Feasibility of Therapeutic Drug Monitoring (TDM) for Imatinib: Preliminary considerations on the dosage adjustment approach for CML patients enrolled in the Imatinib Concentration Monitoring (I-COME) study

Background: As imatinib pharmacokinetics are highly variable, plasma levels differ largely between patients under the same dosage. Retrospective studies in chronic myeloid leukemia (CML) patients showed significant correlations between low levels and suboptimal response, and between high levels and poor tolerability. Monitoring of plasma levels is thus increasingly advised, targeting trough concentrations of 1000 μg/L and above. Objectives: Our study was launched to assess the clinical usefulness of systematic imatinib TDM in CML patients. The present preliminary evaluation questions the appropriateness of dosage adjustment following plasma level measurement to reach the recommended trough level, while allowing an interval of 4-24 h after last drug intake for blood sampling. Methods: Initial blood samples from the first 9 patients in the intervention arm were obtained 4-25 h after last dose. Trough levels in 7 patients were predicted to be significantly away from the target (6 <750 μg/L, and 1 >1500 μg/L with poor tolerance), based on a Bayesian approach using a population pharmacokinetic model. Individual dosage adjustments were taken up in 5 patients, who had a control measurement 1-4 weeks after dosage change. Predicted trough levels were confronted to anterior model-based extrapolations. Results: Before dosage adjustment, observed concentrations extrapolated at trough ranged from 359 to 1832 μg/L (median 710; mean 804, CV 53%) in the 9 patients. After dosage adjustment they were expected to target between 720 and 1090 μg/L (median 878; mean 872, CV 13%). Observed levels of the 5 recheck measurements extrapolated at trough actually ranged from 710 to 1069 μg/L (median 1015; mean 950, CV 16%) and had absolute differences of 21 to 241 μg/L to the model-based predictions (median 175; mean 157, CV 52%). Differences between observed and predicted trough levels were larger when intervals between last drug intake and sampling were very short (~4 h). Conclusion: These preliminary results suggest that TDM of imatinib using a Bayesian interpretation is able to bring trough levels closer to 1000 μg/L (with CV decreasing from 53% to 16%). While this may simplify blood collection in daily practice, as samples do not have to be drawn exactly at trough, the largest possible interval to last drug intake yet remains preferable. This encourages the evaluation of the clinical benefit of a routine TDM intervention in CML patients, which the randomized Swiss I-COME study aims to.

Caracterização fenológica da videira cv. Itália (Vitis vinifera L.) sob diferentes épocas de poda na região norte do estado do Rio de Janeiro

O experimento foi instalado no município de Cardoso Moreira, região Norte do Estado do Rio de Janeiro, durante o ano de 2001, com o objetivo de descrever a fenologia da videira 'Itália' e estimar a necessidade térmica em graus-dia (GD), sob diferentes épocas de poda (abril, maio, junho e julho). Avaliou-se o comportamento fenológico para os seguintes períodos: poda à gema algodão, gema algodão à brotação, brotação ao aparecimento da inflorescência, aparecimento da inflorescência ao florescimento, florescimento ao início da maturação e início da maturação à colheita. Foi determinada a soma térmica, em graus-dia, para o ciclo poda-colheita. A duração do ciclo foi de 138; 151; 150 e 157 dias para podas realizadas nos meses de abril, maio, junho e julho, respectivamente. A soma térmica necessária foi de 1727GD para poda realizada em abril, 1564GD para poda realizada em maio, 1702GD para poda realizada em junho e 1840GD para poda realizada em julho, utilizando-se de temperatura-base de 12ºC.

Pseudoachondroplasia and multiple epiphyseal dysplasia: a 7-year comprehensive analysis of the known disease genes identify novel and recurrent mutations and provides an accurate assessment of their relative contribution.

