Academic literature on the topic 'Esca diseases complex'

Fomitiporia mediterranea M. Fisch. (Fmed) is a basidiomycete first described in 2002, and was considered up to then as part of Fomitiporia punctata (P. Karst) Murrill. This fungus can degrade lignocellulosic biomass, causing white rot and leaving bleached fibrous host residues. In Europe Fmed is considered the main grapevine wood rot (Esca) agent within the Esca disease complex, which includes some of the most economically important Grapevine Trunk Diseases (GTDs). This review summarises and evaluates published research on Fmed, on white rot elimination by curettage or management by treatments with specific products applied to diseased grapevines, and on the relationship between wood symptoms and Grapevine Leaf Stripe Disease (GLSD) in the Esca disease complex. Information is also reviewed on the fungus biology, mechanisms of pathogenicity, and their possible relationships with external foliar symptoms of the Esca disease complex. Information on Fmed control strategies is also reviewed.

Edwardsiella tardais an important Gram-negative pathogen that employs a type III secretion system (T3SS) to deliver effectors into host cells to facilitate bacterial survival and replication. These effectors are translocated into host cells through a translocon complex composed of three secreted proteins, namely, EseB, EseC, and EseD. The secretion of EseB and EseD requires a chaperone protein called EscC, whereas the secretion of EseC requires the chaperone EscA. In this study, we identified a novel protein (EseE) that also regulates the secretion of EseC. AneseEdeletion mutant secreted much less EseC into supernatants, accompanied by increased EseC levels within bacterial cells. We also demonstrated that EseE interacted directly with EseC in a pulldown assay. Interestingly, EseC, EseE, and EscA were able to form a ternary complex, as revealed by pulldown and gel filtration assays. Of particular importance, the deletion ofeseEresulted in decreased levels of EseB and EseD proteins in both the bacterial pellet and supernatant fraction. Furthermore, real-time PCR assays showed that EseE positively regulated the transcription of the translocon operonescC-eseE, comprisingescC,eseB,escA,eseC,eseD, andeseE. These effects of EseE on the translocon components/operon appeared to have a functional consequence, since the ΔeseEstrain was outcompeted by wild-typeE. tardain a mixed infection in blue gourami fish. Collectively, our results demonstrate that EseE not only functions as a chaperone for EseC but also acts as a positive regulator controlling the expression of the translocon operonescC-eseE, thus contributing to the pathogenesis ofE. tardain fish.

Among all causes of grapevine decline, Grapevine Trunk Diseases (GTDs) are major concerns for grape growers. This paper reviews knowledge and proposes hypotheses on two major GTDs, esca and Botryosphaeria dieback, and assembles a conceptual model. The objective was to collect information into a sequence, from grapevine nursery propagation processes, through foliar symptom expression, to plant death in mature vineyards. Pathogen infection and colonization steps in woody vine tissues, and the hypotheses that have been formulated to explain the outburst of foliar symptoms, are reported and discussed. Factors that could aggravate or repress GTD symptoms and incidence expansion are also addressed. Vine physiology and pathology together could expand understanding of these diseases. Knowledge and hypotheses that need validation are summarized, and a conceptual model is proposed to explain the occurrence of symptoms and the influencing factors. The model could be useful to cope with the complexity of GTDs, and as a starting point for research to unravel knowledge gaps and suggest new disease management strategies.

In the last few years, trunk surgery has gained increasing attention as a method to reduce foliar symptoms typical of some of the Esca complex diseases. The technique relies on the mechanical removal of decayed wood by a chainsaw. A study on a 14-year-old Cabernet Sauvignon vineyard was carried out to validate the efficacy of trunk surgery and explore possible explanations behind it. Three levels of treatment were applied to three of the most characteristic symptoms associated with some diseases of the Esca complex, such as leaf stripe symptoms (LS), wilted shoots (WS) and apoplexy (APP). The most promising results were obtained by complete trunk surgery, where the larger decay removal allowed lower symptom re-expression. According to the wood types analyzed (decay, medium and sound wood), different changes in microbiota were observed. Alpha-diversity generally decreased for bacteria and increased for fungi. More specifically, main changes were observed for Fomitiporia mediterranea abundance that decreased considerably after trunk surgery. A possible explanation for LS symptom reduction after trunk surgery could be the microbiota shifting caused by the technique itself affecting a microbic-shared biochemical pathway involved in symptom expression.

Esca disease is one of the major grapevine trunk diseases in Europe and the etiology is complex, since several inhabiting fungi are identified to be associated with this disease. Among the foliar symptom expressions, the apoplectic form may be distinguished and characterized by sudden dieback of shoots, leaf drop, and shriveling of grape clusters in a few days that can ultimately induce the plant death. To further understand this drastic event, we conducted transcriptomic and metabolomic analyses to characterize responses of leaves during the period preceding symptom appearance (20 and 7 days before foliar symptom expression) and at the day of apoplexy expression. Transcriptomic and metabolomic analyses provide signatures for the apoplectic leaves and most changes concerning the metabolism of carbohydrates, amino acids, and phenylpropanoids. In deciphering glutathione-S-transferase (GST), its preferential location in phloem, correlated with the upregulation of GST genes and a decrease of the glutathione level, offers further support to the putative role of glutathione during apoplexy expression.

