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This study explores how melanin synthesis in adipose tissue may help mitigate obesity-related secondary complications, focusing on metabolic syndrome and non-alcoholic fatty liver disease. Investigating protective factors in obese individuals with high BMI and stagnant fat deposits. Includes gene expression profiling data and cytokine analysis.
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Hypothesis: AN ECTOPIC SYNTHESIS OF THE MELANIN IN ADIPOSE MAY HELP TO COUNTERACT SECONDARY COMPLICATIONS OF OBESITY Manpreet Randhawa, Tom Huff, Julio C. Valencia, Zobair Younossi, Vikas Chandhoke, Vincent J. Hearing, Ancha Baranova
Why obesity is so dangerous ? whyfiles.org/276metabolic_syndrome/
METABOLIC SYNDROME Common complications : Cardiovascular diseases Diabetes type II Non-alcoholic fatty liver disease (NAFLD) Non-alcoholic steatohepatitis (NASH)
Prevalence of the metabolic syndrome increases with age National Health and Nutrition Examination Survey III, 1988-1994(8814 US adults)
Prevalence of metabolic syndrome increases with obesity Males , blacks; , Hispanics; , whites. Females
Cost burden of obesity (U.S. only) Direct cost only; 17% of total direct cost of heart disease, independent of stroke Direct and indirect costs Direct and indirect costs Direct cost only; 17% of total direct cost of hypertension
Health-Care Costs for Obesity Top Those Related to Smoking There has definitely been a feeling that smoking, drinking and substance abuse are bigger problems than obesity. This isn't the case. Obesity is associated with an average increase in hospital and outpatient spending of $395 a year
Prevalence of metabolic syndrome increases with obesity Males , blacks; , Hispanics; , whites. Glass half full or half empty? Some obese people stay healthy despite very high BMI (even within bariatric cohort) WHY? Females
Non-Alcoholic Liver Disease as a modelfor the study of the secondary complications of obesity Liver transplantation Fibrosis increased risk of hepatocellular carcinoma From: Ariel E. Feldstein and Marsha H. Kay, ACG website NAFLD affects up to 20 % of adults and nearly 5 % of children. NASH 2-5 % of adult Americans; up to 20 % of obese subjects. The majority of individuals with NAFLD have no symptoms and a normal examination Can we treat NAFLD ? Not really. Just try to lose weight….
For these who thinks that fat in the liver is microscopic change
IMPORTANT QUESTION: WHY SOME PATIENTS WITH VERY HIGH BMI (>45) STAY FREE OF LIVER DISEASE? ARE SOME PROTECTIVE FACTORS OR PREDISPOSING FACTORS INVOLVED? ARE THESE FACTORS PRESENT IN THE LIVER OR IN THE FAT?
Obese Patients with NASH vs Obese patients without liver pathology Results of the Liver biopsy profiling (5K chip) Results of the visceral adipose profiling (40K chip) > 2.0 in the liver (NASH vs OC) = pro-NASH genes in the liver < 0.5 in the liver (NASH vs OC) = hepatoprotective genes in the liver > 2.0 in the adipose (NASH vs OC) = pro-NASH genes in the fat < 0.5 in the adipose (NASH vs OC) = hepatoprotective genes in the fat Dataset was downsized
Genes that are regulated by TGF-β signal in adipose are important for the development of the primary phenotype of the morbid obesity TNF-α and IL6 regulated genes expressed in adipose play a prominent role in the development of NASH
Major finding: Adipose of the NASH patients overexpresses a number of genes encodingsecreted, mostly pro-inflammatory molecules.
IL-6 IL-8 Visfatin, Vaspin, Apelin, PAI-1, MCP1, other pro-inflammatory molecules Other cells embedded in adipose, including macrophages NAFLD and NASH develop under the influence of the adipokines synthetized in the visceral adipose
ANOTHER study:Profiling of adiponectin, resistin, visfatin, apelin, TNF-alpha, IL-6, IL-8, IL1, IL1R, sIL-6in the serum of patients with and without NAFLD • 100 samples collected and profiled; • Correlation analysis with seven clinical parameters is completed;
A. Visfatin B. B. TNF-α TNF-α 1000 1000 * 100 100 Mean (pg/ml) Mean (pg/ml) 10 10 1 Controls I (N=38) Controls II (N=12) NAFLD (N=45) SS (N=19) NASH (N=26) Controls I (N=38) Controls II (N=12) NAFLD (N=45) SS (N=19) NASH (N=26) TNF-α, pg/ml IL-8 IL-6 C. D. 100 100 1000 100 100 10 Mean (pg/ml) Mean (pg/ml) Mean (pg/ml) Lower than normal levels of TNF-α may prevent the onset of NAFLD in morbidly obese patients. 10 1 1 Controls I (N=38) Controls I (N=38) Controls II (N=12) Controls II (N=12) NAFLD (N=45) NAFLD (N=45) SS (N=19) SS (N=19) NASH (N=26) NASH (N=26) Controls I (N=38) Controls II (N=12) NAFLD (N=45) SS (N=19) NASH (N=26)
General Theme: Visceral fat in some obese subjects remains inert; Something protects obese people with inert fat from metabolic syndrome
Expression profiling in human OBESITY • Comparisons of the visceral fat samples; • >50 patients sampled during bariatric surgeries; • 9 lean peoples donating their kidney;
Fat Tissue Stratagene human Ref. RNA Isolate total RNA Linearly Amplify RNA Linearly Amplify RNA Reverse Transcribe to cDNA, label with Cy5 Reverse Transcribe to cDNA, label with Cy3 Mix, Hybridize and Scan Fat Tissue Fat Tissue Fat Tissue Fat Tissue Stratagene human Ref. RNA Stratagene human Ref. RNA Stratagene human Ref. RNA Stratagene human Ref. RNA Isolate total RNA Isolate total RNA Isolate total RNA Isolate total RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Linearly Amplify RNA Reverse Transcribe to cDNA, label with Cy5 Reverse Transcribe to cDNA, label with Cy5 Reverse Transcribe to cDNA, label with Cy5 Reverse Transcribe to cDNA, label with Cy5 Reverse Transcribe to cDNA, label with Cy3 Reverse Transcribe to cDNA, label with Cy3 Reverse Transcribe to cDNA, label with Cy3 Reverse Transcribe to cDNA, label with Cy3 Mix, Hybridize and Scan Mix, Hybridize and Scan Mix, Hybridize and Scan Mix, Hybridize and Scan METHOD :
Four comparisons were performed: • Morbidly obese (N=50) vs. Controls • Diabetic obese vs. normoglycemic obese • No significant genes found • Diabetic obese (N= 9) vs. Controls • NormoGlycemic Obese (N=22) vs. Controls
All comparison were performed vs. Non-Obese Controls DMO = Obese with diabetes; MO =Obese without diabetes; NGO = NormoGlycemic Obese
A LIST OF MELANOGENESIS RELATED GENES DIFFERENTIALLY EXPRESSED IN OBESE ADIPOSE • Genesfold difference Accession number TYRP1 2.66 AA668457 DCT 2.17 N27147 RAB27A 2.47 AI309109 RAB27B 2.6 R39044 MITF 1.5 N67822 SOX 1.36 AA976578 CHS1 1.22 N74383 Tyrosinase itself was not present on the chip
Expression of TYR, TYRP1 and DCT in adipose tissue as revealed by Quantitative RealTime-PCR P < 0.007 P< 0.024 NS
Fontana-Masson stain of human adipose tissue demonstrates melanin pigment (black staining) mainly in the periphery of the adipocytes. Cryoslicing of visceral adipose Melanin detection Fontana-Masson kit