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1.
J Infect ; 80(3): 271-278, 2020 03.
Article in English | MEDLINE | ID: mdl-31917968

ABSTRACT

OBJECTIVES: To analyze the clinical and economic burden of community-acquired (CA) or community-onset healthcare-associated (COHCA) multidrug-resistant (MDR) infections requiring hospitalization. METHODS: Case-control study. Adults admitted with CA or COHCA MDR infections were considered cases, while those admitted in the same period with non-MDR infections were controls. The matching criteria were source of infection and/or microorganism. Primary outcome was 30-day clinical failure. Secondary outcomes were 90-day and 1-year mortality, hospitalization costs and resource consumption. RESULTS: 194 patients (97 cases and 97 controls) were included. Multivariate analysis identified age (odds ratio [OR], 1.07, 95% confidence interval [CI], 1.01-1.14) and SOFA score (OR, 1.45, CI95%, 1.15-1.84) as independent predictors of 30-day clinical failure. Age (hazard ratio [HR] 1.09, 95%CI, 1.03-1.16) was the only factor associated with 90-day mortality, whereas age (HR 1.06, 95%CI, 1.03-1.09) and Charlson Index (HR 1.2, 95%CI, 1.07-1.34) were associated with 1-year mortality. MDR group showed longer hospitalization (p<0.001) and MDR hospitalization costs almost doubled those in the non-MDR group. MDR infections were associated with higher antimicrobial costs. CONCLUSIONS: Worse economic outcomes were identified with community-onset MDR infections. MDR was associated with worse clinical outcomes but mainly due to higher comorbidity of patients in MDR group, rather than multidrug resistance.


Subject(s)
Cost of Illness , Cross Infection , Adult , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Case-Control Studies , Cross Infection/drug therapy , Drug Resistance, Multiple, Bacterial , Hospitalization , Humans , Risk Factors
2.
Am J Transplant ; 17(11): 2922-2936, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28544101

ABSTRACT

Belatacept, a T cell costimulation blocker, demonstrated superior renal function, lower cardiovascular risk, and improved graft and patient survival in renal transplant recipients. Despite the potential benefits, adoption of belatacept has been limited in part due to concerns regarding higher rates and grades of acute rejection in clinical trials. Since July 2011, we have utilized belatacept-based immunosuppression regimens in clinical practice. In this retrospective analysis of 745 patients undergoing renal transplantation at our center, we compared patients treated with belatacept (n = 535) with a historical cohort receiving a tacrolimus-based protocol (n = 205). Patient and graft survival were equivalent for all groups. An increased rate of acute rejection was observed in an initial cohort treated with a protocol similar to the low-intensity regimen from the BENEFIT trial versus the historical tacrolimus group (50.5% vs. 20.5%). The addition of a transient course of tacrolimus reduced rejection rates to acceptable levels (16%). Treatment with belatacept was associated with superior estimated GFR (belatacept 63.8 mL/min vs. tacrolimus 46.2 mL/min at 4 years, p < 0.0001). There were no differences in serious infections including rates of cytomegalovirus or BK viremia. We describe the development of a costimulatory blockade-based strategy that ultimately allows renal transplant recipients to achieve calcineurin inhibitor-free immunosuppression.


Subject(s)
Abatacept/therapeutic use , Graft Rejection/drug therapy , Graft Survival/drug effects , Isoantibodies/immunology , Kidney Failure, Chronic/surgery , Kidney Transplantation/adverse effects , Adult , Female , Follow-Up Studies , Glomerular Filtration Rate , Graft Rejection/etiology , Humans , Immunosuppressive Agents/therapeutic use , Isoantibodies/drug effects , Kidney Function Tests , Male , Middle Aged , Postoperative Complications , Prognosis , Retrospective Studies , Risk Factors , Transplant Recipients
3.
Am J Transplant ; 16(2): 550-64, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26436448

ABSTRACT

Belatacept is used to prevent allograft rejection but fails to do so in a sizable minority of patients due to inadequate control of costimulation-resistant T cells. In this study, we report control of costimulation-resistant rejection when belatacept was combined with perioperative alemtuzumab-mediated lymphocyte depletion and rapamycin. To assess the means by which the alemtuzumab, belatacept and rapamycin (ABR) regimen controls belatacept-resistant rejection, we studied 20 ABR-treated patients and characterized peripheral lymphocyte phenotype and functional responses to donor, third-party and viral antigens using flow cytometry, intracellular cytokine staining and carboxyfluorescein succinimidyl ester-based lymphocyte proliferation. Compared with conventional immunosuppression in 10 patients, lymphocyte depletion evoked substantial homeostatic lymphocyte activation balanced by regulatory T and B cell phenotypes. The reconstituted T cell repertoire was enriched for CD28(+) naïve cells, notably diminished in belatacept-resistant CD28(-) memory subsets and depleted of polyfunctional donor-specific T cells but able to respond to third-party and latent herpes viruses. B cell responses were similarly favorable, without alloantibody development and a reduction in memory subsets-changes not seen in conventionally treated patients. The ABR regimen uniquely altered the immune profile, producing a repertoire enriched for CD28(+) T cells, hyporesponsive to donor alloantigen and competent in its protective immune capabilities. The resulting repertoire was permissive for control of rejection with belatacept monotherapy.


