1.Detection and characterization of mutations of multidrug-resistant tuberculosis isolates of the Philippine General Hospital
Catangui Franco Antonio C ; Yuga Ann Camille Q ; Ganchua Sharie Keanne C ; Ang Concepcion F ; Mendoza Myrna T ; Parungao-Balolong Marilen M ; Destura Raul V ; Heralde III Francisco M
Acta Medica Philippina 2012;46(1):22-27
Background. Emergence of multidrug-resistant tuberculosis (MDR-TB) poses a major challenge to prevailing disease management. MDR-TB arises from mutations in several genes comprising the resistance determining regions, including rpoB, katG and gyrA.
Objective. To detect and characterize mutations in rpoB, katG and gyrA.
Methods. Thirty selected Mycobacterium tuberculosis isolates from the IDS-PGH were subjected to PCR amplification and sequencing. Sequences were compared to the wild type strain H37Rv.
Results. Mutations were detected in codons 512, 513, 516, 522, 526, 531 and 533 of rpoB, codons 280, 281, 315 and 333 of katG, and codons 90 and 94 of gyrA sequences. The most frequently mutating codons for rpoB, katG and gyrA were 531, 315 and 94, respectively. A clustering analysis of the sequences showed occurrence of seven, four and three clusters for the genes rpoB, katG and gyrA, respectively. The eight clusters obtained from the concatenated sequences of the three genes represent the eight potential genotypes of local strains. One cluster represents the wild type strain genotype, another cluster represents the XDR strain genotype, and six clusters represent the MDR strain genotypes.
Conclusion. These findings indicate the utility of multiple RDR sequence analysis in both identifying specific drug resistance mutation and genotyping of various M. tuberculosis isolates.
TUBERCULOSIS
;
THERAPEUTICS
;
THERAPY
2.Perceptions on susceptibility to exposure to the COVID-19 virus: A qualitative study on pregnant and non-pregnant adult women, their partners, and healthcare workers in Metro Manila
Maria Stephanie Fay S. Cagayan ; Erlidia F. Llamas-Clark ; Basil Stephen S. Cagayan ; Francisco M. Heralde III ; Rodrigo Angelo C. Ong
Acta Medica Philippina 2022;56(16):108-118
Introduction:
The World Health Organization (WHO) reported that special populations are more susceptible to the COVID-19 virus. There is little information on whether COVID-19 affects women of reproductive age and their fertility, pregnancy status, and offspring give: We aimed to assess the knowledge, practices, and perceptions (KPP) on the risk and susceptibility to COVID-19 of women of reproductive age.
Methods:
We conducted a qualitative exploratory descriptive study using the triangulation method. The study
consisted of in-depth interviews (IDIs) with women of reproductive age and their spouses, focus group discussions (FGDs), and key informant interviews (KIIs) with health care professionals (HCP) in University of the Philippines-Philippine General Hospital. We assessed KPP using structured, open-ended interview guides. Interview responses were recorded and transcribed verbatim, and thematic analysis was performed using NVivo 12.
Results:
Eighty participants, 20 women of reproductive age, 20 spouses, 20 non-pregnant women, and 20 HCPs
in UP-PGH were included in the study. All participants were knowledgeable about COVID-19. Pregnant women
would consult their physicians when they felt symptoms related to COVID-19. Spouses of pregnant women and
non-pregnant women observed health measures to prevent the spread of the virus. Both pregnant and non-pregnant patients with COVID-19 felt shamed and stigmatized while the husbands worried that the exposure to the infection will pose a burden to their families. HCWs provided services through teleconsultation and found it challenging to refer patients to other facilities.
Conclusion
The study provided insights on KPP of women with reproductive-age to COVID-19 and views of HCWs in providing care to these patients during the pandemic. The effects of COVID-19 are still detrimental and highly evident from the micro to the macro level.
Qualitative Research
;
Knowledge
;
Perception
;
COVID-19
3.Preliminary identification of Human Leukocyte Antigen (HLA) CLASS II DRB1 Allelic variants in selected Filipino cancer patient samples
Jemicah Tristian P. Cobarrubias ; Ciara Christianne Y. Lim ; Ma. Teresa A. Barzaga ; Francisco M. Heralde III
Acta Medica Philippina 2020;54(4):407-414
Objective:
The Human Leukocyte Antigen (HLA) Class II is the major histocompatibility complex surface glycoproteins of humans responsible for presenting exogenous antigenic peptides which help direct specificity of immune response. In immune-cell therapy, the HLA allelic variants are of particular importance as they determine the successful activation of target cells that results to a desired therapeutic response. However, HLA Class II exhibits high polymorphism and has variable distribution in population, constituting these so-called allelic variants. Specifically, the HLA Class II DRB1 is considered the predominant locus among Filipinos. This research aimed to identify the presence of HLA Class II DRB1 allelic variants in the stem cell samples of ten (10) Filipino cancer patients by reverse transcription polymerase chain reaction (RT-PCR) amplification.
