Plasma and cerebrospinal fluid population pharmacokinetics of temozolomide in malignant glioma patients

RESUME : Objectif: Le glioblastome multiforme (GBM) est la tumeur cérébrale maligne la plus agressive qui conduit au décès de la majorité des patients moins d'une année après le diagnostic. La plupart des agents chimiothérapeutiques actuellement disponibles ne traversent pas la barrière hémato¬encéphalique et ne peuvent par conséquent pas être utilisés pour ce type de tumeur. Le Temozolomide (TMZ) est un nouvel agent alkylant récemment développé pour le traitement des gliomes malins. A ce jour, très peu d'informations sont disponibles sur la pénétration intra-cérébrale de cet agent. Au cours d'une étude pilote de phase II menée auprès de 64 patients atteints de GBM, l'administration précoce de TMZ combinée à une radiothérapie standard (RT) afin d'intervenir au plus tôt dans l'évolution de la maladie, a permis de prolonger la survie de ces patients, résultat qui pu être confirmé par la suite lors de l'étude randomisée de phase III. L'objectif de cette étude a été de déterminer les paramètres pharmacocinétique du TMZ dans le plasma et le liquide céphalo-rachidien (LCR), d'évaluer l'influence de certains facteurs individuels (âge, sexe, surface corporelle, fonction rénale/hépatique, co-médications, RT concomitante) sur ces différents paramètres, et enfin d'explorer la relation existant entre l'exposition au TMZ et certains marqueurs cliniques d'efficacité et de toxicité. Matériel et Méthode: Les concentrations de TMZ ont été mesurées par chromatographie liquide à haute performance (HPLC) dans le plasma et le LCR de 35 patients atteints de GBM nouvellement diagnostiqués (étude pilote) ou de gliomes malins en récidive (étude récidive). L'analyse pharmacocinétique de population a été réalisée à l'aide du programme NONMEM. L'exposition systémique et cérébrale, définie par les AUC (Area Under the time-concentration Curve) dans le plasma et le LCR, a été estimée pour chaque patient et corrélée à la toxicité, la survie ainsi que la survie sans progression tumorale. Résultats: Un modèle à 1 compartiment avec une cinétique d'absorption et de transfert Kplasma -> LCR de ordre a été retenu afin de décrire le profil pharmacocinétique du TMZ. Les valeurs moyennes de population ont été de 10 L/h pour la clairance, de 30.3 L pour le volume de distribution, de 2.1 h pour la 1/2 vie d'élimination, de 5.78 hE-1 pour la constante d'absorption, de 7.2 10E4 hE-1 pour Kplasma->LCR et de 0.76 hE-1 pour KLCR plasma. La surface corporelle a montré une influence significative sur la clairance et le volume de distribution, alors que le sexe influence la clairance uniquement. L'AUC mesurée dans le LCR représente ~20% de celle du plasma et une augmentation de 15% de Kplasma->LCR a été observée lors du traitement concomitant de radiochimiothérapie. Conclusions: Cette étude est la première analyse pharmacocinétique effectuée chez l'homme permettant de quantifier la pénétration intra-cérébrale du TMZ. Le rapport AUC LCR/AUC Plasma a été de 20%. Le degré d'exposition systémique et cérébral au TMZ ne semble pas être un meilleur facteur prédictif de la survie ou de la tolérance au produit que ne l'est la dose cumulée seule. ABSTRACT Purpose: Scarce information is available on the brain penetration of temozolomide (TMZ), although this novel methylating agent is mainly used for the treatment of ma¬lignant brain tumors. The purpose was to assess TNIZ phar¬macokinetics in plasma and cerebrospinal fluid (CSF) along with its inter-individual variability, to characterize covari¬ates and to explore relationships between systemic or cere¬bral drug exposure and clinical outcomes. Experimental Design: TMZ levels were measured by high-performance liquid chromatography in plasma and CSF samples from 35 patients with newly diagnosed or recurrent malignant gliomas. The population pharmacoki¬netic analysis was performed with nonlinear mixed-effect modeling software. Drug exposure, defined by the area un¬der the concentration-time curve (AUC) in plasma and CSF, was estimated for each patient and correlated with toxicity, survival, and progression-free survival. Results: A three-compartment model with first-order absorption and transfer rates between plasma and CSF described the data appropriately. Oral clearance was 10 liter/h; volume of distribution (VD), 30.3 liters; absorption constant rate, 5.8 hE-1; elimination half-time, 2.1 h; transfer rate from plasma to CSF (Kplasma->CSF), 7.2 x 10E-4hE-1 and the backwards rate, 0.76hE-1. Body surface area signifi¬cantly influenced both clearance and VD, and clearance was sex dependent. The AU CSF corresponded to 20% of the AUCplasma. A trend toward an increased K plasma->CSF of 15% was observed in case of concomitant radiochemo-therapy. No significant correlations between AUC in plasma or CSF and toxicity, survival, or progression-free survival were apparent after deduction of dose-effect. Conclusions: This is the first human pharmacokinetic study on TMZ to quantify CSF penetration. The AUC CSF/ AUC plasma ratio was 20%. Systemic or cerebral exposures are not better predictors than the cumulative dose alone for both efficacy and safety.

