ABSTRACT
The diagnosis of cardiovascular disease (CVD) is still limited. Therefore, this study demonstrates the presence of human ether-a-go-go-related gene 1 (hERG1) and heat shock protein 47 (Hsp47) on the surface of small extracellular vesicles (sEVs) in human peripheral blood and their association with CVD. In this research, 20 individuals with heart failure and 26 participants subjected to cardiac stress tests were enrolled. The associations between hERG1 and/or Hsp47 in sEVs and CVD were established using Western blot, flow cytometry, electron microscopy, ELISA, and nanoparticle tracking analysis. The results show that hERG1 and Hsp47 were present in sEV membranes, extravesicularly exposing the sequences 430AFLLKETEEGPPATE445 for hERG1 and 169ALQSINEWAAQTT- DGKLPEVTKDVERTD196 for Hsp47. In addition, upon exposure to hypoxia, rat primary cardiomyocytes released sEVs into the media, and human cardiomyocytes in culture also released sEVs containing hERG1 (EV-hERG1) and/or Hsp47 (EV-Hsp47). Moreover, the levels of sEVs increased in the blood when cardiac ischemia was induced during the stress test, as well as the concentrations of EV-hERG1 and EV-Hsp47. Additionally, the plasma levels of EV-hERG1 and EV-Hsp47 decreased in patients with decompensated heart failure (DHF). Our data provide the first evidence that hERG1 and Hsp47 are present in the membranes of sEVs derived from the human cardiomyocyte cell line, and also in those isolated from human peripheral blood. Total sEVs, EV-hERG1, and EV-Hsp47 may be explored as biomarkers for heart diseases such as heart failure and cardiac ischemia.
Subject(s)
Biomarkers , Cardiovascular Diseases , Extracellular Vesicles , HSP47 Heat-Shock Proteins , Myocytes, Cardiac , Humans , Extracellular Vesicles/metabolism , Biomarkers/blood , Male , Cardiovascular Diseases/metabolism , Female , Myocytes, Cardiac/metabolism , Myocytes, Cardiac/pathology , Middle Aged , Animals , HSP47 Heat-Shock Proteins/metabolism , Rats , ERG1 Potassium Channel/metabolism , Aged , Adult , Ether-A-Go-Go Potassium Channels/metabolism , Heart Failure/metabolism , Heart Failure/pathology , Heart Failure/bloodABSTRACT
La Hemorragia Digestiva (HD) es la pérdida o extravasación de sangre que se origina en cualquier segmento del tubo digestivo, alcanzando la luz esófago-gástrica, intestinal o colónica, constituye un problema frecuente de salud en el mundo y es considerada como causa mayor de morbimortalidad. En la mayoría de los casos la hemorragia digestiva se presenta de manera aguda y con importantes repercusiones sistémicas como hematemesis, melenas, hematoquecia, rectorragia, es importante tomar en cuenta la edad del paciente, comorbilidades, volumen, evolución y origen de la hemorragia digestiva, para determinar medidas urgentes en la estabilización de los pacientes, así como los cuidados de enfermería que se van a proporcionar con el propósito de minimizar la hemorragia y mantener la estabilidad hemodinámica. La Hemorragia Digestiva Alta (HDA) representa la emergencia médica gastroenterológica más frecuente en el mundo, con una prevalencia de 150 por 100 000 adultos por año con una mortalidad entre 10,0% al 20,0%, la Hemorragia Digestiva Baja (HDB) es potencialmente mortal, y puede manifestarse como anemia ferropénica, sangre en heces o hematoquecia; en el Ecuador en el año 2017 según el Instituto Nacional de Estadísticas y Censos (INEC), se reporta un ingreso hospitalario con CIE10 K922 (hemorragia digestiva no especificada) de 2 462 pacientes, con un total de egresos vivos de 2 375, y un total de 87 pacientes fallecidos; en el Hospital de Especialidades Carlos Andrade Marín del año 2017 al 2019 los pacientes con sangrado digestivo alto representan una mortalidad del 3,5 al 10,0% 1. La ruta planteada orienta al personal de Enfermería sobre la evolución, evaluación y manejo de los pacientes adultos con hemorragia digestiva.
Digestive Hemorrhage (HD) is the loss or extravasation of blood that originates in any segment of the digestive tract, reaching the esophagus-gastric, intestinal or colonic lumen, it is a frequent health problem in the world and is considered as a major cause of morbidity and mortality. In most cases, digestive bleeding occurs acutely and with significant systemic repercussions such as hematemesis, melena, hematochezia, rectal bleeding, it is important to take into account the age of the patient, comorbidities, volume, evolution and origin of digestive bleeding, to determine urgent measures in the stabilization of patients, as well as the nursing care that will be provided in order to minimize bleeding and maintain hemodynamic stability. Upper Gastrointestinal Bleeding (HDA) represents the most frequent gastroenterological medical emergency in the world, with a prevalence of 150 per 100 000 adults per year with a mortality between 10,0% to 20,0%, Low Gastrointestinal Bleeding (HDB) is life-threatening, and may ma- nifest as iron deficiency anemia, blood in stool, or hematochezia; in Ecuador in 2017 according to the National Institute of Statistics and Censuses (INEC), a hospital admission with ICD10 K922 (unspecified gastrointestinal bleeding) of 2 462 patients was reported, with a total of 2 375 living discharges, and a total of 87 deceased patients; In the Carlos Andrade Marín Specialties Hospital from 2017 to 2019, patients with upper digestive bleeding represent a mortality of 3,5 to 10,0% 1. The proposed route guides nursing staff on the evolution, evaluation and management of adult patients with gastrointestinal bleeding.
Subject(s)
Humans , Male , Female , Patient Care Planning , Nursing Records , Hemodynamic Monitoring , Nursing Care , Nursing, Practical , Nursing Process , Hematemesis , Melena , Morbidity , Mortality , Nursing , Gastroenterology , Gastrointestinal HemorrhageABSTRACT
Se realizó una investigación analítica realizada in vitro en el laboratorio general del Hospital "Carlos Andrade Marín". La población estuvo compuesta por 20 barras de gutapercha marca Meta®Biomed (Korea), distribuidas en cuatro grupos compuestos por 5 barras atendiendo a características preestablecidas en cuanto a realización de termoplastificación y manipulación. Solo el 15% de las muestras se registró indicios de crecimiento bacteriano, de las que el 66,67% pertenecieron al grupo de barras sólidas de gutapercha que fueron manipuladas, estableciéndose diferencias significativas con respecto al resto de los grupos (p≤0.01), según la prueba de T-stu-dents. La mayoría de las muestras no mostró indicios de crecimiento bacteriano. Sin embargo, dos de las tres muestras que manifestaron esa actividad microbiológica pertenecieron al grupo de las barras sólidas de gutapercha que fueron manipuladas.
An in vitro analytical research was carried out in the general laboratory of the "Carlos Andrade Marín" Hospital. The population consisted of 20 bars of Meta®Biomed brand gutta-percha (Korea) distributed in four groups made up of 5 bars according to the pre-established characteristics in terms of thermoplasticization and handling. Only 15% of the selected samples showed signs of bacterial growth, of which 66.67% belonged to the group of solid gutta-percha bars that were manipulated, establishing specific differences with respect to the rest of the groups (p≤0.01), according to the T-students test. Most of the samples have no evidence of bacterial growth. However, two of the three samples that showed this microbiological activity belonged to the group of solid gutta-percha bars that were manipulated
