Molecular evidence for a single taxon, Anopheles nuneztovari s.l., from two endemic malaria regions in Colombia

To elucidate the Anopheles nuneztovari s.l. taxonomic status at a microgeographic level in four malaria endemic localities from Antioquia and Córdoba, Colombia, fragments of the cytochrome oxidase subunit I (COI) and the white gene were used. The COI analysis showed low genetic differentiation with fixation index (F ST) levels between -0.02-0.137 and Nm values between 3-∞, indicating the presence of high gene flow among An. nuneztovari s.l. populations from the four localities. The COI network showed a single most common haplotype, type 1 (n = 55), present in all localities, as the likely ancestral haplotype. Analysis of the white gene showed that An. nuneztovari s.l. populations from both departments grouped with haplotypes 19 and 20, which are part of lineage 3 reported previously. The results of the present study suggest that An. nuneztovari s.l. is a single taxon in the area of the present study.

How to keep the brain awake? The complex molecular pharmacogenetics of wake promotion.

Wake-promoting drugs are widely used to treat excessive daytime sleepiness. The neuronal pathways involved in wake promotion are multiple and often not well characterized. We tested d-amphetamine, modafinil, and YKP10A, a novel wake-promoting compound, in three inbred strains of mice. The wake duration induced by YKP10A and d-amphetamine depended similarly on genotype, whereas opposite strain differences were observed after modafinil. Electroencephalogram (EEG) analysis during drug-induced wakefulness revealed a transient approximately 2 Hz slowing of theta oscillations and an increase in beta-2 (20-35 Hz) activity only after YKP10A. Gamma activity (35-60 Hz) was induced by all drugs in a drug- and genotype-dependent manner. Brain transcriptome and clustering analyses indicated that the three drugs have both common and specific molecular signatures. The correlation between specific EEG and gene-expression signatures suggests that the neuronal pathways activated to stay awake vary among drugs and genetic background.

