TwinsMX: Exploring the Genetic and Environmental Influences on Health Traits in the Mexican Population.

TwinsMX registry is a national research initiative in Mexico that aims to understand the complex interplay between genetics and environment in shaping physical and mental health traits among the country's population. With a multidisciplinary approach, TwinsMX aims to advance our knowledge of the genetic and environmental mechanisms underlying ethnic variations in complex traits and diseases, including behavioral, psychometric, anthropometric, metabolic, cardiovascular and mental disorders. With information gathered from over 2800 twins, this article updates the prevalence of several complex traits; and describes the advances and novel ideas we have implemented such as magnetic resonance imaging. The future expansion of the TwinsMX registry will enhance our comprehension of the intricate interplay between genetics and environment in shaping health and disease in the Mexican population. Overall, this report describes the progress in the building of a solid database that will allow the study of complex traits in the Mexican population, valuable not only for our consortium, but also for the worldwide scientific community, by providing new insights of understudied genetically admixed populations.

Topological insight of immune-vascular distribution in peri-implantitis lesions.

OBJECTIVE: To characterize the distribution of macrophages, neutrophils, NK cells, and blood vessels in peri-implantitis compared to healthy aged gingiva samples. MATERIALS AND METHODS: This observational study included eight gingival samples from peri-implantitis and eight from periodontally healthy individuals. By immunofluorescence were identified neutrophils, NK cells, macrophages, and their pro-inflammatory or pro-healing phenotypes, and blood vessels. Two ROIs were designated as zone 1, connective tissue closest to the epithelium and zone 2, connective tissue over 200 microns from the rete ridges. Immune cells and vascular structures were quantified and characterized according to their distribution in both zones. RESULTS: Two peri-implantitis zones were characterized by unique macrophage phenotypes and blood vessel architecture. Blood vessels were larger in zone 2 in peri-implantitis. A greater number of NK cells and macrophages were found in peri-implantitis compared to healthy aged samples. A higher presence of pro-inflammatory macrophages was found in zone 1 compared to zone 2. A similar proportion of pro-inflammatory and pro-healing macrophages were found in zone 2. CONCLUSION: A specific distribution for pro-inflammatory macrophages and vascular architecture is observed in peri-implantitis. TNF-α colocalizes with macrophages in the connective tissue near rete ridges. NK cells are more abundant in peri-implantitis than in healthy samples.

Ventricular catheter tissue obstruction and shunt malfunction in 9 hydrocephalus etiologies.

OBJECTIVE: Hydrocephalus is a neurological disorder with an incidence of 80-125 per 100,000 births in the United States. The most common treatment, ventricular shunting, has a failure rate of up to 85% within 10 years of placement. The authors aimed to analyze the association between ventricular catheter (VC) tissue obstructions and shunt malfunction for each hydrocephalus etiology. METHODS: Patient information was collected from 5 hospitals and entered into a REDCap (Research Electronic Data Capture) database by hydrocephalus etiology. The hardware samples were fixed, and each VC tip drainage hole was classified by tissue obstruction after macroscopic analysis. Shunt malfunction data, including shunt revision rate, time to failure, and age at surgery, were correlated with the degree of tissue obstruction in VCs for each etiology. RESULTS: Posthemorrhagic hydrocephalus was the most common etiology (48.9% of total cases). Proximal catheter obstruction was the most frequent cause of hardware removal (90.4%). Myelomeningocele (44% ± 29%), other congenital etiologies (48% ± 40%), hydrocephalus with brain tumors (45% ± 35%), and posthemorrhagic hydrocephalus (41% ± 35%) showed tissue aggregates in more than 40% of the VC holes. A total of 76.8% of samples removed because of symptoms of obstruction showed cellular or tissue aggregates. No conclusive etiological associations were detected when correlating the percentage of holes with tissue for each VC and age at surgery, shunt revision rates, or time between shunt implantation and removal. CONCLUSIONS: The proximal VC obstruction was accompanied by tissue aggregates in 76.8% of cases. However, the presence of tissue in the VC did not seem to be associated with hydrocephalus etiology.

