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Biomedical subjects

D P Muller

Publications and source records attributed to D P Muller.

At least 19 recordsLinked to original sources

New synthesis of (+/-)-alpha-CMBHC and its confirmation as a metabolite of alpha-tocopherol (vitamin E).

There is currently interest in the metabolism of the various compounds which make up the vitamin E family, especially with regards to the possible use of vitamin E metabolites as markers of oxidative stress and adequate vitamin E supply. A number of vitamin E metabolites have been described to date and we have recently developed a method to extract and quantitate a range of vitamin E metabolites in human urine. During the development of this method a new metabolite of alpha-tocopherol was identified, which we tentatively characterised as 5-(6-hydroxy-2,5,7,8-tetramethyl-chroman-2-yl)-2-methyl-pentanoic acid (alpha-CMBHC).(1) Here we describe the synthesis of alpha-CMBHC as a standard and confirm that it is a metabolite of alpha-tocopherol.

Chromatography, Gas↗

Oxidative stress and erythrocyte damage in Kenyan children with severe Plasmodium falciparum malaria.

Anaemia causes significant morbidity in children with Plasmodium falciparum malaria, but the mechanism(s) are unclear. During malarial infection, increased reactive oxygen species (ROS) are generated that may contribute to erythrocyte damage and anaemia. This study measured the concentrations of alpha-tocopherol in plasma and erythrocyte membranes, and the percentage polyunsaturated fatty acid composition (%PUFA) (an indirect marker of ROS damage) in erythrocyte membranes in children with severe P. falciparum malaria from Kilifi, Kenya, and asymptomatic children from the same district. Malarial subjects were stratified into complicated malaria and malaria anaemia. Results demonstrated significant reductions in erythrocyte membrane alpha-tocopherol concentration (1.63 +/- 0.16 versus 3.38 +/- 0.18 micromol/mg protein; P < 0.001) and total %PUFA (30.7 +/- 0.49 versus 32.8 +/- 0.44% P < 0.005) for the malarial subjects (non-stratified) compared with controls. Malarial subjects showed a significant positive correlation between membrane alpha-tocopherol and haemoglobin concentrations (P < 0.005 r = 0.63 complicated malaria group; P < 0.05 r = 0.36 non-stratified data). There were no significant differences in plasma alpha-tocopherol concentration between malaria patients and controls. In conclusion, malarial infection may be associated with oxidative damage and reduced alpha-tocopherol reserve in the erythrocyte membrane, suggesting that local antioxidant depletion may contribute to erythrocyte loss in severe malaria. Erythrocyte membrane alpha-tocopherol appeared a better indicator of ROS exposure than plasma.

Acute Disease↗

A new method for the analysis of urinary vitamin E metabolites and the tentative identification of a novel group of compounds.

There is currently interest in measuring urinary metabolites of vitamin E. It has been suggested that alpha-to-copheronolactone (alphaTL), with an oxidized chroman ring, may be an indicator of in vivo oxidative stress and 2,5,7,8-tetramethyl-2(2'-carboxyethyl)-6-hydroxychroman (alpha-CEHC), with a shortened side chain but intact hydroxychroman ring, may provide a measure of adequate or excess vitamin E status. To date, methods in the literature have tended to concentrate on the estimation of single metabolites. We describe the establishment and validation of a relatively simple and reproducible method to extract and quantitate a range of vitamin E metabolites using 0.5 ml of human urine. The vitamin E metabolites were extracted from urine using solid phase extraction cartridges, deconjugated enzymatically, and analyzed using gas chromatography-mass spectrometry. Using this method we have identified alphaTL and the CEHC metabolites derived from alpha-, delta-, and gamma-tocopherol. In addition we have tentatively identified a novel group of vitamin E metabolites, which are related to the CEHCs but have three extra carbons in the side chain. The possibility of the artifactual oxidation of alpha-CEHC to alphaTL during the assay procedure is also discussed.

Animals↗

Effect of intravenous lipid emulsions on hepatic cholesterol metabolism.