Targeting anticancer therapy : clinical and preclinical approaches

AbstractCancer treatment has shifted from cytotoxic and nonspecific chemotherapy to chronic treatment with targeted molecular therapies. These new classes of drugs directed against cancer-specific molecules and signaling pathways, act at a particular level of the tumor cell development. However, in both types of therapeutic approaches (standard cytotoxic chemotherapy and targeted signal transduction inhibitions), toxicity and side effects can occur. The aim of this thesis was to investigate various approaches to improve the activity and tolerability of cancer treatment, in a clinical setting, a) by molecular targeting through the use of tyrosine kinase inhibitors (TKIs), whose dosage can be adapted to each patient according to plasma levels, and, b) in a preclinical model, by tissue targeting with locoregional administration of cytotoxic chemotherapy to increase drug exposure in the target tissue while reducing systemic toxicity of the treatment.A comprehensive program for the Therapeutic Drug Monitoring (TDM) of the new class of targeted anticancer drugs of TKIs in patient's blood has been therefore initiated comprising the setting up, validation and clinical application of a multiplex assay by liquid chromatography coupled to tandem mass spectrometry of TKIs in plasma from cancer patients. Information on drugs exposure may be clinically useful for an optimal follow-up of patients' anticancer treatment, especially in case of less than optimal clinical response, occurrence of adverse drug reaction effects and the numerous risks of drug-drug interactions. In this context, better knowledge of the potential drug interactions between TKIs and widely prescribed co- medications is of critical importance for clinicians, to improve their daily care of cancer patients. For one of the first TKI imatinib, TDM interpretation is nowadays based on total plasma concentrations but, only the unbound (free) form is likely to enter cell to exert its pharmacological action. Pharmacokinetic analysis of the total and free plasma level of imatinib measured simultaneously in patients have allowed to refine and validate a population pharmacokinetic model integrating factors influencing in patients the exposure of pharmacological active species. The equation developed from this model may be used for extrapolating free imatinib plasma concentration based on the total plasma levels that are currently measured in TDM from patients. Finally, the specific influence of Pglycoprotein on the intracellular disposition of TKIs has been studies in cell systems using the siRNA silencing approach.Another approach to enhance the selectivity of anticancer treatment may be achieved by the loco-regional administration of a cytostatic agent to the target organ while sparing non- affected tissues. Isolated lung perfusion (ILP) was designed for the treatment of loco-regional malignancies of the lung but clinical results have been so far disappointing. It has been shown in a preclinical model in rats that ILP with the cytotoxic agent doxorubicin alone allows a high drug uptake in lung tissue, and a low systemic toxicity, but was characterized by a high spatial tissular heterogeneity in drug exposure and doxorubicin uptake in tumor was comparatively smaller than in normal lung tissue. Photodynamic therapy (PDT) is a new approach for the treatment of superficial tumors, and implies the application of a sensitizer activated by a laser light at a specific wavelength, that disrupts endothelial barrier of tumor vessels to increase locally the distribution of cytostatics into the tumor tissue. PDT pre-treatment before intravenous administration of liposomal doxorubicin was indeed shown to selectively increase drug uptake in tumors in a rat model of sarcoma tumors to the lung.RésuméLe traitement de certains cancers s'est progressivement transformé et est passé de la chimiothérapie, cytotoxique et non spécifique, au traitement chronique des patients avec des thérapies moléculaires ciblées. Ces médicaments ont une action ciblée en interférant à un niveau spécifique du développement de la cellule tumorale. Dans les deux types d'approches thérapeutiques (chimiothérapie cytotoxique et traitements ciblés), on est confronté à la présence de toxicité et aux effets secondaires du traitement anticancéreux. Le but de cette thèse a donc été d'étudier diverses approches visant à améliorer l'efficacité et la tolérabilité du traitement anticancéreux, a) dans le cadre d'une recherche clinique, par le ciblage moléculaire grâce aux inhibiteurs de tyrosines kinases (TKIs) dont la posologie est adaptée à chaque patient, et b) dans un modèle préclinique, par le ciblage tissulaire grâce à l'administration locorégionale de chimiothérapie cytotoxique, afin d'augmenter l'exposition dans le tissu cible et de réduire la toxicité systémique du traitement.Un programme de recherche sur le suivi thérapeutique (Therapeutic Drug Monitoring, TDM) des inhibiteurs de tyrosine kinases a été ainsi mis en place et a impliqué le développement, la validation et l'application clinique d'une méthode multiplex par chromatographie liquide couplée à la spectrométrie de masse en tandem des TKIs chez les patients souffrant de cancer. L'information fournie par le TDM sur l'exposition des patients aux traitements ciblés est cliniquement utile et est susceptible d'optimiser la dose administrée, notamment dans les cas où la réponse clinique au traitement des patients est sous-optimale, en présence d'effets secondaires du traitement ciblé, ou lorsque des risques d'interactions médicamenteuses sont suspectés. Dans ce contexte, l'étude des interactions entre les TKIs et les co-médications couramment associées est utile pour les cliniciens en charge d'améliorer au jour le jour la prise en charge du traitement