Use-dependent block of the voltage-gated Na+ channel by tetrodotoxin and saxitoxin: Effect of pore mutations that change ionic selectivity.

Voltage-gated Na(+) channels (NaV channels) are specifically blocked by guanidinium toxins such as tetrodotoxin (TTX) and saxitoxin (STX) with nanomolar to micromolar affinity depending on key amino acid substitutions in the outer vestibule of the channel that vary with NaV gene isoforms. All NaV channels that have been studied exhibit a use-dependent enhancement of TTX/STX affinity when the channel is stimulated with brief repetitive voltage depolarizations from a hyperpolarized starting voltage. Two models have been proposed to explain the mechanism of TTX/STX use dependence: a conformational mechanism and a trapped ion mechanism. In this study, we used selectivity filter mutations (K1237R, K1237A, and K1237H) of the rat muscle NaV1.4 channel that are known to alter ionic selectivity and Ca(2+) permeability to test the trapped ion mechanism, which attributes use-dependent enhancement of toxin affinity to electrostatic repulsion between the bound toxin and Ca(2+) or Na(+) ions trapped inside the channel vestibule in the closed state. Our results indicate that TTX/STX use dependence is not relieved by mutations that enhance Ca(2+) permeability, suggesting that ion-toxin repulsion is not the primary factor that determines use dependence. Evidence now favors the idea that TTX/STX use dependence arises from conformational coupling of the voltage sensor domain or domains with residues in the toxin-binding site that are also involved in slow inactivation.

Evaluation of enzyme-linked immunosorbent assay using crude Leishmania and recombinant antigens as a diagnostic marker for canine visceral leishmaniasis

The performances of ELISA assays with different antigen preparations, such as Leishmania amazonensis or L. chagasi lysates and the recombinant antigens rK-39 and rK-26, were compared using sera or eluates from dried blood collected on filter paper to detect anti-Leishmania antibodies in dogs from a visceral leishmaniasis-endemic area in Brazil. Of 115 IFAT-reactive dogs at 1:40 titre, 106 (92.2%) were positive in parasitological exams (skin and/or spleen). These animals were compared to healthy animals (n = 25), negative for IFAT at a titre of 1:40 and parasitological exams. The sensitivities of crude and recombinant antigens were similar and remarkably high for both sera and eluates (97-100%). Specificity was higher than 96% for sera and eluates for different antigens, except for L. chagasi antigen using eluates (88%). Concordance values among the tests were higher either for sera or eluates (J = 0.95-1.00). High concordances were observed between sera and eluates tested with different antigens (kappa = 0.93-0.97). Crude and recombinant antigens identified different clinical phases of canine leishmaniasis. These results show that eluates could be used in canine surveys to identify L. chagasi infection. Recombinant antigens added little when compared to crude antigen in identifying positive dogs. Cross-reactivity with other diseases whose distribution often overlaps VL-endemic areas is a limitation of crude antigen use however.

Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination

Purpose: To report the magnetic resonance imaging (MRI) findings in athletic injuries of the extensor carpi ulnaris (ECU) subsheath, assessing the utility of gadolinium-enhanced (Gd) fat-saturated (FS) T1-weighted sequences with wrist pronation and supination. Methods and Materials: Sixteen patients (13 males, 3 females; mean age 30.3 years) with athletic injuries of the ECU subsheath sustained between January 2003 and June 2009 were included in this retrospective study. Initial and follow‑up 1.5-T wrist MRIs were performed with transverse T1-weighted and STIR sequences in pronation, and Gd FS T1-weighted sequences with wrist pronation and supination. Two radiologists assessed the type of injury (A to C), ECU tendon stability, associated lesions and rated pulse sequences using a three-point scale: 1 = poor, 2 = good and 3 = excellent. Results: Gd-enhanced FS T1-weighted transverse sequences in supination (2.63) and pronation (2.56) were most valuable, compared with STIR (2.19) and T1 weighted (1.94). Nine type A, one type B and six type C injuries were found. There were trends towards diminution in size, signal intensity and enhancement of associated pouches on follow‑up MRI and tendon stabilisation within the ulnar groove. Conclusion: Gd-enhanced FS T1-weighted sequences with wrist pronation and supination are most valuable in assessing and follow‑up athletic injuries of the ECU subsheath on 1.5-T MRI.

