Hypertrophic cardiomyopathy (HCM) is a primary disease of the myocardium. 4-11% of HCM is caused by mutations in cardiac troponin T (cTnT) and 65% of them are within the tropomyosin (TM)-binding TNT1 domain. Two of the known mutational hotspots within TNT1 are in the N and C-terminal domains. Unlike the N-terminal domain; no high-resolution structure exists for the highly conserved C-terminal domain limiting both our ability to understand the functional role of this extended domain in myofilament activation and molecular mechanism(s) of HCM. The Δ160E mutation is an in-frame deletion of a glutamic acid residue at position 160 of cTnT. This TNT1 C-terminal mutation is associated with an especially poor prognosis. The Δ160E mutation is located in a putative "hinge region" immediately adjacent to the unstructured flexible linker connecting the TM-binding TNT1 domain to the Ca²⁺-sensitive TNT2 domain. Unwinding of this α-helical hinge may provide the flexibility necessary for thin filament function. Previous regulated in vitro motility assay (R-IVM) data showed mutation-induced impairment of weak actomyosin binding. Thus, we hypothesized that the Δ160E mutation repositions the flexible linker which impairs weak electrostatic binding and ultimately leads to severe cardiac remodeling. The goal of our studies is two-fold: 1) to gain high-resolution insight into the position of the cTnT linker with respect to the C-terminus of TM, and 2) to identify Δ160E-induced positional changes using Fluorescence Resonance Energy Transfer (FRET) in a fully reconstituted thin filament. To this end, residues in the middle and distal regions of the cTnT linker were sequentially cysteine-substituted (A168C, A177C, A192C and S198C) and labeled with the energy donor IAEDANS. The energy acceptor, DABMI was attached to cysteine 190 (C190) in the C-terminal region of TM and FRET measurements were obtained in the presence and absence of Ca²⁺ and myosin subfragment 1 (S1). An all-atom thin filament model in the Ca²⁺–on state was employed to predict the pathogenic effects of the Δ160E mutation on the structure and the dynamics of the cTnT linker region. Our data suggest that the linker domain runs alongside the C-terminus of TM and is differentially repositioned by calcium, myosin and the Δ160E mutation. The Δ160E mutation moves the linker closer to the C-terminus of TM. The in silico model supported this finding and demonstrated a mutation-induced decrease in linker flexibility. Moreover, the model predicted a pathogenic change in the orientation of the middle region of the linker and in the position of the Ca²⁺-sensitive TNT2 domain and the TM-binding TNT1 domain in response to Δ160E mutation. Collectively, our findings suggest that the Δ160E mutation-induced changes in the structure, position and dynamics of the linker region cause steric blocking of weak myosin binding sites on actin and subsequent impairment of contraction and disruption of sarcomeric integrity. These studies, for the first time, provided information regarding the role of the extended linker in both myofilament activation and disease.

