Uncoupling phosphate deficiency from its major effects on growth and transcriptome via PHO1 expression in Arabidopsis.

Inorganic phosphate (Pi) is one of the most limiting nutrients for plant growth in both natural and agricultural contexts. Pi-deficiency leads to a strong decrease in shoot growth, and triggers extensive changes at the developmental, biochemical and gene expression levels that are presumably aimed at improving the acquisition of this nutrient and sustaining growth. The Arabidopsis thaliana PHO1 gene has previously been shown to participate in the transport of Pi from roots to shoots, and the null pho1 mutant has all the hallmarks associated with shoot Pi deficiency. We show here that A. thaliana plants with a reduced expression of PHO1 in roots have shoot growth similar to Pi-sufficient plants, despite leaves being strongly Pi deficient. Furthermore, the gene expression profile normally triggered by Pi deficiency is suppressed in plants with low PHO1 expression. At comparable levels of shoot Pi supply, the wild type reduces shoot growth but maintains adequate shoot vacuolar Pi content, whereas the PHO1 underexpressor maintains maximal growth with strongly depleted Pi reserves. Expression of the Oryza sativa (rice) PHO1 ortholog in the pho1 null mutant also leads to plants that maintain normal growth and suppression of the Pi-deficiency response, despite the low shoot Pi. These data show that it is possible to unlink low shoot Pi content with the responses normally associated with Pi deficiency through the modulation of PHO1 expression or activity. These data also show that reduced shoot growth is not a direct consequence of Pi deficiency, but is more likely to be a result of extensive gene expression reprogramming triggered by Pi deficiency.

Phosphate Deficiency Induces the Jasmonate Pathway and Enhances Resistance to Insect Herbivory.

During their life cycle, plants are typically confronted by simultaneous biotic and abiotic stresses. Low inorganic phosphate (Pi) is one of the most common nutrient deficiencies limiting plant growth in natural and agricultural ecosystems, while insect herbivory accounts for major losses in plant productivity and impacts ecological and evolutionary changes in plant populations. Here, we report that plants experiencing Pi deficiency induce the jasmonic acid (JA) pathway and enhance their defense against insect herbivory. Pi-deficient Arabidopsis (Arabidopsis thaliana) showed enhanced synthesis of JA and the bioactive conjugate JA-isoleucine, as well as activation of the JA signaling pathway, in both shoots and roots of wild-type plants and in shoots of the Pi-deficient mutant pho1 The kinetics of the induction of the JA signaling pathway by Pi deficiency was influenced by PHOSPHATE STARVATION RESPONSE1, the main transcription factor regulating the expression of Pi starvation-induced genes. Phenotypes of the pho1 mutant typically associated with Pi deficiency, such as high shoot anthocyanin levels and poor shoot growth, were significantly attenuated by blocking the JA biosynthesis or signaling pathway. Wounded pho1 leaves hyperaccumulated JA/JA-isoleucine in comparison with the wild type. The pho1 mutant also showed an increased resistance against the generalist herbivore Spodoptera littoralis that was attenuated in JA biosynthesis and signaling mutants. Pi deficiency also triggered increased resistance to S. littoralis in wild-type Arabidopsis as well as tomato (Solanum lycopersicum) and Nicotiana benthamiana, revealing that the link between Pi deficiency and enhanced herbivory resistance is conserved in a diversity of plants, including crops.

