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Unsaturated fatty acids enhance low density lipoprotein uptake and degradation by peripheral blood mononuclear cells.

The precise mechanism by which unsaturated fatty acids lower low density lipoprotein cholesterol is not known. Because cis-unsaturated fatty acids incorporated in cell membranes increase membrane fluidity and can thereby dramatically alter membrane-dependent cellular functions, we examined the effect of linoleate and oleate incorporation in peripheral blood mononuclear cell membranes on the physical properties of the membrane and concomitantly on low density lipoprotein uptake and degradation. We found that membrane enrichment with linoleate increased the rate of low density lipoprotein degradation in both freshly isolated and derepressed mononuclear cells. Enrichment with oleate led to similar increases in degradation. "Specific" low density lipoprotein uptake by derepressed cells was also enhanced by linoleate and oleate incorporation. Enrichment with both of these fatty acids produced an increase in membrane fluidity, as indicated by a reduction in the steady-state fluorescence polarization of 1,6-diphenyl-1,3,5-hexatriene incorporated in the membrane. In contrast, stearate enrichment had little effect on uptake or degradation of low density lipoprotein, nor did it affect membrane fluidity. These data point to a novel mechanism for the reduction in low density lipoprotein produced by unsaturated fatty acids that involves their physical effects on cell membranes as it relates to metabolism of the lipoprotein.

Cell Membrane↗

Saturated free fatty acids and apoptosis in microvascular mesangial cells: palmitate activates pro-apoptotic signaling involving caspase 9 and mitochondrial release of endonuclease G.

BACKGROUND: In type 2 diabetes, free fatty acids (FFA) accumulate in microvascular cells, but the phenotypic consequences of FFA accumulation in the microvasculature are incompletely understood. Here we investigated whether saturated FFA induce apoptosis in human microvascular mesangial cells and analyzed the signaling pathways involved. METHODS: Saturated and unsaturated FFA-albumin complexes were added to cultured human mesangial cells, after which the number of apoptotic cells were quantified and the signal transduction pathways involved were delineated. RESULTS: The saturated FFA palmitate and stearate were apoptotic unlike equivalent concentrations of the unsaturated FFA oleate and linoleate. Palmitate-induced apoptosis was potentiated by etomoxir, an inhibitor of mitochondrial beta-oxidation, but was prevented by an activator of AMP-kinase, which increases fatty acid beta-oxidation. Palmitate stimulated an intrinsic pathway of pro-apoptotic signaling as evidenced by increased mitochondrial release of cytochrome-c and activation of caspase 9. A caspase 9-selective inhibitor blocked caspase 3 activation but incompletely blocked apoptosis in response to palmitate, suggesting an additional caspase 9-independent pathway. Palmitate stimulated mitochondrial release of endonuclease G by a caspase 9-independent mechanism, thereby implicating endonuclease G in caspase 9-independent regulation of apoptosis by saturated FFA. We also observed that the unsaturated FFA oleate and linoleate prevented palmitate-induced mitochondrial release of both cytochrome-c and endonuclease G, which resulted in complete protection from palmitate-induced apoptosis. CONCLUSIONS: Taken together, these results demonstrate that palmitate stimulates apoptosis by evoking an intrinsic pathway of proapoptotic signaling and identify mitochondrial release of endonuclease G as a key step in proapoptotic signaling by saturated FFA and in the anti-apoptotic actions of unsaturated FFA.

Apoptosis↗

Saturated fatty acids synergize with elevated glucose to cause pancreatic beta-cell death.

We have proposed the "glucolipotoxicity" hypothesis in which elevated free fatty acids (FFAs) together with hyperglycemia are synergistic in causing islet beta-cell damage because high glucose inhibits fat oxidation and consequently lipid detoxification. The effects of 1-2 d culture of both rat INS 832/13 cells and human islet beta-cells were investigated in medium containing glucose (5, 11, 20 mM) in the presence or absence of various FFAs. A marked synergistic effect of elevated concentrations of glucose and saturated FFA (palmitate and stearate) on inducing beta-cell death by apoptosis was found in both INS 832/13 and human islet beta-cells. In comparison, linoleate (polyunsaturated) synergized only modestly with high glucose, whereas oleate (monounsaturated) was not toxic. Treating cells with the acyl-coenzyme A synthase inhibitor triacsin C, or the AMP kinase activators metformin and 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside that redirect lipid partitioning to oxidation, curtailed glucolipotoxicity. In contrast, the fat oxidation inhibitor etomoxir, like glucose, markedly enhanced palmitate-induced cell death. The data indicate that FFAs must be metabolized to long chain fatty acyl-CoA to exert toxicity, the effect of which can be reduced by activating fatty acid oxidation. The results support the glucolipotoxicity hypothesis of beta-cell failure proposing that elevated FFAs are particularly toxic in the context of hyperglycemia.

