Novel matrix metalloproteinases in intestinal inflammation and in cancer of the gastrointestinal tract

Matrix metalloproteinases (MMPs) comprise a family of 23 zinc-dependent human endopeptidases that can degrade virtually all components of the extracellular matrix (ECM). They are classified into eight subgroups according to their structure and into six subgroups based on their substrate-specificity. MMPs have been implicated in inflammation, tissue destruction, cell migration, arthritis, vascular remodeling, angiogenesis, and tumor growth and invasion. MMPs are inhibited by their natural inhibitors, tissue inhibitors of metalloproteinases (TIMPs). Different MMPs function in the same tasks depending on the tissue or cancer subtype. I investigated the role of recently discovered MMPs, especially MMPs-19 and -26, in intestinal inflammation, in intestinal and cutaneous wound healing, and in intestinal cancer. Several MMPs and TIMPs were studied to determine their exact location at tissue level and to obtain information on possible functions of MMPs in such tissues and diseases as the healthy intestine, inflammatory bowel disease (IBD), neonatal necrotizing enterocolitis (NEC), pyoderma gangrenosum (PG), and colorectal as well as pancreatic cancers. In latent celiac disease (CD), I attempted to identify markers to predict later onset of CD in children and adolescents. The main methods used were immunohistochemistry, in situ hybridization, and Taqman RT-PCR. My results show that MMP-26 is important for re-epithelialization in intestinal and cutaneous wound healing. In colon and pancreatic cancers, MMP-26 seems to be a marker of invasive potential, although it is not itself expressed at the invasive front. MMP-21 is upregulated in pancreatic cancer and may be associated with tumor differentiation. MMPs-19 and -28 are associated with normal tissue turnover in the intestine, but they disappear in tumor progression as if they were protective markers . MMP-12 is an essential protease in intestinal inflammation and tissue destruction, as seen here in NEC and in previous CD studies. In patients with type 1 diabetes (T1D), MMPs-1, -3, and -12 were upregulated in the intestinal mucosa. Furthermore, MMP-7 was strongly elevated in NEC. In a model of aberrant wound repair, PG, MMPs-8, -9, and 10 and TNFα may promote ECM destruction, while absence of MMP-1 and MMP-26 from keratinocytes retards re-epithelialization. Based on my results, I suggest MMP-26 to be considered a putative marker for poor prognosis in pancreatic and colon cancer. However, since it functions differently in various tissues and tumor subtypes, this use cannot be generalized. Furthermore, MMP-26 is a beneficial marker for wound healing if expressed by migrating epithelial cells. MMP-12 expression in latent CD patients warrants research in a larger patient population to confirm its role as a specific marker for CD in pathologically indistinct cases. MMP-7 should be considered one of the most crucial proteases in NEC-associated tissue destruction; hence, specific inhibitors of this MMP are worth investigating. In PG, TNFα inhibitors are potential therapeutic agents, as shown already in clinical trials. In conclusion, studies of several MMPs in specific diseases and in healthy tissues are needed to elucidate their roles at the tissue level. MMPs and TIMPs are not exclusively destructive or reparative in tissues. They seem to function differently in different tissues. To identify selective MMP inhibitors, we must thoroughly understand the MMP profile (degradome) and their functions in various organs not to interfere with normal reparative functions during wound repair or beneficial host-response effects during cancer initiation and growth.

Expression profiling of lymph nodes in tuberculosis patients reveal inflammatory milieu at site of infection

