Candidate gene study of TRAIL and TRAIL receptors: association with response to interferon beta therapy in multiple sclerosis patients.

TRAIL and TRAIL Receptor genes have been implicated in Multiple Sclerosis pathology as well as in the response to IFN beta therapy. The objective of our study was to evaluate the association of these genes in relation to the age at disease onset (AAO) and to the clinical response upon IFN beta treatment in Spanish MS patients. We carried out a candidate gene study of TRAIL, TRAILR-1, TRAILR-2, TRAILR-3 and TRAILR-4 genes. A total of 54 SNPs were analysed in 509 MS patients under IFN beta treatment, and an additional cohort of 226 MS patients was used to validate the results. Associations of rs1047275 in TRAILR-2 and rs7011559 in TRAILR-4 genes with AAO under an additive model did not withstand Bonferroni correction. In contrast, patients with the TRAILR-1 rs20576-CC genotype showed a better clinical response to IFN beta therapy compared with patients carrying the A-allele (recessive model: p = 8.88×10(-4), pc = 0.048, OR = 0.30). This SNP resulted in a non synonymous substitution of Glutamic acid to Alanine in position 228 (E228A), a change previously associated with susceptibility to different cancer types and risk of metastases, suggesting a lack of functionality of TRAILR-1. In order to unravel how this amino acid change in TRAILR-1 would affect to death signal, we performed a molecular modelling with both alleles. Neither TRAIL binding sites in the receptor nor the expression levels of TRAILR-1 in peripheral blood mononuclear cell subsets (monocytes, CD4+ and CD8+ T cells) were modified, suggesting that this SNP may be altering the death signal by some other mechanism. These findings show a role for TRAILR-1 gene variations in the clinical outcome of IFN beta therapy that might have relevance as a biomarker to predict the response to IFN beta in MS.

Effective diagnosis of Alzheimer's disease by means of large margin-based methodology.

BACKGROUND Functional brain images such as Single-Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) have been widely used to guide the clinicians in the Alzheimer's Disease (AD) diagnosis. However, the subjectivity involved in their evaluation has favoured the development of Computer Aided Diagnosis (CAD) Systems. METHODS It is proposed a novel combination of feature extraction techniques to improve the diagnosis of AD. Firstly, Regions of Interest (ROIs) are selected by means of a t-test carried out on 3D Normalised Mean Square Error (NMSE) features restricted to be located within a predefined brain activation mask. In order to address the small sample-size problem, the dimension of the feature space was further reduced by: Large Margin Nearest Neighbours using a rectangular matrix (LMNN-RECT), Principal Component Analysis (PCA) or Partial Least Squares (PLS) (the two latter also analysed with a LMNN transformation). Regarding the classifiers, kernel Support Vector Machines (SVMs) and LMNN using Euclidean, Mahalanobis and Energy-based metrics were compared. RESULTS Several experiments were conducted in order to evaluate the proposed LMNN-based feature extraction algorithms and its benefits as: i) linear transformation of the PLS or PCA reduced data, ii) feature reduction technique, and iii) classifier (with Euclidean, Mahalanobis or Energy-based methodology). The system was evaluated by means of k-fold cross-validation yielding accuracy, sensitivity and specificity values of 92.78%, 91.07% and 95.12% (for SPECT) and 90.67%, 88% and 93.33% (for PET), respectively, when a NMSE-PLS-LMNN feature extraction method was used in combination with a SVM classifier, thus outperforming recently reported baseline methods. CONCLUSIONS All the proposed methods turned out to be a valid solution for the presented problem. One of the advances is the robustness of the LMNN algorithm that not only provides higher separation rate between the classes but it also makes (in combination with NMSE and PLS) this rate variation more stable. In addition, their generalization ability is another advance since several experiments were performed on two image modalities (SPECT and PET).

Immune responses to JC virus in patients with multiple sclerosis treated with natalizumab: a cross-sectional and longitudinal study.

