1
|
Aguirre CG, Woo JH, Romero-Sosa JL, Rivera ZM, Tejada AN, Munier JJ, Perez J, Goldfarb M, Das K, Gomez M, Ye T, Pannu J, Evans K, O'Neill PR, Spigelman I, Soltani A, Izquierdo A. Dissociable Contributions of Basolateral Amygdala and Ventrolateral Orbitofrontal Cortex to Flexible Learning Under Uncertainty. J Neurosci 2024; 44:e0622232023. [PMID: 37968116 PMCID: PMC10860573 DOI: 10.1523/jneurosci.0622-23.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023] Open
Abstract
Reversal learning measures the ability to form flexible associations between choice outcomes with stimuli and actions that precede them. This type of learning is thought to rely on several cortical and subcortical areas, including the highly interconnected orbitofrontal cortex (OFC) and basolateral amygdala (BLA), and is often impaired in various neuropsychiatric and substance use disorders. However, the unique contributions of these regions to stimulus- and action-based reversal learning have not been systematically compared using a chemogenetic approach particularly before and after the first reversal that introduces new uncertainty. Here, we examined the roles of ventrolateral OFC (vlOFC) and BLA during reversal learning. Male and female rats were prepared with inhibitory designer receptors exclusively activated by designer drugs targeting projection neurons in these regions and tested on a series of deterministic and probabilistic reversals during which they learned about stimulus identity or side (left or right) associated with different reward probabilities. Using a counterbalanced within-subject design, we inhibited these regions prior to reversal sessions. We assessed initial and pre-/post-reversal changes in performance to measure learning and adjustments to reversals, respectively. We found that inhibition of the ventrolateral orbitofrontal cortex (vlOFC), but not BLA, eliminated adjustments to stimulus-based reversals. Inhibition of BLA, but not vlOFC, selectively impaired action-based probabilistic reversal learning, leaving deterministic reversal learning intact. vlOFC exhibited a sex-dependent role in early adjustment to action-based reversals, but not in overall learning. These results reveal dissociable roles for BLA and vlOFC in flexible learning and highlight a more crucial role for BLA in learning meaningful changes in the reward environment.
Collapse
Affiliation(s)
- C G Aguirre
- Department of Psychology, University of California, Los Angeles, California 90095
| | - J H Woo
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755
| | - J L Romero-Sosa
- Department of Psychology, University of California, Los Angeles, California 90095
| | - Z M Rivera
- Department of Psychology, University of California, Los Angeles, California 90095
| | - A N Tejada
- Department of Psychology, University of California, Los Angeles, California 90095
| | - J J Munier
- Section of Biosystems and Function, School of Dentistry, University of California, Los Angeles, California 90095
| | - J Perez
- Department of Psychology, University of California, Los Angeles, California 90095
| | - M Goldfarb
- Department of Psychology, University of California, Los Angeles, California 90095
| | - K Das
- Department of Psychology, University of California, Los Angeles, California 90095
| | - M Gomez
- Department of Psychology, University of California, Los Angeles, California 90095
| | - T Ye
- Department of Psychology, University of California, Los Angeles, California 90095
| | - J Pannu
- Section of Biosystems and Function, School of Dentistry, University of California, Los Angeles, California 90095
| | - K Evans
- Department of Psychology, University of California, Los Angeles, California 90095
| | - P R O'Neill
- Shirley and Stefan Hatos Center for Neuropharmacology, Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California 90095
| | - I Spigelman
- Section of Biosystems and Function, School of Dentistry, University of California, Los Angeles, California 90095
| | - A Soltani
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire 03755
| | - A Izquierdo
- Department of Psychology, University of California, Los Angeles, California 90095
| |
Collapse
|
2
|
Sharma S, Pannu J, Chorlton S, Swett JL, Ecker DJ. Threat Net: A Metagenomic Surveillance Network for Biothreat Detection and Early Warning. Health Secur 2023; 21:347-357. [PMID: 37367195 DOI: 10.1089/hs.2022.0160] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Early detection of novel pathogens can prevent or substantially mitigate biological incidents, including pandemics. Metagenomic next-generation sequencing (mNGS) of symptomatic clinical samples may enable detection early enough to contain outbreaks, limit international spread, and expedite countermeasure development. In this article, we propose a clinical mNGS architecture we call "Threat Net," which focuses on the hospital emergency department as a high-yield surveillance location. We develop a susceptible-exposed-infected-removed (SEIR) simulation model to estimate the effectiveness of Threat Net in detecting novel respiratory pathogen outbreaks. Our analysis serves to quantify the value of routine clinical mNGS for respiratory pandemic detection by estimating the cost and epidemiological effectiveness at differing degrees of hospital coverage across the United States. We estimate that a biological threat detection network such as Threat Net could be deployed across hospitals covering 30% of the population in the United States. Threat Net would cost between $400 million and $800 million annually and have a 95% chance of detecting a novel respiratory pathogen with traits of SARS-CoV-2 after 10 emergency department presentations and 79 infections across the United States. Our analyses suggest that implementing Threat Net could help prevent or substantially mitigate the spread of a respiratory pandemic pathogen in the United States.
Collapse
Affiliation(s)
- Siddhanth Sharma
- Siddhanth Sharma, MD MPH, is a Public Health Registrar, Metropolitan Communicable Disease Control, Perth, Australia
| | - Jaspreet Pannu
- Jaspreet Pannu, MD, is a Resident Physician, Department of Medicine, Stanford University School of Medicine, Stanford, CA. Johns Hopkins Center for Health Security, Baltimore, MD
| | - Sam Chorlton
- Sam Chorlton, MD, D(ABMM), is Chief Executive Officer, BugSeq Bioinformatics, Vancouver, Canada
| | - Jacob L Swett
- Jacob L. Swett, DPhil, is Cofounder, altLabs, Inc., Berkeley, CA
| | - David J Ecker
- David J. Ecker, PhD, is Vice President of Strategic Innovation, Ionis Pharmaceuticals, Carlsbad, CA
| |
Collapse
|
3
|
Pannu J, Glenn JS. Programmable Antivirals and Just-in-Time Vaccines: Biosecurity Implications of Viral RNA Secondary Structure Targeting. Health Secur 2023; 21:81-84. [PMID: 36576394 DOI: 10.1089/hs.2022.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Jaspreet Pannu
- Jaspreet Pannu, MD, is a Resident Physician, Department of Medicine, Stanford University School of Medicine, Stanford, CA; and a Fellow, Center for Health Security, Johns Hopkins School of Public Health, Baltimore, MD
| | - Jeffrey S Glenn
- Jeffrey S. Glenn, MD, PhD, is the Joseph D. Grant Professor, Department of Medicine, and Professor, Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA; and Director, ViRx@Stanford, Stanford Medicine, Stanford, CA. He is also a Physician, Veterans Administration Medical Center, Palo Alto, CA
| |
Collapse
|
4
|
Pannu J, Palmer MJ, Cicero A, Relman DA, Lipsitch M, Inglesby T. Strengthen oversight of risky research on pathogens. Science 2022; 378:1170-1172. [PMID: 36480598 DOI: 10.1126/science.adf6020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Policy reset and convergence on governance are needed.
