The Influence of Obesity on Puberty and Insulin Resistance in Mexican Children.

Obesity is considered the main risk factor associated with the development of insulin resistance (IR). The aim of this study was to evaluate the influence of obesity on puberty onset and IR in Mexican children. A total of 378 children (189 boys and 189 girls) aged 8-14 years participated in the study. IR was estimated using the homeostasis model assessment for IR (HOMA-IR). The mean fasting glucose (FG) and basal insulin levels were 82 mg/dl and 11.0 µIU/ml in boys and 77.3 mg/dl and 12.3 µIU/ml in girls (P < 0.05). Subjects with obesity at Tanner stages II-V showed increased FG levels (P < 0.05). In boys with obesity, there was a decrease in HOMA-IR in Tanner stage IV and differences in age between boys with normal weight and those with obesity in Tanner V, being older the boys with obesity. Obesity in children and adolescents was associated with higher HOMA-IR values. In boys with obesity, IR increased at the end of pubertal maturation, with a delay in puberty. These findings should be considered on the establishment of IR cutoff values for pubertal population in Mexico and in the establishment of strategies to prevent the health problems related to obesity.

Interstitial deletion 14q22.3-q23.2: genotype-phenotype correlation.

The increasing use of molecular tools in genetic diagnosis has produced a surge in the detection of genomic imbalances. Among the growing number of newly discovered chromosome alterations are the interstitial deletions 14q21-q23. In previous reports of this deletion, the patients appear to share ocular defects, pituitary alterations and hand/foot anomalies. Here, we present a 12-year-old girl with dysmorphic face, choanal atresia, gastroesophageal reflux, and moderate developmental delay, in whom an interstitial deletion 14q22.3-q23.2 was detected using a 180k array comparative genome hybridization. The 6.5 Mb deletion contains 27 genes, including three genes of the SIX family: SIX1, SIX4, and SIX6. In mammals, Six1 has been shown to be involved in ocular differentiation, whereas Six4 and Six6 are primarily expressed in the hypothalamus, pituitary gland, and facial bones. We used data on mouse embryos to evaluate the expression of the SIX genes, as well as other representative genes lost in the current patient and a previously published case with a similar phenotype, in order to correlate their pattern of expression with the functional anomalies that constitute the patient's phenotype. We also explored the possibility of other genetic influences, such as the existence of an imprinted region in chromosome 14q, which may provide a better understanding of the observed clinical variability.

Cambios metabólicos durante la epimastigogénesis in vitro de Trypanosoma cruzi / Metabolic changes during in vitro Trypanosoma cruzi epimastigogenesis

La epimastigogénesis de Trypanosoma cruzi es la transformación del tripomastigota sanguícola en epimastigota que ocurre en la porción anterior del tracto intestinal del insecto vector. Se ha reportado la activación de cisteín proteasas durante la epimastigogénesis in vitro en condiciones axénicas, sugiriendo la utilización de aminoácidos como fuente de carbono para la obtención de energía. El objetivo del presente trabajo fue estudiar a través de indicadores los cambios metabólicos producidos durante la diferenciación tripomastigota-epimastigota. Se partió de un 100% de tripomastigotas sobrenadantes de células Vero, incubados en medio LITB a 27ºC en condiciones de alta (epimastigogénesis horizontal) y baja (epimastigogénesis vertical) tensión de oxígeno. Se realizó contaje de parásitos (Cámara de Neubauer) y recuento diferencial (Giemsa) a diferentes tiempos de incubación (0, 1, 2, 4, 6, 8, 11 y 12 días). A cada tiempo se determinó en los sobrenadantes del medio de cultivo las concentraciones de glucosa y amoníaco, así como los valores de pH. Los resultados mostraron que: 1) Independientemente de la tensión de oxígeno se evidenció formas en diferenciación y amastigotas durante el proceso, siendo la aparición de epimastigotas más tardía en alta tensión de oxígeno; 2) El incremento poblacional fue significativamente mayor en condiciones de alta tensión de oxígeno, registrándose alta mortalidad de amastigotas durante los primeros días de incubación en la epimastigogénesis vertical; 3) El consumo de glucosa fue concomitante con la aparición de epimastigotas en ambas condiciones, siendo mayor en alta tensión de oxígeno; 4) No se registró liberación de amoníaco en ninguno de los casos estudiados; 5) Los valores de pH fueron similares hasta el sexto día en ambas condiciones, evidenciándose una acidificación gradual del medio de cultivo en alta tensión de oxígeno. Todo parece sugerir que durante la epimastigogénesis de T. cruzi, los parásitos involucrados en los procesos de diferenciación no muestran activación de las diferentes rutas metabólicas.

