Institut für Ernährungswissenschaft
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Background
Coronavirus disease (COVID-19) has a severe impact on all aspects of patient care. Among the numerous biomarkers of potential validity for diagnostic and clinical management of COVID-19 are biomarkers at the interface of iron metabolism and inflammation.
Methods
The follow-up study included 54 hospitalized patients with laboratory-confirmed COVID-19 with a moderate and severe/critical form of the disease. Iron deficiency specific biomarkers such as iron, ferritin, transferrin receptor, hepcidin, and zinc protoporphyrin (ZnPP) as well as relevant markers of inflammation were evaluated twice: in the first five days when the patient was admitted to the hospital and during five to 15 days; and their validity to diagnose iron deficiency was further assessed. The regression and Receiver Operating Characteristics (ROC) analyses were performed to evaluate the prognosis and determine the probability for predicting the severity of the disease in the first five days of COVID-19.
Results
Based on hemoglobin values, anemia was observed in 21 of 54 patients. Of all iron deficiency anemia-related markers, only ZnPP was significantly elevated (P<0.001) in the anemic group. When patients were grouped according to the severity of disease, slight differences in hemoglobin or other anemia-related parameters could be observed. However, the levels of ZnPP were significantly increased in the severely ill group of patients. The ratio of ZnPP to lymphocyte count (ZnPP/L) had a discrimination power stronger than the neutrophil to lymphocyte count ratio (N/L) to determine disease severity. Additionally, only two markers were independently associated with the severity of COVID-19 in logistic regression analysis; D-dimer (OR (5.606)(95% CI 1.019–30.867)) and ZnPP/L ratio (OR (74.313) (95% CI 1.081–5108.103)).
Conclusions
For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.
Background
Coronavirus disease (COVID-19) has a severe impact on all aspects of patient care. Among the numerous biomarkers of potential validity for diagnostic and clinical management of COVID-19 are biomarkers at the interface of iron metabolism and inflammation.
Methods
The follow-up study included 54 hospitalized patients with laboratory-confirmed COVID-19 with a moderate and severe/critical form of the disease. Iron deficiency specific biomarkers such as iron, ferritin, transferrin receptor, hepcidin, and zinc protoporphyrin (ZnPP) as well as relevant markers of inflammation were evaluated twice: in the first five days when the patient was admitted to the hospital and during five to 15 days; and their validity to diagnose iron deficiency was further assessed. The regression and Receiver Operating Characteristics (ROC) analyses were performed to evaluate the prognosis and determine the probability for predicting the severity of the disease in the first five days of COVID-19.
Results
Based on hemoglobin values, anemia was observed in 21 of 54 patients. Of all iron deficiency anemia-related markers, only ZnPP was significantly elevated (P<0.001) in the anemic group. When patients were grouped according to the severity of disease, slight differences in hemoglobin or other anemia-related parameters could be observed. However, the levels of ZnPP were significantly increased in the severely ill group of patients. The ratio of ZnPP to lymphocyte count (ZnPP/L) had a discrimination power stronger than the neutrophil to lymphocyte count ratio (N/L) to determine disease severity. Additionally, only two markers were independently associated with the severity of COVID-19 in logistic regression analysis; D-dimer (OR (5.606)(95% CI 1.019–30.867)) and ZnPP/L ratio (OR (74.313) (95% CI 1.081–5108.103)).
Conclusions
For the first time ZnPP in COVID-19 patients were reported in this study. Among all iron-related markers tested, ZnPP was the only one that was associated with anemia as based on hemoglobin. The increase in ZnPP might indicate that the underlying cause of anemia in COVID-19 patients is not only due to the inflammation but also of nutritional origin. Additionally, the ZnPP/L ratio might be a valid prognostic marker for the severity of COVID-19.
Countries processing raw coffee beans are burdened with low economical incomes to fight the serious environmental problems caused by the by-products and wastewater that is generated during the wet-coffee processing. The aim of this work was to develop alternative methods of improving the waste by-product quality and thus making the process economically more attractive with valorization options that can be brought to the coffee producers.
The type of processing influences not only the constitution of green coffee but also of by-products and wastewater. Therefore, coffee bean samples as well as by-products and wastewater collected at different production steps of were analyzed. Results show that the composition of wastewater is dependent on how much and how often the wastewater is recycled in the processing. Considering the coffee beans, results indicate that the proteins might be affected during processing and a positive effect of the fermentation on the solubility and accessibility of proteins seems to be probable. The steps of coffee processing influence the different constituents of green coffee beans which, during roasting, give rise to aroma compounds and express the characteristics of roasted coffee beans. Knowing that this group of compounds is involved in the Maillard reaction during roasting, this possibility could be utilized for the coffee producers to improve the quality of green coffee beans and finally the coffee cup quality.
