Estudio observacional de infusión subcutánea continua de insulina a lo largo de 7 años en el tratamiento de la diabetes mellitus tipo 1

This work reports the experience with use of continuous subcutaneous insulin infusion (CSII) in 112 type 1 diabetic patients followed up for 7 years and previously treated with multiple daily insulin injections (MDII).Material and methodsA retrospective, observational study in 112 patients with diabetes mellitus treated with CSII from 2005 to 2012, previously treated with MDII and receiving individualized diabetic education with a specific protocol. Variables analyzed included: prevalence of the different indications of pump treatment; mean annual HbA1c and fructosamine values before and after CSII treatment; and hypoglycemia frequency and symptoms.ResultsThe most common reason for pump treatment was brittle diabetes (74.1%), followed by frequent or severe hypoglycemia or hypoglycemia unawareness (44.6%). Other indications were irregular food intake times for professional reasons (20.2%), dawn phenomenon (15.7%), pregnancy (12.3%), requirement of very low insulin doses (8.9%), and gestational diabetes (0.9%). HbA1c decreased by between 0.6% and 0.9%, and fructosamine by between 5.1% and 12.26%. Nine percent of patients experienced hypoglycemia weekly, 24% every two weeks, and 48% monthly. No hypoglycemia occurred in 19% of patients. Only 10% had neuroglycopenic symptoms. Hypoglycemia unawareness was found in 21%. Hypoglycemia was more common at treatment start, and its frequency rapidly decreased thereafter.ConclusionCSII therapy provides a better glycemic control than MDII treatment. Specific patient training and fine adjustment of insulin infusion doses are required to prevent hypoglycemic episodes, which are the most common complications, mainly at the start of treatment.     

门冬胰岛素与人普通胰岛素及胰岛素泵在2 型糖尿病患者围手术期 的疗效比较

目的:探讨速效胰岛素类似物(门冬胰岛素,诺和锐)与人普通胰岛素(诺和灵R)及胰岛素泵在2型糖尿病(T2DM)围手术期治疗中的有效性和安全性。方法:158例围手术期T2DM患者随机分为胰岛素泵输注门冬胰岛素治疗CSII组52例,门冬胰岛素多次皮下注射治疗MSII(A)组56例,人普通胰岛素多次皮下注射治疗MSII(B)组50例。观察各组患者治疗前后空腹和餐后2h血糖变化、血糖达标时间、胰岛素用量、低血糖发生率及术后并发症发生率。结果:3组治疗后血糖均明显低于治疗前,CSII组治疗后血糖低于MSII(A)组(P<0.05),MSII(A)组治疗后血糖低于MSII(B)组(P<0.05);术后并发症CSII组低于MSII(A)组(P<0.05),MSII(A)组低于MSII(B)组(P<0.05)。结论:门冬胰岛素对T2DM围手术期血糖控制有较好的有效性、安全性和顺应性,胰岛素泵是2型糖尿病患者围手术期胰岛素输注的最佳模式。     

Imaging mass spectrometry reveals characteristic changes in triglyceride and phospholipid species in regenerating mouse liver

After partial hepatectomy (PH), regenerating liver accumulates unknown lipid species. Here, we analyzed lipids in murine liver and adipose tissues following PH by thin-layer chromatography (TLC), imaging mass spectrometry (IMS), and real-time RT-PCR. In liver, IMS revealed that a single TLC band comprised major 19 TG species. Similarly, IMS showed a single phospholipid TLC band to be major 13 species. In adipose tissues, PH induced changes to expression of genes regulating lipid metabolism. Finally, IMS of phosphatidylcholine species demonstrated distribution gradients in lobules that resembled hepatic zonation. IMS is thus a novel and power tool for analyzing lipid species with high resolution.     

