Antioxidant, Anti-Inflammatory and Anti-Proliferative Properties of Stachys circinata on HepG2 and MCF7 Cells

According to the WHO, the overall age-standardized cancer rate keeps declining, and the number of cases diagnosed each year increases, remaining among the leading causes of death in 91 out of 172 recorded countries. In this context, novel cancer prediction and therapeutic protocols are compulsory. The effect of a Stachys circinata L'Hér dichloromethane extract (ScDME) on cell redox homeostasis and tumor proliferation was investigated. HepG2 cell feedback mechanisms to oxidative stress exposure were evaluated by determining catalase (CAT) and reduced glutathione (GSH), following the supply with ScDME (0.0-5.7 µg/µL). Cytotoxicity of ScDME against the human umbilical vein endothelial cell (HUVEC) and two human cancer cell lines (breast: MCF7; liver: HepG2) was evaluated by the MTT assay. H₂O₂-stressed HepG2 cells supplied with the S. circinata extracts exhibited significantly increased CAT and GSH activity as compared to unsupplied ones. The anti-inflammatory activity of the extracts was evaluated by real time-qPCR on IL-1, IL-6 and TNF-α expression. As a result, this research points out that S. circinata dichloromethane extract owns anti-inflammatory and anti-proliferative properties against MCF7 and HepG2 cells and activates CAT and GSH of the HepG2 cells' antioxidant enzyme system.

The adding value of fluid challenge and balloon occlusion tests in patients with atrial septal defect

Background

Careful, step-wise assessment is required in all patients with an atrial septal defect (ASD) to exclude pre-existing pulmonary vascular disease or left ventricular disease. Fluid challenge test (FCT) and balloon occlusion testing (BOT) may unmask left ventricular disease and challenge the pulmonary circulation, but their complementary role in the evaluation of patients with “operable” ASD is not well established.

Aim

To evaluate the haemodynamic changes of the pulmonary circulation by FCT and BOT in ASD patients undergoing percutaneous closure according to the current guidelines.

Methods

Consecutive patients selected for percutaneous ASD closure underwent invasive hemodynamic assessment at baseline and after BOT, FCT and both.

Results

Fifty patients (mean age 47.3±11.7 years, 72% female) were included. All patients had a pulmonary-to-systemic flow ratio (QP/QS) ≥1.5, pulmonary vascular resistance (PVR) <5 WU and pulmonary arterial wedge pressure (PAWP) <15 mmHg. Individuals with a PVR ≥2 WU at baseline were older, more symptomatic, with a higher baseline systemic vascular resistance compared to the lower PVR group (PVR <2 WU; p<0.0001). The response of Qp/Qs to FCT was different between groups (p<0.0001, Figure 1). Patients with a lower baseline PVR experienced an increase in Qp/Qs, which remained above 1.5 in all patients, whereas in almost all (90%) patients with a higher baseline PVR, the Qp/Qs fell to below 1.5.

FCT caused a marked increase in pulmonary blood flow of almost 2 liters (p<0.0001) accompanied by increases in PAWP (p<0.0001). BOT led to a modest increase in PAWP (Δ1.5 [−1.0–7.0] mmHg, p<0.0001). FCT added to BOT caused a further increase in PAWP and Qs (both p<0.0001), while PVR was unchanged (p>0.1).

No difference was observed in the PAWP response to FCT, BOT or both between groups; no patients reached a PAWP ≥18 mmHg following FCT or BOT alone, but 4 (8%) patients did following the addition of FCT to BOT. No acute clinical adverse events were experienced by any patients.

Conclusions

None of the reported ASD patients presented with FCT criteria of post-capillary PH (that is a PAWP >18 mmHg). Even small rises in PVR may have significant implications on cardiovascular haemodynamics. In fact, patients with PVR <2 WU showed an increase in Qp/Qs, which remained above 1.5 in all patients, suggesting that they still had a distensible pulmonary circulation, whereas in almost all patients with a PVR ≥2 WU, the Qp/Qs fell to below 1.5.

Funding Acknowledgement

Type of funding sources: None. Figure 1

4D Flow analysis of intracavitary blood flow dynamics and energetics in the systemic right ventricle

Funding Acknowledgements

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Italian Ministry of Health

Background

The systemic position of a morphologically right ventricle (SRV) makes it vulnerable to fail, leading to high incidence of heart failure and cardiac death [1]. Understanding SRV intracavitary blood flow dynamics and energetics could improve patient risk stratification.

Purpose

Testing the potential of three-dimensional time-resolved phase contrast cardiac magnetic resonance (4D Flow) in quantifying SRV blood flow dynamics and energetics.

Methods

4D Flow prototype sequences were acquired on 3 patients (1 male, 2 females) with SRV in D-loop transposition of great arteries after atrial switch operation (D-TGA/ASO), 3 male patients with SRV in L-loop TGA (L-TGA) and healthy controls (2 males, 1 female).

Kinetic energy (KE), viscous energy loss (EL), dissipation index (DI) calculated as EL to KE ratio, and hemodynamics forces (HFs) resulting from pressure gradients, were computed for the D-TGA/ASO and L-TGA SRVs, and for the control left ventricles (LVs) and right ventricles (RVs). HFs were decomposed in inferior-anterior, septal-lateral and basal-apical components (HFIA, HFSL, HFBA, respectively)

Results

Figure 1 reports the time-course of HF components and the general features of the enrolled subjects.

In systole, all SRVs (Figure 1a-1b) presented a dominant HFIA and a minor HFSL, similarly to RVs (Figure 1c); however, HFSL had a positive peak, indicating septal contraction towards the SRV cavity, opposite to its normal motion. HFBA magnitude was similar to LVs (Figure 1d), suggesting that the shortening of the tricuspid anulus towards the apex is more pronounced than in RVs (Figure 1c).

