Resistance to malathion and lambda-cyhalothrin in Ceratitis capitata (Wiedemann) (Diptera: Tephritidae)

La mosca mediterránea de la fruta, Ceratitis capitata (Wiedemann, 1824) (Diptera: Tephritidae), es una de las plagas de mayor incidencia económica en cítricos y otros frutales a nivel mundial. En España las medidas de control de esta plaga en cítricos, desde mediados de los 90 hasta 2009, se basaron principalmente en el monitoreo de las poblaciones y en la aplicación de tratamientos aéreos y terrestres con malatión cebo. Sin embargo, desde la retirada en la Unión Europea en 2009 de los productos fitosanitarios que contienen malatión, los insecticidas más utilizados para el control de esta plaga han sido lambda-cihalotrina y spinosad. En 2004-2005 se detectaron poblaciones españolas de C. capitata resistentes a malatión. Esta resistencia se ha asociado a una mutación (G328A) en la acetilcolinesterasa (AChE), a una duplicación del gen de la AChE (Ccace2) (una de las copias lleva la mutación G328A) y a resistencia metabólica mediada por esterasas (posiblemente aliesterasas). Sin embargo, cuando se secuenció la aliesterasa CcE7 en individuos de una línea resistente a malatión, no se encontró ninguna de las mutaciones (G137D y/o W251L/S/G) asociadas a resistencia en otras especies, si bien se encontraron otras mutaciones al compararlos con individuos de una línea susceptible. Asimismo, mediante la selección en laboratorio de una línea resistente a malatión (W-4Km) con lambda-cihalotrina, se ha podido obtener una línea resistente a lambda-cihalotrina (W-1K). Finalmente, se ha demostrado la capacidad de esta especie para desarrollar resistencia a spinosad mediante selección en laboratorio. Los múltiples mecanismos de resistencia identificados evidencian el potencial de esta especie para desarrollar resistencia a insecticidas con diferentes modos de acción. Los objetivos de esta tesis doctoral son: 1) evaluar la susceptibilidad de poblaciones españolas de campo de C. capitata a lambda-cihalotrina y dilucidar los mecanismos de resistencia en la línea W-1Kλ; 2) comparar la herencia, el coste biológico y la estabilidad de la resistencia a malatión mediada por la mutación G328A y la duplicación del gen Ccace2 (una de las copias lleva la mutación G328A); y 3) investigar el papel de las mutaciones identificadas en la aliesterasa CcαE7 en la resistencia a malatión. Estos estudios son de utilidad para el desarrollo de estrategias de manejo de la resistencia que puedan prevenir o retrasar la aparición de resistencia y aumentar la sostenibilidad de los insecticidas disponibles para el control de esta plaga. Nuestros resultados indican que las poblaciones españolas de C. capitata analizadas han desarrollado resistencia a lambda-cihalotrina. Los valores de CL50 estimados para las poblaciones recogidas en la Comunidad Valenciana, Cataluña y Andalucía oscilaron entre 129 ppm y 287 ppm, igualando o sobrepasando la concentración recomendada para los tratamientos de campo (125 ppm). Estos resultados contrastan con los obtenidos con tres poblaciones de campo recogidas en Túnez, cuya susceptibilidad fue similar a la de la línea control (C). La línea resistente a lambda-cihalotrina W-1K se continuó seleccionando en el laboratorio alcanzándose unos niveles de resistencia de 205 veces con respecto a la línea C, siendo su CL50 (4224 ppm) más de 30 veces superior a la concentración recomendada para los tratamientos de campo. Esta línea resistente mostró altos niveles de resistencia cruzada a deltametrina (150 veces) y a etofenprox (240 veces), lo que sugiere que el desarrollo de resistencia a lambda-cihalotrina podría comprometer la eficacia de otros piretroides para el control de esta plaga. Hemos demostrado que la resistencia de la línea W-1K a lambda-cihalotrina fue casi completamente suprimida por el sinergista PBO, lo que indica que las enzimas P450 desempeñan un papel muy importante en la resistencia a este insecticida. Sin embargo, tanto las moscas de la línea susceptible C como las de la línea resistente W-1K perdieron inmediatamente la capacidad de caminar (efecto “knock-down”) al ser tratadas tópicamente con lambda-cihalotrina, lo que sugiere que la resistencia no está mediada por alteraciones en la molécula diana (resistencia tipo “kdr”). La resistencia metabólica mediada por P450 fue analizada comparando la expresión de 53 genes CYP (codifican enzimas P450) de las familias CYP4, CYP6, CYP9 y CYP12 en adultos de la línea resistente W-1K y de la línea susceptible C. Nuestros resultados muestran que el gen CYP6A51 (número de acceso GenBank XM_004534804) fue sobreexpresado (13-18 veces) en la línea W-1K. Por otra parte, la expresión del gen CYP6A51 fue inducida tanto en adultos de la línea W-1K como de la línea C al ser tratados con lambda-cihalotrina. Sin embargo, no se obtuvieron diferencias significativas entre la línea susceptible C y la línea resistente W-1K al comparar la cantidad de P450 y la actividad NADPH-citocromo c reductasa presente en fracciones microsomales obtenidas a partir de abdómenes. Asimismo, no hemos podido correlacionar el metabolismo de deltametrina, estimado in vitro mediante la incubación de este insecticida con fracciones microsomales, con el nivel de resistencia a este piretroide observado en los bioensayos con la línea W-1K. Por otro lado, no se encontró ninguna alteración en la región promotora 5'UTR del gen CYP6A51 (-500 pb desde el inicio de la traducción) que pudiera explicar su sobreexpresión en la línea W-1K. Los datos obtenidos sugieren que la resistencia a lambda-cihalotrina en la línea W-1K está mediada por P450 y que la sobreexpresión de CYP6A51 puede desempeñar un papel importante, aunque se necesitan más evidencias para establecer una asociación directa de la resistencia con este gen. Hemos estudiado la herencia, el coste biológico y la estabilidad de la resistencia a malatión mediada por la mutación G328A y la duplicación del gen Ccace2 (una de las copias lleva la mutación G328A). La línea susceptible C, donde no se encuentra la mutación G328A (genotipo S/S), se cruzó con dos isolíneas establecidas para representar genotipos únicos correspondientes a los dos mecanismos de resistencia asociados a la molécula diana: 1) la isolínea 267Y (genotipo R/R) establecida a partir de una pareja que portaba la mutación G328A en homocigosis; 2) la isolínea 306TY (genotipo RS/RS) establecida a partir de una pareja que portaba en homocigosis la duplicación del gen Ccace2. No se realizaron cruces recíprocos, ya que mediante experimentos de hibridación in situ en cromosomas politénicos se pudo comprobar que el locus de la AChE y la duplicación (probablemente en tándem) se localizan en el cromosoma autosómico 2L. La susceptibilidad al malatión de los parentales resistentes (R/R o RS/RS) y susceptibles (S/S), los cruces F1 (S/R, S/RS y R/RS) y los retrocruzamientos indican que la resistencia a malatión es semi-dominante en ambos casos. Sin embargo, nuestros resultados no fueron concluyentes con respecto a la naturaleza monogénica de la resistencia a malatión en estas isolíneas. Por lo tanto, no podemos descartar que otros genes que contribuyan a la resistencia, además de la mutación G328A (isolínea 267Y) y de la duplicación del gen Ccace2 (isolínea 306TY), puedan haber sido seleccionados durante el proceso de selección de 267Y y 306TY. Varios parámetros biológicos fueron evaluados para determinar si estos dos mecanismos de resistencia a malatión suponen un coste biológico para los genotipos resistentes. Individuos con genotipo R/R mostraron un retraso en el tiempo de desarrollo de huevo a pupa, un peso de pupa reducido y una menor longevidad de los adultos, en comparación con los individuos con genotipo S/S. Sin embargo, el peso de pupa de los individuos con genotipo RS/RS fue similar al de los individuos S/S, y su desarrollo de huevo a pupa intermedio entre S/S y R/R. Estas diferencias en el coste biológico pueden estar relacionadas con la reducción de la eficiencia catalítica de la AChE mutada en los individuos R/R, y al efecto compensatorio que la copia no mutada del gen tiene en los individuos RS/RS que portan la duplicación. La estabilidad de la resistencia a malatión mediada por la mutación G328A y la duplicación se analizó mediante el seguimiento de los caracteres de resistencia en la progenie de retrocruzamientos S/R x R/R y S/RS x RS/RS a lo largo de varias generaciones en ausencia de presión de selección con insecticidas. Nuestros resultados muestran que la frecuencia del alelo que porta la mutación G328A disminuyó desde 67,5% en la primera generación del retrocruzamiento S/R x R/R (75% esperado, asumiendo segregación mendeliana y que sólo hay dos alelos: uno mutado y otro no mutado) a 12% después de 10 generaciones. Por el contrario, la frecuencia de la duplicación sólo disminuyó desde 75% en en la primera generación del retrocruzamiento S/RS x RS/RS (75% esperado, asumiendo segregación Mendeliana y que la duplicación segrega como un único alelo) a 50% en el mismo período, lo que indica que la duplicación es más estable que la mutación. Asimismo, se analizó la presencia de la mutación y de la duplicación en poblaciones de campo recogidas en seis localidades en 2004-2007, cuando todavía se usaba el malatión, y se comparó con poblaciones recogidas en los mismos campos en 2010, un año después de la prohibición del malatión en la Unión Europea. La frecuencia media del genotipo susceptible (S/S) aumentó del 55,9% en el período 2004-2007 a 70,8% en 2010, mientras que la frecuencia de los genotipos portadores de la mutación en homocigosis o heterocigosis (R/R y S/R) disminuyó del 30,4 al 9,2%, los que llevan la duplicación en homocigosis o heterocigosis (RS/RS y S/RS) aumentaron levemente desde 12,8 hasta 13,3%, y los que llevan a la vez la mutación y la duplicación (R/RS) también aumentaron del 1 al 6,7%. Estos resultados son consistentes con que la duplicación del gen Ccace2 (con una copia con la mutación G328A y la otra copia no mutada) es más ventajosa que la mutación G328A por si sola, ya que la duplicación mantiene los niveles de resistencia a la vez que limita el coste biológico. Para investigar la asociación entre la resistencia a malatión y las mutaciones encontradas previamente en CcE7, hemos generado isolíneas con mutaciones específicas seleccionadas por su ubicación próxima a la entrada al centro activo de la enzima. La isolínea Sm2 (procedente de una hembra heterocigota para la mutación V96L y un macho homocigoto para el alelo no mutado) mantuvo altos niveles de resistencia a malatión, incluso después de 30 generaciones sin presión de selección. Por el contrario, la isolínea 267Y (compuesta por individuos homocigotos para la mutación L267Y) y la línea 306TY (compuesta por individuos homocigotos para la doble mutación R306T-N307Y) mostraron una reducción significativa en los niveles de resistencia. También hemos encontrado que la resistencia a malatión de la línea Sm2 fue parcialmente revertida por DEF y TPP, y que Sm2 mostró una reducción significativa en la actividad MTB, como se ha descrito en otras especies que muestran resistencia específica a malatión mediada por aliesterases. Además, fue posible asociar la presencia de la mutación V96L en individuos de la línea Sm2 con supervivencia a una concentración discriminante de malatión (5,000 ppm) y con una baja actividad MTB. Estos resultados sugieren una posible relación entre la mutación V96L en la aliesterasa CcE7 y la resistencia a malatión, aunque todavía no se puede concluir que la resistencia es causada por esta mutación, siendo necesarios más estudios para comprobar su contribución a la resistencia. En conclusión, se ha encontrado por primera vez resistencia a lambda-cihalotrina en poblaciones de campo de C. capitata, y nuestros resultados indican que las P450 son el principal mecanismo de resistencia en la línea W-1K. Esta situación se suma al caso previamente descrito de resistencia en campo a malatión asociada a la mutación G328A, a la duplicación del gen Ccace2 (una de las copias lleva la mutación G328A) y a resistencia metabólica mediada por esterasas. Nuestros resultados también indican que la alteración de la molécula diana AChE parece ser responsable de un cierto nivel de resistencia a malatión en C. capitata, que puede ser estimada como aproximadamente 25-40 veces para la mutación G328A y 40-60 veces para la duplicación; mientras que la resistencia mediada por esterasas y que ha sido asociada en este estudio con la mutación V96L en CcE7 puede conferir un efecto multiplicativo (por un factor de 5 a 10) aumentando la resistencia a malatión a 200-400 veces. Por otra parte, hemos demostrado que los insectos resistentes que llevan la duplicación tienen un coste biológico menor y muestran una estabilidad mayor que aquellos con la mutación G328A en ausencia de presión de selección con insecticidas. Esto representa un escenario en el que los genotipos con la duplicación permanecerán en el campo en frecuencias bajas a moderadas, pero podrían ser seleccionados rápidamente si se utilizan malatión u otros insecticidas que muestren resistencia cruzada. Estos resultados tienen importantes implicaciones para los programas de manejo de la resistencia, ya que el repertorio de insecticidas eficaces para el control