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Giralt M, Díaz-Troyano N, Comas I, Blanco A, Conesa L, Mendoza M, Zafon C, Goya M, Ferrer R. Reference ranges of thyroid hormones during the first trimester in Catalan women using the Atellica® IM Solution Immunoassay Analyzer. Ann Clin Biochem 2023:45632231219387. [PMID: 37996255 DOI: 10.1177/00045632231219387] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
BACKGROUND Gestational hypothyroidism has been shown to be associated with adverse pregnancy outcomes as well as adverse outcomes for the child. Thyroid hormones concentrations change in gestation, especially within the first trimester, so the results of thyroid function test often are outside non-pregnant reference ranges. The objective of this study was to establish the first trimester reference ranges for thyroid stimulating hormone (TSH) and free thyroxine (FT4) for pregnant women in Barcelona (Spain). METHODS It was a prospective study in which 673 women were recruited during their first trimester of gestation (8-13 weeks). Serum TSH, FT4 and antithyroid peroxidase antibodies (TPOAb) were measured with Atellica® IM 1600 (Siemens Healthineers). After excluding 418 women, the reference ranges for TSH and FT4 were calculated by the 2.5th and 97.5th percentiles. Potential variables examined in this study were age, body mass index (BMI), ethnicity, iodine supplementation and smoking habit. RESULTS The reference ranges established on the Atellica® IM 1600 for the first trimester pregnancy in our population were 0.111 to 4.291 mIU/L for TSH and 11.45 to 17.76 pmol/L for FT4. No significant differences were found in thyroid hormones concentrations regarding maternal age (≤30 years versus >30 years) (p=0.117), iodine supplementation (p=0.683) and smoking habit (p=0.363). The prevalence of TPOAb was estimated at 10.0%. CONCLUSIONS We found that in our local population the optimal TSH upper reference limit in the first trimester of gestation was 4.3 mIU/L, similar to that proposed by de ATA-2017 guideline (4.0 mIU/L).
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Affiliation(s)
| | | | | | - Albert Blanco
- Department of BiochemistryVall d'Hebron University Hospital
| | - Laura Conesa
- Department of BiochemistryVall d'Hebron University Hospital
| | - Manel Mendoza
- Department of Obstetrics and Reproductive Medicine, Maternal-Fetal Medicine Unit.Vall d'Hebron University Hospital
| | - Carles Zafon
- Diabetes and Metabolism Research Unit (VHIR) and Department of EndocrinologyVall d'Hebron University Hospital
| | - María Goya
- Department of Obstetrics and Reproductive Medicine, Maternal-Fetal Medicine UnitVall d'Hebron University Hospital
| | - Roser Ferrer
- Department of BiochemistryVall d'Hebron University Hospital
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2
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Cebrián-Sastre E, Chiner-Oms A, Torres-Pérez R, Comas I, Oliveros JC, Blázquez J, Castañeda-García A. Selective Pressure by Rifampicin Modulates Mutation Rates and Evolutionary Trajectories of Mycobacterial Genomes. Microbiol Spectr 2023; 11:e0101723. [PMID: 37436169 PMCID: PMC10433840 DOI: 10.1128/spectrum.01017-23] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023] Open
Abstract
Resistance to the frontline antibiotic rifampicin constitutes a challenge to the treatment and control of tuberculosis. Here, we analyzed the mutational landscape of Mycobacterium smegmatis during long-term evolution with increasing concentrations of rifampicin, using a mutation accumulation assay combined with whole-genome sequencing. Antibiotic treatment enhanced the acquisition of mutations, doubling the genome-wide mutation rate of the wild-type cells. While antibiotic exposure led to extinction of almost all wild-type lines, the hypermutable phenotype of the ΔnucS mutant strain (noncanonical mismatch repair deficient) provided an efficient response to the antibiotic, leading to high rates of survival. This adaptative advantage resulted in the emergence of higher levels of rifampicin resistance, an accelerated acquisition of drug resistance mutations in rpoB (β RNA polymerase), and a wider diversity of evolutionary pathways that led to drug resistance. Finally, this approach revealed a subset of adaptive genes under positive selection with rifampicin that could be associated with the development of antibiotic resistance. IMPORTANCE Rifampicin is the most important first-line antibiotic against mycobacterial infections, including tuberculosis, one of the top causes of death worldwide. Acquisition of rifampicin resistance constitutes a major global public health problem that makes the control of the disease challenging. Here, we performed an experimental evolution assay under antibiotic selection to analyze the response and adaptation of mycobacteria, leading to the acquisition of rifampicin resistance. This approach explored the total number of mutations that arose in the mycobacterial genomes under long-term rifampicin exposure, using whole-genome sequencing. Our results revealed the effect of rifampicin at a genomic level, identifying different mechanisms and multiple pathways leading to rifampicin resistance in mycobacteria. Moreover, this study detected that an increase in the rate of mutations led to enhanced levels of drug resistance and survival. In summary, all of these results could be useful to understand and prevent the emergence of drug-resistant isolates in mycobacterial infections.
