Investigación de la trombofilia venosa. Presente y futuro / Venous thrombophilia research. Present and future

La enfermedad tromboembólica venosa es de tipo complejo. Es consecuencia de la interacción de factores ambientales y genéticos que muchas veces se reflejan en los llamados fenotipos intermediarios. Estos se asocian por definición al riesgo de trombosis y por ello tienen una gran utilidad tanto diagnóstica como en la búsqueda de los factores causales últimos (ambientales y genéticos). Las investigaciones actuales van encaminadas a responder por qué se origina un trombo mediante la búsqueda de nuevos mecanismos que se añaden a la tríada descrita por Virchow. Los estudios de genome wide asociation study (GWAS) y las técnicas de secuenciación masiva han permitido identificar nuevas variantes genéticas. A estas técnicas se les suman nuevos campos en desarrollo como la epigenética, la transcriptómica y el estudio del metaboloma. El procesamiento de la inmensa información mediante los algoritmos adecuados y modelos matemáticos y bioinformáticos multiplicará la capacidad para responder cuestiones sobre el espectro mutacional de la trombosis y estimar el riesgo individual de padecerla. El área de investigación de mayor valor clínico aplicado en trombofilia debe ir encaminada al desarrollo de modelos predictivos que permitan estimar el riesgo individual de trombosis o de recidiva, si es el caso

Thrombosis is a complex human disease. It is the result of the interaction between the environment and genes. This interaction is manifested by «intermediary phenotypes». These intermediary phenotypes are useful for estimating the risk of developing the disease. The targets of current investigations are attempting to identify new mechanisms that underlie the classic Virchow’s triad. Modern methodologies, such as genome wide association studies (GWAS) and high-throughput genotyping technology (massive sequencing techniques) are being used to identify genetic variants. The fields of epigenetics, transcriptomics and metabolomics are being developed to complement these studies. The vast amount of data to explain the environmental and genetic factors that predispose for the disease require informatic techniques, such as mathematical and bio-computer models to estimate the individual risk of thrombosis. The research area with the highest clinical application is the development of predictive models to estimate the individual risk of thrombosis

Hiperandrogenismo ovárico funcional y síndrome del ovario poliquístico en la adolescencia / Functional ovarian hyperandrogenism and polycystic ovary syndrome in adolescence

El síndrome del ovario poliquístico (SOP) es la causa más frecuente de exceso de andrógenos en adolescentes y mujeres jóvenes. Los criterios diagnósticos se han redefinido (Rotterdam, mayo 2003) incluyendo: oligoamenorrea crónica, signos clínicos y biológicos de hiperandrogenismo, presencia ecográfica de ovarios poliquísticos y exclusión de otras enfermedades. El SOP se acompaña de hiperinsulinismo y resistencia a la insulina, así como de un perfil lipídico aterogénico, concentraciones bajas de adiponectina, elevación de interleucina-6 y aumento del cociente neutrófilos/linfocitos. Todo ello, junto con una distribución centrípeta de la grasa corporal, son factores de riesgo para el desarrollo de diabetes tipo 2 y enfermedad cardiovascular. Por este motivo, se ha considerado como parte del denominado síndrome metabólico. El desarrollo completo del cuadro clínico del SOP no se produce hasta la adolescencia o la edad adulta; sin embargo, hay indicios claros de que puede tener su origen antes de la pubertad (pubarquia prematura) e incluso en el período prenatal (bajo peso al nacer). Ambas asociaciones pueden conducir a desarrollar un cuadro metabólico sugestivo de SOP antes de la pubertad. El tratamiento clásico del SOP ha sido la administración de anticonceptivos orales; sin embargo, la utilización de sensibilizantes de la insulina, como la metformina, mejora el perfil endocrinometabólico y los marcadores de riesgo cardiovascular. En adolescentes y mujeres jóvenes, la asociación de metformina y un antiandrógeno a bajas dosis, como la flutamida, es mucho más eficaz que la monoterapia con anticonceptivos orales, ya que normaliza la función ovárica y revierte las alteraciones clínicas y metabólicas. Estudios preliminares sugieren que en poblaciones de riesgo el tratamiento con metformina evita el desarrollo de las manifestaciones clínicas del SOP. Sin embargo, se precisan más estudios antes de establecer la eficacia y la tolerancia a largo plazo de este tipo de fármacos (AU)