Collapse
Affiliation(s)
- Jaspreet Pannu
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Megan J Palmer
- Department of Bioengineering, Stanford University, Stanford, CA, USA.,Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Anita Cicero
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - David A Relman
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.,Center for International Security and Cooperation, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.,Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA.,Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Marc Lipsitch
- Center for Communicable Disease Dynamics, Departments of Epidemiology and Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tom Inglesby
- Center for Health Security, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
5
|
Abstract
PURPOSE OF REVIEW Due to the impact of the COVID-19 pandemic this past year, we have witnessed a significant acceleration in the science, technology, and policy of global health security. This review highlights important progress made toward the mitigation of Zika, Ebola, and COVID-19 outbreaks. These epidemics and their shared features suggest a unified policy and technology agenda that could broadly improve global health security. RECENT FINDINGS Molecular epidemiology is not yet in widespread use, but shows promise toward informing on-the-ground decision-making during outbreaks. Point-of-care (POC) diagnostics have been achieved for each of these threats; however, deployment of Zika and Ebola diagnostics lags behind those for COVID-19. POC metagenomics offers the possibility of identifying novel viruses. Vaccines have been successfully approved for Ebola and COVID-19, due in large part to public-private partnerships and advance purchase commitments. Therapeutics trials conducted during ongoing epidemics have identified effective antibody therapeutics for Ebola, as well as steroids (both inhaled and oral) and a broad-spectrum antiviral for COVID-19. SUMMARY Achieving global health security remains a challenge, though headway has been made over the past years. Promising policy and technology strategies that would increase resilience across emerging viral pathogens should be pursued.
Collapse
Affiliation(s)
| | - Michele Barry
- School of Medicine
- Center for Innovation in Global Health, Stanford University, Stanford, California, USA
| |
Collapse
|
6
|
Affiliation(s)
- Jaspreet Pannu
- Stanford School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - Michele Barry
- Stanford School of Medicine, Stanford University, Stanford, CA 94305, USA.
| |
Collapse
|
7
|
Baker N, Bromley-Dulfano R, Chan J, Gupta A, Herman L, Jain N, Taylor AL, Lu J, Pannu J, Patel L, Prunicki M. COVID-19 Solutions Are Climate Solutions: Lessons From Reusable Gowns. Front Public Health 2020; 8:590275. [PMID: 33330335 PMCID: PMC7732643 DOI: 10.3389/fpubh.2020.590275] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/30/2020] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has laid bare the inadequacy of the U.S. healthcare system to deliver timely and resilient care. According to the American Hospital Association, the pandemic has created a $202 billion loss across the healthcare industry, forcing health care systems to lay off workers and making hospitals scramble to minimize supply chain costs. However, as the demand for personal protective equipment (PPE) grows, hospitals have sacrificed sustainable solutions for disposable options that, although convenient, will exacerbate supply strains, financial burden, and waste. We advocate for reusable gowns as a means to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers. Reusable gowns' polyester material provides comparable capacity to reduce microbial cross-transmission and liquid penetration. In addition, previous hospitals have reported a 50% cost reduction in gown expenditures after adopting reusable gowns; given the current 2000% price increase in isolation gowns during COVID-19, reusable gown use will build both healthcare resilience and security from price fluctuations. Finally, with the United States' medical waste stream worsening, reusable isolation gowns show promising reductions in energy and water use, solid waste, and carbon footprint. The gowns are shown to withstand laundering 75–100 times in contrast to the single-use disposable gown. The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.
Collapse
Affiliation(s)
| | | | - Joshua Chan
- Stanford University, Stanford, CA, United States
| | - Anshal Gupta
- Stanford University School of Medicine, Stanford, CA, United States
| | | | - Navami Jain
- Stanford University, Stanford, CA, United States
| | - Anita Lowe Taylor
- Department of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Stanford, CA, United States
| | - Jonathan Lu
- Stanford University School of Medicine, Stanford, CA, United States
| | - Jaspreet Pannu
- Department of Internal Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Lisa Patel
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - Mary Prunicki
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Stanford, CA, United States
| |
Collapse
|
8
|
Pannu J. Inclusive Biomedical Innovation during the COVID-19 Pandemic. Glob Policy 2020; 11:647-649. [PMID: 33230401 PMCID: PMC7675476 DOI: 10.1111/1758-5899.12876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/22/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
CEPI represents the first step towards Joseph Stiglitz's vision, cited by Gubby, of a fund which provides large rewards for cures to common diseases such as malaria, and smaller rewards for rarer diseases or less innovative 'me-too' drugs (Stiglitz, BMJ, 333, 2006, pp. 1279-1280). As a fledgling organization facing a Goliath, it deserves international support in its dual goals of incentivizing innovation and ensuring equitable access to biomedical advances.
Collapse
|
9
|
Cole EJ, Stimpson KH, Bentzley BS, Gulser M, Cherian K, Tischler C, Nejad R, Pankow H, Choi E, Aaron H, Espil FM, Pannu J, Xiao X, Duvio D, Solvason HB, Hawkins J, Guerra A, Jo B, Raj KS, Phillips AL, Barmak F, Bishop JH, Coetzee JP, DeBattista C, Keller J, Schatzberg AF, Sudheimer KD, Williams NR. Stanford Accelerated Intelligent Neuromodulation Therapy for Treatment-Resistant Depression. Am J Psychiatry 2020; 177:716-726. [PMID: 32252538 DOI: 10.1176/appi.ajp.2019.19070720] [Citation(s) in RCA: 261] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE New antidepressant treatments are needed that are effective, rapid acting, safe, and tolerable. Intermittent theta-burst stimulation (iTBS) is a noninvasive brain stimulation treatment that has been approved by the U.S. Food and Drug Administration for treatment-resistant depression. Recent methodological advances suggest that the current iTBS protocol might be improved through 1) treating patients with multiple sessions per day at optimally spaced intervals, 2) applying a higher overall pulse dose of stimulation, and 3) precision targeting of the left dorsolateral prefrontal cortex (DLPFC) to subgenual anterior cingulate cortex (sgACC) circuit. The authors examined the feasibility, tolerability, and preliminary efficacy of Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT), an accelerated, high-dose resting-state functional connectivity MRI (fcMRI)-guided iTBS protocol for treatment-resistant depression. METHODS Twenty-two participants with treatment-resistant depression received open-label SAINT. fcMRI was used to individually target the region of the left DLPFC most anticorrelated with sgACC in each participant. Fifty iTBS sessions (1,800 pulses per session, 50-minute intersession interval) were delivered as 10 daily sessions over 5 consecutive days at 90% resting motor threshold (adjusted for cortical depth). Neuropsychological testing was conducted before and after SAINT. RESULTS One participant withdrew, leaving a sample size of 21. Nineteen of 21 participants (90.5%) met remission criteria (defined as a score <11 on the Montgomery-Åsberg Depression Rating Scale). In the intent-to-treat analysis, 19 of 22 participants (86.4%) met remission criteria. Neuropsychological testing demonstrated no negative cognitive side effects. CONCLUSIONS SAINT, an accelerated, high-dose, iTBS protocol with fcMRI-guided targeting, was well tolerated and safe. Double-blinded sham-controlled trials are needed to confirm the remission rate observed in this initial study.
