beta(1) Adrenergic receptor is key to cold- and diet-induced thermogenesis in mice

Brown adipose tissue (BAT) is predominantly regulated by the sympathetic nervous system (SNS) and the adrenergic receptor signaling pathway. Knowing that a mouse with triple beta-receptor knockout (KO) is cold intolerant and obese, we evaluated the independent role played by the beta(1) isoform in energy homeostasis. First, the 30 min i.v. infusion of norepinephrine (NE) or the beta(1) selective agonist dobutamine (DB) resulted in similar interscapular BAT (iBAT) thermal response in WT mice. Secondly, mice with targeted disruption of the beta(1) gene (KO of beta(1) adrenergic receptor (beta 1KO)) developed hypothermia during cold exposure and exhibited decreased iBAT thermal response to NE or DB infusion. Thirdly, when placed on a high-fat diet (HFD; 40% fat) for 5 weeks, beta 1KO mice were more susceptible to obesity than WT controls and failed to develop diet-induced thermogenesis as assessed by BAT Ucp1 mRNA levels and oxygen consumption. Furthermore, beta 1KO mice exhibited fasting hyperglycemia and more intense glucose intolerance, hypercholesterolemia, and hypertriglyceridemia when placed on the HFD, developing marked non-alcoholic steatohepatitis. In conclusion, the beta(1) signaling pathway mediates most of the SNS stimulation of adaptive thermogenesis. Journal of Endocrinology (2012) 214, 359-365

HYDROGEN SULFIDE AS A CRYOGENIC MEDIATOR OF HYPDXIA-INDUCED ANAPYREXIA

Hypoxia causes a regulated decrease in body temperature (Tb), a response that has been aptly called anapyrexia, but the mechanisms involved are not completely understood. The roles played by nitric oxide (NO) and other neurotransmitters have been documented during hypoxia-induced anapyrexia, but no information exists with respect to hydrogen sulfide (H(2)S), a gaseous molecule endogenously produced by cystathionine beta-synthase (CBS). We tested the hypothesis that HA production is enhanced during hypoxia and that the gas acts in the anteroventral preoptic region (AVPO; the most important thermosensitive and thermointegrative region of the CNS) modulating hypoxia-induced anapyrexia. Thus, we assessed CBS and nitric oxide synthase (NOS) activities [by means of H2S and nitrite/nitrate (NO(x)) production, respectively] as well as cyclic adenosine 3',5'-monophosphate (cAMP) and cyclic guanosine 3',5'-monophosphate (cGMP) levels in the anteroventral third ventricle region (AV3V; where the AVPO is located) during normoxia and hypoxia. Furthermore, we evaluated the effects of pharmacological modifiers of the H2S pathway given i.c.v. or intra-AVPO. I.c.v. or intra-AVPO microinjection of CBS inhibitor caused no change in Tb under normoxia but significantly attenuated hypoxia-induced anapyrexia. During hypoxia there were concurrent increases in H2S production, which could be prevented by CBS inhibitor, indicating the endogenous source of the gas. cAMP concentration, but not cGMP and NOR, correlated with CBS activity. CBS inhibition increased NOS activity, whereas H2S donor decreased NO. production. In conclusion, hypoxia activates H2S endogenous production through the CBS-H(2)S pathway in the AVPO, having a cryogenic effect. Moreover, the present data are consistent with the notion that the two gaseous molecules, H(2)S and NO, play a key role in mediating the drop in Tb caused by hypoxia and that a fine-balanced interplay between NOS-NO and CBS-H(2)S pathways takes place in the AVPO of rats exposed to hypoxia. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.

