De novo genome assembly of white clover (Trifolium repens L.) reveals the role of copy number variation in rapid environmental adaptation.

BACKGROUND: White clover (Trifolium repens) is a globally important perennial forage legume. This species also serves as an eco-evolutionary model system for studying within-species chemical defense variation; it features a well-studied polymorphism for cyanogenesis (HCN release following tissue damage), with higher frequencies of cyanogenic plants favored in warmer locations worldwide. Using a newly generated haplotype-resolved genome and two other long-read assemblies, we tested the hypothesis that copy number variants (CNVs) at cyanogenesis genes play a role in the ability of white clover to rapidly adapt to local environments. We also examined questions on subgenome evolution in this recently evolved allotetraploid species and on chromosomal rearrangements in the broader IRLC legume clade. RESULTS: Integration of PacBio HiFi, Omni-C, Illumina, and linkage map data yielded a completely de novo genome assembly for white clover (created without a priori sequence assignment to subgenomes). We find that white clover has undergone extensive transposon diversification since its origin but otherwise shows highly conserved genome organization and composition with its diploid progenitors. Unlike some other clover species, its chromosomal structure is conserved with other IRLC legumes. We further find extensive evidence of CNVs at the major cyanogenesis loci; these contribute to quantitative variation in the cyanogenic phenotype and to local adaptation across wild North American populations. CONCLUSIONS: This work provides a case study documenting the role of CNVs in local adaptation in a plant species, and it highlights the value of pan-genome data for identifying contributions of structural variants to adaptation in nature.

Beyond cyanogenesis: Temperature gradients drive environmental adaptation in North American white clover (Trifolium repens L.).

Species that repeatedly evolve phenotypic clines across environmental gradients have been highlighted as ideal systems for characterizing the genomic basis of local environmental adaptation. However, few studies have assessed the importance of observed phenotypic clines for local adaptation: conspicuous traits that vary clinally may not necessarily be the most critical in determining local fitness. The present study was designed to fill this gap, using a plant species characterized by repeatedly evolved adaptive phenotypic clines. White clover is naturally polymorphic for its chemical defence cyanogenesis (HCN release with tissue damage); climate-associated cyanogenesis clines have evolved throughout its native and introduced range worldwide. We performed landscape genomic analyses on 415 wild genotypes from 43 locations spanning much of the North American species range to assess the relative importance of cyanogenesis loci vs. other genomic factors in local climatic adaptation. We find clear evidence of local adaptation, with temperature-related climatic variables best describing genome-wide differentiation between sampling locations. The same climatic variables are also strongly correlated with cyanogenesis frequencies and gene copy number variations (CNVs) at cyanogenesis loci. However, landscape genomic analyses indicate no significant contribution of cyanogenesis loci to local adaptation. Instead, several genomic regions containing promising candidate genes for plant response to seasonal cues are identified - some of which are shared with previously identified QTLs for locally adaptive fitness traits in North American white clover. Our findings suggest that local adaptation in white clover is likely determined primarily by genes controlling the timing of growth and flowering in response to local seasonal cues. More generally, this work suggests that caution is warranted when considering the importance of conspicuous phenotypic clines as primary determinants of local adaptation.

Harnessing cold adaptation for postglacial colonisation: Galactinol synthase expression and raffinose accumulation in a polyploid and its progenitors.

Allotetraploid white clover (Trifolium repens) formed during the last glaciation through hybridisation of two European diploid progenitors from restricted niches: one coastal, the other alpine. Here, we examine which hybridisation-derived molecular events may have underpinned white clover's postglacial niche expansion. We compared the transcriptomic frost responses of white clovers (an inbred line and an alpine-adapted ecotype), extant descendants of its progenitor species and a resynthesised white clover neopolyploid to identify genes that were exclusively frost-induced in the alpine progenitor and its derived subgenomes. From these analyses we identified galactinol synthase, the rate-limiting enzyme in biosynthesis of the cryoprotectant raffinose, and found that the extant descendants of the alpine progenitor as well as the neopolyploid white clover rapidly accumulated significantly more galactinol and raffinose than the coastal progenitor under cold stress. The frost-induced galactinol synthase expression and rapid raffinose accumulation derived from the alpine progenitor likely provided an advantage during early postglacial colonisation for white clover compared to its coastal progenitor.

