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Cliff JM, King EC, Lee JS, Sepúlveda N, Wolf AS, Kingdon C, Bowman E, Dockrell HM, Nacul L, Lacerda E, Riley EM. Cellular Immune Function in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Front Immunol 2019; 10:796. [PMID: 31057538 PMCID: PMC6477089 DOI: 10.3389/fimmu.2019.00796] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/26/2019] [Indexed: 12/16/2022] Open
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating condition with unknown aetiology, Myalgic encephalomyelitis unclear pathophysiology and with no diagnostic test or biomarker available. Many patients report their ME/CFS began after an acute infection, and subsequent increased frequency of infections, such as colds or influenza, is common. These factors imply an altered immunological status exists in ME/CFS, in at least a proportion of patients, yet previous studies of peripheral immunity have been discrepant and inconclusive. The UK ME/CFS Biobank, which has collected blood samples from nearly 300 clinically-confirmed ME/CFS patients, enables large-scale studies of immunological function in phenotypically well-characterised participants. In this study, herpes virus serological status and T cell, B cell, NK cell and monocyte populations were investigated in 251 ME/CFS patients, including 54 who were severely affected, and compared with those from 107 healthy participants and with 46 patients with Multiple Sclerosis. There were no differences in seroprevalence for six human herpes viruses between ME/CFS and healthy controls, although seroprevalence for the Epstein-Barr virus was higher in multiple sclerosis patients. Contrary to previous reports, no significant differences were observed in NK cell numbers, subtype proportions or in vitro responsiveness between ME/CFS patients and healthy control participants. In contrast, the T cell compartment was altered in ME/CFS, with increased proportions of effector memory CD8+ T cells and decreased proportions of terminally differentiated effector CD8+ T cells. Conversely, there was a significantly increased proportion of mucosal associated invariant T cells (MAIT) cells, especially in severely affected ME/CFS patients. These abnormalities demonstrate that an altered immunological state does exist in ME/CFS, particularly in severely affected people. This may simply reflect ongoing or recent infection, or may indicate future increased susceptibility to infection. Longitudinal studies of ME/CFS patients are needed to help to determine cause and effect and thus any potential benefits of immuno-modulatory treatments for ME/CFS.
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Affiliation(s)
- Jacqueline M Cliff
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Elizabeth C King
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ji-Sook Lee
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nuno Sepúlveda
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Centre of Statistics and Applications, University of Lisbon, Lisbon, Portugal
| | - Asia-Sophia Wolf
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Caroline Kingdon
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Erinna Bowman
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hazel M Dockrell
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Luis Nacul
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Eliana Lacerda
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Eleanor M Riley
- Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Abolins S, Lazarou L, Weldon L, Hughes L, King EC, Drescher P, Pocock MJO, Hafalla JCR, Riley EM, Viney M. The ecology of immune state in a wild mammal, Mus musculus domesticus. PLoS Biol 2018; 16:e2003538. [PMID: 29652925 PMCID: PMC5919074 DOI: 10.1371/journal.pbio.2003538] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 04/25/2018] [Accepted: 03/09/2018] [Indexed: 01/08/2023] Open
Abstract
The immune state of wild animals is largely unknown. Knowing this and what affects it is important in understanding how infection and disease affects wild animals. The immune state of wild animals is also important in understanding the biology of their pathogens, which is directly relevant to explaining pathogen spillover among species, including to humans. The paucity of knowledge about wild animals' immune state is in stark contrast to our exquisitely detailed understanding of the immunobiology of laboratory animals. Making an immune response is costly, and many factors (such as age, sex, infection status, and body condition) have individually been shown to constrain or promote immune responses. But, whether or not these factors affect immune responses and immune state in wild animals, their relative importance, and how they interact (or do not) are unknown. Here, we have investigated the immune ecology of wild house mice-the same species as the laboratory mouse-as an example of a wild mammal, characterising their adaptive humoral, adaptive cellular, and innate immune state. Firstly, we show how immune variation is structured among mouse populations, finding that there can be extensive immune discordance among neighbouring populations. Secondly, we identify the principal factors that underlie the immunological differences among mice, showing that body condition promotes and age constrains individuals' immune state, while factors such as microparasite infection and season are comparatively unimportant. By applying a multifactorial analysis to an immune system-wide analysis, our results bring a new and unified understanding of the immunobiology of a wild mammal.
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Affiliation(s)
- Stephen Abolins
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Luke Lazarou
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Laura Weldon
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Louise Hughes
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | - Elizabeth C. King
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Paul Drescher
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
| | | | - Julius C. R. Hafalla
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Eleanor M. Riley
- Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
- The Roslin Institute and Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
| | - Mark Viney
- School of Biological Sciences, University of Bristol, Bristol, United Kingdom
- * E-mail:
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King EC, Patel V, Anand M, Zhao X, Crump SM, Hu Z, Weisleder N, Abbott GW. Targeted deletion of Kcne3 impairs skeletal muscle function in mice. FASEB J 2017; 31:2937-2947. [PMID: 28356343 DOI: 10.1096/fj.201600965rr] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/13/2017] [Indexed: 11/11/2022]
Abstract
KCNE3 (MiRP2) forms heteromeric voltage-gated K+ channels with the skeletal muscle-expressed KCNC4 (Kv3.4) α subunit. KCNE3 was the first reported skeletal muscle K+ channel disease gene, but the requirement for KCNE3 in skeletal muscle has been questioned. Here, we confirmed KCNE3 transcript and protein expression in mouse skeletal muscle using Kcne3-/- tissue as a negative control. Whole-transcript microarray analysis (770,317 probes, interrogating 28,853 transcripts) findings were consistent with Kcne3 deletion increasing gastrocnemius oxidative metabolic gene expression and the proportion of type IIa fast-twitch oxidative muscle fibers, which was verified using immunofluorescence. The down-regulated transcript set overlapped with muscle unloading gene expression profiles (≥1.5-fold change; P < 0.05). Gastrocnemius K+ channel α subunit remodeling arising from Kcne3 deletion was highly specific, involving just 3 of 69 α subunit genes probed: known KCNE3 partners KCNC4 and KCNH2 (mERG) were down-regulated, and KCNK4 (TRAAK) was up-regulated (P < 0.05). Functionally, Kcne3-/- mice exhibited abnormal hind-limb clasping upon tail suspension (63% of Kcne3-/- mice ≥10-mo-old vs. 0% age-matched Kcne3+/+ littermates). Whereas 5 of 5 Kcne3+/+ mice exhibited the typical biphasic decline in contractile force with repetitive stimuli of hind-limb muscle, both in vivo and in vitro, this was absent in 6 of 6 Kcne3-/- mice tested. Finally, myoblasts isolated from Kcne3-/- mice exhibit faster-inactivating and smaller sustained outward currents than those from Kcne3+/+ mice. Thus, Kcne3 deletion impairs skeletal muscle function in mice.-King, E. C., Patel, V., Anand, M., Zhao, X., Crump, S. M., Hu, Z., Weisleder, N., Abbott, G. W. Targeted deletion of Kcne3 impairs skeletal muscle function in mice.
