Regulación de la liberación de renina durante la hipertensión renovascular

La hipertensión es un síndrome cardiovascular progresivo que surge de etiologías complejas e interrelacionadas. Los marcadores tempranos del síndrome a menudo están presentes antes de que la elevación de la presión sanguínea sea observada. El desarrollo de la hipertensión arterial se asocia con anomalías cardíacas y vasculares funcionales y estructurales que dañan el corazón, los riñones, el cerebro, los vasos, y otros órganos, y conducen a la morbilidad y muerte prematura. El sistema renina angiotensina y los riñones son los principales mecanismos que subyacen para el desarrollo de la hipertensión. La renina es la enzima limitante para la síntesis de la angiotensina II; la liberación de renina está regulada por mecanismos como el barorreceptor intrarrenal, la mácula densa (MD) y el sistema nervioso simpático. Desde la MD son liberadas prostaglandinas vasodilatadoras (PG) como PGI2 y PGE2, generadas por la ciclooxigenasa 2, que inducen la liberación de renina de las células yuxtaglomerulares. En esta revisión, mostramos los mecanismos interrelacionados entre la ciclooxigenasa 2 de la MD y la angiotensina II renal

Worldwide dynamic biogeography of zoonotic and anthroponotic dengue

Dengue is a viral disease transmitted by mosquitoes. The rapid spread of dengue could lead to a global pandemic, and so the geographical extent of this spread needs to be assessed and predicted. There are also reasons to suggest that transmission of dengue from non-human primates in tropical forest cycles is being underestimated. We investigate the fine-scale geographic changes in transmission risk since the late 20th century, and take into account for the first time the potential role that primate biogeography and sylvatic vectors play in increasing the disease transmission risk. We apply a biogeographic framework to the most recent global dataset of dengue cases. Temporally stratified models describing favorable areas for vector presence and for disease transmission are combined. Our models were validated for predictive capacity, and point to a significant broadening of vector presence in tropical and non-tropical areas globally. We show that dengue transmission is likely to spread to affected areas in China, Papua New Guinea, Australia, USA, Colombia, Venezuela, Madagascar, as well as to cities in Europe and Japan. These models also suggest that dengue transmission is likely to spread to regions where there are presently no or very few reports of occurrence. According to our results, sylvatic dengue cycles account for a small percentage of the global extent of the human case record, but could be increasing in relevance in Asia, Africa, and South America. The spatial distribution of factors favoring transmission risk in different regions of the world allows for distinct management strategies to be prepared

Efecto hipoglucemiante y nefroprotector de Olea europea, Moringa oleifera y Chicorium intibus var en un modelo experimental de diabetes mellitus

La diabetes mellitus tiene una prevalencia del 14% en la República Mexicana, y la población sigue empleando en su tratamiento plantas medicinales, de las cuales se deben corroborar sus propiedades terapéuticas. Por lo que se estudiaron las propiedades hipoglucemiantes y nefroprotectoras de las hojas frescas de Olea europea, Moringa oleífera, y Chicorium intibus var, en un modelo de diabetes mellitus en ratas. Se trabajó con ratas machos, raza Wistar, a las que se les indujo diabetes mellitus por tratamiento con estreptozotocina 55 mg/kg, vía intraperitoneal. A partir del cuarto día se les administraron a ratas diabéticas los extractos etanólicos de las hojas frescas de las plantas (100 y 200 mg/kg, vía oral) durante 2 semanas. Por HPLC se determinaron flavonoides, ácidos fenólicos y terpenoides en los extractos. Se evaluaron la glucemia, la proteinuria y la hipertrofia renal. Los extractos de O. europea, M. oleífera, y C. intibus var mostraron efectos hipoglucemiantes y renoprotectores en las ratas diabéticas.Diabetes mellitus has a prevalence of 14% in the Mexican Republic, and the population continues to use medicinal plants in their treatment, of which their therapeutic properties must be corroborated. To study the hypoglycemic and nephroprotective properties of fresh leaves of Olea europea, Moringa oleifera, and Chicorium intibus var. in a model of diabetes mellitus in rats. Diabetes mellitus was induced in rats by treatment with streptozotocin 55 mg/kg, intraperitoneally. From the fourth day, ethanolic extracts from fresh leaves of plants (100 and 200 mg/kg, orally) were given to diabetic rats for 2 weeks. Flavonoids, phenolic acids, and terpenoids were determined by HPLC in extracts. Blood glucose, proteinuria and renal hypertrophy were evaluated. Extracts of O. europea, M. oleifera, and C. intibus var showed hypoglycaemic and renoprotective effects in diabetic rats

Análisis del riesgo de transmisión de la encefalitis vírica por garrapatas: una aproximación biogeográfica

La garrapata Ixodes ricinus es el principal vector de la encefalitis vírica europea, una zoonosis que afecta a gran parte del continente europeo. En el ciclo zoonótico de esta enfermedad los micromamíferos son reservorios del virus, mientras que otros hospedadores, generalmente cérvidos, favorecen su presencia al llevar consigo garrapatas infectadas. La biogeografía aplicada a la elaboración de modelos de distribución, a través de la Función de Favorabilidad, permite la detección de áreas con potencial de riesgo de transmisión al ser humano. La identificación de nuevas áreas de transmisión proporciona información esencial a las autoridades sanitarias para la prevención y la respuesta rápida frente a nuevos brotes.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Efecto de las vitaminas antioxidantes C y E sobre la hipertrofia renal en ratas diabéticas