低磷胁迫对高等植物中膜脂含量及分布影响的研究

　磷脂酰甘油(PG)是类囊体膜中唯一的磷脂, 并具有独特的结构。其甘油的sn-2位上总是连接着一个棕榈酸 (16:0) 或反式十六碳烯酸 (16:1tans)。很多研究表明, PG在维持类囊体膜的结构与功能方面具有重要的作用。然而，一些研究表明，在缺磷培养条件下，蓝藻、衣藻和拟南芥中PG含量下降，同时双半乳糖甘油二酯(DGDG)和硫代异鼠李糖甘油二酯(SQDG)含量上升，这一现象似乎表明在缺磷条件下，DGDG和SQDG可以取代PG。在本工作中，我们在叶片、类囊体膜和光系统II水平上研究了缺磷对小麦和黄瓜膜脂组成和含量的影响，特别是缺磷对PG含量影响的机理，以阐明PG与其它甘油脂的关系和其在类囊体膜中的功能。 　　通过对生长在不同磷营养水平条件下9天龄和16天龄小麦叶片中光合膜脂含量的分析，发现在磷缺失培养条件下，小麦光合膜脂的相对含量发生了很大变化，这种变化与小麦叶龄密切相关。在16天龄小麦植株中，第一片叶为老叶，第二片叶为较老叶，而第三片叶为新叶，PG和单半乳糖甘油二酯(MGDG)在叶片中的相对含量从新叶到老叶逐渐下降，而DGDG和SQDG含量逐渐上升;在磷缺失条件下，16天龄小麦第一叶片中PG的含量(2.5%)远远低于其在9天龄小麦第一叶片中的含量(5.5%)。这些结果说明，磷缺失引起小麦叶片中脂含量的变化不仅与脂合成有关，而且与PG的降解有关：新生叶片中PG含量减少的主要原因是由于磷供应不足, 从而影响了PG的合成;而PG的降解则是老叶中PG含量下降的主要原因。 　　由于植物叶片中有部分PG并不分布于类囊体膜中，并且PG是类囊体膜中唯一的磷脂，为了阐明缺磷对类囊体膜脂含量的影响，利用黄瓜作为实验材料， 提取了缺磷和对照条件下黄瓜叶片中的类囊体膜和PSII颗粒，并对其中的脂进行了分析，以期在叶片、类囊体膜和PSII颗粒三个不同层次上来分析缺磷对黄瓜膜脂的影响。结果表明： 1. 黄瓜幼苗的缺磷培养可显著改变叶片中膜脂的组成, 表现为所有磷脂含量的下降和DGDG、SQDG含量上升。 2. 对不同叶位中脂含量的分析表明，在缺磷条件下，随着叶片年龄的增加，叶片中磷脂的含量是逐渐下降的并且低磷处理使新生叶中PC和PE的下降幅度明显高于PG，而PG含量的下降只有在老叶中才明显表现出来。由于PC和PE是质膜、内质网膜和线粒体膜等膜系统的主要组成成分，而叶片中PG主要存在于类囊体膜中。这说明，在新生叶中，缺磷对于其类囊体膜外其他膜系统中磷脂的影响要大于类囊体膜;并且在磷缺失条件下，老叶磷脂中的磷可以运送到新叶中被重新利用。 3. 缺磷引起叶片类囊体膜脂含量的变化与叶片类似, 即PG含量的降低伴随着DGDG和SQDG含量的升高。然而，与叶片中不同的是，缺磷使类囊体膜中MGDG含量轻微下降。在植株生长过程中，缺磷导致老叶类囊体膜中PG含量的下降幅度远远大于新生叶中的下降幅度，而伴随着PG含量的下降，老叶类囊体膜中SQDG和DGDG的含量要远远高于新叶中两种脂的含量。这说明，在叶片生长过程中，缺磷条件下类囊体膜脂中DGDG和SQDG含量的上升可以弥补PG含量的下降。 4. 尽管缺磷使类囊体膜中的PG含量有较大幅度的下降, 但是叶绿素荧光动力学和PSII光合放氧活性都没有受到显著的影响。这些结果说明缺磷胁迫并没有对PSII的功能产生显著的影响。进一步研究发现, 在缺磷黄瓜植株中, PSII中PG的含量仍然维持在一个较高的水平。这些结果表明, 缺磷可以导致类囊体膜中某些区域中的PG大幅度降低, 但是对分布在PSII中的PG含量则影响较小。缺磷对类囊体膜脂组成及分布在不同区域PG的影响说明了类囊体膜中的PG可能存在着两种类型: 一些PG分子在类囊体膜中仅仅起结构作用, 当这些PG分子缺少时, 其它脂特别是SQDG可以替代PG; 而另一些PG分子在PSII的结构和功能中起重要的作用, 具有其它脂类分子不可取代的功能。

