Background: Intrahospital transfers of intensive care patients involves multiple risks where patient safety is challenged. Aim: The aim of this study was to investigate intensive care nurses’ experiences and perceptions of patient safety during intrahospital transfers. Method: A qualitative, explorative design was utilized with a phenomenographic approach. Ten intensive care nurses with varying work experience in intensive care were interviewed. The interviews were transcribed and analysed according to the phenomenographic method. Results: The analysis of the intensive care nurses’ experiences and perceptions resulted in four categories: routines, risks, support and job allocation. Patient safety was, according to the intensive care nurses, lower during intrahospital transfers compared to the intensive care ward but perceived as good in general. Their preparations and their ability to predict risks were mostly based on their experience level. They solved emerging problems depending on the situation. According to the intensive care nurses, being new in the profession poses a greater risk. Times when the doctors are on call and night time were especially risky times for transfers. They considered good routines important for patient safety and saw possibilities for improvement. The intensive care nurses expressed both confidence and a lack thereof with regards to the transfers and perceived it as easy to ask for help. Cooperation and communication were, according to the informants, crucial for patient safety. Conclusion: The intensive care nurses’ perceptions of patient safety during intrahospital transports were mainly based on their earlier experiences. A possibility for improvement exists through the implementation of a checklist and team training in simulated scenarios. It is important to ensure that patient safety is high during intrahospital transfers irrespective of the experience level of the staff. / Bakgrund: Intrahospitala transporter av intensivvårdspatienter innebär många risker som leder till att patientsäkerheten kan sättas på spel. Syfte: Studiens syfte var att undersöka intensivvårdssjuksköterskors erfarenheter och uppfattningar av patientsäkerhet vid intrahospitala transporter. Metod: En kvalitativ, explorativ design tillämpades med fenomenografisk ansats i form av semistrukturerade intervjuer. Tio intensivvårdssjuksköterskor med varierande arbetslivserfarenhet inom intensivvården intervjuades. Intervjuerna transkriberades och analyserades enligt fenomenografisk metod. Resultat: Analysen av intensivvårdsjuksköterskornas erfarenheter och uppfattningar resulterade i fyra kategorier: rutiner, risker, stöd och arbetsfördelning. Enligt intensivvårdssjuksköterskorna var patientsäkerheten vid intrahospitala transporter sänkt jämfört med intensivvårdsavdelningen men uppfattades trots detta generellt som god. Förberedelserna intensivvårdssjuksköterskorna gjorde och förmågan att se risker berodde mycket på hur erfarna de var. De löste de problem som uppstod utifrån situationen. Enligt intensivvårdssjuksköterskorna innebar det en extra risk att vara ny i sin profession. Jourtid och nattetid var riskfyllda tidpunkter och förflyttningar av patienterna som ett speciellt riskfyllt moment. De ansåg att bra rutiner var viktigt och de såg möjligheter till förbättringar för att öka patientsäkerheten. Intensivvårdssjuksköterskorna uttryckte både en trygghet och otrygghet i samband med transporterna men uppfattade att det var lätt att be om hjälp. Samarbete och kommunikation var enligt dem avgörande för patientsäkerheten. Slutsats: Intensivvårdsjuksköterskornas uppfattningar av patientsäkerheten under intrahospitala transporter berodde till stor del på deras tidigare erfarenheter. Ett utrymme till förbättringar finns genom ett införande av en checklista samt teamträning i simulerade scenarion. Det är viktigt att säkerställa att patientsäkerheten är hög oberoende av hur erfaren personalen är.

