Calcification in coronary artery disease can be reversed by EDTA-tetracycline long-term chemotherapy

Dystrophic calcinosis: structural and morphological composition, and evaluation of ethylenediaminetetraacetic acid ('EDTA') for potential local treatment

BACKGROUND

To perform a detailed morphological analysis of the inorganic portion of two different clinical presentations of calcium-based deposits retrieved from subjects with SSc and identify a chemical dissolution of these deposits suitable for clinical use.

METHODS

Chemical analysis using Fourier Transform IR spectroscopy ('FTIR'), Raman microscopy, Powder X-Ray Diffraction ('PXRD'), and Transmission Electron Microscopy ('TEM') was undertaken of two distinct types of calcinosis deposits: paste and stone. Calcinosis sample titration with ethylenediaminetetraacetic acid ('EDTA') assessed the concentration at which the EDTA dissolved the calcinosis deposits in vitro.

RESULTS

FTIR spectra of the samples displayed peaks characteristic of hydroxyapatite, where signals attributable to the phosphate and carbonate ions were all identified. Polymorph characterization using Raman spectra were identical to a hydroxyapatite reference while the PXRD and electron diffraction patterns conclusively identified the mineral present as hydroxyapatite. TEM analysis showed differences of morphology between the samples. Rounded particles from stone samples were up to a few micron in size, while needle-like crystals from paste samples reached up to 0.5 µm in length. Calcium phosphate deposits were effectively dissolved with 3% aqueous solutions of EDTA, in vitro. Complete dissolution of both types of deposit was achieved in approximately 30 min using a molar ratio of EDTA/HAp of ≈ 300.

CONCLUSIONS

Stone and paste calcium-based deposits both comprise hydroxyapatite, but the constituent crystals vary in size and morphology. Hydroxyapatite is the only crystalline polymorph present in the SSc-related calcinosis deposits. Hydroxyapatite can be dissolved in vitro using a dosage of EDTA considered safe for clinical application. Further research is required to establish the optimal medium to develop the medical product, determine the protocol for clinical application, and to assess the effectiveness of EDTA for local treatment of dystrophic calcinosis.

Effect of EDTA with porous balloon on calcified lesion: An atherosclerotic cadaver study

BACKGROUND

Ethylene diamine tetra-acetic acid (EDTA) is a chelating agent used to dissolve calcium deposits but evidence in decalcifying atherosclerotic lesions is limited.

AIMS

We assessed the feasibility and efficacy of EDTA delivered via porous balloon to target calcified lesions in cadaveric below-the-knee (BTK) arteries.

METHODS

Using porcine carotid arteries, EDTA concentration was measured in the arterial wall and outside the artery at the 0-, 0.5-, 4-, and 24-h circulation after the injection through a porous balloon. In cadaver BTK samples, the proximal and distal anterior tibial artery (ATA) and distal posterior tibial artery (PTA) were studied. EDTA-2Na/H2O or EDTA-3Na/H2O were administrated using a porous balloon, then circulated for 6 h for EDTA-3Na/H2O and 24 h for EDTA-2Na/H2O and EDTA-3Na/H2O. Micro-CT imaging of the artery segments before and after the circulation and cross-sectional analyses were performed to evaluate calcium burden.

RESULTS

In the porcine carotid study, EDTA was delivered through a porous balloon present in the arterial wall and was retained there for 24 h. In BTK arteries, cross-sectional analyses of micro-CT revealed a significant decrease in the calcium area in the distal ATA segment under 24-h circulation with EDTA-2Na/H2O and in the distal ATA segment under 24-h circulation with EDTA-3Na/H2O. The proximal ATA segment under 6-h circulation with EDTA-3Na/H2O showed no significant change in any parameters of calcium CONCLUSION: EDTA-3Na/H2O or EDTA-2Na/H2O with longer circulation times resulted in greater calcium reduction in atherosclerotic lesion. EDTA may have a potential therapeutic option for the treatment of atherosclerotic calcified lesions.

A new perspective on intervertebral disc calcification-from bench to bedside

Disc degeneration primarily contributes to chronic low back and neck pain. Consequently, there is an urgent need to understand the spectrum of disc degeneration phenotypes such as fibrosis, ectopic calcification, herniation, or mixed phenotypes. Amongst these phenotypes, disc calcification is the least studied. Ectopic calcification, by definition, is the pathological mineralization of soft tissues, widely studied in the context of conditions that afflict vasculature, skin, and cartilage. Clinically, disc calcification is associated with poor surgical outcomes and back pain refractory to conservative treatment. It is frequently seen as a consequence of disc aging and progressive degeneration but exhibits unique molecular and morphological characteristics: hypertrophic chondrocyte-like cell differentiation; TNAP, ENPP1, and ANK upregulation; cell death; altered Pi and PPi homeostasis; and local inflammation. Recent studies in mouse models have provided a better understanding of the mechanisms underlying this phenotype. It is essential to recognize that the presentation and nature of mineralization differ between AF, NP, and EP compartments. Moreover, the combination of anatomic location, genetics, and environmental stressors, such as aging or trauma, govern the predisposition to calcification. Lastly, the systemic regulation of calcium and Pi metabolism is less important than the local activity of PPi modulated by the ANK-ENPP1 axis, along with disc cell death and differentiation status. While there is limited understanding of this phenotype, understanding the molecular pathways governing local intervertebral disc calcification may lead to developing disease-modifying drugs and better clinical management of degeneration-related pathologies.