Over the whole cardiac cycle, DI values were highest in D-TGA/ASO SVRs (0.40-0.55); in L-TGA SRVs, DI values (0.24-0.45) were comparable to healthy LVs (0.22-0.37) and RVs (0.23-0.36). This difference may be related to the fact that in DTGA/ASO the left atrium is functionally replaced by a pulmonary venous baffle, which lacks efficient contraction, as highlighted by the absence of a distinctive A-wave in the KE time-course (Figure 2a).

Due to the adaptation to systemic afterload, SRVs were hypertrophic (Figure 1a-1b), with indexed mass higher than normal RVs (Figure 1c), and presented reduced compliance to the diastolic filling, as suggested by increased KE E-wave slope in L-TGA (Figure 2b) compared to controls (Figure 2c-2d).

Conclusions

Intracavitary HFs in SRVs reveal a partial shift from a RV towards LV pattern. This occurs at the expenses of a higher energetic consumption in D-TGA/ASO than L-TGA, enlightening the crucial role of atrial contribution to impaired SRV diastolic filling. These findings corroborate the previous evidence that patients with D-TGA/ASO have abnormal decrease in stroke volume during exercise whereas L-TGA patients can reach values comparably to healthy controls [2].

Response to fluid challenge in patients with atrial septal defect

Background

A fluid challenge test (FCT) with a rapid infusion of saline allows for discrimination between pre- and post-capillary pulmonary hypertension (PH) and may unmask hidden post-capillary PH. Patients with atrial septal defect (ASD) may develop pre- or post-capillary PH after shunt closure respectively in case of pulmonary vascular disease or left ventricular disease.

Aim

To evaluate the haemodynamic changes of the pulmonary circulation in ASD patients undergoing percutaneous closure with indicated according to the current ESC guidelines.

Methods

Twenty-three patients (mean age 42.9±12.4 years; 15 female) underwent right heart catheterization in basal conditions and after FCT (volume loading with rapid saline infusion of 7 ml/kg in 10 min) before percutaneous closure of the ASD.

Right atrial pressure (RAP), systolic, mean and diastolic pulmonary arterial pressure (sPAP, mPAP and dPAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR) and the ratio between pulmonary and systemic flow (QP/QS) were calculated four times: before and after inflating the sizing balloon both at baseline and immediately after FCT (Fig. 1).

Results

The patients had an increase in pressures and flows after FCT with open ASD: mPAP (18.7±4.4 vs 16.7±4.6 mmHg, p<0.001), PAWP (11.3±3.1 vs 9.2±3.0 mmHg, p<0.001), QP (12.5±2.3 vs 10.3±2.0 l/min, p<0.001), and QS (6.6±1.4 vs 5.9±1.2 l/min, p<0.001) but RAP remained unchanged (8.7±3.0 vs 8.3±2.4 mmHg, p=0.35). PVR (0.2±0.4 vs 0.8±0.3 Wood Units, p<0.001) and SVR (11.2±3.2 vs 12.5±3.2 Wood Units, p=0.02) decreased, and PVR/SVR (0.06±0.02 vs 0.06±0.3, p=0.25) remained unchanged. QP/QS increased in all patients after FCT (mean±SD: 2.0±0.4 vs 1.8±0.4, p<0.001).

During a temporary ASD closure by sizing balloon, the patients had increases of RAP (9.0±2.6 vs 7.6±2.6 mmHg, p<0.001) mPAP (19.5±4.0 vs 17.4±3.7 mmHg, p<0.001), PAWP (13.2±2.1 vs 11.2±2.9 mmHg, p<0.001), and CO (7.7±2.7 vs 6.8±2.3 l/min, p<0.001) after FCT. PVR remained unchanged (0.9±0.4 vs 1.1±0.6, p=0.12) and SVR reduced (9.8±2.7 vs 11.3±2.9, p<0.001) after FCT.

Conclusions

None of the reported ASD patients presented with FCT criteria of post-capillary PH (that is a PAWP >18 mmHg). The FCT was associated with an increase in QP/QS suggesting that the patients still had a distensible pulmonary circulation. Further studies are needed to explore the relevance of a FCT in ASD patients, particularly those with higher PVR values.

Figure 1

Funding Acknowledgement

Type of funding source: None

Genetic and epigenetic dynamics affecting anthocyanin biosynthesis in potato cell culture

Anthocyanins are antioxidant pigments widely used in drugs and food preparations. Flesh-coloured tubers of the cultivated potato Solanum tuberosum are important sources of different anthocyanins. Due to the high degree of decoration achieved by acylation, anthocyanins from potato are very stable and suitable for the food processing industry. The use of cell culture allows to extract anthocyanins on-demand, avoiding seasonality and consequences associated with land-based-tuber production. However, a well-known limit of cell culture is the metabolic instability and loss of anthocyanin production during successive subcultures. To get a general picture of mechanisms responsible for this instability, we explored both genetic and epigenetic regulation that may affect anthocyanin production in cell culture. We selected two clonally related populations of anthocyanin-producing (purple) and non-producing (white) potato cells. Through targeted molecular investigations, we identified and functionally characterized an R3-MYB, here named StMYBATV. This transcription factor can interact with bHLHs belonging to the MBW (R2R3-MYB, bHLH and WD40) anthocyanin activator complex and, potentially, may interfere with its formation. Genome methylation analysis revealed that, for several genomic loci, anthocyanin-producing cells were more methylated than clonally related white cells. In particular, we localized some methylation events in ribosomal protein-coding genes. Overall, our study explores novel molecular aspects associated with loss of anthocyanins in cell culture systems.