Le fer est un élément essentiel pour les plantes, mais toxique lorsqu'il est accumulé en excès. Chez Arabidopsis thaliana, le transporteur IRT1 joue un rôle essentiel dans l'acquisition du Fe depuis la solution du sol, en conditions limitantes en cet élément. Le gène IRT1 est régulé transcriptionnellement par le fer conduisant à une accumulation des transcrits IRT1 dans l'épiderme des racines carencées en fer. Par homologie avec les mécanismes décrits pour le transporteur de zinc ZRT1 de levure, une régulation post-traductionnelle d'IRT1, contrôlant la stabilité de celui-ci en présence de fer a été envisagée. IRT1 a donc été utilisé comme modèle pour caractériser le système endocytique des plantes. Nos travaux révèlent que la protéine IRT1 est localisée au niveau des endosomes précoces (TGN/EE) des cellules de poils racinaires. Des approches pharmacologiques ont permis de révéler un cyclage d'IRT1 entre la membrane plasmique et le TGN/EE ainsi qu'une dégradation vacuolaire. Nous avons également pu montrer que l'internalisation et la dégradation d'IRT1 ne sont pas affectées par la disponibilité en fer et sont sous le contrôle de la monoubiquitination de résidus lysines présents dans les parties cytosoliques de la protéine IRT1. Nos travaux suggèrent un modèle où l'internalisation d'IRT1 depuis la membrane plasmique, contrôlée par monoubiquitination, permet aux plantes de se prémunir contre la toxicité des métaux transportés par IRT1. Enfin, nous avons réalisé un crible double hybride en utilisant la boucle cytosolique d'IRT1 afin d'identifier des protéines contrôlant son trafic et/ou sa dégradation. Ce crible a permis notamment l'identification d'une protéine à domaine FYVE, localisée aux endosomes et dont la caractérisation fonctionnelle a été initiée / Iron is an essential element for plants but toxic when present in excess. IRT1 is the major root iron transporter responsible for iron uptake from the soil under iron limitation in Arabidopsis thaliana. IRT1 is transcriptionally regulated by iron, resulting in a high IRT1 expression in iron-starved root epidermal cells. In addition, IRT1 was suggested to be controlled at the post-translational level, with iron affecting IRT1 protein stability, in a similar fashion with the yeast ZRT1 zinc transporter. To shed light on two poorly-understood phenomena in plants, endocytosis and degradation of plasma membrane proteins, we studied the proposed post-translational regulation of IRT1 in Arabidopsis thaliana. Interestingly IRT1 protein is found in early endosomes of root hair cells. Pharmacological approaches reveal that IRT1 cycles back and forth with the plasma membrane to perform iron uptake, and is sent to the vacuole for proper turnover. We also demonstrate that iron nutrition have no effect on the levels and the subcellular localization of IRT1 protein. The internalization of IRT1 is dependent on the monoubiquitination of several cytosol-exposed lysine residues. Together, these data suggest a model where monoubiquitin-dependent endocytosis/recycling of IRT1 keeps the plasma membrane pool of IRT1 low, to better deal with metal uptake. Finally, in order to indentify genes involves in IRT1 endocytosis/recycling and turnover, we perform a yeast two-hybrid screen with IRT1 cytosolic loop. This screen allows the identification of a FYVE domain-containing protein localized in endocytic compartment which functional characterization was initiated.

No description available.

