Coenzyme Q10 supplementation during in vitro maturation of bovine oocytes (Bos taurus) helps to preserve oocyte integrity after vitrification

Oocyte vitrification causes less cell stress than slow cooling, but cytoskeletal and spindle alterations may occur affecting the oocyte competence. In vitro maturation (IVM) supplementation with different antioxidant molecules has been performed to attenuate this harmful stress. Coenzyme Q₁₀ (CoQ₁₀ ) supplementation has previously shown to have positive effects in bovine and mouse in vitro embryo development. The aim of this study was to evaluate the effects of CoQ₁₀ during bovine oocyte IVM and vitrification. Cumulus-oocyte complexes (COCs) (n = 311) were cultured under standard maturation conditions with 0 μM (control), 25 μM and 50 μM CoQ₁₀ supplementation. After 22 hr, a cohort of 170 oocytes both from the control and from CoQ₁₀ -supplemented groups were vitrified, warmed and returned to incubation until 24 hr of maturation, while the rest of the oocytes (n = 141) remained fresh. Then, oocyte survival was assessed morphologically by stereomicroscopy. Oocytes from all groups were then fixed and stained for assessing cortical granules (CG) migration and nuclear stage. High rates of oocyte MII progression and appropriate CG migration as a continuous layer beneath the plasma membrane were obtained both in control and in CoQ₁₀ groups. Results showed that although vitrification has great impact in survival of IVM bovine oocytes, 50 μM CoQ₁₀ supplementation significantly improved oocyte survival (p = .045) and reduced the premature CG exocytosis, helping to preserve the CG migration pattern (31.3% control vs. 54.5% in 50 μM CoQ₁₀ ; p = .039), attenuating the negative effects of vitrification.

40 Gene Expression Profiling of In Vitro-Produced Blastocysts Derived from In Vitro-Matured Bovine Oocytes Vitrified/Warmed in Media Supplemented with a Biopolymer Produced by an Antarctic Bacterium

Previous reports have demonstrated the beneficial effect of antifreeze glycoprotein supplementation during oocyte vitrification on preventing ice crystal formation and thus enhancing developmental competence after vitrification-warming. Pseudomonas sp. ID1, a bacterium isolated from marine sediment from Antarctica, produces an exopolysaccharide, M1 EPS, as a cold adaptation mechanism. Despite numerous studies on structural and morphological damages induced by cryopreservation in oocytes, few studies have focused on the impact of vitrification on the expression pattern of genes during early embryo development. In the present study, the expression patterns of 6 genes (BAX, BCL2-like 1, DNMT3A, UBE2A, SCLC2A3, and HDAC1) were investigated in Day 8 blastocysts resulting from in vitro-matured oocytes vitrified/warmed in media supplemented with various concentrations of M1 EPS. After 21 h of IVM, 1,062 oocytes were vitrified/warmed in media supplemented with 0, 0.001, 0.01, 0.1, and 1 mg mL−1 M1 EPS. At 24 h of IVM, oocytes were in vitro fertilized and in vitro cultured and the resulting blastocysts were harvested at Day 8 for RNA extraction and qPCR analysis. Fresh, non-vitrified oocytes were used as a control. Analysis of gene expression was performed through Kruskall-Wallis test and followed by Mann-Whitney test, and the level of significance was set at P ≤ 0.05. No significant differences were detected in relative mRNA abundance for SLC2A3, UBE2A, or HDAC-1 between blastocysts derived from vitrified oocytes, regardless of M1 EPS treatment. Expression of DNMT3A was significantly higher in embryos obtained from oocytes vitrified and warmed with 0.1 mg mL−1 M1 EPS compared with other treatment groups. However, no differences in DNMT3A expression were observed when the other vitrified groups were compared. The relative abundance of BAX transcript in embryos from oocytes vitrified in media supplemented with 0.1 mg mL−1 M1 EPS was higher than that in 0 or 0.001 mg mL−1 groups. Embryos from 0.01 and 0.1 mg mL−1 groups showed higher BCL2-like 1 mRNA abundance than those from the 0, 0.001, and 1 mg mL−1 groups. Whereas blastocysts from oocytes vitrified with 0.01 mg mL−1 M1 EPS exhibited the lowest BAX:BCL2-like 1 ratio, no significant differences in BAX:BCL2-like 1 ratio were observed between the other treatments. The significantly lower BAX:BCL2 ratio observed in blastocysts obtained from oocytes vitrified with 0.01 mg mL−1 M1 EPS could be indicative for a better embryo quality. Although optimizing the use of M1 EPS may benefit oocyte cryopreservation protocols, further research is required to clarify the exact mechanism through which it exerts its protective role. This study was supported by the Spanish Ministry of Science and Innovation (Project AGL2016-79802-P and grant CTQ2014-59632-R).

