The Portuguese who Could no Longer Speak French: Primary Progressive Aphasia (PPA) in a Bilingual Man

Introduction:

PPA is characterized by progressive language dissolution, with remarkable spare of other cognitive domains for at least two years, and should be considered in the differential diagnosis of dementia.

Clinical case:

A 56-year-old previously healthy man was seen for speech difficulties. He studied Portuguese for 4 years, and then went to live in France, where he learned French for 3 years. He returned definitely to Portugal when he was 42. Since early adolescence he was fluent on speaking, reading and writing in both languages. In the last 12 years he spoke French mainly when visiting his family. Three years ago he started showing disintegration of his second language preceding that of his native one. Upon examination he had laborious, effortful, nonfluent and agrammatic speech, with severe anomia and some repetition and complex-command comprehension difficulties. He could not name, understand or write any French word. The remaining neurological examination was near-normal to age and education level (MMSE - 25/30). Brain MRI showed left-side predominant frontotemporal cortical atrophy. PET scan revealed hypometabolism in the same area and the temporal lobe, anterior cynguli and dorsolateral frontal cortex.

Conclusion:

Our patient has nonfluent variant of PPA. Cases like this can give further insight into the neural network subserving language acquisition and dissolution. In proficient bilinguals, the main point on language dissolution in PPA seems to be the recency of use. The best way to confirm this would be to systematically characterize PPA patients on secondary language usage, attained proficiency and disintegration sequence.

The Women who Heard Folk Portuguese Music in the Right Ear: A Case of Unilateral Musical Hallucinosis

Introduction:

Although probably undereported, musical hallucinosis is very rare and usually bilateral. It refers to auditory complex hallucinations, for which the patient has full insight, and includes melodies, tunes, rhythms and timbres.

Clinical case:

A 71-year-old women was seen for a history of hearing music in the right ear. She had mild hypertension and auricular fibrillation, being chronically medicated with aspirine, bisoprolol and hydroclorothiazide. Three months previously she started hearing some popular folk Portuguese songs in the right ear. She could identify the lyrics and sing the songs she heard. Weeks later fado and classical music were added to the repertoire, and later on she started hearing less well-formed sounds like “dlam... dlam” or “uhh... uhh”. There were no other auditory or visual hallucinations. She was seen by an otorhinolaryngologist, and made an audiogram showing bilateral, right-predominant, pre-coclear deafness with normal evoked brainstem auditory potentials. An MRI showed small deep subcortical lacunar lesions. EEG was normal. PET scan showed left temporal hypometabolism. On benzodiazepines she had discrete improvement.

Conclusion:

Musical hallucinosis has been found mainly in deaf patients, and a similar mechanism to that of Charles-Bonnet syndrome has been proposed. Sensory deprivation of primary auditory cortex would “release” the secondary auditory cortex, to produce complex auditory hallucinations with full insight. In our patient we were able to demonstrate the integrity of the brainstem pathway, supporting a direct link between diminished right ear sound transmission and left temporal lobe diminished activation as ascertained by the pet scan.

Lorazepam-induced Heightened Sexual Desire

Introduction:

Drug-induced increased libido has been reported mainly with dopaminergic agents. Although benzodiazepines may cause behavioural dishinibition, they were rarely related to sexual undesired urges.

Case:

A 62-year-old woman was seen for breast mucinous carcinoma. Besides mild hypertension and initial insomnia she was otherwise previously healthy. She was chronically medicated with ramipril and diazepam 5mg id. Tumour ressection was carried out and chemotherapy with FEC-T was began. One week after, in a follow-up visit, she complained having difficulties on sleep onset. Lorazepam 1mg at the bedtime was prescribed. After the first dose she felt an overwhelming sexual desire, the urge making her to repeatedly open and close her legs, feeling even the physical intercourse. This sensation fade gradually over the next few hours. On the following day she decided to take another lorazepam pill to be sure it was the cause of that strange feelings. The symptoms of the previous night were completely reproduced. She has now completed the chemotherapy and proposed to adjuvant radiotherapy. She never felt those symptoms again and did not take another lorazepam.

