The design and implementation of a study to investigate the effectiveness of community vs hospital eye service follow-up for patients with neovascular age-related macular degeneration with quiescent disease

Introduction
Standard treatment for neovascular age-related macular degeneration (nAMD) is intravitreal injections of anti-VEGF drugs. Following multiple injections, nAMD lesions often become quiescent but there is a high risk of reactivation, and regular review by hospital ophthalmologists is the norm. The present trial examines the feasibility of community optometrists making lesion reactivation decisions.

Methods
The Effectiveness of Community vs Hospital Eye Service (ECHoES) trial is a virtual trial; lesion reactivation decisions were made about vignettes that comprised clinical data, colour fundus photographs, and optical coherence tomograms displayed on a web-based platform. Participants were either hospital ophthalmologists or community optometrists. All participants were provided with webinar training on the disease, its management, and assessment of the retinal imaging outputs. In a balanced design, 96 participants each assessed 42 vignettes; a total of 288 vignettes were assessed seven times by each professional group.The primary outcome is a participant's judgement of lesion reactivation compared with a reference standard. Secondary outcomes are the frequency of sight threatening errors; judgements about specific lesion components; participant-rated confidence in their decisions about the primary outcome; cost effectiveness of follow-up by optometrists rather than ophthalmologists.

Discussion
This trial addresses an important question for the NHS, namely whether, with appropriate training, community optometrists can make retreatment decisions for patients with nAMD to the same standard as hospital ophthalmologists. The trial employed a novel approach as participation was entirely through a web-based application; the trial required very few resources compared with those that would have been needed for a conventional randomised controlled clinical trial.

Pancreatic zymogen granules: new proteins in unexpected places

Os mecanismos de biogénese, distribuição apical e secreção regulada de enzimas digestivas dos grânulos de zimogénio são, atualmente, pouco conhecidos. De modo a esclarecer e descrever estes processos de elevada importância biológica e clínica, é necessária uma melhor compreensão dos componentes da membrana granular e as funções e interações destes. Neste trabalho, através de uma abordagem proteómica, foi possível identificar novas proteínas granulares previamente associadas ao transporte vesicular sináptico. Para estudar as funções destas proteínas na génese e secreção de grânulos, foram realizados estudos de sobre-expressão, assim como estudos bioquímicos (1D, 2D, and LC-MS/MS) e morfológicos, utilizando céluas de mamífero. Entre as proteínas descobertas, cinco foram selecionadas e analisadas: RMCP-1, Piccolo, Synaptojanin-1, APP e ZG16p. Destas proteínas, confirmou-se a presença da RMCP-1 e APP nos grânulos de zimogénio. Interessantamente, o lectin ZG16p da secreção pâncreatico, encontra-se expressa no cérebro de rato, estando localizada nos terminais pós-sinápticos e em grânulos de RNA, indicando uma possível função desta proteína na formação das vesículas sinápticas. Finalmente, demonstrei que a formação de grânulos de zimogénio pode ser modulada, no modelo de células pancreáticas AR42J, pelas condições de cultura. Em contraste com as proteínas de carga neuroendocrinas, a sobreexpressão de proteínas de carga ou da membrana dos grânulos de zimogénio não foi suficiente para induzir a formação de grânulos ou de estruturas granulares em células constitutivamente secretoras, indicando diferenças na biogénese de grânulos neuroendócrinos e exócrinos.