The effect of a smoking ban introduction to environmental tobacco smoke exposure in Swiss hospitality workers : Abstracts of the 23rd Annual Conference of the International Society of Environmental Epidemiology (ISEE), September 13-16, 2011, Barcelona, Spain

Background and Aims: To protect the population from environmental tobacco smoke (ETS) Switzerland introduced a nationwide rather heterogeneous smoking ban in May 2010. The exposure situation of non-smoking hospitality workers before and after implementation of the new law is being assessed in a prospective cohort study. Methods: Exposure to ETS was measured using a novel method developed by the Institute for Work and Health in Lausanne. It is a passive sampler called MoNIC (Monitor of NICotine). The nicotine of the ETS is fixed onto a filter and transformed into salt of not volatile nicotine. Subsequently the number of passively smoked cigarettes is calculated. Badges were placed at the workplace as well as distributed to the participants for personal measuring. Additionally a salivary sample was taken to determine nicotine concentration. Results: At baseline Spearman's correlation between workplace and personal badge was 0.47. The average cigarette equivalents per day at the workplace obtained by badge significantly dropped from 5.1 (95%- CI: 2.4 to 7.9) at baseline to 0.3 (0.2 to 0.4) at first follow-up (n=29) three months later (p<0.001). For personal badges the number of passively smoked cigarettes declined from 1.5 (2.7 to 0.4) per day to 0.5 (0.3 to 0.8) (n=16).Salivary nicotine concentration in a subset of 13 participants who had worked on the day prior to the examination was 2.63 ng/ml before and 1.53 ng/ml after the ban (p=0.04). Spearman's correlation of salivary nicotine was 0.56 with workplace badge and 0.79 with personal badge concentrations. Conclusions: Workplace measurements clearly reflect the smoking regulation in a venue. The MoNIC badge proves to be a sensitive measuring device to determine personal ETS exposure and it is a demonstrative measure for communication with lay audiences and study participants as the number of passively smoked cigarettes is an easily conceivable result.

Treatment and seroconversion in a cohort of children suffering from recent chronic Chagas infection in Yoro, Honduras

Between 1999-2002, Médécins Sans Frontières-Spain implemented a project seeking to determine the efficacy and safety of benznidazole in the treatment of recent chronic Chagas disease in a cohort of seropositive children in the Yoro Department, Honduras. A total of 24,471 children were screened for Trypanosoma cruzi IgG antibodies through conventional enzyme-linked immunosorbent assays (ELISA) on filter paper. Recombinant ELISA (0.93% seroprevalence) showed 256 initially reactive cases, including 232 confirmed positive cases. Of these, 231 individuals were treated with benznidazole (7.5 mg/kg/day) for 60 days and were followed with a strict weekly medical control and follow-up protocol. At the end of the project, 229 patients were examined by the Honduras Secretariat of Health for post-treatment serological assessments; 88.2% seroconverted after 18 months and 93.9% seroconverted after three years. No differences were found in the seroconversion rates according to age or sex. Most of the side effects of the treatment were minor. These results support the argument that in areas where T. cruzi I is predominant and in areas affected by T. cruzi II, when vector transmission has been interrupted, Chagas disease diagnosis and treatment are feasible, necessary and ethically indisputable.

Early diagnosis of congenital toxoplasmosis in newborn infants using IgG subclasses against two Toxoplasma gondii recombinant proteins

The aim of this work was to evaluate the utility of ELISA-based testing of total IgG (IgGt) antibodies and its subclasses (IgG1, IgG2, IgG3 and IgG4) against soluble (STAg) and recombinant (rSAG1 and rMIC3) antigens of Toxoplasma gondii for diagnosing congenital toxoplasmosis. Sera from 217 newborns initially testing positive for specific IgM in filter paper dried blood spots were tested for specific IgM and IgG by ELFA-VIDAS®. Congenital toxoplasmosis was confirmed in 175 and ruled out in 42 infants. The validity of the ELISA tests was determined using the persistence of IgG antibodies (ELFA-VIDAS® kit) at the end of 12 months, which is considered the reference test for the diagnosis of congenital toxoplasmosis. The frequency of positivity with IgGt against STAg, rSAG1 and rMIC3 was found in 97.2%, 96.3% and 80.2%, respectively, of the newborns with confirmed congenital toxoplasmosis. IgG1 reacted with all three antigens, while IgG3 and IgG4 reacted preferentially with rMIC3. Higher mean values of reactivity (sample optical density/cut-off) were found for all subclasses when using rMIC3. All of the antigens showed high sensitivity and low specificity in detecting anti-T. gondii IgGt and IgG1 and low sensitivity and high specificity in detecting IgG3 and IgG4. In conclusion, the combined detection of IgG antibody subclasses against recombinant toxoplasmic antigens may be useful for the early diagnosis of congenital toxoplasmosis.

