Exercise Training Reduces Inflammation and Fibrosis and Preserves Myocardial Function and Perfusion in a Model of Chronic Chagas Cardiomyopathy. / Treinamento Físico Reduz a Inflamação e a Fibrose e Preserva a Função e a Perfusão Miocárdica em um Modelo de Cardiomiopatia Chagásica Crônica.

BACKGROUND: Chronic Chagas cardiomyopathy (CCC) is caused by an inflammatory process induced by Trypanosoma cruzi, which leads to myocarditis with reactive and reparative fibrosis. CCC progresses with myocardial perfusion abnormalities and histopathological events that affect cardiorespiratory fitness (CRF). OBJECTIVES: We evaluated the effects of aerobic physical training (APT) on myocardial perfusion and on morphological and functional impairments related with inflammation and fibrosis in Syrian hamsters with CCC. As a secondary objective, we analyzed the cross-sectional areas of the skeletal muscle. METHODS: Hamsters with CCC and their respective controls were divided into four groups: CCC sedentary, CCC-APT, sedentary control and APT control. Seven months after infection, the animals underwent echocardiography, myocardial perfusion scintigraphy and cardiopulmonary exercise testing. Moderate-intensity APT was performed for fifty minutes, five times a week, for eight weeks. Subsequently, the animals were reassessed. Histopathological analysis was conducted after the above-mentioned procedures. The level of significance was set at 5% in all analyses (p<0.05). RESULTS: CCC sedentary animals presented worse myocardial perfusion defects (MPD) over time, reduced left ventricle ejection fraction (LVEF) and showed more inflammation and fibrosis when compared to other groups (mixed ANOVA analysis). Conversely, APT was able to mitigate the progression of MPD, ameliorate inflammation and fibrosis and improve CRF efficiency in CCC-APT animals. CONCLUSIONS: Our study demonstrated that APT ameliorated cardiac dysfunction, MPD, and reduced inflammation and fibrosis in CCC hamster models. Additionally, CCC-SED animals presented skeletal muscle atrophy while CCC-APT animals showed preserved skeletal muscle CSA. Understanding APT's effects on CCC's pathophysiological dimensions is crucial for future research and therapeutic interventions.

FUNDAMENTO: A Cardiomiopatia Chagásica Crônica (CCC) é causada por um processo inflamatório induzido pelo Trypanosoma cruzi, que leva à miocardite com fibrose reativa e reparativa. A CCC progride com alterações de perfusão miocárdica e eventos histopatológicos que afetam a Aptidão Cardiorrespiratória (ACR). OBJETIVOS: Avaliamos os efeitos do Treinamento Físico Aeróbico (TFA) na perfusão miocárdica e nos comprometimentos morfológicos e funcionais relacionados à inflamação e fibrose em hamsters sírios com CCC. Como objetivo secundário, analisamos as áreas de secção transversa do músculo esquelético. MÉTODOS: Hamsters com CCC e seus respectivos controles foram divididos em quatro grupos: CCC sedentário, CCC-TFA, controle sedentário e controle TFA. Sete meses após a infecção, os animais foram submetidos à ecocardiografia, à cintilografia de perfusão miocárdica e ao teste de esforço cardiopulmonar. TFA de intensidade moderada foi realizado durante cinquenta minutos, cinco vezes por semana, por oito semanas. Posteriormente, os animais foram reavaliados. A análise histopatológica foi realizada após os procedimentos acima mencionados. O nível de significância foi estabelecido em 5% em todas as análises (p<0,05). RESULTADOS: Animais com CCC sedentários apresentaram piores Defeitos de Perfusão Miocárdica (DPM) ao longo do tempo, Fração de Ejeção do Ventrículo Esquerdo (FEVE) reduzida, e apresentaram mais inflamação e fibrose quando comparados aos demais grupos (análise ANOVA mista). Por outro lado, o TFA foi capaz de mitigar a progressão do DPM, atenuar a inflamação e a fibrose e melhorar a eficiência da ACR em animais CCC-TFA. CONCLUSÃO: Nosso estudo demonstrou que o TFA melhorou a disfunção cardíaca, DPM e reduziu a inflamação e a fibrose em modelos de hamster com CCC. Além disso, os animais CCC-SED apresentaram atrofia do músculo esquelético, enquanto os animais CCC-TFA apresentaram a AST do músculo esquelético preservada. Compreender os efeitos da TFA nas dimensões fisiopatológicas da CCC é crucial para futuras pesquisas e intervenções terapêuticas.

