Severity score system for progressive myelopathy: development and validation of a new clinical scale

Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

Caractérisation et étude d'un élément régulateur du gène codant pour le récepteur à la vasopressine de type 2

Thèse réalisée en cotutelle avec l'Université Pierre et Marie Curie, Paris VI, France

N-acétyltransférase lysosomale : organisation, fonctionnement et défauts moléculaires chez les patients atteints du syndrome de Sanfilippo type C

L’acétylation des résidus de glucosamine terminaux par la N-acétyltransférase lysosomale (HGSNAT) est une étape essentielle de la dégradation catabolique de l’héparan sulfate. Des défauts dans cette réaction causent une maladie de surcharge lysosomale autosomale récessive rare : le désordre de Sanfilippo type C (SFC). À ce jour, 54 mutations ont été rapportées chez des patients SFC, incluant 13 mutations des sites d’épissage, 11 insertions et délétions, 8 mutations non-sens, 18 mutations faux-sens et 4 polymorphismes, avec différentes manifestations phénotypiques. Nous avons identifié 10 d’entre elles et effectué une étude exhaustive portant sur l’éventail des mutations SFC, leur distribution dans la population de patients, ainsi que leur impact potentiel sur la structure de la HGSNAT. Les erreurs d’épissage, les mutations non-sens, les insertions et les délétions devraient toutes entraîner un ARN non fonctionnel qui est rapidement dégradé par des mécanismes de contrôle qualité cellulaire. Les 4 polymorphismes identifiés sont des changements d'acides aminés qui ne modifient pas l'activité enzymatique, la glycosylation ou la localisation et n'ont donc pas de signification au niveau clinique. Au niveau des enzymes, les polymorphismes sont des changements d’acides aminés qui n’affectent pas la fonction, mais dans un contexte d’acides nucléiques ils peuvent être considérés comme des mutations faux-sens. Les dix-huit mutations faux-sens qui ont été exprimées ont produit des protéines inactives, en raison d'erreurs dans leur repliement. Ceci expliquerait donc la progression sévère de la maladie chez les personnes porteuses de ces mutations. Les protéines mutantes mal repliées sont anormalement glycosylées et conservées dans le réticulum endoplasmique. La thérapie par amélioration de l’activité enzymatique par des chaperonnes est une option thérapeutique potentielle, spécifiquement conçue pour exploiter l'activité enzymatique résiduelle de mutants mal repliés, afin d’éliminer les substrats stockés. Nous avons démontré que le traitement de plusieurs lignées de fibroblastes de patients SFC avec le chlorhydrate de glucosamine, un inhibiteur spécifique de la HGSNAT, a partiellement restauré l’activité de l'enzyme mutante, fournissant une preuve de l’utilité future de la thérapie par des chaperonnes dans le traitement de la maladie de SFC.

L’impact de l’inhibition de la iNOS et de la kininase I dans les effets délétères du récepteur B1 des kinines dans le diabète de type 2

