Medicine and Health Sciences | Open Access Articles

Principles Of Management Of Severe Hyponatremia, Antonios H. Tzamaloukas Md, Deepak Malhorta Md, Phd, Bradley H. Rosen Do, Dominic S. C. Raj S. C. Raj Md, Glen H. Murata Md, Joseph I. Shapiro Md

Joseph I Shapiro MD

Hyponatremia represents a serious health hazard.1 Hospitalized patients,2 nursing home residents,3 women,4,5 and children6 exhibit high frequency and/or severity of hyponatremia. Hyponatremia developing during the course of other morbid conditions increases their severity.7–10 Estimates of direct costs for treating hyponatremia in the United States ranged between $1.61 and $3.6 billion.11 Clinical manifestations of hyponatremia are universal12,13 and range from subtle (disturbances of balance, problems in cognition detected only during speciﬁc testing) to life-threatening manifestations of increased intracranial pressure with life-threatening hypoxia14–16 and noncardiac pulmonary edema.17 Although the treating physicians must make an accurate diagnosis based on well-established and described clinical …

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Cyclooxygenase-2 Dependent Metabolism Of 20-Hete Increases Adiposity And Adipocyte Enlargement In Mesenchymal Stem Cell-Derived Adipocytes, Dong Hyun Kim, Nitin Puri, Komal Sodhi, John R. Falck, Nader G. Abraham, Joseph I. Shapiro M.D., Michal L. Schwartzman

Joseph I Shapiro MD

Abstract 20-Hydroxy-5,8,11,14-eicosatetraenoic acid (20-HETE), a product of the cytochrome P450 (CYP)-catalyzed [1] -hydroxylation of arachidonic acid, induces oxidative stress and, in clinical studies, is associated with increased body mass index (BMI) and the metabolic syndrome. This study was designed to examine the effects of exogenous 20- HETE on mesenchymal stem cell (MSC)-derived adipocytes. The expression levels of CYP4A11 and CYP4F2 (major 20-HETE synthases in humans) in MSCs decreased during adipocyte differentiation; however, exogenous administration of 20-HETE (0.1–1 M) increased adipogenesis in a dose dependent manner in these cells ( P < 0.05). The inability of a 20-HETE analog to reproduce these …

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Increased Heme-Oxygenase 1 Expression In Mesenchymal Stem Cell-Derived Adipocytes Decreases Differentiation And Lipid Accumulation Via Upregulation Of The Canonical Wnt Signaling Cascade, Luca Vanella, Komal Sodhi, Dong Hyun Kim, Nitin Puri, Mani Maheshwari, Terry D . Hinds, Lars Bellner, Dov Goldstein, Stephen J . Peterson, Joseph I. Shapiro M.D., Nader G. Abraham

Joseph I Shapiro MD

Introduction: Heme oxygenase (HO), a major cytoprotective enzyme, attenuates oxidative stress and obesity. The canonical Wnt signaling cascade plays a pivotal role in the regulation of adipogenesis. The present study examined the interplay between HO-1and the Wnt canonical pathway in the modulation of adipogenesis in mesenchymal stem cell (MSC)-derived adipocytes. Methods: To verify the role of HO-1 in generating small healthy adipocytes, cobalt protoporphyrin (CoPP), inducer of HO-1, was used during adipocyte differentiation. Lipid accumulation was measured by Oil red O staining and lipid droplet size was measured by BODIPY staining. Results: During adipogenesis in vitro, differentiating pre-adipocytes display transient …

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Na/K-Atpase Mimetic Pnaktide Peptide Inhibits The Growth Of Human Cancer Cells, Zhichuan Li, Zhongbing Zhang, Joe X. Xie, Xin Li, Jiang Tian, Ting Cai, Hongaun Cui, Hanfei Ding, Joseph I. Shapiro Md, Zijian Xie

Joseph I Shapiro MD

Cells contain a large pool of non-pumping Na/K-ATPase that participates in signal transduction. Here, we show that the expression of α1 Na/K-ATPase is significantly reduced in human prostate carcinoma as well as in several human cancer cell lines. This down-regulation impairs the ability of Na/K-ATPase to regulate Src-related signaling processes. Supplement of pNaKtide, a peptide derived from α1 Na/K-ATPase, reduces activities of Src and Src effectors. Consequently, these treatments stimulate apoptosis and inhibit growth in cultures of human cancer cells. Moreover, administration of pNaKtide inhibits angiogenesis and growth of tumor xenograft. Thus, the new findings demonstrate the in vivo effectiveness …

