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Graf MR, Apte S, Terzo E, Padhye S, Shi S, Cox MK, Clark RB, Modur V, Badarinarayana V. Novel read through agent: ZKN-0013 demonstrates efficacy in APC min model of familial adenomatous polyposis. J Mol Med (Berl) 2023; 101:375-385. [PMID: 36808265 DOI: 10.1007/s00109-023-02291-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Familial adenomatous polyposis (FAP) is a precancerous, colorectal disease characterized by hundreds to thousands of adenomatous polyps caused by mutations in the tumor suppressor gene adenomatous polyposis coli (APC). Approximately 30% of these mutations are premature termination codons (PTC), resulting in the production of a truncated, dysfunctional APC protein. Consequently, the β-catenin degradation complex fails to form in the cytoplasm, leading to elevated nuclear levels of β-catenin and unregulated β-catenin/wnt-pathway signaling. We present in vitro and in vivo data demonstrating that the novel macrolide, ZKN-0013, promotes read through of premature stop codons, leading to functional restoration of full-length APC protein. Human colorectal carcinoma SW403 and SW1417 cells harboring PTC mutations in the APC gene showed reduced levels of nuclear β-catenin and c-myc upon treatment with ZKN-0013, indicating that the macrolide-mediated read through of premature stop codons produced bioactive APC protein and inhibited the β-catenin/wnt-pathway. In a mouse model of adenomatous polyposis coli, treatment of APCmin mice with ZKN-0013 caused a significant decrease in intestinal polyps, adenomas, and associated anemia, resulting in increased survival. Immunohistochemistry revealed decreased nuclear β-catenin staining in the epithelial cells of the polyps in ZKN-0013-treated APCmin mice, confirming the impact on the β-catenin/wnt-pathway. These results indicate that ZKN-0013 may have therapeutic potential for the treatment of FAP caused by nonsense mutations in the APC gene. KEY MESSAGES: • ZKN-0013 inhibited the growth of human colon carcinoma cells with APC nonsense mutations. • ZKN-0013 promoted read through of premature stop codons in the APC gene. • In APCmin mice, ZKN-0013 treatment reduced intestinal polyps and their progression to adenomas. • ZKN-0013 treatment in APCmin mice resulted in reduced anemia and increased survival.
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Affiliation(s)
| | - Shruti Apte
- Eloxx Pharmaceuticals, Watertown, MA, 02472, USA
| | | | | | - Shuhao Shi
- Eloxx Pharmaceuticals, Watertown, MA, 02472, USA
| | - Megan K Cox
- Eloxx Pharmaceuticals, Watertown, MA, 02472, USA
| | | | - Vijay Modur
- Eloxx Pharmaceuticals, Watertown, MA, 02472, USA
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Greene B, Russo RJ, Dwyer S, Malley K, Roberts E, Serrielo J, Piepenhagen P, Cummings S, Ryan S, Zarazinski C, Uppuganti S, Bukanov N, Nyman JS, Cox MK, Liu S, Ibraghimov-Beskrovnaya O, Sabbagh Y. Inhibition of TGF-β Increases Bone Volume and Strength in a Mouse Model of Osteogenesis Imperfecta. JBMR Plus 2021; 5:e10530. [PMID: 34532615 PMCID: PMC8441395 DOI: 10.1002/jbm4.10530] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/14/2021] [Accepted: 07/02/2021] [Indexed: 12/29/2022] Open
Abstract
Osteogenesis imperfecta (OI), is a genetic disorder of bone fragility caused by mutations in collagen I or proteins involved in collagen processing. Previous studies in mice and human OI bones have shown that excessive activation of TGF-β signaling plays an important role in dominant and recessive OI disease progression. Inhibition of TGF-β signaling with a murine pan-specific TGF-β neutralizing antibody (1D11) was shown to significantly increase trabecular bone volume and long bone strength in mouse models of OI. To investigate the frequency of dosing and dose options of TGF-β neutralizing antibody therapy, we assessed the effect of 1D11 on disease progression in a dominant OI mouse model (col1a2 gene mutation at G610C). In comparison with OI mice treated with a control antibody, we attempted to define mechanistic effects of 1D11 measured via μCT, biomechanical, dynamic histomorphometry, and serum biomarkers of bone turnover. In addition, osteoblast and osteoclast numbers in histological bone sections were assessed to better understand the mechanism of action of the 1D11 antibody in OI. Here we show that 1D11 treatment resulted in both dose and frequency dependency, increases in trabecular bone volume fraction and ultimate force in lumbar bone, and ultimate force, bending strength, yield force, and yield strength in the femur (p ≤ 0.05). Suppression of serum biomarkers of osteoblast differentiation, osteocalcin, resorption, CTx-1, and bone formation were observed after 1D11 treatment of OI mice. Immunohistochemical analysis showed dose and frequency dependent decreases in runt-related transcription factor, and increase in alkaline phosphatase in lumbar bone sections. In addition, a significant decrease in TRACP and the number of osteoclasts to bone surface area was observed with 1D11 treatment. Our results show that inhibition of the TGF-β pathway corrects the high-turnover aspects of bone disease and improves biomechanical properties of OI mice. These results highlight the potential for a novel treatment for osteogenesis imperfecta. © 2021 Sanofi-Genzyme. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Benjamin Greene
