Interferón alfa-2a pegilado como oportunidad de tratamiento para pacientes embarazadas con leucemia mieloide crónica / Pegylated interferon alfa-2a as a treatment opportunity for pregnant patients with chronic myeloid leukemia

La leucemia mieloide crónica (LMC) es una enfermedad que puede afectar a mujeres en edad fértil con intención de tener hijos. El tratamiento estándar para esta enfermedad neoplásica son los inhibidores de tirosina quinasa (TKIs), sin embargo, no están indicados en caso de embarazo. La estrategia farmacoterapéutica idónea, es intentar una discontinuación del tratamiento en las pacientes candidatas adecuadas que lleven unos 3 años de tratamiento con TKI y al menos 2 años en respuesta molecular mayor.Se presenta el caso de una paciente de 33 años diagnosticada de LMC que, tras 3 de tratamiento con dasatinib decide tener un hijo. Se intenta una actitud terapéutica de discontinuación, pero se produce, antes de la concepción, una progresión de la enfermedad, que se logra controlar con interferón alfa-2a pegilado y se mantiene durante el embarazo. Tras el nacimiento del bebé, se reinicia tratamiento con dasatinib y se vuelve a conseguir una respuesta molecular mayor. (AU)

Chronic myeloid leukemia (CML) is a disease that can affect women of childbearing age with the intention of having children. The standard treatment for this neoplastic disease is tyrosine kinase inhibitors (TKIs), however, they are not indicated in case of pregnancy. The ideal pharmacotherapeutic strategy is to attempt discontinuation of treatment in suitable candidate patients who have undergone 3 years of TKI treatment and at least 2 years in a higher molecular response.We present the case of a 33-year-old patient diagnosed with CML who, after 3 years of treatment with dasatinib, decides to get pregnant. A therapeutic discontinuation approach is attempted, but progression of the disease occurs before conception, which is controlled by pegylated interferon alpha-2a and is maintained during pregnancy. After the baby is born, dasatinib treatment is restarted and a higher molecular response is achieved again. (AU)

A catalogue of molecular, physiological and symbiotic properties of soybean-nodulating rhizobial strains from different soybean cropping areas of China.

We have analysed 198 fast-growing soybean-nodulating rhizobial strains from four different regions of China for the following characteristics: generation time; number of plasmids; lipopolysaccharide (LPS), nodulation factors (LCOs) and PCR profiles; acidification of growth medium; capacity to grow at acid, neutral, and alkaline pH; growth on LC medium; growth at 28 and 37 degrees C; melanin production capacity; Congo red absorption and symbiotic characteristics. These unbiased analyses of a total subset of strains isolated from specific soybean-cropping areas (an approach which could be called "strainomics") can be used to answer various biological questions. We illustrate this by a comparison of the molecular characteristics of five strains with interesting symbiotic properties. From this comparison we conclude, for instance, that differences in the efficiency of nitrogen fixation or competitiveness for nodulation of these strains are not apparently related to differences in Nod factor structure.

Effect of pH and soybean cultivars on the quantitative analyses of soybean rhizobia populations.

Quantitative analyses of fast- and slow-growing soybean rhizobia populations in soils of four different provinces of China (Hubei, Shan Dong, Henan, and Xinjiang) have been carried out using the most probable number technique (MPN). All soils contained fast- (FSR) and slow-growing (SSR) soybean rhizobia. Asiatic and American soybean cultivars grown at acid, neutral and alkaline pH were used as trapping hosts for FSR and SSR strains. The estimated total indigenous soybean-rhizobia populations of the Xinjiang and Shan Dong soil samples greatly varied with the different soybean cultivars used. The soybean cultivar and the pH at which plants were grown also showed clear effects on the FSR/SSR rations isolated from nodules. Results of competition experiments between FSR and SSR strains supported the importance of the soybean cultivar and the pH on the outcome of competition for nodulation between FSR and SSR strains. In general, nodule occupancy by FSRs significantly increased at alkaline pH. Bacterial isolates from soybean cultivar Jing Dou 19 inoculated with Xinjiang soil nodulate cultivars Heinong 33 and Williams very poorly. Plasmid and lipopolysaccharide (LPS) profiles and PCR-RAPD analyses showed that cultivar Jing Dou 19 had trapped a diversity of FSR strains. Most of the isolates from soybean cultivar Heinong 33 inoculated with Xinjiang soil were able to nodulate Heinong 33 and Williams showed very similar, or identical, plasmid, LPS and PCR-RAPD profiles. All the strains isolated from Xinjiang province, regardless of the soybean cultivar used for trapping, showed similar nodulation factor (LCO) profiles as judged by thin layer chromatographic analyses. These results indicate that the existence of soybean rhizobia sub-populations showing marked cultivar specificity, can affect the estimation of total soybean rhizobia populations indigenous to the soil, and can also affect the diversity of soybean rhizobial strains isolated from soybean nodules.

