Cryptic transmission and novel introduction of Dengue 1 and 2 genotypes in Colombia.

Dengue fever remains as a public health challenge in Colombia, standing as the most prevalent infectious disease in the country. The cyclic nature of dengue epidemics, occurring approximately every 3 years, is intricately linked to meteorological events like El Niño Southern Oscillation (ENSO). Therefore, the Colombian system faces challenges in genomic surveillance. This study aimed to evaluate local dengue virus (DENV) transmission and genetic diversity in four Colombian departments with heterogeneous incidence patterns (department is first-level territorial units in Colombia). For this study, we processed 266 serum samples to identify DENV. Subsequently, we obtained 118 genome sequences by sequencing DENV genomes from serum samples of 134 patients infected with DENV-1 and DENV-2 serotypes. The predominant serotype was DENV-2 (108/143), with the Asian-American (AA) genotype (91/118) being the most prevalent one. Phylogenetic analysis revealed concurrent circulation of two lineages of both DENV-2 AA and DENV-1 V, suggesting ongoing genetic exchange with sequences from Venezuela and Cuba. The continuous migration of Venezuelan citizens into Colombia can contribute to this exchange, emphasizing the need for strengthened prevention measures in border areas. Notably, the time to most recent common ancestor analysis identified cryptic transmission of DENV-2 AA since approximately 2015, leading to the recent epidemic. This challenges the notion that major outbreaks are solely triggered by recent virus introductions, emphasizing the importance of active genomic surveillance. The study also highlighted the contrasting selection pressures on DENV-1 V and DENV-2 AA, with the latter experiencing positive selection, possibly influencing its transmissibility. The presence of a cosmopolitan genotype in Colombia, previously reported in Brazil and Peru, raises concerns about transmission routes, emphasizing the necessity for thorough DENV evolution studies. Despite limitations, the study underscores genomic epidemiology's crucial role in early detection and comprehension of DENV genotypes, recommending the use of advanced sequencing techniques as an early warning system to help prevent and control dengue outbreaks in Colombia and worldwide.

Emergence of Dengue Virus Serotype 2 Cosmopolitan Genotype, Colombia.

Using Oxford Nanopore technologies and phylogenetic analyses, we sequenced and identified the cosmopolitan genotype of dengue virus serotype 2 isolated from 2 patients in the city of Villavicencio, Meta department, Colombia. This identification suggests the emergence of this genotype in the country, which warrants further surveillance to identify its epidemic potential.

Infectious diseases in migrant pregnant women from an area of the Colombian Caribbean.

INTRODUCTION: Human migration is an activity that affects society in economic and political aspects and as a social determinant because of its differential impact on individual's health. OBJECTIVE: To describe the situation of health and infectious diseases of vertical transmission risk in migrant pregnant women from an area of the Colombian Caribbean from 2019 to 2021. METHODS: A descriptive cross-sectional study was carried out on pregnant irregular migrants in the Riohacha and Santa Marta municipalities in Colombia. Hemogram, uranalysis, toxoplasma, FTA-ABS, VDRL, rubella, hepatitis B, HIV (TORCHs), vaginal swab, basal glycemia, and transaminases, among other paraclinical tests, were done on pregnant women. Data was arranged, tabulated, and analyzed in SPSS v.23.0. A descriptive statistical analysis with measures of central tendency and dispersion for quantitative variables, and proportions analysis was done for qualitative variables. RESULTS: A total of 555 clinical records were analyzed. Of the infectious agents with a risk of vertical transmission, syphilis was the most frequent with 3.6%. Regarding toxoplasmosis, 2.5% were IgM-positive. 4.2% of the pregnant women had IgG antibodies against Rubella and 2 women showed antibodies against HIV. CONCLUSIONS: Our results reflect the need for the implementation of educational, prevention, and detection health programs with the aim to decrease the number of prenatal infections in the pregnant migrant population for preventing fatal complications both in mothers and newborns.

Polyphosphate Activates von Willebrand Factor Interaction with Glycoprotein Ib in the Absence of Factor VIII In Vitro.

