Poor economics - Transforming challenges in transfusion medicine and science into opportunities

The prospect of cryopreservation of cellular components in the low and medium income (poor economics) part of the world absolutely needs a solid and sustainable infrastructure to build on in line with science, technology and globalization, based on rational thinking, standardization and harmonization of future advances we are currently witnessing in limited parts of the world. With the stepwise development of the healthcare stimulated by the 2012 UN Universal Health Coverage (UHC) program and supported by WHO Model List of Essential Medicines (EM) and Essential in vitro Diagnostics (ED), a slowly growing number of countries will reach a point where quality cryopreservation of cellular components becomes feasible as an advance for implementing specific health care visions, policies and strategies in line with the Sustainable Development Goals 2016-2030

Bacterial dichloropropene degradation in soil:Screening of soils and involvement of plasmids carrying the dhlA gene

The nematocide cis-1,3-dichloropropene is widely used in intensive agricultural practice against root knot nematodes. As a result of the regular application of dichloropropene to six out of eight different soils, the compound was rapidly degraded to CO2, H2O and chloride ions in subsequent applications (adapted soils). Such degradation occurred at a lower rate in the same soil types without a history of dichloropropene use (unadapted soils). In two soils, the effect of repeated dichloropropene treatment was not found, since dichloropropene was already rapidly decomposed in the untreated controls. Since the dehalogenating enzyme haloalkane dehalogenase, encoded by the dhlA gene, is possibly involved in the degradation of dichloropropene, a specific PCR detection system combined with a dhlA probe was developed to detect dhlA in soil DNA extracts. Five of the eight adapted soils as well as three unadapted ones showed a response to this system, indicating the presence of DNA with sequence similarity to dhlA. Fifteen bacterial strains with dichloropropene-degradative capacity were isolated from enrichment cultures grown in the presence of this compound and inoculated with adapted soil (five soil types). Six selected isolates were identified as, respectively, Alcaligenes paradoxus, Pseudomonas cichorii I, Pseudomonas corrugata (2 x), Pseudomonas putida and Pseudomonas sp. Each of the six strains harboured a plasmid of 50-60 kb in size and all but one carried resistance to HgCl2. Filter matings were performed to investigate the possible cotransfer of biodegradative genes and Hg resistance to suitably-marked P. fluorescens R2f recipient strains. Three plasmid donor strains, P. cichorii I, P. corrugata and Pseudomonas sp., transferred the Hg resistance and the plasmid to the recipient used, suggesting that the Hg resistance marker was located on the plasmid. In addition, transconjugants produced with P. cichorii I and P. corrugata donor strains had also acquired 1,3-dichloropropene-degrading capability. PCR amplification with dhlA specific primers, of the plasmids obtained both from the original P. cichorii I and P. corrugata strains and from the respective transconjugant P. fluorescens R2f strains generated 400-500 bp amplification products. After cloning of the product of the P. cichorii I plasmid and sequencing of 180 bases, extensive homology with the dhlA gene was detected. These results suggest that a plasmid-located dhlA-like gene may be involved in dichloropropene degradation in soil by soil bacteria, but the extent to which the gene is involved in the process in situ is not clear.</p

No effects of bosentan on microvasculature in patients with limited cutaneous systemic sclerosis

The endothelium-derived vasoconstrictor molecule endothelin-1 (ET-1) has been suggested to play a role in the pathogenesis of Raynaud's phenomenon (RP) and systemic sclerosis (SSc). We studied the effect of bosentan on microvascular structure and function in patients with RP secondary to limited cutaneous SSc in a mechanistic pilot study. In this single center, open study, 15 patients with limited cutaneous SSc were treated with bosentan for 16 weeks with a follow-up period of 4 weeks. Changes in microvascular structure and function were studied with assessment of vasodilatory microvascular responses using laser Doppler fluxmetry combined with iontophoresis, capillary permeability using fluorescence videomicroscopy, nailfold capillary microscopy, and serological markers of endothelial activation. No significant changes were seen in vasodilator responses to acetylcholine and sodium nitroprusside following bosentan treatment. No effect was noted on capillary permeability during treatment. The number of nailfold capillaries remained unchanged. The endothelial activation marker vascular cell adhesion molecule did not change during treatment, but levels of thrombomodulin significantly decreased after 12 weeks of treatment. Bosentan did not induce significant changes in vasodilator responses, capillary permeability, and capillary density during treatment, so no evidence was obtained for structural improvement of microvascular structure and function in this short-time mechanistic pilot study in patients with lcSSc

Advanced glycation endproducts are increased in rheumatoid arthritis patients with controlled disease