Characterization of PPP1 interacting proteins in male reproduction

A fosforilação reversível de proteínas é um importante mecanismo de controlo em eucariotas. A fosfoproteína fosfatase 1 (PPP1) é uma fosfatase de serina/treonina envolvida em vários processos celulares. Existem três isoformas da subunidade catalítica (α/CA, δ/β/CB e γ/CC) com pequenas diferenças nos terminais amino e carboxílico. O gene PPP1CC sofre ainda splicing alternativo para produzir duas isoformas, a PPP1CC1 ubíqua e a PPP1CC2 enriquecida em testículo e específica de esperma. A localização e especificidade de substratos da PPP1 está dependente da formação de complexos oligoméricos com proteínas que interagem com a PPP1 (PIPs). O objetivo principal desta tese foi estudar novas PIPs, específicas de testículo e esperma, a fim de melhor caracterizar o papel desta fosfatase e dos respetivos complexos na reprodução em mamíferos. Com este fim, estudou-se a presença, localização e possíveis funções de uma PIP previamente conhecida, PPP1R2, e de duas novas PIPs, PPP1R2P3 e Tctex1d4. PPP1R2 e PPP1R2P3 estão presentes em esperma humano colocalizando com a PPP1CC2, na cabeça e na cauda. A hipótese é que as holoenzimas localizadas na cabeça terão um papel na reação acrossómica, enquanto que as holoenzimas presentes no axonema são relevantes para o controlo da motilidade flagelar. De seguida foram estudados os pseudogenes da PPP1R2, em termos de história evolutiva e de possíveis funções. Na espécie humana, a PPP1R2 tem 10 pseudogenes, 7 deles específicos de primatas. Estudos de bioinformática e dados de expressão mostram que os PPP1R2P1/P3/P9 são os pseudogenes com maior probabilidade de serem transcritos e traduzidos. Também identificámos o PPP1R2P9 em esperma humano e mostrámos que alguns pseudogenes poderão estar associados a estados fisiopatológicos. Isto indica que o processo de evolução poderá estar ligado á formação de novos genes ou ao controlo do mRNA da PPP1R2. A sobre-expressão da PPP1R2 ou PPP1R2P3 em testículo de ratinho também foi realizada, para caracterizar os mecanismos envolvidas na função dos complexos PPP1R2/PPP1R2P3-PPP1CC2 na espermatogénese e fisiologia dos espermatozoides. A dineína de cadeia leve, Tctex1d4, foi encontrada como interagindo com a PPP1C e como estando presente em testículo de ratinho e em esperma humano. Demonstrámos que a Tctex1d4 e a PPP1 colocalizam no centro organizador de microtúbulos e nos microtúbulos e que o motivo de ligação à PPP1 presente na Tctex1d4 parece ser importante para manter a PPP1 no centro organizador de microtúbulos e/ou para disromper ou atrasar o seu movimento ao longo dos microtúbulos emergentes. Estes resultados abrem novos caminhos para os possíveis papéis do complexo Tctex1d4-PPP1 na dinâmica dos microtúbulos, motilidade do esperma, reação acrossómica e na regulação da barreira hemato-testicular, provavelmente, através da via de sinalização do TGFß. A análise do motivo de ligação à PPP1 mostra que este é altamente conservado entre os mamíferos, com exceção das Pikas, sugerindo que esta perda aconteceu antes da radiação das Pikas, há 6-20 milhões de anos atrás. Através de um rastreio por mutações demonstrámos que a capacidade da Tctex1d4 se ligar à PPP1 é mantida nas Pikas, embora o motivo de ligação à PPP1 esteja disrompido. Este estudo abre portas para novas descobertas na área da reprodução mostrando o papel da PPP1CC2 na espermatogénese e fisiologia do esperma.

Functional analysis of String/CDC25 phosphatase in post-mitotic neurons

Cell cycle and differentiation are two highly coordinated processes during organ development. Recent studies have demonstrated that core cell cycle regulators also play cell cycle-independent functions in post-mitotic neurons, and are essential for the maintenance of neuronal homeostasis. CDC25 phosphatases are well-established CDK activators and their activity is mainly associated to proliferating tissues. The expression and activity of mammalian CDC25s has been reported in adult brains. However, their physiological relevance and the potential substrates in a non-proliferative context have never been addressed. string (stg) encodes the Drosophila CDC25 homolog. Previous studies from our group showed that stg is expressed in photoreceptors (PRs) and in lamina neurons, which are two differentiated cell types that compose the fly visual system. The aims of this work are to uncover the function of stg and to identify its potential neuronal substrates, using the Drosophila visual system as a model. To gain insight into the function of stg in a non-dividing context we used the GAL4/UAS system to promote downregulation of stg in PR-neurons, through the use of an RNAi transgene. The defects caused by stg loss-of-function were evaluated in the developing eye imaginal disc by immunofluorescence, and during adult stages by scanning electron microscopy. This genetic approach was combined with a specific proteomic method, two-dimensional difference gel electrophoresis (2D-DIGE), to identify the potential substrates in PR-cells. Our results showed that stg downregulation in PRs affects the well-patterned retina organization, inducing the loss of apical maintenance of PR-nuclei on the eye disc, and ommatidia disorganization. We also detected an abnormal accumulation of cytoskeletal proteins and a disruption of the axon structure. As a consequence, the projection of PR-axons into the lamina and medulla neuropils of the optic lobe was impaired. Upon stg downregulation, we also detected that PR-cells accumulate Cyclin B. Although the rough eye phenotype observed upon stg downregulation suggests neurodegeneration, we did not detect neuronal death during larval stages, suggesting that it likely occurs during pupal stages or during adulthood. By 2D-DIGE, we identified seven proteins which were differentially expressed upon stg downregulation, and are potential neuronal substrates of Stg. Altogether, our observations suggest that Stg phosphatase plays an essential role in the Drosophila visual system neurons, regulating several cell components and processes in order to ensure their homeostasis.