BACKGROUND: Natalizumab is used to prevent relapses and progression of disability in patients with multiple sclerosis but has been associated with progressive multifocal leukoencephalopathy (PML). We aimed to better understand the associations between JC virus, which causes PML, and natalizumab treatment. METHODS: We prospectively assessed patients with multiple sclerosis who started treatment with natalizumab. Blood and urine samples were tested for the presence of JC virus DNA with quantitative real-time PCR before treatment and at regular intervals after treatment onset for up to 18 months. At the same timepoints, by use of proliferation and enzyme-linked immunospot assays, the cellular immune responses against JC virus, Epstein-Barr virus, cytomegalovirus, myelin oligodendrocyte glycoprotein, and myelin oligodendrocyte basic protein (MOBP) were assessed. Humoral immune response specific to JC virus was assessed with an enzyme immunoassay. The same experiments were done on blood samples from patients with multiple sclerosis before and 10 months after the start of interferon beta treatment. FINDINGS: We assessed 24 patients with multiple sclerosis who received natalizumab and 16 who received interferon beta. In patients treated with natalizumab, JC virus DNA was not detected in the blood at any timepoint. However, JC virus DNA was present in the urine of six patients and in most of these patients the concentrations of JC virus DNA were stable over time. Compared with pretreatment values, the cellular immune response was increased to cytomegalovirus at 6 months, to JC virus at 1, 9, and 12 months, and to Epstein-Barr virus and MOBP at 12 months. Humoral responses remained stable. There were no increases in cellular immune responses specific to the viruses or myelin proteins in the 16 patients treated with interferon beta. INTERPRETATION: Natalizumab increases cellular immune responses specific to viruses and myelin proteins in the peripheral blood after 1 year, without evidence of viral reactivation. FUNDING: Swiss National Foundation, Swiss Society for Multiple Sclerosis, and Biogen Dompé.

Viral- and myelin-specific cellular immune response in patients treated with natalizumab: a cross-sectional and a longitudinal prospective study

Introduction: Natalizumab, a monoclonal antibody binding to the alpha4 integrins, is efficient in preventing relapses and progression of disability in multiple sclerosis (MS) patients. However, a total of seven MS patients treated with natalizumab suffered from progressive multifocal leukoencephalopathy (PML), on a total of 53?000 patients (data of March 6, 2009) treated with this drug. PML is a disease affecting immunosuppressed people, which is caused by the polyomavirus JC (JCV). This virus produces a lytic infection of the oligodendrocytes. Yet, natalizumab cannot be considered as a classical immunosuppressant, such as suggested by the fact that no increased incidence of other opportunistic infections was reported with this drug. It has been postulated that, by closing the blood-brain, natalizumab might prevent JCV-specific CD8_ T cells to reach the CNS and perform immune surveillance. Alternatively, it has been suggested that this drug acts by releasing JCV from the bone marrow, one of its site of latency. In this study, we address the question whether there is an increased activity of JCV in the blood of natalizumab-treated MS patients. Material and Methods: In this prospective longitudinal study, we are following a cohort of 24 MS patients receiving monthly injections of natalizumab. Blood and urine are drawn every one to three months, up to 12 months. As a control group, we follow 16 MS patients treated with IFN-beta. For this control group, there are two time-points: before and 1094 months after treatment onset. We are analysing the viral (JCV-, EBV- and CMV-) as well as the myelin- (MOG-, MOBP-) specific cellular immune responses using proliferation and ELISPOT (IFNgamma) assays. For JCV, we study the response against VP1, the major capsid protein. For JCV VP1, MOG and MOBP, we use 15-mer peptides overlapping by 10 amino acids, thus eliciting CD4_ as well as CD8_ T cell response. These peptides encompasse the whole sequence of the proteins. For EBV and CMV, we use pools of immunodominant 8- to 10-mer peptides eliciting CD8_ T cells. At the same time-points, using RTPCR, we determine the presence of JCV DNA coding for the VP1 protein in the PBMC, plasma, and urine. Results: At the time of writing this abstract, 16 patients have reached the 9-month (T9), and 11 the T12 time-point. We expect that by the ISNV meeting in June 2009, 18 and 14 patients will be at T9 and T12, respectively. Virological and immunological results will be presented. 9th International Symposium on NeuroVirology 2_6 June 2009 39 J Neurovirol Downloaded from informahealthcare.com by Cantonale et Universitaire on 06/25/10 For personal use only. Conclusions: This ongoing longitudinal prospective study should tell us whether there is an enhanced JCV activity in the peripheral blood of patients on natalizumab. This work is supported by the FNS (PP00B-106716), the Swiss MS Society and a research grant from Biogen Dompe.