Genetics and plasticity of white leaf mark variegation in white clover (Trifolium repens L.).

BACKGROUND AND AIMS: Leaf variegation is common in plants and confers diverse adaptive functions. However, its genetic underpinnings remain largely unresolved; this is particularly true for variegation that arises through modified leaf tissue structure that affects light reflection. White clover is naturally polymorphic for structure-based white leaf mark variegation. It therefore provides a useful system to examine the genetic basis of this phenotype, and to assess potential costs to photosynthetic efficiency resulting from modified leaf structures. This study sought to map the loci controlling the white leaf mark in white clover and evaluate the relationship between white leaf mark, leaf thickness, and photosynthetic efficiency. METHODS: We generated a high-density genetic linkage map from an F3 mapping population, employing reference genome-based SNP markers. White leaf mark was quantified through detailed phenotypic evaluations alongside leaf thickness to test how tissue thickness may affect the variegation phenotype. Quantitative trait locus (QTL) mapping was performed to characterize their genetic bases. Photosynthetic efficiency measurements were used to test for physiological trade-offs between variegation and photosynthetic output. KEY RESULTS: The V locus, a major gene responsible for the white leaf mark polymorphism, was mapped to the distal end of chromosome 5, and several modifier loci were also mapped that contribute additively to variegation intensity. The presence and intensity of white leaf mark was associated with greater leaf thickness; however, increased variegation did not detectably affect photosynthetic efficiency. CONCLUSIONS: We have successfully mapped the major locus governing the white leaf mark in white clover, along with several modifier loci, revealing a complex basis for this structure-based variegation. The apparent absence of compromised photosynthesis in variegated leaves challenges the notion that variegation creates fitness trade-offs between photosynthetic efficiency and other adaptive functions. This finding suggests that other factors may maintain the white leaf mark polymorphism in white clover.

Physiological and comprehensive transcriptome analysis reveals distinct regulatory mechanisms for aluminum tolerance of Trifolium repens.

It is estimated that up to 50 % of arable lands worldwide are acidic, and most crops are severely inhibited due to the high active aluminum (Al). Trifolium repens is an excellent legume forage with a certain acid tolerance, although it is affected by Al toxicity in acidic soil. In this study, physiological and transcriptomic responses of different white clover varieties were analyzed when exposed to a high-level of Al stress. The results revealed that Trifolium repens had a high level of Al toxicity tolerance, and accumulated nearly 70 % of Al3+ in its roots. Al toxicity significantly inhibited the root length and root activity, decreased the chlorophyll (Chl) content and photosynthetic pigments, while significantly increased the intercellular CO2 concentration (Ci). The content of malondialdehyde (MDA), electrolyte leakage (EL), proline and reactive oxygen species (ROS) were significantly accumulated under Al stress. Furthermore, a total of 27,480 differentially expressed genes (DEGs) were identified after the treatment. Gene ontology (GO) and Kyoto encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that most Al-responsive genes enriched to chloroplast thylakoid membrane, chloroplast stroma and photosynthesis in Haifa leaf while in MAG leaf highly enriched in response to regulation of defense response, which could induce the different tolerance of the two cultivars to Al stress. Besides, pectin methylesterase (PME), glycosyl transferases (GT1) and chalcone synthase genes associated with cell wall biosynthesis may improve the Al accumulation and enhance tolerance of Al toxicity. The results established here would help to understand the morphological structure, physiological and biochemical response, and molecular mechanism of white clover under Al tolerance.

Co-culture between Miscanthus x giganteus and Trifolium repens L. to enhance microbial activity, biomass and density in a PAH contaminated technosol.