Collapse
Affiliation(s)
- Eleanor J Cole
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Katy H Stimpson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Merve Gulser
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Claudia Tischler
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Romina Nejad
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Heather Pankow
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Elizabeth Choi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Haley Aaron
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Flint M Espil
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Xiaoqian Xiao
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Dalton Duvio
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Hugh B Solvason
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Austin Guerra
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Booil Jo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Kristin S Raj
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Angela L Phillips
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Fahim Barmak
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - James H Bishop
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - John P Coetzee
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Charles DeBattista
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Keith D Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| | - Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, Calif. (all authors), and Department of Psychology (Stimpson, Cherian, Choi, Aaron, Guerra, Phillips), Palo Alto University, Palo Alto, Calif
| |
Collapse
|
10
|
Affiliation(s)
- Jaspreet Pannu
- Jaspreet Pannu is an Internal Medicine Resident, Stanford University School of Medicine, Palo Alto, CA
| |
Collapse
|
11
|
|
12
|
Williams NR, Sudheimer KD, Bentzley BS, Pannu J, Stimpson KH, Duvio D, Cherian K, Hawkins J, Scherrer KH, Vyssoki B, DeSouza D, Raj KS, Keller J, Schatzberg AF. High-dose spaced theta-burst TMS as a rapid-acting antidepressant in highly refractory depression. Brain 2019; 141:e18. [PMID: 29415152 DOI: 10.1093/brain/awx379] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Keith D Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Katy H Stimpson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Dalton Duvio
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Kirsten Cherian
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | | | - Benjamin Vyssoki
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Danielle DeSouza
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, USA
| | - Kristin S Raj
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Jennifer Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Alan F Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| |
Collapse
|
13
|
Williams NR, Heifets BD, Blasey C, Sudheimer K, Pannu J, Pankow H, Hawkins J, Birnbaum J, Lyons DM, Rodriguez CI, Schatzberg AF. Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism. Am J Psychiatry 2018; 175:1205-1215. [PMID: 30153752 PMCID: PMC6395554 DOI: 10.1176/appi.ajp.2018.18020138] [Citation(s) in RCA: 284] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE In addition to N-methyl-d-aspartate receptor antagonism, ketamine produces opioid system activation. The objective of this study was to determine whether opioid receptor antagonism prior to administration of intravenous ketamine attenuates its acute antidepressant or dissociative effects. METHOD In a proposed double-blind crossover study of 30 adults with treatment-resistant depression, the authors performed a planned interim analysis after studying 14 participants, 12 of whom completed both conditions in randomized order: placebo or 50 mg of naltrexone preceding intravenous infusion of 0.5 mg/kg of ketamine. Response was defined as a reduction ≥50% in score on the 17-item Hamilton Depression Rating Scale (HAM-D) score on postinfusion day 1. RESULTS In the interim analysis, seven of 12 adults with treatment-resistant depression met the response criterion during the ketamine plus placebo condition. Reductions in 6-item and 17-item HAM-D scores among participants in the ketamine plus naltrexone condition were significantly lower than those of participants in the ketamine plus placebo condition on postinfusion days 1 and 3. Secondary analysis of all participants who completed the placebo and naltrexone conditions, regardless of the robustness of response to ketamine, showed similar results. There were no differences in ketamine-induced dissociation between conditions. Because naltrexone dramatically blocked the antidepressant but not the dissociative effects of ketamine, the trial was halted at the interim analysis. CONCLUSIONS The findings suggest that ketamine's acute antidepressant effect requires opioid system activation. The dissociative effects of ketamine are not mediated by the opioid system, and they do not appear sufficient without the opioid effect to produce the acute antidepressant effects of ketamine in adults with treatment-resistant depression.
Collapse
Affiliation(s)
- Nolan R. Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Address correspondence to: Nolan Williams, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5717, , Alan Schatzberg, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5797,
| | - Boris D. Heifets
- Department of Anesthesiology, Perioperative & Pain Medicine, Stanford University
| | - Christine Blasey
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto University
| | - Keith Sudheimer
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Heather Pankow
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Jessica Hawkins
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Justin Birnbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - David M. Lyons
- Department of Psychiatry and Behavioral Sciences, Stanford University
| | - Carolyn I. Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Veterans Affairs Palo Alto Health Care System
| | - Alan F. Schatzberg
- Department of Psychiatry and Behavioral Sciences, Stanford University, Address correspondence to: Nolan Williams, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5717, , Alan Schatzberg, MD, Department of Psychiatry & Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, MailCode: 5797,
| |
Collapse
|
14
|
Williams NR, Bentzley BS, Hopkins T, Pannu J, Sahlem GL, Takacs I, George MS, Nahas Z, Short EB. Optimization of epidural cortical stimulation for treatment-resistant depression. Brain Stimul 2018; 11:239-240. [PMID: 28918944 DOI: 10.1016/j.brs.2017.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 08/29/2017] [Accepted: 09/01/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Nolan R Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA.
| | - Brandon S Bentzley
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Thomas Hopkins
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Jaspreet Pannu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, USA
| | - Gregory L Sahlem
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| | - Istvan Takacs
- Department of Neurosurgery, Medical University of South Carolina, Charleston, USA
| | - Mark S George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Ziad Nahas
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Edward Baron Short
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, USA
| |
Collapse
|
15
|
Pannu J, Poole S, Shah N, Shah NH. Assessing Screening Guidelines for Cardiovascular Disease Risk Factors using Routinely Collected Data. Sci Rep 2017; 7:6488. [PMID: 28747722 PMCID: PMC5529363 DOI: 10.1038/s41598-017-06492-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 02/15/2017] [Accepted: 06/13/2017] [Indexed: 12/13/2022] Open
Abstract
This study investigates if laboratory data can be used to assess whether physician-retesting patterns are in line with established guidelines, and if these guidelines identify deteriorating patients in a timely manner. A total of 7594 patients with high cholesterol were studied, along with 2764 patients with diabetes. More than 90% of borderline high cholesterol patients are retested within the 3 year recommended period, however less than 75% of pre-diabetic patients have repeated tests within the suggested 1-year time frame. Patients with borderline high cholesterol typically progress to full high cholesterol in 2-3 years, and pre-diabetic patients progress to full diabetes in 1-2 years. Data from routinely ordered laboratory tests can be used to monitor adherence to clinical guidelines. These data may also be useful in the design of adaptive testing strategies that reduce unnecessary testing, while ensuring that patient deterioration is identified in a timely manner. Established guidelines for testing of total serum cholesterol for hypercholesterolemia are appropriate and are well-adhered to, whereas guidelines for glycated hemoglobin A1c testing for type 2 diabetes mellitus could be improved to bring them in line with current practice and avoid unnecessary testing.
Collapse
Affiliation(s)
- Jaspreet Pannu
- School of Medicine, Stanford University, Stanford, CA, USA.
| | - Sarah Poole
- Stanford University Center for Bioinformatics Research, Stanford, CA, USA
| | - Neil Shah
- Department of Pathology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Nigam H Shah
- Stanford University Center for Bioinformatics Research, Stanford, CA, USA
| |
Collapse
|
16
|
Williams NR, Bentzley BS, Sahlem GL, Pannu J, Korte JE, Revuelta G, Short EB, George MS. Unilateral ultra-brief pulse electroconvulsive therapy for depression in Parkinson's disease. Acta Neurol Scand 2017; 135:407-411. [PMID: 27241213 DOI: 10.1111/ane.12614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Electroconvulsive therapy (ECT) has demonstrated efficacy in treating core symptoms of Parkinson's disease (PD); however, widespread use of ECT in PD has been limited due to concern over cognitive burden. We investigated the use of a newer ECT technology known to have fewer cognitive side effects (right unilateral [RUL] ultra-brief pulse [UBP]) for the treatment of medically refractory psychiatric dysfunction in PD. MATERIALS AND METHODS This open-label pilot study included 6 patients who were assessed in the motoric, cognitive, and neuropsychiatric domains prior to and after RUL UBP ECT. Primary endpoints were changes in total score on the HAM-D-17 and GDS-30 rating scales. RESULTS Patients were found to improve in motoric and psychiatric domains following RUL UBP ECT without cognitive side effects, both immediately following ECT and at 1-month follow-up. CONCLUSIONS This study demonstrates that RUL UBP ECT is safe, feasible, and potentially efficacious in treating multiple domains of PD, including motor and mood, without clear cognitive side effects.
