Adipose saturation reduces lipotoxic systemic inflammation and explains the obesity paradox

Obesity sometimes seems protective in disease. This obesity paradox is predominantly described in reports from the Western Hemisphere during acute illnesses. Since adipose triglyceride composition corresponds to long-term dietary patterns, we performed a meta-analysis modeling the effect of obesity on severity of acute pancreatitis, in the context of dietary patterns of the countries from which the studies originated. Increased severity was noted in leaner populations with a higher proportion of unsaturated fat intake. In mice, greater hydrolysis of unsaturated visceral triglyceride caused worse organ failure during pancreatitis, even when the mice were leaner than those having saturated triglyceride. Saturation interfered with triglyceride\u27s interaction and lipolysis by pancreatic triglyceride lipase, which mediates organ failure. Unsaturation increased fatty acid monomers in vivo and aqueous media, resulting in greater lipotoxic cellular responses and organ failure. Therefore, visceral triglyceride saturation reduces the ensuing lipotoxicity despite higher adiposity, thus explaining the obesity paradox

Status of Sialic Acids and Their Role on Pseudomonas Aeruginosa in Host-Pathogen Interaction

“Sialic acids are not only the most interesting molecules in the world, but also the most important”, said by Eric Sixmister set the exhilarating theme of the field of sialoglycobiology and challenges encountered by glycobiologists working with this molecule (Vimr, 1994). Sialic acids (Sias) are nine carbon acidic sugars typically found as the terminal residue of cell surface sugar chains as well as on secreted glycoproteins and in the extracellular matrix (Varki et al.,2009). The monosaccharide sialic acid is metabolically derived from two „primary‟ Sias; Nacetylneuraminic acid and 2-keto-3- deoxynomonic acid. N-acetylneuraminic acid(Neu5Ac) is the most common sialic acid in humans. The molecular structure is shown in Figure 1-1. In other mammals Nglycolylneuraminic acid (Neu5Gc) which is resulted due to hydroxylation of Neu5Ac, is also abundant. The enzyme that mediates the hydroxylation reaction contains a specific mutation in humans, which results in the lack of Neu5Gc in normal healthy individuals

Ringer’s Lactate Prevents Early Organ Failure by Providing Extracellular Calcium

Objective: Ringer’s lactate may improve early systemic inflammation during critical illnesses like severe acute pancreatitis, which are associated with hypocalcemia. Ringer’s lactate is buffered and contains lactate and calcium. We, thus analyzed extracellular calcium or lactate’s effects on the mechanisms, intermediary markers, and organ failure in models mimicking human disease with nonesterified fatty acid (NEFA) elevation. Methods: Meta-analyses and experimental studies were performed. Experimentally, extracellular calcium and lactate were compared in their interaction with linoleic acid (LA; a NEFA increased in human severe pancreatitis), and its subsequent effects on mitochondrial depolarization and cytosolic calcium signaling resulting in cell injury. In vivo, the effect of LA was studied on organ failure, along with the effect of calcium or lactate (pH 7.4) on severe acute pancreatitis-associated organ failure. A meta-analysis of human randomized control trials comparing Ringer’s lactate to normal saline was done, focusing on necrosis and organ failure. Results: Calcium reacted ionically with LA and reduced lipotoxic necrosis. In vivo, LA induced organ failure and hypocalcemia. During severe pancreatitis, calcium supplementation in saline pH 7.4, unlike lactate, prevented hypocalcemia, increased NEFA saponification, reduced circulating NEFA and C-reactive protein, reduced pancreatic necrosis adjacent to fat necrosis, and normalized shock (carotid pulse distension) and blood urea nitrogen elevation on day 1. This, however, did not prevent the later increase in serum NEFA which caused delayed organ failure. Meta-analysis showed Ringer’s lactate reduced necrosis, but not organ failure, compared with normal saline. Conclusion: Hypocalcemia occurs due to excess NEFA binding calcium during a critical illness. Ringer’s lactate’s early benefits in systemic inflammation are by the calcium it provides reacting ionically with NEFA. This, however, does not prevent later organ failure from sustained NEFA generation. Future studies comparing calcium supplemented saline resuscitation to Ringer’s lactate may provide insights to this pathophysiology

Sialoglycoproteins adsorbed by Pseudomonas aeruginosa facilitate their survival by impeding neutrophil extracellular trap through siglec-9