Phytoremediation is a biological soil remediation technique using plants and their associated microorganisms to clean-up contaminated soils and improve soils' quality. We tested whether a co-culture between Miscanthus x giganteus (MxG) and Trifolium repens L. would enhance the soil biological quality. The objective was to determine the influence of MxG in mono- and in co-culture with white clover on the soil microbial activity, biomass and density. MxG was tested in mono- and in co-culture with white clover in a mesocosm over 148 days. The microbial respiration (CO2 production), the microbial biomass and the microbial density of the technosol were measured. Results showed that MxG induced an increase in microbial activity in the technosol compared to the non-planted condition with the co-culture having a greater impact. Regarding the bacterial density, MxG in mono- and in co-culture significantly increased the 16S rDNA gene copy number. The co-culture increased the microbial biomass, the fungal density and stimulated the degrading bacterial population, contrary to the monoculture and the non-planted condition. We can conclude the co-culture between MxG and white clover was more interesting than MxG monoculture in regards to the technosol biological quality and its potential for PAH remediation improvement.

Our precedent results have shown the benefits of using Miscanthus x giganteus in association with Trifolium repens L. to improve polycyclic aromatic hydrocarbons dissipation and decrease soil ecotoxicity compared to monocultures. In this study we focused on the plant species' influence on the soil's biological quality to improve MxG biomass productivity in the long term and phytoremediation. Many bioindicators were used such as microbial activity, microbial biomass as well as bacteria, fungi and PAH-degrading bacteria density.We showed it was more beneficial to use co-culture instead of MxG monoculture to improve biological technosol quality and in particular microbial activity and biomass as well as fungi and PAH-degrading bacteria density.

Potential Antidiabetic, Antioxidative and Antiproliferative Properties of Functional Wheat Flour Muffins Enriched with White Clover Flowers (Trifolium repens L.).

The aim of the study was to evaluate the functional properties of muffins fortified with white clover flowers (Trifolium repens L.), which were added to the dough in the following amounts: (i) 0% (control); (ii) 2.5%; (iii) 5.5%; (iv) 7.5%; and (v) 10%. The organoleptic properties were assessed by a panel of consumers. Additionally, the following parameters were also tested: basic chemical composition, total polyphenols, the antioxidant activity together with antiproliferative effects on the A375 melanoma cell line, starch nutritional fractions and the in vitro glycemic index. As a result, replacing wheat flour with white clover flour significantly affected the color, aroma and taste of the muffins. The content of proteins, fats, total ash, dietary fiber, resistant starch (RS), slowly digestible starch (SDS),total polyphenols and antioxidant activity increased statistically significantly with the elevated amount of white clover flour added to the dough. At the same time, the content of free glucose (FG), rapidly available glucose (RAG) and rapidly digestible starch (RDS), the value of the in vitro glycemic index and the viability of melanoma cancer cells decreased significantly. The muffins enriched with white clover flowers might constitute an interesting proposition and extension of the existing assortment of confectionery products.

Green strategies for the valorization of industrial medicinal residues of Serenoa repens small (saw palmetto) as source of bioactive compounds.

Serenoa repens is a medicinal plant well-known for its therapeutic potential in treating various urological disorders and prevention of prostatic cancer. However, the extraction process in the pharmaceutical industry leads to the generation of plant residues, typically discarded, wasting valuable resources. In this study, we aimed to explore a series of green extraction strategies to effectively valorize the residues of Serenoa repens fruits. Initially, we employed supercritical CO2 (1.2% yield on dry biomass) on the discarded biomass to identify and quantify residual fatty acids and polyprenols (1.6% of the extract dry weight), a class of unsaturated isoprenoid alcohols with promising biomedical applications. Subsequently, subcritical water extraction was utilized on the exhausted biomass to extract polar compounds. An increase in the extraction yield was observed with the rise in processing temperature up to 180 °C (yields were found higher than 26%). Phenolic compounds and carbohydrate macromolecules profiles were affected by the increased hydrolytic conditions. Polar extracts exhibited robust bioactivities, demonstrating significant antioxidant activity and antimicrobial efficacy against Gram-positive and Gram-negative bacteria strains. Extracts obtained at 180 °C demonstrated the highest efficacy. Furthermore, in vitro assessment of mannans-rich fraction provided a new perspective of potential applications in the cosmeceuticals field. Results underscore the potential of the sustainable extraction biorefinery for the residue of this medicinal plant and demonstrate that, harnessing these bioactive compounds, new sustainable and eco-friendly approaches for its complete utilization can be offered, thereby promoting near-zero waste practices and contributing to a more sustainable future.