In humans, the functional regulation of facilitative glucose transporters (GLUTs) by insulin plays a central role in the maintenance of glucose homeostasis. The insensitivity of tissues to this regulation results in diabetes mellitus, however, the underlying mechanisms remain largely unknown. To establish Caenorhabditis elegans (C. elegans) as a model system to study the mechanisms of insulin regulation of GLUTs because of the well-conserved insulin/IGF-like signaling (IIS) and many unique advantages of this organism, we functionally characterized 9 candidate genes of human GLUT homologues in C. elegans based on their sequence homologies to GLUTs. We found that FGT-1 is the only functional GLUT homologue with the ability to transport 2-deoxy-D-glucose (2DG) in Xenopus oocytes. FGT-1 mediated 2DG transport could be inhibited by the GLUT inhibitor phloretin and exhibited a Michaelis constant (Km) of 2.8 mM, which is smaller than the Km values of human GLUT1 and GLUT4. In addition to glucose, FGT-1 could also transport mannose, galactose, and fructose. Using a FGT-1::GFP fusion construct under the control of the 5 kb promoter sequence of the fgt-1a gene, FGT-1 was shown to be ubiquitously expressed in C. elegans tissues and cells, including the digestive tract, neurons, and body wall muscle. Two FGT-1 alternative splicing isoforms, FGT-1A and FGT-1B, showed similar transport activity and tissue localization. To study the function of FGT-1 and its regulation by IIS, the changes in several phenotypes that are known to be regulated by IIS were observed in FGT-1-knockdown worms or null strains in the presence or absence of IIS activity. FGT-1 knockdown resulted in fat accumulation but had no effects on dauer formation or brood size in both wild-type and daf-2 (insulin receptor) gene mutant strains. However, the function of FGT-1 in animal growth and aging was dependent on the IIS background, suggesting IIS regulation of FGT-1 function. Consistently, FGT-1 mediated glucose uptake was almost completely defective in the daf-2 and age-1 (PI3 kinase) mutants, and phloretin could only marginally inhibit 2DG uptake in these strains. This defect was only partially related to the approximately 60% decrease in FGT-1 protein levels in these mutants, suggesting the involvements of both post-transcriptional and post-translational regulatory mechanisms. We also found that OGA-1, an O-GlcNAcase, is essential for the function of FGT-1, implying possible regulation of FGT-1 function by glycosylation. In summary, our study has established C. elegans as a powerful model to study the mechanism by which insulin regulates glucose transporters and has provided insights into the mechanism of defective glucose uptake by tissues in patients with diabetes.

Fluoroquinolones (FQ) are broad-spectrum charged antimicrobials exhibiting excellent tissue/fluid permeation. Thus, FQ disposition depends essentially on active transport and facilitative diffusion. Although most early transporter studies investigating renal elimination of FQs have focused on apical efflux of FQs from renal proximal tubule cell (RPTC) into urine, their basolateral uptake mechanism(s) from blood into RPTC (i.e., first step to tubular secretion) has not yet been explored in detail. Renally expressed SLC22 members: organic anion (OATs) and cation (OCTs) transporters are known to transport such small organic ionic substrates (molecular weight ~400 Da). Hence it is of interest to explore the role of these basolateral transporters in renal elimination of FQs, and to further quantitatively assess their impact in clinically observed FQ drug-drug interactions (DDI). An initial systematic review of clinical literature for FQs (n=18) demonstrated substantial differences among their renal clearance (CLren~46-fold) and unbound renal clearance (CLrenu~20-fold), and suggested that tubular secretion and reabsorption could be major determinants of FQ half-life, efficacy, and DDIs. FQs (n=13) identified from the above review were investigated by in-vitro transport studies using stably transfected cell lines, for potential interactions with organic cation [human (h) OCT1, hOCT2 and hOCT3] and anion [mouse (m) and hOAT3, hOAT1; and hOAT4] transporters. Further, kinetic inhibition studies were conducted to determine inhibition potency (Ki/IC50 values) for those FQs exhibiting significant OCT/OAT inhibition in preliminary interaction experiments. Gatifloxacin, moxifloxacin, prulifloxacin, and sparfloxacin were determined to be competitive inhibitors of hOCT1 with Ki = 250±18, 161±19, 136±33, and 94±8 μM, respectively. Moxifloxacin competitively inhibited hOCT3-mediated uptake, Ki = 1,598±146 μM. Enoxacin, fleroxacin, levofloxacin, lomefloxacin, moxifloxacin, prulifloxacin, and sparfloxacin exhibited competitive inhibition for mOat3 with Ki = 396±15, 817±31, 515±22, 539±27, 1356±114, 299±35, 205±12 μM, respectively. Fleroxacin and pefloxacin were found to inhibit hOAT1 with IC50 = 2228±84 and 1819±144 respectively. Despite expression in enterocytes, hepatocytes, and RPTC, hOCT3 does not appear to contribute significantly to FQ disposition. However, due to hepatic and potential RPTC expression, hOCT1 could play an important role in elimination of these antimicrobials. Among renally expressed OATs in humans, hOAT1 and hOAT3 are likely to be involved in FQ elimination.