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Ho-1 Upregulation Attenuates Adipocyte Dysfunction, Obesity, And Isoprostane Levels In Mice Fed High Fructose Diets, Zeid Khitan, Mohit Harsh, Komal Sodhi, Joseph I. Shapiro Md, Nader G. Abraham

Joseph I Shapiro MD

Background. Fructose metabolism is an unregulated metabolic pathway and excessive fructose consumption is known to activate ROS.HO-1 is a potent antioxidant gene that plays a key role in decreasing ROS and isoprostanes.We examinedwhether the fructosemediated increase in adipocyte dysfunction involves an increase in isoprostanes and that pharmacological induction ofHO-1would decrease both isoprostane levels and adipogenesis. Methods and Results. We examined the effect of fructose, on adipogenesis in human MSCs in the presence and absence of CoPP, an inducer of HO-1. Fructose increased adipogenesis and the number of large lipid droplets while decreasing the number of small lipid droplets (𝑃 < 0.05). …

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From Lcme Probation To Compliance: The Marshall University Joan C Edwards School Of Medicine Experience, Bobby Miller, Brian Dzwonek, Aaron Mcguffin, Joseph I. Shapiro Md

Joseph I Shapiro MD

The Joan C Edwards School of Medicine (Marshall University, Huntington, WV, USA) was placed on probation by the Liaison Committee on Medical Education (LCME) in June 2011. In the following 2 years, extensive changes were made to address the numerous citations that resulted in this probation. In October 2013, the LCME lifted probation. In this article, we detail the challenges and solutions identified relevant to our struggle with compliance.

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Principles Of Quantitative Fluid And Cation Replacement In Extreme Hyperglycemia, Antonios H. Tzamaloukas, Yijuan Sun, Nikifor K. Konstantinov, Richard I. Dorin, Todd S. Ing, Deepak Malhorta, Glenn H. Murata, Joseph I. Shapiro M.D.

Joseph I Shapiro MD

Hyperglycemia may cause profound deficits of water, sodium and potassium through osmotic diuresis, which continues during treatment as long as there is glucosuria. Replacement fluids should cover both the deficits at presentation and the ongoing losses during treatment. At presentation with hyperglycemia, quantitative estimates of the deficits in water, sodium and potassium are based on rapid body weight changes, which indicate changes in body water, and on the serum sodium concentration corrected to a normal serum glucose level. The corrected serum sodium concentration provides a measure of the water deficit relative to the cation deficit (sodium, plus potassium) that is …

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Gender Differences In The Development Of Uremic Cardiomyopathy Following Partial Nephrectomy: Role Of Progesterone, Christopher A. Drummond, George Buddny, Steven T. Haller, Jiang Liu, Yanling Yan, Zijian Xie, Deepak Malhotra, Joseph I. Shapiro Md, Jiang Tian

Joseph I Shapiro MD

Gender difference has been suggested as a risk factor for developing cardiovascular and renal diseases in humans and experimental animals. As a major sex hormone, progesterone was reported to compete with cardiotonic steroid binding to Na/K-ATPase. Our previous publication demonstrated that cardiotonic steroids (e.g., marinobufagenin) play an important role in the development of experimental uremic cardiomyopathy. We also observed that the putative mineralocorticoid antagonists, spironolactone and its major metabolite canrenone, antagonize binding of cardiotonic steroids to Na/K-ATPase in a competitive manner and also ameliorate experimental uremic cardiomyopathy induced by partial nephrectomy. In the following studies, we noted that progesterone displayed …

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Involvement Of Reactive Oxygen Species In A Feed-Forward Mechanism Of Na/K-Atpase Mediated Signaling, Yanling Yan, Anna P. Shapiro, Steven Haller, Vinal Katragadda, Lijun Liu, Jiang Tian, Venkatesha Basrur, Deepak Malhotra, Zi-Jian Xie, Nader G. Abraham, Joseph I. Shapiro Md, Jiang Liu

Joseph I Shapiro MD

Cardiotonic steroids (such as ouabain) signaling through Na/K-ATPase regulate sodium reabsorption in the renal proximal tubule. We report here that reactive oxygen species are required to initiate ouabain-stimulated Na/K-ATPase·c-Src signaling. Pretreatment with the antioxidant N-acetyl-L-cysteine prevented ouabain-stimulated Na/K-ATPase·c-Src signaling, protein carbonylation, redistribution of Na/K-ATPase and sodium/proton exchanger isoform 3, and inhibition of active transepithelial 22Na+ transport. Disruption of the Na/K-ATPase·c-Src signaling complex attenuated ouabain-stimulated protein carbonylation. Ouabain-stimulated protein carbonylation is reversed after removal of ouabain, and this reversibility is largely independent of de novo protein synthesis and degradation by either the lysosome or the proteasome pathways. Furthermore, ouabain stimulated direct …

