Investigation into the biochemical changes in Tourette Syndrome with a potential for pharmacological manipulation

Kynurenine (KYN) is the first stable metabolite of the kynurenine pathway, which accounts for over 95% of tryptophan metabolism. Two previous studies by this research group reported elevated plasma KYN in Tourette syndrome (TS) patients when compared with age and sex matched controls and another study showed that KYN potentiated 5-HT2A-mediated head-shakes (HS) in rodents. These movements have been suggested to model tics in TS. This raised the questions how KYN acts in eliciting this response and whether it is an action of its own or of a further metabolite along the kynurenine pathway. In the liver, where most of the kynurenine pathway metabolism takes place under physiological conditions, the first and the rate limiting enzyme is tryptophan-dioxygenase (TDO) which can be induced by cortisol. In extrahepatic tissues the same step of the pathway is catalyzed by indoleamine-dioxygenase (IDO), which is induced by cytokines, predominantly interferon-y (INF-y). Plasma neopterin, which shows parallel increase with KYN following immune stimulation, was also found elevated in one of these studies positively correlating with KYN. In the present work animal studies suggested that KYN potentiates and quinolinic acid (QUINA) dose dependently inhibits the 5-HT2A-mediated HS response in mice. The potentiating effect seen with KYN was suggested to be an effect of KYN itself. Radioligand binding and phosphoinositide (PI) hydrolysis studies were done to explore the mechanisms by which kynurenine pathway metabolites could alter a 5-HT2A-receptor mediated response. None of the kynurenine pathway metabolites tested showed direct binding to 5-HT2A-receptors. PI hydrolysis studies with KYN and QUINA showed that KYN did not have any effect while QUINA inhibited 5-HT2A-mediated PI hydrolysis. Plasma cortisol determination in TS patients with elevated plasma KYN did not show elevated plasma cortisol levels, suggesting that the increase of plasma KYN in these TS patients is unlikely to be due to an increased TDO activity induced by increased cortisol. Attention deficit hyperactivity disorder (ADHD) is commonly associated with TS. Salivary cortisol detected in a group of children primarily affected with ADHD showed significantly lower salivary cortisol levels when compared with age and sex matched controls. Plasma tryptophan, KYN, neopterin, INF-y and KYN/tryptophan ratio and night-time urinary 6-sulphatoxymelatonin (aMT6s) excretion measured in a group of TS patients did not show any difference in their levels when compared with age and sex matched controls, but TS patients failed to show the expected positive correlation seen between plasma INF-y, neopterin and KYN and the negative correlation seen between plasma KYN and night-time urinary aMT6s excretion seen in healthy controls. The relevance of the kynurenine pathway, melatonin secretion and cortisol to Tourette Syndrome and associated conditions and the mechanism by which KYN and QUINA alter the 5-HT2A-receptor mediated HS response are discussed.

Tetrahydrobiopterin metabolism in depression and senile dementia of Alzheimer type

Excretion of biopterin and the related pteridines neopterin and pterin was measured in urine samples from a group of 76 male and female unipolar and bipolar depressed outpatients receiving lithium therapy, and compared to 61 male and female control subjects. The ratio of neopterin to biopterin excreted (N/B) was significantly higher in the patients than the controls. The significant positive correlation between urinary neopterin and biopterin shown by the controls was absent in the patients, indicating disrupted biosynthesis of tetrahydrobiopterin.Urinary cortisol excretion in depressed patients was similar to controls, implying normal hypothalmus-pituitary-adrenal axis function in these patients, Serum folate was shown to correlate with urinary total biopterin excretion in female unipolar patients. Two groups of elderly females with senile dementia of Alzheimer type (SDAT) were examined for urinary pteridine excretion. In the first study of 10 patients, the N/B ratio was significantly higher than in 24 controls and the ratio B/B+ N significantly lower. A second study of 30 SDAT patients and 21 controls confirmed these findings. However, neopterin correlated with biopterin in both patients and controls, indicating that the alteration in tetrahydrobiopterin metabolism may be different to that shown in depression. Lithium had no effect in vivo or in vitro on Wistar rat brain or liver biosynthesis of tetrahydrobiopterin at a range of concentrations and duration of dosing period, showing that lithium was not responsible for the lowered biopterin excretion by depressed patients. No significant effects on tetrahydrobiopterin metabolism in the rat were shown by the tricyclic antidepressant imipramine, the anticonvulsant sodium valproate, the vitamin folic acid, the anticatecholaminergic agent amethylparatyrosine, the synthetic corticosteroid dexamethasone, or stimulation of natural cortisol by immobilisation stress. Scopolamine, an ant ichol inergic drug, lowered rat brain pterin which may relate to the tetrahydrobiopterin deficits shown in SDAT.

