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1.
Fengzhen Yang Qi Zhao Lipeng Wang Jinying Wu Lihua Jiang Li Sheng Leyan Zhang Zhaoping Xue Maoli Yi 《Polish journal of microbiology》2022,71(2):251
Cefoperazone/sulbactam (CSL) and piperacillin/tazobactam (TZP) are commonly used in clinical practice in China because of their excellent antimicrobial activity. CSL and TZP-nonsusceptible Enterobacteriaceae are typically resistant to extended-spectrum cephalosporins such as ceftriaxone (CRO). However, 11 nonrepetitive Enterobacteriaceae strains, which were resistant to CSL and TZP yet susceptible to CRO, were collected from January to December 2020. Antibiotic susceptibility tests and whole-genome sequencing were conducted to elucidate the mechanism for this rare phenotype. Antibiotic susceptibility tests showed that all isolates were amoxicillin/clavulanic-acid resistant and sensitive to ceftazidime, cefepime, cefepime/tazobactam, cefepime/zidebactam, ceftazidime/avibactam, and ceftolozane/tazobactam. Whole-genome sequencing revealed three of seven Klebsiella pneumoniae strains harbored blaSHV-1 only, and four harbored blaSHV-1 and blaTEM-1B. Two Escherichia coli strains carried blaTEM-1B only, while two Klebsiella oxytoca isolates harbored blaOXY-1-3 and blaOXY-1-1, respectively. No mutation in the β-lactamase gene and promoter sequence was found. Outer membrane protein (Omp) gene detection revealed that numerous missense mutations of OmpK36 and OmpK37 were found in all strains of K. pneumoniae. Numerous missense mutations of OmpK36 and OmpK35 and OmpK37 deficiency were found in one K. oxytoca strain, and no OmpK gene was found in the other. No Omp mutations were found in E. coli isolates. These results indicated that narrow spectrum β-lactamases, TEM-1, SHV-1, and OXY-1, alone or in combination with Omp mutation, contributed to the resistance to CSL and TZP in CRO-susceptible Enterobacteriaceae.Antibiotic susceptibility tests
Open in a separate windowCROceftriaxone, CAZceftazidime, FEPcefepime, AMC:amoxicillin clavulanic-acid, CSLcefoperazone/sulbactam, TZP:piperadllin/tazobactam, FPT:cefepime tazobactam, FPZ:cefepime/zidebactam, CZA:ceftazidime/avibactam, CZTceftolozane/tazobactam Gene sequencing results
Open in a separate window 相似文献
Antibiotics | Breakpoint, (μg/ml) | Klebsiella pneumoniae | Escherichia cou | Klebriehd axyoca | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
E1 | E3 | E4 | E7 | E9 | E10 | E11 | E6 | E8 | E2 | E5 | ||
CRO | ≤1≥4 | ≤0.5 | ≤0.5 | ≤0.5 | ≤0.5 1 | ≤0.5 | 1 | ≤0.5 | ≤0.5 | 1 | 1 | |
CAZ | 4 ≥16 | 1 | 2 | 1 | 4 | 4 | 4 | 4 | 2 | 4 | 1 1 | |
FEP | ≤2 216 1 | 1 | 0.25 | 1 | 2 | 2 | 2 | 0.5 | 2 | 1 1 | ||
AMC | ≤8 ≥32 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 | ≥128 |
CSL | ≤16 ≥64 | 64 | 64 | 64 | 64 | ≥128 | 128 | ≥128 | 64 | 128 | 128 | ≥128 |
TZP | ≤16 ≥128 | ≥256 | ≥256 | ≥256 | ≥256 | 2256 | 2256 | ≥256 | ≥256 | ≥256 | ≥256 | ≥256 |
FPT | ≤2 ≥16 | 1 | 0.5 | 0.06 | 0.125 | 2 | 1 | 2 | 0.25 | 1 | 0.125 | 0.25 |
FPZ | ≤2 216 | 0.25 | 0.25 | 0.06 | 0.125 | 0.25 | 0.25 1 | 0.125 | 0.25 | 0.125 | 0.125 | |
CZA | ≤8 216 1 | 0.5 | 0.25 | 0.25 | 1 | 0.25 | 1 | 0.5 | 0.5 | 0.5 | 0.25 | |
CZT | ≤2 28 | 2 | 1 | 0.5 1 | 2 | 2 | 2 1 | 1 | 2 | 2 |
Number | Strain | ST | p-Lactamase gene | Promoter sequence mutation | Omp mutation |
---|---|---|---|---|---|
El | Kpn | 45 | blaSHV-1, blaTEM-lB | none | OmpK36, OmpK3 7 |
E3 | Kpn | 45 | blaSHV-1, blaTEM-lB | none | OmpK36. OmpK3 7 |
E4 | Kpn | 2854 | blaSHV-1 | none | OmpK36, OmpK3 7 |
E7 | Kpn | 2358 | blaSHV-1 - blaTEM-lB | none | OmpK36, OmpK3 7 |
E9 | Kpn | 2358 | blaSHV-1. blaTEM-lB | none | OmpK36. OmpK3 7 |
E10 | Kpn 18 | 9 | blaSHV-1 | none | OmpK36. OmpK3 7 |
Ell | Kpn | 45 | blaSHV-1 | none | OmpK36, OmpK3 7 |
E6 | Eco | 88 | blaTEM-lB | none | none |
ES | Eco | 409 | blaTEM-1B | none | none |
E2 | Kox | 194 | blaOXY-1-3 | none | OmpK36 mutations. OmpK35 and OmpK 37 deficiency |
E5 | Kox 11 | blaOXY-1-1 | none | no OmpK (OmpK3 5, OmpK36 and OmpK37) gene found |
2.