Collapse
Affiliation(s)
- N. R. Williams
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - B. S. Bentzley
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - G. L. Sahlem
- Department of Psychiatry; Medical University of South Carolina; Charleston SC USA
| | - J. Pannu
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - J. E. Korte
- Department of Public Health Sciences; Medical University of South Carolina; Charleston SC USA
| | - G. Revuelta
- Department of Neurology; Medical University of South Carolina; Charleston SC USA
| | - E. B. Short
- Department of Psychiatry; Medical University of South Carolina; Charleston SC USA
| | - M. S. George
- Department of Neurology; Medical University of South Carolina; Charleston SC USA
- Department of Psychiatry; Medical University of South Carolina; Charleston SC USA
- Ralph H. Johnson VA Medical Center; Charleston SC USA
| |
Collapse
|
17
|
Bentzley BS, Pannu J, Badran BW, Halpern CH, Williams NR. It takes time to tune. Ann Transl Med 2017; 5:171. [PMID: 28480207 PMCID: PMC5401673 DOI: 10.21037/atm.2017.03.49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/06/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Brandon S. Bentzley
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Jaspreet Pannu
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bashar W. Badran
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Casey H. Halpern
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Nolan R. Williams
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
18
|
Williams N, Sahlem G, Pannu J, Takacs I, Short B, Revuelta G, George M. Bridging to deep brain stimulation implantation using electroconvulsive therapy in Parkinson’s disease. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.242] [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: 11/28/2022] Open
|
19
|
Williams NR, Sahlem G, Pannu J, Takacs I, Short B, Revuelta G, George MS. Neuroversion: using electroconvulsive therapy as a bridge to deep brain stimulation implantation. Neurocase 2017; 23:26-30. [PMID: 28376692 DOI: 10.1080/13554794.2016.1276605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Parkinson's disease (PD) is a movement disorder with significant neuropsychiatric comorbidities. Electroconvulsive therapy (ECT) is effective in treating these neuropsychiatric symptoms; however, clinicians are reluctant to use ECT in patients with deep brain stimulation (DBS) implantations for fear of damaging the device, as well as potential cognitive side effects. Right unilateral ultra-brief pulse (RUL UBP) ECT has a more favorable cognitive side-effect profile yet has never been reported in PD patients with DBS implants. We present a case series of three patients with a history of PD that all presented with psychiatric decompensation immediately prior to planned DBS surgery. All three patients had DBS electrode(s) in place at the time and an acute course of ECT was utilized in a novel method to "bridge" these individuals to neurosurgery. The patients all experienced symptom resolution (psychosis and/or depression and/or anxiety) without apparent cognitive side effects. This case series not only illustrates that right unilateral ultra-brief pulse can be utilized in patients with DBS electrodes but also illustrates that this intervention can be utilized as a neuromodulatory "bridge", where nonoperative surgical candidates with unstable psychiatric symptoms can be converted to operative candidates in a manner similar to electrical cardioversion.
Collapse
Affiliation(s)
- Nolan R Williams
- a Department of Psychiatry , Stanford University , Stanford , CA , USA
| | - Greg Sahlem
- b Department of Psychiatry , Medical University of South Carolina , Charleston , SC , USA
| | - Jaspreet Pannu
- a Department of Psychiatry , Stanford University , Stanford , CA , USA
| | - Istvan Takacs
- d Department of Neurosurgery , Medical University of South Carolina , Charleston , SC , USA
| | - Baron Short
- b Department of Psychiatry , Medical University of South Carolina , Charleston , SC , USA
| | - Gonzalo Revuelta
- c Department of Neurology , Medical University of South Carolina , Charleston , SC , USA
| | - Mark S George
- b Department of Psychiatry , Medical University of South Carolina , Charleston , SC , USA.,c Department of Neurology , Medical University of South Carolina , Charleston , SC , USA
| |
Collapse
|
20
|
Aldridge C, Behrend EN, Kemppainen RJ, Lee-Fowler TM, Martin LG, Ward CR, Bruyette D, Pannu J, Gaillard P, Lee HP. Comparison of 2 Doses for ACTH Stimulation Testing in Dogs Suspected of or Treated for Hyperadrenocorticism. J Vet Intern Med 2016; 30:1637-1641. [PMID: 27425787 PMCID: PMC5032869 DOI: 10.1111/jvim.14528] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 02/01/2016] [Revised: 05/10/2016] [Accepted: 06/28/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lowering the cosyntropin dose needed for ACTH stimulation would make the test more economical. OBJECTIVES To compare the cortisol response to 1 and 5 μg/kg cosyntropin IV in dogs being screened for hyperadrenocorticism (HAC) and in dogs receiving trilostane or mitotane for pituitary-dependent HAC. ANIMALS Healthy dogs (n = 10); client-owned dogs suspected of having HAC (n = 39) or being treated for pituitary-dependent HAC with mitotane (n = 12) or trilostane (n = 15). PROCEDURES In this prospective study, healthy dogs had consecutive ACTH stimulation tests to ensure 2 tests could be performed in sequence. For the first test, cosyntropin (1 μg/kg IV) was administered; the second test was initiated 4 hours after the start of the first (5 μg/kg cosyntropin IV). Dogs suspected of having HAC or being treated with mitotane were tested as the healthy dogs. Dogs receiving trilostane treatment were tested on consecutive days at the same time post pill using the low dose on day 1. RESULTS In dogs being treated with mitotane or trilostane, the 2 doses were pharmacodynamically equivalent (90% confidence interval, 85.1-108.2%; P = 0.014). However, in dogs suspected of having HAC, the doses were not pharmacodynamically equivalent (90% confidence interval, 73.2-92.8%; P = 0.37); furthermore, in 23% of the dogs, clinical interpretation of test results was different between the doses. CONCLUSIONS AND CLINICAL RELEVANCE For dogs suspected of having HAC, 5 μg/kg cosyntropin IV is still recommended for ACTH stimulation testing. For dogs receiving mitotane or trilostane treatment, a dose of 1 μg/kg cosyntropin IV can be used.
