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de la Puente S, Espinoza ML, Carrillo I, Rico C, Souto H, Acedo JA, Riñón C, Garcés C, Ramos P, Muñoz D, Zamora B, Espinosa R, Huertas AL, Rozas I, González M, Martín A, Alonso JL. Hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation: experience in a pediatric oncological institution. Cir Pediatr 2023; 36:128-134. [PMID: 37417217 DOI: 10.54847/cp.2023.03.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
OBJECTIVE To analyze the risk factors associated with hemorrhagic cystitis (HC) severity and the treatment strategies available in HC patients following allogeneic hematopoietic stem cell transplantation (AHSCT). MATERIALS AND METHODS A retrospective study of medical records was carried out. Patients with HC following AHSCT treated from 2017 to 2021 were divided into two groups according to severity -mild and severe. Demographic data, disease-specific characteristics, urological sequelae, and overall mortality were compared between both groups. The hospital's protocol was used for patient management. RESULTS 33 episodes of HC were collected in 27 patients, 72.7% of whom were male. HC incidence following AHSCT was 23.4% (33/141). 51.5% of HCs were severe (grades III-IV). Severe graft host disease (GHD) (grades III-IV) and thrombopenia at HC onset were associated with severe HC (p= 0.043 and p= 0.039, respectively). This group had longer hematuria times (p< 0.001) and required more platelet transfusions (p= 0.003). In addition, 70.6% required bladder catheterization, but only 1 case needed percutaneous cystostomy. None of the patients with mild HC required catheterization. No differences were found in terms of urological sequelae or overall mortality. CONCLUSIONS Severe HC could be predicted thanks to the presence of severe GHD or thrombopenia at HC onset. Severe HC can be managed with bladder catheterization in most of these patients. A standardized protocol may help reduce the need for invasive procedures in patients with mild HC.
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Affiliation(s)
- S de la Puente
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - M L Espinoza
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - I Carrillo
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - C Rico
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - H Souto
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - J A Acedo
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - C Riñón
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - C Garcés
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - P Ramos
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - D Muñoz
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - B Zamora
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - R Espinosa
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - A L Huertas
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - I Rozas
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - M González
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
| | - A Martín
- Hospital La Paz Reference coordination. Madrid (Spain)
| | - J L Alonso
- Pediatric Surgery Department. Hospital Infantil Universitario Niño Jesús. Madrid (Spain)
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Niño-Serna LF, Mesa Muftoz C, Copete D, Trujillo M, Restrepo A, Garcés C. Experience of the use of lock therapy in pediatric patients with central venous catheter. Andes Pediatr 2023; 94:325-332. [PMID: 37909935 DOI: 10.32641/andespediatr.v94i3.4458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/03/2022] [Indexed: 11/03/2023]
Abstract
Lock therapy is useful for preserving indwelling catheters. Few lock therapy studies have been published in Latin America. OBJECTIVE To describe the clinical characteristics of pediatric patients using therapeutic and prophylactic lock therapy for six years in a high-complexity hospital in Colombia. PATIENTS AND METHOD Cross-sectional descriptive study of patients aged < 18 years who received lock therapy. Collected variables included demographic data, clinical characteristics, blood test results, therapeutic interventions, frequency of admission to the pediatric critical care unit, and mortality. Descriptive analysis was performed. RESULTS 54 patients were included in the study, most of them males, with 67 episodes of therapeutic lock therapy use. The most frequent diagnosis was hematological neoplasm (61%). Among these patients, 88% presented neutropenia while receiving lock therapy. Catheter preservation was achieved in 75% of the cases. Aminoglycosides were the most commonly used antibiotics (38%). Mortality due to catheter-related bacteremia was 6%. Catheter preservation using ethanol solution 70% was achieved in 62% of the patients with prophylactic lock therapy, all of whom had chronic gastrointestinal pathology. CONCLUSION Catheter preservation rates were 75% and 62% in patients with therapeutic and prophylactic lock therapy, respectively, with a higher rate achieved among cancer patients with neutropenia (80%). Aminoglycosides and vancomycin were the most commonly used antibiotics.
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Rueda ZV, Aguilar Y, Maya MA, López L, Restrepo A, Garcés C, Morales O, Roya-Pabón C, Trujillo M, Arango C, Copete ÁR, Vera C, Giraldo MR, Herrera M, Vélez LA. Etiology and the challenge of diagnostic testing of community-acquired pneumonia in children and adolescents. BMC Pediatr 2022; 22:169. [PMID: 35361166 PMCID: PMC8968093 DOI: 10.1186/s12887-022-03235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
Background Pneumonia is the leading cause of mortality in pediatric population. The etiology of pneumonia in this population is variable and changes according to age and disease severity and where the study is conducted. Our aim was to determine the etiology of community-acquired pneumonia (CAP) in children aged 1 month to 17 years admitted to 13 Colombian hospitals. Methods Prospective cohort study. Hospitalized children with radiologically confirmed CAP and ≤ 15 days of symptoms were included and followed together with a control group. Induced sputum (IS) was submitted for stains and cultures for pyogenic bacteria and Mycobacterium tuberculosis, and multiplex PCR (mPCR) for bacteria and viruses; urinary antigens for pneumococcus and Legionella pneumophila; nasopharyngeal swabs for viruses, and paired serology for atypical bacteria and viruses. Additional cultures were taken at the discretion of primary care pediatricians. Results Among 525 children with CAP, 71.6% had non-severe pneumonia; 24.8% severe and 3.6% very severe pneumonia, and no fatal cases. At least one microorganism was identified in 84% of children and 61% were of mixed etiology; 72% had at least one respiratory virus, 28% pyogenic bacteria and 21% atypical bacteria. Respiratory syncytial virus, Parainfluenza, Rhinovirus, Influenza, Mycoplasma pneumoniae, Adenovirus and Streptococcus pneumoniae were the most common etiologies of CAP. Respiratory syncytial virus was more frequent in children under 2 years and in severe pneumonia. Tuberculosis was diagnosed in 2.3% of children. IS was the most useful specimen to identify the etiology (33.6%), and blood cultures were positive in 3.6%. The concordance between all available diagnostic tests was low. A high percentage of healthy children were colonized by S. pneumoniae and Haemophilus influenzae, or were infected by Parainfluenza, Rhinovirus, Influenza and Adenovirus. Conclusions Respiratory viruses are the most frequent etiology of CAP in children and adolescents, in particular in those under 5 years. This study shows the challenges in making an etiologic diagnosis of CAP in pediatric population because of the poor concordance between tests and the high percentage of multiple microorganisms in healthy children. IS is useful for CAP diagnosis in pediatric population. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03235-z.
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Affiliation(s)
- Zulma Vanessa Rueda
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.
| | - Yudy Aguilar
- Grupo Investigador de Problemas en Enfermedades Infecciosas (GRIPE), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.,Clínica Universitaria Bolivariana, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - María Angélica Maya
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Lucelly López
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Andrea Restrepo
- Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellín, Colombia.,Departamento de Pediatría, Universidad CES, Medellín, Colombia
| | - Carlos Garcés
- Departamento de Pediatría y Puericultura, Grupo Pediaciencias, Universidad de Antioquia UdeA, Medellín, Colombia
| | - Olga Morales
- Departamento de Pediatría y Puericultura, Grupo Pediaciencias, Universidad de Antioquia UdeA, Medellín, Colombia.,Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Claudia Roya-Pabón
- Departamento de Pediatría y Puericultura, Grupo Pediaciencias, Universidad de Antioquia UdeA, Medellín, Colombia.,Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellín, Colombia.,Tuberculosis Clinic, Pima County Health Department, Tucson, USA
| | - Mónica Trujillo
- Clínica Universitaria Bolivariana, Universidad Pontificia Bolivariana, Medellín, Colombia.,Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellín, Colombia.,Departamento de Pediatría, Universidad CES, Medellín, Colombia
| | - Catalina Arango
- Departamento de Pediatría y Puericultura, Grupo Pediaciencias, Universidad de Antioquia UdeA, Medellín, Colombia.,Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellín, Colombia
| | - Ángela Rocio Copete
- Grupo Investigador de Problemas en Enfermedades Infecciosas (GRIPE), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.,Laboratorio Integrado de Medicina Especializada, Universidad de Antioquia UdeA, IPS Universitaria, Medellin, Colombia
| | - Cristian Vera
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin, Colombia
| | - Margarita Rosa Giraldo
- Secretaría Seccional de Salud y Protección Social de Antioquia, Gobernación de Antioquia, Medellín, Colombia
| | - Mariana Herrera
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
| | - Lázaro A Vélez
- Grupo Investigador de Problemas en Enfermedades Infecciosas (GRIPE), Facultad de Medicina, Universidad de Antioquia UdeA, Medellín, Colombia.,Unidad de Enfermedades Infecciosas, Hospital Universitario San Vicente Fundación, Medellín, Colombia
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Roya-Pabón C, Restrepo A, Morales O, Arango C, Maya MA, Bermúdez M, López L, Garcés C, Trujillo M, Carmona LF, Giraldo MR, Vélez LA, Rueda ZV. Acute Intrathoracic Tuberculosis in Children and Adolescents with Community-Acquired Pneumonia in an Area with an Intermediate Disease Burden. Pediatr Rep 2022; 14:71-80. [PMID: 35225880 PMCID: PMC8883921 DOI: 10.3390/pediatric14010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023] Open
Abstract
Tuberculosis (TB) in the pediatric population is a major challenge. Our objective was to describe the clinical and microbiological characteristics, radiological patterns, and treatment outcomes of children and adolescents (from 1 month to 17 years) with community-acquired pneumonia (CAP) caused by TB. We performed a prospective cohort study of a pediatric population between 1 month and 17 years of age and hospitalized in Medellín, Colombia, with the diagnosis of radiologically confirmed CAP that had ≤ 15 days of symptoms. The mycobacterial culture of induced sputum was used for the bacteriological confirmation; the history of TB contact, a tuberculin skin test, and clinical improvement with treatment were used to identify microbiologically negative TB cases. Among 499 children with CAP, TB was diagnosed in 12 (2.4%), of which 10 had less than 8 days of a cough, 10 had alveolar opacities, 9 were younger than 5 years old, and 2 had close contact with a TB patient. Among the TB cases, 50% (6) had microbiological confirmation, 8 had viral and/or bacterial confirmation, one patient had multidrug-resistant TB, and 10/12 had non-severe pneumonia. In countries with an intermediate TB burden, Mycobacterium tuberculosis should be included in the etiological differential diagnosis (as a cause or coinfection) of both pneumonia and severe CAP in the pediatric population.
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Affiliation(s)
- Claudia Roya-Pabón
- Grupo Pediaciencias, Departamento de Pediatría y Puericultura, Universidad de Antioquia UdeA, Medellin 050010, Colombia; (C.R.-P.); (O.M.); (C.A.); (C.G.)
- Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
- Pima County Health Department, Tuberculosis Clinic, Tucson, AZ 85713, USA
| | - Andrea Restrepo
- Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellin 050010, Colombia; (A.R.); (M.T.)
- Departamento de Pediatría, Universidad CES, Medellin 050010, Colombia
| | - Olga Morales
- Grupo Pediaciencias, Departamento de Pediatría y Puericultura, Universidad de Antioquia UdeA, Medellin 050010, Colombia; (C.R.-P.); (O.M.); (C.A.); (C.G.)
- Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
| | - Catalina Arango
- Grupo Pediaciencias, Departamento de Pediatría y Puericultura, Universidad de Antioquia UdeA, Medellin 050010, Colombia; (C.R.-P.); (O.M.); (C.A.); (C.G.)
- Departamento de Pediatría, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia
| | - María Angélica Maya
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia; (M.A.M.); (L.A.V.)
| | - Marcela Bermúdez
- Grupo Investigador de Problemas en Enfermedades Infecciosas (GRIPE), Facultad de Medicina, Universidad de Antioquia UdeA, Medellin 050010, Colombia;
| | - Lucelly López
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
| | - Carlos Garcés
- Grupo Pediaciencias, Departamento de Pediatría y Puericultura, Universidad de Antioquia UdeA, Medellin 050010, Colombia; (C.R.-P.); (O.M.); (C.A.); (C.G.)
| | - Mónica Trujillo
- Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellin 050010, Colombia; (A.R.); (M.T.)
- Departamento de Pediatría, Universidad CES, Medellin 050010, Colombia
- Section of Pediatric Infectious Diseases, Clínica Universitaria Bolivariana, Medellin 050010, Colombia
| | - Luisa Fernanda Carmona
- Secretaría Seccional de Salud y Protección Social de Antioquia, Gobernación de Antioquia, Medellin 050010, Colombia; (L.F.C.); (M.R.G.)
| | - Margarita Rosa Giraldo
- Secretaría Seccional de Salud y Protección Social de Antioquia, Gobernación de Antioquia, Medellin 050010, Colombia; (L.F.C.); (M.R.G.)
| | - Lázaro A. Vélez
- Unidad de Enfermedades Infecciosas, Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia; (M.A.M.); (L.A.V.)
- Grupo Investigador de Problemas en Enfermedades Infecciosas (GRIPE), Facultad de Medicina, Universidad de Antioquia UdeA, Medellin 050010, Colombia;
| | - Zulma Vanessa Rueda
- Grupo de Investigación en Salud Pública, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin 050031, Colombia;
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Correspondence: ; Tel.: +1-204-789-3678
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Rueda ZV, Bermúdez M, Restrepo A, Garcés C, Morales O, Roya-Pabón C, Carmona LF, Arango C, Albarracín JL, López L, Aguilar Y, Maya MA, Trujillo M, Copete ÁR, Vera C, Herrera M, Giraldo MR, Niño-Cruz GI, Vélez LA. Induced sputum as an adequate clinical specimen for the etiological diagnosis of community-acquired pneumonia (CAP) in children and adolescents. Int J Infect Dis 2022; 116:348-354. [DOI: 10.1016/j.ijid.2022.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 10/19/2022] Open
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Peña M, Ampuero M, Garcés C, Gaggero A, García P, Velasquez MS, Luza R, Alvarez P, Paredes F, Acevedo J, Farfán MJ, Solari S, Soto-Rifo R, Valiente-Echeverría F. Performance of SARS-CoV-2 rapid antigen test compared with real-time RT-PCR in asymptomatic individuals. Int J Infect Dis 2021; 107:201-204. [PMID: 33945868 PMCID: PMC8088036 DOI: 10.1016/j.ijid.2021.04.087] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/15/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022] Open
Abstract
Screening, testing and contact tracing plays a pivotal role in control of the COVID-19 pandemic. To enable this it is necessary to increase the testing capacity. This study compared a SARS-CoV-2 rapid antigen test (RAT) and RT-PCR in 842 asymptomatic individuals from Tarapacá, Chile. A sensitivity of 69.86%, specificity of 99.61%, PPV of 94.44% and NPP of 97.22% with Ct values (Ct > 27) that were significantly higher among individuals with false-negative RAT were reported. These results support the fact that RAT might have a significant impact on the identification of asymptomatic carriers in areas that lack suitable laboratories to perform SARS-CoV-2 real-time RT-PCR diagnostics, or the results take more than 24-48 h, as well as zones with high traffic of individuals such as border/customs, airports, interregional bus, train stations or in any mass testing campaign requiring rapid results.
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Affiliation(s)
- Mónica Peña
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile
| | - Manuel Ampuero
- Laboratorio de Virología Ambiental, Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile
| | | | - Aldo Gaggero
- Laboratorio de Virología Ambiental, Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile
| | - Patricia García
- Departamento de Laboratorio Clínico, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - María Soledad Velasquez
- Comité asesor de técnicas de laboratorio de diagnóstico de SARS-CoV-2, Ministerio de Salud de Chile, Chile
| | - Ricardo Luza
- Unidad de Epidemiología, Seremi de Salud Tarapacá, Chile
| | - Pía Alvarez
- Departamento de Epidemiología, Ministerio de Salud de Chile, Chile
| | - Fabio Paredes
- Departamento de Epidemiología, Ministerio de Salud de Chile, Chile
| | - Johanna Acevedo
- División de Planificación Sanitaria, DIPLAS, Ministerio de Salud de Chile, Chile
| | - Mauricio J Farfán
- Departamento de Pediatría y Cirugía Infantil Oriente, Hospital Dr. Luis Calvo Mackenna, Facultad de Medicina, Universidad de Chile, Chile
| | - Sandra Solari
- Departamento de Laboratorio Clínico, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Ricardo Soto-Rifo
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile
| | - Fernando Valiente-Echeverría
- Laboratorio de Virología Molecular y Celular, Programa de Virología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Chile.
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Real AD, López-Delgado L, Sañudo C, Pérez-Núñez MI, Laguna E, Menéndez G, Garcés C, García-Montesinos B, García-Ibarbia C, Santurtún A, Riancho JA. Método sensible para monitorizar la migración de las células madre mesenquimales de la médula ósea en modelos murinos. Rev Osteoporos Metab Miner 2020. [DOI: 10.4321/s1889-836x2020000200002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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8
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Arango-Franco CA, Moncada-Vélez M, Beltrán CP, Berrío I, Mogollón C, Restrepo A, Trujillo M, Osorio SD, Castro L, Gómez LV, Muñoz AM, Molina V, Del Río Cobaleda DY, Ruiz AC, Garcés C, Alzate JF, Cabarcas F, Orrego JC, Casanova JL, Bustamante J, Puel A, Arias AA, Franco JL. Early-Onset Invasive Infection Due to Corynespora cassiicola Associated with Compound Heterozygous CARD9 Mutations in a Colombian Patient. J Clin Immunol 2018; 38:794-803. [PMID: 30264381 DOI: 10.1007/s10875-018-0549-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/11/2018] [Indexed: 12/28/2022]
Abstract
PURPOSE CARD9 deficiency is an inborn error of immunity that predisposes otherwise healthy humans to mucocutaneous and invasive fungal infections, mostly caused by Candida, but also by dermatophytes, Aspergillus, and other fungi. Phaeohyphomycosis are an emerging group of fungal infections caused by dematiaceous fungi (phaeohyphomycetes) and are being increasingly identified in patients with CARD9 deficiency. The Corynespora genus belongs to phaeohyphomycetes and only one adult patient with CARD9 deficiency has been reported to suffer from invasive disease caused by C. cassiicola. We identified a Colombian child with an early-onset, deep, and destructive mucocutaneous infection due to C. cassiicola and we searched for mutations in CARD9. METHODS We reviewed the medical records and immunological findings in the patient. Microbiologic tests and biopsies were performed. Whole-exome sequencing (WES) was made and Sanger sequencing was used to confirm the CARD9 mutations in the patient and her family. Finally, CARD9 protein expression was evaluated in peripheral blood mononuclear cells (PBMC) by western blotting. RESULTS The patient was affected by a large, indurated, foul-smelling, and verrucous ulcerated lesion on the left side of the face with extensive necrosis and crusting, due to a C. cassiicola infectious disease. WES led to the identification of compound heterozygous mutations in the patient consisting of the previously reported p.Q289* nonsense (c.865C > T, exon 6) mutation, and a novel deletion (c.23_29del; p.Asp8Alafs10*) leading to a frameshift and a premature stop codon in exon 2. CARD9 protein expression was absent in peripheral blood mononuclear cells from the patient. CONCLUSION We describe here compound heterozygous loss-of-expression mutations in CARD9 leading to severe deep and destructive mucocutaneous phaeohyphomycosis due to C. cassiicola in a Colombian child.
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Affiliation(s)
- Carlos A Arango-Franco
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Marcela Moncada-Vélez
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Claudia Patricia Beltrán
- Departamento de Pediatría, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Indira Berrío
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia.,Hospital General de Medellín "Luz Castro de Gutiérrez" ESE, Medellín, Colombia
| | - Cristian Mogollón
- Infectología, Hospital Universitario Fernando Troconnis, Santa Marta, Colombia
| | | | | | - Sara Daniela Osorio
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Lorena Castro
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Lina Vanessa Gómez
- Hospital Pablo Tobón Uribe, Medellín, Colombia.,Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Ana María Muñoz
- Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Verónica Molina
- Hospital Pablo Tobón Uribe, Medellín, Colombia.,Servicio de Dermatología, Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | - Carlos Garcés
- Departamento de Pediatría, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.,Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Juan Fernando Alzate
- Centro Nacional de Secuenciación Genómica CNSG, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia
| | - Felipe Cabarcas
- Centro Nacional de Secuenciación Genómica CNSG, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No 52-21, Medellín, Colombia.,Grupo SISTEMIC, Facultad de Ingeniería, Universidad de Antioquia UdeA , Calle 70 No 52-21, Medellín, Colombia
| | - Julio Cesar Orrego
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France.,Howard Hughes Medical Institute, New York, NY, USA
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA.,Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, EU, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM-U1163, Paris, EU, France.,Imagine Institute, Paris Descartes University, Paris, EU, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY, USA
| | - Andrés Augusto Arias
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia. .,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia.
