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Costa L, Bermudez-Guzman L, Benouda I, Laissue P, Morel A, Jiménez KM, Fournier T, Stouvenel L, Méhats C, Miralles F, Vaiman D. Linking genotype to trophoblast phenotype in preeclampsia and HELLP syndrome associated with STOX1 genetic variants. iScience 2024; 27:109260. [PMID: 38439971 PMCID: PMC10910284 DOI: 10.1016/j.isci.2024.109260] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/20/2023] [Accepted: 02/13/2024] [Indexed: 03/06/2024] Open
Abstract
Preeclampsia is a major hypertensive pregnancy disorder with a 50% heritability. The first identified gene involved in the disease is STOX1, a transcription factor, whose variant Y153H predisposes to the disease. Two rare mutations were also identified in Colombian women affected by the hemolysis, elevated liver enzyme, low platelet syndrome, a complication of preeclampsia (T188N and R364X). Here, we explore the effects of these variants in trophoblast cell models (BeWo) where STOX1 was previously invalidated. We firstly showed that STOX1 knockout alters response to oxidative stress, cell proliferation, and fusion capacity. Then, we showed that mutant versions of STOX1 trigger alterations in gene profiles, growth, fusion, and oxidative stress management. The results also reveal alterations of the STOX interaction with DNA when the mutations affected the DNA-binding domain of STOX1 (Y153H and T188N). We also reveal here that a major contributor of these effects appears to be the E2F3 transcription factor.
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Affiliation(s)
- Lorenzo Costa
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
- Department of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | | | - Ikram Benouda
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Paul Laissue
- Biopas Laboratoires, Orphan Diseases Unit, BIOPAS GROUP, Bogotá 111111, Colombia
| | - Adrien Morel
- Universidad Del Rosario, School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Bogotá, Colombia
| | - Karen Marcela Jiménez
- Universidad Del Rosario, School of Medicine and Health Sciences, Center for Research in Genetics and Genomics (CIGGUR), Institute of Translational Medicine (IMT), Bogotá, Colombia
| | - Thierry Fournier
- Université Paris Cité, INSERM, UMR-S1139, Pathophysiology & Pharmacotoxicology of the Human Placenta, Pre- & Post-natal Microbiota (3PHM), 75006 Paris, France
| | - Laurence Stouvenel
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Céline Méhats
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Francisco Miralles
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Daniel Vaiman
- Institut Cochin, Team ‘From Gametes To Birth’, INSERM U1016, CNRS UMR8104, Université de Paris, 24 rue du Faubourg St Jacques, 75014 Paris, France
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Muñoz F, Born P, Bruna M, Ulloa R, González C, Philp V, Mondaca R, Blanco JP, Valenzuela ED, Retamal J, Miralles F, Wendel-Garcia PD, Ospina-Tascón GA, Castro R, Rola P, Bakker J, Hernández G, Kattan E. Coexistence of a fluid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study. Crit Care 2024; 28:52. [PMID: 38374167 PMCID: PMC10877871 DOI: 10.1186/s13054-024-04834-1] [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: 10/16/2023] [Accepted: 02/10/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Current recommendations support guiding fluid resuscitation through the assessment of fluid responsiveness. Recently, the concept of fluid tolerance and the prevention of venous congestion (VC) have emerged as relevant aspects to be considered to avoid potentially deleterious side effects of fluid resuscitation. However, there is paucity of data on the relationship of fluid responsiveness and VC. This study aims to compare the prevalence of venous congestion in fluid responsive and fluid unresponsive critically ill patients after intensive care (ICU) admission. METHODS Multicenter, prospective cross-sectional observational study conducted in three medical-surgical ICUs in Chile. Consecutive mechanically ventilated patients that required vasopressors and admitted < 24 h to ICU were included between November 2022 and June 2023. Patients were assessed simultaneously for fluid responsiveness and VC at a single timepoint. Fluid responsiveness status, VC signals such as central venous pressure, estimation of left ventricular filling pressures, lung, and abdominal ultrasound congestion indexes and relevant clinical data were collected. RESULTS Ninety patients were included. Median age was 63 [45-71] years old, and median SOFA score was 9 [7-11]. Thirty-eight percent of the patients were fluid responsive (FR+), while 62% were fluid unresponsive (FR-). The most prevalent diagnosis was sepsis (41%) followed by respiratory failure (22%). The prevalence of at least one VC signal was not significantly different between FR+ and FR- groups (53% vs. 57%, p = 0.69), as well as the proportion of patients with 2 or 3 VC signals (15% vs. 21%, p = 0.4). We found no association between fluid balance, CRT status, or diagnostic group and the presence of VC signals. CONCLUSIONS Venous congestion signals were prevalent in both fluid responsive and unresponsive critically ill patients. The presence of venous congestion was not associated with fluid balance or diagnostic group. Further studies should assess the clinical relevance of these results and their potential impact on resuscitation and monitoring practices.
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Affiliation(s)
- Felipe Muñoz
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Pablo Born
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Mario Bruna
- Unidad de Cuidados Intensivos, Hospital de Quilpué, Quilpué, Chile
| | - Rodrigo Ulloa
- Unidad de Cuidados Intensivos, Hospital Las Higueras, Talcahuano, Chile
| | - Cecilia González
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Valerie Philp
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Roberto Mondaca
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Juan Pablo Blanco
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Emilio Daniel Valenzuela
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Jaime Retamal
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | | | - Pedro D Wendel-Garcia
- Institute of Intensive Care Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Gustavo A Ospina-Tascón
- Department of Intensive Care Medicine, Fundación Valle del Lili, Cali, Colombia
- Translational Research Laboratory in Critical Care Medicine (TransLab-CCM), Universidad Icesi, Cali, Colombia
| | - Ricardo Castro
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Philippe Rola
- Intensive Care Unit, Hopital Santa Cabrini, CIUSSS EMTL, Montreal, Canada
| | - Jan Bakker
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
- Department of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University Medical Center, New York, USA
| | - Glenn Hernández
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile
| | - Eduardo Kattan
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Avenida Diagonal Paraguay 362, Santiago, Chile.
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Miralles F, Vaiman D. Abnormal placental DNA methylation following environmental stress: a mere biomarker in a highly sensitive target organ? Epigenomics 2023; 15:719-721. [PMID: 37485923 DOI: 10.2217/epi-2023-0200] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Affiliation(s)
- Francisco Miralles
- Institut Cochin, U1016 INSERM, CNRS UMR8104, Faculté de Paris, 24 Rue du Faubourg St Jacques, Paris, 75014, France
| | - Daniel Vaiman
- Institut Cochin, U1016 INSERM, CNRS UMR8104, Faculté de Paris, 24 Rue du Faubourg St Jacques, Paris, 75014, France
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Apicella C, Ruano CSM, Thilaganathan B, Khalil A, Giorgione V, Gascoin G, Marcellin L, Gaspar C, Jacques S, Murdoch CE, Miralles F, Méhats C, Vaiman D. Pan-Genomic Regulation of Gene Expression in Normal and Pathological Human Placentas. Cells 2023; 12:cells12040578. [PMID: 36831244 PMCID: PMC9954093 DOI: 10.3390/cells12040578] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/17/2023] [Accepted: 01/28/2023] [Indexed: 02/17/2023] Open
Abstract
In this study, we attempted to find genetic variants affecting gene expression (eQTL = expression Quantitative Trait Loci) in the human placenta in normal and pathological situations. The analysis of gene expression in placental diseases (Pre-eclampsia and Intra-Uterine Growth Restriction) is hindered by the fact that diseased placental tissue samples are generally taken at earlier gestations compared to control samples. The difference in gestational age is considered a major confounding factor in the transcriptome regulation of the placenta. To alleviate this significant problem, we propose here a novel approach to pinpoint disease-specific cis-eQTLs. By statistical correction for gestational age at sampling as well as other confounding/surrogate variables systematically searched and identified, we found 43 e-genes for which proximal SNPs influence expression level. Then, we performed the analysis again, removing the disease status from the covariates, and we identified 54 e-genes, 16 of which are identified de novo and, thus, possibly related to placental disease. We found a highly significant overlap with previous studies for the list of 43 e-genes, validating our methodology and findings. Among the 16 disease-specific e-genes, several are intrinsic to trophoblast biology and, therefore, constitute novel targets of interest to better characterize placental pathology and its varied clinical consequences. The approach that we used may also be applied to the study of other human diseases where confounding factors have hampered a better understanding of the pathology.
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Affiliation(s)
- Clara Apicella
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
| | - Camino S. M. Ruano
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
| | - Basky Thilaganathan
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
| | - Asma Khalil
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
| | - Veronica Giorgione
- Fetal Medicine Unit, St George’s University Hospitals NHS Foundation Trust, London SW17 0RE, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George’s University of London, London SW17 0RE, UK
| | - Géraldine Gascoin
- Department of Neonatology, Angers University Hospital, F-49000 Angers, France
| | - Louis Marcellin
- Department of Gynaecology, Obstetrics and Reproductive Medicine, Centre Hospitalier Universitaire (CHU) Cochin Faculté de Médecine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris Centre (HUPC), Université de Paris, 138 Boulevard de Port-Royal, 75014 Paris, France
| | - Cassandra Gaspar
- Sorbonne Université, Inserm, UMS Production et Analyse des données en Sciences de la vie et en Santé, PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, 75013 Paris, France
| | - Sébastien Jacques
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
| | - Colin E. Murdoch
- Systems Medicine, School of Medicine, University of Dundee, Dundee DD1 9SY, UK
| | - Francisco Miralles
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
| | - Céline Méhats
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
| | - Daniel Vaiman
- Team ‘From Gametes to Birth’, Institut Cochin, U1016 INSERM, UMR 8104 CNRS, Paris-Descartes University, 75014 Paris, France
- Correspondence: ; Tel.: +33-1-44412301; Fax: +33-1-44412302
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Chatre L, Ducat A, Spradley FT, Palei AC, Chéreau C, Couderc B, Thomas KC, Wilson AR, Amaral LM, Gaillard I, Méhats C, Lagoutte I, Jacques S, Miralles F, Batteux F, Granger JP, Ricchetti M, Vaiman D. Increased NOS coupling by the metabolite tetrahydrobiopterin (BH4) reduces preeclampsia/IUGR consequences. Redox Biol 2022; 55:102406. [PMID: 35964341 PMCID: PMC9389306 DOI: 10.1016/j.redox.2022.102406] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 11/24/2022] Open
Abstract
Preeclampsia (PE) is a high-prevalence pregnancy disease characterized by placental insufficiency, gestational hypertension, and proteinuria. Overexpression of the A isoform of the STOX1 transcription factor (STOX1A) recapitulates PE in mice, and STOX1A overexpressing trophoblasts recapitulate PE patients hallmarks in terms of gene expression and pathophysiology. STOX1 overexpression induces nitroso-redox imbalance and mitochondrial hyper-activation. Here, by a thorough analysis on cell models, we show that STOX1 overexpression in trophoblasts alters inducible nitric oxide synthase (iNOS), nitric oxide (NO) content, the nitroso-redox balance, the antioxidant defense, and mitochondrial function. This is accompanied by specific alterations of the Krebs cycle leading to reduced l-malate content. By increasing NOS coupling using the metabolite tetrahydrobiopterin (BH4) we restore this multi-step pathway in vitro. Moving in vivo on two different rodent models (STOX1 mice and RUPP rats, alike early onset and late onset preeclampsia, respectively), we show by transcriptomics that BH4 directly reverts STOX1-deregulated gene expression including glutathione metabolism, oxidative phosphorylation, cholesterol metabolism, inflammation, lipoprotein metabolism and platelet activation, successfully treating placental hypotrophy, gestational hypertension, proteinuria and heart hypertrophy. In the RUPP rats we show that the major fetal issue of preeclampsia, Intra Uterine Growth Restriction (IUGR), is efficiently corrected. Our work posits on solid bases BH4 as a novel potential therapy for preeclampsia.
