CALU-3 lung cells three-dimensionally assembled onto CellFate® matrix present angiotensin-converting enzyme-2 activity.

Currently, there is a great need for the development of three-dimensional (3D) in vitro lung models. Particularly, the production of a suitable 3D model of pulmonary epithelium for understanding the pathophysiology of diseases such as the COVID-19 must consider the tissue architecture and presence, for example, of the angiotensin-converting enzyme-2 (ACE-2) in the cells. Different polymeric membranes are being used to support cell culturing, especially of lung cells, however, there is still no information about the culture of these cells onto bacterial nanocellulose (BNC) matrices. We have used the BNC matrix CellFate® as a support for the assembly of a 3D in vitro model of lung epithelium, composed of human lung fibroblasts (HLF) and lung adenocarcinoma cells (CALU-3). CellFate® matrices were made from bacterial fermentation resulting in a natural and biocompatible biopolymer. Cells were cultured onto CellFate® and maintained in a 5% CO2 humidified atmosphere at 37°C. Cell viability was assessed by the resazurin method The samples were, then, exposed to the air-liquid interface (ALI), and histologically analyzed. ACE-2 activity was verified on the hydrolyze of the fluorogenic substrate Mca-APK(Dnp)-OH, and its presence was evaluated by flow cytometry. The expression of the anionic transporter SLCO3A1 was evaluated by qPCR. Cell viability analysis indicates that CellFate® was not toxic to these cells. By flow cytometry, the presence of the ACE-2 was identified in the CALU-3 cells surface corroborating the results obtained from enzymatic activity analysis. The SLCO3A1 transporter expression was identified in cells cultured onto CellFate®, but not in cells cultured onto the transwell (control). CALU-3 cells cultivated onto CellFate® resulted in a pseudostratified organization, a typical morphology of the human respiratory tract epithelium. The current model opens perspectives for studies involving physiological characterization, improving its relevance for the understanding of the pathophysiology of diseases as well as the response to drugs.

Delivery of superoxide dismutase by TAT and abalone peptides for the protection of skin cells against oxidative stress.

Trichoderma reesei superoxide dismutase (TrSOD) is a well-characterized enzyme being stable between 30 and 90°C for 1 h with activity at pH between 2.6 and 9.0. This work aimed to clone, express, purify, and evaluate the protective effect antioxidant of this enzyme on skin cells when fused to transactivator of transcription (TAT) protein transduction domain of HIV-1 and abalone (Ab) peptides to allow cell penetration. TrSOD, TAT-TrSOD-Yfp (fused to yellow fluorescent protein), and Ab-TrSOD were expressed in E. coli and purified as soluble proteins. The cytotoxicity of the enzymes, at the concentrations of 1, 3, and 6 µmol/L, was evaluated for a period of 24 and 48 h of incubation, with no cytotoxic effect on 3T3 fibroblasts. The 3T3 cells were exposed to the oxidant agent tert-butyl hydroperoxide and evaluated for reactive oxygen species (ROS) generation, in the presence or not of the recombinant enzymes. TAT-TrSOD-Yfp was able to decrease the generation of ROS by 15% when used in the concentrations of 3 and 6 µmol/L in comparison to the control, but there was no difference in relation to the effect of TrSOD. Ab-TrSOD, when compared to TrSOD, promoted a decrease in the formation of ROS of 19% and 14% at the concentrations of 1 and 6 µmol/L, respectively, indicating that this recombinant form was more effective in reducing oxidative stress compared to SOD without the cell-penetrating peptide (CPP). Together, these results indicate that the fusion of SOD with these CPP increased the antioxidant capacity of fibroblasts, identified by the reduction in the generation of ROS. In addition, such molecules, in the concentrations initially used, were not toxic to the cells, opening perspectives for the development of products for antioxidant protection of the skin that may have therapeutic and cosmetic application.

Mesenchymal stem cells differentiate into keratinocytes and express epidermal kallikreins: Towards an in vitro model of human epidermis.