Heterologous rhizobial lipochitin oligosaccharides and chitin oligomers induce cortical cell divisions in red clover roots, transformed with the pea lectin gene.

Division of cortical cells in roots of leguminous plants is triggered by lipochitin oligosaccharides (LCOs) secreted by the rhizobial microsymbiont. Previously, we have shown that presence of pea lectin in transgenic white clover hairy roots renders these roots susceptible to induction of root nodule formation by pea-specific rhizobia (C. L. Díaz, L. S. Melchers, P. J. J. Hooykaas, B. J. J. Lugtenberg, and J. W. Kijne, Nature 338:579-581, 1989). Here, we report that pea lectin-transformed red clover hairy roots form nodule primordium-like structures after inoculation with pea-, alfalfa-, and Lotus-specific rhizobia, which normally do not nodulate red clover. External application of a broad range of purified LCOs showed all of them to be active in induction of cortical cell divisions and cell expansion in a radial direction, resulting in formation of structures that resemble nodule primordia induced by clover-specific rhizobia. This activity was obvious in about 50% of the red clover plants carrying hairy roots transformed with the pea lectin gene. Also, chitopentaose, chitotetraose, chitotriose, and chitobiose were able to induce cortical cell divisions and cell expansion in a radial direction in transgenic roots, but not in control roots. Sugar-binding activity of pea lectin was essential for its effect. These results show that transformation of red clover roots with pea lectin results in a broadened response of legume root cortical cells to externally applied potentially mitogenic oligochitin signals.

[Protein quality of three strains of Mexican mushrooms (Pleurotus ostreatus)]. / Calidad proteínica de tres cepas mexicanas de setas (Pleurotus ostreatus).

The protein quality of fruits bodies of three Pleurotus ostreatus Mexican strains (INIREB-8, CDBB-H-896 and CDBB-H-897) was evaluated. The protein concentration (Nx4.38) ranged from 17.26 to 19.97 g/100 g dry weight; chemical scores were between 74 and 93% with available lysine as a first limiting amino acid in either INIREB-8 and CDBB-H-896 strains or leucine in CDBB-H-897 strain. The nutritional evaluation revealed 67.75 to 68.38% in vitro digestibility. Relative protein values were from 100.06-107.85%, which were lower than soybean meal and whole egg but larger than those of rice, maize, beans, fava beans and pasta, no differences were found between these values and those of skim milk powder, casein plus methionine and albumin. In accordance with the last results we concluded that due to their essential amino acids content, mushroom proteins are a good complement of cereals; furthermore, it is highly recommended to include Pleurotus in the daily diet.

[Chemical composition of three Mexican strains of mushrooms (Pleurotus ostratus)]. / Composición química de tres cepas mexicanas de setas (Pleurotus ostreatus).

The chemical composition of three Mexican strains of Pleurotus ostreatus (INIREB-8, CDBB-H-896 and CDBB-H-897), were determined. The mushrooms were cultivated on wheat straw in a greenhouse (22-28 degrees C temperature and 80 +/- 5% of relative humidity). Fruits bodies of P. ostreatus contained (all values are expressed in g/100 g dry wt.), protein (N x 6.25): 24.64 +/- 0.21-28.50 +/- 0.26; lipids: 1.10 +/- 0.16-1.85 +/- 0.22; mineral matter: 7.66 +/- 0.23-8.79 +/- 0.25; dietary fibre: 32.14 +/- 0.14-36.81 +/- 0.40; and available carbohydrates: 26.33 +/- 1.04-30.46 +/- 0.21. They contain vitamins (mg/100 g dry wt): riboflavin: 3.31-3.7, thiamin: 1.92-1.96, niacin: 35.98-36.56 and ascorbic acid: 28-35. The main fatty acid was linoleic (0.70-1.19 g/100 g dry wt), it was also reported a low calcium and phosphorus content. Concluding the Pleurotus ostreatus could be a source of some of the complex B vitamins, dietary fiber, protein and linoleic acid.

