Psoriasis triggered by toll-like receptor 7 agonist imiquimod in the presence of dermal plasmacytoid dendritic cell precursors.

BACKGROUND: It has been proposed that the innate immune system plays a central role in driving the autoimmune T-cell cascade leading to psoriasis; however, there is no direct evidence for this. OBSERVATIONS: We observed aggravation and spreading of a psoriatic plaque when treated topically with the toll-like receptor (TLR) 7 agonist imiquimod. The exacerbation of psoriasis was accompanied by a massive induction of lesional type I interferon activity, detected by MxA expression after imiquimod therapy. Since imiquimod induces large amounts of type I interferon production from TLR7-expressing plasmacytoid dendritic cell precursors (PDCs), the natural interferon-producing cells of the peripheral blood, we asked whether PDCs are present in psoriatic skin. We identified high numbers of PDCs in psoriatic skin lesions (up to 16% of the total dermal infiltrate) based on their coexpression of BDCA2 and CD123. By contrast, PDCs were present at very low levels in atopic dermatitis and not detected in normal human skin. CONCLUSIONS: This study shows that psoriasis can be driven by the innate immune system through TLR ligation. Furthermore, our finding that large numbers of PDCs infiltrate psoriatic skin suggests a role of lesional PDCs as type I interferon-producing targets for the TLR7 agonist imiquimod.

Tuberculosis screening in patients with psoriasis before antitumour necrosis factor therapy: comparison of an interferon-gamma release assay vs. tuberculin skin test.

BACKGROUND: Antitumour necrosis factor (anti-TNF) treatments may reactivate latent tuberculosis infection (LTBI). For detecting LTBI, the tuberculin skin test (TST) has low sensitivity and specificity. Interferon-gamma release assays (IGRA) have been shown to be more sensitive and specific than TST. OBJECTIVE: To compare the TST and the T-SPOT.TB IGRA for identifying LTBI in patients with psoriasis before anti-TNF treatment. METHODS: A retrospective study was carried out over a 4-year period on patients with psoriasis requiring anti-TNF treatment. All were subjected to the TST, T-SPOT.TB and chest X-ray. Risk factors for LTBI and history of bacillus Calmette-Guérin (BCG) vaccination were recorded. The association of T-SPOT.TB and TST results with risk factors for LTBI was tested through univariate logistic regression models. Agreement between tests was quantified using kappa statistics. Treatment for LTBI was started 1 month before anti-TNF therapy when indicated. RESULTS: Fifty patients were included; 90% had prior BCG vaccination. A positive T-SPOT.TB was strongly associated with a presumptive diagnosis of LTBI (odds ratio 7.43; 95% confidence interval 1.38-39.9), which was not the case for the TST. Agreement between the T-SPOT.TB and TST was poor, kappa = 0.33 (SD 0.13). LTBI was detected and treated in 20% of the patients. In 20% of the cases, LTBI was not retained in spite of a positive TST but a negative T-SPOT.TB. All patients received an anti-TNF agent for a median of 56 weeks (range 20-188); among patients with a positive TST/negative T-SPOT.TB, no tuberculosis was detected with a median follow-up of 64 weeks (44-188). One case of disseminated tuberculosis occurred after 28 weeks of adalimumab treatment in a patient with LTBI in spite of treatment with rifampicin. CONCLUSION: This study is the first to underline the frequency of LTBI in patients with psoriasis (20%), and to support the use of IGRA instead of the TST for its detection. Nevertheless, there is still a risk of tuberculosis under anti-TNF therapy, even if LTBI is correctly diagnosed and treated.