Epidermal differentiation is a complex process in which keratinocytes go through morphological and biochemical changes in approximately 15 to 30 days. Abnormal keratinocyte differentiation is involved in the pathophysiology of several skin diseases. In this scenario, mesenchymal stem cells (MSCs) emerge as a promising approach to study skin biology in both normal and pathological conditions. Herein, we have studied the differentiation of MSC from umbilical cord into keratinocytes. MSC were cultured in Dulbecco's modified Eagle's medium (DMEM) (proliferation medium) and, after characterization, differentiation was induced by culturing cells in a defined keratinocyte serum-free medium (KSFM) supplemented with epidermal growth factor (EGF) and calcium chloride ions. Cells cultivated in DMEM were used as control. Cultures were evaluated from day 1 to 23, based on the cell morphology, the expression of p63, involucrin and cytokeratins (KRTs) KRT5, KRT10 and KRT14, by quantitative polymerase chain reaction, Western blot analysis or immunofluorescence, and by the detection of epidermal kallikreins activity. In cells grown in keratinocyte serum-free medium with EGF and 1.8 mM calcium, KRT5 and KRT14 expression was shown at the first day, followed by the expression of p63 at the seventh day. KRT10 expression was detected from day seventh while involucrin was observed after this period. Data showed higher kallikrein (KLK) activity in KSFM-cultured cells from day 11th in comparison to control. These data indicate that MSC differentiated into keratinocytes similarly to that occurs in the human epidermis. KLK activity detection appears to be a good methodology for the monitoring the differentiation of MSC into the keratinocyte lineage, providing useful tools for the better understanding of the skin biology.

Effect of Uncaria tomentosa aqueous extract on the response to palmitate-induced lipotoxicity in cultured skeletal muscle cells.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is frequently associated with dyslipidemia, which corresponds to the increase in the triglycerides and fatty acid concentrations in tissues, such as the skeletal muscle. Also, T2DM molecular mechanism involves increasing in reactive oxygen species (ROS) production and oxidative stress. The use of herbal medicines such as Uncaria tomentosa (Ut) has been proposed as an auxiliary treatment for patients with T2DM. In this study, it was evaluated the effect of Ut aqueous extract on cell viability and ROS production, in skeletal myoblasts from C2C12 lineage exposed to the free fatty acid palmitate (PA). METHODS: Cells were incubated with PA in different concentrations ranging from 10 to 1000 µM, for 24 or 48 h, for cytotoxicity assay. Cell death, DNA fragmentation and ROS production assays were performed in cell cultures incubated with PA for 24 h, in the pre (preventive condition) or post treatment (therapeutic condition) with 250 µg/ml Ut aqueous extract, for 2 or 6 h. Cell death was evaluated by MTT method or flow cytometry. ROS generation was measured by fluorescence spectroscopy using the DCFDA probe. RESULTS: Cell viability was reduced to approximately 44% after the incubation with PA for 24 h from the concentration of 500 µM. In the incubation of cells with 500 µM PA and Ut extract for 6 h, in both conditions (preventive or therapeutic), it was observed an increase of 27 and 70% in cell viability respectively, in comparison to the cultures incubated with only PA. Also, the incubation of cultures with 500 µM PA, for 24 h, increased 20-fold the ROS formation, while the treatment with Ut extract, for 6 h, both in the preventive or therapeutic conditions, promoted decrease of 21 and 55%, respectively. CONCLUSION: The Ut extract was efficient in promoting cell protection against PA lipotoxicity and ROS generation, potentially preventing oxidative stress in C2C12 skeletal muscle cells. Since T2DM molecular mechanism involves oxidative stress condition and it is often associated with dyslipidemia and fatty acid accumulation in muscle tissue, these results open perspectives for the use of Ut as an auxiliary strategy for T2DM management.

Mesenchymal stem cells express epidermal markers in an in vitro reconstructed human skin model.

