Caracterización del gen de la dopamina B-hidroxilasa en población mestiza colombiana

La dopamina B-hidroxilasa cataliza la conversión de dopamina en norepinefrina y es blanco promisorio de intervenciones farmacológicas. Polimorfismos del gen DBH son responsables de las diferencias individuales en el tono dopaminérgico y adrenérgico de los sistemas nervioso central y autónomo. Ya que las mutaciones defectuosas de la enzima y sus frecuencias varían entre las etnias, se justifican los estudios conducentes a la caracterización genotípica y fenotípica de la enzima en mestizos colombianos

Stratification of radiosensitive brain metastases based on an actionable S100A9/RAGE resistance mechanism

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.Whole-brain radiotherapy (WBRT) is the treatment backbone for many patients with brain metastasis; however, its efficacy in preventing disease progression and the associated toxicity have questioned the clinical impact of this approach and emphasized the need for alternative treatments. Given the limited therapeutic options available for these patients and the poor understanding of the molecular mechanisms underlying the resistance of metastatic lesions to WBRT, we sought to uncover actionable targets and biomarkers that could help to refine patient selection. Through an unbiased analysis of experimental in vivo models of brain metastasis resistant to WBRT, we identified activation of the S100A9-RAGE-NF-κB-JunB pathway in brain metastases as a potential mediator of resistance in this organ. Targeting this pathway genetically or pharmacologically was sufficient to revert the WBRT resistance and increase therapeutic benefits in vivo at lower doses of radiation. In patients with primary melanoma, lung or breast adenocarcinoma developing brain metastasis, endogenous S100A9 levels in brain lesions correlated with clinical response to WBRT and underscored the potential of S100A9 levels in the blood as a noninvasive biomarker. Collectively, we provide a molecular framework to personalize WBRT and improve its efficacy through combination with a radiosensitizer that balances therapeutic benefit and toxicity.info:eu-repo/semantics/publishedVersio

Is diet partly responsible for differences in COVID-19 death rates between and within countries?

Correction: Volume: 10 Issue: 1 Article Number: 44 DOI: 10.1186/s13601-020-00351-w Published: OCT 26 2020Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit.Peer reviewe

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

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Caracterización del gen de la dopamina β-hidroxilasa en población mestiza colombiana

Introducción: la dopamina β-hidroxilasa cataliza la conversión de dopamina en norepinefrina y es blanco promisorio de intervenciones farmacológicas. Polimorfismos del gen DβH son responsables de las diferencias individuales en el tono dopaminérgico y adrenérgico de los sistemas nervioso central y autónomo. Ya que las mutaciones defectuosas de la enzima y sus frecuencias varían entre las etnias, se justifican los estudios conducentes a la caracterización genotípica yfenotípica de la enzima en mestizos colombianos. Métodos: determinamos las frecuencias de los alelos -2073C&gt;T, -970C&gt;T, 444A&gt;G y 1603C&gt;T del gen DβH en 143 adultos sanos, rasgos mestizos, ambos sexos y no consanguíneos. La genotipificación se hizo por PCR-real time y minisecuenciación (SnaPshot). Resultados: las frecuencias de los genotipos polimórficos fueron: -2073C&gt;T (CC61,5%, CT 32,9%, TT 5,6%), -970C&gt;T (CC 49,6%, CT 43,4, TT 7%) y 444A&gt;G (AA 42%, AG 41,2%, GG 16,8%). Las tres mutaciones están en desequilibrio de ligamiento (D´=1) pero no se sustituyen mutuamente (r2&lt;0,8). 15 personas (10,5%) tuvieron haplotipo de triple homocigoto nativo (CC/CC/AA). Conclusión: nuestras frecuencias alélicas se asemejan a las reportadas en otros grupos mestizos latinoamericanos.AbstractIntroduction: dopamine β- hidroxylase catalyzes the conversion of dopamine to norepinephrine and it is a promising target for pharmacological inventions. DβH gene polymorphisms are responsible for individual differences in dopaminergic and adrenergic tone of the central and autonomic nervous systems. Since defective enzyme mutations and their frequencies vary among ethnic groups, it is justify the studies leading to the genotypic and phenotypic characterization of the enzyme in Colombian mestizos. Methods: we determined the frequencies of the alleles -2073C&gt;T, -970C&gt;T, 444A&gt;G and 1603C&gt;T DβH gene in 143 healthy adults, mestizo features, both sexes and nonconsanguineous. PCR-real time and minisequencing (SnaPshot)tecnhiques were used for the genotyping. Results: the frequencies of polymorphic genotypes were: -2073C&gt;T (CC 61,5%, CT 32,9%, TT 5,6%), -970C&gt;T (CC 49,6%, CT 43,4, TT 7%) and 444A&gt;G (AA42%, AG 41,2%, GG 16,8%).The three alleles are in linkage disequilibrium (D´=1) but they do not replace each other (r2&lt;0,8). 15 people (10,5%) had the homozygous triple native haplotype (CC/CC/AA). Conclusion: our allelic frequencies are similar to those reported in other Latin American mestizo groups.Keywords Dopamine β-Hydroxylase; Pharmacogenetics; Genotype; Genetic polymorphism

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

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. 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: A total of 3120 patients with IE (1327  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 th