-
European Journal of Medical Research Nov 2022Traumatic brain injury (TBI) causes mortality and long-term disability among young adults and imposes a notable cost on the healthcare system. In addition to the first... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Traumatic brain injury (TBI) causes mortality and long-term disability among young adults and imposes a notable cost on the healthcare system. In addition to the first physical hit, secondary injury, which is associated with increased intracranial pressure (ICP), is defined as biochemical, cellular, and physiological changes after the physical injury. Mannitol and Hypertonic saline (HTS) are the treatment bases for elevated ICP in TBI. This systematic review and meta-analysis evaluates the effectiveness of HTS in the management of patients with TBI.
METHODS
This study was conducted following the Joanna Briggs Institute (JBI) methods and PRISMA statement. A systematic search was performed through six databases in February 2022, to find studies that evaluated the effects of HTS, on increased ICP. Meta-analysis was performed using comprehensive meta-analysis (CMA).
RESULTS
Out of 1321 results, 8 studies were included in the systematic review, and 3 of them were included in the quantitative synthesis. The results of the meta-analysis reached a 35.9% (95% CI 15.0-56.9) reduction in ICP in TBI patients receiving HTS, with no significant risk of publication bias (t-value = 0.38, df = 2, p-value = 0.73). The most common source of bias in our included studies was the transparency of blinding methods for both patients and outcome assessors.
CONCLUSION
HTS can significantly reduce the ICP, which may prevent secondary injury. Also, based on the available evidence, HTS has relatively similar efficacy to Mannitol, which is considered the gold standard therapy for TBI, in boosting patients' neurological condition and reducing mortality rates.
Topics: Humans; Young Adult; Intracranial Pressure; Brain Injuries; Saline Solution, Hypertonic; Intracranial Hypertension; Brain Injuries, Traumatic; Mannitol
PubMed: 36404350
DOI: 10.1186/s40001-022-00897-4 -
Journal of Drugs in Dermatology : JDD Sep 2019Injectable poly-L-lactic acid (PLLA) is a biodegradable synthetic polymer that stimulates collagen production, leading to gradual volume restoration. The treatment of...
Injectable poly-L-lactic acid (PLLA) is a biodegradable synthetic polymer that stimulates collagen production, leading to gradual volume restoration. The treatment of sagging skin in body areas is still a big challenge, as there are few aesthetic procedures aiming to improve it. This article provides recommendations on the use of PLLA in the treatment of skin laxity in off-face areas, as the neck, décolletage, arms, abdomen, buttocks, and thighs, including the patient selection, product preparation, and injection techniques. The use of PLLA is a promising method for the treatment of skin laxity in corporal areas, improving body contour and appearance. Further investigation is needed to better understand the efficacy and durability of PLLA in non-facial indications and to provide the best evidence for optimal patient outcomes. J Drugs Dermatol. 2019;18(9):929-935.
Topics: Age Factors; Cellulose; Cosmetic Techniques; Elasticity; Esthetics; Female; Humans; Injections, Subcutaneous; Lactic Acid; Mannitol; Middle Aged; Patient Selection; Practice Guidelines as Topic; Rejuvenation; Skin; Skin Aging
PubMed: 31524350
DOI: No ID Found -
The European Respiratory Journal Jan 2022
Topics: Antibodies, Monoclonal, Humanized; Asthma; Bronchial Hyperreactivity; Bronchial Provocation Tests; Humans; Mannitol; Respiratory Hypersensitivity
PubMed: 34049943
DOI: 10.1183/13993003.01296-2021 -
The Journal of Allergy and Clinical... Oct 2019
Topics: Asthma, Exercise-Induced; Bronchi; Bronchial Provocation Tests; Bronchoconstriction; Epoprostenol; Humans; Mannitol; Mast Cells
PubMed: 31472165
DOI: 10.1016/j.jaci.2019.06.048 -
Clinical Gastroenterology and... May 2022In addition to gastric sensorimotor dysfunctions, functional dyspepsia (FD) is also variably associated with duodenal micro-inflammation and epithelial barrier...
BACKGROUND & AIMS
In addition to gastric sensorimotor dysfunctions, functional dyspepsia (FD) is also variably associated with duodenal micro-inflammation and epithelial barrier dysfunction, the pathogenesis and clinical significance of which are unknown. Our hypothesis was that miRNAs and/or inflammation degrade epithelial barrier proteins, resulting in increased duodenal mucosal permeability in FD.
METHODS
We compared the duodenal mucosal gene expression and miRNAs, in vivo permeability (lactulose-mannitol excretion between 0 and 60 and 60 and 120 minutes after saccharide ingestion), ex vivo assessments (transmucosal resistance, fluorescein isothiocyanate [FITC]-dextran flux, and basal ion transport), and duodenal histology (light and electron microscopy) in 40 patients with FD and 24 controls.
