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Gheinani AH, Sack BS, Bigger-Allen A, Thaker H, Atta H, Lambrinos G, Costa K, Doyle C, Gharaee-Kermani M, Patalano S, Piper M, Cotellessa JF, Vitko D, Li H, Prabhakaran MK, Cristofaro V, Froehlich J, Lee RS, Yang W, Sullivan MP, Macoska JA, Adam RM. Integrated omics analysis unveils a DNA damage response to neurogenic injury. bioRxiv 2023:2023.12.10.571015. [PMID: 38106029 PMCID: PMC10723451 DOI: 10.1101/2023.12.10.571015] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Spinal cord injury (SCI) evokes profound bladder dysfunction. Current treatments are limited by a lack of molecular data to inform novel therapeutic avenues. Previously, we showed systemic inosine treatment improved bladder function following SCI in rats. Here, we applied multi-omics analysis to explore molecular alterations in the bladder and their sensitivity to inosine following SCI. Canonical pathways regulated by SCI included those associated with protein synthesis, neuroplasticity, wound healing, and neurotransmitter degradation. Upstream regulator analysis identified MYC as a key regulator, whereas causal network analysis predicted multiple regulators of DNA damage response signaling following injury, including PARP-1. Staining for both DNA damage (γH2AX) and PARP activity (poly-ADP-ribose) markers in the bladder was increased following SCI, and attenuated in inosine-treated tissues. Proteomics analysis suggested that SCI induced changes in protein synthesis-, neuroplasticity-, and oxidative stress-associated pathways, a subset of which were shown in transcriptomics data to be inosine-sensitive. These findings provide novel insights into the molecular landscape of the bladder following SCI, and highlight a potential role for PARP inhibition to treat neurogenic bladder dysfunction.
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Affiliation(s)
- Ali Hashemi Gheinani
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Functional Urology Research Group, Department for BioMedical Research DBMR, University of Bern, Switzerland
- Department of Urology, Inselspital University Hospital, 3010 Bern, Switzerland
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bryan S Sack
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Functional Urology Research Group, Department for BioMedical Research DBMR, University of Bern, Switzerland
| | - Alex Bigger-Allen
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Biological & Biomedical Sciences Graduate Program, Division of Medical Sciences, Harvard Medical School, Boston, MA
| | - Hatim Thaker
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Hussein Atta
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - George Lambrinos
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Kyle Costa
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
| | - Claire Doyle
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | | | | | - Mary Piper
- Harvard Chan Bioinformatics Core, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Justin F Cotellessa
- Departments of Surgery and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Dijana Vitko
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Haiying Li
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Manubhai Kadayil Prabhakaran
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Vivian Cristofaro
- Division of Urology, VA Boston Healthcare System, Boston, MA, USA
- University of Massachusetts, Boston, MA, USA
| | - John Froehlich
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Richard S Lee
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Wei Yang
- Departments of Surgery and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Maryrose P Sullivan
- Division of Urology, VA Boston Healthcare System, Boston, MA, USA
- University of Massachusetts, Boston, MA, USA
| | | | - Rosalyn M Adam
- Urological Diseases Research Center, Boston Children's Hospital, Boston, MA, USA
- Department of Urology, Inselspital University Hospital, 3010 Bern, Switzerland
- Department of Surgery, Harvard Medical School, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
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Sad K, Jones CY, Adams M, Lustenberger S, Lee RS, Elayavalli SR, Farhi J, Lemon LD, Fasken MB, Corbett AH, Spangle JM. Histone H3 E50K mutation confers oncogenic activity and supports an EMT phenotype. bioRxiv 2023:2023.10.11.561775. [PMID: 37873162 PMCID: PMC10592736 DOI: 10.1101/2023.10.11.561775] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Sequencing of human patient tumors has identified recurrent missense mutations in genes encoding core histones. We report that mutations that convert histone H3 amino acid 50 from a glutamate to a lysine (H3E50K) support an oncogenic phenotype in human cells. Expression of H3E50K is sufficient to transform human cells as evidenced by a dramatic increase in cell migration and invasion, and a statistically significant increase in proliferation and clonogenicity. H3E50K also increases the invasive phenotype in the context of co-occurring BRAF mutations, which are present in patient tumors characterized by H3E50K. H3E50 lies on the globular domain surface in a region that contacts H4 within the nucleosome. We find that H3E50K perturbs proximal H3 post-translational modifications globally and dysregulates gene expression, activating the epithelial to mesenchymal transition. Functional studies using S. cerevisiae reveal that, while yeast cells that express H3E50K as the sole copy of histone H3 show sensitivity to cellular stressors, including caffeine, H3E50K cells display some genetic interactions that are distinct from the characterized H3K36M oncohistone yeast model. Taken together, these data suggest that additional histone H3 mutations have the potential to be oncogenic drivers and function through distinct mechanisms that dysregulate gene expression.
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Affiliation(s)
- K Sad
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322
| | - CY Jones
- Department of Biology; Emory College of Arts and Sciences, Atlanta GA 30322
| | - M Adams
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322
| | - S Lustenberger
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA
| | - RS Lee
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322
| | - SR Elayavalli
- Department of Biology; Emory College of Arts and Sciences, Atlanta GA 30322
| | - J Farhi
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322
| | - LD Lemon
- Department of Biology; Emory College of Arts and Sciences, Atlanta GA 30322
| | - MB Fasken
- Department of Biology; Emory College of Arts and Sciences, Atlanta GA 30322
| | - AH Corbett
- Department of Biology; Emory College of Arts and Sciences, Atlanta GA 30322
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322
| | - JM Spangle
- Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA 30322
- Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA 30322
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Balthazar AK, Finkelstein JB, Williams V, Lee T, Lajoie D, Logvinenko T, Kim YJ, Chacko S, Borer JG, Lee RS. Enhanced Recovery After Surgery for an Uncommon Complex Urological Procedure: The Complete Primary Repair of Bladder Exstrophy. J Urol 2023; 210:696-703. [PMID: 37335023 PMCID: PMC10883646 DOI: 10.1097/ju.0000000000003593] [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] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE ERAS (enhanced recovery after surgery) protocols are designed to optimize perioperative care and expedite recovery. Historically, complete primary repair of bladder exstrophy has included postoperative recovery in the intensive care unit and extended length of stay. We hypothesized that instituting ERAS principles would benefit children undergoing complete primary repair of bladder exstrophy, decreasing length of stay. We describe implementation of a complete primary repair of bladder exstrophy-ERAS pathway at a single, freestanding children's hospital. MATERIALS AND METHODS A multidisciplinary team developed an ERAS pathway for complete primary repair of bladder exstrophy, which launched in June 2020 and included a new surgical approach that divided the lengthy procedure into 2 consecutive operative days. The complete primary repair of bladder exstrophy-ERAS pathway was continuously refined, and the final pathway went into effect in May 2021. Post-ERAS patient outcomes were compared with a pre-ERAS historical cohort (2013-2020). RESULTS A total of 30 historical and 10 post-ERAS patients were included. All post-ERAS patients had immediate extubation (P = .04) and 90% received early feeding (P < .001). The median intensive care unit and overall length of stay decreased from 2.5 to 1 days (P = .005) and from 14.5 to 7.5 days (P < .001), respectively. After final pathway implementation, there was no intensive care unit use (n=4). Postoperatively, no ERAS patient required escalation of care, and there was no difference in emergency department visits or readmissions. CONCLUSIONS Applying ERAS principles to complete primary repair of bladder exstrophy was associated with decreased variations in care, improved patient outcomes, and effective resource utilization. Although ERAS has typically been utilized for high-volume procedures, our study highlights that an enhanced recovery pathway is both feasible and adaptable to less common urological surgeries.
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Affiliation(s)
- Andrea K Balthazar
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | | | - Vivian Williams
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Ted Lee
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Debra Lajoie
- Surgical Programs, Boston Children's Hospital, Boston, Massachusetts
| | - Tanya Logvinenko
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Young-Jo Kim
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Sabeena Chacko
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Joseph G Borer
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
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Cai PY, Lee RS. Ureteropelvic Junction Obstruction/Hydronephrosis. Urol Clin North Am 2023; 50:361-369. [PMID: 37385700 DOI: 10.1016/j.ucl.2023.04.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Congenital hydronephrosis can be classified and managed based on the Urinary Tract Dilation consensus scoring system. Ureteropelvic junction obstruction is one of the most common causes of hydronephrosis in the pediatric population. Although most cases can be managed conservatively with follow-up and serial imaging, some patients need surgical repair because of renal function deterioration, infections, or symptoms. Additional research to create predictive algorithms or develop noninvasive biomarkers for renal deterioration is necessary to better identify surgical candidates. The robotic-assisted approach for pyeloplasty is becoming increasingly widespread and associated with shorter hospital stay, high success rates, and low complication rates.
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Affiliation(s)
- Peter Y Cai
- Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Hunnewell 390, Boston, MA 02115, USA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Hunnewell 390, Boston, MA 02115, USA; Department of Surgery, Harvard Medical School, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Wang HH, Zhang TR, Ramakrishnan VM, Valovska MT, Retik AB, Lee RS. Long-term Urological Outcomes in Pelvic Genitourinary Rhabdomyosarcoma: A 48-Year Single-center Experience. J Urol 2023; 209:1202-1209. [PMID: 36848055 DOI: 10.1097/ju.0000000000003393] [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] [Received: 10/15/2022] [Accepted: 02/21/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Multimodal therapy has improved survival in genitourinary rhabdomyosarcoma, a rare pediatric cancer. However, little is reported regarding postoperative complications and long-term urinary and sexual function and quality of life. MATERIALS AND METHODS We reviewed records from 1970-2018 to identify patients with genitourinary rhabdomyosarcoma of the bladder, prostate, pelvis, vagina, and uterus. We assessed modes of therapy, and if surgical, the type of resection, reconstruction, and reoperation. Primary outcomes included urinary continence, urinary tract infection occurrence, and stone formation. We also surveyed patients older than 18 years for urinary and sexual function. RESULTS Fifty-one patients were identified for the post-treatment outcomes cohort. All received chemotherapy, 46 (90.2%) underwent surgery, and 34 (67%) received radiation. Twenty-nine patients (56.9%) received trimodal therapy, 17 (33.3%) received chemotherapy/surgery, and 5 (9.8%) received chemotherapy/radiation. Twenty-six had up-front radical surgery (with staged continence mechanism creation); these patients had higher rates of continence, similar rates of urinary tract infection, and higher rates of stone formation compared to those who were organ-spared. A third (4/12) of organ-spared patients underwent additional corrective surgery. Thirty patients with genitourinary rhabdomyosarcoma were surveyed and 14 responded to questionnaires. Overall, urinary complaints were mild, but both male and female respondents reported significant sexual dysfunction. CONCLUSIONS Organ-sparing treatment was more likely to predispose patients to high rates of additional reconstructive surgery due to compromised urological function. In survey results, both men and women reported poor sexual function, but the majority of patients remained satisfied with their urinary function.
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Affiliation(s)
- Hsin-Hsiao Wang
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Tenny R. Zhang
- Department of Urology, NewYork-Presbyterian/Weill Cornell, New York, New York
| | | | | | - Alan B. Retik
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Richard S. Lee
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
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Lee T, Weiss D, Roth E, Bortnick E, Jarosz S, Eftekharzadeh S, Groth T, Shukla A, Kryger JV, Lee RS, Canning DA, Mitchell ME, Borer JG. Prenatal Diagnosis of Bladder Exstrophy and OEIS over 20 Years. Urology 2023; 172:174-177. [PMID: 36460061 DOI: 10.1016/j.urology.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 10/28/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To examine the prenatal diagnosis rates of bladder exstrophy (BE) and Omphalocele-Exstrophy-Imperforate anus-Spinal Defect Syndrome (OEIS) in a large cohort of patients over a 20-year period. We hypothesized that prenatal diagnosis rates improved over time due to evolving techniques in fetal imaging. METHODS A multi-institutional database was queried to identify BE or OEIS patients who underwent primary closure between 2000 and 2020. We retrospectively determined prenatal or postnatal diagnosis. Those with unknown prenatal history were excluded. Multivariable logistic regression was used to investigate temporal pattern in rate of prenatal diagnosis while adjusting for sex and treating institution. RESULTS Among 197 BE and 52 OEIS patients, 155 BE and 45 OEIS patients had known prenatal history. Overall prenatal diagnosis rates of BE and OEIS were 47.1% (73/155) and 82.2% (37/45), respectively. Prenatal diagnosis rate was significantly lower in BE compared to OEIS (P <.0001). The prenatal diagnosis rate for BE significantly increased over time (OR 1.10; [95%CI: 1.03-1.17]; P = .003). Between 2000 and 2005, the prenatal diagnosis rate of BE was 30.3% (10/33). Between 2015 and 2020, prenatal diagnosis rate of BE was 61.1% (33/54). Prenatal diagnosis rate for OEIS did not change over time. Rates of prenatal diagnosis did not differ by sex or treating institution. CONCLUSION Rates of prenatal diagnosis of BE and OEIS are higher than previously reported. Prenatal diagnosis rate of BE doubled in the last 5 years compared to the first 5 years of the study period. Nonetheless, a significant proportion of both BE and OEIS patients remain undiagnosed prior to delivery.
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Affiliation(s)
- Ted Lee
- Department of Urology, Boston Children's Hospital, Boston, MA.
| | - Dana Weiss
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Elizabeth Roth
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Eric Bortnick
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Susan Jarosz
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | | | - Travis Groth
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Aseem Shukla
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - John V Kryger
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Douglas A Canning
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Joseph G Borer
- Department of Urology, Boston Children's Hospital, Boston, MA
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Jones RB, Farhi J, Adams M, Parwani KK, Cooper GW, Zecevic M, Lee RS, Hong AL, Spangle JM. Targeting MLL Methyltransferases Enhances the Antitumor Effects of PI3K Inhibition in Hormone Receptor-positive Breast Cancer. Cancer Res Commun 2022; 2:1569-1578. [PMID: 36970726 PMCID: PMC10036132 DOI: 10.1158/2767-9764.crc-22-0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/03/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022]
Abstract
The high frequency of aberrant PI3K pathway activation in hormone receptor-positive (HR+) breast cancer has led to the development, clinical testing, and approval of the p110α-selective PI3K inhibitor alpelisib. The limited clinical efficacy of alpelisib and other PI3K inhibitors is partially attributed to the functional antagonism between PI3K and estrogen receptor (ER) signaling, which is mitigated via combined PI3K inhibition and endocrine therapy. We and others have previously demonstrated chromatin-associated mechanisms by which PI3K supports cancer development and antagonizes ER signaling through the modulation of the H3K4 methylation axis, inhibition of KDM5A promoter H3K4 demethylation and KMT2D/MLL4-directed enhancer H3K4 methylation. Here we show that inhibition of the H3K4 histone methyltransferase MLL1 in combination with PI3K inhibition impairs HR+ breast cancer clonogenicity and cell proliferation. While combined PI3K/MLL1 inhibition reduces PI3K/AKT signaling and H3K4 methylation, MLL1 inhibition increases PI3K/AKT signaling through the dysregulation of gene expression associated with AKT activation. These data reveal a feedback loop between MLL1 and AKT whereby MLL1 inhibition reactivates AKT. We show that combined PI3K and MLL1 inhibition synergizes to cause cell death in in vitro and in vivo models of HR+ breast cancer, which is enhanced by the additional genetic ablation of the H3K4 methyltransferase and AKT target KMT2D/MLL4. Together, our data provide evidence of a feedback mechanism connecting histone methylation with AKT and may support the preclinical development and testing of pan-MLL inhibitors. Significance Here the authors leverage PI3K/AKT-driven chromatin modification to identify histone methyltransferases as a therapeutic target. Dual PI3K and MLL inhibition synergize to reduce clonogenicity and cell proliferation, and promote in vivo tumor regression. These findings suggest patients with PIK3CA-mutant, HR+ breast cancer may derive clinical benefit from combined PI3K/MLL inhibition.