Cotyledons of tomato seedlings that germinated in a 20 µM AlK(SO4)2 solution remained chlorotic while those germinated in an aluminum free medium were normal (green) in color. Previously, we have reported the effect of aluminum toxicity on root proteome in tomato seedlings (Zhou et al.1). Two dimensional DIGE protein analysis demonstrated that Al stress affected three major processes in the chlorotic cotyledons: antioxidant and detoxification metabolism (induced), glyoxylate and glycolytic processes (enhanced), and the photosynthetic and carbon fixation machinery (suppressed).Key words: aluminum, cotyledons, proteome, tomatoDifferent biochemical processes occur depending on the developmental stages of cotyledons. During early seed germination, before the greening of the cotyledons, glyoxysomes enzymes are very active. Fatty acids are converted to glucose via the gluconeogenesis pathway.2,3 In greening cotyledons, chloroplast proteins for photosynthesis and leaf peroxisomal enzymes in the glycolate pathway for photorespiration are metabolized.2–4 Enzymes involved in regulatory mechanisms such as protein kinases, protein phosphatases, and mitochondrial enzymes are highly expressed.3,5,6The chlorotic cotyledons are similar to other chlorotic counterparts in that both contains lower levels of chlorophyll, thus the photosynthetic activities are not as active. In order to understand the impact of Al on tomato cotyledon development, a comparative proteome analysis was performed using 2D-DIGE following the as previously described procedure.1 Some proteins accumulated differentially in Al-treated (chlorotic) and untreated cotyledons (Fig. 1). Mass spectrometry of tryptic digestion fragments of the proteins followed by database search has identified some of the differentially expressed proteins (Open in a separate windowFigure 1Image of protein spots generated by Samspot analysis of Al treated and untreated tomato cotyledons proteomes separated on 2D-DIGE.
Open in a separate window 相似文献
Table 1
Proteins identified from tomato cotyledons of seeds germinating in Al-solutionSpot No. | Fold (treated/ctr) | ANOVA (p value) | Annotation | SGN accession |
1 | 2.34 | 0.001374 | 12S seed storages protein (CRA1) | SGN-U314355 |
2 | 2.13 | 0.003651 | unidentified | |
3 | 2.0 | 0.006353 | lipase class 3 family | SGN-U312972 |
4 | 1.96 | 0.002351 | large subunit of RUBISCO | SGN-U346314 |
5 | 1.95 | 2.66E-05 | arginine-tRNA ligase | SGN-U316216 |
6 | 1.95 | 0.003343 | unidentified | |
7 | 1.78 | 0.009219 | Monodehydroascorbate reductase (NADH) | SGN-U315877 |
8 | 1.78 | 0.000343 | unidentified | |
9 | 1.75 | 4.67E-05 | unidentified | |
12 | 1.70 | 0.002093 | unidentified | |
13 | 1.68 | 0.004522 | unidentified | |
15 | 1.66 | 0.019437 | Glutamate dehydrogenase 1 | SGN-U312368 |
16 | 1.66 | 0.027183 | unidentified | |
17 | 1.62 | 2.01E-08 | Major latex protein-related, pathogenesis-related | SGN-U312368 |
18 | −1.61 | 0.009019 | RUBisCo activase | SGN-U312543 |
19 | 1.61 | 0.003876 | Cupin family protein | SGN-U312537 |
20 | 1.60 | 0.000376 | unidentified | |
22 | 1.59 | 0.037216 | unidentified | |
0.003147 | unidentified | |||
29 | −1.56 | 0.001267 | RUBisCo activase | SGN-U312543 |
35 | 1.52 | 0.001955 | unidentified | |
40 | 1.47 | 0.007025 | unidentified | |
41 | 1.47 | 0.009446 | unidentified | |
45 | 1.45 | 0.001134 | unidentified | |
59 | −1.40 | 5.91E-05 | 12 S seed storage protein | SGN-U314355 |
61 | 1.39 | 1.96E-05 | MD-2-related lipid recognition domain containing protein | SGN-U312452 |
65 | 1.37 | 0.000608 | triosephosphate isomerase, cytosolic | SGN-U312988 |
68 | 1.36 | 0.004225 | unidentified | |
81 | 1.32 | 0.001128 | unidentified | |
82 | −1.31 | 0.001408 | 33 kDa precursor protein of oxygen-evolving complex | SGN-U312530 |
87 | 1.30 | 0.002306 | unidentified | |
89 | −1.3 | 0.000765 | unidentified | |
92 | 1.29 | 0.000125 | superoxide dismutase | SGN-U314405 |
98 | 1.28 | 0.000246 | triosephosphate isomerase, cytosolic | SGN-U312988 |
3.
