Rosalia Lo Presti

Wine, Diet, and Arterial Hypertension

Hypertension is one of the leading causes of death in developed countries, and the number of prehypertensive patients is increasing. The beneficial effects of moderate wine consumption on cardiovascular diseases have been demonstrated, along with the healthy influence of a Mediterranean dietary pattern. The association of these 2 factors on hypertension and its complications is considered here. As wine polyphenols exert a vasorelaxing action, they might positively influence the hemodynamic situation of these patients. These effects could be enhanced by dietary constituents, such as garlic, onions, and olive oil, which are widely employed in Mediterranean cooking. By evaluating many studies performed in animal models and in humans, the authors conclude that moderate wine consumption, if associated with a healthy dietary pattern, such as the Mediterranean one, could help hypertensive patients to ameliorate their arterial pressure and quality of life by reducing cardiovascular morbidity and mortality rates.

Granulocyte integrins before and after activation in acute ischaemic stroke.

We examined in 19 subjects with acute ischaemic stroke (AIS) the PMN integrin pattern (CD11a, CD11b, CD11c, CD18), using indirect immunofluorescence and adopting a flow cytometer, at baseline and during activation, prolonged for 5 and 15 min, with 4-phorbol 12-myristate 13-acetate (PMA). At baseline, an increase in the expression of CD11c and CD18 and a decrease in the CD11b were evident in AIS subjects compared to normals. After activation, we found in normals a constant and significant increase of all PMN adhesive molecules, while in AIS subjects, we found an increase in CD11b and CD18, a decrease in CD11a and no variation in CD11c. While the basal upregulation of CD11c and CD18 may depend on the PMN spontaneous activation or on the increase of cytokines, the decrease of CD11b may be due to its self-consumption. After activation, the decrease in CD11a noted in AIS may be related to its cleavage or to an altered integrin phosphorylation/dephosphorylation balance.

Gelatinases and Their Tissue Inhibitors in a Group of Subjects With Metabolic Syndrome

Aim To evaluate matrix metalloproteases (MMP)-2 and MMP-9 and tissue inhibitor of metalloproteases (TIMP)-1 and TIMP-2 in a group of subjects with metabolic syndrome (MS) subdivided according to the presence or absence of diabetes mellitus. Methods We examined in 90 subjects (51 men and 39 women) with MS, defined following the International Diabetes Federation criteria, and subsequently subdivided into diabetic subjects (22 men and 11 women) and nondiabetic subjects s (29 men and 28 women), the plasma concentrations of MMP-2 and MMP-9 and of TIMP-1 and TIMP-2 using specific enzyme-linked immunosorbent assay kits. Results We found a significant increase in plasma concentrations of MMP-2, MMP-9, TIMP-1, and TIMP-2 in the whole group of MS subjects (P < 0.001) and in both subgroups of MS subjects with diabetes mellitus (P < 0.001) and without diabetes mellitus (P < 0.001) in comparison with healthy controls. We also noted higher concentrations of all the examined parameters in the MS subjects with diabetes mellitus in comparison with the MS subjects without diabetes mellitus. Matrix metalloproteases and TIMPs showed some significant correlations with body mass index and waist circumference and with metabolic parameters in the whole group of MS subjects. Conclusion An altered pattern of MMPs and their inhibitors is demonstrated in MS; the presence of diabetes mellitus strongly influences the concentration of MMP and TIMP, contributing probably to the increased cardiovascular risk of MS subjects.

Pathophysiology of polymorphonuclear leukocyte in arterial hypertension.

This review shows how polymorphonuclear leukocytes (PMNs) play a pivotal role in the development of the organ injury that is associated with arterial hypertension. Elevated white blood cell count and higher levels of PMNs activation are risk factors for arterial hypertension and cardiovascular disease. Spontaneously activated PMNs release proinflammatory factors and reactive oxygen species, which have negative effects on vascular tone and on their adhesion to the endothelium. The oxidative stress in hypertensive PMNs is revealed by increased NADPH-oxidase production and lipid peroxidation and by decreased cytosolic and mitochondrial superoxide dismutase concentrations. The overexpression of adhesion molecules, such as beta2-integrin, promotes PMNs rolling and leukocyte-endothelium interactions too. All these events underline how polymorphonuclear leukocytes may contribute to the vascular damage accompanying arterial hypertension.

