Mitochondrial health index correlates with plasma circulating cell-free mitochondrial DNA in bipolar disorder

Although mitochondrial dysfunction is known to play an essential role in the pathophysiology of bipolar disorder (BD), there is a glaring gap in our understanding of how mitochondrial dysfunction can modulate clinical phenotypes. An emerging paradigm suggests mitochondria play an important non-energetic role in adaptation to stress, impacting cellular resilience and acting as a source of systemic allostatic load. Known as mitochondrial allostatic load, this (phenomenon) occurs when mitochondria are unable to recalibrate and maintain cell homeostasis. This study aimed to evaluate the composite mitochondrial health index (MHI) in BD subjects and non-psychiatry controls. We will also explore whether lower MIH will be related to higher cell-free mtDNA (ccf-mtDNA) levels and poor clinical outcomes. In this study, 14 BD-I patients and 16 age- and sex-matched non-psychiatry controls were enrolled. Peripheral blood mononuclear cells (PBMCs) were used to measure the enzymatic activities of citrate synthase and complexes I, II, and IV and mtDNA copy number. Ccf-mtDNA was evaluated by qPCR in plasma. Mitochondrial quality control (MQC) proteins were evaluated by western blotting. After adjusting for confounding variables, such as age, sex, body mass index (BMI), and smoking status, patients with BD presented lower MHI compared to non-psychiatry controls, as well as higher ccf-mtDNA levels that negatively correlated with MHI. Because the MQC network is essential to maintain mitochondrial health, MHI and ccf-mtDNA were also examined in relation to several MQC-related proteins, such as Fis-1, Opa-1, and LC3. Our results showed that MHI correlated negatively with Fis-1 and positively with Opa-1 and LC3. Accordingly, ccf-mtDNA had a positive correlation with Fis-1 and a negative correlation with Opa-1 and LC3. Furthermore, we found a noteworthy inverse correlation between illness severity and MHI, with lower MHI and higher ccf-mtDNA levels in subjects with a longer illness duration, worse functional status, and higher depressive symptoms. Our findings indicate that mitochondrial allostatic load contributes to BD, suggesting mitochondria represent a potential biological intersection point that could contribute to impaired cellular resilience and increased vulnerability to stress and mood episodes. Ultimately, by linking mitochondrial dysfunction to disease progression and poor outcomes, we might be able to build a predictive marker that explains how mitochondrial function and its regulation contribute to BD development and that may eventually serve as a treatment guide for both old and new therapeutic targets.

Environmental and anthropic variabilities at Guanabara Bay (Brazil): A comparative perspective of metal depositions in different time scales during the last 5,500 yrs

The determination of age-dated metal sediment accumulation rates in a representative South American bay is able to portray the dimension of human impacts during the colonial occupation and industrial periods. Many studies have assessed metal distribution and chronology at Guanabara Bay, in Brazil. However, understanding natural variabilities associated to paleoclimatic changes and comparing these natural variabilities to anthropogenic processes are not well established to date. Accurate geochronological control integrating ages determined by ²¹⁰Pb and ¹⁴C chronologies through an exponential spline fit model allowed for a precise definition of changes associated to the holocene marine transgression, as well as the colonial period, leading to intense land use changes, and the industrial period. The reference values of the system were defined based on their concentrations and the accumulation rates of ecotoxicologically important metals. Al, Ba, Fe, Cd, Cu, Cr, Li, Ni, Mn, Pb, Si, Ti, V, and Zn distributions were determined in a Guanabara Bay core (BG-28) by the EPA 3051 method. Elemental distribution profile assessment allowed for the identification of variabilities associated to weathering processes, predominantly of lithogenic origin, mainly for Al, Ba, Fe, Li, Si, and V. Weathering processes occurred simultaneously to land use changes in the drainage basin since the colonial period, at 400 cal yr BP, and during the industrial period, mainly after the 1960s, denoted by Cd, Cr, Cu, Mn, Pb and Zn increases. The highest average metal enrichment values metals associated to industrial processes reached 5.95, with 119.1-fold higher accumulation rates than the background accumulation values observed between 4200 and 500 cal yr BP.