Pro-inflammatory cerebrospinal fluid profile of neonates with intraventricular hemorrhage: clinical relevance and contrast with CNS infection.

BACKGROUND: Interpretation of cerebrospinal fluid (CSF) studies can be challenging in preterm infants. We hypothesized that intraventricular hemorrhage (IVH), post-hemorrhagic hydrocephalus (PHH), and infection (meningitis) promote pro-inflammatory CSF conditions reflected in CSF parameters. METHODS: Biochemical and cytological profiles of lumbar CSF and peripheral blood samples were analyzed for 81 control, 29 IVH grade 1/2 (IVH1/2), 13 IVH grade 3/4 (IVH3/4), 15 PHH, 20 culture-confirmed bacterial meningitis (BM), and 27 viral meningitis (VM) infants at 36.5 ± 4 weeks estimated gestational age. RESULTS: PHH infants had higher (p < 0.02) CSF total cell and red blood cell (RBC) counts compared to control, IVH1/2, BM, and VM infants. No differences in white blood cell (WBC) count were found between IVH3/4, PHH, BM, and VM infants. CSF neutrophil counts increased (p ≤ 0.03) for all groups compared to controls except IVH1/2. CSF protein levels were higher (p ≤ 0.02) and CSF glucose levels were lower (p ≤ 0.003) for PHH infants compared to all other groups. In peripheral blood, PHH infants had higher (p ≤ 0.001) WBC counts and lower (p ≤ 0.03) hemoglobin and hematocrit than all groups except for IVH3/4. CONCLUSIONS: Similarities in CSF parameters may reflect common pathological processes in the inflammatory response and show the complexity associated with interpreting CSF profiles, especially in PHH and meningitis/ventriculitis.

Impact of environmental factors on spider silk properties.

Spider orb webs have evolved to stop flying prey, fast and slow alike. One of the main web elements dissipating impact energy is the radial fibers, or major ampullate silks, which possess a toughness surpassing most man-made materials. Orb webs are extended phenotypes, and as such their architectural elements, including major ampullate silks, have been selected to optimize prey capture under the respective environmental conditions. In this study, we investigated the correlation of three landscape scales and three microhabitat characteristics with intrinsic silk properties (elastic modulus, yield stress, tensile strength, extensibility, and toughness) to understand underlying ecological patterns. For this purpose, we collected and mechanically tested major ampullate silks from 50 spider species inhabiting large altitudinal and climatic gradients in Colombia. Using regression analysis and model selection, we investigated the environmental drivers of inter- and intra-specific patterns of major ampullate silk properties, taking into account phylogenetic relatedness based on newly sequenced mitochondrial genomes. We found that the total amount of energy absorbed, i.e., toughness and tensile strength, is higher for fibers from species inhabiting regions where heavy rainfall is common. Interestingly, we observe the same general trend between individuals of the same species, stressing the importance of this environmental driver. We also observe a phylogenetic conservation in the relation of environmental variables with silk tensile strength and yield stress. In conclusion, the increase in major ampullate silk tensile strength and toughness may reflect an adaptation to prevent frequent rain damage to orb webs and the associated energetic loss.

Quality of life, exercise capacity, cognition, and mental health of Chilean patients after COVID-19: an experience of a multidisciplinary rehabilitation program at a physical and rehabilitation medicine unit.