Characterization of GLUT8 and GLUT9, two novel glucose transporter isoforms

Summary Prevalence of type 2 diabetes is increasing worldwide at alarming rates, probably secondarily to that of obesity. As type 2 diabetes is characterized by blood hyperglycemia, controlling glucose entry into tissues from the bloodstream is key to maintain glycemia within acceptable ranges. In this context, several glucose transporter isoforms have been cloned recently and some of them have appeared to play important regulatory roles. Better characterizing two of them (GLUT8 and GLUT9) was the purpose of my work. The first part of my work was focused on GLUT8, which is mainly expressed in the brain and is able to transport glucose with high affinity. GLUT8 is retained intracellularly at basal state depending on an N-terminal dileucine motif, thus implying that cell surface expression may be induced by extracellular triggers. In this regard, I was interested in better defining GLUT8 subcellular localization at basal state and in finding signals promoting its translocation, using an adenoviral vector expressing a myc epitope-tagged version of the transporter, thus allowing expression and detection of cell-surface GLUT8 in primary hippocampal neurons and PC 12 cells. This tool enabled me to found out that GLUT8 resides in a unique compartment different from lysosomes, endoplasmic reticulum, endosomes and the Golgi. In addition, absence of GLUT8 translocation following pharmacological activation of several signalling pathways suggests that GLUT8 does not ever translocate to the cell surface, but would rather fulfill its role in its unique intracellular compartment. The second part of my work was focused on GLUT9, which -contrarily to GLUT8 - is unable to transport glucose, but retains the ability to bind glucose-derived cross-linker molecules, thereby suggesting that it may be a glucose sensor rather than a true glucose transporter. The aim of the project was thus to define if GLUT9 triggers intracellular signals when activated. Therefore, adenoviral vectors expressing GLUTS were used to infect both ßpancreatic and liver-derived cell lines, as GLUTS is endogenously expressed in the liver. Comparison of gene expression between cells infected with the GLUTS-expressing adenovirus and cells infected with a GFP-expressing control adenovirus ended up in the identification of the transcription factor HNF4α as being upregulated in aGLUT9-dependent manner. Résumé La prévalence du diabète de type 2 augmente de façon alarmante dans le monde entier, probablement secondairement à celle de l'obésité. Le diabète de type 2 étant caractérisé par une glycémie sanguine élevée, l'entrée du glucose dans les tissus depuis la circulation sanguine constitue un point de contrôle important pour maintenir la glycémie à des valeurs acceptables. Dans ce contexte, plusieurs isoformes de transporteurs au glucose ont été clonées récemment et certaines d'entre elles sont apparues comme jouant d'importants rôles régulateurs. Mieux caractériser deux d'entre elles (GLUT8 et GLUT9) était le but de mon travail. La première partie de mon travail a été centrée sur GLUT8, qui est exprimé principalement dans le cerveau et qui peut transporter le glucose avec une haute affinité. GLUT8 est retenu intracellulairement à l'état basal de façon dépendante d'un motif dileucine N-terminal, ce qui implique que son expression à la surface cellulaire pourrait être induite par des stimuli extracellulaires. Dans cette optique, je me suis intéressé à mieux définir la localisation subcellulaire de GLUT8 à l'état basal et à trouver des signaux activant sa translocation, en utilisant comme outil un vecteur adénoviral exprimant une version marquée (tag myc) du transporteur, me permettant ainsi d'exprimer et de détecter GLUT8 à la surface cellulaire dans des neurones hippocampiques primaires et des cellules PC12. Cet outil m'a permis de montrer que GLUT8 réside dans un compartiment unique différent des lysosomes, du réticulum endoplasmique, des endosomes, ainsi que du Golgi. De plus, l'absence de translocation de GLUT8 à la suite de l'activation pharmacologique de plusieurs voies de signalisation suggère que GLUT8 ne transloque jamais à la membrane plasmique, mais jouerait plutôt un rôle au sein même de son compartiment intracellulaire unique. La seconde partie de mon travail a été centrée sur GLUT9, lequel -contrairement à GLUT8 -est incapable de transporter le glucose, mais conserve la capacité de se lier à des molécules dérivées du glucose, suggérant