Évaluation des effets d’une intervention infirmière sur l'adhésion thérapeutique des personnes diabétiques de type 2 Libanais

Au Liban, le diabète est évalué à 12%, il est appelé à doubler d’ici l’an 2025. Devant cette augmentation, il est pertinent d’évaluer les effets d’une intervention éducative auprès de personnes présentant un DT2 sur leur sentiment d’auto-efficacité et leur capacité d’auto-soins afin de rendre leur adhésion thérapeutique la plus optimale possible. Le devis est expérimental avant/après 3 mois. L’adhésion a été évaluée à l’aide de l’HbA1c à <7 % et de du SDSCA pour les comportements d’auto-soins, du DMSES pour l’auto-efficacité. L’échantillon formé : 71 GE et 65 GC. Le GE s’est amélioré au niveau des comportements d’auto-soins, l’application des recommandations, du sentiment d’auto-efficacité et du taux d’HbA1c. Ainsi une éducation infirmière favorise l’adhésion chez les DT2. Cette étude a pu contribuer au développement du savoir infirmier et au renouvellement des pratiques cliniques.

Relation entre CaMKII et les dynamiques calciques endothéliales : impact de l'hypertension arterielle.

L’endothélium vasculaire joue un rôle prépondérant dans la régulation du tonus vasculaire en générant l’oxyde nitrique (NO), la prostacycline (PGI2) et les facteurs hyperpolarisants dérivés de l’endothélium (EDHF) comme puissants vasodilatateurs. Ces mécanismes requièrent le calcium (Ca2+) à divers niveaux, démontrant l’importance des dynamiques calciques endothéliales. Une perturbation de l’homéostasie calcique est observée dans une dysfonction endothéliale liée à l’hypertension artérielle. Il est impératif d’approfondir nos connaissances sur les signalisations calciques endothéliales impliquées dans le contrôle du tonus vasculaire. Des études récentes ont montré qu’une variation locale de la concentration en Ca2+ libre intracellulaire ([Ca2+]i) est suffisante pour générer une réponse physiologique importante. Les pulsars calciques sont caractérisés par une augmentation de [Ca2+]i spontanée et transitoire spécifiquement localisée au niveau des projections myoendothéliales (PMEs). Ces PMEs sont des sites de communication privilégiés entre les cellules endothéliales (CEs) et les cellules musculaires lisses vasculaires (CMLVs). Les pulsars calciques sont impliqués dans le mécanisme de l’EDHF via l’activation des canaux potassiques Ca2+-dépendant de moyenne conductance (KCa3.1 ou IKCa). Les travaux de cette thèse visent à améliorer nos connaissances sur les signalisations calciques locales en caractérisant une nouvelle voie de signalisation pouvant être impliquée dans la régulation du tonus vasculaire en condition physiopathologique. Outre les canaux KCa3.1 peu d’informations sont disponibles sur les cibles sensibles aux pulsars calciques. Une première étude a permis d’identifier la protéine kinase II dépendante du complexe Ca2+/calmoduline (CaMKII) sous ses isoformes α, β et δ dans les CEs d’artères natives de souris comme une cible pouvant être modulée par les pulsars calciques. Des études en immunofluorescence ont permis d’observer la localisation particulière de CaMKII endothéliale dans les PMEs, les sites des pulsars calciques. Une stimulation spécifique des pulsars calciques par la phényléphrine (PE) engendre un recrutement de CaMKII dans les PMEs. Sachant que CaMKII active l’oxyde nitrique synthase endothéliale (NOS3), nous avons évalué l’impact d’une stimulation des pulsars calciques sur la production de NO en présence d’un inhibiteur de CaMKII, le KN-93. Nous avons démontré que la production de NO est en partie dépendante de l’activation de CaMKII par les pulsars calciques. En utilisant un modèle d’hypertension induite par l’infusion chronique de PE, nous avons permis de mettre en évidence une perturbation dans la relation entre les pulsars calciques et CaMKII. Dans une seconde étude nous avons établi deux modèles (normo- et hypertendus) d’infusion chronique à l’angiotensine II (AngII) afin évaluer l’impact des ROS et de l’hypertension sur la voie de signalisation pulsars/CaMKII/NO. Nos résultats ont montré une augmentation des pulsars calciques accompagnée d’un recrutement de CaMKII dans les PMEs. Une stimulation aigue à l’AngII suggère que les ROS modulent les dynamiques calciques et que l’AngII stimule la production de NO. Cette étude propose que ces voies de signalisations impliquent les récepteurs de type 1 et 2 à l’AngII (AT1 et AT2). L’étude des pulsars calciques dépend fortement de la structure native des artères qui permet de conserver la formation des PMEs. La dernière étude présentée dans cette thèse a permis d’établir une relation entre les PMEs et les pulsars calciques dans trois lits vasculaires distincts (artères mésentériques, pulmonaires et coronariennes). Nos résultats ont montré que les paramètres cinétiques des pulsars calciques sont fortement conservés entre les différents lits vasculaires. Toutefois, la fréquence globale ainsi que le nombre de sites actifs des pulsars calciques diffèrent avec une proportion plus élevée dans les artères mésentériques et coronariennes comparativement aux artères pulmonaires. Ces résultats corrèlent avec le nombre plus élevé de PMEs retrouvé dans les artères mésentériques et coronariennes. Ces travaux suggèrent que les pulsars calciques sont fondamentaux pour les artères de résistance. Les études de cette thèse ont mené à l’identification d’une nouvelle voie de signalisation impliquant les pulsars calciques et CaMKII endothéliale dans la stimulation de la production de NO. Cette nouvelle voie de signalisation pourrait être impliquée dans la régulation du tonus vasculaire en condition physiopathologique. Les pulsars calciques semblent être fortement conservés entre les différentes artères de résistances et ce malgré la disparité dans les PMEs, suggérant un rôle prépondérant dans la fonction vasculaire. Ces travaux ouvrent une avenue pour le développement de potentielles cibles thérapeutiques pouvant contrer la dysfonction endothéliale associée à l’hypertension artérielle.