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Affiliation(s)
- E. Cebrián-Sastre
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología (CNB), CSIC, Madrid, Spain
| | - A. Chiner-Oms
- Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
| | - R. Torres-Pérez
- Servicio de Bioinformática para Genómica y Proteómica. Centro Nacional de Biotecnología (CNB), CSIC, Madrid, Spain
| | - I. Comas
- Instituto de Biomedicina de Valencia (IBV), CSIC, Valencia, Spain
| | - J. C. Oliveros
- Servicio de Bioinformática para Genómica y Proteómica. Centro Nacional de Biotecnología (CNB), CSIC, Madrid, Spain
| | - J. Blázquez
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología (CNB), CSIC, Madrid, Spain
| | - A. Castañeda-García
- Departamento de Biotecnología Microbiana, Centro Nacional de Biotecnología (CNB), CSIC, Madrid, Spain
- Centro Nacional de Microbiología, Instituto de Salud Carlos III (CNM-ISCIII), Majadahonda (Madrid), Spain
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Van Rie A, de Viedma DG, Meehan C, Comas I, Heupink TH, De Vos E, de Oñate WA, Mathys V, Ceyssens PJ, Groenen G, González-Candelas F, Forier A, Juengst E. Whole-genome sequencing for TB source investigations: principles of ethical precision public health. Int J Tuberc Lung Dis 2021; 25:222-227. [PMID: 33688811 DOI: 10.5588/ijtld.20.0886] [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: 11/10/2022] Open
Abstract
BACKGROUND: Whole-genome sequencing (WGS) of Mycobacterium tuberculosis allows rapid, accurate inferences about the sources, location and timing of transmission. However, in an era of heightened concern for personal privacy and science distrust, such inferences could result in unintended harm and undermine the public´s trust.METHODS: We held interdisciplinary stakeholder discussions and performed ethical analyses of real-world illustrative cases to identify principles that optimise benefit and mitigate harm of M. tuberculosis WGS-driven TB source investigations.RESULTS: The speed and precision with which real-time WGS can be used to associate M. tuberculosis strains with sensitive information has raised important concerns. While detailed understanding of transmission events could mitigate harm to vulnerable patients and communities when otherwise unfairly blamed for TB outbreaks, the precision of WGS can also identify transmission events resulting in social blame, fear, discrimination, individual or location stigma, and the use of defaming language by the public, politicians and scientists. Public health programmes should balance the need to safeguard privacy with public health goals, transparency and individual rights, including the right to know who infects whom or where.CONCLUSIONS: Ethical challenges raised by real-time WGS-driven TB source investigation requires public health authorities to move beyond their current legal mandate and embrace transparency, privacy and community engagement.
