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1.
Biochemistry ; 59(14): 1410-1419, 2020 04 14.
Artículo en Inglés | MEDLINE | ID: mdl-32208682

RESUMEN

Somapacitan, a human growth hormone derivative that binds reversibly to albumin, was investigated for human serum albumin (HSA) and HSA domain binding. Isothermal titration calorimetry (ITC) binding profiles showed high-affinity binding (∼100-1000 nM) of one somapacitan molecule and low-affinity binding (∼1000-10000 nM) of one to two somapacitan molecules to HSA. The high-affinity site was identified in HSA domain III using size exclusion chromatography (SEC) and ITC. SEC studies showed that the neonatal Fc receptor shields one binding site for somapacitan, indicating its position in domain III. A crystal structure of somapacitan in complex with HSA optimized for neonatal Fc receptor binding, having four amino acid residue replacements, identified a low-affinity site in fatty acid-binding site 6 (domain II). Surface plasmon resonance (SPR) showed these replacements affect the kinetics of the high-affinity binding site. Furthermore, small-angle X-ray scattering and SPR brace two somapacitan-binding sites on HSA.


Asunto(s)
Hormona del Crecimiento/química , Albúmina Sérica Humana/química , Sitios de Unión , Hormona del Crecimiento/análogos & derivados , Hormona del Crecimiento/metabolismo , Humanos , Cinética , Unión Proteica , Dominios Proteicos , Albúmina Sérica Humana/metabolismo , Resonancia por Plasmón de Superficie
2.
Protein Sci ; 23(8): 1023-35, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24832484

RESUMEN

The interaction of lipolytic enzymes with anionic surfactants is of great interest with respect to industrially produced detergents. Here, we report the interaction of cutinase from the thermophilic fungus Humicola insolens with the anionic surfactant SDS, and show the enzyme specifically binds a single SDS molecule under nondenaturing concentrations. Protein interaction with SDS was investigated by NMR, ITC and molecular dynamics simulations. The NMR resonances of the protein were assigned, with large stretches of the protein molecule not showing any detectable resonances. SDS is shown to specifically interact with the loops surrounding the catalytic triad with medium affinity (Ka ≈ 10(5) M(-1) ). The mode of binding is closely similar to that seen previously for binding of amphiphilic molecules and substrate analogues to cutinases, and hence SDS acts as a substrate mimic. In addition, the structure of the enzyme has been solved by X-ray crystallography in its apo form and after cocrystallization with diethyl p-nitrophenyl phosphate (DNPP) leading to a complex with monoethylphosphate (MEP) esterified to the catalytically active serine. The enzyme has the same fold as reported for other cutinases but, unexpectedly, esterification of the active site serine is accompanied by the ethylation of the active site histidine which flips out from its usual position in the triad.


Asunto(s)
Ascomicetos/enzimología , Hidrolasas de Éster Carboxílico/química , Dodecil Sulfato de Sodio/química , Sitios de Unión , Hidrolasas de Éster Carboxílico/metabolismo , Cristalografía por Rayos X , Espectroscopía de Resonancia Magnética , Modelos Moleculares , Estructura Molecular , Dodecil Sulfato de Sodio/metabolismo , Termodinámica
3.
J Pharm Sci ; 103(1): 115-27, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24282022

RESUMEN

Few studies have so far directly compared the impact of antibody subclass on protein stability. This case study investigates two mAbs (one IgG1 and one IgG4 ) with identical variable region. Investigations of mAbs that recognize similar epitopes are necessary to identify possible differences between the IgG subclasses. Both physical and chemical stability were evaluated by applying a range of methods to measure formation of protein aggregates [size-exclusion chromatography (SEC)-HPLC and UV340 nm], structural integrity (circular dichroism and FTIR), thermodynamic stability (differential scanning calorimetry), colloidal interactions (dynamic light scattering), and fragmentation and deamidation (SEC-HPLC and capillary isoelectric focusing). The impact of pH (4-9) and ionic strength (10 and 150 mM) was investigated using highly-concentrated (150 mg/mL) mAb formulations. Lower conformational stability was identified for the IgG4 resulting in increased levels of soluble aggregates. The IgG1 was chemically less stable as compared with the IgG4 , presumably because of the higher flexibility in the IgG1 hinge region. The thermodynamic stability of individual mAb domains was also addressed in detail. The stability of our mAb molecules is clearly affected by the IgG framework, and this study suggests that subclass switching may alter aggregation propensity and aggregation pathway and thus potentially improve the overall formulation stability while retaining antigen specificity.


