1
|
Yang F, Bevilacqua C, Hambura S, Neves A, Gopalan A, Watanabe K, Govendir M, Bernabeu M, Ellenberg J, Diz-Muñoz A, Köhler S, Rapti G, Jechlinger M, Prevedel R. Author Correction: Pulsed stimulated Brillouin microscopy enables high-sensitivity mechanical imaging of live and fragile biological specimens. Nat Methods 2024; 21:922. [PMID: 38561451 PMCID: PMC11093723 DOI: 10.1038/s41592-024-02259-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Fan Yang
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Shanghai, China.
| | - Carlo Bevilacqua
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Sebastian Hambura
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Ana Neves
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Anusha Gopalan
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Koki Watanabe
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Matt Govendir
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- European Molecular Biology Laboratory Barcelona, Barcelona, Spain
| | - Maria Bernabeu
- European Molecular Biology Laboratory Barcelona, Barcelona, Spain
| | - Jan Ellenberg
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Alba Diz-Muñoz
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Simone Köhler
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Georgia Rapti
- Developmental Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Interdisciplinary Center of Neurosciences, Heidelberg University, Heidelberg, Germany
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory, Rome, Italy
| | - Martin Jechlinger
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- MOLIT Institute for Personalized Medicine gGmbH, Heilbronn, Germany
| | - Robert Prevedel
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Developmental Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Interdisciplinary Center of Neurosciences, Heidelberg University, Heidelberg, Germany.
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory, Rome, Italy.
- Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- German Center for Lung Research (DZL), Heidelberg, Germany.
| |
Collapse
|
2
|
Noé E, Gómez A, Bernabeu M, Quemada I, Rodríguez R, Pérez T, López C, Laxe S, Colomer C, Ríos M, Juárez-Belaúnde A, González C, Pelayo R, Ferri J. Guidelines: basic principles of neurorehabilitation for patients with acquired brain injury. Recommendations of the Spanish Society of Neurorehabilitation. Neurologia 2024; 39:261-281. [PMID: 37116696 DOI: 10.1016/j.nrleng.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/27/2021] [Indexed: 04/30/2023] Open
Abstract
INTRODUCTION We present the Spanish Society of Neurorehabilitation's guidelines for adult acquired brain injury (ABI) rehabilitation. These recommendations are based on a review of international clinical practice guidelines published between 2013 and 2020. DEVELOPMENT We establish recommendations based on the levels of evidence of the studies reviewed and expert consensus on population characteristics and the specific aspects of the intervention or procedure under research. CONCLUSIONS All patients with ABI should receive neurorehabilitation therapy once they present a minimal level of clinical stability. Neurorehabilitation should offer as much treatment as possible in terms of frequency, duration, and intensity (at least 45-60minutes of each specific form of therapy that is needed). Neurorehabilitation requires a coordinated, multidisciplinary team with the knowledge, experience, and skills needed to work in collaboration both with patients and with their families. Inpatient rehabilitation interventions are recommended for patients with more severe deficits and those in the acute phase, with outpatient treatment to be offered as soon as the patient's clinical situation allows it, as long as intensity criteria can be maintained. The duration of treatment should be based on treatment response and the possibilities for further improvement, according to the best available evidence. At discharge, patients should be offered health promotion, physical activity, support, and follow-up services to ensure that the benefits achieved are maintained, to detect possible complications, and to assess possible changes in functional status that may lead the patient to need other treatment programmes.
Collapse
Affiliation(s)
- E Noé
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain.
| | - A Gómez
- Centro Estatal de Atención al Daño Cerebral-CEADAC, Madrid, Spain
| | | | - I Quemada
- Red Menni de Daño Cerebral, Bilbao, Spain
| | | | - T Pérez
- Clínica San Vicente, Madrid, Spain
| | - C López
- Centro Lescer, Madrid, Spain
| | - S Laxe
- Hospital Clínic, Barcelona, Spain
| | - C Colomer
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain
| | - M Ríos
- Unidad de Daño Cerebral, Hospital Beata María Ana, Madrid, Spain
| | | | - C González
- Centro Estatal de Atención al Daño Cerebral-CEADAC, Madrid, Spain
| | - R Pelayo
- Institut Guttmann, Barcelona, Spain
| | - J Ferri
- NEURORHB Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Hospitales Vithas, Valencia, Spain
| |
Collapse
|
3
|
Reyes RA, Raghavan SSR, Hurlburt NK, Introini V, Kana IH, Jensen RW, Martinez-Scholze E, Gestal-Mato M, Bau CB, Fernández-Quintero ML, Loeffler JR, Ferguson JA, Lee WH, Martin GM, Theander TG, Ssewanyana I, Feeney ME, Greenhouse B, Bol S, Ward AB, Bernabeu M, Pancera M, Turner L, Bunnik EM, Lavstsen T. Broadly inhibitory antibodies against severe malaria virulence proteins. bioRxiv 2024:2024.01.25.577124. [PMID: 38328068 PMCID: PMC10849712 DOI: 10.1101/2024.01.25.577124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
Plasmodium falciparum pathology is driven by the accumulation of parasite-infected erythrocytes in microvessels. This process is mediated by the parasite's polymorphic erythrocyte membrane protein 1 (PfEMP1) adhesion proteins. A subset of PfEMP1 variants that bind human endothelial protein C receptor (EPCR) through their CIDRα1 domains is responsible for severe malaria pathogenesis. A longstanding question is whether individual antibodies can recognize the large repertoire of circulating PfEMP1 variants. Here, we describe two broadly reactive and binding-inhibitory human monoclonal antibodies against CIDRα1. The antibodies isolated from two different individuals exhibited a similar and consistent EPCR-binding inhibition of 34 CIDRα1 domains, representing five of the six subclasses of CIDRα1. Both antibodies inhibited EPCR binding of both recombinant full-length and native PfEMP1 proteins as well as parasite sequestration in bioengineered 3D brain microvessels under physiologically relevant flow conditions. Structural analyses of the two antibodies in complex with two different CIDRα1 antigen variants reveal similar binding mechanisms that depend on interactions with three highly conserved amino acid residues of the EPCR-binding site in CIDRα1. These broadly reactive antibodies likely represent a common mechanism of acquired immunity to severe malaria and offer novel insights for the design of a vaccine or treatment targeting severe malaria.
Collapse
Affiliation(s)
- Raphael A. Reyes
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Sai Sundar Rajan Raghavan
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Nicholas K. Hurlburt
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Viola Introini
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona 08003, Spain
| | - Ikhlaq Hussain Kana
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
| | - Rasmus W. Jensen
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
| | - Elizabeth Martinez-Scholze
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Maria Gestal-Mato
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona 08003, Spain
| | | | | | - Johannes R. Loeffler
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - James Alexander Ferguson
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Wen-Hsin Lee
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Greg Michael Martin
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Thor G. Theander
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
| | | | - Margaret E. Feeney
- Department of Medicine, University of California San Francisco, San Francisco, CA 94110, USA
- Department of Pediatrics, University of California San Francisco, San Francisco, CA 94110, USA
| | - Bryan Greenhouse
- Department of Medicine, University of California San Francisco, San Francisco, CA 94110, USA
| | - Sebastiaan Bol
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Andrew B. Ward
- Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA 92037, USA
| | - Maria Bernabeu
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona 08003, Spain
| | - Marie Pancera
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Louise Turner
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
| | - Evelien M. Bunnik
- Department of Microbiology, Immunology and Molecular Genetics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Thomas Lavstsen
- Centre for translational Medicine & Parasitology, Department of Immunology and Microbiology, University of Copenhagen and Department of Infectious Diseases, Righospitalet, Copenhagen, Denmark
| |
Collapse
|
4
|
Yang F, Bevilacqua C, Hambura S, Neves A, Gopalan A, Watanabe K, Govendir M, Bernabeu M, Ellenberg J, Diz-Muñoz A, Köhler S, Rapti G, Jechlinger M, Prevedel R. Pulsed stimulated Brillouin microscopy enables high-sensitivity mechanical imaging of live and fragile biological specimens. Nat Methods 2023; 20:1971-1979. [PMID: 37884795 PMCID: PMC10703689 DOI: 10.1038/s41592-023-02054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023]
Abstract
Brillouin microscopy is an emerging optical elastography technique capable of assessing mechanical properties of biological samples in a three-dimensional, all-optical and noncontact fashion. The typically weak Brillouin scattering signal can be substantially enhanced via a stimulated Brillouin scattering (SBS) process; however, current implementations require high pump powers, which prohibit applications to photosensitive or live imaging of biological samples. Here we present a pulsed SBS scheme that takes advantage of the nonlinearity of the pump-probe interaction. In particular, we show that the required pump laser power can be decreased ~20-fold without affecting the signal levels or spectral precision. We demonstrate the low phototoxicity and high specificity of our pulsed SBS approach by imaging, with subcellular detail, sensitive single cells, zebrafish larvae, mouse embryos and adult Caenorhabditis elegans. Furthermore, our method permits observing the mechanics of organoids and C. elegans embryos over time, opening up further possibilities for the field of mechanobiology.
