Biofilm penetration, triggered release and in vivo activity of inhaled liposomal amikacin in chronic Pseudomonas aeruginosa lung infections.

OBJECTIVES: Chronic infections of Pseudomonas aeruginosa in the lungs of cystic fibrosis patients are intractable antibiotic targets because of their biofilm mode of growth. We have investigated the biofilm penetration, mechanism of drug release and in vivo antimicrobial activity of a unique nanoscale liposomal formulation of amikacin designed specifically for nebulization and inhaled delivery. METHODS: Penetration of fluorescently labelled liposomes into sputum or P. aeruginosa (PA3064) biofilms was monitored by a filter assay and by epifluorescence or confocal scanning laser microscopy. Amikacin release in vitro and rat lung levels after inhalation of nebulized material were measured by fluorescence polarization immunoassay. A 14 day agar bead model of chronic Pseudomonas lung infection in rats was used to assess the efficacy of liposomal amikacin versus free aminoglycosides in the reduction of bacterial count. RESULTS: Fluorescent liposomes penetrated readily into biofilms and infected mucus, whereas larger (1 microm) fluorescent beads did not. Amikacin release from liposomes was mediated by sputum or Pseudomonas biofilm supernatants. Rhamnolipids were implicated as the major releasing factors in these supernatants, active at one rhamnolipid per several hundred lipids within the liposomes. Inhaled liposomal amikacin was released in a slow, sustained manner in normal rat lungs and was orders of magnitude more efficacious than inhaled free amikacin in infected lungs. CONCLUSIONS: Penetration of biofilm and targeted, sustained release from liposomes can explain the superior in vivo efficacy of inhaled liposomal amikacin versus free drug observed in a 14 day infection model. Inhaled liposomal amikacin may represent an important therapy for chronic lung infections.

Metabolic fate of a large amount of 13C-glycerol ingested during prolonged exercise.

We have shown that the oxidation rate of exogenous glycerol and glucose during prolonged exercise were similar when ingested in small amounts (0.36 g/kg) (J Appl Physiol 90:1685,2001). The oxidation rate of exogenous carbohydrate increases with the amount ingested. We, thus, hypothesized that the oxidation rate of exogenous glycerol would also be larger when ingested in large amount. The study was conducted on six male subjects exercising for 120 min at 64 (2)% VO(2)max while ingesting 1 g/kg of (13)C-glycerol. Substrate oxidation was measured using indirect respiratory calorimetry corrected for protein oxidation, and from V(13)CO(2) at the mouth. The (13)C enrichment of plasma glucose was also measured in order to follow the possible conversion of (13)C-glycerol into glucose. In spite of the large amount of glycerol ingested and absorbed (plasma glycerol concentration = 8.0 (0.3) mmol/l at min 100), exogenous glycerol oxidation over the last 80 min of exercise [8.8 (1.6) g providing 4.1 (0.7)% of the energy yield] was similar to that observed when 0.36 g/kg was ingested. The comparison between the (13)C enrichment of plasma glucose and the oxidation rate of (13)C-glycerol showed that a portion of exogenous glycerol was converted into glucose before being oxidized, but also suggested that another portion could have been directly oxidized in peripheral tissues.

[Ultrasound-guided vacuum-assisted biopsy: review of 382 cases]. / Macrobiopsies assistées par le vide sous guidage échographique: à propos de 382 cas.

PURPOSE: To evaluate the use of US-guided vacuum biopsy for diagnosis and treatment of probably benign breast masses. MATERIALS AND METHOD: Retrospective review of 382 US guided vacuum biopsies over a 44 months period (september 2001 to may 2005) with the 11-g handheld mammotome. A total of 308 benign tumors, 59 borderline lesions and 15 carcinomas were diagnosed. The average number of specimens is 13.1 (3-37). Surgical resection has been systematic for carcinomas and selective for papillomas. Surgical correlation (n:35) or mammographic follow-up (n:347) are presented. RESULTS: Complete removal occurred in 371/382 (97.1%) immediately after biopsy and 337/382 (88.2%) after one month: 138/142 (93.7%) for fibroadenomas and 52/53 (98.1%) papillomas less than 15 mm. Open surgical biopsy was carried out for 35 patients on the basis of incomplete removal (3 cases) or histologic findings (8 invasive carcinomas, 7 ductal carcinoma in situ, 3 atypical ductal hyperplasia, 1 fibrocystic changes with atypia and 11 papillomas). No lesion was under-diagnosed and the rate of avoided surgery was 94.5%. Of the 347 lesions that were not surgically biopsied (42 borderline lesions and 305 benign lesions), 337 were monitored at 1-43 months (average: 20 months, > or =24 months: 57 patients). Ten underwent additional biopsy but no missed cancer was detected. Patients tolerance was good or very good in 83%, and the complication rate was 1.3%. CONCLUSION: US-guided vacuum biopsy is an accurate and well tolerated technique. It is an alternative to surgery for masses less than 15 mm including fibroadenomas and papillomas or in patients with imaging-histologic discordance at core biopsy.