Lipid peroxidation and total antioxidant status in unprofessional athletes before and after a cardiopulmonary test.

We examined lipid peroxidation, expressed as thiobarbituric acid-reactive substances (TBARS) and total antioxidant status (TAS) before and after a cardiopulmonary test, in 20 sedentary controls and in 62 unprofessional male athletes subdivided into 3 subgroups. The first included subjects who practised endurance sports (14 cyclists and 9 endurance swimmers), the second subjects who practised mixed sports (6 basket players, 6 judoists, 8 water polo players) and the third group subjects who practised power sports (3 sprint runners, 4 weightlifters, 12 sprint swimmers). In the whole group of athletes an increase in TBARS and a decrease in TAS were present at baseline. Subdividing the whole group into three subgroups we observed an increase in TBARS in all and a decrease in TAS only in the endurance and mixed athletes. After the test, TBARS showed a more significant increase in controls compared to the whole group and each subgroup of athletes, while TAS increased only in the whole group and in those who practised mixed sports. In conclusion, at baseline in athletes the oxidative status shows a different behaviour compared to controls, while after the test the antioxidant protection is more marked and it may be related to an increase of antioxidant systems.

Polymorphonuclear Integrins, Membrane Fluidity, and Cytosolic Ca2+ Content After Activation in Essential Hypertension

The purpose of this research was to obtain further information about the role of polymorphonuclear leukocytes in essential hypertension. These cells could be involved in the pathogenesis of organ injury. Thirty subjects (14 men and 16 women) with essential hypertension were enrolled. In these subjects we determined, at baseline and after in vitro activation with 4-phorbol 12-myristate 13-acetate and N-formyl-methionyl-leucyl-phenylalanine, the polymorphonuclear leukocyte membrane fluidity, obtained by labeling the cells with 1-[4-(trimethylamino)phenyl]-6-phenyl-1,3,5-hexatriene, cytosolic Ca2+ concentration, obtained by marking the cells with Fura 2-AM, and integrin pattern (CD11a, CD11b, CD11c, and CD18), by using the indirect immunofluorescence with a flow cytometer. At baseline there was no difference in membrane fluidity between normal subjects and hypertensives, whereas hypertensives showed an increase in cytosolic Ca2+ content and an increase of the phenotypical expression of CD11a, CD11b, and CD18. In normal subjects and in hypertensives, after activation, no variation was found in membrane fluidity and cytosolic Ca2+ content. In normal subjects, after activation, we observed a significant increase of the expression of all adhesion molecules, whereas in hypertensives we found an increase of the expression of CD11b, CD11c, and CD18 but also a decrease of CD11a. The behavior of the polymorphonuclear leukocyte integrin profile may have several explanations, and in particular, the trend of CD11a after chemotactic activation may be related to its cleavage or to an altered integrin phosphorylation/dephosphorylation balance hypothetically present in this clinical condition.

Elastase, myeloperoxidase, nitric oxide metabolites and oxidative status in subjects with clinical stable chronic renal failure on conservative treatment

We evaluated, in a group of 41 CRF undialyzed subjects (29 men and 12 women, mean age 64.1 +/- 11.3 years), some parameters that reflect leukocyte activation (elastase, myeloperoxidase - MPO), plasma NO metabolites (NO(x)) and the oxidative status (lipid peroxidation expressed as thiobarbituric acid-reactive substances (TBARS) and total antioxidant status (TAS). Elastase was determined, on plasma separated from fasting venous blood, as elastase/alpha1-proteinase inhibitor complex. MPO was evaluated employing the Myeloperoxidase ELISA kit. The NO production was evaluated by a micromethod. The oxidation of polyunsaturated fatty acids was evaluated in plasma by detection of the thiobarbituric acid-reactive substances (TBARS). Total antioxidant status was measured by spectrophotometry. We found a significant increase of elastase, TBARS and NO(x), without any significant variation of MPO and TAS. In this group of CRF subjects, no statistical correlation was found between these examined parameters, creatinine level, creatinine clearance, leukocyte count and hemoglobin level. These findings need to be underlined if we consider that chronic renal failure is an inflammatory condition and this research furtherly supports literature data regarding the role of activated leukocytes in the development of the vascular complications. These observations explain why the examination of leukocyte count and function could become a tool to verify the clinical outcome in these patients.