| | - José Luis Franco
- Grupo de Inmunodeficiencias Primarias, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
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9
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van de Geer A, Nieto-Patlán A, Kuhns DB, Tool AT, Arias AA, Bouaziz M, de Boer M, Franco JL, Gazendam RP, van Hamme JL, van Houdt M, van Leeuwen K, Verkuijlen PJ, van den Berg TK, Alzate JF, Arango-Franco CA, Batura V, Bernasconi AR, Boardman B, Booth C, Burns SO, Cabarcas F, Bensussan NC, Charbit-Henrion F, Corveleyn A, Deswarte C, Azcoiti ME, Foell D, Gallin JI, Garcés C, Guedes M, Hinze CH, Holland SM, Hughes SM, Ibañez P, Malech HL, Meyts I, Moncada-Velez M, Moriya K, Neves E, Oleastro M, Perez L, Rattina V, Oleaga-Quintas C, Warner N, Muise AM, López JS, Trindade E, Vasconcelos J, Vermeire S, Wittkowski H, Worth A, Abel L, Dinauer MC, Arkwright PD, Roos D, Casanova JL, Kuijpers TW, Bustamante J. Inherited p40phox deficiency differs from classic chronic granulomatous disease. J Clin Invest 2018; 128:3957-3975. [PMID: 29969437 PMCID: PMC6118590 DOI: 10.1172/jci97116] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 06/14/2018] [Indexed: 12/23/2022] Open
Abstract
Biallelic loss-of-function (LOF) mutations of the NCF4 gene, encoding the p40phox subunit of the phagocyte NADPH oxidase, have been described in only 1 patient. We report on 24 p40phox-deficient patients from 12 additional families in 8 countries. These patients display 8 different in-frame or out-of-frame mutations of NCF4 that are homozygous in 11 of the families and compound heterozygous in another. When overexpressed in NB4 neutrophil-like cells and EBV-transformed B cells in vitro, the mutant alleles were found to be LOF, with the exception of the p.R58C and c.120_134del alleles, which were hypomorphic. Particle-induced NADPH oxidase activity was severely impaired in the patients' neutrophils, whereas PMA-induced dihydrorhodamine-1,2,3 (DHR) oxidation, which is widely used as a diagnostic test for chronic granulomatous disease (CGD), was normal or mildly impaired in the patients. Moreover, the NADPH oxidase activity of EBV-transformed B cells was also severely impaired, whereas that of mononuclear phagocytes was normal. Finally, the killing of Candida albicans and Aspergillus fumigatus hyphae by neutrophils was conserved in these patients, unlike in patients with CGD. The patients suffer from hyperinflammation and peripheral infections, but they do not have any of the invasive bacterial or fungal infections seen in CGD. Inherited p40phox deficiency underlies a distinctive condition, resembling a mild, atypical form of CGD.
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Affiliation(s)
- Annemarie van de Geer
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Alejandro Nieto-Patlán
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Department of Immunology, National School of Biological Science, National Polytechnic Institute, ENCB - IPN, Mexico
| | - Douglas B Kuhns
- Neutrophil Monitoring Laboratory, Clinical Services Program, Leidos Biomedical Research Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
| | - Anton Tj Tool
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Andrés A Arias
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, and.,School of Microbiology, University of Antioquia, Medellin, Colombia
| | - Matthieu Bouaziz
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Martin de Boer
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - José Luis Franco
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, and
| | - Roel P Gazendam
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - John L van Hamme
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Michel van Houdt
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Karin van Leeuwen
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Paul Jh Verkuijlen
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Timo K van den Berg
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Molecular Cell Biology and Immunology, VU Medical Center, VU University, Amsterdam, Netherlands
| | - Juan F Alzate
- National Center for Genomic Sequencing - CNSG-SIU, School of Medicine, University of Antioquia, Medellin, Colombia
| | - Carlos A Arango-Franco
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, and.,School of Microbiology, University of Antioquia, Medellin, Colombia
| | - Vritika Batura
- Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea R Bernasconi
- Service of Immunology and Rheumatology, Garrahan National Pediatric Hospital, Buenos Aires, Argentina
| | - Barbara Boardman
- Department of Pediatric Allergy and Immunology, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom
| | - Claire Booth
- Department of Immunology, Great Ormond Street Hospital, NHS Foundation Trust, London, United Kingdom
| | - Siobhan O Burns
- Institute of Immunity and Transplantation, University College London, London, United Kingdom.,Department of Clinical Immunology, Royal Free London, NHS Foundation Trust, London, United Kingdom
| | - Felipe Cabarcas
- National Center for Genomic Sequencing - CNSG-SIU, School of Medicine, University of Antioquia, Medellin, Colombia.,SISTEMIC Group, Electronic Engineering Department, University of Antioquia, Medellin, Colombia
| | - Nadine Cerf Bensussan
- Laboratory of Intestinal Immunity, INSERM U1163, Imagine Institute, Paris, France.,GENIUS group (GENetically ImmUne-mediated enteropathieS) of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN).,Paris Descartes University, Paris, France
| | - Fabienne Charbit-Henrion
- Laboratory of Intestinal Immunity, INSERM U1163, Imagine Institute, Paris, France.,GENIUS group (GENetically ImmUne-mediated enteropathieS) of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN).,Paris Descartes University, Paris, France.,Pediatric Gastroenterology, Hepatology and Nutrition Unit, AP-HP, Necker Hospital for Sick Children, Paris, France
| | - Anniek Corveleyn
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | - Caroline Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - María Esnaola Azcoiti
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Department of Immunology, Ricardo Gutierrez Children's Hospital, Buenos Aires, Argentina
| | - Dirk Foell
- Department of Pediatric Rheumatology and Immunology, Munster University Hospital, Munster, Germany
| | - John I Gallin
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Carlos Garcés
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, and
| | - Margarida Guedes
- Department of Pediatrics, Santo Antonio Hospital, Porto, Portugal
| | - Claas H Hinze
- Department of Pediatric Rheumatology and Immunology, Munster University Hospital, Munster, Germany
| | - Steven M Holland
- Laboratory of Clinical Infectious Diseases, NIAID, NIH, Bethesda, Maryland, USA
| | - Stephen M Hughes
- Department of Pediatric Allergy and Immunology, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom
| | - Patricio Ibañez
- Inflammatory Bowel Disease Program, Gastroenterology Department, Clinic Las Condes Medical Center, University of Chile, Santiago de Chile, Chile
| | - Harry L Malech
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, Maryland, USA
| | - Isabelle Meyts
- Department of Pediatric Hematology and Oncology and.,Department of Microbiology and Immunology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Marcela Moncada-Velez
- Primary Immunodeficiencies Group, Department of Microbiology and Parasitology, School of Medicine, and
| | - Kunihiko Moriya
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Esmeralda Neves
- Department of Immunology, Santo Antonio Hospital, Porto, Portugal
| | - Matias Oleastro
- Service of Immunology and Rheumatology, Garrahan National Pediatric Hospital, Buenos Aires, Argentina
| | - Laura Perez
- Service of Immunology and Rheumatology, Garrahan National Pediatric Hospital, Buenos Aires, Argentina
| | - Vimel Rattina
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Carmen Oleaga-Quintas
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Neil Warner
- SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, and
| | - Aleixo M Muise
- Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada.,SickKids Inflammatory Bowel Disease Center and Cell Biology Program, Research Institute, and.,Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics and Biochemistry, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jeanet Serafín López
- Department of Immunology, National School of Biological Science, National Polytechnic Institute, ENCB - IPN, Mexico
| | - Eunice Trindade
- Pediatric Gastroenterology Unit, Sao Joao Hospital, Porto, Portugal
| | | | - Séverine Vermeire
- Division of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium.,Department of Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Helmut Wittkowski
- Department of Pediatric Rheumatology and Immunology, Munster University Hospital, Munster, Germany
| | - Austen Worth
- Department of Immunology, Great Ormond Street Hospital, NHS Foundation Trust, London, United Kingdom
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, New York, USA
| | - Mary C Dinauer
- Department of Pediatrics, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Peter D Arkwright
- Department of Pediatric Allergy and Immunology, Royal Manchester Children's Hospital, University of Manchester, Manchester, United Kingdom
| | - Dirk Roos
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Howard Hughes Medical Institute, New York, New York, USA.,Pediatric Hematology and Immunology Unit, AP-HP, Necker Hospital for Sick Children, Paris, France
| | - Taco W Kuijpers
- Department of Blood Cell Research, Sanquin Research, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Pediatric Hematology, Immunology and Infectious Diseases, Emma Children's Hospital, Amsterdam, Netherlands.,Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
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10
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Ramírez M, Cortés E, Betancur J, Garcés C. [Cerebral tuberculosis without meningitis in a immunocompetent child]. Rev Chilena Infectol 2018; 35:207-212. [PMID: 29912262 DOI: 10.4067/s0716-10182018000200207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 03/13/2018] [Indexed: 11/17/2022] Open
Abstract
Cerebral tuberculosis TB (tuberculomas) without meningitis is an uncommon disease with a high morbidity and mortality. We report on a case that illustrates the complexity of this clinical presentation. An 11 month old, previously healthy male infant was brought to the clinic due to fever present during the last 1.5 months, associated with loss of neurodevelopmental goals and signs of endocranial hypertension. CT scan of the skull revealed dilatation of the ventricular system with transependimary edema; MRI showed multiple intra- and extra-axial micronodular images and hydrocephalus. Studies of CSF (cyto-chemical analysis, staining, culture for aerobes, fungi, mycobacteria, and molecular tests for TB were negative). Empirical management for subacute meningoencephalitis was prescribed complemented with tetraconjugated treatment for TB and steroids. As there was no microbiological isolation, biopsy of a cerebellar lesion was performed, which revealed chronic necrotizing granulomatous inflammation and acid-alcohol resistant bacilli. The diagnosis of cerebral TB without meningeal involvement was confirmed. The objective of the present report is to emphasize the importance of considering this presentation of TB in children, to remark the need of exhaustive search for the etiologic agent by obtaining samples of the different fluids and tissues even if it implies recurring to invasive methods.
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11
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Arias AA, Perez-Velez CM, Orrego JC, Moncada-Velez M, Rojas JL, Wilches A, Restrepo A, Trujillo M, Garcés C, Arango-Ferreira C, González N, Oleaga-Quintas C, Fernández D, Isaza-Correa JM, Gongóra DE, Gonzalez-Loaiza D, Sierra JE, Casanova JL, Bustamante J, Franco JL. Severe Enteropathy and Hypogammaglobulinemia Complicating Refractory Mycobacterium tuberculosis Complex Disseminated Disease in a Child with IL-12Rβ1 Deficiency. J Clin Immunol 2017; 37:732-738. [PMID: 28865061 DOI: 10.1007/s10875-017-0435-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 08/16/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE Mendelian susceptibility to mycobacterial disease is a rare clinical condition characterized by a predisposition to infectious diseases caused by poorly virulent mycobacteria. Other infections such as salmonellosis and candidiasis are also reported. The purpose of this article is to describe a young boy affected with various infectious diseases caused by Mycobacterium tuberculosis complex, Salmonella sp, Klebsiella pneumonie, Citrobacter sp., and Candida sp, complicated with severe enteropathy and transient hypogammaglobulinemia. METHODS We reviewed medical records and performed flow cytometry staining for lymphocyte populations, lymphocyte proliferation in response to PHA, and intracellular IFN-γ production in T cell PHA blasts in the patient and a healthy control. Sanger sequencing was used to confirm the genetic variants in the patient and relatives. RESULTS Genetic analysis revealed a bi-allelic mutation in IL12RB1 (C291Y) resulting in complete IL-12Rβ1 deficiency. Functional analysis demonstrated the lack of intracellular production of IFN-γ in CD3+ T lymphocytes from the patient in response to rhIL-12p70. CONCLUSIONS To our knowledge, this is the third patient with MSMD due to IL-12Rβ1 deficiency complicated with enteropathy and hypogammaglobulinemia and the first case of this disease to be described in Colombia.
