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1.
J Periodontal Res ; 51(2): 196-202, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26200226

ABSTRACT

BACKGROUND AND OBJECTIVE: Although surveys in the USA have shown that male subjects are more prone to develop periodontitis, sex as a risk factor in periodontitis, and its mechanism, remain controversial. Animal models are ideal for investigating immunological mechanisms of sex dimorphism in periodontitis because in these models it is possible to exclude the interference of gender-related risk factors, such as smoking and oral hygiene habits. Based on surveys in humans and reports on sex dimorphism in other diseases, our hypothesis is that sex is a risk factor in periodontitis. MATERIAL AND METHODS: Different murine models (oral gavage model and ligature model) for periodontitis have been utilized to determine susceptibility to periodontitis in female and male mice. Periodontal bone levels were measured as the distance from the cemento-enamel junction to the alveolar bone crest (CEJ-ABC) in young female or male mice (8-10 wk of age). Differential expression of inflammatory mediators in the gingivae of female and male mice was determined by quantitative real-time PCR. RESULTS: In comparison with male mice, female mice displayed significantly (p < 0.05) increased periodontal bone loss, accompanied by elevated expression of proinflammatory cytokines (interleukin-1ß, interleukin-6 and interleukin-17A) and higher numbers of oral bacteria. CONCLUSION: In contrast to the results in humans, in which periodontitis susceptibility is also influenced by confounding gender-related behaviors, in the murine oral gavage model and ligature model, female mice appear to be more susceptible to periodontal bone loss than male mice. In the ligature model, we observed significantly (p < 0.05) higher CEJ-ABC distance, gingival proinflammatory cytokine production and number of oral bacteria in female mice. Furthermore, our results imply that female mice develop periodontitis with a higher progression rate. Our study has therefore established that animal models can be used to dissect the mechanisms underlying genuine gender-based differences in periodontal disease susceptibility and/or progression.


Subject(s)
Periodontitis , Alveolar Bone Loss , Animals , Disease Models, Animal , Female , Interleukin-17 , Interleukin-6 , Male , Mice , Sex Characteristics
2.
Ann Biomed Eng ; 42(6): 1207-23, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24590490

ABSTRACT

The continuing lack of longitudinal histopathological and biomechanical data for human arteries in health and disease highlights the importance of studying the many genetic, pharmacological, and surgical models that are available in mice. As a result, there has been a significant increase in the number of reports on the biomechanics of murine arteries over the past decade, particularly for the common carotid artery. Whereas most of these studies have focused on wild-type controls or comparing controls vs. a single model of altered hemodynamics or vascular disease, there is a pressing need to compare results across many different models to understand more broadly the effects of genetic mutations, pharmacological treatments, or surgical alterations on the evolving hemodynamics and the microstructure and biomechanical properties of these vessels. This paper represents a first step toward this goal, that is, a biomechanical phenotyping of common carotid arteries from control mice and seven different mouse models that represent alterations in elastic fiber integrity, collagen remodeling, and smooth muscle cell functionality.


Subject(s)
Carotid Artery Diseases/genetics , Carotid Artery Diseases/physiopathology , Carotid Artery, Common/physiopathology , Hemodynamics , Models, Cardiovascular , Animals , Biomechanical Phenomena/genetics , Carotid Artery Diseases/drug therapy , Carotid Artery Diseases/pathology , Carotid Artery, Common/pathology , Disease Models, Animal , Humans , Mice
4.
J Biomech ; 42(1): 1-8, 2009 Jan 05.
Article in English | MEDLINE | ID: mdl-19070860

ABSTRACT

Arteries exhibit a remarkable ability to adapt to diverse genetic defects and sustained alterations in mechanical loading. For example, changes in blood flow induced wall shear stress tend to control arterial caliber and changes in blood pressure induced circumferential wall stress tend to control wall thickness. We submit, however, that the axial component of wall stress plays a similarly fundamental role in controlling arterial geometry, structure, and function, that is, compensatory adaptations. This observation comes from a review of findings reported in the literature and a comparison of four recent studies from our laboratory that quantified changes in the biaxial mechanical properties of mouse carotid arteries in cases of altered cell-matrix interactions, extracellular matrix composition, blood pressure, or axial extension. There is, therefore, a pressing need to include the fundamental role of axial wall stress in conceptual and theoretical models of arterial growth and remodeling and, consequently, there is a need for increased attention to evolving biaxial mechanical properties in cases of altered genetics and mechanical stimuli.