Asunto(s)
Anticuerpos Monoclonales/química , Inmunoglobulina G/química , Concentración de Iones de Hidrógeno , Concentración Osmolar , Temperatura , Termodinámica
4.
Eur J Pharm Sci ; 49(3): 400-10, 2013 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-23624326

RESUMEN

The purpose of this work was to explore the relation between protein-protein interactions (PPIs) and solution viscosity at high protein concentration using three monoclonal antibodies (mAbs), two of the IgG4 subclass and one of the IgG1 subclass. A range of methods was used to quantify the PPI either at low concentration (interaction parameter (kD) obtained from dynamic light scattering, DLS) or at high concentration (solution storage modulus (G') from ultrasonic shear rheology). We also developed a novel method for the determination of PPI using the apparent radius of the protein at either low or high protein concentration determined using DLS. The PPI measurements were correlated with solution viscosity (measured by DLS using polystyrene nanospheres and ultrasonic shear rheology) as a function of pH (4-9) and ionic strength (10, 50 and 150 mM). Our measurements showed that the highest solution viscosity was observed under conditions with the most negative kD, the highest apparent radius and the lowest net charge. An increase in ionic strength resulted in a change in the nature of the PPI at low pH from repulsive to attractive. In the neutral to alkaline pH region the mAbs behaved differently with respect to increase in ionic strength. Two mAbs (A and B) showed little or no effect of increasing ionic strength, whereas mAb-C showed a remarkable decrease in attractive PPI and viscosity. Previous studies have mainly investigated mAbs of the IgG1 and IgG2 subclass. We show here, for the first time, that mAbs of the IgG4 subclass behave similar as the other subclasses. By comparison of the three tested mAbs with mAbs investigated in other studies a clear linear trend emerges between the pH of strongest attractive PPI and highest solution viscosity. The determination of PPI using either kD or apparent radius is thus a useful prediction tool in the determination of solution conditions that favors low solution viscosity at high protein concentration of therapeutically used mAb molecules. The novel methodology using apparent radius is a simple and rapid alternative to determine relative PPI directly under formulation conditions. The method can potentially serve as a high-throughput screening tool in formulation development.


Asunto(s)
Anticuerpos Monoclonales/química , Inmunoglobulina G/química , Concentración de Iones de Hidrógeno , Nanosferas/química , Concentración Osmolar , Poliestirenos/química , Mapeo de Interacción de Proteínas , Viscosidad
5.
Eur J Pharm Biopharm ; 79(2): 399-405, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21620970

RESUMEN

The effects of PEGylation on the structural, thermal and functional stability of bovine serum albumin (BSA) were investigated using BSA and 6 linear mono-PEGylated BSA compounds. The secondary and tertiary structure of BSA measured by circular dichroism (CD) was independent of PEGylation. In contrast, the thermal stability of BSA was affected by PEGylation. The apparent unfolding temperature T(max) measured by differential scanning calorimetry (DSC) decreased with PEGylation, whereas the temperature of aggregation, T(agg), measured by dynamic light scattering (DLS) increased with PEGylation. The unfolding temperature and the temperature of aggregation were both independent of the molecular weight of the PEG chain. Possible functional changes of BSA after PEGylation were measured by Isothermal Titration Calorimetry (ITC), where the binding of sodium dodecyl sulphate (SDS) to BSA and PEGylated BSA was analysed. At 25°C, two distinct classes of binding sites (high affinity and low affinity) for BSA and one class of binding site (low affinity) for PEGylated BSA were identified. The binding isotherm was modelled assuming independence and thermodynamic equivalence of the sites within each class. From the present biophysical characterisation, it is concluded that after PEGylation BSA appears to be unaffected structurally (secondary and tertiary structure), slightly destabilised thermally (unfolding temperature), stabilised kinetically (temperature of aggregation) and has an altered functionality (binding profile). These biophysical characteristics are all independent of the molecular weight of the attached polymer chain.