Extrapulmonary manifestations constitute 15 to 20% of tuberculosis cases, with lymph node tuberculosis (LNTB) as the most common form of infection. However, diagnosis and treatment advances are hindered by lack of understanding of LNTB biology. To identify host response, Mycobacterium tuberculosis infected lymph nodes from LNTB patients were studied by means of transcriptomics and quantitative proteomics analyses. The selected targets obtained by comparative analyses were validated by quantitative PCR and immunohistochemistry. This approach provided expression data for 8,728 transcripts and 102 proteins, differentially regulated in the infected human lymph node. Enhanced inflammation with upregulation of T-helper1-related genes, combined with marked dysregulation of matrix metalloproteinases, indicates tissue damage due to high immunoactivity at infected niche. This expression signature was accompanied by significant upregulation of an immunoregulatory gene, leukotriene A4 hydrolase, at both transcript and protein levels. Comparative transcriptional analyses revealed LNTB-specific perturbations. In contrast to pulmonary TB-associated increase in lipid metabolism, genes involved in fatty-acid metabolism were found to be downregulated in LNTB suggesting differential lipid metabolic signature. This study investigates the tissue molecular signature of LNTB patients for the first time and presents findings that indicate the possible mechanism of disease pathology through dysregulation of inflammatory and tissue-repair processes.

Kirjallisuusosa: Alzheimerin taudin rottamallien vastaavuus tautiin ihmisessä ja mallien käyttökelpoisuus

Kirjallisuusosa: Alzheimerin taudin hoitoon olisi tarvetta uusille taudinkulkuun vaikuttaville lääkeaineille. Niiden kehittämiseksi tarvitaan eläinmalleja, joissa esiintyy taudin patofysiologisia piirteitä. Rottamalleista vanhemmat skopolamiini- tai MK-801-häirintä sekä ikääntyneiden rottien käyttö eivät kovin hyvin vastaa taudin patofysiologiaa, vaikka niissä eläimen muisti käyttäytymiskokeissa onkin heikentynyt. Uudemmat transgeeniset rottamallit ja mallit, joissa annetaan Aβ:a aivoihin, ilmentävät huomattavasti paremmin Alzheimerin taudin kaltaista tilaa aivoissa ainakin Aβ:n osalta. Taupatofysiologiaa ei silti kummassakaan näistä malleista juuri esiinny. Toisaalta Aβ:lla näyttäisi olevan huomattavasti tau:ta suurempi rooli taudissa, joten sen ilmeneminen mallissa onkin keskeisempi tekijä. Nämä mallit ilmentävät melko suurelti osin yhtä hyvin Alzheimerin taudin patofysiologiaa. Aβ:n antaminen on hieman yksinkertaisempi suorittaa käytännössä, sillä siinä ei tarvitse luoda transgeenista kantaa. Toisaalta transgeenisessa mallissa Aβ-patofysiologia syntyy enemmän Alzheimerin taudin kaltaisesti solujen sisällä eikä valmiita aggregoituvia Aβ-peptidejä anneta ulkopuolelta aivoihin. Molemmat mallit ovat kuitenkin käyttökelpoisia, ja soveltuvat erityisesti Aβ:an vaikuttavien lääkeaineiden kehittämiseen. Kokeellinen osa: Kokeen tarkoituksena oli validoida kohotettu ristikko-sokkelo (elevated plus-maze, EPM) hiirillä kognitiomallina. Kokeessa käytettiin kahden koekerran (trial, T) menetelmää, jossa koekertojen pituus oli viisi minuuttia. Näin saatiin useita oppimista kuvaavia parametreja. Hiirille yritettiin saada muistihäiriö aikaviiveen avulla (koekertojen väli 1-18 vrk) tai antamalla muskariinireseptoriantagonistia skopolamiinia (0,1-0,8 mg/kg i.p.) 30 minuuttia ennen T1:tä. Nämä kokeet suoritettiin sekä C57BL/6J- että ICR:(CD-1)-hiirillä. Aikaviivekokeissa ainut ryhmä, jolla oli viitettä unohtamisesta, oli ICR:(CD-1)-hiirien 18 vrk:n ryhmä. Tämän perusteella tutkittiin vielä 21 vuorokauden aikaväli, mutta selvää muistihäiriötä ei esiintynyt. Skopolamiini ei häirinnyt muistia ICR:(CD-1)-hiirillä, mutta C57BL/6J-hiirillä 0,2 mg/kg:n annoksesta ylöspäin merkitsevä muistihäiriö esiintyi. Näin ollen jatkokokeissa käytettäväksi valittiin skopolamiinin annos 0,2 mg/kg C57BL/6J-hiirillä, ja siinä tutkittiin donepetsiilin (0,3, 0,8 ja 1,5 mg/kg s.c), memantiinin (5,0 ja 10,0 mg/kg s.c) ja kokeellisen 5-HT6-antagonistin SB742457:n (1,5 ja 6,0 mg/kg s.c) muistia parantavia vaikutuksia. Tutkittavat lääkeaineet annettiin 40 minuuttia ennen T1:tä ja skopolamiini 30 minuuttia ennen. Memantiinilla (5,0 mg/kg) oli selkeä skopolamiinin heikentämää kognitiota parantava vaikutus ja donepetsiilillakin (1,5 mg/kg) suuntaus tähän. Tulosten perusteella malli näyttäisi soveltuvan muisti- ja oppimisvaikutusten tutkimiseen käytettäväksi malliksi.