[Underestimation of breast carcinoma with 11-gauge stereotactically guided directional vacuum-assisted biopsy]. / Sous-estimation du cancer du sein par les macrobiopsies stéréotaxiques 11-gauge assistées par le vide.

PURPOSE: To assess the reliability of vacuum-assisted biopsy in diagnosing and managing atypical ductal hyperplasia and ductal carcinoma in situ of the breast. MATERIALS AND METHOD: Retrospective review of 2130 stereotactic large-core biopsies in 1638 patients over a 40 month period (January 2000 to May 2003) using the mammotome 11-gauge and a dedicated Fischer table. A total of 135 cases of atypical ductal hyperplasia and 322 cases of ductal carcinoma in situ were diagnosed. The average number of cores was 18 (5-64). Surgical resection was systematic for carcinomas and selective for atypical ductal hyperplasia. Correlation with surgical findings (n:356) or mammographic follow-up (n:98) is presented. The influence of various factors on the risk of underestimation was analyzed. RESULTS: Resection revealed an underestimation of 10/37 (27%) for atypical ductal hyperplasia. It was lower (9%) when the radiological lesion had completely disappeared. Underestimation of ductal carcinoma in situ was 12/319 (3.8%). It was higher for masses, high-grade lesions or with micro-infiltration, or in the case where the peripheral edge was affected. Of the 98 atypical ductal hyperplasia that were not surgically biopsied, 81 were monitored at 9-42 months (average: 29 months). Sixteen underwent repeat biopsy: two infiltrating lobular carcinomas were detected in the same area. CONCLUSION: Underestimation of atypical ductal hyperplasia was high, justifying systematic surgical resection. Underestimation of ductal carcinoma in situ and its practical consequences are not significant with the extension of sentinel lymphadenectomy to the wide high-grade lesions or with micro-infiltration.

Binding of anionic phospholipids to retinal pigment epithelium may be mediated by the scavenger receptor CD36.

The specific recognition of negatively charged phospholipids in cell membranes has been suggested to play an important role in a variety of physiological and pathophysiological processes. Recent work (Rigotti, A., Acton, S. L., and Krieger, M. (1995) J. Biol. Chem. 270, 16221-16224) has described specific and tight binding of anionic phospholipids, such as phosphatidylserine (PS) and phosphatidylinositol (PI), to the class B scavenger receptors, CD36 and SR-B1. We have previously reported that CD36 is present on retinal pigment epithelium (RPE) and plays a role in the phagocytosis of photoreceptor outer segments (ROS), a function critical to the normal visual process (Ryeom, S. W., Sparrow, J. R., and Silverstein, R. L. (1996) J. Cell Sci. 109, 387-395). We now report that phospholipid liposomes PS and PI, but not phosphatidylethanolamine, bind specifically to RPE. Cross-competition experiments suggest that PS and PI recognize the same receptor on RPE, while immunoinhibition studies indicate that the receptor is CD36. RPE cells isolated from a mutant rat strain, the RPE of which does not express CD36 ( Sparrow, J. R., Ryeom, S. W. , Abumrad, N., Ibrahimi, A., and Silverstein, R. L. (1996) Exp. Eye Res., in press), did not bind PS or PI, further confirming the role of CD36. We also showed that purified ROS blocked binding and uptake of anionic phospholipid liposomes by RPE and that PS and PI liposomes blocked ROS uptake by RPE, suggesting that PS and PI on the ROS membrane may be the ligands on ROS recognized by CD36. This is the first demonstration that CD36-phospholipid interactions may play a role in normal physiology.

Interactions of retinol with lipid bilayers: studies with vesicles of different radii.

The interactions of retinol with vesicles of dioleoylphosphatidylcholine of varying radii were studied. The rate constants of dissociation of retinol from bilayers (k(off)) and the equilibrium partition constants (Keq) of retinol into bilayers of different sized vesicles were measured. The rate constants for association of retinol with vesicles were calculated from the expression Keq = k(on)/k(off). k(off) was 10-fold faster in the smallest versus the largest vesicles tested. K(on) was also somewhat faster in vesicles with small radii, but the effect on k(off) was more pronounced, leading to an overall higher affinity for retinol of bilayers in large vesicles. The thermodynamic parameters of the dissociation reaction were studied in vesicles with 0.025, 0.1, and 0.4 microns diameter. The enthalpy of activation decreased while the entropy of activation of the dissociation of retinol from bilayers increased as the vesicles become larger. It is suggested that restructuring of lipid-lipid interactions within the bilayer play a role in determining the rate by which retinol is solvated off bilayers. Overall, the data indicate that the rates by which retinol moves between different cell types in vivo may depend on the geometry of cellular surfaces.

