Pigmentation and production of vitamins in mango (Mangifera indica L.)

Mango (Mangifera indica L.) is the fifth most cultivated vegetable in the world. One way to classify the mango is according to the color of the peel, they are classified as green, yellow and red. Color is a visual attribute that defines consumer preference in some countries. This diversity of pigmentation is defined by families of genes that code for the production of proteins, which lead to biosynthetic pathways responsible for the production of vitamins and their precursors. In Mexico there is a wide range of colors in the native mango germplasm, which could represent an important source of antioxidants, pigments and would bring benefits for the human health of Mexicans, through the consumption of fresh fruit, or commercial / industrial exploitation of these. According to the literature, this diversity of colors represents a genetic wealth that could be exploited in the genetic improvement programs of the species in the country, to generate new varieties with desirable characteristics in the national and international market. In order to gather and discuss information that contributes to understanding the biochemical and genetic processes that determine said pigmentation and the production of vitamins in mango, this review makes a description of the main genes involved and the biosynthetic pathways of the most common pigments, considering the impact on human health when consuming them, and highlighting the challenges and opportunities that could arise from the use of pigments from Mexican germplasm.Mango (Mangifera indica L.) is the fifth most cultivated plant in the world. One way to classify mango is according to the color of the skin; mangoes are classified as green,  yellow and red. Color is a visual attribute that defines consumer preference in some countries. This pigmentation diversity is defined by families of genes that encode for protein production, which lead to biosynthetic pathways responsible for the production of vitamins and vitamin precursors. In Mexico there is a wide range of colors in the native mango germplasm, which could represent an important source of antioxidants, pigments and would bring benefits to the human health of Mexicans, through the consumption of the fresh fruits, or the commercial/industrial exploitationof these. According to the literature, this diversity of colors represents a genetic richness that could be exploited in the genetic breeding programs of the species in the country, to generate new varieties with desirable characteristics in the national and international market. In order to gather and discuss information that contributes to the understanding of the biochemical and genetic processes that determine such pigmentation and the production of vitamins in mango, this review describes the main genes involved and the biosynthetic pathways of the most common pigments, considering the impact on human health when they are consumed, and highlighting the challenges and opportunities that could be derived from the utilization of pigmentsfrom the Mexican germplasm

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy