Irritable bowel syndrome displays three different subtypes: constipation (IBS-C), diarrhea (IBS-D), and mixed (IBS-M). Treatment with dietary fiber is used, with consideration given both to the ...chemical composition of the fiber and to the different subtypes of IBS. The IBS-D subtype is usually treated with a low-FODMAPs diet, whereas the IBS-C subtype suggests prebiotics and probiotics to promote microbiota restoration. The aim of this study was to assess the effects of employing agave fructans as the soluble fiber of a jelly (Gelyfun®gastro) containing 8 g per serving in the IBS-C group (n = 50), using a randomized, double-blind, time-limited trial for four weeks. We evaluated changes in the frequency and types of bowel movements through the Bristol scale, and the improvement of the condition was evaluated using quality of life (IBS-QOL) and anxiety–depression (HADS) scales. The main results were that the number of bowel movements increased by more than 80%, with at least one stool per day from fifteen days onwards, without a laxative effect for the group treated. Finally, the quality of life with the prebiotic jelly was significantly improved compared to the placebo in all specific domains, in addition to significantly reducing anxiety and depression.
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•Health effects of consuming bread enriched with agave fructans, β-cyclodextrins, and probiotics on the health of growing mice.•Bread enriched with agave fructans, β-cyclodextrins, ...and probiotics diet can provide health benefits (satiety, decreased blood sugar and benefits in the microbiota).
This study investigated the potential health effects of consuming bread enriched with agave fructans, β-cyclodextrins, and probiotics on the health of growing mice. ICR mice (35 males and 35 females) in the growth stage were used. Five diets were administered: 1) Standard (S), 2) Bread with agave fructans (FB), 3) Bread with β-cyclodextrins (CBD), 4) Bread with agave fructans + β-cyclodextrins (FB-CD), and 5) Bread with agave fructans + β-cyclodextrins + probiotics (FB-CD-P). The results showed that the FB-CD-P diet showed a decrease in dietary intake in mice. FB-containing diets showed higher fecal excretion than diet S. Blood glucose levels of female mice fed FB, CBD, FB-CD, and FB-CD-P diets exhibited a hypoglycemic effect. Histological results showed that the FB-CD-P diet presented larger mucin vesicles than the other diets. The results suggest that bread enriched with the FB-CD-P diet can provide health benefits.
Chronic Chagas cardiomyopathy (CCC) is the most frequent and severe clinical form of chronic Chagas disease, representing one of the leading causes of morbidity and mortality in Latin America, and a ...growing global public health problem. There is currently no approved treatment for CCC; however, omics technologies have enabled significant progress to be made in the search for new therapeutic targets. The metabolic alterations associated with pathogenic mechanisms of CCC and their relationship to cellular and immunopathogenic processes in cardiac tissue remain largely unknown. This exploratory study aimed to evaluate the potential underlying pathogenic mechanisms in the failing myocardium of patients with end-stage heart failure (ESHF) secondary to CCC by applying an untargeted metabolomic profiling approach. Cardiac tissue samples from the left ventricle of patients with ESHF of CCC etiology (n = 7) and healthy donors (n = 7) were analyzed using liquid chromatography-mass spectrometry. Metabolite profiles showed altered branched-chain amino acid and acylcarnitine levels, decreased fatty acid uptake and oxidation, increased activity of the pentose phosphate pathway, dysregulation of the TCA cycle, and alterations in critical cellular antioxidant systems. These findings suggest processes of energy deficit, alterations in substrate availability, and enhanced production of reactive oxygen species in the affected myocardium. This profile potentially contributes to the development and maintenance of a chronic inflammatory state that leads to progression and severity of CCC. Further studies involving larger sample sizes and comparisons with heart failure patients without CCC are needed to validate these results, opening an avenue to investigate new therapeutic approaches for the treatment and prevention of progression of this unique and severe cardiomyopathy.
Objectives
To analyse the effect of parasite load assessed by quantitative reverse transcription PCR (RT‐qPCR) in serum on the prognosis of patients with chronic Chagas cardiomyopathy (CCM) after a ...2‐year follow‐up.
Methods
Prospective cohort study conducted between 2015 and 2017. One hundred patients with CCM were included. Basal parasitaemia levels of Trypanosoma cruzi (T. cruzi) were measured using a quantitative polymerase chain reaction (qPCR) test. The primary composite outcome (CO) was all‐cause mortality, cardiac transplantation and implantation of a left ventricular assist device. Secondary outcomes were the baseline levels of serum biomarkers and echocardiographic variables.
