Do Implant Retained Prostheses Improve the Quality of Life of Patients with Extraoral Maxillofacial Defects - A Systematic Review

BACKGROUND

There is limited evidence available regarding patient satisfaction and quality of life assessment in patients with extraoral maxillofacial prostheses.

OBJECTIVES

This systematic review aims to understand the impact of extraoral implant retained prosthesis in improving the quality of life in patients with extraoral maxillofacial defects/abnormalities.

METHODS

A comprehensive search was performed of nine electronic databases up to August 2022, which yielded three articles that satisfied the inclusion criteria. The study characteristics and findings were extracted, and the included studies were assessed for quality.

RESULTS

Three cohort studies were selected. Despite the lack of uniformity in the quality of life instruments, there was a general trend in improvement in the quality of life for patients with implant retained extraoral prostheses. The studies were also deemed to be of high quality on assessment.

CONCLUSION

Given the limitations of this systematic review, there exists limited evidence indicating that implant prostheses may enhance the quality of life for individuals with extraoral maxillofacial defects or abnormalities.

NOX1 is essential for TNFα-induced intestinal epithelial ROS secretion and inhibits M cell signatures

OBJECTIVE

Loss-of-function mutations in genes generating reactive oxygen species (ROS), such as NOX1, are associated with IBD. Mechanisms whereby loss of ROS drive IBD are incompletely defined.

DESIGN

ROS measurements and single-cell transcriptomics were performed on colonoids stratified by NOX1 genotype and TNFα stimulation. Clustering of epithelial cells from human UC (inflamed and uninflamed) scRNASeq was performed. Validation of M cell induction was performed by immunohistochemistry using UEA1 (ulex europaeus agglutin-1 lectin) and in vivo with DSS injury.

RESULTS

TNFα induces ROS production more in NOX1-WT versus NOX1-deficient murine colonoids under a range of Wnt-mediated and Notch-mediated conditions. scRNASeq from inflamed and uninflamed human colitis versus TNFα stimulated, in vitro colonoids defines substantially shared, induced transcription factors; NOX1-deficient colonoids express substantially lower levels of STAT3 (signal transducer and activator of transcription 3), CEBPD (CCAAT enhancer-binding protein delta), DNMT1 (DNA methyltransferase) and HIF1A (hypoxia-inducible factor) baseline. Subclustering unexpectedly showed marked TNFα-mediated induction of M cells (sentinel cells overlying lymphoid aggregates) in NOX1-deficient colonoids. M cell induction by UEA1 staining is rescued with H2O2 and paraquat, defining extra- and intracellular ROS roles in maintenance of LGR5+ stem cells. DSS injury demonstrated GP2 (glycoprotein-2), basal lymphoplasmacytosis and UEA1 induction in NOX1-deficiency. Principal components analyses of M cell genes and decreased DNMT1 RNA velocity correlate with UC inflammation.

CONCLUSIONS

NOX1 deficiency plus TNFα stimulation contribute to colitis through dysregulation of the stem cell niche and altered cell differentiation, enhancing basal lymphoplasmacytosis. Our findings prioritise ROS modulation for future therapies.

Single-cell transcriptomics reveals conserved cell identities and fibrogenic phenotypes in zebrafish and human liver

The mechanisms underlying liver fibrosis are multifaceted and remain elusive with no approved antifibrotic treatments available. The adult zebrafish has been an underutilized tool to study liver fibrosis. We aimed to characterize the single-cell transcriptome of the adult zebrafish liver to determine its utility as a model for studying liver fibrosis. We used single-cell RNA sequencing (scRNA-seq) of adult zebrafish liver to study the molecular and cellular dynamics at a single-cell level. We performed a comparative analysis to scRNA-seq of human liver with a focus on hepatic stellate cells (HSCs), the driver cells in liver fibrosis. scRNA-seq reveals transcriptionally unique populations of hepatic cell types that comprise the zebrafish liver. Joint clustering with human liver scRNA-seq data demonstrates high conservation of transcriptional profiles and human marker genes in zebrafish. Human and zebrafish HSCs show conservation of transcriptional profiles, and we uncover collectin subfamily member 11 (colec11) as a novel, conserved marker for zebrafish HSCs. To demonstrate the power of scRNA-seq to study liver fibrosis using zebrafish, we performed scRNA-seq on our zebrafish model of a pediatric liver disease with mutation in mannose phosphate isomerase (MPI) and characteristic early liver fibrosis. We found fibrosis signaling pathways and upstream regulators conserved across MPI-depleted zebrafish and human HSCs. CellPhoneDB analysis of zebrafish transcriptome identified neuropilin 1 as a potential driver of liver fibrosis. Conclusion: This study establishes the first scRNA-seq atlas of the adult zebrafish liver, highlights the high degree of similarity to human liver, and strengthens its value as a model to study liver fibrosis.

