RIP140 regulates transcription factor HES1 oscillatory expression and mitogenic activity in colon cancer cells

The transcription factor receptor-interacting protein 140 (RIP140) regulates intestinal homeostasis and tumorigenesis through Wnt signaling. In this study, we investigated its effect on the Notch/HES1 signaling pathway. In colorectal cancer (CRC) cell lines, RIP140 positively regulated HES1 gene expression at the transcriptional level via a recombining binding protein suppressor of hairless (RBPJ)/neurogenic locus notch homolog protein 1 (NICD)-mediated mechanism. In support of these in vitro data, RIP140 and HES1 expression significantly correlated in mouse intestine and in a cohort of CRC samples, thus supporting the positive regulation of HES1 gene expression by RIP140. Interestingly, when the Notch pathway is fully activated, RIP140 exerted a strong inhibition of HES1 gene transcription controlled by the level of HES1 itself. Moreover, RIP140 directly interacts with HES1 and reversed its mitogenic activity in human CRC cells. In line with this observation, HES1 levels were associated with a better patient survival only when tumors expressed high levels of RIP140. Our data identify RIP140 as a key regulator of the Notch/HES1 signaling pathway, with a dual effect on HES1 gene expression at the transcriptional level and a strong impact on colon cancer cell proliferation.

Efficacy, safety, and immunogenicity of a booster regimen of Ad26.COV2.S vaccine against COVID-19 (ENSEMBLE2): results of a randomised, double-blind, placebo-controlled, phase 3 trial

BACKGROUND

Despite the availability of effective vaccines against COVID-19, booster vaccinations are needed to maintain vaccine-induced protection against variant strains and breakthrough infections. This study aimed to investigate the efficacy, safety, and immunogenicity of the Ad26.COV2.S vaccine (Janssen) as primary vaccination plus a booster dose.

METHODS

ENSEMBLE2 is a randomised, double-blind, placebo-controlled, phase 3 trial including crossover vaccination after emergency authorisation of COVID-19 vaccines. Adults aged at least 18 years without previous COVID-19 vaccination at public and private medical practices and hospitals in Belgium, Brazil, Colombia, France, Germany, the Philippines, South Africa, Spain, the UK, and the USA were randomly assigned 1:1 via a computer algorithm to receive intramuscularly administered Ad26.COV2.S as a primary dose plus a booster dose at 2 months or two placebo injections 2 months apart. The primary endpoint was vaccine efficacy against the first occurrence of molecularly confirmed moderate to severe-critical COVID-19 with onset at least 14 days after booster vaccination, which was assessed in participants who received two doses of vaccine or placebo, were negative for SARS-CoV-2 by PCR at baseline and on serology at baseline and day 71, had no major protocol deviations, and were at risk of COVID-19 (ie, had no PCR-positive result or discontinued the study before day 71). Safety was assessed in all participants; reactogenicity, in terms of solicited local and systemic adverse events, was assessed as a secondary endpoint in a safety subset (approximately 6000 randomly selected participants). The trial is registered with ClinicalTrials.gov, NCT04614948, and is ongoing.

FINDINGS

Enrolment began on Nov 16, 2020, and the primary analysis data cutoff was June 25, 2021. From 34 571 participants screened, the double-blind phase enrolled 31 300 participants, 14 492 of whom received two doses (7484 in the Ad26.COV2.S group and 7008 in the placebo group) and 11 639 of whom were eligible for inclusion in the assessment of the primary endpoint (6024 in the Ad26.COV2.S group and 5615 in the placebo group). The median (IQR) follow-up post-booster vaccination was 36·0 (15·0-62·0) days. Vaccine efficacy was 75·2% (adjusted 95% CI 54·6-87·3) against moderate to severe-critical COVID-19 (14 cases in the Ad26.COV2.S group and 52 cases in the placebo group). Most cases were due to the variants alpha (B.1.1.7) and mu (B.1.621); endpoints for the primary analysis accrued from Nov 16, 2020, to June 25, 2021, before the global dominance of delta (B.1.617.2) or omicron (B.1.1.529). The booster vaccine exhibited an acceptable safety profile. The overall frequencies of solicited local and systemic adverse events (evaluated in the safety subset, n=6067) were higher among vaccine recipients than placebo recipients after the primary and booster doses. The frequency of solicited adverse events in the Ad26.COV2.S group were similar following the primary and booster vaccinations (local adverse events, 1676 [55·6%] of 3015 vs 896 [57·5%] of 1559, respectively; systemic adverse events, 1764 [58·5%] of 3015 vs 821 [52·7%] of 1559, respectively). Solicited adverse events were transient and mostly grade 1-2 in severity.