RESULTS
Compared with controls, the mRNA expression of several barrier proteins (zonula occludens-1, occludin, claudin-12, and E-cadherin) was modestly reduced (ie, a fold change of 0.8-0.85) in FD with increased expression of several miRNAs (eg, miR-142-3p and miR-144-3-p), which suppress these genes. The urinary lactulose excretion and the lactulose:mannitol ratio between 60 and 120 minutes were greater in FD than in controls (P < .05). The FITC-dextran flux, which reflects paracellular permeability, was inversely correlated (r = -0.32, P = .03) with transmucosal resistance and directly correlated (r = 0.4, P = .02) with lactulose:mannitol ratio. Other parameters (mucosal eosinophils, intraepithelial lymphocytes, and mast cells, transmucosal resistance, FITC-dextran flux, average intercellular distance, and proportion of dilated junctions) were not significantly different between groups.
CONCLUSIONS
In FD, there is a modest reduction in the expression of several duodenal epithelial barrier proteins, which may be secondary to up-regulation of regulatory miRNAs, and increased small intestinal permeability measured in vivo.
Topics: Dyspepsia; Humans; Inflammation; Intestinal Mucosa; Lactulose; Mannitol; MicroRNAs; Permeability; Tight Junctions
PubMed: 34607017
DOI: 10.1016/j.cgh.2021.09.029 -
Circulation Research Sep 2023Cardiac conduction is understood to occur through gap junctions. Recent evidence supports ephaptic coupling as another mechanism of electrical communication in the...
BACKGROUND
Cardiac conduction is understood to occur through gap junctions. Recent evidence supports ephaptic coupling as another mechanism of electrical communication in the heart. Conduction via gap junctions predicts a direct relationship between conduction velocity (CV) and bulk extracellular resistance. By contrast, ephaptic theory is premised on the existence of a biphasic relationship between CV and the volume of specialized extracellular clefts within intercalated discs such as the perinexus. Our objective was to determine the relationship between ventricular CV and structural changes to micro- and nanoscale extracellular spaces.
METHODS
Conduction and Cx43 (connexin43) protein expression were quantified from optically mapped guinea pig whole-heart preparations perfused with the osmotic agents albumin, mannitol, dextran 70 kDa, or dextran 2 MDa. Peak sodium current was quantified in isolated guinea pig ventricular myocytes. Extracellular resistance was quantified by impedance spectroscopy. Intercellular communication was assessed in a heterologous expression system with fluorescence recovery after photobleaching. Perinexal width was quantified from transmission electron micrographs.
RESULTS
CV primarily in the transverse direction of propagation was significantly reduced by mannitol and increased by albumin and both dextrans. The combination of albumin and dextran 70 kDa decreased CV relative to albumin alone. Extracellular resistance was reduced by mannitol, unchanged by albumin, and increased by both dextrans. Cx43 expression and conductance and peak sodium currents were not significantly altered by the osmotic agents. In response to osmotic agents, perinexal width, in order of narrowest to widest, was albumin with dextran 70 kDa; albumin or dextran 2 MDa; dextran 70 kDa or no osmotic agent, and mannitol. When compared in the same order, CV was biphasically related to perinexal width.
CONCLUSIONS
Cardiac conduction does not correlate with extracellular resistance but is biphasically related to perinexal separation, providing evidence that the relationship between CV and extracellular volume is determined by ephaptic mechanisms under conditions of normal gap junctional coupling.
Topics: Animals; Guinea Pigs; Dextrans; Connexin 43; Myocytes, Cardiac; Sodium; Gap Junctions; Albumins; Mannitol; Action Potentials
PubMed: 37681314
DOI: 10.1161/CIRCRESAHA.123.322567 -
Applied Biochemistry and Biotechnology Jun 2022Obesity, diabetes, and other cardiovascular diseases are directly related to the high consumption of processed sugars with high caloric content. The current food... (Review)
Review
Obesity, diabetes, and other cardiovascular diseases are directly related to the high consumption of processed sugars with high caloric content. The current food industry has novel trends related to replacing highly caloric sugars with non-caloric or low-calorie sweeteners. Mannitol, a polyol, represents a suitable substitute because it has a low caloric content and does not induce a glycemic response, which is crucial for diabetic people. Consequently, this polyol has multiple applications in the food, pharmaceutical, and medicine industries. Mannitol can be produced by plant extraction, chemical or enzymatic synthesis, or microbial fermentation. Different in vitro processes have been developed regarding enzymatic synthesis to obtain mannitol from fructose, glucose, or starch-derived substrates. Various microorganisms such as yeast, fungi, and bacteria are applied for microbial fermentation. Among them, heterofermentative lactic acid bacteria (LAB) represent a reliable and feasible alternative due to their metabolic characteristics. In this regard, the yield and productivity of mannitol depend on the culture system, the growing conditions, and the culture medium composition. In situ mannitol production represents a novel approach to decrease the sugar content in food and beverages. Also, genetic engineering offers an interesting option to obtain mannitol-producing strains. This review presents and discusses the most significant advances that have been made in the mannitol production through fermentation by heterofermentative LAB, including the pertinent and critical analysis of culture conditions considering broth composition, reaction systems, and their effects on productivities and yields.
