The clinical and biochemical effects of atrial fibrillation on heart failure with reduced ejection fraction; a sub-saharan African perspective

Background

Sub Saharan Africa (SSA) has seen one of the sharpest increases in cardiovascular disease-related mortality. This increase is evidenced by a growing burden of heart failure and atrial fibrillation (AF) risk factors. Atrial fibrillation is a common comorbidity of heart failure with reduced ejection fraction (HFrEF) which predisposes to an increased risk of morbidity and mortality. Studies done in high income countries (HIC) suggest that there may be an essential role for ethnic differences. However, in the absence of accurate epidemiological data in Sub-Saharan Africa, this cannot be proven. To date, there has never been a prospective systematic description of patients with HFrEF/AF and HFrEF/sinus rhythm (SR).

Aim

Our study aimed to describe the clinical and biochemical profile of patients with HFrEF/AF and HFrEF/SR in a Sub-Saharan African cohort.

Methods

The study was conducted inthe division of our Academic Hospital in South Africa. We enrolled 141 patients, consecutively, with HFrEF. Baseline clinical characteristics and exploratory biomarkers were recorded. All participants underwent comprehensive echocardiography. Novel left atrial strain was measured using 2D-speckle tracking echocardiography. These values were compared between patients in SR and in AF.

Results

The prevalence of AF was 21.38%. Hypertensive heart disease was the leading cause of HFrEF (36%). HFrEF/AF patients were significantly older (66.7±11.9) than those in SR (53.7±14.4) (p=0.000) with significantly different racial proportions (p=0.001). Coronary artery disease was prevalent in patients with HFrEF/AF. Patients with HFrEF/AF had significantly lower Kansas City Cardiomyopathy Questionnaire scores (29.83±15.27) compared to those in SR (44.26±16.30) (p=0.000) as well as worsening functional class (NYHA III–IV; 64.3% vs 22.7%, p=0.000). Measured levels of sST2 were greater in HFrEF/AF patients 40.45ng/mL (17.6–68.6) vs 20.8 (7.9–44.0) in HFrEF/SR (p=0.031). Patients with HFrEF/AF had a significantly greater left atrial volume (ml) (83.9 [64–99.9]) than those with HFrEF/SR (61.53±25.46) (p=0.038). Left atrial strain reservoir function (%) was significantly lower in patients with HFrEF/AF (29.00±13.60) compared to those with HFrEF/SR (41.56±15.46) (p=0.0004)

Conclusion

Our findings demonstrate that patients with HFrEF/AF are older than those in SR but much younger compared to patients in HICs. Hypertensive heart disease is a major cause of HFrEF in South Africa. We demonstrate that patients with HFrEF/AF are clinically worse off than those with HFrEF/SR. Atrial fibrillation is a marker of fibrosis and disease severity in HFrEF. Patients with HFrEF/AF had elevated sST2 levels a more deformed left atrium morphologically and poor tissue doppler function. On strain imaging, HFrEF/AF patients had poor left atrial reservoir function.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): The South African Medical Research Council

Longitudinal changes in vitamin D and its metabolites in pregnant South Africans

BACKGROUND

Vitamin D deficiency (VDD) has been associated with adverse maternal and foetal outcomes and is determined by measuring 25 hydroxyvitamin D (25(OH)D). The 25(OH)D is catabolized to 24, 25-(OH) ₂D and the ratio of 25(OH) D to 24, 25-(OH)₂D, the vitamin D metabolite ratio (VMR), is thought to be a superior marker of VDD, being elevated in such states. The aims of this study were to assess the longitudinal vitamin D status of pregnant women by measuring cholecalciferol, 25(OH)D, 24, 25-(OH)₂D and VMR at two time points and also to determine any association of vitamin D and metabolites with gestational age at birth, birth length and weight.

METHODS

We recruited 400 pregnant black African women in their first trimester (V1) and measured weights and heights. Ultrasound scans were performed for gestational age. Blood was drawn at V1 and at about 26 weeks (V2) of gestation for cholecalciferol, 25(OH)D, 24, 25-(OH)₂D, VMR and parathyroid hormone (PTH). An OGTT was performed at V2 where fasting glucose, insulin and 30-minute glucose were measured. At birth, we measured birth weight, length and gestational age. Maternal insulin, PTH and vitamin D binding protein (VDBP) were measured by immunoassay. Maternal albumin was measured colorimetrically. Maternal cholecalciferol, 25(OH)D and 24, 25-(OH)₂D, were measured by mass spectrometry and free and bioavailable vitamin D were calculated. Initial gestation was determined by ultrasound. We compared analytes by visit as well as by 25(OH)D status. Vitamin D deficiency (<30 nmol/L) was defined according to the National Academy of Medicine guidelines. Linear regression analysis was used to determine associations of vitamin D molecules with maternal blood pressure, fasting and 30-minute insulin and blood glucose and neonatal parameters.

RESULTS

Results are presented for participants for whom we had complete data (n = 330-346 depending on variable). The prevalence of vitamin D deficiency (VDD) was 35.8 % at V1 and 32.4 % at V2. Levels of 25(OH)D did not change significantly between visits. Levels of 24, 25(OH)₂D dropped from the first to the second visit (17.64 ± 12.64 to 9.39 ± 9.07 nmol/L; p < 0.0001) while VMR increased ((3.15 (1.31; 7.67) to 7.90 (2.44; 25.98); p < 0.0001). The proportion of women with the lowest cholecalciferol concentrations increased at V2 compared to the V1 (36.1-42.8 %; p = 0.02). In multivariable regression models 25(OH)D was negatively associated with 30-minute glucose concentrations (p = 0.038) whilst 24, 25-(OH)₂D was positively associated with fasting insulin (p = 0.017) and HOM A-I R (p = 0.023). There was no correlation of 25(OH)D or metabolites with infant birth weight, birth length or gestational age.