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Affiliation(s)
- A Van Rie
- Department of Family Medicine and Population Health, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | - D G de Viedma
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
| | - C Meehan
- School of Chemistry and Bioscience, University of Bradford, UK
| | - I Comas
- Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO) Public Health Valencia, Valencia, Spain
| | - T H Heupink
- Department of Family Medicine and Population Health, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | - E De Vos
- Department of Family Medicine and Population Health, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | - W A de Oñate
- Flemish Association of Respiratory Health and Tuberculosis Control, Antwerp, Belgium, Belgian Lung and Tuberculosis Association, Brussels, Belgium
| | - V Mathys
- National Reference Centre of Tuberculosis and Mycobacteria, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - P-J Ceyssens
- National Reference Centre of Tuberculosis and Mycobacteria, Infectious Diseases in Humans, Sciensano, Brussels, Belgium
| | - G Groenen
- Belgian Lung and Tuberculosis Association, Brussels, Belgium
| | - F González-Candelas
- Joint Research Unit "Infection and Public Health" FISABIO/University of Valencia-I2SysBio and CIBER in Epidemiology and Public Health, Valencia, Spain
| | - A Forier
- Agency for Care and Health, Government of Flanders, Brussels, Belgium
| | - E Juengst
- Department of Social Medicine, University of North Carolina at Chapel Hill, NC, USA
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Palà E, Pagola J, Juega J, Francisco-Pascual J, Bustamante A, Penalba A, Comas I, Rodriguez M, De Lera Alfonso M, Arenillas JF, de Torres R, Pérez-Sánchez S, Cabezas JA, Moniche F, González-Alujas T, Molina CA, Montaner J. B-type natriuretic peptide over N-terminal pro-brain natriuretic peptide to predict incident atrial fibrillation after cryptogenic stroke. Eur J Neurol 2020; 28:540-547. [PMID: 33043545 DOI: 10.1111/ene.14579] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 07/20/2020] [Accepted: 10/06/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE B-type natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are well-known surrogates of atrial fibrillation (AF) detection but studies usually present data on either BNP or NT-proBNP. The aim was to determine and directly compare the validity of the two biomarkers as a tool to predict AF and guide prolonged cardiac monitoring in cryptogenic stroke patients. METHODS Non-lacunar acute ischaemic stroke (<72 h) patients over 55 years of age with cryptogenic stroke after standard evaluation were included in the Crypto-AF study and blood was collected. BNP and NT-proBNP levels were determined by automated immunoassays. AF was assessed by 28 days' monitoring. Highest (optimizing specificity) and lowest (optimizing sensitivity) quartiles were used as biomarker cut-offs to build predictive models adjusted by sex and age. The integrated discrimination improvement index (IDI) and DeLong test were used to compare the performance of the two biomarkers. RESULTS From 320 patients evaluated, 218 were included in the analysis. AF was detected in 50 patients (22.9%). NT-proBNP (P < 0.001) and BNP (P < 0.001) levels were higher in subjects with AF and their levels correlated (r = 0.495, P < 0.001). BNP showed an increased area under the curve (0.720 vs. 0.669; P = 0.0218) and a better predictive capacity (IDI = 3.63%, 95% confidence interval 1.36%-5.91%) compared to NT-proBNP. BNP performed better than NT-proBNP in a specific model (IDI = 3.7%, 95% confidence interval 0.87%-6.5%), whilst both biomarkers performed similarly in the case of a sensitive model. CONCLUSIONS Both BNP and NT-proBNP were increased in cryptogenic stroke patients with AF detection. Interestingly, BNP outperforms NT-proBNP, especially in terms of specificity.