The epimastigogenesis of Trypanosoma cruzi is the transformation from bloodstream trypomastigote to epimastigote that occurs in the anterior portion of the intestinal tract of the insect vector. It has been reported cysteine proteases activation during axenic epimastigogenesis in vitro, suggesting the use of amino acids as a carbon source for the production of energy. The aim of this work was to study through indicators metabolic changes produced during the trypomastigote-epimastigote differentiation. We started with a 100% trypomastigotes derived from Vero cell supernatants, incubated in LITB medium at 27°C under high (horizontal epimastigogenesis) and low (vertical epimastigogenesis) oxygen tension. We estimated parasites number (Neubauer chamber) and differential morphology (Giemsa) at different incubation times (0, 1, 2, 4, 6, 8, 11 and 12 days). Each time was determined in the supernatants of the culture medium glucose and ammonia concentrations as well as the pH values. The results showed that: 1) Regardless of the oxygen tension it was evidenced differentiation forms and amastigote during the process, with the later occurrence of epimastigotes in high oxygen tension; 2) Population growth was significantly greater in high oxygen tension, registering high mortality of amastigotes during the firsts incubation days in the vertical epimastigogenesis; 3) Glucose consumption was concomitant with the appearance of epimastigotes in both conditions, being higher in high oxygen tension; 4) There was no ammonia release in any of the cases studied; 5) The pH values were similar to the sixth day in both conditions, showing gradual acidification of the culture medium at high oxygen tension. Everything seems to suggest that during the epimastigogenesis of T. cruzi parasites involved in differentiation processes show no activation of different metabolic pathways.

Cambios morfológicos, proteicos, glicoproteicos y antigénicos de Trypanosoma cruzi cultivado en medio axénico con tensiones de oxígeno diferentes / Morphological, protein, glycoprotein and antigenic changes of Trypanosoma cruzi cultured in axenic medium with different oxygen tensions

Se ha reportado cultivo axénico de amastigotas de Trypanosoma cruzi derivados de epimastigotas. Se cuestiona si formas redondas en cultivos axénicos son verdaderos amastigotas. Aquí se compararon los cambios biológicos y moleculares de epimastigotas creciendo en alta y baja tensión de oxígeno. T. cruzi (EPm6) se creció en frascos con diferentes alturas de medio LITB (condición horizontal 3 mm y vertical 83 mm). Se colectaron masas de parásitos de diferentes tiempos de crecimiento para análisis proteico, glicoproteico y antigénico. Se estudiaron los cambios morfológicos, incremento de inóculo y resistencia al complemento por microscopia de fases y tinción con Giemsa. Los cambios proteicos y glicoproteicos se compararon por SDS-PAGE. Los cambios antigénicos se analizaron por Western blot con suero de conejo y anticuerpos IgY contra formas amastigotas. En condición vertical, los epimastigotas mantuvieron su morfología típica a lo largo de la curva de crecimiento y no mostraron cambios moleculares significativos. En condición horizontal al 4to y 6to día predominaron formas redondas con capacidad de resistir la lisis por complemento. A partir del 4to día se observaron cambios en los perfiles proteicos y glicoproteicos, concomitantemente con los cambios morfológicos. El suero anti-amastigotas reveló un antígeno amastigota-específico transitorio de 55 kDa en parásitos de 4 días en la condición horizontal, mientras el anticuerpo IgY anti-amastigotas no reveló diferencias entre parásitos creciendo en ambas condiciones. Estas evidencias sugieren que epimastigotas de T. cruzi condicionados a sobrevivir en alta tensión de oxígeno puede mimetizar propiedades biológicas y antigénicas propias del estadio amastigota.

Axenic culture of epimastigote-derived amastigotes of Trypanosoma cruzi has been reported. Have been inquired why round forms appear in culture media and if are true amastigotes. Our proposal was study molecular and biological changes in epimastigotes growing in high and low oxygen tension. T. cruzi (EPm6) were grown in flasks with different height of LITB medium (horizontal condition 3 mm and vertical 83 mm). Parasites were collected masses of different times of growth for proteins, glycoproteins and antigenic analysis. Morphological changes, increase of inoculum and resistance to complement lyses were studied in phase’s microscopy and Giemsa-stained smears. Protein and glycoprotein changes were compared by SDS-PAGE. Antigenic changes were analyzed by Western blot with rabbit serum and IgY antibody against amastigote forms. In vertical condition, the epimastigote maintained its typical morphology along the growth curve and not showed significant molecular changes. In horizontal condition round forms prevailed at 4 and 6 days with capacity to resist lyses by complement. From the 4th day changes in proteins and glycoproteins profiles were observed, concomitantly with the morphological changes. Anti-amastigotes serum revealed a 55 kDa transitory amastigote-specific antigen in four day parasites’ from horizontal condition, while IgY antibody anti-amastigotes don’t revealed differences between parasites grown in both conditions. These evidences suggest that epimastigotes of T. cruzi conditioned to survive in high oxygen tension can mimic biological and antigenic properties own the amastigote-stage.