que ce pourrait être un senseur de glucose plutôt qu'un vrai transporteur. Le but du projet a donc été de définir si GLUT9 active des signaux intracellulaires quand il est lui-même activé. Pour ce faire, des vecteurs adénoviraux exprimant GLUT9 ont été utilisés pour infecter des lignées cellulaires dérivées de cellules ßpancréatiques et d'hépatocytes, GLUT9 étant exprimé de façon endogène dans le foie. La comparaison de l'expression des gènes entre des cellules infectées avec l'adénovirus exprimant GLUT9 et un adénovirus contrôle exprimant la GFP a permis d'identifier le facteur de transcription HNF4α comme étant régulé de façon GLUT9-dépendante. Résumé tout public Il existe deux types bien distincts de diabète. Le diabète de type 1 constitue environ 10 des cas de diabète et se déclare généralement à l'enfance. Il est caractérisé par une incapacité du pancréas à sécréter une hormone, l'insuline, qui régule la concentration sanguine du glucose (glycémie). Il en résulte une hyperglycémie sévère qui, si le patient n'est pas traité à l'insuline, conduit à de graves dommages à divers organes, ce qui peut mener à la cécité, à la perte des membres inférieurs, ainsi qu'à l'insuffisance rénale. Le diabète de type 2 se déclare plus tard dans la vie. Il n'est pas causé par une déficience en insuline, mais plutôt par une incapacité de l'insuline à agir sur ses tissus cibles. Le nombre de cas de diabète de type 2 augmente de façon dramatique, probablement à la suite de l'augmentation des cas d'obésité, le surpoids chronique étant le principal facteur de risque de diabète. Chez l'individu sain, le glucose sanguin est transporté dans différents organes (foie, muscles, tissu adipeux,...) où il est utilisé comme source d'énergie. Chez le patient diabétique, le captage de glucose est altéré, expliquant ainsi l'hyperglycémie. Il est ainsi crucial d'étudier les mécanismes permettant ce captage. Ainsi, des protéines permettant l'entrée de glucose dans la cellule depuis le milieu extracellulaire ont été découvertes depuis une vingtaine d'années. La plupart d'entre elles appartiennent à une sous-famille de protéines nommée GLUT (pour "GLUcose Transporters") dont cinq membres ont été caractérisés et nommés selon l'ordre de leur découverte (GLUT1-5). Néanmoins, la suppression de ces protéines chez la souris par des techniques moléculaires n'affecte pas totalement le captage de glucose, suggérant ainsi que des transporteurs de glucose encore inconnus pourraient exister. De telles protéines ont été isolées ces dernières années et nommées selon l'ordre de leur découverte (GLUT6-14). Durant mon travail de thèse, je me suis intéressé à deux d'entre elles, GLUT8 et GLUT9, qui ont été découvertes précédemment dans le laboratoire. GLUT8 est exprimé principalement dans le cerveau. La protéine n'est pas exprimée à la surface de la cellule, mais est retenue à l'intérieur. Des mécanismes complexes doivent donc exister pour déplacer le transporteur à la surface cellulaire, afin qu'il puisse permettre l'entrée du glucose dans la cellule. Mon travail a consisté d'une part à définir où se trouve le transporteur à l'intérieur de la cellule, et d'autre part à comprendre les mécanismes capables de déplacer GLUT8 vers la surface cellulaire, en utilisant des neurones exprimant une version marquée du transporteur, permettant ainsi sa détection par des méthodes biochimiques. Cela m'a permis de montrer que GLUT8 est localisé dans une partie de la cellule encore non décrite à ce jour et qu'il n'est jamais déplacé à la surface cellulaire, ce qui suggère que le transporteur doit jouer un rôle à l'intérieur de la cellule et non à sa surface. GLUT9 est exprimé dans le foie et dans les reins. Il ressemble beaucoup à GLUT8, mais ne transporte pas le glucose, ce qui suggère que ce pourrait être un récepteur au glucose plutôt qu'un transporteur à proprement parler. Le but de mon travail a été de tester cette hypothèse, en comparant des cellules du foie exprimant GLUT9 avec d'autres n'exprimant pas la protéine. Par des méthodes d'analyses moléculaires, j'ai pu montrer que la présence de GLUT9 dans les cellules du foie augmente l'expression de HNF4α, une protéine connue pour réguler la sécrétion d'insuline dans le pancréas ainsi que la production de glucose dans le foie. Des expériences complémentaires seront nécessaires afin de mieux comprendre par quels mécanismes GLUT9 influence l'expression de HNF4α dans le foie, ainsi que de définir l'importance de GLUT9 dans la régulation de la glycémie chez l'animal entier.