Subject(s)
Abatacept/therapeutic use , Graft Rejection/prevention & control , Immunologic Memory/immunology , Kidney Failure, Chronic/immunology , Kidney Transplantation , Sirolimus/therapeutic use , T-Lymphocytes, Regulatory/immunology , Adult , Aged , CD28 Antigens/metabolism , Female , Flow Cytometry , Follow-Up Studies , Glomerular Filtration Rate , Graft Rejection/drug therapy , Graft Rejection/immunology , Graft Survival , Humans , Immunologic Memory/drug effects , Immunosuppressive Agents/therapeutic use , Isoantigens/immunology , Kidney Failure, Chronic/surgery , Kidney Function Tests , Lymphocyte Depletion , Male , Middle Aged , Pilot Projects , Prognosis , Risk Factors , T-Lymphocytes, Regulatory/drug effects , Transplant Recipients , Young Adult
4.
Am J Transplant ; 14(5): 1142-51, 2014 May.
Article in English | MEDLINE | ID: mdl-24684552

ABSTRACT

Kidney transplantation remains limited by toxicities of calcineurin inhibitors (CNIs) and steroids. Belatacept is a less toxic CNI alternative, but existing regimens rely on steroids and have higher rejection rates. Experimentally, donor bone marrow and sirolimus promote belatacept's efficacy. To investigate a belatacept-based regimen without CNIs or steroids, we transplanted recipients of live donor kidneys using alemtuzumab induction, monthly belatacept and daily sirolimus. Patients were randomized 1:1 to receive unfractionated donor bone marrow. After 1 year, patients were allowed to wean from sirolimus. Patients were followed clinically and with surveillance biopsies. Twenty patients were transplanted, all successfully. Mean creatinine (estimated GFR) was 1.10 ± 0.07 mg/dL (89 ± 3.56 mL/min) and 1.13 ± 0.07 mg/dL (and 88 ± 3.48 mL/min) at 12 and 36 months, respectively. Excellent results were achieved irrespective of bone marrow infusion. Ten patients elected oral immunosuppressant weaning, seven of whom were maintained rejection-free on monotherapy belatacept. Those failing to wean were successfully maintained on belatacept-based regimens supplemented by oral immunosuppression. Seven patients declined immunosuppressant weaning and three patients were denied weaning for associated medical conditions; all remained rejection-free. Belatacept and sirolimus effectively prevent kidney allograft rejection without CNIs or steroids when used following alemtuzumab induction. Selected, immunologically low-risk patients can be maintained solely on once monthly intravenous belatacept.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Calcineurin Inhibitors/therapeutic use , Graft Rejection/prevention & control , Immunoconjugates/therapeutic use , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/surgery , Kidney Transplantation , Abatacept , Adult , Aged , Disease Management , Female , Flow Cytometry , Follow-Up Studies , Graft Survival/drug effects , Humans , Male , Middle Aged , Postoperative Complications/prevention & control , Prognosis , Sirolimus/therapeutic use , Young Adult
5.
Acta Crystallogr D Biol Crystallogr ; 69(Pt 2): 194-212, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23385456

ABSTRACT

The different changes observed in the diffraction patterns of three different crystal forms (hexagonal, trigonal and monoclinic) of PurE (EC 4.1.1.21), an enzyme from the purine-biosynthesis pathway of Bacillus anthracis, upon a wide range of changes in the relative humidity environment of the crystals are documented. In addition, the changes in the unit-cell parameters, volume and bulk solvent in the three different crystal forms were systematically followed. In an attempt to explain the elastic (P6(5)22) and inelastic (P3(1)21) changes in the diffraction pattern, refined structures of the three different crystal forms determined at 100 K are presented, with particular emphasis on the tertiary and quaternary structural differences, crystal packing, intermolecular and intramolecular interactions and solvent structure. The refined structures show that the precipitant salts, solvent structure (both ordered and bulk) and conformation of the C-termini all play a role in creating a unique cement at both the intramolecular and intermolecular contacts of the different crystal forms. It is suggested that it is the combination of polyethylene glycol and the structure of the ordered water molecules (first and second layers) as well as the structure of the bulk solvent that are the critical factors in the plasticity of the hexagonal crystal packing as opposed to the inelastic responses of the lower symmetry forms.


