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Biomedical subjects

C Grunfeld

Publications and source records attributed to C Grunfeld.

At least 73 records · Page 4Linked to original sources

Soluble (1-->3)-beta-D-glucan purified from Candida albicans: biologic effects and distribution in blood and organs in rabbits.

(1-->3)-beta-D-glucan is a ubiquitous constituent of fungi, and elevated plasma glucan levels are commonly present in patients with deep mycosis or fungemia. The pharmacokinetics, biologic effects, and distribution in blood and organs of iodine 125-labeled (1--> 3)-beta-D-glucan purified from Candida albicans organisms were analyzed in rabbits during the 24-hour period after intravenous administration of this constituent. The intravascular half-life of beta-glucan was 1.8 minutes in the low-dose group (9.3 micrograms/kg, n = 3) and 1.4 minutes in the high-dose group (222 micrograms/kg, n = 3), and the total body clearance was 1.12 +/- 0.30 ml/min and 1.17 +/- 0.16 ml/min (mean +/- SD), respectively (not significantly different). The serum concentration of (1-->3)-beta-D-glucan was also biologically determined by a test using coagulation factor G of the Japanese horse-shoe crab (G test). There was good correlation between the clearance of beta-glucan measured biologically and isotopically. During the 24-hour period of observation the rabbits remained well and beta-glucan failed to alter blood cell counts, tumor necrosis factor levels, or lipid metabolism. 125I-labeled beta-glucan associated with the blood cellular compartment initially was less than 3% (the majority in the platelets) and decreased further during the following 2-hour period. Over 97% of circulating 125I-labeled beta-glucan was associated with the cell-free plasma, and the majority of this glucan in plasma appeared not to be associated with lipoproteins. The liver contained more than 80% of the 125I-labeled beta-glucan detected in the six major organs analyzed.

Animals↗

Barrier disruption stimulates interleukin-1 alpha expression and release from a pre-formed pool in murine epidermis.

Previous studies have shown that barrier disruption increases epidermal mRNA levels of interleukin-1 alpha (IL-1 alpha). We used immunohistochemistry to examine IL-1 alpha expression in hairless mouse skin under basal conditions and following barrier abrogation. In untreated mice, IL-1 alpha was present in the dermis and nucleated epidermal layers in a diffuse, generalized pattern. In essential fatty acid deficient mice IL-1 alpha was present in all epidermal layers and the dermis, with prominent staining in the stratum corneum. After acute barrier disruption with tape-stripping, IL-1 alpha increased in the epidermis and dermis within 10 min, remained elevated at 2 and 4 h, and decreased to near basal levels by 24 h. Moreover, intense, perinuclear, basal cell staining appeared at 10 min, persisting until 4 h after barrier disruption. Since the increase in IL-1 alpha immunostaining after acute barrier abrogation precedes the increase in mRNA, we hypothesized that the IL-1 alpha might derive from a pre-formed pool. Prolonged occlusion of normal skin, a treatment that specifically reduces epidermal mRNA levels of IL-1 alpha, decreased basal immunostaining for IL-1 alpha and blunted the increase in IL-1 alpha usually seen following barrier disruption. Moreover, tape-stripping of skin, maintained ex vivo at 4 degrees C, resulted in increased IL-1 alpha immunostaining within the upper nucleated epidermal layers, as well as release of mature IL-1 alpha into the medium, as measured by Western blotting and enzyme-linked immunosorbent assay. In addition, the stratum corneum attached to the tape contained IL-1 alpha. These studies show that acute barrier disruption induces both the immediate release and dispersion of IL-1 alpha from a pre-formed, epidermal pool, as well as increased IL-1 alpha synthesis; both mechanisms are consistent with a role for IL-1 alpha in the regulation of proinflammatory and homeostatic processes in the skin.

Animals↗

LIF and CNTF, which share the gp130 transduction system, stimulate hepatic lipid metabolism in rats.

