Development and evaluation of a colorimetric LAMP based-assay targeting the Bacteroides HF183 marker for tracking sewage pollution in environmental waters.

Surface waters are vulnerable to contamination by human and animal feces, posing risks to human health due to potential exposure to enteric pathogens. This research developed a colorimetric loop-mediated isothermal amplification (cLAMP) assay to detect sewage associated Bacteroides dorei HF183/BacR287 (HF183) marker in wastewater and environmental water samples. The host sensitivity and host specificity of the assay were evaluated, and their performance was compared to the Bacteroides HF183 qPCR assay using control materials (gBlocks), environmental water samples seeded with untreated sewage, and ambient environmental water samples. In serial dilutions of control materials, qPCR produced quantifiable data across all dilutions, while cLAMP detected the marker down to 0.001 pg/µL of control materials, which was two orders of magnitude less sensitive than qPCR. All untreated sewage samples (n = 12) tested positive for HF183 by both the qPCR and cLAMP assays, demonstrating a host sensitivity value of 1.00 (maximum value of 1.00). The host specificity by analysing 70 non-human fecal nucleic acid samples revealed cLAMP's specificity value of 0.81 compared to qPCR's 0.64. When testing sewage-seeded environmental water samples, both methods detected HF183 for the lowest amount of sewage, indicating similar detection sensitivity. The application of cLAMP for tracking sewage pollution in environmental waters showed promising results, with moderate agreement between cLAMP and qPCR (κ = 0.510). However, cLAMP occasionally missed detections compared to qPCR, particularly in low-concentration samples. Overall, the cLAMP HF183 assay demonstrated promising potential as a rapid and sensitive method for detecting sewage pollution, offering a viable alternative to qPCR in certain environmental monitoring scenarios.

Hollow-fiber liquid phase microextraction for determination of fluoxetine in human serum by nano-liquid chromatography coupled to high resolution mass spectrometry.

Therapeutic drug monitoring (TDM) is a personalized care tool based on the determination of a target drug concentration in human serum. An antidepressant drug of interest for such investigations is fluoxetine (FXT), due to a severe impact of genetic polymorphisms on its metabolism. A bioanalytical method employed for TDM purposes must exhibit satisfactory selectivity and detectability, which becomes more difficult due to highly complex biological matrices. In this study, a highly selective bioanalytical method for the determination of FXT in human serum is proposed, which provides excellent clean-up efficiency based on a low cost hollow fiber liquid-phase microextraction (HF-LPME) sample preparation step and nano-liquid chromatography coupled to high-resolution mass spectrometry (nano-LC-HRMS). HF-LPME was performed using a two-phase "U" configuration, with 6 cm fiber, 20 µL of 1-octanol acting as supported liquid membrane, and ammonium hydroxide (pH 10) as the donor phase with NaCl (10 % m/v) and methanol (5 % v/v) as additives, requiring only 250 µL of the sample. The procedure was conducted for 30 min under a 750 rpm stirring rate. Gradient elution was carried out employing an acetonitrile-water as mobile phase, the composition of 30:70 to 100:00 (v/v) for 15 min, using formic acid 0.1 % (v/v) as an additive. MS1 was acquired in an Orbitrap mass analyzer, while MS2 was acquired in a linear trap quadrupole. Satisfactory linearity (Pearson's r = 0.99709) was obtained for a concentration range of 0.02 to 2.5 µg mL-1, which is compatible with the therapeutic and toxic range for FXT. The developed method presents adequate precision (1.61 to 7.45 %) and accuracy (95 to 114 %) and allows the dilution of high concentration samples in a 1:4 ratio (v/v), enabling its application for forensic serum samples. To our knowledge, this is the first study reporting a method based on HF-LPME and nano-LC-HRMS with any analytical purpose, especially with a TDM focus.

Non­synonymous polymorphisms in the HRC and ADRB1 genes may be associated with all­cause death in patients with non­ischemic heart failure.

