Latent and Overt Polyautoimmunity in Children and Adolescents With Immune Thrombocytopenia.

Autoantibodies are biomarkers for autoimmune disease diagnosis, monitoring, and prediction. Therefore, this study established the frequency of latent and overt polyautoimmunity in children and adolescents with >6 months of diagnosis of immune thrombocytopenia (ITP). Forty-seven patients with chronic or persistent disease had non-organ-specific and organ-specific autoantibodies assessed. Frequency of latent polyautoimmunity was 36.2%, and, of overt polyautoimmunity, it was 4.3%. Of ITP patients with latent polyautoimmunity, 52.9% were positive for antinuclear antibody (ANA), 47.1% for autoantibodies other than ANA, and 64.7% for multiple autoantibodies. In addition, patients with latent polyautoimmunity and those positive for ANA were significantly older at disease onset. Both ITP patients positive and negative for autoantibodies reported family members with autoimmune diseases. The autoantibodies observed were as follows: ANA, anti-dsDNA, anti-SSA/Ro, IgM aCL, anti-GAD, anti-IA2, anti-IAA, anti-TG, anti-TPO, anti-LKM1, and SMA. Of ITP patients with overt polyautoimmunity, 1 was diagnosed with type 1 diabetes mellitus and the other with thyroiditis. In conclusion, children and adolescents with ITP present high frequency of latent and overt polyautoimmunity even for autoantibodies other than ANA. Therefore, ANA and other non-organ-specific and organ-specific autoantibodies should be considered for assessment during ITP patients' follow-up.

Correction: Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: A randomized controlled pragmatic clinical trial.

[This corrects the article DOI: 10.1371/journal.pone.0227347.].

Apical periodontitis healing and postoperative pain following endodontic treatment with a reciprocating single-file, single-cone approach: A randomized controlled pragmatic clinical trial.

This trial assessed post-operative pain and healing of apical periodontitis following endodontic therapy with a reciprocating system compared to a crown-down technique with hand files and lateral compaction filling. One-hundred and twenty nonvital anterior teeth with apical periodontitis were randomly treated using either a reciprocating single file followed by matching-taper single-cone filling or a hand file and lateral compaction filling. Postoperative pain was assessed during the 7 days after the treatment, using a visual analogue scale and a verbal rating scale. Apical healing was assessed using the periapical index score after a 12-month follow-up. The hypothesis tested was that both protocols were equivalent and present similar effectiveness in healing periapical lesions. Data were analyzed through two one-sided tests, t-tests, as well as Mann-Whitney and Chi-squared tests (α = 0.05). Logistic regression was used to investigate the association of clinical and demographic factors with the success of treatment. Regardless of the assessment time, no difference in incidence (38%-43% at first 24h), intensity of postoperative pain, and incidence of flare-up (≈ 3%) was observed between the two endodontic protocols. Both protocols resulted in a similar healing rate of apical periodontitis. After 12 months, the success rate ranged from 73% to 78% and the difference between the treatments fell within the pre-established equivalence margin (-0.1; -0.41 to 0.2). Endodontic treatment combining a reciprocating single file with matching-taper single cone showed similar clinical effectiveness to the treatment using hand-file instrumentation and the lateral compaction filling.

Increased sMer, but not sAxl, sTyro3, and Gas6 relate with active disease in juvenile systemic lupus erythematosus.