We determined the effects of leukemia inhibitory factor (LIF) and ciliary neurotrophic factor (CNTF) on lipid metabolism in intact rats. Administration of LIF and CNTF increased serum triglycerides in a dose-dependent manner with peak values at 2 h. The effects of LIF and CNTF on serum cholesterol were very small, and serum glucose was unaffected. Both LIF and CNTF stimulated hepatic triglyceride secretion, hepatic de novo fatty acid synthesis, and lipolysis. Pretreatment with phenylisopropyl adenosine, which inhibits lipolysis, partially inhibited LIF- and CNTF-induced hypertriglyceridemia. Interleukin-4, which inhibits cytokine-induced hepatic fatty acid synthesis, also partially inhibited LIF- and CNTF-induced hypertriglyceridemia. These results indicate that both lipolysis and de novo fatty acid synthesis play a role in providing fatty acids for the increase in hepatic triglyceride secretion. Neither indomethacin nor adrenergic receptor antagonists affected the hypertriglyceridemia. The combination of LIF plus CNTF showed no additive effects consistent with the action of both cytokines through the gp130 transduction system. Thus LIF and CNTF have similar effects on lipid metabolism; they join a growing list of cytokines that stimulate hepatic triglyceride secretion and may mediate the changes in lipid metabolism that accompany the acute phase response.

Animals↗

Endocrine and metabolic disturbances in human immunodeficiency virus infection and the acquired immune deficiency syndrome.

Numerous alterations in endocrine function are observed in HIV infection. Direct destruction of endocrine organs by HIV itself or by invasive infection with opportunistic organisms resulting in loss of function is rare. When acutely ill, HIV patients can develop the metabolic derangements that accompany any severe systemic disorder. Studies of thyroid function tests emphasize that the presence of acute secondary infection must be analyzed when evaluating such patients. In addition to euthyroid sick syndrome other hormonal axes are affected by severe illness. These alterations may be cytokine mediated. As with seronegative patients, these changes can be transient and resolve with successful treatment of the intervening illness. Given the complexity of HIV disease, future reports should characterize patients by CD4 cell count, history of AIDS-indicating illnesses, and viral load. Viral burden is an independent predictor of immunosuppression and progression to AIDS. A large number of medications used in the treatment of HIV infection and related illnesses can alter endocrine function, mineral and electrolyte balance, and substrate turnover. Drug therapy must be considered in the evaluation of endocrine abnormalities in HIV-infected patients and carefully characterized in studies of these patients. The endocrine effects of medications used in the treatment of HIV infection are summarized in Table 3. Concomitant factors that affect endocrine function independent of the HIV virus can confound results in these patients. For example, opiate use affects PRL, gonadotropins, and cortisol response to ACTH stimulation. Investigations in HIV-infected patients must include careful descriptions of the study population and comparison to relevant controls. HIV-infected patients may also demonstrate more subtle alterations in endocrinological function in early, relatively asymptomatic, stages. The etiology and clinical significance of these changes, particularly their relationship to cytokines, continues to be investigated. The sequential studies of stable aldosterone levels despite decreased aldosterone response to ACTH stimulation indicate that alterations in response to provocative testing do not predict the development of hormonal insufficiency in this patient population. Similar longitudinal studies need to be done for the other hormonal axes to further delineate the endocrinological alterations in HIV infection. Finally, when the rationale for hormone replacement is debatable, double-blind, placebo-controlled studies are necessary. Transient improvement in clinical status during open-label treatment does not prove hormone insufficiency. The long-term efficacy and safety of hormonal therapy must be demonstrated.

Acquired Immunodeficiency Syndrome↗

Serum leptin levels in the acquired immunodeficiency syndrome.

Leptin, a hormone that is secreted by adipose tissue in proportion to fat stores, regulates energy balance and appetite. Recently, tumor necrosis factor and interleukin-1, cytokines that regulate the host response to infection, have been shown to acutely increase leptin levels, raising the possibility that leptin could mediate the anorexia of some infections. We measured leptin levels in patients with the acquired immunodeficiency syndrome and found that leptin levels were not increased relative to body fat in patients who were anorectic, were losing weight, or had a history of weight loss. Furthermore, leptin levels were not increased during secondary infection, suggesting that elevations in leptin do not play a key role in the anorexia of infections associated with acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗

Endotoxin, TNF, and IL-1 decrease cholesterol 7 alpha-hydroxylase mRNA levels and activity.