Bacterial polysaccharides suppress induced innate immunity by calcium chelation

Bacterial pathogens and symbionts must suppress or negate host innate immunity. However, pathogens release conserved oligomeric and polymeric molecules or MAMPs (Microbial Associated Molecular Patterns), which elicit host defenses [1], [2] and [3]. Extracellular polysaccharides (EPSs) are key virulence factors in plant and animal pathogenesis, but their precise function in establishing basic compatibility remains unclear [4], [5], [6] and [7]. Here, we show that EPSs suppress MAMP-induced signaling in plants through their polyanionic nature [4] and consequent ability to chelate divalent calcium ions [8]. In plants, Ca2+ ion influx to the cytosol from the apoplast (where bacteria multiply [4], [5] and [9]) is a prerequisite for activation of myriad defenses by MAMPs [10]. We show that EPSs from diverse plant and animal pathogens and symbionts bind calcium. EPS-defective mutants or pure MAMPs, such as the flagellin peptide flg22, elicit calcium influx, expression of host defense genes, and downstream resistance. Furthermore, EPSs, produced by wild-type strains or purified, suppress induced responses but do not block flg22-receptor binding in Arabidopsis cells. EPS production was confirmed in planta, and the amounts in bacterial biofilms greatly exceed those required for binding of apoplastic calcium. These data reveal a novel, fundamental role for bacterial EPS in disease establishment, encouraging novel control strategies.

Carbon monoxide inhibition of Cav3.2 T-type Ca2+ channels reveals tonic modulation by thioredoxin

T-type Ca2+ channels play diverse roles in tissues such as sensory neurons, vascular smooth muscle, and cancers, where increased expression of the cytoprotective enzyme, heme oxygenase-1 (HO-1) is often found. Here, we report regulation of T-type Ca2+ channels by carbon monoxide (CO) a HO-1 by-product. CO (applied as CORM-2) caused a concentration-dependent, poorly reversible inhibition of all T-type channel isoforms (Cav3.1-3.3, IC50 ∼3 μM) expressed in HEK293 cells, and native T-type channels in NG108-15 cells and primary rat sensory neurons. No recognized CO-sensitive signaling pathway could account for the CO inhibition of Cav3.2. Instead, CO sensitivity was mediated by an extracellular redox-sensitive site, which was also highly sensitive to thioredoxin (Trx). Trx depletion (using auranofin, 2-5 μM) reduced Cav3.2 currents and their CO sensitivity by >50% but increased sensitivity to dithiothreitol ∼3-fold. By contrast, Cav3.1 and Cav3.3 channels, and their sensitivity to CO, were unaffected in identical experiments. Our data propose a novel signaling pathway in which Trx acts as a tonic, endogenous regulator of Cav3.2 channels, while HO-1-derived CO disrupts this regulation, causing channel inhibition. CO modulation of T-type channels has widespread implications for diverse physiological and pathophysiological mechanisms, such as excitability, contractility, and proliferation