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Affiliation(s)
- Elizabeth C King
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, USA
| | - Vishal Patel
- Department of Physiology and Biophysics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Marie Anand
- Department of Pharmacology, School of Medicine, University of California, Irvine, California, USA.,Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Xiaoli Zhao
- Department of Physiology and Biophysics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Shawn M Crump
- Department of Pharmacology, School of Medicine, University of California, Irvine, California, USA.,Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Zhaoyang Hu
- Department of Pharmacology, School of Medicine, University of California, Irvine, California, USA.,Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Noah Weisleder
- Department of Physiology and Biophysics, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA;
| | - Geoffrey W Abbott
- Department of Pharmacology, School of Medicine, University of California, Irvine, California, USA; .,Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, California, USA
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Lacerda EM, Bowman EW, Cliff JM, Kingdon CC, King EC, Lee JS, Clark TG, Dockrell HM, Riley EM, Curran H, Nacul L. The UK ME/CFS Biobank for biomedical research on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and Multiple Sclerosis. Open J Bioresour 2017; 4:4. [PMID: 28649428 PMCID: PMC5482226 DOI: 10.5334/ojb.28] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The UK ME/CFS Biobank was launched in August 2011 following extensive consultation with professionals and patient representatives. The bioresource aims to enhance research on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), related to pathophysiology, biomarkers and therapeutic approaches. The cohort includes 18-60 year olds, encompassing 284 clinically-confirmed ME/CFS cases, 60 neurologist-diagnosed multiple sclerosis (MS) cases, and 135 healthy individuals. The Biobank contains blood samples, aliquoted into serum, plasma, peripheral blood mononuclear cells (PBMC), red blood cells/granulocyte pellet, whole blood, and RNA (totalling 29,863 aliquots). Extensive dataset (700 clinical and socio-demographic variables/participant) enables comprehensive phenotyping. Potential reuse is conditional to ethical approval.
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Affiliation(s)
- Eliana M Lacerda
- CureME Research Team, International Centre for Evidence in Disability (ICED), Department of Clinical Research (CRD), Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Erinna W Bowman
- CureME Research Team, International Centre for Evidence in Disability (ICED), Department of Clinical Research (CRD), Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Jacqueline M Cliff
- Department of Immunology & Infection, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Caroline C Kingdon
- CureME Research Team, International Centre for Evidence in Disability (ICED), Department of Clinical Research (CRD), Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Elizabeth C King
- Department of Immunology & Infection, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Ji-Sook Lee
- Department of Immunology & Infection, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Taane G Clark
- Department of Pathogen Molecular Biology, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Hazel M Dockrell
- Department of Immunology & Infection, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Eleanor M Riley
- Department of Immunology & Infection, Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Hayley Curran
- CureME Research Team, International Centre for Evidence in Disability (ICED), Department of Clinical Research (CRD), Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
| | - Luis Nacul
- CureME Research Team, International Centre for Evidence in Disability (ICED), Department of Clinical Research (CRD), Faculty of Infectious and Tropical Diseases at the London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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Ryan TD, Lucky AW, King EC, Huang G, Towbin JA, Jefferies JL. Ventricular dysfunction and aortic dilation in patients with recessive dystrophic epidermolysis bullosa. Br J Dermatol 2015; 174:671-3. [PMID: 26370777 DOI: 10.1111/bjd.14168] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2015] [Indexed: 11/30/2022]
Affiliation(s)
- T D Ryan
- The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229-2003, U.S.A.
| | - A W Lucky
- The Epidermolysis Bullosa Center, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229-2003, U.S.A
| | - E C King
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229-2003, U.S.A
| | - G Huang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229-2003, U.S.A
| | - J A Towbin
- Heart Institute, Le Bonheur Children's Hospital, Memphis, TN, U.S.A
| | - J L Jefferies
- The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2003, Cincinnati, OH, 45229-2003, U.S.A
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Hassan SS, Akram M, King EC, Dockrell HM, Cliff JM. PD-1, PD-L1 and PD-L2 Gene Expression on T-Cells and Natural Killer Cells Declines in Conjunction with a Reduction in PD-1 Protein during the Intensive Phase of Tuberculosis Treatment. PLoS One 2015; 10:e0137646. [PMID: 26359860 PMCID: PMC4567315 DOI: 10.1371/journal.pone.0137646] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 08/20/2015] [Indexed: 01/28/2023] Open
Abstract
Background The PD-1 axis is a cell intrinsic immunoregulatory pathway that mediates T cell exhaustion in chronic infection particularly in some viral infections. We hypothesized that PD-1, PD-L1 and PD-L2 would be highly expressed in untreated tuberculosis patients compared to controls due to their chronic infection and would decrease with successful TB treatment. Materials and Methods Untreated tuberculosis patients (n = 26) were recruited at diagnosis and followed up during treatment. Household contacts (n = 24) were recruited to establish baseline differences. Blood gene expression ex vivo was investigated using qRT-PCR. Flow cytometry was performed to establish protein expression patterns. Results PD-L1 gene expression was found to be elevated in active TB disease; however, this was not observed for PD-1 or PD-L2. The intensive phase of TB treatment was associated with a significant decline in PD-1, PD-L1 and PD-L2 gene expression. PD-1 protein expression on the surface of NK cells, CD8+ and CD4+ T cells was similar in patients with active TB disease compared to controls but declined with successful TB treatment, with the greatest decline occurring on the NK cells followed by CD8+ T cells and then CD4+ T cells. Granzyme B/PD-1 co-expression declined with successful intensive phase treatment. Conclusion Modulation of PD-1/PD-L1 pathway through TB treatment indicates changes in the peripheral T cell response caused by live Mycobacterium tuberculosis (Mtb) followed by the response to dead bacilli, antigen-release and immuno-pathology resolution. The PD-1 axis could be a host drug target for immunomodulatory treatments in the future.
