55 research outputs found
Ethylene is involved in pistil fate by modulating the onset of ovule senescence and the GA-mediated fruit set in Arabidopsis
Background: Ovule lifespan is an important factor in determining the ability to set fruits and produce seeds. Once
ovule senescence is established, fruit set capacity in response to gibberellins (GAs) is lost. We aimed to elucidate
whether ethylene plays a role in controlling ovule senescence and the fruit set response in Arabidopsis.
Results: Ethylene response inhibitors, silver thiosulphate (STS) and 1-methylcyclopropene (1-MCP), were able to
delay the loss of pistil response to GA3
. In addition, ethylene insensitive mutants ein2-5 and ein3-1 showed delayed
loss of pistil response, as in plants treated with STS and 1-MCP, while constitutive mutant ctr1-1 displayed
premature loss of response. The analysis of the expression of ethylene biosynthesis genes suggests that ethylene is
synthesised in ovules at the onset of ovule senescence, while a transcriptional meta-analysis also supports an
activated ethylene-dependent senescence upon the establishment of ovule senescence. Finally, a SAG12:GUS
reporter line proved useful to monitor ovule senescence and to directly demonstrate that ethylene specifically
modulates ovule senescence.
Conclusions: We have shown that ethylene is involved in both the control of the ovule lifespan and the
determination of the pistil/fruit fate. Our data support a role of the ovule in modulating the GA response during
fruit set in Arabidopsis. A possible mechanism that links the ethylene modulation of the ovule senescence and the
GA3
-induced fruit set response is discussed.The authors wish to thank Drs. Alonso and Amasino for their gifts of seeds; Drs. Alonso, Alabadi, and Blazquez for critically reading the manuscript, and Ms. Argomaniz and Ms. Fuster for technical assistance in the lab. This work has been supported by grants BIO2005-07156-C02-01 and BIO2008-01039 from the Spanish Ministry of Science and Innovation, Plan Nacional de I+D. PCB received a PhD fellowship from the Spanish Ministry of Science and Innovation.Carbonell Bejerano, P.; Urbez Lagunas, C.; Granell Richart, A.; Carbonell Gisbert, J.; Perez Amador, MA. (2011). Ethylene is involved in pistil fate by modulating the onset of ovule senescence and the GA-mediated fruit set in Arabidopsis. BMC Plant Biology. 11:84-84. https://doi.org/10.1186/1471-2229-11-84S84841
A new set of ESTs and cDNA clones from full-length and normalized libraries for gene discovery and functional characterization in citrus
<p>Abstract</p> <p>Background</p> <p>Interpretation of ever-increasing raw sequence information generated by modern genome sequencing technologies faces multiple challenges, such as gene function analysis and genome annotation. Indeed, nearly 40% of genes in plants encode proteins of unknown function. Functional characterization of these genes is one of the main challenges in modern biology. In this regard, the availability of full-length cDNA clones may fill in the gap created between sequence information and biological knowledge. Full-length cDNA clones facilitate functional analysis of the corresponding genes enabling manipulation of their expression in heterologous systems and the generation of a variety of tagged versions of the native protein. In addition, the development of full-length cDNA sequences has the power to improve the quality of genome annotation.</p> <p>Results</p> <p>We developed an integrated method to generate a new normalized EST collection enriched in full-length and rare transcripts of different citrus species from multiple tissues and developmental stages. We constructed a total of 15 cDNA libraries, from which we isolated 10,898 high-quality ESTs representing 6142 different genes. Percentages of redundancy and proportion of full-length clones range from 8 to 33, and 67 to 85, respectively, indicating good efficiency of the approach employed. The new EST collection adds 2113 new citrus ESTs, representing 1831 unigenes, to the collection of citrus genes available in the public databases. To facilitate functional analysis, cDNAs were introduced in a Gateway-based cloning vector for high-throughput functional analysis of genes <it>in planta</it>. Herein, we describe the technical methods used in the library construction, sequence analysis of clones and the overexpression of <it>CitrSEP</it>, a citrus homolog to the Arabidopsis <it>SEP3 </it>gene, in Arabidopsis as an example of a practical application of the engineered Gateway vector for functional analysis.