Membrane Fluidity, Membrane Lipid Pattern, and Cytosolic Ca2+ Content in Platelets from a Group of Type II Diabetic Patients with Macrovascular Complications

OBJECTIVE To evaluate platelet membrane fluidity and some platelet metabolic parameters in type II diabetic patients with macrovascular complications. RESEARCH DESIGN AND METHODS In a group of 21 type II diabetic patients with macrovascular complications, we evaluated platelet membrane fluidity [marking intact resting platelets with the fluorescent probe 1,4-(trimethylamino)-phenyl-4-phenylhexatriene (TMA-DPH)], platelet membrane lipid pattern (cholesterol :phospholipid [C:PL] ratio and individual phospholipids), and platelet cytosolic Ca2+ content (marking intact resting platelets with the fluorescent probe Fura 2AM). RESULTS Platelet membrane fluidity is decreased in type II diabetic patients with macrovascular complications compared with normal subjects (P < 0.001). Platelet membrane C:PL ratio and cytosolic Ca2+ content do not discriminate normal subjects from diabetic patients, and for individual phospholipids, only phosphatidylethanol-amine is decreased in diabetic patients compared with control subjects (P = 0.051). In normal subjects, the polarization degree of TMA-DPH is related to phosphatidylserine (P < 0.05) and phosphatidylcholine (P < 0.05), and in diabetic patients the polarization degree of TMA-DPH is related to C:PL ratio (P < 0.05) and sphyngomyelin (P < 0.05). CONCLUSIONS In type II diabetic patients with macrovascular complications, we observed an abnormality of platelet membrane fluidity, which may contribute to platelet functional alteration present in this clinical condition.

Platelet membrane fluidity and platelet membrane lipid pattern in essential hypertension

In a group of subjects with essential hypertension platelets were studied in resting conditions: platelet membrane fluidity was measured with the fluorescent probe 1.4-(trimethylamino)-phenyl-4-phenylhexatriene (TMA-DPH), platelet membrane cholesterol/phospholipid ratio was evaluated separating the membrane lipids with column chromatography, and platelet membrane individual phospholipids were determined using two-dimensional thin-layer chromatography. From the obtained results, it is evident that platelet membrane fluidity does not differentiate normals from hypertensives; platelet membrane cholesterol/phospholipid ratio is increased in hypertensives, while of the platelet membrane individual phospholipids, only the phosphatidylcholine is increased. In normals and hypertensives, no relation is evident between platelet membrane fluidity, platelet membrane lipid pattern, and systolic and diastolic blood pressure values.

Evaluation of nitric oxide metabolites in a group of subjects with metabolic syndrome

AIM To evaluate the concentration of metabolites (NO(2)(-), NO(3)(-)) of nitric oxide (NO) in metabolic syndrome (MS). MATERIALS AND METHODS We enrolled 106 subjects (45 women and 61 men) with MS of which 43 (14 women and 27 men) with diabetes mellitus and 63 (31 women and 32 men) without diabetes mellitus, and 54 subjects (19 women and 35 men) as control group. The nitric oxide metabolites (nitrite+nitrate=NOx) were evaluated employing the Griess reagent. RESULTS In the whole group of MS subjects was evident, in comparison with control group, a significant increase in NOx. The same finding was also present between control group and diabetic subjects with MS and between control group and nondiabetic subjects with MS. No difference was observed between the two subgroups (diabetic and nondiabetic subjects with MS) about NOx. Contrasting information were obtained examining the linear regression among NOx, age, anthropometric profile, blood pressure values and glycometabolic pattern of subjects with MS. CONCLUSIONS In MS subjects we found a significant increase in NOx not influenced by diabetes mellitus. The NOx is a parameter that must be considered in MS keeping in mind that its behavior is related to chronic inflammation that accompanies this clinical condition.