Aminoimidazole Carboxamide↗

Fatty acid-induced insulin resistance in adipocytes.

Elevated serum-free fatty acid (FFA) levels induce insulin resistance in whole animals and humans. To understand the direct mechanism by which FFAs impact insulin-responsive tissue, we have used our previously developed in vitro model of long-chain saturated fatty acids (LCSFA)-induced insulin resistance in adipocytes. In addition to explanted rat adipocytes, we now demonstrate that overnight exposure of 3T3-L1 adipocytes to 1 mM individually of the LCSFA palmitate, myristate, and stearate, leads to an approximately 50% inhibition of insulin-induced glucose transport. Insulin resistance can be accomplished at 0.3 mM palmitate, which is within the range ofpalmitate found in diabetic and obese individuals. This inhibition was noted within 4 h of exposure to FFA, which is comparable to in vivo lipid infusion studies. Initial LCSFA-induced resistance is specific to glucose transport and does not affect insulin stimulation of glucose incorporation into glycogen. In 3T3-L1 adipocytes overexpressing the EGF receptor, LCSFA exposure also specifically inhibited EGF-induced GLUT4-mediated glucose transport, but not EGF-induced glycogen synthesis. We find that LCSFA treatment did not impair insulin stimulation of GLUT4 translocation or exofacial presentation on the cell surface as determined by trypsin accessibility. Our results suggest that the initial direct effect of elevated LCSFA is to impair activation of GLUT4 transporter activity and that this effect is specific for glucose transport.

Adipocytes↗

Transdermal delivery of paracetamol for paediatric use: effects of vehicle formulations on the percutaneous penetration.

Paracetamol is a safe and effective analgesic and antipyretic agent, and is one of the most widely used medications for infants and children. The formulations currently available have been designed for oral and rectal administration. However, they are not practical in young patients with vomiting and diarrhoea, or in those who refuse to take the full dose. An alternative route of administration would be a significant contribution to the paediatric pharmacopoeia. The aim of this study was to develop a new transdermal system for optional therapeutic administration of paracetamol in infants and children. In-vivo studies were carried out in animals using a transdermal system of high-loaded, soluble paracetamol in a hydrogel patch, which was also tested in-vitro for 8 h. Although the beneficial contribution of glyceryl oleate to the transdermal penetration of paracetamol seemed to be significant in-vitro, it was shown to be insufficient in-vivo. To improve the penetration of the drug, 4% PEG-40 stearate and 10% ethanol were incorporated as absorption enhancers into the dermal patches. A few hours after application of the improved patches to rats, plasma drug concentrations were elevated to levels comparable with those obtained after oral and subcutaneous administration of a high dose of paracetamol. Since plasma drug concentrations did not reach a constant steady state (as a peak or plateau) during the short-term animal experiments, longer pharmacokinetic studies in conscious animals are necessary.

Acetaminophen↗

Physically cross-linked chitosan hydrogels as topical vehicles for hydrophilic drugs.

Physically cross-linked chitosan hydrogels with lauric, myristic, palmitic or stearic acid were prepared by freeze-drying and have been studied for topical use. This study selected propranolol hydrochloride as a hydrophilic model drug to design a transdermal delivery system. We evaluated the effect of the nature of the cross-linker on drug permeation through porcine skin and the main permeation parameters (diffusion coefficient, flux and lag time) were calculated. All the chitosan hydrogels analysed provided more transcutaneous permeation of propranolol hydrochloride than the corresponding solution of the commercial drug. Among the different chitosan vehicles, chitosan-laurate and chitosan-myristate hydrogels enhanced lyophilised drug diffusion through the skin with respect to chitosan-palmitate and chitosan-stearate hydrogels. This can been explained by the interaction of the hydrogels with the stratum corneum, increasing the solubility of the drug in the skin.