Subject(s)
Bacterial Proteins/chemistry , Carboxy-Lyases/chemistry , Elastic Modulus , Humidity , Amino Acid Sequence , Bacillus anthracis/enzymology , Crystallography, X-Ray , Escherichia coli/enzymology , Models, Molecular , Molecular Sequence Data , Mycobacterium tuberculosis/enzymology
6.
Article in English | MEDLINE | ID: mdl-23366612

ABSTRACT

The human heart tissue has a limited capacity for regeneration. Tissue and cellular therapies based on the use of stem cells may be useful alternatives to limit the size of myocardial infarction. In this paper, the preliminary results from an experimental campaign for on-line monitoring of myocardium scar infarction are presented. This study has been carried out under a research project that has as main objective the development and application of a bioactive patch implant for regeneration of myocardial infarction. Electrical Impedance Spectroscopy (EIS) has been chosen as a tissue state monitoring technique. What is presented in this communication is the first results of an implantable EIS measurement system which has been implanted in a subset of the animals corresponding to the control group, along one month. In all the animals, the myocardial infarction was induced by the ligation of the first circumflex marginal artery. In the animal group presented, the bioactive patch scaffold and the electrodes were implanted without the stem cells load. The scaffold is a piece of decellularized human pericardium, lyophilized and rehydrated with hydrogel RAD16-I. Nanogold particles were also placed near the electrodes to improve the electrode area conductivity. The results presented correspond to the subset of animals (n = 5), which had implanted the bioimpedance system monitoring the electrical impedance spectrum in vivo during 1 month. Two electrodes were connected to the bioactive patch implant. A total of 14 logarithmically spaced frequencies were measured every 5 minutes, from 100 Hz to 200 kHz. Results show a convergence of low-frequency and high frequency impedance magnitudes along the measurement period, which is coherent with the scar formation.


Subject(s)
Electric Impedance , Myocardial Infarction/diagnosis , Animals , Pericardium/pathology , Swine
7.
Acta Crystallogr Sect F Struct Biol Cryst Commun ; 67(Pt 10): 1300-8, 2011 Oct 01.
Article in English | MEDLINE | ID: mdl-22102052

ABSTRACT

The use of relative humidity control of protein crystals to overcome some of the shortcomings of soaking ligands (i.e. inhibitors, substrate analogs, weak ligands) into pre-grown apoprotein crystals has been explored. Crystals of PurE (EC 4.1.1.21), an enzyme from the purine-biosynthesis pathway of Bacillus anthracis, were used as a test case. The findings can be summarized as follows: (i) using humidity control, it is possible to improve/optimize the diffraction quality of crystals soaked in solutions of organic solvent (DMSO, ethanol) containing ligands/inhibitors; (ii) optimization of the relative humidity can compensate for the deterioration of the diffraction pattern that is observed upon desalting crystals grown in high salt; (iii) combining desalting protocols with the addition of PEG it is possible to achieve very high concentrations of weak ligands (in the 5-10 mM range) in soaking solutions and (iv) fine control of the relative humidity of crystals soaked in these solutions can compensate for the deterioration of crystal diffraction and restore `high-resolution' diffraction for structure-based and fragment-based drug design. It is suggested that these experimental protocols may be useful in other protein systems and may be applicable in academic or private research to increase the probability of obtaining structures of protein-ligand complexes at high resolution.


Subject(s)
Bacillus anthracis/enzymology , Carboxy-Lyases/chemistry , Crystallization , Crystallography, X-Ray , Humidity , Solutions/chemistry
8.
Am J Transplant ; 6(10): 2307-15, 2006 Oct.
Article in English | MEDLINE | ID: mdl-16939516

ABSTRACT

Renal transplant patients sensitized to HLA antigens comprise nearly one-third of the UNOS wait-list and receive 14% of deceased donor (DD) transplants, a rate half that of unsensitized patients. Between 1999 and 2003, we performed 492 adult renal transplants from DD; 120 patients (approximately 25%) had a panel reactive antibody (PRA) of >30%, with nearly half (n = 58) having a PRA of >80%. Our approach is based upon high-resolution solid-phase HLA antibody analysis to identify class I/II antibodies and a 'virtual crossmatch' to predict compatible donor/recipient combinations. Recipients are excluded from the United Network for Organ Sharing match run if donors possess unacceptable antigens. Thus, when sensitized patients appear on the match run, they have a high probability of a negative final crossmatch. Here, we describe our 5-year experience with this approach. Five-year graft survival ranged from 66% to 70% among unsensitized (n = 272), moderately sensitized (PRA < 30%, n = 100) and highly sensitized (>30% PRA; n = 120) patients, equal to the average national graft survival (65.7%). The application of this approach (the Emory Algorithm) provides a logical and systematic approach to improve the access of sensitized patients to DD organs and promote more equitable allocation to a highly disadvantaged group of patients awaiting renal transplantation.