Many plant species can be induced to flower by responding to stress factors. The short-day plants Pharbitis nil and Perilla frutescens var. crispa flower under long days in response to the stress of poor nutrition or low-intensity light. Grafting experiments using two varieties of P. nil revealed that a transmissible flowering stimulus is involved in stress-induced flowering. The P. nil and P. frutescens plants that were induced to flower by stress reached anthesis, fruited and produced seeds. These seeds germinated, and the progeny of the stressed plants developed normally. Phenylalanine ammonialyase inhibitors inhibited this stress-induced flowering, and the inhibition was overcome by salicylic acid (SA), suggesting that there is an involvement of SA in stress-induced flowering. PnFT2, a P. nil ortholog of the flowering gene FLOWERING LOCUS T (FT) of Arabidopsis thaliana, was expressed when the P. nil plants were induced to flower under poor-nutrition stress conditions, but expression of PnFT1, another ortholog of FT, was not induced, suggesting that PnFT2 is involved in stress-induced flowering.Key words: flowering, stress, phenylalanine ammonia-lyase, salicylic acid, FLOWERING LOCUS T, Pharbitis nil, Perilla frutescensFlowering in many plant species is regulated by environmental factors, such as night-length in photoperiodic flowering and temperature in vernalization. On the other hand, a short-day (SD) plant such as Pharbitis nil (synonym Ipomoea nil) can be induced to flower under long days (LD) when grown under poor-nutrition, low-temperature or high-intensity light conditions.1–9 The flowering induced by these conditions is accompanied by an increase in phenylalanine ammonia-lyase (PAL) activity.10 Taken together, these facts suggest that the flowering induced by these conditions might be regulated by a common mechanism. Poor nutrition, low temperature and high-intensity light can be regarded as stress factors, and PAL activity increases under these stress conditions.11 Accordingly, we assumed that such LD flowering in P. nil might be induced by stress. Non-photoperiodic flowering has also been sporadically reported in several plant species other than P. nil, and a review of these studies suggested that most of the factors responsible for flowering could be regarded as stress. Some examples of these factors are summarized in 12–14
Open in a separate window 相似文献
Table 1
Some cases of stress-induced floweringStress factor | Species | Flowering response | Reference |
high-intensity light | Pharbitis nil | induction | 5 |
low-intensity light | Lemna paucicostata | induction | 29 |
Perilla frutescens var. crispa | induction | 14 | |
ultraviolet C | Arabidopsis thaliana | induction | 23 |
drought | Douglas-fir | induction | 30 |
tropical pasture Legumes | induction | 31 | |
lemon | induction | 32–35 | |
Ipomoea batatas | promotion | 36 | |
poor nutrition | Pharbitis nil | induction | 3, 4, 13 |
Macroptilium atropurpureum | promotion | 37 | |
Cyclamen persicum | promotion | 38 | |
Ipomoea batatas | promotion | 36 | |
Arabidopsis thaliana | induction | 39 | |
poor nitrogen | Lemna paucicostata | induction | 40 |
poor oxygen | Pharbitis nil | induction | 41 |
low temperature | Pharbitis nil | induction | 9, 12 |
high conc. GA4/7 | Douglas-fir | promotion | 42 |
girdling | Douglas-fir | induction | 43 |
root pruning | Citrus sp. | induction | 44 |
Pharbitis nil | induction | 45 | |
mechanical stimulation | Ananas comosus | induction | 46 |
suppression of root elongation | Pharbitis nil | induction | 7 |
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Lisa Jacobsen Lisa Durso Tyrell Conway Kenneth W. Nickerson 《Applied and environmental microbiology》2009,75(13):4633-4635