Administration, Cutaneous↗

Chemical imaging of wood-polypropylene composites.

Recent investigations of wood plastic composites have revealed a detrimental effect of using lubricant systems in production. This includes nullifying part or all of the mechanical benefit of using a polar compatibilizer, maleic anhydride polypropylene (MAPP), in the composite formulation. This investigation utilizes lubricants labeled with deuterium in conjunction with Fourier transform infrared (FT-IR) spectroscopy to allow for the separation of individual lubricants from all other material constituents. All of the deuterium labeled lubricants, used without MAPP, revealed their expulsion from the wood interface during crystallization. MAPP coupling agent was found to exist near the wood, but it is unclear if any covalent bonding with the hydroxyl functionality on the wood surface occurred. The addition of zinc stearate lubricants appears to nullify the activity of the anhydride functionality near the wood surface as evidenced by a shift in the FT-IR spectra to the hydrolyzed form of the coupling agent. Most of the additives collect at the edges of the spherulites in mostly amorphous regions of the material. The consequence of this morphology may be a weak interface between crystallites.

Deuterium↗

Fatty acid ethyl esters in hair as markers of alcohol consumption. Segmental hair analysis of alcoholics, social drinkers, and teetotalers.

BACKGROUND: Fatty acid ethyl esters (FAEEs) are products of nonoxidative ethanol metabolism. After incorporation in hair, they should be suitable long-term markers of alcohol abuse. METHODS: Hair samples from 19 alcoholics in a treatment program, 10 fatalities with verified excessive alcohol consumption, 13 moderate social drinkers who consumed up to 20 g ethanol/day, and 5 strict teetotalers were analyzed in 1-12 segments for four FAEEs (ethyl myristate, ethyl palmitate, ethyl oleate, and ethyl stearate) by external degreasing with n-heptane, extraction with a dimethyl sulfoxide-n-heptane mixture, headspace solid-phase microextraction of the extracts, and gas chromatography-mass spectrometry with deuterated internal standards. The n-heptane washings were analyzed in the same way for FAEEs from the hair surface. RESULTS: The sum of the four ester concentrations in hair calculated for the proximal 0-6 cm segment was 2.5-13.5 ng/mg (mean, 6.8 ng/mg) for the fatalities, 0.92-11.6 ng/mg (mean, 4.0 ng/mg) for 17 of the alcoholics in treatment, 0.20-0.85 ng/mg (mean, 0.41 ng/mg) for the moderate social drinkers, and 0.06-0.37 ng/mg (mean, 0.16 ng/mg) for the teetotalers. In almost all cases the segmental concentrations increased from proximal to distal. There was no agreement between the self-reported drinking histories of the participants and the FAEE concentrations along the hair length. Ethyl oleate was the dominant ester in all samples. CONCLUSIONS: FAEEs are deposited in hair mainly from sebum. Despite large individual differences, FAEE hair concentrations can be used as markers for excessive alcohol consumption with relatively high accuracy.

Alcohol Drinking↗

Investigation of some materials as dry binders for direct compression in tablet manufacture. Part 5: Effects of lubricants and flow conditions.

The effect of talc, magnesium stearate, stearic acid, and Acrawax C, which are commonly used as lubricants, on the dry-binding efficiency of tragacanth, polyethylene glycol 4000, polyvinylpyrrolidone, and mannitol were investigated. The effect of Aerosil which is sometimes utilized as a flow conditioner for directly compressible powder blends was also studied. The type and concentration of lubricant or flow conditioner appeared to influence the binding efficiency of the binders investigated to various degrees. The results showed that the bonding characteristics of all the binders tested except mannitol were reduced by the addition of the lubricants and the flow conditioner.

Chemistry, Pharmaceutical↗

Studies on the topical action of 10-undecen-1-il thiopseudourea iodide (AHR-1911) in acute and chronic dermatitis.