A peculiar symptom that may develop in grapevines affected by wood pathogens involved in the esca complex of diseases is the leaf stripe symptom, which also gives the name to the Grapevine Leaf Stripe Disease. Multiple studies have revealed strong links between fungal presence, wood symptomatology and expression of the leaf stripe symptom. However, numerous other factors have been shown to play roles in symptom onset, incidence, severity and yearly fluctuation of this disease. While the factors triggering the leaf stripe symptom are still under investigation, three control strategies have been proven effective for substantially reducing its expression, namely trunk surgery, and applications of sodium arsenite or a fertilizer mixture. These control strategies are examined here, including their (putative or confirmed) modes of action, and how they may influence the leaf stripe symptom development. In this article, we also propose the ‘edge’ hypothesis to tentatively explain symptoms onset, keeping in consideration past knowledge and recent advances in the understanding of the esca leaf stripe symptom. Ultimately, it is our intention to offer food-for-thought and stimulate debate within the phytopathological community.

Grapevine trunk diseases (GTDs) represent one of the most important problems for viticulture worldwide. Beyond the original causes of this outbreak in some countries like France, the lack of efficient control protocols and the prohibition of using active ingredients such as sodium arsenite and benzimidazoles, until recently used to reduce the impact of some GTDs but deleterious for humans and the environment, have probably worsened the impact of the diseases, leading to increasing economic losses. Since 1990, searches have been made to find efficient tools to control GTDs, testing a wide range of active ingredients and biocontrol agents. This review provides readers with an overview of the results reported in the scientific literature over the last 15 years. In particular, the review focuses on the trials carried out applying chemicals or microorganisms to control Esca complex diseases, Botryosphaeria dieback, and Eutypa dieback, the most widespread GTDs.

Esca disease and Botryosphaeria dieback are currently considered as serious grapevine diseases which affect vineyard health and induce economic losses. Both of these trunk diseases (GTDs) are caused by a complex of pathogens, and foliar expression is influenced by several factors, including environmental factors such as water stress. To manage water stress in some vine areas, culture practice based on irrigation systems for limiting water stress have been developed; however, little knowledge of the influence of such systems on GTD emergence is currently available. The present paper addresses the impact of irrigation systems and climatic factors (rainfall and temperature) on the expression of GTDs, specifically esca and Botryosphaeria dieback. A field experiment on Chardonnay in North East Spain, a vine growing area where drought is present and which is managed by an irrigation system, was therefore carried out during a 3-year period. The water stress impact on GTD expression was evaluated by measuring the GTD incidence and analysing different physiological parameters at different phenological stages, including principal component analysis and gene expression. The main finding of this study was the significant roles of vine transpiration and water availability, which depend on irrigation volume and rainfall amount; together, they may explain the erratic symptom expression in plants infected by GTD fungi depending on the year. All these parameters are discussed to better understand the relationship between GTD expression, irrigation system and climatic factors.

Grapevine trunk diseases (GTDs), caused by fungal pathogens, are a serious threat to vineyards worldwide, causing significant yield and economic loss. To date, curative methods are not available for GTDs, and the relationship between the pathogen and symptom expression is poorly understood. Several plant pathologists, molecular biologists, and chemists have been investigating different aspects of the pathogenicity, biochemistry, and chemical ecology of the fungal species involved in GTDs. Many studies have been conducted to investigate virulence factors, including the chemical characterization of phytotoxic metabolites (PMs) that assist fungi in invading and colonizing crops such as grapevines. Moreover, multidisciplinary studies on their role in pathogenicity, symptom development, and plant-pathogen interactions have also been carried out. The aim of the present review is to provide an illustrative overview of the biological and chemical characterization of PMs produced by fungi involved in Eutypa dieback, Esca complex, and Botryosphaeria dieback. Moreover, multidisciplinary investigations on host-pathogen interactions, including those using cutting-edge Omics techniques, will also be reviewed and discussed. Finally, challenges and opportunities in the role of PMs for reliable field diagnosis and control of GTDs in vineyards will also be explored.

Grapevine trunk diseases (GTD) are among the most important diseases reported in vineyards in central Transylvania. On average, up to 5% of the vineyards are affected by the GTD although there are also vineyards where the incidence of the attack exceeds 15%. Recent studies show that the importance of pathogens in wood is so great that they are considered limiting factors that affect the stability of the world’s vineyards. The main objective of this study is to develop new sustainable management alternatives for the GTD control. For this purpose, an agroecological variant including prophylactic and cultural measures and two treatments with biofungicides based on: Trichoderma atroviride strain 8, Trichoderma atroviride strain B11 and Trichoderma harzianum, were tested. The frequency of the attack of the main four GTD diseases (Esca complex, Phomopsis dieback, Eutypa dieback and Crown gall) on the SCDVV Blaj homologated grapevine varieties, ‘Astra’, ‘Amurg’, ‘Brumariu’, ‘Blasius’ ‘Radames’, ‘Rubin’ and ‘Selena’, was assessed showing that these had a lower frequency of the symptoms compared with the widely cultivated variety ‘Feteasca regala’. Also the effect of training system (Classical versus semi-high Guyot) on GTD is presented. The classical system had decreased the frequency of crown gall and Phomopsis dieback, and the semi-high Guyot system had decreased Eutypa dieback’s frequency, indicating that the training system is an important tool of the agroecological system in maintaing the health of grapevine. Biofungicides tested help reduce the symptoms of GTD, but not enough to help reduce the premature death of grapevine.

