Cerebral involvement in sitosterolemia.

BACKGROUND: Sitosterolemia, an autosomal recessive condition, is characterized by impaired metabolism of plant sterols. Clinical symptoms include skin xanthoma, premature atherosclerotic disease, arthritis, and unexplained hematological abnormalities. However, there is a dearth of studies on sitosterolemia-related brain damage. METHODS: This study focused on the family of two sitosterolemia patients who presented with severe hypercholesterolemia and xanthoma. Radiological examinations, biopsies, whole-exome sequencing (WES), and plant sterol tests were conducted. RESULTS: The index patient, a 66-year-old female, initially exhibited weakness in both lower limbs and later developed urinary and fecal incontinence. Neuroimaging showed that the falx of the brain had irregular fusiform thickening. Significant tissue edema was observed around the lesions in the bilateral frontal-parietal lobes. Pathological analysis of the biopsied brain lesion revealed extensive cholesterol crystal deposition and lymphocyte infiltration in the matrix. The index patient who experienced cerebral impairment and her sister both carried two compound heterozygous variants in ATP binding cassette transporter G5 (ABCG5). These included the nonsense variants NM_022436: c.751 C > T (p.Q251X) in exon 6 and NM_022436: c.1336 C > T (p.R446X) in exon 10. A notable increase in plant sterol levels was observed in the younger sister of the index patient. CONCLUSION: This study highlights a previously unreported neurological aspect of sitosterolemia. Imaging and pathology findings suggest that cholesterol crystals may be deposited in connective tissues such as the cerebral falx and pia mater through blood circulation.

Development of a PCSK9-targeted nanoparticle vaccine to effectively decrease the hypercholesterolemia.

Proprotein convertase subtilisin/kexin type 9 (PCSK9) binds to the low-density lipoprotein receptor (LDLR) and mediates its internalization and degradation, resulting in an increase in LDL cholesterol levels. Recently, PCSK9 emerged as a therapeutic target for hypercholesterolemia and atherosclerosis. In this study, we develop a PCSK9 nanoparticle (NP) vaccine by covalently conjugating the catalytic domain (aa 153-aa 454, D374Y) of PCSK9 to self-assembled 24-mer ferritin NPs. We demonstrate that the PCSK9 NP vaccine effectively induces interfering antibodies against PCSK9 and reduces serum lipids levels in both a high-fat diet-induced hypercholesterolemia model and an adeno-associated virus-hPCSK9D374Y-induced hypercholesterolemia model. Additionally, the vaccine significantly reduces plaque lesion areas in the aorta and macrophages infiltration in an atherosclerosis mouse model. Furthermore, we discover that the vaccine's efficacy relied on T follicular help cells and LDLR. Overall, these findings suggest that the PCSK9 NP vaccine holds promise as an effective treatment for hypercholesterolemia and atherosclerosis.

27-Hydroxycholesterol inhibits trophoblast fusion during placenta development by activating PI3K/AKT/mTOR signaling pathway.

Trophoblast cell syncytialization is essential for placental and fetal development. Abnormal trophoblast cell fusion leads to pregnancy pathologies, such as preeclampsia (PE), intrauterine growth restriction (IUGR), and miscarriage. 27-hydroxycholesterol (27-OHC) is the most abundant oxysterol in human peripheral blood synthesized by sterol 27-hydroxylase (CYP27A1) and is considered a critical mediator between hypercholesterolemia and a variety of related disorders. Gestational hypercholesterolemia was associated with spontaneous preterm delivery and low birth weight (LBW) in term infants, yet the mechanism is unclear. In this study, two trophoblast cell models and CD-1 mice were used to evaluate the effects of 27-OHC on trophoblast fusion during placenta development. Two different kinds of trophoblast cells received a dosage of 2.5, 5, or 10 uM 27-OHC. Three groups of pregnant mice were randomly assigned: control, full treatment (E0.5-E17.5), or late treatment (E13.5-E17.5). All mice received daily intraperitoneal injections of saline (control group) and 27-OHC (treatment group; 5.5 mg/kg). In vitro experiments, we found that 27-OHC inhibited trophoblast cell fusion in primary human trophoblasts (PHT) and forskolin (FSK)-induced BeWo cells. 27-OHC up-regulated the expression of the PI3K/AKT/mTOR signaling pathway-related proteins. Moreover, the PI3K inhibitor LY294002 rescued the inhibitory effect of 27-OHC. Inhibition of trophoblast cell fusion by 27-OHC was also observed in CD-1 mice. Furthermore, fetal weight and placental efficiency decreased and fetal blood vessel development was inhibited in pregnant mice treated with 27-OHC. This study was the first to prove that 27-OHC inhibits trophoblast cell fusion by Activating PI3K/AKT/mTOR signaling pathway. This study reveals a novel mechanism by which dyslipidemia during pregnancy results in adverse pregnancy outcomes.

