[The role of folates in the diverse biochemical processes that control mental function]

A variety of studies indicate that folate deficiency is associated with the appearance of problems of a neuromuscular or neurological nature such as depression, muscular and mental fatigue, states of confusion and non-senile dementia, and that these processes improve fully or partly when the deficiency is corrected. Because of the role of folates in the reactions in synthesis of neuro-transmitter and elements of neuron structure, it is not surprising that a deficiency is associated with depression and other mental problems. Folates are involved in the synthesis of S-adenosylmethionine (SAM) which is the main contributor of methyl groups in the nervous system and whose action as an antidepressive agent is confirmed. They are also involved in the synthesis of glutamate which is an excitant neurotransmitter, and in the formation of puric and pyrimidic bases. An alternative mechanism for explaining the etiopathogenesis of folate deficiency in depression and other mental disorders involves the regeneration of tetrahydrobiopterin (THB) which is an essential cofactor in hydroxylation process in the brains of mammals. Folate deficiency is a common nutritional problem in many groups of the Spanish population and, given the role of this vitamin in the operation of the nervous system, we might consider the possibility that, in some case, folate deficiency may cause or aggravate some alterations to mental function.

Utility of home oximetry as a screening test for patients with moderate to severe symptoms of obstructive sleep apnea

OBJECTIVE

To determine the value of home oximetry as a screening test in patients with moderate to severe symptoms of obstructive sleep apnea (OSA).

DESIGN

Retrospective, observational study.

SETTING

The Sleep Unit of a tertiary referral, university hospital.

PATIENTS

116 patients referred for evaluation of moderate to severe symptoms of OSA in which both home oximetry and polysomnography (PSG) were performed.

INTERVENTIONS

NA.

RESULTS

Three numerical oximetry indices were evaluated: average of desaturations > or =4% and average of resaturations > or =3% per hour of analysis time (DI4% and RI3%, respectively); and cumulative percentages of time spent at saturations below 90% (CT90%). A qualitative assessment was also performed. Oximetry indices were compared with apnea/hypopnea index (AHI) by simple linear regression and Bland-Altman analyses. Optimal cut-off points, in terms of sensitivity and specificity, for the oximetry indices were searched using ROC analysis, at an AHI threshold of > or =10. The correlation between AHI and the desaturation indices was r = 0.50 for CT90%, r = 0.60 for DI4%, and r = 0.58 for RI3%. No bias was found between PSG and oximetry indices in Bland-Altman plots. Neither the numerical indices nor the qualitative analysis achieved an adequate (>0.8) area under the ROC curve. A CT90% <0.79 excluded OSA with 84% sensitivity. A DI4% > or =31.4 or a RI3% > or =40.5 diagnosed OSA with 97% specificity. Using these values, 38% of the patients would have been correctly classified by oximetry alone, 10% would have been incorrectly classified, and 50% could not have been classified with certainty. Eleven (15%) OSA patients would have been missed by oximetry.

CONCLUSIONS

Correlation between home oximetry and PSG was not high. Oximetry was more useful to confirm than to exclude OSA in our study. Qualitative assessment was not better than numerical analysis. The greatest value of oximetry in this setting seems to be as a tool to rapidly recognize and treat more severe OSA patients in waiting list for PSG.

Isolation and typing methods for the epidemiologic investigation of thermotolerant campylobacters

Thermotolerant campylobacters, C. jejuni, C. coli, C. lari and C. upsaliensis, are spiral bacteria involved in human enteric disease. The prevalence of these emerging pathogens, mainly C. jejuni and to a lesser extent C. coli, as etiologic agents of enteric disease in industrialized countries has increased over the last decade. The isolation and culture of these microorganisms is tedious and time-consuming mainly due to their complex nutritional and environmental requirements. This review discusses the techniques and methods developed for the selective isolation of thermotolerant campylobacters from food, environmental and clinical samples. Additionally, both traditional and newer molecular biology techniques applied to this group of thermophilic organisms for typing and taxonomic purposes are summarized.

The promoter element GTACAAG of the SGA and STA2 genes is a possible target site for repression by the STA10 gene product from Saccharomyces cerevisiae

The SGA and STA2 genes that, respectively, encode the intra- and extracellular glucoamylases of Saccharomyces cerevisiae are coregulated negatively, at the level of transcription, by the STA10 gene. This finding was re-examined by determining the effects of STA10 on the expression of gene constructs containing different fragments from the SGA and STA2 promoter regions fused to the lacZ gene. Repression was observed only for promoter fragments carrying the sequence GTACAAG indicating that this element is responsible for the coregulation of SGA and STA2 by STA10.