Epigenetics: a new warrior against cardiovascular calcification, a forerunner in modern lifestyle diseases

Arterial and aortic valve calcifications are the most prevalent pathophysiological conditions among all the reported cases of cardiovascular calcifications. It increases with several risk factors like age, hypertension, external stimuli, mechanical forces, lipid deposition, malfunction of genes and signaling pathways, enhancement of naturally occurring calcium inhibitors, and many others. Modern-day lifestyle is affected by numerous environmental factors and harmful toxins that impair our health rather than providing benefits. Applying the combinatorial approach or targeting the exact mechanism could be a new strategy for drug designing or attenuating the severity of calcification. Most of the non-communicable diseases are life-threatening; thus, altering the phenotype and not the genotype may reveal the gateway for fighting with upcoming hurdles. Overall, this review summarizes the reason behind the generation of arterial and aortic valve calcification and its related signaling pathways and also the detrimental effects of calcification. In addition, the individual process of epigenetics and how the implementation of this process becomes a novel approach for diminishing the harmful effect of calcification are discussed. Noteworthy, as epigenetics is linked with genetics and environmental factors necessitates further clinical trials for complete and in-depth understanding and application of this strategy in a more specific and prudent manner.

Vascular Calcification in Chronic Kidney Disease: Diversity in the Vessel Wall

Vascular calcification (VC) is one of the major causes of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD). VC is a complex process expressing similarity to bone metabolism in onset and progression. VC in CKD is promoted by various factors not limited to hyperphosphatemia, Ca/Pi imbalance, uremic toxins, chronic inflammation, oxidative stress, and activation of multiple signaling pathways in different cell types, including vascular smooth muscle cells (VSMCs), macrophages, and endothelial cells. In the current review, we provide an in-depth analysis of the various kinds of VC, the clinical significance and available therapies, significant contributions from multiple cell types, and the associated cellular and molecular mechanisms for the VC process in the setting of CKD. Thus, we seek to highlight the key factors and cell types driving the pathology of VC in CKD in order to assist in the identification of preventative, diagnostic, and therapeutic strategies for patients burdened with this disease.

Effect of zinc oxide nanoparticles on broilers' performance and health status

The current study investigated the effects of zinc oxide nanoparticles (ZONPs) and oxytetracycline (OTC) supplementation on broilers' behavior, performance, carcass quality, biochemical parameters, and intestinal microbial populations and birds' response to Newcastle disease (ND) vaccine. A total of 336 seven-day-old IR broiler chicks were randomly allotted to six dietary treatments containing 0, 10, 20, 30 and 40 ppm ZONPs or 50 ppm OTC. Each diet was fed to 7 replicates (8 birds/pen). The results clarified that 10 ppm ZONPs significantly improved the body weight gain and feed conversion in comparison to the control. No changes in behavior were recorded. The 10 ppm and 30 ppm ZONPs and OTC significantly reduced the gizzard weight in comparison to the control. While, 10 ppm ZONPs significantly increased the spleen weight, and all ZONPs doses increased bursa weight in comparison to the control and OTC groups. 20 ppm ZONPs increased the eviscerated yield and edible yield in comparison to the control and OTC groups. 40 ppm ZONPs increased pH, reduced meat color and overall acceptability in comparison to the control. In addition, results revealed that the 20 ppm ZONPs increased Calcium (Ca), High density low cholesterol (HDL-C), reduced urea (UA) and triglyceride (TG). Also, 40 ppm ZONPs and OTC increased creatinine (Cr) and reduced ND-HI titer in comparison to the control. For microbial population, OTC group was significantly lower than ZONPs groups in the total anaerobic, aerobic and lactobacilli count. In conclusion, the dietary inclusion of ZONPs can be applied as antibiotic growth promoter substitutions in broilers' diet. However, further investigations are still needed.

Induction of apoptosis and autophagy by calcifying nanoparticles in human bladder cancer cells

Calcifying nanoparticles have been linked to various types of human disease, but how they contribute to disease processes is unclear. Here, we examined whether and how calcifying nanoparticles isolated from patients with kidney stones are cytotoxic to human bladder cancer cells. Calcifying nanoparticles were isolated from midstream urine of patients with renal calcium oxalate stones and examined by electron microscopy. Human bladder cancer cells (EJ cells) were cultured in the presence of calcifying nanoparticles or nanohydroxyapatites for 12 and 72 h and examined for toxicity using the Cell Counting Kit-8, for autophagy using transmission electron microscopy and confocal microscopy, and for apoptosis using fluorescence microscopy, transmission electron microscopy, and flow cytometry. Changes in protein expression were analyzed by Western blotting. The results showed that the size and shape of the isolated calcifying nanoparticles were as expected. Calcifying nanoparticles were cytotoxic to EJ cells, more so than nanohydroxyapatites, and this was due, at least in part, to the production of intracellular reactive oxygen species. Transmission electron microscopy showed that calcifying nanoparticles were packaged into vesicles and autolysosomes. Calcifying nanoparticles induced greater autophagy and apoptosis than nanohydroxyapatites. Our findings demonstrate that calcifying nanoparticles can trigger bladder cancer cell injury by boosting reactive oxygen species production and stimulating autophagy and apoptosis.

