The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease

Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.

FRI0406 CARTILAGE REPAIR ACTIVITY DURING JOINT-PRESERVING TREATMENT MAY BE ACCOMPANIED BY OSTEOPHYTE FORMATION

Background:

Knee joint distraction (KJD) is a joint-preserving treatment to postpone total knee arthroplasty (TKA) and has shown cartilage repair and clinical improvement in patients with severe knee osteoarthritis (OA), as has high tibial osteotomy (HTO). The observed cartilage repair activity could be related to an increase in transforming growth factor-β1 (TGFβ-1), which increases in the synovial fluid (SF) during KJD treatment.1However, animal and ex vivo human studies have shown that TGFβ-1 also induce formation of osteophytes, generally seen as an OA severity hallmark. Similarly, interleukin-6 (IL-6) was observed to increase in SF during KJD treatment and may also be associated with osteophytosis.

As such, we hypothesized that joint-preserving regenerative treatments demonstrating cartilage repair activity lead to general tissue (re)generation, including osteophytosis.

Objectives:

To analyze osteophytosis after KJD and compare this to HTO and natural progression in knee OA.

Methods:

63 KJD patients were included in several clinical trials, one of which was a randomized controlled trial comparing patients indicated for HTO, but treated with KJD (KJDHTO; n=23) vs. patients treated with HTO (n=46). All patients received standardized radiographs before and one and two years after treatment, used to measure osteophyte size. Only patients with measurements at baseline and two-year follow-up were included. As a control group for natural progression, untreated knee OA patients from Cohort Hip & Cohort Knee (CHECK; n=1002) were studied. Only patients who received a TKA during follow-up were included, using their last two measurements before treatment to reflect natural two-year progression (n=44).

A separate group of 20 patients treated with KJD in regular care underwent SF aspirations before and after treatment, and TGFβ-1 and IL-6 levels were measured by immunoassay (Mesoscale Discovery). Unstandardized radiographs were acquired before and one year after treatment, used to score osteophytes with the revised Altman score, resulting in a 0 (normal) to 12 (severe) whole-joint score. Only patients with radiographs and SF aspirations at both baseline and one-year follow-up were included.

Results:

After two years, both KJD (n=58) and HTO (n=38) patients showed a significant increase in osteophyte size (+6.2mm2 and +7.0mm2 resp.; both p<0.003; figure 1), with no significant differences between the treatments (p>0.38). Untreated CHECK patients who underwent TKA did not show significant two-year osteophyte changes before treatment (+2.1mm2; p=0.207; figure 1) and showed significant differences compared with KJD and HTO groups (both p<0.044). In the KJD SF aspiration group (n=17), the Altman osteophyte score was not different at one year compared to baseline (+0.2 points; p=0.653) and there was no association between baseline biomarker values and the baseline Altman osteophyte score, or between changes in these parameters (all p≥0.28). Trichotomization of patients in groups with a decrease, no change or increase in total Altman osteophyte score indicated that there was a statistically significant difference between the three groups in changes in TGFβ-1 (p=0.044; figure 2A), but not IL-6 (p=0.898; figure 2B).

Conclusion:

After KJD treatment, joint space widening and clinical improvement are accompanied by osteophytosis. Similar results were observed after treatment with HTO, suggesting effects occur in regenerative joint-preserving treatments in general. The increased osteophytosis may be a bystander effect of cartilage repair activity related to intra-articular factors like TGFβ-1 and questions whether osteophytosis should necessarily be considered a hallmark of OA worsening.

