COVID-19 coagulopathy and antiphospholipid syndrome

The presence of thrombotic events in COVID-19 patients has been described since the beginning of the pandemic. This association has been confirmed in most of the reported studies. Autopsy reports have shown that most thromboses are located in the lung, although they have also been observed in other organs such as the skin and kidneys. SARS-CoV2 infection induces a generalized prothrombotic state, which is attributed to a combination of factors such as hypoxia, excess cellular apoptosis, and mainly to overactivation of the immune system. Among immune-mediated prothrombotic situations, antiphospholipid syndrome (APS) stands out. Recurrent thrombotic events are observed in APS in the presence of antiphospholipid antibodies (aPL). There are numerous studies that report high prevalence of aPL in patients with COVID-19 infection. However, the results show discrepancies in the data on the prevalence of aPL, and its role in the pathogenesis of thrombosis in these patients. This could be due to the heterogeneity of the detection procedures for aPL or to transient elevations of non-pathogenic aPL levels in the context of infection. In this review we try to clarify the role of aPL in COVID-19 infection, and attempt to answer the question of whether it is a coagulopathy of its own, or secondary to APS.

La presencia de eventos trombóticos en los pacientes con COVID-19 se describió desde el inicio de la pandemia, asociación que ha sido confirmada en la mayoría de los estudios reportados. Los informes de necropsias han puesto de manifiesto que la mayoría de las trombosis se localiza en el pulmón, aunque también se han observado en otros órganos, como la piel y los riñones. La infección por SARS-CoV-2 induce un estado protrombótico generalizado que se atribuye a una conjunción de factores como la hipoxia, el exceso de apoptosis celular y, sobre todo, una hiperactivación del sistema inmune. Entre las situaciones protrombóticas inmunomediadas destaca el síndrome antifosfolipídico, en el cual se observan eventos trombóticos de repetición en presencia de anticuerpos antifosfolipídicos (AAF). Existen numerosos estudios que reportan una elevada prevalencia de AAF en los pacientes con infección por la COVID-19; sin embargo, los resultados muestran discordancias en los datos de prevalencia de AAF y su rol en la patogenia sobre la trombosis en estos pacientes, lo que que podría deberse a la heterogeneidad de los procedimientos de detección de los AAF o a elevaciones transitorias de los niveles de AAF no patogénicos en el contexto de la infección. En esta revisión se busca aclarar el papel de los AAF en la infección por COVID-19, intentando responder a la pregunta de si se trata de una coagulopatía propia o es secundaria a un síndrome antifosfolipídico.

The Relationship between Mitochondria and NLRP3 Inflammasome

Mitochondria participate in various intracellular metabolic pathways such as generating intracellular ATP, synthesizing several essential molecules, regulating calcium homeostasis, and producing the cell's reactive oxygen species (ROS). Emerging studies have demonstrated newly discovered roles of mitochondria, which participate in the regulation of innate immune responses by modulating NLRP3 inflammasomes. Here, we review the recently proposed pathways to be involved in mitochondria-mediated regulation of inflammasome activation and inflammation: 1) mitochondrial ROS, 2) calcium mobilization, 3) nicotinamide adenine dinucleotide (NAD+) reduction, 4) cardiolipin, 5) mitofusin, 6) mitochondrial DNA, 7) mitochondrial antiviral signaling protein. Furthermore, we highlight the significance of mitophagy as a negative regulator of mitochondrial damage and NLRP3 inflammasome activation, as potentially helpful therapeutic approaches which could potentially address uncontrolled inflammation.

Identification of a Novel De Novo Mutation of the TAZ Gene in a Korean Patient with Barth Syndrome

Barth syndrome (BTHS) is a rare genetic disorder characterized by various types of cardiomyopathy, neutropenia, failure to thrive, skeletal myopathy, and 3-methylglutaconic aciduria. BTHS is caused by loss-of-function mutations in the tafazzin (TAZ) gene located on chromosome Xq28, leading to cardiolipin deficiency. We report a 13-month-old boy with BTHS who had a novel de novo mutation in the TAZ gene. To the best of our knowledge, this is the first reported case of a BTHS patient with a de novo mutation in Korea. This report will contribute towards expanding the knowledge on the mutation spectrum of the TAZ gene in BTHS.