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Affiliation(s)
- Robert B. Jones
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Jonathan Farhi
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
- Cancer Biology Graduate Program, Emory University School of Medicine, Atlanta, Georgia
| | - Miranda Adams
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
- Cancer Biology Graduate Program, Emory University School of Medicine, Atlanta, Georgia
| | - Kiran K. Parwani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
- Cancer Biology Graduate Program, Emory University School of Medicine, Atlanta, Georgia
| | - Garrett W. Cooper
- Genetics and Molecular Biology Graduate Program, Emory University School of Medicine, Atlanta, Georgia
| | - Milica Zecevic
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Richard S. Lee
- Department of Biology, Emory University, Atlanta, Georgia
| | - Andrew L. Hong
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Jennifer M. Spangle
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
- Cancer Biology Graduate Program, Emory University School of Medicine, Atlanta, Georgia
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Wu CHW, Lim TY, Wang C, Seltzsam S, Zheng B, Schierbaum L, Schneider S, Mann N, Connaughton DM, Nakayama M, van der Ven AT, Dai R, Kolvenbach CM, Kause F, Ottlewski I, Stajic N, Soliman NA, Kari JA, El Desoky S, Fathy HM, Milosevic D, Turudic D, Al Saffar M, Awad HS, Eid LA, Ramanathan A, Senguttuvan P, Mane SM, Lee RS, Bauer SB, Lu W, Hilger AC, Tasic V, Shril S, Sanna-Cherchi S, Hildebrandt F. Copy Number Variation Analysis Facilitates Identification of Genetic Causation in Patients with Congenital Anomalies of the Kidney and Urinary Tract. EUR UROL SUPPL 2022; 44:106-112. [PMID: 36185583 PMCID: PMC9520493 DOI: 10.1016/j.euros.2022.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/27/2022] Open
Abstract
Background Congenital anomalies of the kidneys and urinary tract (CAKUT) are the most common cause of chronic kidney disease among children and adults younger than 30 yr. In our previous study, whole-exome sequencing (WES) identified a known monogenic cause of isolated or syndromic CAKUT in 13% of families with CAKUT. However, WES has limitations and detection of copy number variations (CNV) is technically challenging, and CNVs causative of CAKUT have previously been detected in up to 16% of cases. Objective To detect CNVs causing CAKUT in this WES cohort and increase the diagnostic yield. Design setting and participants We performed a genome-wide single nucleotide polymorphism (SNP)-based CNV analysis on the same CAKUT cohort for whom WES was previously conducted. Outcome measurements and statistical analysis We evaluated and classified the CNVs using previously published predefined criteria. Results and limitations In a cohort of 170 CAKUT families, we detected a pathogenic CNV known to cause CAKUT in nine families (5.29%, 9/170). There were no competing variants on genome-wide CNV analysis or WES analysis. In addition, we identified novel likely pathogenic CNVs that may cause a CAKUT phenotype in three of the 170 families (1.76%). Conclusions CNV analysis in this cohort of 170 CAKUT families previously examined via WES increased the rate of diagnosis of genetic causes of CAKUT from 13% on WES to 18% on WES + CNV analysis combined. We also identified three candidate loci that may potentially cause CAKUT. Patient summary We conducted a genetics study on families with congenital anomalies of the kidney and urinary tract (CAKUT). We identified gene mutations that can explain CAKUT symptoms in 5.29% of the families, which increased the percentage of genetic causes of CAKUT to 18% from a previous study, so roughly one in five of our patients with CAKUT had a genetic cause. These analyses can help patients with CAKUT and their families in identifying a possible genetic cause.
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Affiliation(s)
- Chen-Han Wilfred Wu
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Urology, Case Western Reserve University and University Hospitals, Cleveland, OH, USA
- Department of Genetics and Genome Sciences, Case Western Reserve University and University Hospitals, Cleveland, OH, USA
| | - Tze Y. Lim
- Division of Nephrology, Columbia University Irving Medical Center, New York, NY, USA
| | - Chunyan Wang
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Steve Seltzsam
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Bixia Zheng
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Luca Schierbaum
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Sophia Schneider
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Nina Mann
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Dervla M. Connaughton
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Makiko Nakayama
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Amelie T. van der Ven
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Rufeng Dai
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Caroline M. Kolvenbach
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Franziska Kause
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Isabel Ottlewski
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Natasa Stajic
- Department of Pediatric Nephrology, Institute for Mother and Child Health Care, Belgrade, Serbia
| | - Neveen A. Soliman
- Department of Pediatrics, Center of Pediatric Nephrology & Transplantation, Cairo University, Egyptian Group for Orphan Renal Diseases, Cairo, Egypt
| | - Jameela A. Kari
- Department of Pediatrics, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Sherif El Desoky
- Department of Pediatrics, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Hanan M. Fathy
- Pediatric Nephrology Unit, University of Alexandria, Alexandria, Egypt
| | - Danko Milosevic
- Department of Pediatric Nephrology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Daniel Turudic
- Department of Pediatric Nephrology, University Hospital Center Zagreb, Zagreb, Croatia
| | - Muna Al Saffar
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Paediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hazem S. Awad
- Pediatric Nephrology Department, Dubai Hospital, Dubai, United Arab Emirates
| | - Loai A. Eid
- Pediatric Nephrology Department, Dubai Hospital, Dubai, United Arab Emirates
- Department of Pediatrics, Dubai Medical College and Kidney Centre of Excellence, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates
| | - Aravind Ramanathan
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Prabha Senguttuvan
- Department of Pediatric Nephrology, Dr. Mehta’s Multi-Specialty Hospital, Chennai, India
| | - Shrikant M. Mane
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Richard S. Lee
- Department of Urology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Stuart B. Bauer
- Department of Urology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Weining Lu
- Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA, USA
| | - Alina C. Hilger
- Department of Pediatric and Adolescent Medicine, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Velibor Tasic
- Medical Faculty Skopje, University Children’s Hospital, Skopje, Macedonia
| | - Shirlee Shril
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Simone Sanna-Cherchi
- Division of Nephrology, Columbia University Irving Medical Center, New York, NY, USA
| | - Friedhelm Hildebrandt
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Corresponding author. Division of Nephrology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. Tel. +1 617 3556129; Fax: +1 617 8300365.
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9
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Ostertag-Hill CA, Nandivada P, McNamara ER, Lee RS, Dickie BH. Primary and secondary vaginal reconstruction with autologous buccal mucosa and intravaginal wound vacuum therapy. J Pediatr Surg 2022; 57:1687-1693. [PMID: 35525806 DOI: 10.1016/j.jpedsurg.2022.04.006] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vaginal reconstruction with autologous buccal mucosa graft offers a promising alternative to the use of skin grafts and vascularized intestinal segments. Given the novelty of this procedure, the optimal approach to postoperative wound management remains unclear with current practices often requiring many months of vaginal stents/molds. This study aims to evaluate a newly developed negative pressure intravaginal wound vacuum placed at the conclusion of the vaginoplasty with the goals of facilitating graft take and healing. METHODS A retrospective review of patients (age 12-21 years) who underwent eight primary and secondary vaginoplasty procedures using autologous buccal mucosa coupled with intravaginal wound vacuum placement was performed. RESULTS Vaginal reconstruction with fenestrated full-thickness buccal mucosa graft and intravaginal wound vacuum placement was successfully performed eight times in seven patients at a median age of 15.6 years. Four patients underwent robotic vaginal pull-through with buccal mucosa serving as an interposition graft, and four patients underwent vaginoplasty with buccal graft alone. All cases had excellent engraftment at time of wound vacuum removal on postoperative day seven and had healthy-appearing buccal mucosa at a mean follow-up of 148 days. Postoperatively, one patient developed a stricture at the anastomosis between native vagina and buccal mucosa graft, requiring a second buccal mucosa graft six months after the first operation. CONCLUSIONS The use of autologous buccal mucosa graft for primary and secondary vaginal reconstruction coupled with intravaginal wound vacuum therapy offers a promising new approach. Negative pressure wound vacuum therapy may provide a more optimal wound healing environment for improved outcomes. TYPE OF STUDY Retrospective Study LEVELS OF EVIDENCE: Level IV.
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Affiliation(s)
- Claire A Ostertag-Hill
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Fegan 3, Boston, 02115 MA, United States
| | - Prathima Nandivada
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Fegan 3, Boston, 02115 MA, United States
| | - Erin R McNamara
- Department of Urology, Boston Children's Hospital, 300 Longwood Ave, Hunnewell 3, Boston, 02115 MA, United States
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, 300 Longwood Ave, Hunnewell 3, Boston, 02115 MA, United States
| | - Belinda H Dickie
- Department of Surgery, Boston Children's Hospital, 300 Longwood Ave, Fegan 3, Boston, 02115 MA, United States.
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10
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Lemon LD, Kannan S, Mo KW, Adams M, Choi HG, Gulka AOD, Withers ES, Nurelegne HT, Gomez V, Ambrocio RE, Tumminkatti R, Lee RS, Wan M, Fasken MB, Spangle JM, Corbett AH. A Saccharomyces cerevisiae model and screen to define the functional consequences of oncogenic histone missense mutations. G3 Genes|Genomes|Genetics 2022; 12:6585874. [PMID: 35567477 PMCID: PMC9258546 DOI: 10.1093/g3journal/jkac120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/06/2022] [Indexed: 11/17/2022]
Abstract
Somatic missense mutations in histone genes turn these essential proteins into oncohistones, which can drive oncogenesis. Understanding how missense mutations alter histone function is challenging in mammals as mutations occur in a single histone gene. For example, described oncohistone mutations predominantly occur in the histone H3.3 gene, despite the human genome encoding 15 H3 genes. To understand how oncogenic histone missense mutations alter histone function, we leveraged the budding yeast model, which contains only 2 H3 genes, to explore the functional consequences of oncohistones H3K36M, H3G34W, H3G34L, H3G34R, and H3G34V. Analysis of cells that express each of these variants as the sole copy of H3 reveals that H3K36 mutants show different drug sensitivities compared to H3G34 mutants. This finding suggests that changes to proximal amino acids in the H3 N-terminal tail alter distinct biological pathways. We exploited the caffeine-sensitive growth of H3K36-mutant cells to perform a high copy suppressor screen. This screen identified genes linked to histone function and transcriptional regulation, including Esa1, a histone H4/H2A acetyltransferase; Tos4, a forkhead-associated domain-containing gene expression regulator; Pho92, an N6-methyladenosine RNA-binding protein; and Sgv1/Bur1, a cyclin-dependent kinase. We show that the Esa1 lysine acetyltransferase activity is critical for suppression of the caffeine-sensitive growth of H3K36R-mutant cells while the previously characterized binding interactions of Tos4 and Pho92 are not required for suppression. This screen identifies pathways that could be altered by oncohistone mutations and highlights the value of yeast genetics to identify pathways altered by such mutations.
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Affiliation(s)
- Laramie D Lemon
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Sneha Kannan
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Kim Wai Mo
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Miranda Adams
- Department of Biology, Emory University , Atlanta, GA 30322, USA
- Department of Radiation Oncology, Emory University , Atlanta, GA 30322, USA
- Graduate Program in Cancer Biology, Emory University , Atlanta, GA 30322, USA
| | - Haley G Choi
- Department of Biology, Emory University , Atlanta, GA 30322, USA
- Department of Radiation Oncology, Emory University , Atlanta, GA 30322, USA
| | - Alexander O D Gulka
- Department of Biology, Emory University , Atlanta, GA 30322, USA
- Graduate Program in Genetics and Molecular Biology, Emory University , Atlanta, GA 30322, USA
| | - Elise S Withers
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | | | - Valeria Gomez
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Reina E Ambrocio
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Rhea Tumminkatti
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Richard S Lee
- Department of Biology, Emory University , Atlanta, GA 30322, USA
- Department of Radiation Oncology, Emory University , Atlanta, GA 30322, USA
| | - Morris Wan
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Milo B Fasken
- Department of Biology, Emory University , Atlanta, GA 30322, USA
| | - Jennifer M Spangle
- Department of Radiation Oncology, Emory University , Atlanta, GA 30322, USA
| | - Anita H Corbett
- Department of Biology, Emory University , Atlanta, GA 30322, USA
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11
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Ito T, Saeki H, Guo X, Sysa-Shah P, Tamashiro KL, Lee RS, Ishiyama S, Orita H, Sato K, Brock MV, Gabrielson KL. Prenatal stress enhances atherosclerosis and telomere shortening in ApoE knockout mouse offspring. Am J Physiol Regul Integr Comp Physiol 2022; 323:R68-R80. [PMID: 35411811 DOI: 10.1152/ajpregu.00201.2021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Children born to women who experience stress during pregnancy have an increased risk of atherosclerosis in later life, but few animal models have explored mechanisms. To study this phenomena, timed-bred ApoE knockout mice were determined pregnant with ultrasound and randomly assigned on gestation day 8.5 to either a control (no stress) or prenatal stress (PS) group using two hours of restraint for five consecutive days. PS significantly increased plasma corticosterone levels in pregnant mice. The litters from PS mice showed increased neonatal mortality within the first week of life. Body weights (at euthanasia) of adult offspring at 25 weeks from the PS group were significantly increased compared to weights of controls. Adult offspring from these pregnancies were serially imaged with ultrasound to measure plaque thickness and were compared with plaque macro- and microscopic pathology. PS groups had increased plaques thickness by ultrasound, gross, histological evaluation and increased aortic root and valve macrophage infiltration at 25 weeks. Five-week old mice from PS group had significant decrease in mean arterial pressure, yet blood pressure normalized by 10 weeks. Since prenatal stress induced increased atherosclerosis, and telomeres are susceptible to stress, aortas from 10 week old mice were compared for telomere lengths and were found to be significantly shorter in PS mice compared to control mice. These studies support future investigation of how stress impacts telomere shortening in animal models and human aortas. This model could be further utilized to investigate the role of prenatal stress, telomere biology and atherosclerosis pathogenesis in adults.
