage and membrane cholesterol composition on NKA pump activity in schizophrenia.

SETTINGS AND DESIGN

It was a hospital-based, cross-sectional, observational study in 49 cases and 51 controls for 1 year.

MATERIALS AND METHODS

NKA pump activity in red blood cell membrane, serum levels of thiobarbituric acid reactive substances (TBARS), protein carbonyl (PC) adducts, and cholesterol were measured by standard spectrophotometric techniques in newly diagnosed schizophrenia patients by Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition, Text Revision criteria. Membrane cholesterol was analyzed by chloroform and isopropanol extraction followed by measuring the cholesterol concentration by spectrophotometric technique.

STATISTICAL ANALYSIS AND RESULTS

Mean values for NKA pump activity, membrane cholesterol level, and serum cholesterol levels were significantly lower in the case group (P < 0.001). The activity of NKA pump was found to be directly correlated to membrane cholesterol level rather than with the serum cholesterol values. Although the NKA pump activity showed inverse relationship with the serum values of TBARS and PC products both, on multiple linear regression analysis, it was found to be significantly positively dependent on the membrane cholesterol (β = 0.268, P = 0.01) and negatively dependent on the serum TBARS (β = -0.63, P < 0.001) levels only.

CONCLUSION

Reduced membrane cholesterol and oxidative stress-induced damage to membrane lipids play crucial roles in decreasing the NKA activity in schizophrenia. Hence, for a better prognosis and treatment, measures are required to maintain optimum levels of cholesterol in neuronal tissues along with a proper control on oxidative stress.

Sexual dimorphism in the hypophysiotropic tyrosine hydroxylase-positive neurons in the preoptic area of the teleost, Clarias batrachus

BACKGROUND

Dopamine (DA) neurons in the anteroventral periventricular nucleus (AVPV) in the preoptic area (POA) of mammals express estrogen receptors, regulate luteinizing hormone (LH) secretion, and show distinct sexual dimorphism. In teleosts, hypophysiotropic DA neurons of the nucleus preopticus periventricularis (NPP), located in the anteroventral POA, express estrogen receptors, innervate LH cells, and emerged as a neuroanatomical substrate for inhibiting LH cells. Interestingly, the NPP and AVPV seem to share several similarities. Whether DAergic neurons in the NPP show sexual dimorphism is, however, not known. Based on the proposed homology to AVPV and previous studies showing greater tyrosine hydroxylase (TH) mRNA and enzyme activity levels in the brain of female catfish, we hypothesize that females have greater number of DAergic neurons in the NPP and correspondingly more TH-immunoreactive fiber innervation of the pituitary.

METHODS

Adult, male and female Clarias batrachus collected during the prespawning phase of their reproductive cycle were used. Fish were anesthetized and perfused transcardially with phosphate-buffered saline (pH 7.4) and 4 % paraformaldehyde in phosphate buffer. Sections through the rostro-caudal extent of the POA and pituitary were processed for TH immunofluorescence. Using double immunofluorescence, the association between TH-immunoreactive fibers and LH cells in the pituitary was explored. Sections were analyzed using semiquantitative analysis.

RESULTS

NPP in POA of C. batrachus has two distinct subdivisions, viz, anterior (NPPa) and posterior (NPPp), and TH neurons were observed in both the subdivisions. Compared to that in the males, a significantly higher (P < 0.05) number of TH neurons was consistently observed in the NPPa of females. TH neurons in NPPp, however, showed no difference in the number or immunoreactivity. Since DA neurons in NPPa are hypophysiotropic, we compared TH-fiber innervation of the pituitary in both sexes. Compared to males, proximal pars distalis and LH cells in this region of the pituitary in females were densely innervated by TH fibers.

CONCLUSIONS

Neurons of NPPa and their innervation to the pituitary seem to be a distinct sexually dimorphic DAergic system in C. batrachus. The DAergic system may serve as a component of the neural mechanisms controlling the sexually dimorphic LH surge in teleosts. Given the similarities shared by NPPa and AVPV, homology between these two nuclei is suggested.

