Cutaneous papillomavirus E6 oncoproteins associate with MAML1 to repress transactivation and NOTCH signaling

Papillomavirus E6 oncoproteins associate with LXXLL motifs on target cellular proteins to alter their function. Using a proteomic approach, we found the E6 oncoproteins of cutaneous papillomaviruses Bovine Papillomavirus Type 1 (BE6) and HPV types 1 and 8 (1E6 and 8E6) associated with the MAML1 transcriptional co-activator. All three E6 proteins bind to an acidic LXXLL motif at the carboxy-terminus of MAML1 and repress transactivation by MAML1. MAML1 is best known as the co-activator and effector of NOTCH induced transcription, and BPV-1 E6 represses synthetic NOTCH responsive promoters, endogenous NOTCH responsive promoters, and is found in a complex with MAML1 in stably transformed cells. BPV-1 induced papillomas show characteristics of repressed NOTCH signal transduction, including suprabasal expression of integrins, talin, and basal type keratins, and delayed expression of the NOTCH dependent HES1 transcription factor. These observations give rise to a model whereby papillomavirus oncoproteins including BPV-1 E6 and the cancer associated HPV-8 E6 repress Notch induced transcription, thereby delaying keratinocyte differentiation.

STUDIES ON THE HEMOLYTIC STREPTOCOCCUS OF HUMAN ORIGIN : I. OBSERVATIONS ON THE VIRULENT, ATTENUATED, AND AVIRULENT VARIANTS

1. Four common variants of the hemolytic streptococcus of human origin have been described. These have been designated the F, M, attenuated M, and C variants. 2. The F and M variants only have been isolated from the blood stream in streptococcal infections. Only the M, however, has any primary virulence for the mouse. 3. Both these variants resist phagocytosis in human blood under suitable conditions, and this appears to be a reliable test for human virulence. 4. The attenuated M variant, found only in laboratory cultures, has a capsule as well developed as that of the virulent variants, and yet does not resist phagocytosis. 5. The C variant has no capsule and is readily phagocyted. It appears to correspond to the avirulent variant in other species. 6. An attempt has been made to correlate these four variants with those already described in the literature. 7. The application of these findings to the problem of virulence has been discussed.

STUDIES ON THE HEMOLYTIC STREPTOCOCCUS OF HUMAN ORIGIN : II. OBSERVATIONS ON THE PROTECTIVE MECHANISM AGAINST THE VIRULENT VARIANTS

1. Anantiserum which specifically protects mice against a virulent culture (M variant) of the hemolytic streptococcus contains specific opsonin. Phagocytosis of the organisms can be observed in the peritoneum of the protected mouse. 2. An antiserum prepared by injecting an animal with the living M variant specifically opsonizes both the F and the M variant of the strain. 3. Evidence is presented which indicates the probable identity of the specific opsonin and the anti-M precipitin of Lancefield (7). Agglutination appears to be dependent upon a different antibody. 4. It is possible to type the hemolytic streptococci by means of specific opsonins, and the opsonic method has certain advantages over agglutination, precipitation, and mouse protection tests. It is evident from what little has been done that there are many types. 5. The serum of infants contains no opsonin for the virulent hemolytic streptococci, but the serum of adults may contain specific opsonins for certain strains. Inasmuch as no opsonins were demonstrable in two polyvalent antibacterial sera examined, the possibilities of therapeutic transfusion are discussed.

Pulmonary Orthopoxvirus infection compromises a murine OVA peptide immune response in a dose-dependent manner (39.8)

Cowpox virus (CPXV), a close relative of variola virus that causes smallpox, can suppress the immune system through a large array of immunosuppressive gene products. We developed a murine model in which DO11.10 T cells specific for an OVA peptide were transferred into BALB/c mice to assess the impact of a pulmonary CPXV infection on DO11.10 T cell proliferation in lung draining lymph nodes following intranasal OVA peptide delivery. High and low-dose CPXV infections were compared. Both doses lead to clinical illness, but the high dose is lethal. A high-dose infection reduced DO11.10 T cell proliferation, but a low-dose infection did not. At the time that proliferation of T cells was assessed (6d),15±1% of lung dendritic cells (DCs) were infected at the high-dose, but only 5±1% of DCs at the low-dose. At both doses, infected and uninfected DCs had decreased expression of co-stimulatory molecules. We speculated that the lung microenvironment created by infection, rather than direct infection of the DCs, suppressed DC immune function. In support, we found that bronchoalveolar lavage fluid and supernatant derived from lung homogenates from infected mice suppressed the function of uninfected lung DCs in vitro. Furthermore, the suppressive activity was more highly concentrated in lungs from high-dose infected mice. These studies strongly suggest that orthopoxvirus infections create an immunosuppressive microenvironment that compromises the host pulmonary immune responses.