Epimastigogénesis de Trypanosoma cruzi Dm28c en medio ML15-HA: Análisis proteico, glicoproteico y antigénico / Trypanosoma cruzi Dm28c Epimastigogenesis in ML15-HA medium: protein, glycoprotein and antigen analyses

El medio ML15-HA permite simular in vitro los eventos morfogenéticos del ciclo vital de T. cruzi. Se ha evidenciado que los cambios morfológicos de la epimastigogénesis del clon Dm28c de T. cruzi en ML15-HA, ocurren más rápidamente que para otros aislados. Nuestro propósito fue investigar si los cambios macromoleculares ocurren concomitantemente con la rápida transformación morfológica. Tripomastigotas derivados de células infectadas se incubaron por diferentes tiempos en medio ML15-HA a 27ºC. Los cambios morfológicos se determinaron por microscopía de contraste de fases y coloración con Giemsa. Los perfiles peptídico y glicopeptídico se analizaron mediante SDS-PAGE y coloraciones específicas. Los cambios antigénicos se estudiaron mediante Western blot usando sueros anti-Tripomastigotas y anti-Epimastigotas. Los resultados muestran: (1) caída del porcentaje de tripomastigotas e incremento de amastigotas en las primeras 24 horas, con incremento gradual de epimastigotas a partir de 48 horas; (2) tres perfiles peptídicos y glicopeptídicos diferentes: tripomastigotas, epimastigotas a partir del día 4, y un perfil intermedio los días 2 y 3, demostrando la estrecha correlación entre los eventos morfológicos y los cambios proteicos y glicoproteicos; (3) los perfiles antigénicos revelaron estrecha relación entre los cambios morfológicos y la expresión de antígenos estadio-específicos. Los resultados obtenidos evidencian de manera concluyente que los cambios moleculares son más acelerados para el clon Dm28c en medio ML15-HA que en otros medios. Estos hallazgos abren la interrogante, sí la velocidad de la epimastigogénesis está determinada por la constitución genética del aislado o por la riqueza nutricional del medio de diferenciación.

The ML15-HA medium allows simulate in vitro morphogenetic events in the life cycle of T. cruzi. It has been demonstrated that the morphological changes of epimastigogenesis in ML15-HA of the T. cruzi clone Dm28c, occur faster than for other isolates. Our purpose was to investigate whether macromolecular changes occur concomitantly with rapid morphological transformation. Trypomastigotes derived from infected cells were incubated for different times in ML15-HA medium at 27°C. Morphological changes were determined by phase contrast microscopy and staining with Giemsa. Peptide and glycopeptide profiles were analyzed by SDS-PAGE and specific staining. Antigenic changes were studied by Western blot using serum anti-trypomastigotes and anti-epimastigotes. The results show: (1) decline in the percentage of trypomastigotes and amastigotes increased in the first 24 hours, epimastigotes gradually increases from 48 hours, (2) three peptide and glycopeptide profiles different: trypomastigotes, epimastigotes from the day 4 and an intermediate profile on days 2 and 3, showing the close correlation between morphological events and protein and glycoprotein changes, (3) antigenic profiles showed close relationship between the morphological changes and the expression of stage-specific antigens. The results show conclusively that the molecular changes are more rapid for clone Dm28c in ML15-HA medium than in other media. These findings open the question, if the epimastigogenesis speed is determined by the genetic constitution of isolated or nutritional wealth differentiation medium.

Relación entre cambios en la expresión de proteasas y metaciclogénesis espontánea asociadas a las condiciones de mantenimiento de Trypanosoma cruzi en el laboratorio / Relationship between changes in the expression of proteases and spontaneous metacyclogenesis associated to Trypanosoma cruzi maintenance conditions in the laboratory

La metaciclogénesis de Trypanosoma cruzi es la transformación del estadio epimastigota en tripomastigota metacíciclico que ocurre en la ampolla rectal del insecto vector. Durante este proceso se ha implicado una activación del metabolismo proteico, con probable participación de proteasas en la degradación de proteínas del parásito. En el presente trabajo se determinó el efecto de las condiciones de mantenimiento de T. cruzi en el laboratorio sobre la actividad de proteasas y su relación sobre la metaciclogénesis espontánea en cultivos axénicos. Se trabajó con el clon Dm30L de Trypanosoma cruzi mantenido en el laboratorio mediante pases trimestrales chipo-ratón (condición triatomino: CT) o repiques semanales durante 15 años en medio LITB (condición cultivo: CC). En ambas condiciones, se hizo curva de crecimiento durante 30 días en medio LITB suplementado con 10, 24 y 48 mM glucosa, calculándose el porcentaje de metacíclicos espontáneos y determinación de la actividad de proteasas. En 10 mM glucosa, parásitos de la CT presentaron mayor expresión de proteasas y porcentaje de metacíclicos respecto a la CC. En la CT, el crecimiento en 48 mM glucosa redujo las variables antes mencionadas, mientras que no se evidenció actividad proteolítica ni metaciclogénesis espontánea en parásitos de la CC en altas concentraciones de glucosa. En todos los casos se evidenció mayor actividad de cisteín proteasas durante la fase estacionaria del cultivo. No se reportó actividades metaloproteasas en ninguna de las condiciones estudiadas, pero sí en el clon Dm28c utilizado como control de la expresión de este tipo de enzima. Estos resultados sugieren que la expresión de proteasas está influenciada por la constitución genética del parásito y que la CC provoca disminución de la actividad proteolítica que persisten aún en condiciones de agotamiento de carbohidratos del medio, con una concomitante reducción significativa en el porcentaje de metacíclicos espontáneos.