Guidelines for the use and interpretation of assays for monitoring autophagy.

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field.

Common variants associated with plasma triglycerides and risk for coronary artery disease.

Triglycerides are transported in plasma by specific triglyceride-rich lipoproteins; in epidemiological studies, increased triglyceride levels correlate with higher risk for coronary artery disease (CAD). However, it is unclear whether this association reflects causal processes. We used 185 common variants recently mapped for plasma lipids (P < 5 × 10(-8) for each) to examine the role of triglycerides in risk for CAD. First, we highlight loci associated with both low-density lipoprotein cholesterol (LDL-C) and triglyceride levels, and we show that the direction and magnitude of the associations with both traits are factors in determining CAD risk. Second, we consider loci with only a strong association with triglycerides and show that these loci are also associated with CAD. Finally, in a model accounting for effects on LDL-C and/or high-density lipoprotein cholesterol (HDL-C) levels, the strength of a polymorphism's effect on triglyceride levels is correlated with the magnitude of its effect on CAD risk. These results suggest that triglyceride-rich lipoproteins causally influence risk for CAD.

Immunoscintigraphic localization of inflammatory lesions: concept, radiolabelling and in vitro testing of a granulocyte specific antibody.

Current nuclear medicine techniques for the localization of inflammatory processes are based on injection of 111In labelled autologous granulocytes which need to be isolated and radiolabelled in vitro before reinjection. A new technique is presented here that obviates the need for cell isolation by the direct intravenous injection of a granulocyte specific 123I labelled monoclonal antibody. In this publication the basic parameters of the antibody granulocyte interaction are described. Antibody binding does not inhibit vital functions of the granulocytes, such as chemotaxis and superoxide generation. Scatchard analysis of binding data reveals an apparent affinity of the antibody for granulocytes of 6.8 X 10(9) l/mol and approximately 7.1 X 10(4) binding sites per cell. Due to the high specificity of the antibody, the only expected interference is from CEA producing tumors.

Genome-wide association analyses identify 18 new loci associated with serum urate concentrations.

Elevated serum urate concentrations can cause gout, a prevalent and painful inflammatory arthritis. By combining data from >140,000 individuals of European ancestry within the Global Urate Genetics Consortium (GUGC), we identified and replicated 28 genome-wide significant loci in association with serum urate concentrations (18 new regions in or near TRIM46, INHBB, SFMBT1, TMEM171, VEGFA, BAZ1B, PRKAG2, STC1, HNF4G, A1CF, ATXN2, UBE2Q2, IGF1R, NFAT5, MAF, HLF, ACVR1B-ACVRL1 and B3GNT4). Associations for many of the loci were of similar magnitude in individuals of non-European ancestry. We further characterized these loci for associations with gout, transcript expression and the fractional excretion of urate. Network analyses implicate the inhibins-activins signaling pathways and glucose metabolism in systemic urate control. New candidate genes for serum urate concentration highlight the importance of metabolic control of urate production and excretion, which may have implications for the treatment and prevention of gout.

