Relationships between appetite and quality of life in hemodialysis patients

The aim of this paper was to investigate the association between appetite and Kidney-Disease Specific Quality of Life in maintenance hemodialysis patients. Quality of Life (QoL) was measured using the Kidney Disease Quality Of Life survey. Appetite was measured using self-reported categories and a visual analog scale. Other nutritional parameters included Patient-Generated Subjective Global Assessment (PGSGA), dietary intake, body mass index and biochemical markers C-Reactive Protein and albumin. Even in this well nourished sample (n=62) of hemodialysis patients, PGSGA score (r=-0.629), subjective hunger sensations (r=0.420) and body mass index (r=-0.409) were all significantly associated with the Physical Health Domain of QoL. As self-reported appetite declined, QoL was significantly lower in nine domains which were mostly in the SF36 component and covered social functioning and physical domains. Appetite and other nutritional parameters were not as strongly associated with the Mental Health domain and Kidney Disease Component Summary Domains. Nutritional parameters, especially PGSGA score and appetite, appear to be important components of the physical health domain of QoL. As even small reductions in nutritional status were associated with significantly lower QoL scores, monitoring appetite and nutritional status is an important component of care for hemodialysis patients.

Is recovery driven by central or peripheral factors? A role for the brain in recovery following intermittent-sprint exercise

Prolonged intermittent-sprint exercise (i.e., team sports) induce disturbances in skeletal muscle structure and function that are associated with reduced contractile function, a cascade of inflammatory responses, perceptual soreness, and a delayed return to optimal physical performance. In this context, recovery from exercise-induced fatigue is traditionally treated from a peripheral viewpoint, with the regeneration of muscle physiology and other peripheral factors the target of recovery strategies. The direction of this research narrative on post-exercise recovery differs to the increasing emphasis on the complex interaction between both central and peripheral factors regulating exercise intensity during exercise performance. Given the role of the central nervous system (CNS) in motor-unit recruitment during exercise, it too may have an integral role in post-exercise recovery. Indeed, this hypothesis is indirectly supported by an apparent disconnect in time-course changes in physiological and biochemical markers resultant from exercise and the ensuing recovery of exercise performance. Equally, improvements in perceptual recovery, even withstanding the physiological state of recovery, may interact with both feed-forward/feed-back mechanisms to influence subsequent efforts. Considering the research interest afforded to recovery methodologies designed to hasten the return of homeostasis within the muscle, the limited focus on contributors to post-exercise recovery from CNS origins is somewhat surprising. Based on this context, the current review aims to outline the potential contributions of the brain to performance recovery after strenuous exercise.

Molecular profiling of exudate from chronic ulcerated wounds

Non-healing wounds represent a significant burden to healthcare systems and societies worldwide. Current best practice treatments of chronic wounds can require patients to undergo extensive periods of therapy without any positive outcome. This consumes substantial healthcare resources and severely impacts patient quality of life. At present, there are no measures to predict a patient's response to best practice care. The hypothesis of this thesis was that biochemical markers could be found within the wound fluid of chronic ulcers and these markers could predict the healing outcome of an ulcer undergoing best practice care. Discovery phase proteomic and mass spectrometry techniques were utilised to determine novel proteins that correlated with the healing outcome of ulcers. These candidate biomarkers could be developed into simple dip-stick tools for use in clinical practice. This would aid clinicians in the choice of effective wound management strategies to address hard-to-heal wounds.

Novel loci affecting iron homeostasis and their effects in individuals at risk for hemochromatosis

Variation in body iron is associated with or causes diseases, including anaemia and iron overload. Here, we analyse genetic association data on biochemical markers of iron status from 11 European-population studies, with replication in eight additional cohorts (total up to 48,972 subjects). We find 11 genome-wide-significant (P<5 × 10−8) loci, some including known iron-related genes (​HFE, ​SLC40A1, ​TF, ​TFR2, ​TFRC, ​TMPRSS6) and others novel (​ABO, ​ARNTL, ​FADS2, ​NAT2, ​TEX14). SNPs at ​ARNTL, ​TF, and ​TFR2 affect iron markers in ​HFE C282Y homozygotes at risk for hemochromatosis. There is substantial overlap between our iron loci and loci affecting erythrocyte and lipid phenotypes. These results will facilitate investigation of the roles of iron in disease.

