RESUMO
Background: Cluster B personality disorders (PDs) are considered some of the most severe mental health conditions. Scarce evidence exists about the real-world utilization of psychotropics for cluster B PD individuals. Objective: We aimed to uncover trends and patterns of psychotropic medication use among individuals diagnosed with cluster B PD in the year before and after their diagnosis and to identify factors associated with medication use in a large cohort of individuals newly diagnosed with cluster B PDs. Methods: We conducted a population-based observational study using Quebec's health services register. We identified Quebec residents aged ≥14 years and insured with the provincial drug plan with a first diagnosis of cluster B PD recorded between April 1, 2002, and March 31, 2019. Cluster B PD was defined with ICD-9/10 diagnostic codes. We retrieved all claims for the main psychotropic medication classes: antipsychotics, antidepressants, anxiolytics, mood stabilizers, and attention-deficit/hyperactivity disorder (ADHD) medications. We calculated the proportion of individuals exposed to these medication classes and analyzed trends over the years using robust Poisson regression models, adjusting for potential confounders. We used robust Poisson regression to identify factors associated with medication class use. Results: We identified 87,778 new cases of cluster B PD, with a mean age of 44.5 years; 57.5% were women. Most frequent psychiatric comorbidities in the five years before cluster B PD diagnosis were depression (50.9%), anxiety (49.7%), and psychotic disorders (37.5%). Most individuals (71.0%) received at least one psychotropic during the year before cluster B PD diagnosis, and 78.5% received at least one of these medications in the subsequent year. The proportion of users increased after the diagnosis for antidepressants (51.6-54.7%), antipsychotics (35.9-45.2%), mood stabilizers (14.8-17.0%), and ADHD medications (5.1-5.9%), and remained relatively stable for anxiolytics (41.4-41.7%). Trends over time showed statistically significant increased use of antipsychotics and ADHD medications, decreased use of anxiolytics and mood stabilizers, and a stable use of antidepressants. Conclusion: Psychotropic medication use is highly prevalent among cluster B PD individuals. We observed an increase in medication use in the months following the diagnosis, particularly for antipsychotics, antidepressants, and mood stabilizers.
RESUMO
OBJECTIVE: The comparable severities of cluster B personality disorders and schizophrenia are increasingly recognized. The authors sought to compare the general medical and psychiatric comorbid conditions and use of medical services among individuals with one or both of these disorders. METHODS: Data were collected from the linked health administrative databases of Quebec's universal health plan in the Quebec Integrated Chronic Disease Surveillance System, which covers 99% of Quebec's population. The study cohort of 2016-2017 included almost 7.05 million people, and the study covered the 1996-2017 period. RESULTS: Comorbid conditions were extremely prevalent in the three groups studied-persons with cluster B personality disorders, schizophrenia, or both-compared with the general population. People having both disorders had the highest prevalence of comorbid conditions. Psychiatric services were used more frequently by individuals in all three groups than among those in the general population, and use was especially high among people with both disorders. Medical care service use was heterogeneous, with patients with cluster B personality disorders using more medical care services but fewer specialized outpatient treatments and psychotherapy than those with schizophrenia or with both disorders. CONCLUSIONS: The three cohorts had higher rates of comorbid conditions and health care service use than individuals in the general population. Patients with cluster B personality disorders used fewer psychiatric services than patients with schizophrenia or with both disorders. One explanation for this difference may be that people with cluster B personality disorders encounter more obstacles in accessing mental health care services.
