Vaccine-carditis study: Spanish multicenter registry of inflammatory heart disease after COVID-19 vaccination

INTRODUCTION AND OBJECTIVES

Vaccines against SARS-CoV-2 have been a major scientific and medical achievement in the control of the COVID-19 pandemic. However, very infrequent cases of inflammatory heart disease have been described as adverse events, leading to uncertainty in the scientific community and in the general population.

METHODS

The Vaccine-Carditis Registry has included all cases of myocarditis and pericarditis diagnosed within 30 days after COVID-19 vaccination since August 1, 2021 in 29 centers throughout the Spanish territory. The definitions of myocarditis (probable or confirmed) and pericarditis followed the consensus of the Centers for Disease Control and the Clinical Practice Guidelines of the European Society of Cardiology. A comprehensive analysis of clinical characteristics and 3-month evolution is presented.

RESULTS

From August 1, 2021, to March 10, 2022, 139 cases of myocarditis or pericarditis were recorded (81.3% male, median age 28 years). Most cases were detected in the 1st week after administration of an mRNA vaccine, the majority after the second dose. The most common presentation was mixed inflammatory disease (myocarditis and pericarditis). 11% had left ventricular systolic dysfunction, 4% had right ventricular systolic dysfunction, and 21% had pericardial effusion. In cardiac magnetic resonance studies, left ventricular inferolateral involvement was the most frequent pattern (58%). More than 90% of cases had a benign clinical course. After a 3-month follow-up, the incidence of adverse events was 12.78% (1.44% mortality).

CONCLUSIONS

In our setting, inflammatory heart disease after vaccination against SARS-CoV-2 predominantly affects young men in the 1st week after the second dose of RNA-m vaccine and presents a favorable clinical course in most cases.

The role of cellular plasticity in cancer development

It has traditionally been accepted that, in the process of cellular differentiation, developmental options are progressively restricted until commitment to a specific fate is established and then only terminal differentiation along this lineage is possible. Although this is usually the case in normal physiological development, the latest experimental evidences indicate that the differentiated state of mature cells is not always as stable and durable as it was thought to be. In fact, recently, a hidden plasticity has been revealed in differentiated cells which allows them to deviate to other cell types that might be, functionally, very far away in other developmental pathways. This plasticity has biological significance since it is necessary for normal development to occur, but it also makes possible the emergence of aberrant lineages when interferences with the normal transcriptional and epigenetic mechanisms in charge of maintaining cellular identity do appear. Cancer is one of the possible outcomes of this aberrant reprogramming. The plasticity of the initial cell suffering the first oncogenic alteration plays an essential role in cancer development, since only if this cell possesses enough plasticity a tumoral reprogramming will be possible and a full-blown tumor will develop. Also, plasticity makes it possible for differentiated cells to acquire cancer stem cell properties in the presence of the appropriate oncogenic insults. In this review we discuss the role of cellular plasticity in the normal development of adult tissues and how cellular susceptibility to reprogramming plays an essential part in cancer development.

Ethanol and phosphatidylethanol reduce the binding of [3H]inositol 1,4,5-trisphosphate to rat cerebellar membranes

In this study, we have analysed the effect of ethanol and phosphatidylethanol, a unique phospholipid formed only in the presence of ethanol, on the binding of [3H]inositol 1,4,5-trisphosphate to rat cerebellar membranes. Rats were intraperitoneally injected daily with 3 g of ethanol/kg body weight for different periods of time. Repeated administration of ethanol induced a reduction in the binding capacity (Bmax) without affecting the affinity constant (Kd). A significant 32% reduction was observed after 21 days of exposure (from control Bmax values of 25 +/- 3 pmol/mg and Kd values of 9 +/- 2 nM). In an in-vitro assay, phosphatidylethanol (500 microM) and phosphatidic acid (500 microM, but no other phospholipids tested, induced a reduction in Bmax (39% and 43%, respectively). The observed effect displayed by phosphatidylethanol was not due to its degradation to phosphatidic acid or other phospholipids. The results emphasize the importance of examining phosphatidylethanol (PEth) as a possible mediator of the effects of ethanol on cellular processes. However, the role of PEth in the observed effect of long-term ethanol exposure still needs further consideration.