Sudden cardiac death (SCD) is an unpredictable and common mode of death in patients with heart failure (HF). Alterations in calcium handling may lead to malignant arrhythmias, resulting in SCD, and variants in calcium signaling-related genes have a significant association with SCD. Therefore, the aim of the present retrospective cohort study was to investigate the association of Ser96Ala [histidine-rich calcium-binding protein (HRC)], Ser49Gly [ß1-adrenergic receptor (ADRB1)], Arg389Gly (ADRB1) and Gly1886Ser [ryanodine receptor 2 (RYR2)] polymorphisms with serious arrhythmic events and overall mortality in patients with HF with reduced left ventricular ejection fraction of non-ischemic etiology. In total, 136 patients with HF underwent physical examination, routine laboratory tests, non-invasive assessment of cardiac function and an invasive electrophysiological study. The primary outcome was the occurrence of serious arrhythmic events, set as either SCD or appropriate implantable cardioverter-defibrillator (ICD) therapy, and the secondary outcome was all-cause death. During a median follow-up of 37 months, arrhythmic events occurred in 26 patients (19%) and 41 patients (30%) died. Patients carrying the Ser allele of the Ser96Ala polymorphism in HRC had worse survival than those with the Ala/Ala genotype (log-rank P=0.043). Despite the difference in survival time, the Ala/Ala genotype was not associated with all-cause death in the regression analysis [unadjusted hazard ratio (HR)=0.17; 95% CI, 0.02-1.21]. Regarding the Ser49Gly and Arg389Gly polymorphisms in ADRB1, homozygosity for the major alleles at both sites (Ser49Ser and Arg389Arg) was associated with a two-fold increased risk of all-cause death compared with the other genotype combinations (unadjusted HR=1.98; 95% CI, 1.02-3.82). However, this association was lost after controlling for clinical covariates. No association was observed for the Gly1886Ser polymorphism in RYR2. Overall, the present findings are concurrent with the hypothesis that the Ser96Ala (HRC), Ser49Gly (ADRB1) and Arg389Gly (ADRB1) polymorphisms may be associated with HF prognosis. In particular, the Ser96Ala polymorphism might aid in risk stratification and patient selection for ICD implantation.

FT-IR spectroscopy analysis of HF-treated mineral soils, a direct approach for deciphering organo-mineral interactions.

Soil organic matter (SOM) constitutes roughly 60% organic carbon (OC) and therefore plays a crucial role in regulating global climate. However, our understanding of the long-term dynamics of the soil carbon pool remains constrained by limitations in analytical approaches capable of providing high resolution molecular-level information from arguably the most complex biomaterial on the planet. In this contribution, we combine hydrofluoric acid (HF) treatment with a spectroscopic approach as a strategy to provide refined molecular-level information on the interactions between soil minerals and SOM. Critically, we have not seen the use of this combined approach anywhere in the literature and strongly believe that it could allow us to improve our overall understanding to the mechanisms and pathways that regulate SOM transformation. Results clearly illustrates which organic structures are preferentially adsorbed to soil minerals and are likely to be protected from degradation, as well as spatial co-variations of SOM with specific mineral components such as Al3+, Si4+ and dibasic cations such as Mg2+as a function of their importance in the interaction process.•Soil samples were collected from different land-use types in rural farming communities of the Upper Rio Grande Valley.•Samples were oven dried, disaggregated, sieved, treated with 10% HF, rinsed and oven dried.•Oven dried samples were subjected to Mid-infrared (4000-400 cm-1), XRD and ED-XRF analyses.

Photocatalytic degradation of bisphenol-A (BPA) over titanium dioxide, and determination of its by-products by HF-LPME/GC-MS.

In this work, analytical strategies were developed based on the technique of hollow fiber liquid-phase microextraction and chromatographic methods (LC-UV and GC/MS). These methods allowed the identification of the main Bisphenol-A by-products applying heterogeneous photocatalysis in water samples. BPA degradation in this study was in the order of 90%, and the conditions used in the HF-LPME were optimized through 23 factorial design (6 cm fiber length, stirring speed of 750 rpm, and an extraction time of 30 min). Using a HF-LPME/GC-MS analytical strategy, it was possible to identify six by-products of BPA photodegradation, two of which have not been reported in the literature so far. This knowledge was quite important since the degradation can lead to the formation of more toxic and persistent by-products than the BPA. With the Toxtree software, three degradation products were found to be persistent to the environment, in addition to BPA; however, in 360 minutes of reaction, chromatographic peaks of the precursors were not identified, suggesting that there may have been a total degradation of these compounds. The results showed a great application potential of a miniaturized extraction technique to extract and pre-concentrate the degradation products of emerging contaminants.

