Azathioprine dose tailoring based on pharmacogenetic information: Insights of clinical implementation

Supplementary data associated with this article can be found in the online version at doi:10.1016/j.biopha.2023.115706Azathioprine is commonly used as an immunosuppressive antimetabolite in the treatment of acute lymphoblastic leukemia, autoimmune disorders (such as Crohn's disease and rheumatoid arthritis), and in patients receiving organ transplants. Thiopurine-S-methyltransferase (TPMT) is a cytoplasmic trans-methylase catalyzing the S-methylation of thiopurines. The active metabolites obtained from thiopurines are hydrolyzed into inactive forms by the Nudix hydrolase 15 (NUDT15). The TPMT*2 (defined by rs1800462), *3A (defined by rs1800460 and rs1142345), *3B (defined by rs1800460), *3C (defined by rs1142345), *6 (defined by rs75543815), and NUDT15 rs116855232 genetic variant have been associated, with the highest level of evidence, with the response to azathioprine, and, the approved drug label for azathioprine and main pharmacogenetic dosing guidelines recommend starting with reduced initial doses in TPMT intermediate metabolizer (IM) patients and considering an alternative treatment in TPMT poor metabolizer (PM) patients. This study aims to assess the clinical impact of azathioprine dose tailoring based on TPMT genotyping studying the azathioprine toxicity and efficacy, treatment starts, and dose adjustments during follow-up, comparing TPMT IM/PM and normal metabolizer (NM) patients. It also studied the association of NUDT15 rs116855232 with response to azathioprine in patients receiving a tailored treatment based on TPMT and characterized the TMPT and NUDT15 studied variants in our population. Results show that azathioprine dose reduction in TPMT IM patients (TPMT*1/*2, *1/*3A, or *1/*3C genotypes) is related to lower toxicity events compared to TPMT NM (TPMT *1/*1 genotype), and lower azathioprine dose adjustments during follow-up without showing differences in the efficacy. The results support the hypothesis of existing other genetic variants affecting azathioprine toxicity

Instantaneous transport of salt, nutrients, suspended matter and chlorophyll-a in the tropical estuarine system of Santos

A contribuição dos canais estuarinos de Santos e São Vicente para a eutrofização da baía de Santos foi avaliada quantificando-se o transporte instantâneo de sal, fosfato e nitrogênio inorgânico dissolvido (NID), material em suspensão orgânico (MSO) e inorgânico (MSI) e clorofila-a, durante a estação seca (inverno austral- Agosto/1999) e chuvosa (verão austral- Janeiro/ 2000). As amostragens foram realizadas em períodos de sizígia e quadratura, durante as marés enchentes e vazantes, nas secções transversais das bocas dos canais de São Vicente e Santos. Os valores de transporte instantâneo obtidos durante o período de amostragem indicaram exportação de NID, principalmente sobre a forma de N-NH4 (valor máximo de 1155,1 g s-1) na estação chuvosa; importação de fosfato durante a estação seca (máximo de 385,6 g s-1) e exportação de MSI, MSO e clorofila-a em períodos de maior contribuição fluvial. Estes resultados indicam uma importante contribuição dos canais estuarinos de Santos e São Vicente para a eutrofização da baía de Santos, especialmente durante o período chuvoso.The contribution of the polluted São Vicente and Santos estuarine channels to the eutrophication of Santos bay was assessed through the quantification of instantaneous transport of salt, dissolved inorganic nitrogen (DIN) and phosphate, organic and inorganic matter (OSM and ISM) and chlorophyll-a (Chl-a), during dry (austral winter- August/ 1999) and rainy (austral summer- January/2000) seasons. Samplings were carried out during spring and neap tides, in flood and ebb phases, in two transversal sections at the mouths of the São Vicente and Santos channels. Instantaneous transport values generally indicated importation of salt to the estuarine channels, exportation of DIN to the bay, mainly as N-NH4, at a maximum rate of 1155.1 g s-1 during the rainy season; importation of phosphate during the dry season (maximum of 385 g s-1) and exportation of ISM, OSM and Chl-a during periods of greater freshwater discharge. These results demonstrate the great contribution made by the Santos and São Vicente estuaries to the eutrophication of Santos bay, especially in the rainy season

Óxido de zinco e biosílica de diatomáceas: potencias fotoeletrodos? / Zinc oxide and diatomaceous biosylics: potentials of photoelectrodes?

