Revegetação de cava de extração de argila com Acacia mangium: I - atributos químicos do solo, ácidos fúlvicos e húmicos

O presente trabalho teve como objetivo avaliar alterações nos atributos químicos do solo e dos ácidos húmicos e fúlvicos extraídos de cava de extração de argila com vegetação espontânea de gramínea [Brachiaria mutica (Forsk.) Stapf] e revegetada de Acacia mangium Willd. Foram coletadas amostras de solo nas profundidades de 0-10, 10-20 e 20-30 cm. Na cobertura com A. mangium em relação a B. mutica, observaram-se acréscimos no estoque de carbono de 33 e 80 %, respectivamente nas profundidades de 0-10 e 20-30 cm. O menor estoque de C ocorreu na fração ácidos fúlvicos livres (AFL). Na cobertura com A. mangium foi observado aumento no grau de humificação da matéria orgânica, que variou de 38 a 280 % na fração ácidos fúlvicos (AF) e de 26 a 217 % nos ácidos húmicos (AH), dependendo da profundidade do solo. A acidez total, tanto da fração AF como dos AH, foi elevada, variando na faixa de 810 a 920 cmol c kg-1. No entanto, em torno de 67 % da capacidade de troca de H+ deveu-se a grupos OH- fenólicos, caracterizados como grupamentos ácidos mais fracos. Os valores observados para a relação E4/E6 ficaram dentro da faixa normalmente encontrada para AF (entre 8,2 e 10,5) e AH (entre 1,3 e 3,9). Os AH isolados da cava com cobertura de A. mangium apresentaram valores mais elevados da relação E4/E6, sugerindo a presença de fração humificada menos condensada e de menor massa molecular.