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Affiliation(s)
- Tomoaki Ito
- Sidney Kimmel Cancer Center. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Surgery, Juntendo University Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan, United States
| | - Harumi Saeki
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Human Pathology, Juntendo University School of Medicine, Tokyo, Japan, United States
| | - Xin Guo
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Polina Sysa-Shah
- Department of Urology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kellie L Tamashiro
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Shun Ishiyama
- Sidney Kimmel Cancer Center. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Department of Coloproctological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hajime Orita
- Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Koichi Sato
- Department of Surgery, Juntendo University Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan, United States
| | - Malcolm V Brock
- Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Kathleen L Gabrielson
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.,Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
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12
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Vitko D, McQuaid JW, Gheinani AH, Hasegawa K, DiMartino S, Davis KH, Chung CY, Petrosino JF, Adam RM, Mansbach JM, Lee RS. Urinary Tract Infections in Children with Vesicoureteral Reflux Are Accompanied by Alterations in Urinary Microbiota and Metabolome Profiles. Eur Urol 2022; 81:151-154. [PMID: 34538688 DOI: 10.1016/j.eururo.2021.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 08/20/2021] [Indexed: 12/21/2022]
Abstract
Children with vesicoureteral reflux (VUR) are at an increased risk of recurrent urinary tract infections (UTIs) and renal scarring. Gut microbiota are associated with disease phenotypes, but there has been no study that associates urinary microbiota (uMB) and metabolic profiles with VUR pathology. To identify dominant uMB genera and metabolites associated with UTIs in VUR, urine samples collected under sterile conditions underwent 16S ribosomal RNA sequencing (n = 49) and metabolomic analysis by mass spectrometry (n = 96). Alterations in uMB and metabolomic profiles in VUR patients suggest remodeling of urinary bacterial communities after UTIs: Dorea- and Escherichia-dominant uMB profiles were more frequently identified in participants with VUR. Prevotella- and Lactobacillus-dominant uMB profiles were more prevalent in controls (p < 0.001). Microbial composition varied based on recurrent febrile UTI status (p = 0.001). A total of 243 urinary metabolites involved in energy, amino acid, nucleotide, and lipid metabolism were altered in VUR patients with UTIs (p < 0.05). Importantly, VUR specimens revealed changes in the bacteria-associated metabolic pathways such as glutamate degradation, methyl-citrate cycle, and bile acid metabolism. PATIENT SUMMARY: Differences in urinary commensal bacteria and metabolites exist between children with and without vesicoureteral reflux (VUR). These changes may be utilized to identify patients at risk of VUR-associated kidney damage.
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Affiliation(s)
- Dijana Vitko
- Department of Urology, Boston Children's Hospital, Boston, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Joseph W McQuaid
- Department of Urology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ali Hashemi Gheinani
- Department of Urology, Boston Children's Hospital, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Kylie H Davis
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
| | - Candace Y Chung
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
| | - Joseph F Petrosino
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Rosalyn M Adam
- Department of Urology, Boston Children's Hospital, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA
| | | | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA, USA; Department of Surgery, Harvard Medical School, Boston, MA, USA.
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13
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Daisy CC, Varinos S, Howell DR, Kaplan K, Mannix R, Meehan WP, Wang F, Berkstresser B, Lee RS, Froehlich JW, Zurakowski D, Moses MA. Proteomic Discovery of Noninvasive Biomarkers Associated With Sport-Related Concussions. Neurology 2022; 98:e186-e198. [PMID: 34675105 PMCID: PMC8762586 DOI: 10.1212/wnl.0000000000013001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/14/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Sport-related concussions affect millions of individuals across the United States each year, and current techniques to diagnose and monitor them rely largely on subjective measures. Our goal was to discover and validate objective, quantifiable noninvasive biomarkers with the potential to be used in sport-related concussion diagnosis. METHODS Urine samples from a convenience series of healthy control collegiate athletes who had not sustained a concussion and athletes who sustained a concussion as diagnosed by a sports medicine physician within 7 days were collected prospectively and studied. Participants also completed an instrumented single-task gait analysis as a functional measure. Participants were recruited from a single collegiate athletic program and were ≥18 years of age and were excluded if they had a concomitant injury, active psychiatric conditions, or preexisting neurologic disorders. Using Tandem Mass Tags (TMT) mass spectroscopy and ELISA, we identified and validated urinary biomarkers of concussion. RESULTS Forty-eight control and 47 age- and sex-matched athletes with concussion were included in the study (51.6% female, 48.4% male, average age 19.6 years). Participants represented both contact and noncontact sports. All but 1 of the postconcussion participants reported experiencing symptoms at the time of data collection. Insulin-like growth factor 1 (IGF-1) and IGF binding protein 5 (IGFBP5) were downregulated in the urine of athletes with concussions compared to healthy controls. Multivariable risk algorithms developed to predict the probability of sport-related concussion showed that IGF-1 multiplexed with single-task gait velocity predicts concussion risk across a range of postinjury time points (area under the curve [AUC] 0.786, 95% confidence interval [CI] 0.690-0.884). When IGF-1 and IGFBP5 are multiplexed with single-task gait velocity, they accurately distinguish between healthy controls and individuals with concussion at acute time points (AUC 0.835, 95% CI 0.701-0.968, p < 0.001). DISCUSSION These noninvasive biomarkers, discovered in an objective and validated manner, may be useful in diagnosing and monitoring sport-related concussions in both acute phases of injury and several days after injury. TRIAL REGISTRATION INFORMATION ClinicalTrials.gov Identifier: NCT02354469 (submitted February 2015, first patient enrolled August 2015). CLASSIFICATION OF EVIDENCE This study provides Class III evidence that urinary IGF-1 and IGFBP5 multiplexed with single-task gait velocity may be useful in diagnosing sport-related concussion.
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Affiliation(s)
- Cassandra C Daisy
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Speros Varinos
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - David R Howell
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Katherine Kaplan
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Rebekah Mannix
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - William P Meehan
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Francis Wang
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Brant Berkstresser
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Richard S Lee
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - John W Froehlich
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - David Zurakowski
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA
| | - Marsha A Moses
- From the Vascular Biology Program (C.C.D., S.V., K.K., M.A.M.), Division of Sports Medicine (D.R.H., W.P.M.), Department of Orthopaedics, Brain Injury Center (D.R.H., R.M., W.P.M.), Sports Concussion Clinic (R.M.), Division of Sports Medicine, Division of Emergency Medicine (R.M.), Department of Urology (R.S.L., J.W.F.), Department of Anesthesia (D.Z.), and Department of Surgery (M.A.M.), Boston Children's Hospital; The Micheli Center for Sports Injury Prevention (D.R.H., R.M., W.P.M.), Waltham, MA; Sports Medicine Center (D.R.H.), Children's Hospital Colorado; Department of Orthopedics (D.R.H.), University of Colorado School of Medicine, Aurora; Departments of Pediatrics (W.P.M.), and Orthopaedic Surgery (W.P.M.), and Surgery (R.S.L., J.W.F., D.Z., M.A.M.), Harvard Medical School; and Harvard Sports Medicine (F.W., B.B.), Boston, MA.
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14
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Wang HHS, Cho PS, Zhi H, Kostel SA, DiMartino S, Dagher AM, Davis KH, Cabour LD, Shimmel A, Lee J, Froehlich JW, Zurakowski D, Moses MA, Lee RS. Association between urinary biomarkers MMP-7/TIMP-2 and reduced renal function in children with ureteropelvic junction obstruction. PLoS One 2022; 17:e0270018. [PMID: 35834547 PMCID: PMC9282603 DOI: 10.1371/journal.pone.0270018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/09/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
IMPORTANCE Extracellular matrix proteins and enzymes involved in degradation have been found to be associated with tissue fibrosis and ureteropelvic junction obstruction (UPJO). In this study we developed a promising urinary biomarker model which can identify reduced renal function in UPJ obstruction patients. This can potentially serve as a non-invasive way to enhance surgical decision making for patients and urologists. OBJECTIVE We sought to develop a predictive model to identify UPJO patients at risk for reduced renal function. DESIGN Prospective cohort study. SETTING Pre-operative urine samples were collected in a prospectively enrolled UPJO biomarker registry at our institution. Urinary MMP-2, MMP-7, TIMP-2, and NGAL were measured as well as clinical characteristics including hydronephrosis grade, differential renal function, t1/2, and UPJO etiology. PARTICIPANTS Children who underwent pyeloplasty for UPJO. MAIN OUTCOME MEASUREMENT Primary outcome was reduced renal function defined as MAG3 function <40%. Multivariable logistic regression was applied to identify the independent predictive biomarkers in the original Training cohort. Model validation and generalizability were evaluated in a new UPJO Testing cohort. RESULTS We included 71 patients with UPJO in the original training cohort and 39 in the validation cohort. Median age was 3.3 years (70% male). By univariate analysis, reduced renal function was associated with higher MMP-2 (p = 0.064), MMP-7 (p = 0.047), NGAL (p = 0.001), and lower TIMP-2 (p = 0.033). Combining MMP-7 with TIMP-2, the multivariable logistic regression model predicted reduced renal function with good performance (AUC = 0.830; 95% CI: 0.722-0.938). The independent testing dataset validated the results with good predictive performance (AUC = 0.738). CONCLUSIONS AND RELEVANCE Combination of urinary MMP-7 and TIMP-2 can identify reduced renal function in UPJO patients. With the high sensitivity cutoffs, patients can be categorized into high risk (aggressive management) versus lower risk (observation).
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Affiliation(s)
- Hsin-Hsiao S. Wang
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Patricia S. Cho
- Department of Urology, University of Massachusetts, Worcester, MA, United States of America
| | - Hui Zhi
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Stephen A. Kostel
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Shannon DiMartino
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Adelle M. Dagher
- The Program in Vascular Biology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Kylie H. Davis
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Lily D. Cabour
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Ashley Shimmel
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - James Lee
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - John W. Froehlich
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - David Zurakowski
- Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Marsha A. Moses
- The Program in Vascular Biology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
- Department of Surgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Richard S. Lee
- Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States of America
- * E-mail:
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15
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Portella AK, Papantoni A, Joseph AT, Chen L, Lee RS, Silveira PP, Dube L, Carnell S. Genetically-predicted prefrontal DRD4 gene expression modulates differentiated brain responses to food cues in adolescent girls and boys. Sci Rep 2021; 11:24094. [PMID: 34916545 PMCID: PMC8677785 DOI: 10.1038/s41598-021-02797-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
The dopamine receptor 4 (DRD4) in the prefrontal cortex (PFC) acts to modulate behaviours including cognitive control and motivation, and has been implicated in behavioral inhibition and responsivity to food cues. Adolescence is a sensitive period for the development of habitual eating behaviors and obesity risk, with potential mediation by development of the PFC. We previously found that genetic variations influencing DRD4 function or expression were associated with measures of laboratory and real-world eating behavior in girls and boys. Here we investigated brain responses to high energy–density (ED) and low-ED food cues using an fMRI task conducted in the satiated state. We used the gene-based association method PrediXcan to estimate tissue-specific DRD4 gene expression in prefrontal brain areas from individual genotypes. Among girls, those with lower vs. higher predicted prefrontal DRD4 expression showed lesser activation to high-ED and low-ED vs. non-food cues in a distributed network of regions implicated in attention and sensorimotor processing including middle frontal gyrus, and lesser activation to low-ED vs non-food cues in key regions implicated in valuation including orbitofrontal cortex and ventromedial PFC. In contrast, males with lower vs. higher predicted prefrontal DRD4 expression showed minimal differences in food cue response, namely relatively greater activation to high-ED and low-ED vs. non-food cues in the inferior parietal lobule. Our data suggest sex-specific effects of prefrontal DRD4 on brain food responsiveness in adolescence, with modulation of distributed regions relevant to cognitive control and motivation observable in female adolescents.
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Affiliation(s)
- Andre K Portella
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada.,Postgraduate Program in Pediatrics, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brazil
| | - Afroditi Papantoni
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Antoneta T Joseph
- McGill Centre for the Convergence of Health and Economics (MCCHE), McGill University, Montreal, Canada
| | - Liuyi Chen
- Department of Psychiatry and Behavioral Sciences, Division of Psychiatric Neuroimaging, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patricia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, QC, Canada.,Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Laurette Dube
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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16
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Lee RS, Zandi PP, Santos A, Aulinas A, Carey JL, Webb SM, McCaul ME, Resmini E, Wand GS. Cross-species Association Between Telomere Length and Glucocorticoid Exposure. J Clin Endocrinol Metab 2021; 106:e5124-e5135. [PMID: 34265046 PMCID: PMC8787853 DOI: 10.1210/clinem/dgab519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT Chronic exposure to glucocorticoids (GCs) or stress increases the risk of medical disorders, including cardiovascular and neuropsychiatric disorders. GCs contribute to accelerated aging; however, while the link between chronic GC exposure and disease onset is well established, the underpinning mechanisms are not clear. OBJECTIVE We explored the potential nexus between GCs or stress exposure and telomere length. METHODS In addition to rats exposed to 3 weeks of chronic stress, an iatrogenic mouse model of Cushing syndrome (CS), and a mouse neuronal cell line, we studied 32 patients with CS and age-matched controls and another cohort of 75 healthy humans. RESULTS (1) Exposure to stress in rats was associated with a 54.5% (P = 0.036) reduction in telomere length in T cells. Genomic DNA (gDNA) extracted from the dentate gyrus of stressed and unstressed rats showed 43.2% reduction in telomere length (P = 0.006). (2) Mice exposed to corticosterone had a 61.4% reduction in telomere length in blood gDNA (P = 5.75 × 10-5) and 58.8% reduction in telomere length in the dentate gyrus (P = 0.002). (3) We observed a 40.8% reduction in the telomere length in patients with active CS compared to healthy controls (P = 0.006). There was a 17.8% reduction in telomere length in cured CS patients, which was not different from that of healthy controls (P = 0.08). For both cured and active CS, telomere length correlated significantly with duration of hypercortisolism (R2 = 0.22, P = 0.007). (4) There was a 27.6% reduction in telomere length between low and high tertiles in bedtime cortisol levels of healthy participants (P = 0.019). CONCLUSION Our findings demonstrate that exposure to stress and/or GCs is associated with shortened telomeres, which may be partially reversible.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
| | - Alicia Santos
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Anna Aulinas
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jenny L Carey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Susan M Webb
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Eugenia Resmini
- Correspondence: Eugenia Resmini, MD, PhD, Endocrinology/Medicine Department, Hospital Sant Pau, CIBER-ER, Unit747, IIB-Sant Pau, ISCIII, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - Gary S Wand
- Gary S. Wand, MD, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
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Froehlich JW, Scott Wang HH, Logvinenko T, Kostel S, DiMartino S, van Bokhoven A, Moses MA, Lee RS. "The Urinary Proteomic Profile Implicates Key Regulators for Urologic Chronic Pelvic Pain Syndrome (UCPPS): A MAPP Research Network Study". Mol Cell Proteomics 2021; 21:100176. [PMID: 34774759 PMCID: PMC8733275 DOI: 10.1016/j.mcpro.2021.100176] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/08/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022] Open
Abstract
Urologic chronic pelvic pain syndrome (UCPPS) is a condition of unknown etiology characterized by pelvic pain and urinary frequency and/or urgency. As the proximal fluid of this syndrome, urine is an ideal candidate sample matrix for an unbiased study of UCPPS. In this study, a large, discovery-phase, TMT-based quantitative urinary proteomics analysis of 244 participants was performed. The participants included patients with UCPPS (n = 82), healthy controls (HC) (n = 94), and disparate chronic pain diseases, termed positive controls (PC) (n = 68). Using training and testing cohorts, we identified and validated a small and distinct set of proteins that distinguished UCPPS from HC (n = 9) and UCPPS from PC (n = 3). The validated UCPPS: HC proteins were predominantly extracellular matrix/extracellular matrix modifying or immunomodulatory/host defense in nature. Significantly varying proteins in the UCPPS: HC comparison were overrepresented by the members of several dysregulated biological processes including decreased immune cell migration, decreased development of epithelial tissue, and increased bleeding. Comparison with the PC cohort enabled the evaluation of UCPPS-specific upstream regulators, contrasting UCPPS with other conditions that cause chronic pain. Specific to UCPPS were alterations in the predicted signaling of several upstream regulators, including alpha-catenin, interleukin-6, epidermal growth factor, and transforming growth factor beta 1, among others. These findings advance our knowledge of the etiology of UCPPS and inform potential future clinical translation into a diagnostic panel for UCPPS. The proteomics of urinary chronic pelvic pain syndrome (UCPPS) found altered pathways. Key changes among the extracellular matrix and inflammatory response proteins were found. Several of these pathways and proteins were exclusively altered in UCPPS. These findings may have diagnostic and/or therapeutic potential in the future.