Subject(s)
Algorithms , B-Lymphocytes/immunology , Graft Rejection/immunology , Immunity, Cellular , Immunization/methods , Kidney Transplantation/immunology , T-Lymphocytes/immunology , Female , Flow Cytometry , Follow-Up Studies , Graft Rejection/prevention & control , Graft Survival , HLA Antigens/immunology , Histocompatibility Antigens Class I/immunology , Histocompatibility Antigens Class II/immunology , Humans , Immunosuppressive Agents/therapeutic use , Male , Retrospective Studies , Risk Factors , Transplantation, Homologous
9.
Kidney Int ; 60(5): 1938-47, 2001 Nov.
Article in English | MEDLINE | ID: mdl-11703613

ABSTRACT

BACKGROUND: The long-term outcome of renal allografts is characterized by a progressive deterioration of renal function and graft loss. Our aim was to determine early glomerular functional abnormalities, before they become clinically apparent. METHODS: Glomerular hemodynamics and dextran sieving were characterized in 21 well-functioning cadaveric renal allograft recipients [normal glomerular filtration rate (GFR) and albumin excretion rate (AER), who also had a kidney biopsy with normal or minimal histological changes] and in 15 uninephrectomized kidney donors. Both groups were one to three years after transplantation or uninephrectomy. RESULTS: The GFR and renal plasma flow (RPF) were similar in both groups (62 +/- 3 vs. 63 +/- 4, and 343 +/- 26 vs. 334 +/- 21 mL/min/1.73 m2 for GFR and RPF, in cadaveric recipients vs. donors, respectively), the AER was normal in both groups, but the mean arterial pressure was higher in renal recipients (103 +/- 3 vs. 94 +/- 3 mm Hg in uninephrectomy controls, P < 0.05). Despite similar levels of overall glomerular function in the two groups, the dextran sieving curve was uniformly elevated in the renal allograft recipients versus uninephrectomy controls (P < 0.05 for dextrans 38 to 66 A). Using a log-normal glomerular pore-size distribution model to analyze potential mechanisms, the elevation in the dextran sieving curve resulted from a shift in the distribution of glomerular filtering pores to a larger size (mean glomerular pore size 46 +/- 2 vs. 43 +/- 2 A for uninephrectomy controls, P < 0.05), resulting in a larger fraction of filtrate volume permeating very large pores. By morphometric analysis, the thickness of the glomerular basement membrane was increased in kidney allograft as compared to 2-kidney biopsy controls (614 +/- 33 vs. 427 +/- 22 nm, respectively, P < 0.05). CONCLUSIONS: Even in "well functioning" renal allografts there is a glomerular dysfunction characterized by increased permeability to macromolecules resulting from a shift of the glomerular pores to a larger size. These changes could be mediated by ultrastructural alterations at the glomerular capillary or by alterations in intraglomerular hemodynamics. Early allograft dysfunction may contribute to the progressive renal insufficiency of renal allografts.


Subject(s)
Kidney Glomerulus/physiopathology , Kidney Transplantation , Adolescent , Adult , Aged , Female , Glomerular Filtration Rate , Humans , Male , Middle Aged , Transplantation, Homologous
10.
J Struct Biol ; 135(2): 219-29, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11580271

ABSTRACT

The microtubule cytoskeleton consists of a highly organized network of microtubule polymers bound to their accessory proteins: microtubule-associated proteins, molecular motors, and microtubule-organizing proteins. The microtubule subunits are heterodimers composed of one alpha-tubulin polypeptide and one beta-tubulin polypeptide that should undergo a complex folding processing before they achieve a quaternary structure that will allow their incorporation into the polymer. Due to the extremely high protein concentration that exists at the cell cytoplasm, there are alpha- and beta-tubulin interacting proteins that prevent the unwanted interaction of these polypeptides with the surrounding protein pool during folding, thus allowing microtubule dynamics. Several years ago, the development of a nondenaturing electrophoretic technique made it possible to identify different tubulin intermediate complexes during tubulin biogenesis in vitro. By these means, the cytosolic chaperonin containing TCP-1 (CCT or TriC) and prefoldin have been demonstrated to intervene through tubulin and actin folding. Various other cofactors also identified along the alpha- and beta-tubulin postchaperonin folding route are now known to have additional roles in tubulin biogenesis such as participating in the synthesis, transport, and storage of alpha- and beta-tubulin. The future characterization of the tubulin-binding sites to these proteins, and perhaps other still unknown proteins, will help in the development of chemicals that could interfere with tubulin folding and thus modulating microtubule dynamics. In this paper, current knowledge of the above postchaperonin folding cofactors, which are in fact chaperones involved in tubulin heterodimer quaternary structure achievement, will be reviewed.


Subject(s)
Microtubules/metabolism , Protein Folding , Tubulin/chemistry , Animals , Chaperonins/metabolism , Humans , Microtubule-Associated Proteins/physiology , Microtubule-Organizing Center/physiology , Saccharomyces cerevisiae Proteins , Tubulin/metabolism
11.
Structure ; 9(10): 967-76, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11591351

