Salivary Gland Transcriptomes and Proteomes of Phlebotomus tobbi and Phlebotomus sergenti, Vectors of Leishmaniasis

Phlebotomine female sand flies require a blood meal for egg development, and it is during the blood feeding that pathogens can be transmitted to a host. Leishmania parasites are among these pathogens and can cause disfiguring cutaneous or even possibly fatal visceral disease. The Leishmania parasites are deposited into the bite wound along with the sand fly saliva. The components of the saliva have many pharmacologic and immune functions important in blood feeding and disease establishment. In this article, the authors identify and investigate the protein components of saliva of two important vectors of leishmaniasis, Phlebotomus tobbi and P. sergenti, by sequencing the transcriptomes of the salivary glands. We then compared the predicted protein sequences of these salivary proteins to those of other bloodsucking insects to elucidate the similarity in composition, structure, and enzymatic activity. Finally, this descriptive analysis of P. tobbi and P. sergenti transcriptomes can aid future research in identifying molecules for epidemiologic assays and in investigating sand fly-host interactions

Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial

Aims  The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results  Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion  After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p

Prevalence of vitamin D deficiency during the summer and its relationship with sun exposure and skin phototype in elderly men living in the tropics

Marcelo Azevedo Cabral,1 Carla N&uacute;bia Borges,1 Juliana Maria Coelho Maia,1 Caio Augusto Martins Aires,2 Francisco Bandeira3 1Department of Clinical Medicine, University of Pernambuco Medical School, 2Department of Biomedicine, University of Pernambuco Medical School, 3Division of Endocrinology, University of Pernambuco Medical School, Recife, Brazil Objective: The aim of the study reported here was to determine the prevalence of vitamin D deficiency among elderly men and its association with sun exposure and skin phototypes. Subjects and methods: This was an analytical cross-sectional study, which involved 284 men aged 60 years or over, randomly recruited from a basic care unit in the city of Recife (Brazil). Measurements: Serum levels of 25 hydroxyvitamin D (25(OH)D), sun index, and skin phototypes were evaluated. Results: The prevalence of vitamin D deficiency was 31.5% and 66.7% when cut points of less than 20 and 30 ng/mL, respectively, were used. Mean serum 25(OH)D was 27.86 &plusmn; 13.52 standard deviation (SD) ng/mL. There was no difference (P = 0.113) in 25(OH)D (23.98 &plusmn; 14.66 SD vs 29.88 &plusmn; 13.78 SD) between individuals in the lowest quartile (Q) of the sun index (Q1: 1.96) compared with those in the highest (Q4: 7.86). When considering a cutoff of 20 ng/mL, the sun index was different in the two groups (P = 0.006), but there was no difference when cutoffs of 25 and 30 ng/mL were used. After adjustment, sun index and body mass index were associated positively and negatively, respectively with serum 25(OH)D independently. Most subjects (66.7%) had Fitzpatrick&rsquo;s skin phototypes IV, V, and VI. Low calcium intake was observed in 72%. There was no difference in serum 25(OH)D levels between patients with low intake and those with intermediate and high intakes. Only 2.5% were taking a vitamin supplement. Conclusion: We found a high prevalence of vitamin D deficiency among elderly men despite their high sun exposure during the summer months. Keywords: sun index, serum 25(OH)D levels, body mass index, Brazi