Reference values for triceps surae tissue oxygen saturation by near-infrared spectroscopy.

Objective.To establish the reference values for peripheral tissue perfusion of the triceps surae muscle assessed by Near-infrared spectroscopy (NIRS) at rest and in progressive effort.Approach.A total of 288 apparently healthy individuals of both sexes were included; between 30 and 79 years of age; nonsmokers; without diagnosis of diabetes mellitus, systemic arterial hypertension, kidney disease, symptoms of angina and intermittent claudication, or any musculoskeletal alteration that would prevent physical exertion; and without diagnosis of Peripheral arterial disease (PAD) or other associated symptoms. All individuals performed anthropometric measurements, physical activity levels, and tissue oxygen saturation (StO2) assessments by NIRS during and after arterial occlusion maneuver and incremental shuttle walking test. The variables obtained by NIRS were presented in percentiles (P) for general comparison between sexes and for comparison between sexes according to age group. The relationship between the NIRS data and other variables was tested.Main results.Considering P50 and p<0.05, men had lower StO2 values, higher deoxygenation and reoxygenation (Tx-reox) rates at rest, and higher Tx-reox during progressive effort. There were correlations (p<0.0001) of body composition with the lowest StO2 and Tx-reox values and of functional capacity with Tx-reox in occlusion and Tx-reox.Significance.The percentiles presented can clinically assist in the diagnosis and monitoring of different health conditions; however, it is important to consider the individual's sex, body composition, and functional capacity.

Oxygen pulse best predicts energy expenditure during stair ascent and descent in individuals with chronic stroke.

BACKGROUND: To determine whether minute ventilation-to-carbon dioxide production (VE/VCO2), oxygen pulse (VO2/HR), and rate pressure product (RPP: VO2 * HR/1000) can explain energy expenditure during stair ascent/descent and whether energy expenditure during stair ascent/descent can discriminate between walking abilities in individuals with chronic stroke. MATERIALS AND METHODS: Regression analysis of cross-sectional data from 50 individuals between 1 and 4 years post-stroke was carried out to investigate the prediction of energy expenditure during stair ascent/descent. In addition, discriminant analysis was carried out to investigate the discrimination between walking abilities for energy expenditure: community (walking speed ≥ 0.8 m/s) and non-community (walking speed < 0.8 m/s) walkers. RESULTS: Oxygen pulse and rate pressure product were retained in the model. Oxygen pulse alone explained 70% of the variance in energy expenditure during stair ascent/descent. By adding rate pressure product, 79% of the variance was explained. Energy expenditure was able to discriminate the community from the non-community walkers, with a cutoff value of 13.8 ml∙kg-1∙min-1 and correctly classified 62% of the non-community and 78% of the community walkers. CONCLUSION: Oxygen pulse and rate pressure product significantly predicted energy expenditure during stair ascent/descent in individuals with chronic stroke. Energy expenditure during stair ascent/descent discriminated community from non-community walkers.

Limitação do VEINES QOL/SYM em discriminar a gravidade da insuficiência venosa crônica / Limitations of VEINES QOL/SYM for discriminating chronic venous insufficiency severity