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Affiliation(s)
- John W Froehlich
- Department of Urology, Boston Children's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Hsin-Hsaio Scott Wang
- Department of Urology, Boston Children's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Tanya Logvinenko
- Department of Urology, Boston Children's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Stephen Kostel
- Department of Urology, Boston Children's Hospital, Boston, MA
| | | | - Adrie van Bokhoven
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Marsha A Moses
- Department of Surgery, Harvard Medical School, Boston, MA; Vascular Biology Program, Boston Children's Hospital, Boston, MA; Department of Surgery, Boston Children's Hospital, Boston, MA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
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18
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Lee RS, Zandi PP, Lin Y, Seifuddin F, Benke KS, McCaul ME, Reitz K, Wand GS. Methylomic and transcriptomic predictors of one-month exposure to cortisol in healthy individuals. Stress 2021; 24:840-848. [PMID: 34279166 DOI: 10.1080/10253890.2021.1946509] [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] [Indexed: 10/20/2022] Open
Abstract
Allostatic load (AL) refers to the cumulative "wear and tear" on an organism throughout its lifetime. One of the primary contributing factors to AL is prolonged exposure to stress or its primary catabolic agent cortisol. Chronic exposure to stress or cortisol is associated with numerous diseases, including cardiovascular disease, metabolic disorders, and psychiatric disorders. Therefore, a molecular marker capable of integrating a past history of cortisol exposure would be of great utility for assessing disease risk. To this end, we recruited 87 healthy males and females of European ancestry between 18 and 60 years old, extracted genomic DNA and RNA from leukocytes, and implemented a gene-centric DNA enrichment method coupled with bisulfite sequencing and RNA-Seq of total RNA for the determination of genome-wide methylation and gene transcription, respectively. Sequencing data were analyzed against awakening and bedtime cortisol data to identify differentially methylated regions (DMRs) and CpGs (DMCs) and differentially expressed genes (DEGs). Six candidate DMCs (punadjusted < 0.005) and nine DEGs (punadjusted < 0.0005) were used to construct a prediction model that could capture past 30+ days of both bedtime and awakening cortisol levels. Utilizing a cross-validation approach, we obtained a regression coefficient of R2 = 0.308 for predicting continuous awakening cortisol and an area under the curve (AUC) = 0.753 for dichotomous (high vs. low tertile) awakening cortisol, and R2 = 0.224 and AUC = 0.723 for continuous and dichotomous bedtime cortisol levels, respectively. To our knowledge, the current study represents the first attempt to identify genome-wide predictors of cortisol exposure that utilizes both methylation and transcription targets. The utility of our approach needs to be replicated in an independent cohort of samples for which similar cortisol metrics are available.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yian Lin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fayaz Seifuddin
- Bioinformatics and Computational Biology Core, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kelly S Benke
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kendall Reitz
- Department of and Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gary S Wand
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of and Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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19
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Cordner ZA, Marshall-Thomas I, Boersma GJ, Lee RS, Potash JB, Tamashiro KL. Fluoxetine and environmental enrichment similarly reverse chronic social stress-related depression- and anxiety-like behavior, but have differential effects on amygdala gene expression. Neurobiol Stress 2021; 15:100392. [PMID: 34568521 PMCID: PMC8449130 DOI: 10.1016/j.ynstr.2021.100392] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/20/2021] [Accepted: 09/08/2021] [Indexed: 01/26/2023] Open
Abstract
The adverse effects of stress on brain and behavior have long been known and well-studied, with abundant evidence linking stress to, among other things, mood and anxiety disorders. Likewise, many have investigated potential treatments for stress-related mood and anxiety phenotypes and demonstrated good response to standard antidepressant medications like selective serotonin reuptake inhibitors (SSRIs), as well as environmental manipulations like exercise or enrichment. However, the extent to which stress and various treatments act on overlapping pathways in the brain is less well understood. Here, we used a widely studied social defeat stress paradigm to induce a robust depression- and anxiety-like phenotype and chronic corticosterone elevation that persisted for at least 4 weeks in wild type male mice. When mice were treated with either the SSRI fluoxetine or an enriched environment, both led to similar behavioral recovery from social defeat. We then focused on the amygdala and assessed the effects of social defeat, fluoxetine, and enrichment on 168 genes broadly related to synaptic plasticity or oxidative stress. We found 24 differentially expressed genes in response to social defeat stress. Interestingly, fluoxetine led to broad normalization of the stress-induced expression pattern while enrichment led to expression changes in a separate set of genes. Together, this study provides additional insight into the chronic effects of social defeat stress on behavior and gene expression in the amygdala. The findings also suggest that, for a subset of genes assessed, fluoxetine and environmental enrichment have strikingly divergent effects on expression in the amygdala, despite leading to similar behavioral outcomes.
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Affiliation(s)
- Zachary A. Cordner
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
| | - Isaiah Marshall-Thomas
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
| | - Gretha J. Boersma
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
| | - Richard S. Lee
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
| | - James B. Potash
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
| | - Kellie L.K. Tamashiro
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
- Cellular & Molecular Medicine Program, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA
- Corresponding author. Department of Psychiatry & Behavioral Sciences Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross 618, Baltimore, MD, 21205, USA.
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20
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Sterrett MC, Enyenihi L, Leung SW, Hess L, Strassler SE, Farchi D, Lee RS, Withers ES, Kremsky I, Baker RE, Basrai MA, van Hoof A, Fasken MB, Corbett AH. A budding yeast model for human disease mutations in the EXOSC2 cap subunit of the RNA exosome complex. RNA 2021; 27:1046-1067. [PMID: 34162742 PMCID: PMC8370739 DOI: 10.1261/rna.078618.120] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
RNA exosomopathies, a growing family of diseases, are linked to missense mutations in genes encoding structural subunits of the evolutionarily conserved, 10-subunit exoribonuclease complex, the RNA exosome. This complex consists of a three-subunit cap, a six-subunit, barrel-shaped core, and a catalytic base subunit. While a number of mutations in RNA exosome genes cause pontocerebellar hypoplasia, mutations in the cap subunit gene EXOSC2 cause an apparently distinct clinical presentation that has been defined as a novel syndrome SHRF (short stature, hearing loss, retinitis pigmentosa, and distinctive facies). We generated the first in vivo model of the SHRF pathogenic amino acid substitutions using budding yeast by modeling pathogenic EXOSC2 missense mutations (p.Gly30Val and p.Gly198Asp) in the orthologous S. cerevisiae gene RRP4 The resulting rrp4 mutant cells show defects in cell growth and RNA exosome function. Consistent with altered RNA exosome function, we detect significant transcriptomic changes in both coding and noncoding RNAs in rrp4-G226D cells that model EXOSC2 p.Gly198Asp, suggesting defects in nuclear surveillance. Biochemical and genetic analyses suggest that the Rrp4 G226D variant subunit shows impaired interactions with key RNA exosome cofactors that modulate the function of the complex. These results provide the first in vivo evidence that pathogenic missense mutations present in EXOSC2 impair the function of the RNA exosome. This study also sets the stage to compare exosomopathy models to understand how defects in RNA exosome function underlie distinct pathologies.
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Affiliation(s)
- Maria C Sterrett
- Biochemistry, Cell and Developmental Biology Graduate Program, Emory University, Atlanta, Georgia 30322, USA
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Liz Enyenihi
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Sara W Leung
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Laurie Hess
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Sarah E Strassler
- Biochemistry, Cell and Developmental Biology Graduate Program, Emory University, Atlanta, Georgia 30322, USA
- Department of Biochemistry, Emory University, Atlanta, Georgia 30322, USA
| | - Daniela Farchi
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Richard S Lee
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Elise S Withers
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Isaac Kremsky
- Loma Linda University School of Medicine, Loma Linda, California 92350, USA
| | - Richard E Baker
- Department of Microbiology and Physiological Systems, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA
| | - Munira A Basrai
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892, USA
| | - Ambro van Hoof
- Department of Microbiology and Molecular Genetics, University of Texas Health Science Center at Houston, Houston, Texas 77030, USA
| | - Milo B Fasken
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
| | - Anita H Corbett
- Department of Biology, Emory University, Atlanta, Georgia 30322, USA
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21
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Lee RS, Song SQ, Garrison-Desany HM, Carey JL, Lasutschinkow P, Zabel A, Bressler J, Gropman A, Samango-Sprouse C. DNA methylation and behavioral dysfunction in males with 47,XXY and 49,XXXXY: a pilot study. Clin Epigenetics 2021; 13:136. [PMID: 34210361 PMCID: PMC8252231 DOI: 10.1186/s13148-021-01123-4] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Abstract
Background Equal dosage of X-linked genes between males and females is maintained by the X-inactivation of the second X chromosome in females through epigenetic mechanisms. Boys with aneuploidy of the X chromosome exhibit a host of symptoms such as low fertility, musculoskeletal anomalies, and cognitive and behavioral deficits that are presumed to be caused by the abnormal dosage of these genes. The objective of this pilot study is to assess the relationship between CpG methylation, an epigenetic modification, at several genes on the X chromosome and behavioral dysfunction in boys with supernumerary X chromosomes. Results Two parental questionnaires, the Behavior Rating Inventory of Executive Function (BRIEF) and Child Behavior Checklist (CBCL), were analyzed, and they showed expected differences in both internal and external behaviors between neurotypical (46,XY) boys and boys with 49,XXXXY. There were several CpGs in AR and MAOA of boys with 49,XXXXY whose methylation levels were skewed from levels predicted from having one active (Xa) and three inactive (Xi) X chromosomes. Further, methylation levels of multiple CpGs in MAOA showed nominally significant association with externalizing behavior on the CBCL, and the methylation level of one CpG in AR showed nominally significant association with the BRIEF Regulation Index. Conclusions Boys with 49,XXXXY displayed higher levels of CpG methylation at regulatory intronic regions in X-linked genes encoding the androgen receptor (AR) and monoamine oxidase A (MAOA), compared to that in boys with 47,XXY and neurotypical boys. Our pilot study results suggest a link between CpG methylation levels and behavior in boys with 49,XXXXY. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01123-4.
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Affiliation(s)
- Richard S Lee
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sophia Q Song
- Department of Research, The Focus Foundation, Davidsonville, MD, USA
| | - Henri M Garrison-Desany
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jenny L Carey
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Andrea Gropman
- Department of Neurology, George Washington University, Washington, DC, USA.,Division of Neurogenetics and Developmental Pediatrics, Children's National Health System, Washington, DC, USA
| | - Carole Samango-Sprouse
- Department of Research, The Focus Foundation, Davidsonville, MD, USA. .,Department of Pediatrics, George Washington University, Washington, DC, USA. .,Department of Human and Molecular Genetics, Florida International University, Miami, FL, USA.
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22
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Ito T, Saeki H, Guo X, Sysa-Shah P, Coulter J, Tamashiro KLK, Lee RS, Orita H, Sato K, Ishiyama S, Hulbert A, Smith WE, Peterson LA, Brock MV, Gabrielson KL. Prenatal stress enhances NNK-induced lung tumors in A/J mice. Carcinogenesis 2021; 41:1713-1723. [PMID: 32249286 DOI: 10.1093/carcin/bgaa033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 11/14/2022] Open
Abstract
Children born to women who experience stress during pregnancy have an increased risk of cancer in later life, but no previous animal studies have tested such a link. We questioned whether prenatal stress (PS) in A/J mice affected the development of lung tumors after postnatal response to tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK). Timed-bred A/J mice were randomly assigned on gestation day 12.5 to PS by restraint for 5 consecutive days or control (no restraint). Adult offspring of control and stressed pregnancies were all treated with three NNK injections (50 mg/kg every other day) and euthanized 16 weeks later to examine their lungs. Compared with controls, PS dams exhibited significantly increased levels of plasma corticosterone, increased adrenal weights and decreased fetus weights without fetal loss. Prenatally stressed litters had a significantly higher neonatal death rate within first week of life, and surviving male and female offspring developed lung epithelial proliferations with increase multiplicity, increased area and aggressive morphology. PS also induced more advanced atypical adenomatous hyperplasia lesions. We found no difference in lung NNK-derived methyl DNA adducts, but PS did significantly enhance CD3+ T cell and Foxp3+ T cell tumor infiltration. PS significantly increases multiplicity, area of NNK-induced lung tumors and advanced morphology. PS did not affect production of NNK-derived methyl DNA adducts but did increase lymphocytic infiltration of lung tumors. To our knowledge, this is the first animal model of PS with evaluation of cancer development in offspring.
