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1.
J Phys Chem B ; 127(41): 8736-8748, 2023 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-37791815

RESUMO

Adrenaline acts on ß1 receptors in the heart muscle to enhance contractility, increase the heart rate, and increase the rate of relaxation (lusitropy) via activation of the cyclic AMP-dependent protein kinase, PKA. Phosphorylation of serines 22 and 23 in the N-terminal peptide of cardiac troponin I is responsible for lusitropy. Mutations associated with cardiomyopathy suppress the phosphorylation-dependent change. Key parts of troponin responsible for this modulatory system are disordered and cannot be resolved by conventional structural approaches. We performed all-atom molecular dynamics simulations (5 × 1.5 µs runs) of the troponin core (419 amino acids) in the presence of Ca2+ in the bisphosphorylated and unphosphorylated states for both wild-type troponin and the troponin C (cTnC) G159D mutant. PKA phosphorylation affects troponin dynamics. There is significant rigidification of the structure involving rearrangement of the cTnI(1-33)-cTnC interaction and changes in the distribution of the cTnC helix A/B angle, troponin I (cTnI) switch peptide (149-164) docking, and the angle between the regulatory head and ITC arm domains. The familial dilated cardiomyopathy cTnC G159D mutation whose Ca2+ sensitivity is not modulated by cTnI phosphorylation exhibits a structure inherently more rigid than the wild type, with phosphorylation reversing the direction of all metrics relative to the wild type.


Assuntos
Simulação de Dinâmica Molecular , Troponina I , Fosforilação , Troponina I/genética , Troponina I/metabolismo , Mutação , Miocárdio/metabolismo , Peptídeos/metabolismo , Cálcio/metabolismo
2.
Child Adolesc Ment Health ; 27(3): 256-258, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35871751

RESUMO

The debate articles in CAMH Journal, May 2022, have received some responses from contributors who are well known for their anti-diagnosis views concerning borderline personality disorder (BPD). Within these responses, we had hoped to see these campaigners try to test their worldview against our tragic experiences but we have been sadly disappointed. Our daughters actually lived in the world these campaigners hope to construct: a world where professionals behave as if BPD does not exist, a world where NICE Guidance for BPD is therefore entirely ignored. That world led to our daughters' deterioration and deaths. We address the main arguments against diagnosis as we have come to understand them and end with a plea to channel the passions of this debate into a solution that would have helped Sam and Chris.


Assuntos
Transtorno da Personalidade Borderline , Neoplasias , Humanos
3.
Arch Biochem Biophys ; 725: 109282, 2022 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-35577070

RESUMO

Tropomyosin, controlled by troponin-linked Ca2+-binding, regulates muscle contraction by a macromolecular scale steric-mechanism that governs myosin-crossbridge-actin interactions. At low-Ca2+, C-terminal domains of troponin-I (TnI) trap tropomyosin in a position on thin filaments that interferes with myosin-binding, thus causing muscle relaxation. Steric inhibition is reversed at high-Ca2+ when TnI releases from F-actin-tropomyosin as Ca2+ and the TnI switch-peptide bind to the N-lobe of troponin-C (TnC). The opposite end of cardiac TnI contains a phosphorylation-sensitive ∼30 residue-long N-terminal peptide that is absent in skeletal muscle, and likely modifies these interactions in hearts. Here, PKA-dependent phosphorylation of serine 23 and 24 modulates Ca2+ and possibly switch-peptide binding to TnC, causing faster relaxation during the cardiac-cycle (lusitropy). The cardiac-specific N-terminal TnI domain is not captured in crystal structures of troponin or in cryo-EM reconstructions of thin filaments; thus, its global impact on thin filament structure and function is uncertain. Here, we used protein-protein docking and molecular dynamics simulation-based protocols to build a troponin model that was guided by and hence consistent with the recent seminal Yamada structure of Ca2+-activated thin filaments. We find that when present on thin filaments, phosphorylated Ser23/24 along with adjacent polar TnI residues interact closely with both tropomyosin and the N-lobe of TnC during our simulations. These interactions would likely bias tropomyosin to an off-state positioning on actin. In situ, such enhanced relaxation kinetics would promote cardiac lusitropy.