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Affiliation(s)
- Andrés Augusto Arias
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia.,Escuela de Microbiología, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Carlos M Perez-Velez
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia.,Tuberculosis Clinic, Pima County Health Department, Tucson, USA.,Division of Infectious Diseases, University of Arizona College of Medicine, Tucson, USA
| | - Julio César Orrego
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Marcela Moncada-Velez
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Jessica Lineth Rojas
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Alejandra Wilches
- Hospital Universitario San Vicente Fundación, Medellin, Colombia.,Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Andrea Restrepo
- Departamento de Pediatría, Hospital Pablo Tobon Uribe, Medellin, Colombia.,Clínica Universitaria Bolivariana, Medellin, Colombia
| | - Mónica Trujillo
- Departamento de Pediatría, Hospital Pablo Tobon Uribe, Medellin, Colombia
| | - Carlos Garcés
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia.,Departamento de Pediatría, Hospital Pablo Tobon Uribe, Medellin, Colombia
| | - Catalina Arango-Ferreira
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia.,Hospital Universitario San Vicente Fundación, Medellin, Colombia.,Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Natalia González
- Hospital Infantil Rafael Henao Toro, Manizales, Colombia.,Fundación Universitaria de las Américas, Pereira, Colombia
| | - Carmen Oleaga-Quintas
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France
| | - Diana Fernández
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Johana Marcela Isaza-Correa
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Diego Eduardo Gongóra
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Daniel Gonzalez-Loaiza
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Juan Esteban Sierra
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia
| | - Jean Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France.,Howard Hughes Medical Institute, New York, USA.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, The Rockefeller University, New York, NY, USA
| | - Jacinta Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Necker Hospital for Sick Children, Paris, France.,Paris Descartes University, Imagine Institute, Paris, France.,St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller branch, The Rockefeller University, New York, NY, USA.,Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - José Luis Franco
- Grupo de Inmunodeficiencias Primarias, Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Antioquia UdeA, Calle 70 No, 52-21, Medellín, Colombia.
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12
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García-Ibarbia C, Neila S, Garcés C, Alonso MA, Zarrabeitia MT, Valero C, Ortiz F, Riancho JA. Non-synonymous WNT16 polymorphisms alleles are associated with different osteoarthritis phenotypes. Rheumatol Int 2017; 37:1667-1672. [PMID: 28766055 DOI: 10.1007/s00296-017-3783-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 07/26/2017] [Indexed: 11/28/2022]
Abstract
Hereditary factors have a strong influence on osteoarthritis (OA). The Wnt pathway is involved in bone and cartilage homeostasis. Hence, we hypothesized that allelic variations of WNT16 could influence the OA phenotype. We studied 509 Caucasian patients undergoing joint replacement due to severe primary OA. Radiographs were used to classify the OA as atrophic or hypertrophic. Two nonsynonymous polymorphisms of WNT16 (rs2707466 and rs2908004) were analyzed. The association between the genotypes and the OA phenotype was analyzed by logistic regression and adjusted for age and body mass index. A genotype-phenotype association was found in the sex-stratified analysis. Thus, there was a significant difference in the genotypic frequencies of rs2707466 between hypertrophic and atrophic hip OA in males (p = 0.003), with overrepresentation of G alleles in the hypertrophic phenotype (OR 2.08; CI 1.28-3.38). An association in the same direction was observed between these alleles and the type of knee OA, with G alleles being more common in the hypertrophic than in atrophic knee phenotypes (p = 0.008; OR 1.956, CI 1.19-3.19). Similar associations were found for the rs2908004 SNP, but it only reached statistical significance for knee OA (p = 0.017; OR 0.92, CI 0.86-0.989). This is the first study attempting to explore the association of genetic variants with the OA phenotype. These data suggest the need to consider the OA phenotype in future genetic association studies of OA.
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Affiliation(s)
- Carmen García-Ibarbia
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - Sara Neila
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - Carlos Garcés
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - Maria A Alonso
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - María T Zarrabeitia
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - Carmen Valero
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - Fernando Ortiz
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain
| | - José A Riancho
- Departments of Internal Medicine and Orthopedic Surgery, Hospital UM Valdecilla, University of Cantabria, IDIVAL, Av Valdecilla sn, 39008, Santander, Spain.
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13
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Pérez-Campo FM, Santurtún A, García-Ibarbia C, Pascual MA, Valero C, Garcés C, Sañudo C, Zarrabeitia MT, Riancho JA. Osterix and RUNX2 are Transcriptional Regulators of Sclerostin in Human Bone. Calcif Tissue Int 2016; 99:302-9. [PMID: 27154028 DOI: 10.1007/s00223-016-0144-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
Sclerostin, encoded by the SOST gene, works as an inhibitor of the Wnt pathway and therefore is an important regulator of bone homeostasis. Due to its potent action as an inhibitor of bone formation, blocking sclerostin activity is the purpose of recently developed anti-osteoporotic treatments. Two bone-specific transcription factors, RUNX2 and OSX, have been shown to interact and co-ordinately regulate the expression of bone-specific genes. Although it has been recently shown that sclerostin is targeted by OSX in mice, there is currently no information of whether this is also the case in human cells. We have identified SP-protein family and AML1 consensus binding sequences at the human SOST promoter and have shown that OSX, together with RUNX2, binds to a specific region close to the transcription start site. Furthermore, we show that OSX and RUNX2 activate SOST expression in a co-ordinated manner in vitro and that SOST expression levels show a significant positive correlation with OSX/RUNX2 expression levels in human bone. We also confirmed previous results showing an association of several SOST/RUNX2 polymorphisms with bone mineral density.
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Affiliation(s)
- Flor M Pérez-Campo
- Faculty of Medicine Department of Molecular Biology, University of Cantabria, Santander, Spain
| | - Ana Santurtún
- Unit of Legal Medicine, Faculty of Medicine, University of Cantabria, Santander, Spain
| | - Carmen García-Ibarbia
- Department of Internal Medicine, Hospital U. Marqués de Valdecilla-IDIVAL, University of Cantabria, Avda. Valdecilla S/N, 39008, Santander, Spain
| | - María A Pascual
- Service of Traumatology and Orthopedic Surgery, Hospital U. Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - Carmen Valero
- Department of Internal Medicine, Hospital U. Marqués de Valdecilla-IDIVAL, University of Cantabria, Avda. Valdecilla S/N, 39008, Santander, Spain
| | - Carlos Garcés
- Service of Traumatology and Orthopedic Surgery, Hospital U. Marqués de Valdecilla, University of Cantabria, Santander, Spain
| | - Carolina Sañudo
- Department of Internal Medicine, Hospital U. Marqués de Valdecilla-IDIVAL, University of Cantabria, Avda. Valdecilla S/N, 39008, Santander, Spain
| | - María T Zarrabeitia
- Unit of Legal Medicine, Faculty of Medicine, University of Cantabria, Santander, Spain
| | - José A Riancho
- Department of Internal Medicine, Hospital U. Marqués de Valdecilla-IDIVAL, University of Cantabria, Avda. Valdecilla S/N, 39008, Santander, Spain.
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Vivas R, Beltran C, Munera MI, Trujillo M, Restrepo A, Garcés C. Fungemia due to Kodamaea ohmeri in a young infant and review of the literature. Med Mycol Case Rep 2016; 13:5-8. [PMID: 27630816 PMCID: PMC5013248 DOI: 10.1016/j.mmcr.2016.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/08/2016] [Accepted: 06/20/2016] [Indexed: 11/19/2022] Open
Abstract
Fungal infections have become an important cause of morbidity and mortality in hospitalized children due to many complicating and underlying conditions. We present the case of a newborn infant with fungemia due to Kodamaea ohmeri who had a good outcome of the infection after using the combination of antifungal treatment and central venous catheter removal.
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Affiliation(s)
- Rosalba Vivas
- CES University, Medellin, Antioquia 050035, Colombia
- Corresponding author.
| | | | | | - Monica Trujillo
- CES University, Medellin, Antioquia 050035, Colombia
- Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
| | - Andrea Restrepo
- CES University, Medellin, Antioquia 050035, Colombia
- Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
| | - Carlos Garcés
- Hospital Pablo Tobon Uribe, Medellin, Antioquia, Colombia
- Antioquia University, Medellin, Antioquia, Colombia
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Gavela-Pérez T, Garcés C, Navarro-Sánchez P, López Villanueva L, Soriano-Guillén L. Earlier menarcheal age in Spanish girls is related with an increase in body mass index between pre-pubertal school age and adolescence. Pediatr Obes 2015; 10:410-5. [PMID: 25641777 DOI: 10.1111/ijpo.277] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Revised: 10/20/2014] [Accepted: 10/24/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Higher body mass index (BMI) has been associated with earlier pubertal development. OBJECTIVE The aim of this longitudinal study was to determine menarcheal age in a Spanish cohort and to assess its association with anthropometric variables at birth, childhood and adolescence. We also analyse whether the tracking of weight between different ages could affect the timing of menarche. METHODS The sample population included 195 randomly selected 6-8-year-old girls who participated in the baseline of the Four Provinces Study and in the follow-up of this study at 13-16 years old. Anthropometrical variables were measured and BMI and BMI z-score were calculated. Information regarding birth weight and menarche was obtained by means of self-report questionnaire. RESULTS Correlation analysis showed a significant negative association of age at menarche with weight, BMI and BMI z-score in the baseline and follow-up groups but not with weight at birth. Fat mass at adolescence is related to a significantly earlier menarcheal age. When comparing weight categories, earliest menarcheal age is associated with an increase of BMI between 6-8-year-old and 13-16-year-old girls. CONCLUSION In our study, high weight in girls is associated with the earliest age at menarche. This becomes a major influence when weight gain occurs between pre-pubertal school age and adolescence.
