Evaluation of platelet activity by multiple electrode impedance aggregometry in acute coronary syndromes: pilot study in a Brazilian tertiary-care public hospital

There is no definite recommendation for testing platelet aggregation (PA) in acute coronary syndromes (ACS) due to inconclusive evidence on the usefulness of platelet function tests to guide therapy and improve clinical outcomes. The evaluation of PA with multiple electrode impedance platelet aggregometry (MEA) may be useful to manage antiplatelet therapy and possibly influence patient outcome. The primary aim of this study was to measure PA with MEA in Brazilian patients with ACS and evaluate the association between PA and adverse clinical outcomes. Forty-seven consecutive patients admitted with ACS to a Brazilian tertiary-care public hospital were studied and PA was evaluated using MEA. Patients were followed for six months for the occurrence of all-cause death, acute myocardial infarction, or stroke. Suboptimal inhibition of PA was found in 7 patients (14.9%); 5 (10.6%) in response to ASA (acetylsalicylic acid), 2 (5.0%) to clopidogrel, and none to ticagrelor. Inadequate PA inhibition in response to ASA was significantly associated with the composite end point, but there was no significant association for insufficient PA inhibition in response to clopidogrel. This study suggested that the evaluation of PA in ACS using MEA may identify non-responders to ASA. Larger studies are necessary to define, in a public health scenario, the value of MEA in the management of ACS

Chronic Low-Grade Inflammation in Childhood Obesity Is Associated with Decreased IL-10 Expression by Monocyte Subsets

Submitted by Nuzia Santos ([email protected]) on 2017-12-13T16:42:49Z No. of bitstreams: 1 Chronic Low-Grade Inflammation in Childhood Obesity.pdf: 7367809 bytes, checksum: 7fe44c78117bdbeba3fb468364e5ffbb (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2017-12-13T16:49:29Z (GMT) No. of bitstreams: 1 Chronic Low-Grade Inflammation in Childhood Obesity.pdf: 7367809 bytes, checksum: 7fe44c78117bdbeba3fb468364e5ffbb (MD5)Made available in DSpace on 2017-12-13T16:49:29Z (GMT). No. of bitstreams: 1 Chronic Low-Grade Inflammation in Childhood Obesity.pdf: 7367809 bytes, checksum: 7fe44c78117bdbeba3fb468364e5ffbb (MD5) Previous issue date: 2016FAPEMIG/CNPqUniversidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Biologia das Interacões Celulares. Belo Horizonte, MG, BrasilUniversidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Biologia das Interacões Celulares. Belo Horizonte, MG, Brasil/Fundação Oswaldo Cruz. Instituto Rene Rachou. Laboratorio de Imunologia Celular e Molecular. Belo Horizonte, MG, BrasilUniversidade Estadual de Santa Cruz. Departamento de Genetica. Ilheus, BA, Brasil/Servico de Medicina Preventiva da Unimed. Aracaju, SE, BrasilFundação Oswaldo Cruz. Instituto Rene Rachou. Laboratorio de Imunologia Celular e Molecular. Belo Horizonte, MG, BrasilUniversidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Biologia das Interacões Celulares. Belo Horizonte, MG, BrasilUniversidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Biologia das Interacões Celulares. Belo Horizonte, MG, Brasil/ Instituto Nacional de Ciência e Tecnologia em Doencas Tropicais—INCT-DTUniversidade Federal de Mato Grasso. Departamento de Ciências Basicas da Saude. Faculdade de Medicina. Cuiaba, MT, BrasilFundação Oswaldo Cruz. Instituto Rene Rachou. Laboratorio de Imunologia Celular e Molecular. Belo Horizonte, MG, Brasil/ Instituto Nacional de Ciência e Tecnologia em Doencas Tropicais—INCT-DTUniversidade Federal de Minas Gerais. Instituto de Ciências Biologicas. Departamento de Morfologia. Laboratorio de Biologia das Interacões Celulares. Belo Horizonte, MG, BrasilChronic low-grade inflammation is related to the development of comorbidities and poor prognosis in obesity. Monocytes are main sources of cytokines and play a pivotal role in inflammation. We evaluated monocyte frequency, phenotype and cytokine profile of monocyte subsets, to determine their association with the pathogenesis of childhood obesity. Children with obesity were evaluated for biochemical and anthropometric parameters. Monocyte subsets were characterized by flow cytometry, considering cytokine production and activation/recognition molecules. Correlation analysis between clinical parameters and immunological data delineated the monocytes contribution for low-grade inflammation. We observed a higher frequency of non-classical monocytes in the childhood obesity group (CO) than normal-weight group (NW). All subsets displayed higher TLR4 expression in CO, but their recognition and antigen presentation functions seem to be diminished due to lower expression of CD40, CD80/86 and HLA-DR. All subsets showed a lower expression of IL-10 in CO and correlation analyses showed changes in IL-10 expression profile. The lower expression of IL-10 may be decisive for the maintenance of the low-grade inflammation status in CO, especially for alterations in non-classical monocytes profile. These cells may contribute to supporting inflammation and loss of regulation in the immune response of children with obesity