Ce travail a consisté en l'étude l'application du phosphate de calcium comme système de transporteur (" drug delivery ") pour la protection de la vigne (Vitis vinifera L.). Ce biomatériau a été étudié avec succès dans le domaine médical, de la fonctionnalité du phosphate de calcium avec des molécules anticancéreuses, à la mise au point d'un dentifrice innovant. Des essais préliminaires dans le contrôle des maladies fongiques de la vigne ont révélé des résultats prometteurs.Dans ce contexte, l'hydroxyapatite inorganique et biomimétique a été étudié en tant que système transporteur potentiel de substances bioactives autorisées en agriculture biologique pour la protection des plantes. À travers une approche multidisciplinaire, l'objectif de l'étude était d'évaluer l'efficacité de l'hydroxyapatite dans l'amélioration de l'activité biologique des composés de cuivre(II) pour lutter contre des maladies fongiques telles que le mildiou et les maladies du bois. Cette étude a pour ambition de contribuer à l'optimisation de la distribution et de la persistance des substances bioactives dans les tissus végétaux, y compris vasculaires, où des pathogènes nocifs peuvent se développer ainsi qu'à la réduction des quantités de fongicides.Cette recherche a ainsi permis de (i) comprendre l'interaction entre le système transporteur, la substance fonctionnelle et les tissus de la vigne ; (ii) démontrer le mécanisme sur lequel l'efficacité supérieure de la substance fonctionnelle est basé ; (iii) recueillir de nouvelles informations sur les mécanismes impliqués dans l'expression des symptômes des maladies du bois en étudiant les réactions de défense des plantes induites par les traitements
The research investigates the application of biomimetic calcium phosphate as innovative delivery system for grapevine (Vitis vinifera L.) protection purposes. This smart material was successfully studied in the biomedical field, from the functionalization of biomimetic calcium phosphate with anti-cancer molecules for localized releases, to the development of an innovative toothpaste for oral hygiene. Preliminary assays to implement the control of the grapevine fungal diseases, have revealed promising results. In this framework, the biomimetic inorganic hydroxyapatite was investigated as potential delivery system of bioactive substances allowed in organic agriculture for plant protection.Through a multidisciplinary approach, the study was aimed to evaluate the efficiency of hydroxyapatite in enhancing the biological activity of copper(II) compounds, on the control of relevant common diseases, like downy mildew, and complex fungal diseases, such as the grapevine trunk diseases. This aim is related to further ambitious goals: the significant reduction of the fungicides amounts applied in plant protection and the optimization of the distribution and persistence of the bioactive substances in the plant tissues, including the vascular ones, where harmful pathogens can develop. Overall, the experimental activities allowed: (i) to understand the interaction between delivery system, functional substance and grapevine tissues; (ii) to demonstrate the mechanism on which the higher efficacy of the functional substance is based; (iii) to collect new information on the mechanisms involved in the symptoms expression by studying the plant defense reactions induced by the treatments

