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We investigated the effects of obesity on metabolic, inflammatory, and oxidative stress parameters in the adipose tissue of patients with fatal COVID-19. Postmortem biopsies of subcutaneous adipose tissue were obtained from 25 unvaccinated inpatients who passed from COVID-19, stratified as nonobese (N-OB; body mass index [BMI], 26.5 ± 2.3 kg m-2) or obese (OB BMI 34.2 ± 5.1 kg m-2). Univariate and multivariate analyses revealed that body composition was responsible for most of the variations detected in the metabolome, with greater dispersion observed in the OB group. Fifteen metabolites were major segregation factors. Results from the OB group showed higher levels of creatinine, myo-inositol, O-acetylcholine, and succinate, and lower levels of sarcosine. The N-OB group showed lower levels of glutathione peroxidase activity, as well as higher content of IL-6 and adiponectin. We revealed significant changes in the metabolomic profile of the adipose tissue in fatal COVID-19 cases, with high adiposity playing a key role in these observed variations. These findings highlight the potential involvement of metabolic and inflammatory pathways, possibly dependent on hypoxia, shedding light on the impact of obesity on disease pathogenesis and suggesting avenues for further research and possible therapeutic targets.
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Autopsia , COVID-19 , Metaboloma , Obesidad , Humanos , COVID-19/metabolismo , COVID-19/mortalidad , COVID-19/patología , COVID-19/virología , Obesidad/metabolismo , Obesidad/patología , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , SARS-CoV-2/metabolismo , Tejido Adiposo/metabolismo , Tejido Adiposo/patología , Metabolómica/métodos , Índice de Masa Corporal , Adulto , Estrés Oxidativo , Interleucina-6/metabolismoRESUMEN
PURPOSE OF REVIEW: To discuss the recent discoveries and limitations of the available literature on emerging circulating biomarkers of cancer cachexia. RECENT FINDINGS: Studies on circulating factors in cancer cachexia show promising alternatives for diagnosing the syndrome in a minimally invasive manner in the clinic setting, as well as potential targets for cancer cachexia treatment. Factors secreted by the tumor and the adipose tissue, such as extracellular vesicles and soluble proteins, respectively, have been shown to either directly induce wasting in vitro and in vivo or to be altered in the cachectic phenotype. The detection and characterization of circulating cells allows detection of the precachectic stage and the levels of the soluble immune checkpoint protein programmed death ligand-1 (PD-L1) are correlated with the presence of the hallmarks of cancer cachexia. SUMMARY: Structural, molecular, and metabolic alterations have been observed in various tissues, revealing the occurrence of sustained inter-compartment crosstalk in cachectic patients. Early diagnosis of cancer cachexia becomes crucial to avoid the establishment of refractory cachexia through the implementation of interventions that may attenuate systemic inflammation and muscle loss. More studies on human cancer cachexia are required in order to address the recently discovered cachexia-associated circulating factors' value as biomarkers of the syndrome.
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Caquexia , Neoplasias , Humanos , Caquexia/diagnóstico , Caquexia/etiología , Caquexia/metabolismo , Investigación Biomédica Traslacional , Neoplasias/metabolismo , Tejido Adiposo/metabolismo , Biomarcadores/metabolismo , Músculo Esquelético/metabolismoRESUMEN
(1) Background: We examined the effect of the acute administration of olive oil (EVOO), linseed oil (GLO), soybean oil (SO), and palm oil (PO) on gastric motility and appetite in rats. (2) Methods: We assessed food intake, gastric retention (GR), and gene expression in all groups. (3) Results: Both EVOO and GLO were found to enhance the rate of stomach retention, leading to a decrease in hunger. On the other hand, the reduction in food intake caused by SO was accompanied by delayed effects on stomach retention. PO caused an alteration in the mRNA expression of NPY, POMC, and CART. Although PO increased stomach retention after 180 min, it did not affect food intake. It was subsequently verified that the absence of an autonomic reaction did not nullify the influence of EVOO in reducing food consumption. Moreover, in the absence of parasympathetic responses, animals that received PO exhibited a significant decrease in food consumption, probably mediated by lower NPY expression. (4) Conclusions: This study discovered that different oils induce various effects on parameters related to food consumption. Specifically, EVOO reduces food consumption primarily through its impact on the gastrointestinal tract, making it a recommended adjunct for weight loss. Conversely, the intake of PO limits food consumption in the absence of an autonomic reaction, but it is not advised due to its contribution to the development of cardiometabolic disorders.