Placental abruption : Studies on incidence, risk factors and potential predictive biomarkers

Placental abruption, one of the most significant causes of perinatal mortality and maternal morbidity, occurs in 0.5-1% of pregnancies. Its etiology is unknown, but defective trophoblastic invasion of the spiral arteries and consequent poor vascularization may play a role. The aim of this study was to define the prepregnancy risk factors of placental abruption, to define the risk factors during the index pregnancy, and to describe the clinical presentation of placental abruption. We also wanted to find a biochemical marker for predicting placental abruption early in pregnancy. Among women delivering at the University Hospital of Helsinki in 1997-2001 (n=46,742), 198 women with placental abruption and 396 control women were identified. The overall incidence of placental abruption was 0.42%. The prepregnancy risk factors were smoking (OR 1.7; 95% CI 1.1, 2.7), uterine malformation (OR 8.1; 1.7, 40), previous cesarean section (OR 1.7; 1.1, 2.8), and history of placental abruption (OR 4.5; 1.1, 18). The risk factors during the index pregnancy were maternal (adjusted OR 1.8; 95% CI 1.1, 2.9) and paternal smoking (2.2; 1.3, 3.6), use of alcohol (2.2; 1.1, 4.4), placenta previa (5.7; 1.4, 23.1), preeclampsia (2.7; 1.3, 5.6) and chorioamnionitis (3.3; 1.0, 10.0). Vaginal bleeding (70%), abdominal pain (51%), bloody amniotic fluid (50%) and fetal heart rate abnormalities (69%) were the most common clinical manifestations of placental abruption. Retroplacental blood clot was seen by ultrasound in 15% of the cases. Neither bleeding nor pain was present in 19% of the cases. Overall, 59% went into preterm labor (OR 12.9; 95% CI 8.3, 19.8), and 91% were delivered by cesarean section (34.7; 20.0, 60.1). Of the newborns, 25% were growth restricted. The perinatal mortality rate was 9.2% (OR 10.1; 95% CI 3.4, 30.1). We then tested selected biochemical markers for prediction of placental abruption. The median of the maternal serum alpha-fetoprotein (MSAFP) multiples of median (MoM) (1.21) was significantly higher in the abruption group (n=57) than in the control group (n=108) (1.07) (p=0.004) at 15-16 gestational weeks. In multivariate analysis, elevated MSAFP remained as an independent risk factor for placental abruption, adjusting for parity ≥ 3, smoking, previous placental abruption, preeclampsia, bleeding in II or III trimester, and placenta previa. MSAFP ≥ 1.5 MoM had a sensitivity of 29% and a false positive rate of 10%. The levels of the maternal serum free beta human chorionic gonadotrophin MoM did not differ between the cases and the controls. None of the angiogenic factors (soluble endoglin, soluble fms-like tyrosine kinase 1, or placental growth factor) showed any difference between the cases (n=42) and the controls (n=50) in the second trimester. The levels of C-reactive protein (CRP) showed no difference between the cases (n=181) and the controls (n=261) (median 2.35 mg/l [interquartile range {IQR} 1.09-5.93] versus 2.28 mg/l [IQR 0.92-5.01], not significant) when tested in the first trimester (mean 10.4 gestational weeks). Chlamydia pneumoniae specific immunoglobulin G (IgG) and immunoglobulin A (IgA) as well as C. trachomatis specific IgG, IgA and chlamydial heat-shock protein 60 antibody rates were similar between the groups. In conclusion, although univariate analysis identified many prepregnancy risk factors for placental abruption, only smoking, uterine malformation, previous cesarean section and history of placental abruption remained significant by multivariate analysis. During the index pregnancy maternal alcohol consumption and smoking and smoking by the partner turned out to be the major independent risk factors for placental abruption. Smoking by both partners multiplied the risk. The liberal use of ultrasound examination contributed little to the management of women with placental abruption. Although second-trimester MSAFP levels were higher in women with subsequent placental abruption, clinical usefulness of this test is limited due to low sensitivity and high false positive rate. Similarly, angiogenic factors in early second trimester, or CRP levels, or chlamydial antibodies in the first trimester failed to predict placental abruption.

