Dysbiosis and leaky gut in hyper-inflated COPD patients: Have smoking and exercise training any role?

BACKGROUND: To characterize the leaky gut syndrome in a cohort of COPD patients with lung hyperinflation according to their clinical history (i.e. hyperinflation severity, chronic respiratory failure [CRF] presence, GOLD stage, prescribed therapy, smoking history) and with or without recent exercise training activity. METHODS: At the ambulatory visit, we evaluated selected COPD patients with lung hyperinflation [residual volume (RV)≥110% pred, TLC≤120% pred)] in clinical stability, identifying them as those who have attended a recent program of exercise training and those who were waiting for it. Clinical and respiratory characteristics (forced expiratory volume at the first second, forced vital capacity, and arterial blood gasses) were collected. Microbiota composition (CFU/ml), and intestinal permeability (i.e., Zonulin ng/ml) were measured in the stool and normalized to the normality cutoff value. RESULTS: All patients [n = 32, median age: 67 years, median RV: 185.0% pred (IQR: 162.0-206.0) and TLC 125.0% pred (IQR: 113.0-138.0)] showed depletion of Lactobacilli, Bacteroides and a great increase in E. Coli, KES (2 and 6.4 times) and Saccharomyces concentrations (2.5 times) other than normality. All evaluations on gut microbiota composition in the whole population were independent of BMI, CRF, GOLD stage or hyperinflation severity, and inhaled steroid therapy. Smoking habits (smokers vs ex-smokers) influenced only Bacteroides species (p<0.05) and no systemic inflammation was present in these patients. On the contrary, Zonulin concentration, a marker of intestinal permeability, was significantly higher than normal (2.8 times) and was correlated with Saccharomyces (p = 0.013). Zonulin (p = 0.001) and Saccharomyces (p<0.0001) were also significantly different in patients undergoing exercise training with respect to those on the waiting list for training. These findings were not influenced by smoking habits. CONCLUSIONS: A marked dysbiosis and leaky gut alteration characterize all COPD hyper-inflated patients, being worse in patients waiting for exercise training. A pre-to-post study is necessary to confirm these preliminary findings.

Effects of a Metabolic Mixture on Gut Inflammation and Permeability in Elderly Patients with Chronic Kidney Disease: A Proof-of-Concept Study.

Intestinal barrier dysfunction is a risk factor for the progression of Chronic Kidney Disease (CKD). In this proof-of-concept study, we tested the effects of a mixture of Essential Amino Acids (EAAs) and mitochondrial substrates on intestinal inflammation and permeability of CKD patients. Eight patients with stage 3b-4 CKD and 11 healthy controls after overnight fasting underwent fecal measures of calprotectin and zonulin levels (indicators of gut inflammation and permeability, respectively) and determinations of plasma amino acids. Only CKD patients were supplemented with the mixture (8 g/d diluted in water). Compared to controls, baseline fecal calprotectin, zonulin and plasma levels of some AA in CKD patients were significantly higher (p = 0.005; p = 0.001 and p = 0.02 to 0.003, respectively). After six months of supplementation, CKD baseline fecal levels of calprotectin and zonulin significantly (borderline for zonulin) decreased (p = 0.008 and p = 0.05, respectively). Plasma AA concentrations, including glutamine and alanine, were higher than at the baseline (p: 0.05 to 0.008). The supplementation of this mixture was associated with improved intestinal barrier dysfunction. Increased plasma AA levels might contribute to the improvement of gut barrier dysfunction.

Qualitative Nitrogen Malnutrition Damages Gut and Alters Microbiome in Adult Mice. A Preliminary Histopathological Study.

Amino-acids (AAs) are the exclusive source of nitrogen for cells. AAs result from the breakdown of food proteins and are absorbed by mucosa of the small intestine that act as a barrier to harmful materials. The quality of food proteins may differ, since it reflects content in Essential-AAs (EAAs) and digestibility but, until now, attention was paid mainly to the interaction between indigested proteins as a whole and microbiota. The link between microbiome and quality of proteins has been poorly studied, although these metabolic interactions are becoming more significant in different illnesses. We studied the effects of a special diet containing unbalanced EAAs/Non-EAAs ratio, providing excess of Non-EAAs, on the histopathology of gut epithelium and on the microbiome in adult mice, as model of qualitative malnutrition. Excess in Non-EAAs have unfavorable quick effect on body weight, gut cells, and microbiome, promoting weakening of the intestinal barrier. Re-feeding these animals with standard diet partially reversed the body alterations. The results prove that an unbalanced EAAs/Non-EAAs ratio is primarily responsible for microbiome modifications, not vice-versa. Therefore, treating microbiota independently by treating co-existing qualitative malnutrition does not make sense. This study also provides a reproducible model of sarcopenia-wasting cachexia like the human protein malnutrition.