Geographical variation of the chemical composition in essential oils extracted from Sardinian Salvia verbenaca

Salvia verbenaca is a perennial herbaceous plant well appreciated as medicinal herb which can be found in Mediterranean area, Europe, Africa and Asia. In this study, S. verbenaca flowers and leaves were collected in six different geographical areas of Sardinia (Italy). Information about the variation of the chemical composition of plants grown in different locations were obtained from gas chromatography analysis of the extracted essential oils. Gas chromatography analysis detected 33 compounds, which have been grouped in oxygenated monoterpenes, monoterpene hydrocarbons, sesquiterpenes and other compounds. The chemical composition of each group resulted significantly affected by sampling site in terms of geography and altitude. Concerning the geographical distribution of the detected chemicals, sesquiterpenes were found in considerable amount in three localities, monoterpenes hydrocarbons in two and other compounds were predominant only in one site. Regarding the altitude level, monoterpenes, sesquiterpenes and other compounds were predominant, respectively, at medium and medium-high altitude.

P6093D echocardiography versus cardiovascular magnetic resonance in the evaluation of the right ventricle in patients with congenital heart disease after pulmonary valve replacement

Background

Cardiac MR (CMR) is the gold standard for right ventricular (RV) quantification. Three-dimensional echo (3DE) is a relatively new technique which may offer a rapid alternative for the examination of the right heart. The purpose of this study was to investigate the clinical significance and interchangeability of these modalities to evaluate patients with congenital heart disease (CHD) who underwent percutaneous pulmonary valve implantation (PPVI) for RV outflow tract dysfunction.

Methods

36 patients who underwent PPVI were evaluated with 3DE and CMR to quantify the RV. RV volumes and ejection fraction (EF) were measured for both imaging techniques with commercially available softwares (Tomtec-Germany for 3DE and Medimatic-Netherlands for CMR data). Paired t-test, Bland-Altman analysis, and Pearson's correlation analysis were used as most appropriate to compare both measured techniques with CMR regarded as the reference standard.

Results

86% of the patients (31 patients) had adequate image quality on 3DE and was included in the study. Patients underwent both 3D echo and CMR within a mean of 9 days of each other and at a mean time of 3 years after PPVI. Compared to CMR, 3D echo significantly underestimated volumes in all patients and overestimate RV ejection fraction (EF). Mean RV End-diastolic Volumes (EDV) and End-Systolic Volumes (ESV) were significantly greater when measured by CMR compared to 3D echo (EDV: 99 ml/m2 vs. 85 ml/m2; p<0.01, ESV: 52 ml/m2 vs. 41 ml/m2; p<0.01). Mean RV EF was lower when measured by CMR compared to 3D echo (48% vs 52%; p<0.05). Linear regression analysis showed high correlation coefficients between 3DE and CMR (r=0,68 for EDV, r=0,62 for ESV, and r=0,57 for EF; p<0.001). Bland-Altman analysis demonstrated that for both RV EDV and RV ESV there was a significant and systematic under-estimation of volume by 3D echo compared to CMR. Both 3DE and CMR measurements were found to be highly reproducible in terms of intra-observer variability.

Conclusions

Statistically significant and clinically meaningful differences in volumetric measurements were observed between 3DE and CMR in the evaluation of RV volumes and function in patients with CHD after PPVI. Despite linear regression and Bland-Altman analysis showed that the two techniques are related and present some degree of agreement, 3D Echocardiography systematically underestimates volumes and overestimates EF and this would have to be considered in the clinical practice.

Seasonal Variation of Essential Oil in Rosmarinus officinalis Leaves in Sardinia

Rosmarinus officinalis L. is an aromatic plant belonging to the Lamiaceae family widely distributed in the Mediterranean area. The interest on this species is related to the multiple uses of the plant as a food ingredient, in the pharmaceutical and cosmetic industries. The chemical composition of essential oil (EO) from 5 accessions of R. officinalis L., collected monthly through a full year in Sardinia, has been studied by gas chromatography (GC) and GC-mass spectrometry technique. The EO ranged from 0.29% to 0.89%. The qualitative determinations revealed the presence of 27 compounds belonging to 6 chemical groups (hydrocarbon monoterpene, alcohols, aldehydes, ketones, esters, hydrocarbon sesquiterpene). Overall the GC-flame ionization detector analysis showed the presence of 7 major compounds: α-pinene (26%-28%), camphene (5%-8%), 1,8-cineole (15%-25%), borneol (5%-11%), camphor (3%-12%), verbenone (6%-15%), and bornyl acetate (4%-7%). Chromatographic data were also subjected to a chemometric approach that evidenced discrimination of the samples according to the site of collection.

Body mass index stratification in hospitalized Italian adults with congenital heart disease in relation to complexity, diagnosis, sex and age

BACKGROUND AND AIMS

Adults with congenital heart disease (ACHD) are at risk of overweight and obesity, two major health problems, though underweight can be a negative prognostic factor too. Awareness of the body mass index (BMI) in ACHD is very limited. The present study describes the use and prevalence of BMI in Italian symptomatic hospitalized ACHD patients in relation to complexity by Bethesda system classification, diagnosis, sex and age.

METHODS AND RESULTS

We classified 1388 ACHD patients, aged 18-69 years, on the basis of their BMI, and compared them to the Italian reference population. In our total ACHD population we found a significantly higher prevalence of underweight compared to the Italian reference population (6.34% vs 3.20%). ACHD women were more underweight than men. Underweight decreased with age. Overweight was significantly less frequent in the total ACHD population (26.73% compared to 31.70%) in the Italian reference population. Men were more likely to be overweight than women. In statistical terms obesity was similar in the Italian reference population (10.50%) and our ACHD population (9.58%). Both overweight and obesity increased with age. Results were comparable using a diagnostic anatomical-functional classification and the Bethesda system classification.

CONCLUSIONS

In our cohort of ACHD the prevalence of underweight was double that of the Italian reference population. The prevalence of overweight was lower, while obesity was similar. Since BMI does not account for differences in body fat distribution, a future aim will be to quantify the visceral component of the adipose tissue in ACHD patients and examine their body composition in order to reflect their risk of acquired cardiovascular disease better, and either to maintain or achieve an adequate visceral component.