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Reduction Of Na/K-Atpase Potentiates Marinobufagenin-Induced Cardiac Dysfunction And Myocyte Apoptosis, Changxuan Liu, Yan Bai, Yiliang Chen, Yu Wang, Yoann Sottejeau, Lijun Liu, Xiaomei Li, Jerry B. Lingrel, Deepak Malhorta, Christopher Cooper, Joseph I. Shapiro M.D., Zi-Jian Xie, Jiang Tian

Joseph I Shapiro MD

Background: Na/K-ATPase decrease has been reported in patients with heart failure and is related to cardiac dysfunction. Results: Reducing Na/K-ATPase activates caspase 9 and induces cardiac dilation when treated with marinobufagenin. Conclusion: Reduction of Na/K-ATPase potentiates marinobufagenin-induced cardiac myocyte apoptosis. Significance: Decreased Na/K-ATPase content together with increased cardiotonic steroids levels is a novel mechanism that may account for cardiac dysfunction.

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Pparδ Binding To Heme Oxygenase 1 Promoter Prevents Angiotensin Ii-Induced Adipocyte Dysfunction In Goldblatt Hypertensive Rats, Komal Sodhi, Nitin Puri, Dong Hyun Kim, Terry D. Hinds Jr., Lance A. Stechschulte, Gaia Favero, Luigi Rodella, Joseph I. Shapiro M.D., David C. Jude, Nader X. Abraham

Joseph I Shapiro MD

Abstract: OBJECTIVE: Renin–angiotensin system (RAS) regulates adipogenic response with adipocyte hypertrophy by increasing oxidative stress. Recent studies have shown the role of peroxisome proliferator-activated receptor-d (PPARδ) agonist in attenuation of angiotensin II-induced oxidative stress. The aim of this study was to explore a potential mechanistic link between PPARδ and the cytoprotective enzyme heme oxygenase-1 (HO-1) and to elucidate the contribution of HO-1 to the adipocyte regulatory effects of PPARδ agonism in an animal model of enhanced RAS, the Goldblatt 2 kidney 1 clip (2K1C) model. METHOD: We first established a direct stimulatory effect of the PPARδ agonist (GW 501516) on …

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Intracellular Reactive Oxygen Species Mediate The Linkage Of Na+/K+-Atpase To Hypertrophy And Its Marker Genes In Cardiac Myocytes, Joseph I. Shapiro, Amir Askari, Zijian Xie, Peter Kometiani, Jie Li, Jiang Liu

Joseph I Shapiro MD

We showed before that in cardiac myocytes partial inhibition of Na+/K+-ATPase by nontoxic concentrations of ouabain causes hypertrophy and transcriptional regulations of growth-related marker genes through multiple Ca2+-dependent signal pathways many of which involve Ras and p42/44 mitogen-activated protein kinases. The aim of this work was to explore the roles of intracellular reactive oxygen species (ROS) in these ouabain-initiated pathways. Ouabain caused a rapid generation of ROS within the myocytes that was prevented by preexposure of cells to N-acetylcysteine (NAC) or vitamin E. These antioxidants also blocked or attenuated the following actions of ouabain: inductions of the genes of skeletal …

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Ouabain Interaction With Cardiac Na+/K+-Atpase Initiates Signal Cascades Independent Of Changes In Intracellular Na+ And Ca2+, Jiang Liu, Jiang Tian, Michael Haas, Joseph I. Shapiro, Amir Askari, Zijian Xie

Joseph I Shapiro MD

We have shown previously that partial inhibition of the cardiac myocyte Na+/K+-ATPase activates signal pathways that regulate myocyte growth and growth-related genes and that increases in intracellular Ca2+ concentration ([Ca2+]i) and reactive oxygen species (ROS) are two essential second messengers within these pathways. The aim of this work was to explore the relation between [Ca2+]i and ROS. When myocytes were in a Ca2+-free medium, ouabain caused no change in [Ca2+]i, but it increased ROS as it did when the cells were in a Ca2+-containing medium. Ouabain-induced increase in ROS also occurred under conditions where there was little or no change …