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Affiliation(s)
- Laurent Chatre
- Institut Pasteur, Department of Developmental & Stem Cell Biology, Stem Cell & Development, 25-28 Rue du Dr. Roux, Paris, France; UMR 3738 CNRS, 25 Rue du Dr. Roux, Paris, 75015, France
| | - Aurélien Ducat
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Frank T Spradley
- Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Ana C Palei
- Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Christiane Chéreau
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Betty Couderc
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Kamryn C Thomas
- Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Anna R Wilson
- Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Lorena M Amaral
- Department of Pharmacology & Toxicology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Irène Gaillard
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Céline Méhats
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Isabelle Lagoutte
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Sébastien Jacques
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Francisco Miralles
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Frédéric Batteux
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France
| | - Joey P Granger
- Department of Physiology & Biophysics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA
| | - Miria Ricchetti
- Institut Pasteur, Department of Developmental & Stem Cell Biology, Stem Cell & Development, 25-28 Rue du Dr. Roux, Paris, France; UMR 3738 CNRS, 25 Rue du Dr. Roux, Paris, 75015, France; Institut Pasteur, Molecular Mechanisms of Pathological and Physiological Ageing, 25-28 Rue du Dr. Roux, Paris, France
| | - Daniel Vaiman
- Institut Cochin U1016, INSERM UMR8104 CNRS, 24, rue du Fg St Jacques, Paris, France.
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6
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Mercadal J, Borrat X, Hernández A, Denault A, Beaubien-Souligny W, González-Delgado D, Vives M, Carmona P, Nagore D, Sánchez E, Serna M, Cuesta P, Bengoetxea U, Miralles F. A simple algorithm for differential diagnosis in hemodynamic shock based on left ventricle outflow tract velocity–time integral measurement: a case series. Ultrasound J 2022; 14:36. [PMID: 36001157 PMCID: PMC9402822 DOI: 10.1186/s13089-022-00286-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
Echocardiography has gained wide acceptance among intensive care physicians during the last 15 years. The lack of accredited formation, the long learning curve required and the excessive structural orientation of the present algorithms to evaluate hemodynamically unstable patients hampers its daily use in the intensive care unit. The aim of this article is to show 4 cases where the use of our simple algorithm based on VTI, was crucial. Subsequently, to explain the benefit of using the proposed algorithm with a more functional perspective, as a means for clinical decision-making. A simple algorithm based on left ventricle outflow tract velocity–time integral measurement for a functional hemodynamic monitoring on patients suffering hemodynamic shock or instability is proposed by Spanish Critical Care Ultrasound Network Group. This algorithm considers perfusion and congestion variables. Its simplicity might be useful for guiding physicians in their daily decision-making managing critically ill patients in hemodynamic shock.
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7
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Apicella C, Ruano CSM, Gascoin G, Miralles F, Méhats C, Vaiman D. Identification of Expression Quantitative Trait Loci in Human Placenta. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ruano CSM, Apicella C, Miralles F, Mehats C, Vaiman D. Methylation DNA patterns in Pathological Placental Samples. Placenta 2021. [DOI: 10.1016/j.placenta.2021.07.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Apicella C, Ruano CSM, Jacques S, Gascoin G, Méhats C, Vaiman D, Miralles F. Urothelial Cancer Associated 1 (UCA1) and miR-193 Are Two Non-coding RNAs Involved in Trophoblast Fusion and Placental Diseases. Front Cell Dev Biol 2021; 9:633937. [PMID: 34055770 PMCID: PMC8155540 DOI: 10.3389/fcell.2021.633937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/26/2020] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
A bioinformatics screen for non-coding genes was performed from microarrays analyzing on the one hand trophoblast fusion in the BeWo cell model, and on the other hand, placental diseases (preeclampsia and Intra-Uterine Growth Restriction). Intersecting the deregulated genes allowed to identify two miRNA (mir193b and miR365a) and one long non-coding RNA (UCA1) that are pivotal for trophoblast fusion, and deregulated in placental diseases. We show that miR-193b is a hub for the down-regulation of 135 cell targets mainly involved in cell cycle progression and energy usage/nutrient transport. UCA1 was explored by siRNA knock-down in the BeWo cell model. We show that its down-regulation is associated with the deregulation of important trophoblast physiology genes, involved in differentiation, proliferation, oxidative stress, vacuolization, membrane repair and endocrine production. Overall, UCA1 knockdown leads to an incomplete gene expression profile modification of trophoblast cells when they are induced to fuse into syncytiotrophoblast. Then we performed the same type of analysis in cells overexpressing one of the two major isoforms of the STOX1 transcription factor, STOX1A and STOX1B (associated previously to impaired trophoblast fusion). We could show that when STOX1B is abundant, the effects of UCA1 down-regulation on forskolin response are alleviated.
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Affiliation(s)
- Clara Apicella
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
| | - Camino S M Ruano
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
| | - Sébastien Jacques
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
| | - Géraldine Gascoin
- Unité Mixte de Recherche MITOVASC, Équipe Mitolab, CNRS 6015, INSERM U1083, Université d'Angers, Angers, France.,Réanimation et Médecine Néonatales, Centre Hospitalier Universitaire, Angers, France
| | - Céline Méhats
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
| | - Daniel Vaiman
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
| | - Francisco Miralles
- Institut Cochin, Université de Paris, U1016 INSERM, UMR 8104, CNRS, Paris, France
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10
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Ruano CSM, Apicella C, Jacques S, Gascoin G, Gaspar C, Miralles F, Méhats C, Vaiman D. Alternative splicing in normal and pathological human placentas is correlated to genetic variants. Hum Genet 2021; 140:827-848. [PMID: 33433680 PMCID: PMC8052246 DOI: 10.1007/s00439-020-02248-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 10/06/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
Two major obstetric diseases, preeclampsia (PE), a pregnancy-induced endothelial dysfunction leading to hypertension and proteinuria, and intra-uterine growth-restriction (IUGR), a failure of the fetus to acquire its normal growth, are generally triggered by placental dysfunction. Many studies have evaluated gene expression deregulations in these diseases, but none has tackled systematically the role of alternative splicing. In the present study, we show that alternative splicing is an essential feature of placental diseases, affecting 1060 and 1409 genes in PE vs controls and IUGR vs controls, respectively, many of those involved in placental function. While in IUGR placentas, alternative splicing affects genes specifically related to pregnancy, in preeclamptic placentas, it impacts a mix of genes related to pregnancy and brain diseases. Also, alternative splicing variations can be detected at the individual level as sharp splicing differences between different placentas. We correlate these variations with genetic variants to define splicing Quantitative Trait Loci (sQTL) in the subset of the 48 genes the most strongly alternatively spliced in placental diseases. We show that alternative splicing is at least partly piloted by genetic variants located either in cis (52 QTL identified) or in trans (52 QTL identified). In particular, we found four chromosomal regions that impact the splicing of genes in the placenta. The present work provides a new vision of placental gene expression regulation that warrants further studies.
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Affiliation(s)
- Camino S M Ruano
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Clara Apicella
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Sébastien Jacques
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Géraldine Gascoin
- Unité Mixte de Recherche MITOVASC, Équipe Mitolab, CNRS 6015, INSERM U1083, Université d'Angers, Angers, France
- Réanimation et Médecine Néonatales, Centre Hospitalier Universitaire, Angers, France
| | - Cassandra Gaspar
- Sorbonne Université, Inserm, UMS Production et Analyse des Données en Sciences de la vie et en Santé, PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, 75013, Paris, France
| | - Francisco Miralles
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Céline Méhats
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Daniel Vaiman
- Université de Paris, Institut Cochin, Inserm U1016, CNRS, 24 rue du Faubourg St Jacques, 75014, Paris, France.
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Ducat A, Couderc B, Bouter A, Biquard L, Aouache R, Passet B, Doridot L, Cohen MB, Ribaux P, Apicella C, Gaillard I, Palfray S, Chen Y, Vargas A, Julé A, Frelin L, Cocquet J, San Martin CR, Jacques S, Busato F, Tost J, Méhats C, Laissue P, Vilotte JL, Miralles F, Vaiman D. Molecular Mechanisms of Trophoblast Dysfunction Mediated by Imbalance between STOX1 Isoforms. iScience 2020; 23:101086. [PMID: 32371375 PMCID: PMC7200942 DOI: 10.1016/j.isci.2020.101086] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 11/05/2019] [Revised: 03/16/2020] [Accepted: 04/15/2020] [Indexed: 12/16/2022] Open
Abstract
STOX1 is a transcription factor involved in preeclampsia and Alzheimer disease. We show that the knock-down of the gene induces rather mild effect on gene expression in trophoblast cell lines (BeWo). We identified binding sites of STOX1 shared by the two major isoforms, STOX1A and STOX1B. Profiling gene expression of cells overexpressing either STOX1A or STOX1B, we identified genes downregulated by both isoforms, with a STOX1 binding site in their promoters. Among those, STOX1-induced Annexin A1 downregulation led to abolished membrane repair in BeWo cells. By contrast, overexpression of STOX1A or B has opposite effects on trophoblast fusion (acceleration and inhibition, respectively) accompanied by syncytin genes deregulation. Also, STOX1A overexpression led to abnormal regulation of oxidative and nitrosative stress. In sum, our work shows that STOX1 isoform imbalance is a cause of gene expression deregulation in the trophoblast, possibly leading to placental dysfunction and preeclampsia.