Profiling of the Bioactive Compounds in Flowers, Leaves and Roots of Vinca sardoa

Vinca sardoa (Stern) Pignatti (Apocynaceae) is largely distributed in Sardinia where it is considered a typical endemism. Since the plant is used in traditional folk medicine, the aim of the present work was to identify and quantify the polyphenolic metabolites, due to the well-known importance of polyphenolic compounds, as well as to evaluate antioxidant activity in different parts of the plant. The compounds were identified and determined in the methanol extracts of leaves, flowers, and roots by developing different LC-MS/MS methods. The obtained data show that leaves possess the highest amount of polyphenols, in particular quinic acid (3401 mg/100 g), chlorogenic acid (1082 mg/100 g), caffeoylquinic acid isomer 1 (190 mg/100 g), and robinin (633 mg/100 g). Likewise, antioxidant tests showed that leaves possess the main radical scavenging activities in both ABTS (49.19 ± 3.41 μg/mL, 30.88 ± 3.04 μg/mL at time zero and after 50 min, respectively) and DPPH assays (223.97 ± 30.81 μg/mL, 109.52 ± 12.89 μg/mL at time zero and after 30 min, respectively). Taking into account that leaves differed most from flowers and roots in the content of caffeoylquinic acid and chlorogenic acid, of which antioxidant properties are widely recognized, it is reasonable to assume that these two compounds are involved in the differences described. The relationship between the high polyphenolic content and interesting antioxidant activities, justifies its use in ethnobotany and may be suggest a use of this specie, after removal of the alkaloid fraction, in the pharmaceutical, phytotherapy, and cosmetic industries.

Metabolomic study of wild and cultivated caper (Capparis spinosa L.) from different areas of Sardinia and their comparative evaluation

Capparis spinosa L. (Capparidaceae), also known as caper, is widely known for its very aromatic flower buds (capers),that are largely employed as a flavouring in cooking. Capparis species are regarded as a potential source of important bioactive compounds, in fact, due to their botanical relationship with Brassica species; they contain glucosinolates, secondary plant metabolites, that have been studied for their potential anticarcinogenic properties. In addition, the presence of other numerous beneficial compounds such as polyphenols, alkaloids, lipids, vitamins and minerals have been reported. The aim of this study was to individuate and determinate the principal bioactive compounds occurring in different part (leaves, buds and flowers) of wild and cultivated C. spinosa collected from different area of Sardinia (Italy). Ultra-high performance liquid chromatography-triple quadrupole/linear ion trap tandem mass spectrometry methods were used for identification and simultaneous determination of 27 bioactive molecules. Analysis of different samples revealed qualitative and quantitative differences in the content of flavonoids, glucosinolates, anthocyanins and phenolic acids. In particular, glucocapparin resulted the most abundant with values ranging from 112 to 364 mg/100 g Fresh Weight (FW); followed by rutin with highest value of 126 mg/100 g FW, 4-hydroxyglucobrassicin with highest value of 42 mg/100 g FW and isorhamnetin 3-O-rutinoside with highest value of 24 mg/100 g FW. Based on this metabolomic targeted approach, quantitative results were treated by principal component analysis to explore and visualise correlation and discrimination among collections of C. spinosa samples. Copyright © 2016 John Wiley & Sons, Ltd.

Profiling and Simultaneous Quantitative Determination of Anthocyanins in Wild Myrtus communis L. Berries from Different Geographical Areas in Sardinia and their Comparative Evaluation

INTRODUCTION

Myrtus communis L. (Myrtaceae) is a self-seeded shrub, widespread in Sardinia, with anti-inflammatory, antiseptic, antimicrobial, hypoglycemic and balsamic properties. Its berries, employed for the production of sweet myrtle liqueur, are characterised by a high content of bioactive polyphenols, mainly anthocyanins. Anthocyanin composition is quite specific for vegetables/fruits and can be used as a fingerprint to determine the authenticity, geographical origin and quality of raw materials, products and extracts.

OBJECTIVE

To rapidly analyse and determine anthocyanins in 17 samples of Myrtus communis berries by developing a platform based on the integration of UHPLC-MS/MS quantitative data and multivariate analysis with the aim of extracting the most information possible from the data.

METHODOLOGY

UHPLC-ESI-MS/MS methods, working in positive ion mode, were performed for the detection and determination of target compounds in multiple reaction monitoring (MRM) mode. Optimal chromatographic conditions were achieved using an XSelect HSS T3 column and a gradient elution with 0.1% formic acid in water and 0.1% formic acid in acetonitrile. Principal component analysis (PCA) was applied to the quantitative data to correlate and discriminate 17 geographical collections of Myrtus communis.

RESULTS

The developed quantitative method was reliable, sensitive and specific and was successfully applied to the quantification of 17 anthocyanins. Peonidin-3-O-glucoside was the most abundant compound in all the extracts investigated.

CONCLUSION

The developed methodology allows the identification of quali-quantitative differences among M. communis samples and thus defines the quality and value of this raw material for marketed products. Moreover, the reported data have an immediate commercial value due to the current interest in developing antioxidant nutraceuticals from Mediterranean plants, including Sardinian Myrtus communis. Copyright © 2016 John Wiley & Sons, Ltd.

