PrevenBox: Evaluation of concomitant use of preventive medications with OnabotulinumtoxinA in migraine

P114 Background: OnabotulinumtoxinA is an effective, tolerable and safepreventive treatment for chronic migraine (CM). Other than a reduc-tion in headache frequency or disability, in CM the withdrawal ofconcomitant preventive medication indicates treatment effectivenessand quality of life improvement. Objective: To characterize the change in the use of oral preventivemedication after treatment with OnabotulinumtoxinA in patientswith migraine. Methods: This is a multicentre study. We consecutively included pa-tients with migraine (ICHD-3) that were on preventive treatment withOnabotulinumtoxinA. We retrospectively collected demographic data, diagnosis of migraine, frequency and intensity changes, number ofcycle and OnabotulinumtoxinA dose. In addition, we listed the initialand current preventive treatment (number of drugs and group) andthe number and cycle of medications withdrawn. We performed aunivariate and logistic regression analysis. Results: We included 542 patients: 87.6% women, mean age 47.6 ±11.7 years. A 89.3% had chronic migraine and 10.8% had high fre-quency episodic migraine. The mean reduction in frequency aftertreatment was 13.4±8.2 headache days/month. At baseline, a 91.3%took other preventives and during treatment with Onabotulinumtox-inA a 58.6% withdrew at least one drug, 25.8% stopped completelyall oral preventive drugs. Factors associated with withdrawal were:being male, having >50% response in frequency and intensity, thenumber of infiltrations and a shorter chronification period until thefirst OnabotulinumtoxinA administration (p <0.05). The multivariateanalysis showed that a better response in intensity (OR:1.8 [1.4-2.2], p<0.001), a greater number of infiltrations (OR:1.1 [1.0-1.2], p<0.001)and a shorter chronification period (OR:0.994 [0.992-0.997], p<0.001)were predictors of withdrawal. The ROC curve, showed that 6 Onabo-tulinumtoxinA cycles was the cut-off point that better predicted oralpreventive medication withdrawal (p <0.001). Conclusions: Treatment with OnabotulinumtoxinA reduces the use ofother preventive medications for migraine. The highest probability ofwithdrawal occurs after 6 cycles of treatment

SK channels contribution to ventricular electrophysiology in heart failure patients

Heart failure (HF) is characterized by deterioration of the electrical and contractile function of the heart due to structural and functional remodelling, leading to development of arrhythmias and increased sudden cardiac death risk. SK channels are a type of calcium-activated potassium channels that do not play a relevant role in normal ventricular electrophysiology. However, it has been hypothesized that these channels become more relevant in pathologies such as HF. Nontheless, their role in human ventricular electrophysiology is not fully characterized

Inhibition of intermediate-conductance calcium-activated K channel (KCa3.1) and fibroblast mitogenesis by a-linolenic acid and alterations of channel expression in the lysosomal storage disorders, fabry disease, and niemann pick C

The calcium/calmodulin-gated KCa3.1 channel regulates normal and abnormal mitogenesis by controlling K+-efflux, cell volume, and membrane hyperpolarization-driven calcium-entry. Recent studies suggest modulation of KCa3.1 by omega-3 fatty acids as negative modulators and impaired KCa3.1 functions in the inherited lysosomal storage disorder (LSD), Fabry disease (FD). In the first part of present study, we characterize KCa3.1 in murine and human fibroblasts and test the impact of omega-3 fatty acids on fibroblast proliferation. In the second, we study whether KCa3.1 is altered in the LSDs, FD, and Niemann-Pick disease type C (NPC). Our patch-clamp and mRNA-expression studies on murine and human fibroblasts show functional expression of KCa3.1. KCa currents display the typical pharmacological fingerprint of KCa3.1: Ca2+-activation, potentiation by the positive-gating modulators, SKA-31 and SKA-121, and inhibition by TRAM-34, Senicapoc (ICA-17043), and the negative-gating modulator, 13b. Considering modulation by omega-3 fatty acids we found that a-linolenic acid (a-LA) and docosahexanenoic acid (DHA) inhibit KCa3.1 currents and strongly reduce fibroblast growth. The a-LA-rich linseed oil and ¿-LA-rich borage oil at 0.5% produce channel inhibition while a-LA/¿-LA-low oils has no anti-proliferative effect. Concerning KCa3.1 in LSD, mRNA expression studies, and patch-clamp on primary fibroblasts from FD and NPC patients reveal lower KCa3.1-gene expression and membrane expression than in control fibroblasts. In conclusion, the omega-3 fatty acid, a-LA, and a-LA/¿-LA-rich plant oils, inhibit fibroblast KCa3.1 channels and mitogenesis. Reduced fibroblast KCa3.1 functions are a feature and possible biomarker of cell dysfunction in FD and NPC and supports the concept that biased lipid metabolism is capable of negatively modulating KCa3.1 expression

Conformations of Proteins in Equilibrium

We introduce a simple theoretical approach for an equilibrium study of proteins with known native state structures. We test our approach with results on well-studied globular proteins, Chymotrypsin Inhibitor (2ci2), Barnase and the alpha spectrin SH3 domain and present evidence for a hierarchical onset of order on lowering the temperature with significant organization at the local level even at high temperatures. A further application to the folding process of HIV-1 protease shows that the model can be reliably used to identify key folding sites that are responsible for the development of drug resistance .Comment: 6 pages, 3 eps figure

