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Cunningham PS, Kitchen GB, Jackson C, Papachristos S, Springthorpe T, van Dellen D, Gibbs J, Felton TW, Wilson AJ, Bannard-Smith J, Rutter MK, House T, Dark P, Augustine T, Akman OE, Hazel AL, Blaikley JF. ClinCirc identifies alterations of the circadian peripheral oscillator in critical care patients. J Clin Invest 2023; 133:e162775. [PMID: 36538377 PMCID: PMC9927929 DOI: 10.1172/jci162775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open
Abstract
BackgroundAssessing circadian rhythmicity from infrequently sampled data is challenging; however, these types of data are often encountered when measuring circadian transcripts in hospitalized patients.MethodsWe present ClinCirc. This method combines 2 existing mathematical methods (Lomb-Scargle periodogram and cosinor) sequentially and is designed to measure circadian oscillations from infrequently sampled clinical data. The accuracy of this method was compared against 9 other methods using simulated and frequently sampled biological data. ClinCirc was then evaluated in 13 intensive care unit (ICU) patients as well as in a separate cohort of 29 kidney-transplant recipients. Finally, the consequences of circadian alterations were investigated in a retrospective cohort of 726 kidney-transplant recipients.ResultsClinCirc had comparable performance to existing methods for analyzing simulated data or clock transcript expression of healthy volunteers. It had improved accuracy compared with the cosinor method in evaluating circadian parameters in PER2:luc cell lines. In ICU patients, it was the only method investigated to suggest that loss of circadian oscillations in the peripheral oscillator was associated with inflammation, a feature widely reported in animal models. Additionally, ClinCirc was able to detect other circadian alterations, including a phase shift following kidney transplantation that was associated with the administration of glucocorticoids. This phase shift could explain why a significant complication of kidney transplantation (delayed graft dysfunction) oscillates according to the time of day kidney transplantation is performed.ConclusionClinCirc analysis of the peripheral oscillator reveals important clinical associations in hospitalized patients.FundingUK Research and Innovation (UKRI), National Institute of Health Research (NIHR), Engineering and Physical Sciences Research Council (EPSRC), National Institute on Academic Anaesthesia (NIAA), Asthma+Lung UK, Kidneys for Life.
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Affiliation(s)
- Peter S. Cunningham
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Gareth B. Kitchen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Callum Jackson
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Stavros Papachristos
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Thomas Springthorpe
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - David van Dellen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Julie Gibbs
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Timothy W. Felton
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Wythenshawe Hospital, MFT, Manchester, United Kingdom
| | - Anthony J. Wilson
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Jonathan Bannard-Smith
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Martin K. Rutter
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Thomas House
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - Paul Dark
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Northern Care Alliance NHS Foundation Trust (Salford Care Organisation), Salford, United Kingdom
| | - Titus Augustine
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Manchester Royal Infirmary, Manchester University NHS Foundation Trust (MFT), Manchester, United Kingdom
| | - Ozgur E. Akman
- School of Mathematics, University of Exeter, Exeter, United Kingdom
| | - Andrew L. Hazel
- Department of Mathematics, University of Manchester, Manchester, United Kingdom
| | - John F. Blaikley
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- Wythenshawe Hospital, MFT, Manchester, United Kingdom
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2
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Baxter M, Poolman T, Cunningham P, Hunter L, Voronkov M, Kitchen GB, Goosey L, Begley N, Kay D, Hespe A, Maidstone R, Loudon ASI, Ray DW. Circadian clock function does not require the histone methyltransferase MLL3. FASEB J 2022; 36:e22356. [PMID: 35704036 PMCID: PMC9328146 DOI: 10.1096/fj.202200368r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/26/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Abstract
The circadian clock controls the physiological function of tissues through the regulation of thousands of genes in a cell-type-specific manner. The core cellular circadian clock is a transcription-translation negative feedback loop, which can recruit epigenetic regulators to facilitate temporal control of gene expression. Histone methyltransferase, mixed lineage leukemia gene 3 (MLL3) was reported to be required for the maintenance of circadian oscillations in cultured cells. Here, we test the role of MLL3 in circadian organization in whole animals. Using mice expressing catalytically inactive MLL3, we show that MLL3 methyltransferase activity is in fact not required for circadian oscillations in vitro in a range of tissues, nor for the maintenance of circadian behavioral rhythms in vivo. In contrast to a previous report, loss of MLL3-dependent methylation did not affect the global levels of H3K4 methylation in liver, indicating substantial compensation from other methyltransferases. Furthermore, we found little evidence of genomic repositioning of H3K4me3 marks. We did, however, observe repositioning of H3K4me1 from intronic regions to intergenic regions and gene promoters; however, there were no changes in H3K4me1 mark abundance around core circadian clock genes. Output functions of the circadian clock, such as control of inflammation, were largely intact in MLL3-methyltransferase-deficient mice, although some gene-specific changes were observed, with sexually dimorphic loss of circadian regulation of specific cytokines. Taken together, these observations indicate that MLL3-directed histone methylation is not essential for core circadian clock function; however, it may influence the inflammatory response.