Endotoxin (LPS) and cytokines increase cholesterol synthesis and the secretion of lipoproteins by the liver in rodents resulting in hypercholesterolemia. Cholesterol 7 alpha-hydroxylase (CAH) is the rate-limiting enzyme in the conversion of cholesterol to bile acids in the liver, the major regulated pathway by which cholesterol is eliminated from the body. Decreases in CAH would increase the quantity of cholesterol available for lipoprotein production. In the present study, we demonstrate that LPS, TNF, or IL-1 administration to Syrian hamsters produces a marked decrease in the levels of CAH mRNA in the liver. This marked decrease occurred even when the basal level of CAH expression was increased by feeding the bile acid sequestrant, colestipol. Additionally, a marked decrease was also observed when the animals were fed a cholesterol-enriched diet. Moreover, the decrease in CAH mRNA occurred very rapidly (decreased 66% by 90 min after LPS administration) and required relatively small doses of LPS (100 ng/100 g body weight). Lastly, the decrease in mRNA levels was accompanied by a decrease in CAH activity. This decrease in CAH could contribute to the increase in hepatic lipoprotein production induced by LPS and cytokines. CAH can be added to the growing list of proteins that regulate lipid metabolism and that are altered during the acute phase response.

Animals↗

Triglyceride-rich lipoproteins prevent septic death in rats.

Triglyceride-rich lipoproteins bind and inactive bacterial endotoxin in vitro and prevent death when given before a lethal dose of endotoxin in animals. However, lipoproteins have not yet been demonstrated to improve survival in polymicrobial gram-negative sepsis. We therefore tested the ability of triglyceride-rich lipoproteins to prevent death after cecal ligation and puncture (CLP) in rats. Animals were given bolus infusions of either chylomicrons (1 g triglyceride/kg per 4 h) or an equal volume of saline for 28 h after CLP. Chylomicron infusions significantly improved survival (measured at 96 h) compared with saline controls (80 vs 27%, P < or = 0.03). Chylomicron infusions also reduced serum levels of endotoxin, measured 90 min (26 +/- 3 vs 136 +/- 51 pg/ml, mean +/- SEM, P < or = 0.03) and 6 h (121 +/- 54 vs 1,026 +/- 459 pg/ml, P < or = 0.05) after CLP. The reduction in serum endotoxin correlated with a reduction in serum tumor necrosis factor, measured 6 h after CLP (0 +/- 0 vs 58 +/- 24 pg/ml, P < or = 0.03), suggesting that chylomicrons improve survival in this model by limiting macrophage exposure to endotoxin and thereby reducing secretion of inflammatory cytokines. Infusions of a synthetic triglyceride-rich lipid emulsion (Intralipid; KabiVitrum, Inc., Alameda, CA) (1 g triglyceride/kg) also significantly improved survival compared with saline controls (71 vs 27%, P < or = 0.03). These data demonstrate that triglyceride-rich lipoproteins can protect animals from lethal polymicrobial gram-negative sepsis.

Animals↗

Triglyceride-rich lipoproteins improve survival when given after endotoxin in rats.

