MMP2 rs243866 and rs2285053 Polymorphisms and Alzheimer’s Disease Risk in Slovak Caucasian Population

Alzheimer’s disease (AD) is an age-related neurodegenerative disorder characterised by progressive loss of memory. In the AD brain, matrix metalloproteinases (MMPs) are involved in the disruption of the blood-brain barrier resulting in a neuroinflammatory response. The objective of our investigation was to assess the association of MMP2 rs243866 and rs2285053 polymorphisms with susceptibility to AD, to assess the interaction of MMP2 variants with APOE ε4 risk allele, and to evaluate their influence on the age at disease onset and MoCA score. A total of 215 late-onset AD patients and 373 control subjects from Slovakia were genotyped for MMP2 rs243866 and rs2285053 polymorphisms. The MMP2 association with AD risk and clinical parameters was evaluated by logistic and linear regression analyses. No statistically significant differences in either MMP2 rs243866 and rs2285053 allele or genotype frequencies between AD patients and the control group have been observed (p > 0.05). However, the correlation with clinical findings revealed a higher age at disease onset in MMP2 rs243866 GG carriers in the dominant model as compared to other MMP2 genotype carriers (p = 0.024). Our results suggest that MMP2 rs243866 promoter polymorphism may have an impact on the age at AD onset in the patients.

Protective Effect of Vegan Microbiota on Liver Steatosis Is Conveyed by Dietary Fiber: Implications for Fecal Microbiota Transfer Therapy

Fecal microbiota transfer may serve as a therapeutic tool for treating obesity and related disorders but currently, there is no consensus regarding the optimal donor characteristics. We studied how microbiota from vegan donors, who exhibit a low incidence of non-communicable diseases, impact on metabolic effects of an obesogenic diet and the potential role of dietary inulin in mediating these effects. Ex-germ-free animals were colonized with human vegan microbiota and fed a standard or Western-type diet (WD) with or without inulin supplementation. Despite the colonization with vegan microbiota, WD induced excessive weight gain, impaired glucose metabolism, insulin resistance, and liver steatosis. However, supplementation with inulin reversed steatosis and improved glucose homeostasis. In contrast, inulin did not affect WD-induced metabolic changes in non-humanized conventional mice. In vegan microbiota-colonized mice, inulin supplementation resulted in a significant change in gut microbiota composition and its metabolic performance, inducing the shift from proteolytic towards saccharolytic fermentation (decrease of sulfur-containing compounds, increase of SCFA). We found that (i) vegan microbiota alone does not protect against adverse effects of WD; and (ii) supplementation with inulin reversed steatosis and normalized glucose metabolism. This phenomenon is associated with the shift in microbiota composition and accentuation of saccharolytic fermentation at the expense of proteolytic fermentation.

Mental health of the Slovak population during COVID-19 pandemic: A cross-sectional survey

BACKGROUND

Population’s mental health surveillance is essential for knowing the distribution of mental well-being and mental disorders in the society. This allows for the establishment, evaluation, and revision of preventive measures and curative services. The results of such monitoring should serve as a database for evidence-based mental health policy. Mental disorders are among the top ten causes of burden globally and crisis situations such as the pandemic increase the risk of mental health problems, as they cause constant fear of contagion and the implementation of restrictive measures. The impact of the coronavirus disease 2019 (COVID-19) pandemic on the general population of the Slovak Republic has not yet been studied. The hypothesis was that more than one fifth of the population (women to a greater extent) will have symptoms of anxiety and depression.

AIM

To assess the mental health of the general Slovak population aged 15 years and older in the summer of 2021 by determining the prevalence of depressive and anxiety symptoms.

METHODS

An anonymous cross-sectional survey was implemented in a sample of 1501 respondents in the summer of 2021 during the COVID-19 pandemic. The inclusion criteria were age of 15 years and older and ability to complete the survey questionnaire online or in a face-to-face interview. The survey assessed anxiety symptoms by the seven-item general anxiety disorder and depressive symptoms by the nine-item patient health questionnaire instruments. Recognized cut-off scores of 10 or greater were used for both.