</p> <p>Conclusion</p> <p>The new EST collection denotes an important step towards the identification of all genes in the citrus genome. Furthermore, public availability of the cDNA clones generated in this study, and not only their sequence, enables testing of the biological function of the genes represented in the collection. Expression of the citrus <it>SEP3 </it>homologue, <it>CitrSEP</it>, in Arabidopsis results in early flowering, along with other phenotypes resembling the over-expression of the Arabidopsis <it>SEPALLATA </it>genes. Our findings suggest that the members of the <it>SEP </it>gene family play similar roles in these quite distant plant species.</p
Systems analysis of auxin transport in the Arabidopsis root apex
Auxin is a key regulator of plant growth and development. Within the root tip, auxin distribution plays a crucial role specifying developmental zones and coordinating tropic responses. Determining how the organ-scale auxin pattern is regulated at the cellular scale is essential to understanding how these processes are controlled. In this study, we developed an auxin transport model based on actual root cell geometries and carrier subcellular localizations. We tested model predictions using the DII-VENUS auxin sensor in conjunction with state-of-the-art segmentation tools. Our study revealed that auxin efflux carriers alone cannot create the pattern of auxin distribution at the root tip and that AUX1/LAX influx carriers are also required. We observed that AUX1 in lateral root cap (LRC) and elongating epidermal cells greatly enhance auxin’s shootward flux, with this flux being predominantly through the LRC, entering the epidermal cells only as they enter the elongation zone. We conclude that the nonpolar AUX1/LAX influx carriers control which tissues have high auxin levels, whereas the polar PIN carriers control the direction of auxin transport within these tissues
Gibberellin-mediated RGA-LIKE1 degradation regulates embryo sac development in Arabidopsis
[EN] Ovule development is essential for plant survival, as it allows correct embryo and seed development upon fertilization. The female gametophyte is formed in the central area of the nucellus during ovule development, in a complex developmental programme that involves key regulatory genes and the plant hormones auxins and brassinosteroids. Here we provide novel evidence of the role of gibberellins (GAs) in the control of megagametogenesis and embryo sac development, via the GA-dependent degradation of RGA-LIKE1 (RGL1) in the ovule primordia. YPet-rgl1.17 plants, which express a dominant version of RGL1, showed reduced fertility, mainly due to altered embryo sac formation that varied from partial to total ablation. YPet-rgl1.17 ovules followed normal development of the megaspore mother cell, meiosis, and formation of the functional megaspore, but YPet-rgl1.17 plants had impaired mitotic divisions of the functional megaspore. This phenotype is RGL1-specific, as it is not observed in any other dominant mutants of the DELLA proteins. Expression analysis of YPet-rgl1.17 coupled to in situ localization of bioactive GAs in ovule primordia led us to propose a mechanism of GA-mediated RGL1 degradation that allows proper embryo sac development. Taken together, our data unravel a novel specific role of GAs in the control of female gametophyte development.We wish to thank the IBMCP microscopy facility, and Ms J. Yun for technical assistance. We also thank Jennifer Nemhauser (University of Washington, USA) for the HACR sensor. Cambridge proofreading (https://proofreading.org/order/) provided proofreading and editing of this manuscript. This work was supported by grants from the Spanish Ministry for Science and Innovation-FEDER [BIO2017-83138R] to MAP-A and National Science Foundation [MCB-0923727] to JMA. MAP-A received a fellowship of the `Salvador de Madariaga' program from Spanish Ministry of Science and Innovation. We acknowledge support of the publication fee by the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI).Gomez, MD.; Barro-Trastoy, D.; Fuster Almunia, C.; Tornero Feliciano, P.; Alonso, JM.; Perez Amador, MA. (2020). Gibberellin-mediated RGA-LIKE1 degradation regulates embryo sac development in Arabidopsis. Journal of Experimental Botany. 