Ageing and inequality: unintentional death in the elderly in Campinas in the 21st century

According to WHO falls are the second leading cause of preventable unintentional death and people older than 65 years of age are more likely to suffer from fatal falls. Low and middle-income countries are most affected with 80% of fall related deaths. This study provides an overall view of fall-related deaths in the city of Campinas, Brazil, with special attention to the elderly in the last 2 decades. This study aims to highlight the unequal distribution of deaths related to fall, concerning the elderly in Campinas (total population of around 1,000,000), which in 2010 had a very high Human Develop Index (0.805), but also a very high inequality rate (Gini index of 0.56 in 2010).

This ecological study in Campinas evaluates fall-related deaths in the elderly between years 2000 and 2018. Trend analysis were applied to the specific mortality ratios related to falls obtained from Brazil's official databases. Specific mortality trends were also analyzed regarding Human Development Index by neighborhood. The number of deaths due to fall in the elderly throughout the period totaled 1700 (1 million of population). The annual average was 85 (minimum of 31 in 2000 and maximum of 157 in 2018). Although trend analysis of mortality in the elder due to “overall external causes” and of mortality due to “fall in the elderly” didn't show clear growing tendencies (R2=0.546 and R2=0.622), the ratio between “number of deaths due to fall in the elderly” and “total deaths due to fall” shows a reliable average of 1.17% increase per year (from 3.73% in 2000 to 26.03% in 2018, R2=0.93). Trend-analysis based on community HDI mortality rates additionally shows a tendency of increase both in “number of deaths” and “mortality rate” in low-HDI elder (with R2=0.85 and R2=0.786).

Despite decreasing violence levels in Campinas, fatal deaths due to fall seem to target low-HDI elder population. Effort must be taken in all levels of the healthcare system as well as in policies to soften inequality's effect.

Key messages

Violent, unintentional causes of death in the elderly population are increasing along with population ageing. Politicians and health managers must pay attention to inequality-related health problems and take into account population ageing for a sustainable universal health system coverage.

Different settings of violence and risk factor for suicide: a case-control study in Campinas, Brazil

Background

According to WHO, “800,000 people die due to suicide every year” and “is the third leading cause of death in 15-19-years-old”. And although the main risk factor to suicide is a prior attempt, this study tried to find other risk factors, which can guide a broader discussion amongst global and local communities as well as policy makers and healthcare professionals effort against all forms of violence. The aim of the study is to measure the risk of suicide in different sets of violence.

Methods

This is a case-control study held in Campinas-SP, by epiGeo research group on violence during 2019. Cases are defined as people who commited suicide; information on child abuse were collected through verbal autopsy interviews with kinships. For controls, R randomly selected addresses for interview with someone randomly selected. Odds Ratio was obtained by generalized logistic regression. Confidence Interval was set to 95%.

Results

Final analysis shows that suicides represented 14.2% of death due to external causes in 2019. A relation between male sex and suicide was observed (OR: 4.35; CI 2.55 - 7.41; p < 0.0001). Abuse during childhood also showed positive relation (RR: 2.16; CI 1.09 - 4.27; p = 0.0001). Another relation were observed in people with disabilities and suicide risk (RR: 2.04; CI 1.26 - 3.31; p = 0.004).

Conclusions

People who suffered child abuse and people with disabilities are amongst the ones who suffer higher risks of suicide, and the most probable hypothesis relating both conditions is violence. Action must be taken by the global and local communities, policy makers in a broad sense, against maltreatment, bullying, youth violence, intimate partner violence, sexual violence, emotional and psychological violence, and gender-based violence.

Key messages

Strengthening protective policy to overcome violence and abuse against child and other vulnerable people is of major importance to fight suicide risk. Accessibility and protective policies are of utmost importance to a more inclusive and welcoming society.

The socio-economical impact of work related deaths: the problem of work precarization

According to ILO, 6000 people die of work-related conditions. In Brazil, 4th in the rank of deaths related to work, 1 person day each 4 hours due to fatal accidents related to work (FARW). This study is an attempt to provide an overview on the impact of FARW in the family of the deceased workers. This is an epidemiological study, part of a research, conducted by epiGeo, in the city of Campinas, Brazil, 2015 and 2020, when the families of 73 workers (out of 82) that died of FARW were interviewed. The aim of the interviews was to evaluate the social impacts of FARW in the families, considering pre-determined parameters as follows.