Introduction: In skin traumas, such as burns, epidermal homeostasis is affected, often requiring clinical approaches. Different therapeutic strategies can be used including transplantation, besides the use of synthetic or natural materials with allogeneic cells. In this context, tissue engineering is an essential tool for skin regeneration, and using mesenchymal stem cells (MSC) from the umbilical cord appears to be a promising strategy in regenerative medicine due to its renewal and differentiation potential and hypo immunogenicity. We evaluated the transdifferentiation of MSC from umbilical cord into keratinocytes in three-dimensional (3D) in vitro skin models, using dermal equivalents composed by type I collagen with dermal fibroblasts and a commercial porcine skin decellularized matrix, both cultured at air-liquid interface (ALI). Methods: The expression of epidermal proteins cytokeratins (CK) 5, 14 and 10, involucrin and filaggrin was investigated by real-time PCR and immunofluorescence, in addition to the activity of epidermal kallikreins (KLK) on the hydrolysis of fluorogenic substrates. Results and discussion: The cultivation of MSCs with differentiation medium on these dermal supports resulted in organotypic cultures characterized by the expression of the epidermal markers CK5, CK14, CK10 and involucrin, mainly on the 7th day of culture, and filaggrin at 10th day in ALI. Also, there was a 3-fold increase in the KLK activity in the epidermal equivalents composed by MSC induced to differentiate into keratinocytes compared to the control (MSC cultivated in the proliferation medium). Specifically, the use of collagen and fibroblasts resulted in a more organized MSC-based organotypic culture in comparison to the decellularized matrix. Despite the non-typical epithelium structure formed by MSC onto dermal equivalents, the expression of important epidermal markers in addition to the paracrine effects of these cells in skin may indicate its potential use to produce skin-based substitutes.

A modified hydrogel production protocol to decrease cellular content.

PURPOSE: To analyze the cytotoxicity and cell in porcine-derived decellularized skin matrix. METHODS: We analyzed the effect of multiple decellularization processes by histological analysis, DNA quantification, and flow cytometry. Subsequently, we analyzed the most appropriate hydrogel concentration to minimize cytotoxicity on fibroblast culture and to maximize cell proliferation. RESULTS: After the fourth decellularization, the DNA quantification showed the lowest DNA concentration (< 50 ng/mg). Histological analysis showed no cell components in the hydrogel. Moreover, hematoxylin and eosin showed a heterogeneous structure of collagen fibers. The best hydrogel concentration ranged from 3 to 25%, and there was no significant difference between the 24 hours and seven days. CONCLUSIONS: The process of hydrogel production was effective for removing cells and DNA elements. The best hydrogel concentration ranged from 3 to 25%.

Reporter system controlled by the involucrin promoter as a tool to follow epidermal differentiation.

Various approaches have been explored to study skin biology, including the use of stem cells. Mesenchymal stem cells (MSCs) from the umbilical cord can be safely and easily obtained; however, a simple strategy to monitor their differentiation is essential. Involucrin is a marker of keratinocyte differentiation, and its promoter (pINV) directs stratum-specific expression of this protein. We designed a reporter system containing EGFP under the control of pINV to assess MSC transdifferentiation into keratinocytes. The functional sequence of pINV was inserted into a lentiviral vector, producing LeGO-GpINV. MSCs were transduced with LeGO-GpINV and induced to transdifferentiate into keratinocytes under cultivation with keratinocyte serum-free medium. MSC transdifferentiation was confirmed by morphological changes and by the expression of epidermal markers by flow cytometry, quantitative PCR, Western blot and the activity of epidermal kallikreins 5, 6 and 7. After 14 days of transdifferentiation, MSCs transduced with LeGO-GpINV showed an increase in EGFP fluorescence and expressed CK10, CK14, involucrin and filaggrin. There was also an increase in kallikrein activity. This reporter system allowed us to temporally assess epidermal differentiation, simultaneously with involucrin expression, opening possibilities for the in vivo study of skin biology and in regenerative medicine.

Vitamins Modulate the Expression of Antioxidant Genes in Progesterone-Treated Pancreatic ß Cells: Perspectives for Gestational Diabetes Management.