GC-MS analysis and biological activity of hydroalcholic extracts and essential oils of Rhus typhina L. wood (anacardiaceae) in comparison with leaves and fruits.

Hydroalcoholic extracts (HE) and essential oils (EO) of branches, leaves and fruits of Rhus typhina L., were characterized by GC-MS. HE (yealds: branches 68.30 mg/g, leaves 35.82 mg/g and fruits 257.76 mg/g), showed different compositions dominated by gallic acid (33.46%) in branches, its precursor 1-cyclohexane-3,4,5-hydroxy-carboxylic acid (20.55%) in leaves and malic acid (89.15%) in fruits. EO yields were 210 µg/g for branches (main component δ-cadinene, 22.00%), followed by fruits with 132 µg/g (ß-pinene 32.2%) and by leaves with 54 µg/g and phenylacetaldehyde as major component (40.13%). Total phenolic content (TPC) was highest in branches HE (5.87 µg GAE/mL) and in EO leaves (17.71 µg GAE/mL). The highest value of radical scavenging activity (DPPH test) was detected in leaves HE and EO. The branches EO antimicrobial activity was strong against C. albicans and negligible against E. coli. Leaves and fruits EO showed strong activity against C. albicans and intermediate activity against Escherichia coli.

Evaluation of Gut Microbiota in Patients With Vulvovestibular Syndrome.

BACKGROUND: Vulvovestibular syndrome (VVS) or vulvodynia is a chronic, heterogeneous and multifactorial disease that dramatically affects women's health and quality of life. Despite important advancements in understanding VVS etiology have been achieved in the past decades, VVS still remains an elusive and complex condition without identifiable causes and effective treatments. In the present observational, retrospective, case-control study, we sought to investigate whether gut dysbiosis developed in patients with VVS. METHODS: To this aim, we compared both bacterial and fungal composition in VVS patients (n = 74; 34.3 ± 10.9 years old) with those of women without gynecological symptoms (n = 13 healthy control; 38.3 ± 10.4 years old). Furthermore, to assess whether gut ecology may have an impact on gut function, the degree of intestinal inflammation (calprotectin levels) and gut permeability (zonulin levels) were also evaluated. RESULTS: VVS patient developed gut dysbiosis, mainly characterized by a significant increase of Escherichia coli along with increased colonization of mold/yeast compared to healthy controls. Furthermore, fecal levels of zonulin indicated that in VVS patients gut dysbiosis translated into increased gut permeability. CONCLUSION: Our preliminary study, by demonstrating that alterations in gut microbiota and intestinal permeability are present in patients with VVS, highlights the novel notion that gut dysbiosis may be considered an important associated factor for VVS. These findings, if confirmed, may be clinically relevant and may help in choosing further diagnostic methods and more effective therapies for these patients.

Effect of Heat Treatment on Microstructure and Selective Corrosion of LPBF-AlSi10Mg by Means of SKPFM and Exo-Electron Emission.

The paper deals with the evolution of the microstructure of AlSi10Mg alloy obtained by laser powder bed fusion (LPBF), as a function of the post-processing heat treatment temperature. This was approached by complementary methods including FE-scanning electron microscopy, scanning Kelvin probe force microscopy and exo-electron emission techniques. The fast cooling rate of the LPBF process as compared to traditional casting produces a very fine microstructure with high mechanical properties and corrosion resistance. However, the LPBF-AlSi10Mg alloy can be susceptible to selective corrosion at the edge of the melt pools generated by the laser scan tracks. Post-process thermal treatments of the Al alloy induce a marked modification of the silicon network at melt pool edges, in particular at high temperature such as 400 °C. It was found that this is associated to a more homogeneous distribution of Volta potential. Analysis of exo-electron emission confirms the silicon diffusion during thermal treatment. The modification of the silicon network structure of the LPBF-AlSi10Mg during thermal treatment reduces the susceptibility to selective corrosion.

