The search for south European cystic fibrosis mutations: identification of two new mutations, four variants, and intronic sequences

The major mutation in the cystic fibrosis (CF) gene is a 3-bp deletion (delta F508) in exon 10. About 50% of the CF chromosomes in Southern Europe carry this mutation, while other previously described mutations account for less than 4%. To identify other common mutations in CF patients from the Mediterranean area, we have sequenced, exon by exon, 16 chromosomes that did not show the delta F508 deletion from a selected panel of eight unrelated CF patients. We describe here one missense and one nonsense mutation, and four sequence polymorphisms. We have also found two previously reported mutations in three chromosomes. Overall, these mutations may account for about 20% of CF alleles in the Italian and Spanish populations. No other mutations were detected in 10 out of 16 CF chromosomes after analyzing about 90% of the coding region of the CF gene, and 39 out of 54 intron/exon boundaries. Therefore, about 26% of CF mutations remain to be identified. In addition we provide the intron/exon boundary sequences for exons 4 to 9. These results together with previously reported linkage data suggest that in the Mediterranean populations further mutations may lie in the promoter region, or in intron sequences not yet analyzed.     

Solitary fibrous tumor of the thigh with epithelioid features: a case report

Background

Extrapleural Solitary Fibrous tumors (SFTs) have been increasingly reported. The retroperitoneum, deep soft tissues of proximal extremities, abdominal cavity, trunk, head and neck are the most common extraserosal locations reported. Microscopically they show a wide range of morphological features, and so the differential diagnosis is extensive. Immunohistochemically, they commonly express CD34, vimentin, bcl-2 and CD99. Epithelial membrane antigen (EMA) and smooth muscle actin (SMA) may occasionally be expressed. Epithelioid morphology in extrapleural SFT has only very occasionally been described (five cases reported), some of them with biphasic pattern and others with malignant characteristics.

Case presentation

A SFT of the thigh with epithelioid areas in a 63 year old woman is reported. Microscopically the tumor showed areas hypo and hipercellular. At the periphery of the hipercellular areas there were nodules composed of epithelioid cells. Immunohistochemically both the spindle and epithelioid cells were positive for CD34, vimentin, bcl-2 and CD99. Epithelial, neural and muscular markers were negative. Molecular study was done and ruled out a synovial sarcoma.

Conclusion

Ten cases of SFT of the thigh have been reported but to our knowledge this is the first case with epithelioid morphology affecting the extremities. Identification of this pattern of SFT is of importance, to avoid misdiagnosis with other more aggressive conditions in soft tissue.

     

Socioeconomic Factors and All Cause and Cause-Specific Mortality among Older People in Latin America,India, and China: A Population-Based Cohort Study

Background

Even in low and middle income countries most deaths occur in older adults. In Europe, the effects of better education and home ownership upon mortality seem to persist into old age, but these effects may not generalise to LMICs. Reliable data on causes and determinants of mortality are lacking.

Methods and Findings

The vital status of 12,373 people aged 65 y and over was determined 3–5 y after baseline survey in sites in Latin America, India, and China. We report crude and standardised mortality rates, standardized mortality ratios comparing mortality experience with that in the United States, and estimated associations with socioeconomic factors using Cox''s proportional hazards regression. Cause-specific mortality fractions were estimated using the InterVA algorithm. Crude mortality rates varied from 27.3 to 70.0 per 1,000 person-years, a 3-fold variation persisting after standardisation for demographic and economic factors. Compared with the US, mortality was much higher in urban India and rural China, much lower in Peru, Venezuela, and urban Mexico, and similar in other sites. Mortality rates were higher among men, and increased with age. Adjusting for these effects, it was found that education, occupational attainment, assets, and pension receipt were all inversely associated with mortality, and food insecurity positively associated. Mutually adjusted, only education remained protective (pooled hazard ratio 0.93, 95% CI 0.89–0.98). Most deaths occurred at home, but, except in India, most individuals received medical attention during their final illness. Chronic diseases were the main causes of death, together with tuberculosis and liver disease, with stroke the leading cause in nearly all sites.

Conclusions

Education seems to have an important latent effect on mortality into late life. However, compositional differences in socioeconomic position do not explain differences in mortality between sites. Social protection for older people, and the effectiveness of health systems in preventing and treating chronic disease, may be as important as economic and human development. Please see later in the article for the Editors'' Summary     

Attractive sinks, or how individual behavioural decisions determine source–sink dynamics

Gundersen et al . (2001 , Source-sink dynamics: how sinks affect demography of sources. Ecol. Lett. , 4, 14–21.) suggested that sinks can severely affect the demography of populations in source habitats. We propose this is a common result when animals lack cues associated with reduced fitness inside sinks and consequently select habitat inappropriately. These attractive sinks can result either from undetected risks of mortality (as in the experiment of Gundersen et al . 2001 ) or from undetected poor breeding probabilities (due to bioaccumulation of pesticides, for instance). Thus, individual habitat choice is a key process underlying source–sink dynamics.     