Psychophysiological responses to pain identify reproducible human clusters

Pain is a ubiquitous yet highly variable experience. The psychophysiological and genetic factors responsible for this variability remain unresolved. We hypothesised the existence of distinct human pain clusters (PCs) composed of distinct psychophysiological and genetic profiles coupled with differences in the perception and the brain processing of pain. We studied 120 healthy subjects in whom the baseline personality and anxiety traits and the serotonin transporter-linked polymorphic region (5-HTTLPR) genotype were measured. Real-time autonomic nervous system parameters and serum cortisol were measured at baseline and after standardised visceral and somatic pain stimuli. Brain processing reactions to visceral pain were studied in 29 subjects using functional magnetic resonance imaging (fMRI). The reproducibility of the psychophysiological responses to pain was assessed at 1 year. In group analysis, visceral and somatic pain caused an expected increase in sympathetic and cortisol responses and activated the pain matrix according to fMRI studies. However, using cluster analysis, we found 2 reproducible PCs: at baseline, PC1 had higher neuroticism/anxiety scores (P ≤ 0.01); greater sympathetic tone (P < 0.05); and higher cortisol levels (P ≤ 0.001). During pain, less stimulus was tolerated (P ≤ 0.01), and there was an increase in parasympathetic tone (P ≤ 0.05). The 5-HTTLPR short allele was over-represented (P ≤ 0.005). PC2 had the converse profile at baseline and during pain. Brain activity differed (P ≤ 0.001); greater activity occurred in the left frontal cortex in PC1, whereas PC2 showed greater activity in the right medial/frontal cortex and right anterior insula. In health, 2 distinct reproducible PCs exist in humans. In the future, PC characterization may help to identify subjects at risk for developing chronic pain and may reduce variability in brain imaging studies. © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Weight loss strategies, stress, and cognitive function:supervised versus unsupervised dieting

The early stages of dieting to lose weight have been associated with neuro-psychological impairments. Previous work has not elucidated whether these impairments are a function solely of unsupported or supported dieting. Raised cortico-steroid levels have been implicated as a possible causal mechanism. Healthy, overweight, pre-menopausal women were randomised to one of three conditions in which they dieted either as part of a commercially available weight loss group, dieted without any group support or acted as non-dieting controls for 8 weeks. Testing occurred at baseline and at 1, 4 and 8 weeks post baseline. During each session, participants completed measures of simple reaction time, motor speed, vigilance, immediate verbal recall, visuo-spatial processing and (at Week 1 only) executive function. Cortisol levels were gathered at the beginning and 30 min into each test session, via saliva samples. Also, food intake was self-recorded prior to each session and fasting body weight and percentage body fat were measured at each session. Participants in the unsupported diet condition displayed poorer vigilance performance (p=0.001) and impaired executive planning function (p=0.013) (along with a marginally significant trend for poorer visual recall (p=0.089)) after 1 week of dieting. No such impairments were observed in the other two groups. In addition, the unsupported dieters experienced a significant rise in salivary cortisol levels after 1 week of dieting (p<0.001). Both dieting groups lost roughly the same amount of body mass (p=0.011) over the course of the 8 weeks of dieting, although only the unsupported dieters experienced a significant drop in percentage body fat over the course of dieting (p=0.016). The precise causal nature of the relationship between stress, cortisol, unsupported dieting and cognitive function is, however, uncertain and should be the focus of further research. © 2005 Elsevier Ltd. All rights reserved.

