Topical formulations containing Trichilia catigua extract as therapeutic options for a genital and an acyclovir-resistant strain of herpes recurrent infection.

Herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) infect, respectively, 67% and 13% of the world population, most commonly causing mild symptoms, such as blisters/ulcers. However, severe conditions such as keratitis, encephalitis, and systemic infections may occur, generally associated with the patient's immunological condition. Although Acyclovir® (ACV) and its analogs are the reference drugs for herpetic infections, the number of ACV-resistant HSV infections is growing exponentially. Therefore, new natural products' bioactive compounds have been studied to develop novel effective anti-herpetics. Trichilia catigua is a plant widely used in traditional medicine, including the treatment of skin diseases and sexual infections. In our study, 16 extracts from the bark of T. catigua, obtained with different solvents and their combinations, were evaluated against HSV-1 AR and HSV-2, respectively, ACV resistance and genital strains in vitro. The extracts with the highest selectivity index were used to prepare new topical anti-herpetic formulations and confirmed in vivo. Two new topical formulations were suggested to treat cutaneous and genital herpetic recurrent lesions. The cytotoxicity and antiviral activity were tested using the MTT method. The cytotoxic (CC50) and inhibitory (IC50) concentrations of 50% and the selectivity index (SI: CC50/IC50) were determined. Tc12, Tc13, and Tc16 were added to the formulations. Infected BALB/c mice were treated for 8 days, and the severity of the herpetic lesions was analyzed daily. All CEs showed a CC50 value ranging from 143 to 400 µg/mL, except for Tc3 and Tc10. Tc12, Tc13, and Tc16 showed the best SI in the 0 h, virucidal, and adsorption inhibition assays. In the in vivo test against HSV-1 AR, the infected animals treated with creams were statistically different from the infected non-treated animals and similar to ACV-treated mice. In HSV-2-infected genitalia, similar effects were found for Tc13 and Tc16 gels. The present study demonstrated that extracts from the bark of T. catigua, traditionally used in folk medicine, are a valuable source of active compounds with anti-herpetic activity. The extracts showed a virucidal mechanism of action and prevented the initial stages of viral replication. The cutaneous and genital infections were strongly inhibited by the Tc12, Tc13, and Tc16 extracts. New topical therapeutic alternatives using Trichilia catigua extracts are suggested for patients infected with ACV-resistant strains of HSV.

Sulfonated (1 → 6)-ß-d-Glucan (Lasiodiplodan): A Promising Candidate against the Acyclovir-Resistant Herpes Simplex Virus Type 1 (HSV-1) Strain.

Herpes simplex virus type 1 (HSV-1) is a persistent human pathogen, and the emergence of strains resistant to Acyclovir (ACV, reference drug) shows the urgency to develop new treatments. We report the antiherpetic mechanism of the action of lasiodiplodan (LAS-N, (1 → 6)-ß-d-glucan) and its sulfonated derivative (LAS-S3) in vitro and in vivo. LAS-S3 showed anti-HSV-1 action with high selectivity indices for HSV-1 KOS (88.1) and AR (189.2), sensitive and resistant to ACV, respectively. LAS-S3 inhibited >80% of HSV-1 infection in different treatment protocols (virucidal, adsorption inhibition, and post-adsorption effects), even at low doses, and showed a preventive effect and DNA and protein synthesis inhibition. The antiherpetic effect was confirmed in vivo by the cosmetic LAS-S3-CRÈME decreasing cutaneous lesions of HSV-1, including the AR strain. LAS-S3 possessed a broad-spectrum mechanism of action acting in the early and post-adsorption stages of HSV-1 infection, and LAS-S3-CRÈME is a potential antiherpetic candidate for patients infected by HSV-1-resistant strains.

Sulfonated and Carboxymethylated ß-Glucan Derivatives with Inhibitory Activity against Herpes and Dengue Viruses.