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Affiliation(s)
- Aurélien Ducat
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Betty Couderc
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Anthony Bouter
- Institute of Chemistry and Biology of Membranes and Nano-objects, UMR 5248, CNRS, University of Bordeaux, IPB, 33600 Pessac, France
| | - Louise Biquard
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Rajaa Aouache
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Bruno Passet
- Université Paris-Saclay, INRAE, AgroParisTech, UMR1313-GABI, 78350, Jouy-en-Josas, France
| | - Ludivine Doridot
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Marie-Benoîte Cohen
- Department of Gynecology Obstetrics, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Pascale Ribaux
- Department of Gynecology Obstetrics, Faculty of Medicine, University of Geneva, 1205 Geneva, Switzerland
| | - Clara Apicella
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Irène Gaillard
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Sophia Palfray
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Yulian Chen
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Alexandra Vargas
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Amélie Julé
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Léo Frelin
- Institute of Chemistry and Biology of Membranes and Nano-objects, UMR 5248, CNRS, University of Bordeaux, IPB, 33600 Pessac, France
| | - Julie Cocquet
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Camino Ruano San Martin
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Sébastien Jacques
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Florence Busato
- Laboratory for Epigenetics and Environment, Institut de Biologie François Jacob, Commissariat àl'Energie Atomique, Evry 91057, France
| | - Jorg Tost
- Laboratory for Epigenetics and Environment, Institut de Biologie François Jacob, Commissariat àl'Energie Atomique, Evry 91057, France
| | - Céline Méhats
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Paul Laissue
- Biopas Laboratoires, BIOPAS GROUP, Bogotá, Colombia
| | - Jean-Luc Vilotte
- Université Paris-Saclay, INRAE, AgroParisTech, UMR1313-GABI, 78350, Jouy-en-Josas, France
| | - Francisco Miralles
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France
| | - Daniel Vaiman
- Institut Cochin, U1016, INSERM, UMR 8504 CNRS, Université Paris Descartes, Paris 75014, France.
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Torres LM, Sánchez C, Romero AP, Cádiz DMD, Hernández RG, Miralles F. The mask (which we need so much is the one we would have needed). ACTA ACUST UNITED AC 2020; 67:275-286. [PMID: 32416858 PMCID: PMC7255158 DOI: 10.1016/j.redar.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Calixto Sánchez
- Jefe de Servicio de Anestesia y Reanimación Hospital de Elda. Alicante
| | - Antonio Pernía Romero
- Jefe de Sección del Servicio de Anestesia y Reanimación Hospital Universitario Puerta del Mar de Cádiz
| | - Del Mar de Cádiz
- Jefe de Sección del Servicio de Anestesia y Reanimación Hospital Universitario Puerta del Mar de Cádiz
| | - Rafael García Hernández
- Adjunto del Servicio de Anestesia y Reanimación Hospital Universitario Puerta del Mar de Cádiz
| | - Francisco Miralles
- Adjunto del Servicio de Anestesia y Reanimación Hospital Universitario Puerta del Mar de Cádiz
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Torres L, Sánchez C, Pernía Romero A, de Cádiz D, Hernández R, Miralles F. The mask (which we need so much is the one we would have needed). Revista Española de Anestesiología y Reanimación (English Edition) 2020. [PMCID: PMC7255161 DOI: 10.1016/j.redare.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- L.M. Torres
- Prof Anestesia, Universidad de Cádiz, Spain
- Corresponding author.
| | - C. Sánchez
- Jefe de Servicio de Anestesia y Reanimación Hospital de Elda, Alicante, Spain
| | - A. Pernía Romero
- Jefe de Sección del Servicio de Anestesia y Reanimación, Hospital Universitario Puerta del Mar de Cádiz, Spain
| | - D.M. de Cádiz
- Jefe de Sección del Servicio de Anestesia y Reanimación, Hospital Universitario Puerta del Mar de Cádiz, Spain
| | - R.García Hernández
- Adjunto del Servicio de Anestesia y Reanimación, Hospital Universitario Puerta del Mar de Cádiz, Spain
| | - F. Miralles
- Adjunto del Servicio de Anestesia y Reanimación, Hospital Universitario Puerta del Mar de Cádiz, Spain
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Miralles F, Collinot H, Boumerdassi Y, Ducat A, Duché A, Renault G, Marchiol C, Lagoutte I, Bertholle C, Andrieu M, Jacques S, Méhats C, Vaiman D. Long-term cardiovascular disorders in the STOX1 mouse model of preeclampsia. Sci Rep 2019; 9:11918. [PMID: 31417152 PMCID: PMC6695383 DOI: 10.1038/s41598-019-48427-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [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: 02/22/2019] [Accepted: 07/31/2019] [Indexed: 12/14/2022] Open
Abstract
Adverse long-term cardiovascular (CV) consequences of PE are well established in women. However, the mechanism responsible for that risk remains unknown. Here, we mated wild-type female mice of the FVB/N strain to STOX1A-overexpressing mice to mimic severe PE and investigated the long-term consequences on the maternal cardiovascular system. Ultrasonography parameters were analyzed in mice before pregnancy and at 3 and 6 months post-pregnancy. At 6 months post-pregnancy, cardiac stress test induced by dobutamine injection revealed an abnormal ultrasonography Doppler profile in mice with previous PE. Eight months post-pregnancy, the heart, endothelial cells (ECs) and plasma of females were analyzed and compared to controls. The heart of mice with PE showed left-ventricular hypertrophy associated with altered histology (fibrosis). Transcriptomic analysis revealed the deregulation of 1149 genes in purified ECs and of 165 genes in the hearts, many being involved in heart hypertrophy. In ECs, the upregulated genes were associated with inflammation and cellular stress. Systems biology analysis identified interleukin 6 (IL-6) as a hub gene connecting these pathways. Plasma profiling of 33 cytokines showed that, 8 of them (Cxcl13, Cxcl16, Cxcl11, IL-16, IL-10, IL-2, IL-4 and Ccl1) allowed to discriminate mice with previous PE from controls. Thus, PE triggers female long-term CV consequences on the STOX1 mouse model.
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Affiliation(s)
- Francisco Miralles
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Hélène Collinot
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Yasmine Boumerdassi
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Aurélien Ducat
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Angéline Duché
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Genom'IC Platform, Bâtiment Gustave Roussy, 27 rue du faubourg Saint Jacques, 75014, Paris, France
| | - Gilles Renault
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, PIV Platform, 22 rue Méchain, 75014, Paris, France
| | - Carmen Marchiol
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, PIV Platform, 22 rue Méchain, 75014, Paris, France
| | - Isabelle Lagoutte
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, PIV Platform, 22 rue Méchain, 75014, Paris, France
| | - Céline Bertholle
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, CYBIO Platform, 27 rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Muriel Andrieu
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, CYBIO Platform, 27 rue du Faubourg Saint Jacques, 75014, Paris, France
| | - Sébastien Jacques
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Genom'IC Platform, Bâtiment Gustave Roussy, 27 rue du faubourg Saint Jacques, 75014, Paris, France
| | - Céline Méhats
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France
| | - Daniel Vaiman
- Institut Cochin, U1016 INSERM - UMR8104, CNRS - Université Paris Descartes, Team "From Gametes To Birth", 24 rue du Faubourg St Jacques, 75014, Paris, France.
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Apicella C, Ruano CSM, Méhats C, Miralles F, Vaiman D. The Role of Epigenetics in Placental Development and the Etiology of Preeclampsia. Int J Mol Sci 2019; 20:ijms20112837. [PMID: 31212604 PMCID: PMC6600551 DOI: 10.3390/ijms20112837] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 12/12/2022] Open
Abstract
In this review, we comprehensively present the function of epigenetic regulations in normal placental development as well as in a prominent disease of placental origin, preeclampsia (PE). We describe current progress concerning the impact of DNA methylation, non-coding RNA (with a special emphasis on long non-coding RNA (lncRNA) and microRNA (miRNA)) and more marginally histone post-translational modifications, in the processes leading to normal and abnormal placental function. We also explore the potential use of epigenetic marks circulating in the maternal blood flow as putative biomarkers able to prognosticate the onset of PE, as well as classifying it according to its severity. The correlation between epigenetic marks and impacts on gene expression is systematically evaluated for the different epigenetic marks analyzed.
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Affiliation(s)
- Clara Apicella
- Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris Descartes, 24 rue du faubourg St Jacques, 75014 Paris, France.
| | - Camino S M Ruano
- Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris Descartes, 24 rue du faubourg St Jacques, 75014 Paris, France.
| | - Céline Méhats
- Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris Descartes, 24 rue du faubourg St Jacques, 75014 Paris, France.
| | - Francisco Miralles
- Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris Descartes, 24 rue du faubourg St Jacques, 75014 Paris, France.
| | - Daniel Vaiman
- Institut Cochin, U1016 INSERM, UMR8104 CNRS, Université Paris Descartes, 24 rue du faubourg St Jacques, 75014 Paris, France.
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16
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Ducat A, Vargas A, Doridot L, Bagattin A, Lerner J, Vilotte JL, Buffat C, Pontoglio M, Miralles F, Vaiman D. Low-dose aspirin protective effects are correlated with deregulation of HNF factor expression in the preeclamptic placentas from mice and humans. Cell Death Discov 2019; 5:94. [PMID: 31098302 PMCID: PMC6510804 DOI: 10.1038/s41420-019-0170-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 01/31/2019] [Revised: 03/21/2019] [Accepted: 03/28/2019] [Indexed: 01/07/2023] Open
Abstract
Aspirin (acetyl-salicylic acid) is one of the most ancient drugs of the human pharmacopeia. Nonetheless, its action at low doses is not well understood at the molecular level. One of the applications of low-dose aspirin treatment is the prevention of preeclampsia (PE) in patients at risk. Foeto-placental overexpression of the STOX1A transcription factor in mice triggers PE symptoms. Transcriptomic analysis of the placentas, showed that aspirin massively down-regulates genes of the coagulation and complement cascade, as well as genes involved in lipid transport. The genes modified by aspirin treatment are not the ones that are modified by STOX1 overexpression, suggesting that aspirin could act downstream, symptomatically on the preeclamptic disease. Bioinformatics analysis of the promoters of the deregulated genes showed that they are strongly enriched in HNF transcription factors-binding sites, in accordance with existing literature showing their roles as regulators of coagulation. Two of these transcription factors, Hnf1β and Hnf4α are found down-regulated by aspirin treatment. In parallel, we show that in human patient placentas, aspirin-induced deregulations of genes of the coagulation cascade are also observed. Finally, the expression of Hnf1β target sequences (Kif12, F2, Hnf4α promoters and a synthetic concatemer of the Hnf1β-binding site) were investigated by transfection in trophoblast cell models, with or without aspirin treatment and with or without STOX1A overexpression. In this model we observed that STOX1A and aspirin tended to synergize in the down-regulation of Hnf1β target genes in trophoblasts.