de C. capitata es cada vez más limitado. Además, la coexistencia de múltiples mecanismos de resistencia en poblaciones de campo ofrece el potencial para desarrollar resistencia frente a otros insecticidas disponibles para el control de esta plaga. Estrategias para de manejo de la resistencia basadas en la alternancia de insecticidas con diferentes modos de acción, y su combinación con otros métodos de control, deben ser implementadas para evitar el desarrollo de resistencia en campo. ABSTRACT The Mediterranean fruit fly (Medfly), Ceratitis capitata (Wiedemann, 1824) (Diptera: Tephritidae), is one of the most economically damaging pests of citrus and other fruit crops worldwide. Control measures in citrus crops in Spain from the mid 90's to 2009 were mainly based on field monitoring of population levels and aerial and ground treatments with malathion bait sprays. However, since the withdrawal of phytosanitary products containing malathion in the European Union in 2009, lambda-cyhalothrin and spinosad have become the most widely used insecticides for the control of this pest. Resistance to malathion was found in Spanish field populations of C. capitata in 2004-2005. This resistance has been associated with a mutation G328A in the acetylcholinesterase (AChE), a duplication of the AChE gene (Ccace2) (one of the copies bearing the mutation G328A), and metabolic resistance mediated by esterases (probably aliesterases). However, when the gene of the aliesterase CcE7 was sequenced in individuals from a malathion resistant strain of C. capitata, none of the known G137D and/or W251L/S/G mutations associated to resistance in other species were found, though other mutations were detected when compared with individuals from a susceptible strain. Noteworthy, a lambda-cyhalothrin resistant strain (W-1K) was obtained by selecting a field-derived malathion resistant strain (W-4Km) with lambda-cyhalothrin. Moreover, it has also been demonstrated the capacity of this species to develop resistance to spinosad by laboratory selection. The multiple resistance mechanisms identified highlight the potential of this species to develop resistance to insecticides with different modes of action. The objectives of this PhD Thesis are: 1) to assess the susceptibility of Spanish field populations of C. capitata to lambda-cyhalothrin and to elucidate the resistance mechanisms in the W-1Kλ strain; 2) to compare the inheritance, fitness cost and stability of the malathion resistance mediated by the G328A mutation and the duplication of the Ccace2 gene (with one of the copies bearing the mutation G328A); and 3) to investigate the role of the aliesterase CcαE7 mutations in malathion resistance. All these studies will be of use for devising proactive resistance management strategies that could prevent or delay resistance development and would increase the sustainability of the insecticides available for Medfly control. Our results indicate that Spanish field populations of C. capitata have developed resistance to lambda-cyhalothrin. The LC50 values estimated for populations collected at Comunidad Valenciana, Cataluña and Andalucía ranged from 129 ppm to 287 ppm, equaling or overpassing the recommended concentration for field treatments (125 ppm). These results contrast with those obtained with three different Tunisian field populations, whose susceptibility was similar to that of the control (C) strain. The lambda-cyhalothrin resistant W-1K strain has been further selected to achieve a 205-fold resistance compared to the C strain, being its LC50 (4,224 ppm) more than 30 times higher than the recommended concentration for field applications. This resistant strain showed high levels of cross-resistance to deltamethrin (150-fold) and etofenprox (240-fold), suggesting that the development of resistance to lambda-cyhalothrin may compromise the effectiveness of other pyrethroids for the control of this species. We have shown that the resistance of the W-1K strain to lambda-cyhalothrin was almost completely suppressed by the synergist PBO, indicating that P450 enzymes play a very important role in resistance to this insecticide. However, both susceptible C and resistant W-1K flies were knocked down after topical treatment with lambda-cyhalothrin, suggesting that kdr resistance mediated by alterations of the target site is not playing a major role. Metabolic resistance mediated by P450 was further analyzed by comparing the expression of 53 genes of the families CYP4, CYP6, CYP9 and CYP12 in adults flies from the resistant W-1K and the susceptible C strains. We found that the gene CYP6A51 (GenBank accession number XM_004534804) was overexpressed (13-18-fold) in the W-1K strain. Moreover, the expression of the CYP6A51 gene was induced when adults of the W-1K and C strains were treated with lambda-cyhalothrin. However, no significant differences were obtained between susceptible C and resistant W-1K strains for the quantity of P450 and for the activity of NADPH- cytochrome c reductase measured in microsomal fractions obtained from abdomens. Moreover, we failed to correlate the metabolism of deltamethrin, analyzed in vitro by incubating this insecticide with microsomal fractions, with the resistance level against this pyrethroid observed in bioassays with W-1K. The sequencing of the 5´UTR region of the CYP6A51 gene failed in finding an alteration in the promoter region (-500 bp from translation start site) that could explain overexpression in the W-1K strain. All data obtained suggest that resistance to lambda-cyhalothrin in the W- 1K strain is mediated by P450 and that overexpression of CYP6A51 may play a major role, although further evidences are needed to establish a direct association of resistance with this gene. We have studied the inheritance, fitness cost and stability of the malathion resistance mediated by the G328A mutation and the duplication of the Ccace2 gene (with one of the copies bearing the mutation G328A). The malathion-susceptible C strain where the G328A mutation is not found (S/S genotype) was crossed with two isolines established to represent unique genotypes corresponding to the two target-site resistance mechanisms: 1) the 267Y isoline (genotype R/R) was established from a couple bearing the mutation G328A in homozygosis; and 2) the 306TY isoline (genotype RS/RS) was established from a couple being homozygous for the duplication of the Ccace2 gene. Reciprocal crosses have not been performed, since in situ hybridization on polythene chromosomes showed that the AChE locus and the duplication (most probably in tandem) are placed at the autosomal chromosome 2L. Mortality