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Affiliation(s)
- Syeda S. Hassan
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, United Kingdom
- * E-mail:
| | | | - Elizabeth C. King
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Hazel M. Dockrell
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, United Kingdom
| | - Jacqueline M. Cliff
- Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, United Kingdom
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Cliff JM, Cho JE, Lee JS, Ronacher K, King EC, van Helden P, Walzl G, Dockrell HM. Excessive Cytolytic Responses Predict Tuberculosis Relapse After Apparently Successful Treatment. J Infect Dis 2015; 213:485-95. [PMID: 26351358 PMCID: PMC4704670 DOI: 10.1093/infdis/jiv447] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/31/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Currently, there are no tools to accurately predict tuberculosis relapse. This study aimed to determine whether patients who experience tuberculosis relapse have different immune responses to mycobacteria in vitro than patients who remain cured for 2 years. METHODS Patients with an initial episode of pulmonary tuberculosis were recruited in South Africa. Diluted blood, collected at diagnosis and after 2 and 4 weeks of treatment, was cultured with live Mycobacterium tuberculosis for 6 days, and cellular RNA was frozen. Gene expression in samples from 10 patients who subsequently experienced relapse, confirmed by strain genotyping, was compared to that in samples from patients who remained cured, using microarrays. RESULTS At diagnosis, expression of 668 genes was significantly different in samples from patients who experienced relapse, compared with expression in patients who remained successfully cured; these differences persisted for at least 4 weeks. Gene ontology and biological pathways analyses revealed significant upregulation of genes involved in cytotoxic cell-mediated killing. Results were confirmed by real-time quantitative reverse-transcription polymerase chain reaction analysis in a wider patient cohort. CONCLUSIONS These data show that patients who will subsequently experience relapse exhibit altered immune responses, including excessively robust cytolytic responses to M. tuberculosis in vitro, at the time of diagnosis, compared with patients who will achieve durable cure. Together with microbiological and clinical indices, these differences could be exploited in drug development.
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Affiliation(s)
- Jacqueline M Cliff
- TB Centre and Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Jang-Eun Cho
- TB Centre and Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Ji-Sook Lee
- TB Centre and Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Katharina Ronacher
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences/MRC Centre for Molecular and Cellular Biology/DST NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Elizabeth C King
- TB Centre and Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
| | - Paul van Helden
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences/MRC Centre for Molecular and Cellular Biology/DST NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Gerhard Walzl
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences/MRC Centre for Molecular and Cellular Biology/DST NRF Centre of Excellence for Biomedical TB Research, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Hazel M Dockrell
- TB Centre and Department of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, United Kingdom
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Dincheva I, Drysdale AT, Hartley CA, Johnson DC, Jing D, King EC, Ra S, Gray JM, Yang R, DeGruccio AM, Huang C, Cravatt BF, Glatt CE, Hill MN, Casey BJ, Lee FS. FAAH genetic variation enhances fronto-amygdala function in mouse and human. Nat Commun 2015; 6:6395. [PMID: 25731744 PMCID: PMC4351757 DOI: 10.1038/ncomms7395] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 01/23/2015] [Indexed: 01/19/2023] Open
Abstract
Cross-species studies enable rapid translational discovery and produce the broadest impact when both mechanism and phenotype are consistent across organisms. We developed a knock-in mouse that biologically recapitulates a common human mutation in the gene for fatty acid amide hydrolase (FAAH) (C385A; rs324420), the primary catabolic enzyme for the endocannabinoid anandamide. This common polymorphism impacts the expression and activity of FAAH, thereby increasing anandamide levels. Here, we show that the genetic knock-in mouse and human variant allele carriers exhibit parallel alterations in biochemisty, neurocircuitry, and behavior. Specifically, there is reduced FAAH expression associated with the variant allele that selectively enhances fronto-amygdala connectivity and fear extinction learning, and decreases anxiety-like behaviors. These results suggest a gain-of-function in fear regulation and may indicate for whom and for what anxiety symptoms FAAH inhibitors or exposure-based therapies will be most efficacious, bridging an important translational gap between the mouse and human.