CONCLUSIONS

Maternal VDD is common in pregnant black South African women. Decreased VMR suggest that catabolism of 25(OH)D is reduced in pregnancy to maintain adequate free vitamin D levels.

In vitro marginal and internal adaptation of metal-ceramic crowns with cobalt-chrome and titanium framework fabricated with CAD/CAM and casting technique

Aim

The purpose of this study was to compare the marginal and internal fit of Co-Cr and titanium ceramic crowns fabricated with 2 different techniques: CAD/CAM milling and traditional casting (TC).

Materials and Methods

Ten traditional casting of Co-Cr (TCC), 10 CAD/CAM milling of Co-Cr (MC), 10 traditional casting of titanium (TCT), 10 CAD/CAM milling of titanium ceramic crowns (MT) were fabricated. Silicone replicas were obtained to measure internal gap volume, marginal gap and internal adaptation that was evaluated at 3 regions: axial wall, axio-occlusal angle, and occlusal surface. Measurements were made with a X-ray micro computerized tomography (micro-CT) and analyzed with Bonferroni and Dunnet T3 post-hoc tests (α = 0.05).

Results

One-way ANOVA revealed no statistically significant differences among the groups for measurements at the marginal gap (P > 0.05). At axial wall region the mean values of TCT group were higher than those of groups but only statistically not significant for TCC group (P < 0.05). TCC group statistically gives better results than MC group in axio-occlusal and occlusal regions (P < 0.05). The mean measurement of internal gap volume were 20.59 ± 0.83 mm³ for TCC, 22.73 ± 0.82 mm³ for MC, 22.83 ± 1.11 mm³ for TCT and 20.51 ± 1.16 mm³ for MT. Mean internal gap volume values MT group were smaller than those of groups but only statistically not significant for TCC group (P > 0.05).

Conclusion

All groups performed similar marginal adaptation. The cement film thickness at axio-occlusal angle point and occlusal region were higher for MC crowns.

Effects of sandblasting and silicoating on bond strength between titanium and porcelain

Purpose

The aim of this study was to evaluate the effects of the different sized alumina particles (50 and 150 μm) and tribochemical silica-modified alumina particles (110 μm) on titanium (Ti) surface to identify the most effective method of increasing the bond strength between porcelain and Ti.

Materials and Methods

Thirty rectangular plates (15 mm × 50 mm × 1 mm) of commercially pure Ti (Cp Ti) Grade 5 (GC Dental Industrial Corporation, Tokyo, Japan) were divided into three groups for different surface modification procedures (n = 10). Ti bonder porcelain, opaque, and dentin layers were fired separately on Ti plates. All specimens were placed in a bending jig for four-point bending test. The load and crosshead displacement data were collected to calculate the strain energy release rate as a G value.

Results

Lowest mean G values in J/m² were in the group sandblasted with 150 μm Al₂O₃particles (Group 2) (18.6 ± 5), followed by the group sandblasted with 50 μm Al₂O₃particles (Group 3) (20.8 ± 6.1) and the group sandblasted with 110 μm silicoated Al₂O₃particles (Group 1) (24.5 ± 4.1). The one-way ANOVA and Bonferroni post hoc tests indicated that there was a statistically significant difference between Group 1 and Group 2 (P < 0.05). There were also no statistically significant differences between Group 1 and Group 3 and Group 2 and Group 3 (P > 0.05).

Conclusion

The size of alumina particles is not a factor that is directly effective in enhancing the bond strength of Ti-porcelain systems. The bond strength of Ti-porcelain systems can be extremely improved by the application of sandblasting with silica-coated alumina particles.

Visceral adiposity is a predictor of parathyroid hormone levels in healthy adults

PURPOSE

Parathyroid hormone (PTH) has been shown to correlate positively with fat mass, however there are no studies that have investigated whether this association is a result of, or is modified by, body fat distribution. The aim of this study was to investigate the association of PTH with several body composition indices, namely visceral (VAT) and subcutaneous adiposity (SCAT) as well as with lean mass and with serum leptin, which has been reported to increase PTH.

METHODS

This was a cross-sectional study in which PTH was measured by chemiluminescent assay; body fat and lean mass by dual-energy X-ray absorptiometry (DXA) and abdominal fat by ultrasonography in 714 healthy adults aged 18-65 years. Serum leptin was measured by ELISA.

RESULTS

In a multivariate linear regression model that included height, age, gender, ethnicity, serum 25 hydroxyvitamin D, leptin levels, calcium, magnesium and phosphate concentrations, glomerular filtration rate, smoking status, and calcium and vitamin D supplementation as independent variables and PTH as the dependent variable, VAT (β = 0.094, p = 0.035) correlated significantly with PTH levels but SCAT (β = -0.045, p = 0.386) and body fat mass (β = 0.098, p = 0.126) did not. Leptin did not correlate with PTH (β = 0.013, p = 0.832) in this regression model.

CONCLUSIONS

Plasma PTH is significantly associated with VAT in healthy adults. In view of the association of PTH with increased cardiovascular mortality, it is important to investigate this association further.

Effect of chlorhexidine on bond strength between glass-fiber post and root canal dentine after six month of water storage

Aim of this study was to assess the influence of chlorhexidine digluconate (CHX) application on bond strength of glass fibre reinforced composite (FRC) posts to root dentine using adhesive luting systems. Forty extracted human mandibular premolars were endodontically treated and root canals were prepared. Teeth were divided into 2 groups according to luting system as SuperBond C&B (etch-and-rinse/chemical cure) and FuturaBond DC (self-etch/ dual cure). Each group was further divided in 2 subgroups (n=10) according to whether CHX was applied or not. Group Futura/CHX: FuturaBond DC + CHX; group Futura: FuturaBond DC; group Super/CHX: Super Bond C&B + CHX; group Super: SuperBond C&B + CHX. Mean and standard deviation (in parenthesis) values of bond strength in MPa were: group Futura/CHX: 8.86 (1.96), group Futura: 7.65 (1.01), group Super/CHX: 17.47(2.93), group Super: 12.41 (3.83). Bond strength values were affected by the type of luting agent and CHX irrigation (p=0.001, two-way ANOVA). There were statistically significant differences among the groups according to one-way ANOVA (p<0.001). Significant differences were observed in bond strength between groups Super/CHX and Super (p=0.023), between groups Futura/CHX and Super/CHX (p<0.001). Application of CHX before luting procedure with etch-and-rinse/chemical cure luting agent of glass FRC post improved long-term bond strength between glass FRC and root dentine.

