Biomedical subjects

P Barbero

Publications and source records attributed to P Barbero.

At least 19 recordsLinked to original sources

PubMed2006

Every-other-day interferon beta-1b versus once-weekly interferon beta-1a for multiple sclerosis (INCOMIN Trial) II: analysis of MRI responses to treatment and correlation with Nab.

BACKGROUND: In RRMS, clinical exacerbations are usually associated with different types of active lesions at MRI, including: hyperintense lesions on T1-weighted post-gadolinium sequences; new hyperintense lesions or enlarging old lesions on PD/T2-weighted scans; or new hypointense lesions on T1-weighted pre-Gd sequences. OBJECTIVE/METHODS: Primary outcome was the occurrence of patients with at least one active MRI lesion of the different types indicated above during treatment with 250 microg every other day (EOD) interferon beta (IFNbeta)-1b or 30 microg once weekly (OW) IFNbeta-1a in outpatients with RRMS (INCOMIN Trial). RESULTS: The number of patients with at least one 'active' lesion, evaluated over the two-year follow-up, was significantly (P = 0.014) lower in the EOD IFNbeta-1 b arm (1 3/76, 17%) then in the OW IFNbeta-1a arm (25/73, 34%). NAb frequency over two-year follow-up was 22/65 (33.8%) in the EOD IFNbeta-1b arm and 4/62 (6.5%) in the OW IFNbeta-1a arm, significantly greater in the EOD IFNbeta-1b arm. CONCLUSIONS: The development of MRI active lesions is strongly reduced by EOD-IFNbeta-1b compared with OW-IFNbeta-1a, indicating that EOD-IFNbeta-1b is more effective than OW-IFNbeta-1a in reducing ongoing inflammation and demyelination in MS. Logistic regression showed that NAb status did not affect the risk of MRI activity.

Adjuvants, Immunologic↗

PubMed2005

[Intrathecal baclofen and Botulinum toxin in infantile cerebral palsy].

INTRODUCTION: Infantile cerebral palsy is considered to be a motor disorder affecting both posture and movement. It is the manifestation of a cerebral lesion that took place during the maturing process of the brain. Spastic cerebral palsy is the most frequent variety. The spasticity presented by these patients strongly influences their functioning and gives rise to several complications that affect their quality of life. AIMS AND DEVELOPMENT: The main aim of this study is to determine a set of suitable and effective therapeutic steps that can be used to improve patients' spasticity and to prevent the complications that stem from them, such as contractures, deformities, surgery, etc. Multiple treatments were used, including physiotherapy, rehabilitation and oral pharmacotherapy, with few satisfactory results. At present there are two very promising therapeutic alternatives for patients with infantile cerebral palsy: Botulinum toxin, which we already have a great deal of experience with, and intrathecal treatment with baclofen. We report on a series of 10 patients aged between 8 and 15 years who had had an intrathecal baclofen infusion pump implanted. To date (maximum follow-up: 12 months), their clinical course has been satisfactory in most cases, with no severe complications related to the surgical technique, except in one individual who presented a fistula that resolved spontaneously. CONCLUSIONS: Intrathecal baclofen seems to be a very useful alternative in the treatment of spasticity to improve the quality of life of these patients and those around them.

Baclofen↗

PubMed2004

Choanal atresia associated with prenatal methimazole exposure: three new patients.

We report three patients with bilateral choanal atresia in children prenatally exposed to methimazole (MMI) in order to define a MMI embryopathy clinical pattern. The combination of choanal atresia and other specific malformations strongly resembles previously reported patients exposed to MMI in utero. At present, propylthiouracil is considered the best treatment in pregnancies. However in Argentina and some other countries MMI is the only antithyroid drug, possibly posing a significant risk to the unborn fetus.

Antithyroid Agents↗

PubMed2004

Thalidomide neuropathy: clinical, electrophysiological and neuroradiological features.

