Highly secreted tryptophanyl tRNA synthetase 1 as a potential theranostic target for hypercytokinemic severe sepsis

Despite intensive clinical and scientific efforts, the mortality rate of sepsis remains high due to the lack of precise biomarkers for patient stratification and therapeutic guidance. Secreted human tryptophanyl-tRNA synthetase 1 (WARS1), an endogenous ligand for Toll-like receptor (TLR) 2 and TLR4 against infection, activates the genes that signify the hyperinflammatory sepsis phenotype. High plasma WARS1 levels stratified the early death of critically ill patients with sepsis, along with elevated levels of cytokines, chemokines, and lactate, as well as increased numbers of absolute neutrophils and monocytes, and higher Sequential Organ Failure Assessment (SOFA) scores. These symptoms were recapitulated in severely ill septic mice with hypercytokinemia. Further, injection of WARS1 into mildly septic mice worsened morbidity and mortality. We created an anti-human WARS1-neutralizing antibody that suppresses proinflammatory cytokine expression in marmosets with endotoxemia. Administration of this antibody into severe septic mice attenuated cytokine storm, organ failure, and early mortality. With antibiotics, the antibody almost completely prevented fatalities. These data imply that blood-circulating WARS1-guided anti-WARS1 therapy may provide a novel theranostic strategy for life-threatening systemic hyperinflammatory sepsis.

Tryptophan-dependent and -independent secretions of tryptophanyl- tRNA synthetase mediate innate inflammatory responses

While cytoplasmic tryptophanyl-tRNA synthetase (WARS1) ligates tryptophan (Trp) to its cognate tRNAs for protein synthesis, it also plays a role as an innate immune activator in extracellular space. However, its secretion mechanism remains elusive. Here, we report that in response to stimuli, WARS1 can be secreted via two distinct pathways: via Trp-dependent secretion of naked protein and via Trp-independent plasma-membrane-derived vesicles (PMVs). In the direct pathway, Trp binding to WARS1 induces a "closed" conformation, generating a hydrophobic surface and basic pocket. The Trp-bound WARS1 then binds stable phosphatidylinositol (4,5)-biphosphate and inner plasma membrane leaflet, passing across the membrane. In the PMV-mediated secretion, WARS1 recruits calpain 2, which is activated by calcium. WARS1 released from PMVs induces inflammatory responses in vivo. These results provide insights into the secretion mechanisms of WARS1 and improve our understanding of how WARS1 is involved in the control of local and systemic inflammation upon infection.

Effects of red ginseng on gut, microbiota, and brain in a mouse model of post-infectious irritable bowel syndrome

Background

Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut–brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS.

Methods

Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut–brain axis responses were analyzed.

Results

Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone.

Conclusion

RG may be a potential therapeutic option for the management of human IBS.

Alleviation of Irritable Bowel Syndrome-Like Symptoms and Control of Gut and Brain Responses with Oral Administration of Dolichos lablab L. in a Mouse Model

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder manifesting as unexplained abdominal pain and bowel habit changes. The pathogenesis of post-infectious IBS is associated with gut–brain axis dysfunction, including low-grade colonic inflammation and anxiety-related long-term brain changes. This study analyzed the efficacy of a standardized extract of Dolichos lablab L. extract (DL), a bean species, in an IBS mouse model resembling post-infectious, diarrhea-dominant IBS. Using a zymosan-induced animal IBS model, we found that oral administration of DL significantly attenuated zymosan-induced increases in colonic macroscopic scores and minimized weight loss without affecting food intake. In the DL-treated mice, the mast cell count and tumor necrosis factor-α level in the colon markedly decreased, similar to results in sulfasalazine-treated mice and in mice with lipopolysaccharide-stimulated bone marrow-derived mast cells. The number of visceral pain-related behaviors was much lower in the DL-treated mice. Anxiety-like behaviors significantly improved, comparable to that after treatment with amitriptyline. The c-Fos expression level in the prefrontal cortex was significantly reduced. Our data suggest that DL could be beneficial for treating IBS by acting on the gut and brain.

Administration of Wasabia koreana Ameliorates Irritable Bowel Syndrome-Like Symptoms in a Zymosan-Induced Mouse Model

Irritable bowel syndrome (IBS) is a functional gastrointestinal disease with complex pathophysiology involving the brain-gut axis. To assess the effects of Wasabia koreana (WK) on IBS, we employed a mouse model of colonic zymosan injection presenting with diarrhea-predominant IBS-like symptoms. Oral WK administration significantly diminished stool score, suppressed colon length and weight change, and minimized body weight loss without affecting food intake. In WK-treated mice, the submucosal thickening and epithelial lining of the colon were inhibited and were similar to those of naïve mice. Infiltration of mast cells into the colon and serum tumor necrosis factor-α levels were markedly suppressed. These effects were comparable to those of sulfasalazine, an anti-inflammatory drug. Furthermore, the number of visceral pain-related behaviors was significantly decreased, and locomotion activities measured in the elevated plus maze and open field tests were significantly increased by WK in a dose-dependent manner compared with amitriptyline, an antidepressant. These changes were accompanied by reduced FosB2 expression in the brain. Taken together, these data suggest that WK may have potential as a medicinal food for IBS by acting on inflammatory diarrhea and neural activity.