Characterization of CD34⁺ thymocytes in newborn dogs

Using two-color flow cytometry, we characterized CD34(+) cells in the newborn canine thymus. CD34(+) thymic cells comprised approximately 5% of cells recovered by thymus tissue teasing and both large and small thymocytes have been present in this population, the former being 7-12 times more frequent. All CD34(+) cells expressed the pan-leukocyte antigen CD45. The expression of CD44 profile on the large and small CD34(+) thymocytes differed: almost all large CD34(+) cells were CD44(+), while only 75% of small CD34(+) thymocytes co-expressed the CD44 antigen. We have previously described that CD172α is present on the surface of CD34(+) bone marrow cells in dogs. In the thymus, CD172α was expressed on 5-10% and less than 5% of large and small CD34(+) cells, respectively. Some CD34(+) thymocytes also co-expressed T-lineage-specific markers like CD3, CD4, CD8, TCR1 and TCR2. Their expression increased during the large-to-small thymocyte transition. Based on our findings we suggest that thymocyte progenitors enter their primary differentiation center as large CD34(+), CD44(+), CD45(+) and CD172α(+) cells. T-cell specific markers appear on their surface at early stages of differentiation. As the size of progenitors decreases with terminal primary differentiation, the CD34, CD44, and CD172α surface markers are down-regulated.

Experimental Actinobacillus pleuropneumoniae infection in piglets with different types and levels of specific protection: Immunophenotypic analysis of lymphocyte subsets in the circulation and respiratory mucosal lymphoid tissue

Actinobacillus pleuropneumoniae (APP) infection in piglets results in severe and fatal fibrinous hemorrhagic necrotizing pneumoniae. The aim of our study was to analyze changes in lymphocyte subset distribution in peripheral blood, bronchoalveolar lavage fluid (BALF) and tracheobronchal lymph nodes (TLN) in non-immune piglets upon a challenge with a high dose of APP and to compare the quality of such changes in unprotected piglets with counterparts exhibiting specific immunity mediated by high titers of colostrum-derived APP-specific antibodies and/or a low dose APP infection in the early postnatal period. Challenge with APP resulted in a massive increase in CD8-negative gammadelta T-cells in parallel with a reduction in numbers of CD3-CD8low cells in BALF independent of the type and level of immunity and this seems to be a general phenomenon associated with experimental infection. An increase in B-lymphocyte numbers in TLN was another characteristic feature accompanying APP infection in all experimental groups. In piglets with colostrum-derived APP-specific antibodies, this was associated with higher relative numbers of IgM+CD2+ lymphocytes in TLN, while B-cells with the CD2- surface phenotype apparently expanded in the absence of passive humoral immunity.

Effect of luting agents and reconstruction techniques on the fracture resistance of pre-fabricated post systems

Fracture resistance and fracture modes of endodontically treated maxillary central incisors restored with different post-and-core systems covered with all-ceramic copings were evaluated. Ten samples were prepared for each group. Groups 1, 2 and 3 consisted of tooth-coloured post-and-core, zirconia post (Cosmopost) with a composite core (Tetric Ceram), zirconia post (Cosmopost) with a custom made ceramic core (Cosmo Ingot), glass fibre-reinforced post (FRC Postec) with a composite core (Tetric Ceram), respectively. Group 4 consisted of a titanium post (ERpost) with a composite core (Tetric Ceram). The control group (group 5) consisted of root-filled incisors without posts. Tooth-coloured posts were cemented in the roots using Variolink-2, while titanium posts were cemented in the roots using Harvard cement. The all-ceramic copings were cemented using Variolink-2. Static load was applied to 2 mm below the incisal edge on the palatinal surface of each sample until they were fractured. Fracture data were obtained and statistically analysed with One-way anova and a Tukey's test. The results of the means and standard deviations of the fracture resistance during static loading were: 497.5 +/- 61.94 (1), 474.61 +/- 96.84 (2), 494.61 +/- 104.67 (3), 581.34 +/- 105.36 (4), 420.42 +/- 127.48 (5). There were statistically significant differences between groups 4 and 5. Glass fibre-reinforced posts and composite cores (group 3) showed the most catastrophic failure. Consequently, zirconia ceramic posts can be used in clinical practice.

Systemic and Local Antibody Responses after Experimental Infection with Actinobacillus pleuropneumoniae in Piglets with Passive or Active Immunity

The objectives of the present study was to describe different dynamics of humoral immune responses to experimental infection in piglets of different stages of infection and immunity. Two groups of piglets originating from non-immune (group 1) and immune (group 2) sows at the age of 3 weeks were subdivided as follows: a half of each group of piglets was exposed to a low-dose infection with Actinobacillus pleuropneumoniae (APP) strain 9. At the age of 8 weeks, all four groups of piglets were challenged with a high infection dose of APP of the same strain. Isotype characterization of the specific antibodies in sera and in bronchoalveolar lavage fluids (BALF) to a lipopolysaccharide was carried out, besides monitoring clinical signs and post-mortem examinations. A typical primary immune response was observed in specific antibody-free piglets infected with a challenge infection. Colostrum-derived immunoglobulin-G (IgG) antibodies persisted in sera and BALF of piglets up to the age of 8 weeks. However, they did not prevent induction of specific-primary antibody response, either in 8 or 4 weeks of age, when levels of specific colostrum-derived antibodies were still high. It was demonstrated by the increase of specific IgM antibodies in sera. The infection induced an increase in the levels of IgA antibodies in BALF regardless the severity of infection and presence of specific colostrum-derived antibodies. The specific antibodies of IgG isotype increased only in BALF from piglets without colostrum-derived antibodies.