Collapse
Affiliation(s)
- C Aldridge
- Department of Clinical Sciences, Auburn University, Auburn, AL
| | - E N Behrend
- Department of Clinical Sciences, Auburn University, Auburn, AL.
| | - R J Kemppainen
- Department of Anatomy, Physiology, and Pharmacology, Auburn University, Auburn, AL
| | - T M Lee-Fowler
- Department of Clinical Sciences, Auburn University, Auburn, AL
| | - L G Martin
- Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA
| | - C R Ward
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - D Bruyette
- VCA West Los Angeles Animal Hospital, Los Angeles, CA
| | - J Pannu
- Department of Mathematics and Statistics, Auburn University, Auburn, AL
| | - P Gaillard
- Department of Mathematics and Statistics, Auburn University, Auburn, AL
| | - H P Lee
- Department of Clinical Sciences, Auburn University, Auburn, AL
| |
Collapse
|
21
|
Pannu J, Belle JI, Förster M, Duerr CU, Shen S, Kane L, Harcourt K, Fritz JH, Clare S, Nijnik A. Ubiquitin specific protease 21 is dispensable for normal development, hematopoiesis and lymphocyte differentiation. PLoS One 2015; 10:e0117304. [PMID: 25680095 PMCID: PMC4332479 DOI: 10.1371/journal.pone.0117304] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [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: 02/11/2014] [Accepted: 12/22/2014] [Indexed: 02/06/2023] Open
Abstract
USP21 is a ubiquitin specific protease that catalyzes protein deubiquitination, however the identification of its physiological substrates remains challenging. USP21 is known to deubiquitinate transcription factor GATA3 and death-domain kinase RIPK1 in vitro, however the in vivo settings where this regulation plays a biologically significant role remain unknown. In order to determine whether USP21 is an essential and non-redundant regulator of GATA3 or RIPK1 activity in vivo, we characterized Usp21-deficient mice, focusing on mouse viability and development, hematopoietic stem cell function, and lymphocyte differentiation. The Usp21-knockout mice were found to be viable and fertile, with no significant dysmorphology, in contrast to the GATA3 and RIPK1 knockout lines that exhibit embryonic or perinatal lethality. Loss of USP21 also had no effect on hematopoietic stem cell function, lymphocyte development, or the responses of antigen presenting cells to TLR and TNFR stimulation. GATA3 levels in hematopoietic stem cells or T lymphocytes remained unchanged. We observed that aged Usp21-knockout mice exhibited spontaneous T cell activation, however this was not linked to altered GATA3 levels in the affected cells. The contrast in the phenotype of the Usp21-knockout line with the previously characterized GATA3 and RIPK1 knockout mice strongly indicates that USP21 is redundant for the regulation of GATA3 and RIPK1 activity during mouse development, in hematopoietic stem cells, and in lymphocyte differentiation. The Usp21-deficient mouse line characterized in this study may serve as a useful tool for the future characterization of USP21 physiological functions.
Collapse
Affiliation(s)
- Jaspreet Pannu
- Department of Physiology, McGill University, Montreal, Canada
- Department of Biology, McGill University, Montreal, Canada
| | - Jad I. Belle
- Department of Physiology, McGill University, Montreal, Canada
- Complex Traits Group, McGill University, Montreal, Canada
| | - Michael Förster
- Department of Physiology, McGill University, Montreal, Canada
- Complex Traits Group, McGill University, Montreal, Canada
| | - Claudia U. Duerr
- Complex Traits Group, McGill University, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Shiyang Shen
- Department of Physiology, McGill University, Montreal, Canada
- Complex Traits Group, McGill University, Montreal, Canada
| | - Leanne Kane
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Katherine Harcourt
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Jörg H. Fritz
- Complex Traits Group, McGill University, Montreal, Canada
- Department of Microbiology and Immunology, McGill University, Montreal, Canada
| | - Simon Clare
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom
| | - Anastasia Nijnik
- Department of Physiology, McGill University, Montreal, Canada
- Complex Traits Group, McGill University, Montreal, Canada
- * E-mail:
| |
Collapse
|
22
|
Pannu J, Asano Y, Nakerakanti S, Smith E, Jablonska S, Blaszczyk M, ten Dijke P, Trojanowska M. Smad1 pathway is activated in systemic sclerosis fibroblasts and is targeted by imatinib mesylate. ACTA ACUST UNITED AC 2008; 58:2528-37. [DOI: 10.1002/art.23698] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
23
|
Tourkina E, Richard M, Gööz P, Bonner M, Pannu J, Harley R, Bernatchez PN, Sessa WC, Silver RM, Hoffman S. Antifibrotic properties of caveolin-1 scaffolding domain in vitro and in vivo. Am J Physiol Lung Cell Mol Physiol 2008; 294:L843-61. [DOI: 10.1152/ajplung.00295.2007] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lung fibrosis involves the overexpression of ECM proteins, primarily collagen, by α-smooth muscle actin (ASMA)-positive cells. Caveolin-1 is a master regulator of collagen expression by cultured lung fibroblasts and of lung fibrosis in vivo. A peptide equivalent to the caveolin-1 scaffolding domain (CSD peptide) inhibits collagen and tenascin-C expression by normal lung fibroblasts (NLF) and fibroblasts from the fibrotic lungs of scleroderma patients (SLF). CSD peptide inhibits ASMA expression in SLF but not NLF. Similar inhibition of collagen, tenascin-C, and ASMA expression was also observed when caveolin-1 expression was upregulated using adenovirus. These observations suggest that the low caveolin-1 levels in SLF cause their overexpression of collagen, tenascin-C, and ASMA. In mechanistic studies, MEK, ERK, JNK, and Akt were hyperactivated in SLF, and CSD peptide inhibited their activation and altered their subcellular localization. These studies and experiments using kinase inhibitors suggest many differences between NLF and SLF in signaling cascades. To validate these data, we determined that the alterations in signaling molecule activation observed in SLF also occur in fibrotic lung tissue from scleroderma patients and in mice with bleomycin-induced lung fibrosis. Finally, we demonstrated that systemic administration of CSD peptide to bleomycin-treated mice blocks epithelial cell apoptosis, inflammatory cell infiltration, and changes in tissue morphology as well as signaling molecule activation and collagen, tenascin-C, and ASMA expression associated with lung fibrosis. CSD peptide may be a prototype for novel treatments for human lung fibrosis that act, in part, by inhibiting the expression of ASMA and ECM proteins.
Collapse
|
24
|
Bujor AM, Pannu J, Bu S, Smith EA, Muise-Helmericks RC, Trojanowska M. Akt blockade downregulates collagen and upregulates MMP1 in human dermal fibroblasts. J Invest Dermatol 2008; 128:1906-14. [PMID: 18323784 DOI: 10.1038/jid.2008.39] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Acutely transforming retrovirus AKT8 in rodent T-cell lymphoma (Akt) is a serine/threonine kinase that plays important roles in survival, cell-cycle progression, and cell proliferation, and has recently been implicated in collagen regulation. The aim of this study was to determine the role of Akt in collagen deposition by normal dermal fibroblasts, and to determine the sensitivity of cultured systemic sclerosis (SSc) fibroblasts to Akt inhibition. We show that blockade of Akt using pharmacological inhibitors, small interfering RNA (siRNA), and a dominant-negative Akt mutant led to inhibition of the basal type I collagen production. Furthermore, inhibition of Akt upregulated basal matrix metalloproteinase 1 (MMP1) production and reversed the inhibitory effect of transforming growth factor-beta (TGF-beta) on MMP1 gene expression. In addition, SSc fibroblasts were more sensitive to Akt inhibition, with respect to collagen and MMP1 production. These findings suggest that in human dermal fibroblasts, Akt has dual profibrotic effects, increasing collagen synthesis and decreasing its degradation via downregulation of MMP1. Akt could directly contribute to elevated collagen in SSc fibroblasts and it may represent an attractive target for therapy of SSc fibrosis.