From single-target to cellular niche targeting in Crohn's disease: intercepting bad communications

The mainstay of moderate to severe Crohn's disease (CD), anti-TNF treatment, shows no clinical benefit in ∼40% of patients, likely due to incomplete cellular targeting and delayed treatment institution. While single-target therapeutics have been highly effective for some CD patients, substantial limitations with respect to safety, efficacy, and long-term, complete remission remain. Deconvolution of the cellular and molecular circuitry of tissue lesions underscores the importance of combinatorial strategies targeting cellular niches. This review aims to evaluate current therapeutic approaches used to manage CD, and highlight recent advances to our cellular, genetic, and molecular understanding of mechanisms driving pathogenic niche activation in CD. We propose new frameworks outlining that combinatorial therapies, along with serial tissue sampling and studies guided by genetics and genomics, can advance on current treatment approaches and will inform newer strategies upon which we can move towards precision therapeutics in IBD.

Maladaptive autophagy in the pathogenesis of autoimmune epithelitis in Sjӧgren's Syndrome

OBJECTIVE

Salivary gland epithelial cells (SGECs) are key cellular drivers in the pathogenesis of primary Sjӧgren's Syndrome (pSS); however, the mechanisms sustaining SGECs activation in pSS remain undetermined. The aim of this study is to determine the role of autophagy in the survival and activation of SGECs in pSS.

METHODS

Primary SGECs isolated from minor salivary glands (SG) of patients with pSS or sicca syndrome were evaluated by flow-cytometry, immunoblotting, and immunofluorescence to assess autophagy (autophagic-flux, LC3IIB, p62, LC3B+/LAMP1+ staining), apoptosis (annexin V/PI, Caspase-3) and activation (ICAM, VCAM). Focus score and germinal centers presence was assessed in SG from the same patients to correlate with histological severity. Human salivary gland (HSG) cells were stimulated in vitro with PBMCs and serum from pSS patients in the presence or absence of autophagy inhibitors to determine changes in autophagy and epithelial cell activation.

RESULTS

SGECs from pSS patients (n=24) exhibited increased autophagy (autophagic-flux p=0.001; LC3IIB p=0.02; p62 p=0.064; LC3IIB/LAMP1+ staining), increased expression of anti-apoptotic molecules (Bcl2 p=0.006), and reduced apoptosis (Annexin-V/PI p=0.002, Caspase-3 p=0.057) compared to sicca (n=16). Autophagy correlated with histologic disease severity. In vitro experiments on HSG cells stimulated with serum and PBMCs from pSS patients confirmed activation of autophagy and expression of adhesion molecules, which was reverted upon pharmacologic inhibition of autophagy.

CONCLUSIONS

In pSS SGECs, inflammation induces autophagy and pro-survival mechanisms, which promote SGEC activation and mirror histological severity. These findings indicate that autophagy is a central contributor to the pathogenesis of pSS and a new therapeutic target.

A Role for CXCR3 Ligands as Biomarkers of Post-Operative Crohn's Disease Recurrence

BACKGROUND AND AIMS

Crohn's disease [CD] recurrence following ileocolic resection [ICR] is common. We sought to identify blood-based biomarkers associated with CD recurrence.

METHODS

CD patients undergoing ICR were recruited across six centres. Serum samples were obtained at post-operative colonoscopy. A multiplex immunoassay was used to analyse 92 inflammation-related proteins [Olink Proteomics]. Bayesian analysis was used to identify proteins associated with increasing Rutgeerts score. Identified proteins were used in receiver operating characteristic [ROC] analysis to examine the ability to identify CD recurrence [Rutgeerts score ≥i2]. Existing single cell data were interrogated to further elucidate the role of the identified proteins.

RESULTS

Data from 276 colonoscopies in 213 patients were available. Median time from surgery to first and second colonoscopy was 7 (interquartile range [IQR] 6-9) and 19 [IQR 16-23] months, respectively. Disease recurrence was evident at 60 [30%] first and 36 [49%] second colonoscopies. Of 14 proteins significantly associated with Rutgeerts score, the strongest signal was seen for CXCL9 and MMP1. Among patients on anti-tumour necrosis factor drugs, CXCL9 and CXCL11 were most strongly associated with Rutgeerts score. Both are CXCR3 ligands. Incorporation of identified proteins into ROC analysis improved the ability to identify disease recurrence as compared to C-reactive protein alone: area under the curve [AUC] 0.75 (95% confidence interval [CI]: 0.66-0.82] vs 0.64 [95% CI 0.56-0.72], p = 0.012. Single cell transcriptomic data provide evidence that innate immune cells are the primary source of the identified proteins.

CONCLUSIONS

CXCR3 ligands are associated with CD recurrence following ICR. Incorporation of novel blood-based candidate biomarkers may aid in identification of CD recurrence.

927 Efficacy of Surgical Helmet Systems for Protection Against COVID-19: A Double-Blinded Randomised Control Study

Introduction

This study assesses whether sterile surgical helmet systems (SSHS) provide additional protection from aerosol pathogens alongside protecting against splash. There has been debate on whether to use such systems in orthopaedic surgery during the COVID-19 pandemic.