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Affiliation(s)
- Aurélien Ducat
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Alexandra Vargas
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France.,2Epigenetics and Cell Signaling, Institute for Advanced Biosciences, Inserm U1209, CNRS UMR 5309, Université Grenoble Alpes, 38000 Grenoble, France
| | - Ludivine Doridot
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Alessia Bagattin
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Jonathan Lerner
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Jean-Luc Vilotte
- 3GABI, INRA, AgroParisTech, Université Paris-Saclay, 78352 Jouy-en-Josas, France
| | - Christophe Buffat
- 4Department of Neonatology, Hôpital La Conception, 147 Boulevard Baille, 13005 Marseille, France
| | - Marco Pontoglio
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Francisco Miralles
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
| | - Daniel Vaiman
- Institut Cochin, INSERM U1016, UMR 8104 CNRS, Faculté René Descartes, 24 rue du Faubourg St Jacques, 75014 Paris, France
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Vaiman D, Aouache R, Miralles F. 63. Molecular and functional long-term effects of preeclampsia on the cardiovascular system assessed on a mouse model of severe preeclampsia. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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18
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Biquard L, Ducat A, Aouache R, Couderc B, Mehats C, Miralles F, Vaiman D. 206. Identification of new candidate proteins involved in preeclampsia. Pregnancy Hypertens 2018. [DOI: 10.1016/j.preghy.2018.08.292] [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: 10/28/2022]
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Abstract
Preeclampsia is a major, frequent and potentially severe condition of pregnancy, characterized by severe hypertension and proteinuria. In this review, we describe recent advances in understanding the pathology, and discuss the long-term impacts on maternal vascular health. Next, we describe the genetic, epigenetic and immunological basis of preeclampsia. We describe the links between preeclampsia and oxidative stress in placental (trophoblast) and endothelial cells. We mention cellular and animal models commonly used to decipher modified pathophysiological pathways in a preeclamptic pregnancy compared to a normal pregnancy. Finally, we discuss the therapeutic options, readily available or in development, to improve the monitoring of pregnancies, the health of patients and that of children born from preeclamptic pregnancies.
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Affiliation(s)
- Céline Méhats
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
| | - Francisco Miralles
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
| | - Daniel Vaiman
- Inserm U1016, CNRS UMR8104, Institut Cochin, équipe FGTB, 24, rue du faubourg Saint-Jacques, 75014 Paris, France
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20
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Abstract
INTRODUCTION Preeclampsia is a major pregnancy disease, explained partly by genetic predispositions. STOX1, a transcription factor discovered in 2005, was the first gene directly associated with genetic forms of the disease. Alterations of STOX1 expression as well as STOX1 variants have also been associated to Alzheimer's disease. These observations make of this gene a putative therapeutic target. Area covered: Two major isoforms (STOX1A and STOX1B) are encoded by the gene and are theoretically able to compete for the same binding site, while only the most complete (STOX1A) is supposed to be able to activate gene expression. This makes the ratio between STOX1A and STOX1B as well as their position inside the cell (nucleus or cytoplasm) crucial to understand how STOX1 functions. STOX1 appears to have multiple gene targets, especially in pathways connected to inflammation, oxidative stress, and cell cycle. Expert opinion: STOX1-directed therapies, could be directed either towards its targets (genes or pathways), or directly at STOX1. For this the addressing of STOX1 to various cell compartments could theoretically be modified; also it could be possible of altering the balance between the two isoforms, through selectively inhibiting one of them, possibly improving the outcomes in severe preeclampsia.
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Affiliation(s)
- Daniel Vaiman
- a Department of Development, Reproduction and Cancer , Institut Cochin , Paris , France
| | - Francisco Miralles
- a Department of Development, Reproduction and Cancer , Institut Cochin , Paris , France
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Cresson P, Bouchoucha M, Miralles F, Elleboode R, Mahé K, Marusczak N, Thebault H, Cossa D. Are red mullet efficient as bio-indicators of mercury contamination? A case study from the French Mediterranean. Mar Pollut Bull 2015; 91:191-199. [PMID: 25540915 DOI: 10.1016/j.marpolbul.2014.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 12/02/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
Mercury (Hg) is one of the main chemicals currently altering Mediterranean ecosystems. Red mullet (Mullus barbatus and M. surmuletus) have been widely used as quantitative bio-indicators of chemical contamination. In this study, we reassess the ability of these species to be used as efficient bio-indicators of Hg contamination by monitoring during 18 months Hg concentrations in muscle tissue of mullet sampled from 5 French Mediterranean coastal areas. Mean concentrations ranged between 0.23 and 0.78 μg g(-1) dry mass for both species. Values were consistent with expected contamination patterns of all sites except Corsica. Results confirmed that red mullets are efficient bio-indicators of Hg contamination. Nevertheless, the observed variability in Hg concentrations calls for caution regarding the period and the sample size. Attention should be paid to environmental and biologic specificities of each studied site, as they can alter the bioaccumulation of Hg, and lead to inferences about environmental Hg concentrations.
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Affiliation(s)
- P Cresson
- IFREMER, Centre de Méditerranée, CS 20330, F-83507 La Seyne sur Mer, France; IFREMER, Centre Manche - Mer du Nord, BP 669, F-62321 Boulogne sur Mer, France.
| | - M Bouchoucha
- IFREMER, Centre de Méditerranée, CS 20330, F-83507 La Seyne sur Mer, France
| | - F Miralles
- IFREMER, Centre de Méditerranée, CS 20330, F-83507 La Seyne sur Mer, France
| | - R Elleboode
- IFREMER, Centre Manche - Mer du Nord, BP 669, F-62321 Boulogne sur Mer, France
| | - K Mahé
- IFREMER, Centre Manche - Mer du Nord, BP 669, F-62321 Boulogne sur Mer, France
| | - N Marusczak
- IFREMER, Centre de Méditerranée, CS 20330, F-83507 La Seyne sur Mer, France; Observatoire Midi-Pyrénées, Laboratoire Géosciences Environnement Toulouse, CNRS/IRD/Université Toulouse III, 14 avenue Edouard Belin, 31400 Toulouse, France
| | - H Thebault
- Institut de Radioprotection et de Sûreté Nucléaire, PRP-ENV/SESURE/LERCM, CS 20330, F-83507 La Seyne sur Mer, France
| | - D Cossa
- IFREMER, Centre de Méditerranée, CS 20330, F-83507 La Seyne sur Mer, France; ISTerre, Université Joseph Fourier, BP 53, F-38041 Grenoble, France
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Calicchio R, Doridot L, Miralles F, Méhats C, Vaiman D. DNA methylation, an epigenetic mode of gene expression regulation in reproductive science. Curr Pharm Des 2014; 20:1726-50. [PMID: 23888966 DOI: 10.2174/13816128113199990517] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 07/18/2013] [Indexed: 11/22/2022]
Abstract
DNA methylation is an important part of the epigenetic code governing gene expression. In human reproductive diseases, recent studies have shown the existence of deviations from the normal methylation profile at various genome loci. In this review, this type of epigenetic alterations is explored in pathological spermatogenesis, ovarian diseases, placental syndromes, such as preeclampsia and Intra- Uterine Growth Restriction, uterine diseases such as endometriosis, and putative pathophysiological effects of Assisted Reproductive Technologies. We review the notion of epigenetics, the technical methods available to analyze methylation, and the known associations between reproductive diseases and DNA methylation, focusing on human pathologies and on animal models when available. We show that imprinted genes control regions (ICRs) are a prominent and frequent target of methylation anomalies in reproductive disorders, but such alterations also affect non-imprinted genes. The mechanistic aspects of gene regulation in response to methylation anomalies are also discussed in this review when they have been investigated.
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Affiliation(s)
| | | | | | | | - Daniel Vaiman
- Institut Cochin, Genetics and Development Department, 24 rue du Faubourg St Jacques, 75014, Paris, France.
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Cresson P, Fabri MC, Bouchoucha M, Brach Papa C, Chavanon F, Jadaud A, Knoery J, Miralles F, Cossa D. Mercury in organisms from the Northwestern Mediterranean slope: importance of food sources. Sci Total Environ 2014; 497-498:229-238. [PMID: 25129158 DOI: 10.1016/j.scitotenv.2014.07.069] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 07/20/2014] [Accepted: 07/20/2014] [Indexed: 06/03/2023]
Abstract
Mercury (Hg) is a global threat for marine ecosystems, especially within the Mediterranean Sea. The concern is higher for deep-sea organisms, as the Hg concentration in their tissues is commonly high. To assess the influence of food supply at two trophic levels, total Hg concentrations and carbon and nitrogen stable isotope ratios were determined in 7 species (4 teleosts, 2 sharks, and 1 crustacean) sampled on the upper part of the continental slope of the Gulf of Lions (Northwestern Mediterranean Sea), at depths between 284 and 816 m. Mean Hg concentrations ranged from 1.30±0.61 to 7.13±7.09 μg g(-1) dry mass, with maximum values observed for small-spotted catshark Scyliorhinus canicula. For all species except blue whiting Micromesistius poutassou, Hg concentrations were above the health safety limits for human consumption defined by the European Commission, with a variable proportion of the individuals exceeding limits (from 23% for the Norway lobster Nephrops norvegicus to 82% for the blackbelly rosefish Helicolenus dactylopterus). Measured concentrations increased with increasing trophic levels. Carbon isotopic ratios measured for these organisms demonstrated that settling phytoplanktonic organic matter is not only the main source fueling trophic webs but also the carrier of Hg to this habitat. Inter- and intraspecific variations of Hg concentrations revealed the importance of feeding patterns in Hg bioaccumulation. In addition, biological parameters, such as growth rate or bathymetric range explain the observed contamination trends.