Les kinines sont des peptides vasoactifs et des neuromédiateurs centraux impliqués dans un bon nombre de processus biologiques et inflammatoires. Elles agissent sur deux types de récepteurs (R) couplés aux protéines G, le RB2 constitutif et le RB1 qui est induit par le stress oxydatif et les cytokines pro-inflammatoires via le facteur de transcription nucléaire, le NF-kB. Le RB1 est un puissant activateur de la iNOS et il augmente son expression chez le rat insulino-résistant. Dans ce modèle de rats soumis à une diète riche en D-glucose, un traitement d’une semaine avec un antagoniste non peptidique du RB1, le SSR240612, renverse la plupart des complications diabétiques. Ces travaux nous mènent à émettre l’hypothèse que la iNOS contribue aux effets délétères du RB1 chez le rat insulino-résistant. Nous avons donc évalué les effets d’un traitement prolongé d’une semaine soit avec le 1400W (1 mg/kg x 2 fois/jour), un inhibiteur sélectif de la iNOS, ou avec le Mergetpa (1mg/kg x 2 fois/jour), un inhibiteur non sélectif de la carboxypeptidase M (CPM) qui supprime la formation d’agonistes du RB1. Ces deux traitements devraient reproduire les effets bénéfiques de l’antagoniste du RB1 (SSR240612). En effet, le 1400W et le Mergetpa corrigent l’hyperglycémie, la résistance à l’insuline (l’indice HOMA), l’allodynie au froid et l’expression de plusieurs marqueurs de l’inflammation (Cox-2, iNOS, RB1, IL-1, anion superoxyde). Ces résultats confirment la contribution de la iNOS dans les effets délétères du RB1 chez le rat insulino-résistant. Dans un autre volet, ce mémoire vise à mieux comprendre l’impact de l’inhibition du RB1 par le SSR240612 (10 μg/g/jour) combiné ou pas avec le Pioglitazone (1.6 mg/g/jour) (un anti-diabétique de la famille des thiazolidinediones, le TZD) dans un modèle de diabète de type 2 associé à l’obésité chez la souris C57BL/6J soumise à une diète riche vi en gras pendant vingt semaines. Un traitement pendant deux semaines avec le TZD corrige l’intolérance au glucose et réduit les taux plasmatiques d’insuline alors que le SSR n’a pas d’effet. Les traitements combinés du TZD avec le SSR corrigent davantage la perte de la sensibilité à l’insuline et réduisent les taux plasmatiques de leptine. Les résultats obtenus suggèrent que le SSR n’apporte pas l’effet bénéfique souhaité, dans ce modèle avancé de diabète de type 2, contrairement au modèle des rats insulino-résistants (pré-diabétiques).

Uranyl(VI) and lanthanum(III) thio-diglycolamides complexes: synthesis and structural studies involving nitrate complexation

New tri-functional ligands of the type R2NCCCH2SCH2CCNR2 (where R = iso-propyl, n-butyl or iso-butyl) were prepared and characterized. The coordination chemistry of these ligands with uranyl and lanthanum(III) nitrates was studied by using the IR, (HNMR)-H-1 and elemental analysis methods. Structures for the compounds [UO2(NO3)(2)((Pr2NCOCH2SCH2CONPr2)-Pr-i-Pr-i)] [UO2(NO3)(2)((Bu2NCOCH2SCH2CONBu2)-Bu-i-Bu-i)(2)] [La(NO3)(3)((Pr2NCOCH2SCH2CONPr2)-Pr-i-Pr-i)(2)] and [La(NO3)(3)((Bu2NCOCH2SCH2CONBu2)-Bu-i-Bu-i)(2)] were determined by single crystal X-ray diffraction. These structures show that the ligand acts as a bidentate chelating ligand and bonds through both the carbamoyl groups to the uranyl and lanthanum(III) nitrate groups. Solvent extraction studies show that the ligand can extract the uranyl ion from the nitric acid medium but does not show any ability to extract the americium (III) ion. (C) 2009 Elsevier Ltd. All rights reserved.

Chemical, electrochemical and structural studies of some cis-dioxomolybdenum(VI) complexes of two tridentate ONS chelating ligands

Several cis-dioxomolybdenum complexes of two tridentate ONS chelating ligands H2L1 and H2L2 ( obtained by condensation of S-benzyl and S-methyl dithiocarbazates with 2-hydroxyacetophenone) have been prepared and characterized. Complexes 1 and 2 are found to be of the form MoO2 (CH3OH)L-1.CH3OH and MoO2L, respectively, (where L2-=dianion of H2L1 and H2L2). The sixth coordination site of the complexes acts as a binding site for various neutral monodentate Lewis bases, B, forming complexes 3 - 10 of the type MoO2LB (where B=gamma-picoline, imidazole, thiophene, THF). The complexes were characterized by elemental analyses, various spectroscopic techniques, ( UV-Vis, IR and H-1 NMR), measurement of magnetic susceptibility at room temperature, molar conductivity in solution and by cyclic voltammetry. Two of the complexes MoO2(CH3OH)L-1.CH3OH (1) and MoO2L1(imz) (5) were structurally characterized by single crystal X-ray diffraction. Oxo abstruction reactions of 1 and 5 led to formation of oxomolybdenum(IV) complex of the MoOL type.