Pseudoachondroplasia (PSACH) and multiple epiphyseal dysplasia (MED) are relatively common skeletal dysplasias resulting in short-limbed dwarfism, joint pain, and stiffness. PSACH and the largest proportion of autosomal dominant MED (AD-MED) results from mutations in cartilage oligomeric matrix protein (COMP); however, AD-MED is genetically heterogenous and can also result from mutations in matrilin-3 (MATN3) and type IX collagen (COL9A1, COL9A2, and COL9A3). In contrast, autosomal recessive MED (rMED) appears to result exclusively from mutations in sulphate transporter solute carrier family 26 (SLC26A2). The diagnosis of PSACH and MED can be difficult for the nonexpert due to various complications and similarities with other related diseases and often mutation analysis is requested to either confirm or exclude the diagnosis. Since 2003, the European Skeletal Dysplasia Network (ESDN) has used an on-line review system to efficiently diagnose cases referred to the network prior to mutation analysis. In this study, we present the molecular findings in 130 patients referred to ESDN, which includes the identification of novel and recurrent mutations in over 100 patients. Furthermore, this study provides the first indication of the relative contribution of each gene and confirms that they account for the majority of PSACH and MED.

Definition of key variables for the induction of optimal NY-ESO-1-specific T cells in HLA transgene mice.

An attractive treatment of cancer consists in inducing tumor-eradicating CD8(+) CTL specific for tumor-associated Ags, such as NY-ESO-1 (ESO), a strongly immunogenic cancer germ line gene-encoded tumor-associated Ag, widely expressed on diverse tumors. To establish optimal priming of ESO-specific CTL and to define critical vaccine variables and mechanisms, we used HLA-A2/DR1 H-2(-/-) transgenic mice and sequential immunization with immunodominant DR1- and A2-restricted ESO peptides. Immunization of mice first with the DR1-restricted ESO(123-137) peptide and subsequently with mature dendritic cells (DCs) presenting this and the A2-restriced ESO(157-165) epitope generated abundant, circulating, high-avidity primary and memory CD8(+) T cells that efficiently killed A2/ESO(157-165)(+) tumor cells. This prime boost regimen was superior to other vaccine regimes and required strong Th1 cell responses, copresentation of MHC class I and MHC class II peptides by the same DC, and resulted in upregulation of sphingosine 1-phosphate receptor 1, and thus egress of freshly primed CD8(+) T cells from the draining lymph nodes into circulation. This well-defined system allowed detailed mechanistic analysis, which revealed that 1) the Th1 cytokines IFN-gamma and IL-2 played key roles in CTL priming, namely by upregulating on naive CD8(+) T cells the chemokine receptor CCR5; 2) the inflammatory chemokines CCL4 (MIP-1beta) and CCL3 (MIP-1alpha) chemoattracted primed CD4(+) T cells to mature DCs and activated, naive CD8(+) T cells to DC-CD4 conjugates, respectively; and 3) blockade of these chemokines or their common receptor CCR5 ablated priming of CD8(+) T cells and upregulation of sphingosine 1-phosphate receptor 1. These findings provide new opportunities for improving T cell cancer vaccines.

El pensament econòmic en l’àmbit de la cultura

Els fenòmens culturals són, certament, fenòmens socials caracteritzats per l’estètica, l’artístic i l’imaginari, amb un alt grau de subjectivitat i d’abstracció. Constitueixen, també, una activitat econòmica amb una estructura productiva particular, lliurada a l’intercanvi i posteriorment consumida i, per tant, susceptible de ser estudiada pels economistes. Tanmateix, no ha estat fins les darreres dècades que els economistes han donat importància a l’estudi de les activitats culturals. Els paràgrafs que segueixen es proposen donar una perspectiva a vista d’ocell de com la disciplina econòmica ha analitzat el sector cultural.

El patrimoni vegetal de l’espai natural «Coladors de Boldú-Montsuar» a la comarca de l’Urgell

En aquest article es fa una descripció dels valors naturals presents al paratge conegut amb el nom de Coladors de Boldú-Montsuar, ubicat a la plana urgellenca, així com una proposta de redacció d’un Pla especial de protecció del medi natural i del paisatge que a manca d’altres figures normatives permetria garantir la conservació i tutela d’aquest espai.