OBJECTIVE: Thalidomide is a promising therapy for multiple myeloma. Sensory neuropathy is a side effect of thalidomide and resulted to be partially reversible in 50% of cases, suggesting a sensory ganglionopathy. Spinal cord magnetic resonance imaging (MRI) was found to be useful in the diagnosis of sensory ganglionopathies and we use it to determine if thalidomide neuropathy has features of a ganglionopathy. MATERIAL AND METHODS: Six patients with multiple myeloma developed thalidomide-induced polyneuropathy. Nerve conduction studies, somatosensory-evoked potentials (SEPs) and cervical and dorsal spinal cord MRI were obtained in all. RESULTS: All patients had a sensory neuropathy, with clinical or electrophysiological abnormalities involving all four limbs. Spinal cord MRI showed high signal intensity in the posterior columns in only one patient, with abnormal central conduction time at SEPs. CONCLUSION: Our results suggest that thalidomide can induce either an axonal length-dependent neuropathy or, less frequently, a ganglionopathy.

Adult↗

PubMed2004

[Unusual forms of clinical presentation of attention deficit hyperactivity disorder].

INTRODUCTION AND DEVELOPMENT: Attention deficit hyperactivity disorder (ADHD) is one of the most frequently observed processes in our Neuropaediatric unit, and in recent years has become one of the leading reason for visits, together with headaches. On occasions, the diagnosis that should be made, in accordance with the criteria included in the DSM IV, is more difficult because initially they are patients who visit because of some other problem that becomes the centre of our clinical attention. Headaches, in our experience, are the main reason for visiting in these cases. A careful review of the patient's history and a physical examination, together with their observation during the interview, lead us to suspect a genuine case of ADHD underlying the problem that presents with other non specific symptoms. These patients are mainly boys and, less frequently, girls who see how the chances of academic and social failure increase and then become worried to such an extent that they start suffering from important tension type headaches. Concentrating the study and the therapy on just solving the problem of the headaches sometimes gives rise to therapeutic failure, which occasionally goes on for months. Other symptoms, such as tics, unspecific dizziness, pains in the abdomen and visual disorders, can also be the reason that brings ADHD patients to visit. CONCLUSIONS: When faced with these symptoms we should always bear in mind (mainly in the case of headaches) the possibility referred to above and special care must be taken not to diagnose ADHD in excess, and always base our judgment on objective proof that meets the criteria required for its diagnosis. Therapy based on pharmacological treatment and a suitable psychopedagogical intervention solves the problem in these cases and significantly reduces the symptomatology that led to the visit.

Attention Deficit Disorder with Hyperactivity↗

PubMed2003

[Neuropsychological problems of cerebrovascular pathology in children].

Cerebrovascular pathology in infancy is, unlike in adults, infrequent. However, this must not lead us to think it is unimportant. There are a number of different vascular processes that exert an influence to varying degrees on the neurological and psychological future of our young patients. These sequelae can be of more or less importance and, on some occasions, can be lesions that will accompany them throughout the rest of their lives, in spite of the therapeutic methods we have available today. We basically differentiate vascular organic lesions that are pre-established or due to malformations from other causes acquired as a consequence of an anomalous situation inherent to other pathologies and that have an extravascular origin. The most striking of these, because of their frequency, gravity and cellular pathology, are peri/intraventricular haemorrhages (PIVH) in those born premature and those weighing very little at birth. The causes from malformations remain and are relatively rare with a stable frequency, while the number of cases of PIVH has risen sharply in recent years due to different causes, the most notable of which is the increase in preterm multiple births, at around 30-32 weeks of gestation. This group of the population requires early and continuous neuropaediatric monitoring. Some of the sequelae are detected and dealt with quickly; others may appear later and will need the joint, coordinated attention of neuropaediatricians, psychologists, educators and physiotherapists.

Cerebrovascular Disorders↗

PubMed2001

Thyroid function and anti-thyroid antibodies in MS patients screened for interferon treatment. A multicenter study.

