Infectious Inequity: How the Gut Microbiome and Social Determinants of Health May Contribute to Clostridioides difficile Infection Among Racial and Ethnic Minorities.

Infectious diseases are a leading contributor to death in the United States, and racial differences in clinical outcomes have been increasingly reported. Clostridioides difficile infection (CDI) is a growing public health concern, as it causes nearly half a million infections per year and considerable excess hospital costs. Concurrent with other infectious diseases, recent literature denotes racial disparities in CDI incidence rates, mortality, and associated morbidity. Of note, investigations into CDI and causative factors suggest that inequities in health-related social needs and other social determinants of health (SDoH) may cause disruption to the gut microbiome, thereby contributing to the observed deleterious outcomes in racially and ethnically minoritized individuals. Despite these discoveries, there is limited literature that provides context for the recognized racial disparities in CDI, particularly the influence of structural and systemic barriers. Here, we synthesize the available literature describing racial inequities in CDI outcomes and discuss the interrelationship of SDoH on microbiome dysregulation. Finally, we provide actionable considerations for infectious diseases professionals to aid in narrowing CDI equity gaps.

Nivel de conocimiento del profesional de enfermería al administrar el activador plasminógeno tisular en pacientes con ICTUS / Level of knowledge of the nursing professional when applying tissue plasminogen activator in patients with STROKE

Introducción: el tratamiento con activador recombinante del plasminógeno tisular (siglas en inglés rt-PA), aplicado vía intravenosa (IV) es el procedimiento de primera línea en casos de evento vascular cerebral (EVC) en una ventana de 4,5 horas a partir del inicio de los síntomas y con bajo riesgo de transformación hemorrágica del infarto cerebral. El personal de enfermería es un elemento clave para el tratamiento de las personas que han padecido un EVC y se encuentra en su etapa aguda. La fibrinólisis con alteplasa (rt-PA) se ha establecido como tratamiento de primera línea para los casos de ictus isquémico, la administración de este fármaco, control y seguimiento de estos pacientes idealmente debe realizarse por el personal de enfermería en las unidades de ictus. Objetivo: investigar el nivel de conocimiento del personal de enfermería en la administración del activador recombinante del plasminógeno tisular (rt-PA) en el servicio de urgencias en una institución de tercer nivel. Material y métodos: se realizó un estudio descriptivo y transversal en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez de la Ciudad de México, con un muestreo por conveniencia, participaron 33 profesionales de enfermería que laboran en el servicio de urgencias, se observaron las 24 horas del día. Se tomó en cuenta a enfermeras de todas las categorías, excluyendo a personal médico, camilleros y enfermeras suplentes. Se aplicó un instrumento para evaluar el conocimiento sobre enfermedad vascular isquémica e intervenciones de enfermería en el cuidado inmediato y mediato en la administración del fármaco activador tisular de plasminógeno (rt-PA). Resultados: llama la atención que sólo 58 % del personal de enfermería conozca el tiempo vital para recuperar al cerebro, otro dato que alarma es que el 30 % no tiene claro el concepto de ictus y al ser una institución de especialidad neurológica de debe establecer un programa de capacitación para establecer intervenciones oportunas con (rt-PA) para reducir secuelas o daño neurológico. Discusión: el papel del personal de enfermería en unidades especializadas en afecciones neurológicas a los pacientes con ictus es proporcionar un cuidado de calidad, eficaz y eficiente, además de participar en la valoración integral del paciente y en la administración del actilyse cuando se trata de una terapia fibrinolítica. En consecuencia, la enfermera debe estar formada sobre los cuidados que requiere este tipo de pacientes, las complicaciones propias de la patología, tratamiento y efectos secundarios del mismo. Proponer un plan de cuidados integral, porque ya el personal tiene conocimientos al respecto de la enfermedad y la aplicación del activador tisular, pero sería interesante implementar para los profesionales en formación, sin olvidar la elaboración de una propuesta como guía de actuación. Conclusión: los cuidados que el personal de enfermería lleva a cabo deben ser especializados en constante actualización y capacitación para ser capaces de detectar y prevenir las complicaciones del proceso patológico y tratamiento.

