Cathepsin D Deficiency - Molecular and Cellular Mechanisms of Neurodegeneration

Cathepsin D (CTSD) is a lysosomal protease, the deficiency of which is fatal and associated with neurodegeneration. CTSD knock-out mice, which die at the age of four weeks, show intestinal necrosis, loss of lymphoid cells and moderate pathological changes in the brain. An active-site mutation in the CTSD gene underlies a neurodegenerative disease in newborn sheep, characterized by brain atrophy without any changes to visceral tissues. The CTSD deficiences belong to the group of neuronal ceroid-lipofuscinoses (NCLs), severe neurodegenerative lysosomal storage disorders. The aim of this thesis was to examine the molecular and cellular mechanisms behind neurodegeneration in CTSD deficiency. We found the developmental expression pattern of CTSD to resemble that of synaptophysin and the increasing expression of CTSD to coincide with the active period of myelination in the rat brain, suggesting a role for CTSD in early rat brain development. An active-site mutation underlying the congenital ovine NCL not only affected enzymatic activity, but also changed the stability, processing and transport of the mutant protein, possibly contributing to the disease pathogenesis. We also provide CTSD deficiency as a first molecular explanation for human congenital NCL, a lysosomal storage disorder, characterized by neuronal loss and demyelination in the central nervous system. Finally, we show the first evidence for synaptic abnormalities and thalamocortical changes in CTSD-deficient mice at the molecular and ultrastructural levels. Keywords: cathepsin D, congenital, cortex, lysosomal storage disorder, lysosome, mutation, neurodegeneration, neuronal ceroid-lipofuscinosis, overexpression, synapse, thalamus

Vitamin D deficiency in children with chronic illnesses: Predisposing and protecting factors

This thesis assesses clinical differences in patients with low and high vitamin D levels. The factors analyzed included the underlying disease, body size, age, ethnic background, use of vitamin D supplements and the season when the blood sample was taken. Fifty patients with the lowest and 50 patients with the highest vitamin D concentrations were selected from a cohort of 1351 chronically ill children and adolescents who had had their vitamin D status assessed at Children's Hospital. Protective factors appeared to be the usage of vitamin D supplements and young age, especially age <2 years. Predisposing factors included non-Finnish ethnic background and older age, especially age 12-18 years. High vitamin D values were more prevalent in the summer and autumn and low values in the winter and spring. Patients with non-Finnish background were overrepresented in the low value group. No differences regarding the underlying diseases could be detected. Conclusions: In the Northern latitudes UVB-radiation is insufficient for vitamin D synthesis. Vitamin D recommendations appear to be inadequate to fulfill the needs of chronically ill patients whose requirements for vitamin D are elevated compared to the general population. New guidelines for vitamin D supplementation are needed particularly for those at risk of developing vitamin D deficiency.

Cholesterol Disturbances in Inherited Neurodegenerative Diseases : Studies on Npc1, Ppt1 and Ctsd deficient mice

