Magnetic resonance imaging in patients with sarcoidosis using parametric mapping
21. 9. 2020 |
Sarcoidosis is a disease of uncertain origin that affects multiple systems, but especially the respiratory tract. The formation of granulomas is typical - therefore sarcoidosis is one of the granulomatous diseases. Granulomas are deposits in tissue in which cells of the immune system respond to a hitherto unknown stimulus. Sarcoidosis more often affects women than men, in a ratio of 1.5–2.0: 1. Cardiac sarcoidosis is clinically rare, probably affecting less than 5% of patients (although according to some studies up to 40% of patients), yet it is one of the most serious forms of the disease because it causes arrhythmias, which can result in sudden death.
Researchers from the Cardiovascular Magnetic Resonance Research team of the International Clinical Research Center of St. Anne's University Hospital Brno (FNUSA-ICRC) in their study entitled "Myocardial T1 mapping using SMART1Map and MOLLI mapping in asymptomatic patients with recently diagnosed extracardiac sarcoidosis" focused on whether magnetic resonance imaging could detect cardiac involvement in time.
One hundred and twenty patients with a recently diagnosed extracardiac sarcoidosis and no history of heart disease were included in the study - one hundred and thirteen of them underwent CMR examination. The mean time since diagnosis of sarcoidosis was 0.8 (0.2-3.3) years. "T1 mapping is a relatively new cardiac magnetic resonance imaging technique, which allows data on T1 relaxation time and extracellular volume (ECV) of the myocardium, which are characteristics that should be affected by the possible occurrence of granulomas in the myocardium," said doc. MUDr. Roman Panovský Ph.D., head of the research team.
The results of the study, contrary to expectations, showed that asymptomatic patients with extracardiac sarcoidosis showed no evidence of cardiac involvement using standard parameters assessing overall and regional left ventricular function. In addition, no prolongation of native myocardial T1 relaxation times was found and the ECV value was not increased. The study shows that in the early stages, sarcoidosis may not affect the heart at all, probably affecting the myocardium later, with some latency. The study was published in NMR in Biomedicine (IF 3.2).
Taking a glance at biological processes with DNA nanosensors
15. 9. 2020 |
Nanomedicine is one of the latest branches of medicine that uses DNA nanotechnology, the artificial structure of nucleic acids. In the study entitled "Dissecting the intracellular signaling and fate of a DNA nanosensor by super-resolution and quantitative microscopy", researchers from the Cardiovascular System - Mechanobiology (CSM) team of the International Clinical Research Center of St. Anne's University Hospital Brno (FNUSA-ICRC) focused on the possibilitiy of observing protein localization using the latest DNA nanotechnology.
DNA-binding proteins are involved in several fundamental biological processes - such as apoptosis (programmed cell death), differentiation, cell survival or proliferation. Due to their fundamental role in the regulation of cellular processes, they are a promising target for drug development and cell therapy. There are already attempts to transfer DNA nanoparticles from in vitro to living cells, but we do not yet fully understand their functionality and behavior inside a living cell. "Current techniques for monitoring and quantifying DNA-binding proteins are multi-step, time-consuming and reagent-intensive, so a new approach to monitoring transcription factors (TF) directly in living cells would be very valuable," said Fabiana Martino, CSM researcher.
In their study, the researchers used the most modern imaging methods of current microscopy. "We designed a DNA nanoswitch for the quantitative and qualitative detection of a DNA-binding protein called nuclear factor kappa B (NF-κB)," Fabiana Martino described. "Combining several microscopic techniques, including FRET imaging microscopy, fluorescence correlation spectroscopy (FCS), fluorescence imaging microscopy (FLIM) and stochastic optical reconstruction microscopy (STORM), we demonstrated effective binding of DNA-nanoswitch molecules to NF-κB proteins." In nanometer resolution it was possible to observe a DNA nanoswitch in a bound, unbound, and degraded state.
The presented approach can be extended to other DNA nanostructures, and thus to investigate their intracellular dynamics and functionality.