The valorization of coffee wastes through modification to activated carbon has been considered as a low-cost option creating an adsorbent with prospective to compete with commercial carbons. Activation protocol using spent coffee and parchment was developed and prepared to assess their adsorption capacity for organic compounds. Spent coffee grounds and parchment proved to have similar adsorption efficiency to commercial activated carbon.
The results of this study document a significant information originating from the processing of the de-pulped to green coffee beans. Furthermore, it showed that coffee parchment and spent coffee grounds can be valorized as low-cost option to produce activated carbons. Further work needs to be directed to the optimization of the activation methods to improve the quality of the materials produced and the viability of applying such experiments in-situ to bring the coffee producer further valorization opportunities with environmental perspectives.
Coffee producers would profit in establishing appropriate simple technologies to improve green coffee quality, re-use coffee by-products, and wastewater valorization.
Respiratorische Erkrankungen stellen zunehmend eine relevante globale Problematik dar. Die Erweiterung bzw. Modifizierung von Applikationswegen möglicher Arzneimittel für gezielte topische Anwendungen ist dabei von größter Bedeutung. Die Variation eines bekannten Applikationsweges durch unterschiedliche technologische Umsetzungen kann die Vielfalt der Anwendungsmöglichkeiten, aber auch die Patienten-Compliance erhöhen. Die einfache und flexible Verfahrensweise durch schnelle Verfügbarkeit und eine handliche Technologie sind heutzutage wichtige Eigenschaften im Entwicklungsprozess eines Produktes. Eine direkte topische Behandlung von Atemwegserkrankungen am Wirkort in Form einer inhalativen Applikation bietet dabei viele Vorteile gegenüber einer systemischen Therapie. Die medizinische Inhalation von Wirkstoffen über die Lunge ist jedoch eine komplexe Herausforderung. Inhalatoren gehören zu den erklärungsbedürftigen Applikationsformen, die zur Erhöhung der konsequenten Einhaltung der Verordnung so einfach, wie möglich gestaltet werden müssen. Parallel besitzen und nutzen weltweit annähernd 68 Millionen Menschen die Technologie eines inhalativen Applikators zur bewussten Schädigung ihrer Gesundheit in Form einer elektronischen Zigarette. Diese bekannte Anwendung bietet die potentielle Möglichkeit einer verfügbaren, kostengünstigen und qualitätsgeprüften Gesundheitsmaßnahme zur Kontrolle, Prävention und Heilung von Atemwegserkrankungen. Sie erzeugt ein Aerosol durch elektrothermische Erwärmung eines sogenannten Liquids, das durch Kapillarkräfte eines Trägermaterials an ein Heizelement gelangt und verdampft. Ihr Bekanntheitsgrad zeigt, dass eine beabsichtigte Wirkung in den Atemwegen eintritt. Diese Wirkung könnte jedoch auch auf potentielle pharmazeutische Einsatzgebiete übertragbar sein. Die Vorteile der pulmonalen Verabreichung sind dabei vielfältig. Im Vergleich zur peroralen Applikation gelangt der Wirkstoff gezielt zum Wirkort. Wenn eine systemische Applikation zu Arzneimittelkonzentrationen unterhalb der therapeutischen Wirksamkeit in der Lunge führt, könnte eine inhalative Darreichung bereits bei niedriger Dosierung die gewünschten höheren Konzentrationen am Wirkort hervorrufen. Aufgrund der großen Resorptionsfläche der Lunge sind eine höhere Bioverfügbarkeit und ein schnellerer Wirkungseintritt infolge des fehlenden First-Pass-Effektes möglich. Es kommt ebenfalls zu minimalen systemischen Nebenwirkungen. Die elektronische Zigarette erzeugt wie die medizinischen Inhalatoren lungengängige Partikel. Die atemzuggesteuerte Technik ermöglicht eine unkomplizierte und intuitive Anwendung. Der prinzipielle Aufbau besteht aus einer elektrisch beheizten Wendel und einem Akku. Die Heizwendel ist von einem sogenannten Liquid in einem Tank umgeben und erzeugt das Aerosol. Das Liquid beinhaltet eine Basismischung bestehend aus Propylenglycol, Glycerin und reinem Wasser in unterschiedlichen prozentualen Anteilen. Es besteht die Annahme, dass das Basisliquid auch mit pharmazeutischen Wirkstoffen für die pulmonale Applikation beladen werden kann. Aufgrund der thermischen Belastung durch die e-Zigarette müssen potentielle Wirkstoffe sowie das Vehikel eine thermische Stabilität aufweisen.
