MicroRNAs Involved in Intrinsic Apoptotic Pathway during Cisplatin-Induced Nephrotoxicity: Potential Use of Natural Products against DDP-Induced Apoptosis.

Cisplatin (cis-diamminedichloroplatinum (II), DDP) is an antineoplastic agent widely used in the treatment of solid tumors because of its extensive cytotoxic activity. However, the main limiting side effect of DDP use is nephrotoxicity, a rapid deterioration in kidney function due to toxic chemicals. Several studies have shown that epigenetic processes are involved in DDP-induced nephrotoxicity. Noncoding RNAs (ncRNAs), a class of epigenetic processes, are molecules that regulate gene expression under physiological and pathological conditions. MicroRNAs (miRNAs) are the most characterized class of ncRNAs and are engaged in many cellular processes. In this review, we describe how different miRNAs regulate some pathways leading to cell death by apoptosis, specifically the intrinsic apoptosis pathway. Accordingly, many classes of natural products have been tested for their ability to prevent DDP-induced apoptosis. The study of epigenetic regulation for underlying cell death is still being studied, which will allow new strategies for the diagnosis and therapy of this unwanted disease, which is presented as a side effect of antineoplastic treatment.

Microbiota intestinal y modulación del tejido adiposo en la patogénesis de la obesidad / Gut microbiota and modulation of adipose tissue in the pathogenesis of obesity

Las investigaciones realizadas durante el último siglo relacionadas con la descripción de la Microbiota Intestinal (MI) sugieren una relación concreta entre su composición y la salud del huésped. Su desregulación denominada disbiosis intestinal ha sido asociada a distintos tipos de enfermedades gastrointestinales, metabólicas, oncológicas e incluso psiquiátricas. Destacan numerosos reportes que han informado la condición de disbiosis en la obesidad, tanto en modelos animales como humanos de distintos grupos etarios y regiones del mundo. A su vez, la composición del microbioma también ha logrado asociarse a las diferentes comorbilidades de la obesidad, postulando que la MI posee influencia en la disfunción del tejido adiposo (TA), entendiendo que corresponde al principal modulador de la patogénesis de la obesidad. Sin embargo, aún no es posible establecer una explicación mecanicista plausible. Actualmente, la utilización de tecnologías multiómicas, junto con la evaluación de variables fisiológicas, nos podrían proporcionar una mejor comprensión a la incógnita planteada. Frente a esto, el presente trabajo tiene como objetivo revisar los últimos avances en la comprensión de la influencia de la microbiota intestinal en el TA y su contribución a los mecanismos relacionados con la patogénesis de la obesidad. Entre los principales mecanismos identificados, la evidencia reporta nexos fisiológicos entre la composición de la MI y la modulación de inflamación, permeabilidad intestinal y adipogénesis. Las vías implicadas derivan de la influencia de la disbiosis intestinal en el accionar de ácidos grasos de cadena corta, claudinas, macrófagos, oligosacáridos, entre otros. Los mecanismos implicados, principalmente estudiados en modelos animales, deberían ser considerados para su evaluación en próximos estudios longitudinales y experimentales en humanos con el fin de obtener una mayor comprensión sobre la implicancia de cada mecanismo en la patogenia global de la obesidad(AU)

The investigations carried out during the last century related to the description of the Gut Microbiota (GM) suggest a concrete relationship between its composition and the health of the host. Its deregulation called intestinal dysbiosis has been associated with different types of gastrointestinal, metabolic, oncological and even psychiatric diseases. Numerous reports that have described the condition of dysbiosis in obesity stand out, both in animal and human models of different age groups and regions of the world. In turn, the composition of the microbiome has also been associated with the different comorbidities of obesity, postulating that MI has an influence on adipose tissue (AT) dysfunction, understanding that it corresponds to the main modulator of the pathogenesis of obesity. However, it is not yet possible to establish a plausible mechanistic explanation. Currently, the use of multi-omics technologies, together with the evaluation of physiological variables, could provide us with a better understanding of the question raised. In view of this, this review aims to review the latest advances in understanding the influence of the intestinal microbiota on AT and its contribution to the mechanisms related to the pathogenesis of obesity. Among the main mechanisms identified, the evidence reports physiological links between the composition of GM and the modulation of inflammation, intestinal permeability and adipogenesis. The pathways involved derive from the influence of intestinal dysbiosis on the action of short-chain fatty acids, claudins, macrophages, oligosaccharides, among others. The mechanisms involved, mainly studied in animal models, should be considered for evaluation in future longitudinal and experimental studies in humans in order to obtain a better understanding of the implication of each mechanism in the global pathogenesis of obesity(AU)

Personal and household PM2.5 and black carbon exposure measures and respiratory symptoms in 8 low- and middle-income countries.