Assuntos
Serviços de Saúde Mental , Esquizofrenia , Comorbidade , Atenção à Saúde , Humanos , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/terapia , Psicoterapia , Esquizofrenia/epidemiologia , Esquizofrenia/terapiaRESUMO
BACKGROUND: Malaria disease commences when blood-stage parasites, called merozoites, invade human erythrocytes. Whilst the process of invasion is traditionally seen as being entirely merozoite-driven, emerging data suggests erythrocyte biophysical properties markedly influence invasion. Cholesterol is a major determinant of cell membrane biophysical properties demanding its interrogation as a potential mediator of resistance to merozoite invasion of the erythrocyte. METHODS: Biophysical measurements of erythrocyte deformability by flicker spectroscopy were used to assess changes in erythrocyte bending modulus on forced integration of cholesterol and how these artificial changes affect invasion by human Plasmodium falciparum merozoites. To validate these observations in a natural context, either murine Plasmodium berghei or human Plasmodium falciparum merozoites were tested for their ability to invade erythrocytes from a hypercholesterolaemic mouse model or human clinical erythrocyte samples deriving from patients with a range of serum cholesterol concentrations, respectively. RESULTS: Erythrocyte bending modulus (a measure of deformability) was shown to be markedly affected by artificial modulation of cholesterol content and negatively correlated with merozoite invasion efficiency. In an in vitro infection context, however, erythrocytes taken from hypercholesterolaemic mice or from human clinical samples with varying serum cholesterol levels showed little difference in their susceptibility to merozoite invasion. Explaining this, membrane cholesterol levels in both mouse and human hypercholesterolaemia erythrocytes were subsequently found to be no different from matched normal serum controls. CONCLUSIONS: Based on these observations, serum cholesterol does not appear to impact on erythrocyte susceptibility to merozoite entry. Indeed, no relationship between serum cholesterol and cholesterol content of the erythrocyte is apparent. This work, nonetheless, suggests that native polymorphisms which do affect membrane lipid composition would be expected to affect parasite entry. This supports investigation of erythrocyte biophysical properties in endemic settings, which may yet identify naturally protective lipid-related polymorphisms.
Assuntos
Colesterol/sangue , Dislipidemias/etiologia , Eritrócitos/parasitologia , Malária/fisiopatologia , Plasmodium berghei/fisiologia , Plasmodium falciparum/fisiologia , Animais , Fenômenos Biofísicos , Humanos , Malária Falciparum/fisiopatologia , Masculino , CamundongosRESUMO
Malaria is caused by Plasmodium parasites, which invade and replicate in erythrocytes. For Plasmodium falciparum, the major cause of severe malaria in humans, a heterotrimeric complex comprised of the secreted parasite proteins, PfCyRPA, PfRIPR and PfRH5 is essential for erythrocyte invasion, mediated by the interaction between PfRH5 and erythrocyte receptor basigin (BSG). However, whilst CyRPA and RIPR are present in most Plasmodium species, RH5 is found only in the small Laverania subgenus. Existence of a complex analogous to PfRH5-PfCyRPA-PfRIPR targeting BSG, and involvement of CyRPA and RIPR in invasion, however, has not been addressed in non-Laverania parasites. Here, we establish that unlike P. falciparum, P. knowlesi and P. vivax do not universally require BSG as a host cell invasion receptor. Although we show that both PkCyRPA and PkRIPR are essential for successful invasion of erythrocytes by P. knowlesi parasites in vitro, neither protein forms a complex with each other or with an RH5-like molecule. Instead, PkRIPR is part of a different trimeric protein complex whereas PkCyRPA appears to function without other parasite binding partners. It therefore appears that in the absence of RH5, outside of the Laverania subgenus, RIPR and CyRPA have different, independent functions crucial for parasite survival.
