HMGXB4 Targets Sleeping Beauty Transposition to Germinal Stem Cells

Transposons are parasitic genetic elements that frequently hijack vital cellular processes of their host. HMGXB4 is a known Wnt signaling-regulating HMG-box protein, previously identified as a host-encoded factor of Sleeping Beauty (SB) transposition. Here, we show that HMGXB4 is predominantly maternally expressed, and marks both germinal progenitor and somatic stem cells. SB piggybacks HMGXB4 to activate transposase expression and target transposition to germinal stem cells, thereby potentiating heritable transposon insertions. The HMGXB4 promoter is located within an active chromatin domain, offering multiple looping possibilities with neighboring genomic regions. HMGXB4 is activated by ERK2/MAPK1, ELK1 transcription factors, coordinating pluripotency and self-renewal pathways, but suppressed by the KRAB-ZNF/TRIM28 epigenetic repression machinery, also known to regulate transposable elements. At the post-translational level, SUMOylation regulates HMGXB4, which modulates binding affinity to its protein interaction partners and controls its transcriptional activator function via nucleolar compartmentalization. When expressed, HMGXB4 can participate in nuclear-remodeling protein complexes and transactivate target gene expression in vertebrates. Our study highlights HMGXB4 as an evolutionarily conserved host-encoded factor that assists Tc1/Mariner transposons to target the germline, which was necessary for their fixation and may explain their abundance in vertebrate genomes.

[Comparison of catheter-associated quality of life in external urinary diversion: nephrostomy vs. suprapubic catheter]

Einleitung

Die katheterbezogene Lebensqualität (LQ) bei Nephrostomieträgern wurde bisher noch nie systematisch untersucht. Dies sollte nun erstmalig vergleichend mit einer ebenfalls externen Urinableitung, dem suprapubischen Katheter, geschehen.

Methodik

Das die katheterbezogene LQ untersuchende Assessment nach Mary Wilde wurde bei Patienten mit perkutaner Nephrostomie (PCN) in lebenslanger Intention und minimaler Liegedauer von 3 Monaten vorgelegt.

Ergebnisse

Es zeigte sich insgesamt bei 66 Patienten (davon 42 mit unilateraler PCN) mit einem Punktwert von median 4,0 auf einer Skala von 0–5 eine nur moderat eingeschränkte katheterbezogene LQ. Diese wurde insgesamt und in allen Domänen schlechter als bei Patienten mit suprapubischem Katheter (SPK) bewertet, bei denen sich ein Score von 4,3 im Median fand. Signifikant waren die Unterschiede in den Einzelitems „Gefühl der Erniedrigung“, „Konflikte mit ärztlichem oder pflegerischem Personal“, „Angst vor schmerzhaften Katheterwechseln“, „Gefühl als kranke Person“, „Behinderungen in Aktivitäten des täglichen Lebens“ und „Besorgnis, nicht alles tun zu können, was ich mag“. Ebenso ergaben sich bei PCN-Trägern signifikant häufiger Angst vor Katheterlecks und Uringeruch. Die Anzahl der einliegenden PCN und die Grunderkrankung spielten für die Beurteilung der LQ keine Rolle.

Schlussfolgerung

Erstmals wurde die katheterassoziierte LQ, die sich bei PCN-Trägern nur moderat eingeschränkt fand, mit einem validierten Assessment quantitativ eingeordnet. Die Angabe der Betroffenen, sich als „krank“ und in der Ausübung von Aktivitäten des täglichen Lebens „behindert“ zu fühlen und die Angst vor Urinleckagen und schmerzhaften Wechseln sollten Ansporn für eine sorgfältige Indikationsstellung und technisch korrekte Katheterwechsel sein.

[Guidelines for consultations regarding incontinence care products]

An investigation of the German consumer organisation "Stiftung Warentest" in 2017 confirmed significant deficiencies in the information, advice and supply of incontinence care products received by urinary incontinence patients. The German Society of Urology (DGU) thereupon drafted and later published guidelines concerning the consultation of patients in the context of incontinence care. Important aspects of the consultation process include the determination of the type of incontinence as well as its severity, clinical examination, and advice regarding possible curative treatments. However, the advice appointment takes centre stage and should ideally be conducted by a qualified person in a separate room granting sufficient privacy and time. Furthermore, repeated supply of a selection of samples for differing degrees and types of incontinence, accommodating the patient's individual preferences and anatomical features, is crucial in order to ensure optimal incontinence care. In the case of commercial health care service providers, transparency relating to the financial implications of e.g. expensive products is key, which is what has been intended by German health insurance providers. The new guidelines concerning urinary incontinence care consultation constitute a step towards the improvement and structuring of processes in the consultation regarding, and the supply of, incontinence care products.

[Quality of life for wearers of a suprapubic or transurethral bladder catheter as lifelong permanent care]

Hintergrund

Die Anlage eines transurethralen Dauerkatheters (DK) oder suprapubischen Harnblasenkatheters (SPK) in lebenslanger Indikation stellt einen Eingriff mit relevanten Komplikationen, Komorbiditäten und möglichen Auswirkungen auf die katheterassoziierte Lebensqualität des Betroffenen dar. Letztere wurde aber bisher noch nicht untersucht.