Ether-A -go-go 1 (Eag1) Potassium Channel Expression in Dopaminergic Neurons of Basal Ganglia is Modulated by 6-Hydroxydopamine Lesion

The ether A go-go (Eag) gene encodes the voltage-gated potassium (K+) ion channel Kv10.1, whose function still remains unknown. As dopamine may directly affect K+ channels, we evaluated whether a nigrostriatal dopaminergic lesion induced by the neurotoxin 6-hydroxydopamine (6-OHDA) would alter Eag1-K+ channel expression in the rat basal ganglia and related brain regions. Male Wistar rats received a microinjection of either saline or 6-OHDA (unilaterally) into the medial forebrain bundle. The extent of the dopaminergic lesion induced by 6-OHDA was evaluated by apomorphine-induced rotational behavior and by tyrosine hydroxylase (TH) immunoreactivity. The 6-OHDA microinjection caused a partial or complete lesion of dopaminergic cells, as well as a reduction of Eag1+ cells in a manner proportional to the extent of the lesion. In addition, we observed a decrease in TH immunoreactivity in the ipsilateral striatum. In conclusion, the expression of the Eag1-K+-channel throughout the nigrostriatal pathway in the rat brain, its co-localization with dopaminergic cells and its reduction mirroring the extent of the lesion highlight a physiological circuitry where the functional role of this channel can be investigated. The Eag1-K+ channel expression in dopaminergic cells suggests that these channels are part of the diversified group of ion channels that generate and maintain the electrophysiological activity pattern of dopaminergic midbrain neurons.

Intervenção educativa sobre hipotermia: uma estratégia de ensino para aprendizagem em centro cirúrgico

Este trabalho trata-se de um estudo quase experimental aplicado em uma intervenção educativa de curta duração aos auxiliares de enfermagem do Centro Cirúrgico, cujos objetivos foram conhecer as características sociais e de formação dos auxiliares de enfermagem; identificar a diferença no conhecimento sobre hipotermia no auxiliar de enfermagem após a intervenção educativa e relacionar as ações de enfermagem às variáveis estudadas. A intervenção educativa foi efetiva, uma vez que a diferença na média das ações de enfermagem foi de 5,35 após a intervenção educativa. Entretanto, não se verificou diferença significativa das ações de enfermagem quando relacionadas às variáveis estudadas. Recomenda-se realizar estudos sobre educação nos profissionais de Enfermagem, baseado na aprendizagem significativa nas diferentes unidades.

Temperatura corporal, índice Aldrete e Kroulik e alta do paciente da Unidade de Recuperação Pós-Anestésica

A alta do paciente da recuperação pós-anestésica (RPA) depende, dentre outros fatores, do retorno à normotermia e do escore alcançado pelo Índice de Aldrete e Kroulik. Sendo assim, o objetivo deste estudo foi verificar a relação entre o Índice de Aldrete e Kroulik e a temperatura corporal dos pacientes. O local de pesquisa foi o Hospital Universitário da Universidade de São Paulo. O cálculo amostral foi determinado por conveniência e foi constituído por 60 pacientes, entre 18 e 60 anos, submetidos à anestesia geral. Foram verificados a temperatura corporal na região timpânica e o Índice de Aldrete e Kroulik do paciente na recepção e alta da recuperação pós-anestésica. Os dados obtidos foram processados pelo pacote estatístico SPSS, com um nível de 5% de significância, e aplicaram-se o teste de Spearman e o teste de Wilcoxon. Conclui-se que não houve correlação significativa entre os dois parâmetros indicativos de alta.

Conhecimento sobre hipotermia dos profissionais de Enfermagem do Centro Cirúrgico

Objetivou-se identificar a diferença no conhecimento sobre hipotermia do auxiliar de enfermagem após a intervenção educativa. A base conceitual de educação fundamenta-se na perspectiva da aprendizagem significativa, aliada à construção de mapa conceitual e à realização de estudo de caso. Os dados foram coletados por meio de um questionário validado por especialistas. A média do conhecimento após a intervenção educativa teve aumento de 3,49 pontos. Não se verificou diferença significativa do conhecimento quando foi relacionado às variáveis sociais e de formação estudadas. Conclui-se que a intervenção educativa foi satisfatória na medida em que as informações sobre hipotermia foram ancoradas e modificadas na estrutura cognitiva dos auxiliares de enfermagem.