Phenotypic and molecular characterization of Bruck syndrome (Osteogenesis imperfecta with contractures of the large joints) caused by a recessive mutation in PLOD2

Le Syndrome de Bruck (Bruck Syndrome; BS) est une maladie autosomique récessive assemblant la combinaison inhabituelle de fragilité osseuse semblable à celle de l'Ostéogenèse Imparfaite (0I) avec des contractures congénitales tendineuses et cutanées des grandes articulations («ptérygia»). Les cas décrits jusqu'à ce jour mettent en évidence une grande hétérogénéité du tableau clinique, liée en partie au manque d'un diagnostic biochimique ou moléculaire. Nous savons que dans le BS les gènes codant pour le collagène 1 ne sont pas mutés, mais savons néanmoins, grâce à l'étude du collagène extrait de biopsies osseuses, qu'il y a un déficit d'hydroxylation des résidus de lysine dans les télopeptides du collagène 1 qui servent à la formation des liens intermoléculaires (crosslinks) et donc à la stabilisation des fibres de collagène. Un locus génétique du BS à été mappé sur 17q12, mais le gène responsable sur ce locus reste inconnu; plus récemment, deux mutations dans le gène de la lysyl hydroxylase 2 (PLOD2, position chromosomique 3q23-q24) ont été identifiées, démontrant l'hétérogénéité génétique du ES. La proportion de ES liée à 17p22 (BS type 1) et celle liée à une mutation dans PLOD2 (BS type 2) est encore incertaine et nous manquons de données sur la corrélation phenotype-génotype. Nous avons étudié le cas d'un garçon avec des contractures et des ptérygia dès la naissance, combinées à une ostéopénie sévère de type OI menant à des fractures multiples. Ses urines contenaient une quantité élevée d'hydroxyproline, indiquant un remaniement important du tissu osseux, mais peu de produits de dégradation des crosslinks du collagène, indiquant donc une réduction de la proportion de crosslinks dans le collagène in vivo. Nous avons pu démontrer chez lui la présence d'une nouvelle mutation homozygote dans le gène PLOD2 menant à une substitution Arg598His; les deux parents du sujet étaient hétérozygotes pour la mutation et celle-ci était absente dans notre population témoin. La mutation est adjacente aux deux mutations rapportées précédemment (Gly601Val et Thr608Ile), ce qui suggère la présence d'un ''hotspot'' mutationnel mais aussi d'une région de grande importance fonctionnelle sur PLOD2 : cette observation est importante pour la création d'inhibiteurs de PLOD2, recherchés en ce moment pour le traitement de la fibrose. La combinaison de ptérygia et de fragilité osseuse, comme illustrée par notre patient est apparemment contradictoire et donc difficilement explicable mais indique que l'hydroxylation des résidus lysyl des télopeptides est importante non seulement pour la stabilité osseuse mais aussi dans la morphogénèse et la formation des articulations dans la période prénatale. Finalement, la mesure des produits de dégradation du collagène dans l'urine et l'analyse de mutation de PLOD2 permet le diagnostic du syndrome de Bruck et permet de le différencier de l'Osteogénèse Imparfaite. -- Bruck syndrome (BS) is a recessively-inherited phenotypic disorder featuring the unusual combination of skeletal changes resembling osteogenesis imperfecta (0I) with congenital contractures of the large joints. Clinical heterogeneity is apparent in cases reported thus far. While the genes coding for collagen 1 chains are unaffected in BS, there is biochemical evidence for a defect in the hydroxylation of lysine residues in collagen 1 telopeptides. One BS locus has been mapped at 17p12, but more recently, two mutations in the lysyl hydroxylase 2 gene (PLOD2, 3q23-q24) have been identified in BS, showing genetic heterogeneity. The proportion of BS cases linked to 17p22 (BS type 1) or caused by mutations in PLOD2 (BS type 2) is still uncertain, and phenotypic correlations are lacking. We report on a boy who had congenital contractures with pterygia at birth and severe 0I-like osteopenia and multiple frac-tures. His urine contained high amounts of hydroxyproline but low amounts of collagen crosslinks degradation products; and he was shown to be homozygous for a novel mutation leading to an Arg598His substitution in PLOD2. The mutation is adjacent to the two mutations previously reported (Gly601Val and Thr608Ile), suggesting a functionally important hotspot in PLOD2. The combination of pterygia with bone fragility, as illustrated by this case, is difficult to explain; it suggests that telopeptide lysyl hydroxylation must be involved in prenatal joint formation and morphogenesis. Collagen degradation products in urine and mutation analysis ofPLOD2 maybe used to diagnose BS and differentiate it from M.

