Medication reconciliation and adherence: a call for clinical pharmacist

Introduction and Objectives: With the population ageing, there is a growing number of people who have several comorbidities and make use of a variety of drugs. These factors lead to a greater predisposition to adverse drug events, as well as to medication errors. The clinical pharmacist is the most indicated health professional to target these issues. The aims of this study were to analyze the profile of medication reconciliation and assess the role of the clinical pharmacist regarding medication adherence. Material and Methods: Prospective observational cohort study conducted from Jan-Mar 2013 at the Surgical Clinic of the University Hospital of the University of Sao Paulo. 117 admitted patients - over the age of 18 years, under continuous medication use and with length of hospitalization up to 120h - were included. Discrepancies were classified as intentional/unintentional and according to their risk to cause harm, and interventions were divided into accepted/not accepted. Medication adherence was measured by Morisky questionnaire. Results and Conclusions: Only 30% of hospital prescriptions showed no discrepancies between the medications that the patient was using at home and those which were being prescribed at the hospital and more than one third of those had the potential to cause moderate discomfort or clinical deterioration. One third of total discrepancies were classified as unintentional. About 90% of the interventions were accepted by the medical staff. In addition, about 63% of patients had poor adherence to drug therapy. The study revealed the importance of the medication reconciliation at patient admission, ensuring greater safety and therapeutic efficacy of the treatment during hospitalization, and orienting the patient at discharge, assuring the therapy safety.

Effect of Nontronite Smectite Clay on the Chemical Evolution of Several Organic Molecules under Simulated Martian Surface Ultraviolet Radiation Conditions

Most of the phyllosilicates detected at the surface of Mars today are probably remnants of ancient environments that sustained long-term bodies of liquid water at the surface or subsurface and were possibly favorable for the emergence of life. Consequently, phyllosilicates have become the main mineral target in the search for organics on Mars. But are phyllosilicates efficient at preserving organic molecules under current environmental conditions at the surface of Mars? We monitored the qualitative and quantitative evolutions of glycine, urea, and adenine in interaction with the Fe3+-smectite clay nontronite, one of the most abundant phyllosilicates present at the surface of Mars, under simulated martian surface ultraviolet light (190-400 nm), mean temperature (218 +/- 2 K), and pressure (6 +/- 1 mbar) in a laboratory simulation setup. We tested organic-rich samples that were representative of the evaporation of a small, warm pond of liquid water containing a high concentration of organics. For each molecule, we observed how the nontronite influences its quantum efficiency of photodecomposition and the nature of its solid evolution products. The results reveal a pronounced photoprotective effect of nontronite on the evolution of glycine and adenine; their efficiencies of photodecomposition were reduced by a factor of 5 when mixed at a concentration of 2.6x10(-2) mol of molecules per gram of nontronite. Moreover, when the amount of nontronite in the sample of glycine was increased by a factor of 2, the gain of photoprotection was multiplied by a factor of 5. This indicates that the photoprotection provided by the nontronite is not a purely mechanical shielding effect but is also due to stabilizing interactions. No new evolution product was firmly identified, but the results obtained with urea suggest a particular reactivity in the presence of nontronite, leading to an increase of its dissociation rate. Key Words: Martian surface-Organic chemistry-Photochemistry-Astrochemistry-Nontronite-Phyllosilicates. Astrobiology 15, 221-237.

(Table 1) Chlorophyll concentration and pigment composition of carotenoids in three heathland bryophytes, northern Sweden