Collapse
Affiliation(s)
- Fan Yang
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Shanghai Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, Shanghai, China.
| | - Carlo Bevilacqua
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Sebastian Hambura
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Ana Neves
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Anusha Gopalan
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Collaboration for joint PhD degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Koki Watanabe
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Matt Govendir
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- European Molecular Biology Laboratory Barcelona, Barcelona, Spain
| | - Maria Bernabeu
- European Molecular Biology Laboratory Barcelona, Barcelona, Spain
| | - Jan Ellenberg
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Alba Diz-Muñoz
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Simone Köhler
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
| | - Georgia Rapti
- Developmental Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- Interdisciplinary Center of Neurosciences, Heidelberg University, Heidelberg, Germany
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory, Rome, Italy
| | - Martin Jechlinger
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany
- MOLIT Institute for Personalized Medicine gGmbH, Heilbronn, Germany
| | - Robert Prevedel
- Cell Biology and Biophysics Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Developmental Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- Interdisciplinary Center of Neurosciences, Heidelberg University, Heidelberg, Germany.
- Epigenetics and Neurobiology Unit, European Molecular Biology Laboratory, Rome, Italy.
- Molecular Medicine Partnership Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
- German Center for Lung Research (DZL), Heidelberg, Germany.
| |
Collapse
|
5
|
Quintana JF, Harding C, Huet D, Sateriale A, Bernabeu M. Editorial: Disruptive technologies for the study of host-pathogen interactions. Front Cell Infect Microbiol 2022; 12:1048342. [PMID: 36310863 PMCID: PMC9608136 DOI: 10.3389/fcimb.2022.1048342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Juan F. Quintana
- Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, United Kingdom
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- *Correspondence: Juan F. Quintana, ; Clare Harding, ; Diego Huet, ; Adam Sateriale, ; Maria Bernabeu,
| | - Clare Harding
- Wellcome Centre for Integrative Parasitology, University of Glasgow, Glasgow, United Kingdom
- *Correspondence: Juan F. Quintana, ; Clare Harding, ; Diego Huet, ; Adam Sateriale, ; Maria Bernabeu,
| | - Diego Huet
- Centre for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA, United States
- Department of Pharmaceutical and Biomedical Sciences, University of Georgia, Athens, GA, United States
- *Correspondence: Juan F. Quintana, ; Clare Harding, ; Diego Huet, ; Adam Sateriale, ; Maria Bernabeu,
| | - Adam Sateriale
- The Francis Crick Institute, London, United Kingdom
- *Correspondence: Juan F. Quintana, ; Clare Harding, ; Diego Huet, ; Adam Sateriale, ; Maria Bernabeu,
| | - Maria Bernabeu
- European Molecular Biology Laboratory (EMBL), Tissue Biology and Disease Modelling Unit, Barcelona, Spain
- *Correspondence: Juan F. Quintana, ; Clare Harding, ; Diego Huet, ; Adam Sateriale, ; Maria Bernabeu,
| |
Collapse
|
6
|
Bernabeu M, Conroy AL, Craig AG, Renia L. Editorial: Models to study malaria parasite-host interactions and pathogenesis. Front Cell Infect Microbiol 2022; 12:1039887. [PMID: 36211953 PMCID: PMC9535354 DOI: 10.3389/fcimb.2022.1039887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Maria Bernabeu
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | - Andrea L. Conroy
- Ryan White Center for Paediatric Infectious Diseases and Global Health, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Alister G. Craig
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- *Correspondence: Alister G. Craig,
| | - Laurent Renia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| |
Collapse
|
7
|
Introini V, Govendir MA, Rayner JC, Cicuta P, Bernabeu M. Biophysical Tools and Concepts Enable Understanding of Asexual Blood Stage Malaria. Front Cell Infect Microbiol 2022; 12:908241. [PMID: 35711656 PMCID: PMC9192966 DOI: 10.3389/fcimb.2022.908241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/27/2022] [Indexed: 12/02/2022] Open
Abstract
Forces and mechanical properties of cells and tissues set constraints on biological functions, and are key determinants of human physiology. Changes in cell mechanics may arise from disease, or directly contribute to pathogenesis. Malaria gives many striking examples. Plasmodium parasites, the causative agents of malaria, are single-celled organisms that cannot survive outside their hosts; thus, thost-pathogen interactions are fundamental for parasite’s biological success and to the host response to infection. These interactions are often combinations of biochemical and mechanical factors, but most research focuses on the molecular side. However, Plasmodium infection of human red blood cells leads to changes in their mechanical properties, which has a crucial impact on disease pathogenesis because of the interaction of infected red blood cells with other human tissues through various adhesion mechanisms, which can be probed and modelled with biophysical techniques. Recently, natural polymorphisms affecting red blood cell biomechanics have also been shown to protect human populations, highlighting the potential of understanding biomechanical factors to inform future vaccines and drug development. Here we review biophysical techniques that have revealed new aspects of Plasmodium falciparum invasion of red blood cells and cytoadhesion of infected cells to the host vasculature. These mechanisms occur differently across Plasmodium species and are linked to malaria pathogenesis. We highlight promising techniques from the fields of bioengineering, immunomechanics, and soft matter physics that could be beneficial for studying malaria. Some approaches might also be applied to other phases of the malaria lifecycle and to apicomplexan infections with complex host-pathogen interactions.
Collapse
Affiliation(s)
- Viola Introini
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
- Cavendish Laboratory, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Viola Introini,
| | - Matt A. Govendir
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | - Julian C. Rayner
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Pietro Cicuta
- Cavendish Laboratory, University of Cambridge, Cambridge, United Kingdom
| | - Maria Bernabeu
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| |
Collapse
|
8
|
García-Rudolph A, Laxe S, Cegarra B, Saurí-Ruiz J, Opisso E, Tormos JM, Bernabeu M. Inpatient rehabilitation of working-age adults with ischemic stroke: comparing men and women clinical and functional characteristics at admission and predicting functionality. Rev Neurol 2022; 74:69-77. [PMID: 35084731 DOI: 10.33588/rn.7403.2021297] [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: 06/14/2023]
Abstract
INTRODUCTION The role of gender in functional independence for activities of daily living after ischemic stroke is still controversial. We aim to a) compare clinical characteristics of men and women at inpatient rehabilitation admission b) compare their functional independence at admission and discharge c) identify predictors of functional independence. MATERIALS AND METHODS Retrospective observational cohort study. State-of-the-art variables were used for admission and discharge comparisons and to predict total FIM (Functional Independence Measure) at discharge, FIM gain, FIM efficiency and FIM effectiveness using multivariate linear regressions. RESULTS 144 patients (33% women) admitted to inpatient rehabilitation in a Spanish specialized center, with less than 3 weeks since ischemic stroke onset were included. Men were older (p = 0.039), 19.6% of men had diabetes mellitus (6.4% of women) (p = 0.038), with 52.6% of men being non-smokers (72.3% of women) (p = 0.022). No significant differences were observed in FIM at admission, discharge, FIM gain, efficiency or effectiveness (total, motor either cognitive FIM). Regression analysis identified sex (ß = -0.13), stroke severity (ß = -0.25) and admission total FIM (ß = -0.69) as significant predictors of total FIM gain (R2 = 0.42). The same variables predicted discharge total FIM: sex (ß = -0.12), severity (ß = -0.23) and admission total FIM (ß = 0.59) (R2 = 0.51). FIM efficiency was predicted by admission total FIM (ß = -0.64), severity (ß = -0.24), age (ß = -0.17) and length of stay (ß = -0.45) (R2 = 39.9%). FIM effectiveness model explained only 13.5% of the variance. CONCLUSIONS No functional differences between men and women in any independence measure were found. Sex was a significant predictor but leaving half of the variance unexplained.