INTERPRETATION

A homologous Ad26.COV2.S booster administered 2 months after primary single-dose vaccination in adults had an acceptable safety profile and was efficacious against moderate to severe-critical COVID-19. Studies assessing efficacy against newer variants and with longer follow-up are needed.

FUNDING

Janssen Research & Development.

[Drug-induced acute angle closure glaucoma]

Acute angle closure glaucoma is an ophthalmic emergency that can lead to blindness in some cases. The presenting signs are often suggestive, like ocular pain and blurred vision accompanied by headache, nausea and vomiting. These symptoms must be recognized as soon as possible, and the patient must be addressed, urgently, to an ophthalmologist for treatment. Many drugs may lead to an acute angle closure glaucoma in patients with risk factors. This article aims to remind the anatomical risk factors as well as the drugs that may induce an acute angle closure glaucoma. For a better understanding, this article will provide a brief reminder of the pathophysiological mechanism of acute angle closure glaucoma.

Spatial dependency of the PPG morphology at right carotid common artery

PhotoPlethysmoGraphy (PPG) is ubiquitously employed in wearable devices for health monitoring. Photodiode signal inversion is observed in rare occasions, most of the time when the sensor is pressed against the skin. We report in this article such observations made at the right common carotid artery site. Indeed we have systematically observed a photodiode signal inversion when the PPG sensor is placed where the pulse is the best felt at the carotid. In addition to be inverted, the pulse is steeper during the systolic phase. Such inversion has implications in terms of pulse arrival time (PAT) measurements In our experiments, this causes a difference of 20 ms in the carotid PAT when measured at the absolute maximum slope. The mechanical and optical properties of tissues must be better accounted to explain the PPG signal morphology. Clinical Relevance- Understanding the role of mechanical tissue properties seems relevant in order to obtain more reproducible results in PPG signal analysis.

Assessing the contribution of diazotrophs to microbial Fe uptake using a group specific approach in the Western Tropical South Pacific Ocean

Diazotrophs are often limited by iron (Fe) availability in the oligotrophic ocean. The Western Tropical South Pacific (WTSP) ocean has been suggested as an intense N2 fixation area due to Fe fertilizations through shallow hydrothermal activity. Yet, the Fe demand of diazotrophs in their natural habitat, where they cohabit with other microbial organisms also requiring Fe, remains unknown. Here we develop and apply a method consisting of coupling 55Fe uptake experiments with cell-sorting by flow cytometry, and provide group-specific rates of in situ Fe uptake by the microbial community in the WTSP, in addition to bulk and size fractionation rates. We reveal that the diazotrophs Crocosphaera watsonii and Trichodesmium contribute substantially to the bulk in situ Fe uptake (~33% on average over the studied area), despite being numerically less abundant compared to the rest of the planktonic community. Trichodesmium had the highest cell-specific Fe uptake rates, followed by C. watsonii, picoeukaryotes, Prochlorococcus, Synechococcus and finally heterotrophic bacteria. Calculated Fe:C quotas were higher (by 2 to 52-fold) for both studied diazotrophs compared to those of the non-diazotrophic plankton, reflecting their high intrinsic Fe demand. This translates into a diazotroph biogeographical distribution that appears to be influenced by ambient dissolved Fe concentrations in the WTSP. Despite having low cell-specific uptake rates, Prochlorococcus and heterotrophic bacteria were largely the main contributors to the bulk Fe uptake (~23% and ~12%, respectively). Overall, this group-specific approach increases our ability to examine the ecophysiological role of functional groups, including those of less abundant and/or less active microbes.

RIP140 regulates POLK gene expression and the response to alkylating drugs in colon cancer cells

Aim: The transcription factor RIP140 (receptor interacting protein of 140 kDa) is involved in intestinal tumorigenesis. It plays a role in the control of microsatellite instability (MSI), through the regulation of MSH2 and MSH6 gene expression. The aim of this study was to explore its effect on the expression of POLK, the gene encoding the specialized translesion synthesis (TLS) DNA polymerase κ known to perform accurate DNA synthesis at microsatellites.

Methods: Different mouse models and engineered human colorectal cancer (CRC) cell lines were used to analyze by RT-qPCR, while Western blotting and luciferase assays were used to elucidate the role of RIP140 on POLK gene expression. Published DNA microarray datasets were reanalyzed. The in vitro sensitivity of CRC cells to methyl methane sulfonate and cisplatin was determined.