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Affiliation(s)
- Iva Dincheva
- 1] Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA [2] Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Andrew T Drysdale
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Catherine A Hartley
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - David C Johnson
- Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Deqiang Jing
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Elizabeth C King
- 1] Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA [2] Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Stephen Ra
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - J Megan Gray
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, Departments of Cell Biology and Anatomy &Psychiatry, University of Calgary, 3330 Hospital Drive NW, Calgary AB Canada T2N4N1
| | - Ruirong Yang
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Ann Marie DeGruccio
- inGenious Targeting Laboratory, 2200 Smithtown Avenue, Ronkonkoma, New York 11779, USA
| | - Chienchun Huang
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Benjamin F Cravatt
- Department of Chemical Physiology, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, California 92037, USA
| | - Charles E Glatt
- Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Matthew N Hill
- Hotchkiss Brain Institute and Mathison Centre for Mental Health Research and Education, Departments of Cell Biology and Anatomy &Psychiatry, University of Calgary, 3330 Hospital Drive NW, Calgary AB Canada T2N4N1
| | - B J Casey
- 1] Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA [2] Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
| | - Francis S Lee
- 1] Department of Psychiatry, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA [2] Department of Pharmacology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA [3] Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College of Cornell University, 1300 York Avenue, New York, New York 10065, USA
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King EC. Synthetic Biology and Morality: Artificial Life and the Bounds of Nature [Book Review]. IEEE Pulse 2014. [DOI: 10.1109/mpul.2014.2355331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hu Z, Kant R, Anand M, King EC, Krogh-Madsen T, Christini DJ, Abbott GW. Kcne2 deletion creates a multisystem syndrome predisposing to sudden cardiac death. ACTA ACUST UNITED AC 2014; 7:33-42. [PMID: 24403551 DOI: 10.1161/circgenetics.113.000315] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Sudden cardiac death (SCD) is the leading global cause of mortality, exhibiting increased incidence in patients with diabetes mellitus. Ion channel gene perturbations provide a well-established ventricular arrhythmogenic substrate for SCD. However, most arrhythmia-susceptibility genes, including the KCNE2 K(+) channel β subunit, are expressed in multiple tissues, suggesting potential multiplex SCD substrates. METHODS AND RESULTS Using whole-transcript transcriptomics, we uncovered cardiac angiotensinogen upregulation and remodeling of cardiac angiotensinogen interaction networks in P21 Kcne2(-/-) mouse pups and adrenal remodeling consistent with metabolic syndrome in adult Kcne2(-/-) mice. This led to the discovery that Kcne2 disruption causes multiple acknowledged SCD substrates of extracardiac origin: diabetes mellitus, hypercholesterolemia, hyperkalemia, anemia, and elevated angiotensin II. Kcne2 deletion was also a prerequisite for aging-dependent QT prolongation, ventricular fibrillation and SCD immediately after transient ischemia, and fasting-dependent hypoglycemia, myocardial ischemia, and AV block. CONCLUSIONS Disruption of a single, widely expressed arrhythmia-susceptibility gene can generate a multisystem syndrome comprising manifold electric and systemic substrates and triggers of SCD. This paradigm is expected to apply to other arrhythmia-susceptibility genes, the majority of which encode ubiquitously expressed ion channel subunits or regulatory proteins.
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Affiliation(s)
- Zhaoyang Hu
- Bioelectricity Laboratory, Departments of Pharmacology and Physiology and Biophysics, School of Medicine, University of California, Irvine
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Abstract
Adolescence represents a uniquely sensitive developmental stage in the transition from childhood to adulthood. During this transition, neuronal circuits are particularly susceptible to modification by experience. In addition, adolescence is a stage in which the incidence of anxiety disorders peaks in humans and over 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. While postnatal critical periods of plasticity for primary sensory processes, such as in the visual system are well established, less is known about potential critical or sensitive periods for fear learning and memory. Here, we review the non-linear developmental aspects of fear learning and memory during a transition period into and out of adolescence. We also review the literature on the non-linear development of GABAergic neurotransmission, a key regulator of critical period plasticity. We provide a model that may inform improved treatment strategies for children and adolescents with fear-related disorders.
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Abstract
The transition into and out of adolescence is a unique developmental period during which neuronal circuits are particularly susceptible to modification by experience. Adolescence is associated with an increased incidence of anxiety disorders in humans, and an estimated 75% of adults with fear-related disorders met diagnostic criteria as children and adolescents. Conserved neural circuitry of rodents and humans has facilitated neurodevelopmental studies of behavioral and molecular processes associated with fear learning and memory that lie at the heart of many anxiety disorders. Here, we review the nonlinear developmental aspects of fear learning and memory during a transition period into and out of adolescence and provide a discussion of the molecular mechanisms that may underlie these alterations in behavior. We provide a model that may help to inform novel treatment strategies for children and adolescents with fear-related disorders.
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Affiliation(s)
- Elizabeth C King
- Departments of Pharmacology; Psychiatry, Weill Cornell Medical College of Cornell University, New York, New York
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Cliff JM, Lee JS, Constantinou N, Cho JE, Clark TG, Ronacher K, King EC, Lukey PT, Duncan K, Van Helden PD, Walzl G, Dockrell HM. Distinct phases of blood gene expression pattern through tuberculosis treatment reflect modulation of the humoral immune response. J Infect Dis 2012; 207:18-29. [PMID: 22872737 DOI: 10.1093/infdis/jis499] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Accurate assessment of treatment efficacy would facilitate clinical trials of new antituberculosis drugs. We hypothesized that early alterations in peripheral immunity could be measured by gene expression profiling in tuberculosis patients undergoing successful conventional combination treatment. METHODS Ex vivo blood samples from 27 pulmonary tuberculosis patients were assayed at diagnosis and during treatment. RNA was processed and hybridized to Affymetrix GeneChips, to determine expression of over 47,000 transcripts. RESULTS There were significant ≥ 2-fold changes in expression of >4000 genes during treatment. Rapid, large-scale changes were detected, with down-regulated expression of 1261 genes within the first week, including inflammatory markers such as complement components C1q and C2. This was followed by slower changes in expression of different networks of genes, including a later increase in expression of B-cell markers, transcription factors, and signaling molecules. CONCLUSIONS The fast initial down-regulation of expression of inflammatory mediators coincided with rapid killing of actively dividing bacilli, whereas slower delayed changes occurred as drugs acted on dormant bacilli and coincided with lung pathology resolution. Measurement of biosignatures during clinical trials of new drugs could be useful predictors of rapid bactericidal or sterilizing drug activity, and would expedite the licensing of new treatment regimens.
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Affiliation(s)
- Jacqueline M Cliff
- Immunology and Infection Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.
