Polyphenols, Antioxidants, and Wound Healing of Lecythis pisonis Seed Coats.

To better use the Lecythis pisonis Cambess. biomass, this study investigates whether Sapucaia seed coats present wound healing properties. We analyzed the antibacterial, antioxidant, and wound healing-promoting potentials, plus cytotoxicity and stimulation of vascular endothelial growth factor-A. The chemical composition was analyzed by positive ion mode electrospray ionization Fourier transform ion cyclotron resonance mass spectrometry. A total of 19 compounds were identified, such as proanthocyanidin A1, procyanidins A1, B2, and C1, epigallocatechin, and kaempferol (p-coumaroyl) glycoside. Potent antioxidant strength/index was verified for 2,2-diphenyl-1-picrylhydrazyl radical (IC50 = 0.99 µg/mL) and ferric reducing antioxidant power (IC50 = 1.09 µg/mL). The extract did not present cytotoxicity and promoted significant cell migration and/or proliferation of fibroblasts (p < 0.05). Vascular endothelial growth factor-A was stimulated dose-dependently at 6 µg/mL (167.13 ± 8.30 pg/mL), 12.5 µg/mL (210.3 ± 14.2 pg/mL), and 25 µg/mL (411.6 ± 29.4 pg/mL). Platelet-derived growth factor (PDGF) (0.002 µg/mL) was stimulated at 215.98 pg/mL. Staphylococcus aureus was susceptible to the extract, with a minimum inhibitory concentration of 31.25 µg/mL. The identified compounds benefit the antioxidant activity, promoting hemostasis for the wound healing process, indicating that this extract has the potential for use in dermatological cosmetics.

Antiulcerogenic Potential of the Ethanolic Extract of Ceiba speciosa (A. St.-Hil.) Ravenna Evaluated by In Vitro and In Vivo Studies.

Gastrointestinal diseases, such as peptic ulcers, are caused by a damage in the gastric mucosa provoked by several factors. This stomach injury is regulated by many inflammatory mediators and is commonly treated with proton-pump inhibitors, histamine H2 receptor blockers and antacids. However, various medicinal plants have demonstrated positive effects on gastric ulcer treatment, including plants of the Ceiba genus. The aim of this study was to evaluate the antiulcer and anti-inflammatory activities of the stem bark ethanolic extract of Ceiba speciosa (A. St.-Hil.) Ravenna. We performed a preliminary quantification of phenolic compounds by high-performance liquid chromatography-diode array detection (HPLC-DAD), followed by the prospection of other chemical groups through nuclear magnetic resonance (NMR) spectroscopy. A set of in vitro assays was used to evaluate the extract potential regarding its antioxidant activity (DPPH: 19.83 ± 0.34 µg/mL; TPC: 307.20 ± 6.20 mg GAE/g of extract), effects on cell viability and on the release of TNF-α in whole human blood. Additionally, in vivo assays were performed to evaluate the leukocyte accumulation and total protein quantification in carrageenan-induced air pouch, as well as the antiulcerogenic effect of the extract on an ethanol-induced ulcer in rats. The extract contains flavonoids and phenolic compounds, as well as sugars and quinic acid derivatives exhibiting potent antioxidant activity and low toxicity. The extract reduced the release of TNF-α in human blood and inhibited the activity of p38α (1.66 µg/mL), JAK3 (5.25 µg/mL), and JNK3 (8.34 µg/mL). Moreover, it reduced the leukocyte recruitment on the pouch exudate and the formation of edema, reverting the effects caused by carrageenan. The extract presented a significant prevention of ulcer formation and a higher reduction than the reference drug, Omeprazole. Therefore, C. speciosa extract has demonstrated relevant therapeutic potential for the treatment of gastric diseases, deserving the continuation of further studies to unveil the mechanisms of action of plant bioactive ingredients.

Boron recovery from desalination seawater brines by selective ion exchange resins.