Resumo Contexto O questionário Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptom (VEINES-QOL/Sym) foi desenvolvido para avaliar a qualidade de vida dos indivíduos com insuficiência venosa crônica (IVC), mas ele tem se mostrado pouco sensível em discriminar indivíduos com diferentes gravidades da doença. Objetivos a) Propor uma nova forma de cálculo do escore do VEINES-QOL/Sym e avaliar se esse novo escore é capaz de discriminar a gravidade da doença; b) Avaliar a associação entre o VEINES-QOL/Sym e a gravidade da doença. Métodos Noventa e oito participantes com IVC, de ambos os sexos, idade 60,73 ± 14,11 anos, responderam o questionário VEINES-QOL/Sym, versão português do Brasil. Para o cálculo do novo escore, foi realizada uma transformação dos escores originais para uma escala de 0 a 100. Para verificar a capacidade dos escores do VEINES-QOL/Sym, originais e modificados, em discriminar e classificar corretamente os grupos caracterizados pela classificação clínica, etiológica, anatômica e patofisiológica (CEAP), foi realizada a análise discriminante, sendo considerado significante um alfa de 5%. Resultados Não houve diferença significativa entre os grupos classificados pela CEAP quanto aos escores originais e modificados do VEINES-QOL/Sym. A análise discriminante também não foi capaz de classificar corretamente os grupos CEAP, tanto para os escores originais quanto para os escores modificados do VEINES-QOL/Sym. Além disso, não houve associação entre a classificação CEAP e os escores obtidos pelo questionário. Conclusões O VEINES-QOL/Sym mostrou-se limitado para avaliar qualidade de vida e sintomatologia dos indivíduos com diferentes estágios de IVC.

Abstract Background The Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms (VEINES-QOL / Sym) questionnaire was developed to evaluate the quality of life of individuals with chronic venous insufficiency (CVI), but it has shown limited sensitivity for discriminating between people with different of disease severity. Objectives a) to propose a new formula for calculating the VEINES-QOL/Sym score and to evaluate whether this new score is capable of discriminating disease severity; and b) to evaluate the association between VEINES-QOL/Sym scores and disease severity. Methods Ninety-eight participants with CVI of both sexes, aged 60.73 ± 14.11 years, answered the Portuguese Brazilian version of the VEINES-QOL/Sym questionnaire. The new score was calculated by transforming the original scores to a 0 to 100 scale. Discriminant analysis was used to test the capability of the original and modified VEINES-QOL/Sym scores to discriminate between and correctly classify groups characterized by the clinical, etiological, anatomical and pathophysiological classification (CEAP). Alpha of 5% was defined as the cutoff for significance. Results There were no significant differences between CEAP groups in terms of the original or modified VEINES-QOL/Sym scores. Discriminant analysis was also unable to correctly classify CEAP groups, using either original or modified scores. Furthermore, there were no associations between CEAP classifications and scores obtained using the questionnaire. Conclusions The VEINES-QOL/Sym proved to have limitations for assessment of the quality of life and symptomatology of people with CVI at different stages.

Limitations of VEINES QOL/SYM for discriminating chronic venous insufficiency severity.

BACKGROUND: The Venous Insufficiency Epidemiological and Economic Study - Quality of Life/Symptoms (VEINES-QOL / Sym) questionnaire was developed to evaluate the quality of life of individuals with chronic venous insufficiency (CVI), but it has shown limited sensitivity for discriminating between people with different of disease severity. OBJECTIVES: a) to propose a new formula for calculating the VEINES-QOL/Sym score and to evaluate whether this new score is capable of discriminating disease severity; and b) to evaluate the association between VEINES-QOL/Sym scores and disease severity. METHODS: Ninety-eight participants with CVI of both sexes, aged 60.73 ± 14.11 years, answered the Portuguese Brazilian version of the VEINES-QOL/Sym questionnaire. The new score was calculated by transforming the original scores to a 0 to 100 scale. Discriminant analysis was used to test the capability of the original and modified VEINES-QOL/Sym scores to discriminate between and correctly classify groups characterized by the clinical, etiological, anatomical and pathophysiological classification (CEAP). Alpha of 5% was defined as the cutoff for significance. RESULTS: There were no significant differences between CEAP groups in terms of the original or modified VEINES-QOL/Sym scores. Discriminant analysis was also unable to correctly classify CEAP groups, using either original or modified scores. Furthermore, there were no associations between CEAP classifications and scores obtained using the questionnaire. CONCLUSIONS: The VEINES-QOL/Sym proved to have limitations for assessment of the quality of life and symptomatology of people with CVI at different stages.