BACKGROUND: Household air pollution (HAP) from cooking with solid fuels has been associated with adverse respiratory effects, but most studies use surveys of fuel use to define HAP exposure, rather than on actual air pollution exposure measurements. OBJECTIVE: To examine associations between household and personal fine particulate matter (PM2.5) and black carbon (BC) measures and respiratory symptoms. METHODS: As part of the Prospective Urban and Rural Epidemiology Air Pollution study, we analyzed 48-h household and personal PM2.5 and BC measurements for 870 individuals using different cooking fuels from 62 communities in 8 countries (Bangladesh, Chile, China, Colombia, India, Pakistan, Tanzania, and Zimbabwe). Self-reported respiratory symptoms were collected after monitoring. Associations between PM2.5 and BC exposures and respiratory symptoms were examined using logistic regression models, controlling for individual, household, and community covariates. RESULTS: The median (interquartile range) of household and personal PM2.5 was 73.5 (119.1) and 65.3 (91.5) µg/m3, and for household and personal BC was 3.4 (8.3) and 2.5 (4.9) x10-5 m-1, respectively. We observed associations between household PM2.5 and wheeze (OR: 1.25; 95%CI: 1.07, 1.46), cough (OR: 1.22; 95%CI: 1.06, 1.39), and sputum (OR: 1.26; 95%CI: 1.10, 1.44), as well as exposure to household BC and wheeze (OR: 1.20; 95%CI: 1.03, 1.39) and sputum (OR: 1.20; 95%CI: 1.05, 1.36), per IQR increase. We observed associations between personal PM2.5 and wheeze (OR: 1.23; 95%CI: 1.00, 1.50) and sputum (OR: 1.19; 95%CI: 1.00, 1.41). For household PM2.5 and BC, associations were generally stronger for females compared to males. Models using an indicator variable of solid versus clean fuels resulted in larger OR estimates with less precision. CONCLUSIONS: We used measurements of household and personal air pollution for individuals using different cooking fuels and documented strong associations with respiratory symptoms.

Contribution of MicroRNAs in Chemoresistance to Cisplatin in the Top Five Deadliest Cancer: An Updated Review.

Cisplatin (DDP) is a well-known anticancer drug used for the treatment of numerous human cancers in solid organs, including bladder, breast, cervical, head and neck squamous cell, ovarian, among others. Its most important mode of action is the DNA-platinum adducts formation, inducing DNA damage response, silencing or activating several genes to induce apoptosis; these mechanisms result in genetics and epigenetics modifications. The ability of DDP to induce tumor cell death is often challenged by the presence of anti-apoptotic regulators, leading to chemoresistance, wherein many patients who have or will develop DDP-resistance. Cancer cells resist the apoptotic effect of chemotherapy, being a problem that severely restricts the successful results of treatment for many human cancers. In the last 30 years, researchers have discovered there are several types of RNAs, and among the most important are non-coding RNAs (ncRNAs), a class of RNAs that are not involved in protein production, but they are implicated in gene expression regulation, and representing the 98% of the human genome non-translated. Some ncRNAs of great interest are long ncRNAs, circular RNAs, and microRNAs (miRs). Accumulating studies reveal that aberrant miRs expression can affect the development of chemotherapy drug resistance, by modulating the expression of relevant target proteins. Thus, identifying molecular mechanisms underlying chemoresistance development is fundamental for setting strategies to improve the prognosis of patients with different types of cancer. Therefore, this review aimed to identify and summarize miRs that modulate chemoresistance in DDP-resistant in the top five deadliest cancer, both in vitro and in vivo human models.

Dysregulated MicroRNAs as Biomarkers or Therapeutic Targets in Cisplatin-Induced Nephrotoxicity: A Systematic Review.

The purpose of this systematic review was to map out and summarize scientific evidence on dysregulated microRNAs (miRNAs) that can be possible biomarkers or therapeutic targets for cisplatin nephrotoxicity and have already been tested in humans, animals, or cells. In addition, an in silico analysis of the two miRNAs found to be dysregulated in the majority of studies was performed. A literature search was performed using eight databases for studies published up to 4 July 2021. Two independent reviewers selected the studies and extracted the data; disagreements were resolved by a third and fourth reviewers. A total of 1002 records were identified, of which 30 met the eligibility criteria. All studies were published in English and reported between 2010 and 2021. The main findings were as follows: (a) miR-34a and miR-21 were the main miRNAs identified by the studies as possible biomarkers and therapeutic targets of cisplatin nephrotoxicity; (b) the in silico analysis revealed 124 and 131 different strongly validated targets for miR-34a and miR-21, respectively; and (c) studies in humans remain scarce.

