2nd ESMO Consensus Conference on Lung Cancer: non-small-cell lung cancer first-line/second and further lines of treatment in advanced disease.

To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines of treatment in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on first line/second and further lines of treatment in advanced disease.

Closed loop electrical muscle stimulation in spinal cord injured rehabilitation

The effect of motor training using closed loop controlled Functional Electrical Stimulation (FES) on motor performance was studied in 5 spinal cord injured (SCI) volunteers. The subjects trained 2 to 3 times a week during 2 months on a newly developed rehabilitation robot (MotionMaker?). The FES induced muscle force could be adequately adjusted throughout the programmed exercises by the way of a closed loop control of the stimulation currents. The software of the MotionMaker? allowed spasms to be detected accurately and managed in a way to prevent any harm to the SCI persons. Subjects with incomplete SCI reported an increased proprioceptive awareness for motion and were able to achieve a better voluntary activation of their leg muscles during controlled FES. At the end of the training, the voluntary force of the 4 incomplete SCI patients was found increased by 388% on their most affected leg and by 193% on the other leg. Active mobilisation with controlled FES seems to be effective in improving motor function in SCI persons by increasing the sensory input to neuronal circuits involved in motor control as well as by increasing muscle strength.

Holter implantable: reveal [The implantable loop recorder]

The implantable loop recorder developed by Medtronic (Reveal plus) is a small device inserted subcutaneously under local anesthesia in patients with syncope of unexplained origin. This device enables a single lead-ECG recording and has autonomy of two years. Memories are activated during episodes of bradycardia or tachycardia, either automatically or manually. Several studies have shown a high diagnostic rate reaching 50% and demonstrated its cost-effectiveness. There is also a significant reduction in syncopal episodes and a higher quality of life score in patients with syncope of unexplained origin.

Intracellular thiol-mediated modulation of epithelial sodium channel activity.

The epithelial sodium channel ENaC is physiologically important in the kidney for the regulation of the extracellular fluid volume, and in the lungs for the maintenance of the appropriate airway surface liquid volume that lines the pulmonary epithelium. Besides the regulation of ENaC by hormones, intracellular factors such as Na(+) ions, pH, or Ca(2+) are responsible for fast adaptive responses of ENaC activity to changes in the intracellular milieu. In this study, we show that ENaC is rapidly and reversibly inhibited by internal sulfhydryl-reactive molecules such as methanethiosulfonate derivatives of different sizes, the metal cations Cd(2+) and Zn(2+), or copper(II) phenanthroline, a mild oxidizing agent that promotes the formation of disulfide bonds. At the single channel level, these agents applied intracellularly induce the appearance of long channel closures, suggesting an effect on ENaC gating. The intracellular reducing agent dithiothreitol fully reverses the rundown of ENaC activity in inside-out patches. Our observations suggest that changes in intracellular redox potential modulate ENaC activity and may regulate ENaC-mediated Na(+) transport in epithelia. Finally, substitution experiments reveal that multiple cysteine residues in the amino and carboxyl termini of ENaC subunits are responsible for this thiol-mediated inhibition of ENaC.

Glucagon-like peptide-1 increases beta-cell glucose competence and proliferation by translational induction of insulin-like growth factor-1 receptor expression.

Glucagon-like peptide-1 (GLP-1) protects beta-cells against apoptosis, increases their glucose competence, and induces their proliferation. We previously demonstrated that the anti-apoptotic effect was mediated by an increase in insulin-like growth factor-1 receptor (IGF-1R) expression and signaling, which was dependent on autocrine secretion of insulin-like growth factor 2 (IGF-2). Here, we further investigated how GLP-1 induces IGF-1R expression and whether the IGF-2/IGF-1R autocrine loop is also involved in mediating GLP-1-increase in glucose competence and proliferation. We show that GLP-1 up-regulated IGF-1R expression by a protein kinase A-dependent translational control mechanism, whereas isobutylmethylxanthine, which led to higher intracellular accumulation of cAMP than GLP-1, increased both IGF-1R transcription and translation. We then demonstrated, using MIN6 cells and primary islets, that the glucose competence of these cells was dependent on the level of IGF-1R expression and on IGF-2 secretion. We showed that GLP-1-induced primary beta-cell proliferation was suppressed by Igf-1r gene inactivation and by IGF-2 immunoneutralization or knockdown. Together our data show that regulation of beta-cell number and function by GLP-1 depends on the cAMP/protein kinase A mediated-induction of IGF-1R expression and the increased activity of an IGF-2/IGF-1R autocrine loop.