Suicide attempts among children and adolescents: partial or total injury? / Tentativa de suicídio infanto-juvenil: lesão da parte ou do todo?

This study sought to verify the records on file and the number of cases of attempted suicide among children and adolescents who were attended by Emergency Care health professionals in the municipality of Matozinhos, Minas Gerais, Brazil. Documentary and descriptive research was conducted, the data for which was collected by means of an investigation of Outpatient Records from 2008 to 2010. Of the 73,000 files evaluated, those dealing with cases of attempted suicide among children and adolescents between the age of 3 and 18 years were selected. It was revealed that the health professionals, particularly physicians and nurses, fail to register the cases appropriately, invalidating information about the problem and potential prevention measures. The conclusion reached was that underreporting and the discrepancy of the diagnoses which were not duly referred to the competent agencies require rethinking and reviewing medical practices, and taking a systematic and careful look to address the individual as a complex whole.

Neste estudo procurou-se verificar o registro e o número de casos de tentativa de suicídio entre crianças e adolescentes do município de Matozinhos, Minas Gerais, Brasil, que foram atendidos pelos profissionais de saúde do Pronto-Atendimento. Trata-se de uma pesquisa documental e descritiva, cuja coleta dos dados ocorreu por meio de investigação nas Fichas Ambulatoriais, no período de 2008 a 2010. Das 73.000 fichas levantadas, selecionaram-se aquelas que tratavam de casos de tentativa de suicídio entre crianças e adolescentes do município, com idades entre três e 18 anos. Percebeu-se que os profissionais de saúde, mais especificamente os médicos e enfermeiros, não registram os casos de forma adequada, inviabilizando a informação sobre o problema e as medidas de prevenção. Concluiu-se que a subnotificação, a discrepância dos diagnósticos e o não encaminhamento aos órgãos competentes exigem repensar e rever a prática médica e dirigir um olhar sistematizado e cuidadoso para perceber o sujeito como um todo complexo.

Avaliação da agregação plaquetária em presença de anticorpos antifosfolípides: anti-β2GP1 e anticardiolipina / Evaluation of platelet aggregation in the presence of antiphospholipid antibodies: anti-β2GP1 and anticardiolipin

INTRODUÇÃO: A síndrome antifosfolípide (SAF) é uma condição autoimune que apresenta fenômenos trombóticos arteriais e venosos de repetição além de complicações obstétricas. Sua patogênese está associada à presença de anticorpos antifosfolípides e/ou anti-β2 glicoproteína I (β2GPI) que aparentemente modificam o efeito anticoagulante da β2GPI. A dimerização da β2GPI induzida por anticorpos parece estar relacionada à indução da agregação plaquetária contribuindo para o estado trombofílico na SAF. OBJETIVOS: O presente trabalho objetiva demonstrar a influencia dos anticorpos antifosfolípides em testes de agregação plaquetária com diferentes agonistas (ADP, colágeno e adrenalina). MÉTODOS: Foram analisados testes de agregação de plaquetas normais com diferentes agonistas (ADP, colágeno, adrenalina) na presença de soro contendo anticorpos antifosfolípides em diferentes concentrações. RESULTADOS: As análises obtidas mostraram uma inibição significativa (P < 0,05) nas curvas de agregação plaquetária induzidas por ADP e adrenalina quando comparadas ao controle. O paradoxo entre o estado protrombótico e a presença de autoanticorpos que in vitro apresentam atividade anticoagulante foi demonstrado na literatura, dificultando o entendimento patofisiológico da síndrome antifosfolípide. CONCLUSÃO: Os resultados obtidos demonstraram que o soro rico em anticorpos anticardiolipina e anti-β2GPI, ambas da classe IgG, interferem em testes de curvas de agregação plaquetária.