Abstract FUNCTIONAL AND BIOCHEMICAL CONSEQUENCES OF SINGLE NUCLEOTIDE POLYMORPHISMS IN THE HUMAN VESICULAR MONOAMINE TRANSPORTER 1 GENE (SLC18A1) By Sally Gamal Shukry, B.S. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Biology at Virginia Commonwealth University. Virginia Commonwealth University, 2012 Major Advisor: Jennifer K. Stewart Associate Professor and Graduate Director, Department of Biology Single nucleotide polymorphisms (SNP) in the human VMAT1 gene (SLC18A1) have been associated with schizophrenia in three different populations: Han Chinese, Western European and Japanese. Effects of these mutations on transport function of the hVMAT1 protein have not been reported. The goal of this study was to investigate functional and biochemical differences in human VMAT1 proteins with a threonine or proline at amino acid position 4 (Thr4Pro) and a serine or threonine at position 98 (Ser98Thr). COS1 cells were transfected with variant SNPs coding for 4Thr/98Ser, 4Pro/98Ser, or 4Thr98Thr. Western blotting demonstrated robust over expression of the genes and no differences in electrophoretic mobility of the proteins. Maximal transport of serotonin by the VMAT1 protein with 4Pro/98Ser was less than that of the 4Thr/98Ser or the 4Thr/98Thr. Response of the 4Pro/Ser98 to the VMAT inhibitor reserpine was lower than that of the 4Thr/98Thr. These findings suggest mechanisms for human VMAT1 links to schizophrenia.

In the last few years, there has been continued concern about synthetic drug abuse in both the United States and worldwide. Small adjustments in drug compound structure often allow synthetic drug makers to manufacture a legal product that can produce the same highs as illegal counterparts. Unfortunately, this is happening faster than the government can outlaw the drug compounds, and a wide variety of synthetics are now appearing on the street. This study evaluated the effects on the human serotonin transporter of six different 4-para substituted methcathinone compounds. Using a Xenopus oocyte model, the efficacy of each MCAT analogue at hSERT was calculated by applying the Hill equation to the oocyte data. This study suggests that volume, size, and steric bulk of the compound may generally influence efficacy at hSERT in a direct manner, but that other factors, like lipophilicity, may also play an important role in potency at the transporter.

