Epithelial Na+ channel mutants causing Liddle's syndrome retain ability to respond to aldosterone and vasopressin.

Liddle's syndrome is a monogenic form of hypertension caused by mutations in the PY motif of the COOH terminus of beta- and gamma-epithelial Na+ channel (ENaC) subunits. These mutations lead to retention of active channels at the cell surface. Because of the critical role of this PY motif in the stability of ENaCs at the cell surface, we have investigated its contribution to the ENaC response to aldosterone and vasopressin. Mutants of the PY motif in beta- and gamma-ENaC subunits (beta-Y618A, beta-P616L, beta-R564stop, and gamma-K570stop) were stably expressed by retroviral gene transfer in a renal cortical collecting duct cell line (mpkCCDcl4), and transepithelial Na+ transport was assessed by measurements of the benzamil-sensitive short-circuit current (Isc). Cells that express ENaC mutants of the PY motif showed a five- to sixfold higher basal Isc compared with control cells and responded to stimulation by aldosterone (10(-6) M) or vasopressin (10(-9) M) with a further increase in Isc. The rates of the initial increases in Isc after aldosterone or vasopressin stimulation were comparable in cells transduced with wild-type and mutant ENaCs, but reversal of the effects of aldosterone and vasopressin was slower in cells that expressed the ENaC mutants. The conserved sensitivity of ENaC mutants to stimulation by aldosterone and vasopressin together with the prolonged activity at the cell surface likely contribute to the increased Na+ absorption in the distal nephron of patients with Liddle's syndrome.

On the cellular site of two-pore channel TPC1 action in the Poaceae.

The slow vacuolar (SV) channel has been characterized in different dicots by patch-clamp recordings. This channel represents the major cation conductance of the largest organelle in most plant cells. Studies with the tpc1-2 mutant of the model dicot plant Arabidopsis thaliana identified the SV channel as the product of the TPC1 gene. By contrast, research on rice and wheat TPC1 suggested that the monocot gene encodes a plasma membrane calcium-permeable channel. To explore the site of action of grass TPC1 channels, we expressed OsTPC1 from rice (Oryza sativa) and TaTPC1 from wheat (Triticum aestivum) in the background of the Arabidopsis tpc1-2 mutant. Cross-species tpc1 complementation and patch-clamping of vacuoles using Arabidopsis and rice tpc1 null mutants documented that both monocot TPC1 genes were capable of rescuing the SV channel deficit. Vacuoles from wild-type rice but not the tpc1 loss-of-function mutant harbor SV channels exhibiting the hallmark properties of dicot TPC1/SV channels. When expressed in human embryonic kidney (HEK293) cells OsTPC1 was targeted to Lysotracker-Red-positive organelles. The finding that the rice TPC1, just like those from the model plant Arabidopsis and even animal cells, is localized and active in lyso-vacuolar membranes associates this cation channel species with endomembrane function.

Structural alterations of the coronary arterial wall are associated with myocardial flow heterogeneity in type 2 diabetes mellitus.

PURPOSE: To determine the relationship between carotid intima-media thickness (IMT), coronary artery calcification (CAC), and myocardial blood flow (MBF) at rest and during vasomotor stress in type 2 diabetes mellitus (DM). METHODS: In 68 individuals, carotid IMT was measured using high-resolution vascular ultrasound, while the presence of CAC was determined with electron beam tomography (EBT). Global and regional MBF was determined in milliliters per gram per minute with (13)N-ammonia and positron emission tomography (PET) at rest, during cold pressor testing (CPT), and during adenosine (ADO) stimulation. RESULTS: There was neither a relationship between carotid IMT and CAC (r = 0.10, p = 0.32) nor between carotid IMT and coronary circulatory function in response to CPT and during ADO (r = -0.18, p = 0.25 and r = 0.10, p = 0.54, respectively). In 33 individuals, EBT detected CAC with a mean Agatston-derived calcium score of 44 +/- 18. There was a significant difference in regional MBFs between territories with and without CAC at rest and during ADO-stimulated hyperemia (0.69 +/- 0.24 vs. 0.74 +/- 0.23 and 1.82 +/- 0.50 vs. 1.95 +/- 0.51 ml/g/min; p < or = 0.05, respectively) and also during CPT in DM but less pronounced (0.81 +/- 0.24 vs. 0.83 +/- 0.23 ml/g/min; p = ns). The increase in CAC was paralleled with a progressive regional decrease in resting as well as in CPT- and ADO-related MBFs (r = -0.36, p < or = 0.014; r = -0.46, p < or = 0.007; and r = -0.33, p < or = 0.041, respectively). CONCLUSIONS: The absence of any correlation between carotid IMT and coronary circulatory function in type 2 DM suggests different features and stages of early atherosclerosis in the peripheral and coronary circulation. PET-measured MBF heterogeneity at rest and during vasomotor stress may reflect downstream fluid dynamic effects of coronary artery disease (CAD)-related early structural alterations of the arterial wall.