Gestational diabetes (GD) is a condition defined as carbohydrate intolerance and hyperglycemia beginning in the second trimester of pregnancy, which overlaps with the progesterone exponential increase. Progesterone has been shown to cause pancreatic ß-cell death by a mechanism dependent on the generation of reactive oxygen species and oxidative stress. Herein, we studied the effect of this hormone on the expression of 84 genes related to oxidative stress and oxidant defense in pancreatic RINm5F cell lineage. Cells were incubated with 0.1, 1.0, or 100 µM progesterone for 6 or 24 h, in the presence or absence of the vitamins E and C. Among the investigated genes, five of them had their expression increased, at least 2-fold, in two different concentrations independently of the time of incubation, or at the same concentration at the different time points, including those that encode for stearoyl-CoA desaturase 1 (Scd1), dual oxidase 1 (Duox1), glutathione peroxidase 6 (GPx6), heme oxygenase 1 (Hmox1), and heat shock protein a1a (Hspa1a). Vitamins E and C were able to increase, in progesterone-treated cells, the expression of genes with antioxidant function such as Hmox1, but decreased Scd1 expression, a gene with prooxidant function. At cytoplasmic level, progesterone positively modulated Hmox1 and Hspa1a content. These results suggest that the protein encoded by these genes might protect cells against progesterone induced-oxidative damage, opening perspectives to elucidate the molecular mechanism involved in progesterone action in GD, as well as for the development of antioxidant strategies for the prevention and treatment of this disease.

Polycaprolactone/Gelatin Nanofiber Membranes Containing EGCG-Loaded Liposomes and Their Potential Use for Skin Regeneration.

Polymeric scaffolds incorporating plant-derived compounds, produced by electrospinning, have attracted attention in the field of skin tissue engineering. This study evaluates the sustained antioxidant activity of polycaprolactone (PCL)/gelatin nanofibers prepared by electrospinning and incorporating loaded liposomes of epigallocatechin-3-gallate (EGCG), a strong antibacterial and antioxidant molecule found in green tea, that significantly accelerates the wound-healing process. The morphology and the structural properties of the membranes were characterized by scanning electron microscopy (SEM) and FTIR spectroscopy. Results revealed that the EGCG released from PCL+gelatin nanofibers scavenges the toxic ROS species generated by exposure to either H2O2 or UV radiation and slows down the oxidation events associated with damage. This study provides the basis for development of promising nanofiber formulations containing EGCG that might enhance repair/regeneration of skin tissue.

Galactomannan use in clinical practice: providing free testing is not the full answer.

INTRODUCTION: Invasive aspergillosis is a condition associated with a high mortality rate mostly due to difficulties in performing an early diagnosis. In recent years, galactomannan detection has markedly improved the diagnosis of invasive aspergillosis, but very little is known on how physicians deal with this test in clinical practice. METHODS: This cross-sectional study aimed to analyze the indications for the use of serum galactomannan in a large Brazilian hospital, between 2015 and 2016. No specific protocol was in place for GM request. We reviewed the medical records of adult (>18 years-old) patients who were tested for galactomannan due to one the following indications: screening, diagnosis, or treatment follow-up. Additional variables included demographic data, underlying diseases, presence of neutropenia, and use of previous antifungal (anti-Aspergillus) drugs. RESULTS: The mean age of the patients was 51 years-old (sd±15.8), and 63.3% of patients were male. Patients with hematological malignancies accounted for 60.1% of the cases, mostly acute myeloid leukemia (19.6%). Galactomannan testing was positive in 12.2% of patients, including 1.6% of occasions in which the test was used for screening purposes, 13.2% for diagnosis, and 32.4% during follow-up. Median time for chest imaging request was two days before GM testing. Previous antifungal therapy was reported for 35.1% of patients, mostly amphotericin B (57.1%). CONCLUSION: The correct use of galactomannan testing is essential for an early diagnosis of invasive aspergillosis, which may improve the prognosis of the disease. We demonstrated that clinicians usually ask for galactomannan tests to confirm imaging findings in patients who frequently were on antifungal drugs, something that could be improved by medical education. We observed a low frequency of galactomannan use for preemptive antifungal therapy (25.7%), which is worrying considering the well-known beneficial use of GM testing in this scenario.

