Advances in sickle cell disease treatment: From drug discovery until the patient monitoring

Sickle Cell Disease (SCD) is one of the most prevalent hematological diseases in the world. Despite the immense progress in molecular knowledge about SCD in last years few therapeutical sources are currently available. Nowadays the treatment is performed mainly with drugs such as hydroxyurea or other fetal hemoglobin inducers and chelating agents. This review summarizes current knowledge about the treatment and the advancements in drug design in order to discover more effective and safe drugs. Patient monitoring methods in SCD are also discussed. © 2011 Bentham Science Publishers Ltd.

Eritrograma e medição dos eritrócitos de avestruzes (Struthio camelus) em Sãojosé do Rio Preto-SP, Brasil

Ostriches' erythrocytic parameters help on the diagnosis of specific pathologies and serve as basic knowledge for studies in comparative avian pathology. To obtain reference values of erythrocyte indices for ostriches (Struthio camelus) raised in a commercial system in Brazil and verify if there are differences between gender and age groups, 240 healthy from both sexes animals were bled. Heparinized blood samples were analyzed using standard techniques to determine the red blood cell (RBC) count, hemoglobin concentration, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) values, besides the red cell morphometry analysis using a computer software that calculates the greater and the smaller diameters of the erythrocytes. Prior to data analysis, ostriches were divided into three different age groups: from four to 13 months, from 13 to 23 months and from 23 to 30 months the. Younger ostriches presented lower erythrocyte indices than the older ones. The age group effect was only significant in females for the erythrocyte, hemoglobin, MCV, MCH, and MCHC variables. The female ostriches presented PCV, MCV, MCH, and MCHC values significantly higher than males in some age groups. It was observed that the erythrocytes of the female ostriches are more elongated and larger than males. It was concluded that erythrocytic parameters of ostriches in São José do Rio Preto-SP, Brazil are influenced by gender and age, highlighting the importance of consider besides these factors also the geoclimatic conditions to an adequate interpretation of the erythrogram.

Análise das prevalências de doenças detectadas pelo programa nacional de triagem neonatal no município de Araraquara no ano de 2009

The National Neonatal Screening Program (NNSP) set up in all Brazil, aims, through planned phases of local implementation, to detect diseases such as phenylketonuria, congenital hypothyroidism, hemoglobinopathies and cystic fibrosis. The aim of this study was to assess, through a cross-sectional observational study, the prevalence of the diseases detected by the NNSP in the city of Araraquara, in records issued by the São Paulo APAE laboratory in the period between April and December 2009.The results show that Araraquara had a prevalence of phenylketonuria and congenital hypothyroidism 0.06% above the national averages of 0.01% and 0.03% respectively. With respect to hemoglobinopathies, the prevalence of sickle cell trait was 2.15% below the national average of 2.6%. The prevalence of Hb C in the city was 0.57%, similar to national values reported in the literature. Confirmed Hb Bart's had a prevalence of 0.13% in Araraquara, below the average of 0.38% for the surrounding region. The neonatal screening by heel-prick test and counseling for caregivers are important factors in reducing morbidity related to the evolution of these diseases.

Influence of δβ-thalassemia or regulatory elements in individuals with increased fetal Hb levels in the São Paulo northwest population