Escherichia coli isolates (72 commensal and 10 O157:H7 isolates) were compared with regard to physiological and growth parameters related to their ability to survive and persist in the gastrointestinal tract and found to be similar. We propose that nonhuman hosts in E. coli O157:H7 strains function similarly to other E. coli strains in regard to attributes relevant to gastrointestinal colonization.Escherichia coli is well known for its ecological versatility (15). A life cycle which includes both gastrointestinal and environmental stages has been stressed by both Savageau (15) and Adamowicz et al. (1). The gastrointestinal stage would be subjected to acid and detergent stress. The environmental stage is implicit in E. coli having transport systems for fungal siderophores (4) as well as pyrroloquinoline quinone-dependent periplasmic glucose utilization (1) because their presence indicates evolution in a location containing fungal siderophores and pyrroloquinoline quinone (1).Since its recognition as a food-borne pathogen, there have been numerous outbreaks of food-borne infection due to E. coli O157:H7, in both ground beef and vegetable crops (6, 13). Cattle are widely considered to be the primary reservoir of E. coli O157:H7 (14), but E. coli O157:H7 does not appear to cause disease in cattle. To what extent is E. coli O157:H7 physiologically unique compared to the other naturally occurring E. coli strains? We feel that the uniqueness of E. coli O157:H7 should be evaluated against a backdrop of other wild-type E. coli strains, and in this regard, we chose the 72-strain ECOR reference collection originally described by Ochman and Selander (10). These strains were chosen from a collection of 2,600 E. coli isolates to provide diversity with regard to host species, geographical distribution, and electromorph profiles at 11 enzyme loci (10).In our study we compared the 72 strains of the ECOR collection against 10 strains of E. coli O157:H7 and six strains of E. coli which had been in laboratory use for many years (Table (Table1).1). The in vitro comparisons were made with regard to factors potentially relevant to the bacteria''s ability to colonize animal guts, i.e., acid tolerance, detergent tolerance, and the presence of the Entner-Doudoroff (ED) pathway (Table (Table2).2). Our longstanding interest in the ED pathway (11) derives in part from work by Paul Cohen''s group (16, 17) showing that the ED pathway is important for E. coli colonization of the mouse large intestine. Growth was assessed by replica plating 88 strains of E. coli under 40 conditions (Table (Table2).2). These included two LB controls (aerobic and anaerobic), 14 for detergent stress (sodium dodecyl sulfate [SDS], hexadecyltrimethylammonium bromide [CTAB], and benzalkonium chloride, both aerobic and anaerobic), 16 for acid stress (pH 6.5, 6.0, 5.0, 4.6, 4.3, 4.2, 4.1, and 4.0), four for the ability to grow in a defined minimal medium (M63 glucose salts with and without thiamine), and four for the presence or absence of a functional ED pathway (M63 with gluconate or glucuronate). All tests were done with duplicate plates in two or three separate trials. The data are available in Tables S1 to S14 in the supplemental material, and they are summarized in Table Table22.
Open in a separate window
Open in a separate windowaEight LB controls were run, two for each set of LB experiments: SDS, CTAB, benzalkonium chloride (BAC), and pH stress.bGrowth was measured as either +++, +, or 0 (good, poor, and none, respectively), with +++ being the growth achieved on the LB control plates. “Variable” means that two or three replicates did not agree. All experiments were done at 37°C.c“Anaerobic” refers to use of an Oxoid anaerobic chamber. Aerobic and anaerobic growth data are presented together when the results were identical and separately when the results were not the same or the anaerobic set had not been done. LB plates were measured after 1 (aerobic) or 2 (anaerobic) days, and the M63 plates were measured after 2 or 3 days.dCTAB used at 0.05, 0.2%, and 0.4%.eM63 defined medium (3) was supplemented with glucose, gluconate, or glucuronate, all at 0.2%.fIdentical results were obtained with and without 0.0001% thiamine.gND, not determined. 相似文献
TABLE 1.