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Basigina/metabolismo , Malária/metabolismo , Complexos Multiproteicos/metabolismo , Plasmodium knowlesi/metabolismo , Proteínas de Protozoários/metabolismo , Basigina/genética , Humanos , Malária/genética , Complexos Multiproteicos/genética , Plasmodium falciparum/genética , Plasmodium falciparum/metabolismo , Plasmodium knowlesi/genética , Plasmodium vivax/genética , Plasmodium vivax/metabolismo , Proteínas de Protozoários/genética , Especificidade da EspécieRESUMO
Invasion of the red blood cell (RBC) by the Plasmodium parasite defines the start of malaria disease pathogenesis. To date, experimental investigations into invasion have focused predominantly on the role of parasite adhesins or signaling pathways and the identity of binding receptors on the red cell surface. A potential role for signaling pathways within the erythrocyte, which might alter red cell biophysical properties to facilitate invasion, has largely been ignored. The parasite erythrocyte-binding antigen 175 (EBA175), a protein required for entry in most parasite strains, plays a key role by binding to glycophorin A (GPA) on the red cell surface, although the function of this binding interaction is unknown. Here, using real-time deformability cytometry and flicker spectroscopy to define biophysical properties of the erythrocyte, we show that EBA175 binding to GPA leads to an increase in the cytoskeletal tension of the red cell and a reduction in the bending modulus of the cell's membrane. We isolate the changes in the cytoskeleton and membrane and show that reduction in the bending modulus is directly correlated with parasite invasion efficiency. These data strongly imply that the malaria parasite primes the erythrocyte surface through its binding antigens, altering the biophysical nature of the target cell and thus reducing a critical energy barrier to invasion. This finding would constitute a major change in our concept of malaria parasite invasion, suggesting it is, in fact, a balance between parasite and host cell physical forces working together to facilitate entry.
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Antígenos de Protozoários/metabolismo , Membrana Celular/patologia , Eritrócitos/patologia , Glicoforinas/metabolismo , Malária Falciparum/patologia , Plasmodium falciparum/patogenicidade , Proteínas de Protozoários/metabolismo , Antígenos de Protozoários/genética , Biofísica , Membrana Celular/metabolismo , Membrana Celular/parasitologia , Citoesqueleto , Eritrócitos/metabolismo , Eritrócitos/parasitologia , Glicoforinas/genética , Interações Hospedeiro-Parasita , Humanos , Malária Falciparum/metabolismo , Malária Falciparum/parasitologia , Plasmodium falciparum/isolamento & purificação , Ligação Proteica , Proteínas de Protozoários/genética , Transdução de SinaisRESUMO
Polypeptide aggregation into amyloid is linked with several debilitating human diseases. Despite the inherent risk of aggregation-induced cytotoxicity, bacteria control the export of amyloid-prone subunits and assemble adhesive amyloid fibres during biofilm formation. An Escherichia protein, CsgC potently inhibits amyloid formation of curli amyloid proteins. Here we unlock its mechanism of action, and show that CsgC strongly inhibits primary nucleation via electrostatically-guided molecular encounters, which expands the conformational distribution of disordered curli subunits. This delays the formation of higher order intermediates and maintains amyloidogenic subunits in a secretion-competent form. New structural insight also reveal that CsgC is part of diverse family of bacterial amyloid inhibitors. Curli assembly is therefore not only arrested in the periplasm, but the preservation of conformational flexibility also enables efficient secretion to the cell surface. Understanding how bacteria safely handle amyloidogenic polypeptides contribute towards efforts to control aggregation in disease-causing amyloids and amyloid-based biotechnological applications.
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Amiloide/química , Proteínas de Escherichia coli/química , Chaperonas Moleculares/química , Eletricidade Estática , Transporte Ativo do Núcleo Celular , Amiloide/classificação , Amiloide/genética , Amiloide/metabolismo , Proteínas de Escherichia coli/metabolismo , Cinética , Chaperonas Moleculares/metabolismo , Concentração Osmolar , Ligação Proteica , Conformação Proteica , Dobramento de ProteínaRESUMO
Despite decades of research, we still know little about the mechanics of Plasmodium host cell invasion. Fundamentally, while the essential or non-essential nature of different parasite proteins is becoming clearer, their actual function and how each comes together to govern invasion are poorly understood. Furthermore, in recent years an emerging world view is shifting focus away from the parasite actin-myosin motor being the sole force responsible for entry to an appreciation of host cell dynamics and forces and their contribution to the process. In this review, we discuss merozoite invasion of the erythrocyte, focusing on the complex set of pre-invasion events and how these might prime the red cell to facilitate invasion. While traditionally parasite interactions at this stage have been viewed simplistically as mediating adhesion only, recent work makes it apparent that by interacting with a number of host receptors and signalling pathways, combined with secretion of parasite-derived lipid material, that the merozoite may initiate cytoskeletal re-arrangements and biophysical changes in the erythrocyte that greatly reduce energy barriers for entry. Seen in this light Plasmodium invasion may well turn out to be a balance between host and parasite forces, much like that of other pathogen infection mechanisms.