Stress Corrosion Cracking of Additively Manufactured Alloy 625.

Laser bed powder fusion (LPBF) is an additive manufacturing technology for the fabrication of semi-finished components directly from computer-aided design modelling, through melting and consolidation, layer upon layer, of a metallic powder, with a laser source. This manufacturing technique is particularly indicated for poor machinable alloys, such as Alloy 625. However, the unique microstructure generated could modify the resistance of the alloy to environment assisted cracking. The aim of this work was to analyze the stress corrosion cracking (SCC) and hydrogen embrittlement resistance behavior of Alloy 625 obtained by LPBF, both in as-built condition and after a standard heat treatment (grade 1). U-bend testing performed in boiling magnesium chloride at 155 and 170 °C confirmed the immunity of the alloy to SCC. However, slow strain rate tests in simulated ocean water on cathodically polarized specimens highlighted the possibility of the occurrence of hydrogen embrittlement in a specific range of strain rate and cathodic polarization. The very fine grain size and dislocation density of the thermally untreated specimens appeared to increase the hydrogen diffusion and embrittlement effect on pre-charged specimens that were deformed at the high strain rate. Conversely, heat treatment appeared to mitigate hydrogen embrittlement at high strain rates, however at the slow strain rate all the specimens showed a similar behavior.

Hydrogen Permeation in X65 Steel under Cyclic Loading.

This experimental work analyzes the hydrogen embrittlement mechanism in quenched and tempered low-alloyed steels. Experimental tests were performed to study hydrogen diffusion under applied cyclic loading. The permeation curves were fitted by considering literature models in order to evaluate the role of trapping-both reversible and irreversible-on the diffusion mechanism. Under loading conditions, a marked shift to the right of the permeation curves was noticed mainly at values exceeding the tensile yield stress. In the presence of a relevant plastic strain, the curve changes due to the presence of irreversible traps, which efficiently subtract diffusible atomic hydrogen. A significant reduction in the apparent diffusion coefficient and a considerable increase in the number of traps were noticed as the maximum load exceeded the yield strength. Cyclic loading at a tensile stress slightly higher than the yield strength of the material increases the hydrogen entrapment phenomena. The tensile stress causes a marked and instant reduction in the concentration of mobile hydrogen within the metal lattice from 55% of the yield strength, and it increases significantly in the plastic field.

Effect of Load on the Corrosion Behavior of Friction Stir Welded AA 7075-T6 Aluminum Alloy.

The paper focuses on the corrosion behavior of aluminum joints made by friction stir welding as a function of loading conditions. A four-points bend-beam test, constant loading test, and slow strain-rate test were carried out on AA 7075-T6 alloy in aerated NaCl 35g/L solution at room temperature monitoring the free corrosion potential. The penetration depth of the intergranular attack was deeper after the four-point bent-beam tests compared to all the other testing techniques. Preferential dissolution along the grain boundaries was found in the heat-affected zone and the attack follows the elongated grains structure along the rolling direction. However, no stress-corrosion cracking phenomena were detected. No relevant stress corrosion cracking (SCC) crack embryos propagation was noticed under uniaxial tensile tests-both constant loading and slow strain-rate tests-manly due to the high dissolution rate occurring at the crack tip which promoted premature shear ruptures.

Stress Corrosion Cracking of Friction Stir-Welded AA-2024 T3 Alloy.

The paper is devoted to the study of stress corrosion cracking phenomena in friction stir welding AA-2024 T3 joints. Constant load (CL) cell and slow strain rate (SSR) tests were carried out in aerated NaCl 35 g/L solution. During the tests, open circuit potential (OCP) and electrochemical impedance spectroscopy (EIS) were measured in the different zones of the welding. The results evidenced initial practical nobilty of the nugget lower compared to both heat-affected zone and the base metal. This effect can be mainly ascribed to the aluminum matrix depletion in copper, which precipitates in form of copper-rich second phases. In this zones, no stress corrosion cracking was noticed, but well-evident stress-enhanced intergranular corrosion occurred. This is due to the uneven distribution of platic deformation during the slow strain rate tests. Higher strain values are localized at the heat affected zone, where softening occurs. On the contrary, stress values at the nugget are not sufficient to favor both the initiation and propagation of stress corrosion cracks. In the range of processing parameter studied in this experimental work, the stress corrosion cracking susceptibility of the friction stir welding (FSW)-ed alloy is then similar to that of the base metal.