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Affiliation(s)
- T Gavela-Pérez
- Lipid Research Laboratory, IIS-Fundacion Jimenez Díaz, Madrid, Spain.,Department of Pediatrics, IIS-Fundacion Jimenez Díaz, Madrid, Spain
| | - C Garcés
- Lipid Research Laboratory, IIS-Fundacion Jimenez Díaz, Madrid, Spain
| | - P Navarro-Sánchez
- Lipid Research Laboratory, IIS-Fundacion Jimenez Díaz, Madrid, Spain
| | | | - L Soriano-Guillén
- Lipid Research Laboratory, IIS-Fundacion Jimenez Díaz, Madrid, Spain.,Department of Pediatrics, IIS-Fundacion Jimenez Díaz, Madrid, Spain
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Jois A, Navarro P, Ortega-Senovilla H, Gavela-Pérez T, Soriano-Guillén L, Garcés C. Relationship of high leptin levels with an adverse lipid and insulin profile in 6-8 year-old children in Spain. Nutr Metab Cardiovasc Dis 2015; 25:1111-1116. [PMID: 26610652 DOI: 10.1016/j.numecd.2015.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/31/2015] [Accepted: 09/08/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Leptin, an adipokine elevated in obesity, may be related to an adverse cardiovascular risk profile in childhood. However, evidence for this relationship in pre-pubertal children is scarce. We aimed to analyze the relationship between leptin levels and lipid and insulin profiles in Spanish children. METHODS AND RESULTS Our population-based sample included 389 males and 369 females aged 6-8 years. Lipid levels were determined by standard methods, insulin by radioimmunoassay and leptin by sandwich ELISA. Leptin levels were higher in girls (8.6 ng/ml) than boys (4.7 ng/ml) (p < 0.001). Leptin increased from ages 6 to 8 in girls, but remained steady in boys. In both sexes, leptin increased significantly (p < 0.001) across weight category from normal weight to obese. Children in the highest tertile of leptin concentration showed significantly (p < 0.01) lower levels of HDL-cholesterol (HDL-C) and apolipoprotein-AI (apo-AI) and significantly higher triglyceride (TG) levels than children in lower tertiles. However, in linear regression analysis, after adjustment for body mass index (BMI), leptin only accounted for 1.5% of the variance of HDL-C in boys, and 2.6% of the variance of apo-AI in girls. Leptin was strongly and positively correlated with insulin and HOMA. Upon regression analysis, leptin contributed to over 20% of the variability in insulin and HOMA, independent of BMI. CONCLUSION Leptin levels show sex differences in pre-pubertal children. In this age group, leptin levels are strongly related to insulin, and affect lipid profile -namely HDL-C, apo-AI and TG- particularly when leptin levels are high.
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Affiliation(s)
- A Jois
- Lipid Laboratory, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - P Navarro
- Lipid Laboratory, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - H Ortega-Senovilla
- Servicio de Bioquímica-Investigación, Hospital Ramón y Cajal, Madrid, Spain
| | - T Gavela-Pérez
- Department of Pediatrics, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - L Soriano-Guillén
- Department of Pediatrics, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - C Garcés
- Lipid Laboratory, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain.
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Jois A, Navarro P, Gavela-Pérez T, Soriano-Guillén L, Garcés C. Relationship of leptin with lipid profile and insulin levels in 6-8 year-old children in Spain. Atherosclerosis 2015. [DOI: 10.1016/j.atherosclerosis.2015.04.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Macías A, Aguirre C, Bustamante A, Garcés C, Echeverri V, Díaz A. Cat scratch disease in Medellín, Colombia. Oxf Med Case Reports 2015; 2014:43-5. [PMID: 25988023 PMCID: PMC4369997 DOI: 10.1093/omcr/omu018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/27/2014] [Accepted: 05/01/2014] [Indexed: 01/26/2023] Open
Abstract
Cat scratch disease (CSD) is the most common zoonosis transmitted by household animals. There is limited data on the epidemiology and clinical presentation of this disease in Colombia. The typical presentation includes subacute or chronic lymph node infection following inoculation of Bartonella henselae bacilli through a cat scratch. Cats have a B. henselae seroprevalence as high as 90%. Here, we report the case of a preschool boy from a rural area of Antioquia, Colombia, who presented with chronic lymphadenopathy in the right axilla. Other important infectious etiologies were ruled out, and confirmation was made with the Warthin Starry stain of a lymph node biopsy. We also discuss the most important aspects of the diagnosis, treatment and prevention of the disease.
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Affiliation(s)
| | - Carlos Aguirre
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Alberto Bustamante
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
| | - Carlos Garcés
- Pediatrics Department, School of Medicine , Universidad de Antioquia , Medellín , Colombia
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Delgado-Calle J, Alonso M, Ortiz J, Montero A, Garcés C, Sañudo C, Pérez-Aguilar M, Pérez Núñez M, Riancho J. Análisis comparativo del epigenoma del tejido óseo y de osteoblastos primarios. Rev Osteoporos Metab Miner 2014. [DOI: 10.4321/s1889-836x2014000200002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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20
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Hurtado IC, Sánchez DP, Espinal DA, Garcés C. [Clinical and laboratory evolution of the febrile neutropenia episodes in pediatric patients hospitalized in a Colombian hospital in 2007-2009]. Rev Chilena Infectol 2013; 29:672-6. [PMID: 23412039 DOI: 10.4067/s0716-10182012000700015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 09/12/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Neutropenia is one of the most common complications in children with cancer, and it's the most important parameter to determine infection risk. In neutropenic patients the signs and symptoms could be scarce and in occasions fever could be the only symptom. For these reasons all patients with febrile neutropenia (FN) should be considered as if they had a possibly severe disease. AIM To describe the clinical characteristics and laboratory parameters observed in cancer patients with FN attended at our hospital to perform a more rational management of this complication in the future. PATIENTS AND METHODS The clinical files accumulated during 36 months, belonging to patients aged 0 to 15 years that were hospitalized because of cancer and FN were reviewed. RESULTS In this series the source of fever was found in 48.6% of 105 NF episodes, and bacteria were isolated from blood or urine culture in 38%. The most frequent bacterial species recovered were methicillin susceptible S. aureus (20.8%) and ESBL negative E. coli (20.8%). Piperacillin/tazobactam was the most used first line antibiotic prescribed (87.6%) and meropenem was the second choice (18%). Granulocyte colony stimulating factor was used in 61.9% of the cases and episodes mortality rate was 6.7%. CONCLUSION Clinical characteristics and bacteriological findings in our institution do not differ significantly from what has been described for pediatric cancer patients in other series.
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Affiliation(s)
- Isabel C Hurtado
- Departamento de Pediatría, Hospital Pablo Tobón Uribe, Medellín, Colombia.
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Gutiérrez-Medina S, Gavela-Pérez T, Domínguez-Garrido MN, Blanco-Rodríguez M, Garcés C, Rovira A, Soriano-Guillén L. [High prevalence of vitamin D deficiency among spanish obese children and adolescents]. An Pediatr (Barc) 2013; 80:229-35. [PMID: 24206653 DOI: 10.1016/j.anpedi.2013.06.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 06/06/2013] [Accepted: 06/23/2013] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Vitamin D deficiency has been associated with extra-skeletal outcomes such as, insulin resistance, type 2 diabetes, and cardiovascular disease. The aim of this study is to determine the prevalence of vitamin D deficiency among obese children and adolescents in Spain and to analyze the relationship between 25-OH-vitamin D (25-OH-D) levels and markers of abnormal glucose metabolism. PATIENTS AND METHODS A cross-sectional study was conducted in which the clinical and biochemical data were recorded for 120 obese and 50 non-overweight children in Pediatric Clinics from January 2011 to January 2013. RESULTS The mean 25-OH-D levels among obese children was 19.5 ng/ml and among non-overweight children was 31.6 ng/ml. 58,3% of obese subjects, and 10% of non-overweight subjects had vitamin D deficiency. Serum 25-OH-D levels were lower in winter. Higher HOMA-SDS (3.8 versus 2.4), and triglycerides (97 versus 81 mg/dl) were found in vitamin D deficient obese children compared to obese children without vitamin D deficiency. A negative correlation was found between 25-OH-D levels and HOMA in absolute values (r=-0.2; P=.04) that was not maintained when HOMA-SDS was analyzed. CONCLUSIONS There is a high prevalence of vitamin D deficiency among obese children with a multifactorial etiology. A lower 25-OH-D level could be a risk factor for developing insulin resistance and type 2 diabetes in obese population.
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Affiliation(s)
- S Gutiérrez-Medina
- Servicio de Endocrinología y Nutrición, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - T Gavela-Pérez
- Servicio de Pediatría, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - M N Domínguez-Garrido
- Servicio de Pediatría, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - M Blanco-Rodríguez
- Servicio de Pediatría, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - C Garcés
- Unidad de Lípidos, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - A Rovira
- Servicio de Endocrinología y Nutrición, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España
| | - L Soriano-Guillén
- Servicio de Pediatría, Instituto de Investigación Sanitaria-Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España.
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del Villar-Rubín S, Escorihuela R, Ortega-Senovilla H, de Oya M, Garcés C. High tracking of apolipoprotein B levels from the prepubertal age to adolescence in Spanish children. Acta Paediatr 2013; 102:e374-7. [PMID: 23679859 DOI: 10.1111/apa.12292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/05/2013] [Accepted: 05/13/2013] [Indexed: 11/26/2022]
Abstract
AIM To assess tracking of lipid and apolipoproteins from the prepubertal age (baseline, 6-8 years old) to adolescence (follow-up, 13-16 years old) in Spanish children. METHODS The sample population included 385 healthy children (179 boys and 206 girls). Tracking was estimated by correlations between baseline and follow-up levels, multiple regression models in which the follow-up lipid was the dependent variable and analysing the percentage of individuals who remained in the same lipid levels status from prepubertal age to adolescence. RESULTS Correlations between baseline and follow-up levels for low density lipoprotein (LDL)-cholesterol and apolipoprotein B (apo B) were stronger in boys and for high density lipoprotein-cholesterol and apo A-I stronger in girls. Regression analyses showed that, after adjusting by body mass index (BMI), baseline LDL-cholesterol and apo B levels explain 23% and 39% of the variation of follow-up LDL-cholesterol and apo B levels, respectively, in boys and 13% and 22%, respectively, in girls. The strength of tracking for LDL-cholesterol and apo B was 79% and 89%, respectively, in boys and 72% and 82%, respectively, in girls. CONCLUSION Apolipoprotein B showed the strongest tracking in both sexes, stronger than for LDL-cholesterol, which supports the importance of determining apo B levels as a marker of dyslipidaemia in children.
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García-Anguita A, Ortega L, Garcés C. Relationship of dehydroepiandrosterone sulfate with overweight and insulin sensitivity in 12-16-year-old Spanish children. Horm Metab Res 2013; 45:545-7. [PMID: 23508718 DOI: 10.1055/s-0033-1337974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
DHEA-S is the most abundant steroid hormone in human circulation. Although a relationship of DHEA-S with obesity-related diseases has been reported, the metabolic role of this hormone remains unclear, particularly in children. In our study, we have investigated the relationship of DHEA-S levels with anthropometric variables, insulin, HOMA, and free fatty acids in adolescents. The study sample included 812 healthy 12-16-year-old children (383 boys and 429 girls). Plasma DHEA-S was determined by RIA, insulin concentrations by IRMA, and free fatty acids by using a commercial kit. Insulin resistance was estimated using the HOMA index. No significant differences in plasma DHEA-S levels were found between sexes. DHEA-S levels in overweight children were significantly higher than in normal-weight children. DHEA-S levels were significantly correlated with weight and BMI after adjusting for age. Significant positive correlations between DHEA-S and free fatty acids levels were found after adjusting for age and BMI, particularly in boys, but not between DHEA-S levels and insulin or HOMA in either gender. DHEA-S levels in 12-16-year-old children are correlated with weight and BMI independently of age. We failed to find any association between DHEA-S and insulin levels, but we did find a -significant correlation between DHEA-S and free fatty acids levels, suggesting that its association with free fatty acids may be related to the onset of the association of DHEA-S with insulin resi-stance.