Subject(s)
Arteries/anatomy & histology , Arteries/physiology , Stress, Mechanical , Adaptation, Biological , Animals , Arteries/metabolism , Extracellular Matrix/metabolism , Hemodynamics , Humans
5.
J Appl Physiol (1985) ; 103(2): 664-72, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17525297

ABSTRACT

Muscular dystrophy is characterized by skeletal muscle weakness and wasting, but little is known about possible alterations to the vasculature. Many muscular dystrophies are caused by a defective dystrophin-glycoprotein complex (DGC), which plays an important role in mechanotransduction and maintenance of structural integrity in muscle cells. The DGC is a group of membrane-associated proteins, including dystrophin and sarcoglycan-delta, that helps connect the cytoskeleton of muscle cells to the extracellular matrix. In this paper, mice lacking genes encoding dystrophin (mdx) or sarcoglycan-delta (sgcd-/-) were studied to detect possible alterations to vascular wall mechanics. Pressure-diameter and axial force-length tests were performed on common carotid arteries from mdx, sgcd-/-, and wild-type mice in active (basal) and passive smooth muscle states, and functional responses to three vasoactive compounds were determined at constant pressure and length. Apparent biomechanical differences included the following: mdx and sgcd-/- arteries had decreased distensibilities in pressure-diameter tests, with mdx arteries exhibiting elevated circumferential stresses, and mdx and sgcd-/- arteries generated elevated axial loads and stresses in axial force-length tests. Interestingly, however, mdx and sgcd-/- arteries also had significantly lower in vivo axial stretches than did the wild type. Accounting for this possible adaptation largely eliminated the apparent differences in circumferential and axial stiffness, thus suggesting that loss of DGC proteins may induce adaptive biomechanical changes that can maintain overall wall mechanics in response to normal loads. Nevertheless, there remains a need to understand better possible vascular adaptations in response to sustained altered loads in patients with muscular dystrophy.


Subject(s)
Carotid Arteries/physiopathology , Dystrophin/physiology , Muscular Dystrophy, Animal/physiopathology , Sarcoglycans/physiology , Animals , Biomechanical Phenomena , Carotid Arteries/pathology , Disease Models, Animal , Dystrophin/genetics , Gene Expression Regulation , Male , Mice , Mice, Inbred C57BL , Mice, Inbred mdx , Mice, Knockout , Muscle, Smooth, Vascular/physiopathology , Muscular Dystrophy, Animal/pathology , Organ Culture Techniques , Sarcoglycans/genetics
6.
Sci Total Environ ; 361(1-3): 179-88, 2006 May 15.
Article in English | MEDLINE | ID: mdl-16129474

ABSTRACT

We evaluated the potential of prairie wetlands in North America as carbon sinks. Agricultural conversion has resulted in the average loss of 10.1 Mg ha(-1) of soil organic carbon on over 16 million ha of wetlands in this region. Wetland restoration has potential to sequester 378 Tg of organic carbon over a 10-year period. Wetlands can sequester over twice the organic carbon as no-till cropland on only about 17% of the total land area in the region. We estimate that wetland restoration has potential to offset 2.4% of the annual fossil CO(2) emission reported for North America in 1990.


Subject(s)
Carbon/analysis , Agriculture , Canada , Conservation of Natural Resources , Soil/analysis , United States
7.
Oral Microbiol Immunol ; 20(4): 233-8, 2005 Aug.
Article in English | MEDLINE | ID: mdl-15943768

ABSTRACT

BACKGROUND/AIMS: The etiologic relationship between periodontitis and Porphyromonas gingivalis is attributed to the ability of the organism to express a variety of virulence factors, many of which are cell surface components including lipopolysaccharide and arginine-specific cysteine proteases (Arg-gingipains, RgpA, and RgpB). P. gingivalis responds to the stress of rapid elevation in temperature by activating a set of genes to produce heat shock proteins that mediate the effects of sudden changes in environmental temperatures by repairing or eliminating cellular proteins denatured by that stress. METHODS: We used restriction fragment differential display (RFDD) to identify and measure the genes expressed by surrogates of environmental stresses, heat and oxidative stress. The results were then confirmed using quantitative reverse-transcription polymerase chain reaction. RESULTS: We selected 16 genes differentially induced from over 800 total expression fragments on the RFDD gels for further characterization. With primers designed from those fragments we found that a + 5 degrees C heat shock caused a statistically significant increase in expression compared 12 of 18 untreated genes tested. The exposure of P. gingivalis to atmospheric oxygen resulted in statistically significant increases in five of the target genes. These genes are likely involved in transport and synthesis of components of the lipopolysaccharide biosynthetic pathway important in anchoring the Arg-gingipains required for virulence-related activities. CONCLUSION: These results emphasize the need for studies to measure the coordinated responses of bacteria like P. gingivalis which use a multitude of interrelated metabolic activities to survive the environmental hazards of the infection process.