High-quality chromosome-level de novo assembly of the Trifolium repens.

BACKGROUND: White clover (Trifolium repens L.), an excellent perennial legume forage, is an allotetraploid native to southeastern Europe and southern Asia. It has high nutritional, ecological, genetic breeding, and medicinal values and exhibits excellent resistance to cold, drought, trample, and weed infestation. Thus, white clover is widely planted in Europe, America, and China; however, the lack of reference genome limits its breeding and cultivation. This study generated a white clover de novo genome assembly at the chromosomal level and annotated its components. RESULTS: The PacBio third-generation Hi-Fi assembly and sequencing methods generated a 1096 Mb genome size of T. repens, with contigs of N50 = 14 Mb, scaffolds of N50 = 65 Mb, and BUSCO value of 98.5%. The newly assembled genome has better continuity and integrity than the previously reported white clover reference genome; thus provides important resources for the molecular breeding and evolution of white clover and other forage. Additionally, we annotated 90,128 high-confidence gene models from the genome. White clover was closely related to Trifolium pratense and Trifolium medium but distantly related to Glycine max, Vigna radiata, Medicago truncatula, and Cicer arietinum. The expansion, contraction, and GO functional enrichment analysis of the gene families showed that T. repens gene families were associated with biological processes, molecular function, cellular components, and environmental resistance, which explained its excellent agronomic traits. CONCLUSIONS: This study reports a high-quality de novo assembly of white clover genome obtained at the chromosomal level using PacBio Hi-Fi sequencing, a third-generation sequencing. The generated high-quality genome assembly of white clover provides a key basis for accelerating the research and molecular breeding of this important forage crop. The genome is also valuable for future studies on legume forage biology, evolution, and genome-wide mapping of quantitative trait loci associated with the relevant agronomic traits.

Microfilaremic Dirofilaria repens Infection in Patient from Serbia.

We report a case of Dirofilaria repens infection causing microfilaremia in a patient from Serbia. Serum samples tested positive for D. repens IgG by ELISA. Our findings and those of others suggest the parasite's progressive adaptation to humans. Clinicians should be aware that microfilaremia can develop during Dirofilaria spp. infections.

What kills the virtually immortal palms of the Florida scrub?

PREMISE: Life span varies greatly across plants, with some species being capable of extreme longevity. Yet even long-lived individuals are susceptible to climatic events, fire, and other challenges. We examined rare mortality events and their causes in two long-lived palmettos over four decades. METHODS: We monitored the survival of the clonal Serenoa repens and non-clonal, Florida-endemic Sabal etonia from 1981 to 2022 in four habitats along an elevational gradient within the globally imperiled Florida scrub ecosystem. We considered several challenges to palmetto survival, including extreme fires, shading due to lack of fire, droughts, periods of high precipitation, and possible pathogens. RESULTS: Survival of palmettos was remarkably high, and mortality was infrequent (Serenoa: cumulative, 5.7%; annualized, 0%-0.68%; Sabal: cumulative, 3.5%; annualized, 0%-0.43%). Mortality was highest in higher-elevation habitats with greater soil drainage, and smaller palmettos were more likely to die. When subjected to extreme fire, Serenoa suffered greater mortality than Sabal. Mortality in long-unburned habitats with increased shading rivaled that which occurred with extreme fire. There was no evidence of mortality due to lethal bronzing palm disease. CONCLUSIONS: Both palmettos had exceptionally low mortality rates, which, coupled with earlier work showing slow rates of transition from seedling to adult and remarkable adult longevity, suggest notably low rates of population turnover. Observed mortality in long-unburned habitats suggests the importance of fire-management planning with prescription burning. Lengthy age to reproduction and/or dependency on clonal propagation limits migration or genetic adaptation to altered conditions caused by climate change.

Variable expression of cyanide detoxification and tolerance genes in cyanogenic and acyanogenic white clover (Trifolium repens).