Sugar-Binding Activity of Pea Lectin Expressed in White Clover Hairy Roots.

Introduction of the pea (Pisum sativum L.) lectin (PSL) gene into white clover (Trifolium repens L.) hairy roots facilitates nodulation by the nitrogen-fixing bacterium Rhizobium leguminosarum biovar viciae, which normally nodulates pea and not white clover (C.L. Diaz, L.S. Melchers, P.J.J. Hooykaas, B.J.J. Lugtenberg, and J.W. Kijne [1989] Nature 338: 579-581). Here, we show that PSL is functionally expressed in transgenic white clover hairy roots transformed with the PSL gene. PSL could be isolated from these roots by affinity chromatography. Immunoanalysis of PSL showed the presence of polypeptides corresponding to the PSL precursor and its [beta] subunits. In addition, we developed a highly sensitive localization technique based on specific binding of a glycan moiety of rat IgE to PSL. Similar to the situation in pea roots, PSL appeared to be localized on the external cell surface of elongated epidermal cells and on the tips of emerging and growing root hairs of transgenic white clover hairy roots. PSL was not observed on normal white clover roots and on hairy roots without the PSL gene. These results show that (a) in transgenic white clover hairy roots, PSL is correctly processed and targeted to root cells susceptible to rhizobial infection, and (b) like in pea roots, PSL is surface bound with at least one of its two sugar-binding sites available for (rhizobial) ligands.

Sugar-binding activity of pea (Pisum sativum) lectin is essential for heterologous infection of transgenic white clover hairy roots by Rhizobium leguminosarum biovar viciae.

Legume lectin stimulates infection of roots in the symbiosis between leguminous plants and bacteria of the genus Rhizobium. Introduction of the Pisum sativum lectin gene (psl) into white clover hairy roots enables heterologous infection and nodulation by the pea symbiont R. leguminosarum biovar viciae (R.l. viciae). Legume lectins contain a specific sugar-binding site. Here, we show that inoculation of white clover hairy roots co-transformed with a psl mutant encoding a non-sugar-binding lectin (PSL N125D) with R.l. viciae yielded only background pseudo-nodule formation, in contrast to the situation after transformation with wild type psl or with a psl mutant encoding sugar-binding PSL (PSL A126V). For every construct tested, nodulation by the homologous symbiont R.l. trifolii was normal. These results strongly suggest that (1) sugar-binding activity of PSL is necessary for infection of white clover hairy roots by R.l. viciae, and (2) the rhizobial ligand of host lectin is a sugar residue rather than a lipid.

Pea (Pisum sativum L.) seed isolectins 1 and 2 and pea root lectin result from carboxypeptidase-like processing of a single gene product.

The complete amino acid sequences of the alpha-subunits of pea (Pisum sativum L.) seed and root lectin, the C-terminal amino acids of the beta-subunits of pea seed lectin, and most of the sequence of the beta-subunit of pea root lectin were determined. In contrast to earlier reports it was shown that the beta-subunits of both seed isolectins end at Asn-181. The alpha 1 subunits end at Gln-241 (major fraction) or Lys-240 (minor fraction), whereas the alpha 2 subunits end at Ser-239, Ser-238, Ser-237 or Thr-236. psl cDNA clones from seed are identical to psl cDNA clones from root, and root PSL is identical to seed PSL2, ending at Ser-239, Ser-238 or Ser-237. It seems that the presence of Lys-240 is the sole determinant of the charge difference between pea isolectins. PSL1 can be converted into PSL2 by carboxypeptidase P from Penicillium janthinellum. These results confirm that PSL from roots is encoded by the same gene as PSL from seeds. Thus, it seems that, next to an Asn-X specific protease responsible for the processing at positions 181/182 and 187/188, a carboxypeptidase is responsible for the conversion of PSL1 and PSL2, which is probably the final processing product.

