The role of statins in endothelial dysfunction in hypertension

PURPOSE OF REVIEW

Hypertension and dyslipidemia frequently coexist, and endothelial dysfunction is associated with the pathophysiology of both atherosclerosis and hypertension. Evidence is convincing for an overlapping role of oxidative stress, renin-angiotensin system activation, and dyslipidemia in the genesis of endothelial dysfunction.

RECENT FINDINGS

Ample experimental and human data suggest that common cellular pathways are involved in the pathogenesis of hypertension, increased vascular resistance, and plaque formation. Multiple interventions such as dietary modification, exercise, antioxidants, and antihypertensive drugs improve endothelial dysfunction in hypertension. Statin drugs are a cornerstone of dyslipidemia therapy. Studies have demonstrated that statins correct endothelial function and vascular stiffening and may be useful in reducing blood pressure to target levels.

SUMMARY

Statins may be a useful adjunct in the treatment of hypertension in patients with dyslipidemia and possibly those with normal cholesterol levels.

Epidemiology of HIV infection among brothel-based sex workers in Kolkata, India

A cross-sectional study was carried out during January-June 2004 to assess the status of HIV infection among brothel-based sex workers in Kolkata city, India. Six hundred and twenty-two sex workers, selected from six brothels, were included in the study to assess their HIV status, and 362 sex workers, a subset of the above population, were interviewed to study their risk behaviour and practices. Blood samples were collected from each sex worker for testing HIV by an unlinked anonymous method. The prevalence of HIV infection was 9.6%, but was much higher among younger sex workers aged 20 years or less (27.7%) compared to the older age group (8.4%). This difference was statistically significant, indicating an association of younger ages with HIV infection [p = 0.006 and odds ratio (OR) = 4.18; (95% confidence interval (CI) 1.2-13.8)]. HIV was not associated with duration of sex work, average number of clients entertained per day, condom use, practice of sex during menstruation, pre-coital examination of penis for visible ulcer/discharge, suffering from sexually transmitted infections, and entertaining clients outside the brothel. There was a big gap between the reported and the evaluated condom use by sex workers. The results suggest that there is a need to develop suitable HIV intervention strategies, considering the socioeconomic and cultural aspects of city sex workers, with a provision for continuous monitoring and evaluation.

Biomonitoring insecticide pollution using non-target soil microarthropods

The scope of biomonitoring insecticide pollution in soil is discussed with the help of field and laboratory findings on the density, prey-predator ratio and fecundity of non-target microarthropod fauna. Field experiments were conducted in small plots with mustard, wheat and lady's finger crops and insecticides namely heptachlor 20EC (3.25 kg ai/ha = 16.25 lit/ha) and endosulfan 35EC (0.875 kg ai/ha = 2.5 lit/ha) applied at the seedling stages. Soil microarthropod population estimated at fortnightly intervals in the treated and untreated control plots revealed a general trend of adverse effect of the insecticides, prominently on the density and relative abundance of major prey groups like Collembola and Acari leading to notable decline in prey-predator ratio. Comparison of the percentage reductions of major taxonomic and trophic groups between pre-treatment and post-treatment intervals also demonstrated the ill effect of both heptachlor and endosulfan, notably on Collembola and the prey category. In the laboratory the survival success and fecundity of Cyphoderus javanus (Collembola) and Archegozetes longisetosus (Acari) were compared by exposing freshly emerged adults to sub-lethal concentrations of heptachlor and endosulfan for varying durations. The untreated control sets recorded high fecundity for both C. javanus and A. longisetosus, but chronic toxicity of the insecticides on adults confined to the treated soil resulted into very low fecundity. Even short duration exposure to heptachlor and endosulfan treated soil for 24 or 72 hours only was found to delay the egg-laying and decrease the fecundity of both the species. It is concluded that population responses and reproductive sensitivity in non-target soil microarthropods are potential eco-toxicological parameters for detecting pesticide pollution in soil and for ecological health assessment since the results are based on the bioactivity of toxicants.

Polymorphism of HIV-1 gag (p17) gene from female sex workers in Calcutta, India

HIV-1 subtype C is the major subtype in India as evidenced from the analysis of specific regions within envelope and gag gene. The matrix protein (p17) of HIV-1 which is involved in several functions like the viral RNA transport, nuclear localization, assembly of pre-integration complex into host nucleus has been used to study the strain diversity among female sexworkers in Calcutta. The gene encoding for the HIV-1 matrix protein, p17 was amplified by nested polymerase chain reaction (PCR) from blood samples of HIV-1 seropositive female sex workers (FSW) in Calcutta, India. Genes of twenty-two samples were sequenced and the phylogenetic analysis with different global strains showed that the majority (seventeen) was clustered with Indian type C. A few samples were found to be close to other C subtypes isolated from South Africa, China and Myanmar. The comparison of Calcutta samples with the samples from other regions of India along with other non-asian subtype C sequences clearly revealed a different cluster of Indian sequences. The two samples, cal 242 and cal 709 was found to be the most divergent type and showed close relatedness with African C subtypes.