Conclusion:

It is believed that dopaminomimetic drugs can heighten sexual desire by increasing dopamine concentration on the mesolimbic pathway. In this way, benzodiazepines, as GABA enhancers, would inhibit dopamine release leading to reduced libido. On the other hand, GABA also inhibits serotoninergic-mediated vigilance and impulse control, leading to dishinibition and impulsivity. In our patient, lorazepam has caused a “virtual intercourse” as previously found in electric and mechanic stimulation of septal region and amygdala.

Relief influence on the spatial distribution of the Atlantic Forest cover on the Ibiúna Plateau, SP

Several studies suggest that, on a large scale, relief conditions influence the Atlantic Forest cover. The aim of this work was to explore these relationships on a local scale, in Caucaia do Alto, on the Ibiúna Plateau. Within an area of about 78 km(2), the distribution of forest cover, divided into two successional stages, was associated with relief attribute data (slope, slope orientation and altitude). The mapping of the vegetation was based on the interpretation of stereoscopic pairs of aerial photographs, from April 2000, on a scale of 1:10,000, while the relief attributes were obtained by geoprocessing from digitalized topographic maps on a scale of 1:10,000. Statistical analyses, based on qui-square tests, revealed that there was a more extensive forest cover, irrespective of the successional stage, in steeper areas (>10 degrees) located at higher altitudes (>923 m), but no influence of the slope orientation. There was no sign of direct influence of relief on the forest cover through environmental gradients that might have contributed to the forest regeneration. Likewise, there was no evidence that these results could have been influenced by the distance from roads or urban areas or with respect to permanent preservation areas. Relief seems to influence the forest cover indirectly, since agricultural land use is preferably made in flatter and lower areas. These results suggest a general distribution pattern of the forest remnants, independent of the scale of study, on which relief indirectly has a strong influence, since it determines human occupation.

Non-viral lipid-based nanoparticles for targeted cancer systemic gene silencing

New molecular biology techniques have uncovered the hidden role of genes in cancer. Identification of activated oncogenes, as fundamental genetic differences relative to normal cells, has made it possible to consider such genes as targets for antitumor therapy, namely by applying gene silencing strategies. In this regard, antisense oligonucleotides or small interfering RNAs, constitute promising therapeutic tools. The widespread clinical application of such molecules as modulators of gene expression, is still dependent on several aspects that limit their bioavailability, including: enhanced biological stability, favourable pharmacokinetics, enhanced tumor cell uptake and, consequently, efficient targeted delivery. One of the most promising strategies to overcome the barriers faced by gene silencing molecules, upon systemic administration, involves the use of lipid-based nanoparticles. The first part of this review aims at providing the reader with the molecular mechanism of action of the most important gene silencing molecules used in anticancer therapy. The primary obstacle for translating gene silencing technology from an effective research tool into a feasible therapeutic strategy remains its efficient delivery to the targeted cell type in vivo. Therefore, an overview of different lipid-based strategies for nucleic acid delivery will be presented on the second part. As we learn more about the pharmacokinetics and pharmacodynamics of the carrier and/or of the gene silencing molecules, it will be possible to further improve the delivery strategy that likely in the future will lead to the ideal non-viral particle for targeted cancer systemic gene silencing.

Cellular and molecular events associated with the antitumor response induced by the cytosine deaminase/5-fluorocytosine suicide gene therapy system in a rat liver metastasis model

The bacterial cytosine deaminase (CD) gene converts the non-toxic prodrug 5-fluorocytosine (5-FC) into 5-fluorouracil. We have previously shown, in a rat liver metastasis model from colon carcinoma, that intratumoral injection of a CD-expressing plasmid into the animals followed by 5-FC treatment results in the regression of the treated tumor as well as distant uninjected tumors. The aim of this study was to further analyze the mechanisms associated with tumor regression induced upon application of suicide CD/5-FC strategy. Tumor regression was associated with an increased apoptosis, the recruitment of natural killer cells, CD4- and CD8 T lymphocytes within the tumors and an increased expression of several cytokines/chemokines mRNAs. These data indicate that the CD/5-FC suicide strategy is associated with the triggering of cellular and molecular events leading to an efficient antitumor immune response involving both innate and acquired immunity.

siRNA delivery by a transferrin-associated lipid-based vector: a non-viral strategy to mediate gene silencing

BACKGROUND

RNA interference provides a powerful technology for specific gene silencing. Therapeutic applications of small interfering RNA (siRNA) however require efficient vehicles for stable complexation, protection, and extra- and intracellular delivery of these nucleic acids. Here, we evaluated the potential of transferrin (Tf)-associated liposomes for siRNA complexation and gene silencing.

