The Gap In Meeting The Educational And Support Needs Of Women With Takotsubo Syndrome Compared To Women With An Acute Coronary Syndrome

Background: Takotsubo Syndrome is a condition that causes impairment in cardiac function in the absence of significant causative coronary artery disease. Takotsubo Syndrome is most commonly reported in older women, has identical presenting symptoms to acute coronary syndrome (ACS),but differs in cause, management and outcomes. Ongoing symptoms and recurrence of Takotsubo Syndrome are not uncommon but little support is available for these women.   Aims: This study compares (1) educational support and (2) participation rates in outpatient cardiac rehabilitation for women with Takotsubo Syndrome or acute coronary syndrome, and (3) ascertains whether or not they perceived similar benefits from these strategies.   Methods: 23 women with Takotsubo Syndrome and 23 age-matched women with acute coronary syndrome were mailed a structured questionnaire based on cardiac rehabilitation (CR) components.   Findings: The questionnaire response rate was 48% (n=11) for the Takotsubo Syndrome group and 30% (n=7) for the acute coronary syndrome group.  18% (n=2) of the women with Takotsubo Syndrome and 71% (n=5) of the women with acute coronary syndrome attended cardiac rehabilitation, with all attendees perceiving that it was beneficial in aiding their recovery.  Of the nine women with Takotsubo Syndrome that did not attend cardiac rehabilitation, 67% (n=6) perceived that it would have been helpful in aiding their recovery. Women with Takotsubo Syndrome were less likely to receive educational support about their condition, particularly stress management and participate in CR compared with women with ACS, despite perceiving that elements of CR would have been helpful in aiding their recovery.   Conclusions: Women with ACS had higher CR participation rates than those with Takotsubo Syndrome, and were more likely to receive educational support, particularly following hospital discharge.  The majority of women with Takotsubo Syndrome were not exposed to educational support in their recovery, suggesting a role for CR tailored to the needs of these women. Nurses can take practical steps to address these gaps by providing emotional support and education for women with Takotsubo Syndrome in stress management to enhance their quality of life and reduce potential recurrence

A reciprocal repression between ZEB1 and members of the miR-200 family promotes EMT and invasion in cancer cells

The embryonic programme ‘epithelial–mesenchymal transition' (EMT) is thought to promote malignant tumour progression. The transcriptional repressor zinc-finger E-box binding homeobox 1 (ZEB1) is a crucial inducer of EMT in various human tumours, and was recently shown to promote invasion and metastasis of tumour cells. Here, we report that ZEB1 directly suppresses transcription of microRNA-200 family members miR-141 and miR-200c, which strongly activate epithelial differentiation in pancreatic, colorectal and breast cancer cells. Notably, the EMT activators transforming growth factor β2 and ZEB1 are the predominant targets downregulated by these microRNAs. These results indicate that ZEB1 triggers an microRNA-mediated feedforward loop that stabilizes EMT and promotes invasion of cancer cells. Alternatively, depending on the environmental trigger, this loop might switch and induce epithelial differentiation, and thus explain the strong intratumorous heterogeneity observed in many human cancers

Characterization of a multifunctional caffeoyl-CoA O-methyltransferase activated in grape berries upon drought stress

Drought stress affects anthocyanin accumulation and modification in vegetative and reproductive plant tissues. Anthocyanins are the most abundant flavonoids in grape (Vitis vinifera L.) coloured berry genotypes and are essential markers of grape winemaking quality. They are mostly mono- and di-methylated, such modifications increase their stability and improve berry quality for winemaking. Anthocyanin methylation in grape berries is induced by drought stress. A few caffeoyl-CoA O-methyltransferases (CCoAOMTs) active on anthocyanins have been described in grape. However, no drought-activated O-methyltransferases have been described in grape berries yet. In this study, we characterized VvCCoAOMT, a grapevine gene known to induce methylation of CoA esters in cultured grape cells. Transcript accumulation of VvCCoAOMT was detected in berry skins, and increased during berry ripening on the plant, and in cultured berries treated with ABA, concomitantly with accumulation of methylated anthocyanins, suggesting that anthocyanins may be substrates of this enzyme. Contrary as previously observed in cell cultures, biotic stress (Botrytis cinerea inoculation) did not affect VvCCoAOMT gene expression in leaves or berries, while drought stress increased VvCCoAOMT transcript in berries. The recombinant VvCCoAOMT protein showed in vitro methylating activity on cyanidin 3-O-glucoside. We conclude that VvCCoAOMT is a multifunctional O-methyltransferase that may contribute to anthocyanin methylation activity in grape berries, in particular under drought stress conditions

Alertness Training Increases Visual Processing Speed in Healthy Older Adults

In this study, we investigated whether alertness training in healthy older adults increases visual processing speed (VPS) and whether functional connectivity in the cingulo-opercular network predicts training gain. Using the theory of visual attention, we derived quantitative estimates of VPS before and after training. In Study 1, 75 healthy older adults participated in alertness training, active-control training, or no training (n = 25 each). A significant Group × Session interaction indicated an increase in VPS in the alertness-training group but not in the control group, despite VPS not differing significantly between groups before training. In Study 2, 29 healthy older adults underwent resting-state functional MRI and then participated in alertness training. Pretraining functional connectivity in the cingulo-opercular network correlated with the individual training-induced change in VPS. In conclusion, results indicate that alertness training improves visual processing in older adults and that functional connectivity in the cingulo-opercular network provides a neural marker for predicting individual training gain

Development of an inhibiting antibody against equine interleukin 5 to treat insect bite hypersensitivity of horses

Insect bite hypersensitivity (IBH) is the most common allergic skin disease of horses. It is caused by insect bites of the Culicoides spp. which mediate a type I/IVb allergy with strong involvement of eosinophil cells. No specific treatment option is available so far. One concept could be the use of a therapeutic antibody targeting equine interleukin 5, the main activator and regulator of eosinophils. Therefore, antibodies were selected by phage display using the naïve human antibody gene libraries HAL9/10, tested in a cellular in vitro inhibition assay and subjected to an in vitro affinity maturation. In total, 28 antibodies were selected by phage display out of which eleven have been found to be inhibiting in the final format as chimeric immunoglobulin G with equine constant domains. The two most promising candidates were further improved by in vitro affinity maturation up to factor 2.5 regarding their binding activity and up to factor 2.0 regarding their inhibition effect. The final antibody named NOL226-2-D10 showed a strong inhibition of the interleukin 5 binding to its receptor (IC50 = 4 nM). Furthermore, a nanomolar binding activity (EC50 = 8.8 nM), stable behavior and satisfactory producibility were demonstrated. This antibody is an excellent candidate for in vivo studies for the treatment of equine IBH