published_or_final_version / Social Work / Master / Master of Social Sciences

Macrophage-derived foam cells play a predominant role in the deposition of arterial plaques during the early stages of atherosclerosis. The deposition of arterial plaques is known to be effected by several factors, including a person’s dietary habits. The consumption of a high-fat (>60% of calories from fat) meal is known to elevate serum LDL and triglycerides, which have been previously implicated in the formation pf foam cells. One limitation of current research models is that it is not possible to directly measure foam cells in vivo. Thus, the purpose of the present study was to validate the use of blood derived monocytes as a proxy measure of foam cells. In order to complete this objective, we evaluated monocyte oxLDL phagocytosis capacity following consumption of a high-fat meal. Eight men and women participated in the present study and venous blood samples were collected prior to the meal, 1-h, 3-h, and 5-h post-meal. Monocytes (CD14+/16- and CD14+/16+) were evaluated for adhesion molecule expression (CD11a, CD11b, and CD18), scavenger R (CD36) expression, and oxLDL phagocytosis using an image-based flow cytometry method developed in our laboratory for this purpose. Data was statistically analyzed for significance using a single-factor ANOVA with repeated measures and a p < 0.05. Consumption of a high-fat meal caused an increase significant increase in the proportion of pro-inflammatory monocytes (CD14+/16+) and a decrease in classic monocytes (CD14+/16-), with the greatest difference occurring at 5 h post prandial (p = 0.038). We also found that pro-inflammatory monocyte expression of adhesion molecules and CD36 increased in a manner that would promote in vivo movement of monocytes into the subendothelial space. Finally, over the course of the 5 h postprandial period, the majority of oxLDL uptake occurred in pro-inflammatory compared to classic monocytes. These results suggest that consuming a high-fat meal increases the potential of monocytes to become foam cells for at least 5 h postprandial.

Appendum consists of last two leaves. / Copies of author's previously published articles inserted. / Bibliography: leaves 241-283. / xviii, 284 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / The studies described were designed to identify and address (through the application of relatively novel and potentially useful adjunctive therapeutic strategies) some of the determinants of sub-optimal therapeutic response in intermediate coronary syndrome and chronic congestive heart failure; especially when targeted towards those patients who fail to gain the maximal benefit from pre-existing modalities of pharmacological treatment. / Thesis (Ph.D.)--University of Adelaide, Dept. of Medicine, 1999

Thesis (MSc (Biomedical Technology))--Cape Peninsula University of Technology, 2016. / Cardiovascular diseases (CVD) are the leading cause of global mortality, of which over 75% occurred in low- and middle-income countries such as South Africa. The lipid profile, specifically decreased levels of high density lipoprotein cholesterol (HDL-C), elevated triglyceride levels and the presence of small-dense low density lipoprotein (sdLDL) has been reported associated with CVD. An increased number of sdLDL is also common in metabolic syndrome (MetS), visceral obesity and diabetes mellitus, the last a known risk factor for CVD. The modification of low density lipoprotein (LDL) size, or number of sdLDL particles, has been reported to significantly reduce CVD risk, but not conclusively so and needs further investigation. In this regard, sdLDL particles are seldom estimated routinely for clinical use because of financial and other limitations. Currently, an alternative approach for estimating sdLDL is to use equations derived from routine lipid measures, as has been proposed by several groups. However, there is a need for extensive evaluation of this equation across different ethnic and disease groups, especially since reports showed an inadequate performance of the equation in a Korean population. The aim of this study was to assess the performance of a recently proposed equation for the estimation of sdLDL in healthy and diabetic mixed ancestry South Africans. Furthermore, we also investigated the role of sdLDL as a cardiometabolic risk factor, as measured against known risk factors such as the glycemic and lipid profiles.