RESULTS

Anxiety symptoms were present in 19.32% and depression in 24.65% of the sample. Symptoms of both disorders were more common in females: 15.00% of males and 24.00% of females experienced anxiety symptoms, and 19.00% of males and 30.00% of females experienced symptoms of depression. Symptoms of both disorders were the most common in the youngest age group (15-25 years old): One fifth of males (20.29%) and one third of females (35.32%) had symptoms of anxiety, and 26.09% males and 43.79% females had symptoms of depression. Mean score for anxiety was 5.44 [standard deviations (SD) = 4.96] for the overall sample, 6.15 (SD = 5.14) for females, and 4.67 (SD = 4.63) for males. The youngest females of the 15-25 years age group had the highest score (7.55, SD = 5.27) among all age groups, for both sexes. Mean score for depression was 6.74 for the overall sample (SD = 5.75), 7.43 for females (SD = 5.87), and 5.99 (SD = 5.52) for males. The highest depression score was observed in the youngest females of the 15-25 years age group (9.34, SD = 6.07). We found a significant association between anxiety or depressive symptoms and younger age [odds ratio (OR): 1.69, 95% confidence interval (CI): 1.16-2.45 and OR: 1.65, 95%CI: 1.17-2.34, respectively], being female (OR: 1.86, 95%CI: 1.42-2.42 and OR: 1.76, 95%CI: 0.20-0.29, respectively), and having primary education (OR: 1.66, 95%CI: 1.08-2.54 and OR: 1.65, 95%CI: 1.16-2.63, respectively).

CONCLUSION

Results of our study indicate that anxiety and depression are frequent in the Slovak Republic during the COVID-19 pandemic. This important observation should serve as an information basis for the development of effective mental health policies, consisting of preventive programs, and early detection and effective treatment services. The study results provide strong argument for the necessity of mental health reform that is currently being shaped in the Slovak Republic.

Vegan Diet Is Associated With Favorable Effects on the Metabolic Performance of Intestinal Microbiota: A Cross-Sectional Multi-Omics Study

Background and Aim: Plant-based diets are associated with potential health benefits, but the contribution of gut microbiota remains to be clarified. We aimed to identify differences in key features of microbiome composition and function with relevance to metabolic health in individuals adhering to a vegan vs. omnivore diet. Methods: This cross-sectional study involved lean, healthy vegans (n = 62) and omnivore (n = 33) subjects. We assessed their glucose and lipid metabolism and employed an integrated multi-omics approach (16S rRNA sequencing, metabolomics profiling) to compare dietary intake, metabolic health, gut microbiome, and fecal, serum, and urine metabolomes. Results: The vegans had more favorable glucose and lipid homeostasis profiles than the omnivores. Long-term reported adherence to a vegan diet affected only 14.8% of all detected bacterial genera in fecal microbiome. However, significant differences in vegan and omnivore metabolomes were observed. In feces, 43.3% of all identified metabolites were significantly different between the vegans and omnivores, such as amino acid fermentation products p-cresol, scatole, indole, methional (lower in the vegans), and polysaccharide fermentation product short- and medium-chain fatty acids (SCFAs, MCFAs), and their derivatives (higher in the vegans). Vegan serum metabolome differed markedly from the omnivores (55.8% of all metabolites), especially in amino acid composition, such as low BCAAs, high SCFAs (formic-, acetic-, propionic-, butyric acids), and dimethylsulfone, the latter two being potential host microbiome co-metabolites. Using a machine-learning approach, we tested the discriminative power of each dataset. Best results were obtained for serum metabolome (accuracy rate 91.6%). Conclusion: While only small differences in the gut microbiota were found between the groups, their metabolic activity differed substantially. In particular, we observed a significantly different abundance of fermentation products associated with protein and carbohydrate intakes in the vegans. Vegans had significantly lower abundances of potentially harmful (such as p-cresol, lithocholic acid, BCAAs, aromatic compounds, etc.) and higher occurrence of potentially beneficial metabolites (SCFAs and their derivatives).

Gender differences in LDL and HDL subfractions in atherogenic and nonatherogenic phenotypes

OBJECTIVES

The aim of our study was to examine the role of low density lipoprotein (LDL)-subfractions in individuals with the atherogenic and non-atherogenic phenotype and the gender differences in lipoprotein subfractions including small dense LDL (sdLDL) and small high density lipoprotein (sHDL) subfractions representing the most atherogenic lipoprotein subfractions.

DESIGN & METHODS

35 persons in the atherogenic group (AG) (with sdLDL_3-7 subfractions ≥6 mg/dl) and 104 individuals in the non-atherogenic group (NAG) (sdLDL_3-7 subfractions <6 mg/dl) were included in our study. To analyze plasma lipoprotein subfractions, a polyacrylamide gel electrophoresis-the Lipoprint system was used.