The infection of mammalian cells by enveloped viruses is triggered by the interaction of viral envelope glycoproteins with the glycosaminoglycan, heparan sulfate. By mimicking this carbohydrate, some anionic polysaccharides can block this interaction and inhibit viral entry and infection. As heparan sulfate carries both carboxyl and sulfate groups, this work focused on the derivatization of a (1→3)(1→6)-ß-D-glucan, botryosphaeran, with these negatively-charged groups in an attempt to improve its antiviral activity. Carboxyl and sulfonate groups were introduced by carboxymethylation and sulfonylation reactions, respectively. Three derivatives with the same degree of carboxymethylation (0.9) and different degrees of sulfonation (0.1; 0.2; 0.4) were obtained. All derivatives were chemically characterized and evaluated for their antiviral activity against herpes (HSV-1, strains KOS and AR) and dengue (DENV-2) viruses. Carboxymethylated botryosphaeran did not inhibit the viruses, while all sulfonated-carboxymethylated derivatives were able to inhibit HSV-1. DENV-2 was inhibited only by one of these derivatives with an intermediate degree of sulfonation (0.2), demonstrating that the dengue virus is more resistant to anionic ß-D-glucans than the Herpes simplex virus. By comparison with a previous study on the antiviral activity of sulfonated botryosphaerans, we conclude that the presence of carboxymethyl groups might have a detrimental effect on antiviral activity.

ß-Glucans as a panacea for a healthy heart? Their roles in preventing and treating cardiovascular diseases.

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Factors increasing the risks for CVD development are related to obesity, diabetes, high blood cholesterol, high blood pressure and lifestyle. CVD risk factors may be treated with appropriate drugs, but prolonged can use cause undesirable side-effects. Among the natural products used in complementary and alternative medicines, are the ß-ᴅ-glucans; biopolymers found in foods (cereals, mushrooms), and can easily be produced by microbial fermentation. Independent of source, ß-glucans of the mixed-linked types [(1 → 3)(1 → 6)-ß-ᴅ-glucans - fungal, and (1 → 3)(1 → 4)-ß-ᴅ-glucans - cereal] have widely been studied because of their biological activities, and have demonstrated cardiovascular protective effects. In this review, we discuss the roles of ß-ᴅ-glucans in various pathophysiological conditions that lead to CVDs including obesity, dyslipidemia, hyperglycemia, oxidative stress, hypertension, atherosclerosis and stroke. The ß-glucans from all of the sources cited demonstrated potential hypoglycemic, hypocholesterolemic and anti-obesogenicity activities, reduced hypertension and ameliorated the atherosclerosis condition. More recently, ß-glucans are recognized as possessing prebiotic properties that modulate the gut microbiome and impact on the health benefits including cardiovascular. Overall, all the studies investigated unequivocally demonstrated the dietary benefits of consuming ß-glucans regardless of source, thus constituting a promising panaceutical approach to reduce CVD risk factors.

Viral infections and their relationship to neurological disorders.

The chronic dysfunction of neuronal cells, both central and peripheral, a characteristic of neurological disorders, may be caused by irreversible damage and cell death. In 2016, more than 276 million cases of neurological disorders were reported worldwide. Moreover, neurological disorders are the second leading cause of death. Generally, the etiology of neurological diseases is not fully understood. Recent studies have related the onset of neurological disorders to viral infections, which may cause neurological symptoms or lead to immune responses that trigger these pathological signs. Currently, this relationship is mostly based on epidemiological data on infections and seroprevalence of patients who present with neurological disorders. The number of studies aiming to elucidate the mechanism of action by which viral infections may directly or indirectly contribute to the development of neurological disorders has been increasing over the years but these studies are still scarce. Comprehending the pathogenesis of these diseases and exploring novel theories may favor the development of new strategies for diagnosis and therapy in the future. Therefore, the objective of the present study was to review the main pieces of evidence for the relationship between viral infection and neurological disorders such as Alzheimer's disease, Parkinson's disease, Guillain-Barré syndrome, multiple sclerosis, and epilepsy. Viruses belonging to the families Herpesviridae, Orthomyxoviridae, Flaviviridae, and Retroviridae have been reported to be involved in one or more of these conditions. Also, neurological symptoms and the future impact of infection with SARS-CoV-2, a member of the family Coronaviridae that is responsible for the COVID-19 pandemic that started in late 2019, are reported and discussed.

