Expressão e localização celular da diguanilato ciclase DgcP em Pseudomonas aeruginosa / Expression and cell localization of the diguanylate cyclase DgcP in Pseudomonas aeruginosa

A bactéria Gram-negativa Pseudomonas aeruginosa é um patógeno oportunista frequentemente associado a vítimas de queimaduras graves ou indivíduos com fibrose cística, sendo os isolados resistentes a carbepenêmicos dessa espécie considerados pela OMS como uma das maiores ameaças ao controle de infecções. O estabelecimento da infecção por esse patógeno é dependente de uma série de fatores de virulência, entre eles o pilus tipo IV (T4P), que possui papel importante na adesão a superfícies e motilidade do tipo twitching, essenciais para a colonização do hospedeiro. Uma das moléculas importantes na diferenciação entre as formas séssil e planctônica de P. aeruginosa é o segundo mensageiro bis-(3,5)-di-guanosina monofosfato cíclico (c-di-GMP), cuja síntese é feita enzimaticamente por diguanilato ciclases (DGCs). DgcP é uma DGC localizada nos polos da célula, que tem sua atividade de síntese de c-di-GMP aumentada na presença da proteína FimV, essencial para a montagem do T4P em P. aeruginosa. Neste trabalho, ensaios de microscopia de fluorescência, organização e expressão gênica foram realizados com o objetivo de aumentar a compreensão sobre o papel de DgcP em relação a sua expressão e aos fatores que regulam o T4P de P. aeruginosa. A proteína DgcP em fusão com mNeonGreen no C-terminal, expressa a partir do locus cromossômico, se localiza de maneira predominantemente bipolar tanto na linhagem selvagem quanto nos mutantes ΔpilA, ΔpilR e ΔchpA, evidenciando que seu padrão de localização não depende dos sistemas de regulação Pil-Chp e PilS-PilR. Ensaios de RT-PCRmostraram que dgcP se encontra em operon com PA14_72430 e dsbA1, indicando um papel celular conjunto entre esses genes, até o momento, desconhecido. Por fim, ensaios de qRT-PCR revelaram que os níveis de mRNA de dgcP são invariáveis nas linhagens WT, ΔpilA, ΔpilR, ΔchpA e ΔfimV, cultivadas em meio líquido ou meio sólido. Os resultados aqui mostrados, combinados com trabalhos prévios do nosso e de outros grupos, sugerem que DgcP é uma diguanilato ciclase responsável por geração constante de c-di-GMP nos polos da célula, possivelmente, atuando na sinalização local dependente do dinucleotídeo cíclico, cuja localização e atividade não são dependentes dos sistemas de regulação que atuam sobre o T4P

The Gram-negative bacterium Pseudomonas aeruginosa is an opportunistic pathogen often associated with severe burn victims or individuals with cystic fibrosis, which carbapenem-resistant isolates were classified by th World Health Organization classified one of the greatest threats to infection control. The establishment of infection by this pathogen is dependent on a series of virulence factors, including the type IV pilus (T4P), which plays an important role in adhesion to surfaces and twitching motility, essential features for host colonization. Bis-(3',5')-cyclic dimeric guanosine monophosphate (c-di-GMP) is a second messenger that involved in processes of biofilm formation, motility, and virulence. The diguanylate cyclase DgcP synthetizes cdi-GMP and it is located at the cell poles, and its activity depends on the scaffold protein FimV, essential for T4P assembly in P. aeruginosa. By increasing c-di-GMP levels, DgcP decreases flagellum-dependent motility and increases biofilm formation. In this work, fluorescence microscopy, gene organization and expression assays were performed to understand the whether DgcP localization and expression are under the control of T4P regulatory proteins. Fluorescence microscopy analysis showed that DgcP localizes predominantly at both cell poles in ΔpilA, ΔpilR, and ΔchpA mutants, showing that its localization pattern does not depend on the Pil-Chp and PilS-PilR systems. Furthermore, RT-PCR assays showed that dgcP is found in an operon with PA14_72430 and dsbA1, indicating an unknown putative related cellular role for these genes. Finally, qRT-PCR assays indicated that DgcP expression is invariant in ΔpilA, ΔpilR, ΔchpA, and ΔfimV mutants, either in liquid or solid medium. The results shownhere, combined with previous work by ours and other groups, suggest that DgcP is a diguanylate cyclase responsible for constant generation of c-di-GMP at the cell poles, possibly acting in local signaling dependent on the cyclic dinucleotide, but that is not under the control of the known T4P regulatory systems

Effectiveness of FibroTouch combined with four hepatic fibrosis biomarkers for evaluation of the liver fibrosis degree among patients with chronic schistosomiasis-induced liver disorders / 中国血吸虫病防治杂志

