Relationship between circulating VCAM-1, ICAM-1, E-selectin and MMP9 and the extent of coronary lesions

OBJECTIVES: Inflammatory molecules play a role in the development of atherosclerosis, which is the primary origin of cardiovascular disorders. However, to the best of our knowledge, no study has attempted to investigate the relationship between these circulating molecules and the prediction of cardiovascular risk. The present study aimed to investigate the relationships of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 serum concentrations with the extent of coronary lesions. METHODS: Seventy-four individuals who were undergoing coronary angiography for the first time for diagnostic purposes were enrolled in this study. The extent of the coronary lesion was assessed using the Friesinger Index, and subjects were classified into four groups: no lesions, minor lesions, intermediate lesions and major lesions. Serum biochemical parameters and serum concentrations of vascular cell adhesion molecule-1, intercellular adhesion molecule-1, E-selectin and matrix metalloproteinase 9 were analyzed. RESULTS: The vascular cell adhesion molecule-1 concentration was higher than 876 ng/mL in individuals with intermediate and major lesions (

Transcriptomic and proteomic of peripheral blood as approaches to biomarkers cardiovascular discovers

INTRODUÇÃO: A principal manifestação clínica da doença aterosclerótica é o infarto agudo do miocárdio, caracterizada como emergência médica, que necessita de diagnóstico correto, rápido, preciso e terapia eficaz. Os estudos de transcriptoma e proteoma possibilitam obter informações que nos permite compreender de forma mais abrangente a evolução fisiopatológica das doenças, sendo as cardiovasculares particularmente favorecidas por terem etiologia multifatorial e sem dúvida multigênica, portanto a utilização destas ferramentas num modelo de doença aguda pode auxiliar, de forma singular, na obtenção de novas informações, tais como novos marcadores precoces de injúria. OBJETIVO: Identificar novos biomarcadores de doenças cardiovasculares através da análise do perfil de expressão de RNAm de células do sangue periférico e proteínas plasmáticas de pacientes com SCA. CASUÍSTICA E MÉTODOS: É um estudo caso-controle de pacientes com SCA recrutados no Pronto-Socorro do Instituto Dante Pazzanese de Cardiologia. Foram recrutados 84 indivíduos com Síndrome Coronariana Aguda (SCA), 47 indivíduos sem doença cardiovascular (grupo controle), de ambos os sexos com idade entre 30 a 65 anos, atendidos no Instituto Dante Pazzanese do Estado de São Paulo - Brasil. A avaliação de expressão gênica global de 10 pacientes e 6 controles (pareados) durante as primeiras 48 h após o IAM foi realizada através dos microarranjos de DNA (sistema Affymetrix) e a análise de plasma por separação em sistema de microarranjos (ProteinChip®), seguida da identificação e quantificação por espectrometria de massa, em sistema SELDI-TOF/MS. Os resultados de microarranjo de DNA foram validados tecnicamente (a partir das mesmas amostras processadas por microarranjo de DNA) e, posteriormente validados biologicamente (a partir das outras amostras não processadas por microarranjo de DNA) através da PCR em tempo real. RESULTADOS: Foram observados ao total 599 genes diferentemente expressos nas primeiras 48 h após IAM. Trinta e três genes foram selecionados e submetidos à validação técnica, sendo que destes, 20 genes foram submetidos à validação biológica através da PCR em tempo real. Os validados foram: ALOX15, AREG, BCL2A1, BCL2L1, CA1, COX7B, ECDHC3,KCNE1, IL18R1, IRS2, MYL4, MMP9 e TREML4. Na análise, foram identificados 479 espectros de proteínas plasmáticas diferentemente expressos em relação ao controle, destes destacam-se 16 possíveis proteínas correspondentes ao peso molecular entre 6386.5 Da e 17807,7 Da. CONCLUSÃO: Os resultados desses estudos sugerem novos marcadores para avaliação da síndrome coronariana aguda e provavelmente com valor prognóstico importante.BACKGROUND: The main clinical manifestation of atherosclerosis is the acute myocardial infarction (AMI), which is a medical emergency that requires prompt diagnosis and efficient therapy. The transcriptomic and proteomic approaches are both powerful tools for the study of AMI and may be instrumental to identify news biomarkers involved in the inflammatory and apoptotic process of cardiovascular diseases. OBJECTIVE: The aim of this study is to determine the gene expression of RNAm and protein in blood cells following an AMI to identify new biomarkers. PATIENTS AND METHODS: For this study eighty four patients with acute coronary syndrome (ACS) and forty seven control individuals were selected among patients of the Instituto Dante Pazzanese, São Paulo state, Brazil. A global gene expression profile by GeneChip® Exon 1.0 ST Array (Affymetrix) and proteomic plasma profile by ProteinChip® Biomarker System and SELDI-TOF/MS were evaluated for ten patients from the ACS group and six from the control group. These patients were followed up for the first 48 h following the AMI. The genes differently expressed by microarray analysis were submitted to technical (same casuistic) and biologic (new casuistic) validation by PCR real time. RESULTS: 599 genes were differentially expressed at the first 48 h after AMI. Thirty-three genes were selected and submitted to the technical validation, and 20 were subjected to biological validation by real time PCR afterwards. The validated ones were: ALOX15, Areg, BCL2A1, BCL2L1, CA1, COX7B, ECDHC3, KCNE1, IL18R1, IRS2, MYL4, MMP9 and TREML4. At proteomic analysis, 479 peaks of plasma proteins differentially expressed were identified. 16 peaks were considered as high potentially biomarkers. Their molecular weight was between 6386.5 Da and 17807.7 Da. CONCLUSION: Results from this study were able to identify changes in gene and protein profiles in the plasma, and suggest new markers for evaluation of acute coronary syndrome and probably with important prognostic value