responses to malathion of resistant isolines (R/R or RS/RS) and susceptible (S/S) genotypes, F1 crosses (S/R, S/RS, and R/RS), and the back-crosses indicated that resistance to malathion is inherited as a semi-dominant trait in both cases. However, our results were not conclusive about the monogenic nature of the resistance to malathion in these isolines. Thus, we can not discard that other genes contributing to resistance, in addition to the mutation G328A (isoline 267Y) and the duplication of the Ccace2 gene (isoline 306TY), may have been selected during the selection process of 267Y and 306TY. Several biological parameters were evaluated to determine if these two malathion resistance mechanisms impose a fitness cost for resistant genotypes. Individuals with genotype R/R have a reduced fitness in terms of developmental time from egg to pupa, pupal weight and adult longevity, when compared to susceptible individuals (genotype S/S). Interestingly, the fitness cost was substantially diminished in individuals with genotype RS/RS. These differences in fitness may be related to the reduction of the catalytic efficiency of mutated AChE in individuals R/R, and the compensatory effect that the non-mutated copy of the gene has on individuals RS/RS bearing the duplication. The stability of malathion reistance associated with the mutation G328A or the duplication was analyzed by following these resistant traits in the progeny of the back-crosses S/RS x RS/RS and S/R x R/R over consecutive generations in the absence of insecticide selection pressure. Our results show that the frequency of the allele bearing the mutation G328A decreased from 67.5% at the first generation of the back-cross S/R x R/R (75% expected, assuming Mendelian segregation and that there are only two alleles: one mutated and the other non-mutated) to 12% after 10 generations. By contrast, the frequency of the duplication only declined from 75% at the first generation of the back-cross S/RS x RS/RS (75% expected, assuming Mendelian segregation and that the duplication segregates as an unique allele) to 50% in the same period, indicating that the duplication is more stable than the mutation. The presence of the mutation and the duplication was analyzed in field populations collected in six localities in 2004-2007, when malathion was still used, and compared to populations collected in the same fields in 2010, one year after the prohibition of malathion in the European Union. The average frequency of the susceptible genotype (S/S) increased from 55.9% in the period 2004-2007 to 70.8% in 2010, whereas the frequency of those genotypes carrying the mutation in homozygosis or heterozygosis (R/R and S/R) declined from 30.4 to 9.2%, those carrying the duplication in homozygosis or heterozygosis (RS/RS and S/RS) increased slightly from 12.8 to 13.3%, and those carrying both the mutation and the duplication (R/RS) also increased from 1 to 6.7%. These results are consistent with the duplication of the Ccace2 gene (with one of the copies bearing the mutation G328A and the other copy non-mutated) being more advantageous than the G328A mutation alone by maintaining resistance while restoring part of the fitness. In order to investigate the association of malathion resistance with mutations previously found in the aliesterase CcE7, we have generated isolines bearing specific mutations selected by their putative location near the upper part of the active site gorge of the enzyme. The isoline Sm2 (originating from a female heterozygous for the mutation V96L and a male homozygous for the non-mutated allele) kept high levels of resistance to malathion, even after 30 generations without selection pressure. On the contrary, the isoline 267Y (composed by individuals homozygous for the mutation L267Y) and the strain 306TY (composed by homozygous for the double mutation R306T-N307Y) showed a significant reduction in the levels of resistance. We have found also that resistance to malathion in the Sm2 isoline was partially reverted by DEF and TPP, and that Sm2 showed a significant reduction in MTB activity, as reported for other species showing malathion-specific resistance mediated by aliesterases. Besides, it was possible to associate the presence of the mutation V96L in individuals from the Sm2 isoline with both survival to a discriminating concentration of malathion (5,000 ppm) and low MTB activity. Our results point out to a possible connection betwen the mutation V96L in the aliesterase CcE7 and resistance to malathion, though we can not yet conclude that the resistance is caused by the mutation, being needed further work to understand its contribution to resistance. In conclusion, resistance to lambda-cyhalothrin has been found for the first time in field populations of C. capitata, and metabolic resistance mediated by P450 appears to be the main resistance mechanism in the resistant strain W-1K. These findings add to the previously reported case of field resistance to malathion, associated to the G328A mutation and the duplication of the Ccace2 gene (with one of the copies bearing the mutation G328A) and to metabolic resistance mediated by esterases. Our results also indicate that altered target site AChE appears to be responsible for a certain level of resistance to malathion in C. capitata, that can be estimated as about 25-40-fold for the mutation G328A and 40-60-fold for the duplication; whereas metabolic resistance mediated by esterases and associated in this study with the mutation V96L in CcE7 may confer a multiplicative effect (by a factor of 5 to10) increasing malathion resistance to 200-400-fold. Moreover, we have shown that resistant insects carrying the duplication have better fitness and exhibit a higher stability than those with the mutation G328A in the absence of insecticide pressure. This represents a scenario where genotypes with the duplication will remain in the field at low to moderate frequencies, but could be rapidly selected if malathion or other insecticides showing cross-resistance are used. These findings have important implications for resistance management programs, as the repertoire of effective insecticides for C. capitata control is becoming very limited. Besides, multiple resistance mechanisms coexisting in field populations provide the potential to develop resistance to other available insecticides for the control of this pest. Appropriate resistance management strategies based on the alternation of insecticides with different modes of action, and their combination with other control methods, must then be implemented to avoid the evolution of resistance in the field.

