[Paranoid personality disorder and criminal offense]. / Trouble de personnalité paranoïaque et infractions pénales.

BACKGROUND: Currently, all of the studies that focus on the relationship between paranoia and criminal offenses exclusively concern subjects suffering from a delusional paranoid disorder. However, subjects with single paranoid personality disorder, without any associated delusional disorder, are not uncommon in forensic practice. OBJECTIVES: This study aims to describe the offenses committed by subjects suffering from a single paranoid personality disorder and to compare them with the offenses committed by the subjects affected by a paranoid delusional disorder associated with paranoid personality disorder. Our initial hypothesis is that both populations have a comparable criminological profile. METHODS: Based on a 17 year-long experience carried out in the framework of a forensic assessment, we have selected all subjects presenting a paranoid personality disorder, whether single or associated with paranoid delusional disorder. The selected individuals were divided into two groups according to whether they presented paranoid delusional disorder or not. The offenses were grouped into criminal categories. The alpha risk was fixed at 1%. Data analysis is done by SAS software version 9.4. RESULTS: In a sample of 106 subjects presenting a paranoid personality disorder, including 4 women and 102 men, we found 79 subjects with a single paranoid personality and 27 with an associated paranoid delusional disorder. The average age at the time of the offense was 41 for those with single personality disorders and 49 for those with paranoid delusional disorders. Both groups had forensic antecedents (41%, 11/27 of paranoid delusional disorder and 51%, 40/79 of single paranoid personality disorder). Psychiatric history was more frequent in the paranoid delusional disorder group (59%, 16/27) than in the single paranoid personality disorder group (13%, 10/79). History of addiction was comparable in terms of alcohol abuse (26% in both groups) and other substances (7.5%, 2/27 of paranoid delusional disorder and 9%, 7/79 of single paranoid personality disorder). Comparison of the two groups highlighted significant differences in the type of criminal offenses committed (Fisher's exact test: P=0.0003, alpha risk <0.0001). The offenses committed by delusional authors essentially came down to verbal or physical violence, including homicide (44%, 12/27), and were usually focused on a designated persecutor. Sexual violence was rare. On the other hand, paranoid personality disorder was associated with a wider variety of offenses. Sexual offenses (including 28 rapes, 35%, 28/79) were thus almost as frequent as murder, and attempted murder (38%, 30/79). This diversity of committed offenses was found in their forensic antecedents. In these subjects, the logic of omnipotence may had over ruled the logic of revenge. CONCLUSION: We conducted a retrospective study on 106 subjects with paranoid personality disorder, including 27 subjects with associated paranoid delusional disorder. The comparison of the two groups demonstrated significant differences in offenses. Verbal and physical but non-sexual violence, committed in a delusional logic, was found among delusional subjects, while the forms of violence were more multiform in the single paranoid personality disorder group, frequently including sexual violence. This is, as far as we know, the first study describing the medico-legal acting-out of paranoid personalities. These results, which will need to be confirmed by future studies, point out the importance of the criminological risk that may be associated with paranoid personality disorder, without any associated delusional disorder.

Strategy for anti-aquaporin-4 auto-antibody identification and quantification using a new cell-based assay.

NMO-IgG is a specific biomarker of neuromyelitis optica (NMO) that targets the aquaporin-4 (AQP4) water channel protein. The current gold standard for NMO-IgG identification is indirect immunofluorescence (IIF). Our aim in this study was to develop a new quantitative cell-based assay (CBA) and to propose a rational strategy for anti-AQP4 Ab identification and quantification. We observed an excellent correlation between the CBA and IIF for NMO-IgG/anti-AQP4 detection. The CBA appeared more sensitive than IIF but on the other hand, IIF allows the simultaneous detection of various auto-Abs, underlining the complementarity between both methods. In conclusion, we propose to use IIF for the screening of patients at diagnosis in order to identify auto-Abs targeting the central nervous system. A highly sensitive, AQP4 specific and quantitative assay such as our CBA could be used thereafter to specifically identify the target of the Ab and to monitor its serum concentration under treatment.

NF-kappa B mediates up-regulation of CFTR gene expression in Calu-3 cells by interleukin-1beta.

Inflammation of the airways is a major feature of the inherited disease cystic fibrosis. Previous studies have shown that the pro-inflammatory cytokines tumor necrosis factor alpha and interferon gamma reduce the expression of the cystic fibrosis transmembrane conductance regulator (CFTR) gene (CFTR) in HT-29 and T84 cells by acting post-transcriptionally. We have investigated the effect of the pro-inflammatory peptide interleukin 1beta (IL-1beta) on the expression of the CFTR in Calu-3 cells. IL-1beta increased the production of CFTR mRNA in a dose- and time-dependent manner. Its action was inhibited by inhibitors of the NF-kappaB pathway, including N-acetyl-l-cysteine, pyrrolidine dithiocarbamate, and a synthetic cell-permeable peptide containing the NF-kappaB nuclear localization signal sequence. Gel shift analysis showed that IL-1beta activated NF-kappaB in Calu-3 cells, and transfection experiments using p50 and RelA expressing vectors showed that exogenous transfected NF-kappaB subunits increased the concentration of CFTR mRNA. Gel shift analysis with antibody supershifting also showed that IL-1beta caused the binding of NF-kappaB to a kappaB-like response element at position -1103 to -1093 in the CFTR 5'-flanking region. Transfection experiments using -2150 to +52 CFTR reporter gene constructs showed that the activity of the CFTR promoter is enhanced by exogenous transfected NF-kappaB and IL-1beta and that this enhancement is due, at least in part, to the -1103 to -1093 kappaB site. We conclude that the intracellular signaling that leads to increased CFTR mRNA in response to IL-1beta in Calu-3 cells includes the binding of NF-kappaB to the -1103 kappaB element and a subsequent increase in CFTR promoter activity.