Les systèmes de sécrétion de NO3– de la membrane plasmique des cellules végétales jouent un rôle important dans l'activité stomatique et la réponse des plantes à des stress biotiques et abiotiques. Malgré quelques avancées récentes, ces systèmes restent mal connus sur le plan moléculaire. Mon travail de thèse a consisté à caractériser le rôle physiologique de NAXT2, un membre du sous-groupe NAXT (NitrAte eXcretion Transporter) de la famille des transporteurs NRT1/PTR chez Arabidopsis thaliana. Mes résultats montrent que NAXT2 est un transporteur de NO3– et qu'il est principalement exprimé dans les cellules du péricycle de la racine, au voisinage des vaisseaux xylémiens. Sous contrainte saline et comparativement aux plantes sauvages (WT), un mutant knock-out pour NAXT2 (naxt2-1) présente un défaut de distribution du NO3– vers les feuilles et de sécrétion du NO3– dans la sève xylémienne, qui se traduisent par une diminution des teneurs en NO3– foliaires. NAXT2 est donc impliqué dans la charge du xylème en NO3– sous contrainte saline. Aucune des différences phénotypiques mises en évidence entre le mutant et WT sous contrainte saline n'a été observée sous stress osmotique ou en condition standard, suggérant que NAXT2 est essentiellement impliqué dans la réponse à la composante ionique du stress salin. Enfin, après un traitement salin prolongé, la biomasse foliaire de naxt2-1 est inférieure à celle de WT, ce qui indique que NAXT2 joue un rôle important dans l'adaptation des plantes aux contraintes salines modérées. Dans l'ensemble, ce travail suggère que NAXT2 est impliqué dans une fonction physiologique majeure, la translocation du NO3–, point de contrôle de la distribution du nitrate, et dans l'adaptation de la plante aux contraintes salines. / NO3– secretion systems at the plasma membrane of plant cells play an important role in stomata activity and plant response to biotic and abiotic stresses. Despite of few recent advances, these systems are still poorly known at the molecular level. During my thesis, I worked on the characterization of the physiological role of NAXT2, a member of the NAXT (NitrAte eXcretion Transporter) sub-group from the large NRT1/PTR transporters family in Arabidopsis thaliana. The results presented here show that NAXT2 is a NO3– transporter and that it is mainly expressed in root pericycle cells, close to the xylem vessels. Under salinity constraint and relatively to wild type plants (WT), a NAXT2 knock-out mutant (naxt2-1) displayed a defect in NO3– distribution towards the shoots and in NO3– secretion into the xylem sap, which lead to a decrease in shoot NO3– content. Thus, NAXT2 is involved in NO3– xylem loading under salinity constraint. None of the phenotypic differences described in this work between WT and mutant was observed under osmotic stress or standard culture conditions, suggesting that NAXT2 is specifically involved in response to the ionic component of salt stress. Finally, after a prolonged salt treatment, naxt2-1 shoot biomass was lower than that of WT, indicating that NAXT2 plays an important role in plant adaptation to mild salinity constraint. Altogether, this work suggests that NAXT2 is involved in a major physiological function, the NO3– translocation, control point of nitrate distribution and in plant adaptation to salinity constraint.

Breast cancer is a leading cause of death among women in many countries. In the treatment of the breast cancer cytotoxic drugs (chemotherapy) are often used. Interindividual differences of drug response are an important cause of treatment failures. Bioavailability also depends on a major extent from the expression and activity of drug transport across biomembranes. In particular efflux transporters of the ATP-binding cassette family such as ABCB1, ABCC1 and ABCC2 have been identified as major determinants of chemoresistance in tumor cells. It was hypothesized that variance in the gene expression of membrane transporters and their genetic variance could explain at least in part interindividual differences of pharmacokinetics and clinical outcome of a variety of drugs. This thesis focuses on the functional significance of gene expression of ABCB1, ABCC1 and ABCC2 and single nucleotide polymorphisms in ABCC1 gene.

Protozoan parasites of the genus Plasmodium are the causative agent of malaria. The most severe form of human malaria is caused by P. falciparum, responsible for approximately three quarters of a million deaths each year. One major problem in the treatment of malaria is resistance to existing chemotherapies. Consequently, there is an urgent need to identify and validate novel drug targets. A possible recently identified drug target is the PfNitA protein of P. falciparum which contains orthologues in other Plasmodium species but is absent from humans. The gene is annotated as a putative formate-nitrite transporter and orthologues are found in a range of prokaryotes as well as the lower eukaryotes algae and fungi. To determine the biological function of the protein, pfnita was expressed in Escherichia coli strains lacking the endogenous formate and nitrite transporters. In order to analyse the essentiality of the gene a reverse genetics approach was taken and the data discussed. Results indicate that the PfNitA protein is located in the plasma membrane and digestive vacuole of intraerythrocytic parasites suggesting a role in the uptake or excretion of metabolites. A second complexity with regard to treatment is the lack of a vaccine. A problem in crating a vaccine is antigenic variation. The PIR family of proteins contain a so-called hypervariable domain that has led to the suggestion that the family may play a role in antigenic variation. The objective of the work carried out in this thesis was to investigate the topology and structure of the PcCir2 protein of Plasmodium chabaudi, using E. coli as the expression host. The topology of Cir2 has been examined by means of reporter fusions and overexpression/purification studies undertaken towards crystallisation. As the PcCir2 amino acid sequence does not show significant homology to other proteins, structural data may provide insights into potential functional or binding domains.