Asunto(s)
Polietilenglicoles/química , Polímeros/química , Albúmina Sérica Bovina/química , Animales , Sitios de Unión , Rastreo Diferencial de Calorimetría/métodos , Bovinos , Dicroismo Circular/métodos , Peso Molecular , Unión Proteica , Temperatura , Termodinámica
6.
J Pharm Biomed Anal ; 55(3): 597-602, 2011 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-21429688

RESUMEN

The effects of GlycoPEGylation on the molar hydrodynamic volume of recombinant human rFVIIa were investigated using rFVIIa and two GlycoPEGylated recombinant human FVIIa derivatives, a linear 10kDa PEG and a branched 40kDa PEG, respectively. Molar hydrodynamic volumes were determined by capillary viscometry and mass spectrometry. The intrinsic viscosities of rFVIIa, its two GlycoPEGylated compounds, and of linear 8kDa, 10kDa, 20kDa and branched 40kDa PEG polymers were determined. The measured intrinsic viscosity of rFVIIa is 6.0mL/g, while the intrinsic viscosities of 10kDa PEG-rFVIIa and 40kDa PEG-rFVIIa are 29.5mL/g and 79.0mL/g, respectively. The intrinsic viscosities of the linear PEG polymers are 20, 22.6 and 41.4mL/g for 8, 10, and 20kDa, respectively, and 61.1mL/g for the branched 40kDa PEG. From the results of the intrinsic viscosity and MALDI-TOF measurements it is evident, that the molar hydrodynamic volume of the conjugated protein is not just an addition of the molar hydrodynamic volume of the PEG and the protein. The molar hydrodynamic volume of the GlycoPEGylated protein is larger than the volume of its composites. These results suggest that both the linear and the branched PEG are not wrapped around the surface of rFVIIa but are chains that are significantly stretched out when attached to the protein.


Asunto(s)
Factor VIIa/química , Electroforesis en Gel de Poliacrilamida , Humanos , Hidrodinámica , Peso Molecular , Proteínas Recombinantes/química , Soluciones , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Viscosidad
7.
Eur J Pharm Biopharm ; 78(2): 222-8, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21220008

RESUMEN

The effects of calcium chloride on the structural, kinetic and thermal stability of recombinant human factor VIIa (rFVIIa) were investigated using rFVIIa and two GlycoPEGylated recombinant human FVIIa derivatives, a linear 10 kDa PEG and a branched 40 kDa PEG, respectively. Three different CaCl(2) concentrations were used: 10mM, 35 mM and 100mM. The secondary structure and tertiary structure of rFVIIa at 25°C, measured by circular dichroism (CD), were maintained upon GlycoPEGylation as well as CaCl(2) content. In contrast, the thermal stability of the three rFVIIa compounds, measured by differential scanning calorimetry (DSC) and circular dichroism (CD), and aggregation behaviour, measured by light scattering (LS), were affected by the increasing calcium concentration. Increasing the CaCl(2) concentration from 10mM to 35 mM resulted in a decrease in the apparent unfolding temperature, T(m), of rFVIIa, whereas the concentration of CaCl(2) has to be raised to 100mM in order to see the same effect on the GlycoPEGylated rFVIIa compounds. The temperature of aggregation of rFVIIa, T(agg), increased as the CaCl(2) concentration increased from 35 mM to 100 mM, while T(agg) for the GlycoPEGylated rFVIIa compounds was practically independent of the CaCl(2) concentration. From the obtained results, it is concluded that GlycoPEGylation postpones the calcium induced thermal destabilisation of rFVIIa, and a much higher calcium concentration also postpones the thermally induced aggregation of rFVIIa. The thermally induced aggregation of the GlycoPEGylated rFVIIa compounds is unaffected by an increasing calcium chloride concentration.


Asunto(s)
Cloruro de Calcio/química , Factor VIIa/química , Rastreo Diferencial de Calorimetría , Dicroismo Circular , Electroforesis en Gel de Poliacrilamida , Humanos , Cinética , Proteínas Recombinantes/química , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción
8.
Int J Pharm ; 406(1-2): 62-8, 2011 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-21236324

RESUMEN

The effects of GlycoPEGylation on the structural, kinetic and thermal stability of recombinant human FVIIa were investigated using rFVIIa and linear 10 kDa and branched 40 kDa GlycoPEGylated(®) recombinant human FVIIa derivatives. The secondary and tertiary structure of rFVIIa measured by circular dichroism (CD) was maintained upon PEGylation. In contrast, the thermal and kinetic stability of rFVIIa was affected by GlycoPEGylation, as the apparent unfolding temperature T(m) measured by differential scanning calorimetry (DSC) and the temperature of aggregation, T(agg), measured by light scattering (LS) both increased with GlycoPEGylation. Both T(m) and T(agg) were independent of the molecular weight and the shape of the PEG chain. From the present biophysical characterisation it is concluded that after GlycoPEGylation, rFVIIa appears to be unaffected structurally (secondary and tertiary structure), slightly stabilised thermally (unfolding temperature) and stabilised kinetically (temperature of aggregation).