Doutoramento em Biologia - Instituto Superior de Agronomia / UL
The ‘esca disease complex’ is a term used to identify several syndromes associated with a fungal infection of the wood of Vitis vinifera L. or other Vitis species. The pathogenic agents induce the appearance of internal symptoms in the perennial organs, such as brown wood streaking, wood necrosis and wood decay; and they are believed to be indirectly involved in the manifestation of external symptoms in annual organs as well. Overall, an esca infection induces lower vigor, productivity, quality of the yield and sorter life span of affected plants. Despite several points regarding the etiology and epidemiology of this disease complex remain controversial, due to the recent increase in the disease’s reports and worldwide incidence, there is an urgent need to find effective control strategies both to prevent the spread of esca-associated pathogens and to treat infected vines. To tackle this issue, three strategies were investigated upon: biological control, endotherapy and foliar spray with selected fungicides
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Mestrado em Viticultura e Enologia - Instituto Superior de Agronomia - UL / Faculdade de Ciências - Universidade do Porto
During the past decades, Grapevine (Vitis vinifera) Trunk Diseases (GTDs) have been under study due to their increase in incidence through all winegrowing regions worldwide. Among the most common GTDs, the esca disease complex is one of the most concerning, leading to important losses in longevity and yield. Pruning wounds are considered the main entry port for fungal spores which, if not protected, may allow the penetration of several wood pathogens, such as Phaeomoniella chlamydospora (Pch) and Phaeoacremonium minimum. In the present study, the first goal was to evaluate nine chemicals – cyprodinil + fludioxonil, copper oxychloride, copper oxychloride + summer oil, blad, fosetyl-Al, elemental silver, hydrogen peroxide, glutaraldehyde and a bituminous coating - in vitro against the growth of these fungi. The second goal was to evaluate four selected chemicals - cyprodinil + fludioxonil, copper oxychloride + summer oil, blad and a bituminous coating - as pruning wound protectants under field conditions against Pch in cv Cabernet Sauvignon. The pruning wounds were inoculated with Pch 1, 31 and 90 days after pruning. Three months after each inoculation the canes were collected and reisolations of the isolate were made. Our study found that most chemicals tested were effective in vitro, in reducing mycelial growth of both fungi. However, the results obtained under field conditions showed that one of the treatments significantly reduced the presence of Pch on the first inoculation, providing a partial protection to fresh wound. The remaining treatments were not effective as wound protectants. In summary, novel chemicals were tested that were capable to greatly inhibit in vitro the growth of esca-related pathogens and a chemical treatment was identified which was capable of reducing the incidence of Pch as wound protectant. This study improved the current knowledge in chemicals used against some esca-related fungi and in pruning wound protection
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Tese de Doutoramento em Biociências, no ramo de Biologia Celular e Molecular, apresentada ao Departamento de Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra
The designation Grapevine Trunk Diseases (GTDs) comprises several grapevine pathologies, associated with different phytopathogenic fungi, that by affecting the permanent structure of the plant lead to its weakening and death. GTDs share a cryptic nature with characteristic symptoms in wood and on foliage that may take several years to manifest. GTDs are common to all winegrowing countries and are responsible for significant losses by causing premature decline and dieback in vineyards worldwide. The present thesis seeks to contribute to the improvement of GTDs knowledge in the Dão wine region. In a literature review on the state-of-the-art of GTD research, esca, Eutypa and Botryosphaeria associated diebacks were considered as the main GTDs referenced in adult vines, whereas in young plants Petri disease and black-foot disease were the most common. This review evidenced the esca complex as a major GTD worldwide, with Phaeomoniella chlamydospora being recognised as the most important species involved in the aetiology of that complex. In this thesis first chapter “Contribution for a better understanding of grapevine fungal trunk diseases in the Portuguese Dão wine region”, a leaflet and a simple questionnaire were produced and issued to winegrowers. The leaflet, with detailed colour photos of the main symptoms associated with each GTD, aimed to elucidate the winegrowers on the GTDs’ theme. While browsing through the information stated on the leaflet, the inquired were invited to fulfil the questionnaire on the presence and relevance of those diseases in their vineyards. The results obtained in the survey represent a first concise indication of the extent of GTDs in the Dão wine region. Besides confirming GTDs’ presence, the local winegrower’s knowledge on GTDs was improved, concluding that the GTDs situation within that region was a matter of concern. Esca and “Phomopsis cane and leaf spot” were both well known. The esca complex, mainly esca and esca proper, were considered the foremost GTDs within the Dão, although mostly at low frequencies. Botryosphaeria dieback was not as well-known and young grapevine declines were considered lesser problems. In the second chapter of the thesis, “Molecular and phenotypic characterisation of Phaeomoniella chlamydospora isolates from the demarcated wine region of Dão (Portugal)”, 68 isolates of P. chlamydospora were characterised for phenotypic and molecular diversity to determine its intraspecific variability and population structure. Morphological and molecular characterisation were performed, and molecular analyses were used to infer phylogenetic relationships. Isolates were in two groups, supported by phenotypic and molecular analyses, but no correspondence was found between the two approaches. Nevertheless, both analyses revealed strong homogeneity among all isolates, despite their diverse geographical origin, year of isolation and scion/rootstock combination, supporting the clonal reproduction strategy described for this species. In the third chapter, "Pathogenicity of Phaeomoniella chlamydospora isolates", a greenhouse pathogenicity assay was performed on two-year potted grapevines, kept under controlled conditions, using 22 of the 68 P. chlamydospora isolates. All P. chlamydospora isolates proved pathogenic, causing vascular discolouration, and being reisolated from those lesions. However, infected plants did not show GTD related foliar symptoms. Most of the isolates included in ITS sequencing “Group 1” revealed more aggressive, causing longer lesions than the ones included in “Group 2”. The same tendency continued with P. chlamydospora reisolation frequencies, where most of the plants infected with “Group 1” isolates had the highest fungal recovery frequencies. These results allow, to a certain extent, some inferences relating the potential aggressiveness of the isolates to each of the formed clusters. Finally, in the fourth chapter, the response of Dão most common grapevine cultivars (Alfrocheiro, Aragonez, Jaen and Touriga Nacional) to infection by P. chlamydospora, was investigated. During a three-year trial, those grapevine cultivars were separately infected with three Portuguese isolates of P. chlamydospora. Our results showed cv. Alfrocheiro as the most susceptible, while cv. Jaen was the less susceptible. Variation in parameters like lesion length and fungal recovery from infected spurs within different trial years suggest a relation with weather data. Differences in aggressiveness among isolates were noticed. The results produced in this thesis are now available to the local winegrowing sector, constituting an added value for their activity: a) improved knowledge of the various GTDs; b) a concrete assessment of the situation of those diseases, facilitating the demonstration of their importance to the public authorities and the need to promote their study and control; c) the confirmed pathogenicity of the various isolates studied reinforces the need to revise european legislation on the production of grapevine vegetative propagating material to include restrictive measures concerning fungi associated with GTDs; d) confirms the existence of different susceptibilities to P. chlamydospora infection among some grapevine cultivars; e) provides a decision tool to the establishment of new vineyards and indicates the need to study the genetic richness of the Portuguese grapevine cultivar pool in relation to its phytosanitary behaviour; f) supports and suggests adjustments to the recommended pruning strategies to control esca, specifically leaving longer spurs and avoiding late winter pruning, thus making difficult the trunk colonization by P. chlamydospora.
A designação Doenças do Lenho da Videira (DLV) compreende várias patologias, associadas a diferentes fungos fitopatogénicos, que ao afetar a estrutura fixa da planta conduzem ao seu enfraquecimento e morte. As DLV têm em comum uma natureza críptica com manifestação de sintomas característicos ao nível da madeira e da folhagem que podem demorar vários anos até se manifestarem. Estas doenças são comuns a todos os países vitícolas, sendo responsáveis por elevados prejuízos que põem em causa a viabilidade dos vinhedos afetados. A presente tese procurou contribuir para a melhoria do conhecimento sobre DLV na região vitivinícola do Dão. Numa revisão bibliográfica sobre o estado-da-arte da investigação sobre DLV, identificaram-se a esca, a eutipiose e “dieback” associado a fungos da família Botryosphaeriaceae como as principais DLV referenciadas em videiras adultas enquanto que em plantas jovens a doença de Petri e a doença do pé-negro foram as principais DLV identificadas. O complexo da esca representa uma das DLV mais relevantes, sendo Phaeomoniella chlamydospora identificada como a principal espécie envolvida na sua etiologia. No primeiro capítulo da tese “Contribution for a better understanding of grapevine fungal trunk diseases in the Portuguese Dão wine region” elaborou-se e distribuiu-se, na região do Dão, um folheto acompanhado de um questionário. O folheto com imagens detalhadas dos principais sintomas que caracterizam as diferentes DLV pretendia elucidar os vitivinicultores sobre o tema e permitiu o preenchimento do questionário e a subsequente recolha de dados acerca da presença e relevância dessas doenças nas vinhas dos participantes. Os resultados obtidos representam uma primeira indicação concisa da situação das DLV no Dão. Confirmou-se a presença das DLV, melhorou-se o conhecimento dos viticultores e concluiu-se que a severidade e incidência das DLV nas vinhas do Dão era preocupante. A Esca e a escoriose foram as doenças mais reconhecidas. O complexo da esca foi considerada a DLV mais importante no Dão, embora com baixa severidade na maior parte das vinhas. Os sintomas de “dieback” associado a fungos da família Botryosphaeriaceae e os declínios de jovens videiras, foram considerados problemas menores. No segundo capítulo da tese, “Molecular and phenotypic characterisation of Phaeomoniella chlamydospora isolates from the demarcated wine region of Dão (Portugal)”, caracterizaram-se 68 isolados de P. chlamydospora avaliando a sua diversidade fenotípica e molecular para determinar a sua variabilidade intraespecífica e estrutura populacional. Os isolados formaram dois grupos, tanto nas análises fenotípicas como moleculares, não havendo correspondência entre os grupos formados nas duas abordagens. Este estudo revelou homogeneidade entre todos os isolados, apesar da sua origem geográfica diversa, diferentes anos de isolamento e combinações casta/porta-enxerto, suportando a estratégia de reprodução clonal descrita para esta espécie. No terceiro capítulo, “Pathogenicity of Phaeomoniella chlamydospora isolates”, descreve-se um ensaio de patogenicidade em videiras jovens, realizado em condições controladas, usando 22 isolados de P. chlamydospora. Todos os isolados demonstraram ser patogénicos ao causar lesões vasculares e ao serem reisolados a partir dessas lesões. As plantas infetadas não manifestaram sintomas foliares típicos de DLV. A maioria dos isolados incluídos por sequenciação de ITS no “Grupo 1” revelou-se mais agressiva, causando lesões mais longas do que os incluídos no “Grupo 2”. A frequência de reisolamento de P. chlamydospora revelou a mesma tendência, tendo na maioria das amostras infetadas com os isolados do “Grupo 1” sido obtidos valores mais elevados de reisolamento. Estes resultados permitem, em certa medida, algumas inferências relacionando a agressividade dos isolados e os agrupamentos formados. Por fim, no quarto capítulo intitulado “Grapevine cultivar susceptibility to Phaeomoniella chlamydospora infection” foi investigada a suscetibilidade de quatro das castas do encepamento do Dão (Alfrocheiro, Aragonez, Jaen e Touriga Nacional) à infeção por P. chlamydospora. Num ensaio, ao longo de três anos, realizado em vinhas estabelecidas, videiras daquelas castas foram infetadas separadamente com três isolados portugueses de P. chlamydospora. Os resultados obtidos revelaram a casta Alfrocheiro como a mais suscetível das quatro utilizadas e a casta Jaen a menos suscetível. A variação, ao longo do ensaio dos parâmetros analisados, sugere uma possível relação com os dados meteorológicos. Foram também observadas diferenças na agressividade manifestada pelos diferentes isolados. Os resultados obtidos nesta tese disponibilizam aos vitivinicultores do Dão informação que constitui uma clara mais-valia para a sua atividade: a) a melhoria do conhecimento das diversas DLV; b) a avaliação concreta da situação dessas doenças, facilitando a demonstração da sua importância e a necessidade de promover o seu estudo e combate; c) a patogenicidade confirmada dos vários isolados estudados reforça a necessidade de revisão da legislação europeia sobre produção e comercialização de material de propagação vegetativa de videira; d) a confirmação da existência de diferentes suscetibilidades entre algumas das castas locais à infeção por P. chlamydospora; providencia uma ferramenta de decisão na constituição de novos encepamentos; e) indicam a necessidade de estudar a diversidade das castas portuguesas quanto ao seu comportamento em termos sanitários; f) sustentam e sugerem ajustes nas estratégias de poda recomendadas para o controle da esca, especificamente deixando talões mais compridos e evitando podas tardias, dificultando a colonização do tronco por P. chlamydospora.

