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The Role of the Microbiota and the Application of Probiotics in Reducing the Risk of Cardiovascular Diseases
Published in Marcela Albuquerque Cavalcanti de Albuquerque, Alejandra de Moreno de LeBlanc, Jean Guy LeBlanc, Raquel Bedani, Lactic Acid Bacteria, 2020
Raquel Bedani, Susana Marta Isay Saad
Little is known about which microbial species or communities are the main TMA-producing in mouse or human gut (Brown and Hazen 2018). An in vitro study showed that specific bacteria such as Anaerococcus hydrogenalis, Clostridium asparagiforme, Clostridium hathewayi, Clostridium sporogenes, Escherichia fergusonii, Proteus penneri, Providencia rettgeri, and Edwardsiellatarda may contribute to the production of TMAO from TMA (Romano et al. 2015, Peng et al. 2018). Using gnotobiotic mice, the authors verified that TMAO can accumulate in the serum of animals colonized with TMA-producing species and not in the serum of animals colonized with intestinal microorganisms that do not produce TMA from choline in vitro (Romano et al. 2015). Some studies with mouse models displayed that the groups of microorganisms associated with circulating TMAO levels include the order of RF39; the families Erysipelotrichaceae, Lachnospiraceae, and Porphyromonadaceae; the genera Prevotella and Anaeroplasma; and the species Akkermansia muciniphila (Brown and Hazen 2018).
Fibrinolytic Enzymes for Thrombolytic Therapy
Published in Peter Grunwald, Pharmaceutical Biocatalysis, 2019
Swaroop S. Kumar, Sabu Abdulhameed
Various bacterial species excluding Bacillus sp. and Streptomyces sp. are also reported to produce fibrinolytic enzymes although those two genera contribute most of the fibrinolytic enzymes discovered so far. A 63.3 kDa serine protease was isolated from Paenibacillus polymyxa EJS-3 named PPFE-I. It was found dissolving Aα-chain of fibrinogen quickly and subsequently Bβ-chain and followed by γ-chain during fibrinogenolysis (Lu et al., 2010). Paenibacillus sp. IND8 is also known to produce fibrinolytic enzyme (Vijayaraghavan and Vincent, 2016a). A 50 kDa metalloprotease with thrombolytic effect was reported from Serratia sp. RSPB11 and Serratia sp. KG-2-1 (Lakshmi and Prakasham, 2013; Taneja et al., 2017). Another fibrinolytic enzyme producer is Shewanella sp. IND20 which contributed a 55.5 kDa thrombolytic enzyme (Vijayaraghavan and Vincent, 2015). Psuedoalteromonas sp. IND11 yielded a 64 kDa protease which acted as plasminogen activator and disintegrated blood clot directly (Vijayaraghavan et al., 2015). Treponema denticola also reported with thrombolytic enzyme production (Rosen et al., 1994). Fibrinolytic enzyme from Proteus penneri showed higher affinity towards α-chain followed by β-chain, showing lower affinity towards γ-chain. It leaves partially hydrolyzed γ-chain after fibrinolysis (Jhample et al., 2015). Nattokinase enzyme production was reported from Pseudomonas sp. TKU015 with molecular weight of 24 kDa as determined by gel filtration chromatography (Wang et al., 2009). Bacterial fibrinolytic enzymes other than those from Bacillus sp. and actinomycetes are shown in Table 4.7.
Emphysematous osteomyelitis of the forefoot
Published in Baylor University Medical Center Proceedings, 2018
Ahmed Abdelbaki, Neeraj Bhatt, Nishant Gupta, Shuo Li, Shady Abdelbaki, Yogesh Kumar
A 33-year-old man with type 1 diabetes mellitus and left transmetatarsal amputation presented with a 3-day history of fevers, chills, left foot pain, and drainage from the amputation stump. He was febrile, was tachycardic, and had malodorous discharge from his left foot. His laboratory values were significant for a sodium level of 131 mmol/L and glucose level of 315 mg/dL. An x-ray of the left foot demonstrated evidence of prior transmetatarsal amputation, marked soft tissue swelling, and foci of air in the subcutaneous and deep soft tissues, with a large pocket of air along the lateral aspect of the foot, raising the possibility of necrotizing fasciitis (Figure 1). Subsequently, a CT scan of the left lower extremity without contrast demonstrated a moderate amount of subcutaneous and deep air, evidence of bone destruction, and air within the cancellous portion of the second metatarsal (Figure 2). CT scan also demonstrated a 2.0 × 1.6 cm fluid collection with an air fluid level along the lateral aspect of the foot. The patient was admitted to the surgical intensive care unit, started on empiric intravenous cefepime and Flagyl, and had a left above-ankle guillotine amputation performed. Tissue and blood cultures grew Staphylococcus aureus and Proteus penneri, and his antibiotics were narrowed down to oxacillin. The patient's general condition improved drastically and he was taken to the operating room to undergo completion below-knee amputation before his discharge from the hospital.