Oxidative stress precedes skeletal muscle mitochondrial dysfunction during experimental aortic cross-clamping but is not associated with early lung, heart, brain, liver, or kidney mitochondrial impairment

ObjectiveLower limb ischemia-reperfusion results in skeletal muscle mitochondrial alterations, production of reactive oxygen species (ROS), and remote organ impairments that are largely involved in patient prognosis. However, whether ischemia without reperfusion increases ROS production and precedes mitochondrial alteration and whether mitochondrial dysfunction occurs early in remote organs is unknown. This study determined muscle mitochondrial function and ROS production after ischemia alone, or followed by two periods of reperfusion, and investigated heart, lung, liver, kidney, and brain mitochondrial functions after lower limb ischemia-reperfusion.MethodsWistar rats were randomized into four groups: sham (aortic exposure but no ischemia, n = 9), I3 (ischemia alone induced by aortic cross-clamping for 3 hours, n = 9), I3R10′ and I3R2 (aortic cross-clamping, followed by reperfusion for 10 minutes [n = 8] or 2 hours [n = 9]). Blood lactate, alanine aminotransferase, aspartate aminotransferase, and creatinine were measured. Mitochondrial respiratory chain complexes I, II, III, and IV activities and mitochondrial coupling (acceptor control ratio) were analyzed using a Clark oxygen electrode in skeletal muscle, lung, heart, brain, liver, and kidney. ROS production was determined using dihydroethidium staining in muscle, heart, liver, and kidney. Inflammation was also investigated in remote organs (heart, liver, and kidney) using monocyte-macrophage-2 antibody staining.ResultsLactate level increased after ischemia in all groups. In muscle, ROS increased significantly after ischemia alone (+324% ± 66%; P = .038), normalized after 10 minutes of reperfusion, and increased again at 2 hours of reperfusion (+349.2 ± 67%; P = .024). Interestingly, mitochondrial function was unaffected by ischemia alone or followed by 10 minutes of reperfusion, but maximal mitochondrial oxidative capacity (6.10 ± 0.51 vs 4.24 ± 0.36 μmol/min/g, −30%; P < .05) and mitochondrial coupling decreased after 2 hours of reperfusion (1.93 ± 0.17 vs 1.33 ± 0.07, −45%; P < .01), in sham and I3R2 rats, respectively. Despite increased serum aspartate aminotransferase (×13; P < .0001), alanine aminotransferase (×6; P = .0019), and creatinine (×3; P = .0004), remote organs did not show mitochondrial alteration, inflammation, or ROS production enhancement after 2 hours of reperfusion.ConclusionsOxidative stress precedes skeletal muscle mitochondrial dysfunction during lower limb ischemia. Such a kinetic explains the efficacy of ischemic preconditioning and supports that therapy should be conducted even during ongoing ischemia, suggesting that ischemic preconditioning might be a successful approach.Clinical RelevanceAortic cross-clamping increases reactive oxygen species (ROS) and impairs skeletal muscle and remote organs, which is involved in patient prognosis. However, the temporal relationship between ROS production and mitochondrial dysfunction during lower limb ischemia reperfusion is unknown. This study demonstrates for the first time that ROS production occurs during ischemia alone, without reperfusion, and precedes skeletal muscle mitochondrial impairments. Although involved in multiorgan failure, lung, heart, brain, liver, and kidney mitochondria are not affected early. These results support a need for muscle protection even during lower limb ischemia and that ischemic preconditioning (conditioning performed during ongoing ischemia) might be a successful approach

Micelle formation, gelation and phase separation of amphiphilic multiblock copolymers

The phase behaviour of amphiphilic multiblock copolymers with a large number of blocks in semidilute solutions is studied by lattice Monte Carlo simulations. The influence on the resulting structures of the concentration, the solvent quality and the ratio of hydrophobic to hydrophilic monomers in the chains has been assessed explicitely. Several distinct regimes are put in evidence. For poorly substituted (mainly hydrophilic) copolymers formation of micelles is observed, either isolated or connected by the hydrophilic moieties, depending on concentration and chain length. For more highly substituted chains larger tubular hydrophobic structures appear which, at higher concentration, join to form extended hydrophobic cores. For both substitution ratios gelation is observed, but with a very different gel network structure. For the poorly substituted chains the gel consists of micelles cross-linked by hydrophilic blocks whereas for the highly substituted copolymers the extended hydrophobic cores form the gelling network. The interplay between gelation and phase separation clearly appears in the phase diagram. In particular, for poorly substituted copolymers and in a narrow concentration range, we observe a sol-gel transition followed by an inverse gel-sol transition when increasing the interaction energy. The simulation results are discussed in the context of the experimentally observed phase properties of methylcellulose, a hydrophobically substituted polysaccharide.Comment: 14 pages, 14 figures; Soft Matter (2011