M.A. (Psychology) / The health context of South Africa is on the one hand unique in comparison to the rest of the world. On the other hand does it also. show characteristics of both Third World and First World disease patterns. There is a substantial component of the South African health sector that is negatively affected. This can possibly be ascribed to previous health policies. South Africa has unique characteristics concerning the chronic degenerative aspects of the First World disease pattern. White South Africans have the same cardiovascular disease patterns as the rest of the world with the exception that the South African disease patterns has a much larger incidence and degree of seriousness that the rest of the world. Research in the area of the chronic degenerative nature of heart disease and vascular disease is of great importance. It becomes necessary to address degenerative disease and also lifestyle diseases not only medically but also in terms of an individual's lifestyle. The management of an individual's lifestyle will not only have preventive consequences in the South African context, but it can also be utilised in the treat~ent of cardiovascular disease. Research undertaken at the Clinic and Centre for Behavioral Medicine at the Rand Afrikaans University found that the management or treatment of the Type A behavior pattern for the prevention of recurrent cardiovascular diseases were particularly effective. It therefore seems that technology developed elsewhere proves to be effective for the South African context. According to Johnston (1992) two types of risk factors contribute to the development of cardiovascular disease. The first constitute of classical risk factors which include aspects of blood pressure and cholesterol. The second risk factor includes psychological aspects and in particular the Type A behavior pattern and its components. Johnson and Broman (1987) indicate that the components of anger and hostility of the Type A behavior pattern constitute the most important behavioral factor of Type A coronary-prone behavior and cardiovascular disease. Research also indicate that the component of hostility presents a significant predictor of cardiovascular disease (Helmers et al., 1993) . The role of aggression and its components in the Type A behavior pattern was investigated in this study. An attempt was made to establish whether there is a simultaneous reduction in aggression, its components and the Type A behavior pattern and whether certain components of aggression were more important that others. A group of 39 heart patients were investigated on the following indexes: psychological, cardiological and biochemical in order to establish heart disease risk factors in a biopsychosocial context. A modified Type A treatment progranme was administered to this group over a period of twelve weeks at a local heart rehabilitation centre. A second group of 19 patients served as a no-treatment waitinglist control group, but simultaneously underwent an aerobic exercise and cardiovascular counselling programne. The results of this study indicated that cynical hostility was probably the major risk factor of all the components of aggression in the Type A behavior pattern. The second most important component of aggression in the Type A behavior pattern is the expression of anger in general. The latter also corresponds with results found in research on this subj ect. Ov-ert or specific expression of anger .nd the control of anger also contribute to the psychosocial causation of Type A behavior pattern in cardiovascular disease. Comparisons of the experimental and control groups after the intervention showed statistically significant differences of anger expression in general, specific anger expression, inhibition of anger, control of anger, and hostility. It was concluded that significant differences for the diverse components of aggression have been found due to the experimental intervention programme.

