Clinical improvement of DM1 patients reflected by reversal of disease-induced gene expression in blood

BACKGROUND

Myotonic dystrophy type 1 (DM1) is an incurable multisystem disease caused by a CTG-repeat expansion in the DM1 protein kinase (DMPK) gene. The OPTIMISTIC clinical trial demonstrated positive and heterogenous effects of cognitive behavioral therapy (CBT) on the capacity for activity and social participations in DM1 patients. Through a process of reverse engineering, this study aims to identify druggable molecular biomarkers associated with the clinical improvement in the OPTIMISTIC cohort.

METHODS

Based on full blood samples collected during OPTIMISTIC, we performed paired mRNA sequencing for 27 patients before and after the CBT intervention. Linear mixed effect models were used to identify biomarkers associated with the disease-causing CTG expansion and the mean clinical improvement across all clinical outcome measures.

RESULTS

We identified 608 genes for which their expression was significantly associated with the CTG-repeat expansion, as well as 1176 genes significantly associated with the average clinical response towards the intervention. Remarkably, all 97 genes associated with both returned to more normal levels in patients who benefited the most from CBT. This main finding has been replicated based on an external dataset of mRNA data of DM1 patients and controls, singling these genes out as candidate biomarkers for therapy response. Among these candidate genes were DNAJB12, HDAC5, and TRIM8, each belonging to a protein family that is being studied in the context of neurological disorders or muscular dystrophies. Across the different gene sets, gene pathway enrichment analysis revealed disease-relevant impaired signaling in, among others, insulin-, metabolism-, and immune-related pathways. Furthermore, evidence for shared dysregulations with another neuromuscular disease, Duchenne muscular dystrophy, was found, suggesting a partial overlap in blood-based gene dysregulation.

CONCLUSIONS

DM1-relevant disease signatures can be identified on a molecular level in peripheral blood, opening new avenues for drug discovery and therapy efficacy assessments.

Ageing appearance in China: biophysical profile of facial skin and its relationship to perceived age

BACKGROUND

Perceived age is important to women and is a primary driver for topical product use and facial cosmetic surgery. Changes in facial features and biophysical skin parameters with chronological age and their associations with perceived age have not been described in Asian populations.

OBJECTIVE

To investigate the relationship between biophysical properties of the skin, visual features of skin ageing and perceived facial age in Chinese women.

METHODS

Facial photographs were collected of 250 Chinese women, aged 25-70 years in Shanghai, China. The perceived facial age was determined and related to the chronological age for each participant and to a range of visual assessments of skin appearance and objective biophysical measurements of the skin. The profile of changes in these parameters with age was investigated together with the differences in those parameters for women judged to look younger than their chronological age and those judged to look older than their chronological age.

RESULTS

Large discrepancies in perceived age (up to 29 years) were found in women of the same chronological age. Each objective skin measure and visual assessment parameter had a stronger correlation with perceived age than with chronological age. The strongest relationships to perceived age were for wrinkles and hyperpigmentation. Skin colour, hydration and trans-epidermal water loss (TEWL) had weaker associations with perceived age. Women judged to look older than their chronological age had significantly higher scores than those judged to look younger for coarse wrinkles and hyperpigmentation across all age groups. The appearance differences between these groups were evident in composite facial images of the same average chronological age.

CONCLUSIONS

We have identified the skin attributes which differ with perceived age in Chinese women. Perceived age is a better measure of the biological age of facial skin than is chronological age in this population.

Funding system incentives and the restructuring of health care

The 1970s and 1980s were decades of rapid growth in health care services and expenditures in Canada. Numerous government sponsored reports laid our principles for restructured health services delivery. These principles included directions such as community orientation, continuity of care and health promotion. The principles were similar, and so were the results: throughout Canada there has been limited action on these principles.

Rollerball endometrial ablation: a histological study in danazol pretreated patients

Endomyometrial biopsies were taken from danazol pretreated patients about to undergo rollerball endometrial ablation for menorrhagia. The biopsies were taken with a loop electrode at hysteroscopy before and after 1, 2, 3 passes of a rollerball electrode over the endometrium using powers of electrocoagulation diathermy varying from 30 to 100 watts. The biopsies were then assessed histologically. Nineteen biopsies from the perceived endocervical canal, 25 posttreatment curettings and 3 hysterectomy specimens were also assessed. Biopsies taken after danazol pretreatment but before diathermy showed a thinned inactive endometrium. A histological classification of the effect of electrocoagulation diathermy on the endometrium was developed describing increasing endometrial damage. The degree of endometrial damage was directly related to the number of rolls of the ball over the endometrium and to the power of electrocoagulation diathermy. Endometrium was found in 84% of biopsies from the perceived endocervical canal and endometrium was found in curettings from 3 of 11 patients who were amenorrhoeic following ablation.

The products of photoreversing rhodopsin bleaching by microsecond flashes in the isolated vertebrate retina

Bleaching experiments were carried out at room temperature on rhodopsin in isolated rat, frog and rat retinas with blue and orange laser flashes of very high energy and duration less than 3 microseconds. Blue flashes bleached a maximum of about 50% at the highest energies; orange ones bleached about 30% at intermediate energies but the value decreased to below 20% as the energy increased. This bleaching behaviour can be explained in terms of a kinetic model which assumes that bleaching is photoreversed during the flashes and which incorporates the relevant properties of rhodopsin, isorhodopsin, bathorhodopsin and lumirhodopsin.