References:

[1]Watt et al, Osteoarthritis Cartilage 2020

Disclosure of Interests:

Mylène Jansen: None declared, Simon Mastbergen: None declared, Fiona Watt: None declared, Elske Willemse: None declared, Tonia Vincent Consultant of: Ad hoc consultancy GSK, Mundipharma, UCB, Sander Spruijt Consultant of: Consultancy to Zimmer Biomet Inc., Pieter Emans Shareholder of: Shareholder and cofounder start-up company Chondropeptix, Roel Custers: None declared, Ronald Van Heerwaarden: None declared, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV

Quantitative analysis of multiple elements in healthy and remodeled epithelium from human upper airway mucosa using nuclear microscopy

Elements are vital in airway mucosal physiology and pathology, but their distribution and levels in the mucosa remain unclear. This study uses the state-of-the-art nuclear microscopy facility to map and quantify multiple elements in the histology sections of nasal mucosa from patients with nasal polyps or inverted papilloma. Our results demonstrate that P and Ca are the most abundant elements in mucosa and their distinct difference between epithelial and subepithelial regions; more importantly, our results reveal decreased amounts of Cu and Zn in the remodeled epithelium as compared to the normal epithelium. These findings suggest that Cu and Zn may be beneficial targets to regulate aberrant epithelial remodeling in airway inflammation.

The Human Cell Atlas

The recent advent of methods for high-throughput single-cell molecular profiling has catalyzed a growing sense in the scientific community that the time is ripe to complete the 150-year-old effort to identify all cell types in the human body. The Human Cell Atlas Project is an international collaborative effort that aims to define all human cell types in terms of distinctive molecular profiles (such as gene expression profiles) and to connect this information with classical cellular descriptions (such as location and morphology). An open comprehensive reference map of the molecular state of cells in healthy human tissues would propel the systematic study of physiological states, developmental trajectories, regulatory circuitry and interactions of cells, and also provide a framework for understanding cellular dysregulation in human disease. Here we describe the idea, its potential utility, early proofs-of-concept, and some design considerations for the Human Cell Atlas, including a commitment to open data, code, and community.

The Human Cell Atlas

The recent advent of methods for high-throughput single-cell molecular profiling has catalyzed a growing sense in the scientific community that the time is ripe to complete the 150-year-old effort to identify all cell types in the human body. The Human Cell Atlas Project is an international collaborative effort that aims to define all human cell types in terms of distinctive molecular profiles (such as gene expression profiles) and to connect this information with classical cellular descriptions (such as location and morphology). An open comprehensive reference map of the molecular state of cells in healthy human tissues would propel the systematic study of physiological states, developmental trajectories, regulatory circuitry and interactions of cells, and also provide a framework for understanding cellular dysregulation in human disease. Here we describe the idea, its potential utility, early proofs-of-concept, and some design considerations for the Human Cell Atlas, including a commitment to open data, code, and community.

3D map distribution of metallic nanoparticles in whole cells using MeV ion microscopy

In this work, a new tool was developed, the MORIA program that readily translates Rutherford backscattering spectrometry (RBS) output data into visual information, creating a display of the distribution of elements in a true three-dimensional (3D) environment. The program methodology is illustrated with the analysis of yeast Saccharomyces cerevisiae cells, exposed to copper oxide nanoparticles (CuO-NP) and HeLa cells in the presence of gold nanoparticles (Au-NP), using different beam species, energies and nuclear microscopy systems. Results demonstrate that for both cell types, the NP internalization can be clearly perceived. The 3D models of the distribution of CuO-NP in S. cerevisiae cells indicate the nonuniform distribution of NP in the cellular environment and a relevant confinement of CuO-NP to the cell wall. This suggests the impenetrability of certain cellular organelles or compartments for NP. By contrast, using a high-resolution ion beam system, discretized agglomerates of Au-NP were visualized inside the HeLa cell. This is consistent with the mechanism of entry of these NPs in the cellular space by endocytosis enclosed in endosomal vesicles. This approach shows RBS to be a powerful imaging technique assigning to nuclear microscopy unparalleled potential to assess nanoparticle distribution inside the cellular volume.