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Affiliation(s)
- A García-Anguita
- Lipid Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
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Jiménez JN, Ocampo AM, Vanegas JM, Rodriguez EA, Mediavilla JR, Chen L, Muskus CE, Vélez LA, Rojas C, Restrepo AV, Garcés C, Kreiswirth BN, Correa MM. A comparison of methicillin-resistant and methicillin-susceptible Staphylococcus aureus reveals no clinical and epidemiological but molecular differences. Int J Med Microbiol 2013; 303:76-83. [PMID: 23369303 DOI: 10.1016/j.ijmm.2012.12.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 11/15/2012] [Accepted: 12/09/2012] [Indexed: 12/01/2022] Open
Abstract
Most studies on Staphylococcus aureus have focused on the molecular epidemiology of methicillin-resistant S. aureus (MRSA) infections. In contrast, little information is available regarding the molecular epidemiology of currently circulating methicillin-susceptible S. aureus (MSSA) isolates in hospital settings, an epoch when the epidemiology of S. aureus has undergone significant changes. We conducted a cross-sectional study to compare the clinical, epidemiological, and genetic characteristics of MSSA and MRSA isolates at 3 tertiary-care hospitals in Medellín, Colombia, from February 2008 to June 2010. The infections were classified according to the Centers for Disease Control and Prevention (CDC) definitions. Genotypic analysis included spa typing, multilocus sequence typing (MLST) and staphylococcal cassette chromosome (mec) (SCCmec) typing. A total of 810 patients was enrolled. One hundred infections (12.3%) were classified as community-associated (31 CA-MSSA, 69 CA-MRSA), 379 (46.8%) as healthcare-associated community-onset (136 HACO-MSSA, 243 HACO-MRSA), and 331 (40.9%) as healthcare-associated hospital-onset (104 HAHO-MSSA, 227 HAHO-MRSA). Genotype analyses showed a higher diversity and a more varied spa type repertoire in MSSA than in MRSA strains. Most of the clinical-epidemiological characteristics and risk factors evaluated did not allow for discriminating MRSA- from MSSA-infected patients. The lack of equivalence among the genetic backgrounds of the major MSSA and MRSA clones would suggest that the MRSA clones are imported instead of arising from successful MSSA clones. This study emphasizes the importance of local surveillance to create public awareness on the changing S. aureus epidemiology.
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Affiliation(s)
- J Natalia Jiménez
- Grupo de Microbiología Molecular, Escuela de Microbiología, Universidad de Antioquia, Calle 67 No. 53-108, Bloque 5, Lab 437, Medellín, Colombia.
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Hurtado IC, Trujillo M, Restrepo A, Garcés C, Tamayo C, Mesa JG. Experiencia con el uso compasivo de tigeciclina en pacientes pediátricos infectados por Klebsiella pneumoniae productora de carbapenemasas. Rev Chilena Infectol 2012; 29:317-21. [DOI: 10.4067/s0716-10182012000300011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 04/09/2011] [Indexed: 11/17/2022] Open
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Larrodé I, Real J, Garcés C, Alonso Y, Povar J, Abad-Sazatornil M. Drug poisoning: a reason for care in a hospital emergencies unit. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Elorza M, Atehortúa S, Garcés C, Restrepo A, Trujillo M. Histoplasmosis diseminada en niños inmunocompetentes: reporte de dos casos en el departamento de Antioquia y revisión de la literatura. Infectio 2011. [DOI: 10.1016/s0123-9392(11)70084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Garcés C, Gómez C, Florez ID, Muñoz JD. [An unusual presentation of Fournier's gangrene. Is there a relationship with NSAID use? Pediatric case report]. Rev Chilena Infectol 2010; 27:341-4. [PMID: 21046720 DOI: 10.4067/s0716-10182010000500010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Fournier's gangrene is a rare but life-threatening disease characterized by necrotizing fasciitis of the perineal area. It mostly affects adult patients with an immunosuppressant factor and there are only a few cases reported in children. Use of nonsteroidal anti-inflammatory drugs has been associated with necrotizing fasciitis probably because of suppressing host immunity during infection. We describe a case of a six month old infant without immunosuppressant factors, with Founier's gangrene probably associated with nonsteroidal anti-inflammatory intake.
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Affiliation(s)
- Carlos Garcés
- Departamento de Infectologia Pediátrica, Hospital Universitario San Vicente de Paul, Medellín, Colombia
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Riestra P, García-Anguita A, Schoppen S, López-Simón L, De Oya M, Garcés C. Sex-specific association between leptin receptor polymorphisms and leptin levels and BMI in healthy adolescents. Acta Paediatr 2010; 99:1527-30. [PMID: 20491703 DOI: 10.1111/j.1651-2227.2010.01877.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To examine the relationship of three common polymorphisms in the leptin receptor (LEPR) gene, implicated in the regulation of body weight, with leptin levels and obesity-related phenotypes in a population-based sample of healthy pubertal children in Spain. METHODS The study included 806 boys and girls aged 12-16 whose anthropometrical data and body composition were recorded. Serum leptin levels were determined by ELISA. The LEPR Q223R, K109R and K656N polymorphisms were determined by TaqMan® allelic discrimination assays. RESULTS When analysing the Q223R polymorphism, we observed that female carriers of the RR genotype had significantly higher plasma leptin levels (18.2 vs. 15.1 ng/mL p = 0.016) and significantly higher mean BMI values (22.5 vs. 21.3 Kg/m² p = 0.032) than QR carriers. Furthermore, the frequency of the RR genotype in overweight-obese girls was significantly higher than that found in normal-weight girls. No significant differences were observed in boys. Neither boys nor girls showed significant differences when comparing leptin levels, anthropometric variables or body composition by K109R or K656N genotype. CONCLUSION The fact, that the Q223R polymorphism in the LEPR gene is significantly associated with leptin levels and BMI only in girls, suggests a sex-specific influence of this polymorphism on these variables.
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Affiliation(s)
- P Riestra
- Lipid Research Laboratory, IIS-Fundación Jiménez Díaz, Madrid, Spain
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Restrepo A, Garcés C, Trujillo M, María Serna L, Suárez MM. Infección intracraneal y rinosinusitis aguda: reporte de tres casos pediátricos. Infectio 2010. [DOI: 10.1016/s0123-9392(10)70113-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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López-Simón L, Riestra P, Lasunción MA, Schoppen S, Garcés C. Abstract: P368 CETP TAQIB POLYMORPHISM AND PLASMA HDL-C LEVELS IN PREPUBERTAL CHILDREN. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70663-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Monreal M, Peidro L, Resines C, Garcés C, Fernández JL, Garagorri E, González JC. Limited diagnostic workup for deep vein thrombosis after major joint surgery: findings from a prospective, multicentre, cohort study. Thromb Haemost 2008; 99:1112-5. [PMID: 18521516 DOI: 10.1160/th08-02-0115] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
While deep vein thrombosis (DVT) may be clinically suspected at several time points after major orthopedic surgery, clinical examination is often unreliable, and compression ultrasonography (CUS) screening at discharge is of limited value. A prospective cohort study was carried out in 1,033 consecutive patients who had undergone major hip or knee surgery, aimed to assess the accuracy of a strategy consisting of clinical investigation followed by CUS in the detection of proximal DVT before discharge. The circumferences of both legs were measured in all patients; those exhibiting >2 cm difference between them were considered to have suspected DVT, and underwent bilateral CUS. The same diagnostic workup was repeated on days 45 and 90 after surgery. Three patients developed pulmonary embolism (PE) during admission (one died). Five additional patients died before discharge. Routine clinical evaluation before discharge was done in 1,025 patients, and 105 (10%) had suspected DVT. CUS confirmed the diagnosis in 24 (2.3% of the overall series). After discharge, 59 patients had suspected DVT on day 45, 53 on day 90. DVT diagnosis was confirmed by CUS in 27 (26%). Three additional patients developed PE (1 fatal). This translates into a sensitivity of the routine examinations at discharge of 44%. A limited diagnostic workup for DVT before discharge has the capacity to identify 44% of those patients who will become symptomatic afterwards.
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Affiliation(s)
- Manuel Monreal
- Servicio de Medicina Interna, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
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Royo-Bordonada MA, Garcés C, Gorgojo L, Martín-Moreno JM, Lasunción MA, Rodríguez-Artalejo F, Fernández O, de Oya M. Saturated fat in the diet of Spanish children: relationship with anthropometric, alimentary, nutritional and lipid profiles. Public Health Nutr 2007; 9:429-35. [PMID: 16870014 DOI: 10.1079/phn2005870] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AbstractObjectiveTo compare the anthropometric, alimentary, nutritional and lipid profiles and global diet quality of Spanish children according to saturated fat intake.DesignThis was a cross-sectional study. Food data were collected using a food-frequency questionnaire.Subjects and methodsThe sample included 1112 children of both sexes, aged between 6 and 7 years, selected by means of random cluster sampling in schools. The plasma lipid profile included measurements of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (apoA1) and apolipoprotein B (apoB). Global diet quality was evaluated by the Dietary Variety Index (DVI) and the Healthy Eating Index (HEI).ResultsEnergy intake, DVI and HEI of children from the lower quartile of saturated fat intake (LL) were higher (P < 001) than in the remaining children (UL). However, there were no significant differences in average height or weight between groups. The UL children had lower intakes of meat, fish, vegetables, fruits and olive oil and a higher intake of dairy products (P < 0.001). The intakes of fibre, vitamins C, D, B6, E and folic acid were higher in the LL children, who had lower intakes of vitamin A and calcium. The ratios LDL-C/HDL-C and apoB/apoA1 were lower (P = 0.04) in the LL children (1.87 and 0.52, respectively) than in the UL children (2.02 and 0.54, respectively).ConclusionsThe growth rate of children does not seem to be affected by the level of saturated fat intake. Furthermore, at the levels of intake observed in this study, diets with less saturated fat are associated with better alimentary, nutritional and plasma lipid profiles.