Lymphatic organ development in dogs: major lymphocyte subsets and activity

In the present study, we have characterized lymphocyte subsets and activity in peripheral blood, spleen, mesenteric and popliteal lymph nodes in pups from birth till the age of one month and compared the results with the situation in the group of three adult dogs. In neonatal pups, lower numbers of CD3(+) T-cells were detected in both the spleen and peripheral blood than in lymph nodes. In contrast to the other compartments, CD21(+) B-cells prevailed in the spleen, which resulted in low values (<1) of the CD3(+)/CD21(+) ratio. Low numbers of CD8(+) lymphocytes were characteristic in all compartments immediately after birth; consequently a high CD4(+)/CD8(+) ratio has been calculated. Postnatal development was characterized by an increasing frequency of CD8(+) lymphocytes in all organs studied. Another typical feature of the early period of life was a relative decrease of B-cell numbers, which was compensated by an increasing proportion of T-lymphocytes, particularly in the peripheral blood and spleen. DNA synthesis in newborn pups' cells as measured by in vitro thymidine incorporation was surprisingly high in non-stimulated control samples, notably in the spleen. Further development of lymphocyte activity was characterized by the decline in spontaneous activity in all organs. Stimulation indices upon mitogen-induced proliferation increased proportionally to the decrease in spontaneous activity. Based on our experimental data, we have concluded that pups are born with a relatively competent immune system the structure of which, however, markedly develops during a few postnatal weeks.

Postnatal development of leukocyte subset composition and activity in dogs

The aim of the presentation is to summarise our data on the counts and activity of circulating canine leukocytes at birth and on their changes in the first 3 months of life. On day 1, neutrophil counts were almost three times higher than lymphocyte counts. During the first week of life, a decrease of neutrophil and an increase of lymphocyte counts, resulting in a predominance of lymphocytes, were observed. Neutrophil counts reached values comparable with those in adults in 1 month. Lymphocyte counts were higher than those in adults during the first 3 months. From birth to the age of 3 months, the phagocytic activity of neutrophils was nonsignificantly higher than in young adults. When compared with adults, the peripheral blood of new-born pups contained a lower proportion of T lymphocytes (detected by CD3 and CD5 markers), with a very low percentage of CD8(+) cells and a higher proportion of CD21(+) B lymphocytes. The counts of individual subsets levelled out during the first 3 months of life, although the proportion of CD21(+) B cells remained higher all the time. Lymphocytes of new-born pups were able to respond to nonspecific mitogen stimulation. Spontaneous proliferation in vitro was higher during the first week of life. Although in vitro stimulation of lymphocytes with Concanavalin A in some pups was comparable with that of adult dogs, mean activity was weaker. Pups with zero or very low levels of maternal antibodies were able to develop specific immune responses to a parvovirus antigen as early as at 2 weeks of age. On the basis of these data, we assume that pups are born with an immune system that can respond to external stimuli. Nevertheless its development continues in the postnatal period and some parameters differ from adult values for at least 3 months after birth.

The intrauterine environment is a strong determinant of glucose tolerance during the neonatal period, even in prematurity

The aim of this study was to determine the contribution of birth weight and gestational age to glucose tolerance in premature neonates. The study group consisted of 100 premature and/or small-for-gestational age infants. Anthropometric measurements were performed both at birth and at the time of a standardized milk feed carried out at 19.6 +/- 12.1 d (range, 1-65 d) after birth. Fasting and postprandial glucose and insulin levels were measured. Birth weight, as a proxy mirror of the intrauterine environment, was found to influence the glucose concentration following a standardized milk feed (beta = -0.46; P = 0.01 for birth weight z-score with 60-min glucose level), whereas gestational age did not. Small-for-gestational age neonates had higher 60-min insulin levels than appropriate-for-gestational age neonates (115.4 +/- 9.5 vs. 68.4 +/- 14.2; P < 0.05) despite similar glucose levels. Neonates born of mothers who were on antihypertensive treatment were smaller and had a higher insulin secretory response than neonates from normotensive mothers. Postnatal growth velocity (kilograms per day) correlated with birth weight (beta = -0.65; P < 0.0001) and insulin resistance (beta = -0.31; P = 0.0004), independently of each other. This study shows that glucose tolerance of the neonate is determined by weight attained at birth irrespective of gestational age and that maternal blood pressure may influence insulin sensitivity of the newborn. Furthermore, catch-up growth in neonates is determined by birth weight and insulin sensitivity.