The central nervous system (CNS) is the most cholesterol-rich organ in the body. Cholesterol is essential to CNS functions such as synaptogenesis and formation of myelin. Significant differences exist in cholesterol metabolism between the CNS and the peripheral organs. However, the regulation of cholesterol metabolism in the CNS is poorly understood compared to our knowledge of the regulation of cholesterol homeostasis in organs reached by cholesterol-carrying lipoprotein particles in the circulation. Defects in CNS cholesterol homeostasis have been linked to a variety of neurodegenerative diseases, including common diseases with complex pathogenetic mechanisms such as Alzheimer s disease. In spite of intense effort, the mechanisms which link disturbed cholesterol homeostasis to these diseases remain elusive. We used three inherited recessive neurodegenerative disorders as models in the studies included in this thesis: Niemann-Pick type C (NPC), infantile neuronal ceroid lipofuscinosis and cathepsin D deficiency. Of these three, NPC has previously been linked to disturbed intracellular cholesterol metabolism. Elucidating the mechanisms with which disturbances of cholesterol homeostasis link to neurodegeneration in recessive inherited disorders with known genetic lesions should shed light on how cholesterol is handled in the healthy CNS and help to understand how these and more complex diseases develop. In the first study we analyzed the synthesis of sterols and the assembly and secretion of lipoprotein particles in Npc1 deficient primary astrocytes. We found that both wild type and Npc1 deficient astrocytes retain significant amounts of desmosterol and other cholesterol precursor sterols as membrane constituents. No difference was observed in the synthesis of sterols and the secretion of newly synthesized sterols between Npc1 wild type, heterozygote or knockout astrocytes. We found that the incorporation of newly synthesized sterols into secreted lipoprotein particles was not inhibited by Npc1 mutation, and the lipoprotein particles were similar to those excreted by wild type astrocytes in shape and size. The bulk of cholesterol was found to be secreted independently of secreted NPC2. These observations demonstrate the ability of Npc1 deficient astrocytes to handle de novo sterols, and highlight the unique sterol composition in the developing brain. Infantile neuronal ceroid lipofuscinosis is caused by the deficiency of a functional Ppt1 enzyme in the cells. In the second study, global gene expression studies of approximately 14000 mouse genes showed significant changes in the expression of 135 genes in Ppt1 deficient neurons compared to wild type. Several genes encoding for enzymes of the mevalonate pathway of cholesterol biosynthesis showed increased expression. As predicted by the expression data, sterol biosynthesis was found to be upregulated in the knockout neurons. These data link Ppt1 deficiency to disturbed cholesterol metabolism in CNS neurons. In the third study we investigated the effect of cathepsin D deficiency on the structure of myelin and lipid homeostasis in the brain. Our proteomics data, immunohistochemistry and western blotting data showed altered levels of the myelin protein components myelin basic protein, proteolipid protein and 2 , 3 -cyclic nucleotide 3 phosphodiesterase in the brains of cathepsin D deficient mice. Electron microscopy revealed altered myelin structure in cathepsin D deficient brains. Additionally, plasmalogen-derived alkenyl chains and 20- and 24-carbon saturated and monounsaturated fatty acids typical for glycosphingolipids were found to be significantly reduced, but polyunsaturated species were significantly increased in the knockout brains, pointing to a decrease in white matter. The levels of ApoE and ABCA1 proteins linked to cholesterol efflux in the CNS were found to be altered in the brains of cathepsin D deficient mice, along with an accumulation of cholesteryl esters and a decrease in triglycerols. Together these data demonstrate altered myelin architecture in cathepsin D deficient mice and link cathepsin D deficiency to aberrant cholesterol metabolism and trafficking. Basic research into rare monogenic diseases sheds light on the underlying biological processes which are perturbed in these conditions and contributes to our understanding of the physiological function of healthy cells. Eventually, understanding gained from the study of disease models may contribute towards establishing treatment for these disorders and further our understanding of the pathogenesis of other, more complex and common diseases.

Bone Health in Children and Adolescents with Juvenile Idiopathic Arthritis and Solid Organ Transplant

Osteoporosis is a skeletal disorder characterized by compromised bone strength that predisposes to increased fracture risk. Childhood and adolescence are critical periods for bone mass gain. Peak bone mass is mostly acquired by the age of 18 years and is an important determinant of adult bone health and lifetime risk for fractures. Medications, especially glucocorticoids (GCs), chronic inflammation, decreased physical activity, hormonal deficiencies, delayed puberty, and poor nutrition may predispose children and adolescents with a chronic disease to impaired bone health. In this work, we studied overall bone health, the incidence and prevalence of fractures in children and adolescents who were treated for juvenile idiopathic arthritis (JIA) or had undergone solid organ transplantation. The first study cohort included 62 patients diagnosed with JIA and treated with GCs. The epidemiology of fractures after transplantation was investigated in 196 patients and a more detailed analysis of bone health determinants was performed on 40 liver (LTx) and 106 renal (RTx) transplantation patients. Bone mineral density (BMD) and vertebral morphology were assessed by dual-energy x-ray absorptiometry. Standard radiographs were obtained to detect vertebral fractures and to determine bone age; BMD values were adjusted for skeletal maturity. Our study showed that median BMD values were subnormal in all patient cohorts. The values were highest in patients with JIA and lowest in patients with LTx. Age at transplantation influenced BMD values in LTx but not RTx patients; BMD values were higher in patients who had LTx before the age of two years. BMD was lowest during the immediate posttransplantation years and increased subnormally during puberty. Delayed skeletal maturation was common in all patient groups. The prevalence of vertebral fractures ranged from 10% to 19% in the cohorts. Most of the fractures were asymptomatic and diagnosed only at screening. Vertebral fractures were most common in LTx patients. Vitamin D deficiency was common in all patient groups, and only 3% of patients with JIA and 25% of transplantation patients were considered to have adequate serum vitamin D levels. The total cumulative weight-adjusted dose of GC was not associated with BMD values in JIA or LTx patients. The combination of female gender and age over 15 years, parathyroid hormone concentration over 100 ng/L, and cumulative weight-adjusted methylprednisolone dose over 150 mg/kg during the three preceding years were found to be important predictors for low lumbar spine BMD in RTx patients. Based on the high prevalence of osteoporosis in the study cohorts more efforts should be put to prevention and early diagnosis of osteoporosis in these pediatric patients.