Background and Aims: Anthropogenic depletion of stratospheric ozone in Arctic latitudes has resulted in an increase of ultraviolet-B radiation (UV-B) reaching the biosphere. UV-B exposure is known to reduce aboveground biomass and plant height, to increase DNA damage and cause accumulation of UV-absorbing compounds in polar plants. However, many studies on Arctic mosses tended to be inconclusive. The importance of different water availability in influencing UV-B impacts on lower plants in the Arctic has been poorly explored and might partially explain the observed wide variation of responses, given the importance of water in controlling bryophyte physiology. This study aimed to assess the long-term responses of three common sub-Arctic bryophytes to enhanced UV-B radiation (+UV-B) and to elucidate the influence of water supply on those responses. Results: Responses were species specific: H. splendens responded most to +UV-B, with reduction in both annual growth (-22%) and sporophyte production (-44%), together with increased b-carotene, violaxanthin, total chlorophyll and NPQ, and decreased zeaxanthin and de-epoxidation of the xanthophyll cycle pool (DES). Barbilophozia lycopodioides responded less to +UV-B, showing increased b-carotene and sclerophylly and decreased UV-absorbing compounds. Polytrichum commune only showed small morphogenetic changes. No effect of UV-B on bryophyte cover was observed. Water availability had profound effects on bryophyte ecophysiology, and plants showed, in general, lower growth and ETR, together with a higher photoprotection in the drier site. Water availability also influenced bryophyte responses to +UV-B and, in particular, responses were less detectable in the drier site. Conclusions: Impacts of UV-B exposure on Arctic bryophytes were significant, in contrast to modest or absent UV-B effects measured in previous studies. The impacts were more easily detectable in species with high plasticity such as H. splendens and less obvious, or more subtle, under drier conditions. Species biology and water supply greatly influences the impact of UV-B on at least some Arctic bryophytes and could contribute to the wide variation of responses observed previously.

Seawater carbonate chemistry and dark respiration and photosynthetic capacity during experiments with coral Acropora formosa, 2010

Ocean acidification is expected to lower the net accretion of coral reefs yet little is known about its effect on coral photophysiology. This study investigated the effect of increasing CO2 on photosynthetic capacity and photoprotection in Acropora formosa. The photoprotective role of photorespiration within dinoflagellates (genus Symbiodinium) has largely been overlooked due to focus on the presence of a carbon-concentrating mechanism despite the evolutionary persistence of a Form II Rubisco. The photorespiratory fixation of oxygen produces phosphoglycolate that would otherwise inhibit carbon fixation though the Calvin cycle if it were not converted to glycolate by phosphoglycolate phosphatase (PGPase). Glycolate is then either excreted or dealt with by enzymes in the photorespiratory glycolate and/or glycerate pathways adding to the pool of carbon fixed in photosynthesis. We found that CO2 enrichment led to enhanced photoacclimation (increased chlorophyll a per cell) to the subsaturating light levels. Light-enhanced dark respiration per cell and xanthophyll de-epoxidation increased, with resultant decreases in photosynthetic capacity (Pnmax) per chlorophyll. The conservative CO2 emission scenario (A1B; 600-790 ppm) led to a 38% increase in the Pnmax per cell whereas the 'business-as-usual' scenario (A1F1; 1160-1500 ppm) led to a 45% reduction in PGPase expression and no change in Pnmax per cell. These findings support an important functional role for PGPase in dinoflagellates that is potentially compromised under CO2 enrichment.

Physiological responses of the marine diatom Thalassiosira pseudonana to increased pCO2 and seawater acidity

We studied the effects of elevated CO2 concentration and seawater acidity on inorganic carbon acquisition, photoinhibition and photoprotection as well as growth and respiration in the marine diatom Thalassiosira pseudonana. After having grown under the elevated CO2 level (1000 µatm, pH 7.83) at sub-saturating photosynthetically active radiation (PAR, 75 µmol photons/m**2/s) for 20 generations, photosynthesis and dark respiration of the alga increased by 25% (14.69 ± 2.55 fmol C/cell/h) and by 35% (4.42 ± 0.98 fmol O2/cell/h), respectively, compared to that grown under the ambient CO2 level (390 µatm, pH 8.16), leading to insignificant effects on growth (1.09 ± 0.08 (1/d))v 1.04 ± 0.07 (1/d)). The photosynthetic affinity for CO2 was lowered in the high-CO2 grown cells, reflecting a down-regulation of the CO2 concentrating mechanism (CCM). When exposed to an excessively high level of PAR, photochemical and non-photochemical quenching responded similarly in the low- and high-CO2 grown cells, reflecting that photoinhibition was not influenced by the enriched level of CO2. In T. pseudonana, it appeared that the energy saved due to the down-regulated CCM did not contribute to any additional light stress as previously found in another diatom Phaeodactylum tricornutum, indicating differential physiological responses to ocean acidification between these two diatom species.