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Affiliation(s)
- P Cresson
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France.
| | - M C Fabri
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France.
| | - M Bouchoucha
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France.
| | - C Brach Papa
- Ifremer, Centre Atlantique, BP 21105, F-44311 Nantes Cedex 03, France.
| | - F Chavanon
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France.
| | - A Jadaud
- Ifremer, Centre de Méditerranée, CS 30171, F-34203 Sète Cedex, France.
| | - J Knoery
- Ifremer, Centre Atlantique, BP 21105, F-44311 Nantes Cedex 03, France.
| | - F Miralles
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France.
| | - D Cossa
- Ifremer, Centre de Méditerranée, CS 20330, F-83 507 La Seyne-sur-Mer, France; IS Terre, Université Joseph Fourier, BP 53, F-38041 Grenoble, France.
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Garciacaballero M, Reyes-Ortiz A, Toval JA, Martínez-Moreno JM, Miralles F. Development of type 2 diabetes mellitus thirty-one years after Billroth II in a patient asking for diabetes surgery. NUTR HOSP 2014; 30:219-21. [PMID: 25137284 DOI: 10.3305/nh.2014.30.1.7472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Diabetes surgery in obese and slim patients seems to be a superior alternative to the current medical treatment. Gastric bypass is an alternative treatment for diabetes. Nevertheless, there are still doubts whether diabetes can recur if you gain weight or if the effects are maintained over time. Other questions refer to the type of surgery to make the bypass limb length or reservoir size for the resolution of the Diabetes Mellitus. PRESENTATION OF CASE Male patient 69-year-old came to us in order to perform tailored One Anastomosis Gastric Bypass (BAGUA) to treat his type 2 diabetes mellitus and metabolic syndrome. He has a history of peptic ulcer treated with subtotal gastrectomy and Billroth II reconstruction 49 years ago. He currently is not obese and developed diabetes 31 years after surgery. DISCUSSION Globally there are no reports of patients with normal BMI that after performing gastric bypass developed diabetes mellitus. There are cases where obese diabetic patients after gastric bypass improve or remits the T2DM, but it relapses due to insufficient weight loss or gain it. The patient with gastric bypass Billroth II type, should not developed diabetes. He is normal weight and not had weight gain that could be linked to the development of diabetes. CONCLUSIONS The results generated by bariatric surgery are encouraging, but still do not clarify the precise way how surgery produces rapid improvement of systemic metabolism as in diabetes, but in our patient, the effect was quite different because the gastric bypass had no protective effect against diabetes.
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Affiliation(s)
| | | | - J A Toval
- Dept. of Surgery, Medical Faculty. Málaga. Spain. Autonomous University of the State of México. México. U.M.F. 229, Del. 16. Mexican Social Security Institute. México..
| | | | - F Miralles
- Internal Medicine Dept. Associate University Hospital Parque San Antonio. Málaga. Spain..
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Garciacaballero M, Martínez-Moreno JM, Toval JA, Miralles F, Mínguez A, Osorio D, Mata JM, Reyes-Ortiz A. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA). NUTR HOSP 2014; 28 Suppl 2:35-46. [PMID: 23834045 DOI: 10.3305/nh.2013.28.sup2.6712] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes), the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others). PATIENTS AND METHODS We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months) after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA). RESULTS All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%), FPG (Fasting Plasma Glucose) [from 222.36 ± 16.87 to 94 ± 5 (mg/dl)] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d) and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day). It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy. CONCLUSIONS Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy.
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Affiliation(s)
- M Garciacaballero
- Department of Surgery, University Málaga,. University Hospital Parque San Antonio, Málaga, Spain.
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Abstract
MicroRNAs (miRNAs) have recently become essential actors in various fields of physiology and medicine, especially as easily accessible circulating biomarkers, or as modulators of cell differentiation. To this respect, terminal differentiation of trophoblasts (the characteristic cells of the placenta in Therian mammals) into syncytiotrophoblast, villous trophoblast, or extravillous trophoblast constitutes a good example of such a choice, where miRNAs have recently been shown to play an important role. The aim of this review is to provide a snapshot of what is known today in placentation mechanisms that are mediated by miRNA, under the angles of materno–fetal immune dialog regulation, trophoblast differentiation, and angiogenesis at the materno–fetal interface. Also, two aspects of regulation of these issues will be highlighted: the part played by oxygen concentration and the specific function of imprinted genes in the developing placenta.
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Affiliation(s)
- Ludivine Doridot
- Institut Cochin, INSERM U1016-CNRS UMR8104, Université Paris Descartes Paris, France
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27
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Fernández V, Valls-Sole J, Relova J, Raguer N, Miralles F, Dinca L, Taramundi S, Costa-Frossard L, Ferrandiz M, Ramió-Torrentà L, Villoslada P, Saiz A, Calles C, Antigüedad A, Alvarez-Cermeño J, Prieto J, Izquierdo G, Montalbán X, Fernández O. Recommendations for the clinical use of motor evoked potentials in multiple sclerosis. Neurología (English Edition) 2013. [DOI: 10.1016/j.nrleng.2013.09.003] [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: 10/26/2022] Open
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Abstract
Preeclampsia is a pregnancy disease affecting 5 to 8% of pregnant women and a leading cause of both maternal and fetal mortality and morbidity. Because of a default in the process of implantation, the placenta of preeclamptic women undergoes insufficient vascularization. This results in placental ischemia, inflammation and subsequent release of placental debris and vasoactive factors in the maternal circulation causing a systemic endothelial activation. Several microarray studies have analyzed the transcriptome of the preeclamptic placentas to identify genes which could be involved in placental dysfunction. In this study, we compared the data from publicly available microarray analyses to obtain a consensus list of modified genes. This allowed to identify consistently modified genes in the preeclamptic placenta. Of these, 67 were up-regulated and 31 down-regulated. Assuming that changes in the transcription level of co-expressed genes may result from the coordinated action of a limited number of transcription factors, we looked for over-represented putative transcription factor binding sites in the promoters of these genes. Indeed, we found that the promoters of up-regulated genes are enriched in putative binding sites for NFkB, CREB, ANRT, REEB1, SP1, and AP-2. In the promoters of down-regulated genes, the most prevalent putative binding sites are those of MZF-1, NFYA, E2F1 and MEF2A. These transcriptions factors are known to regulate specific biological pathways such as cell responses to inflammation, hypoxia, DNA damage and proliferation. We discuss here the molecular mechanisms of action of these transcription factors and how they can be related to the placental dysfunction in the context of preeclampsia.
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Affiliation(s)
- Daniel Vaiman
- INSERM U1016-CNRS UMR8104, Université Paris Descartes, Institut Cochin, Paris, France
| | - Rosamaria Calicchio
- INSERM U1016-CNRS UMR8104, Université Paris Descartes, Institut Cochin, Paris, France
| | - Francisco Miralles
- INSERM U1016-CNRS UMR8104, Université Paris Descartes, Institut Cochin, Paris, France
- * E-mail:
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Calicchio R, Buffat C, Vaiman D, Miralles F. [Endothelial dysfunction: role in the maternal syndrome of preeclampsia and long-term consequences for the cardiovascular system]. Ann Cardiol Angeiol (Paris) 2013; 62:215-220. [PMID: 23721989 DOI: 10.1016/j.ancard.2013.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 03/08/2013] [Indexed: 06/02/2023]
Abstract
Preeclampsia is a pregnancy disorder being a leading cause of maternal and fetal mortality and morbidity. It is a complex multisystem disease characterized by hypertension and proteinuria. In preeclampsia the placenta releases factors into the maternal circulation which cause a systemic endothelial dysfunction. Here, we review data demonstrating the central role played by the endothelium in the development of the maternal syndrome of preeclampsia. We present also original data showing how circulating factors present in the plasma of preeclamptic women can alter the transcriptome of endothelial cells. The expression of genes involved in essential functions such as vasoregulation, oxidative stress, apoptosis and cell proliferation show differential expression when endothelial cells are exposed to preeclamptic or normal pregnancy plasma. We conclude by discussing the growing evidences that the alterations of the endothelium during preeclampsia are linked to an increased risk of cardiovascular diseases latter on life. Therefore, a better understanding of the modifications undergone by the endothelial cells during preeclampsia is essential to develop new therapeutic approaches to both, manage preeclampsia and to prevent the long-term sequelae of the disease on women cardiovascular system.
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Affiliation(s)
- R Calicchio
- Inserm U1016-CNRS UMR8104, université Paris Descartes, institut Cochin, 24, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Faller J, Torrellas S, Miralles F, Holzner C, Kapeller C, Guger C, Bund J, Müller-Putz GR, Scherer R. Prototype of an auto-calibrating, context-aware, hybrid brain-computer interface. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2012:1827-30. [PMID: 23366267 DOI: 10.1109/embc.2012.6346306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
We present the prototype of a context-aware framework that allows users to control smart home devices and to access internet services via a Hybrid BCI system of an auto-calibrating sensorimotor rhythm (SMR) based BCI and another assistive device (Integra Mouse mouth joystick). While there is extensive literature that describes the merit of Hybrid BCIs, auto-calibrating and co-adaptive ERD BCI training paradigms, specialized BCI user interfaces, context-awareness and smart home control, there is up to now, no system that includes all these concepts in one integrated easy-to-use framework that can truly benefit individuals with severe functional disabilities by increasing independence and social inclusion. Here we integrate all these technologies in a prototype framework that does not require expert knowledge or excess time for calibration. In a first pilot-study, 3 healthy volunteers successfully operated the system using input signals from an ERD BCI and an Integra Mouse and reached average positive predictive values (PPV) of 72 and 98% respectively. Based on what we learned here we are planning to improve the system for a test with a larger number of healthy volunteers so we can soon bring the system to benefit individuals with severe functional disability.
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Affiliation(s)
- J Faller
- Institute for Knowledge Discovery, Graz University of Technology, 8010 Graz, Austria.
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García-Caballero M, Valle M, Martínez-Moreno JM, Miralles F, Toval JA, Mata JM, Osorio D, Mínguez A. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24-29 BMI patients with One Anastomosis Gastric Bypass. NUTR HOSP 2012; 27:623-31. [PMID: 22732993 DOI: 10.1590/s0212-16112012000200041] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2011] [Accepted: 12/15/2011] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Diabetes mellitus type 2 (DMT2) is a major cause of death in the world. The medical therapy for this disease has had enormous progress, but it still leaves many patients exposed to the complications developed from the disease. It is well known the beneficial effects of bariatric surgery in obese diabetic patients, however it is important to investigate if the same principles of bariatric surgery that improve diabetes in obese patients, could be applied to non obese normal weight diabetics. MATERIAL AND METHODS Thirteen diabetic patients operated by One Anastomosis Gastric Bypass (BAGUA), were evaluated in the preoperative period and 1,3 and 6 months after surgery. Body weight and composition, Fasting Plasma Glucose, HbA1c levels, blood pressure and serum lipids levels were analyzed, as well as the monitoring of the immediate postoperative treatment necessities for Diabetes and other metabolic syndrome comorbidities. RESULTS After the surgery the 77% of the patients resolves its T2DM, 46% from surgery, and rest noted an significant improvement of the disease in spite of having a C peptide level near to zero some of the patients. The comorbidities, mainly hypertension and lipid abnormalities experience improvement early. All patients reduce their weight and the amount of fat mass until values consistent with their age and height. CONCLUSIONS The One Anastomosis Gastric Bypass leads to resolution or improvement of T2DM in non obese normal weight patients. The best results are obtained in patients with few years of diabetes, without or short term use of insulin treatment and high C-peptide levels.