Psychophysiological responses to visceral and somatic pain in functional chest pain identify clinically relevant pain clusters

Background: Despite chronic pain being a feature of functional chest pain (FCP) its experience is variable. The factors responsible for this variability remain unresolved. We aimed to address these knowledge gaps, hypothesizing that the psychophysiological profiles of FCP patients will be distinct from healthy subjects. Methods: 20 Rome III defined FCP patients (nine males, mean age 38.7 years, range 28-59 years) and 20 healthy age-, sex-, and ethnicity-matched controls (nine males, mean 38.2 years, range 24-49) had anxiety, depression, and personality traits measured. Subjects had sympathetic and parasympathetic nervous system parameters measured at baseline and continuously thereafter. Subjects received standardized somatic (nail bed pressure) and visceral (esophageal balloon distension) stimuli to pain tolerance. Venous blood was sampled for cortisol at baseline, post somatic pain and post visceral pain. Key Results: Patients had higher neuroticism, state and trait anxiety, and depression scores but lower extroversion scores vs controls (all p < 0.005). Patients tolerated less somatic (p < 0.0001) and visceral stimulus (p = 0.009) and had a higher cortisol at baseline, and following pain (all p < 0.001). At baseline, patients had a higher sympathetic tone (p = 0.04), whereas in response to pain they increased their parasympathetic tone (p ≤ 0.008). The amalgamating the data, we identified two psychophysiologically distinct 'pain clusters'. Patients were overrepresented in the cluster characterized by high neuroticism, trait anxiety, baseline cortisol, pain hypersensitivity, and parasympathetic response to pain (all p < 0.03). Conclusions & Inferences: In future, such delineations in FCP populations may facilitate individualization of treatment based on psychophysiological profiling. © 2013 John Wiley & Sons Ltd.

The effect of male -male competition and its underlying regulatory mechanisms on the electric signal of the gymnotiform fish Brachyhypopomus gauderio

Sexually-selected communication signals can be used by competing males to settle contests without incurring the costs of fighting. The ability to dynamically regulate the signal in a context-dependent manner can further minimize the costs of male aggressive interactions. Such is the case in the gymnotiform fish Brachyhypopomus gauderio, which, by coupling its electric organ discharge (EOD) waveform to endocrine systems with circadian, seasonal, and behavioral drivers, can regulate its signal to derive the greatest reproductive benefit. My dissertation research examined the functional role of the EOD plasticity observed in male B. gauderio and the physiological mechanisms that regulate the enhanced male EOD. To evaluate whether social competition drives the EOD changes observed during male-male interactions, I manipulated the number of males in breeding groups to create conditions that exemplified low and high competition and measured their EOD and steroid hormone levels. My results showed that social competition drives the enhancement of the EOD amplitude of male B. gauderio. In addition, changes in the EOD of males due to changes in their social environment were paralleled by changes in the levels of androgens and cortisol. I also examined the relationship between body size asymmetry, EOD waveform parameters, and aggressive physical behaviors during male-male interactions in B. gauderio, in order to understand more fully the role of EOD waveforms as reliable signals. While body size was the best determinant of dominance in male B. gauderio, EOD amplitude reliably predicted body condition, a composite of length and weight, for fish in good body condition. To further characterize the mechanisms underlying the relationship between male-male interactions and EOD plasticity, I identified the expression of the serotonin receptor 1A, a key player in the regulation of aggressive behavior, in the brains of B. gauderio. I also identified putative regulatory regions in this receptor in B. gauderio and other teleost fish, highlighting the presence of additional plasticity. In conclusion, male-male competition seems to be a strong selective driver in the evolution of the male EOD plasticity in B. gauderio via the regulatory control of steroid hormones and the serotonergic system.