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Regulación del Apetito , Hipotálamo , Neuropéptido Y , Aceite de Oliva , Aceite de Palma , Aceite de Soja , Nervio Vago , Animales , Nervio Vago/efectos de los fármacos , Nervio Vago/fisiología , Hipotálamo/metabolismo , Hipotálamo/efectos de los fármacos , Masculino , Aceite de Oliva/farmacología , Neuropéptido Y/genética , Neuropéptido Y/metabolismo , Aceite de Palma/farmacología , Regulación del Apetito/efectos de los fármacos , Aceite de Soja/administración & dosificación , Aceite de Soja/farmacología , Ratas Wistar , Aceite de Linaza/farmacología , Ratas , Ingestión de Alimentos/efectos de los fármacos , Aceites de Plantas/farmacología , Proopiomelanocortina/genética , Proopiomelanocortina/metabolismo , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/metabolismo , Motilidad Gastrointestinal/efectos de los fármacos , Regulación de la Expresión Génica/efectos de los fármacos , ARN Mensajero/metabolismo , ARN Mensajero/genéticaRESUMEN
Introduction: Post-COVID-19 condition (PCC) is characterised by a plethora of symptoms, with fatigue appearing as the most frequently reported. The alterations that drive both the persistent and post-acute disease newly acquired symptoms are not yet fully described. Given the lack of robust knowledge regarding the mechanisms of PCC we have examined the impact of inflammation in PCC, by evaluating serum cytokine profile and its potential involvement in inducing the different symptoms reported. Methods: In this cross-sectional study, we recruited 227 participants who were hospitalised with acute COVID-19 in 2020 and came back for a follow-up assessment 6-12 months after hospital discharge. The participants were enrolled in two symptomatic groups: Self-Reported Symptoms group (SR, n = 96), who did not present major organ lesions, yet reported several debilitating symptoms such as fatigue, muscle weakness, and persistent loss of sense of smell and taste; and the Self-Reported Symptoms and decreased Pulmonary Function group (SRPF, n = 54), composed by individuals with the same symptoms described by SR, plus diagnosed pulmonary lesions. A Control group (n = 77), with participants with minor complaints following acute COVID-19, was also included in the study. Serum cytokine levels, symptom questionnaires, physical performance tests and general clinical data were obtained in the follow-up assessment. Results: SRPF presented lower IL-4 concentration compared with Control (q = 0.0018) and with SR (q = 0.030), and lower IFN-α2 serum content compared with Control (q = 0.007). In addition, SRPF presented higher MIP-1ß serum concentration compared with SR (q = 0.029). SR presented lower CCL11 (q = 0.012 and q = 0.001, respectively) and MCP-1 levels (q = 0.052 for both) compared with Control and SRPF. SRPF presented lower G-CSF compared to Control (q = 0.014). Female participants in SR showed lower handgrip strength in relation to SRPF (q = 0.0082). Male participants in SR and SRPF needed more time to complete the timed up-and-go test, as compared with men in the Control group (q = 0.0302 and q = 0.0078, respectively). Our results indicate that different PCC symptom profiles are accompanied by distinct inflammatory markers in the circulation. Of particular concern are the lower muscle function findings, with likely long-lasting consequences for health and quality of life, found for both PCC phenotypes.
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Introduction: The COVID-19 pandemic has prompted global research efforts to reduce infection impact, highlighting the potential of cross-disciplinary collaboration to enhance research quality and efficiency. Methods: At the FMUSP-HC academic health system, we implemented innovative flow management routines for collecting, organizing and analyzing demographic data, COVID-related data and biological materials from over 4,500 patients with confirmed SARS-CoV-2 infection hospitalized from 2020 to 2022. This strategy was mainly planned in three areas: organizing a database with data from the hospitalizations; setting-up a multidisciplinary taskforce to conduct follow-up assessments after discharge; and organizing a biobank. Additionally, a COVID-19 curated collection was created within the institutional digital library of academic papers to map the research output. Results: Over the course of the experience, the possible benefits and challenges of this type of research support approach were identified and discussed, leading to a set of recommended strategies to enhance collaboration within the research institution. Demographic and clinical data from COVID-19 hospitalizations were compiled in a database including adults and a minority of children and adolescents with laboratory confirmed COVID-19, covering 2020-2022, with approximately 350 fields per patient. To date, this database has been used in 16 published studies. Additionally, we assessed 700 adults 6 to 11 months after hospitalization through comprehensive, multidisciplinary in-person evaluations; this database, comprising around 2000 fields per subject, was used in 15 publications. Furthermore, thousands of blood samples collected during the acute phase and follow-up assessments remain stored for future investigations. To date, more than 3,700 aliquots have been used in ongoing research investigating various aspects of COVID-19. Lastly, the mapping of the overall research output revealed that between 2020 and 2022 our academic system produced 1,394 scientific articles on COVID-19. Discussion: Research is a crucial component of an effective epidemic response, and the preparation process should include a well-defined plan for organizing and sharing resources. The initiatives described in the present paper were successful in our aim to foster large-scale research in our institution. Although a single model may not be appropriate for all contexts, cross-disciplinary collaboration and open data sharing should make health research systems more efficient to generate the best evidence.