Interaction between dopamine and neuropeptide Y in the telencephalon of the Indian major carp, Cirrhinus cirrhosus

In teleosts, while neuropeptide Y (NPY) has emerged as one of the potent regulators of GnRH-LH axis, entopeduncular nucleus (EN) in the ventral telencephalon serves as major site for NPY synthesis/storage. Neurons of the EN innervate preoptic area and pituitary, respond to gonadal steroids, undergo reproduction phase-related changes, and are believed to convey sex steroid-borne information to GnRH neurons. In spite of the importance of EN, the neural circuitry associated with the nucleus has not been defined. Aim of the present study is to examine the possibility of the dopaminergic regulation of EN. NPY-immunoreactive cells and fibers were extensively distributed in the forebrain and pituitary of Cirrhinus cirrhosus. NPY immunoreactivity was observed in the olfactory receptor neurons, ganglion cells of terminal nerve, and in neurons of area ventralis telencephali/pars lateralis, EN, nucleus preopticus periventricularis (NPP), and nucleus lateralis tuberis. NPY-fibers were observed in the dorsal telencephalon, tuberal area and pituitary. While the area ventralis telencephali/pars intermedialis (Vi) located just above the EN contained a distinct population of tyrosine hydroxylase neurons, their axons seem to innervate NPY neurons in EN. Superfused brain slices containing EN were treated with DA D1- and D2-like receptor agonists. NPY-immunoreactivity in the EN showed significant increase (P<0.001) following DA D1-like receptor agonist, SKF-38393 treatment, but DA D2-like receptor agonist, quinpirole was ineffective. DA may regulate NPY neurons in EN via D1-like receptors. DA-NPY interaction in the EN might be important in the central regulation of reproduction in teleosts.

Association of single-nucleotide polymorphism of cholecystokinin receptor A gene with schizophrenia in an Eastern Indian population

CONTEXT

Cholecystokinin A receptor (CCK-AR) gene polymorphism is being increasingly reported in schizophrenia. It varies among different population groups but is associated with several complications of schizophrenia.

AIMS

The present study was undertaken to assess whether the CCK-AR polymorphism is stabilized and is more consistently associated with schizophrenia in an Eastern Indian sub-population.

SETTINGS AND DESIGN

It was carried out as a cross-sectional, observational, hospital-based study on 95 schizophrenia patients and 138 control subjects selected by the method of convenience.

MATERIALS AND METHODS

Single-nucleotide polymorphisms located in the regulatory region of the CCK-AR gene were assessed by restriction fragment length polymorphism (RFLP) in the polymerase chain reaction (PCR) amplified product of CCK-AR gene in study subjects. RFLP was done by the digestion of the PCR product by the restriction enzyme Pst-1 followed by gel electrophoresis.

STATISTICAL ANALYSIS

Assessment of the stability of C/T polymorphism in the study population was done by applying Hardy-Weinberg equilibrium rule. The significance of difference in the allelic distribution between case and controls was analyzed by Chi-square (χ(2)) test and odds ratio (OR) analysis.

RESULT

CCK-R polymorphism was in Hardy-Weinberg equilibrium in both groups. Distribution of the C allele of this gene was significantly higher in schizophrenia patients (χ(2) = 4.35, OR = 1.51; confidence interval at 95% =1.04-2.20).

CONCLUSION

C/T polymorphism of the CCK-R gene is a stable polymorphism in our study population. Moreover, the C allele is significantly more abundant in schizophrenia patients imparting them a greater risk of development of complications like auditory hallucination.

Prevalence of Depression in Patients with Type II Diabetes Mellitus and its Impact on Quality of Life

BACKGROUND

Diabetes mellitus (DM) is a frequently encountered chronic metabolic disease with various complications throughout its course, which causes severe restriction and disability in an individual's life. It has been well documented that the incidence of depression is higher in diabetic patients and co-morbid depression causes further deterioration in the quality of life in diabetic patients.

AIMS

To study the prevalence of depression and its impact on quality of life in patients with type II DM.

SETTINGS AND DESIGN

Single centre, cross-sectional, single interview.