Progression of coronary artery calcification at the crossroads: sign of progression or stabilization of coronary atherosclerosis?

Coronary artery calcification (CAC) has been strongly established as an independent predictor of adverse events, with a significant incremental prognostic value over traditional risk stratification algorithms. CAC progression has been associated with a higher rate of events. In parallel, several randomized studies and meta-analysis have shown the effectiveness of statins to slow progression and even promote plaque regression. However, evidence regarding the effect of routine medical therapy on CAC has yielded conflicting results, with initial studies showing significant CAC regression, and contemporaneous data showing rather the opposite. Accordingly, there is currently a great controversy on whether progression of CAC is a sign of progression or stabilization of coronary artery disease (CAD). The finding of inexorable CAC progression despite the implementation of intensive contemporaneous medical therapy suggests that further understanding of this phenomenon should be undertaken before the implementation of CAC as a surrogate endpoint for longitudinal studies, or for prospective follow-up of patients under routine medical treatment.

Effect of combination of ethylenediaminetetraacetic acid + tetracycline with coronally positioned flap in the treatment of gingival recession: A clinical study

CONTEXT

Gingival recession is the apical migration of gingival margin results from destruction of the connective tissue leading to various esthetic problems. Many surgical procedures have been attempted to achieve root coverage that include free gingival grafts, pedicle flaps such as semilunar coronally repositioned flaps (SCRFs) and guided tissue regeneration. The exposed root surface has undergone substantial alterations and may no longer serve as an appropriate substrate for cell attachment and fiber development. When the denuded root surfaces are treated with biomodifiers following mechanical instrumentation, the resulting surface favors both the attachment of fibroblasts and new connective tissue attachment. It was then necessary to evaluate the surface characteristics of the acid demineralized root surface and its effect on periodontal wound healing.

AIM

To evaluate the effect of the combination of ethylenediaminetetraacetic acid (EDTA) and tetracycline as root bio-modifiers along with SCRF for root coverage.

SETTINGS AND DESIGN

Twenty subjects were randomly assigned into two groups as cases (SCRF + EDTA + tetracycline [TTC]) and controls (SCRF).

MATERIALS AND METHODS

Twenty-four percentage EDTA and 100 mg/ml TTC hydrochloride were used along with semilunar coronally positioned flap. The clinical parameters such as recession height, the width of keratinized tissue, recession width, clinical attachment level, probing depth, plaque index, and gingival index were recorded at baseline, 1 and 3 months.

STATISTICAL ANALYSES USED

The clinical parameters were compared using post-hoc test and the comparison between cases and controls was done using Mann-Whitney U-test.

RESULTS

No statistical significant difference has been observed between the groups.

CONCLUSION

It was concluded that no clinical benefit was observed after the application of a combination of 100 mg/ml TTC hydrochloride and 24% EDTA on the root surface.

If It's Not One Thing, It's Another: An Inverse Relationship of Malignancy and Atherosclerotic Disease

Atherosclerosis and malignancy are pervasive pathological conditions that account for the bulk of morbidity and mortality in developed countries. Our current understanding of the patholobiology of these fundamental disorders suggests that inflammatory processes may differentially affect them; thus, atherosclerosis can be largely driven by inflammation, where as cancer often flourishes as inflammatory responses are modulated. A corollary of this hypothesis is that cancer (or its treatment may significantly attenuate atherosclerotic disease by diminishing host inflammatory response, suggesting potential therapeutic approaches. To evaluate the relationship between cancer and cardiovascular atherosclerotic disease, we assessed 1,024 autopsy reports from Brigham and Women's Hospital and performed correlative analyses on atherosclerotic severity and cancer prevalence. In gender- and age-matched populations, there is a statistically significant inverse correlation between history of malignancy and autopsy-proven atherosclerotic disease. In a second analysis, we evaluated 147,779 patients through analysis of the Harvard Catalyst SHRINE database and demonstrated a reduced non-coronary atherosclerotic disease rate: control (27.40%), leukemia/lymphoma (12.57%), lung (17.63%), colorectal (18.17%), breast (9.79%), uterus/cervix (11.47%), and prostate (18.40%). We herein report that, based on two separate medical records analysis, an inverse correlation between cancer and atherosclerosis. Furthermore, this correlation is not uniformly associated with anti-neoplastic treatment, suggesting that the inverse relationship may be in part attributable to an individual's intrinsic inflammatory propensity, and/or to inflammation-modulatory properties of neoplasms.

