Psychological Therapies Used for the Reduction of Habitual Cigarette Smoking Cigarette Consumption: A Systematic Review.

Globally, there are around 1.3 billion cigarette consumers, indicating it to be the second highest risk factor for early death and morbidity. Meanwhile, psychological therapy offers tools based on its different models and techniques, which can contribute to smoking cessation. In this context, this study gathers scientific evidence to identify psychological therapies that can be used to reduce cigarette consumption. A systematic review of controlled clinical studies was conducted, implementing the PRISMA methodology. Search queries were performed with terms extracted from MESH (Medical Subject Headings) and DECS (Descriptors in Health Sciences). Subsequently, the search was queried in the scientific databases of Medline/PubMed, Cochrane, Scopus, Science Direct, ProQuest, and PsycNet, with subsequent verification of methodological quality using the Joanna Briggs Institute checklists. The selected documents revealed that cognitive behavioral therapy prevails due to its use and effectiveness in seven publications (25%). The cognitive approach with mindfulness therapy is found in 4 publications (14%), the transtheoretical model with motivational therapy in 4 publications (14%), brief psychological therapy in 3 publications (10%), and the remaining 10 documents (37%) correspond with others. Intervention studies refer to cognitive behavioral therapy as the most used in reducing cigarette consumption; in terms of the duration of abstinence, scientific evidence shows beneficial effects with short-term reduction.

The synergy of halotolerant PGPB and mauran mitigates salt stress in tomato (Solanum lycopersicum) via osmoprotectants accumulation.

Salinity stress is one of the major abiotic factors limiting sustainable agriculture. Halotolerant plant growth-promoting bacteria (PGPB) increased salt stress tolerance in plants, but the mechanisms underlying the tolerance are poorly understood. This study investigated the PGP activity of four halotolerant bacteria under salinity stress and the tomato salt-tolerance mechanisms induced by the synergy of these bacteria with the exopolysaccharide (EPS) mauran. All PGPB tested in this study were able to offer a significant improvement of tomato plant biomass under salinity stress; Peribacillus castrilensis N3 being the most efficient one. Tomato plants treated with N3 and the EPS mauran showed greater tolerance to NaCl than the treatment in the absence of EPS and PGPB. The synergy of N3 with mauran confers salt stress tolerance in tomato plants by increasing sodium transporter genes' expression and osmoprotectant content, including soluble sugars, polyols, proline, GABA, phenols and the polyamine putrescine. These osmolytes together with the induction of sodium transporter genes increase the osmotic adjustment capacity to resist water loss and maintain ionic homeostasis. These findings suggest that the synergy of the halotolerant bacterium N3 and the EPS mauran could enhance tomato plant growth by mitigating salt stress and could have great potential as an inductor of salinity tolerance in the agriculture sector.

Postharvest Treatment with Abscisic Acid Alleviates Chilling Injury in Zucchini Fruit by Regulating Phenolic Metabolism and Non-Enzymatic Antioxidant System.

Reports show that phytohormone abscisic acid (ABA) is involved in reducing zucchini postharvest chilling injury. During the storage of harvested fruit at low temperatures, chilling injury symptoms were associated with cell damage through the production of reactive oxygen species. In this work, we have studied the importance of different non-enzymatic antioxidants on tolerance to cold stress in zucchini fruit treated with ABA. The application of ABA increases the antioxidant capacity of zucchini fruit during storage through the accumulation of ascorbate, carotenoids and polyphenolic compounds. The quantification of specific phenols was performed by UPLC/MS-MS, observing that exogenous ABA mainly activated the production of flavonoids. The rise in all these non-enzymatic antioxidants due to ABA correlates with a reduction in oxidative stress in treated fruit during cold stress. The results showed that the ABA mainly induces antioxidant metabolism during the first day of exposure to low temperatures, and this response is key to avoiding the occurrence of chilling injury. This work suggests an important protective role of non-enzymatic antioxidants and polyphenolic metabolism in the prevention of chilling injury in zucchini fruit.

Expression of toll like receptor 8 (TLR8) in specific groups of mouse hippocampal interneurons.