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Affiliation(s)
- E Palà
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Pagola
- Stroke Unit, Medicine Department, Vall d'Hebrón Hospital and Autonomous University of Barcelona, Barcelona, Spain
| | - J Juega
- Stroke Unit, Medicine Department, Vall d'Hebrón Hospital and Autonomous University of Barcelona, Barcelona, Spain
| | - J Francisco-Pascual
- Arrhythmia Unit-Cardiology Department, Vall d'Hebrón Hospital, Barcelona, Spain
| | - A Bustamante
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Penalba
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Comas
- Clinical Biochemestry Service, Clinical Laboratories, Vall d'Hebrón Hospital, Barcelona, Spain
| | - M Rodriguez
- Stroke Unit, Medicine Department, Vall d'Hebrón Hospital and Autonomous University of Barcelona, Barcelona, Spain
| | | | - J F Arenillas
- Stroke Unit, University Hospital of Valladolid, Valladolid, Spain
| | - R de Torres
- Stroke Unit, University Hospital Virgen del Rocio, Seville, Spain
| | - S Pérez-Sánchez
- Stroke Unit, University Hospital Virgen del Rocio, Seville, Spain
| | - J A Cabezas
- Stroke Unit, University Hospital Virgen del Rocio, Seville, Spain
| | - F Moniche
- Stroke Unit, University Hospital Virgen del Rocio, Seville, Spain
| | - T González-Alujas
- Echocardiography Lab Cardiology Department, Vall d'Hebrón Hospital, Barcelona, Spain
| | - C A Molina
- Stroke Unit, Medicine Department, Vall d'Hebrón Hospital and Autonomous University of Barcelona, Barcelona, Spain
| | - J Montaner
- Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Castañeda-García A, Martín-Blecua I, Cebrián-Sastre E, Chiner-Oms A, Torres-Puente M, Comas I, Blázquez J. Specificity and mutagenesis bias of the mycobacterial alternative mismatch repair analyzed by mutation accumulation studies. Sci Adv 2020; 6:eaay4453. [PMID: 32095527 PMCID: PMC7015689 DOI: 10.1126/sciadv.aay4453] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 11/25/2019] [Indexed: 05/09/2023]
Abstract
The postreplicative mismatch repair (MMR) is an almost ubiquitous DNA repair essential for maintaining genome stability. It has been suggested that Mycobacteria have an alternative MMR in which NucS, an endonuclease with no structural homology to the canonical MMR proteins (MutS/MutL), is the key factor. Here, we analyze the spontaneous mutations accumulated in a neutral manner over thousands of generations by Mycobacterium smegmatis and its MMR-deficient derivative (ΔnucS). The base pair substitution rates per genome per generation are 0.004 and 0.165 for wild type and ΔnucS, respectively. By comparing the activity of different bacterial MMR pathways, we demonstrate that both MutS/L- and NucS-based systems display similar specificity and mutagenesis bias, revealing a functional evolutionary convergence. However, NucS is not able to repair indels in vivo. Our results provide an unparalleled view of how this mycobacterial system works in vivo to maintain genome stability and how it may affect Mycobacterium evolution.
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Affiliation(s)
- A. Castañeda-García
- Centro Nacional de Biotecnología–CSIC, Madrid, Spain
- Corresponding author. (A.C.-G.); (J.B.)
| | | | | | - A. Chiner-Oms
- Instituto de Biomedicina de Valencia, IBV-CSIC, Valencia, Spain
| | | | - I. Comas
- Instituto de Biomedicina de Valencia, IBV-CSIC, Valencia, Spain
- CIBER in Epidemiology and Public Health
| | - J. Blázquez
- Centro Nacional de Biotecnología–CSIC, Madrid, Spain
- Corresponding author. (A.C.-G.); (J.B.)
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6
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Chiner-Oms Á, Sánchez-Busó L, Corander J, Gagneux S, Harris SR, Young D, González-Candelas F, Comas I. Genomic determinants of speciation and spread of the Mycobacterium tuberculosis complex. Sci Adv 2019; 5:eaaw3307. [PMID: 31448322 PMCID: PMC6691555 DOI: 10.1126/sciadv.aaw3307] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 05/10/2019] [Indexed: 06/10/2023]
Abstract
Models on how bacterial lineages differentiate increase our understanding of early bacterial speciation events and the genetic loci involved. Here, we analyze the population genomics events leading to the emergence of the tuberculosis pathogen. The emergence is characterized by a combination of recombination events involving core pathogenesis functions and purifying selection on early diverging loci. We identify the phoR gene, the sensor kinase of a two-component system involved in virulence, as a key functional player subject to pervasive positive selection after the divergence of the Mycobacterium tuberculosis complex from its ancestor. Previous evidence showed that phoR mutations played a central role in the adaptation of the pathogen to different host species. Now, we show that phoR mutations have been under selection during the early spread of human tuberculosis, during later expansions, and in ongoing transmission events. Our results show that linking pathogen evolution across evolutionary and epidemiological time scales points to past and present virulence determinants.