Destabilization of pea lectin by substitution of a single amino acid in a surface loop.

Legume lectins are considered to be antinutritional factors (ANF) in the animal feeding industry. Inactivation of ANF is an important element in processing of food. In our study on the stability of Pisum sativum L. lectin (PSL), a conserved hydrophobic amino acid (Val103) in a surface loop was replaced with alanine. The mutant lectin, PSL V103A, showed a decrease in unfolding temperature (Tm) by some 10 degrees C in comparison with wild-type (wt) PSL, and the denaturation energy (delta H) is only about 55% of that of wt PSL. Replacement of an adjacent amino acid (Phe104) with alanine did not result in a significant difference in stability in comparison with wt PSL. Both mutations did not change the sugar-binding properties of the lectin, as compared with wt PSL and with PSL from pea seeds, at ambient temperatures. The double mutant, PSL V103A/F104A, was produced in Escherichia coli, but could not be isolated in an active (i.e. sugar-binding) form. Interestingly, the mutation in PSL V103A reversibly affected sugar-binding at 37 degrees C, as judged from haemagglutination assays. These results open the possibility of production of lectins that are active in planta at ambient temperatures, but are inactive and possibly non-toxic at 37 degrees C in the intestines of mammals.

Mutational analysis of pea lectin. Substitution of Asn125 for Asp in the monosaccharide-binding site eliminates mannose/glucose-binding activity.

As part of a strategy to determine the precise role of pea (Pisum sativum) lectin, Psl, in nodulation of pea by Rhizobium leguminosarum, mutations were introduced into the genetic determinant for pea lectin by site-directed mutagenesis using PCR. Introduction of a specific mutation, N125D, into a central area of the sugar-binding site resulted in complete loss of binding of Psl to dextran as well as of mannose/glucose-sensitive haemagglutination activity. As a control, substitution of an adjacent residue, A126V, did not have any detectable influence on sugar-binding activity. Both mutants appeared to represent normal Psl dimers with a molecular mass of about 55 kDa, in which binding of Ca2+ and Mn2+ ions was not affected. These results demonstrate that the NHD2 group of Asn125 is essential in sugar binding by Psl. To our knowledge, Psl N125D is the first mutant legume lectin which is unable to bind sugar residues. This mutant could be useful in the identification of the potential role of the lectin in the recognition of homologous symbionts.

Distribution of glucose/mannose-specific isolectins in pea (Pisum sativum L.) seedlings.

We report on the distribution and initial characterization of glucose/mannose-specific isolectins of 4- and 7-d-old pea (Pisum sativum L.) seedlings grown with or without nitrate supply. Particular attention was payed to root lectin, which probably functions as a determinant of host-plant specificity during the infection of pea roots by Rhizobium leguminosarum bv. viciae. A pair of seedling cotyledons yielded 545±49 µg of affinity-purified lectin, approx. 25% more lectin than did dry seeds. Shoots and roots of 4-d-old seedlings contained 100-fold less lectin than cotyledons, whereas only traces of lectin could be found in shoots and roots from 7-d-old seedlings. Polypeptides with a subunit structure similar to the precursor of the pea seed lectin could be demonstrated in cotyledons, shoots and roots. Chromatofocusing and isoelectric focusing showed that seed and non-seed isolectin differ in composition. An isolectin with an isoelectric point at pH 7.2 appeared to be a typical pea seed isolectin, whereas an isolectin focusing at pH 6.1 was the major non-seed lectin. The latter isolectin was also found in root cell-wall extracts, detached root hairs and root-surface washings. All non-seed isolectins were cross-reactive with rabbit antiserum raised against the seed isolectin with an isolectric point at pH 6.1. A protein similar to this acidic glucose/mannose-specific seed isolectin possibly represents the major lectin to be encountered by Rhizobium leguminosarum bv. viciae in the pea rhizosphere and at the root surface. Growth of pea seedlings in a nitrate-rich medium neither affected the distribution of isolectins nor their hemagglutination activity; however, the yield of affinity-purified root lectin was significantly reduced whereas shoot lectin yield slightly increased. Agglutination-inhibition tests demonstrated an overall similar sugar-binding specificity for pea seed and non-seed lectin. However root lectin from seedlings grown with or without nitrate supplement, and shoot lectin from nitrate-supplied seedlings showed a slightly different spectrum of sugar binding. The absorption spectra obtained by circular dichroism of seed and root lectin in the presence of a hapten also differed. These data indicate that nutritional conditions may affect the sugar-binding activity of non-seed isolectin, and that despite their similarities, seed and non-seed isolectins have different properties that may reflect tissue-specialization.