Source: DOI: 10.1039/d0nr03087b
Kardiovize 2030 saves lives
4. 9. 2020 |
The new principal investigator of the research team Kardiovize 2030 of the International Clinical Research Center of St. Anne's University Hospital Brno (FNUSA-ICRC) became Juan Pablo Gonzalez Rivas MD. Congratulations on obtaining this prestigious position, and because the journey of Dr. Rivas from Venezuela to Brno was not easy, we asked him for a short interview. We had no idea how complicated it really was, and without exaggeration we dare to compare it to a Hollywood thriller. Equally interesting and extremely ambitious, however, are the plans of the Kardiovize 2030 team for the coming years. When everything goes as it should, not only the inhabitants of the city of Brno will feel it, but it will have a positive impact on the quality of life of the entire Czech population..
1. From Venezuela to the Czech Republic. This is a real change and certainly not just geographical. What surprised you the most in Brno?
I can say that the biggest surprise is that there was not a big surprise. There are obvious differences between a highly organized country, like the Czech Republic, and a highly disorganized country, like Venezuela, including transportation, security, economy, and so on. Because of the rich history of the Czech Republic, we expected a huge cultural difference with my natal country, but this was not completely true. Czech Republic is highly globalized, you can find in Brno all the products, brands, and services that you can need in America or other parts of the world, this facilitated our adaptation, for example, we found in Brno “Harina Pan®” a pre-cooked white maize product that we use to prepare “arepa” the most typical food of Venezuela.
Of course, there are different custom between both countries, for example, the since my first Friday in my new job, and then every Friday, my co-workers ask me “what are you going to do this weekend?”, in my country, when you make that question represents that you are planning to invite this person to do something on weekend or you want that this person invites you to share the weekend. “Nothing concrete”, I replied “I’ll be available for any option”, and their answer was “good”. Then, on Monday, “What you did on weekend?”, they asked, and I was thinking “what the hell, why do you want to know? I was expecting your message, and nothing happened”, but I said, “nothing relevant, reading, and working a little bit”, “working?” they say, with surprise! I was a little shocked about two aspects, why each Friday and Monday they make the same question? And why the surprise about working on weekend? Then, I realized that here there are a lot of beautiful places, not only the usual touristic places, but those surrounded by nature that you can visit very often because are very close and cheap. Additionally, there is all kind of diverse activities in downtown that involve beer (Pivo – a keyword in Czech for foreigners) and wine. People here have all the weekend programmed with diverse funny activities. That was the reason for the question, they have a genuine curiosity about your planes on the next weekend, what kind of adventure, very different from work, is expecting you. With time, I started to discover the diverse places around, and I started to do the same question each Friday “what are you planning to do this weekend?”.
When you sum all the different customs you create a culture, and you understand that there are differences with any part of the world, but when you look deep into it, there is not any real difference. I believe that the differences that you will find in other places different than your native country are those that you take with you. We see mirrors, you only see those things that you carry on.
2. How did you find out about FNUSA-ICRC?
That was thanks to the partnership between FNUSA-ICRC and the Mayo Clinic. Jose Medina Inojosa is a Venezuelan researcher of the Mayo Clinic that works in partnership with the Kardiovize project in ICRC, I met Jose doing a meta-analysis and then he shows me the open opportunity in Brno. The needs of the team fit perfectly with my experience and abilities, which facilitate me a lot the integration with the job.
3. Just so we can imagine - what were the formalities of your transfer like and how long did it all take?
You have no idea hahaha. Venezuela is in a humanitarian crisis due to the narco-government that took the power two decades ago, and the opposition self-created a second president, in consequence, we do not have almost any embassy in the country. The Czech Embassy is in Bogota, Colombia, but the frontier between both countries open and close intermittent. To arrive in Bogota, from my city Merida, I had to take a bus ride of 4 hours to the frontier, then cross the frontier to the city of Cutuca walking, crossing the river “illegally” because the Venezuelan frontier was “close”, pay between 500 to 1.000 CK to the paramilitary forces that control the area, so the “allow me” to cross, and then you arrive to Colombia. The first time that I did it, I arrived at the frontier at 4 am, without any light in the side of Venezuela because there was an electric blackout (very common), I pay 500 CK to a teenager and he drives me in his bike to the border, when we arrived, I pay 500 KC more to the paramilitary forces to let me cross, but one of them stop me, they are dressed like regular people, they are a combination between the members of Las FARC (the Colombia paramilitary forces that control drug traffic in Colombia) and Venezuelan soldiers (Now the “military forces” of Venezuela are the main drug distributors in Latin America), and he asked me “are you a cop? Because you look like a cop and we kill cops here”, I replied “If I would be a cop, I could cross the frontier by the bridge, not by the river” After he checked if I was carrying a gun he let me cross the river. Then in Cucuta, you must take the bus to Bogota, around 14 hours more across the Andes. I had appointments for two embassies in Bogota, to the Czech Embassy to came here, and to the US Embassy to attend to the Bernard Lown Program at Harvard for a scholarship that I was awarded. The people working in the Czech Embassy were aware of the two appointments and recommend me contact them after receiving my US visa. After two weeks, I did it, and then my appointment to the Czech Embassy was suspended because the lady in charge was living out for vacations, so they re-schedule in three weeks. I lost my travel to that embassy in that opportunity.