Avaliação dos fatores que caracterizam a berinjela (Solanum melongena L. ) como um alimento funcional / Evaluation factors featuring eggplant (Solanum melongena L. ) as a functional food

Currently, the role of healthy food is to optimize the nutrition of individuals, providing not only increased health and well-being, but also reduced risks of developing diseases caused by poor diets. Functional foods contain substances with different biological functions, called bioactive compounds, which can modulate the physiology of the body, ensuring the maintenance of health. Eggplant (Solanum melongena L.) has been cited by several authors as one of the vegetables that can be classified as functional food. The lay population has used eggplant in different ways, without criteria and evidence from studies with different objectives. Among its main uses, the treatment and/or prevention of dyslipidemia and as adjuvant in weight loss can be highlighted. This work aims to study and analyze the most recent publications in order to justify the characterization of eggplant (Solanum melongena L.) as a functional food. To this end, a literature review of articles was conducted in the Scielo, Medline, Pubmed, Bireme, and Lilacs databases, as well as in books and journals from 1992 to 2012. The selection of bibliographic reference sought to select studies that investigated the chemical composition of eggplant, elucidated its habitual use by populations, and attempted to demonstrate its functional properties. Although some studies have demonstrated the effectiveness of eggplant, more accurate investigations with standardized methodologies are needed. These further studies should address the usual forms of consumption by the population and the correlation of these forms with the objectives of the proposed use.

Actualmente, el papel de la alimentación considerada saludable es el de optimizar la nutrición de las personas, garantizándoles el aumento de la salud y del bienestar, al mismo tiempo que reduce el riesgo de desarrollar enfermedades causadas por la mala alimentación. Los alimentos funcionales presentan sustancias, denominadas compuestos bioactivos, que tienen diferentes funciones biológicas y que son capaces de modular la fisiología del organismo, garantizando el mantenimiento de la salud. La berenjena (Solanum melongena L.) ha sido citada por muchos autores como una de las hortalizas que se puede clasificar como alimento funcional. La berenjena ha sido utilizada por la población de diversas formas, aunque sin evidencias ni pruebas que lo respalden, y con diversos objetivos, entre los que podemos destacar el tratamiento y/o prevención de la dislipidemia y el auxilio en el adelgazamiento. Este trabajo tiene como objetivo estudiar y analizar las publicaciones más recientes que justifiquen la clasificación de la berenjena (Solanum melongena L.) como un alimento funcional. Para la estructuración de este estudio se realizó una revisión bibliográfica de artículos en las bases de datos Scielo, Medline, Pubmed, Bireme, Lilacs, así como en libros y revistas científicas, teniendo en cuenta el período de 1992 a 2012. La selección de la referencia bibliográfica intentó seleccionar aquellos estudios que investigaron la composición química de la berenjena, dilucidaron su uso habitual en las poblaciones y trataron de demostrar sus propiedades funcionales. Aunque algunos estudios han demostrado la eficacia de la berenjena, se necesitan investigaciones más precisas, con metodologías estandarizadas, que tengan en cuenta las formas habituales de consumo y las relacionen con los objetivos propuestos para su uso.

