Influence of the resistance training on heart rate variability, functional capacity and muscle strength in the chronic obstructive pulmonary disease

Background. The chronic obstructive pulmonary disease (COPD) is associated with the strength and resistance decreasing in addition to the dysfunction on autonomic nervous system (ANS). The aerobic training isolated or in association with the resistance training showed evidence of beneficial effects on an autonomic modulation of COPD; however, there are no studies addressing the effect of isolated resistance training.Aims. This study aims at investigating the influence of resistance training on an autonomic modulation through heart rate variability (HRV), functional capacity and muscle strength in individuals with COPD.Design. Clinical series study.Setting. Outpatients.Population. The study involved 13 individuals with COPD.Methods. The experimental protocol was composed by an initial and final evaluation that consisted in autonomic evaluations (HRV), cardiopulmonary functional capacity evaluation (6-minute walk test) and strength evaluation (dynamometry) in addition by the resistance training performed by 24 sessions lasted 60 minutes each one and on a frequency of three times a week. The intensity was determined initially with 60% of one maximum repetition and was progressively increased in each five sessions until 80%.Results. The HRV temporal and spectral indexes analysis demonstrates improvement of autonomic modulation, with significant statistical increases to sympathetic and parasympathetic components of ANS representing by SDNN, LF and HF. In addition, it was observed significant statistical increases to shoulder abduction and. knee flexion strength and functional capacity.Conclusion. The exclusive resistance training performed was able to positively influence the autonomic modulation; in addition it promoted benefits on cardiorespiratory functional capacity and strength benefits in individuals with COPD.Clinical Rehabilitation Impact. This study could contribute to clinical and professionals researchers that act with COPD, even though the resistance component of pulmonary rehabilitation presents consensual benefits on several healthy indicators parameters. There is no evidence about the effects on HRV before. Moreover, this study showed, on clinical practice, the HRV uses as an ANS activity on sinus node evaluation and highlights further importance on scientific context.

Ivabradine: Just another New Pharmacological Option for Heart Rate Control?

Ivabradine (IVB) is a heart rate lowering agent that acts via selective inhibition of the pacemaker funny current in sinoatrial nodal P cells, thus, reducing heart rate at rest and during exercise with minimal effect on myocardial contractility, blood pressure, and intracardiac conduction. IVB exerts no effect on external respiratory function parameters and it may also play a role in patients with concurrent chronic obstructive pulmonary disease. This property constitutes an important advantage over β-blockers. IVB acts by reducing the heart rate in a mechanism different from β-blockers, calcium channel blockers or late sodium channel blockers, three commonly prescribed antianginal drugs. As clinical trials have shown, it is remarkably well-tolerated and offers an alternative for patients who cannot take β-blockers. The combination of IVB and atenolol at commonly used doses in patients with chronic stable angina produced additional efficacy with no untoward effect on safety or tolerability. Additionally, side effects are rare and largely limited to a luminous phenomenon or phosphenes. This sensation is thought to be due to a block of Ih in the retina, a current very similar to cardiac If channels. IVB is contraindicated in patients with sick sinus syndrome or sinus node dysfunction and in patients taking hepatic inhibitors of Cytochrome P450 family 3, subfamily A, polypeptide 4 (abbreviated CYP3A4), with exception of omeprazole or lansoprazole. This review briefly summarizes the main studies regarding this drug.

Modelagem computacional das túnicas cardíacas para processamento e controle de qualidade

This paper considers a study of the anatomical features of the cardiac system and a three-dimensional model of the different tunics that comprise the heart wall, for processing and quality control of radiological images. The structures are built by the layer overlapping method, where a layer can be understood as a slice of the three-dimensional object. The pericardium, myocardium and endocardium were represented with three-dimensional cylinders and hexagons. The spatial arrangement of the cardiac system is determined by an background image of a real model, which values are defined according to the shape of the region and on the anatomical patients characteristics. The results are significant, considering the anatomical structures details, as well as the representation of the thicknesses of the regions of the heart wall. The validation of the anatomical model was accomplished through comparisons with dimensions obtained from a real model and allows verifying that the model is appropriate. The degree of representation will allow the verification of the influence of radiological parameters, morphometric peculiarities and stage of the diseases on the quality of the images, as well as on the performance of the Computer-Aided Diagnosis (CAD).