Spontaneous incorporation of bacteriorhodopsin into large preformed vesicles.

Bacteriorhodopsin, either as purple membrane sheets or as detergent-solubilized protein, was found to incorporate spontaneously into both large unilamellar vesicles (LUVs) and sized multilamellar vesicles (MLVs) under either gel-phase or liquid-phase conditions. These results were obtained with LUVs of various lipid compositions, including dimyristoylphosphatidylcholine (DMPC), DMPC and cholesterol, dioleoylphosphatidylcholine (DOPC), and DOPC and cholesterol. The lipid to protein (L/P) ratio of all proteoliposomes arising from these preformed vesicles continually increased in the presence of protein-free vesicles. Under fluid-phase conditions, the mixing of LUVs of DMPC with proteoliposomes showed vesicle growth independent of lipid concentration, suggesting that growth was due to lipid transfer. However, under gel-phase conditions a more rapid, concentration-dependent increase in the L/P ratio of the proteoliposome was observed, suggesting that growth occurred by a mechanism other than lipid transfer from vesicles to proteoliposomes. The use of the proteoliposome as an artificial lipid-protein membrane model is discussed.

Effect of proteins on fluorophore lifetime heterogeneity in lipid bilayers.

The effect of three different membrane proteins on the fluorescence lifetime heterogeneity of 1,6-diphenyl-1,3,5-hexatriene (DPH) in phospholipid vesicle systems was investigated. For large unilamellar vesicles of dimyristoylphosphatidylcholine (DMPC) and 1-palmitoyl-2-oleoylphosphatidylcholine (POPC) at 37 degrees C, the fluorescence decay was essentially monoexponential (8.6 and 8.2 ns, respectively) except for a minor component typical of DPH. For gramicidin D reconstituted into DMPC vesicles at a protein/lipid molar ratio of 1/7, the most appropriate analysis of the data was found to be in the form of a bimodal Lorentzian distribution. Centers of the major lifetime components were almost identical with those recovered for vesicles without proteins, while broad distributional widths of some 4.0 ns were recovered. Variation of the protein/lipid molar ratio in sonicated POPC vesicles revealed an abrupt increase in distributional width at ratios approximating 1/15-1/20, which leveled off at about 2.5 ns. For bacteriorhodopsin in DMPC vesicles and cytochrome b5 in POPC, the most appropriate analysis of the data was again found to be in the form of a bimodal Lorentzian also with broad distributional widths in the major component. Lifetime centers were decreased for these proteins due to fluorescence energy transfer to the retinal of the bacteriorhodopsin and heme of the cytochrome b5. Fluorescence energy transfer is distance dependent, and since a range of donor-acceptor distances would be expected in a membrane, lifetime distributions should therefore be recovered independently of other effects for proteins possessing acceptor chromophores.(ABSTRACT TRUNCATED AT 250 WORDS)

Reconstitution of membrane proteins. Spontaneous incorporation of integral membrane proteins into preformed bilayers of pure phospholipid.

The spontaneous reconstitution of lipid-protein complexes was examined by mixing bacteriorhodopsin or UDP-glucuronosyltransferase with preformed, unilamellar bilayers of pure dimyristoylphosphatidylcholine. Spontaneous insertion of these proteins into vesicles of dimyristoylphosphatidylcholine was facilitated by resonicating the vesicles at 4 degrees C. The property of resonicated vesicles that led to spontaneous reconstitution could be annealed by melting the bilayers, which slowed down reconstitution. The overall process of reconstitution consisted, however, of two steps. There was an initial insertion of proteins into a small portion of vesicles followed by subsequent fusion between protein-free vesicles and vesicles containing lipid-protein complexes. The first step appeared to proceed rapidly in all vesicles in a gel phase, whether or not they were resonicated or whether or not resonicated vesicles were annealed. The rate of the second step was sensitive to these treatments. The membrane proteins also inserted into preformed vesicles in a liquid crystalline phase, but this step was slower than for vesicles in a gel phase. Fusion between protein-free and protein-containing vesicles in a liquid crystalline phase was extremely slow. The data show that the spontaneous insertion of pure membrane proteins into preformed vesicles can be a facile event and that the overall reconstitution of membrane proteins into preformed unilamellar vesicles may be simpler to achieve than has been appreciated.