INTRODUCTION/OBJECTIVES: Tyro3, Axl, and Mer (TAM) receptors and ligands mediate apoptotic bodies engulfment which alteration has been related with juvenile systemic lupus erythematosus (JSLE) pathogenesis. Thus, the aim was to determine their soluble levels. METHODS: Serum sTyro3, sAxl, sMer, and Gas6 levels were measured using ELISA in 67 JSLE patients, 12 juvenile idiopathic arthritis (JIA) inflammatory and 20 healthy controls and related with SLEDAI-2K score, anti-dsDNA antibody, ESR, CRP, C3, C4 levels, and nephritis. RESULTS: JSLE patients with active disease (SLEDAI-2K> 4) had significantly increased sMer levels compared with healthy controls (median 8.4 vs. 6.0 ng/mL, p = 0.009) and inactive disease patients (5.2 ng/mL, p = 0.0003). sMer levels correlated with SLEDAI-2K (r = 0.44; p = 0.0004) and ESR (r = 0.24; p = 0.04), while sAxl correlated with SLEDAI-2K (r = 0.33; p = 0.008) and C4 levels (r = - 0.24; p = 0.04). JSLE patients taking glucocorticoid had increased sAxl and sMer levels. Moreover, sAxl correlated with sMer and sTyro3 levels. Patients with nephritis and those with focal or diffuse proliferative glomerulonephritis had these protein levels similar to healthy controls and patients without renal involvement. sTyro3 levels of JSLE patients taking glucocorticoid were decreased, and correlated with Gas6 and sAxl, while Gas6 levels correlated with age upon enrollment. JIA controls had protein levels similar to healthy controls and JSLE patients. CONCLUSIONS: This study reinforces that sMer is increased in active JSLE patients, yet sMer and sAxl correlates with disease activity parameters, and their alterations are disease-specific. However, further studies are needed to determine exact roles of sTyro3 and Gas6 in disease pathogenesis. Key Points • sMer and sAxl serum levels are related with active disease in JSLE patients • sMer correlated with SLEDAI-2K score in JSLE • sTyro3, sAxl, sMer and Gas6 levels did not related with nephritis in JSLE patients • sTyro3 and Gas6 exact roles in JSLE are not established and further studies are needed.

Effectiveness of a reciprocating single file, single cone endodontic treatment approach: a randomized controlled pragmatic clinical trial.

OBJECTIVES: To compare the root filling quality, the sealer extrusion, and the healing rates of apical lesions addressed via two endodontic treatment approaches. The hypothesis tested was that both techniques present similar apical periodontitis healing results. MATERIALS AND METHODS: This study was a parallel-design, pragmatic, and randomized clinical trial. One hundred twenty anterior teeth with necrotic pulps and apical periodontitis were randomly allocated to be either instrumented with hand files and obturated with the lateral compaction technique or instrumented with a single file in a reciprocating movement and obturated with a single-cone technique. The root canal filling quality, the occurrence of sealer extrusion, and apical periodontitis healing were the outcomes of interest. Data were analyzed through chi-square analysis, and the odds ratio for healing was adjusted using a logistic regression model (α = 0.05). RESULTS: No significant differences were observed between the endodontic techniques regarding the root filling quality or sealer extrusion. Six months after treatment, both endodontic techniques presented equivalent results regarding apical periodontitis healing. The healing rate was affected only by the periapical status at baseline. CONCLUSIONS: The obturation of the root canal of the anterior teeth using reciprocating file-matched single cones presented a similar quality to that obtained with manual instrumentation followed by the lateral condensation technique. Similar healing rates of apical lesions were also observed. CLINICAL RELEVANCE: For treating anterior teeth with apical periodontitis, a reciprocating single-file, single-treatment protocol was as effective as a traditional protocol combining hand instrumentation and the lateral compaction obturation technique.

Acquisition of specific antibodies and their influence on cell-mediated immune response in neonatal cord blood after maternal pertussis vaccination during pregnancy.

Maternal immunization with pertussis acellular vaccine (Tdap) is an intervention that provides protection to newborns. However, it has been reported that high maternal antibody levels may adversely affect the immune response of infants after active immunization. In this study, we evaluated neonatal passive acquisition of pertussis-specific antibodies and their influence on the neonatal cell-mediated immune response. Pregnant women were either vaccinated with Tdap vaccine (case group, n = 66) or received no vaccine (control group, n = 101). Whole-cell Bordetella pertussis (Bp), pertussis toxin (PT), filamentous hemagglutinin (FHA) and pertactin (PRN)-specific serum IgG were quantified in paired maternal-cord sera, and Bp- and PT-specific IgA were evaluated in colostrum by ELISA. Ex vivo neonatal blood lymphocyte responsiveness after Bp stimulation was assessed in case (n = 17) and control (n = 15) groups using flow cytometry to detect proliferation, cytokine production and activation phenotype of lymphocytes in the context of high specific IgG acquired after maternal vaccination. Anti-Bp, PT, FHA and PRN IgG concentrations in maternal and cord sera from case group were higher than those in control group with positive correlation indexes in both groups for all pertussis antigens. The control group presented higher placental transfer ratios of specific antibodies and, in the case group, vaccination between 26 and 31 gestation weeks was associated with the best placental transfer ratios. Specific IgA concentrations in colostrum were not affected by vaccine status. Whole blood assays revealed that newborns responded to Bp stimulation with higher expression of CD40L, CD69 and CD4+ T cell proliferation compared to unstimulated cells, and a lower Th1 response, while a preserved Th2 response compared to adults, but there were no differences between the neonatal groups for any of the studied parameters. Our results indicate that higher pertussis-specific IgG levels in newborn sera after maternal vaccination do not affect the neonatal ex vivo cell-mediated immune response.