Therapeutic drug monitoring and metabolites profil analysis of antiviral drugs

The widespread use of combination antiretroviral therapy (ARVs) has considerably improved the prognosis of patients infected with HIV. Conversely, considerable advances have been recently realized for the therapy of hepatitis C infection with the recent advent of potent new anti-HCV drugs that allow an increasing rate HCV infection cure. Despite their overall efficacy, a significant number of patients do not achieve or maintain adequate clinical response, defined as an undetectable viral load for HIV, and a sustained virological response (or cure) in HCV infection. Treatment failure therefore still remains an important issue besides drugs toxicities and viral resistance which is not uncommon in a significant percentage of patients who do not reach adequate virological suppression. The reasons of variability in drug response are multifactorial and apart from viral genetics, other factors such as environmental factors, drug- drug interactions, and imperfect compliance may have profound impact on antiviral drugs' clinical response. The possibility of measuring plasma concentration of antiviral drugs enables to guide antiviral drug therapy and ensure optimal drug exposure. The overall objective of this research was to widen up the current knowledge on pharmacokinetic and pharmacogenetic factors that influence the clinical response and toxicity of current and newly approved antiretroviral and anti-HCV drugs. To that endeavour, analytical methods using liquid chromatography coupled with tandem mass spectrometry have been developed and validated for the precise and accurate measurement of new antiretroviral and anti-HCV drugs . These assays have been applied for the TDM of ARVs and anti-HCV in patients infected with either HIV or HCV respectively, and co-infected with HIV- HCV. A pharmacokinetic population model was developed to characterize inter and intra-patient variability of rilpivirine, the latest marketed Non Nucleoside Reverse transcriptase (NNRTI) Inhibitor of HIVand to identify genetic and non genetic covariates influencing rilpivirine exposure. None of the factors investigated so far showed however any influence of RPV clearance. Importantly, we have found that the standard daily dosage regimen (25 mg QD) proposed for rilpivirine results in concentrations below the proposed therapeutic target in about 40% of patients. In these conditions, virologie escape is a potential risk that remains to be further investigated, notably via the TDM approach that can be a useful tool to identify patients who are at risk for being exposed to less than optimal levels of rilpivirine in plasma. Besides the last generation NNRTI rilpivirine, we have studied efavirenz, the major NNRTI clinically used so far. Namely for efavirenz, we aimed at identifying a potential new marker of toxicity that may be incriminated for the neuropsychological sides effects and hence discontinuation of efavirenz therapy. To that endeavour, a comprehensive analysis of phase I and phase II metabolites profiles has been performed in plasma, CSF and in urine from patients under efavirenz therapy. We have found that phase II metabolites of EFV constitute the major species circulating in blood, sometimes exceeding the levels of the parent drug efavirenz. Moreover we have identified a new metabolite of efavirenz in humans, namely the 8-OH-EFV- sulfate which is present at high concentrations in all body compartments from patients under efavirenz therapy. These investigations may open the way to possible alternate phenotypic markers of efavirenz toxicity. Finally, the specific influence of P-glycoprotein on the cellular disposition of a series ARVs (NNRTIs and Pis] has been studies in in vitro cell systems using the siRNA silencing approach. -- Depuis l'introduction de la thérapie antirétrovirale (ARVs) la morbidité et la mortalité liées au VIH ont considérablement diminué. En parallèle le traitement contre le virus de l'hépatite C (VHC) a connu récemment d'énormes progrès avec l'arrivée de nouveaux médicaments puissants, ce qui a permis une augmentation considérable de la guérison de l'infection par le VHC. En dépit de l'efficacité de ces traitements antiviraux, les échecs thérapeutiques ainsi que les effets secondaires des traitements restent un problème important. Une réponse imparfaite ou la toxicité du traitement est certainement multifactorielle. Le suivi thérapeutique des médicaments [Therapeutic Drug Monitoring TDM) à travers la mesure des concentrations plasmatiques constitue une approche importante pour guider le traitement médicamenteux et de s'assurer que les patients sont exposés à des concentrations optimales des médicaments dans le sang, et puissent tirer tout le bénéfice potentiel du traitement. L'objectif global de cette thèse était d'étudier les facteurs pharmacocinétiques et pharmacogénétiques qui influencent l'exposition des médicaments antiviraux (ARVs et anti- VHC) récemment approuvés. A cet effet, des méthodes de quantification des concentrations plasmatiques des médicaments antirétroviraux, anti-VHC ainsi que pour certains métabolites ont été développées et validées en utilisant la Chromatographie liquide couplée à la spectrométrie de masse tandem. Ces méthodes ont été utilisées pour le TDM des ARVs et pour les agents anti-VHC chez les patients infectés par le VIH, et le VHC, respectivement, mais aussi chez les patients co-infectés par le VIH-VHC. Un modèle de pharmacocinétique de population a été développé pour caractériser la variabilité inter-et intra-patient du médicament rilpivirine, un inhibiteur non nucléosidique de la transcriptase de VIH et d'identifier les variables génétiques et non génétiques influençant l'exposition au médicament. Aucun des facteurs étudiés n'a montré d'influence notable sur la clairance de la rilpivirine. Toutefois, la concentration résiduelle extrapolée selon le modèle de pharmacocinétique de population qui a été développé, a montré qu'une grande proportion des patients présente des concentrations minimales inférieures à la cible thérapeutique proposée. Dans ce contexte, la relation entre les concentrations minimales et l'échappement virologique nécessite une surveillance étroite des taux sanguins des patients recevant de la rilpivirine. A cet effet, le suivi thérapeutique est un outil important pour l'identification des patients à risque soient sous-exposés à lai rilpivirine. Pour identifier de nouveaux marqueurs de la toxicité qui pourraient induire l'arrêt du traitement, le profil des métabolites de phase I et de phase II a été étudié dans différentes matrices [plasma, LCR et urine) provenant de patients recevant de l'efavirenz. Les métabolites de phase II, qui n'avaient à ce jour jamais été investigués, constituent les principales espèces présentes dans les matrices étudiées. Au cours de ces investigations, un nouveau métabolite 8- OH-EFV-sulfate a été identifié chez l'homme, et ce dernier est. présent à des concentrations importantes. L'influence de certains facteurs pharmacogénétique des patients sur le profil des métabolites a été étudiée et ouvre la voie à de possibles nouveaux marqueurs phénotypiques alternatifs qui pourraient possiblement mieux prédire la toxicité associée au traitement par l'efavirenz. Finalement, nous nous sommes intéressés à étudier dans un modèle in vitro certains facteurs, comme la P-glycoprotéine, qui influencent la disposition cellulaire de certains médicaments antirétroviraux, en utilisant l'approche par la technologie du siRNA permettant de bloquer sélectivement l'expression du gène de cette protéine d'efflux des médicaments. -- Depuis l'introduction de la thérapie antiretrovirale (ARVs] la morbidité et la mortalité liées au VIH ont considérablement diminué. En parallèle le traitement contre le virus de l'hépatite C (VHC) a connu récemment d'énormes progrès avec l'arrivée de nouveaux médicaments puissants, ce qui a permis une augmentation considérable de la guérison de l'infection par le VHC. En dépit de l'efficacité de ces traitements antiviraux, les échecs thérapeutiques ainsi que les effets secondaires des traitements restent un problème important. Il a pu être démontré que la concentration de médicament présente dans l'organisme est corrélée avec l'efficacité clinique pour la plupart des médicaments agissant contre le VIH et contre le VHC. Les médicaments antiviraux sont généralement donnés à une posologie fixe et standardisée, à tous les patients, il existe cependant une importante variabilité entre les concentrations sanguines mesurées chez les individus. Cette variabilité peut être expliquée par plusieurs facteurs démographiques, environnementaux ou génétiques. Dans ce contexte, le suivi des concentrations sanguines (ou Therapeutic Drug Monitoring, TDM) permet de contrôler que les patients soient exposés à des concentrations suffisantes (pour bloquer la réplication du virus dans l'organisme) et éviter des concentrations excessives, ce qui peut entraîner l'apparition d'intolérence au traitement. Le but de ce travail de thèse est d'améliorer la compréhension des facteurs pharmacologiques et génétiques qui peuvent influencer l'efficacité et/ou la toxicité des médicaments antiviraux, dans le but d'améliorer le suivi des patients. A cet effet, des méthodes de dosage très sensibles et ont été mises au point pour permettre de quantifier les médicaments antiviraux dans le sang et dans d'autres liquides biologiques. Ces méthodes de dosage sont maintenant utilisées d'une part dans le cadre de la prise en charge des patients en routine et d'autre part pour diverses études cliniques chez les patients infectés soit par le HIV, le HCV ou bien coinfectés par les deux virus. Une partie de ce travail a été consacrée à l'investigation des différents facteurs démographiques, génétiques et environnementaux qui pourraient l'influencer la réponse clinique à la rilpivirine, un nouveau médicament contre le VIH. Toutefois, parmi tous les facteurs étudiés à ce jour, aucun n'a permis d'expliquer la variabilité de l'exposition à la rilpivirine chez les patients. On a pu cependant observer qu'à la posologie standard recommandée, un pourcentage relativement élevé de patients pourrait présenter des concentrations inférieures à la concentration sanguine minimale actuellement proposée. Il est donc utile de surveiller étroitement les concentrations de rilpivirine chez les patients pour identifier sans délai ceux qui risquent d'être sous-exposés. Dans l'organisme, le médicament subit diverses transformations (métabolisme) par des enzymes, notamment dans le foie, il est transporté dans les cellules et tissus par des protéines qui modulent sa concentration au site de son action pharmacologique. A cet effet, différents composés (métabolites) produits dans l'organisme après l'administration d'efavirenz, un autre médicament anti-VIH, ont été étudiés. En conclusion, nous nous sommes intéressés à la fois aux facteurs pharmacologiques et génétiques des traitements antiviraux, une approche qui s'inscrit dans l'optique d'une stratégie globale de prise en charge du patient. Dans ce contexte, le suivi des concentrations sanguines de médicaments constitue une des facettes du domaine émergent de la Médecine Personnalisée qui vise à maximiser le bénéfice thérapeutique et le profil de tolérance des médicaments antiviraux