Parathyroid hormone as an outcome indicator in old age

Serum parathyroid hormone (PTH) and vitamin D are the major regulators of extracellular calcium homeostasis. The inverse association between PTH and vitamin D and the common age-related elevation of the PTH concentration are well known phenomena. However, the confounding or modifying factors of this relationship and their impact on the response of PTH levels to vitamin D supplementation need further investigation. Clinical conditions such as primary hyperparathyroidism (PHPT), renal failure and vitamin D deficiency, characterized by an elevation of the PTH concentration, have been associated with impaired long-term health outcomes. Curative treatments for these conditions have also been shown to decreases PTH concentration and attenuate some of the adverse health effects. In PHPT it has also been commonly held that hypercalcaemia, the other hallmark of the disease, is the key mediator of the adverse health outcomes. In chronic kidney disease the systemic vascular disease has been proposed to have the most important impact on general health. Some evidence also indicates that vitamin D may have significant extraskeletal actions. However, the frank elevation of PTH concentration seen in advanced PHPT and in end-stage renal failure have also been suggested to be at least partly causally related to an increased risk of death as well as cognitive dysfunction. However, the exact mechanisms have remained unclear. Furthermore, the predictive value of elevated PTH in unselected older populations has been less well studied. The studies presented in this thesis investigated the impact of age and mobility on the responses of PTH levels to vitamin D deficiency and supplementation. Furthermore, the predictive value of PTH for long-term survival and cognitive decline was addressed in an unselected population of older people. The hypothesis was that age and chronic immobility are related to a persistently blunted elevation of PTH concentration, even in the presence of chronic vitamin D deficiency, and to attenuated responses of PTH to vitamin D supplementation. It was also further hypothesized that a slightly elevated or even high-normal PTH concentration is an independent indicator of an increased risk of death and cognitive decline in the general aged population. The data of this thesis are based on three samples: a meta-analysis of published vitamin D supplementation trials, a randomized placebo controlled six-month vitamin D supplementation trial, and a longitudinal prospective cohort study on a general aged population. Based on a PubMed search, a meta-analysis of 52 clinical trials with 6 290 adult participants was performed to evaluate the impact of age and immobility on the responses of PTH to 25-OHD levels and vitamin D supplementation. A total of 218 chronically immobile, very old inpatients were also enrolled into a vitamin D supplementation trial. Mortality data for these patients was also collected after a two-year follow-up. Finally, data from the Helsinki Aging Study, which followed three random age cohorts (75, 80 and 85 years) until death in almost all subjects, was used to evaluate the predictive value of PTH for long-term survival and cognitive decline. This series of studies demonstrated that in older people without overt renal failure or severe hypercalcaemia, serum 25-OHD and PTH were closely associated, but this relationship was also affected by age and immobility. Furthermore, a substantial proportion of old chronically bedridden patients did not respond to vitamin D deficiency by elevating PTH, and the effect of a high-dose (1200 IU/d) six-month cholecalciferol supplementation on the PTH concentration was minor. This study demonstrated longitudinally for the first time that the blunted PTH also persisted over time. Even a subtle elevation of PTH to high-normal levels predicted impaired long-term health outcomes. Slightly elevated PTH concentrations indicated an increased risk of clinically significant cognitive decline and death during the last years of life in a general aged population. This association was also independent of serum ionized calcium (Ca2+) and the estimated glomerular filtration rate (GFR). A slightly elevated PTH also indicated impaired two-year survival during the terminal years of frail elderly subjects independently of Ca2+, GFR, and of 25-OHD levels. The interplay between PTH and vitamin D in the regulation of calcium homeostasis is more complex than has been generally considered. In addition to muskuloskeletal health parathyroid hormone is also related to the maintenance of other important domains of health in old age. Higher PTH concentrations, even within conventional laboratory reference ranges, seem to be an independent indicator of an increased risk of all-cause and of cardiovascular mortality, independently of established cardiovascular risk factors, disturbances in mineral metabolism, and renal failure. Limited and inconsistent evidence supports the role of vitamin D deficiency-related lack of neuroprotective effects over the causal association between PTH and impaired cognitive functions. However, the causality of these associations remains unclear. The clinical implications of the observed relationships remain to be elucidated by future studies interfering with PTH concentrations, especially by long-term interventions to reduce PTH.