ABSTRACT

BACKGROUND: Domain swapping has been proposed as a mechanism that explains the evolution from monomeric to oligomeric proteins. Bovine and human pancreatic ribonucleases are monomers with no biological properties other than their RNA cleavage ability. In contrast, the closely related bovine seminal ribonuclease is a natural domain-swapped dimer that has special biological properties, such as cytotoxicity to tumour cells. Several recombinant ribonuclease variants are domain-swapped dimers, but a structure of this kind has not yet been reported for the human enzyme. RESULTS: The crystal structure at 2 A resolution of an engineered ribonuclease variant called PM8 reveals a new kind of domain-swapped dimer, based on the change of N-terminal domains between the two subunits. The swapping is fastened at both hinge peptides by the newly introduced Gln101, involved in two intermolecular hydrogen bonds and in a stacking interaction between residues of different chains. Two antiparallel salt bridges and water-mediated hydrogen bonds complete a new interface between subunits, while the hinge loop becomes organized in a 3(10) helix structure. CONCLUSIONS: Proteins capable of domain swapping may quickly evolve toward an oligomeric form. As shown in the present structure, a single residue substitution reinforces the quaternary structure by forming an open interface. An evolutionary advantage derived from the new oligomeric state will fix the mutation and favour others, leading to a more extended complementary dimerization surface, until domain swapping is no longer necessary for dimer formation. The newly engineered swapped dimer reported here follows this hypothetical pathway for the rapid evolution of proteins.


Subject(s)
Evolution, Molecular , Mutagenesis, Site-Directed , Proteins/chemistry , Ribonucleases/chemistry , Amino Acid Sequence , Animals , Cattle , Crystallography, X-Ray , Dimerization , Endoribonucleases/antagonists & inhibitors , Endoribonucleases/chemistry , Endoribonucleases/genetics , Enzyme Inhibitors/chemistry , Humans , Molecular Sequence Data , Peptide Fragments/chemistry , Peptide Fragments/genetics , Placental Hormones/chemistry , Protein Structure, Tertiary/genetics , Proteins/genetics , Ribonuclease, Pancreatic/antagonists & inhibitors , Ribonuclease, Pancreatic/chemistry , Ribonuclease, Pancreatic/genetics , Ribonucleases/antagonists & inhibitors , Ribonucleases/genetics
12.
Kidney Int ; 58(5): 1963-72, 2000 Nov.
Article in English | MEDLINE | ID: mdl-11044216

ABSTRACT

BACKGROUND: The recently discovered arachidonic acid derivatives, isoprostanes, are increased in pathological conditions associated with oxidative stress, such as diabetes. No role has yet been described for isoprostanes during the development of diabetic nephropathy. Cell culture in high ambient glucose has been used as a model in elucidating cellular mechanisms underlying diabetic nephropathy. Among the growth factors involved in the effect of high glucose, transforming growth factor-beta (TGF-beta) has been described as playing a key role in the development of nephropathy. METHODS: Streptozotocin-induced diabetic rats were supplemented in their diet with the antioxidant vitamin E (1000 U/kg diet). Blood and urine samples were taken to determine renal function and isoprostane concentration, as determined by gas chromatography/mass spectrometry. Glomerular mesangial and endothelial cells were cultured in high ambient glucose to determine the synthesis of isoprostanes and the role of isoprostanes in high glucose-induced synthesis of TGF-beta. RESULTS: Streptozotocin-induced diabetic rats had marked increases in plasma levels and urinary excretion rates of F(2)-isoprostanes. Dietary supplementation with vitamin E normalized (plasma) and reduced (urine) isoprostane levels and, surprisingly, improved proteinuria and blood urea nitrogen (BUN) levels. High ambient glucose increased F(2)-isoprostane synthesis in glomerular endothelial and mesangial cells in culture. Incubation of glomerular cells with F(2)-isoprostanes stimulated the production of TGF-beta. CONCLUSIONS: Increased F(2)-isoprostane synthesis during diabetes appears to be responsible in part for the increase in renal TGF-beta, a well-known mediator of diabetic nephropathy.


Subject(s)
Diabetes Mellitus, Experimental/metabolism , Dinoprost/analogs & derivatives , Dinoprost/physiology , Glucose/physiology , Kidney Glomerulus/metabolism , Proteinuria/etiology , Transforming Growth Factor beta/biosynthesis , Animals , Cells, Cultured , Diabetes Mellitus, Experimental/urine , Diabetes Mellitus, Type 1/metabolism , Diabetes Mellitus, Type 1/urine , Dinoprost/biosynthesis , Dinoprost/blood , Dinoprost/urine , Endothelium/cytology , Endothelium/drug effects , Endothelium/metabolism , F2-Isoprostanes , Glomerular Mesangium/cytology , Glomerular Mesangium/drug effects , Glomerular Mesangium/metabolism , Glucose/pharmacology , Kidney Glomerulus/drug effects , Male , Mice , Mice, Inbred Strains , Rats , Rats, Sprague-Dawley
13.
J Mol Biol ; 303(1): 49-60, 2000 Oct 13.
Article in English | MEDLINE | ID: mdl-11021969

ABSTRACT

We have determined the crystal structure of a human pancreatic ribonuclease or RNase 1 variant at 1.65 A resolution. Five residues in the N-terminal region were substituted by the corresponding amino acids of the bovine seminal RNase. In addition, a Pro to Ser mutation was present at position 50. The substitution of part of the N terminus has been critical both in improving the expression of this enzyme as a recombinant protein and in achieving its crystallisation. The determination of the crystal structure revealed the characteristic RNase fold including a V-shaped beta-sheet and three alpha-helices. It differs from its bovine RNase orthologue mainly in the loop regions. The active-site cleft shows a similar architecture to that of its bovine counterpart, with the essential residues occupying equivalent positions. In the present structure, however, His119 is displaced as it is in the structure of RNase A at high pH. An interaction model of human ribonuclease with the ribonuclease inhibitor, together with inhibition assays, indicate that, in contrast to RNase A, the modification of the loop beta4beta5 is not enough to avoid inhibition. This study represents the first crystallographic approach to the human enzyme, and should constitute an invaluable tool for the design of ribonuclease variants with acquired cytotoxic properties.