Collapse
Affiliation(s)
- A García-Rudolph
- Universitat Autònoma de Barcelona, Bellaterra, España
- Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| | - S Laxe
- Hospital Clínic de Barcelona, 08036 Barcelona, España
| | - B Cegarra
- Institut Universitari de Neurorehabilitació Guttmann-UAB, 08916 Badalona, España
- Universitat Autònoma de Barcelona, Bellaterra, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| | - J Saurí-Ruiz
- Institut Universitari de Neurorehabilitació Guttmann-UAB, 08916 Badalona, España
- Universitat Autònoma de Barcelona, Bellaterra, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| | - E Opisso
- Institut Universitari de Neurorehabilitació Guttmann-UAB, 08916 Badalona, España
- Universitat Autònoma de Barcelona, Bellaterra, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| | - J M Tormos
- Institut Universitari de Neurorehabilitació Guttmann-UAB, 08916 Badalona, España
- Universitat Autònoma de Barcelona, Bellaterra, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| | - M Bernabeu
- Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, España
- Universitat Autònoma de Barcelona, Bellaterra, España
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, España
| |
Collapse
|
9
|
Piatti L, Howard CC, Zheng Y, Bernabeu M. Binding of Plasmodium falciparum-Infected Red Blood Cells to Engineered 3D Microvessels. Methods Mol Biol 2022; 2470:557-585. [PMID: 35881375 DOI: 10.1007/978-1-0716-2189-9_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
P. falciparum-infected red blood cell (iRBC) sequestration in the microvasculature is a pivotal event in severe malaria pathogenesis. In vitro binding assays using endothelial cell monolayers under static and flow conditions have revealed key ligand-receptor interactions for iRBC sequestration. However, mechanisms remain elusive for iRBC sequestration in specific vascular locations, which prevents further development of effective therapies. New models are needed to better recapitulate the complex geometry of blood flow in human blood vessels and organ-specific vascular signatures. Recent advances in engineering 3D microvessels in vitro have emerged as promising technologies to not only model complex human vascular structures but also allow for precise and step-wise control of individual biological and biomechanical parameters. By designing networks with different branching structures and change of vessel diameter along the flow path, these models recapitulate pressure and flow changes occurring in vivo. Here, we describe the methodology employed to build 3D microvessels using soft lithography and injection molding techniques, as well as the protocol to fabricate capillary-size vessels through collagen photoablation. Furthermore, we describe the methodology of using these models to study malaria and narrate necessary steps for perfusion of P. falciparum through 3D microvessels and different options to quantify P. falciparum-iRBC binding.
Collapse
Affiliation(s)
- Livia Piatti
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | - Caitlin C Howard
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Ying Zheng
- Department of Bioengineering, University of Washington, Seattle, WA, USA
| | - Maria Bernabeu
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain.
| |
Collapse
|
10
|
Long RKM, Piatti L, Korbmacher F, Bernabeu M. Understanding parasite-brain microvascular interactions with engineered 3D blood-brain barrier models. Mol Microbiol 2021; 117:693-704. [PMID: 34837419 DOI: 10.1111/mmi.14852] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 01/25/2023]
Abstract
Microbial interactions with the blood-brain barrier (BBB) can be highly pathogenic and are still not well understood. Among these, parasites present complex interactions with the brain microvasculature that are difficult to decipher using experimental animal models or reductionist 2D in vitro cultures. Novel 3D engineered blood-brain barrier models hold great promise to overcome limitations in traditional research approaches. These models better mimic the intricate 3D architecture of the brain microvasculature and recapitulate several aspects of BBB properties, physiology, and function. Moreover, they provide improved control over biophysical and biochemical experimental parameters and are compatible with advanced imaging and molecular biology techniques. Here, we review design considerations and methodologies utilized to successfully engineer BBB microvessels. Finally, we highlight the advantages and limitations of existing engineered models and propose applications to study parasite interactions with the BBB, including mechanisms of barrier disruption.
Collapse
Affiliation(s)
- Rory K M Long
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | - Livia Piatti
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| | | | - Maria Bernabeu
- European Molecular Biology Laboratory (EMBL) Barcelona, Barcelona, Spain
| |
Collapse
|
11
|
García-Rudolph A, Cegarra B, Saurí J, Opisso E, Tormos JM, Bernabeu M. [The impact of educational level on cognitive assessments in young patients admitted to rehabilitation after ischaemic stroke]. Rehabilitacion (Madr) 2021; 56:264-273. [PMID: 34702593 DOI: 10.1016/j.rh.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVE We propose to assess the impact of educational level on cognitive tests at admission and discharge after a period of cognitive rehabilitation in young patients after ischaemic stroke. MATERIALS AND METHODS We considered secondary and higher education (group A) and less than 6 years of formal education (group B). We compared A and B using χ2 and Kruskal-Wallis. We studied A and B as predictors of verbal and working memory at discharge. Verbal and working memories were assessed at admission and discharge using Rey Auditory Verbal Learning Test (RAVLT) and DIGITS of the Barcelona Test respectively. RESULTS We analysed n=277 patients (55% belonging to A, mean age of 51 years) admitted to a specialised centre in Spain between 2009 and 2019. We found significant differences (P<.05) at admission, all in favour of A in the assessments of attention, inhibition, visuoperception, visuoconstruction, verbal fluency and comprehension. In DIGITS and RAVLT-learning we found differences at admission. In Digits and RAVLT-recognition we found differences at discharge, all in favour of A. We found no differences in age, severity, time at admission, or length of stay in hospital. Nor did we find differences in cognitive gains or treatment efficiency in memory tests. The groups A and B did not predict RAVLT (R2=.53) or DIGITS (R2=.48). CONCLUSIONS A scores better in 63% of tests at admission and in 75% of tests at discharge, A and B are similar in gains and efficiency on memory tests.
Collapse
Affiliation(s)
- A García-Rudolph
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España
| | - B Cegarra
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España; Universitat de Barcelona, Barcelona, España.
| | - J Saurí
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España
| | - E Opisso
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España
| | - J M Tormos
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España
| | - M Bernabeu
- Recerca i Innovació Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, España; Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut, Germans Trias i Pujol, Badalona, Barcelona, España
| |
Collapse
|
12
|
Noé E, Gómez A, Bernabeu M, Quemada I, Rodríguez R, Pérez T, López C, Laxe S, Colomer C, Ríos M, Juárez-Belaúnde A, González C, Pelayo R, Ferri J. Guía: Principios básicos de la neurorrehabilitación del paciente con daño cerebral adquirido. Recomendaciones de la Sociedad Española de Neurorrehabilitación. Neurologia 2021. [DOI: 10.1016/j.nrl.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
13
|
Sahu PK, Duffy FJ, Dankwa S, Vishnyakova M, Majhi M, Pirpamer L, Vigdorovich V, Bage J, Maharana S, Mandala W, Rogerson SJ, Seydel KB, Taylor TE, Kim K, Sather DN, Mohanty A, Mohanty RR, Mohanty A, Pattnaik R, Aitchison JD, Hoffman A, Mohanty S, Smith JD, Bernabeu M, Wassmer SC. Determinants of brain swelling in pediatric and adult cerebral malaria. JCI Insight 2021; 6:145823. [PMID: 34549725 PMCID: PMC8492338 DOI: 10.1172/jci.insight.145823] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 07/28/2021] [Indexed: 01/08/2023] Open
Abstract
Cerebral malaria (CM) affects children and adults, but brain swelling is more severe in children. To investigate features associated with brain swelling in malaria, we performed blood profiling and brain MRI in a cohort of pediatric and adult patients with CM in Rourkela, India, and compared them with an African pediatric CM cohort in Malawi. We determined that higher plasma Plasmodium falciparum histidine rich protein 2 (PfHRP2) levels and elevated var transcripts that encode for binding to endothelial protein C receptor (EPCR) were linked to CM at both sites. Machine learning models trained on the African pediatric cohort could classify brain swelling in Indian children CM cases but had weaker performance for adult classification, due to overall lower parasite var transcript levels in this age group and more severe thrombocytopenia in Rourkela adults. Subgrouping of patients with CM revealed higher parasite biomass linked to severe thrombocytopenia and higher Group A–EPCR var transcripts in mild thrombocytopenia. Overall, these findings provide evidence that higher parasite biomass and a subset of Group A–EPCR binding variants are common features in children and adult CM cases, despite age differences in brain swelling.
