Effects of overweight and obesity on economic outcomes among U.S. adults with kidney disease

Background. Kidney disease is a growing public health phenomenon in the U.S. and in the world. Downstream interventions, dialysis and renal transplants covered by Medicare's renal disease entitlement policy in those who are 65 years and over have been expensive treatments that have been not foolproof. The shortage of kidney donors in the U.S. has grown in the last two decades. Therefore study of upstream events in kidney disease development and progression is justified to prevent the rising prevalence of kidney disease. Previous studies have documented the biological route by which obesity can progress and accelerate kidney disease, but health services literature on quantifying the effects of overweight and obesity on economic outcomes in the context of renal disease were lacking. Objectives . The specific aims of this study were (1) to determine the likelihood of overweight and obesity in renal disease and in three specific adult renal disease sub-populations, hypertensive, diabetic and both hypertensive and diabetic (2) to determine the incremental health service use and spending in overweight and obese renal disease populations and (3) to determine who financed the cost of healthcare for renal disease in overweight and obese adult populations less than 65 years of age. Methods. This study was a retrospective cross-sectional study of renal disease cases pooled for years 2002 to 2009 from the Medical Expenditure Panel Survey. The likelihood of overweight and obesity was estimated using chi-square test. Negative binomial regression and generalized gamma model with log link were used to estimate healthcare utilization and healthcare expenditures for six health event categories. Payments by self/family, public and private insurance were described for overweight and obese kidney disease sub-populations. Results. The likelihood of overweight and obesity was 0.29 and 0.46 among renal disease and obesity was common in hypertensive and diabetic renal disease population. Among obese renal disease population, negative binomial regression estimates of healthcare utilization per person per year as compared to normal weight renal disease persons were significant for office-based provider visits and agency home health visits respectively (p=0.001; p=0.005). Among overweight kidney disease population health service use was significant for inpatient hospital discharges (p=0.027). Over years 2002 to 2009, overweight and obese renal disease sub-populations had 53% and 63% higher inpatient facility and doctor expenditures as compared to normal weight renal disease population and these result were statistically significant (p=0.007; p=0.026). Overweigh renal disease population had significant total expenses per person per year for office-based and outpatient associated care. Overweight and obese renal disease persons paid less from out-of-pocket overall compared to normal weight renal disease population. Medicare and Medicaid had the highest mean annual payments for obese renal disease persons, while mean annual payments per year were highest for private insurance among normal weight renal disease population. Conclusion. Overweight and obesity were common in those with acute and chronic kidney disease and resulted in higher healthcare spending and increased utilization of office-based providers, hospital inpatient department and agency home healthcare. Healthcare for overweight and obese renal disease persons younger than 65 years of age was financed more by private and public insurance and less by out of pocket payments. With the increasing epidemic of obesity in the U.S. and the aging of the baby boomer population, the findings of the present study have implications for public health and for greater dissemination of healthcare resources to prevent, manage and delay the onset of overweight and obesity that can progress and accelerate the course of the kidney disease.^

Dissection of antitumor activity by lymphokine -activated killer cells: Role of FcR+ precursors and obligatory role of tumor necrosis factor-$\alpha$ in antibody -dependent cellular cytotoxicity

Human peripheral blood lymphocytes (PBL) cultured for varying lengths of time in IL-2 are able to mediate antibody independent cellular cytotoxicity (AICC) as well as antibody dependent cellular cytotoxicity (ADCC) against a wide range of tumor targets. The objective of our study is to determine the cytotoxic potential of the subset of LAK cells involved in ADCC, the tumor recognition mechanism in ADCC, the kinetics of ADCC mediated by PBL cultured under various conditions and the role of TNF-$\alpha$ in the development and maturation of ADCC effectors in the LAK population.^ The model system in this study for ADCC used a monoclonal antibody 14G2a (IgG2a), that recognizes the GD2 epitope on human melanoma cell line, SK-Mel-1. The target recognition mechanism operative in AICC (traditionally known as lymphokine activated killing or LAK) is an acquired property of these IL-2 activated cells which confers on them the unique ability to distinguish between tumor and normal cells. This recognition probably involves the presence of a trypsin sensitive N-linked glycoprotein epitope on tumor cells. Proteolytic treatment of the tumor cells with trypsin renders them resistant to AICC by PBL cultured in IL-2. However, ADCC is unaffected. This ADCC, mediated by the relatively small population of cells that are positive for the Fc receptor for IgG (FcR), is an indication that this subset of "LAK" cells does not require the trypsin sensitive epitope on tumor cells to mediate killing. Enriching PBL for FcR+ cells markedly enhanced both AICC and ADCC and also reduced the IL-2 requirement of these cells.^ The stoichiometry of Fc receptor (FcR) expression on the cytotoxic effectors does not correlate with ADCC lytic activity. Although FcRs are necessary to mediate ADCC, other factors, appear to regulate the magnitude of cytolytic activity. In order to investigate these putative factors, the kinetics of ADCC development was studied under various conditions (in IL-2 (10u/ml) and 100u/ml), in IL-2(10u/ml) + TNF$\alpha$ (500u/ml) and in TNF-$\alpha$ (500u/ml) alone). Addition of exogenous TNF-$\alpha$ into the four hour cytotoxicity assay did not increase ADCC, nor did anti-TNF antibodies result in inhibition. On the other hand, addition of anti-TNF antibodies to PBL and IL-2 for 24 hours, resulted in a marked inhibition of the ADCC, suggesting that endogenous TNF-$\alpha$ is obligatory for the maturation and differentiation of ADCC effectors. ^