Results
After a 2 years of follow‐up, the primary CO rate was 16%. A positive qPCR was not associated with a higher risk of the CO. However, when parasitaemia was evaluated by comparing tertiles (tertile 1: undetectable parasitaemia, tertile 2: low parasitaemia and tertile 3: high parasitaemia), a higher risk of the CO (HR 3.66; 95% CI 1.11–12.21) was evidenced in tertile 2. Moreover, patients in tertile 2 had significantly higher levels of high‐sensitivity troponin T and cystatin C and more frequently exhibited an ejection fraction <50%.
Conclusion
Low parasitaemia was associated with severity markers of myocardial injury and a higher risk of the composite outcome when compared with undetectable parasitaemia. This finding could be hypothetically explained by a more vigorous immune response in patients with low parasitaemia that could decrease T. cruzi load more efficiently, but be associated with increased myocardial damage. Additional studies with a larger number of patients and cytokine measurement are required to support this hypothesis.
Objectifs
Analyser l'effet de la charge parasitaire évaluée par PCR quantitative de transcription inverse (RT‐qPCR) dans le sérum sur le pronostic des patients atteints de cardiomyopathie chronique de Chagas (CCM) après un suivi de deux ans.
Méthodes
Etude de cohorte prospective menée entre 2015 et 2017. Une centaine de patients atteints de CCM ont été inclus. Les niveaux de parasitémie basale de Trypanosoma cruzi (T. cruzi) ont été mesurés en utilisant un test de réaction en chaîne de la polymérase quantitative (qPCR). Le principal résultat composite (RC) était la mortalité toutes causes, la transplantation cardiaque et l'implantation d'un dispositif d'assistance ventriculaire gauche. Les critères secondaires étaient les niveaux de base des biomarqueurs sériques et des variables échocardiographiques.
Résultats
Après 2 ans de suivi, le taux de RC primaire était de 16%. Une qPCR positive n'était pas associée à un risque plus élevé de RC. Cependant, lorsque la parasitémie était évaluée en comparant les tertiles (tertile 1: parasitémie indétectable, tertile 2: parasitémie faible et tertile 3: parasitémie élevée), un risque plus élevé de RC (HR: 3,66; IC95%: 1,11–12,21) a été mis en évidence dans le tertile 2. De plus, les patients du tertile 2 avaient des niveaux significativement plus élevés de troponine T et de cystatine‐C à haute sensibilité et présentaient plus fréquemment une fraction d'éjection <50%.
Conclusion
Une faible parasitémie était associée à des marqueurs de sévérité des lésions myocardiques et à un risque plus élevé de résultat composite par rapport à une parasitémie indétectable. Cette découverte pourrait être hypothétiquement expliquée par une réponse immunitaire plus vigoureuse chez les patients présentant une faible parasitémie qui pourrait diminuer la charge de T. cruzi plus efficacement mais être associée à une augmentation des lésions myocardiques. Des études supplémentaires avec un plus grand nombre de patients et une mesure des cytokines sont nécessaires pour étayer cette hypothèse.
Introduction: Caregivers of people with chronic disease adopt a new role that may involve responses such as anxiety, depression, and loneliness.
Objective: Todescribe and correlate the variables of ...adoption of the role of caregiver, depression, anxiety and loneliness in family caregivers of people with chronic disease in the Guanentina province in San Gil, Santander (Colombia), during the year 2021.
Methods: Descriptive study, cross-sectional analysis carried out with 112 family caregivers of people with chronic diseases. A characterization sheet and the ROL, UCLA and HADS instruments were used.
Results: the profile of the caregivers was predominantly female and average age of 49 years; married, single or in civil union; maximum degree of high school education; of household occupation and low and low-middle socioeconomic level. High levels of anxiety were found in 18,3% of them, depression in 4,3% and loneliness in 0,9%, in addition, satisfactory levels of adoption of the caregiver role were evidenced in 100%. A weak correlation was found between anxiety, depression and loneliness and an inverse correlation between these variables with the adoption of the caregiver role. Similarly, a direct correlation was found between the patient’s age and the months of diagnosis with the hours of care per day. Finally, anxiety and depression were found to be predictive of role adoption, of anxiety and role adoption on depression, and of loneliness and depression on anxiety.
