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Aceruloplasminemia is a rare autosomal recessive genetic disease characterized by mild microcytic anemia, diabetes, retinopathy, liver disease, and progressive neurological symptoms due to iron accumulation in pancreas, retina, liver, and brain. The disease is caused by mutations in the Ceruloplasmin (CP) gene that produce a strong reduction or absence of ceruloplasmin ferroxidase activity, leading to an impairment of iron metabolism. Most patients described so far are from Japan. Prompt diagnosis and therapy are crucial to prevent neurological complications since, once established, they are usually irreversible. Here, we describe the largest series of non-Japanese patients with aceruloplasminemia published so far, including 13 individuals from 11 families carrying 13 mutations in the CP gene (7 missense, 3 frameshifts, and 3 splicing mutations), 10 of which are novel. All missense mutations were studied by computational modeling. Clinical manifestations were heterogeneous, but anemia, often but not necessarily microcytic, was frequently the earliest one. This study confirms the clinical and genetic heterogeneity of aceruloplasminemia, a disease expected to be increasingly diagnosed in the Next-Generation Sequencing (NGS) era. Unexplained anemia with low transferrin saturation and high ferritin levels without inflammation should prompt the suspicion of aceruloplasminemia, which can be easily confirmed by low serum ceruloplasmin levels. Collaborative joint efforts are needed to better understand the pathophysiology of this potentially disabling disease.

Vitamin D deficiency is associated with a range of clinical disorders. To study the mechanisms involved and improve treatments, animal models are tremendously useful. Current vitamin D deficient rat models have important practical limitations, including time requirements when using, exclusively, a vitamin D deficient diet. More importantly, induction of hypovitaminosis D causes significant fluctuations in parathyroid hormone (PTH) and mineral levels, complicating the interpretation of study results. To overcome these shortcomings, we report the successful induction of vitamin D deficiency within three weeks, with stable serum PTH and minerals levels, in Wistar rats. We incorporated two additional manoeuvres compared to a conventional diet. Firstly, the vitamin D depleted diet is calcium (Ca) enriched, to attenuate the development of secondary hyperparathyroidism. Secondly, six intraperitoneal injections of paricalcitol during the first two weeks are given to induce the rapid degradation of circulating vitamin D metabolites. After three weeks, serum 25-hydroxyvitamin D3 (25D) and 1,25-dihydroxyvitamin D3 (1,25D) levels had dropped below detection limits, with unchanged serum PTH, Ca, and phosphate (P) levels. Therefore, this model provides a useful tool to examine the sole effect of hypovitaminosis D, in a wide range of research settings, without confounding changes in PTH, Ca, and P.

Peritoneal dialysis (PD) is associated with structural and functional alterations of the peritoneal membrane, consisting of fibrosis, angiogenesis, and loss of ultrafiltration capacity. Vitamin D receptor activation (VDRA) plays an important role in mineral metabolism and inflammation, but also antiangiogenic and antifibrotic properties have been reported. Therefore, the effects of active vitamin D treatment on peritoneal function and remodeling were investigated. Rats were either kept naïve to PDF exposure or daily exposed to 10 mL PDF and were treated for five or seven weeks with oral paricalcitol or vehicle control. Non-PDF-exposed rats showed no peritoneal changes upon paricalcitol treatment. Paricalcitol reduced endogenous calcitriol but did not affect mineral homeostasis. However, upon PDF exposure, loss of ultrafiltration capacity ensued which was fully rescued by paricalcitol treatment. Furthermore, PD-induced ECM thickening was significantly reduced and omental PD-induced angiogenesis was less pronounced upon paricalcitol treatment. No effect of paricalcitol treatment on total amount of peritoneal cells, peritoneal leukocyte composition, and epithelial to mesenchymal transition (EMT) was observed. Our data indicates that oral VDRA reduces tissue remodeling during chronic experimental PD and prevents loss of ultrafiltration capacity. Therefore, VDRA is potentially relevant in the prevention of treatment technique failure in PD patients.