Toll-like receptors (TLR) are one of the main constituents of the innate immune system in mammals. They can detect conserved microbial structures (pathogen-associated molecular patterns) and host-derived ligands that are produced during cellular stress and damage (danger-associated molecular patterns) and may then initiate an intracellular signaling cascade leading to the expression of pro-inflammatory cytokines and immediate immune responses. Some TLR (TLR1, 2, 4, 5, and 6) are expressed on the cell surface while others (TLR3, 7, 8 and 9) are present on the surface of endosomes and their ligands require internalization before recognition is possible. Several TLR have also been detected in neurons where they may serve functions that are not related to immune responses. TLR2, 3, and 4 have been described in cortical neurons and, for TLR4, a seizure-promoting role in epilepsies associated with inflammation has been shown. TLR3, 7, and 8 expressed in neurons seem to influence the growth or withdrawal of neurites and robust activation of TLR8 in neurons may even induce neuronal death. The goal of the current study was to investigate the expression of TLR8 in the hippocampus of mice during postnatal development and in adulthood. We focused on three functionally distinct groups of GABAergic interneurons characterized by the expression of the molecular markers parvalbumin, somatostatin, or calretinin, and we applied double fluorescence immunohistochemistry and cell counts to quantify co-expression of TLR8 in the three groups of GABA-interneurons across hippocampal subregions. We found subregion-specific differences in the expression of TLR8 in these interneurons. During postnatal development, TLR8 was detected only in mice older than P5. While only a small fraction of hippocampal calretinin-positive interneurons expressed TLR8, most parvalbumin-positive interneurons in all hippocampal subregions co-expressed TLR8. Somatostatin-positive interneurons co-expressing TLR8 were mainly present in hippocampal sector CA3 but rare in the dentate gyrus and CA1. High expression of TLR8 in parvalbumin-interneurons may contribute to their high vulnerability in human temporal lobe epilepsy.

Targeting Toll-like Receptor (TLR) Pathways in Inflammatory Arthritis: Two Better Than One?

Inflammatory arthritis is a cluster of diseases caused by unregulated activity of the immune system. The lost homeostasis is followed by the immune attack of one's self, what damages healthy cells and tissues and leads to chronic inflammation of various tissues and organs (e.g., joints, lungs, heart, eyes). Different medications to control the excessive immune response are in use, however, drug resistances, flare-reactions and adverse effects to the current therapies are common in the affected patients. Thus, it is essential to broaden the spectrum of alternative treatments and to develop disease-modifying drugs. In the last 20 years, the involvement of the innate immune receptors TLRs in inflammatory arthritis has been widely investigated and targeting either the receptor itself or the proteins in the downstream signalling cascades has emerged as a promising therapeutic strategy. Yet, concerns about the use of pharmacological agents that inhibit TLR activity and may leave the host unprotected against invading pathogens and toxicity issues amid inhibition of downstream kinases crucial in various cellular functions have arisen. This review summarizes the existing knowledge on the role of TLRs in inflammatory arthritis; in addition, the likely druggable related targets and the developed inhibitors, and discusses the pros and cons of their potential clinical use.

A case report of pseudoaneurysm after a core needle biopsy of breast cancer.

Breast pseudoaneurysms after a core needle biopsy are a rare complication with a low incidence. However, it is important to be aware of the possibility of complications that require treatment.

Developments in anticancer vaccination: budding new adjuvants.

The immune system has a limited capacity to recognize and fight cells that become cancerous and in cancer patients, the immune system has to seek the right balance between cancer rejection and host-immunosupression. The tumor milieu builds a protective shell and tumor cells rapidly accumulate mutations that promote antigen variability and immune-escape. Therapeutic vaccination of cancer is a promising strategy the success of which depends on a powerful activation of the cells of the adaptive immune system specific for tumor-cell detection and killing (e.g. CD4+ and CD8+ T-cells). In the last decades, the search for novel adjuvants that enhance dendritic cell (DC) function and their ability to prime T-cells has flourished and some Toll-like receptor (TLR) agonists have long been known to be valid immune adjuvants. The implementation of TLR-synthetic agonists in clinical studies of cancer vaccination is replacing the initial use of microbial-derived products with some encouraging results. The purpose of this review is to summarize the latest discoveries of TLR-synthetic agonists with adjuvant potential in anti-cancer vaccination.

INH14, a Small-Molecule Urea Derivative, Inhibits the IKKα/ß-Dependent TLR Inflammatory Response.

