Lysis strategy of Streptococcus pneumoniae bacteriophages : mechanisms and host implications

Tese de doutoramento, Ciências e Tecnologias da Saúde (Microbiologia), Universidade de Lisboa, Faculdade de Medicina, 2011Bacteriophages (phages), the most abundant entities in the biosphere, play a central role in the shaping of natural populations of bacteria. Phages have also been the focus of several studies due to their potential as tools for therapeutic purposes. Notably, detailed analysis carried out in different bacterial species established that phages have a prominent influence in virulence. The abundance of lysogenic phages in Streptococcus pneumoniae isolates associated with infection was suggested some years ago, and recently, it has been proposed that lysogens account for as much as 76% of the samples analyzed. However, the role of pneumococcal prophages in the pathogenic potential of its host remains so far unknown. Bacterial lysis promoted by the major autolysin LytA has been implicated in the capacity of pneumococcus to cause infection, essentially due to the release of proinflammatory cell wall compounds and intracellular virulence factors. Even if no phage-encoded virulence factors were ever found, prophage-mediated host lysis by itself may contribute significantly to pneumococcal pathogenesis. Therefore, investigating the phage lysis system is clearly important in furthering our understanding of this effect. This work explores the exact mechanism underlying the lysis strategy of S. pneumoniae phages to release their progeny and also the implications of lysogeny, particularly due to induced cell lysis, in the host ability to form biofilms, a bacterial lifestyle associated with pneumococcal human infections. Pneumococcal phages lyse their bacterial hosts, and consequently release the newly formed phage particles, at the end of the vegetative cycle through the combined action of holins that form lesions in the cytoplasmic membrane and lysins that degrade the bacterial peptidoglycan. The powerful lytic activity of the S. pneumoniae autolysin raised the possibility that it could play an important role in this process. By deleting the bacterial and phage lysins in both lysogenic and lysogenized strains, the contribution of LytA to phage release was evaluated based on bacterial culture lysis monitoring and phage plaque assays. It was found that, independently of the host genetic background, the bacterial autolysin is activated during phage-mediated lysis. Flow cytometry assessment of the membrane integrity after phage induction revealed that LytA triggering results from holininduced membrane disruption, similarly to the activation of the phage lysin. These results provide evidence that the energy status of the membrane may be involved in autolysin regulation at the cell surface. 3 We were able to demonstrate that, in the absence of the phage lytic enzyme, LytA by itself mediates extensive bacterial lysis, accompanied by the release of a large amount of fully functional phages capable of completing their life cycle since phage plaques were clearly detected. The overwhelming majority of phages of other bacterial species are absolutely incapable of bacterial lysis, trapping the phage progeny within the host cell, when the genes encoding lysins are deleted. Moreover, those rare mutants that bring about lysis depend only on phage-encoded factors. Nevertheless, exclusive dependence on the autolysin delayed the lysis timing and reduced the lysis extent. Accordingly, phage plaques were detected later than those in the presence of both host and phage lysins and a significant decrease on the number of virions released was observed. Therefore, lysis strictly dependent on LytA can lead to phage fitness impairment by retaining phage progeny longer within the host and reducing the amount of particles that actually escapes from entrapment. Nonetheless, under normal conditions, it was found that the concurrent activation of LytA with the phage lysin increases the total number of phages that exit the cell when the infective cycle is completed. Hence, pneumococcal phages use the ubiquitous host autolysin to accomplish an optimal phage exiting strategy and are unique among lysin-equipped phages in their dependence on bacterial lytic factors to achieve such task. Although the function of holin and phage lysin is characterized, the interplay between them to achieve lysis in S. pneumoniae was never fully determined. It has been shown that pneumococcal phage lysins are structurally and functionally similar to LytA, thus, they may share the same cellular localization and control mechanisms. Our finding that holin-induced membrane lesions trigger the bacterial cell wall autolysin prompted a deeper study of the pneumococcal lysis strategy. For this purpose, deletions of the holin and autolysin were performed in a lysogenic strain, in which the resident phage has a typical holin-lysin cassette. In the absence of these functions, western blot analysis and the effect of membrane permeabilizing and proton motive force (pmf)-dissipating agents on culture lysis allowed concluding that pneumococcal phage lysins accumulate with time across the lytic cycle and are continuously targeted to the cell wall. The phage lysin remains inactive associated with the choline residues within this structure. Therefore, the access of pneumococcal phage lysins to the bacterial surface is holin independent, hence they can be