Subject(s)
Gene Expression Profiling/methods , Heat-Shock Proteins/genetics , Oxidative Stress/genetics , Porphyromonas gingivalis/genetics , Adhesins, Bacterial , Cysteine Endopeptidases/biosynthesis , Cysteine Endopeptidases/genetics , Electrophoresis, Polyacrylamide Gel , Gene Expression Regulation, Bacterial , Gingipain Cysteine Endopeptidases , Heat-Shock Proteins/biosynthesis , Hemagglutinins/biosynthesis , Hemagglutinins/genetics , Lipopolysaccharides/biosynthesis , Polymerase Chain Reaction , Porphyromonas gingivalis/metabolism , Transcriptional Activation , Virulence Factors/biosynthesis , Virulence Factors/genetics
8.
J Biomech ; 38(6): 1255-61, 2005 Jun.
Article in English | MEDLINE | ID: mdl-15863110

ABSTRACT

Three recent studies reveal that the unloaded length of a carotid artery increases significantly and rapidly in response to sustained increases in axial extension. Moreover, such lengthening involves an "unprecedented" increase in the rate of turnover of cells and matrix. Although current data are not sufficient for detailed biomechanical analyses, we present general numerical simulations that are consistent with the reported observations and support the hypothesis that rates of turnover correlate with the extent that stresses are perturbed from normal. In particular, a 3-D analysis of wall stress suggests that moderate (15%) increases in axial extension can increase the axial stress to a much greater extent than marked (50%) increases in blood pressure increase the circumferential stress. Furthermore, such increases in axial stress can occur without inducing significant gradients in stress within the wall. Consequently, we use a new, 2-D constrained mixture model to study evolving changes in the geometry, structure, and properties of carotid arteries in response to a sustained increase in axial extension. These simulations are qualitatively similar to the reports in the literature and support the notion that the stress-free lengths of individual constituents evolve during growth and remodeling.


Subject(s)
Carotid Arteries/growth & development , Carotid Arteries/physiology , Extracellular Matrix/physiology , Mechanotransduction, Cellular/physiology , Models, Cardiovascular , Muscle, Smooth, Vascular/physiopathology , Adaptation, Physiological/physiology , Animals , Blood Pressure/physiology , Computer Simulation , Elasticity , Humans , Physical Stimulation/methods , Stress, Mechanical
9.
J Biomech Eng ; 126(3): 371-81, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15341175

ABSTRACT

Evidence from diverse investigations suggests that arterial growth and remodeling correlates well with changes in mechanical stresses from their homeostatic values. Ultimately, therefore, there is a need for a comprehensive theory that accounts for changes in the 3-D distribution of stress within the arterial wall, including residual stress, and its relation to the mechanisms of mechanotransduction. Here, however, we consider a simpler theory that allows competing hypotheses to be tested easily, that can provide guidance in the development of a 3-D theory, and that may be useful in modeling solid-fluid interactions and interpreting clinical data. Specifically, we present a 2-D constrained mixture model for the adaptation of a cylindrical artery in response to a sustained alteration in flow. Using a rule-of-mixtures model for the stress response and first order kinetics for the production and removal of the three primary load-bearing constituents within the wall, we illustrate capabilities of the model by comparing responses given complete versus negligible turnover of elastin. Findings suggest that biological constraints may result in suboptimal adaptations, consistent with reported observations. To build upon this finding, however, there is a need for significantly more data to guide the hypothesis testing as well as the formulation of specific constitutive relations within the model.


