An integrated toolkit for human microglia functional genomics

BACKGROUND

Microglia, the brain's resident immune cells, play vital roles in brain development, and disorders like Alzheimer's disease (AD). Human iPSC-derived microglia (iMG) provide a promising model to study these processes. However, existing iMG generation protocols face challenges, such as prolonged differentiation time, lack of detailed characterization, and limited gene function investigation via CRISPR-Cas9.

METHODS

Our integrated toolkit for in-vitro microglia functional genomics optimizes iPSC differentiation into iMG through a streamlined two-step, 20-day process, producing iMG with a normal karyotype. We confirmed the iMG's authenticity and quality through single-cell RNA sequencing, chromatin accessibility profiles (ATAC-Seq), proteomics and functional tests. The toolkit also incorporates a drug-dependent CRISPR-ON/OFF system for temporally controlled gene expression. Further, we facilitate the use of multi-omic data by providing online searchable platform that compares new iMG profiles to human primary microglia: https://sherlab.shinyapps.io/IPSC-derived-Microglia/ .

RESULTS

Our method generates iMG that closely align with human primary microglia in terms of transcriptomic, proteomic, and chromatin accessibility profiles. Functionally, these iMG exhibit Ca2 + transients, cytokine driven migration, immune responses to inflammatory signals, and active phagocytosis of CNS related substrates including synaptosomes, amyloid beta and myelin. Significantly, the toolkit facilitates repeated iMG harvesting, essential for large-scale experiments like CRISPR-Cas9 screens. The standalone ATAC-Seq profiles of our iMG closely resemble primary microglia, positioning them as ideal tools to study AD-associated single nucleotide variants (SNV) especially in the genome regulatory regions.

CONCLUSIONS

Our advanced two-step protocol rapidly and efficiently produces authentic iMG. With features like the CRISPR-ON/OFF system and a comprehensive multi-omic data platform, our toolkit equips researchers for robust microglial functional genomic studies. By facilitating detailed SNV investigation and offering a sustainable cell harvest mechanism, the toolkit heralds significant progress in neurodegenerative disease drug research and therapeutic advancement.

Immune Response following FLASH and Conventional Radiation in Diffuse Midline Glioma

PURPOSE

Diffuse midline glioma (DMG) is a fatal tumor traditionally treated with radiation therapy (RT) and previously characterized as having a noninflammatory tumor immune microenvironment (TIME). FLASH is a novel RT technique using ultra-high dose rate that is associated with decreased toxicity and effective tumor control. However, the effect of FLASH and conventional (CONV) RT on the DMG TIME has not yet been explored.

METHODS AND MATERIALS

Here, we performed single-cell RNA sequencing (scRNA-seq) and flow cytometry on immune cells isolated from an orthotopic syngeneic murine model of brainstem DMG after the use of FLASH (90 Gy/sec) or CONV (2 Gy/min) dose-rate RT and compared to unirradiated tumor (SHAM).

RESULTS

At day 4 post-RT, FLASH exerted similar effects as CONV in the predominant microglial (MG) population, including the presence of two activated subtypes. However, at day 10 post-RT, we observed a significant increase in the type 1 interferon α/β receptor (IFNAR+) in MG in CONV and SHAM compared to FLASH. In the non-resident myeloid clusters of macrophages (MACs) and dendritic cells (DCs), we found increased type 1 interferon (IFN1) pathway enrichment for CONV compared to FLASH and SHAM by scRNA-seq. We observed this trend by flow cytometry at day 4 post-RT in IFNAR+ MACs and DCs, which equalized by day 10 post-RT. DMG control and murine survival were equivalent between RT dose rates.

CONCLUSIONS

Our work is the first to map CONV and FLASH immune alterations of the DMG TIME with single-cell resolution. Although DMG tumor control and survival were similar between CONV and FLASH, we found that changes in immune compartments differed over time. Importantly, although both RT modalities increased IFN1, we found that the timing of this response was cell-type and dose-rate dependent. These temporal differences, particularly in the context of tumor control, warrant further study.