Design, synthesis, and biological and crystallographic evaluation of novel inhibitors of Plasmodium falciparum enoyl-ACP-reductase (PfFabI).

Malaria, a disease of worldwide significance, is responsible for over one million deaths annually. The liver-stage of Plasmodium's life cycle is the first, obligatory, but clinically silent step in malaria infection. The P. falciparum type II fatty acid biosynthesis pathway (PfFAS-II) has been found to be essential for complete liver-stage development and has been regarded as a potential antimalarial target for the development of drugs for malaria prophylaxis and liver-stage eradication. In this paper, new coumarin-based triclosan analogues are reported and their biological profile is explored in terms of inhibitory potency against enzymes of the PfFAS-II pathway. Among the tested compounds, 7 and 8 showed the highest inhibitory potency against Pf enoyl-ACP-reductase (PfFabI), followed by 15 and 3. Finally, we determined the crystal structures of compounds 7 and 11 in complex with PfFabI to identify their mode of binding and to confirm outcomes of docking simulations.

Coregulator Control of Androgen Receptor Action by a Novel Nuclear Receptor-Binding Motif

The androgen receptor (AR) is a ligand-activated transcription factor that is essential for prostate cancer development. It is activated by androgens through its ligand-binding domain (LBD), which consists predominantly of 11 α-helices. Upon ligand binding, the last helix is reorganized to an agonist conformation termed activator function-2 (AF-2) for coactivator binding. Several coactivators bind to the AF-2 pocket through conserved LXXLL or FXXLF sequences to enhance the activity of the receptor. Recently, a small compound-binding surface adjacent to AF-2 has been identified as an allosteric modulator of the AF-2 activity and is termed binding function-3 (BF-3). However, the role of BF-3 in vivo is currently unknown, and little is understood about what proteins can bind to it. Here we demonstrate that a duplicated GARRPR motif at the N terminus of the cochaperone Bag-1L functions through the BF-3 pocket. These findings are supported by the fact that a selective BF-3 inhibitor or mutations within the BF-3 pocket abolish the interaction between the GARRPR motif(s) and the BF-3. Conversely, amino acid exchanges in the two GARRPR motifs of Bag-1L can impair the interaction between Bag-1L and AR without altering the ability of Bag-1L to bind to chromatin. Furthermore, the mutant Bag-1L increases androgen-dependent activation of a subset of AR targets in a genome-wide transcriptome analysis, demonstrating a repressive function of the GARRPR/BF-3 interaction. We have therefore identified GARRPR as a novel BF-3 regulatory sequence important for fine-tuning the activity of the AR.

Functional analysis of cis- and trans-acting elements of the Candida albicans CDR2 promoter with a novel promoter reporter system.

Azole resistance in Candida albicans can be mediated by the upregulation of the ATP binding cassette transporter genes CDR1 and CDR2. Both genes are regulated by a cis-acting element called the drug-responsive element (DRE), with the consensus sequence 5'-CGGAWATCGGATATTTTTTT-3', and the transcription factor Tac1p. In order to analyze in detail the DRE sequence necessary for the regulation of CDR1 and CDR2 and properties of TAC1 alleles, a one-hybrid system was designed. This system is based on a P((CDR2))-HIS3 reporter system in which complementation of histidine auxotrophy can be monitored by activation of the reporter system by CDR2-inducing drugs such as estradiol. Our results show that most of the modifications within the DRE, but especially at the level of CGG triplets, strongly reduce CDR2 expression. The CDR2 DRE was replaced by putative DREs deduced from promoters of coregulated genes (CDR1, RTA3, and IFU5). Surprisingly, even if Tac1p was able to bind these putative DREs, as shown by chromatin immunoprecipitation, those from RTA3 and IFU5 did not functionally replace the CDR2 DRE. The one-hybrid system was also used for the identification of gain-of-function (GOF) mutations either in TAC1 alleles from clinical C. albicans isolates or inserted in TAC1 wild-type alleles by random mutagenesis. In all, 17 different GOF mutations were identified at 13 distinct positions. Five of them (G980E, N972D, A736V, T225A, and N977D) have already been described in clinical isolates, and four others (G980W, A736T, N972S, and N972I) occurred at already-described positions, thus suggesting that GOF mutations can occur in a limited number of positions in Tac1p. In conclusion, the one-hybrid system developed here is rapid and powerful and can be used for characterization of cis- and trans-acting elements in C. albicans.

Circulating microRNAs as novel biomarkers for diabetes mellitus.