Hydrogen Embrittlement Evaluation of Micro Alloyed Steels by Means of J-Integral Curve.

The aim of this work is the evaluation of the hydrogen effect on the J-integral parameter. It is well-known that the micro alloyed steels are affected by Hydrogen Embrittlement phenomena only when they are subjected at the same time to plastic deformation and hydrogen evolution at their surface. Previous works have pointed out the absence of Hydrogen Embrittlement effects on pipeline steels cathodically protected under static load conditions. On the contrary, in slow strain rate tests it is possible to observe the effect of the imposed potential and the strain rate on the hydrogen embrittlement steel behavior only after the necking of the specimens. J vs. Δa curves were measured on different pipeline steels in air and in aerated NaCl 3.5 g/L solution at free corrosion potential or under cathodic polarization at -1.05 and -2 V vs. SCE. The area under the J vs. Δa curves and the maximum crack propagation rate were taken into account. These parameters were compared with the ratio between the reduction of area in environment and in air obtained by slow strain rate test in the same environmental conditions and used to rank the different steels.

Effects of chronic exercise on gut microbiota and intestinal barrier in human with type 2 diabetes.

BACKGROUND: Intestinal dysbiosis has been proposed as a possible contributor of the development of type 2 diabetes (T2D). Indeed, commensal fungi and opportunistic bacteria stimulate the local immune system, altering intestinal permeability with consequent leaky gut, which in turn activates systemic inflammation responsible for insulin resistance. It is also well known that chronic exercise improves glucose control and diabetes-induced damage. The aim of this study was to evaluate the role of chronic exercise on gut flora composition and leaky gut in T2D stable patients. METHODS: Thirty clinically stable patients with T2D were studied before and after a six months program of endurance, resistance and flexibility training. Metabolic and anthropometric evaluations were carried out. Gut flora and intestinal permeability were measured in stools by selective agar culture medium and molecular biology measurements of zonulin, which is the protein that modulates enterocyte tight junctions. RESULTS: Diabetes causes significant intestinal mycetes overgrowth, increased intestinal permeability and systemic low-grade inflammation. However, exercise improved glycemia, functional and anthropometric variables. Moreover, chronic exercise reduced intestinal mycetes overgrowth, leaky gut, and systemic inflammation. Interestingly, these variables are closely correlated. CONCLUSIONS: Exercise controls diabetes by also modifying intestinal microbiota composition and gut barrier function. This data shows an additional mechanism of chronic exercise and suggests that improving gut flora could be an important step in tailored therapies of T2D.

Microstructure and Selective Corrosion of Alloy 625 Obtained by Means of Laser Powder Bed Fusion.

The effect of microstructure on the susceptibility to selective corrosion of Alloy 625 produced by laser powder bed fusion (LPBF) process was investigated through intergranular corrosion tests according to ASTM G28 standard. The effect of heat treatment on selective corrosion susceptibility was also evaluated. The behavior was compared to commercial hot-worked, heat treated Grade 1 Alloy 625. The morphology of attack after boiling ferric sulfate-sulfuric acid test according to ASTM G28 standard is less penetrating for LPBF 625 alloy compared to hot-worked and heat-treated alloy both in as-built condition and after heat treatment. The different attack morphology can be ascribed to the oversaturation of the alloying elements in the nickel austenitic matrix obtained due to the very high cooling rate. On as-built specimens, a shallow selective attack of the border of the melt pools was observed, which disappeared after the heat treatment. The results confirmed similar intergranular corrosion susceptibility, but different corrosion morphologies were detected. The results are discussed in relation to the unique microstructures of LPBF manufactured alloys.

Corrosion Behavior of Heat-Treated AlSi10Mg Manufactured by Laser Powder Bed Fusion.