Gestão Integrada dos Recursos Hídricos da Ilha do Maio (Cabo Verde): o Contributo das Águas Subterrâneas

Cabo Verde é constituído por 10 ilhas, sendo a ilha do Maio a mais antiga do arquipélago, com uma área de 269 km2, tendo como comprimento máximo 24100 m, uma largura máxima de 16300 m e uma população total de 6740 habitantes. No que concerne à geomorfologia e geologia, a ilha é considerada plana e é composta por formações eruptivas e sedimentares, sendo as formações sedimentares dominantes na ilha. Apresenta as formações mais antigas de Cabo Verde, de idade jurássica e cretácica. No entanto, não apresenta as formações eruptivas mais recentes como as restantes ilhas. A ilha do Maio enquadra-se num clima do tipo árido e semiárido, com uma temperatura média de 24.5 ºC e uma precipitação anual de 125.4 mm. Estimativas efectuadas com base no modelo do balanço hídrico sequencial diário mostram que cerca de 7% da precipitação corresponde a escoamento superficial e 14.1% a escoamento subterrâneo. Pela aplicação deste modelo e do método do balanço químico do ião cloreto, os recursos hídricos subterrâneos renováveis anualmente na ilha do Maio estão, em ano médio, compreendidos entre 3.44 x 106 m3 e 4.76 x 106 m3.por sua vez, o escoamento total é estimado em 7.8 x 106 m3 anuais, o que equivale a cerca de 21 400 m3/dia. O escoamento subterrâneo na ilha do Maio faz-se globalmente de um modo centrífugo a partir das elevações do maciço central. O gradiente hidráulico assume valores entre 0.05% e 2.9%, sendo que o valor mais baixo ocorre no sector norte da ilha, o que favorece o fenómeno de intrusão salina. Relativamente à qualidade da água, verifica-se que as amostras recolhidas correspondem a águas muito mineralizadas, com valores de condutividade eléctrica compreendidos entre 832 μS/cm e 7730 μS/cm. Por sua vez, os valores de TDS estão compreendidos entre 705.8 mg/L e 4210.4 mg/L. Nestas condições, as águas subterrâneas analisadas podem ser consideradas águas salobras. A fácies hidroquímica dominante é a cloretada sódica, sendo que grande parte das amostras pode ser considerada cloretada-bicarbonatada sódica. Admitindo que a amostragem efectuada tem significado estatístico, poderá dizer-se que, a nível físico-químico, cerca de 20% das águas subterrâneas são próprias para o consumo humano. No que respeita à utilização da água para rega, as águas analisadas apresentam baixo a alto perigo de alcalinização do solo e alto a muito alto perigo de salinização. Em síntese, pode concluir-se que, não obstante o carácter árido da ilha do Maio, a mesma apresenta um potencial de recursos hídricos não negligenciável, eventualmente suficiente para suprir as necessidades hídricas da população. No entanto, o estudo desenvolvido mostra a necessidade de implementar medidas susceptíveis de proporcionarem um aproveitamento sustentado dos recursos hídricos, no quadro da gestão integrada dos recursos hídricos da ilha do Maio.