Method:
This study employed a PCR-based HLA Class II typing to identify the HLA Class II DRB1 allelic variant in Filipino cancer patients. Design of forward and reverse primers for HLA Class II DRB1, optimization of PCR conditions for amplifying HLA Class II DRB1, and identification of HLA Class II DRB1 allelic variants from samples by sequencing and database comparison were conducted.
Results:
PCR optimization showed that optimum annealing temperature for HLA DRB1 was 58.8°C with 1 mM MgCl2. PCR amplification of HLA DRB1 from ten anonymized cancer patient samples and DNA sequencing revealed that Patients 1, 2, 5, 8, 9, and 10 harbor HLA DRB1 allelic variants, particularly, the HLA DRB1*04:06:01, HLA DRB1*12:01:01, HLA DRB1*0813, HLA DRB1*04:05:01, HLA DRB1*09:01:02, and HLA DRB1*16:02:01, allelic variants, respectively.
Conclusion
Using the designed primers and optimized RT-PCR protocol, HLA information derived from six out of ten patient samples can be used for further applications in developing personalized or generic antigenic peptides such as dendritic cell cancer vaccine.
HLA Antigens
4.In silico prediction of SARS-CoV-2 epitopes for vaccine development
Kitz Paul D. Marco ; Julia Patricia B. Llagas ; Maria Teresa A. Barzaga ; Francisco M. Heralde III
Philippine Journal of Health Research and Development 2020;24(4):1-19
The ongoing coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is causing major damages in health and economies worldwide. The development of safe and effective vaccines for COVID-19 is of utmost importance yet none have been licensed to date. One of the strategies for vaccine development utilizes dendritic cells which express class I and class II human leukocyte antigen (HLA) molecules. These HLA molecules present the antigenic peptides to T cells which mediate the immune response. Thus, the study aimed to identify SARS-CoV-2 peptides with potential binding to HLA class I and class II molecules using different bioinformatics tools. SYFPEITHI and IEDB were used to predict epitopes for the most common HLA class I and II alleles among Filipinos. The top predicted epitopes were subjected to de novo and template-based molecular docking. Then, binding energies of the generated peptide-HLA complexes to putative T cell receptors were predicted using a homology modeling approach. Several predicted epitopes showed promising MHC and TCR binding, although results varied considerably between the prediction methods used. In particular, the results of de novo and template-based docking
methods did not coincide, the latter of which generated complexes that more closely resemble typical
peptide-HLA complexes. The results of this study will be validated by the next stage of the vaccine
development project which is the in vitro assessment of the T cell responses elicited by dendritic cells pulsed with the candidate peptides.
COVID-19
;
SARS-CoV-2
;
Vaccines
;
Molecular Docking Simulation
5.Molecular biomarkers detected using fluorescence in situ hybridizationin a Filipino with retinoblastoma
Arnold Dominic A. Barzaga ; Glenmarie Angelica S. Perias ; Lia Angela E. Reyes ; Patrick Gabriel G. Moreno ; Patrick R. Relacion ; Richelle Ann M. Manalo ; Yasmyne C. Ronquillo ; Francisco M. Heralde III
Acta Medica Philippina 2024;58(10):99-107
Background and Objective:
Retinoblastoma is one of the most common intraocular cancers among children usually caused by the loss of retinoblastoma protein function. Despite being a highly heritable disease, conventional diagnostic and prognostic methods depend on clinical examination, with limited consideration of cancer genetics in the standard of care. CD133, KRT19, and MUC1 are commonly explored genes for their utility in liquid biopsies of cancer including lung adenocarcinoma. To date, there are few extensive molecular studies on retinoblastoma in Filipino patients. To this end, the study aimed to describe the copy number of CD133, KRT19, and MUC1 in retinoblastoma samples from a Filipino patient and quantitate the respective expression level of these genes.
Methods:
Hematoxylin & Eosin (H&E) staining was utilized to characterize the retinoblastoma tissue while fluorescence in situ hybridization (FISH) using probes specific to CD133, KRT19, and MUC1 was performed to determine the copy number of genes in retinoblastoma samples from a Filipino patient (n = 1). The gene expression of CD133, MUC1, and KRT19 was quantitated using RT-qPCR.
