scholarly journals Tryptophan Metabolism, Inflammation, and Oxidative Stress in Patients with Neurovascular Disease

Metabolites ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 208 ◽  
Author(s):  
Martin Hajsl ◽  
Alzbeta Hlavackova ◽  
Karolina Broulikova ◽  
Martin Sramek ◽  
Martin Maly ◽  
...  

Atherosclerosis is a leading cause of major vascular events, myocardial infarction, and ischemic stroke. Tryptophan (TRP) catabolism was recognized as an important player in inflammation and immune response having together with oxidative stress (OS) significant effects on each phase of atherosclerosis. The aim of the study is to analyze the relationship of plasma levels of TRP metabolites, inflammation, and OS in patients with neurovascular diseases (acute ischemic stroke (AIS), significant carotid artery stenosis (SCAS)) and in healthy controls. Blood samples were collected from 43 patients (25 with SCAS, 18 with AIS) and from 25 healthy controls. The concentrations of twelve TRP metabolites, riboflavin, neopterin (NEO, marker of inflammation), and malondialdehyde (MDA, marker of OS) were measured by liquid chromatography–tandem mass spectrometry (LC-MS/MS). Concentrations of seven TRP metabolites (TRP, kynurenine (KYN), 3-hydroxykynurenine (3-HK), 3-hydroxyanthranilic acid (3-HAA), anthranilic acid (AA), melatonin (MEL), tryptamine (TA)), NEO, and MDA were significantly different in the studied groups. Significantly lower concentrations of TRP, KYN, 3-HAA, MEL, TA, and higher MDA concentrations were found in AIS compared to SCAS patients. MDA concentration was higher in both AIS and SCAS group (p < 0.001, p = 0.004, respectively) compared to controls, NEO concentration was enhanced (p < 0.003) in AIS. MDA did not directly correlate with TRP metabolites in the study groups, except for 1) a negative correlation with kynurenine acid and 2) the activity of kynurenine aminotransferase in AIS patients (r = −0.552, p = 0.018; r = −0.504, p = 0.033, respectively). In summary, TRP metabolism is clearly more deregulated in AIS compared to SCAS patients; the effect of TRP metabolites on OS should be further elucidated.

Author(s):  
Elisabeth Kliem ◽  
Elise Gjestad ◽  
Truls Ryum ◽  
Alexander Olsen ◽  
Bente Thommessen ◽  
...  

Abstract Objective: Findings on the relationship of psychiatric symptoms with performance-based and self-reported cognitive function post-stroke are inconclusive. We aimed to (1) study the relation of depression and anxiety to performance-based cognitive function and (2) explore a broader spectrum of psychiatric symptoms and their association with performance-based versus self-reported cognitive function. Method: Individuals with supratentorial ischemic stroke performed neuropsychological examination 3 months after stroke. For primary analyses, composite scores for memory and attention/executive function were calculated based on selected neuropsychological tests, and the Hospital Anxiety and Depression Scale (HADS) was used. Psychiatric symptoms and self-reported cognitive function for secondary aims were assessed using the Symptom-Checklist-90 – Revised (SCL-90-R). Results: In a sample of 86 patients [mean (M) age: 64.6 ± 9.2; Mini-Mental State Examination (MMSE), 3–7 days post-stroke: M = 28.4 ± 1.7; National Institutes of Health Stroke Scale (NIHSS) after 3 months: M = 0.7 ± 1.6] depressive symptoms (HADS) were associated with poorer memory performance after controlling for age, sex, and education (p ≤ .01). In a subsample (n = 41; Age: M = 65.7 ± 8.1; MMSE: M = 28.4 ± 1.8; NIHSS: M = 1.0 ± 1.9), symptoms of phobic anxiety (SCL-90-R) were associated with poorer performance-based memory and attention/executive function, and symptoms of anxiety (SCL-90-R) with lower attention/executive function. Higher levels of self-reported cognitive difficulties were associated with higher scores in all psychiatric domains (p ≤ .05). Conclusion: Even in relatively well-functioning stroke patients, depressive symptoms are associated with poorer memory. The results also suggest that various psychiatric symptoms are more related to self-reported rather than to performance-based cognitive function. Screening for self-reported cognitive difficulties may not only help to identify patients with cognitive impairment, but also those who need psychological treatment.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Janet Prvu Bettger ◽  
Xin Zhao ◽  
Cheryl Bushnell ◽  
Louise Zimmer ◽  
Ying Xian ◽  
...  