Trypanosoma cruzi metacyclogenesis is the transformation of epimastigote stage to trypomastigote metacyclic that happens in the rectal ampulla of the insect vector. During this process it has been implicated protein metabolism activation, with proteases likely involvement in parasite protein degradation. In this study we determined the effect of T. cruzi keeping conditions in the laboratory on the activity of proteases and their relationship on spontaneous metacyclogenesis in axenic culture. We worked with Trypanosoma cruzi Dm30L clone maintained in the laboratory by quarterly passes triatomine-mouse (triatomine condition: TC) or serial culture media during 15 years in LITB medium (culture condition: CC). In both conditions, growth curve was made for 30 days in LITB medium supplemented with 10, 24 and 48 mM glucose, calculating the percentage of spontaneous metacyclics and determining proteases activity. In 10 mM glucose, TC parasites showed higher expression of proteases and metacyclic percentage relative to the CC. In TC, the growth in 48 mM glucose reduced the above variables, while no evidenced proteolytic activity nor spontaneous metacyclogenesis on CC parasites in high glucose concentrations. In all cases there was greater cysteine proteases activity during the stationary phase of the culture. Metalloprotease activity was not reported in any of the conditions studied, but it was detected in clone Dm28c used as control of expression of this type of enzyme. These results suggest that the expression of proteases is influenced by the genetic makeup of the parasite and the CC causes decrease of proteolytic activity which persists even in carbohydrate depleted conditions of the medium, with a concomitant significant reduction in the percentage of spontaneous metacyclics.

El estadio amastigota precede la evolución del epimastigota durante la epimastigogénesis in vitro de Trypanosoma cruzi / The amastigote stadium precedes epimastigote evolution during in vitro Trypasnosoma cruzi epimastigogenesis

La transformación de tripomastigotas sanguíneos de Trypanosoma cruzi en epimastigotas, ocurre naturalmente en el intestino del insecto y se identifica como epimastigogénesis. Aquí reportamos que durante la epimastigogénesis in vitro, los tripomastigotas se transforman en formas redondeadas, biológica y antigénicamente equivalentes al estadio amastigota; con un tiempo de persistencia dependiente de la altura del medio de cultivo. Formas tripomastigotas procedentes de cultivo de tejidos infectados se incubaron en envases con diferentes alturas de medio LITB (3 y 83 mm), y se compararon las cinéticas de transformación hacia epimastigotas. Para la obtención de antígenos se colectaron masas de parásitos a diferentes tiempos de diferenciación. Los cambios morfológicos, incremento del inóculo y resistencia a complemento, se estudiaron por microscopía de contraste de fases y extendidos coloreados con Giemsa. Los cambios antigénicos se analizaron mediante Western Blot usando anticuerpo IgY anti-amastigotas. Los resultados mostraron que las formas redondeadas resisten la lisis por complemento, expresan antígenos amastigota-específicos y la velocidad de transformación hacia epimastigotas depende de la altura del medio sobrenadante en el cultivo. Las evidencias sugieren que además de caída de la temperatura, una baja tensión de oxígeno disuelto y una alta densidad de parásitos por área, aceleran el proceso de diferenciación.

Transformation of blood Trypanosoma cruzi tripomastigotes into epimastigotes occurs naturally at the insect gut and is identified as epimastigogenesis. Here we report that during in vitro epimastigogenesis, tripomastigotes transform into rounded forms, biologically and antigenically equivalent to the amastigote stadium, with a persistance time which depends on the height of the culture medium. Tripomastigote forms from cultures of infected tissues were incubated in flasks with different LITB medium heights (3 and 83 mm), and kinetics of transformation to epimastigotes were compared. Masses of parasites at different differentiation times were collected for antigen production. Morphological changes, inoculum increase and resistance to complement were studied by phase contrast microscopy and Giemsa stained smears. Antigenic changes were analyzed through Western Blot using an IgY anti-amastigote antibody. Results showed that rounded forms resist lysis by complement, express amastigote-specific antigens, and that the speed of transformation to epimastigotes depends on the height of the supernatant medium in the culture. Evidences suggest that apart from a temperature fall, a low dissolved oxygen tension and a high parasite per area density accelerate the differentiation process.