The European Union (EU) depends on third markets to supply many important raw materials. Increasing the circularity of critical raw materials within the EU is important not only from an environmental perspective, but also as a competitive advantage for the EU economy. In the case of boron, the EU's import dependency is about 100%. This work aims to evaluate the boron recovery from seawater desalination plants (SWDP) brines using ion-exchange resins in a circular economy approach. Commercial boron selective resins Purolite S108, DIAION CRB03 and CRB05 were tested and compared on batch and dynamic experiments. Thermodynamic and kinetic experiments were performed, and results were fitted by linear and non-linear models. After a comparison, results showed a good fit to the Langmuir isotherm and the pseudo-second order model, respectively, for all the commercial resins tested. The DIAION CRB03 resin presented higher sorption capacity and percentage of boron sorbed than the other resins and was selected as the best option for boron recovery from SWDP brine. Dynamic experiments in fixed bed column using DIAION CRB03 resulted in a sorption capacity of 13 mg/g of resin, a boron recovery of 98% and a concentration factor of 30, for an initial boron concentration of 50 mg/L. In addition, an economic analysis was carried out as a preliminary estimate of the revenues obtained from the production of boric acid from the brine produced by El Prat desalination plant.

A genetic variant in the TRAF1/C5 gene lead susceptibility to active pulmonary tuberculosis by decreased TNF-α levels.

Host genetics are important to consider in the role of resistance or susceptibility for developing active pulmonary tuberculosis (TB). Several association studies have reported the role of variants in STAT4 and TRAF1/C5 as risk factors to autoimmune diseases. Nevertheless, more data is needed to elucidate the role of these gene variants in infectious disease. Our data reports for the first time, variant rs10818488 in the TRAF1/C5 gene (found 47% of the population worldwide), is associated with susceptibility (OR = 1.51) to development TB. Multivariate analysis evidenced association between rs10818488 TRAF1/C5 and risk to multibacillary TB (OR = 4.18), confers increased bacteria load in the lung, indicates a decreased ability to control pathogen levels in the lung, and spread of the pathogen to new hosts. We showed that the "loss-of-function" variant in TRAF1/C5 led to susceptibility for TB by decreased production of TNF-α. Our results suggest the role of variant TRAF1/C5 in susceptibility to TB as well as in clinical presentation of multibacillary TB.

Anti-inflammatory and antioxidant properties of Alternanthera brasiliana improve cutaneous wound healing in rats.

Alternanthera brasiliana (L.) Kuntze is recognized for its healing properties; however, its therapeutic effects remain unclear. Therefore, our study aimed to elucidate the wound healing activities of A. brasiliana using in vitro and in vivo assays. In vitro assays were used to evaluate the antibacterial, anti-inflammatory, and antioxidant effects of A. brasiliana extract. For the in vivo study, two dorsal excisions were established in Wistar rats using a punch (1.5 cm in diameter), which were topically treated daily with 2% carbopol gel (Ctrl group) or 20% hydroalcoholic plant extract with 2% carbopol gel (A. brasiliana-Ab group). After the 2nd, 7th, 14th, and 21st days, inflammation, oxidative damage, antioxidants, angiogenesis, tissue formation, and re-epithelialization were evaluated. In vitro, Ab reduced nitric oxide, anion superoxide, and pro-inflammatory cytokine production. In vivo, Ab presented lower levels of inflammatory infiltrate, although increased levels of IL-1ß and TGF-ß1 were observed. The plant extract controlled oxidative damage by antioxidants, which favored angiogenesis, collagenesis, and wound re-epithelialization. Thus, the topical application of the hydroalcoholic extract of 20% A. brasiliana was distinguished by its important anti-inflammatory and antioxidant activities both in vivo and in vitro. The plant extract also stimulated angiogenesis and tissue formation, accelerating total re-epithelization, which is promising for wound healing.

In vitro anti-inflammatory activity of terpenes via suppression of superoxide and nitric oxide generation and the NF-κB signalling pathway.

