Cardiovascular biomarkers in sickle cell disease− clinical and echocardiographic correlations in a cross-sectional study with 126 patients

INTRODUCTION: Cardiac biomarkers can be useful in understanding the systemic and heart manifestations of sickle cell disease (SCD). Biomarkers reflect various aspects of heart disease (remodeling, injury and myocardial strain), with discriminatory potential for non-cardiac complications. Patients and METHODS: SCD patients (SS/Sß0) in steady state, were studied, correlating clinical manifestations and echo parameters (myocardial work - MW and speckle tracking), pre-MSCD severity score (integrating clinical and echo data), and cardiac biomarkers (high-sensitivity troponins ­ hs-cTn I and T, NT-pro-BNP, ST2s, and galectin-3 - GAL3). Quantitative characteristics were analyzed by Spearman tests, and qualitative characteristics by Mann-Whitney test. Hemolytic Index (HI) was calculated through Principal Component Analysis. Generalized linear Poisson models were generated for hs-cTn, and γ-distribution models were employed for other markers, with final models selected through the Stepwise Backward method. RESULTS: We studied 126 patients (mean age 37.2 ± 11.6 years), 42.1% male, and 80.2% SS. 47% were on hydroxyurea treatment and 30.2% on a chronic transfusion. NT-pro-BNP was elevated in 44% (> 160 ng/mL in 37%), correlated with female gender (p < 0.001), severity score (p = 0.001), uric acid (p = 0.017), HI (p < 0.001), Global Work Index (GWI) (p = 0.003), left atrial (LA) stiffness (p = 0.003), and ventricular mass (VM) (p = 0.02). ST2s were elevated in 11% and correlated with male gender (p > 0.001), HI (p > 0.001), cardiac index (p = 0.015), and LA strain reservoir function (p = 0.034). GAL3 was elevated in 42.8%, correlated with E/e'ratio (p = 0.006), uric acid (p = 0.005), and absence of chronic pain (p = 0.046). hs-cTn correlated with age (c-TnI p = 0.004; c-TnT p > 0.001), HI (p > 0.001), diastolic dysfunction (p > 0.001), left VM (p < 0.001), increased GWI (p < 0.001), and reduced MW efficiency (p < 0.001). hs-cTn I also correlated with increased LA reservoir function (p < 0.001) with reduced conduit function (p < 0.001). hs-cTn T correlated with uric acid (p = 0.001), and in univariate analysis was also correlated with severity score. The values of both hs-cTn correlated with increased GWI (p < 0.001) and reduced MW efficiency (p < 0.001). DISCUSSION: The biomarkers demonstrated various clinical and pathophysiological aspects of SCD. NT-pro-BNP is a routine marker with correlations similar to literature, except for higher values in females, also observed in non-SCD population. ST2 and GAL3 had limited correlations with echo findings, likely due to their production in extracardiac tissues affected by inflammation/vaso-occlusion. Both were linked to the HI, and the decrease in GAL3 in chronic pain can be attributed to chronic opioid use causing reduced synthesis of it. The elevation of hs-cTn was expected due to the analytical characteristics of high-sensitivity assays, but low in terms of the extent of heart involvement. hs-cTnT was more associated with general severity, like in the general population, where it is associated with overall mortality, while hs-cTnI is more connected to heart disease. MW in SCD is optimized to the maximum with a very low Global Work Wasted, and hs-cTn elevation is associated with reduced MW efficiency, indicating mecano-energetic uncoupling and subtle systolic dysfunction. CONCLUSION: Our study demonstrates that cardiac biomarkers can be used for clinical and pathophysiological evaluation, with NT-pro-BNP confirming its role in clinical stratification. ST2s and GAL3 may reveal new pathophysiological pathways in hemolysis and the interaction of opioids and chronic pain. Troponins are promising as prospective tool and may unveil ischemic damage resulting from myocardial mecano-energetic dissociation.

Características físicas e microbiológicas de compostagem de resíduos animais / Physical and microbiological characteristics process of composting waste from animals

Objetivou-se com o presente trabalho caracterizar o processo de compostagem de fluxo contínuo e aeração passiva de resíduos da produção e abate da caprino-ovinocultura e de seu composto orgânico gerado. O processo de compostagem utilizou resíduos sólidos provenientes da produção e do abate de caprinos e ovinos e foi realizado em galpão de alvenaria. Os resíduos agropecuários utilizados incluíram sobras de capim-elefante triturado seco, poda de árvores, esterco e carcaça de caprinos e ovinos. Os tratamentos empregados foram três níveis de umidade aplicados nas leiras de compostagem (30, 50 e 70% com base no peso da carcaça dos animais) e épocas do ano de montagem (período seco, transição e úmido) com base na precipitação, com três repetições. As variáveis avaliadas foram atributos químicos, físicos, microbiológicos e parasitológicos do composto e sua comparação com a legislação vigente. O composto orgânico gerado atende as especificações das legislações utilizadas para comparação. Independentemente da época do ano ou da umidade aplicada, o processo de compostagem foi eficiente em reduzir passivos ambientais, como carcaças. A compostagem promoveu a eliminação dos patógenos avaliados, indicando que o composto não oferece risco de transmissão e pode ser utilizado de forma segura.(AU)