Results:
The H&E staining in the retinoblastoma tissue shows poorly differentiated cells with prominent basophilic nuclei. CD133 was approximately 1.5-fold overexpressed in the retinoblastoma tissue with respect to the normal tissue, while MUC1 and KRT19 are only slightly expressed. Multiple intense signals of each probe were localized in the same nuclear areas throughout the retinoblastoma tissue, with high background noise.
Conclusion
These findings suggest that CD133 is a potential biomarker for the staging and diagnosis of retinoblastoma in Filipino cancer patients. However, further optimization of the hybridization procedures is recommended.
Retinoblastoma
;
Biomarkers
;
In Situ Hybridization
6.UPLC-QTOF mass spectrometry detection of four endocrine disrupting chemicals (Methyl Paraben, 2,4-Dichlorophenoxyacetic acid, Monobutyl Phthalate, and Bisphenol A) in urine of Filipino women
Francisco M. Heralde III ; Zaidy T. Martin ; Maria Stephanie Fay S. Cagayan ; Ma. Esterlita V. Uy ; Paulyn Jean R. Ubial ; Michael C. Velarde ; Erlidia F. Llamas-Clark
Acta Medica Philippina 2024;58(Early Access 2024):1-10
Background and Objective:
Endocrine Disrupting Chemicals (EDCs) are ubiquitously found as low-level contaminants and pose serious threat to women’s health. EDCs may result in various reproductive disorders, fetal birth and developmental abnormalities, and endocrine and metabolic disorders. EDCs can be detected in body fluids of exposed individuals including blood and urine. This study aimed to detect four EDCs — Methyl Paraben (MP), 2,4-Dichlorophenoxyacetic acid (2,4-D), Monobutyl Phthalate (MBP), and Bisphenol A (BPA) in urine samples of women using Ultra-Performance Liquid Chromatography – Quadrupole Time-of-Flight (UPLC-QTOF) mass spectrometry.
Methods:
Sequential steps of enzymatic deconjugation, liquid-liquid extraction, solid phase extraction, and liquid chromatography separation and mass spectrometry detection were optimized in urine samples. The method was used to analyze 70 urine samples from women of reproductive age.
Results:
The sample preparation method showed a recovery ranging from 86.6% (MBP) to 100 % (2,4-D). The method demonstrated limits of quantitation ranging from 1.52 ng/m(MP) to 6.46 ng/mL(2,4D). Intra-day precisions expressed as relative standard deviation were all below 15% while accuracy was shown to range from 67.10% (2,4-D) to 102.39% (MBP). MP was detected in nine samples (12.86%) with a geometric mean value of 10.15 ng/ml (range: 3.62-52.39 ng/ml). MBP was detected in 68 samples (97.14%) with a geometric mean value of 97.62 ng/ml (range: 15.32-698.18 ng/ml). BPA was detected only once (9.58 ng/ml) while 2, 4-D was not detected in all samples.
Conclusion
A UPLC-QTOF mass spectrometry method to detect four EDCs at parts per billion level (ng/ml) was adapted and applied for analysis of urine samples. This method can find applicability in routine testing of clinical specimens as well as surveillance and other epidemiological studies.
Endocrine Disruptors
7.Comparative copy number variation profiling of GL01, an immortalized non-small cell lung cancer cell line derived from a Filipino patient, and A549 lung adenocarcinoma cells
Treena Rica D. Teh ; Kim Claudette J. Fernandez ; Maria Katrina Diana M. Cruz ; Patrick Gabriel G. Moreno ; Ruel C. Nacario ; Gladys C. Completo ; Francisco M. Heralde III
Acta Medica Philippina 2024;58(Early Access 2024):1-15
Background and Objectives:
Cell lines serve as invaluable tools in studying lung cancer biology and developing new therapies to combat the disease. However, commercially available cell lines are typically of Caucasian origin and may be less representative of the local genetic background. To address this, our lab previously immortalized cells from pleural fluid of a Filipino non-small cell lung cancer (NSCLC) patient via CDK4 transduction. Copy number variations (CNVs) are a type of genetic variation which may affect physiology and disease by disrupting gene function or altering gene expression, and in cancer, these may be associated with patient outcomes. CNV profiling can be valuable for understanding the biology of our immortalized cells and identifying genes that could serve as potential targets for diagnostic, prognostic, and therapeutic interventions. This study aimed to characterize previously immortalized NSCLC-derived cells, GL01, in comparison with an established lung adenocarcinoma (LUAD) cell line, A549, through whole-genome microarray-based copy number profiling.