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COVID-19 , Adulto , Adolescente , Niño , Humanos , SARS-CoV-2 , Pandemias , América LatinaRESUMEN
OBJECTIVES: To prospectively evaluate demographic, anthropometric and health-related quality of life (HRQoL) in pediatric patients with laboratory-confirmed coronavirus disease 2019 (COVID-19) METHODS: This was a longitudinal observational study of surviving pediatric post-COVID-19 patients (n=53) and pediatric subjects without laboratory-confirmed COVID-19 included as controls (n=52) was performed. RESULTS: The median duration between COVID-19 diagnosis (n=53) and follow-up was 4.4 months (0.8-10.7). Twenty-three of 53 (43%) patients reported at least one persistent symptom at the longitudinal follow-up visit and 12/53 (23%) had long COVID-19, with at least one symptom lasting for >12 weeks. The most frequently reported symptoms at the longitudinal follow-up visit were headache (19%), severe recurrent headache (9%), tiredness (9%), dyspnea (8%), and concentration difficulty (4%). At the longitudinal follow-up visit, the frequencies of anemia (11% versus 0%, p=0.030), lymphopenia (42% versus 18%, p=0.020), C-reactive protein level of >30 mg/L (35% versus 0%, p=0.0001), and D-dimer level of >1000 ng/mL (43% versus 6%, p=0.0004) significantly reduced compared with baseline values. Chest X-ray abnormalities (11% versus 2%, p=0.178) and cardiac alterations on echocardiogram (33% versus 22%, p=0.462) were similar at both visits. Comparison of characteristic data between patients with COVID-19 at the longitudinal follow-up visit and controls showed similar age (p=0.962), proportion of male sex (p=0.907), ethnicity (p=0.566), family minimum monthly wage (p=0.664), body mass index (p=0.601), and pediatric pre-existing chronic conditions (p=1.000). The Pediatric Quality of Live Inventory 4.0 scores, median physical score (69 [0-100] versus 81 [34-100], p=0.012), and school score (60 [15-100] versus 70 [15-95], p=0.028) were significantly lower in pediatric patients with COVID-19 at the longitudinal follow-up visit than in controls. CONCLUSIONS: Pediatric patients with COVID-19 showed a longitudinal impact on HRQoL parameters, particularly in physical/school domains, reinforcing the need for a prospective multidisciplinary approach for these patients. These data highlight the importance of closer monitoring of children and adolescents by the clinical team after COVID-19.
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Humanos , Masculino , Niño , Adolescente , COVID-19/complicaciones , Calidad de Vida , Estudios Prospectivos , Centros de Atención Terciaria , Prueba de COVID-19 , SARS-CoV-2 , América LatinaRESUMEN
OBJETIVO: Avaliar os efeitos da infiltração de dióxido de carbono em adipócitos presentes na parede abdominal. MÉTODOS: Quinze voluntárias foram submetidas a sessões de infusão de CO2 durante três semanas consecutivas (duas sessões por semana com intervalos de dois a três dias entre cada sessão). O volume de gás carbônico infundido por sessão, em pontos previamente demarcados, foi sempre calculado com base na superfície da área a ser tratada, com volume infundido fixo de 250 mL/100cm² de superfície tratada. Os pontos de infiltração foram demarcados respeitando-se o limite eqüidistante 2cm entre eles. Em cada ponto se injetou 10mL, por sessão, com fluxo de 80mL/min. Foram colhidos fragmentos de tecido celular subcutâneo da parede abdominal anterior antes e após o tratamento. O número e as alterações histomorfológicas dos adipócitos (diâmetro médio, perímetro, comprimento, largura e número de adipócitos por campos de observação) foram mensurados por citometria computadorizada. Os resultados foram analisados com o teste t de Student pareado, adotando-se nível de significância de 5 por cento (p<0,05). RESULTADOS: Encontrou-se redução significativa no número de adipócitos da parede abdominal e na área, diâmetro, perímetro, comprimento e largura após o uso da hipercapnia (p=0,0001). CONCLUSÃO: A infiltração percutânea de CO2 reduz a população e modifica a morfologia dos adipócitos presentes na parede abdominal anterior.
