Theodoros Kelesidis

Adiponectin and cancer: a systematic review

Recent studies have demonstrated that obesity is a significant risk factor for the development of several malignancies, but the mechanisms underlying this relationship remain to be fully elucidated. Adiponectin, an adipocyte secreted endogenous insulin sensitizer, appears to play an important role not only in glucose and lipid metabolism but also in the development and progression of several obesity-related malignancies. In this review, we present recent findings on the association of adiponectin with several malignancies as well as recent data on underlying molecular mechanisms that provide novel insights into the association between obesity and cancer risk. We also identify important research questions that remain unanswered.

Cord Blood Leptin and Adiponectin as Predictors of Adiposity in Children at 3 Years of Age: A Prospective Cohort Study

OBJECTIVES. Leptin and adiponectin are adipocyte-secreted hormones that regulate energy homeostasis and metabolism. Because their roles in the neonatal period and in early childhood are poorly understood, we aimed in this prospective cohort study to determine the extent to which umbilical cord blood leptin and adiponectin concentrations predict measures of adiposity and growth at 3 years of age. PATIENTS AND METHODS. We studied 588 children participating in the prospective prebirth cohort study Project Viva. We examined associations of cord blood leptin and adiponectin levels with weight changes during the first 6 months of life, 3-year circulating leptin and adiponectin concentrations, and the following adiposity-related outcomes at 3 years of age: BMI z score, height-for-age z score, and sums of triceps and subscapular skinfold thicknesses to represent overall adiposity, as well as subscapular/triceps skinfold ratio to represent central adiposity. RESULTS. Cord blood leptin and adiponectin were each directly associated with the duration of gestation and birth weight for gestational age z scores. Cord blood leptin levels were negatively associated with change in weight-for-length, weight-for-age, and length-for-age z scores between birth and 6 months of age. Similarly, cord blood adiponectin was negatively associated with change in weight-for-length and weight-for-age z scores. After adjusting for several maternal and child factors related to obesity, each 10 ng/mL increment of cord blood leptin was associated with a reduction in BMI z score and higher leptin levels at 3 years but not with skinfold thicknesses. Each 10 μg/mL increment of cord blood adiponectin was positively associated with a higher subscapular skinfold thickness/triceps skinfold thickness ratio at 3 years. CONCLUSIONS. Lower cord blood leptin levels are associated with smaller size at birth but more pronounced weight gain in the first 6 months of life and higher BMI at 3 years of age. Cord blood adiponectin levels are also directly associated with birth weight for gestational age, inversely associated with weight gain in the first 6 months of life, and predict an increase in central adiposity at age 3 years.

Total and High–Molecular Weight Adiponectin in Relation to Metabolic Variables at Baseline and in Response to an Exercise Treatment Program: Comparative evaluation of three assays

OBJECTIVE—Adiponectin, an adipocyte-secreted hormone, circulates in the serum in several multimeric forms. Compared with total adiponectin, high–molecular weight (HMW) adiponectin has been suggested to be a better predictor of metabolic parameters and insulin sensitivity in humans. Our objective was to compare total adiponectin with HMW adiponectin as predictors of metabolic variables and insulin sensitivity at both baseline and after an exercise intervention. RESEARCH DESIGN AND METHODS—We obtained blood samples from 60 men and women with normal glucose tolerance (n = 20), impaired glucose tolerance (IGT) (n = 20), or type 2 diabetes (n = 20) at baseline and after 4 weeks of training to measure metabolic variables. Using commercially available assays, we measured plasma total adiponectin using LINCO, Mediagnost, and ALPCO assays and HMW adiponectin using an ALPCO assay. RESULTS—HMW adiponectin and total adiponectin (ALPCO) had similar ability to predict the presence of insulin resistance. Total adiponectin, as measured by radioimmunoassay (LINCO) and enzyme-linked immunosorbent assay (ELISA) (Mediagnost), correlated most strongly with measures of insulin sensitivity (P < 0.01) and lipid profile (P < 0.01) at baseline, showed greater improvements of adiponectin levels (P < 0.001), was more closely associated with improvements of lipid measures with exercise training (P < 0.01), and more accurately predicted insulin resistance and IGT in comparison with total adiponectin or HMW measured with the ALPCO ELISA. CONCLUSIONS—These results do not support the superiority of HMW over total adiponectin (measured using currently available assays) in assessing metabolic variables at baseline or in response to physical training. Moreover, there are significant differences in the ability of commercially available assays for total adiponectin to predict metabolic variables.

Human infections associated with wild birds

n Summaryn n Introductionn Wild birds and especially migratory species can become long-distance vectors for a wide range of microorganisms. The objective of the current paper is to summarize available literature on pathogens causing human disease that have been associated with wild bird species.n n n Methodsn A systematic literature search was performed to identify specific pathogens known to be associated with wild and migratory birds. The evidence for direct transmission of an avian borne pathogen to a human was assessed. Transmission to humans was classified as direct if there is published evidence for such transmission from the avian species to a person or indirect if the transmission requires a vector other than the avian species.n n n Resultsn Several wild and migratory birds serve as reservoirs and/or mechanical vectors (simply carrying a pathogen or dispersing infected arthropod vectors) for numerous infectious agents. An association with transmission from birds to humans was identified for 10 pathogens. Wild birds including migratory species may play a significant role in the epidemiology of influenza A virus, arboviruses such as West Nile virus and enteric bacterial pathogens. Nevertheless only one case of direct transmission from wild birds to humans was found.n n n Conclusionn The available evidence suggests wild birds play a limited role in human infectious diseases. Direct transmission of an infectious agent from wild birds to humans is rarely identified. Potential factors and mechanisms involved in the transmission of infectious agents from birds to humans need further elucidation.n n