Method

Thirty-five participants were enrolled in a double-blinded randomised controlled study investigating efficacy of the Stryker Flyte Surgical Helmet (Stryker Corporation, Kalamazoo, MI, USA) as protection against respiratory droplets. Wearing the SSHS in a fit testing hood, subjects were randomised to nebulised saccharin solution or placebo. Twenty were allocated to the saccharin group with 15 to placebo. Positive sweet taste represented test failure. Taste tests were performed with the helmet fan turned on and off.

Results

SSHS did not prevent saccharin taste (p < 0.0001). Within the saccharin cohort, 40% recorded a positive taste with the fan on and 100% with the fan off. There was a statistically significant difference in mean time-to-taste saccharin (p = 0.049) comparing fan on (123.5 s) vs. off (62.6 s).

Conclusions

SSHS do not protect against aerosol particulate and therefore are not efficacious in protection against COVID-19. The fan system employed may even increase risk by drawing in particulates and delaying recognition of intraoperative cues that point to respirator mask leak.

Inflamed Ulcerative Colitis Regions Associated With MRGPRX2-Mediated Mast Cell Degranulation and Cell Activation Modules, Defining a New Therapeutic Target

BACKGROUND & AIMS

Recent literature has implicated a key role for mast cells in murine models of colonic inflammation, but their role in human ulcerative colitis (UC) is not well established. A major advance has been the identification of mrgprb2 (human orthologue, MRGPX2) as mediating IgE-independent mast cell activation. We sought to define mechanisms of mast cell activation and MRGPRX2 in human UC.

METHODS

Colon tissues were collected from patients with UC for bulk RNA sequencing and lamina propria cells were isolated for MRGPRX2 activation studies and single-cell RNA sequencing. Genetic association of all protein-altering G-protein coupled receptor single-nucleotide polymorphism was performed in an Ashkenazi Jewish UC case-control cohort. Variants of MRGPRX2 were transfected into Chinese hamster ovary (CHO) and human mast cell (HMC) 1.1 cells to detect genotype-dependent effects on β-arrestin recruitment, IP-1 accumulation, and phosphorylated extracellular signal-regulated kinase.

RESULTS

Mast cell-specific mediators and adrenomedullin (proteolytic precursor of PAMP-12, an MRGPRX2 agonist) are up-regulated in inflamed compared to uninflamed UC. MRGPRX2 stimulation induces carboxypeptidase secretion from inflamed UC. Of all protein-altering GPCR alleles, a unique variant of MRGPRX2, Asn62Ser, was most associated with and was bioinformatically predicted to alter arrestin recruitment. We validated that the UC protective serine allele enhances β-arrestin recruitment, decreases IP-1, and increases phosphorylated extracellular signal-regulated kinase with MRGPRX2 agonists. Single-cell RNA sequencing defines that adrenomedullin is expressed by activated fibroblasts and epithelial cells and that interferon gamma is a key upstream regulator of mast cell gene expression.

CONCLUSION

Inflamed UC regions are distinguished by MRGPRX2-mediated activation of mast cells, with decreased activation observed with a UC-protective genetic variant. These results define cell modules of UC activation and a new therapeutic target.

Machine learning identifies novel blood protein predictors of penetrating and stricturing complications in newly diagnosed paediatric Crohn's disease

BACKGROUND

There is a need for improved risk stratification in Crohn's disease.

AIM

To identify novel blood protein biomarkers associated with future Crohn's disease complications METHODS: We performed a case-cohort study utilising a paediatric inception cohort, the Risk Stratification and Identification of Immunogenetic and Microbial Markers of Rapid Disease Progression in Children with Crohn's disease (RISK) study. All patients had inflammatory disease (B1) at baseline. Outcomes were development of stricturing (B2) or penetrating (B3) complications. We assayed 92 inflammation-related proteins in baseline plasma using a proximity extension assay (Olink Proteomics). An ensemble machine learning technique, random survival forests (RSF), selected variables predicting B2 and B3 complications. Selected analytes were compared to clinical variables and serology only models. We examined selected proteins in a single-cell sequencing cohort to analyse differential cell expression in blood and ileum.

RESULTS

We included 265 patients with mean age 11.6 years (standard deviation [SD] 3.2). Seventy-three and 34 patients, respectively, had B2 and B3 complications within mean 1123 (SD 477) days for B2 and 1251 (442) for B3. A model with 5 protein markers predicted B3 complications with an area under the curve (AUC) of 0.79 (95% confidence interval [CI] 0.76-0.82) compared to 0.69 (95% CI 0.66-0.72) for serologies and 0.74 (95% CI 0.71-0.77) for clinical variables. A model with 4 protein markers predicted B2 complications with an AUC of 0.68 (95% CI 0.65-0.71) compared to 0.62 (95% CI 0.59-0.65) for serologies and 0.52 (95% CI 0.50-0.55) for clinical variables. B2 analytes were highly expressed in ileal stromal cells while B3 analytes were prominent in peripheral blood and ileal T cells.