OBJECTIVE: To evaluate the effects of carbon dioxide infusion to abdominal wall adipocytes. METHODS: Fifteen volunteers were subjected to sessions of CO2 infusion for three consecutive weeks (two sessions per week with intervals of two to three days between each). The volume of carbon dioxide infused per session, at points previously marked, was always calculated on the basis of surface area to be treated, with a fixed infused volume of 250 ml/100cm² of treated surface. The infiltration points were marked respecting the limit of 2cm equidistant between them. At each point 10 ml was injected per session, with a flow of 80ml/min. Fragments were collected from subcutaneous tissue of the anterior abdominal wall before and after treatment. The number and histomorphological changes of adipocytes (mean diameter, perimeter, length, width and number of adipocytes per field of observation) were measured by computerized cytometry. The results were analyzed with paired Student t test, adopting a significance level of 5 percent (p <0.05). RESULTS: There was a significant reduction in the number of adipocytes in the abdominal wall, as well as the area, diameter, perimeter, length and width of the adipocytes, after the infusion of CO2 (p = 0.0001). CONCLUSION: The percutaneous infiltration of CO2 reduces the population of adipocytes of the anterior abdominal wall and modifies their morphology.
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Adulto , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Adipocitos/efectos de los fármacos , Dióxido de Carbono/farmacología , Técnicas Citológicas , Dióxido de Carbono/administración & dosificación , Estudios Prospectivos , Grasa Subcutánea AbdominalRESUMEN
INTRODUÇÃO: O arco e flecha é um esporte estático que requer força e resistência da parte superior do corpo, sendo que a habilidade do arqueiro é definida pela capacidade de atirar a flecha no alvo em um intervalo de tempo com precisão. A contração muscular gerada durante a execução do gesto esportivo propicia o aumento da temperatura corporal, da oxidação de glicose e da sudorese, podendo esta ser potencializada pelas condições climáticas às quais o atleta é exposto. Todos estes fatores alteram a percepção de esforço e a própria geração de força, impondo um estresse negativo à performance. OBJETIVOS: Avaliar e relacionar o estado de hidratação de atletas de arco e flecha com alterações fisiológicas e de força intervenientes no rendimento competitivo. MÉTODOS: Participaram 11 arqueiros em duas competições distintas (indoor e outdoor). Foram mensurados parâmetros relacionados ao estado de hidratação, glicemia, percepção de esforço subjetivo e alteração na força de preensão palmar. RESULTADOS: Os atletas analisados apresentaram alterações significativas nos parâmetros relacionados ao estado hídrico em diferentes dias, provavelmente relacionadas às condições climáticas adversas na competição outdoor (34ºC e 60 por cento URA) em relação à competição indoor (22ºC e 90 por cento URA). O mesmo não foi observado para a glicemia. CONCLUSÃO: Este trabalho é o primeiro a comprovar a relação direta entre fatores climáticos e de rendimento em arqueiros de alto nível durante evento competitivo, assim como a evidenciar quais métodos não invasivos seriam os mais indicados para a avaliação do impacto destas alterações.
INTRODUCTION: Archery is a static sport that requires strength and resistance from the upper part of the body, and the skill of the archer is defined by the capacity to shoot the arrow on the target in an interval of time with accuracy. The muscle contraction generated during the performance of the sports gesture causes the increase in body temperature, glucose oxidation and the sweat loss, being able to be boosted by the climate conditions to which the athlete is exposed. These factors combined modify the effort perception and the proper strength generation, imposing hence stress negative to performance. OBJECTIVE: To evaluate and to relate the hydration status of archery athletes to intervening physiological and strength alterations in the competitive performance. METHODS: 11 archers participated in two distinct competitions (indoor and outdoor). Parameters related to the hydration status, glycemia, subjective perceived exertion and alteration in handgrip were measured. RESULTS: The analyzed athletes presented significant alterations in the parameters related to their hydration on different days, probably related to the adverse weather conditions in the outdoor events(34ºC and 60 percent). The same situation was not observed for glycemia. CONCLUSION: This investigation is a pioneer in proving the straight relation between weather conditions and performance in high-level archers during competitive events, as well as evidencing which non-invasive methods would be recommended to assessment of the impact of these alterations.
