Candida albicans
,
C. glabrata
,
C. parapsilosis
, and
C. tropicalis
are able to form biofilms on virtually any biomaterial implanted in a human host. Biofilms are a primary cause of mortality in ...immunocompromised and hospitalized patients, as they cause recurrent and invasive candidiasis, which is difficult to eradicate. This is due to the fact that the biofilm cells show high resistance to antifungal treatments and the host defense mechanisms, and exhibit an excellent ability to adhere to biomaterials. Elucidation of the mechanisms of antifungal resistance in
Candida
biofilms is of unquestionable importance; therefore, this review analyzes both the chemical composition of biomaterials used to fabricate the medical devices, as well as the
Candida
genes and proteins that confer drug resistance.
Background. Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease. Low vitamin D levels have been reported to be a risk factor for MS, and genetic variances could be implicated. The ...aim of this study was to evaluate the association of MS with rs10766197 polymorphism of CYP2R1 gene and rs10877012 polymorphism of CYP27B1 gene. The second aim was to analyse whether these polymorphisms are associated with the severity of the progression of MS. Material and Methods. In a case-control study, we included 116 MS patients and 226 controls, all of whom were Mexican Mestizo. MS was diagnosed by McDonald criteria (2017). A complete neurological evaluation was performed to evaluate the severity of disease progression. Serum 25-hydroxyvitamin D 25(OH) vitamin D levels were measured by ELISA. Single nucleotide polymorphisms rs10766197 of CYP2R1 gene and rs10877012 SNP of CYP27B1 gene were genotyped by real-time PCR. Results. Serum 25(OH) vitamin D levels were lower in MS patients than in controls (p=0.009). No differences were observed between serum 25(OH) vitamin D levels of MS patients with severe progression compared to low progression (p=0.88). A higher frequency of the A allele of CYP2R1 rs10766197 was observed between MS patients and controls (p=0.05). No differences were observed in the frequency of T allele of CYP27B1 rs10877012 (p=0.65). In subanalysis, patients with GA+AA genotypes of CYP2R1 rs10766197 had an increased risk of MS compared to controls (p=0.03). No increased risk was observed in GT+TT genotypes of CYP27B1 rs10877012 (p=0.63). No differences were observed in allele frequencies of either polymorphism between patients with severe vs. low disease progression. Conclusion. Lower serum 25(OH) vitamin D levels were observed in MS patients than in controls, although these levels were not associated with disease progression. Carriers of GA+AA genotypes of CYP2R1 rs10766197 had an increased risk of MS. None of these polymorphisms was associated with severe progression of MS.
The Receptor Activator Nuclear of κB Ligand (RANKL) plays an important function in immune responses, activating osteoclast cells and unchanged bone resorption, which in turn leads to bone erosion and ...inflammation. Genetic variants in the promoter region of the RANKL gene could lead to a higher risk of rheumatoid arthritis (RA). Objective: To assess the association of rs9533155 (-693C>G) and rs9533156 (-643T>C) genetic variants with RA risk. Methods: A case–control study was carried out. A total of 94 patients with RA (RA group) and 134 subjects without any rheumatologic disease (control group) were included. Genetic DNA was extracted from peripheral white blood cells (leukocytes). Genetic variant rs9533155 (-693C>G) was screened by an approach based on Polymerase Chain Reaction–Restriction Fragment Length Polymorphism (PCR-RFLP), while rs9533156 (-643T>C) was screened using quantitative polymerase chain reaction (qPCR) with TaqMan probes. RANKL serum levels were measured by ELISA. Results: For rs9533155 (-693C>G), the polymorphic homozygous genotype frequencies (CC) were higher in the RA group (p = 0.006). Individuals carrying the risk genotype presented higher levels of serum RANKL. Carriers of the polymorphic homozygous genotype in the dominant model (CC vs. CG + GG) had an increased risk of developing RA (OR: 1.8, 95% CI 1.04 to 3.1). No association between rs9533156 (-643T>C) and the haplotypes with RA risk was observed. Conclusion: The rs9533155 (-693C>G) genetic variant exhibits a potential role in RA risk. The studied population had no association with the rs9533156 (-643T>C) genetic variant.
