Viral shedding and viraemia of Andes virus during acute hantavirus infection: a prospective study.

BACKGROUND: Andes virus (ANDV) is a zoonotic Orthohantavirus leading to hantavirus cardiopulmonary syndrome. Although most transmissions occur through environmental exposure to rodent faeces and urine, rare person-to-person transmission has been documented, mainly for close contacts. This study investigates the presence and infectivity of ANDV in body fluids from confirmed cases and the duration of viraemia. METHODS: In this prospective study, 131 participants with confirmed ANDV infection were enrolled in Chile in a prospective study between 2008 and 2022. Clinical samples (buffy coat, plasma, gingival crevicular fluid [GCF], saliva, nasopharyngeal swabs [NPS], and urine) were collected weekly for 3 weeks together with clinical and epidemiological data. Samples were categorised as acute or convalescent (up to and after 16 days following onset of symptoms). Infectivity of positive fluids was assessed after the culture of samples on Vero E6 cells and use of flow cytometry assays to determine the production of ANDV nucleoprotein. FINDINGS: ANDV RNA was detected in 100% of buffy coats during acute phase, declining to 95% by day 17, and to 93% between days 23-29. ANDV RNA in GCF and saliva decreased from 30% and 12%, respectively, during the acute phase, to 12% and 11% during the convalescent phase. Successful infectivity assays of RT-qPCR-positive fluids, including GCF, saliva, NPS, and urine, were observed in 18 (42%) of 43 samples obtained during the acute phase of infection. After re-culture, the capacity to infect Vero E6 cells was maintained in 16 (89%) of 18 samples. Severity was associated with the presence of ANDV RNA in one or more fluids besides blood (odds ratio 2·58 [95% CI 1·42-5·18]). INTERPRETATION: ANDV infection is a systemic and viraemic infection, that affects various organs. The presence of infectious particles in body fluids contributes to our understanding of potential mechanisms for person-to-person transmission, supporting the development of preventive strategies. Detection of ANDV RNA in additional fluids at hospital admission is a predictor of disease severity. FUNDING: None. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.

Characterization of Oral Immunity in Cases and Close Household Contacts Exposed to Andes Orthohantavirus (ANDV).

Background: Andes orthohantavirus (ANDV) is the sole etiologic agent of Hantavirus Cardiopulmonary Syndrome in Chile and, until now, the only Hantavirus known to be transmitted by person-to-person route. The main risk of person-to-person transmission is to be a sexual partner of an index case, and deep kissing the main mechanism of infection. Experimental reports suggest that ANDV infection can be inhibited by some saliva components. Therefore, some host factors like saliva quality, could help to explain why some individuals do not become infected even though their exposure to the virus is high. Aim: To compare some saliva components, such cytokines and mucins, between ANDV-infected cases (exposed-sick), their close household contacts (exposed-not sick) and healthy control not exposed. Methods: Sixty-nine confirmed ANDV-infected cases, 76 close household contacts exposed to ANDV but not infected (CHC) and 39 healthy control not exposed (HCNE). The following components were measured in saliva: secretory immunoglobulin A (sIgA) by ELISA; cytokines (IL1ß, IL12p70, TNFα, INFy, IL10, IL6, VEGF, IP10, and IL8) by Multiplex Assay and mucins MUC7 and MUC5B by Western Blotting. Results: Among infected cases, CHC and HCNE analyzed 74, 45, and 33% were men, respectively (p ≤ 0.05). The average age for cases, CHC and HCNE was 37.7, 28.7, and 32 years, respectively (p ≤ 0.05). The average concentration of sIgA in infected cases was 4.846 mg/mL, higher than for CHC group, 0.333 mg/mL (p ≤ 0.05). For cytokines, significant differences were found comparing all groups for IFNy, IL12p70, and IL8. Among CHC group, there was a higher frequency of detection of MUC7 isoform (62.6%; 31/49) compared to ANDV-infected cases (40.5%; 17/42) (p < 0.05). Similarly, presence of MUC5B was higher among CHC groups (62.16%; 46/74) than in ANDV-infected cases (44.4%; 28/63) (p < 0.05). Conclusions: Three salivary components showed differences between infected cases and close household contacts (sIgA, cytokines, and mucins). These differences can be explained by the acute state of the disease in the ANDV-infected cases group. However, the differences in MUC5B and isoforms of MUC7 are not entirely explainable by the infection itself. This work represents a novel description of salivary components in the context of ANDV infection.