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | - Ryan J Russo
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | - Shannon Dwyer
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | - Katie Malley
- Global Discovery Pathology Sanofi Framingham MA USA
| | | | - Joseph Serrielo
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | | | | | - Susan Ryan
- Global Discovery Pathology Sanofi Framingham MA USA
| | | | - Sasidhar Uppuganti
- Department of Orthopaedic Surgery Vanderbilt University Medical Center Nashville TN USA.,Center for Bone Biology Vanderbilt University Medical Center Nashville TN USA
| | - Nikolai Bukanov
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | - Jeffry S Nyman
- Department of Orthopaedic Surgery Vanderbilt University Medical Center Nashville TN USA.,Center for Bone Biology Vanderbilt University Medical Center Nashville TN USA
| | - Megan K Cox
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | - Shiguang Liu
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA
| | | | - Yves Sabbagh
- Rare and Neurologic Diseases Research Sanofi Framingham MA USA.,Inozyme Pharma Boston MA USA
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Cox MK, Ward JL, Matsuura M, Aing R, Schoenfuss HL, Kohno S. Estrone exposure interacts with temperature to alter predator evasion performance and systemic mRNA abundances. Sci Total Environ 2019; 692:519-528. [PMID: 31351294 DOI: 10.1016/j.scitotenv.2019.07.142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/05/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
Environmental estrogens from anthropogenic activities are ubiquitous in aquatic ecosystems. Ambient temperature in these systems also fluctuates in daily, seasonal, and long-term rhythms. While both factors have been studied extensively, their interaction on aquatic life is critical to understand. The objective of this study was, therefore, to examine how behavior and gene expression are impacted by estrogenic exposure across a range of environmental temperatures. Larval fathead minnows (Pimephales promelas) were exposed to estrone (E1) at two concentrations (nominal 625 and 1250 ng/L) or to an ethanol solvent control, at one of four temperatures (15, 18, 21 and 24 °C) from fertilization to 21 days post-hatch. Exposed larvae were assessed for alterations in predator evasion performance and mRNA abundances of two genes for calcium channel receptors found in muscles - dihydropyridine receptor (dhpr) and ryanodine receptor 1, and the gonadal genes anti-Müllerian hormone, cytochrome P450 gonadal aromatase (cyp19a), doublesex and mab-3 related transcription factor 1 (dmrt1) and estrogen receptor 1 (esr1). Larval escape angle, escape latency, as well as systemic esr1 and cyp19a mRNA abundances were altered by an interaction between E1 concentration and temperature. E1-exposed larval exhibited reduced escape performance across all tested temperatures, whereas decreased systemic dhpr mRNA abundance was observed only at 18 °C. E1-exposure reduced systemic mRNA abundances of amh, cyp19a, dhpr, and ryr1, while temperature significantly reduced systemic cyp19a and dhpr mRNA abundances. E1-exposure and temperature significant enhanced systemic mRNA abundances of esr1 and cyp19a, respectively. These complex results illustrate the importance of considering how abiotic factors may moderate the effects of contaminant exposure during the sensitive larval developmental stage, as temperature modulates effects of estrogenic exposure on animal performance and mRNA abundances.
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Affiliation(s)
- Megan K Cox
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - Jessica L Ward
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States; Department of Biology, Ball State University, Cooper Life Sciences Building. 2000 West University Avenue, Muncie, IN 47306, United States
| | - Michelle Matsuura
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - Raingsey Aing
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - Heiko L Schoenfuss
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - Satomi Kohno
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States.