Abstract 2016: Mst2 is required for tumor progression and Yap activity

The survival of patients with head and neck cancer has remained unchanged for decades [1]. Novel therapeutic approaches are needed. The transcription co-activator Yap is known to initiate proliferation and migration programs in response to cytoskeletal cues [2]. As evidence of the relevance of Yap in cancer increases, the lack of pharmacological strategies to inhibit it hinders the possibility of clinical testing. The main Yap regulatory signals in mammals are cytoskeletal integrity and cell shape [2]. Interestingly, Mst2 regulates microtubule coordination in parallel to kinesin Eg5 motor activity[3] and actin polymerization through Rac1 activation [4]. We set out to explore the role of Mst2 in cancer biology and the influence of its cytoskeletal effects in Yap activity using silencing and overexpression systems in early passage oral squamous cell cancer cell lines. In clinically annotated databases, high Mst2 expression correlated with poor prognosis in lung, breast and head and neck cancer. Standard in vitro experiments showed that Mst2 was required and promoted cell migration and invasion. Immunofluorescence staining quantification revealed that Mst2 was necessary for actin polymerization, microtubule targeting to the focal adhesions and microtubule distribution. These effects increased cell height and reduced cell spreading. In keeping with cytoskeletal and cell shape changes, in luciferase reporter assays Mst2 was required for Yap activation, and inhibition of kinesin Eg5 with Monastrol reduced Yap activity in an Mst2 dependent manner. Confocal imaging quantification of 3D organotypic tumors revealed that Mst2 was required for primary tumor invasion into human dermis. Consistently, in an orthotopic xenograft model, tumors with lower Mst2 expression showed a significant reduction in circulating tumor DNA and lung metastasis formation. Although further preclinical studies are warranted, our results support the hypothesis that kinesin Eg5 inhibitors may be used to target Yap activity in oral squamous cell cancers with high Mst2 expression.

1. CRUK. CRUK Oral Cancer Statistics. 2009 [cited 2013; Available from: http://www.cancerresearchuk.org/cancer-info/cancerstats/types/oral/].

2. Pan, D., The hippo signaling pathway in development and cancer. Dev Cell, 2010. 19(4): p. 491-505.

3. Mardin, B.R., et al., Components of the Hippo pathway cooperate with Nek2 kinase to regulate centrosome disjunction. Nat Cell Biol, 2010. 12(12): p. 1166-76.

4. Mou, F., et al., The Mst1 and Mst2 kinases control activation of rho family GTPases and thymic egress of mature thymocytes. J Exp Med, 2012. 209(4): p. 741-59.

Citation Format: Carles Escriu, Klaas Mulder, Samuel Woodhouse, Nathan Benaich, Simon Broad, Frances Richards, Duncan Jodrell, Fiona Watt. Mst2 is required for tumor progression and Yap activity. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2016. doi:10.1158/1538-7445.AM2014-2016

Autoantibodies to posttranslationally modified type II collagen as potential biomarkers for rheumatoid arthritis

OBJECTIVE

Type II collagen (CII) posttranslationally modified by reactive oxygen species (ROS-CII) that are present in the inflamed joint is an autoantigen in rheumatoid arthritis (RA). The aim of this study was to investigate the potential use of anti-ROS-CII autoantibodies as a biomarker of RA.

METHODS

CII was exposed to oxidants that are present in the rheumatoid joint. Autoreactivity to ROS-CII was assessed by enzyme-linked immunosorbent assays in synovial fluid (SF) and serum samples obtained from patients during various phases of RA. This group included disease-modifying antirheumatic drug (DMARD)-naive patients with early RA (n = 85 serum samples) and patients with established RA (n = 80 serum and 50 SF samples), who were categorized as either DMARD responders or DMARD nonresponders. Control subjects included anti-citrullinated protein antibody (ACPA)-positive patients with arthralgia (n = 58 serum samples), patients with osteoarthritis (OA; n = 49 serum and 52 SF samples), and healthy individuals (n = 51 serum samples).