Kinetic and thermodynamic investigations on the HF elimination reactions from neutral and ionized CF3CH2F.

This work discusses the possible HF formation routes via recombination reactions from CF3CH2F (R-134a) and its cation. The molecular properties of the main reagents were first evaluated at the M06-2X/cc-pVTZ level. Then, changes in energy (ΔE) for all reactions comprising a possible HF formation from the studied systems were evaluated at the CCSD(T)/CBS//M06-2X/cc-pVTZ level. With the aid of Intrinsic Reaction Coordinate (IRC) calculations for each path, it is found that the HF formation reaction takes place majorly through the "1,2" elimination, resulting in an olefin as the secondary product. In turn, the IRC associated with "2,2" reactions allowed to find a post-barrier complex between the carbene :CHCF3 and HF in its exit channel, with dissociation energy of ∼4 kcal mol-1. Similarly, the cationic system exhibits favoritism towards the "1,2" elimination, and an ion-dipole post-barrier complex is found. The ΔE of such a complex production is negative in both directions, indicating this complex (25.5 kcal/mol more stable than CF3CH2F+) should be a minimum on the R-134a cation surface. However, unlike the neutral "2,2" path, there is no F atom migration transition state for the 2,2-HF elimination from CF3CH2F+. Hence, the F migration is expected to occur simultaneously with the rest of the structural changes towards the ion-dipole complex. The rate coefficients computed at the current level of theory, including corrections for anharmonicity and hindered rotations, showed a reasonable agreement with the available experimental data, inspiring confidence in our predictions for the cationic system.

Determination of hormones in urine by hollow fiber microporous membrane liquid-liquid extraction associated with 96-well plate system and HPLC-FLD detection.

In this work, hollow-fiber microporous membrane liquid-liquid extraction (HF-MMLLE) was associated with a 96-well plate system for the determination of estrone, 17-ß-estradiol, estriol and 17-α-ethinylestradiol in urine samples. This method exhibited some advantages, such as low cost, easy application, high-throughput and environmentally-friendly aspects. The type of organic solvent to fill the membrane, ionic strength effect, sample dilution, extraction and desorption time, and desorption solvent were examined. After the optimizations, the conditions were comprised of 45 min of extraction, 1-octanol as organic solvent and 15% (w/v) of NaCl; methanol was used as desorption solvent, and the desorption time was fixed at 10 min. The dilution of the sample increased the sensitivity due to the reduction of matrix effects; thus, urine samples were diluted 40-fold. The limits of detection ranged from 0.03 µg L-1 for 17-ß-estradiol to 15 µg L-1 for estrone, and the limits of quantification ranged from 0.1 µg L-1 for 17-ß-estradiol to 10 µg L-1 for estrone. The intra-day precision varied from 1.0% for estriol to 13.3% for 17-α-ethinylestradiol, and inter-day precision varied from 7.3% for estrone to 18.1% for estriol. The relative recoveries varied from 82 to 118%.

Multiclass determination of endocrine disruptors in urine by hollow fiber microporous membrane and liquid chromatography.

A simple and rapid methodology was developed using hollow fiber membrane microporous and a 96-well plate system for a high throughput multiclass determination of endocrine disruptors in human urine (diclofenac, diazepam, carbamazepine, ibuprofen, naproxen, carbofuran, methyl parathion, 17-α-ethynyl estradiol, bisphenol A and benzophenone). The quantification and detection of the chemicals were carried out by an HPLC-diode array detector. The fixed conditions for carrying out the method optimization were 1.5 mL of sample and 300 µL of solvent desorption. Multivariate and univariate models were applied to optimize the parameters of the method, achieving the following conditions: 20% diluted urine, 1-octanol of extraction solvent impregnated in the microporous membrane, 70 min extraction in pH 3.0 and 30 min with a mixture of 75% methanol and 25% acetonitrile (v/v) for the desorption. The R2 were ≤ 0.9973 for ibuprofen. The LOD ranged from 3.3 to 16.7 ng mL-1 and the LOQ from 10 to 50 ng mL-1. Relative recoveries ranged from 71% to 126%. The repeatability (n = 3) ranged from 0.22% to 12.01%, and the intermediate precision (n = 9) ranged from 0.13% to 17.76%. The method presents a good alternative for the determination of different classes of compounds in human urine.