MATERIALS AND METHODS

Total 195 type II DM patients are included in this study. To diagnose Depressive Episode Structured Clinical Interview for DSM IV Axis-1 Disorders, Research Version patient edition was applied. All patients were evaluated with a semi-structured socio-demographic proforma to assess socio-demographic characteristics, Hamilton Rating Scale for Depression (HAM-D) and Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) SF (Short Form) to measure the quality of life.

RESULTS

Among them, 46.15% (N=90; males: 41, females: 49) met the DSM-IV diagnostic criteria for major depressive episodes. Among the depressed group, majority were (36.7%) moderately depressed. QLESQ-SF total and each item scores were significantly lower in the depressed group than in the non-depressed group. Both the HAM-D scores and HbA1c level have significant negative correlations with QLESQ-SF total scores.

CONCLUSION

Our study demonstrates that the presence of depression in type II DM further deteriorates the quality of life of the patients. Therefore, treating depression would have a beneficial effect on the quality of life.

Drought yield index to select high yielding rice lines under different drought stress severities

BACKGROUND

Drought is the most severe abiotic stress reducing rice yield in rainfed drought prone ecosystems. Variation in intensity and severity of drought from season to season and place to place requires cultivation of rice varieties with different level of drought tolerance in different areas. Multi environment evaluation of breeding lines helps breeder to identify appropriate genotypes for areas prone to similar level of drought stress. From a set of 129 advanced rice (Oryza sativa L.) breeding lines evaluated under rainfed drought-prone situations at three locations in eastern India from 2005 to 2007, a subset of 39 genotypes that were tested for two or more years was selected to develop a drought yield index (DYI) and mean yield index (MYI) based on yield under irrigated, moderate and severe reproductive-stage drought stress to help breeders select appropriate genotypes for different environments.

RESULTS

ARB 8 and IR55419-04 recorded the highest drought yield index (DYI) and are identified as the best drought-tolerant lines. The proposed DYI provides a more effective assessment as it is calculated after accounting for a significant genotype x stress-level interaction across environments. For rainfed areas with variable frequency of drought occurrence, Mean yield index (MYI) along with deviation in performance of genotypes from currently cultivated popular varieties in all situations helps to select genotypes with a superior performance across irrigated, moderate and severe reproductive-stage drought situations. IR74371-70-1-1 and DGI 75 are the two genotypes identified to have shown a superior performance over IR64 and MTU1010 under all situations.

CONCLUSION

For highly drought-prone areas, a combination of DYI with deviation in performance of genotypes under irrigated situations can enable breeders to select genotypes with no reduction in yield under favorable environments compared with currently cultivated varieties. For rainfed areas with variable frequency of drought stress, use of MYI together with deviation in performance of genotypes under different situations as compared to presently cultivated varieties will help breeders to select genotypes with superior performance under all situations.

Melatonin independent protective role of l-tryptophan in experimental reflux esophagitis in rats

Melatonin is implicated in sustaining the esophageal integrity in gastro-esophageal reflux disease. However, the role of its synthetic precursor l-tryptophan is not clear in this pathology. The present study was designed to explore the effects of l-tryptophan on esophageal damage following reflux esophagitis (RE)-establishment and concurrent alterations in factors possibly influencing esophageal integrity such as esophageal melatonin level, luminal acidity, H(+)K(+)-ATPase activity, mucin and gastric PGE(2) levels. RE was established in rats by simultaneous ligation of pylorus region and fore-stomach. RE significantly decreased the esophageal-melatonin level and the expression of its synthesizing enzymes: arylalkylamine-N-acetyltransferase (AA-NAT) and hydroxyindole-O-methyltransferase (HIOMT). Administration of l-tryptophan significantly decreased the RE-induced esophageal mucosal damage, without altering the levels of melatonin. l-Tryptophan pretreatment also normalized the esophageal mucosal damage caused by melatonin receptor antagonist-luzindole. Simultaneously, l-tryptophan significantly increased the RE-decreased expression of AA-NAT with insignificant effect on HIOMT gene expression. In contrast, l-tryptophan per se caused a significant elevation in the esophageal melatonin level, with no significant effect on the expression of AA-NAT and HIOMT enzymes. Further, l-tryptophan significantly normalized the RE-induced changes in the gastric juice volume, acidity and pH. However, it did not significantly inhibit the H(+)K(+)-ATPase activity in vitro. Also, l-tryptophan significantly increased the RE-reduced mucin level, COX-2 activity and thereby PGE(2) levels. Interestingly, indomethacin (PGE(2) synthesis blocker), aggravated the RE-induced tissue injury with simultaneous changes in the gastric volume, acidity, pH and mucin content, which l-tryptophan failed to reverse, suggesting that the attenuating effect of l-tryptophan on gastric secretions could be PGE(2) driven. Thus the current study provide evidences that protective functions of l-tryptophan against RE is independent of its conversion into melatonin, and possibly involve mobilization of factors such as COX-2 derived PGE(2) and mucin that counterbalance the detrimental effect of gastric acid on esophageal mucosa, signifying the therapeutic efficacy of l-tryptophan against the esophageal pathologies.

