Cellular localization and mechanism of amyloid precursor protein (APP) homodimer formation in an oxidizing environment

The amyloid precursor protein (APP) is a type I transmembrane glycoprotein, which resembles a cell surface receptor, comprising a large ectodomain, a single spanning transmembrane part and a short C-terminal, cytoplasmic domain. It belongs to a conserved gene family, with over 17 members, including also the two mammalian APP homologues proteins APLP1 and APLP2 („amyloid precursor like proteins“). APP is encoded by 19 exons, of which exons 7, 8, and 15 can be alternatively spliced to produce three major protein isoforms APP770, APP751 and APP695, reflecting the number of amino acids. The neuronal APP695 is the only isoform that lacks a Kunitz Protease Inhibitor (KPI) domain in its extracellular portion whereas the two larger, peripheral APP isoforms, contain the 57-amino-acid KPI insert. rnRecently, research effort has suggested that APP metabolism and function is thought to be influenced by homodimerization and that the oligomerization state of APP could also play a role in the pathology of Alzheimer's disease (AD), by regulating its processing and amyloid beta production. Several independent studies have shown that APP can form homodimers within the cell, driven by motifs present in the extracellular domain, as well as in the juxtamembrane (JM) and transmembrane (TM) regions of the molecule, whereby the exact molecular mechanism and the origin of dimer formation remains elusive. Therefore, we focused in our study on the actual subcellular origin of APP homodimerization within the cell, an underlying mechanism, and a possible impact on dimerization properties of its homologue APLP1. Furthermore, we analyzed homodimerization of various APP isoforms, in particular APP695, APP751 and APP770, which differ in the presence of a Kunitz-type protease inhibitor domain (KPI) in the extracellular region. In order to assess the cellular origin of dimerization under different cellular conditions, we established a mammalian cell culture model-system in CHO-K1 (chinese hamster ovary) cells, stably overexpressing human APP, harboring dilysine based organelle sorting motifs at the very C-terminus [KKAA-Endoplasmic Reticulum (ER); KKFF-Golgi]. In this study we show that APP exists as disulfide-bound, SDS-stable dimers, when it was retained in the ER, unlike when it progressed further to the cis-Golgi, due to the KKFF ER exit determinant. These stable APP complexes were isolated from cells, and analyzed by SDS–polyacrylamide gel electrophoresis under non-reducing conditions, whereas strong denaturing and reducing conditions completely converted those dimers to monomers. Our findings suggested that APP homodimer formation starts early in the secretory pathway and that the unique oxidizing environment of the ER likely promotes intermolecular disulfide bond formation between APP molecules. We particularly visualized APP dimerization employing a variety of biochemical experiments and investigated the origin of its generation by using a Bimolecular Fluorescence Complementation (BiFC) approach with split GFP-APP chimeras. Moreover, using N-terminal deletion constructs, we demonstrate that intermolecular disulfide linkage between cysteine residues, exclusively located in the extracellular E1 domain, represents another mechanism of how an APP sub-fraction can dimerize within the cell. Additionally, mutational studies revealed that cysteines at positions 98 and 105, embedded in the conserved loop region within the E1 domain, are critical for interchain disulfide bond formation. Using a pharmacological treatment approach, we show that once generated in the oxidative environment of the ER, APP dimers remain stably associated during transport, reaching the plasma membrane. In addition, we demonstrate that APP isoforms, encompassing the KPI domain, exhibit a strongly reduced ability to form cis-directed dimers in the ER, whereas trans-directed cell aggregation of Drosophila Schneider (S2)-cells was isoform independent, mediating cell-cell contacts. Thus, suggesting that steric properties of KPI-APP might be the cause for weaker cis-interaction in the ER, compared to APP695. Finally, we provide evidence that APP/APLP1 heterointeractions are likewise initiated in the ER, suggesting a similar mechanism for heterodimerization. Therefore, dynamic alterations of APP between monomeric, homodimeric, and possibly heterodimeric status could at least partially explain some of the variety in the physiological functions of APP.rn

Einfluss der Phosphorylierung durch die Casein Kinase II auf den HSP90-Chaperone-Zyklus in humanen Zellen