Topics: Fermentation; Humans; Lactobacillales; Mannitol; Sugars; Sweetening Agents
PubMed: 35195836
DOI: 10.1007/s12010-022-03836-5 -
Applied Microbiology and Biotechnology Aug 2020Mannitol is a naturally occurring six-carbon sugar alcohol that has wide applications in the food and pharmaceutical industry because of its many properties, namely... (Review)
Review
Mannitol is a naturally occurring six-carbon sugar alcohol that has wide applications in the food and pharmaceutical industry because of its many properties, namely being a natural sweetener with a low metabolism and no glycemic index. The increasing demand for mannitol has spurred many studies of its production. Compared with its chemical synthesis and extraction from plants, both of which are difficult to satisfy for industrial requirements, biotechnological production of mannitol has received considerably more attention and interest from scientists because of its known advantages over those two methods. Accordingly, in this review, we summarize recent advances made in the production of mannitol through various biotechnological methods. The physicochemical properties, sources, and physiological functionalities and applications of mannitol are systematically covered and presented. Then, different determination methods for mannitol are also described and compared. Furthermore, different biotechnological strategies for the production of mannitol via fermentation engineering, protein engineering, and metabolic engineering receive a detailed overview in terms of mannitol-producing strains, enzymes, and their key reaction parameters and conditions. KEY POINTS: • Physiological functionalities and applications of mannitol are presented in detail. • Different determination methods for mannitol are also described and compared. • Various biotechnological strategies for the production of mannitol are reviewed.
Topics: Biotechnology; Fermentation; Mannitol; Metabolic Engineering; Protein Engineering; Sweetening Agents
PubMed: 32601737
DOI: 10.1007/s00253-020-10757-y -
Journal of Pharmaceutical Sciences Jan 2023The review summarizes the current state of knowledge of mannitol as an excipient in lyophilized injectable small and large molecule formulations. When compared with... (Review)
Review
The review summarizes the current state of knowledge of mannitol as an excipient in lyophilized injectable small and large molecule formulations. When compared with glycine, the physicochemical properties of mannitol make it a desirable and preferred bulking agent. Though mannitol is a popular bulking agent in freeze-dried formulations, its use may pose certain challenges such as vial breakage or its existence as a metastable crystalline hemihydrate in the final cake, necessitating appropriate mitigation strategies. The understanding of the phase behavior of mannitol in aqueous systems, during the various stages of freeze-drying, can be critical for the optimization of freeze-drying cycle parameters in multi-component formulations. Finally, using a decision tree as a guiding tool, we demonstrate the use of orthogonal techniques for attaining a stable and cost-effective lyophilized drug product containing mannitol.
Topics: Excipients; Mannitol; Freeze Drying; Drug Compounding; Freezing; Sucrose; Calorimetry, Differential Scanning
PubMed: 36030846
DOI: 10.1016/j.xphs.2022.08.029 -
Physiologia Plantarum Mar 2023Callose is a polymer deposited on the cell wall and is necessary for plant growth and development. Callose is synthesized by genes from the glucan synthase-like family...
Callose is a polymer deposited on the cell wall and is necessary for plant growth and development. Callose is synthesized by genes from the glucan synthase-like family (GSL) and dynamically responds to various types of stress. Callose can inhibit pathogenic infection, in the case of biotic stresses, and maintain cell turgor and stiffen the plant cell wall in abiotic stresses. Here, we report the identification of 23 GSL genes (GmGSL) in the soybean genome. We performed phylogenetic analyses, gene structure prediction, duplication patterns, and expression profiles on several RNA-Seq libraries. Our analyses show that WGD/Segmental duplication contributed to expanding this gene family in soybean. Next, we analyzed the callose responses in soybean under abiotic and biotic stresses. The data show that callose is induced by both osmotic stress and flagellin 22 (flg22) and is related to the activity of β-1,3-glucanases. By using RT-qPCR, we evaluated the expression of GSL genes during the treatment of soybean roots with mannitol and flg22. The GmGSL23 gene was upregulated in seedlings treated with osmotic stress or flg22, showing the essential role of this gene in the soybean defense response to pathogenic organisms and osmotic stress. Our results provide an important understanding of the role of callose deposition and regulation of GSL genes in response to osmotic stress and flg22 infection in soybean seedlings.
Topics: Arabidopsis; Seedlings; Glycine max; Flagellin; Phylogeny; Mannitol; Gene Expression Regulation, Plant
PubMed: 36811487
DOI: 10.1111/ppl.13877