缺磷胁迫导致高等植物叶片中磷脂酰甘油（PG）含量降低的机理研究

磷脂酰甘油（PG）是植物类囊体膜中唯一的磷脂，在它的sn-2位上总是连着一个棕榈酸（16：0）或反式十六碳烯酸（16：1 trans）。由于PG的分子结构独特，对它的功能已有了很多研究，目前认为PG在维持类囊体膜的结构与功能方面具有非常重要的作用。缺磷胁迫下，蓝藻、衣藻及拟南芥、大麦等物种中均检测到了PG含量的下降。对这一现象的常见解释是缺磷导致了PG生物合成受阻，从而引起了其含量的降低。但迄今为止尚没有试验证据支持。本研究比较了缺磷对不同叶龄的小麦与烟草叶片中PG含量与PG水解酶的活性的影响，同时对缺磷叶片酶粗提液水解外源PG后的主要产物、几种磷脂酶抑制剂对上述酶反应的影响等进行了研究，以阐明缺磷条件下叶片中PG含量下降的主要原 因。 缺磷小麦第一叶完全展开时，PG含量与PG水解酶活性均与对照相似;而第三叶完全展开时，尽管缺磷第三叶中PG水解酶活性也与对照相似，但其PG含量低于对照。这一结果表明，在小麦叶片完全展开之前，缺磷条件未影响叶片中的PG水解酶活性，第三叶中较低的PG含量应由PG的生物合成受阻引起。并且，由于缺磷植株第一叶完全展开时PG含量未受影响而第三叶中却表现出了轻微降低，可以推测叶片萌发越晚，PG生物合成受到的抑制就会越严重。 为了研究叶片衰老过程中PG含量下降的原因，我们比较了6，10，14与18日龄时缺磷与对照小麦植株第一叶中PG的相对含量与PG水解酶活性。研究发现：6日龄时，刚刚完全展开的缺磷和对照小麦第一叶中无论是PG含量还是PG水解酶活性都较为相似;而随着叶片的逐渐衰老，缺磷植株第一叶中PG含量大幅度下降，同时伴随着PG水解酶活性的急剧上升。18日龄时，缺磷小麦第一叶中的PG含量较对照降低了69.1%，其PG水解酶活性也远高于对照，37ºC下温育30min后，缺磷叶片的酶粗提液使外源PG含量降低了74.16%，而对照中只降低了13.7%。上述结果表明，缺磷条件下，小麦叶片中PG含量降低的程度与PG水解酶活性的强弱密切相关，PG水解加剧是导致老叶中PG含量降低的一个重要原因。 磷脂酶是水解磷脂的主要酶类。目前在植物体中发现的磷脂酶种类主要有磷脂酶D（PLD）、磷脂酶C（PLC）与磷脂酶A（PLA）。通过薄层层析（TLC），我们发现缺磷小麦叶片的酶粗提液水解外源PG后的主要产物是磷脂酸（PA）、二脂酰甘油（DAG）与游离脂肪酸（FFA）。将n-丁醇加入到缺磷小麦叶片的体外酶反应体系中后，观察到PA、DAG与FFA的生成量均表现出一定程度的降低。由于n-丁醇是PA经PLD途径生成的抑制剂，因此，上述结果表明PLD参与了缺磷条件下小麦叶片中PG的水解。硫酸新霉素是PLC的非特异性抑制剂，低浓度的硫酸新霉素（100μM 和 200μM ）加入到缺磷小麦叶片的体外酶反应体系后，三种产物的生成受到了严重抑制，表明PLC也与缺磷叶片中PG的降解密切相关。 为了进一步分析缺磷导致PG含量降低的原因，我们以烟草为试验材料，检测了缺磷胁迫对烟草嫩叶和老叶中的PG含量、PG水解酶活性、与PG降解相关的酶的种类及PLC、PLDα、PLDβ与PAT-1基因在mRNA上表达水平的的影响。结果表明，缺磷烟草叶片中PG含量的降低由PG生物合成受阻与PG降解加剧共同导致，PLC和PLD活性与烟草叶片中PG的降解有关。缺磷植株老叶中PG水解酶活性及PLC、PLDα、PLDβ基因在mRNA水平上的表达量均高于对照，表明在磷胁迫条件下，老叶中PG水解酶活性可能受到转录水平上的调节， PLC、PLDα、PLDβ转录活性的增强导致了PLC、PLD活性加强，从而引起PG降解的加剧，最终导致了PG含量的降低。与PLC、PLDα和PLDβ不同，缺磷胁迫对patatin蛋白（表现PLA2活性）的编码基因PAT-1在转录水平上的表达无影响，TLC分析PG的水解产物也未检测到溶血磷脂酰甘油（LPG）的生成。由此可见，PLA活性可能与缺磷条件下PG的降解无关。