The Effect of male-male competition and its Underlying Regulatory Mechanisms on the Electric Signal of the Gymnotiform fish Brachyhypopomus gauderio

Sexually-selected communication signals can be used by competing males to settle contests without incurring the costs of fighting. The ability to dynamically regulate the signal in a context-dependent manner can further minimize the costs of male aggressive interactions. Such is the case in the gymnotiform fish Brachyhypopomus gauderio, which, by coupling its electric organ discharge (EOD) waveform to endocrine systems with circadian, seasonal, and behavioral drivers, can regulate its signal to derive the greatest reproductive benefit. My dissertation research examined the functional role of the EOD plasticity observed in male B. gauderio and the physiological mechanisms that regulate the enhanced male EOD. To evaluate whether social competition drives the EOD changes observed during male-male interactions, I manipulated the number of males in breeding groups to create conditions that exemplified low and high competition and measured their EOD and steroid hormone levels. My results showed that social competition drives the enhancement of the EOD amplitude of male B. gauderio. In addition, changes in the EOD of males due to changes in their social environment were paralleled by changes in the levels of androgens and cortisol. I also examined the relationship between body size asymmetry, EOD waveform parameters, and aggressive physical behaviors during male-male interactions in B. gauderio, in order to understand more fully the role of EOD waveforms as reliable signals. While body size was the best determinant of dominance in male B. gauderio, EOD amplitude reliably predicted body condition, a composite of length and weight, for fish in good body condition. To further characterize the mechanisms underlying the relationship between male-male interactions and EOD plasticity, I identified the expression of the serotonin receptor 1A, a key player in the regulation of aggressive behavior, in the brains of B. gauderio. I also identified putative regulatory regions in this receptor in B. gauderio and other teleost fish, highlighting the presence of additional plasticity. In conclusion, male-male competition seems to be a strong selective driver in the evolution of the male EOD plasticity in B. gauderio via the regulatory control of steroid hormones and the serotonergic system.

Circadian rhythm disruption and post-surgical recovery

Circadian rhythms, patterns of each twenty-four hour period, are found in most bodily functions. The biological cycles of between 20 and 28 hours have a profound effect on an individual's mood, level of performance, and physical well being. Loss of synchrony of these biological rhythms occurs with hospitalization, surgery and anesthesia. The purpose of this comparative, correlational study was to determine the effects of circadian rhythm disruption in post-surgical recovery. Data were collected during the pre-operative and post-operative periods in the following indices: body temperature, blood pressure, heart rate, urine cortisol level and locomotor activity. The data were analyzed by cosinor analysis for evidence of circadian rhythmicity and disruptions throughout the six day study period which encompassed two days pre-operatively, two days post-operatively, and two days after hospital discharge. The sample consisted of five men and five women who served as their own pre-surgical control. The surgical procedures were varied. Findings showed evidence of circadian disruptions in all subjects post-operatively, lending support for the hypotheses.

Desempenho físico em idosos com diferenciados perfis epidemiológicos: análise do estudo IMIAS International Mobility in Aging Study sob a perspectiva do curso da vida e de biomarcadores da inflamação e do estresse