RESULTS

Reactivity to ROS-CII among DMARD-naive patients with early RA was significantly higher than that among patients with ACPA-positive arthralgia, patients with OA, and healthy control subjects (P < 0.0001), with 92.9% of serum samples from the patients with early RA binding to anti-ROS-II. There was no significant difference in anti-ROS-CII reactivity between ACPA-positive and ACPA-negative patients with RA, with 93.8% and 91.6% of serum samples, respectively, binding to ROS-CII. The sensitivity and specificity of binding to ROS-CII in patients with early RA were 92% and 98%, respectively. Among patients with established RA, serum reactivity in DMARD nonresponders was significantly higher than that in DMARD responders (P < 0.01); 58.3% of serum samples from nonresponders and 7.6% of serum samples from responders bound to HOCl-ROS, while the respective values for SF were 70% and 60%. In patients with longstanding RA, autoreactivity to ROS-CII changed longitudinally.

CONCLUSION

Autoantibodies to ROS-CII have the potential to become diagnostic biomarkers of RA.

The eLife approach to peer review

All editorial decisions at eLife are taken by working scientists in a process that emphasizes fairness, speed and transparency.

Launching eLife, Part 2

With a commitment to open access and innovation in peer review, eLife aims to publish important results in the life and biomedical sciences in a flexible digital format that allows authors to present their work in full, including the key data on which the conclusions are based.

Launching eLife, Part 1

The new open-access journal eLife has launched, making its first content available in PubMed Central. In addition to publishing science of the highest quality, the journal aims to improve both the peer-review process and the presentation of new research results.

Single-cell electroporation using proton beam fabricated biochips

We report the design and fabrication of a novel single cell electroporation biochip featuring high aspect ratio nickel micro-electrodes with smooth side walls between which individual cells are attached. The biochip is fabricated using Proton Beam Writing (PBW), a new direct write lithographic technique capable of fabricating high quality high-aspect-ratio nano and microstructures. By applying electrical impulses across the biochip electrodes, SYTOX® Green nucleic acid stain is incorporated into mouse neuroblastoma (N2a) cells and observed via green fluorescence when the stain binds with DNA inside the cell nucleus. Three parameters; electric field strength, pulse duration, and numbers of pulses have been investigated for the single cell electroporation process. The results indicate high transfection rates as well as cell viability of 82.1 and 86.7% respectively. This single cell electroporation system may represent a promising method for the introduction of a wide variety of fluorophores, nanoparticles, quantum dots, DNAs and proteins into cells.

Sin3a is essential for the genome integrity and viability of pluripotent cells

The Sin3a/HDAC co-repressor complex is a critical regulator of transcription networks that govern cell cycle control and apoptosis throughout development. Previous studies have identified Sin3a as essential for embryonic development around the time of implantation, during which the epiblast cell cycle is uniquely structured to achieve very rapid divisions with little tolerance of DNA damage. This study investigates the specific requirement for Sin3a in the early mouse embryo and shows that embryos lacking Sin3a suffer unresolved DNA damage and acute p53-independent apoptosis specifically in the E3.5–4.5 epiblast. Surprisingly, Myc and E2F targets in Sin3a-null ICMs are downregulated, suggesting a central but non-canonical role for Sin3a in regulating the pluripotent embryonic cell cycle. ES cells deleted for Sin3a mount a DNA damage response indicative of unresolved double-strand breaks, profoundly arrest at G2, and undergo apoptosis. These results indicate that Sin3a protects the genomic integrity of pluripotent embryonic cells and governs their unusual cell cycle.

Zinc mapping and density imaging of rabbit pancreas endocrine tissue sections using nuclear microscopy

Nuclear microscopy is a suite of techniques based on a focused beam of MeV protons. These techniques have the unique ability to image density and structural variations in relatively thick tissue sections, map trace elements at the cellular level to the microgram per gram (dry weight) level, and extract quantitative information on these elements. The trace elemental studies can be carried out on unstained freeze-dried tissue sections, thereby minimizing any problems of contamination or redistribution of elements during conventional staining and fixing procedures. The pancreas is a gland with different specialized cells and a complex hormonal activity where trace elements play an important role. For example, zinc has an active role in insulin production, and calcium ions participate in the stimulation and secretion process of insulin. Using nuclear microscopy with a spatial resolution of 1 mum, we have located, using zinc mapping, the islets of Langerhans in freeze-dried normal rabbit tissue sections. The islets of Langerhans contain beta-cells responsible for insulin production. Subsequent quantitative analyses have indicated elevations in most elements within the islets of Langerhans, and significantly so for the concentrations of Zn [3,300 compared to 90 microg/g (dry weight)] and Ca [1,100 compared to 390 microg/g (dry weight)].

