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Lee Y, Brietzke E, Cao B, Chen Y, Linnaranta O, Mansur RB, Cortes P, Kösters M, Majeed A, Tamura JK, Lui LMW, Vinberg M, Keinänen J, Kisely S, Naveed S, Barbui C, Parker G, Owolabi M, Nishi D, Lee J, Srisurapanont M, Gill H, Guo L, Balanzá-Martínez V, Partonen T, Nolen WA, Lee JH, Kim JH, Chavannes NH, Ewais T, Atienza-Carbonell B, Silven AV, Yasuma N, Gil A, Novikov A, Lacey C, Versluis A, von Malortie S, Chan LF, Waqas A, Purgato M, Aardoom JJ, Ly-Uson JT, Sim K, Tuineag M, van der Kleij RMJJ, van Luenen S, Suttajit S, Hajek T, Lee YW, Porter RJ, Alsuwaidan M, Rosenblat JD, Ravindran AV, Lam RW, McIntyre RS. Development and implementation of guidelines for the management of depression: a systematic review. Bull World Health Organ 2020; 98:683-697H. [PMID: 33177758 PMCID: PMC7652558 DOI: 10.2471/blt.20.251405] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 01/21/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate the development and implementation of clinical practice guidelines for the management of depression globally. Methods We conducted a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder. For each identified guideline, we assessed compliance with measures of guideline development quality (such as transparency in guideline development processes and funding, multidisciplinary author group composition, systematic review of comparative efficacy research) and implementation (such as quality indicators). We compared guidelines from low- and middle-income countries with those from high-income countries. Findings We identified 82 national and 13 international clinical practice guidelines from 83 countries in 27 languages. Guideline development processes and funding sources were explicitly specified in a smaller proportion of guidelines from low- and middle-income countries (8/29; 28%) relative to high-income countries (35/58; 60%). Fewer guidelines (2/29; 7%) from low- and middle-income countries, relative to high-income countries (22/58; 38%), were authored by a multidisciplinary development group. A systematic review of comparative effectiveness was conducted in 31% (9/29) of low- and middle-income country guidelines versus 71% (41/58) of high-income country guidelines. Only 10% (3/29) of low- and middle-income country and 19% (11/58) of high-income country guidelines described plans to assess quality indicators or recommendation adherence. Conclusion Globally, guideline implementation is inadequately planned, reported and measured. Narrowing disparities in the development and implementation of guidelines in low- and middle-income countries is a priority. Future guidelines should present strategies to implement recommendations and measure feasibility, cost–effectiveness and impact on health outcomes.
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Affiliation(s)
- Yena Lee
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
| | - Bing Cao
- School of Psychology and Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Yan Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Outi Linnaranta
- Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montréal, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Paulina Cortes
- Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| | - Markus Kösters
- Department of Psychiatry II, Ulm University, Ulm, Germany
| | - Amna Majeed
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Jocelyn K Tamura
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Leanna M W Lui
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Maj Vinberg
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Hilleroed, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Jaakko Keinänen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Steve Kisely
- School of Clinical Medicine, The University of Queensland, Brisbane, Australia
| | - Sadiq Naveed
- Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas, USA
| | - Corrado Barbui
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Biomedicine and Movement Sciences, Verona, Italy
| | - Gary Parker
- Global Alliance for Chronic Diseases, Wellcome Trust, London, England
| | - Mayowa Owolabi
- Center for Genomics and Precision Medicine, University of Ibadan, Ibadan, Nigeria
| | - Daisuke Nishi
- Department of Mental Health, The University of Tokyo, Tokyo, Japan
| | - JungGoo Lee
- Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea
| | | | - Hartej Gill
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
| | - Lan Guo
- School of Public Health, Sun Yat-sen University, Guangdong, China
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, University of Valencia, Valencia, CIBERSAM, Spain
| | - Timo Partonen
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Willem A Nolen
- Department of Psychiatry, University of Groningen, Groningen, Netherlands
| | - Jae-Hon Lee
- Department of Psychiatry, Gyeongsang National University Hospital, Jinju, Republic of Korea
| | - Ji Hwan Kim
- Paik Institute for Clinical Research, Inje University, Busan, Republic of Korea
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Tatjana Ewais
- School of Clinical Medicine, The University of Queensland, Brisbane, Australia
| | | | - Anna V Silven
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Naonori Yasuma
- Department of Mental Health, The University of Tokyo, Tokyo, Japan
| | - Artyom Gil
- WHO European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programme, Moscow, Russian Federation
| | - Andrey Novikov
- Psychiatric and Neurological Hospital, Surgut, Russian Federation
| | - Cameron Lacey
- Maori Indigenous Health Institute, University of Otago, Christchurch, New Zealand
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | | | - Lai Fong Chan
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Department of Psychiatry, Queen's University School of Medicine, Kingston, Canada
| | - Ahmed Waqas
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,School of Psychology and Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Marianna Purgato
- WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Biomedicine and Movement Sciences, Verona, Italy
| | - Jiska Joëlle Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Josefina T Ly-Uson
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kang Sim
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montréal, Canada
| | - Maria Tuineag
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| | | | - Sanne van Luenen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Sirijit Suttajit
- Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Tomas Hajek
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Department of Psychiatry II, Ulm University, Ulm, Germany
| | - Yu Wei Lee
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montréal, Canada
| | - Richard J Porter
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Psychiatric Research Unit, Psychiatric Centre North Zealand, Hilleroed, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Mohammad Alsuwaidan
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,School of Clinical Medicine, The University of Queensland, Brisbane, Australia
| | - Arun V Ravindran
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,School of Clinical Medicine, The University of Queensland, Brisbane, Australia
| | - Raymond W Lam
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada.,Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas, USA
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Toronto Western Hospital, University Health Network, 399 Bathurst St 9MP-325, Toronto, Ontario, Canada
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Lepetit L, Cortes P, Thomas L. Progress of ISO Standards on the Confinement Systems in Fusion Facilities Using Tritium. Fusion Science and Technology 2017. [DOI: 10.1080/15361055.2017.1290951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- L. Lepetit
- ITER Organization , CS 90046, St Paul les Durance 13067, France
| | - P. Cortes
- ITER Organization , CS 90046, St Paul les Durance 13067, France
| | - L. Thomas
- ISO/TC85/SC2 secretariat, AFNOR , 11 Rue Francis de Pressensé, Saint-Denis 932100, France
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Cortes P, Riser B, Narins RG. Glomerular hypertension and progressive renal disease: the interplay of mesangial cell stretch, cytokine formation and extracellular matrix synthesis. Contrib Nephrol 2015; 118:229-33. [PMID: 8744062 DOI: 10.1159/000425098] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- P Cortes
- Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, Mich., USA
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Affiliation(s)
- R Sousa
- Department of Oncology, Hospital Universitário de Santa Maria, Lisbon, Portugal