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Humanos , Masculino , Femenino , Adulto , Atletas , Rendimiento Atlético , Conducta Competitiva , Deshidratación , Fuerza Muscular , Deportes , Sudoración , AnsiedadRESUMEN
FUNDAMENTO: Estudos recentes demonstram que a expressão de mediadores inflamatórios, como as citocinas, é um importante fator de desenvolvimento e progressão da insuficiência cardíaca (IC), principalmente na presença de disfunção ventricular esquerda. Essas alterações têm sido demonstradas tanto no plasma como no músculo cardíaco e, mais recentemente, no músculo esquelético de ratos e pacientes com IC. OBJETIVO: Investigar a produção e expressão do fator de necrose tumoral-α (TNF-α) e interleucina-10 (IL-10) no músculo sóleo e extensor digital longo (EDL) em animais com disfunção ventricular pós-infarto do miocárdio (IM). MÉTODOS: Utilizaram-se ratos Wistar machos que foram submetidos à ligadura da artéria coronária esquerda sem posterior reperfusão. Quatro semanas após esse procedimento, os animais foram submetidos à análise ecocardiográfica e divididos nos seguintes grupos experimentais: falso operado (Sham) e IM. Mantiveram-se em observação por um período adicional de 8 semanas. RESULTADOS: O nível da citocina TNF-α aumentou 26,5 por cento (p < 0,05), e sua expressão gênica, 3 vezes (p < 0,01). O nível de IL-10 apresentou diminuição de 38,2 por cento (p < 0,05). Ambas as alterações ocorreram apenas no músculo sóleo, sem alterações no EDL. A diminuição (36,5 por cento, p < 0,05) na razão IL-10/ TNF-α deveu-se tanto ao aumento dos níveis teciduais do TNF-α quanto à diminuição da IL-10 dos níveis teciduais. CONCLUSÃO: Nossos resultados demonstraram alterações relevantes na razão IL-10/ TNF-α, o que pode ter um papel aditivo na avaliação da deterioração e progressão do quadro da disfunção ventricular esquerda pós-IM. Além disso, nosso estudo sugere que essas alterações parecem estar relacionadas ao tipo de fibra muscular.
BACKGROUND: Recent studies show that the expression of inflammatory mediators, such as cytokines, is an important factor for the development and progression of heart failure (HF), especially in the presence of left ventricular dysfunction. These changes have been demonstrated both in the plasma and heart muscle and, more recently, in skeletal muscle of rats and in patients with HF. OBJECTIVE: To investigate the production and expression of tumor necrosis factor-α (TNF) and interleukin-10 (IL-10) in the soleus and the extensor digitorum longus (EDL) muscles of animals with left ventricular dysfunction after myocardial infarction (MI). METHODS: We used male Wistar rats that underwent ligation of the left coronary artery without reperfusion. Four weeks after this procedure, the animals underwent echocardiography and were divided into the following experimental groups: sham operated (sham) and IM. They remained under observation for a further period of 8 weeks. RESULTS: The level of the cytokine TNF-α increased by 26.5 percent (p <0.05), and its gene expression increased 3 times (p <0.01). The level of IL-10 decreased by 38.2 percent (p <0.05). Both changes occurred only in the soleus muscle, with no change in the EDL. The decrease (36.5 percent, p <0.05) in the IL-10/TNF-α ratio was due to both increased tissue levels of TNF-α and decreased tissue levels of IL-10. CONCLUSION: Our results showed significant changes in the IL-10/TNF-α ratio, which may have an additive role in the assessment of deterioration and progression of left ventricular dysfunction post-MI. Furthermore, our study suggests that these changes seem to be related to the muscle fiber type. (Arq Bras Cardiol 2010; 94(3):293-300)
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Animales , Masculino , Ratas , /biosíntesis , Músculo Esquelético/metabolismo , Infarto del Miocardio/complicaciones , Factor de Necrosis Tumoral alfa/biosíntesis , Disfunción Ventricular Izquierda/metabolismo , Modelos Animales de Enfermedad , /genética , Modelos Animales , Ratas Wistar , Factores de Tiempo , Factor de Necrosis Tumoral alfa/genética , Función VentricularRESUMEN
Nos últimos 50 anos, a compreensão sobre as alterações deteriorativas envolvidas na progressão da insuficiência cardíaca (IC), descritas inicialmente como decorrentes de alterações na retenção de sais e fluidos, ou alterações nos parâmetros hemodinâmicos, mudou significatiamente. Recentemente, diversos estudos em pacientes com IC demonstraram níveis plasmáticos (ou no soro) alterados de citocinas pro-inflamatórias, tais como o fator α de necrose tumoral (TNF-α), as interleucinas 1, 6 e 18, e a cardiotropina-1, dentre outros marcadores inflamatórios. Essas alterações monstraram-se independentes da etiologia da IC, sugerindo uma via patogênica comum. Em reposta a esses novos achados, intervenções no sentido de evitar e/ou reduzir essas alterações inflamatória tem sido propostas. Os benefícios cardiovasculares, induzidos treinamento aeróbio realizados em intensidades variando de leve a moderada, têm sido previamente relatados. Além disso, tem-se demonstrado que o treinamento físico (aeróbio moderado) parece capaz de modular, na vigência de um quadro inflamatório crônico anormal, a expressão elevada de citocinas pró-inflamatórias, moléculas de adesão solúveis, fatores quimioatratantes e estresse oxidativo. Tomados em conjunto, esses dados indicam um possível efeito anti-inflamatório induzido pelo treinamento físico. Dessa forma, esta revisão tem por objetivo abordar o treinamento físico como uma alternativa não farmacológica adjuvante a ser administrada em alguns quadros patológicos em que predominam as alterações crônicas do TNF-α, como na IC. Por sua vez, o "efeito anti-inflamatório" induzido pelo treinamento físico parece ser mediado principalmente pela IL-10.