Nonpsychotropic plant cannabinoids, cannabidivarin (CBDV) and cannabidiol (CBD), activate and desensitize transient receptor potential vanilloid 1 (TRPV1) channels in vitro: potential for the treatment of neuronal hyperexcitability

Epilepsy is the most common neurological disorder, with over 50 million people worldwide affected. Recent evidence suggests that the transient receptor potential cation channel subfamily V member 1 (TRPV1) may contribute to the onset and progression of some forms of epilepsy. Since the two nonpsychotropic cannabinoids cannabidivarin (CBDV) and cannabidiol (CBD) exert anticonvulsant activity in vivo and produce TRPV1-mediated intracellular calcium elevation in vitro, we evaluated the effects of these two compounds on TRPV1 channel activation and desensitization and in an in vitro model of epileptiform activity. Patch clamp analysis in transfected HEK293 cells demonstrated that CBD and CBDV dose-dependently activate and rapidly desensitize TRPV1, as well as TRP channels of subfamily V type 2 (TRPV2) and subfamily A type 1 (TRPA1). TRPV1 and TRPV2 transcripts were shown to be expressed in rat hippocampal tissue. When tested on epileptiform neuronal spike activity in hippocampal brain slices exposed to a Mg2+-free solution using multielectrode arrays (MEAs), CBDV reduced both epileptiform burst amplitude and duration. The prototypical TRPV1 agonist, capsaicin, produced similar, although not identical effects. Capsaicin, but not CBDV, effects on burst amplitude were reversed by IRTX, a selective TRPV1 antagonist. These data suggest that CBDV antiepileptiform effects in the Mg2+-free model are not uniquely mediated via activation of TRPV1. However, TRPV1 was strongly phosphorylated (and hence likely sensitized) in Mg2+-free solution-treated hippocampal tissue, and both capsaicin and CBDV caused TRPV1 dephosphorylation, consistent with TRPV1 desensitization. We propose that CBDV effects on TRP channels should be studied further in different in vitro and in vivo models of epilepsy.

Hydrogen sulfide inhibits Cav3.2 T-type Ca2+ channels

The importance of H2S as a physiological signaling molecule continues to develop, and ion channels are emerging as a major family of target proteins through which H2S exerts many actions. The purpose of the present study was to investigate its effects on T-type Ca2+ channels. Using patch-clamp electrophysiology, we demonstrate that the H2S donor, NaHS (10 μM-1 mM) selectively inhibits Cav3.2 T-type channels heterologously expressed in HEK293 cells, whereas Cav3.1 and Cav3.3 channels were unaffected. The sensitivity of Cav3.2 channels to H2S required the presence of the redox-sensitive extracellular residue H191, which is also required for tonic binding of Zn2+ to this channel. Chelation of Zn2+ with N,N,N',N'-tetra-2-picolylethylenediamine prevented channel inhibition by H2S and also reversed H2S inhibition when applied after H2S exposure, suggesting that H2S may act via increasing the affinity of the channel for extracellular Zn2+ binding. Inhibition of native T-type channels in 3 cell lines correlated with expression of Cav3.2 and not Cav3.1 channels. Notably, H2S also inhibited native T-type (primarily Cav3.2) channels in sensory dorsal root ganglion neurons. Our data demonstrate a novel target for H2S regulation, the T-type Ca2+ channel Cav3.2, and suggest that such modulation cannot account for the pronociceptive effects of this gasotransmitter.

Effect of milk type and processing on iodine concentration of organic and conventional winter milk at retail: implications for nutrition

Milk is the largest source of iodine in UK diets and an earlier study showed that organic summer milk had significantly lower iodine concentration than conventional milk. There are no comparable studies with winter milk or the effect of milk fat class or heat processing method. Two retail studies with winter milk are reported. Study 1 showed no effect of fat class but organic milk was 32.2% lower in iodine than conventional milk (404 vs. 595 μg/L; P < 0.001). Study 2 found no difference between conventional and Channel Island milk but organic milk contained 35.5% less iodine than conventional milk (474 vs. 306 μg/L; P < 0.001). UHT and branded organic milk also had lower iodine concentrations than conventional milk (331 μg/L; P < 0.001 and 268 μg/L: P < 0.0001 respectively). The results indicate that replacement of conventional milk by organic or UHT milk will increase the risk of sub-optimal iodine status especially for pregnant/lactating women.