The generation and analysis of combined legless 1 and 2 knock-out mice

Summary The Wnt signaling pathway plays an important role during development and also for maintaining tissue homeostasis due to its function in proliferation, differentiation and cell fate decisions. Wnt ligands bind to Frizzled receptors and activate a signaling cascade that results in the stabilization of β-Catenin, a key component of the pathway. β-Catenin translocates to the nucleus, where, together with a transcription factor of the Tcf/Lef family, it activates the expression of target genes. Legless and Pygopus are two recently discovered essential components of the Wnt pathway in Drosophila, which may mediate the nuclear import and retention of beta-Catenin and/or contribute directly to the activation of Wnt target genes. To address the function of Legless in the mouse, we have generated compound constitutive and conditional knockout alleles of the two homologues legless 'I (bc1-9) and 2. We have induced the deletion of legless in self-renewing tissues such as the gastrointestinal tract, the mammary gland and the skin during adulthood and constitutively in the embryo. The present thesis focused on the consequences of the inactivation of legless in epithelial homeostasis as well as in a regeneration model and its comparison to pygopus. Deletion of neither legless nor pygopus in the adult small intestine resulted in any apparent anomaly, contrasting expectations from the phenotype caused by over-expression of Dickkopf, a Wnt inhibitor (Pinto et al., 2003). These observations indicate that canonical Wnt signaling might not be indispensable for normal gastrointestinal epithelium homeostasis, or that, in this context, Legless and Pygopus are not essential components of the Wnt pathway. However, the regeneration of the colonic epithelium after DSS induced damage was markedly impaired in legless, but not in pygopus deficient mice. Thus, unlike in Drosophila, deletion of mammalian legless and pygopus resulted in different phenotypes, suggesting that Legless might interact with as yet unidentified partners in addition to Pygopus. Resumé La voie de signalisation Wnt joue un rôle important au cours du développement ainsi que pour le maintien de l' homéostase tissulaire due à sa fonction durant la prolifération, la différentiation et les décisions sur l'avenir des cellules. Les ligands de Wnt se lient aux récepteurs Frizzled et activent une cascade de signalisation résultant en la stabilisation de β-Catenin, un composant central de cette voie. β-Catenin est transloquée dans le noyau ou, avec l'aide des facteurs de transcription de la famille Tcf/lef, elle active la transcription des gènes cibles. Legless et Pygopus sont deux composants récemment découverts et essentiels de la voie de signalisation Wnt chez la Drosophile qui pourraient être des médiateurs de l'import et de la rétention nucléaire de bêta-catenin et/ou contribuer directement a l'activation des gènes cibles. Afin de comprendre la fonction de Legless chez la souris, nous avons généré simultanément les allèles « knock-out » constitutifs et conditionnels des deux homologues legless 1 (bc1-9) et 2. Nous avons induit la délétion de legless dans des tissus capables de s'auto renouveler comme le tract gastro-intestinal, la glande mammaire et la peau chez l'adulte et nous avons supprimé constitutivement legless chez l'embryon. La présente thèse est concentrée sur les conséquences de l'inactivation de legless au cours de l' homéostase épithéliale ainsi que dans un modèle de régénération et sur sa comparaison avec pygopus. Ni la délétion de legless ni celle de pygopus dans l'intestin adulte n'ont résulté en quelque anomalie, contrastant nos attentes provenant des phénotypes causes par la surexpression de Dickkpof, un inhibiteur de Wnt (Pinto et al., 2003). Ces observations indiquent que la voie de signalisation Wnt/β-Catenin pourrait ne pas être indispensable à l' homéostase normale du tract gastro-intestinal, ou que, dans ce contexte, Legless et Pygopus ne sont pas des composants essentiels de la vole Wnt. Cependant, la régénération de l'épithélium du colon après induction de son endommagement au DSS fut dramatiquement diminuée chez legless mais pas chez les souris mutantes pour pygopus. Ainsi, a la différence de chez la Drosophile, la délétion de legless et pygopus chez les mammifères a résulté en des phénotypes différents, suggérant que Legless pourrait interagir avec d'autres partenaires, encore non identifies, que Pygopus.