一氧化氮在磷酸盐调节拟南芥根系形态变化中的作用

磷缺乏已成为制约世界农业生产的重要因子。植物根系的大小和形态是决定植物吸收土壤磷能力的重要因素，而且根系的生长发育与磷素的分布及其有效性密切相关。关于磷酸盐调节植物根系生长研究已有很多报道，但其生理和分子机制仍不清楚。一氧化氮 (NO) 是一种重要的气体信号分子，参与调控植物的生长发育和对多种逆境胁迫的应答反应。本文选用拟南芥为实验材料，研究探讨了NO与缺磷诱导的拟南芥根系形态变化之间的关系，主要结果如下： 用正常磷水平 (1 mM) 和低磷水平 (1 µM) 处理拟南芥幼苗，发现低磷抑制主根伸长，刺激侧根发生。外源NO供体销普纳 (SNP) 也抑制主根、刺激侧根生长，与低磷诱导根系形态变化相似。NO清除剂c-PTIO和一氧化氮合成酶 （NOS）抑制剂L-NNA均可部分减缓由低磷引起的对主根生长的抑制和对侧根的刺激作用。暗示低磷诱导的拟南芥根系形态的变化可能与NO含量的降低有关。 利用NO荧光标记物DAF-FM和激光共聚焦显微成像技术，本研究发现缺磷6 h和24 h后根细胞内源NO含量显著增加，而且NOS 抑制剂能减少低磷诱导的根细胞NO含量的增加。与正常供磷处理相比，低磷处理6 h和24 h，拟南芥根中编码与NO合成相关的基因（AtNOA1）的表达量增加，缺磷24 h后根中NOS酶活性升高。为了明确低磷诱导的NO 增加是否与硝酸还原酶（NR）介导的NO合成有关，本论文进一步研究了低磷对拟南芥硝酸还原酶活性和编码NR基因 （AtNR1和AtNR2）表达的影响。研究发现低磷处理6 h和24 h后和AtNR1和AtNR2基因的表达均没有变化，且蛭石中生长的拟南芥缺磷1个月后NR活性也没有发生变化;拟南芥的NR双突变体nia1，nia2在低磷处理24 h后，其根中的内源NO含量表现出与野生型相同的增加。因此这些研究结果表明，缺磷后拟南芥根细胞NO的含量增加主要由于NOS的活性升高，而与NR介导的NO合成无关。 已有资料表明低磷诱导植物根细胞内源过氧化氢（H2O2）分布和含量的变化。本论文研究了低磷处理对用H2O2标记物CM-H2DCFDA标记不同磷处理下的拟南芥根中的H2O2。研究发现，缺磷6 h根中H2O2的分布无明显变化，缺磷24 h后H2O2呈斑块状分布，且多集中在根尖伸长区。缺磷24 h后，叶片中的抗氧化保护酶—超氧化物歧化酶（SOD）、过氧化物酶（POD）和过氧化氢酶（CAT）活性没有明显变化。说明缺磷24 h 后产生的H2O2没有引起氧化胁迫，而是作为一种信号分子，与NO相互作用共同介导低磷胁迫的应答反应。关于NO与H2O2在低磷诱导的根形态变化中的信号转导过程还有待进一步研究。

Trait directed de novo population transcriptome dissects genetic regulation of a balanced polymorphism in phosphorus nutrition/arsenate tolerance in a wild grass Holcus lanatus

The aim of this study was to characterize the transcriptome of a balanced polymorphism, under the regulation of a single gene, for phosphate fertilizer responsiveness/arsenate toler- ance in wild grass Holcus lanatus genotypes screened from the same habitat.