CONCLUSIONS

We identified novel blood proteomic markers, distinct for B2 and B3, associated with progression of paediatric Crohn's disease.

THU0220 AUTOPHAGY IN SJOGREN’S SYNDROME SALIVARY GLAND EPITHELIAL CELLS (SGECS) IS ASSOCIATED WITH THE SEVERITY OF INFLAMMATION AND EPITHELIAL CELLS ACTIVATION

Background:

Sjögren’s Syndrome (SS) is characterized by chronic inflammation supported by intrinsic activation of salivary gland epithelial cells (SGECs). Eventually, apoptosis of SGECs ensues, which leads to salivary gland dysfunction and exposition of autoantigens. Autophagy is a stress coping mechanisms of cells implicated in both survival and exposition of autoantigens, and is thereby plausibly implicated in the pathogenesis of SS. At present, the exact relationship between apoptosis and autophagy in SS SGECs is unclear, as is the link between these mechanisms and SGECs activation.

Objectives:

To explore autophagy in SGECs from patients with SS and to evaluate its relationship with apoptosis and SGECs activation.

Methods:

Consecutive patients with suspected SS referring to our “Sjogren Clinic” were enrolled, and minor salivary gland (MSG) biopsies were collected for: (1) SGECs culture, (2) PCR analysis, (3) IFI analysis. In SGECs cultures, the expression of autophagy (LC3II), apoptosis (annexin V/PI) and adhesion molecules (ICAM) was investigated by flow cytometry (results expressed as mean % ± SD). The expression of the autophagy gene MAP1LC3II was evaluated by PCR (expressed as 2^deltaCT normalized to GADPH) on both MSG sections and MSG acinar and ductal epithelium samples obtained by laser capture microdissection. Tissue expression of LC3II was evaluated by IFI on SS MSG.

Results:

Primary SGECs cultures were established from 14 MSG obtained for diagnostic purposes (SS n=8, Sicca n=6). These cells exhibited an inverse correlation between apoptosis and autophagy (p=0.007, r=-0.784), with lower levels of apoptosis (19.7±6.5 vs 24.5±8.5, p=ns) and higher levels of autophagy (59.7±13.1 vs 54.19±19.4, p=ns) in SS compared to Sicca. In SS, MAP1LC3 was positively correlated with Focus Score (p=0.021 r=0.478); however, PCR studies did not reveal significant differences in MAP1LC3 expression between SS (n=26) and Sicca (n=15) (0.024±0.010 vs 0.022±0.008, p=ns). Ductal SGECs (n=4) isolated by laser microdissection of MSG revealed a higher expression of MAP1LC3 (0.005±0.0005 vs 0.003±0.0008; p=0.057) compared to normal acinar epithelium (n=5); a major expression of LC3II in ducts was confirmed by IFI (Image).

In SS, a higher expression of ICAM compared to sicca was observed (11.1±3.8 vs 6.9±6.9, p=0.006) and autophagy and apoptosis showed a trend of positive and negative correlation with this molecule, respectively (p=0.683 r=0.118 and p=0.106 r=-0.446).

Figure.

LC3-II staining in SS MSG [LC3-II+ (green) and Hoechst stain (blue); 60x magnification].

Conclusion:

In SS, autophagy is upregulated in SGECs and inversely correlated with apoptosis, thus supporting a role of this process in cells’ death prevention during inflammatory process. Indeed, the degree of msg inflammation is correlated more with the activation of autophagy than apoptosis. Interesting, in SS, SGECs autophagy is mainly observed at ductal level and is correlated with higher expression of adhesion molecules suggesting a link between this pathway and changes in SGECs immune phenotype.

Disclosure of Interests: :

Serena Colafrancesco: None declared, cristiana barbati: None declared, Valentina Iannizzotto: None declared, Linda Mastromanno: None declared, Saba Nayar: None declared, Elena Pipi: None declared, angelica gattamelata: None declared, francesco ciccia Grant/research support from: pfizer, novartis, roche, Consultant of: pfizer, novartis, lilly, abbvie, Speakers bureau: pfizer, novartis, lilly, abbvie, cristiano alessandri Grant/research support from: Pfizer, Francesca Barone: None declared, fabrizio conti Speakers bureau: BMS, Lilly, Abbvie, Pfizer, Sanofi, Roberta Priori: None declared

Glycemic Index of Wheat and Rice are Similar When Consumed as Part of a North Indian Mixed Meal

INTRODUCTION

Wheat is preferable over rice due to its lower glycemic index (GI). It is not known if the same is true when these staples are a part of mixed meals, hence we compared the Glycemic responses of wheat/rice containing mixed meals.

MATERIALS AND METHODS

Glycemic responses of 2 mixed meals were compared with reference meal (glucose) where each was designed to provide a total of 50 g of available carbohydrate (AvCHO), in 10 healthy adult volunteers as per recent recommendations. Test meal 1 comprised of a pulse preparation (green gram dal), a vegetable (ladies' finger), and 2 wheat chapattis. In test meal 2 these wheat chapattis were replaced by cooked rice supplying an equal amount of AvCHO. After an overnight fast of 10- 14 h, capillary blood glucose estimations were done subsequent to eating each test meal or glucose. GI of test meals was calculated by comparing their area under curve (AUCs) with AUC for glucose. GI of test meals were compared using unpaired t test.