Epigenetic Mechanisms Involved in Cisplatin-Induced Nephrotoxicity: An Update.

Cisplatin is an antineoplastic drug used for the treatment of many solid tumors. Among its various side effects, nephrotoxicity is the most detrimental. In recent years, epigenetic regulation has emerged as a modulatory mechanism of cisplatin-induced nephrotoxicity, involving non-coding RNAs, DNA methylation and histone modifications. These epigenetic marks alter different signaling pathways leading to damage and cell death. In this review, we describe how different epigenetic modifications alter different pathways leading to cell death by apoptosis, autophagy, necroptosis, among others. The study of epigenetic regulation is still under development, and much research remains to fully determine the epigenetic mechanisms underlying cell death, which will allow leading new strategies for the diagnosis and therapy of this disease.

Protective effect of Pinot noir pomace extract against the cytotoxicity induced by polycyclic aromatic hydrocarbons on endothelial cells.

Polycyclic Aromatic Hydrocarbons (PAHs) are pollutants found in the air generated mainly by the combustion of coal or biomass burning. Exposure to Polycyclic Aromatic Hydrocarbons is positively correlated with cardiovascular diseases. Phenolic compounds are widely found in the plant kingdom, and their availability from agri-food processing waste has led to an increased interest in their recovery. The production of large amounts of organic waste created by the wine industry has emphasized the valuation of these wastes to generate high-added-value by-products. The objective of this work was to investigate the protective effect of Pinot noir pomace extract on human endothelial cells against PAHs found in the polluted air of Temuco, Chile. The pomace extract was characterized by spectrophotometric analysis and high-performance liquid chromatography (HPLC). Results revealed the presence of 5 glycosylated anthocyanins and 9 low molecular weight polyphenols. Molecular docking indicated that cyanidin-3-glucoside (-9.2 kcal/mol) and quercetin (-9.6 kcal/mol) had the highest affinities for the Nrf2 binding site in the Keap1 protein, suggesting a possible competition with this transcription factor. Endothelial cells from the human umbilical vein were exposed to increasing concentrations of Phenanthrene, Fluoranthene, and Pyrene diluted in DMSO in a ratio of 3:1:1 (10 µM-200 µM). Viability through the MTS assay showed that 150 µM of PAHs was sufficient to reduce viability by 75% (p ˂ 0.0001). When the cells were pre-treated with 400 µg/ml of the extract, 150 µM of PAHs did not exert cell death (80% viability). Our preliminary results show that polyphenolic components found in Pinot noir pomace might have a beneficial effect as a protective agent.

Evaluation of the chemopreventive potentials of ezetimibe and aspirin in a novel mouse model of gallbladder preneoplasia.

Gallbladder stones (cholecystolithiasis) are the main risk factor for gallbladder cancer (GBC), a lethal biliary malignancy with poor survival rates worldwide. Gallbladder stones are thought to damage the gallbladder epithelium and trigger chronic inflammation. Preneoplastic lesions that arise in such an inflammatory microenvironment can eventually develop into invasive carcinoma, through mechanisms that are not fully understood. Here, we developed a novel gallbladder preneoplasia mouse model through the administration of two lithogenic diets (a low- or a high-cholesterol diet) in wild-type C57BL/6 mice over a period of 9 months. Additionally, we evaluated the chemopreventive potentials of the anti-inflammatory drug aspirin and the cholesterol absorption inhibitor ezetimibe. Both lithogenic diets induced early formation of gallbladder stones, together with extensive inflammatory changes and widespread induction of metaplasia, an epithelial adaptation to tissue injury. Dysplastic lesions were presented only in mice fed with high-cholesterol diet (62.5%) in late stages (9th month), and no invasive carcinoma was observed at any stage. The cholesterol absorption inhibitor ezetimibe inhibited gallbladder stone formation and completely prevented the onset of metaplasia and dysplasia in both lithogenic diets, whereas aspirin partially reduced metaplasia development only in the low-cholesterol diet setting. This model recapitulates several of the structural and inflammatory findings observed in human cholecystolithiasic gallbladders, making it relevant for the study of gallbladder carcinogenesis. In addition, our results suggest that the use of cholesterol absorption inhibitors and anti-inflammatory drugs can be evaluated as chemopreventive strategies to reduce the burden of GBC among high-risk populations.

Prodigiosin Modulates the Immune Response and Could Promote a Stable Atherosclerotic Lession in C57bl/6 Ldlr-/- Mice.