The ESC Textbook of Cardiovascular Nursing is the official textbook of the European Society of Cardiology (ESC) Association of Cardiovascular Nursing and Allied Professions. It aims to provide in-depth learning for nurses specializing in caring for patients with coronary heart disease, heart failure, valvular disease, arrhythmias, congenital heart disease, and inherited cardiovascular conditions. The textbook builds on the ESC Core Curriculum for the Continuing Professional Development of Nurses Working in Cardiovascular Care. The pathology of these conditions is described as well as the normal anatomy and physiology of the heart. While tailoring nursing assessment and interventions to the care of patients with heart disease, the textbook emphasizes high-quality holistic care taking account of the needs of patients with complex comorbidities, as well as their families. The imperative of prevention and rehabilitation in terms of both primary and secondary prevention is confirmed as well as educational, behavioural, and therapeutic interventions. The epidemiology of cardiovascular disease is covered including disease burden and inequalities across European regions. Chapters devoted to education and communication and pharmacology are also included. The textbook concludes with a chapter which looks into the future challenges and opportunities for nurses and the evolution of nursing in cardiovascular care. The hope of the editors is that the textbook inspires readers to ask questions, search for answers, and become the best cardiovascular nurses they can be, especially given the strong body of evidence showing that educational provision for nurses increases patient safety and saves lives.