Functional expression of a pseudohypoaldosteronism type I mutated epithelial Na+ channel lacking the pore-forming region of its alpha subunit.

The autosomal recessive form of type I pseudohypoaldosteronism (PHA-I) is an inherited salt-losing syndrome resulting from diminution-of-function mutations in the 3 subunits of the epithelial Na+ channel (ENaC). A PHA-I stop mutation (alpha(R508stop)) of the ENaC alpha subunit is predicted to lack the second transmembrane domain and the intracellular COOH-terminus, regions of the protein involved in pore function. Nonetheless, we observed a measurable Na+ current in Xenopus laevis oocytes that coexpress the beta and gamma subunits with the truncated alpha subunit. The mutant alpha was coassembled with beta and gamma subunits and was present at the cell surface at a lower density, consistent with the lower Na+ current seen in oocytes with the truncated alpha subunit. The single-channel Na+ conductance for the mutant channel was only slightly decreased, and the appearance of the macroscopic currents was delayed by 48 hours with respect to wild-type. Our data suggest novel roles for the alpha subunit in the assembly and targeting of an active channel to the cell surface, and suggest that channel pores consisting of only the beta and gamma subunits can provide significant residual activity. This activity may be sufficient to explain the absence of a severe pulmonary phenotype in patients with PHA-I.

Caractéristiques cliniques des leucémies lymphoblastiques aiguës de type T immature (E-rosette négatif) détecté par l'anticorps monoclonal LAU-A1 [Clinical characteristics of immature T-type (negative E-rosette) acute lymphoblastic leukemia detected by LAU-A1 monoclonal antibody]

Immature T-ALL is a newly defined subgroup of ALL in which the blasts lack the receptor for sheep erythrocytes (ER) and the usual T-cell markers, but express the 40 kDa pan-T surface antigen recognized by our monoclonal antibody LAU-A1. Patients with immature T-ALL represent 10% of all cases of adult ALL. Leukocyte counts are lower and spleen, liver and lymph node enlargement is less prominent, but mediastinal enlargement is more frequent than in mature (ER-positive) T-ALL. 7 patients with immature T-ALL (median age 42 years, range 13-73) were treated with intensified chemotherapy regimens, and only one 47-year-old female entered a short-lived complete remission. The overall survival of our patients was poor (median 7.5 months, with only one patient surviving at 15 months) and seemed not to be influenced by age. Our study indicates that immature T-ALL can only be accurately identified by the use of monoclonal antibodies recognizing the 40 kDa pan-T antigen, and that immature T-ALL is a separate disease entity typified by a poor prognosis.

Evolution de la perception de l'activité physique des patients diabétiques de type 2 dans un programme éducatif centré sur l'activité physique (DIAfit).

Objectif: Évaluer la concordance entre l'évolution de la perception des patients diabétiques type 2 et l'évolution de mesures quantifiables, dans le contexte d'un programme d'activité physique adapté. Ce programme se base sur l'accompagnement interdisciplinaire dans un concept éducatif et motivationnel (36 séances d'activité physique et 6-8 h d'atelier). Matériels et méthodes: Évaluation de la perception des patients portant sur : activité physique, condition physique, contrôle métabolique, gestion des corrections hypo/hyperglycémie, autonomisation et bien-être. Nous avons utilisé une cible d'auto-évaluation, composée d'échelles de Likert de 1 à 10 (1 = mauvais 10 = excellent). Concernant la condition physique nous avons mesuré : endurance, vitesse de marche, force, équilibre et souplesse. En fin de programme un questionnaire de satisfaction comprenant 5 items a été distribué. Résultats: Analyse des données de 40 patients, âge 59 ± 10 ans, 60 % femmes. Avant programme, 60 % des patients s'estiment insuffisants (moyenne < 5/10) face à la pratique de l'activité, la condition physique et le contrôle métabolique. Le bien-être se situe en moyenne à 5,4/10. Après programme, 75 % des patients montrent une progression dans tous les domaines (moyenne 7,4/10). Une corrélation positive apparaît entre l'amélioration de la condition physique et le bienêtre. Tous les paramètres physiques mesurés se sont aussi améliorés. L'amélioration de la condition physique perçue est corrélée avec celle de la force (p = 0,006). Le travail interdisciplinaire réalisé a été perçu positivement par 87,9 % des patients. La communication était de bonne qualité pour 78,1 % ainsi que le climat d'apprentissage (82,4 %). La majorité des patients (64,7 %) est très satisfaite du programme. Conclusion: Ce programme est prometteur, il montre l'amélioration de la perception et de la condition physique avec une concordance entre les deux. Cette amélioration laisse imaginer que les plus confiants sur leur capacité à agir puissent s'impliquer d'avantage dans la gestion quotidienne et dans la poursuite d'un projet d'activité.