Microglial cells are involved in the susceptibility of NADPH oxidase knockout mice to 6-hydroxy-dopamine-induced neurodegeneration

We explored the impact of Nox-2 in modulating inflammatory-mediated microglial responses in the 6-hydroxydopamine (6-OHDA)-induced Parkinson’s disease (PD) model. Nox1 and Nox2 gene expression were found to increase in striatum, whereas a marked increase of Nox2 expression was observed in substantia nigra (SN) of wild-type (wt) mice after PD induction. Gp91phox-/- 6-OHDA-lesioned mice exhibited a significant reduction in the apomorphine-induced rotational behavior, when compared to wt mice. Immunolabeling assays indicated that striatal 6-OHDA injections reduced the number of dopaminergic (DA) neurons in the SN of wt mice. In gp91phox-/- 6-OHDA-lesioned mice the DA degeneration was negligible, suggesting an involvement of Nox in 6-OHDA-mediated SN degeneration. Gp91phox-/- 6-OHDA-lesioned mice treated with minocycline, a tetracycline derivative that exerts multiple anti-inflammatory effects, including microglial inhibition, exhibited increased apomorphine-induced rotational behavior and degeneration of DA neurons after 6-OHDA injections. The same treatment also increased TNF-α release and potentiated NF-κB activation in the SN of gp91phox-/--lesioned mice. Our results demonstrate for the first time that inhibition of microglial cells increases the susceptibility of gp91phox-/- 6-OHDA lesioned mice to develop PD. Blockade of microglia leads to NF-κB activation and TNF-α release into the SN of gp91phox-/- 6-OHDA lesioned mice, a likely mechanism whereby gp91phox-/- 6-OHDA lesioned mice may be more susceptible to develop PD after microglial cell inhibition. Nox2 adds an essential level of regulation to signaling pathways underlying the inflammatory response after PD induction

Der Einfluss von Hypothermie oder Dexmedetomidin auf den neuronalen Zelluntergang nach inkompletter zerebraler Hemisphärenischämie und Reperfusion bei der Ratte

Es ist bekannt, dass sowohl Hypothermie (HT) als auch Dexmedetomidin (DEX) das neurologische Endergebnis verbessern können. In dieser Studie wird der Einfluss von HT oder DEX auf den neuronalen Zelluntergang bei 104 Ratten nach inkompletter zerebraler Hemisphärenischämie durch unilaterale Karotis-Okklusion unter hämorrhagischer Hypotension und anschließender Reperfusion untersucht. In beiden Behandlungs-Gruppen zeigt sich gegenüber der Kontroll-Gruppe in der Hämatoxylin-Eosin-Färbung eine tendentielle Reduktion des Ausmaßes der Schädigung und der Anzahl nekrotischer Zellen, in der immunhistologischen Färbung mit Antikörpern gegen aktivierte Caspase-3 eine tendentielle Verringerung apoptotischer Zellen. Diese Arbeit deutet darauf hin, dass sowohl HT als auch DEX den neuronalen Schaden nach zerebraler Ischämie tendentiell zu reduzieren vermögen.

Predittori precoci di outcome neurologico nei neonati affetti da Encefalopatia Ipossico-Ischemica sottoposti a trattamento ipotermico. Studio combinato Elettroencefalogramma ad integrazione di ampiezza e Spettroscopia nel vicino infrarosso