A new method for isolation of leukocytes from the peripheral blood of amphibians [Bufo himalayanus, (Gunther)] and study of their surface morphology by scanning electron microscopy

Using percoll as the density gradient, a new single step method to isolate leukocytes from the peripheral blood of amphibians (B. himalayanus) has been described. Isolated leukocytes were photographed under the scanning electron microscope and an attempt has been made to characterize the leukocyte population on the basis of surface morphology. Apart from regular blood cell types, B. himalayanus have slender, elongated and slightly curved leukocyte type cells in their peripheral blood. Such slender elongated cells were absent in the blood of a related species B. stomnaticus and hence could not be categorized under the known blood cell types.

Estimation of tear glucose level and its role as a prompt indicator of blood sugar level

Tear glucose level was measured by glucose oxidase method to determine the relationship between tear glucose and corresponding blood glucose levels in 200 patients. It was observed that this test had a definite value in finding the hyperglycaemics semiquantitatively.

An unusual case of a retained metallic arrowhead in the orbit and sphenoidal sinus

A case of retained metallic arrowhead in orbit and sphenoidal sinus through an unusual route is reported. The eyeball was removed because of a possible risk of sympathetic ophthalmia.

Revolutions in ophthalmology

Cataract is the major cause of blindness worldwide. The transition of couching of cataract to most modem phaco-emulsification gained popularity with more scientific capsulorhexis. Ongoing research is taking place with laser technologies for removal of cataract. Surgery has an important role in advanced corneal diseases. Corneal transplantation is the most successful form. The refractive errors can be corrected by laser-assisted in-situ keratomileusis, intrastromal corneal rings and phacic intra-ocular lenses. Current research is going on to identify the gene responsible for glaucoma and once this is identified, medical therapy can be developed to control the disease. Thermocautery or photocoagulation and indenting the globe so as to bring the choroid nearer the break by scleral buckling forms the basis of modern surgery of retinal detachment. Vitreoretinal diseases, macular degeneration, diabetic retinopathy are no longer considered problematic. We are optimistic that more clinical breakthroughs are expected in the 21st century with new advances of ophthalmic researches.

Estimation of total collagen and types I and III collagen in canine rotator cuff tendons

The collagen composition of the supraspinatus, infraspinatus, and subscapularis tendons, which form part of the rotator cuff of the shoulder, was determined. Tendons were obtained from adult, male beagle dogs and total collagen was estimated by measurement of hydroxyproline. There was little variation in collagen content among the three major cuff tendons and the quantity approximated that cited in the literature for other tendons. However, the collagen content in the insertion zone of the supraspinatus tendon was significantly higher than in the tendon proper. NaCl fractionation of supraspinatus collagen indicated that type I was the predominant collagen but significant amounts of type III and possibly some type II and type V were also present. Interestingly, there appeared to be more type III collagen in the insertion zone than in the tendon proper, cyanogen bromide digestion and peptide mapping confirmed this finding. The differential collagen composition of the supraspinatus tendon may contribute to the high incidence of tear that is associated with this rotator cuff tendon.

Protective effect of neoglycoprotein-conjugated muramyl dipeptide against Leishmania donovani infection: the role of cytokines

Active targeting of muramyl dipeptide (MDP) to macrophages was studied by conjugation with the neoglycoprotein, mannosyl human serum albumin (mannose-HSA) using visceral leishmaniasis as the model macrophage disease. Conjugation did not decrease the affinity of the neoglycoprotein for macrophage mannose receptor. Mannose-HSA-MDP was 50 times more efficient than free MDP in inhibiting the growth of Leishmania donovani inside peritoneal macrophages. Moreover, in a 60-day murine model of visceral leishmaniasis, 95% of the spleen parasite burden was reduced by mannose-HSA-MDP at a dose of 0.5 mg/kg/day given for 4 days. Free MDP at a similar dose had very little effect. In vitro exposure of MDP caused enhanced generation of O2- by macrophages, whereas generation of nitric oxide (NO) was not induced. The elevated antileishmanial activity of MDP-treated macrophages in culture was abrogated by O2- scavengers. In contrast, considerably enhanced amounts of NO and O2- were generated from macrophages of mannose-HSA-MDP-treated animals, and their splenocytes secreted soluble factors providing all the signals required for the induction of NO biosynthesis. The increase in NO production was paralleled by a concomitant increase in antileishmanial activity, which was reversed by NO synthesis inhibitors. Splenocyte supernatants treated with anti-IFN-gamma or anti-TNF-alpha Abs suppressed inducible NO generation by macrophages. Moreover, i.v. administration of anti-IFN-gamma and anti-TNF-alpha along with mannose-HSA-MDP greatly reduced protection against L. donovani infection. Neoglycoprotein-conjugated MDP, therefore, activated mouse macrophages in vivo to kill L. donovani, and this may depend on the physiologic generation of NO induced by IFN-gamma and TNF-alpha.