Fetal hemoglobin (Hb F), formed by two alpha globin chains (α) and two gamma chains (γ) (α2 γ2), has reduced expression in adults, ranging from 0 to 1% of total hemoglobin. Increased levels of Hb F are due to mutations in the β-globin family, which cause hereditary persistence of fetal hemoglobin (HPFH) and delta-beta thalassemia (δβ-thalassemia).The control of the production takes place by the regulatory region and regions outside the β-globin family, among them 2q16, 6q23, 8q, and Xp22.2.The aims of this study were to determine the presence and frequency of two mutations for δβ-thalassemia, the XmnI polymorphism and β-globin haplotypes in healthy individuals with increased Hb F in the State of São Paulo. We analyzed 60 samples of peripheral blood of healthy adults, without complaints of anemia. The samples were separated into two groups according to Hb F level: group I - 34 samples with Hb F ranging from 2 to 15% and group II - 26 samples with Hb F over 15%. In relation to the polymorphisms examined, we found three heterozygous individuals (5%) for Spanish δβ-thalassemia, belonging to group I, whose Hb F levels were within the normal range.The Sicilian δβ-thalassemia mutation was not found, indicating the need to study other polymorphisms related to the increase of Hb F in adult life.The frequency of XmnI polymorphism was 33.3% and the mean Hb F levels were 15.48 ± 11.69%.The frequency observed in our study for this polymorphic site is higher than that found in the literature for healthy subjects.This polymorphism was more prevalent in individuals with Hb F levels below 15%. For four samples positive for this polymorphism, the Hb F levels were explained by the presence of HPFH and Spanish δβ-thalassemia mutations, so that the presence of the XmnI polymorphic site was not a determinant in the overexpression of γ-globin genes. Regarding β-globin haplotypes, 18 alleles and 27 distinct genotypic patterns were found.The pattern Atp1/Atp2 was the mostfrequent genotype (13.72%).Of the 18 alleles, 13 showed atypical patterns.The results show that the haplotype V was the most frequent (27.45%), followed by atypical Atp2 (13.72%) and Atp1 (11.76%), and that there was a higher correlation with the presence of HPFH and XmnI polymorphism.The high frequency of haplotype V in our samples and high frequency of atypical haplotypes may reflect a high rate of miscegenation in this population, suggesting an ethnic characteristic for the Brazilian population, requiring the evaluation of population genetic markers to corroborate this hypothesis. © FUNPEC-RP.

Evaluation of HPFH and δβ-thalassemia mutations in a Brazilian group with high Hb F levels.

Fetal hemoglobin (Hb F) is characteristic of the fetal development period. However, in some genetic conditions, such as hereditary persistence of fetal hemoglobin (HPFH) and delta-beta thalassemia (δβ-thalassemia), Hb F continues to be produced in adulthood. We evaluated the frequency of two mutations of HPFH, HPFH-1 and HPFH-2 African, and two mutations in δβ-thalassemia, Sicilian and Spanish, in a Brazilian population. Peripheral blood samples were collected from adults from hospitals and blood centers in southeast and northeast Brazil. These individuals were healthy and without complaints of anemia, but had increased Hb F. Samples were submitted to electrophoretic and chromatographic analyses to quantify Hb F values and, subsequently, to molecular analyses to verify the mutations. In the molecular analysis, 16 of the 60 samples showed a heterozygous profile for the HPFH mutations, two for HPFH-1 and 14 for HPFH-2. In the same sample set, three were heterozygous for Spanish δβ-thalassemia and none were heterozygous for Sicilian δβ- thalassemia. The Hb F values in the HPFH-2 heterozygotes differed from those previously reported for this mutation. In this group, the HPFH mutations were more frequent than the δβ-thalassemia mutations. The finding of these mutations in this Brazilian population reflects the mixing process that occurred during its formation.

Anemia at one year is an independent risk factor of graft survival

Background Post-transplant anemia is multifactorial and highly prevalent. Some studies have associated anemia with mortality and graft failure. The purpose of this study was to assess whether the presence of anemia at 1 year is an independent risk factor of mortality and graft survival. Methods All patients transplanted at a single center who survived at least 1 year after transplantation and showed no graft loss (n = 214) were included. Demographic and clinical data were collected at baseline and at 1 year. Patients were divided into two groups (anemic and nonanemic) based on the presence of anemia (hemoglobin<130 g/l in men and 120 g/l in women). Results Baseline characteristics such as age, gender, type of donor, CKD etiology, rejection, andmismatches were similar in both groups. Creatinine clearance was similar in both anemic and nonanemic groups (69.32 ± 29.8 × 75.69 ± 30.5 ml/mim; P = 0.17). A Kaplan- Meier plot showed significantly poorer death-censored graft survival in the anemic group, P = 0.003. Multivariate analysis revealed that anemic patients had a hazard ratio for the graft loss of 3.85 (95% CI: 1.49-9.96; P = 0.005). Conclusions In this study, anemia at 1 year was independently associated with death-censored graft survival and anemic patients were 3.8-fold more likely to lose the graft. © 2010 Springer Science+Business Media, B.V.