Myasthenia gravis and neuromyelitis optica spectrum disorder A multicenter study of 16 patients

Objective: To describe 16 patients with a coincidence of 2 rare diseases: aquaporin-4 antibody (AQP4-Ab)-mediated neuromyelitis optica spectrum disorder (AQP4-NMOSD) and acetylcholine receptor antibody (AChR-Ab)-mediated myasthenia gravis (AChR-MG). Methods: The clinical details and antibody results of 16 patients with AChR-MG and AQP4-NMOSD were analyzed retrospectively. Results: All had early-onset AChR-MG, the majority with mild generalized disease, and a high proportion achieved remission. Fifteen were female; 11 were Caucasian. In 14/16, the MG preceded NMOSD (median interval: 16 years) and 11 of these had had a thymectomy although 1 only after NMOSD onset. In 4/5 patients tested, AQP4-Abs were detectable between 4 and 16 years prior to disease onset, including 2 patients with detectable AQP4-Abs prior to thymectomy. AChR-Abs decreased and the AQP4-Ab levels increased over time in concordance with the relevant disease. AChR-Abs were detectable at NMOSD onset in the one sample available from 1 of the 2 patients with NMOSD before MG. Conclusions: Although both conditions are rare, the association of MG and NMOSD occurs much more frequently than by chance and the MG appears to follow a benign course. AChR-Abs or AQP4-Abs may be present years before onset of the relevant disease and the antibody titers against AQP4 and AChR tend to change in opposite directions. Although most cases had MG prior to NMOSD onset, and had undergone thymectomy, NMOSD can occur first and in patients who have not had their thymus removed. Neurology (R) 2012;78:1601-1607

Räumliche und jahreszeitliche Verteilung von OH- und HO 2-Radikalen in der Troposphäre über Europa