Ethanol potentiates the uptake of [14C]serine into phosphatidylserine by base-exchange reaction in NG 108-15 cells

Phospholipid base-exchange enzymes catalyze the incorporation of nitrogenous bases into phosphoglycerides by a calcium-dependent mechanism. In this study, we describe the effect of ethanol on the incorporation of radioactive serine, choline and ethanolamine into their respective phospholipids in a neuroblastoma x glioma hybrid cell line (NG 108-15). Long term ethanol exposure induced a potentiation of the incorporation of [14C]serine into phosphatidylserine. Moreover, the phosphorus content of PS was found to be increased after long-term ethanol exposure. No concomitant changes in the phosphorus content of other phospholipids were observed. The results indicate that in NG 108-15 cells, the incorporation of radiolabelled serine into PS is potentiated during chronic ethanol exposure.

[The endoscopic treatment of pancreatic pseudocyst]

We define in this paper different modalities of endoscopic treatment as well as the criteria for this procedure. Endoscopic drainage were done through cystoenterostomy and nasocystic drainage and enterocystic prosthesis plus sphincterostomy of the principal pancreatic and biliary duct, in all patients, but only in eleven of them we implanted the prosthesis in both ducts. The complication was bleeding, in two patients (16.7%) and they were treated with endoscopic inyectotherapy.

Mechanisms of adaptation to the effects of ethanol on activation of phospholipase C in NG 108-15 cells

In this study the effect of different times of exposure to ethanol (1-7 days, 100 mM) on bradykinin and GTP(S)-stimulated activation of phospholipase C in NG 108-15 cells and on the binding of [3H]bradykinin to its receptors was investigated. Ethanol attenuated both agonist and GTP-analogue-induced hydrolysis of phosphoinositides for a period of up to 4 days of treatment, while exerting no effect on binding to bradykinin receptors. However, after 7 days of exposure to ethanol, the agonist-induced activation of phospholipase C was completely resistant to the inhibitory effects of alcohol. This finding correlated to a change in the affinity of the bradykinin receptor population after 7 days of treatment. The results indicate that bradykinin-induced breakdown of phosphatidylinositol 4,5-bisphosphate adapts to the effects of ethanol, after long-term treatment. Possible adaptative changes taking place at the level of the G protein(s), may induce a shift in the affinity of the receptor population and, consequently, serve as a compensatory mechanism to counteract the inhibitory effect of ethanol.

A method for maintaining constant ethanol concentrations in cell culture media

The present study reports on the development of a model for maintaining constant ethanol concentrations over time in cell culture media. When neuroblastoma x glioma cells (NG 108-15) were grown in ethanol containing media under standard cultivation conditions in the incubator at 37 degrees C, a 90% evaporation was observed after 24 hr. To counteract evaporation, the cell culture dishes were placed inside polystyrene boxes together with an open dish containing an appropriate amount of ethanol. By using such procedure, the decrease in ethanol concentration in the culture media was completely avoided. Cultivating cells in ethanol-free media inside sealed plastic boxes did not change their viability, growth rate, protein and phospholipid composition of the cells or the pH of the media, compared to cultures grown outside the boxes.

Antinociceptive activity of glycosidic enkephalin analogues

The antinociceptive activity of two new enkephalin analogues: N1.5-(beta-D-glucopyranosyl)[D-Met2, Pro5]enkephalinamide and N1.5-(beta-D-galactopyranosyl)[D-Met2, Pro5]enkephalinamide was assessed using the tail immersion and paw pressure behavioural tests. Both enkephalin analogues appear to be more active than morphine when injected either into the fourth ventricle or intrathecally; the galactose analogue is more than 5000 times more active than morphine when injected into the fourth ventricle. The analgesic effects produced by the analogues are partially reversed by SC naloxone (0.1 mg/kg) and totally reversed when the dose of naloxone used was 1 mg/kg, suggesting that the analogues act upon more than one type of opiate receptor (mu/delta).

Intrathecal administration of 5,6-DHT or 5,7-DHT reduces morphine and substance P-antinociceptive activity in the rat

The administration of SP (15 and 50 ug) and morphine sulphate (10 ug) either into the IV ventricle or intrathecally produces an analgesic effect. This effect was attenuated when the rats received previously an intrathecal dose of 5,6-DHT or 5,7-DHT. The consequences of neurotoxin administration upon monoamine descending systems were evaluated by measuring 14C-5HT and 3H-NA synaptosomal uptake in different structures of the CNS. SP levels were also determined in the animals injected with the neurotoxins. Our results confirm the existence of a relationship injected with the neurotoxins. Our results confirm the existence of a relationship between the 5HT and SP descending systems, which control the nociceptive information at the level of the dorsal horn of the spinal cord.