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Affiliation(s)
- Matthew Baxter
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Toryn Poolman
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Peter Cunningham
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Louise Hunter
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Maria Voronkov
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Gareth B. Kitchen
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Laurence Goosey
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Nicola Begley
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - Danielle Kay
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Abby Hespe
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Robert Maidstone
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Andrew S. I. Loudon
- Centre for Biological TimingFaculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
| | - David W. Ray
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
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Poole J, Kitchen GB. Circadian regulation of innate immunity in animals and humans and implications for human disease. Semin Immunopathol 2022; 44:183-192. [PMID: 35169890 PMCID: PMC8853148 DOI: 10.1007/s00281-022-00921-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 11/26/2021] [Accepted: 02/03/2022] [Indexed: 01/19/2023]
Abstract
Circadian rhythms are 24-h oscillating variations in physiology generated by the core circadian clock. There is now a wide body of evidence showing circadian regulation of the immune system. Innate immune cells contain the molecular circadian clock which drives rhythmic responses, from the magnitude of the inflammatory response to the numbers of circulating immune cells varying throughout the day. This leads to rhythmic presentation of disease clinically, for example the classic presentation of nocturnal asthma or the sudden development of pulmonary oedema from acute myocardial infarction first thing in the morning.
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Affiliation(s)
- Joanna Poole
- Southmead Hospital, North Bristol Trust, Southmead Rd, Bristol, BS10 5NB, UK
| | - Gareth B Kitchen
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, M13 9PT, UK.
- Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, M13 9WL, UK.
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4
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Kitchen GB, Hopwood T, Gali Ramamoorthy T, Downton P, Begley N, Hussell T, Dockrell DH, Gibbs JE, Ray DW, Loudon ASI. The histone methyltransferase Ezh2 restrains macrophage inflammatory responses. FASEB J 2021; 35:e21843. [PMID: 34464475 PMCID: PMC8573545 DOI: 10.1096/fj.202100044rrr] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/06/2021] [Accepted: 07/23/2021] [Indexed: 01/02/2023]
Abstract
Robust inflammatory responses are critical to survival following respiratory infection, with current attention focused on the clinical consequences of the Coronavirus pandemic. Epigenetic factors are increasingly recognized as important determinants of immune responses, and EZH2 is a prominent target due to the availability of highly specific and efficacious antagonists. However, very little is known about the role of EZH2 in the myeloid lineage. Here, we show EZH2 acts in macrophages to limit inflammatory responses to activation, and in neutrophils for chemotaxis. Selective genetic deletion in macrophages results in a remarkable gain in protection from infection with the prevalent lung pathogen, pneumococcus. In contrast, neutrophils lacking EZH2 showed impaired mobility in response to chemotactic signals, and resulted in increased susceptibility to pneumococcus. In summary, EZH2 shows complex, and divergent roles in different myeloid lineages, likely contributing to the earlier conflicting reports. Compounds targeting EZH2 are likely to impair mucosal immunity; however, they may prove useful for conditions driven by pulmonary neutrophil influx, such as adult respiratory distress syndrome.