Conclusions: the caregivers had normal levels of anxiety, depression and loneliness that, when correlated with each other and with the adoption of the caregiver role, validate the idea that, if caregivers are intervened in their trajectory with guidance on their role in terms of the tasks, the organization and the answers can contribute in the reduction of anxiety, depression and loneliness.
Discussion: The direct connection observed between loneliness, depression and anxiety is consistent with what has been reported in previous studies with caregivers. In accordance with what has been reported in the literature, satisfactory performance of the role facilitates the outcomes in caregivers, in this case, the moderation of anxiety, depression and loneliness
Introducción: los cuidadores de personas con enfermedad crónica adoptan un nuevo rol que puede implicar respuestas como ansiedad, depresión y soledad.
Objetivo: describir y correlacionar las variables de adopción del rol del cuidador, depresión, ansiedad y soledad en cuidadores familiares de personas con enfermedad crónica en la provincia de Guanentina, en San Gil, Santander (Colombia), durante el año 2021.
Método: estudio descriptivo, analítico de corte transversal realizado con 112 cuidadores familiares de personas con enfermedades crónicas. Se utilizó una ficha de caracterización y los instrumentos: Escala adopción del rol del cuidador ROL, escala de soledad de UCLA (University of California at Los Ángeles) y Escala Hospitalaria de Ansiedad y Depresión HADS.
Resultados: el perfil de los cuidadores fue predominantemente mujer; de 49 años en promedio; casadas, solteras o en unión libre; grado máximo de escolaridad bachiller; de ocupación hogar y nivel socioeconómico medio bajo y bajo. Se encontraron niveles altos de ansiedad en el 18,3 % de ellas, depresión en el 4,3% y soledad en el 0,9%, además, se evidenciaron niveles de adopción del rol del cuidador satisfactorios en el 100%. Se encontró una correlación débil entre ansiedad, depresión y soledad y una correlación inversa entre estas variables con la adopción del rol del cuidador. De igual manera, se encontró una correlación directa entre la edad del paciente y los meses de diagnóstico con las horas de cuidado al día. Por último, se halló carácter predictivo de la ansiedad y la depresión sobre la adopción del rol, de la ansiedad y la adopción del rol sobre la depresión, y de la soledad y la depresión sobre la ansiedad.
Conclusiones: los cuidadores tenían niveles de ansiedad, depresión y soledad normales que, al correlacionarse entre sí y con la adopción del rol del cuidador, validan la idea de que, si se interviene a los cuidadores en su trayectoria con orientaciones sobre su rol en cuanto a las labores, la organización y las respuestas se puede contribuir en la disminución de la ansiedad, depresión y soledad.
Discusión: la correlación directa observada entre la soledad, depresión y ansiedad es coherente con lo reportado en estudios previos con cuidadores. Acorde con lo reportado por la literatura el desempeño satisfactorio del rol facilita los desenlaces en los cuidadores, en este caso, la moderación de la ansiedad, depresión y soledad.
C-phycocyanin (CPC) is an antioxidant protein that, when purified, is photosensitive and can be affected by environmental and gastrointestinal conditions. This can impact its biological activity, ...requiring an increase in the effective amount to achieve a therapeutic effect. Therefore, the aim of this study was to develop a microencapsulate of a complex matrix, as a strategy to protect and establish a matrix for the controlled release of CPC based on polysaccharides such as agavins (AGV) using ionic gelation. Four matrices were formulated: M1 (alginate: ALG), M2 (ALG and AGV), M3 (ALG, AGV, and κ-carrageenan: CGN), and M4 (ALG, AGV, CGN, and carboxymethylcellulose: CMC) with increasing concentrations of CPC. The retention and diffusion capacities of C-phycocyanin provided by each matrix were evaluated, as well as their stability under simulated gastrointestinal conditions. The results showed that the encapsulation efficiency of the matrix-type encapsulates with complex composites increased as more components were added to the mixtures. CMC increased the retention due to the hydrophobicity that it provides by being in the polysaccharide matrix; CGN enabled the controlled diffusive release; and AGV provided protection of the CPC beads under simulated gastrointestinal conditions. Therefore, matrix M4 exhibited an encapsulation efficiency for CPC of 98% and a bioaccessibility of 10.65 ± 0.65% after the passage of encapsulates through in vitro digestion.