Estudio de otolitos de Odonthestes regia r., Pejerrey: determinación de edad

El estudio de los incrementos marginales de crecimiento mensual de otolitos de pejerrey , sugiere: Un inicio de formación de anillo para el mes de julio y otra formación para enero; ambos se encuentran relacionados al ápice y secundario del desove. La regresión que relaciona la longitud del pez (cm) con la longitud del otolito (mm) corresponde a: Y=2 .302 + 7.72163 X, R=0. 99, N=427 especímenes . La distribución mensual de longitudes del total de pe­ces N=798, sugiere que hay una reducción del tamaño modal después de abril con una alta proporción de peces menores de 15 cm y ésto alcanza su máximo más o menos entre julio y setiembre. Este cambio puede significar que el reclutamiento tomaría lugar entre mayo y octubre con el ápice en agosto. La madurez sexual , estudio de la distribución porcentual por estadios a lo largo de todos los meses del año 1975, Sugiere: considerando los estadíos V, VI, VII juntos y el VI separadamente, que el ápice del desove es en julio con un rango entre mayo y octubre y con un ápice secundario en enero. El contaje de anillos anuales en la estructura de los otolitos nos dice que esta especie es de vida corta no más de tres años. La ecuación de crecimiento de von Bertalanf fy corresponde)

Efeito de ZN, Cd e Cu no comportamento de fungos ectomicorrízicos em meio de cultura

Os fungos ectomicorrízicos são capazes de tolerar concentrações de metais pesados tóxicas às plantas hospedeiras, apesar de serem adversamente influenciados pelo excesso de alguns metais. Avaliou-se o crescimento de um isolado de Pisolithus tinctorius e outro de Suillus bovinus em meio de cultura líquido com doses crescentes de sais de Zn, Cu ou Cd adicionados individualmente em frascos de 125 mL que continham 50 mL de meio Mellin-Norkrans modificado (MNM), em pH 4,8. Os fungos cresceram por 20 dias em câmara de crescimento a 28ºC. O crescimento dos fungos foi inibido com a elevação das concentrações dos metais, porém de forma diferenciada. As concentrações suficientes para inibir 50% do crescimento foram de 2,71 x 10-3 mol L-1 de Zn, 1,18 x 10-3 mol L-1 de Cu e 12,2 x 10-6 mol L-1 de Cd, para o P. tinctorius, e de 2,15 x 10-3 mol L-1 de Zn, 0,12 x 10-3 mol L-1 de Cu e 7,2 x 10-6 mol L-1 de Cd, para o S. bovinus. O efeito inibitório dos metais sobre o crescimento dos fungos seguiu a seguinte ordem decrescente: Cd > Cu > Zn. O isolado de S. bovinus apresentou tolerância ao Zn similar à observada para o P. tinctorius, mas foi menos tolerante que este em relação aos outros dois metais. O crescimento de P. tinctorius foi favorecido por pequena dose de Cu. A produção de pigmentos extracelulares nestes isolados foi estimulada por todos os metais estudados. O P. tinctorius, o mais tolerante, produziu mais pigmentos extracelulares por grama de micélio, o que sugere a relação positiva entre a capacidade de produção de pigmentos e a tolerância aos metais.

Genetic loci for retinal arteriolar microcirculation.

Narrow arterioles in the retina have been shown to predict hypertension as well as other vascular diseases, likely through an increase in the peripheral resistance of the microcirculatory flow. In this study, we performed a genome-wide association study in 18,722 unrelated individuals of European ancestry from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium and the Blue Mountain Eye Study, to identify genetic determinants associated with variations in retinal arteriolar caliber. Retinal vascular calibers were measured on digitized retinal photographs using a standardized protocol. One variant (rs2194025 on chromosome 5q14 near the myocyte enhancer factor 2C MEF2C gene) was associated with retinal arteriolar caliber in the meta-analysis of the discovery cohorts at genome-wide significance of P-value <5×10(-8). This variant was replicated in an additional 3,939 individuals of European ancestry from the Australian Twins Study and Multi-Ethnic Study of Atherosclerosis (rs2194025, P-value = 2.11×10(-12) in combined meta-analysis of discovery and replication cohorts). In independent studies of modest sample sizes, no significant association was found between this variant and clinical outcomes including coronary artery disease, stroke, myocardial infarction or hypertension. In conclusion, we found one novel loci which underlie genetic variation in microvasculature which may be relevant to vascular disease. The relevance of these findings to clinical outcomes remains to be determined.