First-year profile of biomarkers for early detection of renal injury in infants with congenital urinary tract obstruction.

BACKGROUND: Diagnosis of renal function impairment and deterioration in congenital urinary tract obstruction (UTO) continues to be extremely challenging. Use of renal biomarkers in this setting may favor early renal injury detection, allowing for a reliable choice of optimal therapeutic options and prevention or minimization of definitive renal damage. METHODS: This longitudinal, prospective study analyzed the first-year profile of two serum renal biomarkers: creatinine (sCr) and cystatin C (sCyC); and six urinary renal biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), transforming growth factor beta-1 (TGF-ß1), retinol-binding protein (RBP), cystatin C (uCyC), and microalbuminuria (µALB) in a cohort of 37 infants with UTO divided into three subgroups: 14/37 with unilateral hydro(uretero)nephrosis, 13/37 with bilateral hydro(uretero)nephrosis, and 10/37 patients with lower urinary tract obstruction (LUTO), compared with 24 healthy infants matched by gestational age and birth weight. RESULTS: All urine biomarkers showed significantly higher values at the first month of life (p ≤ 0.009), while NGAL (p = 0.005), TGF-ß1 (p < 0.001), and µALB (p < 0.001) were high since birth compared to controls. Best single biomarker performances were RBP in bilateral hydronephrosis and LUTO subgroups and KIM-1 in unilateral hydronephrosis subgroup. Best biomarker combination results for all subgroups were obtained by matching RBP with TGF-ß1 or KIM-1 and NGAL with CyC ([AUC] ≤ 0.934; sensitivity ≤ 92.4%; specificity ≤ 92.8%). CONCLUSIONS: RBP, NGAL, KIM-1, TGF-ß1, and CyC, alone and especially in combination, are relatively efficient in identifying surgically amenable congenital UTO and could be of practical use in indicating on-time surgery.

Increased Soluble Cytoplasmic Bcl-2 Protein Serum Levels and Expression and Decreased Fas Expression in Lymphocytes and Monocytes in Juvenile Dermatomyositis.

OBJECTIVE: To evaluate soluble Fas antigen (sFas), sFas ligand (sFasL), soluble tumor necrosis factor-related apoptosis-inducing ligand, and soluble cytoplasmic Bcl-2 protein (sBcl-2) serum levels, Fas and Bcl-2 expressions in T and B lymphocytes and monocytes and relations with erythrocyte sedimentation rate, C-reactive protein (CRP), Childhood Myositis Assessment Scale, and manual muscle testing in juvenile dermatomyositis (JDM). METHODS: Serum levels were determined by ELISA and peripheral cell expressions by flow cytometry for patients with JDM or juvenile idiopathic arthritis (JIA), and healthy controls. RESULTS: Patients with JDM had increased sBcl-2, which correlated with CRP. Expression of Bcl-2 was increased and expression of Fas was decreased in CD3+, CD4+, and CD8+ T lymphocytes compared with JIA and/or healthy controls. CONCLUSION: Patients with JDM presented a unique apoptosis-related proteins profile, which may contribute to disease development.

Passive acquisition of anti-Staphylococcus aureus antibodies by newborns via transplacental transfer and breastfeeding, regardless of maternal colonization

OBJECTIVE: To investigate the transmission of anti-Staphylococcus aureus (Sa) IgG, IgG1 and IgG2 via placental transfer and the transfer of IgA via the colostrum according to maternal Sa carrier status at delivery. METHODS: We evaluated anti-Sa IgG, IgG1 and IgG2 in maternal and cord sera and IgA in colostrum from a case (n=49, Sa+) and a control group (n=98, Sa-). RESULTS: Of the 250 parturients analyzed for this study, 49 were nasally colonized with S. aureus (prevalence of 19.6%). Ninety-eight non-colonized subjects were selected for the control group. The anti-Sa IgG, IgG1 and IgG2 levels and the IgG avidity indexes in the maternal and cord sera did not differ between the groups, with a low transfer ratio of anti-Sa IgG to the newborns in both groups. The anti-Sa IgG2 titers were significantly higher than the IgG1 titers in the maternal and cord sera. Inversely, the transfer ratios were higher for anti-Sa IgG1 compared with IgG2; however, no differences between the groups were detected. The Sa-specific IgA levels and avidity indexes in the colostrum were equivalent between groups. CONCLUSIONS: Maternal Sa nasal colonization at delivery is not associated with higher antibody levels in the mother or newborns. The high titers of anti-Sa IgG2 found in the cord serum indicate a greater reactivity with non-protein antigens, which may further contribute to the susceptibility to staphylococcal infections at birth. The presence of IgA in the colostrum with avidity to S. aureus reinforces the importance of breastfeeding shortly after birth.