Home-Based Cardiac Rehabilitation in Brazil's Public Health Care: Protocol for a Randomized Controlled Trial.

BACKGROUND: Coronary artery disease (CAD) is among the main causes of hospitalization and death worldwide, therefore, the implementation of programs to reduce its impact is necessary. Supervised cardiac rehabilitation has been shown to have positive effects on CAD control. However, there are barriers to patient participation in the traditional, face-to-face cardiac rehabilitation programs, mainly in low-resource environments. OBJECTIVE: This study aimed to verify patient compliance to a home-based cardiac rehabilitation program, which includes unsupervised health education and physical exercises, guided by telephone. Moreover, we compare this new method to the traditional supervised cardiac rehabilitation offered in most hospital centers. METHODS: We present here a two-arm, single-blinded, and randomized controlled design protocol, which compares the traditional cardiac rehabilitation (CenterRehab) with the home-based cardiac rehabilitation (Home-Based) in 72 patients affected by CAD. The primary outcome is the compliance to the cardiac rehabilitation sessions. The secondary outcomes (to evaluate effectiveness) include measurable variables such as functional capacity, CAD risk factors (blood pressure, waist circumference, glycemic, cholesterol levels, depressive symptoms, and the level of physical activity), the patient's quality of life, the disease knowledge, and the morbidity rate. Parameters such as the program cost and the usability will also be evaluated. The programs will last 12 weeks, with a total of 60 rehabilitation and 6 educational sessions. Patients of the CenterRehab program will participate in 24 supervised sessions and 36 home sessions, while the patients of the Home-Based program will participate in 2 supervised sessions and 58 home sessions, guided by telephone. After the 12-week period all participants will be recommended to continue practicing physical exercises at home or at a community center, and they will be invited for re-evaluation after 3 months. The outcomes will be evaluated at baseline, and after 3 and 6 months. RESULTS: Participants are currently being recruited for the trial. Data collection is anticipated to be completed by October 2019. CONCLUSIONS: This is the first study in Brazil comparing the traditional cardiac rehabilitation approach with a novel, home-based protocol that uses an accessible and low-cost technology. If positive results are obtained, the study will contribute to establish a new and viable model of cardiac rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov NCT03605992; https://clinicaltrials.gov/ct2/show/NCT03605992. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/13901.

Evaluation of the Glittre-ADL test as an instrument for classifying functional capacity of individuals with cardiovascular diseases.

BACKGROUND: The assessment of functional capacity in individuals with cardiovascular disease is closely related to lower limb function. The Glittre-ADL test is a global test to evaluate this patients. OBJECTIVE: We aimed to verify whether the Glittre-ADL test discriminates functional status while evaluating individuals with cardiovascular disease. METHODS: A total of 42 participants were evaluated using the Glittre-ADL test Incremental Shuttle Walking Test (shuttle test), Human Activity Profile, and Duke Activity Status Index. Data from the shuttle test, Human Activity Profile, and DASI were divided into tertiles for statistical analysis. The time required to complete the Glittre-ADL test was compared among tertiles of the shuttle test, Duke Activity Status Index and Human Activity Profile using analysis of variance. RESULTS: There were significant differences between the tertiles of the shuttle test. Tertile 1 was different from tertiles 2 (mean difference, 47.63; 95% CI, 19.86-75.39) and 3 (mean difference, 67.15; 95% CI, 41.25-93.05). For the Duke Activity Status Index there were significant between-group differences. Tertile 1 was different from tertiles 2 (mean difference, 42.45; 95% CI, 8.82-76.09) and 3 (mean difference, 43.56; 95% CI, 13.68-73.44). For the Human Activity Profile there were significant between-group differences. Tertile 3 was different from tertiles 1 (mean difference, 51.46; 95% CI, 21.27-81.64) and 2 (mean difference, 33.01; 95% CI, 3.52-62.51). CONCLUSION: The Glittre-ADL test is able to discriminate the functional status in individuals with cardiovascular disease, most of whom have hypertension. The Glittre-ADL test was sensitive to discriminate more functionally affected individuals.