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Affiliation(s)
- Tomoaki Ito
- Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University, School of Medicine, Baltimore, MD, USA.,Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Surgery, Juntendo University Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan
| | - Harumi Saeki
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Pathology and Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Xin Guo
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Polina Sysa-Shah
- Department of Urology, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jonathan Coulter
- Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kellie L K Tamashiro
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Richard S Lee
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Hajime Orita
- Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University school of Medicine, Tokyo, Japan
| | - Koichi Sato
- Department of Surgery, Juntendo University Shizuoka Hospital, Juntendo University School of Medicine, Shizuoka, Japan
| | - Shun Ishiyama
- Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University, School of Medicine, Baltimore, MD, USA.,Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Coloproctological Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Alicia Hulbert
- Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University, School of Medicine, Baltimore, MD, USA.,Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Surgery, University of Illinois at Chicago School of Medicine, Chicago, IL, USA
| | - William E Smith
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Lisa A Peterson
- Division of Environmental Health Sciences and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Malcolm V Brock
- Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University, School of Medicine, Baltimore, MD, USA.,Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathleen L Gabrielson
- Sidney Kimmel Cancer Center, Department of Oncology, The Johns Hopkins University, School of Medicine, Baltimore, MD, USA.,Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
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23
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Watt KI, Henstridge DC, Ziemann M, Sim CB, Montgomery MK, Samocha-Bonet D, Parker BL, Dodd GT, Bond ST, Salmi TM, Lee RS, Thomson RE, Hagg A, Davey JR, Qian H, Koopman R, El-Osta A, Greenfield JR, Watt MJ, Febbraio MA, Drew BG, Cox AG, Porrello ER, Harvey KF, Gregorevic P. Yap regulates skeletal muscle fatty acid oxidation and adiposity in metabolic disease. Nat Commun 2021; 12:2887. [PMID: 34001905 PMCID: PMC8129430 DOI: 10.1038/s41467-021-23240-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/13/2021] [Indexed: 02/07/2023] Open
Abstract
Obesity is a major risk factor underlying the development of metabolic disease and a growing public health concern globally. Strategies to promote skeletal muscle metabolism can be effective to limit the progression of metabolic disease. Here, we demonstrate that the levels of the Hippo pathway transcriptional co-activator YAP are decreased in muscle biopsies from obese, insulin-resistant humans and mice. Targeted disruption of Yap in adult skeletal muscle resulted in incomplete oxidation of fatty acids and lipotoxicity. Integrated 'omics analysis from isolated adult muscle nuclei revealed that Yap regulates a transcriptional profile associated with metabolic substrate utilisation. In line with these findings, increasing Yap abundance in the striated muscle of obese (db/db) mice enhanced energy expenditure and attenuated adiposity. Our results demonstrate a vital role for Yap as a mediator of skeletal muscle metabolism. Strategies to enhance Yap activity in skeletal muscle warrant consideration as part of comprehensive approaches to treat metabolic disease.
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Affiliation(s)
- K I Watt
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Dept of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - D C Henstridge
- School of Health Sciences, University of Tasmania, Hobart, Tas, Australia
| | - M Ziemann
- Deakin University, Melbourne, VIC, Australia
| | - C B Sim
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - M K Montgomery
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - D Samocha-Bonet
- Division of Healthy Aging, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - B L Parker
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - G T Dodd
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - S T Bond
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - T M Salmi
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Dept of Biochemistry and Molecular Biology, The University of Melbourne, Melbourne, VIC, Australia
- Sir Peter MacCallum Dept of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - R S Lee
- Metabolic Disease and Obesity Phenotyping Facility, Monash University, Melbourne, VIC, Australia
| | - R E Thomson
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
| | - A Hagg
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
| | - J R Davey
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
| | - H Qian
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
| | - R Koopman
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia
| | - A El-Osta
- Dept of Diabetes, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Dept of Pathology, The University of Melbourne, Melbourne, VIC, Australia
- Hong Kong Institute of Diabetes and Obesity, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J R Greenfield
- Division of Healthy Aging, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
- St Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Dept of Diabetes and Endocrinology, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - M J Watt
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - M A Febbraio
- Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - B G Drew
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - A G Cox
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Dept of Biochemistry and Molecular Biology, The University of Melbourne, Melbourne, VIC, Australia
- Sir Peter MacCallum Dept of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - E R Porrello
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - K F Harvey
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Dept of Oncology, The University of Melbourne, Melbourne, VIC, Australia
- Dept of Anatomy and Developmental Biology, and Biomedicine Discovery Institute, Monash University, Melbourne, VIC, Australia
| | - P Gregorevic
- Centre for Muscle Research, The University of Melbourne, Melbourne, VIC, Australia.
- Dept of Physiology, The University of Melbourne, Melbourne, VIC, Australia.
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
- Dept of Neurology, The University of Washington School of Medicine, Seattle, WA, USA.
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24
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Pirooznia M, Han S, Lee RS. Editorial: Machine Learning and Network-Driven Integrative Genomics. Front Genet 2021; 12:660201. [PMID: 33777114 PMCID: PMC7990759 DOI: 10.3389/fgene.2021.660201] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/22/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Mehdi Pirooznia
- Bioinformatics and Computational Biology Laboratory, National Heart, Lung, and Blood Institute National Institutes of Health, Bethesda, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Shizhong Han
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Lieber Institute for Brain Development, Johns Hopkins Medical, Baltimore, MD, United States
| | - Richard S Lee
- Lieber Institute for Brain Development, Johns Hopkins Medical, Baltimore, MD, United States
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25
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Li H, Kostel SA, DiMartino SE, Hashemi Gheinani A, Froehlich JW, Lee RS. Uromodulin Isolation and Its N-Glycosylation Analysis by NanoLC-MS/MS. J Proteome Res 2021; 20:2662-2672. [PMID: 33650863 DOI: 10.1021/acs.jproteome.0c01053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The glycoprotein uromodulin (UMOD) is the most abundant protein in urine, and N-glycans are critical for many biological functions of UMOD. Comprehensive glycan profiling of UMOD provides valuable information to understand the exact mechanisms of glycan-regulated functions. To perform comprehensive glycosylation analysis of UMOD from urine samples with limited volumes, we developed a streamlined workflow that included UMOD isolation from 5 mL of urine from 6 healthy adult donors (3 males and 3 females) and a glycosylation analysis using a highly sensitive and reproducible nanoLC-MS/MS based glycomics approach. In total, 212 N-glycan compositions were identified from the purified UMOD, and 17% were high-mannose glycans, 2% were afucosylated/asialylated, 3% were neutral fucosylated, 28% were sialylated (with no fucose), 46% were fucosylated and sialylated, and 4% were sulfated. We found that isolation of UMOD resulted in a significant decrease in the relative quantity of high-mannose and sulfated glycans with a significant increase of neutral fucosylated glycans in the UMOD-depleted urine relative to the undepleted urine, but depletion had little impact on the sialylated glycans. To our knowledge, this is the first study to perform comprehensive N-glycan profiling of UMOD using nanoLC-MS/MS. This analytical workflow would be very beneficial for studies with limited sample size, such as pediatric studies, and can be applied to larger patient cohorts not only for UMOD interrogation but also for global glycan analysis.
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Affiliation(s)
- Haiying Li
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Stephen A Kostel
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Shannon E DiMartino
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Ali Hashemi Gheinani
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States.,Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, United States
| | - John W Froehlich
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Richard S Lee
- Department of Urology and The Proteomics Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
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26
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Cox OH, Song HY, Garrison-Desany HM, Gadiwalla N, Carey JL, Menzies J, Lee RS. Characterization of glucocorticoid-induced loss of DNA methylation of the stress-response gene Fkbp5 in neuronal cells. Epigenetics 2021; 16:1377-1397. [PMID: 33319620 DOI: 10.1080/15592294.2020.1864169] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Exposure to stress or glucocorticoids (GCs) is associated with epigenetic and transcriptional changes in genes that either mediate or are targets of GC signalling. FKBP5 (FK506 binding protein 5) is one such gene that also plays a central role in negative feedback regulation of GC signalling and several stress-related psychiatric disorders. In this study, we sought to examine how the mouse Fkbp5 gene is regulated in a neuronal context and identify requisite factors that can mediate the epigenetic sequelae of excess GC exposure. Mice treated with GCs were used to establish the widespread changes in DNA methylation (DNAm) and expression of Fkbp5 across four brain regions. Then two cell lines were used to test the persistence, decay, and functional significance of GC-induced methylation changes near two GC response elements (GREs) in the fifth intron of Fkbp5. We also tested the involvement of DNMT1, cell proliferation, and MeCP2 in mediating the effect of GCs on DNAm and gene activation. DNAm changes at some CpGs persist while others decay, and reduced methylation states are associated with a more robust transcriptional response. Importantly, the ability to undergo GC-induced DNAm loss is tied to DNMT1 function during cell division. Further, GC-induced DNAm loss is associated with reduced binding of MeCP2 at intron 5 and a physical interaction between the fifth intron and promoter of Fkbp5. Our results highlight several key factors at the Fkbp5 locus that may have important implications for GC- or stress-exposure during early stages of neurodevelopment.
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Affiliation(s)
- Olivia H Cox
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ha Young Song
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Henri M Garrison-Desany
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nuriya Gadiwalla
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jenny L Carey
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Julia Menzies
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard S Lee
- The Mood Disorders Center, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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27
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Coll-Font J, Afacan O, Chow JS, Lee RS, Warfield SK, Kurugol S. Modeling dynamic radial contrast enhanced MRI with linear time invariant systems for motion correction in quantitative assessment of kidney function. Med Image Anal 2021; 67:101880. [PMID: 33147561 PMCID: PMC7735437 DOI: 10.1016/j.media.2020.101880] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 12/11/2022]
Abstract
Early identification of kidney function deterioration is essential to determine which newborn patients with congenital kidney disease should be considered for surgical intervention as opposed to observation. Kidney function can be measured by fitting a tracer kinetic (TK) model onto a series of Dynamic Contrast Enhanced (DCE) MR images and estimating the filtration rate parameter from the model. Unfortunately, breathing and large bulk motion events due to patient movement in the scanner create outliers and misalignments that introduce large errors in the TK model parameter estimates even when using a motion-robust dynamic radial VIBE sequence for DCE-MR imaging. The misalignments between the series of volumes are difficult to correct using standard registration due to 1) the large differences in geometry and contrast between volumes of the dynamic sequence and 2) the requirement of fast dynamic imaging to achieve high temporal resolution and motion deteriorates image quality. These difficulties reduce the accuracy and stability of registration over the dynamic sequence. An alternative registration approach is to generate noise and motion free templates of the original data from the TK model and use them to register each volume to its contrast-matched template. However, the TK models used to characterize DCE-MRI are tissue specific, non-linear and sensitive to the same motion and sampling artifacts that hinder registration in the first place. Hence, these can only be applied to register accurately pre-segmented regions of interest, such as kidneys, and might converge to local minima under the presence of large artifacts. Here we introduce a novel linear time invariant (LTI) model to characterize DCE-MR data for different tissue types within a volume. We approximate the LTI model as a sparse sum of first order LTI functions to introduce robustness to motion and sampling artifacts. Hence, this model is well suited for registration of the entire field of view of DCE-MR data with artifacts and outliers. We incorporate this LTI model into a registration framework and evaluate it on both synthetic data and data from 20 children. For each subject, we reconstructed the sequence of DCE-MR images, detected corrupted volumes acquired during motion, aligned the sequence of volumes and recovered the corrupted volumes using the LTI model. The results show that our approach correctly aligned the volumes, provided the most stable registration in time and improved the tracer kinetic model fit.
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Affiliation(s)
- Jaume Coll-Font
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA.
| | - Onur Afacan
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA
| | - Jeanne S Chow
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA
| | - Richard S Lee
- Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA; Department of Urology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA
| | - Simon K Warfield
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA
| | - Sila Kurugol
- Department of Radiology, Boston Children's Hospital, 300 Longwood Ave., Boston MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston MA 02115, USA
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28
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Roy R, Stephens AJ, Daisy C, Merritt L, Newcomb CW, Yang J, Dagher A, Curatolo A, Sachdev M, McNeish B, Landis R, van Bokhoven A, El-Hayek A, Froehlich J, Pontari MA, Zurakowski D, Lee RS, Moses MA. Association of Longitudinal Changes in Symptoms and Urinary Biomarkers in Patients with Urological Chronic Pelvic Pain Syndrome: A MAPP Research Network Study. J Urol 2020; 205:514-523. [PMID: 33026902 DOI: 10.1097/ju.0000000000001391] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE We analyzed a series of novel noninvasive urinary biomarkers for their ability to objectively monitor the longitudinal clinical status of patients with urological chronic pelvic pain syndrome. MATERIALS AND METHODS Baseline, 6 and 12-month urine samples were collected (216) and used to quantify vascular endothelial growth factor, vascular endothelial growth factor (VEGF) receptor 1 (R1), neutrophil gelatinase associated lipocalin (NGAL), matrix metalloproteinase-2, matrix metalloproteinase (MMP)-9, and MMP-9/NGAL complex by enzyme-linked immunosorbent assays. Patient symptom changes were classified as improved, stable or worse using a functional clustering algorithm. Proportional odds models were used to evaluate the association between symptom change and urinary biomarkers. RESULTS Across all sampled participants, longitudinal decreases in normalized VEGF concentration (pg/μg) were associated with pain severity improvement, and decreases in MMP-9, NGAL and VEGF-R1 concentration (pg/ml) as well as NGAL normalized concentration were associated with improved urinary symptoms. Longitudinal decreases in normalized VEGF-R1 were associated with pain improvement in patients with moderate widespreadness, no bladder symptoms and no painful filling. Lower baseline normalized VEGF-R1 concentration was associated with pain improvement in patients with pelvic pain only. Higher baseline MMP-9/NGAL levels were associated with pain and urinary improvement across all participants. Moreover, longitudinal increases in MMP-2 concentration was associated with improved pain in men and patients with painful filling. CONCLUSIONS Our results suggest these urinary biomarkers may be useful in monitoring urological chronic pelvic pain syndrome symptom changes with respect to both urinary severity and pain severity. With further testing, they may represent objective biological measures of urological chronic pelvic pain syndrome progression and/or resolution while also providing insight into the pathophysiology of urological chronic pelvic pain syndrome.
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Affiliation(s)
- Roopali Roy
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Alisa J Stephens
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Cassandra Daisy
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Lauren Merritt
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Craig W Newcomb
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jiang Yang
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Adelle Dagher
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Adam Curatolo
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Monisha Sachdev
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Brendan McNeish
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - Richard Landis
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Adrie van Bokhoven
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Andrew El-Hayek
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts
| | - John Froehlich
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Michel A Pontari
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - David Zurakowski
- Department of Surgery, Harvard Medical School, Boston, Massachusetts.,Department of Anesthesia, Boston Children's Hospital, Boston, Massachusetts
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
| | - Marsha A Moses
- Vascular Biology Program, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Boston Children's Hospital, Boston, Massachusetts.,Department of Surgery, Harvard Medical School, Boston, Massachusetts
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29
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Li H, Patel V, DiMartino SE, Froehlich JW, Lee RS. An in-depth Comparison of the Pediatric and Adult Urinary N-glycomes. Mol Cell Proteomics 2020; 19:1767-1776. [PMID: 32737218 DOI: 10.1074/mcp.ra120.002225] [Citation(s) in RCA: 9] [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] [Received: 07/13/2020] [Indexed: 12/26/2022] Open
Abstract
We performed an in-depth characterization and comparison of the pediatric and adult urinary glycomes using a nanoLC-MS/MS based glycomics method, which included normal healthy pediatric (1-10 years, n = 21) and adult (21-50 years, n = 22) individuals. A total of 116 N-glycan compositions were identified, and 46 of them could be reproducibly quantified. We performed quantitative comparisons of the 46 glycan compositions between different age and sex groups. The results showed significant quantitative changes between the pediatric and adult cohorts. The pediatric urinary N-glycome was found to contain a higher level of high-mannose (HM), asialylated/afucosylated glycans (excluding HM), neutral fucosylated and agalactosylated glycans, and a lower level of trisialylated glycans compared with the adult. We further analyzed gender-associated glycan changes in the pediatric and adult group, respectively. In the pediatric group, there was almost no difference of glycan levels between males and females. In adult, the majority of glycans were more abundant in males than females, except the high-mannose and tetrasialylated glycans. These findings highlight the importance to consider age-matching and adult sex-matching for urinary glycan studies. The identified normal pediatric and adult urinary glycomes can serve as a baseline reference for comparisons to other disease states affected by glycosylation.