Methodik

Zur Anwendung kam ein validiertes Assessment zur katheterbezogenen Lebensqualität mit 25 Items in 5 Domänen. Befragt wurden im Rahmen eines Katheterwechsels Patienten mit einem DK oder SPK in lebenslanger Intention, die diesen mindestens 3 Monate trugen.

Ergebnisse

Fragebögen von 357 Patienten, davon 260 Männer und 97 Frauen, 193 mit SPK und 162 mit DK (2 ohne Angabe) lagen vor. Patienten mit DK waren mit 78,9 ± 11,1 Jahren signifikant älter als solche mit SPK mit 74,4 ± 12,6 Jahren (p < 0,001). Der mittlere Gesamtlebensqualitätsscore lag bei 4,1 ± 0,9 Punkten auf einer Skala von 1 (maximal beeinträchtigte Lebensqualität) bis 5 (keine Beeinträchtigung der Lebensqualität). Es zeigten sich u. a. mit niedrigeren Scores eine vermehrte Angst vor Katheterlecks, Angst vor Uringeruch und Harnwegsinfektionen und vor schmerzhaften Katheterwechseln. Diese Sorgen waren v. a. bei Frauen, solchen mit Harninkontinenz, Trägern eines Katheters ≥ 18 Ch und bei Patienten < 70 Jahren vorhanden. Frauen mit einem SPK wiesen eine schlechtere Bewertung ihrer Lebensqualität als Männer mit SPK auf.

Schlussfolgerung

Die gefundenen Ergebnisse sollten in die Aufklärung zu einer lebenslangen Katheterableitung einfließen bzw. im Kontext möglicher Alternativen wie z. B. einer operativen Desobstruktion oder einer Hilfsmittelversorgung mit dem Patienten bzw. Betreuungspersonen besprochen werden.

Zusatzmaterial online

Die Online-Version dieses Beitrags (10.1007/s00120-021-01642-1) enthält weitere Tabellen mit detaillierten Ergebnissen der Fragen der 5 abgefragten Domänen.

Arabidopsis retrotransposon virus-like particles and their regulation by epigenetically activated small RNA

In Arabidopsis, LTR retrotransposons are activated by mutations in the chromatin gene DECREASE in DNA METHYLATION 1 (DDM1), giving rise to 21- to 22-nt epigenetically activated siRNA (easiRNA) that depend on RNA DEPENDENT RNA POLYMERASE 6 (RDR6). We purified virus-like particles (VLPs) from ddm1 and ddm1rdr6 mutants in which genomic RNA is reverse transcribed into complementary DNA. High-throughput short-read and long-read sequencing of VLP DNA (VLP DNA-seq) revealed a comprehensive catalog of active LTR retrotransposons without the need for mapping transposition, as well as independent of genomic copy number. Linear replication intermediates of the functionally intact COPIA element EVADE revealed multiple central polypurine tracts (cPPTs), a feature shared with HIV in which cPPTs promote nuclear localization. For one member of the ATCOPIA52 subfamily (SISYPHUS), cPPT intermediates were not observed, but abundant circular DNA indicated transposon “suicide” by auto-integration within the VLP. easiRNA targeted EVADE genomic RNA, polysome association of GYPSY (ATHILA) subgenomic RNA, and transcription via histone H3 lysine-9 dimethylation. VLP DNA-seq provides a comprehensive landscape of LTR retrotransposons and their control at transcriptional, post-transcriptional, and reverse transcriptional levels.

Natural-orifice transluminal endoscopic surgery: low-pressure pneumoperitoneum is sufficient and is associated with an improved cardiopulmonary response (PressurePig Study)

BACKGROUND AND AIMS

The aim of this randomized trial in the acute porcine model was to compare the quality of transgastric peritoneoscopy with the use of low-pressure versus standard-pressure pneumoperitoneum and to evaluate the respective associated cardiopulmonary changes.

METHODS

For transgastric peritoneoscopy, carbon dioxide was insufflated via the endoscope for a constant intraperitoneal pressure of 6 mmHg or 12 mmHg in 9 pigs each. The quality of transgastric peritoneoscopy was rated on a visual analog scale (0 mm, min.; 100 mm, max.) by the endoscopist, who was blinded to the intraperitoneal pressure. The cardiac index and global end-diastolic volume index (GEDVI, reflecting preload) were measured every 3 minutes by transpulmonary thermodilution. The following were also recorded: heart rate, mean arterial pressure (MAP), systemic vascular resistance index (SVRI, reflecting afterload), peak inspiratory pressure (PIP), pH, PCO (2), and PO (2).