Defective Function of the Fas Apoptotic Pathway in Type 1 Diabetes Mellitus Correlates with Age at Onset

The Fas death receptor triggers lymphocyte apoptosis through an extrinsic and an intrinsic pathway involving caspase-8 and -9 respectively. Inherited defects of Fas function are displayed by a proportion of patients with Type 1 diabetes mellitus (T1DM) especially those with a second autoimmunity (T1DM-p). This study assesses activation of both pathways in Fas-resistant (FasR) patients to localize the defect. 21/28 (75%) T1DM-p, 14/50 (38%) T1DM, and 7/150 (5%) controls were FasR. Analysis of the 35 FasR patients and 20 Fas-sensitive (FasS) controls showed that caspase-9 activity was lower in T1DM-p and T1DM than in controls, whereas caspase-8 activity was lower in T1DM-p than in T1DM and the controls. Single patient analysis showed that 16/35 patients displayed defective activity of one (FasR1), whereas 19 displayed normal activity of both caspases (FasR2) Ages at onset of diabetes mellitus in T1DM and the second autoimmune disease in T1DM-p were lower in FasR than in FasS patients. All FasR1 patients developed diabetes mellitus before the age of 9 years, whereas a later onset was displayed by 26% FasR2 and 53% FasS patients. These data show that defective Fas function may involve both the extrinsic and intrinsic pathway in T1DM and severity correlates with the precocity of the autoimmune attack and its tissue polyreactivity.

Antioxidant and antiproliferative activity of Stachys glutinosa L. ethanol extract

Ethanol extracts of Stachys glutinosa L. (Lamiaceae) were investigated for antioxidative properties, as well as antiproliferative action on various cell lines. The antioxidant activities were investigated by ABTS (2,2'-azinobis-3-ethylbenzothiazoline-6-sulphonic acid) assay, DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging, β-carotene/linoleic acid assay, scavenging of hydrogen peroxide (horseradish peroxidase test), superoxide anion scavenging, and hypochlorous acid scavenging (taurine test). The antioxidant activity was reported as IC50 and reveals antioxidant effects. Antiproliferative effects were measured in vitro on three cell lines: HepG2 (human hepatocarcinoma), MCF7 (breast human adenocarcinoma) and C2C12 (mouse myoblast) cell lines by MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The ethanol extract induced variations in cell viability on all cell lines tested. At 200 μg/mL, the effects on cell viability were - 23%, - 27% and - 37%, respectively, for C2C12, MCF7 and HepG2.

'Moringa oleifera: study of phenolics and glucosinolates by mass spectrometry'

Moringa oleifera is a medicinal plant and an excellent dietary source of micronutrients (vitamins and minerals) and health-promoting phytochemicals (phenolic compounds, glucosinolates and isothiocyanates). Glucosinolates and isothiocyanates are known to possess anti-carcinogenic and antioxidant effects and have attracted great interest from both toxicological and pharmacological points of view, as they are able to induce phase 2 detoxification enzymes and to inhibit phase 1 activation enzymes. Phenolic compounds possess antioxidant properties and may exert a preventative effect in regards to the development of chronic degenerative diseases. The aim of this work was to assess the profile and the level of bioactive compounds in all parts of M. oleifera seedlings, by using different MS approaches. First, flow injection electrospray ionization mass spectrometry (FI-ESI-MS) fingerprinting techniques and chemometrics (PCA) were used to achieve the characterization of the different plant's organs in terms of profile of phenolic compounds and glucosinolates. Second, LC-MS and LC-MS/MS qualitative and quantitative methods were used for the identification and/or determination of phenolics and glucosinolates in M. oleifera.

Antimicrobial activity against beneficial microorganisms and chemical composition of essential oil of Mentha suaveolens ssp. insularis grown in Sardinia

The aim of this work was to determine the chemical constituents and in vitro antimicrobial activity of the essential oil (EO) of the aerial parts of Mentha sueveolens spp. insularis grown in Sardinia (Italy) against probiotic and starter microorganisms. The gas chromatography-mass spectrometry (GC-MS) analysis allowed to identified 34 compounds, most of oxygenated monoterpene compounds (82.5%) and among them, pulegone was found as major compound (46.5%). The agar diffusion test carried out employing the EO of Mentha suaveolens spp. insularis showed a low antibacterial activity, in particular no action was noticed for probiotic bacteria belonging to lactic acid bacteria groups, whereas almost all yeasts strains tested were inhibited. The automated microtitter dilution assay showed a clear effect at increasing concentration of EO on the specific growth rate (μ) and extension of the lag phase (λ) only for S. xylosus SA23 among bacteria and for Saccharomyces cerevisiae, Tetrapisispora phaffii CBS 4417, Metschnikowia pulcherrima, and Candida zemplinina among yeasts. Results obtained in this work allow us to broaden the knowledge on the effect of EOs on probiotic and food-related microorganisms.

PRACTICAL APPLICATION

Mentha suaveolens spp. insularis may be used in combination with probiotic bacteria into the food matrix or encapsulated in coating and edible films for food preservation.

In vitro Inhibitory Effects of Limonium contortirameum and L. virgatum Extracts from Sardinia on α-Amylase, α-Glucosidase and Pancreatic Lipase

Pancreatic triacylglycerol lipase (PL), α-amylase and α-glucosidase are interesting pharmacological targets for the management of dyslipidemia, atherosclerosis, and obesity-diabetes. Limonium spp (Plumbaginaceae) are endemic to Sardinia, Italy. Comparable with acarbose, aqueous extracts (AE) of L. contortirameum and L. virgatum, and their phytoconstituent gallic acid concentration gradients (mg/mL) were identified as in vitro potent ( p<0.001, n=3) and efficacious dual inhibitors of α-amylase and α-glucosidase with respective IC50 (mg/mL) values of 0.6 ± 0.1, 1.2 ± 0.1 and 0.15 ± 0.02. Equivalent to orlistat (PL IC50 of 0.114 ± 0.004 μg/mL), L. contortirameum, L. virgatum AE and their phytoprinciple gallic acid inhibited PL substantially ( p<0.001, n=3) in a dose-dependent manner in vitro with PL- IC50 (μg/mL) of 920.4 ± 105.2, 593.1 ± 56.8 and 8.4 ± 0.9, respectively. LC-MS analysis of extracts revealed the presence of several phenolic compounds in their aglycon and glycoside forms. These are catechins, flavones, epigallocatechins and flavonols. Flavonoid- and polyphenol-rich L contortirameum and L. virgatum, modulating gastrointestinal carbohydrate and lipid digestion and absorption, may be advocated as candidates for obesity-diabetes prevention and phytotherapy.