Objective To evaluate the performance of FibroTouch in combination with four hepatic fibrosis biomarkers for assessment of the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver disorders. Methods A total of 63 patients with chronic schistosomiasis-induced liver diseases admitted to The Third People’s Hospital of Kunshan City from January to March 2021 were enrolled as the observation group, while 50 healthy volunteers receiving health examinations in the hospital during the study period were randomly selected as the control group. The liver stiffness measurement (LSM) was determined using the FibroTouch technique, and the serum levels of four hepatic fibrosis biomarkers were detected using chemilumi-nescence immunoassay, including type IV collagen (IV-C), type III procollagen (PC-III), hyaluronidase (HA) and laminin (LN). The receiver operating characteristic (ROC) curves of LSM and four hepatic fibrosis biomarkers alone and in combination for assessing the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver disorders were plotted and the area under the ROC curve (AUC) was estimated to examine the value of LSM and four hepatic fibrosis biomarkers alone and in combination for assessing the degree of hepatic fibrosis. Results There were 63 subjects in the observation group, including 28 men and 35 women, and the participants had a mean age of (65.34 ± 12.56) years and a mean body mass index (BMI) of (24.47 ± 11.05) kg/m2. There were 50 subjects in the control group, including 22 men and 28 women, and the participants had a mean age of (64.28 ± 13.10) years and a mean BMI of (25.12 ± 11.64) kg/m2. There were no significant differences between the observation and control groups in terms of gender ratio (χ2 = 0.002, P > 0.05), age (t = 0.437, P > 0.05) or BMI (t = 0.303, P > 0.05). The LSM [(8.65 ± 5.22) vs. (3.24 ± 1.10) kPa; t = 8.013, P < 0.05], IV-C [(51.80 ± 9.45) vs. (30.10 ± 10.34) ng/L; t = 11.506, P < 0.05], PC-III [(77.28 ± 17.22) vs. (48.62 ± 9.54) ng/L; t = 11.224, P < 0.05], HA [(39.55 ± 5.32) vs. (84.89 ± 10.34) ng/L; t = 30.158, P < 0.05] and LN [(99.47 ± 7.37) vs. (61.93 ± 9.80) ng/L; t = 22.496, P < 0.05] were significantly greater in the observation group than in the control group, and Spearman correlation analysis showed that the degree of liver fibrosis positively correlated with LSM (rs = 0.675, P < 0.01), IV-C (rs = 0.421, P < 0.01), PC-III (rs = 0.517, P < 0.01), HA (rs = 0.550, P < 0.01) and LN (rs = 0.539, P < 0.01) among patients with chronic schistosomiasis-induced liver diseases. ROC curve analysis revealed that the AUC of LSM for assessment of the hepatic fibrosis degree was 0.884 (P < 0.001), and the LSM cutoff, sensitivity and specificity were 11.75 kPa, 71.43% and 84.00% at the highest Youden index, respectively. In addition, the AUC of four hepatic fibrosis biomarkers for assessment of the hepatic fibrosis degree was 0.577 to 0.670, with 70.174 to 115.237 ng/L cutoff values, 17.46% to 68.25% sensitivity and 71.01% to 96.00% specificity. In addition, the sensitivity and specificity of LSM combined with four hepatic fibrosis biomarkers were 92.06% and 95.07% for assessment of the hepatic fibrosis degree among patients with chronic schistosomiasis-induced liver diseases. Conclusion FibroTouch in combination with detection of four hepatic fibrosis biomarkers has a high sensitivity and specificity for assessing the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver diseases, which deserves widespread clinical uses.

A case of cutaneous collagenous vasculopathy / 中华皮肤科杂志

A 22-year-old female patient presented with skin flushing in the bilateral legs for 4 years, which gradually spread throughout the whole lower limbs and forearms 6 months ago. Skin examination showed diffuse flushing and dilated capillaries in the lower limbs and both forearms, and the flushing faded after a press. Histopathological examination of the skin lesion on the leg showed hyperkeratosis in a basket-like shape, increased pigmentation in the basal layer, infiltration of the superficial dermis with scattered lymphocytes, with no obvious red blood cell overflow; periodic acid-Schiff staining showed thickened and homogeneous deposits around the blood vessels; immunohistochemical staining showed thickened blood vessel walls and positive staining for type Ⅳ collagen. Diagnosis: cutaneous collagenous vasculopathy.

Pitiriasis rubra pilaris en niños:informe de 2 casos / Pityriasis Rubra Pilaris in children: 2 case reports

RESUMEN Antecedentes: La pitiriasis rubra pilaris es una enfermedad infrecuente pápulo-escamosa crónica en la que existe un trastorno de la queratinización de la epidermis, caracterizada por pápulas foliculares hiperqueratósicas con tendencia a formar placas de coloración asalmonada, descamativas, con islas de piel sana asociadas a queratodermia palmo plantar. Presenta una distribución bimodal en la primera y sexta década de la vida, afectando a ambos sexos por igual. Su etiopatogenia es desconocida, se ha postulado una respuesta inmune anormal ante diferentes estímulos antigénicos, así como alteración del metabolismo de la vitamina A. Se ha clasificado en 6 tipos en base a su presentación, edad de inicio, curso y pronóstico, tratándose en forma tópica o sistémica. Casos clínicos: Se presentan dos casos en pacientes de 10 y 2 años de edad, con manifestaciones clínicas correspondientes al tipo juvenil circunscrito, que es el más frecuente en edad pediátrica y juvenil clásico respectivamente, con histopatología compatible y excelente respuesta al tratamiento tópico. Conclusiones: Aunque la pitiriasis rubra pilaris es una patología rara, deberá ser sospechada si el cuadro clínico es sugestivo, y si es compatible su histopatología. Debe considerarse que el tratamientotópico puede ser suficiente para lograr la resolución del cuadro.

ABSTRACT Background: Pityriasis rubra pilaris is an infrequent chronic papulosquamous disease in which there is a disorder of keratinization of the epidermis, characterized by hyperkeratotic follicular papules with a tendency to form salmon-colored, scaly plaques, with islands of healthy skin associated with palmoplantar keratoderma. It presents a bimodal distribution in the first and sixth decades of life, affecting both sexes equally. Its etiopathogenesis is unknown, an abnormal immune response has been postulated to different antigenic stimuli, as well as alteration of the metabolism of vitamin A. It has been classified into 6 types based on its presentation, age of onset, course and prognosis, being treated appropriately topical or systemic. Clinical cases: Two cases of 10 and 2 years of age are presented, with clinical manifestations corresponding to the circumscribed juvenile type, which is the most frequent in pediatric and classic juvenile age respectively, with compatible histopathology and excellent response to topical treatment. Conclusions: Although pityriasis rubra pilaris is a rare pathology, it should be suspected if the clinical picture is suggestive and its histopathology is compatible. It should be considered that topical treatment may be sufficient to achieve resolution of the condition.