Polyphosphate (polyP), a phosphate polymer released by activated platelets, may modulate various stages of hemostasis by binding to blood proteins. In this context, we previously reported that polyP binds to the von Willebrand factor (VWF). One of the most significant functions of VWF is to bind to and protect the blood circulating Factor VIII (FVIII). Therefore, here, we study the role of polyP in the VWF-FVIII complex in vitro and suggest its biological significance. Surface plasmon resonance and electrophoretic mobility assays indicated that polyP binds dynamically to VWF only in the absence of FVIII. Using the VWF Ristocetin Cofactor assay, the most accepted method for studying VWF in platelet adhesion, we found that polyP activates this role of VWF only at low levels of FVIII, such as in plasmas with chemically depleted FVIII and plasmas from severe hemophilia A patients. Moreover, we demonstrated that FVIII competes with polyP in the activation of VWF. Finally, polyP also increases the binding of VWF to platelets in samples from patients with type 2 and type 3 von Willebrand disease. We propose that polyP may be used in designing new therapies to activate VWF when FVIII cannot be used.

Proinflammatory Polyphosphate Increases in Plasma of Obese Children with Insulin Resistance and Adults with Severe Type 2 Diabetes.

Obesity increases the risk of insulin resistance and type 2 diabetes through increased inflammation at cellular and tissue levels. Therefore, study of the molecular elements involved in obesity-related inflammation may contribute to preventing and controlling it. Inorganic polyphosphate is a natural phosphate polymer that has recently been attracting more attention for its role in inflammation and hemostasis processes. Polyphosphates are one of the main constituents of human platelets, which are secreted after platelet activation. Among other roles, they interact with multiple proteins of the coagulation cascade, trigger bradykinin release, and inhibit the complement system. Despite its importance, determinations of polyphosphate levels in blood plasma had been elusive until recently, when we developed a method to detect these levels precisely. Here, we perform cross sectional studies to evaluate plasma polyphosphate in: 25 children, most of them with obesity and overweight, and 20 adults, half of them with severe type 2 diabetes. Our results show that polyphosphate increases, in a significant manner, in children with insulin resistance and in type 2 diabetes patients. As we demonstrated before that polyphosphate decreases in healthy overweight individuals, these results suggest that this polymer could be an inflammation biomarker in the metabolic disease onset before diabetes.

Biomarkers of the prothrombotic state in abdominal obesity / Biomarcadores de estado protrombótico en la obesidad abdominal

Introduction: Central obesity is specifically associated with cardiovascular disease. Nevertheless, the molecular events that promote these conditions remain incompletely defined and risk stratifying patients for cardiovascular disease continues a challenge. Objective: The aim of this study was to assess some cost-efficient haemostatic markers, and its association with central obesity and traditional cardiovascular risk factors, in a cohort of middle aged subjects, without clinical cardiovascular disease, as basis for an improved prevention and intervention. Methods: We studied 307 men, aged 45±7 years, which underwent medical history, physical examination, anthropometric measurements, plasmatic biochemical parameters, plasma concentrations of fibrinogen, prothrombin activity, activated partial thromboplastin time, platelet count and mean platelet volume. Results: Prothrombin activity values were significantly higher in patients with central obesity (103 ± 16 % vs 111 ± 17 %, p<0.001). Across tertiles of fibrinogen (low and high), there was an increase in cholesterol, adjusted for age and body mass index (4.9±0.9 mmol/L vs 5.4±1.1 mmol/L, p< 0.01). High tertile of prothrombin activity showed higher levels of cholesterol (4.8±1.0 mmol/L vs 5.4±0.9 mmol/L , p< 0.05), triglycerides (1.07±0.6 mmol/L vs 1.32±0.9 mmol/L, p< 0.05), and waist circumference (92.8±8.3 cm vs 96.5±8.8 cm, p= ns) . Mean values of cholesterol were higher in low-activated partial thromboplastin time tertile (5.3±0.9 mmol/L vs 4.9±1.1 mmol/L, p<0.01). Participants in the high-mean platelet volume tertile showed higher levels of glycemia (5.7±0.6 mmol/L vs 5.99±0.7 mmol/L, p<0.05). Significant positive correlations were observed between fibrinogen and cholesterol (r=0.198, p<0.001) and triglycerides (r=0.116, p<0.05). Prothrombin activity was positively correlated with waist circumference (r=0.156, p<0.05), glucose (r=0.227, p<0.001), cholesterol (r=0.270, p=0.001), triglycerides (r=0.187, p=0.001) and mean platelet volume (r=0.130, p=0.05). Activated partial thromboplastin time was inversely related cholesterol (r=-0.172, p<0.01) concentrations. Mean platelet volume rose with increasing glucose concentrations (r=0.170, p<0.01). Conclusions: Haemostatic markers studied have shown association with abdominal adiposity and established cardiovascular risk factors. These markers are widely available, relatively inexpensive, and might allow risk stratifying patients for cardiovascular disease and the identification of hypercoagulable state in patients who might deserve preventive measures and are potential tools for assessing the impact of these measures (AU)

