Kirsty A. Hunter

Tissue protein synthesis rates in critically ill patients

OBJECTIVES The aims of this study were to simultaneously determine the in vivo rates of protein synthesis in skeletal muscle, peripheral blood lymphocytes, and serum albumin in critically ill patients; to establish whether a relationship between the responses of these tissues could be observed; and to demonstrate if a protein synthesis pattern characteristic of critical illness exists. DESIGN Descriptive study. SETTING Intensive care unit of a 1000-bed university hospital. PATIENTS Fifteen patients treated in the intensive care unit. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Rates of tissue protein synthesis were determined in vivo once during the course of critical illness, using the flooding method with L-(2H5)phenylalanine. Protein synthesis in muscle was 1.49 +/- 0.16%/day; in circulating lymphocytes (i.e., mononuclear cells), protein synthesis was 11.10 +/- 1.82%/day. Albumin synthesis was 12.81 +/- 1.23%/day when expressed as the fractional rate, and was 184 +/- 19 mg/kg/day when expressed as the absolute rate. CONCLUSIONS The individual tissues responded differently to trauma, and showed a wide range of values. The responses were not significantly correlated with each other and no pattern of tissue protein synthesis characteristic of critical illness was observed. However, both muscle protein and albumin synthesis rates correlated with metabolic status and clinical indices of the severity of illness.

Estimation of cis-9, trans-11 conjugated linoleic acid content in UK foods and assessment of dietary intake in a cohort of healthy adults.

Dietary conjugated linoleic acid (CLA) from ruminant-derived foods may be potentially beneficial to health. The quantity of cis-9, trans-11 CLA and trans-10, cis-12 CLA in a range of UK foodstuffs (112 foods) was determined using triple-column silver ion HPLC. The cis-9, trans-11 CLA content ranged from 1.9 mg/g lipid (mild Cheddar) to 7.3 mg/g lipid (processed cheese) in cheeses, from 0.9 mg/g lipid (ice cream) to 3.7 mg/g lipid (double cream) in non-cheese dairy products, and from 2.9 mg/g lipid (Swedish meatballs) to 6.0 mg/g lipid (minced lamb) in meat products. cis-9, trans-11 CLA concentrations for chocolate and sweets ranged from 0.1 mg/g lipid (hot chocolate) to 4.8 mg/g lipid (buttermint). The trans-10, cis-12 CLA isomer was undetected or negligible in the food samples examined. To provide information about dietary cis-9, trans-11 CLA intakes in the UK, a study was performed to estimate the daily intake of CLA in a cohort of eighteen healthy volunteers (nine female and nine male; aged 21-60 years; mean BMI = 24.0 kg/m2 (sd 2.2)) with a 7-d weighed food record. This information combined with the CLA isomer contents of UK foodstuffs was used to estimate the daily intake of the cohort. The mean daily intake of cis-9, trans-11 CLA was estimated to be 97.5 (sd 73.3) mg/d. Due to its potential health benefits, it is important to determine the CLA content of food and dietary intake as these data will be useful in determining the role of CLA in health and disease.

A prebiotic galactooligosaccharide mixture reduces severity of hyperpnoea-induced bronchoconstriction and markers of airway inflammation

Gut microbes have a substantial influence on systemic immune function and allergic sensitisation. Manipulation of the gut microbiome through prebiotics may provide a potential strategy to influence the immunopathology of asthma. This study investigated the effects of prebiotic Bimuno-galactooligosaccharide (B-GOS) supplementation on hyperpnoea-induced bronchoconstriction (HIB), a surrogate for exercise-induced bronchoconstriction, and airway inflammation. A total of ten adults with asthma and HIB and eight controls without asthma were randomised to receive 5·5 g/d of either B-GOS or placebo for 3 weeks separated by a 2-week washout period. The peak fall in forced expiratory volume in 1 s (FEV1) following eucapnic voluntary hyperpnoea (EVH) defined HIB severity. Markers of airway inflammation were measured at baseline and after EVH. Pulmonary function remained unchanged in the control group. In the HIB group, the peak post-EVH fall in FEV1 at day 0 (-880 (sd 480) ml) was unchanged after placebo, but was attenuated by 40 % (-940 (sd 460) v. -570 (sd 310) ml, P=0·004) after B-GOS. In the HIB group, B-GOS reduced baseline chemokine CC ligand 17 (399 (sd 140) v. 323 (sd 144) pg/ml, P=0·005) and TNF-α (2·68 (sd 0·98) v. 2·18 (sd 0·59) pg/ml, P=0·040) and abolished the EVH-induced 29 % increase in TNF-α. Baseline C-reactive protein was reduced following B-GOS in HIB (2·46 (sd 1·14) v. 1·44 (sd 0·41) mg/l, P=0·015) and control (2·16 (sd 1·02) v. 1·47 (sd 0·33) mg/l, P=0·050) groups. Chemokine CC ligand 11 and fraction of exhaled nitric oxide remained unchanged. B-GOS supplementation attenuated airway hyper-responsiveness with concomitant reductions in markers of airway inflammation associated with HIB.

