Utilisation of a novel ProteaseTag™ activity immunoassay for the specific measurement of neutrophil elastase in BAL from children with cystic fibrosis

Introduction: Neutrophil elastase (NE) is a serine protease implicated in the pathogenesis of several respiratory diseases including cystic fibrosis (CF). The presence of free NE in BAL is a predictor of subsequent bronchiectasis in children with CF (Sly et al, 2013, NEJM 368: 1963-1970). Furthermore, children with higher levels of sputum NE activity (NEa) tend to experience a more rapid decline in FEV1 over time even after adjusting for age, gender and baseline FEV1 (Sagel et al, 2012, AJRCCM 186: 857-865). Its detection and quantification in biological samples is however confounded by a lack of robust methodologies. Standard assays using chromogenic or fluorogenic substrates are not specific when added to complex samples containing multiple proteolytic and hydrolytic enzymes. ELISA systems measure total protein levels which can be a mixture of latent, active and protease-inhibitor complexes. We have therefore developed a novel assay (ProteaseTag™ Active NE Immunoassay), which couples an activity dependent NE-Tag with a specific antibody step, resulting in an assay which is both selective and specific for NEa. Aims: To clinically validate ProteaseTag™ Active NE for the detection of free NEa in BAL from children with CF. Methods: A total of 95 paediatric BAL samples [CF (n=76; 44M, 32F) non-CF (n=19; 12M, 7F)] collected through the Study of Host Immunity and Early Lung Disease in CF (SHIELD CF) were analysed for NEa using ProteaseTag™ Active NE (ProAxsis Ltd) and a fluorogenic substrate-based assay utilising Suc-AAPV-AMC (Sigma). IL-8 was measured by ELISA (R&amp;D Systems). Results were analysed to show comparisons in free NEa between CF and non-CF samples alongside correlations with a range of clinical parameters. Results: NEa measured by ProteaseTag™ Active NE correlated significantly with age (r=0.3, p=0.01) and highly significantly with both IL-8 (r=0.4, p=<0.0001) and the absolute neutrophil count (ANC) (r=0.4, p=<0.0001). These correlations were not observed when NEa was measured by the substrate assay even though a significant correlation was found between the two assays (r=0.8, p<0.0001). A trend towards significance was found between NEa in the CF and non-CF groups when measured by ProteaseTag™ Active NE (p=0.07). Highly significant differences were found with the other inflammatory parameters between the 2 groups (IL-8: p=0.0002 and ANC: p=0.006). Conclusion: NEa as a primary efficacy endpoint in clinical trials or as a marker of inflammation within the clinic has been hampered by the lack of a robust and simple to use assay. ProteaseTag™ Active NE has been shown to be a specific and superior tool in the measurement of NEa in paediatric CF BAL samples (supporting data from previous studies using adult CF expectorated samples). The technology is currently being transferred to a lateral flow device for use at Point of Care. Acknowledgements: This work was supported by the National Children’s Research Centre, Dublin (SHIELD CF) and grants from the Medical Research Council and Cystic Fibrosis Foundation Therapeutics.

Efficacy and Long-Term Outcomes of Palivizumab Prophylaxis to Prevent Respiratory Syncytial Virus Infection in Infants with Cystic Fibrosis in Northern Ireland

BACKGROUND: RSV causes considerable morbidity and mortality in children. In cystic fibrosis (CF) viral infections are associated with worsening respiratory symptoms and bacterial colonization. Palivizumab is effective in reducing RSV hospitalization in high risk patient groups. Evidence regarding its effectiveness and safety in CF is inconclusive. CF screening in N. Ireland enabled timely palivizumab prophylaxis, becoming routine in 2002.

OBJECTIVES: To determine the effect of palivizumab on RSV-related hospitalization and compare lung function and bacterial colonization at age 6 years for those born pre- and post-introduction of palivizumab prophylaxis.

METHODS: A retrospective audit was conducted for all patients diagnosed with CF during the period from 1997 to 2007 inclusive. RSV-related hospitalization, time to Pseudomonas aeruginosa (PA) 1st isolate, lung function and growth parameters were recorded. Comparisons were made for outcomes pre- and post-introduction of routine palivizumab administration in 2002. A cost evaluation was also performed.

RESULTS: Ninety-two children were included; 47 pre- and 45 post-palivizumab introduction. The overall RSV-positive hospitalization rate was 13%. The relative risk of RSV infection in palivizumab non-recipients versus recipients was 4.78 (95%CI: 1.1-20.7), P = 0.027. Notably, PA 1st isolate was significantly earlier in the palivizumab recipient cohort versus non-recipient cohort (median 57 vs. 96 months, P < 0.025) with a relative risk of 2.5. Chronic PA infection at 6 years remained low in both groups, with similar lung function and growth parameters. Total costs were calculated at £96,127 ($151,880) for the non-recipient cohort versus £137,954 ($217,967) for the recipient cohort.