Substance misuse problems during pregnancy with special emphasis on buprenorphine

Maternal drug abuse during pregnancy endangers the future health and wellbeing of the infant and growing child. On the other hand, via maternal abstinence, these problems would never occur; so the problems would be totally preventable. Buprenorphine is widely used in opioid maintenance treatment as a substitute medication. In Finland, during 2000 s buprenorphine misuse has steadily increased. In 2009 almost one third of clientele of substance treatment units were in treatment because of buprenorphine dependence. At Helsinki Women s Clinic the first child with prenatal buprenorphine exposure was born in 2001. During 1992-2001 in the three capital area maternity hospitals (Women s clinic, Maternity hospital, Jorvi hospital) 524 women were followed at special antenatal clinics due to substance abuse problems. Three control women were drawn from birth register to each case woman and matched for parity and same place and date of the index birth. According to register data mortality rate was 38-fold higher among cases than controls within 6-15 years after index birth. Especially, the risk for violent or accidental death was increased. The women with substance misuse problems had also elevated risk for viral hepatitis and psychiatric morbidity. They were more often reimbursed for psychopharmaceuticals. Disability pensions and rehabilitation allowances were more often granted to cases than controls. In total 626 children were born from these pregnancies. According to register data 38% of these children were placed in out-of-home care as part of child protection services by the age of two years, and half of them by the age of 12 years, the median follow-up time was 5.8 years. The risk for out-of-home care was associated with factors identifiable during the pre- and perinatal period. In 2002-2005 67 pregnant women with buprenorphine dependence were followed up at the Helsinki University Hospital, Department of Obstetrics and Gynecology. Their pregnancies were uneventful. The prematurity rate was similar and there were no more major anomalies compared to the national statistics. The neonates were lighter compared to the national statistics. They were also born in good condition, with no perinatal hypoxia as defined by standard clinical parameters or certain biochemical markers in the cord blood: erythropoietin, S100 and cardiac troponin-t. Almost 80% of newborns developed neonatal abstinence syndrome (NAS) and two third of them needed morphine medication for it. Maternal smoking over ten cigarettes per day aggravated and benzodiazepine use attenuated NAS. An infant s highest urinary norbuprenorphine concentration during their first 3 days of life correlated with the duration of morphine treatment. The average length of infant s hospital stay was 25 days.

Zoledronic acid in combination with alfacalcidol has additive effects on trabecular microarchitecture and mechanical properties in osteopenic ovariectomized rats

We conducted the present study to investigate the therapeutic effects of the antiresorptive agent zoledronic acid (ZOL), alone and in combination with alfacalcidol (ALF), in a rat model of postmenopausal osteoporosis. Female Wistar rats were ovariectomized (OVX) or sham-operated at 3 months of age. Twelve weeks post surgery, rats were randomized into six groups: (1) sham + vehicle, (2) OVX + vehicle, (3) OVX + ZOL (100 mu g/kg, i.v. single dose), (4) OVX + ZOL (50 mu g/kg, i.v. single dose), (5) OVX + ALF (0.5 mu g/kg, oral gauge daily) and (6) OVX + ZOL (50 mu g/kg, i.v. single dose) + ALF (0.5 mu g/kg, oral gauge daily) for 12 weeks. After treatment, we evaluated the mechanical properties of the lumbar vertebra and femoral mid-shaft. Femurs were also tested for bone density, porosity and trabecular micro-architecture. Biochemical markers in serum and urine were also determined. With respect to improvement in the mechanical strength of the lumbar spine and the femoral mid-shaft, the combination treatment of ZOL and ALF was more effective than each administered as a monotherapy. Moreover, combination therapy using ZOL and ALF preserved the trabecular micro-architecture and cortical bone porosity. Furthermore, the combination treatment of ZOL and ALF corrected the decrease in serum calcium and increase in serum alkaline phosphatase and the tartarate-resistant acid phosphatase level better than single-drug therapy using ZOL or ALF in OVX rats. In addition, the combination treatment of ZOL and ALF corrected the increase in urine calcium, phosphorous and creatinine levels better than single-drug therapy using ZOL or ALF in OVX rats. These data suggest that the combination treatment of ZOL and ALF has a therapeutic advantage over each monotherapy for the treatment of osteoporosis.