BACKGROUND AND AIMS: Terpenes are considered the main components of essential oils and an important source for the identification of novel lead molecules. This study aimed to investigate the in vitro anti-inflammatory activity of L-carveol, L-carvone, and m-cimene (monoterpenes) and of valencene and guaiene (sesquiterpenes). METHODS: The influence on intracellular nitric oxide (NO) and pro- and anti-inflammatory cytokine (TNF-α, IL-1α and IL-10) production and on nuclear factor kappa B (NF-κB) activity was determined using Griess reagent, immunoenzymatic assay kits (ELISA) and chemiluminescence measurements in cell-based assays, respectively. Antioxidant activity was assayed through the protective effect against cellular oxidative damage produced by superoxide anion production (O 2 ·- ) and hydrogen peroxide on macrophages and by the quenching activity of the NO radical. RESULTS AND DISCUSSION: Terpenes reduced the pro-inflammatory cytokines TNF-α and IL-1α and increased the production of IL-10. In addition, the terpenes, especially guaiene (53.3 ± 2.4%) and m-cymene (38.1 ± 0.6%), significantly inhibited NO production in a macrophage cell culture-based assay, whereas no effect was observed in the scavenging activity of this radical. L-carveol and m-cymene significantly inhibited O 2 ·- production with reductions of approximately 68.6 ± 2.2% and 48.2 ± 4.2%, respectively, at a concentration of 10 µM. Moreover, these terpenes were verified to suppress NF-κB activity. The results indicate that these terpenes have therapeutic potential and may be used to suppress inflammatory diseases or as a leading compounds.

Wound healing activity of terpinolene and α-phellandrene by attenuating inflammation and oxidative stress in vitro.

This study was undertaken to investigate the in vitro wound healing effects and the anti-inflammatory and antioxidant activities of terpinolene and α-phellandrene. The in vitro stimulatory effects on the proliferation and migration of fibroblasts were assessed using the scratch assay. The anti-inflammatory activity was evaluated using cell-based assays by investigating their influence on nitric oxide (NO), superoxide anion (O2•-), tumour necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) production and using the TNF-α-induced nuclear factor kappa (NF-κB) assay. Antioxidant activity was determined by the ABTS cation radical scavenging capacity, ferric reducing/antioxidant potential (FRAP), and NO free radical scavenging assays. Terpinolene and α-phellandrene significantly increased the migration and proliferation of fibroblasts and suppressed the pro-inflammatory cytokines IL-6 and TNF-α in a dose-dependent manner. Terpinolene and α-phellandrene at a concentration of 100 µM significantly inhibited NO production (41.3 and 63.8%, respectively) in a macrophage cell-culture-based assay, and resulted in reductions in O2•- production of 82.1 ±â€¯3.5% and 70.6 ±â€¯4.3%, respectively. Moreover, these monoterpenes were verified to suppress NF-κB activity. In summary, terpinolene and α-phellandrene may contribute to broadening clinical options in the treatment of wounds by attenuating inflammation and oxidative stress in vitro.

Potential anti-inflammatory, antioxidant and antimicrobial activities of Sambucus australis.

CONTEXT: Sambucus australis Cham. & Schltdl. (Adoxaceae) is used in Brazilian folk medicine to treat inflammatory disorders. OBJECTIVE: To evaluate the in vitro anti-inflammatory, antioxidant and antimicrobial properties of S. australis. MATERIALS AND METHODS: The anti-inflammatory activity of ethanol extracts of the leaf and bark of S. australis (1-100 µg/mL) were studied in lipopolysaccharide/interferon γ stimulated murine macrophages RAW 264.7 cells (24 h incubation) by investigating the release of nitric oxide (NO) and tumour necrosis factor-alpha (TNF-α) and in the TNF-α-induced nuclear factor kappa (NF-κB) assay. Minimum inhibitory concentration (MIC) was determined by the microdilution test (24 h incubation). Antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant power (FRAP) and the NO scavenging assays. Chemical composition was assessed by LC-MS/MS. RESULTS: Antioxidant activities in the DPPH (IC50 43.5 and 66.2 µg/mL), FRAP (IC50 312.6 and 568.3 µg/mL) and NO radical scavenging assays (IC50 285.0 and 972.6 µg/mL) were observed in the leaf and bark ethanol extracts, respectively. Solely the leaf extract showed significant inhibition of NO and TNF-α production in RAW264.7 cells at concentrations of 2 and 100 µg/mL, respectively, and suppression of TNF-α inhibition of NF-κB by 12.8 and 20.4% at concentrations of 50 and 100 µg/mL, respectively. The extract also exhibited antibacterial activity against Salmonella typhimurium (MIC 250 µg/mL) and Klebsiella pneumoniae (MIC 250 µg/mL). LC-MS/MS revealed the presence of chlorogenic acid and rutin as major compounds. DISCUSSION AND CONCLUSION: The results indicate that the ethanol leaf extract of S. australis exhibit prominent anti-inflammatory effects.

Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone.

BACKGROUND: Brazil's public health system, the largest in the world, faces great challenges in establishing access to specialized care for all Brazilians. "Regula Mais Brasil" is a structuring project from the Ministry of Health that aims to optimize the referral process for specialized care throughout Brazil and uses telemedicine to support primary care physicians. The high demand for support and referrals in the neurology specialty raises questions about what the difficulties and doubts in managing these patients are and whether the training of the coordinating physician influences the orientation and outcome of referral. METHODS: In a retrospective analysis on a database, all teleconsultations in the neurology specialty were evaluated. The diagnoses were categorized using the ICD-10 and according to the specialty of the coordinating teleconsultant for multiple comparisons. RESULTS: In total, 1687 teleconsultations were conducted between January 10 and December 2, 2019, in the cities of Belo Horizonte and Porto Alegre and in the Federal District. The most frequent area of doubt for doctors was about epilepsy. After discussion via telemedicine, 25% of the referrals were avoided and the specialty of the teleconsultant physician did not impact the decision made: 72.3, 72.6 and 66.5%, in relation to approval by neurologists, family doctors and other experts, respectively. CONCLUSION: Increasing access to specialists, not only for patients but also for doctors, helps in achieving early resolution of issues of greater difficulty for primary healthcare doctors, thus resulting in lower numbers of referrals.

Single-Nucleotide Variants in the AIM2 - Absent in Melanoma 2 Gene (rs1103577) Associated With Protection for Tuberculosis.

Tuberculosis (TB) remains a serious public health burden worldwide. TB is an infectious disease caused by the Mycobacterium tuberculosis Complex. Innate immune response is critical for controlling mycobacterial infection. NOD-like receptor pyrin domain containing 3/ absent in melanoma 2 (NLRP3/AIM2) inflammasomes are suggested to play an important role in TB. NLRP3/AIM2 mediate the release of pro-inflammatory cytokines IL-1ß and IL-18 to control M. tuberculosis infection. Variants of genes involved in inflammasomes may contribute to elucidation of host immune responses to TB infection. The present study evaluated single-nucleotide variants (SNVs) in inflammasome genes AIM2 (rs1103577), CARD8 (rs2009373), and CTSB (rs1692816) in 401 patients with pulmonary TB (PTB), 133 patients with extrapulmonary TB (EPTB), and 366 healthy control (HC) subjects with no history of TB residing in the Amazonas state. Quantitative Real Time PCR was performed for allelic discrimination. The SNV of AIM2 (rs1103577) is associated with protection for PTB (padj: 0.033, ORadj: 0.69, 95% CI: 0.49-0.97). CTSB (rs1692816) is associated with reduced risk for EPTB when compared with PTB (padj: 0.034, ORadj: 0.50, 95% CI: 0.27-0.94). Serum IL-1ß concentrations were higher in patients with PTB than those in HCs (p = 0,0003). The SNV rs1103577 of AIM2 appeared to influence IL-1ß release. In a dominant model, individuals with the CC genotype (mean 3.78 ± SD 0.81) appeared to have a higher level of IL-1ß compared to carriers of the T allele (mean 3.45 ± SD 0.84) among the patients with PTB (p = 0,0040). We found that SNVs of AIM2 and CTSB were associated with TB, and the mechanisms involved in this process require further study.

Chemical composition and anti-inflammatory activity of essential oil and ethanolic extract of Campomanesia phaea (O. Berg.) Landrum leaves.