TLR expression, phagocytosis and oxidative burst in healthy and septic newborns in response to Gram-negative and Gram-positive rods.

The objective was to investigate whether phagocytes from healthy and septic newborns have a developmental deficiency in their capacity to recognize, phagocytize and generate hydrogen peroxide (H2O2) in response to Escherichia coli and Staphylococcus aureus. TLR expression and phagocytic ability of neutrophils and monocytes from 44 healthy preterm and term neonates, from 13 newborns with late-onset sepsis and from 24 healthy adults were determined using flow cytometry, and H2O2 production was measured by dihydrorhodamine test. TLR-2 and TLR-4 expressions were similar among the groups. The phagocytic ability of monocytes and neutrophils exposed to E. coli and S. aureus in healthy and septic neonates was significantly reduced compared to that of adults. Monocytes from septic newborns exposed to E. coli had higher H2O2 production than those of the other groups. The oxidative burst of monocytes exposed to S. aureus was reduced in preterm newborns compared with term ones and those with sepsis, and no differences were found in the oxidative burst of neutrophils. Even with the ability to recognize bacteria, a decreased clearance of pathogens can cause an imbalance in the immune response, which could lead to a predisposition to sepsis. Once established, the increased production of cytokines and ROS in an attempt to control the infection as well as the lack of full phagocytic activity leads to persistence of the pathogen and a state of constant inflammation.

Passive acquisition of anti-Staphylococcus aureus antibodies by newborns via transplacental transfer and breastfeeding, regardless of maternal colonization.

OBJECTIVE:: To investigate the transmission of anti-Staphylococcus aureus (Sa) IgG, IgG1 and IgG2 via placental transfer and the transfer of IgA via the colostrum according to maternal Sa carrier status at delivery. METHODS:: We evaluated anti-Sa IgG, IgG1 and IgG2 in maternal and cord sera and IgA in colostrum from a case (n=49, Sa+) and a control group (n=98, Sa-). RESULTS:: Of the 250 parturients analyzed for this study, 49 were nasally colonized with S. aureus (prevalence of 19.6%). Ninety-eight non-colonized subjects were selected for the control group. The anti-Sa IgG, IgG1 and IgG2 levels and the IgG avidity indexes in the maternal and cord sera did not differ between the groups, with a low transfer ratio of anti-Sa IgG to the newborns in both groups. The anti-Sa IgG2 titers were significantly higher than the IgG1 titers in the maternal and cord sera. Inversely, the transfer ratios were higher for anti-Sa IgG1 compared with IgG2; however, no differences between the groups were detected. The Sa-specific IgA levels and avidity indexes in the colostrum were equivalent between groups. CONCLUSIONS:: Maternal Sa nasal colonization at delivery is not associated with higher antibody levels in the mother or newborns. The high titers of anti-Sa IgG2 found in the cord serum indicate a greater reactivity with non-protein antigens, which may further contribute to the susceptibility to staphylococcal infections at birth. The presence of IgA in the colostrum with avidity to S. aureus reinforces the importance of breastfeeding shortly after birth.

Effects of prior exercise on glycemic responses following carbohydrate inges on in individuals with type 2 diabetes.

