Reactivation of rheumatoid arthritis after pregnancy: increased phagocyte and recurring lymphocyte gene activity

OBJECTIVE: Pregnancy is associated with reduced disease activity in rheumatoid arthritis (RA) and frequently with disease exacerbation after delivery. This study was undertaken to generate a systematic overview of the molecular mechanisms related to disease remission and postpartum reactivation. METHODS: Transcriptomes of peripheral blood mononuclear cells (PBMCs) were generated from RA patients and healthy women by transcription profiling during the third trimester and 24 weeks after delivery. For functional interpretation, signatures of highly purified immune cells as well as Kyoto Encyclopedia of Genes and Genomes pathway annotations were used as a reference. RESULTS: Only minor differences in gene expression in PBMCs during pregnancy were found between RA patients and controls. In contrast, RA postpartum profiles presented the most dominant changes. Systematic comparison with expression signatures of monocytes, T cells, and B cells in healthy donors revealed reduced lymphocyte and elevated monocyte gene activity during pregnancy in patients with RA and in controls. Monocyte activity decreased after delivery in controls but persisted in RA patients. Furthermore, analysis of 32 immunologically relevant cellular pathways demonstrated a significant additional activation of genes related to adhesion, migration, defense of pathogens, and cell activation, including Notch, phosphatidylinositol, mTOR, Wnt, and MAPK signaling, in RA patients postpartum. CONCLUSION: Our findings indicate that innate immune functions play an important role in postpartum reactivation of arthritis. However, this may depend not only on the monocyte itself, but also on the recurrence of lymphocyte functions postpartum and thus on a critical interaction between both arms of the immune system.

Fetal gene therapy: opportunities and risks

Advances in human prenatal medicine and molecular genetics have allowed the diagnosis of many genetic diseases early in gestation. In-utero transplantation of allogeneic hematopoietic stem cells (HSC) has been successfully used as a therapy in different animal models and recently also in human fetuses. Unfortunately, clinical success of this novel treatment is limited by the lack of donor cell engraftment in non-immunocompromised hosts and is thus restricted to diseases where the fetus is affected by severe immunodeficiency. Gene therapy using genetically modified autologous HSC circumvents allogeneic HLA barriers and constitutes one of the most promising new approaches to correct genetic deficits in the fetus. Recent developments of strategies to overcome failure of efficient transduction of quiescent hematopoietic cells include the use of new vector constructs and transduction protocols. These improvements open new perspectives for gene therapy in general and for prenatal gene transfer in particular. The fetus may be especially susceptible for successful gene therapy due to the immunologic naiveté of the immature hematopoietic system during gestation, precluding an immune reaction towards the transgene. Ethical issues, in particular those regarding treatment safety, must be taken into account before clinical trials with fetal gene therapy in human pregnancies can be initiated.

Gender-specific modulation of immune system complement gene expression in marine medaka Oryzias melastigma following dietary exposure of BDE-47