In vitro inhibitory effects of Limonium contortirameum and L. virgatum extracts from sardinia on alpha-amylase, alpha-glucosidase and pancreatic lipase

Pancreatic triacylglycerol lipase (PL), alpha-amylase and alpha-glucosidase are interesting pharmacological targets for the management of dyslipidemia, atherosclerosis, and obesity-diabetes. Limonium spp (Plumbaginaceae) are endemic to Sardinia, Italy. Comparable with acarbose, aqueous extracts (AE) of L. contortirameum and L. virgatum, and their phytoconstituent gallic acid concentration gradients (mg/mL) were identified as in vitro potent (p<0.001, n=3) and efficacious dual inhibitors of alpha-amylase and alpha-glucosidase with respective IC50 (mg/mL) values of 0.6 +/- 0.1, 1.2 +/- 0.1 and 0.15 +/- 0.02. Equivalent to orlistat (PL IC50 of 0.114 +/- 0.004 microg/mL), L. contortirameum, L. virgatum AE and their phytoprinciple gallic acid inhibited PL substantially (p<0.001, n=3) in a dose-dependent manner in vitro with PL- IC50 (microg/mL) of 920.4 +/- 105.2, 593.1 +/- 56.8 and 8.4 +/- 0.9, respectively. LC-MS analysis of extracts revealed the presence of several phenolic compounds in their aglycon and glycoside forms. These are catechins, flavones, epigallocatechins and flavonols. Flavonoid- and polyphenol-rich L contortirameum and L. virgatum, modulating gastrointestinal carbohydrate and lipid digestion and absorption, may be advocated as candidates for obesity-diabetes prevention and phytotherapy.

[Art therapy for hospitalised congenital heart disease patients: a method of psychological intervention at the IRCCS Policlinico San Donato Milanese Hospital]

The current work is the presentation of a new project at the IRCSS San Donato Milanese University hospital, in the sphere of Psychocardiology. Hospitalised children and adolescents often face psychosocial difficulties and the psychological condition of their parents frequently has an impact on their wellbeing. A strong need to take care, beyond the mere cure, is necessary in the hospital settings - that is a need to pay attention also to psychological aspects apart from the medical ones. Art therapy could be an answer for this need: the literature has outlined its efficacy in hospital, also due to the higher inclination of children and adolescents toward creativity. By providing and analysing the drawings of 10 young patients with congenital heart disease (CHD), this study outlines how the art therapy program gives these patients the opportunity to freely and directly express fears and anxieties about medical procedures and their disease. Moreover, through the creation of a tangible product, psychologists can better evaluate the psychological troubles of young patients and provide them and their parents with more focused and personalized support. This study also focuses on the perception of the utility that parents have of this new therapeutic intervention, offered at the Department of Paediatric Cardiac Surgery, confirming that art therapy is perceived as being effective and is definitely a good instrument in helping to "take care" of children and adolescents suffering from CHD.

Chemical, biological, morphoanatomical and antimicrobial study of Ocotea puchury-major Mart

Ocotea puchury-major Mart. is a tree native to the Brazilian rain forest, where it is popularly known as puxurì. In local folk medicine the leaves are used for their sedative, gastroenteric and antireumatic properties. The morphoanatomical study determined those features useful in distinguishing this species from other closely related taxa. Chemical analysis was focused on the study of the volatile oil. Gas chromatography-mass spectrometry analyses indicated safrol as the main compound of the volatile oil (39%). The results confirm and authenticate the use of its leaves in folk medicine. Furthermore, safrol is economically important as the starting material for hemisynthesis of several products. The antimicrobial activity of the essential oil was studied which showed promising activity against environmental microorganisms as well as anti-inflammatory activity.

Genetic and metabolite diversity of Sardinian populations of Helichrysum italicum

Background

Helichrysum italicum (Asteraceae) is a small shrub endemic to the Mediterranean Basin, growing in fragmented and diverse habitats. The species has attracted attention due to its secondary metabolite content, but little effort has as yet been dedicated to assessing the genetic and metabolite diversity present in these populations. Here, we describe the diversity of 50 H. italicum populations collected from a range of habitats in Sardinia.

Methods

H. italicum plants were AFLP fingerprinted and the composition of their leaf essential oil characterized by GC-MS. The relationships between the genetic structure of the populations, soil, habitat and climatic variables and the essential oil chemotypes present were evaluated using Bayesian clustering, contingency analyses and AMOVA.

Key results

The Sardinian germplasm could be partitioned into two AFLP-based clades. Populations collected from the southwestern region constituted a homogeneous group which remained virtually intact even at high levels of K. The second, much larger clade was more diverse. A positive correlation between genetic diversity and elevation suggested the action of natural purifying selection. Four main classes of compounds were identified among the essential oils, namely monoterpenes, oxygenated monoterpenes, sesquiterpenes and oxygenated sesquiterpenes. Oxygenated monoterpene levels were significantly correlated with the AFLP-based clade structure, suggesting a correspondence between gene pool and chemical diversity.

Conclusions

The results suggest an association between chemotype, genetic diversity and collection location which is relevant for the planning of future collections aimed at identifying valuable sources of essential oil.