Sea-suface microlayer (SML) and underlying water (ULW) samples focusing on CDOM spectral characteristics during METEOR cruise M91

The coastal upwelling system off the coast of Peru is characterized by high biological activity and a pronounced subsurface oxygen minimum zone, as well as associated emissions of atmospheric trace gases such as N2O, CH4 and CO2. From 3 to 23 December 2012, R/V Meteor (M91) cruise took place in the Peruvian upwelling system between 4.59 and 15.4°S, and 82.0 to 77.5°W. During M91 we investigated the composition of the sea-surface microlayer (SML), the oceanic uppermost boundary directly subject to high solar radiation, often enriched in specific organic compounds of biological origin like chromophoric dissolved organic matter (CDOM) and marine gels. In the SML, the continuous photochemical and microbial recycling of organic matter may strongly influence gas exchange between marine systems and the atmosphere. We analyzed SML and underlying water (ULW) samples at 38 stations focusing on CDOM spectral characteristics as indicator of photochemical and microbial alteration processes. CDOM composition was characterized by spectral slope (S) values and excitation-emission matrix fluorescence (EEMs), which allow us to track changes in molecular weight (MW) of DOM, and to determine potential DOM sources and sinks. Spectral slope S varied between 0.012 to 0.043 1 nm-1 and was quite similar between SML and ULW, with no significant differences between the two compartments. Higher S values were observed in the ULW of the southern stations below 15°S. By EEMs, we identified five fluorescent components (F1-5) of the CDOM pool, of which two had excitation/emission characteristics of amino-acid-like fluorophores (F1, F4) and were highly enriched in the SML, with a median ratio SML : ULW of 1.5 for both fluorophores. In the study region, values for CDOM absorption ranged from 0.07 to 1.47 m-1. CDOM was generally highly concentrated in the SML, with a median enrichment with respect to the ULW of 1.2. CDOM composition and changes in spectral slope properties suggested a local microbial release of DOM directly in the SML as a response to light exposure in this extreme environment. In a conceptual model of the sources and modifications of optically active DOM in the SML and underlying seawater (ULW), we describe processes we think may take place (Fig. 1); the production of CDOM of higher MW by microbial release through growth, exudation and lysis in the euphotic zone, includes the identified fluorophores (F1, F2, F3, F4, F5). Specific amino-acid-like fluorophores (F1, F4) accumulate in the SML with respect to the ULW, as photochemistry may enhance microbial CDOM release by (a) photoprotection mechanisms and (b) cell-lysis processes. Microbial and photochemical degradation are potential sinks of the amino-acid-like fluorophores (F1, F4), and potential sources of reworked and more refractory humic-like components (F2, F3, F5). In the highly productive upwelling region along the Peruvian coast, the interplay of microbial and photochemical processes controls the enrichment of amino-acid-like CDOM in the SML. We discuss potential implications for air-sea gas exchange in this area.

Photophysiological responses of Southern Ocean phytoplankton to changes in CO2 concentrations: Short-term versus acclimation effects

The present study examines how different pCO2 acclimations affect the CO2- and light-dependence of photophysiological processes and O2 fluxes in four Southern Ocean (SO) key phytoplankton species. We grew Chaetoceros debilis (Cleve), Pseudo-nitzschia subcurvata (Hasle), Fragilariopsis kerguelensis (O'Meara) and Phaeocystis antarctica (Karsten) under low (160 µatm) and high (1000 ?atm) pCO2. The CO2- and light-dependence of fluorescence parameters of photosystem II (PSII) were determined by means of a fluorescence induction relaxation system (FIRe). In all tested species, nonphotochemical quenching (NPQ) is the primary photoprotection strategy in response to short-term exposure to high light or low CO2 concentrations. In C. debilis and P. subcurvata, PSII connectivity (p) and functional absorption cross-sections of PSII in ambient light (sigma PSII') also contributed to photoprotection while changes in re-oxidation times of Qa acceptor (tQa) were more significant in F. kerguelensis. The latter was also the only species being responsive to high acclimation pCO2, as these cells had enhanced relative electron transport rates (rETRs) and sigma PSII' while tQa and p were reduced under short-term exposure to high irradiance. Low CO2-acclimated cells of F. kerguelensis and all pCO2 acclimations of C. debilis and P. subcurvata showed dynamic photoinhibition with increasing irradiance. To test for the role and presence of the Mehler reaction in C. debilis and P. subcurvata, the light-dependence of O2 fluxes was estimated using membrane inlet mass spectrometry (MIMS). Our results show that the Mehler reaction is absent in both species under the tested conditions. We also observed that dark respiration was strongly reduced under high pCO2 in C. debilis while it remained unaltered in P. subcurvata. Our study revealed species-specific differences in the photophysiological responses to pCO2, both on the acclimation as well as the short-term level.