Cardiovascular disease (e.g., myocardial infarction, stroke, coronary artery disease) is the leading cause of death and disability worldwide. There is a growing body of literature that indicates sexual minority (e.g., gay, lesbian, bisexual, queer) adults are at a higher risk of cardiovascular disease than their heterosexual counterparts. The aim of this dissertation was to identify factors that contribute to the cardiovascular health (CVH) disparities that have been observed among sexual minority individuals. Guided by an adaptation of the minority stress model of CVH among sexual minority individuals, this dissertation includes three studies. In the first study (i.e., Chapter 2), we conducted a scoping review of the literature that investigated social determinants of cardiovascular health among sexual minority adults. Although findings were mixed, several social determinants of health were found to influence the CVH of sexual minority adults. For instance, sexual minority adults who lived in environments that were more supportive of sexual and gender minority people had lower odds of being overweight or obese. In the second study (i.e., Chapter 3), we used data from a racially and ethnically diverse sample of sexual minority women to examine the associations of family-related factors (i.e., sexual identity disclosure and family social support) with self-reported incident hypertension. Additionally, we examined whether these associations were moderated by race/ethnicity and sexual identity, or mediated by depressive symptoms. We found that higher levels of family social support were associated with lower levels of depressive symptoms among sexual minority women. However, family-related factors were not associated with self-reported incident hypertension. Further, race/ethnicity and sexual identity did not moderate the associations between family-related factors and reported incident hypertension. In the third study (i.e., Chapter 4), we used data from a nationally representative sample of adults to investigate sexual identity differences in ideal CVH (as defined by the American Heart Association’s Life Simple 7) and whether these associations were mediated by depressive symptoms. Compared to exclusively heterosexual women, mostly heterosexual and lesbian women were less likely to meet ideal criteria for tobacco use. In contrast, lesbian women were more likely to meet ideal criteria for glycosylated hemoglobin than exclusively heterosexual women. Among men, relative to exclusively heterosexual men, mostly heterosexual men were less likely to meet ideal criteria for tobacco use. Gay and bisexual men were less likely to meet ideal criteria for physical activity, whereas gay men were more likely to meet ideal criteria for body mass index compared to exclusively heterosexual men. Bisexual men were less likely to meet ideal criteria for blood pressure relative to exclusively heterosexual men. Depressive symptoms were found to partially mediate the association between sexual identity and physical activity only among mostly heterosexual women. Overall, these dissertation findings highlight CVH disparities among sexual minority adults. Clinicians should be educated about the CVH disparities that have been documented among sexual minority adults to provide personalized and culturally competent care. Results also indicate there is a need to develop behavioral interventions tailored specifically to the needs of sexual minority adults to improve their CVH outcomes and reduce CVH-related disparities.

It is well established that continual consumption of a diet high in fat leads to the development of chronic conditions such as obesity, cardio metabolic syndrome, and atherosclerosis that are associated with high incidence of cardiovascular disease. Recent studies have identified endotoxin-derived inflammation as a major diving force for the development of these conditions. Our laboratory has recently demonstrated that consumption of a single high-fat meal results in acute postprandial endotoxemia and alters monocyte cell surface adhesion molecule expression and scavenger receptor CD36 expression. These collective projects describe our efforts to understand the physiological significance of these postprandial changes and if supplementation with spore-based probiotics are able to provide any form of protection against these responses that are associated with the onset of atherogenesis.