Predicting high risk of exacerbations in bronchiectasis: the E-FACED score

Background

Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the natural history of these patients.

Objective

Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality.

Methods

The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three countries (Brazil, Argentina, and Chile). The main outcome was the number of annual exacerbations/hospitalizations, with all-cause and respiratory-related deaths as the secondary outcomes. A statistical evaluation comprised the relative weight and ideal cut-off point for the number or severity of the exacerbations and was incorporated into the FACED score (E-FACED). The results obtained after the application of FACED and E-FACED were compared in both the cohorts.

Results

A total of 1,470 patients with bronchiectasis (819 from the construction cohorts and 651 from the external validation cohorts) were followed up for 5 years after diagnosis. The best cut-off point was at least two exacerbations in the previous year (two additional points), meaning that the E-FACED has nine points of growing severity. E-FACED presented an excellent prognostic capacity for exacerbations (areas under the receiver operating characteristic curve: 0.82 for at least two exacerbations in 1 year and 0.87 for at least one hospitalization in 1 year) that was statistically better than that of the FACED score (0.72 and 0.78, P<0.05, respectively). The predictive capacities for all-cause and respiratory mortality were 0.87 and 0.86, respectively, with both being similar to those of the FACED.

Conclusion

E-FACED score significantly increases the FACED capacity to predict future yearly exacerbations while maintaining the score’s simplicity and prognostic capacity for death.

Efecto del almacenamiento en atmósferas bajas en oxígeno sobre la calidad e incidencia de escaldado superficial en manzanas Topred / Effect of low-oxygen atmospheres on quality and superficial scald of Topred apples

In a 2-year study, Topred (TR) apples harvested from the area of Lleida (NE Spain) were treated with 3 rates (0, 1000 and 2000 ppm) of diphenylamine (DPA) and held in 3 different experimental storage conditions: standard controlled atmosphere (CA) with 3% O2 and 3% CO2; low oxygen (LO) atmosphere with 2% O2 and 2% CO2; ultra-low oxygen (ULO) atmosphere with 1% O2 and 1% CO2. All samples were maintained at 1 °C and 93-94% relative humidity. The incidence of super ficial scald and quality parameters were assessed in February, April and June, after storage plus 1 and 7 days at 20 °C, in samples from each treatment (anti-scald rate and storage atmosphere). Storage in ULO was effective in extending the storage life of the fruit. Firmness retention was better in these fruits than in fruits held in CA and LO storage; generally, after a 7-day post-storage holding period at 20 °C, the differences were maintained. The soluble solids content and titratable acidity were similar for all treatments. These changes were similar for the 2 years studied. Over one season (1993-94) the ULO atmosphere provided the best control of superficial scald in TR apples, although a low concentration of anti-scald was necessary in some cases. During the 7-day post-storage holding period the fruit of all treatments showed an increased incidence of scald, but fruit from the ULO treatment could be considered acceptable for market distribution. Susceptibility of fruit to scald exhib ited seasonal variation; in the 1994-95 season, DPA treatment was necessary to control scald in ULO apples. No appreciable increase in low O2 injury was found in this cultivar held in 1 or 2% O2.

Harvest maturity related changes in the cold-induced activation of 1-aminocyclopropane-1-carboxylic acid metabolism in Granny Smith apples / Efecto del estado de madurez sobre la activación por frío del metabolismo del ácido 1-aminociclopropano-1-carboxílico en manzanas Granny Smith

Changes in 1-aminocyclopropane-1-carboxylic acid metabolism in apples ( Malus domestica Borkh cv Granny Smith) were studied in relation to cold storage. Emphasis was given to the differential re sponsiveness of fruits to cold treatment as a function of stage of maturity at harvest. Fruits were held at 1 or 20 °C for 30 days, respectively, or exposed to 1 °C for 10 days and then storaged at 20 °C for up to 30 days. Fruits at 20 °C showed typical climacteric behavior. Differences at 1 °C between maturity stages in ethylene production and ACC oxidase activity were abolished, which showed that cold treatment is an important inducer of climacteric rise in preclimacteric Granny Smith apples. At 1 °C, ethylene production was lower than at 20 °C and the maxima in production were similar for all the stages of maturity, but took place at different times which corresponded exactly to the initial differ ences in harvest dates. After the transfer to 20 °C, fruits exhibited similar behavior as regards ethyl ene production, ACC oxidase activity, and ACC and MACC levels in relation to a harmonization process which is discussed in this study.

Prevalence and factors associated with nontuberculous mycobacteria in non-cystic fibrosis bronchiectasis: a multicenter observational study

Background

Data on the prevalence of and factors associated with nontuberculous mycobacteria (NTM) in patients with non–cystic fibrosis (CF) bronchiectasis are limited. Our aim was to determine the prevalence and factors associated with isolation of NTM in this population.