L'ecfrasis nel Piacere di Gabriele D'Annunzio

Tutkielman aiheena on ekfrasis Gabriele D'Annunzion romaanissa Il Piacere (1889). Lähtökohtana on selvittää, millaisissa muodoissa ekfrasis esiintyy romaanissa sekä miten ekfrasis vaikuttaa teoksen tulkintatradition esille tuomaan tematiikkaan. Pyrkimyksenä on myös selkeyttää ekfrasiksen käsitettä, jonka ongelmana ovat sanaan eri aikakausina liitetyt eri merkitykset. Tärkeimpiä lähdeteoksia ovat James A.W. Heffernanin Museum of Words (1993) ja W.J.T. Mitchellin Picture Theory (1994), Marinella Cantelmon Il Piacere dei leggitori: D'Annunzio e la comunicazione letteraria (1996) sekä John Hollanderin artikkeli "The Poetics of Ekphrasis" (1988). Tutkielman avainkäsitteenä on Heffernanin määritelmä, jonka mukaan ekfrasis on sanallinen esitys kuvallisesta esityksestä. Määritelmää sovellettaessa on otettu huomioon representaatiokäsityksen avautuminen, jolloin vastaanottaja, ympäristö etc. ovat osa esitystä. Korpuksen muodostavat tapahtumaympäristöä, taideteoksia, esineistöä ja henkilöhahmoja kuvaavat ekfrastiset katkelmat. Luokittelussa toimivat alakäsitteinä Valerie Robillardin kuvaileva, attributiivinen ja assosiatiivinen ekfrasis sekä Tamar Yacobin ekfrastinen vertaus. Analyysi osoittaa, että kuvaileva ekfrasis on yleisin, mutta vain kuvitteellisten teosten yhteydessä. Katkelmissa on näkyvissä ekfrasikselle luonteenomainen kerronnallinen impulssi. Ekfrasis osallistuu tunnetun ja uuden elementin vuoropuheluun ankkuroimalla kuvitteelliset taideteokset lukijalle tuttuun ympäristöön, jolloin myös uusi tulee toden kaltaiseksi. Attributiivinen ekfrasis takaa välittömän tunnistettavuuden. Henkilöhahmot, erityisesti keskeiset naishahmot, on määritelty ekfrastisten vertausten kautta. Ekfrasis ilmentää osaltaan naishahmojen vaihdettavuuden tematiikkaa. Kyseessä on myös toiseuden haltuunotto. Kuvallisen viittaussuhteen ansiosta ekfrasis toimii tehokeinona. Tekstuaalisena strategiana ekfrasis luo siteitä tapahtumien välille ja rytmittää teoksen vaiheita. Ekfrastiset katkelmat tarjoavat myös väylän vaihtoehtoiselle tulkinnalle haastamalla tekstin totuuskäsityksen. Kuvallinen ja sanallinen esitys tuovat tekstiin omat merkityksensä, jolloin merkityskenttä laajenee. Il Piacere on intertekstuaalinen kollaasi, jossa kokonaiskuva muodostuu eri elementtien vuorovaikutuksesta. D'Annunzion mielestä kauneus on taiteen ensisijainen tarkoitus, ja ekfrasis retorisena keinona on osa pyrkimystä tavoittaa täydellinen muoto.