Collapse
Affiliation(s)
- Praveen K Sahu
- Center for the Study of Complex Malaria in India, Ispat General Hospital (IGH), Rourkela, Odisha, India
| | - Fergal J Duffy
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - Selasi Dankwa
- Seattle Children's Research Institute, Seattle, Washington, USA
| | | | | | - Lukas Pirpamer
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Jabamani Bage
- Center for the Study of Complex Malaria in India, Ispat General Hospital (IGH), Rourkela, Odisha, India
| | - Sameer Maharana
- Center for the Study of Complex Malaria in India, Ispat General Hospital (IGH), Rourkela, Odisha, India
| | - Wilson Mandala
- Malawi University of Science and Technology, Limbe, Malawi
| | - Stephen J Rogerson
- Department of Medicine, The Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Karl B Seydel
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.,Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Terrie E Taylor
- Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan, USA.,Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Kami Kim
- Division of Infectious Diseases and International Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - D Noah Sather
- Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Akshaya Mohanty
- Infectious Diseases Biology Unit, Institute of Life Sciences, Bhubaneswar, Odisha, India
| | | | - Anita Mohanty
- Department of Intensive Care, IGH, Rourkela, Odisha, India
| | | | - John D Aitchison
- Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Angelika Hoffman
- Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany.,University Institute of Diagnostic and Interventional Neuroradiology, University Hospital Bern, Inselspital, University of Bern, Switzerland
| | - Sanjib Mohanty
- Center for the Study of Complex Malaria in India, Ispat General Hospital (IGH), Rourkela, Odisha, India
| | - Joseph D Smith
- Seattle Children's Research Institute, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Maria Bernabeu
- Seattle Children's Research Institute, Seattle, Washington, USA.,European Molecular Biology Laboratory (EMBL), Barcelona, Spain
| | - Samuel C Wassmer
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| |
Collapse
|
14
|
Prieto A, Bernabeu M, Falgenhauer L, Chakraborty T, Hüttener M, Juárez A. Overexpression of the third H-NS paralogue H-NS2 compensates fitness loss in hns mutants of the enteroaggregative Escherichia coli strain 042. Sci Rep 2020; 10:18131. [PMID: 33093592 PMCID: PMC7582179 DOI: 10.1038/s41598-020-75204-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/13/2020] [Accepted: 10/07/2020] [Indexed: 11/10/2022] Open
Abstract
Members of the H-NS protein family play a role both in the chromosome architecture and in the regulation of gene expression in bacteria. The genomes of the enterobacteria encode an H-NS paralogue, the StpA protein. StpA displays specific regulatory properties and provides a molecular backup for H-NS. Some enterobacteria also encode third H-NS paralogues. This is the case of the enteroaggregative E. coli (EAEC) strain 042, which encodes the hns, stpA and hns2 genes. We provide in this paper novel information about the role of the H-NS2 protein in strain 042. A C > T transition in the hns2 promoter leading to increased H-NS2 expression is readily selected in hns mutants. Increased H-NS2 expression partially compensates for H-NS loss. H-NS2 levels are critical for the strain 042 fitness. Under some circumstances, high H-NS2 expression levels dictated by the mutant hns2 promoter can be deleterious. The selection of T > C revertants or of clones harboring insertional inactivations of the hns2 gene can then occur. Temperature also plays a relevant role in the H-NS2 regulatory activity. At 37 °C, H-NS2 targets a subset of the H-NS repressed genes contributing to their silencing. When temperature drops to 25 °C, the repressory ability of H-NS2 is significantly reduced. At low temperature, H-NS plays the main repressory role.
Collapse
Affiliation(s)
- A Prieto
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - M Bernabeu
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - L Falgenhauer
- Institute of Hygiene and Environmental Medicine, Justus Liebig University Giessen, Schubertstrasse 81, 35392, Giessen, Germany.,German Center for Infection Research DZIF, Partner Site Giessen-Marburg-Langen, Campus, Giessen, Germany
| | - T Chakraborty
- German Center for Infection Research DZIF, Partner Site Giessen-Marburg-Langen, Campus, Giessen, Germany.,Institute of Medical Microbiology, Justus-Liebig University, Schubertstrasse 81, 35392, Giessen, Germany
| | - M Hüttener
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - A Juárez
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain. .,Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain.
| |
Collapse
|
15
|
Arakawa C, Gunnarsson C, Howard C, Bernabeu M, Phong K, Yang E, DeForest CA, Smith JD, Zheng Y. Biophysical and biomolecular interactions of malaria-infected erythrocytes in engineered human capillaries. Sci Adv 2020; 6:eaay7243. [PMID: 32010773 PMCID: PMC6968943 DOI: 10.1126/sciadv.aay7243] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 11/20/2019] [Indexed: 05/14/2023]
Abstract
Microcirculatory obstruction is a hallmark of severe malaria, but mechanisms of parasite sequestration are only partially understood. Here, we developed a robust three-dimensional microvessel model that mimics the arteriole-capillary-venule (ACV) transition consisting of a narrow 5- to 10-μm-diameter capillary region flanked by arteriole- or venule-sized vessels. Using this platform, we investigated red blood cell (RBC) transit at the single cell and at physiological hematocrits. We showed normal RBCs deformed via in vivo-like stretching and tumbling with negligible interactions with the vessel wall. By comparison, Plasmodium falciparum-infected RBCs exhibited virtually no deformation and rapidly accumulated in the capillary-sized region. Comparison of wild-type parasites to those lacking either cytoadhesion ligands or membrane-stiffening knobs showed highly distinctive spatial and temporal kinetics of accumulation, linked to velocity transition in ACVs. Our findings shed light on mechanisms of microcirculatory obstruction in malaria and establish a new platform to study hematologic and microvascular diseases.
Collapse
Affiliation(s)
- Christopher Arakawa
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Celina Gunnarsson
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Caitlin Howard
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Maria Bernabeu
- Seattle Children’s Research Institute, Seattle, WA 98101, USA
| | - Kiet Phong
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Eric Yang
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| | - Cole A. DeForest
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
- Department of Chemical Engineering, University of Washington, Seattle, WA 98195, USA
| | - Joseph D. Smith
- Seattle Children’s Research Institute, Seattle, WA 98101, USA
- Department of Global Health, University of Washington, Seattle, WA 98105, USA
| | - Ying Zheng
- Department of Bioengineering, University of Washington, Seattle, WA 98105, USA
| |
Collapse
|
16
|
Prieto A, Bernabeu M, Aznar S, Ruiz-Cruz S, Bravo A, Queiroz MH, Juárez A. Evolution of Bacterial Global Modulators: Role of a Novel H-NS Paralogue in the Enteroaggregative Escherichia coli Strain 042. mSystems 2018; 3:e00220-17. [PMID: 29577085 PMCID: PMC5861252 DOI: 10.1128/msystems.00220-17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 02/14/2018] [Indexed: 11/20/2022] Open
Abstract
Bacterial genomes sometimes contain genes that code for homologues of global regulators, the function of which is unclear. In members of the family Enterobacteriaceae, cells express the global regulator H-NS and its paralogue StpA. In Escherichia coli, out of providing a molecular backup for H-NS, the role of StpA is poorly characterized. The enteroaggregative E. coli strain 042 carries, in addition to the hns and stpA genes, a third gene encoding an hns paralogue (hns2). We present in this paper information about its biological function. Transcriptomic analysis has shown that the H-NS2 protein targets a subset of the genes targeted by H-NS. Genes targeted by H-NS2 correspond mainly with horizontally transferred (HGT) genes and are also targeted by the Hha protein, a fine-tuner of H-NS activity. Compared with H-NS, H-NS2 expression levels are lower. In addition, H-NS2 expression exhibits specific features: it is sensitive to the growth temperature and to the nature of the culture medium. This novel H-NS paralogue is widespread within the Enterobacteriaceae. IMPORTANCE Global regulators such as H-NS play key relevant roles enabling bacterial cells to adapt to a changing environment. H-NS modulates both core and horizontally transferred (HGT) genes, but the mechanism by which H-NS can differentially regulate these genes remains to be elucidated. There are several instances of bacterial cells carrying genes that encode homologues of the global regulators. The question is what the roles of these proteins are. We noticed that the enteroaggregative E. coli strain 042 carries a new hitherto uncharacterized copy of the hns gene. We decided to investigate why this pathogenic E. coli strain requires an extra H-NS paralogue, termed H-NS2. In our work, we show that H-NS2 displays specific expression and regulatory properties. H-NS2 targets a subset of H-NS-specific genes and may help to differentially modulate core and HGT genes by the H-NS cellular pool.
Collapse
Affiliation(s)
- A. Prieto
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - M. Bernabeu
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - S. Aznar
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - S. Ruiz-Cruz
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - A. Bravo
- Centro de Investigaciones Biológicas, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - M. H. Queiroz
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
| | - A. Juárez
- Department of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
| |
Collapse
|
17
|
Kessler A, Dankwa S, Bernabeu M, Harawa V, Danziger SA, Duffy F, Kampondeni SD, Potchen MJ, Dambrauskas N, Vigdorovich V, Oliver BG, Hochman SE, Mowrey WB, MacCormick IJC, Mandala WL, Rogerson SJ, Sather DN, Aitchison JD, Taylor TE, Seydel KB, Smith JD, Kim K. Linking EPCR-Binding PfEMP1 to Brain Swelling in Pediatric Cerebral Malaria. Cell Host Microbe 2017; 22:601-614.e5. [PMID: 29107642 DOI: 10.1016/j.chom.2017.09.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/06/2017] [Accepted: 09/22/2017] [Indexed: 11/16/2022]
Abstract
Brain swelling is a major predictor of mortality in pediatric cerebral malaria (CM). However, the mechanisms leading to swelling remain poorly defined. Here, we combined neuroimaging, parasite transcript profiling, and laboratory blood profiles to develop machine-learning models of malarial retinopathy and brain swelling. We found that parasite var transcripts encoding endothelial protein C receptor (EPCR)-binding domains, in combination with high parasite biomass and low platelet levels, are strong indicators of CM cases with malarial retinopathy. Swelling cases presented low platelet levels and increased transcript abundance of parasite PfEMP1 DC8 and group A EPCR-binding domains. Remarkably, the dominant transcript in 50% of swelling cases encoded PfEMP1 group A CIDRα1.7 domains. Furthermore, a recombinant CIDRα1.7 domain from a pediatric CM brain autopsy inhibited the barrier-protective properties of EPCR in human brain endothelial cells in vitro. Together, these findings suggest a detrimental role for EPCR-binding CIDRα1 domains in brain swelling.