In Trauma Patients, the Occurrence of Early-Onset Nosocomial Infections is Associated With Increased Plasma Concentrations of Chromogranin A:

In previously healthy persons suffering from acute illnesses, nosocomial infections (NIs) are frequent. Their prevalence suggests the existence of as yet unknown conditions that may promote care-related infection. This study assessed whether the measurement of plasma chromogranin A, a stress-related protein involved in innate defense, is related to NI risk, and whether any chromogranin A-derived fragment included in vasostatin-I displays immunosuppressive activities related to AP-1 or NF-kappa B downregulation. At the clinical level, trauma patients and healthy controls were recruited to be eligible. Clinical histories were recorded, and standard biological tests (including plasma chromogranin A) were performed. For 9 randomly chosen patients and 16 controls, the time-dependent concentrations of chromogranin A (CGA) were assessed twice a day over 66 h. The data show that trauma patients present a higher value of CGA concentration during 66 h in comparison with healthy controls. In addition, patients maintaining this significant increase in CGA readily develop NIs. We therefore studied the effects of chromogranin A-derived peptides on monocytes, focusing on transcription factors that play a central role in inflammation. In vitro assay demonstrated that a chromogranin A-derived fragment (CGA47-70) displays a significant inhibition of NF-kappa B and AP-1 transcriptional activities in these cells. In conclusion, the occurrence of NI in trauma patients is associated with significantly increased plasma CGA concentrations. Downregulation of the two transcription factors by CGA47-70 might induce early acquired immune defect after a serious medical stress

Lawmakers\u27 Use of Scientific Evidence Can Be Improved

Core to the goal of scientific exploration is the opportunity to guide future decision-making. Yet, elected officials often miss opportunities to use science in their policymaking. This work reports on an experiment with the US Congress-evaluating the effects of a randomized, dual-population (i.e., researchers and congressional offices) outreach model for supporting legislative use of research evidence regarding child and family policy issues. In this experiment, we found that congressional offices randomized to the intervention reported greater value of research for understanding issues than the control group following implementation. More research use was also observed in legislation introduced by the intervention group. Further, we found that researchers randomized to the intervention advanced their own policy knowledge and engagement as well as reported benefits for their research following implementation

Lawmakers' use of scientific evidence can be improved.

Core to the goal of scientific exploration is the opportunity to guide future decision-making. Yet, elected officials often miss opportunities to use science in their policymaking. This work reports on an experiment with the US Congress-evaluating the effects of a randomized, dual-population (i.e., researchers and congressional offices) outreach model for supporting legislative use of research evidence regarding child and family policy issues. In this experiment, we found that congressional offices randomized to the intervention reported greater value of research for understanding issues than the control group following implementation. More research use was also observed in legislation introduced by the intervention group. Further, we found that researchers randomized to the intervention advanced their own policy knowledge and engagement as well as reported benefits for their research following implementation

Local and systemic oxidative stress and mitochondrial dysfunction after skeletal muscle ischemia reperfusion : effect of ischemic preconditioning and pharmacological postconditioning on mitochondrial function