Intracellular targeting of GLUT4 in transfected insulinoma cells: evidence for association with constitutively recycling vesicles distinct from synaptophysin and insulin vesicles.

In adipocytes and muscle cells, the GLUT4 glucose transporter isoform is present in intracellular vesicles which continuously recycle between an intracytoplasmic location and the plasma membrane. It is not clear whether the GLUT4-vesicles represent a specific kind of vesicle or resemble typical secretory granules or synaptic-like microvesicles. To approach this question, we expressed GLUT4 in the beta cell line RINm5F and determined its intracellular localization by subcellular fractionation and by immunofluorescence and immunoelectron microscopy. GLUT4 was not found in insulin granules but was associated with a subpopulation of smooth-surface vesicles present in the trans-Golgi region and in vesicular structures adjacent to the plasma membrane. In the trans-Golgi region, GLUT4 did not colocalize with synaptophysin or TGN38. Incubation of the cells with horseradish peroxidase (HRP) led to colocalization of HRP and GLUT4 in some endosomal structures adjacent to the plasma membrane and in occasional trans-Golgi region vesicles. When cells were incubated in the presence of Bafilomycin A, analysis by confocal microscopy revealed GLUT4 in numerous large spots present throughout the cytoplasm, many of which costained for TGN38 and synaptophysin. By immunoelectron microscopy, numerous endosomes were observed which stained strongly for GLUT4. Together our data demonstrate that ectopic expression of GLUT4 in insulinoma cells reveals the presence of a subset of vesicular structures distinct from synaptic-like vesicles and insulin secretory granules. Furthermore, they indicate that GLUT4 constitutively recycles between the plasma membrane and its intracellular location by an endocytic route also taken by TGN38 and synaptophysin.

Intracellular trafficking of interleukin-1 receptor I requires Tollip.

Interleukin-1 receptor (IL-1RI) is a master regulator of inflammation and innate immunity. When triggered by IL-1beta, IL-1RI aggregates with IL-1R-associated protein (IL-1RAcP) and forms a membrane proximal signalosome that potently activates downstream signaling cascades. IL-1beta also rapidly triggers endocytosis of IL-1RI. Although internalization of IL-1RI significantly impacts signaling, very little is known about trafficking of IL-1RI and therefore about precisely how endocytosis modulates the overall cellular response to IL-1beta. Upon internalization, activated receptors are often sorted through endosomes and delivered to lysosomes for degradation. This is a highly regulated process that requires ubiquitination of cargo proteins as well as protein-sorting complexes that specifically recognize ubiquitinated cargo. Here, we show that IL-1beta induces ubiquitination of IL-1RI and that via these attached ubiquitin groups, IL-1RI interacts with the ubiquitin-binding protein Tollip. By using an assay to follow trafficking of IL-1RI from the cell surface to late endosomes and lysosomes, we demonstrate that Tollip is required for sorting of IL-1RI at late endosomes. In Tollip-deficient cells and cells expressing only mutated Tollip (incapable of binding IL-1RI and ubiquitin), IL-1RI accumulates on late endosomes and is not efficiently degraded. Furthermore, we show that IL-1RI interacts with Tom1, an ubiquitin-, clathrin-, and Tollip-binding protein, and that Tom1 knockdown also results in the accumulation of IL-1RI at late endosomes. Our findings suggest that Tollip functions as an endosomal adaptor linking IL-1RI, via Tom1, to the endosomal degradation machinery.