INTRODUCTION: The antiphospholipid syndrome (APS) is an autoimmune condition characterized by recurrent arterial and venous thrombosis, besides obstetric complications. The pathogenesis is associated with the presence of antiphospholipid and/or anti-b2-glicoprotein I (anti-b2GPI) antibodies that appear to change the anticoagulant activity of b2GPI. Antibody-induced dimerization of b2GPI seems to be related to the induction of platelet aggregation, contributing to the development of thrombosis in APS. OBJECTIVES: The objective of the present study is to demonstrate the influence of antiphospholipid antibodies in platelet aggregation tests with different agonists (ADP, collagen, and adrenaline). METHODS: We analyzed platelet aggregation tests with different agonists (ADP, collagen, adrenalin) when normal platelets were exposed to serum with different concentrations of antiphospholipid antibodies. RESULTS: Results demonstrated a significant inhibition in adrenalin- and ADP-induced platelet aggregation curves (P < 0.05) in all antibody concentrations tested when compared to the control. The paradox between the prothrombotic state and the presence of autoantibodies that show anticoagulant activity in vitro was demonstrated in the literature, making it difficult to understand the pathophysiologic mechanism of the antiphospholipid syndrome. CONCLUSION: Results showed that anticardiolipin and anti-b2GPI antibodies-rich serum, both of which belonging to the IgG class, can interfere with platelet aggregation curves.

Respiratory supercomplexes: structure, function and assembly

The mitochondrial respiratory chain consists of 5 enzyme complexes that are responsible for ATP generation. The paradigm of the electron transport chain as discrete enzymes diffused in the inner mitochondrial membrane has been replaced by the solid state supercomplex model wherein the respiratory complexes associate with each other to form supramolecular complexes. Defects in these supercomplexes, which have been shown to be functionally active and required for forming stable respiratory complexes, have been associated with many genetic and neurodegenerative disorders demonstrating their biomedical significance. In this review, we will summarize the functional and structural significance of supercomplexes and provide a comprehensive review of their assembly and the assembly factors currently known to play a role in this process.

Antiphospholipid Syndrome Presented With Anterior Spinal Artery Syndrome

Antibodies to cardiolipin and other phospholipid have been associated with recurrent thrombotic events, including ischemic strokes, especially in children and young adults. Recently it has been shown that anti-beta2-glycoprotein I antibodies may be more specific in predicting thrombosis. We report a case of anterior spinal artery syndrome with elevated titer of antibodies to beta2-glycoprotein I in young adult.

Molecular detection of Treponema pallidum sp. pallidum in blood samples of VDRL-seroreactive women with lethal pregnancy outcomes: a retrospective observational study in northern Brazil / Detecção molecular do Treponema pallidum sp. pallidum em amostras de sangue de mulheres sororeativas ao VDRL com resultado letal da gravidez: um estudo observacional retrospectivo no norte do Brasil

INTRODUCTION: Although control measures of maternal and congenital syphilis are available in Brazil, difficulties exist within the healthcare network in providing a laboratory diagnosis of the infection during the prenatal period. The objective of this study was to confirm the presence of Treponema pallidum by PCR in women with positive VDRL serology and lethal pregnancy outcomes, i.e., abortion, stillbirth and neonatal death. METHODS: A retrospective study was conducted on VDRLseroreactive women with lethal pregnancy outcomes admitted to the Fundação Santa Casa de Misericórdia do Pará (FSCM-PA) between January and July 2004. Serum samples and DNA from whole blood were obtained at the time of screening by the VDRL test. These samples were analyzed by IgG ELISA, IgM FTA-Abs and simple PCR (polA). RESULTS: During the study period, 0.7% (36/4,912) of women with lethal pregnancy outcomes presented a positive VDRL test. The polAgene was amplified in 72.7% (24/33) of these women, with 55.6% (20/36) and 94.4% (34/36) presenting IgM and IgG antibodies against T. pallidum, respectively. Comparison of these results showed a significant difference, with agreement between the PCR and IgM FTA-Abs results, suggesting that maternal syphilis was an active infection. No basic cause of death of the conceptus was reported in 97.2% (35/36) of cases. Among women who were submitted to the VDRL test during the prenatal period, only four of the nine seroreactive patients underwent treatment. CONCLUSIONS: The high frequency of syphilis in the group studied indicates the fragility of the service of infection diagnosis, treatment and monitoring, compromising epidemiological control.