BACKGROUND: Triglyceride-rich lipoproteins have been shown to bind bacterial endotoxin and inhibit its activity in vitro and to protect animals from death when administered before a lethal injection of endotoxin. We now demonstrate that triglyceride-rich lipoproteins can neutralize the toxic effects of endotoxin already in circulation. METHODS: Rats were infused with a lethal dose of endotoxin, followed at various time intervals by an infusion of either mesenteric lymph containing nascent chylomicrons (1 gm chylomicron triglyceride/kg) or an equal volume of normal saline solution. Survival was measured at 48 hours. The experiment was then repeated, substituting the synthetic triglyceride-rich lipid emulsion (1 gm/kg) for chylomicrons. We also measured the clearance and tissue distribution of radioiodinated endotoxin in rats treated subsequently with chylomicrons or saline solution. RESULTS: Chylomicron infusions significantly improved survival when given up to 30 minutes after a lethal dose of endotoxin (p < 0.05). Chylomicrons accelerated endotoxin clearance from the blood and increased endotoxin uptake by the liver. The synthetic triglyceride-rich lipid emulsion significantly improved survival when given up to 15 minutes after a lethal dose of endotoxin (p < 0.05). CONCLUSIONS: Triglyceride-rich lipoproteins and synthetic triglyceride-rich lipid emulsions significantly improve survival of rats when given after a lethal dose of endotoxin. Lipoprotein treatment accelerates endotoxin clearance to the liver, which may account for the observed protection. These data suggest a possible therapeutic role for triglyceride-rich lipoproteins or synthetic lipid emulsions in the treatment of the endotoxemia of gram-negative sepsis.

Animals↗

Effects of endotoxin on lipid metabolism.

Endotoxin, via cytokines, induces marked changes in lipid metabolism which are now considered part of the acute phase response. The endotoxin induced hyperlipidemia may represent a nonspecific immune response that can decrease the toxicity of a variety of harmful biological and chemical agents and serve to redistribute nutrients to cells important in host defense. The endotoxin induced changes in lipid metabolism may therefore be beneficial.

Animals↗

Cutaneous permeability barrier disruption increases fatty acid synthetic enzyme activity in the epidermis of hairless mice.

Previous studies have shown that abrogation of the cutaneous permeability barrier stimulates epidermal fatty acid synthesis and that this increase is required for barrier repair. The purpose of the present study was to determine the enzymatic basis for this increase in synthesis. Acute barrier disruption by tape stripping increased both acetyl CoA carboxylase (62%) and fatty acid synthase (54%) activities in the epidermis. Similarly, acute disruption of the barrier by topical acetone treatment increased epidermal acetyl CoA carboxylase (69%) and fatty acid synthase (43%) activities. In both acute models, provision of an artificial barrier by occlusion with an impermeable membrane prevented the increase in acetyl CoA carboxylase and fatty acid synthase activities, indicating that the increased activity was dependent on an increase in transepidermal water loss and cannot be attributed to nonspecific effects. In addition, chronic disruption of the barrier, produced by feeding an essential-fatty-acid-deficient diet, also increased acetyl CoA carboxylase (127%) and fatty acid synthase (49%) activities in the epidermis. Again, occlusion with an impermeable membrane decreased both acetyl CoA carboxylase and fatty acid synthase activities toward normal. These results indicate that the increase in fatty acid synthesis that occurs in the epidermis after barrier disruption is due to a coordinate increase in the activities of both epidermal acetyl CoA carboxylase and fatty acid synthase.

Acetyl-CoA Carboxylase↗

Increased lipopolysaccharide-induced tumour necrosis factor levels and death in hypercholesterolaemic rabbits.

Nutritional-induced hypercholesterolaemia in New Zealand rabbits causes increased susceptibility to experimental infections. Rabbits fed cholesterol (0.5 g%) for 8 weeks were injected intravenously with varying doses of Escherichia coli 0127: B8 lipopolysaccharide (LPS; 3-100 micrograms/kg). The levels of cholesterol, triglycerides, tumour necrosis factor (TNF), and the survival rates of treated rabbits were then measured. Rabbits fed either normal chow or chow impregnated with sesame oil were used as controls. LPS induced higher serum TNF levels in hypercholesterolaemic rabbits than in normal rabbits or rabbits fed with chow containing sesame oil. TNF levels rose faster in hypercholesterolaemic rabbits than in normal rabbits, reaching maximum levels at 60 min and 120 min, respectively, after LPS injection. The survival rate of hypercholesterolaemic rabbits (1/11) was lower than in normal rabbits (6/7) or rabbits fed with the sesame oil chow (4/4) at the higher LPS doses. No death occurred at lower doses. One possible interpretation of these results, also supported by neutralization experiments, is that increased TNF secretion in hypercholesterolaemic rabbits raises the host's susceptibility to experimental endotoxaemia and possibly to Gram-negative infection.