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Affiliation(s)
- Haiying Li
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Viral Patel
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shannon E DiMartino
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - John W Froehlich
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Coll-Font J, Afacan O, Chow JS, Lee RS, Stemmer A, Warfield SK, Kurugol S. Bulk motion-compensated DCE-MRI for functional imaging of kidneys in newborns. J Magn Reson Imaging 2020; 52:207-216. [PMID: 31837071 PMCID: PMC7293568 DOI: 10.1002/jmri.27021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 11/26/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Evaluation of kidney function in newborns with hydronephrosis is important for clinical decisions. Dynamic contrast-enhanced (DCE) MRI can provide the necessary anatomical and functional information. Golden angle dynamic radial acquisition and compressed sensing reconstruction provides sufficient spatiotemporal resolution to achieve accurate parameter estimation for functional imaging of kidneys. However, bulk motion during imaging (rigid or nonrigid movement of the subject resulting in signal dropout) remains an unresolved challenge. PURPOSE To evaluate a motion-compensated (MoCo) DCE-MRI technique for robust evaluation of kidney function in newborns. Our method includes: 1) motion detection, 2) motion-robust image reconstruction, 3) joint realignment of the volumes, and 4) tracer-kinetic (TK) model fitting to evaluate kidney function parameters. STUDY TYPE Retrospective. SUBJECTS Eleven newborn patients (ages <6 months, 6 female). FIELD STRENGTH/SEQUENCE 3T; dynamic "stack-of-stars" 3D fast low-angle shot (FLASH) sequence using a multichannel body-matrix coil. ASSESSMENT We evaluated the proposed technique in terms of the signal-to-noise ratio (SNR) of the reconstructed images, the presence of discontinuities in the contrast agent concentration time curves due to motion with a total variation (TV) metric and the goodness of fit of the TK model, and the standard variation of its parameters. STATISTICAL TESTS We used a paired t-test to compare the MoCo and no-MoCo results. RESULTS The proposed MoCo method successfully detected motion and improved the SNR by 3.3 (P = 0.012) and decreased TV by 0.374 (P = 0.017) across all subjects. Moreover, it decreased nRMSE of the TK model fit for the subjects with less than five isolated bulk motion events in 6 minutes (mean 1.53, P = 0.043), but not for the subjects with more frequent events or no motion (P = 0.745 and P = 0.683). DATA CONCLUSION Our results indicate that the proposed MoCo technique improves the image quality and accuracy of the TK model fit for subjects who present isolated bulk motion events. LEVEL OF EVIDENCE 3 Technical Efficacy Stage: 1 J. Magn. Reson. Imaging 2020;52:207-216.
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Affiliation(s)
- Jaume Coll-Font
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Onur Afacan
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Jeanne S. Chow
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Urology, Boston Children’s Hospital, Boston, MA, United States
| | - Richard S. Lee
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Urology, Boston Children’s Hospital, Boston, MA, United States
| | | | - Simon K. Warfield
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Sila Kurugol
- Radiology, Boston Children’s Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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Portella AK, Papantoni A, Paquet C, Moore S, Rosch KS, Mostofsky S, Lee RS, Smith KR, Levitan R, Silveira PP, Carnell S, Dube L. Predicted DRD4 prefrontal gene expression moderates snack intake and stress perception in response to the environment in adolescents. PLoS One 2020; 15:e0234601. [PMID: 32589693 PMCID: PMC7319347 DOI: 10.1371/journal.pone.0234601] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Body weight is substantially determined by eating behaviors, which are themselves driven by biological factors interacting with the environment. Previous studies in young children suggest that genetic influences on dopamine function may confer differential susceptibility to the environment in such a way that increases behavioral obesity risk in a lower socioeconomic status (SES) environment but decreases it in a higher SES environment. We aimed to test if this pattern of effect could also be observed in adolescence, another critical period for development in brain and behavior, using a novel measure of predicted expression of the dopamine receptor 4 (DRD4) gene in prefrontal cortex. In a sample of 76 adolescents (37 boys and 39 girls from Baltimore, Maryland/US, aged 14-18y), we estimated individual levels of DRD4 gene expression (PredDRD4) in prefrontal cortex from individual genomic data using PrediXcan, and tested interactions with a composite SES score derived from their annual household income, maternal education, food insecurity, perceived resource availability, and receipt of public assistance. Primary outcomes were snack intake during a multi-item ad libitum meal test, and food-related impulsivity assessed using a food-adapted go/no-go task. A linear regression model adjusted for sex, BMI z-score, and genetic ethnicity demonstrated a PredDRD4 by composite SES score interaction for snack intake (p = 0.009), such that adolescents who had lower PredDRD4 levels exhibited greater snack intake in the lower SES group, but lesser snack intake in the higher SES group. Exploratory analysis revealed a similar pattern for scores on the Perceived Stress Scale (p = 0.001) such that the low PredDRD4 group reported higher stress in the lower SES group, but less stress in the higher SES group, suggesting that PredDRD4 may act in part by affecting perceptions of the environment. These results are consistent with a differential susceptibility model in which genes influencing environmental responsiveness interact with environments varying in obesogenicity to confer behavioral obesity risk in a less favorable environment, but behavioral obesity protection in a favorable one.
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Affiliation(s)
- Andre Krumel Portella
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
- Postgraduate Program in Pediatrics, Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS, Brasil
| | - Afroditi Papantoni
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Catherine Paquet
- Australian Centre for Precision Health, School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Keri Shiels Rosch
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- Center for Neurodevelopmental and Imaging Research and Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States of America
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Stewart Mostofsky
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
- Center for Neurodevelopmental and Imaging Research and Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, United States of America
| | - Richard S. Lee
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Kimberly R. Smith
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Robert Levitan
- Centre for Addition and Mental Health (CAMH), Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, QC, Canada
| | - Patricia Pelufo Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Laurette Dube
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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Lee K, Lee RS, Kim YH. Highly efficient synthesis of 1,2,4-thiadiazoles from thioamides utilizing tetra( n-butyl)ammonium peroxydisulfate. SYNTHETIC COMMUN 2020. [DOI: 10.1080/00397911.2020.1751854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Kieseung Lee
- Department of Applied Chemistry, Woosuk University, Chonbuk, Republic of Korea
- Department of Pharmaceutical Engineering, Woosuk University, Chonbuk, Republic of Korea
| | - Richard S. Lee
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Yong Hae Kim
- Department of Chemistry, Korea Advanced Institute of Science & Technology, Daejon, Republic of Korea
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Lee HH, Lee T, Lee RS, Borer JG. Necrotizing Fasciitis Following Routine Genitourinary Surgery in Healthy Infants. Urology 2020; 145:250-252. [PMID: 32531466 DOI: 10.1016/j.urology.2020.05.054] [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] [Received: 05/17/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
Morbidity and mortality associated with pediatric necrotizing fasciitis are strongly dependent on early diagnosis and timely intervention. Yet, the lack of early cutaneous findings and nonspecific symptoms may result in initial delayed diagnosis or misdiagnosis. Infants may be particularly at risk of missed or delayed diagnosis due to inherent barriers in communication and rarity of the condition, especially among healthy patients. We describe 2 cases of necrotizing fasciitis following routine genitourinary surgery in healthy infants.
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Affiliation(s)
- Harry H Lee
- Georgetown University School of Medicine, Washington, DC
| | - Ted Lee
- Boston Children's Hospital, Department of Urology, Boston, MA.
| | - Richard S Lee
- Boston Children's Hospital, Department of Urology, Boston, MA
| | - Joseph G Borer
- Boston Children's Hospital, Department of Urology, Boston, MA
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de Araújo CM, Hudziak J, Crocetti D, Wymbs NF, Montalvo-Ortiz JL, Orr C, Albaugh MD, Althoff RR, O'Loughlin K, Holbrook H, Garavan H, Yang BZ, Mostofsky S, Jackowski A, Lee RS, Gelernter J, Kaufman J. Tubulin Polymerization Promoting Protein (TPPP) gene methylation and corpus callosum measures in maltreated children. Psychiatry Res Neuroimaging 2020; 298:111058. [PMID: 32120304 DOI: 10.1016/j.pscychresns.2020.111058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/16/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022]
Abstract
The goal of the current study was to evaluate the impact of Tubulin Polymerization Promoting Protein (TPPP) methylation on structural and fractional anisotropy (FA) corpus callosum (CC) measures. TPPP is involved in the development of white matter tracts in the brain and was implicated in stress-related psychiatric disorders in an unbiased whole epigenome methylation study. The cohort included 63 participants (11.73 y/o ±1.91) from a larger study investigating risk and resilience in maltreated children. Voxel-based morphometry (VBM) was used to process the structural data, fractional anisotropy (FA) was determined using an atlas-based approach, and DNA specimens were derived from saliva in two batches using the 450 K (N = 39) and 850 K (N = 24) Illumina arrays, with the data from each batch analyzed separately. After controlling for multiple comparisons and relevant covariates (e.g., demographics, brain volume, cell composition, 3 PCs), 850 K derived TPPP methylation values, in interaction with a dimensional measure of children's trauma experiences, predicted left and right CC body volumes and genu, body and splenium FA (p < .007, all comparisons). The findings in the splenium replicated in subjects with the 450 K data. The results extend prior investigations and suggest a role for TPPP in brain changes associated with stress-related psychiatric disorders.
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Affiliation(s)
- Célia Maria de Araújo
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States; Universidade Federal de São Paulo, São Paulo, Brazil
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States
| | - Nicholas F Wymbs
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States
| | | | - Catherine Orr
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Matthew D Albaugh
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Robert R Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Kerry O'Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Hannah Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Hugh Garavan
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, Burlington, VT, United States
| | - Bao-Zhu Yang
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, United States; Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, , United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Joel Gelernter
- Department of Psychiatry, Yale University, New Haven, CT, United States; Veterans Administration, West Haven, CT, United States
| | - Joan Kaufman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States; Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, United States.
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Lee K, Lee RS, Lee JS. Modified and environmentally friendly oxidation of phosphorane ylides to vicinal tricarbonyls using unsupported moist Oxone in dichloromethane. SYNTHETIC COMMUN 2020. [DOI: 10.1080/00397911.2020.1719422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Kieseung Lee
- Department of Applied Chemistry & Department of Pharmaceutical Engineering, Woosuk University, Chonbuk, Republic of Korea
| | - Richard S. Lee
- School of Pharmacy, University of Southern California, Los Angeles, CA, USA
| | - Joanne S. Lee
- School of Pharmacy, University of the Pacific, Stockton, CA, USA
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Vitko D, Cho PS, Kostel SA, DiMartino SE, Cabour LD, Migliozzi MA, Logvinenko T, Warren PG, Froehlich JW, Lee RS. Characterizing Patients with Recurrent Urinary Tract Infections in Vesicoureteral Reflux: A Pilot Study of the Urinary Proteome. Mol Cell Proteomics 2020; 19:456-466. [PMID: 31896675 PMCID: PMC7050111 DOI: 10.1074/mcp.ra119.001873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 11/19/2019] [Revised: 12/25/2019] [Indexed: 01/23/2023] Open
Abstract
Recurrent urinary tract infections (UTIs) pose a significant burden on the health care system. Underlying mechanisms predisposing children to UTIs and associated changes in the urinary proteome are not well understood. We aimed to investigate the urinary proteome of a subset of children who have vesicoureteral reflux (VUR) and recurrent UTIs because of their risk of developing infection-related renal damage. Improving diagnostic modalities to identify UTI risk factors would significantly alter the clinical management of children with VUR. We profiled the urinary proteomes of 22 VUR patients with low grade VUR (1-3 out of 5), a history of recurrent UTIs, and renal scarring, comparing them to those obtained from 22 age-matched controls. Urinary proteins were analyzed by mass spectrometry followed by protein quantitation based on spectral counting. Of the 2,551 proteins identified across both cohorts, 964 were robustly quantified, as defined by meeting criteria with spectral count (SC) ≥2 in at least 7 patients in either VUR or control cohort. Eighty proteins had differential expression between the two cohorts, with 44 proteins significantly up-regulated and 36 downregulated (q <0.075, FC ≥1.2). Urinary proteins involved in inflammation, acute phase response (APR), modulation of extracellular matrix (ECM), and carbohydrate metabolism were altered among the study cohort.
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Affiliation(s)
- Dijana Vitko
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Patricia S Cho
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts; Department of Urology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Stephen A Kostel
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | | | - Lily D Cabour
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | | | - Tanya Logvinenko
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Peter G Warren
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - John W Froehlich
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, Massachusetts.
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Finkelstein JB, Rague JT, Chow J, Venna A, Logvinenko T, Nelson CP, Lee RS. Accuracy of Ultrasound in Identifying Renal Scarring as Compared to DMSA Scan. Urology 2020; 138:134-137. [PMID: 32004557 DOI: 10.1016/j.urology.2020.01.019] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the accuracy of renal ultrasound (RUS) in detecting renal scarring (RS). METHODS All initial DMSA scans performed from 2006 to 2009 for history of urinary tract infection (UTI) or vesicoureteral reflux (VUR) in patients under 14 years old were identified, and clinical history obtained via chart review. Patients who had RUS within 4 months of DMSA scan and no documented UTI during that interval were included. Decreased uptake of tracer associated with loss of contours or cortical thinning defined a positive DMSA study. Increased echogenicity/dysplasia, cortical thinning, atrophic kidney and/or abnormal corticomedullary differentiation defined a positive RUS. The sensitivity and specificity of RUS in identifying RS were calculated using DMSA scan as the gold standard. RESULTS A total of 144 patients had initial DMSA scans performed for UTI or VUR, with a RUS within 4 months, and no UTI between the 2 studies. Ninety-five of 144 (66%) had RS on DMSA and 49/144 (34%) did not. Patients with or without RS on DMSA were not different in gender (P = .073), age (P = .432), insurance (P = 1.000) or VUR grade (P = .132). Only 39/144 (27.1%) patients had positive RUS. The sensitivity of RUS for RS was 35.8% and the specificity was 89.8%, leading to an accuracy of 54.2% (95%CI; 45.7-62.5%, P = .999). CONCLUSION RUS demonstrated poor sensitivity for RS visualized on DMSA scan. This suggests that RUS is a poor screening test for RS or indicators of future renal scar. A normal ultrasound does not rule out RS or risk of future renal scar. Specificity of RUS was excellent.