Respostas da frequência cardíaca ao teste de 1RM e da modulação autonômica da frequência cardíaca no período de recuperação em indivíduos com fatores de risco para doenças cardiovasculares

Pós-graduação em Desenvolvimento Humano e Tecnologias - IBRC

Avaliação de contaminação com óleo diesel por meio dos métodos de Eletrorresistividade e Polarização Induzida em Santa Ernestina-SP

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

A Comparative Wet Collapse Buckling Study for the Carcass Layer of Flexible Pipes

When there is a failure on the external sheath of a flexible pipe, a high value of hydrostatic pressure is transferred to its internal plastic layer and consequently to its interlocked carcass, leading to the possibility of collapse. The design of a flexible pipe must predict the maximum value of external pressure the carcass layer can be subjected to without collapse. This value depends on the initial ovalization due to manufacturing tolerances. To study that problem, two numerical finite element models were developed to simulate the behavior of the carcass subjected to external pressure, including the plastic behavior of the materials. The first one is a full 3D model and the second one is a 3D ring model, both composed by solid elements. An interesting conclusion is that both the models provide the same results. An analytical model using an equivalent thickness approach for the carcass layer was also constructed. A good correlation between analytical and numerical models was achieved for pre-collapse behavior but the collapse pressure value and post-collapse behavior were not well predicted by the analytical model. [DOI: 10.1115/1.4005185]

Hero's journey in bifurcation diagram

The hero's journey is a narrative structure identified by several authors in comparative studies on folklore and mythology. This storytelling template presents the stages of inner metamorphosis undergone by the protagonist after being called to an adventure. In a simplified version, this journey is divided into three acts separated by two crucial moments. Here we propose a discrete-time dynamical system for representing the protagonist's evolution. The suffering along the journey is taken as the control parameter of this system. The bifurcation diagram exhibits stationary, periodic and chaotic behaviors. In this diagram, there are transition from fixed point to chaos and transition from limit cycle to fixed point. We found that the values of the control parameter corresponding to these two transitions are in quantitative agreement with the two critical moments of the three-act hero's journey identified in 10 movies appearing in the list of the 200 worldwide highest-grossing films. (C) 2011 Elsevier B.V. All rights reserved.

Modellazione multibody di veicoli ferroviari: sviluppo ed implementazione di modelli innovativi per l'analisi del contatto ruota - rotaia

