Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
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Gas chromatography/mass spectrometry and selected ion monitoring (SIM), employing both electron (EI) and chemical ionization (CI), was used to detect 10-methyloctadecanoic (tuberculostearic) and 2, 4, 8, 8-tetramethyloctacosanoic (C32 mycocerosic) acids in bacteria of 14 species of Mycobacterium and 3 species of Nocardia. Tuberculostearic acid was found in all species studied, while C32 mycocerosic acid was demonstrated only in M. africanum, M bovis, M. bovis strain BCG, M. kansasii and M. tuberculosis. The relative amounts of these acids in the organisms of these five species varied, thereby constituting a presumptive diagnostic technique. The lowest detectable amount of C32 mycocerosic acid was approximately 5 pg when using EI-SIM, monitoring at m/zz 88 and m/z 101. When using CI, employing isobutane as reactant gas, and focusing at m/z 495, 2 pg could be detected, and when ammonia was the reactant gas, the corresponding figure was 1 pg, monitoring at m/z 512. Tuberculostearic acid was demonstrated in 5-day incubated sputum specimens from 6 patients with pulmonary tuberculosis, including 5 patients infected with M tuberculosis and 1 patient infected with M. avium. C32 mycocerosic acid was detected in 4 of the 5 patients with M. tuberculosis infection. None of the acids was found in a further 8 patients who had viral or bacterial (non-mycobacterial) pneumonia. Tuberculostearic acid could be demonstrated in 10 of another 12 sputum specimens from patients with tuberculosis, when the samples were analyzed directly, viz prior to culturing. The possibility of using SIM for the rapid diagnosis of pulmonary tuberculosis is thus worth consideration.
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PMID:Use of selected ion monitoring for detection of tuberculostearic and C32 mycocerosic acid in mycobacteria and in five-day-old cultures of sputum specimens from patients with pulmonary tuberculosis. 679 40

Pneumocystis carinii pneumonia remains a prevalent opportunistic disease among immunocompromised individuals. Although aggressive prophylaxis has decreased the number of acute P. carinii pneumonia cases, many patients cannot tolerate the available drugs, and experience recurrence of the infection, which can be fatal. It is now generally agreed that the organism should be placed with the fungi, but the identification of extant fungal species representing its closest kins, remains debated. Most recent data indicate that P. carinii represents a diverse group of organisms. Since the lack of methods for the continuous subcultivation of this organism hampered P. carinii research, molecular cloning and nucleotide sequencing approaches led the way for understanding the biochemical nature of this pathogen. However, within the last 5 years, the development of improved protocols for isolating and purifying viable organisms from infected mammalian host lungs has enabled direct biochemical and metabolism studies on the organism. The protein moiety of the major high mol. wt surface antigen, represented by numerous isoforms, is encoded by different genes. These proteins are post-transcriptionally modified by carbohydrates and lipids. The organism has the shikimic acid pathway that leads to the formation of compounds which mammals cannot synthesise (e.g., folic acid), hence drugs that inhibit these pathways are effective against the pathogen. Ornithine decarboxylase has now been detected; rapid and complete depletion of polyamines occurs in response to difluoromethylornithine (DFMO). Instead of ergosterol (the major sterol of higher fungi), P. carinii synthesises distinct delta7, C-24-alkylated sterols. An unusual C32 sterol, pneumocysterol, has been identified in human-derived P. carinii. Another signature lipid discovered is cis-9,10-epoxy stearic acid. CoQ10, identified as the major ubiquinone homologue, is synthesised de novo by P. carinii. Atovaquone and other hydroxynaphthoquinone drugs with anti-P. carinii activity probably inhibit pathogen respiration as CoQ analogues. Unlike its effects on Plasmodium, atovaquone does not inhibit the P. carinii dihydroorotate dehydrogenase and pyrimidine metabolism.
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PMID:Pneumocystis carinii pneumonia: the status of Pneumocystis biochemistry. 950 36

Pneumocystis carinii is the paradigm of opportunistic infections in immunocompromised mammals. Prior to the acquired immunodeficiency syndrome (AIDS) pandemic and the use of immunosuppressive therapy in organ transplant and cancer patients, P. carinii was regarded as a curiosity, rarely observed clinically. Interest in this organism exploded when it was identified as the agent of P. carinii pneumonia (PcP), the direct cause of death among many AIDS patients. Aggressive prophylaxis has decreased the number of acute PcP cases, but it remains among the most prevalent opportunistic infections found within this patient population. The taxonomic assignment of P. carinii has long been argued; molecular genetics data now demonstrate that it is a fungus. Several antimycotic drugs are targeted against ergosterol or its biosynthesis, but these are not as effective against PcP as they are against other fungal infections. This can now be explained in part by the identification of the sterols of P. carinii. The organism lacks ergosterol but contains distinct C28 and C29 delta7 24-alkylsterols. Also, 24-methylenelanost-8-en-3beta-ol (C31) and pneumocysterol, (24Z)-ethylidenelanost-8-en-3beta-ol (C32) were recently identified in organisms infecting humans. Together, the delta7 24-alkylsterols and pneumocysterol are regarded as signature lipids of the pathogen that can be useful for the diagnosis of PcP, since no other lung pathogen is known to contain them. Cholesterol (C27), the dominant sterol component in P. carinii, is probably totally scavenged from the host. De novo synthesis of sterols has been demonstrated by the presence of lovastatin-sensitive 3-hydroxy-3-methylglutaryl-CoA reductase activity, the incorporation of radiolabeled mevalonate and squalene into P. carinii sterols, and the reduction in cellular ATP in cells treated with inhibitors of enzymes in sterol biosynthesis.
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PMID:C27 to C32 sterols found in Pneumocystis, an opportunistic pathogen of immunocompromised mammals. 1078 9