Atualmente o papel da alimentação considerada saudável é otimizar a nutrição dos indivíduos garantindo a estes o aumento da saúde e do bem-estar como também reduzir o risco de desenvolver doenças decorrentes da má alimentação. Os alimentos funcionais apresentam substâncias com distintas funções biológicas, denominadas compostos bioativos, que são capazes de modular a fisiologia do organismo, garantindo a manutenção da saúde. A berinjela (Solanum melongena L.) tem sido citada por diversos autores como um dos vegetais que podem ser classificados como alimento funcional. A utilização da berinjela vem sendo feita pela população leiga sob diversas formas, mesmo sem critérios e comprovações por estudos com objetivos diversos, entre eles destaca-se sua utilização para o tratamento e/ou prevenção da dislipidemia e também como coadjuvante na perda de peso. Este trabalho tem como objetivo estudar e analisar as publicações mais recentes que justifiquem a caracterização da berinjela (Solanum melongena L.) como um alimento funcional. Para a estruturação deste estudo, foi realizada uma revisão da literatura em artigos nas bases de dados Scielo, Medline, Pubmed, Bireme, Lilacs bem como em livros e revistas científicas, considerando o período de 1992 a 2012. A seleção da referência bibliográfica preocupou-se em selecionar os estudos que pesquisaram a composição química da berinjela, elucidaram seu uso habitual nas populações, bem como tentaram demonstrar suas propriedades funcionais. Apesar de alguns estudos demonstrarem a eficácia da berinjela, são necessárias investigações mais precisas, com metodologias padronizadas, realizadas com as formas habituais de consumo entre a população e relacioná-las com os objetivos propostos do seu uso.

High plasma concentrations of asymmetric dimethylarginine inhibit ischemic cardioprotection in hypercholesterolemic rats

A low concentration of nitric oxide associated with a high concentration of asymmetric dimethylarginine (ADMA) can explain the lack of ischemic cardioprotection observed in the presence of hypercholesterolemia. The objective of the present study was to evaluate the effect of hypercholesterolemia on ischemic pre- and postconditioning and its correlation with plasma concentrations of ADMA. Male Wistar rats (6-8 weeks old) fed a 2% cholesterol diet (n = 21) for 8 weeks were compared to controls (n = 25) and were subjected to experimental myocardial infarction and reperfusion, with ischemic pre- and postconditioning. Total cholesterol and ADMA were measured in plasma before the experimental infarct and the infarct area was quantified. Weight, total cholesterol and plasma ADMA (means ± SE; 1.20 ± 0.06, 1.27 ± 0.08 and 1.20 ± 0.08 vs 0.97 ± 0.04, 0.93 ± 0.05 and 0.97 ± 0.04 µM) were higher in animals on the hypercholesterolemic diet than in controls, respectively. Cardioprotection did not reduce infarct size in the hypercholesterolemic animals (pre: 13.55% and post: 8% compared to 7.95% observed in the group subjected only to ischemia and reperfusion), whereas infarct size was reduced in the animals on a normocholesterolemic diet (pre: 8.25% and post: 6.10% compared to 12.31%). Hypercholesterolemia elevated ADMA and eliminated the cardioprotective effects of ischemic pre- and postconditioning in rats.

Aumento da imunorreatividade ao VEGFR-1 no complexo coroido-escleral em modelo experimental de hipercolesterolemia / Increased VEGFR-1 immunoreactivity in the choroid-scleral complex in hypercholesterolemia experimental model

OBJETIVO: O objetivo deste trabalho é investigar a expressão do fator de crescimento vascular endotelial (VEGF) na coroide e esclera, utilizando um modelo experimental de hipercolesterolemia. MÉTODO: Coelhos New Zealand foram organizados em dois grupos: O grupo dieta normal (GN), composto por 8 coelhos (8 olhos), recebeu ração padrão para coelhos, durante 4 semanas; e o grupo hipercolesterolêmico (GH), composto por 13 coelhos (13 olhos), recebeu dieta rica em colesterol a 1% por 8 semanas. Foi realizada a dosagem sérica de colesterol total, triglicerídeos, HDL colesterol, glicemia de jejum no início do experimento e no momento da eutanásia. Ao final da 8ª semana para o GH e 4ª semana para o GN foi realizada a eutanásia dos animais e os olhos foram submetidos à análise imuno-histoquímica com os anticorpos RAM-11 e VEGFR-1. RESULTADOS: Observou-se significativo aumento do colesterol total e triglicerídeos do GH em relação ao GN (p<0,001). Houve significativo aumento da expressão da RAM-11 e VEGFR-1 na coroide e esclera dos animais do GH em relação ao GN (p<0,001). CONCLUSÃO: Este estudo demonstra que a dieta hipercolesterolêmica em coelhos induz ao aumento da concentração de macrófagos e da imunorreatividade ao VEGFR-1 na coroide e esclera, expressando similaridade com a degeneração macular relacionada à idade (DMRI) humana.