RESULTS

Males compared to females in the AG had significantly higher levels of atherogenic lipoprotein subfractions such as HDL_8, HDL₉ and HDL₁₀. All participants in AG had significantly lower levels of intermediate density lipoprotein IDL-A than those in NAG but significantly higher levels of IDL-B and IDL-C. Males in the AG compared to NAG had significantly lower levels of LDL₁ and higher levels of LDL₂ and LDL_3-7 subfractions. In the NAG LDL₂ positively correlated with sHDL subfractions while in the AG with the large HDL subfraction.

CONCLUSION

Results of our study demonstrate more atherogenic profile in males compared to females and a double role of LDL2 subfraction in the atherogenic process depending on the phenotype (atherogenic/non-atherogenic) of individuals.

Neurocognitive Predictors of Understanding of Intentions in Parkinson Disease

OBJECTIVES

Theory of Mind (ToM), the ability to understand other people's mental states, is essential in everyday social interactions. The relationship between cognitive domains and ToM impairment in Parkinson disease (PD) has been receiving growing attention with ambiguous findings. The objective of the current study was to ascertain which cognitive domain predicts understanding of intentions and the impact of PD-specific clinical measures on ToM performance. A secondary aim was to evaluate whether cognitive impairment mediates the relationship between severity of illness and ToM impairment.

METHODS

Fifty-one nondemented patients with idiopathic PD, ranging from early to advanced stages, were enrolled. A comprehensive neurocognitive battery and 2 ToM tasks (Hinting Task and Comic Strip Task) were administered during the patients' best "on" medication state.

RESULTS

Only the task of measuring working memory capacity was significantly associated with both ToM tasks (Hinting Task Spearman rank correlation [ rs] = 0.309, P ≤ .05; Comic Strip Task rs = 0.595, P ≤ .01). Patients with more progressed disease and higher doses of dopaminergic medication performed significantly worse in the Comic Strip Task. Based on the mediation analysis, relationship between the severity of the illness and understanding of intentions was mediated by cognitive flexibility.

CONCLUSION

In PD, understanding of intentions is related to neurocognition, with working memory and cognitive flexibility playing a crucial role. The severity of PD predicts ToM performance.

Prevalence, Recognition, and Treatment of Dementia in Assisted Living Facilities

BACKGROUND/AIMS

Dementia and psychiatric disorders are common in assisted living facilities (ALFs) and have suboptimal rates of recognition and treatment. Therefore, we aimed to obtain a direct estimate of the prevalence of cognitive impairment and especially dementia among residents of ALFs in western Slovakia and their rates of primary recognition and adequate treatment.

METHODS

We conducted two cross-sectional studies. Ten ALFs within the city of Bratislava were chosen for the study in 2004, and again in 2011. A total of 866 residents in ALFs were examined in 2004, and 821 residents in ALFs were examined in 2011. The rate and characterization of dementia, its primary recognition and adequate treatment were investigated in both cross-sectional studies.

RESULTS

In 2004, 57% of the participants had dementia. Only 7.2% of the participants with probable Alzheimer disease were treated with acetylcholinesterase inhibitors. In 2011, we observed a significant improvement in primary diagnostics and therapy. 66.9% of the cases of dementia were adequately evaluated, and 52.1% were adequately treated.

CONCLUSION

Cognitive deficit and dementia are significantly underdiagnosed and undertreated in assisted living settings. In the second cross-sectional study we detected significant but not complete improvement in the primary recognition and adequate therapy of dementia.

Experience with high doses of ibuprofen in the long-term treatment of rheumatoid arthritis

Ibuprofen (Brufen) is a non-steroidal anti-inflammatory drug well-established in the symptomatic treatment of rheumatoid arthritis. In view of its exceptionally good tolerance it has become fashionable to prescribe increasingly large doses for severe cases or in those patients unable to tolerate other anti-rheumatic compounds. This study illustrates the sustained therapeutic benefit and almost complete lack of toxicity in fify-nine rheumatoid patients treated with up to 1,600 mg ibuprofen daily over six months. Significant improvement occurred in all clinical parameters and gastro-intestinal upset leading to discontinuance of therapy was reported in just two patients. There were no abnormalities in any of the biochemical tests performed.