Introduction: recombinant tissue plasminogen activator (rt-PA) therapy, given intravenously (IV), is the first-line procedure in cases of cerebral vascular event (CVE) within 4.5 hours of symptom onset and with low risk of haemorrhagic transformation of cerebral infarction. Nurses are a key element in the management of people who have suffered a stroke and are in the acute stage. Fibrinolysis with alteplase (rt-PA) has been established as the first-line treatment for ischaemic stroke, and the administration of this drug, control and follow-up of these patients should ideally be carried out by nurses in stroke units. Objective: to investigate the level of nursing staff knowledge in the administration of recombinant tissue plasminogen activator (rt-PA) in the emergency department of a tertiary care institution. Material and methods: a descriptive, cross-sectional study was carried out at the Manuel Velasco Suárez National Institute of Neurology and Neurosurgery in Mexico City, with convenience sampling. 33 nursing professionals working in the emergency department participated, and 24 hours a day were observed. All categories of nurses were considered, excluding medical staff, orderlies and substitute nurses. An instrument was used to assess knowledge of ischaemic vascular disease and nursing interventions in immediate and intermediate care in the administration of tissue plasminogen activator (rt-PA). Results: It is striking that only 58 % of nursing staff are aware of the vital time to recover the brain, another alarming fact is that 30 % are not clear about the concept of stroke and, being a neurological speciality institution, a training programme should be established to establish timely interventions with (rt-PA) to reduce sequelae or neurological damage. Discussion: the role of nurses in units specialising in neurological disorders in stroke patients is to provide quality, effective and efficient care, in addition to participating in the comprehensive assessment of the patient and in the administration of actilyse in the case of fibrinolytic therapy. Consequently, the nurse must be trained in the care required by this type of patient, the complications of the pathology, treatment and its side effects. Propose a comprehensive care plan, because the staff already has knowledge of the disease and the application of the tissue activator, but it would be interesting to implement it for professionals in training, without forgetting the development of a proposal as a guide for action. Conclusion: the care carried out by nursing staff must be specialised and constantly updated and trained in order to be able to detect and prevent complications of the pathological process and treatment.

Patient-cost survey for tuberculosis in the context of patient-pathway modelling.

SETTING: Eight tuberculosis treatment sites in Cavite Province, the Philippines, including two sites specialising in management of multidrug-resistant tuberculosis (MDR-TB).OBJECTIVE: To evaluate costs incurred by TB patients and to determine the proportion of households that faced catastrophic costs, then to consider cost survey responses alongside results of detailed patient-pathway modelling.DESIGN: Clustered cross-sectional survey using a field testing version of the WHO TB patient-costing tool and protocol; face-to-face interviews with 194 patients conducted in May-August 2016. Costs included direct-medical, direct non-medical and indirect costs using the human capital approach. Patients were deemed to incur catastrophic expenditure if TB-related costs exceeded 20% of annual household income. Patient pathways were modelled following multiple health staff interviews.RESULTS: Estimated mean cost incurred by patients with drug-susceptible TB was US$321 vs. $2356 for MDR-TB patients. Catastrophic costs were suffered by 28% of drug-susceptible and 80% of MDR-TB patients, with lost income being the largest contributor. Patient-pathway modelling suggested most patients had under-reported health visits.CONCLUSION: Survey results indicate that patient costs are large for all patients in Cavite, particularly for MDR-TB patients. Patient-pathway modelling suggests these costs are an underestimate due to poor recollection of health visits, suggesting that the WHO instrument and protocol could be improved to better capture the diagnostic journey.

Viable bacterial colonization is highly limited in the human intestine in utero.

Mucosal immunity develops in the human fetal intestine by 11-14 weeks of gestation, yet whether viable microbes exist in utero and interact with the intestinal immune system is unknown. Bacteria-like morphology was identified in pockets of human fetal meconium at mid-gestation by scanning electron microscopy (n = 4), and a sparse bacterial signal was detected by 16S rRNA sequencing (n = 40 of 50) compared to environmental controls (n = 87). Eighteen taxa were enriched in fetal meconium, with Micrococcaceae (n = 9) and Lactobacillus (n = 6) the most abundant. Fetal intestines dominated by Micrococcaceae exhibited distinct patterns of T cell composition and epithelial transcription. Fetal Micrococcus luteus, isolated only in the presence of monocytes, grew on placental hormones, remained viable within antigen presenting cells, limited inflammation ex vivo and possessed genomic features linked with survival in the fetus. Thus, viable bacteria are highly limited in the fetal intestine at mid-gestation, although strains with immunomodulatory capacity are detected in subsets of specimens.