Interferon beta (IFNB) treatment for multiple sclerosis (MS) has been associated with thyroid disorders (TD), in particular in patients with subclinical TD or anti-thyroid (AT) autoantibodies (autoAb) before starting treatment. TD and AT autoAb frequency was reported increased in MS. To determine whether MS patients have subclinical thyroid function abnormalities or anti-thyroid autoimmunity predisposing to develop TD, we performed a prospective multicenter screening of thyroid function and autoimmunity in 152 relapsing-remitting (RR) MS patients selected to receive IFNB treatment and in 437 healthy normothyroidal controls. Thyroid-related hormones and anti-thyroid microsomal antigen (anti-TMA) autoAb were tested with sensitive immunoradiometric or chromatographic assays. Cases were stratified for different progressively decreasing or increasing cutoff values of thyroid-stimulating hormone (TSH) (0.3, 0.2, 0.1, 3 and 5 mIU/l), and odds ratios (OR) with 95% confidence intervals (CI) calculated using logistic regression adjusted for gender, age, and anti-TMA autoAb positivity. The frequency of cases below or above the TSH cutoff values was not significantly different in MS patients and controls, and the risk to have an abnormal TSH level was not significantly increased in MS patients (OR ranging 0.37-0.84; CI, 0.05-3.01), even if anti-TMA autoAb positive (OR ranging 0.35-0.85; CI, 0.04-3.00). Frequencies of subclinical hypothyroidism and of anti-TMA autoAb positivity were, however, trending higher in MS men (ranging 5-7%) than in controls (3%). MS patients do not have an increased risk of subtle thyroid function abnormalities, subclinical TD, or anti-TMA autoAb positivity that may predispose to develop thyroid dysfunction during IFNB treatment. The positive trend for subclinical hypothyroidism and anti-TMA autoAb positivity, however, advises a longitudinal study of thyroid function and autoimmunity during IFNB treatment to see whether patients with baseline subclinical thyroid dysfunction develop clinically significant alteration during treatment.

Adolescent↗

PubMed2001

Role of Rab9 GTPase in facilitating receptor recruitment by TIP47.

Mannose 6-phosphate receptors (MPRs) deliver lysosomal hydrolases from the Golgi to endosomes and then return to the Golgi complex. TIP47 recognizes the cytoplasmic domains of MPRs and is required for endosome-to-Golgi transport. Here we show that TIP47 also bound directly to the Rab9 guanosine triphosphatase (GTPase) in its active, GTP-bound conformation. Moreover, Rab9 increased the affinity of TIP47 for its cargo. A functional Rab9 binding site was required for TIP47 stimulation of MPR transport in vivo. Thus, a cytosolic cargo selection device may be selectively recruited onto a specific organelle, and vesicle budding might be coupled to the presence of an active Rab GTPase.

Amino Acid Substitution↗

PubMed2001

TIP47 is not a component of lipid droplets.

TIP47 functions in the delivery of mannose 6-phosphate receptors from endosomes to the trans-Golgi network both in vitro and in vivo. It binds directly and very specifically to the cytoplasmic domains of both the cation-independent and cation-dependent mannose 6-phosphate receptors. TIP47 is 43% identical to a lipid droplet-associated protein named adipophilin; much of the identity resides near the N termini of these proteins. It was recently reported in this journal, in a study using antiserum from this laboratory, that TIP47 is a constituent of lipid droplets (Wolins, N. E., Rubin, B., and Brasaemle, D. L. (2001) J. Biol. Chem. 276, 5101-5108). We show here that the findings of Wolins et al. were likely due to either a cross-reactive, unidentified protein in HeLa cells that is recognized by our antiserum and/or the fact that our serum also cross-reacts with the adipophilin protein itself, shown directly by expression of adipophilin in Escherichia coli. Using antibodies specific for residues 152-434 of TIP47, we show that TIP47 is not a constituent of lipid droplets.

Amino Acid Sequence↗

PubMed2001

Terminal latency index in polyneuropathy with IgM paraproteinemia and anti-MAG antibody.