A distinct element involved in the lipopolysaccharide activation of the tumor necrosis factor -alpha promoter in a promonocytic cell line, THP-1

TNF-α is a pleiotropic cytokine involved in normal homeostasis and plays a key role in defending the host from infection and malignancy. However when deregulated, TNF-α can lead to various disease states. Therefore, understanding the mechanisms by which TNF-α is regulated may aid in its control. In spite of the knowledge gained regarding the transcriptional regulation of TNF-α further characterization of specific TNF-α promoter elements remains to be elucidated. In particular, the T&barbelow;NF-α A&barbelow;P-1/C&barbelow;RE-like (TAC) element of the TNF-α promoter has been shown to be important in the regulation of TNF-α in lymphocytes. Activating transcription factor-2 (ATF-2) and c-Jun were shown to bind to and transactivate the TAC element However, the role of TAC and transcription factors ATF-2 and c-Jun in the regulation of TNF-α in monocytes is not as well characterized. Lipopolysaccharide (LPS), a potent activator of TNF-α in monocytes, provides a good model to study the involvement of TAC in TNF-α regulation. On the other hand, all-tram retinoic acid (ATRA), a physiological monocyte-differentiation agent, is unable to induce TNF-α protein release. ^ To delineate the functional role of TAC, we transfected the wildtype or the TAC deleted TNF-α promoter-CAT construct into THP-1 promonocytic cells before stimulating them with LPS. CAT activity was induced 17-fold with the wildtype TNF-α promoter, whereas the CAT activity was uninducible when the TAC deletion mutant was used. This daft suggests that TAC is vital for LPS to activate the TNF-α promoter. Electrophoretic mobility shift assays using the TAC element as a probe showed a unique pattern for LPS-activated cells: the disappearance of the upper band of a doublet seen in untreated and ATRA treated cells. Supershift analysis identified c-Jun and ATF-2 as components of the LPS-stimulated binding complex. Transient transfection studies using dominant negative mutants of JNK, c-Jun, or ATF-2 suggest that these proteins we important for LPS to activate the TNF-α promoter. Furthermore, an increase in phosphorylated or activated c-Jun was bound to the TAC element in LPS-stimulated cells. Increased c-Jun activation was correlated with increased activity of Jun N-terminal kinase (JNK), a known upstream stimulator of c-Jun and ATF-2, in LPS-stimulated monocytes. On the other hand, ATRA did not induce TNF-α protein release nor changes in the phosphorylation of c-Jun or JNK activity, suggesting that pathways leading to ATRA differentiation of monocytic cells are independent of TNF-α activation. Together, the induction of TNF-α gene expression seems to require JNK activation, and activated c-Jun binding to the TAC element of the TNF-α promoter in THP-1 promonocytic cells. ^

Patrón génico de fibrosis y apoptosis en nefropatía obstructiva experimental : : modulación por rosuvastatina