The wheel - rail contact analysis plays a fundamental role in the multibody modeling of railway vehicles. A good contact model must provide an accurate description of the global contact phenomena (contact forces and torques, number and position of the contact points) and of the local contact phenomena (position and shape of the contact patch, stresses and displacements). The model has also to assure high numerical efficiency (in order to be implemented directly online within multibody models) and a good compatibility with commercial multibody software (Simpack Rail, Adams Rail). The wheel - rail contact problem has been discussed by several authors and many models can be found in the literature. The contact models can be subdivided into two different categories: the global models and the local (or differential) models. Currently, as regards the global models, the main approaches to the problem are the so - called rigid contact formulation and the semi – elastic contact description. The rigid approach considers the wheel and the rail as rigid bodies. The contact is imposed by means of constraint equations and the contact points are detected during the dynamic simulation by solving the nonlinear algebraic differential equations associated to the constrained multibody system. Indentation between the bodies is not permitted and the normal contact forces are calculated through the Lagrange multipliers. Finally the Hertz’s and the Kalker’s theories allow to evaluate the shape of the contact patch and the tangential forces respectively. Also the semi - elastic approach considers the wheel and the rail as rigid bodies. However in this case no kinematic constraints are imposed and the indentation between the bodies is permitted. The contact points are detected by means of approximated procedures (based on look - up tables and simplifying hypotheses on the problem geometry). The normal contact forces are calculated as a function of the indentation while, as in the rigid approach, the Hertz’s and the Kalker’s theories allow to evaluate the shape of the contact patch and the tangential forces. Both the described multibody approaches are computationally very efficient but their generality and accuracy turn out to be often insufficient because the physical hypotheses behind these theories are too restrictive and, in many circumstances, unverified. In order to obtain a complete description of the contact phenomena, local (or differential) contact models are needed. In other words wheel and rail have to be considered elastic bodies governed by the Navier’s equations and the contact has to be described by suitable analytical contact conditions. The contact between elastic bodies has been widely studied in literature both in the general case and in the rolling case. Many procedures based on variational inequalities, FEM techniques and convex optimization have been developed. This kind of approach assures high generality and accuracy but still needs very large computational costs and memory consumption. Due to the high computational load and memory consumption, referring to the current state of the art, the integration between multibody and differential modeling is almost absent in literature especially in the railway field. However this integration is very important because only the differential modeling allows an accurate analysis of the contact problem (in terms of contact forces and torques, position and shape of the contact patch, stresses and displacements) while the multibody modeling is the standard in the study of the railway dynamics. In this thesis some innovative wheel – rail contact models developed during the Ph. D. activity will be described. Concerning the global models, two new models belonging to the semi – elastic approach will be presented; the models satisfy the following specifics: 1) the models have to be 3D and to consider all the six relative degrees of freedom between wheel and rail 2) the models have to consider generic railway tracks and generic wheel and rail profiles 3) the models have to assure a general and accurate handling of the multiple contact without simplifying hypotheses on the problem geometry; in particular the models have to evaluate the number and the position of the contact points and, for each point, the contact forces and torques 4) the models have to be implementable directly online within the multibody models without look - up tables 5) the models have to assure computation times comparable with those of commercial multibody software (Simpack Rail, Adams Rail) and compatible with RT and HIL applications 6) the models have to be compatible with commercial multibody software (Simpack Rail, Adams Rail). The most innovative aspect of the new global contact models regards the detection of the contact points. In particular both the models aim to reduce the algebraic problem dimension by means of suitable analytical techniques. This kind of reduction allows to obtain an high numerical efficiency that makes possible the online implementation of the new procedure and the achievement of performance comparable with those of commercial multibody software. At the same time the analytical approach assures high accuracy and generality. Concerning the local (or differential) contact models, one new model satisfying the following specifics will be presented: 1) the model has to be 3D and to consider all the six relative degrees of freedom between wheel and rail 2) the model has to consider generic railway tracks and generic wheel and rail profiles 3) the model has to assure a general and accurate handling of the multiple contact without simplifying hypotheses on the problem geometry; in particular the model has to able to calculate both the global contact variables (contact forces and torques) and the local contact variables (position and shape of the contact patch, stresses and displacements) 4) the model has to be implementable directly online within the multibody models 5) the model has to assure high numerical efficiency and a reduced memory consumption in order to achieve a good integration between multibody and differential modeling (the base for the local contact models) 6) the model has to be compatible with commercial multibody software (Simpack Rail, Adams Rail). In this case the most innovative aspects of the new local contact model regard the contact modeling (by means of suitable analytical conditions) and the implementation of the numerical algorithms needed to solve the discrete problem arising from the discretization of the original continuum problem. Moreover, during the development of the local model, the achievement of a good compromise between accuracy and efficiency turned out to be very important to obtain a good integration between multibody and differential modeling. At this point the contact models has been inserted within a 3D multibody model of a railway vehicle to obtain a complete model of the wagon. The railway vehicle chosen as benchmark is the Manchester Wagon the physical and geometrical characteristics of which are easily available in the literature. The model of the whole railway vehicle (multibody model and contact model) has been implemented in the Matlab/Simulink environment. The multibody model has been implemented in SimMechanics, a Matlab toolbox specifically designed for multibody dynamics, while, as regards the contact models, the CS – functions have been used; this particular Matlab architecture allows to efficiently connect the Matlab/Simulink and the C/C++ environment. The 3D multibody model of the same vehicle (this time equipped with a standard contact model based on the semi - elastic approach) has been then implemented also in Simpack Rail, a commercial multibody software for railway vehicles widely tested and validated. Finally numerical simulations of the vehicle dynamics have been carried out on many different railway tracks with the aim of evaluating the performances of the whole model. The comparison between the results obtained by the Matlab/ Simulink model and those obtained by the Simpack Rail model has allowed an accurate and reliable validation of the new contact models. In conclusion to this brief introduction to my Ph. D. thesis, we would like to thank Trenitalia and the Regione Toscana for the support provided during all the Ph. D. activity. Moreover we would also like to thank the INTEC GmbH, the society the develops the software Simpack Rail, with which we are currently working together to develop innovative toolboxes specifically designed for the wheel rail contact analysis.