Could peak oxygen uptake be estimated from proposed equations based on the six-minute walk test in chronic heart failure subjects?

OBJECTIVES: To evaluate the agreement between the measured peak oxygen uptake (VO2peak) and the VO2peak estimated by four prediction equations based on the six-minute walk test (6MWT) in chronic heart failure patients. METHOD: Thirty-six chronic heart failure patients underwent cardiopulmonary exercise testing and the 6MWT to assess their VO2peak. Four previously published equations that include the variable six-minute walk distance were used to estimate the VO2peak: Cahalin, 1996a (1); Cahalin, 1996b (2); Ross, 2010 (3); and Adedoyin, 2010 (4). The agreement between the VO2peak in the cardiopulmonary exercise testing and the estimated values was assessed using the Bland-Altman method. A p-value of <0.05 was considered statistically significant. RESULTS: All estimated VO2peak values presented moderate correlation (ranging from 0.55 to 0.70; p<0.001) with measured VO2peak values. Equations 2, 3, and 4 underestimated the VO2peak by 30%, 15.2%, and 51.2%, respectively, showing significant differences from the actual VO2peak measured in the cardiopulmonary exercise testing (p<0.0001 for all), and the limits of agreement were elevated. The VO2peak estimated by equation 1 was similar to that measured by the cardiopulmonary exercise testing, and despite the agreement, bias increased as VO2peak increased. CONCLUSIONS: Only equation 1 showed estimated VO2peak similar to the measured VO2peak; however, a large limits of agreement range (∼3 METs) does not allow its use to estimate maximal VO2peak.

Assessment of intensity effort of middle-aged adults practicing regular walking.

BACKGROUND: Walking is one of the most commonly recommended activities for sedentary individuals. When performed at the correct intensity, it can provide cardiovascular, respiratory, metabolic, and other benefits by providing a training effect in addition to reducing the risk of death from cardiovascular diseases and other chronic health conditions. OBJECTIVES: The primary aim of this study was to assess whether individuals who practiced regular unsupervised walking carry out the activity safely and with sufficient effort intensity parameters to have a positive physiological (training) effect. The secondary objective was to compare the training heart rate (HR) and the stability of the HR within the ideal range of training between the sexes. METHOD: Individuals were selected from walking tracks within the city of Belo Horizonte, Brazil. The study included subjects from 40 to 60 years of age who had practiced walking for at least two months prior to the study, walking at least three times a week. Individuals who agreed to participate in the survey were asked to walk 15 minutes at their usual pace with their HR measured every 5 minutes using a heart rate monitor. Their average walking HR was compared to the average training HR based on the formula: (220 - age) × 70 to 80% that would result in a positive physiological training effect. RESULTS: Of the 142 individuals evaluated, 25.4% achieved the average training HR. This result was significantly lower than those who did not achieve the average training HR while walking (p=0.002). There were significant differences between men and women who had reached the training HR (p=0.0001). CONCLUSION: The authors found that individuals who walk regularly performed outside the range of the ideal HR intensity that would cause a positive physiological effect and therefore would probably not achieve a beneficial training effect while walking.

Assessment of intensity effort of middle-aged adults practicing regular walking

Background: Walking is one of the most commonly recommended activities for sedentary individuals. When performed at the correct intensity, it can provide cardiovascular, respiratory, metabolic, and other benefits by providing a training effect in addition to reducing the risk of death from cardiovascular diseases and other chronic health conditions. Objectives: The primary aim of this study was to assess whether individuals who practiced regular unsupervised walking carry out the activity safely and with sufficient effort intensity parameters to have a positive physiological (training) effect. The secondary objective was to compare the training heart rate (HR) and the stability of the HR within the ideal range of training between the sexes. Method: Individuals were selected from walking tracks within the city of Belo Horizonte, Brazil. The study included subjects from 40 to 60 years of age who had practiced walking for at least two months prior to the study, walking at least three times a week. Individuals who agreed to participate in the survey were asked to walk 15 minutes at their usual pace with their HR measured every 5 minutes using a heart rate monitor. Their average walking HR was compared to the average training HR based on the formula: (220 - age) × 70 to 80% that would result in a positive physiological training effect. Results: Of the 142 individuals evaluated, 25.4% achieved the average training HR. This result was significantly lower than those who did not achieve the average training HR while walking (p=0.002). There were significant differences between men and women who had reached the training HR (p=0.0001). Conclusion: The authors found that individuals who walk regularly performed outside the range of the ideal HR intensity that would cause a positive physiological effect and therefore would probably not achieve a beneficial training effect while walking.