Durch geologische Prozesse freigesetzte sowie biogen und anthropogen emittierte Gase werden hauptsächlich von der untersten Atmosphärenschicht, der Troposphäre, aufgenommen und abgebaut. Durch in die Troposphä¬re einfallende solare Strahlung wird ein Abbau des Großteils der emittierten Spurengase durch reaktive Radikale initiiert. Der wichtigste Vertreter dieser reaktiven Radikale in der Troposphäre ist das Hydroxylradikal (OH-Radikal), welches im schnellen Gleichgewicht mit Hydroperoxyradikalen (HO2-Radikal) vorliegt, sodass die Summe aus OH- und HO2-Radikalen oft als HOx zusammengefasst wird. HOx-Radikale bilden tagsüber den Hauptteil der Oxidationskapazität der Troposphäre und sind somit verantwortlich für den oxidativen Abbau vieler, auch chemisch und photolytisch stabiler, Spurengase. Daher wird die Oxidationskapazität als Selbstreinigungskraft der Troposphäre verstanden. rnIm Rahmen meiner Arbeit wurde die wissenschaftliche Fragestellung auf die Oxidationskapazität der Troposphäre über Europa fokussiert. Die Höhen- und Breitenverteilung der OH- und HO2-Mischungsverhältnisse und ihre jahreszeitliche Variation wurde während der flugzeuggestützten HOOVER-Kampagnen (HOOVER 1 & 2) charakterisiert, wobei ein Fokus auf der oberen Troposphäre lag. Es wird gezeigt, welchen Einfluss die einfallende Strahlung, die Variation von HOx-Vorläufersubstanzen (wie z. B. Ozon) und die Variation von Substanzen, die das HOx-Gleichgewicht beeinflussen (z. B. Stickstoffmonoxid), auf das HOx-Budget haben. rnEs wird beispielhaft für den Höhenbereich zwischen 8 und 9.5 km gezeigt, dass die Oxidationskapazität in der oberen Troposphäre des Sommers im Ver¬gleich zu der des Herbstes aufgrund von einer verstärkten HO2-Zyklierung im Mittel deutlich erhöht ist (500 %). rnDurch konvektiven Transport werden im Sommer im Gegensatz zum Herbst regelmäßig Luftmassen aus der planetaren Grenzschicht in die obere Troposphäre eingemischt. Daher wurden der konvektive Luftmassentransport und der Einfluss der eingemischten Spurengase auf die Oxidationskapazität der oberen Troposphäre anhand eines konvektiven Elements über Südostdeutschland untersucht. Wie in dieser Arbeit berichtet wird, wurden in den Luftmassen der Ausströmregion mit bis zu 3.5 pmol/mol (Maximum 10 s-Mittelwert) sehr hohe OH-Mischungsverhältnisse gefunden, die aus der HO2-Konversion mit NO gebildet wurden. Das modellierte HOx-Budget zeigt, dass die HOx-Chemie - unter den beobachteten Bedingungen in der Ausströmregion - durch HOx-Zyklierungsreaktionen beherrscht wird. rnDie gemessenen OH-Mischungsverhältnisse in der Ausströmregion liegen etwa um einen Faktor fünf höher, als die während dieses Fluges in der konvektiv unbeeinflussten oberen Troposphäre gemessenen OH-Mischungsverhältnisse. Am Beispiel der NO2- und CH4-Lebensdauer wird ein schnellerer Abbau von Spurengasen aufgrund der erhöhten Oxidationskapazität nachgewiesen. Aus der NO2-Lebensdauer wird abgeschätzt, wie lange die Oxidationskapazität aufgrund des konvektiven Transports von NOx in den Luftmassen des Ausströmgebietes erhöht ist.rnDie während den Kampagnen durchgeführten Messungen wurden genutzt, um Modellberechnungen des vertikalen HOx-Budgets (über Südschweden) und des meridionalen HOx-Budgets zwischen Nordeuropa und Korsika durchzuführen. Es wurde gezeigt, dass das Modell die OH- und HO2-Mischungsverhältnisse im Allgemeinen gut reproduziert (Modell/Messung: OH im Sommer 94 %, HO2 im Sommer 93 % im Herbst 95 %), wohingegen die vergleichsweise kleinen OH-Mischungsverhältnisse im Herbst aufgrund von einer überschätzten H2O2 abhängigen OH-Produktion stark überschätzt wurden (Modell/Messung: 147 %). rnZur Charakterisierung der Oxidationskapazität innerhalb der planetaren Grenzschicht wurden die DOMINO-Kampagnen durchgeführt. Dabei wurde die Zusammensetzung unterschiedlicher Luftmassen untersucht, die aus verschiedenen Herkunftsorten zum Messort transportiert wurden und aufgrund ihres Ursprungs kaum prozessierte bis prozessierte anthropogen emittierte Spurengase enthielten. Zusätzlich enthielt ein Teil der Luftmassen biogen emittierte Spurengase. Komplementäre Messungen ermöglichen die Berechnung der totalen OH-Produktion und den Vergleich mit den bekannten OH-Quellen. Der Vergleich zeigt, dass offenbar wichtige OH-Produktionskanäle durch die gemessenen Spurengase oder die durchgeführten Berechnungen nicht abgebildet werden. Es wird gezeigt, dass die Stärke der unbekannten OH-Quellen, vor allem unter niedrigen NO-Bedingungen, groß ist und mit den Isopren-, RO2- und HO2-Mischungsverhältnissen korreliert.rn

Definição dos padrões químicos e geológicos naturais do Paul de Arzila e da sua envolvente

A Reserva Natural do Paul de Arzila (Decreto Lei nº 219/88 de 27 de Junho) está integrada na Rede Europeia de Reservas Biogen ticas do Concelho da Europa desde 1990. A Reserva Natural do Paul de Arzila goza de um estatuto privilegiado pelo que o planeamento da área em questão está sujeito aos ditames do Concelho da Europa que garante o equilírio biológico e, consequentemente, a conservação da diversidade genética da Reserva. Impõe-se assim a necessidade de se proceder à definição dos padrões químicos e geológicos naturais não só da área da Reserva Natural do Paul de Arzila, mas também da sua envolvente. Inicialmente procedeu-se, a uma caracterização da área do Paul de Arzila referente à fisiografia, relevo, geologia, tectónica, unidades pedológicas e capacidade de uso do solo, recursos naturais, focos de poluição e seus impactos e caracterização sócio - económica. A caracterização geoquímica do Paul de Arzila foi estabelecida com base nos resultados das análises químicas efectuadas em amostras de solos, sedimentos de corrente e águas. Trata-se de um projecto que, a longo prazo, permitirá alargar a problemática da conservação ambiental e da diversidade gené tica das Reserva existentes ao nível do público local e nacional com a implementação de projectos de preservação e sensibilização ambiental.