Abstract The first aim of this study was to investigate the relationship between Doppler ultrasonographic parameters and biochemical markers of human fetal cardiac dysfunction and myocardial cell damage in pregnancies complicated by placental insufficiency and/or fetal growth restriction. Our second aim was to examine fetal central and peripheral hemodynamic characteristics associated with retrograde aortic isthmus net blood flow. Fetuses with significant myocardial cell damage (cTnT > 0.10 ng/ml) had increased pulsatility in the blood velocity waveforms of ductus venosus, left hepatic vein and inferior vena cava, and had more often atrial pulsations in the umbilical vein. Their umbilical artery NT-proANP concentrations were higher than in fetuses without myocardial cell damage. The proportion of left ventricular cardiac output of the combined cardiac output was greater and the corresponding proportion of the right ventricle was less than in fetuses with only increased NT-proANP levels ( > 1145 pmol/l). Tricuspid regurgitation was present more often and the right ventricular fractional shortening was less in fetuses with myocardial cell damage than in fetuses with normal umbilical artery cTnT levels. In fetuses with placental insufficiency and/or growth restriction (n = 48), umbilical artery NT-proANP concentrations showed a significant positive correlation with ductus venosus, left hepatic vein and inferior vena cava pulsatility index values for veins. Fetuses with placental insufficiency and antegrade aortic isthmus net blood flow demonstrated a shift in their right ventricular cardiac output from the pulmonary to the systemic circulation, and foramen ovale volume blood flow made up the majority of the left ventricular cardiac output. Fetuses with retrograde aortic isthmus net blood flow failed to demonstrate these changes, and they had signs of increased left atrial pressure. In addition, right ventricular fractional shortening was decreased and the pulsatility in the ductus venosus blood velocity waveforms was increased. In conclusion, human fetal myocardial cell damage was associated with a rise in systemic venous pressure, a change in the distribution of cardiac output towards the left ventricle and a rise in right ventricular afterload. Fetuses with retrograde aortic isthmus net blood flow failed to rearrange the distribution of the cardiac output and they had signs of increased left atrial pressure. In addition, right ventricular afterload and pulsatility in the ductus venosus blood velocity waveforms were increased.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-19T15:38:52Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese Sérgio Rocha para Defesa OK.pdf: 3444360 bytes, checksum: da9ca3f2c9d898e60430ef1b21bd681a (MD5) / Made available in DSpace on 2016-04-19T15:38:52Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese Sérgio Rocha para Defesa OK.pdf: 3444360 bytes, checksum: da9ca3f2c9d898e60430ef1b21bd681a (MD5) Previous issue date: 2015-02-25 / O infarto agudo do miocárdio (IAM) representa hoje um dos maiores problemas de saúde mundial prevalecendo sobre doenças como câncer, AIDS e doenças respiratórias. Em virtude da relevância, métodos cada vez mais eficientes para auxilio no diagnóstico do IAM vem sendo desenvolvidos. Um destes métodos, os aptassensores, chegam como ferramenta analítica alternativa para detecção de marcadores de necrose miocárdica. Neste trabalho um aptassensor simples e livre de marcação foi desenvolvido para detecção de troponina T cardíaca (cTnT), para isto, nanopartículas de prata foram sintetizadas eletroquimicamente sobre eletrodos impressos de tinta de carbono. Em seguida, 5 μL de cisteína foi adicionada à superfície sensora com intuito de servir de braço químico e possibilitar a imobilização do aptâmero. O aptâmero usado consiste em DNA fita simples modificado com grupos amino (NH2-ssDNA) e específico para o analito em questão. As condições ideais para imobilização do aptâmero e reconhecimento da molécula alvo, assim como a caracterização eletroquímica do aptassensor, foram investigados através das técnicas de voltametria cíclica (CV) e voltametria de pulso diferencial (DPV). A especificidade do aptassensor foi investigada utilizando para isso moléculas