INTRODUÇÃO: Apesar das medidas de controle da sífilis materna e congênita estarem disponíveis no Brasil, existem dificuldades da rede em prover o diagnóstico laboratorial da infecção durante o pré-natal. O objetivo deste estudo foi confirmar a presença do Treponema pallidum pela PCR em mulheres com sorologia positiva ao VDRL e com resultado letal da gravidez, isto é, aborto, natimorto e neomorto. MÉTODOS: Estudo retrospectivo realizado em mulheres VDRL-sororeativas com resultado negativo da gravidez, admitidas na Fundação Santa Casa de Misericórdia do Pará FSCM-PA entre janeiro e julho de 2004. As amostras de soro e DNA de sangue total foram obtidas no mesmo período da triagem pelo VDRL. Estas amostras foram analisadas pelo ELISA IgG, FTA-Abs IgM e PCR simples (polA). RESULTADOS: Durante o período de estudo, 0,7% (36/4.912) das mulheres com resultado letal da gravidez apresentaram VDRL positivo. O genepolA foi amplificado em 72,7% (24/33) destas mulheres,com 55,6% (20/36) e 94,4% (34/36) apresentando anticorpos tipo IgG e IgM contra o T. pallidum, respectivamente. A comparação destes resultados mostrou uma diferença estatística significativa, sendo que os resultados da PCR versus FTA-Abs Ig Mmostraram-se concordantes, sugerindo que a sífilis materna era uma infecção ativa. A causa básica de morte dos conceptos não foi relatada em 97,2% (35/36) dos casos. Entre as mulheres que foram submetidas ao VDRL no pré-natal, somente quatro das nove soropositivas receberam tratamento. CONCLUSÕES: A elevada frequência de sífilis no grupo de estudo indica a fragilidade do serviço no diagnóstico, tratamento e monitoramento da infecção, comprometendo o controle epidemiológico.

A cardiolipina é o alvo da cardiotoxicidade dos anestésicos locais?: [revisão] / Is cardiolipin the target of local anesthetic cardiotoxicity?: [review]

JUSTIFICATIVA E OBJETIVOS: Os anestésicos locais são amplamente utilizados na prevenção ou na reversão de dor aguda e no tratamento de dor crônica. A reação de cardiotoxicidade induzida pelos anestésicos locais é um evento acidental sem terapia farmacológica, exceto a infusão de intralípides relatados recentemente cujo mecanismo de ação ainda não é bem compreendido. CONTEÚDO: A cardiolipina, um fosfolipídio aniônico, desempenha papel relevante na determinação de reação respiratória mitocondrial, metabolismo de ácidos graxos e apoptose celular. A disfunção do metabolismo energético mitocondrial é sugerida em associação com a cardiotoxicidade dos anestésicos locais, a partir de um estudo in vitro de que ela talvez se deva a fortes ligações eletrostáticas entre os anestésicos locais e a cardiolipina na membrana mitocondrial. Não há, contudo, evidência experimental. Portanto, levantamos a hipótese de que as interações anestésico-cardiolipina sejam o principal determinante associado à reação de cardiotoxicidade, o que pode ser estabelecido com a adoção de métodos teóricos e biológicos estruturais. Esse modelo de interação nos daria uma pista sobre o mecanismo da cardiotoxicidade dos anestésicos locais, visando a futuras pesquisas na área de desenvolvimento de fármacos de prevenção a esse evento na prática clínica. CONCLUSÕES: A interação entre a cardiolipina mitocondrial e os anestésicos locais pode ser a principal fonte de sua cardiotoxicidade, em função de seus efeitos sobre o metabolismo energético e o estado eletrostático.