Assuntos
Tropomiosina , Troponina I , Actinas/metabolismo , Cálcio/metabolismo , Simulação de Dinâmica Molecular , Peptídeos/metabolismo , Tropomiosina/química , Troponina C/metabolismo , Troponina I/química
4.
Antibiotics (Basel) ; 10(8)2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34439017

RESUMO

The need for synergy testing is driven by the necessity to extend the antimicrobial spectrum, reducing drug dosage/toxicity and the development of resistance. Despite the abundance of synergy testing methods, there is the absence of a gold standard and a lack of synergy correlation among methods. The most popular method (checkerboard) is labor-intensive and is not practical for clinical use. Most clinical laboratories use several gradient synergy methods which are quicker/easier to use. This study sought to evaluate three gradient synergy methods (direct overlay, cross, MIC:MIC ratio) with the checkerboard, and compare two interpretative criteria (the fractional inhibitory concentration index (FICI) and susceptibility breakpoint index (SBPI)) regarding these methods. We tested 70 multidrug-resistant Pseudomonas aeruginosa, using a tobramycin and ceftazidime combination. The agreement between the checkerboard and gradient methods was 60 to 77% for FICI, while agreements for SBPI that ranged between 67 and 82.86% were statistically significant (p ≤ 0.001). High kappa agreements were observed using SBPI (Ƙ > 0.356) compared to FICI (Ƙ < 0.291) criteria, and the MIC:MIC method demonstrated the highest, albeit moderate, intraclass correlation coefficient (ICC = 0.542) estimate. Isolate resistance profiles suggest method-dependent synergism for isolates, with ceftazidime susceptibility after increased exposure. The results show that when interpretative criteria are considered, gradient diffusion (especially MIC:MIC) is a valuable and practical method that can inform the treatment of cystic fibrosis patients who are chronically infected with P. aeruginosa.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33820772

RESUMO

Antimicrobial combination therapy is a time/resource-intensive procedure commonly employed in the treatment of cystic fibrosis (CF) pulmonary exacerbations caused by Pseudomonas aeruginosa Ten years ago, the most promising antimicrobial combinations were proposed, but there has since been the introduction of new ß-lactam plus ß-lactamase inhibitor antimicrobial combinations. The aims of this study were to (i) compare in vitro activity of these new antimicrobials with other antipseudomonal agents and suggest their most synergistic antimicrobial combinations and (ii) determine antimicrobial resistance rates and study inherent trends of antimicrobials over 10 years. A total of 721 multidrug-resistant P. aeruginosa isolates from 183 patients were collated over the study period. Antimicrobial susceptibility and combination testing were carried out using the Etest method. The results were further assessed using the fractional inhibitory concentration index (FICI) and the susceptible breakpoint index (SBPI). Resistance to almost all antimicrobial agents maintained a similar level during the studied period. Colistin (P < 0.001) and tobramycin (P = 0.001) were the only antimicrobials with significant increasing isolate susceptibility, while an increasing resistance trend was observed for levofloxacin. The most active antimicrobials were colistin, ceftolozane-tazobactam, ceftazidime-avibactam, and gentamicin. All combinations with ß-lactam plus ß-lactamase inhibitors produced some synergistic results. Ciprofloxacin plus ceftolozane-tazobactam (40%) and amikacin plus ceftazidime (36.7%) were the most synergistic combinations, while colistin combinations gave the best median SBPI (50.11). This study suggests that effective fluoroquinolone stewardship should be employed for CF patients. It also presents in vitro data to support the efficacy of novel combinations for use in the treatment of chronic P. aeruginosa infections.