Transcriptional regulation and functional characterization of the tumor suppressor genes Hugl-1 and Hugl-2

Cancer is a multi-step process in which both the activation of oncogenes and the inactivation of tumor suppressor genes alter the normal cellular programs to a state of proliferation and growth. The regulation of a number of tumor suppressor genes and the mechanism underlying the tumor suppression have been intensively studied. Hugl-1 and Hugl-2, the human homologues of Drosophila lgl are shown to be down-regulated in a variety of cancers including breast, colon, lung and melanoma, but the mechanism responsible for loss of expression is not yet known. The regulation of gene expression is influenced by factors inducing or repressing transcription. The present study was focused on the identification and characterization of the active promoters of Hugl-1 and Hugl-2. Further, the regulation of the promoter and functional consequences of this regulation by specific transcription factors was analyzed. Experiments to delineate the function of the mouse homologue of Hugl-2, mgl2 using transgenic mice model were performed. This study shows that the active promoter for both Hugl-1 and Hugl-2 is located 1000bp upstream of transcription start sites. The study also provides first insight into the regulation of Hugl-2 by an important EMT transcriptional regulator, Snail. Direct binding of Snail to four E-boxes present in Hugl-2 promoter region results in repression of Hugl-2 expression. Hugl-1 and Hugl-2 plays pivotal role in establishment and maintenance of cell polarity in a diversity of cell types and organisms. Loss of epithelial cell polarity is a prerequisite for cancer progression and metastasis and is an important step in inducing EMT in cells. Regulation of Hugl-2 by Snail suggests one of the initial events towards loss of epithelial cell polarity during Snail-mediated EMT. Another important finding of this study is the induction of Hugl-2 expression can reverse the Snail-driven EMT. Inducing Hugl-2 in Snail expressing cells results in the re-expression of epithelial markers E-cadherin and Cytokeratin-18. Further, Hugl-2 also reduces the rate of tumor growth, cell migration and induces the epithelial phenotype in 3D culture model in cells expressing Snail. Studies to gain insight into the signaling pathways involved in reversing Snail-mediated EMT revealed that induction of Hugl-2 expression interferes with the activation of extracellular receptor kinase, Erk. Functional aspects of mammalian lgl in vivo was investigated by establishing mgl2 conditional knockout mice. Though disruption of mgl2 gene in hepatic tissues did not alter the growth and development, ubiquitous disruption of mgl2 gene causes embryonic lethality which is evident by the fact that no mgl2-/- mice were born.