RESULTS

The quality of transgastric peritoneoscopy with the use of low-pressure pneumoperitoneum was not inferior to that obtained using standard-pressure pneumoperitoneum (87.0 mm vs. 87.3 mm; P<0.05). In both groups we observed a statistically significant rise in MAP and SVRI. The increase in SVRI was less pronounced during low-pressure peritoneum ( P=0.042), indicating a reduced stress response in comparison to standard-pressure peritoneum. There were no relevant differences between the groups in relation to cardiac index, GEDVI, and heart rate. An intra-abdominal pressure of 6 mmHg also led to better oxygenation ( P=0.031 for difference in PO (2) between the two groups) due to lower peak inspiratory pressure ( P<0.001 for difference). There were only slight differences between the groups with regard to pH and PCO (2).

CONCLUSIONS

Pneumoperitoneum of 12-16 mmHg is used for standard laparoscopy. For NOTES, low-pressure pneumoperitoneum is sufficient and is associated with an improved cardiopulmonary response compared to standard-pressure pneumoperitoneum.

Transcriptional activities of the Sleeping Beauty transposon and shielding its genetic cargo with insulators

The Sleeping Beauty (SB) transposable element shows efficient transposition in human cells, and provides long-term transgene expression in preclinical animal models. Random chromosomal insertion of SB vectors represents a safety issue in human gene therapeutic applications, due to potential genotoxic effects associated with transposon integration. We investigated the transcriptional activities of SB in order to assess its potential to alter host gene expression upon integration. The untranslated regions (UTRs) of the transposon direct convergent, inward-directed transcription. Transcription from the 5'-UTR of SB is upregulated by the host-encoded factor high-mobility group 2-like 1 (HMG2L1), and requires a 65-base pair (bp) region not present in commonly used SB vectors. The SB transposase antagonizes the effect of HMG2L1, suggesting that natural transposase expression is under a negative feedback regulation. SB transposon vectors lacking the 65-bp region associated with HMG2L1-dependent upregulation exhibit benign transcriptional activities, at a level up to 100-times lower than that of the murine leukemia virus (MLV) long terminal repeat (LTR). Incorporation of chicken beta-globin HS4 insulator sequences in SB-based vectors reduces the transactivation of model promoters by transposon-borne enhancers, and thus may lower the risk of transcriptional activation of host genes situated close to a transposon insertion site.

Predictive value of the anatomical location of ultrasound-guided systematic sextant prostate biopsies for the nodal status of patients with localized prostate cancer

OBJECTIVE

The aim of this study was to determine the predictive value of the anatomical location of positive prostate biopsies for the nodal status of patients with localized prostate cancer.

METHODS

A total of 130 patients were included in this analysis. Prior to surgery, all patients underwent digital rectal examination (DRE), prostate-specific antigen (PSA) analysis and transrectal ultrasonography with systematic sextant biopsies. Each biopsy core was analyzed separately. Subsequently, all patients underwent pelvic lymphadenectomy and radical retropubic prostatectomy. The final pathological stage was correlated with the number of anatomical location of positive prostate biopsies.

RESULTS

Eighteen patients (13.8%) had positive lymph nodes. Based on clinical stage, serum PSA and the anatomical location of positive prostate biopsies, a staging model was developed with particular emphasis on the nodal status. In group I (n = 33; 25.4%), defined by negative basal biopsies and clinical stage T2 (irrespective of PSA), all patients had negative lymph nodes. Similarly, all but 1 patient were lymph node negative in group II (n = 36; 27.7%), which included cases of positive basal biopsy, PSA < 10 ng/ml clinical T2. Finally, group III (n = 61; 46.9%), defined by a positive basal biopsy and/or PSA > 10 ng/ml and/or clinical T3 included 17/18 (94.4%) node-positive patients.

CONCLUSION

Based on these data we consider it safe not to perform lymphadenectomy in group I and group II patients as only 1/69 patients (1.4%) was node positive. Patients meeting the group III criteria, however, should undergo pelvic lymphadenectomy, as 94.5% of all lymph-node-positive cases were in this group.

[Percutaneous, perineal, ultrasound-controlled implantation of 125iodine in prostatic cancer: technics, report of initial experiences and comparison with the retropubic method of implantation]

After a 4 years experience with the conventional retropubic operative free-hand technique the implantation procedure has been modified. For local therapy the volume of the prostate is measured endosonographically and biopsies are taken from defined areas of the prostate under transrectal ultrasonographic guidance using a puncture attachment (prostate mapping). According to the data of volumetry and pathology the brachytherapist calculates number and precise location of the seeds, which are inserted in a second procedure after diagnostic lymphadenectomy percutaneously and transperineally under ultrasonographic guidance with a afterloading technique. Since 1984 24 patients has been treated in this manner. Implantation procedure is described, preliminary clinical results are presented and the percutaneous technique is compared with the retropubic operative approach. The percutaneous, transperineal and ultrasonically guided 125Iodine implantation represents an alternative procedure to the radical prostatectomy and gives a good local tumor control in prostatic carcinoma with minimal side effects.

Long-term survival of untreated bilateral renal cell carcinoma with supradiaphragmatic vena caval thrombus

We report a case of bilateral, synchronous and biopsy proved renal cell carcinoma with a vena caval thrombus and supradiaphragmatic extension. Although the patient was not treated she is asymptomatic 5 1/2 years after the diagnosis was established.