Variáveis de acidez em função da mineralogia da fração argila do solo

A acidez do solo e variáveis associadas são muito importantes nos manejos dos solos, especialmente nas regiões tropicais e subtropicais. Com o objetivo de estudar algumas variáveis da acidez do solo e verificar a influência da mineralogia da fração argila sobre a relação entre pH em CaCl2 e grau de saturação por bases (V), amostraram-se os horizontes B e C de diferentes classes de solo no Estado do Paraná: Latossolo Bruno ácrico húmico (LBw-1), Latossolo Bruno distrófico húmico (LBw-2), Latossolo Vermelho distroférrico húmico (LVdf), Cambissolo Háplico alumínico típico (CXa) e Cambissolo Húmico distroférrico típico (CHd). A fração argila foi estudada por difratometria de raios X, análise termodiferencial, análise termogravimétrica e análises químicas. As amostras de solo foram incubadas por 60 dias, após terem recebido doses crescentes de óxido de cálcio, para atingir valores preestabelecidos do grau de saturação por bases (natural, 25, 45, 60, 70, 125 e 150 %). Em seguida, determinaram-se os teores de cátions trocáveis e os valores de pH em H2O e solução de CaCl2 1 mol L-1. Os solos apresentaram o seguinte comportamento quanto à mineralogia da fração argila: mais esmectítico/vermiculítico - CXa; mais oxídico, principalmente óxidos de Fe - LVdf e óxidos de Al - LBw1; mais caulinítico, com menores teores de óxidos de Fe e Al - CHd e LBw2. Essa diversidade mineralógica foi determinante na relação pH em CaCl2 e grau de saturação por bases (V) dos solos. As curvas que mostraram essa relação foram não lineares, o que significa poder tamponante diferenciado ao longo da faixa de pH em CaCl2 estudada; formato convexo dos solos mais oxídicos e côncavo dos solos cauliníticos e com argila 2:1. O formato convexo das curvas foi conseqüência da formação de cargas negativas e dissociação de H+ preferencialmente a valores elevados de pH em CaCl2 (acima de 5), devido à menor acidez (PCZ mais alto) dos radicais Fe-OH e Al-OH. O formato côncavo foi atribuído a cargas permanentes e a maior dissociação de H+ a valores menores de pH em CaCl2 (abaixo de pH 5), uma vez que o radical Si-OH é considerado um ácido forte (PCZ baixo). Para um mesmo pH em CaCl2 verificou-se a seguinte seqüência nos valores de V em função da mineralogia da fração argila: solos com predomínio de óxidos de Fe e Al < solos com predomínio de caulinita < solos cauliníticos com minerais 2:1.