La nefropatía obstructiva puede ser un desorden renal complejo de tratar debido al severo cuadro inflamatorio, desbalance oxidativo, apoptosis y fibrosis. Estudios previos sostienen que rosuvastatina (Ros) podría tener utilidad como una opción terapéutica en enfermedades renales que cursarían con apoptosis y fibrosis. Objetivo: Evaluar los posibles efectos antiapoptóticos y antifibróticos de Ros durante la obstrucción ureteral unilateral en ratas neonatas. Materiales y Métodos: Ratas Wistar neonatas de 48 hs. de vida fueron intervenidas quirúrgicamente (grupo experimental) o no (grupo control). Ambos grupos fueron subdivididos en tratadas o no tratadas con Ros (10mg / kg por día) vía oral durante 14 días. Posteriormente se procedió a nefrectomizar y procesar las cortezas renales para determinar por RT-PCR las expresiones de genes: óxido nítrico sintasa inducible (iNOS), factor promotor génico de chaperonas (hsf1), proteína de shock térmico (hsp70), bax, bcL2, wt1, p53, snail, proteína morfogénica del hueso (bmp7), caderina E, factor transformador de crecimiento (tgf-β) y factor de necrosis tumoral (tnf-α). Resultados: La obstrucción ureteral unilateral neonatal indujo una marcada fibrosis y apoptosis, mientras que el tratamiento con Ros moduló el patrón de genes fibróticos y apoptóticos mediante disminución de la expresión de bmp7, caderina E, wt1, p53 y bcl2; además indujo una caída en la expresión de los genes profibróticos y proapoptóticos (bax, tnf-α y tgf-β). El análisis de los resultados presentados, permiten sugerir que la protección renal de rosuvastatina durante nefropatía obstructiva de ratas neonatas estaría asociado a la interacción entre hsp70 y la biodisponibilidad del óxido nítrico con el concomitante descenso en genes pro-apoptóticos.

(Table 1) Retinol (vitamin A) and alpha-tocopherol (vitamin E) concentration in polar bear (Ursus maritimus) kidney

Vitamins A and E content of inner organs, among these the kidneys, are increasingly being used as an indicator of adverse effects caused to the organism by e.g. environmental contaminants. In general, only a renal sub sample is used for analyses, and it is thus essential to know which part of the organ to sample in order to get a representative value for this important biomarker. The aim here was to assess the distribution of vitamins A (retinol) and E (alpha-tocopherol) within the polar bear multireniculate kidney (i.e. polar vs. medial position) and also within the cortex vs. medulla of each separate renculi. The results showed no significant difference between the medial and polar renculi with regards to either retinol (p = 0.44) or alpha-tocopherol (p = 0.75). There were, however, significant differences between cortex and medulla for both vitamins (retinol, p = 0.0003; alpha-tocopherol, p<0.0001). The kidney cortex contained higher values of both vitamins than the medulla; on average 29% more retinol and 57% more alpha-tocopherol. Mean concentrations in the medulla was 2.7 mg/kg for retinol and 116 mg/kg for alpha-tocopherol, and in the cortex 3.5 mg/kg for retinol and 182 mg/kg for alpha-tocopherol. These results clearly indicate that one should take precautions when analyzing retinol and alpha-tocopherol in polar bear kidneys. Prior to analysis, the renculi should be separated into medulla and cortex. The results indicated no significant differences between renculi from different parts of the kidney.

Caracterización de la necrosis sistémica inducida por la interacción sinérgica entre el Virus X de la patata y potyvirus en Nicotiana benthamiana