Basic calcium phosphate crystals induce monocyte/macrophage IL-1(beta) secretion through the NLRP3 inflammasome in vitro.

Basic calcium phosphate (BCP) crystals are associated with severe osteoarthritis and acute periarticular inflammation. Three main forms of BCP crystals have been identified from pathological tissues: octacalcium phosphate, carbonate-substituted apatite, and hydroxyapatite. We investigated the proinflammatory effects of these BCP crystals in vitro with special regard to the involvement of the NLRP3-inflammasome in THP-1 cells, primary human monocytes and macrophages, and mouse bone marrow-derived macrophages (BMDM). THP-1 cells stimulated with BCP crystals produced IL-1β in a dose-dependent manner. Similarly, primary human cells and BMDM from wild-type mice also produced high concentrations of IL-1β after crystal stimulation. THP-1 cells transfected with short hairpin RNA against the components of the NLRP3 inflammasome and mouse BMDM from mice deficient for NLRP3, apoptosis-associated speck-like protein, or caspase-1 did not produce IL-1β after BCP crystal stimulation. BCP crystals induced macrophage apoptosis/necrosis as demonstrated by MTT and flow cytometric analysis. Collectively, these results demonstrate that BCP crystals induce IL-1β secretion through activating the NLRP3 inflammasome. Furthermore, we speculate that IL-1 blockade could be a novel strategy to inhibit BCP-induced inflammation in human disease.

DIAfit, un programme suisse pour promouvoir l'activité physique chez les patients avec diabète de type 2 [DIAfit, a Swiss program encouraging physical activity in patients with type 2 diabetes].

Physical activity has a beneficial effect on the cardiovascular risk and the well-being in patients with type 2 diabetes. Thereby, both aerobic physical activities and resistance activities are recommended. DIAfit is a programm for patients with type 2 diabetes that is being implemented in Switzerland. Its objective is to allow the initiation of a structured physical activity in the setting of a pluridisciplinary team to promote a healthy lifestyle.

Développement d'une puce à ADN métabolique et application à l'étude d'un modèle murin d'obésité et de diabète de type II