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Gligorov J, Doval D, Bines J, Jiang Z, Alba E, Cortes P, Srock S, de Ducla S, Freudensprung U, Mustacchi G. Efficacy and Safety of Maintenance Bevacizumab (Bev) with or Without Capecitabine (Cap) After Initial First-Line Bev Plus Docetaxel (Doc) for Her2-Negative Metastatic Breast Cancer (Mbc): Imelda Randomised Phase III Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pascal R, Cortes P, Friconneau JP, Giancarli L, Gotewal K, Iseli M, Kim B, Levesy B, Martins JP, Merola M, Nevière JC, Patisson L, Siarras A, Tesini A. Main maintenance operations for Test Blanket Systems in ITER TBM port cells. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.05.081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Dammann A, Arumugam A, Beaudoin V, Beltran D, Benchikhoune M, Berruyer F, Cortes P, Gandini F, Ghirelli N, Gray A, Hurzlmeier H, Le Page M, Lemée A, Lentini G, Loughlin M, Mita Y, Patisson L, Rigoni G, Rathi D, Song I. Nuclear shielding of openings in ITER Tokamak building. Fusion Engineering and Design 2013. [DOI: 10.1016/j.fusengdes.2013.02.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Pascal R, Beloglazov S, Bonagiri S, Commin L, Cortes P, Giancarli L, Gliss C, Iseli M, Lanza R, Levesy B, Martins JP, Nevière JC, Patisson L, Plutino D, Shu W, Swami H. Progress in the integration of Test Blanket Systems in ITER equatorial port cells and in the interfaces definition. Fusion Engineering and Design 2012. [DOI: 10.1016/j.fusengdes.2012.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hu JCY, Seo BK, Neri QV, Rozenwaks Z, Palermo GD, Fields T, Neri QV, Monahan D, Rosenwaks Z, Palermo GD, Szkodziak P, Plewka K, Wozniak S, Czuczwar P, Mroczkowski A, Lorenzo Leon C, Hernandez J, Chinea Mendez E, Concepcion Lorenzo C, Sanabria Perez V, Puopolo M, Palumbo A, Toth B, Franz C, Montag M, Boing A, Strowitzki T, Nieuwland R, Griesinger G, Schultze-Mosgau A, Cordes T, Depenbusch M, Diedrich K, Vloeberghs V, Verheyen G, Camus M, Van de Velde H, Goossens A, Tournaye H, Coppola G, Di Caprio G, Wilding M, Ferraro P, Esposito G, Di Matteo L, Dale R, Coppola G, Dale B, Daoud S, Auger J, Wolf JP, Dulioust E, Lafuente R, Lopez G, Brassesco M, Hamad M, Montenarh M, Hammadeh M, Robles F, Magli MC, Crippa A, Pescatori E, Ferraretti AP, Gianaroli L, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Crippa A, Ferraretti AP, Magli MC, Crivello AM, Robles F, Gianaroli L, Sermondade N, Dupont C, Hafhouf E, Cedrin-Durnerin I, Poncelet C, Benzacken B, Levy R, Sifer C, Ferfouri F, Boitrelle F, Clement P, Molina Gomes D, Bailly M, Selva J, Vialard F, Yaprak E, Basar M, Guzel E, Arda O, Irez T, Norambuena P, Krenkova P, Tuettelmann F, Kliesch S, Paulasova P, Stambergova A, Macek M, Macek M, Rivera R, Garrido-Gomez T, Galletero S, Meseguer M, Dominguez F, Garrido N, Mallidis C, Sanchez V, Weigeng L, Redmann K, Wistuba J, Gross P, Wuebbelling F, Fallnich C, Burger M, Kliesch S, Schlatt S, San Celestino Carchenilla M, Pacheco Castro A, Simon Sanjurjo P, Molinero Ballesteros A, Rubio Garcia S, Garcia Velasco JA, Macanovic B, Otasevic V, Korac A, Vucetic M, Garalejic E, Ivanovic Burmazovic I, Filipovic MR, Buzadzic B, Stancic A, Jankovic A, Velickovic K, Golic I, Markelic M, Korac B, Gosalvez J, Ruiz-Jorro M, Garcia-Ochoa C, Sachez-Martin P, Martinez-Moya M, Caballero P, Hasegawa N, Fukunaga N, Nagai R, Kitasaka H, Yoshimura T, Tamura F, Kato M, Nakayama K, Oono H, Kojima E, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Das M, Al-Hathal N, San-Gabriel M, Phillips S, Kadoch IJ, Bissonnette F, Holzer H, Zini A, Zebitay AG, Irez T, Ocal P, Sahmay S, Karahuseyinoglu S, Usta T, Repping S, Silber S, Van Wely M, Datta A, Nayini K, Eapen A, Barlow S, Lockwood G, Tavares R, Baptista M, Publicover SJ, Ramalho-Santos J, Vaamonde D, Rodriguez I, Diaz A, Darr C, Chow V, Ma S, Smith R, Jeria F, Rivera J, Gabler F, Nicolai H, Cunha M, Viana P, Goncalves A, Silva J, Oliveira C, Teixeira da Silva J, Ferraz L, Madureira C, Doria S, Sousa M, Barros A, Herrero MB, Delbes G, Troueng E, Holzer H, Chan PTK, Vingris L, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A, Borges E, Sargin Oruc A, Gulerman C, Zeyrek T, Yilmaz N, Tuzcuoglu D, Cicek N, Scarselli F, Terribile M, Franco G, Zavaglia D, Dente D, Zazzaro V, Riccio T, Minasi MG, Greco E, Cejudo-Roman A, Ravina CG, Candenas L, Gallardo-Castro M, Martin-Lozano D, Fernandez-Sanchez M, Pinto FM, Balasuriya A, Serhal P, Doshi A, Harper J, Romany L, Garrido N, Fernandez JL, Pellicer A, Meseguer M, Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Prada E, Jorda I, Cortes P, Llagostera M, Navarro J, Benet J, Kesici H, Cayli S, Erdemir F, Karaca Z, Aslan H, Karaca Z, Cayli S, Ocakli S, Kesici H, Erdemir F, Aslan H, Tas U, Ozdemir AA, Aktas RG, Tok OE, Ocakli S, Cayli S, Karaca Z, Erdemir F, Aslan H, Li S, Lu C, Hwu Y, Lee RK, Landaburu I, Gonzalvo MC, Clavero A, Ramirez JP, Pedrinaci S, Serrano M, Montero L, Carrillo S, Weiss J, Ortiz AP, Castilla JA, Sahin O, Bakircioglu E, Serdarogullari M, Bayram A, Yayla S, Ulug U, Tosun SB, Bahceci M, Aktas RG, Ozdemir AA, Tok OE, Yoon SY, Shin DH, Shin TE, Park EA, Won HJ, Kim YS, Lee WS, Yoon TK, Lee DR, Hattori H, Nakajo Y, Kyoya T, Kuchiki M, Kanto S, Kyono K, Park M, Park MR, Lim EJ, Lee WS, Yoon TK, Lee DR, Choi Y, Mitra A, Bhattacharya J, Kundu A, Mukhopadhaya D, Pal M, Enciso M, Alfarawati S, Wells D, Fernandez-Encinas A, Garcia-Peiro A, Ribas-Maynou J, Abad C, Amengual MJ, Navarro J, Benet J, Esmaeili V, Safiri M, Shahverdi AH, Alizadeh AR, Ebrahimi B, Brucculeri AM, Ruvolo G, Giovannelli L, Schillaci R, Cittadini E, Scaravelli G, Perino A, Cortes Gallego S, Gabriel Segovia A, Nunez Calonge R, Guijarro Ponce A, Ortega Lopez L, Caballero Peregrin P, Heindryckx B, Kashir J, Jones C, Mounce G, Ramadan WM, Lemmon B, De Sutter P, Parrington J, Turner K, Child T, McVeigh E, Coward K, Bakircioglu E, Ulug U, Tosun S, Serdarogullari M, Bayram A, Ciray N, Bahceci M, Saeidi S, Shapouri F, Hoseinifar H, Sabbaghian M, Pacey A, Aflatoonian R, Bosco L, Ruvolo G, Carrillo L, Pane A, Manno M, Roccheri MC, Cittadini E, Selles E, Garcia-Herrero S, Martinez JA, Munoz M, Meseguer M, Garrido N, Durmaz A, Dikmen N, Gunduz C, Tavmergen Goker E, Tavmergen E, Gozuacik D, Vatansever HS, Kara B, Calimlioglu N, Yasar P, Tavmergen E, Tavmergen Goker E, Semerci B, Baka M, Ozbilgin K, Karabulut A, Tekin A, Sabah B, Cottin V, Kottelat D, Fellmann M, Halm S, Rosenthaler E, Kisida T, Kojima F, Sakamoto T, Makutina VA, Balezin SL, Rosly OF, Slishkina TV, Hatzi E, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Zikopoulos K, Georgiou I, Zikopoulos K, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Georgiou I, Georgiou I, Lazaros L, Xita N, Makrydimas G, Sofikitis N, Kaponis A, Stefos T, Hatzi E, Zikopoulos K, Hibi H, Ohori T, Sumitomo M, Asada Y, Anarte C, Calvo I, Domingo A, Presilla N, Aleman M, Bou R, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Zhylkova I, Feskov O, Feskova I, Zozulina O, Somova O, Nabi A, Khalili MA, Roudbari F, Parmegiani L, Cognigni GE, Bernardi S, Taraborrelli S, Troilo E, Ciampaglia W, Pocognoli P, Infante FE, Tabarelli de fatis C, Arnone A, Maccarini AM, Filicori M, Silva L, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Cavagna M, Baruffi RLR, Franco JG, Fujii Y, Endou Y, Mtoyama H, Shokri S, Aitken RJ. ANDROLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.73] [Citation(s) in RCA: 4] [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: 11/13/2022] Open
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Cortes P, Iseli M, Lepetit L, Camp P, Taylor N, Rannou A, Delaforge T. Creation of ISO Standards Related to the Confinement Systems in Tritium Facilities. Fusion Science and Technology 2011. [DOI: 10.13182/fst11-a12556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- P. Cortes
- ITER Organization, CS 90046, 13115 St Paul les Durance France
| | - M. Iseli
- ITER Organization, CS 90046, 13115 St Paul les Durance France
| | - L. Lepetit
- ITER Organization, CS 90046, 13115 St Paul les Durance France
| | - P. Camp
- ITER Organization, CS 90046, 13115 St Paul les Durance France
| | - N. Taylor
- ITER Organization, CS 90046, 13115 St Paul les Durance France
| | - A. Rannou
- ISO/TC85/SC2 chairman, IRSN, Route du panorama, 92260 Fontenay aux roses France
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Ribeiro J, Luís I, Costa C, Correia L, Semedo M, Lourenço C, Cortes P, Quintela A, Costa L. 195 Correlation between hormonal receptors and HERr2 status of primary and metastatic breast cancer according to the metastatic organ involved. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70225-1] [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: 11/25/2022] Open
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Figueroa RA, Valdivieso S, Turpaud M, Cortes P, Barros J, Castaño C. Journal club experience in a postgraduate psychiatry program in Chile. Acad Psychiatry 2009; 33:407-409. [PMID: 19828859 DOI: 10.1176/appi.ap.33.5.407] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Literature about journal clubs in postgraduate psychiatry programs is scarce, and there is no reference to residents' preferences. METHODS Residents were asked to respond to a survey about their general satisfaction with the current journal club format and paper preferences, according to subject, scope, and type. RESULTS Residents' general satisfaction was high. Residents preferred clinically relevant meta-analyses and randomized controlled trials about mood and psychotic disorders, neuroscience, and biological therapies. CONCLUSION There is a trend to prefer articles related to biological aspects of psychiatry, centered in evidence-based medicine methodology. An effort should be made to broaden the scope of selection of papers, incorporating, for instance, humanistic views, psychotherapy, and other methodologies.