RESULTS

The study sample comprised of 7 males and 3 females with mean age 30.9 ± 5.1y. The GI of test meal 1 (85.5 ± 11.8%) and test meal 2 (83.6 ± 11.4%) was not significantly different (P = 0.7095).

CONCLUSION

The present study found no differences in glycemic index of wheat chapatti and rice based mixed meals with equivalent AvCHO content of the staple.

Single-Cell Analysis of Crohn's Disease Lesions Identifies a Pathogenic Cellular Module Associated with Resistance to Anti-TNF Therapy

Clinical benefits of cytokine blockade in ileal Crohn's disease (iCD) are limited to a subset of patients. Here, we applied single-cell technologies to iCD lesions to address whether cellular heterogeneity contributes to treatment resistance. We found that a subset of patients expressed a unique cellular module in inflamed tissues that consisted of IgG plasma cells, inflammatory mononuclear phagocytes, activated T cells, and stromal cells, which we named the GIMATS module. Analysis of ligand-receptor interaction pairs identified a distinct network connectivity that likely drives the GIMATS module. Strikingly, the GIMATS module was also present in a subset of patients in four independent iCD cohorts (n = 441), and its presence at diagnosis correlated with failure to achieve durable corticosteroid-free remission upon anti-TNF therapy. These results emphasize the limitations of current diagnostic assays and the potential for single-cell mapping tools to identify novel biomarkers of treatment response and tailored therapeutic opportunities.

Zebrafish modeling of intestinal injury, bacterial exposures and medications defines epithelial in vivo responses relevant to human inflammatory bowel disease

Genome-wide association studies have identified over 200 genomic loci associated with inflammatory bowel disease (IBD). High-effect risk alleles define key roles for genes involved in bacterial response and innate defense. More high-throughput in vivo systems are required to rapidly evaluate therapeutic agents. We visualize, in zebrafish, the effects on epithelial barrier function and intestinal autophagy of one-course and repetitive injury. Repetitive injury induces increased mortality, impaired recovery of intestinal barrier function, failure to contain bacteria within the intestine and impaired autophagy. Prostaglandin E2 (PGE2) administration protected against injury by enhancing epithelial barrier function and limiting systemic infection. Effects of IBD therapeutic agents were defined: mesalamine showed protective features during injury, whereas 6-mercaptopurine displayed marked induction of autophagy during recovery. Given the highly conserved nature of innate defense in zebrafish, it represents an ideal model system with which to test established and new IBD therapies targeted to the epithelial barrier.This article has an associated First Person interview with the first author of the paper.

An Unusual Case of Pulmonary Mucormycosis

Invasive fungal infections in solid organ transplant recipients are associated with significant morbidity and mortality. Of these fungal infections, mucormycosis presents as an aggressive, frequently fatal angioinvasive infection. Immunocompromised hosts and diabetes are important risk factors. These infections are frequently difficult to diagnose. A high index of suspicion in the appropriate setting and early, aggressive treatment with the newer antifungal agents have altered the previously grave prognosis. We present the first reported case of cavitating pulmonary mucormycosis in a renal transplant recipient caused by an unusual species of Mucorales. The patient was treated with a combination of lobectomy and antifungal treatment comprising of amphotericin B and posaconazole. He remains free of disease recurrence on monotherapy with posaconazole.

Isolated Neurogenic Bladder Associated With Human T-Lymphotropic Virus Type 1 Infection in a Renal Transplant Patient From Central Australia: A Case Report

BACKGROUND

Human T-lymphotropic virus type 1 (HTLV-1) is endemic amongst the Aborigines of the Northern Territory of Australia. HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been associated with this infection. In general population, isolated neurogenic bladder dysfunction in HTLV-1-infected individuals without HAM/TSP has been reported, and the HTLV-1 proviral load has been found to be higher in such patients compared with asymptomatic carriers. In solid organ transplantation, few cases of HAM/TSP have been reported worldwide, but not an isolated neurogenic bladder.

CASE

A 50-year-old indigenous women from Alice Springs with end stage renal disease secondary to diabetic nephropathy with no prior history of bladder dysfunction received a cadaveric renal allograft following which she developed recurrent urinary tract infections. The recipient was seropositive for HTLV-1 infection. HTLV-1 status of donor was not checked. Urodynamic studies revealed stress incontinence and detrusor overactivity without urethral intrinsic sphincter deficiency. She had no features of myelopathy. There was elevation of the serum and cerebrospinal fluid HTLV-1 proviral load. The magnetic resonance imaging myelogram was normal. Pyelonephritis was diagnosed based on clinical features, positive cultures, and renal allograft biopsy. Continuous suprapubic catheter drainage helped preventing further episodes of allograft pyelonephritis in spite of chronic colonization of the urinary tract.

