Aftereffects in Epigenetic Age Related to Cognitive Decline and Inflammatory Markers in Healthcare Personnel with Post-COVID-19: A Cross-Sectional Study.

Purpose: Epigenetic age and inflammatory markers have been proposed as indicators of severity and mortality in patients with COVID-19. Furthermore, they have been associated with the occurrence of neurological symptoms, psychiatric manifestations, and cognitive impairment. Therefore, we aimed to explore the possible associations between epigenetic age, neuropsychiatric manifestations and inflammatory markers (neutrophil-lymphocyte ratio [NLR], platelet-lymphocyte ratio [PLR], monocyte-lymphocyte ratio [MLR], and systemic immune-inflammation index [SII]) in healthcare personnel with post-COVID condition. Patients and Methods: We applied the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) tests to 51 Mexican healthcare workers with post-COVID-19 condition; we also estimated their epigenetic age using the PhenoAge calculator. Results: The participants had a post-COVID condition that lasted a median of 14 months (range: 1-20). High NLR (>1.73) had association with mild cognitive impairment by MMSE (p=0.013). Likewise, high MLR (>0.24) were associated with language domain in MOCA (p=0.046). Low PLR (<103.9) was also related to delayed recall in MOCA (p=0.040). Regarding comorbidities, hypertension was associated with SII (p=0.007), overweight with PLR (p=0.047) and alcoholism was associated with MLR (p=0.043). Interestingly, we observed associations of low PLR (<103.9) and low SII (<1.35) levels with increased duration of post-COVID condition (p=0.027, p=0.031). Likewise, increases in PhenoAge were associated with high levels of SII (OR=1.11, p=0.049), PLR (OR=1.12, p=0.035) and MLR (OR=1.12, p=0.030). Conclusion: We observed neurocognitive changes related to inflammatory markers and increases in epigenetic age in healthcare personnel with post-COVID-19 condition. Future research is required to assess mental and physical health in individuals with post-COVID-19 symptoms.

Clinical and Virological Features of SARS-CoV-2 Variants during the Four Waves of the Pandemic in the Mexican Southeast.

We conducted a retrospective study using a population of patients who were hospitalized at Dr. Juan Graham Casasus Hospital in Villahermosa (Tabasco, Mexico) and had a positive RT-PCR test for SARS-CoV-2 between June 2020 and January 2022. We analyzed all medical records, including demographic data, SARS-CoV-2 exposure history, underlying comorbidities, symptoms, signs at admission, laboratory findings during the hospital stay, outcome, and whole-genome sequencing data. Finally, the data were analyzed in different sub-groups according to distribution during waves of the COVID-19 pandemic regarding Mexican reports from June 2020 to January 2022. Of the 200 patients who tested positive via PCR for SARS-CoV-2, only 197 had samples that could be sequenced. Of the samples, 58.9% (n = 116) were males and 41.1% (n = 81) females, with a median age of 61.7 ± 17.0 years. Comparisons between the waves of the pandemic revealed there were significant differences in the fourth wave: the age of patients was higher (p = 0.002); comorbidities such as obesity were lower (p = 0.000), while CKD was higher (p = 0.011); and hospital stays were shorter (p = 0.003). The SARS-CoV-2 sequences revealed the presence of 11 clades in the study population. Overall, we found that adult patients admitted to a third-level Mexican hospital had a wide range of clinical presentations. The current study provides evidence for the simultaneous circulation of SARS-CoV-2 variants during the four pandemic waves.

Resistant Starch Consumption Effects on Glycemic Control and Glycemic Variability in Patients with Type 2 Diabetes: A Randomized Crossover Study.

We previously observed beneficial effects of native banana starch (NBS) with a high resistant starch (RS) content on glycemic response in lean and obese participants. Here, we aimed to determine the effects of NBS and high-amylose maize starch (HMS) on glycemic control (GC) and glycemic variability (GV) in patients with type 2 diabetes (T2D) when treatments were matched for digestible starch content. In a randomized, crossover study, continuous glucose monitoring (CGM) was performed in 17 participants (aged 28-65 years, BMI ≥ 25 kg/m2, both genders) consuming HMS, NBS, or digestible maize starch (DMS) for 4 days. HMS and NBS induced an increase in 24 h mean blood glucose during days 2 to 4 (p < 0.05). CONGA, GRADE, and J-index values were higher in HMS compared with DMS only at day 4 (p < 0.05). Yet, NBS intake provoked a reduction in fasting glycemia changes from baseline compared with DMS (p = 0.0074). In conclusion, under the experimental conditions, RS from two sources did not improve GC or GV. Future longer studies are needed to determine whether these findings were affected by a different baseline microbiota or other environmental factors.