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Affiliation(s)
- M García-Caballero
- Departamento de Cirugía, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.
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Santamaría Fernández S, Miralles F, Ruiz Serrato A, García Alegría J, Ruiz Cantero A, García Ordoñez MA, San Román Terán CM, González Zorzano E, Gómez-Huelgas R. Prevalence of thoracic vertebral fractures in Spanish patients hospitalized in Internal Medicine Departments. Assessment of the clinical inertia. (PREFRAMI study). Eur J Intern Med 2012; 23:e44-7. [PMID: 22284255 DOI: 10.1016/j.ejim.2011.11.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 11/07/2011] [Accepted: 11/26/2011] [Indexed: 11/19/2022]
Abstract
PURPOSE To study the prevalence of vertebral fractures (VF), the associated risk factors and the degree of diagnosis and prescription upon discharge in a series of hospitalized medical patients ≥50 years of age. METHODS A cross-sectional, multicentre and observational study in which a prevalence cut-off was carried out concerning patients admitted to six Internal Medicine departments in Malaga (Spain). The main variables were the existence of a fracture in the spine lateral x-ray, the inclusion of the diagnosis of a fracture in the discharge report, and the establishment of anti-osteoporotic treatment at discharge. RESULTS 254 patients were included (mean age 66.4±14.9 years). The prevalence of VF was of 14.2% (36 cases). Patients with VF presented with a higher mean age, compared to those without VF (70.14 vs. 65.7 years) (p=0.035). The means contrast for the FRAX index variable (major osteoporotic and hip fracture), grouping according to the presence of VF, did not show any statistical significance (p=0.369 and p=0.788, respectively). Only in 8.3% of the discharge reports of patients with VF had the diagnosis of VF and/or osteoporosis been recorded and the prescription of anti-osteoporotic drugs been included. CONCLUSIONS A high prevalence of asymptomatic VF is verified in medical inpatients ≥50 years of age. The FRAX index did not turn out to be predictive of the presence of VF in this population. There is an underdiagnosis of osteoporotic VF in the coding at hospital discharge. Action protocols are necessary to avoid clinical inactivity regarding this entity.
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Salinas M, López-Garrigós M, Miralles F, Chinchilla V, Ortuño M, Aguado C, Marcaida G, Guaita M, Carratala A, Díaz J, Yago M, Esteban A, Laíz B, Rodríguez-Borja E, Lorente MA, Uris J. Evaluation of PSA testing by general practitioners: regional study in the autonomic Community of Valencia. ARCH ESP UROL 2011; 64:435-440. [PMID: 21705816] [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: 05/31/2023]
Abstract
OBJECTIVES The aim of the study is to compare the use of PSA testing among general practitioners (GPs). METHODS The number of PSA tests ordered by general practitioners in the years 2008-2009 was examined in a cross-sectional study of nine health districts of Spain. The percentage of PSA ordered to men younger than 50 (PSA<50/PSAtotal) and 40 years (PSA<40/PSAtotal) was calculated. The percentage of men over 50 years who were attended was also calculated and this data was compared with the number of PSA ordered to this population. For two of the departments, these data were also compared between GPs and urologists. RESULTS PSA testing in 2009 is higher than 2008 in seven health districts. PSA testing in men younger than 50 years was increased along the period of the study and in men younger than 40 years remained steady. The differences between the values of the indicators for urologists and GPs are significant. CONCLUSIONS The number of PSA tests and the percentage performed to men younger 50 years has been increasing and the variability is high. These data are suggestive for interventions focused on PSA testing and prostate cancer screening in primary care settings.
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Affiliation(s)
- María Salinas
- Department of Clinical Laboratory, Hospital de San Juan, Alicante, Spain
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Miralles F. Compositional properties and thermal adaptation of SRP-RNA in bacteria and archaea. J Mol Evol 2010; 70:181-9. [PMID: 20069286 DOI: 10.1007/s00239-009-9319-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 12/21/2009] [Indexed: 10/20/2022]
Abstract
Previous studies have reported a positive correlation between the GC content of the double-stranded regions of structural RNAs and the optimal growth temperature (OGT) in prokaryotes. These observations led to the hypothesis that natural selection favors an increase in GC content to ensure the correct folding and the structural stability of the molecule at high temperature. To date these studies have focused mainly on ribosomal and transfer RNAs. Therefore, we addressed the question of the relationship between GC content and OGT in a different and universally conserved structural RNA, the RNA component of the signal recognition particle (SRP). To this end we generated the secondary structures of SRP-RNAs for mesophilic, thermophilic, and hyperthermophilic bacterial and archaeal species. The analysis of the GC content in the stems and loops of the SRP-RNA of these organisms failed to detect a relationship between the GC contents in the stems of this structural RNA and the growth temperature of bacteria. By contrast, we found that in archaea the GC content in the stem regions of SRP-RNA is highest in hyperthermophiles, intermediate in thermophiles, and lower in mesophiles. In these organisms, we demonstrated a clear positive correlation between the GC content of the stem regions of their SRP-RNAs and their OGT. This correlation was confirmed by a phylogenetic nonindependence analysis. Thus we conclude that in archaea the increase in GC content in the stem regions of SRP-RNA is an adaptation response to environmental temperature.
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Affiliation(s)
- Francisco Miralles
- Institut Jacques Monod, CNRS UMR7592, Université Paris Diderot-Paris 7, Bat. Buffon, 75205 Paris Cedex 13, France.
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Gacto P, Barrera F, Sicilia-Castro D, Miralles F, Collell M, Leal S, De La Higuera J, Parra C, Gómez-Cía T. A three-dimensional virtual reality model for limb reconstruction in burned patients. Burns 2009; 35:1042-6. [DOI: 10.1016/j.burns.2008.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 09/01/2008] [Indexed: 11/16/2022]
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Ztouti M, Kaddour H, Miralles F, Simian C, Vergne J, Hervé G, Maurel MC. Adenine, a hairpin ribozyme cofactor - high-pressure and competition studies. FEBS J 2009; 276:2574-88. [DOI: 10.1111/j.1742-4658.2009.06983.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Gacto P, Miralles F, Pereyra JJ, Perez A, Martínez E. Haemostatic effects of adrenaline-lidocaine subcutaneous infiltration at donor sites. Burns 2008; 35:343-7. [PMID: 18950945 DOI: 10.1016/j.burns.2008.06.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Accepted: 06/30/2008] [Indexed: 11/17/2022]
Abstract
This study sought methods in burn surgery to reduce postoperative pain and blood loss at donor sites. A prospective, randomised, controlled, blinded trial included 56 people undergoing burn surgery, divided into two groups. Both groups received subcutaneous infiltration at donor sites, with either 1:500,000 adrenaline solution containing added lidocaine or with 0.45% normal saline (controls). Outcome measurements included amount of intraoperative bleeding, need for electrocautery, days the hydrocolloid dressing remained on donor sites, percentage of re-epithelialised skin at donor sites 1 week after surgery and viability of skin grafts. Results indicated that subcutaneous adrenaline-lidocaine infiltration at donor sites reduced intraoperative bleeding, decreased postoperative pain, shortened the duration of surgery and general anaesthesia and accelerated re-epithelialisation at the donor site. The overall graft take in both groups was similar.
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Affiliation(s)
- P Gacto
- Department of Plastic and Reconstructive Surgery, Virgen del Rocío University Hospitals, Sevilla, Spain.
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Buffat C, Mondon F, Rigourd V, Boubred F, Bessières B, Fayol L, Feuerstein JM, Gamerre M, Jammes H, Rebourcet R, Miralles F, Courbières B, Basire A, Dignat-Georges F, Carbonne B, Simeoni U, Vaiman D. A hierarchical analysis of transcriptome alterations in intrauterine growth restriction (IUGR) reveals common pathophysiological pathways in mammals. J Pathol 2007; 213:337-46. [PMID: 17893880 DOI: 10.1002/path.2233] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [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: 01/21/2023]
Abstract
Intra-uterine growth restriction (IUGR) is a frequent disease, affecting up to 10% of human pregnancies and responsible for increased perinatal morbidity and mortality. Moreover, low birth weight is an important cause of the metabolic syndrome in the adult. Protein depletion during the gestation of rat females has been widely used as a model for human IUGR. By transcriptome analysis of control and protein-deprived rat placentas, we were able to identify 2543 transcripts modified more than 2.5 fold (1347 induced and 1196 repressed). Automatic functional classification enabled us to identify clusters of induced genes affecting chromosome structure, transcription, intracellular transport, protein modifications and apoptosis. In particular, we suggest the existence of a complex balance regulating apoptosis. Among repressed genes, we noted several groups of genes involved in immunity, signalling and degradation of noxious chemicals. These observations suggest that IUGR placentas have a decreased resistance to external aggression. The promoters of the most induced and most repressed genes were contrasted for their composition in putative transcription factor binding sites. There was an over-representation of Zn finger (ZNF) proteins and Pdx1 (pancreatic and duodenal homeobox protein 1) putative binding sites. Consistently, Pdx1 and a high proportion of ZNF genes were induced at the transcriptional level. A similar analysis of ZNF promoters showed an increased presence of putative binding sites for the Tata box binding protein (Tbp). Consistently again, we showed that the Tbp and TBP-associated factors (Tafs) were up-regulated in IUGR placentas. Also, samples of human IUGR and control placentas showed that human orthologous ZNFs and PDX1 were transcriptionally induced, especially in non-vascular IUGR. Immunohistochemistry revealed increased expression of PDX1 in IUGR human placentas. In conclusion, our approach permitted the proposition of hypotheses on a hierarchy of gene inductions/repressions leading to massive transcriptional alterations in the IUGR placenta, in humans and in rodents.