Circulating MicroRNAs as Potential Biomarkers of Atrial Fibrillation

Atrial fibrillation (AF) is the most common supraventricular arrhythmia in the population. MicroRNAs (small endogenous noncoding RNAs) are attractive candidates as biomarkers for AF, especially considering that miRNAs are stable and are detected within easily accessible biofluids such as blood. In this review, we selected twelve studies (2012 to 2016) that were classified according to the sample type. We aimed to provide an overview of the role of circulating miRNAs in AF and to discuss the variability of the results, seeking to improve the perspective of the use of miRNAs as potential noninvasive biomarkers for this heart disease

Circulating Exosomal miRNAs as Biomarkers for the Diagnosis and Prognosis of Colorectal Cancer

Colorectal cancer (CRC) is one of the most common malignant tumors in the gastrointestinal tract. It is a multifactorial disease that involves environmental factors, genetic factors, and lifestyle factors. Due to the absence of specific and sensitive biomarkers, CRC patients are usually diagnosed at an advanced stage and consequently suffer from a low 5-year overall survival rate. Despite improvements in surgical resection and adjuvant chemotherapy, the prognosis of patients with CRC remains unfavorable due to local and distant metastases. Several studies have shown that small noncoding RNAs, such as microRNAs packed in exosomes, are potential biomarkers in various types of cancers, including CRC, and that they can be detected in a stable form in both serum and plasma. In this review, we report the potential of circulating exosomal miRNAs to act as biomarkers for the diagnosis and prognosis of CRC

Development and validation of a clinical instrument to predict risk of an adverse drug reactions in hospitalized patients.