Elemental analysis of neurofibrillary tangles in Alzheimer's disease using proton-induced X-ray analysis

We have investigated the elemental content of hippocampal slices from normal human brain and from brains of Alzheimer's disease patients by X-ray fluorescence using both electron and proton beam microprobes. The sections have been stained with a dye--toluidine blue--which contains sulphur so that the X-ray fluorescence map can be correlated with known intracellular sites as seen under the light microscope. The results show that associated with neurofibrillary tangles and Hirano bodies (the distinctive internal visual features of cells from Alzheimer's disease patients) there is increased calcium. We cannot confirm that there are peculiarities in the distribution of aluminium in cells.

A novel MASH1 enhancer with N-myc and CREB-binding sites is active in neuroblastoma

Neuroblastoma is one of the most common solid tumors in childhood. With the aim of developing a targeting vector for neuroblastoma, we cloned and characterized an enhancer in the 5'-flanking regions of the MASH1 gene by a random-trap method from a 36 kb cosmid DNA. The enhancer-containing clone was identified by the expression of GFP when transfected into neuroblastoma cell lines. The enhancer-luciferase activity is higher in neuroblastoma cell lines, IMR32, BE2 and SH-SY5Y, compared with those in non-neuroblastoma cell lines, U1242 glioma, N417 small cell lung cancer and EOMA hemangioma. The core enhancer was determined within a 0.2 kb fragment, yielding three- to fourfold higher activity than that of the MASH1 promoter alone in IMR32 and BE2. This area possesses GATA- and CREB-binding sites, as well as the E-box. EMSA on this area demonstrated that CREB/ATF could bind the DNA. Chromatin immunoprecipitation assay revealed that N-myc, CREB, and co-activators CBP and PCAF, but not HDAC1, are bound to the core enhancer at the same time as the co-activators and N-myc bind to the promoter. This supports the idea that the commonly overexpressed genes HASH1 and N-myc are regulated in concert, confirming their importance as prognostic markers or targets for therapy.

Iron and copper accumulation in the brain of coxsackievirus-infected mice exposed to cadmium

Cadmium (Cd) is a potentially toxic metal widely distributed in the environment and known to cause adverse health effects in humans. During coxsackievirus infection, the concentrations of essential and nonessential trace elements (e.g., iron (Fe), copper (Cu), and Cd) change in different target organs of the infection. Fe and Cu are recognized cofactors in host defence reactions, and Fe is known to be associated with certain pathological conditions of the brain. However, whether nonessential trace elements could influence the balance of essential trace elements in the brain is unknown. In this study the brain Fe, Cu, and Cd contents were measured through inductively coupled plasma mass spectrometry and their distributions determined by nuclear microscopy in the early phase (day 3) of coxsackievirus B3 (CB3) infection in nonexposed and in Cd-exposed female Balb/c mice. In CB3 infection the brain is a well-known target that has not been studied with regard to trace element balance. The brain concentration of Cu compared with that of noninfected control mice was increased by 9% (P < 0.05) in infected mice not exposed to Cd and by 10% (not significant) in infected Cd-exposed mice. A similar response was seen for Fe, which in infected Cd-exposed mice, compared to noninfected control mice, tended to increase by 16%. Cu showed an even tissue distribution, whereas Fe was distributed in focal deposits. Changes in Cd concentration in the brain of infected mice were less consistent but evenly distributed. Further studies are needed to define whether the accumulation and distribution of trace elements in the brain have an impact on brain function.