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Cox MK, Peterson KN, Tan D, Novak PJ, Schoenfuss HL, Ward JL. Temperature modulates estrone degradation and biological effects of exposure in fathead minnows. Sci Total Environ 2018; 621:1591-1600. [PMID: 29054667 DOI: 10.1016/j.scitotenv.2017.10.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/20/2017] [Accepted: 10/08/2017] [Indexed: 06/07/2023]
Abstract
Environmental pollutants, including estrogens, are widespread in aquatic environments frequently as a result of treated wastewater effluent discharged. Exposure to estrogens has been correlated with disruption of the normal physiological and reproductive function in aquatic organisms, which could impair the sustainability of exposed populations. However, assessing the effects of estrogen exposure on individuals is complicated by the fact that rates of chemical uptake and environmental degradation are temperature dependent. Because annual temperature regimes often coincide with critical periods of biological activity, temperature-dependent changes in estrogen degradation efficacy during wastewater treatment could modulate biological effects. We examined the interactions between ambient water temperature and degradation of estrone (E1) during wastewater treatment. In addition, we exposed mature fathead minnows (Pimephales promelas) to three environmentally relevant concentrations of E1 at four different water temperatures (15°C, 18°C, 21°C, and 24°C) to reflect natural seasonal variation. E1 degradation occurred with and without the support of robust nitrification at all temperatures; however, the onset of E1 degradation was delayed at cooler water temperatures. In addition, we observed significant interactive effects between temperature and E1 exposure. Female morphometric endpoints were more susceptible to temperature-modulating effects while physiological endpoints were more strongly affected in males. Collectively, the data demonstrate that natural seasonal fluctuations in temperature are sufficient to affect E1 degradation during wastewater treatment and induce sex-dependent physiological and anatomical changes in exposed fish.
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Affiliation(s)
- M K Cox
- Department of Biology, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - K N Peterson
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, 500 Pillsbury Drive S.E., Minneapolis, MN 55455, United States
| | - D Tan
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, 500 Pillsbury Drive S.E., Minneapolis, MN 55455, United States
| | - P J Novak
- Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, 500 Pillsbury Drive S.E., Minneapolis, MN 55455, United States
| | - H L Schoenfuss
- Department of Biology, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States.
| | - J L Ward
- Department of Biology, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
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Shazeeb MS, Cox MK, Gupta A, Tang W, Singh K, Pryce CT, Fogle R, Mu Y, Weber WD, Bangari DS, Ying X, Sabbagh Y. Skeletal Characterization of the Fgfr3 Mouse Model of Achondroplasia Using Micro-CT and MRI Volumetric Imaging. Sci Rep 2018; 8:469. [PMID: 29323153 PMCID: PMC5765052 DOI: 10.1038/s41598-017-18801-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/18/2017] [Indexed: 01/16/2023] Open
Abstract
Achondroplasia, the most common form of dwarfism, affects more than a quarter million people worldwide and remains an unmet medical need. Achondroplasia is caused by mutations in the fibroblast growth factor receptor 3 (FGFR3) gene which results in over-activation of the receptor, interfering with normal skeletal development leading to disproportional short stature. Multiple mouse models have been generated to study achondroplasia. The characterization of these preclinical models has been primarily done with 2D measurements. In this study, we explored the transgenic model expressing mouse Fgfr3 containing the achondroplasia mutation G380R under the Col2 promoter (Ach). Survival and growth rate of the Ach mice were reduced compared to wild-type (WT) littermates. Axial skeletal defects and abnormalities of the sternebrae and vertebrae were observed in the Ach mice. Further evaluation of the Ach mouse model was performed by developing 3D parameters from micro-computed tomography (micro-CT) and magnetic resonance imaging (MRI). The 3-week-old mice showed greater differences between the Ach and WT groups compared to the 6-week-old mice for all parameters. Deeper understanding of skeletal abnormalities of this model will help guide future studies for evaluating novel and effective therapeutic approaches for the treatment of achondroplasia.