O crescimento demográfico de idosos é um fenômeno mundial e exerce influência sobre o desenvolvimento e funcionamento das sociedades. Fatores sociais, econômicos, ambientais, biológicos e culturais influenciam o processo de envelhecimento, que pode vir acompanhado de contínua perda na capacidade de adaptação do indivíduo ao meio ambiente, de maior vulnerabilidade ao estresse, limitações funcionais e diminuição da qualidade de vida do indivíduo. Todavia, ao longo do curso da vida, o indivíduo vivencia múltiplas exposições adversas à saúde, e o declínio da mobilidade surge como um dos primeiros sinais do envelhecimento, repercutindo na saúde física e mental do indivíduo. Para contribuir com o conhecimento sobre os desfechos relacionados ao envelhecimento e mobilidade, o estudo IMIAS investiga idosos em quatro países com diferentes perfis epidemiológicos. O presente estudo abordou os possíveis fatores associados ao declínio físico em idosos de distintas sociedades, sobre a perspectiva epidemiológica do curso da vida e dos biomarcadores da inflamação e do estresse. Objetivos: 1) Analisar as relações entre as adversidades sociais e econômicas, vivenciadas durante a infância, a fase adulta e a velhice, com o baixo desempenho físico em populações idosas, de diferentes contextos sociais, econômicos e culturais. 2) Verificar a associação entre os níveis elevados da proteína c-reativa (PCR) com o desempenho físico em idosos de diferentes populações. 3) Avaliar se a desregulação nos níveis de cortisol diurno exerce influência sobre o desempenho físico em idosos com distintos perfis epidemiológicos. Métodos: Foram utilizados dados da linha de base do IMIAS – Estudo Internacional de Mobilidade no Envelhecimento, composto por 1.995 indivíduos entre 65 e 74 anos de idade, residentes em comunidades de quatro países (Albânia, Brasil, Canadá, Colômbia). O desempenho físico foi avaliado através do Short Physical Performance Battery (SPPB) e da força de preensão manual. As adversidades durante o curso da vida foram estimadas a partir de eventos e exposições sociais, econômicas e culturais ocorridas durante a infância, fase adulta e velhice. Para avaliar o percurso biológico e suas associações com a mobilidade, a proteína c-reativa e o cortisol foram considerados como biomarcadores da inflamação e do estresse, respectivamente. No sentido de responder as questões de investigações, foram conduzidas análises de estatística descritiva, bivariada e multivariada, mediante técnicas de distribuição de frequências, teste qui-quadrado, odds ratio e regressões logística, linear e multinível. Resultados: O desempenho físico foi menor nos participantes que vivem na Colômbia, Brasil e Albânia do que nos que vivem no Canadá, mesmo quando ajustados por idade, sexo e adversidades durante o curso da vida. O baixo nível de desempenho físico (SPPB < 8) foi associado a ter sofrido adversidade social e econômica na infância, ter tido ocupação semiqualificada na fase adulta, morar sozinho e possuir renda insuficiente na velhice. A PCR esteve associada com a baixa força de preensão manual e com o SPPB<8. Entretanto, a associação entre a PCR e a força de preensão manual não se manteve quando ajustada por fatores socioeconômicos e hábitos de saúde. As associações negativas entre SPPB e PCR permaneceram significativas mesmo após ajustes por idade, sexo, escolaridade, local de pesquisa e condições de saúde. O baixo desempenho físico (SPPB ≤ 8) foi associado com uma significativa diminuição nos níveis de cortisol ao acordar, em comparação com os níveis de cortisol de idosos com bom desempenho físico (SPPB > 8), mesmo após modelos controlados por local de estudo, sexo, depressão, hábitos de saúde, uso de psicotrópicos e índice de massa corporal. Conclusões: Os resultados evidenciaram associação entre a inflamação, o estresse e as desigualdades sociais e econômicas na infância, sobre o desempenho físico de idosos com diferenciados perfis epidemiológicos. Enfatizamos que a promoção do envelhecimento saudável requer considerar políticas e práticas que favoreçam o bem-estar econômico e social para crianças, adultos e idosos.

Estudo comparativo entre antipsicóticos atípicos no tratamento da esquizofrenia e sua influência na qualidade de vida dos pacientes