A novel device for the study of antimicrobial activity by vapor-contact of volatile substances on food products

A novel device for the study of antimicrobial activity by vapour contact of volatile substances have been designed. This "big size" system, made up in inert acrylic material, is furnished with a fan and a hot plate with the aim to have a quick evaporation of volatile substances. It is able to contain fruits or other food products under controlled atmosphere and it can simulate real condition of storage or as well real condition of food pre-treatment by antimicrobial volatile substances. Such system is suitable to perform both in vitro (disk diffusion test) and in vivo (exposure and testing of food products) experiments. To shed light on the behaviour of this chamber the concentration in the head space of several substances have been monitored by GC-MS analysis during the time. Both single (mono-terpene compounds) and mixture of terpenoids have been studied. Different behaviours have been founds depending on the starting molecules studied. Limonene, myrcene and eucalyptol, in single standard experiment, show a similar shape of head space concentration curve versus the time: the concentration increases at the beginning, then reaches a maximum and decreases until it reaches a plateau. In contrast linalool shows a head space concentration curve constant during the time, whereas mixtures of terpenes like myrcene and linalool show a concentration curve of vapour phase in agreement with Raloult's Law. The experiments carried out with Essential Oils (EOs) shows that in our system only more volatile fraction of EOs compose the vapour phase.

Chemical and biological study on the essential oil of Artemisia caerulescens L. ssp. densiflora (Viv.)

Artemisia caerulescens L. ssp. densiflora (Viv.) is a wild shrub that grows in the archipelago of La Maddalena, Sardinia, Italy. The antifungal activity of the volatile oil of this sub-species has not been evaluated earlier. This study aimed to identify the main components of the essential oil of A. caerulescens L. ssp. densiflora and to investigate its antifungal activity. Identification of the different components of the essential oil obtained by hydrodistillation from A. caerulescens L. ssp. densiflora was done by both techniques: GC-MS and NMR analyses ((1)H, (13)C, HSQC-NMR). Antifungal activity was evaluated by agar disc diffusion technique against environmental isolates of fungal strains: two yeasts (Rhodotorula spp., Candida spp.), three moulds (Aspergillus spp., Alternaria spp., Fusarium spp.) and a mixture of moulds. GC-MS analysis of the essential oil yielded 42 compounds, out of which, 26 compounds were identified. The main compound was identified as terpinen-4-ol (22%) followed by p-cymene (7.6%) and α-terpineol (3.02%). The significant inhibition spectrum of the essential oil of A. caerulescens L. ssp. densiflora can be considered as an alternative to common disinfectants.

Chemical composition and antibacterial activity of the essential oil from Mentha requienii Bentham

The chemical composition of essential oil obtained by hydrodistillation of the fresh aerial parts of Mentha requienii Bentham (Lamiaceae) collected on the Gennargentu Mountains (Sardinia, Italy) has been investigated by gas chromatography and gas chromatography-mass spectrometry. The main constituents that resulted were pulegone (78%), menthone (0.5%), isomenthone (18%), isopulegone (1.3%) and limonene (1.76%). In vitro antifungal activity is evaluated in order to identify new means that could be helpful in the prevention of contamination in indoor environments.

Postoperative nutrition of neonates undergoing heart surgery

OBJECTIVE

Postoperative nutrition of newborns undergoing heart surgery (HS) is ill-defined. We compared the postoperative growth rates (grams/day) of neonates with congenital heart defects (CHDs) fed with their own mothers' milk (HU), a starting formula (SF; 67 kcal/100 mL), or a "preterm formula" (PF; 80 kcal/100 mL).

PATIENTS AND METHODS

We studied 122 newborns undergoing HS: 81 underwent corrective surgery (group A), and 41 palliative surgery (group B).

RESULTS

No statistically significant differences were found in the growth rate between group A and B. Moreover, in both groups, no differences in terms of growth rate between infants fed HU, SF, or PF were observed. This was also true when analyses were limited to infants undergoing HS either with or without cardiopulmonary bypass.

CONCLUSIONS

In neonates undergoing HS, human milk allowed a growth rate similar to that observed with starting formulas and "preterm formulas". This effect may depend on the particular features of human milk and its protective properties for the intestinal mucosa.

Pattern of cerebral ultrasound in neonatal heart surgery

AIM

No study described reliably the changes in cerebral ultrasound (CUS) findings in neonatal heart surgery. We tried to define the modifications of CUS before and after heart surgery in neonates.

PATIENTS

We studied 48 neonates with congenital heart defects were studied. Of these, 33 had correction of the malformation with cardiopulmonary bypass (CPB group); 15 underwent coarctation repair/shunting procedures (no-CPB group). Patients had CUS pre-operatively, 48-72 hours after surgery, and at discharge.

RESULTS

Pre-operative studies did not show significant differences between the groups. In CPB group, preoperatively, 6/33 infants showed echogenicity of basal ganglia and 1/33 grade I IVH. In the early postoperative evaluation, 24/33 infants had abnormal scans: increased echogenicity of basal ganglia in 24 and grade I IVH in 14. At discharge, abnormal scans persisted in 20/33 (basal ganglia echogenicity in 20, grade I IVH in 12). In the no-CPB group, preoperatively, 1/15 infant showed echogenicity of basal ganglia. In the early postoperative evaluation, 6/15 had abnormal scans: increased echogenicity of basal ganglia in 6, grade I IVH in 4. At discharge, abnormal scans persisted in 3/15.

CONCLUSIONS

CUS after neonatal heart surgery shows a definite pattern of increased echogenicity of the basal ganglia, more consistent after CPB. These changes may reflect disturbances of deep grey matter, and last 10-15 days at least.

[Infective endocarditis in patients with congenital heart disease]

The incidence of infective endocarditis (IE) in patients with congenital heart disease (CHD) is higher than in general population; this is a major problem considering the continuous expansion of such group of patients. Generally the more complex is the congenital heart disease the higher is the risk of IE. The aetiology, clinical features, complications, basis for diagnosis and treatment of IE in CHD patients don't differ from those in acquired cardiac disease; however, right-sided IE is more frequent in CHD patients. Due to the complex anatomy or presence of artificial material in many CHD, the transesophageal echocardiogram is extremely useful although echocardiographic assessment remains difficult. Prognosis is better than in other forms of IE with a mortality rate <10%. Primary prevention is crucial: a good oral-dental hygiene and regular dental review are as important as antibiotic prophylaxis; however this awareness in the CHD population is still not satisfactorily spread due to an educational problem. New IE guidelines from International Cardiology Societies emphasize the role of primary prevention and limit antibiotic prophylaxis to the highest risk patients undergoing the highest risk procedures. This article reviews the main reasons justifying the revision of previous IE guidelines, focuses on criteria to select CHD patients requiring antibiotic prophylaxis and gives information about antibiotic therapy to use.