ObjectiveDevelopment and internal validation of a clinical tool for assessment of the risk of adverse drug reactions (ADR) in hospitalized patients.MethodologyNested case-control study in an open cohort of all patients admitted to a general hospital. Cases of ADR were matched to two controls. Eighty four patient variables collected at the time of the ADR were analyzed by conditional logistic regression. Multivariate logistic regression with clustering of cases in a random sample of 2/3 of the cases and respective controls, with baseline odds-ratio corrected with an estimate of ADR incidence, was used to obtain regression coefficients for each risk factor and to develop a risk score. The clinical tool was validated in the remaining 1/3 observations. The study was approved by the institution's research ethics committee.ResultsIn the 8060 hospitalized patients, ADR occurred in 343 (5.31%), who were matched to 686 controls. Fourteen variables were identified as independent risk factors of ADR: female, past history of ADR, heart rate ≥72 bpm, systolic blood pressure≥148 mmHg, diastolic blood pressure ConclusionWe report a clinical tool for ADR risk stratification in patients hospitalized in general wards based on 14 variables

Metabolismo de glicose em gêmeos monozigóticos discordantes para aptidão cardiorrespiratória

OBJETIVO: Verificar se as concentrações de glicose e insulina em jejum são reguladas pela aptidão cardiorrespiratória (VO2máx), independentemente dos efeitos genéticos. MÉTODOS: Dados de 38 pares de gêmeos monozigóticos (11 a 18 anos) foram analisados transversalmente. Os participantes foram submetidos a um teste de esforço máximo com ergoespirometria aberta (MedGraphics VO2000® - Medical Graphics Corp., St. Paul, MN) e à coleta de sangue para estimar a concentração de glicose e insulina em jejum. A zigosidade foi determinada por intermédio da investigação de concordância dos gêmeos em relação a 15 marcadores genéticos polimórficos. Nove pares demonstraram diferença média intrapar para o consumo máximo de oxigênio ≥10mL.kg-1.min-1 e foram divididos em dois grupos, de alta e baixa aptidão. Os grupos foram comparados a partir do teste pareado de Wilcoxon, tendo em vista a assimetria dos dados. RESULTADOS: em média, os gêmeos do grupo de alta aptidão apresentaram consumo máximo de oxigênio 17% superior (13,5±3,7mL.kg-1.min-1) a seus irmãos menos aptos. Não houve diferença entre os grupos para as concentrações de insulina (36,5±34,6 versus 25,3±13,7mg/dL; p<0,813), porém, os gêmeos mais aptos demonstraram menor concentração de glicose do que seus contrapares menos aptos (82,9±7,3 versus 86,7±7,6mg/dL; p<0,010). CONCLUSÕES: Neste estudo, caracterizado como caso-controle (gêmeos monozigóticos discordantes), o irmão com menor aptidão cardiorrespiratória apresentou maior concentração de glicose em jejum, sugerindo que a baixa aptidão cardiorrespiratória está associada a distúrbios no metabolismo de glicose.OBJETIVO: Verificar si las concentraciones de glucosa e insulina en ayuno son reguladas por la aptitud cardiorrespiratoria (VO2máx), independiente de los efectos genéticos. MÉTODOS: Datos de 38 pares de gemelos monocigóticos (11 a 18 años) fueron analizados transversalmente. Los participantes fueron sometidos a una prueba de esfuerzo máximo con ergoespirometría abierta (MedGraphics VO2000® Medical Graphics Corp., St. Paul, MN) y a la recolección de sangre para estimar la concentración de glucosa e insulina en ayuno. La cigosidad fue determinada por medio de la investigación de concordancia de los gemelos respecto a 15 marcadores genéticos polimórficos. Nueve pares demostraron diferencia mediana intrapares para el consumo máximo de oxígeno ≥10mL.kg-1.min-1 y fueron divididos en dos grupos, de alta y baja aptitud. Los grupos fueron comparados a partir de la prueba pareada de Wilcoxon, teniendo en vista la asimetría de los datos. RESULTADOS: En promedio, los gemelos del grupo de alta aptitud presentaron consumo máximo de oxígeno el 17% superior (13,5±3,7mL.kg-1.min-1) a sus hermanos menos aptos. No hubo diferencia entre los grupos para las concentraciones de insulina (36,5±34,6 versus 25,3±13,7mg/dL; p<0,813), pero los gemelos más aptos demostraron menor concentración de glucosa que sus contrapares menos aptos (82,9±7,3 versus 86,7±7,6mg/dL; p<0,010, respectivamente). CONCLUSIONES: En este estudio, caracterizado como caso-control (gemelos monocigóticos discordantes), el hermano con menor aptitud cardiorrespiratoria presentó mayor concentración de glucosa en ayuno, sugiriendo que la baja aptitud cardiorrespiratoria está asociada a disturbios en el metabolismo de glucosa.OBJECTIVE: To determine if glucose and insulin concentrations are regulated by cardiorespiratory fitness (VO2max) regardless of their genetic effects. METHODS: This cross-sectional study enrolled 38 pairs of young monozygotic twins (11 to 18 years-old). All subjects underwent a progressive maximal exercise test on a treadmill to determine the VO2max with gas exchange analysis (MedGraphics VO2000® - Medical Graphics Corp., St. Paul, MN). Blood samples were drawn after fasting to determine glucose and insulin levels. Monozygosity was confirmed by genotyping 15 informative genetic markers. Nine pairs had at least 10mL.kg-1.min-1 difference in VO2max and were divided into the more and less active group, according to their VO2max. Mean differences between more and less active groups were evaluated by Wilcoxon's test for paired data. RESULTS: on average, twins from the more active group presented a 17% (13.5±3.7mL.kg-1.min-1) higher VO2max compared to their less active siblings. No significant differences were observed between the groups for fasting insulin (36.5±34.6 versus 25.3±13.7mg/dL; p<0.813). However, the more active twins had lower fasting glucose than the less active ones (82.9±7.3 versus 86.7±7.6mg/dL; p<0.010). CONCLUSIONS: In this case-control study (discordant monozygotic twins), the less active co-twins were characterized by higher fasting plasma glucose levels. This implies that poor cardiorespiratory fitness can be associated with defective glucose metabolism regardless of genetic factors