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Ying SW, Kanda VA, Hu Z, Purtell K, King EC, Abbott GW, Goldstein PA. Targeted deletion of Kcne2 impairs HCN channel function in mouse thalamocortical circuits. PLoS One 2012; 7:e42756. [PMID: 22880098 PMCID: PMC3411840 DOI: 10.1371/journal.pone.0042756] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/12/2012] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hyperpolarization-activated, cyclic nucleotide-gated (HCN) channels generate the pacemaking current, I(h), which regulates neuronal excitability, burst firing activity, rhythmogenesis, and synaptic integration. The physiological consequence of HCN activation depends on regulation of channel gating by endogenous modulators and stabilization of the channel complex formed by principal and ancillary subunits. KCNE2 is a voltage-gated potassium channel ancillary subunit that also regulates heterologously expressed HCN channels; whether KCNE2 regulates neuronal HCN channel function is unknown. METHODOLOGY/PRINCIPAL FINDINGS We investigated the effects of Kcne2 gene deletion on I(h) properties and excitability in ventrobasal (VB) and cortical layer 6 pyramidal neurons using brain slices prepared from Kcne2(+/+) and Kcne2(-/-) mice. Kcne2 deletion shifted the voltage-dependence of I(h) activation to more hyperpolarized potentials, slowed gating kinetics, and decreased I(h) density. Kcne2 deletion was associated with a reduction in whole-brain expression of both HCN1 and HCN2 (but not HCN4), although co-immunoprecipitation from whole-brain lysates failed to detect interaction of KCNE2 with HCN1 or 2. Kcne2 deletion also increased input resistance and temporal summation of subthreshold voltage responses; this increased intrinsic excitability enhanced burst firing in response to 4-aminopyridine. Burst duration increased in corticothalamic, but not thalamocortical, neurons, suggesting enhanced cortical excitatory input to the thalamus; such augmented excitability did not result from changes in glutamate release machinery since miniature EPSC frequency was unaltered in Kcne2(-/-) neurons. CONCLUSIONS/SIGNIFICANCE Loss of KCNE2 leads to downregulation of HCN channel function associated with increased excitability in neurons in the cortico-thalamo-cortical loop. Such findings further our understanding of the normal physiology of brain circuitry critically involved in cognition and have implications for our understanding of various disorders of consciousness.
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Affiliation(s)
- Shui-Wang Ying
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States of America
| | - Vikram A. Kanda
- Department of Pharmacology, Weill Cornell Medical College, New York, New York, United States of America
| | - Zhaoyang Hu
- Departments of Pharmacology, and Physiology and Biophysics, University of California Irvine, Irvine, California, United States of America
| | - Kerry Purtell
- Department of Pharmacology, Weill Cornell Medical College, New York, New York, United States of America
| | - Elizabeth C. King
- Department of Pharmacology, Weill Cornell Medical College, New York, New York, United States of America
| | - Geoffrey W. Abbott
- Departments of Pharmacology, and Physiology and Biophysics, University of California Irvine, Irvine, California, United States of America
| | - Peter A. Goldstein
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States of America
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Roepke TK, Kanda VA, Purtell K, King EC, Lerner DJ, Abbott GW. KCNE2 forms potassium channels with KCNA3 and KCNQ1 in the choroid plexus epithelium. FASEB J 2011; 25:4264-73. [PMID: 21859894 DOI: 10.1096/fj.11-187609] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cerebrospinal fluid (CSF) is crucial for normal function and mechanical protection of the CNS. The choroid plexus epithelium (CPe) is primarily responsible for secreting CSF and regulating its composition by mechanisms currently not fully understood. Previously, the heteromeric KCNQ1-KCNE2 K(+) channel was functionally linked to epithelial processes including gastric acid secretion and thyroid hormone biosynthesis. Here, using Kcne2(-/-) tissue as a negative control, we found cerebral expression of KCNE2 to be markedly enriched in the CPe apical membrane, where we also discovered expression of KCNQ1. Targeted Kcne2 gene deletion in C57B6 mice increased CPe outward K(+) current 2-fold. The Kcne2 deletion-enhanced portion of the current was inhibited by XE991 (10 μM) and margatoxin (10 μM) but not by dendrotoxin (100 nM), indicating that it arose from augmentation of KCNQ subfamily and KCNA3 but not KCNA1 K(+) channel activity. Kcne2 deletion in C57B6 mice also altered the polarity of CPe KCNQ1 and KCNA3 trafficking, hyperpolarized the CPe membrane by 9 ± 2 mV, and increased CSF [Cl(-)] by 14% compared with wild-type mice. These findings constitute the first report of CPe dysfunction caused by cation channel gene disruption and suggest that KCNE2 influences blood-CSF anion flux by regulating KCNQ1 and KCNA3 in the CPe.
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Affiliation(s)
- Torsten K Roepke
- Department of Pharmacology, Weill Cornell Medical College, 1300 York Ave., New York, NY 10021, USA
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16
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Roepke TK, King EC, Purtell K, Kanda VA, Lerner DJ, Abbott GW. Genetic dissection reveals unexpected influence of beta subunits on KCNQ1 K+ channel polarized trafficking in vivo. FASEB J 2010; 25:727-36. [PMID: 21084694 DOI: 10.1096/fj.10-173682] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Targeted deletion of the Kcne2 potassium channel β subunit gene ablates gastric acid secretion and predisposes to gastric neoplasia in mice. Here, we discovered that Kcne2 deletion basolaterally reroutes the Kcnq1 α subunit in vivo in parietal cells (PCs), in which the normally apical location of the Kcnq1-Kcne2 channel facilitates its essential role in gastric acid secretion. Quantitative RT-PCR and Western blotting revealed that Kcne2 deletion remodeled fundic Kcne3 (2.9±0.8-fold mRNA increase, n=10; 5.3±0.4-fold protein increase, n=7) but not Kcne1, 4, or 5, and resulted in basolateral Kcnq1-Kcne3 complex formation in Kcne2(-/-) PCs. Concomitant targeted deletion of Kcne3 (creating Kcne2(-/-)Kcne3(-/-) mice) restored PC apical Kcnq1 localization without Kcne1, 4, or 5 remodeling (assessed by quantitative RT-PCR; n=5-10), indicating Kcne3 actively, basolaterally rerouted Kcnq1 in Kcne2(-/-) PCs. Despite this, Kcne3 deletion exacerbated gastric hyperplasia in Kcne2(-/-) mice, and both hypochlorhydria and hyperplasia in Kcne2(+/-) mice, suggesting that Kcne3 up-regulation was beneficial in Kcne2-depleted PCs. The findings reveal, in vivo, Kcne-dependent α subunit polarized trafficking and the existence and consequences of potassium channel β subunit remodeling.