Results: RIP140 positively regulates, at the transcriptional level, the expression of the POLK gene, and this effect involves, at least partly, the p53 tumor suppressor. In different cohorts of CRC biopsies (with or without MSI), a strong positive correlation was observed between RIP140 and POLK gene expression. In connection with its effect on POLK levels and the TLS function of this polymerase, the cellular response to methyl methane sulfonate was increased in cells lacking the Rip140 gene. Finally, the association of RIP140 expression with better overall survival of CRC patients was observed only when the corresponding tumors exhibited low levels of POLK, thus strengthening the functional link between the two genes in human CRC.

Conclusion: The regulation of POLK gene expression by RIP140 could thus contribute to the maintenance of microsatellite stability, and more generally to the control of genome integrity.

Artefact subspace reconstruction for both EEG and fNIRS co-registred signals

Combining electroencephalography (EEG) to functional near-infrared spectroscopy (fNIRS) is a promising technique that has gained momentum thanks to their complementarity. While EEG measures the electrical activity of the brain, fNIRS records the variations in cerebral blood flow and related hemoglobin concentrations. However, both modalities are typically contaminated with artefacts. Muscle and eye artefacts, affect the EEG signals, while hemodynamic and oxygenation changes in the extracerebral compartment due to systemic changes (superficial layer) corrupt the fNIRS signals. Moreover, both signals are sensitive to sensor motion artefacts characterized by large amplitude. There are several well-established methods for removing artefacts for both modalities. The objective of this paper is to apply a common approach to denoise both EEG and fNIRS signals. Indeed Artifact Subspace Reconstruction (ASR) method, which is an automatic, online-capable and efficient method for deleting transient or large-amplitude EEG artefacts, can be a good alternative to also denoise fNIRS signals. In this paper, we first propose, a new more comprehensive formulation of ASR. Then, we study the effectiveness of the method in denoising both the EEG and fNIRS signals.

Aliasing affects ActiLife software raw accelerometry to count conversion from different sampling frequencies

Accelerometry counts are widely used to quantify physical activity in an objective manner. ActiGraph™ accelerometers offer to record acceleration signal with different sampling frequency (fs). Nevertheless additional counts were shown to be computed by ActiLife software from acceleration signal with a sampling frequency fs>30 Hz compared to signal with default fs=30 Hz or multiple. This paper relies on the study of synthetic signals to point out the origin of this error and to recommend an adjusted method. A piecewise-frequency sinus time series (0-15 Hz) was generated at different sampling frequencies (fs=30, 50 and 100 Hz). The artificial acceleration raw signal was resampled to 30 Hz using different antialiasing lowpass filters before ActiLife count computation. The use of an antialiasing filter which did not properly attenuate aliasing replicas was found to induce aliasing frequencies within ActiLife bandpass filter which is the cause of extract activity counts. We were able to reproduce fictitious counts for acceleration around 10 Hz. A simple adjustment of antialiasing filter parameters allowed to avoid this problem. This study reproduces ActiLife counts processing from 50 and 100 Hz sampled signal. Count overestimations from fs=50 and 100 Hz signal were induced because of aliasing in the frequency bandwidth of the ActiLife count filter. This can be corrected by a relevant antialiasing filtering before ActiLife software processing or this can be done in high-level mathematical programing.

Evaluation of a dual-PPG system for pulse transit time monitoring

This work presents a new dual-photoplethysmographic (PPG) system for pulse transit time (PTT) monitoring. An experiment has been set up in order to compare the PTT measurement between carotid and radial arteries from two systems: our physiological multimodal platform (PMP) and the Complior® tonometer. This work explores the comparison between such optical and mechanical modalities. The results show that the PPG device tends to overestimate the PTT (RMSE = 16 ms). Furthermore, both mechanical and optical signals have been superposed and demonstrated that pulse morphologies are quite similar.Clinical Relevance-Carotid-radial pulse wave velocity (PWV) is compared on a small cohort of subjects and significant differences are observed between optical and mechanical-based systems.

RIP140 Represses Intestinal Paneth Cell Differentiation and Interplays with SOX9 Signaling in Colorectal Cancer

RIP140 is a major transcriptional coregulator of gut homeostasis and tumorigenesis through the regulation of Wnt/APC signaling. Here, we investigated the effect of RIP140 on Paneth cell differentiation and its interplay with the transcription factor SOX9. Using loss of function mouse models, human colon cancer cells, and tumor microarray data sets we evaluated the role of RIP140 in SOX9 expression and activity using RT-qPCR, immunohistochemistry, luciferase reporter assays, and GST-pull down. We first evidence that RIP140 strongly represses the Paneth cell lineage in the intestinal epithelium cells by inhibiting Sox9 expression. We then demonstrate that RIP140 interacts with SOX9 and inhibits its transcriptional activity. Our results reveal that the Wnt signaling pathway exerts an opposite regulation on SOX9 and RIP140. Finally, the levels of expression of RIP140 and SOX9 exhibit a reverse response and prognosis value in human colorectal cancer biopsies. This work highlights an intimate transcriptional cross-talk between RIP140 and SOX9 in intestinal physiopathology.