Criação de Manual de Procedimentos para Gestão de Risco de dispositivos médicos de uma Unidade de Saúde

A melhoria progressiva na prestação de cuidados de saúde que se verifica nos dias de hoje, deve-se maioritariamente ao desenvolvimento de novas tecnologias médicas, que se traduzem na criação de inovadores dispositivos médicos, cujo fim é auxiliar no diagnóstico, prevenção e tratamento de doenças, melhorando assim as condições de trabalho e os cuidados oferecidos aos pacientes. No entanto estas melhorias apenas são vantajosas quando as novas tecnologias são utilizadas de forma segura, o que leva a uma preocupação crescente com a segurança dos profissionais de saúde e dos pacientes em ambiente hospitalar. Como forma de reduzir e controlar os riscos existentes, as unidades de saúde introduziram mecanismos de gestão que permitem o conhecimento das fontes de risco e respetivos mecanismos de ação. A presente dissertação de mestrado apresenta uma proposta de modelo de Manual de Procedimentos para Gestão de Risco de Dispositivos Médicos, aplicável a todos os dispositivos médicos existentes nas Unidades de Saúde. Para a criação deste manual, foram utilizados por meio de adaptação, as etapas da gestão de risco definidas na Norma ISO 14971:2007 em conjunto com o método de gestão de risco utilizado pela Unidade Local de Saúde de Matosinhos O desenvolvimento deste manual de procedimentos permitirá a esta unidade de saúde, a aquisição e fornecimento de informações úteis na tomada de decisão sobre os procedimentos de controlo de risco de dispositivos médicos, com o objetivo de manter o risco destes dispositivos dentro dos níveis previamente estabelecidos e auxiliar a tomada de decisão de programas de manutenção preventiva e de aquisição de dispositivos médicos.