classified as exolysins. These findings are in contrast to what is observed in the large majority of holin-lysin phages where endolysins accumulate in the cytoplasm since they lack an intrinsic secretory signal sequence and consequently depend on holins to reach the peptidoglycan target. In addition, the involvement of the host Sec pathway in the phage lysin export was investigated. We assessed the cell wall localization of the phage 4 lysin by the same experimental procedures after culture treatment with the Sec inhibitor sodium azide. It was found that the phage lytic enzyme is possibly exported by the Sec system of pneumococci in spite of the striking absence of a signal sequence that could target it to the extracytoplasmic environment. This may constitute the first evidence, on phages encoding only holins and lysins in their lytic cassettes, of an exolysin without a secretion signal that is translocated through the membrane by the host Sec machinery. Furthermore, since the cell wall located autolysin also lacks obvious motifs or signals for an external localization, these results may provide clues for its transport mechanism. Dependence exclusively on the pmf-dissipating agent for complete host lysis, together with the previous observation of holin’s permeabilizing effect, showed that collapse of the cytoplasmic membrane electrochemical gradient achieved by the holins is the triggering signal to activate the phage lysin. In this study, it was further confirmed that activation of the externalized bacterial autolysin LytA, previously shown to contribute to phage progeny release, is also equally related to perturbations on the energized membrane. Thus, these results demonstrate that in S. pneumoniae phages, holin is not required for lysin export but is crucial to trigger the phage and bacterial lysins already residing in the cell wall by pmf dissipation upon formation of lesions on the membrane. In this regard, holins are the timing device that dictates when lysis takes place. After the characterization of the phage lytic mechanism, the contribution of lysis mediated by lysogenic phages to pneumococcal biofilms was investigated. S. pneumoniae lysogens are associated with human infections and pneumococcal biofilms have been implicated both in colonization and infection. It was explored if prophage spontaneous induction and consequent bacterial lysis enhance pneumococcal biofilm development providing a source of extracellular DNA (eDNA), a major factor in the biofilm matrix. Monitoring biofilm growth of lysogens and nonlysogenic bacteria by biomass quantification, viable cell counts and confocal laser scanning microscopy (CLSM), indicated that lysogenic bacteria are more prone to form biofilms, yielding structures with higher biomass and cell viability and showing denser biofilms in CLSM. Spontaneous phage induction was demonstrated to occur continuously as phages could be detected throughout biofilm formation through measurement of the total number of PFUs (plaque forming units) at specific time points. When comparing biofilm development between wild-type lysogens and those deleted in the phage lysin, bacterial autolysin LytA or both lysins, it was observed that phagemediated lytic events influence positively the biofilm structure. These results established that prophage promotes biofilm development due to bacterial lysis upon spontaneous induction. In 5 agreement, lysis inside biofilms also occurs in other bacterial species and it might be related to increased biofilm fitness. However, the effects created by the ablation of either the phage or bacterial lysins were overcome by the addition of external DNA. Additionally, in independent experiments, it was found that treatment with DNase I resulted in sparser and thinner biofilms while supplementation with DNA resulted in a thicker and more densely packed structure, confirming the important role of eDNA in pneumococcal biofilms. The quantification of eDNA released within these structures by real-time PCR also supported that lytic events promoted by phage are an important source of this matrix component, as biofilms of lytic strains contained more eDNA than those of nonlytic strains. Therefore, limited phage-mediated host lysis constitutes an important source of eDNA in S. pneumoniae biofilms favoring biofilm formation by lysogenic strains. Interestingly, massive phage induction leading to a high proportion of lysis was observed to disrupt severely biofilms of pneumococcal lysogens with a significant decrease in biofilm mass confirmed by CLSM visualization. These findings corroborate previous studies that show the potential use of lytic phages to destroy bacterial biofilms. The presented results and conclusions are of great value not only to directly increase our knowledge on phage biology and their relationship with the host bacteria, but ultimately to uncover the role of lysogeny in pneumococcal virulence. In this context, massive prophageinduced lysis of the host could mimic the major bacterial autolysin by releasing factors known to contribute to the course of infection. On the other hand, lysis due to spontaneous levels of induction, characteristic of prophage carriage, may have an impact in pathogenesis by enhancing S. pneumoniae biofilm formation, which has been implicated in the processes of colonization and disease. A deeper understanding of the mechanisms underlying pneumococcal infection is of vital significance to manage this