Steric effects on uranyl complexation: synthetic, structural, and theoretical studies of carbamoyl pyrazole compounds of the uranyl(VI) ion

New bifunctional pyrazole based ligands of the type [C3HR2N2CONR'] (where R = H or CH3; R' = CH3, C2H5, or (C3H7)-C-i) were prepared and characterized. The coordination chemistry of these ligands with uranyl nitrate and uranyl bis(dibenzoyl methanate) was studied with infrared (IR), H-1 NMR, electrospray-mass spectrometry (ES-MS), elemental analysis, and single crystal X-ray diffraction methods. The structure of compound [UO2(NO3)(2)(C3H3N2CON{C2H5}(2))] (2) shows that the uranium(VI) ion is surrounded by one nitrogen atom and seven oxygen atoms in a hexagonal bipyramidal geometry with the ligand acting as a bidentate chelating ligand and bonds through both the carbamoyl oxygen and pyrazolyl nitrogen atoms. In the structure of [UO2(NO3)(2)(H2O)(2)(C5H7N2CON {C2H5}(2))(2)], (5) the pyrazole figand acts as a second sphere ligand and hydrogen bonds to the water molecules through carbamoyl oxygen and pyrazolyl nitrogen atoms. The structure of [UO2(DBM)(2)C3H3N2CON{C2H5}(2)] (8) (where DBM = C6H5COCHCOC6H5) shows that the pyrazole ligand acts as a monodentate ligand and bonds through the carbamoyl oxygen to the uranyl group. The ES-MS spectra of 2 and 8 show that the ligand is similarly bonded to the metal ion in solution. Ab initio quantum chemical studies show that the steric effect plays the key role in complexation behavior.

Synthesis, chemical, electrochemical characterization of oxomolybdenum(V) complexes of 2-(3,5-dimethyl pyrazol-1-yl) benzothiazole ligand: crystal structure of ligand and oxomolybdenum(VI) complex and density functional theory (DFT) calculation

This work reports the ligational behavior of the neutral bidentate chelating molecule 2-(3,5-dimethyl pyrazol-1-yl) benzothiazole towards the oxomolybdenum(V) center. Both mononuclear complexes of the type (MoOX3L)-O-V and binuclear complexes of the formula (Mo2O4X2L2)-O-V (where X = Cl, Br) are isolated in the solid state. The complexes are characterized by elemental analyses, various spectroscopic techniques (UV-Vis IR), magnetic susceptibility measurement at room temperature, and cyclic voltammetry for their redox behavior at a platinum electrode in CH3CN. The mononuclear complexes (MoOX3L)-O-V are found to be paramagnetic while the binuclear complexes Mo2O4X2L2 are diamagnetic. Crystal and molecular structure of the ligand and the dioxomolybdenum complex (MoO2Br2L)-O-VI (obtained from the complex MoOBr3L during crystallization) have been solved by single crystal X-ray diffraction technique. Relevant DFT calculations of the ligand and the complex (MoO2Br2L)-O-VI are also carried out.