Criteria for the diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) are met by the polyneuropathy associated with immunoglobulin M (IgM) paraproteinemia and anti-myelin-associated glycoprotein (MAG) antibody (MAG-CIDP). However, MAG-CIDP differs from other types of CIDP, mainly in its poorer response to treatment. The utility of terminal latency index (TLI) as an electrophysiological marker for MAG-CIDP has been debated. In this study we confirmed its diagnostic usefulness and evaluated TLI threshold values for motor nerves investigated in routine nerve conduction studies. Median, ulnar, peroneal, and tibial TLIs of 11 subjects with MAG-CIDP, 18 with CIDP, and 76 healthy controls were compared, and threshold values for MAG-CIDP evaluated as the lowest value with a likelihood ratio higher than 10. Mean TLI values and TLIs of all but the peroneal nerve were significantly lower in MAG-CIDP. Median nerve TLI of 0.26 and ulnar nerve TLI of 0.33 were identified as the threshold TLI values for MAG-CIDP.

Aged↗

PubMed2001

Interferon-beta dose and efficacy: the OPTIMS study.

Interferon beta (IFN-beta) reduces exacerbation rates in patients with relapsing-remitting multiple sclerosis (MS), but some patients do not respond to treatment. Recent studies have shown a clear dose-response effect on the reduction of exacerbation rates, and on burden of disease accumulation and active lesion frequency seen on MRI. During treatment with 8 MIU IFN-beta we noticed a 30% rate of treatment failure. We then treated non-responders with 12 MIU IFN-beta and observed significant improvement in the clinical signs of disease activity. In order to compare the efficacy of two different doses of IFN-beta-1b, a multicenter study for the optimization of interferon for MS (OPTIMS) has been organized. The design of the study is presented here.

Dose-Response Relationship, Drug↗

PubMed2001

Anti-GM1 and anti-sulfatide antibodies in polyneuropathies. Threshold titers and accuracy.

OBJECTIVES: To determine threshold titers and diagnostic accuracy of anti-GM1 and anti-sulfatide antibodies (Ab) for autoimmune polyneuropathies (PN) in overall and for particular subtypes of them. MATERIALS AND METHODS: In this study 84 PN patients, 120 epileptics and 93 healthy controls' sera were tested by enzyme-linked immunosorbent assay for autoAbs and results confirmed by thin-layer chromatography. Frequencies of positive patients at increasing cut-off were compared to determine threshold titers. Accuracy was determined by Receiver Operator Characteristic analysis. RESULTS: A 1:2,000 titer for IgM anti-GM1 and a 1:4,000 titer for IgM anti-sulfatide Ab resulted to be threshold titers for autoimmune PN in overall. IgM anti-GM1 and anti-sulfatide Ab had low discriminating capacity between autoimmune PN and other PN, but good discriminating capacity between motor neuropathy (for anti-GM1 Ab) or PN in IgM-paraproteinemia or chronic painful sensory axonal PN (for anti-sulfatide Ab) and other PN. CONCLUSION: Our results suggest that testing IgM anti-GM1 or anti-sulfatide Ab is useful only for diagnostic confirmation of specific subtypes of autoimmune PN.

Aged↗

PubMed2000

Does high-dose interferon beta-1b improve clinical response in more severely disabled multiple sclerosis patients?

Prospective clinical open label follow-up of 52 multiple sclerosis patients treated with interferon beta-1b. After 18 months of treatment at standard 8 million international units (MIU) dose, subcutaneously on alternate days, IFNB dose was increased to 12 MIU in ten clinically non-responder patients. Eighteen months after, mean exacerbation rate, number and severity of exacerbations and number of patients with exacerbations or requiring corticosteroid treatment significantly improved, becoming similar to those of IFNB responders, always treated with 8 MIU. Baseline EDSS score of non-responders was higher than that of responders. Frequency and severity of adverse events were trending higher and dropout frequency higher in 12 MIU IFNB-treated patients.

Adjuvants, Immunologic↗

PubMed2000

Regional and cellular localization of the neuroendocrine prohormone convertases PC1 and PC2 in the rat central nervous system.

