ABSTRACT
BACKGROUND: The true burden of Lyme disease in primary care in Scotland is unknown. Epidemiological data is currently based on laboratory confirmed reports as there is no mandatory reporting of clinical cases AIM: To analyse data from general practice in NHS Highland (North) over a six year period to assess the incidence and management of Lyme disease in primary care. DESIGN & SETTING: This was a retrospective descriptive study. Study data was extracted from all 63 general practices within NHS Highland (North) from 2017 to 2022. METHOD: Lyme disease consultations were identified via Lyme-related clinical read codes, borrelia test requests, free text 'tags' and/or Lyme disease antibiotic scripts. RESULTS: Using read codes to identify patients with Lyme disease/ suspected Lyme disease gave an estimated average annual incidence of 124/100,000 population, which was 2.1-fold more than those based on laboratory confirmed reports only. Incidence figures increased to 5.2-fold more (362/100,000 population) when those patients with Lyme disease/ suspected Lyme disease (identified via readcodes, laboratory test requests and free text 'tags') who were given antibiotic treatment were taken into account. Local 'hotspots' of infection were identified. Analysis of the antibiotic data indicates that antibiotic prescribing in NHS Highland largely follows NICE guidelines. CONCLUSION: This data analysis pathway can, and should, be rolled out to assess the incidence and management of Lyme disease in primary care throughout the whole of Scotland to allow appropriate resources to be allocated.
ABSTRACT
Alterations in lipid metabolism have been progressively documented as a characteristic property of cancer cells. Though, human ABHD2 gene was found to be highly expressed in breast and lung cancers, its biochemical functionality is yet uncharacterized. In the present study we report, human ABHD2 as triacylglycerol (TAG) lipase along with ester hydrolysing capacity. Sequence analysis of ABHD2 revealed the presence of conserved motifs G(205)XS(207)XG(209) and H(120)XXXXD(125) Phylogenetic analysis showed homology to known lipases, Drosophila melanogaster CG3488. To evaluate the biochemical role, recombinant ABHD2 was expressed in Saccharomyces cerevisiae using pYES2/CT vector and His-tag purified protein showed TAG lipase activity. Ester hydrolase activity was confirmed with pNP acetate, butyrate and palmitate substrates respectively. Further, the ABHD2 homology model was built and the modelled protein was analysed based on the RMSD and root mean square fluctuation (RMSF) of the 100 ns simulation trajectory. Docking the acetate, butyrate and palmitate ligands with the model confirmed covalent binding of ligands with the Ser(207) of the GXSXG motif. The model was validated with a mutant ABHD2 developed with alanine in place of Ser(207) and the docking studies revealed loss of interaction between selected ligands and the mutant protein active site. Based on the above results, human ABHD2 was identified as a novel TAG lipase and ester hydrolase.