In der vorliegenden Arbeit wurde eine Analysenmethode auf Basis der Massenbestimmung über Elektrospray-Ionisation qualifiziert, mit der es möglich ist, den Gehalt beider in humanen Zellen vorliegenden isoformen Chaperone HSP90-alpha und HSP90-beta sowie deren Phosphorylierungsstatus in der sog. „charged linker“-Region (CLR) getrennt voneinander zu bestimmen. Die Quantifizierung dieser posttranslationalen Modifikation von HSP90 in der noch wenig untersuchten Region des Chaperons stellte eine besondere Herausforderung an das analytische Messsystem dar, da diese sich fast ausschließlich aus geladenen Aminosäuren zusammensetzt und eine hohe Sequenzhomologie der beiden Isoformen in humanen Zellen vorliegt. Mit dieser Methode ist es gelungen, sowohl die stärkere Expression beider Isoformen in Tumor-Zelllinien im Vergleich zu Nicht-Tumor-Zelllinien als auch signifikant höhere Level beider phosphorylierten Varianten in den Tumor-Zelllinien nachzuweisen. Des Weiteren konnte durch gezielte Arretierung der Tumor-Zelllinie HCT116 in der G0/G1-Phase des Zellzyklus der Nachweis erbracht werden, dass nur HSP90-alpha in diesem Ruhestadium der Zellteilung in der phosphorylierten Form vorliegt. rnDa die Phosphorylierung der CLR von HSP90 als ein Marker für die Substrataktivierung herangezogen werden kann, besteht jetzt die Möglichkeit, Auswirkungen von z. B. HSP90-Inhibitoren auf beide HSP90-Isoformen hinsichtlich ihrer Expression und Phosphorylierung durch die Casein Kinase II (CK II) im zellulären Umfeld zu testen.rnIn-vitro konnte die Phosphorylierung der CLR von HSP90-alpha und -beta mit der CK II an den rekombinant hergestellten Proteinen nachgestellt werden. Dieses typische Phosphorylierungs-Motiv (S-X-X-E/D) findet man bei sehr vielen Co-Chaperonen wie auch bei der Prostaglandin E Synthase p23, das ebenfalls durch eine in-vitro Kinase-Reaktion mit der CK II an drei Positionen phosphoryliert wurde. Durch ein Binde-Assay zeigte sich, dass p23 nur in dieser modifizierten Form an HSP90-alpha bindet. Das Bindeverhalten von p23 an die beta-Isoform wird durch diese Phosphorylierung jedoch nicht beeinflusst. Diese Erkenntnisse erweitern das Verständnis des bis dato beschriebenen Chaperon-Zyklus von HSP90 und zeigen deutliche Unterschiede in den Aktivierungszyklen beider Isoformen auf. Da die Casein Kinase II hier entscheidend in den durch HSP90 vermittelten Aktivierungsprozess eingreift, eröffnet sich ein weites Feld an Möglichkeiten, diese Prozesse an weiteren Co-Chaperonen und Substratproteinen zu studieren.rn

