Anthrax is a life-threatening infectious disease caused by spore-forming Gram-positive bacterium Bacillus anthracis. There has been much research interest on understanding the pathophysiology of anthrax infection especially after the anthrax bioterrorism in USA in 2001 in which postal workers died of inhalational anthrax.
A recent study published in BMC Medicine evaluated whether the antioxidant enzyme catalase protects against a lethal dose of anthrax using transgenic mice and determined the underlying mechanisms involved.
The results showed catalase overexpression in cardiac muscle cells has a beneficial effect against anthrax toxin by rescuing cardiac contractile dysfunction and intracellular calcium homoeostasis. The catalase beneficial effects are additionally associated with alleviation of oxidative stress, loss of mitochondrial membrane potential, decrease in proteosome activity, moderation of autophagy and increased ubiquitination. Interestingly, cardiomyocytes overexpressing catalase that were pretreated with the rapamycin (autophagy inducer) did not show the cardioprotective benefit of catalase overexpression against anthrax. However, the 3-methyadenine (autophagy inhibitor) mimicked the catalase-elicited beneficial effect.
Overall Prof Ren and colleagues recommend molecules that scavenge reactive oxygen species and suppress autophagy have therapeutic promise in the clinical management of anthrax induced cardiovascular complications.
Continuing on the topic of cardiovascular disorders, BMC Medicine attended the Cardiology Update meeting which took place at the Royal College of Physicians on 10 October 2012. This was jointly organized by the British Cardiovascular Society, attended by 130 delegates including general physicians, consultants, specialist registrars, cardiologists and general practitioners.
The meeting commenced with updates on the NICE and ESC (European Society of Cardiology) guidelines on acute myocardial infarction, and the President of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) discussed the 2012 update of the seven BACPR standards and core components. This includes a multidisciplinary approach involving prevention, behaviour change and education to deliver a cardiac rehabilitation programme.
Other topics discussed at this meeting included management of cardiogenic shock, key cardiology trials in 2012, understanding echocardiogram reports, acute management of atrial fibrillation and pacing.
The conference rounded up with a fascinating talk from Dr Adam Fitzpatrick at the Central Manchester University Hospital NHS Trust on the management of transient loss of consciousness (T-LOC). In this presentation Dr Fitzpatrick explained how T-LOC differs from epilepsy and syncope and discussed the assessment tool for triage risk at the blackouts clinic. This was followed by a provocative debate session on the topic of triple rule out (TRO) CT angiography for acute chest pain. TRO scans for acute aortic syndrome, coronary stenosis and pulmonary embolism and this system being recommended by clinicians and NHS managers in the near future. Thus the presentation addressed the issues with regard to training, finance and equipment to implement this procedure.
In summary, the Cardiology Update focused on educating a clinical audience on several cardiac procedures and highlighted important guidelines, standards and trials in the field.