Arabidopsis Basic Helix-Loop-Helix Transcription Factors MYC2, MYC3, and MYC4 Regulate Glucosinolate Biosynthesis, Insect Performance, and Feeding Behavior.

Arabidopsis thaliana plants fend off insect attack by constitutive and inducible production of toxic metabolites, such as glucosinolates (GSs). A triple mutant lacking MYC2, MYC3, and MYC4, three basic helix-loop-helix transcription factors that are known to additively control jasmonate-related defense responses, was shown to have a highly reduced expression of GS biosynthesis genes. The myc2 myc3 myc4 (myc234) triple mutant was almost completely devoid of GS and was extremely susceptible to the generalist herbivore Spodoptera littoralis. On the contrary, the specialist Pieris brassicae was unaffected by the presence of GS and preferred to feed on wild-type plants. In addition, lack of GS in myc234 drastically modified S. littoralis feeding behavior. Surprisingly, the expression of MYB factors known to regulate GS biosynthesis genes was not altered in myc234, suggesting that MYC2/MYC3/MYC4 are necessary for direct transcriptional activation of GS biosynthesis genes. To support this, chromatin immunoprecipitation analysis showed that MYC2 binds directly to the promoter of several GS biosynthesis genes in vivo. Furthermore, yeast two-hybrid and pull-down experiments indicated that MYC2/MYC3/MYC4 interact directly with GS-related MYBs. This specific MYC-MYB interaction plays a crucial role in the regulation of defense secondary metabolite production and underlines the importance of GS in shaping plant interactions with adapted and nonadapted herbivores.

Génération d'une souris dépourvue du gène VIT32 de manière conditionnelle: étude du phénotype rénal chez les souris dépourvues de RGS2