Los virus de plantas pueden causar enfermedades severas que conllevan serias pérdidas económicas a nivel mundial. Además, en la naturaleza son comunes las infecciones simultáneas con distintos virus que conducen a la exacerbación de los síntomas de enfermedad, fenómeno al que se conoce como sinergismo viral. Una de las sintomatologías más severas causadas por los virus en plantas susceptibles es la necrosis sistémica (NS), que incluso puede conducir a la muerte del huésped. Este fenotipo ha sido comparado en ocasiones con la respuesta de resistencia de tipo HR, permitiendo establecer una serie de paralelismos entre ambos tipos de respuesta que sugieren que la NS producida en interacciones compatibles sería el resultado de una respuesta hipersensible sistémica (SHR). Sin embargo, los mecanismos moleculares implicados en el desarrollo de la NS, su relación con procesos de defensa antiviral o su relevancia biológica aún no son bien entendidos, al igual que tampoco han sido estudiados los cambios producidos en la planta a escala genómica en infecciones múltiples que muestran sinergismo en patología. En esta tesis doctoral se han empleado distintas aproximaciones de análisis de expresión génica, junto con otras técnicas genéticas y bioquímicas, en el sistema modelo de Nicotiana benthamiana para estudiar la NS producida por la infección sinérgica entre el Virus X de la patata (PVX) y diversos potyvirus. Se han comparado los cambios producidos en el huésped a nivel genómico y fisiológico entre la infección doble con PVX y el Virus Y de la patata (PVY), y las infecciones simples con PVX o PVY. Además, los cambios transcriptómicos y hormonales asociados a la infección con la quimera viral PVX/HC‐Pro, que reproduce los síntomas del sinergismo entre PVX‐potyvirus, se han comparado con aquellos producidos por otros dos tipos de muerte celular, la PCD ligada a una interacción incompatible y la PCD producida por la disfunción del proteasoma. Por último, técnicas de genética reversa han permitido conocer la implicación de factores del huésped, como las oxilipinas, en el desarrollo de la NS asociada al sinergismo entre PVXpotyvirus. Los resultados revelan que, respecto a las infecciones con solo uno de los virus, la infección doble con PVX‐PVY produce en el huésped diferencias cualitativas además de cuantitativas en el perfil transcriptómico relacionado con el metabolismo primario. Otros cambios en la expresión génica, que reflejan la activación de mecanismos de defensa, correlacionan con un fuerte estrés oxidativo en las plantas doblemente infectadas que no se detecta en las infecciones simples. Además, medidas en la acumulación de determinados miRNAs implicados en diversos procesos celulares muestran como la infección doble altera de manera diferencial tanto la acumulación de estos miRNAs como su funcionalidad, lo cual podría estar relacionado con los cambios en el transcriptoma, así como con la sintomatología de la infección. La comparación a nivel transcriptómico y hormonal entre la NS producida por PVX/HC‐Pro y la interacción incompatible del Virus del mosaico del tabaco en plantas que expresan el gen N de resistencia (SHR), muestra que la respuesta en la interacción compatible es similar a la que se produce durante la SHR, si bien se presenta de manera retardada en el tiempo. Sin embargo, los perfiles de expresión de genes de defensa y de respuesta a hormonas, así como la acumulación relativa de ácido salicílico (SA), ácido jasmonico (JA) y ácido abscísico, en la interacción compatible son más semejantes a la respuesta PCD producida por la disfunción del proteasoma que a la interacción incompatible. Estos datos sugieren una contribución de la interferencia sobre la funcionalidad del proteasoma en el incremento de la patogenicidad, observado en el sinergismo PVX‐potyvirus. Por último, los resultados obtenidos al disminuir la expresión de 9‐LOX, α‐DOX1 y COI1, relacionados con la síntesis o con la señalización de oxilipinas, y mediante la aplicación exógena de JA y SA, muestran la implicación del metabolismo de las oxilipinas en el desarrollo de la NS producida por la infección sinérgica entre PVXpotyvirus en N. benthamiana. Además, estos resultados indican que la PCD asociada a esta infección, al igual que ocurre en interacciones incompatibles, no contiene necesariamente la acumulación viral, lo cual indica que necrosis e inhibición de la multiplicación viral son procesos independientes. ABSTRACT Plant viruses cause severe diseases that lead to serious economic losses worldwide. Moreover, simultaneous infections with several viruses are common in nature leading to exacerbation of the disease symptoms. This phenomenon is known as viral synergism. Systemic necrosis (SN) is one of the most severe symptoms caused by plant viruses in susceptible plants, even leading to death of the host. This phenotype has been compared with the hypersensitive response (HR) displayed by resistant plants, and some parallelisms have been found between both responses, which suggest that SN induced by compatible interactions could be the result of a systemic hypersensitive response (SHR). However, the molecular mechanisms involved in the development of SN, its relationship with antiviral defence processes and its biological relevance are still unknown. Furthermore, the changes produced in plants by mixed infections that cause synergistic pathological effects have not been studied in a genome‐wide scale. In this doctoral thesis different approaches have been used to analyse gene expression, together with other genetic and biochemical techniques, in the model plant Nicotiana benthamiana, in order to study the SN produced by the synergistic infection of Potato virus X (PVX) with several potyviruses. Genomic and physiological changes produced in the host by double infection with PVX and Potato virus Y (PVY), and by single infection with PVX or PVY have been compared. In addition, transcriptional and hormonal changes associated with infection by the chimeric virus PVX/HC‐Pro, which produces synergistic symptoms similar to those caused by PVX‐potyvirus, have been compared with those produced by other types of cell death. These types of cell death are: PCD associated with an incompatible interaction, and PCD produced by proteasome disruption. Finally, reverse genetic techniques have revealed the involvement of host factors, such as oxylipins, in the development of SN associated with PVX‐potyvirus synergism. The results revealed that compared with single infections, double infection with PVX‐PVY produced qualitative and quantitative differences in the transcriptome profile, mainly related to primary metabolism. Other changes in gene expression, which reflected the activation of defence mechanisms, correlated with a severe oxidative stress in doubly infected plants that was undetected in single infections. Additionally, accumulation levels of several miRNAs involved in different cellular processes were measured, and the results showed that double infection not only produced the greatest variations in miRNA accumulation levels but also in miRNA functionality. These variations could be related with transcriptomic changes and the symptomatology of the infection. Transcriptome and hormone level comparisons between SN induced by PVX/HCPro and the incompatible interaction produced by Tobacco mosaic virus in plants expressing the N resistance gene (SHR), showed some similarities between both responses, even though the compatible interaction appeared retarded in time. Nevertheless, the expression profiles of both defence‐related genes and hormoneresponsive genes, as well as the relative accumulation of salicylic acid (SA), jasmonic acid (JA) and abscisic acid in the compatible interaction are more similar to the PCD response produced by proteasome disruption. These data suggest that interference with proteasome functionality contributes to the increase in pathogenicity associated with PVX‐potyvirus synergism. Finally, the results obtained by reducing the expression of 9‐LOX, α‐DOX1 and COI1, related with synthesis or signalling of oxylipins, and by applying exogenously JA and SA, revealed that oxylipin metabolism is involved in the development of SN induced by PVX‐potyvirus synergistic infections in N. benthamiana. Moreover, these results also indicated that PVX‐potyvirus associated PCD does not necessarily restrict viral accumulation, as is also the case in incompatible interactions. This indicates that both necrosis and inhibition of viral multiplication are independent processes.

