The ntd operon in Bacillus subtilis is essential for biosynthesis of 3,3'-neotrehalosadiamine (NTD), an unusual nonreducing disaccharide reported to have antibiotic properties. It has been proposed that the three enzymes encoded within this operon, NtdA, NtdB, and NtdC, constitute a complete set of enzymes required for NTD synthesis, although their functions have never been demonstrated in vitro. We now report that these enzymes catalyze the biosynthesis of kanosamine from glucose-6-phosphate: NtdC is a glucose-6-phosphate 3-dehydrogenase, NtdA is a pyridoxal phosphate-dependent 3-oxo-glucose-6-phosphate:glutamate aminotransferase, and NtdB is a kanosamine-6-phosphate phosphatase. None of these enzymatic reactions have been reported before. This pathway represents an alternate route to the previously reported pathway from Amycolatopsis mediterranei which derives kanosamine from UDP-glucose.
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Glioma is the most common type of tumor in the central nervous system (CNS). Diagnosis is made by history, physical examination, radiology, histology and molecular profiles. Magnetic resonance imaging is a standard workup for all CNS tumors. Multidisciplinary team management is strongly recommended. The management of low grade gliomas is still controversial with regards to early surgery, radiotherapy, chemotherapy, versus watchful waiting. Patients with suspected high grade gliomas should undergo assessment by neurosurgeons for consideration of maximum safe resection to achieve optimal tumor debulking, and to provide adequate tissue for histologic and molecular diagnosis. Post-operative radiotherapy and/or chemotherapy are given depending on disease grade and patient performance. Most consider glioblastoma incurable. Treatment approaches in the elderly, pediatric population and recurrent gliomas are discussed with latest updates in the literature. Treatment considerations include performance status, neurocognitive functioning, and co-morbidities. Important genetic mutations, clinical trials and guidelines are summarized in this review.
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