PURPOSE: The aim of this study is to investigate the expression of vascular endothelial growth factor (VEGF) in the choroid and sclera using hypercholesterolemia experimental model. METHODS: New Zealand rabbits were divided into two groups: 8 rabbits (8 eyes), in the normal diet group (NG), were fed by a standard diet for 4 weeks; and 13 rabbits (13 eyes), in the hypercholesterolemic group (HG), were fed by a 1% cholesterol-enriched diet for 8 weeks. Total serum cholesterol, triglyceride, HDL cholesterol and fasting blood glucose exams were performed at the initiation of the experiment and at the euthanasia time. After hypercholesterolemic group 8th week and NG 4th week, animals were euthanized and their eyes underwent immunohistochemical analysis with the RAM-11 and VEGFR-1). RESULTS: The diet has induced a significant increase in total cholesterol and triglyceride levels in HG when compared with NG (p<0.001). There was a significant increase in the RAM-11 and VEGFR-1 expressions in hypercholesterolemic group choroid and sclera in relation to NG (p<0,001). CONCLUSION: This study has revealed that the hypercholesterolemic diet in rabbits induces an increase in the macrophage concentration and immunoreactivity to VEGFR-1 in the choroid and sclera, resembling human age-related macular degeneration (ARMD).

Polimorfismos del gen de apolipoproteína E y polimorfimo Pro12Ala del gen PPARy-2 en niños pre-puberes con factores de riesgo cardiometabólicos / Apolipoprotein E gene polymorphisms and Pro12Ala polymorfphism of PPARy-2 gene in children with risk factors to cardiometabolic disease

La resistencia a la insulina es muy frecuente en niños y adolescentes obesos, la cual conlleva a un significativo riesgo de desarrollar enfermedades cardiometabólicas causadas por la combinación de factores genéticos y factores asociados al estilo de vida. Evaluar la relación entre los polimorfismos del gen ApoE y el polimorfismo Pro12Ala del gen PPARγ2 en niños pre-púberes con factores de riesgo cardiometabólicos. Población y Métodos: Se evaluaron 141 niños (CANIA y Hospital “JM de los Ríos”), de los cuales 46 tienen obesidad, 33 hipercolesterolemia, 30 resistentes a la insulina (RI) y 32 controles. Se determinó colesterol total y fracciones, triglicéridos, glucosa, insulina e índice HOMA; se realizó extracción de ADN y análisis de los polimorfismos. La distribución de la frecuencia del alelo ε4 del gen de ApoE fue: 10,9% obesos, 7,6% hipercolesterolémicos, 18,3% RI y 4,6% controles. La frecuencia del polimorfismo Pro12Ala fue de 6,4% en la población estudiada. En los niños obesos e hipercolesterolémicos se observó aumento de colesterol total, LDL-c y triglicéridos asociados con la presencia del ε4; en el grupo con RI, se encontró que existen diferencias estadísticamente significativas entre el alelo ε4 con respecto al grupo control, lo que refiere que puede haber una relación clínica importante entre la presencia del alelo y el desarrollo de la enfermedad. No se encontró relación entre el polimorfismo Pro12Ala del gen PPARγ2 con factores de riesgo cardiometabólico. La presencia de varios polimorfismos en un mismo individuo podría estar asociada a factores de riesgo para enfermedad cardiometabólica