Raft association of SNAP receptors acting in apical trafficking in Madin–Darby canine kidney cells

We have investigated the relationships between the apical sorting mechanism using lipid rafts and the soluble N-ethyl maleimide-sensitive factor attachment protein receptor (SNARE) machinery, which is involved in membrane docking and fusion. We first confirmed that anti-alpha-SNAP antibodies inhibit the apical pathway in Madin– Darby canine kidney (MDCK) cells; in addition, we report that a recombinant SNAP protein stimulates the apical transport whereas a SNAP mutant inhibits this transport step. Based on t-SNARE overexpression experiments and the effect of botulinum neurotoxin E, syntaxin 3 and SNAP-23 have been implicated in apical membrane trafficking. Here, we show in permeabilized MDCK cells that antisyntaxin 3 and anti-SNAP-23 antibodies lower surface delivery of an apical reporter protein. Moreover, using a similar approach, we show that tetanus toxin-insensitive, vesicle-associated membrane protein (TI-VAMP; also called VAMP7), a recently described apical v-SNARE, is involved. Furthermore, we show the presence of syntaxin 3 and TI-VAMP in isolated apical carriers. Polarized apical sorting has been postulated to be mediated by the clustering of apical proteins into dynamic sphingolipid-cholesterol rafts. We provide evidence that syntaxin 3 and TI-VAMP are raft-associated. These data support a raft-based mechanism for the sorting of not only apically destined cargo but also of SNAREs having functions in apical membrane-docking and fusion events.

Requirement of mitogen-activated protein kinase kinase 3 (MKK3) for tumor necrosis factor-induced cytokine expression

The p38 mitogen-activated protein kinase is activated by treatment of cells with cytokines and by exposure to environmental stress. The effects of these stimuli on p38 MAP kinase are mediated by the MAP kinase kinases (MKKs) MKK3, MKK4, and MKK6. We have examined the function of the p38 MAP kinase signaling pathway by investigating the effect of targeted disruption of the Mkk3 gene. Here we report that Mkk3 gene disruption caused a selective defect in the response of fibroblasts to the proinflammatory cytokine tumor necrosis factor, including reduced p38 MAP kinase activation and cytokine expression. These data demonstrate that the MKK3 protein kinase is a critical component of a tumor necrosis factor-stimulated signaling pathway that causes increased expression of inflammatory cytokines.