Metallic nanoparticles reduce the migration of human fibroblasts in vitro.

Nanoparticles have extremely wide applications in the medical and biological fields. They are being used in biosensors, local drug delivery, diagnostics, and medical therapy. However, the potential effects of nanoparticles on target cell and tissue function, apart from cytotoxicity, are not completely understood. Thus, the aim of this study was to investigate the in vitro effects of silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) on human fibroblasts with respect to their interaction with the extracellular matrix and in cell migration. Immunofluorescence analysis revealed that treatment with AgNPs or AuNPs decreased collagen and laminin production at all the concentrations tested (0.1, 1, and 10 µg/mL). Furthermore, cytofluorometric analysis showed that treatment with AgNPs reduced the percentage of cells expressing the collagen receptor very late antigen 2, α2ß1 integrin (VLA-2) and the laminin receptor very late antigen 6, α6ß1 integrin (VLA-6). In contrast, AuNP treatment increased and decreased the percentages of VLA-2-positive and VLA-6-positive cells, respectively, as compared to the findings for the controls. Analysis of cytoskeletal reorganization showed that treatment with both types of nanoparticles increased the formation of stress fibres and number of cell protrusions and impaired cell polarity. Fibroblasts exposed to different concentrations of AuNPs and AgNPs showed reduced migration through transwell chambers in the functional chemotaxis assay. These results demonstrated that metal nanoparticles may influence fibroblast function by negatively modulating the deposition of extracellular matrix molecules (ECM) and altering the expression of ECM receptors, cytoskeletal reorganization, and cell migration.

Induced pluripotent stem cells reprogramming: Epigenetics and applications in the regenerative medicine.

Induced pluripotent stem cells (iPSCs) are somatic cells reprogrammed into an embryonic-like pluripotent state by the expression of specific transcription factors. iPSC technology is expected to revolutionize regenerative medicine in the near future. Despite the fact that these cells have the capacity to self-renew, they present low efficiency of reprogramming. Recent studies have demonstrated that the previous somatic epigenetic signature is a limiting factor in iPSC performance. Indeed, the process of effective reprogramming involves a complete remodeling of the existing somatic epigenetic memory, followed by the establishment of a "new epigenetic signature" that complies with the new type of cell to be differentiated. Therefore, further investigations of epigenetic modifications associated with iPSC reprogramming are required in an attempt to improve their self-renew capacity and potency, as well as their application in regenerative medicine, with a new strategy to reduce the damage in degenerative diseases. Our review aimed to summarize the most recent findings on epigenetics and iPSC, focusing on DNA methylation, histone modifications and microRNAs, highlighting their potential in translating cell therapy into clinics.

Interprofissionalidade na atenção primária: intencionalidades das equipes versus realidade do processo de trabalho / La colaboración interprofesional en la atención primaria: la intencionalidad de los equipos versus la realidad del proceso de trabajo / Interprofessional collaboration in primary health care: the team's intentions versus the reality of work processes

Resumo Objetivo comparar atitudes relacionadas à colaboração interprofissional autorrelatadas por diferentes equipes da atenção primária com a realidade observada de seus processos de trabalho. Método abordagem qualitativa e quantitativa implementada em duas etapas de coleta de dados, entre dezembro de 2019 e outubro de 2020. Na qualitativa, empregou-se a observação sistemática dos atendimentos em unidades de saúde. Utilizou-se roteiro de observação baseado no Referencial para Competências em Interprofissionalidade e no Fluxograma Analisador do processo de trabalho centrado no usuário. As observações foram registradas em diário de campo. Na etapa quantitativa, aplicou-se a Escala de Atitudes Relacionadas à Colaboração Interprofissional. Resultados noventa e um profissionais da atenção básica responderam a escala. Obteve-se uma média de 120 de pontuação, que significa valorização do trabalho colaborativo por respondentes de todas as equipes. Apesar disso, foram observadas divergências entre o falado e o vivido, pois o processo de trabalho estruturado parece limitar atitudes colaborativas. Conclusões e implicações para a prática valorização de atividades programadas para o trabalho interprofissional da equipe de saúde e de enfermagem na atenção primária, como espaços na agenda para reuniões. Necessidade de promoção da educação interprofissional com trabalhadores, bem como de políticas públicas que garantam mecanismos para o trabalho colaborativo na atenção básica.

