Apo AIV and citrulline plasma concentrations in Short Bowel Syndrome patients: the influence of Short Bowel Anatomy

Introduction Parenteral nutrition (PN) dependence in short bowel syndrome (SBS) patients is linked to the functionality of the remnant small bowel (RSB). Patients may wean off PN following a period of intestinal adaptation that restores this functionality. Currently, plasma citrulline is the standard biomarker for monitoring intestinal functionality and adaptation. However, available studies reveal that the relationship the biomarker with the length and function of the RSB is arguable. Thus, having additional biomarkers would improve pointing out PN weaning. Aim By measuring concomitant changes in citrulline and the novel biomarker apolipoprotein AIV (Apo AIV), as well as taking into account the anatomy of the RSB, this exploratory study aims to a better understanding of the intestinal adaptation process and characterization of the SBS patients under PN. Methods Thirty four adult SBS patients were selected and assigned to adapted (aSBS) and non-adapted (nSBS) groups after reconstructive surgeries. Remaining jejunum and ileum lengths were recorded. The aSBS patients were either on an oral diet (ORAL group), those with intestinal insufficiency, or on oral and home parenteral nutrition (HPN group), those with chronic intestinal failure. Apo AIV and citrulline were analyzed in plasma samples after overnight fasting. An exploratory ROC analysis using citrulline as gold standard was performed. Results Biomarkers, Apo AIV and citrulline showed a significant correlation with RSBL in aSBS patients. In jejuno-ileocolic patients, only Apo AIV correlated with RSBL (rb = 0.54) and with ileum length (rb = 0.84). In patients without ileum neither biomarker showed any correlation with RSBL. ROC analysis indicated the Apo AIV cut-off value to be 4.6 mg /100 mL for differentiating between the aSBS HPN and ORAL groups. Conclusions Therefore, in addition to citrulline, Apo AIV can be set as a biomarker to monitor intestinal adaptation in SBS patients. As short bowel anatomy is shown to influence citrulline and Apo AIV plasma values, both biomarkers complement each other furnishing a new insight to manage PN dependence

Cerium Oxide Nanoparticles Protect against Oxidant Injury and Interfere with Oxidative Mediated Kinase Signaling in Human-Derived Hepatocytes

Cerium oxide nanoparticles (CeO2NPs) possess powerful antioxidant properties, thus emerging as a potential therapeutic tool in non-alcoholic fatty liver disease (NAFLD) progression, which is characterized by a high presence of reactive oxygen species (ROS). The aim of this study was to elucidate whether CeO2NPs can prevent or attenuate oxidant injury in the hepatic human cell line HepG2 and to investigate the mechanisms involved in this phenomenon. The effect of CeO2NPs on cell viability and ROS scavenging was determined, the differential expression of pro-inflammatory and oxidative stress-related genes was analyzed, and a proteomic analysis was performed to assess the impact of CeO2NPs on cell phosphorylation in human hepatic cells under oxidative stress conditions. CeO2NPs did not modify HepG2 cell viability in basal conditions but reduced H2O2- and lipopolysaccharide (LPS)-induced cell death and prevented H2O2-induced overexpression of MPO, PTGS1 and iNOS. Phosphoproteomic analysis showed that CeO2NPs reverted the H2O2-mediated increase in the phosphorylation of peptides related to cellular proliferation, stress response, and gene transcription regulation, and interfered with H2O2 effects on mTOR, MAPK/ERK, CK2A1 and PKACA signaling pathways. In conclusion, CeO2NPs protect HepG2 cells from cell-induced oxidative damage, reducing ROS generation and inflammatory gene expression as well as regulation of kinase-driven cell survival pathways

Bespoken nanoceria: A new effective treatment in experimental hepatocellular carcinoma