Background: Socioeconomic status (SES) is widely recognized as an area of inequity that affects health outcomes. However, social determinants of health are less frequently measured in longitudinal studies of acute stroke patients. The relationship of SES on disability 3-months post-stroke is unknown. Methods: We analyzed ischemic stroke patients in the AVAIL registry who were enrolled at 98 hospitals participating in Get With The Guidelines-Stroke. Patients who died (n=64) or did not complete a modified Rankin Scale (mRS) at 3-months (n=154) were excluded. Multivariable logistic regression was used to examine the relationship of SES (defined by level of education, work status, and perceived adequacy of household income to meet needs) and disability (mRS scores 3-5). Results: Among the 2092 stroke patients who met eligibility criteria, the mean age was 65.5 ± 13.7, 44.2% were female, and 82.7% were White. Fifty seven percent had a high school or less education, 11.4% were not working post-stroke and were home not by choice, and 25.7% were without an adequate household income. A third of the sample had some level of disability at 3-months (34.6% mRS 3-5). Those with disability were more likely to be older, non-White, female, single, less educated, have inadequate income, and were home not by choice. In the multivariable analysis, lower education, inadequate income, and being home but not by choice (compared with those who returned to work) were independently associated with disability (p<0.01; Table ). Conclusion: In this national cohort of stroke survivors, socioeconomic status as measured by level of education, work status, and income were independently associated with post-stroke disability.


2019 ◽  
Vol 3 (24) ◽  
pp. 40-44
Author(s):  
Yu. V. Kotsyubinskaya ◽  
A. V. Kazakov ◽  
N. Yu. Safonova

Currently, studies aimed at assessing the emotional state and cognitive processes associated with the processing of emotionally determined information in patients with ischemic stroke, as well as finding the relationship between them are particularly relevant, mainly for the subsequent optimization of the therapeutic process. In order to identify the features of the emotional state and cognitive processes, a group of patients with ischemic stroke in the acute period in the amount of 25 people was examined. It was established that in patients with a lesion in the anterior cortex, depressive states in the acute period of stroke are more pronounced. Patients successfully reproduce emotionally significant words in comparison with neutral words; an interrelation between the level of anxiety and depression was found, which indicates that these states are comorbid. But, in turn, the relationship of the severity of anxiety and depression with the cognitive processes of recognition and reproduction, as well as differences in mnestic and gnostic activity in patients with different levels of anxiety and depression were not identified. After the treatment with Semax an improvement was noted.


2018 ◽  
Vol 15 (3) ◽  
pp. 14-20
Author(s):  
Yassine Chahirou ◽  
Abdelhalim Mesfioui ◽  
Ali Ouichou ◽  
Aboubaker Hessni

Current studies show that metabolic and behavioral disorders represent severe health problems. Several questions arise about the molecular relationship of metabolic and behavioral disorders. This review will discuss the relationship of lipid metabolism and fructose consumption accompanied by an increase in weight as well as associated disorders: hypertension, insulin-resistance, oxidative stress and depression. Adipose tissue is considered as an endocrine tissue with intense secretory activities (metabolic and inflammatory). These adipokines are responsible for an alteration of several physiological functions. In this review we will try to understand how lipogenesis that causes dyslipidemia can influence insulin resistance, hypertension, oxidative stress, depression and the relationship between these various disorders.


2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Bingyang Liu ◽  
Yue Li ◽  
Jiamei Guo ◽  
Yuting Fan ◽  
Ling Li ◽  
...  

Aims. To investigate the influence of body mass index (BMI) and its change from adolescence to adulthood (ΔBMI) on the risk of metabolic syndrome (MetS) in early adulthood. Methods. We selected 931 students from 12 to 16 years of age in Liaoyang City, China. Ninety-three participants from 18 to 22 years of age with complete baseline data were available for follow-up after 5 years. Statistical analysis determined the relationship of MetS at follow-up with baseline BMI (BMIb), ΔBMI, and follow-up BMI (BMIf). Results. ΔBMI was positively correlated with the change of waist circumference (ΔWC), systolic blood pressure (ΔSBP), triglycerides (ΔTG), uric acid, and glycosylated hemoglobin (ΔHbA1c) in follow-up ( p < 0.05 ). For every 1 kg/m2 increase in BMIb, ΔBMI, and BMIf, the risk of MetS at follow-up increased 1.201-fold, 1.406-fold, and 1.579-fold, respectively. Both BMIb and ΔBMI were predictive of MetS at follow-up, with prediction thresholds of 23.47 kg/m2 and 1.95 kg/m2. The participants were divided by the predicted BMIb and ΔBMI threshold values into four study groups. Interestingly, the group with lower BMI but a higher increase in BMI presented the same metabolic derangements and Mets% of the group with higher BMI but lower Δ BMI. Conclusion. Both BMI of adolescence and ΔBMI were predictive of MetS and cardiovascular risk factors in adulthood. Control of both variables in adolescents would be more effective in decreasing the risk of MetS in young adults than control of BMI alone.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
xiaoqing bu ◽  
Yonghong Zhang ◽  
Tan Xu ◽  
Hao Peng ◽  
Jing Chen ◽  
...  