BACKGROUND: Exercise is effective in reducing glycemia, especially when it is performed in the postprandial period. However, no consensus exists in the literature about the effect of exercise on postprandial glucose control when it is performed before carbohydrate consumption. AIMS: The main aim was to determine whether 20 min of exercise performed prior to carbohydrate consumption reduces postprandial glycemic and insulinemic responses. A secondary aim was to analyze the effectiveness of short-term (10 min) exercise bout with respect to postprandial glycemia reduction. METHODS: Nine individuals with type 2 diabetes (54.9 ± 1.7 years; 30.7 ± 1.8 kg/m2; glycemia level of 167.0 ±10.6 mg/dL) participated in the study and underwent the following procedures: (a) an incremental test to determine the lactate threshold; (b) an exercise session for 20 minutes at moderate intensity (90% of the lactate threshold); and c) a control session. The last two sessions were randomized, and the participants were monitored during 135 minutes of post-exercise recovery. A standard meal was consumed two hours before the experimental procedures started. A dextrose solution was administered at 45 minutes of post-exercise recovery while monitoring glucose and insulin concentrations. At 135 min of post-exercise recovery, eight of the participants performed an additional 10-min exercise bout following induced hyperglycemia. RESULTS: Exercise reduced glycemia (-46.6 ± 7.9 mg/dL) and the insulin/glucose ratio (from 1.73 ± 0.59 to 0.93 ± 0.22 µU/mL/mmol/L) during the first 45 minutes of post-exercise recovery. Glycemia was significantly increased after carbohydrate consumption, reaching its peak value at 105 minutes of post-exercise recovery (261.8 ± 15.8 mg/dL) or control (281.3 ± 13.4 mg/dL). There was no effect of the previous exercise in attenuating glycemia or reducing the area under the curve for glucose and insulin after carbohydrate consumption. However, the effectiveness of exercise in reducing glycemia was shown again when it was performed at the end of the experimental session, even in case of only a 10-min exercise (reduction of -44.5 ± 4.9 mg/dL). CONCLUSIONS: Twenty minutes of moderate exercise does not alter the kinetics or the area under the curve in terms of glycemia and insulinemia after subsequent carbohydrate consumption. However, moderate exercise, even if performed for only 10-20 minutes, is effective in reducing postprandial glycemia in individuals with type 2 diabetes. RELEVANCE FOR PATIENTS: Moderate-intensity exercise, even of short duration, may benefit individuals with type 2 diabetes on blood glucose control. A fast reduction in postprandial glycemia can be obtained with only ten minutes of exercise that, in turn, may ameliorate some of complications associated with the disease.

Effective analysis of the use of peracetic acid after instrumentation of root canals contaminated with Enterococcus faecalis.

INTRODUCTION: The aim of this study was to evaluate the effectiveness of peracetic acid (PAA) in cleaning root canals contaminated with Enterococcus faecalis. METHODS: Sixty first and second mandibular molars were used. Their mesiobuccal canals were prepared with the Reciproc System (VDW, Munich, Germany). The canals were irrigated with 10 mL saline during instrumentation. The teeth were randomly divided into 3 groups (n = 20), according to the irrigation solution to be used after instrumentation: group PAA (5 mL 1% PAA), group EDTA/sodium hypochlorite (NaOCl) (5 mL 17% EDTA followed by 5 mL 2.5% sodium hypochlorite), and group S (5 mL saline). Microbiological samples were collected before instrumentation and after final irrigation. Bacterial quantification was performed by counting the number of colony-forming units (CFUs/mL). The results were analyzed by the nonparametric Wilcoxon and Kruskal-Wallis tests. RESULTS: The 3 groups showed a significant reduction (P < .05) in CFUs/mL after final irrigation. PAA and NaOCl associated with EDTA produced a significantly higher reduction in CFUs/mL (P < .05) compared with saline. There was no statistically significant difference between PAA and EDTA + 2.5% NaOCl (P > .05). CONCLUSIONS: According to the results of the present study, the effectiveness of 1% PAA was similar to that of 17% EDTA + 2.5% NaOCl in cleaning curved root canals contaminated with E. faecalis.

Type 2 diabetes elicits lower nitric oxide, bradykinin concentration and kallikrein activity together with higher DesArg(9)-BK and reduced post-exercise hypotension compared to non-diabetic condition.