Asunto(s)
Factor VIIa/química , Fenómenos Biofísicos , Rastreo Diferencial de Calorimetría , Dicroismo Circular , Estabilidad de Medicamentos , Electroforesis en Gel de Poliacrilamida , Humanos , Luz , Estabilidad Proteica , Estructura Secundaria de Proteína , Estructura Terciaria de Proteína , Proteínas Recombinantes/química , Dispersión de Radiación , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción
9.
Int J Antimicrob Agents ; 30 Suppl 1: S93-102, 2007 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17890063

RESUMEN

TREAT is a decision support system for antibiotic treatment in inpatients with common bacterial infections. It was tested in a randomised controlled trial in three countries and shown to improve the percentage of appropriate empirical antibiotic treatments, while at the same time reducing hospital stay and the use of broad-spectrum antibiotics. TREAT is based on a causal probabilistic network and uses a cost-benefit model for antibiotic treatment, including costs assigned to future resistance. In the present review we discuss the advantages of using causal probabilistic models for prediction and decision support, and the various decisions that were taken in the TREAT project.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Sistemas de Apoyo a Decisiones Clínicas , Utilización de Medicamentos , Humanos , Tiempo de Internación , Modelos Estadísticos
10.
J Antimicrob Chemother ; 59(6): 1204-7, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17449883

RESUMEN

BACKGROUND: Prediction of bacterial infections and their pathogens allows for early, directed investigation and treatment. We assessed the ability of TREAT, a computerized decision support system, to predict specific pathogens. METHODS: TREAT uses data available within the first few hours of infection presentation in a causal probabilistic network to predict sites of infection and specific pathogens. We included 3529 patients (920 with microbiologically documented infections) participating in the observational and interventional trials of the TREAT system in Israel, Germany and Italy. Discriminatory performance of TREAT to predict individual pathogens was expressed by the AUC with 95% confidence intervals. Calibration was assessed using the Hosmer-Lemeshow goodness-of-fit statistic. RESULTS: The AUCs for Gram-negative bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella spp. and Escherichia coli, ranged between 0.70 and 0.80 (all significant). Adequate calibration was demonstrated for any Gram-negative infection and individual bacteria, except for E. coli. Discrimination and calibration were acceptable for Enterococcus spp. (AUC 0.71, 0.65-0.78), but not for Staphylococcus aureus (AUC 0.63, 0.55-0.71). The few infections caused by Candida spp. and Clostridium difficile were well predicted (AUCs 0.74, 0.54-0.95; and 0.94, 0.88-1.00, respectively). The coverage with TREAT's recommendation exceeded that observed with physicians' treatment for all pathogens, except Candida spp. CONCLUSIONS: TREAT predicted individual pathogens causing infection well. Prediction of S. aureus was inferior to that observed with other pathogens. TREAT can be used to triage patients by the risk for specific pathogens. The system's predictions enable it to prescribe appropriate antibiotic treatment prior to pathogen identification.


Asunto(s)
Antibacterianos/uso terapéutico , Toma de Decisiones Asistida por Computador , Sepsis/tratamiento farmacológico , Sepsis/microbiología , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/microbiología , Calibración , Estudios de Cohortes , Bacterias Gramnegativas/efectos de los fármacos , Humanos , Modelos Estadísticos , Micosis/tratamiento farmacológico , Micosis/microbiología , Redes Neurales de la Computación , Valor Predictivo de las Pruebas , Curva ROC , Programas Informáticos
11.
J Phys Chem B ; 111(11): 2941-7, 2007 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-17319710