anticancéreux. Pour le premier TKI imatinib, l'interprétation TDM est actuellement basée sur la mesure des concentrations plasmatiques totales alors que seule la fraction libre (médicament non lié aux protéines plasmatiques circulantes) est susceptible de pénétrer dans la cellule pour exercer son action pharmacologique. L'analyse pharmacocinétique des taux plasmatiques totaux et libres d'imatinib mesurés simultanément chez les patients a permis d'affiner et de valider un modèle de pharmacocinétique de population qui intègre les facteurs influençant l'exposition à la fraction de médicament pharmacologiquement active. L'équation développée à partir de ce modèle permet d'extrapoler les concentrations libres d'imatinib à partir des concentrations plasmatiques totales qui sont actuellement mesurées lors du TDM des patients. Finalement, l'influence de la P-glycoprotéine sur la disposition cellulaire des TKIs a été étudiée dans un modèle cellulaire utilisant l'approche par la technologie du siRNA permettant de bloquer sélectivement l'expression du gène de cette protéine d'efflux des médicaments.Une autre approche pour augmenter la sélectivité du traitement anticancéreux consiste en une administration loco-régionale d'un agent cytostatique directement au sein de l'organe cible tout en préservant les tissus sains. La perfusion isolée du poumon (ILP) a été conçue pour le traitement loco-régional des cancers affectant les tissus pulmonaires mais les résultats cliniques ont été jusqu'à ce jour décevants. Dans des modèles précliniques chez le rat, il a pu être démontré que l'ILP avec la doxorubicine, un agent cytotoxique, administré seul, permet une exposition élevée au niveau du tissu pulmonaire, et une faible toxicité systémique. Toutefois, cette technique est caractérisée par une importante variabilité de la distribution dans les tissus pulmonaires et une pénétration du médicament au sein de la tumeur comparativement plus faible que dans les tissus sains.La thérapie photodynamique (PDT) est une nouvelle approche pour le traitement des tumeurs superficielles, qui consiste en l'application d'un agent sensibilisateur activé par une lumière laser de longueur d'onde spécifique, qui perturbe l'intégrité physiologique de la barrière endothéliale des vaisseaux alimentant la tumeur et permet d'augmenter localement la pénétration des agents cytostatiques.Nos études ont montré qu'un pré-traitement par PDT permet d'augmenter sélectivement l'absorption de doxorubicine dans les tumeurs lors d'administration i.v. de doxorubicine liposomale dans un modèle de sarcome de poumons de rongeurs.Résumé large publicDepuis une dizaine d'année, le traitement de certains cancers s'est progressivement transformé et les patients qui devaient jusqu'alors subir des chimiothérapies, toxiques et non spécifiques, peuvent maintenant bénéficier de traitements chroniques avec des thérapies ciblées. Avec les deux types d'approches thérapeutiques, on reste cependant confronté à la toxicité et aux effets secondaires du traitement.Le but de cette thèse a été d'étudier chez les patients et dans des modèles précliniques les diverses approches visant à améliorer l'activité et la tolérance des traitements à travers un meilleur ciblage de la thérapie anticancéreuse. Cet effort de recherche nous a conduits à nous intéresser à l'optimisation du traitement par les inhibiteurs de tyrosines kinases (TKIs), une nouvelle génération d'agents anticancéreux ciblés agissant sélectivement sur les cellules tumorales, en particulier chez les patients souffrant de leucémie myéloïde chronique et de tumeurs stromales gastro-intestinales. L'activité clinique ainsi que la toxicité de ces TKIs paraissent dépendre non pas de la dose de médicament administrée, mais de la quantité de médicaments circulant dans le sang auxquelles les tumeurs cancéreuses sont exposées et qui varient beaucoup d'un patient à l'autre. A cet effet, nous avons développé une méthode par chromatographie couplée à la spectrométrie de masse pour mesurer chez les patients les taux de médicaments de la classe des TKIs dans la perspective de piloter le traitement par une approche de suivi thérapeutique (Therapeutic Drug Monitoring, TDM). Le TDM repose sur la mesure de la quantité de médicament dans le sang d'un patient dans le but d'adapter individuellement la posologie la plus appropriée: des quantités insuffisantes de médicament dans le sang peuvent conduire à un échec thérapeutique alors qu'un taux sanguin excessif peut entraîner des manifestations toxiques.Dans une seconde partie préclinique, nous nous sommes concentrés sur l'optimisation de la chimiothérapie loco-régionale dans un modèle de sarcome du poumon chez le rat, afin d'augmenter l'exposition dans la tumeur tout en réduisant la toxicité dans les tissus non affectés.La perfusion isolée du poumon (ILP) permet d'administrer un médicament anticancéreux cytotoxique comme la doxorubicine, sélectivement au niveau le tissu pulmonaire où sont généralement localisées les métastases de sarcome. L'administration par ILP de doxorubicine, toxique pour le coeur, a permis une forte accumulation des médicaments dans le poumon, tout en épargnant le coeur. Il a été malheureusement constaté que la doxorubicine ne pénètre que faiblement dans la tumeur sarcomateuse, témoignant des réponses cliniques décevantes observées avec cette approche en clinique. Nous avons ainsi étudié l'impact sur la pénétration tumorale de l'association d'une chimiothérapie cytotoxique avec la thérapie photodynamique (PDT) qui consiste en l'irradiation spécifique du tissu-cible cancéreux, après l'administration d'un agent photosensibilisateur. Dans ce modèle animal, nous avons observé qu'un traitement par PDT permet effectivement d'augmenter de façon sélective l'accumulation de doxorubicine dans les tumeurs lors d'administration intraveineuse de médicament.