Methods

We performed a multicenter observational study of historical cohorts comprising consecutive patients with non-CF bronchiectasis and at least 2 sputum samples cultured for mycobacteria over a period of 5 years.

Results

The study population included 218 adult patients (61.9 % women) with a mean (SD) age of 55.7 (16) years and a mean (SD) of 5.1 (3.3) cultures/patient. NTM was isolated from sputum in 18 patients (8.3 %). Of these, 5 patients (28 %) met the American Thoracic Society criteria for NTM disease. Mycobacterium avium complex was the most frequently isolated microorganism (9 patients, 4.1 %). The variables independently associated with isolation of NTM were FVC ≥ 75 % predicted (OR, 4.84; 95 % CI 1.47 to 15.9; p < 0.05), age ≥ 50 years (OR, 4.74; 95 % CI 1.25 to 17.97; p < 0.05), and body mass index (BMI) ≤ 23 kg/m² (OR, 2.97; 95 % CI 1.03-8.58; p < 0.05). Patients with these three characteristics had a 40 % probability of having at least one isolation of NMT.

Conclusions

A significant number of patients with non-CF bronchiectasis are positive for the isolation of NTM. M. avium complex is the most frequently isolated mycobacteria. FVC ≥ 75 % predicted, age ≥ 50 years, and a BMI ≤ 23 kg/m² were independently associated with the presence of NTM in patients with non-CF bronchiectasis.

Magnesium sulphate and (123)I-MIBG in pheochromocytoma: Two useful techniques for a complicated disease

Pheochromocytoma is a tumour of the chromaffin tissue. It may, through catecholamine release, have deleterious effects on myocardial structure. A 48-year-old woman with a history of hypertension and type II diabetes mellitus (ASA II) was diagnosed of pheochromocytoma-induced myocarditis, which caused severe cardiogenic shock, with an ejection fraction of 20%. Extreme blood pressure swings required aggressive therapy with vasoactive drugs (norepinephrine and dopamine) and an intra-aortic balloon pump, despite which severe haemodynamic instability persisted. Finally, the use of magnesium sulphate allowed for cardiovascular stabilization and weaning off vasoactive drugs prior to surgery. (123)I-metaiodobenzylguanidine scintigraphy helps not only to functionally confirm tumour tissue, but also to assess severity and prognosis of cardiac failure. Prognosis of pheochromocytoma-induced heart failure can be very poor. The use of these two well-known and relatively simple 'tools' for treatment and prognosis is a helpful option to keep in mind.

Coagulation profiles of unexpected DCDD donors do not indicate a role for exogenous fibrinolysis

It has been suggested that vascular stasis during cardio-circulatory arrest leads to the formation of microvascular thrombi and the viability of organs arising from donation after circulatory determination of death (DCDD) donors may be improved through the application of fibrinolytic therapy. Our aim was to comprehensively study the coagulation profiles of Maastricht category II DCDD donors in order to determine the presence of coagulation abnormalities that could benefit from fibrinolytic therapy. Whole blood from potential DCDD donors suffering out-of-hospital cardiac arrest was sampled after declaration of death in the emergency department, and rotational thromboelastomeric analysis was performed. Between July 2012 and December 2013, samples from 33 potential DCDD donors were analyzed. All patients demonstrated hyperfibrinolysis (HF), as reflected by maximum clot lysis of 98-100% in all cases, indicating that there is no role for additional fibrinolytic therapy in this setting. As well, we observed correlations between thromboelastomeric lysis parameters and maximum hepatic transaminase levels measured in potential donors and renal artery flows measured during ex situ hypothermic oxygenated machine perfusion, indicating that further studies on the utility of thromboelastometry to evaluate organ injury and perhaps even viability in unexpected DCDD may be warranted.

[Cerebrovascular accident with haemorrhagic transformation in a patient on antiplatelet treatment subjected to surgery of a hypophyseal macroadenoma]

The case is presented of a 51 year-old woman, proposed for endoscopic endonasal transsphenoidal resection of a hypophyseal macroadenoma diagnosed in the context of a stroke suffered 10 weeks before the date of the surgery. During this time, she had been treated with antiplatelet drugs, which were withdrawn 5 days before the surgery. The surgical procedure was performed without any incidents. On the second day after the surgery, the patient had an ischaemic infarction of the left cerebellar hemisphere, with signs of hydrocephaly and a posterior haemorrhagic transformation, with brain death 5 days after the operation. There are no definitive guidelines on the use of antiplatelet drugs in the perioperative period of neurosurgery. Also, there is no agreement as regards the waiting time between a cerebrovascular event and surgery, it appears that between 4 and 12 weeks would be the most advisable. The importance of an individual assessment of each patient before surgery is emphasised, as well as a review of the antiplatelet management of the patient with a risk of thrombosis in the context of neurosurgery, and their possible postoperative complications.