Introducción: La obesidad central está especialmente asociada con la enfermedad cardiovascular. No obstante, los mecanismos moleculares que la promueven no están completamente definidos y la estratificación del riesgo de los pacientes para la enfermedad cardiovascular sigue siendo un reto. Objetivo: Evaluar la asociación de la adiposidad central con marcadores hemostáticos coste-eficientes y con los factores de riesgo cardiovascular tradicionales en una cohorte de varones de mediana edad sin enfermedad cardiovascular clínica con objeto de mejorar la prevención y la intervención. Métodos: Estudiamos 307 varones de 45±7 años, a los que se realizó historia clínica, examen físico, mediciones antropométricas y determinaciones plasmáticas bioquímicas y de fibrinógeno, actividad protrombina, tiempo de tromboplastina parcial activada, recuento de plaquetas y volumen plaquetario medio. Resultados: Los valores de actividad protrombina fueron significativamente más elevados en pacientes con obesidad central (103 ± 16 % vs 111 ± 17 %, p<0.001). Los sujetos con cifras de fibrinógeno en el tertil alto presentaban un aumento en las concentraciones plasmáticas de colesterol (4.9±0.9 mmol/L vs 5.4±1.1 mmol/L, p< 0.01), ajustado por edad e índice de masa corporal. El tertil alto de actividad protrombina mostró concentraciones más elevadas de colesterol plasmático (4.8±1.0 mmol/L vs 5.4±0.9 mmol/L, p< 0.05), triglicéridos (1.07±0.6 mmol/L vs 1.32±0.9 mmol/L, p< 0.05), and medida de la circunferencia de la cintura (92.8±8.3 cm vs 96.5±8.8 cm, p= ns) . Las concentraciones medias de colesterol fueron más altas en el tertil bajo de tiempo de tromboplastina parcial activado (5.3±0.9 mmol/L vs 4.9±1.1 mmol/L, p<0.01). Los individuos en el tertil alto de volumen plaquetario medio presentaron glucemia más elevada (5.7±0.6 mmol/L vs 5.99±0.7 mmol/L, p<0.05). Se observaron correlaciones significativas positivas entre fibrinógeno y colesterol (r=0.198, p<0.001) and triglicéridos (r=0.116, p<0.05). La actividad protrombina estuvo positivamente correlacionada con la medida de la circunferencia de la cintura (r=0.156, p<0.05), glucemia (r=0.227, p<0.001), colesterol (r=0.270, p=0.001), triglicéridos (r=0.187, p=0.001) y volumen plaquetario medio (r=0.130, p=0.05). El tiempo de tromboplastina parcial activado estuvo inversamente relacionado con las concentraciones de colesterol (r=-0.172, p<0.01). El volumen plaquetario medio se correlacionó con las concentraciones de glucosa (r=0.170, p<0.01). Conclusiones: Los marcadores hemostáticos estudiados se asocian con la adiposidad abdominal y con los factores de riesgo cardiovascular establecidos. Estos marcadores están disponibles en clínica, son asequibles y podrían ser de ayuda en la estratificación del riesgo cardiovascular de los pacientes y en la identificación del estado hipercoagulable en personas que podrían beneficiarse de medidas preventivas. Además de ser herramientas potenciales para evaluar el impacto de dichas medidas (AU)

Biomarkers of the prothrombotic state in abdominal obesity.