Stat1 is an inducible transcriptional repressor of neural stem cells self-renewal program during neuroinflammation

A central issue in regenerative medicine is understanding the mechanisms that regulate the self-renewal of endogenous stem cells in response to injury and disease. Interferons increase hematopoietic stem cells during infection by activating STAT1, but the mechanisms by which STAT1 regulates intrinsic programs in neural stem cells (NSCs) during neuroinflammation is less known. Here we explored the role of STAT1 on NSC self-renewal. We show that overexpressing Stat1 in NSCs derived from the subventricular zone (SVZ) decreases NSC self-renewal capacity while Stat1 deletion increases NSC self-renewal, neurogenesis, and oligodendrogenesis in isolated NSCs. Importantly, we find upregulation of STAT1 in NSCs in a mouse model of multiple sclerosis (MS) and an increase in pathological T cells expressing IFN-γ rather than interleukin 17 (IL-17) in the cerebrospinal fluid of affected mice. We find IFN-γ is superior to IL-17 in reducing proliferation and precipitating an abnormal NSC phenotype featuring increased STAT1 phosphorylation and Stat1 and p16ink4a gene expression. Notably, Stat1-/- NSCs were resistant to the effect of IFN-γ. Lastly, we identified a Stat1-dependent gene expression profile associated with an increase in the Sox9 transcription factor, a regulator of self-renewal. Stat1 binds and transcriptionally represses Sox9 in a transcriptional luciferase assay. We conclude that Stat1 serves as an inducible checkpoint for NSC self-renewal that is upregulated during chronic brain inflammation leading to decreased self-renewal. As such, Stat1 may be a potential target to modulate for next generation therapies to prevent progression and loss of repair function in NSCs/neural progenitors in MS.

Zero COVID 19 Occurrence among 206 of 1023 Migrants of War from Syria at the Czech Border (Rapid Research Note)

Recent war conflicts in Europe and Middle East generate new refugee wawes and possible dissemination of Covid I9 variants from countries with low vaccination activity due to armed events.Therefore we have tested all migrants of war(206) coming via Hungarian Slovak Czech Border,within one week among 1023 refugees of war..who had symptoms of respiratory infection.None of tested symptomatic individuals was positive by rapid antigen test.Therefore the the risk ofCOVID I9 dissemination was not been confirmed.

TMIC-68. EVALUATING FLASH AND CONVENTIONAL DOSE-RATE RADIATION AND IMMUNE RESPONSE WITH SINGLE-CELL SEQUENCING IN DIFFUSE MIDLINE GLIOMA (DMG)

Diffuse Midline Glioma – H3K27M mutant (DMG), is a fatal and inoperable pediatric brain tumor with limited treatment options as radiation provides only temporary reprieve, leaving the median survival between 9-15 months. Conventional dose-rate radiation (2Gray/minute, CONV) has been shown in other cancers to recruit an immune component, however, this has not been studied in DMG. Ultra-high dose-rate radiation given at 90 Gray/second (FLASH), is a novel technique associated with decreased toxicity and effective tumor control. Using a syngeneic model of brainstem DMG, we performed single-cell RNA sequencing on CD45+ immune cells isolated from tumors irradiated with 15Gray using FLASH or CONV, and compared to unirradiated tumor and normal brainstem. Isolation of 33,308 immune cells revealed 17 unique clusters, most abundant of which was microglia (73.8%), present in four distinct subtypes representing a spectrum from homeostatic to activated. In the most activated microglia, both FLASH and CONV showed an enrichment in type 1 interferon (IFN1) pathway scores compared to untreated tumors (p< 0.001 and p< 0.001, respectively). The most differential response was found in macrophages (MAC) and dendritic cells (DC) with a robust enrichment of IFN1 pathway scores for CONV compared to FLASH (p< 0.001, MAC and p< 0.001 DC). FLASH showed an increase in anti-inflammatory MAC markers such as Mrc1, Cd163, and Maf and an enrichment of myeloid-derived suppressor cell (MDSC) signature in monocytes, not seen in CONV (p< 0.001). Finally, we correlated our data with publicly available single-cell data taken from the cerebrospinal fluid of DMG patients treated with anti-GD2 CAR T Cell therapy and found similar inflammatory markers characteristic of our unirradiated murine tumors. In summary, our work is the first to study immune alterations comparing different dose-rates of radiation with single-cell resolution in DMG, highlighting the potential for combining radiation and immunotherapy in these tumors.

Collapse of Healthcare Providers-medical and Paramedical-healthcare Staff after last Three Years of Pandemics and War Conflicts

This Editorial dispatch focuses on absolute shortage of healthcare workers and their psychical and physical exhaustion with devastation consequences on healthcare providers and management of pandemics and health destruction within ongoing armed conflicts in Europe and Middle East,focusing on non prioritizing HCW versus healthcare infrastructure, vaccines medications, but putting both to the same level of priority.