Evidence of mesenchymal stromal cell adaptation to local microenvironment following subcutaneous transplantation

Subcutaneous transplantation of mesenchymal stromal cells (MSC) emerged as an alternative to intravenous administration because it avoids the pulmonary embolism and prolongs post‐transplantation lifetime. The goal of this study was to investigate the mechanisms by which these cells could affect remote organs. To this aim, murine bone marrow–derived MSC were subcutaneously transplanted in different anatomical regions and the survival and behaviour have been followed. The results showed that upon subcutaneous transplantation in mice, MSC formed multicellular aggregates and did not migrate significantly from the site of injection. Our data suggest an important role of hypoxia‐inducible signalling pathways in stimulating local angiogenesis and the ensuing modulation of the kinetics of circulating cytokines with putative protective effects at distant sites. These data expand the current understanding of cell behaviour after subcutaneous transplantation and contribute to the development of a non‐invasive cell‐based therapy for distant organ protection.     

Fluoxetine, 17-β estradiol or folic acid combined with intra-lateral septal infusions of neuropeptide Y produced antidepressant-like actions in ovariectomized rats forced to swim

Folic acid is antidepressant, either alone or combined with several antidepressant drugs. However, the antidepressant-like actions of folic acid combined with intra-lateral septal (LSN) infusions of neuropeptide Y (NPY) in the forced swimming test (FST) have not been tested before. Thus, systemic injections of fluoxetine (20.0 mg/kg, P < 0.05; s.c.) or 17-β estradiol (10.0 μg/rat, P < 0.05; s.c.) or oral administrations of folic acid (50.0 mg/kg, P < 0.05; 75.0 mg/kg, P < 0.05) or NPY intra-LSN (3.0 μg, P < 0.05; 3.5 μg, P < 0.05) reduced immobility of ovariectomized Wistar rats. Subthreshold doses of: folic acid (25.0 mg/kg) or 17-β estradiol (5.0 μg/rat, P < 0.05) or fluoxetine (15.0 mg/kg, P < 0.05; s.c.) combined with subthreshold doses of NPY (2.5 μg/rat, P < 0.05; intra-LSN) and these combinations produced antidepressant-like actions; which were canceled by BIBP 3226 (a NPY-Y1 receptor antagonist). It is concluded that folic acid produced antidepressant-like effects probably through the participation of the NPY Y1 receptors found in the lateral septal nuclei.     

Effect of industrially produced trans fat on markers of systemic inflammation: evidence from a randomized trial in women

Consumption of industrially produced trans fatty acids (IP-TFA) has been positively associated with systemic markers of low-grade inflammation and endothelial dysfunction in cross-sectional studies, but results from intervention studies are inconclusive. Therefore, we conducted a 16 week double-blind parallel intervention study with the objective to examine the effect of IP-TFA intake on biomarkers of inflammation, oxidative stress, and endothelial dysfunction. Fifty-two healthy overweight postmenopausal women (49 completers) were randomly assigned to receive either partially hydrogenated soybean oil (15.7 g/day IP-TFA) or control oil without IP-TFA. After 16 weeks, IP-TFA intake increased baseline-adjusted serum tumor necrosis factor (TNF) α by 12% [95% confidence interval (CI): 5-20; P = 0.002] more in the IP-TFA group compared with controls. Plasma soluble TNF receptors 1 and 2 were also increased by IP-TFA [155 pg/ml (CI: 63-247); P < 0.001 and 480 pg/ml (CI: 72-887); P = 0.02, respectively]. Serum C-reactive protein, interleukin (IL) 6 and adiponectin and subcutaneous abdominal adipose tissue mRNA expression of IL6, IL8, TNFα, and adiponectin as well as ceramide content were not affected by IP-TFA, nor was urinary 8-iso-prostaglandin-F(2α). In conclusion, this dietary trial indicates that the mechanisms linking dietary IP-TFA to cardiovascular disease may involve activation of the TNFα system.     