Peptidases and peptidase inhibitors in gut of caterpillars and in the latex of their host plants.

Studies investigating the resistance-susceptibility of crop insects to proteins found in latex fluids have been reported. However, latex-bearing plants also host insects. In this study, the gut proteolytic system of Pseudosphinx tetrio, which feeds on Plumeria rubra leaves, was characterized and further challenged against the latex proteolytic system of its own host plant and those of other latex-bearing plants. The gut proteolytic system of Danaus plexippus (monarch) and the latex proteolytic system of its host plant (Calotropis procera) were also studied. The latex proteins underwent extensive hydrolysis when mixed with the corresponding gut homogenates of the hosted insects. The gut homogenates partially digested the latex proteins of foreign plants. The fifth instar of D. plexippus that were fed diets containing foreign latex developed as well as those individuals who were fed diets containing latex proteins from their host plant. In vitro assays detected serine and cysteine peptidase inhibitors in both the gut homogenates and the latex fluids. Curiously, the peptidase inhibitors of caterpillars did not inhibit the latex peptidases of their host plants. However, the peptidase inhibitors of laticifer origin inhibited the proteolysis of gut homogenates. In vivo analyses of the peritrophic membrane proteins of D. plexippus demonstrate resistance against latex peptidases. Only discrete changes were observed when the peritrophic membrane was directly treated with purified latex peptidases in vitro. This study concludes that peptidase inhibitors are involved in the defensive systems of both caterpillars and their host plants. Although latex peptidase inhibitors inhibit gut peptidases (in vitro), the ability of gut peptidases to digest latex proteins (in vivo) regardless of their origin seems to be important in governing the resistance-susceptibility of caterpillars.

Optoelectronic plethysmography: intra-rater and inter-rater reliability in healthy subjects.

Optoelectronic plethysmography (OEP) has been used to measure changes in chest wall volume and its compartments. However, literature lacks research on its reliability. The purpose of this study was to evaluate the intra-rater and inter-rater reliability of OEP. Thirty-two healthy subjects were evaluated at rest and during submaximal exercise on a cycle ergometer. The following variables were assessed: chest wall volume (VCW); percentage contribution of the pulmonary rib cage (V(rcp)%), abdominal rib cage (V(rca)%), rib cage (V(rc)%) and abdomen (Vab%); chest wall end-expiratory volume (Vee(cw)); chest wall end-inspiratory volume (Vei(cw)); ratio of inspiratory time to total time of the respiratory cycle (Ti/T(tot)); respiratory rate (f) and mean inspiratory flow (V(cw)/Ti). Intraclass correlation coefficient (ICC) and coefficient of variation of Method Error (CV(ME)) were used to evaluate reliability. Results showed ICC values higher than 0.75 and CV(ME) values less than 10% for most variables at rest and during exercise indicating that OEP is a reliable instrument to assess chest wall volumes at rest and during exercise in healthy subjects.

Effects of physical exercise on plasma levels of brain-derived neurotrophic factor and depressive symptoms in elderly women--a randomized clinical trial.