Polycystic ovary syndrome (PCOS) is the most frequent cause of androgen excess in adolescents and young women. The diagnostic criteria have recently been redefined (Rotterdam, May 2003) and include clinical and biochemical signs of hyperandrogenism, chronic oligo-ovulation, ultrasonographic evidence of polycystic ovaries, and the exclusion of known disorders. PCOS is accompanied by hyperinsulinemia and insulin resistance and is also associated with an atherogenic lipid profile, low adiponectin levels, high interleukin-6 concentrations, an increased neutrophil/lymphocyte ratio, and central adiposity. These metabolic abnormalities are reminiscent of the metabolic syndrome and are considered to be risk factors for the development of type 2 diabetes and cardiovascular disease. PCOS does not fully develop until adolescence or early adulthood; however, there is clear evidence that the syndrome may begin to develop before puberty (precocious pubarche) and even in the prenatal period (low birth weight). The clinical signs and symptoms are heralded by a pre-clinical phase in which the metabolic abnormalities that characterize PCOS are already detectable before puberty. The classical therapeutic approach in PCOS has been the use of oral contraceptives; however, the use of insulin sensitizers such as metformin improves the endocrine-metabolic profile and markers of cardiovascular risk. In adolescents and young women, the lowdose combination of metformin and flutamide (an androgen-receptor blocker) is much more effective than monotherapy with oral contraceptives, since it normalizes ovarian function and reverses the clinical and metabolic alterations of PCOS. Preliminary studies suggest that in highrisk girls with a combined history of low birthweight and precocious pubarche, metformin therapy prevents the development of clinical PCOS. Future studies are required to establish the safety of long-term, early metformin therapy (AU)

Identification of lactic acid bacteria from spoilage associations of cooked and brined shrimps stored under modified atmosphere between 0 degrees C and 25 degrees C.

AIMS: To evaluate spoilage and identify lactic acid bacteria (LAB) from spoilage associations of cooked and brined shrimps stored under modified atmosphere packaging (MAP) at 0, 5, 8, 15 and 25 degrees C. METHODS AND RESULTS: Bacterial isolates (102) from spoilage associations of cooked and brined MAP shrimps were characterized by phenotypic tests and identified as lactic acid bacteria (78 isolates), other Gram-positive bacteria (13 isolates) and Gram-negative bacteria (11 isolates). A selection of 48 LAB isolates were further characterized and identified by phenotypic tests and SDS-PAGE electrophoresis of whole cell proteins. Selected clusters of LAB isolates were analysed by plasmid profiling, pulsed field gel electrophoresis and 16S rRNA gene sequencing. Enterococcus faecalis was identified in spoilage associations at 15 degrees C and 25 degrees C, and its metabolic activity corresponded to chemical changes in spoiled products. Carnobacterium divergens, a non-motile Carnobacterium sp. nov. and Lactobacillus curvatus were the LAB species observed in spoilage associations of products stored at 0 degrees C, 5 degrees C and 8 degrees C. CONCLUSIONS: Enterococcus spp. and Carnobacterium spp. were the dominant parts of spoilage associations of cooked and brined MAP shrimps stored at high and low temperatures, respectively. SIGNIFICANCE AND IMPACT OF THE STUDY: The SDS-PAGE technique and simple biochemical keys allowed the majority of LAB isolates from spoilage associations of cooked and brined MAP shrimps to be identified at the species level.

Lactobacillus durianis sp. nov., isolated from an acid-fermented condiment (tempoyak) in Malaysia.

Lactic acid bacteria (LAB) are the predominant micro-organisms in tempoyak, a Malaysian acid-fermented condiment. In a study on the diversity of LAB in this product, three isolates could not be identified using SDS-PAGE of whole-cell proteins or API 50 CH. The taxonomic position of the three isolates was clarified in the present study. 16S rDNA sequencing classified a representative strain in the genus Lactobacillus, clearly separated from all known species, and most closely related to the Lactobacillus reuteri phylogenetic group. DNA-DNA hybridization experiments and an extensive phenotypic description confirm that the strains represent a single and separate novel species among the obligately heterofermentative lactobacilli. The three isolates are distinguished at the intra-species level by plasmid profiling, pulsed-field gel electrophoresis of macro-restriction fragments and biochemical features. The name Lactobacillus durianis sp. nov. is proposed for the novel taxon and the type strain is LMG 19193T (= CCUG 45405T).

Nuevas indicaciones de los agentes sensibilizantes a la insulina: hiperinsulinismo e hiperandrogenismo en la adolescencia y síndrome del ovario poliquístico / New perspectives in insulin sensitizing agents: hyperinsulinism and hyperandrogenism in adolescents and polycystic ovary syndrome

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Anti-inflammatory activity of leaf extract of Verbena officinalis L.

The anti-inflammatory activity of a 50% methanol extract of the leaves of Verbena officinalis L. was investigated on topical and oral administration. In the TPA-induced ear inflammation model, the extract showed a high reduction of edema, but in the carrageenin-induced rat paw edema the effect observed was less at the two doses employed. These results confirm the use of this plant in folk medicine as a topical anti-inflammatory, herbal drug.