CONCLUSION: Palivizumab was effective in reducing RSV-related hospitalization infection in CF patients. Surprisingly, we found a significantly earlier time to 1st isolate of PA in palivizumab recipients which we could not explain by altered or improved diagnostic tests. 

Closed circuit rebreathing to achieve inert gas wash-in for multiple breath wash-out

Multiple breath wash-out (MBW) testing requires prior wash-in of inert tracer gas. Wash-in efficiency can be enhanced by a rebreathing tracer in a closed circuit. Previous attempts to deploy this did not account for the impact of CO2 accumulation on patients and were unsuccessful. We hypothesised that an effective rebreathe wash-in could be delivered and it would not alter wash-out parameters. Computer modelling was used to assess the impact of the rebreathe method on wash-in efficiency. Clinical testing of open and closed circuit wash-in–wash-out was performed in healthy controls and adult patients with cystic fibrosis (CF) using a circuit with an effective CO2 scrubber and a refined wash-in protocol. Wash-in efficiency was enhanced by rebreathing. There was no difference in mean lung clearance index between the two wash-in methods for controls (6.5 versus 6.4; p=0.2, n=12) or patients with CF (10.9 versus 10.8; p=0.2, n=19). Test time was reduced by rebreathe wash-in (156 versus 230 s for CF patients, p<0.001) and both methods were well tolerated. End wash-in CO2 was maintained below 2% in most cases. Rebreathe–wash-in is a promising development that, when correctly deployed, reduces wash-in time and facilitates portable MBW testing. For mild CF, wash-out outcomes are equivalent to an open circuit.

Production of extended-spectrum β-lactamases and the potential indirect pathogenic role of Prevotella</i> isolates from the cystic fibrosis respiratory microbiota

Extended-spectrum β-lactamase (ESBL) production and the prevalence of the β-lactamase-encoding gene blaTEM were determined in Prevotella isolates (n=50) cultured from the respiratory tract of adults and young people with cystic fibrosis (CF). Time-kill studies were used to investigate the concept of passive antibiotic resistance and to ascertain whether a β-lactamase-positive Prevotella isolate can protect a recognised CF pathogen from the action of ceftazidime in vitro. The results indicated that approximately three-quarters (38/50; 76%) of Prevotella isolates produced ESBLs. Isolates positive for ESBL production had higher minimum inhibitory concentrations (MICs) of β-lactam antibiotics compared with isolates negative for production of ESBLs (P<0.001). The blaTEM gene was detected more frequently in CF Prevotella isolates from paediatric patients compared with isolates from adults (P=0.002), with sequence analysis demonstrating that 21/22 (95%) partial blaTEM genes detected were identical to blaTEM-116. Furthermore, a β-lactamase-positive Prevotella isolate protected Pseudomonas aeruginosa from the antimicrobial effects of ceftazidime (P=0.03). Prevotella isolated from the CF respiratory microbiota produce ESBLs and may influence the pathogenesis of chronic lung infection via indirect methods, including shielding recognised pathogens from the action of ceftazidime.

Inhibition of protease-ENaC signaling improves mucociliary function in cystic fibrosis airways

Rationale: In cystic fibrosis (CF) a reduction in airway surface liquid (ASL) height
compromises mucociliary clearance, favoring mucus plugging and chronic bacterial infection. Inhibitors of ENaC have therapeutic potential in CF airways to reduce the hyperstimulated sodium and fluid absorption to levels which can restore airways hydration.

Objectives: To determine whether a novel compound (QUB-TL1) designed to inhibit protease/ENaC signaling in CF airways restores ASL volume and mucociliary function.

Methods: Protease activity was measured using fluorogenic activity assays. Differentiated primary airway epithelial cell cultures (F508del homozygotes) were used to determined ENaC activity (Ussing chamber recordings), ASL height (confocal microscopy) and mucociliary function (by tracking the surface flow of apically applied microbeads). Cell toxicity was measured by LDH assay.

Measurements and Results: QUB-TL1 inhibits extracellularly-located CAPs, including prostasin, matriptase and furin, the activities of which are observed at excessive levels at the apical surface of CF airway epithelial cells (AECs). QUB-TL1-mediated CAPs inhibition results in diminished ENaC-mediated Na+ absorption in CF AECs due to internalization of a prominent pool of cleaved (active) ENaCγ from the cell surface. Importantly, diminished ENaC activity correlates with improved airway hydration status and mucociliary clearance. We further demonstrate QUB-TL1-mediated furin inhibition, which is in contrast to other serine protease inhibitors (camostat mesylate and aprotinin), affords protection against neutrophil elastase-mediated ENaC activation and Pseudomonas aeruginosa exotoxin A induced cell death.