important human pathogen.Os bacteriófagos (fagos) são entidades extremamente abundantes na natureza que desempenham um papel central na modulação das populações bacterianas. Devido ao seu potencial como ferramentas para fins terapêutico, os fagos têm sido alvo de diversos estudos. A análise detalhada realizada em diferentes espécies bacterianas permitiu estabelecer que os fagos têm uma influência marcante na virulência. A abundância de estirpes lisogénicas de Streptococcus pneumoniae responsáveis por infecção foi sugerida há alguns anos e, recentemente, foi proposto que correspondem aproximadamente a 76%. No entanto, o papel dos profagos no potencial infeccioso dos pneumococos é ainda desconhecido. A lise bacteriana promovida pela principal autolisina LytA foi implicada na capacidade de S. pneumoniae causar infecção sobretudo por promover a libertação de componentes da parede celular com actividade pro-inflamatória e factores de virulência intracelulares. Mesmo que, até à data, não tenham sido identificados factores de virulência nos genomas fágicos, a lise bacteriana mediada pelos profagos pode por si só contribuir significativamente para a patogenicidade do pneumococo. Desta forma, é importante estudar o sistema de lise dos fagos. O presente trabalho explora os mecanismos da estratégia de lise adoptada pelos fagos de S. pneumoniae para libertar a descendência fágica e as implicações da lisogenia, particularmente devido à indução de lise, na capacidade do hospedeiro formar biofilmes, uma forma de crescimento bacteriano associada com infecções pneumocócicas. Os fagos de S. pneumoniae lisam as células hospedeiras, e consequentemente libertam as partículas fágicas recém-formadas, no final do ciclo lítico através da acção conjunta de holinas que formam lesões na membrana citoplasmática e lisinas que degradam o peptidoglicano da bactéria. No entanto, como a autolisina de S. pneumoniae é caracterizada por uma extensa actividade lítica, é possível que possa desempenhar um papel importante neste processo. A contribuição de LytA na libertação dos fagos foi avaliada através da eliminação das actividades das lisinas fágica e bacteriana em estirpes lisogénicas e lisogenizadas, subsequente acompanhamento da lise das culturas bacterianas e realização de ensaios de placas fágicas. Foi determinado que, independentemente do contexto genético do hospedeiro, a autolisina bacteriana é activada durante a lise mediada pelo fago. A avaliação da integridade da membrana por citometria de fluxo após indução do fago revelou que a activação de LytA resulta, tal como a activação das lisinas fágicas, dos danos na membrana induzidos pelas holinas. Estes resultados sugerem que o estado energético da membrana está envolvido na regulação da autolisina na superfície celular. 3 Na ausência da enzima lítica do fago, demonstrou-se que LytA medeia uma lise bacteriana extensa acompanhada da libertação de uma grande quantidade de fagos funcionais capazes de completar o ciclo infeccioso, uma vez que foram claramente detectadas placas fágicas. A grande maioria dos fagos que infectam outras espécies bacterianas é absolutamente incapaz de causar lise bacteriana, aprisionando a descendência fágica dentro da célula hospedeira, quando são eliminados os genes que codificam as suas lisinas. Além disso, os poucos mutantes capazes de lisarem as bactérias hospedeiras dependem unicamente de factores codificados por si próprios. No entanto, a dependência exclusiva na autolisina adiou o momento da lise e reduziu a sua extensão. Em concordância, as placas fágicas foram detectadas mais tarde do que as observadas na presença de ambas as lisinas (bacteriana e fágica) e observou-se uma diminuição significativa no número de viriões libertados. Assim, a lise estritamente dependente de LytA pode influenciar negativamente o “fitness” do fago ao reter a descendência fágica durante mais tempo no interior do hospedeiro e ao reduzir a quantidade de partículas que de facto escapam ao aprisionamento. No entanto, em circunstâncias normais de infecção bacteriana, verificou-se que a activação de LytA em simultâneo com a da lisina fágica aumenta o número total de fagos libertos da célula hospedeira uma vez completo o ciclo infeccioso. Logo, os fagos de S. pneumoniae utilizam a ubíqua autolisina bacteriana para optimizar a sua estratégia de libertação da descendência sendo, entre os fagos equipados com lisinas, os únicos que dependem de factores líticos bacterianos para a libertação óptima. Embora as funções da holina e da lisina fágica estejam caracterizadas, a interacção entre estas proteínas para alcançar a lise em S. pneumoniae não foi integralmente determinada. Como as lisinas fágicas são estrutural e funcionalmente similares a LytA, é possível que partilhem a mesma localização celular e mecanismos de regulação. A observação de que as lesões na membrana provocadas pelas holinas activam a autolisina bacteriana localizada na parede celular, incitou a um estudo mais detalhado sobre a estratégia de lise do pneumococo. Para isso, foram eliminadas as funções da holina e da autolisina numa estirpe lisogénica em que o profago contém uma cassete holina-lisina típica. Na ausência destas actividades, a análise por “western blot” e a avaliação na lise das culturas do efeito de agentes que permeabilizam a membrana e dissipam a força motriz protónica (fmp) permitiram concluir que as lisinas fágicas de S. pneumoniae acumulam-se ao longo do tempo durante o ciclo