Medroxyprogesterone Acetate Alters Mycobacterium Bovis BCG-Induced Cytokine Production in Peripheral Blood Mononuclear Cells of Contraceptive Users

Most individuals latently infected with Mycobacterium tuberculosis (M.tb) contain the infection by a balance of effector and regulatory immune responses. This balance can be influenced by steroid hormones such as glucocorticoids. The widely used contraceptive medroxyprogesterone acetate (MPA) possesses glucocorticoid activity. We investigated the effect of this hormone on immune responses to BCG in household contacts of active TB patients. Multiplex bead array analysis revealed that MPA demonstrated both glucocorticoid and progestogenic properties at saturating and pharmacological concentrations in peripheral blood mononuclear cells (PBMCs) and suppressed antigen specific cytokine production. Furthermore we showed that PBMCs from women using MPA produced significantly lower levels of IL-1α, IL-12p40, IL-10, IL-13 and G-CSF in response to BCG which corresponded with lower numbers of circulating monocytes observed in these women. Our research study is the first to show that MPA impacts on infections outside the genital tract due to a systemic effect on immune function. Therefore MPA use could alter susceptibility to TB, TB disease severity as well as change the efficacy of new BCG-based vaccines, especially prime-boost vaccine strategies which may be administered to adult or adolescent women in the future

A Multifaceted Analysis of Immune-Endocrine-Metabolic Alterations in Patients with Pulmonary Tuberculosis

Our study investigated the circulating levels of factors involved in immune-inflammatory-endocrine-metabolic responses in patients with tuberculosis with the aim of uncovering a relation between certain immune and hormonal patterns, their clinical status and in vitro immune response. The concentration of leptin, adiponectin, IL-6, IL-1β, ghrelin, C-reactive protein (CRP), cortisol and dehydroepiandrosterone (DHEA), and the in vitro immune response (lymphoproliferation and IFN-γ production) was evaluated in 53 patients with active untreated tuberculosis, 27 household contacts and 25 healthy controls, without significant age- or sex-related differences. Patients had a lower body mass index (BMI), reduced levels of leptin and DHEA, and increased concentrations of CRP, IL-6, cortisol, IL-1β and nearly significant adiponectin values than household contacts and controls. Within tuberculosis patients the BMI and leptin levels were positively correlated and decreased with increasing disease severity, whereas higher concentrations of IL-6, CRP, IL-1β, cortisol, and ghrelin were seen in cases with moderate to severe tuberculosis. Household contacts had lower DHEA and higher IL-6 levels than controls. Group classification by means of discriminant analysis and the k-nearest neighbor method showed that tuberculosis patients were clearly different from the other groups, having higher levels of CRP and lower DHEA concentration and BMI. Furthermore, plasma leptin levels were positively associated with the basal in vitro IFN-γ production and the ConA-driven proliferation of cells from tuberculosis patients. Present alterations in the communication between the neuro-endocrine and immune systems in tuberculosis may contribute to disease worsening

Genética molecular de caracteres cuantitativos en cruzamientos dialélicos de tomate

El objetivo de este trabajo fue evaluar marcadores moleculares y caracteres cuantitativos en un cruzamiento dialélico completo sin recíprocos, entre cinco líneas recombinantes de tomate y sus híbridos. Se obtuvieron perfiles de AFLP ("amplified fragment length polymorphism") y de polipéptidos del pericarpio en cuatro estados de madurez del fruto de 15 genotipos. Se evaluaron, entre otros: peso, acidez titulable, pH, vida poscosecha y firmeza. Se calculó el porcentaje de polimorfismo para los marcadores moleculares y el porcentaje de variabilidad genética para los caracteres cuantitativos en el grupo de líneas recombinantes, el de híbridos y el conjunto de genotipos. Se realizaron análisis de agrupamiento con cada nivel de variación genética. Para AFLP, el porcentaje de polimorfismo varió entre 34 y 54% y, para los perfiles polipeptídicos, entre 40 y 78%. Mayor polimorfismo fue observado en el grupo de híbridos. La variabilidad genética fue de 100% para acidez y 34% para firmeza, con los mayores valores en los parentales. La similitud genética varió entre los genotipos según el nivel de variación genética; pero la consistencia en el agrupamiento de algunas líneas recombinantes y sus híbridos fue conservada, lo que evidenció asociaciones entre los datos moleculares y fenotípicos

Exposición ocupacional y cáncer de pulmón en fumadores Exposição ocupacional e câncer de pulmão em fumantes Occupational exposure and lung cancer in smokers

