Calcium-dependent Nedd4-2 upregulation mediates degradation of the cardiac sodium channel Nav1.5: implications for heart failure

AIM

Reductions in voltage-gated sodium channel (Nav1.5) function/expression provide a slowed-conduction substrate for cardiac arrhythmias. Nedd4-2, which is activated by calcium, post-translationally modulates Nav1.5. We aim to investigate whether elevated intracellular calcium ([Ca²⁺ ]_i ) reduces Nav1.5 through Nedd4-2 and its role in heart failure (HF).

METHODS

Using a combination of biochemical, electrophysiological, cellular and in vivo methods, we tested the effect and mechanism of calcium on Nedd4-2 and in turn Nav1.5.

RESULTS

Increased [Ca²⁺ ]_i , following 24-h ionomycin treatment, decreased sodium current (I_Na ) density and Nav1.5 protein without altering its mRNA in both neonatal rat cardiomyocytes (NRCMs) and HEK 293 cells stably expressing Nav1.5. The calcium chelator BAPTA-AM restored the reduced Nav1.5 and I_Na in NRCMs pre-treated by ionomycin. Nav1.5 was decreased by Nedd4-2 transfection and further decreased by 6-h ionomycin treatment. These effects were not observed in cells transfected with the catalytically inactive mutant, Nedd4-2 C801S, or with Y1977A-Nav1.5 mutant containing the impaired Nedd4-2 binding motif. Furthermore, elevated [Ca²⁺ ]_i increased Nedd4-2, the interaction between Nedd4-2 and Nav1.5, and Nav1.5 ubiquitination. Nav1.5 protein is decreased, whereas Nedd4-2 is increased in volume-overload HF rat hearts, with increased co-localization of Nav1.5 with ubiquitin or Nedd4-2 as indicated by immunofluorescence staining. BAPTA-AM rescued the reduced Nav1.5 protein, I_Na and increased Nedd4-2 in hypertrophied NRCMs induced by isoproterenol or angiotensin II.

CONCLUSION

Calcium-mediated increases in Nedd4-2 downregulate Nav1.5 by ubiquitination. Nav1.5 is downregulated and co-localizes with Nedd4-2 and ubiquitin in failing rat heart. These data suggest a role of Nedd4-2 in Nav1.5 downregulation in HF.

ASP2409, A Next-Generation CTLA4-Ig, Versus Belatacept in Renal Allograft Survival in Cynomolgus Monkeys

Belatacept is the first costimulatory blockade agent approved for maintenance immunosuppression in kidney transplant recipients. Clinical results have indicated that belatacept is associated with superior renal function and improved metabolic profile; however, higher incidence of acute rejection and posttransplant lymphoproliferative disorder are the shortcomings of this agent. In this study, ASP2409, a new cytotoxic T-lymphocyte associated protein 4-immunoglobulin possessing 14-fold higher in vitro CD86 binding affinity than belatacept, was tested for renal allograft survival in cynomolgus monkeys. ASP2409 monotherapy dose-dependently prolonged renal allograft survival. Low-dose ASP2409 in combination with a subtherapeutic dose of tacrolimus showed much longer median survival time than monotherapy. Similar allograft survival results were observed in regimens based on high-dose ASP2409, belatacept, and therapeutic-dose tacrolimus. The results of renal allograft histopathology with high-dose ASP2409-based regimens were not inferior to the belatacept-based regimen. Moreover, higher frequencies of FoxP3-positive regulatory T cells in renal allografts were observed in ASP2409- and belatacept-based regimens compared with tacrolimus-based regimens. No serious side effects related to ASP2409 administration were found during the study. These data suggest that ASP2409 is a promising candidate for calcineurin inhibitor-sparing or -avoidance regimens.