Introduction: Advanced glycation end products (AGEs) are produced and can accumulate during chronic inflammation, as might be present in patients with rheumatoid arthritis (RA). AGEs are involved in the development of cardiovascular disease. The aim of this study is to evaluate whether AGEs are increased in patients with long-standing RA and whether AGE accumulation is related to disease activity, disease severity and measures of (premature) atherosclerosis, such as endothelial activation, endothelial dysfunction and intima media thickness (IMT). Methods: In a cross-sectional study, 49 consecutive RA patients with longstanding disease (median disease duration of 12.3 years (range 9.3 to 15.1)), receiving standard of care, were included and compared with 49 age-and sex-matched healthy controls (HC). AGEs were determined by skin autofluorescence. Disease activity was evaluated by the Disease Activity Score of 28 joints (DAS-28) score and joint damage by modified Sharp-v.d. Heijde score. Endothelial activation (soluble vascular cellular adhesion molecule-1) sVCAM-1, von Willebrand factor (vWF), thrombomodulin), endothelial dysfunction (determined by small artery elasticity (SAE)) and IMT were measured and related to AGE accumulation. Results: AGEs were increased in RA patients (median 2.4 arbitrary units (a.u.), range 1.6 to 4.2) compared to HC (2.2, 1.3 to 3.8). RA patients had a DAS-28 score of 2.9 (0.8 to 6.9) and a modified Sharp-v.d. Heijde score of 19 (0 to 103). sVCAM-1 and vWF levels were higher in RA patients. SAE was significantly decreased in RA (3.9 ml/mmHg (1.4 to 12.2) vs. 6.1 in HC (1.7 to 12.9). IMT did not differ between the two groups. Combining both groups' AGEs correlated with vWF, sVCAM-1 and IMT, and was inversely related to SAE. In RA, AGEs had an inverse relation with SAE, but did not relate to disease activity or radiological damage. In multivariate analysis for both groups, smoking, glucose levels, vWF, SAE and male gender were significantly related to the formation of AGEs. Conclusions: AGEs were increased in RA patients with long-standing disease and without signs of premature atherosclerosis. AGEs were related to endothelial activation and endothelial dysfunction. This supports the hypothesis that in RA AGEs may be an early marker of cardiovascular disease

Epidemiological Aspects of Hepatitis B and C Markers in Blood Donors in Kazakhstan; 2000-2011

Transfusion-transmissible infections such as hepatitis B and hepatitis C are among the greatest threats to blood safety for transfusion recipients and pose a serious public health problem. The aim of this study was to assess the epidemiological aspects of hepatitis B and C in Kazakhstani donor's blood over the period 2000-2011.The data were obtained from the annual reports of the Republican Blood Center. The retrospective study was conducted from 2000 to 2011.Over the study period in the republic a growth of volumes of procured blood from 312.4 to 398.0 units was noted, in total equaled to 4,277.8 units. The proportion of blood wasted increased from 8.3% to 8.7%. In the dynamics the proportion of viral hepatitis among all causes of blood wasted decreased from 29% to 15.5% (HBV) and from 33.5% to 9.9% (HCV). The proportion of HBV and HCV in whole blood decreased considerably, in plasma and red cell concentrate the rates changed slightly. The average annual prevalence of HBV and HCV were 2.1% and 1.8%, respectively.Despite the reduction of viral hepatitis rates among blood donors in Kazakhstan the prevalence still remains high. The HBV prevalence is higher compared to HCV, which needs further investigations in the general population to address the issue

Early atherosclerosis in systemic sclerosis and its relation to disease or traditional risk factors

INTRODUCTION: Several systemic autoimmune diseases are associated with an increased prevalence of atherosclerosis which could not be explained by traditional risk factors alone. In systemic sclerosis (SSc), microvascular abnormalities are well recognized. Previous studies have suggested an increased prevalence of macrovascular disease as well. We compared patients with SSc to healthy controls for signs of early atherosclerosis by measuring intima-media thickness (IMT) of the common carotid artery in relation to traditional risk factors and markers of endothelial activation. METHODS: Forty-nine patients with SSc, of whom 92% had limited cutaneous SSc, and 32 healthy controls were studied. Common carotid IMT was measured by using B-mode ultrasound. Traditional risk factors for cardiovascular disease were assessed and serum markers for endothelial activation were measured. RESULTS: In patients with SSc, the mean IMT (median 0.69 mm, interquartile range [IQR] 0.62 to 0.79 mm) was not significantly increased compared with healthy controls (0.68 mm, IQR 0.56 to 0.75 mm; P = 0.067). Also, after correction for the confounders age, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein cholesterol (P = 0.328) or using a different model taking into account the confounders age, HDL cholesterol, and history of macrovascular disease (P = 0.474), no difference in IMT was present between SSc patients and healthy controls. Plaques were found in three patients and not in healthy controls (P = 0.274). In patients, no correlations were found between maximum IMT, disease-related variables, and markers of endothelial activation. Endothelial activation markers were not increased in SSc patients compared with controls. CONCLUSION: SSc is not associated with an increased prevalence of early signs of atherosclerosis