Résumé Dans le rein, la vasopressine possède un rôle essentiel dans la régulation fine du transport d'eau et participe au contrôle de la réabsorption du sodium. Cette action est conduite par l'activation du récepteur à la vasopressine V2R situé dans l'anse de Henle, dans le tubule connecteur et dans le canal collecteur du néphron des rongeurs et conduit à la formation d'AMPc entraînant un mécanisme d'action caractérisé par deux phases distinctes. Le premier effet de la vasopressine est non génomique et a lieu rapidement après l'activation du récepteur, la deuxième phase est plus tardive et possède la caractéristique de moduler la transcription d'un réseau de gènes. Parmi ces gènes, plusieurs sont directement impliqués dans le transport d'eau et de sodium, comme l'Aqp2 et 3, ENaC et la Na,K-ATPase. L'identification des effets de la voie de signalisation de la vasopressine représente un point crucial pour la compréhension des mécanismes moléculaires de la réabsorption de l'eau et du sodium dans le néphron. L'analyse en série de l'expression de gènes (SAGE) réalisée en 2001 dans notre laboratoire a permis de caractériser le transcriptome dépendant de la vasopressine dans la lignée cellulaire mpkCCDc14,a dérivée du canal collecteur cortical (CCD) de souris. Deux des transcrits induits par la vasopressine (VIT) ont fait l'objet des études de ce travail de thèse. Le premier est VIT32 (Vasopressin induced transcript 32) qui code pour une protéine ne possédant aucune homologie avec des domaines protéiques dont la fonction est connue. Dans le système d'expression de l'ovocyte de Xenopus laevis, VIT32 induit la maturation des ovocytes et diminue le courant sensible à l'amiloride de manière dépendante de la voie des MAPK. Dans les mpkCCDc14, l'inhibition de la voie des MAPK diminue le courant sodique en diminuant l'activité de la Na,K-ATPase, mais sans modifier le courant d'ENaC. Ainsi la voie de signalisation des MAPK peut avoir des cibles différentes suivant le système dans lequel elle est étudiée. C'est pourquoi nous avons décidé de poursuivre l'étude de VIT32 dans un contexte physiologique en créant une souris dépourvue du gène codant pour VIT32 de manière conditionnelle (conditional knockout). La première partie de cette thèse a donc consisté à générer cette souris. Le deuxième transcrit induit par la vasopressine qui a été étudié dans cette thèse est RGS2 (Regulator of G protein Signaling 2). In vitro, il a été montré que RGS2 inhibe des voies de signalisation dépendantes de récepteurs couplés à des protéines Gq et Gs. Dans notre étude, nous avons montré que dans le néphron de rein de souris, RGS2 est colocalisé avec V2R. In vivo, la vasopressine sécrétée lors d'une restriction en eau imposée à des souris augmente l'expression de RGS2. De plus, l'accumulation d'AMPc engendrée par l'action de la vasopressine sur les canaux collecteurs est significativement plus grande chez les souris dépourvues de RGS2 (rgs2 -/-). Cette induction de la signalisation de la vasopressine est corrélée à une augmentation de la réabsorption d'eau chez les souris rgs2 -/-. Ainsi RGS2 serait impliqué dans le rétrocontrôle négatif de la voie de signalisation de la vasopressine. Abstract In the kidney, vasopressin plays a key role in the control of water balance and participates in salt reabsorption. These actions are induced by the activation of V2 vasopressin receptor (V2R) located in the loop of Henle, in the connecting tubule and in the collecting duct leading to an increase in intracellular cAMP levels. The V2R-mediated vasopressin action elicits a rapid, non-genomic effect, during which water and salt reabsorption is rapidly increased and a late or genomic effect characterised by the long-term regulation of water and salt reabsorption through the transcriptional activation of a gene network that includes Aqp2, Aqp3, ENaC and Na,K-ATPase. Serial analysis of gene expression (SAGE) performed in 2001 in our laboratory characterised the vasopressin induced transcripts (VIT) in the mpkCCDc14 cell line. Two of them are studied in this thesis. The first one is VIT32 (Vasopressin induced transcript 32) that encodes a protein that has no homology with any protein domain of known function. In the Xenopus laevis oocyte, VIT32 induces oocyte maturation and downregulates the ENaC amiloride sensitive current via the activation of the MAPK pathway. In mpkCCDc14 cell line, the MAPK pathway inhibition leads to a decrease of Na,K-ATPase activity without affecting ENaC current. Therefore, the MAPK pathway can act on different targets depending on the cellular context. Thus, we decided to investigate the function of VIT32 in its physiological environment by performing a conditional knockout mouse of VIT32. The first part of this thesis consisted in generating this mouse. The second studied vasopressin induced transcript is RGS2 (Regulator of G protein Signaling 2). In vitro, RGS2 has been shown to inhibit Gq and Gs protein-coupled receptor pathway. In our study we show that RGS2 is co-localized with V2R in the mouse nephron. In vivo, vasopressin secreted during water restriction up-regulates RGS2 expression. Moreover, vasopressin-dependant accumulation of CAMP is significantly increased in the cortical collecting duct of RGS2 knockout mice. This increase is correlated with an increase in water reabsorption. RGS2 could be involved in the negative feedback regulation of V2R signalling. Résumé tout public Le corps humain est composé d'environ 60% d'eau répartie à l'intérieur et à l'extérieur des cellules de notre organisme. Les cellules, unités fondamentales du vivant, puisent l'oxygène et les nutriments indispensables à leur fonctionnement dans le liquide extracellulaire. La composition du milieu doit être constante, car les variations peuvent perturber considérablement et parfois fatalement la fonction des cellules. Ainsi les organismes pluricellulaires ont développé des mécanismes permettant de contrôler la constance du milieu extracellulaire afin de maintenir l'état d'équilibre nommé homéostasie. Le rein joue un rôle majeur dans cette homéostasie grâce à sa capacité de réabsorber l'eau et les solutés en fonction des besoins de l'organisme. Cette fonction du rein est régulée par différentes hormones comme la vasopressine, qui permet de contrôler la réabsorption fine de l'eau et des solutés. Dans leurs membranes, les cellules possèdent des récepteurs leur permettant de répondre aux signaux extracellulaires comme le sont entre autres les hormones. Ainsi les cellules sensibles à la vasopressine possèdent un récepteur nommé V2R qui permet d'intégrer les signaux de la vasopressine en déclenchant tout une cascade d'événements conduisant à une modification de l'expression de certaines protéines impliquées directement ou non dans la réabsorption de l'eau et des solutés. Une étude précédente élaborée au sein de notre laboratoire a permis de répertorier les protéines dont l'expression est augmentée par de la vasopressine. Deux de ces protéines ont fait l'objet des études de cette thèse. La première protéine induite par la vasopressine est VIT32 (Vasopressin induced transcript 32). Cette protéine est entre autres impliquée dans la réabsorption du sodium, mais la fonction précise de VIT32 dans ce transport n'a pas pu être déterminée. Une des approches possibles pour l'étude de la fonction d'une protéine est de supprimer son expression chez la souris et d'étudier les conséquences de son absence. Ces souris sont appelées des souris knockout, puisque la protéine en question ne peut plus agir. La première partie de cette thèse a donc consisté à générer une souris dépourvue du gène de VIT32. La deuxième protéine étudiée est RGS2 (Regulator of G protein Signaling 2). Cette protéine inhibe certaines voies de signalisation activées par différentes hormones. Dans cette partie du travail de thèse, nous avons pu mettre en évidence que RGS2 agit comme un inhibiteur de la voie de signalisation de la vasopressine. En modifiant cette signalisation, RGS2 serait donc un médiateur du contrôle de la réabsorption d'eau dans les cellules du rein sensibles à la vasopressine.