Background and aims: Despite the availability of new-generation drugs, hepatocellular carcinoma (HCC) is still the third most frequent cause of cancer-related deaths worldwide. Cerium oxide nanoparticles (CeO2 NPs) have emerged as an antioxidant agent in experimental liver disease because of their antioxidant, anti-inflammatory, and antisteatotic properties. In the present study, we aimed to elucidate the potential of CeO2 NPs as therapeutic agents in HCC. Approach and results: HCC was induced in 110 Wistar rats by intraperitoneal administration of diethylnitrosamine for 16 weeks. Animals were treated with vehicle or CeO2 NPs at weeks 16 and 17. At the eighteenth week, nanoceria biodistribution was assessed by mass spectrometry (MS). The effect of CeO2 NPs on tumor progression and animal survival was investigated. Hepatic tissue MS-based phosphoproteomics as well as analysis of principal lipid components were performed. The intracellular uptake of CeO2 NPs by human ex vivo perfused livers and human hepatocytes was analyzed. Nanoceria was mainly accumulated in the liver, where it reduced macrophage infiltration and inflammatory gene expression. Nanoceria treatment increased liver apoptotic activity, while proliferation was attenuated. Phosphoproteomic analysis revealed that CeO2 NPs affected the phosphorylation of proteins mainly related to cell adhesion and RNA splicing. CeO2 NPs decreased phosphatidylcholine-derived arachidonic acid and reverted the HCC-induced increase of linoleic acid in several lipid components. Furthermore, CeO2 NPs reduced serum alpha-protein levels and improved the survival of HCC rats. Nanoceria uptake by ex vivo perfused human livers and in vitro human hepatocytes was also demonstrated. Conclusions: These data indicate that CeO2 NPs partially revert the cellular mechanisms involved in tumor progression and significantly increase survival in HCC rats, suggesting that they could be effective in patients with HCC. © 2020 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of American Association for the Study of Liver Diseases

Nuevos tratamientos contra la hipertensión portal en la cirrosis hepática experimental: 1. Nanopartículas de óxido de cerio y 2. Agonismo parcial del receptor V1a de la vasopresina

[spa] La cirrosis afecta a un gran número de pacientes en el mundo, de hecho constituye una de las enfermedades más prevalente en los países occidentales. Puede ser definida como el estadio final de la fibrosis hepática, que consiste en la formación de nódulos y en la alteración de la función hepática. La fibrosis hepática se produce como consecuencia de una cicatrización continua en respuesta a un daño crónico en el hígado. En los últimos 20 años ha habido un gran progreso en el conocimiento de los mecanismos moleculares que se dan en la fibrosis hepática y, en particular, en las vías moleculares que conectan la inflamación crónica del hígado con la fibrosis hepática progresiva. Las investigaciones que están en marcha tienen como diana estos mecanismos moleculares, en un esfuerzo para atenuar la respuesta fibrogénica. Sin embargo, actualmente la mejor terapia para las enfermedades crónicas del hígado continúa siendo la eliminación de la causa primaria de la enfermedad. A pesar de ello existen casos donde no es posible o no es suficiente con eliminar el agente etiológico. Es por tanto fundamental identificar nuevas estrategias terapéuticas que permitan detener o revertir la progresión de la enfermedad hepática. Una de las terapias más prometedoras y que ya ha sido evaluada en pacientes con enfermedad hepática crónica, son los compuestos antioxidantes. El estrés oxidativo se produce por medio de un aumento de las especies reactivas del oxígeno y del nitrógeno (ROS, RNS) y/o una disminución de los antioxidantes presentes en el hígado. Las ROS y RNS tienen un rol crucial en la inducción y progresión de la enfermedad hepática, independientemente de su etiología. Las nanopartículas de CeO2 debido a su tamaño, estructura y composición química presentan una gran afinidad por el hígado, y a diferencia de otros compuestos antioxidantes, son auto-regenerativas, de manera que permiten evitar una administración continuada. En este sentido, el primer objetivo de la presente tesis doctoral fue investigar el efecto antioxidante de las nanopartículas de CeO2 en ratas con fibrosis hepática, así como el papel que ejerce esta propiedad terapéutica en la inflamación y en la consecuente hipertensión portal. Por otra parte, las nuevas estrategias no sólo se deben dirigir a prevenir y/o revertir la fibrosis hepática, sino que también es importante atenuar los principales trastornos que aparecen en los pacientes con cirrosis hepática avanzada. Dentro de estos trastornos, la hipertensión portal es un síndrome clínico frecuente en los pacientes con cirrosis y se caracteriza por un incremento en la presión venosa portal. En estos pacientes la hipertensión portal es la principal causa de muerte y de trasplante de hígado. Es por ello que se reducción representa una de las principales dianas terapéuticas para mejorar la prognosis en los pacientes con cirrosis avanzada. Estudios han demostrado que los agonistas del receptor de la vasopresina, gracias a su capacidad de vasoconstricción sistémica y mesentérica, son capaces de reducir la presión portal. En este sentido el segundo estudio de la presente tesis analiza el efecto de una nueva generación de agentes farmacológicos capaces de interactuar selectivamente con el receptor V1a de la vasopresina, en la vasodilatación esplácnica y en la hipertensión portal. Globalmente y según los resultados obtenidos en esta tesis doctoral, se puede concluir que la hipertensión portal puede ser tratada, en función del estadio de la enfermedad hepática, mediante dos novedosas y prometedoras estrategias terapéuticas. Por un lado, las CeO2NPs a través de sus efectos antioxidantes y antiinflamatorios pueden prevenir y/o reducir de forma secundaria la presión portal en animales con fibrosis compensada. Así es como la aplicación de la nanotecnología en el campo de la medicina podría ser una nueva estrategia para tratar en el futuro las enfermedades hepáticas crónicas. Por otra parte, en la cirrosis descompensada hay un aumento de los receptores V1a de la vasopresina a nivel esplácnico. El agonismo parcial de estos receptores permite reducir la hipertensión portal al tener un efecto vasoconstrictor en el mesenterio, movilizando el líquido intravascular hacia la circulación central e incrementando la excreción de sodio y agua.[eng] Chronic liver diseases are characterized by persisting parenchymal injury that can result in chronic activation of inflammatory and wound healing response. Cerium oxide nanoparticles (CeO2NPs) have proven to behave as free radical scavengers and/or anti-inflammatory agents. The aim of the first study was to determine whether CeO2NPs display hepatoprotective properties in experimental chronic liver disease. Most CeO2NPs were located in the liver and it reduced hepatic steatosis, ameliorated systemic inflammatory biomarkers and improved portal pressure without affecting mean arterial pressure. In addition, a marked reduction in mRNA expression of inflammatory cytokines, ET-1 and messengers related to oxidative or endoplasmic reticulum stress signaling pathways was observed in the liver of rats receiving CeO2NPs. This was associated with reduced macrophage infiltration and reduced abundance of caspase-3, a-SMA and inflammatory cytokines. In conclusion, CeO2NPs administration to CCl4-treated rats protects against chronic liver injury by reducing liver steatosis and portal hypertension and markedly attenuating the intensity of the inflammatory response, thereby suggesting that CeO2NPs may be of therapeutic value in chronic liver disease. Patients and rats with advanced cirrhosis have portal hypertension and circulatory dysfunction. Synthetic arginine vasopressin (AVP) receptor agonists able to induce systemic and mesenteric vasoconstriction have shown their usefulness in reducing portal pressure (PP) in this condition. In the second study, we assessed the potential therapeutic value of a new V1a-AVP receptor partial agonist with a preferential splanchnic vasoconstrictor effect (FE-204038) in rats with cirrhosis and ascites. The hemodynamic effects of cumulative intravenous doses of FE-204038, terlipressin, or vehicle were investigated. FE-204038 dose-dependently decreased PP, did not modify mean arterial pressure, and increased SVR. The effect of the V1a-AVP receptor partial agonist on PP was associated with an improvement in urine volume and urinary excretion of sodium during the first day of treatment. SVR was higher and cardiac output and ascites volume were lower in rats with cirrhosis and ascites treated with FE-204038. V1a-AVP receptor expression in rats with cirrhosis and ascites was markedly enhanced in the mesenteric circulation compared to the thoracic aorta. Conclusion: FE-204038 increases sodium excretion and reduces portal hypertension and ascites in experimental cirrhosis. V1a-AVP receptor partial agonism could be a useful pharmacological treatment in decompensated patients with cirrhosis

