Los niveles en ayunas de Apolipoproteína b48 no son útiles como marcador de la Hiperliproteinemia tipo I

Los quilomicrones se encuentran elevados en las hiperlipoproteinemias tipo I y tipo V; diferenciar ambas requiere una tediosa ultracentrifugación. Esta comunicación trata de evaluar si la cuantificación en ayunas de la apolipoproteina B48 podría ser útil para diferenciarlasUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Efecto de las variantes genéticas en apoa5 en la activación de la lipoproteina lipasa y su asociación al síndrome de quilomicronemia familiar

La lipoproteína Lipasa (LPL) tiene entre sus activadores a la APO-AV, aunque existe controversia sobre si esta resulta esencial en la activación de la enzima. Nuestro objetivo fue estudiar el efecto de determinadas variantes genéticas en APOA5 presentes en 4 pacientes con historia de Hipertrigliceridemia Grave (HTG) sobre la actividad de la Lipoproteína Lipasa post-heparina in vitro y su asociación con las manifestaciones clínicas del Síndrome de Quilomicronemia Familiar (SQF). Material y métodos: Para estudiar la capacidad de activación del suero cada paciente sobre la actividad Lipoproteína Lipasa, se añadieron cantidades crecientes del suero pre-heparina de cada paciente, como fuente de APO-AV, a la mezcla de reacción (10, 20 y 40 µL; pre-calentados a 56 °C durante 60 minutos con PMSF al 0.1% (m/v)). En cada ensayo enzimático a punto final se empleó LPL de un plasma post-heparina (100 U/Kg) procedente de un individuo sano. Por otro lado, se estableció el perfil apolipoproteico mediante turbidimetría, ELISA y ultracentrifugación secuencial, se estableció la presencia de HPLI mediante el cálculo del cociente de triglicéridos en quilomicrones entre triglicéridos en VLDL y se recogieron datos clínicos y antropométricos. Resultados: PACIENTE RESUMEN DE VARIANTES GENÉTICAS EN APOA5 1 Hom c.758T>C 2 het c.758T>C & c.326_327insC 3 Het c.990_993delAACA & c.289C>T 4 het c.289C>T & c.50-2ª>G Los pacientes 1, 2 y 3, presentaron HPLI, y hospitalizaciones por episodios de pancreatitis. Además, los sueros pre-heparina de estos pacientes no activaron significativamente la actividad LPL (p<0.05). En cambio, el paciente 4 no presentó HPLI, no tuvo episodios de pancreatitis y su plasma pre-heparina sí activó significativamente la actividad LPL (p<0.05). Conclusiones: En pacientes con historia clínica de HTG, determinadas variantes genéticas en APOA5 no activan a la LPL, asociándose además a la presencia de HPLI y a una clínica compatible con SQF.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Lansoprazole Increases Inorganic Pyrophosphate in Patients with Pseudoxanthoma Elasticum: A Double-Blind, Randomized, Placebo-Controlled Crossover Trial

Pseudoxanthoma elasticum (PXE) is characterized by low levels of inorganic pyrophosphate (PPi) and a high activity of tissue-nonspecific alkaline phosphatase (TNAP). Lansoprazole is a partial inhibitor of TNAP. The aim was to investigate whether lansoprazole increases plasma PPi levels in subjects with PXE. We conducted a 2 × 2 randomized, double-blind, placebo-controlled crossover trial in patients with PXE. Patients were allocated 30 mg/day of lansoprazole or a placebo in two sequences of 8 weeks. The primary outcome was the differences in plasma PPi levels between the placebo and lansoprazole phases. 29 patients were included in the study. There were eight drop-outs due to the pandemic lockdown after the first visit and one due to gastric intolerance, so twenty patients completed the trial. A generalized linear mixed model was used to evaluate the effect of lansoprazole. Overall, lansoprazole increased plasma PPi levels from 0.34 ± 0.10 µM to 0.41 ± 0.16 µM (p = 0.0302), with no statistically significant changes in TNAP activity. There were no important adverse events. 30 mg/day of lansoprazole was able to significantly increase plasma PPi in patients with PXE; despite this, the study should be replicated with a large number of participants in a multicenter trial, with a clinical end point as the primary outcome.Funding for open access charge: Universidad de Málag

Structural and functional brain changes in middle-aged type 2 diabetic patients: a cross-sectional study.

Journal Article;BACKGROUND Type 2 diabetes mellitus (T2DM) is an emerging risk factor for cognitive impairment. Whether this impairment is a direct effect of this metabolic disorder on brain function, a consequence of vascular disease, or both, remains unknown. Structural and functional neuroimaging studies in patients with T2DM could help to elucidate this question. OBJECTIVE We designed a cross-sectional study comparing 25 T2DM patients with 25 age- and gender-matched healthy control participants. Clinical information, APOE genotype, lipid and glucose analysis, structural cerebral magnetic resonance imaging including voxel-based morphometry, and F-18 fluorodeoxyglucose positron emission tomography were obtained in all subjects. METHODS Gray matter densities and metabolic differences between groups were analyzed using statistical parametric mapping. In addition to comparing the neuroimaging profiles of both groups, we correlated neuroimaging findings with HbA1c levels, duration of T2DM, and insulin resistance measurement (HOMA-IR) in the diabetic patients group. Results: Patients with T2DM presented reduced gray matter densities and reduced cerebral glucose metabolism in several fronto-temporal brain regions after controlling for various vascular risk factors. Furthermore, within the T2DM group, longer disease duration, and higher HbA1c levels and HOMA-IR were associated with lower gray matter density and reduced cerebral glucose metabolism in fronto-temporal regions. CONCLUSION In agreement with previous reports, our findings indicate that T2DM leads to structural and metabolic abnormalities in fronto-temporal areas. Furthermore, they suggest that these abnormalities are not entirely explained by the role of T2DM as a cardiovascular risk factor.Ye

Plasma inorganic pyrophosphate and alkaline phosphatase in patients with pseudoxanthoma elasticum

Background: Inorganic pyrophosphate (PPi) plays a major role inhibiting dystrophic calcification. The aim was to analyze levels of PPi in patients having pseudoxanthoma elasticum (PXE), and controls as well as the enzymes who regulate the PPi plasma concentration. Methods: We collected fasting blood samples from PXE patients and age- and sex-matched controls in ethylenediamine tetraacetic acid (EDTA) and citrate-theophylline-adenosine-dipyridamole (CTAD) containing tubes. We measured PPi, ENPP1 mass and activity, alkaline phosphatase (AP) and tissue non-specific alkaline phosphatase (TNAP), CD73 and Human Platelet Factor-4 (CXCL4). Results: PPi in EDTA and CTAD samples were lower in PXE subjects than in controls (1.11±0.26 vs. 1.43±0.41 µM/L and 0.35±0.15 vs. 0.61±0.18 µM/L respectively, P<0.05). TNAP and liver TNAP activities were also higher in PXE than in controls (80.3±27.0 vs. 63.3±16.4 UI/L and 25.6±14.9 vs. 12.9±9.2 UI/L respectively, P<0.05). ENPP1 mass and activity as well as CD73 were almost identical. There was a weak but significant inverse correlation between TNAP activity and PPi levels (Pearson correlation −0.379, P<0.05) in both groups. Conclusions: High TNAP activity seems to contribute to low plasma levels of PPi in subjects with PXE, reinforcing the idea that pharmacological reduction of TNAP activity may help to reduce dystrophic calcification in PXE patients