Escolhas sequenciais e simultâneas em humanos: processamento independente ou por competição?

Dissertação de mestrado integrado em Psicologia

Endogenous and exogenously-induced immunomodulation of tumour-host responsiveness

In spite of the availability of multiple effector mechanisms of the immune system to combat tumour growth and metastases, their impairment frequently accompanies the appearance of cancer. Factors contributing to this impairment may be related to properties of the host and/or the tumour itself and may be with respect to their origin -endogenous or exogenour. Based on the unique biological behavior of prostate cancer (PCa), and its apparent escape from immune surveillance in the presence of tumour immuno genicity, continuing investigation of endogenous and exogenous factors thought to be relevant to its pathogenesis have been made. For this purpose further studies of the suggested role of human seminal plasma (SePl) and the synthetic oestrogen, diethylstiboestrol (DES), as representative endogenous and exogenous immunomodulatory factors (IMF) of tumour-host responsiveness, together with evaluation of human prostatic tissue extracts and leuprolide (the luteinizing-hormone-releasing-hormone proposed as an alternate to DES therapy) have been made by evaluating their effect on the lytic activity of natural killer (NK) cells. SePl and prostate extracts significantly suppressed NK cell lysis. Physicochemical studies suggest SePl and prostate IMF to be associated with high and low molecular weight macromolecules; and implicate the participation of transglutaminase and prostaglandins. Comparative study of therapeutic levels of DES vs. leuprolide on NK cell lysis demonstrated significant suppression by DES vs. a negligible effect of leuprolide. Metastases are highly prevalent in PCa, and contribute significantly to its morbidity and mortality. Further knowledge of the range of effects of endogenous and exogenous IMF on effector mechanisms of tumour-host responsiveness, to include suppression of NK cells, and elucidation of their nature, may contribute toward our understanding of the unique biological behavior of tumours of the prostate, in addition to improvement in their clinical management.

Development and preclinical assessment of a bioartificial pancreas.

Transplantation of insulin secreting cells is regarded as a possible treatment for type 1 diabetes. One major difficulty in this approach is, however, that the transplanted cells are exposed to the patient's inflammatory and autoimmune environment, which originally destroyed their own beta-cells. Therefore, even if a good source of insulin-secreting cells can be identified for transplantation therapy, these cells need to be protected against these destructive influences. The aim of this project was to evaluate, using a clonal mouse beta-cell line, whether genetic engineering of protective genes could be a viable option to allow these cells to survive when transplanted into autoimmune diabetic mice. We demonstrated that transfer of the Bcl-2 anti-apoptotic gene and of several genes specifically interfering with cytokines intracellular signalling pathways, greatly improved resistance of the cells to inflammatory stresses in vitro. We further showed that these modifications did not interfere with the capacity of these cells to correct hyperglycaemia for several months in syngeneic or allogeneic streptozocin-diabetic mice. However, these cells were not protected against autoimmune destruction when transplanted into type 1 diabetic NOD mice. This suggests that in addition to inflammatory attacks by cytokines, autoimmunity very efficiently kills the transplanted cells, indicating that multiple protective mechanisms are required for efficient transplantation of insulin-secreting cells to treat type 1 diabetes.

Deficient selenium status of a healthy adult Spanish population.

INTRODUCTION Selenium is an essential micronutrient for human health, being a cofactor for enzymes with antioxidant activity that protect the organism from oxidative damage. An inadequate intake of this mineral has been associated with the onset and progression of chronic diseases such as hypertension, diabetes, coronary diseases, asthma, and cancer. For this reason, knowledge of the plasma and erythrocyte selenium levels of a population makes a relevant contribution to assessment of its nutritional status. OBJECTIVE The objective of the present study was to determine the nutritional status of selenium and risk of selenium deficiency in a healthy adult population in Spain by examining food and nutrient intake and analyzing biochemical parameters related to selenium metabolism, including plasma and erythrocyte levels and selenium-dependent glutathione peroxidase (GPx) enzymatic activity. MATERIAL AND METHODS We studied 84 healthy adults (31 males and 53 females) from the province of Granada, determining their plasma and erythrocyte selenium concentrations and the association of these levels with the enzymatic activity of glutathione peroxidase (GPx) and with life style factors. We also gathered data on their food and nutrient intake and the results of biochemical analyses. Correlations were studied among all of these variables. RESULTS The mean plasma selenium concentration was 76.6 ± 17.3 μg/L (87.3 ± 17.4 μg/L in males, 67.3 ± 10.7 μg/L in females), whereas the mean erythrocyte selenium concentration was 104.6 μg/L (107.9 ± 26.1 μg/L in males and 101.7 ± 21.7 μg/L in females). The nutritional status of selenium was defined by the plasma concentration required to reach maximum GPx activity, establishing 90 μg/L as reference value. According to this criterion, 50% of the men and 53% of the women were selenium deficient. CONCLUSIONS Selenium is subjected to multiple regulation mechanisms. Erythrocyte selenium is a good marker of longer term selenium status, while plasma selenium appears to be a marker of short-term nutritional status. The present findings indicate a positive correlation between plasma selenium concentration and the practice of physical activity. Bioavailability studies are required to establish appropriate reference levels of this mineral for the Spanish population.

Prognostic value of arginase-II expression and regulatory T-cell infiltration in head and neck squamous cell carcinoma.

Tumor-infiltrating lymphocytes are present in a variety of tumors and play a central role in antitumor immune responses. Nevertheless, most cancers progress probably because tumors are only weakly immunogenic and develop multiple immunosuppressive mechanisms. In the present study, on head and neck squamous cell carcinoma, we found high intraepithelial infiltration of regulatory FOXP3(+) T cells, and relatively high levels of BDCA2(+) and FOXP3(+) cells in stromal (peripheral) regions of the tumors. Tumor-infiltrating (intraepithelial) FOXP3(+) T cells were significantly more frequent in patients with oropharynx and oral cavity squamous cell carcinoma and in patients without lymph node metastasis. Furthermore, arginase-II (ARG2) was expressed by 60%, inducible nitric oxide synthetase by 9%, cyclooxygenase-2 by 43%, and B-cell lymphoma 2 (BCL2) by 26% of tumors. Interestingly, the absence of ARG2 expression, enhanced stromal infiltration of CD11c(+) myeloid dendritic cells, and high numbers of FOXP3(+) T cells were each significantly associated with prolonged overall survival, and the latter two parameters were also confirmed by multivariate analysis. For disease-free survival, multivariate analysis revealed significant negative correlations with BCL2 and ARG2 expression by tumor cells. These findings shed new light on mechanisms of cancer progression, and provide rationales for therapeutic inhibition of immunosuppressive mechanisms in head and neck squamous cell carcinoma.