Development, in vitro and in vivo characterization of zoledronic acid functionalized hydroxyapatite nanoparticle based formulation for treatment of osteoporosis in animal model

We investigated the potential of using novel zoledronic acid (ZOL)-hydroxyapatite (HA) nanoparticle based drug formulation in a rat model of postmenopausal osteoporosis. By a classical adsorption method, nanoparticles of HA loaded with ZOL (HNLZ) drug formulation with a size range of 100-130 nm were prepared. 56 female Wistar rats were ovariectomized (OVX) or sham-operated at 3 months of age. Twelve weeks post surgery, rats were randomized into seven groups and treated with various doses of HNLZ (100, 50 and 25 mu g/kg, intravenous single dose), ZOL (100 mu g/kg, intravenous single dose) and HA nanoparticle (100 mu g/kg, intravenous single dose). Untreated OVX and sham OVX served as controls. After three months treatment period, we evaluated the mechanical properties of the lumbar vertebra and femoral mid-shaft. Femurs were also tested for trabecular microarchitecture. Sensitive biochemical markers of bone formation and bone resorption in serum were also determined. With respect to improvement in the mechanical strength of the lumbar spine and the femoral mid-shaft, the therapy with HNLZ drug formulation was more effective than ZOL therapy in OVX rats. Moreover, HNLZ drug therapy preserved the trabecular microarchitecture better than ZOL therapy in OVX rats. Furthermore, the HNLZ drug formulation corrected increase in serum levels of bone-specific alkaline phosphatase, procollagen type I N-terminal propeptide, osteocalcin, tartrate-resistant acid phosphatase 5b and C-telopeptide of type 1 collagen better than ZOL therapy in OVX rats. The results strongly suggest that HNLZ novel drug formulation appears to be more effective approach for treating severe osteoporosis in humans. (C) 2014 Elsevier B.V. All rights reserved.

Influência do exercício físico sobre a massa e o metabolismo ósseo de indivíduos com lesão medular cervical

Indivíduos que permanecem longo tempo em cadeira de rodas apresentam importante perda de massa óssea, principalmente nos membros inferiores, possivelmente agravada pela baixa ingestão de cálcio dietético e pelo inadequado estado nutricional de vitamina D. O exercício físico pode contribuir para a manutenção ou aumento da massa óssea em diferentes populações e nos indivíduos com lesão medular pode contribuir para atenuar a perda de massa óssea. O objetivo do presente estudo foi avaliar a influência da prática regular de exercício físico sobre a adequação da massa óssea, indicadores bioquímicos do metabolismo ósseo e estado nutricional de vitamina D em indivíduos com lesão medular cervical há pelo menos um ano. Em vinte e cinco homens de 19 a 56 anos sendo 15 fisicamente ativos e 10 sedentários, foi realizada análise sérica de cálcio, PTH, 25(OH)D, IGF-1, osteocalcina e NTx. As medidas do conteúdo mineral ósseo, densidade mineral óssea (DMO), massa magra e massa gorda foram realizadas por DXA. A pigmentação da pele (constitutiva e por bronzeamento) foi determinada por colorimetria com o objetivo de investigar sua influência sobre o estado de vitamina D. A ingestão habitual de cálcio foi registrada em um questionário de frequência alimentar direcionado para alimentos fonte. As comparações entre os dois grupos foram realizadas pela aplicação do Teste t de Student exceto para as variáveis ósseas que foram realizadas após ajustes pela massa corporal total, tempo de lesão e ingestão de cálcio utilizando-se análise de co-variância. Associações entre as variáveis estudadas foram avaliadas através de análise de correlação de Pearson. Valores de p<0.05 foram considerados significativos. Não foram observadas diferenças estatisticamente significativas entre os grupos para nenhuma variável óssea com exceção do z-score da DMO da coluna lombar, que foi significativamente maior no grupo de indivíduos sedentários (0,9 1,7 vs -0,7 0,8; p<0,05). No entanto, entre os indivíduos ativos, aqueles que iniciaram a prática de exercício físico com menos tempo decorrido após a lesão apresentaram maior DMO do fêmur (r=-0,60; p<0,05). Nos indivíduos ativos, a freqüência do exercício apresentou associação negativa com a concentração sérica de i-PTH (r = -0,50; p =0,05) e positiva com a concentração de 25(OH)D (r= 0,58; p <0,05). Após ajustes pela massa corporal total e tempo de lesão foram observadas associações positivas entre a ingestão diária de cálcio e z-score da DMO da coluna lombar (r = 0,73 e p <0,01) e DMO do rádio (r = 0,56 e p <0,05). Os resultados do presente estudo apontam para um efeito benéfico do exercício físico sobre a massa óssea e o perfil hormonal relacionado ao metabolismo ósseo. O início da prática regular de exercício físico o quanto antes após a lesão parece contribuir para atenuar a perda de massa óssea nos membros inferiores. Além disso, os resultados deste estudo sugerem uma possível potencialização do efeito osteogênico do exercício físico quando combinado a uma adequada ingestão de cálcio.