Short-term renal and metabolic effects of low dose vildagliptin treatment added-on insulin therapy in non-proteinuric patients with type 2 diabetes: open-label randomized prospective study

ABSTRACT Objective The aim of this randomized comparative study was to assess renal and metabolic effects of vildagliptin in insulin-treated type 2 diabetes (T2DM) patients without overt chronic kidney disease. Subjects and methods We randomized 47 insulin-treated non-proteinuric patients with satisfactory controlled T2DM and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m 2 either to continue insulin therapy (control) or to receive combined insulin-vildagliptin treatment (VIG group). We assessed eGFR using serum creatinine (eGFRcreat), cystatin C (eGFRcys), and both (eGFRcreat-cys), and urinary creatinine-adjusted excretion of albumin (UACR), type IV collagen (uCol IV/Cr), and neutrophil gelatinase-associated lipocalin (uNGAL/Cr) at baseline and after 6 months of treatment. Results Study groups were comparable in terms of age and sex (60.1 ± 6.1 years and 42.9% men in control group vs. 60.8 ± 5.2 years and 39.1% in VIG group). After 6 months of treatment, there were no significant changes in main assessed parameters in control group. VIG group demonstrated significant decrease in HbA1c, diastolic blood pressure, frequency of hypoglycemia, and high-sensitivity C-reactive protein level as compared to the changes in control group. While eGFRcreat, UACR, and uNGAL/Cr showed no significant changes after vildagliptin addition, eGFRcys, eGFRcreat-cys, and uCol IV/Cr changed significantly in comparison with control group (+7.0% [3.7;13.3]; +5.1% [1.4;8.5]; -32,8% [-55.8;-24.4], respectively, p < 0.01 each). Correlation and regression analysis revealed glucose-independent pattern of these changes. Conclusion Addition of vildagliptin to ongoing insulin therapy in patients with T2DM was associated with a reduction in uCol IV/Cr and an increase in eGFRcys and eGFRcreat-cys, independent of T2DM control parameters.

Distribuição ultraestrutural de colágeno tipo IV em feridas experimentais após tratamento com papaína / Ultrastructural distribution of type IV collagen in experimental wounds after treatment with papaine

RESUMO: Modelo do estudo: Experimental. Objetivo: Investigar a distribuição de fibras colágeno tipo IV, por microscopia eletrônica de transmissão, em feridas experimentais tratadas com soluções de papaína. Metodologia: Ratos Wistar (n=18), machos, adultos, foram submetidos a procedimento cirúrgico para a retirada de seção quadrada de pele da região cervical, e posteriormente separados em dois grupos: Grupo I (n = 9), sem tratamento; e Grupo II (n = 9), tratado com soluções de papaína a 10% (até o 7º dia), 6% (do 8º ao 14º dia) e 4% (do 15º ao 21º dia). Todos os animais foram sacrificados com 7, 14 e 21 dias, e as áreas lesadas retiradas, lavadas em PBS e fixadas em 2,5% de glutaraldeo, 4% de formaldeio recém preparado, em solução tamponada contendo 60 mM Pipes, 20 mM Hepes, 10 mM etilenoglicol-bis- (B-aminoetiléter) - Ácido N, N, N'-tetraacético, KCl 70 mM e MgCl2 5 mM pH 7,2 por 1h; pós-fixadas em solução contendo tetróxido de ósmio a 1%, ferrocianeto a 0,8% e cloreto de cálcio a 5 mM; desidratados em acetona graduada e embebidos em Epon® para confecção de secções finas, coradas com acetato de uranilo e citrato de chumbo, e examinadas em microscópio electrônico de transmissão Zeiss LEO EM 906 (TEM). Resultados: A distribuição das fibras colágeno tipo IV das lesões tratadas com papaína (Grupo II), com 14 e 21 dias, mostraram-se mais organizadas que as fibras do Grupo I. Conclusões: A papaína mostrou-se um importante facilitador para a organização de fibras colágeno tipo IV em feridas experimentais. (AU)

ABSTRACT Study model: Experimental. Objective: Investigate the distribution of type IV collagen fibers by transmission electron microscopy, in experimental wounds treated with papaine solutions. Methodology: Adult male Wistar rats (n = 18) underwent a surgical procedure to remove a square section of skin from the cervical region, and then separated into two groups: Group I (n = 9), without treatment; and Group II (n = 9), treated with papain solutions of 10% (up to the 7th day), 6% (from the 8th to the 14th day) and 4% (from the 15th to the 21st day). All animals were sacrificed at 7, 14 and 21 days, and the injured areas removed, washed in PBS, and fixed in 2.5% glutaraldehyde, 4% freshly prepared formaldehyde in buffered solution containing 60 mM Pipes, 20 mM Hepes, 10 mM ethyleneglycol-bis- (B-aminoethylether) -N, N, N'-tetraacetic acid, 70 mM KCl, and 5 mM MgCl 2 pH 7.2 for 1h; post-fixed in solution containing 1% osmium tethoxide, 0.8% ferrocyanide, and 5 mM calcium chloride; dehy-drated in graduated acetone and soaked in Epon® to make thin sections stained with uranyl acetate and lead citrate and examined under a Zeiss LEO EM 906 (TEM) transmission electron microscope. Results: The distribution of type IV collagen fibers from papaine-treated lesions (Group II) at 14 and 21 days was more organized than Group I fibers. Conclusions: Papaine has proven to be an important facilitator for the organization of type IV collagen fibers in experimental wounds. (AU)

Effects of moderate treadmill exercise on alpha-smooth muscle actin and type iv collagen in the liver of type 2 diabetic rats / 中国组织工程研究

