OBJECTIVE: To investigate the interaction between α-amylase (α-AMS) and inflammatory response in patients with ventilator-associated pneumonia (VAP) and their predictive value for prognosis. METHODS: A prospective cohort study was conducted. Patients with mechanical ventilation who were treated in the intensive care unit (ICU) of the Second Hospital of Hebei Medical University from June 2020 to June 2023 were enrolled, and the patients were divided into VAP group and non-VAP group according to whether VAP occurred. VAP patients were stratified into mild [acute physiology and chronic health evaluation II (APACHE II) < 10 scores], moderate (APACHE II were 10-20 scores), and severe (APACHE II > 20 scores) groups based on the APACHE II. All patients were followed up for 28 days. In addition, healthy subjects who underwent health examination in our hospital at the same time were selected as the healthy control group. Baseline data including gender, age, mechanical ventilation mode, mechanical ventilation time, underlying diseases, drug use, and laboratory test indicators were collected. The serum levels of α-AMS, interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and other inflammatory factors were analyzed and compared. Pearson correlation analysis was performed to analyze the correlation between serum α-AMS and inflammatory factors. Logistic regression was used to analyze the influencing factors of poor prognosis in patients with VAP. The receiver operator characteristic curve (ROC curve) was plotted to evaluate the predictive value of α-AMS on the poor prognosis of patients with VAP. RESULTS: A total of 100 mechanically ventilated patients were enrolled, including 60 cases in the VAP group and 40 cases in the non-VAP group. Among the patients with VAP, there were 24 cases in the mild group, 20 cases in the moderate group, and 16 cases in the severe group. A total of 44 patients survived at 28 days, while 16 died. Additionally, 100 healthy individuals were included as the healthy control group. Serum levels of α-AMS, IL-6, TNF-α and CRP in the VAP group were significantly higher than those in the non-VAP group and the healthy control group, while the levels of α-AMS, IL-6, TNF-α and CRP in the non-VAP group were significantly higher than those in the healthy control group. There were statistically significant differences in serum α-AMS, IL-6, TNF-α, CRP levels and APACHE II scores among VAP patients with different disease severities, and the levels of the above indicators in the severe group were significantly higher than those in the moderate group and mild group, and the levels of the above indicators in the moderate VAP group were significantly higher than those in the mild group. Pearson correlation analysis showed that serum α-AMS was positively correlated with IL-6, TNF-α, CRP, and APACHE II scores (r values were 0.404, 0.392 and 0.493, 0.493, all P < 0.01). Univariate analysis showed that age, mechanical ventilation, diabetes mellitus, ventilation time, ventilation position, prophylactic use of antimicrobial drugs, and serum α-AMS, IL-6, TNF-α, CRP, and APACHE II scores were correlated with the prognosis of VAP patients (all P < 0.05). Multivariate Logistic regression analysis identified age [odds ratio (OR) = 1.340, 95% confidence interval (95%CI) was 1.119-1.605], tracheostomy (OR = 3.050, 95%CI was 1.016-9.157), diabetes mellitus (OR = 1.379, 95%CI was 1.102-1.724), and ventilation time ≥ 7 days (OR = 2.557, 95%CI was 1.163-5.623) and serum α-AMS (OR = 1.428, 95%CI was 1.098-1.856), IL-6 (OR = 1.543, 95%CI was 1.005-2.371), TNF-α (OR = 2.228, 95%CI was 1.107-4.485), CRP (OR = 1.252, 95%CI was 1.131-1.387), APACHE II scores (OR = 1.422, 95%CI was 1.033-1.957) were independent influencing factors for the 28-day prognosis of patients with VAP (all P < 0.05). ROC curve analysis demonstrated that serum α-AMS, IL-6, TNF-α and CRP exhibited significant predictive performance on the prognosis of patients with VAP. The best cut-off value for α-AMS had a sensitivity of 81.3%, specificity of 75.0%, and an area under the ROC curve (AUC) of 0.791, which was significantly higher than those of inflammatory markers IL-6, TNF-α, and CRP (P < 0.05). The combined parameter diagnostic performance was significantly better than those of individual parameters (P < 0.05), with the highest diagnostic performance when combined, corresponding to an AUC of 0.868 (95%CI was 0.798-0.938), sensitivity of 87.5%, and specificity of 79.5%. CONCLUSIONS VAP in mechanically ventilated patients can lead to an increase in the levels of peripheral blood α-AMS and inflammatory factors, and there is an interaction between α-AMS and inflammatory markers in severe VAP patients. These markers are closely related to the severity of the disease and prognosis and have significant implications for predicting patient outcomes.
Humans ; Pneumonia, Ventilator-Associated/diagnosis* ; Prognosis ; Prospective Studies ; Respiration, Artificial ; alpha-Amylases/blood* ; Interleukin-6/blood* ; Male ; Female ; C-Reactive Protein/metabolism* ; APACHE ; Inflammation ; Middle Aged ; Intensive Care Units ; Tumor Necrosis Factor-alpha/blood* ; Aged