PA is an opportunistic pathogen that is commonly associated with severe infection in immunocompromised hosts. Siglec-9 binds with Sias by cis interaction on the neutrophil surface, thereby reducing immunological activity. However, neutrophils bind with pathogens through trans interactions of siglec-9 with Sias. Neutrophils kill invading pathogens by NETs, along with extracellular phagocytosis. Here, we report the mode of the adsorption of Sias by PA from host serum, the interaction of PA+Sias with human neutrophils, and the resulting neutrophil immunological activity. The α2-3-linked sialoglycoproteins adsorbed by PA exhibited potent binding with the soluble siglec-9-Fc chimeras, CHO-siglec-9 and siglec-9 on neutrophils. The binding between PA+Sias and neutrophils was blocked by the synthetic sialoglycan Neu5Acα2-3Galβ1-4GlcNAc, confirming the linkage-specific, Sias-siglec-9 interaction. The PA+Sias and siglec-9 interaction on neutrophils reduced the level of ROS and the release of elastase, resulting in a reduction of NETs formation, demonstrating the role of the sialoglycoproteins adsorbed by PA in the weakening of neutrophil activity. The resistance of PA+Sias to NETs was made evident by the increased survival of PA+Sias. Moreover, the decrease in PA-Sias survival demonstrated the involvement of NETs formation in the absence of the Sias-Nsiglec-9 interaction. N-actylcysteine or sivelestat-pretreated neutrophils enhanced the survival of PA-Sias. DNAse-pretreated neutrophils did not exhibit any NETs formation, resulting in the enhanced escape of PA-Sias. Taken together, one of the survival mechanisms of PA+Sias is the diminution of innate immunity via its adsorption of sialoglycoproteins by its engagement of the inhibitory molecule siglec-9. This is possibly a general mechanism for pathogens that cannot synthesize Sias to subvert immunity

Music for Special Kids: Musical Activities, Songs, Instruments and Resources

Plasmonic fluorescence enhancement is used to study fluorescence correlation spectroscopy (FCS) at higher concentrations than in regular diffraction-limited FCS experiments. Previous studies suffered from sticking to the substrate and were performed mainly with poorly emitting dyes. A lipid bilayer forms a passivating surface, preventing sticking of the dye or the protein, and allows for specific anchoring of probe molecules. For dyes with high quantum yields, the fluorescence background of unenhanced molecules is high, and the fluorescence enhancement is weak, less than about 10. Nonetheless, we show that FCS is possible at micromolar concentrations of the probe molecule. Enhanced FCS is recorded by selecting signals on the basis of their shortened lifetime. This selection enhances the contrast of the correlation by more than an order of magnitude. The lipid bilayer can be used to anchor biomolecules and perform enhanced FCS, as we show for a dye-labeled protein

Chemokines in ICU Delirium: An Exploratory Study

OBJECTIVES:. The pathophysiology of delirium is complex and incompletely understood. Inflammation is hypothesized to be integral to its development due to effects on blood brain barrier integrity, facilitation of leukocyte extravasation into brain parenchyma, and propagation of neuroinflammation. Septic shock is the prototypical condition associated with ICU delirium; however, the relative contribution of resultant hypotension and systemic inflammation to the development of delirium is unknown. DESIGN:. This was a prospective exploratory study. SETTING:. A multidisciplinary ICU at an academic medical center in Phoenix, AZ. PATIENTS:. Critically ill patients older than or equal to 18 years old admitted to the ICU. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. Screening for delirium was performed using the Confusion Assessment Method for the ICU tool. The levels of C-C motif ligand 2 (CCL2), C-C motif ligand 3, C-X-C motif chemokine ligand 1, C-X-C motif chemokine ligand 10, and interleukin-8 were measured in serum samples obtained within 12 hours of ICU admission. Univariate and multivariate analyses were performed to assess the association of delirium with patient data pertaining to hospital course, laboratory values, vital signs, medication administration, and levels of the aforementioned chemokines. Forty-one of 119 patients (34.5%) in the study cohort developed ICU delirium. Each chemokine studied was associated with delirium on univariate analyses; however, CCL2 was the only chemokine found to be independently associated with the development of delirium on multivariable analysis. The association of increased CCL2 levels with delirium remained robust in various models controlling for age, presence of shock, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation IV score, mean arterial pressure at presentation, lowest mean arterial pressure, and total opioid, midazolam, propofol, and dexmedetomidine exposure. CONCLUSIONS:. The demonstrated relationship between CCL2 and delirium suggests this chemokine may play a role in the development of delirium and warrants further investigation