alvo específicas e inespecíficas. O reconhecimento do alvo apresentou alta sensibilidade com limite de detecção em 0,1 ng mL−1 de cTnT e uma boa reprodutibilidade (CV = 4%). O sensor também foi testado com amostras de soro humano, apresentando ótima concordância (95% de nível de confiança) com o padrão ouro, o método ECLIA. Neste trabalho pôde-se constatar que as nanopartículas de prata incorporadas a superfície eletródica melhoraram a reprodutibilidade, a condutividade e, consequentemente a resposta sensora, enquanto os aptâmeros asseguraram a sensibilidade e especificidade do aptasensor, apresentando, este modelo, grande potencial para uso no monitoramento dos níveis séricos de troponina cardíaca. / Acute myocardial infarction (AMI) it is one of the most serious diseases in the world responsible for approximately 17 million of deaths in 2012. Therefore, early diagnosis and prompt medical response are of paramount importance for patient survival. Aptasensors can be an alternative, which in combination with electrochemical techniques can provide the simplicity and speed required. A simple and sensitive label-free aptasensor for cardiac troponin T (cTnT) detection was successfully developed. For this purpose, it was chosen a DNA aptamers modified with amino group (NH2-ssDNA) specific to bind cTnT with a high specificity and stability. Herein, silver nanoparticles electrochemically synthesized and cysteine were used to modify the electrode, providing binding sites for aptamer immobilization. The optimum conditions for immobilization of the aptamer and target recognition were investigated by cyclic voltammetry (CV) and differential pulse voltammetry (DPV) technique. The aptasensor achieved a low limit of detection (0.3 ng mL−1) and a linear range between 0.1 and 10 ng mL−1 cTnT, significant for acute myocardial infarction diagnosis. Good reproducibility was obtained by the proposed aptasensor supported by a coefficient of variation of 4%. The silver nanoparticles incorporated to the electrode surface improved the reproducibility, while the aptamer secured the sensitivity of the biosensor. The sensor was also tested for human serum samples presenting a good agreement with the ECLIA methods at 95% confident level. This point-of-care approach presents a great potential for use in several situations releasing the aptasensor for use in the cardiac troponin detection.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-31T14:13:50Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese doutorado Bárbara V M Silva.pdf: 8451335 bytes, checksum: 8f05c2e3a44caad45cfbe00e5b36c3eb (MD5) / Made available in DSpace on 2016-08-31T14:13:50Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese doutorado Bárbara V M Silva.pdf: 8451335 bytes, checksum: 8f05c2e3a44caad45cfbe00e5b36c3eb (MD5) Previous issue date: 2016-02-24 / CAPEs / A presente tese descreve o desenvolvimento de sensores eletroquímicos para imunoensaios empregando a tecnologia de eletrodos impressos com a finalidade de detectar a troponina T cardíaca, o marcador mais específico, atualmente, do infarto agudo do miocárdio. Um dos desafios na confecção de sensores eletroquímicos para imunoensaios é alcançar baixos limites de detecção. Nanomateriais de carbono são, recentemente, considerados excelentes estratégias no preparo de superfícies sensoras devido às suas excelentes propriedades, tais como rápida transferência elétrica e atividade catalítica, aumento da relação superfície/volume e, consequentemente, maior quantidade de biomoléculas imobilizadas. Nesta tese, nanotubos de carbono e grafeno foram utilizados sob diferentes abordagens para modificação de superfícies eletródicas. Um imunossensor baseado em eletrodos serigrafados obtidos pela impressão de filmes de nanotubos de carbono amino funcionalizados incorporados em tinta de carbono foi desenvolvido para detecção “livre de marcação”. Os grupos amino dos nanotubos expostos na interface sensora impressa foram utilizados para imobilização orientada dos anticorpos monoclonais anti-troponina T. Os nanofilmes impressos apresentaram uma excelente estabilidade e reprodutibilidade, exibindo um desvio padrão relativo (DP) menor que ~2% (n = 8), comparado com controle (DP ~9%, n = 8). A resposta analítica do sensor, obtida