RESUMEN
BACKGROUND: Patients with diabetes mellitus (DM) are at risk for a higher incidence and severity of COVID-19, as well as its adverse outcomes, including post-Covid syndrome. AIM: to assess the incidence of cardiorenal complications in patients with type 1 and type 2 diabetes (T1DM/T2DM) who have had COVID-19, and to analyze the structure and severity of disorders according to examination data at the Diamobil mobile medical diagnostic and treatment center. MATERIALS AND METHODS: a cohort of T1DM and T2DM patients examined in Diamobil (n=318), with a confirmed anamnesis of COVID-19 (n=236). The time interval between COVID-19 and the visit to Diamobil was 8.7/8.2 months for T1DM/T2DM. The parameters of the last visit before COVID-19 recorded in the Federal Register of Diabetes (FRD) were used as initial data. RESULTS: Clinical characteristics of patients with T1DM/T2DM: age - 49.2/64.5 years, duration of DM - 22/11 years, proportion of women - 64/73%, respectively. After analysis the data from visits before and after COVID-19 there weren't statistically significant differences in HbA1c levels for both types of DM (before 9.0/8.3%; after 8.4/8.2%, respectively), there was the intensification of glucose lowering therapy (the proportion of patients with T2DM on 2 and 3 component therapy increased by 4.3% and 1.6%, the proportion of patients on insulin therapy by 16%). After COVID-19, there was a statistically significant decrease in glomerular filtration rate (GFR) in T1DM from 88.1 to 62 ml/min/1.73 m2; with T2DM from 74.7 to 54.1 ml/min/1.73 m2. When assessing acute diabetic complications, there was an increase in the frequency of coma in T1DM by 1.5 times, severe hypoglycemia in T1DM by 3 times, and in T2DM by 1.7 times. Analysis of the frequency of cardiorenal complications before and after COVID-19 showed a total increase of 8.5% in T1DM, by 13.2% in T2DM, of which myocardial infarction, ischemic heart disease, and CHF increased in T1DM in the range from 1.5 to 5 times, with T2DM by 1.3 times, the frequency of CKD with T1DM by 1.5 times, with T2DM by 5.6 times. CONCLUSION: There was a decline of kidney filtration function (decrease in GFR) and an increase in the frequency of cardiovascular complications in both types of diabetes in post-Covid period while patients achieved a stable HbA1c levels by intensifying therapy during the COVID-19 infection. This fact reflects combined damage to the kidney and cardiovascular system as a part of the post-Covid syndrome and determines a key set of measures for the development of preventive strategies.
Asunto(s)
COVID-19 , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , SARS-CoV-2 , Humanos , COVID-19/complicaciones , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Femenino , Masculino , Diabetes Mellitus Tipo 1/complicaciones , Persona de Mediana Edad , Anciano , Adulto , Federación de Rusia/epidemiología , Incidencia , Síndrome Cardiorrenal/etiología , Síndrome Cardiorrenal/epidemiología , Síndrome Post Agudo de COVID-19RESUMEN
The National diabetes register (NDR) was created as unified dynamic database in online format. It allows providing clinical and epidemiological monitoring of diabetes mellitus (DM) in the whole country. AIM: To analyze the epidemiological characteristics of diabetes over the past decade, to access the dynamics of the prevalence of acute (coma) and chronic (micro - and macrovascular) complications of DM. MATERIALS AND METHODS: The object of the study was the depersonized NDR database of DM patients. It consists of 84 regions of the Russian Federation (RF), included in the online registry system on 01.01.2019. RESULTS AND DISCUSSION: The total number of patients with DM in RF on 01.01.2019 was 4 584 575 (3.12% of the population), comprising 256.2 thousand patients with T1DM, 4.24 million with T2DM, 89.9 thousand other types of DM. Since 2000, the number of DM patients in RF has grown 2.2 times. 34.7% patients with T1DM reached target level of HbA1c.
Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Retinopatía Diabética , Humanos , Prevalencia , Factores de Riesgo , Federación de RusiaRESUMEN
Nucleotide sequences encoding full-length protein of Pseudomonas aeruginosa exotoxin A and its atoxic form were cloned and expressed in Escherichia coli cells. Purified recombinant exotoxin and immune rabbit sera protected mice from exotoxin A.
