Subtypes of genotype A Candida albicans isolates determined by restriction endonuclease and sequence analyses

Systemic yeast infections are the leading cause of mortality and morbidity in immunocompromized patients. Candida albicans, being the most frequently isolated fungal pathogen in these patients, can be divided into three genotypes (genotypes A, B and C) by 25S intron analysis. In our study, we found that molecular sizes of genotype A C. albicans isolates were heterogeneous. In order to determine the molecular basis of this difference, HaeIII digestion was applied, and strains forming different band patterns were analyzed by automated sequence analysis. As a result of sequence analysis, eight different subtypes (a→h) were found among genotype A C. albicans strains and an easy differentiation scheme consisting of HaeIII and MspI digestions was constructed.     

蕈样肉芽肿和湿疹中p53, Cox-2 的表达分析

目的:探讨蕈样肉芽肿、湿疹、正常皮肤中p53、Cox-2蛋白的表达差异性及其临床意义。方法:运用免疫组织化学法检测30例蕈样肉芽肿、20例湿疹及15例正常人皮肤组织中p53、Cox-2蛋白的表达情况。结果:蕈样肉芽肿表皮中及真皮中p53、Cox-2的阳性表达率显著高于湿疹及正常皮肤,差异均有统计学意义(P0.05)。各时期蕈样肉芽肿表皮、真皮中p53、Cox-2的表达比较差异均无统计学意义(P0.05)。结论:p53、Cox-2在蕈样肉芽肿和湿疹、正常皮肤的表达有显著差异,提示p53和Cox-2的表达异常在蕈样肉芽肿的发生中起着重要作用,p53、Cox-2可能作为鉴别诊断MF、皮肤炎症性疾病有价值的参考指标。     

Micosis fungoide papular en el anciano: a propósito de 2 casos

Papular mycosis fungoides (MF) is an uncommon clinical variant of early MF without prognostic implications that follows an indolent course over years. It is characterized by the presence of multiple, small, pruritic, flat-topped, erythematous papules, often presenting as a nonspecific papular eruption which makes early diagnosis difficult. We describe two cases of elderly patients with papular MF, a probably underdiagnosed entity, which causes a significant deterioration in quality of life of patients who may benefit from specific treatments such as phototherapy.     

Structural alterations of the FAS gene in cutaneous T-cell lymphoma (CTCL)

FAS (TNF receptor superfamily member 6, also known as CD95) plays a major role in T-cell apoptosis and is often dysregulated in CTCL. We searched for structural alterations of the FAS gene with the potential to affect its function. Although several heterozygous FAS promoter single nucleotide polymorphisms (SNPs) were detected, the only homozygous one was the −671 GG SNP present in 24/80 CTCL cases (30%). This SNP maps to an interferon response element activated by STAT-1. EMSA and supershift EMSA showed decreased CTCL nuclear protein/STAT-1 binding to oligonucleotides bearing this SNP. Luciferase reporters showed significantly less interferon-alfa responsive expression by FAS promoter constructs containing this SNP in multiple CTCL lines. Finally, FAS was upregulated by interferon-alfa in wildtype CTCL cells but not those bearing the −671 GG SNP. These findings indicate that many CTCL patients harbor the homozygous FAS promoter −671 GG SNP capable of blunting its response to interferon. This may have implications for CTCL pathogenesis, racial incidence and the response of patients to interferon-alfa therapy. In contrast, functionally significant mutations in FAS coding sequences were detected uncommonly. Among CTCL lines with the potential to serve as models of FAS regulation, FAS-high MyLa had both FAS alleles, FAS-low HH was FAS-hemizygous and FAS-negative SeAx was FAS-null.     

Clinical results of the total skin electron irradiation of the mycosis fungoides in adults. Conventional fractionation and low dose schemes

Background

Mycosis fungoides (MF) is a rare skin condition, effectively treated by irradiation. Since 1951, different methods of total skin irradiation have been developed. Although dose–response effect has been demonstrated in many publications, controversies about low dose treatment still exist.

Aim

The analysis of results of the total skin electron irradiation (TSEI), especially low dose TSEI in comparison with standard dose treatment is the subject of this review. Also, acute and late side effects of radiotherapy in MF are discussed.

Materials and methods

Medline search and analysis of studies published between 1995 and 2012, containing key words: mycosis fungoides, standard dose TSEI, low dose TSEI, total skin electron beam therapy (TSEBT).