Genotype-phenotype correlation for pulmonary function in cystic fibrosis

BACKGROUND

Since the CFTR gene was cloned, more than 1000 mutations have been identified. To date, a clear relationship has not been established between genotype and the progression of lung damage. A study was undertaken of the relationship between genotype, progression of lung disease, and survival in adult patients with cystic fibrosis (CF).

METHODS

A prospective cohort of adult patients with CF and two CFTR mutations followed up in an adult cystic fibrosis unit was analysed. Patients were classified according to functional effects of classes of CFTR mutations and were grouped based on the CFTR molecular position on the epithelial cell surface (I-II/I-II, I-II/III-V). Spirometric values, progression of lung disease, probability of survival, and clinical characteristics were analysed between groups.

RESULTS

Seventy four patients were included in the study. Patients with genotype I-II/I-II had significantly lower current spirometric values (p < 0.001), greater loss of pulmonary function (p < 0.04), a higher proportion of end-stage lung disease (p < 0.001), a higher risk of suffering from moderate to severe lung disease (odds ratio 7.12 (95% CI 1.3 to 40.5)) and a lower probability of survival than patients with genotype I-II/III, I-II/IV and I-II/V (p < 0.001).

CONCLUSIONS

The presence of class I or II mutations on both chromosomes is associated with worse respiratory disease and a lower probability of survival.

Utility of the antibody response to a conjugated Haemophilus influenzae type B vaccine for diagnosis of primary humoral immunodeficiency

Antibody response to an Haemophilus influenzae type b (Hib)-conjugated vaccine was studied in 59 healthy adults (mean age: 32 yr) and 22 patients with humoral immunodeficiencies (mean age: 32 yr) to determine its usefulness in the diagnosis of defective antibody formation. Twenty of the healthy adults and nine of the patients were also immunized with a pneumococcal vaccine. Serum specific antibodies were measured by ELISA. Adequate response to both vaccines was defined using the lower limit of the two-tailed 90% probability interval of postimmunization specific IgG of the healthy adults. By using this cutoff, responders were considered to be those with an absolute increase in anti-Hib IgG titers higher than 2.28 microgram/ml, and in anti-Streptococcus pneumoniae IgG higher than 395 arbitrary units/ml. With these criteria, 85% (50 of 59) of the healthy adults responded with anti-Hib IgG and 75% (15 of 20) with anti-pneumococcal IgG. All healthy adults receiving both vaccines responded to at least one. None of the patients with humoral immunodeficiencies responded to either vaccine. Evaluation of the antibody response to both the Hib and pneumococcal vaccines may facilitate the diagnosis of humoral immunodeficiency and selection of patients to receive immunoglobulin therapy.

Specific antibody response against the 23-valent pneumococcal vaccine in patients with alpha(1)-antitrypsin deficiency with and without bronchiectasis

OBJECTIVE

To assess the specific antibody response against polyvalent pneumococcal vaccine in patients with alpha(1)-antitrypsin deficiency (AATD) and respiratory infections.

DESIGN AND PARTICIPANTS

We investigated specific IgG, IgG1, and IgG2 antibody responses against the 23-valent antipneumococcal vaccine in 18 patients with AATD phenotype PiZZ, 9 of whom had bronchiectasis and 4 a history of recurrent pneumonia, and compared them with a control group of 40 healthy volunteers.

INTERVENTIONS

Blood samples were drawn just prior to and 3 weeks after immunization.

MEASUREMENTS AND RESULTS

Quantification of specific IgG and its subclasses was performed by an enzyme-linked immunosorbent assay. For patients with AATD, mean increases in specific antipneumococcal titers were 4.7-fold (25 to 75% quartiles, 2.5- to 6.8-fold) for total IgG, 3.2-fold (1.2- to 4.9-fold) for IgG1, and 2.1-fold (1.8- to 3.7-fold) for IgG2. For the control group, the values were 3.3-fold (1.8- to 5.8-fold) for total IgG, 2. 5-fold (1.9- to 3.4-fold) for IgG1, and 3.1-fold (1.9- to 4.5-fold) for IgG2; differences were not significant. Patients with bronchiectasis showed a tendency toward higher levels of IgG subclasses than both control subjects and patients without bronchiectasis; however, there was a tendency toward lower postvaccination serum levels of specific antipneumococcal IgG, IgG1, and IgG2 in patients with bronchiectasis compared with patients without bronchiectasis, but this trend did not reach statistical significance. Three of the four patients with recurrent pneumonia did not show an appropriate IgG2 response.