lítico e são continuamente transportadas para a parede celular, onde permanecem inactivas associadas aos resíduos de colina. Assim, o acesso das lisinas fágicas à superfície bacteriana é independente das holinas, podendo ser caracterizadas como exolisinas. Estes resultados diferem do que se observa na grande maioria dos fagos dependentes do sistema holina-lisina. Nesses casos, as endolisinas acumulam-se no citoplasma, uma vez que são desprovidas de uma 4 sequência sinal secretória intrínseca e, consequentemente, dependem das holinas para alcançarem o peptidoglicano. Foi também estudado o envolvimento do sistema Sec do hospedeiro na exportação da lisina fágica. A localização da lisina fágica na parede celular foi avaliada pelos mesmos procedimentos experimentais após tratamento das culturas com azida de sódio, um inibidor desta via de transporte. Demonstrou-se que a enzima lítica fágica é possivelmente exportada pelo sistema Sec de S. pneumoniae apesar da ausência de sequências sinal que a possam dirigir para o compartimento extracitoplasmático. Estes resultados podem constituir a primeira evidência experimental, nos fagos que codificam nas suas cassetes líticas apenas as funções de holina e lisina, de uma exolisina sem sinal de exportação que é translocada através da membrana pelo sistema Sec do hospedeiro. Além disso, uma vez que a autolisina bacteriana localizada na parede celular também não apresenta motivos nem sequências de sinalização que justifiquem uma localização externa, estas observações podem ajudar a elucidar o seu mecanismo de transporte. A lise completa devido exclusivamente ao agente que dissipa a fmp, conjuntamente com a observação anterior do efeito permeabilizante das holinas, demonstrou que o colapso do gradiente electroquímico da membrana citoplasmática provocado pelas holinas constitui o sinal para activar a lisina fágica. Neste estudo, foi também confirmado que a activação da autolisina bacteriana externalizada, que se tinha verificado anteriormente contribuir para a libertação da descendência fágica, está igualmente relacionada com perturbações no estado energético da membrana. Logo, estes resultados demonstram que nos fagos de S. pneumoniae, a holina não é necessária para a exportação da lisina mas é crucial para activar tanto a lisina fágica como a bacteriana residentes na parede celular por dissipação da fmp aquando da formação de lesões na membrana, determinando o momento da lise. Após a caracterização do mecanismo fágico de lise, foi investigada a contribuição da lise mediada por fagos lisogénicos nos biofilmes do pneumococo. Em S. pneumoniae, as estirpes lisogénicas estão associadas com a infecção e os biofilmes foram implicados em ambos os processos de colonização e infecção. Foi estudado se a indução espontânea dos profagos e a consequente lise bacteriana favorece o desenvolvimento de biofilmes de S. pneumoniae por ser uma fonte de DNA extracelular (eDNA), um factor importante na matriz dos biofilmes. O desenvolvimento de biofilmes de estirpes lisogénicas e não lisogénicas foi analisado por quantificação da biomassa, determinação da viabilidade celular e por CLSM (“confocal laser scanning microscopy”). Observou-se que as estirpes lisogénicas são mais propensas a formar biofilmes, os quais se caracterizam por maior biomassa e viabilidade celular relacionadas com a maior densidade observada por CLSM. Foi demonstrado que a indução espontânea do fago ocorre continuamente uma vez que se detectaram partículas fágicas durante todo o 5 desenvolvimento do biofilme por medição do número total de UFPs (unidades formadoras de placas) a tempos específicos. Por comparação da formação do biofilme entre estirpes lisogénicas com e sem a lisina fágica, a autolisina bacteriana ou ambas, foi observado que eventos líticos mediados pelo fago influenciam positivamente a estrutura do biofilme. Estes resultados estabeleceram que o profago promove o desenvolvimento do biofilme através da lise bacteriana aquando da indução espontânea. Em concordância, a lise em biofilmes também ocorre noutras espécies bacterianas e parece estar relacionada com o aumento do crescimento do biofilme. No entanto, os efeitos da eliminação quer da lisina fágica quer da lisina bacteriana, foram anulados pela adição de DNA. Em experiências independentes, verificou-se que o tratamento com DNase I resultou em biofilmes menos compactos e densos enquanto a suplementação com DNA originou estruturas mais robustas, confirmando o papel importante de eDNA nos biofilmes de S. pneumoniae. A quantificação de eDNA presente nestas estruturas por PCR em tempo real também demonstrou que eventos líticos promovidos pelo fago são uma fonte importante deste componente da matriz pois biofilmes de estirpes capazes de lise continham mais eDNA do que as estirpes sem lisinas. Desta forma, a lise limitada mediada pelo fago constitui uma fonte importante de eDNA nos biofilmes de S. pneumoniae favorecendo o seu desenvolvimento no caso de estirpes lisogénicas. Interessantemente, a indução substancial do fago, levando a uma elevada proporção de lise, destrói gravemente os biofilmes de estirpes lisogénicas diminuindo significativamente a massa do biofilme como confirmado por CLSM. Estas observações corroboram estudos anteriores que demonstram o potencial do uso de fagos líticos para eliminar biofilmes bacterianos. Os resultados e conclusões apresentados são importantes não só por alargarem directamente o conhecimento acerca da biolo