Subject(s)
Blood Flow Velocity/physiology , Carotid Arteries/anatomy & histology , Carotid Arteries/physiology , Hemostasis/physiology , Mechanotransduction, Cellular/physiology , Models, Cardiovascular , Animals , Blood Pressure , Collagen/physiology , Computer Simulation , Elasticity , Elastin/physiology , Humans , Muscle, Smooth, Vascular/physiology , Pulsatile Flow , Stress, Mechanical , Viscosity
10.
J Vasc Res ; 41(4): 352-63, 2004.
Article in English | MEDLINE | ID: mdl-15353893

ABSTRACT

Hypertension results in a thickening of the arterial wall due to a net increase in wall constituents via a coordinated production and removal of smooth muscle and extracellular matrix. Although many reports address the associated changes in material properties, few models address the biomechanics of the growth and remodeling process. In this paper, we employ a new, fundamentally different approach to modeling arterial adaptation in hypertension. In particular, basic, characteristic features of hypertension are simulated using a constrained mixture model wherein individual constituents can turnover at different rates and can have different natural configurations. We show, for example, that if there is no turnover of elastin (which approximates responses in maturity), the model vessel is able to reduce an early elevation in wall stress via a thickening of the wall even though the adaptation may be suboptimal. Conversely, if all constituents can turnover completely (which may approximate late development), the model vessel can restore the state of stress and material properties to native values. Given the potential of such a model, there is a need for more data on the history of turnover of individual constituents and their individual material properties.


Subject(s)
Carotid Artery, Common/physiopathology , Hypertension/physiopathology , Models, Cardiovascular , Adaptation, Physiological , Blood Pressure , Carotid Artery, Common/growth & development , Computer Simulation , Humans , Muscle Tonus , Muscle, Smooth, Vascular/physiopathology
11.
J Biomech Eng ; 126(6): 787-95, 2004 Dec.
Article in English | MEDLINE | ID: mdl-15796337

ABSTRACT

Much of our understanding of vascular mechanotransduction has come from studies using either cell culture or in vivo animal models, but the recent success of organ culture systems offers an exciting alternative. In studying cell-mediated vascular adaptations to altered loading, organ culture allows one to impose well-controlled mechanical loads and to perform multiaxial mechanical tests on the same vessel throughout the culture period, and thereby to observe cell-mediated vascular adaptations independent of neural and hormonal effects. Here, we present a computer-controlled perfused organ culture and biomechanical testing device designed for small caliber (50-5000 micron) blood vessels. This device can control precisely the pulsatile pressure, luminal flow, and axial load (or stretch) and perform intermittent biaxial (pressure-diameter and axial load-length) and functional tests to quantify adaptations in mechanical behavior and cellular function, respectively. Device capabilities are demonstrated by culturing mouse carotid arteries for 4 days.


Subject(s)
Biomechanical Phenomena/instrumentation , Carotid Arteries/physiology , Mechanotransduction, Cellular/physiology , Organ Culture Techniques/instrumentation , Physical Stimulation/instrumentation , Robotics/instrumentation , Animals , Anisotropy , Biomechanical Phenomena/methods , Blood Flow Velocity/physiology , Blood Pressure/physiology , Elasticity , Equipment Design , Equipment Failure Analysis , Feasibility Studies , Male , Mice , Organ Culture Techniques/methods , Physical Stimulation/methods , Robotics/methods
12.
J Psychosom Res ; 51(2): 435-41, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11516766

ABSTRACT

Hyperarousal Scale scores for certain self-reported behaviors reportedly correlate with EEG arousal measures. We tested whether an insomnia subject group had different Hyperarousal Scale scores compared with hypersomnia, delayed sleep phase syndrome, procrastinator or normal subject groups. Compared with 139 normal subjects, mean scores for a group of 256 insomnia subjects was significantly 1.2 S.D. higher on Hyperarousal total scale score, 0.82 S.D. higher on React subscale score and 0.85 S.D. higher on Introspectiveness subscale score. The insomnia group median Extreme score was 2.25 times that of the normal group. These self-report findings suggest that insomnia subjects may be more responsive generally. All sleep disorder groups had increased total Hyperarousal scores, although these increases were accounted for by different scale items. The procrastinator group had Hyperarousal score patterns that generally differed from those of the other groups.