[Cardiopulmonary exercise test in adults with congenital heart disease]

Cardiopulmonary exercise testing (CPET) gives important information about functional capacity by direct measurement of exercise respiratory gas exchange. It provides assessment of the integrative exercise responses involving the cardiovascular, respiratory and muscle-skeletal systems which are not adequately investigated through the measurement of individual organ system function. CPET involves measurements of oxygen uptake (VO2), carbon dioxide production (VCO2) and several ventilatory measures. CPET is increasingly being used as a clinical tool to determine functional capacity, prognosis and potential need for medical or surgical interventions in patients affected by congenital heart disease (CHD). Also in this population, peak VO2 and slope VE/VCO2 are the most predictive parameters in terms of mortality and need of hospitalization. Cyanotic patients with Esisenmenger syndrome show the worst functional limitation and consequently the worst prognosis. This article provides basic and practical information about CPET and focuses on its interpretation in patients with CHD.

[Psychosocial difficulties and hospitalisation experiences in adults with congenital heart disease. The utility of psychological interventions]

Adults with congenital heart disease, especially the ones who require constant medical care, encounter many psychosocial difficulties. These difficulties also occur in the interventional departments of cardiology and cardiac surgery, where they often have to make important decisions, undergo cardiology interventions and cardiac surgeries, and more rarely they also have to deal with unexpected complications that can lengthen their hospitalisation duration considerably. The literature has also outline predictive factors when it comes to the psychological difficulties encountered in this population. For these reasons, the inclusion of the psychologist in this context is essential.

[Interventional procedure in the Cath Lab: the state of art]

Many paediatric cardiac patients now survive to adulthood following early surgery. This population of adult patients with a congenital heart disease offer distinct challenges such as unusual anatomy and demands such as pregnancy and exercise tolerability not found in conventional paediatric or traditional adult interventional patients. Starting with neonatal balloon atrial septostomy for transposition of the great arteries, improving and changing percutaneous interventional techniques have increasingly replaced surgery as a treatment option in several congenital heart diseases. There has been a rapid growth in interventional cardiology techniques to treat adults with congenital heart disease, mirroring the rise of interventional cardiology as a cardiology subspecialty and the increasing population of adults with congenital abnormalities. We review current indications for adult congenital heart disease intervention and best practice, reviewing the patient spectrum commonly treated, devices used, and emerging treatments.

[Adult with congenital heart disease: an overview]

The improvement of surgical procedures over the past 40 years has changed the medical history of the congenital heart defect. It is estimated that 85% of children with congenital heart disease now have the opportunity to reach adulthood and that this percentage will increase over the next two decades. This special issue of the Journal aims to offer a basic information on key topics of this field of cardiology not newer, but still rapidly evolving.

Rosmarinus officinalis L.: Chemical Modifications of the Essential oil and Evaluation of Antioxidant and Antimicrobial Activity

Rosmarinus officinalis essential oil was separated into its hydrocarbon and oxygenated fractions. The major compounds in the hydrocarbon fraction were α-pinene (44.2%), camphene (24.5%), and limonene (11.7%), while in the oxygenated fraction they were 1,8-cineole (37.6%), camphor (16.5%), and bornyl acetate (21.4%). The hydrocarbon fraction was submitted to a hydroformylation process and the antioxidant activity of the product was screened by the DPPH and β-carotene/linoleic acid tests. The hydroformylated fraction maintained the antioxidant activity of the whole oil. The MIC (minimal inhibitory concentration) and the MBC (minimal bactericidal concentration) of the essential oil, hydrocarbon, oxygenated and hydroformylated fractions were also tested on several microorganisms. Aeromonas sobria and Candida strains were the most susceptible micro-organisms. The hydroformylated fraction exhibited a MBC against Candida strains resistant to the other fractions.

Rosmarinus officinalis L.: chemical modifications of the essential oil and evaluation of antioxidant and antimicrobial activity

Rosmarinus officinalis essential oil was separated into its hydrocarbon and oxygenated fractions. The major compounds in the hydrocarbon fraction were alpha-pinene (44.2%), camphene (24.5%), and limonene (11.7%), while in the oxygenated fraction they were 1,8-cineole (37.6%), camphor (16.5%), and bornyl acetate (21.4%). The hydrocarbon fraction was submitted to a hydroformylation process and the antioxidant activity of the product was screened by the DPPH and beta-carotene/linoleic acid tests. The hydroformylated fraction maintained the antioxidant activity of the whole oil. The MIC (minimal inhibitory concentration) and the MBC (minimal bactericidal concentration) of the essential oil, hydrocarbon, oxygenated and hydroformylated fractions were also tested on several microorganisms. Aeromonas sobria and Candida strains were the most susceptible micro-organisms. The hydroformylated fraction exhibited a MBC against Candida strains resistant to the other fractions.

Giant mid-esophageal diverticulum. Conservative treatment of postoperative leakage

Mid-esophageal diverticula are rare entities. Only symptomatic patients usually receive surgical treatment. Esophageal leakage is one of the most common complications after these procedures. Though in literature, operative management is the preferred treatment for esophageal fistula, conservative approach is described in case of small leaks. We report a case of an operated giant mid-esophageal diverticulum complicated with an esophageal fistula. The patient underwent a surgical treatment and recovered completely.