OBJECTIVES: To investigate the effect of 2 standardized exercise programs, muscle strength exercises (SE) and aerobic exercises (AE), on the plasma levels of brain-derived neurotrophic factor (BDNF) and depressive symptoms in 451 elderly women. DESIGN: A randomized controlled trial. SETTING: Belo Horizonte/MG-Brazil. PARTICIPANTS: Community-dwelling older women (N=451; age, 65-89y). INTERVENTION: The participants were divided into 2 groups: SE and AE. Both protocols lasted 10 weeks, and 30 sessions (1-h sessions) in total were performed 3 times a week under the direct supervision of physical therapists. MAIN OUTCOME MEASURES: Plasma levels of BDNF (enzyme-linked immunosorbent assay) and depressive symptoms (Geriatric Depression Scale). RESULTS: There was a significant difference for BDNF plasma levels between the SE and AE groups (P=.009). Post hoc analysis revealed a pre-post intervention difference in BDNF levels only for the SE group (P=.008). A statistically significant difference was found for the pre- and postintervention Geriatric Depression Scale scores in both groups (P=.001), showing that the effects of both exercise protocols were comparable regarding depressive symptoms (P=.185). CONCLUSIONS: The present findings have demonstrated the positive effect of muscle strengthening and aerobic intervention on depressive symptoms in community-dwelling elderly women. Interestingly, only SE significantly increased the plasma levels of BDNF in our sample. The positive effects of physical exercise on depressive symptoms in the elderly were not mediated by BDNF.

Interaction between cytokine gene polymorphisms and the effect of physical exercise on clinical and inflammatory parameters in older women: study protocol for a randomized controlled trial.

BACKGROUND: Aging is associated with chronic low-grade inflammatory activity with an elevation of cytokine levels. An association between regular physical activity and reduction of blood levels of anti-inflammatory cytokines is demonstrated in the literature pointing to an anti-inflammatory effect related to exercise. However, there is no consensus regarding which type of exercise and which parameters are the most appropriate to influence inflammatory markers. Evidence indicates that the single nucleotide polymorphism (SNP) can influence the synthesis of those cytokines affecting their production. METHODS/DESIGN: The design of this study is a randomized controlled trial. The aim of this study is to investigate the interaction between the cytokine genes SNP and the effect of physical activity on older women. The main outcomes are: serum levels of sTNFR-1, sTNFR-2, interleukin (IL)-6, IL-10, measured by the ELISA method; genotyping of tumor necrosis factor- (TNF)-alpha (rs1800629), IL6 (rs1800795), IL10 (rs1800896) by the TaqMan Method (Applied Biosystems, Foster City, CA, USA); and physical performance assessed by Timed Up and Go and 10-Meter Walk Tests. Secondary outcomes include: Geriatric Depression Scale, Perceived Stress Scaleand aerobic capacity, assessed by the six-minute walk; and lower limb muscle strength, using an isokinetic dinamometer (Biodex Medical Systems, Inc., Shirley, NY,USA). Both exercise protocols will be performed three times a week for 10 weeks, 30 sessions in total. DISCUSSION: Investigating the interaction between genetic factors and exercise effects of both protocols of exercise on the levels of inflammatory cytokine levels can contribute to guide clinical practice related to treatment and prevention of functional changes due to chronic inflammatory activity in older adults. This approach could develop new perspectives on preventive and treatment proposals in physical therapy and in the management of the older patient. TRIAL REGISTRATION: (ReBEC) RBR9v9cwf.

Laticifer proteins play a defensive role against hemibiotrophic and necrotrophic phytopathogens.

Proteins from latex of Calotropis procera (CpLP), Plumeria rubra (PrLP), Carica candamarcensis (P1G10) and Euphorbia tirucalli (EtLP) were tested for antifungal activity against phytopathogens. CpLP and P1G10 inhibited each fungi analyzed. PrLP and EtLP did not exert inhibition. CpLP and P1G10 exhibited preferential inhibitory activity towards R. solani (IC50 = 20.7 and 25.3 µg/ml, respectively). The inhibitory activity was lost after heat treatment or proteolysis, providing evidence for the involvement of proteins in the inhibitory effect. Treatment of CpLP or P1G10 with Dithiothreitol improved both, the endogenous proteolytic activity and the antifungal properties. Conversely, pre-treatment of CpLP or P1G10 with iodoacetamide drastically reduced endogenous proteolytic activities and partially abrogated antifungal activity. Similar results were observed when spores were challenged to germinate in the presence of laticifer proteins. The purified cysteine proteinase CMS2MS2 from Carica candamarcensis latex or papain (E.C. 3.4.22.2), a cysteine proteinase from latex of Carica papaya L., but not trypsin (EC 3.4.21.4) or chymotrypsin (EC 3.4.21.1), two serine proteases, replicated the results obtained with CpLP or P1G10, thus restricting the antifungal property to latex plant cysteine proteinases. CpLP, CMS2MS2 and papain induced production of reactive oxygen species in spores of F. solani, suggesting that inhibition could be linked to oxidative stress. Proteome analysis of CpLP by 2-D electrophoresis and MALDI-TOF-TOF confirmed the existence of various pathogenic-related proteins such as chitinases, peroxidases and osmotins. The results support that laticifer proteins are part of plant defense repertoire against phytopathogenic fungi.

Potential of laticifer fluids for inhibiting Aedes aegypti larval development: evidence for the involvement of proteolytic activity.

It has been shown previously that the laticifer fluid of Calotropis procera (Ait.) R.Br. is highly toxic to the egg hatching and larval development of Aedes aegypti L. In the present study, the larvicidal potential of other laticifer fluids obtained from Cryptostegia grandiflora R.Br., Plumeria rubra L. and Euphorbia tirucalli L. was evaluated. We attempted to correlate larvicidal activity with the presence of endogenous proteolytic activity in the protein fraction of the fluids. After collection, the fluids were processed by centrifugation and dialysis to obtain the soluble laticifer protein (LP) fractions and eliminate water insoluble and low molecular mass molecules. LP did not visibly affect egg hatching at the doses assayed. LP from Cr. grandiflora exhibited the highest larval toxicity, while P. rubra was almost inactive. E. tirucalli was slightly active, but its activity could not be correlated to proteins since no protein was detected in the fluid. The larvicidal effects of LP from C. procera and Cr. grandiflora showed a significant relationship with the proteolytic activity of cysteine proteinases, which are present in both materials. A purified cysteine proteinase (papain) from the latex of Carica papaya (obtained from Sigma) was similarly effective, whereas trypsin and chymotrypsin (both serine proteinases) were ineffective. The results provide evidence for the involvement of cysteine proteinase activity in the larvicidal action of some laticifer fluids. C. procera is an invasive species found in areas infested with Ae. aegypti and thus could prove useful for combating mosquito proliferation. This is the first report to present evidence for the use of proteolytic enzymes as chemical agents to destroy Ae. aegypti larvae.

Potential of laticifer fluids for inhibiting Aedes aegypti larval development: evidence for the involvement of proteolytic activity

It has been shown previously that the laticifer fluid of Calotropis procera (Ait.) R.Br. is highly toxic to the egg hatching and larval development of Aedes aegypti L. In the present study, the larvicidal potential of other laticifer fluids obtained from Cryptostegia grandiflora R.Br., Plumeria rubra L. and Euphorbia tirucalli L. was evaluated. We attempted to correlate larvicidal activity with the presence of endogenous proteolytic activity in the protein fraction of the fluids. After collection, the fluids were processed by centrifugation and dialysis to obtain the soluble laticifer protein (LP) fractions and eliminate water insoluble and low molecular mass molecules. LP did not visibly affect egg hatching at the doses assayed. LP from Cr. grandiflora exhibited the highest larval toxicity, while P. rubra was almost inactive. E. tirucalli was slightly active, but its activity could not be correlated to proteins since no protein was detected in the fluid. The larvicidal effects of LP from C. procera and Cr. grandiflora showed a significant relationship with the proteolytic activity of cysteine proteinases, which are present in both materials. A purified cysteine proteinase (papain) from the latex of Carica papaya (obtained from Sigma) was similarly effective, whereas trypsin and chymotrypsin (both serine proteinases) were ineffective. The results provide evidence for the involvement of cysteine proteinase activity in the larvicidal action of some laticifer fluids. C. procera is an invasive species found in areas infested with Ae. aegypti and thus could prove useful for combating mosquito proliferation. This is the first report to present evidence for the use of proteolytic enzymes as chemical agents to destroy Ae. aegypti larvae.