BDE-47 is one of the most widely found congeners of PBDEs in marine environments. The potential immunomodulatory effects of BDE-47 on fish complement system were studied using the marine medaka Oryzias melastigma as a model fish. Three-month-old O. melastigma were subjected to short-term (5 days) and long-term (21 days) exposure to two concentrations of BDE-47 (low dose at 290 +/- 172 ng/day; high dose at 580 +/- 344 ng/day) via dietary uptake of BDE-47 encapsulated in Artemia nauplii. Body burdens of BDE-47 and other metabolic products were analyzed in the exposed and control fish. Only a small amount of debrominated product, BDE-28, was detected, while other metabolic products were all under detection limit. Transcriptional expression of six major complement system genes involved in complement activation: C1r/s (classical pathway), MBL-2 (lectin pathway), CFP (alternative pathway), F2 (coagulation pathway), C3 (the central component of complement system), and C9 (cell lysis) were quantified in the liver of marine medaka. Endogenous expression of all six complement system genes was found to be higher in males than in females (p < 0.05). Upon dietary exposure of marine medaka to BDE-47, expression of all six complement genes were downregulated in males at day 5 (or longer), whereas in females, MBl-2, CFP, and F2 mRNAs expression were upregulated, but C3 and C9 remained stable with exposure time and dose. A significant negative relationship was found between BDE-47 body burden and mRNA expression of C1r/s, CFP, and C3 in male fish (r = -0.8576 to -0.9447). The above findings on changes in complement gene expression patterns indicate the complement system may be compromised in male O. melastigma upon dietary exposure to BDE-47. Distinct gender difference in expression of six major complement system genes was evident in marine medaka under resting condition and dietary BDE-47 challenge. The immunomodulatory effects of BDE-47 on transcriptional expression of these complement components in marine medaka were likely induced by the parent compound instead of biotransformed products. Our results clearly demonstrate that future direction for fish immunotoxicology and risk assessment of immunosuppressive chemicals must include parallel evaluation for both genders.

Heart failure gene therapy: the path to clinical practice

Gene therapy, aimed at the correction of key pathologies being out of reach for conventional drugs, bears the potential to alter the treatment of cardiovascular diseases radically and thereby of heart failure. Heart failure gene therapy refers to a therapeutic system of targeted drug delivery to the heart that uses formulations of DNA and RNA, whose products determine the therapeutic classification through their biological actions. Among resident cardiac cells, cardiomyocytes have been the therapeutic target of numerous attempts to regenerate systolic and diastolic performance, to reverse remodeling and restore electric stability and metabolism. Although the concept to intervene directly within the genetic and molecular foundation of cardiac cells is simple and elegant, the path to clinical reality has been arduous because of the challenge on delivery technologies and vectors, expression regulation, and complex mechanisms of action of therapeutic gene products. Nonetheless, since the first demonstration of in vivo gene transfer into myocardium, there have been a series of advancements that have driven the evolution of heart failure gene therapy from an experimental tool to the threshold of becoming a viable clinical option. The objective of this review is to discuss the current state of the art in the field and point out inevitable innovations on which the future evolution of heart failure gene therapy into an effective and safe clinical treatment relies.

Detection and sequence analysis of a nickel-induced mutation in a retroviral model system

We have developed a novel way to assess the mutagenicity of environmentally important metal carcinogens, such as nickel, by creating a positive selection system based upon the conditional expression of a retroviral transforming gene. The target gene is the v-mos gene in MuSVts110, a murine retrovirus possessing a growth temperature dependent defect in expression of the transforming gene due to viral RNA splicing. In normal rat kidney cells infected with MuSVts110 (6m2 cells), splicing of the MuSVts110 RNA to form the mRNA from which the transforming protein, p85$\sp{\rm gag-mos}$, is translated is growth-temperature dependent, occurring at 33 C and below but not at 39 C and above. This splicing "defect" is mediated by cis-acting viral sequences. Nickel chloride treatment of 6m2 cells followed by growth at 39 C, allowed the selection of "revertant" cells which constitutively express p85$\sp{\rm gag-mos}$ due to stable changes in the viral RNA splicing phenotype, suggesting that nickel, a carcinogen whose mutagenicity has not been well established, could induce mutations in mammalian genes. We also show by direct sequencing of PCR-amplified integrated MuSVts110 DNA from a 6m2 nickel-revertant cell line that the nickel-induced mutation affecting the splicing phenotype is a cis-acting 70-base duplication of a region of the viral DNA surrounding the 3$\sp\prime$ splice site. These findings provide the first example of the molecular basis for a nickel-induced DNA lesion and establish the mutagenicity of this potent carcinogen. ^