Increased clopidogrel response is associated with ABCC3 expression: A pilot study

Background: The aim of this study was investigate the relationship between ABCB1 and ABCC3 gene expressions in peripheral blood cells (PBC) and the response to clopidogrel in patients with coronary arterial disease (CAD). Methods: Twenty-six male CAD patients (50-70 years) under treatment with clopidogrel (75 mg/day) for at least 5 days were selected. Blood samples were obtained to evaluate platelet reactivity and ABCB1 and ABCC3 mRNA expression. Platelet reactivity was measured in P2Y12 Reaction Units (PRU) using VerifyNow. RNA was extracted from PBC and mRNA levels were measured by qPCR, using GAPD as a reference gene. Results: Platelet response to clopidogrel was categorized in to PRU quartiles. Individuals with PRU values within the first quartile (Q1, &lt;151 units) were considered good responders, while those who had PRU within the fourth quartile (Q4. PRU&gt;260) were considered non-responders. ABCC3 was 1.7 times more expressed in Q4 than in Q1 PRU group (p=0.048). Moreover, CAD patients with low ABCC3 expression (Qe1, &lt;2.5x10(-3)) had higher probability to have a good response to clopidogrel (OR: 18.00, 95%CI: 1.90-169.99, p=0.001). Univariate linear regression analysis demonstrated that low ABCC3 mRNA expression contributed with a reduction of 73 PRU in relation to the patients with expression value higher than 2.5x10(-3) (p=0.027). Neither ABCB1 mRNA levels nor clinical variables studied influenced PRU values. Conclusions: Low ABCC3 mRNA expression in peripheral blood cells is associated with increased clopidogrel response, but further studies are needed to describe the functional relationship of clopidogrel with the ABCC3. Crown Copyright (C) 2011 Published by Elsevier B.V. All rights reserved