Background: Brain cooling (BC) represents the elective treatment in asphyxiated newborns. Amplitude Integrated Electroencephalography (aEEG) and Near Infrared Spectroscopy (NIRS) monitoring may help to evaluate changes in cerebral electrical activity and cerebral hemodynamics during hypothermia. Objectives: To evaluate the prognostic value of aEEG time course and NIRS data in asphyxiated cooled infants. Methods: 12 term neonates admitted to our NICU with moderate-severe Hypoxic-Ischemic Encephalopathy (HIE) underwent selective BC. aEEG and NIRS monitoring were started as soon as possible and maintained during the whole hypothermic treatment. Follow-up was scheduled at regular intervals; adverse outcome was defined as death, cerebral palsy (CP) or global quotient < 88.7 at Griffiths’ Scale. Results: 2/12 infants died, 2 developed CP, 1 was normal at 6 months of age and then lost at follow-up and 7 showed a normal outcome at least at 1 year of age. The aEEG background pattern at 24 hours of life was abnormal in 10 newborns; only 4 of them developed an adverse outcome, whereas the 2 infants with a normal aEEG developed normally. In infants with adverse outcome NIRS showed a higher Tissue Oxygenation Index (TOI) than those with normal outcome (80.0±10.5% vs 66.9±7.0%, p=0.057; 79.7±9.4% vs 67.1±7.9%, p=0.034; 80.2±8.8% vs 71.6±5.9%, p=0.069 at 6, 12 and 24 hours of life, respectively). Conclusions: The aEEG background pattern at 24 hours of life loses its positive predictive value after BC implementation; TOI could be useful to predict early on infants that may benefit from other innovative therapies.

Aspetti ipnici e vegetativi dell'inibizione del controllo nervoso centrale della termogenesi nel ratto

La possibilità di indurre stati ipotermici ed ipometabolici come il torpore o l’ibernazione in animali non ibernanti può avere dei risvolti utili nella pratica medica, in quanto permetterebbe di trarre vantaggio dagli effetti benefici dell’ipotermia senza gli effetti compensatori negativi causati dalla risposta omeostatica dell’organismo. Con questo lavoro vogliamo proporre un nuovo approccio, che coinvolge il blocco farmacologico dell’attività dei neuroni nel bulbo rostroventromediale (RVMM), un nucleo troncoencefalico che si è rivelato essere uno snodo chiave nella regolazione della termogenesi attraverso il controllo dell’attività del tessuto adiposo bruno, della vasomozione cutanea e del cuore. Nel nostro esperimento, sei iniezioni consecutive del agonista GABAA muscimolo nel RVMM, inducono uno stato reversibile di profonda ipotermia (21°C al Nadir) in ratti esposti ad una temperatura ambientale di 15°C. Lo stato ipotermico/ipomentabolico prodotto dall’inibizione dei neuroni del RVMM mostra forti similitudini col torpore naturale, anche per quanto concerne le modificazioni elettroencefalografiche osservate durante e dopo la procedura. Come negli ibernati naturali, nei ratti cui viene inibito il controllo della termogenesi si osserva uno spostamento verso le regioni lente delle spettro di tutte le frequenze dello spettro EEG durante l’ipotermia, ed un forte incremento dello spettro EEG dopo il ritorno alla normotermia, in particolare della banda Delta (0,5-4Hz) durante il sonno NREM. Per concludere, questi risultati dimostrano che l’inibizione farmacologica selettiva di un nucleo troncoencefalico chiave nel controllo della termogenesi è sufficiente per indurre uno stato di psuedo-torpore nel ratto, una specie che non presenta stati di torpore spontaneo. Un approccio di questo tipo può aprire nuove prospettive per l’utilizzo in ambito medico dell’ipotermia.

Einfluss moderater intraischämischer Hypothermie auf die Proliferation und Differenzierung neuronaler Stammzellen 28 Tage nach inkompletter Vorderhirnischämie und Reperfusion der adulten Ratte