N-(4-Ethylphenyl)-N'-phenylurea (INH14) is a fragment-like compound that inhibits the toll-like receptor 2 (TLR2)-mediated inflammatory activity and other inflammatory pathways (i.e., TLR4, TNF-R and IL-1R). In this study, we determined the molecular target of INH14. Overexpression of proteins that are part of the TLR2 pathway in cells treated with INH14 indicated that the target lay downstream of the complex TAK1/TAB1. Immunoblot assays showed that INH14 decreased IkBα degradation in cells activated by lipopeptide (TLR2 ligand). These data indicated the kinases IKKα and/or IKKß as the targets of INH14, which was confirmed with kinase assays (IC50 IKKα=8.97 µm; IC50 IKKß=3.59 µm). Furthermore, in vivo experiments showed that INH14 decreased TNFα formed after lipopeptide-induced inflammation, and treatment of ovarian cancer cells with INH14 led to a reduction of NF-kB constitutive activity and a reduction in the wound-closing ability of these cells. These results demonstrate that INH14 decreases NF-kB activation through the inhibition of IKKs. Optimization of INH14 could lead to potent inhibitors of IKKs that might be used as antiinflammatory drugs.

Demoras en mortalidad materna en el departamento de Santander 2012 a 2015 / Delays related to maternal mortality in the department of Santander from 2012 to 2015

RESUMEN Objetivo Caracterizar las muertes maternas en el departamento de Santander y las demoras que contribuyeron a dichas muertes, durante los años 2012 a 2015, mediante los análisis de las atenciones en salud, con el fin de ofrecer un insumo que permita plantear acciones para disminuir desenlaces fatales. Materiales y Métodos Estudio descriptivo, retrospectivo, de corte transversal, en el cual se determinaron las características de la mortalidad materna en las mujeres gestantes o en puerperio a quienes se les realizaron unidades de análisis completas y que no fueron por causas externas o violentas. Resultados La demora que más se presentó en los 49 casos de muertes maternas fue la tipo IV relacionada con recibir un tratamiento médico adecuado y oportuno (87,8%), debido principalmente a deficiencias en los servicios de promoción y prevención (63,2%). La mayor parte de las muertes fueron evitables (61,2%), en el puerperio (84%) y en usuarias del régimen subsidiado (57,1%). Conclusiones Las mujeres afiliadas al régimen subsidiado presentaron mayor frecuencia del evento, lo cual refleja que existen importantes oportunidades de mejora en la atención que se brinda a las gestantes en el régimen subsidiado.(AU)

ABSTRACT Objective To characterize maternal deaths in the department of Santander, Colombia, and the delays that contributed to these deaths during the period 2012-2015, through a systematic review of health care, in order to offer an input that allows proposing actions that contribute to reduce these fatal outcomes. Materials and Methods Descriptive, retrospective, cross-sectional study that determines the characteristics of maternal mortality in pregnant or postpartum women who were administered complete analysis units and whose death was not caused by external or violent causes. Results The most frequent delay in the 49 cases of maternal deaths was type IV, which refers to the delay in receiving adequate and timely medical treatment (87.8%), mainly due to deficiencies in promotion and prevention strategies (63.2%). The majority of the deaths were avoidable (61.2%) in the puerperium (84%), and in users of the subsidized insurance scheme (57.1%). Conclusions Although 98% of mothers were affiliated to the health system (subsidized, contributory, special or exceptional schemes), it was possible to demonstrate that women who were affiliated to the subsidized regime showed a greater frequency of the event, which reflects that there are important opportunities for improvement in the care provided to pregnant women in this type of scheme.(AU)

[Delays related to maternal mortality in the department of Santander from 2012 to 2015]. / Demoras en mortalidad materna en el departamento de Santander 2012 a 2015.

OBJECTIVE: To characterize maternal deaths in the department of Santander, Colombia, and the delays that contributed to these deaths during the period 2012-2015, through a systematic review of health care, in order to offer an input that allows proposing actions that contribute to reduce these fatal outcomes. MATERIALS AND METHODS: Descriptive, retrospective, cross-sectional study that determines the characteristics of maternal mortality in pregnant or postpartum women who were administered complete analysis units and whose death was not caused by external or violent causes. RESULTS: The most frequent delay in the 49 cases of maternal deaths was type IV, which refers to the delay in receiving adequate and timely medical treatment (87.8%), mainly due to deficiencies in promotion and prevention strategies (63.2%). The majority of the deaths were avoidable (61.2%) in the puerperium (84%), and in users of the subsidized insurance scheme (57.1%). CONCLUSIONS: Although 98% of mothers were affiliated to the health system (subsidized, contributory, special or exceptional schemes), it was possible to demonstrate that women who were affiliated to the subsidized regime showed a greater frequency of the event, which reflects that there are important opportunities for improvement in the care provided to pregnant women in this type of scheme.