RESUMEN

Cutinase from Humicola insolens (HiC) has previously been shown to bind anomalously low amounts of the anionic surfactant sodium dodecylsulfate (SDS). In the current work, we have applied scanning and titration calorimetry to investigate possible relationships between this weak interaction and the effect of SDS on the equilibrium and kinetic stability of HiC. The results are presented in a "state-diagram," which specifies the stable form of the protein as a function of temperature and SDS concentration. In comparison with other proteins, the equilibrium stability HiC is strongly decreased by SDS. For low SDS concentrations (SDS:HiC molar ratio, MR < 8) this trait is also found for the kinetically controlled thermal aggregation of the protein. At higher MR, however, SDS stabilizes noticeably against irreversible aggregation. We suggest that this relies on electrostatic repulsion of the increasingly negatively charged HiC-SDS complexes. The combined interpretation of calorimetric and binding data allowed the calculation of the changes in enthalpy and heat capacity for the association of HiC and SDS near the saturation point. The latter function was about -410 J mol(-1) K(-1) or similar to the heat capacity change for micelle formation (-470 J mol(-1) K(-1)). This suggests that SDS is hydrated to a similar extent in the micellar and protein associated forms. The results are discussed in terms of the Wyman theory for linked equilibria. Quantitative analysis along these lines suggests that the reversible thermal unfolding of the protein couples to the binding of 2-3 additional SDS molecules. This corresponds to a 15-20% increase in the binding number. Wyman theory also rationalizes relationships between low affinity and high susceptibility observed in this study.


Asunto(s)
Ascomicetos/efectos de los fármacos , Ascomicetos/enzimología , Hidrolasas de Éster Carboxílico/metabolismo , Dodecil Sulfato de Sodio/farmacología , Calorimetría , Estabilidad de Enzimas , Soluciones , Temperatura , Termodinámica
12.
Am J Med ; 119(11): 970-6, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17071166

RESUMEN

PURPOSE: We evaluated the effect of inappropriate antibiotic treatment on mortality and duration of hospital stay in medical inpatients with bacterial infections. SUBJECTS AND METHODS: Two cohorts of febrile adult patients (excluding patients with acquired immune deficiency syndrome and organ transplant recipients), hospitalized in three medical centers in Israel, Italy, and Germany, were included. Patients' data were collected prospectively. Initial empirical treatment was defined as appropriate if an antibiotic prescribed within 24 hours of the first encounter with the patient matched the in vitro susceptibility of a pathogen deemed to be the likely cause of infection. The results of cultures and serologic or direct tests, and data on outcomes were collected 30 days after initiation of empirical treatment. RESULTS: A total of 920 patients (26% of 3529 included patients) had microbiologically documented infections, and mortality data were available for 895 patients (97%). Inappropriate initial antibiotic treatment was prescribed in 36% of patients (N=319). All-cause 30-day mortality rates were 20.1% (N=64) and 11.8% (N=68) in patients who received inappropriate and appropriate treatment, respectively (odds ratio=1.88, 95% confidence interval [CI], 1.29-2.72, P=.001). When adjustment was made for medical center and other variables, the association between inappropriate with mortality was significant (odds ratio=1.58, 95% CI, 0.99-2.54, P=.058). In all 3 medical centers, the mean duration of hospital stay was at least 2 days longer for patients who were prescribed inappropriate antibiotic treatment (overall P=.002). This association was consistent after adjusting for other variables (P=.006). CONCLUSION: Appropriate empirical antibiotic treatment is associated with a better survival and shortened duration of hospital stay in medical patients with bacterial infections.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones/tratamiento farmacológico , Infecciones/mortalidad , Tiempo de Internación , Adulto , Anciano , Femenino , Alemania/epidemiología , Humanos , Infecciones/microbiología , Israel/epidemiología , Italia/epidemiología , Modelos Lineales , Modelos Logísticos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Oportunidad Relativa , Estudios Prospectivos
13.
J Antimicrob Chemother ; 58(6): 1238-45, 2006 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-16998208