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Affiliation(s)
- Rodrigo A Figueroa
- Department of Psychiatry at Pontificia Universidad Catôlica de Chile in Santiago, Chile
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Ahn S, Kozlov M, Cortes P, Cunningham-Rundles C. Defective Double-Strand DNA Break Repair and V(D) J Recombination In Patients With Common Variable Immune Deficiency. J Allergy Clin Immunol 2009. [DOI: 10.1016/j.jaci.2008.12.224] [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: 11/30/2022]
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Aldaco F, Perez P, Cervantes G, Torrecillas L, Cortes P, Hernandez B, Erazo AA. EPID (etoposide, cisplatin, ifosfamide and dexamethasone) with or without rituximab as second line treatment in patients with non Hodgkin lymphoma not candidates for haematopoietic stem cell transplantation (HSCT): A single center retrospective study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19500] [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: 11/20/2022] Open
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Ribeiro J, Luis I, Fortunato M, Correia L, Quintela A, Cortes P, Costa L. Fulvestrant in metastatic breast cancer previously treated with aromatase inhibitors. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70751-1] [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: 10/22/2022] Open
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Abstract
Glomerulosclerosis is one of the complications of diabetes that occurs after many years of uncontrolled hyperglycemia. Mesangial cells (MCs) exposed to high glucose (HG) for short periods have shown that transforming growth factor-beta (TGF-beta) and activated diacylglycerol-dependent protein kinase C (PKC) mediate increased collagen formation. Our study examined collagen formation by MCs exposed to HG for 8 weeks. Exposure to HG in overnight culture resulted in the activation of all PKC isoforms. In contrast, 8-week exposure to HG resulted in the persistent activation of PKC-delta, did not change PKC-alpha or -beta activity, and decreased PKC-epsilon activity while increasing collagen I and IV gene and protein expression. Collagen IV accumulation was reversed by specific PKC-delta inhibition. Collagen IV gene expression was completely normalized by TGF-beta neutralization; however, this was associated with plasminogen activator inhibitor-1 (PAI-1) overexpression and a modest reduction in collagen protein. Our studies suggest that prolonged exposure to HG results in PKC-delta-driven collagen accumulation by MCs mediated by PAI-1 but independent of TGF-beta.
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Affiliation(s)
- M H A Baccora
- Division of Nephrology, Department of Medicine, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA
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18
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Soto C, Torrecillas L, Reyes S, Ramirez M, Perez L, Cervantes G, Gonzalez F, Tellez E, Cortes P, Benitez H. Capecitabine (X) and taxanes in patients (pts) with anthracycline-pretreated metastatic breast cancer (MBC): Sequential vs. combined therapy results from a MOSG randomized phase III trial. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.570] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
570 Introduction: Capecitabine (Xeloda [X]) shows synergy with taxanes and adding X to docetaxel (T) extends overall survival (OS), response rate (RR) and progression free-survival (PFS) beyond T alone. Sequential single-agent therapy could confer convenience benefits and may be more appropriate than combination chemotherapy for some pts. Methods: Pts with anthracycline-pretreated MBC received 3-weekly cycles of 1 of the following regimens: X→taxane (X 1250mg/m2 bid d1–14, followed after progression (PD) by T 100mg/m2 or paclitaxel [P] 175mg/m2 day 1; X+P (X 825mg/m2 bid days 1–14 + P 175mg/m2 day 1) or X+T (X 825mg/m2 bid days 1–14 + T 75mg/m2 day 1). Results: Of the 368 pts enrolled, 91 are either still on therapy or not evaluable. The table shows baseline characteristics, efficacy and safety in evaluable pts. Median follow up is 15.5 months. Median doses for X in each arm (1st cycle vs. 8th cycle, mg/m2 bid): 1218 vs. 1054; 948 vs. 900; 846 vs. 751. Median doses for P and T (1st cycle vs. 8th cycle, mg/m2): 173 vs. 169 and 75 vs. 72, respectively. In the X→taxane arm, 58 pts (64%) received sequential taxane; the remainder did not receive a taxane, either because they were still on X, had CR or had rapid PD. Conclusions: RR is higher with XP and XT, but PFS and OS are similar at a median follow-up of 15.5 months. All regimens were well tolerated with minimal grade 4 AEs. Because there is no clear superiority of sequential vs. combined therapy, pt characteristics are likely to be used to decide which regimen is the most appropriate. [Table: see text] [Table: see text]
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Affiliation(s)
- C. Soto
- IMSS - ISSSTE, Mexico City, Mexico
| | | | - S. Reyes
- IMSS - ISSSTE, Mexico City, Mexico
| | | | - L. Perez
- IMSS - ISSSTE, Mexico City, Mexico
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Abstract
Otitis interna was diagnosed in five 9-to-21-day-old turkey poults with clinical signs of paralysis, opisthotonus, torticollis, blindness, and increased mortality. Gross and microscopic lesions in the poults included omphalitis, typhlitis, hepatitis, meningoencephalitis, ophthalmitis, neuritis and ganglionitis of the vestibulocochlear nerve, and otitis interna. Salmonella enterica arizonae was isolated from the brains, eyes, intestines, yolk sacs, and livers of poults. Birds with otitis interna also had meningoencephalitis. It is most likely that the S. enterica arizonae infection spread from the brain to the internal ears through the vestibulocochlear nerve. This is the first documentation of otitis interna caused by bacteria in an avian species.
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Affiliation(s)
- H L Shivaprasad
- California Animal Health and Food Safety Laboratory System, Fresno Branch, School of Veterinary Medicine, University of California, Davis, 2789 South Orange Avenue, Fresno, CA 93725, USA
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20
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Cavender-Bares J, Cortes P, Rambal S, Joffre R, Miles B, Rocheteau A. Summer and winter sensitivity of leaves and xylem to minimum freezing temperatures: a comparison of co-occurring Mediterranean oaks that differ in leaf lifespan. New Phytol 2005; 168:597-612. [PMID: 16313643 DOI: 10.1111/j.1469-8137.2005.01555.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Freezing sensitivity of leaves and xylem was examined in four co-occurring Mediterranean oaks (Quercus spp.) grown in a common garden to determine whether freezing responses of leaves and xylem were coordinated and could be predicted by leaf lifespan. Freezing-induced embolism and loss of photosynthetic function were measured after overnight exposure to a range of subzero temperatures in both summer and winter. Both measures were found to be dependent on minimum freezing temperature and were correlated with leaf lifespan and vessel diameter. The dependence of xylem embolism on minimum freezing temperature may result from the decline in water potential with ice temperature that influences the redistribution of water during freezing and leads to an increase in xylem tension. Winter acclimatization had a relatively small effect on the vulnerability to freezing-induced embolism, although leaf photosynthetic function showed a strong acclimatization response, particularly in the two evergreen species. Quercus ilex, the species with the longest leaf lifespan and narrowest vessel diameters, showed the highest freezing tolerance. This helps explain its ability to inhabit a broad range throughout the Mediterranean region. By contrast, the inability of the deciduous oaks to maintain photosynthetic and vascular function throughout the winter indicates a competitive disadvantage that may prevent them from expanding their ranges.
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Affiliation(s)
- J Cavender-Bares
- Department of Ecology, Evolution and Behavior, University of Minnesota, St Paul, MN, USA.
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21
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Torrecillas L, Ballesteros D, Cervantes G, Cortes P, Aldaco F, Martell R, Fernandez A, Ortega B, Rosas L, Erazo A. 163 Capecitabine chemoradiation for stage II B- III B cervical cancer: preliminary phase I results, Mexican Oncology Study Group. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90196-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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22
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Pascual-Castroviejo I, Cortes P, Fernández-Cuadrado J, de la Flor-Crespo M, Pascual Pascual SI. [Cutaneous haemangioma associated with a hepatic haemangioma and neurofibromatosis type 1 (NF1)]. Rev Neurol 2002; 34:652-4. [PMID: 12080515] [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: 02/25/2023]
Abstract
OBJECTIVE To present a girl with cutaneous cavernous hemangioma associated with hemangioma of the liver and neurofibromatosis type 1 (NF1). PATIENTS AND METHODS A 3 year old girl showed cutaneous cavernous hemangioma on the right hypochondral region and numerous caf au lait spots. She was studied with abdominal echography and abdominal and thoracic magnetic resonance (MR) as well as with cerebral MR angiography. RESULTS Both image studies, echography and MR, revealed a mass 2 x 2 cm of hemangiomatous type in the upper zone of the liver, near the external cutaneous cavernous hemangioma. Echographical follow up showed a progressive diminution of the hepatic hemangioma size. At 2 1/2 years of age a voluminous thoracic tumor extending between aorta and sternon very difficult of being removed was found. CONCLUSION Hemangioma of the liver appears to be related with cutaneous cavernous hemangioma as a finding of the syndrome of Pascual Castroviejo II. Furthermore, the patient has NF1 which has not been previously related with the cutaneous and/or the liver pathology.
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23
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Abstract
Connective tissue growth factor (CTGF), a member of the closely related CCN family of cytokines appears to be fibrotic in skin. To determine whether CTGF is implicated in diabetic glomerulosclerosis we studied cultured rat mesangial cells (MC) as well as kidney cortex and microdissected glomeruli from obese, diabetic db/db mice and their normal counterparts. Exposure of MC to rhCTGF significantly increased fibronectin and collagen type I secretion. Further, unstimulated MC expressed low levels of CTGF message and secreted minimal amounts of CTGF protein (36-38 kDa). However, exposure to TGF-beta, increased glucose concentrations, or cyclic mechanical strain, all causal factors in glomerulosclerosis, markedly induced the expression of CTGF transcripts. With all but mechanical strain there was a concomitant stimulation of CTGF protein secretion. TGF-beta also induced abundant quantities of a small molecular weight form of CTGF (18 kDa). The induction of CTGF protein by a high glucose concentration was mediated by TGF-beta, since a TGF-beta neutralizing antibody blocked this stimulation. In vivo studies using quantitative RT-PCR demonstrated that while CTGF transcripts were low in the glomeruli of control mice, expression was increased 27-fold after approximately 3.5 months of diabetes. These changes occurred early in diabetic nephropathy when mesangial expansion was mild, and interstitial disease and proteinuria were absent. A substantially reduced elevation of CTGF mRNA (2-fold) observed in whole kidney cortices indicted that the primary alteration of CTGF expression was in the glomerulus. These results suggest that CTGF upregulation is an important factor in the pathogenesis of mesangial matrix accumulation in both diabetic and non-diabetic glomerulosclerosis, acting downstream of TGF-beta.