71(22):7059-7072. https://doi.org/10.1093/jxb/eraa395S705970727122Bai, M.-Y., Shang, J.-X., Oh, E., Fan, M., Bai, Y., Zentella, R., … Wang, Z.-Y. (2012). Brassinosteroid, gibberellin and phytochrome impinge on a common transcription module in Arabidopsis. Nature Cell Biology, 14(8), 810-817. doi:10.1038/ncb2546Battaglia, R., Brambilla, V., & Colombo, L. (2008). Morphological analysis of female gametophyte development in thebel1 stk shp1 shp2mutant. Plant Biosystems - An International Journal Dealing with all Aspects of Plant Biology, 142(3), 643-649. doi:10.1080/11263500802411098Beeckman, T., De Rycke, R., Viane, R., & Inzé, D. (2000). Histological Study of Seed Coat Development in Arabidopsis thaliana. Journal of Plant Research, 113(2), 139-148. doi:10.1007/pl00013924Bencivenga, S., Simonini, S., Benková, E., & Colombo, L. (2012). The Transcription Factors BEL1 and SPL Are Required for Cytokinin and Auxin Signaling During Ovule Development in Arabidopsis. The Plant Cell, 24(7), 2886-2897. doi:10.1105/tpc.112.100164Brumos, J., Zhao, C., Gong, Y., Soriano, D., Patel, A. P., Perez-Amador, M. A., … Alonso, J. M. (2019). An Improved Recombineering Toolset for Plants. The Plant Cell, 32(1), 100-122. doi:10.1105/tpc.19.00431Clough, S. J., & Bent, A. F. (1998). Floral dip: a simplified method forAgrobacterium-mediated transformation ofArabidopsis thaliana. The Plant Journal, 16(6), 735-743. doi:10.1046/j.1365-313x.1998.00343.xCoen, O., Lu, J., Xu, W., De Vos, D., Péchoux, C., Domergue, F., … Magnani, E. (2019). Deposition of a cutin apoplastic barrier separating seed maternal and zygotic tissues. BMC Plant Biology, 19(1). doi:10.1186/s12870-019-1877-9Cucinotta, M., Di Marzo, M., Guazzotti, A., de Folter, S., Kater, M. M., & Colombo, L. (2020). Gynoecium size and ovule number are interconnected traits that impact seed yield. Journal of Experimental Botany, 71(9), 2479-2489. doi:10.1093/jxb/eraa050Davière, J.-M., & Achard, P. (2013). Gibberellin signaling in plants. Development, 140(6), 1147-1151. doi:10.1242/dev.087650Davière, J.-M., & Achard, P. (2016). A Pivotal Role of DELLAs in Regulating Multiple Hormone Signals. Molecular Plant, 9(1), 10-20. doi:10.1016/j.molp.2015.09.011Dill, A., Jung, H.-S., & Sun, T. -p. (2001). The DELLA motif is essential for gibberellin-induced degradation of RGA. Proceedings of the National Academy of Sciences, 98(24), 14162-14167. doi:10.1073/pnas.251534098Ferreira, L. G., de Alencar Dusi, D. M., Irsigler, A. S. T., Gomes, A. C. M. M., Mendes, M. A., Colombo, L., & de Campos Carneiro, V. T. (2017). GID1 expression is associated with ovule development of sexual and apomictic plants. Plant Cell Reports, 37(2), 293-306. doi:10.1007/s00299-017-2230-0Fleck, B., & Harberd, N. P. (2002). Evidence that theArabidopsisnuclear gibberellin signalling protein GAI is not destabilised by gibberellin. The Plant Journal, 32(6), 935-947. doi:10.1046/j.1365-313x.2002.01478.xGallego-Bartolome, J., Minguet, E. G., Grau-Enguix, F., Abbas, M., Locascio, A., Thomas, S. G., … Blazquez, M. A. (2012). Molecular mechanism for the interaction between gibberellin and brassinosteroid signaling pathways in Arabidopsis. Proceedings of the National Academy of Sciences, 109(33), 13446-13451. doi:10.1073/pnas.1119992109Gallego-Bartolome, J., Minguet, E. G., Marin, J. A., Prat, S., Blazquez, M. A., & Alabadi, D. (2010). Transcriptional Diversification and Functional Conservation between DELLA Proteins in Arabidopsis. Molecular Biology and Evolution, 27(6), 1247-1256. doi:10.1093/molbev/msq012Gomez, M. D., Barro-Trastoy, D., Escoms, E., Saura-Sánchez, M., Sánchez, I., Briones-Moreno, A., … Perez-Amador, M. A. (2018). Gibberellins negatively modulate ovule number in plants. Development. doi:10.1242/dev.163865G�mez, M. D., Beltr�n, J.