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Affiliation(s)
- Mohammed Salman Shazeeb
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Megan K Cox
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA
| | - Anurag Gupta
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Wen Tang
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA
| | - Kuldeep Singh
- Global Discovery Pathology, Translational In-vivo Models, Sanofi R&D Global Research Platform, 5 The Mountain Road, Framingham, MA, 01701, USA
| | - Cynthia T Pryce
- Translational Sciences, Sanofi R&D Global Research Platform, 49 New York avenue, Framingham, MA, 01701, United States
| | - Robert Fogle
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - Ying Mu
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States
| | - William D Weber
- Translational Sciences, Sanofi R&D Global Research Platform, 49 New York avenue, Framingham, MA, 01701, United States
| | - Dinesh S Bangari
- Global Discovery Pathology, Translational In-vivo Models, Sanofi R&D Global Research Platform, 5 The Mountain Road, Framingham, MA, 01701, USA
| | - Xiaoyou Ying
- Global Bioimaging Department, Translational In-vivo Models, Sanofi R&D Global Research Platform, 49 New York Avenue, Framingham, MA, 01701, United States.
| | - Yves Sabbagh
- Rare Diseases, Sanofi, 49 New York Avenue, Framingham, MA, 01701, USA.
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Ward JL, Cox MK, Schoenfuss H. Thermal modulation of anthropogenic estrogen exposure on a freshwater fish at two life stages. Horm Behav 2017; 94:21-32. [PMID: 28571937 DOI: 10.1016/j.yhbeh.2017.05.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 05/05/2017] [Accepted: 05/28/2017] [Indexed: 11/22/2022]
Abstract
Human-mediated environmental change can induce changes in the expression of complex behaviors within individuals and alter the outcomes of interactions between individuals. Although the independent effects of numerous stressors on aquatic biota are well documented (e.g., exposure to environmental contaminants), fewer studies have examined how natural variation in the ambient environment modulates these effects. In this study, we exposed reproductively mature and larval fathead minnows (Pimephales promelas) to three environmentally relevant concentrations (14, 22, and 65ng/L) of a common environmental estrogen, estrone (E1), at four water temperatures (15, 18, 21, and 24°C) reflecting natural spring and summer variation. We then conducted a series of behavioral experiments to assess the independent and interactive effects of temperature and estrogen exposure on intra- and interspecific interactions in three contexts with important fitness consequences; reproduction, foraging, and predator evasion. Our data demonstrated significant independent effects of temperature and/or estrogen exposure on the physiology, survival, and behavior of larval and adult fish. We also found evidence suggesting that thermal regime can modulate the effects of exposure on larval survival and predator-prey interactions, even within a relatively narrow range of seasonally fluctuating temperatures. These findings improve our understanding of the outcomes of interactions between anthropogenic stressors and natural abiotic environmental factors, and suggest that such interactions can have ecological and evolutionary implications for freshwater populations and communities.
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Affiliation(s)
- J L Ward
- Department of Biology, Ball State University, Cooper Life Science Building, Muncie, IN 47306, United States.
| | - M K Cox
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
| | - H Schoenfuss
- Aquatic Toxicology Laboratory, Saint Cloud State University, 720 Fourth Avenue South, Saint Cloud, MN 56301, United States
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Wang Y, Cox MK, Coricor G, MacDougall M, Serra R. Inactivation of Tgfbr2 in Osterix-Cre expressing dental mesenchyme disrupts molar root formation. Dev Biol 2013; 382:27-37. [PMID: 23933490 DOI: 10.1016/j.ydbio.2013.08.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [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: 07/09/2013] [Accepted: 08/01/2013] [Indexed: 11/19/2022]
Abstract
It has been difficult to examine the role of TGF-ß in post-natal tooth development due to perinatal lethality in many of the signaling deficient mouse models. To address the role of Tgfbr2 in postnatal tooth development, we generated a mouse in which Tgfbr2 was deleted in odontoblast- and bone-producing mesenchyme. Osx-Cre;Tgfbr2(fl/fl) mice were generated (Tgfbr2(cko)) and post-natal tooth development was compared in Tgfbr2(cko) and control littermates. X-ray and μCT analysis showed that in Tgfbr2(cko) mice radicular dentin matrix density was reduced in the molars. Molar shape was abnormal and molar eruption was delayed in the mutant mice. Most significantly, defects in root formation, including failure of the root to elongate, were observed by postnatal day 10. Immunostaining for Keratin-14 (K14) was used to delineate Hertwig's epithelial root sheath (HERS). The results showed a delay in elongation and disorganization of the HERS in Tgfbr2(cko) mice. In addition, the HERS was maintained and the break up into epithelial rests was attenuated suggesting that Tgfbr2 acts on dental mesenchyme to indirectly regulate the formation and maintenance of the HERS. Altered odontoblast organization and reduced Dspp expression indicated that odontoblast differentiation was disrupted in the mutant mice likely contributing to the defect in root formation. Nevertheless, expression of Nfic, a key mesenchymal regulator of root development, was similar in Tgfbr2(cko) mice and controls. The number of osteoclasts in the bone surrounding the tooth was reduced and osteoblast differentiation was disrupted likely contributing to both root and eruption defects. We conclude that Tgfbr2 in dental mesenchyme and bone is required for tooth development particularly root formation.