Assuntos
Fibrose Cística , Infecções por Pseudomonas , Antibacterianos/farmacologia , Ceftazidima/farmacologia , Cefalosporinas/farmacologia , Farmacorresistência Bacteriana , Farmacorresistência Bacteriana Múltipla , Humanos , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa
6.
Sci Rep ; 10(1): 18450, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33116198

RESUMO

Phosphatidylinositol phosphates (PIPs) are membrane phospholipids that play crucial roles in a wide range of cellular processes. Their function is dictated by the number and positions of the phosphate groups in the inositol ring (with seven different PIPs being active in the cell). Therefore, there is significant interest in developing small-molecule receptors that can bind selectively to these species and in doing so affect their cellular function or be the basis for molecular probes. However, to date there are very few examples of such molecular receptors. Towards this aim, herein we report a novel tripodal molecule that acts as receptor for mono- and bis-phosphorylated PIPs in a cell free environment. To assess their affinity to PIPs we have developed a new cell free assay based on the ability of the receptor to prevent alkaline phosphatase from hydrolysing these substrates. The new receptor displays selectivity towards two out of the seven PIPs, namely PI(3)P and PI(3,4)P2. To rationalise these results, a DFT computational study was performed which corroborated the experimental results and provided insight into the host-guest binding mode.


Assuntos
Fosfatos de Fosfatidilinositol/química
7.
Antimicrob Agents Chemother ; 64(11)2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-32816722

RESUMO

Achromobacter spp. are recognized as emerging pathogens in patients with cystic fibrosis (CF). Though recent works have established species-level identification using nrdA sequencing, there is a dearth in knowledge relating to species-level antimicrobial susceptibility patterns and antimicrobial combinations, which hampers the use of optimal antimicrobial combinations for the treatment of chronic infections. The aims of this study were to (i) identify at species-level referred Achromobacter isolates, (ii) describe species-level antimicrobial susceptibility profiles, and (iii) determine the most promising antimicrobial combination for chronic Achromobacter infections. A total of 112 multidrug-resistant (MDR) Achromobacter species isolates from 39 patients were identified using nrdA sequencing. Antimicrobial susceptibility and combination testing were carried out using the Etest method. We detected six species of Achromobacter and found that Achromobacter xylosoxidans was the most prevalent species. Interestingly, sequence analysis showed it was responsible for persistent infection (18/28 patients), followed by Achromobacter ruhlandii (2/3 patients). Piperacillin-tazobactam (70.27%) and co-trimoxazole (69.72%) were the most active antimicrobials. Differences were observed in species-level susceptibility to ceftazidime, carbapenems, ticarcillin-clavulanate, and tetracycline. Antimicrobial combinations with co-trimoxazole or tobramycin demonstrate the best synergy, while co-trimoxazole gave the best susceptibility breakpoint index values. This study enriches the understanding of MDR Achromobacter spp. epidemiology and confirms prevalence and chronic colonization of A. xylosoxidans in CF lungs. It presents in vitro data to support the efficacy of new combinations for use in the treatment of chronic Achromobacter infections.


Assuntos
Achromobacter denitrificans , Achromobacter , Fibrose Cística , Infecções por Bactérias Gram-Negativas , Achromobacter/genética , Achromobacter denitrificans/genética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Fibrose Cística/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana
8.
Clinicoecon Outcomes Res ; 12: 317-325, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32606848

RESUMO

OBJECTIVE: To estimate the budgetary impact of adopting selinexor (XPOVIO; Karyopharm Therapeutics, Inc.) for the treatment of adult patients with penta-refractory multiple myeloma (MM) from the perspective of a third-party payer in the United States (US). METHODS: A budget impact analysis was conducted in one-year increments for the first 3 years after the introduction of selinexor for a private payer or Medicare Part D. Total annual treatment costs (2018 US dollars) were calculated as the sum of drug costs, costs of adverse events (AEs; grade ≥3), along with ongoing best supportive care costs. The number of eligible patients was derived from national epidemiology statistics, healthcare databases, and published literature. RESULTS: In the base-case analysis, selinexor was associated with a per member per month (PMPM) cost of $0.0103 in year 3, assuming a market uptake of 64%, for a hypothetical private payer plan with one million members and four eligible patients. In a scenario analysis with 16 eligible patients with triple-class refractory MM regardless of the line of therapy (this additional scenario analysis was performed with an eligible population that does not fit squarely within the approved label for selinexor but was performed strictly for the purpose of demonstrating the results of the budget impact model when based on a larger pool of eligible patients), the estimated PMPM cost in year 3 was $0.0388. The model showed comparable sensitivity to treatment duration, wholesale acquisition cost for selinexor, and year 1 uptake. The base-case analysis conducted from the perspective of Medicare Part D was associated with a PMPM cost of $0.0078 in year 3 with 159 eligible patients. CONCLUSIONS: The model estimates a small and manageable budget impact of adopting selinexor into a third-party US payer plan, given the low prevalence of penta-refractory MM.