OBJETIVO: Caracterizar las muertes maternas en el departamento de Santander y las demoras que contribuyeron a dichas muertes, durante los años 2012 a 2015, mediante los análisis de las atenciones en salud, con el fin de ofrecer un insumo que permita plantear acciones para disminuir desenlaces fatales. MATERIALES Y MÉTODOS: Estudio descriptivo, retrospectivo, de corte transversal, en el cual se determinaron las características de la mortalidad materna en las mujeres gestantes o en puerperio a quienes se les realizaron unidades de análisis completas y que no fueron por causas externas o violentas. RESULTADOS: La demora que más se presentó en los 49 casos de muertes maternas fue la tipo IV relacionada con recibir un tratamiento médico adecuado y oportuno (87,8%), debido principalmente a deficiencias en los servicios de promoción y prevención (63,2%). La mayor parte de las muertes fueron evitables (61,2%), en el puerperio (84%) y en usuarias del régimen subsidiado (57,1%). CONCLUSIONES: Las mujeres afiliadas al régimen subsidiado presentaron mayor frecuencia del evento, lo cual refleja que existen importantes oportunidades de mejora en la atención que se brinda a las gestantes en el régimen subsidiado.

Percepción de autoeficacia vs. rechazo del uso del condón en las prácticas sexuales de mujeres y hombres jóvenes / Self-efficacy perception vs. rejection of condom use in the sexual practices of young women and men

Resumen En las relaciones sexuales de jóvenes, las variables asociadas al uso del condón son diversas y comúnmente se presentan con otras variables que, a su vez, se asocian con la práctica sexual desprotegida. Los objetivos de este estudio consistieron en determinar en qué medida la percepción de autoeficacia, la baja percepción de riesgo y el rechazo del uso del condón se relacionan con el uso del condón en las relaciones sexuales de jóvenes colombianos. Participaron en él 308 estu diantes universitarios de la ciudad de Cúcuta, Colombia. Los resultados indican correlaciones significativas en hombres entre el uso del condón y la percepción de autoeficacia, y correlaciones negativas en mujeres entre el uso del condón, la baja percepción de riesgo y el rechazo del uso del condón. Solo en el grupo de hombres, la percepción de autoeficacia predice el uso del condón.

Abstract In the sexual relations of the youth, the variables associated with condom use are diverse and are often presented with other variables, that are also associated with unprotected sexual practice. This study aimed to determine to what extent the perception of self-efficacy, low risk perception and condom use shunning are associated with condom use in sexual relations of young Colom bians. 308 university students in the city of Cúcuta, Colombia, participated in the study. The results indicate significant correlations in men between condom use and self-efficacy perception and negative correlations in women between condom use, low risk perception and condom use shunning. Only in the male groups, the perception of self-efficacy predicts condom use.

A coordinated transition model for patients with cystinosis: from pediatrics to adult care. / Transición coordinada del paciente con cistinosis desde la medicina pediátrica a la medicina del adulto.

INTRODUCTION: Improved outcome and longer life-expectancy in patients with cystinosis, and disease complexity itself, justify planning a guided-transition of affected patients from Pediatrics to adult medicine. The aims of the process are to guarantee the continuum of care and patient empowerment, moving from guardian-care to self-care. METHODS: review of articles, expert opinion and anonymous surveys of patients, relatives and patient advocacy groups. RESULTS: elaboration a new document to support and coordinate the transition of patients with cystinosis providing specific proposals in a variety of medical fields, and adherence promotion. Nephrologists play a key role in transition due the fact that most cystinotic patients suffer severe chronic kidney disease, and need kidney transplantation before adulthood. CONCLUSION: we present a document providing recommendations and suggesting a chronogram to help the process of transition of adolescents and young adults with cystinosis in our area.

Prospective virtual screening in a sparse data scenario: design of small-molecule TLR2 antagonists.

Toll-like receptors (TLRs) are critical signaling molecules with roles in various severe clinical conditions such as sepsis and rheumatoid arthritis, and have therefore been advocated as promising drug targets for the treatment of these diseases. The aim of this study was to discover small-molecule antagonists of TLR2 by computer-aided drug design. This goal poses several challenges due to the lack of available data on TLR2 modulators. To overcome these hurdles we developed a combined structure- and ligand-based virtual screening approach. First, we calculated molecular interaction fields of the TLR2 binding site to derive a structure-based 3D pharmacophore, which was then used for virtual screening. We then performed a two-step shape- and feature-based similarity search using known TLR2 ligands as query structures. A selection of virtual screening hits was biologically tested in a cell-based assay for TLR2 signaling inhibition, leading to the identification of several compounds with antagonistic activity (IC50 values) in the low-micromolar range.