Subject(s)
Cytotoxins/chemistry , Cytotoxins/genetics , Drug Design , Genetic Variation/genetics , Ribonuclease, Pancreatic/chemistry , Ribonuclease, Pancreatic/genetics , Amino Acid Sequence , Amino Acid Substitution/genetics , Animals , Binding Sites , Cattle , Crystallography, X-Ray , Cytotoxins/antagonists & inhibitors , Cytotoxins/metabolism , Enzyme Inhibitors/chemistry , Enzyme Inhibitors/metabolism , Humans , Hydrogen Bonding , Intracellular Signaling Peptides and Proteins , Ligands , Models, Molecular , Molecular Sequence Data , Mutation/genetics , Proline/chemistry , Proline/metabolism , Protein Binding , Protein Structure, Secondary , Proteins/chemistry , Proteins/metabolism , Ribonuclease, Pancreatic/antagonists & inhibitors , Ribonuclease, Pancreatic/metabolism , Sequence Alignment , Static Electricity , Swine
14.
Kidney Int ; 56(1): 261-7, 1999 Jul.
Article in English | MEDLINE | ID: mdl-10411701

ABSTRACT

BACKGROUND: Leukotrienes are 5-lipoxygenated (5-LO) metabolites of arachidonic acid that mediate some of the glomerular hemodynamic and structural changes in experimental and human glomerulonephritis. METHODS: We conducted an open-label, pilot study of the short-term effects of leukotriene biosynthesis inhibition using an orally active 5-LO activating protein (FLAP) antagonist (MK-591) on glomerular function in patients with glomerulonephritis. Eleven adult patients (seven women, median age 38 years) with glomerulonephritis (5 lupus nephritis, 2 IgA nephropathy, 1 membranoproliferative, 1 membranous, 1 C1q-deficiency, and 1 idiopathic crescentic) and moderate renal insufficiency [glomerular filtration rate (GFR) 62 +/- 9 ml/min/1.73 m2] were given MK-591 at a dose of 100 mg orally twice a day for four days. RESULTS: MK-591 reduced proteinuria (albumin and IgG excretion rates) from 3233 +/- 1074 to 1702 +/- 555 microg/min and from 196 +/- 78 to 148 +/- 55 microg/min for albumin and IgG, respectively (P < 0.05 for both). This was not accompanied by a reduction in systemic arterial pressure, GFR, or renal plasma flow. By analysis of the fractional clearance of polydisperse dextrans, baseline proteinuria resulted from a loss of size selectivity with enhanced passage of large (>52 A) dextrans as compared with healthy controls. Treatment with MK-591 caused a selective improvement in the enhanced passage of large (>58 A) dextrans without affecting the handling of smaller dextrans, indicating an improvement in glomerular size selectivity. MK-591 was well tolerated, and no adverse effects were observed. CONCLUSIONS: Short-term therapy with MK-591 reduces proteinuria by restoring glomerular size selectivity and thus reduces transglomerular protein trafficking. These benefits may result from glomerular leukotriene biosynthesis inhibition, but other MK-591-specific actions cannot be excluded.


Subject(s)
Glomerulonephritis/drug therapy , Glomerulonephritis/metabolism , Indoles/therapeutic use , Kidney Glomerulus/drug effects , Kidney Glomerulus/metabolism , Lipoxygenase Inhibitors/therapeutic use , Proteinuria/urine , Quinolines/therapeutic use , Adult , Aged , Female , Glomerulonephritis/urine , Humans , Indoles/adverse effects , Lipoxygenase Inhibitors/adverse effects , Male , Middle Aged , Permeability , Pilot Projects , Proteinuria/etiology , Quinolines/adverse effects , Treatment Outcome
15.
J Am Soc Nephrol ; 10(5): 1014-9, 1999 May.
Article in English | MEDLINE | ID: mdl-10232687