Résumé tout public : Le développement du diabète de type II et de l'obésité est causé par l'interaction entre des gènes de susceptibilité et des facteurs environnementaux, en particulier une alimentation riche en calories et une activité physique insuffisante. Afín d'évaluer le rôle de l'alimentation en absence d'hétérogénéité génétique, nous avons nourri une lignée de souris génétiquement pure avec un régime extrêmement gras. Ce régime a conduit à l'établissement de différents phénotypes parmi ces souris, soit : un diabète et une obésité (ObD), un diabète mais pas d'obésité (LD) ou ni un diabète, ni une obésité (LnD). Nous avons fait l'hypothèse que ces adaptations différentes au stress nutritionnel induit par le régime gras étaient dues à l'établissement de programmes génétiques différents dans les principaux organes impliqués dans le maintien de l'équilibre énergétique. Afin d'évaluer cette hypothèse, nous avons développé une puce à ADN contenant approximativement 700 gènes du métabolisme. Cette puce à ADN, en rendant possible la mesure simultanée de l'expression de nombreux gènes, nous a permis d'établir les profils d'expression des gènes caractéristiques de chaque groupe de souris nourries avec le régime gras, dans le foie et le muscle squelettique. Les données que nous avons obtenues à partir de ces profils d'expression ont montré que des changements d'expression marqués se produisaient dans le foie et le muscle entre les différents groupes de souris nourries avec le régime gras. Dans l'ensemble, ces changements suggèrent que l'établissement du diabète de type II et de l'obésité induits par un régime gras est associé à une synthèse accrue de lipides par le foie et à un flux augmenté de lipides du foie jusqu'à la périphérie (muscles squelettiques). Dans un deuxième temps, ces profils d'expression des gènes ont été utilisés pour sélectionner un sous-ensemble de gènes suffisamment discriminants pour pouvoir distinguer entre les différents phénotypes. Ce sous-ensemble de gènes nous a permis de construire un classificateur phénotypique capable de prédire avec une précision relativement élevée le phénotype des souris. Dans le futur, de tels « prédicteurs » basés sur l'expression des gènes pourraient servir d'outils pour le diagnostic de pathologies liées au métabolisme. Summary: Aetiology of obesity and type II diabetes is multifactorial, involving both genetic and environmental factors, such as calory-rich diets or lack of exercice. Genetically homogenous C57BL/6J mice fed a high fat diet (HFD) up to nine months develop differential adaptation, becoming either obese and diabetic (ObD) or remaining lean in the presence (LD) or absence (LnD) of diabetes development. Each phenotype is associated with diverse metabolic alterations, which may result from diverse molecular adaptations of key organs involved in the control of energy homeostasis. In this study, we evaluated if specific patterns of gene expression could be associated with each different phenotype of HFD mice in the liver and the skeletal muscles. To perform this, we constructed a metabolic cDNA microarray containing approximately 700 cDNA representing genes involved in the main metabolic pathways of energy homeostasis. Our data indicate that the development of diet-induced obesity and type II diabetes is linked to some defects in lipid metabolism, involving a preserved hepatic lipogenesis and increased levels of very low density lipoproteins (VLDL). In skeletal muscles, an increase in fatty acids uptake, as suggested by the increased expression of lipoprotein lipase, would contribute to the increased level of insulin resistance observed in the ObD mice. Conversely, both groups of lean mice showed a reduced expression in lipogenic genes, particularly stearoyl-CoA desaturase 1 (Scd-1), a gene linked to sensitivity to diet-induced obesity. Secondly, we identified a subset of genes from expression profiles that classified with relative accuracy the different groups of mice. Such classifiers may be used in the future as diagnostic tools of each metabolic state in each tissue. Résumé Développement d'une puce à ADN métabolique et application à l'étude d'un modèle murin d'obésité et de diabète de type II L'étiologie de l'obésité et du diabète de type II est multifactorielle, impliquant à la fois des facteurs génétiques et environnementaux, tels que des régimes riches en calories ou un manque d'exercice physique. Des souris génétiquement homogènes C57BL/6J nourries avec un régime extrêmement gras (HFD) pendant 9 mois développent une adaptation métabolique différentielle, soit en devenant obèses et diabétiques (ObD), soit en restant minces en présence (LD) ou en absence (LnD) d'un diabète. Chaque phénotype est associé à diverses altérations métaboliques, qui pourraient résulter de diverses adaptations moléculaires des organes impliqués dans le contrôle de l'homéostasie énergétique. Dans cette étude, nous avons évalué si des profils d'expression des gènes dans le foie et le muscle squelettique pouvaient être associés à chacun des phénotypes de souris HFD. Dans ce but, nous avons développé une puce à ADN métabolique contenant approximativement 700 ADNc représentant des gènes impliqués dans les différentes voies métaboliques de l'homéostasie énergétique. Nos données indiquent que le développement de l'obésité et du diabète de type II induit par un régime gras est associé à certains défauts du métabolisme lipidique, impliquant une lipogenèse hépatique préservée et des niveaux de lipoprotéines de très faible densité (VLDL) augmentés. Au niveau du muscle squelettique, une augmentation du captage des acides gras, suggéré par l'expression augmentée de la lipoprotéine lipase, contribuerait à expliquer la résistance à l'insuline plus marquée observée chez les souris ObD. Au contraire, les souris minces ont montré une réduction marquée de l'expression des gènes lipogéniques, en particulier de la stéaroyl-CoA désaturase 1 (scd-1), un gène associé à la sensibilité au développement de l'obésité par un régime gras. Dans un deuxième temps, nous avons identifié un sous-ensemble de gènes à partir des profils d'expression, qui permettent de classifier avec une précision relativement élevée les différents groupes de souris. De tels classificateurs pourraient être utilisés dans le futur comme outils pour le diagnostic de l'état métabolique d'un tissu donné.