Conclusions: QUB-TL1 corrects aberrant CAP activities providing a mechanism to delay or prevent the development of CF lung disease in a manner independent of CFTR mutation.

Prevotella denticola Lipopolysaccharide from a Cystic Fibrosis Isolate Possesses a Unique Chemical Structure

We report the first complete structural characterization of the lipopolysaccharide (LPS) from a cystic fibrosis (CF) clinical isolate of Prevotella denticola (B003V1S1X). Chemical, spectroscopic, and spectrometric analyses revealed a unique rough-type LPS (LOS) structure. The structure has a highly negatively charged heptasaccharide core region containing hexoses, with the first two sugars, 3-deoxy-D-manno-oct-2-ulosonic acid (Kdo) and mannose, highly phosphorylated. Furthermore, the lipid A moiety has the typical structure for the genus Prevotella, and was also highly phosphorylated.

O papel do técnico oficial de contas na elabora��ão dos relatórios de sustentabilidade:um estudo aplicado às maiores empresas portuguesas

Disserta��ão, Mestrado, Contabilidade e Finanças, Instituto Politécnico de Santarém, Escola Superior de Gestão e Tecnologia, 2014

Imagens das línguas e afectividade em contexto escolar

Enquadrado numa perspectiva sócio-construtivista em Didáctica de Línguas (DL), o presente trabalho propõe-se identificar e descrever as imagens face às línguas estrangeiras, em particular à língua Alemã, e sua aprendizagem, que se manifestam numa determinada comunidade escolar. Com base nas imagens identificadas, pretende-se compreender de que forma elas se relacionam com a dimensão afectiva presente no processo de ensinoaprendizagem, nomeadamente no que diz respeito à rela��ão afectiva que o aprendente vai construindo com o alemão, objecto de estudo. Neste quadro, foram tra��adas as seguintes questões de investiga��ão para este trabalho: (1) Que imagens face às línguas escolares (inglês, francês, espanhol, português e, em particular, alemão), se manifestam numa determinada comunidade escolar (considerando os alunos, encarregados de educa��ão, professores, administra��ão da escola e funcionários)?; Como se (inter-) relacionam estas imagens nos diferentes públicos considerados?; (2) De que forma se manifestam as imagens face à língua alemã e sua aprendizagem na interacção em sala de aula de Alemão (LE)? Quais as marcas discursivas que as identificam e tecem?; De que forma estão estas imagens associadas às emoções e (3) Quais as emoções associadas às imagens do Alemão e sua aprendizagem em contexto de sala de aula? A investiga��ão recente em DL sugere que as imagens que um determinado sujeito constrói face a uma dada língua permitem compreender as suas atitudes e comportamentos face à mesma, nomeadamente no que diz respeito à rela��ão afectiva que vai construindo com a língua em causa e sua aprendizagem (cf. ARA��JO E SÁ & SCHMIDT 2008, DE PIETRO & MÜLLER 1997, MÜLLER 1998, PERREFORT 2001). Estas imagens, enquanto constructos sociais, elaboram-se, revitalizam-se e cristalizam-se na e pela interacção verbal em sala de aula. Nesta perspectiva, o presente trabalho discute os conceitos de imagem/representa��ão face às línguas, relacionandoos com a dimensão afectiva (inegavelmente) presente nos processos de ensino-aprendizagem das LE e à luz de uma abordagem interaccional em DL. A investiga��ão desenrolou-se em duas fases. Numa primeira, aplicou-se um inquérito por questionário a toda uma comunidade escolar (incluindo todos os públicos anteriormente referidos), numa escola secundária com terceiro ciclo em Albergaria-a-Velha, no distrito de Aveiro. Os dados recolhidos foram analisados segundo uma abordagem mista (quantitativa e qualitativa). Os resultados apontam para imagens fortemente escolarizadas, na medida em que os inquiridos parecem considerar as línguas estrangeiras sobretudo enquanto objectos de apropria��ão em contextos escolares. Identificaram-se imagens homogéneas e consistentes das línguas estrangeiras, evidenciando-se, no que à língua alemã diz respeito, a sua dificuldade. Os resultados relacionam-se com os obtidos noutras investiga��ões realizadas em terreno nacional em DL, corroborando alguns e complementando outros (ARA��JO E SÁ 2008, SIMÕES 2006, PINTO 2005, MELO 2006 e Projecto Imagens das Línguas na comunica��ão intercultural: contributos para o desenvolvimento da competência plurilingue). Numa segunda fase, acompanhou-se uma turma de alemão (LE) ao longo de um ano lectivo completo, tendo-se procedido à vídeo-grava��ão das aulas e, posteriormente, à identifica��ão do que designámos por ‘episódios significativos’, para constituição do corpus de análise. A análise interaccional destes episódios permitiu a identifica��ão de diferentes marcas discursivas (verbais, para-verbais e não-verbais) que indiciam, por um lado, a circula��ão e (re)construção de imagens face ao alemão e sua aprendizagem e, por outro, a presença de um conjunto de emoções associadas a estas imagens, nos discursos dos aprendentes e da professora. No que diz respeito à imagem da dificuldade do alemão e da sua aprendizagem, cristalizaram-se seis indicadores: (1) a compreensão oral e a pronúncia, (2) o léxico e as palavras compostas (3) os números, (4) a leitura, (5) o sistema de regras gramaticais e, finalmente, (6) a auto-imagem dos alunos enquanto aprendentes de alemão. Os resultados sugerem ainda a associa��ão destas imagens a emoções tendencialmente ‘negativas’ (por exemplo a arrelia e o embara��o), isto é, que se traduzem numa atitude de distanciamento e de evitamento linguístico. Face às conclusões obtidas, propõe-se um conjunto de princípios enquadradores para uma educa��ão em línguas ‘afectivamente consciente’ e capaz de promover imagens mais positivas das línguas e das suas aprendizagens, designadamante do alemão. Considerando-se a diminuição acentuada dos aprendentes de alemão (LE) em contexto escolar nacional nos últimos dez anos, aponta-se para a necessidade de melhor compreender a rela��ão entre a falta de popularidade escolar desta língua e a imagem da sua dificuldade (de aprendizagem).