Atherosclerosis is a chronic inflammatory disease, whose progression and stability are modulated, among other factors, by an innate and adaptive immune response. Prodiginines are bacterial secondary metabolites with antiproliferative and immunomodulatory activities; however, their effect on the progression or vulnerability of atheromatous plaque has not been evaluated. This study assessed the therapeutic potential of prodigiosin and undecylprodigiosin on inflammatory marker expression and atherosclerosis. An in vitro and in vivo study was carried out. Migration, low-density lipoprotein (LDL) uptake and angiogenesis assays were performed on cell types involved in the pathophysiology of atherosclerosis. In addition, male LDL receptor null (Ldlr-/-) C57BL/6J mice were treated with prodigiosin or undecylprodigiosin for 28 days. Morphometric analysis of atherosclerotic plaques, gene expression of atherogenic factors in the aortic sinus and serum cytokine quantification were performed. The treatments applied had slight effects on the in vitro tests performed, highlighting the inhibitory effect on the migration of SMCs (smooth muscle cells). On the other hand, although no significant difference in atherosclerotic plaque progression was observed, gene expression of IL-4 and chemokine (C-C motif) ligand 2 (Ccl2) was downregulated. In addition, 50 µg/Kg/day of both treatments was sufficient to inhibit circulating tumor necrosis factor alpha (TNF-α), interleukin-2 (IL-2) and interferon-gamma (IFN-γ) in serum. These results suggested that prodigiosin and undecylprodigiosin modulated inflammatory markers and could have an impact in reducing atherosclerotic plaque vulnerability.

Propolis Reduces the Expression of Autophagy-Related Proteins in Chondrocytes under Interleukin-1ß Stimulus.

BACKGROUND: Osteoarthritis (OA) is a progressive and multifactorial disease that is associated with aging. A number of changes occur in aged cartilage, such as increased oxidative stress, decreased markers of healthy cartilage, and alterations in the autophagy pathway. Propolis extracts contain a mixture of polyphenols and it has been proved that they have high antioxidant capacity and could regulate the autophagic pathway. Our objective was to evaluate the effect of ethanolic extract of propolis (EEP) on chondrocytes that were stimulated with IL-1ß. METHODS: Rabbit chondrocytes were isolated and stimulated with IL-1ß and treated with EEP. We evaluated cell viability, nitric oxide production, healthy cartilage, and OA markers, and the expression of three proteins associated with the autophagy pathway LC3, ATG5, and AKT1. RESULTS: The EEP treatment reduces the expression of LC3, ATG5, and AKT1, reduces the production of nitric oxide, increases the expression of healthy markers, and reduces OA markers. CONCLUSIONS: These results suggest that treatment with EEP in chondrocytes that were stimulated with IL-1ß has beneficial effects, such as a decrease in the expression of proteins associated with autophagy, MMP13, and production of nitric oxide, and also increased collagen II.

Confiabilidad en la medición de la presión inspiratoria máxima y de la capacidad inspiratoria de un fisioterapeuta en entrenamiento / Confiabilidade na mensuração da pressão inspiratória máxima e da capacidade inspiratória de um fisioterapeuta em treinamento / Reliability in the measurement of maximum inspiratory pressure and inspiratory capacity of a physiotherapist in training

RESUMEN Este estudio pretende explorar el impacto de la experiencia clínica en la fiabilidad y consistencia de la medición de la presión inspiratoria máxima (PIM) y la capacidad inspiratoria (CI) durante el período de la entrenamiento clínico. Los 37 participantes fueron evaluados por un fisioterapeuta especializado (FE) y un fisioterapeuta novato (FN), por medio de un pletismógrafo corporal. Se utilizó el coeficiente de correlación intraclase (ICC, en inglés) para analizar la fiabilidad de las pruebas PIM y CI, mientas que para explorar las diferencias individuales se utilizaron los gráficos de Bland-Altman (gB/A). El análisis ICC en tres estudios clínicos demostró excelente fiabilidad interevaluadores (ICC 1°: 0,914; ICC 2°: 0,915; ICC 3°: 0,925) para la prueba PIM y (ICC 1 °: 0,955; ICC 2°: 0,965; ICC 3°: 0,970) para la prueba CI. Sin embargo, la correlación según gB/A entre los evaluadores reveló una tendencia sistemática con resultados absolutos más elevados para FE de 9,2 cmH2O en PIM y 0,06 L en CI, respectivamente. Los resultados demostraron que el FN tuvo habilidades técnicas y de discernimiento fiables en la prueba PIM y CI, pero los pacientes suelen mejorar el rendimiento con un evaluador experimentado. La experiencia del evaluador influye en los resultados obtenidos de la medición de PIM en los pacientes, la formación de un FN requiere la incorporación de más habilidades para que se reconozca su verdadero esfuerzo.