Relationship Between Hormonal Mechanisms of Diabetes Mellitus and Hypothyroidism Post-Bariatric Surgery.

BACKGROUND: Obesity, diabetes mellitus may be related to the health, the relationship and the physiological capacity of the production of thyroid hormones (TH), triiodothyronine (T3) and thyroxine (T4). OBJECTIVES: The main aims of this review are to describe the relationship between obesity, appetite, weight management, hormonal mechanisms of diabetes mellitus and hypothyroidism post-bariatric surgery. METHODOLOGY: An in-depth literature search was conducted to identify scientific studies, which analyzed the correlation between diabetes mellitus and hypothyroidism post-bariatric surgery. RESULTS: Bariatric surgery decreases hypothyroidism, reduces the need for pharmacological action (such as levothyroxine), controls the weight and body fat and increases the sensitivity to leptin and insulin. CONCLUSION: The reduction of the stomach and intestine by bariatric surgery is an evolutionary and beneficial action, because it may lead to a drastic decrease on numbers of conditions such as diabetes, obesity, hypothyroidism, and others. Thus, new studies should also focus on patients' post-operatory conditions, such as lifetime, regulation and functioning of organs after reduced nutrition, and consumption and delivery of nutrients to health maintenance.

Risk factors and postoperative complications in oncologic surgeries / Fatores de risco e complicações pós operatórias em cirurgia oncológica

Abstract Introduction: Oncological patients who are submitted to surgical procedures might have postoperative pulmonary complications (PPCs). Thus, preoperative physical conditions must be considered, since it is an important predictor of postoperative development. Objective: The purpose of this study was to analyze the risk factors for postoperative pulmonary complications that might compromise the recovery after oncologic surgery. Method: The present observational transversal study was made between March and October of 2015. Patients diagnosed with cancer were analyzed to determine pulmonary and functional condition and to identify the risk factors for the development of PPCs. The post-surgery recovery was followed through medical records. Data collected from patients' analyses was correlated with post-surgery development. Results: Thirty patients were analyzed. A negative and moderate correlation was found between maximal inspiratory pressure (MIP) and PPCs (r=-0.39; p=0.032). A positive correlation between the time of permanence in the Intensive Care Unit (ICU) and hospitalization days (r=0.40; p=0.02) was observed. Correlations between PPCs and mechanical ventilation (r=0.36; p=0.04) and hospitalization days (r=0.40; p=0.02) were also noticed in the present study. Conclusion: PPCs might prejudice post-surgery outcome. The greater are physical condition and pulmonary functions of the patients before surgery, the better is their recovery.

Resumo Introdução: Pacientes oncológicos submetidos a procedimentos cirúrgicos podem apresentar complicações pulmonares no pós-operatório. A condição física pré-operatória deve ser considerada, pois é um importante preditor do desenvolvimento pós-operatório. Objetivo: Analisar os fatores de risco para complicações pulmonares pós-operatórias (CPPO) que podem comprometer a recuperação após a cirurgia oncológica. Método: O presente estudo observacional transversal foi realizado entre os meses de março e outubro de 2015. Pacientes oncológicos participaram de uma avaliação para determinação da condição pulmonar e funcional pré-operatória e identificação dos fatores de risco para desenvolvimento de CPPO. A evolução pós-operatória foi acompanhada por meio de prontuários. Os dados coletados da avaliação foram correlacionados com o desenvolvimento pós-operatório. Resultados: Trinta pacientes foram analisados. Foi encontrada correlação negativa e moderada entre a PImáx e as CPPO (r=-0,39; p=0,032). A permanência na UTI apresentou correlação positiva com os dias de internamento hospitalar (r=0,40; p=0,02). A ventilação mecânica (r= 0,36; p=0,04) e os dias de internamento no hospital (r=0,40; p=0,02) tiveram correlação com o tipo de CPPO. Conclusão: CPPO podem prejudicar o desfecho pós-operatório. Bom estado físico e boa função pulmonar prévias à cirurgia oncológica possibilitam melhor desempenho para o paciente no pós-operatório.