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Affiliation(s)
- C Buffat
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital La Conception, AP-HM, Marseille/Upres EA 2193 Faculté de Médecine, Marseille, France
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Anguera I, Miro JM, San Roman JA, de Alarcon A, Anguita M, Almirante B, Evangelista A, Cabell CH, Vilacosta I, Ripoll T, Muñoz P, Navas E, Gonzalez-Juanatey C, Sarria C, Garcia-Bolao I, Fariñas MC, Rufi G, Miralles F, Pare C, Fowler VG, Mestres CA, de Lazzari E, Guma JR, del Río A, Corey GR. Periannular complications in infective endocarditis involving prosthetic aortic valves. Am J Cardiol 2006; 98:1261-8. [PMID: 17056343 DOI: 10.1016/j.amjcard.2006.05.066] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Revised: 05/30/2006] [Accepted: 05/30/2006] [Indexed: 01/11/2023]
Abstract
The periannular extension of infection in prosthetic valve endocarditis (PVE) is a serious complication of infective endocarditis associated with high mortality. Periannular lesions in PVE occasionally rupture into adjacent cardiac chambers, leading to aortocavitary fistulae and intracardiac shunting. It is unknown whether the prognosis of patients with aortocavitary fistulae is worse than that of those with nonruptured abscesses. The aims of this study were to determine the distinctive clinical characteristics of patients with PVE and either aortocavitary fistulization or nonruptured abscesses. In a retrospective multicenter study of >872 PVE episodes, 150 patients (17%) with periannular complications in PVE in the aortic position were identified (29 with aortocavitary fistulization and 121 with nonruptured abscesses). Early-onset PVE was present in 73 patients (49%). Rates of heart failure (p = 0.09), ventricular septal defect (p <0.01), and third-degree atrioventricular block (p = 0.07) were higher in patients with fistulization. Surgical treatment was undertaken in 128 patients (83%). In-hospital mortality in the overall population was 39%. Multivariate analysis identified heart failure (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.6 to 6.8), renal failure (OR 2.5, 95% CI 1.2 to 5.2), and co-morbidity (OR 2.4, 95% CI 1.1 to 5.1) as independent risk factors for death. Fistulous tract formation was not associated with increased in-hospital mortality (OR 1.6, 95% CI 0.7 to 3.7). The actuarial 5-year survival rate in surgical survivors was 100% in patients with fistulae and 78% in patients with nonruptured abscesses (log-rank p = 0.14). In conclusion, aortocavitary fistulous tract formation in PVE complicated with periannular complications is associated with higher rates of heart failure, ventricular septal defect, and atrioventricular block than nonruptured abscesses. Despite the frequent complications, fistulous tract formation in the current era of infective endocarditis is not an independent risk factor for mortality.
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Affiliation(s)
- Ignasi Anguera
- Corporacio Sanitaria Parc Tauli-Hospital de Sabadell, Sabadell, Spain
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40
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Anguera I, Miro JM, Evangelista A, Cabell CH, San Roman JA, Vilacosta I, Almirante B, Ripoll T, Fariñas MC, Anguita M, Navas E, Gonzalez-Juanatey C, Garcia-Bolao I, Muñoz P, de Alarcon A, Sarria C, Rufi G, Miralles F, Pare C, Fowler VG, Mestres CA, de Lazzari E, Guma JR, Moreno A, Corey GR. Periannular complications in infective endocarditis involving native aortic valves. Am J Cardiol 2006; 98:1254-60. [PMID: 17056342 DOI: 10.1016/j.amjcard.2006.06.016] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Revised: 06/07/2006] [Accepted: 06/07/2006] [Indexed: 01/11/2023]
Abstract
The extension of infection in native valve infective endocarditis (IE) from valvular structures to the periannular tissue is incompletely understood. It is unknown, for example, whether the prognosis of patients with aortocavitary fistulae is worse than that of those with nonruptured abscesses. The aims of this study were to determine the distinct clinical characteristics of patients with aortocavitary fistulae and nonruptured abscesses in native valve IE and to evaluate the impact of fistulization on the outcomes of patients with native aortic valve IE complicated with periannular lesions. In a retrospective multicenter study of 2,055 native valve IE episodes, 201 patients (9.8%) with periannular complications in aortic valve IE were identified (46 with aortocavitary fistulization and 155 with nonruptured abscesses). Rates of heart failure (p = 0.07), ventricular septal defect (p <0.001), and third-degree atrioventricular block (p = 0.07) were higher in patients with fistulization. Surgical treatment was undertaken in 172 patients (86%), and in-hospital mortality in the overall population was 29%. Multivariate analysis identified age >60 years (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.3 to 5.2), renal failure (OR 3.0, 95% CI 1.5 to 6.0), and moderate or severe heart failure (OR 2.5, 95% CI 1.2 to 5.2) as independent risk factors for death. There was a trend toward increased in-hospital mortality in patients with aortocavitary fistulae (OR 1.5, 95% CI 0.7 to 3.0). The actuarial 5-year survival rate in surgical survivors was 80% in patients with fistulae and 92% in patients with nonruptured abscesses (log-rank p = 0.6). In conclusion, aortocavitary fistulous tract formation in the setting of native valve IE is associated with higher rates of heart failure, ventricular septal defect, and atrioventricular block than nonruptured abscess. Despite these higher rates of complications, fistulous tract formation in the current era of IE is not an independent risk factor for mortality.
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Affiliation(s)
- Ignasi Anguera
- Corporacio Sanitaria Parc Tauli-Hospital de Sabadell, Sabadell, Spain
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41
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Miralles F, Hebrard S, Lamotte L, Durel B, Gilgenkrantz H, Li Z, Daegelen D, Tuil D, Joshi RL. Conditional inactivation of the murine serum response factor in the pancreas leads to severe pancreatitis. J Transl Med 2006; 86:1020-36. [PMID: 16894357 DOI: 10.1038/labinvest.3700457] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The Serum Response Factor (SRF) is widely expressed transcription factor acting at the confluence of multiple signaling pathways and has been implicated in the control of differentiation, growth, and cell death. In the present study, we found that SRF is expressed in the developing and adult pancreas. To explore the possible role of SRF in this organ, we have generated mutant mice with conditional disruption of the Srf gene. Such mutants presented normal development of both the exocrine and endocrine pancreas indicating that SRF is dispensable for pancreas ontogenesis. However, after weaning, these mice developed profound morphological alterations of the exocrine pancreas, which were reminiscent of severe pancreatitis. In these mice, massive acinar injury, Nuclear Factor Kappa B activation and proinflammatory cytokines release led to complete destruction of the exocrine pancreas and its replacement by adipose tissue. Despite these changes, the organization and function of the endocrine islets of Langerhans remained well-preserved. This new animal model of spontaneous pancreatitis could prove a valuable tool to gain further insight into the physiopathology of this disease.
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Affiliation(s)
- Francisco Miralles
- Departement de Génétique et Développement, Institut Cochin, INSERM U567, CNRS UMR8104, Université René Descartes Paris V, Paris, France.
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Miralles F, Lamotte L, Couton D, Joshi RL. Interplay between FGF10 and Notch signalling is required for the self-renewal of pancreatic progenitors. Int J Dev Biol 2006; 50:17-26. [PMID: 16323074 DOI: 10.1387/ijdb.052080fm] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent studies have shown that persistent expression of FGF10 in the developing pancreas of transgenic mice results in enhanced and prolonged proliferation of pancreatic progenitors, pancreatic hyperplasia and impaired pancreatic differentiation. These studies have also suggested that FGF10 prevents the differentiation of pancreatic progenitors by maintaining persistent Notch signalling. Here, we provide experimental evidence sustaining the capacity of FGF10 to induce the proliferation of pancreatic precursors, while preventing their differentiation. Using explant cultures of E10.5 isolated dorsal pancreatic epithelium, we found that FGF10 maintained Notch activation and induced the expansion of pancreatic precursors while blocking their differentiation. In addition, by using a gamma-secretase inhibitor, we were able to down-regulate the expression of Hes1, a target gene of the Notch pathway in explant cultures of pancreatic epithelium treated with FGF10. In such explants, the effect of FGF10 on the proliferation and maintenance of pancreatic progenitors was suppressed. These results demonstrate that activation of the Notch pathway is required as a downstream mediator of FGF10 signalling in pancreatic precursor cells.
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Affiliation(s)
- Francisco Miralles
- Institut Cochin, Department of Genetics, Development and Molecular Pathology, INSERM U567, CNRS UMR8104, Universite Rene Descartes Paris V, France.
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Miralles F, Tarongí S, Espino A. Quantification of the drawing of an Archimedes spiral through the analysis of its digitized picture. J Neurosci Methods 2005; 152:18-31. [PMID: 16185769 DOI: 10.1016/j.jneumeth.2005.08.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2005] [Revised: 07/30/2005] [Accepted: 08/08/2005] [Indexed: 10/25/2022]
Abstract
We have developed a new quantitative analysis of spiral drawing that is able to evaluate any spiral execution and it has not temporal or spatial limitations in the obtaining of specimens. Thirty-one patients with action tremor and 24 control subjects were asked to draw an Archimedes spiral over a print template. Specimens were scanned and then treated through a semiautomatic computer program that reconstructs the temporal sequence of the spiral drawing by the subject. The spirals were first analysed by means of the cross-correlation coefficient with the spiral template. Secondly, the mean and the standard deviation of the distance between each point of the spiral drawing and the corresponding point of the spiral model were determined. Finally, the reconstructed spiral was analysed using the Fourier Transform. Its results were interpreted with the aid of a computer model of a tremulous spiral. The experimental variables were greater in the patients group respect to age-matched controls. There was also a high linear correlation between them and the clinical score given by three neurologists. Finally, Receiver Operating Characteristic (ROC) curves analysis shown that the method classified the spirals better than human ratters.
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Affiliation(s)
- F Miralles
- Gabinet d'Electromiografia Central i Control Motor, Servei de Neurologia, Hospital Universitari Son Dureta, C/. Andrea Doria 55, 07014 Palma de Mallorca, Spain.
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Abstract
Three patients are described who had dysphagia as the sole manifestation of myasthenia gravis. Severity ranged from the need to be fed by nasogastric tube to moderate dysphagia requiring only diet change. Oesophageal manometry was carried out in two patients and showed generalised weakness of peristaltic contractions which included the smooth muscle part of the oesophagus. These disturbances worsened with repeated swallows. They were partly reversed by intravenous edrophonium and by rest. Repetitive nerve stimulation was normal in all three patients, but stimulated single fibre EMG of the frontalis muscle showed that all had impairment of neuromuscular transmission. Anti-AChR antibodies were found in only one patient. The most affected patient was treated with pyridostigmine, plasmapheresis, and high dose prednisone. The remaining two patients received only oral anticholinesterases.