Results

Detailed analysis of relevant studies demonstrated that standard dose radiotherapy 30–36 Gy is the most effective treatment used in clinical practice. Objective response rate (ORR) is high, especially for less advanced stages of disease. Complete response rate (CR), although slightly lower, is still relatively high.For more advanced MF, TSEI serves as a very good method of palliative treatment and relief of symptoms, like pruritus, pain or desquamation.There is no consensus regarding low dose TSEI; the method is widely accepted as a palliative treatment or in case of reirradiation.

Conclusions

Standard dose TSEI is an effective method of MF treatment for radical and palliative treatment, producing high rate of ORR and reasonably long time to progression (TTP). Acute and late side effect of treatment are mostly mild and easy to manage. Low dose TSEI is still in the phase of clinical studies.     

Infección por Scedosporium apiospermum en una paciente con trasplante renal

Background

Emerging fungi infections, although being not the most frequent, are a cause of major morbidity and mortality in recipients of solid organ transplants. The infections caused by the fungi Scedosporium apiospermum are a paradigmatic example of these.

Spontaneous cryptococcosis of a squirrel monkey (Saimiri sciureus) in French Guyana

An old female squirrel monkey (Saimiri sciureus) with a tumor-like growth of the lower jaw died in shock after 2 months of illness. Histological studies of different tissue samples demonstrated that the pathological agent was Cryptococcus. Multiple foci of fungus existed in the thoracic cavity with essentially pulmonary and glandular localizations.     

Diagnostics in mycosis fungoides and Sezary syndrome

Aim

The aim of this paper was to present diagnostic methods helping in the recognition of mycosis fungoides (MF) and Sezary syndrome (SS).

Background

Mycosis fungoides is the most common form of primary cutaneous T-cell lymphomas. It is characterized by a distinctive long-term course and malignant T-cell proliferation. MF diagnosis is not easy, mainly due to the atypical clinical presentation of the disease at an early stage.

Materials and methods

Low specific changes, which can be observed at the histopathological examination. Initially, the skin lesions may resemble psoriasis, atopic dermatitis or chronic eczema. Patients are qualified according to the available, and generally accepted WHO-EORTC classification, based on a combination of clinical and histopathological markers. From a clinical point of view, it is also important to carry out the qualification according to the TNMB assessment, which allows to specify the stage of the disease, and is helpful in the monitoring of the course of disease and therapeutic effects.

Results

In this paper we try to present currently available diagnostic methods.

Conclusion

Diagnosis of MF and SS still causes many problems due to less characteristic changes in the early stage of disease and requires wide interdisciplinary knowledge.     

Diversity of coelomycetous fungi in human infections: A 10-y experience of two European reference centres

The coelomycetous fungi are difficult to properly identify from their phenotypic characterization and their role as etiologic agents of human infections is not clear. We studied the species distribution of these fungi among clinical isolates that had been collected and stored over a ten-year period in two European reference laboratories (France and Spain). We identified phenotypically and molecularly 97 isolates by sequencing the D1-D2 fragment of the 28S nrRNA (LSU) gene and we provided the in vitro antifungal susceptibility pattern of seven antifungals against 46 isolates. Species of the orders Pleosporales and Glomerellales were present in both collections, and Botryosphaeriales and Diaporthales only in the French one. The most prevalent species were Medicopsis romeroi, Neocucurbitaria keratinophila, Neocucurbitaria unguis-hominis and Paraconiothyrium cyclothyrioides, which had been recovered primarily from superficial tissues. The Didymellaceae was the most common family represented, with 27 isolates distributed into five genera. Most of the isolates tested were susceptible to antifungals, and only the geometric mean (GM) and minimal inhibitory concentration (MIC) values of itraconazole and caspofungin had higher values. This study provides a good picture of the great diversity of coelomycetous fungi in the European clinical context, and the basis for future studies on this interesting but neglected group of fungi.     

TCR基因重排在蕈样肉芽肿诊断中的应用

T细胞在成熟过程中通过T细胞表面受体基因重排,从而具有特异性识别抗原的能力,在这一过程中的任何失调都会导致疾病。蕈样肉芽肿是由于淋巴细胞的恶性增殖所导致的,病变组织表现出T细胞受体基因重排克隆性。通过Southern印迹分析技术和PCR技术来检测T细胞受体基因重排。T细胞受体基因重排的检测在蕈样肉芽肿的诊断的应用上有重要的参考价值。