10.
Int J Antimicrob Agents ; 53(6): 774-780, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30831233

RESUMO

Pseudomonas aeruginosa is one of the most important pathogens in cystic fibrosis. This study was conducted to analyse the genetic basis and phylogenetic profile of resistance to ceftazidime/avibactam, ceftolozane/tazobactam and carbapenems in cystic fibrosis P. aeruginosa isolates. Whole genome sequence analysis was conducted of isolates resistant to piperacillin/tazobactam collected from seven hospitals in Scotland since the introduction of these two cephalosporin/ß-lactamase inhibitor combinations. Ceftazidime resistance was primarily related to AmpC induction, as tested by cloxacillin inhibition assays, while high-level ceftazidime resistance not reversed by cloxacillin was associated with amino acid variations in AmpC. Only isolates resistant to both ceftazidime/avibactam and ceftolozane/tazobactam carried AmpD mutations, likely resulting in ampC overexpression. All isolates resistant to ceftazidime/avibactam and/or ceftolozane/tazobactam were resistant to carbapenems and showed inactivating mutations in the chromosomal oprD gene. None of the isolates bore class A, B, D plasmid-encoded carbapenemases. This study showed that mutational resistance emerged in phylogenetically distant lineages, which indicates the mutations occur independently without conferring a selective advantage to any phylogenetic lineage. These findings confirm the strong contribution of mutation-driven evolution to the population structure of P. aeruginosa.


Assuntos
Antibacterianos/farmacologia , Compostos Azabicíclicos/farmacologia , Carbapenêmicos/farmacologia , Ceftazidima/farmacologia , Cefalosporinas/farmacologia , Farmacorresistência Bacteriana , Combinação Piperacilina e Tazobactam/farmacologia , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Tazobactam/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/biossíntese , Proteínas de Bactérias/genética , Fibrose Cística/complicações , Combinação de Medicamentos , Feminino , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Porinas/genética , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação , Escócia , Sequenciamento Completo do Genoma , Inibidores de beta-Lactamases/farmacologia , beta-Lactamases/biossíntese , beta-Lactamases/genética
11.
Mol Biosyst ; 12(12): 3600-3610, 2016 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-27714012

RESUMO

The ETS family of transcription factors regulate gene targets by binding to a core GGAA DNA-sequence. The ETS factor ERG is required for homeostasis and lineage-specific functions in endothelial cells, some subset of haemopoietic cells and chondrocytes; its ectopic expression is linked to oncogenesis in multiple tissues. To date details of the DNA-binding process of ERG including DNA-sequence recognition outside the core GGAA-sequence are largely unknown. We combined available structural and experimental data to perform molecular dynamics simulations to study the DNA-binding process of ERG. In particular we were able to reproduce the ERG DNA-complex with a DNA-binding simulation starting in an unbound configuration with a final root-mean-square-deviation (RMSD) of 2.1 Å to the core ETS domain DNA-complex crystal structure. This allowed us to elucidate the relevance of amino acids involved in the formation of the ERG DNA-complex and to identify Arg385 as a novel key residue in the DNA-binding process. Moreover we were able to show that water-mediated hydrogen bonds are present between ERG and DNA in our simulations and that those interactions have the potential to achieve sequence recognition outside the GGAA core DNA-sequence. The methodology employed in this study shows the promising capabilities of modern molecular dynamics simulations in the field of protein DNA-interactions.