Die potentielle medizinische Anwendung der Technologie einer handelsüblichen e-Zigarette wurde anhand von drei Schwerpunkten an vier Wirkstoffen untersucht. Die drei ätherischen Öle Eucalyptusöl, Minzöl und Nelkenöl wurden aufgrund ihrer leichten Flüchtigkeit und der historischen pharmazeutischen Anwendung anhand von Inhalationen bei Erkältungssymptomen bzw. im zahnmedizinischen Bereich gewählt. Das eingesetzte Cannabinoid Cannabidiol (CBD) hat einen aktuellen Bezug zu dem pharmazeutischen Markt Deutschlands zur Legalisierung von cannabishaltigen Produkten und der medizinischen Forschung zum inhalativen Konsum. Es wurden relevante wirkstoffhaltige Flüssigformulierungen entwickelt und hinsichtlich ihrer Verdampfbarkeit zu Aerosolen bewertet. In den quantitativen und qualitativen chromatographischen Untersuchungen konnten spezifische Verdampfungsprofile der Wirkstoffe erfasst und bewertet werden. Dabei stieg die verdampfte Masse der Leitsubstanzen 1,8-Cineol (Eucalyptusöl), Menthol (Minzöl) und Eugenol (Nelkenöl) zwischen 33,6 µg und 156,2 µg pro Zug proportional zur Konzentration im Liquid im Bereich zwischen 0,5% und 1,5% bei einer Leistung von 20 Watt. Die Freisetzungsrate von Cannabidiol hingegen schien unabhängig von der Konzentration im Liquid im Mittelwert bei 13,3 µg pro Zug zu liegen. Dieses konnte an fünf CBD-haltigen Liquids im Konzentrationsbereich zwischen 31 µg/g und 5120 µg/g Liquid gezeigt werden. Außerdem konnte eine Steigerung der verdampften Massen mit Zunahme der Leistung der e-Zigarette festgestellt werden. Die Interaktion der Liquids bzw. Aerosole mit den Bestandteilen des Speichels sowie weiterer gastrointestinaler Flüssigkeiten wurde über die Anwendung von zugehörigen in vitro Modellen und Einsatz von Enzymaktivitäts-Assays geprüft. In den Untersuchungen wurden Änderungen von Enzymaktivitäten anhand des oralen Schlüsselenzyms α-Amylase sowie von Proteasen ermittelt. Damit sollte exemplarisch ein möglicher Einfluss auf physiologische bzw. metabolische Prozesse im humanen Organismus geprüft werden. Das Bedampfen von biologischen Suspensionen führte bei niedriger Leistung der e-Zigarette (20 Watt) zu keiner bzw. einer leichten Änderung der Enzymaktivität. Die Anwendung einer hohen Leistung (80 Watt) bewirkte tendenziell das Herabsetzen der Enzymaktivitäten. Die Erhöhung der Enzymaktivitäten könnte zu einem enzymatischen Abbau von Schleimstoffen wie Mucinen führen, was wiederum die effektive, mechanische Abwehr gegenüber bakteriellen Infektionen zur Folge hätte. Da eine Anwendung der Applikation insbesondere bei bakteriellen Atemwegserkrankungen denkbar wäre, folgten abschließend Untersuchungen der antibakteriellen Eigenschaften der Liquids bzw. Aerosole in vitro. Es wurden sechs klinisch relevante bakterielle Krankheitserreger ausgewählt, die nach zwei Charakteristika gruppiert werden können. Die drei multiresistenten Bakterien Pseudomonas aeruginosa, Klebsiella pneumoniae und Methicillin-resistenter Staphylococcus aureus können mithilfe von üblichen Therapien mit Antibiotika nicht abgetötet werden und haben vor allem eine nosokomiale Relevanz. Die zweite Gruppe weist Eigenschaften auf, die vordergründig assoziiert sind mit respiratorischen Erkrankungen. Die Bakterien Streptococcus pneumoniae, Moraxella catarrhalis und Haemophilus influenzae sind repräsentativ beteiligt an Atemwegserkrankungen mit diverser Symptomatik. Die Bakterienarten wurden mit den jeweiligen Liquids behandelt bzw. bedampft und deren grundlegende Dosis-Wirkungsbeziehung charakterisiert. Dabei konnte eine antibakterielle Aktivität der Formulierungen ermittelt werden, die durch Zugabe eines Wirkstoffes die bereits antibakterielle Wirkung der Bestandteile Glycerin und Propylenglycol verstärkte. Die hygroskopischen Eigenschaften dieser Substanzen sind vermutlich für eine Wirkung in aerosolierter Form verantwortlich. Sie entziehen die Feuchtigkeit aus der Luft und haben einen austrocknenden Effekt auf die Bakterien. Das Bedampfen der Bakterienarten Streptococcus pneumoniae, Moraxella catarrhalis und Haemophilus influenzae hatte einen antibakteriellen Effekt, der zeitlich abhängig von der Leistung der e-Zigarette war.
