Does JC polyomavirus cause nephropathy in renal transplant patients?

INTRODUCTION

BK polyomavirus (BKV) reactivation characterized by active viruria occurs in 23%-57% of renal allograft recipients and BKV-associated nephropathy in as many as 8% of renal allograft recipients. Only a few cases of nephritis have been attributed to JC polyomavirus (JCV) with limited information about JCV replication and its impact on graft function and survival of kidney transplant patients. We sought to determine the prevalence of BKV and JCV replication, the risk factors associated with viral reactivation, and their implications for the development of polyomavirus nephropathy (PVN) among renal transplant patients.

MATERIALS AND METHODS

The study included 186 kidney transplant recipients who were transplanted between 2005 and 2009 with a 1-year follow-up. If the urine polymerase chain reaction (PCR) was positive, we performed a PCR on blood. If this was positive or renal dysfunction was present, we performed a renal biopsy.

RESULTS

Viruria was positive in 72 cases (39%) and viremia in 12 (6.5%); including, 3 patients (1.6%) who developed PVN. In the patients with viruria, BKV was detected in 47% and JCV in 46%; both were detected in 7%, although the combination of viremia and nephropathy were caused by BKV in all cases.

CONCLUSION

In renal transplant patients, the incidence of BKV and JCV viruria was similar, although in our series the JCV serotype did not cause viremia or PVN. Our experience suggested that JCV did not have the ability to cause PVN.

Morphological and biometrical features of Trypanosoma evansi isolates from an outbreak in mainland Spain

According to several authors, Trypanosoma evansi is a monomorphic trypanosome found exclusively in slender intermediate forms, although additional studies have revealed that many strains present stumpy forms on rare occasions. In a recent T. evansi outbreak in mainland Spain, several atypical forms were observed in blood smear examinations. Molecular procedures were then necessary to confirm the causal agent. Morphological and biometric measures were taken to characterize the different forms of T. evansi. In contrast to published information, the results of this study would indicate that biometrically distinct T. evansi could also be found in the same farm and even in the same animal species. These data could be useful for many trypanosomes endemic areas of the world where molecular methods are not commonly available.

Seroprevalence of Coxiella burnetii in domestic ruminants in Gran Canaria Island, Spain

Coxiella burnetii is the causative agent of Q fever, a zoonosis with worldwide occurrence. In the Canary Islands, the overall seroprevalence in humans has been estimated to be 21.5%. Gran Canaria island concentrates the highest ruminant population in the archipelago and the prevalence of the human infection is 23.5%. To evaluate the seroprevalence in livestock and the affected areas in Gran Canaria island, a total of 1249 ruminants were randomly selected for this study (733 goats, 369 sheep and 147 cattle). The samples were evaluated using an indirect ELISA Kit. The results showed seroprevalences of 60.4%, 31.7% and 12.2% in goats, sheep and cattle, respectively. Based on these results, Q fever could be considered as endemic in Gran Canaria island. Sanitary measures should be taken at the farm level to minimize the risk of exposure of C. burnetii to humans.

Renal transplantation in old recipients from expanded criteria donors selected by kidney biopsy

BACKGROUND

In Spain, the number of ideal kidney transplant donors has fallen, with at the same time an increase in the number of older recipients on the waiting list.

AIM

To analyze the results of expanded criteria cadaveric donor kidney transplants into older recipients using grafts selected by kidney biopsy.

PATIENTS AND METHODS

We studied 360 kidney transplant recipients who had been followed to December 2009: 180 in the study group and 180 in a control group composed of younger patients who received grafts from non-expanded criteria donors between 1999 and 2006. A paraffin-embedded kidney biopsy was evaluated by the percentages of sclerosed glomeruli, arteriolar hyalinosis, intimal wall thickening, interstitial fibrosis, and tubular atrophy.

RESULTS

Significant differences were observed in donor age (63.50±5.46 vs 31.90±13.29 years; P<.001) and recipient age (58.40±8.80 vs 40.71±13.23 years; P<.001). Donor renal function was significantly worse among the expanded criteria group (90.80 vs 108.11 mL/min/1.73 m2; P=.006), remaining so over time in the recipient (at 1 year: 42.08 vs 63.71 [P<.001]; at 3 years: 41.25 vs 62.31 [P<.001], and at 7 years: 38.17 vs 64.18 [P<.001]). Censored 7-year graft survivals were 73% versus 87% (P<.001) with similar patient survivals (90.5% vs 95%; P=.39).

CONCLUSIONS

Selection of expanded criteria donors by kidney biopsy resulted in good renal function as well as graft and patient survivals at 7 years in older recipients.