The Outer Chloroplast Envelope Protein OEP16-1 for Plastid Import of NADPH:Protochlorophyllide Oxidoreductase A in Arabidopsis thaliana

The outer plastid envelope protein OEP16-1 was previously identified as an amino acid-selective channel protein and translocation pore for NADPH:protochlorophyllide oxidoreductase A (PORA). Reverse genetic approaches used to dissect these mutually not exclusive functions of OEP16-1 in planta have led to descriptions of different phenotypes resulting from the presence of several mutant lines in the SALK_024018 seed stock. In addition to the T-DNA insertion in the AtOEP16-1 gene, lines were purified that contain two additional T-DNA insertions and as yet unidentified point mutations. In a first attempt to resolve the genetic basis of four different lines in the SALK_024018 seed stock, we used genetic transformation with the OEP16-1 cDNA and segregation analyses after crossing out presumed point mutations. We show that AtOEP16-1 is involved in PORA precursor import and by virtue of this activity confers photoprotection onto etiolated seedlings during greening

Enzyme plus light therapy to repair DNA damage in ultraviolet-B-irradiated human skin

Ultraviolet-B (UVB) (290–320 nm) radiation-induced cyclobutane pyrimidine dimers within the DNA of epidermal cells are detrimental to human health by causing mutations and immunosuppressive effects that presumably contribute to photocarcinogenesis. Conventional photoprotection by sunscreens is exclusively prophylactic in nature and of no value once DNA damage has occurred. In this paper, we have therefore assessed whether it is possible to repair UVB radiation-induced DNA damage through topical application of the DNA-repair enzyme photolyase, derived from Anacystis nidulans, that specifically converts cyclobutane dimers into their original DNA structure after exposure to photoreactivating light. When a dose of UVB radiation sufficient to induce erythema was administered to the skin of healthy subjects, significant numbers of dimers were formed within epidermal cells. Topical application of photolyase-containing liposomes to UVB-irradiated skin and subsequent exposure to photoreactivating light decreased the number of UVB radiation-induced dimers by 40–45%. No reduction was observed if the liposomes were not filled with photolyase or if photoreactivating exposure preceded the application of filled liposomes. The UVB dose administered resulted in suppression of intercellular adhesion molecule-1 (ICAM-1), a molecule required for immunity and inflammatory events in the epidermis. In addition, in subjects hypersensitive to nickel sulfate, elicitation of the hypersensitivity reaction in irradiated skin areas was prevented. Photolyase-induced dimer repair completely prevented these UVB radiation-induced immunosuppressive effects as well as erythema and sunburn-cell formation. These studies demonstrate that topical application of photolyase is effective in dimer reversal and thereby leads to immunoprotection.

An unusual pathway of excitation energy deactivation in carotenoids: Singlet-to-triplet conversion on an ultrafast timescale in a photosynthetic antenna

Carotenoids are important biomolecules that are ubiquitous in nature and find widespread application in medicine. In photosynthesis, they have a large role in light harvesting (LH) and photoprotection. They exert their LH function by donating their excited singlet state to nearby (bacterio)chlorophyll molecules. In photosynthetic bacteria, the efficiency of this energy transfer process can be as low as 30%. Here, we present evidence that an unusual pathway of excited state relaxation in carotenoids underlies this poor LH function, by which carotenoid triplet states are generated directly from carotenoid singlet states. This pathway, operative on a femtosecond and picosecond timescale, involves an intermediate state, which we identify as a new, hitherto uncharacterized carotenoid singlet excited state. In LH complex-bound carotenoids, this state is the precursor on the reaction pathway to the triplet state, whereas in extracted carotenoids in solution, this state returns to the singlet ground state without forming any triplets. We discuss the possible identity of this excited state and argue that fission of the singlet state into a pair of triplet states on individual carotenoid molecules constitutes the mechanism by which the triplets are generated. This is, to our knowledge, the first ever direct observation of a singlet-to-triplet conversion process on an ultrafast timescale in a photosynthetic antenna.