I did that travel three times more, thank God, the frontier was open, and I cross through the Bridge, those three times with my family, however, it is not easy to cross one of the most dangerous frontiers with your family so many times...
On the first picture is my wife sleeping at 6 am waiting for the opening of the frontier, and one of my daughters with her Teddy. Next photo - now, we are in Brno extremely happy surrounded by great people :)
4. In Brno, you work in the field of cardiovascular health in the Kardiovize team. Can you tell us what you are working on right now?
Since July, I’m the Principal Investigator of the Kardiovize team, and we are focused on three aims:
1. Publications of high-quality epidemiologic studies using the most innovative approaches, for example, we are presenting the prevalence of obesity using the new concept proposed of adiposity based chronic diseases (ABCD), this new approach is going to change obesity as we know it, because the term of obesity is highly related to stigma and lack of action from the patient and the doctor to treat more intensively this disease, with the data of Brno population, we are going to be the first group of researchers in the world presenting the validation of this concept. I will tell you more when the publication is ready.
2. Design and execution of intervention programs. We are extremely worried about two components that are affecting the Czech population. One is diabetes, thanks to the improvement in the health care system in the country the number of deaths related to heart diseases and stroke is reducing, but not diabetes, deaths related to diabetes increased by 68% in the last decades. We want to adapt and implement a lifestyle intervention programs to reduce the burden related to diabetes, the pilot of this intervention will be in the first semester of 2021. The second is hypertension, despite the reduction in cardiovascular deaths in the country, around 5900 deaths occur each year in the Czech Republic in subjects younger than 70 years old consequence of hypertension, these deaths can be and should be prevented, and the main reason that is creating these deaths is that 7 out of 10 persons with hypertension in the country are not controlled, we aim to increase the rate of control of hypertension in Brno from 30% to 80% in this decade. We need to design and implement an intensive program to achieve this ambitious goal. Any person in the city, researcher or not, interested in helping us to save thousands of lives in Brno increasing the rate of control of hypertension can contact us, we are in the stage of the program design, we welcome all kind of help.
3. As a highly organized country, Czech Republic is in a good position to help to improve the cardiovascular health of people in developing countries. I’m a Lown Scholar of the Cardiovascular Health Program of the Harvard School of Public Health, we are focused on improving the health of people in underserved areas. Two months ago, we applied for a grant to help people in Uganda to increase the rate of hypertension control. In this country, for every 100 persons with hypertension, 98 are not controlled. A collaboration between Brno and the population of Kizissi in Uganda can contribute to save many lives in this country.
5. A recent article you co-authored on cardiometabolic risk factors in Venezuela. Is there any significant difference between the Venezuelan and domestic populations?
We recently published the results of the EVESCAM study in Venezuela, this is the first national cross-sectional evaluation in the country, we assessed 3420 subjects (https://doi.org/10.1016/j.pcd.2020.07.006). It was a wonderful experience.
The comparison between Venezuelan and Czech Republic shows interesting differences, because both countries are exposed to different levels of environmental stressors, and a huge different health care system. Brno population tend to show better cardiovascular health than Venezuelan population, mostly driven by better dietary and physical activity habits. When we analyze in more detail, Venezuelan women tend to be more obese than Czech women, however, Czech adults show a higher frequency of high cholesterol and higher prevalence of smoking habits.