This experimental work is aimed at studying the effect of microstructural modifications induced by post-processing heat treatments on the corrosion behavior of silicon-aluminum alloys produced by means of laser powder bed fusion (LPBF). The manufacturing technique leads to microstructures characterized by the presence of melt pools, which are quite different compared to casting alloys. In this study, the behavior of an AlSi10Mg alloy was evaluated by means of intergranular corrosion tests according to ISO 11846 standard on heat-treated samples ranging from 200 to 500 °C as well as on untreated samples. We found that temperatures above 200 °C reduced microhardness of the alloy, and different corrosion morphologies occurred due to the modification of both size and distribution of silicon precipitates. Selective penetrating attacks occurred at melt pool borders. The intergranular corrosion phenomena were less intense for as-produced specimens without heat treatments compared to the heat-treated specimens at 200 and 300 °C. General corrosion morphologies were noticed for specimens heat treated at temperatures exceeding 400 °C.

Air dispersed essential oils combined with standard sanitization procedures for environmental microbiota control in nosocomial hospitalization rooms.

OBJECTIVE: Environmental bacterial contaminant microorganisms are an ongoing problem in hospitals. Essential oil vapours (EO) may help reducing this type of contamination. Aim of this study was to evaluate the efficacy of nebulized selected essential oils (EO) in reducing the microbial contamination in residential health care house rooms. DESIGN: The study was carried out in a two-story 112-bed tertiary care structure (approximately 1060 m(2)). Contamination in rooms and corridors was monitored for a total of n=5 months, including a starting baseline sampling and one end-study point, and without combined treatment (standard sanitization alone). Contact slides were collected for microbiological analysis. RESULTS: Reductions in both bacterial and fungal contamination were observed between rooms cleaned using standard sanitization alone or in combination with essential oils nebulization (average 90% decrease for total count, P<0.01; 90% for yeasts and molds, P<0.05). Decreases of antibiotic (70%), mucolytic (100%), bronchodilators (100%), and steroidal (67%) and non-steroidal anti-inflammatory drugs (33%) prescriptions were observed, with no adverse effects on patients. CONCLUSIONS: The selected EO composition is effective in reducing both the environmental microbial contamination and pharmaceutical drugs consumption in a nosocomial health care house. This study demonstrates that aerial EO diffusion combined with standard sanitization procedures, has great potential to reduce the microbial contamination in critical hospital environments such as hospitalization rooms.

Pathogenic Gut Flora in Patients With Chronic Heart Failure.

OBJECTIVES: The goal of this study was to measure the presence of pathogenic gut flora and intestinal permeability (IP) and their correlations with disease severity, venous blood congestion, and inflammation in patients with chronic heart failure (CHF). BACKGROUND: Evidence suggests that translocation of gut flora and/or their toxins from the intestine to the bloodstream is a possible trigger of systemic CHF inflammation. However, the relation between pathogenic gut flora and CHF severity, as well as IP, venous blood congestion as right atrial pressure (RAP), and/or systemic inflammation (C-reactive protein [CRP]), is still unknown. METHODS: This study analyzed 60 well-nourished patients in stable condition with mild CHF (New York Heart Association [NYHA] functional class I to II; n = 30) and moderate to severe CHF (NYHA functional class III to IV; n = 30) and matched healthy control subjects (n = 20). In all subjects, the presence and development in the feces of bacteria and fungi (Candida species) were measured; IP according to cellobiose sugar test results was documented. The study data were then correlated with RAP (echocardiography) and systemic inflammation. RESULTS: Compared with normal control subjects, the entire CHF population had massive quantities of pathogenic bacteria and Candida such as Campylobacter (85.3 ± 3.7 CFU/ml vs. 1.0 ± 0.3 CFU/ml; p < 0.001), Shigella (38.9 ± 12.3 CFU/ml vs. 1.6 ± 0.2 CFU/ml; p < 0.001), Salmonella (31.3 ± 9.1 CFU/ml vs 0 CFU/ml; p < 0.001), Yersinia enterocolitica (22.9 ± 6.3 CFU/ml vs. 0 CFU/ml; p < 0.0001), and Candida species (21.3 ± 1.6 CFU/ml vs. 0.8 ± 0.4 CFU/ml; p < 0.001); altered IP (10.2 ± 1.2 mg vs. 1.5 ± 0.8 mg; p < 0.001); and increased RAP (12.6 ± 0.6 mm Hg) and inflammation (12.5 ± 0.6 mg/dl). These variables were more pronounced in patients with moderate to severe NYHA functional classes than in patients with the mild NYHA functional class. Notably, IP, RAP, and CRP were mutually interrelated (IP vs. RAP, r = 0.55; p < 0.0001; IP vs. CRP, r = 0.78; p < 0.0001; and RAP vs. CRP, r = 0.78; p < 0.0001). CONCLUSIONS: This study showed that patients with CHF may have intestinal overgrowth of pathogenic bacteria and Candida species and increased IP associated with clinical disease severity, venous blood congestion, and inflammation.

