Life expectancy and death pattern associated with systemic lupus erythematosus diagnosis in Brazil between 2000 and 2019

OBJECTIVES

to evaluate the main factors associated with mortality and determine the life expectancy of SLE patients between 2000 and 2019 years in Brazil.

METHODS

death data related to SLE available in the Brazilian Unified Health System (SUS) (DATASUS) were evaluated in all Brazilian states. Three groups of death causes potentially associated from SLE were evaluated: cardiovascular and kidney diseases and infections.

RESULTS

The main causes of death associated with SLE were infection and kidney disease. Most SLE patients died between 19 and 50 years of age. Deaths associated with kidney disease were proportionally higher than in the general population with progressive decrease during the period. Instead, there have been an increase in the proportion of deaths due to infections both in SLE and in the general population.

CONCLUSIONS

SLE patients presented higher mortality compared to the general population matched for sex and age and the main causes associated with death were infection and kidney disease. Public health policies that promote early diagnosis, treatment and prevention of damage are necessary to reduce morbidity and mortality in SLE patients.

143 Stimulated glycolysis is able to maintain ATP levels and motility of bull spermatozoa submitted to mitochondrial depolarisation

Studies have reported the importance of mitochondria in sperm metabolism. However, for some species, glycolysis appears to be as essential as oxidative phosphorylation in sperm physiology. On the other hand, these mechanisms have not been fully elucidated for bovine spermatozoa. Therefore, the aim of this study was to evaluate the role of mitochondria and glycolysis in ATP synthesis and sperm kinetics of bovine spermatozoa. For this purpose, sperm from seven bovine epididymides (n=7) was collected and diluted to a concentration of 100×106 spermatozoamL−1 in Tyrode's albumin lactate pyruvate medium. Then, each sample was divided into 10 aliquots and evaluated in a 2×5 factorial design, with the first factor being the presence or absence of glucose (5mM) to stimulate glycolysis and the second factor being treatment with the mitochondrial uncoupler carbonyl cyanide 4-(trifluoromethoxy) phenylhydrazone (FCCP; 0, 0.1, 0.3, 1, and 3 µM) to deplete mitochondrial ATP. Sperm samples were subjected to measurements of ATP levels using a luminescence technique (CellTiter-Glokit, Promega), with ATP levels measured in duplicate. In addition, sperm samples were subjected to computerised analysis of total and progressive motilities (ISAS, Proiser). Statistical analysis was performed using SAS (SAS Institute Inc.), where the interaction between the factors was analysed using PROC GLM and the comparison between groups was performed using means analysis of variance (least significant difference test). It was considered significant at 5%. Adenosine triphosphate was lower at FCCP concentrations of 0.3 µM (180.3±31.9nM), 1 µM (220.2±40.4nM), and 3 µM (272.3±70.4nM) than at 0 µM (control; 448.6±63.7nM) and 0.1 µM (422.4±41.5nM) in the absence of glucose. However, in the groups treated with FCCP supplemented with glucose, ATP concentrations did not differ among the groups (0 µM: 577.2±70.4 nM; 0.1 µM: 610.8±57.8 nM; 0.3 µM: 606.2±64.2 nM; 1 µM: 670.9±61.9 nM; 3 µM: 696.1±68.5nM). Additionally, total motility was lower in FCCP-treated groups without glucose supplementation. On the other hand, total motility increased in the groups treated with 0.3, 0.1, 1, and 3 µM FCCP supplemented with glucose. A similar effect was verified for progressive motility. Based on these results, we can suggest that glucose supplementation is able to maintain ATP levels and motility in bull sperm undergoing FCCP-induced mitochondrial depolarisation.

154 Exposure of bulls to heat stress had deleterious effects on embryo development

Concerns about global climate change reducing animal fertility are arising. Therefore, our objective was to determine the effects of increased environmental temperature on Holstein bulls and its effects on sperm quality and embryo development. Frozen semen samples were obtained from 6 bulls exposed to natural heat stress (HS) in August 2016, compared with a lower temperature (control) in March 2016 (temperature-humidity index of up to 74.5 and 40.6, respectively). We evaluated sperm morphology, embryo development, gene expression, inner cell mass/trophectoderm ratio (ICM/TE), and apoptosis cell ratio of Day-8 blastocysts. Sperm morphology was evaluated using eosin/nigrosin staining. Blastocysts were produced by routine in vitro methods (Wydooghe et al. 2014 Reprod. Fertil. Dev.). Cleavage rates were determined 48h after insemination, and blastocyst rates were determined on Days 7 and 8. Expression of NANOG, SOX2, POU5F1, DNMT (1, 3a, 3b), HSP (A1a, A2, A8, 10, 60, 90), HSF1, IFNT2, H19, SNRPN, IGF2, IGF2R, MEST, PHLDA2, MEG3, MEG9, PEG10 and PLAGL1 were analysed. Total RNA was extracted from Day-8 blastocysts for gene expression analysis using RNeasy Micro Kit (Qiagen, Valencia, CA, USA). Reverse transcription and qPCR were performed with iScript (BioRad, Hercules, CA, USA) and SsoAdvanced™ Universal SYBR® Green Supermix (BioRad) in a CFX Connect system (BioRad). Blastocysts were differentially stained (Wydooghe et al. 2011 Anal. Biochem.) and analysed using a Leica TCS-SP8×confocal microscope (Leica Microsystems, Wetzlar, Germany). Data analyses included a GLM procedure and paired-samples Student’s t test (P ≤ 0.05). A normal distribution was verified with a UNIVARIATE procedure and Shapiro-Wilk test. A Wilcoxon signed rank test was used to analyse qPCR data. Detached heads (P=0.006) and coiled tails (P=0.018) were significantly lower in the HS group (4.9 and 0.2%, respectively) compared with the control (5.5 and 0.5%). Moreover, proximal droplets (P=0.051) were lower in the HS group (0.7%) compared with the control (1.3%). Remarkably, cleavage and blastocyst rates at Days 7 and 8 were significantly higher in control (78.4, 19.6 and 29.5%, respectively) compared with HS (75, 14.5 and 23.2%). Early and normal blastocysts were grouped as early stage, whereas expanded, hatching and hatched blastocysts were grouped as advanced stage. There was a significant reduction in the HS group of early stage blastocysts on Day 7 and of advanced stage blastocysts on Days 7 and 8. However, in Day-8 blastocysts, there was no significant difference in gene expression for any target gene. Moreover, there were no significant differences in total number of cells or apoptosis cell ratio in blastocysts. However, the ICM/TE ratio was significantly higher (P=0.021) in control (0.7) compared with HS (0.56). Sperm samples collected in August had reduced fertility compared with those obtained in March. Although fewer sperm abnormalities were present in HS, based on decreased blastocyst rates and ICM/TE ratio in embryos produced with HS semen, we inferred that molecular mechanisms for advanced blastocyst development were affected. However, those mechanisms did not involve our target genes. This work was funded by the European Union, Horizon 2020 Marie Sklodowska-Curie Action, REPBIOTECH 675526.