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Ramzy A, Edeer N, Baker RK, O’Dwyer S, Mojibian M, Verchere CB, Kieffer TJ. Insulin Null β-cells Have a Prohormone Processing Defect That Is Not Reversed by AAV Rescue of Proinsulin Expression. Endocrinology 2022; 163:6569864. [PMID: 35435956 PMCID: PMC9119694 DOI: 10.1210/endocr/bqac051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Indexed: 11/19/2022]
Abstract
Up to 6% of diabetes has a monogenic cause including mutations in the insulin gene, and patients are candidates for a gene therapy. Using a mouse model of permanent neonatal diabetes, we assessed the efficacy of an adeno-associated virus (AAV)-mediated gene therapy. We used AAVs with a rat insulin 1 promoter (Ins1) regulating a human insulin gene (INS; AAV Ins1-INS) or native mouse insulin 1 (Ins1; AAV Ins-Ins1) to deliver an insulin gene to β-cells of constitutive insulin null mice (Ins1-/-Ins2-/-) and adult inducible insulin-deficient mice [Ins1-/-Ins2f/f PdxCreER and Ins1-/-Ins2f/f mice administered AAV Ins1-Cre)]. Although AAV Ins1-INS could successfully infect and confer insulin expression to β-cells, insulin null β-cells had a prohormone processing defect. Secretion of abundant proinsulin transiently reversed diabetes. We reattempted therapy with AAV Ins1-Ins1, but Ins1-/-Ins2-/- β-cells still had a processing defect of both replaced Ins1 and pro-islet amyloid polypeptide (proIAPP). In adult inducible models, β-cells that lost insulin expression developed a processing defect that resulted in impaired proIAPP processing and elevated circulating proIAPP, and cells infected with AAV Ins1-Ins1 to rescue insulin expression secreted proinsulin. We assessed the subcellular localization of prohormone convertase 1/3 (PC1/3) and detected defective sorting of PC1/3 to glycogen-containing vacuoles and retention in the endoplasmic reticulum as a potential mechanism underlying defective processing. We provide evidence that persistent production of endogenous proinsulin within β-cells is necessary for β-cells to be able to properly store and process proinsulin.
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Affiliation(s)
- Adam Ramzy
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Nazde Edeer
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Robert K Baker
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Shannon O’Dwyer
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - Majid Mojibian
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, BC, Canada
| | - C Bruce Verchere
- Department of Pathology and Laboratory Medicine, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
- Department of Surgery, University of British Columbia, Vancouver, BC, Canada
| | - Timothy J Kieffer
- Correspondence: Timothy J. Kieffer, PhD, Department of Cellular and Physiological Sciences, University of British Columbia, 2350 Health Sciences Mall, Vancouver, V6T 1Z3, Canada.
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Donaldson M, Edeer N, Bhangu G, Greiner J, Murray M. 457. Low Rates of COVID-19 in a Vulnerable Population: Learning from Early and Decisive Public Health Policies. Open Forum Infect Dis 2020. [PMCID: PMC7776696 DOI: 10.1093/ofid/ofaa439.650] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Disasters, including pandemics, disproportionately affect vulnerable populations. The Downtown Eastside (DTES) neighborhood of Vancouver has high prevalence of mental illness, substance use, infectious disease and homelessness. While studies have described clinical characteristics of COVID-19 patients in other centres worldwide, data is lacking on marginalized groups. We describe the clinical characteristics and outcomes of COVID-19 patients seen at two urban hospitals who care for the vulnerable population in the DTES of Vancouver, British Columbia (BC), Canada. Methods A retrospective chart review was conducted on all COVID-19 patients ≥19 years seen at either centre from January 1 to June 10, 2020. Descriptive statistics assessed demographics, comorbidities, presenting symptoms, laboratory values and outcomes, and were compared between subjects managed as inpatients (died vs. discharged) and outpatients. Results Of 71 COVID-19 subjects, mean age was 57y (SD 20); 36 (51%) were male. Time to presentation, symptoms and laboratory values were similar to other reports. 