Schizophrenia is a severe and persistent mental illness; diagnosis occurs mainly during adolescence. The pharmacological treatment is done with typical and atypical antipsychotics. Atypical have the advantage of reduced extrapyramidal effects, which make them promising for the treatment of schizophrenia, furthermore, they have shown significant metabolic and hormonal changes. The objective of this study was to evaluate the influence of atypical antipsychotics, olanzapine and risperidone on the quality of life and on their adverse effects in schizophrenic patients. For this we analyzed the quality of life of patients with implementation of EuroQol-5D-3L instrument and performing biochemical and hormonal tests, blood pressure measurement, and measurement of anthropometric indices, besides the application of Ugvalg scales for Kliniske Undersgelser (UKU) and Simpson-Angus, who evaluated the side effects caused by drugs. Data were analyzed using the Student t test and chi-square test, with 5% significance level. The results showed that the EuroQol the antipsychotic olanzapine causes significant losses associated with personal care (p <0.001). Comparing the two groups of antipsychotics, the average years of quality-adjusted life, known per QALY was favorable for the risperidone group (p <0.032). The results of olanzapine and risperidone groups were compared. In terms of socioeconomic, it was observed that men used, the prevalent form, olanzapine (p <0.008); this same group showed the following results significantly unfavorable, related to anthropometric variables: waist circumference (p <0.01), hip circumference (p <0.02), weight (p <0.02) and blood pressure (p <0.04). The biochemical and hormonal analyzes showed that olanzapine resulted in losses related to the following variables: triglycerides (p <0.04), HDL cholesterol in men (p < 0.02) and cortisol (p < 0.01). In risperidone users, the only negative value was prolactin (p < 0.04). Regarding the analysis of the Simpson-Angus scale, the group treated with olanzapine was handicapped because the average total scores for olanzapine was 0.38, while for risperidone was 0.11 (p < 0.02). In the UKU scale, the following results were obtained also unfavorable for the olanzapine group: fatigue (P <0.02), dystonia (p <0.01) and tremor (p <0.03). According to the UKU scale, the side effects present in the risperidone group included: gynecomastia (p <0.01), ejaculatory dysfunction (p <0.02) and erectile dysfunction (p <0.02). It was concluded that olanzapine users had the worst score of quality of life, higher metabolic risks associated with overweight and inadequate lipid profile and greater tendency to extrapyramidal manifestations. However, risperidone users were more likely to adverse reactions due to hormonal changes.

Modulaçao do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e plasticidade neuronal em saguis (Callithrix jacchus) juvenis: um modelo psiquiátrico e cognitivo

Nos períodos críticos de plasticidade neural ocorre uma maior permissividade do sistema nervoso ao ambiente, por isto, a ação do estresse sobre o individuo e suas repercussões sobre áreas responsáveis pelo controle dos sistemas de resposta ao estresse e por funções cognitivas complexas vem recebendo bastante atenção. A utilização de modelos experimentais translacionais tem sido imprescindível na elucidação destes mecanismos e das patologias associadas. Diante disto, este trabalho investigou os efeitos do estresse social sobre parâmetros fisiológicos, comportamentais, cognitivos e sobre a neurogênese no córtex pré-frontal (CPF) durante um período crítico de plasticidade cerebral, a fase juvenil, em machos de Callithrix jacchus. Durante cinco meses, 5 animais foram acompanhados em suas famílias (GF) e 5 animais foram isolados socialmente por 4 meses (GI), após um mês em observação em ambiente familiar (fase basal- FB). Ao final do 5º mês foram aplicados 2 testes de memória de trabalho (MT) nos animais GF e GI. Em seguida, 3 animais de cada grupo foram sacrificados para análise do fator de neurogênese BDNF ( Brain Derived Neurotrophic Factor) por imunofluorescência no CPF (sub-regiões orbitofrontal e lateral). Os animais do GF não variaram significativamente o cortisol ao longo do estudo, enquanto o GI elevou o cortisol e comportamentos indicadores de ansiedade (CA) na primeira semana do isolamento. Em seguida, o GI apresentou uma redução no cortisol, nos CA, no peso corporal e um aumento de comportamentos estereotipados e da anedonia, alterações tipicamente depressivas em primatas não-humanos. Ao final, o GI apresentaram níveis de cortisol menores que em FB. Ambos os grupos apresentaram dificuldades em realizar e aprender as tarefas cognitivas e a presença de BDNF no córtex pré-frontal foi independente do grupo (GF ou GI), porém correlacionou-se com os níveis de cortisol presentes na ultima semana do estudo, e os animais com presença de BDNF no CPF lateral e orbitofrontal apresentaram maiores níveis de cortisol. Estes resultados contribuem no processo de validação do sagui como um bom modelo psiquiátrico translacional e aponta para possibilidade de estudos sobre transtornos depressivos na juventude e suas repercussões posteriores. Além disto, os resultados observados para as tarefas cognitivas levou-nos a fazer uma releitura dos protocolos utilizados em estudos de memoria de trabalho com animais adultos desta espécie, com a finalidade de aprimora-los facilitando a aprendizagem em animais juvenis, naives e em situações de estresse. Ademais, evidenciou-se pela primeira vez a relação do estresse, cortisol e níveis de BDNF, em animais juvenis desta espécie, com a fim de contribuir com sua utilização como modelo animal neurocognitivo.