As a follow-up of a preliminary trial, the therapeutic results obtained in 40 cases of acute and chronic dermatitis by the topical application of 10-undecen-1-yl-pseudothiourea hydroiodide (AHR-1911) in an evanescent vehicle containing triethanolamine stearate are presented. The treatment led to complete remission in 14/40 and to favorable results in 18/40 cases. In 2 out of 3 cases of infantile atopic dermatitis improvement was followed by relapse. The responsiveness to AHR-1911 of patients with delayed hypersensitivity, which requires steroids for treatment, is considered of clinical importance. The prompt action of the drug in acute dermatitis, such as is produced by insect-bites, appeared to be impressive. None of the total of 50 cases treated by the author with this new preparation showed any manifestation of intolerance or reaction to the drug.

Acute Disease↗

[Intra operative embolization of unresectable cerebral arterio-venous malformations. Occlusion attempt by means of a delayed polymerization mixture. Report of two cases (author's transl)].

Two cases of unresectable intra-cranial arterio-venous malformation (AVM) are reported, treated by direct intra-operative embolization. A 50% mixture of Butyl-2-Cyano-Acrylate and Mono-Iodo-Stearate of Ethyle (Duroliopaque) was used after catheterization of some of the feeding cortical arteries. No intra-operative angiography was performed. The first patient, admitted after subarachnoid hemorrhage and presenting with a mild transient right hemiparesia and aphasia, showed evidence of a left temporal AVM with a left middle cerebral artery supply and contribution from the left cerebral posterior artery. The AVM was embolized with 3 cc of the mixture. A mild aphasia occurred after surgery and completely recovered after two weeks. Roughly half of the AVM was occluded on the postoperative angiograms. The second patient suffering from a long history of seizures had a huge right frontal AVM, with a right middle cerebral artery and right anterior cerebral artery supply, and contribution from a right lenticulostriate artery, the left anterior cerebral artery and the right posterior cerebral artery. The AVM was embolized with 7 cc of the mixture. A complete palsy of the left upper limb occurred after surgery, with complete recovery after two weeks. On the post-operative angiograms, more than three fourth of the AVM was occluded.

Adult↗

Modulation of polymorphonuclear leukocyte locomotion by synthetic amphiphiles.

The effect of synthetic amphiphiles, poly(ethyleneglycol) 6000 (PEG) esterified with saturated fatty acids (C2-C18), on the locomotion of polymorphonuclear leucocytes (PMNL) has been investigated. It was noticed that PEG-myristate (M-PEG; C14) stimulated the random locomotion of PMNL populations in concentrations up to about 1 g/l. By contrast, the esters with shorter aliphatic chains had negligible effects and those with longer chains, PEG-palmitate (P-PEG; C16) and PEG-stearate (S-PEG; C18) reduced the locomotion, irrespectively of concentration. The ability of the PMNL to be stimulated by an attractant liberated from normal human serum was slightly impaired with M-PEG, but not with P-PEG. The response to M-PEG of individual PMNL was heterogeneous in that some cells were stimulated and others were inhibited, but the average result was a reduction of the motility. This indicates that methods used for the study of the locomotion of cell populations do not always reproduce the true behaviour of the whole population, but rather of a selected subpopulation. It was also concluded that the different effects of M-PEG and P-PEG were probably not due to phagocytosis or selective binding of either substance, but rather due to dissimilar effects on the membrane structure of the PMNL, since (i) M-PEG perturbated the PMNL membrane more than P-PEG, as assayed by the release of superoxide anion (O2-) although the binding was smaller, and (ii) M-PEG and P-PEG increased and decreased the membrane fluidity, respectively, as measured with fluorescence bleaching and recovery after bleaching of labeled PMNL. The results indicate a subtle coupling between membrane structure and PMNL locomotion.

Cell Membrane↗

[Preparation of patients in diagnostic contrast radiography of the urinary and bile tracts and the large intestine].

A preparation schedule including, for clysterisation, a substance based on palmitate, stearate and oleate of sodium of vegetable origin has been experimented in 130 patients of both sexes (70 awaiting contrastography of the urinary and bile ways, and 60 double contrastography of the colon). Excellent results were obtained in urography and colangiocholecystography when the schedule was limited to just one clyster with double dose of Radioced carried out on the same morning as the investigation. For an examination like double contrast clyster, which is more demanding from the viewpoint of correct intestinal cleansing, the number of clysters has to be increased to four. Three, at appropriate intervals, are carried out on the day preceding examination, and the last no more than two hours prior to the clyster. In all four, a double dose of Radioced dissolved in warm water (two litres for each of the first three and a litre and a half for the fourth) is used. Still on double contrast clyster, the preparation schedule requires a three-day diet (the first two involving low-waste foods and the third a liquid diet only) plus 30 g of Epsom salts (and no less than a litre of water) the day before double contrastography.