Collapse
Affiliation(s)
- Andreea M Bujor
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA
| | | | | | | | | | | |
Collapse
|
25
|
Pannu J, Nakerakanti S, Smith E, ten Dijke P, Trojanowska M. Transforming growth factor-beta receptor type I-dependent fibrogenic gene program is mediated via activation of Smad1 and ERK1/2 pathways. J Biol Chem 2007; 282:10405-13. [PMID: 17317656 DOI: 10.1074/jbc.m611742200] [Citation(s) in RCA: 162] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The transforming growth factor (TGF)-beta/Smad3 signaling pathway is considered a central mediator of pathological organ fibrosis; however, contribution of Smad2/3-independent TGF-beta signaling has not been fully explored. The present study utilized previously a described model of scleroderma (SSc) fibrosis based on forced expression of the TGF-betaRI (ALK5) (Pannu, J., Gardner, H., Shearstone, J. R., Smith, E., and Trojanowska, M. (2006) Arthritis Rheum. 54, 3011-3021). This study was aimed at determining the molecular mechanisms underlying the profibrotic program in this model. We demonstrate that the TGF-betaRI-dependent up-regulation of collagen and CCN2 (CTGF) does not involve Smad2/3 activation but is mediated by ALK1/Smad1 and ERK1/2 pathways. The following findings support this conclusion: (i) Smad2 and -3 were not phosphorylated in response to TGF-betaRI, (ii) a TGF-betaRI mutant defective in Smad2/3 activation, ALK5(3A), potently stimulated collagen production, (iii) elevation of TGF-betaRI triggered sustained association of ALK5 with ALK1 and high levels of Smad1 phosphorylation, (iv) blockade of Smad1 via small interfering RNA abrogated collagen and CCN2 up-regulation in this model, (v) elevated TGF-betaRI led to a prolonged activation of ERK1/2, (vi) the pharmacologic inhibitor of ERK1/2 inhibited Smad1 phosphorylation and abrogated profibrotic effects of elevated TGFbeta-RI. Additional experiments demonstrated that a GC-rich response element located -6 to -16 (upstream of the transcription start site) in the CCN2 promoter mediated Smad1-dependent increased promoter activity in this model. This element was shown previously to mediate up-regulation of the CCN2 promoter in SSc fibroblasts. In conclusion, this study defines a novel ALK1/Smad1- and ERK1/2-dependent, Smad3-independent mode of TGF-beta signaling that may operate during chronic stages of fibrosis in SSc.
Collapse
MESH Headings
- Activin Receptors, Type I/genetics
- Activin Receptors, Type I/metabolism
- Activin Receptors, Type II/metabolism
- Cells, Cultured
- Connective Tissue Growth Factor
- Fibroblasts/metabolism
- Fibroblasts/pathology
- Fibrosis/genetics
- Fibrosis/metabolism
- Fibrosis/pathology
- GC Rich Sequence
- Humans
- Immediate-Early Proteins/biosynthesis
- Immediate-Early Proteins/genetics
- Intercellular Signaling Peptides and Proteins/biosynthesis
- Intercellular Signaling Peptides and Proteins/genetics
- MAP Kinase Signaling System
- Mitogen-Activated Protein Kinase 1/metabolism
- Mitogen-Activated Protein Kinase 3/metabolism
- Models, Biological
- Mutation
- Protein Serine-Threonine Kinases
- Receptor, Transforming Growth Factor-beta Type I
- Receptors, Transforming Growth Factor beta/genetics
- Receptors, Transforming Growth Factor beta/metabolism
- Response Elements
- Scleroderma, Localized/genetics
- Scleroderma, Localized/metabolism
- Scleroderma, Localized/pathology
- Smad1 Protein/metabolism
- Smad2 Protein/metabolism
- Smad3 Protein/metabolism
- Up-Regulation
Collapse
Affiliation(s)
- Jaspreet Pannu
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA
| | | | | | | | | |
Collapse
|
26
|
Pannu J, Gardner H, Shearstone JR, Smith E, Trojanowska M. Increased levels of transforming growth factor beta receptor type I and up-regulation of matrix gene program: A model of scleroderma. ACTA ACUST UNITED AC 2006; 54:3011-21. [PMID: 16947635 DOI: 10.1002/art.22063] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previously published studies have demonstrated that a majority of systemic sclerosis (SSc) fibroblasts exhibit elevated levels of transforming growth factor beta type I receptor (TGFbetaRI). An experimental model that recapitulates this condition was established in control dermal fibroblasts by titrating the dose of adenovirus vector expressing TGFbetaRI (AdTGFbetaRI). The present study was undertaken to determine the functional consequences of increased levels of TGFbetaRI in SSc. METHODS Gene array analysis of control dermal fibroblasts transduced with AdTGFbetaRI was performed using GeneChip expression arrays. Gene validation was done by Northern blot, quantitative reverse transcriptase-polymerase chain reaction, and Western blot techniques. TGFbeta blockade was performed using soluble TGFbeta receptor. TGFbetaRI kinase/activin receptor-like kinase 5 was inhibited with pharmacologic inhibitors. TGFbetaRI and TGFbetaRII protein levels and collagen production were examined by Western blotting in primary dermal fibroblasts from 9 SSc patients and 9 healthy adults. Endogenous TGFbetaRI levels were suppressed in control and SSc fibroblasts using specific small interfering RNA (siRNA). RESULTS Global gene analysis indicated that a 2-fold increase in TGFbetaRI levels in control fibroblasts resulted in profibrotic changes that closely resembled the phenotype of SSc fibroblasts. A total of 125 genes were up-regulated, including COL1A1, COL1A2, and connective tissue growth factor, and 206 genes were down-regulated. Elevated production of collagen in cells transduced with AdTGFbetaRI was dependent on the autocrine TGFbeta, but not TGFbetaRI kinase activity. Eight of the 9 SSc strains exhibited increased levels of TGFbetaRI protein, which correlated with increased collagen synthesis. Treatment of SSc and matched control fibroblasts with siRNA that normalizes TGFbetaRI levels reverted collagen protein production in SSc fibroblasts to the levels observed in control fibroblasts. CONCLUSION Our findings demonstrate that aberrantly expressed TGFbetaRI may drive an autocrine loop involved in the up-regulation of collagen and other matrix-related genes in SSc fibroblasts.
Collapse
Affiliation(s)
- Jaspreet Pannu
- Medical University of South Carolina, Charleston, SC 29425, USA
| | | | | | | | | |
Collapse
|
27
|
Gardner H, Shearstone JR, Bandaru R, Crowell T, Lynes M, Trojanowska M, Pannu J, Smith E, Jablonska S, Blaszczyk M, Tan FK, Mayes MD. Gene profiling of scleroderma skin reveals robust signatures of disease that are imperfectly reflected in the transcript profiles of explanted fibroblasts. ACTA ACUST UNITED AC 2006; 54:1961-73. [PMID: 16736506 DOI: 10.1002/art.21894] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine whether biopsy specimens obtained from systemic sclerosis (SSc) lesions show a distinctive gene profile, whether that gene profile is maintained in fibroblasts cultured from SSc skin biopsy specimens, and whether results from tissue obtained from multiple clinical centers can be combined to yield useful observations in this rare disease. METHODS Biopsy samples and passaged fibroblasts were stored in RNAlater solution prior to processing for RNA. RNA from SSc and control skin biopsy specimens, as well as SSc and control explanted passage 4 fibroblasts, from 9 patients and 9 controls was hybridized to Affymetrix HG-U133A arrays. Data were analyzed using the BRB ArrayTools system. When appropriate, findings were followed up with immunohistochemical analysis or TaqMan studies. RESULTS Biopsy samples obtained from patients with SSc had a robust and distinctive gene profile, with approximately 1,800 qualifiers distinguishing normal skin from SSc skin at a significant level. The SSc phenotype was the major driver of sample clusters, independent of origin. Alterations in transforming growth factor beta and Wnt pathways, extracellular matrix proteins, and the CCN family were prominent. Explanted fibroblasts from SSc biopsy samples showed a far smaller subset of changes that were relatively variable between samples, suggesting that either nonfibroblast cell types or other aspects of the dermal milieu are required for full expression of the SSc phenotype. CONCLUSION SSc has a distinct gene profile that is not confounded by geographic location, indicating that extended multicenter studies may be worthwhile to identify distinct subsets of disease by transcript profiling. Explanted SSc fibroblasts show an incomplete reflection of the SSc phenotype.