Significant lethality following liver resection in A20 heterozygous knockout mice uncovers a key role for A20 in liver regeneration

Hepatic expression of A20, including in hepatocytes, increases in response to injury, inflammation and resection. This increase likely serves a hepatoprotective purpose. The characteristic unfettered liver inflammation and necrosis in A20 knockout mice established physiologic upregulation of A20 as integral to the anti-inflammatory and anti-apoptotic armamentarium of hepatocytes. However, the implication of physiologic upregulation of A20 in modulating hepatocytes' proliferative responses following liver resection remains controversial. To resolve the impact of A20 on hepatocyte proliferation and the liver's regenerative capacity, we examined whether decreased A20 expression, as in A20 heterozygous knockout mice, affects outcome following two-third partial hepatectomy. A20 heterozygous mice do not demonstrate a striking liver phenotype, indicating that their A20 expression levels are still sufficient to contain inflammation and cell death at baseline. However, usually benign partial hepatectomy provoked a staggering lethality (>40%) in these mice, uncovering an unsuspected phenotype. Heightened lethality in A20 heterozygous mice following partial hepatectomy resulted from impaired hepatocyte proliferation due to heightened levels of cyclin-dependent kinase inhibitor, p21, and deficient upregulation of cyclins D1, E and A, in the context of worsened liver steatosis. A20 heterozygous knockout minimally affected baseline liver transcriptome, mostly circadian rhythm genes. Nevertheless, this caused differential expression of >1000 genes post hepatectomy, hindering lipid metabolism, bile acid biosynthesis, insulin signaling and cell cycle, all critical cellular processes for liver regeneration. These results demonstrate that mere reduction of A20 levels causes worse outcome post hepatectomy than full knockout of bona fide liver pro-regenerative players such as IL-6, clearly ascertaining A20's primordial role in enabling liver regeneration. Clinical implications of these data are of utmost importance as they caution safety of extensive hepatectomy for donation or tumor in carriers of A20/TNFAIP3 single nucleotide polymorphisms alleles that decrease A20 expression or function, and prompt the development of A20-based liver pro-regenerative therapies.

Tormentic acid reduces inflammation in BV-2 microglia by activating the liver X receptor alpha

Tormentic acid (TA) has been reported to have anticancer, anti-inflammatory and anti-atherogenic properties. However, the effects of TA on neuroinflammation have not been reported. In this study, we investigated whether TA inhibited lipopolysaccharide (LPS)-induced inflammatory response in BV2 microglia cells. BV2 microglia cells were treated with TA for 1h before exposure to LPS. The expression of inducible nitric oxide synthase (iNOS), Cyclooxygenase-2 (COX-2), Nuclear factor κB (NF-κB) and liver X receptor alpha (LXRα) was detected by western blotting. The expression of cytokines Tumor necrosis factor-alpha (TNF-α) and interleukin 1beta (IL-1β) was detected by enzyme-linked immunosorbent assays (ELISA). Results showed that TA inhibited nitric oxide (NO), prostaglandin E2 (PGE2) production by inhibiting iNOS and COX-2 expression. TA also inhibited LPS-induced inflammatory cytokines TNF-α and IL-1β expression. Furthermore, TA could activate LXRα and inhibit LPS-induced NF-κB activation. Knowdown of LXRα reversed the anti-inflammatory effects of TA. In conclusion, our results indicate that TA exerts an anti-inflammatory effect on LPS-stimulated BV2 microglia cells by activating LXRα.

Differences and determinants in access to essential public health services in China: a case study with hypertension people and under-sixes as target population

BACKGROUND

Since 2009, health reform had launched in China and essential public health services were provided for all residents to ensure service equity and accessibility, and to achieve sustained population-wide health improvement. This study aimed to investigate the differences and determinants among populations with different characteristics access to essential public health services in China, especially hypertension people and children aged 0-6 years.

METHODS

A cross-sectional study with socio-demographic data analysis was undertaken to estimate distribution characteristics of receiving essential public health services of hypertension patients and children. Regular follow-ups and effective blood pressure control reflected the effective management for hypertension patients, and for children, public services provided were vaccination on schedule and regular physical check-up. Logistic regression was used to determine the predictors for effective management.

RESULTS

A total of 1 505 hypertension patients and 749 children were involved; 39.14% of hypertension participants could control their blood pressure in the normal range, and the rate in urban areas (43.61%) was higher than that in rural (31.88%). And 34.68% of them could receive more than 4 times follow-ups by the medical technician. Of 754 children, 79.84% could receive the periodic physical examination and 98.40% had vaccinated regularly. Children living in rural areas were more likely to have regular check-ups (83.96%) and regular vaccination (nearly 99%). Overall, geographic location and education level were the determinants of people access to essential public health services.