The effects of a prebiotic supplement (Prebio Support) on fecal and salivary IgA in neonatal dairy calves.

The newborn calf's gastrointestinal tract is sterile at birth, but by 3 days of age coliforms, Lactobacilli, and Bifidobacteria are the predominant flora in the feces. During the preweaning period, calves are susceptible to diarrhea that can lead to high levels of morbidity and mortality. Diarrhea has been related with a decrease of beneficial microbiota and an increase of coliform counts in feces. Prebiotic supplements are believed to decrease diarrhea and positively affect some parameters of the immune system. In calves, these supplements have shown some promising effects on intestinal microbial populations but there is limited information about effects on immunity. The main objectives of this study were to evaluate effects of a prebiotic supplement containing fermentation products of lactic acid bacteria on the mucosal immune system by measuring fecal and salivary IgA and to evaluate calf health and growth performance. In this trial 40 Holstein calves were randomly assigned to receive milk replacer with a prebiotic supplement (20 g/day Prebio Support™; Meiji Feed Co., Ltd. Tokyo, Japan) or the same milk replacer with no prebiotic (control). Fecal and salivary IgA, calf health, plasma IgG, and lymphocyte counts were not affected by treatment. Lactobacilli count in feces was higher (P = 0.05) and Bifidobacteria tended to be higher (P = 0.07) in calves fed prebiotic. Prebiotic supplement increased beneficial bacteria in calves, but did not decrease overall incidence of diarrhea in this trial. Calves in this study were all affected by cryptosporidiosis and some were treated with antibiotics, so it is possible that this limited some of the effects of the prebiotic product. Fecal IgA seemed to be a good measure of mucosal immunity, and more studies are needed to develop methods to measure this type of immunity in calves.

El dilema ético de la fluoración del agua potable / The ethical dilemma of water fluoridation

Dental caries remains a worldwide public health problem because of its magnitude and impact on affected people's quality of life. Among preventive strategies, water fluoridation is one of the most important, but its value still remains uncertain after more than a half of Century of its use. The aim of this study is to analyse some of the ethical arguments for and against water fluoridation and to determine if empirical data allow to decide if there are correct policies from a bioethical perspective. Autonomy, compulsory medication (mass medication), precautionary principle, justice in health care and ethics of protection are discussed. It is concluded that fluoridation is beneficial and that there is no ethical reason to oppose it, based on a specific kind of ethics developed to analyse and clarify complex public health's issues.

Evolucion de la situación alimentaria en Chile / Evolution of the food situation in Chile

The aim of this work was to assess the evolution of the food situation in Chile between 1964 and 2003. Food balance sheets (FAO), household survey of budget expenses (National Institute of Statistics) and quality of life and health survey (Health Ministry) were analysed. The dietary energy supply rose from 2,630 kcal/day/person in 1965 to 2,872 kcal/day/person in 2003. The amount of meat available for human consumption increased 20,6% between 1995 and 2003, but there was a decrease in fish/seafood (-33,3%) and fruits (-20,6%)availability. The intake of fat rose 50,5% between 1988 and 1997; household food expenses increased 31,1%, while its weight on total household expenses decreased 18,5%. This nutritional profile could explain the high prevalence of overweight/obesity and non-communicable chronic diseases observed in Chile. The modification of household food expenses also suggests an improvement in household income. Some opportunities and challenges for intervention in the Chilean population are proposed.

El objetivo fue evaluar la evolución de la situación alimentaria en Chile entre 1964 y 2003. Se analizó la información disponible en hojas de balance (FAO), encuestas de presupuestos familiares (INE) y encuesta de calidad de vida y salud (MINSAL). Los resultados mostraron aumento del suministro de energía alimentario desde 2630 kcal/día/persona en 1965 a 2872 en 2003. La disponibilidad de carnes aumentó 20,6% entre 1995 y 2003, pero disminuyó la de pescados/mariscos (-33%) y frutas (-22,1%). Entre 1988 y 1997, el consumo aparente de grasas aumentó 50,5%; el gasto en alimentación aumentó 31,1%, mientras que su ponderación del gasto total disminuyó 18,5%. Este cambio en el perfil alimentario contribuye a explicar las altas prevalencias de trastornos nutricionales por exceso y de enfermedades crónicas no transmisibles, mientras que las modificaciones en el gasto en alimentación sugieren un aumento en el nivel de ingresos. A partir de lo anterior se identifican oportunidades y desafíos de intervención para la población chilena.