CONCLUSION

Isolated bladder dysfunction is a rare manifestation of HTLV-1 infection and is probably associated with high proviral loads. This may adversely affect renal allograft and patient outcomes.

Molecular and Cellular Requirements for the Assembly of Tertiary Lymphoid Structures

At sites of chronic inflammation, recruited immune cells form structures that resemble secondary lymphoid organs (SLOs). Those are characterized by segregated areas of prevalent T- or B-cell aggregation, differentiation of high endothelial venules (HEVs) and local activation of resident stromal cells. B-cell proliferation and affinity maturation towards locally displayed autoantigens have been demonstrated at those sites, known as tertiary lymphoid structures (TLSs). TLS formation has been associated with local disease persistence and progression as well as increased systemic manifestations. While bearing a similar histological structure to SLO, the signals that regulate TLS and SLO formation can diverge, and a series of pro-inflammatory cytokines has been ascribed as responsible for TLS formation at different anatomical sites. Here we review the structural elements as well as the signals responsible for TLS aggregation, aiming to provide an overview to this complex immunological phenomenon.

MPI depletion enhances O-GlcNAcylation of p53 and suppresses the Warburg effect

Rapid cellular proliferation in early development and cancer depends on glucose metabolism to fuel macromolecule biosynthesis. Metabolic enzymes are presumed regulators of this glycolysis-driven metabolic program, known as the Warburg effect; however, few have been identified. We uncover a previously unappreciated role for Mannose phosphate isomerase (MPI) as a metabolic enzyme required to maintain Warburg metabolism in zebrafish embryos and in both primary and malignant mammalian cells. The functional consequences of MPI loss are striking: glycolysis is blocked and cells die. These phenotypes are caused by induction of p53 and accumulation of the glycolytic intermediate fructose 6-phosphate, leading to engagement of the hexosamine biosynthetic pathway (HBP), increased O-GlcNAcylation, and p53 stabilization. Inhibiting the HBP through genetic and chemical methods reverses p53 stabilization and rescues the Mpi-deficient phenotype. This work provides mechanistic evidence by which MPI loss induces p53, and identifies MPI as a novel regulator of p53 and Warburg metabolism.

DOI:http://dx.doi.org/10.7554/eLife.22477.001

trappc11 is required for protein glycosylation in zebrafish and humans

Activation of the unfolded protein response (UPR) can be either adaptive or pathological. We term the pathological UPR that causes fatty liver disease a "stressed UPR." Here we investigate the mechanism of stressed UPR activation in zebrafish bearing a mutation in thetrappc11gene, which encodes a component of the transport protein particle (TRAPP) complex.trappc11mutants are characterized by secretory pathway defects, reflecting disruption of the TRAPP complex. In addition, we uncover a defect in protein glycosylation intrappc11mutants that is associated with reduced levels of lipid-linked oligosaccharides (LLOs) and compensatory up-regulation of genes in the terpenoid biosynthetic pathway that produces the LLO anchor dolichol. Treating wild-type larvae with terpenoid or LLO synthesis inhibitors phenocopies the stressed UPR seen intrappc11mutants and is synthetically lethal withtrappc11mutation. We propose that reduced LLO level causing hypoglycosylation is a mechanism of stressed UPR induction intrappc11mutants. Of importance, in human cells, depletion of TRAPPC11, but not other TRAPP components, causes protein hypoglycosylation, and lipid droplets accumulate in fibroblasts from patients with theTRAPPC11mutation. These data point to a previously unanticipated and conserved role for TRAPPC11 in LLO biosynthesis and protein glycosylation in addition to its established function in vesicle trafficking.

Uptake of inorganic phosphorus by temperate seagrass beds of Posidonia and Amphibolis in Southern Australia

Seagrasses occupy a narrow band of sandy seabed close to the coast and are therefore vulnerable to anthropogenic influences, particularly meadows near large population centres. Over 5000 ha of seagrasses have been lost from Adelaide coastal waters (South Australia) over the past 70 years and much of this loss has been attributed to nutrient inputs from wastewater, industrial and stormwater discharges. This led to the Adelaide Coastal Waters Study to understand processes along the Adelaide metropolitan coast that led to seagrass loss. This study, a subset of the larger ACWS study, used in situ nutrient spike approach to obtain ecologically relevant estimates of seasonal variability in phosphorus uptake in two species of temperate seagrass common to this coast (Amphibolis antarctica and Posidonia angustifolia). Total uptake of phosphorus by biological components in the seagrass beds, viz., seagrass, epiphytes and phytoplankton, was negligible, never exceeding 0.5% of the total resource. Phosphorus uptake rate varied seasonally with higher rates in winter (1.49 μmol P.g(-1) DW.h(-1)) and lower rates in spring (0.70 μmol P.g(-1) DW.h(-1)) for Amphibolis and highest in winter (2.09 μmol P.g(-1) DW.h(-1)) and least in spring (0.14 μmol P.g(-1) DW.h(-1)) for Posidonia. Low biological uptake rates of inorganic phosphorus could be attributed to carbonate sediments and particulates in the water column binding inorganic phosphorus, limiting its availability for biological uptake. From an environmental perspective, seagrass beds in the Adelaide coastal waters account for the assimilation of only 5.4% (19.53 t yr(-1)) of the total anthropogenic inputs of phosphorus.