The objective of this study to characterize the process of continuous flow of composting and passive aeration of waste production and slaughter the goat and sheep industry and its generated organic compound. The composting process, performed in a brick barn, used solid residues (manure and carcass parts) from the slaughter of goats and sheep along with chopped dry elephant grass and tree trimmings. The treatments employed three moisture levels in the piles and four collections of samples from the piles at timed intervals (0, 30, 60 and 120 days), with three repetitions. The variables evaluated were the chemical and physical attributes of the compost generated. The treatments were three moisture levels applied in compost piles (30, 50 and 70% based on the housing of animals) and assembly times of the year (dry, transitional and humid) based on rainfall, with three replications. The variables were chemical, physical, microbiological and parasitological of the compound and its comparison with current legislation. The generated organic compound meets the specifications of the laws used for comparison. Regardless of the time of year or moisture applied, the composting process was effective in reducing environmental liabilities as carcasses. Composting promoted elimination of this pathogen, indicating that the compound can be used safely.(AU)

Utilization of CD11b knockout mice to characterize the role of complement receptor 3 (CR3, CD11b/CD18) in the growth of Mycobacterium tuberculosis in macrophages.

Using CD11b knockout mice as a source of macrophages (Mphi;), we show that complement receptor 3 (CR3) mediates approximately 40-50% of nonopsonic binding and 50-60% of serum-mediated binding of Mycobacterium tuberculosis to resident Mphi;. We demonstrate that opsonic binding of M. tuberculosis to Mphi; is mediated by an immunoglobulin-independent, heat-labile component of serum, in both the presence and the absence of CD11b. The survival and replication of M. tuberculosis in an in vitro Mphi; model and an in vivo mouse model of infection were not significantly affected by the absence of CD11b, indicating that CR3-mediated uptake of M. tuberculosis is not a major factor in controlling the subsequent intracellular survival of the mycobacteria. However, whether a mycobacterium will gain access to the intracellular environment, and the type of Mφ that the bacterium enters, is significantly affected by the presence or absence of CR3.

Interaction of Mycobacterium tuberculosis with MH-S, an immortalized murine alveolar macrophage cell line: a comparison with primary murine macrophages.

UNLABELLED: We are interested in identifying a suitable model for investigating mycobacteria interactions with alveolar macrophages. MH-S, a murine alveolar macrophage cell line, is a possible candidate. OBJECTIVE: To compare the receptor mediated interactions of mycobacteria with primary murine macrophages and MH-S. DESIGN: The association of MH-S monolayers with Mycobacterium tuberculosis (MTB) and other defined particles was compared to that of resident Day 1 peritoneal macrophage (PM) and Day 4 alveolar macrophage (AM) monolayers. RESULTS: In the absence of serum, the association of MTB with MH-S was comparable to that of AM, with approximately 35% of each macrophage type binding at least one bacterium. In contrast, almost 80% of PM bound at least one bacterium. MTB binding was enhanced for all macrophage types by a heat-labile component of normal mouse serum. Antibodies recognising CR3 inhibited the serum-mediated enhanced binding of MTB by MH-S. Binding of latex, immunoglobulin coated or complement coated SRBC by MH-S, AM and PM was comparable. Binding of zymosan by MH-S was greatly inferior to AM and PM. CONCLUSION: The receptor expression and particle binding properties of MH-S are similar to AM in many, but not all, ways. MH-S, therefore, has the potential to be used as a model for investigating MTB-macrophage interactions.

Comparison of the prevalence of antibodies to human herpesvirus 8 (Kaposi's sarcoma-associated herpesvirus) in Brazil and Colorado.

The prevalence of human herpesvirus 8 (HHV-8; Kaposi's sarcoma [KS] herpesvirus) infection was determined by IFA in 297 persons living in Brazil and Colorado. The prevalence of antibody to HHV-8 in human immunodeficiency virus (HIV) type 1-seropositive gay men with and without KS was similar in Brazil and Colorado. In Brazil, the prevalence of HHV-8 antibody was significantly greater in HIV-1-seronegative gay men than in HIV-1-seronegative male intravenous drug users. HHV-8-seropositive Brazilian gay men who had a clinical diagnosis of KS or who were infected with HIV-1 had significantly higher titers of HHV-8 antibody than did HHV-8-seropositive, HIV-1-seronegative Brazilian gay men. These findings provide further support for the association between HHV-8 infection and KS and suggest that, as in the United States, HHV-8 infection is transmitted sexually in Brazil.