Hypothermie schützt Neurone vor hypoxischen, ischämischen und traumatischen Schädigungen. Bisher ist jedoch unklar, ob Hypothermie auch endogene Reparaturmechanismen beeinflusst. Die vorliegende Arbeit untersucht daher den Einfluss intraischämischer Hypothermie auf das neuroregenerative Potential des Gehirns nach zerebraler Ischämie.rn50 männliche Sprague-Dawley Ratten wurden hierzu anästhesiert, intubiert und in folgende Versuchsgruppen randomisiert: Normotherme Ischämie (Normo/BACO), intraischämische Hypothermie (Hypo/BACO) sowie korrespondierende scheinoperierte Kontrollgruppen (Normo/Sham und Hypo/Sham). In den Gruppen Normo/Sham und Normo/BACO wurde die perikranielle Temperatur konstant bei 37 °C gehalten während sie in den Gruppen Hypo/Sham und Hypo/BACO für 85 min auf 33 °C gesenkt wurde. Durch bilaterale Okklusion der Aa. carotides communes in Kombination mit hämorrhagischer Hypotension wurde in BACO-Tieren eine 14-minütige inkomplette globale zerebrale Ischämie induziert. Tiere der Kontroll-Gruppen (Sham) blieben ohne Induktion einer Ischämie in Narkose. 15 weitere Tiere durchliefen nicht den operativen Versuchsteil und bildeten die Nativ-Gruppe, die als Referenz für die natürliche Neurogenese diente. Zur in-vivo-Markierung der Stammzellen wurde vom ersten bis siebten postoperativen Tag Bromodeoxyurindine (BrdU) injiziert. Nach 28 Tagen wurden die Gehirne entnommen. Die Analyse des histopathologischen Schadens erfolgte anhand HE-gefärbter Hirnschnitte, die Quantifikation der absoluten Anzahl neu gebildeter Zellen im Gyrus dentatus erfolgte mittels BrdU-Färbung. Anhand einer BrdU/NeuN-Immunfluoreszenz-Doppelfärbung konnte der Anteil neu generierter Neurone bestimmt werden.rnNach zerebraler Ischämie zeigten Tiere mit Normothermie eine Schädigung der CA 1-Region von über 50 % während hypotherme Ischämietiere einen Schaden von weniger als 10 % aufwiesen. Tiere ohne Ischämie (Hypo/Sham, Normo/Sham, Nativ) zeigten keinen histopathologischen Schaden. Die Anzahl neu gebildeter Neurone im Gyrus dentatus lag für normotherme Ischämietiere (Normo/BACO) bei 18819 und für Tiere mit intraischämischer Hypothermie (Hypo/BACO) bei 15175 neuen Neuronen. In den Kontroll-Gruppen wiesen Tiere der Gruppe Normo/Sham 5501, Tiere der Gruppe Hypo/Sham 4600 und Tiere der Nativ-Gruppe 5974 neu generierte Neurone auf.rnDiese Daten bestätigen frühere Studien, die eine Reduktion des neuronalen Schadens durch intraischämische Hypothermie zeigten. Infolge des ischämischen Stimulus kam es im Vergleich zu beiden Kontroll- und der Nativ-Gruppe zu einem signifikanten Anstieg der Anzahl neuer Neurone in beiden Ischämiegruppen unabhängig von der Temperatur. Somit scheint das Ausmaß der histopathologischen Schädigung keinen Einfluss auf die Anzahl neu gebildeter Neurone zu haben. Darüber hinaus beeinflusste die therapeutische Hypothermie auch nicht die natürliche Neurogeneserate. Die erhobenen Daten lassen vermuten, dass Hypothermie keinen Effekt auf die Anzahl und Differenzierung neuronaler Stammzellen aufweist, unabhängig davon, ob eine zerebrale Schädigung vorliegt.

Sublethal effects of a common neonicotinoid pesticide, thiamethoxam, on honey bees: impact on locomotion and thermoregulation