Diabetes mellitus is characterized by insulin secretion from pancreatic β cells that is insufficient to maintain blood glucose homeostasis. Autoimmune destruction of β cells results in type 1 diabetes mellitus, whereas conditions that reduce insulin sensitivity and negatively affect β-cell activities result in type 2 diabetes mellitus. Without proper management, patients with diabetes mellitus develop serious complications that reduce their quality of life and life expectancy. Biomarkers for early detection of the disease and identification of individuals at risk of developing complications would greatly improve the care of these patients. Small non-coding RNAs called microRNAs (miRNAs) control gene expression and participate in many physiopathological processes. Hundreds of miRNAs are actively or passively released in the circulation and can be used to evaluate health status and disease progression. Both type 1 diabetes mellitus and type 2 diabetes mellitus are associated with distinct modifications in the profile of miRNAs in the blood, which are sometimes detectable several years before the disease manifests. Moreover, circulating levels of certain miRNAs seem to be predictive of long-term complications. Technical and scientific obstacles still exist that need to be overcome, but circulating miRNAs might soon become part of the diagnostic arsenal to identify individuals at risk of developing diabetes mellitus and its devastating complications.

Endoluminal surgical triangulation: overcoming challenges of colonic endoscopic submucosal dissections using a novel flexible endoscopic surgical platform: feasibility study in a porcine model.

BACKGROUND: Colonic endoscopic submucosal dissection (ESD) is challenging as a result of the limited ability of conventional endoscopic instruments to achieve traction and exposure. The aim of this study was to evaluate the feasibility of colonic ESD in a porcine model using a novel endoscopic surgical platform, the Anubiscope (Karl Storz, Tüttlingen, Germany), equipped with two working channels for surgical instruments with four degrees of freedom offering surgical triangulation. METHODS: Nine ESDs were performed by a surgeon without any ESD experience in three swine, at 25, 15, and 10 cm above the anal verge with the Anubiscope. Sixteen ESDs were performed by an experienced endoscopist in five swine using conventional endoscopic instruments. Major ESD steps included the following for both groups: scoring the area, submucosal injection of glycerol, precut, and submucosal dissection. Outcomes measured were as follows: dissection time and speed, specimen size, en bloc dissection, and complications. RESULTS: No perforations occurred in the Anubis group, while there were eight perforations (50 %) in the conventional group (p = 0.02). Complete and en bloc dissections were achieved in all cases in the Anubis group. Mean dissection time for completed cases was statistically significantly shorter in the Anubis group (32.3 ± 16.1 vs. 55.87 ± 7.66 min; p = 0.0019). Mean specimen size was higher in the conventional group (1321 ± 230 vs. 927.77 ± 229.96 mm(2); p = 0.003), but mean dissection speed was similar (35.95 ± 18.93 vs. 23.98 ± 5.02 mm(2)/min in the Anubis and conventional groups, respectively; p = 0.1). CONCLUSIONS: Colonic ESDs were feasible in pig models with the Anubiscope. This surgical endoscopic platform is promising for endoluminal surgical procedures such as ESD, as it is user-friendly, effective, and safe.

Calcineurin as a Multifunctional Regulator: Unraveling Novel Functions in Fungal Stress Responses, Hyphal Growth, Drug Resistance, and Pathogenesis.

Calcineurin signaling plays diverse roles in fungi in regulating stress responses, morphogenesis and pathogenesis. Although calcineurin signaling is conserved among fungi, recent studies indicate important divergences in calcineurin-dependent cellular functions among different human fungal pathogens. Fungal pathogens utilize the calcineurin pathway to effectively survive the host environment and cause life-threatening infections. The immunosuppressive calcineurin inhibitors (FK506 and cyclosporine A) are active against fungi, making targeting calcineurin a promising antifungal drug development strategy. Here we summarize current knowledge on calcineurin in yeasts and filamentous fungi, and review the importance of understanding fungal-specific attributes of calcineurin to decipher fungal pathogenesis and develop novel antifungal therapeutic approaches.

Novel Bioconjugates of Aminolevulinic Acid with Nucleosides

Esters and amino acid derivatives of 5-aminolevulinic acid (ALA) are efficient prodrugs for the production of protoporphyrin IX (PpIX), which has been used in photodynamic cancer therapy (PDT). The synthesis of novel bioconjugates combining ALA with adenosine and thymidine is reported. The novel bioconjugates have been made using a robust methodology. The new class of prodrugs contains one, two, or three ALA per molecule. Preliminary cell tests in human cancer cell lines indicate that the thymidine conjugate of ALA is an efficient prodrug for PDT.