Síndrome antifosfolípide e trombocitopenia na infância

Objective: To report the case of a child diagnosed with antiphospholipid syndrome associated with severe thrombocytopenia, and to review the literature on the subject. Case description: Child aged nine years and eight months old with severe thrombocytopenia associated with a positive anticardiolipin antibody. Data were collected by clinical history, physical examination, and laboratorial exams. Diagnosis was confirmed according to criteria established for the antiophospholipid syndrome, associated with the presence of the most common manifestations of the syndrome in children: livedo reticularis and thrombocytopenia. Comments: The antiphospholipid syndrome is an uncommon pediatric disease, and clinical manifestations such as decreased platelet number should be considered.

Relationship between incubation temperature and egg size with heart hypoplasy in broiler chicks at hatching

It was analyzed if the effects of continuous incubation temperature deviations during the second half on the development of body, organs and hematological respiratory and energetic parameters differ between male and female from 30- and 60-week-old breeder eggs. From day 13, Cobb eggs were exposed to 36°C, 37.5°C, or 39°C. At 3, 6, 12, 24, 48 and 72 h after this change in the temperature and at hatch, red cells count, hematocrit, hemoglobin, mean corpuscular volume, plasma glucose level and body, liver and heart weights were evaluated. Independent of incubation temperature, sexes and breeder ages, mean corpuscular volume decreased and the other variables increased during late incubation. In 30-week-old breeder eggs, body weights and erythrocytic parameters were not influenced by temperature but liver and heart weights decreased increasing incubation temperature and glucose level increased at 36 and 39°C. In 60-week-old breeder eggs, males were heavier at hatching with incubation at 36°C and females had smaller body weights with incubation at 39°C. In both sexes, liver weight decreased and glucose concentration was higher at 36 and 39°C and heart weights and erythrocytes parameters were not influenced by temperature. Independent of breeder age, hatchability was lower at 39°C. The data show that high temperature from day 13 of incubation reduced more intensively the hatching success and caused cardiac hypoplasia in chicks from 30-week-old breeder eggs only, revealing for the first time that the susceptibility for ascites syndrome, by reduced heart development at hatching, is associated to a relationship between incubation temperature and egg size. © Asian Network for Scientific Information, 2012.

Blood parameters of chicks from eggs injected with ascorbic acid and subjected to thermal stress

This study was aimed to verify if chicks from eggs injected with ascorbic acid and subjected to thermal stress would have higher immunity than chicks from incubation at thermoneutrality without injection of ascorbic acid. The parameters evaluated were temperature on oxygen saturation in hemoglobin, glucose, number of erythrocytes, hematocrit rate and number of hemoglobins of newly hatched male chicks, hatched from eggs injected with ascorbic acid (AA) and subjected to thermal stress during incubation. The experimental design was completely randomized in factorial scheme 5 (application levels of ascorbic acid) x 2 (incubation temperatures). The data were subjected to analysis of variance using the General Linear Model procedure (GLM) of SAS ®. For the parameters (number of erythrocytes, rate of hematrocit and values of hemoglobin), there was significant interaction (p <0.05) between treatments in egg and incubation temperatures. Analyzing the interactions for these parameters, it was observed that the application of 0% ascorbic acid in egg minimized the effect of heat stress when compared with treatment without injection. The application of ascorbic acid levels in eggs incubated under heat stress failed to maximize the immunity of newly hatched chicks. It is assumed that the increased liquid in the amniotic fluid, in those embryos injected with water, favored the lower heat conductance for these embryos, thus helping in their development in relation to immunity. Considering that hemoglobin is related to the transport of gases, these data suggest that increasing the concentration of AA solution inoculated may influence the respiratory rates of eggs.