Método simples e rápido para seleção de fungos filamentosos produtores de compostos absorvedores de radiação UV para aplicação em protetores solares

Foram estudadas trinta e uma cepas fúngicas não identificadas, as quais foram denominadasX1 a X31. O potencial fotoprotetor foi avaliado pela medida espectrofotométrica da absorçãodos extratos na região do UV (280-400 nm). Os extratos com os melhores perfis de absorção em cultura estacionária foram X1, X2, X6, X12, X13, X18, X19, X22, X24 e X31 e, em cultura agitada X4 e X17. A reprodutibilidade do processo foi avaliada e as cepas fúngicas que apresentaram coeficiente de variação menor que 15% foram selecionadas para o estudo de fotoestabilidade. A fotoestabilidade dos extratos foi avaliada pela medida da viabilidade celular de fibroblastos L929 tratados com extratos previamente irradiados sob radiação UVA (11,2 J/cm2) e UVB (3,43 J/cm2) e extratos não irradiados, bem como, pela comparação das áreas sob as curvas de absorção na região do UV dos extratos irradiados e não irradiados. Os extratos selecionados para o estudo de fotoestabilidade foram X4, X12, X19, X22, X24 e X31. Os extratos não irradiados apresentaram os seguintes valores deIC50 para viabilidade celular (citotoxidade): X4-130µg/ml, X19-20µg/ml, X22-10 µg/ml e X24-60µg/ml. Após a radiação UVA e UVB, os extratos apresentaram redução significativa da viabilidade celular em relação ao IC50 dos extratos não irradiados. Sob luz UVB, os extratos X12 (IC50 35µg/ml) e X31 (IC50 70µg/ml) mantiveram a mesma porcentagem de redução da viabilidade celular quando comparado ao IC50 dos extratos não irradiados. No entanto após exposição à luz UVA, o extrato X12 aumentou a viabilidade celular de 50% (quando não irradiado) para 75% (irradiado). Enquanto que o extrato X31, mesmo após a radiação UVA, manteve a mesma redução de 50% da viabilidade celular. Nessa etapa os extratos selecionados foram os X12 e X31. O espectro de absorção na região do UV obtido para o extrato X12 mostrou uma redução da absorbância de 28,3% sob radiação UVB e de 60% sob radiação UVA em relação ao extrato não irradiado. O extrato X31 apresentou uma redução da absorbância de 17,6% e30% sob radiação UVB e UVA respectivamente, em relação ao extrato não irradiado. Os fungos selecionados foram identificados por PCR, sugerindo que o fungo X12 seja o Aspergillus terreus e o X31 seja o Talaromyces pinophilus. Por fim, foi feita a identificação da substância ativa do extrato X12 empregando a técnica de desreplicação, a qual fez o uso da instrumentação analítica acoplada UHPLC-DAD-(ESI)-HRMS associada ao banco de dados Chapman& Hall\'s Dictionary of Natural Products (DNP). No extrato X12 o composto majoritário foi identificado como sendo a citreoviridina. Assim, os resultados do presente trabalho permitiu estabelecer um procedimento para a seleção de fungos produtores de compostos absorvedores de radiação UV, que poderia ser aplicado na obtenção de novos filtros orgânicos naturais para protetores solares.

Potencial dos biflavonóides de Araucaria angustifolia (Bert.) O. Kuntze como antioxidantes e fotoprotetores

A Araucaria angustifolia é uma conífera endêmica das regiões sul e sudeste do Brasil sendo considerada uma espécie em extinção devido ao extenso extrativismo madeireiro. Atualmente, existem inúmeros projetos visando o reflorestamento e o uso sustentável deste pinheiro. Em vista destes pontos, o estudo das propriedades dos componentes das folhas com o intuito da utilização destes com fins comerciais tornou-se de extrema importância. As suas folhas foram submetidas à extração com solventes e foram identificados seis biflavonóides majoritários, dentre estes a amentoflavona e a ginkgetina, que são apontados como agentes contra inflamações e artrites. A fração rica de biflavonóides (BFF) extraída da araucaria foi testada frente a sua atividade em proteger contra danos em biomoléculas provocadas por espécies reativas de oxigênio, capacidade em quelar metais e proteção contra raios UV. A capacidade do BFF em proteger contra danos provocados por espécies reativas de oxigênio foi comparado com compostos conhecidamente antioxidantes, como o α-tocoferol, Trolox®, quercetina, rutina e com padrões de biflavonóides, a amentoflavona e ginkgetina. O BFF demonstrou que possui uma constante de supressão do 1O2 (50 x 106 M-1s-1), superior ao da quercetina (9 x 106 M-1s-1) e foi o mais eficiente na proteção contra quebras de simples fita em DNA plasmidial, provocado por esta espécie reativa. Ainda em relação à proteção de DNA plasmidial o BFF foi capaz de proteger também contra estes danos provocados através da reação de Fenton, apesar de não demonstrar a mesma eficiência da quercetina que mostrou ser um potente protetor destes danos. O BFF protegeu contra lipoperoxidação em lipossomos de fosfatidilcolina induzida por raios UV e reação de Fenton. Em análises realizadas com espectrometria de massas foi observada a formação de complexos destes biflavonóides com íons metálicos como ferro, cobre e alumínio que possuem um papel importante na formação de radicais livres. Em relação à capacidade fotoprotetora do BFF, este inibiu a formação de dímeros de pirimidina que são apontados como causadores de câncer de pele induzidos, principalmente por radiação UV-B. Esta ação protetora foi superior àquela conferida ao p-metoxicinamato de octila, um conhecido fotoprotetor. Com o intuito de permitir a solubilização do BFF em soluções aquosas e assim, avaliar a ação do BFF em células, incorporou-se o BFF em ciclodextrina. Essa inclusão favoreceu a incorporação de BFF em células CV1-P na concentração aproximada de 0,4 µg/ml após 24 horas de incubação. Essa concentração incorporada não demonstrou ser tóxica para as células no teste com MTT. Assim, o BFF tem despertado grande interesse em relação ao seu potencial na utilização nas mais variadas áreas como cosmética, alimentos e fitoterápicos.

