Fatty Acid-Rich Extract from Holothuria atra for Hyperuricemia via Expressions Modulation of GLUT9a and GLUT9b in Rat Model.

An edible sea cucumber Holothuria atra has been hypothesized to have medicinal benefits against hyperuricemia owing to its bioactive compounds, including mono- and poly-unsaturated fatty acids. Herein, we aimed to investigate the fatty acids-rich extract produced from H. atra to treat hyperuricemic rats (Rattus novergicus). The extraction was carried out using n-hexane solvent and then administered to potassium oxonate-induced hyperuricemic rats, with allopurinol acting as a positive control. The extract (50, 100, 150 mg/kg body weight) and allopurinol (10 mg/kg) were administered QD through an oral route using a nasogastric tube. Serum uric acid, creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and blood urea nitrogen of the abdominal aortic blood were investigated. Our results suggested that the extract was rich in polyunsaturated (arachidonic acid) and monounsaturated fatty acids (oleic acid), in which its administration of 150 mg/kg could significantly reduce serum uric acid (p < 0.001), AST (p = 0.001), and ALT (p = 0.0302). The anti-hyperuricemic activity could be associated with the modulation of GLUT9 by the H. atra extract. In conclusion, the n-hexane extract from H. atra is a potential serum uric acid-lowering agent targeting GLUT9, where further investigations are crucially warranted.

Effect of umbilical cord mesenchymal stem cells on hypoxia-inducible factor-1 alpha (HIF-1α) production in arteriovenous fistula (AVF) animal model: A preliminary study.

Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that plays a crucial role in cellular responses to hypoxia, such as in the development of intimal hyperplasia, a common complication in arteriovenous fistula (AVF) creation. While the application of umbilical cord mesenchymal stem cells (UC-MSCs) has shown promise in various regenerative medicine applications, including tissue repair and angiogenesis, the effect of UC-MSCs on HIF-1α level in the AVF has not been tested. Therefore, the aim of this study was to evaluate the effect of UC-MSCs administration on HIF-1α levels in the AVF animal model. An experimental study was conducted on 28 local male rabbits (Lepus domestica) using a post-test-only design. The rabbits were divided randomly into four groups: normal rabbit group (negative control), placebo-treated AVF rabbit group (positive control), AVF rabbits treated with in-situ UC-MSCs injection (one dose, 106 UC-MSCs/kg body weight), and AVF rabbits treated with intravenous UC-MSCs (one dose, 106 UC-MSCs/kg body weight (BW). HIF-1α level was measured using ELISA method after 28 days post-treatment. All data were analyzed using the one-way analysis of variance (ANOVA) and continued with the Duncan's post-hoc test. The data indicated that the levels of HIF-1α were different among all four groups (p<0.001). The post-hoc analysis revealed that the HIF-1α levels in both UC-MSC treated groups were significantly lower compared to untreated AVF rabbits (p<0.05). This study suggests that UC-MSCs could be a promising therapy to prevent and reduce intimal hyperplasia in AVF.

Predictors of the conservative management outcomes in patients with lumbar herniated nucleus pulposus: A prospective study in Indonesia.

BACKGROUND: The objective of this study was to identify the predictors of the conservative management outcomes in patients with lumbar herniated nucleus pulposus (HNP). METHODS: A prospective study was conducted between June 2010 and April 2012 in Banda Aceh, Indonesia. Clinical and baseline neurologic examinations such as passive straight leg raising test (SLRT), cross SLRT, and patellar and Achilles reflexes were assessed prior to the conservative management. The patients were evaluated at 2nd, 4th, 8th, 12th and 24th week following commencement of the conservative management. RESULTS: We recruited and followed 171 HNP patients of which 35.7% of them had good outcome. At univariate analysis, patients with more than 12 months duration of complaint, those with dominant radicular pain, severe pain intensity (visual analogue scale 7-10), positive SLRT, positive cross SLRT, and reduced motor power of knee extensors (muscle strength grade 1-4), were associated with poor outcome. Multivariate analysis suggested that patients with dominant radicular type of pain were likely to had poor outcome compared to those with dominant back pain (odd ratio (OR) 10.57 with 95% confidence interval (CI) 1.15-96.93). Patients with reduced motor power of knee extensors also had a higher chance to have poor outcome compared to those who were normal (OR: 10.57; 95% CI: 1.15-96.93). CONCLUSION: Type of pain and the strength of lower extremities could be able to predict the failure of conservative management in patients with lumbar disc herniation. However, further studies with the bigger sample size are warrant to validate our results.