These differences express huge health inequalities between both populations, and its analysis help to understand the aspects that can be improved in both populations.
6. What are your plans for the future?
This September 2020 I’m having my first year in Brno and FNUSA-ICRC, this year was mostly about adaptation and help to the team to clarify ideas and provide them tools to release all their potential, you did a couple of interviews to one of our youngest members of the team and she reflects how we are improving things. Now, we are a strong team with clear goals. For 2021, we plan to implement the pilot interventions in the city commented before, to continue with the publication of high-quality papers, and expand our network worldwide. If everything goes to the plan, in 2025, Brno patients with obesity, prediabetes, and diabetes will have access in diverse places offering lifestyle programs based on the best scientific evidence, with this they can let behind these diseases. Can you imagen the face of some of your friends living in Brno that is diagnosed with type 2 diabetes and you can tell him “in Kardiovize we have the program to let behind this terrible disease” that will be great. In that year, the face of hypertension in Brno will look different, we are planning to surpass the rate of control of 60% by then.
New challenge for the Clinical Trials Department - COVID-19 vaccination study
3. 9. 2020 |
Ing. Lucie Tesárková is the interim head of the Clinical Trials Department of the International Clinical Research Center of St. Anne's University Hospital Brno (FNUSA-ICRC). On this occasion, we asked her for a short interview, where she would present the activities of the department and describe plans for the future.
How would you describe the activities of the FNUSA-ICRC Clinical Trials Department to the general public?
We can simply say that our department is in charge of everything related to the preparation and implementation of clinical studies at the St. Anne's University Hospital Brno (FNUSA), from the solution of clinical study offers to their archiving. We have employees who are responsible for the process of negotiating and concluding contracts for clinical trials of all phases carried out at FNUSA, as well as employees who take care of the financial management of clinical trials. Another integral activity that we provide is the support of physicians and other medical staff during the implementation of the study through study coordinators. An equally important area we deal with is the administrative support of physicians in the field of academic clinical research carried out at FNUSA.
How is the cooperation with the hospital set up?
Due to the fact that we process clinical studies within the entire teaching hospital, we work very closely with the legal department, finance department and other professional workplaces that are involved in conducting clinical studies.
In which areas are clinical trials conducted the most?
We can say that the studies take place in basically every clinic in FNUSA. These are mainly clinical studies in the field of neurology, cardiology, gastroenterology, dermatology, rheumatology and oncology.
How will patients find out about ongoing studies at FNUSA and how can they possibly sign up?
A list of clinical trials in which patients are being recruited is published on the FNUSA website in the Clinical Studies Department section. We update this report regularly. For each study, there is a contact person to whom the patient can contact if they are interested in more information about the study. We are currently working to support patient recruitment in clinical trials for patients with Crohn's disease, ulcerative colitis or rheumatoid arthritis.
How did the epidemiological situation in connection with COVID-19 affect the activities of the Department of Clinical Studies?
At the beginning of the pandemic, the situation was very confusing for us and it was difficult to predict its further course. Despite all the circumstances that the unfavorable epidemiological situation brought, it was a priority for us to provide care for patients enrolled in clinical trials so that their treatment could continue smoothly. My colleagues and I worked out several variants of plans for different degrees of severity of the epidemiological situation so that the relatively smooth running of the studies could be maintained for each of them. Of course, we also had to reckon with the worst option, ie a situation where our hospital would close and serve only patients with COVID disease. Fortunately, this did not happen, and I think I can say that in cooperation with doctors and other health professionals, we managed the situation very well.
Is FNUSA involved in the implementation of COVID-19 clinical trials?
Yes, FNUSA is also being approached with offers to conduct studies focusing on COVID-19. These are studies evaluating the safety and efficacy of medicines for patients with COVID-19 disease of varying severity, but also offers for vaccination studies performed in healthy volunteers. Vaccination studies are a new area for us that we are now working on. We are currently preparing for the implementation of the first large vaccination studies with the participation of healthy volunteers. We are very pleased to have been approached with an offer, as FNUSA's medical staff are able to provide high-quality studies that can lead to the development of an effective vaccine.