Le processus de travail d'une correspondante: une étude observationnelle

Pro gradu -tutkielman aiheena on kirjeenvaihtajan työprosessi. Tutkielma kuuluu kääntämisen sosiologian piiriin. Tutkimuksen kohteena oli Helsingin Sanomien Pariisin-kirjeenvaihtaja Minna Nalbantoglu, jonka työskentelyä tutkielman tekijä havainnoi Pariisissa viiden päivän ajan syyskuussa 2006. Tutkimuksen päämetodina oli tapaustutkimus, jonka lisäksi tutkimuksessa käytettiin metodina haastattelua ja havainnointia sekä dokumenttien, tallenteiden ja työnäytteiden analysointia. Tutkimuksen aineisto muodostui havaintomuistiinpanoista, kirjeenvaihtajan haastattelusta, ääneenajatteluprotokollista, haastattelunauhoista, kirjeenvaihtajan tuottamista artikkeleista, kirjeenvaihtajan käyttämistä lähteistä ja juttupäiväkirjoista. Tutkielman tarkoituksena oli muodostaa kokonaiskuva kirjeenvaihtajan työprosessista. Tavoitteena oli vastata seuraavin kysymyksiin: 1) Miten ja millä kriteereillä kirjeenvaihtaja valitsee Helsingin Sanomien lukijoille välitettävät uutiset? 2) Miten uutinen tuotetaan? 3) Minkälaista kääntämistä tai käännöseditointia (transediting) kirjeenvaihtajan työssä esiintyy? Tutkimustulokset on analysoitu viiden käsitteen avulla, jotka ovat uutiskriteerit, uutisen tuottamisprosessi, kääntäminen, käännöseditointi ja portinvartiointi (gatekeeping). Ensimmäiseen tutkimuskysymykseen vastattiin analysoimalla kirjeenvaihtajan tutkimusviikon aikana tuottamia artikkeleita Johan Galtungin ja Mari Holmboe Rugen (1965) klassisten uutiskriteerien avulla, joita täydennettiin Judy McGregorin (2002) päivitetyillä uutiskriteereillä. Toiseen tutkimuskysymykseen vastattiin kuvailemalla uutisten tuottamisprosessia. Samalla selvitettiin, mitä lähteitä kirjeenvaihtaja oli käyttänyt jutuissansa. Kolmatta tutkimuskysymystä varten artikkelit analysoitiin Teun A. van Dijkin (1988) uutisen tuottamisprosessin tutkimista varten kehittämällä mallilla. Van Dijkin mallin avulla määriteltiin, mikä tekstinkäsittelystrategia on kääntämistä ja mitkä käännöseditointia. Analyysin perusteella todettiin, että tekstin tuottamisprosessissa esiintyy myös uuden tekstin luomista ja tuotantoa yksikielisen materiaalin pohjalta. Kääntäminen ja käännöseditointi (Karen Stetting 1989) -käsitteitä pohdittiin ennen analyysia työn teoriaosuudessa. Uutisaiheiden analyysin perusteella todettiin, että mitä enemmän tapahtuma täyttää uutiskriteereitä, sitä todennäköisemmin se valitaan uutiseksi. Niin ikään mitä enemmän tapahtuma täyttää McGregorin päivittämiä uutiskriteereitä, sitä todennäköisemmin se valitaan uutiseksi. Analysoitujen uutisten määrä oli kuitenkin pieni, eikä tuloksia voida pitää kuin suuntaa-antavina. Artikkeleiden lähteenä oli käytetty lähinnä haastatteluita, lehtiartikkeleita ja uutistoimistojen sähkeitä. Muiden lähteiden käyttö oli satunnaista. Lähteiden ja käännösstrategioiden välillä ei havaittu korrelaatiota. Eniten käytetty tekstinkäsittelystrategia oli tiivistäminen. Käännöseditoinnin osuus oli yli puolet artikkeleiden tekstistä (keskiarvo 62 %) ja kääntämisen osuus vain kahdeksan prosenttia. Tutkimuksen perusteella käännöseditointi-käsitteen käyttö on perusteltua puhuttaessa kyseisen kirjeenvaihtajan työstä. Tutkimuksen perusteella on kehitetty uusi portinvartiointimalli, joka pohjautuu van Dijkin uutisen tuottamisprosessimalliin. Mallin avulla voidaan analysoida uutisen tuottamisprosessia ja päätellä, minkä verran kääntämistä ja käännöseditointia työssä esiintyy. Mallia ehdotetaan sovellettavaksi paitsi muiden kirjeenvaihtajien niin myös monikielisen materiaalin parissa työskentelevien toimittajien työn sekä uutiskääntämisen analysointiin.

Nés sous de bons auspices? Etude qualitative de facteurs contribuant à l'acquisition du bilinguisme par les enfants d'un couple mixte

Pro gradu- tutkielmassani tarkastelen suomi-ranska kaksikielisyyden kehittymistä perheissä, joissa vanhemmilla on eri äidinkieli. Työni tavoitteena on ollut tutkia kuinka eri ympäristötekijät vaikuttavat kaksikielisyyden omaksumiseen ja miten perheiden erilainen panostus vähemmistökielen, ts. kielen joka ei esiinny ympäristössä, oppimiseen näkyy saavutetuissa tuloksissa. Tutkimukseeni osallistui 13 perhettä, joilla on 10-12 vuotiaita, ranskaa ja suomea päivittäin käyttäviä lapsia. Lapsia oli yhteensä 18. Voidakseni tarkastella myös kieliympäristön vaikutusta oppimiseen valittiin perheistä kuusi Suomesta ja seitsemän Ranskasta sekä Sveitsin ranskankieliseltä alueelta. Tutkimusmenetelmiini kuului vanhempien haastattelu perheen sosiolingvististen tekijöiden selville saamiseksi ja lasten kanssa keskustelu suullisen kielitaidon arvioimiseksi. Pääpaino kielitaidon arvioinnissa oli kuitenkin kirjallisella tekstillä, jonka lapset tuottivat molemmilla kielillä tekstittömän kirjan kuvien perusteella. Teksteistä suoritettiin virheanalyysit, joissa eri virheet jaettiin ortografisiin, semanttisiin ja kieliopillisiin virheisiin. Jokaiselle lapselle lasketiin myös keskiarvo, joka osoitti kuinka monta sanaa tekstissä oli jokaista virhettä kohti. Näiden keskiarvojen pohjalta tutkittiin yhteneväisyyksiä virhemäärien sekä perheiden sosiolingvististen tekijöiden kesken. Yhteenvedossa verrattiin myös tuloksia teoriaosassa esitettyihin kielitieteilijöiden tarjoamiin periaatteisiin. Tutkielman perusteella voidaan todeta, että ympäristön vaikutus näytetään usein aliarvioitaneen kaksikielisyyttä koskevissa teoksissa. Hyvään kielitaitoon vähemmistökielessä tarvitaan enemmän kuin yksi kieli - yksi henkilö menetelmä, jossa vanhemmat puhuvat lapselle omaa äidinkieltään. Hyviksi vahvistuskeinoiksi havaittiin varsinkin kaksikielinen koulu sekä useat vierailut toisen vanhemman kotimaahan. Varsinkin perheen nuorimpien lasten vähemmistökielen oppimiseen tulisi panostaa sillä näillä on syntymästään asti mahdollisuus käyttää enemmistökieltä myös vanhempien sisarusten kanssa. Kieliympäristön vaikutuksesta havaittiin, että Suomessa asuvat lapset hallitsivat yleisesti ottaen paremmin vähemmistökielensä kuin Ranskassa asuvat. Tähän pidettiin syynä ranskalais-suomalaisen koulun positiivista vaikutusta kielen oppimiselle sekä ranskankielen arvostettua asemaa Suomessa. Avainsanat: Kaksikielisyys, kieltenoppiminen, bilinguisme, acquisition des langues, couple mixte