Lymphocyte subsets in peripheral blood of dogs--a flow cytometric study

Slight differences in the results of papers describing lymphocyte subsets distribution in the peripheral blood of healthy dogs may be explained by differences in monoclonal antibody clones and sources, breed and age of animals examined, methods of sample treatment, or methods of result analysis. In this paper, we described the effect of sample processing and of sample storage as well as the effect of age, breed, and gender of dogs on lymphocyte subset distribution. No significant differences were found between samples processed following a whole-blood lysis method and samples processed after density gradient separation. Furthermore, no significant differences were found between samples processed within 2h after collection and those stored at 4 degrees C for 12-16 h before processing. Age-related changes were evident in lymphocyte subset distribution in the peripheral blood of 38 Beagles divided according to their age into the six groups: (1) 5-6 days; (2) 2 months; (3) 6 months; (4) 1-2 years; (5) 3-5 years; and (6) >5 years. The percentage of B-lymphocytes (CD21-like positive cells) in the peripheral blood of newborn pups was 39.5+/-5.7 and decreased with advancing age. The percentage of CD8+ lymphocytes was 7.7+/-3.4 after birth and increased with advancing age. No age-related changes were observed in the percentages of CD4+ lymphocytes. The CD4+:CD8+ ratio decreased with advancing age. No significant age-related change was observed for lymphocytes bearing the gammadelta-TCR. Some breed differences were evident. Adult (1-5-year-old) Beagles, German Shepherds, Dalmatians, and Dachshunds were examined. The percentages of lymphocytes were higher in Beagles and Dachshunds than in Dalmatians and German Shepherds. The highest and the lowest absolute lymphocyte counts were found in Beagles and German Shepherds, respectively. As a consequence, German Shepherds showed the lowest absolute counts of the individual lymphocyte subpopulations and the widest neutrophil:lymphocyte ratio. Dalmatians showed the lowest percentage of CD3+ cells, the highest percentage of CD21+ cells, and the lowest CD4+:CD8+ ratio. German Shepherds showed the lowest percentage of CD21+ cells and the highest CD4+:CD8+ ratio. Females in Beagles and Dachshuns had nonsignificantly higher percentages of total lymphocytes, CD3+, CD4+, and nonsignificantly lower percentages of CD21+ lymphocytes. We concluded that there are age-, breed-, and perhaps also gender-related differences in lymphocyte subset distribution in the peripheral blood of dogs. Therefore, there is need to use appropriate control group in the experimental protocols. Among-breed differences could explain, at least partly, breed predisposition for some diseases.

Weight-related differences in glucose metabolism and free fatty acid production in two South African population groups

OBJECTIVE

The effects of free fatty acids (FFA), leptin, tumour necrosis factor (TNF) alpha and body fat distribution on in vivo oxidation of a glucose load were studied in two South African ethnic groups.

DESIGN AND MEASUREMENTS

Anthropometric and various metabolic indices were measured at fasting and during a 7 h oral glucose tolerance test (OGTT). Body composition was measured using bioelectrical impedance analysis and subcutaneous and visceral fat mass was assessed using a five- and two-level CT-scan respectively. Glucose oxidation was evaluated by measuring the ratio of (13)CO(2) to (12)CO(2) in breath following ingestion of 1-(13)C-labelled glucose.

SUBJECTS

Ten lean black women (LBW), ten obese black women (OBW), nine lean white women (LWW) and nine obese white women (OWW) were investigated after an overnight fast.

RESULTS

Visceral fat levels were significantly higher (P<0.01) in obese white than black women, despite similar body mass indexes (BMIs). There were no ethnic differences in glucose oxidation however; in the lean subjects of both ethnic groups the area under the curve (AUC) was higher than in obese subjects (P<0.05 for both) and was found to correlate negatively with weight (r=-0.69, P<0.01) after correcting for age. Basal TNF alpha concentrations were similar in all groups. Percentage suppression of FFAs at 30 min of the OGTT was 24+/-12% in OWW and -38+/-23% (P<0.05) in OBW, ie the 30 min FFA level was higher than the fasting level in the latter group. AUC for FFAs during the late postprandial period (120--420 min) was significantly higher in OWW than OBW (P<0.01) and LWW (P<0.01) and correlated positively with visceral fat mass independent of age (r=0.78, P<0.05) in the OWW only. Leptin levels were higher (P<0.01) both at fasting and during the course of the OGTT in obese women from both ethnic groups compared to the lean women.

CONCLUSIONS

Glucose oxidation is reduced in obese subjects of both ethnic groups; inter- and intra-ethnic differences were observed in visceral fat mass and FFA production and it is possible that such differences may play a role in the differing prevalences of obesity-related disorders that have been reported in these two populations.

Ethnic differences in lipid metabolism in two groups of obese South African women

There is a higher prevalence of ischemic heart disease (IHD) in South African white than black women. The objective of this study was to determine biochemical explanations for this prevalence. The study group contained 15 obese black women (OBW) and 14 obese white women (OWW), all premenopausal, who were examined after an overnight fast. Anthropometric measurements and blood concentrations of glucose, non-esterified fatty acids (NEFAs), catecholamines, plasminogen activator inhibitor-1, C-peptide, proinsulin, lipograms, cortisol, growth hormone, and post-heparin lipoprotein lipase activity were measured during an oral glucose tolerance test (OGTT). Body composition was measured using bioelectrical impedance analysis, and subcutaneous and visceral fat mass were assessed with CT-scans. Visceral fat area was higher in OWW (139.7 +/- 10.7 cm(2)) than in OBW (72.3 +/- 3.9 cm(2)) (P < 0.01), as were fasting and 3 h triglyceride concentrations (P < 0.05 for all). OWW also had higher NEFA levels than OBW at 3 and 4 h compared with OBW (P < 0.05 for both). Fasting cortisol (266 +/- 24 vs. 197 +/- 19 nmol/l; P < 0.05) was higher in OWW than in OBW. These data demonstrate that OWW have higher visceral fat mass than OBW, which may lead to a more atherogenic fasting and postprandial lipid profile. The higher cortisol levels of the OWW may promote visceral fat deposition.

Variations among unbred heifers in the activities of polymorphonuclear leucocytes from the mammary gland and blood

