Intuitive pharmacogenetics: spontaneous risperidone dosage is related to CYP2D6, CYP3A5 and ABCB1 genotypes

The aim of this study is to evaluate whether the quantitative prescription of risperidone (dosage) is related to the patient's metabolic status. Metabolic status was defined in terms of the most relevant polymorphisms of CYP2D6 (*3, *4, *5, *6 and *1xN), CYP3A5 (*3A) and ABCB1 (G2677T) determined a posteriori and blinded to the clinicians. This prospective and observational study includes a cohort of 151 Caucasian psychiatric patients treated with risperidone. Significant differences (Kruskal-Wallis test p=0.01) among the doses administered were observed to correlate (Spearman's r=1, p=0.02) with the different CYP2D6 groups. Poor metabolizers received the lowest doses and ultra rapid metabolizers the highest. No significant correlations were observed with regard to CYP3A5 and ABCB1. We find that, despite not knowing patients' metabolic status, clinicians modify risperidone dosage in order to obtain the best therapeutic option.

Physicochemical analysis of full-fat, reduced-fat, and low-fat artisan-style goat cheese

The objective of this study was to examine the physicochemical properties of cheese elaborated via traditional artisan methods using goat milk containing 5, 1.5, or 0.4% fat and ripened for 1, 7, 14, or 28 d. Seventy-two cheeses were produced (2 batches x 3 fat levels x 4 ripening times x triplicate). Proximal composition, pH, texture analysis, and color were recorded in each cheese. Protein and moisture were increased in cheese, and fat and fat in DM were decreased with decreasing fat in milk. Internal and external pH was higher in low-fat and reduced-fat cheese, and pH values decreased during the first 2 wk of ripening but increased slightly on d 28. Cheese fracturability, cohesiveness, masticability, and hardness increased with decreasing fat, whereas elasticity and adhesiveness decreased. Cheese lightness and red and yellow indexes decreased with decreasing fat content; during ripening, lightness decreased further but yellow index increased.

Lack of association between antipsychotic-induced extrapyramidal symptoms and polymorphisms in dopamine metabolism and transport genes

The purpose of this study was to investigate the relationship between functional polymorphisms in genes coding for dopamine metabolism and transport enzymes and the incidence of acute antipsychotic (AP)-induced extrapyramidal symptoms (EPS). We did not find evidence of the involvement of these polymorphisms in the predisposition towards or protection from EPS.

Administration of a probiotic associated with nasal vaccination with inactivated Lactococcus lactis-PppA induces effective protection against pneumoccocal infection in young mice

Streptococcus pneumoniae is a serious public health problem, especially in developing countries, where available vaccines are not part of the vaccination calendar. We evaluated different respiratory mucosa immunization protocols that included the nasal administration of Lactococcus lactis-pneumococcal protective protein A (PppA) live, inactivated, and in association with a probiotic (Lc) to young mice. The animals that received Lc by the oral and nasal route presented the highest levels of immunoglobulin (Ig)A and IgG anti-PppA antibodies in bronchoalveolar lavages (BAL) and IgG in serum, which no doubt contributed to the protection against infection. However, only the groups that received the live and inactivated vaccine associated with the oral administration of the probiotic were able to prevent lung colonization by S. pneumoniae serotypes 3 and 14 in a respiratory infection model. This would be related to a preferential stimulation of the T helper type 1 (Th1) cells at local and systemic levels and with a moderate Th2 and Th17 response, shown by the cytokine profile induced in BAL and by the results of the IgG1/IgG2a ratio at local and systemic levels. Nasal immunization with the inactivated recombinant strain associated with oral Lc administration was able to stimulate the specific cellular and humoral immune response and afford protection against the challenge with the two S. pneumoniae serotypes. The results obtained show the probiotic-inactivated vaccine association as a valuable alternative for application to human health, especially in at-risk populations, and are the first report of a safe and effective immunization strategy using an inactivated recombinant strain.

ARVCF single marker and haplotypic association with schizophrenia

We present a schizophrenia association study using an extensive linkage disequilibrium (LD) mapping approach in seven candidate genes with a well established link to dopamine, including receptors (DRD2, DRD3) and genes involved in its metabolism and transport (ACE, COMT, DAT, MAO-A, MAO-B). The sample included 242 subjects diagnosed with schizophrenia and related disorders and 373 hospital-based controls. 84 tag SNPs in candidate genes were genotyped. After extensive data cleaning 70 SNPs were analyzed for association of single markers and haplotypes. One block of four SNPs (rs165849, rs2518823, rs887199 and rs2239395) in the 3' downstream region of the COMT gene which included a non-dopaminergic candidate gene, the ARVCF (Armadillo like VeloCardio Facial) gene, was associated with the risk of schizophrenia. The genetic region including the ARVCF gene in the 22q11.21 chromosome is associated with schizophrenia in a Spanish series. Our results will assist in the interpretation of the controversy generated by genetic associations of COMT and schizophrenia, which could be the result of different LD patterns between COMT markers and the 3' region of the ARVCF gene.

