Epigenetic regulation in neural crest development : role of DNA methyltransferases 3A and 3B

The neural crest is a group of migratory, multipotent stem cells that play a crucial role in many aspects of embryonic development. This uniquely vertebrate cell population forms within the dorsal neural tube but then emigrates out and migrates long distances to different regions of the body. These cells contribute to formation of many structures such as the peripheral nervous system, craniofacial skeleton, and pigmentation of the skin. Why some neural tube cells undergo a change from neural to neural crest cell fate is unknown as is the timing of both onset and cessation of their emigration from the neural tube. In recent years, growing evidence supports an important role for epigenetic regulation as a new mechanism for controlling aspects of neural crest development. In this thesis, I dissect the roles of the de novo DNA methyltransferases (DNMTs) 3A and 3B in neural crest specification, migration and differentiation. First, I show that DNMT3A limits the spatial boundary between neural crest versus neural tube progenitors within the neuroepithelium. DNMT3A promotes neural crest specification by directly mediating repression of neural genes, like Sox2 and Sox3. Its knockdown causes ectopic Sox2 and Sox3 expression at the expense of neural crest territory. Thus, DNMT3A functions as a molecular switch, repressing neural to favor neural crest cell fate. Second, I find that DNMT3B restricts the temporal window during which the neural crest cells emigrate from the dorsal neural tube. Knockdown of DNMT3B causes an excess of neural crest emigration, by extending the time that the neural tube is competent to generate emigrating neural crest cells. In older embryos, this resulted in premature neuronal differentiation. Thus, DNMT3B regulates the duration of neural crest production by the neural tube and the timing of their differentiation. My results in avian embryos suggest that de novo DNA methylation, exerted by both DNMT3A and DNMT3B, plays a dual role in neural crest development, with each individual paralogue apparently functioning during a distinct temporal window. The results suggest that de novo DNA methylation is a critical epigenetic mark used for cell fate restriction of progenitor cells during neural crest cell fate specification. Our discovery provides important insights into the mechanisms that determine whether a cell becomes part of the central nervous system or peripheral cell lineages.

Insights into Neural Crest Evolution

Neural crest cells are unique to vertebrates and essential to the development and evolution of the craniofacial skeleton. Using a combination of DiI cell lineage tracing, transcriptomics, and analysis of key transcription factors of the Sox Family, I examined neural crest development in the sea lamprey, Petromyzon marinus, as the most basal extant vertebrate from which it is possible to get embryos. The results have uncovered distinct cranial and trunk neural crest subpopulations along the anterior-posterior axis of the lamprey embryo, with a clear separation between the two. However, no evidence of the presence of an intermediate vagal neural crest population was uncovered. Comparing cranial neural crest genes between lamprey and chick, either by examining individual candidate genes or whole genome transcriptome analysis, reveals significant changes in the cranial neural crest gene regulatory network of lamprey compared with chick. In particular, the lamprey cranial neural crest is "missing" several gnathostome cranial crest genes. We speculate that these may underlie the evolutionary divergence of craniofacial development between jawed and jawless vertebrates. Despite the absence of vagal neural crest, DiI-labeling shows that trunk neural crest-derived cells, likely homologous to mammalian Schwann cell precursors, contribute to the lamprey enteric nervous system, potentially representing the most primitive form of neural crest cells contribution to the ENS. Finally, I characterized key members of the Sox Family (Sox B-F) due to their importance in neural crest specification in other species. In comparative studies of the SoxC genes (Sox4, Sox11, and Sox12) in both lamprey and Xenopus, I found similar expression patterns and a novel key role in early neural crest specification, suggesting a conserved role of the SoxC genes amongst vertebrates. Taken together, this work represents important progress in characterizing the early evolution of the neural crest in vertebrates and its role in the transition from jawless to jawed vertebrates.