Collapse
Affiliation(s)
- Anne Kessler
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Selasi Dankwa
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | - Maria Bernabeu
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | - Visopo Harawa
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre BT3, Malawi; University of Malawi, College of Medicine, Biomedical Department, Blantyre BT3, Malawi
| | | | - Fergal Duffy
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | | | - Michael J Potchen
- Department of Imaging Sciences, University of Rochester, Rochester, NY 14642, USA
| | | | | | - Brian G Oliver
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | - Sarah E Hochman
- Department of Medicine, New York University Langone Health, New York, NY 10016, USA
| | - Wenzhu B Mowrey
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA
| | - Ian J C MacCormick
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre BT3, Malawi; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK; Department of Eye and Vision Sciences, University of Liverpool, Liverpool L69 3BX, UK
| | - Wilson L Mandala
- Malawi-Liverpool Wellcome Trust Clinical Research Programme, Blantyre BT3, Malawi; University of Malawi, College of Medicine, Biomedical Department, Blantyre BT3, Malawi; Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo BT3, Malawi
| | - Stephen J Rogerson
- Department of Medicine at the Doherty Institute, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - D Noah Sather
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | | | - Terrie E Taylor
- Blantyre Malaria Project, Blantyre BT3, Malawi; Department of Osteopathic Medical Specialities, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Karl B Seydel
- Blantyre Malaria Project, Blantyre BT3, Malawi; Department of Osteopathic Medical Specialities, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA.
| | - Joseph D Smith
- Center for Infectious Disease Research, Seattle, WA 98109, USA; Department of Global Health, University of Washington, Seattle, WA 98195, USA.
| | - Kami Kim
- Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10461, USA.
| |
Collapse
|
18
|
Bernabeu M, Smith JD. EPCR and Malaria Severity: The Center of a Perfect Storm. Trends Parasitol 2016; 33:295-308. [PMID: 27939609 DOI: 10.1016/j.pt.2016.11.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/07/2016] [Accepted: 11/10/2016] [Indexed: 12/20/2022]
Abstract
Severe malaria due to Plasmodium falciparum infection causes nearly half a million deaths per year. The different symptomatology and disease manifestations among patients have hampered understanding of severe malaria pathology and complicated efforts to develop targeted disease interventions. Infected erythrocyte sequestration in the microvasculature plays a critical role in the development of severe disease, and there is increasing evidence that cytoadherent parasites interact with host factors to enhance the damage caused by the parasite. The recent discovery that parasite binding to endothelial protein C receptor (EPCR) is associated with severe disease has suggested new mechanisms of pathology and provided new avenues for severe malaria adjunctive therapy research.
Collapse
Affiliation(s)
- Maria Bernabeu
- Center for Infectious Disease Research, Seattle, WA 98109, USA
| | - Joseph D Smith
- Center for Infectious Disease Research, Seattle, WA 98109, USA; Department of Global Health, University of Washington, Seattle, WA 98195, USA.
| |
Collapse
|
19
|
Chery L, Maki JN, Mascarenhas A, Walke JT, Gawas P, Almeida A, Fernandes M, Vaz M, Ramanan R, Shirodkar D, Bernabeu M, Manoharan SK, Pereira L, Dash R, Sharma A, Shaik RB, Chakrabarti R, Babar P, White J, Mudeppa DG, Kumar S, Zuo W, Skillman KM, Kanjee U, Lim C, Shaw-Saliba K, Kumar A, Valecha N, Jindal VN, Khandeparkar A, Naik P, Amonkar S, Duraisingh MT, Tuljapurkar S, Smith JD, Dubhashi N, Pinto RGW, Silveria M, Gomes E, Rathod PK. Demographic and clinical profiles of Plasmodium falciparum and Plasmodium vivax patients at a tertiary care centre in southwestern India. Malar J 2016; 15:569. [PMID: 27884146 PMCID: PMC5123287 DOI: 10.1186/s12936-016-1619-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 11/15/2016] [Indexed: 01/11/2023] Open
Abstract
Background Malaria remains an important cause of morbidity and mortality in India. Though many comprehensive studies have been carried out in Africa and Southeast Asia to characterize and examine determinants of Plasmodium falciparum and Plasmodium vivax malaria pathogenesis, fewer have been conducted in India. Methods A prospective study of malaria-positive individuals was conducted at Goa Medical College and Hospital (GMC) from 2012 to 2015 to identify demographic, diagnostic and clinical indicators associated with P. falciparum and P. vivax infection on univariate analysis. Results Between 2012 and 2015, 74,571 febrile individuals, 6287 (8.4%) of whom were malaria positive, presented to GMC. The total number of malaria cases at GMC increased more than two-fold over four years, with both P. vivax and P. falciparum cases present year-round. Some 1116 malaria-positive individuals (mean age = 27, 91% male), 88.2% of whom were born outside of Goa and 51% of whom were construction workers, were enroled in the study. Of 1088 confirmed malaria-positive patients, 77.0% had P. vivax, 21.0% had P. falciparum and 2.0% had mixed malaria. Patients over 40 years of age and with P. falciparum infection were significantly (p < 0.001) more likely to be hospitalised than younger and P. vivax patients, respectively. While approximately equal percentages of hospitalised P. falciparum (76.6%) and P. vivax (78.9%) cases presented with at least one WHO severity indicator, a greater percentage of P. falciparum inpatients presented with at least two (43.9%, p < 0.05) and at least three (29.9%, p < 0.01) severity features. There were six deaths among the 182 hospitalised malaria positive patients, all of whom had P. falciparum. Conclusion During the four year study period at GMC, the number of malaria cases increased substantially and the greatest burden of severe disease was contributed by P. falciparum.
Collapse
Affiliation(s)
- Laura Chery
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA
| | - Jennifer N Maki
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA
| | - Anjali Mascarenhas
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Jayashri T Walke
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Pooja Gawas
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Anvily Almeida
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Mezia Fernandes
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Marina Vaz
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Rakesh Ramanan
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | | | - Maria Bernabeu
- Center for Infectious Disease Research (CIDR), Seattle, WA, 98109, USA
| | - Suresh Kumar Manoharan
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Ligia Pereira
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Rashmi Dash
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Ambika Sharma
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Riaz Basha Shaik
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Rimi Chakrabarti
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Prasad Babar
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.,Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - John White
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA
| | - Devaraja G Mudeppa
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA
| | - Shiva Kumar
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA
| | - Wenyun Zuo
- Department of Biology, Stanford University, Stanford, CA, 94305, USA
| | - Kristen M Skillman
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Usheer Kanjee
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Caeul Lim
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Kathryn Shaw-Saliba
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Ashwani Kumar
- National Institute of Malaria Research, Field Unit, Campal, Goa, 403001, India
| | - Neena Valecha
- National Institute of Malaria Research (ICMR), Sector 8, Dwarka, New Delhi, 110077, India
| | - V N Jindal
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | | | - Pradeep Naik
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Sunanda Amonkar
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Manoj T Duraisingh
- Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | | | - Joseph D Smith
- Center for Infectious Disease Research (CIDR), Seattle, WA, 98109, USA
| | - Nagesh Dubhashi
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Roque G W Pinto
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Maria Silveria
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Edwin Gomes
- Goa Medical College and Hospital, Bambolim, Goa, 403202, India
| | - Pradipsinh K Rathod
- Departments of Chemistry and Global Health, University of Washington, Seattle, WA, 98195, USA.
| |
Collapse
|
20
|
Sampath S, Brazier AJ, Avril M, Bernabeu M, Vigdorovich V, Mascarenhas A, Gomes E, Sather DN, Esmon CT, Smith JD. Plasmodium falciparum adhesion domains linked to severe malaria differ in blockade of endothelial protein C receptor. Cell Microbiol 2015; 17:1868-82. [PMID: 26118955 PMCID: PMC4661071 DOI: 10.1111/cmi.12478] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 11/28/2022]
Abstract
Cytoadhesion of Plasmodium falciparum-infected erythrocytes to endothelial protein C receptor (EPCR) is associated with severe malaria. It has been postulated that parasite binding could exacerbate microvascular coagulation and endothelial dysfunction in cerebral malaria by impairing the protein C-EPCR interaction, but the extent of binding inhibition has not been fully determined. Here we expressed the cysteine-rich interdomain region (CIDRα1) domain from a variety of domain cassette (DC) 8 and DC13 P. falciparum erythrocyte membrane protein 1 proteins and show they interact in a distinct manner with EPCR resulting in weak, moderate and strong inhibition of the activated protein C (APC)-EPCR interaction. Overall, there was a positive correlation between CIDRα1-EPCR binding activity and APC blockade activity. In addition, our analysis from a combination of mutagenesis and blocking antibodies finds that an Arg81 (R81) in EPCR plays a pivotal role in CIDRα1 binding, but domains with weak and strong APC blockade activity were distinguished by their sensitivity to inhibition by anti-EPCR mAb 1535, implying subtle differences in their binding footprints. These data reveal a previously unknown functional heterogeneity in the interaction between P. falciparum and EPCR and have major implications for understanding the distinct clinical pathologies of cerebral malaria and developing new treatment strategies.