BACKGROUND: Diabetes-induced liver damage is easy to be ignored in the early stage. Exercise therapy can increase the sensitivity of insulin, which is an important means of prevention and treatment of diabetes. OBJECTIVE: To explore the effect of moderate intensity exercise intervention on liver injury during the occurrence of diabetes mellitus. METHODS: The experimental protocol was approved by the Laboratory Animal Care Ethics Committee of Wuhan Sports University. Thirty SPF Sprague-Dawley rats were divided into three groups: normal control group, diabetic control group and diabetic exercise intervention group. Normal control group was fed with normal diet, with no exercise. Diabetes control group was fed with high sugar and high fat diet for 8 weeks, followed by a small dose of streptozotocin (30 mg/kg) injected intraperitoneally, with o exercise. Diabetes exercise intervention group was fed and injected in the same way as diabetes control group, and at the same time carried out moderate intensity treadmill training. After 7 days of streptozotocin injection, hematoxylin-eosin and Masson staining were used to observe the cell morphology, the expression of α-smooth muscle actin was observed by immunohistochemistry, and orbital blood samples were collected to detect the concentration of serum type IV collagen using ELISA. RESULTS AND CONCLUSION: Compared with the normal control group, hematoxylin-eosin staining showed that the structure of liver lobule in the diabetic control group was disordered, a large number of fat vacuoles were seen, and the bile duct in the portal area was obviously proliferated; Masson staining that there were showed fat vacuoles, the structure of liver lobule was seriously damaged, and blue stained collagen fibers were seen in the portal area, and light blue stained collagen fibers were seen between liver cells. The above pathological changes were alleviated in the diabetic exercise intervention group, and the fatty degeneration of liver cells was obviously reduced. The expression of α-smooth muscle actin in the diabetic control group and diabetic exercise intervention group was significantly higher than that in the normal control group (P < 0.05), and that in the diabetic exercise intervention group was significantly lower than that in the diabetic control group (P < 0.05). The level of type IV collagen in the diabetic exercise intervention group was significantly lower than that in the diabetic control group (P < 0.05), to slow down the progress of fibrosis. To conclude, moderate intensity exercise has a good effect on streptozotocin induced liver fibrosis in diabetic rats.

Cutaneous collagenous vasculopathy: light and transmission electron microscopy

Abstract Cutaneous collagenous vasculopathy is a rare acquired idiopathic microangiopathy characterized by progressive development of diffuse asymptomatic telangiectasias and histologically by accumulation of collagen type IV around the affected vessels. It is diagnosed by its clinical history, confirmed by light microscopy with collagen-specific immunostaining. We report a case of a patient with extensive acquired telangiectasias on the left arm, clinically resembling unilateral nevoid telangiectasia. Dilated blood vessels with thickened walls were observed in the dermis. Immunohistochemistry with collagen IV antibodies revealed marked collagen deposition around the vessels, confirming the diagnosis. Transmission electron microscopy observed duplicate and triplicate vascular basal membrane associated with deposition of amorphous material around the membranes.

Clinical Outcomes of Minimally Invasive Surgery in Sanders Type IV Intra-Articular Calcaneal Fractures

PURPOSE: This study evaluated the radiologic and clinical results in patients who underwent minimal invasive surgery using sinus tarsi approach in Sanders type IV calcaneal fracture. MATERIALS AND METHODS: This retrospective study evaluated 13 cases of Sanders type IV calcaneus fractures that were treated by minimal invasive surgery using the sinus tarsi approach from July 2012 to April 2017. Further, these cases could be followed up for more than 12 months. Bone union, radiologic parameters such as Böhler's angle, Gissane's angle, calcaneal height, length, and width, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the postoperative complications were evaluated. RESULTS: Bony union was achieved in all the cases at the final follow up, and the mean union time was 5.5 months. One patient underwent reoperation for a surgical site infection, six patients had post traumatic arthritis, and two of them underwent subtalar joint fusion. The mean AOFAS ankle-hindfoot score was 81.2. At the final follow-up, the mean values of Böhler's angle and Gissane's angle were 20° and 119.8°, respectively, and the mean values of the calcaneus height, length, and width were 46.8 mm, 81.8 mm, and 45.6 mm, respectively. CONCLUSION: Minimal invasive surgery using the sinus tarsi approach for Sanders type IV calcaneal fracture resulted in satisfactory anatomic reduction and stable fixation, and satisfactory clinical and radiologic results were obtained in most of the patients. Minimal invasive surgery is thought to reduce the soft tissue-related complications as compared to surgery using the extensile lateral approach.

Congenital Insensitivity to Pain with Anhidrosis: Five-Year-Old Girl with a Neglected Distal Femur Fracture / 대한정형외과학회잡지

Congenital insensitivity to pain with anhidrosis (CIPA) is a rare disease that affects the sensory and autonomic nervous system. The patients do not have the ability to sense different sensations, such as pain, which tends to lead to different injuries. In addition, the patients suffer from fluctuations in body temperature due to autonomic involvement. The present case was a five-year-old girl with a neglected distal femur fracture. X-rays taken during the follow-up showed marked callus formation and pseudarthrosis of the distal femur. She had biting injuries of the tongue, auto-amputation of the fingers, some developmental delay and a history of recurrent fever with an unknown origin. The electrodiagnostic study was normal. The quantitative sudomotor axon reflex test revealed markedly reduced postganglionic sudomotor axonal responses at all sites recorded on the left. She was diagnosed with CIPA. As the initial presentation of CIPA involves the musculoskeletal system, orthopedic surgeons should have a high index of suspicion.