Neonicotinoids have been pointed to as a factor responsible for the increased honey bee colony losses in the last decades. Many studies have investigated the effects of the first marketed neonicotinoid, imidacloprid, while fewer have focused on thiamethoxam. One recent study showed that sublethal doses of thiamethoxam lead to colony failure by decreasing forager homing flight success. We thus decided to investigate the mechanism which caused this phenomenon. Our hypothesis was that this effect was caused by impairment of forager locomotion abilities. Therefore we tested the effects of sublethal acute and chronic exposures to thiamethoxam on forager walking (Chapter 2) and flight (Chapter 3) performances. The acute treatment (1.34 ng/bee) affected walking locomotion firstly triggering hyperactivity (30 min post-treatment) and then impairing motor functioning (60 min post-treatment). 2-day continuous exposures to thiamethoxam (32.5, 45 ppb) elicited fewer effects on walking locomotion, however both exposure modes elicited an increased positive phototaxis. Similarly, in flight experiments, the single dose (1.34 ng/bee) elicited hyperactivity shortly after intoxication (increased flight duration and distance), while longer and continuous exposures (32.5, 45 ppb) impaired forager motor functions (decreased flight duration, distance, velocity). It is known that flight muscles temperature needs to be precisely regulated by bees during flight. Therefore, we further hypothesized that the impaired flight performances of neonicotinoid intoxicated bees were caused also by thermoregulation anomalies. We tested the effects that acute thiamethoxam exposures (0.2, 1, 2 ng/bee) elicit on forager thorax temperature (Chapter 4). Foragers treated with high doses exhibited hyperthermia or hypothermia when respectively exposed to high or low environmental temperatures. In summary, we show that sublethal doses of thiamethoxam affected forager walking and flight locomotion, phototaxis and thermoregulation. We also display the intricate mode of action of thiamethoxam which triggered, at different extents, inverse sublethal effects in relation to time and dose.

Resistive-Polymer Versus Forced-Air Warming: Comparable Efficacy in Orthopedic Patients

BACKGROUND: Several adverse consequences are caused by mild perioperative hypothermia. Maintaining normothermia with patient warming systems, today mostly with forced air (FA), has thus become a standard procedure during anesthesia. Recently, a polymer-based resistive patient warming system was developed. We compared the efficacy of a widely distributed FA system with the resistive-polymer (RP) system in a prospective, randomized clinical study. METHODS: Eighty patients scheduled for orthopedic surgery were randomized to either FA warming (Bair Hugger warming blanket #522 and blower #750, Arizant, Eden Prairie, MN) or RP warming (Hot Dog Multi-Position Blanket and Hot Dog controller, Augustine Biomedical, Eden Prairie, MN). Core temperature, skin temperature (head, upper and lower arm, chest, abdomen, back, thigh, and calf), and room temperature (general and near the patient) were recorded continuously. RESULTS: After an initial decrease, core temperatures increased in both groups at comparable rates (FA: 0.33 degrees C/h +/- 0.34 degrees C/h; RP: 0.29 degrees C/h +/- 0.35 degrees C/h; P = 0.6). There was also no difference in the course of mean skin and mean body (core) temperature. FA warming increased the environment close to the patient (the workplace of anesthesiologists and surgeons) more than RP warming (24.4 degrees C +/- 5.2 degrees C for FA vs 22.6 degrees C +/- 1.9 degrees C for RP at 30 minutes; P(AUC) <0.01). CONCLUSION: RP warming performed as efficiently as FA warming in patients undergoing orthopedic surgery.

Perioperative metabolic changes in patients undergoing cardiac surgery

Perioperative metabolic changes in cardiac surgical patients are not only induced by tissue injury and extracorporeal circulation per se: the systemic inflammatory response to surgical trauma and extracorporeal circulation, perioperative hypothermia, cardiovascular and neuroendocrine responses, and drugs and blood products used to maintain cardiovascular function and anesthesia contribute to varying degrees. The pathophysiologic changes include increased oxygen consumption and energy expenditure; increased secretion of adrenocorticotrophic hormone, cortisol, epinephrine, norepinephrine, insulin, and growth hormone; and decreased total tri-iodothyronine levels. Easily measurable metabolic consequences of these changes include hyperglycemia, hyperlactatemia, increased aspartate, glutamate and free fatty acid concentrations, hypokalemia, increased production of inflammatory cytokines, and increased consumption of complement and adhesion molecules. Nutritional risk before elective cardiac surgery-defined as preoperative unintended pathologic weight loss/low amount of food intake in the preceding week or low body mass index-is related to adverse postoperative outcome. Improvements in surgical techniques, anesthesia, and perioperative management have been designed to minimize the stressful stimulus to catabolism, thereby slowing the wasting process to the point where much less nutrition is required to meet metabolic requirements. Early nutrition in cardiac surgery is safe and well tolerated.