BACKGROUND AND OBJECTIVES: Local anesthetics are used broadly to prevent or reverse acute pain and treat symptoms of chronic pain. Local anesthetic-induced cardiotoxic reaction has been considered the accidental event without currently effective therapeutic drugs except for recently reported intralipid infusion whose possible mechanism of action is not well known. CONTENTS: Cardiolipin, an anionic phospholipid, plays a key role in determining mitochondrial respiratory reaction, fatty acid metabolism and cellular apoptosis. Mitochondrial energy metabolism dysfunction is suggested as associated with local anesthetic cardiotoxicity, from an in vitro study report that the local anesthetic cardiotoxicity may be due to the strong electrostatic interaction of local anesthetics and cardiolipin in the mitochondria membrane, although there is a lack for experimental evidence. Herein we hypothesized that local anesthetic-cardiolipin interactions were the major determinant of local anesthetic-associated cardiotoxic reaction, established by means of theoretic and structural biological methods. This interacting model would give an insight on the underlying mechanism of local anesthetic cardiotoxicity and provide clues for further in depth research on designing preventive drugs for such inadvertent accidence in routine clinical practice. CONCLUSIONS: The interaction between local anesthetic and mitochondrial cardiolipin may be the underlying mechanism for cardiotoxicity affecting its energy metabolism and electrostatic status.

Síndrome antifosfolipídico catastrófico: síndrome de asherson: [revisión] / Catastrophic antiphospholipid syndrome: asherson syndrome: [review]

Aunque representan menos del 1% de todos los pacientes con síndrome antifosfolipídico, los pacientes con síndrome antifosfolipídico catastrófico generalmente se encuentran en una situación médica urgente que requiere un seguimiento clínico exhaustivo. Sin embargo, la rareza de esta variante dificulta extraordinariamente su estudio sistemático. Con la finalidad de incluir todos los casos publicados con síndrome antifosfolipídico catastrófi co, así como los nuevos casos que se van diagnosticando en todo el mundo, se creó en el año 2000 un registro internacional (“CAPS Registry”), promovido por el European Forum on Antiphospholipid Antibodies. Actualmente, este registro documenta las manifestaciones clínicas y los datos de laboratorio y terapéuticos de más de 300 pacientes. Se puede consultar libremente en Internet (www.med.ub.es/MIMMUN/FORUM/CAPS.HTM) y se espera que el análisis periódico de sus datos permita incrementar los conocimientos sobre el síndrome antifosfolipídico catastrófico. En este artículo se revisan los principales conocimientos obtenidos hasta la fecha sobre este síndrome...

Although less than 1% of patients with the antiphospholipid syndrome (APS) develop the catastrophic variant, its potentially lethal outcome emphasizes its importance in clinical medicine today. However, the rarity of this variant makes it extraordinarily difficult to study in any systematic way. In order to put together all the published case reports as well as the new diagnosed cases from all over the world, an international registry of patients with catastrophic APS (“CAPS Registry”) was created in 2000 by the European Forum on Antiphospholipid Antibodies.Currently, it documents the entire clinical, laboratory and therapeutic data of more than 300 patients whose data has been fully registered. This registry can be freely consulted at the Internet (www.med.ub.es/MIMMUN/FORUM/CAPS.HTM) and it is expected that the periodical analysis of these data will allow us to increase our knowledge of this condition. This review article describes the state of the art on the catastrophic APS...

Detecção de sífilis por ensaios de ELISA e VDRL em doadores de sangue do Hemonúcleo de Guarapuava, Estado do Paraná / Syphilis detection using ELISA and VDRL tests on blood donors at the blood center of Guarapuava, State of Paraná

O objetivo desse estudo foi avaliar a soroprevalência de sífilis em 5.752 doadores de sangue atendidos no Hemonúcleo de Guarapuava-PR, em 2006. As taxas de positividade foram de 2,1 por cento pelo teste de ensaio imunoenzimático e 0,2 por cento pelo Veneral Disease Research Laboratory, mostrando baixa prevalência de sífilis nos indivíduos que procuraram este banco de sangue.