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Affiliation(s)
- B L Riser
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA.
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24
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O'Donnell A, Scurr M, Banerji U, Benson C, Gallagher N, Cortes P, Judson I. ZD9331 in combination with gemcitabine in patients with refractory solid tumours - a phase I study. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)80755-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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Villa A, Sobacchi C, Notarangelo LD, Bozzi F, Abinun M, Abrahamsen TG, Arkwright PD, Baniyash M, Brooks EG, Conley ME, Cortes P, Duse M, Fasth A, Filipovich AM, Infante AJ, Jones A, Mazzolari E, Muller SM, Pasic S, Rechavi G, Sacco MG, Santagata S, Schroeder ML, Seger R, Strina D, Ugazio A, Väliaho J, Vihinen M, Vogler LB, Ochs H, Vezzoni P, Friedrich W, Schwarz K. V(D)J recombination defects in lymphocytes due to RAG mutations: severe immunodeficiency with a spectrum of clinical presentations. Blood 2001; 97:81-8. [PMID: 11133745 DOI: 10.1182/blood.v97.1.81] [Citation(s) in RCA: 272] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Severe combined immunodeficiency (SCID) comprises a heterogeneous group of primary immunodeficiencies, a proportion of which are due to mutations in either of the 2 recombination activating genes (RAG)-1 and -2, which mediate the process of V(D)J recombination leading to the assembly of antigen receptor genes. It is reported here that the clinical and immunologic phenotypes of patients bearing mutations in RAGs are more diverse than previously thought and that this variability is related, in part, to the specific type of RAG mutation. By analyzing 44 such patients from 41 families, the following conclusions were reached: (1) null mutations on both alleles lead to the T-B-SCID phenotype; (2) patients manifesting classic Omenn syndrome (OS) have missense mutations on at least one allele and maintain partial V(D)J recombination activity, which accounts for the generation of residual, oligoclonal T-lymphocytes; (3) in a third group of patients, findings were only partially compatible with OS, and these patients, who also carried at least one missense mutation, may be considered to have atypical SCID/OS; (4) patients with engraftment of maternal T cells as a complication of a transplacental transfusion represented a fourth group, and these patients, who often presented with a clinical phenotype mimicking OS, may be observed regardless of the type of RAG gene mutation. Analysis of the RAG genes by direct sequencing is an effective way to provide accurate diagnosis of RAG-deficient as opposed to RAG-independent V(D)J recombination defects, a distinction that cannot be made based on clinical and immunologic phenotype alone.
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Affiliation(s)
- A Villa
- Department of Human Genome and Multifactorial Disease, Istituto di Tecnologie, Biomediche Avanzate, Consiglio Nazionale delle Ricerche, Segrate, Italy
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Riser BL, Varani J, Cortes P, Yee J, Dame M, Sharba AK. Cyclic stretching of mesangial cells up-regulates intercellular adhesion molecule-1 and leukocyte adherence: a possible new mechanism for glomerulosclerosis. Am J Pathol 2001; 158:11-7. [PMID: 11141473 PMCID: PMC1850278 DOI: 10.1016/s0002-9440(10)63938-7] [Citation(s) in RCA: 41] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Intraglomerular hypertension is a primary causal factor in the progressive glomerulosclerosis that characterizes diabetic nephropathy or severe renal ablation. However, inflammation of the glomerular mesangium also participates in at least the early phase of these diseases. In glomerulonephritis, where inflammation is thought to be the predominant causal factor, intraglomerular hypertension is also often present. Mesangial cells (MCs) are critical in orchestrating key functions of the glomerulus including extracellular matrix metabolism, cytokine production, and interaction with leukocytes. Because MCs are subject to increased stretching when intraglomerular hypertension is present, and in glomerulonephritis MC/leukocyte interactions seem to be mediated primarily via the up-regulation of intercellular adhesion molecule-1 (ICAM-1), we examine the possibility that cyclic stretching is a stimulus for increased MC ICAM-1 activity. We demonstrate that the normal low levels of MC ICAM-1 mRNA and protein are dramatically up-regulated by even short intervals of cyclic stretch. This effect is dose- and time-dependent, and requires little amplitude and a brief period of elongation for significant induction. Stretch-induced MC ICAM-1 also leads to a marked elevation in phagocytic leukocyte adherence. This stimulated adherence is equal or greater than that induced by the inflammatory cytokine tumor necrosis factor-alpha, whereas an additive effect occurs when both are applied in combination. Our results indicate that stretch-induced ICAM-1 may provide a direct link between hypertension and inflammation in the progression of injury and glomerulosclerosis in diabetes, renal ablation, and other forms of glomerulonephritis.
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Affiliation(s)
- B L Riser
- Department of Medicine, Division of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI 48202, USA.
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27
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Santagata S, Gomez CA, Sobacchi C, Bozzi F, Abinun M, Pasic S, Cortes P, Vezzoni P, Villa A. N-terminal RAG1 frameshift mutations in Omenn's syndrome: internal methionine usage leads to partial V(D)J recombination activity and reveals a fundamental role in vivo for the N-terminal domains. Proc Natl Acad Sci U S A 2000; 97:14572-7. [PMID: 11121059 PMCID: PMC18960 DOI: 10.1073/pnas.97.26.14572] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Omenn's syndrome is an autosomal recessive primary immunodeficiency characterized by variable numbers of T lymphocytes of limited clonality, hypereosinophilia, and high IgE levels with a paradoxical absence of circulating B lymphocytes. We have previously attributed this disorder to missense mutations that render the RAG1/RAG2 recombinase only partially active. Here we report seven Omenn's patients with a novel class of genetic lesions: frameshift mutations within the 5' coding region of RAG1. Interestingly, we demonstrate in transient expression experiments that these frameshift deletion alleles remain partially functional for both deletional and inversional recombination and can hence explain the partial rearrangement phenotype observed in these patients. The rearrangement activity is mediated by truncated RAG1 proteins that are generated by alternative ATG usage 3' to the frameshift deletion and that demonstrate improper cellular localization. Taken together, our results suggest a novel mechanism for the development of immunodeficiency in a subset of Omenn's syndrome patients.
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Affiliation(s)
- S Santagata
- Ruttenberg Cancer Center, Immunobiology Center, Mount Sinai School of Medicine, 1425 Madison Avenue, New York, NY 10029, USA
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Cortes P, Méndez M, Riser BL, Guérin CJ, Rodríguez-Barbero A, Hassett C, Yee J. F-actin fiber distribution in glomerular cells: structural and functional implications. Kidney Int 2000; 58:2452-61. [PMID: 11115078 DOI: 10.1046/j.1523-1755.2000.00428.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Glomerular distention is associated with cellular mechanical strain. In addition, glomerular distention/contraction is assumed to influence the filtration rate through changes in filtration surface area. A contractile cytoskeleton in podocytes and mesangial cells, formed by F-actin-containing stress fibers, maintains structural integrity and modulates glomerular expansion. In this study, the glomerular cell distribution of F-actin and vimentin filaments was studied in normal control and nine-month streptozotocin-diabetic rats. Results in situ were compared with observations in tissue culture. METHODS Microdissected rat glomeruli were perfused to obtain a physiological 25% glomerular expansion over the basal value. Fixation was done without change in glomerular volume. Dual fluorescent labeling of F-actin and vimentin was carried out, and samples were examined by confocal laser scanning microscopy. RESULTS The podocyte cell bodies and their cytoplasmic projections, including the foot processes, contained bundles of vimentin-containing fibers. Except for a thin layer at the base of foot processes, they did not demonstrate F-actin. While mesangial cells in culture had F-actin as long stress fibers resembling tense cables, mesangial cells stretched in situ contained a maze of short tortuous F-actin fibers organized in bundles that often encircled vascular spaces. This fibrillar organization was disrupted in diabetic glomeruli. CONCLUSION Mesangial cells, but not podocytes, contain a cytoskeleton capable of contraction that is disorganized in long-term diabetes. Together with previous observations, the distribution of this cytoskeleton suggests that mesangial cell contraction may be involved in the redistribution of glomerular capillary blood flow, but not substantially in the modulation of glomerular distention. Disorganization of stress fibers may be a cause of hyperfiltration in diabetes.
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Affiliation(s)
- P Cortes
- Division of Nephrology and Hypertension, Department of Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA.
