552 research outputs found
Impaired hepatic drug and steroid metabolism in congenital adrenal hyperplasia due to P450 oxidoreductase deficiency
Objective: Patients with congenital adrenal hyperplasia due to P450 oxidoreductase (POR) deficiency(ORD) present with disordered sex development and glucocorticoid deficiency. This is due to disruption of electron transfer from mutant POR to microsomal cytochrome P450 (CYP) enzymes that play a key role in glucocorticoid and sex steroid synthesis. POR also transfers electrons to all major drugmetabolizing CYP enzymes, including CYP3A4 that inactivates glucocorticoid and oestrogens. However, whether ORD results in impairment of in vivo drug metabolism has never been studied.
Design:We studied an adult patient with ORD due to homozygous POR A287P, the most frequent POR mutation in Caucasians, and her clinically unaffected, heterozygous mother. The patient had received standard dose oestrogen replacement from 17 until 37 years of age when it was stopped after she developed breast cancer.
Methods: Both subjects underwent in vivo cocktail phenotyping comprising the oral administration of caffeine, tolbutamide, omeprazole, dextromethorphan hydrobromide and midazolam to assess the five major drug-metabolizing CYP enzymes. We also performed genotyping for variant CYP alleles known to affect drug metabolism.
Results: Though CYP enzyme genotyping predicted normal or high enzymatic activities in both subjects, in vivo assessment showed subnormal activities of CYP1A2, CYP2C9, CYP2D6 and CYP3A4 in the patient and of CYP1A2 and CYP2C9 in her mother.
Conclusions: Our results provide in vivo evidence for an important role of POR in regulating drug metabolism and detoxification. In patients with ORD, in vivo assessment of drug-metabolizing activities with subsequent tailoring of drug therapy and steroid replacement should be considered
Concert recording 2017-04-23b
[Track 1]. Slowing down. I. Rotations in an emergency [Track 2]. II. Under the city [Track 3]. III. Forfeit [Track 4]. IV. Something comfortable to fall into / Jeremiah Flannery
National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010.
BACKGROUND: National estimates for the numbers of babies born small for gestational age and the comorbidity with preterm birth are unavailable. We aimed to estimate the prevalence of term and preterm babies born small for gestational age (term-SGA and preterm-SGA), and the relation to low birthweight (<2500 g), in 138 countries of low and middle income in 2010. METHODS: Small for gestational age was defined as lower than the 10th centile for fetal growth from the 1991 US national reference population. Data from 22 birth cohort studies (14 low-income and middle-income countries) and from the WHO Global Survey on Maternal and Perinatal Health (23 countries) were used to model the prevalence of term-SGA births. Prevalence of preterm-SGA infants was calculated from meta-analyses. FINDINGS: In 2010, an estimated 32·4 million infants were born small for gestational age in low-income and middle-income countries (27% of livebirths), of whom 10·6 million infants were born at term and low birthweight. The prevalence of term-SGA babies ranged from 5·3% of livebirths in east Asia to 41·5% in south Asia, and the prevalence of preterm-SGA infants ranged from 1·2% in north Africa to 3·0% in southeast Asia. Of 18 million low-birthweight babies, 59% were term-SGA and 41% were preterm-SGA. Two-thirds of small-for-gestational-age infants were born in Asia (17·4 million in south Asia). Preterm-SGA babies totalled 2·8 million births in low-income and middle-income countries. Most small-for-gestational-age infants were born in India, Pakistan, Nigeria, and Bangladesh. INTERPRETATION: The burden of small-for-gestational-age births is very high in countries of low and middle income and is concentrated in south Asia. Implementation of effective interventions for babies born too small or too soon is an urgent priority to increase survival and reduce disability, stunting, and non-communicable diseases. FUNDING: Bill & Melinda Gates Foundation by a grant to the US Fund for UNICEF to support the activities of the Child Health Epidemiology Reference Group (CHERG)
Estimates of Burden and Consequences of Infants Born Small for Gestational Age in Low and Middle Income Countries with INTERGROWTH-21(st) Standard: Analysis of CHERG Datasets.
Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard. Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. With available national level data, prevalence of small for gestational age and population attributable fractions of neonatal mortality attributable to small for gestational age were estimated. Setting CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small for gestational age; the number and proportion of neonatal deaths that could be prevented by reducing the prevalence of small for gestational age to 10%. Results In 2012, an estimated 23.3 million infants (uncertainty range 17.6 to 31.9; 19.3% of live births) were born small for gestational age in low and middle income countries. Among these, 11.2 million (0.8 to 15.8) were term and not low birth weight (≥2500 g), 10.7 million (7.6 to 15.0) were term and low birth weight (\u3c2500 g) and 1.5 million (0.9 to 2.6) were preterm. In low and middle income countries, an estimated 606 500 (495 000 to 773 000) neonatal deaths were attributable to infants born small for gestational age, 21.9% of all neonatal deaths. The largest burden was in South Asia, where the prevalence was the highest (34%); about 26% of neonatal deaths were attributable to infants born small for gestational age. Reduction of the prevalence of small for gestational age from 19.3% to 10.0% in these countries could reduce neonatal deaths by 9.2% (254 600 neonatal deaths; 164 800 to 449 700). Conclusions In low and middle income countries, about one in five infants are born small for gestational age, and one in four neonatal deaths are among such infants. Increased efforts are required to improve the quality of care for and survival of these high risk infants in low and middle income countrie
Healthy living on a healthy planet - Summary
Unsere Lebensweise macht krank und zerstört die natürlichen Lebensgrundlagen. In der Vision „Gesund leben auf einer gesunden Erde“ werden menschliche Lebensbereiche – Ernähren, Bewegen, Wohnen – gesund und umweltverträglich gestaltet sowie planetare Risiken – Klimawandel, Biodiversitätsverlust, Verschmutzung – bewältigt. Gesundheitssysteme nutzen ihre transformativen Potenziale, Bildung und Wissenschaft befördern gesellschaftliche Veränderungen. Die Vision ist nur mit internationaler Kooperation realisierbar und erfordert eine globale Dringlichkeitsgovernance.Our lifestyle is making us ill and is destroying the natural life-support systems. In the vision of ‘healthy living on a healthy planet’, human spheres of life – what we eat, how we move, where we live – are designed to be both healthy and environmentally compatible, and planetary risks – climate change, biodiversity loss, pollution – have been overcome. Health systems harness their transformative potential; education and science promote societal change. The vision can only be realized with international cooperation and requires what the WBGU terms global urgency governance
Detection of Carbon Monoxide in the Atmosphere of WASP-39b Applying Standard Cross-Correlation Techniques to JWST NIRSpec G395H Data
Carbon monoxide was recently reported in the atmosphere of the hot Jupiter
WASP-39b using the NIRSpec PRISM transit observation of this planet, collected
as part of the JWST Transiting Exoplanet Community Early Release Science (JTEC
ERS) Program. This detection, however, could not be confidently confirmed in
the initial analysis of the higher resolution observations with NIRSpec G395H
disperser. Here we confirm the detection of CO in the atmosphere of WASP-39b
using the NIRSpec G395H data and cross-correlation techniques. We do this by
searching for the CO signal in the unbinned transmission spectrum of the planet
between 4.6 and 5.0 m, where the contribution of CO is expected to be
higher than that of other anticipated molecules in the planet's atmosphere. Our
search results in a detection of CO with a cross-correlation function (CCF)
significance of when using a template with only lines. The CCF significance of the CO signal increases to when including in the template lines from additional CO isotopologues,
with the largest contribution being from . Our results
highlight how cross-correlation techniques can be a powerful tool for unveiling
the chemical composition of exoplanetary atmospheres from medium-resolution
transmission spectra, including the detection of isotopologues.Comment: Accepted for publication in The Astrophysical Journal Letter
Early Release Science of the exoplanet WASP-39b with JWST NIRCam
Measuring the metallicity and carbon-to-oxygen (C/O) ratio in exoplanet
atmospheres is a fundamental step towards constraining the dominant chemical
processes at work and, if in equilibrium, revealing planet formation histories.
Transmission spectroscopy provides the necessary means by constraining the
abundances of oxygen- and carbon-bearing species; however, this requires broad
wavelength coverage, moderate spectral resolution, and high precision that,
together, are not achievable with previous observatories. Now that JWST has
commenced science operations, we are able to observe exoplanets at previously
uncharted wavelengths and spectral resolutions. Here we report time-series
observations of the transiting exoplanet WASP-39b using JWST's Near InfraRed
Camera (NIRCam). The long-wavelength spectroscopic and short-wavelength
photometric light curves span 2.0 - 4.0 m, exhibit minimal systematics,
and reveal well-defined molecular absorption features in the planet's spectrum.