Predictors of severe relapse in pregnant women with psychotic or bipolar disorders

Pregnancy in women with severe mental illness is associated with adverse outcomes for mother and infant. There are limited data on prevalence and predictors of relapse in pregnancy. A historical cohort study using anonymised comprehensive electronic health records from secondary mental health care linked with national maternity data was carried out. Women with a history of serious mental illness who were pregnant (2007–2011), and in remission at the start of pregnancy, were studied; severe relapse was defined as admission to acute care or self-harm. Predictors of relapse were analysed using random effects logistic regression to account for repeated measures in women with more than one pregnancy in the study period. In 454 pregnancies (389 women) there were 58 (24%) relapses in women with non-affective psychoses and 25 (12%) in women with affective psychotic or bipolar disorders. Independent predictors of relapse included non-affective psychosis (adjusted OR = 2.03; 95% CI = 1.16–3.54), number of recent admissions (1.37; 1.03–1.84), recent self-harm (2.24; 1.15–4.34), substance use (2.15; 1.13–4.08), smoking (2.52; 1.26–5.02) and non-white ethnicity (black ethnicity: 2.37; 1.23,4.57, mixed/other ethnicity: 2.94; 1.32,6.56). Women on no regular medication throughout first trimester were also at greater risk of relapse in pregnancy (1.99; 1.05–3.75). There was no interaction between severity of illness and medication status as relapse predictors. Therefore, women with non-affective psychosis and higher number of recent acute admissions are at significant risk of severe relapse in pregnancy. Continuation of medication in women with severe mental illness who become pregnant may be protective

Analysis of age-related left ventricular collagen remodeling in living donors: Implications in arrhythmogenesis

Age-related fibrosis in the left ventricle (LV) has been mainly studied in animals by assessing collagen content. Using second-harmonic generation microscopy and image processing, we evaluated amount, aggregation and spatial distribution of LV collagen in young to old pigs, and middle-age and elder living donors. All collagen features increased when comparing adult and old pigs with young ones, but not when comparing adult with old pigs or middle-age with elder individuals. Remarkably, all collagen parameters strongly correlated with lipofuscin, a biological age marker, in humans. By building patient-specific models of human ventricular tissue electrophysiology, we confirmed that amount and organization of fibrosis modulated arrhythmia vulnerability, and that distribution should be accounted for arrhythmia risk assessment. In conclusion, we characterize the age-associated changes in LV collagen and its potential implications for ventricular arrhythmia development. Consistency between pig and human results substantiate the pig as a relevant model of age-related LV collagen dynamics. © 2022 The Author(s

Idoneidad del uso del MALDI-TOF MS para la identificación de Staphylococcus aureus y miembros del grupo de Staphylococcus intermedius (S.I.G.)

A pesar de que el género Staphylococcus es comúnmente aislado en humanos y animales, su identificación sigue siendo problemática. Este estudio evalúa la idoneidad del MALDI-TOF MS (Biotyper 3) para su identificación, comparando los resultados obtenidos mediante diferentes métodos: fenotípicos, MALDITOF MS (añadiendo o no ácido fórmico) y moleculares. Una colección de 37 cepas fue identificada por técnicas convencionales como S. aureus (n= 7), S. intermedius (n=1) y S. pseudintermedius (n=29). Los aislamientos provenían de perros, tanto sanos como enfermos (n=27), y humanos (n=10), a partir de diferentes muestras biológicas. Todas ellas fueron también identificadas por biología molecular y los cultivos puros fueron procesados en el MALDI-TOF MS. La información fue analizada con DAG_Stat. La sensibilidad, especificidad, eficiencia y el índice kappa se estimaron para cada especie bacteriana con un nivel de confianza del 95%, tomando la biología molecular como gold standard. Se detectaron Estafilococos de 27 perros y de sus dueños. Solamente una cepa de S. intermedius fue aislada, así que los parámetros relacionados con ella tienen que ser considerados con cautela. Todos los S. aureus fueron identificados correctamente. Usando MALDI-TOF MS con ácido fórmico, hubo una concordancia casi perfecta entre pruebas en la identificación de S. aureus y S. pseudintermedius. Cuando no se añadía ácido fórmico, la concordancia fue perfecta para S. aureus, mientras que para S. pseudintermedius fue buena. Este trabajo demuestra la validez, la utilidad y la fiabilidad del MALDI-TOF MS para la identificación de aislamientos bacterianos pertenecientes a Staphylococcus spp

Circular Permutation in Proteins

This is a ‘‘Topic Page’ ’ article for PLoS Computational Biology. Circular permutation describes a type of relationship between proteins, whereby the proteins have a changed order of amino acids in their protein sequence, such that the sequence of the first portion of one protein (adjacent to the N-terminus) is related to that of the second portion of the other protein (near its C-terminus), and vice versa (see Figure 1). This is directly analogous to the mathematical notion of a cyclic permutation over the set of residues in a protein. Circular permutation can be the result of evolutionary events, post-translational modifications, or artificially engineered mutations. The result is a protein structure with different connectivity, but overall similar three-dimensional (3D) shape. The homology between portions of the proteins can be established by observing similar sequences between N- and C-terminal portions of the tw