Abstract P3-07-14: Prosigna® intrinsic subtyping predicts response to neoadjuvant combination therapy in study that includes herceptin within HER2+ (IHC) patients

Background: The role of the HER2-enriched (HER2E) subtype determined by the Prosigna Assay in the neoadjuvant setting has remained largely uncharacterized. In this study, we examine whether Prosigna can identify a subgroup of HER2+ patients for whom combination neoadjuvant therapy that includes trastuzumab (Herceptin) is associated with a greater likelihood of pathological complete response (pCR). Methods: In this single-arm retrospective analysis, 75 patients determined to be HER2+ by IHC were treated with a neoadjuvant regimen (NAC) consisting of 8-12 cycles of anthracyclines and taxanes as well as Herceptin. The Prosigna Assay was performed on the NanoString nCounter® Dx Analysis System at HU Virgende la Victoria de Málaga/CIMES-UMA. pCR was used as the endpoint for this study and was determined using the Miller & Payne scoring criteria. Results: Mean patient age for this study population was 49 (±11.1yr) and all patients were determined to be HER2+ by IHC. The overall pCR rate in this patient population was 46.2%. Of the 75 patient samples analyzed for this study, 59 (78.6%) were HER2E, 4 (5.3%) were Luminal A and 12 (16.1%) were Luminal B, as identified by the Prosigna Assay. Of the 16 tumors classified as Luminal (A or B) by Prosigna within this HER2+ population, only 2 (12.5%) responders were observed. Categorical analysis revealed that Prosigna subtype predicted response to a NAC regimen combined with Herceptin (Odds ratio [Her2E vs. non-Her2E]=6.4, p=0.023). Further analysis of the Her2E subtype revealed that tumors with profile expression that correlated well with the prototypical Her2E centroid were significantly more likely to respond to combination NAC and Herceptin (Odds ratio [Unit increase of 1 in Her2E correlation]=88.2, p=0.004). Conclusions: The results of this study indicate that HER2+ patients with greater correlations to the HER2E subtype have an increased likelihood of response to combination neoadjuvant regimens that included HER2-targeted therapy.

Citation Format: Santonja Á, Ribelles N, Jiménez-Rodríguez B, Sánchez Rovira P, Álvarez M, Vicioso L, Isabel Fernandez A, de Luque V, Fernández de Sousa C, Villar E, Zarcos I, Ramírez C, González-Hermoso C, Jeiranian A, Dowidar N, Schaper C, Buckingham W, Ferree S, Jiménez A, Prat A, Alba E. Prosigna® intrinsic subtyping predicts response to neoadjuvant combination therapy in study that includes herceptin within HER2+ (IHC) patients. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-14.

Role of cell wall-degrading enzymes in pathogenicity of Fusarium oxysporum

Fusarium oxysporum invades its host plants through the roots and colonizes the vascular system. It produces a great variety of cell-wall degrading enzymes (CWDE), such as cellulases, xylanases, pectinases and proteases. Our group has purified and characterized an endopolygalacturonase (PG1), two exopolygalacturonases (PG2 and PG3), an endoxylanase (XYL1) and an endo pectatelyase (PL1). We have isolated the following CWDE-encoding genes: pg1, pgx4, pg5, xyl2, xyl3, prt1 and pl1. Gene expression in different culture conditions has been determined by Northern analysis. The occurrence of these genes in different formae speciales has been analyzed by Southern analysis and PCR. All these genes are expressed during different stages of the interaction with the host plant indicating a possible role in pathogenesis. At present, targeted gene disruption is being carried out, in order to determine the role of each gene in the pathogenicity process.

HLA genetic polymorphisms and prognosis of patients with COVID-19

Objective

Different genetic polymorphisms of human leukocyte antigen (HLA) have been associated with the risk and prognosis of autoimmune and infectious diseases. The objectives of this study were to determine whether there is an association between HLA genetic polymorphisms and the susceptibility to and mortality of coronavirus disease 2019 (COVID-19) patients.

Design

Observational and prospective study.

Setting

Eight Intensive Care Units (ICU) from 6 hospitals of Canary Islands (Spain).

Patients

COVID-19 patients admitted in ICU and healthy subjects.

Interventions

Determination of HLA genetic polymorphisms.

Main variable of interest

Mortality at 30 days.

Results

A total of 3886 healthy controls and 72 COVID-19 patients (10 non-survivors and 62 survivor patients at 30 days) were included. We found a trend to a higher rate of the alleles HLA-A*32 (p = 0.004) in healthy controls than in COVID-19 patients, and of the alleles HLA-B*39 (p = 0.02) and HLA-C*16 (p = 0.02) in COVID-19 patients than in healthy controls; however, all these p-values were not significant after correction for multiple comparisons. Logistic regression analysis showed that the presence of certain alleles was associated with higher mortality, such as the allele HLA-A*11 after controlling for SOFA (OR = 7.693; 95% CI = 1.063–55.650; p = 0.04) or APACHE-II (OR = 11.858; 95% CI = 1.524–92.273; p = 0.02), the allele HLA-C*01 after controlling for SOFA (OR = 11.182; 95% CI = 1.053–118.700; p = 0.04) or APACHE-II (OR = 17.604; 95% CI = 1.629–190.211; p = 0.02), and the allele HLA-DQB1*04 after controlling for SOFA (OR = 9.963; 95% CI = 1.235–80.358; p = 0.03).

Conclusions

The new finding from our preliminary study of small sample size was that HLA genetic polymorphisms could be associated with COVID-19 mortality; however, studies with a larger sample size before definitive conclusions can be drawn.