Molecular markers and genetic diversity of Plasmodium vivax

Enhanced understanding of the transmission dynamics and population genetics for Plasmodium vivax is crucial in predicting the emergence and spread of novel parasite phenotypes with major public health implications, such as new relapsing patterns, drug resistance and increased virulence. Suitable molecular markers are required for these population genetic studies. Here, we focus on two groups of molecular markers that are commonly used to analyse natural populations of P. vivax. We use markers under selective pressure, for instance, antigen-coding polymorphic genes, and markers that are not under strong natural selection, such as most minisatellite and microsatellite loci. First, we review data obtained using genes encoding for P. vivax antigens: circumsporozoite protein, merozoite surface proteins 1 and 3α, apical membrane antigen 1 and Duffy binding antigen. We next address neutral or nearly neutral molecular markers, especially microsatellite loci, providing a complete list of markers that have already been used in P. vivax populations studies. We also analyse the microsatellite loci identified in the P. vivax genome project. Finally, we discuss some practical uses for P. vivax genotyping, for example, detecting multiple-clone infections and tracking the geographic origin of isolates.

Molecular divergence in the timeless and cpr genes among three sympatric cryptic species of the Anopheles triannulatus complex

Anopheles triannulatus s.l. is a malaria vector with a wide geographic distribution, ranging from Argentina-Nicaragua and Trinidad. Here we analysed sequences of two genes, timeless and cpr, to assess the genetic variability and divergence among three sympatric cryptic species of this complex from Salobra, central-western Brazil. The timeless gene sequences did not conclusively differentiate Anopheles halophylus and An. triannulatus species "C". However, a partial separation has been observed between these species and An. triannulatus s.s. Importantly, the analysis of the cpr gene sequences revealed fixed differences, no shared polymorphisms and considerable genetic differentiation among the three species of the An. triannulatus complex. The results confirm that An. triannulatus s.s., An. halophylus and An. triannulatus species C are distinct taxa, with the latter two likely representing a more recent speciation event.

Application of Molecular Diagnostic Techniques for Viral Testing.

Nucleic acid amplification techniques are commonly used currently to diagnose viral diseases and manage patients with this kind of illnesses. These techniques have had a rapid but unconventional route of development during the last 30 years, with the discovery and introduction of several assays in clinical diagnosis. The increase in the number of commercially available methods has facilitated the use of this technology in the majority of laboratories worldwide. This technology has reduced the use of some other techniques such as viral culture based methods and serological assays in the clinical virology laboratory. Moreover, nucleic acid amplification techniques are now the methods of reference and also the most useful assays for the diagnosis in several diseases. The introduction of these techniques and their automation provides new opportunities for the clinical laboratory to affect patient care. The main objectives in performing nucleic acid tests in this field are to provide timely results useful for high-quality patient care at a reasonable cost, because rapid results are associated with improvements in patients care. The use of amplification techniques such as polymerase chain reaction, real-time polymerase chain reaction or nucleic acid sequence-based amplification for virus detection, genotyping and quantification have some advantages like high sensitivity and reproducibility, as well as a broad dynamic range. This review is an up-to-date of the main nucleic acid techniques and their clinical applications, and special challenges and opportunities that these techniques currently provide for the clinical virology laboratory.

Lymphoblastic transformation of follicular lymphoma: a clinicopathologic and molecular analysis of 7 patients.

Approximately 30% of patients with follicular lymphoma (FL) transform to a more aggressive malignancy, most commonly diffuse large B cell lymphoma. Rarely, FL transformation results in clinical findings, histology, and immunophenotype reminiscent of B-lymphoblastic leukemia/lymphoma. We report the largest series to date with detailed analysis of 7 such patients. Lymphoblastic transformation occurred on average 2 years after initial diagnosis of FL. Five patients had prior intensive chemotherapy. Two patients developed mature high-grade lymphoma, followed by the lymphoblastic transformation. FL had BCL2 gene rearrangement in 4 of 5 cases. High-grade transformation was accompanied by MYC gene rearrangement (5 of 5). Transformation was characterized by expression of TdT, loss of Bcl6, variable loss of immunoglobulin light chain, and persistence of Pax-5, Bcl2, and CD10. Whole-exome sequencing in 1 case revealed presence of several actionable mutations (CD79B, CCND3, CDK12). FL, aggressive mature B cell lymphoma, and lymphoblastic transformation were clonally related in 6 evaluable cases. After transformation, survival ranged from 1 to 14 months. Four patients died of disease, 2 were in remission after stem cell transplant, and 1 was alive with disease.

A combined approach of VNTR and MLST analysis: improving molecular typing of Argentinean isolates of Leptospira interrogans

Leptospirosis is an emerging infectious disease that has been identified as both a human and animal health problem worldwide. Regular outbreaks associated with specific risk factors have been reported in Argentina. However, there are no available data concerning the genetic population level for this pathogen. Therefore, the aim of this work was to describe the genetic diversity of Leptospira interrogans through the application of two molecular typing strategies: variable number of tandem repeats (VNTR) and multilocus sequence typing (MLST). For this purpose, seven reference strains and 18 non-epidemiologically related isolates from diverse hosts and Argentinean regions were analysed. Among them, nine genotypes and seven sequence types (STs), including three unreported STs, were described using VNTR and MLST, respectively. eBURST analysis demonstrated that ST37 was the most frequent and founder genotype of a clonal complex (CCs) containing STN1 and STN3, suggesting the importance of studying the serovars belonging to this CC in Argentina. The data from maximum parsimony analysis, which combined both techniques, achieved intra-serovar discrimination, surmounted microscopic agglutination test discrepancies and increased the discriminatory power of each technique applied separately. This study is the first to combine both strategies for L. interrogans typing to generate a more comprehensive molecular genotyping of isolates from Argentina in a global context.