Activation of porcine endothelium in response to xenogeneic serum causes thrombosis independently of platelet activation.

BACKGROUND: Endothelial cell activation and microvascular thrombosis are hallmarks of hyperacute xenograft rejection. However, the molecular determinants of platelet-endothelial interaction and thrombus formation are poorly understood. This study investigated whether: (i) xenogeneic human serum (HS), as a source of xenoreactive antibodies and complement, activates porcine aortic endothelial cells (PAEC) to promote thrombus formation under high shear stress; (ii) the endothelial adhesive proteins vitronectin receptor and P-selectin are involved in the von Willebrand factor (VWF)-platelet interaction during the thrombotic process under flow; (iii) reactive oxygen species (ROS) are activated by complement and served as intracellular signals for adhesive protein up-regulation. METHODS: The PAEC were pre-exposed for 90 min in static conditions to medium plus 10, 20, and 50% HS or 20% porcine serum (PS), as control, then cells were perfused at 50 dynes/cm2 in a parallel plate flow chamber with human blood and area occupied by thrombi was measured. The role of complement in HS-induced thrombus formation was assessed by incubating PAEC with 20% HS in the presence of soluble complement receptor type 1 (sCR1) before blood perfusion. The effect of platelet activation was assessed using human blood treated or not with ADP and then flowed over PAEC pre-exposed to 20% HS or 20% PS as control. To identify the endothelial adhesive proteins involved in thrombus formation PAEC treated with 20% HS were then incubated with anti-vitronectin receptor antibody, anti-P-selectin antibody or P-selectin glycoprotein ligand-1 (PSGL-1), the soluble ligand of P-selectin, before the adhesion assay. Confocal microscopy was used to detect changes in endothelial adhesive protein expression. VWF interaction with platelet receptors GPIb and alphaIIbbeta3 was assessed adding aurin tricarboxylic acid (ATA) and anti-alphaIIbbeta3 antibody to blood before perfusion. The ROS involvement in xenogeneic serum-induced thrombus formation was determined studying the intracellular production of hydrogen peroxide (H2O2). The effect of antioxidants and metal chelators on HS-induced thrombus formation was evaluated treating PAEC with pyrrolidine dithiocarbamate (PDTC) or 1,3-dimethyl-2-thiourea (DMTU) before and during incubation with 20% HS followed by blood perfusion. The effect of antioxidants and sCR1 on ROS generation was investigated treating PAEC with PDTC or DMTU before and during incubation with 20% HS. Intracellular ROS generation was measured by fluorescence spectroscopy using the probe dihydrorhodamine 123 (DHR-123). RESULTS: Human serum but not PS caused thrombus formation on PAEC under high shear stress. Blockade of complement activation by sCR1 prevented xenogeneic serum-induced thrombus formation. Activated platelets did not promote thrombus formation on resting endothelium, and did not further increase platelet deposition on xenogeneic serum-treated PAEC. Vitronectin receptor and P-selectin were up-regulated on the endothelial surface by HS. Their functional blockade by specific antibodies prevented platelet deposition and thrombus formation. H2O2 production significantly increased when PAEC were exposed to the xenogeneic condition. Antioxidants and sCR1 completely prevented thrombus formation by reducing excessive ROS production and the expression of vitronectin receptor and P-selectin. CONCLUSIONS: Xenogeneic complement induces endothelial cell activation and thrombosis which is independent of platelet activation. Complement deposition elicits a rapid generation of ROS that lead to overexpression of endothelial adhesive molecules instrumental for platelet deposition.