The Negligent Eye

An exhibition which explores artists use of scanners and the implications of this form of mediation. the exhibition aims to explore the social philosophical and aesthetic implications of scanning both as a technology and a form of attention due to the ever increasing speed of image circulation and production.This builds on former research such as Print in 3D at the V&A in 2009.

Feasibility of Undertaking Off-Site Infant Eye-Tracking Assessments of Neuro-Cognitive Functioning in Early-Intervention Centres

Recent work suggests that differences in functional brain development are already identifiable in 6- to 9-month-old infants from low socio-economic status (SES) backgrounds. Investigation of early SES-related differences in neuro-cognitive functioning requires the recruitment of large and diverse samples of infants, yet it is often difficult to persuade low-SES parents to come to a university setting. One solution is to recruit infants through early intervention children’s centres (CCs). These are often located in areas of high relative deprivation to support young children. Given the increasing portability of eye-tracking equipment, assessment of large clusters of infants could be undertaken in centres by suitably trained early intervention staff. Here, we report on a study involving 174 infants and their parents, carried out in partnership with CCs, exploring the feasibility of this approach. We report the processes of setting up the project and participant recruitment. We report the diversity of sample obtained on the engagement of CC staff in training and the process of assessment itself.We report the quality of the data obtained, and the levels of engagement of parents and infants. We conclude that this approach has great potential for recruiting large and diverse samples worldwide, provides sufficiently reliable data and is engaging to staff, parents and infants.

Endocrine regulation of extracellular matrix proteins in calcified tissue in teleost fish

Tese dout., Biologia, Universidade do Algarve, 2005

Cloning, expression and purification of pneumococcal proteins = clonagem, expressão e purificação de proteínas de pneumococcus

Dissertação de mest., Engenharia Biológica, Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2008

Evolution of matrix and bone gamma-carboxyglutamic acid proteins in vertebrates

The evolution of calcified tissues is a defining feature in vertebrate evolution. Investigating the evolution of proteins involved in tissue calcification should help elucidate how calcified tissues have evolved. The purpose of this study was to collect and compare sequences of matrix and bone γ-carboxyglutamic acid proteins (MGP and BGP, respectively) to identify common features and determine the evolutionary relationship between MGP and BGP. Thirteen cDNAs and genes were cloned using standard methods or reconstructed through the use of comparative genomics and data mining. These sequences were compared with available annotated sequences (a total of 48 complete or nearly complete sequences, 28 BGPs and 20 MGPs) have been identified across 32 different species (representing most classes of vertebrates), and evolutionarily conserved features in both MGP and BGP were analyzed using bioinformatic tools and the Tree-Puzzle software. We propose that: 1) MGP and BGP genes originated from two genome duplications that occurred around 500 and 400 million years ago before jawless and jawed fish evolved, respectively; 2) MGP appeared first concomitantly with the emergence of cartilaginous structures, and BGP appeared thereafter along with bony structures; and 3) BGP derives from MGP. We also propose a highly specific pattern definition for the Gla domain of BGP and MGP. Previous Section Next Section BGP1 (bone Gla protein or osteocalcin) and MGP (matrix Gla protein) belong to the growing family of vitamin K-dependent (VKD) proteins, the members of which are involved in a broad range of biological functions such as skeletogenesis and bone maintenance (BGP and MGP), hemostasis (prothrombin, clotting factors VII, IX, and X, and proteins C, S, and Z), growth control (gas6), and potentially signal transduction (proline-rich Gla proteins 1 and 2). VKD proteins are characterized by the presence of several Gla residues resulting from the post-translational vitamin K-dependent γ-carboxylation of specific glutamates, through which they can bind to calcium-containing mineral such as hydroxyapatite. To date, VKD proteins have only been clearly identified in vertebrates (1) although the presence of a γ-glutamyl carboxylase has been reported in the fruit fly Drosophila melanogaster (2) and in marine snails belonging to the genus Conus (3). Gla residues have also been found in neuropeptides from Conus venoms (4), suggesting a wider prevalence of γ-carboxylation.