RESUMEN

BACKGROUND: Appropriate antibiotic treatment decreases mortality, while superfluous treatment is associated with antibiotic resistance. We built a computerized decision support system for antibiotic treatment (TREAT) targeting these outcomes. METHODS: Prospective cohort study comparing TREAT's advice to physician's treatment followed by a cluster randomized trial comparing wards using TREAT (intervention) versus antibiotic monitoring without TREAT (control). We included patients suspected of harbouring bacterial infections in three hospitals (Israel, Germany and Italy). The primary outcome, appropriate antibiotic treatment, was assessed among patients with microbiologically documented infections (MDI). Length of hospital stay, adverse events, mortality (interventional trial) and antibiotic costs (both studies), including costs related to future antibiotic resistance, were compared among all included patients. RESULTS: Among 1203 patients included in the cohort study (350 with MDI), TREAT prescribed appropriate empirical antibiotic treatment significantly more frequently than physicians (70% versus 57%, P < 0.001) using less broad-spectrum antibiotics at half physicians' antibiotic costs. The randomized trial included 2326 patients, 570 with MDI. The rate of appropriate empirical antibiotic treatment was higher in intervention versus control wards [73% versus 64%, odds ratio (OR): 1.48, 95% confidence interval (CI): 0.95-2.29, intention to treat, adjusted for location and clustering]. For patients treated according to TREAT's advice in intervention wards, the difference with controls was highly significant (OR: 3.40, 95% CI: 2.25-5.14). Length of hospital stay, costs related to future resistance and total antibiotic costs were lower in intervention versus control wards. CONCLUSIONS: TREAT improved the rate of appropriate empirical antibiotic treatment while reducing antibiotic costs and the use of broad-spectrum antibiotic treatment.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Técnicas de Apoyo para la Decisión , Prescripciones de Medicamentos , Quimioterapia Asistida por Computador , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/efectos adversos , Antibacterianos/economía , Infecciones Bacterianas/mortalidad , Estudios de Cohortes , Femenino , Alemania , Humanos , Israel , Italia , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del Tratamiento
14.
Clin Infect Dis ; 42(9): 1274-82, 2006 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-16586387

RESUMEN

BACKGROUND: Prediction of bloodstream infection at the time of sepsis onset allows one to make appropriate and economical management decisions. METHODS: The TREAT computerized decision-support system uses a causal probabilistic network, which is locally calibrated, to predict cases of bacteremia. We assessed the system's performance in 2 independent cohorts that included patients with suspected sepsis. Both studies were conducted in Israel, Italy, and Germany. Data were collected prospectively and were entered into the TREAT system at the time that blood samples were obtained for culture. Discriminative power was assessed using a receiver-operating characteristics curve. RESULTS: In the first cohort, 790 patients were included. The area under the receiver-operating characteristics curve for prediction of bacteremia using the TREAT system was 0.68 (95% confidence interval [CI], 0.63-0.73). We used TREAT's prediction values to draw thresholds defining a low-, intermediate-, and high-risk groups for bacteremia, in which 3 (2.4%) of 123, 62 (12.8%) of 483, and 55 (29.9%) of 184 patients were bacteremic, respectively. In the second cohort, 1724 patients were included. The area under the receiver-operating characteristics curve was 0.70 (95% CI, 0.67-0.73). The prevalence of bacteremia observed in the low-, intermediate-, and high-risk groups defined by the first cohort were 1.3% (4 of 300 patients), 13.2% (150 of 1139 patients), and 28.1% (80 of 285 patients), respectively. The low-risk groups in the 2 cohorts comprised 15%-17% of all patients. Performance was stable in the 3 sites. CONCLUSIONS: Using variables available at the time that blood cultures were performed, the TREAT system successfully stratified patients on the basis of the risk for bacteremia. The system's predictions were stable in 3 locations. The TREAT system can define a low-risk group of inpatients with suspected sepsis for whom blood cultures may not be needed.


Asunto(s)
Bacteriemia/diagnóstico , Sistemas de Apoyo a Decisiones Clínicas , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/epidemiología , Estudios de Cohortes , Femenino , Alemania/epidemiología , Humanos , Israel/epidemiología , Italia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo
15.
Biochim Biophys Acta ; 1752(2): 124-32, 2005 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-16162423

RESUMEN

We have studied interactions of cutinase (HiC) from Humicula insolens and sodium dodecyl sulphate (SDS) by parallel calorimetric and fluorescence investigations of systems in which the concentration of both components was changed systematically. Results from the two methods exhibit a number of synchronous characteristics, when plotted against the total SDS concentration, [SDS]tot. The molecular origin of several of these anomalies was assigned, and five intervals of [SDS]tot in which different modes of interactions dominated were identified. Going from low to high [SDS]tot, these modes were: binding of (a few) SDS to native HiC, formation of oligomeric protein aggregates, denaturation of HiC and adsorption of SDS on denatured protein. For [SDS]tot>3-6 mM (depending on the protein concentration), the adsorption saturated, and no further protein-detergent interaction could be detected. Two particularly conspicuous anomalies in the calorimetric data were ascribed to respectively denaturation and saturation. It was found that [SDS]tot at these points depended linearly on the (total) protein concentration, [HiC]. We suggest that this reflects the balance between bound and free SDS [SDS]tot=[SDS]aq+[HiC] Nb where [SDS]aq and Nb are, respectively, the aqueous ("free") concentration of SDS and the average number of SDS bound per protein. Interpretation of the results along these lines showed that at 22 degrees C and pH 7.0, HiC denatures with approximately 14 bound surfactant molecules at [SDS]aq=1.0 mM. Saturation is characterized by Nb approximately 39 and [SDS]aq=2.2 mM. The latter value is equal to CMC in the (protein free) buffer. These results are discussed with respect to the SDS-binding capacity of HiC and the origin and location of the saturation point.