Effect of light on ex situ production of symbiotic corals

The increasing interest in coral culture for biotechnological applications, to supply the marine aquarium trade, or for reef restoration programs, has prompted researchers to optimize coral culture protocols, with emphasis to ex situ production. When cultured ex situ, the growth performance of corals can be influenced by several physical, chemical and biological parameters. For corals harbouring zooxanthellae, light is one of such key factors, as it can influence the photosynthetic performance of these endosymbionts, as well as coral physiology, survival and growth. The economic feasibility of ex situ coral aquaculture is strongly dependent on production costs, namely those associated with the energetic needs directly resulting from the use of artificial lighting systems. In the present study we developed a versatile modular culture system for experimental coral production ex situ, assembled solely using materials and equipment readily available from suppliers all over the world; this approach allows researchers from different institutions to perform truly replicated experimental set-ups, with the possibility to directly compare experimental results. Afterwards, we aimed to evaluate the effect of contrasting Photosynthetically Active Radiation (PAR) levels, and light spectra emission on zooxanthellae photochemical performance, through the evaluation of the maximum quantum yield of PSII (Fv/Fm) (monitored non-invasively and non-destructively through Pulse Amplitude Modulation fluorometry, PAM), chlorophyll a content (also determined non-destructively by using the spectral reflectance index Normalized Difference Vegetation Index, NDVI), photosynthetic and accessory pigments, number of zooxanthellae, coral survival and growth. We studied two soft coral species, Sarcophyton cf. glaucum and Sinularia flexibilis, as they are good representatives of two of the most specious genera in family Alcyoniidae, which include several species with interest for biotechnological applications, as well as for the marine aquarium trade; we also studied two commercially important scleractinian corals: Acropora formosa and Stylophora pistillata. We used different light sources: hydrargyrum quartz iodide (HQI) lamps with different light color temperatures, T5 fluorescent lamps, Light Emitting Plasma (LEP) and Light Emitting Diode (LED). The results achieved revealed that keeping S. flexibilis fragments under the same light conditions as their mother colonies seems to be photobiologically acceptable for a short-term husbandry, notwithstanding the fact that they can be successfully stocked at lower PAR intensities. We also proved that low PAR intensities are suitable to support the ex situ culture S. cf. glaucum in captivity at lower production costs, since the survival recorded during the experiment was 100%, the physiological wellness of coral fragments was evidenced, and we did not detect significant differences in coral growth. Finally, we concluded that blue light sources, such as LED lighting, allow a higher growth for A. formosa and S. pistillata, and promote significant differences on microstructure organization and macrostructure morphometry in coral skeletons; these findings may have potential applications as bone graft substitutes for veterinary and/or other medical uses. Thus, LED technology seems to be a promising option for scleractinian corals aquaculture ex situ.