Lectin-enhanced accumulation of manganese-limited Rhizobium leguminosarum cells on pea root hair tips.

The ability of Rhizobium leguminosarum 248 to attach to developing Pisum sativum root hairs was investigated during various phases of bacterial growth in yeast extract-mannitol medium. Direct cell counting revealed that growth of the rhizobia transiently stopped three successive times during batch culture in yeast extract-mannitol medium. These interruptions of growth, as well as the simultaneous autoagglutination of the bacteria, appeared to be caused by manganese limitation. Rhizobia harvested during the transient phases of growth inhibition appeared to have a better attachment ability than did exponentially growing rhizobia. The attachment characteristics of these manganese-limited rhizobia were compared with those of carbon-limited rhizobia (G. Smit, J. W. Kijne, and B. J. J. Lugtenberg, J. Bacteriol. 168:821-827, 1986, and J. Bacteriol. 169:4294-4301, 1987). In contrast to the attachment of carbon-limited cells, accumulation of manganese-limited rhizobia (cap formation) was already in full progress after 10 min of incubation; significantly delayed by 3-O-methyl-D-glucose, a pea lectin haptenic monosaccharide; partially resistant to sodium chloride; and partially resistant to pretreatment of the bacteria with cellulase. Binding of single bacteria to the root hair tips was not inhibited by 3-O-methyl-D-glucose. Whereas attachment of single R. leguminosarum cells to the surface of pea root hair tips seemed to be similar for both carbon- and manganese-limited cells, the subsequent accumulation of manganese-limited rhizobia at the root hair tips is apparently accelerated by pea lectin molecules. Moreover, spot inoculation tests with rhizobia grown under various culture conditions indicated that differences in attachment between manganese- and carbon-limited R. leguminosarum cells are correlated with a significant difference in infectivity in that manganese-limited rhizobia, in contrast to carbon-limited rhizobia, are infective. This growth-medium-dependent behavior offers and explanation for the seemingly conflicting data on the involvement of host plant lectins in attachment of rhizobia to root hairs of leguminous plants. Sym plasmid-borne genes do not play a role in manganese-limitation-induced attachment of R. leguminosarum.

Patient medication instruction and provider interactions: effects on knowledge and attitudes.

This prospective study examines whether a patient medication instruction sheet (PMI) given to clinic patients by their health care provider affects knowledge and/or attitudes with thiazide diuretic use as part of an antihypertensive regimen. Adult male patients (N = 285) in a general medicine clinic were assigned to groups receiving the American Medical Association PMI describing their diuretic. Patients getting the PMI obtained it either directly from their provider or at the pharmacy dispensing window. All patients were surveyed by phone 1 week following the clinic visit with regard to the PMI, knowledge of medication use, and attitudes toward drug use. Results indicate that a provider-dispensed PMI results in higher levels of drug knowledge and greater patient satisfaction with their knowledge than a pharmacy-dispensed PMI. In addition, the PMIs educational value may be lessened by an incomplete verbal consult. This study demonstrates that the AMA PMI is an effective educational tool when distributed by a provider and can promote better understanding and use of prescribed medications.

Correlation between infection by Rhizobium leguminosarum and lectin on the surface of Pisum sativum L. roots.