Calcium Flux in Neuroblastoma Cells Is a Coupling Mechanism between Non-Genomic and Genomic Modes of Estrogens

Estrogens have been demonstrated to rapidly modulate calcium levels in a variety of cell types. However, the significance of estrogen-mediated calcium flux in neuronal cells is largely unknown. The relative importance of intra- and extracellular sources of calcium in estrogenic effects on neurons is also not well understood. Previously, we have demonstrated that membrane-limited estrogens, such as E-BSA given before an administration of a 2-hour pulse of 17beta-estradiol (E(2)), can potentiate the transcription mediated by E(2) from a consensus estrogen response element (ERE)-driven reporter gene. Inhibitors to signal transduction cascades given along with E-BSA or E(2) demonstrated that calcium flux is important for E-BSA-mediated potentiation of transcription in a transiently transfected neuroblastoma cell line. In this report, we have used inhibitors to different voltage-gated calcium channels (VGCCs) and to intracellular store receptors along with E-BSA in the first pulse or with E(2) in the second pulse to investigate the relative importance of these channels to estrogen-mediated transcription. Neither L- nor P-type VGCCs seem to play a role in estrogen action in these cells; while N-type VGCCs are important in both the non-genomic and genomic modes of estrogen action. Specific inhibitors also showed that the ryanodine receptor and the inositol trisphosphate receptor are important to E-BSA-mediated transcriptional potentiation. This report provides evidence that while intracellular stores of calcium are required to couple non-genomic actions of estrogen initiated at the membrane to transcription in the nucleus, extracellular sources of calcium are also important in both non-genomic and genomic actions of estrogens. Copyright (c) 2005 S. Karger AG, Basel.

Does fertilizer type and method of application cause significant differences in essential oil yield and composition in rosemary (Rosmarinus officinalis L.)?

Organic fertilizers based on seaweed extract potentially have beneficial effects on many crop plants. Herewe investigate the impact of organic fertilizer on Rosmarinus officinalis measured by both yield and oilquality. Plants grown in a temperature-controlled greenhouse with a natural photoperiod and a controlledirrigation system were treated with seaweed fertilizer and an inorganic fertilizer of matching mineralcomposition but with no organic content. Treatments were either by spraying on to the foliage or wateringdirect to the compost. The essential oil was extracted by hydro-distillation with a Clevenger apparatusand analysed by gas-chromatography mass-spectrometry (GC–MS) and NMR. The chemical composi-tions of the plants were compared, and qualitative differences were found between fertilizer treatmentsand application methods. Thus sprayed seaweed fertilizer showed a significantly higher percentage of�-pinene, �-phellandrene, �-terpinene (monoterpenes) and 3-methylenecycloheptene than other treat-ments. Italicene, �-bisabolol (sesquiterpenes), �-thujene, and E-isocitral (monoterpenes) occurred insignificantly higher percentages for plants watered with the seaweed extract. Each was significantly dif-ferent to the inorganic fertilizer and to controls. The seaweed treatments caused a significant increasein oil amount and leaf area as compared with both inorganic treatments and the control regardless ofapplication method.

Relationship Between Expression of Voltage-Dependent Anion Channel (VDAC) Isoforms and Type of Hexokinase Binding Sites on Brain Mitochondria

Voltage-dependent anion channels (VDAC) are pore-forming proteins found in the outer mitochondrial membrane of eukaryotes. VDACs are known to play an essential role in cellular metabolism and in early stages of apoptosis. In mammals, three VDAC isoforms have been identified. A proteomic approach was exploited to study the expression of VDAC isoforms in rat, bovine, and chicken brain mitochondria. Given the importance of mitochondrially bound hexokinase in regulation of aerobic glycolysis in brain, we studied the possibility that differences in the relative expression of VDAC isoforms may be a factor in determining the species-dependent ratio of type A/type B hexokinase binding sites on brain mitochondria. The spots were characterized, and the signal intensities among spots were compared. VDAC1 was the most abundantly expressed of the three isoforms. Moreover the expression of VDAC1 plus VDAC2 was significantly higher in bovine than in rat brain. Chicken brain mitochondria showed the highest VDAC1 expression and the lowest of VDAC2. Bovine brain mitochondria had the highest VDAC2 levels. We concluded that the nature of hexokinase binding site is not determined by the expression of a single VDAC isoform.