Managing nitrogen inputs into seagrass meadows near a coastal city: flow-on from research to environmental improvement plans

Increased human habitation has led to a 30 to 50-fold increase in nutrient loads to the coastal waters of Adelaide, resulting in the loss of over 5000 ha of seagrass meadows. The rate of loss since the 1940s has been irregular, averaging 85 ha yr(-1), marked by a substantial peak between 1971 and 1977. A modelling approach allowed comparison of the annual input with the annual uptake rates for the different biotic components in the seagrass bed. In 2005, the estimated uptake of ammonium (465 t yr(-1)) and nitrate (3.04 t yr(-1)) by the seagrass and associated epiphytes in the Adelaide region accounted for 31% of the ammonium and <1% of the nitrate that is currently discharged into the coastal waters. Environment Improvement Programs, such as the one implemented in 1996, may reduce the total nitrogen loads to 700 t yr(-1), possibly stemming further losses and facilitating recolonisation of new seagrass.

Uptake and resource allocation of ammonium and nitrate in temperate seagrasses Posidonia and Amphibolis

Ecologically relevant estimates of seasonal variability in nitrogen uptake and allocation in two species of temperate seagrasses were obtained using in situ isotope-labelling approach. Significantly higher uptake rates of ammonium by leaves, roots and epiphytes of Amphibolis than Posidonia were observed. Overall, root uptake rates were lower than other components. Effect of season was not significant for leaves, roots or epiphytes of the two species. However, plankton uptake varied seasonally with higher rates in winter (0.98 mg N g(-1)D Wh(-1)). In contrast, nitrate uptake rates for various components were significantly affected by seasons. Uptake rates by plankton were highest ranging from 0.003 mg N g(-1)D Wh(-1) (summer, Amphibolis) to 0.69 mg N g(-1)DWh(-1) (winter, Posidonia). Uptake of nitrate by roots was negligible. Biotic uptake rates for nitrate were an order of magnitude slower than ammonium, demonstrating an affinity for ammonium over nitrate as a preferred inorganic nitrogen source. Adelaide coastal waters have lost over 5000 ha of seagrasses, much of this attributed to nutrient inputs from wastewater, industrial and stormwater. Managing these inputs into future requires better understanding of the fate of nutrients, particularly biological uptake. This study attempts to quantify uptake rates of nitrogen by seagrasses.

Extramedullary paraspinal hematopoiesis in hereditary spherocytosis

Hereditary spherocytosis (HS) is a common inherited hemolytic anemia due to red cell membrane defects. Extramedullary hematopoiesis is a compensatory response to insufficient bone marrow blood cell production. The preferred sites of extramedullary hematopoietic involvement are the spleen, liver and lymph nodes; but in HS, the posterior paravertebral mediastinum is also commonly involved. We report a case of a 50-year-old male who presented to us in respiratory distress and with bilateral paravertebral posterior mediastinal masses, which on trucut biopsy were found to be extra-hematopoietic masses; and the patient was found to have hereditary spherocytosis.

Environmental effects of dredging on sediment nutrients, carbon and granulometry in a tropical estuary

This monitoring study encompassed a period prior to dredging, during dredging and post dredging between July 1999 to June 2000 in Ponggol estuary located along the northeastern coast of Singapore. Mean concentrations of sediment nutrients in mg x Kg(-1) (+/- standard error of means) prior to dredging, during dredging and post dredging were 9.75 +/- 4.24, 8.18 +/- 4.29 and 11.46 +/- 4.74 for ammonium, 0.08 +/- 0.05, 0.06 +/- 0.02 and 0.09 +/- 0.01 for nitrite, 0.04 +/- 0.04, 0.11 +/- 0.17 and 0.25 +/- 0.30 for nitrate, 4.83 +/- 3.48, 0.77 +/- 0.48 and 8.33 +/- 9.73 for phosphate respectively. Pre dredge, dredge and post dredge levels of total carbon (TC) were 18.5 +/- 3.7, 20.2 +/- 3.5 and 34.6 +/- 12.0, of total organic carbon (TOC) were 10.5 +/- 2.9, 19.5 +/- 3.6 and 34.6 +/- 12.0 and of total inorganic carbon (TIC) were 7.9 +/- 1.0, 0.7 +/- 0.4 and non detectable in the sediments, respectively. Both, sediment nutrients and carbon registered lower concentrations with onset of dredging, with the exception of nitrate and TOC. A shift in sedimentary carbon from inorganic carbon to organic carbon was also observed with the onset of the dredging activities when the organically enriched historically contaminated layer was exposed. Sediment granulometry showed that the sediments in the estuary were predominantly silt and clay prior to dredging, which changed to sand with onset of dredging. Silt load in the sediments was highest post-dredge. Sediment nutrients and sediment organic carbon were observed to associate with the finer fractions (silt and clay) of sediments. Finer fractions of sediments get resuspended during a dredging event and are dispersed spatially as the result of tides and water movements. Prior to this study, the potential for nutrient release and sediment granulometry due to dredging have been suggested, but there have been few studies of it, especially in the tropics. The baseline information gathered from this study could be used to work out effective management strategies to protect similar tropical ecosystems elsewhere, should there be no other alternative to dredging.