Cholangiography↗

Role of calcium ion in Schistosoma mansoni cercarial tail loss induced by unsaturated fatty acids.

Linoleate (C18: 2) and oleate (C18: 1), but not stearate (C18: 0), induced tail removal in cercariae. Linoleate stimulated tail loss more strongly than oleate did. Tail loss induced by linoleate was significantly suppressed by incubating cercariae with ethyleneglycol-bis-(beta-aminoethyl ether) N,N,N',N'-tetraacetic acid (EGTA). Preincubation of cercariae with EGTA for 5 min caused further inhibition of the tail loss. Calcium ionophore A23187 (A23187) increased the cercarial tail-loss rate. When A23187 was combined with linoleate at 0.03 mM, an additive effect on tail loss appeared, whereas the ionophore in combination with linoleate at 0.3 mM had no such effect. EGTA almost completely abolished cercarial tail loss induced by linoleate at both 0.03 and 0.3 mM in the presence and absence of A23187. Linoleate at 3 mM provoked cercarial tail loss even in the presence of EGTA, although the effect of oleate at 3 mM disappeared. Under these conditions, the effect of linoleate was synergistically enhanced by the combination with A23187. A similar, but not significant, synergism took place in cercariae stimulated by oleate. These findings suggest that unsaturated fatty acids enhance calcium influx into cercariae, resulting in triggering tail loss, and, furthermore, that the fatty acids have other potentiating effects on cercarial tail loss. Protein kinases play an insignificant role in fatty acid-induced cercarial tail loss, because a protein kinase C inhibitor, 1-(5-isoquinolinylsulfonyl)-2-methylpiperazine (H-7), and an inhibitor of various protein kinases, staurosporine, had little or no effect on cercarial tail loss induced by linoleate at 3 mM.

Animals↗

Population-based drug-induced agranulocytosis.

BACKGROUND: Since the publication of a major international case-control study on the risk of agranulocytosis associated with the use of medicines in the 1980s, many new drugs have been introduced in therapeutics. METHODS: Seventeen units of hematology contribute to the case-control surveillance of agranulocytosis and aplastic anemia in Barcelona, Spain. After a follow-up of 78.73 million person-years, 177 community cases of agranulocytosis were compared with 586 sex-, age, and hospital-matched control subjects with regard to previous use of medicines. RESULTS: The annual incidence of community-acquired agranulocytosis was 3.46:1 million, and it increased with age. The fatality rate was 7.0%, and the mortality rate was 0.24:1 million. The drug most strongly associated with a risk of agranulocytosis was ticlopidine hydrochloride with an odds ratio (OR) of 103.23 (95% confidence interval [CI], 12.73-837.44), followed by calcium dobesilate (OR, 77.84 [95% CI, 4.50-1346.20]), antithyroid drugs (OR, 52.75 [95% CI, 5.82-478.03]), dipyrone (metamizole sodium and metamizole magnesium) (OR, 25.76 [95% CI, 8.39-179.12]), and spironolactone (OR, 19.97 [95% CI, 2.27-175.89]). Other drugs associated with a significant risk were pyrithyldione, cinepazide, aprindine hydrochloride, carbamazepine, sulfonamides, phenytoin and phenytoin sodium, beta-lactam antibiotics, erythromycin stearate and erythromycin ethylsuccinate, and diclofenac sodium. Individual attributable incidences for all these drugs, which collectively accounted for 68.6% of cases, were less than 1:1 million per year. CONCLUSIONS: Agranulocytosis is rare but serious. A few drugs account for two thirds of the cases. Our results also provide reassurance regarding the risk associated with a number of newly marketed drugs.

Adolescent↗

Group B streptococcus bacteremia in nonpregnant adults.