Specifically, we detect gaseous HO in the atmosphere and place an upper
limit on the abundance of CH. The otherwise prominent CO feature at 2.8
m is largely masked by HO. The best-fit chemical equilibrium models
favour an atmospheric metallicity of 1-100 solar (i.e., an enrichment
of elements heavier than helium relative to the Sun) and a sub-stellar
carbon-to-oxygen (C/O) ratio. The inferred high metallicity and low C/O ratio
may indicate significant accretion of solid materials during planet formation
or disequilibrium processes in the upper atmosphere.Comment: 35 pages, 13 figures, 3 tables, Nature, accepte
Early Release Science of the exoplanet WASP-39b with JWST NIRISS
Transmission spectroscopy provides insight into the atmospheric properties
and consequently the formation history, physics, and chemistry of transiting
exoplanets. However, obtaining precise inferences of atmospheric properties
from transmission spectra requires simultaneously measuring the strength and
shape of multiple spectral absorption features from a wide range of chemical
species. This has been challenging given the precision and wavelength coverage
of previous observatories. Here, we present the transmission spectrum of the
Saturn-mass exoplanet WASP-39b obtained using the SOSS mode of the NIRISS
instrument on the JWST. This spectrum spans m in wavelength and
reveals multiple water absorption bands, the potassium resonance doublet, as
well as signatures of clouds. The precision and broad wavelength coverage of
NIRISS-SOSS allows us to break model degeneracies between cloud properties and
the atmospheric composition of WASP-39b, favoring a heavy element enhancement
("metallicity") of the solar value, a sub-solar
carbon-to-oxygen (C/O) ratio, and a solar-to-super-solar potassium-to-oxygen
(K/O) ratio. The observations are best explained by wavelength-dependent,
non-gray clouds with inhomogeneous coverage of the planet's terminator.Comment: 48 pages, 12 figures, 2 tables. Under review at Natur
Early Release Science of the Exoplanet WASP-39b with JWST NIRSpec G395H
Measuring the abundances of carbon and oxygen in exoplanet atmospheres is
considered a crucial avenue for unlocking the formation and evolution of
exoplanetary systems. Access to an exoplanet's chemical inventory requires
high-precision observations, often inferred from individual molecular
detections with low-resolution space-based and high-resolution ground-based
facilities. Here we report the medium-resolution (R600) transmission
spectrum of an exoplanet atmosphere between 3-5 m covering multiple
absorption features for the Saturn-mass exoplanet WASP-39b, obtained with JWST
NIRSpec G395H. Our observations achieve 1.46x photon precision, providing an
average transit depth uncertainty of 221 ppm per spectroscopic bin, and present
minimal impacts from systematic effects. We detect significant absorption from
CO (28.5) and HO (21.5), and identify SO as the
source of absorption at 4.1 m (4.8). Best-fit atmospheric models
range between 3 and 10x solar metallicity, with sub-solar to solar C/O ratios.
These results, including the detection of SO, underscore the importance of
characterising the chemistry in exoplanet atmospheres, and showcase NIRSpec
G395H as an excellent mode for time series observations over this critical
wavelength range.Comment: 44 pages, 11 figures, 3 tables. Resubmitted after revision to Natur
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Nightside clouds and disequilibrium chemistry on the hot Jupiter WASP-43b
Hot Jupiters are among the best-studied exoplanets, but it is still poorly understood how their chemical composition and cloud properties vary with longitude. Theoretical models predict that clouds may condense on the nightside and that molecular abundances can be driven out of equilibrium by zonal winds. Here we report a phase-resolved emission spectrum of the hot Jupiter WASP-43b measured from 5 μm to 12 μm with the JWST’s Mid-Infrared Instrument. The spectra reveal a large day–night temperature contrast (with average brightness temperatures of 1,524 ± 35 K and 863 ± 23 K, respectively) and evidence for water absorption at all orbital phases. Comparisons with three-dimensional atmospheric models show that both the phase-curve shape and emission spectra strongly suggest the presence of nightside clouds that become optically thick to thermal emission at pressures greater than ~100 mbar. The dayside is consistent with a cloudless atmosphere above the mid-infrared photosphere. Contrary to expectations from equilibrium chemistry but consistent with disequilibrium kinetics models, methane is not detected on the nightside (2σ upper limit of 1–6 ppm, depending on model assumptions). Our results provide strong evidence that the atmosphere of WASP-43b is shaped by disequilibrium processes and provide new insights into the properties of the planet’s nightside clouds. However, the remaining discrepancies between our observations and our predictive atmospheric models emphasize the importance of further exploring the effects of clouds and disequilibrium chemistry in numerical models.Peer reviewe
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