BACKGROUND: Total parenteral nutrition offers the chance of survival to children who have had extensive gut resections or gut failure. However, in infants it is often associated with serious complications including cholestatic liver disease. The causes of these complications remain unclear, although it has been suggested that the lipid emulsions used in total parenteral nutrition may be responsible. METHODS: An in vitro system was developed to study the effect of lipid emulsions on hepatic cholesterol metabolism using cultured hepatocytes. RESULTS: Incubations of Hep G2 cells with medium containing Intralipid (Pharmacia and Upjohn, Milton Keynes, UK) demonstrated that the fat emulsion mediated a powerful dose-dependent but reversible inhibition of cholesterol uptake. In addition Intralipid was shown to stimulate the efflux of cholesterol from Hep G2 cells. The component or components of the Intralipid responsible for these effects and the mechanism by which they act remain to be established. CONCLUSIONS: Intravenous lipid emulsions may interfere with hepatic cholesterol metabolism in vivo. This may have implications for the development of total parenteral nutrition-associated cholestasis in neonates.

Carcinoma, Hepatocellular↗

Lipid peroxidation can be reduced in infants on total parenteral nutrition by promoting fat utilisation.

BACKGROUND/PURPOSE: Increased oxygen-derived free radical activity has been reported during total parenteral nutrition (TPN) in infants and has been specifically linked to the fat infusion. The aim of this study was to test the hypothesis that during TPN, oxygen-derived free radical production can be reduced by increasing the utilisation of fat. METHODS: In experiment A (17 patients) the fat infusion was kept constant (3 g/kg/d) and the carbohydrate infusion was changed from 18 g/kg/d on day 1 to 10 g/kg/d on day 2. In experiment B (six patients) the carbohydrate infusion remained constant and the fat infusion was changed from 3 g/kg/d on day 1 to 0 g/kg/d on day 2. Fat utilisation was measured by indirect calorimetry. Plasma malondialdehyde, an index of lipid peroxidation resulting from increased oxygen-derived free radical activity, was measured by a colorimetric assay. RESULTS: In both experiments there was no significant change between the two study phases in oxygen consumption, carbon dioxide production, and resting energy expenditure demonstrating that the patients were metabolically stable. In experiment A there was a significant (P = .0005) increase in fat utilisation and a significant (P = .009) decrease in malondialdehyde (MDA) concentration between the two phases. In experiment B there was also a significant (P = .007) decrease in MDA concentration. The decrease in MDA concentration was similar between the two experiments. CONCLUSIONS: It is not necessary to stop the infusion of fat to reduce free radical production. Promoting fat utilisation by reducing the carbohydrate-fat ratio of the TPN reduces free radical activity to a similar extent as fat exclusion. These findings have important implications for the composition of TPN.

Calorimetry, Indirect↗

Free radical formation in infants: the effect of critical illness, parenteral nutrition, and enteral feeding.

BACKGROUND/PURPOSE: An increase in free radical activity has been observed in patients suffering from a variety of illnesses and has been correlated with disease severity. Free radical production is increased by the administration of total parenteral nutrition (TPN) and may be linked to its adverse effects. Some of the complications of TPN can be ameliorated by partial enteral feeding. The aim of this study was to investigate free radical activity during critical illness and during the administration of parenteral nutrition. METHODS: Three groups of surgical infants were studied: (1) control infants (n = 8) before minor surgery, (2) stable infants on the ward recovering from a major operation (n = 24), (3) critically ill infants in the neonatal intensive care unit (NICU, n = 28). Fourteen patients in the ward and 17 patients in NICU were receiving parenteral nutrition. Of the 31 patients on TPN, 9 were also receiving minimal enteral feeding (3% to 24% of total calorie intake). Plasma malondialdehyde (MDA), an index of free radical activity, was measured in all 60 infants. The Paediatric Risk of Mortality (PRISM) score was obtained on NICU patients. The cytokines tumor necrosis factor (TNF-alpha) and interleukin 6 (IL-6) were measured in 25 patients. RESULTS: Plasma MDA was significantly higher in (1) the stable patients on the ward compared with control patients (P < .001) and (2) patients in NICU compared with stable patients in the ward (P < .001). Parenteral nutrition was associated with higher levels of plasma MDA both in stable patients in the ward and critically ill infants in NICU. There was no correlation between the PRISM score and MDA. In patients not receiving TPN there is a correlation between MDA and TNF-alpha (r = 0.54, P = .02) and between MDA and IL-6 (r = 0.74, P = .001). The level of free radical activity in patients on TPN is not changed by partial enteral feeding. CONCLUSIONS: Critical illness causes a rise in free radical production. Parenteral nutrition causes a significant elevation in free radical activity in both stable infants in the ward and critically ill infants in NICU. The addition of minimal enteral feeding to parenteral nutrition does not reduce free radical activity. We hypothesize that the parenteral nutrition solution directly initiates free radical production.