A novel dominant mutation of the Nav1.4 alpha-subunit domain I leading to sodium channel myotonia.

BACKGROUND: Mutations in SCN4A may lead to myotonia. METHODS: Presentation of a large family with myotonia, including molecular studies and patch clamp experiments using human embryonic kidney 293 cells expressing wild-type and mutated channels. RESULTS: In a large family with historic data on seven generations and a clear phenotype, including myotonia at movement onset, with worsening by cold temperature, pregnancy, mental stress, and especially after rest after intense physical activity, but without weakness, the phenotype was linked with the muscle sodium channel gene (SCN4A) locus, in which a novel p.I141V mutation was found. This modification is located within the first transmembrane segment of domain I of the Na(v)1.4 alpha subunit, a region where no mutation has been reported so far. Patch clamp experiments revealed a mutation-induced hyperpolarizing shift (-12.9 mV) of the voltage dependence of activation, leading to a significant increase (approximately twofold) of the window current amplitude. In addition, the mutation shifted the voltage dependence of slow inactivation by -8.7 mV and accelerated the entry to this state. CONCLUSIONS: We propose that the gain-of-function alteration in activation leads to the observed myotonic phenotype, whereas the enhanced slow inactivation may prevent depolarization-induced paralysis.

The epithelial sodium channel mediates the directionality of galvanotaxis in human keratinocytes.

Cellular directional migration in an electric field (galvanotaxis) is one of the mechanisms guiding cell movement in embryogenesis and in skin epidermal repair. The epithelial sodium channel (ENaC), in addition to its function of regulating sodium transport in kidney, has recently been found to modulate cell locomotory speed. Here we tested whether ENaC has an additional function of mediating the directional migration of galvanotaxis in keratinocytes. Genetic depletion of ENaC completely blocks only galvanotaxis and does not decrease migration speed. Overexpression of ENaC is sufficient to drive galvanotaxis in otherwise unresponsive cells. Pharmacologic blockade or maintenance of the open state of ENaC also decreases or increases, respectively, galvanotaxis, suggesting that the channel open state is responsible for the response. Stable lamellipodial extensions formed at the cathodal sides of wild-type cells at the start of galvanotaxis; these were absent in the ENaC knockout keratinocytes, suggesting that ENaC mediates galvanotaxis by generating stable lamellipodia that steer cell migration. We provide evidence that ENaC is required for directional migration of keratinocytes in an electric field, supporting a role for ENaC in skin wound healing.

A Heterozygous Deletion Mutation in the Cardiac Sodium Channel Gene SCN5A with Loss- and Gain-of-Function Characteristics Manifests as Isolated Conduction Disease, without Signs of Brugada or Long QT Syndrome.

BACKGROUND: The SCN5A gene encodes for the α-subunit of the cardiac sodium channel NaV1.5, which is responsible for the rapid upstroke of the cardiac action potential. Mutations in this gene may lead to multiple life-threatening disorders of cardiac rhythm or are linked to structural cardiac defects. Here, we characterized a large family with a mutation in SCN5A presenting with an atrioventricular conduction disease and absence of Brugada syndrome. METHOD AND RESULTS: In a large family with a high incidence of sudden cardiac deaths, a heterozygous SCN5A mutation (p.1493delK) with an autosomal dominant inheritance has been identified. Mutation carriers were devoid of any cardiac structural changes. Typical ECG findings were an increased P-wave duration, an AV-block I° and a prolonged QRS duration with an intraventricular conduction delay and no signs for Brugada syndrome. HEK293 cells transfected with 1493delK showed strongly (5-fold) reduced Na(+) currents with altered inactivation kinetics compared to wild-type channels. Immunocytochemical staining demonstrated strongly decreased expression of SCN5A 1493delK in the sarcolemma consistent with an intracellular trafficking defect and thereby a loss-of-function. In addition, SCN5A 1493delK channels that reached cell membrane showed gain-of-function aspects (slowing of the fast inactivation, reduction in the relative fraction of channels that fast inactivate, hastening of the recovery from inactivation). CONCLUSION: In a large family, congregation of a heterozygous SCN5A gene mutation (p.1493delK) predisposes for conduction slowing without evidence for Brugada syndrome due to a predominantly trafficking defect that reduces Na(+) current and depolarization force.