E. coli strains used in this studyE. coli strain (n) | Source |
---|---|
ECOR strains (72) | Thomas Whittman |
Laboratory adapted (6) | |
K-12 Davis | Paul Blum |
CG5C 4401 | Paul Blum |
K-12 Stanford | Paul Blum |
W3110 | Paul Blum |
B | Tyler Kokjohn |
AB 1157 | Tyler Kokjohn |
O157:H7 (10) | |
FRIK 528 | Andrew Benson |
ATCC 43895 | Andrew Benson |
MC 1061 | Andrew Benson |
C536 | Tim Cebula |
C503 | Tim Cebula |
C535 | Tim Cebula |
ATCC 43889 | William Cray, Jr. |
ATCC 43890 | William Cray, Jr. |
ATCC 43888 | Willaim Cray, Jr. |
ATCC 43894 | William Cray, Jr. |
TABLE 2.
Physiological comparison of 88 strains of Escherichia coliGrowth medium or condition | Oxygenc | No. of strains with type of growthb
| |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ECOR strains (n = 72)
| Laboratory strains (n = 6)
| O157:H7 strains (n = 10)
| |||||||||||
Good | Poor | None | Variable | Good | Poor | None | Variable | Good | Poor | None | Variable | ||
LB controla | Both | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 | 0 | 0 |
1% SDS | Aerobic | 69 | 3 | 0 | 0 | 6 | 0 | 0 | 0 | 8 | 0 | 0 | 2 |
5% SDS | Aerobic | 68 | 4 | 0 | 0 | 6 | 0 | 0 | 0 | 8 | 2 | 0 | 0 |
1% SDS | Anaerobic | 53 | 15 | 4 | 0 | 2 | 3 | 1 | 0 | 1 | 7 | 0 | 2 |
5% SDS | Anaerobic | 0 | 68 | 4 | 0 | 0 | 4 | 2 | 0 | 0 | 7 | 0 | 4 |
CTABd (all) | Both | 0 | 0 | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 |
0.05% BAC | Aerobic | 3 | 11 | 58 | 2 | 0 | 2 | 2 | 2 | 0 | 0 | 9 | 1 |
0.2% BAC | Aerobic | 0 | 1 | 71 | 0 | 1 | 0 | 5 | 0 | 0 | 0 | 10 | 0 |
0.05% BAC | Anaerobic | 2 | 3 | 67 | 0 | 0 | 1 | 5 | 0 | 0 | 0 | 9 | 1 |
0.2% BAC | Anaerobic | 0 | 0 | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 |
pH 6.5 | Both | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 | 0 | 0 |
pH 6 | Both | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 | 0 | 0 |
pH 5 | Both | 70 | 2 | 0 | 0 | 6 | 0 | 0 | 0 | 9 | 0 | 0 | 1 |
pH 4.6 | Both | 70 | 2 | 0 | 0 | 6 | 0 | 0 | 0 | 10 | 0 | 0 | 0 |
pH 4.3 | Aerobic | 14 | 0 | 1 | 57 | 3 | 1 | 2 | 0 | 3 | 2 | 0 | 5 |
pH 4.3 | Anaerobic | 69 | 3 | 0 | 0 | 3 | 1 | 2 | 0 | 1 | 1 | 0 | 0 |
pH 4.1 or 4.2 | Aerobic | 0 | 0 | 72 | 0 | NDg | ND | ||||||
pH 4.0 | Both | 0 | 0 | 72 | 0 | 0 | 0 | 6 | 0 | 0 | 0 | 9 | 1 |
M63 with supplemente | |||||||||||||
Glucose | Aerobicf | 69 | 1 | 2 | 0 | 5 | 0 | 1 | 0 | 9 | 0 | 1 | 0 |
Glucose | Anaerobicf | 70 | 0 | 2 | 0 | 5 | 0 | 1 | 0 | 9 | 0 | 1 | 0 |
Gluconate | Both | 69 | 1 | 2 | 0 | 5 | 0 | 1 | 0 | 9 | 0 | 1 | 0 |
Glucuronate | Aerobic | 68 | 2 | 2 | 0 | 5 | 0 | 1 | 0 | 9 | 0 | 1 | 0 |
Glucuronate | Anaerobic | 69 | 1 | 2 | 0 | 5 | 0 | 1 | 0 | 9 | 0 | 1 | 0 |
9.