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Affiliation(s)
- Ying Wang
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Megan K Cox
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - George Coricor
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Mary MacDougall
- Institute of Oral Health Research, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Rosa Serra
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Abstract
Phosphate is required for terminal differentiation of hypertrophic chondrocytes during postnatal growth plate maturation. In vitro models of chondrocyte differentiation demonstrate that 7 mM phosphate, a concentration analogous to that of the late gestational fetus, activates the mitochondrial apoptotic pathway in hypertrophic chondrocytes. This raises the question as to whether extracellular phosphate modulates chondrocyte differentiation and apoptosis during embryonic endochondral bone formation. To address this question, we performed investigations in the mouse metatarsal culture model that recapitulates in vivo bone development. Metatarsals were cultured for 4, 8, and 12 days with 1.25 and 7 mM phosphate. Metatarsals cultured with 7 mM phosphate showed a decrease in proliferation compared to those cultured in 1.25 mM phosphate. This decrease in proliferation was accompanied by an early enhancement in hypertrophic chondrocyte differentiation, associated with an increase in FGF18 expression. By 8 days in culture, an increase caspase-9 activation and apoptosis of hypertrophic chondrocytes was observed in the metatarsals cultured in 7 mM phosphate. Immunohistochemical analyses of embryonic bones demonstrated activation of caspase-9 in hypertrophic chondrocytes, associated with vascular invasion. Thus, these investigations demonstrate that phosphate promotes chondrocyte differentiation during embryonic development and implicate a physiological role for phosphate activation of the mitochondrial apoptotic pathway during embryonic endochondral bone formation.
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Affiliation(s)
- Alena A Zalutskaya
- Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
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Cox MK, Tambralli A, Sohn P, Jun HW, Serra R. Tgf-β and intervertebral disc development. Dev Biol 2009. [DOI: 10.1016/j.ydbio.2009.05.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
The concept of career burnout has been investigated in a wide variety of human services settings. Several investigations have extended the study of burnout to individuals in private sector reorganizations although burnout factors have only been derived on one sample of private sector employees. In the current research, burnout factors from previous private sector research were replicated. Results showed a strong congruency between factors from the two studies. Support was provided for rewording burnout questions from the human services scales for private sector research.
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Cox MK. A peek at nursing in the Soviet Union. Weather Vane 1983; 52:6-7. [PMID: 6553439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Kuehn GD, Williams RC, Cox MK, Jackson JC. Intracellular and extracellular beta-N-acetylhexosaminidases from Physarum polycephalum. Comparison of vegetative and spherulation enzymes. Arch Biochem Biophys 1977; 183:686-99. [PMID: 21622 DOI: 10.1016/0003-9861(77)90402-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Cox MK. Any nurse can prevent dehumanization by the CCU experience. Aviat Space Environ Med 1977; 48:568-70. [PMID: 869846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This presentation deals with the Air Force Nurse as a movice assigned to a CCU area and her contributions to patient care as a member of the Air Force Health Care Team. The novice nurse's contributions to the patients care lie in her ability to manage expected behavioral responses to the CCU experience even with a basic working knowledge of normal sinus rhythm and CPR procedure. The expected responses to the CCU expereince discussed are: anxiety, denial, depression, and aggressive sexual behavior. These usual behavioral responses have, at times, been referred to as "a disease of medical progress" or the so-called "intensive care syndrome". The nurse is in a key position to observe the patient's behavioral responses since she spends most of the time with the patient. When these behavioral patterns are considered as part of a normal patterns of adaptation, the nurse can utilize these for effective management of the patient's hospitalization experience as well as an indicator to the patient standpoint in his process of adaptation. It would be wise to mention that the detailed manifestations and primary causes of these behavioral responses should be part of the nurse's working knowledge and can be easily referred to in recent texts on coronary care nursing. The presentation progresses to specific discussion on nursing intervention of the behavioral responses. In summary, the Air Force novice nurse to a CCU area can be an equally contributory member on the Health Care Team if not compelled to place an exaggerated amount of attention on equipment, but focus more on the patient, leaving more technical learning until she becomes more aware of the unit administration and has the opportunity to attend a coronary training course.
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