Observation of many coherent oscillations for MeV protons transmitted through stacking faults

High spatial resolution, high-contrast transmission channeling images of stacking faults in silicon have been produced using a beam of 2 MeV protons focused to a spot size of 60 nm. Over a narrow range of beam tilts to the (011) planes, up to ten periodic intensity oscillations are observed, providing evidence of a long-range coherency of the planar channeled trajectories. This behavior is characterized using Monte Carlo computer simulations, and a phase-space model of planar channeled ion interactions with stacking faults is developed which incorporates all observed channeling and blocking phenomena.

A Tissue-Specific Enhancer of the Prostate-Specific Membrane Antigen Gene, FOLH1

Prostate-specific membrane antigen (PSMA) is an integral membrane protein that is highly expressed on the surface of prostate epithelial cells. It is also expressed on the vascular endothelium of a number of tumor types. We have used an enhancer trap approach with randomly cleaved overlapping DNA fragments from an approximately 55-kb P1 cosmid insert encompassing the 5' half and upstream sequences of the PSMA gene (FOLH1) to isolate an enhancer that strongly activates the FOLH1 core promoter region. The enhancer (PSME) is located in the third intron about 12 kb downstream from the start site of transcription and is characterized by a 72-bp direct repeat within a 331-bp core region. The PSME activates transcription from its own and heterologous promoters in prostate cell lines; enhancement is greatest in the PSMA-expressing cell line LNCaP (>250-fold). The PSME shows essentially no activity in five nonprostate cell lines. PSME-enhanced expression is repressed in the presence of androgen, mimicking the repression of the endogenous FOLH1 gene. The data demonstrate that both cell-type specificity and androgen regulation are intrinsic properties of the enhancer. These properties make the PSME an excellent candidate for regulation of gene expression in gene therapy approaches to prostate cancer.

Overview of evolving strategies incorporating prostate-specific membrane antigen as target for therapy

Prostate-specific membrane antigen (PSMA) is a potential target in prostate cancer patients because it is very highly expressed and because it has been reported to be upregulated by androgen deprivation. This overview addresses the expression of the PSMA gene in terms of the promoter and enhancer and how that may play a role in gene therapy. We also review PSMA as a target for antibodies for imaging and treatment and the development of a novel hybrid T-cell receptor that combines the specificity of anti-PSMA antibodies with that of T-cell receptor activation when introduced into primary lymphocytes by retroviral-mediated gene transfer. We also discuss our recent findings on the expression of a PSMA-like gene and how that understanding allows specific targeting of PSMA.

Hard metal lung disease--the first case in Singapore

INTRODUCTION

We report the first case of hard metal lung disease in Singapore and the occupational investigative work and control measures that were undertaken.

CLINICAL PICTURE

A 38-year-old machinist in the tool manufacturing industry presented with exertional dyspnoea and cough. Chest X-ray revealed bilateral reticulonodular infiltrates with honeycombing. High resolution computed tomography scan of the thorax confirmed the presence of interstitial fibrosis. Open biopsy of the lung showed features of pneumoconiosis. Particle induced X-ray emission (PIXE) analysis, a relatively new elemental analysis technique, performed on the lung biopsy specimen confirmed the presence of tungsten and titanium; and he was diagnosed to have hard metal lung disease. Microbiologic, serologic and histologic investigations excluded an infective cause. Serial pulmonary function tests on follow-up showed no progression. He presented with haemoptysis 10 months later and was diagnosed to have tuberculosis on the basis of positive sputum and bronchoalveolar lavage cultures for Mycobacterium tuberculosis complex.

TREATMENT

Preventive measures and permanent transfer to non-cobalt work were instituted.

OUTCOME

The interstitial fibrosis appears to have stabilised.

CONCLUSION

The diagnosis of hard metal lung disease must be considered in a worker exposed to cobalt presenting with interstitial fibrosis.