A new survey of the serology of human Trypanosoma cruziinfection in the Rio Negro microregion, Brazilian Amazon: a critical analysis

The serology of human Trypanosoma cruziinfection in the Rio Negro microregion is very complex because of the large numbers of false-positive cases that result from low antibody titres and cross-reactions with other infections. In the present study, we collected 4,880 blood samples on filter paper; of these, indirect immunofluorescence (IIF) was strongly reactive in 221 (4.5%), which were considered to be positive (IIF strongly reactive; high intensity of fluorescence) and weakly reactive in 302 (6.2%), which were considered to be doubtful (IIF weakly reactive; low intensity of fluorescence). The confirmatory test on the serum using at least two of three techniques (IIF, conventional ELISA and recombinant ELISA) on 137 samples that were positive in the screening test only confirmed 33 cases (24.1%). Of the 178 samples that were considered doubtful in the screening test, only 10 (5.6%) were considered to be positive in the confirmatory test. Finally, we recommend that the serological diagnosis of T. cruziinfection in the Amazon region be made using at least two different techniques, for example immunofluorescence and ELISA and confirmed by Western blot analysis when possible.

Is imidacloprid an effective alternative for controlling pyrethroid-resistant populations of Triatoma infestans (Hemiptera: Reduviidae) in the Gran Chaco ecoregion?

The prevention of Chagas disease is based primarily on the chemical control of Triatoma infestans (Klug) using pyrethroid insecticides. However, high resistance levels, correlated with control failures, have been detected in Argentina and Bolivia. A previous study at our laboratory found that imidacloprid could serve as an alternative to pyrethroid insecticides. We studied the delayed toxicity of imidacloprid and the influence of the blood feeding condition of the insect on the toxicity of this insecticide; we also studied the effectiveness of various commercial imidacloprid formulations against a pyrethroid-resistant T. infestans population from the Gran Chaco ecoregion. Variations in the toxic effects of imidacloprid were not observed up to 72 h after exposure and were not found to depend on the blood feeding condition of susceptible and resistant individuals. Of the three different studied formulations of imidacloprid on glass and filter paper, only the spot-on formulation was effective. This formulation was applied to pigeons at doses of 1, 5, 20 and 40 mg/bird. The nymphs that fed on pigeons treated with 20 mg or 40 mg of the formulation showed a higher mortality rate than the control group one day and seven days post-treatment (p < 0.01). A spot-on formulation of imidacloprid was effective against pyrethroid-resistant T. infestans populations at the laboratory level.

Validity of the "Drift without pronation" sign in conversion disorder.

BACKGROUND: Conversion disorder (CD) is a psychiatric disorder, yet the diagnosis cannot be established without the expertise of a neurologist, as distinguishing a functional from an organic symptom relies on careful bedside examination. Joseph Babinski considered the absence of pronator drift as a 'positive sign' for hysterical paresis but the validity of this sign has never been evaluated. The aim of this study was to examine the sensitivity and specificity of the "drift without pronation" sign. METHODS: Twenty-six patients with unilateral functional upper limb paresis diagnosed with CD (DSM-IV) and a control group of 28 patients with an organic neurological condition were consecutively included. The arm stabilisation test was performed with arms stretched out in full supination, fingers adducted, eyes closed for 10 seconds. A positive "drift without pronation" sign was defined by the presence of a downward drift without pronation. RESULTS: All CD subjects (100%) displayed a positive sign when only 7.1% of organic subjects did (Fisher's p < 0.001). The sign yielded a sensitivity of 100% (95% CI:84%-100%) and a specificity of 93% (95% CI:76%-98%). CONCLUSION: The observation of a "drift without pronation" sign is specific for Conversion Disorder and can be of help in making a quick distinction between organic and functional paresis at the bedside.

Segmentation and grid generation for numerical simulations of vad connections with patient-specific data

Objectives: We are interested in the numerical simulation of the anastomotic region comprised between outflow canula of LVAD and the aorta. Segmenta¬tion, geometry reconstruction and grid generation from patient-specific data remain an issue because of the variable quality of DICOM images, in particular CT-scan (e.g. metallic noise of the device, non-aortic contrast phase). We pro¬pose a general framework to overcome this problem and create suitable grids for numerical simulations.Methods: Preliminary treatment of images is performed by reducing the level window and enhancing the contrast of the greyscale image using contrast-limited adaptive histogram equalization. A gradient anisotropic diffusion filter is applied to reduce the noise. Then, watershed segmentation algorithms and mathematical morphology filters allow reconstructing the patient geometry. This is done using the InsightToolKit library (www.itk.org). Finally the Vascular Model¬ing ToolKit (www.vmtk.org) and gmsh (www.geuz.org/gmsh) are used to create the meshes for the fluid (blood) and structure (arterial wall, outflow canula) and to a priori identify the boundary layers. The method is tested on five different patients with left ventricular assistance and who underwent a CT-scan exam.Results: This method produced good results in four patients. The anastomosis area is recovered and the generated grids are suitable for numerical simulations. In one patient the method failed to produce a good segmentation because of the small dimension of the aortic arch with respect to the image resolution.Conclusions: The described framework allows the use of data that could not be otherwise segmented by standard automatic segmentation tools. In particular the computational grids that have been generated are suitable for simulations that take into account fluid-structure interactions. Finally the presented method features a good reproducibility and fast application.