Asunto(s)
Ascomicetos/metabolismo , Hidrolasas de Éster Carboxílico/metabolismo , Dodecil Sulfato de Sodio/metabolismo , Tensoactivos/metabolismo , Ascomicetos/enzimología , Calorimetría , Hidrolasas de Éster Carboxílico/fisiología , Unión Proteica , Desnaturalización Proteica/fisiología , Espectrometría de Fluorescencia
16.
Langmuir ; 21(10): 4299-307, 2005 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-16032839

RESUMEN

The interaction of cutinase from Humicula insolens (HiC) and sodium dodecyl sulfate (SDS) has been investigated by small-angle neutron scattering (SANS) and isothermal titration calorimetry (ITC). The concerted interpretation of structural and thermodynamic information for identical systems proved valuable in attempts to elucidate the complex modes of protein-detergent interaction. Particularly so at the experimental temperature 22 degrees C, where the formation of SDS micelles is athermal (deltaH = 0), and the effects of protein-detergent interactions stand out clearly in the thermograms. It was found that the effect of SDS on cutinase depended strongly on the sample composition. Thus, addition of SDS corresponding to a molar ratio, n(s) = n(SDS)/n(HiC) of about 10, was associated with the formation of HiC/SDS aggregates, which include more than one protein molecule. The SANS results suggested that on the average such adducts contained two HiC, and the ITC traces showed that they form and break down slowly. At slightly higher SDS concentrations (n(s) = 10-25) these "dimers" dissociated, and the protein denatured. The denaturation showed the characteristic positive enthalpy change, but the SDS denatured state of HiC was unusually compact with a radius of gyration close to that of the native conformation. Further titration with SDS was associated with exothermic binding to the denatured protein until the saturation point at about n(s) = 90. At this point, the free monomer concentration was 2.2 mM and the binding number was approximately 40 SDS/HiC. Interestingly, this degree of SDS binding (approximately 0.5 g of SDS/g of HiC) is less than half the amount bound to typical water-soluble proteins.


Asunto(s)
Ascomicetos/enzimología , Hidrolasas de Éster Carboxílico/química , Calorimetría , Modelos Químicos , Neutrones , Conformación Proteica , Dispersión de Radiación , Dodecil Sulfato de Sodio , Tensoactivos , Termodinámica
17.
Biochim Biophys Acta ; 1652(1): 52-63, 2003 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-14580996

RESUMEN

The thermal stability of a recombinant alpha-amylase from Bacillus halmapalus alpha-amylase (BHA) has been investigated using circular dichroism spectroscopy (CD) and differential scanning calorimetry (DSC). This alpha-amylase is homologous to other Bacillus alpha-amylases where crystallographic studies have identified the existence of three calcium binding sites in the structure. Denaturation of BHA is irreversible with a T(m) of approximately 89 degrees C and DSC thermograms can be described using a one-step irreversible model. A 5 degrees C increase in T(m) in the presence of 10-fold excess CaCl(2) was observed. However, a concomitant increase in the tendency to aggregate was also observed. The presence of 30-40-fold excess calcium chelator (ethylenediaminetetraacetic acid (EDTA) or ethylene glycol-bis[beta-aminoethyl ether] N,N,N',N'-tetraacetic acid (EGTA)) results in a large destabilization of BHA, corresponding to about 40 degrees C lower T(m) as determined by both CD and DSC. Ten-fold excess EGTA reveals complex DSC thermograms corresponding to both reversible and irreversible transitions, which probably originate from different populations of BHA/calcium complexes. Combined interpretation of these observations and structural information on homologous alpha-amylases forms the basis for a suggested mechanism underlying the inactivation mechanism of BHA. The mechanism includes irreversible thermal denaturation of different BHA/calcium complexes and the calcium binding equilibria. Furthermore, the model accounts for a temperature-induced reversible structural change associated with calcium binding.