THE BIOSYNTHESIS AND CHARACTERIZATION OF MURINE LEUKEMIA VIRAL PROTEINS

Two murine leukemia viruses (MuLVs), Rauscher (R-MuLV) and Moloney (Mo-MuLV) MuLVs, were studied to identify the biosynthetic pathways leading to the generation of mature virion proteins. Emphasis was placed on the examination of the clone 1 Mo-MuLV infected cell system.^ At least three genetic loci vital to virion replication exist on the MuLV genome. The 'gag' gene encodes information for the virion core proteins. The 'pol' gene specifies information for the RNA-dependent-DNA-polymerase (pol), or reverse transcriptase (RT). The 'env' gene contains information for the virion envelope proteins.^ MuLV specified proteins were synthesized by way of precursor polyproteins, which were processed to yield mature virion proteins. Pulse-chase kinetic studies, radioimmunoprecipitation, and peptide mapping were the techniques used to identify and characterize the MuLV viral precursor polyproteins and mature virion proteins.^ The 'gag' gene of Mo-MuLV coded for two primary gene products. One 'gag' gene product was found to be a polyprotein of 65,000 daltons M(,r) (Pr65('gag)). Pr65('gag) contained the antigenic and structural determinants of all four viral core proteins--p30, p15, pp12 and p10. Pr65('gag) was the major intracellular precursor polyprotein in the generation of mature viral core proteins. The second 'gag' gene product was a glycosylated gene product (gPr('gag)). An 85,000 dalton M(,r) polyprotein (gPr85('gag)) and an 80,000 dalton M(,r) (gPr80('gag)) polyprotein were the products of the 'gag' genes of Mo-MuLV and R-MuLV, respectively. gPr('gag) contained the antigenic and structural determinants of the four virion core proteins. In addition, gPr('gag) contained peptide information over and above that of Pr65('gag). Pulse-chase kinetic studies in the presence of tunicamycin revealed a separate processing pathway of gPr('gag) that did not seem to involve the generation of mature virion core proteins. Subglycosylated gPr('gag) was found to have a molecular weight of 75,000 daltons (Pr75('gag)) for both Mo-MuLV and R-MuLV.^ The Mo-MuLV 'pol' gene product was initially synthesized as a read-through 'gag-pol' intracellular polyprotein containing both antigenic and structural determinants of both the 'gag' and 'pol' genes. This read-through polyprotein was found to be a closely spaced doublet of two similarly sized proteins at 220-200,000 daltons M(,r) (Pr220/200('gag-pol)). Pulse-chase kinetic studies revealed processing of Pr220/200('gag-pol) to unstable intermediate intracellular proteins of 145,000 (Pr145('pol)), 135,000 (Pr135('pol)), and 125,000 (Pr125('pol)) daltons M(,r). Further chase incubations demonstrated the appearance of an 80,000 dalton M(,r) protein, which represented the mature polymerase (p80('pol)).^ The primary intracellular Mo-MuLV 'env' gene product was found to be a glycosylated polyprotein of 83,000 daltons M(,r) (gPr83('env)). gPr83('env) contained the antigenic and structural determinants of both mature virion envelope proteins, gp70 and p15E. In addition, gPr83('env) contained unique peptide sequences not present in either gp70 or p15E. The subglycosylated form of gPr83('env) had a molecular weight of 62,000 daltons (Pr62('env)).^ Virion core proteins of R-MuLV and Mo-MuLV were examined. Structural homology was observed betwen p30s and p10s. Significant structural non-homology was demonstrated between p15s and pp12s. ^

Viral Escape in the Central Nervous System with Multidrug-Resistant Human Immunodeficiency Virus-1

In this study, we report the case of a patient infected with human immunodeficiency virus (HIV)-1 who developed ataxia and neurocognitive impairment due to viral escape within the central nervous system (CNS) with a multidrug-resistant HIV-1 despite long-term viral suppression in plasma. Antiretroviral therapy optimization with drugs with high CNS penetration led to viral suppression in the CSF, regression of ataxia, and improvement of neurocognitive symptoms.