Wirkmechanismen der trifunktionalen Antikörper catumaxomab und ertumaxomab in humanen Tumorsphäroid-Kokulturen

Ein neuer Ansatz der immunologischen Krebstherapie ist die Verwendung der bispezifischen, trifunktionalen Antikörper catumaxomab (anti-EpCAM x anti-CD3) und ertumaxomab (anti-Her2/neu x anti-CD3). Die Bispezifität besteht in der Bindung eines Tumor-assoziierten Antigens (EpCAM bzw. Her2/neu) und des CD3 Moleküls auf der Oberfläche von T-Zellen. Darüber hinaus stellt die Interaktion des Fc-Teils mit FcγRI/IIa/III positiven akzessorischen Immunzellen die dritte Funktion der Antikörper dar. Diese einzigartige Kombination ermöglicht theoretisch die Ausbildung eines Tri-Zell-Komplexes. In klinischen Studien konnte bereits die Wirksamkeit beider Antikörper nachgewiesen werden. Die eigentlichen Wirkmechanismen der trifunktionalen Antikörper jedoch sind noch nicht ausreichend bekannt. Um die Wechselwirkung zwischen den stark EpCAM- und schwach Her2/neu-positive FaDu- sowie den stabil mit humanem Her2/neu transfizierten FaDu E593-Tumorzellen, peripheren Blutmonozyten (PBMC) und trifunktionalen Antikörpern systematisch zu untersuchen wurde ein 3D-Tumormodell, die so genannten multizellulären Tumorsphäroide (MCTS), angewandt. Als Endpunkte zur Beurteilung der Therapieeffizienz dienten das Volumenwachstum der Sphäroide, sowie die Klonogenität und die Zellvitalität. Zur Beurteilung der PBMC-Penetration in die Sphäroide erfolgten immunhistochemische Färbungen und molekularbiologische Nachweise der Abwehrzellantigene. Entsprechend wurden in den Sphäroiden die Proliferationsrate über eine Ki67-Färbung sowie die Apoptoserate über eine FragEL-Markierung identifiziert. Die Aktivität der PBMC wurde durch die Bestimmung ausgewählter Zytokine (ELISA) und der Zellzahl aus den Medienüberständen charakterisiert. Die an den FaDu- und E593-Sphäroiden erzielten Ergebnisse zeigten, dass catumaxomab und ertumaxomab eine konzentrations- und zeitabhängige Abnahme des Sphäroidvolumens bewirkten. Die Schrumpfung der Tumorsphäroide ging mit einer Reduktion des proliferativen und mit einer Steigerung des apoptotischen Tumorzellanteils einher. Die histologischen Befunde weisen darauf hin, dass die Volumenreduktion durch eine gesteigerte Anzahl infiltrierender Leukozyten bedingt ist. Auf verschiedenen Methoden basierende Analysen der Immunzellsubtypen zeigten eine dominierende Infiltration von zytotoxischen T-Zellen in die Tumorsphäroide. Der Aktivitätsnachweis der T-Zellen wurde über die Detektion der IL-2 mRNA und des sekretierten Zytokins erbracht. Einen zusätzlichen Hinweis auf eine zelluläre Immunantwort liefert das Zytokinmuster mit hohen Konzentrationen an IFN-γ. Der direkte Vergleich beider Antikörper zeigte, dass der anti-tumorale Effekt abhängig von der Antigenexpression auf den Tumorzellen war. Die Analyse von Medienüberständen wies auf eine mehrheitlich höhere Zytokinausschüttung in Gegenwart des Tumorantigens hin. Sphäroid-Kokulturen, die mit dem parentalen anti-EpCAM Antikörper behandelt wurden, zeigten keine Volumenreduktion. Im Gegensatz dazu führte der parentale CD3-Antikörper, das CD3- und Tumorzell-bindende catumaxomab F(ab')2 Fragment oder eine Kombination beider parentaler Antikörper zu einer anti-tumoralen Wirkung, die jedoch nicht so stark war wie die des trifunktionalen Antikörpers catumaxomab. Demnach ist für catumaxomab gezeigt, dass für die Effektivität des Antikörpers die Trifunktionalität unabdingbar ist. Daraus leitet sich ab, dass die Aktivierung der Abwehrzellen durch kostimulatorische Signale notwendig ist und über die Tumorantigenbindung Mechanismen wie ADCC (antibody-dependent cellular cytotoxicity) zum Tragen kommen. Die Experimente mit gleichzeitiger Gabe von trifunktionalen Antikörpern und Immunsuppressiva haben gezeigt, dass eine Kombination beider Agenzien möglich ist. Die Konzentrationen sind jedoch sorgfältig derart zu wählen, dass die Zytokinausschüttung und die damit verbundenen Nebenwirkungen reduziert sind, ohne dass die anti-tumorale Wirkung der Antikörper maßgeblich beeinflusst wird. T-Zellen bedienen sich nach Aktivierung für die rasche Proliferation einer gesteigerten aeroben Glykolyse. Unter Behandlung der Kokulturen mit catumaxomab konnte im Vergleich zu anderen immunstimulatorischen Agenzien die größte Steigerung der Laktatproduktion bzw. der Azidifizierungs- und Sauerstoffverbrauchsrate detektiert werden. Diese Effekte weisen auf eine metabolische Aktivierung der PBMC durch catumaxomab hin. Das von den Tumorzellen abgegebene Laktat kann die Immunzellen jedoch inhibieren. Daher wäre die Kombination mit Glykolyseinhibitoren ein möglicher Ansatz, um die Therapieeffizienz weiter zu steigern. Darüber hinaus konnte gezeigt werden, dass eine Komedikation der trifunktionalen Antikörper mit Chemotherapeutika zu einer gesteigerter Wirkung führte. Insgesamt liegt die Zukunft der Immuntherapien wohl in der Kombination mit anderen Wirkstoffklassen, die anti-tumorale Effekte verstärken oder immunsupprimierende Mechanismen inhibieren.