Peptide YY levels are decreased by fasting and elevated following caloric intake but are not regulated by leptin

Aims/hypothesisPeptide YY (PYY) is a gut-derived hormone that has been shown to reduce short-term food intake in animals and humans. It has been proposed that deficiency of PYY contributes to obesity in humans. However, the physiology of PYY regulation by factors such as caloric restriction, or by other molecules important in energy homeostasis, e.g. leptin, remains to be fully elucidated.Materials and methodsWe evaluated the effect on PYY levels of: (1) caloric ingestion (a mixed meal) in five healthy normal-weight subjects; (2) fasting for 2 or 3xa0days in eight lean men and seven lean women respectively; and (3) recombinant human leptin administration at physiological replacement and pharmacological doses.ResultsPYY levels increased 50% after a mixed meal (p=0.01), and short-term complete fasting for 2 or 3xa0days decreased leptin and PYY levels to 20–30% and 40–60% of baseline, respectively (both p<0.05). However, recombinant human leptin administration at physiological doses to restore the fasting-induced decrease of leptin levels and at pharmacological doses over the short term had no effect on PYY levels.Conclusions/interpretationPYY increases after meal ingestion and decreases after fasting in a manner consistent with a meal-related signal of energy homeostasis. Importantly, circulating levels of this gut-secreted molecule are independent of regulation by leptin over the short term. These findings contribute towards our understanding of the homeostatic systems that regulate appetite in humans, including the possible redundancy of gastrointestinally secreted and adipocyte-secreted signals. This may be of importance for the future development of medications to treat obesity.

De Novo Daptomycin- Nonsusceptible Enterococcal Infections

Potential emergence of enterococcal daptomycin nonsusceptibility among patients with no prior exposure to daptomycin poses clinical and public health challenges. We found that development of infections with daptomycin-nonsusceptible enterococci in these patients could be associated with sporadic emergence and clonal spread.

Maternal diet and cord blood leptin and adiponectin concentrations at birth

BACKGROUND & AIMSnThe purpose of this study was to determine the effects of total energy intake, macronutrient intake, and maternal adherence to Mediterranean diet or Alternative Healthy Eating Index (AHEI) on cord blood leptin and adiponectin levels, which have been associated with childhood adiposity.nnnMETHODSnWe used multivariable linear regression to assess associations of maternal diet, averaged over 1st and 2nd trimesters, with cord blood adipokines of 780 women from the prospective cohort study Project Viva.nnnRESULTSnMean (SD) energy intake during pregnancy was 2135 (596) kcal. Mean (SD) cord blood levels of leptin and adiponectin were 9.0 (6.6) ng/ml and 28.6 (6.7) μg/ml, respectively. Neither closer adherence to a Mediterranean/AHEI pattern diet nor energy intake was associated with either cord blood leptin or adiponectin. Protein intake was associated with both marginally lower leptin (-0.22 ng/ml [95% CI -0.41, -0.02] for each 1% of energy) and adiponectin (-0.25 μg/ml [95% CI -0.48, -0.02]).nnnCONCLUSIONSnCloser adherence to a Mediterranean/AHEI pattern diet during pregnancy was not associated with cord blood leptin or adiponectin. Maternal protein intake was weakly but significantly associated with lower cord blood leptin and adiponectin.

Bloodstream infection with Anaerobiospirillum succiniciproducens: a potentially lethal infection.

Anaerobiospirillum succiniciproducens (A succiniciproducens), a spiral, Gram-negative anaerobic rod which is part of the normal intestinal flora of cats and dogs, has rarely been reported as a cause of bacteremia and diarrhea in humans, particularly in immunocompromised hosts. Although it can be associated with significant mortality, the full extent of its pathogenicity, clinical spectrum, and optimal therapy remain to be determined. We review the available literature on microbiology, clinical manifestations, and treatment options for Anaerobiospirillum infection.

An Unusual Cutaneous Tumor: African Histoplasmosis following Mudbaths: Case Report and Review

African histoplasmosis, caused by Histoplasma capsulatum var. duboisii, is endemic in Africa. The disease usually involves the skin, subcutaneous tissue, and bones. A case of African histoplasmosis presenting as a cutaneous tumor and non-healing wound in a 66-year-old immunocompetent male residing in Africa, the first ever reported following mudbaths and acupuncture, is hereby reported. Diagnosis was confirmed by means of polymerase chain reaction performed on tissue material. The patient was started on long-term itraconazole therapy and he responded well. African histoplasmosis should be included in the differential diagnosis of non-healing wounds or tumor-like lesions, especially in the context of mudbaths in an endemic area.

Emphysematous cystitis in the absence of known risk factors: an unusual clinical entity.

Emphysematous cystitis is a rare disorder that is usually associated with immunosuppression, poorly controlled diabetes mellitus, and other risk factors such as previous urinary tract infection and/or recent instrumentation of the urinary tract. The case of an 89-year-old woman with emphysematous cystitis who had no evidence of immunodeficiency or other risk factors except for advanced age is reported. A review of the literature on emphysematous cystitis in immunocompetent, nondiabetic individuals is presented.