Assuntos
DNA/química , Simulação de Dinâmica Molecular , Regulador Transcricional ERG/química , Sequência de Bases , DNA/metabolismo , Proteínas de Ligação a DNA/química , Proteínas de Ligação a DNA/metabolismo , Ligação de Hidrogênio , Conformação Molecular , Simulação de Acoplamento Molecular , Mutação , Domínios e Motivos de Interação entre Proteínas , Regulador Transcricional ERG/genética , Regulador Transcricional ERG/metabolismo
12.
Int J Antimicrob Agents ; 48(5): 521-527, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27665523

RESUMO

The Burkholderia cepacia complex (Bcc) is notorious for the life-threatening pulmonary infections it causes in patients with cystic fibrosis. The multidrug-resistant nature of Bcc and differing infective Bcc species make the design of appropriate treatment regimens challenging. Previous synergy studies have failed to take account of the species of Bcc isolates. Etest methodology was used to facilitate minimum inhibitory concentration (MIC) and antimicrobial combination testing on 258 isolates of Bcc, identified to species level by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). The most active antimicrobials were trimethoprim/sulphamethoxazole, doxycycline and minocycline (52.5%, 46.4% and 45.9% of isolates susceptible, respectively). Synergy was observed in 9.2% of the 1799 combinations tested; the most common synergistic combinations were tobramycin + ceftazidime, meropenem + tobramycin and levofloxacin + piperacillin/tazobactam (35.4%, 32.3% and 22.2% synergy, respectively). Antimicrobial susceptibility analysis revealed differences between Burkholderia cenocepacia and Burkholderia multivorans. Disparity in clinical outcome during infection with these two micro-organisms necessitates further investigation into the clinical outcomes of treatment regimens in light of species identification and in vitro antimicrobial susceptibility studies.


Assuntos
Antibacterianos/farmacologia , Complexo Burkholderia cepacia/efeitos dos fármacos , Interações Medicamentosas , Testes de Sensibilidade Microbiana/métodos , Complexo Burkholderia cepacia/química , Complexo Burkholderia cepacia/classificação , Complexo Burkholderia cepacia/isolamento & purificação , Feminino , Humanos , Masculino , Estudos Retrospectivos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Adulto Jovem
13.
Circ Cardiovasc Genet ; 8(5): 643-52, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26175529

RESUMO

BACKGROUND: Mutations in sarcomeric and cytoskeletal proteins are a major cause of hereditary cardiomyopathies, but our knowledge remains incomplete as to how the genetic defects execute their effects. METHODS AND RESULTS: We used cysteine and glycine-rich protein 3, a known cardiomyopathy gene, in a yeast 2-hybrid screen and identified zinc-finger and BTB domain-containing protein 17 (ZBTB17) as a novel interacting partner. ZBTB17 is a transcription factor that contains the peak association signal (rs10927875) at the replicated 1p36 cardiomyopathy locus. ZBTB17 expression protected cardiac myocytes from apoptosis in vitro and in a mouse model with cardiac myocyte-specific deletion of Zbtb17, which develops cardiomyopathy and fibrosis after biomechanical stress. ZBTB17 also regulated cardiac myocyte hypertrophy in vitro and in vivo in a calcineurin-dependent manner. CONCLUSIONS: We revealed new functions for ZBTB17 in the heart, a transcription factor that may play a role as a novel cardiomyopathy gene.


Assuntos
Cardiomiopatias/genética , Insuficiência Cardíaca/genética , Proteínas Nucleares/genética , Animais , Proteínas de Ligação a DNA , Coração/fisiologia , Humanos , Fatores de Transcrição Kruppel-Like/genética , Fatores de Transcrição Kruppel-Like/fisiologia , Proteínas com Domínio LIM/genética , Proteínas com Domínio LIM/metabolismo , Camundongos , Proteínas Musculares/genética , Proteínas Musculares/metabolismo , Proteínas Nucleares/fisiologia , Proteínas Inibidoras de STAT Ativados/genética , Proteínas Inibidoras de STAT Ativados/fisiologia , Ratos , Estresse Fisiológico , Técnicas de Cultura de Tecidos , Ubiquitina-Proteína Ligases
14.
BMJ Open ; 5(3): e006596, 2015 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-25814495