Dimer formation by symbiotic donor–acceptor interaction between two molecules of a specially designed dioxomolybdenum(VI) complex containing both donor and acceptor centers – A structural, spectroscopic and DFT study

This work presents a model study for the formation of a dimeric dioxomolybdenum(VI) complex [MoO2L]2, generated by simultaneous satisfaction of acceptor and donor character existing in the corresponding monomeric Mo(VI) complex MoO2L. This mononuclear complex is specially designed to contain a coordinatively unsaturated Mo(VI) acceptor centre and a free donor group, (e.g. –NH2 group) strategically placed in the ligand skeleton [H2L = 2-hydroxyacetophenonehydrazone of 2-aminobenzoylhydrazine]. Apart from the dimer [MoO2L]2, complexes of the type MoO2L·B (where B = CH3OH, γ-picoline and imidazole) are also reported. All the complexes are characterized by elemental analysis, spectroscopic (UV–Vis, IR, 1H NMR) techniques and cyclic voltammetry. Single crystal X-ray structures of [MoO2L]2 (1), MoO2L·CH3OH (2), and MoO2L.(γ-pic) (3) have been determined and discussed. DFT calculation on these complexes corroborates experimental data and provides clue for the facile formation of this type of dimer not reported previously. The process of dimer formation may also be viewed as an interaction between two molecules of a specially designed complex acting as a monodentate ligand. This work is expected to open up a new field of design and synthesis of dimeric complexes through the process of symbiotic donor–acceptor (acid–base) interaction between two molecules of a specially designed monomer.

Type 1 Design I Starboard Side

Print No 97; Initials Lower Left: WH; Initials Lower Left: VI; Initials Lower Left: RN

Type 1 Design I Port

Print No. 76; handwritten pencil notes "Dist #4" "14" on back.; Initials Lower Left: WH; Initials Lower Left: VI; Initials Lower Left: RN

Terapia de reposição enzimática para as mucopolissacaridoses I, II e VI: recomendações de um grupo de especialistas brasileiros

As mucopolissacaridoses (MPS) são doenças genéticas raras causadas pela deficiência de enzimas lisossômicas específicas que afetam o catabolismo de glicosaminoglicanos (GAG). O acúmulo de GAG em vários órgãos e tecidos nos pacientes afetados pelas MPS resulta em uma série de sinais e sintomas, integrantes de um quadro clínico multissistêmico que compromete ossos e articulações, vias respiratórias, sistema cardiovascular e muitos outros órgãos e tecidos, incluindo, em alguns casos, as funções cognitivas. Já foram identificados 11 defeitos enzimáticos que causam sete tipos diferentes de MPS. Antes do advento de terapias dirigidas para a restauração da atividade da enzima deficiente, o tratamento das MPS tinha como principal foco a prevenção e o cuidado das complicações, aspecto ainda bastante importante no manejo desses pacientes. Na década de 80 foi proposto o tratamento das MPS com transplante de medula óssea/transplante de células tronco hematopoiéticas (TMO/TCTH) e na década de 90 começou o desenvolvimento da Terapia de Reposição Enzimática (TRE), que se tornou uma realidade aprovada para uso clínico nas MPS I, II e VI na primeira década do século 21. Os autores deste trabalho têm a convicção de que um melhor futuro para os pacientes afetados pelas MPS depende da identificação, compreensão e manejo adequado das manifestações multissistêmicas dessas doenças, incluindo medidas de suporte (que devem fazer parte da assistência multidisciplinar regular destes pacientes) e terapias específicas. Embora a inibição da síntese de GAG e o resgate da atividade enzimática com moléculas pequenas também possam vir a ter um papel no manejo das MPS, o grande avanço disponível no momento é a TRE intravenosa. A TRE permitiu modificar radicalmente o panorama do tratamento das mucopolissacaridoses I, II e VI na última década, sendo que ainda pode estender seus benefícios em breve para a MPS IV A (cuja TRE já está em desenvolvimento clínico), com perspectivas para o tratamento da MPS III A e do déficit cognitivo na MPS II através de administração da enzima diretamente no sistema nervoso central (SNC). Um grande número de centros brasileiros, incluindo serviços de todas as regiões do país, já têm experiência com TRE para MPS I, II e VI. Essa experiência foi adquirida não só com o tratamento de pacientes como também com a participação de alguns grupos em ensaios clínicos envolvendo TRE para essas condições. Somados os três tipos de MPS, mais de 250 pacientes já foram tratados com TRE em nosso país. A experiência dos profissionais brasileiros, somada aos dados disponíveis na literatura internacional, permitiu elaborar este documento, produzido com o objetivo de reunir e harmonizar as informações disponíveis sobre o tratamento destas doenças graves e progressivas, mas que, felizmente, são hoje tratáveis, uma realidade que traz novas perspectivas para os pacientes brasileiros afetados por essas condições.