por voltametria de pulso diferencial, apresentou uma faixa linear entre 0,0025 e 0,5 ng/mL de troponina T (r = 0,995; p<0,0001; n=7), combinado a um baixo erro relativo (<<1%) e limite de detecção de 0,0035 ng/mL. Com o propósito de substituir os anticorpos anti-troponina T, visto que estes constituem parte onerosa do dispositivo, um sensor biomimético foi desenvolvido a partir de uma superfície nanoestruturada de grafeno e polipirrol. A técnica de impressão biomimética em superfície (“surface imprinting”) foi utilizada como estratégia para simplificar e reduzir em uma única etapa a produção das cavidades biomiméticas. Estas foram obtidas através da eletropolimerização do polipirrol e derivados copoliméricos orgânicos mimetizando grupos proteicos amino-reativos. As respostas analíticas do sensor foram geradas por voltametria de pulso diferencial, exibindo uma faixa linear de resposta variando de 0,01 a 0,1 ng/mL de troponina T (r = 0,9953; p<0,0001; n=5) e um limite de detecção de 0,006 ng/mL, mostrando um ótimo desempenho do sensor biomimético. As cavidades biomiméticas apresentaram uma constante de dissociação (KD) de 7,3 10- 13 mol/L, indicando boa afinidade à troponina quando comparadas com o sensor controle (sem troponina T), KD igual a 11,6 10-13 mol/L. Em conclusão, ambas as plataformas sensoras mostram potencial para detecção da troponina T em níveis de importância clínica no diagnóstico do infarto agudo, constituindo testes de pronto atendimento para emergências cardiológicas. / This thesis describes the development of electrochemical sensors for immunoassay by using a screen-printed electrodes technology in order to detect the human cardiac troponin T, the most important marker currently of the acute myocardial infarction. One of the challenges in the manufacturing of electrochemical sensors for immunoassays is to reach low limits of detection. Carbon nanomaterials are recently considered excellent strategies in preparing sensing surfaces due to theirs excellent properties, such as rapid electrical transfer and catalytic activity, increase surface / volume ratio and, consequently, offering higher amount of immobilized biomolecules. In this thesis, carbon nanotubes and graphene were used under different approaches in order to modify the sensors surfaces. An immunosensor based on screen printed electrode obtained by printing of amino functionalized carbon nanotubes films incorporated into carbon ink has been developed for "label-free" detection. The amino groups exposed on the imprinted sensor interface were utilized for oriented immobilization of the monoclonal antibody anti-troponin T. The imprinted nanofilms showed an excellent stability and reproducibility, exhibiting a relative standard deviation (RSD) less than ~2% (n = 8) compared to control (RSD ~9%, n = 8). The analytical response of the sensor, obtained by differential pulse voltammetry, showed a linear range between 0.0025 and 0.5 ng/mL (r = 0.995; p <0.0001, n = 7), combined with a low relative error (<< 1 %) and a calculated limit of detection of 0.0035 ng/mL. In order to replace the anti-troponin T antibody, since these are costly part of the device, a biomimetic sensor was developed from a nanostructured surface of graphene and polypyrrole. The biomimetic technique of surface imprinting was used as a strategy for simplify and reduce in a one-step production of the biomimetic cavities. These were obtained by electropolymerization of the pyrrole and its organic copolymers mimicking amino reactive protein groups. The analytical responses of the sensor were obtained by differential pulse voltammetry, exhibiting a linear range response in 0.01 and 0.1 ng/mL of troponin T (r = 0.9953; p <0.0001, n = 5) and a limit of detection of 0.006 ng/mL, showing a good performance of the biomimetic sensor. The biomimetic sites exhibited a dissociation constant (KD) of 7.3 10-13 mol/L, indicating a good affinity to troponin when compared to its control (without troponin T), KD equal to 11.6 10-13 mol/L. In conclusion, both sensor platform the sensor platforms showed a potential for troponin T detection in levels of clinical important for acute myocardial infarction diagnostic, constituting point-of-care testing for cardiac emergency departments.