Systemic Effects of Hemorrhagic Snake Venom Metalloproteinases: Untargeted Peptidomics to Explore the Pathodegradome of Plasma Proteins.

Hemorrhage induced by snake venom metalloproteinases (SVMPs) is a complex phenomenon that involves capillary disruption and blood extravasation. HF3 (hemorrhagic factor 3) is an extremely hemorrhagic SVMP of Bothrops jararaca venom. Studies using proteomic approaches revealed targets of HF3 among intracellular and extracellular proteins. However, the role of the cleavage of plasma proteins in the context of the hemorrhage remains not fully understood. The main goal of this study was to analyze the degradome of HF3 in human plasma. For this purpose, approaches for the depletion of the most abundant proteins, and for the enrichment of low abundant proteins of human plasma, were used to minimize the dynamic range of protein concentration, in order to assess the proteolytic activity of HF3 on a wide spectrum of proteins, and to detect the degradation products using mass spectrometry-based untargeted peptidomics. The results revealed the hydrolysis products generated by HF3 and allowed the identification of cleavage sites. A total of 61 plasma proteins were identified as cleaved by HF3. Some of these proteins corroborate previous studies, and others are new HF3 targets, including proteins of the coagulation cascade, of the complement system, proteins acting on the modulation of inflammation, and plasma proteinase inhibitors. Overall, the data indicate that HF3 escapes inhibition and sculpts the plasma proteome by degrading key proteins and generating peptides that may act synergistically in the hemorrhagic process.

Pulmonary Hypertension in Obese Mice Is Accompanied by a Reduction in PPAR-γ Expression in Pulmonary Artery.

Obesity and insulin resistance (IR) are well-studied risk factors for systemic cardiovascular disease, but their impact on pulmonary hypertension (PH) is not well clarified. This study aims to investigate if diet-induced obesity induces PH and if peroxisome-proliferator-activated receptor (PPAR-γ) and/or endoplasmic reticulum (ER) stress are involved in this process. Mice were maintained on a high-fat diet (HFD) for 4 months, and IR and PH were confirmed. In a separate group, after 4 months of HFD, mice were treated with pioglitazone (PIO) or 4-phenylbutyric acid for the last month. The results demonstrated that HFD for at least 4 months is able to increase pulmonary artery pressure, which is maintained, and this animal model can be used to investigate the link between IR and PH, without changes in ER stress in the pulmonary artery. There was also a reduction in circulating adiponectin and in perivascular adiponectin expression in the pulmonary artery, associated with a reduction in PPAR-γ expression. Treatment with PIO improved IR and PH and reversed the lower expression of adiponectin and PPAR-γ in the pulmonary artery, highlighting this drug as potential benefit for this poorly recognized complication of obesity.

Multiple Coronary Fistulas After Several Penetrating Chest Wounds: A Rare Case of Refractory Heart Failure.

Coronary artery fistulas are rare coronary abnormalities. Most of these fistulas have a congenital origin, and only a few are acquired. We report the case of a patient with late-acquired multiple coronary fistulas secondary to a stab wound, diagnosed in the setting of ischemic heart failure secondary to coronary steal syndrome. (Level of Difficulty: Intermediate.).

Heart Failure and Diabetes: Perspective of a Dangerous Association.