Over the past 50 years, the understanding of the deteriorative changes involved in the progression of heart failure (HF), initially described as resulting from changes in salt and fluid retention, or changes in hemodynamic parameters, have changed significantly. Recently, several studies conducted in HF patients showed altered plasma (or serum) levels of pro-inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukins 1, 6, and 18, and cardiotropin-1, among other inflammatory markers. These changes were independent of HF etiology, suggesting a common pathogenic pathway. In response to these new findings, interventions to prevent and/or reduce these inflammatory changes have been proposed. The aerobic training-induced cardiovascular benefits of physical exercises performed at intensities ranging from mild to moderate have been previously reported. Moreover, it has been shown that moderate aerobic physical training seems to be able to modulate, in the presence of an abnormal chronic inflammatory condition, the overexpression of pro-inflammatory cytokines, soluble adhesion molecules, chemoattractant factors and oxidative stress. Altogether, these data indicate a possible anti-inflammatory effect induced by physical training. Therefore, this review aims to assess the role of physical training as an alternative non-pharmacological adjuvant to be administered in some pathological conditions in which TNF-α chronic changes are predominant, as in HF. The "anti-inflammatory effect" induced by physical training seems to be primarily mediated by IL-10.
En los últimos 50 años, la comprensión sobre las alteraciones deteriorativas involucradas en la progresión de la insuficiencia cardiaca (IC), descriptas inicialmente como causadas por alteraciones en la retención de sales y fluidos, o alteraciones en los parámetros hemodinámicos, ha cambiado significativamente. Recientemente, diversos estudios en pacientes con IC han demostrado niveles plasmáticos (o en el suero) alterados de citosinas proinflamatorias, tales como el factor α de necrosis tumoral (TNF-α), las interleuquinas 1, 6 y 18, y la cardiotropina-1, entre otros marcadores inflamatorios. Esas alteraciones se mostraron independientes de la etiología de la IC, sugiriendo una vía patogénica común. En respuesta a esos nuevos hallazgos, se vienen proponiendo intervenciones en el sentido de evitar y/o reducir esas alteraciones inflamatorias. Se viene relatando previamente los beneficios cardiovasculares, inducidos por el entrenamiento aerobio realizado en intensidad variando de ligera a moderada. Además, se está demostrando que el entrenamiento físico (aerobio moderado) parece capaz de modular, en la vigencia de un cuadro inflamatorio crónico anormal, la expresión elevada de citosinas proinflamatorias, moléculas de adhesión solubles, factores quimioatractantes y estrés oxidactivo. Tomados en conjunto, esos datos indican un posible efecto Antiinflamatorio inducido por el entrenamiento físico. Así, esta revisión tiene por objeto abordar el entrenamiento físico como una alternativa no farmacológica adyuvante que se administrará en algunos cuadros patológicos donde predominan las alteraciones crónicas del TNF-α, como en la IC. A su vez, el "efecto antiinflamatorio" que el entrenamiento físico induce parece mediarse sobre todo por la IL-10.
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Humanos , Terapia por Ejercicio/métodos , Insuficiencia Cardíaca/metabolismo , Mediadores de Inflamación/metabolismo , /metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Insuficiencia Cardíaca/terapiaRESUMEN
O ácido graxo (AG) é uma importante fonte de energia para o músculo esquelético. Durante o exercício sua mobilização é aumentada para suprir as necessidades da musculatura ativa. Acredita-se que diversos pontos de regulação atuem no controle da oxidação dos AG, sendo o principal a atividade do complexo carnitina palmitoil transferase (CPT), entre os quais três componentes estão envolvidos: a CPT I, a CPT II e carnitina acilcarnitina translocase. A função da CPT I durante o exercício físico é controlar a entrada de AG para o interior da mitocôndria, para posterior oxidação do AG e produção de energia. Em resposta ao treinamento físico há um aumento na atividade e expressão da CPT I no músculo esquelético. Devido sua grande importância no metabolismo de lipídios, os mecanismos que controlam sua atividade e sua expressão gênica são revisados no presente estudo. Reguladores da expressão gênica de proteínas envolvidas no metabolismo de lipídios no músculo esquelético, os receptores ativados por proliferadores de peroxissomas (PPAR) alfa e beta, são discutidos com um enfoque na resposta ao treinamento físico.