Remediation of a marine shore tailings deposit and the importance of water-rock interaction on element cycling in the coastal aquifer

We present the study of the geochemical processes associated with the first successful remediation of a marine shore tailings deposit in a coastal desert environment (Bahia de Ite, in the Atacama Desert of Peru). The remediation approach implemented a wetland on top of the oxidized tailings. The site is characterized by a high hydrauliz gradient produced by agricultural irrigation on upstream gravel terraces that pushed river water (similar to 500 mg/L SO(4)) toward the sea and through the tailings deposit. The geochemical and isotopic (delta(2)H(water) and delta(18)O(water), delta(34)S(sulfate) , delta(18)O(sulfate)) approach applied here revealed that evaporite horizons (anhydrite and halite) in the gravel terraces are the source of increased concentrations of SO(4), Cl, and Na up to similar to 1500 mg/L in the springs at the base of the gravel terraces. Deeper groundwater interacting with underlying marine sequences increased the concentrations of SO(4), Cl, and Na up to 6000 mg/L and increased the alkalinity up to 923 mg/L CaCO(3) eq. in the coastal aquifer. These waters infiltrated into the tailings deposit at the shelf-tailings interface. Nonremediated tailings had a low-pH oxidation zone (pH 1-4) with significant accumulations of efflorescent salts (10-20 cm thick) at the surface because of upward capillary transport of metal cations in the arid climate. Remediated tailings were characterized by neutral pH and reducing conditions (pH similar to 7, Eh similar to 100 mV). As a result, most bivalent metals such as Cu, Zn, and Ni had very low concentrations (around 0.01 mg/L or below detection limit) because of reduction and sorption processes. In contrast, these reducing conditions increased the mobility of iron from two sources in this system: (1) The originally Fe(III)-rich oxidation zone, where Fe(II) was reduced during the remediation process and formed an Fe(II) plume, and (2) reductive dissolution of Fe(III) oxides present in the original shelf lithology formed an Fe-Mn plume at 10-m depth. These two Fe-rich plumes were pushed toward the shoreline where more oxidizing and higher pH conditions triggered the precipitation of Fe(HI)hydroxide coatings on silicates. These coatings acted as a filter for the arsenic, which naturally infiltrated with the river water (similar to 500 mu g/L As natural background) into the tailings deposit.

The Effect Of Induced Intraocular Straylight (cataract Simulation) On Sensitivity Measures Of Standard Automated Perimetry, Pulsar Perimetry And Moorfields Motion Displacement Test

Purpose: To investigate the effect of incremental increases in intraocular straylight on threshold measurements made by three modern forms of perimetry: Standard Automated Perimetry (SAP) using Octopus (Dynamic, G-Pattern), Pulsar Perimetry (PP) (TOP, 66 points) and the Moorfields Motion Displacement Test (MDT) (WEBS, 32 points).Methods: Four healthy young observers were recruited (mean age 26yrs [25yrs, 28yrs]), refractive correction [+2 D, -4.25D]). Five white opacity filters (WOF), each scattering light by different amounts were used to create incremental increases in intraocular straylight (IS). Resultant IS values were measured with each WOF and at baseline (no WOF) for each subject using a C-Quant Straylight Meter (Oculus, Wetzlar, Germany). A 25 yr old has an IS value of ~0.85 log(s). An increase of 40% in IS to 1.2log(s) corresponds to the physiological value of a 70yr old. Each WOFs created an increase in IS between 10-150% from baseline, ranging from effects similar to normal aging to those found with considerable cataract. Each subject underwent 6 test sessions over a 2-week period; each session consisted of the 3 perimetric tests using one of the five WOFs and baseline (both instrument and filter were randomised).Results: The reduction in sensitivity from baseline was calculated. A two-way ANOVA on mean change in threshold (where subjects were treated as rows in the block and each increment in fog filters was treated as column) was used to examine the effect of incremental increases in straylight. Both SAP (p<0.001) and Pulsar (p<0.001) were significantly affected by increases in straylight. The MDT (p=0.35) remained comparatively robust to increases in straylight.Conclusions: The Moorfields MDT measurement of threshold is robust to effects of additional straylight as compared to SAP and PP.