Thesis (MSc)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: Please see fulltext for abstract / AFRIKAANSE OPSOMMING: Sien asb volteks vir opsomming

Thesis (MScMedSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: It is well-established that transient activation of the β-adrenergic signalling pathway with ligands such as isoproterenol, formoterol and dobutamine, elicits cardioprotection against subsequent long periods of ischaemia. Initially the focus was on the β1- and β2-adrenergic receptors (β1-AR, β2-AR), but recently the β3-AR also emerged as a potential target in the treatment of heart disease. In heart failure, β1- and β2-AR are typically known to be down-regulated while β3-ARs, on the other hand, are up-regulated (Moniotte et al., 2001). Thus, it has become important to examine the significance of the β3-AR and its downstream signalling under similar states of stress. It has been shown that β3-AR stimulation is resistant to short term agonist-promoted desensitization in vitro and in vivo (Liggett et al., 1993) and after being activated, this receptor is able to convey continual intracellular signals (Lafontan et al., 1994). Thus, it could be an ideal target for therapeutic intervention, also in ischaemic heart disease. We hypothesized that selective β3-AR stimulation during ischaemia / reperfusion may be cardioprotective, whereas selective inhibition of this receptor may prove useful in the end stages of sustained ischaemia and early reperfusion. Methods: The isolated working rat heart, subjected to 35 min of regional ischaemia (RI) and 60 min reperfusion was used as model. The β3-AR agonist (BRL37344) (1 μM) or antagonist (SR59230A) (0.1 μM) were applied as follows: (i) before 35 min RI (PT), (ii) during the last 10 min of RI (PerT) and /or (iii) at the onset of reperfusion (PostT) and (iv) administration of BRL37344 during the last 10 min of RI BRL37344 (PerT) was followed by SR59230A during first 10 min of reperfusion SR59230A (Post). The contribution of nitric oxide synthase (NOS) in β3-AR was assessed, using the non-specific NOS inhibitor, L-NAME (50 μM). Endpoints were functional recovery and infarct size. In another set of experiments BRL37344 and SR59230A were applied according to the same protocols, but the left ventricle was dissected from the heart and freeze clamped at 10 min reperfusion for Western blot analysis of extracellular signal-regulated kinase (ERK p44/p42), protein kinase B (PKB/Akt), glycogen synthase kinase-3β (GSK-3β), and endothelial nitric oxide synthase (eNOS). Data were analyzed with one or two-way analysis of variance (ANOVA). Results: Administration of the selective β3-AR agonist (BRL37344) (1μM) before 35 min RI (BRL37344 (PT), significantly reduced infarct size when compared to the non-pretreatment group (NPT) (21.43±2.52 vs 43.17±1.20, p < 0.001). BRL37344 had similar effects on infarct size when applied during the last 10 min of regional ischaemia BRL37344 (PerT) (14.94±2.34, vs NPT, p < 0.001) or at the onset of reperfusion BRL37344 (PostT) (19.06±1.81, vs NPT, p < 0.001). When BRL37344 was applied as a (PerT+PostT) strategy, infarct size was once again significantly reduced (20.55±2.01 vs 43.17±1.20, p <0.001). In contrast, administration of the β3-antagonist SR59230A according to the same protocol did not reduce infarct size and values similar to those of untreated hearts (NPT) were obtained. Surprisingly, when BRL37344 was applied during the last 10 min of regional ischaemia followed by the administration of the β3-AR antagonist (SR59230A) at the onset of reperfusion, [BRL37344 (PerT) & SR59230A (PostT)], infarct size was significantly reduced to 20.78±3.02 (p <0.001 vs NPT and SR59230A (PerT + PostT). Involvement of nitric oxide (NO) was shown since the reduction in infarct size elicited by BRL37344 was totally abolished by, L-NAME, when administered in combination with BRL37344 for 10 minutes