Tempo de permanência no CATL (centro de actividades de tempos livres) e formação de conceitos

Inexistent

Cor/raça e desigualdades em saúde bucal entre adolescentes brasileiros

This study assessed oral health outcomes (perceived dental treatment need, untreated dental caries, gingival bleeding, periodontal pockets, and pain in teeth and gums), in relation to color/race inequalities among adolescents in each Brazilian region. The database included dental examination and interview of 16,833 15-19-year-old adolescents, surveyed by the Brazilian health authority, from May 2002 to October 2003, in accordance with international diagnostic criteria standardized by the World Health Organization. Prevalence ratios estimated by Poisson regression, and controlled by socioeconomic status and access to fluoridated piped water, assessed oral health differentials among color/race groups and country's regions. Except for periodontal pockets, prevalence figures were higher in the North and Northeast: perceived dental treatment needs, untreated dental caries, gingival bleeding at probing and pain in teeth and gums varied between 80-83%, 75-76%, 38-43%, and 17-18%, respectively, in these regions. Adolescents living in the Southeast - the richest Brazilian region - presented a better general profile of oral health than their counterparts living in the remaining regions; they had a lower prevalence of untreated dental caries (54%) and unfavorable gingival status (29%). However, the Southeast presented color/race inequalities in all oral health outcomes, with a poorer profile systematically affecting browns or blacks, depending on the oral health condition under consideration. These results reinforce the need for expanding the amplitude of health initiatives aimed at adolescent oral health. Socially appropriate health programs should concurrently aim at the reduction of levels of oral disease and its inequalities.O presente estudo avaliou desfechos de saúde bucal (necessidade de tratamento dentário autopercebida, cárie dentária não tratada, sangramento gengival, bolsa periodontal e dor nos dentes e gengivas) com o intuito de identificar desigualdades por cor/raça entre adolescentes em cada uma das macro-regiões brasileiras. O banco de dados incluiu informações sociodemográficas e de exames bucais de 16.833 adolescentes entre 15-19 anos de idade, investigados pelo Ministério de Saúde entre maio de 2002 e outubro de 2003, conforme critérios diagnósticos preconizados pela Organização Mundial da Saúde. Foram utilizadas razões de prevalência, calculadas por regressão de Poisson e ajustadas para variáveis socioeconômicas e acesso a água fluoretada, para estimar desigualdades nos desfechos de saúde bucal entre os grupos de cor/raça e as macro-regiões brasileiras. Exceto para bolsa periodontal, as estimativas de prevalência foram mais altas no Norte e no Nordeste: necessidade de tratamento dentário autopercebida, cárie dentária não tratada, sangramento gengival e dor nos dentes e gengivas variaram entre 80-83%, 75-76%, 38-43% e 17-18%, respectivamente, nestas regiões. Os adolescentes do Sudeste - a macro-região mais rica do país - apresentaram, em geral, melhores condições de saúde bucal, quando comparados com seus pares das demais macro-regiões; os adolescentes do Sudeste apresentaram menores prevalências de cárie dentária não tratada (54%) e de sangramento gengival (29%). Entretanto, o Sudeste demonstrou desigualdades por cor/raça em todos os desfechos investigados, com piores condições afetando sistematicamente pardos ou pretos, a depender da condição de saúde bucal investigada. Estes resultados reforçam a necessidade de expandir as ações dirigidas à saúde bucal dos adolescentes brasileiros. Programas/intervenções em saúde socialmente sensíveis devem visar a redução de níveis de morbidades bucais, bem como de suas desigualdades.(CNPq) Brazilian Council for Scientific and Technological Developmen