The relationship between diabetes and risk of heart failure has been described in previous trials, releasing the importance of the hyperglycemic state that, added to other risk factors, favors the development of coronary heart disease. The mechanism by which, in the absence of hypertension, obesity and/or dyslipidemia, diabetic patients develop cardiomyopathy has been less studied. Recently, the Sodium Glucose Co-transporter type 2 inhibitors (SGLT2 inhibitors) used for the treatment of heart failure patients with or without diabetes has been a breakthrough in the field of medicine. This review describes the established pathophysiology of diabetic cardiomyopathy and SGLT2 inhibitors, their mechanisms of action, and benefits in this group of patients.

Heart Rate Variability as a Predictor of Mortality in Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically review the medical literature to determine the utility of heart rate variability in predicting mortality for moderate to severe traumatic brain injury. METHODS: A search for randomized controlled trials, nonrandomized trials, and prospective and retrospective cohort studies was carried out using PubMed, SCOPUS, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. Reference lists of included studies were also searched to identify potentially eligible studies. RESULTS: Five articles comprising 542 patients met inclusion criteria. Heart rate variability as low-frequency/high-frequency ratio (area under the curve [AUC] receiver operating characteristic [ROC]) for predicting mortality was found to be statistically significant (AUC ROC 0.810, P < 0.001) with high heterogeneity (I2 = 61.98%, P = 0.032). Meta-analysis of low-frequency/high-frequency ratio, High frequency peak, and total power were statistically significant for predicting mortality. Odd's ratio for predicting mortality for LF/HF ratio, HF peak, and TP were 16.17, 19.09, 22.59 respectively. High-frequency peak in predicting mortality showed an AUC ROC of 0.986 (P ≤ 0.001) with a low level of heterogeneity. Total power (TP) showed an AUC ROC of 0.93 (P < 0.001) in predicting mortality with a high level of heterogeneity (I2 = 83.16%, P = 0.002). Funnel plot analysis to assess the presence of publication bias for TP showed a high level of heterogeneity and asymmetry among studies. CONCLUSIONS: This meta-analysis predicted high mortality based on odds ratio for variables low-frequency/high-frequency ratio, high-frequency peak, and TP. However, the statistical analysis was weakened owing to the high level of heterogeneity in the included studies. Further research is needed to generate high-quality recommendations regarding heart rate variability as a predictor of mortality after traumatic brain injury.

Systemic effects of hemorrhagic snake venom metalloproteinases: untargeted peptidomics to explore the pathodegradome of plasma proteins

Hemorrhage induced by snake venom metalloproteinases (SVMPs) is a complex phenomenon that involves capillary disruption and blood extravasation. HF3 (hemorrhagic factor 3) is an extremely hemorrhagic SVMP of Bothrops jararaca venom. Studies using proteomic approaches revealed targets of HF3 among intracellular and extracellular proteins. However, the role of the cleavage of plasma proteins in the context of the hemorrhage remains not fully understood. The main goal of this study was to analyze the degradome of HF3 in human plasma. For this purpose, approaches for the depletion of the most abundant proteins, and for the enrichment of low abundant proteins of human plasma, were used to minimize the dynamic range of protein concentration, in order to assess the proteolytic activity of HF3 on a wide spectrum of proteins, and to detect the degradation products using mass spectrometry-based untargeted peptidomics. The results revealed the hydrolysis products generated by HF3 and allowed the identification of cleavage sites. A total of 61 plasma proteins were identified as cleaved by HF3. Some of these proteins corroborate previous studies, and others are new HF3 targets, including proteins of the coagulation cascade, of the complement system, proteins acting on the modulation of inflammation, and plasma proteinase inhibitors. Overall, the data indicate that HF3 escapes inhibition and sculpts the plasma proteome by degrading key proteins and generating peptides that may act synergistically in the hemorrhagic process.

Alpha-decay half-life of Hafnium isotopes reinvestigated by a semi-empirical approach.