Insulin resistance (IR) is very frequent in children and adolescents obeses, which could contribute significantly in the development of cardiometabolic diseases, this could be associated to a combination of genetics factors and life’s style. Aim: To evaluate the relationship between ApoE gene polymorphisms and PPARγ2 gene Pro12Ala polymorphisms with risk factors to cardiometabolic disease in children. Population and Materials: 141 children (CANIA and Hospital “JM de los Ríos”), 46 with obesity, 33 with hypercholesterolemia, 30 with IR and 32 normal subjects. Total cholesterol and fractions, glucose, insulin and triglycerides were measured; also it was determinated the polymorphism genes on each patient. Results: The distribution of the frequency of the allele E4 of the ApoE gene were: 10, 9% obese, 7,6% hypercholesterolemia, 18,3% IR and 4,6% on normal subjects. The frequency of Pro12Ala polymorphism were up to 6,4% on the total subjects in the study. In the obese and hypercholesterolemic groups we found an increase of the total cholesterol, LDL-c and triglycerides, associated with the presence of allele ε4. In children with IR we got a significant difference of the presence of allele ε4 compared with the control group, which means that this allele could be related with the development of thedisease. It was not found a relation between the Pro12Ala of PPARγ2 gene and the development of obesity, hypercholesterolemia and insulin resistance in children. The presence of several polymorphisms in a same individual could be associated with risk factors to cardiometabolic disease

Equivalencia terapéutica entre atorvastatina amorfa (Atovarol) y atorvastatina cristalina tipo I (Lipitor) en el tratamiento de pacientes con hipercolesterolemia / Therapeutic equivalence of amorphous atorvastatin (atovarol) and type I crystalline atorvastatin (lipitor) in the treatment of hypercholesterolemic patients

Determinar la equivalencia terapéutica y la seguridad de la atorvastatina amorfa y la atorvastatina cristalina, utilizadas en la fabricación de Atovarol® y Lipitor ®, a la dosis de 10 mg/día en pacientes con hipercolesterolemia. Estudio clínico multicéntrico, prospectivo, comparativo, simple-ciego, distribuido al azar, de grupos paralelos. A los pacientes que cumplieron los criterios de inclusión les fue administrada atorvastatina amorfa (Atovarol®) o atorvastatina cristalina (Lipitor®) durante un mes. Se realizó una evaluación de laboratorio previa y otra al mes de tratamiento. Se incluyeron 43 pacientes, de los cuales uno fue retirado del estudio por efectos adversos. Los 42 pacientes que completaron el tratamiento con atorvastatina (20 pacientes en el grupo atorvastatina amorfa y 22 pacientes en el grupo atorvastatina cristalina) durante un período de 4 semanas presentaron reducciones estadísticamente significativas en los valores séricos de colesterol total, colesterol LDL y triglicéridos comparados con los valores basales en cada grupo de tratamiento. No se observaron diferencias estadísticamente significativas entre los dos grupos de tratamiento, ni previo ni posterior al tratamiento. Atorvastatina amorfa fue terapéuticamente equivalente a atorvastatina cristalina en la disminución de los valores de colesterol total, colesterol LDL y triglicéridos. El porcentaje de reducción de estos valores está dentro de los rangos reportado por otros estudios clínicos realizados con atorvastatina.

To determine the therapeutic equivalence and the safety of amoãphous and crystalline atorvastatin, used in the manufacture of Atovarol® and Lipitor®, at a dose of 10 mg/day in patients with hypercholesterolemia. Multicenter, prospective, comparative, somple-blind, randomized, parallel group clínical study. Amorphous atorvastatin (Atovarol®) or crystalline atorvastatin (Lipitor®) were administered for one month to patients that met the inclusion criteria. Laboratory evaluations were performed previously and one month after treatment. 43 patients were included, of which one was withdrawn from the study due to adverse effects. The 42 patients that completed atorvastatin treatment for a period of 4 weeks (20 patients in the amorphous atorvastatin and 22 patients in the crystalline atorvastatin group), presented statistically significant reductions in serum values of total cholesterol, cholesterol-LDL and triglycerides, as compared with pretreatment values in each group. Statistically significant differences were not observed between the groups, either before or after treatment. Amorphous atorvastatin is therapeutically equivalent to crystalline atorvastatin in the reduction of total cholesterol, cholesteron-LDL and triglyceride values. The percentage of reduction of these values is withim the range reported by other atorvastatin clinical studies.