Resumen Objetivo comparar las actitudes relacionadas con la colaboración interprofesional autoinformada por diferentes equipos de la atención primaria con la realidad observada en sus procesos de trabajo. Método investigación cualitativa y cuantitativa. La recolección de datos ocurrió entre diciembre de 2019 y octubre de 2020. En la etapa cualitativa se utilizó la observación sistemática de la atención en las unidades de salud, con un guión de observación basado en el Referencial de Competencias Interprofesionales y el Diagrama Analizador del Flujo del proceso de trabajo centrado en el usuario. Registramos las observaciones en el diario de campo. En la etapa cuantitativa se aplicó la Escala de Actitudes Relacionadas con la Colaboración Interprofesional. Resultados 91 profesionales respondieron la escala. Se obtuvo una media de 120 puntos, lo que supone valorización del trabajo colaborativo por profesionales de todos los equipos evaluados. Sin embargo, verificamos diferencias entre lo relatado y lo vivido, ya que el proceso de trabajo estructurado parece limitar las actitudes para el trabajo colaborativo. Conclusiones e implicaciones para la práctica valorización de actividades programadas para el trabajo interprofesional de los equipos de salud y de enfermería, como reuniones programadas. Necesidad de promoción de la educación interprofesional, así como de políticas públicas que garanticen mecanismos de trabajo colaborativo.

Abstract Objective to compare self-reported interprofessional attitudes according to the teams from different primary health care services with the actual context of work processes. Method Quantitative and qualitative study in which data were collected in two stages between December of 2019 and October of 2020. Systematic observation was the strategy used to collect data from primary health care centers. A script based on the Canadian Interprofessional Health Collaborative framework and the Analyzer Flowchart was used to observe the patient-centered work process. Observations were recorded in a Field Diary, and the Brazilian version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration was used. Results 91 primary health workers completed the scale. The median score was 120, meaning all the health teams value collaborative work. Nonetheless, differences were found between what the participants say and what they do, considering that the structured work process limits collaborative practice. Conclusions and Implications to Practice the services need to value programmed activities to promote interprofessional collaboration among health and nursing teams working in primary health care, and reserve time, and give opportunities for meetings to occur. Additionally, training addressing interprofessional collaboration needs to be provided to workers in addition to public policies to ensure mechanisms that promote collaborative practices.

Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study.

Previous studies have proposed only one prediction equation for respiratory muscle strength without taking into consideration differences between ages in pediatric population. In addition, those researches were single-center studies. The objective of this study was to establish reference equations for maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) in children and teenagers. In a multicenter study, 450 healthy volunteers were evaluated (aged 6-18yrs). There were included volunteers with normal lung function. We excluded volunteers who could not perform the tests; participated in physical activity more than twice a week; were born prematurely; smokers; chronic respiratory, cardiologic, and/or neurologic diseases; had acute respiratory disease during the prior three weeks. The volunteers were divided into two groups: Group 6-11 (6-11yrs) and Group 12-18 (12-18yrs). PImax and PEmax were measured according to statement. The mean PImax value was 85.6 (95%IC 83.6-87.6 cmH2O), and PEmax 84.6 (95%IC 85.5-86.2 cmH2O). The prediction equations for PImax and PEmax for Group 6-11 were 37.458-0.559 + (age * 3.253) + (BMI * 0.843) + (age * gender * 0.985); and 38.556 + 15.892 + (age * 3.023) + (BMI * 0.579) + (age * gender * 0.881), respectively (R2 = 0.34 and 0.31, P<0.001). The equations for Group 12-18 were 92.472 + (gender * 9.894) + 7.103, (R2 = 0.27, P = 0.006) for PImax; and 68.113 + (gender * 17.022) + 6.46 + (BMI * 0.927), (R2 = 0.34, P<0.0001) for PEmax. This multicenter study determined the respiratory muscle strength prediction equations for children and teenagers.