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Affiliation(s)
- M Llabrés
- Servei de Neurologia, Hospital Universitari Son Dureta, C/. Andrea Doria 55, 07014 Palma de Mallorca, Spain
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45
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Anguera I, Miro JM, Vilacosta I, Almirante B, Anguita M, Muñoz P, San Roman JA, de Alarcon A, Ripoll T, Navas E, Gonzalez-Juanatey C, Cabell CH, Sarria C, Garcia-Bolao I, Fariñas MC, Leta R, Rufi G, Miralles F, Pare C, Evangelista A, Fowler VG, Mestres CA, de Lazzari E, Guma JR. Aorto-cavitary fistulous tract formation in infective endocarditis: clinical and echocardiographic features of 76 cases and risk factors for mortality. Eur Heart J 2004; 26:288-97. [PMID: 15618052 DOI: 10.1093/eurheartj/ehi034] [Citation(s) in RCA: 161] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
AIMS To investigate the clinical features, echocardiographic characteristics, management, and prognostic factors of mortality of aorto-cavitary fistulization (ACF) in infective endocarditis (IE). Extension of infection in aortic valve IE beyond valvular structures may result in peri-annular complications with resulting necrosis and rupture, and subsequent development of ACF. Aorto-cavitary communications create intra-cardiac shunts, which may result in further clinical deterioration and haemodynamic instability. METHODS AND RESULTS In a retrospective multi-centre study over 4681 episodes of IE, a total of 76 patients with ACF [1.6%, confidence interval (CI) 95%: 1.2-2.0%] diagnosed by echocardiography or during surgery were identified. Fistulae were found in 1.8% of cases of native valve IE and in 3.5% of cases of prosthetic valve IE from the general population and in 0.4% of drug abusers. PVE was present in 31 (41%) cases of ACF. Transthoracic and transoesophageal echocardiography detected the fistulous tracts in 53 and 97% of cases, respectively. Peri-annular abscesses were detected in 78% of cases, fistulae originated in similar rates from the three sinuses of Valsalva, and the four cardiac chambers were equally involved in the fistulous tracts. Heart failure (HF) developed in 62% of cases and surgery was performed in 66 (87% CI 95% 77-93%) patients with a mortality of 41% (95% CI 30-53%) in the overall population. Multivariate analysis identified HF (OR 3.4, CI 95% 1.0-11.5), prosthetic IE (OR 4.6, CI 95% 1.4-15.4) and urgent or emergency surgical treatment (OR 4.3, CI 95% 1.3-16.6) as variables significantly associated with an increased risk of death. Major complications during follow-up (death, re-operation, or re-admission for HF) among the five operative survivors with residual fistulae occurred in 20 and 100% of patients at 1 and 2 years, respectively. CONCLUSION Aorto-cavitary fistulous tract formation is an uncommon but extremely serious complication of IE. In-hospital mortality was exceptionally high despite aggressive management with surgical intervention in the majority of patients. Prosthetic IE, urgent surgery, and the development of HF identify the subgroup of patients with IE and ACF that have significantly increased risk of in-hospital death.
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Affiliation(s)
- Ignasi Anguera
- Corporacio Sanitaria Parc Tauli-Hospital de Sabadell, Sabadell, Spain
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46
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Reguera JM, Alarcón A, Miralles F, Pachón J, Juárez C, Colmenero JD. Brucella Endocarditis: Clinical, Diagnostic, and Therapeutic Approach. Eur J Clin Microbiol Infect Dis 2003; 22:647-50. [PMID: 14566576 DOI: 10.1007/s10096-003-1026-z] [Citation(s) in RCA: 66] [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] [Indexed: 10/26/2022]
Abstract
Brucella endocarditis is an uncommon focal complication of brucellosis. Presented here are 11 cases of Brucella endocarditis, all managed uniformly. The median duration of symptoms prior to diagnosis was 3 months. Five patients (45%) had underlying valvular damage, and in six (55%) endocarditis involved a normal valve. There was a predominance of aortic involvement (82%) and a high incidence of left ventricular failure (91%). Diagnostic suspicion was essential in order to test blood cultures correctly, which in this series were positive in 63% of the patients. Surgical treatment was undertaken in eight patients (72%), all with aortic involvement and left ventricular failure impossible to control with medication. One patient died during the immediate postoperative period. All the other patients received antibiotic therapy for 3 months, with no signs of relapse of the infection or malfunction of the prosthesis during a minimum follow-up period of 24 months.
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Affiliation(s)
- J M Reguera
- Infectious Diseases INIT, Internal Medicine Department, Carlos Haya University Hospital, Avenida Carlos Haya, 29010 Malaga, Spain.
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Abstract
Neuromuscular jitter is a sensitive measure of the safety factor of neuromuscular transmission. Nevertheless, the actual relationship between jitter and the safety factor is unknown because these parameters have not been simultaneously measured. In order to explore the theoretical relationship between them, a computer model of mammalian neuromuscular transmission has been developed. If the safety factor is expressed as the absolute value of the natural logarithm of the probability of a block, the model predicts a double exponential relationship between the safety factor and jitter, except when the percentage of blocks is greater than 90%. In that case, the jitter value decreases. Simulation of acetylcholinesterase inhibition shows that this treatment decreases the neuromuscular transmission blocks more effectively in postsynaptic than in presynaptic disorders. In contrast, when the percentage of blocks is greater than 60%, the jitter value increases in both conditions.
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Affiliation(s)
- F Miralles
- Unitat de Patologia Neuromuscular, Servei de Neurologia, Hospital Universitari Son Dureta, C/. Andrea Doria 55, 07014, Palma de Mallorca, Spain.
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Morata P, Queipo-Ortuño MI, Reguera JM, Miralles F, Lopez-Gonzalez JJ, Colmenero JD. Diagnostic yield of a PCR assay in focal complications of brucellosis. J Clin Microbiol 2001; 39:3743-6. [PMID: 11574607 PMCID: PMC88423 DOI: 10.1128/jcm.39.10.3743-3746.2001] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2001] [Accepted: 07/23/2001] [Indexed: 11/20/2022] Open
Abstract
In order to evaluate the diagnostic yield of a PCR assay for patients with focal complications of brucellosis, we studied by PCR and by conventional microbiological techniques 34 nonblood samples from 32 patients with different focal forms of brucellosis. The samples from patients with brucellosis were paired to an equal number of control samples from the same locations of patients whose illnesses had different etiologies. Thirty-three of the 34 nonblood samples (97%) from the brucellosis patients were positive by PCR, whereas Brucella spp. were isolated from only 29.4% of the conventional cultures. For 11.4% of the patients, the confirmatory serological tests were either negative or showed titers below the diagnostic range. Two patients (6.2%) from the control group, both with tuberculous vertebral osteomyelitis, had a positive PCR result. The brucella PCR of blood from these two patients was also positive, and the two strains of Mycobacterium tuberculosis isolated were analyzed by the brucella PCR, with no evidence of amplification. These results show that the PCR assay is far more sensitive than conventional cultures, and this, coupled with its speed and reduction in risk to laboratory workers, makes this technique a very useful tool for the diagnosis of focal complications of brucellosis.
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Affiliation(s)
- P Morata
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Málaga University, Spain
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Abstract
Hrp65, a protein with two conserved RNA-binding domains, has been identified in Chironomus tentans as a component of nuclear fibers associated with ribonucleoprotein particles in transit from the gene to the nuclear pore. We have cloned two novel hrp65 isoforms and characterized the structure of the hrp65 gene. Comparison of the hrp65 gene to the hrp65 cDNAs revealed that the multiple hrp65 isoforms, hrp65-1, hrp65-2 and hrp65-3, are generated by alternative splicing of a single pre-mRNA. The hrp65-3 mRNA is only detected in C. tentans tissue culture cells of embryonic origin, whereas hrp65-1 and hrp65-2 mRNAs appear to be constitutively expressed. The hrp65 mRNAs are generated by differential 3' splice site selection at the last exon of the gene. Thus, the three hrp65 transcripts contain different 3' UTRs and encode proteins that vary in their C-terminal ends. Interestingly, the variant C-terminal region determines the subcellular localization of the hrp65 proteins. In transient transfection assays, hrp65-1 is efficiently targetted to the nucleus, whereas hrp65-2 and hrp65-3 localize mainly to the cytoplasm. Moreover, hrp65-3 is associated with cytoplasmic actin fibers. All together, our findings suggest that the different hrp65 isoforms serve specialized roles related to mRNA localization/transport in the different cell compartments.
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Affiliation(s)
- F Miralles
- Department of Molecular Biology and Functional Genomics, Stockholm University, Stockholm, SE-106 91, Sweden
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Abstract
The Goto-Kakisaki (GK) rat is a genetic model of type 2 diabetes obtained by selective inbreeding of mildly glucose-intolerant Wistar rats. Previous studies have shown that at birth, the beta-cell mass of the GK rat is severely reduced compared with that of the Wistar rat. Therefore, beta-cell deficit could be the primary defect leading to type 2 diabetes in this model. To identify the abnormality at the origin of the beta-cell mass deficit, we compared the fetal development of GK and Wistar rats. Our study reveals that during early development (embryonic day 12-14 [E12-14]), GK fetuses present a delayed global growth that progressively recovers: at birth, no size or weight difference persists. However, from E18 onward, the weight and DNA content of the pancreas and liver are reduced by 30% in the GK fetuses. Cell proliferation is reduced in the GK pancreas from E16 to E20. Whereas apoptotic cells are scarce in the Wistar fetal pancreas, a wave of apoptosis from E16 to E18 was detected in the GK pancreas. Analysis of pancreas differentiation revealed that from E12 to E14, there are no significant differences in the number of alpha- and beta-cells between the GK and Wistar pancreas. However, by E16, the average number of beta-cells in the GK pancreas represents only 50% that of the Wistar pancreas, and this difference persists until birth. The number of alpha-cells was reduced by 25% from E18 to E21. To determine whether the defect in GK pancreas development depends on intrinsic pancreatic factors or on endocrine extrapancreatic factors, we performed in vitro cultures of E12 pancreatic rudiments. The cultures show that in vitro, the growth and endocrine differentiation of the GK and Wistar pancreatic rudiments are identical. Thus, impaired development of the GK pancreas probably results from insufficiency of extrapancreatic factor(s) necessary for the growth and survival of fetal pancreatic cells.
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Affiliation(s)
- F Miralles
- Laboratoire de Physiopathologie de la Nutrition, CNRS-ESA7059, Université Paris, France.
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