Biochemical mechanisms involved in pulmonary hypo-alveolarization induced by peroxides contaminating parenteral nutrition in newborn guinea pig

La dysplasie broncho-pulmonaire (DBP), caractérisée par un défaut de l’alvéolarisation, est une complication pathologique associée à un stress oxydant chez le nouveau-né prématuré. La DBP est présente chez près de 50 % des nouveau-nés de moins de 29 semaines de gestation. La nutrition parentérale (NP) que ces nouveau-nés reçoivent pour cause d’immaturité gastro-intestinale est une source importante de stress oxydant. En effet, leur NP est contaminée par des peroxydes, dont l’ascorbylperoxyde qui est une forme peroxydée du déshydroascorbate. La génération des peroxydes est catalysée par la lumière ambiante. La photoprotection de la NP, quoique difficile d’application en clinique, est associée à une diminution de l’incidence de la DBP chez les enfants prématurés. Chez l’animal nouveau-né, la photoprotection de la NP est associée à un meilleur développement alvéolaire. Ainsi, nous émettons l’hypothèse que l’ascorbylperoxide infusé avec la NP cause la perte d’alvéoles suite à une apoptose exagérée induite par l’oxydation du potentiel redox du glutathion. Cette oxydation du potentiel redox serait occasionnée par l’inhibition de la transformation hépatique de la méthionine en cystéine, menant à une diminution de la synthèse de glutathion au foie et dans les tissus tels que les poumons. La confirmation de cette hypothèse suggérera qu’un ajout de glutathion dans la NP permettra une meilleure détoxification de l’ascorbylperoxide par l’action de la glutathion peroxydase, et préviendra l’oxydation du potentiel redox et ainsi, la perte d'alvéoles par apoptose. Objectifs : Le but de mon projet de recherche est de comprendre les mécanismes biochimiques liant la NP et le développement de la DBP chez le nouveau-né prématuré et de proposer une alternative nutritionnelle prévenant le développement de cette complication fréquemment observée dans cette population. Les objectifs spécifiques sont : 1) d’évaluer l’impact, au poumon, de l’infusion de l’ascorbylperoxyde sur l’axe métabolique potentiel redox du glutathion - apoptose - le développement alvéolaire; 2) d’étudier l’impact de l’ascorbylperoxyde et du potentiel redox sur l’activité hépatique de la méthionine adénosyltransférase (MAT), première enzyme de la cascade métabolique transformant la méthionine en cystéine; et 3) de tenter de prévenir l’impact négatif de la NP ou de l’infusion d’ascorbylperoxyde sur le poumon en améliorant le statut en glutathion. Méthodes: Par un cathéter fixé dans la jugulaire, des cochons d’Inde de trois jours de vie (n = 8 par groupe) ont reçu en continu durant 4 jours une NP ou une solution de base (dextrose + NaCl) enrichie des différentes molécules à l’essai. Le premier objectif a été atteint en enrichissant la solution de base en ascorbylperoxyde à 0, 20, 60 et 180 μM. Ces solutions contenaient ou non 350 μM H2O2 pour se rapprocher des conditions cliniques. Le second objectif a été atteint en investiguant les mécanismes d’inhibition de la MAT dans des animaux infusés ou non avec des solutions contenant la solution de base, des peroxydes, du glutathion et la NP (dextrose + acides aminés + multivitamines + lipides). Le troisième objectif a été atteint en ajoutant ou non à une solution d’ascorbylperoxide ou à la NP 10 μM de glutathion (GSSG), afin d’obtenir une concentration plasmatique normale de glutathion. Après 4 jours, les poumons étaient prélevés et traités pour la détermination de GSH et GSSG par électrophorèse capillaire, le potentiel redox était calculé selon l'équation de Nernst et le niveau de caspase-3 actif (marqueur d’apoptose) par Western blot et l’index d’alvéolarisation quantifié par le nombre d’interceptes entre des structures histologiques et une droite calibrée. Les données étaient comparées par ANOVA, les effets étaient considérés comme significatifs si le p était inférieur à 0,05. Résultats: L’infusion de l’ascorbylperoxyde, indépendamment du H2O2, a induit une hypoalvéolarisation, une activation de la caspase-3 et une oxydation du potentiel redox de manière dose-dépendante. Ces effets ont été empêchés par l’ajout de GSSG à la NP ou à la solution d’ascorbylperoxyde (180 M). L’ascorbylperoxyde et le H2O2 ont inhibé l’activité de MAT tandis qu’elle était linéairement modulée par la valeur du potentiel redox hépatique. Conclusion : Nos résultats suggèrent que l’ascorbylperoxyde est l’agent actif de la NP conduisant au développement de la DBP. Ainsi la correction des bas niveaux de glutathion induits par les peroxydes de la NP favorise la détoxification des peroxydes et la correction du potentiel redox pulmonaire ; ce qui a protégé les poumons des effets délétères de la NP en outrepassant l’inhibition de la MAT hépatique. Nos résultats sont d'une grande importance car ils donnent de l'espoir pour une prévention possible de la DBP.