Galactomannan use in clinical practice: providing free testing is not the full answer

ABSTRACT Introduction: Invasive aspergillosis is a condition associated with a high mortality rate mostly due to difficulties in performing an early diagnosis. In recent years, galactomannan detection has markedly improved the diagnosis of invasive aspergillosis, but very little is known on how physicians deal with this test in clinical practice. Methods: This cross-sectional study aimed to analyze the indications for the use of serum galactomannan in a large Brazilian hospital, between 2015 and 2016. No specific protocol was in place for GM request. We reviewed the medical records of adult (>18 years-old) patients who were tested for galactomannan due to one the following indications: screening, diagnosis, or treatment follow-up. Additional variables included demographic data, underlying diseases, presence of neutropenia, and use of previous antifungal (anti-Aspergillus) drugs. Results: The mean age of the patients was 51 years-old (sd ± 15.8), and 63.3% of patients were male. Patients with hematological malignancies accounted for 60.1% of the cases, mostly acute myeloid leukemia (19.6%). Galactomannan testing was positive in 12.2% of patients, including 1.6% of occasions in which the test was used for screening purposes, 13.2% for diagnosis, and 32.4% during follow-up. Median time for chest imaging request was two days before GM testing. Previous antifungal therapy was reported for 35.1% of patients, mostly amphotericin B (57.1%). Conclusion: The correct use of galactomannan testing is essential for an early diagnosis of invasive aspergillosis, which may improve the prognosis of the disease. We demonstrated that clinicians usually ask for galactomannan tests to confirm imaging findings in patients who frequently were on antifungal drugs, something that could be improved by medical education. We observed a low frequency of galactomannan use for preemptive antifungal therapy (25.7%), which is worrying considering the well-known beneficial use of GM testing in this scenario.

Induced pluripotent stem cells reprogramming: Epigenetics and applications in the regenerative medicine / Células-tronco de pluripotência induzida: papel da epigenética na reprogramação e sua aplicabilidade clínica

Summary Induced pluripotent stem cells (iPSCs) are somatic cells reprogrammed into an embryonic-like pluripotent state by the expression of specific transcription factors. iPSC technology is expected to revolutionize regenerative medicine in the near future. Despite the fact that these cells have the capacity to self-renew, they present low efficiency of reprogramming. Recent studies have demonstrated that the previous somatic epigenetic signature is a limiting factor in iPSC performance. Indeed, the process of effective reprogramming involves a complete remodeling of the existing somatic epigenetic memory, followed by the establishment of a "new epigenetic signature" that complies with the new type of cell to be differentiated. Therefore, further investigations of epigenetic modifications associated with iPSC reprogramming are required in an attempt to improve their self-renew capacity and potency, as well as their application in regenerative medicine, with a new strategy to reduce the damage in degenerative diseases. Our review aimed to summarize the most recent findings on epigenetics and iPSC, focusing on DNA methylation, histone modifications and microRNAs, highlighting their potential in translating cell therapy into clinics.

Resumo As células-tronco de pluripotência induzida (CTPI) ou do inglês induced pluripotent stem cells (iPSCs) são células somáticas reprogramadas para o estado embrionário por meio da expressão de fatores ectópicos de transcrição específicos, tornando-as um alvo promissor para a medicina regenerativa. Apesar das CTPI compartilharem características embrionárias, como pluripotência e capacidade de autorrenovação, elas possuem uma baixa eficiência de reprogramação, sendo a memória epigenética uma das principais barreiras nesse processo. A epigenética é caracterizada por alterações reversíveis e herdáveis no genoma funcional que não alteram a sequência de nucleotídeos do DNA. Dentre as diferentes modificações epigenéticas, destacam-se metilação de DNA, alterações em histonas e microRNA. Atualmente, sabe-se que o processo de reprogramação efetivo das CTPI envolve um completo remodelamento da memória epigenética somática existente, seguido pelo estabelecimento de uma "assinatura epigenética" que esteja de acordo com o novo tipo de célula a ser diferenciada. Modificações epigenéticas personalizadas são capazes de melhorar o rendimento e a efetividade das CTPI geradas, abrindo uma nova perspectiva para a terapia celular. Nesta revisão reunimos as principais informações sobre os fatores epigenéticos que afetam a reprogramação das CTPI, bem como seus benefícios na aplicação da terapia celular.