Prevalencia de las deformidades óseas y estructurales en pacientes con pie diabético que acuden al área de consulta externa de traumatología del Hospital Regional Vicente Corral Moscoso, Cuenca-Ecuador 2015

Objetivo general: Establecer la prevalencia de las deformidades óseas y estructurales en pacientes con pie diabético que acudieron al área de consulta externa de Traumatología del Hospital Regional Vicente Corral Moscoso durante el período de tres meses. Metodología: Estudio descriptivo llevado a cabo en 100 pacientes con pie diabético que acudieron a la consulta externa de Traumatología durante tres meses. El método de investigación fue la observación directa; las técnicas comprendieron entrevista, evaluación mediante plantoscopía y valoración radiográfica, los instrumentos usados fueron los formularios, los datos tras su validación fueron ingresados en una base en el programa SPSS V15; mediante el cual se realizó el análisis usando tablas simples con porcentajes y frecuencias relativas. Resultados: La media de edad fue de 64,09 años con el 84% de la población de sexo femenino; el cuadro clínico se caracterizó por presencia de callosidades 62%; metatarsalgia 57%; talalgia 48% y dolor en bunion de 21%. Tomando en consideración los parámetros radiográficos se diagnosticó hallux valgus 71%; deformidades de los dedos en garra 56%; pie plano 34%; dedos en martillo 31%; juanetillo de sastre 30%; hallux rigidus 16% y pie cavo 13%. La valoración mediante el uso de plantoscopía reveló 39% de pacientes pie plano y el 17% pie cavo

Características de las malformaciones congénitas en recién nacidos del Hospital Vicente Corral Moscoso, 2010-2014

Objetivo Determinar la prevalencia de las malformaciones congénitas y las características de las madres y de los recién nacidos malformados en el Hospital Vicente Corral Moscoso. Metodología Se realizó un estudio de tipo descriptivo (se determinó la prevalencia por año), se revisaron las historias clínicas de las madres con recién nacidos entre el periodo del 2010 al 2014. Para recolectar la información se empleó un formulario pre elaborado, los datos se agruparon según la clasificación del CIE-10 y se tabularan usando Microsoft Excel. Para el análisis de los datos se utilizó el software estadístico SPSS versión 15. Se describieron las variables del estudio de acuerdo a las medidas estadísticas apropiadas. Resultados La prevalencia de las malformaciones congénitas fue de 1.70 por cada 100 recién nacidos. Las mujeres entre 20 a 24 años, presentaron el mayor porcentaje de recién nacidos malformados con un 34.95%. Los recién nacidos malformados fueron mayoritariamente del sexo masculino con 53.83%. El grupo de malformación más frecuente fueron las malformaciones y deformidades congénitas del sistema osteomuscular con 18.88%, de las cuales la gastrosquisis fue la más frecuente, representada por el 4.85%. El síndrome polimalformativo fue el tipo de malformación congénita con el mayor porcentaje con un 10.71%. Conclusiones El presente estudio revela que la prevalencia encontrada de recién nacidos con malformaciones congénitas, fue similar a investigaciones previas a nivel regional y local. Se incluyeron únicamente las malformaciones que constituyen alteraciones morfológicas evidentes, encontrándose una mayor frecuencia del síndrome polimalformativo

Functional outcomes in the Cleft Care UK study - Part 3:oral health and audiology

OBJECTIVES: To compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies. SETTING AND SAMPLE POPULATION: Two UK-based cross-sectional studies of 5-year-olds born with non-syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low-volume operators. CCUK children were treated in a centralized, high volume operator system. MATERIALS AND METHODS: Oral health data were collected using a standardized proforma. Hearing was assessed using pure tone audiometry and middle ear status by otoscopy and tympanometry. ENT and hearing history were collected from medical notes and parental report. RESULTS: Oral health was assessed in 264 of 268 children (98.5%). The mean dmft was 2.3, 48% were caries free, and 44.7% had untreated caries. There was no evidence this had changed since the CSAG survey. Oral hygiene was generally good, 96% were enrolled with a dentist. Audiology was assessed in 227 of 268 children (84.7%). Forty-three per cent of children received at least one set of grommets--a 17.6% reduction compared to CSAG. Abnormal middle ear status was apparent in 50.7% of children. There was no change in hearing levels, but more children with hearing loss were managed with hearing aids. CONCLUSIONS: Outcomes for dental caries and hearing were no better in CCUK than in CSAG, although there was reduced use of grommets and increased use of hearing aids. The service specifications and recommendations should be scrutinized and implemented.