Analysis of Variance↗

Comparison of the effects of four anaesthetic agents on somatosensory evoked potentials in the rat.

Electrophysiological techniques provide an objective and non-invasive measure of neurological function. In order to undertake detailed evoked potential studies in rats on repeated occasions, it is necessary to find an appropriate anaesthetic agent which has minimal and reproducible effects on the parameters to be studied and also has a minimal effect on the general welfare of the animals. In this study we compared the effects of four common anaesthetic agents (ketamine-xylazine, medetomidine, isoflurane and fentanyl/fluanisone-midazolam) on somatosensory evoked potentials (SEPs) in rats following electrical stimulation of the fore- and hind-paw. Fentanyl/fluanisone-midazolam was found to be well tolerated by the animals and to have, in general, the least deleterious effect on SEPs. For example, the response recorded at the level of the somatosensory cortex (P1), following forelimb stimulation, appeared on average 1.80 ms earlier with fentanyl/fluanisone-midazolam than with the other agents and the peak-to-peak amplitude (CI to CII) of the response recorded at the cervical (C3) level was on average 5.86 microV greater with fentanyl/fluanisone-midazolam. Fentanyl/fluanisone-midazolam is, therefore, recommended as the anaesthetic of choice for longitudinal studies of SEPs in the rat.

Anesthesia↗

Retinal abnormalities in experimental vitamin E deficiency.

Physiological and biochemical studies have been carried out longitudinally over a period of 12 months in vitamin E deficient and control rats to gain an understanding of the mechanism whereby vitamin E conserves normal retinal function. Electroretinographic studies indicated that the primary effect of vitamin E deficiency was on the photoreceptors. Ultrastructural studies, however, did not show any morphological changes to the photoreceptors which could explain receptor dysfunction. A 30-40% loss of vitamin A (retinol) was found to be associated with vitamin E deficiency. This could be corrected by repletion with vitamin E, but there was no associated improvement in visual function. An irreversible loss of the long-chain polyunsaturated fatty acids from the retina, increased lipid peroxidation and alterations in membrane fluidity were also detected during vitamin E deficiency. We suggest that a deficiency of vitamin E leads to changes in the membrane microenvironment, which could affect photo transduction by either impairing the ability of rhodopsin to undergo conformational changes to the active form, or by disrupting the hyperpolarising and depolarising processes of the photoreceptors.

Animals↗

Familial lipoprotein lipase (LPL) deficiency: a catalogue of LPL gene mutations identified in 20 patients from the UK, Sweden, and Italy.

The aim of this study was to identify mutations in the lipoprotein lipase (LPL) gene in 20 unrelated patients with familial lipoprotein deficiency (FLLD) and to investigate the genotype/phenotype relationship. The previously reported G188E mutation (Monsalve et al., J Clin Invest 86:728-734, 1990) was screened for and found to be present in seven individuals (12/40 alleles). In addition, three patients were heterozygous for the 2.0 kb insertion (Langlois et al., Proc Nalt Acad Sci US 86:948-952, 1989). Two approaches were taken for new mutation detection; single-strand conformation polymorphism and sequencing to identify micro-mutations in the proximal promoter and exons 1-9 of the LPL gene and Southern blotting to identify gross mutations. Ten different point mutations were found (W86G, A158T, H183Q, G188E, S193R, P207L, L252X, N291S, M301T, L303P). Additionally, a two nucleotide deletion in exon 6 (delta1006-1007), a six nucleotide deletion in exon 8 (delta1441-1447), and a silent substitution in the wobble position of codon E118 were identified. In vitro mutagenesis and expression in COS-B cells suggested that the A158T and S193R substitutions virtually abolished enzyme activity. In analysing the genotype/phenotype relationship, there was no strong association between age at diagnosis, severity of symptoms, lipid levels, and the nature/position of the mutation. Triglyceride levels, however, were higher in compound heterozygotes compared to true homozygotes, possibly reflecting increased instability of heterodimers. Overall, 29 of 40 (72.5%) mutant alleles were identified. Failure to identify the mutation in 11 alleles might reflect the inadequacy of the method or the possibility that mutations lie within regions of the gene not screened in the study because of lack of availability of sequence.