The aim of this study was to evaluate the syphilis seroprevalence among 5,752 blood donors who were attended at the blood center of Guarapuava, State of Paraná, in 2006. The seropositivity rates were 2.1 percent for enzyme Linked Immuno Sorbent Assay and 0.2 percent for Veneral Disease Research Laboratory, thus showing low prevalence of syphilis among the individuals who came to this blood bank.

Prevalência da co-infecção HIV-sífilis em um hospital universitário da cidade do Rio de Janeiro no ano de 2005 / Prevalence of HIV-syphilis coinfection in a university hospital in the city of Rio de Janeiro in 2005

Estudo de prevalência da co-infecção HIV-sífilis realizado com 830 pacientes em acompanhamento ambulatorial para HIV/aids entre janeiro e maio de 2005 no Hospital na cidade do Rio de Janeiro. Os participantes realizaram exames de VDRL (veneral disease research laboratory), contagens de células CD4+/CD8+ e de carga viral e responderam perguntas sobre características sócio-demográficas e história prévia de sífilis. A prevalência da sífilis foi de 2,7 por cento (22), a relação entre homens e mulheres co-infectados foi de 4:1, aproximadamente. Homossexuais masculinos foram os mais acometidos e não encontramos associação entre co-infecção e idade, escolaridade e parâmetros laboratoriais testados. Do total de casos com sífilis, 73 por cento (16) relataram tratamento prévio; destes, 14 (88 por cento) pacientes foram re-infectados, enquanto 2 (12 por cento) pacientes realizaram tratamento inapropriado. A presença de co-infecção HIV-sífilis em pacientes em acompanhamento rotineiro alerta-nos para necessidade de aconselhá-los a adotar práticas sexuais seguras durante os seus atendimentos ambulatoriais.

This was a study on the prevalence of HIV-syphilis coinfection among 830 HIV/AIDS patients who were being followed up as outpatients at a hospital in Rio de Janeiro between January and May 2005. The participants underwent laboratory tests at the venereal disease research laboratory (VDRL) consisting of CD4+/CD8+ cell counts and viral load tests. They answered questions about their sociodemographic characteristics and past medical history of syphilis. The prevalence of syphilis was 2.7 percent (22 patients) and the ratio between men and women with coinfection was approximately 4:1. Homosexual men were the category most affected. We did not find any association between coinfection and age, schooling and the laboratory parameters tested. Out of the total number of patients with syphilis, 73 percent (16) reported previous treatment; of these, 14 (88 percent) were reinfected, while two (12 percent) underwent inappropriate treatment. The presence of HIV-syphilis coinfection among patients undergoing routine follow-up signals the need to advise them to adopt safe sex practices, during their outpatient visits.

Single photon emission computed tomography of technetium-99m tetrofosmin myocardial perfusion imaging in patients with systemic lupus erythematosus

Was to evaluate the utility of single-photon emission computed tomography [SPECT] of technetium-99m tetrofosmin [Tc-99m TF] myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus [SLE] and its relation to presence or absence of cardiolipin antibodies [aCL]. Three groups of subjects-group 1: 33 SLE female patients with non-specific cardiac symptoms and signs, group 2: 28 female SLE patients without any cardiac symptoms and signs, and group 3: 24 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT. Cardiolipin antibodies had been assessed in all cases. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 82% and 43% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Multivariate analysis revealed a positive correlation between age and the number of CAD risk factors [r[2]=0.482]. Also, lower HDL, higher incidence of smoking, higher body mass index and postmenopausal status are an important determinant factors for presence of CAD in SLE patients. However, there is statistically higher prevalence of reversible perfusion defects [RDs] in group 2 with [+] aCL [31%] compared to [-] aCL [13.3%] in the same group. Also, RDs were statistically higher in [-] aCL of group 1 [61.1%] compared to [-] aCL in group 2. Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. Lower HDL cholesterol level, age and postmenopausal status in addition to higher body mass index were the variables associated with myocardial perfusion abnormalities in our patients