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Abstract
Omenn syndrome (OS) is a peculiar, autosomal recessive severe combined immunodeficiency (SCID) associated with early-onset, generalized, exudative erythrodermia; lymphoadenopathy; hepato- and splenomegaly; hypereosinophilia; elevated serum IgE; and normal to high activated, yet non-functional, oligoclonal T cells. Recent investigations have shown that the primum movens of all these puzzling features lies in a defect of the lymphoid-specific V(D)J recombination process. Abnormalities in both alleles of either Rag-1 or -2 genes are found in all OS patients. At variance with T B- SCID, whose Rag mutations represent null alleles, OS mutations maintain a residual recombination activity, allowing limited T-cell receptor gene rearrangements to occur in the thymus. The gene rearrangements are subsequently expanded in the periphery after environmental antigen exposure. Missense mutations detected in OS have been examined in a number of biochemical assays and have contributed to dissect the various functional domains of both Rag-1 and Rag-2 proteins. The examination of a set of mutations occurring in the Rag-1 N-terminal portion has demonstrated that this region plays a fundamental role in vivo. The elucidation of the molecular basis of OS has allowed us to perform early prenatal diagnosis and could be the basis for trials of in utero bone marrow transplantation or gene therapy approaches.
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Affiliation(s)
- S Santagata
- Ruttenberg Cancer Center, Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA
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Gomez CA, Ptaszek LM, Villa A, Bozzi F, Sobacchi C, Brooks EG, Notarangelo LD, Spanopoulou E, Pan ZQ, Vezzoni P, Cortes P, Santagata S. Mutations in conserved regions of the predicted RAG2 kelch repeats block initiation of V(D)J recombination and result in primary immunodeficiencies. Mol Cell Biol 2000; 20:5653-64. [PMID: 10891502 PMCID: PMC86034 DOI: 10.1128/mcb.20.15.5653-5664.2000] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The V(D)J recombination reaction is composed of multiple nucleolytic processing steps mediated by the recombination-activating proteins RAG1 and RAG2. Sequence analysis has suggested that RAG2 contains six kelch repeat motifs that are predicted to form a six-bladed beta-propeller structure, with the second beta-strand of each repeat demonstrating marked conservation both within and between kelch repeat-containing proteins. Here we demonstrate that mutations G95R and DeltaI273 within the predicted second beta-strand of repeats 2 and 5 of RAG2 lead to immunodeficiency in patients P1 and P2. Green fluorescent protein fusions with the mutant proteins reveal appropriate localization to the nucleus. However, both mutations reduce the capacity of RAG2 to interact with RAG1 and block recombination signal cleavage, therefore implicating a defect in the early steps of the recombination reaction as the basis of the clinical phenotype. The present experiments, performed with an extensive panel of site-directed mutations within each of the six kelch motifs, further support the critical role of both hydrophobic and glycine-rich regions within the second beta-strand for RAG1-RAG2 interaction and recombination signal recognition and cleavage. In contrast, multiple mutations within the variable-loop regions of the kelch repeats had either mild or no effects on RAG1-RAG2 interaction and hence on the ability to mediate recombination. In all, the data demonstrate a critical role of the RAG2 kelch repeats for V(D)J recombination and highlight the importance of the conserved elements of the kelch motif.
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Affiliation(s)
- C A Gomez
- Ruttenberg Cancer Center, Mount Sinai School of Medicine of New York University, New York, New York 10029, USA
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Abstract
It has recently been shown that mesangial cells are subjected to multiple forms of mechanical strain (fluid shear, hydrostatic pressure, and triaxial stretch) as a result of forces exerted by the vasculature. Nevertheless, the exact nature and the relative response to these stimuli have not been clarified. Although it is now well established that cyclic stretching of mesangial cells in culture results in the overproduction of extracellular matrix, indicating how intraglomerular hypertension may lead to glomerular scar formation, the contribution of different intracellular signalling mechanisms and extracellular mediators of the response are only now being identified. Recent studies point to a role for high glucose concentrations, transforming growth factor beta and its receptors, vascular endothelial growth factor, and connective tissue growth factor as important mediators, or modifiers of the response to mechanical strain. Although evidence exists for a role for protein kinase C, recent studies also implicate the mitogen-activated protein kinases along with enhanced DNA-binding activity of AP-1 as part of the signalling cascade altering matrix synthesis and cell proliferation in response to stretch. Finally, recent studies examining the effects of oscillating hyperbaric pressure demonstrate similarities, as well as differences, in comparison to those of cyclic stretch.
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Affiliation(s)
- B L Riser
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
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Santagata S, Besmer E, Villa A, Bozzi F, Allingham JS, Sobacchi C, Haniford DB, Vezzoni P, Nussenzweig MC, Pan ZQ, Cortes P. The RAG1/RAG2 complex constitutes a 3' flap endonuclease: implications for junctional diversity in V(D)J and transpositional recombination. Mol Cell 1999; 4:935-47. [PMID: 10635319 DOI: 10.1016/s1097-2765(00)80223-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
During V(D)J recombination, processing of branched coding end intermediates is essential for generating junctional diversity. Here, we report that the RAG1/ RAG2 recombinase is a 3' flap endonuclease. Substrates of this nuclease activity include various coding end intermediates, suggesting a direct role for RAG1/ RAG2 in generating junctional diversity during V(D)J recombination. Evidence is also provided indicating that site-specific RSS nicking involves RAG1/RAG2-mediated processing of a localized flap-like structure, implying 3' flap nicking in multiple DNA processing reactions. We have also demonstrated that the bacterial transposase Tn10 contains a 3' flap endonuclease activity, suggesting a mechanistic parallel between RAG1/RAG2 and other transposases. Based on these data, we propose that numerous transposases may facilitate genomic evolution by removing single-stranded extensions during the processing of excision site junctions.
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Affiliation(s)
- S Santagata
- Ruttenberg Cancer Center, Mount Sinai School of Medicine, New York, New York 10029, USA
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Riser BL, Ladson-Wofford S, Sharba A, Cortes P, Drake K, Guerin CJ, Yee J, Choi ME, Segarini PR, Narins RG. TGF-beta receptor expression and binding in rat mesangial cells: modulation by glucose and cyclic mechanical strain. Kidney Int 1999; 56:428-39. [PMID: 10432381 DOI: 10.1046/j.1523-1755.1999.00600.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.6] [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: 11/20/2022]
Abstract
BACKGROUND Transforming growth factor-beta (TGF-beta) is a causal factor in experimental glomerulosclerosis, and it mediates the increased extracellular matrix (ECM) accumulation that occurs in cultured mesangial cells (MCs) exposed to high glucose concentrations and cyclic mechanical strain. This change is associated with increased levels of TGF-beta, but may also involve alterations in receptor expression and binding. METHODS Rat MCs cultured in media containing either 8 or 35 mM glucose were seeded into culture plates with elastin-coated flexible bottoms. Thereafter, they were subjected to cyclic stretch or static conditions and then examined for 125I-TGF-beta1 binding and expression of TGF-beta receptors at the gene and protein levels. RESULTS Kinetic studies showed that MCs bound TGF-beta1 in a time- and concentration-dependent manner, expressing 6800 high-affinity receptors per cell, with an apparent dissociation constant (Kd) of 15.4 pM, while cross-linking analysis identified three TGF-beta receptors (betaR) corresponding to betaRI, betaRII, and betaRIII of 54, 73, and 200 kDa, respectively. Immunocytochemical studies of betaRI and betaRII protein revealed MC expression in a homogeneous, punctate distribution, whereas Northern analysis demonstrated the presence of the corresponding mRNAs. Exposure to cyclic stretching significantly increased (10%) the overall number of TGF-beta receptors, whereas ligands associated with betaRs I, II, and III also increased (25 to 50%). The finding of increased (30 to 40%) betaRI and betaRII transcript levels and immunoreactive protein (163 and 59%, respectively) in the absence of significant changes in the apparent Kd indicated that stretch-induced binding was the result of increased receptor synthesis and expression and not due to a change in binding affinity. In a similar, but more dramatic fashion, exposure to high glucose also elevated (50%) the receptor number, as well as the amount of ligands associated with betaRs I, II, and III (100 to 250%). This same treatment also increased the levels of betaRI and betaRII mRNA (30 to 40%) and the immunoreactive protein (82 and 82%, respectively), without significantly altering the binding affinity of the receptor. A concerted or synergistic effect of both stimuli was not evidenced. CONCLUSION These results suggest that the modulation of TGF-beta receptors may be an additional control point in mediating the glucose- and mechanical force-induced increase in ECM deposition by MCs.
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MESH Headings
- Activin Receptors, Type I
- Animals
- Blotting, Northern
- Cells, Cultured
- Cross-Linking Reagents/metabolism
- Diabetes Mellitus, Experimental/metabolism
- Dose-Response Relationship, Drug
- Elasticity
- Extracellular Matrix/metabolism
- Fluorescent Antibody Technique
- Gene Expression/drug effects
- Gene Expression/physiology
- Glomerular Mesangium/chemistry
- Glomerular Mesangium/cytology
- Glomerular Mesangium/metabolism
- Glucose/pharmacology
- Iodine Radioisotopes
- Kinetics
- Protein Binding/drug effects
- Protein Serine-Threonine Kinases/analysis
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/metabolism
- RNA, Messenger/analysis
- Rats
- Rats, Inbred F344
- Receptor, Transforming Growth Factor-beta Type I
- Receptor, Transforming Growth Factor-beta Type II
- Receptors, Transforming Growth Factor beta/analysis
- Receptors, Transforming Growth Factor beta/genetics
- Receptors, Transforming Growth Factor beta/metabolism
- Stress, Mechanical
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Affiliation(s)
- B L Riser
- Department of Internal Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, Michigan 48202, USA.