A cross-sectional survey of 5-year-old children with non-syndromic unilateral cleft lip and palate:the Cleft Care UK study. Part 1: background and methodology

OBJECTIVES: We describe the methodology for a major study investigating the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after an initial survey, detailed in the Clinical Standards Advisory Group (CSAG) report in 1998, had informed government recommendations on centralization. SETTING AND SAMPLE POPULATION: This is a UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Children born between 1 April 2005 and 31 March 2007 were seen in cleft centre audit clinics. MATERIALS AND METHODS: Consent was obtained for the collection of routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) and anthropometric measures (height, weight, head circumference). The methodology for each clinical measure followed those of the earlier survey as closely as possible. RESULTS: We identified 359 eligible children and recruited 268 (74.7%) to the study. Eleven separate records for each child were collected at the audit clinics. In total, 2666 (90.4%) were collected from a potential 2948 records. The response rates for the self-reported questionnaires, completed at home, were 52.6% for the Health and Lifestyle Questionnaire and 52.2% for the Satisfaction with Service Questionnaire. CONCLUSIONS: Response rates and measures were similar to those achieved in the previous survey. There are practical, administrative and methodological challenges in repeating cross-sectional surveys 15 years apart and producing comparable data.

Centralization of cleft care in the UK. Part 6:a tale of two studies

OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG). SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007. MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies. RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure. CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.

Self-healing thermal annealing: surface morphological restructuring control of GaN nanorods

With advances in nanolithography and dry etching, top-down methods of nanostructuring have become a widely used tool for improving the efficiency of optoelectronics. These nano dimensions can offer various benefits to the device performance in terms of light extraction and efficiency, but often at the expense of emission color quality. Broadening of the target emission peak and unwanted yellow luminescence are characteristic defect-related effects due to the ion beam etching damage, particularly for III–N based materials. In this article we focus on GaN based nanorods, showing that through thermal annealing the surface roughness and deformities of the crystal structure can be “self-healed”. Correlative electron microscopy and atomic force microscopy show the change from spherical nanorods to faceted hexagonal structures, revealing the temperature-dependent surface morphology faceting evolution. The faceted nanorods were shown to be strain- and defect-free by cathodoluminescence hyperspectral imaging, micro-Raman, and transmission electron microscopy (TEM). In-situ TEM thermal annealing experiments allowed for real time observation of dislocation movements and surface restructuring observed in ex-situ annealing TEM sampling. This thermal annealing investigation gives new insight into the redistribution path of GaN material and dislocation movement post growth, allowing for improved understanding and in turn advances in optoelectronic device processing of compound semiconductors.

Recidiva do tratamento ortodôntico por respiração bucal

A respiração bucal é altamente comprometedora no que respeita correto crescimento e desenvolvimento das estruturas craniofaciais, podendo provocar uma série de desvios e alterações, nomeadamente alterações dentofaciais de carácter ortodôntico. O presente trabalho visa a elaboração de uma revisão bibliográfica sobre a recidiva ortodôntica em sujeitos com respiração bucal, dando especial atenção às características clínicas que permitem a identificação do respirador oral, por forma a contribuir para um diagnóstico mais atempado e, consequentemente, para uma maior eficácia do tratamento. Com base numa pesquisa efetuada em 5 bases de dados e com a utilização das palavras chave, foi feito um levantamento bibliográfico da literatura considerada relevante para a temática em estudo e uma seleção da mesma, de acordo com o seu nível de evidência cientifica. A respiração bucal é um dos múltiplos fatores etiológicos de instabilidade dentária que está na origem da recidiva ortodôntica, pelo que é necessária uma intervenção adequada e eficaz com o intuito de minimizar as consequências decorrentes da respiração bucal, antes de qualquer procedimento ortodôntico. O tratamento deve ser multidisciplinar, com associação de várias áreas, entre elas a Ortodontia, a terapia miofuncional, a otorrinolaringologia, e a ortopedia funcional dos maxilares e o diagnóstico precoce é de relevada importância para o sucesso do mesmo.