Glicerina bruta na dieta de bovinos de corte confinados: Efeito sobre o hemograma

The aim of this study was to evaluate the hemogram in cattle fed crude glycerin. 30 Nellore steers, were used for blood sampling, which were done each 28 days. The animals were confined for 103 days and were fed with five diets containing 0, 7.5, 15, 22.5 and 30% crude glycerin based on dry matter, formulated in a forage:concentrate ratio of 30:70. Corn silage was used as forage and the concentrate was composed by corn grain, soybean hulls, sunflower meal, glycerin, limestone, dicalcium phosphate and salt. The experimental design was a randomized block with five treatments. Orthogonal contrasts were used to determine the linear, quadratic, cubic effects and gliceryn treatments × the control one. There was no treatment effect (P>0,05) on blood concentrations of erythrocytes, hematocrit, basophils, eosinophils, band neutrophils and lymphocytes, but were linearly effect on the concentrations of platelets, hemoglobin and monocytes (P=0.009, P=0.001 and P=0.043, respectivelly), and cubic effect on the concentrations of total leukocytes and segmented neutrophils (P=0.008 and P=0.004, respectivelly). Diets for beef cattle, with forage:concentrate ratio of 30:70 added with crude glycerin promote changes in the erytrhogram and leucogram of these animals.

Aerocistite aguda induzida por tioglicolato, lipolisacarídeo e Aeromona hydrophila inativada em Piaractus mesopotamicus: Efeitos hematológicos

The effects of swim bladder injection with thioglycolate, Escherichia coli lipopolysaccharide (LPS) and heat-inactivated Aeromonas hydrophila were assessed on hematological responses in pacu, Piaractus mesopotamicus (Characidae). A quantitative assessment was done on erythrocytes, thrombocytes e leucocytes at 6, 24, and 48 h pos-injection of the inflammatory agents and compared with fish injected with saline solution (control). Fish injected with inactivated A. hydrophila showed a reduction of erythrocytes and hemoglobin, whereas the hematocrit increased 6 h pos-injection. The results show that thioglycolate and LPS also induced a reduction on hemoglobin and an increase on the hematocrit. The thrombocytes count decreased 6 h post A. hydrophila injection, whereas increased 48 hours post LPS injection. The leukocytes count increased after 6 h post A. hydrophila injection, while the lymphocytes and PAS-positive granular leukocytes (PAS-LG) count decreased after 24 h post injection. In fish injected with thioglycolate or with LPS showed an increase in the LG-PAS counts when compared to A. hydrophila or control groups. The monocytes count was not affected by the different inflammatory agents.

Variáveis epidemiológicas e alterações clínicas, hematológicas e urinárias em cães sororreagentes para Leptospira spp

In order to determine antibodies anti-Leptospira spp. in dogs from Botucatu-SP with a clinical suspicion and the risk factors for this zoonosis, as well possible hematological and urine alterations were collected blood samples from 248 dogs. The diagnostic test performed was the Microscopic Agglutination Test (MAT) with 29 serovars of leptospires. Titers were considered reagent ≥200 and detected in 17.7% (44/248) of the dogs. The most frequent serovars were Autumnalis (20.5%); Pyrogenes (18.2%); Gryppothyphosa (15.9%); Canicola (13.6%); Bratislava and Copenhageni (9.1%); Andamana (4.5%) and Djasiman (2.3%). Regarding the analysis of the epidemiological questionnaire administered to owners of the dogs, there was statistical significance for sex, age and presence of rats at home, showing that, by logistic regression analysis, only the sex variable was been significantly associated to the presence of antibodies anti-Leptospira. The levels of urea and creatinine were significantly increased in the group of animals reagents to the Microscopic Agglutination Test, showing the renal damage in these animals and decreased hemoglobin level.