Asunto(s)
Bacillus/enzimología , Cloruro de Calcio/farmacología , alfa-Amilasas/química , Sitios de Unión , Cloruro de Calcio/química , Cloruro de Calcio/metabolismo , Rastreo Diferencial de Calorimetría , Quelantes/química , Quelantes/farmacología , Dicroismo Circular , Ácido Edético/química , Ácido Edético/farmacología , Ácido Egtácico/química , Ácido Egtácico/farmacología , Estabilidad de Enzimas , Calor , Cinética , Desnaturalización Proteica , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Termodinámica , alfa-Amilasas/genética
18.
Biochem J ; 373(Pt 2): 337-43, 2003 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-12689333

RESUMEN

The effect of temperature and calcium ions on the denaturation of a recombinant alpha-amylase from Bacillus halmapalus alpha-amylase (BHA) has been studied using calorimetry. It was found that thermal inactivation of BHA is irreversible and that calcium ions have a significant effect on stability. Thus an apparent denaturation temperature ( T (d)) of 83 degrees C in the presence of excess calcium ions was observed, whereas T (d) decreased to 48 degrees C when calcium was removed. The difference in thermal stability with and without calcium ions has been used to develop an isothermal titration calorimetric (ITC) procedure that allows simultaneous determination of kinetic parameters and enthalpy changes of the denaturation of calcium-depleted BHA. An activation energy E (A) of 101 kJ/mol was found for the denaturation of calcium-depleted BHA. The results support a kinetic denaturation mechanism where the calcium-depleted amylase denatures irreversibly at low temperature and if calcium ions are in excess, the amylase denatures irreversibly at high temperatures. The two denaturation reactions are coupled with the calcium-binding equilibrium between calcium-bound and -depleted amylase. A combination of the kinetic denaturation results and calcium-binding constants, determined by isothermal titration calorimetry, has been used to estimate kinetic stability, expressed in terms of the half-life of BHA as a function of temperature and free-calcium-ion concentration. Thus it is estimated that the apparent E (A) can be increased to approx. 123 kJ/mol by increasing the free-calcium concentration.


Asunto(s)
Bacillus/enzimología , Calcio/farmacología , alfa-Amilasas/metabolismo , Calorimetría , Estabilidad de Enzimas , Calor , Cinética , Ligandos , Desnaturalización Proteica/efectos de los fármacos , Proteínas Recombinantes , Termodinámica
19.
Anal Biochem ; 314(2): 227-34, 2003 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-12654309

RESUMEN

Determination of binding parameters for metal ion binding to proteins usually requires preceding steps to remove protein-bound metal ions. Removal of bound metal ions from protein is often associated with decreased stability and inactivation. We present two simple isothermal titration calorimetric procedures that eliminate separate metal ion removal steps and directly monitor the exchange of metal ions between buffer, protein, and chelator. The concept is to add either excess chelator or metal ion to the protein under investigation and subsequently titrate with metal ion or chelator, respectively. It is thereby possible in the same experimental trial to obtain both chelator-metal ion and protein-metal ion binding parameters due to the different thermodynamic "fingerprints" of chelator and protein. The binding models and regression routines necessary to analyze the corresponding binding isotherms have been constructed. Verifications of the models have been done by titrations of mixtures of calcium chelators (BAPTA, HEDTA, and EGTA) and calcium ions and they were both able to account satisfactorily for the observed binding isotherms. Therefore, it was possible to determine stoichiometric and thermodynamic binding parameters. In addition, the concept has been tested on a recombinant alpha-amylase from Bacillus halmapalus where it proved to be a consistent procedure to obtain calcium binding parameters.


Asunto(s)
Calcio/metabolismo , Calorimetría/métodos , Quelantes/metabolismo , Ácido Edético/análogos & derivados , Ácido Egtácico/análogos & derivados , alfa-Amilasas/metabolismo , Bacillus/genética , Sitios de Unión/efectos de los fármacos , Calcio/farmacología , Proteínas de Unión al Calcio/química , Proteínas de Unión al Calcio/metabolismo , Quelantes/farmacología , Ácido Edético/metabolismo , Ácido Edético/farmacología , Ácido Egtácico/metabolismo , Ácido Egtácico/farmacología , Concentración de Iones de Hidrógeno , Cinética , Ligandos , Unión Proteica/efectos de los fármacos , Proteínas Recombinantes/metabolismo , Temperatura , Termodinámica , alfa-Amilasas/genética
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