[The ethical dilemma of water fluoridation]. / El dilema ético de la fluoración del agua potable.

Dental caries remains a worldwide public health problem because of its magnitude and impact on affected people's quality of life. Among preventive strategies, water fluoridation is one of the most important, but its value still remains uncertain after more than a half century of its use. The aim of this study is to analyse some of the ethical arguments for and against water fluoridation and to determine if empirical data allow to decide if there are correct policies from a bioethical perspective. Autonomy, compulsory medication (mass medication), precautionary principle, justice in health care and ethics of protection are discussed. It is concluded that fluoridation is beneficial and that there is no ethical reason to oppose it, based on a specific kind of ethics developed to analyse and clarify complex public health issues.

A combination of a transforming growth factor-beta antagonist and an inhibitor of cyclooxygenase is an effective treatment for murine pulmonary tuberculosis.

Transforming growth factor-beta (TGF-beta) and prostaglandins (PG) regulate the cell-mediated immune response, so it has been proposed that they affect the progression of pulmonary tuberculosis. Here we report that the administration of soluble betaglycan, a potent TGF-beta antagonist, and niflumic acid, a PG synthesis inhibitor, during the chronic phase of experimental murine tuberculosis enhanced Th1 and decreased Th2 cytokines, increased the expression of iNOS and reduced pulmonary inflammation, fibrosis and bacillary load. This immunotherapeutic approach resulted in significant control of the disease comparable to that achieved by anti-microbial treatment alone. Importantly, the combination of immunotherapy and anti-microbials resulted in an accelerated clearance of bacilli from the lung. These results confirm that TGF-beta and PG have a central pathophysiological role in the progression of pulmonary tuberculosis in the mouse and suggest that the addition of immunotherapy to conventional anti-microbial drugs might result in improved treatment of the disease.

Protection of islets in culture by delivery of oxygen binding neuroglobin via protein transduction.

Islet transplantation has become an accepted method to treat type 1 diabetes. To succeed and achieve normal levels of glucose in transplant recipients, the quality of the transplanted islets is of the utmost importance. Lack of oxygen during organ procurement, islet isolation, and subsequent culture triggers apoptosis or necrosis and loss of islet function, causing the yield and quality to diminish. A promising candidate for cytoprotection against oxygen deprivation is neuroglobin (Ngb). Ngb is a recently described member of globin family and is expressed in neurons, retina, and pancreatic islets. To overexpress this protein in the islets and study its ability to protect them, we utilized protein transduction. Protein transduction is achieved by fusing Ngb to the TAT/PTD transduction domain, a peptide originated from the HIV transcriptional transactivator protein. Our study proved that TAT-Ngb is an efficient fusion protein capable of protecting the human islets in culture from loss of cell mass and function, thus increasing the quality of transplantable islets. If the islets could be cultured for a longer period of time without suffering harmful effects, it would be possible to precondition the recipient and there would be more time to assess their quality and function before transplantation.

A comparative analysis of abandoned street children and formerly abandoned street children in La Paz, Bolivia.

AIMS AND METHODS: A comparative study of abandoned street children and formerly abandoned street children was conducted in La Paz, Bolivia, representing the first such comparative assessment. Between August and December 1997, all abandoned street children in La Paz, Bolivia, who were willing to participate (n = 124) were interviewed repeatedly at night using standardised questionnaires to collect information on family history, demographics, socioeconomics, drug use, and physical/sexual abuse. The same questionnaires were administered to all former abandoned street children who chose to enter a local orphanage (n = 35). RESULTS: The persistent street children differed greatly from those who entered the orphanage, most markedly in their higher risk of police abuse (95% versus 38%), absence from school (84% versus 19%), engagement in robbery (26% versus 4%), paint thinner use (88% versus 41%), alcohol use (58% versus 12%), and a serious medical problem (53% versus 20%). The risks for street children increased rapidly with age. CONCLUSIONS: A cascade of adverse outcomes afflicts the vast majority of abandoned street children in La Paz, which cumulate with age and diminish the likelihood of successful rehabilitation through lasting placement in an orphanage or residential home. Informed by these findings, the investigators operate a home for abandoned street children in La Paz.