The phenotypic characteristics are described for the activity of polymorphonuclear leucocytes NMN) obtained by either lavage of the cavity system of juvenile mammary glands stimulated with a synthetic muramyl dipeptide analogue or isolation from the peripheral blood. Attention was paid to the variability of characteristics and its sources, and to correlations among them. The following characteristics were investigated in 27 clinically healthy, unbred Bohemian Red Pied x Holstein heifers: migration activity in situ, number of phagocytosing PMN, phagocytotic index, bactericidal activity of PMN and unstimulated and zymosan-stimulated luminol-dependent chemiluminescence. Considerable individual variation was found in the characteristics. Significant differences between blood PMN and PMN from lavages after influx induction were found for bactericidal activity (P < 0.05) and chemiluminescence (P < 0.01). A significant correlation between blood PMN and mammary gland PMN was found only for the number of phagocytosing cells (r = 0.329; P < 0.01). Highly significant positive correlations (P < 0.01) were demonstrated between the number of phagocytosing PMN [a], phagocytotic index [b], and bactericidal activity [c] in both blood PMN (r(ab) = 0.602; r(ac) = 0.565; r(bc) = 0.529) and mammary gland PMN (r(ab) = 0.730, r(ac) = 0.618, r(bc) = 0.589). No significant correlation was demonstrated for non-stimulated (NS), zymosan-stimulated (ZS), or opsonized zymosan-stimulated (OZS) chemiluminescence with any of the other characteristics of phagocytotic activity, in either blood PMN or mammary gland PMN (P > 0.05). The animal was a highly significant source of variability for all the phagocytotic activity characteristics (P < 0.01). Udder quarter was a non-significant source of variability for all the characteristics of phagocytotic activity except for NS chemiluminescence (P < 0.05) and ZS or OZS chemiluminescence (P < 0.01). However, udder quarter was a non-significant source of variability of chemiluminescence indices ZS/NS and OZS/NS (P > 0.05). It has been demonstrated that in situ migration activity, the number of phagocytosing PMN, phagocytotic index, bactericidal activity of PMN and chemiluminescence indices of PMN collected from juvenile mammary glands of unbred heifers after influx induction can be regarded as candidate early markers of resistance to mammary infections.

Immunosuppression in bitches with pyometra

The function of the immune system was studied in 34 bitches affected by pyometra. The mean age of the animals was 8.1 +/- 2.8 years. Samples of peripheral blood were examined using a battery of immunological tests. Data obtained from four sets of animals, grouped according to the severity of their disease, were compared. Leucocytosis (neutrophilia and partial monocytosis) and lymphopenia were detected in 62 per cent and 35 per cent of the bitches, respectively. The increase in the number of leucocytes was higher in the severely affected bitches. Inhibition of mitogen-driven lymphocyte proliferation was the characteristic feature of the immunological profile in bitches affected by pyometra, and this corresponded with the impairment of the general state of health. Sera from bitches showing functional inhibition of lymphocytes suppressed the activity of lymphocytes isolated from normal dogs. Sera from bitches affected by pyometra also had higher levels of immunoglobulins, lysozyme and circulating immune complexes. It can be concluded that pyometra is associated with an inflammatory response, but also with a marked suppression of immune system activity.

Fatal toxoplasmosis in brown hares (Lepus europaeus): possible reasons of their high susceptibility to the infection

Brown hares (Lepus europaeus) trapped in the countryside and domestic rabbits were experimentally infected with Toxoplasma gondii (K7 strain) oocysts. Hares (n=12) were divided into groups of 4 and infected with 10, 10(3) and 10(5) oocysts. Rabbits (n=12) were infected in the same way. The experimentally infected animals were monitored for 33 days after infection (p.i.). Most of the infected hares demonstrated behavioural changes, and all of them died between 8 and 19 days p.i. Three of the rabbits demonstrated only clinical changes related to the concurrent pasteurellosis. The typical pathological finding in the hares were haemorrhagic enteritis, enlargement and hyperaemia of mesenteric lymph nodes, splenomegaly and multiple miliary necrotic lesions in the parenchyma of the liver and other organs. Pathological changes in the rabbits were less pronounced than in the hares. In rabbit brains, tissue cysts of the T. gondii were found. The incidence of T. gondii antibodies both in the hares and the rabbits was first ascertained on day 7 p.i. On day 12 p.i., antibodies were already found in all the animals infected. Antibody titres in indirect fluorescence antibody test (IFAT) using the anti-rabbit conjugate were markedly higher in rabbits than in hares. In all hares, T. gondii was isolated post mortem from the liver, brain, spleen, kidney, lung, heart and skeletal muscles. Although T. gondii was also isolated in all rabbits, it was not always isolated in all their organs. In all hares, parasitemia was demonstrated on days 7 and 12 p.i. The percentage of rabbits with detected parasitemia was lower. In hares, a decrease in the numbers of leukocytes during the infection was observed. No such decrease was observed in the rabbits. The lymphocyte activity after the stimulation with non-specific mitogens showed significant differences between the hares and the rabbits even before the infection. After the infection, the hares infected with 10(3) and 10(5) doses and in rabbits infected with a 10(5) dose showed a decrease of lymphocyte activity. Rabbits infected with a 10(3) dose showed an increase of the lymphocyte activity. While in hares toxoplasmosis was an acute and fatal disease, the infection in rabbits had subclinical manifestations only and easily passed to a latent stage. The different courses of toxoplasmosis in the hare and the rabbit may be due to the differences in the natural sensitivity of the two species to the T. gondii infection or a negative impact of stress to the immune status of hares.

Relation between weight gain and beta-cell secretory activity and non-esterified fatty acid production in 7-year-old African children: results from the Birth to Ten study

AIMS/HYPOTHESIS

This study aimed to assess the effects of fetal and childhood growth on beta-cell activity and insulin sensitivity in 7-year-old children.

METHODS

Insulin, des-31,32 proinsulin, proinsulin, non-esterified fatty acids and glucose concentrations were measured in oral glucose tolerance tests in 152 South African children for whom longitudinal weight data was available.

RESULTS

Children with low weights at birth and 7 years (low-low) had relatively low beta-cell activity whereas children with low birth weight and high weight at 7 years (low-high) had relatively high beta-cell activity. The low-low group had higher 30-min glucose concentrations than children with high birth weights. When each insulin-related peptide was expressed as a percentage of all these peptides the low-low children had the highest percentage of insulin but the lowest of the prohormones. The low-high children had the lowest percentage of insulin but the highest of the prohormones. Non-esterified fatty acid concentrations were lowest and their suppression post-glucose load highest in the low-high group.