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Affiliation(s)
- Á. Chiner-Oms
- Unidad Mixta “Infección y Salud Pública” FISABIO-CSISP/Universidad de Valencia, Instituto de Biología Integrativa de Sistemas (ISysBio), Valencia, Spain
| | - L. Sánchez-Busó
- Pathogen Genomics, Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
| | - J. Corander
- Pathogen Genomics, Wellcome Trust Sanger Institute, Cambridge CB10 1SA, UK
- Department of Biostatistics, University of Oslo, 0317 Oslo, Norway
- Helsinki Institute of Information Technology (HIIT), Department of Mathematics and Statistics, University of Helsinki, 00014 Helsinki, Finland
| | - S. Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - S. R. Harris
- Microbiotica, BioData Innovation Centre, Wellcome Genome Campus, Cambridge CB10 1DR, UK
| | - D. Young
- The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
| | - F. González-Candelas
- Unidad Mixta “Infección y Salud Pública” FISABIO-CSISP/Universidad de Valencia, Instituto de Biología Integrativa de Sistemas (ISysBio), Valencia, Spain
- CIBER en Epidemiología y Salud Pública, Valencia, Spain
| | - I. Comas
- CIBER en Epidemiología y Salud Pública, Valencia, Spain
- Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain
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7
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Comas I, Cancino-Muñoz I, Goig GA, Chiner-Oms Á, López MG, Torres-Puente M, Moreno-Molina MÁ, Villamayor LM, Furió V. GENOMIC EPIDEMIOLOGY OF TUBERCULOSIS: FROM WITHIN HOST EVOLUTION TO GLOBAL MIGRATION PATTERNS. ACTA ACUST UNITED AC 2019. [DOI: 10.15789/2220-7619-2018-4-6.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- I. Comas
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | | | - G. A. Goig
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | - Á. Chiner-Oms
- Unidad Mixta Genómica y Salud, Centro Superior de Investigación en Salud Pública (FISABIO)-Universitat de València, Valencia
| | - M. G. López
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | - M. Torres-Puente
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | - M. Á. Moreno-Molina
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | - L. M. Villamayor
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
| | - V. Furió
- Tuberculosis Genomics Unit, Biomedicine Institute of Valencia, Spanish Research Council, Valencia
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Comas I, Ferrer R, Planas J, Celma A, Regis L, Morote J. A systematic review of methods for quantifying serum testosterone in patients with prostate cancer who underwent castration. Actas Urol Esp 2018; 42:86-93. [PMID: 28259362 DOI: 10.1016/j.acuro.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 01/04/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND The clinical practice guidelines recommend measuring serum testosterone in patients with prostate cancer (PC) who undergo castration. The serum testosterone concentration should be <50ng/dL, a level established by using a radioimmunoassay method. The use of chemiluminescent immunoassays (IA) has become widespread, although their metrological characteristics do not seem appropriate for quantifying low testosterone concentrations. The objective of this review is to analyse the methods for quantifying testosterone and to establish whether there is scientific evidence that justifies measuring it in patients with PC who undergo castration, through liquid chromatography attached to a mass spectrometry in tandem (LC-MSMS). MATERIAL AND METHODS We performed a search in PubMed with the following MeSH terms: measurement, testosterone, androgen suppression and prostate cancer. We selected 12 studies that compared the metrological characteristics of various methods for quantifying serum testosterone compared with MS detection methods. RESULTS IAs are standard tools for measuring testosterone levels; however, there is evidence that IAs lack accuracy and precision for quantifying low concentrations. Most chemiluminescent IAs overestimate their concentration, especially below 100ng/dL. The procedures that use LC-MSMS have an adequate lower quantification limit and proper accuracy and precision. We found no specific evidence in patients with PC who underwent castration. CONCLUSIONS LC-MSMS is the appropriate method for quantifying low serum testosterone concentrations. We need to define the level of castration with this method and the optimal level related to better progression of the disease.