Biochemical mechanisms involved in pulmonary hypo-alveolarization induced by peroxides contaminating parenteral nutrition in newborn guinea pig

La dysplasie broncho-pulmonaire (DBP), caractérisée par un défaut de l’alvéolarisation, est une complication pathologique associée à un stress oxydant chez le nouveau-né prématuré. La DBP est présente chez près de 50 % des nouveau-nés de moins de 29 semaines de gestation. La nutrition parentérale (NP) que ces nouveau-nés reçoivent pour cause d’immaturité gastro-intestinale est une source importante de stress oxydant. En effet, leur NP est contaminée par des peroxydes, dont l’ascorbylperoxyde qui est une forme peroxydée du déshydroascorbate. La génération des peroxydes est catalysée par la lumière ambiante. La photoprotection de la NP, quoique difficile d’application en clinique, est associée à une diminution de l’incidence de la DBP chez les enfants prématurés. Chez l’animal nouveau-né, la photoprotection de la NP est associée à un meilleur développement alvéolaire. Ainsi, nous émettons l’hypothèse que l’ascorbylperoxide infusé avec la NP cause la perte d’alvéoles suite à une apoptose exagérée induite par l’oxydation du potentiel redox du glutathion. Cette oxydation du potentiel redox serait occasionnée par l’inhibition de la transformation hépatique de la méthionine en cystéine, menant à une diminution de la synthèse de glutathion au foie et dans les tissus tels que les poumons. La confirmation de cette hypothèse suggérera qu’un ajout de glutathion dans la NP permettra une meilleure détoxification de l’ascorbylperoxide par l’action de la glutathion peroxydase, et préviendra l’oxydation du potentiel redox et ainsi, la perte d'alvéoles par apoptose. Objectifs : Le but de mon projet de recherche est de comprendre les mécanismes biochimiques liant la NP et le développement de la DBP chez le nouveau-né prématuré et de proposer une alternative nutritionnelle prévenant le développement de cette complication fréquemment observée dans cette population. Les objectifs spécifiques sont : 1) d’évaluer l’impact, au poumon, de l’infusion de l’ascorbylperoxyde sur l’axe métabolique potentiel redox du glutathion - apoptose - le développement alvéolaire; 2) d’étudier l’impact de l’ascorbylperoxyde et du potentiel redox sur l’activité hépatique de la méthionine adénosyltransférase (MAT), première enzyme de la cascade métabolique transformant la méthionine en cystéine; et 3) de tenter de prévenir l’impact négatif de la NP ou de l’infusion d’ascorbylperoxyde sur le poumon en améliorant le statut en glutathion. Méthodes: Par un cathéter fixé dans la jugulaire, des cochons d’Inde de trois jours de vie (n = 8 par groupe) ont reçu en continu durant 4 jours une NP ou une solution de base (dextrose + NaCl) enrichie des différentes molécules à l’essai. Le premier objectif a été atteint en enrichissant la solution de base en ascorbylperoxyde à 0, 20, 60 et 180 μM. Ces solutions contenaient ou non 350 μM H2O2 pour se rapprocher des conditions cliniques. Le second objectif a été atteint en investiguant les mécanismes d’inhibition de la MAT dans des animaux infusés ou non avec des solutions contenant la solution de base, des peroxydes, du glutathion et la NP (dextrose + acides aminés + multivitamines + lipides). Le troisième objectif a été atteint en ajoutant ou non à une solution d’ascorbylperoxide ou à la NP 10 μM de glutathion (GSSG), afin d’obtenir une concentration