Introduction: The relationship between estimated-glomerular filtration rate (eGFR) and acute ischemic stroke outcomes remains controversial. Hypothesis: We aimed to evaluate the impact of eGFR on all-cause mortality, recurrent stroke, and vascular events in patients with acute ischemic stroke. Methods: 4036 patients with acute ischemic stroke recruited from 26 hospitals across China from August 2009 to May 2013 were included in our study. GFR was estimated by CKD-EPI equations based on serum creatinine and/or cystatin C (CKD-EPIcr, CKD-EPIcys, and CKD-EPIcr-cys). The Cox proportional hazards models were used to examine the relationship between declined eGFR and 1-year all-cause mortality, recurrent stroke, and vascular events. Declined eGFR was defined as <60 mL/min /1.73 m2. Results: Declined eGFR was present in 7.22% (n=281) of patients based on the CKD-EPIcr equation, 3.43% (n=119) based on the CKD-EPIcys equation, and 5.67% (n=170) based on the CKD-EPIcr-cys equation. Compared to patients with an eGFR ≥90 mL/min /1.73 m2, adjusted hazard ratios (95% confidence interval) for all-cause mortality associated with eGFR<60 mL/min /1.73 m2 were 1.68 (1.06 to 2.66, p=0.026), 2.29 (1.29 to 4.06, p=0.005), and 1.79 (1.08 to 2.98, p=0.024) using CKD-EPIcr, CKD-EPIcys, and CKD-EPIcr-cys equations, respectively. For recurrent stroke, adjusted hazard ratios (95% confidence interval) were 0.90 (0.49 to 1.66, p=0.743), 0.60 (0.19 to 1.93, p=0.393), and 0.89 (0.40 to 1.95, p=0.762), respectively. For vascular events, adjusted hazard ratios (95% confidence interval) were 1.33 (0.81 to 2.19, p=0.266), 1.07 (0.46 to 2.47, p=0.880), and 1.31 (0.70 to 2.43, p=0.403), respectively. Conclusion: Our study indicates that declined eGFR is a strong independent risk factor for total mortality among patients with acute ischemic stroke. However, there is no association between low eGFR and recurrent stroke or vascular events among patients with acute ischemic stroke. In addition, the association of eGFR with all-cause mortality among patients with acute ischemic stroke is stronger when eGFR was calculated based on the CKD-EPIcys equation compared to CKD-EPIcr and CKD-EPIcr-cys equations.


Neurology ◽  
2020 ◽  
pp. 10.1212/WNL.0000000000011258
Author(s):  
Longting Lin ◽  
Jianhong Yang ◽  
Chushuang Chen ◽  
Huiqiao Tian ◽  
Andrew Bivard ◽  
...  

ObjectiveTo test the hypothesis that acute ischemic patients with poorer collaterals would have faster ischemic core growth, we included 2 cohorts in the study, cohort 1 of 342 patients for derivation and cohort 2 of 414 patients for validation purpose.MethodsAcute ischemic stroke patients with large vessel occlusion were included. Core growth rate was calculated by the following equation: Core growth rate = Acute core volume on CTP/Time from stroke onset to CTP. Collateral status was assessed by the ratio of severe hypoperfusion volume within the hypoperfusion region of CTP. The CTP collateral index was categorized in tertiles; for each tertile, core growth rate was summarized as median and inter-quartile range. Simple linear regressions were then performed to measure the predictive power of CTP collateral index in core growth rate.ResultsFor patients allocated to good collateral on CT perfusion (tertile 1 of collateral index), moderate collateral (tertile 2), and poor collateral (tertile 3), the median core growth rate was 2.93 mL/h (1.10–7.94), 8.65 mL/h (4.53–18.13), and 25.41 mL/h (12.83–45.07) respectively. Increments in the collateral index by 1% resulted in an increase of core growth by 0.57 mL/h (coefficient = 0.57, 95% confidence interval = [0.46, 0.68], p < 0.001). The relationship of core growth and CTP collateral index was validated in cohort 2. An increment in collateral index by 1% resulted in an increase of core growth by 0.59 mL/h (coefficient = 0.59 [0.48–0.71], p < 0.001) in cohort 2.ConclusionCollateral status is a major determinant of ischemic core growth.


1987 ◽  
Vol 7 (3) ◽  
pp. 168-173 ◽  
Author(s):  
Mrinal K. Oasgupta ◽  
Kelvin B. Bettcher ◽  
Raymond A. Ulan ◽  
Valorie Burns ◽  
Kan Lam ◽  
...  

To examine the relationship of the formation of biofilm (adherent bacterial microcolonies) to recurrent peritonitis in patients on continuous ambulatory peritoneal dialysis (CAPO) we examined the surfaces of 25 recovered Tenckhoff (T) catheters by scanning electron microscopy (SEM) and microbiological examination of scrapings. Twelve catheters had been removed after successful transplantation; the patients had not been dialyzed for three months and had no evidence of peritonitis during that period (control group), and only seven had experienced peritonitis (I or 2 episodes) before transplantation. All 13 patients in the study group had experienced repeated episodes of peritonitis (range 3–13, average, 5.6). We detected no significant differences between the control and study groups with respect to the percentage of catheter-surface covered by biofilm, or the proportion of catheter segments whose scrapings yielded positive bacterial cultures. It is concluded that large areas of the T catheters of CAPO patients are colonized by bacterial biofilms but only active dialysis predisposes to recurrent peritonitis.


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