Collapse
Affiliation(s)
- Sowmya Sampath
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Andrew Jay Brazier
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Marion Avril
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Maria Bernabeu
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Vladimir Vigdorovich
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Anjali Mascarenhas
- University of Washington, Department of Chemistry, Seattle, Washington, 98195, USA
| | - Edwin Gomes
- Goa Medical College & Hospital, Bambolim, Goa, India
| | - D. Noah Sather
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
| | - Charles T. Esmon
- Coagulation Biology Laboratory, Oklahoma Medical Research Foundation, Oklahoma City, OK, 73104, USA
| | - Joseph D. Smith
- Center for Infectious Disease Research (formerly Seattle Biomedical Research Institute), Seattle, Washington, 98109, USA
- Department of Global Health, University of Washington, Seattle, Washington, 98195, USA
| |
Collapse
|
21
|
Rigat-Brugarolas LG, Elizalde-Torrent A, Bernabeu M, De Niz M, Martin-Jaular L, Fernandez-Becerra C, Homs-Corbera A, Samitier J, del Portillo HA. A functional microengineered model of the human splenon-on-a-chip. Lab Chip 2014; 14:1715-1724. [PMID: 24663955 DOI: 10.1039/c3lc51449h] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The spleen is a secondary lymphoid organ specialized in the filtration of senescent, damaged, or infected red blood cells. This unique filtering capacity is largely due to blood microcirculation through filtration beds of the splenic red pulp in an open-slow microcirculation compartment where the hematocrit increases, facilitating the recognition and destruction of unhealthy red blood cells by specialized macrophages. Moreover, in sinusal spleens such as those of humans, blood in the open-slow microcirculation compartment has a unidirectional passage through interendothelial slits before reaching the venous system. This further physical constraint represents a second stringent test for erythrocytes ensuring elimination of those cells lacking deformability. With the aim of replicating the filtering function of the spleen on a chip, we have designed a novel microengineered device mimicking the hydrodynamic forces and the physical properties of the splenon, the minimal functional unit of the red pulp able to maintain filtering functions. In this biomimetic platform, we have evaluated the mechanical and physiological responses of the splenon using human red blood cells and malaria-infected cells. This novel device should facilitate future functional studies of the spleen in relation to malaria and other hematological disorders.
Collapse
Affiliation(s)
- L G Rigat-Brugarolas
- Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC), Baldiri Reixac, 10-12, 08028 Barcelona, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Sanz S, Bandini G, Ospina D, Bernabeu M, Mariño K, Fernández-Becerra C, Izquierdo L. Biosynthesis of GDP-fucose and other sugar nucleotides in the blood stages of Plasmodium falciparum. J Biol Chem 2013; 288:16506-16517. [PMID: 23615908 DOI: 10.1074/jbc.m112.439828] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Carbohydrate structures play important roles in many biological processes, including cell adhesion, cell-cell communication, and host-pathogen interactions. Sugar nucleotides are activated forms of sugars used by the cell as donors for most glycosylation reactions. Using a liquid chromatography-tandem mass spectrometry-based method, we identified and quantified the pools of UDP-glucose, UDP-galactose, UDP-N-acetylglucosamine, GDP-mannose, and GDP-fucose in Plasmodium falciparum intraerythrocytic life stages. We assembled these data with the in silico functional reconstruction of the parasite metabolic pathways obtained from the P. falciparum annotated genome, exposing new active biosynthetic routes crucial for further glycosylation reactions. Fucose is a sugar present in glycoconjugates often associated with recognition and adhesion events. Thus, the GDP-fucose precursor is essential in a wide variety of organisms. P. falciparum presents homologues of GDP-mannose 4,6-dehydratase and GDP-L-fucose synthase enzymes that are active in vitro, indicating that most GDP-fucose is formed by a de novo pathway that involves the bioconversion of GDP-mannose. Homologues for enzymes involved in a fucose salvage pathway are apparently absent in the P. falciparum genome. This is in agreement with in vivo metabolic labeling experiments showing that fucose is not significantly incorporated by the parasite. Fluorescence microscopy of epitope-tagged versions of P. falciparum GDP-mannose 4,6-dehydratase and GDP-L-fucose synthase expressed in transgenic 3D7 parasites shows that these enzymes localize in the cytoplasm of P. falciparum during the intraerythrocytic developmental cycle. Although the function of fucose in the parasite is not known, the presence of GDP-fucose suggests that the metabolite may be used for further fucosylation reactions.
Collapse
Affiliation(s)
- Sílvia Sanz
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, CEK, 1a Planta, Rosselló 149-153, 08036, Barcelona, Spain
| | - Giulia Bandini
- College of Life Sciences, University of Dundee, Division of Biological Chemistry and Drug Discovery, Wellcome Trust Biocentre, Dundee DD15EH, Scotland, United Kingdom
| | - Diego Ospina
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, CEK, 1a Planta, Rosselló 149-153, 08036, Barcelona, Spain
| | - Maria Bernabeu
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, CEK, 1a Planta, Rosselló 149-153, 08036, Barcelona, Spain
| | - Karina Mariño
- College of Life Sciences, University of Dundee, Division of Biological Chemistry and Drug Discovery, Wellcome Trust Biocentre, Dundee DD15EH, Scotland, United Kingdom
| | - Carmen Fernández-Becerra
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, CEK, 1a Planta, Rosselló 149-153, 08036, Barcelona, Spain
| | - Luis Izquierdo
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, CEK, 1a Planta, Rosselló 149-153, 08036, Barcelona, Spain.
| |
Collapse
|
23
|
Lopez FJ, Bernabeu M, Fernandez-Becerra C, del Portillo HA. A new computational approach redefines the subtelomeric vir superfamily of Plasmodium vivax. BMC Genomics 2013; 14:8. [PMID: 23324551 PMCID: PMC3566924 DOI: 10.1186/1471-2164-14-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [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: 08/23/2012] [Accepted: 01/02/2013] [Indexed: 01/20/2023] Open
Abstract
Background Subtelomeric multigene families of malaria parasites encode virulent determinants. The published genome sequence of Plasmodium vivax revealed the largest subtelomeric multigene family of human malaria parasites, the vir super-family, presently composed of 346 vir genes subdivided into 12 different subfamilies based on sequence homologies detected by BLAST. Results A novel computational approach was used to redefine vir genes. First, a protein-weighted graph was built based on BLAST alignments. This graph was processed to ensure that edge weights are not exclusively based on the BLAST score between the two corresponding proteins, but strongly dependant on their graph neighbours and their associations. Then the Markov Clustering Algorithm was applied to the protein graph. Next, the Homology Block concept was used to further validate this clustering approach. Finally, proteome-wide analysis was carried out to predict new VIR members. Results showed that (i) three previous subfamilies cannot longer be classified as vir genes; (ii) most previously unclustered vir genes were clustered into vir subfamilies; (iii) 39 hypothetical proteins were predicted as VIR proteins; (iv) many of these findings are supported by a number of structural and functional evidences, sub-cellular localization studies, gene expression analysis and chromosome localization (v) this approach can be used to study other multigene families in malaria. Conclusions This methodology, resource and new classification of vir genes will contribute to a new structural framing of this multigene family and other multigene families of malaria parasites, facilitating the design of experiments to understand their role in pathology, which in turn may help furthering vaccine development.
Collapse
Affiliation(s)
- Francisco Javier Lopez
- Barcelona Centre for International Health Research, CRESIB, Hospital Clínic-Universitat de Barcelona, Roselló 153, 1a planta CEK Building, 08036 Barcelona, Spain
| | | | | | | |
Collapse
|
24
|
Bernabeu M, Gomez-Perez GP, Sissoko S, Niambélé MB, Haibala AA, Sanz A, Théra MA, Fernandez-Becerra C, Traoré K, Alonso PL, Bassat Q, Del Portillo HA, Doumbo O. Plasmodium vivax malaria in Mali: a study from three different regions. Malar J 2012; 11:405. [PMID: 23217064 PMCID: PMC3547733 DOI: 10.1186/1475-2875-11-405] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [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: 09/07/2012] [Accepted: 11/30/2012] [Indexed: 12/03/2022] Open
Abstract
Background Plasmodium vivax has traditionally been considered virtually absent from Western and Central Africa, due to the absence of the Duffy blood group in most of the population living in these areas. Recent reports, however, suggest the circulation of P. vivax in sub-Saharan Africa. Methods Giemsa/Field-stained smears from febrile patients recruited in five different cities (Goundam, Tombouctou, Gao, Bourem and Kidal) pertaining to three regions from Northern Mali were examined. Nested-PCR and DNA sequence analyses of selected samples were performed to fully confirm the presence of P. vivax infections. Results Results demonstrated the presence of P. vivax infections in close to 30% of the cases as detected by Giemsa/Field-stained smears and nested-PCR and DNA-sequence analyses of selected samples unequivocally confirmed the presence of P. vivax. Conclusions The diagnostics of this human malaria parasite should be taken into account in the context of malaria control and elimination efforts, not only in Mali, but also in sub-Saharan Africa.