Mother-to-Child Transmission of Andes Virus through Breast Milk, Chile1.

Andes virus (ANDV) is the only hantavirus transmitted between humans through close contact. We detected the genome and proteins of ANDV in breast milk cells from an infected mother in Chile who transmitted the virus to her child, suggesting gastrointestinal infection through breast milk as a route of ANDV person-to-person transmission.

A hypoperfusion context may aid to interpret hyperlactatemia in sepsis-3 septic shock patients: a proof-of-concept study.

BACKGROUND: Persistent hyperlactatemia is particularly difficult to interpret in septic shock. Besides hypoperfusion, adrenergic-driven lactate production and impaired lactate clearance are important contributors. However, clinical recognition of different sources of hyperlactatemia is unfortunately not a common practice and patients are treated with the same strategy despite the risk of over-resuscitation in some. Indeed, pursuing additional resuscitation in non-hypoperfusion-related cases might lead to the toxicity of fluid overload and vasoactive drugs. We hypothesized that two different clinical patterns can be recognized in septic shock patients through a multimodal perfusion monitoring. Hyperlactatemic patients with a hypoperfusion context probably represent a more severe acute circulatory dysfunction, and the absence of a hypoperfusion context is eventually associated with a good outcome. We performed a retrospective analysis of a database of septic shock patients with persistent hyperlactatemia after initial resuscitation. RESULTS: We defined hypoperfusion context by the presence of a ScvO2 < 70%, or a P(cv-a)CO2 ≥6 mmHg, or a CRT ≥4 s together with hyperlactatemia. Ninety patients were included, of whom seventy exhibited a hypoperfusion-related pattern and 20 did not. Although lactate values were comparable at baseline (4.8 ± 2.8 vs. 4.7 ± 3.7 mmol/L), patients with a hypoperfusion context exhibited a more severe circulatory dysfunction with higher vasopressor requirements, and a trend to longer mechanical ventilation days, ICU stay, and more rescue therapies. Only one of the 20 hyperlactatemic patients without a hypoperfusion context died (5%) compared to 11 of the 70 with hypoperfusion-related hyperlactatemia (16%). CONCLUSIONS: Two different clinical patterns among hyperlactatemic septic shock patients may be identified according to hypoperfusion context. Patients with hyperlactatemia plus low ScvO2, or high P(cv-a)CO2, or high CRT values exhibited a more severe circulatory dysfunction. This provides a starting point to launch further prospective studies to confirm if this approach can lead to a more selective resuscitation strategy.

Phenolic compounds content and antioxidant capacity of meals provided to elementary public schools in Chile during 2011 / Contenido de compuestos fenólicos y capacidad antioxidante de alimentos entregados a las escuelas públicas de enseñanza básica en Chile durante 2011