Statistical analysis of the error associated with the simplification of the stratigraphy in geotechnical models

The uncertainties in the determination of the stratigraphic profile of natural soils is one of the main problems in geotechnics, in particular for landslide characterization and modeling. The study deals with a new approach in geotechnical modeling which relays on a stochastic generation of different soil layers distributions, following a boolean logic – the method has been thus called BoSG (Boolean Stochastic Generation). In this way, it is possible to randomize the presence of a specific material interdigitated in a uniform matrix. In the building of a geotechnical model it is generally common to discard some stratigraphic data in order to simplify the model itself, assuming that the significance of the results of the modeling procedure would not be affected. With the proposed technique it is possible to quantify the error associated with this simplification. Moreover, it could be used to determine the most significant zones where eventual further investigations and surveys would be more effective to build the geotechnical model of the slope. The commercial software FLAC was used for the 2D and 3D geotechnical model. The distribution of the materials was randomized through a specifically coded MatLab program that automatically generates text files, each of them representing a specific soil configuration. Besides, a routine was designed to automate the computation of FLAC with the different data files in order to maximize the sample number. The methodology is applied with reference to a simplified slope in 2D, a simplified slope in 3D and an actual landslide, namely the Mortisa mudslide (Cortina d’Ampezzo, BL, Italy). However, it could be extended to numerous different cases, especially for hydrogeological analysis and landslide stability assessment, in different geological and geomorphological contexts.

PS-GANS: A Patient-Specific, Gravity Assisted Navigation System for Acetabular Cup Placement

In this paper we propose a new system that allows reliable acetabular cup placement when the THA is operated in lateral approach. Conceptually it combines the accuracy of computer-generated patient-specific morphology information with an easy-to-use mechanical guide, which effectively uses natural gravity as the angular reference. The former is achieved by using a statistical shape model-based 2D-3D reconstruction technique that can generate a scaled, patient-specific 3D shape model of the pelvis from a single conventional anteroposterior (AP) pelvic X-ray radiograph. The reconstructed 3D shape model facilitates a reliable and accurate co-registration of the mechanical guide with the patient’s anatomy in the operating theater. We validated the accuracy of our system by conducting experiments on placing seven cups to four pelvises with different morphologies. Taking the measurements from an image-free navigation system as the ground truth, our system showed an average accuracy of 2.1 ±0.7 o for inclination and an average accuracy of 1.2 ±1.4 o for anteversion.

