Evidence of a kallikrein inhibitor in human kidney. A new ring of the kallikrein-renin-angiotensin-aldosterone chain

By means of immunohistochemical reactions, the authors proved the inhibitor II-related immunoreactivity in distal convoluted tubules of human kidney. A sharp inhibitor II-related immunoreactivity was also present in the blood vessels' wall. On the contrary, in the wall of proximal tubules and glomeruli only low reactivity was found. The demonstration of an inhibitor II-related immunoreactivity in the distal convoluted tubules and vessels of human kidney represents a strong evidence that an inhibitor of kallikrein exists and acts also in humans as an important key in the kallikrein-renin-angiotensin aldosterone chain and hitherto confirms the experimental data of the literature. The proved inhibitor in the human kidney may intervene in the modulation of the kallikrein-kinin system and thus represents a key role in the intrarenal mechanisms related to the blood flow and arterial pressure regulation

ORAL BACTERIA MICROBIOME IN CAROTID ATHEROSCLEROTIC PLAQUE

INTRODUZIONE L\u2019arterosclerosi \ue8 una patologia frequente che porta ad un aumento di morbilit\ue0 e mortalit\ue0(1) \ue8 infatti una delle maggiori cause di mortalit\ue0 ed un terzo della popolazione ha qualche manifestazione di tale patologia (coronaropatia, cerebrovasculopatia e/o vasculopatia periferica)(2). Tuttavia, circa la met\ue0 dei pazienti affetti da arterosclerosi non presenta i tradizionali fattori di rischio cardiovascolari e la causa della progressione delle placche arteriosclerotiche non \ue8 del tutto chiara. E\u2019 noto che alcuni microrganismi possono avere un ruolo nella patogenesi dell\u2019arteriosclerosi e possono rappresentare importanti fattori di rischio in alcuni pazienti non affetti dai tradizionali fattori di rischio. Tra i differenti microrganismi batterici i periodontopatogeni sono tra i maggiori indiziati vista l\u2019infiammazione cronica che causano ed \ue8 inoltre dimostrato come dal punto di vista epidemiologico vi sia un aumento di prevalenza ed incidenza di coronaropatia nei pazienti con periodontiti(4). MATERIALI E METODI Abbiamo disegnato uno studio prospettico monocentrico con l\u2019obiettivo di verificare la presenza di microbioma batterico all\u2019interno delle placche carotidee e di evidenziare la coesistenza dello stesso microbioma nella placca carotide e sottogengivale in ogni singolo paziente. Sei pazienti candidati ad endoarterectomia carotidea sono stati arruolati e sottoposti a valutazione odontoiatrica approfondita con prelievo di placca sottogengivale. Durante l\u2019intervento chirurgico un campione di placca carotide \ue8 stato raccolto e successivamente trattato. RISULTATI Il microbioma di almeno un periodontopatogeno \ue8 stato individuato in ogni placca orale. Nei campioni di placca carotide non \ue8 stato invece possibile rilevare la presenza di microbioma batterico. CONCLUSIONI La presenza di DNA batterico nelle placche arteriosclerotiche \ue8 tutt\u2019oggi argomento discusso. I dati presenti in letteratura supportano ma non dimostrano una associazione causale tra infezione periodontale ed aterosclerosi. Tuttavia, alcuni studi, come il nostro, non hanno trovato periodontopatogeni all\u2019interno di placche aterosclerotiche quindi la trasmissione di tali batteri a livello delle placche ed il loro ruolo \ue8 ancor motivo di discussione(5, 6). Bibliografia 1. Buhlin K, Hultin M, Norderyd O, Persson L, Pockley AG, Rabe P, et al. Risk factors for atherosclerosis in cases with severe periodontitis. J Clin Periodontol. 2009;36(7):541-9. 2. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-44. 3. Trevisan M, Dorn J. The relationship between periodontal disease (pd) and cardiovascular disease (cvd). Mediterr J Hematol Infect Dis. 2010;2(3):e2010030. 4. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J. 2007;154(5):830-7. 