Capacidade antioxidante e a prática de atividade física em indivíduos com lesão medular cervical

A lesão medular está associada a uma série de alterações bioquímicas e decomposição corporal. O aumento da gordura corporal e seu acúmulo na regiãoabdominal aliados a processos infecciosos decorrentes da lesão medular podemacarretar o incremento da concentração plasmática da proteína c-reativa (PCR).Tanto a gordura corporal quanto a elevada concentração da PCR estimulam aprodução de espécies reativas de oxigênio, favorecendo o desequilíbrio oxidativo e odesencadeamento de doenças. É possível que a prática de atividade física regularpossa atuar de modo benéfico através da melhor distribuição da gordura corporal eadaptação dos sistemas antioxidantes nesses indivíduos. Considerando aimportância deste tema e a escassos estudos sobre o assunto, o objetivo desteestudo foi comparar, em indivíduos com lesão medular cervical a composiçãocorporal e indicadores bioquímicos de estado antioxidante em indivíduos fisicamenteativos e não ativos. Participaram do estudo 24 tetraplégicos do gênero masculino(3210 anos de idade e 108 anos de tempo de lesão), divididos em dois grupos,fisicamente ativos (n=15, com pratica de atividade física há pelo menos 3 meses, 3vezes/semana ou mais, totalizando tempo mínimo de 150 minutos/semana) e nãoativos (n=9). A composição corporal foi determinada por absorciometria de duplaemissão de raio-X. Amostras de sangue foram coletadas após jejum de 12 horaspara determinação dos indicadores bioquímicos: de capacidade antioxidante, ácidoúrico, bilirrubina, albumina, alfa-tocoferol, malondialdeído e PCR no plasma eatividade da superóxido dismutase em eritrócitos. O grupo não ativo apresentoumaior IMC (=0,003), gordura total (%) e de tronco (%) (=<0,001) do que o grupoppfisicamente ativo. Foi encontrada relação entre a PCR e a porcentagem de gorduratotal (r=0,72, p=<0,001), de tronco (r=0,70, p=<0,001), massa gorda total (r=0,73,p=<0,001) e de tronco (r=0,67, p=0,001). Não houve diferença significativa entre osindicadores bioquímicos de estado antioxidante, exceto a concentração da PCR quefoi maior no grupo não ativo (p=0,034). Considerando todos indivíduos, 50% apresentavam deficiência de alfa-tocoferol (concentração plasmática <11,6 mol/L).Foi observada relação negativa entre a concentração plasmática de alfa-tocoferol e aPCR (r=-0,18, =0,038).No grupo ativo houve correlação positiva entre a razãoptempo de atividade física:tempo de lesão e concentração plasmática demalondialdeido (r=0,38, =0,014). Nossos resultados, analisados em conjunto,psugerem que prática contínua de atividade física após a lesão atua auxiliando a umamelhor composição corporal e, possivelmente, a uma menor concentraçãoplasmática de PCR. O estado nutricional inadequado em alfa-tocoferol podecomprometer capacidade antioxidante, sendo necessárias medidas de apoionutricional para adequar a ingestão de alfa-tocoferol para este grupo.

Efeitos de modificação dietética associada ou não a uma rotina de exercícios aeróbicos na microcirculação em modelo animal de obesidade exógena