De novo mutations in COL4A5 identified by whole exome sequencing in 2 girls with Alport syndrome in Korea / 소아과

Alport syndrome (ATS) is an inherited glomerular disease caused by mutations in one of the type IV collagen novel chains (α3, α4, and α5). ATS is characterized by persistent microscopic hematuria that starts during infancy, eventually leading to either progressive nephritis or end-stage renal disease. There are 3 known genetic forms of ATS, namely X-linked ATS, autosomal recessive ATS, and autosomal dominant ATS. About 80% of patients with ATS have X-linked ATS, which is caused by mutations in the type IV collagen α5 chain gene, COL4A5. Although an 80% mutation detection rate is observed in men with X-linked ATS, some difficulties do exist in the genetic diagnosis of ATS. Most mutations are point mutations without hotspots in the COL4A3, COL4A4, and COL4A5 genes. Further, there are insufficient data on the detection of COL4A3 and COL4A4 mutations for their comparison between patients with autosomal recessive or dominant ATS. Therefore, diagnosis of ATS in female patients with no apparent family history can be challenging. Therefore, in this study, we used whole-exome sequencing (WES) to identify mutations in type IV collagen in 2 girls with glomerular basement membrane structural changes suspected to be associated with ATS; these patients had no relevant family history. Our results revealed de novo c.4688G>A (p.Arg1563Gln) and c.2714G>A (p.Gly905Asp) mutations in COL4A5. Therefore, we suggest that WES is an effective approach to obtain genetic information in ATS, particularly in female patients without a relevant family history, to detect unexpected DNA variations.

Wilson Disease Comorbid with Hereditary Sensory Autonomic Neuropathy Type IV and Gitelman Syndrome / 대한소아소화기영양학회지

Wilson disease a rare autosomal recessive inherited disorder of copper metabolism, is characterized by excessive deposition of copper in the liver, brain, and other tissues. Wilson disease is often fatal if it is not recognized early and treated when it is symptomatic. Gitelman syndrome is also an autosomal recessive kidney disorder characterized by low blood levels of potassium and magnesium, decreased excretion of calcium in the urine, and elevated blood pH. Hereditary sensory autonomic neuropathy type IV (HSAN-IV), a very rare condition that presents in infancy, is characterized by anhidrosis, absence of pain sensation, and self-mutilation. It is usually accompanied by developmental delay and mental retardation. We report a case of Wilson disease manifested as fulminant hepatitis, acute pancreatitis, and acute kidney injury in a 15-year-old boy comorbid with HSAN-IV and Gitelman syndrome. Such concurrence of three genetic diseases is an extremely rare case.

Effects of urantide on expressions of type IV collagen in thoracic aorta and VSMC of atherosclerotic rats / 吉林大学学报(医学版)

Objective: To investigate the effects of urantide on the expressions of type IV collagen (Col IV) in thoracic aorta and vascular smooth muscle cells (VSMC) in the rats with atherosclerosis (AS), and to clarify its mechanism of prevention and treatment of AS Methods: A total of 180 Wistar rats were randomly divided into normal control group (n=30) and AS model group (n=150). The rat models of AS were established by feeding on high-fat diet or intraperitoneally injecting vitamin Da (VDa). The AS model rats were randomly divided into AS group, fluvestation (Flu) group and urantide group (3, 7, and 14 d groups). The expression of Col IV in thoracic aorta wall of the rats was detected by immunohistochemistry. The levels of hydroxyproline (HYP) in serum and urine of the rats in various groups were measured by ELISA. The VSMC were randomly divided into normal control group, urotensin E (U II 10~smol • L_ 1) group, Flu group and urantide (10~10to 10~" mol • L_ 1) groups. The levels of Col IV in VSMC of the rats in various groups were determined by ELISA. Results: There was a significant difference in the expression levels of Col IV in the irregular plaques of the thoracic aorta of the rats between various groups (F = 3 5 . 0 9, P < 0 . 01). The expression levels of Col IV in thoracic aorta of the rats in AS group were significantly increased compared with normal control group (P < 0 . 01); the intensity and extent of Col IV positive staining in urantide group were lower than those in AS group (P < 0 . 01). There were significant differences in the serum and urine HYP levels between various groups (F = 2 4 . 38, P < 0 . 01; F=26. 72, P < 0 . 01). Compared with normal control group, the serum HYP level of the rats in AS group were significantly increased (P < 0 . 01), and the urine HYP level was significantly decreased (P < 0 . 01). Compared with AS group, the serum HYP levels in urantide groups were significantly decreased (P < 0 . 01) and the urine HYP levels were significantly increased (P < 0. 01), no less than the level in Flu group. The expression levels of Col IV in the culture supernatant of VSMC in the rats in various groups had significantly difference (F = 3 1 . 04, P < 0 . 01). The expression level of Col IV in the culture supernatant of VSMC of the rats in U II group was significantly increased compared with normal control group (P < 0 . 01); the expression levels of Col IV in the culture supernatant of VSMC of the rats in urantide groups were significantly decreased compared with U II group (P < 0 . 05 or P < 0 . 01). Conclusion: Urantide can inhibit the expressions of Col IV in the thoracic aorta and VSMC of the AS rats and alleviate the degree of AS lesions, which provides the experimental evidence for the clinical application of urantide in the treatment of AS.

Surgery treatment of Meyers-Mckeever-Zaricnyj type IV tibial eminence fracture patients under arthroscope: A report of 7 cases and literature review / 吉林大学学报(医学版)

Objective: To observe the efficacy of Endobutton combined with the suture in the treatment of Meyers-Mckeever-Zaricnyj type IV tibial eminence fracture, and to explore the characteristics and treatment methods of Meyers-Mckeever-Zaricnyj type IV fracture. Methods: The clinical data of seven patients with Meyers-Mckeever-Zaricnyj type IV tibial eminence fracture were collected; the literature review was performed, and the surgical treatment methods, key points of operation and precautions of the patients were analyzed. Results: After arthroscopic debridement, 3 kinds of main fractures were found: anterior cruciate ligament connected fragment (ACLCF), anterior horn of lateral meniscus connected fragment (ALMCF), and posterior-medial cartilage connected fragment (PMCCF). The PMCCF was first fixed after pre-reduction from back to front and from deep to shallow orders, then the ALMCF and ACLCF were fixed, avoiding the secondary displacement and bone cutting. The follow-up periods of 7 patients were 6-12 months, with an average followed-up period of 7 months. The front drawer test (-), Lachman test (-); the average Lysholm score of patients before operation was less than that in the last follow-up period (P<0. 05). The knee joint stability of patients was good, and the knee joint had no movement disorder and infection. Conclusion: The intra-operative reduction order is crucial during the operation of Meyers-Mckeever-Zaricnyj type IV tibial eminence fracture. Perfect fixation can be achieved by using Endobutton combined with suture.