prior to RI or at the onset of reperfusion for 10 minutes (% infarct size: 41.48±3.18 and 35.75±3.54, p <0.001 vs BRL37344 (PT) and BRL37344 (PostT), respectively. Western blot results show that PKB/Akt is activated by BRL37344 regardless of the time of administration. The intervention BRL37344 (PerT+PostT), exhibited the most significant phosphorylation of PKB/Akt (fold increase: 14.2±3.71, p<0.01 vs NPT and p<0.05 vs BRL37344 (PostT). In addition, BRL37344 (PT), (PerT), (PostT) and [BRL37344 (PerT) +SR59230A (PostT)] showed significant activation of this kinase (2.92±0.22, 5.54±0.43, 4.73±0.47, and 6.60±0.78, respectively). ERKp44/p42 however, was not significantly activated by any of the treatments. Phosphorylation of eNOS and GSK-3β was significant only in the BRL37344 (PerT+PostT) and [BRL37344 (PerT) + SR59230A (PostT)] groups. The activation of eNOS-S-1177 in the BRL37344 (PerT+PostT) group was (2.82±0.46, p<0.01 and 0.05 vs NPT and BRL37344 (PostT), respectively) and in the [BRL37344 (PerT) + SR59230A (PostT)] group was (2.26±0.48, p<0.05 vs NPT). A very significant increased phosphorylation of GSK-3β was seen in the same two groups (68.8±7.73, p<0.001 vs NPT and 25.5±5.42 vs NPT, p<0.05, respectively). Conclusion: β3-AR has potent cardioprotective effects when administered either before, during and after ischaemia during early reperfusion as indicated by the reduction in infarct size as well as activation of PKB, GSK-3β and eNOS. These beneficial effects can be linked to NO production through activation of eNOS. / AFRIKAANSE OPSOMMING: Dit is bekend dat verbygaande aktivering van die β-adrenerge seinpad, met ligande soos isoproterenol, formoterol en dobutamien, die hart teen daaropvolgende lang periodes van iskemie beskerm. Aanvanklik was die fokus op die β1- en β2-adrenerge reseptore (β1-AR, β2-AR); maar onlangs is ook die β3-AR as 'n potensiële teiken in die behandeling van hartsiektes ge-eien. In hartversaking, is dit bekend dat β1- en β2-AR afreguleer word, terwyl β3-ARs, aan die ander kant, opreguleer word (Moniotte et al., 2001). Dit het dus belangrik geword om die belang van die β3-AR en sy stroomaf seinpad onder soortgelyke strestoestande te ondersoek. Dit is bewys dat β3-AR stimulasie teen korttermyn agonis geïnduseerde desensitisering in vitro en in vivo bestand is (Liggett et al., 1993) en wanneer geaktiveer, is hierdie reseptor in staat om intrasellulêre seine voortdurend oor te dra (Granneman, 1995). Dit kan dus ‘n ideale teiken vir terapeutiese intervensie wees, ook in iskemiese hartsiekte. Ons hipotetiseer dat selektiewe β3-AR stimulasie tydens iskemie / reperfusie kardiobeskermende mag wees, terwyl selektiewe inhibisie van hierdie reseptor effektief kan wees in die eindstadia van volgehoue iskemie en vroeë herperfusie. Metodes: Die geïsoleerde werkende rothart, onderwerp aan 35 min van streeksiskemie (SI) en 60 min herperfusie, is as model gebruik. Die β3-AR agonis (BRL37344) (1μM) of antagonis (SR59230A) (0.1 μM), is as volg toegedien: (i) voor 35 min SI (PT), (ii) gedurende die laaste 10 min van SI (PerT) en / of (iii) tydens die aanvang van herperfusie (PostT) en (iv) gedurende die laaste 10 min van SI is BRL toediening BRL37344 (PerT) gevolg deur SR59230A tydens die eerste 10 min van herperfusie SR59230A (Post). Die rol van stikstofoksiedsintase (NOS) in β3-AR is met behulp van die nie-spesifieke NOS inhibitor, L-NAME (50 μM) ondersoek. Eindpunte was funksionele herstel tydens herperfusie en infarktgrootte. In 'n ander reeks eksperimente is BRL37344 en SR59230A volgens dieselfde protokolle toegedien, maar die linker ventrikel is uit die hart gedissekteer na 10 min herperfusie en gevriesklamp vir Western klad analise van ekstrasellulêre-sein gereguleerde kinase (ERK p44/p42), proteïen kinase B (PKB/Akt), glikogeen sintase kinase-3β (GSK-3β), en endoteel stikstofoksied- sintase (eNOS). Data is met een of twee-rigting variansie analise (ANOVA) ontleed. Resultate: Administrasie van die selektiewe β3-AR agonis (BRL37344) (1μM) voor 35 min SI BRL37344 (PT), het die infarktgrootte beduidend verminder vergeleke met die nie-behandelde