Multiple sclerosis (MS) is a chronic and demyelinating disease with an autoimmune origin, which leads to neurodegeneration and progressive disability. Approximately 30 to 50% of patients do not ...respond optimally to disease-modifying therapies (DMTs), and therapeutic response may be influenced by genetic factors such as genetic variants. Therefore, our study aimed to investigate the association of the HLA-DRB1*0403 genetic variant and therapeutic response to DMTs in MS. We included 105 patients with MS diagnosis. No evidence of disease activity based on the absence of clinical relapse, disability progression or radiological activity (NEDA-3) was used to classify the therapeutic response. Patients were classified as follows: (a) controls: patients who achieved NEDA-3; (b) cases: patients who did not achieve NEDA-3. DNA was extracted from peripheral blood leukocytes. HLA-DRB1*0403 genetic variant was analyzed by quantitative polymerase chain reaction (qPCR) using TaqMan probes. NEDA-3 was achieved in 86.7% of MS patients treated with DMTs. Genotype frequencies were GG 50.5%, GA 34.3%, and AA 15.2%. No differences were observed in the genetic variant AA between patients who achieved NEDA-3 versus patients who did not achieve NEDA-3 (48.7% vs. 43.1%, p = 0.6). We concluded that in Mexican patients with MS, HLA-DRB1*0403 was not associated with the therapeutic response to DMTs.
Providing appropriate cardio-pulmonary reanimation after cardio-pulmonary arrest is paramount for survival. An effective and low-cost approach to learn and practice the cardio-pulmonary reanimation ...is through a computerized life-size patient simulator. The present work describes the development of a patient simulator for the Centre of Education and Certification of Medical Aptitudes (CECAM) from the UNAM's Faculty of Medicine. This patient simulator has many new and innovative features, such real-time feedback to the medical student, which improves the whole teaching/learning experience.
As they manifest specifically and reversibly, lectins are proteins or glycoproteins with the characteristic of agglutinating erythrocytes. Given that grain legume lectins can represent 10% of protein ...content and can have various biological functions, they are extensively studied. The objective of this work was to purify and partially characterize the lectins of
black, var surco and vara (LBBS and LBBV). Both lectin types were purified by affinity chromatography on stroma matrix, which agglutinated human erythrocytes type A, B, and O, as well as rabbit, hamster, pig, and chicken erythrocytes. Native-PAGE was employed for molecular mass determination, yielding 109.36 and 112.68 kDa for BBS and BBV, respectively. Further analyses revealed that these lectins are tetrameric glycoproteins that require Ca
, Mn
and Mg
ions for exhibiting their hemagglutinating function, which can be inhibited by fetuin. Moreover, optimal pH was established for both lectins (10.5 for LBBS and 7-9 for LBBV), while their activity was temperature-dependent and ceased above 70 °C. Finally, the observed differences in the biochemical characteristics and bioactive functions were ascribed to the different physiological characteristics of each seed, as well as the protein itself.
Introduction: The 5-year relative survival in patients aged 15-24 years old is around 57% (Blood 2019; 134: 407-410), with a median survival after relapse of 10 months. No uniform consensus about ...rescue treatment is available, but those who achieve a complete remission can undergo to an allogeneic transplant if feasible. The use of intense rescue chemotherapy is associated with systemic toxicities and risk of serious infections that can delay an allogeneic transplant.
Objective: We describe the combination of two ALL targeted therapies, combining bispecific T-cell engager (BiTE) against CD 19 (Blinatumomab) and selective inhibitor of the B-cell lymphoma 2 (Bcl-2) regulator protein, an antiapoptotic protein (Venetoclax). This combination was developed based in their mechanism of action that offers synergetic effects against ALL cells and the reports of ongoing clinical trials using Venetoclax combinations for ALL, but no with Blinatumomab.
Patients and methods: Patients with B cell precursors ALL in minimal residual disease relapse by flow cytometry. Rescue treatment with Blinatumomab and Venetoclax before allogeneic transplant.
Results: Two patients treated with LAFAMI-LLA-2002 Protocol (Blood 2009; 114: 4104 and Hematologia 2016; 17: 5137), adapted to young adults with high dose methotrexate at 5 gr/m2 every four months in the maintenance phase, had MDR positivity by FC in the surveillance phase, with normal CBC. One male with 22 years old at the time of relapse, after 60 months of surveillance with 1.9 % of malignant lymphoblasts. One female with 21 years old at the time of relapse, after 25 months of surveillance with 0.2 % of malignant lymphoblasts. Both relapses were confirmed with an additional MRD one week after. Extension studies were performed, including PET-CT, to determinate other affected sites and were negative. Treatment administrated was Blinatumomab at 9 mcg/day continuous IV infusion on days 1-7 and 28 mcg/day on days 8-14 with Venetoclax in a ramp-up phase for 5 weeks. Both patients were in negative MRD after the complete Blinatumomab and continue with Venetoclax while a donor was available. No side effects were observed during and after the treatment. Both patients had a compatible sibling and underwent for allogeneic transplant. At the moment of this report the patients have 11 months and 18 months after transplant with EMR negative and complete donor cells from the bone marrow, with no secondary effects.