De novo transcriptome sequencing, RNAseq (RNA sequencing) and single nucleotide poly- morphism (SNP) calling were conducted on RNA extracted from H.lanatus. Roche 454 sequencing data were assembled into c. 22 000 isotigs, and paired-end Illumina reads for phosphorus-starved (P) and phosphorus-treated (P+) genovars of tolerant (T) and nontoler- ant (N) phenotypes were mapped to this reference transcriptome.

Heatmaps of the gene expression data showed strong clustering of each P+/P treated genovar, as well as clustering by N/T phenotype. Statistical analysis identified 87 isotigs to be significantly differentially expressed between N and T phenotypes and 258 between P+ and P treated plants. SNPs and transcript expression that systematically differed between N and T phenotypes had regulatory function, namely proteases, kinases and ribonuclear RNA- binding protein and transposable elements.

A single gene for arsenate tolerance led to distinct phenotype transcriptomes and SNP pro- files, with large differences in upstream post-translational and post-transcriptional regulatory genes rather than in genes directly involved in P nutrition transport and metabolism per se.

Phosphorus nutrition of Caustis blakei grown with two phosphorus sources of different solubility in two soils of differing phosphorus adsorption capacity

A barrier to the domestication of the phosphorus (P) sensitive Australian species Caustis blakei (Cyperaceae) is the standard production systems used commercially which invariably result in problems associated either with P deficiency or P toxicity. This paper reports on the growth responses of Caustis blakei cv. M63 to applications of fertiliser P as either monocalcium phosphate (MCP) or granulated Guano Gold (R) rock phosphate (RP) in two soils with different capacities to adsorb P. The Caustis M63 plants grown in the two soils did not show P toxicity symptoms when fertilised with RP, but shoot dry weight was 30-60% lower than the control in both soils at the highest rate of MCP-P application (156 kg ha(-1), 184 g m(-3)) and this was associated with visible symptoms of drying of the tips of the ultimate branchlets, in the Mt Cotton soil only. The greatest shoot and root dry weights were achieved by plants grown in the higher P adsorbing Palmwoods soil fertilised with RP at P rates of 30-184 g m(-3). Caustis plants grown in the Palmwoods soil had 2.3 times greater root dry weights than plants grown in the Mt Cotton soil irrespective of the P fertiliser type used. Caustis plants growing in Mt Cotton soil which did not receive P showed significantly lower shoot and root dry weight when compared to plants in the Palmwoods soil, probably due to the low initial bicarbonate-extractable P and the high buffering capacity of the Mt Cotton soil. The P concentration in shoots of Caustis fertilised with MCP at 184 g m(-3) was higher when grown in Mt Cotton soil (0.22%) than in the Palmwoods soil (0.15%). The P concentration was lower in the terminal ultimate branchlets (TUB); 0.15% for the Mt Cotton soil and 0.10% for the Palmwoods soil, suggesting that shoots would provide a more useful indicator of P toxicity than the TUB. It is interesting to speculate as to why plants in the Palmwoods soil showed greater root growth and fewer symptoms of P toxicity. This could be because the Palmwoods soil had the greater P adsorption capacity. These results indicate in ground production of Caustis cut foliage will require careful management of P nutrition and understanding of the complex soil/plant interactions associated with the acquisition of P. (c) 2006 Elsevier B.V. All rights reserved.