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Affiliation(s)
- Torsten K Roepke
- Department of Pharmacology, Weill Medical College of Cornell University, New York, NY 10021, USA
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Roepke TK, Purtell K, King EC, La Perle KMD, Lerner DJ, Abbott GW. Targeted deletion of Kcne2 causes gastritis cystica profunda and gastric neoplasia. PLoS One 2010; 5:e11451. [PMID: 20625512 PMCID: PMC2897890 DOI: 10.1371/journal.pone.0011451] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 06/13/2010] [Indexed: 01/02/2023] Open
Abstract
Gastric cancer is the second leading cause of cancer death worldwide. Predisposing factors include achlorhydria, Helicobacter pylori infection, oxyntic atrophy and TFF2-expressing metaplasia. In parietal cells, apical potassium channels comprising the KCNQ1 α subunit and the KCNE2 β subunit provide a K+ efflux current to facilitate gastric acid secretion by the apical H+K+ATPase. Accordingly, genetic deletion of murine Kcnq1 or Kcne2 impairs gastric acid secretion. Other evidence has suggested a role for KCNE2 in human gastric cancer cell proliferation, independent of its role in gastric acidification. Here, we demonstrate that 1-year-old Kcne2−/− mice in a pathogen-free environment all exhibit a severe gastric preneoplastic phenotype comprising gastritis cystica profunda, 6-fold increased stomach mass, increased Ki67 and nuclear Cyclin D1 expression, and TFF2- and cytokeratin 7-expressing metaplasia. Some Kcne2−/−mice also exhibited pyloric polypoid adenomas extending into the duodenum, and neoplastic invasion of thin walled vessels in the sub-mucosa. Finally, analysis of human gastric cancer tissue indicated reduced parietal cell KCNE2 expression. Together with previous findings, the results suggest KCNE2 disruption as a possible risk factor for gastric neoplasia.
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Affiliation(s)
- Torsten K. Roepke
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Kerry Purtell
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Elizabeth C. King
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Krista M. D. La Perle
- Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Daniel J. Lerner
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
| | - Geoffrey W. Abbott
- Department of Pharmacology, Weill Medical College of Cornell University, New York, New York, United States of America
- Department of Medicine, Weill Medical College of Cornell University, New York, New York, United States of America
- * E-mail:
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Abbott GW, Purtell K, King EC, Panaghie G, Lerner DJ, Roepke TK. Effects of Kcne Subunit Deletion on Polarized Trafficking of the KCNQ1 Potassium Channel in Vivo. Biophys J 2010. [DOI: 10.1016/j.bpj.2009.12.540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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King EC, Blacker AJ, Bugg TD. Enzymatic breakdown of poly-gamma-D-glutamic acid in Bacillus licheniformis: identification of a polyglutamyl gamma-hydrolase enzyme. Biomacromolecules 2002; 1:75-83. [PMID: 11709846 DOI: 10.1021/bm990001n] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A polyglutamyl gamma-hydrolase enzyme has been identified which catalyses the hydrolytic breakdown of poly-gamma-D-glutamic acid (PGA) from Bacillus licheniformis 9945a. The enzyme was found to be physically associated with the polymer and was activated by Zn2+ or Ca2+ salts. The enzyme can be solubilized from the polymer by treatment with 0.5% SDS and 1 mM ZnCl2 and can then be renatured onto exogenous PGA upon dilution below the detergent critical micellar concentration. The enzyme was partially purified by affinity chromatography, using immobilized PGA. Peptide thioesters containing one and two gamma-glutamyl units were synthesized as potential chromogenic substrates but showed no activity with the solubilized enzyme. Examination of 14C-labeled reaction products indicated that the enzyme is an endo-type hydrolase.
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Affiliation(s)
- E C King
- Department of Chemistry, University of Southampton, Highfield, Southampton SO17 1BJ, U.K
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Sarwahi V, Sarwark JF, Schafer MF, Backer C, Lee M, King EC, Aminian A, Grayhack JJ. Standards in anterior spine surgery in pediatric patients with neuromuscular scoliosis. J Pediatr Orthop 2001; 21:756-60. [PMID: 11675549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The authors reviewed 111 patients with neuromuscular disease who underwent anterior spine surgery for correction of scoliosis. An overall complication rate of 44.1% was found, 21.6% major and 22.5% minor. Pulmonary complications were the most common major complications, urinary tract infections the most common minor complications. The rate of complications was greater in patients with cerebral palsy, thoracoabdominal and transthoracic approaches, staged procedures, operative blood loss >1,000 mL, or previous spine surgery. In addition, statistical analysis confirmed that curve magnitude >100 degrees degrees was a risk factor for complications.