Direct adenovirus-mediated gene transfer of interleukin 1 and tumor necrosis factor α soluble receptors to rabbit knees with experimental arthritis has local and distal anti-arthritic effects

Adenoviral vectors were used to deliver genes encoding a soluble interleukin 1 (IL-1)-type I receptor-IgG fusion protein and/or a soluble type I tumor necrosis factor α (TNFα) receptor-IgG fusion protein directly to the knees of rabbits with antigen-induced arthritis. When tested individually, knees receiving the soluble IL-1 receptor had significantly reduced cartilage matrix degradation and white blood cell infiltration into the joint space. Delivery of the soluble TNFα receptor was less effective, having only a moderate effect on white blood cell infiltration and no effect on cartilage breakdown. When both soluble receptors were used together, there was a greater inhibition of white blood cell infiltration and cartilage breakdown with a considerable reduction of synovitis. Interestingly, anti-arthritic effects were also seen in contralateral control knees receiving only a marker gene, suggesting that sustained local inhibition of disease activity in one joint may confer an anti-arthritic effect on other joints. These results suggest that local intra-articular gene transfer could be used to treat systemic polyarticular arthritides.

Hepatitis B virus HBx protein sensitizes cells to apoptotic killing by tumor necrosis factor α

Persistent infection with hepatitis B virus (HBV) is a leading cause of human liver disease and is strongly associated with hepatocellular carcinoma, one of the most prevalent forms of human cancer. Apoptosis (programmed cell death) is an important mediator of chronic liver disease caused by HBV infection. It is demonstrated that the HBV HBx protein acutely sensitizes cells to apoptotic killing when expressed during viral replication in cultured cells and in transfected cells independently of other HBV genes. Cells that were resistant to apoptotic killing by high doses of tumor necrosis factor α (TNFα), a cytokine associated with liver damage during HBV infection, were made sensitive to very low doses of TNFα by HBx. HBx induced apoptosis by prolonged stimulation of N-Myc and the stress-mediated mitogen-activated-protein kinase kinase 1 (MEKK1) pathway but not by up-regulating TNF receptors. Cell killing was blocked by inhibiting HBx stimulation of N-Myc or mitogen-activated-protein kinase kinase 1 using dominant-interfering forms or by retargeting HBx from the cytoplasm to the nucleus, which prevents HBx activation of cytoplasmic signal transduction cascades. Treatment of cells with a mitogenic growth factor produced by many virus-induced tumors impaired induction of apoptosis by HBx and TNFα. These results indicate that HBx might be involved in HBV pathogenesis (liver disease) during virus infection and that enhanced apoptotic killing by HBx and TNFα might select for neoplastic hepatocytes that survive by synthesizing mitogenic growth factors.

KDIGO-based acute kidney injury criteria operate differently in hospitals and the community—findings from a large population cohort

ACKNOWLEDGEMENTS We acknowledge the data management support of Grampian Data Safe Haven (DaSH) and the associated financial support of NHS Research Scotland, through NHS Grampian investment in the Grampian DaSH. S.S. is supported by a Clinical Research Training Fellowship from the Wellcome Trust (Ref 102729/Z/13/Z). We also acknowledge the support from The Farr Institute of Health Informatics Research. The Farr Institute is supported by a 10-funder consortium: Arthritis Research UK, the British Heart Foundation, Cancer Research UK, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council, the National Institute of Health Research, the National Institute for Social Care and Health Research (Welsh Assembly Government), the Chief Scientist Office (Scottish Government Health Directorates) and the Wellcome Trust (MRC Grant Nos: Scotland MR/K007017/1).

Tumor necrosis factor (TNF)-mediated kinase cascades: Bifurcation of Nuclear Factor-κB and c-jun N-terminal kinase (JNK/SAPK) pathways at TNF receptor-associated factor 2

TNF-induced activation of the transcription factor NF-κB and the c-jun N-terminal kinase (JNK/SAPK) requires TNF receptor-associated factor 2 (TRAF2). The NF-κB-inducing kinase (NIK) associates with TRAF2 and mediates TNF activation of NF-κB. Herein we show that NIK interacts with additional members of the TRAF family and that this interaction requires the conserved “WKI” motif within the TRAF domain. We also investigated the role of NIK in JNK activation by TNF. Whereas overexpression of NIK potently induced NF-κB activation, it failed to stimulate JNK activation. A kinase-inactive mutant of NIK was a dominant negative inhibitor of NF-κB activation but did not suppress TNF- or TRAF2-induced JNK activation. Thus, TRAF2 is the bifurcation point of two kinase cascades leading to activation of NF-κB and JNK, respectively.