Loss of Memo, a novel FGFR regulator, results in reduced lifespan.

Memo is a widely expressed 33-kDa protein required for heregulin (HRG)-, epidermal growth factor (EGF)-, and fibroblast growth factor (FGF)-induced cell motility. Studies in mouse embryonic fibroblasts, wild-type or knockout for Memo, were performed to further investigate the role of Memo downstream of FGFR. We demonstrated that Memo associates with the FGFR signalosome and is necessary for optimal activation of signaling. To uncover Memo's physiological role, Memo conditional-knockout mice were generated. These animals showed a reduced life span, increased insulin sensitivity, small stature, graying hair, alopecia, kyphosis, loss of subcutaneous fat, and loss of spermatozoa in the epididymis. Memo-knockout mice also have elevated serum levels of active vitamin D, 1,25-dihydroxyvitamin D3 (1,25(OH)2D), and calcium compared to control littermates expressing Memo. In summary, the results from in vivo and in vitro models support the hypothesis that Memo is a novel regulator of FGFR signaling with a role in controlling 1,25(OH)2D production and normal calcium homeostasis.

Oral administration of a low dose of midazolam (75 microg) as an in vivo probe for CYP3A activity.

OBJECTIVE: We investigated whether the oral administration of a low dose (75 micro g) of midazolam, a CYP3A probe, can be used to measure the in vivo CYP3A activity. METHODS: Plasma concentrations of midazolam, 1'OH-midazolam and 4'OH-midazolam were measured after the oral administration of 7.5 mg and 75 micro g midazolam in 13 healthy subjects without medication, in four subjects pretreated for 2 days with ketoconazole (200 mg b.i.d.), a CYP3A inhibitor, and in four subjects pretreated for 4 days with rifampicin (450 mg q.d.), a CYP3A inducer. RESULTS: After oral administration of 75 micro g midazolam, the 30-min total (unconjugated + conjugated) 1'OH-midazolam/midazolam ratios measured in the groups without co-medication, with ketoconazole and with rifampicin were (mean+/-SD): 6.23+/-2.61, 0.79+/-0.39 and 56.1+/-12.4, respectively. No side effects were reported by the subjects taking this low dose of midazolam. Good correlations were observed between the 30-min total 1'OH-midazolam/midazolam ratio and midazolam clearance in the group without co-medication (r(2)=0.64, P<0.001) and in the three groups taken together (r(2)=0.91, P<0.0001). Good correlations were also observed between midazolam plasma levels and midazolam clearance, measured between 1.5 h and 4 h. CONCLUSION: A low oral dose of midazolam can be used to phenotype CYP3A, either by the determination of total 1'OH-midazolam/midazolam ratios at 30 min or by the determination of midazolam plasma levels between 1.5 h and 4 h after its administration.

Postmenopausal circulating levels of 2- and 16α-hydroxyestrone and risk of endometrial cancer.

Background:It has been suggested that the relative importance of oestrogen-metabolising pathways may affect the risk of oestrogen-dependent tumours including endometrial cancer. One hypothesis is that the 2-hydroxy pathway is protective, whereas the 16α-hydroxy pathway is harmful.Methods:We conducted a case-control study nested within three prospective cohorts to assess whether the circulating 2-hydroxyestrone : 16α-hydroxyestrone (2-OHE1 : 16α-OHE1) ratio is inversely associated with endometrial cancer risk in postmenopausal women. A total of 179 cases and 336 controls, matching cases on cohort, age and date of blood donation, were included. Levels of 2-OHE1 and 16α-OHE1 were measured using a monoclonal antibody-based enzyme assay.Results:Endometrial cancer risk increased with increasing levels of both metabolites, with odds ratios in the top tertiles of 2.4 (95% CI=1.3, 4.6; P(trend)=0.007) for 2-OHE1 and 1.9 (95% CI=1.1, 3.5; P(trend)=0.03) for 16α-OHE1 in analyses adjusting for endometrial cancer risk factors. These associations were attenuated and no longer statistically significant after further adjustment for oestrone or oestradiol levels. No significant association was observed for the 2-OHE1 : 16α-OHE1 ratio.Conclusion:Our results do not support the hypothesis that greater metabolism of oestrogen via the 2-OH pathway, relative to the 16α-OH pathway, protects against endometrial cancer.