CONCLUSION/INTERPRETATION

Poor fetal and neonatal growth give rise to low beta-cell numbers compensated for by increased efficiency of proinsulin processing to insulin. Poor fetal followed by higher postnatal growth results in low beta-cell numbers and reduced whole-body glucose uptake which leads to reduced efficiency in the processing of proinsulin. Growth in utero and postnatally therefore have profound effects on beta-cell activity and insulin sensitivity with poor fetal coupled with high postnatal growth being detrimental to these processes but not detrimental to the suppression of lipolysis.

Epidemiology of feline leukaemia and feline immunodeficiency virus infections in the Czech Republic

Commercial serological sets were used for the examination of 727 cats kept in larger towns of the Czech Republic. FeLV antigen and antibodies to FIV were demonstrated in 96 (13.2%) and 42 (5.8%) of the animals, respectively. Seven (0.96%) animals were positive for both FeLV and FIV. Most of the FeLV and/or FIV positive patients were intact rambling males aged 1-4 years. Chronic gastrointestinal and respiratory diseases were found in 54.2% and 43.8% of the FeLV-positive patients, respectively. Chronic urinary tract diseases and generalized lymphadenopathy were found in 47.6% and 45.2% of the FIV-positive patients, respectively. The results of this first survey in the Czech Republic have shown prevalence values and clinical patterns similar to those reported formerly from other European countries.

Secondary immunodeficiency in dogs with enteric, dermatologic, infectious or parasitic diseases

A group of 238 dogs with various infectious and parasitic disease, in which suppressed activity of the immune system could e presumed, was examined using a set of immunological methods. The frequency and depth of immunosuppression and its association with certain infectious or parasitic disease were determined. Marked immunosuppression was found 62 (26%) of the dogs examined. Dogs with distemper, parvovirosis and German Shepherd dog pyoderma (GSP) were the most severely impaired. Dogs in acute phases of distemper or parvovirosis had decreased numbers and activity of lymphocytes and decreased immunoglobulin levels. Dogs with GSP had some of the following immunologic symptoms: inhibition of phagocytosis, reduced activity of lymphocytes, decreased levels of haemolytic complement and increased levels of immunoglobulin and lysozyme. A persistent immunosuppression was found in 12 dogs. These dogs were diagnosed with deep pyoderma, giardiasis, dermatophytosis or neoplasms. Although samples were not taken before the clinical diseases appeared, it can be presumed that some diseases caused immunosuppression (distemper or parvovirosis), and for other diseases immunosuppression was a predisposing factor (dermatophytosis, giardiasis and possibly GSP).

Effects of environmental pollutants on the porcine and bovine immune systems

Immunological examinations were done in 30 fattening pigs from three swine farms (D., M., T.) and 20 dairy cows from one cattle farm (N.) in the district of Hodonín in 1994. At the same time, samples of stable dust deposits collected in the four farms were analysed for the contents of mercury, cadmium, lead, gamma-HCH (lindane), and total DDT and polychlorinated biphenyls (PCB). Decreased blood level of lysozyme (0.92 mg/l) was found in the swine herd D. Ten percent of the pigs in the herd were affected with purulent skin lesions. The concentrations of the pollutants under study in the dust deposits collected in the herd D. were low. An increased concentration of PCB (0.263 mg/kg) in stable dust but no adverse effects on the immune system were found in the swine herd M. Eosinophilia (6.2%), increased extensity of Ascaris suum infection (25%) and a high content of lead in stable dust (11.2 mg/kg) were typical of the swine herd T. A high content of lindane (0.139 mg/kg) and an extremely high content of lead (214 mg/kg), which can participate in the immunosuppression of lymphocytes, were found in the cattle herd N. The activity of lymphocytes was depressed in 35% of the cows and the mean value was at the lower limit of the physiological range. Hazardous pollutants can affect the immune system of farm animals and their penetration into the stable environment should be prevented.

Immunosuppression in dogs with pyoderma and/or demodicosis

The occurrence of decreased activity of the immune system was studied in a group of 66 dogs with various combinations of pyoderma and demodicosis. Our complex examination of the dogs included the following: leukocyte count, differential count, phagocytosis, blastogenic lymphocyte transformation and quantitation of total serum immunoglobulins, lysozyme and haemolytic complement. Immunosuppression was found in 19 (28.8%) cases. Immunosuppression was rare in dogs with demodicosis and did not appear without a concurrent pyoderma. An increase in the neutrophil counts and total serum immunoglobulin levels significant was found in dogs with demodicosis combined with pyoderma. On the contrary, marked immunosuppression was detected in dogs with deep pyoderma. A considerable immunosuppression was present in 7 of 10 German shepherds dog pyoderma (GSP). Significant depressions were found in phagocyte activity and lymphocyte activity. Immunosuppression was observed in 4 of 9 dogs in other breeds with uncomplicated deep pyoderma. All groups of dogs with pyoderma showed a significant increase in total serum immunoglobulins. Conclusion from these findings is that deep pyoderma more than Demodicosis was concerned with immunosuppression. German shepherds with deep pyoderma had more expressed immunosuppression than other breeds.

Enhancement of antibody response to bovine herpesvirus 1 with non-specific immunostimulants

Stimulatory effects of aluminium hydroxide, lipopolysaccharide (LPS), muramyldipeptide (MDP), and empty liposomes on the antigenicity of inactivated bovine herpesvirus 1 were tested in mice. Compared with the standard effect of aluminium hydroxide, stronger antibody responses were observed in mice treated with empty liposomes or LPS alone, or a combination thereof. The strongest antibody response was recorded in mice treated with a combination of inactivated BHV-1, MDP and empty liposomes.