Two specific populations of GABAergic neurons originating from the medial and the caudal ganglionic eminences aid in proper navigation of callosal axons.

The corpus callosum (CC) plays a crucial role in interhemispheric communication. It has been shown that CC formation relies on the guidepost cells located in the midline region that include glutamatergic and GABAergic neurons as well as glial cells. However, the origin of these guidepost GABAergic neurons and their precise function in callosal axon pathfinding remain to be investigated. Here, we show that two distinct GABAergic neuronal subpopulations converge toward the midline prior to the arrival of callosal axons. Using in vivo and ex vivo fate mapping we show that CC GABAergic neurons originate in the caudal and medial ganglionic eminences (CGE and MGE) but not in the lateral ganglionic eminence (LGE). Time lapse imaging on organotypic slices and in vivo analyses further revealed that CC GABAergic neurons contribute to the normal navigation of callosal axons. The use of Nkx2.1 knockout (KO) mice confirmed a role of these neurons in the maintenance of proper behavior of callosal axons while growing through the CC. Indeed, using in vitro transplantation assays, we demonstrated that both MGE- and CGE-derived GABAergic neurons exert an attractive activity on callosal axons. Furthermore, by combining a sensitive RT-PCR technique with in situ hybridization, we demonstrate that CC neurons express multiple short and long range guidance cues. This study strongly suggests that MGE- and CGE-derived interneurons may guide CC axons by multiple guidance mechanisms and signaling pathways. © 2013 Wiley Periodicals, Inc. Develop Neurobiol 73: 647-672, 2013.

Evaluation of Microcracking and Chemical Deterioration in Concrete Pavements, October 31, 1995

The major objective of this research project was to investigate the chemistry and morphology of portland cement concrete pavements in Iowa. The integrity of the various pavements was evaluated qualitatively, based on the presence or absence of microcracks, the presence or absence of sulfate minerals, and the presence or absence of alkali-silica gel(s). Major equipment delays and subsequent equipment replacements resulted in significant delays over the course of this research project. However, all these details were resolved and the equipment is currently in place and fully operational. The equipment that was purchased for this project included: (I) a LECO VP 50, 12-inch diameter, variable speed grinder/polisher: (2) a Hitachi S-2460N variable pressure scanning electron microscope; and (3) a OXFORD Instruments Link ISIS microanalysis system with a GEM (high-purity germanium) X-ray detector. This study has indicated that many of the concrete pavements contained evidence of multiple deterioration mechanisms: and hence, the identification of a single reason for the distress that was observed in any given pavement typically had to be based on opinion rather than empirical evidence.

Evaluation of Microcracking and Chemical Deterioration in Concrete Pavements Final Report, October 31, 1995

The major objective of this research project was to investigate the chemistry and morphology of portland cement concrete pavements in Iowa. The integrity of the various pavements was evaluated qualitatively, based on the presence or absence of microcracks, the presence or absence of sulfate minerals, and the presence or absence of alkali-silica gel(s). Major equipment delays and subsequent equipment replacements resulted in significant delays over the course of this research project. However, all these details were resolved and the equipment is currently in place and fully operational. The equipment that was purchased for this project included: ( I ) a LECO VP 50, 12-inch diameter, variable speed grinder/polisher: (2) a Hitachi S-2460N variable pressure scanning electron microscope; and (3) a OXFORD Instruments Link ISIS microanalysis system with a GEM (high-purity germanium) X-ray detector. This study has indicated that many of the concrete pavements contained evidence of multiple deterioration mechanisms: and hence, the identification of a single reason for the distress that was observed in any given pavement typically had to be based on opinion rather than empirical evidence.

Functional compensation of motor function in pre-symptomatic Huntington's disease.

Involuntary choreiform movements are a clinical hallmark of Huntington's disease. Studies in clinically affected patients suggest a shift of motor activations to parietal cortices in response to progressive neurodegeneration. Here, we studied pre-symptomatic gene carriers to examine the compensatory mechanisms that underlie the phenomenon of retained motor function in the presence of degenerative change. Fifteen pre-symptomatic gene carriers and 12 matched controls performed button presses paced by a metronome at either 0.5 or 2 Hz with four fingers of the right hand whilst being scanned with functional magnetic resonance imaging. Subjects pressed buttons either in the order of a previously learnt 10-item finger sequence, from left to right, or kept still. Error rates ranged from 2% to 7% in the pre-symptomatic gene carriers and from 0.5% to 4% in controls, depending on the condition. No significant difference in task performance was found between groups for any of the conditions. Activations in the supplementary motor area (SMA) and superior parietal lobe differed with gene status. Compared with healthy controls, gene carriers showed greater activations of left caudal SMA with all movement conditions. Activations correlated with increasing speed of movement were greater the closer the gene carriers were to estimated clinical diagnosis, defined by the onset of unequivocal motor signs. Activations associated with increased movement complexity (i.e. with the pre-learnt 10-item sequence) decreased in the rostral SMA with nearing diagnostic onset. The left superior parietal lobe showed reduced activation with increased movement complexity in gene carriers compared with controls, and in the right superior parietal lobe showed greater activations with all but the most demanding movements. We identified a complex pattern of motor compensation in pre-symptomatic gene carriers. The results show that preclinical compensation goes beyond a simple shift of activity from premotor to parietal regions involving multiple compensatory mechanisms in executive and cognitive motor areas. Critically, the pattern of motor compensation is flexible depending on the actual task demands on motor control.