Sipa1l1 is an early biomarker of liver fibrosis in CCl4-treated rats

At present, several procedures are used for staging liver fibrosis. However, these methods may involve clinical complications and/or present diagnostic uncertainty mainly in the early stages of the disease. Thus, this study was designed to unveil new non-invasive biomarkers of liver fibrosis in an in vivo model of fibrosis/cirrhosis induction by CCl4 inhalation by using a label-free quantitative LC-MS/MS approach. We analyzed 94 serum samples from adult Wistar rats with different degrees of liver fibrosis and 36 control rats. Firstly, serum samples from 18 CCl4-treated rats were clustered into three different groups according to the severity of hepatic and the serum proteome was characterized by label-free LC-MS/MS. Furthermore, three different pooled serum samples obtained from 16 control Wistar rats were also analyzed. Based on the proteomic data obtained, we performed a multivariate analysis which displayed three main cell signaling pathways altered in fibrosis. In cirrhosis, more biological imbalances were detected as well as multi-organ alterations. In addition, hemopexin and signal-induced proliferation-associated 1 like 1 (SIPA1L1) were selected as potential serum markers of liver fibrogenesis among all the analyzed proteins. The results were validated by ELISA in an independent group of 76 fibrotic/cirrhotic rats and 20 controls which confirmed SIPA1L1 as a potential non-invasive biomarker of liver fibrosis. In particular, SIPA1L1 showed a clear diminution in serum samples from fibrotic/cirrhotic rats and a great accuracy at identifying early fibrotic stages. In conclusion, the proteomic analysis of serum samples from CCl4-treated rats has enabled the identification of SIPA1L1 as a non-invasive marker of early liver fibrosis. © 2016. Published by The Company of Biologists Ltd