-P., & Ca�as, L. A. (2004). The pea END1 promoter drives anther-specific gene expression in different plant species. Planta, 219(6), 967-981. doi:10.1007/s00425-004-1300-zGómez, M. D., Fuster-Almunia, C., Ocaña-Cuesta, J., Alonso, J. M., & Pérez-Amador, M. A. (2019). RGL2 controls flower development, ovule number and fertility in Arabidopsis. Plant Science, 281, 82-92. doi:10.1016/j.plantsci.2019.01.014Gomez, M. D., Ventimilla, D., Sacristan, R., & Perez-Amador, M. A. (2016). Gibberellins Regulate Ovule Integument Development by Interfering with the Transcription Factor ATS. Plant Physiology, 172(4), 2403-2415. doi:10.1104/pp.16.01231Hedden, P., & Sponsel, V. (2015). A Century of Gibberellin Research. Journal of Plant Growth Regulation, 34(4), 740-760. doi:10.1007/s00344-015-9546-1Khakhar, A., Leydon, A. R., Lemmex, A. C., Klavins, E., & Nemhauser, J. L. (2018). Synthetic hormone-responsive transcription factors can monitor and re-program plant development. eLife, 7. doi:10.7554/elife.34702Koorneef, M., Elgersma, A., Hanhart, C. J., Loenen-Martinet, E. P., Rijn, L., & Zeevaart, J. A. D. (1985). A gibberellin insensitive mutant of Arabidopsis thaliana. Physiologia Plantarum, 65(1), 33-39. doi:10.1111/j.1399-3054.1985.tb02355.xKurihara, D., Mizuta, Y., Sato, Y., & Higashiyama, T. (2015). ClearSee: a rapid optical clearing reagent for whole-plant fluorescence imaging. Development. doi:10.1242/dev.127613Lee, S. (2002). Gibberellin regulates Arabidopsis seed germination via RGL2, a GAI/RGA-like gene whose expression is up-regulated following imbibition. Genes & Development, 16(5), 646-658. doi:10.1101/gad.969002Li, Q.-F., Wang, C., Jiang, L., Li, S., Sun, S. S. M., & He, J.-X. (2012). An Interaction Between BZR1 and DELLAs Mediates Direct Signaling Crosstalk Between Brassinosteroids and Gibberellins in
Arabidopsis. Science Signaling, 5(244). doi:10.1126/scisignal.2002908Lieber, D., Lora, J., Schrempp, S., Lenhard, M., & Laux, T. (2011). Arabidopsis WIH1 and WIH2 Genes Act in the Transition from Somatic to Reproductive Cell Fate. Current Biology, 21(12), 1009-1017. doi:10.1016/j.cub.2011.05.015Lora, J., Herrero, M., Tucker, M. R., & Hormaza, J. I. (2016). The transition from somatic to germline identity shows conserved and specialized features during angiosperm evolution. New Phytologist, 216(2), 495-509. doi:10.1111/nph.14330Murashige, T., & Skoog, F. (1962). A Revised Medium for Rapid Growth and Bio Assays with Tobacco Tissue Cultures. Physiologia Plantarum, 15(3), 473-497. doi:10.1111/j.1399-3054.1962.tb08052.xPeng, J., Carol, P., Richards, D. E., King, K. E., Cowling, R. J., Murphy, G. P., & Harberd, N. P. (1997). The Arabidopsis GAI gene defines a signaling pathway that negatively regulates gibberellin responses . Genes & Development, 11(23), 3194-3205. doi:10.1101/gad.11.23.3194Pinto, S. C., Mendes, M. A., Coimbra, S., & Tucker, M. R. (2019). Revisiting the Female Germline and Its Expanding Toolbox. Trends in Plant Science, 24(5), 455-467. doi:10.1016/j.tplants.2019.02.003Schneitz, K., Hulskamp, M., & Pruitt, R. E. (1995). Wild-type ovule development in Arabidopsis thaliana: a light microscope study of cleared whole-mount tissue. The Plant Journal, 7(5), 731-749. doi:10.1046/j.1365-313x.1995.07050731.xErbasol Serbes, I., Palovaara, J., & Groß-Hardt, R. (2019). Development and function of the flowering plant female gametophyte. Plant Development and Evolution, 401-434. doi:10.1016/bs.ctdb.2018.11.016Sun, T. (2011). The Molecular Mechanism and Evolution of the GA–GID1–DELLA Signaling Module in Plants. Current Biology, 21(9), R338-R345. doi:10.1016/j.cub.2011.02.036Tucker, M. R., Okada, T., Hu, Y., Scholefield, A., Taylor, J. M., & Koltunow, A. M. G. (2012). Somatic small RNA pathways promote the mitotic events of megagametogenesis during female reproductive development in Arabidopsis. Development, 139(8), 1399-1404. doi:10.1242/dev.075390Ursache, R., Andersen, T. G., Marhavý, P., & Geldner, N. (2018). A protocol for combining fluorescent proteins with histological stains for diverse cell wall components. The Plant Journal, 93(2), 399-412. doi:10.1111/tpj.13784Villanueva, J. M., Broadhvest, J., Hauser, B. A., Meister, R. J., Schneitz, K., & Gasser, C. S. (1999). INNER NO OUTER regulates abaxial- adaxial patterning in Arabidopsis ovules. Genes & Development, 13(23), 3160-3169. doi:10.1101/gad.13.23.3160Wen, C.-K., & Chang, C. (2002). Arabidopsis RGL1 Encodes a Negative Regulator of Gibberellin Responses. The Plant Cell, 14(1), 87-100. doi:10.1105/tpc.010325Wu, J., Mohamed, D., Dowhanik, S., Petrella, R., Gregis, V., Li, J., … Gazzarrini, S. (2020). Spatiotemporal Restriction of FUSCA3 Expression by Class I BPCs Promotes Ovule Development and Coordinates Embryo and Endosperm Growth. The Plant Cell, 32(6), 1886-1904. doi:10.1105/tpc.19.00764Yang, W.-C., Shi, D.-Q., & Chen, Y.-H. (2010). Female Gametophyte Development in Flowering Plants. Annual Review of Plant Biology, 61(1), 89-108. doi:10.1146/annurev-arplant-042809-112203Yang, W.