Ketogenesis favors oxidative phosphorylation to promote disease tolerance.

Pseudomonas aeruginosa is an opportunistic pathogen of great medical relevance, although the mechanisms involved in chronic P. aeruginosa infection are unclear. Tomlinson et al. have now shown that systemic and local pathogen-induced ketone bodies (KBs) select strains that preserve respiratory integrity by failing to substantially increase glycolysis, which drives immunopathology resulting from resistance mechanisms.

Different antibody-associated autoimmune diseases have distinct patterns of T follicular cell dysregulation.

Autoantibodies are produced within germinal centers (GC), in a process regulated by interactions between B, T follicular helper (Tfh), and T follicular regulatory (Tfr) cells. The GC dysregulation in human autoimmunity has been inferred from circulating cells, albeit with conflicting results due to diverse experimental approaches. We applied a consistent approach to compare circulating Tfr and Tfh subsets in patients with different autoimmune diseases. We recruited 97 participants, including 72 patients with Hashimoto's thyroiditis (HT, n = 18), rheumatoid arthritis (RA, n = 16), or systemic lupus erythematosus (SLE, n = 32), and 31 matched healthy donors (HD). We found that the frequency of circulating T follicular subsets differed across diseases. Patients with HT had an increased frequency of blood Tfh cells (p = 0.0215) and a reduced Tfr/Tfh ratio (p = 0.0338) when compared with HD. This was not observed in patients with systemic autoimmune rheumatic diseases (RA, SLE), who had a reduction in both Tfh (p = 0.0494 and p = 0.0392, respectively) and Tfr (p = 0.0003 and p = 0.0001, respectively) cells, resulting in an unchanged Tfr/Tfh ratio. Activated PD-1+ICOS+Tfh and CD4+PD-1+CXCR5-Tph cells were raised only in patients with SLE (p = 0.0022 and p = 0.0054), without association with disease activity. Our data suggest that GC dysregulation, assessed by T follicular subsets, is not uniform in human autoimmunity. Specific patterns of dysregulation may become potential biomarkers for disease and patient stratification.

Tetracyclines: four rings to rule infections through resistance and disease tolerance.

Several classes of antibiotics have long been known for protective properties that cannot be explained through their direct antimicrobial effects. However, the molecular bases of these beneficial roles have been elusive. In this issue of the JCI, Mottis et al. report that tetracyclines induced disease tolerance against influenza virus infection, expanding their protection potential beyond resistance and disease tolerance against bacterial infections. The authors dissociated tetracycline's disease-resistance properties from its disease-tolerance properties by identifying potent tetracycline derivatives with minimal antimicrobial activity but increased capacity to induce an adaptive mitochondrial stress response that initiated disease tolerance mechanisms. These findings have potential clinical applications in viral infections.

Eco-innovation assessment of biodigesters technology: an application in cassava processing industries in the south of Brazil, Parana state.

Eco-innovations are innovations capable of helping to reduce the environmental impacts of production processes. In this sense, the adoption of models that assess comprehensively, in an integrated manner and in different perspectives, the general performance of these innovations allows managers to guide their decisions. The object of this research is the use of an eco-innovation in the production processes of cassava, where the waste generated is treated by biodigesters. These cassava processing industries are located in southern Brazil, Paraná State, comprising a multiple case study. A literature review was also carried out to propose a set of indicators capable of assessing the overall impact of this eco-innovation in eight lines of action: (1) environmental, (2) social, (3) economic, (4) human resource training, (5) institutional development, (6) introduction of innovation, (7) unwanted occurrences, and (8) characteristics of environmental management. To compile and process the data, the computerized model INOVA-tec System was used. The objective was to employ the INOVA-tec System model as an instrument for evaluating eco-innovative processes in leading companies in its segment, looking for evidence to expand its usability to other realities in the agro-industry. The results show that the technology scenario is favorable to its dissemination; however, the low performance of the indicators together makes it underutilized.

Ischaemia alters the effects of cardiomyocyte-derived extracellular vesicles on macrophage activation.

Myocardial ischaemia is associated with an exacerbated inflammatory response, as well as with a deregulation of intercellular communication systems. Macrophages have been implicated in the maintenance of heart homeostasis and in the progression and resolution of the ischaemic injury. Nevertheless, the mechanisms underlying the crosstalk between cardiomyocytes and macrophages remain largely underexplored. Extracellular vesicles (EVs) have emerged as key players of cell-cell communication in cardiac health and disease. Hence, the main objective of this study was to characterize the impact of cardiomyocyte-derived EVs upon macrophage activation. Results obtained demonstrate that EVs released by H9c2 cells induced a pro-inflammatory profile in macrophages, via p38MAPK activation and increased expression of iNOS, IL-1ß and IL-6, being these effects less pronounced with ischaemic EVs. EVs derived from neonatal cardiomyocytes, maintained either in control or ischaemia, induced a similar pattern of p38MAPK activation, expression of iNOS, IL-1ß, IL-6, IL-10 and TNFα. Importantly, adhesion of macrophages to fibronectin was enhanced by EVs released by cardiomyocytes under ischaemia, whereas phagocytic capacity and adhesion to cardiomyocytes were higher in macrophages incubated with control EVs. Additionally, serum-circulating EVs isolated from human controls or acute myocardial infarction patients induce macrophage activation. According to our model, in basal conditions, cardiomyocyte-derived EVs maintain a macrophage profile that ensure heart homeostasis, whereas during ischaemia, this crosstalk is affected, likely impacting healing and post-infarction remodelling.

Agentes comunitários de saúde e território: uma intervenção em saúde do idoso em Franco da Rocha (SP) / Community health and territory agents: an elderly health intervention in Franco da Rocha (SP)

O novo cenário de envelhecimento populacional tem resultado no aumento dos gastos com as tecnologias nos diferentes níveis de atenção para o cuidado dos idosos com doenças crônicas não-transmissíveis, sendo a mais comum, o diabetes e a hipertensão arterial...(AU)