Analysis of formulations of probiotics accessible to the population of Tabasco, México / Análisis de formulaciones de probióticos accesibles a la población de Tabasco, México

Abstract Objective: To analyze the composition of formulations of probiotics sold in establishments in the State of Tabasco or that can be purchased online. Materials and methods: A descriptive study in which formulations of probiotics sold in 21 establishments in the city of Villahermosa were identified and compared with 30 probiotic supplements sold online. Product information was organized in a database and analyzed according to the dosage form, probiotic genera, species/subspecies contained and their classification as probiotics or synbiotics and as drugs or supplements. Results: Thirty-one local products and 30 online products formulated with probiotics in 6 different dosage forms were analyzed. Only five local products and no online products are certified by COFEPRIS as drugs. Forty-eight percent of the formulations are monostrain and the rest are multistrain. Seventy-two percent of the formulations are probiotics and the rest are synbiotics. Among the 61 products analyzed, 46 species belonging to 13 different genera were identified, and 39% were common to local and online products. Many of products contain species of the Lactobacillus and Bifidobacterium genera. The genus Bacillus was the only genus that was never combined with other genera in the formulations analyzed in this study. Conclusions: The population of the state of Tabasco can find at least 31 formulations of probiotics in local establishments. The variety increases if we consider the dietary supplements available for sale online. Multistrain supplements are particularly abundant in online retailers. The products certified by COFEPRIS ensure that the benefits of the formulation are supported by clinical trials in humans and are manufactured following good manufacturing practices.

Resumen Objetivo: Analizar la composición de formulaciones de probióticos que se venden en establecimientos del Estado de Tabasco o que se pueden comprar en línea. Materiales y métodos: Estudio descriptivo en el que se identificaron formulaciones de probióticos comercializados en 21 establecimientos de la ciudad de Villahermosa y se compararon con 30 suplementos probióticos comercializados en línea. La información del producto se organizó en una base de datos y se analizó de acuerdo con la forma de dosificación, los géneros y especies / subespecies de probióticos presentes y su clasificación como probióticos o simbióticos y como medicamentos o suplementos. Resultados: Se analizaron 31 productos locales y 30 productos de venta en línea formulados con probióticos en 6 formas de dosificación diferentes. Solo cinco productos locales y ningún producto en línea están certificados por COFEPRIS como medicamentos. El 48% de las formulaciones son monocepa y el resto son multicepa. El 72% de las formulaciones son probióticos y el resto son simbióticos. Entre los 61 productos analizados, se identificaron 46 especies pertenecientes a 13 géneros diferentes y el 39% fueron comunes a productos locales y de venta en línea. Muchos de los productos contienen especies de los géneros Lactobacillus y Bifidobacterium. El género Bacillus fue el único que nunca se combinó con otros géneros en las formulaciones analizadas en este estudio. Conclusiones: La población del estado de Tabasco puede encontrar al menos 31 formulaciones de probióticos en establecimientos locales. La variedad aumenta si tenemos en cuenta los suplementos dietéticos disponibles de venta en línea. Los suplementos multicepa son particularmente abundantes en los productos en línea. Los productos certificados por COFEPRIS aseguran que los beneficios de la formulación están respaldados por ensayos clínicos en humanos y se fabrican siguiendo buenas prácticas de fabricación.

Identification and functional analysis of c.422_423InsT, a novel mutation of the HNF1A gene in a patient with diabetes.

BACKGROUND: HNF1A gene regulates liver-specific genes, and genes that have a role in glucose metabolism, transport, and secretion of insulin. HNF1A gene mutations are frequently associated with type 2 diabetes. HNF1A protein has three domains: the dimerization domain, the DNA-binding domain, and the trans-activation domain. Some mutations in the dimerization or DNA-binding domains have no influence on the normal allele, while others have dominant negative effects. The I27L, A98V, and S487N polymorphisms are common variants of the HNF1A gene; they have been found in T2D and non-diabetic subjects. METHODS AND RESULTS: We searched for mutations in the first three exons of the HNF1A gen in an Amerindian population of 71 diabetic patients. DNA sequencing revealed the previously reported I27L polymorphism (c.79A>C) in 53% of diabetic patients and in 67% of the control group. Thus, the I27L/L27L polymorphism might be a marker of Amerindians. In addition, we found the c.422_423InsT mutation in the HNF1A gene of one patient, which had not been previously reported. This mutation resulted in a frame shift of the open reading frame and a new translation stop in codon 187, leading to a truncated polypeptide of 186 amino acids (Q141Hfs*47). This novel mutation affects the DNA-binding capacity of the mutant HNF1A protein by EMSA; its intracellular localization by fluorescence and confocal microscopy, and a dominant-negative effect affecting the DNA-binding capacity of the normal HNF1A by EMSA. We also studied the homology modeling structure to understand the effect of this mutation on its DNA-binding capacity and its dominant negative effect. CONCLUSION: The HNF1A Q141Hfs*47 mutant polypeptide has no DNA-binding capacity and exerts a dominant negative effect on the HNF1A protein. Therefore, it might produce severe phenotypic effects on the expression levels of a set of ß-cell genes. Consequently, its screening should be included in the genetic analysis of diabetic patients after more functional studies are performed.