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Eritrócitos/parasitologia , Interações Hospedeiro-Parasita/fisiologia , Plasmodium/patogenicidade , Humanos , Malária Falciparum/parasitologia , Merozoítos/fisiologia , Proteínas de Protozoários/metabolismoRESUMO
Curli are extracellular functional amyloids that are assembled by enteric bacteria during biofilm formation and host colonization. An efficient secretion system and chaperone network ensures that the major curli fiber subunit, CsgA, does not form intracellular amyloid aggregates. We discovered that the periplasmic protein CsgC was a highly effective inhibitor of CsgA amyloid formation. In the absence of CsgC, CsgA formed toxic intracellular aggregates. In vitro, CsgC inhibited CsgA amyloid formation at substoichiometric concentrations and maintained CsgA in a non-ß-sheet-rich conformation. Interestingly, CsgC inhibited amyloid assembly of human α-synuclein, but not Aß42, in vitro. We identified a common D-Q-Φ-X0,1-G-K-N-ζ-E motif in CsgC client proteins that is not found in Aß42. CsgC is therefore both an efficient and selective amyloid inhibitor. Dedicated functional amyloid inhibitors may be a key feature that distinguishes functional amyloids from disease-associated amyloids.
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Proteínas de Escherichia coli/metabolismo , Proteínas de Escherichia coli/farmacologia , Escherichia coli/genética , Agregados Proteicos/efeitos dos fármacos , alfa-Sinucleína/metabolismo , Motivos de Aminoácidos , Peptídeos beta-Amiloides/metabolismo , Sequência de Bases , Escherichia coli/metabolismo , Proteínas de Escherichia coli/química , Proteínas de Escherichia coli/genética , Humanos , Técnicas In Vitro , Dados de Sequência Molecular , Estrutura Secundária de Proteína , alfa-Sinucleína/químicaRESUMO
Rhizobia have a versatile catabolism that allows them to compete successfully with other microorganisms for nutrients in the soil and in the rhizosphere of their respective host plants. In this study, Bradyrhizobium japonicum USDA 110 was found to be able to utilize oxalate as the sole carbon source. A proteome analysis of cells grown in minimal medium containing arabinose suggested that oxalate oxidation extends the arabinose degradation branch via glycolaldehyde. A mutant of the key pathway genes oxc (for oxalyl-coenzyme A decarboxylase) and frc (for formyl-coenzyme A transferase) was constructed and shown to be (i) impaired in growth on arabinose and (ii) unable to grow on oxalate. Oxalate was detected in roots and, at elevated levels, in root nodules of four different B. japonicum host plants. Mixed-inoculation experiments with wild-type and oxc-frc mutant cells revealed that oxalotrophy might be a beneficial trait of B. japonicum at some stage during legume root nodule colonization.
Assuntos
Arabinose/metabolismo , Bradyrhizobium/metabolismo , Carbono/metabolismo , Oxalatos/metabolismo , Proteínas de Bactérias/análise , Bradyrhizobium/química , Bradyrhizobium/crescimento & desenvolvimento , Meios de Cultura/química , Genes Bacterianos , Redes e Vias Metabólicas/genética , Mutação , Raízes de Plantas/química , Raízes de Plantas/microbiologia , Plantas/química , Plantas/microbiologia , Proteoma/análiseRESUMO
Multidrug efflux systems not only cause resistance against antibiotics and toxic compounds but also mediate successful host colonization by certain plant-associated bacteria. The genome of the nitrogen-fixing soybean symbiont Bradyrhizobium japonicum encodes 24 members of the family of resistance/nodulation/cell division (RND) multidrug efflux systems, of which BdeAB is genetically controlled by the RegSR two-component regulatory system. Phylogenetic analysis of the membrane components of these 24 RND-type transporters revealed that BdeB is more closely related to functionally characterized orthologs in other bacteria, including those associated with plants, than to any of the other 23 paralogs in B. japonicum. A mutant with a deletion of the bdeAB genes was more susceptible to inhibition by the aminoglycosides kanamycin and gentamicin than the wild type, and had a strongly decreased symbiotic nitrogen-fixation activity on soybean, but not on the alternative host plants mungbean and cowpea, and only very marginally on siratro. The host-specific role of a multidrug efflux pump is a novel feature in the rhizobia-legume symbioses. Consistent with the RegSR dependency of bdeAB, a B. japonicum regR mutant was found to have a greater sensitivity against the two tested antibiotics and a symbiotic defect that is most pronounced for soybean.