INTRODUCTION: Central obesity is specifically associated with cardiovascular disease. Nevertheless, the molecular events that promote these conditions remain incompletely defined and risk stratifying patients for cardiovascular disease continues a challenge. OBJECTIVE: The aim of this study was to assess some cost-efficient haemostatic markers, and its association with central obesity and traditional cardiovascular risk factors, in a cohort of middle aged subjects, without clinical cardiovascular disease, as basis for an improved prevention and intervention. METHODS: We studied 307 men, aged 45±7 years, which underwent medical history, physical examination, anthropometric measurements, plasmatic biochemical parameters, plasma concentrations of fibrinogen, prothrombin activity, activated partial thromboplastin time, platelet count and mean platelet volume. RESULTS: Prothrombin activity values were significantly higher in patients with central obesity (103 ± 16 % vs 111 ± 17 %, p<0.001). Across tertiles of fibrinogen (low and high), there was an increase in cholesterol, adjusted for age and body mass index (4.9±0.9 mmol/L vs 5.4±1.1 mmol/L, p< 0.01). High tertile of prothrombin activity showed higher levels of cholesterol (4.8±1.0 mmol/L vs 5.4±0.9 mmol/L , p< 0.05), triglycerides (1.07±0.6 mmol/L vs 1.32±0.9 mmol/L, p< 0.05), and waist circumference (92.8±8.3 cm vs 96.5±8.8 cm, p= ns) . Mean values of cholesterol were higher in low-activated partial thromboplastin time tertile (5.3±0.9 mmol/L vs 4.9±1.1 mmol/L, p<0.01). Participants in the high-mean platelet volume tertile showed higher levels of glycemia (5.7±0.6 mmol/L vs 5.99±0.7 mmol/L, p<0.05). Significant positive correlations were observed between fibrinogen and cholesterol (r=0.198, p<0.001) and triglycerides (r=0.116, p<0.05). Prothrombin activity was positively correlated with waist circumference (r=0.156, p<0.05), glucose (r=0.227, p<0.001), cholesterol (r=0.270, p=0.001), triglycerides (r=0.187, p=0.001) and mean platelet volume (r=0.130, p=0.05). Activated partial thromboplastin time was inversely related cholesterol (r=-0.172, p<0.01) concentrations. Mean platelet volume rose with increasing glucose concentrations (r=0.170, p<0.01). CONCLUSIONS: Haemostatic markers studied have shown association with abdominal adiposity and established cardiovascular risk factors. These markers are widely available, relatively inexpensive, and might allow risk stratifying patients for cardiovascular disease and the identification of hypercoagulable state in patients who might deserve preventive measures and are potential tools for assessing the impact of these measures.

Introducción: La obesidad central está especialmente asociada con la enfermedad cardiovascular. No obstante, los mecanismos moleculares que la promueven no están completamente definidos y la estratificación del riesgo de los pacientes para la enfermedad cardiovascular sigue siendo un reto. Objetivo: Evaluar la asociación de la adiposidad central con marcadores hemostáticos coste-eficientes y con los factores de riesgo cardiovascular tradicionales en una cohorte de varones de mediana edad sin enfermedad cardiovascular clínica con objeto de mejorar la prevención y la intervención. Métodos: Estudiamos 307 varones de 45±7 años, a los que se realizó historia clínica, examen físico, mediciones antropométricas y determinaciones plasmáticas bioquímicas y de fibrinógeno, actividad protrombina, tiempo de tromboplastina parcial activada, recuento de plaquetas y volumen plaquetario medio. Resultados: Los valores de actividad protrombina fueron significativamente más elevados en pacientes con obesidad central (103 ± 16 % vs 111 ± 17 %, p.