Collapse
|
28
|
Bhattacharyya S, Ghosh AK, Pannu J, Mori Y, Takagawa S, Chen G, Trojanowska M, Gilliam AC, Varga J. Fibroblast expression of the coactivator p300 governs the intensity of profibrotic response to transforming growth factor beta. ACTA ACUST UNITED AC 2005; 52:1248-58. [PMID: 15818659 DOI: 10.1002/art.20996] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Transforming growth factor beta (TGFbeta) induces profibrotic responses in normal fibroblasts, and plays a fundamental role in the pathogenesis of fibrosis in scleroderma (systemic sclerosis [SSc]). The intensity of cellular responses elicited by cytokines is modulated by transcriptional coactivators such as the histone acetylase p300. The objective of these studies was to delineate the physiologic role of p300 in Smad-dependent profibrotic responses elicited by TGFbeta. METHODS Ectopic p300 was transiently expressed in normal dermal fibroblasts. Cellular p300 levels were suppressed using p300-specific ribozymes. The regulation of gene expression was examined by transient transfection assays, Northern blotting, and immunoblot analysis. The expression of p300 in normal and scleroderma fibroblasts was evaluated by confocal microscopy and immunoblotting, and p300 levels in skin from mice with experimental scleroderma were assessed by immunohistochemistry. RESULTS In normal fibroblasts, TGFbeta induced an increase in the levels of p300. Forced expression of ectopic p300 in these cells dramatically enhanced the magnitude of TGFbeta responses, whereas selective depletion of p300 using ribozyme resulted in abrogation of TGFbeta-induced collagen synthesis and promoter activity. Furthermore, TGFbeta lost its ability to induce Smad-dependent transcription in p300-depleted fibroblasts. These responses could be fully rescued with ectopic p300. Abrogation of Smad-mediated TGFbeta signaling was not due to alterations in the levels or the ligand-dependent phosphorylation or intracellular trafficking of endogenous Smads. Immunohistochemical analysis demonstrated substantially increased p300 expression in lesional skin from mice with chronic graft-versus-host disease, an animal model of scleroderma. Furthermore, levels of p300 were 2-3-fold higher in cultured fibroblasts derived from SSc patients than in fibroblasts from matched normal controls. CONCLUSION These results establish, for the first time, that the coactivator histone acetylase p300, itself a target of TGFbeta regulation, is an essential component of the cellular TGFbeta signal transduction pathways mediating stimulation of collagen synthesis in fibroblasts. Since the cellular abundance of p300 appears to govern the intensity of profibrotic responses elicited by TGFbeta, elevated p300 expression in lesional tissue may contribute to the progression of skin fibrosis in scleroderma.
Collapse
|
29
|
Tourkina E, Gooz P, Pannu J, Bonner M, Scholz D, Hacker S, Silver RM, Trojanowska M, Hoffman S. Opposing effects of protein kinase Calpha and protein kinase Cepsilon on collagen expression by human lung fibroblasts are mediated via MEK/ERK and caveolin-1 signaling. J Biol Chem 2005; 280:13879-87. [PMID: 15691837 DOI: 10.1074/jbc.m412551200] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The roles of MEK, ERK, the epsilon and alpha isoforms of protein kinase C (PKC), and caveolin-1 in regulating collagen expression were studied in normal lung fibroblasts. Knocking down caveolin-1 gave particularly striking results. A 70% decrease caused a 5-fold increase in MEK/ERK activation and collagen expression. The combined data reveal a branched signaling pathway. In its central portion MEK activates ERK, leading to increased collagen expression. Two branches converge on MEK/ERK. In one, increased PKCepsilon leads to MEK/ERK activation. In another, increased PKCalpha induces caveolin-1 expression, which in turn inhibits MEK/ERK activation and collagen expression. Lung fibroblasts from scleroderma patients with pulmonary fibrosis showed altered signaling. Consistent with their overexpression of collagen, scleroderma lung fibroblasts contain more activated MEK/ERK and less caveolin-1 than normal lung fibroblasts. Because cutaneous fibrosis is the hallmark of scleroderma, we also studied dermal fibroblasts. As in lung, there was more activated MEK/ERK in cells from scleroderma patients than in control cells, and MEK inhibition decreased collagen expression. However, the distinctive levels of PKCepsilon, PKCalpha, and caveolin-1 in lung and dermal fibroblasts from scleroderma patients and control subjects indicate that the links between these signaling proteins and MEK/ERK must function differently in the four cell types. Finally, we confirmed the relevance of these signaling cascades in vivo. The combined results demonstrate that a branched signaling pathway involving MEK, ERK, PKCepsilon, PKCalpha, and caveolin-1 regulates collagen expression in normal lung tissue and is perturbed during fibrosis.
Collapse
Affiliation(s)
- Elena Tourkina
- Division of Rheumatology and Immunology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
PURPOSE OF REVIEW Systemic sclerosis is a complex disease manifesting itself by fibrosis of skin and other internal organs. Fibroblasts isolated from scleroderma lesions and cultured in vitro are characterized by increased synthesis of collagen and other extracellular matrix proteins, consistent with the disease phenotype. Cultured systemic sclerosis fibroblasts therefore serve as a principal experimental model for studying the molecular and cellular mechanisms involved in collagen overproduction in this disease. This review will discuss recent findings related to intracellular signal transduction pathways implicated in deregulated extracellular matrix deposition by systemic sclerosis fibroblasts. RECENT FINDINGS Recent findings suggest that constitutively elevated synthesis of extracellular matrix by cultured systemic sclerosis fibroblasts is, at least in part, due to the aberrant activation of the autocrine transforming growth factor-beta signaling. Enhanced constitutive transforming growth factor-beta signaling may result from the elevated levels of transforming growth factor-beta receptor type I and/or inappropriate activation of Smad3. These alterations of the transforming growth factor-beta signaling in systemic sclerosis fibroblasts may facilitate increased collagen production in vivo even under conditions of low ligand availability. However, there exist many inconsistencies among published reports regarding the detailed mechanisms of this pathway in systemic sclerosis fibroblasts, and additional studies in this area are needed. Other signaling molecules implicated in fibrotic phenotype include several members of the protein kinase C family, mammalian target of rapamycin, mitogen-activated protein kinase, necdin, reactive oxygen species, and sphingolipids. These signaling pathways may work in conjunction with transforming growth factor-beta signaling to regulate the behavior of systemic sclerosis fibroblasts. SUMMARY Alterations in multiple signaling pathways contribute to elevated extracellular matrix synthesis by systemic sclerosis fibroblasts. Improved understanding of the key signaling molecules may provide a novel avenue for therapeutic interventions.