Physiotherapy & Psychosocial Rehabilitation in Postcovid & Postconflict Era: New Roles with same Staff? (dispatch)

Waves of COVID-19 have been managed successfully within US, EU, Southeast Asia and Latin America, however, South Asia and Sub-saharan Africa still suffer new variants and EU fights with UK and United States of ,,new waves of old disease“, postcovide or long covide syndrome. The aim of this communication and research is to prepare our auditors for the size and extent of postcovid systems and the importance of non-doctors and non-medicine experts in management of its consequences.

Ethical Challenge of Discerning Refugees from Economic Migrants: Critical Observations and Conclusions Regarding Slovak Capital Facing Huge Tide of Ukrainian Citizens Nowadays (Case Study)

Objective: The aim of our research was to determine the distinction between behavioral patterns of refugees versus economic migrants from Ukraine in order to confute widespread Slovak media image of all incoming Ukrainian citizens as severily suffering from war trauma and being at the edge of their financial or material survival.Design: Case Study from the Capital of Slovakia. Participants: Ukrainian citizens living in Bratislava who entered Slovakia at the beginning of the time of the Russian invasion until today. Methods: Analytical evaluation based on a critical approach to media image confronted with real situations regarding refugees versus economic migrants from Ukraine was applied. To grasp the issue of behavior of incoming persons, firstly, naturalistic observation method has been used. Results: Using sensitive and detailed observation the distinction between Ukrainian refugees and economic migrants can be drawn and should be applied on a common basis. This should be based on their behavioral patterns as seen in praxis. Conclusion: Discerning refugees from economic migrants needs to be done in order to ensure fairness towards incoming persons and also locals. The distinction should be based on objective observation of behavioral patterns of all the incoming Ukrainian citizens and based on that decisions of competent institutions and preparation of relevant legislation should be made. It is inevitable to start to grasp the problem of unjust generalizing approach and also to stop antisocial behavior on the streets, in the city transport, at the shops, in the doctor´s waiting room, etc. of incoming Ukrainian citizens, who do not show any signs of war trauma and are obviously economic migrants, moreover, inadaptable. Continuation of peaceful living of locals should be granted by Slovak government both in the form of issuing proper legislation and by immediate implementation of legislation into practice. The Slovak media image of the current situation concerning this matter needs to be straight reconsidered, revised and by these steps to prevent and protect the community from further demage and overall reduction in the quality of life of all the inhabitants of the capital.

Call for Socioeconomic and Health Infrastructure Rehabilitation after Pandemics and armed Conflicts - an ultimate wake up Call for the International Community?

This current issue of Clinical Social Work and Health Intervention (CSW, 1-5) summarizes the three last issues focused on two devastating events. 1st – the two year pandemics of coronavirus infection originated from Hongkong 2003; via Abu Dhabi 2012; Busan 2017; Wuchan 2019 via Italy, France and large airports and sports/ cultural events to Central and Eastern Europe. 2nd – three war conflicts, two of them in Europe, or very close to the EU: first in 2012-2020 in Yemen due to airstries and infrastructure bombing of Taizz, Sanaa and Hodeida; second in Karabakh, Stepanakert Region by shelling from Azerbajjjan; third in Ukraine after bombing and still permanent shelling from Russian and Russia-satellite allies to Ukraine. We have to face the part played by devastating infrastructure destruction of hospitals schools, socio-economic and industrial damage to health and sanitary with consequences such as has been noted after an earthquake in Haiti and war in Rwanda and DRC. Currently, unfortunately, dealing with destroyed urban infrastructure in Mariopil and other towns, such as cholera outbreaks and Covid 19 resurgence results in massive a flow of refugees of war - a classic example of how socio-economic tragedy is followed by large health catastrophe. The EU is prepared for country rehabilitation including healthcare and educational support. The ultimate condition however is the immediate stopping of armed activities especially bombing and shelling of the water supplies and sanitary infrastructure.

Low occurence of Tuberculosis and HIV among Ukrainian Immigrants of War at the Border post in Uzhorod – Vysne Nemecke at point prevalence testing (note)

Point prevalence studies bring us approximate situations in border emergency settings where longitudinal or comparative studies are not realistic from logistic safety points of view. The one day point prevalence study performed at most frequently used checkpoints between Ukraine (UA) and Slovakia (SK). No case of TB screened by the WHO recommended questionnaire, or HIV performed by rapid test has been noted on day 7 after the war was declared.

Weakness Period in Food Assistance as Part of Social Work for Ukrainian Migrants of War Conflicts

Food supplies are leading priorities during reception and first contact with all refugees of war. The aim of the study was to longitudinally document the clients flow in a food and clothing center at SEUC in Bratislava, serving clients sent from various checkpoints between Ukraine, Slovakia and Poland.