METHODS

Cationic liposomes composed of DOTAP : Cholesterol associated with or without transferrin (Tf) were complexed with siRNA at different lipid/siRNA charge ratios. Complexation and protection of siRNA from enzymatic degradation was assessed with the PicoGreen intercalation assay and gel electrophoresis. Cellular internalization of these siRNA Tf-lipoplexes was detected by confocal microscopy. Luciferase assay, immunoblot and fluorescence-activated cell sorting (FACS) analysis were used to evaluate reporter gene silencing in Huh-7 hepatocarcinoma and U-373 glioma cells. c-Jun knockdown in HT-22 cells was evaluated by quantitative real-time polymerase chain reaction (RT-PCR). Cytotoxicity of the siRNA complexes was assessed by Alamar blue, lactate dehydrogenase and MTT assays.

RESULTS

Complexation of siRNA with the cationic liposomes in the presence of Tf results in the formation of stable particles and prevents serum-mediated degradation. Confocal microscopy showed fast cellular internalization of the Tf-lipoplexes via endocytosis. In the GFP glioma cells Tf-lipoplexes showed enhanced gene silencing at minimum toxicity in comparison to Tf-free lipoplexes. Targeting luciferase in the hepatocarcinoma cell line resulted in more than 70% reduction of luciferase activity, while in HT-22 cells 50% knockdown of endogenous c-Jun resulted in a significant protection from glutamate-mediated toxicity.

CONCLUSIONS

Cationic liposomes associated with Tf form stable siRNA lipoplexes with reduced toxicity and enhanced specific gene knockdown activity compared to conventional lipoplexes. Thus, such formulations may constitute efficient delivery systems for therapeutic siRNA applications.

Evaluation of the antitumoral effect mediated by IL-12 and HSV-tk genes when delivered by a novel lipid-based system

In the present work, we used a novel albumin-associated lipoplex formulation, containing the cationic lipid 1-palmitoyl-2-oleoyl-sn-glycero-3-ethylphosphocholine (EPOPC) and cholesterol (Chol), to evaluate the antitumoral efficacy of two gene therapy strategies: immuno-gene therapy, mediated by IL-12 gene expression, and "suicide" gene therapy, mediated by HSV-tk gene expression followed by ganciclovir (GCV) treatment. Our data show that, in an animal model bearing a subcutaneous TSA (mouse mammary adenocarcinoma) tumor, intratumoral administration of the albumin-associated complexes containing the plasmid encoding IL-12 results in a strong antitumoral effect, as demonstrated by the smaller tumor size, the higher T-lymphocyte tumor infiltration and the more extensive tumor necrotic and hemorrhagic areas, as compared to that observed in animals treated with control complexes. On the other hand, the application of the "suicide" gene therapy strategy results in a significant antitumoral activity, which is similar to that achieved with the immuno-gene therapy strategy, although involving different antineoplastic mechanisms. For the tested model, albumin-associated complexes were shown to efficiently mediate intratumoral delivery of therapeutic genes, thus leading to a significant antitumoral effect. This finding is particularly relevant since TSA tumors are characterized for being poorly immunogenic, aggressive and exhibiting high proliferation capacity.

Tf-lipoplex-mediated NGF gene transfer to the CNS: neuronal protection and recovery in an excitotoxic model of brain injury

The development of efficient systems for in vivo gene transfer to the central nervous system (CNS) may provide a useful therapeutic strategy for the alleviation of several neurological disorders. In this study, we evaluated the feasibility of nonviral gene therapy to the CNS mediated by cationic liposomes. We present evidence of the successful delivery and expression of both a reporter and a therapeutic gene in the rodent brain, as evaluated by immunohistochemical assays. Our results indicate that transferrin-associated cationic liposome/DNA complexes (Tf-lipoplexes) allow a significant enhancement of transfection activity as compared to plain complexes, and that 8/1 (+/-) Tf-lipoplexes constitute the best formulation to mediate in vivo gene transfer. We demonstrated that Tf-lipoplex-mediated nerve growth factor transgene expression attenuates the morphological damages of the kainic acid-induced lesion as assessed by 2,3,5-triphenyltetrazolium chloride (TTC) vital staining. These findings suggest the usefulness of these lipid-based vectors in mediating the delivery of therapeutic genes to the CNS.