Supplementation with protected fat to manage gastro-intestinal nematode infections in Santa Ines sheep

This experiment aimed to determine the influence of supplementation with protected fat on nematode infections in periparturient sheep or sheep in their final stage of pregnancy. Fifty Santa Ines ewes received 200 g of concentrate/animal/day, mineral salt and water and were grouped according to their weight, hematocrit and the number of eggs per gram of feces (EPG). Two diets were used: a control treatment and a treatment consisting of supplementation with 30 g/animal/day of protected fat in the concentrate. Three monthly evaluations were performed over a total of 84 days of testing. The variables analyzed were weight, body condition, EPG and coprocultures; blood tests were performed for the determination of packed cell volume, hemoglobin concentration and total plasma protein, and leukograms and eosinophil counts were performed. For weight and hemoglobin concentrations, interactions were observed between diet and collection date (P<0.05); body condition, total plasma protein, packed cell volume and total leukocytes did not differ statistically among treatments (P> 0. 05) but did differ by collection day (P <0.05). The EPG and eosinophil counts did not differ statistically by either diet or collection date (P>0.05). The genus Haemonchus was predominant, followed by the genera Cooperia, Trichostrongylus and Oesophagostomum. The protected fat did not decrease EPG and did not improve the blood parameters of infected sheep.

Small-angle X-ray scattering and structural modeling of full-length: Cellobiohydrolase I from Trichoderma harzianum

Cellobiohydrolases hydrolyze cellulose releasing cellobiose units. They are very important for a number of biotechnological applications, such as, for example, production of cellulosic ethanol and cotton fiber processing. The Trichoderma cellobiohydrolase I (CBH1 or Cel7A) is an industrially important exocellulase. It exhibits a typical two domain architecture, with a small C-terminal cellulose-binding domain and a large N-terminal catalytic core domain, connected by an O-glycosylated linker peptide. The mechanism by which the linker mediates the concerted action of the two domains remains a conundrum. Here, we probe the protein shape and domain organization of the CBH1 of Trichoderma harzianum (ThCel7A) by small angle X-ray scattering (SAXS) and structural modeling. Our SAXS data shows that ThCel7A linker is partially-extended in solution. Structural modeling suggests that this linker conformation is stabilized by inter- and intra-molecular interactions involving the linker peptide and its O-glycosylations. © 2013 Springer Science+Business Media Dordrecht.

Acute phase protein profile in agoutis (Dasyprocta azarae; Lichtenstein, 1823) in captivity, determined by sodium dodecyl sulfate polyacrilamyde gel electrophoresis

The acute phase response refers to a nonspecific and complex systemic reaction of the organism that occurs shortly after any tissue injury. The acute phase response is considered a part of the innate host defense system, which is responsible for the survival of the host during the critical early stages of attack, and in evolutionary terms, it precedes the acquired immune response. The purpose of this study was to determine serum protein concentrations, including the acute phase protein profile in agoutis (Dasyprocta azarae) in captivity, by means of sodium dodecyl sulfate polyacrylamide gel electrophoresis. Blood samples from 11 adult healthy animals (nine females and two males) were obtained. The serum proteinogram had 21 proteins with molecular weights ranging from 15 to 240 kD. The acute phase proteins identified were: ceruloplasmin, transferrin, albumin, haptoglobin, α-1-acid glycoprotein, and hemoglobin. IgA, IgG heavy and light chains, and nonnominal identified proteins of 240, 210, 140, 98, 78, 48, 35, 31, 23, and 15 kD were also identified. The determination of the acute phase protein concentrations is a useful method for the early detection of subclinical disease or changes in the healthy animal, with predictive information on the development of disease in the future. It is possible to standardize the reference values of the serum protein profile of agoutis, which can be used for diagnosis and prognosis, treatment and clinical follow-up of nutritional disorders, and immune-mediated inflammatory diseases that may affect these animals. © 2012 Springer-Verlag London Limited.