Modela��ão da qualidade microbiológica da água na Ria Formosa

Este estudo integra-se numa avalia��ão hidrodinâmica e monitoriza��ão microbiológica da qualidade da água da Ria Formosa. A monitoriza��ão foi implementada pela DRAOT Algarve com a colabora��ão da EST, da FCMA e do IST. A metodologia utilizada consiste na aplica��ão de um modelo matemático para simula��ão das variáveis hidrodinâmicas e da qualidade da água. Utilizam-se como tra��adores os coliformes fecais (CF), considerados indicadores de contamina��ão fecal pelo Dec-Lei 236/98 de 1 de Agosto, relativo à qualidade de águas do litoral e salobras para fins aquícolas- águas conquícolas. As águas da ria são usadas para cultura de diversas espécies conquícolas de bivalves. Estes são organismos que filtram e retêm no seu interior material particulado existente em suspensão na água tais como os CF entre outros microorganismos presentes na água. Para avaliar a concentra��ão de coliformes nos bivalves e gastrópodes foi desenvolvido um modelo que simula a bioacumula��ão desta propriedade por parte do bivalve. Da sua aplica��ão permite classificar a Ria em várias classes conforme o estabelecido no Dec. Lei nº 293/98 de 18 de Setembro.

Experimental study of the macrobenthic colonisation and secondary production in the artificial reefs of Algarve coast

Tese de dout., Ciências do Mar, Faculdade de Ciências do Mar e do Ambiente, Universidade do Algarve, 2010

The status of the invasive sea squirts and barnacles found in the marinas and ports of Algarve, Southern Portugal

Disserta��ão de mestrado, Biologia Marinha, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Ecologia alimentar, idade e crescimento, rela��ões morfométricas e aspetos reprodutivos de Sardinella aurita (Valenciennes, 1847) e Sardinella maderensis Lowe (1838) na Costa Sul de Angola (Namibe)

Disserta��ão de Mestrado, Biologia Marinha, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

Prédiction de la digestibilité des acides aminés des ingrédients utilisés en alimentation porcine : approche par méta-analyse

En alimentation animale, l’utilisation adéquate des aliments nécessite une connaissance précise des valeurs nutritionnelles de leurs composantes, dont celle en acides aminés. Cependant, ces valeurs nutritionnelles dépendent de la teneur en acides aminés essentiels (AAE) totaux et de la digestibilité iléale standardisée (DIS) de ces AAE. Cette dernière varie en fonction de plusieurs facteurs, dont l’origine botanique des graines, les conditions de culture des récoltes, le stockage des aliments, les traitements physico-chimiques appliqués aux grains, les facteurs antinutritionnels (FANs) et les techniques expérimentales utilisées pour le dosage et l’estimation de la digestibilité des AAE. Une approche par méta-analyse a permis d’établir des modèles de prédiction de la valeur nutritionnelle en AAE des ingrédients à partir de leur composition chimique en considérant la protéine brute (PB), les AAE totaux, la teneur en fibre (Acid Detergent Fiber (ADF), Neutral Detergent Fiber (NDF) et Fibre Brute (FB)) et les FANs comme les inhibiteurs de la trypsine. En se référant à l’analyse graphique et statistique, les données ont été réparties en 4 groupes : 1) les tourteaux (tourteau de soja, colza/canola et coton); 2) les légumineuses (féveroles, lupins, pois et soja); 3) les céréales (blé, orge, avoine, sorgho et ma��s); 4) les drêches de distilleries (blé et ma��s). Ainsi, un modèle général ajusté en fonction du type d’ingrédients a été généré et les facteurs de variation de la digestibilité en AAE ont été identifiés. Pour les tourteaux, la DIS des AAE est réduite par un accroissement de la teneur en NDF, tandis que la DIS des AAE de la féverole, pois et lupin est principalement influencée par la teneur en PB et en FANs. Concernant les graines de soja la DIS des AAE est réduite par une hausse de la teneur en fibre (FB et ADF). Enfin pour les céréales et les sous- produit de céréales telles que les drêches, la PB et les fibres (ADF ou NDF) étaient les meilleurs nutriments pour prédire la DIS des AAE. Ces résultats démontrent que la DIS des AAE peut être prédite avec précision à partir de la composition chimique pour la plupart des ingrédients.

Desenvolvimento de indicadores de comunica��ão em cuidados farmacêuticos : estudo piloto da sua aplicabilidade em farmácias comunitárias europeias

Tese de mestrado, Cuidados Farmacêuticos, Universidade de Lisboa, Faculdade de Farmácia, 2013