Accuracy in Copy Number Calling by qPCR and PRT : A Matter of DNA

7 p.

Designing conformational control of human tissue transglutaminase

Understanding the mechanisms of enzymes is crucial for our understanding of their role in biology and for designing methods to perturb or harness their activities for medical treatments, industrial processes, or biological engineering. One aspect of enzymes that makes them difficult to fully understand is that they are in constant motion, and these motions and the conformations adopted throughout these transitions often play a role in their function.

Traditionally, it has been difficult to isolate a protein in a particular conformation to determine what role each form plays in the reaction or biology of that enzyme. A new technology, computational protein design, makes the isolation of various conformations possible, and therefore is an extremely powerful tool in enabling a fuller understanding of the role a protein conformation plays in various biological processes.

One such protein that undergoes large structural shifts during different activities is human type II transglutaminase (TG2). TG2 is an enzyme that exists in two dramatically different conformational states: (1) an open, extended form, which is adopted upon the binding of calcium, and (2) a closed, compact form, which is adopted upon the binding of GTP or GDP. TG2 possess two separate active sites, each with a radically different activity. This open, calcium-bound form of TG2 is believed to act as a transglutaminse, where it catalyzes the formation of an isopeptide bond between the sidechain of a peptide-bound glutamine and a primary amine. The closed, GTP-bound conformation is believed to act as a GTPase. TG2 is also implicated in a variety of biological and pathological processes.

To better understand the effects of TG2’s conformations on its activities and pathological processes, we set out to design variants of TG2 isolated in either the closed or open conformations. We were able to design open-locked and closed-biased TG2 variants, and use these designs to unseat the current understanding of the activities and their concurrent conformations of TG2 and explore each conformation’s role in celiac disease models. This work also enabled us to help explain older confusing results in regards to this enzyme and its activities. The new model for TG2 activity has immense implications for our understanding of its functional capabilities in various environments, and for our ability to understand which conformations need to be inhibited in the design of new drugs for diseases in which TG2’s activities are believed to elicit pathological effects.

Prevalência de doença celíaca em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia Digestiva do Hospital Universitário Pedro Ernesto da UERJ