Reproducibility of the bronchoconstrictive response to eucapnic voluntary hyperpnoea

BACKGROUND Eucapnic voluntary hyperpnoea (EVH) is considered an effective bronchoprovocation challenge for identifying exercise-induced bronchoconstriction (EIB). However, the reproducibility of the hyperpnoea-induced bronchoconstriction (HIB) response elicited by EVH remains unknown and was therefore the focus of this study. METHODS Two cohorts of 16 physically active males (each cohort comprised 8 controls and 8 with physician diagnosis of asthma) participated in two studies of the short- and long-term reproducibility of the bronchoconstrictive response to an EVH test with dry air. EVH was performed on days 0, 7, 14, and 21 (short-term study), and 0, 35, and 70 (long-term study). HIB was diagnosed by a ≥10% fall in forced expiratory volume in 1 s (FEV1) after EVH. RESULTS On day 0 of the short-term study, FEV1 fell by 2 ± 1% (P < 0.05) and 27 ± 18% (P < 0.01) from pre-to post-EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the short-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 12%, 328 mL, and 164 mL, respectively. On day 0 of the long-term study, FEV1 fell by 2 ± 2% and 25 ± 18% (P < 0.01) after EVH in control and HIB-positive groups respectively. The post-EVH fall in FEV1 did not differ across the long-term study test days. In the HIB-positive group, the day-to-day coefficient of variation, reproducibility, and smallest meaningful change for the fall in FEV1 were 10%, 196 mL, and 98 mL respectively. CONCLUSION The EVH test elicits a reproducible bronchoconstrictive response in physically active males with physician diagnosed asthma. These data thus support the clinical utility of the EVH test for EIB screening and monitoring.

Comparable reductions in hyperpnoea-induced bronchoconstriction and markers of airway inflammation after supplementation with 6·2 and 3·1 g/d of long-chain n-3 PUFA in adults with asthma

Although high dose n-3 PUFA supplementation reduces exercise- and hyperpnoea-induced bronchoconstriction (EIB/HIB), there are concurrent issues with cost, compliance and gastrointestinal discomfort. It is thus pertinent to establish the efficacy of lower n-3 PUFA doses. Eight male adults with asthma and HIB and eight controls without asthma were randomly supplemented with two n-3 PUFA doses (6·2 g/d (3·7 g EPA and 2·5 g DHA) and 3·1 g/d (1·8 g EPA and 1·3 g DHA)) and a placebo, each for 21 d followed by 14 d washout. A eucapnic voluntary hyperpnoea (EVH) challenge was performed before and after treatments. Outcome measures remained unchanged in the control group. In the HIB group, the peak fall in forced expiratory volume in 1 s (FEV1) after EVH at day 0 (-1005 (sd 520) ml, -30 (sd 18) %) was unchanged after placebo. The peak fall in FEV1 was similarly reduced from day 0 to day 21 of 6·2 g/d n-3 PUFA (-1000 (sd 460) ml, -29 (sd 17) % v. -690 (sd 460) ml, -20 (sd 15) %) and 3·1 g/d n-3 PUFA (-970 (sd 480) ml, -28 (sd 18) % v. -700 (sd 420) ml, -21 (sd 15) %) (P<0·001). Baseline fraction of exhaled nitric oxide was reduced by 24 % (P=0·020) and 31 % (P=0·018) after 6·2 and 3·1 g/d n-3 PUFA, respectively. Peak increases in 9α, 11β PGF2 after EVH were reduced by 65 % (P=0·009) and 56 % (P=0·041) after 6·2 and 3·1 g/d n-3 PUFA, respectively. In conclusion, 3·1 g/d n-3 PUFA supplementation attenuated HIB and markers of airway inflammation to a similar extent as a higher dose. Lower doses of n-3 PUFA thus represent a potentially beneficial adjunct treatment for adults with asthma and EIB.

Addressing Food Waste Through University and Community Partnerships

The sustainability of local and global food systems is a significant challenge with far-reaching implications for all. The purpose of this paper, which addresses the specific issue of food waste, is to offer replicable practices from five different projects which aimed to reduce or reuse food waste. These were partnership projects between university staff, students and local organisations to facilitate extra-curricular student activity, support students’ sustainability literacy, and to contribute towards creating sustainable communities. Projects included a ‘Super Kitchen’, where food destined for waste was used to create nutritious meals, a ‘Feeding the 5000’ event in partnership with a local Council and three other projects. The paper details findings from the project evaluations to explore student participation rates, motivation, and student awareness of food waste issues as well as reflections on the most effective aspects of project design for student appeal. The projects themselves contributed to the reduction of local food waste and the majority of participants reported that the projects transformed their perceptions of food waste. The paper may be of interest to academics and researchers interested in student perceptions of sustainability and of particular interest to those looking to establish their own sustainability-themed partnership projects.