The War in Ukraine and the Participation of St. Elizabeth University of Health and Social Work in Helping at Border Crossing Points

War always means sacrifice, death, forced departure, pain, sorrow and suffering. All wars leave scars on the soul. The current situation in Ukraine is very serious. The war has affected millions of innocent people. St. Elizabeth's College of Healthcare and Social Work supports calls for solidarity, an end to the war and peace. Everyone from the university contributes not only by hand but also by heart to the joint work. Suffering must end!

DIPG-45. Radiation induces a robust interferon response in Diffuse Midline Glioma (DMG), improving the potential for combination immunotherapy

Diffuse Midline Glioma (DMG), H3K27M altered, confers a dismal survival of 9-15 months and has a non-inflammatory tumor immune microenvironment (TIME). Radiation therapy (RT) is the mainstay treatment for DMG and has been shown in other cancers to recruit an immune component. However, the effect of RT on the DMG TIME has not been explored. In a syngeneic murine model of pontine DMG (PDGFB+, H3.3K27M, p53−/−), mice were treated with single fraction 15Gy RT or sham control, four mice per group. We performed single cell sequencing after CD45 isolation to evaluate the TIME 4 days post RT and compare to untreated tumor (sham control). Unsupervised clustering of 14,848 CD45+ cells revealed 16 immune cell subsets, most abundantly microglia at 75% of cells, with four subtypes representing a spectrum of homeostatic to activated. Microglia from RT are more concentrated in the activated subtypes with an upregulation of interferon response (i.e. Isg15, Ifit3) compared to untreated tumor with an increase in several interferon pathways using REACTOME. Consistent with RT response, RT treated tumors have increase in cell cycle regulatory genes such as Cdkn1a, across all clusters. In non-resident myeloid cells, compared to untreated tumor, RT is associated with a robust upregulation of interferon response genes in both macrophages (Isg15 Fold Change (FC) 2.30; Ifit1 FC 1.64; Ifit3 FC 2.02; Cxcl10 FC 2.29) and dendritic cells (Isg15 FC 2.67; Ifit1 FC 1.72; Ifit3 FC 2.06; Cxcl10 FC 1.50). We also find differential expression of immune checkpoints in RT-treated versus untreated tumor with decreased expression of Lag3, Tim3 (Havcr2), and Csf1R and increased expression of Cd47, Sirpa and Gitr (Tnfrsf18) post RT. In summary, RT stimulates a pro-inflammatory TIME response and alters immune checkpoints in DMG, highlighting the potential for combining RT and immunotherapy in these tumors.

Acute Post Trauma Stress Syndrome (PSS) versus Chronic PSS after Armed Operations in Bosna, Yemen versus Lebanon and Syria

Post Trauma Stress Syndrome has two forms, acute and chronic; depending on the interval and duration of stress, since this is a typically reactive psychosocial disorder with vegetative medical symptomatology evoked by acute or chronic stress.                                                       The aim of this three cohort comparative study is to compare the position of PTSS between: victims of bombing in Yemen (air strikes only); combined war operations in Ukraine; and combined operations in Syria, and chronic military unrests in Lebanon

Spectrum of Humanitarian Help to migrants of War from Multi-ethnic vs. Mono-ethnic Regions (Note)

After armed conflict due to invasion of Russian Fed forces to Ukraine, humanitarian help from neighboring countries emerged, mainly Poland, Slovakia, Czech Republic, Hungary,Romania, Moldova, etc. The aim of this short research note is to compare the type of humanitarian assistance from a multiethnic area of Rimavska Sobota (multi-ethnic area with about one fifth of Hungarian; a third of Roma population; a district of highest unemployment; to the Bratislava area with lowest unemployment with Slovak nationals in majority.

Health Care for Refugees and Asylum Seekers in the Setting of Refugee Camps at Europe’s Entry Points

St. Elizabeth University, Bratislava, and its Tropic team has had an active participation in refugee and migrant humanitarian aid since 2015. In the beginning, it was mainly providing health care in the border areas of Hungary, Serbia, and Slovenia, which represented transit points on the route to Western European final destinations. The uncontrolled influx of fleeing people (mainly Syrians at that time) was stopped in March 2016. The diplomatic EU-Turkey deal and subsequent closure of Balkan borders resulted in an extensive humanitarian catastrophe when thousands ended up stranded in Greece. Since then, the members of St. Elizabeth’s Tropic team operate in affected Greek areas. At first, the University had its presence in the northern part of mainland Greece, which later moved to Lesbos Island. Cooperating closely with the Greek Ministry of Health as well as with multiple non-governmental non-profit organizations registered in Greece. The Topic team focuses on refugee health care inside as well as outside the Greek refugee camps.