This study compared the plasma kallikrein activity (PKA), bradykinin concentration (BK), DesArg(9)-BK production, nitric oxide release (NO) and blood pressure (BP) response after moderate-intensity aerobic exercise performed by individuals with and without type 2 diabetes. Ten subjects with type 2 diabetes (T2D) and 10 without type 2 diabetes (ND) underwent three sessions: 1) maximal incremental test on cycle ergometer to determine lactate threshold (LT); 2) 20-min of constant-load exercise on cycle ergometer, at 90% LT and; 3) control session. BP and oxygen uptake were measured at rest and at 15, 30 and 45 min post-exercise. Venous blood samples were collected at 15 and 45 minutes of the recovery period for further analysis of PKA, BK and DesArg(9)-BK. Nitrite plus nitrate (NOx) was analyzed at 15 minutes post exercise. The ND group presented post-exercise hypotension (PEH) of systolic blood pressure and mean arterial pressure on the 90% LT session but T2D group did not. Plasma NOx increased ~24.4% for ND and ~13.8% for T2D group 15 min after the exercise session. Additionally, only ND individuals showed increases in PKA and BK in response to exercise and only T2D group showed increased DesArg(9)-BK production. It was concluded that T2D individuals presented lower PKA, BK and NOx release as well as higher DesArg(9)-BK production and reduced PEH in relation to ND participants after a single exercise session.

Sex-specific effects of exercise ancestry on metabolic, morphological and gene expression phenotypes in multiple generations of mouse offspring.

Early life and preconception environmental stimuli can affect adult health-related phenotypes. Exercise training is an environmental stimulus affecting many systems throughout the body and appears to alter offspring phenotypes. The aim of this study was to examine the influence of parental exercise training, or 'exercise ancestry', on morphological and metabolic phenotypes in two generations of mouse offspring. The F0 C57BL/6 mice were exposed to voluntary exercise (EX) or sedentary lifestyle (SED) and bred with like-exposed mates to produce an F1 generation. The F1 mice of both ancestries were sedentary and killed at 8 weeks or bred with littermates to produce an F2 generation, which was also sedentary and killed at 8 weeks. Small but broad generation- and sex-specific effects of exercise ancestry were observed for body mass, fat and muscle mass, serum insulin, glucose tolerance and muscle gene expression. The F1 EX females were lighter than F1 SED females and had lower absolute tibialis anterior and omental fat masses. Serum insulin was higher in F1 EX females compared with F1 SED females. The F2 EX females had impaired glucose tolerance compared with F2 SED females. Analysis of skeletal muscle mRNA levels revealed several generation- and sex-specific differences in mRNA levels for multiple genes, especially those related to metabolic genes (e.g. F1 EX males had lower mRNA levels of Hk2, Ppard, Ppargc1a, Adipoq and Scd1 than F1 SED males). These results provide preliminary evidence that parental exercise training can influence health-related phenotypes in mouse offspring.

Exercise alters mRNA expression of telomere-repeat binding factor 1 in skeletal muscle via p38 MAPK.

Telomeres protect chromosome ends and shorten with age in most tissues. Integral to the maintenance of telomeres is the protein complex shelterin. The gene expression regulation of shelterin proteins to physiological stressors is not understood in vivo. We have recently reported increased telomere-repeat binding factor 1 (TRF1) protein expression and longer telomere length in skeletal muscle of sedentary compared with chronically active mice. These provocative observations led us to examine the effects of acute physiological stress on shelterin expression in vivo in mice and to further define potential mechanisms associated with gene regulation of shelterin. Three groups of female C57Bl/6 mice were studied: one control group and two groups that underwent a 30-min treadmill running bout and were killed either immediately following or 1-h after the exercise. Following the exercise bout, mRNA expression of Trf1 was significantly reduced in the plantaris muscle, and this reduction was paralleled by significant increases in p38 MAPK phosphorylation. To determine if p38 mediated the decreases in Trf1 mRNA expression, C2C12 myotubes were treated with the calcium ionophore, A23187. In response to the A23187, Trf1 gene expression was significantly reduced, coupled with significant increases in p38 phosphorylation, similar to in vivo data. C2C12 myotubes pretreated with a p38 inhibitor (SB-202190) prevented the A23187-induced decrease in Trf1 mRNA expression, indicating a link between Trf1 gene expression and p38 MAPK activation. While it is too early to definitively report the effect of exercise on telomere biology in rodents or humans, these data provide important mechanistic insights into the paradoxical telomere shortening that occurs in skeletal muscle in response to chronic exercise in mice.

Chronic exercise modifies age-related telomere dynamics in a tissue-specific fashion.