Of nanobacteria, nanoparticles, biofilms and their role in health and disease: facts, fancy and future

Nanobacteria have been at the center of a major scientific controversy in recent years owing to claims that they represent not only the smallest living microorganisms on earth but also new emerging pathogens associated with several human diseases. We and others have carefully examined these claims and concluded that nanobacteria are in fact nonliving mineralo-organic nanoparticles (NPs) that form spontaneously in body fluids. We have shown that these mineral particles possess intriguing biomimetic properties that include the formation of cell- and tissue-like morphologies and the possibility to grow, proliferate and propagate by subculture. Similar mineral NPs (bions) have now been found in both physiological and pathological calcification processes and they appear to represent precursors of physiological calcification cycles, which may at times go awry in disease conditions. Furthermore, by functioning at the nanoscale, these mineralo-organic NPs or bions may shed light on the fate of nanomaterials in the body, from both nanotoxicological and nanopathological perspectives.

Vascular calcification: an update on mechanisms and challenges in treatment

Vascular calcification is highly associated with cardiovascular disease mortality, particularly in high-risk patients with diabetes and chronic kidney diseases (CKD). In blood vessels, intimal calcification is associated with atherosclerosis, whereas medial calcification is a nonocclusive process which leads to increased vascular stiffness and reduced vascular compliance. In the valves, calcification of the leaflets can change the mechanical properties of the tissue and result in stenosis. For many decades, vascular calcification has been noted as a consequence of aging. Studies now confirm that vascular calcification is an actively regulated process and shares many features with bone development and metabolism. This review provides an update on the mechanisms of vascular calcification including the emerging roles of the RANK/RANKL/OPG triad, osteoclasts, and microRNAs. Potential treatments adapted from osteoporosis and CKD treatments that are under investigation for preventing and/or regressing vascular calcification are also reviewed.

Aortic valve-derived calcifyng nanoparticles: no evidence of life

INTRODUCTION AND OBJECTIVES

Calcifying nanoparticles, also known as "nanobacteria," are very small bacteria-like structures (0.1-0.5 μm) with the ability to facilitate the precipitation and growth of calcium phosphate in pathological conditions and have been associated with aortic valve calcification. The status of nanobacteria is controversial; some have proposed that they are a new class of living organism while others describe calcifying nanoparticles as mineralo-fetuin complexes. The objective of the present study is to elucidate if calcifying nanoparticles are living entities, based on whether or not they have metabolic activity, a characteristic of life, irrespective of their composition.

METHODS

Calcifying nanoparticles were grown from 6 different valves randomly chosen among 84 consecutively explanted aortic valves, as described in the literature. The (1)H-NMR spectra were acquired from calcifying nanoparticles culture media to assess metabolic changes and the presence of 16sRNA in the culture media was investigated by real-time polymerase chain reaction.

RESULTS

After 6 weeks in culture, calcifying nanoparticles could be seen clearly attached to the surface of culture flasks. All samples were negative for 16sRNA, discarding the presence of known bacteria. (1)H-NMR spectra showed no difference between calcifying nanoparticles and 6-week-old sterile culture media maintained under the same conditions.

CONCLUSIONS

Our results show that calcifying nanoparticles cannot be considered as living organisms.

The role of calcifying nanoparticles in biology and medicine

Calcifying nanoparticles (CNPs) (nanobacteria, nanobacteria-like particles, nanobes) were discovered over 25 years ago; nevertheless, their nature is still obscure. To date, nobody has been successful in credibly determining whether they are the smallest self-replicating life form on Earth, or whether they represent mineralo-protein complexes without any relation to living organisms. Proponents of both theories have a number of arguments in favor of the validity of their hypotheses. However, after epistemological analysis carried out in this review, all arguments used by proponents of the theory about the physicochemical model of CNP formation may be refuted on the basis of the performed investigations, and therefore published data suggest a biological nature of CNPs. The only obstacle to establish CNPs as living organisms is the absence of a fairly accurately sequenced genome at the present time. Moreover, it is clear that CNPs play an important role in etiopathogenesis of many diseases, and this association is independent from their nature. Consequently, emergence of CNPs in an organism is a pathological, not a physiological, process. The classification and new directions of further investigations devoted to the role of CNPs in biology and medicine are proposed.

Incorporation of proteinase inhibitors into silk-based delivery devices for enhanced control of degradation and drug release

Controlling the rate of silk degradation is critical to its potential use in biomedical applications, including drug delivery and tissue engineering. The effect of protease concentration on accelerating degradation, and the use of ethylenediamine tetraacetic acid (EDTA) on reducing rates of degradation and on drug release from silk-based drug carriers was studied. Increased rates of proteolysis resulted in increased dye release from silk carriers, while EDTA release from the silk carriers inhibited proteolysis. The sustained release of EDTA from silk carriers in combination with the release of the small molecule anti-convulsant adenosine was investigated in vitro. This combination of factors resulted in delayed release of adenosine by inhibiting proteolytic activity. These results introduce a promising strategy to control drug delivery through the regulation of silk degradation rate, achieved via manipulation of local proteolytic activity. This ability to modulate enzyme function could be applicable to a range of silk biomaterial formats as well as other biodegradable polymers where enzymatic functions control biomaterial degradation and drug release rates.