- New estimates of partial α-decay half-life, T1/2, for 156-162,174,176Hf isotopes by a semi-empirical, one-parameter model are given. The used model is based on the quantum mechanical tunneling mechanism through a potential barrier, where the Coulomb, centrifugal and overlapping components to the barrier have been considered within the spherical nucleus approximation. This approach enables to reproduce, within a factor 2, the measured T1/2 of ground-state to ground-state (gs-gs) α-transitions for the artificially produced 156-162Hf isotopes. Half-life predictions for α-transitions from the ground-state of 159,161Hf isotopes to the first gamma-excited level of 155,157Yb isotopes are reported for the first time. The model also provides T1/2-values of (2.43±0.28)×1016 a and (1.47±0.19)×1020 a for the naturally occurring 174Hf and 176Hf isotopes, respectively, in quite good agreement with a number of estimates by other authors. In addition, the present methodology indicates that 174,176Hf isotopes exhibit α-transition to the first gamma-excited level of their daughter Ytterbium isotopes which half-lives are found (0.9±0.1)×1018 a and (0.72±0.08)×1022 a, respectively, with a chance of being measured by improved α-detection and α-spectrometry methods available nowadays.

A green - high throughput -extraction method based on hydrophobic natural deep eutectic solvent for the determination of emerging contaminants in water by high performance liquid chromatography - diode array detection.

This study reports the use ofa natural deep eutectic solvent (NADES) with hollow fiber-microporous membrane liquid-liquid microextraction (HF-MMLLE) for the multiclass determination of 11 compounds classified as emerging contaminantsin water. Different deep eutectic solvents were synthetized and Thymol: Camphor (1:1 molar fraction) wasused as extraction solvent. The Thymol:Camphor was impregnated into the polypropylene membrane porous for 10 min, replacing commonly used solvents (ex. hexane and octanol). The optimized parameters were obtained by multi and univariate models. Extractions were carried out for 50 min using 1.5 mL of water sample at pH 6 and without addition of salt while desorption was made in a mixture of acetone: methanol (3:1, v/v) for 15 min. Separation/quantification was conducted by HPLC with a diode array detection (DAD)and calibration curves were obtained for each analyte. Determination coefficients higher than 0.9906 and limits of detection ranged from 0.3 to 6.1 µg L-1. Intraday precision (n = 3) ranged from 1.6 to 18.4% and inter day from 5.0 to 21.3%. Relative recoveries were performed in tap and stream water and ranged from 64 to 123%.

Recently Approved and Under Investigation Drugs for Treating Patients with Heart Failure.

Heart Failure (HF) represents a leading cause of morbidity and mortality worldwide. Despite the recent advances in the treatment of this condition, patients´ prognosis remains unfavorable in most cases. Sacubitril/valsartan and ivabradine have been recently approved to improve clinical outcomes in patients with HF with reduced ejection fraction. Drugs under investigation for treating patients with HF encompass many novel mechanisms including vasoactive peptides, blocking inflammatory- mediators, natriuretic peptides, selective non-steroidal mineralocorticoid-receptor antagonists, myocardial ß3 adrenoreceptor agonists, inhibiting the cytochrome C/cardiolipin peroxidase complex, neuregulin-1/ErbB signaling and inhibiting late inward sodium current. The aim of this manuscript is to review the main drugs under investigation for the treatment of patients with HF and give perspectives for their implementation into clinical practice.

Hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. The disease is characterized by marked variability in morphological expression and natural history, ranging from asymptomatic to heart failure or sudden cardiac death. Left ventricular hypertrophy and abnormal ventricular configuration result in dynamic left ventricular outflow obstruction in most patients. The goal of pharmacological therapy in HCM is to alleviate the symptoms, and it includes pharmacotherapies and septal reduction therapies. In this review, we summarize the relevant clinical issues and treatment options of HCM.

Lo mejor del Congreso AHA/ACC 2019 / The best of the 2019 AHA/ACC Congress / O melhor do Congresso da AHA/ACC 2019