[Congenital ocular melanocytosis]

Congenital oculodermal melanocytosis represents a unilateral accumulation of melanocytes in the episclera, sclera and uveal tract. Clinically, it manifests with iris heterochromia, episcleral and scleral pigmented patches, dark pigmentation of the trabecular meshwork and the fundus. This congenital disorder is a predisposing factor for uveal melanoma and chronic glaucoma. We report here the case of a Caucasian woman who presents some of these characteristics.

Direct oral anticoagulants in the treatment of acute venous thromboembolism in patients with obesity: A systematic review with meta-analysis

BACKGROUND

Direct oral anticoagulants' (DOAC) pharmacokinetics are affected by obesity. Their efficacy and safety in obesity (BMI≥30 kg/m²) and morbid obesity (BMI≥40 kg/m²) are still unclear in the treatment of venous thromboembolism (VTE).

OBJECTIVES

To compare the efficacy/safety of DOAC versus vitamin K antagonist (VKA)/low molecular weight heparin (LMWH) for the treatment of VTE in patients with obesity and morbid obesity. The primary efficacy/safety outcomes were VTE recurrence and major bleeding (MB). Clinically relevant non-MB and mortality were also evaluated.

METHODS

A systematic literature search (MEDLINE, EMBASE, CENTRAL, Web of Science) identified studies evaluating DOAC in the treatment of VTE in patients with obesity and reporting one of the outcomes. Relative risks (RR) and 95 % confidence intervals (CI) were estimated using the Mantel-Haenszel method.

RESULTS

We included 21 studies (50,360pts) of which 16,150 patients had a BMI≥30 kg/m² and 6443 patients had a BMI≥40 kg/m². VTE recurrence was similar with DOAC compared to VKA/LMWH in patients with obesity (RR 1.03;95 %CI 0.93-1.15;p = 0.55) and morbid obesity (RR 1.06;95 %CI 0.94-1.19;p = 0.35). DOAC were also associated with a reduction in MB (RR 0.57;95 %CI 0.34-0.94;p = 0.03 and RR 0.71;95 %CI 0.50-1.00;p = 0.05 in patients with obesity and morbid obesity, respectively). Subgroup analyses comparing randomized controlled trials to observational studies showed consistent results. No difference was observed in regards of clinically relevant non-MB and mortality.

CONCLUSION

There is no signal for differences in VTE recurrence in patients with obesity and morbid obesity treated with DOAC compared to VKA/LMWH, while DOAC likely reduce the risk of MB compared to VKA/LMWH.

Blood pressure measurement by coupling an external pressure and photo-plethysmographic signals

This work presents a new technique for the noninvasive measurement of systolic blood pressure (sBP), mean blood pressure (mBP) and diastolic blood pressure (dBP) using photo-plethysmographic (PPG) sensors when an artery is exposed to an external pressure. Two sets of experiments were performed: a first study combining PPG with an oscillometric device and the second combining PPG with a force/pressure sensor. These two experiments enable the estimation of BP values. PPG results were found to be comparable to oscillometric results, with bias and precision errors of -0.81 and 5.26 for sBP, 1.12 and 5.61 for mBP and 1.67 and 9.09 for dBP (n = 28). Furthermore, amplification over the brachial-to-finger path was found to be 1.02 ± 0.08 for mBP (n = 20) confirming that mBP does not undergo any amplification along the arterial tree whereas, for sBP, an amplification of 1.20 ± 0.12 (n = 7) was found for green wavelength, 1.35 ± 0.09 (n = 6) for red wavelength and 1.36 ± 0.09 (n = 6) for infrared wavelength. Thus, amplification for sBP is bigger for red and infrared wavelengths compared to green one.