The Chilean National School Feeding Program (NSFP) delivers breakfast and lunch meals that supply 250 and 450 kcal, respectively, along the country. In the last decades, a significant increase of obesity has been observed in primary education children, and it involves risk factors of non-communicable diseases. The dietary intake of foods containing phenolic compounds (PC) exerts favorable effects on health by reducing risk factors of prevalent diseases. The aim of the study was to measure the PC content and antioxidant capacity (AC) [ORAC and DPPH] of meals provided by the NSFP in Quillota, Chile, in 2011. The PC supply of the whole meals served ranged from 362.7 to 1,730 mg GAE. The best breakfast foods include whole grain cookie (2.59±0.3 mg GAE/g), bread with avocado, quince jelly or strawberry jam (1.61±0.13 to 2.05±0.3 mg GAE/g); while the best lunch salads include beetroot, lettuce, and cabbage/fish (1.66±0.3 to 2.35±0.1 mg GAE/g), and main courses contain legumes, or mixed vegetables. The lowest PC contents were observed in pasta and rice preparations (p<0.05). Among desserts, the best source of PC is fruit (1.81±0.04 to 6.91±0.31 mg GAE/g). The correlation between PC and AC varied according to the type of meal. PC content and AC are additional criteria for selecting the best quality meals, in addition to the nutrients and energy content. The results support the recommendation to increase the supply of fruits and vegetable/legumes preparations and fruits instead of starchy foods to scholars.

El Programa de Alimentación Escolar (PAE) para enseñanza básica en Chile distribuye, en todo el país, desayunos y almuerzos que aportan 250 y 450 kcal, respectivamente. En las últimas décadas ha aumentado significativamente la obesidad en escolares, lo que induce factores de riesgo de enfermedades no transmisibles. La ingestión de alimentos que contienen polifenoles (PF) ejerce efectos beneficiosos al reducir factores de riesgo de enfermedades prevalentes. El objetivo del estudio fue determinar el contenido de PF y la capacidad antioxidante (CA) [ORAC y DPPH] de los alimentos entregados por el PAE en Quillota, Chile, en 2011. El aporte de PF en las raciones servidas fluctuó entre 362.7 y 1,730 mg EAG. El mejor desayuno contenía galletón con granos integrales (2.59±0.3 mg EAG/g), pan con palta, dulce de membrillo o de fresas (1.61±0.13 a 2.05±0.3 mg EAG /g) y el mejor almuerzo, ensaladas de remolacha, lechuga, o col/pescado (1.66±0.3 a 2.35±0.1 mg EAG /g), y un plato principal con leguminosas o vegetales mixtos. Los contenidos menores de PF se observaron en platos con pastas y arroz (p<0.05). Entre los postres, la mejor fuente de PF es la fruta (1.81±0.04 a 6.91±0.31 mg EAG/g). La correlación entre PF y CA fluctuó según el tipo de preparación. El contenido de PF y la CA son criterios de calidad adicionales al aporte de energía y nutrientes de las preparaciones. Los resultados apoyan la recomendación de aumentar el aporte a los escolares de frutas y vegetales/leguminosas en lugar de alimentos con alto contenido de almidones.

Phenolic compounds content and antioxidant capacity of meals provided to elementary public schools in Chile during 2011.

The Chilean National School Feeding Program (NSFP) delivers breakfast and lunch meals that supply 250 and 450 kcal, respectively, along the country. In the last decades, a significant increase of obesity has been observed in primary education children, and it involves risk factors of non-communicable diseases. The dietary intake of foods containing phenolic compounds (PC) exerts favorable effects on health by reducing risk factors of prevalent diseases. The aim of the study was to measure the PC content and antioxidant capacity (AC) [ORAC and DPPH] of meals provided by the NSFP in Quillota, Chile, in 2011. The PC supply of the whole meals served ranged from 362.7 to 1,730 mg GAE. The best breakfast foods include whole grain cookie (2.59 ± 0.3 mg GAE/g), bread with avocado, quince jelly or strawberry jam (1.61 ± 0.13 to 2.05 ± 0.3 mg GAE/g); while the best lunch salads include beetroot, lettuce, and cabbage/fish (1.66 ± 0.3 to 2.35 ± 0.1 mg GAE/g), and main courses contain legumes, or mixed vegetables. The lowest PC contents were observed in pasta and rice preparations (p < 0.05). Among desserts, the best source of PC is fruit (1.81 ± 0.04 to 6.91 ± 0.31 mg GAE/g). The correlation between PC and AC varied according to the type of meal. PC content and AC are additional criteria for selecting the best quality meals, in addition to the nutrients and energy content. The results support the recommendation to increase the supply of fruits and vegetable/legumes preparations and fruits instead of starchy foods to scholars.