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Affiliation(s)
| | - James T Rague
- Department of Urology, Boston Medical Center, Boston, MA
| | - Jeanne Chow
- Department of Radiology, Boston Children's Hospital, Boston, MA
| | - Alyssia Venna
- Department of Urology, Boston Children's Hospital, Boston, MA
| | | | - Caleb P Nelson
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA.
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Kurugol S, Seager CM, Thaker H, Coll-Font J, Afacan O, Nichols RC, Warfield SK, Lee RS, Chow JS. Feed and wrap magnetic resonance urography provides anatomic and functional imaging in infants without anesthesia. J Pediatr Urol 2020; 16:116-120. [PMID: 31889687 DOI: 10.1016/j.jpurol.2019.11.002] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/05/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe a technique for performing magnetic resonance urogram (MRU) in infants without sedation or anesthesia. METHODS Eighteen infants underwent MRU in the absence of sedating medications using a 'feed and wrap' technique (FW-MRU). Dynamic contrast enhanced images were obtained. Dynamic radial VIBE and compressed sensing image reconstruction were used to correct for motion artifact. RESULTS Seventeen of the 18 patients had successful FW-MRU. Feed and wrap' magnetic resonance urogram provided high-quality anatomic and functional renal data. CONCLUSION Initial experience with FW-MRU demonstrates it to be a promising anesthesia-free modality for obtaining anatomic and functional imaging of the urinary tract in infants.
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Affiliation(s)
- Sila Kurugol
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Catherine M Seager
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Hatim Thaker
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Jaume Coll-Font
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Onur Afacan
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Reid C Nichols
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Simon K Warfield
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA.
| | - Jeanne S Chow
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA; Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston MA 02115, USA
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Mann N, Kause F, Henze EK, Gharpure A, Shril S, Connaughton DM, Nakayama M, Klämbt V, Majmundar AJ, Wu CHW, Kolvenbach CM, Dai R, Chen J, van der Ven AT, Ityel H, Tooley MJ, Kari JA, Bownass L, El Desoky S, De Franco E, Shalaby M, Tasic V, Bauer SB, Lee RS, Beckel JM, Yu W, Mane SM, Lifton RP, Reutter H, Ellard S, Hibbs RE, Kawate T, Hildebrandt F. CAKUT and Autonomic Dysfunction Caused by Acetylcholine Receptor Mutations. Am J Hum Genet 2019; 105:1286-1293. [PMID: 31708116 DOI: 10.1016/j.ajhg.2019.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/09/2019] [Indexed: 12/13/2022] Open
Abstract
Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of chronic kidney disease in the first three decades of life, and in utero obstruction to urine flow is a frequent cause of secondary upper urinary tract malformations. Here, using whole-exome sequencing, we identified three different biallelic mutations in CHRNA3, which encodes the α3 subunit of the nicotinic acetylcholine receptor, in five affected individuals from three unrelated families with functional lower urinary tract obstruction and secondary CAKUT. Four individuals from two families have additional dysautonomic features, including impaired pupillary light reflexes. Functional studies in vitro demonstrated that the mutant nicotinic acetylcholine receptors were unable to generate current following stimulation with acetylcholine. Moreover, the truncating mutations p.Thr337Asnfs∗81 and p.Ser340∗ led to impaired plasma membrane localization of CHRNA3. Although the importance of acetylcholine signaling in normal bladder function has been recognized, we demonstrate for the first time that mutations in CHRNA3 can cause bladder dysfunction, urinary tract malformations, and dysautonomia. These data point to a pathophysiologic sequence by which monogenic mutations in genes that regulate bladder innervation may secondarily cause CAKUT.
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Rodríguez B, Nani JV, Almeida PGC, Brietzke E, Lee RS, Hayashi MAF. Neuropeptides and oligopeptidases in schizophrenia. Neurosci Biobehav Rev 2019; 108:679-693. [PMID: 31794779 DOI: 10.1016/j.neubiorev.2019.11.024] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/14/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022]
Abstract
Schizophrenia (SCZ) is a complex psychiatric disorder with severe impact on patient's livelihood. In the last years, the importance of neuropeptides in SCZ and other CNS disorders has been recognized, mainly due to their ability to modulate the signaling of classical monoaminergic neurotransmitters as dopamine. In addition, a class of enzymes coined as oligopeptidases are able to cleave several of these neuropeptides, and their potential implication in SCZ was also demonstrated. Interestingly, these enzymes are able to play roles as modulators of neuropeptidergic systems, and they were also implicated in neurogenesis, neurite outgrowth, neuron migration, and therefore, in neurodevelopment and brain formation. Altered activity of oligopeptidases in SCZ was described only more recently, suggesting their possible utility as biomarkers for mental disorders diagnosis or treatment response. We provide here an updated and comprehensive review on neuropeptides and oligopeptidases involved in mental disorders, aiming to attract the attention of physicians to the potential of targeting this system for improving the therapy and for understanding the neurobiology underlying mental disorders as SCZ.
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Affiliation(s)
- Benjamín Rodríguez
- Departamento de Farmacologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - João Victor Nani
- Departamento de Farmacologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq/FAPESP/CAPES), Ribeirão Preto, Brazil
| | - Priscila G C Almeida
- Departamento de Farmacologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elisa Brietzke
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
| | - Richard S Lee
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - Mirian A F Hayashi
- Departamento de Farmacologia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM, CNPq/FAPESP/CAPES), Ribeirão Preto, Brazil.
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41
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Gaine ME, Seifuddin F, Sabunciyan S, Lee RS, Benke KS, Monson ET, Zandi PP, Potash JB, Willour VL. Differentially methylated regions in bipolar disorder and suicide. Am J Med Genet B Neuropsychiatr Genet 2019; 180:496-507. [PMID: 31350827 PMCID: PMC8375453 DOI: 10.1002/ajmg.b.32754] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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] [Received: 02/20/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/29/2022]
Abstract
The addition of a methyl group to, typically, a cytosine-guanine dinucleotide (CpG) creates distinct DNA methylation patterns across the genome that can regulate gene expression. Aberrant DNA methylation of CpG sites has been associated with many psychiatric disorders including bipolar disorder (BD) and suicide. Using the SureSelectXT system, Methyl-Seq, we investigated the DNA methylation status of CpG sites throughout the genome in 50 BD individuals (23 subjects who died by suicide and 27 subjects who died from other causes) and 31 nonpsychiatric controls. We identified differentially methylated regions (DMRs) from three analyses: (a) BD subjects compared to nonpsychiatric controls (BD-NC), (b) BD subjects who died by suicide compared to nonpsychiatric controls (BDS-NC), and (c) BDS subjects compared to BD subjects who died from other causes (BDS-BDNS). One DMR from the BDS-NC analysis, located in ARHGEF38, was significantly hypomethylated (23.4%) in BDS subjects. This finding remained significant after multiple testing (PBootstrapped = 9.0 × 10-3 ), was validated using pyrosequencing, and was more significant in males. A secondary analysis utilized Ingenuity Pathway Analysis to identify enrichment in nominally significant DMRs. This identified an association with several pathways including axonal guidance signaling, calcium signaling, β-adrenergic signaling, and opioid signaling. Our comprehensive study provides further support that DNA methylation alterations influence the risk for BD and suicide. However, further investigation is required to confirm these associations and identify their functional consequences.
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Affiliation(s)
- Marie E. Gaine
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Fayaz Seifuddin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sarven Sabunciyan
- Center for Epigenetics, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard S. Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kelly S. Benke
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Virginia L. Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Nelson CP, Lee RS, Trout AT, Servaes S, Kraft KH, Barnewolt CE, Logvinenko T, Chow JS. The association of postnatal urinary tract dilation risk score with clinical outcomes. J Pediatr Urol 2019; 15:341.e1-341.e6. [PMID: 31164273 DOI: 10.1016/j.jpurol.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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] [Received: 01/04/2019] [Accepted: 05/01/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND There are limited data on the predictive value of the consensus urinary tract dilation (UTD) score with respect to subsequent clinical diagnoses. We sought to define the relationship between postnatal UTD risk score and clinical outcomes during childhood. METHODS Complete ultrasound image sets from a random selection of infants aged 0-90 days undergoing initial ultrasound at a single institution for prenatal hydronephrosis between 2012 and 2014 were assigned a UTD score by 1 pediatric urologist and 1 pediatric radiologist. Urinary tract dilation risk score was analyzed for association with a composite outcome comprising urinary tract infection, vesicoureteral reflux (VUR), ureteropelvic junction obstruction, non-refluxing megaureter (NRM), ureterocele, bladder outlet obstruction (BOO), and chronic kidney disease. Surgical intervention and resolution of UTD were evaluated separately. Descriptive and survival analyses were performed. RESULTS Urinary tract dilation scores for 494 subjects were P0 in 23.5%, P1 in 26.5%, P2 in 23.5%, and P3 in 26.5%. Seventy-four percent were male. Median age at initial imaging was 28 days; median follow-up was 19.8 months. The composite outcome occurred in 138 of 494 patients (27.9%) and varied significantly (p < 0.001) by UTD score: 11.2% for P0, 10.7% for P1, 29.3% for P2, and 58.8% for P3. On survival analysis (Summary Figure), higher UTD grade was significantly associated with the composite outcome (hazard ratio for P3 vs. P0 was 7.4 [95% CI: 3.44-15.92, p < 0.001]). Urinary tract infection and VUR diagnosis varied by UTD score (p = 0.03 and p < 0.001, respectively). Ureteropelvic junction obstruction was diagnosed (based on MAG3 results) in 6.3% of patients, 84% of whom were P3. Non-refluxing megaureter was diagnosed in 7.7%. Ureterocele and BOO were uncommon (1.4%, and 0.6%, respectively). Surgical intervention was also associated with UTD risk, with 46% of P3 undergoing surgery vs. 1% of P0, 1% of P1, and 6% of P2 (p < 0.001). Resolution of UTD occurred in 41% (median 10.1 months) and varied significantly by UTD risk (p < 0.001). DISCUSSION Urinary tract dilation risk score is associated with clinical events, although ascertainment bias may influence some of the differences in outcomes, particularly for VUR, because VCUG utilization varied by the UTD group. The lack of any significant difference in outcomes between patients with UTD P0 versus P1 suggests that the P1 category could be eliminated as it does not meaningfully distinguish between outcome risk. CONCLUSIONS Higher UTD risk scores are strongly associated with genitourinary diagnoses during the first two years of life.
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Affiliation(s)
- C P Nelson
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA, USA.
| | - R S Lee
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA, USA
| | - A T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center and Department of Radiology, University of Cincinnati Medical Center, Cincinnati OH, USA
| | - S Servaes
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia PA, USA
| | - K H Kraft
- Department of Urology, CS Mott Children's Hospital, University of Michigan, Ann Arbor MI, USA
| | - C E Barnewolt
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston MA, USA
| | - T Logvinenko
- Department of Urology, Boston Children's Hospital and Harvard Medical School, Boston MA, USA
| | - J S Chow
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston MA, USA
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Ma D, Liu S, Lal B, Wei S, Wang S, Zhan D, Zhang H, Lee RS, Gao P, Lopez-Bertoni H, Ying M, Li JJ, Laterra J, Wilson MA, Xia S. Extracellular Matrix Protein Tenascin C Increases Phagocytosis Mediated by CD47 Loss of Function in Glioblastoma. Cancer Res 2019; 79:2697-2708. [PMID: 30898840 DOI: 10.1158/0008-5472.can-18-3125] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 01/30/2019] [Accepted: 03/18/2019] [Indexed: 02/06/2023]
Abstract
Glioblastomas (GBM) are highly infiltrated by myeloid-derived innate immune cells that contribute to the immunosuppressive nature of the brain tumor microenvironment (TME). CD47 has been shown to mediate immune evasion, as the CD47-SIRPα axis prevents phagocytosis of tumor cells by macrophages and other myeloid cells. In this study, we established CD47 homozygous deletion (CD47-/-) in human and mouse GBM cells and investigated the impact of eliminating the "don't eat me" signal on tumor growth and tumor-TME interactions. CD47 knockout (KO) did not significantly alter tumor cell proliferation in vitro but significantly increased phagocytosis of tumor cells by macrophages in cocultures. Compared with CD47 wild-type xenografts, orthotopic xenografts derived from CD47-/- tumor cells grew significantly slower with enhanced tumor cell phagocytosis and increased recruitment of M2-like tumor-associated microglia/macrophages (TAM). CD47 KO increased tumor-associated extracellular matrix protein tenascin C (TNC) in xenografts, which was further examined in vitro. CD47 loss of function upregulated TNC expression in tumor cells via a Notch pathway-mediated mechanism. Depletion of TNC in tumor cells enhanced the growth of CD47-/- xenografts in vivo and decreased the number of TAM. TNC knockdown also inhibited phagocytosis of CD47-/- tumor cells in cocultures. Furthermore, TNC stimulated release of proinflammatory factors including TNFα via a Toll-like receptor 4 and STAT3-dependent mechanism in human macrophage cells. These results reveal a vital role for TNC in immunomodulation in brain tumor biology and demonstrate the prominence of the TME extracellular matrix in affecting the antitumor function of brain innate immune cells. SIGNIFICANCE: These findings link TNC to CD47-driven phagocytosis and demonstrate that TNC affects the antitumor function of brain TAM, facilitating the development of novel innate immune system-based therapies for brain tumors.