Culturally appropriate care for pregnant Latina women who are victims of domestic violence.

Latina women who are pregnant and experiencing domestic violence face many barriers to accessing care and finding culturally appropriate services. These barriers are entwined in a complex web of social, cultural, economic, political, and legal issues. Leininger's cultural care model is presented as a framework to discuss culturally appropriate assessment of Latina women in various health care settings. Recommendations are made for the role of nurses in primary prevention interventions at the individual and community levels.

Synergy of histone-derived peptides of coho salmon with lysozyme and flounder pleurocidin.

Recent research has identified endogenous cationic antimicrobial peptides as important factors in the innate immunity of many organisms, including fish. It is known that antimicrobial activity, as well as lysozyme activity, can be induced in coho salmon (Oncorhynchus kisutch) mucus after exposure of the fish to infectious agents. Since lysozyme alone does not have antimicrobial activity against Vibrio anguillarum and Aeromonas salmonicida, a four-step protein purification protocol was used to isolate and identify antibacterial fractions from bacterially challenged coho salmon mucus and blood. The purification consisted of extraction with hot acetic acid, extraction and concentration on a C(18) cartridge, gel filtration, and reverse-phase chromatography on a C(18) column. N-terminal amino acid sequence analyses revealed that both the blood and the mucus antimicrobial fractions demonstrated identity with the N terminus of trout H1 histone. Mass spectroscopic analysis indicated the presence of the entire histone, as well as fragments thereof, including a 26-amino-acid N-terminal segment. These fractions inhibited the growth of antibiotic-supersuscptible Salmonella enterica serovar Typhimurium, as well as A. salmonicida and V. anguillarum. Synthetic peptides identical to the N-terminally acetylated or C-terminally amidated 26-amino-acid fragment were inactive in antimicrobial assays, but they potentiated the antimicrobial activities of the flounder peptide pleurocidin, lysozyme, and crude lysozyme-containing extracts from coho salmon. The peptides bound specifically to anionic lipid monolayers. However, synergy with pleurocidin did not appear to occur at the cell membrane level. The synergistic activities of inducible histone peptides indicate that they play an important role in the first line of salmon defenses against infectious pathogens and that while some histone fragments may have direct antimicrobial effects, others improve existing defenses.

Recombinant soluble betaglycan is a potent and isoform-selective transforming growth factor-beta neutralizing agent.

Betaglycan is an accessory receptor of members of the transforming growth factor-beta (TGF-beta) superfamily, which regulates their actions through ligand-dependent interactions with type II receptors. A natural soluble form of betaglycan is found in serum and extracellular matrices. Soluble betaglycan, prepared as a recombinant protein using the baculoviral expression system, inhibits the actions of TGF-beta. Because of its potential use as an anti-TGF-beta therapeutic agent, we have purified and characterized baculoviral recombinant soluble betaglycan. Baculoviral soluble betaglycan is a homodimer formed by two 110 kDa monomers associated by non-covalent interactions. This protein is devoid of glycosaminoglycan chains, although it contains the serine residues, which, in vertebrate cells, are modified by these carbohydrates. On the other hand, mannose-rich carbohydrates account for approximately 20 kDa of the mass of the monomer. End-terminal sequence analysis of the soluble betaglycan showed that Gly(24) is the first residue of the mature protein. Similarly to the natural soluble betaglycan, baculoviral soluble betaglycan has an equilibrium dissociation constant (K(d)) of 3.5 nM for TGF-beta1. Ligand competition assays indicate that the relative affinities of recombinant soluble betaglycan for the TGF-beta isoforms are TGF-beta2>TGF-beta3>TGF-beta1. The anti-TGF-beta potency of recombinant soluble betaglycan in vitro is 10-fold higher for TGF-beta2 than for TGF-beta1. Compared with a commercial pan-specific anti-TGF-beta neutralizing antibody, recombinant soluble betaglycan is more potent against TGF-beta2 and similar against TGF-beta1. These results indicate that baculoviral soluble betaglycan has the biochemical and functional properties that would make it a suitable agent for the treatment of the diseases in which excess TGF-beta plays a central physiopathological role.

Neuropsychological profile of patients with primary systemic hypertension.