Endoplasmic reticulum stress and proteasome pathway involvement in human podocyte injury with a truncated COL4A3 mutation / 中华医学杂志(英文版)

Background@#Collagen type IV (COL4)-related nephropathy includes a variety of kidney diseases that occur with or without extra-renal manifestations caused by COL4A3-5 mutations. Previous studies revealed several novel mutations, including three COL4A3 missense mutations (G619R, G801R, and C1616Y) and the COL4A3 chr:228172489delA c.4317delA p.Thr1440ProfsX87 frameshift mutation that resulted in a truncated NC1 domain (hereafter named COL4A3 c.4317delA); however, the mutation mechanisms that lead to podocyte injury remain unclear. This study aimed to further explore the mutation mechanisms that lead to podocyte injury.@*Methods@#Wild-type (WT) and four mutant COL4A3 segments were constructed into a lentiviral plasmid, then stably transfected into human podocytes. Real-time polymerase chain reaction and Western blotting were applied to detect endoplasmic reticulum stress (ERS)- and apoptosis-related mRNA and protein levels. Then, human podocytes were treated with MG132 (a proteasome inhibitor) and brefeldin A (a transport protein inhibitor). The human podocyte findings were verified by the establishment of a mus-Col4a3 knockout mouse monoclonal podocyte using clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) technology.@*Results@#Our data showed that COL4A3 mRNA was significantly overexpressed in the lentivirus stably transfected podocytes. Moreover, the COL4A3 protein level was significantly increased in all groups except the COL4A3 c.4317delA group. Compared to the other test groups, the COL4A3 c.4317delA group showed excessive ERS and apoptosis. Podocytes treated with MG132 showed remarkably increased intra-cellular expression of the COL4A3 c.4317delA mutation. MG132 intervention improved higher ERS and apoptosis levels in the COL4A3 c.4317delA group. Mouse monoclonal podocytes with COL4A3 chr:82717932insA c.4852insA p.Arg1618ThrfsX4 were successfully acquired; this NC1-truncated mutation suggested a higher level of ERS and relatively remarkable level of apoptosis compared to that of the WT group.@*Conclusions@#We demonstrated that excessive ERS and ERS-induced apoptosis were involved in the podocyte injury caused by the NC1-truncated COL4A3 mutation. Furthermore, proteasome pathway intervention might become a potential treatment for collagen type IV-related nephropathy caused by a severely truncated COL4A3 mutation.

Mechanisms of Gexia Zhuyu Decoction on anti-angiogenesis of hepatic fibrosis based on regulation of VEGF mRNA expression mediated by HIF-1α / 中草药

Objective To explore the mechanism of improving angiogenesis of hepatic fibrosis by Gexia Zhuyu Decoction (GZD) through the regulation of the mRNA expression of VEGF mediated by HIF-1α. Methods A total of 108 Wistar rats were randomly divided into normal group (n = 18), model group (n = 18), N-acetylcysteine (NAC) group (n = 18), high-dose GZD group (GD, n = 18), middle-dose GZD group (GZ, n = 18), and low-dose GZD group (GX, n = 18). Hepatic fibrosis model was established by intraperitoneal injection of 50% CCl4-olive oil solution (1 mL/kg) twice a week for nine weeks. Each group was administered while model established, until the rats were sacrificed. Normal group and model group were ig given sterile water 10 mL/(kg•d), NAC group was ig given NAC 0.1 g/(kg•d), GD, GZ, GX groups were given 26, 7.8, and 3.9 g/(kg•d) GZD by oral gavage. At 3, 6, and 9 weeks, rats in the corresponding groups were randomly sacrificed. Masson staining was used to make pathological specimens, immunohistochemical analysis of Col-IV and laminin was also performed, and real-time PCR was used to detect the mRNA expression of HIF-1α and VEGF. Western blotting was used to detect the protein expression levels of VEGF and VEGFR2. Results Compared with model group, NAC group and GD group significantly inhibited the expression of LN in the extracellular matrix at 9 weeks (P<0.05). Both NAC and GD groups significantly inhibited the expression of extracellular matrix Col-IV, especially at 6 weeks and 9 weeks. NAC group, GD group, and GZ group can significantly inhibit the high expression of HIF-1α in liver tissue of rats with liver fibrosis (P<0.05). At 6 weeks and 9 weeks of administration, NAC and GD groups significantly inhibited the high expression of VEGF mRNA in liver tissue (P<0.05). Both GZD and NAC could inhibit the protein expression of VEGF and VEGFR2 in liver tissue. Conclusion GZD can regulate the expression of VEGF mRNA mediated by HIF-1α, which may be one of the key mechanisms of its anti-angiogenesis for hepatic fibrosis.