-C., Ye, D., Xu, J., & Sundaresan, V. (1999). The SPOROCYTELESS gene of Arabidopsis is required for initiation of sporogenesis and encodes a novel nuclear protein. Genes & Development, 13(16), 2108-2117. doi:10.1101/gad.13.16.2108Zhao, L., He, J., Cai, H., Lin, H., Li, Y., Liu, R., … Qin, Y. (2014). Comparative expression profiling reveals gene functions in female meiosis and gametophyte development in Arabidopsis. The Plant Journal, 80(4), 615-628. doi:10.1111/tpj.12657Zhou, R., Benavente, L. M., Stepanova, A. N., & Alonso, J. M. (2011). A recombineering-based gene tagging system for Arabidopsis. The Plant Journal, 66(4), 712-723. doi:10.1111/j.1365-313x.2011.04524.
Characterization of constricted fruit (ctf) Mutant Uncovers a Role for AtMYB117/LOF1 in Ovule and Fruit Development in Arabidopsis thaliana
Pistil and fruit morphogenesis is the result of a complex gene network that is not yet fully understood. A search for novel genes is needed to make a more comprehensive model of pistil and fruit development. Screening for mutants with alterations in fruit morphology generated by an activation tagging strategy resulted in the isolation of the ctf (constricted fruit) mutant. It is characterized by a) small and wrinkled fruits, with an enlarged replum, an amorphous structure of the septum and an irregular distribution of ovules and seeds; b) ectopic carpelloid structures in sepals bearing ovule-like structures and c) dwarf plants with curled rosette leaves. The overexpressed gene in ctf was AtMYB117, also named LOF1 (LATERAL ORGAN FUSION1). AtMYB117/LOF1 transcripts were localized in boundary regions of the vegetative shoot apical meristem and leaf primordia and in a group of cells in the adaxial base of petioles and bracts. Transcripts were also detected in the boundaries between each of the four floral whorls and during pistil development in the inner of the medial ridges, the placenta, the base of the ovule primordia, the epidermis of the developing septum and the outer cell layers of the ovule funiculi. Analysis of changes of expression of pistil-related genes in the ctf mutant showed an enhancement of SHATTERPROOF1 (SHP1) and SHP2 expression. All these results suggest that AtMYB117/LOF1 is recruited by a variety of developmental programs for the establishment of boundary regions, including the development of floral organs and the initiation of ovule outgrowth
Virus Adaptation by Manipulation of Host's Gene Expression
Viruses adapt to their hosts by evading defense mechanisms and taking over cellular metabolism for their own benefit. Alterations in cell metabolism as well as side-effects of antiviral responses contribute to symptoms development and virulence. Sometimes, a virus may spill over from its usual host species into a novel one, where usually will fail to successfully infect and further transmit to new host. However, in some cases, the virus transmits and persists after fixing beneficial mutations that allow for a better exploitation of the new host. This situation would represent a case for a new emerging virus. Here we report results from an evolution experiment in which a plant virus was allowed to infect and evolve on a naïve host. After 17 serial passages, the viral genome has accumulated only five changes, three of which were non-synonymous. An amino acid substitution in the viral VPg protein was responsible for the appearance of symptoms, whereas one substitution in the viral P3 protein the epistatically contributed to exacerbate severity. DNA microarray analyses show that the evolved and ancestral viruses affect the global patterns of host gene expression in radically different ways. A major difference is that genes involved in stress and pathogen response are not activated upon infection with the evolved virus, suggesting that selection has favored viral strategies to escape from host defenses
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
RICORS2040 : The need for collaborative research in chronic kidney disease
Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true
Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI).
METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate.
FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally.
INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.
FUNDING: Bill & Melinda Gates Foundation
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