Infravermelho na caracterização de ácidos húmicos de latossolo sob efeito de uso contínuo de lodo de esgoto

Objetivou-se caracterizar, por meio de espectroscopia no infravermelho com transformada de Fourier (IVTF), possíveis mudanças na natureza química de ácidos húmicos (AHs) extraídos de amostras de Latossolo (0-10 cm) do Campo Experimental da Embrapa Meio Ambiente, em Jaguariúna (SP). Os dados foram obtidos após seis cultivos de milho e a aplicação de doses variáveis de lodo de esgoto de Barueri (LB) (base seca), conforme os tratamentos avaliados: LB0, LB1, LB2, LB4 e LB8, sendo 0, 1, 2, 4 e 8 vezes a necessidade de N para o milho. Como referência, foi amostrada uma área sob mata. Foram obtidos espectros de ácidos húmicos e do lodo de esgoto utilizado no experimento, e calculados os índices de hidrofobicidade (IH) e de condensação (IC) nas amostras de ácidos húmicos. Foram notadas pequenas alterações na natureza química de AHs de áreas tratadas com lodo de esgoto, em relação à testemunha. Os AHs apresentam grupos aromáticos, -OH fenólicos, -COOH, estruturas alifáticas, carboidratos e impurezas minerais. O uso contínuo de elevadas doses de LB reduziu a concentração de C-alifático e o grau de condensação dos ácidos húmicos, o que sinaliza que há frações orgânicas com maior biodisponibilidade no solo. Na área de mata, o material húmico se caracteriza pelo caráter hidrofóbico e pelo baixo grau de condensação.

Área superficial específica, porosidade da fração argila e adsorção de fósforo em dois latossolos vermelhos

A porosidade da fração argila é muito importante para entendimento dos fenômenos físico-químicos que estão relacionados com a área superficial específica das partículas sólidas. Por meio de isotermas de adsorção e dessorção com N2, avaliaram-se a área superficial específica (S BET) e a porosidade das frações argila de Latossolos Vermelhos do Estado de Mato Grosso do Sul, sendo um distroférrico (LVdf) e outro distrófico (LVd), além de caulinita natural (KGa2), goethita (Gt) e hematita (Hm) sintéticas. Resultados referentes à S BET e à porosidade das partículas foram relacionados à adsorção máxima de P (Pmáx) determinada pela isoterma de Langmuir. A classe de poros predominante nas frações argila avaliadas foi de mesoporos. As frações argila extraídas dos solos e KGa2 adsorveram quantidades semelhantes de P por unidade de área, mas diferentes das quantidades de P adsorvido por Gt e Hm. Tal diferença, possivelmente, deu-se em função da quantidade e distribuição dos grupamentos OH em superfície, bem como imperfeições superficiais dos materiais. Os óxidos de Fe e de Al e outros materiais amorfos das frações argila extraídas dos solos foram mais importantes que a caulinita para a adsorção de P. A caulinita, embora sendo o filossilicato de maior representatividade nas frações argila de LVDf e LVD, teve menor importância sobre a adsorção de P.

Cardiorespiratory arrest and vitamin D deficiency rickets: A case report

Vitamin D deficiency rickets became a rare disease in industrialized countries due to vitamin D supplementation in infants and nutritional guidelines. Symptoms of hypocalcemia due to vitamin D deficiency rickets may be life threatening. We report a case of a 16 months old infant who initially presented with stridor that was misdiagnosed as viral laryngitis. He presented, two weeks later, a cardiorespiratory arrest related to a laryngospasm secondary to severe hypocalcemia (ionized calcium level: 0.42 mmol/l,total calcium level: 1.15 mmol/). He was successfully resuscitated and vitamin D deficiency rickets was diagnosed. The medical history revealed that the infant was exclusively breast fed without vitamin D supplementation till the age of 10 months and also deprived from other milk products intentionally by the parents due to cultural habits. The laboratory investigations showed an elevated alkaline phosphatase level at 577 U/l, a normal phosphatemia level at 2 mmol/l, a decreased 25 (OH) cholecalciferol at 5.7 mcg/l,a normal calciuria level at 0.35 mol/mol of creatinine and an increased parathyroid hormone level at 325 ng/l. Cardiocirculatory arrest secondary to vitamin D deficiency rickets is very rare. The aim of this presentation is to highlight the symptoms of vitamin D deficiency rickets and to raise pediatricians' awareness to the necessity of including the diagnosis of hypocalcemia in case of stridor especially if the nutritional history or ethnic origin of the infant predispose to vitamin D deficiency. Vitamin D supplementation is important for some ethnic minority population, whom are faced with the risk of developing this disease