OBJECTIVE: To evaluate the therapeutic effects of recombinant Exendin-4 and double-stranded adeno-associated virus (Exendin-4/dsAAV) on SD rats with type 2 diabetes (T2DM) through injecting it into submandibular gland (SG).
 METHODS: The Exendin-4/dsAAV was injected into submandibular gland of diabetic rat. The insulin and α-amylase were detected by real-time PCR at the 2nd, 4th and 8th weeks. The immunohistochemisty was used to detect the insulin contents in SG at the 8th week. The concentration of blood glucose and levels of insulin secretion were detected after pancreatectomy.
 RESULTS: The SG gland was bigger in Exendin-4/dsAAV group than that in the control group, but the changes in α-amylase were not significant. The Exendin-4 and insulin gene expression was increased in the Exendin-4/dsAAV group (P<0.05). The Exendin-4 and insulin were positive in the SG. The blood glucose was lower and insulin concentration was higher in the Exendin-4/dsAAV group than those in the control group after pancreatectomy (P<0.05), and the insulin content was also increased in the dsAAV groups.
 CONCLUSION Continuous expression of Exendin-4 in SG may improve glucose control and insulin secretion in T2DM rats through inducing expression of insulin.
Animals ; Blood Glucose ; analysis ; Dependovirus ; Diabetes Mellitus, Experimental ; therapy ; Diabetes Mellitus, Type 2 ; therapy ; Exenatide ; Genetic Therapy ; Injections ; Insulin ; chemistry ; Peptides ; genetics ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Recombinant Proteins ; genetics ; therapeutic use ; Submandibular Gland ; chemistry ; Venoms ; genetics ; therapeutic use ; alpha-Amylases ; chemistry

OBJECTIVETo investigate the protective effects of captopril against lung injury in a rat model of severe acute pancreatitis (SAP).

METHODSSeventy-two male SD rats were randomized into sham-operated group (SO group), SAP group and captopril intervention group (CAP group). Serum amylase and myeloperoxidase (MPO) activity in the lung tissue were examined at 1, 6 and 12 h after the operation. TNF-&alpha; and AngII in the lung tissue were detected by ELISA, and the histopathological changes of the pancreas and lung were observed microscopically.

RESULTSThe MPO activity , which was similar between SAP group and CAP group at 1 h, were significantly lowered in CAP group at 6 and 12 h (P<0.05). Serum amylase level and the levels of TNF-&alpha; and AngII in the lung tissue homogenate were all reduced significantly in CAP group as compared to those in SAP group (P<0.01). The pathological injury of the lung was obviously lessened in CAP group in comparison with that in SAP group.

CONCLUSIONCaptopril can ameliorate SAP-induced lung injury in rats.

Amylases ; blood ; Angiotensin II ; metabolism ; Animals ; Captopril ; pharmacology ; therapeutic use ; Disease Models, Animal ; Lung ; metabolism ; pathology ; Lung Injury ; etiology ; prevention & control ; Male ; Pancreatitis ; complications ; drug therapy ; Peroxidase ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; metabolism

An alpha-amylase inhibitor (alpha-AI) was isolated from white kidney beans (Phaseolus vulgaris L) by ethanol fractional precipitation, ion exchange chromatography and gel filtration column chromatography. It was a homogeneity glycoprotein demonstrated by SDS-PAGE and gel filtration on CL-6B. The glycoprotein contained 88.2% protein and was rich in aspartic acid, glutamic acid, leucine, threonine and serine. The carbohydrate moiety was consisted of Man, Glc, Gal and Xyl in a mole ratio of 2.42: 1.50: 1.52: 1.00. The glycan and the core protein backbone was connected by O-linkage as determined by beta-elimination reaction. The continuous oral administration of the alpha-AI (150 mg x kg(-1) x d(-1)) for 7 days can lower fasting blood glucose and 300 mg x kg(-1) x d(-1) alpha-AI for 7 days can improve the sugar tolerance on alloxan-dependent diabetic model rats. The result showed the alpha-AI obtained from white kidney beans had good hypoglycemic effect on alloxan induced diabetic rats and may have high potential pharmaceutical value as a regulative digestive-starch degradation in patients suffering from diabetes.
Alloxan ; Amino Acids ; analysis ; Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Experimental ; blood ; chemically induced ; Female ; Glycoproteins ; chemistry ; isolation & purification ; pharmacology ; Molecular Weight ; Monosaccharides ; analysis ; Phaseolus ; chemistry ; Plant Lectins ; chemistry ; isolation & purification ; pharmacology ; Plants, Medicinal ; chemistry ; Rats ; Rats, Sprague-Dawley ; Vegetable Proteins ; analysis ; alpha-Amylases ; antagonists & inhibitors