Interplay of retinol binding protein 4 with obesity and associated chronic alterations (Review).

Obesity is a multifactorial disease, defined as excessive fat deposition in adipose tissue. Adipose tissue is responsible for the production and secretion of numerous adipokines that induce metabolic disorders. Retinol­binding protein 4 (RBP4) is an adipokine that transports vitamin A or retinol in the blood. High levels of RBP4 are associated with development of metabolic disease, including obesity, insulin resistance (IR), metabolic syndrome, and type 2 diabetes (T2D). The present review summarizes the role of RBP4 in obesity and associated chronic alterations. Excessive synthesis of RBP4 contributes to inflammatory characteristic of obesity by activation of immune cells and release of proinflammatory cytokines, such as TNFα and ILs, via the Toll­like receptor/JNK pathway. The retinol­RBP4 complex inhibits insulin signaling directly in adipocytes by activating Janus kinase 2 (JAK2)/STAT5/suppressor of cytokine signaling 3 signaling. This mechanism is retinol­dependent and requires vitamin A receptor stimulation by retinoic acid 6 (STRA6). In muscle, RBP4 is associated with increased serine 307 phosphorylation of insulin receptor substrate­1, which decreases its affinity to PI3K and promotes IR. In the liver, RBP4 increases hepatic expression of phosphoenolpyruvate carboxykinase, which increases production of glucose. Elevated serum RBP4 levels are associated with ß­cell dysfunction in T2D via the STRA6/JAK2/STAT1/insulin gene enhancer protein 1 pathway. By contrast, RBP4 induces endothelial inflammation via the NF­κB/nicotinamide adenine dinucleotide phosphate oxidase pathway independently of retinol and STRA6, which stimulates expression of proinflammatory molecules, such as vascular cell adhesion molecule 1, E­selectin, intercellular adhesion molecule 1, monocyte chemoattractant protein 1 and TNFα. RBP4 promotes oxidative stress by decreasing endothelial mitochondrial function; overall, it may serve as a useful biomarker in the diagnosis of obesity and prognosis of associated disease, as well as a potential therapeutic target for treatment of these diseases.

The activation of hypothalamic AMP-activated protein kinase by oxidative stress is related to hyperphagia in diabetic rats.

OBJECTIVE: During diabetes, there are increased blood glucose levels and oxidative stress. The relationship between oxidative stress and the phosphorylation of AMP-activated protein kinase at the hypothalamic level has been little studied. The objective of this study was to analyze the relationship between oxidative stress and AMP-activated protein kinase activation in Wistar rats with hyperphagia and hyperglycemia. METHODS: Rats at 7, 14, and 28 days with diabetes were used. Control rats were included. Food intake was calculated to determine hyperphagia. The hypothalamus was extracted to evaluate oxidative stress markers by spectrophotometry; phosphorylation of AMP-activated protein kinase, growth hormone receptor 1a, and neuropeptide Y expression were determined by Western blot. RESULTS: There was a significant increase in the consumption of food in the experimental groups. The level of malondialdehyde decreased in the 7-day group (33%) and increased significantly in the 28-day group (90%), glutathione peroxidase activity increased in the 7-day group (70%) and decreased in the 28-day group (34%), and the phosphorylation of AMP-activated protein kinase increased significantly in the 28-day group (86%). Under ex-vivo conditions in animals with 28 days of hyperglycemia, glutathione peroxidase activity increased 195%, the malondialdehyde level decreased 87%, phosphorylation of AMP-activated protein kinase decreased 53%, and growth hormone receptor 1a expression decreased 66%, when treating hyperglycemic hypothalamic tissue with an antioxidant. NPY expression increased in hyperglycemia, and antioxidant treatment did not regulate its expression. CONCLUSIONS: The activation of AMP-activated protein kinase is related with an increase in oxidative stress markers in hyperglycemic and hyperphagic rats.

Association between Th-17 cytokine profile and clinical features in patients with spondyloarthritis.

OBJECTIVES: In recent years, a substantial amount of information has become available on the relationship between cytokines associated with the Th-17 profile and the development of spondyloarthritis (SpA). The purpose of this study was to evaluate inflammation markers in serum and synovial fluid (SF) and levels of cytokines related to the Th-17 profile in patients with different subtypes of SpA and healthy subjects. METHODS: We evaluated this cytokine profile in light of the clinical activity of the disease in 62 patients. Serum cytokine levels (IL-17, IL-6, IL-1 alpha, TNF alpha, IFN-gamma) were measured by flow cytometry. IL-23, serum amyloid (SAA) and metalloproteinase 3 (MMP-3) were measured with ELISA. In all patients, clinical evaluation was performed using the activity and function indexes of the disease. RESULTS: A comparison showed that IL-17, IL-23, IL-1 alpha, IL-6, and TNF-alpha levels were significantly higher in the serum of SpA patients than healthy subjects (HS), and there were no differences among SpA subtypes. In SF we found higher concentrations of cytokines, but only IL-23 showed significant differences (p<0.05). We found a relationship between enthesitis and peripheral involvement and serum IL-17 levels (9 to 63 pg / ml). There was a correlation between levels above 63 pg/ml and a history of infection. Higher levels of IL-23 in synovial fluid could suggest local amplification of the Th-17 cytokine profile. CONCLUSIONS: These results suggest a possible relationship between IL-17 and enthesis involvement in SpA.