Time-dependence of Ferric Reducing Antioxidant Power (FRAP) index in Chilean apples and berries / Influencia del tiempo de incubación sobre la capacidad antioxidante medida según FRAP, en manzanas y berries chilenos

We hypothesize that the Ferric Reducing Antioxidant Power (FRAP) assay that follows the reaction of Fe3+-TPTZ at 593 nm underestimates the antioxidant capacity of fruits, since the standardized time of the reaction (4 min) is not enough to titrate all the reducing compounds available. We measured FRAP, total phenolics and anthocyanins content in a variety of Chilean berry fruits (blueberries, blackberries, raspberries and strawberries) and apples (cv. Fuji, Granny Smith, Pink Lady, Red Delicious and Royal Gala). Taking into account the dependence of FRAP on the time course of the reaction, we propose to measure FRAP indexes after 1 min (FRAP-1), 30 min (FRAP-30) and 120 min (FRAP-120) of incubation. Most fruit extracts showed significant correlations between the antioxidant capacity and the incubation time, although in some cases the FRAP indexes did not correlate with the total phenolics and/or anthocyanins content. In fact, in apples and berries the correlation between anthocyanins content and FRAP indexes decreased with the incubation time. It is concluded that the fruit extracts analyzed require an incubation period higher than the established in the original experimental protocol to reach the equilibrium, due to the presence of a complex mixture of antioxidant compounds. In addition, a kinetic profile should be realized in each sample studied to establish the most suitable incubation period to titrate all the reactive antioxidant species.

Se plantea que el ensayo de la capacidad antioxidante de frutas, medido según el poder reductor de hierro (FRAP), que sigue la reacción de Fe3+-TPTZ a 593 nm, subestima la capacidad antioxidante, debido a que el tiempo de reacción (4 min) no sería suficiente para que reaccionen todos los compuestos reductores disponibles en las muestras. Se analizó la capacidad antioxidante FRAP, el contenido de fenoles y de antocianinas en diversos berries (arándano, mora, frambuesa y frutilla) y manzanas (cv. Fuji, Granny Smith, Pink Lady, Red Delicious y Royal Gala). Tomando en cuenta la dependencia del tiempo de incubación en el valor FRAP, se propone medir los índices FRAP después de 1 min (FRAP-1), 30 min (FRAP-30) y 120 min (FRAP-120). Diversos extractos de las frutas analizadas mostraron una correlación significativa entre la capacidad antioxidante y el tiempo de incubación; sin embargo, en algunos casos los índices FRAP no se correlacionaron con el contenido de fenoles totales y/o antocianinas. En efecto, en manzanas y berries la correlación entre el contenido de antocianinas e índices FRAP disminuyó con el tiempo de incubación. Se concluye que los extractos analizados requieren un tiempo de incubación mayor al que establece el protocolo analítico original para alcanzar el equilibrio, debido a la presencia de una compleja mezcla de compuestos antioxidantes. Además, el perfil cinético de cada muestra debería ser estudiado para establecer el periodo de incubación más adecuado para titular todas las especies antioxidantes reactivas.

Phenolics and antioxidant capacity of table grape (Vitis vinifera L.) cultivars grown in Chile.