Role of a Novel Tetrodotoxin-Resistant Sodium Channel in the Nitrergic Relaxation of Corpus Cavernosum from the South American Rattlesnake Crotalus Durissus Terrificus

Introduction. Coitus in snakes may last up to 28 hours; however, the mechanisms involved are unknown. Aim. To evaluate the relevance of the nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-phosphodiesterase type 5 (PDE5) system in snake corpus cavernosum reactivity. Methods. Hemipenes were removed from anesthetized South American rattlesnakes (Crotalus durissus terrificus) and studied by light and scanning electronic microscopy. Isolated Crotalus corpora cavernosa (CCC) were dissected from the non-spiny region of the hemipenises, and tissue reactivity was assessed in organ baths. Main Outcome Measures. Cumulative concentration-response curves were constructed for acetylcholine (ACh), sodium nitroprusside (SNP), 5-cyclopropyl-2-[1-(2-fluorobenzyl)-1H-pyrazolo[3,4-b]pyridine-3-yl]pyrimidin-4-ylamine (BAY 41-2272), and tadalafil in CCC precontracted with phenylephrine. Relaxation induced by electrical field stimulation (EFS) was also done in the absence and presence of N omega nitro-L-arginine methyl ester (L-NAME; 100 mu M), 1H-[1, 2, 4] oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 10 mu M) and tetrodotoxin (TTX; 1 mu M). Results. The hemipenes consisted of two functionally concentric corpora cavernosa, one of them containing radiating bundles of smooth muscle fibers (confirmed by alpha-actin immunostaining). Endothelial and neural nitric oxide synthases were present in the endothelium and neural structures, respectively; whereas soluble guanylate cyclase and PDE5 were expressed in trabecular smooth muscle. ACh and SNP relaxed isolated CCC, with the relaxations being markedly reduced by L-NAME and ODQ, respectively. BAY 41-2272 and tadalafil caused sustained relaxations with potency (pEC(50)) values of 5.84 +/- 0.17 and 5.10 +/- 0.08 (N = 3-4), respectively. In precontracted CCC, EFS caused frequency-dependent relaxations that lasted three times longer than those in mammalian CC. Although these relaxations were almost abolished by either L-NAME or ODQ, they were unaffected by TTX. In contrast, EFS-induced relaxations in marmoset CC were abolished by TTX. Conclusions. Rattlesnake CC relaxation is mediated by the NO-cGMP-PDE5 pathway in a manner similar to mammals. The novel TTX-resistant Na channel identified here may be responsible for the slow response of smooth muscle following nerve stimulation and could explain the extraordinary duration of snake coitus. Capel RO, Monica FZ, Porto M, Barillas S, Muscara MN, Teixeira SA, Arruda AMM, Pissinatti, L, Pissinatti A, Schenka AA, Antunes E, Nahoum C, Cogo JC, de Oliveira MA, and De Nucci G. Role of a novel tetrodotoxin-resistant sodium channel in the nitrergic relaxation of corpus cavernosum from the South American rattlesnake Crotalus durissus terrificus. J Sex Med 2011;8:1616-1625.

The effect of calcium salts on the viscosity and adsorption behavior of xanthan

The effect of CaCl(2), Ca(NO(3))(2), CaSO(4), CaCO(3) and Ca(3)(PO(4))(2) on the flow behavior of xanthan gum solutions was investigated. Regardless the concentration and type of calcium salt used, xanthan solutions presented pseudoplastic behavior. The soluble salts (CaCl(2) and Ca(NO(3))(2)) induced the disordered state in the xanthan chains at concentration of 1.0 g/L or 10 g/L, decreasing the flow consistency index (K) values. At 100 g/L soluble salts K values were similar to those found for pure xanthan solutions, whereas at the same concentration of insoluble particles the K values increased 20%. The adsorption of xanthan gum onto Si/SiO(2) surfaces in the presence of calcium salts was investigated by ellipsometry and atomic force microscopy (AFM). The adsorbed layer of xanthan onto Si/SiO(2) consisted of two regions: (i) a thin acid resistant sublayer, where xanthan chains were like highly entangled fibers and (ii) a thick upperlayer, whose morphology was calcium salt dependent. (C) 2010 Elsevier Ltd. All rights reserved.

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