Study on the effects of mitochondrial pathways on apoptosis in colon carcinoma cells induced by tumor necrosis factor related apoptosis inducing ligand / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the effects of mitochondrial pathways on apoptosis in colon carcinoma cells induced by Tumor necrosis factor related apoptosis inducing ligand and offer evidences for TRAIL application in clinic.</p><p><b>METHODS</b>Apoptosis, integration of mitochondria (including DeltaPsim, cardiolipin), activity of Caspase-9 and release of cytochrome c in colon carcinoma cells SW1116 treated with TRAIL, were detected by means of flowcytometry, fluorometer method and western-blot at the different time point.</p><p><b>RESULTS</b>After treated with TRAIL for 4 hours, the apoptosis index was 32.98%, and the damage of mitochondria occurred with DeltaPsim, cardiolipin decreased, and the activity of Caspase-9 and cytochrome c increased. The Caspase-9 activity at 24 hour was (48.12+/-2.21)micromol.L(-1).h(-1).mg(-1) protein. Mitochondrial damage induced by TRAIL could be inhibited by Caspase inhibitor Z-VAD. fmk.</p><p><b>CONCLUSION</b>Mitochondrial pathways involved in the apoptosis of colon carcinoma cell induced by TRAIL. Cytochrome c was released and Caspase-9 was activated in the Caspase-dependent manner after the damage of mitochondrial.</p>

Aterosclerose na artrite reumatóide e sua associação com auto-imunidade humoral / Atherosclerosis in rheumatoid arthritis and its relationship with humoral autoimmunity

Objetivos: Muitas questões permanecem sobre as causas da aterosclerose acelerada nos pacientes com doenças inflamatórias sistêmicas como a artrite reumatóide (AR). Estudos na população geral sugeriram que além da inflamação existe uma participação patogênica da auto-imunidade na aterosclerose e discutem a possível associação dos anticorpos contra fosfolípides e proteínas de choque térmico (Hsp). O objetivo deste estudo foi investigar a presença de anticorpos contra fosfolípides, beta2-glicoproteína 1 (beta2-gp1), lipoproteína lipase (LPL) e Hsp em pacientes com AR e avaliar a associação entre estes anticorpos com a presença de aterosclerose subclínica de carótidas. Métodos: Anticorpos contra cardiolipina (aCL) IgG e IgM, beta2-gp1 IgG, IgM e IgA , Hsp 60 e Hsp 65 foram testados por ELISA em um grupo de 71 pacientes com AR comparado com 53 indívíduos controles não portadores de AR, de idade e sexo similar. Foram excluídos os pacientes com HAS, diabetes melitos e os fumantes em ambos os grupos. Níveis de lipoproteínas, parâmetros clínicos da AR, questionário de avaliação de saúde (HAQ), escore de atividade da doença (DAS) 28, velocidade de hemossedimentação (VHS) e proteína C reativa (PCR) foram avaliadas. A associação entre a presença dos anticorpos aCL, beta2-gp1, Hsp 60 e Hsp 65 com os parâmetros clínicos de atividade da doença, com a presença das placas de aterosclerose e com a medida da espessura íntimomedial (IMT) da carótida comum, usando ultra-som (US) modo B de alta resolução foram pesquisadas. Resultados: A idade média no grupo com AR foi 48,93 ± 12,31 vs. 45,37 ± 9,37 no grupo controle saudável (p = 0,20); 90,1% no grupo com AR eram do sexo feminino vs. 86,8% no grupo controle (p = 0,56); índice de massa corporal (IMC) foi 25,72 ± 4,57kg/m² no grupo com AR vs. 26,40 ± 4,52kg/m² no grupo controle (p = 0, 69); Os níveis de colesterol, LDL, triglicerídeos e a relação CT/HDL não foram diferentes quando comparamos os 2 grupos (p > 0,05)...