A decade of stigma and discrimination in mental health: plus ça change, plus c'est la même chose (the more things change, the more they stay the same)

In recent years, efforts to combat stigma and discrimination experienced by mental health service users have ranged from small local initiatives to national and international campaigns. Success has been mixed, with significant, lasting benefits appearing to be elusive. This paper explores the current nature and extent of stigma and discrimination in an area of the north of England and compares findings with those from a study undertaken a decade previously in 1997. Qualitative responses to a postal questionnaire received in 2007 were thematically analysed and compared and contrasted with findings from the 1997 study. Four broad categories of discrimination--(1) employment; (2) professional; (3) communities; and (4) family and friends--arose from the 2007 data, the most common being discrimination in employment. There were close similarities in both sets of data. Stigma and discrimination remain largely as strong, damaging and enduring as they were a decade ago. A range of pre-emptive interventions that support people prior to the escalation of mental health crises could limit the impact of stigma.

An educational evaluation of supervisor and mentor experiences when supporting primary care graduate mental health workers

This paper reports on the findings of a postal survey used to enhance understanding into the backgrounds, experiences and support offered to supervisors and mentors of Primary Care Graduate Mental Health Workers (PCGMHWs). A postal questionnaire was sent to the total population of supervisors and mentors who had supported PCGMHW students from three universities in the Northwest of England, during the period of their introduction 2004-2006. Most supervisors and mentors had previous experience of supervision and mentorship with other types of students but not PCGMHWs. Data suggest that there were difficulties due limited understanding of the role of PCGMHWs and how it was to be operationalized. Respondents reported staff shortages, time constraints and competing commitments, which limited support available to students. The lack of organizational readiness and infrastructure to support the role was widely reported. However, the role has developed and is generally well received. The implications for future development of the PCGMHW and the preparation and support of supervisors and mentors are discussed.

Mental health crisis and respite services: service user and carer aspirations

There is emerging evidence that crisis resolution services can provide alternatives to hospital admission, reducing demand on inpatient beds. Following a public consultation exercise in Lancashire (England), a team of nurses undertook a study, using interactive research methodology, to gain an understanding of how users and carers define a crisis and what range of crisis services, resources and interventions service users and carers thought would help avoid unnecessary hospital admission. Data collection comprised postal questionnaires and 24 group meetings with service users and carers, which were held during 2006. Data were analysed, and seven themes were identified: (1) definitions of a crisis; (2) access to services; (3) interventions; (4) range of services required (before, during and after crisis); (5) place of treatment; (6) recovery and rehabilitation; and (7) community support. We conclude that expressed preferences of service users and carers for pre-emptive services that are delivered flexibly will present a challenge for service commissioners and providers, particularly where stringent access criteria are used. Home-based pre-emptive services that reduce the need for unnecessary hospital treatment may avoid progression to social exclusion of service users.

The Mental Capacity Act 2005: implications for dietetic practice

The Mental Capacity Act (MCA) 2005 will be implemented in England and Wales in 2007 and have consequences for dietitians who work with people who may lack capacity to make specific decisions. This paper will explore issues arising from the introduction of the Act and considers the implications for dietitians involved in the delivery of clinical care, using enteral feeding as an illustrative example. If patients lack capacity to make specific decisions, dietitians will be required to record if, how and why they reached a decision, how they are involved in the decision making process and need to be able to justify their actions in relation to those decisions. This paper discusses the importance of dietitians' involvement in best interests decision making and considers the implications of decision making where people have drawn up a Lasting Power of Attorney. The role of such advance decisions is discussed and consideration is given to the potential compatibility of perspectives between the patient and family that may give rise to disputes. Dietitians may be well placed within multidisciplinary team working to ensure patients and their carers are part of the decision making process through effective communication and support for patients. Dietitians in England and Wales must consider the implications of the MCA upon their clinical practice and others outside these jurisdictions may like to reflect on the relevance of such developments in their own contexts.

Origins and consequences of mitochondrial decline in nucleated erythrocytes

Cellular aging in nucleated erythrocytes from lower vertebrates is accompanied by losses in mitochondria but it remains unclear (i) how these losses accrue (ii) if these changes alter energetics and (iii) whether such changes increase the propensity for apoptosis. We addressed these questions using trout erythrocytes that were separated into age classes using inherent differences in buoyant density. The oldest cells showed a profound decline in mtDNA transcripts, due to reductions in both transcription (90% decline in total RNA) and mtDNA copy number (35%). No alterations in the ratio of 16S rRNA to COX I mRNA were detected, nor was there an accumulation of unprocessed mtDNA transcripts. While older cells had reduced basal respiration, there were no changes in mitochondrial enzymes stoichiometries, tissue ATP levels or dinitrophenol-induced (maximal) respiration rates. Apoptosis could not be induced in either whole blood, young or old erythrocytes by pro-oxidants, mitochondrial inhibitors or staurosporine. In contrast, cyclosporin A (CsA) caused caspase 3 activation, DNA laddering and LDH leakage, but only in young cells. Both CsA and a combination of azide, oligomycin and dinitrophenol cause mitochondrial depolarization and caspase 9 activation, but only CsA induced caspase 3 and apoptosis. Caspase inhibitor studies support the conclusion that mitochondrial changes may accompany CsA-induced cell death, but are not essential in its progression. While pifithrin failed to induce cell death, it enhanced the effects of CsA, implicating a role for p53. Collectively, these studies suggest that the mitochondrial changes with aging do not compromise cellular function, although trout erythrocytes can initiate apoptosis by non-mitochondrial pathways.