Subject(s)
Arousal , Self-Assessment , Sleep Initiation and Maintenance Disorders/diagnosis , Adult , Electroencephalography , Female , Humans , Male , Random Allocation , Retrospective Studies , Severity of Illness Index
13.
Arch Intern Med ; 161(1): 98-101, 2001 Jan 08.
Article in English | MEDLINE | ID: mdl-11146704

ABSTRACT

To determine whether the hypercoagulable state of patients with complications of diabetes can be reversed toward normal, a group of insulin-dependent individuals with proteinuria was treated with intensive insulin protocols. A statistically significant (P<.001) improvement in control of diabetes was achieved (mean +/- SEM glycosylated hemoglobin, 9.51% +/- 0.35% at baseline to 8.36% +/- 0. 39% at 12 months; and mean +/- SEM advanced glycosylated end products, 14.8 +/- 2.8 U/mL at baseline to 8.4 +/- 1.5 U/mL at 12 months). There were statistically significant decreases in 2 procoagulant factors: mean +/- SEM baseline elevated plasma factor VII, 128.69% +/- 5.63% at baseline to 106.24% +/- 3.43% at 12 months (P =.002); and mean +/- SEM plasma fibrinogen, 12.3 +/- 0.7 micromol/L (417.3 +/- 24.7 mg/dL) at baseline to 10.2 +/- 0.7 micromol/L (348.8 +/- 22.6 mg/dL) at 12 months (P =.04). Throughout the study, lipid fractions did not change significantly. Because plasma factor VII and fibrinogen concentrations were elevated while cholesterol and triglyceride concentrations were not, more attention should be paid to procoagulants as markers for thromboembolic complications in diabetic patients undergoing intensive insulin therapy.


Subject(s)
Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/drug therapy , Diabetic Angiopathies/complications , Factor VII/metabolism , Fibrinogen/metabolism , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Adult , Blood Glucose/metabolism , Diabetes Mellitus, Type 1/complications , Glycated Hemoglobin/metabolism , Humans , Middle Aged
14.
Metabolism ; 49(11): 1491-5, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11092517

ABSTRACT

The purpose of this study was to assess the effects of pulsatile intravenous insulin therapy (PIVIT) on the progression of diabetic nephropathy in patients with type 1 diabetes mellitus (DM). This 18-month multicenter, prospective, controlled study involved 49 type 1 DM patients with nephropathy who were following the Diabetes Control and Complications Trial (DCCT) intensive therapy (IT) regimen. Of these, 26 patients formed the control group (C), which continued on IT, while 23 patients formed the treatment group (T) and underwent, in addition to IT, weekly PIVIT. Blood pressure in all patients was maintained below 140/90 mm Hg on antihypertensive medication, preferentially using angiotensin-converting enzyme (ACE) inhibitors. All study patients were seen in the clinic weekly for 18 months, had monthly glycohemoglobin (HbA1c), and every 3 months, 24-hour urinary protein excretion and creatinine clearance (CrCl) determinations. The HbA1c levels declined from 8.61% +/- 0.33% to 7.68% +/- 0.31% (P = .0028) in the T group and from 9.13% +/- 0.36% to 8.19% +/- 0.33% (P = .0015) in the C group during the study period. CrCl declined significantly in both groups, as expected, but the rate of CrCl decline in the T group (2.21 +/- 1.62 mL/min/yr) was significantly less than in the C group (7.69 +/- 1.88 mL/min/yr, P = .0343). We conclude that when PIVIT is added to IT in type 1 DM patients with overt nephropathy, it appears to markedly reduce the progression of diabetic nephropathy. The effect appears independent of ACE inhibitor therapy, blood pressure, or glycemic control.


Subject(s)
Diabetic Nephropathies/drug therapy , Insulin/administration & dosage , Adult , Diabetic Nephropathies/pathology , Disease Progression , Female , Humans , Infusions, Intravenous , Insulin/therapeutic use , Male
15.
Metabolism ; 49(1): 88-91, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10647069