Collapse
Affiliation(s)
- Maria Bernabeu
- Barcelona Centre for International Health Research, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
García-Molina A, Tormos JM, Bernabeu M, Junqué C, Roig-Rovira T. Do traditional executive measures tell us anything about daily-life functioning after traumatic brain injury in Spanish-speaking individuals? Brain Inj 2012; 26:864-74. [PMID: 22583177 DOI: 10.3109/02699052.2012.655362] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To examine the relationship between traditional executive function measures and everyday competence in Spanish-speaking individuals with moderate-to-severe traumatic brain injury (TBI). METHODS AND PROCEDURES Thirty-two TBI patients (24 men, eight women) with an age range of 17-59 years (mean age = 30.73 years; SD = 13.34) were administered a battery of performance-based executive function measures. Such measures included the Trail Making Test part B, Wisconsin Card Sorting Test, Stroop Colour Word Interference Test, Controlled Oral Word Association Test and Letter-Number Sequencing. Behavioural manifestations of executive deficits were assessed by the Behaviour Rating Inventory of Executive Function-Adult version (BRIEF-A). Patient's everyday functioning was examined with the Patient Competency Rating Scale (PCRS). MAIN OUTCOMES AND RESULTS Traditional performance-based executive measures correlated significantly, although moderately, with the PCRS; this relationship was more significant in the Controlled Oral Word Association Test and Trail Making Test part B. A significant correlation was obtained between the BRIEF-A clinical scales and patient's everyday competence as measured by the PCRS. CONCLUSIONS The current findings suggest that traditional performance-based executive measures reveal some degree of ecological validity or real-world relevance, providing relevant information for predicting everyday competence after moderate-to-severe TBI.
Collapse
Affiliation(s)
- A García-Molina
- Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, Spain.
| | | | | | | | | |
Collapse
|
26
|
Costa FTM, Lopes SCP, Ferrer M, Leite JA, Martin-Jaular L, Bernabeu M, Nogueira PA, Mourão MPG, Fernandez-Becerra C, Lacerda MVG, del Portillo H. On cytoadhesion of Plasmodium vivax: raison d'être? Mem Inst Oswaldo Cruz 2012; 106 Suppl 1:79-84. [PMID: 21881760 DOI: 10.1590/s0074-02762011000900010] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Accepted: 06/10/2011] [Indexed: 11/22/2022] Open
Abstract
It is generally accepted that Plasmodium vivax, the most widely distributed human malaria parasite, causes mild disease and that this species does not sequester in the deep capillaries of internal organs. Recent evidence, however, has demonstrated that there is severe disease, sometimes resulting in death, exclusively associated with P. vivax and that P. vivax-infected reticulocytes are able to cytoadhere in vitro to different endothelial cells and placental cryosections. Here, we review the scarce and preliminary data on cytoadherence in P. vivax, reinforcing the importance of this phenomenon in this species and highlighting the avenues that it opens for our understanding of the pathology of this neglected human malaria parasite.
Collapse
Affiliation(s)
- Fabio T M Costa
- Departamento de Genética, Evolução e Bioagentes, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, SP, Brasil.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Bernabeu M, Lopez FJ, Ferrer M, Martin-Jaular L, Razaname A, Corradin G, Maier AG, Del Portillo HA, Fernandez-Becerra C. Functional analysis of Plasmodium vivax VIR proteins reveals different subcellular localizations and cytoadherence to the ICAM-1 endothelial receptor. Cell Microbiol 2011; 14:386-400. [PMID: 22103402 DOI: 10.1111/j.1462-5822.2011.01726.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The subcellular localization and function of variant subtelomeric multigene families in Plasmodium vivax remain vastly unknown. Among them, the vir superfamily is putatively involved in antigenic variation and in mediating adherence to endothelial receptors. In the absence of a continuous in vitro culture system for P. vivax, we have generated P. falciparum transgenic lines expressing VIR proteins to infer location and function. We chose three proteins pertaining to subfamilies A (VIR17), C (VIR14) and D (VIR10), with domains and secondary structures that predictably traffic these proteins to different subcellular compartments. Here, we showed that VIR17 remained inside the parasite and around merozoites, whereas VIR14 and VIR10 were exported to the membrane of infected red blood cells (iRBCs) in an apparent independent pathway of Maurer's clefts. Remarkably, VIR14 was exposed at the surface of iRBCs and mediated adherence to different endothelial receptors expressed in CHO cells under static conditions. Under physiological flow conditions, however, cytoadherence was only observed to ICAM-1, which was the only receptor whose adherence was specifically and significantly inhibited by antibodies against conserved motifs of VIR proteins. Immunofluorescence studies using these antibodies also showed different subcellular localizations of VIR proteins in P. vivax-infected reticulocytes from natural infections. These data suggest that VIR proteins are trafficked to different cellular compartments and functionally demonstrates that VIR proteins can specifically mediate cytoadherence to the ICAM-1 endothelial receptor.
Collapse
Affiliation(s)
- M Bernabeu
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Lima FPS, Lima MO, Leon D, Lucareli PRG, Falcon C, Cogo JC, Bargalló N, Vidal J, Bernabeu M, Junqué C. fMRI of the sensorimotor cortex in patients with traumatic brain injury after intensive rehabilitation. Neurol Sci 2011; 32:633-9. [PMID: 21607756 DOI: 10.1007/s10072-011-0604-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2009] [Accepted: 04/23/2011] [Indexed: 10/18/2022]
Abstract
For evaluating the patterns of brain activation in sensorimotor areas following motor rehabilitation, seven male patients diagnosed with TBI underwent an fMRI study before and after being subjected to motor rehabilitation. Six patients showed a reduction in the BOLD signal of their motor cortical areas during the second fMRI evaluation. A decrease in cerebellum activation was also observed in two patients. Newly activated areas, were observed in four patients after treatment. In addition, an increase in the activation of the supplementary motor area (SMA) following rehabilitation was observed in only one test subject. The findings show that motor rehabilitation in TBI patients produces a decrease in the BOLD signal for the sensorimotor areas that were activated prior to treatment. In addition, we observed the recruitment of different brain areas to compensate for functional loss due to TBI in line with the cortical reorganisation mechanism.
Collapse
Affiliation(s)
- F P S Lima
- Universidade do Vale do Paraíba, Urbanova São Jose dos Campos, SP, Brazil.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Siddiqui S, Jo T, Tamaoka M, Shalaby KH, Ghezzo H, Bernabeu M, Martin JG. Sites of allergic airway smooth muscle remodeling and hyperresponsiveness are not associated in the rat. J Appl Physiol (1985) 2010; 109:1170-8. [PMID: 20651225 DOI: 10.1152/japplphysiol.01168.2009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The cause-and-effect relationship between airway smooth muscle (ASM) remodeling and airway hyperresponsiveness (AHR) following allergen challenge is not well established. Using a rat model of allergen-induced ASM remodeling we explored the relationship between the site of ASM remodeling and AHR. Brown Norway rats, sensitized and challenged (3 times at 5-day intervals) with ovalbumin, were intranasally administered 0.1 mg/kg budesonide 24 and 1 h before challenge. Airway responses to aerosolized methacholine were assessed 48 h or 1 wk after three challenges. Airways were stained and analyzed for total airway wall area, area of smooth muscle-specific α-actin, and goblet cell hyperplasia, and the constant-phase model was used to resolve the changes in respiratory system mechanics into large airway and peripheral lung responses. After three ovalbumin challenges, there was a significant increase in ASM area and in the total wall area in all sized airways as well as an increase in goblet cells in the central airways. Budesonide inhibited ASM growth and central airway goblet cell hyperplasia following ovalbumin challenges. Budesonide also inhibited small but not large airway total wall area. AHR was attributable to excessive responses of the small airways, whereas responsiveness of the large airways was unchanged. Budesonide did not inhibit AHR after repeated challenge. We conclude that ASM remodeling induced by repeated allergen challenges involves the entire bronchial tree, whereas AHR reflects alterations in the lung periphery. Prevention of ASM remodeling by corticosteroid does not abrogate AHR.