Publication from Loschmidt's labs scored overseas
31. 8. 2020 |
An article by authors from the Loschmidt Laboratories of the Faculty of Science of Masaryk University in Brno and the FNUSA-ICRC Protein Engineering research team was also selected among the twenty-five most influential articles in the prestigious ACS Catalysis magazine in its ten years of existence.
Dr. Stanislav Mazurenko, prof. RNDr. Zbyněk Prokop Ph.D. and prof. Dr. Mgr. Jiří Damborský describes the issue and approaches to machine learning. They also focus on advances in experimental and theoretical methods that have the potential to solve these problems. They also present their views on possible future directions of application development for the design of efficient biocatalysts. Original article is here:
The selection was made by the editors themselves, whose task was to choose articles that go thematically beyond the boundaries of the field.
Congratulations to all the authors on this success!
Do the work of a nutrition therapist and science go together? Yes, in Kardiovize team!
28. 8. 2020 |
Mgr. Iuliia Pavlovska is a member of the research team of Cardiovize Brno 2030 of The International Clinical Research Center of St. Anne's University Hospital Brno (FNUSA-ICRC) and a doctoral student at Masaryk University in Brno. We talked about her research, but also her studies and trip to Brno, in a short interview.
In his research, Mgr. Pavlovska focuses on individual components of the metabolic syndrome and their influence on cardiovascular health. We wrote about her last article here:
You speak perfect Czech, have you been here a long time?
Not at all, but Czech and Ukrainian are quite similar languages. I was born in Kiev and came to the Czech Republic to study at university. I wanted to provide nutritional counseling abroad, and at Masaryk University in Brno I found that it existed as a special program in which general medicine did not have to be studied. I then got into FNUSA-ICRC at a time when I was looking for a job that could be well combined with my PhD study. I also wanted something that could be continued even after graduation, and research proved to be ideal for me.
So it wasn't a child's dream come true?
No, it certainly wasn't like that, although I was that studying type, but the interest in science came over time. I'm quite an introvert, I like to read and write, and as a nutritional therapist I was in contact with people all day, which made me quite exhausted. I think that research work is an ideal compromise for me - I spend part of the day with patients, but I also have part of the day only for work alone or just to study for a PhD.
Now research... what you are doing and what your goal is?
I am just starting with another article that will focus on comparing the relationship between different definitions of obesity and arterial wall stiffness. The initial impetus for this research came from the topic of my PhD thesis "Connection of metabolic syndrome and embrittlement of arterial walls". When I searched for articles that exist on this topic, I divided the metabolic syndrome into five parts - high blood pressure, high blood sugar, low HDL (high-density lipoprotein, "nice" cholesterol), high triglycerides and abdominal obesity. There were the fewest articles about the last two, and moreover, there were quite contradictory data - sometimes positive associations, sometimes negative, and sometimes associations were missing, so I started to deal with these two. I would also like to focus on how to properly define obesity. The question is whether to still take it according to the high percentage of fat in the body, according to the high BMI (body mass index), or according to the value of the waist circumference or according to a new metric that includes metabolic complications. Even a visually slim person can suffer from some form of obesity and, conversely, some stocky people would not be obese according to the new metric. In short, the issue of "public health" - I try to find new context and make general recommendations based on that.
The Czechs are the fourth fattest nation in Europe, what would you, as a nutrition therapist, recommend change?
In general, it is a matter of adjusting the overall quantity, composition and quality of the diet. In the classic diet, for example, there is still an excess of fat. Of course, it is unrealistic to change the eating habits of the Czech population, for example, towards Mediterranean cuisine. There are other and traditional ingredients, so we should focus more on diversity. So more vegetables, more fruit, add movement and it will only get better. And then it is also necessary to watch whether it is vegetable or animal fats, vegetable fats are more desirable, animal fats are saturated and have a bad effect on blood parameters, triglycerides and cholesterol. But even with those vegetable fats, it is necessary to be careful and limit palm or coconut oil. I recommend using olive oil in the cold kitchen, and if we can't resist the taste of something fried, I prefer rapeseed oil to sunflower oil, because it is much more stable.
And speaking of Czech cuisine, what is your favorite food?
Now you've got me… Yes, it's sirloin sauce with dumplings :)