ABSTRACT

Patients with diabetes mellitus have a variety of platelet and coagulation system dysfunctions. At least theoretically, these can contribute to microvascular complications. Intensive glycemic control has been demonstrated to decrease microvascular complications in type 1 diabetics. We studied 16 patients with type 1 diabetes mellitus (11 men and five women; mean age, 39 years) with albuminuria greater than 0.1 g/d and/or proteinuria greater than 0.3 g/d and a creatinine clearance rate higher than 30 mL/min. They received a regimen including three to four injections of insulin per day with or without a weekly infusion of intravenous insulin, and were evaluated for 6 months. We compared the plasma level of von Willebrand factor, platelet aggregation responses to adenosine diphosphate (ADP), epinephrine, and collagen, and platelet adhesion at the beginning of the study and at follow-up intervals. Glycemic control improved significantly. There were no significant differences in the platelet aggregation responses to ADP (1.59 +/- 0.34 v 1.88 +/- 0.23 mmol/L, P = .3; normal, 4.6 +/- 0.2), epinephrine (0.50 +/- 0.20 v 1.11 +/- 0.31 mmol/L, P = .06; normal, 7.6 +/- 1.5), or collagen (92.4 +/- 6.61 v 82.60 +/- 3.78 seconds, P = .6; normal, 79.1 +/- 3.1) or in platelet adhesion (126.31 +/- 16.95 v 195.08 +/- 30.2 platelets, P = .34; normal, 68.6 +/- 1.4). Baseline von Willebrand factor increased, but not significantly (166.38% +/- 10.6% v 142.72% +/- 14.73%, P = .21; normal, 102.0% +/- 6.0%). In type 1 diabetic patients with established microvascular complications of nephropathy, a statistically significant improvement in glycemic control did not improve the in vitro platelet function abnormalities. Improved glycemic control delays the progression of microvascular disease through mechanisms not measured by tests of platelet function.


Subject(s)
Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Adenosine Diphosphate/pharmacology , Adult , Blood Platelet Disorders/blood , Collagen/pharmacology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/metabolism , Epinephrine/pharmacology , Female , Humans , Hyperglycemia/blood , Insulin/administration & dosage , Male , Microcirculation/drug effects , Platelet Aggregation/drug effects , Proteinuria/blood , von Willebrand Factor/metabolism
16.
J Microbiol Methods ; 39(2): 97-107, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10576699

ABSTRACT

Our objective was to compare three methods (enzyme-linked immunosorbent assay [ELISA], endpoint and quantitative polymerase chain reaction [E-PCR and Q-PCR]) for detection and quantitation of Bacteroides forsythus in 56 plaque samples from seven subjects with progressive periodontal disease. Samples collected in buffer were pelleted and resuspended in 500 microl of water. Fifty microl aliquots were removed for an ELISA performed on bacteria or plaque immobilized on 96-well plates and probed with B. forsythus specific antibody. An occurrence of 3.7+/-0.6 x 10(4) or more bacteria were detected by ELISA in pure culture; 26 of 54 plaque samples were positive, two samples could not be analyzed. Samples for PCR were autoclaved for 10 min prior to use. The detection level of E-PCR using primers specific for B. forsythus 16S rRNA was 200 cells and 42 out of 56 samples were positive based on ethidium bromide stained agarose gels. Q-PCR using the same primers combined with a nested fluorescent oligonucleotide probe detected 10+/-0.32 bacteria in pure culture; 43 of 56 plaque samples were positive. The ELISA and Q-PCR obtained identical results with 36 of the 54 samples assayed; there were one false positive and 17 false negative ELISA results using Q-PCR as standard. The positive proportions of plaque samples were almost the same for E-PCR and Q-PCR. We conclude that the PCR methods are more appropriate for a multicenter study because of greater sensitivity and convenience of sample transportation from clinics to a central laboratory.


Subject(s)
Bacteroides/isolation & purification , Dental Plaque/microbiology , Enzyme-Linked Immunosorbent Assay/methods , Periodontal Diseases/microbiology , Polymerase Chain Reaction/methods , Bacteroides/genetics , Bacteroides/immunology , Bacteroides Infections/microbiology , Humans
17.
Am J Hypertens ; 12(11 Pt 1): 1135-9, 1999 Nov.
Article in English | MEDLINE | ID: mdl-10604492