Abdominal aortic aneurysms (AAA) are pathological dilations of the abdominal aorta. To date, surgical intervention is the only option for managing large AAAs, with no pharmacological therapies to prevent growth of small aneurysms. A current limitation in investigating further pharmacological avenues is the translatability of results from animal models, or from patient trials that are limited by co-morbidities and disease severity. To bridge this knowledge gap, we created a novel, patient-specific vessel-on-chip (VoC) model of the microcirculation in AAA (AAA-VoC). We found that co-culture of both C (control)-VSMCs and AAA-patient derived VSMCs with healthy, hiPSC-derived ECs generate lumenized and perfusable microvascular networks. We show that AAA-VoCs are characterized by an enlarged average vascular diameter. We furthermore found that AAA-VSMCs show phenotypical deviations from C- VSMCs after 7 days in co-culture such as increased number and surface area, indicative of a preserved pathological phenotype in our in vitro model. Lastly, we demonstrate that AAA-VoCs showed an increased level of pro-inflammatory cytokine expression over C-VoCs and displayed an impaired endothelial barrier function, resulting in vascular leakage. With this study, we show that AAA-VSMCs affect microvascular networks formed by healthy hiPSC-ECs and that a AAA phenotype is preserved in 3D co-culture, making this model valuable for future studies investigating treatments for AAA.

Seventy-five Acinetobacter baumannii strains belonging to different pulsetypes, plus one ceftazidime-susceptible strain, from a pulsetype in which all strains were resistant, were included in this study. The minimum inhibitory concentration of ceftazidime was determined by the microdilution method. The blaADC-like gene, the ISAba₁ element and the ISAba₁ located in the blaADC-like promoter were detected by PCR. The objective of the study was to determine the prevalence of ISAba₁ in a collection of epidemiologically unrelated A. baumannii clinical isolates. The blaADC-like gene was detected in 74 (97.3%) out of the 76 strains analysed. In these 74 strains, 51 (69%) were positive for the IS element and it was not detected in 23 (31%) strains. Among the A. baumannii strains containing the IS element, 40 (78.4%) had the IS element located in the promoter region of the blaADC-like gene. In a high percentage of A. baumannii clinical isolates carrying the ISAba₁, this is inserted into the promoter region of the blaADC-like gene. In addition, two clinical isolates belonging to the same pulsetype, one with and one without the ISAba₁, can be found in the clinical setting, suggesting the potential acquisition or loss of this genetic element in the hospital environment.

Seventy-five Acinetobacter baumannii strains belonging to different pulsetypes, plus one ceftazidime-susceptible strain, from a pulsetype in which all strains were resistant, were included in this study. The minimum inhibitory concentration of ceftazidime was determined by the microdilution method. The bla sub(ADC)-like gene, the IS sub(Aba1) element and the IS sub(Aba1) located in the bla sub(ADC)-like promoter were detected by PCR. The objective of the study was to determine the prevalence of IS sub(Aba1) in a collection of epidemiologically unrelated A. baumannii clinical isolates. The bla sub(ADC)-like gene was detected in 74 (97.3%) out of the 76 strains analysed. In these 74 strains, 51 (69%) were positive for the IS element and it was not detected in 23 (31%) strains. Among the A. baumannii strains containing the IS element, 40 (78.4%) had the IS element located in the promoter region of the bla sub(ADC)-like gene. In a high percentage of A. baumannii clinical isolates carrying the IS sub(Aba1), this is inserted into the promoter region of the bla sub(ADC)-like gene. In addition, two clinical isolates belonging to the same pulsetype, one with and one without the IS sub(iAba1), can be found in the clinical setting, suggesting the potential acquisition or loss of this genetic element in the hospital environment.

Seventy-five Acinetobacter baumannii strains belonging to different pulsetypes, plus one ceftazidime-susceptible strain, from a pulsetype in which all strains were resistant, were included in this study. The minimum inhibitory concentration of ceftazidime was determined by the microdilution method. The bla(ADC)-like gene, the IS(Aba1) element and the IS(Aba1) located in the bla(ADC)-like promoter were detected by PCR. The objective of the study was to determine the prevalence of IS(Aba1) in a collection of epidemiologically unrelated A. baumannii clinical isolates. The bla(ADC)-like gene was detected in 74 (97.3%) out of the 76 strains analysed. In these 74 strains, 51 (69%) were positive for the IS element and it was not detected in 23 (31%) strains. Among the A. baumannii strains containing the IS element, 40 (78.4%) had the IS element located in the promoter region of the bla(ADC)-like gene. In a high percentage of A. baumannii clinical isolates carrying the IS(Aba1), this is inserted into the promoter region of the bla(ADC)-like gene. In addition, two clinical isolates belonging to the same pulsetype, one with and one without the IS(Aba1), can be found in the clinical setting, suggesting the potential acquisition or loss of this genetic element in the hospital environment.