CONCLUSIONS

These results suggest that, as a group, patients with AATD have a preserved antibody response against pneumococcal polysaccharides. Patients with bronchiectasis show a tendency toward a decreased antibody response, even with increased serum levels of most Ig types. Individuals with an impaired IgG2 response seem to be at increased risk of recurrent pneumonia. Considering the pernicious effect of pulmonary infections on these patients and the preserved antibody response in a majority of them, pneumococcal vaccination should be recommended to patients with AATD.

Relationships between volatile production, fruit quality, and sensory evaluation in Granny Smith apples stored in different controlled-atmosphere treatments by means of multivariate analysis

Aroma compounds, quality parameters, and sensory evaluation of Granny Smith apples were analyzed after 3, 5, and 7 months of cold storage in three controlled-atmosphere (CA) treatments, in which oxygen and carbon dioxide were held at 1, 2, and 3%. During poststorage ripening, the apples were kept at 20 degrees C for 1, 5, and 10 days before analytical measurements were made. The highest volatile emission was obtained after 5 months of storage in all CA treatments, reaching its highest value when a low-oxygen CA (LO) was used. Ultralow-oxygen CA (ULO) showed the highest ability to maintain apple firmness. The correlation among analytical and sensory parameters suggests that ethyl 2-methylbutyrate, 1-butanol, pentyl acetate, and tert-butyl propionate are the aroma compounds with the highest influence in the sensorial score. Concerning CA treatments, LO and ULO appear to be very valuable technologies for maintaining the sensorial quality even after 7 months of storage.

Characterization of two divergent endo-beta-1,4-glucanase cDNA clones highly expressed in the nonclimacteric strawberry fruit

Two cDNAs clones (Cel1 and Cel2) encoding divergent endo-beta-1, 4-glucanases (EGases) have been isolated from a cDNA library obtained from ripe strawberry (Fragaria x ananassa Duch) fruit. The analysis of the amino acid sequence suggests that Cel1 and Cel2 EGases have different secondary and tertiary structures and that they differ in the presence of potential N-glycosylation sites. By in vitro translation we show that Cel1 and Cel2 bear a functional signal peptide, the cleavage of which yields mature proteins of 52 and 60 kD, respectively. Phylogenetic analysis revealed that the Cel2 EGase diverged early in evolution from other plant EGases. Northern analysis showed that both EGases are highly expressed in fruit and that they have different temporal patterns of accumulation. The Cel2 EGase was expressed in green fruit, accumulating as the fruit turned from green to white and remaining at an elevated, constant level throughout fruit ripening. In contrast, the Cel1 transcript was not detected in green fruit and only a low level of expression was observed in white fruit. The level of Cel1 mRNA increased gradually during ripening, reaching a maximum in fully ripe fruit. The high levels of Cel1 and Cel2 mRNA in ripe fruit and their overlapping patterns of expression suggest that these EGases play an important role in softening during ripening. In addition, the early expression of Cel2 in green fruit, well before significant softening begins, suggests that the product of this gene may also be involved in processes other than fruit softening, e.g. cell wall expansion.

A gene expression approach to mapping the functional maturation of the hippocampus

Previous studies have shown an association among seizures, neuronal death and the expression of cellular immediate-early genes (cIEG). To understand further the relationship between these processes, we investigated the ability of kainic acid (KAI) to induce behavioral responses and gene expression in the hippocampus of developing fos-lacZ transgenic mice. Despite the fact that KAI elicited seizure-like activity from P2 onwards, Fos-lacZ was first detected at P5 in CA3 pyramidal neurons. Thus, intense behavioral responses were not invariably associated with fos-lacZ expression. Furthermore, while adult CA3 neurons are highly susceptible to KAI toxicity, they are resistant at P5. Therefore, the presence of Fos-lacZ in CA3 neurons is not necessarily predictive of their fate. By P10, Fos-lacZ was induced in CA3 neurons and in the most mature granule neurons of the dentate gyrus (DG). Between P15 and P20, KAI induced fos-lacZ in all CA1 and CA3 pyramidal neurons and most granule neurons of the DG. This stereotypical pattern of fos-lacZ expression mirrors the ontogeny of hippocampal circuitry and glutamate signalling. Thus the fos-lacZ mice can be used to map the functional maturation of the nervous system with single cell resolution. The scope of this approach was extended by administration of additional chemoconvulsants to fos-lacZ mice and by analysis of fos-lacZ transgenic mice with mutations in their FAP site. These additional studies revealed anatomical and mechanistic differences in glutamate receptor-mediated transcriptional responses in the nervous system.