Methods:
DNA was extracted from GL01 and A549 cells using a commercially-available silica-based DNA extraction kit. DNA extracts were quantified and normalized for microarray analysis. Whole-genome copy number profiling was done using the OncoScan CNV Plus Assay following the manufacturer’s protocols, and data was analyzed using the Chromosome Analysis Suite software. Functional analysis of genes identified to be involved in copy number aberrations was done using the PANTHER Classification System.
Results:
Copy number aberrations span 1,592,737,105 bp in GL01 and 1,715,708,552 bp in A549, with a high degree of concordance between the two. Largescale and focal copy number aberrations previously identified to be recurrent in various LUAD cohorts were present in both GL01 and A549. Focal copy number aberrations associated with previously described lung cancer-related genes involve the PDE4D gene in GL01 and the SKIL and CDKN2A/CDKN2B genes in both GL01 and A549. PANTHER Pathway analysis of genes positively correlated with mRNA expression showed that the ubiquitin proteasome pathway was significantly overrepresented in both GL01 (FDR p = 0.000074) and A549 (FDR p = 0.000075), with 20 genes involved. Additionally, the KRAS:p.G12C/S:c.34G>T/A somatic mutation variant was detected in both GL01 and A549.
Conclusion
This study provides a method for identifying potentially clinically-relevant genes associated with a sample’s copy number aberrations and the pathways they represent, providing personalized mechanistic, prognostic, and therapeutic insights into the cancer biology of our cells.
carcinoma, non-small cell lung
;
adenocarcinoma of lung
8.Exposure of reproductive-aged pregnant and nonpregnant women to common environmental pollutants and endocrine-disrupting chemicals A cross-sectional survey at the University of the Philippines-Philippine General Hospital
Erlidia F. Llamas-Clark ; Francisco M. Heralde, III ; Maria Stephanie Fay S. Cagayan ; Maria Esterlita V. Uy ; John Robert Medina ; Paulyn Jean R. Ubial
Philippine Journal of Obstetrics and Gynecology 2023;47(1):3-10
Context:
Exposure to environmental pollutants (EP) and Endocrine-disrupting chemicals (EDCs) is associated with several general negative health effects which compromise women's reproductive health, maternal, and neonatal outcomes. Unfortunately, many nonpregnant and pregnant women are unaware of their active exposure to these potentially slow-acting toxic substances, EPs, and EDCs. At any stage of life, and in the long-term minute exposures, there is no established safe level of exposure to these substances. Due to the potentially harmful effects on women in general, and to the pregnant and her unborn child in particular, it is important to establish the prevalence of their exposure.
Aims:
The aim of this study was to determine the magnitude (prevalence) of exposure among nonpregnant and pregnant women aged 18–49 years to common EPs/EDCs such as bisphenol A, pesticides, phthalates, and perfluorinated compounds among others.
Settings and Design :
This study was conducted at the Philippine General Hospital, University of the Philippines Manila.
Subjects and Methods :
The study participants were nonpregnant and pregnant women, with low-risk singleton pregnancy, and had a prenatal checkup and eventual delivery at the Philippine General Hospital. After consent, women were asked to answer a survey focused on their sociodemographics and frequency of exposure to EP- and EDC-containing items.
Satatistical Analysis Used:
Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Null hypotheses were rejected at 0.05 α-level of significance. The computer software STATA 13.1 was used for data analysis.
Results:
One hundred and fifty-nine survey responses by women were analyzed. Possible EDC-containing household items (carpets, linoleum, upholstered, and stain-resistant furniture) are more prevalent in the homes of pregnant women compared to nonpregnant women. Pregnant women are also exposed to wallpapers compared to nonpregnant individuals. Nonpregnant women were 1.5 times more exposed to lotions. Unexposure to hand sanitizers is 1.3 times higher among pregnant individuals.
Conclusions
There are differences in the prevalence of exposure to household EDC-containing items between pregnant and nonpregnant women, with pregnant women having a higher prevalence of exposure.