Die Ergebnisse der Untersuchungen führen zu dem Schluss, dass jeder Wirkstoff bzw. jede Substanzklasse individuell zu bewerten ist und somit Inhalator und Formulierung aufeinander abgestimmt werden müssen. Der Einsatz der e-Zigarette als Medizinprodukt zur Applikation von Arzneimitteln setzt stets Prüfungen nach Europäischem Arzneibuch voraus. Durch Modifizierungen könnte eine Dosierung gut kontrollierbar gemacht werden, aber auch die Partikelgrößenverteilung kann insoweit reguliert werden, dass die Wirkstoffe je nach Partikelgröße zu einem geeigneten Applikationsort wie Mund, Rachen oder Bronchien transportiert werden. Der Vergleich mit den Eigenschaften anderer medizinischer Inhalatoren führt zu dem Schluss, dass die Technologie der e-Zigarette durchaus eine gleichartige oder bessere Performance für thermisch stabile Wirkstoffe bieten könnte. Dieses fiktive Medizinprodukt könnte aus einer hersteller-unspezifisch produzierten, wieder aufladbaren Energiequelle mit Universalgewinde zum mehrfachen Gebrauch und einer hersteller- und wirkstoffspezifisch produzierten Einheit aus Verdampfer und Arzneimittel bestehen. Das Arzneimittel, ein medizinisches Liquid (Vehikel und Wirkstoff) kann in dem Tank des Verdampfers mit konstanten, nicht variablen Parametern patientenindividuell produziert werden. Inhalative Anwendungen werden perspektivisch wohl nicht zuletzt aufgrund der aktuellen COVID-19-Pandemie eine zunehmende Rolle spielen. Der Bedarf nach alternativen Therapieoptionen wird weiter ansteigen. Diese Arbeit liefert einen Beitrag zum Einsatz der Technologie der elektronischen Zigarette als electronic nicotin delivery system (ENDS) nach Modifizierung zu einem potentiellen pulmonalen Applikationssystem als electronic drug delivery system (EDDS) von inhalativen, thermisch stabilen Arzneimitteln in Form eines Medizinproduktes.
In order to improve a recently established cell-based assay to assess the potency of botulinum neurotoxin, neuroblastoma-derived SiMa cells and induced pluripotent stem-cells (iPSC) were modified to incorporate the coding sequence of a reporter luciferase into a genetic safe harbor utilizing CRISPR/Cas9. A novel method, the double-control quantitative copy number PCR (dc-qcnPCR), was developed to detect off-target integrations of donor DNA. The donor DNA insertion success rate and targeted insertion success rate were analyzed in clones of each cell type. The dc-qcnPCR reliably quantified the copy number in both cell lines. The probability of incorrect donor DNA integration was significantly increased in SiMa cells in comparison to the iPSCs. This can possibly be explained by the lower bundled relative gene expression of a number of double-strand repair genes (BRCA1, DNA2, EXO1, MCPH1, MRE11, and RAD51) in SiMa clones than in iPSC clones. The dc-qcnPCR offers an efficient and cost-effective method to detect off-target CRISPR/Cas9-induced donor DNA integrations.
In order to improve a recently established cell-based assay to assess the potency of botulinum neurotoxin, neuroblastoma-derived SiMa cells and induced pluripotent stem-cells (iPSC) were modified to incorporate the coding sequence of a reporter luciferase into a genetic safe harbor utilizing CRISPR/Cas9. A novel method, the double-control quantitative copy number PCR (dc-qcnPCR), was developed to detect off-target integrations of donor DNA. The donor DNA insertion success rate and targeted insertion success rate were analyzed in clones of each cell type. The dc-qcnPCR reliably quantified the copy number in both cell lines. The probability of incorrect donor DNA integration was significantly increased in SiMa cells in comparison to the iPSCs. This can possibly be explained by the lower bundled relative gene expression of a number of double-strand repair genes (BRCA1, DNA2, EXO1, MCPH1, MRE11, and RAD51) in SiMa clones than in iPSC clones. The dc-qcnPCR offers an efficient and cost-effective method to detect off-target CRISPR/Cas9-induced donor DNA integrations.
Chronic stress is a major cause of neuropsychiatric conditions such as depression. Stress vulnerability varies individually in mice and humans, measured by behavioral changes. In contrast to affective symptoms, motor retardation as a consequence of stress is not well understood. We repeatedly imaged dendritic spines of the motor cortex in Thy1-GFP M mice before and after chronic social defeat stress. Susceptible and resilient phenotypes were discriminated by symptom load and their motor learning abilities were assessed by a gross and fine motor task. Stress phenotypes presented individual short- and long-term changes in the hypothalamic-pituitary-adrenal axis as well as distinct patterns of altered motor learning. Importantly, stress was generally accompanied by a marked reduction of spine density in the motor cortex and spine dynamics depended on the stress phenotype. We found astrogliosis and altered microglia morphology along with increased microglia-neuron interaction in the motor cortex of susceptible mice. In cerebrospinal fluid, proteomic fingerprints link the behavioral changes and structural alterations in the brain to neurodegenerative disorders and dysregulated synaptic homeostasis. Our work emphasizes the importance of synaptic integrity and the risk of neurodegeneration within depression as a threat to brain health.