Background: Post-COVID disabilities, encompassing physical, cognitive, and psychological aspects, constitute the primary health sequelae for survivors. While the rehabilitation needs post COVID-19 are now well understood, each country possesses unique characteristics in terms of populations, healthcare systems, social dynamics, and economic profiles, necessitating context-specific recommendations. This study aims to address two main objectives: (1) analyze the impact of an 8-week multidisciplinary rehabilitation program on the quality of life, functional capacity, cognition, and mental health adaptations in adults recovering from COVID-19 in northern Chile, and (2) propose a personalized model for predicting program dropouts and responses. Methods: A total of 44 subjects were enrolled, forming two groups during the study: a treatment group (n = 32) and a dropout group (n = 12). The treatment group participated in the 8-week multidisciplinary rehabilitation program. Results: The results indicate that (1) After 8 weeks, the quality of life of the patients in the treatment group exhibited significant improvements reflected in all aspects of the Short Form-36 Health Survey (SF36, p < 0.005) and the total score (p < 0.001), with a concurrent decrease in dysfunctionality (p < 0.001). (2) Significant improvements were also observed in various physical performance tests, including the: 6-minute walk test, 1-min sit-to-stand, dynamometry, Tinetti balance, and Berg score (p < 0.001). Moreover, physical therapy led to a reduction in neuropathic symptoms and pain, psychological therapy reduced anxiety and depression, and language therapy enhanced memory and speech (all p < 0.05). (3) Demographic and clinical history characteristics did not predict responses to rehabilitation. (4) A regression model for predicting changes in SF-36 total score, based on physical function, physical role, general health, and mental health, was established based on the data from study (p < 0.01, adjusted R2 = 0.893). (5) Classification models for predicting dropouts achieved 68% accuracy, with key predictors of treatment adherence including diabetes, hypertension, and dyslipidemia, Tinetti balance, physical role, and vitality of SF36, and performance on the 6-minute walk test and 1-minute sit-to-stand. Conclusions: This study demonstrates significant enhancements in quality of life, improved functional performance, and reductions in mental and cognitive burdens within an 8-week rehabilitation program. Additionally, it is possible to identify patients at risk of dropping out using cost-effective, outpatient, and clinically applicable tests.

Toward Sensor Measurement Reliability in Blockchains.

In this work, a secure architecture to send data from an Internet of Things (IoT) device to a blockchain-based supply chain is presented. As is well known, blockchains can process critical information with high security, but the authenticity and accuracy of the stored and processed information depend primarily on the reliability of the information sources. When this information requires acquisition from uncontrolled environments, as is the normal situation in the real world, it may be, intentionally or unintentionally, erroneous. The entities that provide this external information, called Oracles, are critical to guarantee the quality and veracity of the information generated by them, thus affecting the subsequent blockchain-based applications. In the case of IoT devices, there are no effective single solutions in the literature for achieving a secure implementation of an Oracle that is capable of sending data generated by a sensor to a blockchain. In order to fill this gap, in this paper, we present a holistic solution that enables blockchains to verify a set of security requirements in order to accept information from an IoT Oracle. The proposed solution uses Hardware Security Modules (HSMs) to address the security requirements of integrity and device trustworthiness, as well as a novel Public Key Infrastructure (PKI) based on a blockchain for authenticity, traceability, and data freshness. The solution is then implemented on Ethereum and evaluated regarding the fulfillment of the security requirements and time response. The final design has some flexibility limitations that will be approached in future work.

Real-Time Polymerase Chain Reaction Method for the Detection of Onchocerca volvulus in Post-Elimination Surveillance of Onchocerciasis in Ecuador.

Onchocerciasis has been declared eliminated in Ecuador and surveillance measures are of great interest. In this study, we examined the infectivity rates of Simulium exiguum by Onchocerca volvulus in previously hyperendemic areas in Esmeraldas province of Ecuador. These areas had previously undergone mass administration of ivermectin, which led to the interruption of transmission in 2009 and the certification of elimination in 2014. The study included three communities in Río Cayapas and one in Río Canandé, and a total of 2,950 adult S. exiguum were collected in 2018. We used quantitative polymerase chain reaction with O. volvulus O-150 plasmid control DNA to analyze 59 pools. Our findings revealed that the infectivity rates were zero, indicating that the transmission of O. volvulus remained suspended in the area.