Effects of nootropic drugs in a scopolamine-induced amnesia model in mice.

Scopolamine (3 mg/kg IP) given before an acquisition trial, reduced the retention of a one-trial passive avoidance "step through" response in mice. A single administration of cholinergic agonists such as oxotremorine, BM-5, or arecoline, antagonized this amnesic effect of scopolamine. A significant anti-amnesic effect was also found with nootropic drugs such as piracetam and ucb L059, whereas ucb L060 (the enantiomer of ucb L059), oxiracetam and rolziracetam were shown to be ineffective. Moreover, ucb L059, administered twice daily for 3 days, counteracted the amnesic effects of scopolamine completely, whereas ucb L060 was again inactive. The results demonstrate that: (a) this model of impaired cognition by scopolamine is able to discriminate between closely related chemical substances and even stereoisomers; and (b) nootropic drugs, such as ucb L059, are more effective after repeated rather than after acute administration.

Reconstitution of membrane proteins: sequential incorporation of integral membrane proteins into preformed lipid bilayers.

Several integral membrane proteins can be inserted sequentially into preformed unilamellar vesicles (ULV's) composed of dimyristoylphosphatidylcholine (DMPC) and cholesterol in a gel phase. Thus, proteoliposomes of DMPC, cholesterol, and bacteriorhodopsin from Halobacterium halobium rapidly incorporate UDPglucuronosyltransferase (EC 2.4.1.17) from pig liver microsomes, cytochrome oxidase from beef heart mitochondria, and additional bacteriorhodopsin, added sequentially. This process of spontaneous incorporation can be regulated to produce complex artificial membranes that contain phospholipids and proteins at ratios (mol/mol) equivalent to what is found in biological membranes. The ability of the lipid-protein bilayers to incorporate additional integral membrane proteins is not affected by annealing of the proteoliposomes at 37 degrees C nor by the order of addition of the proteins. Bacteriorhodopsin-containing vesicles formed by the sequential addition of integral membrane proteins demonstrate light-driven proton pumping. Therefore, they have retained a vesicular structure. Vesicles containing one or two different proteins will fuse with each other at 21 degrees C or with ULV's devoid of proteins. Incorporation of bacteriorhodopsin or UDPglucuronosyltransferase into proteoliposomes containing DMPC, with or without cholesterol as impurity, also occurs above the phase transition for DMPC. The presence of a protein in a liquid-crystalline bilayer provides the necessary condition for promoting the spontaneous incorporation of other membrane proteins into preformed bilayers.

Reconstitution of membrane proteins: catalysis by cholesterol of insertion of integral membrane proteins into preformed lipid bilayers.

The presence of cholesterol in small unilamellar vesicles (ULV) of dimyristoylphosphatidylcholine (DMPC) catalyzes fusion of the vesicles at temperatures below the upper limit for the gel to liquid-crystalline phase transition of the DMPC. The extent to which ULV grow depends on the concentration of cholesterol in the vesicles and on temperature. Maximum growth occurs at 21 degrees C. It decreases as the temperature is lowered below 21 degrees C. Growth does not occur at temperatures above the phase transition. In addition, the presence of cholesterol in ULV of DMPC catalyzes the insertion of integral membrane proteins into the vesicles. Thus, bacteriorhodopsin from Halobacterium halobrium, UDPglucuronosyltransferase (EC 2.4.1.17) from pig liver microsomes, and cytochrome oxidase from beef heart mitochondria formed stable lipid-protein complexes spontaneously when added to ULV containing cholesterol at temperatures under which these vesicles would fuse. Incorporation of these proteins into the ULV of DMPC did not occur in the absence of cholesterol or in the presence of cholesterol when the temperature of the system was above that for the phase transition. It appears that cholesterol lowers the energy barrier for fusion of ULV of DMPC and for insertion of integral membrane proteins into these bilayers. Studies with bacteriorhodopsin suggest that the energy barrier for insertion of proteins into ULV containing cholesterol is smaller than the energy barrier for fusion of the ULV with each other.

Reconstitution of membrane proteins. Spontaneous association of integral membrane proteins with preformed unilamellar lipid bilayers.