Reorganization of Cajal bodies and nucleolar targeting of coilin in motor neurons of type I spinal muscular atrophy.

Type I spinal muscular atrophy (SMA) is an autosomal recessive disorder caused by loss or mutations of the survival motor neuron 1 (SMN1) gene. The reduction in SMN protein levels in SMA leads to degeneration and death of motor neurons. In this study, we have analyzed the nuclear reorganization of Cajal bodies, PML bodies and nucleoli in type I SMA motor neurons with homozygous deletion of exons 7 and 8 of the SMN1 gene. Western blot analysis is is revealed a marked reduction of SMN levels compared to the control sample. Using a neuronal dissociation procedure to perform a careful immunocytochemical and quantitative analysis of nuclear bodies, we demonstrated a severe decrease in the mean number of Cajal bodies per neuron and in the proportion of motor neurons containing these structures in type I SMA. Moreover, most Cajal bodies fail to recruit SMN and spliceosomal snRNPs, but contain the proteasome activator PA28, a molecular marker associated with the cellular stress response. Neuronal stress in SMA motor neurons also increases PML body number. The existence of chromatolysis and eccentric nuclei in SMA motor neurons correlates with Cajal body disruption and nucleolar relocalization of coil in, a Cajal body marker. Our results indicate that the Cajal body is a pathophysiological target in type I SMA motor neurons. They also suggest the Cajal body-dependent dysfunction of snRNP biogenesis and, therefore, pre-mRNA splicing in these neurons seems to be an essential component for SMA pathogenesis.

UGT2B7_-161C>T polymorphism is associated with lamotrigine concentration-to-dose ratio in a multivariate study.

Lamotrigine (LTG) is metabolized by UGT1A4 but UGT2B7 also contributes to its glucuronidation. The aim of this study was to determine whether UGT2B7_- 161C>T and UGT2B7_372A>G polymorphisms contribute to the intersubject variability in LTG concentration-to-dose ratio (LTG-CDR) in epileptic patients. Fifty-three white epileptic patients attending the Neuropediatric and Neurology Services at the Marqués de Valdecilla University Hospital, in whom LTG serum concentration was to be measured for pharmacokinetic monitoring, were selected according to predefined criteria for LTG-CDR evaluation. All patients had at least one steady-state LTG serum concentration obtained before the first dose in the morning. Patients were classified in 3 groups of comedication: (1) LTG in combination with metabolism-inducer anticonvulsants (n = 22), (2) LTG in combination with valproate (n = 13), and (3) LTG as monotherapy (n = 16) or in combination with valproate and inducers (n = 2). Genotypes were determined by Applied Biosystems Genotyping Assays with TaqMan probes. A significant association was found between LTG-CDR and UGT2B7_-161C>T polymorphism (P = 0.021) when patient age and concomitant antiepileptic drugs were taken into account. Comedication explained 70% of the LTG-CDR variability, patient age 24%, and UGT2B7_-161C>T 12%. In contrast, a significant association between LTG-CDR and this polymorphism was not found in the bivariate study when age and comedication groups were not considered. A significant association between UGT2B7_372A>G and LTG-CDR was not found in the bivariate or the multivariate studies. UGT2B7_-161C>T polymorphism is significantly associated with LTG-CDR when comedication with other antiepileptic drugs and patient age are taken into account in a multivariate analysis.

Genetic factors associated with drug-resistance of epilepsy: relevance of stratification by patient age and aetiology of epilepsy.

Epilepsy drug-resistance may depend on the metabolism of antiepileptic drugs (AEDs), transport to the epileptic focus and/or target sensitivity. Furthermore, drug response depends on multiple characteristics of the patient, the epilepsy, and the antiepileptic drugs used. We have investigated the association between polymorphisms related to antiepileptic drug metabolism (CYP2C9, CYP2C19, and UGT), transport (ABCB1), and targets (SCN1A) both in a crude analysis and after adjusting by clinical factors associated with drug-resistance, and stratifying by patient age or aetiology of epilepsy. Caucasian outpatients (N=289), children (N=80) and adolescent-adults (N=209), with idiopathic (N=69), cryptogenic (N=97) or symptomatic epilepsies (N=123) were selected when they had either drug-resistance (with at least four seizures over the previous year after treatment with more than three appropriate AEDs at appropriate doses) or drug responsiveness (without seizures for at least a year). Samples were genotyped by allelic discrimination using TaqMan probes. No significant association between polymorphisms and drug-resistance was found either in the crude analysis or in the adjusted analysis. However, adults with the ABCB1_3435TT or 2677TT genotypes had a lower risk of drug-resistance than those with the CC or the GG genotypes. Furthermore, patients with symptomatic epilepsies with the ABCB1_3435CT or TT genotypes had a lower risk of drug-resistance than those with the CC genotype. An opposite but insignificant tendency was found in children and in idiopathic epilepsies. Although replication studies will be needed to confirm our results, they suggest that stratification by patient age and by the aetiology of epilepsy could contribute to unmask the association between ABCB1 polymorphisms and drug-resistance of epilepsy.