ETHNOPHARMACOLOGICAL RELEVANCE: Campomanesia species are used in folk medicine for anti-inflammatory, -ulcerogenic, -diabetic, -obesity, and many other purposes. AIM OF THE STUDY: This study aimed to investigate the phytochemical profile and pharmacotherapeutic potential of the essential oil (EO) and ethanolic extract (EXT) of the leaves of Campomanesia phaea in relation to antioxidant and anti-inflammatory effects using chemical methods and in vitro bioassays in cell culture. MATERIALS AND METHODS: Gas and liquid chromatography techniques coupled to mass spectrometry were used to identify the main secondary metabolites. The antioxidant activity was determined by the chemical methods of radical sequestration of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-Azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and by ferric reducing antioxidant power (FRAP); in addition to the protective effect against cellular oxidative damage caused by hydrogen peroxide (H2O2) in macrophage culture. The anti-inflammatory and immunomodulatory activity was evaluated for the influence on the production of nitric oxide and superoxide anion (O2•-), and by the quantification of proinflammatory cytokines tumor necrosis factor (TNF alpha) and interleukin 6 (IL- 6) through Enzyme Linked Immuno Sorbent Assay (ELISA) technique and inhibition of nuclear factor kappa B (NF-κB) through chemiluminescence. RESULTS: A total of 41 compounds were identified in the essential oil (EO), being (E)-caryophyllene (14%) and caryophyllene oxide (6.9%) the major compounds. In the ethanolic extract (EXT), three flavonoids from the flavanones group were identified: alpinetin O-dideoxy-hexoside, 5,7-dimethoxyflavanone and alpinetin. The EO and EXT inhibited the production of O2•- (99.0% and 52.9%) at a concentration of 100 µg/mL, intracellular NO•- (50.0% and 51.9%) and proinflammatory cytokines IL-6 (41.0% and 82.9%) and TNF-α (74.7% and 87.9%) at a concentration of 50 µg/mL, respectively. In addition, inhibition of nuclear factor kappa B (EO 36.2% and EXT 40.9%) was observed at 20 µg/mL. CONCLUSIONS: Taken together, the results indicated that EO and EXT possess potent anti-inflammatory activities and it may hold therapeutic promise in the management of acute and chronic inflammatory conditions.

Development and evaluation of a vegetable oil blend formulation for cutaneous wound healing.

This work aimed to evaluate the in vivo capacity of a vegetable oil blend formulation (VOB) developed to accelerate cutaneous wound closure. Total thickness wounds were punctured on the skin on the back side of each animal and topically treated with the VOB formulation, Dersani® ointment or the vehicle control. After 2, 7, 14, 21 days post-wounding, five animals from each group were euthanized, and the rates of wound closure and re-epithelialization were evaluated. The wounds were harvested for histological and biochemical analysis. VOB resulted in faster and greater re-epithelialization in the in vivo excisional wounds, exhibiting significant wound area reduction of 8.9, 8.0, 35.1, 45.2 and 47.0% after 2, 5, 10, 14 and 21 days post-wounding, respectively, when compared with the vehicle control. Histological and biochemical analyses showed that the VOB-treated wounds exhibited a significant increase of granular tissue and controlled inflammatory response by modulation of the release of pro-inflammatory cytokines TNF-α, IL-6 and IL-1. Moreover, VOB-treated wounds showed a significant and concrete increase in the deposition and organisation of collagen fibres in the wound site and improved the quality of the scar tissue. Altogether, these data revealed that VOB accelerates wound healing processes and might be beneficial for treating wound disorders.

Development and Mechanistic Insight into the Enhanced Cytotoxic Potential of Parvifloron D Albumin Nanoparticles in EGFR-Overexpressing Pancreatic Cancer Cells.