PREMISE: ß-Cyanoalanine synthase (ß-CAS) and alternative oxidase (AOX) play important roles in the ability of plants to detoxify and tolerate hydrogen cyanide (HCN). These functions are critical for all plants because HCN is produced at low levels during basic metabolic processes, and especially for cyanogenic species, which release high levels of HCN following tissue damage. However, expression of ß-CAS and Aox genes has not been examined in cyanogenic species, nor compared between cyanogenic and acyanogenic genotypes within a species. METHODS: We used a natural polymorphism for cyanogenesis in white clover to examine ß-CAS and Aox gene expression in relation to cyanogenesis-associated HCN exposure. We identified all ß-CAS and Aox gene copies present in the genome, including members of the Aox1, Aox2a, and Aox2d subfamilies previously reported in legumes. Expression levels were compared between cyanogenic and acyanogenic genotypes and between damaged and undamaged leaf tissue. RESULTS: ß-CAS and Aox2a expression was differentially elevated in cyanogenic genotypes, and tissue damage was not required to induce this increased expression. Aox2d, in contrast, appeared to be upregulated as a generalized wounding response. CONCLUSIONS: These findings suggest a heightened constitutive role for HCN detoxification (via elevated ß-CAS expression) and HCN-toxicity mitigation (via elevated Aox2a expression) in plants that are capable of cyanogenesis. As such, freezing-induced cyanide autotoxicity is unlikely to be the primary selective factor in the evolution of climate-associated cyanogenesis clines.

Filariasis in dogs brought to the Veterinary Teaching Hospital, University of Peradeniya, Sri Lanka.

Dirofilariasis is the predominant emerging zoonotic filariasis in the world. The two most frequent filarial worms that infect dogs are Dirofilaria repens and Dirofilaria immitis. This study reports filariasis among dogs brought to the Veterinary Teaching Hospital (VTH) at the University of Peradeniya and signifies the first molecular characterization of D. repens, responsible for an emerging zoonotic filarial disease in Sri Lanka. Blood samples were collected and were morphologically analyzed using Modified Knott's Technique, followed by molecular analyses. The difference in filariasis prevalence among gender, breed, and age categories was analyzed using a chi-square test. Infection intensities were analyzed using the Mann-Whitney U test and the Kruskal Wallis test. The dogs were brought to the clinic for either vaccination and/or for a regular checkup, and most were sick having non-specific clinical signs. Among the 87 dogs tested, 27.6% were positive for Dirofilaria. Conventional PCR and bi-directional sequencing of genomic DNA of microscopically tested positive samples revealed that the species in Sri Lanka was D. repens. The infection was significantly higher in males (39.1%) than in females (14.6%; χ2 = 0.447, p = 0.011), though it is not significant between puppies (age < 1 year) and adult dogs. More crossbred dogs were infected compared to older and purebred dogs. There was no difference in intensity of infection based on their gender, age, or breed. Sequences obtained from the current study were unique and were only 63% identical to those of D. repens reported from South India. The high number of Dirofilaria infections in domestic dogs indicates a potential reservoir for emerging human dirofilariasis cases in Sri Lanka. Thus, morphological and molecular diagnosis, along with epidemiological assessment of these zoonoses, is critical for the formulation of effective public health programs and control mechanisms.

Occurrence of Dirofilaria repens in wild carnivores in Poland.

Dirofilaria repens is an expanding vector-borne zoonotic parasite of canines and other carnivores. Sub-clinically infected dogs constitute the most important reservoir of the parasite and the source of infection for its mosquito vectors. However, occurrence of D. repens infection in wild animals may contribute to the transmission of the parasite to humans and may explain the endemicity of filariae in newly invaded regions. The aim of the current study was to determine the occurrence of D. repens in 511 blood and spleen samples from seven species of wild carnivores (wolves, red foxes, Eurasian badgers, raccoons, raccoon dogs, stone martens, and pine martens) from different regions of Poland by means of a PCR protocol targeting the 12S rDNA gene. Dirofilaria repens-positive hosts were identified in seven of fourteen voivodeships in four of the seven regions of Poland: Masovia, Lesser Poland, Pomerania and Warmia-Masuria. The highest prevalence was found in Masovia region (8%), coinciding with the highest previously recorded prevalence in dogs in Central Poland. The DNA of Dirofilaria was detected in 16 samples of three species (total prevalence 3.13%). A low and similar percentage of positive samples (1.9%, 4.2% and 4.8%) was recorded among badgers, red foxes, and wolves, respectively. Dirofilaria repens-positive hosts were identified in seven of fourteen voivodships. Based on detection in different voivodeships, D. repens-positive animals were recorded in four out of the seven regions of Poland: in Masovia, Lesser Poland, Pomerania, and Warmia-Masuria. The highest prevalence of filariae was found in Masovia region (8%), reflecting the highest previously recorded prevalence in dogs (12-50%) in Central Poland. In summary, we conducted the first comprehensive study on the epidemiology of D. repens in seven species of wild hosts in all seven regions of Poland and identified the first case of D. repens infection in Eurasian badgers in Poland and the second in Europe.