Conclusion: This is a novel combination with no reports of its use before our communication. Targeted therapies in low leukemic burden is a feasible treatment with no side effects and rapid control of the relapse, allowing the patients to reach an allogeneic transplant as soon as possible avoiding substantial toxicity and risk of infections. No infusion related reaction or cytokine release syndrome were observed due low leukemic burden. More patients need to be included to this combination to demonstrate reproducibility, optimizing time and costs.
Blinatumomab and Venetoclax combination for acute lymphoblastic leukemia relapse
► We produced a reduced-sugar pomegranate juice jelly added with pomegranate peel (PE). ► Guar, xanthan and tragacanth gums and aqueous PE extract were used. ► The combination of three gums presented ...the better rheological behaviour. ► The addition of PE increased the antioxidant content and activity. ► PE did not affect the physical, rheological and sensory properties.
In the present study, the production of a reduced-sugar pomegranate juice jelly supplemented with an aqueous extract of pomegranate peel (PE) is described. Influence of different carbohydrate polymers (guar (G), xanthan (X) and tragacanth (T) gums) on rheological properties was studied. Combination GXT presented the most similar rheological behaviour to commercial jelly. Jelly (J) and jelly with PE (JE) were stored at 4°C over an 8week period for physical, chemical, antioxidant, microbiological and sensory analysis. J and JE showed similar values for °Brix, colour and Aw, though the pH of JE was lower than J. Thiol and phenolic compounds were higher in JE than in J. Antioxidant activity (radical scavenging activity and autoxidation of linoleic acid) was higher in JE than in J at 0weeks, and were decreasing with time. Pomegranate juice with additives was generally less accepted than J and JE.
Postmenopausal osteoporosis is a multifactorial disease. Genetic factors play an essential role in contributing to bone mineral density (BMD) variability, which ranges from 60 to 85%. Alendronate is ...used as the first line of pharmacological treatment for osteoporosis; however, some patients do not respond adequately to therapy with alendronate.
The aim of this work was to investigate the influence of combinations of potential risk alleles (genetic profiles) associated with response to anti-osteoporotic treatment in postmenopausal women with primary osteoporosis.
A total of 82 postmenopausal women with primary osteoporosis receiving alendronate (70 mg administered orally per week) for one year were observed. The bone mineral density (BMD; g/cm
) of the femoral neck and lumbar spine was measured. According to BMD change, patients were divided into two groups: responders and non-responders to alendronate therapy. Polymorphic variants in
,
,
,
,
,
and
genes were determined and profiles were generated from the combination of risk alleles.
A total of 56 subjects were responders to alendronate and 26 subjects were non-responders. Carriers of the G-C-G-C profile (constructed from rs700518, rs1800795, rs2073618 and rs3102735) were predisposed to response to alendronate treatment (
= 0.001).
Our findings highlight the importance of the identified profiles for the pharmacogenetics of alendronate therapy in osteoporosis.
(1)
: Maturity-onset diabetes of the young (MODY) is a group of diabetes caused by gene defects related to insulin secretion. MODY1, MODY2, and MODY3 are the most common and account for approximately ...80% of all cases. Other types are relatively rare. This study describes the clinical, analytical, and genetic characteristics of a patient with MODY10, and diabetic nephropathy, retinopathy, and functional hypogonadism diagnosis. (2)
: A clinical case was analyzed and whole exome generation sequencing (WES) was used to detect mutations related to a monogenic variant. (3)
: A seventeen-year-old male patient, who was diagnosed with apparent type 1 diabetes at the age of eight was started with insulin therapy. He came to the emergency room with glycemic decompensation, facial, and lower limb edema. During his evaluation, he had near-nephrotic range proteinuria of 2902 mg/24 h, a kidney ultrasound showing mild pyelocalyceal dilation, proliferative diabetic retinopathy, and was also diagnosed with functional hypogonadotropic hypogonadism. These comorbidities improved with adequate glycemic control. WES showed missense variant c.94G>A (p.Gly32Ser) in the INS gene, according to Clinvar corresponding to MODY10. It was a "de novo" variant not reported in his parents. (4)
: Monogenic diabetes (MD) is rare and MODY10 is among the less frequent types. MODY should be suspected in patients with type 1 phenotype with negative autoimmunity even in the absence of a family history of diabetes. To the best of our knowledge, we present here the first patient with these phenotypic traits of MODY10 reported in Latin America.
PDF
