Nutritional conditions during fetal life can influence the risk to develop the metabolic syndrome in adult life (‘metabolic programming’). We aimed to establish a mouse model of metabolic programming focusing on the effects of a maternal low protein diet during gestation on glucose and lipid metabolism in the adult offspring. Pregnant C57BL/6J mice received a control or a low protein diet throughout gestation. Offspring received a low fat diet or a high fat diet from 6–22 weeks of age. Glucose metabolism was studied with a whole‐body‐glucose test using [6,6‐2H]‐glucose. Hepatic gene expression was characterized by microarray. Maternal low‐protein‐diet did not affect glucose metabolism in male offspring. Female offspring from normal‐protein fed dams was relatively resistant to diet‐induced metabolic dysregulation. Maternal low‐protein‐diet during gestation led to deteriorated insulin sensitivity upon high‐fat feeding in female offspring. Microarray analyses showed a sex‐specific effect of the maternal diet. We conclude that, in mice, maternal protein restriction during gestation does not change the glucose response to a high fat diet in male offspring. However, it changes fatty acid and glucose metabolism in female offspring in such a way that it resembles male metabolism. Supported by the Netherlands Heart Foundation, grant 2004T048.

2009-04-01·The FASEB Journal

Vasopressin Regulation During Extracorporeal Membrane Oxygenation (ECMO) in a Pig Model of Septic Shock

作者: Ichimura, Wayne M ; Kinnison, Martin W ; Sato, Aileen K ; Batts, Sherreen G ; Hernandez, Claudia A ; McEntire, Shane P ; Hashiro, Glenn M ; Uyehara, Catherine FT

ECMO is used to provide cardiopulmonary support to critically ill neonates. Vasopressin (VP) plays a vital role in regulating mean arterial pressure (MAP) and regional blood flow in hypotensive disorders, but whether endogenous VP levels can be sustained during ECMO is unclear. In this study, 11 anesthetized, cardiac catheterized piglets were put on veno‐arterial ECMO either during control or endotoxin‐induced septic shock states. ECMO blood flow was delivered to maintain MAP at baseline levels. Plasma VP (pVP) was compared before and after stabilization on ECMO for 2 hours. ECMO caused pVP to drop by 30% (p<0.01) in both control and septic shock conditions. This drop may be due to the ECMO circuit adding to total circulating volume without additional release of VP. To test whether right atrial pressure (RAP) influence on VP release may be disrupted during ECMO due to partial cardiac bypass of blood flow, the relationship between pVP and hemodynamics during control was examined with stepwise regression. Pre‐ECMO, pVP negatively correlated with RAP and heart rate (r=0.83, p<0.05), but not MAP. In contrast, during ECMO, this pVP relationship with RAP was lost, but a strong positive correlation (r=0.76, p<0.05) between pVP and MAP became evident. Results indicate that during ECMO, low pressure atrial baroreceptors no longer regulate VP release, but VP control of MAP is maintained. Supported by US Army CRADA 0709‐T‐C454

1996-12-01·The Journal of Pediatrics2区 · 医学

Intravenous magnesium therapy for moderate to severe pediatric asthma: Results of a randomized, placebo-controlled trial

2区 · 医学

Article

作者: Ciarallo, Lydia ; Shannon, Michael W. ; Sauer, Andrew H.

OBJECTIVETo evaluate the efficacy of intravenous magnesium (IVMg) therapy for moderate to severe asthma exacerbations in pediatric patients.DESIGNRandomized, double-blind, placebo-controlled, clinical trial.SETTINGUrban pediatric emergency department.PARTICIPANTSThirty-one patients aged 6 to 18 years who were being treated for an acute asthma exacerbation with peak expiratory flow rate (PEFR) less than 60% of the predicted value after receiving three beta 2-adrenergic nebulizer treatments.INTERVENTIONSMagnesium sulfate infusion, 25 mg/kg (maximum, 2 gm), or equivolume saline solution for 20 minutes.MEASUREMENTS AND RESULTSVital signs, O2 saturation by pulse oximetry, PEFR, forced vital capacity, forced expiratory volume at 1 second, and physical examination were serially recorded for 110 minutes, with serum magnesium concentrations measured before and after the 20-minute infusion. At 50 minutes the magnesium group had a significantly greater percentage of improvement from baseline in forced expiratory volume at 1 second (34% vs -1%; p = 0.05); this improvement was sustained and even greater at 110 minutes (75% vs 5%; p = 0.01). Results were similar for PEFR at 80 through 110 minutes (59% vs 20% at 110 minutes; p = 0.05) and for forced vital capacity (55% vs 8% at 80 minutes; p = 0.05). There were no significant intergroup differences in blood pressure at any point. Patients who received intravenous magnesium infusions were more likely to be discharged home from the emergency department than those who received placebo (4/15 vs 0/16; p = 0.03).CONCLUSIONSChildren treated with intravenous magnesium infusions for moderate to severe asthma had significantly greater improvement in short-term pulmonary function without any significant alteration in blood pressure, suggesting a role for this agent as an adjunct in the treatment of such patients.

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