5. Cairo F, Gaeta C, Dorigo W, Oggioni MR, Pratesi C, Pini Prato GP, et al. Periodontal pathogens in atheromatous plaques. A controlled clinical and laboratory trial. J Periodontal Res. 2004;39(6):442-6. 6. Aimetti M, Romano F, Nessi F. Microbiologic analysis of periodontal pockets and carotid atheromatous plaques in advanced chronic periodontitis patients. J Periodontol. 2007;78(9):1718-23.INTRODUCTION Atherosclerosis is a highly prevalent disease in humans with significant morbidity and mortality(1) and is one of the leading cause of death and one third of population have some form of the disease, which includes coronary disease, cerebrovascular disease and peripheral artery disease(2). However, half of those with the disease do not have traditional cardiovascular risk factors such as obesity, hypercholesterolemia, hypertension, history of smoking or genetic background(3), and thus the cause(s) of rapid atherosclerotic plaque progression and disease is unknown in many patients. There is a body of evidence that microorganisms play a role in the pathogenesis of atherosclerosis and may be a primary risk factor in people who do not suffer from other established risk factors. Among the various infectious agents, periodontal pathogens are prominent contenders because of the chronic inflammation associated with periodontal disease and there is also a significantly increased prevalence and incidence of coronary artery disease indicating that periodontal disease predicts coronary artery disease(4). MATHERIALS AND METHODS In this prospective monocentric study and the aim is to ascertain the presence of periodontal bacterial DNA in carotid atheromatous plaque and to assess the concomitant presence of the same microbiome, if any, in both periodontal pockets and carotid atheroma. Six patients scheduled to undergo Carotid endarterectomy were recruited and underwent periodontal evaluation with sub gingival plaque collection and vascular surgery with atherosclerotic plaque collection. RESULTS The DNA of at least one of the probed bacteria was detected in each subgingival samples. The carotid specimens of all 6 patients revealed evidence of severe atherosclerosis but no enough DNA of periodontal bacteria was detected in any of the carotid samples. CONCLUSIONS The presence of bacterial DNA in atheromatous plaques still remains a controversial issue. The cumulative evidence in the literature supports, but does not prove, a causal association between periodontal infection and atherosclerotic cardiovascular disease or its sequelae. However, several studies, as ours, were not able to find periopathogens in atherosclerotic plaques, and hence, the transmission of bacteria from the oral cavity to atherosclerotic plaques and possible effects are still under debate(5, 6). Bibliografia 1. Buhlin K, Hultin M, Norderyd O, Persson L, Pockley AG, Rabe P, et al. Risk factors for atherosclerosis in cases with severe periodontitis. J Clin Periodontol. 2009;36(7):541-9. 2. Lockhart PB, Bolger AF, Papapanou PN, Osinbowale O, Trevisan M, Levison ME, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association?: a scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-44. 3. Trevisan M, Dorn J. The relationship between periodontal disease (pd) and cardiovascular disease (cvd). Mediterr J Hematol Infect Dis. 2010;2(3):e2010030. 4. Bahekar AA, Singh S, Saha S, Molnar J, Arora R. The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis. Am Heart J. 2007;154(5):830-7. 5. Cairo F, Gaeta C, Dorigo W, Oggioni MR, Pratesi C, Pini Prato GP, et al. Periodontal pathogens in atheromatous plaques. A controlled clinical and laboratory trial. J Periodontal Res. 2004;39(6):442-6. 6. Aimetti M, Romano F, Nessi F. Microbiologic analysis of periodontal pockets and carotid atheromatous plaques in advanced chronic periodontitis patients. J Periodontol. 2007;78(9):1718-23