Hennie G Raterman Alexandre E Voskuyl Ben AC Dijkmans Michael T Nurmohamed 《Arthritis research & therapy》2009,11(5):413-2
With great interest, we read the article by Toms and colleagues [1] in the previous issue of Arthritis Research & Therapy, in which they assessed prevalences of metabolic syndrome (MetS) in rheumatoid arthritis (RA) patients. Moreover, they identified demographic and clinical factors that may be associated with MetS. Toms and colleagues found prevalences of up to 45% of MetS and demonstrated older age and health status (health assessment questionnaire) to be associated with MetS irrespectively of the definition used. Of most interest, an association between methotrexate (MTX) use and decreased presence of MetS was observed in patients more than 60 years of age. The investigators hypothesized that this may be attributed to a drug-specific effect (and not to an anti-inflammatory effect) either by changing levels of adenosine, which is known to interact with glucose and lipid metabolism, or by an indirect effect mediated through concomitant folic acid administration, thereby decreasing homocysteine levels.Recently, we also examined the prevalence of MetS in (a subgroup of) RA patients in the CARRÉ investigation, a prospective cohort study on prevalent and incident cardiovascular disease and its underlying cardiovascular risk factors [2]. The findings of Toms and colleagues stimulated us to perform additional analyses in our total study population (n = 353).The prevalences of MetS were 35% and 25% (Table (Table1)1) according to criteria of National Cholesterol Education Program (NCEP) 2004 and NCEP 2001, respectively. In multivariate backward regression analyses, we found significant associations between body mass index, pulse rate, creatinine levels, hypothyroidism and diabetes mellitus and the presence of MetS independently of the criteria used (Table (Table2).2). However, an independent association between single use of MTX or use of MTX in combination with other disease-modifying antirheumatic drugs, on the one hand, and a decreased prevalence of MetS, on the other hand, could not be demonstrated (even in the subgroup of patients over the age of 60).
Open in a separate windowaMetabolic syndrome (MetS) according to National Cholesterol Education Program (NCEP) 2001; bMetS according to NCEP 2004. Continuous variables are presented as means (± standard deviations) in cases of normal distribution or as medians (interquartile ranges) in cases of non-normal distribution. BMI, body mass index; CRP, C-reactive protein; DAS28, disease activity score using 28 joint counts; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; HCQ, hydroxychloroquine; MTX, methotrexate; RA, rheumatoid arthritis; SSZ, sulfasalazine; TNF, tumour necrosis factor.
Open in a separate windowaIn multivariate analyses, the following variables were used: gender, age, prednisolone only, methotrexate only, sulfasalazine only, hydroxychloroquine only, tumour necrosis factor-blocking agents, combination of disease-modifying antirheumatic drugs, pack-years, smoking, erosions, DAS28 (disease activity score using 28 joint counts), body mass index, pulse rate, creatinine levels, renal clearance, hypothyroidism and diabetes mellitus. CI, confidence interval; OR, odds ratio.Therefore, to get more support for a drug-specific effect, it is of interest to know whether or not in the study of Toms and colleagues the MTX effect was present only in the group of RA patients with single use of MTX or in the group of MTX-treated patients with other antirheumatic drugs. As patients with MetS were significantly older, it would give further information whether age was an independent risk factor for MetS in regression analyses. Moreover, as readers, we are not informed about comorbidities like diabetes and clinical hypothyroidism, which are notorious cardiometabolic risk factors. On the whole, we could not confirm a plausible protective role for the use of MTX and presence of MetS, and hence further investigation is required to explain the discrepancy between our findings and those of Toms and colleagues. 相似文献