Collapse
Affiliation(s)
- Jaspreet Pannu
- Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | | |
Collapse
|
31
|
Pannu J, Gore-Hyer E, Yamanaka M, Smith EA, Rubinchik S, Dong JY, Jablonska S, Blaszczyk M, Trojanowska M. An increased transforming growth factor beta receptor type I:type II ratio contributes to elevated collagen protein synthesis that is resistant to inhibition via a kinase-deficient transforming growth factor beta receptor type II in scleroderma. ACTA ACUST UNITED AC 2004; 50:1566-77. [PMID: 15146427 DOI: 10.1002/art.20225] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Aberrant transforming growth factor beta (TGFbeta) signaling has been implicated in the pathogenesis of scleroderma (systemic sclerosis [SSc]), but the contribution of specific components in this pathway to SSc fibroblast phenotype remains unclear. This study was undertaken to delineate the role of TGFbeta receptor type I (TGFbetaRI) and TGFbetaRII in collagen overexpression by SSc fibroblasts. METHODS Primary dermal fibroblasts from SSc patients and healthy adults were studied (n = 10 matched pairs). Adenoviral vectors were generated for TGFbetaRI (AdTGFbetaRI), TGFbetaRII (AdTGFbetaRII), and kinase-deficient TGFbetaRII (AdDeltakRII). TGFbetaRI basal protein levels were analyzed by (35)S-methionine labeling/immunoprecipitation and immunohistochemistry. Type I collagen and TGFbetaRII basal protein levels were analyzed by Western blot and newly secreted collagen by (3)H-proline incorporation assay. RESULTS Analysis of endogenous TGFbetaRI and TGFbetaRII protein levels revealed that SSc TGFbetaRI levels were increased 1.7-fold (P = 0.008; n = 7) compared with levels in healthy controls, while TGFbetaRII levels were decreased by 30% (P = 0.03; n = 7). This increased TGFbetaRI:TGFbetaRII ratio correlated with SSc collagen overexpression. To determine the consequences of altered TGFbetaRI:TGFbetaRII ratio on collagen expression, healthy fibroblasts were transduced with AdTGFbetaRI or AdTGFbetaRII. Forced expression of TGFbetaRI in the range corresponding to elevated SSc TGFbetaRI levels increased basal collagen expression in a dose-dependent manner, while similar TGFbetaRII overexpression had no effect, although transduction of fibroblasts at higher multiplicities of infection led to a marked reduction of basal collagen levels. Blockade of TGFbeta signaling via AdDeltakRII resulted in approximately 50% inhibition of basal collagen levels in healthy fibroblasts and in 5 of 9 SSc cell lines. A subset of SSc fibroblasts (4 of 9 cell lines) was resistant to this treatment. SSc fibroblasts with the highest levels of TGFbetaRI were the least responsive to collagen inhibition via DeltakRII. CONCLUSION This study indicates that an increased TGFbetaRI:TGFbetaRII ratio may underlie aberrant TGFbeta signaling in SSc and contribute to elevated basal collagen production, which is insensitive to TGFbeta signaling blockade via DeltakRII.
Collapse
Affiliation(s)
- Jaspreet Pannu
- Division of Rheumatology and Immunology, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Gore-Hyer E, Pannu J, Smith EA, Grotendorst G, Trojanowska M. Selective stimulation of collagen synthesis in the presence of costimulatory insulin signaling by connective tissue growth factor in scleroderma fibroblasts. Arthritis Rheum 2003; 48:798-806. [PMID: 12632435 DOI: 10.1002/art.10953] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine the mechanism of collagen induction by connective tissue growth factor (CTGF), a profibrotic cytokine overexpressed in the skin of patients with systemic sclerosis (SSc). METHODS Dermal fibroblasts from 7 SSc patients and 7 matched healthy adult donors were stimulated with CTGF in the presence or absence of the culture-medium supplement, insulin-transferrin-selenium (ITS). Expression of collagen protein was analyzed by a (3)H-proline incorporation assay. To identify the signaling pathways mediating CTGF induction of collagen, pharmacologic inhibitors were used, including rottlerin, a protein kinase C delta (PKC delta) inhibitor. RESULTS Collagen levels in both SSc and normal fibroblasts were increased after treatment with transforming growth factor beta in serum-free medium, whereas no stimulation was observed following addition of CTGF. In the presence of ITS, CTGF (2.5 ng/ml) potently stimulated collagenous protein levels in SSc cell lines (n = 5); however, CTGF was not stimulatory in the majority of normal fibroblasts (n = 6). ITS alone induced collagen levels in normal fibroblasts to the levels observed in SSc skin fibroblasts, thereby diminishing the hallmark difference in basal collagen levels in these cell types. Insulin was the ITS component responsible for promoting the basal and CTGF stimulation of collagenous proteins. Rottlerin, the PKC delta inhibitor, down-regulated collagen synthesis in normal and SSc fibroblasts cultured in ITS, and inhibited the stimulatory effects of CTGF in cooperation with insulin or of insulin (500 ng/ml) alone. CONCLUSION Increased responsiveness of SSc fibroblasts to CTGF-mediated collagen synthesis requires the costimulatory activation of insulin signaling pathways to induce matrix production. Blockade of this effect via rottlerin may suggest that PKC delta is a downstream signaling molecule necessary for CTGF stimulation of collagen synthesis.
Collapse
|
33
|
Nadarajah N, Van Hamme J, Pannu J, Singh A, Ward O. Enhanced transformation of polycyclic aromatic hydrocarbons using a combined Fenton's reagent, microbial treatment and surfactants. Appl Microbiol Biotechnol 2002; 59:540-4. [PMID: 12172623 DOI: 10.1007/s00253-002-1073-x] [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] [Received: 02/11/2002] [Revised: 06/05/2002] [Accepted: 06/14/2002] [Indexed: 10/27/2022]
Abstract
The potential for using Fenton's reagent (H(2)O(2)+ Fe(2+)) as an advanced oxidation pretreatment process to enhance microbial transformation of two model polycyclic aromatic hydrocarbons, anthracene and benzo[a]pyrene, in an aqueous system was evaluated. Fenton's reagent at a concentration of 0.5% H(2)O(2) and 10 mM Fe(2+) (molar ratio, 15:1) was most effective in transforming anthracene at pH 4. Application of non-ionic surfactants during Fenton's pre-treatment was found to be more effective in the transformation of both anthracene and benzo[a]pyrene. The extent of removal of substrates by a combined Fenton's-biotreatment was 2-4 times higher than with Fenton's treatment or biotreatment alone. In a chemical-biological treatment train, 48 h of Fenton's pre-treatment in the presence of a non-ionic surfactant, followed by 7 days of biological treatment resulted in 80-85% removal of PAHs (100 ppm).
Collapse
Affiliation(s)
- N Nadarajah
- Department of Biology, University of Waterloo, Waterloo, Ontario N2T 2J3, Canada
| | | | | | | | | |
Collapse
|
34
|
Bankowski RA, Corstvet R, Pannu J. Nature of immunity to Newcastle disease in vaccinated chickens. 3. Correlation of signs, virus isolation, and serology following challenge. Avian Dis 1963; 7:135-49. [PMID: 5888713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
35
|
Bankowski RA, Corstvet R, Pannu J. Nature of Immunity to Newcastle Disease in Vaccinated Chickens III. Correlation of Signs, Virus Isolation, and Serology Following Challenge. Avian Dis 1963. [DOI: 10.2307/1588042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|