RESUMO
Extracellular histones, part of the protein group known as damage-associated molecular patterns (DAMPs), are released from damaged or dying cells and can instigate cellular toxicity. Within the context of chronic obstructive pulmonary disease (COPD), there is an observed abundance of extracellular histone H3.3, indicating potential pathogenic implications. Notably, histone H3.3 is often found hyperacetylated (AcH3.3) in the lungs of COPD patients. Despite these observations, the specific role of these acetylated histones in inducing pulmonary tissue damage in COPD remains unclear. To investigate AcH3.3's impact on lung tissue, we administered recombinant histones (rH2A, rH3.3, and rAcH3.3) or vehicle solution to mice via intratracheal instillation. After 48 h, we evaluated the lung toxicity damage and found that the rAcH3.3 treated animals exhibited more severe lung tissue damage compared to those treated with non-acetylated H3.3 and controls. The rAcH3.3 instillation resulted in significant histological changes, including alveolar wall rupture, epithelial cell damage, and immune cell infiltration. Micro-CT analysis confirmed macroscopic structural changes. The rAcH3.3 instillation also increased apoptotic activity (cleavage of caspase 3 and 9) and triggered acute systemic inflammatory marker activation (TNF-α, IL-6, MCP-3, or CXCL-1) in plasma, accompanied by leukocytosis and lymphocytosis. Confocal imaging analysis confirmed lymphocytic and monocytic/macrophage lung infiltration in response to H3.3 and AcH3.3 administration. Taken together, our findings implicate extracellular AcH3.3 in inducing cytotoxicity and acute inflammatory responses, suggesting its potential role in promoting COPD-related lung damage progression.
RESUMO
Resumen Objetivo: Determinar la efectividad del uso de las tecnologías de la información y la comunicación, en la adherencia al tratamiento de los pacientes con insuficiencia cardiaca, que asistieron a una Unidad de Insuficiencia Cardiaca de Bogotá. Métodos: Se realizó un ensayo clínico con preprueba, posprueba y grupo de control. Se conformaron aleatoriamente tres grupos de 37 participantes cada uno, a dos de los cuales se les aplicó una intervención durante dos meses basada en el uso de las tecnologías de la información y la comunicación; el grupo 1 recibió seguimiento telefónico más envío de mensajes de texto, el grupo 2 seguimiento telefónico más envío de correos electrónicos y el grupo 3 correspondiente al grupo de control recibió la intervención de enfermería usual en una Unidad de Insuficiencia Cardiaca. Resultados: Los tres grupos definidos para el estudio modificaron significativamente sus niveles medios de adherencia; en los grupos 1 y 2 dicho incremento es atribuible a la intervención con el uso de las tecnologías de la información y la comunicación, de igual manera la adherencia en los participantes del grupo control que recibieron la atención usual en una Unidad de Insuficiencia Cardiaca, también muestra un incremento significativo. Conclusiones: El uso de las tecnologías de la información y la comunicación: el seguimiento telefónico asociado a los mensajes de texto y los correos electrónicos incrementó la adherencia al tratamiento farmacológico y no farmacológico en pacientes con insuficiencia cardiaca a través de la motivación y el seguimiento de los pacientes.
Abstract Motivation: To determine the efficacy of the use of information and communication technologies in the treatment adherence of patients with heart failure that were assisted at the Heart Failure Unit of Bogotá. Methods: A clinical trial was conducted with pre-, post-test and control group. Three randomised groups of 37 participants each were conformed, two of which received an intervention during two months based in the use of information and communication technology; group 1 received telephone follow-up plus text messages, group 2 telephone follow-up plus emails and group 3, which was the control group, received the usual nurse follow-up at a Heart Failure Unit. Results: The three defined study groups significantly modified their average adherence levels; groups 1 and 2 the increase is attributable to the intervention with the use of information and communication technologies, likewise, adherence of the control group participants who received the usual care at a Heart Failure Unit also showed a significant increase. Conclusion: The use of information and communication technologies, such as the telephone follow-up associated to text messages and emails, rose the adherence to the pharmacological and non-pharmacological treatment in patients with heart failure by motivating and monitoring patients.