Asunto(s)
ADP Ribosa Transferasas/inmunología , Toxinas Bacterianas/inmunología , Exotoxinas/inmunología , Infecciones por Pseudomonas/inmunología , Pseudomonas aeruginosa , Factores de Virulencia/inmunología , ADP Ribosa Transferasas/genética , ADP Ribosa Transferasas/toxicidad , Animales , Toxinas Bacterianas/genética , Toxinas Bacterianas/toxicidad , Clonación Molecular , Exotoxinas/genética , Exotoxinas/toxicidad , Sueros Inmunes , Inmunización , Ratones , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/inmunología , Pseudomonas aeruginosa/metabolismo , Conejos , Proteínas Recombinantes/inmunología , Proteínas Recombinantes/toxicidad , Factores de Virulencia/genética , Factores de Virulencia/toxicidad , Exotoxina A de Pseudomonas aeruginosaRESUMEN
AIM: Evaluation of immunobiological properties of recombinant atoxic forms of the Pseudomonas aeruginosa exotoxin. MATERIALS AND METHODS. 3 recombinant atoxic forms of the P. aeruginosa exotoxin A were produced and studied: aTox1, consisting only of exotoxin A domain 1; aTox1,2, consisting of domain 1 and 2; and aTox1,2,delta3, consisting of both domain 1 and 2, and part of domain 3. RESULTS: aToxl,2 and aTox1,2,delta3 had distinctive antigenic properties. Formulations based on these recombinant proteins were immunogenic and protected animals from exotoxin A in experimental conditions. CONCLUSION: These results maybe used to construct direct-action immunobiological formulations.
Asunto(s)
ADP Ribosa Transferasas/inmunología , Toxinas Bacterianas/inmunología , Exotoxinas/inmunología , Isoformas de Proteínas/inmunología , Infecciones por Pseudomonas/inmunología , Pseudomonas aeruginosa/inmunología , Proteínas Recombinantes/inmunología , Factores de Virulencia/inmunología , ADP Ribosa Transferasas/genética , ADP Ribosa Transferasas/metabolismo , Secuencia de Aminoácidos , Animales , Anticuerpos Antibacterianos/análisis , Toxinas Bacterianas/genética , Toxinas Bacterianas/metabolismo , Clonación Molecular , Escherichia coli , Exotoxinas/genética , Exotoxinas/metabolismo , Técnica del Anticuerpo Fluorescente , Humanos , Inmunización , Inyecciones Intraperitoneales , Ratones , Datos de Secuencia Molecular , Isoformas de Proteínas/genética , Isoformas de Proteínas/metabolismo , Estructura Terciaria de Proteína , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/metabolismo , Conejos , Ratas , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Factores de Virulencia/genética , Factores de Virulencia/metabolismo , Exotoxina A de Pseudomonas aeruginosaRESUMEN
AIM: To obtain recombinant atoxic form of Pseudomonas aeruginosa exotoxin A and assess its protective properties during simultaneous administration with recombinant protein F in experiment. MATERIALS AND METHODS: Genetic methods were employed for construction of deletion variant of P. aeruginosa exotoxin A gene, whereas Escherichia coli cells were used for transformation. Purification of proteins was performed by common method. White outbred mice were used for immunization and experimental infection was produced by intraperitoneal administration of live virulent culture of P. aeruginosa strain PA103. RESULTS: The gene coding defect form of P. aeruginosa exotoxin A with lacked 106 C-terminal aminoacid residues was cloned. Synthesized protein was nontoxic and immunogenic. Recombinant variants of anatoxin A and outer membrane protein F of P. aeruginosa protected animals from experimental infection caused by toxigenic strain PA103 of P. aeruginosa if were administered separately or concomitantly. Nonetheless, the highest protective effect was observed after immunization with both proteins. CONCLUSION: Studied recombinant toxoid and OprF could be the candidates for inclusion in vaccines for prevention of pseudomonas infection.