Manganese (Mn), although important for multiple cellular processes, has posed environmental health concerns due to its neurotoxic effects. In recent years, there have been extensive studies on the mechanism of Mn-induced neuropathology, as well as the sex-dependent vulnerability to its neurotoxic effects. Nonetheless, cellular mechanisms influenced by sex differences in susceptibility to Mn have yet to be adequately characterized. Since oxidative stress is a key mechanism of Mn neurotoxicity, here, we have probed Hsp70 and Nrf2 proteins to investigate the sex-dependent changes following exposure to Mn. Male and female rats were administered intraperitoneal injections of MnCl2 (10 mg/kg and 25 mg/kg) 48 hourly for a total of eight injections (15 days). We evaluated changes in body weight, as well as Mn accumulation, Nrf2 and Hsp70 expression across four brain regions; striatum, cortex, hippocampus and cerebellum in both sexes. Our results showed sex-specific changes in body-weight, specifically in males but not in females. Additionally, we noted sex-dependent accumulation of Mn in the brain, as well as in expression levels of Nrf2 and Hsp70 proteins. These findings revealed sex-dependent susceptibility to Mn-induced neurotoxicity corresponding to differential Mn accumulation, and expression of Hsp70 and Nrf2 across several brain regions.
Growth differentiation factor 15 (GDF15) is a stress-induced cytokine secreted into the circulation by a number of tissues under different pathological conditions such as cardiovascular disease, cancer or mitochondrial dysfunction, among others. While GDF15 signaling through its recently identified hindbrain-specific receptor GDNF family receptor alpha-like (GFRAL) has been proposed to be involved in the metabolic stress response, its endocrine role under chronic stress conditions is still poorly understood. Mitochondrial dysfunction is characterized by the impairment of oxidative phosphorylation (OXPHOS), leading to inefficient functioning of mitochondria and consequently, to mitochondrial stress. Importantly, mitochondrial dysfunction is among the pathologies to most robustly induce GDF15 as a cytokine in the circulation.
The overall aim of this thesis was to elucidate the role of the GDF15-GFRAL pathway under mitochondrial stress conditions. For this purpose, a mouse model of skeletal muscle-specific mitochondrial stress achieved by ectopic expression of uncoupling protein 1 (UCP1), the HSA-Ucp1-transgenic (TG) mouse, was employed. As a consequence of mitochondrial stress, TG mice display a metabolic remodeling consisting of a lean phenotype, an improved glucose metabolism, an increased metabolic flexibility and a metabolic activation of white adipose tissue.
Making use of TG mice crossed with whole body Gdf15-knockout (GdKO) and Gfral-knockout (GfKO) mouse models, this thesis demonstrates that skeletal muscle mitochondrial stress induces the integrated stress response (ISR) and GDF15 in skeletal muscle, which is released into the circulation as a myokine (muscle-induced cytokine) in a circadian manner. Further, this work identifies GDF15-GFRAL signaling to be responsible for the systemic metabolic remodeling elicited by mitochondrial stress in TG mice. Moreover, this study reveals a daytime-restricted anorexia induced by the GDF15-GFRAL axis under muscle mitochondrial stress, which is, mechanistically, mediated through the induction of hypothalamic corticotropin releasing hormone (CRH). Finally, this work elucidates a so far unknown physiological outcome of the GDF15-GFRAL pathway: the induction of anxiety-like behavior.
In conclusion, this study uncovers a muscle-brain crosstalk under skeletal muscle mitochondrial stress conditions through the induction of GDF15 as a myokine that signals through the hindbrain-specific GFRAL receptor to elicit a stress response leading to metabolic remodeling and modulation of ingestive- and anxiety-like behavior.
Western-style obesity-promoting diets are associated with increased inflammation, higher disease incidence and mortality.
In contrast, plant-based diets (PBDs), which incorporate large amounts of vegetables and fruit, legumes, whole grains and only a small amount of meat, are generally associated with better health and lower mortality.
This narrative review summarizes the evidence on health and life span in adults adhering to PBDs and discusses the potentially longevity-promoting mechanism of PBDs as well as limitations due to nutrient deficiencies.
Epidemiologic studies consistently report lower mortality rates in adults who adhering to PBDs when compared with people whose diet regularly includes meat.
PBDs are associated with many health benefits, such as improved metabolic and inflammatory profile.