PC1 and PC2 are two major enzymes involved in the processing of protein precursors directed to the regulated secretory pathway. Whereas transcripts encoding both enzymes are widely distributed in the central nervous system, information regarding the localization of proteins themselves is still lacking. In an attempt to gain insight into the neurobiologic roles of PC1 and PC2, both enzymes were immunolocalized in the rat brain by using C-terminally directed antibodies, which respectively recognize the 87-kDa PC1 and the 75 and 68-kDa PC2 forms. Adjacent sections immunoreacted with PC1 or PC2 antibodies exhibited selective patterns of immunostaining in regions well characterized with respect to their biosynthesis of multiple neuropeptides such as the cerebral cortex, hippocampus, and hypothalamus. PC1 signal intensity was generally weaker than that of PC2, although both enzymes displayed extensive overlapping patterns of expression. As assessed by double-labeling experiments at the cellular level, PC1 and PC2 immunoreactive signals were localized within the trans-Golgi network and nerve terminals, in keeping with the biosynthetic pathways of neuropeptides. Immunoreactive fibers were detected in many areas throughout the brain but were particularly densely distributed in the hypothalamus and the brainstem. Both enzymes were also localized within dendrites of numerous neurons, supporting the hypothesis that dendritic neuropeptide maturation and release may occur in a large number of brain regions. Taken together, our results provide new evidence that both convertases are efficiently targeted to the neuronal regulated secretory pathway and are well poised to process protein precursors in biologically active end-products within the mammalian brain.

Animals↗

PubMed1999

Protein 7B2 is essential for the targeting and activation of PC2 into the regulated secretory pathway of rMTC 6-23 cells.

Among the prohormone convertases, PC2 is unique in that it specifically binds to the neuroendocrine-specific protein 7B2 in the endoplasmic reticulum (ER) and is activated late in the regulated secretory pathway of neuroendocrine cells. Several roles, sometimes contradictory, have been suggested for 7B2 with regard to PC2 cellular fate. Thus, 7B2 was proposed to act as a PC2 chaperone in the ER, or to facilitate 7B2 transport from the ER to the trans-Golgi network and to be necessary for proPC2 activation, or to inhibit PC2 enzymatic activity until the latter reaches the secretory granules. To gain insight into the function of 7B2, we sought to block its expression in PC2-expressing endocrine cells using antisense strategies. We have previously shown that the endocrine rMTC 6-23 cell line expresses PC2 and that the enzyme is responsible for the processing of pro-neurotensin/neuromedin N (proNT/NN). Here, we show that rMTC 6-23 cells express 7B2 and that the protein was coordinately induced with PC2 and proNT/NN by dexamethasone. Stable transfection of rMTC 6-23 cells with 7B2 antisense cDNA led to a marked reduction (>90%) in 7B2 levels. ProPC2 was expressed to normal levels and cleaved to yield a PC2 form that was constitutively released, was not stored within secretory granules and was unable to process proNT/NN. We conclude that 7B2 is essential for the sorting and activation of PC2 into the regulated secretory pathway of endocrine cells.

Animals↗

PubMed1999

Cellular localization and role of prohormone convertases in the processing of pro-melanin concentrating hormone in mammals.

Melanin concentrating hormone (MCH) and neuropeptide EI (NEI) are two peptides produced from the same precursor in mammals, by cleavage at the Arg145-Arg146 site and the Lys129-Arg130 site, respectively. We performed co-localization studies to reveal simultaneously the expression of MCH mRNA and proconvertases (PCs) such as PC1/3 or PC2. In the rat hypothalamus, PC2 was present in all MCH neurons, and PC1/3 was present in about 15-20% of these cells. PC1/3 or PC2 was not found in MCH-positive cells in the spleen. In GH4C1 cells co-infected with vaccinia virus (VV):pro-MCH along with VV:furin, PACE4, PC1/3, PC2, PC5/6A, PC5/6B, or PC7, we observed only efficient cleavage at the Arg145-Arg146 site to generate mature MCH. Co-expression of pro-MCH together with PC2 and 7B2 resulted in very weak processing to NEI. Comparison of pro-MCH processing patterns in PC1/3- or PC2-transfected PC12 cells showed that PC2 but not PC1/3 generated NEI. Finally, we analyzed the pattern of pro-MCH processing in PC2 null mice. In the brain of homozygotic mutants, the production of mature NEI was dramatically reduced. In contrast, MCH content was increased in the hypothalamus of PC2 null mice. In the spleen, a single large MCH-containing peptide was identified in both wild type and PC2 null mice. Together, our data suggest that pro-MCH is processed differently in the brain and in peripheral organs of mammals. PC2 is the key enzyme that produces NEI, whereas several PCs may cleave at the Arg145-Arg146 site to generate MCH in neuronal cell types.