UNLABELLED: Grapes (Vitis vinifera L.) possess health-promoting effects attributed to their supply of a wide variety of bioactive phenolics. Juice and skin fractions of 4 varieties of table grapes: Red Globe, Crimson Seedless, Autumn Royal, and Ribier were prepared to determine and compare their total phenolics content, antioxidant capacity (DPPH, FRAP, and ORAC), anthocyanins, and specific phenolics (caffeic acid, gallic acid, resveratrol, and catechin) content, since a series of positive health benefits are expected from the intake of any of these fractions. Higher amounts of total phenolics and antioxidant capacity were observed in the skin fractions (P < 0.05). Blue grapes (Autumn Royal and Ribier) exhibited higher phenolics content and antioxidant capacity (P < 0.05) than red grapes. The most abundant phenolic compound observed was catechin (P < 0.05). Significant correlations between the antioxidant capacity and total phenolics were observed in grape juice and skin fractions. Autumn Royal juice provides a very high amount of phenolics, anthocyanins, and exhibits the highest antioxidant capacity, offering the best health promoting properties compared with the other grape varieties studied. PRACTICAL APPLICATION: Grapes possess health-promoting effects attributed to their supply of a wide variety of bioactive phenolics. Grape juice made with blue grapes (Autumn Royal, Ribier) exhibit higher phenolics content and antioxidant capacity than juice elaborated with red grapes (Red Globe, Crimson Seedless). The skin is a good source of phenolics and has a high antioxidant capacity. Specific health-promoting phenolics are more abundant in blue grapes, mainly in their skin fraction, which should not be discarded.

Time-dependence of ferric reducing antioxidant power (FRAP) index in Chilean apples and berries.

We hypothesize that the Ferric Reducing Antioxidant Power (FRAP) assay that follows the reaction of Fe(3+)-TPTZ at 593 nm underestimates the antioxidant capacity of fruits, since the standardized time of the reaction (4 min) is not enough to titrate all the reducing compounds available. We measured FRAP, total phenolics and anthocyanins content in a variety of Chilean berry fruits (blueberries, blackberries, raspberries and strawberries) and apples (cv. Fuji, Granny Smith, Pink Lady, Red Delicious and Royal Gala). Taking into account the dependence of FRAP on the time course of the reaction, we propose to measure FRAP indexes after 1 min (FRAP-1), 30 min (FRAP-30) and 120 min (FRAP-120) of incubation. Most fruit extracts showed significant correlations between the antioxidant capacity and the incubation time, although in some cases the FRAP indexes did not correlate with the total phenolics and/or anthocyanins content. In fact, in apples and berries the correlation between anthocyanins content and FRAP indexes decreased with the incubation time. It is concluded that the fruit extracts analyzed require an incubation period higher than the established in the original experimental protocol to reach the equilibrium, due to the presence of a complex mixture of antioxidant compounds. In addition, a kinetic profile should be realized in each sample studied to establish the most suitable incubation period to titrate all the reactive antioxidant species.

Development of an ingredient containing apple peel, as a source of polyphenols and dietary fiber.

Apple peel is a waste product from dried apple manufacture. The content of phenolic compounds, dietary fiber, and mineral are higher in apple peel, compared to other edible parts of this fruits. The objective of this study was to develop an ingredient from Granny Smith apple peel, using a pilot scale double drum-dryer, as drying technology. The control of all steps to maximize the retention of phenolic compounds and dietary fiber was considered. Operational conditions, such as drying temperature and time were determined, as well as important preprocessing steps like grinding and PPO inhibition. In addition, the physical-chemical characteristics, mineral and sugar content, and technological functional properties such as water retention capacity, solubility index, and dispersability among others, were analyzed. A simple, economical, and suitable pilot scale process, to produce a powder ingredient from apple peel by-product, was obtained. The drying process includes the application of ascorbic acid at 0.5% in the fresh apple peel slurry, drum-dryer operational conditions were 110 degrees C, 0.15 rpm and 0.2 mm drum clearance. The ingredient developed could be considered as a source of phenolic compounds (38.6 mg gallic acid equivalent/g dry base) and dietary fiber (39.7% dry base) in the formulation of foods. Practical Application: A method to develop an ingredient from Granny Smith apple peel using a pilot scale double drum-dryer as drying technology was developed. The method is simple, economical, feasible, and suitable and maximizes the retention of phenolic compounds and dietary fiber present in the raw matter. The ingredient could be used in the formulation of foods.