ABSTRACT

There is a large variability in the severity of the clinical manifestations of sickle cell anemia (SSA), including renal involvement. Haplotypes in the beta-globin gene cluster associated with the geographical origin of the sickle mutation, as well as microdeletions in the alpha-globin genes, could provide an epigenetic influence on the heterogeneous outcome in SSA. It has been determined that the cause of progressive renal insufficiency in SSA is a glomerulopathy, clinically detected by the presence of macroalbuminuria (albumin excretion rate >300 mg/g creatinine). To investigate the role of the alpha-globin gene microdeletion and beta-globin gene cluster haplotypes on the degree of glomerular involvement, 76 adult SSA patients (hemoglobin SS) were studied to determine the relationship between these genetic markers and the development of sickle cell glomerulopathy. Macroalbuminuria was present in 22 (29%) of 76 adult SSA patients. The coinheritance of microdeletions in one or two of the four alpha-globin genes (alpha-thalassemia) was associated with a lower prevalence of macroalbuminuria (13%) versus patients with intact alpha-globin genes (40%, P = 0.01). By contrast, there was no association between albuminuria and beta-globin gene haplotypes (Central African Republic [CAR] versus non-CAR haplotypes). Patients with alpha-globin gene microdeletions had lower mean corpuscular volumes and mean corpuscular hemoglobin concentration than patients with all four alpha genes (86+/-2 versus 99+/-3 fl, and 33.9+/-0.2 versus 34.9+/-0.2%, respectively, P<0.05). There were no such hematologic differences between CAR and non-CAR beta-globin haplotypes. There were no differences in duration of disease (age), hemoglobin levels, reticulocyte index, and lactate dehydrogenase levels between those with and without glomerulopathy, but the mean arterial pressure was higher (87+/-1 mm Hg) in patients with intact alpha gene locus versus those with microdeletions (80+/-2 mm Hg, P<0.05). It is concluded that the coinheritance of microdeletions in the alpha-globin gene locus in SSA patients confers "renoprotection" by mechanisms not related to the degree of anemia or the severity of hemolysis, but could be related to a reduced mean corpuscular volume or to a lower erythrocyte hemoglobin concentration.


Subject(s)
Anemia, Sickle Cell/complications , Gene Deletion , Globins/genetics , Kidney Diseases/genetics , Kidney Diseases/prevention & control , Kidney Glomerulus , Adult , Albuminuria/epidemiology , Albuminuria/etiology , Anemia, Sickle Cell/blood , Erythrocyte Indices , Female , Genetic Markers , Haplotypes/physiology , Humans , Male , Middle Aged , Multigene Family/genetics , Prevalence
16.
Acta Crystallogr D Biol Crystallogr ; 55(Pt 3): 679-82, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10089468

ABSTRACT

An intracellular beta-glucosidase (Bgl3) from Streptomyces sp. has been cloned and overexpressed in Escherichia coli. The introduction of a His tag at the N-terminal end of the protein has allowed its purification to homogeneity by a single chromatographic step, with yields of 150-200 mg of pure protein per litre of E. coli culture. The enzyme (52.6 kDa) is a retaining glycosidase able to hydrolyze a wide range of disaccharides and oligosaccharides and to perform transglycosylation. Crystals of recombinant Bgl3 have been grown from an ammonium sulfate solution using the hanging-drop vapour-diffusion method at 293 K. The crystals belong to the orthorhombic space group I222 with unit-cell dimensions a = 101.6, b = 113.4 and c = 187.5 A at room temperature and contain two molecules per asymmetric unit. A full 1.69 A resolution diffraction data set (97.7% completeness) has been collected from frozen crystals in a solution containing 30% sucrose, using synchrotron radiation.


Subject(s)
beta-Glucosidase/chemistry , Base Sequence , Cloning, Molecular , Crystallization , Crystallography, X-Ray , DNA Primers , Escherichia coli/genetics , Protein Conformation , Recombinant Proteins/chemistry , Recombinant Proteins/genetics , Streptomyces/enzymology , beta-Glucosidase/genetics
17.
EMBO J ; 17(24): 7404-15, 1998 Dec 15.
Article in English | MEDLINE | ID: mdl-9857196

ABSTRACT

The structure of the 45 amino acid transcriptional repressor, CopG, has been solved unliganded and bound to its target operator DNA. The protein, encoded by the promiscuous streptococcal plasmid pMV158, is involved in the control of plasmid copy number. The structure of this protein repressor, which is the shortest reported to date and the first isolated from a plasmid, has a homodimeric ribbon-helix-helix arrangement. It is the prototype for a family of homologous plasmid repressors. CopG cooperatively associates, completely protecting several turns on one face of the double helix in both directions from a 13-bp pseudosymmetric primary DNA recognition element. In the complex structure, one protein tetramer binds at one face of a 19-bp oligonucleotide, containing the pseudosymmetric element, with two beta-ribbons inserted into the major groove. The DNA is bent 60 degrees by compression of both major and minor grooves. The protein dimer displays topological similarity to Arc and MetJ repressors. Nevertheless, the functional tetramer has a unique structure with the two vicinal recognition ribbon elements at a short distance, thus inducing strong DNA bend. Further structural resemblance is found with helix-turn-helix regions of unrelated DNA-binding proteins. In contrast to these, however, the bihelical region of CopG has a role in oligomerization instead of DNA recognition. This observation unveils an evolutionary link between ribbon-helix-helix and helix-turn-helix proteins.