CONCLUSIONS

Implementation of the health reform since 2009 has headed China's public health system in the right direction and promoted the improvement of public health system development. Our study highlights the growing needs for more public health services in China, and China's public health system needs to be greatly improved in terms of its quality and accessibility.

Melting of polymer single crystals studied by dynamic Monte Carlo simulations

We report dynamic Monte Carlo simulations of lattice polymers melting from a metastable chain-folded lamellar single crystal. The single crystal was raised and then melted in an ultrathin film of polymers wetting on a solid substrate, mimicking the melting observations made by using Atomic Force Microscopy. We observed that the thickness distribution of the single crystal appears quite inhomogeneous and the thickness increases gradually from facetted edges to the center. Therefore, at low melting temperatures, melting stops at a certain crystal thickness, and melting-recrystallization occurs when allowing crystal thickening; at intermediate temperatures, melting maintains the crystal shape and exhibits different speeds in two stages; at high temperatures, fast melting makes a melting hole in the thinnest region, as well as a saw-tooth-like pattern at the crystal edges. In addition, the linear melting rates at low temperatures align on the curve extrapolated from the linear crystal growth rates. The temperature dependence of the melting rates exhibits a regime transition similar to crystal growth. Such kinetic symmetry persists in the melting rates with variable frictional barriers for c -slip diffusion in the crystal as well as with variable chain lengths. Visual inspections revealed highly frequent reversals upon melting of single chains at the wedge-shaped lateral front of the lamellar crystal. We concluded that the melting kinetics is dominated by the reverse process of intramolecular secondary crystal nucleation of polymers.

Engineer’s role in resolving disputes in offshore projects

Offshore construction and supply projects involve complex contractual arrangements regulating the relationships of operators, contractors, subcontractors and suppliers. Although every effort is made to prevent the occurrence of disputes when parties enter into contract, it is a fact of life that disputes do arise. This paper explains the role of engineers in the dispute resolution process. It highlights the features of disputes which arise out of the offshore construction and supply industry by way of inclusion of a description of: the life cycle of a typical offshore development; a typical engineering, procurement, construction, installation and commissioning project; the engineer’s involvement in the contractual process; types of frequently occurring disputes; and the role of engineers in dispute avoidance. By way of introducing the various methods of disputes resolution, including litigation, arbitration, adjudication, expert determination, mediation, the engineers’ functions in these processes are highlighted.’The paper concludes that engineers are indeed important if not crucial to every stage of an oil and gas construction project. They have every opportunity to assist in dispute avoidance by being more aware of the contractual relationship between various parties and the project procedure. They can be factual witnesses to set out the chain of events that happened, expert witnesses to assist the court or tribunal in understanding the technical issues, and they are also well placed to judge the rights and wrongs of the parties given their technical backgrounds in understanding the day-to-day running of a project.

The toxic activities of Arisaema erubescens and Nerium indicum mixed with Streptomycete against snails

The comparative molluscicidal activities of Arisaema erubescens tuber extracts and Nerium indicum leaf extracts mixed with Streptomycete violacerruber dilution (SD) against the snail Oncomlania hupensis and the responses of the isozymes, esterase (EST) and superoxide dismutase (SOD) to the A. erubescens extracts and the mixtures were investigated. The molluscicidal activity of A. erubescens water extracts mixed with S. violacerruber dilution was 4-5 times higher than a single A. erubescens or S. violacerruber dilution after 24-h exposure, and is also higher than that of N. indicum leaf water extracts mixed with S. violacerruber dilution. At the end of exposure to the N-butanol extracts of A. erubescens tubers (NEAT), the EST activity in snail liver decreased and some enzyme bands (EST 1 and EST 3 in exposure to NEAT) disappeared but the activities of SOD 1 increased. The effect was more obvious in mixture treatment than in single NEAT or SD treatment. The results indicated that molluscicidal activities of plant and microorganism could be more effective than single plant. The decline of the detoxic ability in snail liver cells could be the reason of the snail dying.