A navigation system for open liver surgery: design, workflow and first clinical applications

The surgical treatment of liver tumours relies on precise localization of the lesions and detailed knowledge of the patient-specific vascular and biliary anatomy. Detailed three-dimensional (3D) anatomical information facilitates complete tumour removal while preserving a sufficient amount of functional liver tissue.

Besnoitia besnoiti protein disulfide isomerase (BbPDI): molecular characterization, expression and in silico modelling

Besnoitia besnoiti is an apicomplexan parasite responsible for bovine besnoitiosis, a disease with a high prevalence in tropical and subtropical regions and re-emerging in Europe. Despite the great economical losses associated with besnoitiosis, this disease has been underestimated and poorly studied, and neither an effective therapy nor an efficacious vaccine is available. Protein disulfide isomerase (PDI) is an essential enzyme for the acquisition of the correct three-dimensional structure of proteins. Current evidence suggests that in Neosporacaninum and Toxoplasmagondii, which are closely related to B. besnoiti, PDI play an important role in host cell invasion, is a relevant target for the host immune response, and represents a promising drug target and/or vaccine candidate. In this work, we present the nucleotide sequence of the B. besnoiti PDI gene. BbPDI belongs to the thioredoxin-like superfamily (cluster 00388) and is included in the PDI_a family (cluster defined cd02961) and the PDI_a_PDI_a'_c subfamily (cd02995). A 3D theoretical model was built by comparative homology using Swiss-Model server, using as a template the crystallographic deduced model of Tapasin-ERp57 (PDB code 3F8U chain C). Analysis of the phylogenetic tree for PDI within the phylum apicomplexa reinforces the close relationship among B. besnoiti, N. caninum and T. gondii. When subjected to a PDI-assay based on the polymerisation of reduced insulin, recombinant BbPDI expressed in E. coli exhibited enzymatic activity, which was inhibited by bacitracin. Antiserum directed against recombinant BbPDI reacted with PDI in Western blots and by immunofluorescence with B. besnoiti tachyzoites and bradyzoites.

Identification and in silico analyses of novel TGFBR1 and TGFBR2 mutations in Marfan syndrome-related disorders

Very recently, heterozygous mutations in the genes encoding transforming growth factor beta receptors I (TGFBR1) and II (TGFBR2) have been reported in Loeys-Dietz aortic aneurysm syndrome (LDS). In addition, dominant TGFBR2 mutations have been identified in Marfan syndrome type 2 (MFS2) and familial thoracic aortic aneurysms and dissections (TAAD). In the past, mutations of these genes were associated with atherosclerosis and several human cancers. Here, we report a total of nine novel and one known heterozygous sequence variants in the TGFBR1 and TGFBR2 genes in nine of 70 unrelated individuals with MFS-like phenotypes who previously tested negative for mutations in the gene encoding the extracellular matrix protein fibrillin-1 (FBN1). To assess the pathogenic impact of these sequence variants, in silico analyses were performed by the PolyPhen, SIFT, and Fold-X algorithms and by means of a 3D homology model of the TGFBR2 kinase domain. Our results showed that in all but one of the patients the pathogenic effect of at least one sequence variant is highly probable (c.722C > T, c.799A > C, and c.1460G > A in TGFBR1 and c.773T > G, c.1106G > T, c.1159G > A, c.1181G > A, and c.1561T > C in TGFBR2). These deleterious alleles occurred de novo or segregated with the disease in the families, indicating a causative association between the sequence variants and clinical phenotypes. Since TGFBR2 mutations found in patients with MFS-related disorders cannot be distinguished from heterozygous TGFBR2 mutations reported in tumor samples, we emphasize the importance of segregation analysis in affected families. In order to be able to find the mutation that is indeed responsible for a MFS-related phenotype, we also propose that genetic testing for sequence alterations in TGFBR1 and TGFBR2 should be complemented by mutation screening of the FBN1 gene.