Spinal muscular atrophy type I mimicking critical illness neuropathy in a paediatric intensive care neonate: electrophysiological features.

We report the case of a neonate with spinal muscular atrophy type I (SMA type I or Werdnig-Hoffman disease) who was initially misdiagnosis as having critical illness neuropathy. Electromyography (EMG) showed a moderate loss of voluntary and motor unit potentials of both neurogenic and myopathic appearance. Nerve conduction studies revealed the presence of a severe sensory-motor axonal neuropathy. Finally, a biopsy of quadriceps was compatible with the diagnosis of SMA type I. A genetic study confirmed the existence of a homozygous absence of exons 7 and 8 of the telomeric supervival motoneuron gene (SMN1 gene).

Cultivation of Trypanosoma cruzi epimastigotes in low glucose axenic media shifts its competence to differentiate at metacyclic trypomastigotes.

This study offers an insight into why Trypanosoma cruzi epimastigotes lose their capacity to differentiate into metacyclic forms, if maintained in culture media long-term through serial passages. The biological and metabolic behaviour of two T. cruzi strains isolated from various origins (human, opossum), and maintained under two schedules (alternate triatomine/mouse passages and serial culture media) were compared. To determine the effect of the environment on the parasites, the epimastigotes were grown under extreme conditions (high and low glucose concentrations), and the glucose consumption, ammonia production and changes in pH, either in one compartment (along the growth curve) or two compartments (induced metacyclogenesis) were compared. The glucose effect on the stages involved in metacyclogenesis at antigenic level was also evaluated. The results indicate that T. cruzi adapts to various environmental conditions and also that the ability of epimastigotes to undergo metacyclogenesis are influenced by the maintenance schedule. Antigenic profile analysis supports the idea that epimastigotes adapted to culture media do not complete their molecular differentiation into the trypomastigote metacyclic stage. These transition forms conserve some degree of gene expression of the epimastigote stage.

Screening for subtelomeric chromosome alteration in a consecutive series of newborns with congenital defects.

It is generally accepted that 2.5% of the patients with unexplained mental retardation and dysmorphic features have a chromosome alteration affecting the subtelomeric regions. The frequency of such alterations whether in the general population or in newborns with congenital defects, however, remains unknown. Here, we present an analysis of the subtelomeric regions in a consecutive series of 71 newborn babies with congenital defects, who displayed a normal high resolution G-band karyotype (550-850 bands). After excluding the alterations that could be considered to be polymorphisms, a total of seven subtelomeric anomalies were observed with a frequency of 9.86% (3.96-20.31). We conclude that fluorescence in-situ hybridization screening for subtelomeric alterations is relevant for infants with congenital defects detectable at birth, particularly in those newborn babies with congenital defects and a normal high resolution G-band karyotype.

Conventional and sustained-release valproate in children with newly diagnosed epilepsy: a randomized and crossover study comparing clinical effects, patient preference and pharmacokinetics.

OBJECTIVE: It has been suggested that sustained-release valproate (VPA) formulations may be more effective and better tolerated than conventional VPA due to better compliance and lower fluctuations in VPA serum concentrations, but comparative trials with conventional VPA in children are scarce. This randomized and crossover trial compared the efficacy (complete control of seizures), the tolerability, and the patient (or parents) preference of conventional VPA twice daily (CVbid) with those of sustained-release chrono VPA twice daily (ChVbid), once daily in the morning (ChVom) or once daily in the evening (ChVoe) in monotherapy. METHODS: The study was carried out in 48 children (29 girls), aged 5-14 years, with newly diagnosed partial epilepsy (n=26), or idiopathic generalized epilepsy (n=22). The study duration was 16 months (four phases of 4 months each). VPA pharmacokinetics data were also compared in the different regimens. Mean VPA dosage was of approximately 870 mg/day (approximately 22 mg/kg/day) and mean VPA concentration was of approximately 89 mg/l at 12 h post-dose and of 54 mg/l at 24 h post-dose. RESULTS: By intention in treatment there were no significant differences in efficacy (73%, 83%, 77% and 75%, respectively) or in adverse reaction frequency (56%, 58%, 67% and 46%, respectively). There were significant differences, however, in patient (or parents) preference, the order being ChVoe (31%) > ChVom (25%) > CVbid (17%) > ChVbid (8%). The mean VPA serum concentration fluctuation between 4 h and 0 h post-morning-dose was nonsignificantly lower after CVbid than after ChVbid. Fluctuation was significantly higher after ChVom than after CVbid or ChVbid. The mean VPA serum concentration difference between 12 h and 24 h post-dose was approximately 40 mg/l. CONCLUSION: Although our results should be confirmed by a larger study, they suggest that the efficacy and tolerability of chrono valproate is similar to that of conventional valproate, and that the main advantage is the once-daily administration.