Tumor necrosis factor α plays a central role in immune-mediated clearance of adenoviral vectors

Adenovirus (Ad) gene transfer vectors are rapidly cleared from infected hepatocytes in mice. To determine which effector mechanisms are responsible for elimination of the Ad vectors, we infected mice that were genetically compromised in immune effector pathways [perforin, Fas, or tumor necrosis factor α (TNF-α)] with the Ad vector, Ad5-chloramphenicol acetyl transferase (CAT). Mice were sacrificed at 7–60 days postinfection, and the levels of CAT expression in the liver determined by a quantitative enzymatic assay. When the livers of infected mice were harvested 28 days postinfection, the levels of CAT expression revealed that the effectors most important for the elimination of the Ad vector were TNF-α > Fas > perforin. TNF-α did not have a curative effect on infected hepatocytes, as the administration of TNF-α to infected severe combined immunodeficient mice or to infected cultures in vitro had no specific effect on virus persistence. However, TNF-α-deficient mice demonstrated a striking reduction in the leukocytic infiltration early on in the infection, suggesting that TNF-α deficiency resulted in impaired recruitment of inflammatory cells to the site of inflammation. In addition, the TNF-deficient mice had a significantly reduced humoral immune response to virus infection. These results demonstrate a dominant role of TNF-α in elimination of Ad gene transfer vectors. This result is particularly important because viral proteins that disable TNF-α function have been removed from most Ad vectors, rendering them highly susceptible to TNF-α-mediated elimination.

Suppression of tumor necrosis factor-induced cell death by inhibitor of apoptosis c-IAP2 is under NF-κB control

Members of the NF-κB/Rel and inhibitor of apoptosis (IAP) protein families have been implicated in signal transduction programs that prevent cell death elicited by the cytokine tumor necrosis factor α (TNF). Although NF-κB appears to stimulate the expression of specific protective genes, neither the identities of these genes nor the precise role of IAP proteins in this anti-apoptotic process are known. We demonstrate here that NF-κB is required for TNF-mediated induction of the gene encoding human c-IAP2. When overexpressed in mammalian cells, c-IAP2 activates NF-κB and suppresses TNF cytotoxicity. Both of these c-IAP2 activities are blocked in vivo by coexpressing a dominant form of IκB that is resistant to TNF-induced degradation. In contrast to wild-type c-IAP2, a mutant lacking the C-terminal RING domain inhibits NF-κB induction by TNF and enhances TNF killing. These findings suggest that c-IAP2 is critically involved in TNF signaling and exerts positive feedback control on NF-κB via an IκB targeting mechanism. Functional coupling of NF-κB and c-IAP2 during the TNF response may provide a signal amplification loop that promotes cell survival rather than death.

Na,K-ATPase transport from endoplasmic reticulum to Golgi requires the Golgi spectrin–ankyrin G119 skeleton in Madin Darby canine kidney cells

Spectrin (βIΣ∗) and ankyrin (AnkG119) associate with Golgi membranes and the dynactin complex, but their role in vesicle trafficking remains uncertain. We find that the actin-binding domain and membrane-association domain 1 (MAD1) of βI spectrin together form a constitutive Golgi targeting signal in transfected MDCK cells. Expression of this signal in transfected cells disrupts the endogenous Golgi spectrin skeleton and blocks transport of α- and β-Na,K-ATPase and vesicular stomatitis virus-G protein from the endoplasmic reticulum (ER) but does not disrupt the formation of Golgi stacks, the distribution of β-COP, or the transport and surface display of E-cadherin. The Golgi spectrin skeleton is thus required for the transport of a subset of membrane proteins from the ER to the Golgi. We postulate that together with polyfunctional adapter proteins such as AnkG119, Golgi spectrin forms a docking complex that acts prior to the cis-Golgi, presumably with vesicular–tubular clusters (VTCs or ERGIC), to sequester specific membrane proteins into vesicles transiting between the ER and Golgi, and subsequently (probably involving other isoforms of spectrin and ankyrin) to mediate cargo transport within the Golgi and to other membrane compartments. We hypothesize that this vesicular spectrin–ankyrin adapter-protein trafficking (or tethering) system (SAATS) mediates the capture and transport of many membrane proteins and acts in conjunction with vesicle-targeting molecules to effect the efficient transport of cargo proteins.