Pressurized Liquid (PLE) Truffle Extracts Have Inhibitory Activity on Key Enzymes Related to Type 2 Diabetes (α-Glucosidase and α-Amylase).

An optimized PLE method was applied to several truffle species using three different solvent mixtures to obtain bioactive enriched fractions. The pressurized water extracts contained mainly (1 → 3),(1 → 6)-ß-D-glucans, chitins, and heteropolymers with galactose and mannose in their structures. The ethanol extracts included fatty acids and fungal sterols and others such as brassicasterol and stigmasterol, depending on the species. They also showed a different fatty acid lipid profile depending on the solvent utilized and species considered. Ethanol:water extracts showed interesting lipids and many phenolic compounds; however, no synergic extraction of compounds was noticed. Some of the truffle extracts were able to inhibit enzymes related to type 2 diabetes; pressurized water extracts mainly inhibited the α-amylase enzyme, while ethanolic extracts were more able to inhibit α-glucosidase. Tuber brumale var. moschatum and T. aestivum var. uncinatum extracts showed an IC50 of 29.22 mg/mL towards α-amylase and 7.93 mg/mL towards α-glucosidase. Thus, use of the PLE method allows o bioactive enriched fractions to be obtained from truffles with antidiabetic properties.

Food By-Products and Agro-Industrial Wastes as a Source of ß-Glucans for the Formulation of Novel Nutraceuticals.

Food and agro-industrial by-products provoke a great environmental and economic impact that must be minimized by adding value to these wastes within the framework of circular economy. The relevance of ß-glucans obtained from natural sources (cereals, mushrooms, yeasts, algae, etc.), in terms of their interesting biological activities (hypocholesterolemic, hypoglycemic, immune-modulatory, antioxidant, etc.), has been validated by many scientific publications. Since most of these by-products contain high levels of these polysaccharides or can serve as a substrate of ß-glucan-producing species, this work reviewed the scientific literature, searching for studies that utilized food and agro-industrial wastes to obtain ß-glucan fractions, attending to the applied procedures for extraction and/or purification, the characterization of the glucans and the tested biological activities. Although the results related to ß-glucan production or extraction using wastes are promising, it can be concluded that further research on the glucans' characterization, and particularly on the biological activities in vitro and in vivo (apart from antioxidant capacity), is required to reach the final goal of formulating novel nutraceuticals based on these molecules and these raw materials.

Near-Field Communication Tag for Colorimetric Glutathione Determination with a Paper-Based Microfluidic Device.

Here, we propose a microfluidic paper-based analytical device (µPAD) implemented with a near-field communication (NFC) tag as a portable, simple and fast colorimetric method for glutathione (GSH) determination. The proposed method was based on the fact that Ag+ could oxidize 3,3',5,5'-tetramethylbenzidine (TMB) into oxidized blue TMB. Thus, the presence of GSH could cause the reduction of oxidized TMB, which resulted in a blue color fading. Based on this finding, we developed a method for the colorimetric determination of GSH using a smartphone. A µPAD implemented with the NFC tag allowed the harvesting of energy from a smartphone to activate the LED that allows the capture of a photograph of the µPAD by the smartphone. The integration between electronic interfaces into the hardware of digital image capture served as a means for quantitation. Importantly, this new method shows a low detection limit of 1.0 µM. Therefore, the most important features of this non-enzymatic method are high sensitivity and a simple, fast, portable and low-cost determination of GSH in just 20 min using a colorimetric signal.

Aromatic changes in home-made truffle products after heat treatments.