Out of 73 families interviewed, 15 (20.83%) of them didn't have access to the national social compensations, due to informality. Although 58 of the workers contributed to the national social security system, only 38 (65.55%) of them had access to social security pensions due to the death of their relatives. Regarding income, 47 families (64.38%) reported impacting decrease in income, and 5 of them (6,8%) reported extreme economical hardship. In the last two years Brazilian national policy regarding work-related rights has been changing greatly. According to the Brazilian Geography and Statistics Institute (IBGE), the number of informal jobs had achieved an astonishing record number of 11.7mi workers in 2019, which can have impacts not only on the informalization and precarization of work which will also increase the difficulties to the access to the social security system rights.

Further research should be conducted to understand why people are not having access to their social security rights. Health policy makers and health personnel must be aware of the impact on workers health and working conditions, caused by work precarization legislations. The socio-economic impact of work related deaths: the problem of work precarization.

Key messages

The precarization of work caused by work-related legislative reforms can cause severe impacts on social security access. Families of workers that died of work-related fatal accidents have an important negative impact on income.

Sediment metal enrichment and ecological risk assessment of ten ports and estuaries in the World Harbours Project

Ten global harbours were assessed for sediment quality by quantifying the magnitude of anthropogenic change and ecological risk. Anthropogenic change (enrichment) was high for Derwent River and Sydney estuary, moderate for Santander Harbour, Rio de Janeiro and Dublin Port, slight for Hong Kong, minimal for Darwin. All 10 enrichment indices used showed similar results. Derwent River sediment was rated at high ecological risk, followed by Sydney and Santander estuaries with moderate risk. Auckland and Darwin sediments exhibited minimal ecological risk and sediment in the remaining harbours (Dublin, Hong Kong, Ravenna, Ria de Vigo and Rio de Janeiro) were assessed at slight ecological risk. The extraordinary variety of environments and types/quantities/qualities of data investigated resulted in as much a critique and development of methodology, as an assessment of human impact, including unique techniques for elemental normalisation and contaminant classification. Recommendations for an improved technical framework for sediment quality assessment are provided.

Antidepressant-like effect of nitric oxide synthase inhibitors and sildenafil against lipopolysaccharide-induced depressive-like behavior in mice

Inflammation, oxidative and nitrosative stress underlie depression being assessed in rodents by the systemic administration of lipopolysacharide (LPS). There is an increasing body of evidence of an involvement of nitric oxide (NO) pathway in depression, but this issue was not investigated in LPS-induced model. Thus, herein we evaluated the effects of NO-pathway-modulating drugs, named aminoguanidine, l-NAME, sildenafil and l-arginine, on the behavioral (forced swimming test [FST], sucrose preference [SPT] and prepulse inhibition [PPI] of the startle) and neurochemical (glutathione [GSH], lipid peroxidation, IL-1β) alterations in the prefrontal cortex, hippocampus and striatum as well as in BDNF levels in the hippocampus 24h after LPS (0.5mg/kg, i.p.) administration, a time-point related to depressive-like behavior. Twenty-four hours post LPS there was an increase in immobility time in the FST, decrease in sucrose preference and PPI levels accompanied by a decrease in GSH levels and an increase in lipid peroxidation, IL-1β and hippocampal BDNF levels suggestive of a depressive-like state. The pretreatment with the NOS inhibitors, l-NAME and aminoguanidine as well as sildenafil prevented the behavioral and neurochemical alterations induced by LPS, although sildenafil and l-NAME were not able to prevent the increase in hippocampal BDNF levels induced by LPS. The iNOS inhibitor, aminoguanidine, and imipramine prevented all behavioral and neurochemical alterations induced by LPS. l-arginine did not prevent the alterations in immobility time, sucrose preference and GSH induced by LPS. Taken together our results show that the NO-cGMP pathway is important in the modulation of the depressive-like alterations induced by LPS.