We evaluated the impact of long-term exercise on telomere dynamics in wild-derived short telomere mice (CAST/Ei) over 1 year. We observed significant telomere shortening in liver and cardiac tissues in sedentary 1-year-old mice compared with young (8 weeks) baseline mice that were attenuated in exercised 1-year-old animals. In contrast, skeletal muscle exhibited significant telomere shortening in exercise mice compared with sedentary and young mice. Telomerase enzyme activity was increased in skeletal muscle of exercise compared with sedentary animals but was similar in cardiac and liver tissues. We observed significant age-related decreases in expression of telomere-related genes that were attenuated by exercise in cardiac and skeletal muscle but not liver. Protein content of TRF1 was significantly increased in plantaris muscle with age. In summary, long-term exercise altered telomere dynamics, slowing age-related decreases in telomere length in cardiac and liver tissue but contributing to shortening in exercised skeletal muscle.

Efeito da intensidade do exercício sobre a oxidação de carboidratos e gorduras durante a recuperação pós-exercício em diabéticos tipo 2 / Effects of exercise intensity in fat and carbohydrate oxidation during post-exercise recovery in type 2 diabetes

Indivíduos com diabetes tipo 2 apresentam alterações na utilização de substratos energéticos em repouso e durante o exercício, como capacidade reduzida de utilização de carboidratos e síntese de glicogênio muscular, acentuando a hiperglicemia e a resistência à insulina. Estudos têm demonstrado que o exercício pode ser efetivo no controle e tratamento do diabetes tipo 2, porém o efeito de diferentes intensidades de exercício sobre a contribuição de carboidratos e gorduras durante a recuperação ainda não foi elucidado. Participaram do estudo 20 indivíduos sedentários, divididos em 2 grupos, sendo 9 diabéticos tipo 2 (DB) (2 mulheres) e 11 não diabéticos (ND) (2 mulheres), os quais foram submetidos a 3 sessões experimentais: Teste incremental máximo (TI), seguido de sessão de exercício submáximo realizado a 90% da carga do limiar de lactato (90%LL) e sessão controle (C) sem a realização de exercício, estas duas últimas em ordem randomizada. Em todas as sessões experimentais, os participantes permaneceram em repouso durante 20 min antes do inicio das sessões, bem como por 135 minutos durante o período de recuperação pós-exercício ou controle para a mensuração das variáveis ventilatórias, sendo que aos 45 minutos de recuperação uma solução de carboidrato (CHO) foi administrada. Ambos os grupos apresentaram elevada oxidação de carboidratos durante as sessões de exercício máximo (TI) e submáximo (90%LL) quando comparado aos valores de repouso (p<0,05). A oxidação de gorduras ficou elevada durante o período de recuperação do TI em ambos os grupos (p<0,05), contudo, no grupo DB, essa alteração se prolongou por um maior período de recuperação. Por outro lado, durante a recuperação do exercício submáximo, somente o grupo ND apresentou oxidação de gordura elevada após 60 min de recuperação...

Individuals with type 2 diabetes (DB) have changes in energy substrate utilization at rest and during exercise, with less use of carbohydrate and muscle glycogen synthesis, emphasizing the hyperglycemia and insulin resistance. Exercise can help control and treatment of type 2 diabetes, but effect of different exercise intensities on the carbohydrates and fats contribution during recovery has not yet been elucidated. Participated in the study 20 sedentary individuals, 9 individuals (2 women) with type 2 diabetes (DB) and 11 (2 women) without diabetes (ND), underwent three experimental sessions (SE): maximal incremental test (IT); submaximal exercise, 90% of the load of the lactate threshold (90% LL) and control (Cont) or without exercise (the latter two session in randomized order). In all the SE, the participants were at rest (pre-exercise) for 20 minutes and 135 minutes during the post-exercise for measurement of ventilatory variables, and the 45-minute of recovery the volunteers were given a carbohydrate solution was given. The results showed that both groups had high carbohydrate oxidation during exercise of high and moderate intensity compared with rest (p <0.05). The fat oxidation was higher during the recovery of IT in both groups (p <0.05), and longer in the DB. On the other hand, during recovery from moderate exercise, only ND had higher fat oxidation after 60 min of recovery...