High prevalence of severe vitamin D deficiency in combined antiretroviral therapy-naive and successfully treated Swiss HIV patients.

OBJECTIVES: To evaluate the prevalence of 25-hydroxyvitamin D [25(OH)D] deficiency in HIV-positive patients, a population at risk for osteoporosis. DESIGN: Retrospective assessment of vitamin D levels by season and initiation of combined antiretroviral therapy (cART). METHODS: 25(OH)D was measured in 211 HIV-positive patients: samples were taken before initiation of cART from February to April or from August to October as well as 12 (same season) and 18 months (alternate season) after starting cART. 1,25-Dihydroxyvitamin D [1,25(OH)2D] was measured in a subset of 74 patients. Multivariable analyses included season, sex, age, ethnicity, BMI, intravenous drug use (IDU), renal function, time since HIV diagnosis, previous AIDS, CD4 cell count and cART, in particular nonnucleoside reverse transcriptase inhibitor (NNRTI) and tenofovir (TDF) use. RESULTS: At baseline, median 25(OH)D levels were 37 (interquartile range 20-49) nmol/l in spring and 57 (39-74) nmol/l in the fall; 25(OH)D deficiency less than 30 nmol/l was more prevalent in spring (42%) than in fall (14%), but remained unchanged regardless of cART exposure. In multivariable analysis, 25(OH)D levels were higher in white patients and those with a longer time since HIV diagnosis and lower in springtime measurements and in those with active IDU and NNRTI use. 1-Hydroxylation rates were significantly higher in patients with low 25(OH)D. Hepatitis C seropositivity, previous AIDS and higher CD4 cell counts correlated with lower 1,25(OH)2D levels, whereas BMI and TDF use were associated with higher levels. In TDF-treated patients, higher 1,25(OH)2D correlated with increases in serum alkaline phosphatase. CONCLUSION: Based on the high rate of vitamin D deficiency in HIV-positive patients, systematic screening with consideration of seasonality is warranted. The impact of NNRTIs on 25(OH)D and TDF on 1,25(OH)2D needs further attention.

Can one or two high doses of oral vitamin D3 correct insufficiency in a non-supplemented rheumatologic population?

We evaluated the effectiveness of supplementation with high dose of oral vitamin D3 to correct vitamin D insufficiency. We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients and that the patients who benefited more from supplementation were those with the lowest baseline levels. INTRODUCTION: Adherence with daily oral supplements of vitamin D3 is suboptimal. We evaluated the effectiveness of a single high dose of oral vitamin D3 (300,000 IU) to correct vitamin D insufficiency in a rheumatologic population. METHODS: Over 1 month, 292 patients had levels of 25-OH vitamin D determined. Results were classified as: deficiency <10 ng/ml, insufficiency ≥10 to 30 ng/ml, and normal ≥30 ng/ml. We added a category using the IOM recommended cut-off of 20 ng/ml. Patients with deficient or normal levels were excluded, as well as patients already supplemented with vitamin D3. Selected patients (141) with vitamin D insufficiency (18.5 ng/ml (10.2-29.1) received a prescription for 300,000 IU of oral vitamin D3 and were asked to return after 3 (M3) and 6 months (M6). Patients still insufficient at M3 received a second prescription for 300,000 IU of oral vitamin D3. Relation between changes in 25-OH vitamin D between M3 and M0 and baseline values were assessed. RESULTS: Patients (124) had a blood test at M3. Two (2%) had deficiency (8.1 ng/ml (7.5-8.7)) and 50 (40%) normal results (36.7 ng/ml (30.5-5.5)). Seventy-two (58%) were insufficient (23.6 ng/ml (13.8-29.8)) and received a second prescription for 300,000 IU of oral vitamin D3. Of the 50/124 patients who had normal results at M3 and did not receive a second prescription, 36 (72%) had a test at M6. Seventeen (47%) had normal results (34.8 ng/ml (30.3-42.8)) and 19 (53%) were insufficient (25.6 ng/ml (15.2-29.9)). Of the 72/124 patients who receive a second prescription, 54 (75%) had a test at M6. Twenty-eight (52%) had insufficiency (23.2 ng/ml (12.8-28.7)) and 26 (48%) had normal results (33.8 ng/ml (30.0-43.7)). At M3, 84% patients achieved a 25-OH vitamin D level >20 ng/ml. The lowest the baseline value, the highest the change after 3 months (negative relation with a correlation coefficient r = -0.3, p = 0.0007). CONCLUSIONS: We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients.