Resumen: Del 16 al 18 de noviembre de 2019 se celebró en la ciudad de Philadelphia una nueva reunión del congreso anual del American College of Cardiology. Es uno de los eventos más relevantes de la cardiología mundial, y contó en esta oportunidad con la participación de destacados profesionales que presentaron los últimos ensayos clínicos en las sesiones de Late Breaking Science, abordando diferentes aspectos de la especialidad: estrategias innovadoras para reducir el riesgo cardiovascular, resultados de los ensayos de isquemia, controversias en el manejo contemporáneo de la estenosis aórtica, estado del arte del manejo de pacientes con síndromes coronarios agudos, desafíos en insuficiencia cardíaca y nuevas fronteras en la terapia lipídica. A continuación presentamos un resumen de los principales trabajos presentados: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Summary: A new meeting of the annual congress of the American College of Cardiology, was held from November 16 to 18 last year; located in the city of Philadelphia. As one of the most important events in global cardiology, it was attended by leading professionals who were the last clinical trials in the Late Breaking Science sessions, which addressed different aspects of the specialty: innovative strategies to reduce cardiovascular risk, results of the trials of ischemia, controversies in the contemporary management of aortic stenosis, state of the art of the management of patients with acute coronary syndromes, challenges in heart failure and new frontiers in lipid therapy. We will make a brief summary of the main presented trials: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Resumo: Uma nova reunião do congresso anual do Colégio Americano de Cardiologia, foi realizada de 16 a 18 de novembro do ano passado; localizado na cidade de Filadélfia. Como um dos eventos mais importantes da cardiologia global, contou com a presença de profissionais líderes que apresentaram os últimos ensaios clínicos nas sessões de Late Breaking Science, que abordaram diferentes aspectos da especialidade: estratégias inovadoras para reduzir o risco cardiovascular, resultados dos ensaios de isquemia, controvérsias no tratamento contemporâneo da estenose aórtica, estado da arte do tratamento de pacientes com síndromes coronárias agudas, desafios na insuficiência cardíaca e novas fronteiras na terapia lipídica. Faremos um breve resumo dos principais trabalhos apresentados: - The Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure Trial (DAPA-HF). - The COLchicine Cardiovascular Outcomes Trial (COLCOT). - Global Comparison of a Rivaroxaban-Based Antithrombotic Strategy versus an Antiplatelet-Based Strategy After Transcathether Aortic Replacement to Optimize Clinical Outcomes (GALILEO) Trial: Primary Results. - RECOVERY: Early Surgery versus Conventional Management for Asymptomatic Severe Aortic Stenosis. - International Study of Comparative Health Effectiveness With Medical and Invasive Approaches: Primary Report of Clinical Outcomes (ISCHEMIA).

Deep Profiling of the Cleavage Specificity and Human Substrates of Snake Venom Metalloprotease HF3 by Proteomic Identification of Cleavage Site Specificity (PICS) Using Proteome Derived Peptide Libraries and Terminal Amine Isotopic Labeling of Substrates (TAILS) N-Terminomics.

Snakebite is a major medical concern in many parts of the world with metalloproteases playing important roles in the pathological effects of Viperidae venoms, including local tissue damage, hemorrhage, and coagulopathy. Hemorrhagic Factor 3 (HF3), a metalloprotease from Bothrops jararaca venom, induces local hemorrhage and targets extracellular matrix (ECM) components, including collagens and proteoglycans, and plasma proteins. However, the full substrate repertoire of this metalloprotease is unknown. We report positional proteomic studies identifying >2000 N-termini, including neo-N-termini of HF3 cleavage sites in mouse embryonic fibroblast secretome proteins. Terminal amine isotopic labeling of substrates (TAILS) analysis identified a preference for Leu at the P1' position among candidate HF3 substrates including proteins of the ECM and focal adhesions and the cysteine protease inhibitor cystatin-C. Interestingly, 190 unique peptides matched to annotated cleavage sites in the TopFIND N-termini database, suggesting that these cleavages occurred at a site prone to cleavage or might have been generated by other proteases activated upon incubation with HF3, including caspases-3 and -7, cathepsins D and E, granzyme B, and MMPs 2 and 9. Using Proteomic identification of cleavage site specificity (PICS), a tryptic library derived from THP-1 monocytic cells was used as HF3 substrates for identifying protease cleavage sites and sequence preferences in peptides. A total of 799 unique cleavage sites were detected and, in accordance with TAILS analysis using native secreted protein substrates of MEF cells, revealed a clear preference for Leu at P1'. Taken together, these results greatly expand the known substrate degradome of HF3 and reveal potential new targets, which may serve as a basis to better elucidate the complex pathophysiology of snake envenomation.