We have developed a simple method for reconstituting pure, integral membrane proteins into phospholipid-protein vesicles. The method does not depend on use of detergents or sonication. It has been used successfully with three different types of integral membrane proteins: UDPglucuronosyltransferase (EC 2.4.1.17) from pig liver microsomes, cytochrome oxidase (EC 1.9.3.1) from pig heart, and bacteriorhodopsin from Halobacterium halobium. The method depends on preparing unilamellar vesicles of dimyristoylphosphatidylcholine (DMPC) that contain a small amount of myristate as fusogen. Under conditions that the vesicles of DMPC have the property of fusing, all of the above proteins incorporated into bilayers. Two events appear to be involved in forming the phospholipid-protein complexes. The first is a rapid insertion of all proteins into a small percentage of total vesicles. The second is slower but continued fusion of the remaining phospholipid-protein vesicles, or proteoliposomes, with small unilamellar vesicles of DMPC. This latter process was inhibited by conditions under which vesicles of DMPC themselves would not fuse. On the basis of proton pumping by bacteriorhodopsin and negative staining, the vesicles were unilamellar and large. The data suggest that insertion of the above integral membrane proteins into vesicles occurred independently of fusion between vesicles.

Pyridoxal phosphate protects against an irreversible temperature-dependent inactivation of hepatic delta-aminolevulinic acid synthase.

The stability of hepatic delta-aminolevulinic acid synthase (ALAS), the first and rate-limiting enzyme of the heme biosynthetic pathway, was investigated. Incubation of the mitochondrial matrix fraction obtained from either control or allylisopropylacetamide-induced rats at 37 degrees C in Tris-Cl, pH 7.4, EDTA, and dithiothreitol resulted in a rapid decrease in ALAS activity such that 50-70% of the activity was lost after 30 min. Similar decreases in ALAS activity were observed when a cytosolic fraction from the induced animals was incubated at 37 degrees C. Addition of 0.1 mM pyridoxal-P, the cofactor of ALAS, to the preincubation medium completely prevented the observed loss of activity; however, dialysis of the inactive matrix fraction against several changes of buffer containing pyridoxal-P did not restore activity, suggesting that the inactivation was irreversible. These decreases in ALAS activity in the absence of pyridoxal-P were temperature dependent, as a 55% loss of ALAS activity was observed after a 60-min incubation at 30 degrees C, while the enzyme was completely stable when preincubated at 22 degrees C for 60 min. This inactivation of ALAS does not appear to involve proteolytic digestion, as addition of a wide spectrum of protease inhibitors to the preincubation medium in the absence of pyridoxal-P did not protect against the inactivation. The suggestion is made that the cofactor, pyridoxal-P, may dissociate from the enzyme during the preincubation and, consequently, the apoenzyme may be irreversibly inactivated at temperatures above 22 degrees C.

Aging-related decreases in hepatic mitochondrial and cytosolic delta-aminolevulinic acid synthase during experimental porphyria.

The basal- and allylisopropylacetamide-induced activities of the first enzyme of heme biosynthesis, delta-aminolevulinic acid synthase (ALAS) were measured in hepatic mitochondria and cytosol of young, adult, and aged Fisher 344 rats. The total cellular ALAS activity induced by allylisopropylacetamide decreased 67% with age. The specific activity of mitochondrial ALAS in normal and induced animals decreased with aging when assayed in whole or broken mitochondria. The levels of ALAS which accumulated in the cytosol after allylisopropylacetamide administration were proportionally greater in both the young and senescent than in the mature animals. During aging, no evidence for a fragile population of mitochondria in either normal or induced animals was observed suggesting that mitochondrial matrix proteins are not released during homogenization. The hepatic mitochondrial content decreased during aging when calculated using both a membrane-bound marker enzyme cytochrome oxidase and a matrix marker enzyme citrate synthase and was unaffected by allylisopropylacetamide treatment. This reduced mitochondrial content further diminishes the level of functional ALAS available in the liver during senescence. This study confirms the age-dependent decrease in mitochondria ALAS in normal and induced animals and also suggests an age-related change in the process by which cytosolic ALAS is translocated into the mitochondria.

Topography of brain electrical activity: a bioengineering approach.

The aim of this work is to describe a system for the mono- and bi-dimensional analysis of brain electrical activity. The analysis was carried on either by visual inspection of mono- and bi-dimensional data, or by automatic feature extraction from the bidimensional data. Because of the importance of visual inspection for the analysis of experimental data, particular care was devoted to optimize the displayed data perceptually. For automatic screening of large amounts of data (and to allow long term studies of clinical records), statistical facilities were also provided. One purpose of the system was to develop image processing algorithms oriented toward biomedical images, that could be easily implemented on special purpose, low cost hardware, like VLSI or microcomputer arrays. This was possible because of the modularity of the larger part of bidimensional processing, such as interpolation and statistical analysis. Results of an experiment on Visual Evoked Response are presented, showing that through abidimensional analysis of the recorded data the resolution achievable in the localization of brain electrical activity can be increased to less than 1 cm.