In turn, the incidence of cardiovascular disease is lower in adults consuming PBDs, which contributes to their better health. The health-promoting effects of PBDs are still not entirely clear but most likely multifactorial and include modulation of the gut microbiome. The interest in possible longevity-promoting mechanisms of PBDs has increased in recent years, as many characteristics of PBDs such as protein restriction and restriction of certain amino acids are known to extend the life span.
While there is ample evidence from animal studies, large-scale human studies, which also provide insight into the specific mechanisms of the effect of PBDs on longevity, are missing.
However, due to the lower protein content of PBDs, there appears to be an age limit for the anticipated health effects, as adults over 65 require larger amounts of protein.
The BfR MEAL Study provides representative levels of substances in foods consumed in Germany. Mercury, cadmium, lead, and nickel are contaminants present in foods introduced by environmental and industrial processes. Levels of these elements were investigated in 356 foods. Foods were purchased representatively, prepared as consumed and pooled with similar foods before analysis. Highest mean levels of mercury were determined in fish and seafood, while high levels of cadmium, lead, and nickel were present in cocoa products and legumes, nuts, oilseeds, and spices. The sampling by region, season, and production type showed minor differences in element levels for specific foods, however no tendency over all foods or for some food groups was apparent. The data on mercury, cadmium, lead, and nickel provide a comprehensive basis for chronic dietary exposure assessment of the population in Germany. All levels found were below regulated maximum levels.
Individuals with diabetes face higher risks for macro- and microvascular complications than their non-diabetic counterparts. The concept of precision medicine in diabetes aims to optimise treatment decisions for individual patients to reduce the risk of major diabetic complications, including cardiovascular outcomes, retinopathy, nephropathy, neuropathy and overall mortality. In this context, prognostic models can be used to estimate an individual's risk for relevant complications based on individual risk profiles. This review aims to place the concept of prediction modelling into the context of precision prognostics. As opposed to identification of diabetes subsets, the development of prediction models, including the selection of predictors based on their longitudinal association with the outcome of interest and their discriminatory ability, allows estimation of an individual's absolute risk of complications. As a consequence, such models provide information about potential patient subgroups and their treatment needs. This review provides insight into the methodological issues specifically related to the development and validation of prediction models for diabetes complications. We summarise existing prediction models for macro- and microvascular complications, commonly included predictors, and examples of available validation studies. The review also discusses the potential of non-classical risk markers and omics-based predictors. Finally, it gives insight into the requirements and challenges related to the clinical applications and implementation of developed predictions models to optimise medical decision making.
Pannexin 1
(2022)
Hypoxic pulmonary vasoconstriction is an active alveolar hypoxia-caused physiological response redirecting pulmonary blood flow from poorly ventilated areas to better oxygenated lung regions in order to optimize oxygen supply. However, the signaling pathways underlying this pulmonary vascular response remain an area under investigation. In the present study I investigated the functional relevance of Pannexin 1 (Panx1)-mediated ATP release in hypoxic pulmonary vasoconstriction and chronic hypoxic pulmonary hypertension using murine isolated perfused lungs, chronic hypoxic mice, and pulmonary artery smooth muscle cell culture. In isolated mouse lungs, switch to hypoxic gas induced a marked increase in pulmonary artery pressure. Pharmacological inhibition of Panx1 using probenecid, Panx1 specific inhibitory peptide (10Panx1) or spironolactone as well as genetic deletion of Panx1 in smooth muscle cells diminished hypoxic pulmonary vasoconstriction in isolated perfused mouse lungs. Fura-2 imaging revealed a reduced Ca2+ response to hypoxia in pulmonary artery smooth muscle cells treated with spironolactone or 10Panx1. Although these findings suggested an important role of Panx1 in HPV, neither smooth muscle cell nor endothelial cell specific genetic deletion of Panx1 prevented the development of pulmonary hypertension in chronic hypoxic mice. Surprisingly, hypoxia did not induce ATP release and inhibition of purinergic receptors or ATP degradation by ATPase failed to decrease the pulmonary vasoconstriction response to hypoxia in isolated perfused mouse lungs. However, Panx1 antagonism as well as TRPV4 inhibition prevented the hypoxia-induced increase in intracellular Ca2+ concentration in pulmonary artery smooth muscle cells in an additive manner suggesting that Panx1 might modulate intracellular Ca2+ signaling independently of the ATP-P2-TRPV4 signaling axis. In line with this assumption, overexpression of Panx1 in HeLa cells increased intracellular Ca2+ concentrations in response to acute hypoxia. Conclusion: In this study I identifiy Panx1 as novel regulator of HPV.. Yet, the role of Panx1 was not attributable to the release of ATP and downstream P2 signaling pathways or activation of TRPV4 but rathter relates to a role of Panx1 as indirect or direct modulator of the Ca2+ response to hypoxia in PASMCs. Genetic deletion of Panx1 did not influence the development of chronic hypoxic pulmonary hypertension in mice.