Behavioral and monoaminergic changes after lindane exposure in developing rats

The effects of lindane on behavior and central monoaminergic systems were studied in rat pups at 15 days of postnatal age. Pups were previously given nonconvulsant lindane PO doses, either a single 20 mg/kg or 7-day repeated 10 mg/kg doses. Both treatment schedules improved the passive avoidance acquisition but only the acute administration prolonged the step-through latency. Acute lindane decreased the motor activity, whereas the repeated dosing increased it. Increases of the ratio 5-HIAA/serotonin in several brain regions and of the ratio DOPAC/dopamine in the mesencephalon after a single dose of lindane suggest an enhanced monoaminergic turnover. In contrast, repeated lindane doses decreased monoamine/metabolite ratios excluding the striatum, where an increase of DOPAC/dopamine ratio correlates with the higher motor activity of these animals. It is postulated that both the imbalance of the central monoaminergic systems and the lindane-induced GABAergic blockade may be the basis of the behavioral alterations.

Influence of Different Oxygen and Carbon Dioxide Concentrations during Storage on Production of Volatile Compounds by Starking Delicious Apples

Starking Delicious apples were cold-stored in semicommercial chambers in normal atmosphere and in different controlled atmospheres in which oxygen and carbon dioxide were held at 1%, 2%, and 3% for 3, 5, and 7 months. After storage, fruit was kept at ambient temperature (20 degrees C) for 1, 5, and 10 days. The volatile emission was collected and analyzed. After all storage periods and conditions, the total aromatic volatile emission was higher than at commercial harvest. The highest emission of volatile components was obtained after 5 months of storage, in which controlled-atmosphere conditions gave a lower concentration than normal cold storage. Esters were the main volatiles detected (>98%). Acetate ester concentrations after all storage periods assayed were higher at 3% and 2% O(2)/CO(2). The components that contributed most to the characteristic aroma of Starking Delicious were ethyl 2-methylbutyrate, ethyl butyrate, and ethyl hexanoate. Their concentrations were higher after 5 months of storage and also during poststorage at ambient temperature (20 degrees C).

A cDNA clone highly expressed in ripe banana fruit shows homology to pectate lyases

A cDNA clone (Ban17), encoding a protein homologous to pectate lyase, has been isolated from a cDNA library from climacteric banana fruit by means of differential screening. Northern analysis showed that Ban17 mRNA is first detected in early climacteric fruit, reaches a steady-state maximum at the climacteric peak, and declines thereafter in overripe fruit. Accumulation of the Ban17 transcript can be induced in green banana fruit by exogenous application of ethylene. The demonstrates that expression of this gene is under hormonal control, its induction being regulated by the rapid increase in ethylene production at the onset of ripening. The deduced amino acid sequence derived from the Ban17 cDNA shares significant identity with pectate lyases from pollen and plant pathogenic bacteria of the genus Erwinia. Similarity to bacterial pectate lyases that were proven to break down the pectic substances of the plant cell wall suggest that Ban17 might play a role in the loss of mesocarp firmness during fruit ripening.

Empiric treatments impair the diagnostic yield of BAL in HIV-positive patients

OBJECTIVE

To investigate the influence of empiric treatments prior to fiberoptic bronchoscopy (FOB) on the diagnostic yield of BAL in HIV-positive patients with respiratory symptoms.

METHOD

We studied 123 consecutive FOBs with BAL in HIV-positive patients; 101 of these patients (82%) had received previous antimicrobial treatment from 1 to 60 days. Diagnostic yield of BAL for Pneumocystis carinii, Mycobacterium tuberculosis, and bacterial pneumonia was compared between patients with and without previous empiric treatments.

RESULTS

A diagnosis was obtained in 85 patients (69%), of whom 17 (20%) had multiple infections. Diagnostic yield was higher in patients without previous treatment, 91% (20/22) compared with 64% (65/101), p < 0.03. Diagnostic yield was also higher for bacterial pneumonia: seven isolations from 22 patients not receiving previous empiric treatment (32%), compared with 11 of those who had (11%; p < 0.02). The duration of empiric treatment against P carinii in patients in whom it was isolated was significantly shorter than in those in whom P carinii was not detected (3.5 +/- 1.8 days compared with 5.2 +/- 2.4 days; p = 0.003). FOB permitted a change in treatment in 62% of patients with a final diagnosis.

CONCLUSION

This study demonstrates that empiric treatments prior to FOB significantly impair the diagnostic yield of BAL in detecting common pathogens in HIV-infected patients with respiratory symptoms.