Fatal congenital tuberculosis due to a Beijing strain in a premature neonate

Congenital tuberculosis (TB) remains a rare disease but is fatal if untreated. Early detection is difficult because of the non-specific nature of the symptoms in TB during pregnancy and infancy. This report summarizes a case of congenital TB in a very premature infant, born at 25 weeks gestation. Miliary TB was diagnosed in the mother when the neonate was 20 days old. Antituberculous therapy allowed a rapid improvement in the mother. The infant died at 27 days old. A Beijing genotype strain of Mycobacterium tuberculosis was isolated both in the mother, from pulmonary and urine specimens, and in the infant, from peritoneal fluid.

Impact of nucleosome dynamics and histone modifications on cell proliferation during Arabidopsis development

Eukaryotic chromatin is a highly structured macromolecular complex of which DNA is wrapped around a histone-containing core. DNA can be methylated at specific C residues and each histone molecule can be covalently modified at a large variety of amino acids in both their tail and core domains. Furthermore, nucleosomes are not static entities and both their position and histone composition can also vary. As a consequence, chromatin behaves as a highly dynamic cellular component with a large combinatorial complexity beyond DNA sequence that conforms the epigenetic landscape. This has key consequences on various developmental processes such as root and flower development, gametophyte and embryo formation and response to the environment, among others. Recent evidence indicate that posttranslational modifications of histones also affect cell cycle progression and processes depending on a correct balance of proliferating cell populations, which in the context of a developing organisms includes cell cycle, stem cell dynamics and the exit from the cell cycle to endoreplication and cell differentiation. The impact of epigenetic modifications on these processes will be reviewed here.

Circulating and adipose tissue gene expression of zinc-alpha2-glycoprotein in obesity: its relationship with adipokine and lipolytic gene markers in subcutaneous and visceral fat

CONTEXT

Zinc-alpha2-glycoprotein (ZAG) is a soluble protein similar to the class I major histocompatibility complex heavy chain, which has been implicated in lipid catabolism. We hypothesized that ZAG mRNA expression in adipose tissue may be linked with lipolytic and adipokine gene expression and have a close relationship with clinical phenotype.

OBJECTIVES

The objective of the study was to analyze ZAG gene expression in human adipose tissue from lean and obese subjects. ZAG circulating plasma levels and its relationship with cardiometabolic risk factors were also studied.

DESIGN

Seventy-three Caucasian (43 male and 30 female) subjects were included. Plasma and adipose tissue [sc (SAT) and visceral (VAT)] from the same patient were studied. mRNA of PPARgamma, hormone-sensitive lipase (HSL), adipose triglyceride lipase, adiponectin, omentin, visfatin, and ZAG were quantified. Plasma concentrations of ZAG were determined with ELISA.

RESULTS

ZAG plasma levels showed a negative correlation with insulin (r = -0.39; P = 0.008) and the homeostasis model assessment for insulin resistance index (r = -0.36; P = 0.016). No differences in ZAG circulating levels according to body mass index classification were observed. ZAG expression in SAT was significantly reduced in overweight and obese individuals compared with lean subjects (P < 0.001 and P = 0.007, respectively). ZAG mRNA expression in both SAT and VAT depots were negatively correlated with many clinical and metabolic cardiovascular risk factors. After multiple linear regression analysis, SAT ZAG was mainly predicted by adiponectin mRNA expression (B = 0.993; P < 0.0001) and plasma triglyceride levels (B = -0.565; P = 0.006). VAT ZAG expression was predicted by adiponectin expression (B = 0.449; P < 0.0001), and HSL VAT expression (B = 0.180; P = 0.023).

CONCLUSIONS

The present study provides evidence of a role of ZAG gene in adipose tissue metabolism, with a close association with adiponectin gene expression in sc and visceral fat.

Evaluation of the efficacy and safety of conversion to sirolimus in 85 renal transplant recipients

OBJECTIVE

Treatment with sirolimus (SRL) is a potential therapeutic option for renal transplant recipients, especially those who have developed chronic graft nephropathy (CGN) or a neoplasm. Our aim was to analyze the efficacy and safety of conversion to SRL in renal transplant recipients.

MATERIALS AND METHODS

We undertook a retrospective study of 85 patients converted to SRL, 47% for tumors, 39% for CGN, and 14% for other causes. The follow-up period was 34 months (range, 1-93 months).

