RESUMO
BACKGROUND: The true burden of Lyme disease in primary care in Scotland is unknown. Epidemiological data are currently based on laboratory-confirmed reports as there is no mandatory reporting of clinical cases. AIM: To analyse data from general practice in NHS Highland (North) over a 6-year period to assess the incidence and management of Lyme disease in primary care. DESIGN & SETTING: This was a retrospective descriptive study. Study data from 2017 to 2022 were extracted from all 63 general practices within NHS Highland (North). METHOD: Consultations for Lyme disease were identified via Lyme-related clinical Read codes, requests for borrelia tests , free text, 'tags' and/or Lyme disease antibiotic scripts. RESULTS: Using Read codes to identify patients with Lyme disease or suspected Lyme disease gave an estimated average annual incidence of 124/100 000 population, which was 2.1 times more than estimates based solely on laboratory-confirmed reports. The incidence figures increased 5.2 times (362/100 000 population) when patients with Lyme disease or suspected Lyme disease (identified via Read codes, laboratory test requests, and free text tags) who were given antibiotic treatment were taken into account. Local 'hot spots' of infection were identified. Analysis of the antibiotic data indicates that antibiotic prescribing in NHS Highland largely follows the National Institute for Health and Care Excellence (NICE) guidelines. CONCLUSION: This data analysis pathway can, and should, be rolled out across the whole of Scotland to assess the incidence and management of Lyme disease in primary care and allow appropriate allocation of resources.
RESUMO
Alterations in lipid metabolism have been progressively documented as a characteristic property of cancer cells. Though, human ABHD2 gene was found to be highly expressed in breast and lung cancers, its biochemical functionality is yet uncharacterized. In the present study we report, human ABHD2 as triacylglycerol (TAG) lipase along with ester hydrolysing capacity. Sequence analysis of ABHD2 revealed the presence of conserved motifs G(205)XS(207)XG(209) and H(120)XXXXD(125) Phylogenetic analysis showed homology to known lipases, Drosophila melanogaster CG3488. To evaluate the biochemical role, recombinant ABHD2 was expressed in Saccharomyces cerevisiae using pYES2/CT vector and His-tag purified protein showed TAG lipase activity. Ester hydrolase activity was confirmed with pNP acetate, butyrate and palmitate substrates respectively. Further, the ABHD2 homology model was built and the modelled protein was analysed based on the RMSD and root mean square fluctuation (RMSF) of the 100 ns simulation trajectory. Docking the acetate, butyrate and palmitate ligands with the model confirmed covalent binding of ligands with the Ser(207) of the GXSXG motif. The model was validated with a mutant ABHD2 developed with alanine in place of Ser(207) and the docking studies revealed loss of interaction between selected ligands and the mutant protein active site. Based on the above results, human ABHD2 was identified as a novel TAG lipase and ester hydrolase.