Endocrine-disrupting chemicals
;
environmental pollutants
;
pregnancy
9.Method validation study for SARS-CoV-2 viral RNA detection in cervical, rectal, amniotic fluid, placental, umbilical cord blood, and breastmilk specimens in a cohort of unvaccinated women in Manila, Philippines
Erlidia F. Llamas-Clark ; Mayan U. Lumandas ; Daniel C. Villarico ; Amalea Dulcene D. Nicolasora ; Maria Stephanie Fay S. Cagayan ; Emmanuel S. Baja ; Maria Esterlita T. Villanueva-Uy ; Paulyn Jean B. Rosell-Ubial ; Francisco M. Heralde III
Acta Medica Philippina 2024;58(15):32-38
OBJECTIVES
To validate a method in detecting SARS-CoV-2 via RT-qPCR in pregnant and non-pregnant samples other than nasopharyngeal swabs and/or oropharyngeal swabs such as cervical, rectal, amniotic fluid, placental, umbilical cord blood, and breastmilk.
METHODSWe performed a validation experiment using MGI easy extraction kits and BGI PCR kits on non-conventional specimens, including cervical, rectal, amniotic fluid, placental, umbilical cord blood, and breastmilk to detect and confirm the presence of SARS-CoV-2. In addition, we tested the validated method on 572 purposively sampled field-collected non-conventional specimens from a cohort of 109 unvaccinated pregnant and 47 unvaccinated non-pregnant women to assess which candidate non-conventional maternal- and fetal-associated specimens may contribute to maternal-fetal viral vertical transmission.
RESULTSPositive detection of SARS-CoV-2 viral RNA in non-conventional specimens was demonstrated and verified. Of the 572 non-conventional samples tested, 1.8% (10/572) were positively validated by RT-qPCR for SARS-CoV-2 in the maternal-associated specimens particularly the rectal (5), placental (1), and cervical (4) swabs among six pregnant and four non-pregnant individuals. In contrast, no SARS-CoV-2 viral RNA was detected in fetal-associated specimens.
CONCLUSIONThe results of the validation study may serve as an additional diagnostic screening layer to support maternal-child care. Furthermore, viral detection in these non-conventional maternal specimens may also be utilized to provide guidance in the clinical management of neonates, and pregnant women during delivery.
Philippines ; Sars-cov-2 ; Pregnant Women ; Umbilical Cord ; Amniotic Fluid ; Polymerase Chain Reaction ; Placenta
10.The association of endocrine-disrupting chemicals exposure, sociodemographic factors, and polycystic ovarian syndrome among reproductive-aged nonpregnant women at the Philippine General Hospital: A case–control study
Erlidia Flores Llamas-Clark ; John Robert Carabeo Medina ; aria Esterlita Tagle Villanueva-Uy ; Francisco M. Heralde III ; Maria Stephanie Fay Samadan Cagayan ; Paulyn Jean Buenaflor Rosell-Ubial ; Michael C. Velarde
Philippine Journal of Obstetrics and Gynecology 2024;48(3):151-161
BACKGROUND:
Polycystic ovarian syndrome (PCOS) is a prevalent condition affecting women of reproductive age, characterized by metabolic, endocrine, and reproductive disturbances including insulin resistance, abnormal uterine bleeding, infertility, and hyperandrogenism, and is associated with diabetes and cardiovascular disease. The etiology of PCOS is unclear and exposure to endocrine-disrupting chemicals (EDCs) present in everyday products may play a role by disrupting hormonal pathways.
OBJECTIVES:
To determine the association between exposure to EDC-containing products, sociodemographic factors, and PCOS diagnosis among nonpregnant reproductive-aged women.
MATERIALS AND METHODS:
A survey assessed the frequency of EDC exposure in homes and workplaces. The Rotterdam Criteria were used for the diagnosis of PCO features with clinical history and ultrasound. The association between PCOS and EDC exposure was determined using Chi-square and logistic regression analysis.
RESULTS:
The study identified significant sociodemographic factors associated with PCOS (P < 0.001) including age, civil status, and household income. Increased likelihood of PCOS was linked to frequent use of scented candles (odds ratio [OR] = 2.07), cleaning sprays (OR = 2.28), and floor polish (OR = 2.07), exposure to new upholstered furniture (OR = 4.00), thermal receipts (OR = 2.16), and consumption of microwaved and processed foods (OR = 2.60), as well as water sourced from wells (OR = 7.69). Additional associations were found with access to public markets (OR = 0.26) and the use of paper food wrappers (OR = 1.72).
CONCLUSION
These findings suggest that frequent exposure to EDC-containing products and certain sociodemographic factors may contribute to the development of PCOS among women of reproductive age. Results underscore the importance of reducing exposure to EDCs to prevent or mitigate the development of PCOS and other reproductive consequences.
Female