Identification of two novel human neuronal ceroid lipofuscinosis genes

The neuronal ceroid lipofuscinoses (NCLs) are a group of mostly autosomal recessively inherited neurodegenerative disorders. The aim of this thesis was to characterize the molecular genetic bases of these, previously genetically undetermined, NCL forms. Congenital NCL is the most aggressive form of NCLs. Previously, a mutation in the cathepsin D (CTSD) gene was shown to cause congenital NCL in sheep. Based on the close resemblance of the phenotypes between congenital NCLs in sheep and human, CTSD was considered as a potential candidate gene in humans as well. When screened for mutations by sequencing, a homozygous nucleotide duplication creating a premature stop codon was identified in CTSD in one family with congenital NCL. While in vitro the overexpressed truncated mutant protein was stable although inactive, the absence of CTSD staining in brain tissue samples of patients indicated degradation of the mutant CTSD in vivo. A lack of CTSD staining was detected also in another, unrelated family with congenital NCL. These results imply that CTSD deficiency underlies congenital NCL. While initially Turkish vLINCL was considered a distinct genetic entity (CLN7), mutations in the CLN8 gene were later reported to account for the disease in a subset of Turkish patients with vLINCL. To further dissect the genetic basis of the disease, all known NCL genes were screened for homozygosity by haplotype analysis of microsatellite markers and/or sequenced in 13 mainly consanguineous, Turkish vLINCL families. Two novel, family-specific homozygous mutations were identified in the CLN6 gene. In the remaining families, all known NCL loci were excluded. To identify novel gene(s) underlying vLINCL, a genomewide single nucleotide polymorphism scan, homozygosity mapping, and positional candidate gene sequencing were performed in ten of these families. On chromosome 4q28.1-q28.2, a novel major facilitator superfamily domain containing 8 (MFSD8) gene with six family-specific homozygous mutations in vLINCL patients was identified. MFSD8 transcript was shown to be ubiquitously expressed with a complex pattern of alternative splicing. Our results suggest that MFSD8 is a novel lysosomal integral membrane protein which, as a member of the major facilitator superfamily, is predicted to function as a transporter. Identification of MFSD8 emphasizes the genetic heterogeneity of Turkish vLINCL. In families where no MFSD8 mutations were detected, additional NCL-causing genes remain to be identified. The identification of CTSD and MFSD8 increases the number of known human NCL-causing genes to eight, and is an important step towards the complete understanding of the genetic spectrum underlying NCLs. In addition, it is a starting point for dissecting the molecular mechanisms behind the associated NCLs and contributes to the challenging task of understanding the molecular pathology underlying the group of NCL disorders.