Arterial hypertension represents a risk factor for cerebrovascular disease. It has been hypothesized that chronic hypertension may eventually result in small subcortical infarcts associated with some cognitive impairments. One hundred fourteen patients with primary systemic hypertension (PSH) and 114 matched subjects were selected. PSH patients were further divided in four groups depending upon the hypertension severity. In addition to the medical and laboratory exams, a neuropsychological evaluation was administered. The NEUROPSI neuropsychological test battery was used. An association between level of hypertension and cognitive impairment was observed. Most significant differences were observed in the following domains: Reading, executive functioning, constructional, and memory-recall. No differences were observed in orientation, memory-recognition, and language. Some neuropsychological functions appeared impaired even in the PSH group with the least risk factors. Cognitive evaluation may be important in cases of PSH not only to determine early subtle cognitive changes, but also for follow-up purposes, and to assess the efficacy of different therapeutic procedures.

Learning to read is much more than learning to read: a neuropsychologically based reading program.

Departing from the observation that illiterates significantly underscore in some neuropsychological tests, a learning-to-read method named NEUROALFA was developed. NEUROALFA is directed to reinforce these underscored abilities during the learning-to-read process. It was administered to a sample of 21 adult illiterates in Colima (Mexico). Results were compared with 2 control groups using more traditional procedures in learning to read. The NEUROPSI neuropsychological test battery was administered to all the participants before and after completing the learning-to-read training program. All 3 groups presented some improvement in the test scores. Gains, however, were significantly higher in the experimental group in Orientation in Time, Digits Backward, Visual Detection, Verbal Memory, Copy of a Semi-Complex Figure, Language Comprehension, Phonological Verbal Fluency, Similarities, Calculation Abilities, Sequences, and all the recall subtests, excluding Recognition. Performance in standard reading tests was also significantly higher in the experimental group. Correlations between pretest NEUROPSI scores and reading ability were low. However, correlations between posttest NEUROPSI scores and reading scores were higher and significant for several subtests. Results are interpreting as supporting the assumption that reinforcement of those abilities in which illiterates significantly underscore results in a significant improvement in neuropsychological test scores and strongly facilitates the learning-to-read process. The NEUROALFA method of teaching reading to adult illiterates is beginning to be used extensively in Mexico. To our knowledge, this is the first attempt to apply neuropsychological principles to social problems.

Thyrotoxic periodic paralysis in Mexican mestizo patients: a clinical, biochemical and HLA-serological study.

BACKGROUND: Thyrotoxic periodic paralysis (TPP) is characterized by episodes of neuromuscular weakness occurring in the context of hypokalemia and hyperthyroidism and has been predominantly described in Oriental populations. Whereas it is uncommon in Caucasians and Blacks, TPP does occur in individuals of Native American descent. The objective was to analyze the clinical, biochemical, and HLA characteristics of a group of Mexican mestizo patients with TPP. METHODS: The sample was comprised of 14 men with TPP diagnosed since January 1990, based on one or more episodes of flaccid paralysis, accompanied by hypokalemia and occurring in the context of clinical and biochemical hyperthyroidism. Eight were available for HLA testing. RESULTS: Hyperthyroidism was diagnosed before the development of periodic paralysis in five of the patients, whereas in six it occurred afterward. The severity of paralysis did not correlate with the degree of either hypokalemia or hyperthyroidism. An increased frequency of HLA-DR3 was found in Graves' patients without paralysis but not in those with paralysis, as compared to the general population. CONCLUSIONS: TPP is more common than previously thought in Mexicans, in whom it behaves as in other Native American groups. The lack of HLA-DR3 association in Graves' patients with TPP is interesting, but at the moment has no pathophysiological implications.

Murine betaglycan primary structure, expression and glycosaminoglycan attachment sites.

The primary structure of murine betaglycan, also known as transforming growth factor beta (TGF-beta) type III receptor, was deduced from the nucleotide sequence of a cDNA clone isolated from a heart library. Murine betaglycan is a single spanning membrane polypeptide of 850 amino acids which is highly similar to betaglycan of other species. Transfection of this cDNA into COS1 cells resulted in the expression of a membrane proteoglycan that binds TGF-beta and is recognized by antibodies raised against rat betaglycan. COS1 cells transfected with the double mutant Ser533Ala; Ser544Ala of the murine betaglycan cDNA produced a TGF-beta type III receptor devoid of glycosaminoglycan chains.