Subject(s)
Bacterial Proteins/chemistry , DNA Helicases , DNA, Bacterial/chemistry , Operator Regions, Genetic , Proteins/chemistry , Repressor Proteins/chemistry , Trans-Activators , Amino Acid Sequence , Bacterial Proteins/metabolism , Crystallography, X-Ray , DNA-Binding Proteins/chemistry , Dimerization , Gene Dosage , Models, Molecular , Molecular Sequence Data , Multigene Family , Plasmids , Protein Binding , Proteins/metabolism , Repressor Proteins/metabolism , Sequence Homology, Amino Acid , Viral Proteins/chemistry , Viral Regulatory and Accessory Proteins
18.
J Biol Chem ; 273(40): 25565-72, 1998 Oct 02.
Article in English | MEDLINE | ID: mdl-9748220

ABSTRACT

The kinetics of the hydrolysis of cytidine 2',3'-cyclic phosphate (C>p) to 3'-CMP by ribonuclease A are multiphasic at high substrate concentrations. We have investigated these kinetics by determining 3'-CMP formation both spectrophotometrically and by a highly specific and quantitative chemical sampling method. With the use of RNase A derivatives that lack a functional p2 binding subsite, evidence is presented that the abnormal kinetics with the native enzyme are caused by the sequential binding of the substrate to the several subsites that make up the active site of ribonuclease. The evidence is based on the following points. 1) Some of the unusual features found with native RNase A and C>p as substrate disappear when the derivatives lacking a functional p2 binding subsite are used. 2) The kcat/Km values with oligocytidylic acids of increasing lengths (ending in C>p) show a behavior that parallels the specific velocity with C>p at high concentrations: increase in going from the monomer to the trimer, a decrease from tetramer to hexamer, and then an increase in going to poly(C). 3) Adenosine increases the kcat obtained with a fixed concentration of C>p as substrate. 4) High concentrations of C>p protect the enzyme from digestion with subtilisin, which results in a more compact molecule, implying large substrate concentration-induced conformational changes. The data for the hydrolysis of C>p by RNase A can be fitted to a fifth order polynomial that has been derived from a kinetic scheme based on the sequential binding of several monomeric substrate molecules.


Subject(s)
Cytosine Nucleotides/metabolism , Ribonuclease, Pancreatic/chemistry , Adenosine/pharmacology , Animals , Binding Sites/physiology , Cattle , Cytidine Monophosphate/metabolism , Hydrolysis , Kinetics , Molecular Structure , Mutation/genetics , Oligoribonucleotides/metabolism , Poly C/metabolism , Protein Conformation , Spectrophotometry , Substrate Specificity , Subtilisins/metabolism
19.
FEBS Lett ; 430(3): 283-7, 1998 Jul 03.
Article in English | MEDLINE | ID: mdl-9688556

ABSTRACT

The connector or portal particle from double-stranded DNA bacteriophage phi29 has been crystallized. This structure, which connects the head of the virus with the tail and plays a central role in prohead assembly and DNA packaging and translocation, is formed by 12 subunits of the p10 protein and has a molecular weight of 430 kDa. The connector structure was proteolysed with endoproteinase Glu-C from Staphylococcus aureus V8, which removes 13 and 18 amino acids from the amino- and carboxy-terminal regions of the p10 protein, respectively. Two crystal forms were grown from drops containing an alcohol solution and paraffin oil. Crystals of form I are monoclinic, space group C2 with cell dimensions a = 416.86 A, b = 227.62 A, c = 236.68 A and beta = 96.3 degrees and contain four connector particles per asymmetric unit. Crystals of form II are tetragonal, space group P4(2)2(1)2 with cell dimensions a = b = 170.2 A, c = 156.9 A and contain half a particle per asymmetric unit. X-ray diffraction data from both native crystal forms have been collected to 6.0 and 3.2 A respectively, using synchrotron radiation. Crystals of form II are likely to have the same packing arrangement as the two-dimensional crystals analyzed previously by electron microscopy.


Subject(s)
Bacillus Phages/chemistry , Capsid Proteins , Capsid/chemistry , Capsid/isolation & purification , Crystallography, X-Ray/methods , Bacillus subtilis/virology , Crystallization
20.
J Mol Biol ; 281(2): 219-25, 1998 Aug 14.
Article in English | MEDLINE | ID: mdl-9698542

ABSTRACT

The internal symmetry of the connector or portal particle from the double-stranded DNA bacteriophage phi29 has been examined by X-ray crystallography. This large multimeric structure (420 kDa) is built up by a number of identical subunits of the p10 protein. It connects the head of the virus with the tail and plays a central role in the prohead assembly and DNA packaging. For the first time a bacteriophage connector has been crystallized and X-ray data have been collected up to a resolution of 3.2 A. A self-rotation function has been calculated, unambigously revealing the 12-fold symmetry of the particle and its orientation in the crystal lattice. The orientation has been confirmed by calculating a cross-rotation function using a low resolution model based on electron microscopy reconstructions.


Subject(s)
Bacillus Phages/chemistry , Capsid Proteins , Capsid/chemistry , Crystallography, X-Ray/methods , Capsid/ultrastructure , Crystallization , Image Processing, Computer-Assisted , Microscopy, Electron
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