Collapse
Affiliation(s)
- Sana Siddiqui
- Meakins Christie Laboratories, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | | | | | | | | | | | | |
Collapse
|
30
|
Corrias A, Jie X, Romero L, Bishop MJ, Bernabeu M, Pueyo E, Rodriguez B. Arrhythmic risk biomarkers for the assessment of drug cardiotoxicity: from experiments to computer simulations. Philos Trans A Math Phys Eng Sci 2010; 368:3001-25. [PMID: 20478918 PMCID: PMC2944395 DOI: 10.1098/rsta.2010.0083] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
In this paper, we illustrate how advanced computational modelling and simulation can be used to investigate drug-induced effects on cardiac electrophysiology and on specific biomarkers of pro-arrhythmic risk. To do so, we first perform a thorough literature review of proposed arrhythmic risk biomarkers from the ionic to the electrocardiogram levels. The review highlights the variety of proposed biomarkers, the complexity of the mechanisms of drug-induced pro-arrhythmia and the existence of significant animal species differences in drug-induced effects on cardiac electrophysiology. Predicting drug-induced pro-arrhythmic risk solely using experiments is challenging both preclinically and clinically, as attested by the rise in the cost of releasing new compounds to the market. Computational modelling and simulation has significantly contributed to the understanding of cardiac electrophysiology and arrhythmias over the last 40 years. In the second part of this paper, we illustrate how state-of-the-art open source computational modelling and simulation tools can be used to simulate multi-scale effects of drug-induced ion channel block in ventricular electrophysiology at the cellular, tissue and whole ventricular levels for different animal species. We believe that the use of computational modelling and simulation in combination with experimental techniques could be a powerful tool for the assessment of drug safety pharmacology.
Collapse
Affiliation(s)
- A. Corrias
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
| | - X. Jie
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
| | - L. Romero
- Instituto de Investigación Interuniversitario en Bioingeniería y Tecnología Orientada al Ser Humano, 6 Universidad Politécnica de Valencia (I3BH ), Valencia, Spain
| | - M. J. Bishop
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
| | - M. Bernabeu
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
| | - E. Pueyo
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
- Instituto de Investigación en Ingeniería de Aragón (I3A), Universidad de Zaragoza, Saragossa, Spain
| | - B. Rodriguez
- Oxford University Computing Laboratory, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
- Author for correspondence ()
| |
Collapse
|
31
|
Garcia-Molina A, Roig-Rovira T, Enseñat-Cantallops A, Sanchez-Carrion R, Pico-Azanza N, Bernabeu M, Tormos JM. Neuropsychological profile of persons with anoxic brain injury: Differences regarding physiopathological mechanism. Brain Inj 2009; 20:1139-45. [PMID: 17123930 DOI: 10.1080/02699050600983248] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PRIMARY OBJECTIVE To determine the neuropsychological profile of persons with anoxic brain injury. METHODS AND PROCEDURES A retrospective study on a population of persons with anoxic brain injury admitted to a Brain Injury Unit (Institut Guttmann, Spain) from 1995-2003. The sample was divided according to physiopathological mechanisms in two sub-groups: ischemic anoxia (21 cases) and hypoxemic anoxia (11 cases). Functions assessed included orientation, attention, language, visuo-perceptive and visuo-constructive processing and verbal memory. RESULTS Neuropsychological assessment showed diffuse cognitive impairment in all assessed functions. Episodes of ischemic anoxia caused more severe verbal memory and learning problems than episodes of hypoxemic anoxia. CONCLUSIONS This study shows that memory problems are the most prominent and relevant impairment, although all other cognitive functions are also impaired, affecting both memory itself and general behaviour. Statistical analysis also provides preliminary evidence on the different profile of memory impairment whether cerebral anoxia had hypoxic or ischemic origin.
Collapse
Affiliation(s)
- A Garcia-Molina
- Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, Spain
| | | | | | | | | | | | | |
Collapse
|
32
|
Clave P, Terre´ R, De Kraa M, Girvent M, Farre´ R, Pradas J, Martinell M, Bernabeu M, Serra M. Therapeutic effect of increasing bolus viscosity in neurogenic dysphagia. Clin Nutr 2003. [DOI: 10.1016/s0261-5614(03)80309-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Caballero-Granado FJ, Becerril B, Cuberos L, Bernabeu M, Cisneros JM, Pachón J. Attributable mortality rate and duration of hospital stay associated with enterococcal bacteremia. Clin Infect Dis 2001; 32:587-94. [PMID: 11181122 DOI: 10.1086/318717] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2000] [Revised: 07/12/2000] [Indexed: 11/03/2022] Open
Abstract
The mortality rate of patients with cases of enterococcal bacteremia is high, although it has often been related to the patients' underlying conditions rather than to the infection itself. To analyze the attributable prognosis of enterococcal bacteremia (assessed by its attributable mortality rate and duration of hospital stay), a prospective, matched case-control study was done. All adults with an episode of enterococcal bacteremia without endocarditis were included. A control patient was randomly selected for every case patient and matched by sex, age and hospital ward. Univariate and multivariate analyses were performed. A total of 122 pairs were included, and incidence of enterococcal bacteremia was 2.3 episodes/1000 discharges. Crude 30-day mortality rates for case patients and control patients were 23% and 17%, respectively (P=.29); thus, the estimated attributable mortality rate was 6% (95% confidence interval, -4% to 16%). The mean duration of hospital stay of case patients and control patients were 38 and 17 days, respectively (P<.001); thus, the estimated attributable duration of hospital stay was 21 days (95% CI, 7-32 days). Enterococcal bacteremia without endocarditis does not increase risk of death by itself but extends the duration of hospital stay of patients who develop it.
Collapse
Affiliation(s)
- F J Caballero-Granado
- Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Seville, Spain.
| | | | | | | | | | | |
Collapse
|
34
|
Bascuñana H, Villarreal I, Alfonso S, Terré R, Bernabeu M. [Agitation in head injury. II. Treatment with antidepressant, sympathomimetic, beta blocker , dopaminergic and other drugs]. Rev Neurol 2000; 30:1044-7. [PMID: 10904951] [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: 02/17/2023]
Abstract
OBJECTIVE To review the literature of the past 20 years, using the articles indexed in MEDLINE, on the drug treatment of agitation in traumatic head injury. DEVELOPMENT The treatment of agitation in traumatic head injury should be based on well-designed, randomised, placebo-controlled studies which justify any particular decision regarding drug use. However, care of the agitated traumatic head injury patient is based on the management of other related disorders, on the response of similar patient populations and clinical experience based on empirical observation. Amongst the drugs available, carbamazepine is the most widely used for post-traumatic agitation, followed by antidepressants and as a third option propranolol. We discuss other drugs which are used less frequently in post-traumatic agitation. CONCLUSIONS Many drugs are used and there is little agreement on the subject. However, with regard to certain characteristics of the agitation, different pharmacological treatments may be recommended.
Collapse
Affiliation(s)
- H Bascuñana
- Unidad de Lesión Cerebral, Institut Guttmann, Barcelona, España.
| | | | | | | | | |
Collapse
|
35
|
Bascuñana H, Villarreal I, Alfonso S, Bernabeu M, Terré R. [Agitation in head injury. I. Definition and treatment with anxiolytic neuroleptics and antiepileptic drugs]. Rev Neurol 2000; 30:850-4. [PMID: 10870200] [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: 02/16/2023]
Abstract
OBJECTIVE To carry out a bibliographic review of articles indexed in MEDLINE over the past 20 years concerning the pharmacological treatment of agitation in head injury. DEVELOPMENT Head injury may cause different behaviour changes, of which agitation is the most dramatic. The incidence of agitation after severe head injury varies from 11% to 50% depending on the study involved. This incidence is high enough to warrant specific management. Drug treatment has variable results. When there is imminent danger of harm to the patient himself or to others, or when aggressive behaviour makes medical management difficult, the benzodiazepines have been found useful. Antipsychotic drugs are only indicated in head injury when the agitation causes a clinical emergency, and in such a case the more potent drugs such as haloperidol are best, since they have less sedative effect. They are also effective when the clinical features are similar to those of classical schizophrenia. Antiepileptic drugs have been used successfully for treating agitation-aggressiveness, specially in paroxystic behaviour disorders. We also consider other treatments used for posttraumatic agitation. CONCLUSION There is no general agreement amongst doctors as to the best treatment for posttraumatic agitation in head injury. However, with regard to certain characteristics of agitation different drugs may be recommended for treatment.
Collapse
Affiliation(s)
- H Bascuñana
- Unidad de Lesión Cerebral, Institut Guttmann, Barcelona, España.
| | | | | | | | | |
Collapse
|
36
|
Herrero M, Jiménez-Mejías ME, Alberca R, Luque-Barona R, Pichardo C, Bernabeu M. [Febrile syndrome evolved over a long period and dementia]. Enferm Infecc Microbiol Clin 2000; 18:187-8. [PMID: 10932398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- M Herrero
- Servicio de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla
| | | | | | | | | | | |
Collapse
|
37
|
|
38
|
Bernabeu M, Krupp P, Wiskott E. Long-term safety of cyclosporine in renal transplant recipients: worldwide experience. Transplant Proc 1993; 25:17-9. [PMID: 8351707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- M Bernabeu
- Medical Information Department, Sandoz, Basel, Switzerland
| | | | | |
Collapse
|