Early-onset absence epilepsy: clinical and electroencephalographic features in three children.

To describe the clinical and electroencephalographic features of three infants diagnosed as having early-onset absence seizures. Two males and one female, aged 21-29 months were seen in our neuropaediatric outpatient clinic because of daily episodes of motor arrest and loss of contact. Neurological examination and mental development was considered normal in all of them. Two out three had first-degree relatives with seizures with onset in the childhood and favourable evolution in the adulthood. A video-electroencephalogram was requested. Ictal EEG revealed a normal background and generalised spike-and-wave complexes at 3-3.5 Hz accompanied by disruption of ongoing activity in keeping with absence seizures. The duration of seizures ranged from 2 to 10s. One child (patient 2) experienced rhythmic myoclonic jerks in upper limbs and head as those described in myoclonic absences. Clinical and electroencephalographic follow-up ranged from 8 months to 4 years. Two children were on treatment with valproate and in the case of the patient 3, the combination of valproate and ethosuximide was necessary. Control of absence seizures was achieved in all our cases. Absence seizures should be considered as a possible cause of transient impairment of consciousness even among infants minor than 3 years of age. A video-electroencephalogram is the method of choice in the diagnostic evaluation and syndromic classification of these paroxysmal events.

Producción y purificación de anticuerpos (IgY) a partir de huevos de gallinas inmunizadas con epimastigotas de trypanosoma cruzi / Production and purification of IgY antibodies from eggs laid by hens inmunized with trypanosoma cruzi epimastigotes

No obstante las ventajas de producir anticuerpos en gallinas, no se ha reportado inducción y purificación de anticuerpos contra estadios de Trypanosoma cruzi en el modelo aviario. La inducción de anticuerpos anti-estadios de T. cruzi en gallina puede garantizar la producción de reactivos útiles en diagnóstico y terapéutica de la enfermedad de Chagas. Aquí reportamos la obtención y rápido aislamiento de IGY procedente de yema de huevos de gallinas inmunizadas contra epimastigotas de T. cruzi a los 7, 22 y 61 días post-inmunización. Se compararon tres estrategias de purificación de IgY: el método de la dilución acuosa, el método del polietilén glicol (PEG) y el método del cloroformo-PEG, respecto a un estuche comercial. El método del cloroformo-PEG dio un rendimiento de 6,4 mg/mL de proteínas de yema de huevo de 61 días con una sensibilidad tal que 7 ng de IgY detectaron 1 µg de antígeno (ELISA). Por Western blot, 5 µg/mL de IgY revelaron 11 antígenos diferentes en 8 µg de proteína total de epimastigotas. El análisis por SDS-PAGE demostró que las IgY extraídas contienen dos bandas proteícas dominantes de 70/57 y 37/35 kDa y dos tenues de 81 y 41 kDa, las cuales pueden ser eliminadas por re-precipitación con PEG. Para la extracción de IgY el método del cloroformo-polietilén glicol dio la mejor combinación por facilidad de ejecución y bajo costo. Si bien rindió 50 por ciento menos que el estuche comercial bajo las mismas condiciones, la sensibilidad de los anticuerpos fue 4 veces mayor. Estos resultados evidencian la factibilidad del modelo aviario para producir anticuerpos contra estadios de T. cruzi y muestran la experticia para purificarlos usando una tecnología local de bajo costo

Production of amastigotes from metacyclic trypomastigotes of Trypanosoma cruzi

Attempts to recreate all the developmental stages of Trypanosoma cruzi in vitro have thus far been met with partial success. It is possible, for instance, to produce trypomastigotes in tissue culture and to obtain metacyclic trypomastigotes in axenic conditions. Even though T. cruzi amastigotes are known to differentiate from trypomastigotes and metacyclic trypomastigotes, it has only been possible to generate amastigotes in vitro from the tissue-culture-derived trypomastigotes. The factors and culture conditions required to trigger the transformation of metacyclic trypomastigotes into amastigotes are as yet undetermined. We show here that pre-incubation of metacyclic trypomastigotes in culture (MEMTAU) medium at 37ºC for 48 h is sufficient to commit the parasites to the transformation process. After 72 h of incubation in fresh MEMTAU medium, 90 percent of the metacyclic parasites differentiate into forms that are morphologically indistinguishable from normal amastigotes. SDS-PAGE, Western blot and PAABS analyses indicate that the transformation of axenic metacyclic trypomastigotes to amastigotes is associated with protein, glycoprotein and antigenic modifications. These data suggest that (a) T. cruzi amastigotes can be obtained axenically in large amounts from metacyclic trypomastigotes, and (b) the amastigotes thus obtained are morphological, biological and antigenically similar to intracellular amastigotes. Consequently, this experimental system may facilitate a direct, in vitro assessment of the mechanisms that enable T. cruzi metacyclic trypomastigotes to transform into amastigotes in the cells of mammalian hosts