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Affiliation(s)
- M A Royo-Bordonada
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Garcés C, Cantos M, Benavente M, Granizo JJ, Cano B, Viturro E, De Oya M. Variations in APOE genotype distribution in children from areas with different adult cardiovascular disease mortality in Spain. Hum Biol 2005; 76:615-21. [PMID: 15754976 DOI: 10.1353/hub.2004.0055] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We investigate whether a varying distribution of the APOE genotype could help explain regional differences in ischemic heart disease (IHD) mortality in Spain. APOE genotypes were examined by PCR in 1,274 randomly selected healthy children from four Spanish regions with different adult IHD mortality rates (northwest and central Spain with low rates and southeast and southern Spain with high rates). In the population as a whole the prevalence of the higher risk APOE*3/*4 genotype is 16.8% and the prevalence of the APOE*4 allele is 10.1%. In northwest Spain the frequencies of the APOE*3/*4 genotype (12.9%) and of the APOE*4 allele (8.3%) are smaller than in the other regions. The southeast region shows statistically higher frequencies of the APOE*3/*4 genotype (22.5%) and of the APOE*4 allele (13.2%) than in the other regions or in the group as a whole. We can conclude that Spain is not homogeneous in terms of APOE genotype distribution. Although the prevalence of the APOE*4 allele is generally low, there are areas with higher prevalence of the APOE*4 allele and a higher incidence of adult IHD mortality. This allows us to conclude that in Spain this genetic determinant can be associated with IHD mortality in relatively isolated populations.
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Affiliation(s)
- C Garcés
- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28040 Madrid, Spain
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Royo-Bordonada MA, Gorgojo L, Ortega H, Martín-Moreno JM, Lasunción MA, Garcés C, Gil A, Rodríguez-Artalejo F, de Oya M. Greater dietary variety is associated with better biochemical nutritional status in Spanish children: the Four Provinces Study. Nutr Metab Cardiovasc Dis 2003; 13:357-364. [PMID: 14979682 DOI: 10.1016/s0939-4753(03)80004-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIM Although dietary variety has been associated with a better nutritional profile, its possible role in obesity raises doubts about its overall health benefits. In this study, we examined the association between dietary variety and anthropometric variables, food intake and various food intake biomarkers in Spanish children. METHODS AND RESULTS This was a cross-sectional study of 1112 children aged 6-7 years from Cadiz, Murcia, Orense and Madrid, who were selected by means of the random cluster-sampling of schools. Information concerning food and nutrient intake was obtained using a food frequency questionnaire, and a dietary variety index (DVI) was calculated on the basis of the number of different foods consumed more than once a month. The anthropometric variables (weight and height), and plasma lipid and vitamin levels were determined using standardised methods. Our results show that the body mass index (BMI) did not vary substantially as a function of DVI: it was 16.9 in the lowest DVI tertile and 17.2 in the highest (p=0.20). Unlike BMI, the DVI positively correlated (p<0.05) with the plasma levels of alpha and beta-carotene, lycopene, retinol, alpha-tocopherol and vitamin E, with energy intake, and with most of the foods, particularly vegetables, fruit and sausages (respective correlation coefficients of 0.43, 0.26 and 0.23). CONCLUSIONS Dietary variety is associated with a better food and nutritional profile in Spanish children. Nevertheless, the presence of a positive association between the DVI and energy intake, and the consumption of sausages and pre-cooked products calls for the recommendation of a varied diet of healthy foods, such as cereals (especially whole grains), fruits and vegetables.
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Affiliation(s)
- M A Royo-Bordonada
- Instituto de Salud Carlos III, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Royo-Bordonada MA, Gorgojo L, Martín-Moreno JM, Garcés C, Rodríguez-Artalejo F, Benavente M, Mangas A, de Oya M. Spanish children's diet: compliance with nutrient and food intake guidelines. Eur J Clin Nutr 2003; 57:930-9. [PMID: 12879087 DOI: 10.1038/sj.ejcn.1601627] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To compare the diet of Spanish children against the nutrient and food intake guidelines. To calculate an index of overall diet quality and check its validity against nutrient intake. DESIGN AND SETTING Cross-sectional study in four cities in Spain, where information on food and nutrient intake was obtained from schoolchildren through a food frequency questionnaire. PARTICIPANTS The sample included 1112 children (overall response rate of 85%) attending public and private schools and aged 6-7 y. Children were selected through random cluster sampling in schools, and stratified by sex and socioeconomic level. MAIN OUTCOME MEASURES Mean nutrient intake, number of food servings, and the percentage of children who meet recommended nutrient and food-serving intake levels. The overall dietary quality was assessed using the Healthy Eating Index (HEI). RESULTS Mean micronutrient intake exceeded 100% of the recommended dietary allowances, except for vitamin B6, which registered a mean intake of 77.1%. For almost all children, intake of saturated fat was above, and that of carbohydrate below, the recommended level, in contrast to the relatively high compliance with the recommendations for poly- and monounsaturated fatty acid, salt and fiber intake (69.7, 43.7, 40.7, and 30.1%, respectively). Consumption of food servings for each of the five American pyramid food groups came close to or exceeded USDA guidelines, with the exception of cereals, with 5.4 servings per day. The mean score obtained in the HEI was 64.6. Children who complied with all the food guide pyramid recommendations registered a higher dietary variety and a healthier nutritional profile. CONCLUSIONS Children aged 6-7 y show scant compliance with the macronutrient goals for healthy eating. Micronutrient intake is adequate in general, yet there are small groups of children with risk of deficient intake of vitamins B6 and D. While Spanish children's eating habits are reasonably in line with American food guide pyramid guidelines, consumptions of cereals and fruit should be improved.
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Affiliation(s)
- M A Royo-Bordonada
- Carlos III Institute of Public Health, Ministerio de Sanidad y Consumo, Madrid, Spain.
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Garcés C, Benavente M, Lasunción MA, Ortega H, Nájera G, de Oya M. Gender-specific effects of apolipoprotein E genotype on plasma lipid levels in a population-based sample of 6-7-year-old children in Spain. Acta Paediatr 2003; 91:1039-43. [PMID: 12434887 DOI: 10.1080/080352502760311511] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
AIM The effects of gender on the association between apolipoprotein E genotype and plasma lipid levels remain unclear in children. The aim of the present work was to evaluate these gender differences in a large population-based sample of 6-7-y-old children, free of the effects of sex hormones. METHODS Lipid levels and apo E genotypes were studied in a sample of 1255 (631 M, 624 F) Caucasian schoolchildren, aged 6-7 (mean age, 6.7) y in Spain. RESULTS A significant effect of the apo E genotype on plasma total cholesterol, LDL-C (low-density lipoprotein cholesterol) and apo B levels was observed. Taking the homozygous epsilon3epsilon3 genotype as reference, the presence of the epsilon2 and epsilon4 alleles is associated with substantially lower and higher plasma levels, respectively, of these variables. It was found that the effect of the apo E polymorphism on total cholesterol, LDL-C and particularly on apo B levels was greater in girls than in boys. CONCLUSION At this prepubertal age, the influence of the apo E genotype on total cholesterol, LDL-C and apo B levels is more evident in girls than in boys. This difference in effect is not due to sex hormones. In our opinion, the earlier increase in adrenal androgens in girls than in boys at this age related to pubertal maturation could be responsible for these differences.
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Affiliation(s)
- C Garcés
- Unidad de Lípidos, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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Royo-Bordonada MA, Gorgojo L, de Oya M, Garcés C, Rodríguez-Artalejo F, Rubio R, del Barrio JL, Martín-Moreno JM. Food sources of nutrients in the diet of Spanish children: the Four Provinces Study. Br J Nutr 2003; 89:105-14. [PMID: 12568670 DOI: 10.1079/bjn2002754] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of the present study was to assess the principal food sources of energy and nutrients among Spanish children. We used a cross-sectional study design, based on results obtained from a food-frequency questionnaire. The sample included 1112 children, aged 6-7 years, from Cadiz, Madrid, Orense and Murcia, Spain. Children were selected through random cluster-sampling in schools. We analysed the percentage contributed by each food item to total energy and nutrient intake. The most important food sources were: white bread in the case of carbohydrate (13.4 %); olive oil in the case of total lipids (18.3 %) and monounsaturated fatty acids (29.2 %); whole milk in the case of protein (10.2 %) and saturated fatty acids (14.9 %); chips (French fried potatoes) in the case of polyunsaturated fatty acids (30.4 %). The greatest proportion of Na, consumed in excess, came from salt added to meals. Ham ranked second as a source of saturated fats. Fruits and green leafy vegetables proved to have great relevance as sources of fibre and vitamins, though with regard to the latter, it was observed that fortified foods (breakfast cereals, dairy products, fruit juices, etc.) had come to play a relevant role in many cases. In conclusion, the nutritional profile of Spanish school-aged children aged 6-7 years could be improved by nutritional policies targeted at limiting their consumption of ham (cured or cooked) and of salt added to meals, replacing whole milk with semi-skimmed milk, encouraging the consumption of products rich in complex carbohydrates already present in children's diets (bread, pasta, rice) and promoting less fatty ways of cooking food.
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Affiliation(s)
- M A Royo-Bordonada
- Institute of Health Carlos III, Ministry of Health & Consumer Affairs, Madrid, Spain.
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Rodríguez-Artalejo F, Garcés C, Gorgojo L, López García E, Martín-Moreno JM, Benavente M, del Barrio JL, Rubio R, Ortega H, Fernández O, de Oya M. Dietary patterns among children aged 6-7 y in four Spanish cities with widely differing cardiovascular mortality. Eur J Clin Nutr 2002; 56:141-8. [PMID: 11857047 DOI: 10.1038/sj.ejcn.1601296] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2001] [Revised: 06/22/2001] [Accepted: 06/25/2001] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Classic cardiovascular risk factors, such as smoking, arterial hypertension and hypercholesterolaemia, cannot explain a substantial part of the geographic differences in cardiovascular mortality. Anthropometric and nutritional factors in early stages of life may contribute to adult cardiovascular disease. Therefore, this work examines certain anthropometric variables and diet among children aged 6-7 y, living in four Spanish cities with widely differing ischaemic heart disease (IHD) mortality. DESIGN AND SETTING Cross-sectional anthropometric and dietary survey in four cities in Spain. SUBJECTS A total of 1112 children (50.1% males, 49.9% females) attending public and private schools in Cadiz and Murcia, cities with a relatively high IHD mortality, and Madrid and Orense, cities with a relatively low IHD mortality. A standardized method was used to measure anthropometric variables, and a food-frequency questionnaire completed by subjects' mothers, to measure diet. OUTCOME MEASURES Body mass index (BMI), overweight (BMI>17.6 kg/m(2)), obesity (BMI>20.1 kg/m(2)) and intake of food and nutrients. RESULTS Children in the four cities showed a high prevalence of overweight (range across cities, 28.9-34.5%) and obesity (8.5-15.7%). They also had a moderately hypercaloric diet (range, 2078-2218 kcal/day), marked by an excessive intake of lipids (45.0-47.3% kcal), particularly saturated fats (16.6-16.9% kcal), proteins (17.0-17.3% kcal), sugars (20.0-21.9% kcal) and cholesterol (161.6-182.9 mg/1000 kcal/day), and a low intake of complex carbohydrates (17.5-18.1% kcal) and fibre (19.6-19.9 g/day). Compared with children in the two low-IHD-mortality cities, those in the two high-IHD-mortality cities had a greater BMI (mean difference, 0.61 kg/m(2); P=0.0001) and ponderal index (0.58 kg/m(3); P=0.0001) and a higher intake of energy (104 kcal/day; P=0.007), cholesterol (16.00 mg/1000 kcal/day; P=0.0001) and sodium (321 mg/day; P=0.0001). Inter-city differences in anthropometric variables remained after adjustment for birthweight. CONCLUSIONS Intake of fats, especially saturated fats, and cholesterol should be reduced among Spanish children. It could contribute to a needed reduction of the high prevalence of overweight and obesity in children. If the differences in anthropometric variables and diet between children from the cities with high and low coronary mortality are maintained in future or continue into adulthood, this could contribute to consolidate or even increase the IHD mortality gradient across cities. The finding that differences in anthropometric variables are independent of birthweight suggests that the childhood, rather than intrauterine environment, is involved in the development of such differences. SPONSORSHIP This study was partly funded by grants from the International Olive Oil Board (Consejo Oleícola Internacional), Comunidad Autónoma de Madrid, Fundación Pedro Barrié de la Maza, and Fundación Eugenio Rodríguez Pascual.