Charakterisierung der Latenz des murinen Cytomegalovirus in vivo

Die primäre, produktive Cytomegalovirus (CMV)-Infektion wird im immunkompetenten Patienten effizient durch antivirale CD8+ T-Zellen kontrolliert. Das virale Genom besitzt jedoch die Fähigkeit, in einem nicht replikativen, Latenz genannten Zustand, in gewissen Zelltypen zu persistieren, ohne dass infektiöse Nachkommenviren produziert werden. Die molekularen Mechanismen, welche der Etablierung und Aufrechterhaltung der Latenz zugrundeliegen, sind noch weitestgehend unbekannt. Es gibt Hinweise darauf, dass zelluläre Verteidigungsmechanismen die Zirkularisierung und Chromatinisierung viraler Genome hervorrufen und dadurch die virale Genexpression größtenteils verhindert wird (Marks & Spector, 1984; Reeves et al., 2006).rnAllerdings liegen die Genome nicht in einem komplett inaktiven Zustand vor. Vielmehr konnte für das murine CMV (mCMV) bereits die sporadische Transkription der Gene ie1 und ie2 während der Latenz nachgewiesen werden (Kurz et al., 1999; Grzimek et al., 2001).rnIn der vorliegenden Arbeit wurde zum ersten Mal eine umfassende in vivo Latenz-Analyse zur Charakterisierung der viralen Transkription in einer Kinetik anhand der alle drei kinetischen Klassen repräsentierenden Transkripte IE1, IE3, E1, m164, M105 und M86 vorgenommen.rnNach Latenz-Etablierung, verifiziert durch Abwesenheit von infektiösem Virus, konnten alle getesteten Transkripte in der Lunge quantifiziert werden. Interessanterweise war die transkriptionelle Aktivität zu keinem Analyse-Zeitpunkt mit der klassischen IE-E-L-Kinetik der produktiven Infektion kompatibel. Stattdessen lag eine stochastische Transkript-Expression vor, deren Aktivität mit voranschreitender Zeit immer weiter abnahm.rnWährend der Latenz exprimierte Transkripte, die für antigene Peptide kodieren, können infizierte Zellen für das Immunsystem sichtbar machen, was zu einer fortwährenden Restimulation des memory T-Zell-pools führen würde. Durch zeitgleiche Analyse der Transkript-Expression, sowie der Frequenzen Epitop-spezifischer CD8+ T-Zellen während der Latenz (IE1, m164, M105), wurde eine möglicher Zusammenhang zwischen der transkriptionellen Aktivität und der Expansion des memory T-Zell-pools untersucht. Die weitere Charakterisierung von Subpopulationen der Epitop-spezifischen CD8+ T-Zellen identifizierte die SLECs (short-lived-effector cells; CD127low CD62Llow KLRG1high) als die dominante Population in Lunge und Milz während der mCMV-Latenz.rnIn einem weiteren Teil der Arbeit sollte untersucht werden, ob IE-Genexpression zur Etablierung von Latenz notwendig ist. Mit Hilfe der Rekombinanten mCMV-Δie2-DTR, die die Gensequenz des Diphtherietoxin-Rezeptors (DTR) anstelle des Gens ie2 trägt, konnten infizierte, DTR exprimierende Zellen durch eine DT-Applikation konditional depletiert werden.rnIm latent infizierbaren Zelltyp der Leber, den LSECs (liver sinusoidal endothelial cells) wurde die virale Load durch 90-stündige DT–Applikation nach mCMV-Δie2-DTR Infektion auf das Level latent infizierter LSECs reduziert. Diese Daten sprechen für die Hypothese eines von Beginn an inaktiven Genoms, das keine IE-Genexpression zur Latenz-Etablierung benötigt. Zusätzlich stellt dieser Ansatz ein neues Tier-Modell zur Latenz-Etablierung dar. Verringerte Wartezeiten bis zur vollständigen Latenz-Etablierung, im Vergleich zum bisherigen Knochenmarktransplantations-Modell, könnten anfallende Tierhaltungskosten erheblich reduzieren und das Voranschreiten der Forschung beschleunigen.

The physiological role of APP in the activation of neuroprotective signaling mechanisms

Accumulating evidence indicates that loss of physiological amyloid precursor protein (APP) function leads to enhanced susceptibility of neurons to cellular stress during brain aging. This study investigated the neuroprotective function of the soluble APP ectodomain sAPPα. Recombinant sAPPα protected primary hippocampal neurons and neuroblastoma cells from cell death induced by trophic factor deprivation. This protective effect was abrogated in APP-depleted neurons, but not in APLP1-, APLP2- or IGF1-R-deficient cells, indicating that expression of holo-APP is required for sAPPα-dependent neuroprotection. Strikingly, recombinant sAPPα, APP-E1 domain and the copper-binding growth factor-like domain (GFLD) of APP were able to stimulate PI3K/Akt survival signaling in different wildtype cell models, but failed in APP-deficient cells. An ADAM10 inhibitor blocking endogenous sAPPα secretion exacerbated neuron death in organotypic hippocampal slices subjected to metabolic stress, which could be rescued by exogenous sAPPα. Interestingly, sAPPα-dependent neuroprotection was unaffected in neurons of APP-ΔCT15 mice which lack the intracellular C-terminal YENPTY motif of APP. In contrast, sAPPα-dependent Akt signaling was completely abolished in APP mutant cells lacking the C-terminal G-protein interaction motif and by specifically blocking Gi/o-dependent signaling with pertussis toxin. Collectively, the present thesis provides new mechanistic insights into the physiological role of APP: the data suggest that cell surface APP mediates sAPPα-induced neuroprotection via Go-protein-coupled activation of the Akt pathway.

Turning placenta into brain: placental mesenchymal stem cells differentiate into neurons and oligodendrocytes

We aimed to induce neural stem (NSC) and progenitor cells (NPC) from human placental tissues.

Results of the randomized, placebo-controlled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral arterial disease (CASPAR) trial