The Relationship Between Copper, Iron, and Selenium Levels and Alzheimer Disease.

This study aimed to evaluate the concentrations of copper, iron, and selenium in elderly people with Alzheimer disease (AD), comparing the same parameters in a paired group of healthy people, in order to verify if the amount of these metals may influence the cognitive impairment progression. Patients' cognitive impairment was evaluated by Clinical Dementia Rating (CDR). The elementary quantification of erythrocytes was performed by inductively coupled plasma mass spectrometry technique. The statistical analyses were carried out by SPSS software 20.0 version, employing Shapiro-Wilk, Wilcoxon, Kruskall-Wallis, and Spearman correlation tests, considering significant results of p < 0.05. The sample was composed of 34% (n = 11) of women and 66% (n = 21) of men in each group. The AD group was characterized by a higher concentration of copper (p < 0.0001) and iron (p < 0.0001); however, there is no significant difference in selenium level. The analyses of the metal levels in different stages of AD were not significant in CDR-1, however in CDR-2 and CDR-3, elevated levels of copper and iron were observed; in CDR-3 patients, the level of selenium was lower (p < 0.008) compared to that of healthy controls. Patients with Alzheimer disease studied present increase in biometal blood levels, especially of copper and iron, and such increase can be different according to the disease stage and can cause more impairment cognitive functions in AD.

Intracerebroventricular administration of the (1→6)-ß-d-glucan (lasiodiplodan) in male rats prevents d-penicillamine-induced behavioral alterations and lipoperoxidation in the cortex.

CONTEXT: Lasiodiplodan, an exocellular (1→6)-ß-d-glucan of molecular weight >1.4 × 106 Da produced by MMPI strain of Lasiodiplodia theobromae (Pat.) Griffon & Maubl. (Brotyosphaeriaceae) is known to exhibit anti-proliferative activity on breast cancer cells (MCF-7), anticoagulant activity when sulfonylated, and reduction in transaminase activity when administered in rats. OBJECTIVE: The effect of intracerebroventricular (I.C.V) injection of lasiodiplodan on neurotoxicity and behavioural changes induced by d-penicillamine was investigated. MATERIALS AND METHODS: Twenty-four male Wistar rats were initially separated in groups of six and treated with 0.15 µmol/µL of NaCl (Groups Ct and d-Pen) and 0.01 µg/µL of lasiodiplodan (Groups Las and Las + d-Pen). After 15 min, they received 6 µmol/µL of NaCl (Groups Ct and Las) and 2 µmol/µL of d-penicillamine (Groups d-Pen and Las + d-Pen). The animal behavior was observed in an open-field test for 60 min. Twenty-four h later, the animals were sacrificed and histopathological analysis and Thiobarbituric acid reactive substances (TBARS) production measurements were performed. RESULTS: Lasiodiplodan prevented neurotoxicity induced by d-penicillamine significantly reducing the production of TBARS (308%; p < 0.05), and behavioural signs; convulsive and pre-convulsive. No histopathological alterations in the cerebral cortex were observed. DISCUSSION AND CONCLUSION: The reduction of TBARS production and convulsive episodes suggests that the protector effect provided by lasiodiplodan passes thought an antioxidant path, possibly interfering in a cascade of neurochemical events, triggering cell death and convulsive episodes. These results demonstrated that lasiodiplodan can be effective in treating neurotoxicity, and reducing damage triggered by convulsions in neuropathies related to GABAergic system.