Analysis of 14 cystic fibrosis mutations in five South European populations

Summary We have analysed five Southern European populations (Albanian, Greek, Italian, Spanish and Yugoslavian) for 14 cystic fibrosis (CF) mutations. The most frequent mutations, apart from F508, were G542X (6.04%), R1162X (3.61%) and N1303K (3.24%). Each of the other analysed mutations were present at a frequency of less than 1% (R347P, R334W, S549RA, S549I, G551D, R553X and W1282X), and four mutations (D110H, I507, S549RT, and S1255X) were not found in this sample. The data presented here allows the use of mutation analysis in 69.5% of Spanish, 58% of Greek, and 56.5% of Italian CF cases.     

Comparative study of Spanish and Italian terrestrial small mammal coenoses from different biotopes in Mediterranean peninsular tip regions

A comparison of terrestrial small mammal coenoses belonging to nine different biotopes in the tips of the Iberian and Italian peninsulas was carried out using the pitfall trapping method. The influence of both habitat type and peninsular effect on composition of small mammal coenoses was analysed. In Southern Italy, 203 specimens belonging to seven species were trapped: Suncus etruscus (Savi, 1822), Crocidura suaveolens (Pallas, 1811), C. leucodon (Hermann, 1780), Microtus savii (de Sélys-Longchamps, 1838), Apodemus sylvaticus (L., 1758), A. flavicollis (Melchior, 1834) and Mus musculus domesticus Schwarz & Schwarz, 1943. In Southern Spain 428 specimens belonging to five species were trapped: Suncus etruscus, Crocidura russula (Hermann, 1780), Microtus duodecimcostatus (de Sélys-Longchamps, 1839), Apodemus sylvaticus and Mus spretus Lataste, 1883. The relative density of small mammals occurring in the nine Spanish sampling stations was twice that recorded in the Italian stations; however the number of species recorded in the different biotopes show similar mean values, ranging from three to five in Andalusia and from three to six in Calabria. Apodemus sylvaticus was the dominant species in the Calabrian stations, whereas Crocidura russula prevailed in Andalusia. The biotic diversity values are very similar in the Calabrian and Andalusian biotopes. By contrast, the Insectivora/Rodentia ratio was always higher in Andalusia. The more xerophytic biotopes showed greater similarities between the communities in Southern Spain and Southern Italy, while the cooler biotopes differed between these two peninsulas.     

Effects of an attractive sink leading into maladaptive habitat selection

Habitat sinks can attract dispersing animals if high mortality or breeding failure are difficult to detect (e.g., when due to human hunting or pollution). Using a simple deterministic model, we explore the dynamics of such source-sink systems considering three scenarios: an avoided sink, no habitat preference, and an attractive sink. In the second two scenarios, there is a threshold proportion of sink habitat above which the whole population decreases to extinction, but this extinction threshold varies with habitat preference and the relative qualities of the two habitat types. Hence, it would be necessary to know the habitat preferences of any species in a source-sink system to interpret data on population increases and declines. In the attractive sink scenario, small changes in the proportion of sink habitat may have disproportionate effects on the population persistence. Also, small changes in growth rates at the source and the sink severely affect the threshold and the time of extinction. For some combinations of demographic parameters and proportion of habitat sink, the decline affects the source first; thus, during some time, it will be hidden to population monitoring at the sink, where numbers can even increase. The extinction threshold is also very sensitive to the initial population sizes relative to carrying capacity. Attractive sinks represent a novel aspect of source-sink dynamics with important conservation and management implications.     

Cystic fibrosis in Spain: high frequency of mutation G542X in the Mediterranean coastal area

We have determined the frequency of deletion F508 and mutation G542X, a nonsense mutation in exon 11 of the cystic fibrosis (CF) gene, in a sample of 400 Spanish CF families. Mutation G542X represents 8% of the total number of CF mutations in Spain, making it the second most common mutation after the F508 deletion, which accounts for 48% of CF chromosomes. G542X has a higher frequency in the Mediterranean coastal area (14%) and in the Canary Islands (25%). About 70% of G542X chromosomes are from Andalucia, Múrcia, Valencia, Catalunya and the Canary Islands. The F508 deletion has its highest frequency in the Basque Country (83%). Mutation G542X is associated with the same rare haplotype that is found in association with the F508 mutation. The haplotype homogeneity found for G542X, even when intragenic microsatellites (IVS8CA, IVS17BTA and IVS17BCA) are considered, allows us to postulate that this mutation arose from a single mutational event. The geographic distribution of mutations F508 and G542X suggests that F508 was present in the Iberian Peninsula before the Indo-European invasions, and that G542X was introduced into Spain, via the Mediterranean Sea, probably by the Phoenicians, between 2500 and 3000 years ago.