Evaluation of the binding of vanadium-based anticancer drugs to human serum proteins

Dissertação de mestrado, Qualidade em Análises, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015

La cornée humaine, un modèle évitant la transformation tumorale induite par les rayons ultraviolets : étude comparant la fréquence d’induction de dommages à l’ADN, leur l’efficacité de réparation ainsi que la sensibilité à la mort cellulaire induite par les rayons ultraviolets entre la cornée et l’épiderme

Bien qu’ils soient exposés tous deux aux rayons ultraviolets (UVR) solaires, cette exposition génotoxique n’entraîne pas les mêmes conséquences dans l’oeil et la peau. Le rôle des rayons UV dans l’induction et la progression des cancers cutanés est bien démontré. Ces rayons génotoxiques sont absorbés par l’ADN. Ils y induisent ainsi des changements conformationnels pouvant mener à la formation de différents dommages. On retrouve de façon prédominante la liaison de pyrimidines adjacentes en dimères cyclobutyliques de pyrimidines (CPD). Ceux-ci causent les mutations signatures responsables des cancers de la peau induits par les UVR. Cependant, aucune évidence ne démontre l’existence de cancer induit par les UVR dans la cornée. Nous avons donc tenté de découvrir les mécanismes permettant à la cornée d’éviter la transformation tumorale induite par les UVR. L’irradiation d’yeux de lapins aux rayons UVB a permis de prouver la capacité de ces rayons à induire la formation de CPD, et ce, de la cornée jusqu’au cristallin. Par la suite, l’irradiation d’yeux humains aux trois types de rayons UV (UVA, B et C) a permis d’y établir leur patron d’induction de CPD. Nous avons ainsi démontré que l’épithélium cornéen est particulièrement sensible à l’induction de CPD, tous types de rayons UV confondus. Enfin, la comparaison de la quantité de dommages présents dans des échantillons de peaux et de cornées irradiées à la même dose d’UVB a permis de démontrer que l’épithélium cornéen est 3.4 fois plus sensible à l’induction de CPD que l’épiderme. Nous avons par la suite étudié les mécanismes de réponse à ce stress. L’analyse de la viabilité cellulaire à la suite d’irradiations à différentes doses d’UVB a révélé que les cellules de la cornée et de la peau ont la même sensibilité à la mort cellulaire induite par les UVR. Nous avons alors analysé la vitesse de réparation des dommages induits par les UVR. Nos résultats démontrent que les CPD sont réparés 4 fois plus rapidement dans les cellules de la cornée que de la peau. L’analyse des protéines de reconnaissance des dommages a révélé que les cellules de la cornée possèdent plus de protéines DDB2 que les cellules de la peau, et ce, surtout liées à la chromatine. Nous avons alors tenté d’identifier la cause de cette accumulation. Nos analyses révèlent que la cornée possède une moins grande quantité d’ARNm DDB2, mais que la demi-vie de la protéine y est plus longue. Enfin, nos résultats suggèrent que l’accumulation de DDB2 dans les cellules de la cornée est entre autres due à une demi-vie plus longue de la protéine. Cette forte présence de DDB2 dans les cellules de la cornée permettrait un meilleur balayage de l’ADN, faciliterait de ce fait la détection de CPD ainsi que leur réparation et contribuerait donc à la capacité de la cornée à éviter la transformation tumorale induite par les UVR.