[Obstetrics complications of systemic lupus erythematosus and antiphospholipid syndrome: A multidisciplinary management]. / Complications obstétricales du lupus érythémateux systémique et du SAPL : une prise en charge multidisciplinaire.

The main autoimmune diseases responsible for obstetric complications are systemic lupus erythematosus and antiphospholipid syndrome. They are particularly associated with an increased risk of miscarriage, stillbirth, intrauterine growth restriction, prematurity and pre-eclampsia. Therapeutics to prevent its complications are mainly low dose aspirin and low molecular weight heparins. However, the introduction of these therapies will have to consider the benefit/risk ratio to manage pregnancy and especially delivery. Consistency of care provided by autoimmunity specialists and gynaecologist-obstetricians is extremely important and must be promoted through regular exchanges, fuelled by a mutual culture, through multidisciplinary consultation meetings.

[Cutaneous mucormycosis caused by Rhizopus microsporus]. / Mucormycose cutanée à Rhizopus microsporus.

BACKGROUND: Mucormycosis are rare fungal infections occurring chiefly in the lung or the rhinocerebral compartment, particularly in patients with immunodeficiency or mellitus diabetes. We report the case of an elderly patient with cutaneous mucormycosis caused by Rhizopus microsporus. PATIENTS AND METHODS: An 89-year-old man presented a skin lesion of the forearm rapidly becoming inflammatory and necrotic. The patient had been treated for 2months with oral corticosteroids for idiopathic thrombocytopenia. Histological and mycological examination of the skin biopsy revealed the presence of a filamentous fungus, R. microsporus. The outcome was unfavorable, despite prescription of high-dose liposomal amphotericin B. DISCUSSION: Mucormycosis are infrequent opportunistic infections caused by angio-invasive fungi belonging to the Mucorales order. Cutaneous presentations are rare, and in rare cases the species R. microsporus is isolated in clinical samples. Diagnosis is based on histological examination highlighting the characteristic mycelium within infected tissue, together with ex vivo mycological identification using morphological and molecular methods. Treatment consists of liposomal amphotericin B combined with debridement surgery. CONCLUSION: R. microsporus is a marginal fungal species rarely isolated in clinical practice, and even less in dermatology departments. This clinical case report highlights the severity of infection with this fungus, particularly in the absence of early surgery.

Mycomembrane and S-layer: two important structures of Corynebacterium glutamicum cell envelope with promising biotechnology applications.

Corynebacteria belong to a distinct Gram-positive group of bacteria including mycobacteria and nocardia, which are characterized by the presence of mycolic acids in their cell wall. These bacteria share the property of having an unusual cell envelope structural organization close to Gram-negative bacteria. In addition to the inner membrane, the cell envelope is constituted of a thick arabinogalactan-peptidoglycan polymer covalently linked to an outer lipid layer, which is mainly composed of mycolic acids and probably organized in an outer membrane like structure. In some species, the cell is covered by a crystalline surface layer composed of a single protein species, which is anchored in the outer membrane like barrier. An increasing number of reports have led to a better understanding of the structure of the cell wall of Corynebacterium glutamicum. These works included the characterization of several cell wall proteins like S-layer protein and porins, genetic and biochemical characterization of mycolic acids biosynthesis, ultrastructural description of the cell envelope, and chemical analysis of its constituents. All these data address new aspects regarding cell wall permeability towards macromolecules and amino acids but also open new opportunities for biotechnology applications.

S-layer protein transport across the cell wall of Corynebacterium glutamicum: in vivo kinetics and energy requirements.

Corynebacteria are Gram-positive bacteria with a very peculiar cell envelope structure as it is constituted of an inner membrane and an outer membrane-like structure. Protein secretion in Corynebacterium glutamicum was studied in vivo, using the S-layer protein PS2 as a model. We show that different variants of PS2 protein are exported through the whole cell envelope with a half-life ranging between 2 and 4 min, by a two-step mechanism. The first step, which is over after about 1.5 min, is ATP- and proton motive force-dependent and may correspond to translocation across the inner membrane via the 'Sec' machinery. The second step, across the cell wall and the outer mycolate layer, is rapid but independent of energy sources. This very efficient secretion process across the mycolate layer raises the question of the existence in this layer of a specific machinery.

Study of mycoloyl transferase transport across the cell envelope of Corynebacterium glutamicum.