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Proteínas de Bactérias/metabolismo , Bradyrhizobium/genética , Bradyrhizobium/fisiologia , Farmacorresistência Bacteriana Múltipla , Glycine max/microbiologia , Fixação de Nitrogênio , Simbiose , Proteínas de Bactérias/genética , Sequência de Bases , Bradyrhizobium/efeitos dos fármacos , DNA Bacteriano/genética , Perfilação da Expressão Gênica , Regulação Bacteriana da Expressão Gênica , Genes Bacterianos , Genes MDR , Gentamicinas/farmacologia , Canamicina/farmacologia , Raízes de Plantas/microbiologia , Reação em Cadeia da Polimerase , Deleção de SequênciaRESUMO
Rhizobia are able to infect legume roots, elicit root nodules, and live therein as endosymbiotic, nitrogen-fixing bacteroids. Host recognition and specificity are the results of early programming events in bacteria and plants, in which important signal molecules play key roles. Here, we introduce a new aspect of this symbiosis: the adaptive response to hosts. This refers to late events in bacteroids in which specific genes are transcribed and translated that help the endosymbionts to meet the disparate environmental requirements imposed by the hosts in which they live. The host-adaptation concept was elaborated with Bradyrhizobium japonicum and three different legumes (soybean, cowpea, and siratro). Transcriptomes and proteomes in root-nodule bacteroids were analyzed and compared, and genes and proteins were identified which are specifically induced in only one of the three hosts. We focused on those determinants that were congruent in the two data sets of host-specific transcripts and proteins: seven for soybean, five for siratro, and two for cowpea. One gene cluster for a predicted ABC-type transporter, differentially expressed in siratro, was deleted in B. japonicum. The respective mutant had a symbiotic defect on siratro rather than on soybean or cowpea. This result demonstrates the value of the applied approach and corroborates the host-specific adaptation concept.
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Adaptação Fisiológica/fisiologia , Proteínas de Bactérias/metabolismo , Bradyrhizobium/metabolismo , Perfilação da Expressão Gênica , Regulação Bacteriana da Expressão Gênica/fisiologia , Adaptação Fisiológica/genética , Proteínas de Bactérias/genética , Fabaceae/microbiologia , Nodulação/fisiologia , Especificidade da EspécieRESUMO
Bradyrhizobium japonicum, a gram-negative soil bacterium that establishes an N(2)-fixing symbiosis with its legume host soybean (Glycine max), has been used as a symbiosis model system. Using a sensitive geLC-MS/MS proteomics approach, we report the identification of 2315 B. japonicum strain USDA110 proteins (27.8% of the theoretical proteome) that are expressed 21 days post infection in symbiosis with soybean cultivated in growth chambers, substantially expanding the previously known symbiosis proteome. Integration of transcriptomics data generated under the same conditions (2780 expressed genes) allowed us to compile a comprehensive expression profile of B. japonicum during soybean symbiosis, which comprises 3587 genes/proteins (43% of the predicted B. japonicum genes/proteins). Analysis of this data set revealed both the biases and the complementarity of these global profiling technologies. A functional classification and pathway analysis showed that most of the proteins involved in carbon and nitrogen metabolism are expressed, including a complete set of tricarboxylic acid cycle enzymes, several gluconeogenesis and pentose phosphate pathway enzymes, as well as several proteins that were previously not considered to be present during symbiosis. Congruent results were obtained for B. japonicum bacteroids harvested from soybeans grown under field conditions.