OBJECTIVE: Dual antiplatelet therapy with clopidogrel plus acetylsalicylic acid (ASA) is superior to ASA alone in patients with acute coronary syndromes and in those undergoing percutaneous coronary intervention. We sought to determine whether clopidogrel plus ASA conferred benefit on limb outcomes over ASA alone in patients undergoing below-knee bypass grafting. METHODS: Patients undergoing unilateral, below-knee bypass graft for atherosclerotic peripheral arterial disease (PAD) were enrolled 2 to 4 days after surgery and were randomly assigned to clopidogrel 75 mg/day plus ASA 75 to 100 mg/day or placebo plus ASA 75 to 100 mg/day for 6 to 24 months. The primary efficacy endpoint was a composite of index-graft occlusion or revascularization, above-ankle amputation of the affected limb, or death. The primary safety endpoint was severe bleeding (Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries [GUSTO] classification). RESULTS: In the overall population, the primary endpoint occurred in 149 of 425 patients in the clopidogrel group vs 151 of 426 patients in the placebo (plus ASA) group (hazard ratio [HR], 0.98; 95% confidence interval [CI], 0.78-1.23). In a prespecified subgroup analysis, the primary endpoint was significantly reduced by clopidogrel in prosthetic graft patients (HR, 0.65; 95% CI, 0.45-0.95; P = .025) but not in venous graft patients (HR, 1.25; 95% CI, 0.94-1.67, not significant [NS]). A significant statistical interaction between treatment effect and graft type was observed (P(interaction) = .008). Although total bleeds were more frequent with clopidogrel, there was no significant difference between the rates of severe bleeding in the clopidogrel and placebo (plus ASA) groups (2.1% vs 1.2%). CONCLUSION: The combination of clopidogrel plus ASA did not improve limb or systemic outcomes in the overall population of PAD patients requiring below-knee bypass grafting. Subgroup analysis suggests that clopidogrel plus ASA confers benefit in patients receiving prosthetic grafts without significantly increasing major bleeding risk.

Ventricular prosthesis embolization during transapical aortic valve implantation: the role of transesophageal echocardiography in diagnosis and management

The authors present the case of an 81-year-old patient with severe aortic stenosis who experienced left ventricular embolization of an aortic bioprosthesis during transapical aortic valve implantation. The authors discuss reasons for prosthesis embolization and reinforce the attention to technical details and the widespread use of multimodality imaging techniques. In this context, transesophageal echocardiography appears indispensable in the detection and management of procedure-related complications.

Toward optimal display of physiologic status in critical care: I. Recreating bedside displays from archived physiologic data

BACKGROUND: Physiologic data display is essential to decision making in critical care. Current displays echo first-generation hemodynamic monitors dating to the 1970s and have not kept pace with new insights into physiology or the needs of clinicians who must make progressively more complex decisions about their patients. The effectiveness of any redesign must be tested before deployment. Tools that compare current displays with novel presentations of processed physiologic data are required. Regenerating conventional physiologic displays from archived physiologic data is an essential first step. OBJECTIVES: The purposes of the study were to (1) describe the SSSI (single sensor single indicator) paradigm that is currently used for physiologic signal displays, (2) identify and discuss possible extensions and enhancements of the SSSI paradigm, and (3) develop a general approach and a software prototype to construct such "extended SSSI displays" from raw data. RESULTS: We present Multi Wave Animator (MWA) framework-a set of open source MATLAB (MathWorks, Inc., Natick, MA, USA) scripts aimed to create dynamic visualizations (eg, video files in AVI format) of patient vital signs recorded from bedside (intensive care unit or operating room) monitors. Multi Wave Animator creates animations in which vital signs are displayed to mimic their appearance on current bedside monitors. The source code of MWA is freely available online together with a detailed tutorial and sample data sets.

Factors affecting bony impingement in hip arthroplasty

Computer modeling of 10 patients' computed tomographic scans was used to study the variables affecting hip arthroplasty range of motion before bony impingement (ROMBI) including acetabular offset and height, femoral offset, height and anteversion, and osteophyte removal. The ROMBI was compared with the ROM before component impingement and the native hip ROM. The ROMBI decreased with decreased total offset and limb shortening. Acetabular offset and height had a greater effect on ROMBI than femoral offset and height. The ROMBI lost with decreased acetabular offset was not fully recoverable with an increase in femoral offset or osteophyte removal. Bony impingement increased and component impingement decreased with decreased acetabular offset and increased head diameter.

Role of somatostatins in gastroenteropancreatic neuroendocrine tumor development and therapy