Adult↗

Lipid peroxidation in neural tissues and fractions from vitamin E-deficient rats.

A severe and chronic deficiency of vitamin E results in a characteristic neurological syndrome in both man and experimental animals. This is presumed to result from increased oxidative stress arising from a reduction in antioxidant capacity. In this study we have examined parameters of endogenous lipid peroxidation and susceptibility to in vitro oxidative stress of neural tissues and fractions, and some non-neural tissues from 1-year-old vitamin E-deficient and control rats. We have shown: (1) an increase in endogenous lipid peroxidation (thiobarbituric acid reactive substances and malondialdehyde) in neural tissues from vitamin E-deficient animals compared to controls. (2) The following order of susceptibility of neural tissues to in vitro oxidative stress in both vitamin E-deficient and control animals: brain >> muscle > cord > nerve. (3) The susceptibility of different brain regions to in vitro oxidative stress varied in a consistent manner with the cortex, striatum, and cerebellum showing the greatest and brainstem and hypothalamus the least susceptibility. (4) Fractions isolated from myelinated nerves of brainstem showed the following order of susceptibility to in vitro oxidative stress: axoplasmic membranes and organelles > axolemma enriched fraction > whole homogenate > = myelin. These results would fit with the characteristic neuropathology associated with severe and chronic vitamin E deficiency.

Animals↗

Serotonin metabolism and release in frontal cortex of rats on a vitamin E-deficient diet.

Rats were fed a control or vitamin E (all-rac-alpha-tocopheryl acetate)-deficient diet for 3 or 12 weeks. Serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), tryptophan, and alpha-tocopherol concentrations were determined in the frontal cortex using HPLC, alpha-Tocopherol concentrations fell significantly to 27% of control values at 12 weeks. Tissue 5-HT, 5-HIAA, and tryptophan concentrations were not significantly altered by the vitamin E-deficient diet at either time point. In vivo microdialysis revealed normal basal and K(+)-stimulated concentrations of 5-HT and 5-HIAA, but extracellular concentrations of tryptophan were significantly decreased after 3 weeks on the vitamin E-deficient diet, which resulted in an increase in the tissue/extracellular ratio and suggested a change in compartmentation. However, after 12 weeks on the deficient diet these values had returned to normal. Results in general indicate that a prolonged and substantial depletion of brain vitamin E can occur without major disturbance of serotonergic function.

Animals↗

Effects of dietary polyunsaturated fatty acids on small intestinal secretory and absorptive function: studies in rat jejunum in vitro.

1. Recent initiatives which advocate an increase in dietary polyunsaturated fat intake have led to the study of the effects of this upon gastrointestinal function. 2. Weanling rats were for 21 weeks fed diets containing 10% fat that were either high or low in polyunsaturated fats. Jejunal function was studied in vitro in an Ussing chamber. 3. Basal intestinal short-circuit was similar in both groups. 4. A decreased EC50 for the non-neural electrogenic secretory responses to acetylcholine, bethanecol and isobutylmethylxanthine was apparent in the jejuna of rats fed a diet high in polyunsaturated fatty acids. 5. Submaximal electrogenic galactose absorption was increased in the rats fed a diet high in polyunsaturated fatty acids. 6. Changing the composition of dietary lipid resulted in a change in the fatty composition of the apical enterocyte membrane. 7. Diets high in polyunsaturated fatty acids may be both prosecretory and proabsorptive in the small intestine.

1-Methyl-3-isobutylxanthine↗

Response to drugs and diet in a compound heterozygote for familial hypercholesterolaemia.

A boy with a total plasma cholesterol concentration of 20.9 mmol/l which fell significantly with a low fat diet, cholestyramine and simvastatin, was shown to have two different mutations in the low density lipoprotein receptor gene, demonstrating that some patients with homozygous familial hypercholesterolaemia show a good lipid lowering response to treatment.