DEPOSIZIONE AUTOCATALITICA DI COMPOSITI A MATRICE NI-P

Nel presente lavoro è stata studiata la deposizione autocatalitica di compositi Ni-P-B4C, Ni-P-CNT e Ni-PAl2O3 attraverso l’impiego di un elettrolita a base di sodio ipofosfito in cui sono state disperse particelle nanometriche di B4C, CNT e Al2O3. La dimensione delle particelle di Al2O3 e B4C è compresa rispettivamente tra 50-70 nm e 25-30 nm. I nanotubi di carbonio presentano un diametro compreso tra 10-30 nm. Per ciascun tipo di composito, sono state effettuate prove con concentrazioni comprese tra 0 e 4 g/l. Sono stati studiati gli effetti della concentrazione di particelle all’interno del bagno sulla velocità di deposizione, sulle caratteristiche meccaniche e sulle proprietà tribologiche dei depositi

Venous wall ultrastructure in generalized venomegaly.

The ultrastructure of thè v. colica sinistra in a case of generalized vasomegaìy in man was examined. Elastic material was found in three forms: as a lightly osmiophii amorphous material bordering on myocytes, as a highly osmiophii elastic membrana, and as highly osmiophii slim elastic fibres of different orientation in thè tunica media and adventitia. The slightly osmiophii elastic material is assumed to be newly formed. by pinocytotic activity of thè myocytes. The highly osmiophii elastic material indicatss its impairment. No typical atherosclerotic changes were found in thè examined vein. Based on a comparison with previous findings in thè case of vasomegaìy of thè a. mesenterica inferior, thè authors conclude that thè venomegaly phenomenon is connected with degenerative changes in thè elastic material of thè vessel wall

Endothelial Dysfunction in Patients with Severe Mitral Regurgitation

Mitral valve prolapse (MVP) is the most common cause of severe mitral regurgitation. It has been reported that MVP patients-candidates for mitral valve repair (MVRep)-showed an alteration in the antioxidant defense systems as well as in the L-arginine metabolic pathway. In this study, we investigate if oxidative stress and endothelial dysfunction are an MVP consequence or driving factors. Forty-five patients undergoing MVRep were evaluated before and 6 months post surgery and compared to 29 controls. Oxidized (GSSG) and reduced (GSH) forms of glutathione, and L-arginine metabolic pathway were analyzed using liquid chromatography-tandem mass spectrometry methods while osteoprotegerin (OPG) through the ELISA kit and circulating endothelial microparticles (EMP) by flow cytometry. Six-month post surgery, in MVP patients, the GSSG/GSH ratio decreased while symmetric and asymmetric dimethylarginines levels remained comparable to the baseline. Conversely, OPG levels significantly increased when compared to their baseline. Finally, pre-MVRep EMP levels were significantly higher in patients than in controls and did not change post surgery. Overall, these results highlight that MVRep completely restores the increased oxidative stress levels, as evidenced in MVP patients. Conversely, no amelioration of endothelial dysfunction was evidenced after surgery. Thus, therapies aimed to restore a proper endothelial function before and after surgical repair could benefit MVP patients

Anomalous codeposition of cobalt and ruthenium from chloride-sulfate baths

Codeposition of Ru and Co was studied at room temperature and at 50oC with various Ru3+ and Co2+ concentrations in the electrolyte. The codeposition of Co and Ru proved to be anomalous since no pure Ru could be obtained in the presence of Co2+ in the electrolyte, but a significant Co incorporation into the deposit was detected at potentials where the deposition of pure Co was not possible. The composition of the deposits varied monotonously with the change of the concentration ratio of Co2+ and Ru3+. The deposition of Ru was much hindered and the current efficiency was a few percent only when the molar fraction of Co in the deposit was low. Continuous deposits could be obtained only when the molar fraction of Co in the deposit was at least 40 at.%. The deposit morphology was related to the molar fraction of Co in the deposit. The X-ray diffractograms are in conformity with a hexagonal close-packed alloy and indicate the formation of nanocrystalline deposits. Two-pulse plating did not lead to a multilayer but to a Co-rich alloy. Magnetoresistance of the samples decreased with increasing Ru content

Impact of Valve Morphology on the Prevalence of Coronary Artery Disease : A Systematic Review and Meta-Analysis