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Reinberg D, Orphanides G, Ebright R, Akoulitchev S, Carcamo J, Cho H, Cortes P, Drapkin R, Flores O, Ha I, Inostroza JA, Kim S, Kim TK, Kumar P, Lagrange T, LeRoy G, Lu H, Ma DM, Maldonado E, Merino A, Mermelstein F, Olave I, Sheldon M, Shiekhattar R, Zawel L. The RNA polymerase II general transcription factors: past, present, and future. Cold Spring Harb Symp Quant Biol 1999; 63:83-103. [PMID: 10384273 DOI: 10.1101/sqb.1998.63.83] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- D Reinberg
- Howard Hughes Medical Institute, Department of Biochemistry, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Piscataway 0885, USA
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35
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Cortes P, Riser BL, Yee J, Narins RG. Mechanical strain of glomerular mesangial cells in the pathogenesis of glomerulosclerosis: clinical implications. Nephrol Dial Transplant 1999; 14:1351-4. [PMID: 10382990 DOI: 10.1093/ndt/14.6.1351] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Due to their elasticity, glomeruli will undergo excessive expansion and repetitive cycles of distension contraction under conditions of impaired glomerular pressure autoregulation and systemic arterial hypertension. These alterations in glomerular volume are associated with mesangial cell stretch which in turn stimulates the synthesis and deposition of ECM with eventual mesangial expansion and glomerulosclerosis. Hyperactivity of growth factors with prosclerotic activity is an important component in the translation of cellular mechanical strain into the abnormal metabolism of ECM components. Although mesangial cell mechanical strain is expected to occur in both remnant glomeruli and in glomeruli of diabetic kidneys, quantitatively different factors will determine the resultant metabolic consequences. In remnant glomeruli, the mechanical stretch is intense, being accounted for largely by the marked glomerular hypertrophy and increased glomerular compliance. In diabetic glomeruli, however, the mechanical stretch is less prominent but its effect on ECM synthesis is markedly aggravated by the presence of hyperglycaemia. There are presently no methods clinically available to diminish the prosclerotic action of growth factors at the glomerular level. In addition, there are no effective means to specifically improve glomerular pressure autoregulation. Therefore, current therapies must be aimed at decreasing systemic arterial pressure, blocking angiotensin II action and reducing glomerular hypertrophy. While there are effective drugs for the treatment of hypertension and for angiotensin II inhibition, protein restriction is the only measure available to diminish glomerular hypertrophy. Finally, in diabetes correction of systemic and glomerular hypertension should be coupled with strict glycaemic control to correct both glomerular autoregulation and increased ECM deposition.
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Abstract
BACKGROUND Sulfonylurea receptors are classified as either high-affinity type 1 (SUR1) or low-affinity type 2 receptors (SUR2), and the gene expression of SURs has recently been demonstrated in kidney. However, functional data regarding a renal SUR are lacking. We previously demonstrated that mesangial cell (MC) gene and protein expression of extracellular matrix components were up-regulated by the sulfonylurea, tolazamide. After noting this biological response, we next sought to investigate the presence of a sulfonylurea receptor in rat MCs. METHODS Equilibrium binding studies employing [3H]glibenclamide as a ligand were performed on crude MC membrane preparations. Gene expression for SUR was explored by Northern analysis of cultured MCs and whole kidney tissue. The effect of sulfonylurea on intracellular Ca2+ in MCs was assayed by spectrofluorometry, and glibenclamide-induced changes in the contractility of MCs were assessed. RESULTS MCs bound [3H]glibenclamide with a KD of 2.6 microM and a Bmax of 30.4 pmol/mg protein as determined by Scatchard analysis. Three SUR2 transcripts were detected in MCs. A major transcript was detected at 5.5 kb and minor transcripts at 7.5 and 8.6 kb. Following sulfonylurea treatment of MCs, real-time videomicroscopy revealed intense MC contraction, coinciding with oscillatory increments of intracellular Ca2+ concentration. Further evidence of sulfonylurea-induced MC contraction was demonstrated by glibenclamide-induced deformation of a silicone rubber substrate. CONCLUSIONS These results demonstrate that SUR2 resides on MCs. Functional activation of this receptor by sulfonylurea induces Ca2+ transients that result in MC contraction.
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Affiliation(s)
- K Asano
- Department of Medicine, Division of Nephrology, Henry Ford Hospital, Detroit, Michigan, USA
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37
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Cortes P, Riser BL, Asano K, Rodríguez-Barbero A, Narins RG, Yee J. Effects of oral antihyperglycemic agents on extracellular matrix synthesis by mesangial cells. Kidney Int 1998; 54:1985-98. [PMID: 9853263 DOI: 10.1046/j.1523-1755.1998.00207.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Increased expression of the glucose transporter GLUT1 in mesangial cells (MCs) markedly stimulates glucose transport and the formation of extracellular matrix (ECM), even when ambient glucose concentrations are low. Certain antihyperglycemic agents cause GLUT1 overexpression and increase glucose transport in various tissues. However, their effects on the kidney are unknown. Because diabetic glomerulosclerosis is characterized by the accumulation of mesangial matrix, was studied the effects of antihyperglycemic agents on matrix metabolism in MCs cultured either in 8 or 20 mM glucose. METHODS Membrane-associated GLUT1 was measured by immunoblotting. The initial rate of glucose transport was determined according to the 2-deoxy-D[14C(U)]glucose uptake. Collagen metabolism was studied by metabolic radiolabeling with [14C]-proline. Fibronectin in the medium was measured by ELISA. GLUT1 mRNA was estimated by Northern analysis. RESULTS The sulfonylurea tolazamide increased GLUT1 protein expression by 107 and 69% in 8 and 20 mM glucose-grown cells, respectively. However, GLUT1 mRNA levels remained unchanged. Transporter-dependent deoxyglucose uptake was increased by tolazamide up to 184% in a dose-dependent fashion and was evident at both glucose concentrations after three or five days of exposure to the drug. Tolazamide significantly stimulated transforming growth factor-beta 1 (TGF-beta 1) secretion and the total synthesis of collagen and collagen and fibronectin accumulation in the medium of MCs maintained in high or low glucose concentrations. The biguanide metformin did not alter GLUT1 expression, glucose transport, fibronectin formation, or collagen metabolism, except at high concentrations. CONCLUSION Tolazamide markedly enhances ECM synthesis and accumulation in MCs probably by stimulating GLUT1 expression, glucose transport and TGF-beta 1 secretion, irrespective of the ambient glucose concentration. This effect was dose-dependent and minimally inducible by metformin.
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Affiliation(s)
- P Cortes
- Department of Medicine, Henry Ford Hospital, Detroit, Michigan, USA
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Besmer E, Mansilla-Soto J, Cassard S, Sawchuk DJ, Brown G, Sadofsky M, Lewis SM, Nussenzweig MC, Cortes P. Hairpin coding end opening is mediated by RAG1 and RAG2 proteins. Mol Cell 1998; 2:817-28. [PMID: 9885569 DOI: 10.1016/s1097-2765(00)80296-8] [Citation(s) in RCA: 111] [Impact Index Per Article: 4.3] [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: 11/24/2022]
Abstract
Despite the importance of hairpin opening in antigen receptor gene assembly, the molecular machinery that mediates this reaction has not been defined. Here, we show that RAG1 plus RAG2 can open DNA hairpins. Hairpin opening by RAGs is not sequence specific, but in Mg2+, hairpin opening occurs only in the context of a regulated cleavage complex. The chemical mechanism of hairpin opening by RAGs resembles RSS cleavage and 3' end processing by HIV integrase and Mu transposase in that these reactions can proceed through alcoholysis. Mutations in either RAG1 or RAG2 that interfere with RSS cleavage also interfere with hairpin opening, suggesting that RAGs have a single active site that catalyzes several distinct DNA cleavage reactions.
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Affiliation(s)
- E Besmer
- Laboratory of Molecular Immunology, Rockefeller University, New York, New York 10021, USA
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39
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Riser BL, Cortes P, Yee J, Sharba AK, Asano K, Rodriguez-Barbero A, Narins RG. Mechanical strain- and high glucose-induced alterations in mesangial cell collagen metabolism: role of TGF-beta. J Am Soc Nephrol 1998; 9:827-36. [PMID: 9596080 DOI: 10.1681/asn.v95827] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Cultured mesangial cells (MC) exposed to cyclic mechanical strain or high glucose levels increase their secretion of transforming growth factor-beta1 (TGF-beta1) and collagen, suggesting possible mechanisms for the development of diabetic renal sclerosis resulting from intraglomerular hypertension and/or hyperglycemia. This study examines whether glucose interacts with mechanical strain to influence collagen metabolism and whether this change is mediated by TGF-beta. Accordingly, rat MC were grown on flexible-bottom plates in 8 or 35 mM glucose media, subjected to 2 to 5 d of cyclic stretching, and assayed for TGF-beta1 mRNA, TGF-beta1 secretion, and the incorporation of 14C-proline into free or protein-associated hydroxyproline to assess the dynamics of collagen metabolism. Stretching or high glucose exposure increased TGF-beta1 secretion twofold and TGF-beta1 mRNA levels by 30 and 45%, respectively. However, the combination of these stimuli increased secretion greater than fivefold without further elevating mRNA. In 8 mM glucose medium, stretching significantly increased MC collagen synthesis and breakdown, but did not alter accumulation, whereas those stretched in 35 mM glucose markedly increased collagen accumulation. TGF-beta neutralization significantly reduced baseline collagen synthesis, breakdown, and accumulation in low glucose, but had no significant effect on the changes induced by stretch. In contrast, the same treatment of MC in high glucose medium greatly reduced stretch-induced synthesis and breakdown of collagen and totally abolished the increase in collagen accumulation. These results indicate that TGF-beta plays a positive regulatory role in MC collagen synthesis, breakdown, and accumulation. However, in low glucose there is no stretch-induced collagen accumulation, and the effect of TGF-beta is limited to basal collagen turnover. In high glucose media, TGF-beta is a critical mediator of stretch-induced collagen synthesis and catabolism, and, most importantly, its net accumulation. These data have important implications for the pathogenesis and treatment of diabetic glomerulosclerosis.