Pathological calcification and replicating calcifying-nanoparticles: general approach and correlation

Calcification, a phenomenon often regarded by pathologists little more than evidence of cell death, is becoming recognized to be important in the dynamics of a variety of diseases from which millions of beings suffer in all ages. In calcification, all that is needed for crystal formation to start is nidi (nuclei) and an environment of available dissolved components at or near saturation concentrations, along with the absence of inhibitors for crystal formation. Calcifying nanoparticles (CNP) are the first calcium phosphate mineral containing particles isolated from human blood and were detected in numerous pathologic calcification related diseases. Controversy and critical role of CNP as nidi and triggering factor in human pathologic calcification are discussed.

PET/CT challenge for the non-invasive diagnosis of coronary artery disease

This review will focus on the clinical potential of PET/CT for the characterization of cardiovascular diseases. We describe the technical challenges of combining instrumentation with very different imaging performance and discuss the clinical applications in the field of cardiology.

Fetuin-A/albumin-mineral complexes resembling serum calcium granules and putative nanobacteria: demonstration of a dual inhibition-seeding concept

Serum-derived granulations and purported nanobacteria (NB) are pleomorphic apatite structures shown to resemble calcium granules widely distributed in nature. They appear to be assembled through a dual inhibitory-seeding mechanism involving proteinaceous factors, as determined by protease (trypsin and chymotrypsin) and heat inactivation studies. When inoculated into cell culture medium, the purified proteins fetuin-A and albumin fail to induce mineralization, but they will readily combine with exogenously added calcium and phosphate, even in submillimolar amounts, to form complexes that will undergo morphological transitions from nanoparticles to spindles, films, and aggregates. As a mineralization inhibitor, fetuin-A is much more potent than albumin, and it will only seed particles at higher mineral-to-protein concentrations. Both proteins display a bell-shaped, dose-dependent relationship, indicative of the same dual inhibitory-seeding mechanism seen with whole serum. As ascertained by both seeding experiments and gel electrophoresis, fetuin-A is not only more dominant but it appears to compete avidly for nanoparticle binding at the expense of albumin. The nanoparticles formed in the presence of fetuin-A are smaller than their albumin counterparts, and they have a greater tendency to display a multi-layered ring morphology. In comparison, the particles seeded by albumin appear mostly incomplete, with single walls. Chemically, spectroscopically, and morphologically, the protein-mineral particles resemble closely serum granules and NB. These particles are thus seen to undergo an amorphous to crystalline transformation, the kinetics and completeness of which depend on the protein-to-mineral ratios, with low ratios favoring faster conversion to crystals. Our results point to a dual inhibitory-seeding, de-repression model for the assembly of particles in supersaturated solutions like serum. The presence of proteins and other inhibitory factors tend to block apatite nuclei formation or to stabilize the nascent nuclei as amorphous or semi-crystalline spherical nanoparticles, until the same inhibitory influences are overwhelmed or de-repressed, whereby the apatite nuclei grow in size to coalesce into crystalline spindles and films-a mechanism that may explain not only the formation of calcium granules in nature but also normal or ectopic calcification in the body.

A hypothesis for anti-nanobacteria effects of gallium with observations from treating kidney disease

Nanobacteria, 100-fold smaller than common bacteria, have been purported to exist in urine, and by precipitating calcium and other minerals into carbonate apatite around themselves, induce the formation of surrounding kidney stones. Nanobacteria-like structures have also been shown in blood, within arteries, aortic aneurysms, and cardiac valves. Gallium has antibiotic properties to iron-dependent bacteria and has potent anti-inflammatory, anticancer and anti-hypercalcemic properties, and it readily reverses osteoporosis. It was hypothesized that gallium nitrate might have benefit in treating kidney stones. Gallium nitrate (120mg gallium) was mixed with water making two liters of a gallium mineral water drink to treat chronic, treatment-resistant kidney stone pain and urinary tract bleeding in a 110 pound woman. On the third day of gallium mineral water treatment, the urine appeared snow white, thick (rope-like) and suggestive of a calcific crystalline nature. After release of the white urine, the urine returned to normal in color, viscosity and pH, kidney pain was no longer present, and there was no further evidence of blood in the urine. There were no treatment side effects or sequela. For a one year observation period thereafter, no kidney stones, white urine, kidney or urinary tract pain or blood in the urine was noted. The hypothetical susceptibility of nanobacteria to gallium treatment also suggests application to atherosclerosis and other diseases. Although some support for gallium in treating kidney stones is presented, this hypothesis is built upon another hypothesis, is extremely speculative, and alternative explanations for the white urine exist. Further research into gallium's effects on kidney disease and other nanobacteria-induced diseases such as cardiovascular diseases is suggested.

Simultaneous Determination of Vitexin Rhamnoside and Vitexin Glucoside in Rats by Liquid Chromatography Coupled with Mass Spectrometry

The purpose of the present study was to evaluate the pharmacokinetic interaction of vitexin rhamnoside (vitexin 2″-α-L-rhamnopyranosyl) and vitexin glucoside (vitexin 2″-β-D-glucopyranosyl) in rats by using a high performance liquid chromatography coupled with tandem mass spectrometry quantitative detection method (LC-MS/MS). The method was validated at the concentration range of 5 - 5000 ng/mL for both vitexin rhamnoside and vitexin glucoside with the regression equations Y = 0.00181X - 0.000955 ( r > 0.998) and Y = 0.000788X - 0.000373 ( r > 0.997), respectively. The methodological studies (including linearity, intra-assay / inter-assay accuracy and precision) of these two components were investigated. The pharmacokinetic parameters of these two components were compared, which demonstrated their pharmacokinetic variance, especially when they were administrated simultaneously.