Improving Dynamic Characteristics of Open-loop Controlled Log Crane

The improvement of the dynamics of flexible manipulators like log cranes often requires advanced control methods. This thesis discusses the vibration problems in the cranes used in commercial forestry machines. Two control methods, adaptive filtering and semi-active damping, are presented. The adaptive filter uses a part of the lowest natural frequency of the crane as a filtering frequency. The payload estimation algorithm, filtering of control signal and algorithm for calculation of the lowest natural frequency of the crane are presented. The semi-active damping method is basedon pressure feedback. The pressure vibration, scaled with suitable gain, is added to the control signal of the valve of the lift cylinder to suppress vibrations. The adaptive filter cuts off high frequency impulses coming from the operatorand semi-active damping suppresses the crane?s oscillation, which is often caused by some external disturbance. In field tests performed on the crane, a correctly tuned (25 % tuning) adaptive filter reduced pressure vibration by 14-17 % and semi-active damping correspondingly by 21-43%. Applying of these methods require auxiliary transducers, installed in specific points in the crane, and electronically controlled directional control valves.

Protein loop compaction and the origin of the effect of arginine and glutamic acid mixtures on solubility, stability and transient oligomerization of proteins

Addition of a 50 mM mixture of l-arginine and l-glutamic acid (RE) is extensively used to improve protein solubility and stability, although the origin of the effect is not well understood. We present Small Angle X-ray Scattering (SAXS) and Nuclear Magnetic Resonance (NMR) results showing that RE induces protein compaction by collapsing flexible loops on the protein core. This is suggested to be a general mechanism preventing aggregation and improving resistance to proteases and to originate from the polyelectrolyte nature of RE. Molecular polyelectrolyte mixtures are expected to display long range correlation effects according to dressed interaction site theory. We hypothesize that perturbation of the RE solution by dissolved proteins is proportional to the volume occupied by the protein. As a consequence, loop collapse, minimizing the effective protein volume, is favored in the presence of RE.

2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-small-cell lung cancer.

To complement the existing treatment guidelines for all tumour types, ESMO organises consensus conferences to focus on specific issues in each type of tumour. The 2nd ESMO Consensus Conference on Lung Cancer was held on 11-12 May 2013 in Lugano. A total of 35 experts met to address several questions on non-small-cell lung cancer (NSCLC) in each of four areas: pathology and molecular biomarkers, first-line/second and further lines of treatment in advanced disease, early-stage disease and locally advanced disease. For each question, recommendations were made including reference to the grade of recommendation and level of evidence. This consensus paper focuses on locally advanced disease.