A new oxo-vanadium complex employing an imidazole-rich tripodal ligand: a bioinspired bromide and hydrocarbon oxidation catalyst.

A vanadyl complex with the ligand (bis(1-methylimidazol-2-yl)methyl)(2-(pyridyl-2-yl)ethyl)amine was synthesized and fully characterized by X-ray crystallography, elemental analyses, cyclic voltammetry and infrared, electronic and electron paramagnetic resonance spectroscopies. This compound was designed under the so called hybrid concept. It shows to be able to promiscuously use hydrogen peroxide to oxidize bromide and to catalyze the oxidation of benzene and cyclohexane with very good selectivities.

Efeitos da estimulação cortical por sintetização auditiva conjugada, na marcha de uma criança com diplegia espástica / Effects of auditory stimulation coupled with a program targeting mental gait in children with spastic diplegia

O termo paralisia cerebral é usado para um grupo de condições caracterizadas essencialmente por disfunção motora. Com base nesta assertiva, o presente estudo teve por objetivo investigar os efeitos da estimulação auditiva conjugada a um programa de direcionamento mental na marcha de uma criança com diplegia espástica (DE). Este programa foi, em parte, baseado na abordagem dos neurônios-espelho e nele a criança sendo estudada tinha que observar, mentalizar e executar o ato de levantar e andar que era demonstrado por outra criança. A metodologia é de um estudo de caso (N = 1) de um indivíduo com cinco anos de idade, gênero masculino, diagnosticado com DE, com rigidez muscular de membros inferiores, não deambulando com independência. Procedimentos: Foram aplicadas 48 sessões de 30 minutos de estimulação cerebral de ondas alfa, precedidos de exercícios do programa de educação motora. As mensurações foram feitas através do Sistema de Classificação da Função Motora Grossa para Paralisia Cerebral, da Bateria Psicomotora e da Sequência de Desenvolvimento de Habilidades Locomotoras. O resultado do item tonicidade da bateria psicomotora em medidas pré e pós-intervenção revelou-se significativo, com qui quadrado = 8,428, gl 1 e 18, p < 0,05. Este resultado coincidiu tanto com melhoras inequívocas observadas nos testes do Sistema de Classificação da Função Motora Grossa para Paralisia Cerebral quanto para os da Sequência de Desenvolvimento de Habilidades Locomotoras. A intervenção proposta no estudo pode gerar efeitos muito positivos na marcha de uma criança com DE, como a sua total independência na marcha, além da independência nas suas AVDs.

The term cerebral palsy (CP) is used for a group of conditions primarily characterized by motor dysfunction. The aim of this study was to investigate the effects of auditory cortical stimulation coupled with a program partially based upon the mirror neurons approach and in which a child with spastic diplegia (SD) had to mentally learn and practice the gait pattern observed from another child. This was a case study (N = 1) and the individual was 5 years old, male, with stifness of limbs, not ambulating independently. The combined program included 48 sections of 30 minutes of alpha waves brain stimulation, preceding with exercises within the motor education program. Measurements were taken by the use of The Gross Motor Function Classification System for Cerebral Palsy (GMFCS), a psychomotor battery, and a validated instrument for evaluating the Sequence of Locomotor Skills Development of children (SLSD).The result related to muscles tone parameter, measured by the psychomotor battery, compared between the pre and post-intervention data was significant, being the index Chi2 = 8.428, df 1 and 18, p < 0.05.The beneficial results seen on muscles tone coincided with a clear improvement in most of the itens of the GMFCS for Cerebral Palsy, as well as for the SLSD itens. It was discussed the proposed intervention in this study can be indicated as capable for promoting very positive effects on gait, as a basis for total gait independence, and for independence in ADLs of children with SD, due to a CP accident.