Purported nanobacteria in human blood as calcium carbonate nanoparticles

Recent evidence suggests a role for nanobacteria in a growing number of human diseases, including renal stone formation, cardiovascular diseases, and cancer. This large body of research studies promotes the view that nanobacteria are not only alive but that they are associated with disease pathogenesis. However, it is still unclear whether they represent novel life forms, overlooked nanometer-size bacteria, or some other primitive self-replicating microorganisms. Here, we report that CaCO(3) precipitates prepared in vitro are remarkably similar to purported nanobacteria in terms of their uniformly sized, membrane-delineated vesicular shapes, with cellular division-like formations and aggregations in the form of colonies. The gradual appearance of nanobacteria-like particles in incubated human serum as well as the changes seen with their size and shape can be influenced and explained by introducing varying levels of CO(2) and NaHCO(3) as well as other conditions known to influence the precipitation of CaCO(3). Western blotting reveals that the monoclonal antibodies, claimed to be specific for nanobacteria, react in fact with serum albumin. Furthermore, nanobacteria-like particles obtained from human blood are able to withstand high doses of gamma-irradiation up to 30 kGy, and no bacterial DNA is found by performing broad-range PCR amplifications. Collectively, our results provide a more plausible abiotic explanation for the unusual properties of purported nanobacteria.

The risk of urolithiasis recurrence may be reduced with anti-nanobacterial therapy

Urolithiasis is a common disorder responsible for serious human suffering and economic cost to society. Approximately 13% of men and 7% of women in the United States will be diagnosed with urolithiasis at some time in their lives with a recurrence rate of more than 50% in 5 years. Even if some risk factors are defined for stone formation, none of them can fully explain the etiopathogenesis. A controversial pathogen bacteria called 'nanobacteria' (NB) has been associated with several diseases including stone formation in some studies. It is thought to be the nidi for the stone formation after its' isolation from the renal stones and the occurrence of the stone after the percutaneus renal injection of NB. The clinical trials demonstrated that the eradication of NB prevented the calcifications in coronary arteries and prostate with an acceptable level by performing a novel combination therapy called 'ComET' which comprises a tetracycline antibiotic, nutraceutical and EDTA. Based on these findings, we hypothesize that the risk of urolithiasis recurrence may be reduced with combined anti-nanobacterial therapy. Long term prospective studies should be designed for evaluating the patients with positive NB cultures. If our hypotheses can be further supported with clinical trials it may change the approach of the medical management for urolithiasis.

Quantitative LC/MS/MS method andin vivo pharmacokinetic studies of vitexin rhamnoside, a bioactive constituent on cardiovascular system from hawthorn

A simple and accurate liquid chromatography coupled with tandem mass spectrometry method was developed for determination and in vivo pharmacokinetic studies of vitexin rhamnoside in rat plasma. After protein precipitation using methanol, the analytes were separated by a Luna C(18) column with an isocratic elution and analyzed by mass spectrometry in multiple reaction monitoring mode using the respective negative ion at m/z 577.2-293.0 for vitexin rhamnoside and m/z 593.2-413.0 for internal standard (IS) vitexin glucoside. The method was validated systematically within the concentration range 5-5000 microg/L (R > 0.996) and the lower limit of quantitation was 5 microg/L. Acceptable precision and accuracy were acquired for concentrations over the standard curve range. It was further applied to assess pharmacokinetics and bioavailability of vitexin rhamnoside after intravenous and oral administration to rats. The oral bioavailability of vitexin rhamnoside was only 3.57%, which indicated that vitexin rhamnoside had poor absorption or underwent extensive first-pass metabolism. Practical utility of this new LC/MS/MS method was confirmed in pilot pharmacokinetic studies in rats following both intravenous and oral administration.

Nanobacteria--propagating calcifying nanoparticles

Nanobacteria, also known as calcifying nanoparticles (CNP), are controversial infectious agents not matching the current criteria for 'living organism'. Despite the controversy of their classification, they propagate and cause cell death in vitro and are associated or found in many human diseases. Thus, more efforts should be focussed on research on pathogenicity of CNP.

Reversibility of calcitriol-induced medial artery calcification in rats with intact renal function

VC is an important clinical entity; however, very little information is available on its resolution. Induction and regression of calcitriol-induced VC was studied in 47 rats. After calcitriol withdrawal, there was a relatively rapid regression of VC mediated by an active cellular process.

INTRODUCTION

Vascular calcifications (VCs) represent an important risk factor for cardiovascular death. Although VCs are prevalent in relevant diseases (e.g., chronic kidney disease, osteoporosis, diabetes), the reversibility of extraskeletal calcifications is an unresolved issue. This study was conducted to investigate (1) the in vivo effect of calcitriol on VC and (2) whether calcitriol-induced VC would regress after suppression of calcitriol treatment.