Indiana University-Purdue University Indianapolis (IUPUI) / Noble metal nanostructures display collective oscillation of the surface conduction electrons upon light irradiation as a form of localized surface plasmon resonance (LSPR) properties. Size, shape, and refractive index of the surrounding environment are the key features that control the LSPR properties. Surface passivating ligands on to the nanostructure can modify the charge density of nanostructures. Further, allow resonant wavelengths to match that of the incident light. This unique phenomenon called the “plasmoelectric effect.” According to the Drude model, red and blue shifts of LSPR peak of nanostructures are observed in the event of reducing and increasing charge density, respectively. However, herein, we report unusual LSPR properties of gold triangular nanoprisms (Au TNPs) upon functionalization with para-substituted thiophenols (X-Ph-SH, X = -NH2, -OCH3, -CH3, -H, -Cl, -CF3, and -NO2). Accordingly, we hypothesized that an appropriate energy level alignment between the Au Fermi energy and the HOMO or LUMO of ligands allows the delocalization of surface plasmon excitation at the hybrid inorganic-organic interface. Thus, provides a thermodynamically driven plasmoelectric effect. We further validated our hypothesis by calculating the HOMO and LUMO levels and work function changes of Au TNPs upon functionalization with para-substituted thiol. This reported unique finding then utilized to design ultrasensitive plasmonic substrate for biosensing of cancer microRNA in bladder cancer and cardiovascular diseases. In the discovery of early bladder cancer diagnosis platform, for the first time, we have been utilized to analyze the tumor suppressor microRNA for a more accurate diagnosis of BC. Additionally, we have been advancing our sensing platform to mitigate the false positive and negative responses of the sensing platform using surface-enhanced fluorescence technique. This noninvasive, highly sensitive, highly specific, also does not have false positives techniques that provide the strong key to detect cancer at a very early stage, hence increase the cancer survival rate. Moreover, the electromagnetic field enhancement of Surface-Enhanced Raman Scattering (SERS) and other related surface-enhanced spectroscopic processes resulted from the LSPR property. This dissertation describes the design and development of entirely new SERS nanosensors using a flexible SERS substrate based on the unique LSPR property of Au TNPs. The developed sensor shows an excellent SERS activity (enhancement factor = ~6.0 x 106) and limit of detection (as low as 56 parts-per-quadrillions) with high selectivity by chemometric analyses among three commonly used explosives (TNT, RDX, and PETN). Further, we achieved the programmable self-assembly of Au TNPs using molecular tailoring to form a 3D supper lattice array based on the substrate effect. Here we achieved the highest reported sensitivity for potent drug analysis, including opioids and synthetic cannabinoids from human plasma obtained from the emergency room. This exquisite sensitivity is mainly due to the two reasons, including molecular resonance of the adsorbate molecules and the plasmonic coupling among the nanoparticles. Altogether we are highly optimistic that our research will not only increase the patient survival rate through early detection of cancer but also help to battle the “war against drugs” that together are expected to enhance the quality of human life.

Background Coronavirus Disease-2019 (COVID-19) affected elderly individuals disproportionately in terms of hospitalization and adverse outcome. Objective This cross-sectional study examined the associations of COVID-19 diagnosis (COVID-negative versus COVID-positive) with levels of four clinical markers – cardiac troponin T (cTnT), high-sensitive C-reactive protein (hsCRP), D-dimer and b-type natriuretic peptide (NT-proBNP) – along with potential differences in associations by sex in a hospital-based sample of elderly individuals. Methods The sample comprised individuals aged ≥80 years visiting the Emergency at Karolinska universitetssjukhuset (Huddinge) between January 2020 and December 2021 for whom data on polymerase chain reaction-based COVID-19 testing were available (n=2668). Plasma levels of the markers were measured using standard methods. Right skewed outcome variables were natural-log (Ln) transformed. Multivariable linear regression models were fitted. Results Participants’ median age was 87 years (interquartile range: 85–90) and 58.4% were female. Approximately 13% of the participants were COVID-19 positive. There was no statistically significant association between COVID-positive diagnosis and any of the markers after controlling for age and sex. On sex stratification, COVID-19 positive males had 55.3% (95% confidence interval (CI): 1.1%–138.4%; P=0.044) higher hsCRP levels than COVID-negative males. Additionally, age was positively associated with cTnT (Ln cTnT βadjusted: 0.041; 95% CI: 0.033–0.050; P&lt;0.001) and NT-proBNP (Ln NTproBNP βadjusted: 0.059; 95% CI: 0.015–0.102; P=0.008). Conclusion COVID-positive diagnosis was not related with the markers apart from a sex-specific, positive association with hsCRP observed among males. Future studies should explore the relationship of these markers with mortality to determine their prognostic utility among elderly individuals.