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Affiliation(s)
- B L Riser
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA
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Weis-Garcia F, Besmer E, Sawchuk DJ, Yu W, Hu Y, Cassard S, Nussenzweig MC, Cortes P. V(D)J recombination: in vitro coding joint formation. Mol Cell Biol 1997; 17:6379-85. [PMID: 9343399 PMCID: PMC232489 DOI: 10.1128/mcb.17.11.6379] [Citation(s) in RCA: 26] [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: 02/05/2023] Open
Abstract
Antigen receptor genes are assembled through a mechanism known as V(D)J recombination, which involves two different joining reactions: signal and coding joining. Formation of these joints is essential for antigen receptor assembly as well as maintaining chromosomal integrity. Here we report on a cell-free system for coding joint formation using deletion and inversion recombination substrates. In vitro coding joint formation requires RAG1, RAG2, and heat-labile factors present in the nuclear extract of nonlymphoid cells. Both inversion- and deletion-mediated coding joint reactions produce diverse coding joints, with deletions and P nucleotide addition. We also show that deletion-mediated coding joint formation follows the 12/23 rule and requires the catalytic subunit of DNA-dependent protein kinase.
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Affiliation(s)
- F Weis-Garcia
- Laboratory of Molecular Immunology, The Rockefeller University, New York, New York 10021, USA
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Sawchuk DJ, Weis-Garcia F, Malik S, Besmer E, Bustin M, Nussenzweig MC, Cortes P. V(D)J recombination: modulation of RAG1 and RAG2 cleavage activity on 12/23 substrates by whole cell extract and DNA-bending proteins. J Exp Med 1997; 185:2025-32. [PMID: 9166431 PMCID: PMC2196333 DOI: 10.1084/jem.185.11.2025] [Citation(s) in RCA: 116] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Antigen receptor gene rearrangement is directed by DNA motifs consisting of a conserved heptamer and nonamer separated by a nonconserved spacer of either 12 or 23 base pairs (12 or 23 recombination signal sequences [RSS]). V(D)J recombination requires that the rearranging DNA segments be flanked by RSSs of different spacer lengths, a phenomenon known as the 12/23 rule. Recent studies have shown that this restriction operates at the level of DNA cleavage, which is mediated by the products of the recombination activating genes RAG1 and RAG2. Here, we show that RAG1 and RAG2 are not sufficient for 12/23 dependent cleavage, whereas RAG1 and RAG2 complemented with whole cell extract faithfully recapitulates the 12/23 rule. In addition, HMG box containing proteins HMG1 and HMG2 enhance RAG1- and RAG2-mediated cleavage of substrates containing 23 RSS but not of substrates containing only 12 RSS. These results suggest the existence of a nucleoprotein complex at the cleavage site, consisting of architectural, catalytic, and regulatory components.
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Affiliation(s)
- D J Sawchuk
- Laboratory of Molecular Immunology, The Rockefeller University, New York 10021, USA
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42
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Abstract
Glomerular rigidity limits the glomerular expansion and mesangial cell (MC) stretch induced by variations in intracapillary pressure. In tissue culture, MC stretch stimulates synthesis of extracellular matrix components (ECM). Therefore, altered glomerular rigidity in diabetes may influence ECM accumulation by modulating the glomerular distention and MC stretch associated with glomerular hypertension. An ambient of high glucose concentration per se also enhances MC formation of ECM, possibly altering the cellular response to mechanical stretch. In this study, compliance was measured in isolated perfused glomeruli from streptozotocin-injected rats at four days (4d-D), five weeks (5w-D) and six months (6m-D) after induction of diabetes. In addition, collagen metabolism induced by stretch was investigated in MC cultured in 8 and 35 mM glucose concentrations. Glomerular compliance was normal in 5w-D rats and moderately increased in 4d-D (16%) and 6m-D animals (14%). As compared to static cultures. MC stretch increased total collagen synthesis (8 mM, 50%; 35 mM, 27%) and catabolism. However, while the fraction of newly formed collagen being catabolized increased in 8 mM-stretched cultures, in 35 mM-stretched it was unchanged. This resulted in marked increase in the net collagen accumulated in the incubation medium (4 vs. 24%) and cell layer 5 vs. 15%) only in the latter. In diabetes, the largely unaltered glomerular stiffness renders hypertension-induced MC stretch unopposed. More importantly, the accumulation of ECM caused by any degree of mechanical strain is greatly aggravated in a milieu of high glucose concentration.
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Affiliation(s)
- P Cortes
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA
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Cortes P, Weis-Garcia F, Misulovin Z, Nussenzweig A, Lai JS, Li G, Nussenzweig MC, Baltimore D. In vitro V(D)J recombination: signal joint formation. Proc Natl Acad Sci U S A 1996; 93:14008-13. [PMID: 8943051 PMCID: PMC19485 DOI: 10.1073/pnas.93.24.14008] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [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] [Indexed: 02/03/2023] Open
Abstract
The first step of V(D)J recombination, specific cleavage at the recombination signal sequence (RSS), can be carried out by the recombination activating proteins RAG1 and RAG2. In vivo, the cleaved coding and signal ends must be rejoined to generate functional antigen receptors and maintain chromosomal integrity. We have investigated signal joint formation using deletion and inversion substrates in a cell free system. RAG1 and RAG2 alone or in combination were unable to generate signal joints. However, RAG1 and RAG2 complemented with nuclear extracts were able to recombine an extrachromosomal substrate and form precise signal joints. The in vitro reaction resembled authentic V(D)J recombination in being Ku-antigen-dependent.
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Affiliation(s)
- P Cortes
- Laboratory of Molecular Immunology, Howard Hughes Medical Institute, Rockefeller University, New York, NY 10021, USA
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Fonseca T, Cortes P, Monteiro J, Salgado V, Ferro J, Franco AS, Nogueira JB, da Costa JN. [Acute cerebrovascular disorder and arterial hypertension. Prospective study with 248 patients]. Rev Port Cardiol 1996; 15:565-73, 547-8. [PMID: 8991394] [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: 02/03/2023] Open
Abstract
OBJECTIVE To evaluate the hypertension associated to different types and sub-types of cerebrovascular disease (stroke), with particular reference to the frequency of hypertension, the values of blood pressure, the risk factors and the involvement of other target organs. DEFINITION Prospective study in 248 patients with acute stroke admitted to a Clinical Medicine Unit in three independent time periods. SETTING Internal Medicine Clinic of University Hospital in Lisbon. METHODS Medical, neurological and cardiologic examination were performed and all patients were also submitted to different complementary tests, including a computer tomography scan of the brain, and an echocardiogram. The values of blood pressure were measured in the admission at the urgent service and 24 h after in the the ward. We identified three sub-types of stroke: intracerebral hemorrhage (IH), ischaemic stroke (IS) and lacunes (L). For each sub-type and for those with hypertension or not, we evaluated: age, sex, duration of stay in hospital and mortality. We also compared for each sub-type the values of blood pressure, the risk factor and the repercussion on other target organs. PATIENTS Two hundred and forty eight patients (52% were men) with mean age 68.0 +/- 10.2 years, and ages among 40 and 92 years. Thirty-seven patients (15%) died. MAIN RESULTS In the entire population (n = 248) hypertension were more prevalent in IH 83% and L 82% than in IS 59% (p < 0.0005). Hypertension was present in 172 patients (69%) and 81 (47%) were IS, 58 (34%) L and 33 (19%) IH. Sixty six percent of the 172 patients with hypertension had at least another risk factor and the most aged ones (> 65 years old) were more frequent in IS 75% than in HI 45% or L 58% (p < 0.001). For all subtypes blood pressure measurements were higher in admission than in ward and they were also higher in IH than in IS (p < 0.05). Hypertensive cardiopathy was more prevalent in IH 76% and L 61% than in IS 49% (p < 0.05). Renal failure was more frequent in IS 37% than in IH 28% and L 17% (p < 0.05). CONCLUSIONS Hypertension is very frequent, and like advanced age is a major risk factor of stroke. Hypertension is frequently associated with one or more risk factors. Hypertensive cardiopathy is more related with IH and L and the renal involvement with IS.