Purpose: Many questions remain unanswered about the causes of accelerated atherosclerosis in patients with inflammatory systemic diseases such as rheumatoid arthritis (RA). Some studies have suggested the role of autoimmunity besides inflammation in the pathogenesis of atherosclerosis in general population and have also discussed the possible association with antibodies directed to phospholipids and heat shock proteins (Hsp). The aim of this study was to investigate the presence of antibodies against phospholipids, beta2-glycoprotein1 (beta2-gp1), lipoprotein lipase (LPL) and Hsp in RA subjects and evaluate the association between these antibodies with the presence of subclinical carotid atherosclerosis. Methods: Tests to antibodies against cardiolipin (aCL) IgG and IgM, beta2-gp1 IgG, IgM and IgA ,Hsp 60 and Hsp 65 were done by ELISA test in a group of 71 RA subjects compared with 53 age and sex-matched non-RA subjects. Smoking, diabetic and hypertensive patients were excluded in both groups. The lipoprotein levels, clinical parameters of RA, Health Assessment Questionnaire (HAQ), Disease Activity Score (DAS) 28, Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) were evaluated. The association between the presence of antibodies against cardiolipin, beta2-gp1 and Hsp 60 and 65 with the clinical parameters of disease activity in RA, and with the presence of plaques and mean intimo-medial thickness (IMT) of common carotid using high-resolution B-mode ultrasound were assessed. Results: Mean age in RA group was 48.93 ± 12.31 vs. 45.37 ± 9.37 in healthy control group (p = 0.20); 90.1% were women in RA group vs. 86.8% in healthy control (p = 0.56); body mass index (BMI) were 25.72 ± 4.57 in RA group vs. 26.40 ± 4.52 in healthy control (p = 0.69). The levels of cholesterol, LDL, triglycerides, CT/HDL didn t have difference between the two groups (p > 0.05)...

[ necessity of VDRL test on marriage counseling for syphilis screening]

Syphilis, a chronic systemic infection caused by Treponema pallidum, is usually sexually transmitted and is characterized by episodes of active disease interrupted by periods of latency. VDRL is the commonest test used for screening Syphilis. One of groups for screening syphilis in Iran is men at the time of marriage. With regards to the social position and the financial payments for this assessment, we investigated the necessity of this test in Yazd. In this retrospective- descriptive study from 10725 men for first marriage, 15 women and 15 men for second marriages were referred to the medical health center of Yazd from 2003 to 2005 with positive VDRL test and investigated. The incidence of the positive test for men at the time of first marriages was 0.00%. This percentage is fewer than that reported by Dr. Tara in Mashhad and Dr. Sharify Mod in Sistan and Baluchestan. Anyway, more assessment in other parts of Iran is recommended, and we invite our readers to pay attention to recommendation of the authors

Prevalence of HIV and VDRL seropositivity in blood donors of Delhi.

Blood transfusion has been the transmission mechanism in 15 per cent of total patients infected with human immunodeficiency virus (HIV). A few reports are available regarding the trend of HIV seropositivity in northern India. Prevalence of VDRL (venereal disease research laboratory) reactivity varies from 0.8-15 per cent in blood donors. We present data on the prevalence and trends of infection with HIV 1 and 2 and VDRL reactivity in blood donors in Delhi. Between 2000-2002, a total of 76089 (voluntary and replacement) donors were screened. Majority (82.4%) were replacement donors. Seropositivity for HIV and VDRL was seen in 0.54 and 2.6 per cent of donors respectively. The percentage of seropositivity for HIV and VDRL was significantly higher in replacement donors (P<0.001). It is suggested that extensive donor selection and a voluntary donor service would reduce the number of infectious donors significantly. Non-renumerated repeat voluntary donor services are urgently required to lower the prevalence of transmissible infections. While the need to change to a voluntary donor service and devising effective donor screening cannot be over emphasized, there is also a need to mandate HIV antigen detection in India.