Spatio-temporal fluxes in particulate organic carbon in a tropical coastal lagoon

Temporal and spatial variations in particulate organic carbon (POC) in relation to primary production, chlorophyll a, phaeophytin, plankton abundance, secondary production and suspended particulate matter (SPM) were studied monthly for 1 year from April 1996 to March 1997 in a shallow tropical coastal lagoon on the southwest coast of India. Though temporal variations in all components were significant, spatial variabilities were not statistically significant. POC values range from 200 to 5690 mg C m(3) h(-1), while primary production, chlorophyll a, and phaeophytin varied between 0.02 and 14.53 mg C m(-3) h(-1), 0.87 and 23.11 mg m(-3) and 3.02 and 30.581 mg m(-3), respectively. Phytoplankton and zooplankton abundance varied from 0.01 to 655.5 x 10(5) no m(-3) and negligible to 7.08 x 10(5) no m(-3) respectively; secondary production from 10 to 490 mg C m(-3) and SPM between 0.38 and 74.43 x 10(4) mg m(-3) during this study. Temporally, postmonsoon months were observed to have the highest concentrations of POC in the lagoon waters. The bulk of the POC pool in the lagoon was composed of secondary producers (72%), followed by chlorophyll a (21%), phaeophytin (7%) and suspended particulate matter of inorganic origin (< 0.1%).

Environmental impacts of diesel fuel on bacteria and phytoplankton in a tropical estuary assessed using in situ mesocosms

Dissolved or dispersed petroleum hydrocarbon concentrations (DDPH) were monitored in Ponggol estuary, Singapore, fortnightly from July 1999 to June 2000. DDPH concentrations ranged from 4.4 to 248.9 microg l(-1) and 0.4 to 1099.7 microg l(-1) for surface and subsurface waters, respectively and with mean concentrations of 41.01 microg l(-1) in the water column. Absorbed or adsorbed petroleum hydrocarbon (AAPH) concentrations measured in sediments ranged from 20.6 to 541.0 mg kg(-1), with mean concentrations of 148.23 mg kg(-1). In situ mesocosm studies of bacteria and phytoplankton were based on field monitoring of environmentally measured concentrations of petroleum hydrocarbons, using diesel fuel as the source of contaminant. The mesocosm comprised of 25 L clear polycarbonate carboys incubated in situ for 6 days. Water and sediments from a clean site with undetectable levels of petroleum hydrocarbons were used in controls. The treatment mesocosms comprised of mean and highest concentrations of DDPH and AAPH. The study revealed signs of acute toxicity to autotrophs viz., phytoplankton and autotrophic bacteria in treatments simulating concentrations of diesel fuel found in the sediments. A stimulatory effect was seen at lower concentrations. Bacterial heterotrophs responded positively to all concentrations of diesel fuel because of the abundance of a carbon source, reduced grazing pressure and reduced competition for nutrients from phytoplankton.

Environmental impact of heavy metals from dredged and resuspended sediments on phytoplankton and bacteria assessed in in situ mesocosms

Past and on-going reclamation, dredging, construction and shipping activities impact Ponggol Estuary, located on the northeastern coast of Singapore. Tin, lead, nickel, cadmium, and copper in particulate and dissolved fractions and sediments ranged from ND (undetectable)-92 ppm, ND-303.2 ppm, ND-2818.4 ppm, ND-74.4 ppm and ND-1117.7 ppm, respectively. Intensive dredging activity during the monitoring period may have led to the resuspension and bioavailability of particulate metals. This was tested by the exposure of phytoplankton and bacteria in mesocosms to previously measured environmental levels of heavy metals and the contaminated sediments with the highest heavy metal concentrations from one of the impacted sites. The results showed significant copper toxicity to phytoplankton and autotrophic bacteria, followed by nickel and lead at all concentrations tested. Enhanced rates of heterotrophic bacterial production and total bacterial abundance were observed in treatments with higher metal concentrations. Among the various treatments, particulate and sediment metal concentrations were significantly different from those of the control. Mesocosms using contaminated sediments with the highest metal concentrations compared with the control showed a bioavailability of metals that resulted in the inhibition of phytoplankton and autotrophic bacteria. High concentrations of copper (5.52-11.35 mg L(-1)) and nickel (2.42-2.71 mg L(-1)) observed in the aqueous phase of treatment mesocosms, and attributed to release from the contaminated sediments could account for the toxicity to phytoplankton and autotrophic bacteria.