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Affiliation(s)
- I Comas
- Servicio de Bioquímica Clínica, Laboratoris Clínics, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España.
| | - R Ferrer
- Servicio de Bioquímica Clínica, Laboratoris Clínics, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - J Planas
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - A Celma
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - L Regis
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
| | - J Morote
- Servicio de Urología, Hospital Vall d'Hebron, Universitat Autónoma de Barcelona, Barcelona, España
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Pérez-Lago L, Izco S, Herranz M, Tudó G, Carcelén M, Comas I, Sierra O, González-Martín J, Ruiz-Serrano MJ, Eyene J, Bouza E, García de Viedma D. A novel strategy based on genomics and specific PCR reveals how a multidrug-resistant Mycobacterium tuberculosis strain became prevalent in Equatorial Guinea 15 years after its emergence. Clin Microbiol Infect 2016; 23:92-97. [PMID: 27746398 DOI: 10.1016/j.cmi.2016.10.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/19/2016] [Accepted: 10/06/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Molecular epidemiology techniques in tuberculosis (TB) can identify high-risk strains that are actively transmitted. We aimed to implement a novel strategy to optimize the identification and control of multidrug-resistant (MDR) TB in a specific population. METHODS We developed a strain-specific PCR tailored from whole genome sequencing (WGS) data to track a specific MDR prevalent strain in Equatorial Guinea (EG-MDR). RESULTS The PCR was applied prospectively on remnants of GeneXpert reaction mixtures owing to the lack of culture facilities in Equatorial Guinea. In 147 (93%) of 158 cases, we were able to differentiate between infection by the EG-MDR strain or by any other strain and found that 44% of all rifampicin-resistant TB cases were infected by EG-MDR. We also analysed 93 isolates obtained from Equatorial Guinea 15 years ago, before MDR-TB had become the problem it is today. We found that two of the scarce historical MDR cases were infected by EG-MDR. WGS revealed low variability-six single nucleotide polymorphisms acquired by this strain over 15 years-likely because of the lack in the country of a specific program to treat MDR-TB. CONCLUSIONS Our novel strategy, which integrated WGS analysis and strain-specific PCRs, represents a low-cost, rapid and transferable strategy that allowed a prospective efficient survey and fast historical analysis of MDR-TB in a population.
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Affiliation(s)
- L Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades respiratorias, CIBERES, Spain
| | - S Izco
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades respiratorias, CIBERES, Spain
| | - G Tudó
- Servei de Microbiologia, Hospital Clinic-CDB, Barcelona, Spain; IS Global, Barcelona, Spain
| | - M Carcelén
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - I Comas
- Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain; CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
| | - O Sierra
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J González-Martín
- Servei de Microbiologia, Hospital Clinic-CDB, Barcelona, Spain; IS Global, Barcelona, Spain
| | - M J Ruiz-Serrano
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades respiratorias, CIBERES, Spain
| | - J Eyene
- Programa Nacional TB y Lepra, Malabo, Equatorial Guinea
| | - E Bouza
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades respiratorias, CIBERES, Spain; Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - D García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER Enfermedades respiratorias, CIBERES, Spain.
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10
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Pérez-Lago L, Martínez Lirola M, Herranz M, Comas I, Bouza E, García-de-Viedma D. Fast and low-cost decentralized surveillance of transmission of tuberculosis based on strain-specific PCRs tailored from whole genome sequencing data: a pilot study. Clin Microbiol Infect 2015; 21:249.e1-9. [DOI: 10.1016/j.cmi.2014.10.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/07/2014] [Accepted: 10/08/2014] [Indexed: 11/26/2022]
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11
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Juarez P, Comas I, Gonzalez-Candelas F, Calvete JJ. Evolution of Snake Venom Disintegrins by Positive Darwinian Selection. Mol Biol Evol 2008; 25:2391-407. [DOI: 10.1093/molbev/msn179] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
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