L’ischémie-reperfusion (IR) du muscle squelettique est à l’origine de lésions au niveau local et au niveau systémique. Au niveau musculaire, l’IR est caractérisée par une atteinte de la chaîne respiratoire mitochondriale, une production de ROS et une activation de l’inflammation. Au niveau systémique, ces lésions peuvent aboutir à un tableau de défaillance multiviscérale. La physiopathologie et la chronologie précise de ces évènements demeurent néanmoins imprécises. Enfin, différentes stratégies ont été développées pour limiter ces lésions. Récemment, le dérivé Bβ (15-42) de la fibrine (nommé FX06) et le perconditionnement ont permis de protéger le myocarde des lésions d’IR. Les objectifs de notre travail sont de préciser, au niveau du muscle squelettique, les mécanismes à l’origine de ces lésions et d’évaluer ces deux nouvelles stratégies. Sur un modèle animal d’IR du muscle squelettique, nous avons observé une production de ROS pendant l’ischémie, préalable à l’atteinte mitochondriale et peut-être à l’origine de l’inflammation, et enfin une absence d’atteinte systémique au niveau mitochondrial après 2 heures et 24 heures de reperfusion. En ce qui concerne les traitements étudiés dans ce travail, nous n’avons pas pu démontrer l’efficacité du perconditionnement ischémique. Nous avons pu constater par contre que le peptide FX06 dérivé de la fibrine permet de prévenir l’apparition de ces lésions. Ces nouvelles connaissances vont nous permettre d’élaborer de nouvelles stratégies pour prévenir le développement des lésions d’IR.Lower limb ischemia-reperfusion (IR) results in skeletal muscle mitochondrial alterations, production of reactive oxygen species (ROS), inflammation and remote organ impairments which are largely involved in patients prognosis. However, whether ischemia without reperfusion increases ROS production and preceedes mitochondrial alteration and whether mitochondrial dysfunction occurs early in remote organ is unknown. Remote ischemic perconditioning (PerC) and Fibrin-derived peptide Bβ(15-42) (FX06) prevent during cardiac IR but whether and how PerC and FX06 might protect skeletal muscle is unknown. This study tested whether PerC and FX06 would decrease skeletal muscle inflammation and reduce reactive oxygen species (ROS) production and mitochondrial dysfunction during IR. In an animal lower limb ischemia-reperfusion model, the objectives of our study were therefore to determine simultaneously the kinetic of ROS production, mitochondrial respiration and inflammation changes in skeletal muscle and remote organs during ischemia reperfusion and to challenge the effect of PerC and FX06 on mitochondrial respiratory chain complexes activities, ROS production and inflammation. We observed that oxidative stress preceedes skeletal muscle mitochondrial dysfunction and probably may be seen before inflammation activation. FX06 decreased inflammation, normalized ROS production and restored mitochondrial oxidative capacity during experimental skeletal muscle IR. PerC not only failed to protect ischemic skeletal muscle but impaired contralateral non ischemic suggesting that such therapy should be used with caution. This better knowledge will allow us to develop new strategies to prevent the development of IR lesions

Local and systemic oxidative stress and mitochondrial dysfunction after skeletal muscle ischemia reperfusion : effect of ischemic preconditioning and pharmacological postconditioning on mitochondrial function

L’ischémie-reperfusion (IR) du muscle squelettique est à l’origine de lésions au niveau local et au niveau systémique. Au niveau musculaire, l’IR est caractérisée par une atteinte de la chaîne respiratoire mitochondriale, une production de ROS et une activation de l’inflammation. Au niveau systémique, ces lésions peuvent aboutir à un tableau de défaillance multiviscérale. La physiopathologie et la chronologie précise de ces évènements demeurent néanmoins imprécises. Enfin, différentes stratégies ont été développées pour limiter ces lésions. Récemment, le dérivé Bβ (15-42) de la fibrine (nommé FX06) et le perconditionnement ont permis de protéger le myocarde des lésions d’IR. Les objectifs de notre travail sont de préciser, au niveau du muscle squelettique, les mécanismes à l’origine de ces lésions et d’évaluer ces deux nouvelles stratégies. Sur un modèle animal d’IR du muscle squelettique, nous avons observé une production de ROS pendant l’ischémie, préalable à l’atteinte mitochondriale et peut-être à l’origine de l’inflammation, et enfin une absence d’atteinte systémique au niveau mitochondrial après 2 heures et 24 heures de reperfusion. En ce qui concerne les traitements étudiés dans ce travail, nous n’avons pas pu démontrer l’efficacité du perconditionnement ischémique. Nous avons pu constater par contre que le peptide FX06 dérivé de la fibrine permet de prévenir l’apparition de ces lésions. Ces nouvelles connaissances vont nous permettre d’élaborer de nouvelles stratégies pour prévenir le développement des lésions d’IR.Lower limb ischemia-reperfusion (IR) results in skeletal muscle mitochondrial alterations, production of reactive oxygen species (ROS), inflammation and remote organ impairments which are largely involved in patients prognosis. However, whether ischemia without reperfusion increases ROS production and preceedes mitochondrial alteration and whether mitochondrial dysfunction occurs early in remote organ is unknown. Remote ischemic perconditioning (PerC) and Fibrin-derived peptide Bβ(15-42) (FX06) prevent during cardiac IR but whether and how PerC and FX06 might protect skeletal muscle is unknown. This study tested whether PerC and FX06 would decrease skeletal muscle inflammation and reduce reactive oxygen species (ROS) production and mitochondrial dysfunction during IR. In an animal lower limb ischemia-reperfusion model, the objectives of our study were therefore to determine simultaneously the kinetic of ROS production, mitochondrial respiration and inflammation changes in skeletal muscle and remote organs during ischemia reperfusion and to challenge the effect of PerC and FX06 on mitochondrial respiratory chain complexes activities, ROS production and inflammation. We observed that oxidative stress preceedes skeletal muscle mitochondrial dysfunction and probably may be seen before inflammation activation. FX06 decreased inflammation, normalized ROS production and restored mitochondrial oxidative capacity during experimental skeletal muscle IR. PerC not only failed to protect ischemic skeletal muscle but impaired contralateral non ischemic suggesting that such therapy should be used with caution. This better knowledge will allow us to develop new strategies to prevent the development of IR lesions