Respostas cardiovasculares pós-exercício de natação / Swimming post-exercise cardiovascular responses

INTRODUÇÃO: A crescente procura da natação como um tratamento não-farmacológico da hipertensão arterial tem aumentado. Objetivo: Analisar as respostas da pressão arterial (PA) após o exercício de natação e durante a rotina diária de trabalho de indivíduos pré-hipertensos. MÉTODOS: Oito indivíduos pré-hipertensos (128,2 ± 7,8 / 77,8 ± 6,0mmHg; 41,8 ± 3,2 anos; 84,7 ± 17,9kg; 180,4 ± 4,8cm; 27,3 ± 5,8kg.m2(-1)) foram submetidos a duas sessões, sendo uma de natação (SN) e a outra de controle (SC). A PA foi medida no repouso pré-exercício e durante 12 horas de recuperação pós-exercício. Na SN, os pacientes nadaram por 45min em uma intensidade moderada a alta (PSE 14,5 ± 1,6), e, durante a SC, os sujeitos permaneceram em repouso na posição sentada pelo mesmo período de tempo. RESULTADOS: ANOVA para medidas repetidas evidenciou diminuição significativa (p < 0,05) na PAS por duas horas após a SN em relação ao repouso, e uma diferença significativa entre os deltas do PAS (Δ - PAS variação na recuperação pós-exercício em relação ao repouso pré-exercício) foi observada entre as sessões na primeira e segunda horas após a recuperação, respectivamente (ΔSS = -10,4 e -9,3 vs. ΔCS = 0,8 e 4,4mmHg, p < 0,05). Nγo houve diferenças significativas da PAD, intra e entre as sessões. CONCLUSÃO: O exercício de natação em intensidade moderada a alta foi eficaz para promover redução da PA pós-exercício em indivíduos hipertensos durante a sua rotina de trabalho.

INTRODUCTION: The increasing demand for swimming as a non-pharmacological treatment of hypertension has increased. PURPOSE: To analyze the blood pressure (BP) responses after swimming and during the daily work routine of pre-hypertensive individuals. METHODS: Eight male borderline hypertensive individuals (128.2 ± 7.8 / 77.8 ± 6.0 mmHg; 41.8 ± 3.2 years; 84.7 ± 17.9 kg; 180.4 ± 4.8 cm; 27.3 ± 5.8 kg.m2 (-1)) were submitted to a swimming exercise (SS) and control (CS) sessions. BP was measured at pre-exercise rest and during 12 hours of the post-exercise recovery. In SS, patients swan for 45 minutes in a moderate-high intensity (PSE 14.5 ± 1.6), and during CS the subjects remained at seated rest for 45 min. RESULTS: ANOVA for repeated measures evidenced significant decrease (P < 0.05) in SBP in the for 2 hours after SS in comparison to rest, and a significant difference between the SBP deltas (Δ - SBP variation in the post-exercise recovery compared to pre-exercise rest) was observed when comparing sessions at 1 and 2 hours after recovery, respectively (ΔSS = -10.4 and -9.3 vs. ΔCS = 0.8 and 4.4 mmHg, p <0.05). There were not significant differences in DBP within and between sessions. CONCLUSION: Swimming exercise at moderate-high intensity was effective in promoting post-exercise BP reduction for borderline hypertensive individuals during their daily work routine.

Effects of treadmill running and resistance exercises on lowering blood pressure during the daily work of hypertensive subjects.

The purposes of this study were to compare the hypotensive effects of treadmill running (TR) and resistance exercise (RE) performed by hypertensive subjects and to verify if the hypotensive effects of these exercises are maintained during a regular white-collar workday. Fifteen white-collar workers (42.9 +/- 1.6 years), treated with antihypertensive medication, accomplished three different sessions: 20 minutes of TR (approximately 70-80% of heart rate reserve), 20 minutes of circuit training RE (20 repetitions at 40% of 1 repetition maximum), and a control session without exercise (CON). The systolic blood pressure (BP), diastolic BP, heart rate, and blood lactate were measured at resting (Rest) and after sessions at 15th (R15), 30th (R30), 45th (R45), and 60th (R60) min, as well as after lunch (AL), four (R4h) and seven (R7h) hours of recovery at the participants' workplace. In relation to rest, a higher decrease of systolic BP after TR (-11.1 +/- 7.6 mm Hg) and RE (-12.6 +/- 7.3 mm Hg) was observed respectively at the R30 and R45. For diastolic BP, the highest decreases after TR (-4.0 +/- 6.4 mm Hg) and RE (-9.0 +/- 7.0 mm Hg) were observed respectively at the R45 and R30. The systolic BP and mean BP after TR and RE differed significantly from CON session (p < 0.05), and lower post-exercise values could be observed over the workday. In conclusion, both 20 minutes of TR and RE resulted in postexercise hypotension, and were able to reduce BP throughout 7 hours after exercise, even throughout the subject's regular occupational activities. Also, the RE promoted higher cardiac protection and can be a useful model of physical exercise prescription for hypertension individuals.