RESUMO

OBJECTIVES: To explore temporal associations between planned antibiotic stewardship and infection control interventions and the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Retrospective ecological study and time-series analysis integrating typing data from the Scottish MRSA reference laboratory. SETTING: Regional hospital and primary care in a Scottish Health Board. PARTICIPANTS: General adult (N=1,051,993) or intensive care (18,235) admissions and primary care registrations (460,000 inhabitants) between January 1997 and December 2012. INTERVENTIONS: Hand-hygiene campaign; MRSA admission screening; antibiotic stewardship limiting use of macrolides and '4Cs' (cephalosporins, coamoxiclav, clindamycin and fluoroquinolones). OUTCOME MEASURES: Prevalence density of MRSA clonal complexes CC22, CC30 and CC5/Other in hospital (isolates/1000 occupied bed days, OBDs) and community (isolates/10,000 inhabitant-days). RESULTS: 67% of all clinical MRSA isolates (10,707/15,947) were typed. Regional MRSA population structure was dominated by hospital epidemic strains CC30, CC22 and CC45. Following declines in overall MRSA prevalence density, CC5 and other strains of community origin became increasingly important. Reductions in use of '4Cs' and macrolides anticipated declines in sublineages with higher levels of associated resistances. In multivariate time-series models (R(2)=0.63-0.94) introduction of the hand-hygiene campaign, reductions in mean length of stay (when >4 days) and bed occupancy (when >74 to 78%) predicted declines in CC22 and CC30, but not CC5/other strains. Lower importation pressures, expanded MRSA admission screening, and reductions in macrolide and third generation cephalosporin use (thresholds for association: 135-141, and 48-81 defined daily doses/1000 OBDs, respectively) were followed by declines in all clonal complexes. Strain-specific associations with fluoroquinolones and clindamycin reflected resistance phenotypes of clonal complexes. CONCLUSIONS: Infection control measures and changes in population antibiotic use were important predictors of MRSA strain dynamics in our region. Strategies to control MRSA should consider thresholds for effects and strain-specific impacts.


Assuntos
Antibacterianos/uso terapêutico , Resistência a Medicamentos , Higiene das Mãos , Controle de Infecções/métodos , Tempo de Internação , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas/prevenção & controle , Adulto , Técnicas de Tipagem Bacteriana , Cefalosporinas/uso terapêutico , Infecção Hospitalar/prevenção & controle , Humanos , Macrolídeos/uso terapêutico , Programas de Rastreamento , Staphylococcus aureus Resistente à Meticilina/classificação , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Prevalência , Estudos Retrospectivos , Escócia , Especificidade da Espécie , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia
15.
Lancet Infect Dis ; 13(12): 1057-98, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24252483

RESUMO

The causes of antibiotic resistance are complex and include human behaviour at many levels of society; the consequences affect everybody in the world. Similarities with climate change are evident. Many efforts have been made to describe the many different facets of antibiotic resistance and the interventions needed to meet the challenge. However, coordinated action is largely absent, especially at the political level, both nationally and internationally. Antibiotics paved the way for unprecedented medical and societal developments, and are today indispensible in all health systems. Achievements in modern medicine, such as major surgery, organ transplantation, treatment of preterm babies, and cancer chemotherapy, which we today take for granted, would not be possible without access to effective treatment for bacterial infections. Within just a few years, we might be faced with dire setbacks, medically, socially, and economically, unless real and unprecedented global coordinated actions are immediately taken. Here, we describe the global situation of antibiotic resistance, its major causes and consequences, and identify key areas in which action is urgently needed.


Assuntos
Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Resistência Microbiana a Medicamentos , Animais , Infecções Bacterianas/tratamento farmacológico , Mudança Climática , Saúde Global , Necessidades e Demandas de Serviços de Saúde , Humanos
16.
Infect Control Hosp Epidemiol ; 33(8): 803-8, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22759548