•A successfully model of chronic Chagas disease was induced in rats.•An oral therapy was developed from fractions of Lippia alba essential oils.•Echocardiographycal and histopathological test ...confirmed a cardioprotective effect.•The therapy showed a trypanocidal action similar to Benznidazole by qPCR analysis.•The treatment scheme was apparently non-toxic by clinical and pathological test.
The present study reports the trypanocidal and cardioprotective properties of fractions derived from Lippia alba (Verbenaceae family) essential oils (EOs), in a murine model of chronic Chagas disease (ChD). This infection represents one of the most serious public health problems in Latin American countries, without an effective therapy for chronic infection and its eventual cardiac complications. In the model established herein, the therapeutic scheme which involved 30 oral and daily doses of OxiLim (a mix composed by fractions enriched in citral, caryophyllene oxide, and limonene) was not toxic and exhibited trypanocidal activity comparable to benznidazole (assessed by parasitic DNA quantification - qPCR); but with an additional protective effects against cardiomyopathy progression. This last finding was confirmed by both echocardiography (reduction in the maximum diameter of the cardiac silhouette), and heart histopathology (tissue recovery, abundant fibroblasts, and mild separation of cardiac fibers). Conversely, rats treated only with benznidazole showed a significant increase in cardiac diameter with severe fiber dilation, angiogenesis, and high diversity of immune infiltrate. This research reports a highly trypanocidal (similar to benznidazole) therapeutic scheme based on L. alba essential oil fractions (OxiLim), which also exhibits a positive cardioprotective effect in the course of chronic chagasic cardiomyopathy, in rats.
The present study aimed to characterize the histopathological findings and the phenotype of inflammatory cells in the myocardial tissue of patients with end-stage heart failure (ESHF) secondary to ...CCC in comparison with ESHF secondary to non-Chagas cardiomyopathies (NCC).
A total of 32 explanted hearts were collected from transplanted patients between 2014 and 2017. Of these, 21 were classified as CCC and 11 as other NCC. A macroscopic analysis followed by a microscopic analysis were performed. Finally, the phenotypes of the inflammatory infiltrates were characterized using flow cytometry.
Microscopic analysis revealed more extensive fibrotic involvement in patients with CCC, with more frequent foci of fibrosis, collagen deposits, and degeneration of myocardial fibers, in addition to identifying foci of inflammatory infiltrate of greater magnitude. Finally, cell phenotyping identified more memory T cells, mainly CD8+CD45RO+ T cells, and fewer transitioning T cells (CD45RA+/CD45RO+) in patients with CCC compared with the NCC group.
CCC represents a unique form of myocardial involvement characterized by abundant inflammatory infiltrates, severe interstitial fibrosis, extensive collagen deposits, and marked cardiomyocyte degeneration. The structural myocardial changes observed in late-stage Chagas cardiomyopathy appear to be closely related to the presence of cardiac fibrosis and the colocalization of collagen fibers and inflammatory cells, a finding that serves as a basis for the generation of new hypotheses aimed at better understanding the role of inflammation and fibrogenesis in the progression of CCC. Finally, the predominance of memory T cells in CCC compared with NCC hearts highlights the critical role of the parasite-specific lymphocytic response in the course of the infection.
Encapsulation is a process in which a base material is encapsulated in a wall material that can protect it against external factors and/or improve its bioavailability. Among the different ...encapsulation techniques, ionic gelation stands out as being useful for thermolabile compounds. The aim of this work was to encapsulate Saccharomyces boulardii by ionic gelation using agavins (A) and whey protein (WP) as wall materials and to evaluate the morphostructural changes that occur during in vitro gastrointestinal digestion. Encapsulations at different levels of A and WP were analyzed using microscopic, spectroscopic and thermal techniques. Encapsulation efficiency and cell viability were evaluated. S. boulardii encapsulated at 5% A: 3.75% WP (AWB6) showed 88.5% cell survival after the simulated gastrointestinal digestion; the bead showed a significantly different microstructure from the controls. The mixture of A and WP increased in the survival of S. boulardii respect to those encapsulated with alginate, A or WP alone. The binary material mixture simultaneously allowed a controlled release of S. boulardii by mostly diffusive Fickian mechanisms and swelling. The cell-release time was found to control the increment of the Damköhler number when A and WP were substrates for S. boulardii, in this way allowing greater protection against gastrointestinal conditions.