Pancreatic cancer is one of the most lethal cancers, with an extremely poor prognosis. The development of more effective therapies is thus imperative. Natural origin compounds isolated from Plectranthus genus, such as parvifloron D (PvD), have cytotoxic and antiproliferative activity against human tumour cells. However, PvD is a very low water-soluble compound, being nanotechnology a promising alternative strategy to solve this problem. Therefore, the aim of this study was to optimize a nanosystem for preferential delivery of PvD to pancreatic tumour cells. Albumin nanoparticles (BSA NPs) were produced through a desolvation method. Glucose cross-linking and bioactive functionalization profiles of BSA platform were elucidated and analysed using static lattice atomistic simulations in vacuum. Using the optimized methodology, PvD was encapsulated (yield higher than 80%) while NPs were characterized in terms of size (100-400 nm) and morphology. Importantly, to achieve a preferential targeting to pancreatic cancer cells, erlotinib and cetuximab were attached to the PvD-loaded nanoparticle surface, and their antiproliferative effects were evaluated in BxPC3 and Panc-1 cell lines. Erlotinib conjugated NPs presented the highest antiproliferative effect toward pancreatic tumour cells. Accordingly, cell cycle analysis of the BxPC3 cell line showed marked accumulation of tumour cells in G1-phase and cell cycle arrest promoted by NPs. As a result, erlotinib conjugated PvD-loaded BSA NPs must be considered a suitable and promising carrier to deliver PvD at the tumour site, improving the treatment of pancreatic cancer.

Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone / Telemedicina como apoio à atenção primária para encaminhamento ao neurologista: tomada de decisão entre diferentes especialistas ao guiar o caso pelo telefone

ABSTRACT Background: Brazil's public health system, the largest in the world, faces great challenges in establishing access to specialized care for all Brazilians. "Regula Mais Brasil" is a structuring project from the Ministry of Health that aims to optimize the referral process for specialized care throughout Brazil and uses telemedicine to support primary care physicians. The high demand for support and referrals in the neurology specialty raises questions about what the difficulties and doubts in managing these patients are and whether the training of the coordinating physician influences the orientation and outcome of referral. Methods: In a retrospective analysis on a database, all teleconsultations in the neurology specialty were evaluated. The diagnoses were categorized using the ICD-10 and according to the specialty of the coordinating teleconsultant for multiple comparisons. Results: In total, 1687 teleconsultations were conducted between January 10 and December 2, 2019, in the cities of Belo Horizonte and Porto Alegre and in the Federal District. The most frequent area of doubt for doctors was about epilepsy. After discussion via telemedicine, 25% of the referrals were avoided and the specialty of the teleconsultant physician did not impact the decision made: 72.3, 72.6 and 66.5%, in relation to approval by neurologists, family doctors and other experts, respectively. Conclusion: Increasing access to specialists, not only for patients but also for doctors, helps in achieving early resolution of issues of greater difficulty for primary healthcare doctors, thus resulting in lower numbers of referrals.

RESUMO Introdução: O maior sistema público de saúde do mundo tem um grande desafio para estabelecer acesso à atenção especializada a todos os brasileiros. O Regula Mais Brasil é um projeto estruturante do Ministério da Saúde que visa otimizar o processo de referenciamento para atenção especializada no território brasileiro e utiliza a telemedicina para suporte de médicos da atenção primária. A elevada procura de apoio e encaminhamento na especialidade de neurologia desperta o questionamento sobre quais são as dificuldades e dúvidas no manejo desses pacientes e se a formação do médico regulador influencia a orientação e o desfecho do encaminhamento. Métodos: Em uma análise retrospectiva do banco de dados, foram avaliadas todas as teleconsultorias da especialidade de neurologia, os diagnósticos foram categorizados pelo CID-10 e por especialidade do teleconsultor regulador para comparações múltiplas. Resultados: No total, 1.687 teleconsultorias foram realizadas de 10 de janeiro a 2 de dezembro de 2019, nas cidades de Belo Horizonte, Porto Alegre e Distrito Federal. A área de dúvida mais frequente dos médicos era sobre epilepsia. Após a discussão por telemedicina, 25% dos encaminhamentos foram evitados e a especialidade do médico teleconsultor não impactou na decisão tomada (72,3, 72,6 e 66,5%) em relação à aprovação por neurologistas, médico de família e outros especialistas, respectivamente. Conclusão: Aumentar o acesso não apenas de pacientes, mas dos médicos aos especialistas contribui para que os temas de maior dificuldade para os médicos da Atenção Primária à Saúde sejam resolvidos precocemente, resultando em um menor número de encaminhamentos.