Experiment: Response of Nodularia spumigena to pCO2

The filamentous and diazotrophic cyanobacterium Nodularia spumigena plays a major role in the productivity of the Baltic Sea as it forms extensive blooms regularly. Under phosphorus limiting conditions Nodularia spumigena has a high enzyme affinity for dissolved organic phosphorus (DOP) by production and release of alkaline phosphatase. Additionally, it is able to degrade proteinaceous compounds by expressing the extracellular enzyme leucine aminopeptidase. As atmospheric CO2 concentrations are increasing, we expect marine phytoplankton to experience changes in several environmental parameters including pH, temperature, and nutrient availability. The aim of this study was to investigate the combined effect of CO2-induced changes in seawater carbonate chemistry and of phosphate deficiency on the exudation of organic matter, and its subsequent recycling by extracellular enzymes in a Nodularia spumigena culture. Batch cultures of Nodularia spumigena were grown for 15 days aerated with three different pCO2 levels corresponding to values from glacial periods to future values projected for the year 2100. Extracellular enzyme activities as well as changes in organic and inorganic compound concentrations were monitored. CO2 treatment-related effects were identified for cyanobacterial growth, which in turn was influencing exudation and recycling of organic matter by extracellular enzymes. Biomass production was increased by 56.5% and 90.7% in the medium and high pCO2 treatment, respectively, compared to the low pCO2 treatment and simultaneously increasing exudation. During the growth phase significantly more mucinous substances accumulated in the high pCO2 treatment reaching 363 µg Gum Xanthan eq /l compared to 269 µg Gum Xanthan eq /l in the low pCO2 treatment. However, cell-specific rates did not change. After phosphate depletion, the acquisition of P from DOP by alkaline phosphatase was significantly enhanced. Alkaline phosphatase activities were increased by factor 1.64 and 2.25, respectively, in the medium and high compared to the low pCO2 treatment. In conclusion, our results suggest that Nodularia spumigena can grow faster under elevated pCO2 by enhancing the recycling of organic matter to acquire nutrients.

An unusual distribution of glucose-6-phosphate dehydrogenase deficiency of south Indian newborn population.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is seen at a higher frequency in many national and ethnic groups in areas of current or former malaria endemicity. A screening programme undertaken to evaluate the gene frequencies for this deficiency in the highly inbred South Indian population of Karnataka revealed that of the 5140 neonates screened, 7.8% were G6PD deficient with no correlation between the reported level of inbreeding and enzyme deficiency. An interesting finding was the equal number of male (198) and female (207) individuals, with G6PD activity of less than 3 IU. The possible implications of this finding with regard to the expression of G6PD gene is discussed.

Patient with toxoplasmosis and glucose-6-phosphate dehydrogenase deficiency: a case report

Abstract Introduction Toxoplasmosis, a zoonotic protozoal disease caused by toxoplasma gondii, is prevalent throughout the world, affecting a large proportion of persons who usually have no symptoms. Glucose 6 phosphate dehydrogenase deficiency, an X-linked inherited disorder, is present in over 400 million people world wide. It is more common in tropical and subtropical countries and is one of the important causes of hemolytic anemia. Case presentation This case report relates the occurrence of the two diseases simultaneously in a child of five years old. Conclusion Patients with glucose-6-phosphate dehydrogenase deficiency are more susceptible to toxoplasmosis and this case report, reinforce the findings of this propensity and alert us for such possibility, what it is important, therefore, the treatment of toxoplasmosis can cause serious hemolysis in these patients.

Frequency of Malaria and Glucose-6-phosphate Dehydrogenase Deficiency in Tajikistan

Background During the Soviet era, malaria was close to eradication in Tajikistan. Since the early 1990s, the disease has been on the rise and has become endemic in large areas of southern and western Tajikistan. The standard national treatment for Plasmodium vivax is based on primaquine. This entails the risk of severe haemolysis for patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Seasonal and geographical distribution patterns as well as G6PD deficiency frequency were analysed with a view to improve understanding of the current malaria situation in Tajikistan. Methods Spatial and seasonal distribution was analysed, applying a risk model that included key environmental factors such as temperature and the availability of mosquito breeding sites. The frequency of G6PD deficiency was studied at the health service level, including a cross-sectional sample of 382 adult men. Results Analysis revealed high rates of malaria transmission in most districts of the southern province of Khatlon, as well as in some zones in the northern province of Sughd. Three categories of risk areas were identified: (i) zones at relatively high malaria risk with high current incidence rates, where malaria control and prevention measures should be taken at all stages of the transmission cycle; (ii) zones at relatively high malaria risk with low current incidence rates, where malaria prevention measures are recommended; and (iii) zones at intermediate or low malaria risk with low current incidence rates where no particular measures appear necessary. The average prevalence of G6PD deficiency was 2.1% with apparent differences between ethnic groups and geographical regions. Conclusion The study clearly indicates that malaria is a serious health issue in specific regions of Tajikistan. Transmission is mainly determined by temperature. Consequently, locations at lower altitude are more malaria-prone. G6PD deficiency frequency is too moderate to require fundamental changes in standard national treatment of cases of P. vivax.