A obesidade atinge proporções epidêmicas em países industrializados e está relacionada a uma série de doenças metabólicas e circulatórias. Nesse contexto, a atividade física, tratamento não farmacológico da obesidade, acessível a diversas populações e está relacionada com a redução do risco cardiovasvascular mesmo. O objetivo deste trabalho foi avaliar, após mudança ou não da dieta, associação ou não a um programa de treinamento aeróbico (PTA) durante 8 semanas, a possível reversibilidade dos danos causados por uma dieta hiperlipídica por 12 semanas. Para tal, 120 hamsters machos da espécie Mesocricetus auratus, com massa corporal de 60 g, foram distribuídos em quatro grupos, cada um subdividido em três subgrupos, com dez animais para diferentes análises. Os grupos Obeso Controle (OBC) e Obeso Exercitado (OBEX) receberam a ração hiperlipídica por 20 semanas, com adição do PTA ao grupo OBEX nas últimas 8 semanas. Os Obeso Ração Padrão (OBRP) e Obeso Ração Padrão/Exercício (OBRP/EX) tiveram a ração modificada para comercial padrão e adição do PTA ao grupo OBRP/EX após as 12 semanas iniciais. Para as análises microcirculatórias, a bolsa da bochecha foi usada para determinação do número máximo de extravasamentos induzidos por 30 min de isquemia seguida de reperfusão e da reatividade microvascular após a aplicação tópica de acetilcolina e nitroprussiato de sódio. No sangue coletado foi avaliado o perfil lipídico, glicemias quinzenais e leptina. As expressões de eNOS e iNOS foram determinadas na aorta por imunoblotting e a composição corporal avaliada nos tecidos adiposos visceral, urogenital e retroperitoneal, retirados no dia do experimento. Os resultados foram analisados com os métodos o teste estatístico de análise de variância (One Way ANOVA - Teste de Kruskal-Wallis), seguido pelo pós-teste de Dunn. Resultados mostram que a modificação dietética, associada ou não ao PTA, reduziu significativamente a massa corporal (p<0,0001), comprimento naso-anal (p=0,0011) e tecido adiposo (visceral [p<0,0001], urogenital [p=0.0004] e retroperitoneal [p= 0,0083]). Nas análises sanguíneas não foram encontradas diferenças com relação ao perfil lipídico e glicemia, já na leptina houve uma redução significativa (p=0,0039). A análise da reatividade microvascular mostrou melhora significativa na vasodilatação endotélio-dependente nos grupos submetidos à modificação dietética associada ou não ao PTA. Nas medidas de permeabilidade a macromoléculas houve redução significativa no número de extravasamentos nos grupos submetidos à modificação dietética associada ou não ao PTA, (5 min [p= 0,0207] e 10 min [p= 0,0057]). Houve um aumento na expressão de eNOS nos grupos submetidos à modificação dietética associada ou não ao PTA, em comparação ao grupo OBC (p=0,0352). Os resultados mostraram que a modificação dietética, associada ao protocolo de treinamento aeróbico melhora a vasodilatação endotélio-dependente, aumenta a expressão da óxido nítrico sintase endotelial e reduz o número de extravasamentos induzidos por isquemia e reperfusão, mesmo sem melhoras nos marcadores bioquímicos tradicionais como glicemia e perfil lipídico.

Seasonal thermogenesis and body mass regulation in plateau pikas (Ochotona curzoniae)

Changes in photoperiod, ambient temperature and food availability trigger seasonal acclimatization in physiology and behavior of many animals. In the present study, seasonal adjustments in body mass and in several physiological, hormonal, and biochemical markers were examined in wild-captured plateau pikas (Ochotona curzoniae) from the Qinghai-Tibetan plateau. Our results showed that plateau pikas maintained a relatively constant body mass throughout the year and showed no seasonal changes in body fat mass and circulating levels of serum leptin. However, nonshivering thermogenesis, cytochrome c oxidase activity, and mitochondrial uncoupling protein 1 (UCP1) contents in brown adipose tissues were significantly enhanced in winter. Further, serum leptin levels were positively correlated with body mass and body fat mass while negatively correlated with UCP1 contents. Together, these data suggest that plateau pikas mainly depend on increasing thermogenic capacities, rather than decreasing body mass, to cope with cold, and leptin may play a potential role in their thermogenesis and body mass regulation.

Going retro: oxidative stress biomarkers in modern redox biology

The field of redox biology is inherently intertwined with oxidative stress biomarkers. Oxidative stress biomarkers have been utilized for many different objectives. Our analysis indicates that oxidative stress biomarkers have several salient applications: (1) diagnosing oxidative stress, (2) pinpointing likely redox components in a physiological or pathological process, and (3) estimating the severity, progression and/or regression of a disease. On the contrary, oxidative stress biomarkers do not report on redox signaling. Alternative approaches to gain more mechanistic insights are: (1) measuring molecules that are integrated in pathways linking redox biochemistry with physiology, (2) using the exomarker approach and (3) exploiting -omics techniques. More sophisticated approaches and large trials are needed to establish oxidative stress biomarkers in the clinical setting.