Characterization of the cis‐regulatory regions governing ojoplano locus

Ojoplano (opo) is a vertebrate-specific gene that was first identified in medaka fish as a recessive mutant, showing both neural crest defects and a failure of optic cup folding. In humans, this gene is associated with genetic diseases including hereditary craniofacial malformations and schizophrenia. It is localized in a 2Mb gene desert flanked by insulator sequences, between the genes SLC35B and TFAp2a. This region, syntenic between all vertebrates, represents only 2% of chromosome 6. However, it includes 23% of the all conserved cis-regulatory elements in this chromosome. Using transgenesis assays in zebrafish, we screened the enhancer activity of this locus and obtain a collection of nine enhancers. These regulatory elements were all conserved from human to teleosts and showed epigenetic marks for enhancer activity. We could associate multiple enhancers with ororfacial celfting disease and in order to explore the functionality of the enhancers, we performed a bioinformatics analysis to search for transcription factor bindings in the enhancer sequences. In terms of gene regulation we observe that H6:10137 opo enhancer has two Vsx2 binding sites and that this transcription factor regulates the expression of opo during eye development. Our findings suggest that the regulation of Vsx2 over opo is essential for optic cup folding. So far, there is no clear connection between optic cup patterning and morphogenesis. Vsx2 provides this link by controlling the expression of opo.

MEF2C: expression, regulation and interaction with target genes in health and diseases

Tese de doutoramento, Ciências Biomédicas, Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 2015

Planning and assessment techniques for spine surgeries

The rate of diagnosis and treatment of degenerative spine disorders is increasing, increasing the need for surgical intervention. Posterior spine fusion is one surgical intervention used to treat various spine degeneration pathologies To minimize the risk of complications and provide patients with positive outcomes, preoperative planning and postsurgical assessment are necessary. This PhD aimed to investigate techniques for the surgical planning and assessment of spine surgeries. Three main techniques were assessed: stereophotogrammetric motion analysis, 3D printing of complex spine deformities and finite element analysis of the thoracolumbar spine. Upon reviewing the literature on currently available spine kinematics protocol, a comprehensive motion analysis protocol to measure the multi-segmental spine motion was developed. Using this protocol, the patterns of spine motion in patients before and after posterior spine fixation was mapped. The second part investigated the use of virtual and 3D printed spine models for the surgical planning of complex spine deformity correction. Compared to usual radiographic images, the printed model allowed optimal surgical intervention, reduced surgical time and provided better surgeon-patient communication. The third part assessed the use of polyetheretherketone rods auxiliary to titanium rods to reduce the stiffness of posterior spine fusion constructs. Using a finite element model of the thoracolumbar spine, the rods system showed a decrease in the overall stress of the uppermost instrumented vertebra when compared to regular fixation approaches. Finally, a retrospective biomechanical assessment of a lumbopelvic reconstruction technique was investigated to assess the patients' gait following the surgery, the implant deformation over the years and the extent of bony fusion between spine and implant. In conclusion, this thesis highlighted the need to provide surgeons with new planning and assessment techniques to better understand postsurgical complications. The methodologies investigated in this project can be used in the future to establish a patient-specific planning protocol.

Genotype-phenotype correlation in trisomy 21

Down syndrome (DS) or trisomy 21 (T21) is the most common genetic cause of intellectual disability (ID). Subjects with DS are characterized by complex and variable clinical features including intellectual disability (ID) and craniofacial dysmorphisms. The aim of the thesis is to uncover genotype-phenotype relationships in DS possibly useful to devise therapies based on molecular and cellular mechanisms. In this work, we have investigated different aspects of DS: - we have collected clinical data of children with DS and we have evaluated the cognitive impairment through specific cognitive tests - we have analysed genomics of DS through the study of partial trisomy (PT21) cases. We have described new PT21 cases confirming the hypothesis of the highly restricted DS critical region (HR-DSCR) recently identified as the minimal region whose duplication is shared by all PT21 subjects diagnosed with DS, while it is absent in all PT21 non-DS subjects. Moreover, we have characterized new transcripts included in the HR-DSCR; - we have studied gene expression through RNAseq in blood cells of children with DS; -metabolic alterations in plasma of children with DS were identified through different methods: Nuclear Magnetic resonance, routine blood exams performed during the follow up of the subjects and enzyme-linked immunosorbent assay (ELISA); - to test possible correlations between specific Hsa21 regions and alterations in transcriptomics and metabolomics, we have used trisomic iPSCs and differentiated them into neuronal derivatives. Significant alterations in gene expression and metabolic profiles have been identified, as well as significant correlations with clinical and cognitive aspects. Specific genes and the HR-DSCR may play a role in these alterations: cell models need to be developed to investigate this role. Neural derivatives from trisomic iPSCs are a promising model to better understand genotype-phenotype correlations in DS.