O presente trabalho busca a inovação na tecnologia de células solares através da produção de fotoeletrodos utilizando um compósito do semicondutor ZnO combinado com biosílica extraída de diatomáceas da espécie Thalassiosira pseudonana (BMAK 172). O potencial deste eletrodo foi comparado com o de ZnO puro e de biosílica pura por meio de caracterizações fotoeletroquímicas. Os resultados demonstraram que todos os fotoeletrodos apresentam potencial para aplicação em células fotovoltaicas com destaque para a biosílica pura

Apoptosis, toll-like, RIG-I-like and NOD-like receptors are pathways jointly induced by diverse respiratory bacterial and viral pathogens

Lower respiratory tract infections are among the top five leading causes of human death. Fighting these infections is therefore a world health priority. Searching for induced alterations in host gene expression shared by several relevant respiratory pathogens represents an alternative to identify new targets for wide-range host-oriented therapeutics. With this aim, alveolar macrophages were independently infected with three unrelated bacterial (Streptococcus pneumoniae, Klebsiella pneumoniae, and Staphylococcus aureus) and two dissimilar viral (respiratory syncytial virus and influenza A virus) respiratory pathogens, all of them highly relevant for human health. Cells were also activated with bacterial lipopolysaccharide (LPS) as a prototypical pathogen-associated molecular pattern. Patterns of differentially expressed cellular genes shared by the indicated pathogens were searched by microarray analysis. Most of the commonly up-regulated host genes were related to the innate immune response and/or apoptosis, with Toll-like, RIG-I-like and NOD-like receptors among the top 10 signaling pathways with over-expressed genes. These results identify new potential broad-spectrum targets to fight the important human infections caused by the bacteria and viruses studied here.The authors gratefully acknowledge financial support from the “CIBER de Enfermedades Respiratorias” (CIBERES), an initiative of the “Instituto de Salud Carlos III” (ISCIII), Spain. Research activities in the participating laboratories received further funding from the following sources: Centro Nacional de Microbiología, ISCIII, PI15CIII/00024 and MINECO (SAF2015- 67033-R); Centro Nacional de Biotecnología, MINECO (BFU2014-57797-R); Hospital Universitari Germans Trias I Pujol, Spanish Society of Pneumology and Thoracic Surgery (SEPAR 054/2011); Departamento de Bioquímica y Biología Molecular I, MINECO (SAF2015-65307-R); Centro de Investigaciones Biológicas, MINECO (SAF2012-39444-C01/02); Fundación de Investigación Sanitaria de las Islas Baleares, MINECO (SAF2012-39841); Instituto de Agrobiotecnología, MINECO (SAF2015-66520-R); Instituto de Química Física Rocasolano, MINECO (BFU2015-70052-R) and the Marie Curie Initial Training Network GLYCOPHARM (PITN-GA- 2012-317297). Subprograma Estatal de Formación (BES-2013- 065355)

SARS-CoV-2 viral load in nasopharyngeal swabs is not an independent predictor of unfavorable outcome

The aim was to assess the ability of nasopharyngeal SARS-CoV-2 viral load at first patient’s hospital evaluation to predict unfavorable outcomes. We conducted a prospective cohort study including 321 adult patients with confirmed COVID-19 through RT-PCR in nasopharyngeal swabs. Quantitative Synthetic SARS-CoV-2 RNA cycle threshold values were used to calculate the viral load in log10 copies/mL. Disease severity at the end of follow up was categorized into mild, moderate, and severe. Primary endpoint was a composite of intensive care unit (ICU) admission and/or death (n = 85, 26.4%). Univariable and multivariable logistic regression analyses were performed. Nasopharyngeal SARS-CoV-2 viral load over the second quartile (≥ 7.35 log10 copies/mL, p = 0.003) and second tertile (≥ 8.27 log10 copies/mL, p = 0.01) were associated to unfavorable outcome in the unadjusted logistic regression analysis. However, in the final multivariable analysis, viral load was not independently associated with an unfavorable outcome. Five predictors were independently associated with increased odds of ICU admission and/or death: age ≥ 70 years, SpO2, neutrophils > 7.5 × 103/µL, lactate dehydrogenase ≥ 300 U/L, and C-reactive protein ≥ 100 mg/L. In summary, nasopharyngeal SARS-CoV-2 viral load on admission is generally high in patients with COVID-19, regardless of illness severity, but it cannot be used as an independent predictor of unfavorable clinical outcome

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality