Diabetes and hypertension in elderly women: interactions between severity and failure to control inflammation.

Elderly women are more susceptible to the development of chronic non-communicable diseases. Among these, diabetes mellitus (DM) and systemic arterial hypertension (SAH) stand out. This work aimed to carry out an expanded study on the interactions of anthropometric, biochemical and inflammatory parameters associated with the risk of severity in elderly women with hypertension and diabetes. The study involved the evaluation of 126 elderly women with hypertension and diabetes mellitus. The women were divided according disease severity (low, moderate, high and very high). Anthropometric data were collected by bioimpedance analysis. The inflammatory and biochemical data were obtained from volunteer blood samples. Waist circumference, waist circumference/height ratio, and systolic and diastolic pressures increased with severity. Biochemical marker levels increased with risk of severity, except HDLc. In the very high risk group, there was a higher IL-1ß, IFN-γ and TNF-α production, however, lower IL-10 levels were observed. The very high risk group showed change values for the IL-10/IL-1ß, IL-10/IL-17 and IL-10/TNF-α ratios. The results showed to be extensively altered in the very high risk group, where the inflammatory profile loses its responsiveness. This is the first study that shows an expanded view of the different parameters evaluated in elderly women with hypertension and diabetes.

Physical activity reduces intradermal bacterial load in a murine model submitted to forced swim training - a pilot study.

Regular exercise is beneficial to health. This study evaluated the effects of moderate and intense physical exercise modalities on intradermal infection by Staphylococcus aureus in a murine model. Mice that practiced moderate exercise had lower bacterial load on lymph nodes and less inflammatory infiltrate in dermis. They presented greater weight, however, less amount of epididymal fat: the weight was increased while they had fat diminished. A positive correlation was observed between lipid content and bacterial load in mice trained at moderate intensity. Animals that were under high intensity exercises presented superior bacterial load on the lymph nodes, increased neutrophil count and circulating lymphocytes, and had leukocyte recruitment to the dermis augmented, when compared to the ones in moderate exercise. These findings suggest that moderate physical activity modulates the immune response in dermal infection caused by S. aureus in a murine model.

Gender-related differences in the modulation of anthropometric, biochemical, and immune markers by physical activity in hypertensive and diabetic individuals.

Systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM) compose the two major noncommunicable chronic inflammatory diseases. Physical activity has been shown as a promising complementary approach to control the systemic inflammation. However, it is still unclear whether this modulation is gender-dependent. The objective of this study was evaluate the gender-related influence of physical activity on the inflammatory response and biochemical profile of individuals with SAH and T2DM. An international physical activity questionnaire was applied to 376 individuals diagnosed with SAH and T2DM in order to access their exercises routine and was evaluated the influence of physical activity in biochemical, anthropometrical, and immunological markers involved in these disorders in men and women. Even though active individuals have exhibited lower serum levels of IL-1ß, IFN-γ, TNF-α, and IL-17A, the ratios between IL-10 and all inflammatory cytokines were higher in men than in women. Physically active individuals also demonstrated increased HDL/LDL and HDL/VLDL ratios. Moreover, multiple correlations revealed that in active women both IL-10 and TNF-α serum levels positively correlate with fasting glucose levels, and were negatively associated with HDL levels. Our findings suggest that gender-related differences dictate a distinct crosstalk between inflammatory and biochemical markers in physically active individuals.

Regular physical activity reduces the effects of inflammaging in diabetic and hypertensive men.

The aim of this study was to assess the influence of physical activity in inflammatory, biochemical and endocrine parameters of middle-aged and elderly men with Systemic Arterial Hypertension (SAH) and Type 2 Diabetes Mellitus (T2DM). The assessment was comprised by 77 male volunteers aged between 45 and 59 years old (middle-aged men) or 60 to 86 years old (elderly men), diagnosed with SAH and T2DM, assisted by Family Health Units in Vitória da Conquista, Bahia, Brazil. According to age and lifestyle (sedentary or practicing physical activity), these men were classified as middle-aged sedentary men, middle-aged physically active men, elderly sedentary men, or elderly physically active men. It was noticed that active elderly people with SAH and T2DM had a better inflammatory balance than sedentary middle-aged men, through the evaluation of the relationship between the cytokines IL-10/TNF-α, IL-10/IL-17A and IL-10/IFN-γ. Moreover, in the extended correlation analysis, a greater global balance was observed among anthropometric, blood pressure, biochemical and cytokine parameters. Physical activity beneficially modulates aging-related disease risk factors even in elderly individuals.