Condicionantes nutricionales que influyen sobre los factores de riesgo de síndrome metabólico en niños de la Comunidad de Madrid

El Síndrome Metabólico (SM) es un conjunto de factores de riesgo asociados con el incremento del riesgo de enfermedad cardiovascular y diabetes mellitus de tipo 2 (DM2). Dichos factores son obesidad (OB), resistencia a la Insulina (RI), hiperglucemia, dislipidemia e hipertensión (HTA) e interactúan entre sí sobre las anomalías vasculares, el estrés oxidativo, la grasa visceral, la inflamación y el cortisol en un entorno de OB y RI y bajo la influencia de las predisposiciones genéticas y condiciones ambientales, tales como hábitos de alimentación y actividad física. Según una hipótesis, la RI y la OB son los factores que más contribuyen en la manifestación de anormalidades metabólicas y las manifestaciones más tempranas del desarrollo de SM en niños. Mientras el páncreas compensa adecuadamente la RI mediante una mayor secreción de insulina, las concentraciones de glucosa en sangre se mantienen normales. Sin embargo, en algunos pacientes la capacidad de las células β del páncreas disminuye con el tiempo, lo que conduce al desarrollo de DM2. Otro factor a tener en cuenta en el diagnóstico del SM es la dislipidemia, caracterizada por el aumento de los triglicéridos (TG) y del VLDL‐colesterol, bajas cifras de HDL‐colesterol, así como por la presencia de partículas de LDL‐colesterol más pequeñas y densas de lo normal. Otro factor de riesgo de padecimiento de SM es la presión arterial elevada, que suele aparecer ligada a la presencia de OB, ya que el aumento de algunas adipoquinas que en esta se produce, entre las que se encuentran el AGE, PAI‐1, IL‐6, TNF‐α y leptina, pueden llevar a disfunción endotelial a través de la ruta del óxido nítrico. Debido a que el sobrepeso y el incremento de los valores de insulina plasmática son componentes clave del SM, es importante tener en cuenta los hábitos alimentarios y otros estilos de vida que influyen en los mismos...

Niveaux de vigilance pendant et après une exposition à la lumière vive durant la nuit

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Évaluation de trois solutions épidurales pour l'analgésie en chirurgie cardiaque à coeur battant

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The impact of maternal inflammation and maternal stress in the regulation of neurodevelopment and physiological function

The mechanisms governing fetal development follow a tightly regulated pattern of progression such that interference at any one particular stage is likely to have consequences for all other stages of development in the physiological system that has been affected thereafter. These disturbances can take the form of many different events but two of the most common and widely implicated in causing detrimental effects to the developing fetus are maternal immune activation (MIA) and maternal stress. MIA has been shown to cause an increase in circulating proinflammatory cytokines in both the maternal and fetal circulation. This increase in proinflammatory mediators in the fetus is thought to occur by fetal production rather than through exchange between the maternal-fetal interface. In the case of maternal stress it is increased levels of stress related hormones such as cortisol/corticosterone which is thought to elicit the detrimental effects on fetal development. In the case of both maternal infection and stress the timing and nature of the insult generally dictates the severity and type of effects seen in affected offspring. We investigated the effect of a proinflammatory environment on neural precursor cells of which exposure resulted in a significant decrease in the normal rate of proliferation of NPCs in culture but did not have any effect on cell survival. These effects were seen to be age dependent. Using a restraint stress model we investigated the effects of prenatal stress on the development of a number of different physiological systems in the same cohort of animals. PNS animals exhibited a number of aberrant changes in cardiovascular function with altered responses to stress and hypertension, modifications in respiratory responses to hypercapnic and hypoxic challenges and discrepancies in gastrointestinal innervation. Taken together these findings suggest that both maternal infection and maternal stress are detrimental to the normal development of the fetus.