Adjuvant effect of liposomes and adamantylamide dipeptide on antigenicity of entrapped synthetic peptide derived from HIV-1 transmembrane region glycoprotein gp41

The synthetic peptide antigen (Ag) (the primary structure Tyr-Leu-Lys-Asp-Gln-Gln-Leu-Leu-Gly-Ile-Trp-Gly-Cys-Ser-Gly-Lys-Leu-Ile- Cys-Thr derived from the envelope glycoprotein gp41 of the human immunodeficiency virus type 1 (HIV-1) and exerting specificity with all HIV-1-positive sera available in the Czech Republic (and also in a panel of 10,000 sera from WHO)) was conjugated with bovine serum albumin (BSA) and encapsulated into liposomes. Adjuvant activities of liposomes with various lipid compositions were compared with Freund's complete adjuvant (FCA) and with aluminium hydroxide (AL). The immune response to BSA-Ag liposomes with coentrapped adamantylamide dipeptide (AdDP) was comparable with that of FCA in terms of longevity and levels of specific antibodies in mouse sera.

[Causes of anaphylactoid reactions in cattle after administration of lipoid preparations]

In 1986-1988, adverse anaphylactoid reactions (AR) were observed in animals in Czechoslovakia after the administration of oil adjuvant-containing vaccines or other lipoid drugs. Treated animals showed signs resembling the classic anaphylactic reaction, i.e. restlessness, salivation, pruritus, oedema and cyanosis of udder and vulva, and eyelid oedema, developing within a few minutes. The reactions were not elicited by the antigen alone, but by the oil adjuvant. The aim of our experiments was to identify substances eliciting the reaction in susceptible animals and to investigate possible induction mechanisms. The emulsifier Tween 80 has been demonstrated to be an AR inducing component of vaccines and drugs (Tab. I and III). Weak or moderate reactions were observed in 33% of animals treated with 5% Tween and 66% of those treated with 10% Tween showed strong reactions. On the other hand, no reactions were elicited by treatment with several paraffin oils of different quality (Tab. I) nor with an oil-in-water emulsion containing Montanid as an emulsifier (Tab. II). The role of the vegetative nervous system in the rise of AR has been confirmed. AR were suppressed in animals pretreated with parasympatholytic atropine and enhanced in a part of those pretreated with parasympathomimetic pilocarpine (Tab. III). The percentage of animals affected and the intensity of AR were also lower in animals pretreated with complement inhibitor epsilon-aminocapronic acid (Tab. IV). A major role of complement activation is suggested in the discussion of possible mechanisms of AR induction. It is possible to draw a conclusion on the basis of the results presented here and of the analysis of individual cases that a certain degree of animal susceptibility, depending on the phase of reproductive cycle, metabolism level and neurovegetative balance is necessary besides the administration of an AR inducer (Tween 80 in our case). Hence it seems that the adverse anaphylactoid reactions results from interactions of the two factors, i.e. administration of an AR inducer to susceptible animals.

[Nonspecific immunostimulating activity of Bordetella bronchiseptica bacterin in tests on mice and calves]

Three experimental models were used to verify the effectiveness of immunostimulant preparations of microbial origin. Of the four microbial species, used in the tests with the stimulation of mice against subsequent infection with the virulent strain of Pasteurella multocida, the highest resistance-increasing power was recorded in Bordetella bronchiseptica. There were large differences in stimulation activity between its strains, ranging from those with a low activity up to strain 6229, which increased the LD50 of the infected mice to a level 72 times as high as in the control. The differences in the survival of the mice also varied within the range between immunostimulation and infection, the best effect being obtained when the mice were stimulated 48 h before the infection. No significant difference was recorded between the use of the bacterin of B. bronchiseptica alone or B. bronchiseptica bacterine with oil adjuvant. The immunostimulant activity of B. bronchiseptica was also demonstrated in the model of sublethally irradiated mice in which the preventive administration 24 h before irradiation led to earlier and faster regeneration of the lymphoid tissue: this led to a higher weight of the spleen, to an increase in the number of peripheral leucocytes, and increased activity of chemiluminiscence six days after irradiation. The bacterine of B. bronchiseptica was also used at different concentrations and in combinations with other substances to stimulate two-month-old clinically healthy calves. The most pronounced effect was obtained after the administration of B. bronciseptica bacterine with oil adjuvant and after administration of the same substances together with vitamin A: twenty-four hours after these treatments there was an increased number of peripheral leucocytes and after 2-4 days an increased activity was observed in the MSHP particle phagocytosis test and in the chemiluminiscence test. The activity of lymphocytes in the blastic transformation test was insignificantly increased seven days after stimulation.

[Phagocytic activity of blood leukocytes in calves from birth to 3 months of age]

Forty-three calves of various age from the day of birth to the age of three months were subjected to the 2-hydroxyethylmethacrylate (HEMA) particle phagocytosis test. Significant differences in the phagocytic activity of blood leucocytes were recorded, all depending on age. New-born calves had very low phagocytic activity: only 16.5% of the leucocytes were found to be phagocytic, the phagocytic index being 0.39. A rapid increase in phagocytic activity was recorded during the subsequent days. At the age of three days 43% of the leucocytes of the calves were phagocytic. A decrease in phagocytic activity was found on the sixth to seventh day, and another increase was recorded only from the age of three to four weeks of age. No such changes in the development of phagocytic activity were observed in the calves reared without colostrum administration. Low values were maintained for a longer time after birth without the typical increase on the third to fifth day. Phagocytic activity increased in the zero-colostrum calves experimentally infected with rotavirus.

[Test of phagocytic activity of blood leukocytes in calves]

The 2-hydroxyethylmethacrylate-particle (HEMA) phagocytosis method in whole blood was adapted to the evaluation of the phagocytic activity of the leucocytes of calves. Several test variants were compared and the best procedure was determined, based on the following principles: keeping the heparin concentration at 10 i. u. in 1 ml of blood at the maximum, using fresh samples, incubating at 37 degrees C for 0.5 to 1 hour, thoroughly agitating the sample after incubation, with possible addition of EDTA. The phagocytic activity of nine calves, 2.5 to 3 months old, was examined by the proposed procedure and 18.6% phagocytic leucocytes were found, the phagocytic index being 7.07%.