A Doença Celíaca (DC) é uma doença autoimune que afeta o intestino delgado de indivíduos geneticamente susceptíveis após contato com o glúten. Diversos estudos têm relatado aumento da prevalência ao longo dos anos. Objetivo: Determinar a prevalência de DC em pacientes adultos sem diarreia encaminhados à Disciplina de Gastroenterologia do HUPE da UERJ para serem submetidos a Endoscopia Digestiva Alta (EDA).Comparar os resultados do histopatológico das biópsias duodenais com os resultados sorológicos, utilizando o anticorpo antitransglutaminase tecidual IgA (ATGt IgA). Métodos: Pacientes que foram encaminhados ao nosso serviço para serem submetidos a EDA entre Julho de 2008 e Julho de 2010, com idade entre 18 e 85 anos foram aceitos no estudo. Critérios de exclusão foram cirrose, neoplasias do trato gastrointestinal, HIV, uso de imunossupressores e anticoagulantes, diarreia, hemorragia digestiva e DC. Coleta de sangue para pesquisa do anticorpo ATGt IgA (utilizando KIT ORGENTEC - Alemanha), avaliação endoscópica e exame histopatológico das biópsias de segunda porção duodenal foram feitos para cada paciente. Biópsias foram avaliadas de acordo com o critério de Marsh modificado. Resultados: Trezentos e noventa e nove pacientes consecutivos (112 homens, 287 mulheres), média de idade 49,616,4 anos, variando de 18-85 anos, sem diarreia, foram prospectivamente aceitos. Os sintomas clínicos mais prevalentes foram dor abdominal em 99,5%, pirose em 41,1%, plenitude pós prandial em 30,6%, náuseas e vômitos em 21,3%. Os achados endoscópicos foram: normais em 41,6%, lesões pépticas (esofagite, gastrite, duodenite e úlceras) em 41,6%, hérnia hiatal em 5,5%, pólipos gástricos em 3%, neoplasias em 1,3% e miscelânea em 7%. DC foi endoscopicamente diagnosticada em 13 pacientes (3,3%) com mucosa duodenal exibindo serrilhamento das pregas em 8 (2%), diminuição do pregueado em 2 (0,5%) e mucosa exibindo padrão nodular e mosaico em 3 (0,75%). Os achados histopatológicos de duodeno foram normais em 96,7%, duodenites inespecíficas em 2,7% e 3 pacientes (0,75%) confirmaram DC pelos critérios de Marsh modificado (IIIa, IIIb e IIIc). O anticorpo ATGt IgA foi positivo (>10 U/ml) em 1,3% (5/399). Conclusão: Este estudo mostrou que a prevalência de DC em pacientes dispépticos sem diarreia atendidos na Disciplina de Gastroenterologia e Endoscopia do HUPE/UERJ foi de 0,75% (1:133). A acurácia diagnóstica do anticorpo ATGt IgA é boa para pacientes com Marsh III e achados endoscópicos sugestivos. Nenhum dos pacientes tinha alterações Marsh I ou II. A EDA se mostrou um excelente método de triagem para definir os pacientes com graus mais acentuados de atrofia e que se beneficiariam de biópsia e sorologia para confirmação diagnóstica. Os resultados obtidos neste trabalho não justificam uma triagem rotineira de DC.

Gen LPP : Avances en el conocimiento de uno de los genes candidato de la enfermedad celíaca

[ES] La enfermedad celíaca (EC) es una enteropatía autoinmune de predisposición genética, producida por la ingestión en la dieta de péptidos derivados de cereales como el trigo o la cebada. Aunque se creía que afectaba casi de forma exclusiva a los individuos europeos (1%), actualmente se conocen casos en todo el mundo. El modelo patogénico se centra en los mecanismos de la inmunidad adaptativa dependientes de la estimulación de linfocitos T CD4+ reactivos, pero existe además un efecto tóxico directo del gluten sobre el epitelio intestinal, dependiente de la inmunidad innata. La participación de la Genética en la susceptibilidad a la enfermedad es conocida desde hace tiempo, siendo el locus HLA el que explica aproximadamente el 40% del componente genético de la enfermedad. Para tratar de identificar otros genes con susceptibilidad, se han venido realizando múltiples esfuerzos durante los últimos años. Uno de los últimos, llevado a cabo en 2011, fue el Proyecto Immunochip. En él, se analizaron más de 200.000 variantes y se descubrieron 13 nuevos loci de riesgo para la EC, que junto con los descubiertos en anteriores trabajos y el locus HLA, daban un total de 40 loci de riesgo. Entre ellos, se encontraba la región que ocupa el gen LPP . Localizado en el cromosoma 3, un estudio reciente lo vincula con los procesos de adhesión celular en el intestino. En el presente trabajo, se ha estudiado el efecto de la gliadina sobre la expresión del gen de interés (LPP ) y el posible efecto de un silenciamiento del mismo sobre dos genes relacionados con las uniones celulares (ACTB y TJP1). En el caso de la gliadina, no se halló un cambio significativo en la expresión del gen. Mientras, los resultados del efecto del silenciamiento fueron dispares, no siendo concluyentes para el gen ACTB, pero encontrando una posible asociación entre los genes LPP y TJP1.

