Relationship between endotoxin core, staphylococcal and varicella antibody levels and outcome following aortic valve replacement surgery: a prospective observational study.

BACKGROUND: Morbidity and mortality following cardiac valve surgery is high. Immunity is an important contributor to outcome. This study examines the relationship of staphylococcal and endotoxin antibody levels to outcome following cardiac surgery. METHODS: Using enzyme-linked immunosorbent assays (ELISA), we measured pre-operative levels of antibodies to endotoxin core (EndoCAb); 3 common staphylococcal epitopes and varicella on saved serum of 60 adult patients scheduled to undergo elective primary surgical aortic valve replacement (AVR). Primary outcome measure was post-operative length of stay (LOS) in hospital with secondary outcomes being development of infective complications, length of stay on the intensive care unit (ICU) and 30-day mortality. Patients were quartiled according to antibody levels and outcomes compared between the quartile groups using Mann-Whitney tests for length of stay and Fisher's test for development of infection. RESULTS: Sixty patients (34 M, 26 F) were recruited with mean age 73 years (IQR 66-78), mean body mass index (BMI) 27.7 (IQR 25-31) and EuroSCORE II 1.44 (0.95-1.99). Those patients in the lower quartile for pre-operative antibody level had a longer post-operative stay than the upper quartile. EndoCAb (median IgG level Q1 42.2 MU/ml vs Q4 256 MU/ml) 9 vs 6 days, p = 0.025; alpha-toxin (median IgG level Q1 63 U vs Q4 558 U) 10 vs 7 days, p = 0.034; teichoic acid (median IgG level Q1 14 U vs Q4 419 U) 10 vs 8 days, p = 0.441; staphylococcal enterotoxin A (median IgG level Q1 55 U vs Q4 427 U) 9 vs 7 days, p = 0.865; varicella zoster (median IgG level Q1 1.325 U vs Q4 2.54 U) 8 vs 7 days, p = 1.0; and combined antibody levels 10 vs 6 days, p = 0.017. There were no differences in the number developing post-operative infections for each antibody type. The combined antibody analysis suggested a reduction in proportion of individuals developing infection from the upper vs lower quartile: 0 vs 0.33, p = 0.042. CONCLUSIONS: This study again suggests the inverse relationship between endotoxin core antibody levels and outcome following aortic valve surgery as well as suggesting a similar relationship with antibodies to staphylococcus. There is no such relationship for antibody levels against an organism not providing a peri-operative threat. Understanding this relationship may enable therapeutic manipulation of immune status, re-evaluation of risk and further investigation of the low immune state. TRIAL REGISTRATION: The patients in this study are a sub-group of the RELIEF AS study.ClinicalTrials.gov identifier NCT02174471.

Influence of salicylic acid pretreatment on seeds germination and some defence mechanisms of Zea mays plants under copper stress.

The study was focused on the influence of salicylic acid (SA) on maize seeds germination and on some physiological and biochemical processes in maize plants growing in the hydroponic culture under copper (Cu) stress. A significant influence of SA pretreatment on the advanced induction of the maize seeds metabolic activity and the level of the endogenous SA in germinated seeds and developing roots have been stated. Although, the ability of maize seeds to uptake SA and accumulate it in the germinated roots was confirmed, the growth inhibition of Cu-stressed maize seedlings was not ameliorated by SA seeds pretreatment. Cu-stressed plants exhibited a decrease in the photosynthetic pigment concentration and the increase in non-photochemical quenching (NPQ) - an indicator of an excess energy in PSII antenna assemblies lost as a heat. The amelioration effect of SA application was found only for carotenoids content which increased in stressed plants. It was also shown that maize roots growing in stress conditions significantly differed in the chemical composition in comparison to the roots of control plants, but the SA pretreatment did not affect these differences. On the other hand, it was found that SA seed pretreatment significantly influenced the ability of stressed plants to accumulate copper in the roots. It was stated that a higher level of exogenous SA application led to a lower accumulation of Cu ions in maize roots. Cu-stressed plants exhibited higher oxidative stress in roots than in leaves which was manifested as an increase in the concentration of hydrogen peroxide due to stress factor application. We observed an increase in catalase (CAT) activity in leaves of Cu-stressed plants which corresponded with a lower H2O2 content when compared with roots where the hydrogen peroxide level was higher, and the inhibition of the CAT activity was found. Furthermore, we found that the SA seed pretreatment led to a decrease in the H2O2 content in the roots of the Cu-stressed plants, but it did not influence the H2O2 level in leaves. The increase in hydrogen peroxide content in the roots of Cu-stressed plants correlated with a higher activity of the MnSODI and MnSODII isoforms. It was found that SA pretreatment caused a decrease in MnSODII activity accompanied by the decrease in H2O2 concentration. Achieved results indicated also that the changes in the chemical composition of the root tissue under copper stress constituted protection mechanisms of blocking copper flow into other plant organs. However, it might be assumed that the root tissue remodelling under Cu stress did not only prevent against the Cu ions uptake but also limited the absorption of minerals required for the normal growth leading to the inhibition of the plant development.

Effect of Selected Pyrazine Derivatives on the Production of Phenolics and Rutin in Urtica dioica and Fagopyrum esculentum.

The effect of four pyrazine derivatives on the content of phenolic compounds in Urtica dioica L. and rutin in Fagopyrum esculentum Moench was studied. Pyrazine derivatives H1 and H2 were used on U. dioica, and derivatives S1 and S2 on F. esculentum, both separately and in combination with urea. The content of phenolic compounds in the stems of U. dioica after treatment with H2 at a concentration of 10(-3) M significantly increased compared with the control and to a lower concentration of the same pyrazine derivative. In the case of S1 and S2 for F. esculentum, rutin content also increased in stems, mainly after treatment together with urea. By contrast, rutin and phenolics contents in the leaves did not change in comparison with controls after application of H1, H2, S I and S2. Treatment with H1 and H2 in two chosen concentrations resulted in a significant increase in the net photosynthetic rate, transpiration rate and stomatal conductance. A slight increase in the rate of photosynthesis was observed also after application of variants of S1 and S1 with urea. Pyrazine derivatives did not show any effect on either the relative content of chlorophyll or chlorophyll fluorescence. A slight weight reduction of above ground biomass was shown only after application of Si and S2. Dark necrosis on the edges and center of the leaves was observed in all treated plants after pyrazine application. The results suggest that all the pyrazine derivatives possess herbicidal effects.

Variability of anti-staphylococcal antibodies in healthy volunteers and pre-cardiac surgery patients.

BACKGROUND: Pre-operative antibody levels have been shown to be inversely related to development of post-operative complications. Staphylococcal infection is a major source of morbidity following surgery. METHODS: We examined the variability of anti-staphylococcal antibody levels across a group of healthy volunteers and compared this with patients scheduled to undergo cardiac surgery. RESULTS: Pre-operative cardiac surgical patients exhibited significantly higher levels of staphylococcal antibodies compared with healthy volunteers. CONCLUSIONS: The relationship between pre-surgery staphylococcal antibody levels and outcome warrants further investigation.