RESUMO O objetivo deste estudo foi explorar o impacto da experiência clínica na confiabilidade e concordância da medição da pressão inspiratória máxima (PIM) e da capacidade inspiratória (CI) em um período de treinamento clínico. Por conveniência, 37 participantes foram avaliados em um pletismógrafo corporal por um fisioterapeuta especializado (FE) e um fisioterapeuta novato (FN). O Coeficiente de Correlação Intraclasse (CCI) foi utilizado para analisar a confiabilidade dos testes PIM e CI; enquanto para explorar as diferenças individuais foram usados os gráficos de Bland-Altman (gB/A). A análise CCI em três ensaios mostrou excelente confiabilidade inter-avaliadores (CCI 1°: 0,914; CCI 2°: 0,915; CCI 3°: 0,925) para o teste PIM e (CCI 1°: 0,955; CCI 2°: 0,965; CCI 3°: 0,970) para o teste de CI. No entanto, a concordância de acordo com gB/A entre os avaliadores, mostrou uma tendência sistemática com resultados absolutos mais altos para FE de 9,2 cmH2O em PIM e 0,06 L em CI, respectivamente. Os resultados sugerem que a FN adquiriu habilidades técnicas e discriminativas confiáveis para o teste PIM e CI, mas os pacientes tendem a melhorar o desempenho com um avaliador experiente. A experiência do avaliador influencia os resultados obtidos a partir da medição do PIM nos sujeitos, a formação de um FN exige a incorporação de mais habilidades para reconhecer um verdadeiro esforço.

ABSTRACT The objective of this study was to explore the impact of clinical experience on the reliability and concordance of maximal inspiratory pressure (MIP) and inspiratory capacity (IC) measurements in a period of clinical training. For convenience, 37 participants in a body plethysmograph were evaluated by an experienced physiotherapist (EF) and a novice physiotherapist (NF). Intra-Class Correlation Coefficient (ICC) was used to analyze the reliability of the MIP and IC tests; to explore the individual differences, the Bland-Altman (gB/A) graphs were used. ICC analysis in three trials showed excellent inter-rater reliability (ICC 1st: 0.914; ICC 2nd: 0.915; ICC 3rd: 0.925) for the MIP test and (ICC 1st: 0.955; ICC 2nd: 0.965; ICC 3rd: 0.970) for the IC test. However, concordance according to gB/A among the evaluators showed a systematic trend with higher absolute scores for EF of 9.2 cmH2O in MIP, and of 0.06 L in IC, respectively. The results suggest that NF acquired reliable technical and discriminative skills for the MIP and IC test, but patients tended to improve performance with an experienced assessor. The evaluator's experience influences the results obtained from the measurement of the MIP in the subjects; the formation of a NF requires incorporating more skills to recognize a sincere and maximum effort.

Association of polymorphisms within the Renin-Angiotensin System with metabolic syndrome in a cohort of Chilean subjects

ABSTRACT Objective Metabolic syndrome (MetS) is associated with hypertension, obesity and dyslipidemia. Thus, genetic variants related with these conditions may modulate its development. We evaluated the effect of polymorphisms in the renin-angiotensin system (RAS) on metabolic syndrome risk in a cohort of Chilean subjects. Subjects and methods A total of 152 subjects, 83 with MetS (51.2 ± 9.6 years) and 69 without MetS (49.5 ± 9.3 years) of both genders were included, according to the ATP III update criteria. The rs4340 Insertion/Deletion (I/D), rs699 (T>C) and rs5186 (A>C) of the ACE, AGT and AGTR1 genes, respectively, were genotyped. Results After adjusting for age and gender, we observed the DD genotype of rs4340 associated with MetS (p = 0.02). Specifically, the DD genotype was associated with MetS risk in women (OR = 4.62, 95%CI, 1.41 – 15.04; p < 0.01). In males, the AA genotype for rs5186 variant was associated with an increased risk for developing MetS when compared with women carrying the same genotype (OR = 3.2; 95%CI, 1.03 – 9.89; p = 0.04). In subjects without MetS, DD genotype was associated with increased waist circumference (p = 0.023) while subjects with MetS carrying the rs5186 TT genotype showed higher levels of HDL-cholesterol (p = 0.031). Conclusion The present study contributes data highlighting the role for RAS polymorphisms in predisposing to metabolic syndrome in Chilean subjects.

Polyphenols from Chilean Propolis and Pinocembrin Reduce MMP-9 Gene Expression and Activity in Activated Macrophages.