Fatty acids are an important source of energy for the skeletal muscle. During exercise, their mobilization is increased to supply the muscle energetic needs. Many points of regulation act in the fatty acids metabolism, where the carnitine palmytoiltransferase (CPT) complex is the main control system. Three compounds named CPT I, CPT II and carnitine acyl carnitine translocase (CACT) are components of this system. Its function is to control the influx of fatty acids inside the mitochondria for posterior oxidation and energy production. There is a pronounced increase in both activity and gene expression of CPT I in the skeletal muscle in response to exercise. Due to its importance in lipid metabolism, the controlling mechanisms are reviewed in the present study. The modulation of gene expression by peroxisome proliferator-activated receptors (PPARs) alpha and beta during the physical training is also discussed in this review.
Asunto(s)
Ácidos Grasos/metabolismo , Carnitina O-Palmitoiltransferasa , Expresión Génica , Metabolismo de los Lípidos , Músculo Esquelético , Receptores Activados del Proliferador del PeroxisomaRESUMEN
O objetivo do presente estudo foi verificar o efeito da temporada de basquetebol profissional sobre o perfil lipídico. Sete jogadores profissionais (idade: 23,6 mais ou menos 4,3 anos; massa corporal: 110,2 mais ou menos 17,5 kg; estatura: 195,4 mais ou menos 10,3 cm) foram avaliados antes e após um período de 4 meses, relativos a uma temporada nacional de basquetebol profissional (2 partidas por semana, 2 a 3 sessões de treinos técnicos e tático, 2 a 3 sessões de treino de musculação, 1 a 2 sessões de treino regenerativo e 1 dia de descanso passivo, sendo todos a média por semana) . Os jogadores foram submetidos a análise antropométrica e coleta sanguínea. A primeira visita foi feita antes do início da temporada e a segunda visita dois dias (48 horas) após o término da última partida da temporada. Foram realizadas análises do perfil lipídico (TAG - Triacilglicerol, VLDL - Very low density lipoprotein, LDL-c Low density lipoprotein cholesterol, HDL-c high density lipoprotein cholesterol, e colesterol total) por kits comerciais (Labtest®, Brasil). A comparação entre os resultados foi realizada pareadamente (antes e depois o início da temporada) por teste não paramétrico de Wilcoxon. Utilizou-se o nível de significância de 5% (p menor que 0,05). Após a temporada, foi demonstrada diminuição nas concentrações da LDL-c (pré: 111,40 mais ou menos 9 mg/dL vs pós: 84,60 mais ou menos 8,50 mg/dL; p menor que 0,05), bem como do colesterol total (pré: 171,20 mais ou menos 6,44 mg/dL vs pós: 148,20 mais ou menos 6,37 mg/dL; p menor que 0,05). Além disso, foi encontrado aumento na taxa HDL/colesterol total (pré: 0,22 mais ou menos 0,03 vs pós: 0,27 mais ou menos 0,06; p menor que 0,05)...
The aim of the present study was to verify the effect of the professional basketball season on the lipids profile. Seven professional players (age: 23.6 more or less 4.3 years; body mass: 110.2 more or less 17.5 kg; height: 195.4 more or less 10.3 cm) were evaluated before and after a period ranging 4 moths, during national professional basketball season (2 games per week, 2 to 3 tactical and technical exercise workout, 2 to 3 strength exercise workout, 1 to 2 recuperative workout and 1 day of passive rest, all of then as a median per week). Blood samples and anthropometric measures were taken. The first visit was made before the beginning of the season and the second visit two days (48 hours) after the ending of the last game of the season. The lipids profile (TG - Triglyceride, VLDL - very low density lipoprotein, LDL-c Low density lipoprotein cholesterol, HDL-c High density lipoprotein cholesterol, and total cholesterol) was analyses by commercial kits (Labtest®, Brazil). The comparison between the results (before and after) was carried through by non parametric Wilcoxon pair test. The level of significance of 5% was used (p smaller that 0.05). After basketball season, a reduction in the LDL-c plasma concentrations was demonstrated (before: 111.40 more or less 9 mg/dL after: 84.60 more or less 8.50mg/dL; p smaller that 0.05), as well as in total cholesterol (before: 171.20 more or less 6.44 mg/dL after: 148.20 more or less 6.37 mg/dL; p smaller that 0.05). Besides, increase in rate the HDL/total cholesterol was found (before: 0.22 more or less 0.03 after: 0.27 more or less 0.06; p smaller that 0.05). The results herein found indicate that the basketball season may induce changes in LDL-c, total cholesterol and in rate the HDL/total cholesterol concentrations, suggesting a modulatory effect on the lipid profile in professional basketball player after 4 moths season.