Suscetibilidade magnética do horizonte B de solos do Estado do Paraná

Os minerais ferrimagnéticos maghemita (γFe2O3) e magnetita (Fe3O4) possuem alta relação com a disponibilidade de cátions metálicos e com a capacidade do solo em adsorver ânions como o fosfato. Uma percentagem expressiva dos solos brasileiros apresenta magnetização espontânea. No Estado do Paraná essa área corresponde a aproximadamente 50 %. A determinação da suscetibilidade magnética por unidade de massa (ΧBF) é o método mais simples de identificar a presença e quantificar esses minerais nos solos. A BF é uma técnica rápida, barata, não destrutiva e de boa reprodutibilidade, que pode ser utilizada como critério nos estudos pedogenéticos em que os minerais ferrimagnéticos estão presentes. O objetivo deste trabalho foi verificar a influência do material de origem nos valores de ΧBF da terra fina seca ao ar (TFSA) de amostras do horizonte B de solos do Paraná. As amostras foram coletadas em todo o Estado, num total de 45 pontos. Na TFSA foram determinados os valores de BF e da porcentagem da frequência dependente da suscetibilidade magnética (ΧFD). Os valores de suscetibilidade magnética dos solos formados sobre rochas eruptivas básicas foram significativamente maiores (1.000 a 7.800 x 10-8 m³ kg-1) que os encontrados em solos formados sobre rochas metamórficas e sedimentares (menores do que 500 x 10-8 m³ kg-1), demonstrando a influência do material de origem na presença de minerais ferrimagnéticos. Os valores de ΧFD indicaram a presenca de partículas superparamagnéticas (maghemita) na maioria dos solos paranaenses.

[Illustrations de Orbis situ ac descriptione...] / [Non identifié] ; Le Père Franciscus Monachus, aut. du texte

Comprend : [ Folios A1v ° et A2r °. Vue des deux cartes en couleur de l'hémisphère Européen-Africain et de l'hémisphère Américain. XVIè siècle.] [ Cote : BNF RCB 8010. ]

Seventy-five genetic loci influencing the human red blood cell.

Anaemia is a chief determinant of global ill health, contributing to cognitive impairment, growth retardation and impaired physical capacity. To understand further the genetic factors influencing red blood cells, we carried out a genome-wide association study of haemoglobin concentration and related parameters in up to 135,367 individuals. Here we identify 75 independent genetic loci associated with one or more red blood cell phenotypes at P < 10(-8), which together explain 4-9% of the phenotypic variance per trait. Using expression quantitative trait loci and bioinformatic strategies, we identify 121 candidate genes enriched in functions relevant to red blood cell biology. The candidate genes are expressed preferentially in red blood cell precursors, and 43 have haematopoietic phenotypes in Mus musculus or Drosophila melanogaster. Through open-chromatin and coding-variant analyses we identify potential causal genetic variants at 41 loci. Our findings provide extensive new insights into genetic mechanisms and biological pathways controlling red blood cell formation and function.

Biological, clinical and population relevance of 95 loci for blood lipids.

Plasma concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides are among the most important risk factors for coronary artery disease (CAD) and are targets for therapeutic intervention. We screened the genome for common variants associated with plasma lipids in >100,000 individuals of European ancestry. Here we report 95 significantly associated loci (P < 5 x 10(-8)), with 59 showing genome-wide significant association with lipid traits for the first time. The newly reported associations include single nucleotide polymorphisms (SNPs) near known lipid regulators (for example, CYP7A1, NPC1L1 and SCARB1) as well as in scores of loci not previously implicated in lipoprotein metabolism. The 95 loci contribute not only to normal variation in lipid traits but also to extreme lipid phenotypes and have an impact on lipid traits in three non-European populations (East Asians, South Asians and African Americans). Our results identify several novel loci associated with plasma lipids that are also associated with CAD. Finally, we validated three of the novel genes-GALNT2, PPP1R3B and TTC39B-with experiments in mouse models. Taken together, our findings provide the foundation to develop a broader biological understanding of lipoprotein metabolism and to identify new therapeutic opportunities for the prevention of CAD.