Polyphenols from diverse sources have shown anti-inflammatory activity. In the context of atherosclerosis, macrophages play important roles including matrix metalloproteinases synthesis involved in degradation of matrix extracellular components affecting the atherosclerotic plaque stability. We prepared a propolis extract and pinocembrin in ethanol solution. Propolis extract was chemically characterized using LC-MS. The effect of treatments on gene expression and proteolytic activity was measured in vitro using murine macrophages activated with LPS. Cellular toxicity associated with both treatments and the vehicle was determined using MTT and apoptosis/necrosis detection assays. MMP-9 gene expression and proteolytic activity were measured using qPCR and zymography, respectively. Thirty-two compounds were identified in the propolis extract, including pinocembrin among its major components. Treatment with either ethanolic extract of propolis or pinocembrin inhibits MMP-9 gene expression in a dose-dependent manner. Similarly, an inhibitory effect was observed in proteolytic activity. However, the effect showed by ethanolic extract of propolis was higher than the effect of pinocembrin, suggesting that MMP-9 inhibition results from a joint contribution between the components of the extract. These data suggest a potential role of polyphenols from Chilean propolis in the control of extracellular matrix degradation in atherosclerotic plaques.

Polyphenol-Rich Extract from Propolis Reduces the Expression and Activity of Streptococcus mutans Glucosyltransferases at Subinhibitory Concentrations.

Tooth decay is an infectious disease, whose main causative agent identified is Streptococcus mutans (S. mutans). Diverse treatments have been used to eradicate this microorganism, including propolis. To date, it has been shown that polyphenols from Chilean propolis inhibit S. mutans growth and biofilm formation. However, the molecular mechanisms underlying this process are unclear. In the present study, we assessed the effect of Chilean propolis on the expression and activity of the glycosyltransferases enzymes and their related genes. Polyphenol-rich extract from propolis inhibited gene expression of glycosyltransferases (GtfB, GtfC, and GtfD) and their related regulatory genes, for example, VicK, VicR, and CcpA. Moreover, the treatment inhibited glucosyltransferases activity measured by the formation of sucrose-derived glucans. Additionally, an inhibitory effect was observed in the expression of SpaP involved in sucrose-independent virulence of S. mutans. In summary, our results suggest that Chilean propolis has a dose-dependent effect on the inhibition of genes involved in S. mutans virulence and adherence through the inhibition of glucosyltransferases, showing an anticariogenic potential of polyphenols from propolis beyond S. mutans growth inhibition.

Asociación de polimorfismos del gen factor de necrosis tumoral (TNF) con el desarrollo de reestenosis de stent post angioplastía coronaria / Polymorphisms of tumor necrosis factor gen: are they associated to stent restenosis after coronary angioplasty?

Introducción: La intervención coronaria percutánea (PCI en inglés) con implante de stent coronario es uno de los procedimientos más utilizados para la revascularización miocárdica en condiciones agudas o crónicas. Múltiples factores se han relacionado con la restenosis de stent, incluyendo aspectos clínicos, angiográficos, genéticos y epigenéticos. La respuesta inflamatoria en gran parte está determinada genéticamente y probablemente sea el rol más importante en la restenosis. El factor de necrosis tumoral a (TNF-α;) es un mediador clave en la respuesta inflamatoria actuando en sitios de injuria tisular inducida por el daño de las paredes del vaso. Objetivo: Determinar la asociación entre polimorfismos genéticos del TNF y restenosis en pacientes coronarios sometidos a angioplastía. Métodos: Se diseñó un estudio de casos y controles incidentes no pareados, aprobado por el comité de ética institucional. Se incluyeron pacientes con cardiopatía coronaria sometidos a PCI con implante de stent BMS o DES, con un tiempo de control angiográfico mayor de 6 meses. Los casos fueron definidos como aquellos pacientes con estenosis de stent >50% y como controles aquellos con estenosis <50%, con respecto del lumen del vaso de referencia. Se efectuó la genotipificación de los polimorfismos rs361525 (-238G/A) y rs1799964 (-1031 T/C) del gen TNF mediante PCR en tiempo real mediante sondas alelo-específicas. Además, se registraron variables clínicas y demográficas. Resultados: Se incluyó en este estudio de análisis de genotipificación del polimorfismo del gen TNF 82 pacientes como casos, y 102 controles. No hubo diferencias significativas en las siguientes variables clínicas y demográficas: edad (63.7 ± 10.5 vs. 65.4 ± 9.6 años; p=0.24), género masculino (75 vs. 69%, p=0.5), IMC (28.5 ± 3.6 vs. 28 ± 3.8 Kg/m2; p=0.78) y tabaquismo (79 vs. 77%; p=0.7). En contraste, se observó una diferencia significativa en la frecuencia de DM-2 casos y controles (43.2 vs. 26.5%; p=0.03) y %HbA1c entre ambos grupos (6.78 ± 1.5 vs. 6.1 ± 0.8%; p=0.01). Respecto a las variantes genéticas estudiadas, no hubo diferencias significativas en la frecuencia relativa del alelo mutado tanto para el polimorfismo rs361525 (Alelo A, casos: 0.06 vs. controles: 0.08; p=0.37), como para la variante rs1799964 (Alelo C, casos: 0.2 vs. controles: 0.2; p=0.96). Las OR asociadas a dichos alelos fueron 0.68 (I.C. 95%= 0.29 - 1.59) y 0.99 (I.C. 95%= 0.58 - 1.67), respectivamente; confirmando la ausencia de asociación. Conclusión: Nuestros datos sugieren que las variantes genéticas estudiadas no están relacionadas al desarrollo de restenosis en los sujetos estudiados, y probablemente en nuestra población los factores clínicos sean más determinantes para el desarrollo de reestenosis coronaria post angioplastía que los factores genéticos.