Insulin modulates the inflammatory granulocyte response to streptococci via phosphatidylinositol 3-kinase.

Group B streptococci (GBS; Streptococcus agalactiae) are a major cause of invasive infections in newborn infants and in patients with type 2 diabetes. Both patient groups exhibit peripheral insulin resistance and alterations in polymorphonuclear leukocyte (PML) function. In this investigation, we studied the PML response repertoire to GBS with a focus on TLR signaling and the modulation of this response by insulin in mice and humans. We found that GBS-induced, MyD88-dependent chemokine formation of PML was specifically downmodulated by insulin via insulin receptor-mediated induction of PI3K. PI3K inhibited transcription of chemokine genes on the level of NF-κB activation and binding. Insulin specifically modulated the chemokine response of PML to whole bacteria, but affected neither activation by purified TLR agonists nor antimicrobial properties, such as migration, phagocytosis, bacterial killing, and formation of reactive oxygen species. The targeted modulation of bacteria-induced chemokine formation by insulin via PI3K may form a basis for the development of novel targets of adjunctive sepsis therapy.

Novel pharmacological chaperones that correct phenylketonuria in mice.

Phenylketonuria (PKU) is caused by inherited phenylalanine-hydroxylase (PAH) deficiency and, in many genotypes, it is associated with protein misfolding. The natural cofactor of PAH, tetrahydrobiopterin (BH(4)), can act as a pharmacological chaperone (PC) that rescues enzyme function. However, BH(4) shows limited efficacy in some PKU genotypes and its chemical synthesis is very costly. Taking an integrated drug discovery approach which has not been applied to this target before, we identified alternative PCs for the treatment of PKU. Shape-focused virtual screening of the National Cancer Institute's chemical library identified 84 candidate molecules with potential to bind to the active site of PAH. An in vitro evaluation of these yielded six compounds that restored the enzymatic activity of the unstable PAHV106A variant and increased its stability in cell-based assays against proteolytic degradation. During a 3-day treatment study, two compounds (benzylhydantoin and 6-amino-5-(benzylamino)-uracil) substantially improved the in vivo Phe oxidation and blood Phe concentrations of PKU mice (Pah(enu1)). Notably, benzylhydantoin was twice as effective as tetrahydrobiopterin. In conclusion, we identified two PCs with high in vivo efficacy that may be further developed into a more effective drug treatment of PKU.

Efectividad de la funcionalidad familiar de persona que ha intentado suicidarse / The effectiveness in the functionality of families with a who has tried to commit suicide

Introducción: Para Friedemann toda familia se conforma para funcionar adecuadamente en las dimensiones que la autora ha identificado en su teoría, existiendo momentos críticos cuando uno de sus miembros intenta suicidarse. Ante esta situación surge el siguiente objetivo: determinar y analizar la efectividad del funcionamiento familiar con la persona que ha intentado suicidar. Metodología: Se diseñó un estudio descriptivo transversal, con muestreo por conveniencia, con la utilización la ficha sociodemográfica de convivencia familiar y la Escala de Evaluación de la Efectividad de la Funcionalidad Familiar. En total fueron 23 familias donde una persona ha intentado suicidarse. Resultados: La efectividad de la funcionalidad familiar fue baja en el 60,9% de las familias, debido a que presentaron dificultades en su estabilidad y crecimiento familiar. Conclusiones: Las familias se resisten a modificar sus patrones y costumbres y tienen dificultades en la comunicación asertiva.

Introduction: For Friedemann a family is made up with the purpose of performing adequately in the dimensions that the author has identified in her theory, but some critical problems appear when one of the members of that family tries to commit suicide. When such a situation arises, an objective takes place to determine and analyze the way the individual´s family works. Methodology: A transversal descriptive study was designed using a convenient sampling of the individual´s family´s convenience social demographic form and the Evaluation Scale for the Effectiveness of the Family´s Function. Twenty three families had a person who had tried suicide. Results: The effectiveness of the family´s function was low in a 60.9% of the families because some difficulties appeared when trying to establish their stability and growth. Conclusions: The families refused to modify their patterns and customs and showed difficulties in their assertive communication.