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Affiliation(s)
- V Sarwahi
- Children's Memorial Hospital/Northwestern University Medical School, Chicago, Illinois, USA
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Affiliation(s)
- N M Desmond
- The Garden Clinic, Upton Hospital, Slough, Berkshire, UK
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Chen KS, Bharaj SS, King EC. Induction and relief of nasal congestion in ferrets infected with influenza virus. Int J Exp Pathol 1995; 76:55-64. [PMID: 7537523 PMCID: PMC1997137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Susceptible ferrets intranasally infected with influenza virus consistently responded with maximal nasal secretion of virus, febrile reaction, and influx of inflammatory cells into nasal lumen on day 2 post infection (d.p.i.). Polymorphonuclear leucocytes were the earliest predominant cell, followed by monocytes/macrophages while lymphocytes were maintained as a minor population throughout the 7-day period. Nasal congestion level, continuously monitored by computer aided active anterior rhinomanometry, was reproducibly maximal at 2 d.p.i., diminished in intensity the next day and returned to the basal level within 7 d.p.i. Nasal congestion was effectively relieved by a single intranasal dose of 0.1% oxymetazoline or 0.2% phenylephrine, or a single intragastric administration of pseudoephedrine. Intranasal delivery of a single dose of 1% pyrilamine relieved nasal congestion while 0.8% ipratropium bromide and 30% cimetidine were ineffective. These results suggested that nasal congestion is regulated by alpha-adrenergic receptors in the mucosal vasculature or by H1 histamine receptor, but is unaffected by inhibitors of nasal secretion regulated by the cholinergic nervous system. The present study indicates that the infectious rhinitis ferret model provides a reproducible nasal congestion pattern that can be objectively measured by a refined active anterior rhinomanometric system. This labour intensive measurement, however, makes it difficult either to conduct a large population animal study or to use it for a rapid throughput screening of new drugs. The temporal relation between the influx of inflammatory cells into the nasal lumen and the onset of nasal congestion underlies the model's relevance to the exploration of the pathogenic mechanism(s) during viral rhinitis.
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Affiliation(s)
- K S Chen
- Procter & Gamble Pharmaceutical Research Division, Miami Valley Laboratories, Procter & Gamble Company, Cincinnati, Ohio 45253-8707, USA
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Berger S, King EC. Designing services for the elderly. AORN J 1990; 51:448, 450, 452-4. [PMID: 2407181 DOI: 10.1016/s0001-2092(07)66076-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Even after careful planning and a successful launch, even the best geriatric care program can not always expect smooth sailing, according to industry executives. Allen Mathies, president and chief executive officer at Huntington Memorial Hospital, cited a paradoxical side effect stemming from the success of his hospital's geriatric outreach programs. "On the one hand, by moving patients through a continuum of outpatients services, our program has helped to reduce the extraordinary costs associated with acute care hospitalization," he said. "On the other hand, those patients who are hospitalized tend to be more acutely ill. They use tremendous resources, but at a fixed reimbursement. There is a lack of recognition of our real costs by the payer." Why, then, do Huntington Memorial Hospital, Baptist Medical Center of Oklahoma, Morton F. Plant Hospital, Northwestern Memorial Hospital and other hospitals intend to continue their efforts on behalf of their communities' aging populations? The answer is that, reimbursement problems notwithstanding, benefits can be derived from making a commitment to geriatric care. "We have 19,000 people enrolled in our elder care program," Hupfeld said. "That's a powerful force. They vote. They lobby on our behalf. They support the hospital philanthropically. If you do a good job of reaching the older adults in your community, you'll find they are a powerful marketing force. They can do a lot for your image when it comes to reaching other market segments."
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Berger S, King EC. To centralize management or not still a matter of debate. Provider 1988; 14:16, 37. [PMID: 10287332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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King EC, Lang MJ, Carroll K, Geiger F, Morris F. Developing and negotiating transfer agreements in allied health. J Allied Health 1984; 13:221-30. [PMID: 6501081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The Kentucky Council on Higher Education has developed a statewide articulated system for allied health education. The articulated system permits entry and exit of prepared professionals at a variety of levels. The six disciplinary clusters included in the system are clinical laboratory sciences, dental auxiliaries, dietetics/nutrition, rehabilitation therapies, radiological sciences, and respiratory therapy. Competency-based education was used as the theoretical framework for developing and negotiating transfer agreements. Types of agreements included the block credit transfer agreement and the course specific transfer agreement. Agreements were negotiated between education systems and between specific programs/institutions. To date, approximately 30 transfer agreements have been negotiated. The process for negotiating transfer agreements included the following sequence: identify programs, develop a theoretical articulation model, rank order transfer agreements, determine the type of agreement, review respective curricula, determine the existing amount of transferable coursework, draft a pre-articulation agreement, schedule a meeting between faculty and administrators to discuss the agreement, and secure authorizing signatures on the final transfer agreement. Facilitators and barriers to negotiating agreements are discussed and recommendations offered for others who may be interested in developing transfer agreements.
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King EC, Breegle GG, Carroll KA, Geiger FR, Lang MJ, Morris FJ. Statewide articulation for allied health: a conceptual model in action. J Allied Health 1984; 13:53-62. [PMID: 6715244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Under the auspices of the Kentucky Council on Higher Education, and with the aim of delineating issues in allied health education and making recommendations for alleviating the issues, an indepth, two-year study was completed in 1975. The primary recommendations pertained to the development of a statewide plan for allied health education that would result in an articulated statewide system permitting entry and exit of prepared personnel at a variety of levels and improving inter-institutional efforts to share educational resources. In the following four years a foundation was laid for developing the system. An articulated system of allied health education was developed in six disciplinary clusters to serve as a model for other states: clinical laboratory, dental auxiliaries, dietetics/nutrition, rehabilitation therapies, radiological science, and respiratory therapy programs. All levels of programs within each discipline cluster existing in Kentucky are included in the system. The study includes a design phase and an implementation phase. During the design phase, six discipline advisory groups developed articulation models for the programs in each discipline. Implementation phase accomplishments include signed transfer agreements, development of model and core curricula, design for graduate follow-up, publications, development of manpower models, and increased cooperation among project participants.
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King EC, Breegle GG. A comparison of administrator, faculty/clinician, and student needs to facilitate statewide planning in allied health education. J Allied Health 1983; 12:103-16. [PMID: 6688250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Higher education state coordinating bodies are faced with the difficult task of developing coherent strategies and priorities for planning. To assist in this planning a needs assessment procedure involving administrators, faculty/clinicians, and students was used, and driving and restraining forces relevant to decision making were identified. The Nominal Group Technique was used to identify each population's needs which related to a statewide system for allied health education. The technique ordered the needs of each population. A kendall coefficient of concordance was calculated to test the hypothesis that there was no association between the ranks within a population. Needs were placed in two categories: those common to all three populations, and those unique to one population. Six needs common to the population were identified. Finally, the study reranked the six common needs according to perceived attainability.