Multiple factors have been associated to the development of stent restenosis after coronary angioplasty (PCA). including clinical, angiographic, genetic and epigenetic factors. The inflammatory response is genetically determined and it may be the most important factor. Tumor necrosis factor a (TNFα) is a potent mediator of this response at the endothelial wall. Aim: To determine the association between TNFα; genetic polymorphisms and stent restenosis. Methods: A case-control study was performed in patients submitted to PTCA with stent implantation(-bare metal or drug eluting stent) at least 6 months prior to the study. Cases were defined by the presence of >50% intra stent stenosis. PCR was used for type classification of polymorphisms rs361525 (-238G/A) y rs1799964 (-1031 T/C) of the TNFα; gene. Results: 82 cases and 102 controls were included. No differences were observed in clinical and demographic variables: age (63.7 ± 10.5 vs. 65.4 ± 9.6 years, p=0.24, for cases and controls, respectively), male gender (75 vs. 69%, p=0.5), BMI (28.5 ± 3.6 vs. 28 ± 3.8 Kg/m2, p=0.78) and active smoking (79 vs. 77%, p=0.7). In contrast, Diabetes was more frequent in cases than in controls (43.2 vs. 26.5%, p=0.03). There was no difference in the relative frequency of mutations of the rs361525 polymorphism (Allele A, 0.06 vs 0.08, p=0.37 for cases and controls, respectively) nor for variant rs1799964 (0.2 in both cases and controls). Non significant associations were confirmed by Odd ratios with 0 included in the 95% confidence interval. Conclusion: No association of genetic polymorphisms of TNFa and stent restenosis was found, which suggests that clinical factors my be more important for the development of post PTCA stent restenosis.

ERK1/2 and HIF1α Are Involved in Antiangiogenic Effect of Polyphenols-Enriched Fraction from Chilean Propolis.

Propolis has been shown to modulate the angiogenesis in both in vitro and in vivo models. Thus, we aimed to evaluate the antiangiogenic properties of an ethanolic extract of Chilean propolis (EEP) and Pinocembrin (Pn). Migration, formation of capillary-like structures of endothelial cells, and sprouting from rat aortic rings were used to assess the antiangiogenic properties of EEP or Pn. In addition, microRNAs and VEGFA mRNA expression were studied by qPCR. ERK1/2 phosphorylation and HIF1α stabilization were assessed by western blot. EEP or Pn attenuated the migration, the capillary-like tube formation, and the sprouting in the in vitro assays. In addition, the activation of HIF1α and ERK1/2 and the VEGFA mRNA expression was significantly inhibited in a dose-dependent manner. In summary, these results suggest that HIF1α and ERK1/2 phosphorylation could be involved in the antiangiogenic effect of Chilean propolis, but more studies are needed to corroborate these findings.

SLCO1B1 c.388A>G Polymorphism Is Associated with HDL-C Levels in Response to Atorvastatin in Chilean Individuals.