Long-Term Sheep Implantation of WIMAGINE®, a Wireless 64-Channel Electrocorticogram Recorder

This article deals with the long-term preclinical validation of WIMAGINE^® (Wireless Implantable Multi-channel Acquisition system for Generic Interface with Neurons), a 64-channel wireless implantable recorder that measures the electrical activity at the cortical surface (electrocorticography, ECoG). The WIMAGINE^® implant was designed for chronic wireless neuronal signal acquisition, to be used e.g., as an intracranial Brain–Computer Interface (BCI) for severely motor-impaired patients. Due to the size and shape of WIMAGINE^®, sheep appeared to be the best animal model on which to carry out long-term in vivo validation. The devices were implanted in two sheep for a follow-up period of 10 months, including idle state cortical recordings and Somato-Sensory Evoked Potential (SSEP) sessions. ECoG and SSEP demonstrated relatively stable behavior during the 10-month observation period. Information recorded from the SensoriMotor Cortex (SMC) showed an SSEP phase reversal, indicating the cortical site of the sensorimotor activity was retained after 10 months of contact. Based on weekly recordings of raw ECoG signals, the effective bandwidth was in the range of 230 Hz for both animals and remarkably stable over time, meaning preservation of the high frequency bands valuable for decoding of the brain activity using BCIs. The power spectral density (in dB/Hz), on a log scale, was of the order of 2.2, –4.5 and –18 for the frequency bands (10–40), (40–100), and (100–200) Hz, respectively. The outcome of this preclinical work is the first long-term in vivo validation of the WIMAGINE^® implant, highlighting its ability to record the brain electrical activity through the dura mater and to send wireless digitized data to the external base station. Apart from local adhesion of the dura to the skull, the neurosurgeon did not face any difficulty in the implantation of the WIMAGINE^® device and post-mortem analysis of the brain revealed no side effect related to the implantation. We also report on the reliability of the system; including the implantable device, the antennas module and the external base station.

Physical activity estimation from accelerometry

Objective physical activity (PA) quantification is traditionally achieved using lightweight accelerometers accounting for activity frequency, intensity and duration. The accelerometer data are usually converted into activity counts and these counts can be used on their own to quantify the intensity and duration of a PA period or they can serve as features for energy expenditure computation or activity classification. This paper investigates the way how Actigraph counts are computed. Several points are discussed regarding bandpass filtering and amplitude non-linearities that may hamper some analysis. Experimental data were used 1) to assess reconstructed filter performances to replicate ActiGraph counts during an urban-circuit involving 20 subjects wearing an ActiGraph GT3X+ and 2) explain filter limitations (e.g. plateauphenomenon) thanks to a treadmill test with incremental speed (n=4). This study reproduces well ActiLife filter and reveals the impact of band-pass filtering on ActiLife count conversion. These results provide some keys to interpret knowingly ActiLife count based studies.

[Pseudoxanthoma elasticum revealed by choroidal neovascularization]

Pseudoxanthoma elasticum is a genetic disease caracterised by calcification and fragmentation of elastic fibers affecting primarily the skin, the eyes and the cardiovascular system. We report a case in which the diagnostic was delayed due to an atypical presentation, allowing us to discuss the clinical signs, especially ocular, as well as the diagnosis criteria of this rare pathology. There is no specific treatment to pseudoxanthoma elasticum. It is essential to diagnose it rapidly in order to avoid potentially dramatic systemic outcomes.

A multi-dimensional approach to the relationship between insight and aggressiveness in schizophrenia: Findings from the FACE-SZ cohort

BACKGROUND

Aggressiveness is a stigma frequently associated with schizophrenia. The role of insight as a risk factor of aggressiveness remains contradictory; mainly because single measures of these states mask their complexity and heterogeneity.

METHODS

This study was conducted on 666 patients aged 15 and above with a DSM-IV-TR diagnosis of schizophrenia spectrum disorder, drawn from the French national network of schizophrenia expert center database. Collected data comprised socio-demographics and standardized psychiatric assessments. Aggressiveness was evaluated using the Buss-Perry Aggression Questionnaire and insight using the Scale to assess Unawareness of Mental Disorder (SUMD) and Birchwood Insight Scale (BIS).

RESULTS

Hostility was the aggressiveness dimension the most strongly associated with SUMD insight dimensions. Patients aware of their illness were nearly twice as likely to show hostility than those seriously unaware (OR = 1.95, 95% CI.: 1.08-3.5), but not when further adjusting for depression. Similarly, those aware of the consequences of their illness and of their symptoms were more hostile. Patients moderately aware of illness consequences had a higher risk of both anger and physical aggressiveness than those unaware (OR = 2.63, 95% CI.: 1.42-4.86, OR = 2.47, 95% CI.: 1.33-4.60, respectively), even when adjusting for depression for anger.

CONCLUSION

Our study confirms that a multi-dimensional approach to insight and aggressiveness is essential to understand the types of links between these clinical states. Insight may trigger the expression of an underlying hostile tendency, maybe via depression and self-stigmatisation. This should be taken into account in therapeutic approaches to improve insight.