Animals↗

Insulin-like growth factor 1 and functional status in healthy older men.

OBJECTIVE: To determine if insulin-like growth factor 1 (IGF-1) is associated with strength and functional ability in healthy older men. DESIGN: Cross-sectional study. SETTING: San Francisco Department of Veterans Affairs Medical Center. PARTICIPANTS: One hundred four ambulatory community-dwelling men. MEASUREMENTS: Serum IGF-1 levels were obtained. Measured variables included strength of the knee flexors and extensors, handgrip, score on the Physical Performance Test, body composition, and three tests of cognitive function. RESULTS: The subjects' mean age was 75.5 +/- 4.9 (SD) years (range 70-94 years), and their mean IGF-1 level was 134.7 +/- 43.6 ng/mL. The univariate association of age with the variables was much stronger than the univariate association of IGF-1 with the same variables. In multivariable models, age, but not IGF-1, was associated with the variables. CONCLUSION: In this study of healthy older men, age is the most important variable in predicting functional decline. There was no association of IGF-1 levels to functional status independent of age.

Activities of Daily Living↗

Role for circulating lipoproteins in protection from endotoxin toxicity.

Previous studies have shown that endotoxin (lipopolysaccharide [LPS])-induced death can be prevented by preincubating LPS with lipoproteins in vitro or by infusing large quantities of lipids into animals prior to LPS administration. In the present study we determined whether physiological levels of lipids also provide protection. Serum lipid levels were decreased by two different mechanisms: administration of 4-aminopyrolo-(3,4-D)pyrimide, which prevents the hepatic secretion of lipoproteins, and administration of pharmacological doses of estradiol, which increases the number of hepatic low-density lipoprotein receptors, leading to increased lipoprotein clearance. In both hypolipidemic models, LPS-induced mortality is markedly increased compared with that of controls with normal serum lipid levels. In both hypolipidemic models, administration of exogenous lipoproteins, which increase levels of serum lipids into the physiological range, reduces the increased mortality to levels similar to that seen in normal animals. In normal lipidemic animals, 63% of 125I-LPS in plasma is associated with lipoproteins, where it would not be capable of stimulating cytokine production. In contrast, in hypolipidemic animals, very little LPS (12 to 17%) is associated with lipoproteins. Rather, more LPS is in the lipoprotein-free plasma compartment, where it could exert biological effects. In both hypolipidemic models, LPS produces a greater increase in serum tumor necrosis factor levels than it does in controls (three- to fivefold increase), and administration of exogenous lipoproteins prevents this increase. Cytokines, in particular tumor necrosis factor, are responsible for most of the toxic effects of LPS. These data provide evidence that physiological levels of serum lipids protect animals from LPS toxicity. Thus, lipoproteins, in addition to playing a role in lipid transport, may have protective functions. Moreover, as part of the immune response, cytokine-induced increases in serum lipid levels may play a role in host defense by decreasing the toxicities of biological and chemical agents.

Adenine↗

Keratinocyte growth factor increases fatty acid mobilization and hepatic triglyceride secretion in rats.

Keratinocyte growth factor (KGF) is a member of the fibroblast growth factor family that was originally identified as a keratinocyte mitogen after isolation from a lung fibroblast cell line. In this study, we demonstrate that administration of KGF to mice and rats elevates serum lipid levels. In rats, 1 h after KGF administration, serum triglyceride and FFA levels were increased, with peak values at 2 h (1.9-fold increase). The increase in serum triglyceride levels was sustained for at least 16 h. Serum cholesterol levels were also increased, but the effect was delayed beginning at 4 h, with peak values at 16 h (1.27-fold increase). KGF did not decrease the clearance of triglyceride-rich lipoproteins, but increased hepatic triglyceride secretion. KGF stimulated lipolysis, but not hepatic de novo fatty acid synthesis, and the increased delivery of FFA to the liver plays a crucial role in the KGF-induced hypertriglyceridemia. Neither alpha- nor beta-adrenergic receptor antagonists affected the hypertriglyceridemia induced by KGF, indicating that endogenous catecholamines are not involved in mediating KGF-induced hypertriglyceridemia. These results demonstrate that KGF induces hypertriglyceridemia by increasing hepatic triglyceride secretion, with the fatty acids provided by lipolysis making a major contribution. Thus, KGF could modulate lipid metabolism in vivo.