A large-scale genetic validation study coupled with in vitro analyses reveal a role for vitamin Dsignaling in the pathogenesis and response to treatment of hepatitis C virus infection

Background and Aims: Vitamin D is an important modulatorof numerous cellular processes. Some of us recently observedan association of the 1a-hydroxylase promoter polymorphismCYP27B1-1260 rs10877012 with sustained virologic response (SVR)in a relatively small number of German patients with chronichepatitis C. In the present study, we aimed to validate thisassociation in a large and well characterized patient cohort, theSwiss Hepatitis C Cohort Study (SCCS). In addition, we examinedthe effect of vitamin D on the hepatitis C virus (HCV) life cyclein vitro.Methods: CYP27B1-1260 rs10877012 and IL28B rs12979860 singlenucleotide polymorphisms (SNPs) were genotyped in 1049 patientswith chronic hepatitis C from the SCCS, of whom 698 were treatedwith pegylated interferon-a (PEG-IFN-a) and ribavirin. In addition,112 patients with spontaneous clearance of HCV were examined.SNPs were correlated with variables reflecting the natural courseand treatment outcome of chronic hepatitis C. The effect of1,25-(OH)2D3 (calcitriol) on HCV replication and viral particleproduction was investigated in vitro using human hepatoma celllines (Huh-7.5) harbouring subgenomic replicons and cell culturederivedHCV.Results: The CYP27B1-1260 rs10877012 genotype was notassociated with SVR in patients with the good-response IL28Brs1279860 CC genotype. However, in patients with poor-responseIL28B rs1279860 genotype CT and TT, CYP27B1-1260 rs10877012was a significant independent predictor of SVR (15% difference inSVR between rs10877012 genotype AA vs. CC, p = 0.030, OR = 1.495,95% CI = 1.038-2.152). The CYPB27-1260 rs10877012 genotype wasneither associated with spontaneous clearance of HCV, nor withliver fibrosis progression rate, inflammatory activity of chronichepatitis C, or HCV viral load. Physiological doses of 1,25-(OH)2D3did not significantly affect HCVRNA replication or infectiousparticle production in vitro.Conclusions: The results of this large-scale genetic validationstudy reveal a role of vitamin D metabolism in the responseto treatment in chronic hepatitis C, but 1,25-(OH)2D3 does notexhibit a significant direct inhibitory antiviral effect. Thus, theability of vitamin D to modulate immunity against HCV shouldbe investigated.

Doses de gesso em cafeeiro: influência nos teores de cálcio, magnésio, potássio e ph na solução de um latossolo vermelho distrófico

O desbalanço entre Ca2+, Mg2+ e K+ no solo como consequência das aplicações elevadas de gesso deve-se às relações de tamanho (raio iônico) e densidades de cargas (relação carga/raio) de cada espécie iônica. Quanto maior a densidade de carga, mais intensa será a ligação iônica do cátion com íons de cargas opostas como OH- e SO4-2. Dessa maneira, o uso excessivo de gesso agrícola, sem considerar o balanço de cargas das partículas do solo; o equilíbrio iônico; e a CTC podem resultar em expressiva lixiviação ao longo do perfil do solo. O objetivo deste estudo foi avaliar o efeito de elevadas doses de gesso (0, 7 e 56 t ha-1) nos teores de Ca2+, Mg2+, K+ e pH na solução de um Latossolo Vermelho distrófico cultivado com cafeeiro, obtida pelo método adaptado do extrato aquoso. O solo foi amostrado nas profundidades de 0,15-0,25; 0,35-0,45; 0,75-0,85; 1,15-1,25 e 2,35-2,45 m na linha de plantio, em quatro tratamentos: G-0 - gesso no preparo (aplicação ocorreu em setembro de 2008, distribuído a lanço, na quantidade de 2 t ha-1) e sem gesso na linha de plantio; G-7 - gesso adicionado durante a preparação do solo (2 t ha-1), na mesma condição do G-0 e 7,0 t ha-1 de gesso na linha de plantio; G-56 - gesso adicionado durante a preparação do solo (2 t ha-1), na mesma condição do G-0 e 56 t ha-1 de gesso na linha de plantio (nessas parcelas experimentais as entrelinhas de plantio foram cobertas com braquiária); e CV-7: ausência de braquiária na entrelinha, com gesso no preparo e 7 t ha-1 de gesso na linha, com três repetições distribuídas em blocos ao acaso, totalizando 60 amostras. Após 16 meses da adição de gesso, observou-se redução do pH na solução do solo nas profundidades de 0,15-0,25; 0,35-0,45 e 0,75-0,85 m. A aplicação de gesso agrícola foi eficiente na melhoria do ambiente radicular no subsolo, aumentou a concentração de Mg2+ e Ca2+ na solução do solo, mas reduziu o K+ em profundidade, a partir de 0,85 m. Os teores de Ca2+ e Mg2+ trocáveis na solução do solo estiveram acima do nível crítico; entretanto, os teores de K+ trocável se mantiveram na faixa do valor crítico, indicado para o desenvolvimento da cultura.