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Affiliation(s)
- F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
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Benavente M, Rodríguez-Artalejo F, Garcés C, Gorgojo L, López E, Martín-Moreno J, del Barrio J, Rubio R, Ortega H, Fernández O, de Oya M. Dietary patterns among children aged 6–7 years in four spanish cities with widely differing cardiovascular mortality. ATHEROSCLEROSIS SUPP 2001. [DOI: 10.1016/s1567-5688(01)80320-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Garcés C, Artalejo F, Serrano A, Bonillo J, Almagro F, Garrido J, Zuñiga M, de Oya M. Low incidence of xanthomas in heterozygous familial hypercholesterolemia (FH) in Spain. Atherosclerosis 2000. [DOI: 10.1016/s0021-9150(00)80478-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Garcés C, Rodríguez Artalejo F, Serrano A, González Bonillo J, Almagro F, Garrido JA, Zúñiga M, de Oya M. [Clinical manifestations of heterozygote familial hypercholesterolemia in Spain. Study of 301 cases from the central and northern areas]. Med Clin (Barc) 2000; 114:50-1. [PMID: 10702948 DOI: 10.1016/s0025-7753(00)71186-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
RATIONALE To characterize clinical manifestations of familial hypercholesterolemia (FH) in Spain. PATIENTS AND METHODS A group of 301 cases of FH from central and north regions of Spain. RESULTS With a mean (SD) cholesterol level of 346 (58) mg/dl, only 7.6% of the patients have xanthomas and 20% ischaemic heart disease. 51% have a familial history of ischaemic heart disease. CONCLUSIONS Different from the results of literature, xanthomas are very infrequent in FH in Spain, so diagnosis should be suspected from other data. The high prevalence of familial history of ischaemic heart disease supports the usefulness of this feature as a marker for diagnosis and prevention.
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Affiliation(s)
- C Garcés
- Unidad de Lípidos Fundación Jiménez Díaz, Madrid
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Rodríguez Artalejo F, Garcés C, Gil A, Lasunción MA, Martín Moreno JM, Gorgojo L, de Oya M. [The 4 Provinces Study: its principal objectives and design. The Researchers of the 4 Provinces Study]. Rev Esp Cardiol 1999; 52:319-26. [PMID: 10368583 DOI: 10.1016/s0300-8932(99)74922-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Spain shows an important variation in the geographical distribution of ischaemic heart disease and cerebrovascular disease mortality. In this article, the primary objectives and design of the Four Provinces study are described. In this study we analyzed the contribution of environmental factors (diet, lipid profile and plasma antioxidants), acting in childhood, to explain differences in cardiovascular mortality rates between different provinces in Spain. METHODS An ecological design was projected in which the units to study were four Spanish provinces with a wide variation in cardiovascular mortality in adulthood. The design compares diet, anthropometric variables and biological markers (particularly plasma lipids and antioxidant levels) in 6-7-year-old children, between the two provinces with the highest cardiovascular mortality rates and the two provinces with the lowest. The information for each province is collected in a cross-sectional manner in a representative sample of children from each province. DISCUSSION Evidence from the literature concerning Northern European countries suggest the contribution of environmental factors during early age in the development of cardiovascular disease in adulthood. The "Four Provinces" study will provide, for the first time, information about the influence of factors in early childhood of cardiovascular risk in a Mediterranean country. The study will also offer interesting data about food intake during school age in four provinces and it will allow us to estimate values of population of the variables of interest in those provinces.
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Affiliation(s)
- F Rodríguez Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Universidad País Vasco, Vitoria
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Ruiz-Hidalgo MJ, Garcés C, Laborda J. Notch-1 expression levels in 3T3-L1 cells influence ras signaling and transformation by oncogenic ras. Int J Oncol 1999; 14:777-83. [PMID: 10087329 DOI: 10.3892/ijo.14.4.777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Notch proteins participate in interactions between several cell types involved on the specification of numerous cell fates during development. We previously showed that enforced downregulation of Notch-1 expression prevented adipogenesis of 3T3-L1 cells. Since adipogenesis of 3T3-L1 cells can be induced by oncogenic ras, we studied whether this was also the case in 3T3-L1 cells with decreased levels of Notch-1 expression. We found that oncogenic ras induces transformation and not differentiation of 3T3-L1 cells with diminished levels of Notch-1. This result suggests that Notch-1 is implicated in the interpretation of signals leading to activation of p21 Ras.
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Affiliation(s)
- M J Ruiz-Hidalgo
- Laboratory of Immunobiology, Division of Monoclonal Antibodies, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Rockville, MD 20852, USA
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Garrido JA, Garcés C, de Oya M. [Diet and atherosclerosis]. Rev Esp Cardiol 1999; 51 Suppl 6:36-44. [PMID: 10050143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The relationship between diet and atherosclerosis is due to the diet influence on lipoprotein composition. However, because of the multifactorial basis of the atherosclerosis, diet components have another potential intervention mechanisms in the atherosclerosis process, such as the influence on other cardiovascular risk factors (hypertension, obesity, diabetes) or the influence on the coagulation system and the relationship endothelium-platelets. We will review the effect of diet components on these factors, specially its effects on the haemostasia system, which alteration is responsible for provoking ischemic heart disease. We have to consider that the main objective when treating dyslipidaemias, besides of avoiding acute pancreatitis in cases of strong hypertrigliceridaemia, is to prevent arteriosclerosis development and its clinical manifestations such as ischemic heart disease. Besides, we know that genetic, in addition to provoke familial susceptibility to atherosclerosis, has an essential importance in the response to ambiental factors as diet is.
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Affiliation(s)
- J A Garrido
- Unidad de Lípidos, Fundación Jiménez Díaz, Madrid
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Garcés C, Ruiz-Hidalgo MJ, Bonvini E, Goldstein J, Laborda J. Adipocyte differentiation is modulated by secreted delta-like (dlk) variants and requires the expression of membrane-associated dlk. Differentiation 1999; 64:103-14. [PMID: 10234807 DOI: 10.1046/j.1432-0436.1999.6420103.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Previous studies demonstrate that the delta-like (dlk) and preadipocyte factor 1 (Pref-1) genes encode similar proteins. Pref-1 is downregulated during adipocyte differentiation, and expression of ectopic Pref-1 inhibits adipogenesis. We explored whether dlk functions similarly to Pref-1 and studied the role of alternately spliced dlk variants encoding membrane-associated or -secreted forms. We also studied whether enforced downregulation of dlk/Pref-1 may enhance the differentiation response of non-committed cells. Ectopic expression of a potentially secreted dlk variant, conditioned media from dlk expressing cells or several individual epidermal-growth-factor-dlk peptides inhibited 3T3-L1 differentiation. This demonstrates that dlk and Pref-1 are functionally equivalent. dlk gene mRNA encoding for secreted variants decreased much faster than total dlk gene mRNA during differentiation of 3T3-L1 cells. In fact, total dlk or membrane-associated dlk protein expression increased during the first hours of differentiation. Cells sorted for lowest levels of dlk protein diminished or lost their ability to differentiate. These data suggest that membrane and secreted dlk protein variants play opposite roles in the control of adipogenesis. In addition, enforced downregulation of dlk protein expression in the weakly adipogenic Balb/c 3T3 cell line dramatically enhanced adipogenesis in response to insulin. These results indicate that dlk protein not only participates in processes leading to inhibition of adipogenesis but that the control of its expression and different spliced variants is essential for the adipogenic response to extracellular signals.
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Affiliation(s)
- C Garcés
- Division of Monoclonal Antibodies, U.S. Food and Drug Administration, Rockville, MD 20852, USA
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Garcés C, Ruiz-Hidalgo MJ, Font de Mora J, Park C, Miele L, Goldstein J, Bonvini E, Porrás A, Laborda J. Notch-1 controls the expression of fatty acid-activated transcription factors and is required for adipogenesis. J Biol Chem 1997; 272:29729-34. [PMID: 9368042 DOI: 10.1074/jbc.272.47.29729] [Citation(s) in RCA: 122] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Notch, a transmembrane receptor member of the homeotic epidermal growth factor-like family of proteins, participates in cell-to-cell signaling to control cell fate during development. Activated Notch-1 constructs lacking the extracellular region prevent differentiation of several mammalian cells in vitro. This effect, however, bypasses the normal mechanisms of cell-to-cell interactions in which Notch-1 participates. We investigated the role of Notch-1 in the hormone-induced adipocyte differentiation of 3T3-L1 fibroblasts, a paradigmatic model of adipogenesis that requires cell-to-cell contact. Unlike other differentiation models, Notch-1 expression and function were necessary conditions for adipogenesis. Impaired Notch-1 expression by antisense Notch-1 constructs prevented adipocyte differentiation. Strategies aimed at blocking putative Notch/ligand interactions also blocked adipogenesis, implicating Notch as a critical molecule in cell-to-cell signaling necessary for differentiation. Inhibition of Notch-1 expression or function decreased the expression of peroxisomal proliferator-activated receptors delta and gamma, transcription factors that control adipocyte differentiation and that are up-regulated at cell confluence. These results implicate Notch in the commitment of 3T3-L1 cells to undergo adipogenesis by controlling the expression of the principal regulators of this process.
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Affiliation(s)
- C Garcés
- Laboratory of Immunobiology, Division of Monoclonal Antibodies, Center for Biologics Evaluation and Research, Bethesda, Maryland 20852, USA
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Affiliation(s)
- C Garcés
- Laboratory of Immunobiology, U.S. Food and Drug Administration, Rockville, Maryland 20852, USA
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Alonso R, Mata P, Lahoz C, Andrés R, González F, Garcés C, Blazquez E, Ordovás J, de Oya M. Effect of satured, monounsatured and polyunsatured N-6 and N-3 fatty acid-rich diets on the susceptibility of LDL to oxidative modification in women. Atherosclerosis 1995. [DOI: 10.1016/0021-9150(95)96311-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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