Distribution of metals exposure and associations with cardiometabolic risk factors in the "Modeling the Epidemiologic Transition Study".

BACKGROUND: Metals are known endocrine disruptors and have been linked to cardiometabolic diseases via multiple potential mechanisms, yet few human studies have both the exposure variability and biologically-relevant phenotype data available. We sought to examine the distribution of metals exposure and potential associations with cardiometabolic risk factors in the "Modeling the Epidemiologic Transition Study" (METS), a prospective cohort study designed to assess energy balance and change in body weight, diabetes and cardiovascular disease risk in five countries at different stages of social and economic development. METHODS: Young adults (25-45 years) of African descent were enrolled (N = 500 from each site) in: Ghana, South Africa, Seychelles, Jamaica and the U.S.A. We randomly selected 150 blood samples (N = 30 from each site) to determine concentrations of selected metals (arsenic, cadmium, lead, mercury) in a subset of participants at baseline and to examine associations with cardiometabolic risk factors. RESULTS: Median (interquartile range) metal concentrations (μg/L) were: arsenic 8.5 (7.7); cadmium 0.01 (0.8); lead 16.6 (16.1); and mercury 1.5 (5.0). There were significant differences in metals concentrations by: site location, paid employment status, education, marital status, smoking, alcohol use, and fish intake. After adjusting for these covariates plus age and sex, arsenic (OR 4.1, 95% C.I. 1.2, 14.6) and lead (OR 4.0, 95% C.I. 1.6, 9.6) above the median values were significantly associated with elevated fasting glucose. These associations increased when models were further adjusted for percent body fat: arsenic (OR 5.6, 95% C.I. 1.5, 21.2) and lead (OR 5.0, 95% C.I. 2.0, 12.7). Cadmium and mercury were also related with increased odds of elevated fasting glucose, but the associations were not statistically significant. Arsenic was significantly associated with increased odds of low HDL cholesterol both with (OR 8.0, 95% C.I. 1.8, 35.0) and without (OR 5.9, 95% C.I. 1.5, 23.1) adjustment for percent body fat. CONCLUSIONS: While not consistent for all cardiometabolic disease markers, these results are suggestive of potentially important associations between metals exposure and cardiometabolic risk. Future studies will examine these associations in the larger cohort over time.

Bidding support for computational resources

Peer-reviewed

Selectivity of glyphosate in tank mixtures for RR soybean in sequential applications with mixtures only in the first or second application

Tank mixtures among herbicides of different action mechanisms might increase weed control spectrum and may be an important strategy for preventing the development of resistance in RR soybean. However, little is known about the effects of these herbicide combinations on soybean plants. Hence, two experiments were carried out aiming at evaluating the selectivity of glyphosate mixtures with other active ingredients applied in postemergence to RR soybean. The first application was carried out at V1 to V2 soybean stage and the second at V3 to V4 (15 days after the first one). For experiment I, treatments (rates in g ha-1) evaluated were composed by two sequential applications: the first one with glyphosate (720) in tank mixtures with cloransulam (30.24), fomesafen (125), lactofen (72), chlorimuron (12.5), flumiclorac (30), bentazon (480) and imazethapyr (80); the second application consisted of isolated glyphosate (480). In experiment II, treatments also consisted of two sequential applications, but tank mixtures as described above were applied as the second application. The first one in this experiment consisted of isolated glyphosate (720). For both experiments, sequential applications of glyphosate alone at 720/480, 960/480, 1200/480 and 960/720 (Expt. I) or 720/480, 720/720, 720/960 and 720/1200 (Expt. II) were used as control treatments. Applications of glyphosate tank mixtures with other herbicides are more selective to RR soybean when applied at younger stages whereas applications at later stages might cause yield losses, especially when glyphosate is mixed with lactofen and bentazon.

Morphological and physiological alterations induced by lactofen in soybean leaves are reduced with nitric oxide

Lactofen is a diphenylether herbicide recommended to control broad-leaved weeds in soybean (Glycine max) fields and its mechanism of action is the inhibition of protoporphyrinogen-IX oxidase (Protox), which acts in the chlorophyll biosynthesis. This inhibition results in an accumulation of protoporphyrin-IX, which leads to the production of reactive oxygen species (ROS) that cause oxidative stress. Consequently, spots, wrinkling and leaf burn may occur, resulting in a transitory crop growth interruption. However, nitric oxide (NO) acts as an antioxidant in direct ROS scavenging. Thus, the aim of this work was to verify, through phytometric and biochemical evaluations, the protective effect of NO in soybean plants treated with the herbicide lactofen. Soybean plants were pre-treated with different levels of sodium nitroprusside (SNP), a NO-donor substance, and then sprayed with 168 g a.i. ha-1 lactofen. Pre-treatment with SNP was beneficial because NO decreased the injury symptoms caused by lactofen in young leaflets and kept low the soluble sugar levels. Nevertheless, NO caused slower plant growth, which indicates that further studies are needed in order to elucidate the action mechanisms of NO in signaling the stress caused by lactofen in soybean crop.