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Affiliation(s)
- Gareth B. Kitchen
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
- Manchester University NHS Foundation Trust, Manchester Academic Health Science CentreManchesterUK
| | - Thomas Hopwood
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - Thanuja Gali Ramamoorthy
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - Polly Downton
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - Nicola Begley
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - Tracy Hussell
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - David H. Dockrell
- Department of Infection Medicine and MRC Centre for Inflammation ResearchUniversity of EdinburghEdinburghUK
| | - Julie E. Gibbs
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
| | - David W. Ray
- NIHR Oxford Biomedical Research Centre, John Radcliffe HospitalOxfordUK
- Oxford Centre for Diabetes, Endocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Andrew S. I. Loudon
- Faculty of Biology, Medicine and HealthUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
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Locke S, Bashall A, Al-Adely S, Moore J, Wilson A, Kitchen GB. Natural language processing in medicine: A review. Trends in Anaesthesia and Critical Care 2021. [DOI: 10.1016/j.tacc.2021.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Kitchen GB, Cunningham PS, Poolman TM, Iqbal M, Maidstone R, Baxter M, Bagnall J, Begley N, Saer B, Hussell T, Matthews LC, Dockrell DH, Durrington HJ, Gibbs JE, Blaikley JF, Loudon AS, Ray DW. The clock gene Bmal1 inhibits macrophage motility, phagocytosis, and impairs defense against pneumonia. Proc Natl Acad Sci U S A 2020; 117:1543-1551. [PMID: 31900362 PMCID: PMC6983378 DOI: 10.1073/pnas.1915932117] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The circadian clock regulates many aspects of immunity. Bacterial infections are affected by time of day, but the mechanisms involved remain undefined. Here we show that loss of the core clock protein BMAL1 in macrophages confers protection against pneumococcal pneumonia. Infected mice show both reduced weight loss and lower bacterial burden in circulating blood. In vivo studies of macrophage phagocytosis reveal increased bacterial ingestion following Bmal1 deletion, which was also seen in vitro. BMAL1-/- macrophages exhibited marked differences in actin cytoskeletal organization, a phosphoproteome enriched for cytoskeletal changes, with reduced phosphocofilin and increased active RhoA. Further analysis of the BMAL1-/- macrophages identified altered cell morphology and increased motility. Mechanistically, BMAL1 regulated a network of cell movement genes, 148 of which were within 100 kb of high-confidence BMAL1 binding sites. Links to RhoA function were identified, with 29 genes impacting RhoA expression or activation. RhoA inhibition restored the phagocytic phenotype to that seen in control macrophages. In summary, we identify a surprising gain of antibacterial function due to loss of BMAL1 in macrophages, associated with a RhoA-dependent cytoskeletal change, an increase in cell motility, and gain of phagocytic function.
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Affiliation(s)
- Gareth B Kitchen
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
- Manchester Foundation Trust, Manchester Academic Health Science Centre, M13 9WL Manchester, United Kingdom
| | - Peter S Cunningham
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Toryn M Poolman
- National Institute for Health Research, John Radcliffe Hospital, Oxford Biomedical Research Centre, OX3 9DU Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX37LE Oxford, United Kingdom
| | - Mudassar Iqbal
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Robert Maidstone
- National Institute for Health Research, John Radcliffe Hospital, Oxford Biomedical Research Centre, OX3 9DU Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX37LE Oxford, United Kingdom
| | - Matthew Baxter
- National Institute for Health Research, John Radcliffe Hospital, Oxford Biomedical Research Centre, OX3 9DU Oxford, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX37LE Oxford, United Kingdom
| | - James Bagnall
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Nicola Begley
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Ben Saer
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Tracy Hussell
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - Laura C Matthews
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, LS9 7TF Leeds, United Kingdom
| | - David H Dockrell
- Department of Infection Medicine and Medical Research Council Centre for Inflammation Research, University of Edinburgh, EH16 4TJ Edinburgh, United Kingdom
| | - Hannah J Durrington
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
- Manchester Foundation Trust, Manchester Academic Health Science Centre, M13 9WL Manchester, United Kingdom
| | - Julie E Gibbs
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom
| | - John F Blaikley
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom;
- Manchester Foundation Trust, Manchester Academic Health Science Centre, M13 9WL Manchester, United Kingdom
| | - Andrew S Loudon
- Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, M13 9PT Manchester, United Kingdom;
| | - David W Ray
- National Institute for Health Research, John Radcliffe Hospital, Oxford Biomedical Research Centre, OX3 9DU Oxford, United Kingdom;