Caracterização de dois pares efetor/inibidor associados ao sistema de secreção tipo IV de Xanthomonas citri / Characterization of the two effector/inhibitor pair associated with the type IV secretion system of Xanthomonas citri

O sistema de secreção tipo IV (T4SS) da família de bactérias Xanthomonadaceae transfere efetores (X-Tfes) com a capacidade de matar outras bactérias, conferindo uma vantagem em comunidades bacterianas mistas para colonizar diferentes nichos como o solo ou as superfícies das plantas. Os X-Tfes possuem diferentes domínios putativos com atividades hidrolíticas contra componentes do envelope celular bacteriano do tipo: glicohidrolases, transglicosilases, amidases e lipases. Os X-Tfes por sua atividade biológica inata podem ocasionar dano intracelular para a bactéria que os produz. Para se proteger contra estas atividades, também são produzidas lipoproteínas com função inibitoria (X-Tfis) localizadas no periplasma. Os genes que codificam os X-Tfes e os X-Tfis estão organizados em operons, o que permite gerar os pares efetor/inibidor simultaneamente. Entre os potenciais X-Tfes do fitopatógeno Xanthomonas citri estão Xac1918 e Xac0574. Xac1918 é uma proteína com um domínio da superfamília da lisozima e um domínio conhecido como RTX (Repeats in Toxin) de ligação ao cálcio, enquanto Xac0574 tem um domínio da superfamília da lipase 3. Os seus possíveis inibidores, Xac1917 e Xac0573 respectivamente, apresentam um peptídeo sinal no N-terminal contendo o lipobox representativo das lipoproteínas. As proteínas Xac0574 e Xac0573 são monômeros em solução que formam um complexo estável 1:1, favorecido termodinamicamente (ΔG°= -12 Kcal/mol) com uma constante de dissociação de 2,45 nM, garantindo que a bactéria fique protegida contra os efeitos nocivos de Xac0574 quando é produzida intracelularmente. Xac0574 é uma fosfolipase A1, sem atividade lisofosfolipase, com a capacidade de hidrolisar os três fosfolipídios majoritários que compõem a membrana celular bacteriana, fosfatidilglicerol (PG), cardiolipina e fosfatidiletanolamina (PE), mostrando uma aparente preferência pelo último. A atividade enzimática de Xac0574 explica a forte inibição do crescimento celular em E. coli após da sua indução heteróloga, já que gera uma diminuição de quase 10 vezes da população celular comparada com a cultura não induzida com a mesma construção. Poroutro lado, Xac0573 inibe efetivamente a atividade enzimática de Xac0574 ao formar o complexo, além de não ter atividade fosfolipase nem lisofosfolipase. Foram produzidos cristais da Xac1918 e Xac0573 que difrataram com uma resolução de 3,0 e 2,5 Å, respectivamente. Porém, só foi gerado um modelo de Xac0573. Xac0573 está composta por duas folhas ß antiparalelas com uma topologia característica de ß sanduíche Com uma pequena hélice e duas voltas. Um alinhamento de homólogos de Xac0573 identificou nas extremidades da proteína as regiões conservadas, constituindo duas possíveis interfaces de interação que podem ser as responsáveis por bloquear o acesso dos fosfolipídios ao sítio catalítico ou impedir os rearranjos estruturais de Xac0574 que são necessários para a sua atividade enzimática. Adicionalmente, a topologia da Xac0573 é semelhante do domínio C2, conhecido em eucariotos como domínio de ligação ao lipídio e ao cálcio, e está envolvido em processos de sinalização de segundos mensageiros lipídicos, proteínas de trafego de membranas e mecanismos de fusão de membranas. Nossos resultados apontam para uma nova função biológica do domínio C2 como um inibidor enzimático intracelular em bactérias

The type IV secretion system (T4SS) of the bacteria family Xanthomonadaceae transfers effectors (X-Tfes) with that can kill other bacterial cells, conferring an advantage to the bacterial community during colonization of different niches in the soil or on the plant surface. The X-Tfes possess different putative domains with hydrolytic activity against components of the bacterial cellular envelope, including glycohydrolase, transglycolase, amidase and lipase domain. The innate biological activity of X-Tfes can cause intracellular damage. Therefore, the bacteria that produce them also produce lipoproteins with inhibitor function (X-Tfis) located in the periplasm for their protection. The genes that code for X-Tfes and X-Tfis are organized in operons that allow for their simultaneous expression. Among the X-Tfes of the phytopathogen Xanthomonas citri are Xac1918 and Xac0574. Xac1918 is carries a lysozyme superfamily domain, as well as a domain known as RTX (Repeats in Toxic) predict to bind calcium, while, Xac0574 has a domain belonging to the lipase 3 superfamily. Their possible inhibitors, Xac1917 e Xac0573 respectively, carry an N-terminal signal peptide containing a lipobox found in bacterial lipoproteins. The Xac0574 and Xac0573 proteins are both monomers in solution, They can form a stable 1:1 complex, that is thermodynamically favored (ΔG°= -12 Kcal/mol) with a dissociation constant of 2,45 nM. This affinity ensure that the bacterium is protected against the harmful effects of Xac0574 when it is produced intracellularly. We show that Xac0574 is a phospholipase A1, without lisophospholipase activity, and is able to hydrolyze the three most common phospholipids found in the membranes of Gram negative bacteria, namely phosphatidylglycerol (PG), cardiolipin and phosphatidylethanolamine (PE), presenting an apparent preference for PE. The enzymatic activity of Xac0574 explains the strong inhibition of growth of E. coli cells after its heterologous induction: a nearly 10-fold decrease in the cell population is observed when compared to the non-induced culture with the same construct. On the other hand, Xac0573 effectively inhibits the enzymatic activity of Xac0574. Furthermore, Xac0573 does not possess when forming the complex, besides not having phospholipase nor lysophospholipase activity.Crystals of Xac1918 and Xac0573 were produced which diffracted with to resolution of 3.0 and 2.5 Å, respectively. However, we were able to resolve the structure of only Xac0573. Xac0573 is composed of two anti-parallel sheet that form a ß-sandwich with three small helices. An alignment to Xac0573 homologs identified conserved regions at the ends of the protein that constitute two possible interfaces of interaction that may be responsible for blocking the access of the phospholipids to the catalytic site or impede the structural rearrangements of Xac0574 that are necessary for its enzymatic activity. Additionally, the topology of Xac0573 is similar to that to C2 domains, known in eukaryotes to bind lipids and calcium and to be involved in signaling processes mediated by lipid second messengers, membrane trafficking and membrane fusion mechanisms. Our results point to a new biological function of the C2 domain as an intracellular enzyme inhibitor in bacteria