ABSTRACT

Twenty-six type I diabetic nephropathy patients in a rigorous schedule for glucose control to preserve kidney function were studied to determine autonomic functional changes during 18 months. Intercurrent and nonrelated acute illness, withdrawal from the study for personal reasons, or failure to undergo testing on schedule resulted in complete data at 1 year for 26 of the original 41 patients enrolled, 24 patients completing a further 6 months. Glycohemoglobin A1c dropped for the total group from 9.0 to 7.9 at 6 months, 8.0 at 12 months, and 8.1 at 18 months (P<.01). Autonomic function tests revealed baseline results that were below the anticipated normals for age in 38% to 56% of patients. Timed ventilatory heart rate variations measured for the total group were 1.11, 1.13, 1.10, and 1.09 (normal > or =1.20). Valsalva heart rate variations for the total group were 1.27, 1.30, 1.255, and 1.35 (normal > or =1.50). Assumption of upright posture-related heart rate variations for the total group were 1.10, 1.07, 1.07, and 1.06 (normal > or =1.20). Mean arterial pressure day/night ratios for the total group were 1.04, 1.05, 1.05, and 1.08 (normal > or =1.10). Group analysis based on differences in insulin treatment programs, levels of blood pressure, and levels of renal function revealed no significant differences from the total group or companion groups during 18 months. Patients with a glycohemoglobin A1c of <8.0% were more likely to normalize mean arterial pressure day/night ratios than those with glycohemoglobin A1c > or =8.0%. We conclude that aggressive glucose control in diabetic patients with proteinuria for a period of 18 months resulted in a reproducible pattern of autonomic function tests during that period of time with neither worsening nor improvement. The restoration of day/night mean arterial pressure variation in a minority of patients should be studied with a larger cohort.


Subject(s)
Autonomic Nervous System Diseases/physiopathology , Diabetic Angiopathies/drug therapy , Hypoglycemic Agents/adverse effects , Insulin/adverse effects , Adult , Aged , Autonomic Nervous System Diseases/etiology , Blood Glucose/metabolism , Blood Pressure/drug effects , Circadian Rhythm , Diabetes Mellitus, Type 1/blood , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/drug therapy , Diabetic Angiopathies/blood , Diabetic Angiopathies/complications , Diabetic Nephropathies/complications , Diabetic Nephropathies/drug therapy , Diabetic Nephropathies/metabolism , Disease Progression , Glycated Hemoglobin/metabolism , Heart Rate/drug effects , Humans , Hypoglycemic Agents/administration & dosage , Infusions, Intravenous , Insulin/administration & dosage , Middle Aged , Prognosis , Prospective Studies
18.
J Clin Endocrinol Metab ; 83(5): 1691-6, 1998 May.
Article in English | MEDLINE | ID: mdl-9589678

ABSTRACT

In humans, endotoxin activates the hypothalamic-pituitary-adrenal (HPA) axis, and the resulting increase in cortisol modulates the immune response. There is little information on the HPA axis response to other antigens. We examined the effect of the protein antigen tetanus toxoid on HPA axis activity in 10 healthy, premenopausal women (aged 28.6 +/- 2.6 yr). Subjects received im injections of placebo and tetanus toxoid at 1600 h on consecutive days. Blood samples for ACTH and cortisol were obtained every half-hour from--1 to 6 h and at 8, 12, and 16 h after each injection. Compared to placebo, tetanus toxoid administration stimulated significant increases in plasma ACTH and serum cortisol, with the maximum cortisol increase of 1.6-fold occurring 4.5 h after drug administration. Urinary free cortisol increased 1.8-fold in the 8 h after tetanus toxoid administration compared to that after placebo administration. Additionally, there was a significant inverse correlation (r = 0.87; P < 0.005) between the tetanus toxoid-induced increase in serum cortisol and the increase in tetanus antibody levels measured 1 month postvaccination. Thus, administration of the protein antigen tetanus toxoid activated the HPA axis in healthy, premenopausal women. This activation of the HPA axis correlated inversely with the antibody response to tetanus toxoid.


Subject(s)
Adrenal Glands/physiology , Antibodies/blood , Hypothalamus/physiology , Pituitary Gland/physiology , Tetanus Toxoid/immunology , Tetanus Toxoid/pharmacology , Adrenocorticotropic Hormone/blood , Adult , Antigens/immunology , Female , Humans , Hydrocortisone/blood , Hydrocortisone/urine , Kinetics , Middle Aged , Pain
19.
Am J Hypertens ; 11(3 Pt 1): 302-8, 1998 Mar.
Article in English | MEDLINE | ID: mdl-9544870