The use of statins as the preferred lipid-lowering therapy has clearly demonstrated its efficacy in the treatment of hypercholesterolemia, reducing also the risk of coronary events and cardiovascular disease mortality. In this study, we assessed single nucleotide polymorphisms (SNPs) in the SLCO1B1 gene and their effect on atorvastatin response. We included 129 Chilean hypercholesterolemic patients undergoing 10 mg/day of atorvastatin therapy during 4 weeks. Lipid profile was determined before and after drug administration. Genotyping of SLCO1B1 rs4149056 (c.521T>C) SNP was performed with allele-specific polymerase chain reaction, whilst polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for genotyping the SLCO1B1 rs2306283 (c.388A>G) variant. After statin therapy, concentrations of TC, LDL-C and TG had a decrease from baseline (p < 0.05). Also, HDL-C levels increased (p < 0.05). Minor allele frequencies for the rs2306283 and rs4149056 variants were 0.547 and 0.136, respectively. LDL-C response to atorvastatin was not associated with the SLCO1B1 rs4149056 nor the rs2306283 polymorphisms (p > 0.05). However, the latter SNP was associated with HDL-C variability after atorvastatin medication (p = 0.02). This study indicates that LDL-C reduction following atorvastatin therapy is not influenced by the SNPs evaluated. In addition, the polymorphism rs2306283 at the SLCO1B1 gene determines greater HDL-C concentrations in response to atorvastatin medication in Chilean hypercholesterolemic subjects.

Antibiofilm Activity of Chilean Propolis on Streptococcus mutans Is Influenced by the Year of Collection.

The chemical composition of propolis varies according to factors that could have an influence on its biological properties. Polyphenols from propolis have demonstrated an inhibitory effect on Streptococcus mutans growth. However, it is not known if different years of propolis collection may affect its activity. We aimed to elucidate if the year of collection of propolis influences its activity on Streptococcus mutans. Polyphenol-rich extracts were prepared from propolis collected in three different years, characterized by LC-MS and quantified the content of total polyphenols and flavonoids groups. Finally, was evaluated the antibacterial effect on Streptococcus mutans and the biofilm formation. Qualitative differences were observed in total polyphenols, flavones, and flavonols and the chemical composition between the extracts, affecting the strength of inhibition of biofilm formation but not the antimicrobial assays. In conclusion, chemical composition of propolis depends on the year of collection and influences the strength of the inhibition of biofilm formation.

Frequency and specificity of red blood cell alloimmunization in chilean transfused patients.

BACKGROUND: Alloimmunization is an adverse effect of blood transfusions. In Chile, alloimmunization frequency is not established, and for this reason the aim of this study was to investigate the prevalence and specificity of red blood cell (RBC) alloantibodies in Chilean transfused subjects. METHODS: Records from 4,716 multi-transfused patients were analyzed. In these patients, antibody screening was carried out prior to cross-matching with a commercially available two-cell panel by the microcolum gel test, and samples with a positive screen were analyzed for the specificity of the alloantibody with a 16-cell identification panel. RESULTS: The incidence of RBC alloimmunization in transfused patients was 1.02% (48/4,716) with a higher prevalence in women (40/48). We detected 52 antibodies, the most frequent specificities identified were anti-E (30.8%), anti-K (26.9%), anti-D (7.7%), and anti-Fy(a) (5.8%). The highest incidence of alloantibodies was observed in cancer and gastroenterology patients. CONCLUSION: The data demonstrated a low alloimmunization frequency in Chilean transfused patients, principally associated with antibodies anti-E, anti-K, anti-D, and anti-Fy(a).

Identification of microRNAs involved in the modulation of pro-angiogenic factors in atherosclerosis by a polyphenol-rich extract from propolis.

New vessel formation plays a critical role in the progression and vulnerability of atherosclerotic lesions. It has been shown that polyphenols from propolis attenuate the progression of atherosclerosis and also exert inhibitory effects on angiogenic factors. However, the mechanisms underlying these effects are not completely understood. Thus, this study aimed to identify microRNAs (miRNAs) involved in the modulation of pro-angiogenic factors in the atherosclerotic plaques of LDL receptor gene knockout mice treated with a polyphenol-rich extract of Chilean propolis. The progression of the atherosclerotic lesions was significantly attenuated in treated mice compared with control mice. Using microarray analysis and a bioinformatic approach, we identified 29 differentially expressed miRNAs. Many of these miRNAs were involved in biological processes associated with angiogenesis, such as the cell cycle, cell migration, cell growth and proliferation. Among them, three miRNAs (miR-181a, miR-106a and miR-20b) were over-expressed and inversely related to the expression of Vegfa (vascular endothelial growth factor A) and Hif1a (hypoxia inducible factor 1 alpha). In addition, VEGF-A protein expression was attenuated in histological sections obtained from the aortic sinuses of treated mice. VEGFA is a key pro-angiogenic factor in atherosclerotic plaques, and Hif1a, which is expressed in the necrotic nucleus of the atheroma, is its main inducer. We found a correlation between the over-expression of miR-181a, miR-106a and miR-20b and their target genes, Hif1a and Vegfa, which is consistent with attenuation of the atherosclerotic lesion. In conclusion, our data analysis provides evidence that the anti-angiogenic effects of polyphenols from Chilean propolis can be modulated by miRNAs, in particular miR-181a, miR-106a and miR-20b.