Life Satisfaction of Holocaust Survivors

Objective: Find out the impact of the Holocaust trauma on life satisfaction of alive Czech survivors, and to compare it with a control group of respondents.                                                       Design: Prospective study                                                       Participants: The total number of respondents in the study was 130. The exposed group consisted of 65 Czech Holocaust survivors (average age 88.5 years), control group of 65 Czech seniors (average age 88 years).  Methods: The article presents a quantitative research assessing the life satisfaction of survivors using the standardized Life Satisfaction Questionnaire by Fahrenberg et al. (1986) on a main group, and compares it with a control group. A nonparametric test for two selections (Mann – Whitney) at a significance level of 0.05 was used to test the hypotheses.                                                       Results: In spite of wide spectrum of the Holocaust effects, the exposed group shows higher or the same satisfactionin the most of the monitored areas compared to the control group (Health Me 4 vs. 3, p – 0.000; Workand employment Me 6 vs. 5, p – 0.000; Financial situation Me 6 vs. 4, p – 0.000; Leisure time Me 4 vs. 4, p – 0.002; Marriage and partnership Me 2 vs. 0, p – 0.284; Own self Me 4 vs. 3, p – 0.000; Sexuality Me 3 vs. 3, p – 0.879; Friends and acquaintances Me 5 vs. 4, p – 0.002; Housing Me 5 vs. 4, p – 0.000; Overall life satisfaction Me 5 vs. 4, p – 0.001). On the contrary, they are less satisfied in the area Children (Me 4 vs. 5, p – 0.016).                                                        Conclusions: The research displays integration of hardiness and vulnerability, lust for life and the ability of man to live and survive in extreme conditions and still feel a joy of life.

Urinary Incontinence as a Significant Health and Social Problem of Women

The issue of urinary incontinence is the most commonly discussedissue in the field of urology and urological nursing. It occurs all over the world. 45% of the population suffers from it. An average time from the onset of the first symptomsuntil the visit to the doctor's is 3 years.It occurs at any age, regardless of gender, still women suffer from it more often and the prevalence of affected female-patients increases with age. However, at present, as an exception that proves the rule, we are increasingly often encountering this problem in younger people. This disease affects every area of patients´ lives. Social, professional and private life are all being subordinated to this issue, which significantly affects the comfort and quality of life

Psychosocial Impact of COVID-19 on Elderly/Senior Population

Senior population is one of major social work and healthcare issues in highly developed countries. The aim of this study was assessing the late psychosocial consequences in seniors in Vienna and Bratislava after the first and second waves of the COVID-19 pandemics. The results suggest that elderly patients in contrast to children and adolescents suffer significantly more late psychosocial consequences after having coronavirus acute or chronic di- sease.

Building Bridges Between Social Work and Prenatal Psychology

This issue of Clinical Social Work and Health Intervention is dedicated to decea- sed co-founder of our Journal and President of the International Society of Prenatal and Perinatal Psychology and Medicine, Director of the First Department of Peri- natal Psychology and Medicine, Honorary Doctor and holder of Honorary Degrees and Medals of multiple Universities in Poland, Czechoslovakia, Italy, Malaysia, etc, Doctor of Medicine and Psychology and Editor in chief of four Medical Journ- als: Acta Neurosa Superioris Rediviva, Neuroendocrinology Letters, Clinical Social Work and Health Intervention and Int. Journal of Prenatal and Perinatal Psychology and Medicine (1-4). Together with his spouse Lili Maas, ArtD., who added to the exact science, arts and her heart and love, all of those Journals were not only reading of naked facts and theories, or science but both were teaching us to accept psycho- logy, social work and medicine as art culture and love, what is more than science and knowledge, more than facts. (From the letter of St. Paul and two letters of St. Peter, New Testament)

91 Impact of ultra-fast ‘FLASH’ radiotherapy on single cell immunogenomics in diffuse intrinsic pontine glioma (DIPG)

Background

Diffuse intrinsic pontine gliomas (DIPG’s) are immunologically inert tumors with a median survival of 9–15 months. Radiation therapy (RT) is the mainstay treatment for DIPG but is associated with immunodepletion of the tumor microenvironment (TME) at high dose ranges. FLASH, or ultra-fast dose rate RT, represents a novel ablative technique that may spare TME immune responses while decreasing tumor burden. Here, we present single-cell immune profiling of DIPG tumors treated with FLASH, conventional dose rate RT (CONV) or no RT (SHAM).