PS1 is a major exported protein of Corynebacterium glutamicum homologous to mycobacterial antigen 85. It is largely associated with the mycolic acid-containing cell wall and acts as a mycoloyl transferase. The transport of PS1 to the cell wall is slow and occurs through two energetically distinct steps: the first one, which includes processing by signal peptidase, is rapid and inhibited by sodium azide or carbonyl cyanide m-chlorophenylhydrazone. This step is probably associated with translocation across the cytoplasmic membrane. The kinetics of the second step depend on the size of the polypeptide chain to be transported but neither ATP nor proton motive force is required. This step may correspond to the diffusion of PS1 across the cell wall to its final location.

Voltage-dependent cationic channel of Escherichia coli.

A fraction highly enriched with inner membranes of E. coli was fused with liposomes, using the dehydration-rehydration technique, to produce giant liposomes amenable to patch-clamp recordings. Among the several channels present in this type of preparation, one was further characterized. The channel has a conductance of some 200 pS (in 0.1 M KCl) and is weakly selective for cations (PK/PCl = 4). The channel stays open at negative and low positive membrane potentials and shows an increasing probability of closure with increasing voltage. High positive membrane potentials favor transitions to a long-lived inactivated state, following slow kinetics. Voltage-dependent rapid flickerings of the same amplitude, between open state and other short-lived closed states, are superposed on these kinetics. The channel is presumed to be localized in the inner membrane, but its characteristics are also compatible with those of porins of the outer membrane. However, the major porins OmpF and OmpC, purified and reconstituted into giant liposomes, exhibited a marked different behavior.

Fast and slow kinetics of porin channels from Escherichia coli reconstituted into giant liposomes and studied by patch-clamp.

E. coli porins (OmpF and OmpC) were purified and reconstituted into liposomes which were enlarged to giant proteoliposomes by dehydration-rehydration and studied by patch-clamp. The porins could be closed by voltage pulses under -100 mV. The kinetics of closure was slow, with closure events of about 200 pS in 0.1 M KCl. Rapid fluctuations (in the millisecond range) of about one third (60-70 pS) of the large closure steps were also observed. The data are interpreted as follows: an increase in membrane potential favours the cooperation transition of multimers towards an inactivated state, while monomers which have not been inactivated can flicker rapidly between an open and a short-lived closed state.

Effect of osmotic pressure on membrane energy-linked functions in Escherichia coli.

Osmotic upshock of E. coli cells in NaCl or sucrose medium resulted in a large decrease in the cytoplasmic volume and the inhibition of growth, of the electron transfer chain and of four different types of sugar transport system: the lactose proton symport, the glucose phosphotransferase system, the binding-protein dependent maltose transport system and the glycerol facilitator. In contrast to NaCl and sucrose, the permeant solute glycerol had no marked effect. These inhibitions could be partially relieved by glycine betaine. Despite these inhibitions, the internal pH, the protonmotive force and the ATP pool were maintained. It is concluded that inhibition of electron transfer and of sugar transport is the consequence of conformational changes caused by the deformation of the membrane. It is also concluded that the arrest of growth observed upon osmotic upshock is not due to energy limitations and that it cannot be explained by the inhibition of carbohydrate transport.

A patch-clamp study of ion channels of inner and outer membranes and of contact zones of E. coli, fused into giant liposomes. Pressure-activated channels are localized in the inner membrane.

Inner and outer membranes of Escherichia coli and contact zones were isolated and fused separately with giant liposomes amenable to patch-clamp recording. Different types of large pressure-activated channels were localized in the inner membrane fraction which also contained smaller, pressure-insensitive channels. The outer membrane contained pressure-insensitive channels with large conductances and long opening and closing times which are likely to be porins. Large channels were also observed in contact zones.

The lactose permease of Escherichia coli: evidence in favor of a dimer.

Lactose permease from Escherichia coli T 206 was purified in octyl-beta-D-glucopyranoside (octyl-glucoside) according to Newman et al. [J. Biol. Chem. (1981) 256, 11804-11808]. In this detergent the protein has a very high tendency to aggregate nonspecifically. Therefore, exchange of octyl-glucoside was performed for another nonionic detergent, dodecyl octaethylene glycol monoether (C12E8), in which the protein is more stable. The amounts of bound C12E8 and phospholipids were measured using radioactive detergent and gas chromatography, respectively, and were found to be respectively 0.2 and 0.15 g/g protein. Analytical ultracentrifugation (sedimentation velocity and sedimentation equilibrium) and gel filtration (conventional and high performance liquid chromatography) experiments indicated that in this detergent the lactose permease existed mainly as a dimer. This result is at variance with the monomeric state of the protein reported by Wright et al. [FEBS Lett. (1983) 162, 11-15] in another nonionic detergent (dodecyl-o-beta-maltoside). We discuss the possible reason for this discrepancy and suggest that the dimeric state of association may well reflect the situation that prevails in the membrane.