Ureaplasma diversum clearance in lung mice infection is mediated by neutrophils.

Pneumonia in cattle is one of the causes of morbidity rates and economic loss. The host response to lung infections caused by Ureaplasma diversum in bovines is virtually unknown. Here in the immune response was evaluated in a murine model for an experimental pulmonary infection by U. diversum. Therefore, AJ, BALB/C and C57BL/6 mice received intratracheal inoculation of U. diversum and were evaluated after 1, 2, 3, 7 and 14 days and the clinical specimens were collected. In bronchoalveolar lavages (BAL) an increase of inflammatory cells was observed. Neutrophils were the main cells recruited to the site of infection and the infiltration was coincided with the production of pro-inflammatory cytokines. We found a large amount of neutrophil in this initial period, followed by a decrease 7 and 14 days post infection, accompanied by bacterial clearance. Our results evidenced the presence of U. diversum within the neutrophil that suggests a phagocytic role of this cell in the elimination of the infection. The immune response features reported here are the initial evidence that healthy immune systems may control these microorganisms. This may be the first step to design new strategies immune based to control the infections in naturally infected hosts.

Regular physical activity reduces the proinflammatory response in older women with diabetes and hypertension in the postmenopausal phase.

Aging in women is characterized by extreme hormonal changes leading them to develop a chronic low-grade inflammation that is linked to the development of systemic arterial hypertension (SAH) and type 2 diabetes mellitus (T2DM). In this scenario, physical activity emerges as an interesting methodology, since it seems to be connected to a decrease in serum levels of some pro-inflammatory cytokines. Nevertheless, most studies evaluate these cytokines in an isolated manner not considering the influence of comorbidities on the responsiveness of participants to the benefits of physical activity. So, this study aimed to assess the influence of physical activity on body composition, anthropometric parameters, lipid profile, and inflammatory markers of diabetic and hypertensive older postmenopausal women. We evaluated 163 women aged from 60 to 80 years, diagnosed with T2DM and SAH that were assisted by the Family Health Units in Vitória da Conquista, Bahia, Brazil. The pratice of physical activity was measured by the International Physical Activity Questionnaire with the participants being classified as active or sedentary individuals. Active older women presented better body composition, lipid profile and inflammatory balance. This was connected to a better correlation profile between these factors in active older women, characteristics that were not noticed in sedentary older women. Moreover, IL-17A and the relationship between IL-10 and the other pro-inflammatory cytokines examined was greatly influenced by physical activity. Consequently, physical activity is linked to a global improvement in T2DM and SAH risk factors and with a positive inflammatory modulation in diabetic and hypertensive older women.

Dynamics of Transmission of Urban Arbovirus Dengue, Zika and Chikungunya in Southwestern Region of Bahia, Brazil.

Arboviral diseases are disseminated all over the world. In Brazil, they remain neglected, alerting public authorities to possible outbreaks. Over here, we report the epidemiological indicators of Dengue from 2010 to 2015, Zika between 2015 and 2016, and Chikungunya from 2014 to 2016, within 19 municipalities of Southwestern Region of Bahia, Brazil. The data were collected from Brazilian national public information systems (SISFAD, SINAN, and IBGE) and by Endemic Control Agents. The analysis consisted of a description of vector characteristics, Home Infestation Index and characterization of human reported cases. The years 2011 and 2013 were recorded as having the highest frequencies of positive properties for the presence of the arboviruse vectors. Most municipalities presented high annual values of Home Infestation Index indicating an alert situation (62.28%). In the evaluated period, there were (i) 9,196 cases of Dengue, (ii) 636 cases of Zika and (iii) 224 cases of Chikungunya reported. This is the first report of the epidemiological characteristics of these arboviruses in the 19 municipalities of Bahia. It is believed that the data collected may contribute to public health policies aimed at controlling future epidemics of these arboviruses.