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Full-Text Articles in Medicine and Health Sciences

Principles Of Management Of Severe Hyponatremia, Antonios H. Tzamaloukas Md, Deepak Malhorta Md, Phd, Bradley H. Rosen Do, Dominic S. C. Raj S. C. Raj Md, Glen H. Murata Md, Joseph I. Shapiro Md

Joseph I Shapiro MD

Cyclooxygenase-2 Dependent Metabolism Of 20-Hete Increases Adiposity And Adipocyte Enlargement In Mesenchymal Stem Cell-Derived Adipocytes, Dong Hyun Kim, Nitin Puri, Komal Sodhi, John R. Falck, Nader G. Abraham, Joseph I. Shapiro M.D., Michal L. Schwartzman

Joseph I Shapiro MD

Joseph I Shapiro MD

Na/K-Atpase Mimetic Pnaktide Peptide Inhibits The Growth Of Human Cancer Cells, Zhichuan Li, Zhongbing Zhang, Joe X. Xie, Xin Li, Jiang Tian, Ting Cai, Hongaun Cui, Hanfei Ding, Joseph I. Shapiro Md, Zijian Xie

Joseph I Shapiro MD

Ho-1 Upregulation Attenuates Adipocyte Dysfunction, Obesity, And Isoprostane Levels In Mice Fed High Fructose Diets, Zeid Khitan, Mohit Harsh, Komal Sodhi, Joseph I. Shapiro Md, Nader G. Abraham

Joseph I Shapiro MD

From Lcme Probation To Compliance: The Marshall University Joan C Edwards School Of Medicine Experience, Bobby Miller, Brian Dzwonek, Aaron Mcguffin, Joseph I. Shapiro Md

Joseph I Shapiro MD

Principles Of Quantitative Fluid And Cation Replacement In Extreme Hyperglycemia, Antonios H. Tzamaloukas, Yijuan Sun, Nikifor K. Konstantinov, Richard I. Dorin, Todd S. Ing, Deepak Malhorta, Glenn H. Murata, Joseph I. Shapiro M.D.

Joseph I Shapiro MD

Gender Differences In The Development Of Uremic Cardiomyopathy Following Partial Nephrectomy: Role Of Progesterone, Christopher A. Drummond, George Buddny, Steven T. Haller, Jiang Liu, Yanling Yan, Zijian Xie, Deepak Malhotra, Joseph I. Shapiro Md, Jiang Tian

Joseph I Shapiro MD

Involvement Of Reactive Oxygen Species In A Feed-Forward Mechanism Of Na/K-Atpase Mediated Signaling, Yanling Yan, Anna P. Shapiro, Steven Haller, Vinal Katragadda, Lijun Liu, Jiang Tian, Venkatesha Basrur, Deepak Malhotra, Zi-Jian Xie, Nader G. Abraham, Joseph I. Shapiro Md, Jiang Liu

Joseph I Shapiro MD

Reduction Of Na/K-Atpase Potentiates Marinobufagenin-Induced Cardiac Dysfunction And Myocyte Apoptosis, Changxuan Liu, Yan Bai, Yiliang Chen, Yu Wang, Yoann Sottejeau, Lijun Liu, Xiaomei Li, Jerry B. Lingrel, Deepak Malhorta, Christopher Cooper, Joseph I. Shapiro M.D., Zi-Jian Xie, Jiang Tian

Joseph I Shapiro MD

Pparδ Binding To Heme Oxygenase 1 Promoter Prevents Angiotensin Ii-Induced Adipocyte Dysfunction In Goldblatt Hypertensive Rats, Komal Sodhi, Nitin Puri, Dong Hyun Kim, Terry D. Hinds Jr., Lance A. Stechschulte, Gaia Favero, Luigi Rodella, Joseph I. Shapiro M.D., David C. Jude, Nader X. Abraham

Joseph I Shapiro MD

Intracellular Reactive Oxygen Species Mediate The Linkage Of Na+/K+-Atpase To Hypertrophy And Its Marker Genes In Cardiac Myocytes, Joseph I. Shapiro, Amir Askari, Zijian Xie, Peter Kometiani, Jie Li, Jiang Liu

Joseph I Shapiro MD

Ouabain Interaction With Cardiac Na+/K+-Atpase Initiates Signal Cascades Independent Of Changes In Intracellular Na+ And Ca2+, Jiang Liu, Jiang Tian, Michael Haas, Joseph I. Shapiro, Amir Askari, Zijian Xie

Joseph I Shapiro MD