Suspected adverse reactions to medications and food supplements containing Serenoa repens: A worldwide analysis of pharmacovigilance and phytovigilance spontaneous reports.

The safety of Serenoa repens (SR)-containing products was evaluated conducting a retrospective worldwide analysis of pharmaco- and phytovigilance report forms of suspected adverse reactions (SARs) collected up to 31 January 2022. Multivariate logistic regression was performed to estimate the odds ratios (ORs) of serious SAR. A total of 1810 report forms were analysed; 92% of subjects were males, with a median age of 69 years; 44% of cases were defined as serious. Subjects exposed to dietary supplements had a higher risk of developing serious SARs (OR: 1.60 [95% CI: 1.20-2.15]), as subjects exposed to 2-5 (OR: 1. 83 [95% CI: 1.30-2.58]) or more than 5 (OR: 3.45 [95% CI: 2.36-5.06]) suspect/interacting products. The probability of experiencing serious SAR was higher for subjects exposed to concomitant products (OR: 1.55 [95% CI: 1.15-2.08]), to more than four active compounds (OR: 4.38 [95% CI: 3.21-5.99]) and to SR for more than 14 days (OR: 1.89 [95% CI: 1.10-3, 22]), and lower for subjects exposed to higher doses of SR (OR: of 0.34 [95% CI: 0.20-0.58]). This evidence improves awareness on safety of SR containing products, suggesting the need of a further update of periodic reviews by national and international regulatory agencies.

Unusual cause of unilateral facial oedema: intramuscular dirofilariasis.

INTRODUCTION: Unilateral facial oedema may occur due to inflammatory, infective, or cystic pathology; patients often seek medical help at an early stage. CASE REPORT: We report one such case caused mimicking a parotid abscess, caused by dirofilariasis. CONCLUSION: Dirofilariasis is an emerging zoonosis and should be considered a differential diagnosis of atypical facial swelling. It is equally important for clinicians, radiologists, and pathologists to be familiar with the diagnostic characteristics to avoid misdiagnosis.

Identification and characterization of Colletotrichum truncatum and C. destructivum causing stem rot of white clover in China.

White clover (Trifolium repens L.) is an excellent quality forage legume species with superior planting efficiency, which reduces the cost of artificial weeding and nitrogen fertilizer inputs and has feeding and economic value. However, from June to September 2022, severe stem rot affected the yield and quality of white clover crops in Harbin, Heilongjiang Province, China. The aim of this study was to identify the causative agents of the disease. Overall, Colletotrichum truncatum (6 isolates) and C. destructivum (10 isolates) were obtained from rotten white clover stems and identified according to morpho-molecular characteristics and phylogenetic analyses. Pathogenicity tests of the isolates revealed that C. destructivum had a higher pathogenicity to white clover than C. truncatum. In addition, all isolates were highly pathogenic to broad bean, fodder soybean, soybean, pak choi, and chickpea, pathogenic to mint, and did not infect corn, wheat, or cilantro. C. destructivum and C. truncatum isolates were very sensitive to tebuconazole and pyraclostrobin, with EC50 values of 0.54 to 0.70 µg/ml and 0.42 to 0.62 µg/ml, respectively, efficacies ranging between 93.2 to 94.9% and 90.2 to 95.2% at 600 µg/ml and 450 µg/ml, respectively, and EC90 values of 1.88 to 13.36 µg/ml and 1.32 to 23.39 µg/ml, respectively. Therefore, intercropping of host and non-host plants and chemicals can be considered to control stem rot in white clover. These results provide a basis for controlling C. destructivum and C. truncatum in white clover in China.