Amino Acid Sequence↗

PubMed1999

The relative importance of socio-economic status, parental smoking and air pollution (SO2) on asthma symptoms, spirometry and bronchodilator response in 11-year-old children.

The aim of this study was to evaluate the relative contribution of several risk factors to the prevalence of allergic respiratory symptoms, and the positivity of the bronchodilator test with fenoterol, and to establish the relative importance of these factors on the variability of FVC, FEV1, PEF, MEF25, MEF50 and MEF75. A total of 340 11-year-old children attending school in polluted and non-polluted areas of the city of Cartagena, Spain, were studied. The polluted area had had an annual mean of 75 microg/m3 of SO2 over the last 10 years and the non-polluted area had < 20 microg/m3 during this period. A questionnaire about allergic respiratory symptoms was completed by the parents. Specific questions about parental smoking habits and socio-economic level were included. Each child's performance in spirometry before and after administration of 0.2 mg of inhaled fenoterol was evaluated. The only significant predictive variables in the logistic regression (for suffering any symptom or a positive bronchodilator response) were male sex for nasal symptoms (RR 1.37; p = 0.04) and housing near heavy traffic for eye symptoms (RR 1.45; p = 0.01). Living in the polluted area reduced the risk of a positive bronchodilator response (RR 0.61; p = 0.004). Maternal smoking, even though not statistically significant, tended to increased the risk of suffering any symptom (RR 1.26; p = 0.07) or of having a positive bronchodilator response (RR 1.23; p = 0.1). None of the risk factors studied was of significant importance in explaining the variability of spirometry results. Although none of the risk factors were specifically determinant to the symptom questions, bronchodilator test or spirometric measurements, having a mother who smokes seems more important than living in a polluted area if statistically non-significant trends are considered.

Adult↗

PubMed1998

PC5-A-mediated processing of pro-neurotensin in early compartments of the regulated secretory pathway of PC5-transfected PC12 cells.

Among the members of the proprotein convertase (PC) family, PC1 and PC2 have well established roles as prohormone convertases. Another good candidate for this role is PC5-A that has been shown to be present in the regulated secretory pathway of certain neuroendocrine tissues, but evidence that it can process prohormones is lacking. To determine whether PC5-A could function as a prohormone convertase and to compare its cleavage specificity with that of PC1 and PC2, we stably transfected the rat pheochromocytoma PC12 cell line with PC5-A and analyzed the biosynthesis and subcellular localization of the enzyme, as well as its ability to process pro-neurotensin/neuromedin N (pro-NT/NN) into active peptides. Our data showed that in transfected PC12 cells, PC5-A was converted from its 126-kDa precursor form into a 117-kDa mature form and, to a lesser extent, into a C-terminally truncated 65-kDa form of the 117-kDa product. Metabolic and immunochemical studies showed that PC5-A was sorted to early compartments of the regulated secretory pathway where it colocalized with immunoreactive NT. Furthermore, pro-NT/NN was processed in these compartments according to a pattern that differed from that previously described in PC1- and PC2-transfected PC12 cells. This pattern resembled that previously reported for pro-NT/NN processing in the adrenal medulla, a tissue known to express high levels of PC5-A. Altogether, these data demonstrate for the first time the ability of PC5-A to function as a prohormone convertase in the regulated secretory pathway and suggest a role for this enzyme in the physiological processing of pro-NT/NN.

Amino Acid Sequence↗