Methods

Murine H3.3K27M mutant DIPG cells were stereotactically injected and tumor induction confirmed by magnetic resonance imaging (MRI) 15 days later. DIPG-bearing mice were randomly assigned to one of three treatment groups (n=4/group), FLASH, CONV or SHAM. A fourth group with no tumor (NML) was included as a negative biological control. A modified linear accelerator was used to deliver 15 Gy of electron RT to the brainstem at dose rates of 90 Gy/second and 2 Gy/minute, for the FLASH and CONV groups, respectively. Four days post-RT, mice brainstems were harvested, homogenized, stained for CD45 and tagged with a hashtag antibody specific to each group. CD45+ immune cells were isolated and sequenced using the 10X Genomics chromium single-cell 3’ platform. After processing and alignment of the reads using CellRanger with default parameters, the data was quality checked and filtered before hashtag demultiplexing, unsupervised clustering and downstream analysis was implemented following the Seurat R package. Differential expression evaluated based on the non-parametric Wilcoxon rank sum test. Key genes determine by an adjusted p value of < 0.05 based on bonferroni correction and |avg log2FC| > 0.8.

Results

Preliminary analysis identifies 15 clusters with distinct CD45 immune phenotypes (figure 1). Differential gene expression analysis by hashtag antibody (treatment group) reveals 14 clusters differentially expressing key genes, including 3 clusters upregulated in DIPG compared to NML, and 2 clusters upregulated in irradiated tumors compared to SHAM and NML (figure 2). Notably, analysis demonstrates an individual cluster upregulated in FLASH versus all other groups (p = 3.07E-171). Further deconvolution of specific immune phenotypes represented by each cluster is ongoing.

Abstract 91 Figure 1

tSNE plot based on clustering of RNA signatures, grouped by RNA

Abstract 91 Figure 2

tSNE plot based on clustering of RNA signatures, grouped by hashtag antibody

Conclusions

Our preliminary analysis shows differential immune responses among DIPG tumors compared to NML. We also find several immune cell subsets that are unique to DIPG treated with CONV or FLASH compared to unirradiated samples. Most notably, we identify a single immune cell subset that is exclusive to FLASH alone, indicating that FLASH elicits a unique immune response in murine DIPG.

Emerging Wake-up Call before next Pandemics as Apart of Medicine and Technology: We terribly need Social and Healthcare Workers

Thousands of healthcare and social workers (HCSW) died or lost their ability to work in their field after Covid pandemics in all three waves, and thousands left their profession due to burnout syndrome. Despite development of vaccines took 6- 18 months and refreshment of old molecules for treatment weeks, many countries paid a very high price for this pandemics not due to lack of medications or ventilator assistance devices but due to the increasing lack of trained HCSW.

Epigenomic features related to microglia are associated with attenuated effect of APOE ε4 on Alzheimer's disease risk in humans

Not all apolipoprotein E (APOE) ε4 carriers who survive to advanced age develop Alzheimer's disease (AD); factors attenuating the risk of ε4 on AD may exist. Guided by the top ε4-attenuating signals from methylome-wide association analyses (N = 572, ε4+ and ε4-) of neurofibrillary tangles and neuritic plaques, we conducted a meta-analysis for pathological AD within the ε4+ subgroups (N = 235) across four independent collections of brains. Cortical RNA-seq and microglial morphology measurements were used in functional analyses. Three out of the four significant CpG dinucleotides were captured by one principal component (PC1), which interacts with ε4 on AD, and is associated with expression of innate immune genes and activated microglia. In ε4 carriers, reduction in each unit of PC1 attenuated the odds of AD by 58% (odds ratio = 2.39, 95% confidence interval = [1.64,3.46], P = 7.08 × 10^-6 ). An epigenomic factor associated with a reduced proportion of activated microglia (epigenomic factor of activated microglia, EFAM) appears to attenuate the risk of ε4 on AD.