Searching for Novel Cellular Targets of the Hepatitis C Virus NS3-4A Protease

Background: The hepatitis C virus (HCV) NS3-4A protease isnot only an essential component of the viral replication complexand a prime target for antiviral intervention but also a key playerin the persistence and pathogenesis of HCV. It cleaves andthereby inactivates two crucial adaptor proteins in viral RNAsensing and innate immunity (MAVS and TRIF) as well as aphosphatase involved in growth factor signaling (TC-PTP). Theaim of this ongoing study is to identify novel cellular targets ofthe NS3-4A protease.Methods: Cell lines inducibly expressing the NS3-4A proteasewere established using a tetracycline-regulated geneexpression system. Cells were analyzed in basal as well asinterferon-α-stimulated states. Two-dimensional difference gelelectrophoresis (2D-DIGE) and stable isotopic labeling usingamino acids in cell culture (SILAC) proteomics analysescoupled with mass spectrometry were employed to search forcellular substrates of NS3-4A.Results: A number of candidate cellular targets have beenidentified by these proteomics approaches. These are currentlybeing validated by different experimental techniques. In parallel,we are in the process of further defining the determinants forsubstrate specificity of the NS3-4A protease.Conclusions: The identification of novel cellular targets of theHCV NS3-4A protase should yield new insights into thepathogenesis of hepatitis C and may reveal novel targets forantiviral intervention.

Novel method to estimate the phenotypic variation explained by genome-wide association studies reveals large fraction of the missing heritability.

Genome-wide association studies (GWAS) are conducted with the promise to discover novel genetic variants associated with diverse traits. For most traits, associated markers individually explain just a modest fraction of the phenotypic variation, but their number can well be in the hundreds. We developed a maximum likelihood method that allows us to infer the distribution of associated variants even when many of them were missed by chance. Compared to previous approaches, the novelty of our method is that it (a) does not require having an independent (unbiased) estimate of the effect sizes; (b) makes use of the complete distribution of P-values while allowing for the false discovery rate; (c) takes into account allelic heterogeneity and the SNP pruning strategy. We applied our method to the latest GWAS meta-analysis results of the GIANT consortium. It revealed that while the explained variance of genome-wide (GW) significant SNPs is around 1% for waist-hip ratio (WHR), the observed P-values provide evidence for the existence of variants explaining 10% (CI=[8.5-11.5%]) of the phenotypic variance in total. Similarly, the total explained variance likely to exist for height is estimated to be 29% (CI=[28-30%]), three times higher than what the observed GW significant SNPs give rise to. This methodology also enables us to predict the benefit of future GWA studies that aim to reveal more associated genetic markers via increased sample size.

A novel optical intracellular imaging approach for potassium dynamics in astrocytes.

Astrocytes fulfill a central role in regulating K+ and glutamate, both released by neurons into the extracellular space during activity. Glial glutamate uptake is a secondary active process that involves the influx of three Na+ ions and one proton and the efflux of one K+ ion. Thus, intracellular K+ concentration ([K+]i) is potentially influenced both by extracellular K+ concentration ([K+]o) fluctuations and glutamate transport in astrocytes. We evaluated the impact of these K+ ion movements on [K+]i in primary mouse astrocytes by microspectrofluorimetry. We established a new noninvasive and reliable approach to monitor and quantify [K+]i using the recently developed K+ sensitive fluorescent indicator Asante Potassium Green-1 (APG-1). An in situ calibration procedure enabled us to estimate the resting [K+]i at 133±1 mM. We first investigated the dependency of [K+]i levels on [K+]o. We found that [K+]i followed [K+]o changes nearly proportionally in the range 3-10 mM, which is consistent with previously reported microelectrode measurements of intracellular K+ concentration changes in astrocytes. We then found that glutamate superfusion caused a reversible drop of [K+]i that depended on the glutamate concentration with an apparent EC50 of 11.1±1.4 µM, corresponding to the affinity of astrocyte glutamate transporters. The amplitude of the [K+]i drop was found to be 2.3±0.1 mM for 200 µM glutamate applications. Overall, this study shows that the fluorescent K+ indicator APG-1 is a powerful new tool for addressing important questions regarding fine [K+]i regulation with excellent spatial resolution.