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Bradyrhizobium/metabolismo , Perfilação da Expressão Gênica/métodos , Glycine max/microbiologia , Proteômica/métodos , Proteínas de Bactérias/metabolismo , Bradyrhizobium/genética , Carbono/metabolismo , Cromatografia Líquida , Bases de Dados de Proteínas , Ponto Isoelétrico , Redes e Vias Metabólicas , Peso Molecular , Nitrogênio/metabolismo , Fixação de Nitrogênio , Ácidos Nucleicos/metabolismo , Nódulos Radiculares de Plantas/metabolismo , Simbiose , Espectrometria de Massas em TandemRESUMO
The marked activity of [meso-1, 2-bis(2, 6-difluoro-3-hydroxyphenyl)ethylenediamine]platinum(II) (meso-3-PtLL', L, L' = Cl(2) or L = OH(2), L' = OSO(3)) on the hormone-sensitive MXT-M-3, 2 breast cancer implanted in mice is most probably due to a mechanism based on the reduction of the endogenous estrogen level. Cytotoxic effects which are poorly pronounced in experiments on several breast cancer cell lines (e.g. MCF-7), do not significantly contribute to the anti-breast cancer activity of this compound. In contrast to this, the standard cisplatin and the structurally related comparison compound [meso-1, 2-bis(4-fluorophenyl)ethylenediamine]platinum(II) (meso-4-PtLL', L, L' = Cl(2) or L = OH(2), L' = OSO(3)) are strongly active in vivo as well as in vitro. Both effects entail programmed cell death, which is responsible for the inhibition of the tumor growth. The minor cytotoxicity of meso-3-PtLL' in breast cancer cell cultures is caused neither by an inappropriate rate of reaction with bionucleophiles (e.g. by a too fast inactivation by plasma proteins) nor solely by the observed poor absorption by the tumor cells resulting in an insufficient drug concentration at the DNA. Additionally, an impeded reaction with biologically important, guanine-rich sequences of DNA (owing to the 2, 6-standing F atoms which hinder the drug-target inter action) must be assumed as cause of its marginal cytotoxicity.
Assuntos
Antineoplásicos Hormonais/farmacologia , Neoplasias Mamárias Experimentais/tratamento farmacológico , Neoplasias Hormônio-Dependentes/tratamento farmacológico , Compostos Organoplatínicos/farmacologia , Absorção , Animais , Antineoplásicos Hormonais/química , Antineoplásicos Hormonais/farmacocinética , Morte Celular , Linhagem Celular Tumoral , DNA de Neoplasias/metabolismo , Feminino , Camundongos , Estereoisomerismo , Relação Estrutura-AtividadeRESUMO
Aqua[meso-1, 2-bis(2, 6-difluoro-3-hydroxyphenyl)ethylenediamine]sulfatoplatinum(II) (meso-3-PtSO(4)) and its racemate (rac-3-PtSO(4)) are highly active on the hormone-sensitive MXT-M-3, 2 breast cancer of the mouse. In vitro, on the MXT(+) cell culture derived from this tumor, however, they are inactive (meso-3-PtSO(4)) or moderately active (rac-3-PtSO(4)) in concentrations corresponding to levels of these drugs in animal experiments. The in vivo effect is mainly caused by a reduction of the endogenous estrogen level in the host animals due to an interference with the ovarian steroid biosynthesis as demonstrated for meso-3-PtSO(4). Therefore, a reversal of the breast cancer inhibiting effect of meso-3-PtSO(4) can be achieved by simultaneous estrone administration. Histological results on ovaries, uterus, and tumor of meso-3-PtSO(4)-treated mice also favor such a mode of action. However, especially for rac-3-PtSO(4) cytotoxic effects contributing to the anti-breast cancer activity cannot be excluded. Considerations on the mode of action of Pt-complexes which inhibit breast cancer by interference with estrogen receptor mediated processes of growth control and with DNA replication are presented.