Genome-wide transcriptional responses to shade: Linking shade avoidance and auxin

Plants have the ability to use the composition of incident light as a cue to adapt development and growth to their environment. Arabidopsis thaliana as well as many crops are best adapted to sunny habitats. When subjected to shade, these plants exhibit a variety of physiological responses collectively called shade avoidance syndrome (SAS). It includes increased growth of hypocotyl and petioles, decreased growth rate of cotyledons and reduced branching and crop yield. These responses are mainly mediated by phytochrome photoreceptors, which exist either in an active, far-red light (FR) absorbing or an inactive, red light (R) absorbing isoform. In direct sunlight, the R to FR light (R/FR) ratio is high and converts the phytochromes into their physiologically active state. The phytochromes interact with downstream transcription factors such as PHYTOCHROME INTERACTING FACTOR (PIF), which are subsequently degraded. Light filtered through a canopy is strongly depleted in R, which result in a low R/FR ratio and renders the phytochromes inactive. Protein levels of downstream transcription factors are stabilized, which initiates the expression of shade-induced genes such as HFR1, PIL1 or ATHB-2. In my thesis, I investigated transcriptional responses mediated by the SAS in whole Arabidopsis seedlings. Using microarray and chromatin immunoprecipitation data, we identified genome-wide PIF4 and PIF5 dependent shade regulated gene as well as putative direct target genes of PIF5. This revealed evidence for a direct regulatory link between phytochrome signaling and the growth promoting phytohormone auxin (IAA) at the level of biosynthesis, transport and signaling. Subsequently, it was shown, that free-IAA levels are upregulated in response to shade. It is assumed that shade-induced auxin production takes predominantly place in cotyledons of seedlings. This implies, that IAA is subsequently transported basipetally to the hypocotyl and enhances elongation growth. The importance of auxin transport for growth responses has been established by chemical and genetic approaches. To gain a better understanding of spatio-temporal transcriptional regulation of shade-induce auxin, I generated in a second project, an organ specific high throughput data focusing on cotyledon and hypocotyl of young Arabidopsis seedlings. Interestingly, both organs show an opposite growth regulation by shade. I first investigated the spatio-transcriptional regulation of auxin re- sponsive gene, in order to determine how broad gene expression pattern can be explained by the hypothesized movement of auxin from cotyledons to hypocotyls in shade. The analysis suggests, that several genes are indeed regulated according to our prediction and others are regulated in a more complex manner. In addition, analysis of gene families of auxin biosynthetic and transport components, lead to the identification of essential family members for shade-induced growth re- sponses, which were subsequently experimentally confirmed. Finally, the analysis of expression pattern identified several candidate genes, which possibly explain aspects of the opposite growth response of the different organs.

Compostos fenólicos e atividade antioxidante da casca de uvas Niágara e Isabel

A produção de uvas no Brasil está localizada nas regiões Sul, Sudeste e Nordeste. Constitui-se em atividade consolidada, com importância socioeconômica, principalmente nos Estados do Rio Grande do Sul e de Santa Catarina, os quais respondem por 97% da produção nacional de vinhos. A uva Isabel é uma das principais cultivares de Vitis labrusca, e a Niágara Rosada, resultado da mutação somática ocorrida na uva Niágara Branca (Vitis labrusca L. x Vitis vinifera L.). São destaques como uvas de mesa comuns, sendo variedades rústicas e, portanto, menos exigentes. O desenvolvimento do trabalho foi feito com o objetivo de determinar conteúdo total de compostos fenólicos, utilizando acetona como solvente em diferentes concentrações, a determinação da atividade antioxidante, do teor de antocianinas totais, flavanóis nos extratos da casca das uvas de mesa Niágara Rosada e Isabel. Os resultados médios do teor de fenólicos totais no extrato acetona 75% foi de 1.026,69 a 1.242,78 mg GAE/100g de peso seco nas cultivares Isabel e Niágara , respectivamente. A atividade antioxidante avaliada apresentou valores de 89,22 e 157,31 µmol TEAC/g de amostra com o método ABTS e de 197,00 e 189,82 µmol TEAC/g de amostra no método DPPH para as cultivares Isabel e Niágara. A quantidade de antocianinas foi baixa comparada com outros frutos. Os valores de polifenóis refletem-se nos valores de TEAC, e observa-se uma correlação positiva entre a média do conteúdo de polifenóis totais com a média dos valores TEAC, o que se pode atribuir aos compostos fitoquímicos presentes nas cascas.