Tube sigmoidostomy: a valuable alternative to sigmoidopexy for sigmoid volvulus

OBJECTIVE

To compare the effectiveness of tube sigmoidostomy and sigmoidopexy as effective treatment options for patients with acute uncomplicated sigmoid volvulus.

METHODS

The records of 72 patients with acute uncomplicated sigmoid volvulus with obstruction who were treated by tube sigmoidostomy (Group I: n=32) and sigmoidopexy (Group II: n=40) were reviewed retrospectively. Follow-up period was 22 months (range: 6-51 months).

RESULTS

Results show significant improvement in postoperative tachycardia, respiratory distress and urine output in Group I patients as compared to those in Group II. Most of the clinical parameters of Group I patients normalized by day 3, while it took up to 7 days in Group II patients. Intraabdominal hypertension caused by persistent colonic dilatation after sigmoidopexy was found to be an important determinant of postoperative morbidity. As compared to tube sigmoidostomy, the sigmoidopexy group had delayed recovery, more chances of abdominal fascial dehiscence, and longer hospital stay, as well as more prolonged abdominal discomfort, constipation, and recurrent volvulus rates during follow-up.

CONCLUSION

Tube sigmoidostomy provides both fixation and decompression of the redundant sigmoid colon in the postoperative period while allowing time to recover from massive dilatation and edema caused by prolonged volvulus. Compared with sigmoidopexy for the treatment of uncomplicated sigmoid volvulus, tube sigmoidostomy leads to lesser rates of morbidity and recurrence. Thus, it can be considered as a definitive alternative treatment option for uncomplicated sigmoid volvulus.

Vitamin D Status of term exclusively breastfed infants and their mothers from India

OBJECTIVES

(i) To measure 25-OH vitamin D levels in term infants at 10 weeks and 6 months and to correlate with maternal vitamin D levels at 10-week postpartum (ii) To evaluate infants at 6 months for rickets.

PATIENTS AND METHODS

A total of 179 exclusively breastfed infant-mother pairs 96 appropriate-for-gestational age (Group 1) and 83 small- for- gestational age infants (Group 2) recruited at 10 weeks. At 6 months, 52 in group 1 and 45 in group 2 were evaluated. Venous blood sample were collected at 10 weeks and 6 months in infants and at 10 weeks in mothers for calcium, phosphorus, alkaline phosphatase and 25-OH vitamin D estimation.

RESULTS

Mean 25-OH vitamin D levels of infants (n = 97) were 11.55 ± 7.17 ng/mL at 10 weeks and 16.96 ± 13.33 ng/mL at 6 months (p < 0.001). Mean vitamin D levels of infants in group 1 and group 2 did not differ at recruitment and 6 months (p > 0.05)). Maternal vitamin D levels in group 1 and group 2 were 8.89 ± 5.97 and 9.87 ± 6.44 ng/mL, respectively (p = 0.44). Significant correlation was observed between 25-OH vitamin D of infants and mothers (p < 0.05). At 10 weeks, 55.67% infants, 70% mothers and at 6 months, 44.33% infants had vitamin D < 11 ng/mL. At 6 months, 16.49% infants developed rickets.

CONCLUSIONS

Exclusively breastfed infants and their mothers are Vitamin D deficient, hence the need to improve vitamin D status.