The elucidation of genetic mechanisms affecting the risk of atherosclerosis has largely benefited from recent technological breakthroughs in terms of high-throughput sequencing and genotyping. While a decade ago only a positive family history and mutations causing familial hypercholesterolaemia were proven to confer genetic risk of atherosclerosis, by now multiple genes have been implicated in monogenic and complex forms of accelerated atherosclerosis. At the population level, the discovery of hundreds of common variants, each affecting the risk of atherosclerosis by a small margin, may have even broader implications. A substantial finding from these studies is that the risk of atherosclerosis and its clinical manifestations, such as myocardial infarction, stroke, and peripheral arterial disease, is secondary to a much broader spectrum of underlying (genetic) mechanisms than previously thought, when only the classical risk factors, such as hypertension, dyslipidaemia, diabetes mellitus, and smoking were implicated in the disease aetiology. Currently, the systems biology of the multiple interacting factors contributing to the risk of atherosclerosis as well as respective therapeutic implications, in part addressed by Mendelian randomization studies, is subject to intensive research. Likewise, genetic risk scores are scrutinized to improve the prediction of coronary artery disease in asymptomatic individuals. This chapter gives a brief overview on the current understanding of the genetic underpinnings of atherosclerosis.

The elucidation of genetic mechanisms affecting the risk of atherosclerosis has largely benefited from recent technological breakthroughs in terms of high-throughput sequencing and genotyping. While a decade ago only a positive family history and mutations causing familial hypercholesterolaemia were proven to confer genetic risk of atherosclerosis, by now multiple genes have been implicated in monogenic and complex forms of accelerated atherosclerosis. At the population level, the discovery of hundreds of common variants, each affecting the risk of atherosclerosis by a small margin, may have even broader implications. A substantial finding from these studies is that the risk of atherosclerosis and its clinical manifestations, such as myocardial infarction, stroke, and peripheral arterial disease, is secondary to a much broader spectrum of underlying (genetic) mechanisms than previously thought. Indeed, the genetic variants leading to atherosclerosis go far beyond the effects of classical risk factors, such as hypertension, dyslipidaemia, diabetes mellitus, and smoking. Based on these findings, genetic risk scores are scrutinized to improve the prediction of coronary artery disease in asymptomatic individuals. Remarkably, people with a high genetic risk burden have the greatest benefit from therapeutic lowering of LDL cholesterol. Currently, the systems biology of the multiple interacting factors contributing to the risk of atherosclerosis as well as respective therapeutic implications, in part addressed by Mendelian randomization studies, is subject to intensive research. Likewise, genetic risk scores are scrutinized to improve the prediction of coronary artery disease in asymptomatic individuals. This chapter gives a brief overview on the current understanding of the genetic underpinnings of atherosclerosis.