Genetic evidence for a role of adiponutrin in the metabolism of apolipoprotein B-containing lipoproteins.

Adiponutrin (PNPLA3) is a predominantly liver-expressed transmembrane protein with phospholipase activity that is regulated by fasting and feeding. Recent genome-wide association studies identified PNPLA3 to be associated with hepatic fat content and liver function, thus pointing to a possible involvement in the hepatic lipoprotein metabolism. The aim of this study was to examine the association between two common variants in the adiponutrin gene and parameters of lipoprotein metabolism in 23,274 participants from eight independent West-Eurasian study populations including six population-based studies [Bruneck (n = 800), KORA S3/F3 (n = 1644), KORA S4/F4 (n = 1814), CoLaus (n = 5435), SHIP (n = 4012), Rotterdam (n = 5967)], the SAPHIR Study as a healthy working population (n = 1738) and the Utah Obesity Case-Control Study including a group of 1037 severely obese individuals (average BMI 46 kg/m2) and 827 controls from the same geographical region of Utah. We observed a strong additive association of a common non-synonymous variant within adiponutrin (rs738409) with age-, gender-, and alanine-aminotransferase-adjusted lipoprotein concentrations: each copy of the minor allele decreased levels of total cholesterol on average by 2.43 mg/dl (P = 8.87 x 10(-7)), non-HDL cholesterol levels by 2.35 mg/dl (P = 2.27 x 10(-6)) and LDL cholesterol levels by 1.48 mg/dl (P = 7.99 x 10(-4)). These associations remained significant after correction for multiple testing. We did not observe clear evidence for associations with HDL cholesterol or triglyceride concentrations. In conclusion, our study suggests that adiponutrin is involved in the metabolism of apoB-containing lipoproteins.

Mass movement characterization using a reflexion and refraction seismic survey with the sloping local base level concept

This study proposes a new concept for upscaling local information on failure surfaces derived from geophysical data, in order to develop the spatial information and quickly estimate the magnitude and intensity of a landslide. A new vision of seismic interpretation on landslides is also demonstrated by taking into account basic geomorphic information with a numeric method based on the Sloping Local Base Level (SLBL). The SLBL is a generalization of the base level defined in geomorphology applied to landslides, and allows the calculation of the potential geometry of the landslide failure surface. This approach was applied to a large scale landslide formed mainly in gypsum and situated in a former glacial valley along the Rhone within the Western European Alps. Previous studies identified the existence of two sliding surfaces that may continue below the level of the valley. In this study. seismic refraction-reflexion surveys were carried out to verify the existence of these failure surfaces. The analysis of the seismic data provides a four-layer model where three velocity layers (<1000 ms(-1), 1500 ms(-1) and 3000 ms(-1)) are interpreted as the mobilized mass at different weathering levels and compaction. The highest velocity layer (>4000 ms(-1)) with a maximum depth of similar to 58 m is interpreted as the stable anhydrite bedrock. Two failure surfaces were interpreted from the seismic surveys: an upper failure and a much deeper one (respectively 25 and 50 m deep). The upper failure surface depth deduced from geophysics is slightly different from the results obtained using the SLBL, and the deeper failure surface depth calculated with the SLBL method is underestimated in comparison with the geophysical interpretations. Optimal results were therefore obtained by including the seismic data in the SLBL calculations according to the geomorphic limits of the landslide (maximal volume of mobilized mass = 7.5 x 10(6) m(3)).