Dysregulation of glycerophospholipid metabolism during Behçet's disease contributes to a pro-inflammatory phenotype of circulating monocytes

Behcet's disease (BD) is a relapsing, multisystem and inflammatory condition characterized by systemic vasculitis of small and large vessels. Although the etiopathogenesis of BD remains unknown, immune-mediated mechanisms play a major role in the development of the disease. BD patients present leukocyte infiltration in the mucocutaneous lesions as well as neutrophil hyperactivation. In contrast to neutrophils, whose involvement in the pathogenesis of BD has been extensively studied, the biology of monocytes during BD is less well known. In this study, we analyzed the phenotype and function of circulating monocytes of 38 BD patients from Hospital of Braga. In addition, we evaluated the impact of inflammatory and metabolomic plasma environment on monocyte biology. We observed a worsening of mitochondrial function, with lower mitochondrial mass and increased ROS production, on circulating monocytes of BD patients. Incubation of monocytes from healthy donors with the plasma of BD patients mimicked the observed phenotype, strongly suggesting the involvement of serum mediators. BD patients, regardless of their symptoms, had higher serum pro-inflammatory TNF-alpha and IP-10 levels and IL-1 beta/IL-1RA ratio. Untargeted metabolomic analysis identified a dysregulation of glycerophospholipid metabolism on BD patients, where a significant reduction of phospholipids was observed concomitantly with an increase of lysophospholipids and fatty acids. These observations converged to an enhanced phospholipase A2 (PLA(2)) activation. Indeed, inhibition of PLA(2) with dexamethasone or the downstream cyclooxygenase (COX) enzyme with ibuprofen was able to significantly revert the mitochondrial dysfunction observed on monocytes of BD patients. Our results show that the plasma inflammatory environment coupled with a dysregulation of glycerophospholipid metabolism in BD patients contribute to a dysfunction of circulating monocytes

Conhecimento, Responsabilidade, Visão e Futuro: bases programáticas da Lista F para o 3.º mandato do Conselho Geral da Universidade de Évora 2016-20

O presente documento inclui o programa de acção e os elementos de campanha da Lista F, candidata ao 3.º mandato do Conselho Geral da Universidade de Évora (2016-20)