Association between body composition and inflammation: A central role of IL-17 and IL-10 in diabetic and hypertensive elderly women.

In women, aging is evidenced by physiological hormonal alterations that trigger changes in body composition, emergence of chronic low-grade inflammation, which is an important pre-disposition to the development of chronic diseases such as Systemic Arterial Hypertension (SAH) and Type 2 Diabetes Mellitus (T2DM). Although it is a strong pro-inflammatory nature disorder, little is known about how body composition interferes with inflammatory markers in diabetic and hypertensive elderly women. Therefore, this study's objective was to evaluate the inflammation in diabetic and hypertensive elderly women, and their association with fat mass. It comprised the evaluation of 144 women aged between 60 and 80 years old, diagnosed with SAH and T2DM, assisted by Family Health Units in Vitória da Conquista, Bahia, Brazil. According to body mass index (BMI), these women were classified as either eutrophic or overweight. In the eutrophic females, the IL-10 / IL-17A ratio was increased when compared to those overweight. In addition, IL-17 correlated negatively with HDL and positively with total cholesterol, LDL, triglycerides, VLDL, and glucose in the eutrophic ones, but not in the overweight individuals. IL-10 also showed differences in the correlation pattern observed between the groups, since for this eutrophic cytokine, it presented positive correlation with the waist circumference, waist/height ratio, and negative association with IL-17, while in overweight elderly women, it was not observed such pattern. Hence, this work demonstrates how the amount of fat mass interferes with the balance of cytokines, especially IL-10 and IL-17, and how it may exert an effect on biochemical parameters and risk factors associated with T2DM and SAH.

Surveillance of donated blood during the 2016 arbovirus outbreak in Brazil.

Reports of arboviral transmission via blood transfusion may be a cause of concern among asymptomatic infected donors. This study evaluated the presence of arboviruses in donated blood products during the 2016 outbreak in Vitória da Conquista (Bahia-Brazil). Serum samples (n = 676) were screened for ZIKV, CHIKV, and the four DENV serotypes using a one-step reverse transcriptase-based Real-Time Polymerase Chain Reaction (RT-PCR). No samples tested positive for any of the targets, whereas positive controls performed as expected. The results suggest a low risk of arboviral transmission via transfusion of blood products in the endemic area studied during the 2016 outbreak.

Correlation between infection rate of triatominies and Chagas Disease in Southwest of Bahia, Brazil: a warning sign?

Chagas disease, caused by the Trypanosoma cruzi, has a wide distribution in South America, and its main method of control is the elimination of triatomines. It is presented here the geographic distribution and the rate of natural infection by T. cruzi of triatomines collected and evaluated from 2008 to 2013 in southwest of Bahia. Triatomines were captured in the intradomiciliary and peridomiciliary areas of five cities located in the southwest of Bahia state, identified, and analyzed for the presence of trypanosomatids in their feces. During the study period the number of patients suspected for acute Chagas disease was recovered from the Notifiable Diseases Information System (SINAN). 8966 triatomines were captured and identified as belonging to eight species. Twenty-six presented themselves infected, being Triatoma sordida the most abundant and with the highest percentage of infection by T. cruzi. Tremedal was the city with the highest number of cases of acute Chagas' disease reported to SINAN. All cities showed triatomines infected with T. cruzi, so there is considerable risk of vectorial transmission of Chagas disease in the southwestern Bahia state, evidencing the need for vector transmission control programs and preventive surveillance measures.

Intra-uterine experimental infection by Ureaplasma diversum induces TNF-α mediated womb inflammation in mice.