Expression of matrix metalloproteinase-9, tissue inhibitor of metallopro-teinase-1 and collagen type Ⅳ in lung of rats with multiple organ dysfunc-tion syndrome / 中国病理生理杂志

AIM:To determine the expression of matrix metalloproteinase-9(MMP-9),tissue inhibitor of me-talloproteinase-1(TIMP-1)and collagen type Ⅳ(Ⅳ-C)in the lung of rats with multiple organ dysfunction syndrome(MODS)and to investigate the mechanism of lung injury in MODS.METHODS:Adult male Sprague-Dawley(SD)rats(n=40)were randomly divided into sham control group and cecal ligation and puncture(CLP)model group.The rats in CLP group were divided into 4 subgroups as different intervals(6 h,12 h,24 h and 48 h),and there were 8 rats in each group.The rat model of MODS was established by CLP.All rats were sacrificed at various intervals.The functions of the liver,kidney and lung were determined by blood biochemical and blood gas analysis.The morphological changes of the lung tissues were observed with HE staining.The serum levels of tumor necrosis factor(TNF)-α,interleukin(IL)-1β,MMP-9 and TIMP-1 were measured by ELISA.The expression of MMP-9 and TIMP-1 in the lung tissues was detected by RT-PCR and immunohistochemistry ,and the expression of Ⅳ-C in the lung tissues was detected by immunofluorescence and Western blot.RESULTS:Compared with sham control group ,the functions of the liver ,kidney and lung were damaged at different degrees in model groups.No histopathological change in the lung tissues of sham control group was found ,and the lung injury was serious in model groups.Compared with sham control group ,the serum levels of TNF-α,IL-1β,MMP-9 and TIMP-1 in model groups increased significantly(P<0.05)and peaked at the interval of 12 ～24 h after modeling(P<0.01).The expression of MMP-9 and TIMP-1 in the lung tissues of model groups increased ,and peaked at 12 and 24 h,respectively(P<0.01).The protein level of Ⅳ-C in MODS 6 h group was not changed as compared with control group,while that at the interval of 12～48 h after modeling was significantly decreased and dropped to the lowest at 24 h(P<0.01).CONCLUSION:MMP-9 and TIMP-1 play important roles in lung injury of MODS rats by regulating the syn-thesis and decomposition of IV-C which is the main component of extracellular matrix.

The clinical and genetic analysis of glycogen storage disease type IV in 5 cases / 临床儿科杂志

Objective To investigate the characteristics of glycogen storage disease type IV (GSD IV) clinically, in laboratory tests and in gene mutation. Methods The clinical manifestations, biochemical indexes, activity of chitotriosidase, and the follow-up of the treatment in 5 cases of GSD IV were analyzed. Results Five patients (3 boys and 2 girls) aged 4 months - 5 years presented hepatosplenomegaly and elevated liver enzyme levels for 2 months at hospital visit. Two patients had motor developmental delay and weakness but their creatine kinase (CK) level were normal. Glycogen storage and liver fibrosis were observed in the liver biopsy in 4 patients. Target sequencing found that all 5 children carried the complex heterozygous mutation of the GBE1 gene with 2 reported mutations(p.R515C,p.R524Q)and 7 novel mutations.The novel mutation contains 5 missense mutations (p.I460T, p.F76S, p.F538V, p.L650R, p.W455R), one insertion mutations (c.141_142insGCGC), and one large fragment deletion (exon 3-7). Therefore, diagnosis of liver type of GSD IV was confirmed in those children. Two patients died of liver cirrhosis. The liver transplantation was performed due to liver cirrhosis in one patient whose chitotriosidase activity increased obviously before transplantation and decreased significantly after the transplantation and liver enzyme levels were returned to normal 4 months after transplantation. In the other two patients their growth and liver enzyme levels were normal;one had not received special treatments while the other was treated with raw corn starch and level of chitotriosidase was normal. Conclusions The clinical manifestations of GSD IV are heterogeneous. Target sequencing can be used for fast and noninvasive diagnosis of GSD IV. Chitotriosidase activity is useful in the prognosis assessment for GSD IV.

Cryo-EM structures of the mammalian endo-lysosomal TRPML1 channel elucidate the combined regulation mechanism

TRPML1 channel is a non-selective group-2 transient receptor potential (TRP) channel with Ca permeability. Located mainly in late endosome and lysosome of all mammalian cell types, TRPML1 is indispensable in the processes of endocytosis, membrane trafficking, and lysosome biogenesis. Mutations of TRPML1 cause a severe lysosomal storage disorder called mucolipidosis type IV (MLIV). In the present study, we determined the cryo-electron microscopy (cryo-EM) structures of Mus musculus TRPML1 (mTRPML1) in lipid nanodiscs and Amphipols. Two distinct states of mTRPML1 in Amphipols are added to the closed state, on which could represent two different confirmations upon activation and regulation. The polycystin-mucolipin domain (PMD) may sense the luminal/extracellular stimuli and undergo a "move upward" motion during endocytosis, thus triggering the overall conformational change in TRPML1. Based on the structural comparisons, we propose TRPML1 is regulated by pH, Ca, and phosphoinositides in a combined manner so as to accommodate the dynamic endocytosis process.