Las altas tasas de incidencia y mortalidad por cáncer de pulmón en hombres en Rosario, Argentina motivaron o estudio de 211 pacientes varones. Se comparon las edades al diagnóstico entre los tipos histológicos y ocupaciones, y edad de iniciación, duración e intensidad del hábito de fumar. La edad promedio al diagnóstico fue 61 años, sin diferencias por tipo histológico pero sí por hábito de fumar: 58 años los fumadores y 68 los ex-fumadores (p<0,0001). En estos pacientes se encontró un predominio de tumores epidermoides, lo que podria estar asociado a los contaminantes ocupacionales presentes en esta etapa de industrialización. La asociación entre tipo celular y ocupación fue altamente significativa (p<0,0001), encontrándose el adenocarcinoma con mayor frecuencia en administrativos (oficinistas, docentes, contadores, abogados) y el epidermoide en otras ocupaciones (agricultores, metalúrgicos), especialmente en quienes fueron primeramente agricultores y luego metalúrgicos.<br>Foram estudados 211 pacientes do sexo masculino, fumantes, com câncer de pulmão, em Rosário (Argentina). Compararam-se as idades no momento do diagnóstico entre os tipos histológicos e ocupações e idade de início, duração e intensidade do hábito de fumar. A idade média dos pacientes diagnosticados foi de 61 anos, sem diferença por tipo histológico, porém por hábito de fumar: 58 anos os fumantes e 68 os ex-fumantes (p<0,0001). Nesses pacientes encontrou-se predomínio de tumores epidermoides, o que poderia estar associado aos contaminantes ocupacionais presentes nesta fase de industrialização. A associação entre tipo celular e ocupação foi altamente significativa (p<0,001), encontrando-se o adenocarcinoma com maior freqüência nos trabalhadores administrativos e o epidermoide em outras ocupações, especialmente em homens que primeiramemte foram agricultores e depois metalúrgicos.<br>High male lung cancer incidence and mortality in Rosario city, Argentina, have been found in previous studies. A project was undertaken for the purpose of evaluating the life-time occupational history as well as the duration and intensity of cigarette smoking as determinants of histologic cell types in 211 male patients with primary lung cancer. Their histologic cell types were: squamous 39%, adenocarcinoma 29%, small cell 18%, and others and not specified 14%. An association was found between histologic cell types and occupations (p<0.0001), adenocarcinoma being more prevalent in office personnel, teachers, accountants, lawyers, and squamous in the other, supposedly dirtier working environments, mainly in those men who had begun to work in farming and later transferred to mechanics and metallurgy. These latter ones were diagnosed at a younger age than those in other occupations, with a significant difference for squamous and small cell. No differences in the smoking intensity were found between the occupational groups. The mean age these patients began to smoke at was 15 years for those with squamous and small cell, and 17 years for those with adenocarcinoma (p<0.001). An interesting finding was the difference at their mean-age at diagnosis, 58 years for smokers and 68 for ex-smokers (p<0.0001). Studies are needed to elucidate the interplay of risk factors in the etiology of histologic subtypes of lung cancer

Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism.

BACKGROUND: Whether the oral factor Xa inhibitor edoxaban can be an alternative to warfarin in patients with venous thromboembolism is unclear. METHODS: In a randomized, double-blind, noninferiority study, we randomly assigned patients with acute venous thromboembolism, who had initially received heparin, to receive edoxaban at a dose of 60 mg once daily, or 30 mg once daily (e.g., in the case of patients with creatinine clearance of 30 to 50 ml per minute or a body weight below 60 kg), or to receive warfarin. Patients received the study drug for 3 to 12 months. The primary efficacy outcome was recurrent symptomatic venous thromboembolism. The principal safety outcome was major or clinically relevant nonmajor bleeding. RESULTS: A total of 4921 patients presented with deep-vein thrombosis, and 3319 with a pulmonary embolism. Among patients receiving warfarin, the time in the therapeutic range was 63.5%. Edoxaban was noninferior to warfarin with respect to the primary efficacy outcome, which occurred in 130 patients in the edoxaban group (3.2%) and 146 patients in the warfarin group (3.5%) (hazard ratio, 0.89; 95% confidence interval [CI], 0.70 to 1.13; P&lt;0.001 for noninferiority). The safety outcome occurred in 349 patients (8.5%) in the edoxaban group and 423 patients (10.3%) in the warfarin group (hazard ratio, 0.81; 95% CI, 0.71 to 0.94; P=0.004 for superiority). The rates of other adverse events were similar in the two groups. A total of 938 patients with pulmonary embolism had right ventricular dysfunction, as assessed by measurement of N-terminal pro-brain natriuretic peptide levels; the rate of recurrent venous thromboembolism in this subgroup was 3.3% in the edoxaban group and 6.2% in the warfarin group (hazard ratio, 0.52; 95% CI, 0.28 to 0.98). CONCLUSIONS: Edoxaban administered once daily after initial treatment with heparin was noninferior to high-quality standard therapy and caused significantly less bleeding in a broad spectrum of patients with venous thromboembolism, including those with severe pulmonary embolism. (Funded by Daiichi-Sankyo; Hokusai-VTE ClinicalTrials.gov number, NCT00986154.)