Knowledge on Marriage and Reproduction in Islam for Multicultural Healthcare and Social Work Needs: Results of the Survey at Five Public Universities in Slovakia

Objective: The aim of our research was to find out, if university students of humanities and social sciences at five Slovak public universities have theoretical prerequisites for intercultural competencies mainly needed in multicultural healthcare. These concrete theoretical prerequisites are dealing with knowledge regarding Islamic teachings on: family; female infanticide; reproduction; usage of assisted reproduction technologies; and induced abortion. Design: Research study. Participants: Overall 1000 students at 5 Slovak public universities (at each n=200). Methods: Empirical research was done using our own questionnaire. Verification of our three hypotheses has been done using the method of statistical testing for testing hypotheses on equality of parameters of two alternative divisions with large selection ranges. Results: Responses to questions concerning definition of marriage in Islam (Questions #1 - 3) have shown, that both male and female students have proved better knowledge of this issue than in the case of the area concerning possibilities of use of reproductive medicine achievements in Islam. Responses to question (Question #4) regarding Muhammad´s attitude to feminine infanticide have shown that men, in comparison to women, have manifested more radical (more numerous) inclination to the answer that Muhammad entrusted fathers with decision on its performance. Responses to questions dealing with possibilities to use reproductive medicine achievements in Islam (Questions #5-7) have shown that female, in comparison to male students, have manifested more radical (more numerous) rejective position. Conclusion: Knowledge of marriage and reproductive issues in Islam among students stays at historical level, what causes a problem not to be able to understand and respect contemporary needs of Muslim patients in the frame of an holistic approach in multicultural healthcare and social work in Slovakia. Improvements in current curriculum concerning students´ intercultural competencies mainly connected to an understanding of standpoints of Muslim believers concerning their social foundations, health and entire well-being are inevitable.

A cortical immune network map identifies distinct microglial transcriptional programs associated with β-amyloid and Tau pathologies

Microglial dysfunction has been proposed as one of the many cellular mechanisms that can contribute to the development of Alzheimer's disease (AD). Here, using a transcriptional network map of the human frontal cortex, we identify five modules of co-expressed genes related to microglia and assess their role in the neuropathologic features of AD in 540 subjects from two cohort studies of brain aging. Two of these transcriptional programs-modules 113 and 114-relate to the accumulation of β-amyloid, while module 5 relates to tau pathology. We replicate these associations in brain epigenomic data and in two independent datasets. In terms of tau, we propose that module 5, a marker of activated microglia, may lead to tau accumulation and subsequent cognitive decline. We validate our model further by showing that three representative module 5 genes (ACADVL, TRABD, and VASP) encode proteins that are upregulated in activated microglia in AD.

EPIGENOMIC FEATURES RELATED TO MICROGLIA ARE ASSOCIATED WITH ATTENUATED EFFECT OF APOE ε4 ON ALZHEIMER'S DISEASE RISK IN HUMANS

Not all APOE ε4 carriers who survive to advanced age develop Alzheimer's disease (AD); factors attenuating the risk of ε4 on AD may exist. Guided by the top ε4-attenuating signals from methylome-wide association analyses (N=572, ε4+ and ε4-) of neurofibrillary tangles and neuritic plaques, we conducted a meta-analysis for pathological AD within the ε4+ subgroups (N=235) across four independent collections of brains. Cortical RNA-seq and microglial morphology measurements were used in functional analyses. Three out of the four significant CpG dinucleotides were captured by one principle component (PC1), which interacts with ε4 on AD, and is associated with expression of innate immune genes and activated microglia. In ε4 carriers, reduction in each unit of PC1 attenuated the odds of AD by 58% (OR=2.39, 95%CI=[1.64,3.46], P=7.08x10^-6). An epigenomic factor associated with a reduced proportion of activated microglia (microglial epigenomic factor 1) appears to attenuate the risk of ε4 on AD.

Single cell RNA sequencing of human microglia uncovers a subset associated with Alzheimer's disease

The extent of microglial heterogeneity in humans remains a central yet poorly explored question in light of the development of therapies targeting this cell type. Here, we investigate the population structure of live microglia purified from human cerebral cortex samples obtained at autopsy and during neurosurgical procedures. Using single cell RNA sequencing, we find that some subsets are enriched for disease-related genes and RNA signatures. We confirm the presence of four of these microglial subpopulations histologically and illustrate the utility of our data by characterizing further microglial cluster 7, enriched for genes depleted in the cortex of individuals with Alzheimer's disease (AD). Histologically, these cluster 7 microglia are reduced in frequency in AD tissue, and we validate this observation in an independent set of single nucleus data. Thus, our live human microglia identify a range of subtypes, and we prioritize one of these as being altered in AD.

BIN1 protein isoforms are differentially expressed in astrocytes, neurons, and microglia: neuronal and astrocyte BIN1 are implicated in tau pathology

BACKGROUND

Identified as an Alzheimer's disease (AD) susceptibility gene by genome wide-association studies, BIN1 has 10 isoforms that are expressed in the Central Nervous System (CNS). The distribution of these isoforms in different cell types, as well as their role in AD pathology still remains unclear.