58 (82%) presented from the community, 3 (4%) from long-term care/rehabilitation centres, and 8 (11%) had no fixed address (NFA) or lived in the DTES. 45 (64%) had a known exposure, 20 (28%) were healthcare workers, 85% involved in direct patient care; 0/20 were admitted to hospital. Of the 8 NFA/DTES subjects, mean age was 46y (SD 13), 50% were male, 5 (63%) were admitted to hospital and all survived. Admitted subjects (n=34) were older (mean age 69 vs 46y, p< 0.001), 62% were male, and had more comorbidities (mean [SD] 3 [3] vs. 1 [2], p< 0.001). Eight (24%) died, 26 (76%) were discharged, 29% developed acute respiratory distress syndrome, 21% secondary infection, 18% renal failure, and 15% cardiac dysfunction. Of patients admitted to intensive care, 5/10 died. Conclusion Our results concur with other studies showing older age and comorbidities contribute to more severe COVID-19 disease. 64% of subjects had a known exposure, and only 11% had NFA/DTES residence. Given that there is no financial barrier to access healthcare in Canada and these hospitals serve our most vulnerable populations, our results may indicate that BC Public Health has done an effective job of tracking and limiting community spread of COVID-19. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Mira Donaldson
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazde Edeer
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gurjeet Bhangu
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jesse Greiner
- General Internal Medicine, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Melanie Murray
- Women’s Health Research Institute, BC Women’s Hospital, Vancouver, BC, Canada
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Ramzy A, Tudurí E, Glavas MM, Baker RK, Mojibian M, Fox JK, O'Dwyer SM, Dai D, Hu X, Denroche HC, Edeer N, Gray SL, Verchere CB, Johnson JD, Kieffer TJ. AAV8 Ins1-Cre can produce efficient β-cell recombination but requires consideration of off-target effects. Sci Rep 2020; 10:10518. [PMID: 32601405 PMCID: PMC7324556 DOI: 10.1038/s41598-020-67136-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 01/14/2019] [Accepted: 06/03/2020] [Indexed: 12/11/2022] Open
Abstract
In vivo genetic manipulation is used to study the impact of gene deletion or re-expression on β-cell function and organism physiology. Cre-LoxP is a system wherein LoxP sites flanking a gene are recognized by Cre recombinase. Cre transgenic mice are the most prevalent technology used to deliver Cre but many models have caveats of off-target recombination, impaired β-cell function, and high cost of animal production. Inducible estrogen receptor conjugated Cre models face leaky recombination and confounding effects of tamoxifen. As an alternative, we characterize an adeno associated virus (AAV) with a rat insulin 1 promoter driving Cre recombinase (AAV8 Ins1-Cre) that is economical and rapid to implement, and has limited caveats. Intraperitoneal AAV8 Ins1-Cre produced efficient β-cell recombination, alongside some hepatic, exocrine pancreas, α-cell, δ-cell, and hypothalamic recombination. Delivery of lower doses via the pancreatic duct retained good rates of β-cell recombination and limited rates of off-target recombination. Unlike inducible Cre in transgenic mice, AAV8 Ins1-Cre required no tamoxifen and premature recombination was avoided. We demonstrate the utility of this technology by inducing hyperglycemia in inducible insulin knockout mice (Ins1−/−;Ins2f/f). AAV-mediated expression of Cre in β-cells provides an effective alternative to transgenic approaches for inducible knockout studies.
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Affiliation(s)
- Adam Ramzy
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eva Tudurí
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.,Instituto de Investigación, Desarrollo e innovación en Biotecnología Sanitaria de Elche (IDiBE), Elche, Spain
| | - Maria M Glavas
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Robert K Baker
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Majid Mojibian
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jessica K Fox
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon M O'Dwyer
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Derek Dai
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Xiaoke Hu
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Heather C Denroche
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nazde Edeer
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah L Gray
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Cameron B Verchere
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - James D Johnson
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy J Kieffer
- Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada. .,Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
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