Truffles are highly valued by their aromatic properties and can aromatize food products. However, the truffle aroma could be reduced or lost with heat treatments (pasteurization and sterilization) necessary for products security and safety. In this study, sunflower oil and honey were aromatized with black truffle (lyophilized and fresh) using two different concentrations (5 and 10 %) for 24 h and then heat treatments (pasteurization and sterilization) were carried out. Truffle organic volatile compounds from products were investigated by SPME-GC-MS and sensory analysis by trained panel. More than 80 compounds were detected. Some of them were affected differently by heat process depending on the food matrix. Professional tasters scored higher key aromatic attributes such as sulphurous and olive oil in fresh truffle products, regardless the heat treatment applied.

Intoxicación por metanol por consumo de bebidas alcohólicas adulteradas. Efectos en el sistema nervioso. Reporte de un caso / Methanol Poisoning by Consumption of Adulterated Alcoholic Beverages. Effects on the Nervous System. A Case Report

Resumen La intoxicación por metanol puede ocurrir de forma inadvertida por la ingesta de bebidas alcohólicas adulteradas. Se trata una entidad poco frecuente, sin embargo, se ha reportado un aumento en la incidencia durante la pandemia de COVID-19. La intoxicación con metanol representa una urgencia médica, ya que puede provocar daño severo en el sistema nervioso central y periférico, además de acidosis metabólica, daño renal agudo e incluso la muerte. En este artículo se presenta el caso de un paciente que cursó con intoxicación por metanol de manera inadvertida al consumir bebidas alcohólicas presumiblemente adulteradas. En el encéfalo se demostró necrosis hemorrágica de ambos núcleos putamen, además de cursar con neuritis óptica bilateral y polineuropatía periférica. Fue manejado con pulsos de esteroides intravenosos, con lo cual, mejoró significativamente su función visual, sensitiva y motora. En el presente caso no existieron complicaciones fatales y presentó una buena respuesta al tratamiento, sin embargo, el caso pone de relieve la necesidad de una mejor regulación en la producción y comercialización de bebidas alcohólicas en nuestro país, y, por otro lado, permite hacer a un llamado a los consumidores a tomar más precauciones en el consumo de bebidas alcohólicas de dudosa calidad o procedencia.

Abstract Methanol poisoning can occur unnoticed, by the ingestion of adulterated alcoholic beverages. In general, it is a rare entity, however, an increase in incidence has been reported during the SARS-CoV-2 pandemic. Methanol poisoning represents a medical emergency as it can cause severe damage to the central and peripheral nervous systems, as well as metabolic acidosis, acute kidney injury, and even death. This article presents the case of a patient who inadvertently developed methanol intoxication after consuming presumably adulterated alcoholic beverages. In the brain, hemorrhagic necrosis of both putamen nuclei was demonstrated, in addition to presenting with bilateral optic neuritis and peripheral polyneuropathy. He was managed with intravenous steroid pulses, which significantly improved his visual, sensory, and motor function. In the present case there were no fatal complications and presented a good response to treatment, however, the case highlights the need for better regulation in the production and marketing of alcoholic beverages in our country, and on the other hand, to invite consumers to take more precautions in the consumption of alcoholic beverages of dubious quality or origin.

Valorization of Chicken Slaughterhouse Byproducts to Obtain Antihypertensive Peptides.

Hypertension (HTN) is the leading cause of premature deaths worldwide and the main preventable risk factor for cardiovascular diseases. Therefore, there is a current need for new therapeutics to manage this condition. In this regard, protein hydrolysates containing antihypertensive bioactive peptides are of increasing interest. Thus, agri-food industry byproducts have emerged as a valuable source to obtain these hydrolysates as they are rich in proteins and inexpensive. Among these, byproducts from animal origin stand out as they are abundantly generated worldwide. Hence, this review is focused on evaluating the potential role of chicken slaughterhouse byproducts as a source of peptides for managing HTN. Several of these byproducts such as blood, bones, skins, and especially, chicken feet have been used to obtain protein hydrolysates with angiotensin-converting enzyme (ACE)-inhibitory activity and blood pressure-lowering effects. An increase in levels of endogenous antioxidant compounds, a reduction in ACE activity, and an improvement of HTN-associated endothelial dysfunction were the mechanisms underlying their effects. However, most of these studies were carried out in animal models, and further clinical studies are needed in order to confirm these antihypertensive properties. This would increase the value of these byproducts, contributing to the circular economy model of slaughterhouses.