Base Sequence↗

Nigral dopaminergic cell loss in vitamin E deficient rats.

alpha-Tocopherol concentrations in brain were reduced to 3% of control levels in rats fed a vitamin E deficient diet for 52 weeks. Vitamin E deficiency resulted in a 19-33% loss of tyrosine hydroxylase (TH) immunopositive neurones in the substantia nigra, but not in the adjacent ventral tegmental area, compared with controls. Vitamin E deficiency, however, did not reduce striatal dopamine concentrations or turnover. When antioxidant defence mechanisms are defective, as in chronic vitamin E deficiency, the nigrostriatal pathway may be affected by oxidative damage and this may have implications for Parkinson's disease.

Animals↗

Nigrostriatal function in vitamin E deficiency: clinical, experimental, and positron emission tomographic studies.

Four patients with vitamin E deficiency and sensory ataxia were studied using [18F]dopa positron emission tomography. The 2 most disabled patients, who had severe and prolonged vitamin E deficiency due to abetalipoproteinemia, showed reduced [18F]dopa uptake in both putamen and caudate. Putaminal uptake was in a similar range to that seen in Parkinson's disease. Studies of [3H]mazindol binding in the striatum of vitamin E--deficient rats indicated a reduced number of dopamine terminals, which was most severe in ventrolateral striatum. These observations suggest that severe and prolonged vitamin E deficiency results in loss of nigrostriatal nerve terminals, and support the hypothesis that oxidative stress may contribute to the etiology of Parkinson's disease.

Adult↗

Lipid peroxidation and electrogenic ion transport in the jejunum of the vitamin E deficient rat.

Increased concentrations of reactive oxygen species in children with depleted antioxidant defences have been implicated in a cycle of malnutrition, malabsorption, and infection leading to protracted diarrhoea. A rat model of chronic vitamin E deficiency has been used to study the effects of antioxidant depletion on jejunal structure and function in vitro. Basal intestinal short circuit current (Isc), a measure of net electrogenic ion movement across the intestinal epithelium, was greater in chronically vitamin E deficient jejuna than controls, as was the electrogenic secretory response to aminophylline and Escherichia coli STa but not to bethanechol. The galactose stimulated current was also greater in vitamin E deficient jejuna. Indices of lipid peroxidation (concentrations of thiobarbituric acid reactive substances and malondialdehyde) were increased in the vitamin E deficient small bowel. Small intestinal brush border membranes from vitamin E deficient animals displayed changes in both static and dynamic components of membrane fluidity measured by steady state fluorescence polarography. The results of these studies support the hypothesis that oxidative stress in subjects with compromised antioxidant defences results in small intestinal hypersecretion, which could predispose to or perpetuate protracted diarrhoea.

Animals↗

Modulation of small-intestinal secretion and absorption in chronic vitamin E deficiency: studies in rat jejunum in vitro.

1. A vicious cycle of malabsorption and malnutrition has been implicated in the pathogenesis of protracted diarrhoeal disease in infancy. Vitamin E deficiency is common in malnourished infants with protracted diarrhoea. We have studied the effects of chronic vitamin E deficiency on small-intestinal secretion and absorption in the rat. 2. Weanling rats were fed vitamin E-sufficient or -deficient diets for 21 weeks. Jejunal function was studied in vitro in an Ussing chamber after this period. 3. Steady-state isotopic flux experiments in unstimulated tissues demonstrated net Na+ and Cl- secretion in vitamin E-deficient jejuna but net Na+ and Cl- absorption in vitamin E-sufficient jejuna. 4. Basal intestinal short-circuit current was the same in both groups. 5. Cyclic nucleotide and maximal non-neuronal acetylcholine-mediated electrogenic secretion were increased in vitamin E-deficient jejuna. 6. Exogenous 5-hydroxytryptamine (serotonin) induced a smaller increment in electrogenic secretion in vitamin E-deficient jejuna. 7. Vitamin E-deficient jejuna were less responsive to exogenous noradrenaline, resulting in a smaller alpha 2-adrenergic-mediated decrease in intestinal short-circuit current. 8. Fasting for 72h produced a greater increment in intestinal short-circuit current in vitamin E-deficient jejuna. 9. Chronic vitamin E deficiency is prosecretory in the small intestine and may predispose to the perpetuation of protracted diarrhoeal diseases.

Absorption↗