Distinct genomic aberration patterns are found in familial breast cancer associated with different immunohistochemical subtypes

Five breast cancer subtypes have been described in sporadic breast cancer (SBC) using expression arrays: basal-like, ERBB2, normal breast-like, luminal A and B. These molecular subtypes show different genomic aberration patterns (GAPs). Recently, our group described these breast cancer subtypes in 50 non-BRCA1/2 familial tumors using immunohistochemistry assays. We extended this study to the other classes of familial breast cancer (FBC), including 62 tumors (18 BRCA1, 16 BRCA2 and 28 non-BRCA1/2), with the same panel of 25 immunohistochemical (IHC) markers and histological grade obtaining a similar classification. We combined these data with results generated by a 1 Mb BAC array-based CGH study to evaluate the genomic aberrations of each group. We found that BRCA1-related tumors are preferentially basal-like, whereas non-BRCA1/2 familial tumors are mainly luminal A subtype. We described distinct GAPs related to each IHC subtype. Basal tumors had a greater number of gains/losses, while luminal B tumors had more high-level DNA amplifications. Our data are similar to those obtained in SBC studies, highlighting the existence of distinct genetic pathways of tumor evolution, common to both SBC and FBC.

Case of Staphylococcus schleiferi subspecies coagulans endocarditis and metastatic infection in an immune compromised host

Staphylococcus schleiferi subspecies coagulans is a relatively recently described organism with limited human pathogenicity. Described case reports of infection are primarily limited to canine external otitis with only one reported case of human involvement, localized to a surgical wound infection. Similarities in phenotypic and microbiological characteristics between S. schleiferi subsp. coagulans and S. aureus have resulted in frequent mistakes using common methods of identification. We describe the first case of disseminated human infection with this species, definitively identified using DNA sequencing, and successfully treated with conventional therapy.

[Alternative approaches to ovarian stimulation]

Ovarian stimulation during GnRH agonists treatment can sometimes result in hyperstimulation with the risk of serious complication. Therefore, other protocols, associating antagonists, have been set out in the search for more effective ovarian stimulation resulting in satisfactory implantation with fewer complications. Still, these protocols need confirmation of their efficiency, which most other series have not reported yet; while a higher rate of unsuccessful egg retrieval and a reduction in the number of satisfactory transfers have been observed in the absence of stimulation. Currently, new molecules and personalized treatments offer a new perspective in ovulation induction with the aim of optimizing results and reducing complications.

Copper deficiency with pancytopenia due to enteral nutrition through jejunostomy

Copper deficiency is a rare complication of enteral nutrition. Haematologic abnormalities such as neutropenia and anaemia, but not pancytopenia, have been described associated to copper deficiency. We report the case of a patient requiring long term enteral nutrition through jejunostomy who developed copper deficiency and pancytopenia. In 1991, a 47-year-old woman was admitted with severe gastroesophageal mucositis after an attempted suicide with caustic intake. Enteral nutrition with a commercial, polymeric, fiber-containing formula was started. Twenty-eight months later, the patient developed anemia and neutropenia that did not respond to combined iron and parenteral vitamin B(12) supplementation. In 1996 the patient showed pancytopenia and low serum levels of copper and ceruloplasmin. Pancytopenia improved after copper supplementation. Possible mechanism causing copper deficiency and pancytopenia are discussed. We conclude that assessment of copper status is advisable in patients receiving long-term enteral nutrition by jejunostomy.

Alternatives for Improving Physical, Chemical, and Sensory Characteristics of Goat Cheeses: The Use of Arid-Land Forages in the Diet

To establish the effect of an alternative diet on the quality of Majorero cheese, the basic physicochemical parameters, fatty acid profile, and sensory characteristics were studied. Two groups of 20 Majorero goats were fed 2 different diets: a forage diet (DF), which had a high ratio of long fiber to concentrates (65:35), and a concentrate diet (DC), with a low ratio of long fiber to concentrates (35:65). The DF dietary fiber was supplied by native forages adapted to arid land. A total of 42 Majorero goat cheeses were used for this study: 21 in the DF group and 21 in the DC group. Seven cheeses from each group were tested after 2, 15, and 60 d of ripening. The milk produced by goats fed the DF diet had a higher fat concentration. No significant differences were observed in the milk fatty acid profile. The diet affected the chemical composition of the cheese in pH and fat content, and fat was significantly higher in cheeses made from DF milk than those from DC milk. Dietary characteristics had important effects on the medium-chain fatty acid composition (C6 to C14) of the cheese fat, giving DF cheeses the specific goat's milk flavor that is sought after for this type of cheese. The fatty acid composition (%) differed substantially among different ripening times. The DF cheeses were more appreciated by the panelists, as they had a greater variety of odors and flavors than the DC cheeses. The DF hard cheeses were described as having vegetable and fruity tones as well as tones of hay and dried fruit.

DNA profiling analysis of 100 consecutive de novo acute myeloid leukemia cases reveals patterns of genomic instability that affect all cytogenetic risk groups

We have carried out a high-resolution whole genome DNA profiling analysis on 100 bone marrow samples from a consecutive series of de novo acute myeloid leukemia (AML) cases. After discarding copy number changes that are known to be genetic polymorphisms, we found that genomic aberrations (GA) in the form of gains or losses of genetic material were present in 74% of the samples, with a median of 2 GA per case (range 0-35). In addition to the cytogenetically detected aberration, GA were present in cases from all cytogenetic prognostic groups: 79% in the favorable group, 60% in the intermediate group (including 59% of cases with normal karyotype) and 83% in the adverse group. Five aberrant deleted regions were recurrently associated with cases with a highly aberrant genome (e.g., a 1.5 Mb deletion at 17q11.2 and a 750 kb deletion at 5q31.1). Different degrees of genomic instability showed a statistically significant impact on survival curves, even within the normal karyotype cases. This association was independent of other clinical and genetic parameters. Our study provides, for the first time, a detailed picture of the nature and frequency of DNA copy number aberrations in de novo AML.