Effects of lithium on oxidative stress and behavioral alterations induced by lisdexamfetamine dimesylate: relevance as an animal model of mania

Lisdexamfetamine dimesylate (LDX) is a prodrug that requires conversion to d-amphetamine (d-AMPH) for bioactivity. Treatment with d-AMPH induces hyperlocomotion and is regarded as a putative animal model of bipolar mania. Therefore, we sought to determine the behavioral and oxidative stress alterations induced by sub-chronic LDX administration as well as their reversal and prevention by lithium in rats. A significant increment in locomotor behavior was induced by LDX (10 and 30 mg/kg). To determine Li effects against LDX-induced alterations, in the reversal protocol rats received LDX (10 or 30 mg/kg) or saline for 14 days. Between days 8 and 14 animals received Li (47.5 mg/kg, i.p.) or saline. In the prevention paradigm, rats were pretreated with Li or saline prior to LDX administration. Glutathione (GSH) levels and lipid peroxidation was determined in the prefrontal cortex (PFC), hippocampus (HC) and striatum (ST) of rats. Lithium prevented LDX-induced hyperlocomotion at the doses of 10 and 30 mg/kg, but only reversed LDX-induced hyperlocomotion at dose of 10mg/kg. In addition, both doses of LDX decreased GSH content (in ST and PFC), while Li was able to reverse and prevent these alterations mainly in the PFC. LDX (10 and 30 mg/kg) increased lipid peroxidation which was reversed and prevented by Li. In conclusion, LDX-induced hyperlocomotion along with associated increments in oxidative stress show promise as an alternative animal model of mania.

Effects of alpha-lipoic acid in an animal model of mania induced by D-amphetamine

OBJECTIVES

Oxidative stress and neurotrophic factors are involved in the pathophysiology of bipolar disorder (BD). Alpha-lipoic acid (ALA) is a naturally occurring compound with strong antioxidant properties. The present study investigated ALA effects in an amphetamine-induced model of mania.

METHODS

In the reversal protocol, adult mice were first given d-amphetamine (AMPH) 2 mg/kg, intraperitoneally (i.p.) or saline for 14 days. Between days 8 and 14, the animals received ALA 50 or 100 mg/kg orally, lithium (Li) 47.5 mg/kg i.p., or saline. In the prevention paradigm, mice were pretreated with ALA, Li, or saline prior to AMPH. Locomotor activity was assessed in the open-field task. Superoxide dismutase (SOD) activity, reduced glutathione (GSH), and thiobarbituric acid-reactive substance (TBARS) levels were evaluated in the prefrontal cortex (PFC), hippocampus (HC), and striatum (ST). Brain-derived neurotrophic factor (BDNF) levels were measured in the HC.

RESULTS

ALA and Li prevented and reversed the AMPH-induced increase in locomotor activity. PREVENTION MODEL: ALA and Li co-administration with AMPH prevented the decrease in SOD activity induced by AMPH in the HC and ST, respectively; ALA and Li prevented GSH alteration in the HC and TBARS formation in all brain areas studied. REVERSAL MODEL: ALA reversed the decrease in SOD activity in the ST. TBARS formation was reversed by ALA and Li in all brain areas. Furthermore, ALA reversed AMPH-induced decreases in BDNF and GSH in the HC.

CONCLUSIONS

Our findings showed that ALA, similarly to Li, is effective in reversing and preventing AMPH-induced behavioral and neurochemical alterations, providing a rationale for the design of clinical trials investigating ALA's possible antimanic effect.

Forest fire indicators and mercury deposition in an intense land use change region in the Brazilian Amazon (Alta Floresta, MT)

Black carbon, charcoal and mercury fluxes were measured from sediment cores taken in an artificial water dam in an intense land use change area in the Alta Floresta district in the Brazilian Amazon, in order to characterize the differences in the evolution of human occupation patterns in the region during the last 18 years. A positive correlation between the black carbon and charcoal particle fluxes and the evolution of the Brazilian gross domestic production (GDP) was observed. Mercury fluxes showed a positive correlation with gold production and exhibited a distinct evolution pattern when compared to in relation to the forest fires indicators and Brazilian GDP. The fluxes of forest fires markers showed an increase in deforestation activities in the region after 1993. Mercury deposition showed a substantial decrease after 1994. The patterns of distribution in both forest fires tracers and gold mining tracers indicate substitution of the regional economic model. It also marked different antropogenic impact type in the ecosystem.

Fenestration gingival defect in erupting permanent mandibular incisors: a case report

Bilateral fenestration of the labial gingival tissue of the permanent mandibular central incisors is described. The situation was followed over a 2-year period with no treatment other than prophylaxis and oral hygiene instruction. The final outcome was an apical positioning of the gingival margin, which was lower than that of the adjacent uninvolved teeth.