MATERIALS AND METHODS

The calcifying effect of calcitriol was studied in four groups of rats (n = 8) that received calcitriol (1 mug/kg, IP) for 2, 4, 6, and 8 days. The reversibility of VC was studied in three additional groups (n = 5) treated with 1 mug/kg of calcitriol for 8 days that were subsequently killed 1, 2, and 9 weeks after the last calcitriol dose. Aortic VC was assessed by histology and by quantification of aortic calcium and phosphorus content. The aortic wall was studied by histology and immunohistochemistry. Statistical analysis was performed by ANOVA and t-tests.

RESULTS

Calcitriol administration resulted in a time-dependent induction of VC, with aortic calcium and phosphorus being significantly increased at 6 and 8 days. Treatment with calcitriol for 8 days resulted in massive medial calcification of the aorta with a 10- to 30-fold increase in the aortic Ca and P content. After suppressing calcitriol administration, a progressive decrease in von Kossa staining and aortic Ca (from 32.8 +/- 2.5 to 9.3 +/- 1.8 mg/g of tissue, p < 0.001) and P (from 11.9 +/- 1.2 to 2.7 +/- 1.8 mg/g of tissue, p = 0.001) content was evidenced. Histology of the aortic wall showed monocytes adhered to the aortic endothelium and macrophages involved in the reabsorption of calcium deposits.

CONCLUSIONS

Our results show that calcitriol treatment induces time-dependent VC. After calcitriol withdrawal, VC regress rapidly with aortic calcium and phosphorus decreasing by 75% in the course of 9 weeks. An active cellular process seems to be involved in regression of VC.

The role of nanobacteria in urologic disease

Recent data proposing an extremely small, self-replicating agent termed "nanobacteria" has raised a great deal of controversy within the scientific community. Since these agents have been isolated within the genitourinary tract, much research has focused attention on the potential role these particles may play in the development of urologic pathology, including polycystic kidney disease, renal calculi, and chronic prostatitis. Recent clinical research targeting these agents has proven effective in treating some patients with refractory category III prostatitis (chronic pelvic pain syndrome). This article reviews the current state of nanobacteria research and explore where these particles may impact urologic disease.

Detection of nanobacteria by immune electronic microscopy

AIM: To introduce an effective method of immunogold electron microscopy for the detection of nanobacteria.

METHODS: Nanobacteria were fixed in the 25 g/L glut-araldehyde, and then were embedded in resin. After they were cut into ultrathin slices by diamond knife, an indirect immunogold electronic microscopy staining was performed on the nanobacteria using the specific antibody of nanobacteria.

RESULTS: The nanobacteria were ball- or stick-like with a length of 80-350 nm under electron microscope. Nanobacteria were combined with the specific antibo-dy. The adhesion of the immune colloidal gold granule was observed under the electronic microscopy.

CONCLUSION: The immune electronic microscopy can not only reveal the ultrastructure of nanobacteria, but also indicate its special antigenicity.

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Culture of nanobacteria from human gallbladder bile

AIM: To introduce a method for culturing nanobacteria from human gallbladder bile.

METHODS: The bile samples were collected from 30 patients with gallbladder-stone. After pretreatment with dilution-centrifuge-filtration (DCF) and filtration method, respectively, those samples were cultured under the ro-utine cell culture condition for nanobacteria. The morp-hological features of the obtained nanobacteria were observed under light and electron microscope. Indirect immunofluorescence staining was used to identify the nanobacteria.

RESULTS: Of the 30 bile samples, the positive rate of nanobacteria was 40% when the samples were pre-treated by DCF method, and the positive rate was 57% when they were pretreated by filtration method. There was no significant difference between those two methods (χ² = 1.669, P >0.05). Brown movement of the tiny nanobacteria was observed at 2 wk. At 4 wk, nanobacteria started to attach on the bottom of the cul-ture bottles. Specific combination of the obtained nan-obacteria with 8D10 antibodies was observed. The nanobacteria were ball- or stick-like with a length of 80-350 nm under electron microscope.

CONCLUSION: The infection of nanobacteria exists in the bile of gallbladder-stone patients. Filtration is a si-mple and effective method for the preparation of the gallbladder bile.

Multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome

Category III chronic prostatitis/chronic pelvic pain syndrome is a syndrome rather than a specific disease and the cause can be multifactorial. In clinical practice, monotherapy often has proven ineffective. Multimodal therapy, which sequentially or simultaneously can address infection, inflammation, and neuromuscular spasm appears to have the greatest potential for symptom improvement, especially in patients with longstanding symptoms.

Functions and possible provenance of primordial proteins--Part II: microorganism aggregation in clouds triggered by climate change

Current models predict that the elevation of the Earth's surface temperature due to global warming is accompanied by a warming of the troposphere, and a thickening cloud cover associated with longer-lasting clouds, in particular over land. These effects can have an instant impact on the vitality level of microorganisms in clouds and the spreading of airborne diseases. Microorganisms could originate from locations on the Earth, or even arrive from space. Primordial proteins in nanobacteria, only recently identified in the atmosphere, could play a significant role in clouds--accelerating the formation of cloud droplets and interconnecting nanobacteria (and possibly nanobacteria and other microorganisms), thus enhancing their chances to eventually reach the Earth.