Tryptophan degradation in irritable bowel syndrome: evidence of indoleamine 2,3-dioxygenase activation in a male cohort

Background: Irritable bowel syndrome (IBS) is a common disorder that affects 10–15% of the population. Although characterised by a lack of reliable biological markers, the disease state is increasingly viewed as a disorder of the brain-gut axis. In particular, accumulating evidence points to the involvement of both the central and peripheral serotonergic systems in disease symptomatology. Furthermore, altered tryptophan metabolism and indoleamine 2,3-dioxygenase (IDO) activity are hallmarks of many stress-related disorders. The kynurenine pathway of tryptophan degradation may serve to link these findings to the low level immune activation recently described in IBS. In this study, we investigated tryptophan degradation in a male IBS cohort (n = 10) and control subjects (n = 26). Methods: Plasma samples were obtained from patients and healthy controls. Tryptophan and its metabolites were measured by high performance liquid chromatography (HPLC) and neopterin, a sensitive marker of immune activation, was measured using a commercially available ELISA assay. Results: Both kynurenine levels and the kynurenine:tryptophan ratio were significantly increased in the IBS cohort compared with healthy controls. Neopterin was also increased in the IBS subjects and the concentration of the neuroprotective metabolite kynurenic acid was decreased, as was the kynurenic acid:kynurenine ratio. Conclusion: These findings suggest that the activity of IDO, the immunoresponsive enzyme which is responsible for the degradation of tryptophan along this pathway, is enhanced in IBS patients relative to controls. This study provides novel evidence for an immune-mediated degradation of tryptophan in a male IBS population and identifies the kynurenine pathway as a potential source of biomarkers in this debilitating condition.

Capillary electrophoresis with boron doped diamond electrode for amperometric detection of low molecular weight biological substrate

The research work in this thesis included the sensitive and selective separation of biological substance by capillary electrophoresis with a boron doped diamond electrode for amperometric detection. Chapter 1 introduced the capillary electrophoresis and electrochemical detection. It included the different modes of capillary electrophoresis, polyelectrolyte multilayers coating for open tubular capillary electrochromatography, different modes of electrochemical detection and carbon based electrodes. Chapter 2 showed the synthesized and electropolymerized N-acetyltyramine with a negatively charged sulfobutylether-β-cyclodextrin on a boron doped diamond (BDD) electrode followed by the electropolymerzation of pyrrole to form a stable and permselective film for selective dopamine detection. For comparison, a glassy carbon (GC) electrode with a combined electropolymerized permselective film of polytyramine and polypyrrole-1-propionic acid was used for selective detection of dopamine. The detection limit of dopamine was improved from 100 nM at a GC electrode to 5 nM at a BDD electrode. Chapter 3 showed field-amplified sample stacking using a fused silica capillary coated with gold nanoparticles embedded in poly(diallyldimethylammonium) chloride, which has been investigated for the electrophoretic separation of indoxyl sulphate, homovanillic acid and vanillylmandelic acid. The detection limit of the three analytes obtained by using a boron doped diamond electrode was around 75 nM, which was significantly below their normal physiological levels in biological fluids. This combined separation and detection scheme was applied to the direct analysis of these analytes and other interfereing chemicals including uric and ascorbic acids in urine samples without off-line sample treatment or preconcentration. Chapter 4 showed the selective detection of Pseudomonas Quinolone Signal, PQS for quorum sensing from its precursor HHQ, using a simply boron doped diamond electrode. Furthermore, by combining poly(diallyldimethylammonium) chloride modified fused silica capillary with a BDD electrode for amperometric detection, PQS was separated from HHQ and other analogues. The detection limit of PQS was as low as 65 nM. Different P. aeruginosa mutant strains were studied. Chapter 5 showed the separation of aminothiols by layer-by-layer coating of silica capillary with a boron doped diamond electrode. The capillary was layer-by-layer coated with the polycation poly(diallyldimethylammonium) chloride and negatively charged silica nanoparticles. All the aminothiols was separated and detected using a BDD electrode in an acidic electrolyte. It was a novel scheme for the separation and detection of glutathione reduced and oxidized forms, which is important for estimated overstressed level in the human system.