Somatic, Biochemical and Hepatic Alterations in Wild Type Mice Chronically Fed High Fat Diet / Alteraciones Somáticas Bioquímicas y hepáticas en un Tipo de Ratas Alimentadas Crónicamente con Dieta Alta en Grasas

This study evaluated whether a high fat diet (HFC group) induces overweight, hepatic steatosis and plasma lipoproteins level alteration compared to standard chow diet (SC group). Female mice were submitted to each diet over 6 months. Body mass and food intake were evaluated weekly throughout the experiment. Total cholesterol, TG, LDL-c, HDL-c and VLDL-c were analyzed. Mice were sacrificed to remove liver, spleen, heart and intestine. The volume of the organs was determined according to the submersion method. Fixed livers were embedded in paraffin and stained with hematoxylin and eosin and Masson's trichrome. The analysis used a video microscope system and a test-system with 42 test-points. The volume density was estimated for hepatocytes, steatosis and sinusoids. Animals fed HFC had smaller chow intake than SC group. HFC group presented body mass greater than SC. Animals fed HFC showed heavier liver and spleen and lighter intestine than SC (p<0.05), heart mass was not significant between groups. Plasma lipoproteins differed between groups (p<0.05) except VLDL-c and TG fractions. The liver structure was without major alteration in SC group however, HFC mice group showed different degrees of fatty degeneration with micro- and macrovesicular steatosis dispersed in all liver with typical peri-cellular/peri-sinusoidal fibrosis. The quantitative study showed significant (p<0.05) volume density reduction for hepatocytes and sinusoids. In conclusion, our results clearly show that hepatic steatosis can be induced in mouse by such a fat-rich diet without any toxin ingestion, alimentary deficiency and genes depletion.

Este estudio evaluó cómo una dieta de alta densidad energética (grupo ADE) induce sobrepeso, esteatosis hepática y altera los niveles de las lipoproteínas plasmáticas cuando son comparados con la dieta patrón (grupo SC). Hembras de camundongos fueron sometidas a cada una de las dietas durante 6 meses. La masa corporal y la ingestión de alimento fueron evaluadas semanalmente durante el experimento. Además fueron medidos el colesterol total, TG, LDL-c, HDL-c e VLDL-c. Los animales fueron sacrificados y el hígado, bazo, corazón e intestinos fueron removidos para estudio. El volumen de los órganos fue medido por el método de la sumersión. Fragmentos de hígado fueron preparados para el estudio en microscopía de luz, teñidos con hematoxilina-eosina y tricrómico de Masson. El análisis fue realizado con video microscopía y sistema test M42. La densidad de volumen fue estimada para hepatocitos, esteatosis y sinusoides. Los animales alimentados con dieta ADE presentaron menor ingestión de alimento y tuvieron masa corporal mayor que los animales con dieta patrón. Animales ADE mostraron también hígado y bazo más pesados e intestino más liviano que animales SC (p<0.05). Para la masa del corazón no hubo diferencia significativa entre los dos grupos. Las lipoproteínas plasmáticas fueron diferentes entre los grupos (p<0.05) excepto VLDL-c y fracciones de TG. La estructura hepática no presentó grandes alteraciones en el grupo SC; sin embargo, animales del grupo ADE presentaron diferentes grados de degeneración adiposa con esteatosis macro y microvesicular dispersas en todo el hígado con típica fibrosis pericelular y perisinusoidal, y significativa reducción de la densidad de volumen de hepatocitos y sinosoides. En conclusión, los resultados muestran que la esteatosis hepática puede ser inducida experimentalmente en camundongos, a través de dieta ADE, sin ingestión de cualquier toxina, deficiencia alimentaria o depleción genética.

Obesidade e hipercolesterolemia na adolescencia / Obesity and hipercholesterolemia in adolescence

A obesidade e a hipercolesterolemia sao problemas de saude publica no primeiro mundo e nos paises desenvolvidos. O ginecologista e o profissional que tem contato com esta adolescente e pode orienta-la...