Characterization of specific immunoglobulin G (IgG) and its subclasses (IgG1 and IgG2) against the 23-valent pneumococcal vaccine in a healthy adult population: proposal for response criteria

The aim of the study was to standardize an enzyme-linked immunosorbent assay (ELISA) method for the quantification of immunoglobulin G (IgG) and its subclasses (IgG1 and IgG2) against the 23-valent pneumococcal vaccine and to establish the criteria for a normal response to the vaccine. Forty healthy individuals (20 women and 20 men; mean age, 29 years) were studied. All were vaccinated with the 23-valent pneumococcal vaccine; blood samples were drawn just prior to and 3 weeks after immunization. Quantification of specific IgG and its subclasses was performed by an ELISA with the vaccine as the antigen. The linearity of the ELISA method was demonstrated by the similar slopes of the linear regression lines generated from the titration of sera with different antibody concentrations. The specificity of the antibodies against the vaccine was demonstrated by (i) an absorption test with pneumococcal vaccine, (ii) a cross-reactivity experiment with Haemophilus influenzae type b polysaccharide, and (iii) affinity chromatography with protein A-Sepharose. Response to the vaccine was defined by using the lower level of the 90% probability interval (one-tailed) for postimmunization-specific IgG, IgG1, and IgG2. By using this cutoff, responders were considered to be those with an absolute increase in antibody titers higher than 395 arbitrary units/ml for IgG, 0.350 A450 units for IgG1, and 0.314 A450 units for IgG2. Overall, 20 (50%) subjects had IgG, IgG1, and IgG2 responses, 9 (22.5%) had IgG and IgG2 responses, 4 (10%) had IgG1 responses, 3 (7.5%) had IgG and IgG1 responses, and 4 (10%) were nonresponders. Ninety percent of our population responded to the 23-valent pneumococcal vaccine. Up to 10% of healthy individuals may respond to an IgG subclass without significant increases in total IgG titers. The ELISA method that is described may be useful for evaluating the specific antibody response against polysaccharides.

[Theophyllines of 12- and 24-hour sustained-release. Comparative study]

To compare 24-h and 12-h delayed-release theophylline in asthmatic patients, in terms of clinical stability and respiratory function, side effects and required dose, clinical tolerance and plasma concentrations. Patients with bronchial asthma in stable phase taking theophylline every 12 h were selected. Each patient received 12-h (treatment A) and 24-h (treatment B) theophylline formulas in a prospective, cross-over study with paired data for periods of 15 days. We evaluated theophylline doses, blood levels, clinical course, lung function and side effects. Twenty patients were enrolled. No significant differences between the two treatments were observed in mean dose of theophylline per kg body weight required to obtain therapeutic plasma concentrations (treatment A: 9.36 +/- 1.88 mg/kg/day; treatment B: 9.6 +/- 1.7 mg/kg/day). Mean blood level just before administration of a the next dose was lower with the 24-h formula, but still within therapeutic margins (treatment A: 7.31 +/- 2.27 micrograms/ml; treatment B: 10.66 +/- 2.86 micrograms/ml; p = 0.002). There were no differences in side effects after the adjustment period or in FEV1 after each treatment period. Peak expiratory flow remained stable during the study. The 24-h delayed release theophylline formula was similar to the 12-h formula in dose required by asthmatic patients and in therapeutic plasma concentrations throughout the day.

IgG subclass deficiencies associated with bronchiectasis

Only a small number of patients with IgG subclass deficiencies (IgGSD) have been observed to have bronchiectasis. Moreover, in the series of patients with bronchiectasis, IgGSD have not been found at any frequency, and the etiology of bronchiectasis remains unclear in 29 to 49% of cases. Serum concentrations of total IgG, IgA, and IgG subclasses as well as pulmonary function were measured in 65 patients (aged: 10 to 74 yr) with bronchiectasis of unknown etiology. An ELISA test was performed to quantify subclasses 1 through 4 using subclass-specific antihuman monoclonal antibodies. IgG subclass estimation in a healthy population with age-stratified normal ranges was derived from 100 adults, 37 children aged between 10 and 12 yr, and 27 adolescents aged between 13 and 16 yr. Serum concentrations of specific IgG antibodies to Haemophilus influenzae type b capsular polysaccharide (Hib-PRP) were also assayed by an ELISA test in 19 of the patients (10 with IgGSD and nine with non-IgGSD) and in 58 healthy individuals before and 3 wk after immunization with Hib-PRP conjugated to meningococcal outer membrane protein complex (OMPC). Thirty-one patients (48%) had low serum concentrations of one or more IgG subclasses (19 IgG2 deficiencies, 2 IgG3 deficiencies, 3 IgG4 deficiencies, and 7 combined subclass deficiencies). All patients showed increased levels of total IgG, IgG1, and IgA, but this rise was significantly higher in patients without IgGSD. Patients with IgGSD showed impaired antibody response to Hib-PRP compared with patients with non-IgGSD and the control group. IgGSD, particularly IgG2 deficiency, are not an unusual cause of bronchiectasis. Therefore, serum levels of IgG subclasses must be assayed whenever other causes of bronchiectasis have been ruled out.