RESUMO

OBJECTIVE: To determine the proportion of methicillin-resistant Staphylococcus aureus (MRSA) detections identified by nasal swabbing using agar culture in comparison with multiple body site testing using agar and nutrient broth culture. DESIGN: Cross-sectional study. PATIENTS: Adult patients admitted to 36 general specialty wards of 2 large hospitals in Scotland. METHODS: Patients were screened for MRSA via multiple body site swabs (nasal, throat, axillary, perineal, and wound/invasive device sites) cultured individually on chromogenic agar and pooled in nutrient broth. Combined results from all sites and cultures provided a gold-standard estimate of true MRSA prevalence. RESULTS: This study found that nasal screening performed better than throat, axillary, or perineal screening but at best identified only 66% of true MRSA carriers against the gold standard at an overall prevalence of 2.9%. Axillary screening performed least well. Combining nasal and perineal swabs gave the best 2-site combination (82%). When combined with realistic screening compliance rates of 80%-90%, nasal swabbing alone probably detects just over half of true colonization in practice. Swabbing of clinically relevant sites (wounds, indwelling devices, etc) is important for a small but high-prevalence group. CONCLUSIONS: Nasal swabbing is the standard method in many locations for MRSA screening. Its diagnostic efficiency in practice appears to be limited, however, and the resource implications of multiple body site screening have to be balanced against a potential clinical benefit whose magnitude and nature remains unclear.


Assuntos
Portador Sadio/diagnóstico , Programas de Rastreamento/métodos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Nariz/microbiologia , Infecções Estafilocócicas/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Axila/microbiologia , Técnicas Bacteriológicas , Portador Sadio/microbiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Estudos Transversais , Meios de Cultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Períneo/microbiologia , Faringe/microbiologia , Infecções Estafilocócicas/microbiologia , Ferimentos Penetrantes/microbiologia
17.
Phys Chem Chem Phys ; 14(2): 929-36, 2012 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-22121510

RESUMO

Protein kinase B (PKB) is a serine/threonine kinase that plays a key role in the phosphoinositide 3-kinase (PI3K) pathway-one of the most frequently activated proliferation pathways in cancer. In this pathway, PKB is recruited to the plasma membrane by direct interaction of its pleckstrin homology (PH) domain with the inositol phosphate head-group of phosphatidylinositol 3,4,5-trisphosphate [PtdIns(3,4,5)P(3)] or phosphatidylinositol 3,4-bisphosphate [PtdIns(3,4)P(2)]. This recruitment is a critical stage in the activation of PKB, whose downstream effectors play important roles in cell survival, proliferation and growth. It is therefore of great interest to understand PKB's mode of binding, as well as its specificity and affinity for different phosphoinositides. We have used a total of 3 µs of molecular dynamics (MD) simulations to better understand the interactions of the PKB PH domain with the inositol phosphate head-groups of phosphoinositides involved in the PI3K pathway. Our computational models successfully mirror PKB's in vivo selectivity for 3-phosphorylated phosphoinositides. Furthermore, the models also help to rationalize unexpected in vitro data in which inositol 1,4,5-trisphosphate [Ins(1,4,5)P(3)] binds with a relatively high affinity to the PKB PH domain, despite its parent lipid phosphatidylinositol 4,5-bisphosphate [PtdIns(4,5)P(2)] being known not to bind in vivo. With the support of computational simulations, we propose that when not bonded to a phosphatidate tail Ins(1,4,5)P(3) binds in an orientation in which its inositol ring is flipped with respect to the 3-phosphorylated inositol phosphate ligands and its parent lipid.


Assuntos
Fosfatos de Inositol/química , Proteínas Proto-Oncogênicas c-akt/química , Proteínas Sanguíneas/química , Ligação de Hidrogênio , Simulação de Dinâmica Molecular , Fosfoproteínas/química , Estrutura Terciária de Proteína , Proteínas Proto-Oncogênicas c-akt/metabolismo , Termodinâmica
18.
Biochim Biophys Acta ; 1811(1): 17-24, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20920595