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, OX37LE Oxford, United Kingdom
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8
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Cunningham PS, Meijer P, Nazgiewicz A, Anderson SG, Borthwick LA, Bagnall J, Kitchen GB, Lodyga M, Begley N, Venkateswaran RV, Shah R, Mercer PF, Durrington HJ, Henderson NC, Piper-Hanley K, Fisher AJ, Chambers RC, Bechtold DA, Gibbs JE, Loudon AS, Rutter MK, Hinz B, Ray DW, Blaikley JF. The circadian clock protein REVERBα inhibits pulmonary fibrosis development. Proc Natl Acad Sci U S A 2020; 117:1139-1147. [PMID: 31879343 PMCID: PMC6969503 DOI: 10.1073/pnas.1912109117] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Pulmonary inflammatory responses lie under circadian control; however, the importance of circadian mechanisms in the underlying fibrotic phenotype is not understood. Here, we identify a striking change to these mechanisms resulting in a gain of amplitude and lack of synchrony within pulmonary fibrotic tissue. These changes result from an infiltration of mesenchymal cells, an important cell type in the pathogenesis of pulmonary fibrosis. Mutation of the core clock protein REVERBα in these cells exacerbated the development of bleomycin-induced fibrosis, whereas mutation of REVERBα in club or myeloid cells had no effect on the bleomycin phenotype. Knockdown of REVERBα revealed regulation of the little-understood transcription factor TBPL1. Both REVERBα and TBPL1 altered integrinβ1 focal-adhesion formation, resulting in increased myofibroblast activation. The translational importance of our findings was established through analysis of 2 human cohorts. In the UK Biobank, circadian strain markers (sleep length, chronotype, and shift work) are associated with pulmonary fibrosis, making them risk factors. In a separate cohort, REVERBα expression was increased in human idiopathic pulmonary fibrosis (IPF) lung tissue. Pharmacological targeting of REVERBα inhibited myofibroblast activation in IPF fibroblasts and collagen secretion in organotypic cultures from IPF patients, thus suggesting that targeting of REVERBα could be a viable therapeutic approach.
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Affiliation(s)
- Peter S Cunningham
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Peter Meijer
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Alicja Nazgiewicz
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Simon G Anderson
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
- The George Alleyne Chronic Disease Research Centre, The University of the West Indies, Bridgetown. Barbados BB11000
| | - Lee A Borthwick
- Fibrosis Research Group, Biosciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - James Bagnall
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Gareth B Kitchen
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
| | - Monika Lodyga
- Laboratory of Tissue Repair and Regeneration, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada
| | - Nicola Begley
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Rajamiyer V Venkateswaran
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
| | - Rajesh Shah
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
| | - Paul F Mercer
- Centre for Inflammation and Tissue Repair, Faculty of Medical Sciences, University College London, London WC1E 6JJ, United Kingdom
| | - Hannah J Durrington
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
| | - Neil C Henderson
- Centre for Inflammation Research, University of Edinburgh, EH16 4TJ Edinburgh, United Kingdom
| | - Karen Piper-Hanley
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Andrew J Fisher
- Institute of Transplantation, Freeman Hospital, The Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne NE7 7DN, United Kingdom
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Rachel C Chambers
- Centre for Inflammation and Tissue Repair, Faculty of Medical Sciences, University College London, London WC1E 6JJ, United Kingdom
| | - David A Bechtold
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Julie E Gibbs
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Andrew S Loudon
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
| | - Martin K Rutter
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
| | - Boris Hinz
- Laboratory of Tissue Repair and Regeneration, Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada
| | - David W Ray
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom
- National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, United Kingdom
| | - John F Blaikley
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, United Kingdom;
- Manchester University National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL, United Kingdom
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Kitchen GB. Learning from the experience of others. Trends in Anaesthesia and Critical Care 2014. [DOI: 10.1016/j.tacc.2014.04.011] [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: 11/27/2022]
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Kitchen GB, Humphreys J. Serious games in medical education. Do they have a role in anaesthetic training. Trends in Anaesthesia and Critical Care 2014. [DOI: 10.1016/j.tacc.2014.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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