Treatment strategies for sarcoidosis.

Sarcoidosis is a multisystem disorder of unknown cause with a highly variable course. Corticosteroids are considered the standard agent for treatment, however there is no consensus about when and in whom therapy should be initiated, what dose should be given and for how long. There seems to be a limited benefit on chest radiographic findings, forced vital capacity and diffusing capacity. The evidence supporting the disease-modulating effect is limited. Cytotoxic agents are often used as steroid-sparing in patients requiring chronic therapy, however there are only little randomized controlled trials to support their use and side effects are common. Tumour necrosis factor-a is thought to be crucial in the development of the typical granulomas in sarcoidosis. Many case reports and case series suggest that specific therapy targeted against this cytokine is very effective. Despite these promising results, only limited evidence is found in multicenter randomized controlled trials.

Heart 6-phosphofructo-2-kinase activation by insulin results from Ser-466 and Ser-483 phosphorylation and requires 3-phosphoinositide-dependent kinase-1, but not protein kinase B.

Previous studies have shown that (i) the insulin-induced activation of heart 6-phosphofructo-2-kinase (PFK-2) is wortmannin-sensitive, but is insensitive to rapamycin, suggesting the involvement of phosphatidylinositol 3-kinase; and (ii) protein kinase B (PKB) activates PFK-2 in vitro by phosphorylating Ser-466 and Ser-483. In this work, we have studied the effects of phosphorylation of these residues on PFK-2 activity by replacing each or both residues with glutamate. Mutation of Ser-466 increased the V(max) of PFK-2, whereas mutation of Ser-483 decreased citrate inhibition. Mutation of both residues was required to decrease the K(m) for fructose 6-phosphate. We also studied the insulin-induced activation of heart PFK-2 in transfection experiments performed in human embryonic kidney 293 cells. Insulin activated transfected PFK-2 by phosphorylating Ser-466 and Ser-483. Kinase-dead (KD) PKB and KD 3-phosphoinositide-dependent kinase-1 (PDK-1) cotransfectants acted as dominant negatives because both prevented the insulin-induced activation of PKB as well as the inactivation of glycogen-synthase kinase-3, an established substrate of PKB. However, the insulin-induced activation of PFK-2 was prevented only by KD PDK-1, but not by KD PKB. These results indicate that the insulin-induced activation of heart PFK-2 is mediated by a PDK-1-activated protein kinase other than PKB.

Lipid metabolism responses in rats fed beef tallow, native or randomized fish oil and native or randomized peanut oil.

In experiments with male Wistar rats, we measured the effects of nonpurified diets containing 9.1% added fat (beef tallow, native or randomized fish oil, native or randomized peanut oil) on apparent digestibility of total fat and individual fatty acids. We also investigated the effects of the diets on plasma contents of triglyceride, cholesterolesters and free and total cholesterol as well as on the fatty acid profiles of plasma and liver phospholipids. Randomization of fish oil or peanut oil had no significant effect on any of the lipid measurements. Fat digestibility was significantly lower in the rats fed beef tallow. Apparent absorption of 18:1(n-9) and polyunsaturated fatty acids was not dependent on the fatty acid profile of the dietary fat. Apparent absorption of 16:1(n-7) and saturated fatty acids was generally highest in the rats fed fish oil. Intake of fish oil or peanut oil significantly decreased plasma triglyceride content. Intake of fish oil resulted in substantially decreased contents of total cholesterol and cholesterolesters in plasma, but intake of peanut oil did not. Efficiency of conversion of 18:2(n-6) into 20:4(n-6) was inhibited by long-chain (n-3) fatty acids.