7-Methoxy-4-methylcoumarin: Standard Molar Enthalpy of Formation Prediction in the Gas Phase Using Machine Learning and Its Comparison to the Experimental Data.

Experimentally, the standard molar enthalpy of formation in the crystalline phase at 298.15 K, ΔfHm°(cr) for 7-methoxy-4-methylcoumarin (7M4MC) was calculated by traditional linear regression, which was obtained by combustion calorimetry. Similarly, the standard molar enthalpy of sublimation was determined through the standard molar enthalpy of fusion and by the standard molar enthalpy of vaporization, from differential scanning calorimetry and thermogravimetry, respectively; lately using these results, the standard molar enthalpy of formation in the gas phase was calculated at 298.15 K, ΔfHm°(g). In addition ML was used to predict the standard molar enthalpy of formation in the gas phase for the 7M4MC, constructing an experimental data set containing three kinds of functional groups: esters, coumarins, and aromatic compounds. The procedure was performed by using multiple linear regression algorithms and stochastic gradient descent with a R2 of 0.99. The obtained models were used to compare those predicted values versus experimental for coumarins, resulting in an average error rate of 9.0%. Likewise, four homodesmic reactions were proposed and predicted with the multiple linear regression algorithm of ML obtaining good results.

Potential Role of Bioactive Proteins and Peptides Derived from Legumes towards Metabolic Syndrome.

Legumes have been widely consumed and used to isolate bioactive compounds, mainly proteins. The aim of this study was to review the beneficial actions of different legumes proteins and peptides updating the main findings that correlate legumes consumption and the effects on non-transmissible chronic diseases, specifically metabolic syndrome. An exhaustive revision of five relevant bioactivities (antioxidant, anti-inflammatory, antihypertensive, hypocholesterolemic -all of them linked to metabolic syndrome- and antitumoral) of proteins and peptides from legumes focused on isolation and purification, enzymatic hydrolysis and in vitro gastrointestinal digestion was carried out. The promising potential of bioactive hydrolysates and peptides from pulses has been demonstrated by in vitro tests. However, only a few studies validated these biological activities using animal models. No clinical trials have been carried out yet; so further research is required to elucidate their effective health implications.

Use of Strawberry Tree (Arbutus unedo) as a Source of Functional Fractions with Biological Activities.

Arbutus unedo, commonly named 'strawberry tree' (ST), is a Mediterranean native plant that represents a relevant source of biologically active fractions and compounds. ST fruits, traditionally used with culinary and medicinal purposes, along with other components (leaves, roots, honeys, etc.), have been subjected to varied extraction procedures to obtain enriched and bioactive products. This work reviewed the scientific literature, searching for studies that evaluated the potential health implications of ST fractions and attending to the tested biological activities (antioxidant, antiproliferative, hypoglycemic, immune-modulatory, antihypertensive, antimicrobial, etc.), the part of the tree, the experimental model, the specific bioactive compounds and the selected extraction protocol. Furthermore, the strengths and weaknesses of the current state of the published evidence were critically analysed. Although in vitro results demonstrated the potential of ST fractions, further research is encouraged in order to obtain in vivo evidence (animal and clinical studies), assess additional activities (hypocholesterolemic, microbiome-modulatory), maximize the use of advanced extraction technologies, purify and isolate specific bioactive compounds and broaden the analysis investigating phenolic and non-phenolic molecules and their bioavailability.

Editorial: Functional Nanomaterials for Sensor Applications.

Functional nanomaterials have become one of the most fascinating fields in nanotechnology [...].