Mal connects TLR2 to PI3Kinase activation and phagocyte polarization.

The recognition of bacterial lipoproteins by toll-like receptor (TLR) 2 is pivotal for inflammation initiation and control in many bacterial infections. TLR2-dependent signalling is currently believed to essentially require both adaptor proteins MyD88 (myeloid differentiation primary response gene 88) and Mal/TIRAP (MyD88-adapter-like/TIR-domain-containing adaptor protein). TLR2-dependent, but MyD88-independent responses have not been described yet. We report here on a novel-signalling pathway downstream of TLR2, which does not adhere to the established model. On stimulation of the TLR2/6 heterodimer with diacylated bacterial lipoproteins, Mal directly interacts with the regulatory subunit of phosphoinositide 3-kinase (PI3K), p85alpha, in an inducible fashion. The Mal-p85alpha interaction drives PI3K-dependent phosphorylation of Akt, phosphatidylinositol(3,4,5)P3 (PIP(3)) generation and macrophage polarization. MyD88 is not essential for PI3K activation and Akt phosphorylation; however, cooperates with Mal for PIP(3) formation and accumulation at the leading edge. In contrast to TLR2/6, TLR2/1 does not require Mal or MyD88 for Akt phosphorylation. Hence, Mal specifically connects TLR2/6 to PI3K activation, PIP(3) generation and macrophage polarization.

Role of p38 and early growth response factor 1 in the macrophage response to group B streptococcus.

Group B streptococcus (GBS), the most frequent single isolate in neonatal sepsis and meningitis, potently activates inflammatory macrophage genes via myeloid differentiation antigen 88 (MyD88). However, events parallel to and downstream of MyD88 that instruct the macrophage response are incompletely understood. In this study, we found that only MyD88, not the Toll-like receptor (TLR) adapter proteins MAL/TIRAP, TRIF, and TRAM, essentially mediates the cytokine (tumor necrosis factor [TNF] and interleukin-6) and chemokine (RANTES) responses to whole GBS organisms, although MAL, TRIF, and TRAM have been shown to mediate the responses to substructures in other gram-positive and gram-negative bacteria. GBS-induced, MyD88-dependent phosphorylation of the mitogen-activated protein kinase p38 activated the transcription factor AP-1 and early growth response factor 1 (Egr-1) but not NF-kappaB. Furthermore, phosphorylation of Ets-like molecule 1 (Elk-1) was mediated by p38. However, in contrast to Egr-1 and AP-1, Elk-1 was dispensable for transcriptional activation of TNF by GBS organisms. Studies of macrophages from Elk-1-deficient mice revealed that Elk-1 was furthermore nonessential for the TNF responses to purified TLR2 and TLR4 agonists, which was in notable contrast to what was revealed in studies employing in vitro expression systems. In conclusion, MyD88, p38, and Egr-1, but not Elk-1, essentially mediate the inflammatory cytokine response to GBS organisms.

Lipoproteins are critical TLR2 activating toxins in group B streptococcal sepsis.

Group B streptococcus (GBS) is the most important cause of neonatal sepsis, which is mediated in part by TLR2. However, GBS components that potently induce cytokines via TLR2 are largely unknown. We found that GBS strains of the same serotype differ in released factors that activate TLR2. Several lines of genetic and biochemical evidence indicated that lipoteichoic acid (LTA), the most widely studied TLR2 agonist in Gram-positive bacteria, was not essential for TLR2 activation. We thus examined the role of GBS lipoproteins in this process by inactivating two genes essential for bacterial lipoprotein (BLP) maturation: the prolipoprotein diacylglyceryl transferase gene (lgt) and the lipoprotein signal peptidase gene (lsp). We found that Lgt modification of the N-terminal sequence called lipobox was not critical for Lsp cleavage of BLPs. In the absence of lgt and lsp, lipoprotein signal peptides were processed by the type I signal peptidase. Importantly, both the Deltalgt and the Deltalsp mutant were impaired in TLR2 activation. In contrast to released factors, fixed Deltalgt and Deltalsp GBS cells exhibited normal inflammatory activity indicating that extracellular toxins and cell wall components activate phagocytes through independent pathways. In addition, the Deltalgt mutant exhibited increased lethality in a model of neonatal GBS sepsis. Notably, LTA comprised little, if any, inflammatory potency when extracted from Deltalgt GBS. In conclusion, mature BLPs, and not LTA, are the major TLR2 activating factors from GBS and significantly contribute to GBS sepsis.