Early and late molecular and morphologic changes that occur during the in vitro transformation of Trypanosoma cruzi metacyclic trypomastigotes to amastigotes.

The amastigogenesis primary of T. cruzi occurs naturally when metacyclic trypomastigotes transform into amastigotes within the cells of the mammalian host. The in vitro study of the macromolecular changes that occur over several days during the transformation process should provide significant indications of how the parasite adapts to the mammalian host environment. We show here that metacyclic trypomastigotes pre-incubated at 37 degrees C in a protein-rich medium reach a high degree of transformation to amastigotes when re-incubated in the fresh medium. Giemsa-stained smears show that during the pre-incubation phase, the metacyclic trypomastigotes undergo lengthening at the posterior end and a thinning out of the entire body. SDS-PAGE analysis of polypeptides and glycopeptides or Western blot with stage-specific antisera analyses indicate that the in vitro primary amastigogenesis is associated with abrupt changes in protein, glycoprotein, and stage-specific antigens that occur simultaneously during the first 24 hours of pre-incubation. Since the differentiating system consists of a rich media at 37 degrees C, temperature and medium constitution must trigger a macromolecular differentiation to amastigotes that precedes the morphological transformation by several days. This transformation is associated with the rearrangement of stage-specific antigens and takes place when the culture medium is changed.

Production of amastigotes from metacyclic trypomastigotes of Trypanosoma cruzi.

Attempts to recreate all the developmental stages of Trypanosoma cruzi in vitro have thus far been met with partial success. It is possible, for instance, to produce trypomastigotes in tissue culture and to obtain metacyclic trypomastigotes in axenic conditions. Even though T. cruzi amastigotes are known to differentiate from trypomastigotes and metacyclic trypomastigotes, it has only been possible to generate amastigotes in vitro from the tissue-culture-derived trypomastigotes. The factors and culture conditions required to trigger the transformation of metacyclic trypomastigotes into amastigotes are as yet undetermined. We show here that pre-incubation of metacyclic trypomastigotes in culture (MEMTAU) medium at 37 degrees C for 48 h is sufficient to commit the parasites to the transformation process. After 72 h of incubation in fresh MEMTAU medium, 90% of the metacyclic parasites differentiate into forms that are morphologically indistinguishable from normal amastigotes. SDS-PAGE, Western blot and PAABS analyses indicate that the transformation of axenic metacyclic trypomastigotes to amastigotes is associated with protein, glycoprotein and antigenic modifications. These data suggest that (a) T. cruzi amastigotes can be obtained axenically in large amounts from metacyclic trypomastigotes, and (b) the amastigotes thus obtained are morphological, biological and antigenically similar to intracellular amastigotes. Consequently, this experimental system may facilitate a direct, in vitro assessment of the mechanisms that enable T. cruzi metacyclic trypomastigotes to transform into amastigotes in the cells of mammalian hosts.

Early and late molecular and morphologic changes that occur during the in vitro transformation of Trpanosoma cruzi metacyclic trypomastigotes to amastigotes

The amastigogenesis primary of T. cruzi occurs naturally when metacyclic trypomastigotes transform into amastigotes within the cells of the mammalian host. The in vitro study of the macromolecular changes that occur over several days during the transformation process should provide significant indications of how the parasite adapts to the mammalian host environment. We show here that metacyclic trypomastigotes pre-incubated at 37 degrees C in a protein-rich medium reach a high degree of transformation to amastigotes when re-incubated in the fresh medium. Giemsa-stained smears show that during the pre-incubation phase, the metacyclic trypomastigotes undergo lengthening at the posterior end and a thinning out of the entire body. SDS-PAGE analysis of polypeptides and glycopeptides or Western blot with stage-specific antisera analyses indicate that the in vitro primary amastigogenesis is associated with abrupt changes in protein, glycoprotein, and stage-specific antigens that occur simultaneously during the first 24 hours of pre-incubation. Since the differentiating system consists of a rich media at 37 degrees C, temperature and medium constitution must trigger a macromolecular differentiation to amastigotes that precedes the morphological transformation by several days. This transformation is associated with the rearrangement of stage-specific antigens and takes place when the culture medium is changed.