ASIC1a oligomerization structure-function of its extracellular vestibule and functional characterization of αS243Pβɣ ENaC

Quatre cristaux du canal ASIC1a ont été publiés et soutiennent une stoechiométrie trimérique. Cependant, ces données contredisant de précédentes analyses fonctionnelles effectuées sur des canaux de la même famille, notre intérêt fut porté sur l'oligomérisation d'ASIC1a. Dans ce sens, un nouvel essai couplant la méthode d'analyse par substitution de cystéines (SCAM) avec l'utilisation de réactifs sulfhydryls bifonctionnels (crosslinkers) a été mis en place. Le but étant de stabiliser, puis sélectionner les canaux fonctionnels, pour ensuite les séparer selon leur taille par SDS-PAGE. Grâce à cette technique, nous avons démontré que le complexe stabilisé a une taille coïncidant avec une organisation tétramérique. En plus de son oligomérisation, le chemin emprunté par les ions pour traverser le canal n'est pas clairement défini dans ces structures. De ce fait, utilisant une approche électrophysiologique, nous avons étudié le lien entre la structure et la fonction du vestibule extracellulaire d'ASIC1a. Dans ce but, nous nous sommes intéressés l'accessibilité de cystéines spécifiques localisées dans ce vestibule pour des réactifs méthanethiosulfonates (MTS). Ainsi, nous avons pu corréler les cinétiques de modification de ces cystéines par les MTS avec les effets sur le courant sodique, et donc avoir des informations supplémentaires sur la voie empruntée par les ions. De plus, la simulation informatique de liaison de ces réactifs illustre le remplissage total de ce vestibule. Fonctionnellement, cette interaction ne perturbe pas le passage de ions, c'est pourquoi il nous apparaît probable que le vestibule présente une taille plus large que celle illustrée par les cristaux. Dans un deuxième temps, notre intérêt fut porté sur ENaC. Ce canal est composé des trois sous-unités (a, ß et y) et est exprimé dans divers épithéliums, dont les tubules des reins. Il participe à l'homéostasie sodique et est essentiellement régulé par voie hormonale via l'aldostérone et la Vasopressine, mais également par des sérines protéases ou le Na+. Nous avons étudié la répercussion fonctionnelle de la mutation aS243P, découverte chez un nouveau-né prématuré atteint de pseudohypoaldostéronisme de type 1. Cette maladie autosomale récessive se caractérise, généralement, par une hyponatrémie liée à d'importantes pertes de sel dans les urines, une hyperkaliémie, ainsi qu'un niveau élevé d'aldostérone. Tout d'abord aucune des expériences biochimiques et électrophysiologiques n'a pu démontrer un défaut d'expression ou une forte diminution de l'activité soutenant les données cliniques. Cependant, en challengeant aS243PßyENaC avec une forte concentration de Na+ externe, une hypersensibilité de canal fut observée. En effet, ni les phénomènes régulateurs de « feedback inhibition » ou de « Na+ self-inhibition » n'étaient semblables au canal sauvage. De ce fait, ils apparaissaient exacerbés en présence de la mutation, amenant ainsi à une diminution de la réabsorption de Na+. Ceci corrobore entièrement l'hyponatrémie diagnostiquée. Le rein d'un prématuré étant immature, la quantité de Na+ atteignant la partie distale du néphron est plus élevée, du fait que les autres mécanismes de réabsorption en amont ne sont probablement pas encore en place. Cette hypothèse est renforcée par l'existence d'un frère présentant la même mutation, mais qui, né à terme, ne présentait aucun signe d'hyponatrémie. - The main topic of my thesis is the structure-function relationship of the ENaC/Deg family of ion channels, namely the Acid-Sensing Ion Channel ASIC1a and the Epithelial Na Channel ENaC. The primary part of this research is dedicated to the structure of ASIC1a. Four channel crystals have been published, which support a trimeric stoichiometry, although these data contradict previous functional experiments on other ENaC/Deg members. We are therefore interested in ASIC1a oligomerization and have set up a new assay combining the Substituted- Cysteine Accessibility Method (SCAM) with Afunctional sulfhydryl reagents (crosslinkers) allowing its study. The aim was to first stabilize the channels, then select those that are functional and then resolve them according to their size on SDS-PAGE. We demonstrated that the stabilized complex has a molecular weight corresponding to a tetrameric stoichiometry. In addition to our interest in the oligomerization of the ENaC/Deg family of ion channels, we also wanted to investigate the thus far undefined way of permeation for these channels. Therefore, taking the advantage of a more electrophysiological approach, we studied the accessibility of specific cysteines for methanethiosulfonate reagents (MTS) and were able to correlate the MTS association kinetics on cysteine residues with Na+ currents. These results have given us an insight into ion permeation and our functional evidence indicates that the extracellular is larger than that depicted by the crystal structures. As a side project, we focused on ENaC, which is made up of three subunits (a, ß and y) and is expressed in various epithelia, especially in the distal nephron of the kidneys. It plays a role in Na+ homeostasis and is essentially regulated by hormones via aldosterone and vasopressin, but also by serine proteases or Na+. We have studied the functional impact of the aS243P mutation, discovered in a premature baby suffering from pseudohypoaldosteronism of type 1. This autosomal recessive disease is characterized by hyponatremia, hyperkalemia and high aldosterone levels. Firstly, neither biochemical nor electrophysiological experiments indicated an expression defect or a strong decrease in activity. However, challenging aS243PßyENaC with increased external Na+ concentration showed channel hypersensitivity. Indeed, both the "feedback inhibition" and the "Na+ self-inhibition" regulatory mechanisms are impaired, leading to a decrease in Na+ reabsorption, entirely supports the diagnosis. The kidneys in preterm infants are immature and Na+ levels reaching the distal nephron are higher than normally observed. We hypothesize that the upstream reabsorption machinery is unlikely to be sufficiently matured and this assumption is supported by an asymptomatic sibling carrying the same mutation, but born at term. - La cellule, unité fonctionnelle du corps humain, est délimitée par une membrane plasmique servant de barrière biologique entre les milieux intra et extracellulaires. Une communication entre cellules est indispensable pour un fonctionnement adéquat. Sa survie dépend, entre autres, du maintien de la teneur en ions dans chacun des milieux qui doivent pouvoir être réabsorbés, ou sécrétés, selon les besoins. Les protéines insérées dans la membrane forment un canal et sont un moyen de communication permettant spécifiquement à des ions tel que le sodium (Na+) de traverser. Le Na+ se trouve dans la plupart des aliments et le sel, et est spécifiquement réabsorbé au niveau des reins grâce au canal sodique épithélial ENaC. Cette réabsorption se fait de l'urine primaire vers l'intérieur de la cellule, puis est transporté vers le sang. Pour maintenir un équilibre, une régulation de ce canal est nécessaire. En effet, des dysfonctionnements impliquant la régulation ou l'activité d'ENaC lui-même sont à l'origine de maladies telles que la mucoviscidose, l'hypertension ou encore, le pseudohypoaldostéronisme (PHA). Cette maladie est caractérisée, notamment, par d'importantes pertes de sel dans les urines. Des pédiatres ont diagnostiqué un PHA chez un nouveau-né, ce dernier présentant une modification du canal ENaC, nous avons recréé cette protéine afin d'étudier l'impact de ce changement sur son activité. Nous avons démontré que la régulation d'ENaC était effectivement perturbée, conduisant ainsi à une forte réduction de la réabsorption sodique. Afin de développer des molécules capables de moduler l'activité de protéines. Il est nécessaire d'en connaître la structure. Celle du canal sodique sensible à l'acidification ASIC1, un canal cousin d'ENaC, est connue. Ces données structurales contredisant cependant les analyses fonctionnelles, nous nous sommes penchés une nouvelle fois sur ASIC1. Une protéine est une macromolécule biologique composée d'une chaîne d'acides aminés (aa). De l'enchaînement d'aa à la protéine fonctionnelle, quatre niveaux de structuration existent. Chaque aa donne une indication quant au repliement et plus particulièrement la cystéine. Arborant un groupe sulfhydryle (SH) capable de former une liaison spécifique et stable avec un autre SH, celle-ci est souvent impliquée dans la structure tridimensionnelle de la protéine. Ce type de liaison intervient également dans la stabilisation de la structure quaternaire, qui est l'association de plusieurs protéines identiques (homomère), ou pas (hétéromère). Dans cette partie, nous avons remplacé des aa par des cystéines à des endroits spécifiques. Le but était de stabiliser plusieurs homomères d'ASICl ensemble avec des réactifs créant des ponts entre deux SH. Ainsi, nous avons pu déterminer le nombre de protéines ASIC1 participant à la formation d'un canal fonctionnel. Nos résultats corroborent les données fonctionnelles soutenant un canal tétramérique. Nous avons également étudié l'accessibilité de ces nouvelles cystéines afin d'obtenir des informations supplémentaires sur la structure du chemin emprunté par le Na+ à travers ASIC1 et plus particulièrement du vestibule extracellulaire.