Animals↗

Interleukin-6 stimulates hepatic triglyceride secretion in rats.

Interleukin-6 (IL-6) not only regulates a variety of immune functions, but also is the most potent cytokine in inducing the hepatic acute phase proteins. We determined the effect of IL-6 on serum lipid levels and the mechanism of IL-6-induced hypertriglyceridemia in rats. Intravenous administration of IL-6 (0.1-10 micrograms/200 g BW) increased serum triglyceride levels in a dose-dependent manner. One hour after IL-6 administration, serum triglyceride levels were increased, with peak values at 2 h (2.2-fold increase). Serum cholesterol levels also increased, but the effect was delayed, first occurring at 4 h and peaking at 8 h (1.24-fold increase). IL-6 treatment increased hepatic triglyceride secretion without decreasing the clearance of triglyceride-rich lipoproteins, indicating that the hypertriglyceridemia was due to increased secretion by the liver. Furthermore, IL-6 stimulates lipolysis, and the increased delivery of FFA to the liver significantly contributed to the IL-6-induced hypertriglyceridemia. Neither alpha 1- nor beta-adrenergic receptor antagonists affected the hypertriglyceridemia induced by IL-6, whereas previous studies have shown that endotoxin-induced hypertriglyceridemia was blocked by alpha-adrenergic receptor antagonists. These results demonstrate that IL-6 induces hypertriglyceridemia by stimulating hepatic triglyceride secretion independent of endogenous catecholamines. Thus, changes in hepatic triglyceride metabolism are another acute phase response that can be induced by IL-6.

Animals↗

Endotoxin induces parathyroid hormone-related protein gene expression in splenic stromal and smooth muscle cells, not in splenic lymphocytes.

PTH-related protein (PTHrP), the peptide that is responsible for most cases of hypercalcemia of malignancy, is also produced under normal circumstances by a variety of tissues. Its role and regulation at these sites are not well understood. Recently, we have shown that PTHrP is induced in the spleen during the host response to endotoxin (LPS) and that tumor necrosis factor (TNF) is a major mediator of this effect. Given the large body of in vitro evidence suggesting that PTHrP can be produced by lymphocytes and act in an autocrine loop to alter their function, studies were undertaken to determine whether lymphocytes were the cells responsible for PTHrP production in the spleen. Both constitutive and LPS-induced PTHrP messenger RNA (mRNA) levels were the same in mice lacking mature T cells (nude mice) and in mice lacking natural killer (NK) cells (due to pretreatment with antibody against NK 1.1) compared to levels in normal mice, suggesting that neither mature T cells nor NK cells were the splenic source of PTHrP. Even scid mice that lack functioning T and B cells responded to TNF with the induction of splenic PTHrP mRNA levels comparable to those in control mice. Localization of PTHrP mRNA in subfractions of rat spleens after in vivo treatment with LPS confirmed the results of the murine studies; PTHrP mRNA was barely detectable in the lymphocyte-rich single cell fraction of the spleen. In contrast, the stromal fraction of the spleen was enriched with PTHrP mRNA both in the basal state and in response to LPS. A similar pattern of distribution was seen for interleukin-6; LPS only increased mRNA levels of this TNF-inducible cytokine in the splenic stroma. In addition, mRNA for the PTH/PTHrP receptor, which decreased in response to LPS, colocalized with PTHrP mRNA in the stromal fraction of the spleen. Immunohistochemical studies identified PTHrP in two populations of splenic cells: 1) smooth muscle cells located in the splenic capsule and trabeculae and 2) a subpopulation of stromal cells located in the red pulp of the spleen, primarily in a subcapsular distribution. Consistent with the localization of PTHrP mRNA, lymphocytes in the white pulp of the spleen did not stain for PTHrP.

Animals↗