Evidence-based practice: a buzz word or a reality?
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Biomedical subjects
Publications and source records attributed to Jacqueline Ross.
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The molecular processes that initiate insulitis in type 1 diabetes remain unclear. Chemokines, such as monocyte chemoattractant protein-1 (MCP-1), mediate chemotaxis and leukocyte migration to inflammatory sites. Although MCP-1 mRNA has been shown in islets isolated from NOD mice at 2 weeks of age and at later stages, the cellular sources of this chemokine, at the protein level, and its role in insulitis are unclear. The aims of the present study were to employ immunohistochemical techniques to examine the expression of MCP-1 and quantify its cellular sources in islets of NOD mice both after cyclophosphamide (Cy) administration and in spontaneous diabetes. Tissues were examined at days 1 (=day 73, first day of Cy), 4, 7, 11, and 14 and in age-matched control NOD mice. Pancreatic sections from NOD mice without Cy administration were also studied between days 21-65 and at onset of diabetes and from adult CD-1 mice. In the Cy group, a small number of peri-islet macrophages were immunopositive for MCP-1 at day 1 whereas at day 4, the number declined but increased subsequently at day 7. In the same group, it increased markedly at days 11 and 14 compared with age-matched control NOD mice. In young NOD mice, MCP-1 was present in selective macrophages in islets with early insulitis (day 45) but was absent at diabetes onset. MCP-1 was undetectable in beta cells and in most T cells. Islets from adult CD-1 mice did not show immunostaining for MCP-1. We conclude that MCP-1 is expressed in a proportion of islet and exocrine macrophages. This expression increases during the later stages of Cy-induced diabetes. Thus, MCP-1 positive macrophages that migrate to the islet periphery during the early stages of Cy-induced diabetes and preceding spontaneous diabetes may augment insulitis by further attracting macrophages and T cells.
Lactoferrin induces osteoblast proliferation and survival in vitro and is anabolic to bone in vivo. The molecular mechanisms by which lactoferrin exerts these biological actions are not known, but lactoferrin is known to bind to two members of the low-density lipoprotein receptor family, low- density lipoprotein receptor-related proteins 1 (LRP1) and 2 (LRP2). We have examined the role(s) of these receptors in the actions of lactoferrin on osteoblasts. We show that lactoferrin binds to cultured osteoblastic cells, and that LRP1 and LRP2 are expressed in several osteoblastic cell types. In primary rat osteoblastic cells, the LRP1/2 inhibitor receptor associated protein blocks endocytosis of lactoferrin and abrogates lactoferrin-induced p42/44 MAPK signaling and mitogenesis. Lactoferrin-induced mitogenesis is also inhibited by an antibody to LRP1. Lactoferrin also induces receptor associated protein-sensitive activation of p42/44 MAPK signaling and proliferation in osteoblastic human SaOS-2 cells, which express LRP1 but not LRP2. The mitogenic response of LRP1-null fibroblastic cells to lactoferrin is substantially reduced compared with that of cells expressing wild-type LRP1. The endocytic and signaling functions of LRP1 are independent of each other, because lactoferrin can activate mitogenic signaling in conditions in which endocytosis is inhibited. Taken together, these results 1) suggest that mitogenic signaling through LRP1 to p42/44 MAPKs contributes to the anabolic skeletal actions of lactoferrin; 2) demonstrate growth-promoting actions of a third LRP family member in osteoblasts; and 3) provide further evidence that LRP1 functions as a signaling receptor in addition to its recognized role in ligand endocytosis.
The present and anticipated nursing shortage poses a public health concern. This is a unique shortage because nursing is encountering both an increased demand for nursing care and a lower supply of nurses available to deliver it. Nurses, known for patient advocacy, are ethically bound to provide competent, quality care. Currently, nurses comprise the largest group of health care providers in the United States. Through increased understanding of the current situation, the profession will be in a better position to advocate and promote nursing as a viable, attractive career.