ABSTRACT

The objective of this study was to test the relationship between neurologic and microvascular complications of type 1 diabetes mellitus. It was hypothesized that the mechanisms operative in autonomic dysfunction seen in diabetic patients with microangiopathy play a role in the rapidity of progression to renal failure. Twenty-six type 1 diabetic patients with proteinuria were studied with computerized monitoring of heart rate variation during timed ventilation, assumption of upright posture, and Valsalva maneuver and with 24-h ambulatory blood pressure monitoring at baseline. Renal function was evaluated over the ensuing 12 months of intensive insulin therapy. Blood pressure was treated so as to achieve consistent 24-h readings < 140/90 mm Hg. Angiotensin converting enzyme inhibitors were the preferred antihypertensive agents. Serial serum creatinine concentrations were compared using repeated measures analysis of variance. Over 12 months there were no significant serum creatinine changes for any autonomic test group with normal results at baseline. Groups with abnormal autonomic results at baseline demonstrated statistically significant increases in serum creatinine over 12 months compared to their baseline. Of the tests, Valsalva separated groups of patients with similar degrees of baseline renal impairment. Each of the sympathetic plus Valsalva combinations demonstrated a significant difference in progression of serum creatinine increase over 12 months. In each instance, if both sympathetic and Valsalva results were abnormal, there was a statistically significant increase in serum creatinine over 12 months when compared to groups in which one or both test results were normal. There is a relationship between autonomic function and the progression of renal dysfunction. The inability to vary the heart rate to a Valsalva maneuver identifies a degree of parasympathetic dysfunction that permits unopposed sympathetic tone, heralding more rapid renal destruction. A simple inexpensive bedside laboratory test discerned a relatively low-risk group of diabetic patients with proteinuria that demonstrated no deterioration in renal function over 12 months. When the Valsalva maneuver was markedly abnormal the presence of a mean arterial pressure > 100 mm Hg was associated with a greater likelihood of rapid renal deterioration. This group at higher risk of renal deterioration should undergo aggressive lowering of mean arterial blood pressure to < 95 mm Hg.


Subject(s)
Autonomic Nervous System/physiopathology , Diabetic Nephropathies/physiopathology , Diabetic Neuropathies/physiopathology , Proteinuria/physiopathology , Adult , Aged , Creatinine/blood , Diabetes Mellitus, Type 1 , Disease Progression , Female , Humans , Hypertension/therapy , Male , Middle Aged , Parasympathetic Nervous System/physiopathology , Sympathetic Nervous System/physiopathology , Valsalva Maneuver
20.
Am J Clin Nutr ; 67(4): 640-59, 1998 Apr.
Article in English | MEDLINE | ID: mdl-9537611

ABSTRACT

Daily pattern and rates of whole-body tyrosine oxidation and phenylalanine hydroxylation were determined in young adults (15 men, 1 woman) receiving [13C]tyrosine and [(2)H2]phenylalanine via primed, constant oral infusion and [(2)H4]tyrosine by vein (five subjects also received [(2)H3]leucine simultaneously by vein) continuously for 24 h (12 h fast then 12 h fed). Subjects were given a diet supplying 96.6 (n = 5), 35.6 (the proposed requirement; n = 5), and 18.5 mg phenylalanine x kg(-1) x d(-1) (n = 6) based on an otherwise adequate L-amino acid mixture for 6 d before the 24-h tracer study began. [Each diet was low in tyrosine: 6.79 mg x kg(-1) x d(-1).] Our hypothesis was that subjects would be in tyrosine equilibrium, positive balance, or both, at the 96.6- and 35.6-mg intakes and in distinctly negative balance at the 18.5-mg intake. The diurnal pattern in phenylalanine and tyrosine kinetics was dependent on the intake and, presumably, on the adequacy of dietary phenylalanine. Wholebody tyrosine balances, determined from rates of phenylalanine hydroxylation and tyrosine input and oxidation were negative (0.05 < P < 0.1 from zero balance) with the low (18.5 mg) phenylalanine intake [total aromatic amino acid (AAA) intake: 25.3 mg x kg(-1) x d(-1)] but at equilibrium (P > 0.05 from zero balance) with the two higher phenylalanine intakes. Whole-body AAA balance (AAA intake - tyrosine oxidation) was negative (P < 0.05 from zero balance) with the low intake, at equilibrium with the intermediate intake, and apparently distinctly positive (P < 0.05) with the generous intake. Despite model limitations, as discussed, these findings lend further support for a proposed, tentative value for a total mean requirement of 39 mg AAA x kg(-1) x d(-1).


Subject(s)
Amino Acids/administration & dosage , Nutritional Requirements , Phenylalanine/administration & dosage , Tyrosine , Adolescent , Adult , Carbon Isotopes , Circadian Rhythm , Deuterium , Diet , Female , Humans , Hydroxylation , Kinetics , Male , Oxidation-Reduction , Phenylalanine/blood , Tyrosine/administration & dosage , Tyrosine/blood
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