Background-Literature studies suggested a lower prevalence of coronary artery disease (CAD) in bicuspid aortic valve (BAV) than in tricuspid aortic valve (TAV) patients. However, this finding has been challenged. We performed a meta-analysis to assess whether aortic valve morphology has a different association with CAD, concomitant coronary artery bypass grafting (CABG), and postoperative mortality. Methods and Results-Detailed search was conducted according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline to identify all patients with BAV or TAV and presence of CAD, concomitant myocardial surgical revascularization, and the postoperative mortality. Thirty-one studies on 3017 BAV and 4586 TAV patients undergoing aortic valve surgery were included. BAV patients showed a lower prevalence of CAD (odds ratio [OR]: 0.33; 95% CI: 0.17, 0.65), concomitant CABG (OR, 0.45; 95% CI: 0.35, 0.59), and postoperative mortality (OR, 0.62; 95% CI: 0.40, 0.97) than TAV. However, BAV subjects were significantly younger than TAV (mean difference: -7.29; 95% CI: -11.17, -3.41) were more frequently males (OR, 1.61; 95% CI: 1.33, 1.94) and exhibited a lower prevalence of hypertension (OR, 0.58; 95% CI: 0.39, 0.87) and diabetes (OR, 0.71; 95% CI: 0.54, 0.93). Interestingly, a metaregression analysis showed that younger age and lower prevalence of diabetes were associated with lower prevalence of CAD (Z value: -3.03; P=0.002 and Z value: -3.10; P=0.002, respectively) and CABG (Z value: -2.69; P=0.007 and Z value: -3.36; P=0.001, respectively) documented in BAV patients. Conclusions-Analysis of raw data suggested an association of aortic valve morphology with prevalence of CAD, concomitant CABG, and postoperative mortality. Interestingly, the differences in age and diabetes have a profound impact on prevalence of CAD between BAV and TAV. In conclusion, our meta-analysis suggests that the presence of CAD is independent of aortic valve morphology

Impact of Fractional Flow Reserve Derived from Coronary Computed Tomography Angiography on Heart Team Treatment Decision-Making in Patients with Multivessel Coronary Artery Disease: Insights from the SYNTAX III REVOLUTION Trial

Background: Fractional flow reserve (FFR) is a reliable tool for the functional assessment of coronary stenoses. FFR computed tomography (CT) derived (FFRCT) has shown to be accurate, but its clinical usefulness in patients with complex coronary artery disease remains to be investigated. The present study sought to determine the impact of FFRCT on heart team's treatment decision-making and selection of vessels for revascularization in patients with 3-vessel coronary artery disease. Methods: The trial was an international, multicenter study randomizing 2 heart teams to make a treatment decision between percutaneous coronary interventions and coronary artery bypass grafting using either coronary computed tomography angiography or conventional angiography. The heart teams received the FFRCT and had to make a treatment decision and planning integrating the functional component of the stenoses. Each heart team calculated the anatomic SYNTAX score, the noninvasive functional SYNTAX score and subsequently integrated the clinical information to compute the SYNTAX score III providing a treatment recommendation, that is, coronary artery bypass grafting, percutaneous coronary intervention, or equipoise coronary artery bypass grafting-percutaneous coronary intervention. The primary objective was to determine the proportion of patients in whom FFRCT changed the treatment decision and planning. Results: Overall, 223 patients were included. Coronary computed tomography angiography assessment was feasible in 99% of the patients and FFRCT analysis in 88%. FFRCT was available for 1030 lesions (mean FFRCT value 0.64\ub113). A treatment recommendation of coronary artery bypass grafting was made in 24% of the patients with coronary computed tomography angiography with FFRCT. The addition of FFRCT changed the treatment decision in 7% of the patients and modified selection of vessels for revascularization in 12%. With conventional angiography as reference, FFRCT assessment resulted in reclassification of 14% of patients from intermediate and high to low SYNTAX score tertile. Conclusions: In patients with 3-vessel coronary artery disease, a noninvasive physiology assessment using FFRCT changed heart team's treatment decision-making and procedural planning in one-fifth of the patients