RESUMO

Although the conjugated linoleic acids (CLA) have several isomer-specific biological effects including anti-carcinogenic and anti-adipogenic effects, their mechanisms of action remain unclear. To determine their potential effects on membrane structure and function, we studied the incorporation profiles of four CLA isomers (trans-10 cis-12 (A), trans-9 trans-11 (B), cis-9 trans-11 (C), and cis-9 cis-11 (D)) in CHO and HepG2 cells. All four isomers were incorporated into cellular lipids as efficiently as linoleic acid (LA), with the majority of the incorporated CLA present in membrane rafts. Of the four isomers, only CLA-A increased the cholesterol content of the raft fraction. Over 50% of the incorporated CLAs were recovered in phosphatidylcholine of CHO cells, but in HepG2 the neutral lipids contained the majority of CLA. The desaturation index (18:1/18:0 and 16:1/16:0) was reduced by CLA-A, but increased by CLA-B, the effects being apparent mostly in raft lipids. The Δ9 desaturase activity was inhibited by CLAs A and C. Unlike LA, which was mostly found in the sn-2 position of phospholipids, most CLAs were also incorporated significantly into the sn-1 position in both cell types. These studies show that the incorporation profiles of CLA isomers differ significantly from that of LA, and this could lead to alterations in membrane function, especially in the raft-associated proteins.


Assuntos
Ácido Linoleico/metabolismo , Ácidos Linoleicos Conjugados/metabolismo , Microdomínios da Membrana/metabolismo , Fosfatidilcolinas/metabolismo , Animais , Antineoplásicos/metabolismo , Antineoplásicos/farmacologia , Células CHO , Cricetinae , Cricetulus , Células Hep G2 , Humanos , Ácido Linoleico/farmacologia , Ácidos Linoleicos Conjugados/farmacologia , Proteínas de Membrana/metabolismo
19.
Protein Eng Des Sel ; 24(1-2): 197-207, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20656696

RESUMO

The central role of protein-protein interactions in a wide range of cellular processes makes them a target for research and drug discovery. A variety of methods, both experimental and theoretical, exist for probing protein interfaces for residues that affect activity and binding affinity. Using as an example a protein-protein complex between trypsin and a nine-residue synthetic peptide, we experimentally assay-binding affinities for a variety of mutants and determine their relative free energy of binding, ΔΔG, to rank the importance of interface residues to binding. We then compare how accurately, precisely and reliably computational methods for calculating ΔΔG can replicate these results. We find that a 'post-process alanine scanning' protocol of a single native complex trajectory gives results with better accuracy than running separate molecular dynamics (MD) trajectories for individual mutants. Compared across 10 independent simulations, we find that results from the post-process alanine scanning are also more precise and are obtained over five times faster than their equivalent with the 'full MD' protocol. These results suggest that, although not suitable in every case, post-process alanine scanning is a useful and reliable tool in predicting important residues at protein interfaces with potential for modulation.


Assuntos
Alanina/metabolismo , Peptídeos/metabolismo , Mapeamento de Interação de Proteínas/métodos , Tripsina/metabolismo , Alanina/genética , Animais , Bovinos , Fabaceae/genética , Fabaceae/metabolismo , Simulação de Dinâmica Molecular , Mutagênese , Peptídeos/genética , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Termodinâmica
20.
Faraday Discuss ; 150: 161-74; discussion 257-92, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22457947

RESUMO

The ability to detect molecular complexes and determine their geometries is crucial to our understanding of all biological phenomena, including protein structures and functions. We recently demonstrated that a novel 2DIR technique, EVV 2DIR spectroscopy, can be used for this purpose. In this paper, we evaluate the potential utility of the method for the analysis of protein composition, structure and function. In order to do this we apply computational tools to a group of selected biological systems, for which our calculated spectra all showed features that can in principle be detected with existing sensitivities. We also investigate the possibility of using our technique to detect and analyse hydrogen-bonded systems through a tyrosine-water model.


Assuntos
Elétrons , Imagem Molecular/métodos , Espectrofotometria Infravermelho/métodos , Análise Espectral Raman/métodos , 2,4-Dinitrofenol/química , 2,4-Dinitrofenol/metabolismo , Aciltransferases/química , Aciltransferases/metabolismo , Candida albicans/química , Humanos , Ligação de Hidrogênio , Imunoglobulina E/química , Imunoglobulina E/metabolismo , Modelos Moleculares , Proteínas de Neoplasias/química , Proteínas de Neoplasias/metabolismo , Conformação Proteica , Proteínas Proto-Oncogênicas c-mdm2/química , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Proteína Supressora de Tumor p53/química , Proteína Supressora de Tumor p53/metabolismo , Tirosina/química , Tirosina/metabolismo , Vibração , Água/química , Água/metabolismo
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