plasmatique normale de glutathion. Après 4 jours, les poumons étaient prélevés et traités pour la détermination de GSH et GSSG par électrophorèse capillaire, le potentiel redox était calculé selon l'équation de Nernst et le niveau de caspase-3 actif (marqueur d’apoptose) par Western blot et l’index d’alvéolarisation quantifié par le nombre d’interceptes entre des structures histologiques et une droite calibrée. Les données étaient comparées par ANOVA, les effets étaient considérés comme significatifs si le p était inférieur à 0,05. Résultats: L’infusion de l’ascorbylperoxyde, indépendamment du H2O2, a induit une hypoalvéolarisation, une activation de la caspase-3 et une oxydation du potentiel redox de manière dose-dépendante. Ces effets ont été empêchés par l’ajout de GSSG à la NP ou à la solution d’ascorbylperoxyde (180 M). L’ascorbylperoxyde et le H2O2 ont inhibé l’activité de MAT tandis qu’elle était linéairement modulée par la valeur du potentiel redox hépatique. Conclusion : Nos résultats suggèrent que l’ascorbylperoxyde est l’agent actif de la NP conduisant au développement de la DBP. Ainsi la correction des bas niveaux de glutathion induits par les peroxydes de la NP favorise la détoxification des peroxydes et la correction du potentiel redox pulmonaire ; ce qui a protégé les poumons des effets délétères de la NP en outrepassant l’inhibition de la MAT hépatique. Nos résultats sont d'une grande importance car ils donnent de l'espoir pour une prévention possible de la DBP.

Variation in Coral Photosynthesis, Respiration and Growth Characteristics in Contrasting Light Microhabitats: An Analogue to Plants in Forest Gaps and Understoreys?

1. The often complex architecture of coral reefs forms a diversity of light microhabitats. Analogous to patterns in forest plants, light variation may drive strategies for efficient light utilization and metabolism in corals. 2. We investigated the spatial distribution of light regimes in a spur-and-groove reef environment and examine the photophysiology of the coral Montipora monasteriata (Forskal 1775), a species with a wide habitat distribution. Specifically, we examined the variation in tissue and skeletal thickness, and photosynthetic and metabolic responses among contrasting light microhabitats. 3. Daily irradiances reaching corals in caves and under overhangs were 1-5 and 30-40% of those in open habitats at similar depth (3-5 m), respectively. Daily rates of net photosynthesis of corals in cave habitats approximated zero, suggesting more than two orders of magnitude variation in scope for growth across habitats. 4. Three mechanisms of photoadaptation or acclimation were observed in cave and overhang habitats: (1) a 20-50% thinner tissue layer and 40-60% thinner skeletal plates, maximizing light interception per unit mass; (2) a two- to threefold higher photosynthetic efficiency per unit biomass; and (3) low rates of dark respiration. 5. Specimens from open and cave habitats displayed a high capacity to acclimate to downshifts or upshifts in irradiance, respectively. However, specimens in caves displayed limited acclimation to further irradiance reduction, indicating that these live near their irradiance limit. 6. Analogous to patterns for some plant species in forest gaps, the morphological plasticity and physiological flexibility of M. monasteriata enable it to occupy light habitats that vary by more than two orders of magnitude.