[Arginine]vasopressin hydrolyses phosphoinositides in the medullary thick ascending limb of mouse nephron.

NaCl reabsorption across the thick ascending limb of Henle's loop (TAL) is stimulated by several hormones, in particular vasopressin acting through V2 receptors and cyclic AMP production. This study used suspensions of medullary TAL (mTAL) tubules from the mouse nephron to investigate the possibility that, besides activating adenylyl cyclase, vasopressin also stimulates phospholipase C via V1 receptor occupancy. Two different methods, phosphoinositide labelling and inositol trisphosphate (InsP3) radioimmunoassay, were used to show that [arginine]vasopressin (AVP) rapidly stimulated the formation of InsP3, which peaked at 200%-250% of control within the first minute of incubation with 10 nmol/l vasopressin at 37 degrees C, and declined to basal level after 5-10 min. Dose/response curves for InsP3, established at 30 degrees C and 37 degrees C using radioimmunoassay, showed a half-maximal stimulation of InsP3 production at about 1 nmol/l AVP and a maximal response at 10 nmol/l. Similar values were obtained for the response to AVP in terms of cAMP accumulation. InsP3 content in the presence of higher concentrations of AVP (1 mumol/l) was significantly lower (P < 0.001) than in the presence of 10 nmol/l AVP, giving a bell-shaped appearance to the dose/response curve at 37 degrees C but not at 30 degrees C. The V2 receptor agonist, 1-deamino-[8-D-Arg]vasopressin (dAVP) did not stimulate the formation of InsP3, and the V1 receptor antagonist d(CH2)5[Tyr(Me)2]AVP inhibited AVP-induced InsP3 formation, which therefore appeared to be mediated by V1 receptor occupancy. Under the same conditions, AVP also induced the formation of diradylglycerol via V1 receptor activation, with an analogous dose/response curve.(ABSTRACT TRUNCATED AT 250 WORDS)

A Ca2-activated cation-selective channel in the basolateral membrane of the cortical thick ascending limb of Henle's loop of the mouse.

The patch-clamp technique was used to investigate the properties of a cation-selective channel in the basolateral membrane of microdissected collagenase-treated fragments of cortical thick ascending limbs of Henle's loop from mouse kidney. The channel activity was seldom observed in cell-attached patches (2 out 15 studied cases). In inside-out excised patches immersed in symmetrical NaCl Ringer's solutions, the unit channel conductance was ohmic and ranged from 22 to 33 pS (mean, 26.8 +/- 0.6 pS, n = 24). When NaCl was replaced by KCl (n = 8) or sodium gluconate (n = 2) on the cytoplasmic side of the membrane, single-channel currents still reversed at 0 mV and the conductance was unchanged. The reversal potential was +28.8 +/- 0.4 mV (n = 8) when a NaCl concentration (140 vs. 42 mmol/l) gradient was applied, close to the expected value (approx. 30 mV) for a cation selective channel. The channel was found to discriminate poorly between Na+, K+, Cs+, and Li+ ions. The activity of the channel was not clearly voltage-dependent but was dependent upon the free Ca2+ concentration on the cytoplasmic side of the membrane. We conclude that the channel resembles the non-selective cation channel which has been previously described in several tissues.

Chloride distribution in the proximal convoluted tubule of Necturus kidney.

To assess the mechanism(s) by which intraluminal chloride concentration is raised above equilibrium values, intracellular Cl- activity (alpha iCl) was studied in the proximal tubule of Necturus kidney. Paired measurements of cell membrane PD (VBL) and Cl-selective electrode PD (VBLCl) were performed in single tubules, during reversible shifts of peritubular or luminal fluid composition. Steady-state alpha iCl was estimated at 14.6 +/- 0.6 mmol/liter, a figure substantially higher than that predicted for passive distribution. To determine the site of the uphill Cl- transport into the cell, an inhibitor of anion transport (SITS) was added to the perfusion fluid. Introduction of SITS in peritubular perfusate decreased alpha iCl, whereas addition of the drug in luminal fluid slightly increased alpha iCl; both results are consistent with basolateral membrane uphill Cl- transport from interstitium to the cell. TMA+ for Na+ substitutions in either luminal or peritubular perfusate had no effect on alpha iCl. Removal of bicarbonate from peritubular fluid, at constant pH (a situation increasing HCO3- outflux), resulted in an increase of alpha iCl, presumably related to enhanced Cl- cell influx: we infer that Cl- is exchanged against HCO3- at the basolateral membrane. The following mechanism is suggested to account for the rise in luminal Cl- concentration above equilibrium values: intracellular CO2 hydration gives rise to cell HCO3- concentrations above equilibrium. The passive exit of HCO3- at the basolateral membrane energizes an uphill entry of Cl- into the cell. The resulting increase of alpha iCl, above equilibrium, generates downhill Cl- diffusion from cell to lumen. As a result, luminal Cl- concentration also increases.

Characterization of stable conformational variants of erythrocyte carbonic anhydrases.

Limiting viscosity numbers of bovine and ovine erythrocytes carbonic anhydrase variants were calculated by the objective method of comparing viscosimetric data obtained from low-activity-human erythrocyte carbonic anhydrase and its natural variant. Shifts of mobilities and isoelectric points are shown for all species variants, but variations of limiting viscosity numbers were only detected for human and bovine variants. Results of the study are consistent with the observation that variants arise by deamidation of erythrocyte carbonic anhydrases, and that deamidation is responsible for changes in structure and hydration (i. e. "conformational" modifications). Thus, all the variants so far investigated are stable conformational variants or erythrocyte carbonic anhydrases.