Adsorção de cromo (VI) por carvão ativado granular de soluções diluídas utilizando um sistema batelada sob pH controlado

Na Amazônia o cromo é empregado principalmente na indústria de couro e de madeira, sendo responsável por vários problemas de saúde porque é tóxico para os seres vivos. A remoção de cromo de efluentes industriais é feita por meio de diversos processos como a adsorção. Este trabalho mostra os resultados da adsorção de Cr(VI) por carvão ativado granular comercial (CAG) como adsorvente de soluções diluídas empregando um sistema de adsorção batelada com controle de pH. Os grupos funcionais da superfície do CAG foram determinados pelo método de Boehm. Além disso, o efeito do pH na adsorção de Cr(VI), o equilíbrio e a cinética de adsorção foram estudados nas condições experimentais (pH = 6, MA = 6g, tempo de adsorção 90min.). Na superfície do CAG, os grupos carboxílicos foram determinados em maior concentração (MAS=0,43 mmol/gCAG), estes, presentes em concentrações elevadas aumentam a adsorção do metal, principalmente em valores de pH ácidos. A capacidade de adsorção é dependente do pH da solução, devido a sua influência nas propriedades de superfície do CAG e nas diferentes formas iônicas das soluções de Cr(VI). Os dados de equilíbrio da adsorção foram ajustados satisfatoriamente pela isoterma de Langmuir (R²=0,988), tipo favorável. A partir da cinética de adsorção a 5mg/L e 20mg/L, os resultados obtidos foram compatíveis com o valor limite preconizado na legislação nacional (Res. nº 357/05). Portanto, para o sistema experimental utilizando CAG foi eficiente na remoção de Cr(VI) a partir de correntes líquidas contendo baixas concentrações do metal.

Bonding of Y-TZP to Dentin: Effects of Y-TZP Surface Conditioning, Resin Cement Type, and Aging

Purpose: To evaluate the effects of two surface treatments, aging, and two resin cements on shear bond strength between dentin and yttrium-stabilized tetragonal zirconia polycrystal ceramic (Y-TZP).Materials and Methods: Eighty human molars were embedded in acrylic resin and sectioned 3 mm below the occlusal plane. These teeth and 80 cylindrical Y-TZP specimens (height, 4 mm; diameter, 3.4 mm) were divided into eight groups (n=10) using the following factors: Y-TZP surface treatment (Vi: low-fusing porcelain [vitrification] + hydrofluoric acid etching + silanization or Si: tribochemical silicatization); cementation strategies (PF: Pan avia or CC: Clearfil); and storage (nonaging or aging). Bonding surfaces of 40 Y-TZP specimens received Vi treatment, and the rest received Si treatment. Half of the ceramic-tooth assemblies were cemented with Panavia, the rest with Clearfil. Shear tests were executed using 0.4-mm-thick wire at 0.5 mm/min. Data were analyzed by three-way analysis of variance and Tukey test (alpha=0.05). Fractures were analyzed.Results: Y-TZP surface treatments did not affect bond strength (p=0.762, Vi = Si), while resin cements (p<0.001, Panavia > Clearfil) and aging (p=0.006, nonaging > aging) showed a significant effect. Most failures were in adhesive at dentin-cement interfaces; no failure occurred between zirconia and cement.Conclusion: When Y-TZP ceramic is bonded to dentin, the weakest interface is that between dentin and resin cement. The resin cement/Y-TZP interface was less susceptible to failures, owing to Y-TZP surface treatments.

Imprinted gene expression in in vivo- And in vi/ro-produced bovine embryos and chorio-allantoic membranes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)