Conjugal inflammatory bowel disease : a systematic review and European survey

Background The frequency of inflammatory bowel disease (IBD) is increased after marriage to an individual with the disease. Importantly, the offspring of these couples have a significant risk for developing the disease. Herein, we aimed to better characterize conjugal IBD. Methods A systematic literature search was conducted with predetermined search criteria. Relevant manuscripts reporting on couples with IBD and their offspring were selected. Concomitantly, a cross-sectional survey was conducted of couples where both members were affected with IBD, as well as their offspring, and electronically distributed by patients’ associations. Results We identified 20 reports of IBD in couples, for a total of 68 couples. Of these, 66% were concordant regarding IBD type and 66% were diagnosed after cohabitation. The overall prevalence of IBD in the offspring of these couples was 29%. Our survey identified 58 couples with IBD, with 62% being concordant regarding IBD type; 42.9% were diagnosed prior to cohabitation, in 12.5% one spouse was diagnosed before and the other after cohabitation, and in 44.6% the onset of disease occurred after cohabitation for both. The prevalence of IBD in children born from these couples was 10%. The probability of developing disease in the progeny was 2% at 10 years, 12% at 15 years, and 16% at 20 years of age. Conclusions IBD in couples occurs mostly after marriage to an individual with disease or after many years of cohabitation. In a modern cohort, the risk for the progeny was around 16% by the age of 20, lower than previously reported.peer-reviewe

Portuguese botanical gardens: before and after 2020

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Prophage Spontaneous Activation Promotes DNA Release Enhancing Biofilm Formation in Streptococcus pneumoniae

Streptococcus pneumoniae (pneumococcus) is able to form biofilms in vivo and previous studies propose that pneumococcal biofilms play a relevant role both in colonization and infection. Additionally, pneumococci recovered from human infections are characterized by a high prevalence of lysogenic bacteriophages (phages) residing quiescently in their host chromosome. We investigated a possible link between lysogeny and biofilm formation. Considering that extracellular DNA (eDNA) is a key factor in the biofilm matrix, we reasoned that prophage spontaneous activation with the consequent bacterial host lysis could provide a source of eDNA, enhancing pneumococcal biofilm development. Monitoring biofilm growth of lysogenic and non-lysogenic pneumococcal strains indicated that phage-infected bacteria are more proficient at forming biofilms, that is their biofilms are characterized by a higher biomass and cell viability. The presence of phage particles throughout the lysogenic strains biofilm development implicated prophage spontaneous induction in this effect. Analysis of lysogens deficient for phage lysin and the bacterial major autolysin revealed that the absence of either lytic activity impaired biofilm development and the addition of DNA restored the ability of mutant strains to form robust biofilms. These findings establish that limited phage-mediated host lysis of a fraction of the bacterial population, due to spontaneous phage induction, constitutes an important source of eDNA for the S. pneumoniae biofilm matrix and that this localized release of eDNA favors biofilm formation by the remaining bacterial population

Edentulism and shortened dental arch in Brazilian elderly from the National Survey of Oral Health 2003

OBJECTIVE: To describe the distribution of edentulism and estimate the prevalence of functional dentition and shortened dental arch among elderly population. METHODS: A population-based epidemiological study was carried out with a sample of 5,349 respondents aged 65 to 74 years obtained from the 2002 and 2003 Brazilian Ministry of Health/Division of Oral Health survey database. The following variables were studied: gender; macroregion of residence; missing teeth; percentage that met the World Health Organization goal for oral health in the age group 65 to 74 years (50% having at least 20 natural teeth); presence of shortened dental arch; number of posterior occluding pairs of teeth. The Chi-square test assessed the association between categorical variables. The Kruskal-Wallis and Mann-Whitney tests were used to assess differences of mean between number of posterior occluding pairs teeth, macro-region and gender. RESULTS: The elderly population had an average of 5.49 teeth (SD: 7.93) with a median of 0. The proportion of completely edentulous respondents was 54.7%. Complete edentulism was 18.2% in the upper arch and 1.9% in the lower arch. The World Health Organization goal was achieved in 10% of all respondents studied. However, only 2.7% had acceptable masticatory function and aesthetics (having at least shortened dental arch) and a mean number of posterior occluding pairs of 6.94 (SD=2.97). There were significant differences of the percentage of respondents that met the World Health Organization goal and presence of shortened dental arch between men and women. There were differences in shortened dental arch between macroregions. CONCLUSIONS: The Brazilian epidemiological oral health survey showed high rate of edentulism and low rate of shortened dental arch in the elderly population studied, thus suggesting significant functional and aesthetic impairment in all Brazilian macroregions especially among women