Asunto(s)
Humanos , Masculino , Adulto , HDL-Colesterol , LDL-Colesterol , Ejercicio Físico/fisiología , Lípidos/sangre , Baloncesto/fisiologíaRESUMEN
The present review concerns metabolic alterations related to the establishment of cancer cachexia, a condition of extensive catabolism, responsible, in a great percentage of the cases, for the death of the patient. A brief review on the condition is presented and two major aspects of the host's altered metabolism are considered: the diminished plasma levels of insulin, triggering the catabolic mechanisms; and the reduced carnitine palmitoyltransferase II activity in hepatic mitochondria, rendering the liver unable of oxidizing fatty acids and of synthesizing ketone bodies. These modifications lead to the intensification of the wasting process and thus, from our point of view, might play an important role for the treatment of patients with neoplastic disease.
Asunto(s)
Humanos , Animales , Caquexia/metabolismo , Hígado/metabolismo , Neoplasias/complicaciones , Caquexia/etiología , Carnitina O-Palmitoiltransferasa , Insulina/sangre , Neoplasias/metabolismoRESUMEN
Os ácidos graxos säo o principal substrato energético utilizado pelas fibras musculares durante a realizaçäo de um exercício de intensidade submáxima e longa duraçäo. A instalaçäo da fadiga periférica durante este tipo de atividade está relacionada à reduçäo dos estoques endógenos de carboidrato. A adoçäo da suplementaçäo lipídica visa maximizar a utilizaçäo deste tipo de substrato em detrimento aos estoques de carboidrato, promovendo assim, o efeito poupador de glicogênio ("sparing effect"). A suplementaçäo lipídica para atividades de "endurance" pode ser classificada em duas principais estratégias: a) elevaçäo aguda dos ácidos graxos no plasma e b) administraçäo de dietas hiperlipídicas. Existe, contudo, muita controvérsia em relaçäo aos possíveis efeitos benéficos ou deletérios deste tipo de suplementaçäo para atletas. O objetivo deste trabalho foi revisar a literatura sobre os efeitos da suplementaçäo lipídica sobre o desempenho físico tento de animais como de humanos
Asunto(s)
Humanos , Animales , Desempeño Psicomotor , Fatiga Muscular , Ácidos Grasos/sangre , Ejercicio Físico , Glucógeno , Lípidos/administración & dosificaciónRESUMEN
Diversos estudos relacionam a adoção de dietas hiperlipídicas ao aumento na capacidade de utilização de lipídios e, por conseguinte, à ocorrência do efeito poupador de glicogênio. Além da maior oferta, a qualidade do lipídio oferecido é capaz de alterar sua taxa de oxidação. O objetivo deste estudo foi verificar o efeito da suplementação lipídica com diferentes tipos de óleos sobre a ocorrência do efeito poupador de glicogênio em ratos submetidos ao exercício de endurance (60 VO2 pico por 60 minutos). Os animais foram divididos em três grupos: grupo controle treinado (CT), grupo treinado suplementado com óleo de fígado de bacalhau (OFBT) e grupo treinado suplementado com óleo de palmiste (OPT). Após o exercício, o conteúdo de glicogênio muscular não diferiu significativamente entre todos os grupos (Gastrocnêmio - CT - 0,31 ± 0,02, OFBT - 0,25 ± 0,02, OPT - 0,26 ± 0,02; Sóleo - CT - 0,44 ± 0,04, OFBT - 0,39 ± 0,03, OPT - 0,38 ± 0,04 mg.100 mg-1 de tecido úmido). O contrário foi observado no estoque hepático de glicogênio. Os grupos suplementados (OFBT - 1,21 ± 0,05, OPT - 1,02 ± 0,03 mg.100 mg-1 de tecido úmido)apresentaram uma redução drástica em relação ao CT (2,12 ± 0,14 mg.100 mg-1 de tecido úmido). Em ratos, conforme demonstrado anteriormente, a redução do conteúdo hepático de glicogênio e a subseqüente hipoglicemia constituem os fatores limitantes para o desempenho; portanto, independentemente do tipo de lipídio oferecido,os animais suplementados apresentaram menor estoque hepático de glicogênio e, conseqüentemente, essa adaptação será deletéria para o desempenho.