灌胃和皮下注射脂肪膜蛋白卵黄抗体对大鼠生长和脂肪沉积的影响

目的：研究脂肪膜卵黄抗体不同处理对大鼠生长和脂肪沉积的影响。方法：选用140 g左右雌性SD大鼠96只,随机分成4组,分别灌胃阴性卵黄和含脂肪细胞膜蛋白抗体的阳性卵黄;皮下注射阴性卵黄和含脂肪细胞膜蛋白抗体的阳性卵黄。灌胃每3 d给予1 ml卵黄,皮下注射连续4 d经背部皮下多点注射1 ml卵黄,1月后同方式加强1次。75 d后屠宰并采集血样测定。结果：阳性卵黄处理后大鼠体重和摄食量无显著差异。灌胃阳性卵黄降低肠系膜脂指数、子宫周脂指数和肾脂肪囊指数（P〈0.05）;降低血清甘油三酯（P〈0.05）,升高血清游离脂肪酸（P〈0.01）;降低血清Leptin、胰岛素和TNF-α水平（P〈0.01或P〈0.05）,但对腓肠肌生长、血清总胆固醇无显著影响。皮下注射阳性卵黄提高腓肠肌指数（P〈0.05）;降低血清甘油三脂（P〈0.01）;降低血清Leptin（P〈0.01）,升高血清TNF-α（P〈0.05）;而对脂肪沉积、血清游离脂肪酸、总胆固醇和胰岛素无显著影响。结论：脂肪细胞膜蛋白卵黄抗体能有效改善机体组成,灌胃的效果优于皮下注射。     

Iscom is an efficient mucosal delivery system for Mycoplasma mycoides subsp. mycoides (MmmSC) antigens inducing high mucosal and systemic antibody responses

The purpose of this study was to explore the iscom as a mucosal delivery system for Mycoplasma mycoides subsp. mycoides small colony (MmmSC) antigens. BALB/c female mice were immunised intranasally (i.n.) twice, 8 weeks apart with three different doses (3, 10 and 20 μg) or subcutaneously (s.c.) with 3 μg of M. mycoides antigens incorporated into iscoms. Mycoplasma cells were administered s.c. twice, 8 weeks apart at a dose of 3 μg or i.n. at 10 μg as for iscoms. Both i.n. and s.c. modes of immunisation with iscoms induced prominent primary serum antibody responses in a dose-dependent manner, which were efficiently boosted. Compared to whole mycoplasma cells, iscoms enhanced the total Ig and IgG subclass (IgG1, IgG2a and IgG2b) responses in serum and in lungs greatly, and this enhancement was more prominent after i.n. than after s.c. immunisation. By the i.n. mode of immunisation iscoms containing mycoplasma antigens induced a 60-fold higher IgA response in lungs than the whole cell antigen. Iscoms also induced substantially higher total Ig and IgG subclass responses in the lungs. By Western blot a reduced number of bands (7) were detected in lung secretion after both i.n. and s.c. immunisations with iscoms compared to a high number of bands (more than 30) detected by serum antibodies. Interestingly i.n. immunisation with iscoms induced antibodies in lungs as well as in serum to mycoplasma cell antigens which differed from those induced by s.c. immunisation as revealed by the Western blot patterns.     

Patient-derived orthotopic xenograft (PDOX) mouse model of adult rhabdomyosarcoma invades and recurs after resection in contrast to the subcutaneous ectopic model

Rhabdomyosarcoma (RMS) is a rare mesenchymal tumor. The aim of the present study was to develop a patient-derived orthotopic xenograft (PDOX) mouse model of RMS and compare the PDOX model to a subcutaneous (s.c.)-transplant model. A patient RMS from a striated muscle was grown orthotopically in the right biceps femoris muscle and right quadriceps muscle of nude mice to establish a PDOX model, as well as under the skin to establish an s.c. model. PDOX tumors grew at a statistically-significant faster rate compared to the s.c. tumors. Recurrence after surgical resection occurred only in PDOX tumors, not in the s.c. model. Histologically, only the PDOX model was shown to be invasive. In conclusion, these results indicate that the PDOX model of adult RMS is malignant and the subcutaneous model is benign. These results emphasize that a proper tumor microenvironment is necessary for patient-like behavior of a tumor in a mouse model.