Multicenter Study on the Clinical Effectiveness, Pharmacokinetics, and Pharmacogenetics of Mirtazapine in Depression.

ABSTRACT: Pharmacogenetic tests and therapeutic drug monitoring may considerably improve the pharmacotherapy of depression. The aim of this study was to evaluate the relationship between the efficacy of mirtazapine (MIR) and the steady-state plasma concentrations of its enantiomers and metabolites in moderately to severely depressed patients, taking their pharmacogenetic status into account. Inpatients and outpatients (n = 45; mean age, 51 years; range, 19-79 years) with major depressive episode received MIR for 8 weeks (30 mg/d on days 1-14 and 30-45 mg/d on days 15-56). Mirtazapine treatment resulted in a significant improvement in mean Hamilton Depression Rating Scale total score at the end of the study (P < 0.0001). There was no evidence for a significant plasma concentration-clinical effectiveness relationship regarding any pharmacokinetic parameter. The enantiomers of MIR and its hydroxylated (OH-MIR) and demethylated (DMIR) metabolites in plasma samples on days 14 and 56 were influenced by sex and age. Nonsmokers (n = 28) had higher mean MIR plasma levels than smokers (n = 17): S(+)-enantiomer of MIR, 9.4 (SD, 3.9) versus 6.2 (SD, 5.5) ng/mL (P = 0.005); R(-)-enantiomer of MIR, 24.4 (SD, 6.5) versus 18.5 (SD, 4.1) ng/mL (P = 0.003). Only in nonsmokers, plasma levels of S(+)-enantiomer of MIR and metabolites depended on the CYP2D6 genotype. Therefore, high CYP1A2 activity seen in smokers seems to mask the influence of the CYP2D6 genotype. In patients presenting the CYP2B6 *6/*6 genotype (n = 8), S-OH-MIR concentrations were higher those in the other patients (n = 37). Although it is not known if S-OH-MIR is associated with the therapeutic effect of MIR, the reduction of the Hamilton scores was significantly (P = 0.016) more pronounced in the CYP2B6 *6/*6-genotyped patients at the end of the study. The role of CYP2B6 in the metabolism and effectiveness of MIR should be further investigated.

Hidróxidos duplos lamelares como matrizes para fertilizantes de liberação lenta de nitrato

Diante do extensivo uso de fertilizantes nitrogenados na agricultura e elevado potencial de lixiviação do nitrato, há uma demanda por fertilizantes de liberação lenta ou controlada. Os hidróxidos duplos lamelares (HDLs) sintéticos reúnem características que os qualifica para o uso como matrizes para fertilizantes de liberação lenta de íons nitrato. Os objetivos deste trabalho foram focados na síntese, caracterização e investigação do processo de liberação lenta de nitrato em um HDL contendo íons Mg2+ e Al3+ em sua estrutura. O HDL com a fórmula Mg0,83Al0,17(OH)2(NO3)0,17.0,56H2O foi sintetizado pelo método de coprecipitação em pH alcalino constante, separado por centrifugação e seco em estufa a vácuo. As análises de difração de raios-X, de espectroscopia vibracional na região do infravermelho com transformada Fourier e as análises térmicas comprovam a obtenção do composto contendo o íon nitrato hidratado intercalado, além da fórmula proposta. O composto foi submetido a testes de liberação de nitrato em solução de NaHCO3 tamponado a pH 6,5 e em água destilada. As curvas obtidas evidenciaram dois eventos complementares de liberação de nitrato, um evento inicial rápido e um outro lento e gradativo. O composto investigado neste trabalho demonstrou potencial para ser utilizado como matriz para fertilizante de liberação lenta de nitrato.