Molecular mechanisms of cancer predisposition in HNPCC/Lynch syndrome

Hereditary non-polyposis colorectal carcinoma (HNPCC; Lynch syndrome) is among the most common hereditary cancers in man and a model of cancers arising through deficient DNA mismatch repair (MMR). It is inherited in a dominant manner with predisposing germline mutations in the MMR genes, mainly MLH1, MSH2, MSH6 and PMS2. Both copies of the MMR gene need to be inactivated for cancer development. Since Lynch syndrome family members are born with one defective copy of one of the MMR genes in their germline, they only need to acquire a so called second hit to inactivate the MMR gene. Hence, they usually develop cancer at an early age. MMR gene inactivation leads to accumulation of mutations particularly in short repeat tracts, known as microsatellites, causing microsatellite instability (MSI). MSI is the hallmark of Lynch syndrome tumors, but is present in approximately 15% of sporadic tumors as well. There are several possible mechanisms of somatic inactivation (i.e. the second hit ) of MMR genes, for instance deletion of the wild-type copy, leading to loss of heterozygosity (LOH), methylation of promoter regions necessary for gene transcription, or mitotic recombination or gene conversion. In the Lynch syndrome tumors carrying germline mutations in the MMR gene, LOH was found to be the most frequent mechanism of somatic inactivation in the present study. We also studied MLH1/MSH2 deletion carriers and found that somatic mutations identical to the ones in the germline occurred frequently in colorectal cancers and were also present in extracolonic Lynch syndrome-associated tumors. Chromosome-specific marker analysis implied that gene conversion, rather than mitotic recombination or deletion of the respective gene locus accounted for wild-type inactivation. Lynch syndrome patients are predisposed to certain types of cancers, the most common ones being colorectal, endometrial and gastric cancer. Gastric cancer and uroepithelial tumors of bladder and ureter were observed to be true Lynch syndrome tumors with MMR deficiency as the driving force of tumorigenesis. Brain tumors and kidney carcinoma, on the other hand, were mostly MSS, implying the possibility of alternative routes of tumor development. These results present possible implications in clinical cancer surveillance. In about one-third of families suspected of Lynch syndrome, mutations in MMR genes are not found, and we therefore looked for alternative mechanisms of predisposition. According to our results, large genomic deletions, mainly in MSH2, and germline epimutations in MLH1, together explain a significant fraction of point mutation-negative families suspected of Lynch syndrome and are associated with characteristic clinical and family features. Our findings have important implications in the diagnosis and management of Lynch syndrome families.

Structural analyses of (1->3),(1->4)-β-D-glucan of oats and barley

The structures of (1→3),(1→4)-β-D-glucans of oat bran, whole-grain oats and barley and processed foods were analysed. Various methods of hydrolysis of β-glucan, the content of insoluble fibre of whole grains of oats and barley and the solution behaviour of oat and barley β-glucans were studied. The isolated soluble β-glucans of oat bran and whole-grain oats and barley were hydrolysed with lichenase, an enzyme specific for (1→3),(1→4)-β-D-β-glucans. The amounts of oligosaccharides produced from bran were analysed with capillary electrophoresis and those from whole-grains with high-performance anion-exchange chromatography with pulse-amperometric detection. The main products were 3-O-β-cellobiosyl-D-glucose and 3-O-β-cellotriosyl-D-glucose, the oligosaccharides which have a degree of polymerisation denoted by DP3 and DP4. Small differences were detected between soluble and insoluble β-glucans and also between β-glucans of oats and barley. These differences can only be seen in the DP3:DP4 ratio which was higher for barley than for oat and also higher for insoluble than for soluble β-glucan. A greater proportion of barley β-glucan remained insoluble than of oat β-glucan. The molar masses of soluble β-glucans of oats and barley were the same as were those of insoluble β-glucans of oats and barley. To analyse the effects of cooking, baking, fermentation and drying, β-glucan was isolated from porridge, bread and fermentate and also from their starting materials. More β-glucan was released after cooking and less after baking. Drying decreased the extractability for bread and fermentate but increased it for porridge. Different hydrolysis methods of β-glucan were compared. Acid hydrolysis and the modified AOAC method gave similar results. The results of hydrolysis with lichenase gave higher recoveries than the other two. The combination of lichenase hydrolysis and high-performance anion-exchange chromatography with pulse-amperometric detection was found best for the analysis of β-glucan content. The content of insoluble fibre was higher for barley than for oats and the amount of β-glucan in the insoluble fibre fraction was higher for oats than for barley. The flow properties of both water and aqueous cuoxam solutions of oat and barley β-glucans were studied. Shear thinning was stronger for the water solutions of oat β-glucan than for barley β-glucan. In aqueous cuoxam shear thinning was not observed at the same concentration as in water but only with high concentration solutions. Then the viscosity of barley β-glucan was slightly higher than that of oat β-glucan. The oscillatory measurements showed that the crossover point of the G´ and G´´ curves was much lower for barley β-glucan than for oat β-glucan indicating a higher tendency towards solid-like behaviour for barley β-glucan than for oat β-glucan.