BACKGROUND: We report the largest series of group B streptococcal (GBS) bacteremia cases reported at a single institution. METHODS: During a 10-year period (1985-1994), 90 GBS bacteremia cases (0.95% of significant bacteremic episodes) were detected. We describe the 51 episodes that occurred in nonpregnant adults for which enough clinical and microbiological information is available. RESULTS: Incidence of GBS has significantly increased during the study period (from 0.08 per 1000 admissions in 1985 to 0.3 per 1000 in 1994). Mean age of patients was 63.3 years (range, 21-88 years) and 53% were men. The most common underlying conditions were liver diseases (35.3%), malignancies (33.3%), and diabetes mellitus (27.5%). Only 2 patients did not have any underlying condition and no patient with the human immunodeficiency virus had GBS bacteremia in our series. The origins of the episodes of bacteremia were as follows: primary bacteremia (39.2%), skin and soft tissue infections (15.7%), urinary tract infections (11.8%), pneumonia (9.8%), peritonitis (9.8%), catheter infection (5.9%), postendoscopic bacteremia (5.9%), and endocarditis (2%). All isolates were susceptible to penicillin G potassium, ampicillin sodium, cephalothin sodium, cefotaxime sodium, and vancomycin hydrochloride. One ciprofloxacin hydrochloride-resistant strain was discovered and resistance to erythromycin stearate increased from 8% in 1992 to 18% in 1994. The overall mortality rate was 33.3% and deaths were considered related to the GBS bacteremia in 25.5% of the cases. Factors for poor prognosis were central nervous system diseases, alcoholism, shock, renal failure, and consciousness impairment. CONCLUSIONS: Group B streptococcus is a rising cause of bacteremia in elderly patients with severe underlying conditions. It conveys high morbidity and mortality rates. Macrolides should not be used empirically for treatment of patients with penicillin allergies.

Adult↗

Haemophilus species bacteremia in adults. The importance of the human immunodeficiency virus epidemic.

BACKGROUND: Until the late 1970s, invasive infections caused by Haemophilus species were thought to occur mainly in children and only infrequently in adults. OBJECTIVE: To report the largest series to date of Haemophilus species bacteremia (HB) from a single center. DESIGN: Retrospective. SETTING: Large, tertiary care, general teaching hospital. METHODS: We reviewed the charts of adult patients with HB detected from January 1, 1986, to December 31, 1994. Haemophilus strains were serotyped, and the antimicrobial resistance pattern was analyzed. RESULTS: One hundred sixteen patients had HB (0.26 cases per 1000 admissions). Thirty-eight children and 16 adults were excluded. Human immunodeficiency virus (HIV) infection was the most common underlying condition (n = 18 [29%]), followed by malignant neoplasms (n = 12 [19%]) and chronic obstructive pulmonary disease (n = 12 [19%]). Prevalence in HIV-positive patients was 5 cases per 1000 admissions vs 0.2 cases per 1000 admissions in HIV-negative patients. Infection was nosocomial in 16 patients (26%). Focal diseases were pneumonia in 41 patients (66%), cholangitis in 5 patients (8%), endocarditis in 3 patients (5%), meningitis and septic arthritis each in 1 patient (2%), and primary bacteremia in 9 patients (14%). The HIV-positive patients were significantly younger and presented more frequently with pneumonia (P < .05). Overall, 14 patients died (22%). Bacteremia was polymicrobial in 11 patients (18%). Haemophilus influenzae was isolated in 53 patients (85%). Rates of antimicrobial resistance were 11% to chloramphenicol sodium succinate, 48% to ampicillin sodium, 78% to erythromycin stearate, 76% to combined sulfamethoxazole and trimethoprim, 15% to rifampin, and 57% to clarithromycin. CONCLUSIONS: Infection with HIV has become the most common underlying disease in adults with HB in our hospital. Therapeutic approaches must take into account the high rate of antimicrobial resistance.

AIDS-Related Opportunistic Infections↗

Carbamazepine toxicity induced by concurrent erythromycin therapy.

We describe a 41-year-old woman receiving carbamazepine for epilepsy, in whom concurrent erythromycin stearate administration led to carbamazepine toxicity, including inappropriate antidiuretic hormone syndrome. We review the literature on erythromycin-carbamazepine interaction and discuss the mechanism for such interaction.

Adult↗