A Doença Celíaca

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Cereal products for specific dietary requirements. Evaluation and improvement of technological and nutritional properties of gluten free raw materials and end products

Coeliac disease is one of the most common food intolerances worldwide and at present the gluten free diet remains the only suitable treatment. A market overview conducted as part of this thesis on nutritional and sensory quality of commercially available gluten free breads and pasta showed that improvements are necessary. Many products show strong off-flavors, poor mouthfeel and reduced shelf-life. Since the life-long avoidance of the cereal protein gluten means a major change to the diet, it is important to also consider the nutritional value of products intending to replace staple foods such as bread or pasta. This thesis addresses this issue by characterising available gluten free cereal and pseudocereal flours to facilitate a better raw material choice. It was observed that especially quinoa, buckwheat and teff are high in essential nutrients, such as protein, minerals and folate. In addition the potential of functional ingredients such as inulin, β-glucan, HPMC and xanthan to improve loaf quality were evaluated. Results show that these ingredients can increase loaf volume and reduce crumb hardness as well as rate of staling but that the effect diverges strongly depending on the bread formulation used. Furthermore, fresh egg pasta formulations based on teff and oat flour were developed. The resulting products were characterised regarding sensory and textural properties as well as in vitro digestibility. Scanning electron and confocal laser scanning microscopy was used throughout the thesis to visualise structural changes occurring during baking and pasta making

Dépistage sérologique de la maladie coeliaque: quel test utiliser?

Editorial

The Dietary Approaches to Stop Hypertension (DASH) eating pattern in special populations.

The Dietary Approaches to Stop Hypertension (DASH) trial showed that a diet rich in fruits, vegetables, low-fat dairy products with reduced total and saturated fat, cholesterol, and sugar-sweetened products effectively lowers blood pressure in individuals with prehypertension and stage I hypertension. Limited evidence is available on the safety and efficacy of the DASH eating pattern in special patient populations that were excluded from the trial. Caution should be exercised before initiating the DASH diet in patients with chronic kidney disease, chronic liver disease, and those who are prescribed renin-angiotensin-aldosterone system antagonist, but these conditions are not strict contraindications to DASH. Modifications to the DASH diet may be necessary to facilitate its use in patients with chronic heart failure, uncontrolled diabetes mellitus type II, lactose intolerance, and celiac disease. In general, the DASH diet can be adopted by most patient populations and initiated simultaneously with medication therapy and other lifestyle interventions.

Inorganic arsenic contents in rice-based infant foods from Spain, UK, China and USA

Spanish gluten-free rice, cereals with gluten, and pureed baby foods were analysed for total (t-As) and inorganic As (i-As) using ICP-MS and HPLC-ICP-MS, respectively. Besides, pure infant rice from China, USA, UK and Spain were also analysed. The i-As contents were significantly higher in gluten-free rice than in cereals mixtures with gluten, placing infants with celiac disease at high risk. All rice-based products displayed a high i-As content, with values being above 60% of the t-As content and the remainder being dimethylarsinic acid (DMA). Approximately 77% of the pure infant rice samples showed contents below 150 µg kg(-1) (Chinese limit). When daily intake of i-As by infants (4-12 months) was estimated and expressed on a bodyweight basis (µg d(-1) kg(-1)), it was higher in all infants aged 8-12 months than drinking water maximum exposures predicted for adults (assuming 1 L consumption per day for a 10 µg L(-1) standard).