The role of single nucleotide polymorphisms of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) on susceptibility to herniated nucleus pulposus: a systematic review and meta-analysis.

Background: The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha ( IL-1A), tumor necrosis factor-alpha ( TNF-A), and vitamin D receptor ( VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test and presented as odd ratio (OR) and 95% confidence intervals (95%CI). Results: We screened 3,067 unique studies for eligibility and three, two and nine studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.

Simpson grade 3 resection does not improve clinical outcome in neglected thoracic psammomatous spinal meningioma? A case report.

INTRODUCTION: Thoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure. PRESENTATION OF CASE: A 42-year-old female complaining of back pain for one year and progressive weakness and numbness of both lower limbs with urinary incontinence and constipation for two months. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. The patient underwent laminectomy at D3-D5 level, revealing dural bulge. A midline durotomy performed. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Simpson grade 3 resection was performed. Pedicle screw and rod was placed for posterior stabilization. Histopathological examination demonstrated a psammomatous spinal meningioma. Despite the pain and the sensory sensation was improved, the motoric and autonomic function still showed no significant improvement in the early postoperative period. DISCUSSION: The preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. Meanwhile, the prognosis for recovery depends mainly on two factors: the severity of the neurological deficit and the duration of the deficit before decompression. CONCLUSION: Surgical resection of the tumor may relieve the spinal cord compression in a neglected case. Even though the neurologic function after surgery rarely returns to the functional stage due to chronic neural tissue damage.

Hip geometry and femoral neck fractures: A meta-analysis.

BACKGROUND: Several studies have reported hip geometry to predict the femoral neck fractures. However, they showed inconsistency. OBJECTIVES: To determine the association between hip geometry and femoral neck fractures. METHODS: Published literature from PubMed and Embase databases (until May 25th, 2017) was searched for eligible publications. The information related to (1) name of first author; (2) year of publication; (3) country of origin; (4) sample size of cases and controls and (5) mean and standard deviation of cases and controls were extracted. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between hip geometry and femoral neck fractures were assessed using random or fixed effect model. A Comprehensive Meta-analysis software, version 2.0, was used to analyse the data. RESULTS: A total of 11 studies were included in this study. Our results showed that increase in hip axis length (OR 95% CI = 1.53 [1.06-2.21], p = 0.025), femoral neck angle (OR 95% CI = 1.47 [1.01-2.15], p = 0.044) and neck width (OR 95% CI = 2.68 [1.84-3.91], p < 0.001) was associated with the risk of femoral neck fractures, whereas we could not find the correlation between femoral neck axis length and the risk of femoral neck fractures. CONCLUSION: There is strong evidence that elevated hip axis length, femoral neck angle and neck width are the risk factor for femoral neck fractures.The Translational Potential of this Article: Determining the hip axis length, femoral neck angle and neck width that are most highly associated with femoral neck fracture may allow clinicians to more accurately predict which individuals are likely to experience femoral neck fractures in the future.

The association between interleukin 6 -174 G/C gene polymorphism and the risk of osteoporosis: A meta-analysis.

OBJECTIVES: This study aimed to investigate the association between the IL6 -174 G/C gene polymorphism and the risk of osteoporosis by performing a meta-analysis. METHODS: Published literature from PubMed and Embase databases was searched for eligible publications. The following information was extracted from each study: Name of first author, year of publication, country of origin, sample size of cases and controls, and size of each allele. The combined odds ratio (ORs) and 95% confidence intervals (95%CIs) for the association between the IL6 -174 G/C gene polymorphism and the risk of osteoporosis were assessed using a random or fixed effects model. A comprehensive meta-analysis (CMA) 2.0 was used to analyse the data. RESULTS: Twelve studies (4923 cases/3431 controls) were included in this meta-analysis. The results indicated that IL6 -174 G/C gene polymorphism was associated with an increased (G vs C, OR 95%CI = 1.29 [1.03-1.62], p = 0.029) and decreased risk of osteoporosis (C vs G, OR 95%CI = 0.77 [0.62-0.97], p = 0.029; CC vs GG + GC, OR 95%CI = 0.58 [0.39-0.88], p = 0.010). CONCLUSION: The IL6 -174 G/C gene polymorphism was shown to be positively correlated with osteoporosis risk.