Etude des variations de la pression artérielle pulmonaire pulsée comme indice prédictif de la réponse au remplissage vasculaire

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Liver transplantation in critically ill patients: Preoperative predictive factors of post-transplant mortality to avoid futility

International audienceBACKGROUND:The allocation of liver transplants to patients with acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) with multi-organ failure who are admitted in ICU remains controversial due to their high post-transplant mortality rate and the absence of identified mortality risk factors.METHODS:We performed a single-center retrospective cohort study to determine the post-transplant mortality rate of patients with ALF and ACLF requiring ICU care prior to liver transplant (LT) and identified pretransplant factors of post-transplant mortality.RESULTS:Eighty-four patients (29 with ALF and 55 with ACLF) received a liver transplant while they were hospitalized at the ICU. Their mean model for end-stage liver disease (MELD) score was 41, and their mean sequential organ failure assessment (SOFA) was 15 the day before transplant. The overall 1-year survival rate was 66%. In multivariate analysis, pretransplant lactate level and acute respiratory distress syndrome (ARDS) were the only two independent factors associated with post-transplant mortality. The absence of ARDS and a pretransplant lactate level80%).CONCLUSIONS:Low lactatemia lactate level and the absence of ARDS could be useful criteria in selecting those patients in ICU who could be eligible for liver transplant

Muscles Susceptibility to Ischemia-Reperfusion Injuries Depends on Fiber Type Specific Antioxidant Level

Muscle injury resulting from ischemia-reperfusion largely aggravates patient prognosis but whether and how muscle phenotype modulates ischemia-reperfusion-induced mitochondrial dysfunction remains to be investigated. We challenged the hypothesis that glycolytic muscles are more prone to ischemia-reperfusion-induced injury than oxidative skeletal muscles. We therefore determined simultaneously the effect of 3 h of ischemia induced by aortic clamping followed by 2 h of reperfusion (IR,; n; = 11) on both; gastrocnemius; and; soleus; muscles, as compared to control animals (C,; n; = 11). Further, we investigated whether tempol, an antioxidant mimicking superoxide dismutase, might compensate a reduced defense system, likely characterizing glycolytic muscles (IR-Tempol,; n; = 7). In the glycolytic; gastrocnemius; muscle, as compared to control, ischemia-reperfusion significantly decreased mitochondrial respiration (-30.28 ± 6.16%,; p; = 0.003), increased reactive oxygen species production (+79.15 ± 28.72%,; p; = 0.04), and decreased reduced glutathione (-28.19 ± 6.80%,; p; = 0.011). Less deleterious effects were observed in the oxidative; soleus; muscle (-6.44 ± 6.30%, +4.32 ± 16.84%, and -8.07 ± 10.84%, respectively), characterized by enhanced antioxidant defenses (0.63 ± 0.05 in; gastrocnemius vs; . 1.24 ± 0.08 μmol L; -1; g; -1; in; soleus; ). Further, when previously treated with tempol, glycolytic muscle was largely protected against the deleterious effects of ischemia-reperfusion. Thus, oxidative skeletal muscles are more protected than glycolytic ones against ischemia-reperfusion, thanks to their antioxidant pool. Such pivotal data support that susceptibility to ischemia-reperfusion-induced injury differs between organs, depending on their metabolic phenotypes. This suggests a need to adapt therapeutic strategies to the specific antioxidant power of the target organ to be protected