Protective effect of neoglycoprotein-conjugated muramyl dipeptide against Leishmania donovani infection: the role of cytokines

Active targeting of muramyl dipeptide (MDP) to macrophages was studied by conjugation with the neoglycoprotein, mannosyl human serum albumin (mannose-HSA) using visceral leishmaniasis as the model macrophage disease. Conjugation did not decrease the affinity of the neoglycoprotein for macrophage mannose receptor. Mannose-HSA-MDP was 50 times more efficient than free MDP in inhibiting the growth of Leishmania donovani inside peritoneal macrophages. Moreover, in a 60-day murine model of visceral leishmaniasis, 95% of the spleen parasite burden was reduced by mannose-HSA-MDP at a dose of 0.5 mg/kg/day given for 4 days. Free MDP at a similar dose had very little effect. In vitro exposure of MDP caused enhanced generation of O2- by macrophages, whereas generation of nitric oxide (NO) was not induced. The elevated antileishmanial activity of MDP-treated macrophages in culture was abrogated by O2- scavengers. In contrast, considerably enhanced amounts of NO and O2- were generated from macrophages of mannose-HSA-MDP-treated animals, and their splenocytes secreted soluble factors providing all the signals required for the induction of NO biosynthesis. The increase in NO production was paralleled by a concomitant increase in antileishmanial activity, which was reversed by NO synthesis inhibitors. Splenocyte supernatants treated with anti-IFN-gamma or anti-TNF-alpha Abs suppressed inducible NO generation by macrophages. Moreover, i.v. administration of anti-IFN-gamma and anti-TNF-alpha along with mannose-HSA-MDP greatly reduced protection against L. donovani infection. Neoglycoprotein-conjugated MDP, therefore, activated mouse macrophages in vivo to kill L. donovani, and this may depend on the physiologic generation of NO induced by IFN-gamma and TNF-alpha.

Relationship of national highway with injecting drug abuse and HIV in rural Manipur, India

Earlier study reported that about 1% of general population or urban Manipur was injecting drug users (IDUs). A study was conducted to observe the IDU prevalence in rural Manipur and the role of national highway (NH) in determining the IDU prevalence if any. It was also aimed to study the HIV prevalence among IDUs of different villages. Villages were startified in to 3 categories based on distance and communication facilities from the national highway, which cuts across the villages to the neighboring state, Nagaland. Villages close to NH had the highest IDU prevalence of 1.3% and remote villages had the least prevalence of 0.2% whereas villages in between the above mentioned two groups had a prevalence of 0.9%. It was surprisingly observed that HIV was uniformly distributed among the IDUs of all villages and ranged from 50-51%. This indicates that IDU prevalence at distance is predominantly determined by the presence of drug trafficking route/s like national highway whereas HIV prevalence is mainly determined by the needle sharing behaviour of IDUs.

Evidence of a laminin binding protein on the surface of Leishmania donovani

Both the promastigote and amastigote forms of the intracellular parasite, Leishmania donovani bind the basement membrane glycoprotein laminin with high affinity (Kd = 3.56 x 10(-9) M and 3.98 x 10(-9) M respectively) with approximately 9000 and approximately 800 sites per cell. Bound laminin was identified by direct autoradiography and the binding protein through analysis of the parasite extract by SDS-PAGE and immunoblotting. A major component of 67 kDa was detected. The same protein was obtained when parasite outer membrane proteins were adsorbed to laminin-sepharose affinity matrix and subsequently eluted with SDS. The binding affinity of the isolated receptor was similar to that of the whole cells. Such a receptor isolated in Leishmania for the first time, may function as one of the bridging molecules for extracellular matrix recognition.

Receptor-mediated endocytosis of fucosylated neoglycoprotein by macrophages

The characteristics of the recognition system involved in the receptor mediated endocytosis of the neoglycoprotein, fucose-human serum albumin (HSA) were studied. It was found that (i) fucose-HSA showed strong affinity binding and uptake by various macrophages; (ii) binding was specific for L-fucose and D-mannose; (iii) binding was found to be inhibited by oxidant like H2O2 and swainsonine whereas it was elevated by dexamethasone; (iv) clearance of 125I-fucose-HSA was rapid and strongly inhibited by unlabelled fucose-HSA. Greater than 70% of fucose-HSA was found in liver and more than 60% of this was found in liver lysosomes; (v) uptake of fucose-HSA was thirty-fold more efficient in liver macrophages (Kupffer cells) than in hepatocytes; (vi) moreover, mannose-HSA and ovalbumin which are potent inhibitors of mannose/N-acetylglucosamine receptors inhibited clearance and uptake of fucose-HSA by liver as well as by isolated Kupffer cells suggesting the involvement of both fucose and mannose receptors or a single type of receptor having greater affinity for fucose-HSA than for mannose-HSA. These results emphasize the important role of fucose-terminated glycoproteins in site-specific drug targeting.