Primordial proteins and HIV

Primordial proteins regulate the response of nanobacteria to variations in their environment and reinforce existing pathogenic potentials. By analyzing specific response patterns, we predicted the prevalence of nanobacteria in HIV--and in the atmosphere. A current clinical study indicates the identification of a possibly giant nanobacterial reservoir in Africa: a significant fraction of a test group (40 HIV-infected mothers and 13 babies) was infected with nanobacteria. Concurrently, a multitude of 80-300 nm nanovesicles, apparently nanobacteria, were detected in the atmosphere of the Earth. Nanobacterial infections in HIV are possibly comparable to the twin epidemics HIV and tuberculosis. Models inspired by proteomics recommend methods to inactivate nanobacteria (and other slime-producing bacteria) in the body.

Vascular ossification-calcification in metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and calciphylaxis-calcific uremic arteriolopathy: the emerging role of sodium thiosulfate

Background

Vascular calcification is associated with metabolic syndrome, diabetes, hypertension, atherosclerosis, chronic kidney disease, and end stage renal disease. Each of the above contributes to an accelerated and premature demise primarily due to cardiovascular disease. The above conditions are associated with multiple metabolic toxicities resulting in an increase in reactive oxygen species to the arterial vessel wall, which results in a response to injury wound healing (remodeling). The endothelium seems to be at the very center of these disease processes, acting as the first line of defense against these multiple metabolic toxicities and the first to encounter their damaging effects to the arterial vessel wall.

Results

The pathobiomolecular mechanisms of vascular calcification are presented in order to provide the clinician – researcher a database of knowledge to assist in the clinical management of these high-risk patients and examine newer therapies. Calciphylaxis is associated with medial arteriolar vascular calcification and results in ischemic subcutaneous necrosis with vulnerable skin ulcerations and high mortality. Recently, this clinical syndrome (once thought to be rare) is presenting with increasing frequency. Consequently, newer therapeutic modalities need to be explored. Intravenous sodium thiosulfate is currently used as an antidote for the treatment of cyanide poisioning and prevention of toxicities of cisplatin cancer therapies. It is used as a food and medicinal preservative and topically used as an antifungal medication.

Conclusion

A discussion of sodium thiosulfate's dual role as a potent antioxidant and chelator of calcium is presented in order to better understand its role as an emerging novel therapy for the clinical syndrome of calciphylaxis and its complications.

“Nanobacterium sanguineum” – Is it a new life-form in search of human ailment or commensal: Overview of its transmissibility and chemical means of intervention

Morphological, cultural, and immuno-histochemical characteristics of "Nanobacterium sanguineum" (NB) described in the literature are reviewed. NB is reported to be a motile, Gram negative organism that divides by binary fission within a calcium-coated slimy shell; this yeast-like shell replicates by budding. It measures between 20 and 200 nm with a unique structure containing 16S ribosomal RNA. NB has been observed by electron microscopy in coronary artery plaques (CAD) and in kidney stones (KS) found in renal diseases. On the basis of supportive literature, we suggest that NB is not only present in the human body but also has auxiliary association with human ailments without a specific etiological role; anti-NB antibody has been detected in subjects with calcified lesions and inflammation in diverse ailments including choriodecidual inflammation in pregnancy, ovarian cancers, arthritis and even Alzheimer's disease. More recent report on the detection and vertical transmission of NB antigen and anti-NB antibody in HIV-infected mothers supports the view that NB might be an important opportunistic infective agent contributing to HIV pathology; we note that the presence of viable and transmitting NB was not studied and suggest further studies to establish vertical transmission of NB in HIV-infected persons. On the basis of the foregoing we suggest that NB possibly exacerbates human ailments and raise the question: Is NB a new life-form in search of human ailment or a commensal organism? Recognizing the presence of NB in the human body, we discuss clinical trials, reported in the literature relevant to its eradication, with a rectal suppository containing very high amounts of disodium EDTA and tetracycline. We suggest that tetracycline in this formulation acted in combination with EDTA, more as a chelating agent than an antibiotic; oxytetracycline- a non-chelating form of tetracycline-does not inhibit or kill NB. Evaluation of anti-NB effect of orally administrable and potentially safer as well as therapeutically more acceptable chelating agent -ascorbic acid, acting alone or in combination with antibiotics-that eradicates another slime forming bacterium - Pseudomonas aeruginosa - in children with cystic fibrosis, is suggested.

Keeping nanobacterial infections at bay during space travel

In January 2004, President George W. Bush unveiled plans to send astronauts to the Moon in 2015 and shortly thereafter to Mars. With the prospect of manned exploration of the planets drawing ever closer, the new discipline of Space Medicine is destined to come to the fore. Moreover, investigations of how human beings function under space conditions could provide important new insights into fundamental questions of human physiology and disease. We draw attention here to one such instance of a disease process that can be provoked by extended periods of exposure to low gravity.