The intake of high-fat diets (HFDs) containing large amounts of saturated long-chain fatty acids leads to obesity, oxidative stress, inflammation, and insulin resistance. The trace element selenium, as a crucial part of antioxidative selenoproteins, can protect against the development of diet-induced insulin resistance in white adipose tissue (WAT) by increasing glutathione peroxidase 3 (GPx3) and insulin receptor (IR) expression. Whether selenite (Se) can attenuate insulin resistance in established lipotoxic and obese conditions is unclear. We confirm that GPX3 mRNA expression in adipose tissue correlates with BMI in humans. Cultivating 3T3-L1 pre-adipocytes in palmitate-containing medium followed by Se treatment attenuates insulin resistance with enhanced GPx3 and IR expression and adipocyte differentiation. However, feeding obese mice a selenium-enriched high-fat diet (SRHFD) only resulted in a modest increase in overall selenoprotein gene expression in WAT in mice with unaltered body weight development, glucose tolerance, and insulin resistance. While Se supplementation improved adipocyte morphology, it did not alter WAT insulin sensitivity. However, mice fed a SRHFD exhibited increased insulin content in the pancreas. Overall, while selenite protects against palmitate-induced insulin resistance in vitro, obesity impedes the effect of selenite on insulin action and adipose tissue metabolism in vivo.
The intake of high-fat diets (HFDs) containing large amounts of saturated long-chain fatty acids leads to obesity, oxidative stress, inflammation, and insulin resistance. The trace element selenium, as a crucial part of antioxidative selenoproteins, can protect against the development of diet-induced insulin resistance in white adipose tissue (WAT) by increasing glutathione peroxidase 3 (GPx3) and insulin receptor (IR) expression. Whether selenite (Se) can attenuate insulin resistance in established lipotoxic and obese conditions is unclear. We confirm that GPX3 mRNA expression in adipose tissue correlates with BMI in humans. Cultivating 3T3-L1 pre-adipocytes in palmitate-containing medium followed by Se treatment attenuates insulin resistance with enhanced GPx3 and IR expression and adipocyte differentiation. However, feeding obese mice a selenium-enriched high-fat diet (SRHFD) only resulted in a modest increase in overall selenoprotein gene expression in WAT in mice with unaltered body weight development, glucose tolerance, and insulin resistance. While Se supplementation improved adipocyte morphology, it did not alter WAT insulin sensitivity. However, mice fed a SRHFD exhibited increased insulin content in the pancreas. Overall, while selenite protects against palmitate-induced insulin resistance in vitro, obesity impedes the effect of selenite on insulin action and adipose tissue metabolism in vivo.
Mechanistic studies on the adverse effects of manganese overexposure in differentiated LUHMES cells
(2022)
Manganese (Mn) is an essential trace element, but overexposure is associated with toxicity and neurological dysfunction. Accumulation of Mn can be observed in dopamine-rich regions of the brain in vivo and Mn-induced oxidative stress has been discussed extensively. Nevertheless, Mn-induced DNA damage, adverse effects of DNA repair, and possible resulting consequences for the neurite network are not yet characterized. For this, LUHMES cells were used, as they differentiate into dopaminergic-like neurons and form extensive neurite networks. Experiments were conducted to analyze Mn bioavailability and cytotoxicity of MnCl2, indicating a dose-dependent uptake and substantial cytotoxic effects. DNA damage, analyzed by means of 8-oxo-7,8-dihydro-2'-guanine (8oxodG) and single DNA strand break formation, showed significant dose- and time-dependent increase of DNA damage upon 48 h Mn exposure. Furthermore, the DNA damage response was increased which was assessed by analytical quantification of poly(ADP-ribosyl)ation (PARylation). Gene expression of the respective DNA repair genes was not significantly affected. Degradation of the neuronal network is significantly altered by 48 h Mn exposure. Altogether, this study contributes to the characterization of Mn-induced neurotoxicity, by analyzing the adverse effects of Mn on genome integrity in dopaminergic-like neurons and respective outcomes.
Mammalian arachidonic acid lipoxygenases (ALOXs) have been implicated in cell differentiation and in the pathogenesis of inflammation. The mouse genome involves seven functional Alox genes and the encoded enzymes share a high degree of amino acid conservation with their human orthologs. There are, however, functional differences between mouse and human ALOX orthologs. Human ALOX15B oxygenates arachidonic acid exclusively to its 15-hydroperoxy derivative (15S-HpETE), whereas 8S-HpETE is dominantly formed by mouse Alox15b. The structural basis for this functional difference has been explored and in vitro mutagenesis humanized the reaction specificity of the mouse enzyme. To explore whether this mutagenesis strategy may also humanize the reaction specificity of mouse Alox15b in vivo, we created Alox15b knock-in mice expressing the arachidonic acid 15-lipoxygenating Tyr603Asp+His604Val double mutant instead of the 8-lipoxygenating wildtype enzyme. These mice are fertile, display slightly modified plasma oxylipidomes and develop normally up to an age of 24 weeks. At later developmental stages, male Alox15b-KI mice gain significantly less body weight than outbred wildtype controls, but this effect was not observed for female individuals. To explore the possible reasons for the observed gender-specific growth arrest, we determined the basic hematological parameters and found that aged male Alox15b-KI mice exhibited significantly attenuated red blood cell parameters (erythrocyte counts, hematocrit, hemoglobin). Here again, these differences were not observed in female individuals. These data suggest that humanization of the reaction specificity of mouse Alox15b impairs the functionality of the hematopoietic system in males, which is paralleled by a premature growth arrest.