Association of albumin or protamine to lipoplexes: enhancement of transfection and resistance to serum

BACKGROUND

The successful application of gene therapy depends on the availability of carriers to efficiently deliver genetic material into target cells. Such efficacy is strongly related to key parameters including serum resistance and protection of DNA.

METHODS

The complexes were tested in terms of their biological activity, in the absence or presence of serum, by following transfection activity. Interaction with plasma proteins was evaluated by immunoblotting, while cytotoxicity was assessed by the Alamar Blue assay. Extent of DNA protection was determined both by using ethidium bromide intercalation and DNase I digestion assays.

RESULTS

Our results show that, depending on the charge ratio and on the lipid composition, albumin and protamine can be used (either individually or co-associated) to generate cationic liposome/DNA complexes fulfilling in vivo requirements, while exhibiting high levels of transfection activity. In the present work a novel cationic lipid was tested. It was demonstrated that 1-palmitoyl-2-oleoyl-sn-glycero-3-ethylphosphocholine (EPOPC):cholesterol (Chol) liposomes constitute a very promising carrier for gene delivery as illustrated by their enhancing effect on transfection, as compared with DOTAP-containing liposomes. Moreover, the biological activity of EPOPC-containing complexes is significantly improved upon association of albumin, even in the presence of 60% serum (namely for the 4/1 lipid/DNA charge ratio). Nevertheless, our studies also show that transfection activity mediated by DOTAP-containing complexes can be significantly enhanced upon pre-condensation of DNA with protamine.

CONCLUSIONS

Co-association of HSA and protamine to lipoplexes ensures a high degree of DNA protection and results in high levels of transfection activity even in the presence of serum.

Two African swine fever virus proteins derived from a common precursor exhibit different nucleocytoplasmic transport activities

African swine fever virus (ASFV), a large icosahedral deoxyvirus, is the causative agent of an economically relevant hemorrhagic disease that affects domestic pigs. The major purpose of the present study was to investigate the nuclear transport activities of the ASFV p37 and p14 proteins, which result from the proteolytic processing of a common precursor. Experiments were performed by using yeast-based nucleocytoplasmic transport assays and by analysis of the subcellular localization of different green fluorescent and Myc fusion proteins in mammalian cells. The results obtained both in yeast and mammalian cells clearly demonstrated that ASFV p14 protein is imported into the nucleus but not exported to the cytoplasm. The ability of p37 protein to be exported from the nucleus to the cytoplasm of both yeast and mammalian cells was also demonstrated, and the results clearly indicate that p37 nuclear export is dependent on the interaction of the protein with the CRM-1 receptor. In addition, p37 was shown to exhibit nuclear import activity in mammalian cells. The p37 protein nuclear import and export abilities described here constitute the first report of a nucleocytoplasmic shuttling protein encoded by the ASFV genome. Overall, the overlapping results obtained for green fluorescent protein fusions and Myc-tagged proteins undoubtedly demonstrate that ASFV p37 and p14 proteins exhibit nucleocytoplasmic transport activities. These findings are significant for understanding the role these proteins play in the replication cycle of ASFV.

Cationic liposomes for gene delivery: from biophysics to biological applications

The use of an efficient carrier for nucleic acid-based medicines is considered to be a determinant factor for the successful application of gene therapy. The drawbacks associated with the use of viral vectors, namely those related with safety problems, have prompted investigators to develop alternative methods for gene delivery, cationic lipid-based systems being the most representative. Despite extensive research in the last decade on the use of cationic liposomes as gene transfer vectors and the development of elegant strategies to enhance their biological activity, these systems are still far from being viable alternatives to the use of viral vectors in gene therapy. In this review considerations are made regarding the structure-activity relationships of cationic liposome/DNA complexes and the key formulation parameters influencing the features of lipoplexes are presented and discussed in terms of their effect on biological activity. Particular emphasis is given to the interaction of the lipoplexes with serum components as well as to novel strategies developed to circumvent difficulties that may emerge upon iv administration of the complexes. Finally, since the ability of the lipoplexes to be stored while preserving their transfection activity is a crucial issue for the repeated use of such carriers, approaches reported on the improvement of their physical stability are also reviewed.

