[Microbial interactions with heavy metals]

Living organisms are exposed in nature to heavy metals, commonly present in their ionized species. These ions exert diverse toxic effects on microorganisms. Metal exposure both selects and maintains microbial variants able to tolerate their harmful effects. Varied and efficient metal resistance mechanisms have been identified in diverse species of bacteria, fungi and protists. The study of the interactions between microorganisms and metals may be helpful to understand the relations of toxic metals with higher organisms such as mammals and plants. Some microbial systems of metal tolerance have the potential to be used in biotechnological processes, such as the bioremediation of environmental metal pollution or the recovery of valuable metals. In this work we analyze several examples of the interactions of different types of microbes with heavy metals; these cases are related either with basic research or with possible practical applications.

Advanced glycosylation end products in skin, serum, saliva and urine and its association with complications of patients with type 2 diabetes mellitus

BACKGROUND

The accumulation of advanced glycation end products (AGEs) has a key role in the pathophysiology of diabetes complications. Comparison of AGEs measurement in serum, skin, saliva and urine has not been reported.

AIMS

To compare AGEs in serum, skin, saliva and urine in patients with Type 2 diabetes mellitus, with complications at different stages.

MATERIALS AND METHODS

We examined 50 patients with Type 2 diabetes mellitus (40 women and 10 men) grouped according to the progression of neuropathy, nephropathy and retinopathy. The AGEs content in serum, skin, saliva and urine was measured by spectrofluorometry HPLC.

RESULTS

The patients had a mean age of 56.5 +/- 7.7 yr and 12.8 +/- 6.7 yr since diagnosis. AGEs in skin correlated with years since diagnosis (p = 0.0005). AGEs in serum, skin and saliva increased with the progression of complications, nevertheless, in urine a trend to diminution was found. In the group with end-stage renal disease (ESRD), AGEs in serum increased in greater proportion. In order to account for the decreased AGEs clearance, we corrected the values for creatinine levels, and AGEs in skin gave a better association with complications.

CONCLUSIONS

The AGEs measurement in skin, serum and saliva are useful to evaluate diabetes complications. AGEs in skin are associated with years since diagnosis of diabetes. Correction for renal function might discriminate AGEs in situ formation from accumulation.

Perceived psychological stress in diabetes mellitus type 2

We studied the factors associated with perceived psychosocial stress in patients with diabetes mellitus type 2. A cross-sectional study was carried out in 105 patients (27 men and 78 women) with a mean age of 51.6 (50.2-52.5, 95% CI) years and 8.6 (7.3-9.8, 95% CI) years since diagnosis. The patients were overweight with body mass index (BMI) of 27.6, and most of them had deficient metabolic control (mean glucose of 10.6 nmol/L and HbA1c of 9.2%). Glycated hemoglobin was associated with BMI (negatively, p = 0.002), with adherence to diet (negatively, p = 0.027) and with years since diagnosis (p = 0.031). The association with BMI was found only in women. It was explained by the fact that obese women had fewer years since diagnosis, and recently diagnosed patients have a better metabolic control. A stepwise multiple regression analysis showed perceived stress associated with percent body fat and blood glucose in the total group, with years since diagnosis in women (p = 0.02), and with BMI in men (p = 0.03). No association was found between perceived stress and adherence to treatment. We concluded that in our group, perceived stress was associated with obesity and metabolic control.

Plasma epinephrine and norepinephrine response to stimuli in autonomic neuropathy of type 2 diabetes mellitus

The objective of this study was to examine epinephrine and norepinephrine plasma levels in patients with clinical type 2 diabetes mellitus, at different stages of autonomic neuropathy. Eighteen patients were classified in groups without (n = 6) and with early (n = 6), definite (n = 3) and severe (n = 3) neuropathy. Blood catecholamine levels were measured after the Valsalva maneuver, cold exposure and orthostatic tests. The norepinephrine basal levels were lower in patients with severe neuropathy (0.4 +/- 0.2 nmol/l), compared with the group with no neuropathy (1.3 +/- 0.5 nm/l, p = 0.034), or with early neuropathy (1.3 +/- 0.7 nm/l, p = 0.035). After the Valsalva maneuver, no increase was found in the group with severe alteration. In patients without neuropathy, cold exposure induced a peak of norepinephrine at 5 min (delta = 1.9 +/- 1.6 nmol/l). The increase was lower in groups with definite and severe damage. In patients with definite or moderate neuropathy, the orthostatic test induced minimal or no response. The epinephrine response to the maneuvers was not significant, and no differences were found among the groups. Norepinephrine basal levels and cold responses are diminished in patients with definite and severe autonomic neuropathy. This provides further evidence on their impaired response to stress. The comparable epinephrine levels in patients with or without autonomic neuropathy indicates that adrenal medullar function is not significantly altered.