Mammalian arachidonic acid lipoxygenases (ALOXs) have been implicated in cell differentiation and in the pathogenesis of inflammation. The mouse genome involves seven functional Alox genes and the encoded enzymes share a high degree of amino acid conservation with their human orthologs. There are, however, functional differences between mouse and human ALOX orthologs. Human ALOX15B oxygenates arachidonic acid exclusively to its 15-hydroperoxy derivative (15S-HpETE), whereas 8S-HpETE is dominantly formed by mouse Alox15b. The structural basis for this functional difference has been explored and in vitro mutagenesis humanized the reaction specificity of the mouse enzyme. To explore whether this mutagenesis strategy may also humanize the reaction specificity of mouse Alox15b in vivo, we created Alox15b knock-in mice expressing the arachidonic acid 15-lipoxygenating Tyr603Asp+His604Val double mutant instead of the 8-lipoxygenating wildtype enzyme. These mice are fertile, display slightly modified plasma oxylipidomes and develop normally up to an age of 24 weeks. At later developmental stages, male Alox15b-KI mice gain significantly less body weight than outbred wildtype controls, but this effect was not observed for female individuals. To explore the possible reasons for the observed gender-specific growth arrest, we determined the basic hematological parameters and found that aged male Alox15b-KI mice exhibited significantly attenuated red blood cell parameters (erythrocyte counts, hematocrit, hemoglobin). Here again, these differences were not observed in female individuals. These data suggest that humanization of the reaction specificity of mouse Alox15b impairs the functionality of the hematopoietic system in males, which is paralleled by a premature growth arrest.
Metabolic derangement with poor glycemic control accompanying overweight and obesity is associated with chronic low-grade inflammation and hyperinsulinemia. Macrophages, which present a very heterogeneous population of cells, play a key role in the maintenance of normal tissue homeostasis, but functional alterations in the resident macrophage pool as well as newly recruited monocyte-derived macrophages are important drivers in the development of low-grade inflammation. While metabolic dysfunction, insulin resistance and tissue damage may trigger or advance pro-inflammatory responses in macrophages, the inflammation itself contributes to the development of insulin resistance and the resulting hyperinsulinemia. Macrophages express insulin receptors whose downstream signaling networks share a number of knots with the signaling pathways of pattern recognition and cytokine receptors, which shape macrophage polarity. The shared knots allow insulin to enhance or attenuate both pro-inflammatory and anti-inflammatory macrophage responses. This supposedly physiological function may be impaired by hyperinsulinemia or insulin resistance in macrophages. This review discusses the mutual ambiguous relationship of low-grade inflammation, insulin resistance, hyperinsulinemia and the insulin-dependent modulation of macrophage activity with a focus on adipose tissue and liver.
The drug salinomycin (SAL) is a polyether antibiotic and used in veterinary medicine as coccidiostat and growth promoter. Recently, SAL was suggested as a potential anticancer drug. However, transformation products (TPs) resulting from metabolic and environmental degradation of SAL are incompletely known and structural information is missing. In this study, we therefore systematically investigated the formation and identification of SAL derived TPs using electrochemistry (EC) in an electrochemical reactor and rat and human liver microsome incubation (RLM and HLM) as TP generating methods. Liquid chromatography (LC) coupled to high-resolution mass spectrometry (HRMS) was applied to determine accurate masses in a suspected target analysis to identify TPs and to deduce occurring modification reactions of derived TPs. A total of 14 new, structurally different TPs were found (two EC-TPs, five RLM-TPs, and 11 HLM-TPs). The main modification reactions are decarbonylation for EC-TPs and oxidation (hydroxylation) for RLM/HLM-TPs. Of particular interest are potassium-based TPs identified after liver microsome incubation because these might have been overlooked or declared as oxidated sodium adducts in previous, non-HRMS-based studies due to the small mass difference between K and O + Na of 21 mDa. The MS fragmentation pattern of TPs was used to predict the position of identified modifications in the SAL molecule. The obtained knowledge regarding transformation reactions and novel TPs of SAL will contribute to elucidate SAL-metabolites with regards to structural prediction.