Role of nitric oxide of the median preoptic nucleus (MnPO) in the alterations of salivary flow, arterial pressure and heart rate induced by injection of pilocarpine into the MnPO and intraperitoneally

We investigated the effect of L-NAME, a nitric oxide (NO) inhibitor and sodium nitroprusside (SNP), an NO-donating agent, on pilocarpine-induced alterations in salivary flow, mean arterial blood pressure (MAP) and heart rate (HR) in rats. Male Holtzman rats (250-300 g) were implanted with a stainless steel cannula directly into the median preoptic nucleus (MnPO). Pilocarpine (10, 20, 40, 80, 160 g) injected into the MnPO induced an increase in salivary secretion (P<0.01). Pilocarpine (1, 2, 4, 8, 16 mg/kg) ip also increased salivary secretion (P<0.01). Injection of L-NAME (40 g) into the MnPO prior to pilocarpine (10, 20, 40, 80, 160 g) injected into the MnPO or ip (1, 2, 4, 8, 16 mg/kg) increased salivary secretion (P<0.01). SNP (30 g) injected into the MnPO or ip prior to pilocarpine attenuated salivary secretion (P<0.01). Pilocarpine (40 g) injection into the MnPO increased MAP and decreased HR (P<0.01). Pilocarpine (4 mg/kg body weight) ip produced a decrease in MAP and an increase in HR (P<0.01). Injection of L-NAME (40 g) into the MnPO prior to pilocarpine potentiated the increase in MAP and reduced HR (P<0.01). SNP (30 g) injected into the MnPO prior to pilocarpine attenuated (100%) the effect of pilocarpine on MAP, with no effect on HR. Administration of L-NAME (40 g) into the MnPO potentiated the effect of pilocarpine injected ip. SNP (30 g) injected into the MnPO attenuated the effect of ip pilocarpine on MAP and HR. The present study suggests that in the rat MnPO 1) NO is important for the effects of pilocarpine on salivary flow, and 2) pilocarpine interferes with blood pressure and HR (side effects of pilocarpine), that is attenuated by NO.

The possibility of B-cell-dependent T-cell development

The development of T cells is thought to be independent of B cells. However, defects in cell-mediated immunity in individuals with B-cell deficiency suggest the contrary. To test whether B cells affect T-lymphocyte development, we constructed mice with a monoclonal T-cell compartment (MT) and monoclonal B- and T-cell compartments (MBTs). In these mice, the T cells expressed a DO 11.10 transgenic (DO-T) cell receptor restricted to major histocompatibility complex (MHC) class IId. While CD4+ DO-T lymphocytes are rare in transgenic H-2b MT mice, we found that in H-2b MBT mice under the influence of B cells, DO-T lymphocytes mature into large numbers of CD4+ peripheral T cells. H-2b MBT mice have more CD4+ thymocytes than H-2b MT mice. These data are consistent with the view that B cells play some role in thymocyte development.

Evaluation of lipid-based reagents to mediate intracellular gene delivery

We characterized different cationic lipid-based gene delivery systems consisting of both liposomes and nonliposomal structures, in terms of their in vitro transfection activity, resistance to the presence of serum, protective effect against nuclease degradation and stability under different storage conditions. The effect of lipid/DNA charge ratio of the resulting complexes on these properties was also evaluated. Our results indicate that the highest levels of transfection activity were observed for complexes prepared from nonliposomal structures composed of FuGENE 6. However, their DNA protective effect was shown to be lower than that observed for cationic liposome formulations when prepared at the optimal (+/-) charge ratio. Our results suggest that lipoplexes are resistant to serum up to 30% when prepared at a 2:1 lipid/DNA charge ratio. However, when they were prepared at higher (+/-) charge ratios, they become sensitive to serum for even lower concentrations (10%). Replacement of dioleoyl-phosphatidylethanolamine (DOPE) by cholesterol enhanced the resistance of the complexes to the inhibitory effect of serum. This different biological activity in the presence of serum was attributed to different extents of binding of serum proteins to the complexes, as evaluated by the immunoblotting assay. Studies on the stability under storage show that lipoplexes maintain most of their biological activity when stored at -80 degrees C, following their fast freezing in liquid nitrogen.