The genetics of rare familial hyperlipidaemias have been studied for many years, but the last decade has seen major advances in our understanding of the genetics of common dyslipidaemias. These developments have largely been propelled by the rapid innovations in genotyping and phenotyping technologies. Genome-wide association, whole exome sequencing, and whole genome sequencing studies have identified a large number of genetic loci involved in lipid metabolism. Large-scale meta-analyses have included over 150,000 individuals, increasing statistical power to identify rarer variants, and common variants with smaller phenotypic effects. Furthermore, advances in phenotyping such as nuclear magnetic resonance-based lipidomics have facilitated finer mapping of circulating lipids and lipoproteins. Capitalizing on the findings from these large-scale studies, genetic analyses using the Mendelian randomization principle have been used successfully to explore the causal contributions to heart disease of a range of circulating lipid fractions. Such investigations have confirmed a causal role for low-density lipoprotein cholesterol, suggest a causal role for triglycerides, but cast doubt on that of high-density lipoprotein cholesterol. Furthermore, genetic studies have been shown to have an important application in the validation of novel therapeutic targets for treatment of dyslipidaemias.

Mitochondria are responsible for energy production in most eukaryotic cells. Each cell contains at least one mitochondrion and every mitochondrion contains two to ten copies of a circular DNA molecule (mitochondrial DNA or mtDNA). Cardiomyocytes contain approximately 10,000 mtDNA copies. MtDNA is composed of around 16,500 base pairs and 37 genes encoding 13 subunits of the respiratory chain complexes I, III, IV, and V, 22 mitochondrial tRNAs and 2 rRNAs. With each cell division, mitochondria and mtDNA are randomly distributed to daughter cells. In humans, mitochondria are inherited exclusively from the mother. In healthy people mtDNA copies are usually identical at birth (homoplasmy) but with ageing, mtDNA is particularly prone to somatic mutation because, unlike nuclear DNA, it is continuously replicated, even in non-dividing tissues such as myocardium. This can lead to the propagation of somatic mutations within single cells by a process called clonal expansion. In addition, mtDNA lacks an extensive DNA repair mechanism.

Pericardial and myopericardial diseases are common cardiac presentations in people living with HIV, and may occur at all stages of HIV disease. There are a vast number of aetiologies, the relative likelihood of which is dependent on a complex interplay between host, pathogenic, and environmental factors. The convergence of HIV and tuberculosis in many settings has resulted in an increased prevalence of tuberculous pericardial disease associated with significant morbidity and mortality. The introduction of antiretroviral therapy has resulted in a reduced incidence of viral, bacterial, neoplastic, and idiopathic pericarditis in people living with HIV, but tuberculous pericarditis remains a challenge. The clinical presentation of the pericardial and myopericardial disease may reflect the extent of cardiac involvement, and further investigation should be guided by risk stratification. There is limited evidence to guide the treatment of myopericarditis; however, the principles of treatment are now well established in guidelines. A high index of suspicion for tuberculous pericarditis in high tuberculosis–HIV burden settings, and the appropriate use of empiric tuberculosis treatment may be warranted. While tuberculous pericardial disease continues to confer a high risk of mortality, most other causes of pericardial and myopericardial diseases bear a good prognosis.

The growing adult population with congenital heart disease (CHD) are getting older and their clinical presentation and outcomes are likely to be determined not only by their underlying CHD, but also by the development of acquired cardiovascular diseases such as atherosclerosis. This begins in childhood. The adult CHD population have multiple cardiovascular risk factors, as found in the general population, including obesity, smoking, and sedentary behaviour. Adults with complex congenital heart circulation are likely to be particularly vulnerable to the development of acquired arterial disease. Maintenance of ‘ideal cardiovascular health’ from childhood, is a key target, as leveraged gains can be achieved by early intervention to reduce risk factor exposure.

Great strides have been made in the past decade in our understanding of the genetic basis of atrial fibrillation. We have come to appreciate that atrial fibrillation is heritable and that familial forms of atrial fibrillation are rare. In the next 2 years, we can expect to have a comprehensive picture of the genes underlying atrial fibrillation. Future work will be focused on understanding the function of these atrial fibrillation-related genes, and in translating these findings back into the clinical realm.

Arterial hypertension appears as two genetic types: primary hypertension is to a substantial extent determined by a large number of genetic risk variants, whereas rare patients with a familial hypertensive syndrome have a single gene defect that drives the elevated blood pressure. The familial hypertensive syndromes have been instrumental in highlighting blood pressure-regulating pathways that almost exclusively cluster in the kidney and in the mineralocorticoid pathways. Conversely, hundreds or more genetic variants cause the genetic component of primary hypertension and each risk variant causes a small blood pressure increase. The blood vessels appear to be one tissue in which these variants principally act and surprisingly there is little overlap with pathways of kidney and hormone pathways. Genetic testing is useful for the rare familial hypertensive syndrome, but in primary hypertension cardiovascular risk prediction can currently not be improved by genotyping.

From an evolutionary base in the care of those with cancer, the potential benefits of palliative care for those affected by other life-limiting diseases such as heart failure have been widely recognized. People with heart failure are subject to a symptom burden and mortality risk similar to those associated with malignant disease, but the clinical scenario is often more complicated. This relatively aged clinical population tend to have multiple co-morbidities and an unpredictable disease trajectory. The beneficial but increasingly complex nature of comprehensive heart failure therapy in polypharmacy, implantable devices, and cardiac surgical intervention may undermine clinical coordination, patient autonomy, and ultimately conflict with patients’ and families’ changing preferences for care along a progressive disease course to the end of life. This chapter describes the challenges and opportunities in providing palliative care to this burgeoning clinical cohort.