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Affiliation(s)
- T Fonseca
- Serviço de Medicina I, Hospital de Santa Maria
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Riser BL, Cortes P, Heilig C, Grondin J, Ladson-Wofford S, Patterson D, Narins RG. Cyclic stretching force selectively up-regulates transforming growth factor-beta isoforms in cultured rat mesangial cells. Am J Pathol 1996; 148:1915-23. [PMID: 8669477 PMCID: PMC1861662] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Glomerular distention from increased intraglomerular pressure stretches mesangial cells (MCs). Stretching MCs in culture stimulates extracellular matrix accumulation, suggesting that this may be a mechanism for glomerular hypertension-associated glomerulosclerosis. We examined whether mechanical stretching serves as a stimulus for the synthesis and activation of the prosclerotic molecule transforming growth factor (TGF)-beta, thus providing a potential system for auto-induction of extracellular matrix. Rat MCs cultured on flexible-bottom plates were subjected to cyclic stretching for up to 3 days and then assayed for TGF-beta mRNA, secretion of TGF-beta, and localization of active TGF-beta by immunostaining. MCs contained mRNA for all three mammalian isoforms of TGF-beta. Cyclic stretching for 36 hours increased TGF-beta1 and TGF-beta3 mRNA levels approximately twofold, without altering the levels of TGF-beta2 mRNA. This was followed at 48 to 72 hours by the increased secretion of both latent and active TGF-beta1. Latent, but not active, TGF-beta3 secretion also increased whereas the levels of TGF-beta2 were unaffected by mechanical force. The stretching force in this system is unequally distributed over the culture membrane. Localization of active TGF-beta by immunostaining demonstrated that the quantity of cell-associated cytokine across the culture was directly proportional to the zonal amplitude of the stretching force. These results demonstrate that stretching force stimulates MCs to selectively release and activate TGF-beta1. This mechanical induction of TGF-beta1 may help explain the increased extracellular matrix associated with intraglomerular hypertension.
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Affiliation(s)
- B L Riser
- Department of Internal Medicine, Division of Nephrology and Hypertension, Henry Ford Hospital, MI 48202, USA
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Abstract
Glomerular extracellular matrix accumulation may derive from the stretching of mesangial cells caused by excessive glomerular dilatation. The relationship of glomerular volume (VG) to intraglomerular pressure, expressed as compliance or as mean VG in the isolated, perfused rat glomerulus, was used to analyze factors that regulate VG. Glomeruli were highly distensible over the normal and relevant abnormal range of pressure. Compliance increased directly with basal VG (P < 0.001), i.e., larger glomeruli dilated more than smaller ones at any given pressure. Perfusion with atrial natriuretic peptide did not alter compliance, and inhibitors of nitric oxide synthesis exerted only a trivial effect. VG expansion was consistently reduced by angiotensin II, but this effect was small (3.8%, P < 0.001). After subtotal nephrectomy, compliance increased by 59% in the remnant glomeruli (P < 0.001); 22% of this increase was attributable to structural changes, and the remainder was attributable to the large basal VG of the hypertrophied glomeruli. Thus the major determinants of VG expansion include capillary wall tension, basal VG, and intrinsic distensibility, which is markedly influenced by the character of the extracellular matrix and only slightly altered by an angiotensin II-modified mesangial cell tone.
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Affiliation(s)
- P Cortes
- Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan 48202, USA
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Spanopoulou E, Cortes P, Shih C, Huang CM, Silver DP, Svec P, Baltimore D. Localization, interaction, and RNA binding properties of the V(D)J recombination-activating proteins RAG1 and RAG2. Immunity 1995; 3:715-26. [PMID: 8777717 DOI: 10.1016/1074-7613(95)90061-6] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The RAG1 and RAG2 gene products are indispensable for activating somatic rearrangement of antigen receptor gene segments. The two proteins form a stable complex in primary thymocytes as well as when expressed in adherent cells. In both cell types, most cells localize RAG proteins at the periphery of the nucleus. However, when overexpressed in fibroblast cells, RAG1 is found largely in the nucleolus. Nucleolar localization of RAG1 is mediated by several domains containing stretches of basic amino acids, indicating that RAG1 has affinity for RNA or ssDNA. The RAG1 interacting proteins SRP1 and Rch1 directly bind to the nuclear localization signals of RAG1, which mediate the nuclear and nucleolar translocation of the protein. RAG1 appears to have a binary structure, each half containing multiple regions that can act as NLSs, binding sites for the SRP1/Rch1 family, and RNA binding domains.
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Affiliation(s)
- E Spanopoulou
- Rockefeller University, New York, New York 10021, USA
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48
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Dumler F, Cortes P, Riser B. Effect of Misoprostol on Mesangial Cell Growth and Collagen Metabolism. Am J Ther 1995; 2:922-927. [PMID: 11854809 DOI: 10.1097/00045391-199512000-00004] [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: 11/25/2022]
Abstract
Independent of etiology, progressive chronic renal failure is characterized by accumulation of mesangial matrix and collagenous materials leading to glomerular sclerosis and closure. Pharmacologic intervention aimed at ameliorating this process has significant potential for substantial clinical benefit. We, therefore, assessed the effect of misoprostol on glomerular mesangial cell growth and collagen metabolism. Studies were carried out using a rat glomerular mesangial cell line cloned in our laboratory. At the concentration tested (1 &mgr;M), neither misoprostol nor prostaglandin E(2) had any effect on glomerular mesangial cell proliferation. Misoprostol did not change the absolute synthesis rates for collagen or total protein when measured by (14)C-proline incorporation into protein-associated hydroxyproline and proline respectively. However, the amount of collagen extruded into the medium, as a percentage of protein synthesis, was decreased by 10% in misoprostol-treated cells (p = 0.042). In addition, collagen breakdown was 26% greater in misoprostol-treated cultures (p = 0.044). Misprosotol had no such effects on cell cultures subjected to mechanical stress applied as continuous stretch-relaxation cycles. These results indicate that misoprostol influences mesangial cell collagen metabolism by increasing the rate of endogenous breakdown and decreasing collagen export outside the cell. Misoprostol has no effect on mesangial cell proliferation.
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Affiliation(s)
- F. Dumler
- Division of Nephrology, William Beaumont Hospital, Royal Oak, USA
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49
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Heilig C, Zaloga C, Lee M, Zhao X, Riser B, Brosius F, Cortes P. Immunogold localization of high-affinity glucose transporter isoforms in normal rat kidney. J Transl Med 1995; 73:674-84. [PMID: 7474941] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Facilitative glucose transporters (GLUT) have unique kinetic characteristics and distributions suited to the functions of the tissues in which they reside. However, little is known about their individual roles in renal glucose metabolism, and previous investigations of renal GLUT expression have been extensive only with respect to their mRNA levels. We provide here a complete analysis of three GLUT isoforms along the nephron using a sensitive immunodetection method. EXPERIMENTAL DESIGN Normal rat kidneys were harvested, fixed in paraformaldehyde, and embedded in either paraffin or resin as required for immunogold labeling of individual GLUT Isoforms 1, 3, and 4. Samples were evaluated by light microscopy and selected regions analyzed by high resolution optical scanning with computer-assisted detection of immunogold-labeled GLUT at the subcellular level. We describe, compare, and related to the local patterns of glucose metabolism the cellular and subcellular expression patterns of these GLUT along the nephron. RESULTS GLUT1 was most intensely labeled in the medullary thick ascending limbs of Henle, cortical collecting ducts, and inner medullary collecting ducts. In contrast, GLUT3 was most prominent in the inner medullary collecting ducts and GLUT4 in medullary thick ascending limbs of Henle. All three GLUT were detected in glomerular tufts, and GLUT1 was also detected in parietal epithelial cells. The predominant subcellular distributions in tubule cells were: basolateral and basolateral/cytoplasmic for GLUT1; basolateral and cytoplasmic for GLUT3; and perinuclear/cytoplasmic for GLUT4. GLUT 1 and 3 expressions were confirmed in specific regions by immunoblotting. CONCLUSIONS 1) GLUT 1, 3, and 4 are expressed in both glomeruli and renal tubules. 2) The unique GLUT expression patterns along the renal tubules suggests unique functional roles for these isoforms. 3) The renal cortex demonstrates lesser labeling intensity for the high-affinity GLUT compared with the medulla, where higher rates of glucose oxidation and glycolytic metabolism are paralleled by higher GLUT labeling intensities.
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Affiliation(s)
- C Heilig
- Department of Medicine, Henry Ford Hospital, Detroit, Michigan, USA
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Heilig CW, Concepcion LA, Riser BL, Freytag SO, Zhu M, Cortes P. Overexpression of glucose transporters in rat mesangial cells cultured in a normal glucose milieu mimics the diabetic phenotype. J Clin Invest 1995; 96:1802-14. [PMID: 7560072 PMCID: PMC185817 DOI: 10.1172/jci118226] [Citation(s) in RCA: 183] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
An environment of high glucose concentration stimulates the synthesis of extracellular matrix (ECM) in mesangial cell (MC) cultures. This may result from a similar increase in intracellular glucose concentration. We theorized that increased uptake, rather than glucose concentration per se is the major determinant of exaggerated ECM formation. To test this, we compared the effects of 35 mM glucose on ECM synthesis in normal MCs with those of 8 mM glucose in the same cells overexpressing the glucose transporter GLUT1 (MCGT1). Increasing medium glucose from 8 to 35 mM caused normal MCs to increase total collagen synthesis and catabolism, with a net 81-90% increase in accumulation. MCs transduced with the human GLUT1 gene (MCGT1) grown in 8 mM glucose had a 10-fold greater GLUT1 protein expression and a 1.9, 2.1, and 2.5-fold increase in cell myo-inositol, lactate production, and cell sorbitol content, respectively, as compared to control MCs transduced with bacterial beta-galactosidase (MCLacZ). MCGT1 also demonstrated increased glucose uptake (5-fold) and increased net utilization (43-fold), and greater synthesis of individual ECM components than MCLacZ. In addition, total collagen synthesis and catabolism were also enhanced with a net collagen accumulation 111-118% greater than controls. Thus, glucose transport activity is an important modulator of ECM formation by MCs; the presence of high extracellular glucose concentrations is not necessarily required for the stimulation of matrix synthesis.
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Affiliation(s)
- C W Heilig
- University of Rochester Medical Center, Division of Nephrology, NY 14642, USA
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