Market Basket Survey Shows Elevated Levels of As in South Central U.S. Processed Rice Compared to California: Consequences for Human Dietary Exposure:consequences for human dietary exposure

We report the largest market basket survey of arsenic (As) in U.S. rice to date. Our findings show differences in transitional-metal levels between polished and unpolished rice and geographical variation in As and selenium (Se) between rice processed in California and the South Central U.S. The mean and median As grain levels for the South Central U.S. were 0.30 and 0.27 µg As g-1, respectively, for 107 samples. Levels for California were 41% lower than the South Central U.S., with a mean of 0.17 µg As g-1 and a median of 0.16 µg As g-1 for 27 samples. The mean and median Se grain levels for the South Central U.S. were 0.19 µg Se g-1. Californian rice levels were lower, averaging only 0.08 and 0.06 µg Se g-1 for mean and median values, respectively. The difference between the two regions was found to be significant for As and Se (General Linear Model (GLM):? As p < 0.001; Se p < 0.001). No statistically significant differences were observed in As or Se levels between polished and unpolished rice (GLM:? As p = 0.213; Se p = 0.113). No significant differences in grain levels of manganese (Mn), cobalt (Co), copper (Cu), or zinc (Zn) were observed between California and the South Central U.S. Modeling arsenic intake for the U.S. population based on this survey shows that for certain groups (namely Hispanics, Asians, sufferers of Celiac disease, and infants) dietary exposure to inorganic As from elevated levels in rice potentially exceeds the maximum intake of As from drinking water (based on consumption of 1 L of 0.01 mg L-1 In. As) and Californian state exposure limits. Further studies on the transformation of As in soil, grain As bioavailability in the human gastrointestinal tract, and grain elemental speciation trends are critical.

Arsenic Contents in Spanish Infant Rice, Pureed Infant Foods, and Rice

It seems there is a positive correlation between rice content and arsenic level in foods. This is of extraordinary importance for infants below 1 y of age because their diet is very limited and in some cases is highly dependent on rice-based products; this is particularly true for infants with the celiac disease because they have no other option than consume gluten-free products, such as rice or corn. Arsenic contents were significantly higher (P <0.001) in gluten-free infant rice (0.057 mg kg-1) than in products with gluten, based on a mixture of cereals (0.024 mg kg-1). Besides, especial precaution must be taken when preparing rice-based products at home, because arsenic content in Spanish rice was high, with levels being above 0.3 mg kg-1 in some cases.

Adenovirus 12 E1A gene detection by polymerase chain reaction in both the normal and coeliac duodenum

A 12 amino acid sequence from the adenovirus 12 E1B protein is homologous at the protein level with a similar 12-mer derived from the wheat protein A-gliadin. It has been suggested that exposure to Ad 12 could sensitise individuals to gliadins with resultant gluten sensitive enteropathy. In this study, the polymerase chain reaction (PCR) was used to analyse duodenal biopsy tissue from patients with coeliac disease for the presence of Ad 12. The sensitivity of the assay system was at least 1 in 10(5) cells and specificity was confirmed both by probing with an internal oligonucleotide and by direct sequencing. Ad 12 sequences were detected in three of 17 patients with adult coeliac disease and in five of 16 adult controls with normal duodenal biopsies. Since exposure to the virus would be predicted to occur in infancy we also studied patients with childhood coeliac disease diagnosed at less than 1 year of age. Ad 12 was positive in three of 10 childhood coeliac patients and one of seven controls. In addition, we studied a cohort of patients who presented with a diarrhoeal illness and associated anti alpha gliadin antibodies in 1983. These patients had duodenal biopsies performed at this time. One of three patients with abnormal histology had detectable Ad 12 while two of 14 with normal findings were positive for Ad 12. Finally, the potential oncogenic nature of Ad 12 prompted examination of a group of patients with intestinal tumours. Ad 12 DNA was, however, in only two of 19 tumour samples tested. These data indicate that Ad 12 can be successfully detected using PCR on paraffin embedded tissue. Furthermore, Ad 12 was detected at a relatively high level in normal duodenum. The results do not, however, support the hypothesis that prior exposure to Ad 12 is implicated in the pathogenesis of coeliac disease.