Satellite remote sensing of environmental variables can predict acoustic activity of an orthopteran assemblage.

Passive acoustic monitoring (PAM) is a promising method for biodiversity assessment, which allows for longer and less intrusive sampling when compared to traditional methods (e.g., collecting specimens), by using sound recordings as the primary data source. Insects have great potential as models for the study and monitoring of acoustic assemblages due to their sensitivity to environmental changes. Nevertheless, ecoacoustic studies focused on insects are still scarce when compared to more charismatic groups. Insects' acoustic activity patterns respond to environmental factors, like temperature, moonlight, and precipitation, but community acoustic perspectives have been barely explored. Here, we provide an example of the usefulness of PAM to track temporal patterns of acoustic activity for a nocturnal assemblage of insects (Orthoptera). We integrate satellite remote sensing and astronomically measured environmental factors at a local scale in an Andean Forest of Colombia and evaluate the acoustic response of orthopterans through automated model detections of their songs for nine weeks (March and April of 2020). We describe the acoustic frequency range and diel period for the calling song of each representative species. Three species overlapped in frequency and diel acoustics but inhabit different strata: canopy, understory, and ground surface level. Based on the acoustic frequency and activity, we identified three trends: (i) both sampled cricket species call at lower frequency for shorter periods of time (dusk); (ii) all sampled katydid species call at higher frequency for longer time periods, including later hours at night; and (iii) the diel acoustic activity span window seems to increase proportionally with dominant acoustic frequency, but further research is required. We also identified a dusk chorus in which all the species sing at the same time. To quantify the acoustic response to environmental factors, we calculated a beta regression with the singing activity as a response variable and moon phase, surface temperature and daily precipitation as explanatory variables. The response to the moon phase was significant for the katydids but not for the crickets, possibly due to differences in diel activity periods. Crickets are active during dusk, thus the effects of moonlight on acoustic activity are negligible. The response to precipitation was significant for the two crickets and not for the katydids, possibly because of higher likelihood of rain interrupting crickets' shorter diel activity period. Our study shows how the local survey of orthopteran acoustic assemblages, with a species taxonomic resolution coupled with remote-sensing environmental measurements can reveal responses to environmental factors. In addition, we demonstrate how satellite data might prove to be a useful alternative source of environmental data for community studies with geographical, financial, or other constraints.

The effect of A1 and A2 reactive astrocyte expression on hydrocephalus shunt failure.

BACKGROUND: The composition of tissue obstructing neuroprosthetic devices is largely composed of inflammatory cells with a significant astrocyte component. In a first-of-its-kind study, we profile the astrocyte phenotypes present on hydrocephalus shunts. METHODS: qPCR and RNA in-situ hybridization were used to quantify pro-inflammatory (A1) and anti-inflammatory (A2) reactive astrocyte phenotypes by analyzing C3 and EMP1 genes, respectively. Additionally, CSF cytokine levels were quantified using ELISA. In an in vitro model of astrocyte growth on shunts, different cytokines were used to prevent the activation of resting astrocytes into the A1 and A2 phenotypes. Obstructed and non-obstructed shunts were characterized based on the degree of actual tissue blockage on the shunt surface instead of clinical diagnosis. RESULTS: The results showed a heterogeneous population of A1 and A2 reactive astrocytes on the shunts with obstructed shunts having a significantly higher proportion of A2 astrocytes compared to non-obstructed shunts. In addition, the pro-A2 cytokine IL-6 inducing proliferation of astrocytes was found at higher concentrations among CSF from obstructed samples. Consequently, in the in vitro model of astrocyte growth on shunts, cytokine neutralizing antibodies were used to prevent activation of resting astrocytes into the A1 and A2 phenotypes which resulted in a significant reduction in both A1 and A2 growth. CONCLUSIONS: Therefore, targeting cytokines involved with astrocyte A1 and A2 activation is a promising intervention aimed to prevent shunt obstruction.