METHODS

Utilizing antibodies targeting specific BIN1 epitopes in human post-mortem tissue and analyzing mRNA expression data from purified microglia, we identified three isoforms expressed in neurons and astrocytes (isoforms 1, 2 and 3) and four isoforms expressed in microglia (isoforms 6, 9, 10 and 12). The abundance of selected peptides, which correspond to groups of BIN1 protein isoforms, was measured in dorsolateral prefrontal cortex, and their relation to neuropathological features of AD was assessed.

RESULTS

Peptides contained in exon 7 of BIN1's N-BAR domain were found to be significantly associated with AD-related traits and, particularly, tau tangles. Decreased expression of BIN1 isoforms containing exon 7 is associated with greater accumulation of tangles and subsequent cognitive decline, with astrocytic rather than neuronal BIN1 being the more likely culprit. These effects are independent of the BIN1 AD risk variant.

CONCLUSIONS

Exploring the molecular mechanisms of specific BIN1 isoforms expressed by astrocytes may open new avenues for modulating the accumulation of Tau pathology in AD.

Sleep fragmentation, microglial aging, and cognitive impairment in adults with and without Alzheimer's dementia

Sleep disruption is associated with cognitive decline and dementia in older adults; however, the underlying mechanisms are unclear. In rodents, sleep disruption causes microglial activation, inhibition of which improves cognition. However, data from humans are lacking. We studied participants in two cohort studies of older persons-the Rush Memory and Aging Project and the Religious Orders Study. We assessed sleep fragmentation by actigraphy and related this to cognitive function, to neocortical microglial marker gene expression measured by RNA sequencing, and to the neocortical density of microglia assessed by immunohistochemistry. Greater sleep fragmentation was associated with higher neocortical expression of genes characteristic of aged microglia, and a higher proportion of morphologically activated microglia, independent of chronological age- and dementia-related neuropathologies. Furthermore, these were, in turn, associated with worse cognition. This suggests that sleep fragmentation is accompanied by accelerated microglial aging and activation, which may partially underlie its association with cognitive impairment.

Chi3l3 induces oligodendrogenesis in an experimental model of autoimmune neuroinflammation

In demyelinating diseases including multiple sclerosis (MS), neural stem cells (NSCs) can replace damaged oligodendrocytes if the local microenvironment supports the required differentiation process. Although chitinase-like proteins (CLPs) form part of this microenvironment, their function in this differentiation process is unknown. Here, we demonstrate that murine Chitinase 3-like-3 (Chi3l3/Ym1), human Chi3L1 and Chit1 induce oligodendrogenesis. In mice, Chi3l3 is highly expressed in the subventricular zone, a stem cell niche of the adult brain, and in inflammatory brain lesions during experimental autoimmune encephalomyelitis (EAE). We find that silencing Chi3l3 increases severity of EAE. We present evidence that in NSCs Chi3l3 activates the epidermal growth factor receptor (EGFR), thereby inducing Pyk2-and Erk1/2- dependent expression of a pro-oligodendrogenic transcription factor signature. Our results implicate CLP-EGFR-Pyk2-MEK-ERK as a key intrinsic pathway controlling oligodendrogenesis.

A human microglia-like cellular model for assessing the effects of neurodegenerative disease gene variants

Microglia are emerging as a key cell type in neurodegenerative diseases, yet human microglia are challenging to study in vitro. We developed an in vitro cell model system composed of human monocyte-derived microglia-like (MDMi) cells that recapitulated key aspects of microglia phenotype and function. We then used this model system to perform an expression quantitative trait locus (eQTL) study examining 94 genes from loci associated with Alzheimer's disease, Parkinson's disease, and multiple sclerosis. We found six loci (CD33, PILRB, NUP160, LRRK2, RGS1, and METTL21B) in which the risk haplotype drives the association with both disease susceptibility and altered expression of a nearby gene (cis-eQTL). In the PILRB and LRRK2 loci, the cis-eQTL was found in the MDMi cells but not in human peripheral blood monocytes, suggesting that differentiation of monocytes into microglia-like cells led to the acquisition of a cellular state that could reveal the functional consequences of certain genetic variants. We further validated the effect of risk haplotypes at the protein level for PILRB and CD33, and we confirmed that the CD33 risk haplotype altered phagocytosis by the MDMi cells. We propose that increased LRRK2 gene expression by MDMi cells could be a functional outcome of rs76904798, a single-nucleotide polymorphism in the LRKK2 locus that is associated with Parkinson's disease.