Ureaplasma diversum is an opportunistic pathogen associated with uterine inflammation, impaired embryo implantation, infertility, abortions, premature birth of calves and neonatal pneumonia in cattle. It has been suggested that the intra-uterine infection by Ureaplasma diversum can cause vascular changes that hinder the success of pregnancy. Thus, the aim of this study was to evaluate the changes of intrauterine site of A/J mice in estrus or proestrus phase inoculated with Ureaplasma diversum. The infection was monitored at 24, 48 and 72 hours by the PCR methodology to detect the Ureaplasma in the inoculation site and the profile of circulating blood cells. Morphological changes, intensity of inflammation and the production of cytokines were compared. The infected mice showed local inflammation through the production of IFN-γ and TNF-α. Ureaplasma diversum infections in the reproductive tract of studied mice seemed to be associated with the production of pro-inflammatory cytokines in uterine parenchyma. The levels of TNF-α of infected mice were dependent on the bacterial load of inoculated Ureaplasma. Uterine experimental infections by Ureaplasma diversum have not been mentioned yet and herein we presented the first report of an intrauterine infection model in mice.

DNA vaccination with KMP11 and Lutzomyia longipalpis salivary protein protects hamsters against visceral leishmaniasis.

It was recently shown that immunization of hamsters with DNA plasmids coding LJM19, a sand fly salivary protein, partially protected against a challenge with Leishmania chagasi, whereas immunization with KMP11 DNA plasmid, a Leishmania antigen, induced protection against L. donovani infection. In the present study, we evaluated the protective effect of immunization with both LJM19 and KMP11 DNA plasmid together. Concerning the protection against an infection by L. chagasi, immunization with DNA plasmids coding LJM19 or KMP11, as well as with both plasmids combined, induced IFN-γ production in draining lymph nodes at 7, 14 and 21 days post-immunization. Immunized hamsters challenged with L. chagasi plus Salivary Gland Sonicate (SGS) from Lutzomyia longipalpis showed an enhancement of IFN-γ/IL-10 and IFN-γ/TGF-ß in draining lymph nodes after 7 and 14 days of infection. Two and five months after challenge, immunized animals showed reduced parasite load in the liver and spleen, as well as increased IFN-γ/IL-10 and IFN-γ/TGF-ß ratios in the spleen. Furthermore, immunized animals remained with a normal hematological profile even five months after the challenge, whereas L. chagasi in unimmunized hamsters lead to a significant anemia. The protection observed with LJM19 or KMP11 DNA plasmids used alone was very similar to the protection obtained by the combination of both plasmids.

Lutzomyia longipalpis saliva or salivary protein LJM19 protects against Leishmania braziliensis and the saliva of its vector, Lutzomyia intermedia.

BACKGROUND: Leishmania transmission occurs in the presence of insect saliva. Immunity to Phlebotomus papatasi or Lutzomyia longipalpis saliva or salivary components confers protection against an infection by Leishmania in the presence of the homologous saliva. However, immunization with Lutzomyia intermedia saliva did not protect mice against Leishmania braziliensis plus Lu. intermedia saliva. In the present study, we have studied whether the immunization with Lu. longipalpis saliva or a DNA plasmid coding for LJM19 salivary protein would be protective against L. braziliensis infection in the presence of Lu. intermedia saliva, the natural vector for L. braziliensis. METHODOLOGY/PRINCIPAL FINDINGS: Immunization with Lu. longipalpis saliva or with LJM19 DNA plasmid induced a Delayed-Type Hypersensitivity (DTH) response against Lu. longipalpis as well as against a Lu. intermedia saliva challenge. Immunized and unimmunized control hamsters were then intradermally infected in the ears with L. braziliensis in the presence of Lu. longipalpis or Lu. intermedia saliva. Animals immunized with Lu. longipalpis saliva exhibited smaller lesion sizes as well as reduced disease burdens both at lesion site and in the draining lymph nodes. These alterations were associated with a significant decrease in the expression levels of IL-10 and TGF-ß. Animals immunized with LJM19 DNA plasmid presented similar findings in protection and immune response and additionally increased IFN-γ expression. CONCLUSIONS/SIGNIFICANCE: Immunization with Lu. longipalpis saliva or with a DNA plasmid coding LJM19 salivary protein induced protection in hamsters challenged with L. braziliensis plus Lu. intermedia saliva. These findings point out an important role of immune response against saliva components, suggesting the possibility to develop a vaccine using a single component of Lu. longipalpis saliva to generate protection against different species of Leishmania, even those transmitted by a different vector.