Multimodality imaging of pericardial diseases has recently emerged as a modern approach for patients with suspected pericardial and myopericardial diseases, especially to assess more complex cases and perform an appropriate aetiological search, as well as assessment of diagnostic and prognostic features, that may affect the clinical management.

Introdução: A microbiota humana representa uma ampla gama de microorganismos que compõem a flora intestinal de um indivíduo. Essa comunidade microbiana se forma após o nascimento e está intimamente relacionada com a modulação do sistema imunológico. Considerada um ecossistema extremamente complexo, sua composição varia com a idade, estilo de vida e hábitos alimentares. No último século, após o advento dos antibióticos e da industrialização alimentícia, houve uma mudança significativa nos subgrupos da microbiota intestinal. Concomitantemente, elevou-se o espectro das doenças consideradas imunomediadas. Alergias, demências e distúrbios gastrointestinais prevalecem no cotidiano de grande parcela da população a nível mundial. Questiona-se, então, a relação entre nossos microorganismos intestinais com a ativação e equilíbrio do sistema imunológico. Objetivo: O presente trabalho busca relacionar as mudanças na microbiota e sua relação com a elevada incidência de doenças autoimunes no século XXI. Material e métodos: Realizou-se uma revisão bibliográfica das bases de dados PubMed e Scielo utilizando os descritores: Autoimmune diseases, Microbioma, Microbiota Intestinal e Simbiose Intestinal. Foram selecionados 5 artigos publicados a partir de 2017 para base deste estudo. Resultados: O equilíbrio simbiótico entre microbiota e sistema imune permite que haja tolerância imunológica às bactérias consideradas benéficas ao organismo humano. A médio e longo prazo, nota-se que esses pacientes se tornam mais protegidos de doenças autoimunes. Em contrapartida, pacientes medicados repetidamente com antibióticos apresentam uma disbiose seguida de infecções intestinais oportunistas, como a causada pelo Clostridium difficile. Outrossim, dietas ricas em carboidratos e com baixo teor de fibras mostram-se mais imunogênicas ao comprometer a homeostase de bactérias residentes no TGI. Com isso, há maiores chances de desenvolver doenças inflamatórias intestinais, como Chron e Retocolite. Conclusão: Nosso microbioma intestinal tem mostrado influência no processo de saúde e doença de seu hospedeiro. Entende-se, portanto, que a manutenção de uma microbiota autóctone é capaz de reduzir a incidência de doenças imunomediadas. Tendo isso em mente, alternativas que visem corrigir uma disbiose intestinal, como probióticos, prebióticos e até transplante de microbiota fecal, podem prevenir e tratar uma ampla gama de doenças consideradas emergentes no século XXI.

INTRODUÇÃO As doenças falciformes (DF) compõem um grupo de distúrbios hematológicos bastante prevalentes no mundo todo, os quais podem trazer consigo diversas complicações. Dentre elas, destaca-se o priapismo, uma condição caracterizada por uma ereção peniana persistente e patológica, por vezes dolorosa, independente da presença de estímulo sexual, acarretando grande prejuízo à qualidade de vida dos indivíduos acometidos. OBJETIVOS: Analisar a prevalência de priapismo em homens portadores de doença falciforme. MATERIAL E MÉTODOS: Trata-se de uma revisão integrativa de literatura, realizada a partir da estratégia de busca (priapism) AND (sickle cell disease) AND (prevalence), na base de dados BVS. Os critérios de inclusão foram: textos completos publicados entre 2020 e 2021, nos idiomas português e inglês. Assim, foi encontrado um total de 14 artigos; destes, 3 artigos empíricos foram selecionados como referência para esta revisão, levando em consideração a metodologia - revisões foram excluídas -, o tamanho da amostragem utilizada, e os resultados encontrados; os parâmetros foram obtidos após leitura integral dos artigos. No total, foram analisados 729 homens com DF, com idades entre 2 e 64 anos. Os resultados foram sintetizados de maneira integrada, ampla e ordenada seguindo as fases da revisão integrativa: elaboração de uma questão norteadora, que buscava determinar a prevalência de priapismo em homens com doença falciforme, seguida pela busca organizada através da estratégia de busca supracitada na literatura e coleta de informações; estas nortearam a análise crítica dos dados e a elaboração de uma discussão racionalizada dos resultados obtidos, adiante apresentados. RESULTADOS: O primeiro artigo relatou uma incidência de priapismo consideravelmente maior entre homens portadores de doença falciforme homozigotos (HbSS) (163/500 – 32,6%) em relação a homens sadios (5/250 – 2%). O segundo artigo relatou uma prevalência de priapismo de 35,9% (23/64), entre homens com doenças falciformes, sendo que, dos acometidos, 69,6% (16/23) tinham genótipo HbSS. O último artigo analisou os dados de 270 pacientes com DF, chegando a uma prevalência de priapismo de 26,06% entre os homens (43/165). CONCLUSÃO: A prevalência de priapismo em homens portadores de doenças falciformes é alta, especialmente dentre aqueles com genótipo HbSS, reforçando a importância de um suporte direcionado a esta população.