Sweat test in patients with glucose-6-phosphate-1-dehydrogenase deficiency

BACKGROUND: A false-positive sweat test in patients with deficiency of glucose-6-phosphate-1-dehydrogenase (EC 1.1.1.49; G6PD) is repeatedly reported. METHODS: Sweat chloride or conductivity was measured in 11 patients with G6PD deficiency. RESULTS: Mean (SD) chloride level (n = 8, median age 9.2 years, range 1.9-48.5) was 18.8 (9.6 mmol/l) and, mean (SD) sodium level was 26.0 (10.0 mmol/l), respectively, and mean (SD) conductivity (n = 3, median age 6.6 years, range 1.9-40.5) was 34.3 (6.5 mmol/l). CONCLUSION: In sweat of 11 patients with G6PD deficiency we did not find any abnormality. The reason for alleged false-positive sweat test in patients with G6PD deficiency is not known and we were unable to identify any original reference. It appears that tables of putative false-positive sweat tests in several disease states have been directly "copied and pasted" from one paper or textbook to another without verifying the original literature, a phenomenon one can call "chain citation".

Anesthesia in patients with glucose-6-phosphate dehydrogenase deficiency: case report and perioperative anesthesiologic management

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a frequent congenital human enzyme defect, is the most frequent cause of hemolytic anemia triggered by drugs or infectious diseases. Drugs which induce acute hemolysis in patients with G6PD deficiency are often used in anesthesia and perioperative pain therapy. Considering the fact that patients from geographic regions with a high prevalence of the disease are often treated in European hospitals, special attention should be paid to this problem. We report a case of a 30-year-old female patient with favism and review the disease and anesthesia-related implications.

Fatal hyperammonemia and carbamoyl phosphate synthetase 1 (CPS1) deficiency following high-dose chemotherapy and autologous hematopoietic stem cell transplantation

Fatal hyperammonemia secondary to chemotherapy for hematological malignancies or following bone marrow transplantation has been described in few patients so far. In these, the pathogenesis of hyperammonemia remained unclear and was suggested to be multifactorial. We observed severe hyperammonemia (maximum 475 μmol/L) in a 2-year-old male patient, who underwent high-dose chemotherapy with carboplatin, etoposide and melphalan, and autologous hematopoietic stem cell transplantation for a neuroblastoma stage IV. Despite intensive care treatment, hyperammonemia persisted and the patient died due to cerebral edema. The biochemical profile with elevations of ammonia and glutamine (maximum 1757 μmol/L) suggested urea cycle dysfunction. In liver homogenates, enzymatic activity and protein expression of the urea cycle enzyme carbamoyl phosphate synthetase 1 (CPS1) were virtually absent. However, no mutation was found in CPS1 cDNA from liver and CPS1 mRNA expression was only slightly decreased. We therefore hypothesized that the acute onset of hyperammonemia was due to an acquired, chemotherapy-induced (posttranscriptional) CPS1 deficiency. This was further supported by in vitro experiments in HepG2 cells treated with carboplatin and etoposide showing a dose-dependent decrease in CPS1 protein expression. Due to severe hyperlactatemia, we analysed oxidative phosphorylation complexes in liver tissue and found reduced activities of complexes I and V, which suggested a more general mitochondrial dysfunction. This study adds to the understanding of chemotherapy-induced hyperammonemia as drug-induced CPS1 deficiency is suggested. Moreover, we highlight the need for urgent diagnostic and therapeutic strategies addressing a possible secondary urea cycle failure in future patients with hyperammonemia during chemotherapy and stem cell transplantation.