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King EC, Tate LC, Rhoda C, Sethi J. Evaluating cognitive learning for radiography education. Radiol Technol 1983; 54:350-9. [PMID: 6878664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This discussion has been written to assist radiologic technology educators build better teacher-made tests. The systematic framework for test development has included defining cognitive learning objectives, constructing a test blueprint, writing clear test directions, and writing objective test items. This process enables the faculty to effectively monitor student progress, assess their own teaching effectiveness, and diagnose learning difficulties. It is hoped that this systematic approach to the assessment of cognitive learning will contribute to the education and development of a competent entry level radiologic technologist.
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King EC. Prospective rates: getting your hospital ready. Hosp Forum 1983; 26:56-8. [PMID: 10273330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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King EC. When the only certainty is uncertainty. Trustee 1982; 35:30, 33. [PMID: 10256862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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King EC, Dietrich MC. The school of allied health--a political model of university governance. J Allied Health 1980; 9:242-252. [PMID: 7462087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Curtailment of direct federal funding coupled with greater governmental demands for fiscal accountability in the 1970s has led to events such as allied health program moratoria and a closer scrutiny of the fundamental goals of allied health schools. Resulting organizational stress has also stimulated an emergence of interest groups in these schools. This paper attempts to place these events in a historical and sociological context by: (1) summarizing three governance models; (2) relating these models to the organizational maturation of allied health schools in light of predictions from contemporary management theory; (3) discussing the interrelationships between organizational structure, age of allied health schools, and characteristics of allied health administrators; (4) describing variables of organizational transition that affect organizational effectiveness; and (5) making recommendations to assist schools in organizational planning so they can adjust to the potential negative impact of organizational maturation, shrinking resources, and increasing accountability. A series of recommendations from the Baldridge political model of contemporary organizational research is presented. These recommendations may help facilitate conflict resolution in schools of allied health.
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King EC, Robinson TC. Laboratory staff development practices: a statewide study. Am J Med Technol 1980; 46:564-70. [PMID: 7424955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A statewide survey of staff development practices in New York State was completed to: 1) assess the current staff development practices for laboratory personnel in a variety of health care delivery settings; 2) determine the importance of selected laboratory practices to the professional growth of the laboratory staff; 3) make recommendations for staff development practices based on research findings. The study results are based on responses to a 1978 mail survey to laboratory staff employed in New York State. The most significant findings were that in over half of the laboratory settings surveyed three of six general types of laboratory staff development practices were nonexistent. Furthermore, regardless of size and/or type of laboratory setting, there were rare opportunities for staff development. The findings have implications for level of job satisfaction, level of professionalism, and even performance appraisal.
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Dietrich MC, King EC, Protas EJ. The relationship between biographic profile and job role preceptions of the allied health chair: a national study. J Allied Health 1980; 9:102-11. [PMID: 7400025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The purpose of the study was to construct a professional profile of medical technology and physical therapy baccalaureate chairs to compare male and female respondents in the areas of (1) biographic background, (2) career aspiration, (3) influence in decision making, (4) job-related stress, (5) goals important to role as chair, (6) skills important to role as chair, and (7) perception of ideal power. The response rate to a 1978 national survey was 72%. Statistical analysis on the 25 physical therapy females, 23 physical therapy males, and 20 medical technology female respondents revealed they were comparable in terms of the above variables. The three groups shared a common biographic profile except in the areas of marital status and clinical experience. These chairs exhibited low scholarly productivity and little interest in careers in academic administration or the clinical setting. Rather, they indicated sustained interest in departmental chair status or a return to fulltime faculty status. There was also perceived high participation in decision making, low to moderate job-related stress, and high concern for personal and faculty development. They agreed that selected administrative skills were necessary to their role as chairs. Finally, they reported that a considerable amount of power was necessary to their role as chairs in their institutions. Implications for chair development and recommendations for future research are discussed.
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Karling JW, King EC. Accounting for multi-unit systems. Mod Healthc 1980; 10:104-6. [PMID: 10245566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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King EC, Sawner KA. Status of clinical affiliation agreements: report on a national study. J Allied Health 1979; 8:144-52. [PMID: 10243170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
During spring 1977, a survey of all accredited college based educational programs in 11 allied health disciplines was conducted to assess the nature and content of affiliation agreements, attitudes toward affiliation agreements and the extent to which clinical facilities are being reimbursed by academic institutions for providing clinical instruction. This paper summarizes the data across the 11 disciplines. In contrast to prior research, the formal contract emerges as the most frequently used form of agreement. Specific rights and responsibilities of academic and clinical educators, including personal and professional liability insurance, are delineated. Student rights and responsibilities receive less attention. Eight percent of respondents are charged an overall fee for use of clinical facilities; an additional 32% feel that payment may be required in the future. Recommendations include provision for increased attention to student rights and responsibilities and for legal counsel in developing affiliation agreements.
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King EC. New emphasis placed on prudent buyer concept in health industry. Rev Fed Am Hosp 1979; 12:40-2. [PMID: 10297539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Abstract
The present study examined the effects of lesions of the mammillary system on spatial memory and arousal. Destruction of the medial mammillary nucleus or the mammillotegmental tract produces impairments on a delayed alternation task and greatly increases activity in the open-field. Lesions of the mammillothalamic tract produce a differential effect in that the spatial alternation deficit is accompanied by a general lethargy and unresponsiveness. It is suggested that the mammillary system plays a crucial role in the short-term storage of proprioceptive information necessary for the successive execution of maze choices. It also appears to play a role in the arousal state of the animal.
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Affiliation(s)
- T D Field
- Department of Psychology, University of Southern California, Los Angeles 90007
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King EC, Long TE. Competency based math curricula. J Pract Nurs 1976; 26:28-30. [PMID: 1046459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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