[IgG subclasses in patients with symptomatic IgA deficiency]

BACKGROUND

Patients with IgA deficiency may be asymptomatic or may present recurrent infections mainly respiratory. A possible explanation for this variety of symptoms may be the association with a deficiency of IgG subclasses.

METHODS

Twenty-five patients with a symptomatic IgA deficiency with a mean age of 18 +/- 12 years were studied. The quantification of the IgG subclasses was performed by ELISA test with antisubclass specific monoclonal murine antibodies. Serum from 100 healthy adults was collected to determine normal values of the IgG subclasses.

RESULTS

Twenty-five (48%) had a deficiency of associated IgG subclasses (6 IgG2 deficiency, 1 IgG3, 3 IgG4 and 2 combined deficiency). The patient with a deficiency of associated IgG subclasses had more recurrent respiratory infections (chi 2, p < 0.03) and pneumonias (chi 2, p < 0.04). This group also had a greater FEV1 alteration (Student-t test, p < 0.04).

CONCLUSIONS

Patients with symptomatic IgA deficiency frequently present IgG subclass deficiency and are more likely to have recurrent respiratory infections and greater changes in pulmonary function.

[The use of fibrinogen-thrombin via endoscope in the treatment of massive hemoptysis]

We assessed the efficacy of fibrinogen-thrombin instillation through the fiberoptic bronchoscope to treat massive hemoptysis in patients to whom embolization of bronchial arteries was not available, was contraindicated or had failed. The fibrinogen-thrombin solution used was Tissucol, which in addition to 2% fibrinogen and 4 U/ml of thrombin, also contained factor XIII an aprotinin. The fibrinogen-thrombin solution was instilled with the aid of the Duplojec system and a 70 cm x 2 mm 4-way catheter. In 53 of the 628 fiberoptic bronchoscopies performed during the study, the indication was hemoptysis > or = 150 ml/12 h. Of these, bronchoscopic instillation of fibrinogen-thrombin was indicated in 5 cases because bronchial artery embolization was impossible. The point of bleeding was located by bronchoscopy in all cases and fibrinogen-thrombin instillation controlled hemoptysis immediately and throughout the follow-up period, which ranged 4 to 10 months. Morning expectoration of blood (< 10 ml) was observed in only 1 patient in the 3 days after treatment. The mean time taken for bronchoscopic exploration was 3 minutes (range, 2-7). In all cases fiberoptic bronchoscopy was performed without complications that might have required the procedure to be suspended. We conclude that the local use of fibrinogen-thrombin or fibrin glue instilled through the fiberoptic bronchoscope to the point of bleeding is a simple, fast and cheap way to control massive hemoptysis on a short and long-term basis.(ABSTRACT TRUNCATED AT 250 WORDS)

[The use of human gamma globulin in the treatment of common variable immunodeficiency]

BACKGROUND

The indication for treatment with human gammaglobulin in patients with primary hypogammaglobulinemia is well established. Nonetheless, there are no uniform criteria with regard to dose, periodicity and route of administration.

METHODS

Twenty-seven patients with common variable immunodeficiency (CVI) who received i.m. or i.v. treatment with gammaglobulin were studied, evaluating the secondary effects, stable levels of IgG achieved, control of symptomatology, clinical evolution and the need for adjuvant therapies.

RESULTS

Intravenous administration was more effective than intramuscular administration to achieve higher total IgG serum levels (5.2 +/- 1.2 vs 3.5 +/- 1.6 g/l; p = 0.07) in a shorter period of time (2.1 +/- 1.6 months vs 6.3 +/- 2.8 months; p < 0.01) and with new few secondary effects. The dose and periodicity of the treatment was individualized in each patient on the basis of the needs of consumption and the speed of metabolism of the gammaglobulin, with patients with chronic bronchial suppuration and diarrhea being those requiring the greatest doses (p < 0.0001) and a short interdosis time interval (19.2 +/- 3.1 vs 23.6 +/- 3.6 days; p = 0.01). Treatment with human gammaglobulin allowed the control of recurrent bacterial infection; however, adjuvant treatment with respiratory physical measures and antibiotics were required in patients with chronic bronchial suppuration to avoid progressive alteration of respiratory function.

CONCLUSIONS

The administration of human gammaglobulin at adequate doses and frequency is effective to control infection, avoid the development of chronic bronchial disease, alteration of pulmonary function and the appearance of other complications. Intravenous route is safer and produces fewer secondary effects than intramuscular administration with the doses and period of the treatment requiring individualization for each patient.