A case of recurrent human Dirofilaria repens infection in Uzbekistan.

Dirofilaria repens is a zoonotic mosquito-borne filarioid that parasitizes in the subcutaneous tissues of carnivores, that has been incriminated in the great majority of human dirofilariasis cases reported throughout the Old World. From the Republic of Uzbekistan, recent data showed that this parasite is endemic in domestic and wild carnivores. In contrast, information regarding human infection is scarce and mostly outdated, with a single case report being published during the last decades. The present paper reports a case of recurrent autochthonous infection with D. repens in a patient living in the rural area of the Sirdaryo Region of Uzbekistan and having no international travel history. The first diagnosis was in 2019, when the patient presented with what was suspected to be a tumour of the left breast. Three years later, in 2022, she presented for a consultation after experiencing redness, occasional swelling and persistent itching in the umbilical region of the abdomen. The ultrasound indicated the presence of a living, motile nematode. Following anthelmintic therapy, the parasite was surgically removed and identified as a female D. repens. The present report highlights the possibility of human re-infection with D. repens and further underlines the necessity of raising public awareness and implementing of solid control strategies in carnivores.

[Alpha-blockers or hexanic extract of Serenoa repens for 6 months: sub-analysis of the PERSAT study]. / Alpha-bloquants ou extrait hexanique de Serenoa repens pendant 6 mois : sous-analyse de l'étude PERSAT.

OBJECTIVE: The objective of this sub-analysis of the PERSAT study was to evaluate the efficacy of hexanic extract of S. Repens (HESr) and alpha-blockers (AB), at 6 months in patients with moderate to severe LUTS/BPH. METHODS: The PERSAT observational study was conducted in France by general practitioners on patients with BPH with an IPSS≥12 score. The primary endpoint was the percentage of responders (decrease in total IPSS score ≥ 3) at 6 months. Improvement in quality of life (IPSS-QoL) as well as patient satisfaction were also measured. RESULTS: Of the 759 patients in the study, 324 treated with HESr and 309 with AB were reviewed at 6 months, with no change in treatment during follow-up. Characteristics at inclusion were globally similar with a mean IPSS of 18.2±4.9. The response rates at 6 months (IPSS-total decrease ≥ 3) were 93.7% and 94.8% for patients treated with HESr and AB, with a mean decrease in IPSS score of 10.1±5.6 points, which reached 13.6 and 14.8 points respectively, in severe patients (IPSS>19), without major difference between groups. More than 95% of HESr or AB patients reported a significant overall improvement in their LUTS/BPH. The most frequently reported adverse events with AB were ejaculation disorders (4.9%) and hypotension (4.2%) and with HESr digestive disorders (1.5%). CONCLUSION: This sub-analysis of the PERSAT cohort reported the clinical efficacy of HESr and AB as a first-line treatment in the management of moderate or severe LUTS/BPH patients.

[A case of pleuropulmonary dirofilariasis caused by Dirofilaria repens. Case report].

The differential diagnosis of neoplasms of various localizations is the primary task in clinical practice of all physicians. We present a description of the case of invasion with Dirofilaria repens in the lung of a 68-year-old patient. In 2016 the patient was diagnosed with cancer of the left kidney and underwent a left-sided nephrectomy. During the dynamic observation in 2019, a lump was found in the left lung, which was regarded as a metastasis. An atypical SIX resection of the left lung was performed. Microscopy of the removed lump revealed the presence of a nematode of the genus Dirofilaria, presumably D. repens. The species identity of D. repens was confirmed by polymerase chain reaction using species-specific primers. It is known that the morphological identification of parasites up to the species in the surgical material presents certain difficulties and requires high professional training of the researcher. Therefore, the diagnosis of dirofilariasis in atypical localizations of nematodes in the human body is of great importance in the differentiation of malignant and benign formations, and the use of the polymerase chain reaction method can significantly increase the accuracy in establishing the final diagnosis.