Table 1
Characteristics of the study populationMetS presenta | MetS absenta | MetS presentb | MetS absentb | |||
---|---|---|---|---|---|---|
n = 84 | n = 265 | n = 121 | n = 228 | P valuea | P valueb | |
Demographics | ||||||
Age, years | 63.8 (± 8) | 63.1 (± 7) | 64.3 (± 8) | 62.7 (± 7) | 0.46 | 0.045 |
Female, percentage | 76 | 63 | 74 | 62 | 0.022 | 0.028 |
RA-related characteristics | ||||||
DAS28 | 4.2 (± 1.3) | 3.9 (± 1.4) | 4.1 (± 1.3) | 3.8 (± 1.4) | 0.21 | 0.062 |
ESR, mm/hour | 22 (10-35) | 16 (9-30) | 20 (10-34) | 17 (9-31) | 0.059 | 0.33 |
CRP, mg/L | 11 (4-21) | 6 (3-16) | 8 (3-18) | 6 (3-19) | 0.021 | 0.46 |
RA duration, years | 7 (4-10) | 7 (4-10) | 7 (4-10) | 7 (5-10) | 0.83 | 0.19 |
Erosion, percentage | 77 | 83 | 79 | 83 | 0.20 | 0.36 |
Number of DMARDs | 1 (1-2) | 1 (1-1) | 1 (1-2) | 1 (1-1) | 0.26 | 0.43 |
MTX current, percentage | 62 | 60 | 63 | 59 | 0.71 | 0.46 |
MTX only, percentage | 39 | 39 | 41 | 38 | 0.95 | 0.67 |
SSZ only, percentage | 8 | 13 | 9 | 14 | 0.23 | 0.22 |
HCQ only, percentage | 1 | 4 | 3 | 4 | 0.31 | 0.55 |
Combination of DMARDs, percentage | 31 | 25 | 29 | 25 | 0.24 | 0.38 |
TNF-blocking agent, percentage | 11 | 9 | 11 | 9 | 0.73 | 0.65 |
Prednisolone only, percentage | 1 | 2 | 3 | 1 | 1.00 | 0.42 |
Cardiovascular risk factors | ||||||
Current smoker, percentage | 26 | 31 | 25 | 32 | 0.42 | 0.15 |
Pack-years, years | 17 (0-34) | 19 (2-38) | 19 (0-35) | 18 (2-38) | 0.23 | 0.75 |
BMI, kg/m2 | 30 (± 4) | 26 (± 5) | 29 (± 4) | 25 (± 5) | < 0.001 | < 0.001 |
Creatinine, μmol/L | 89 (± 21) | 89 (± 16) | 91 (± 22) | 87 (± 14) | 0.99 | 0.070 |
Renal clearance, mL/minute | 81 (± 24) | 72 (± 19) | 77 (± 23) | 73 (± 19) | 0.003 | 0.062 |
Pulse, beats per minute | 76 (± 11) | 73 (± 9) | 75 (± 11) | 73 (± 9) | 0.005 | 0.015 |
Diabetes mellitus, percentage | 14 | 3 | 12 | 3 | < 0.001 | 0.001 |
Hypothyroidism, percentage | 12 | 2 | 9 | 2 | 0.001 | 0.003 |
Table 2
Variables associated with metabolic syndromeUnivariate | Multivariatea | |||||
---|---|---|---|---|---|---|
OR | 95% CI | P value | OR | 95% CI | P value | |
Body mass index | 1.2 | 1.1-1.3 | < 0.001 | 1.2 | 1.1-1.3 | < 0.001 |
Pulse | 1.03 | 1.01-1.06 | 0.011 | 1.03 | 1.00-1.06 | 0.020 |
Creatinine | 1.01 | 1.00-1.02 | 0.080 | 1.02 | 1.00-1.03 | 0.017 |
Hypothyroidism | 4.5 | 1.5-13.2 | 0.007 | 4.7 | 1.5-15.0 | 0.009 |
Diabetes mellitus | 4.8 | 1.8-12.9 | 0.002 | 4.5 | 1.4-15.2 | 0.014 |
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L. Pilloni P. Bianco C. Manieli G. Senes P. Coni L. Atzori N. Aste G. Faa 《European journal of histochemistry : EJH》2009,53(2)
Basal cell carcinoma (BCC) is a very common malignant skin tumor that rarely metastatizes, but is often locally aggressive. Several factors, like large size (more than 3 cm), exposure to ultraviolet rays, histological variants, level of infiltration and perineural or perivascular invasion, are associated with a more aggressive clinical course. These morphological features seem to be more determinant in mideface localized BCC, which frequently show a significantly higher recurrence rate. An immunohistochemical profile, characterized by reactivity of tumor cells for p53, Ki67 and alpha-SMA has been associated with a more aggressive behaviour in large BCCs. The aim of this study was to verify if also little (<3 cm) basal cell carcinomas can express immunohistochemical markers typical for an aggressive behaviour.Basal cell carcinoma (BCC) is a very common malignant skin tumor that rarely metastatizes, even If Is often locally aggressive. Several factors, like large size (more than 3 cm), face localization, exposure to ultraviolet rays, histological variants, infiltration level and perineural