RESULTS

Baseline creatinine was 1.8 +/- 0.69 mg/dL (1.6 +/- 0.59 for tumors and 2.3 +/- 0.6 for CGN). At 1 year, the creatinine was the same in both groups: 1.8 mg/dL (P = NS). Graft survival at 12 months was 89% (81% for tumors, 81% for CGN, and 100% for other causes). SRL was withdrawn in 34% of patients: 18% for severe side effects, 7% for patient death, and 9% for graft loss. The serum creatinine and proteinuria were significantly increased among those subjects who returned to dialysis because of CGN compared with those with conserved renal function. Patients who developed pneumonitis showed a lower baseline aMDRD, but no difference in SRL levels. Side effects occurred in 40% of patients, with no difference in renal function, proteinuria, or SRL levels. Renal function showed a significant improvement in the patients who continued SRL (aMDRD 45.7 vs 50.7 mL/min/1.73 m(2) at 12 months; P = .08), more marked among those who converted due to CGN. Increases were seen in levels of serum lipids, as well as in the percentage of patients treated with statins. Proteinuria increased significantly, as did the percentage of patients treated with ACE inhibitors/ARA2.

CONCLUSIONS

Conversion to SRL in patients with CGN was safe when renal function had not undergone marked worsening and there was no proteinuria. Patients who were converted experienced an improvement in renal function.

No evidence for genetic association of interferon regulatory factor 3 in systemic lupus erythematosus

The aim of this study was to determine the potential role of three IRF3 gene polymorphisms (rs2304204, rs7251 and rs2304207) with systemic lupus erythematosus (SLE). Our study population consisted of 610 patients with SLE and 730 healthy controls. All individual were of Spanish Caucasian origin. The IRF3 polymorphisms were genotyped using a PCR system with pre-developed TaqMan allelic discrimination assay. No statistically significant differences were found when allele and genotype distribution of rs2304204, rs7251 and rs2304207 polymorphisms were compared between patients with SLE and controls [overall P values: rs7251, P = 0.06; rs2304204, P = 0.26 and rs2304207, P = 0.36, by chi-squared test on a 3 x 2 contingency table. Overall allelic P values: rs7251, P = 0.8, OR (95%CI) = 1.03 (0.87-1.22); rs2304204, P = 0.2, OR (95%CI) = 1.12 (0.93-1.34) and rs2304207, P = 0.8, OR (95%CI) = 1.02 (0.82-1.26)]. In addition, no evidence of association with haplotypes and clinical features of SLE was found. Our data suggest that the IRF3 polymorphisms do not appear to play a major role in the susceptibility or severity of SLE in a Spanish population.

Investigation of TLR5 and TLR7 as candidate genes for susceptibility to systemic lupus erythematosus

OBJECTIVES

The aim of this study was to evaluate the relevance of genetic variants of TLR5 (rs5744168) and TLR7 (rs179008) gene in systemic lupus erythematosus (SLE) in a Spanish population.

MATERIAL AND METHODS

Our study population consisted of 752 SLE patients and 1107 healthy controls. All individual were of Spanish Caucasian origin. The TLR5 and TLR7 polymorphisms were genotyped using a PCR system with pre-developed TaqMan allelic discrimination assay.

RESULTS

No statistically significant differences were observed when the allele and genotype distribution of TLR5 rs5744168 and TLR7 rs179008 polymorphisms was compared between SLE patients and healthy controls. A significant increase frequency in the CC genotype of the TLR5 rs5744168 polymorphism among SLE patients without nephritis was found (93% vs. 87% in SLE patients with nephritis, p=0.03, OR=2.11 95%CI 0.93-3.51). However, this difference did not reach statistical significance in the allele frequencies (p=0.08).

CONCLUSION

These results suggest that the tested variations of TLR5 and TLR7 genes do not confer a relevant role in the susceptibility or severity to SLE in the Spanish population.

Use of cymelarsan in goats chronically infected with Trypanosoma evansi

Toxicity and therapeutic trials using Cymelarsan (an arsenical compound) against Trypanosoma evansi infection were carried out using chronically infected goats. For the toxicity trial, 40 goats were divided into four groups of 10 animals each; the first three groups received s.c. injections of 5, 10, and 15 mg/kg bw of Cymelarsan, respectively, and the last one served as control. No systemic reaction was observed in any goat throughout the experiment. For the therapeutic trial, 15 adult female goats were inoculated intravenously with at least 1 x 10(5)T. evansi isolated in the Canary Islands. Six months after inoculation, the animals were treated with Cymelarsan at single dose of 0.3 mg/kg (5 animals), 0.5 mg/kg (5 animals), and 0.625 mg/kg (5 animals). At 4 and 6 weeks after treatment, two goats belonging to 0.3 mg/kg group showed recurrence of trypanosomes. Parasitemia, however, was negative in all animals belonging to 0.5 and 0.625 mg/kg groups until the end of the experiment (6 months after treatment). Thus, it can be concluded that Cymelarsan is a safe trypanocidal drug for goats and that the curative dose is 0.5 mg/kg or above.