Coxiella burnetii, the agent of Q fever in Brazil: its hidden role in seronegative arthritis and the importance of molecular diagnosis based on the repetitive element IS1111 associated with the transposase gene

Coxiella burnetii is the agent of Q fever , an emergent worldwide zoonosis of wide clinical spectrum. Although C. burnetii infection is typically associated with acute infection, atypical pneumonia and flu-like symptoms, endocarditis, osteoarticular manifestations and severe disease are possible, especially when the patient has a suppressed immune system; however, these severe complications are typically neglected. This study reports the sequencing of the repetitive element IS1111 of the transposase gene of C. burnetii from blood and bronchoalveolar lavage (BAL) samples from a patient with severe pneumonia following methotrexate therapy, resulting in the molecular diagnosis of Q fever in a patient who had been diagnosed with active seronegative polyarthritis two years earlier. To the best of our knowledge, this represents the first documented case of the isolation of C. burnetii DNA from a BAL sample.

Molecular characterisation of Bartonella species in cats from São Luís, state of Maranhão, north-eastern Brazil

Bartonella species are fastidious bacteria that predominantly infect mammalian erythrocytes and endothelial cells and cause long-lasting bacteraemia in their reservoir hosts. Reports that describe the epidemiology of bartonellosis in Brazil are limited. This study aimed to detect and characterise Bartonella spp DNA from cat blood samples in São Luís, Maranhão, north-eastern Brazil. Among 200 cats tested for multiple genes, nine (4.5%) were positive for Bartonella spp: six cats for Bartonella henselae and three for Bartonella clarridgeiae. Based on the phylogenetic analysis of four genes, the B. henselae strain matched strains previously observed in Brazil and was positioned in the same clade as B. henselae isolates from the United States of America. Moreover, sequence alignment demonstrated that the B. clarridgeiae strain detected in the present study was the same as the one recently detected in cats from southern Brazil.

Molecular characterisation of dengue virus type 1 reveals lineage replacement during circulation in Brazilian territory

Dengue fever is the most important arbovirus infection found in tropical regions around the world. Dispersal of the vector and an increase in migratory flow between countries have led to large epidemics and severe clinical outcomes, such as dengue haemorrhagic fever and dengue shock syndrome. This study analysed the genetic variability of the dengue virus serotype 1 (DENV-1) in Brazil with regard to the full-length structural genes C/prM/M/E among 34 strains isolated during epidemics that occurred in the country between 1994-2011. Virus phylogeny and time of divergence were also evaluated with only the E gene of the strains isolated from 1994-2008. An analysis of amino acid differences between these strains and the French Guiana strain (FGA/89) revealed the presence of important nonsynonymous substitutions in the amino acid sequences, including residues E297 (Met→Thr) and E338 (Ser→Leu). A phylogenetic analysis of E proteins comparing the studied isolates and other strains selected from the GenBank database showed that the Brazilian DENV-1 strains since 1982 belonged to genotype V. This analysis also showed that different introductions of strains from the 1990s represented lineage replacement, with the identification of three lineages that cluster all isolates from the Americas. An analysis of the divergence time of DENV-1 indicated that the lineage circulating in Brazil emerged from an ancestral lineage that originated approximately 44.35 years ago.

Molecular characterization of 39 de novo sSMC: contribution to prognosis and genetic counselling, a prospective study.

Small supernumerary marker chromosomes (sSMCs) are structurally abnormal chromosomes that cannot be characterized by karyotype. In many prenatal cases of de novo sSMC, the outcome of pregnancy is difficult to predict because the euchromatin content is unclear. This study aimed to determine the presence or absence of euchromatin material of 39 de novo prenatally ascertained sSMC by array-comparative genomic hybridization (array-CGH) or single nucleotide polymorphism (SNP) array. Cases were prospectively ascertained from the study of 65,000 prenatal samples [0.060%; 95% confidence interval (CI), 0.042-0.082]. Array-CGH showed that 22 markers were derived from non-acrocentric markers (56.4%) and 7 from acrocentic markers (18%). The 10 additional cases remained unidentified (25.6%), but 7 of 10 could be further identified using fluorescence in situ hybridization; 69% of de novo sSMC contained euchromatin material, 95.4% of which for non-acrocentric markers. Some sSMC containing euchromatin had a normal phenotype (31% for non-acrocentric and 75% for acrocentric markers). Statistical differences between normal and abnormal phenotypes were shown for the size of the euchromatin material (more or less than 1 Mb, p = 0.0006) and number of genes (more or less than 10, p = 0.0009). This study is the largest to date and shows the utility of array-CGH or SNP array in the detection and characterization of de novo sSMC in a prenatal context.