Zinc, magnesium and copper profiles in three experimental models of epilepsy

Trace metals are involved in the mechanisms of CNS excitability, including epilepsy. In this study, atomic absorption spectrophotometry was used to determine concentrations of Mg(2+), Cu(2+) and Zn(2+) in plasma (microg/ml) and hair (microg/g) samples. Differential profiles of trace metals were detected in rats displaying three different kinds of seizures, i.e. acute audiogenic seizures (generalized tonic-clonic type GTC) and audiogenic kindling (limbic type; LS) in Wistar Audiogenic Rats (WARs) and electroshock-induced seizures (ES) in Wistar non-epileptic rats (resistant). Significantly lower Zn(2+) concentrations were observed in the plasma of WARs (0.80+/-0.02) compared with resistants (0.89+/-0.03) in the basal (non-seizing) condition. After GTC, WARs showed lower Zn(2+) levels (0.64+/-0.12) while both Mg(2+) (12.56+/-1.51) and Cu(2+) (0.81+/-0.14) were higher than in non-seizing WARs. After ES-induced seizures only Mg(2+) changed, being higher than in the basal condition (11.78+/-2.25 and 8.90+/-0.95). In hair, basal levels of Mg(2+) and Cu(2+) (192.49+/-36.73 and 13.33+/-1.76) were higher whereas Zn(2+) (136.53+/-15.67) was lower in WARs than in resistants. WARs submitted to 0, 3 and 25 stimuli presented higher Mg(2+) concentrations as the number of stimuli increased. In animals receiving the same number of stimuli, Zn(2+) levels were higher for animals displaying GTC (151.09+/-5.53) than those displaying LS (128.07+/-8.51). In conclusion, seizure type (limbic or generalized tonic-clonic) and number of stimuli seem to be the determinant factors for changes in Zn(2+) and Mg(2+) levels, respectively.

Interaction between paraventricular nucleus and septal area in the control of physiological responses induced by angiotensin II

We determined the effects of losartan (40 nmol) and PD 123319 (40 nmol) (both non-peptides and selective antagonists of the AT1 and AT2 angiotensin receptors, respectively), and [Sar1, Ala8] angiotensin II (ANG II) (40 nmol) (a non-selective peptide antagonist of angiotensin receptors) injected into the paraventricular nucleus (PVN) on the water and salt appetite, diuresis and natriuresis and mean arterial pressure (MAP) induced by administration of 10 nmol of ANG II into the medial septal area (MSA) of male Holtzman rats weighing 250-300 g. The volume of drug solution injected was 0.5 micro l over a period of 10-15 s. The responses were measured over a period of 120 min. ANG II alone injected into the MSA induced an increase in all the above parameters (8.1 +/- 1.2, 1.8 +/- 0.3, and 17.1 +/- 1.0 ml, 217 +/- 25 micro Eq/120 min, and 24 +/- 4 mmHg, respectively, N = 10-12) compared with vehicle-treated rats (1.4 +/- 0.2, 0.6 +/- 0.1, and 9.3 +/- 0.5 ml, 47 +/- 5 micro Eq/120 min, and 4.1 +/- 0.8 mmHg, respectively, N = 10-14). Pretreatment with losartan and [Sar1, Ala8] ANG II completely abolished the water and sodium intake, and the pressor increase (0.5 +/- 0.2, 1.1 +/- 0.2, 0.5 +/- 0.2, and 0.8 +/- 0.2 ml, and 1.2 +/- 3.9, 31 +/- 4.6 mmHg, respectively, N = 9-12), whereas losartan blunted the urinary and sodium excretion induced by ANG II (13.9 +/- 1.0 ml and 187 +/- 10 micro Eq/120 min, respectively, N = 9). Pretreatment with PD 123319 and [Sar1, Ala8] ANG II blocked the urinary and sodium excretion (10.7 +/- 0.8, 9.8 +/- 0.7 ml, and 67 +/- 13 and 57 +/- 17 micro Eq/120 min, respectively, N = 9), whereas pretreatment with PD 123319 partially blocked the water and sodium intake, and the MAP induced by ANG II administration (2.3 +/- 0.3, 1.1 +/- 0.1 ml, and 12 +/- 3 mmHg, respectively, N = 9-10). These results suggest the angiotensinergic effect of the MSA on the AT1 and AT2 receptors of the PVN in terms of water and sodium homeostasis and MAP modulation.