Corynebacterium urealyticum: rare urinary tract infection with serious complications.

Corynebacterium urealyticum is an organism associated with a rare chronic urinary tract infection, which can lead to calcification of the urinary tract and promote rapid lithogenesis. This case illustrates the serious complications that can arise from chronic infection with C. urealyticum, which include rapid progression of luminal and parenchymal urinary tract calcification and concomitant renal failure. This case and a review of the literature demonstrate the need for an increased awareness of this organism with early identification, aggressive management, and test of cure that may help avoid the sequela of these infections.

Alternative luminal activation mechanisms for paneth cell α-defensins.

Paneth cell α-defensins mediate host defense and homeostasis at the intestinal mucosal surface. In mice, matrix metalloproteinase-7 (MMP7) converts inactive pro-α-defensins (proCrps) to bactericidal forms by proteolysis at specific proregion cleavage sites. MMP7(-/-) mice lack mature α-defensins in Paneth cells, accumulating unprocessed precursors for secretion. To test for activation of secreted pro-α-defensins by host and microbial proteinases in the absence of MMP7, we characterized colonic luminal α-defensins. Protein extracts of complete (organ plus luminal contents) ileum, cecum, and colon of MMP7-null and wild-type mice were analyzed by sequential gel permeation chromatography/acid-urea polyacrylamide gel analyses. Mature α-defensins were identified by N-terminal sequencing and mass spectrometry and characterized in bactericidal assays. Abundance of specific bacterial groups was measured by qPCR using group specific 16 S rDNA primers. Intact, native α-defensins, N-terminally truncated α-defensins, and α-defensin variants with novel N termini due to alternative processing were identified in MMP7(-/-) cecum and colon, and proteinases of host and microbial origin catalyzed proCrp4 activation in vitro. Although Paneth cell α-defensin deficiency is associated with ileal microbiota alterations, the cecal and colonic microbiota of MMP7(-/-) and wild-type mice were not significantly different. Thus, despite the absence of MMP7, mature α-defensins are abundant in MMP7(-/-) cecum and colon due to luminal proteolytic activation by alternative host and microbial proteinases. MMP7(-/-) mice only lack processed α-defensins in the small intestine, and the model is not appropriate for studying effects of α-defensin deficiency in cecal or colonic infection or disease.

Antisense Therapy for Cardiovascular Diseases.

Antisense oligonucleotide therapy is a growing field in cardiac, metabolic, and muscular diseases. This precision therapy allows for treatment of diseases due to specific genetic defects. Antisense has few side effects and is relatively long lasting. Some major targets for antisense therapy include hyperglycemia, hyperlipidemia, and hypercholesterolemia. ISIS Pharmaceuticals recently commercialized antisense therapy with Kynamro (Mipomersen) for homozygous familial hypercholesterolemia, opening the door for other antisense oligonucleotides for lowering proteins. Antisense can also be used to increase proteins that are inhibited by mutant exons. Sarepta is testing exon 51 skipping in the mutated dystrophin gene, which if successful will help affected individuals walk, and may help restore some cardiac function. These antisense techniques also could be applied as antisense therapies to overcome gene defects in hypertension, heart disease, muscular defects and metabolic syndrome.

Síndrome de Neu-Laxova / Neu-Laxova syndrome

El síndrome de neu-laxova es una enfermedad genética, que se hereda como rasgo autosómico recesivo. Se caracteriza por retraso del crecimiento intrauterino, microcefalia, ictiosis, exoftalmos y edema generalizado, pero puede asociarse a cualquier tipo de malformaciones cutáneas y viscerales con atrofia o hipoplasia de todas las estructuras del cerebro, microgenitalismo, agenesia renal, hipoplasia pulmonar y mal formación cardiaca. La supervivencia máxima comunicada ha sido de seis semanas.El caso presentado, atendido en el hospital maternidad “Enrique C. Sotomayor” de Guayaquil, trata de recién nacido de sexo femenino. Se observó piel cubierta de placa escamosa amarillenta, brillante, además de malformaciones de extremidades y ectropión, con sobrevida de seis días. El eco transfontanelar reveló hipoplasia de las estructuras cerebrales.Conclusiones: En la mayoría de los casos reportados en la literatura médica, los padres han sido consanguíneos.Recomendaciones: La ultrasonografía nos permite obtener el diagnóstico prenatal.

The neu-laxova syndrome is a very strange genetic illness that is inherited like feature recessive autosómico. It is characterized by delay of the intra-uterine growth, microcephaly, congenital ichthyosis, exoftalmus and generalized edema, but it can be associated to any type of cutaneous and visceral malformations with atrophy or hipoplasia of all the structures of the brain. The survival rate of this illness is six weeks.The present case of a female infant obtained at the “Enrique C. Sotomayor” hospital in Guayaquil. We could observe the presence of congential ichthyosis, One observes skin covered with yellowish, brilliant scaly badge, besides malformations of limbs and ectropion. She lived for six days. The transcranic ecography revealed hipoplasy of the cerebral structures.Conclusions: In most of the cases reported in the medical literature the parents they have been consanguineous.Recommendations: The ultrasonography allows us to obtain the prenatal diagnosis.