Similaridade genética de acessos de mangueira de diferentes origens geográficas avaliadas por marcadores AFLP

As relações genéticas de 105 acessos de diferentes origens geográficas do banco de germoplasma de mangueira da Embrapa foram determinadas com base no marcador AFLP, de forma a orientar trabalhos de melhoramento e manejo de recursos genéticos da espécie para a região Semi-Árida brasileira. Foram ainda incluídos dois acessos de duas espécies do gênero Mangifera, como "outgroup". O DNA dos acessos foi extraído pelo método do CTAB, as reações de AFLP foram realizadas para os iniciadores EcoRI/MseI e as bandas polimórficas foram analisadas para construção de fenograma, baseando-se no coeficiente de similaridade de Jaccard. Foram obtidas 157 e 54 bandas de AFLP polimórficas e monomórficas, respectivamente, em 13 combinações de iniciadores. O valor co-fenético do fenograma foi estimado em 0,81. Foram observados cinco grupos: 1) cultivares como Amrapali, Malika, híbridos Embrapa-Cpac e algumas variedades americanas formando um grupo; 2) grupo formado, predominantemente, por cultivares americanas, com algumas inclusões de híbridos sul-africanos e brasileiros; 3) grande grupo formado por cultivares brasileiras, com algumas inclusões de cultivares australianas, indianas e americanas; 4) grupo formado por algumas variedades tipo Espada, Rosa e acessos de diferentes origens; e 5) grupo formado por M. foetida e M. similis. Os acessos Carabao e Manilla apresentaram a maior similaridade, 97%. Os acessos estudados apresentaram similaridade superior a 51%, evidenciando a alta variabilidade genética da coleção de germoplasma de mangueira estudada.

Food traditions and landscape histories of the Indian Ocean World : theoretical and methodological reflections

Environmental histories of plant exchanges have largely centred on their eco- nomic importance in international trade and on their ecological and social impacts in the places where they were introduced. Yet few studies have at- tempted to examine how plants brought from elsewhere become incorporated over time into the regional cultures of material life and agricultural landscapes. This essay considers the theoretical and methodological problems in inves- tigating the environmental history, diversity and distribution of food plants transferred across the Indian Ocean over several millennia. It brings together concepts of creolisation, syncretism, and hybridity to outline a framework for understanding how biotic exchanges and diffusions have been translated into regional landscape histories through food traditions, ritual practices and articu- lation of cultural identity. We use the banana plant - which underwent early domestication across New Guinea, South-east Asia and peninsular India and reached East Africa roughly two thousand years ago - as an example for il- lustrating the diverse patterns of incorporation into the cultural symbolism, material life and regional landscapes of the Indian Ocean World. We show that this cultural evolutionary approach allows new historical insights to emerge and enriches ongoing debates regarding the antiquity of the plant's diffusion from South-east Asia to Africa.

Cartografía del riesgo de erosión hídrica en grandes cuencas hidrográficas mediante técnicas de teledetección y SIG

En el presente trabajo se propone un método para la cartografía del riesgo de erosión hídrica a escala de reconocimiento en grandes cuencas hidrográficas. El método se basa en la evaluación cualitativa de los factores de erosión: cubierta vegetal, pendiente, erosividad de las lluvias, litología y densidad de la red de drenaje; información adquirida y/o procesada mediante técnicas de teledetección y Sistemas de Información Geográfica (SIG). Este método es útil en áreas en las que se dispone de escasa información territorial y en las que se desea tener una estimación del riesgo de erosión con un bajo coste económico y con una precisión aceptable para una escala de reconocimiento. El método se ha aplicado a la cartografía del riesgo de erosión en la cuenca del embalse Joaquín Costa (Huesca), con graves problemas de pérdida de capacidad y deterioro de los desagües de fondo por aterramiento. La aplicación del método localiza las áreas con mayor riesgo de producción de sedimentos, poniendo de manifiesto el potencial de las técnicas utilizadas para la obtención de cartograrfía a bajo coste y para la toma de decisiones en proyectos de conservación de suelos en grandes cuencas hidrográficas.

Antiphonarium, ns. Katariina-käsikirjoitus, käsikirjoitusfragmentti - [1]

Katkelma Pyhän Henrikin varhaisaamun rukoushetkestä (matutinum), mm. legendaresitaatioiden kera laulettavia responsoriosävelmiä.