groep (NPT) (21.43±2.52 vs 43.17±1.20, p<0.001). BRL37344 het ‘n soortgelyke effek op infarktgrootte wanneer dit gedurende die laaste 10 min van streeksiskemie BRL37344 (PerT) (14.94±2.34, vs NPT, p<0.001) of by die aanvang van herperfusie (BRL37344 (PostT) (19.06±1.81, vs NPT, p<0.001) toegedien word. Wanneer BRL37344 as 'n (PerT+PostT) strategie toegedien is, was infarktgrootte weereens beduidend verlaag (20.55±2.01 vs 43.17±1.20, p<0.001). In teenstelling hiermee, het administrasie van die β3-antagonis SR59230A volgens dieselfde protokol, nie infarktgrootte verminder nie en waardes soortgelyk aan dié van onbehandelde harte (NPT) is verkry. Interessant, wanneer BRL37344 gedurende die laaste 10 min van streeksiskemie toegedien is, gevolg deur die administrasie van die β3-AR antagonis (SR59230A) by die aanvang van herperfusie, [BRL37344(PerT) & SR59230A(PostT)], was infarktgrootte aansienlik verminder tot 20.78±3.02 (p<0.001 vs NPT en SR59230A (PerT+PostT). Die betrokkenheid van stikstofoksied (NO) is waargeneem deurdat die vermindering in infarktgrootte ontlok deur BRL37344, heeltemal deur L-NAME opgehef is, wanneer dit in kombinasie met BRL37344 vir 10 minute voor SI of by die aanvang van herperfusie vir 10 minute toegedien is (% infarktgrootte: 41.48±3.18 en 35.75±3.54, p<0.001 vs BRL37344 (PT) en BRL37344 (PostT) onderskeidelik). Western kladresultate toon dat PKB/Akt deur BRL37344 geaktiveer word ongeag die tyd van die administrasie. Die intervensie BRL37344 (PerT+PostT), toon die mees beduidende fosforilering van PKB/Akt (voudige toename: 14.2±3.71, p<0.01 vs NPT en p<0.05 vs BRL37344 (PostT). Daarbenewens het BRL37344 (PT), (PerT), (PostT) en [BRL37344 (PerT) + SR59230A (PostT)] ook beduidende aktivering van hierdie kinase tot gevolg gehad (2.92±0.22, 5.54±0.43, 4.73±0.47 en 6.60±0.78, onderskeidelik). ERKp44/p42 is egter nie deur enige van die behandelings geaktiveer nie. Fosforilering van eNOS en GSK-3β was net beduidend in die BRL37344 (PerT+PostT) en [BRL37344 (PerT) + SR59230A (PostT)] groepe. Die aktivering van eNOS-S-1177 was beduidend in die BRL37344 (PerT+PostT) en [BRL37344 (PerT) + SR59230A (PostT)] groepe. 'n Baie beduidende toename in fosforilering van GSK-3β is in dieselfde twee groepe (68.8±7.73, p<0.001 en 25.5±5.42, p<0.05 vs NPT onderskeidelik) waargeneem. Gevolgtrekking: β3-AR het kragtige kardiobeskermende effekte wanneer dit, hetsy voor, tydens en na iskemie gedurende vroeë herperfusie toegedien word, soos deur die vermindering in infarktgrootte sowel as die aktivering van PKB, GSK-3β en eNOS aangedui is. Hierdie voordelige effekte kan aan NO produksie deur aktivering van eNOS gekoppel word.

Thesis (PhD (Biomedical Sciences. Medical Physiology))--University of Stellenbosch, 2007. / Nitric oxide (NO) is a major signaling molecule in the heart with various biological effects. The putative role of NO as a cardioprotective agent against ischaemiareperfusion injury and in ischaemic preconditioning (IP) has made it one of the fastest growing fields in basic cardiovascular research. However, NO may also be associated with harmful effects, especially when released in excessive amounts. Little is known about the relative contributions to NO-production by the cardiac microvascular endothelial cells (CMECs) and the adjacent cardiomyocytes. Furthermore, the respective roles of endothelial NOS (eNOS) and inducible NOS (iNOS) are not well characterized in these cell types, particularly in hypoxia. In order to gain a better understanding of the role of NO in the hypoxic/ischaemic heart, the aims of this study were to: (1) develop an isolated cardiomyocyte model in which hypoxia and early IP can be induced and the role of NO assessed; (2) measure NOproduction in cardiomyocytes and CMECs under baseline and hypoxic conditions; and (3) evaluate the expression, regulation and activation of eNOS and iNOS in cardiomyocytes and CMECs (baseline and hypoxia) and establish the relationship with NO-production under these conditions. Cardiomyocytes isolated from adult rat hearts and commercially purchased rat CMECs were used as cell models.