La estimulación de las enzimas antioxidantes en el riñón puede disminuir las complicaciones renales en la diabetes mellitus (DM). En este trabajo se estudió el efecto de las vitaminas C y E como antioxidantes en el daño renal producido por la DM. La DM se indujo con estreptozotocina 65 mg/kg, vía intraperitoneal. A las ratas DM se les administraron las vitaminas E y C en dosis de 250 y 500 mg/kg, vía oral, durante 2 semanas. Las vitaminas C y E restablecieron la función renal en ratas diabéticas: aumentaron la depuración de creatinina y disminuyeron la proteinuria; se observó una disminución del peso del riñón, del área celular tubular proximal y del coeficiente proteínas/DNA, aumentaron la actividad de las enzimas catalasa, superóxido dismutasa y glutatión peroxidasa. Así, las vitaminas E y C restauran las enzimas antioxidantes y retardan el desarrollo de la hipertrofia renal diabéticaStimulation of antioxidant enzymes in the kidney can decrease kidney complications in diabetes mellitus (DM). This paper studied the effect of vitamins C and E as antioxidants on kidney damage caused by DM. DM was induced with streptozotocin 65 mg/kg, intraperitoneally. DM rats were given vitamins E and C in doses of 250 and 500 mg/kg orally for 2 weeks. Vitamins C and E restored renal function in diabetic rats: they increased creatinine purification and decreased proteinuria; a decrease in kidney weight, proximal tubular cell area and protein/DNA coefficient were observed, increased the activity of the enzymes catalase, superoxide dismutase and glutathione peroxidase. Thus, vitamins E and C restore antioxidant enzymes and slow the development of diabetic renal hypertrophy

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Regulación de la liberación de renina durante la hipertensión renovascular

Hypertension is a progressive cardiovascular syndrome arising from complex and interrelated etiologies. Early markers of the syndrome are often present before blood pressure elevation is observed. The development of arterial hypertension is associated with functional and structural cardiac and vascular abnormalities that damage the heart, kidneys, brain, vasculature, and other organs, and lead to morbidity and premature death. The kidney and the renin angiotensin system are the principal mechanisms that underlie for development of hypertension. Renin is the rate limiting enzyme for angiotensin II synthesis, and renin release is regulated by mechanisms as the intrarenal baroreceptor, the macula densa (MD) and the sympathetic nervous system. The MD releases vasodilator prostaglandins (PG) as PGI2 and PGE2, generated by cyclooxygenase 2, which induce renin release from juxtaglomerular cells. In this review, we show interrelated mechanisms between cyclooxygenase 2 of MD and renal angiotensin II.La hipertensión es un síndrome cardiovascular progresivo que surge de etiologías complejas e interrelacionadas. Los marcadores tempranos del síndrome a menudo están presentes antes de que la elevación de la presión sanguínea sea observada. El desarrollo de la hipertensión arterial se asocia con anomalías cardíacas y vasculares funcionales y estructurales que dañan el corazón, los riñones, el cerebro, los vasos, y otros órganos, y conducen a la morbilidad y muerte prematura. El sistema renina angiotensina y los riñones son los principales mecanismos que subyacen para el desarrollo de la hipertensión. La renina es la enzima limitante para la síntesis de la angiotensina II; la liberación de renina está regulada por mecanismos como el barorreceptor intrarrenal, la mácula densa (MD) y el sistema nervioso simpático. Desde la MD son liberadas prostaglandinas vasodilatadoras (PG) como PGI2 y PGE2, generadas por la ciclooxigenasa 2, que inducen la liberación de renina de las células yuxtaglomerulares. En esta revisión, mostramos los mecanismos interrelacionados entre la ciclooxigenasa 2 de la MD y la angiotensina II renal

Extracellular Vesicles Secreted by <i>Acanthamoeba culbertsoni</i> Have COX and Proteolytic Activity and Induce Hemolysis

Several species of Acanthamoeba genus are potential pathogens and etiological agents of several diseases. The pathogenic mechanisms carried out by these amoebae in different target tissues have been documented, evidencing the relevant role of contact-dependent mechanisms. With the purpose of describing the pathogenic processes carried out by these protozoans more precisely, we considered it important to determine the emission of extracellular vesicles (EVs) as part of the contact-independent pathogenicity mechanisms of A. culbertsoni, a highly pathogenic strain. Through transmission electronic microscopy (TEM) and nanoparticle tracking analysis (NTA), EVs were characterized. EVs showed lipid membrane and a size between 60 and 855 nm. The secretion of large vesicles was corroborated by confocal and TEM microscopy. The SDS-PAGE of EVs showed proteins of 45 to 200 kDa. Antigenic recognition was determined by Western Blot, and the internalization of EVs by trophozoites was observed through Dil-labeled EVs. In addition, some EVs biological characteristics were determined, such as proteolytic, hemolytic and COX activity. Furthermore, we highlighted the presence of leishmanolysin in trophozites and EVs. These results suggest that EVs are part of a contact-independent mechanism, which, together with contact-dependent ones, allow for a better understanding of the pathogenicity carried out by Acanthamoeba culbertsoni