The lectin on the surface of 4- and 5-dold pea roots was located by the use of indirect immunofluorescence. Specific antibodies raised in rabbits against pea seed isolectin 2, which crossreact with root lectins, were used as primary immunoglobulins and were visualized with fluorescein- or tetramethylrhodamine-isothiocyanate-labeled goat antirabbit immunoglobulin G. Lectin was observed on the tips of newly formed, growing root hairs and on epidermal cells located just below the young hairs. On both types of cells, lectin was concentrated in dense small patches rather than uniformly distributed. Lectin-positive young hairs were grouped opposite the (proto)xylematic poles. Older but still-elongating root hairs presented only traces of lectin or none at all. A similar pattern of distribution was found in different pea cultivars, as well as in a supernodulating and a non-nodulating pea mutant. Growth in a nitrate concentration which inhibits nodulation did not affect lectin distribution on the surface of pea roots of this age. We tested whether or not the root zones where lectin was observed were susceptible to infection by Rhizobium leguminosarum. When low inoculum doses (consisting of less than 10(6) bacteria·ml(-1)) were placed next to lectin-positive epidermal cells and on newly formed root hairs, nodules on the primary roots were formed in 73% and 90% of the plants, respectively. Only a few plants showed primary root nodulation when the inoculum was placed on the root zone where lectin was scarce or absent. These results show that lectin is present at those sites on the pea root that are susceptible to infection by the bacterial symbiont.

An enzyme-linked lectin binding assay for quantitative determination of lectin receptors.

An enzyme-linked lectin binding assay (ELBA) has been developed for the detection of soluble lectin binding substances (receptors) and the determination of their relative affinity for the lectin. The assay is based on competitive binding to enzyme-labeled lectin of a known lectin receptor, bound to a solid phase, and unknown sample receptors. In this paper the assay is exemplified with the mannose/glucose-specific pea lectin, with the glycoprotein ovalbumin as its receptor, and with horseradish peroxidase (EC 1.11.1.7) as the enzyme used for labeling. Also a method was developed for the preparation of peroxidase-labeled lectin. Labeling was started by mixing equimolar amounts of lectin and periodate-oxidized enzyme at pH 4.5 at a final concentration of 10(-4)M, after which conjugation was started by raising the pH to 9.5. This resulted in complete conjugation, after which the product could be diluted 50-500 times for application in ELBA. For the ELBA ovalbumin was adsorbed onto polystyrene microtiter plates. Sample receptors, added together with the enzyme-labeled lectin, inhibited binding of the latter to ovalbumin. Bound enzyme activity was colorimetrically determined after addition of o-phenylenediamine. Relative lectin affinity (KL) was expressed as (formula; see text) in which [X]50% is the concentration of sample receptor necessary to inhibit 50% of the binding of a certain amount of lectin, and [M]50% is the concentration of D-mannose necessary to inhibit 50% binding of the same amount of lectin. With this technique lectin affinity of both monovalent and polyvalent lectin binding substances can be estimated: low KL values mean high lectin affinity.

Determination of pea (Pisum sativum L.) root lectin using an enzyme-linked immunoassay.

Root lectins are believed to participate in the recognition between Rhizobium and its leguminous host plant. Among other factors, testing this hypothesis is difficult because of the very low amounts in which root lectins are produced. A double-antibody-sandwich enzyme-linked immunoassay, was used to determine nanogram quantities of pea lectin in root slime and salt extracts of root cell-wall material when pea seedlings were 4 and 7 d old. In addition, a critical NO 3 (-) concentration (20 mM) which inhibited nodulation was found, and the lectin present in root slime and salt extracts of root cell walls of 4- and 7-d-old peas supplied with 20 mM NO 3 (-) was comparatively determined. With the enzyme-linked immunoassay, lectin quantities ranging between 20 and 100 nanograms could be determined. The assay is not affected by monomeric mannose and glucose (pealectin haptens). The slime of the 4-d-old roots contained more lectin than the slime of the 7-d-old roots. Salt-extractable, cell-wall-associated lectin accumulated in the older roots. Nitrate affected slime and cell-wall production, and the extractability of cell-wall material in both age groups. The presence of NO 3 (-) increased lectin in the slime, most notably in the younger roots; the relative amount of lectin in the slime was almost doubled. The cell-wall-associated, salt-extractable lectin decreased two- to threefold compared with the control group.

[Arterial pressure in children from 4 to 18 years old]. / Tensión arterial en niños de 4 a 18 años.

The arterial blood pressure values and the evolutive pattern of a normal middle class children population of both sexes between 4 to 18 years of age are reported. The findings are discussed.