The incidence and prevalence of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) have increased in the past 20 years. GEP-NETs are heterogeneous tumors, in terms of clinical and biological features, that originate from the pancreas or the intestinal tract. Some GEP-NETs grow very slowly, some grow rapidly and do not cause symptoms, and others cause hormone hypersecretion and associated symptoms. Most GEP-NETs overexpress receptors for somatostatins. Somatostatins inhibit the release of many hormones and other secretory proteins; their effects are mediated by G protein-coupled receptors that are expressed in a tissue-specific manner. Most GEP-NETs overexpress the somatostatin receptor SSTR2; somatostatin analogues are the best therapeutic option for functional neuroendocrine tumors because they reduce hormone-related symptoms and also have antitumor effects. Long-acting formulations of somatostatin analogues stabilize tumor growth over long periods. The development of radioactive analogues for imaging and peptide receptor radiotherapy has improved the management of GEP-NETs. Peptide receptor radiotherapy has significant antitumor effects, increasing overall survival times of patients with tumors that express a high density of SSTRs, particularly SSTR2 and SSTR5. The multi-receptor somatostatin analogue SOM230 (pasireotide) and chimeric molecules that bind SSTR2 and the dopamine receptor D2 are also being developed to treat patients with GEP-NETs. Combinations of radioactive labeled and unlabeled somatostatin analogues and therapeutics that inhibit other signaling pathways, such as mammalian target of rapamycin (mTOR) and vascular endothelial growth factor, might be the most effective therapeutics for GEP-NETs.

Budesonide is effective in adolescent and adult patients with active eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus characterized by dense tissue eosinophilia; it is refractory to proton pump inhibitor therapy. EoE affects all age groups but most frequently individuals between 20 and 50 years of age. Topical corticosteroids are effective in pediatric patients with EoE, but no controlled studies of corticosteroids have been reported in adult patients.

CONSORT 2010 Explanation and Elaboration: Updated guidelines for reporting parallel group randomised trials

Overwhelming evidence shows the quality of reporting of randomised controlled trials (RCTs) is not optimal. Without transparent reporting, readers cannot judge the reliability and validity of trial findings nor extract information for systematic reviews. Recent methodological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects. Such systematic error is seriously damaging to RCTs, which are considered the gold standard for evaluating interventions because of their ability to minimise or avoid bias. A group of scientists and editors developed the CONSORT (Consolidated Standards of Reporting Trials) statement to improve the quality of reporting of RCTs. It was first published in 1996 and updated in 2001. The statement consists of a checklist and flow diagram that authors can use for reporting an RCT. Many leading medical journals and major international editorial groups have endorsed the CONSORT statement. The statement facilitates critical appraisal and interpretation of RCTs. During the 2001 CONSORT revision, it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports. A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement. After an expert meeting in January 2007, the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement. This update improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition, such as selective outcome reporting bias. This explanatory and elaboration document-intended to enhance the use, understanding, and dissemination of the CONSORT statement-has also been extensively revised. It presents the meaning and rationale for each new and updated checklist item providing examples of good reporting and, where possible, references to relevant empirical studies. Several examples of flow diagrams are included. The CONSORT 2010 Statement, this revised explanatory and elaboration document, and the associated website (www.consort-statement.org) should be helpful resources to improve reporting of randomised trials.

Stab or throw? Biomechanical studies on the injuring potential of glass fragments

During a Christmas party, two male guests started fighting. The perpetrator was allegedly pushed onto a glass table by the victim or fell into the table together with that man so that the glass top broke and caused a cut wound on the perpetrator's back. According to his statement he then threw a fragment of the broken glass table in the direction of the other man hitting him accidentally in a way so that the subclavian artery was severed and he died from exsanguination. Tests on the breaking characteristics of the glass table, the flying behaviour and the kinetics of thrown glass fragments conducted on various models supported the conclusion that the fatal injury on the victim's neck could not have been caused by a thrown glass fragment. It was much more likely that a stab with a blade-shaped glass fragment was the cause of the fatal injuries.

Dual low response to acetylsalicylic acid and clopidogrel is associated with myonecrosis and stent thrombosis after coronary stent implantation

Impaired response to antiplatelet therapy with acetylsalicylic acid (ASA) and clopidogrel (CLO) has been associated with an increased risk of stent thrombosis and ischemic events after coronary stent implantation. We sought to investigate whether patients with a low response (LR) to ASA or CLO are at increased risk for periprocedural and short-term ischemic events after coronary stent implantation.

Getting in touch-3D printing in Forensic Imaging

With the increasing use of medical imaging in forensics, as well as the technological advances in rapid prototyping, we suggest combining these techniques to generate displays of forensic findings. We used computed tomography (CT), CT angiography, magnetic resonance imaging (MRI) and surface scanning with photogrammetry in conjunction with segmentation techniques to generate 3D polygon meshes. Based on these data sets, a 3D printer created colored models of the anatomical structures. Using this technique, we could create models of bone fractures, vessels, cardiac infarctions, ruptured organs as well as bitemark wounds. The final models are anatomically accurate, fully colored representations of bones, vessels and soft tissue, and they demonstrate radiologically visible pathologies. The models are more easily understood by laypersons than volume rendering or 2D reconstructions. Therefore, they are suitable for presentations in courtrooms and for educational purposes.