Treatment of the Midwestern Endemic Mycoses,Blastomycosis and Histoplasmosis

Purpose of Review

The purpose of this review is to assess the recommended treatment regimens for the major endemic mycoses, histoplasmosis and blastomycosis, which occur in the Midwestern USA and to provide information about the use of newer antifungal agents for these diseases.

Recent Findings

The basic approach to treatment of histoplasmosis and blastomycosis outlined in the IDSA Guidelines is helpful in managing these diseases. However, changes since these guidelines were published provide safer and better tolerated treatment regimens. Prolonged treatment with amphotericin B is rarely required, and lipid formulations of this drug have largely replaced the amphotericin B deoxycholate formulation. Although no clinical trials have been performed and the data are anecdotal, voriconazole and posaconazole are increasingly used in patients who cannot tolerate itraconazole. Voriconazole is especially useful when central nervous system infection is present. Posaconazole tablets provide consistently appropriate serum levels and the drug is well tolerated.

Summary

New azole agents provide alternative therapeutic options for histoplasmosis and blastomycosis.

     

Cinnamaldehyde and cinnamaldehyde derivatives reduce virulence in <Emphasis Type="Italic">Vibrio</Emphasis> spp. by decreasing the DNA-binding activity of the quorum sensing response regulator LuxR

Background  

To date, only few compounds targeting the AI-2 based quorum sensing (QS) system are known. In the present study, we screened cinnamaldehyde and substituted cinnamaldehydes for their ability to interfere with AI-2 based QS. The mechanism of QS inhibition was elucidated by measuring the effect on bioluminescence in several Vibrio harveyi mutants. We also studied in vitro the ability of these compounds to interfere with biofilm formation, stress response and virulence of Vibrio spp. The compounds were also evaluated in an in vivo assay measuring the reduction of Vibrio harveyi virulence towards Artemia shrimp.     

Comparative structure-activity relationship studies of 1-(5-methylsulfonylpyrid-2-yl)-5-alkyl and (hetero)aryl triazoles and pyrazoles in canine COX inhibition

Structure-activity relationship (SAR) studies of novel 5-alkyl and 5-aryl/heteroaryl substituted 1,2,4-triazoles are described. The in vitro activity is compared to the pyrazole class of compounds with analogous side chains to delineate the contribution of the triazole ring nitrogen in binding to the active site. Both series are quite potent and selective in the canine whole blood (CWB) COX-2 assay, suggesting the increased binding contribution of the hydrophobic side chains.     

Reproduction and nutritional stress are risk factors for Hendra virus infection in little red flying foxes (Pteropus scapulatus)

Hendra virus (HeV) is a lethal paramyxovirus which emerged in humans in 1994. Poor understanding of HeV dynamics in Pteropus spp. (flying fox or fruit bat) reservoir hosts has limited our ability to determine factors driving its emergence. We initiated a longitudinal field study of HeV in little red flying foxes (LRFF; Pteropus scapulatus) and examined individual and population risk factors for infection, to determine probable modes of intraspecific transmission. We also investigated whether seasonal changes in host behaviour, physiology and demography affect host-pathogen dynamics. Data showed that pregnant and lactating females had significantly higher risk of infection, which may explain previously observed temporal associations between HeV outbreaks and flying fox birthing periods. Age-specific seroprevalence curves generated from field data imply that HeV is transmitted horizontally via faeces, urine or saliva. Rapidly declining seroprevalence between two field seasons suggests that immunity wanes faster in LRFF than in other flying fox species, and highlights the potentially critical role of this species in interspecific viral persistence. The highest seroprevalence was observed when animals showed evidence of nutritional stress, suggesting that environmental processes that alter flying fox food sources, such as habitat loss and climate change, may increase HeV infection and transmission. These insights into the ecology of HeV in flying fox populations suggest causal links between anthropogenic environmental change and HeV emergence.     

Production of acoustic signals during aggression in Coosa bass, <Emphasis Type="Italic">Micropterus coosae</Emphasis>

Although sound production has been described for sunfishes, it is previously unknown for basses, both groups of fishes in the family Centrarchidae. We document production of acoustic signals during aggressive encounters in Coosa bass, Micropterus coosae. During dyadic encounters, presumptive winners of contests produced sounds associated with a variety of behaviors, including chases, lateral displays, circle swims, nudging, jerking and during post aggression, while fish were stationary. These sounds are low-frequency, non-harmonic and consist of one to 41 separate pulses. In most trials larger fish won contests, regardless of territory ownership (which fish was put into the test tank first) and size difference.     

NCX3 is a major functional isoform of the sodium-calcium exchanger in osteoblasts

The calcium phosphate-based skeleton of vertebrates serves as the major reservoir for metabolically available calcium ions. The skeleton is formed by osteoblasts which first secrete a proteinaceous matrix and then provide Ca++ for the calcification process. The two calcium efflux ports found in most cells are the plasma membrane Ca-ATPase (PMCA) and the sodium-calcium exchanger (NCX). In osteoblasts, PMCA and NCX are located on opposing sides of the cell with NCX facing the mineralizing bone surface. Two isoforms of NCX have been identified in osteoblasts NCX1, and NCX3. The purpose of this study was to determine the extent to which each of the two NCX isoforms support delivery of Ca++ into sites of calcification and to discern if one could compensate for the other. SiRNA technology was used to knockdown each isoform separately in MC3T3-E1 osteoblasts. Osteoblasts in which either NCX1 or NCX3 was impaired were tested for Ca++ efflux using the Ca++ specific fluorophore, fluo-4, in a sodium-dependent calcium uptake assay adapted for image analysis. NCX3 was found to serve as a major contributor of Ca++ translocation out of osteoblasts into calcifying bone matrix. NCX1 had little to no involvement.     

Ecological Risk Assessment and Regulation for Genetically-Modified Ornamental Plants

Classic plant breeding has increased the beauty and utility of ornamental plants, but biotechnology can offer completely new traits for plants used in homes and gardens. The creation of blue petal color in carnations and roses are examples where biotechnology has created novelty that conventional hybridization cannot match. However, all innovations have benefits and risks, and future commercialization of transgenic ornamental plants raises complex questions about potential negative impacts to managed landscapes and natural ecosystems. Predictive ecological risk assessment is a process that uses current knowledge to estimate future environmental harms or benefits arising from direct or indirect exposure to a genetically-modified (GM) plant, its genes, or gene products. This article considers GM ornamental plants in the context of current ecological risk assessment principles, research results, and current regulatory frameworks. The use of ecological risk assessment by government agencies to support decision-making is reviewed in the context of ornamental plants. Government risk assessments have usually emphasized the potential for pollen-mediated gene flow, weediness in managed areas, invasion of natural areas, and direct harm to nontarget organisms. Some of the major challenges for predictive risk assessment include characterizing gene flow over time and space, plant fitness in changing environments, and impacts to nontarget organisms, communities and ecosystems. The lack of baseline information about the ecology and biodiversity of urban areas, gardens, and natural ecosystems limits the ability to predict potential hazards, identify exposure pathways, and design hypothesis-driven research. The legacy of introduced ornamental plants as invasive species generates special concern about future invasions, especially for GM plants that exhibit increased stress tolerance or adaptability. While ecological risk assessments are a valuable tool and have helped harmonize regulation of GM plants, they do not define the acceptable level of risk or uncertainty. That responsibility belongs to regulators, stakeholders and citizens.