or perivascular invasion, are associated with a more aggressive clinical course. In particular, the incidence of metastasis and/or death correlates with tumors greater than 3 cm in diameter in which setting patients are said to have 1–2 % risk of metastases that increases to 20–25% in lesions greater than 5 cm and to 50% in lesions greater than 10 cm in diameter (Snow et al., 1994). Histologically morpheiform, keratotic types and infiltrative growth of BCC are also considered features of the most aggressive course (Crowson, 2006). This can be explained by the fact that both the superficial and nodular variants of BCC are surrounded by a continuous basement membrane zone comprising collagens type IV and V admixed with laminin, while the aggressive growth variants (i.e. morpheiform, metatypical, and infiltrative growth subtypes) manifest the absence of basement membrane (Barsky et al., 1987).The molecular markers which characterize aggressive BCC include: increased expression of stromolysin (MMP-3) and collagenase-1 (MMP-1) (Cribier et al., 2001), decreased expression of syndecan-1 proteoglycan (Bayer-Garner et al., 2000) and of anti-apoptotic protein bcl-2 (Ramdial et al., 2000; Staibano et al., 2001).C-ras , c-fos (Urabe et al., 1994; Van der Schroeff et al., 1990) and p53 tumor supressor gene mutations (Auepemikiate et al., 2002) are indicative of an aggressive course.Focusing upon bcl-2 and p53 expression in BCC, there have been numerous studies documenting the utility of bcl-2 as a marker of favourable clinical behaviour while p53 expression may be a feature of a more aggressive outcome (Ramdial et al., 2000; Staibano et al., 2001; Bozdogan et al., 2002).An increased expression of cytoskeletal microfilaments like α–smooth muscle actin, frequently found in invasive BCC subtypes (Jones JCR et al., 1989), may explain an enhanced tumor mobility and deep tissue invasion through the stroma. (Cristian et al., 2001; Law et al., 2003). The aim of this preliminary study was to verify if also little (<3 cm) basal cell carcinomas may express aggressive immunohistochemical markers like p53, Ki67 and alpha-SMA. We used 31 excisional BCCs with tumor size less than 2 cm (ranging from 2 up to 20 mm) and with different skin localization (19 in the face, 6 in the trunk and 6 in the body extremities). All cases were immunostained for p53, BCL2, Ki67 and alpha-smooth muscle actin (α-SMA) (Age Sex Location Hystotype Max.Dim Depth Ulc Ess Inf p53 Bcl-2 Ki67 AML 1 61 M Extr Keratotic 10×8 1 No +++ URD +++ + + - 2 61 M Face Adenoid 10×9 4 No + URD +++ - - - 3 64 M Extr Sup mult 11×13 0.8 No + DRD + - - - 4 73 M Face Nodular 10×8 2 Yes + DRD +++ + ++ +++ 5 84 M Face Nodular 9×12 2 Yes + DRD - - - - 6 84 M Face Adenoid 5 0.8 No + URD +++ - - - 7 84 M Extr Nodular 13×10 3 No + DRD +++ + + - 8 52 F Face Nodular 4 0.8 No + URD + + + - 9 76 F Face Adenoid 10×4 4 No + DRD +++ - ++ - 10 77 F Face Morph 8×6 1 Yes +++ DRD +++ - - - 11 86 M Face Morph 8 1 Yes + DRD +++ - + + 12 63 F Face Adenoid 4 1 No + URD ++ + + + 13 76 F Face Nodular 7 1.5 No + DRD +++ + ++ - 14 84 M Face Nodular 11 4 Yes +++ DRD + - - + 15 63 F Face Keratotic 10×6 1.8 No ++ DRD - + ++ - 16 68 F Trunk Sup mult 10×6 0.7 No ++ URD + + - - 17 67 M Face Sup mult 12×6 0.4 No + URD + - + - 18 67 M Extr Sup mult 4×3 0.3 No + URD + +++ + - 19 32 F Extr Sup mult 1×3 0.4 No + URD + + + - 20 45 M Trunk Nodular 7×5 2 Yes +++ URD + + + - 21 62 M Trunk Sup mult 11×7 0.9 No ++ URD - ++ - ++ 22 65 M Trunk Adenoid 7×6 1.5 No + URD +++ + + - 23 72 M Trunk Nodular 12×6 1 No + URD +++ - + + 24 86 F Face Keratotic 20×11 3.1 No ++ DRD + + + - 25 85 M Face Nodular 0.5 1.3 No ++ DRD ++ + + - 26 74 F Extr Nodular 4×4 0.9 No + URD - - + - 27 71 M Face Nodular 6×12 1.7 No + DRD - - + - 28 64 F Trunk Sup mult 1.3×1.5 0.4 No ++ URD +++ - - - 29 78 F Face Nodular 4×3 1.5 No ++ DRD ++ + - +++ 30 80 M Face Keratotic 4×4 1.6 Yes + DRD - - + +++