Defining Adequate Vitamin D Intake : Cross-sectional and Intervention Studies

D-vitamiini ylläpitää normaalia luun kasvua ja uudistumista koko elämän ajan. Suomessa, kuten monissa muissakin länsimaissa, väestön D-vitamiinitilanne on riittämätön – talvisin osalla jopa puutteellinen. Tässä väitöskirjassa on tutkittu, lisääkö D-vitamiini luumassan kertymistä kasvuiässä, ja ylläpitäkö D-vitamiini luuston tasapainoista aineenvaihduntaa aikuisiällä. Nämä vaikutukset saattavat ehkäisi osteoporoosin kehittymistä eri ikäkausina. Väitöskirjatyössä tutkittiin erisuuruisten D-vitamiinilisäysten vaikutuksia kolmessa eri ikäryhmässä, jotka olivat 11-12 -vuotiaat tytöt (N=228), 21-49 -vuotiaat miehet (N=54) ja 65-85 -vuotiaat naiset (N=52). Tutkittavat satunnaistettiin ryhmiin, jotka nauttivat joko lumevalmistetta tai 5-20 µg D3-vitamiinia vitamiinilisänä. Tutkimukset olivat kaksoissokkoutettuja. Tutkimuksen aikana tutkittavilta otettiin paastoveri- ja virtsanäytteitä. Lisäksi he täyttivät tutkimuslomakkeen taustatietojen kartoittamiseksi sekä frekvenssikyselylomakkeen kalsiumin ja D-vitamiinin saannin selvittämiseksi. Tyttöjen luunmineraalitiheys (BMD) mitattiin DXA–laitteella ja miesten volumetrinen luuntiheys pQCT-menetelmällä. Näytteistä määritettiin mm. seerumin 25-hydroksi-D-vitamiinin (=S-25-OHD), lisäkilpirauhashormonin (=S-PTH) ja luun aineenvaihduntaa kuvaavien merkkiaineiden pitoisuuksia. Murrosikäisten tyttöjen poikkileikkaustutkimuksessa S-25-OHD- ja luun muodostusmerkkiaineen pitoisuudet vaihtelivat kuukausien välillä; suurimmat pitoisuudet mitattiin syyskuussa ja pienimmät maaliskuussa, mikä kuvastaa vuodenaikaisvaihtelua. Vastaava vaihtelu havaittiin lannerangan ja reisiluun BMD:ssä. D-vitamiinilisäyksellä oli myönteinen vaikutus tyttöjen luumassan lisääntymiseen. Suurin D-vitamiinilisä (10 µg/vrk) lisäsi luumassaa 17.2% enemmän reisiluussa ja 12.5% enemmän lannerangassa verrattuna lumevalmistetta nauttivien tyttöjen vastaaviin tuloksiin, mutta tulos riippui hoitomyöntyvyydestä. D-vitamiinin vaikutus luustoon välittyi vähentyneen luun hajotuksen kautta. Tutkimustuloksiin perustuen riittävä D-vitamiinin saanti murrosikäisille tytöille on 15 µg/vrk. D-vitamiinilisän vaikutus 65-85 -vuotiaiden naisten S-25-OHD-pitoisuuteen vakioitui kuudessa viikossa annoksen ollessa 5-20 µg/vrk. Näillä D-vitamiiniannoksilla ei saavutettu tavoiteltavaa S-25-OHD-pitoisuutta, joka on 80 nmol/l. Arvioimme, että 60 nmol/l -pitoisuuden, jota esiintyy kesäisin tämän ikäryhmän suomalaisilla, tämän ikäryhmän naiset saavuttaisivat 24 µg:n päivittäisellä D-vitamiinin saannilla. Terveillä miehillä havaittiin vuodenaikaisvaihtelu S-25-OHD- ja S-PTH-pitoisuudessa sekä luun hajotusta kuvaavassa merkkiainepitoisuudessa. Toisaalta vaihtelua ei havaittu radiuksen volumetrisessä luuntiheydessä eikä luun muodostusmerkkiaineen pitoisuudessa. Vuodenaikaisvaihtelu estettiin 17 µg:n päivittäisellä D-vitamiinin saannilla, mutta tämän ei havaittu vaikuttavan radiuksen luuntiheyteen kuusi kuukautta kestävän tutkimuksen aikana. Yhteenvetona todetaan, että D-vitamiinin saanti on edelleenkin riittämätöntä tutkimusten kohderyhmillä. Tämä näkyy S-25-OHD- ja PTH-pitoisuuden sekä luunaineenvaihduntaa kuvaavien merkkiaineiden vuodenaikaisvaihteluna, mikä on haitallista luuston hyvinvoinnille. D-vitamiinin saantia tulisi lisätä, jotta vähintäänkin riittävä D-vitamiinitilanne (S-25-OHD>50 nmol/l) tai mahdollisesti jopa tavoiteltava D-vitaminitilanne (S-25-OHD≥80 nmol/l) saavutettaisiin. Jotta D-vitamiinin saannin lisääminen olisi kaikissa ikäryhmissä mahdollista, on suunniteltava nykyistä enemmän D-vitamiinilla täydennettyjä elintarvikkeita.