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Affiliation(s)
- Ding Ma
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Senquan Liu
- Department of Medicine, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Bachchu Lal
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Shuang Wei
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Shuyan Wang
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Daqian Zhan
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Hao Zhang
- Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Peisong Gao
- Asthma and Allergy Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Hernando Lopez-Bertoni
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mingyao Ying
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Jian Jian Li
- Department of Radiation Oncology, University of California Davis, Sacramento, California
| | - John Laterra
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland.,Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mary Ann Wilson
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland.,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Shuli Xia
- Hugo W. Moser Research Institute at Kennedy Krieger, Baltimore, Maryland. .,Department of Neurology, Bloomberg School of Public Health, Johns Hopkins School of Medicine, Baltimore, Maryland
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Duis J, Cox OH, Ji Y, Seifuddin F, Lee RS, Wang X. Effect of Genotype and Maternal Affective Disorder on Intronic Methylation of FK506 Binding Protein 5 in Cord Blood DNA. Front Genet 2018; 9:648. [PMID: 30619472 PMCID: PMC6305129 DOI: 10.3389/fgene.2018.00648] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 11/30/2018] [Indexed: 12/20/2022] Open
Abstract
A single nucleotide polymorphism (SNP: rs1360780) in FKBP5 (FK506 Binding Protein 5) has been shown to interact with exposure to childhood adversity to promote loss of methylation and increase in gene expression in adults. We asked whether rs1360780 can influence FKBP5 intronic methylation in the context of exposure to maternal affective disorders in utero. Sixty cord blood DNA samples from the Boston Birth Cohort were genotyped at rs1360780 and studied for methylation changes as they relate to genotype and exposure to affective disorders during pregnancy. Linear regression was employed to contrast the risk (TT) genotype to the heterozygous (CT) and homozygous (CC) genotypes with adjustment for potential confounders. The recessive genotype (TT) was associated with increased methylation at multiple CpGs in the FKBP5 intron 5 region (p < 0.01). These findings were enhanced among cases exposed to maternal affective disorders (p = 0.02). A human cell line treated with cortisol showed that changes in intron 5 CpG methylation and FKBP5 expression were inversely associated. These findings suggest that rs1360780 can influence FKBP5 intronic methylation by acting in cis as a methylation quantitative locus and highlight the impact of genotypic risk on methylation in utero. Additionally, prenatal stress exposure compounded with the risk genotype may lead to a compensatory increase in methylation.
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Affiliation(s)
- Jessica Duis
- Division of Medical Genetics and Genomic Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Olivia H Cox
- Department of Psychiatry and Behavioral Sciences, Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Yuelong Ji
- Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Fayaz Seifuddin
- Department of Psychiatry and Behavioral Sciences, Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Xiaobin Wang
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
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Varda BK, Rajender A, Yu RN, Lee RS. A contemporary single-institution retrospective cohort study comparing perioperative outcomes between robotic and open partial nephrectomy for poorly functioning renal moieties in children with duplex collecting systems. J Pediatr Urol 2018; 14:549.e1-549.e8. [PMID: 30172696 DOI: 10.1016/j.jpurol.2018.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 01/19/2018] [Accepted: 06/04/2018] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Studies evaluating robotic-assisted laparoscopic partial nephrectomy (RALPN) are limited to case series, amounting to a lack of studies directly comparing perioperative outcomes for RALPN to open partial nephrectomy (OPN). OBJECTIVE To compare perioperative outcomes between RALPN and OPN. METHODS A single-institution, retrospective cohort study was performed to compare perioperative outcomes (operative time (OT), length of stay (LOS), complications, readmissions, postoperative interventions, loss in size of the residual moiety, and the presence of postoperative 'contained fluid collections') for RALPN and OPN between February 2007 and July 2014. Descriptive statistics were calculated and unadjusted analyses performed, including Chi-squared/Fisher's exact for categorical variables and Wilcoxon rank sum for continuous variables. RESULTS During the study period, 43 partial nephrectomies were performed for benign disease: 27 (63%) RALPN and 16 (37%) OPN. The RALPN cohort was significantly older than the OPN cohort (3.5 vs. 0.8 years; P = 0.003). The cohorts were otherwise similar regarding race, American Society of Anesthesiologist score (ASA), affected moiety, laterality, associated anomalies, moiety function, and surgical indication. Robotic-assisted laparoscopic partial nephrectomy was associated with a significantly shorter LOS (1 vs. 3 days; P = 0.002). Operative time and complication rates were comparable. The OPN group had a longer median follow-up (2.7 years vs. 1.1; P = 0.03). No differences were observed between the cohorts for readmissions, postoperative interventions, loss in size of residual moiety, or development of 'contained fluid collections'. These outcomes are reported in the Summary Table. 'Contained fluid collections' occurred more frequently after lower pole resections (73% vs. 30%; P = 0.009). DISCUSSION This study is one of the few to directly compare RALPN to OPN, and demonstrated that RALPN has comparable (if not better) outcomes than OPN. In particular, RALPN provides the advantage of a shorter LOS. Avoiding the flank incision used in OPN may also offer reduced pain; however, this was not studied here and the literature provides weak evidence for this effect. This unadjusted analysis may have been confounded by its short median follow-up and significantly younger OPN cohort. CONCLUSION In this contemporary comparative analysis, RALPN predicted a similar median OT and safety profile to OPN while offering the advantage of a shorter LOS. Regardless of surgical cohort, there were no adverse effects on the residual renal moieties and postoperative 'contained fluid collections' occurred with notable frequency and were independently associated with lower pole pathology.
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Affiliation(s)
- B K Varda
- Department of Urology, Boston Children's Hospital, Boston, MA, USA.
| | - A Rajender
- Department of Urology, Boston Medical Center, Boston, MA, USA
| | - R N Yu
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
| | - R S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA, USA
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Lee RS, Mahon PB, Zandi PP, McCaul ME, Yang X, Bali U, Wand GS. DNA methylation and sex-specific expression of FKBP5 as correlates of one-month bedtime cortisol levels in healthy individuals. Psychoneuroendocrinology 2018; 97:164-173. [PMID: 30036794 PMCID: PMC6366448 DOI: 10.1016/j.psyneuen.2018.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/09/2018] [Revised: 05/17/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Abstract
Chronic exposure to cortisol is associated with cardiovascular, metabolic, and psychiatric disorders. Although cortisol can be readily measured from peripheral sources such as blood, urine, or saliva, multiple samplings spanning several days to weeks are necessary to reliably assess chronic cortisol exposure levels (referred to as cortisol load). Although cortisol levels in hair have been proposed as a measure of cortisol load, measurement is cumbersome and many people are not candidates due to short hair length and use of hair dyes. To date, there are no blood biomarkers that capture cortisol load. To identify a blood biomarker capable of integrating one-month cortisol exposure levels, 75 healthy participants provided 30+ days of awakening and bedtime saliva cortisol and completed psychosocial measures of anxiety, depression, and stress. Mean daily awakening and bedtime cortisol levels were then compared to CpG methylation levels, gene expression, and genotypes of the stress response gene FKBP5 obtained from blood drawn on the last day of the study. We found a correlation between FKBP5 methylation levels and mean 30+day awakening and bedtime cortisol levels (|r|≥0.32, p ≤ 0.006). We also observed a sex-specific correlation between bedtime cortisol levels and FKBP5 mRNA expression in female participants (r = 0.42, p = 0.005). Dividing the 30-day sampling period into four weekly bins showed that the correlations for both methylation and expression were not being driven by cortisol levels in the week preceding the blood draw. We also identified a female-specific association between FKBP5 mRNA expression and scores on the Beck Anxiety Inventory (r = 0.37, p = 0.013) and Beck Depression Inventory-II (r = 0.32, p = 0.033). Finally, DNA was genotyped at four SNPs, and variation in rs4713902 was shown to have an effect on FKBP5 expression under a codominant model (f = 3.41, p = 0.048) for females only. Our results suggest that blood FKBP5 DNA methylation and mRNA expression levels may be a useful marker for determining general or sex-specific 30-day cortisol load and justifies genome-wide approaches that can potentially identify additional cortisol markers with broader clinical utility.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States; Department of Psychiatry, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, 21205, United States
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Xiaoju Yang
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Utsav Bali
- Sygnature Discovery, Nottingham, NG1 1GF, UK
| | - Gary S Wand
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States.
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Rague JT, Lee RS. Management of High-grade, Nonmuscle Invasive Urothelial Carcinoma in a Prepubertal Patient With TURBT and Intravesical BCG. Urology 2018; 124:257-259. [PMID: 30366046 DOI: 10.1016/j.urology.2018.10.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/09/2018] [Accepted: 10/15/2018] [Indexed: 11/24/2022]
Abstract
High-grade urothelial carcinoma of the bladder is rare in the pediatric population with no established guidelines for management. We treated a single female patient, 10 years of age, who was found to have high-grade, nonmuscle invasive urothelial carcinoma endoscopically and with intravesical bacille calmette guerin (BCG). Given the child's age, no local adult institution could provide BCG therapy. Utilizing the experience of the local adult institutions, we developed a comprehensive protocol for first-time delivery of BCG at a free-standing children's hospital. The patient has undergone successful induction and maintenance BCG for 7 cycles without disease recurrence and minimal side effects.
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Affiliation(s)
- James T Rague
- Boston Medical Center, Department of Urology, Boston MA
| | - Richard S Lee
- Harvard Medical School, Department of Surgery and Boston Children's Hospital, Department of Urology, Boston, MA.
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48
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Carey JL, Cox OH, Seifuddin F, Marque L, Tamashiro KLK, Zandi PP, Wand GS, Lee RS. A Rat Methyl-Seq Platform to Identify Epigenetic Changes Associated with Stress Exposure. J Vis Exp 2018. [PMID: 30417882 PMCID: PMC6235597 DOI: 10.3791/58617] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
As genomes of a wider variety of animals become available, there is an increasing need for tools that can capture dynamic epigenetic changes in these animal models. The rat is one particular model animal where an epigenetic tool can complement many pharmacological and behavioral studies to provide insightful mechanistic information. To this end, we adapted the SureSelect Target Capture System (referred to as Methyl-Seq) for the rat, which can assess DNA methylation levels across the rat genome. The rat design targeted promoters, CpG islands, island shores, and GC-rich regions from all RefSeq genes. To implement the platform on a rat experiment, male Sprague Dawley rats were exposed to chronic variable stress for 3 weeks, after which blood samples were collected for genomic DNA extraction. Methyl-Seq libraries were constructed from the rat DNA samples by shearing, adapter ligation, target enrichment, bisulfite conversion, and multiplexing. Libraries were sequenced on a next-generation sequencing platform and the sequenced reads were analyzed to identify DMRs between DNA of stressed and unstressed rats. Top candidate DMRs were independently validated by bisulfite pyrosequencing to confirm the robustness of the platform. Results demonstrate that the rat Methyl-Seq platform is a useful epigenetic tool that can capture methylation changes induced by exposure to stress.
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Affiliation(s)
- Jenny L Carey
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Olivia H Cox
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Fayaz Seifuddin
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Leonard Marque
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Kellie L K Tamashiro
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Peter P Zandi
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine; Department of Mental Health, Johns Hopkins School of Public Health
| | - Gary S Wand
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine; Department of Medicine, Johns Hopkins School of Medicine
| | - Richard S Lee
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine;
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T Rague J, Varda BK, Wagner AA, Lee RS. Delayed Return of Ejaculatory Function in Adolescent Males Treated With Retroperitoneal Lymph Node Dissection and Adjuvant Therapy for Paratesticular Rhabdomyosarcoma. Urology 2018; 124:254-256. [PMID: 30366047 DOI: 10.1016/j.urology.2018.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/08/2018] [Accepted: 10/15/2018] [Indexed: 10/28/2022]
Abstract
Due to the rarity of the disease, adverse events related to ejaculatory function following the management of paratesticular rhabdomyosarcoma with multimodal therapy in adolescents are rarely discussed. Two patients, age 14 and 15 at time of diagnosis were treated with multimodal therapy with nerve-sparing retroperitoneal lymph node dissection, chemotherapy, and radiotherapy. Each developed ejaculatory dysfunction during the treatment period, which resolved 1 year after completion of all therapies. We sought to assess the role of each component of multimodal therapy on the observed side effect and the potential for delayed recovery of function after cessation of all therapies.
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Affiliation(s)
- James T Rague
- Department of Urology, Boston Medical Center, Boston, MA
| | - Briony K Varda
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Andrew A Wagner
- Division of Urology, Beth Israel Deaconess Medical Center, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA; Department of Surgery, Harvard Medical School, Boston, MA.
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Kaufman J, Wymbs NF, Montalvo-Ortiz JL, Orr C, Albaugh MD, Althoff R, O’Loughlin K, Holbrook H, Garavan H, Kearney C, Yang BZ, Zhao H, Peña C, Nestler EJ, Lee RS, Mostofsky S, Gelernter J, Hudziak J. Methylation in OTX2 and related genes, maltreatment, and depression in children. Neuropsychopharmacology 2018; 43:2204-2211. [PMID: 30089883 PMCID: PMC6135753 DOI: 10.1038/s41386-018-0157-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 07/02/2018] [Accepted: 07/06/2018] [Indexed: 12/14/2022]
Abstract
Through unbiased transcriptomics and multiple molecular tools, transient downregulation of the Orthodenticle homeobox 2 (OTX2) gene was recently causatively associated with the development of depressive-like behaviors in a mouse model of early life stress. The analyses presented in this manuscript test the translational applicability of these findings by examining peripheral markers of methylation of OTX2 and OTX2-regulated genes in relation to measures of depression and resting-state functional connectivity data collected as part of a larger study examining risk and resilience in maltreated children. The sample included 157 children between the ages of 8 and 15 years (χ = 11.4, SD = 1.9). DNA specimens were derived from saliva samples and processed using the Illumina 450 K beadchip. A subset of children (N = 47) with DNA specimens also had resting-state functional MRI data. After controlling for demographic factors, cell heterogeneity, and three principal components, maltreatment history and methylation in OTX2 significantly predicted depression in the children. In terms of the imaging data, increased OTX2 methylation was found to be associated with increased functional connectivity between the right vmPFC and bilateral regions of the medial frontal cortex and the cingulate, including the subcallosal gyrus, frontal pole, and paracingulate gyrus-key structures implicated in depression. Mouse models of early stress hold significant promise in helping to unravel the mechanisms by which child adversity confers risk for psychopathology, with data presented in this manuscript supporting a potential role for OTX2 and OTX2-related (e.g., WNT1, PAX6) genes in the pathophysiology of stress-related depressive disorders in children.
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Affiliation(s)
- Joan Kaufman
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD, USA. .,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. .,Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Nicholas F. Wymbs
- 0000 0004 0427 667Xgrid.240023.7Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD USA
| | | | - Catherine Orr
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Matthew D. Albaugh
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Robert Althoff
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Kerry O’Loughlin
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Hannah Holbrook
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Hugh Garavan
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
| | - Catherine Kearney
- 0000 0004 0427 667Xgrid.240023.7Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, MD USA
| | - Bao-Zhu Yang
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA
| | - Hongyu Zhao
- 0000000419368710grid.47100.32Department of Biostatistics, Yale University, New Haven, CT USA
| | - Catherine Peña
- 0000 0001 0670 2351grid.59734.3cFishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Eric J. Nestler
- 0000 0001 0670 2351grid.59734.3cFishberg Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Richard S. Lee
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Stewart Mostofsky
- 0000 0004 0427 667Xgrid.240023.7Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD USA ,0000 0001 2171 9311grid.21107.35Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD USA
| | - Joel Gelernter
- 0000000419368710grid.47100.32Department of Psychiatry, Yale University, New Haven, CT USA ,0000000419368710grid.47100.32Department of Biostatistics, Yale University, New Haven, CT USA ,0000 0004 0478 7015grid.418356.dVeterans Administration, West Haven, CT USA
| | - James Hudziak
- 0000 0004 1936 7689grid.59062.38Department of Psychiatry, Vermont Center for Children, Youth, and Families, University of Vermont, Burlington, VT USA
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