Control of stress-induced depressive disorders by So-ochim-tang-gamibang, a Korean herbal medicine

ETHNOPHARMACOLOGICAL RELEVANCE

So-ochim-tang-gamibang (SOCG) is a Korean herbal medicine formula that has been applied to treat depressive moods and depression associated somatoform pain. This decoction consists of Cyperus rotundus L. (Cyperi Rhizoma), Lindera aggregata (Sims) Kosterm. (Linderae Radix), Aquilaria agallochum (Lour.) Roxb. ex Finl. (Aquilariae Resinatum Lignum), Glycyrrhiza uralensis Fisch. (Glycyrrhizae Radix) Platycodon grandiflorum (Jacq.) A. DC. (Platycodi Radix), and Citrus aurantium L. (Aurantii Fructus). The aim of this study is to assess antidepressant-like effects of SOCG and to investigate its possible cellular and molecular mechanisms.

MATERIAL AND METHODS

Using chronic restraint stress animal model, effects of SOCG on depressive-like behaviors, corticosterone, and hippocampal expressions of a neurotrophic factor and an apoptotic marker, were investigated. Mice were exposed to restraint stress 6h per day over a period of two weeks, and orally administrated either SOCG (30, 100, or 300mg/kg/day). The depressive-like behaviors were analyzed by forced swimming test and open field test. The serum levels of corticosterone were measured by enzyme-linked immunosorbent assay. Expressions of caspase-3 and BDNF in the hippocampus were analyzed by immunofluorescence. Further, effects of SOCG were examined in corticosterone-treated PC12 cells. Cellular toxicity was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and lactate dehydrogenase assays. Real-time PCR was applied to investigate the cellular expression levels of Bax, Bcl-2, and BDNF. The levels of caspase-3 and BDNF were examined by Western blotting.

RESULTS

Administration of SOCG not only reduced immobility time of restraint-stressed mice in a dose-dependent manner, but also significantly increased the distance mice moved and the number of crossings in the open field test. Further, SOCG significantly reduced the serum level of corticosterone and expression of caspase-3, while increased expression of BDNF in vivo. SOCG increased cell viability in corticosterone treated PC12 cells, which was accompanied by decreased caspase-3 expression and the ratio of Bax/Bcl-2 mRNA expression as well as increased BDNF expression in vitro.

CONCLUSIONS

Taken together, our data suggested that SOCG may have potential as an antidepressant agent controlling depressive behaviors and corticosterone-induced neuronal damage caused by chronic stress.

The role of high-mobility group box-1 (HMGB1) in the pathogenesis of asthma

BACKGROUND

High-mobility group box 1 protein (HMGB1) belonging to endogenous danger signals prolongs eosinophil survival and acts as a chemoattractant.

OBJECTIVE

The authors evaluated the role of HMGB1 in the pathogenesis of asthma characterized by eosinophilic airway inflammation.

METHODS

Firstly, HMGB1 expressions in induced sputum obtained from human asthmatics were determined. This was followed by an evaluation of the role of HMGB1 in a murine model of asthma using anti-HMGB1 antibodies. Then the effect of HMGB1 on the receptor of advanced glycation end products (RAGE) expressions on CD11b-CD11c(+) cells isolated from a murine model of asthma were measured to elucidate the mechanisms involved.

RESULTS

Sputum HMGB1 expressions were markedly higher in asthmatics than in normal controls, and were positively correlated with sputum eosinophilia and sputum TNF-α, IL-5 and IL-13 expressions. In a murine model of asthma, HMGB1 expressions in lung tissue and HMGB1 levels in bronchoalveolar lavage fluid were significantly elevated and eosinophilic airway inflammation, non-specific airway hyperresponsiveness, and pathological changes were attenuated by blocking HMGB1 activity. Furthermore, we found that enhanced RAGE expressions on CD11b-CD11c(+) also significantly decreased when HMGB1 activity was blocked.

CONCLUSION AND CLINICAL RELEVANCE

Our findings suggest that HMGB1 plays a key role in the pathogenesis of clinical and experimental asthma characterized by eosinophilic airway inflammation.

Phospholipase A(2) of peroxiredoxin 6 has a critical role in tumor necrosis factor-induced apoptosis

Peroxiredoxin 6 (Prdx6) is a bifunctional enzyme with peroxidase and phospholipase A(2) (PLA(2)) activities. Although the cellular function of the peroxidase of Prdx6 has been well elucidated, the function of the PLA(2) of Prdx6 is largely unknown. Here, we report a novel function for the PLA(2) in regulating TNF-induced apoptosis through arachidonic acid (AA) release and interleukin-1β (IL-1β) production. Prdx6 knockdown (Prdx6(KD)) in human bronchial epithelial cells (BEAS2B) shows severe decreases of peroxidase and PLA(2) activities. Surprisingly, Prdx6(KD) cells are markedly resistant to apoptosis induced by TNF-α in the presence of cycloheximide, but are highly sensitive to hydrogen peroxide-induced apoptosis. Furthermore, the release of AA and the production of IL-1β induced by proinflammatory stimuli, such as TNF-α, LPS, and poly I/C, are severely decreased in Prdx6(KD) cells. More interestingly, the restoration of Prdx6 expression with wild-type Prdx6, but not PLA(2)-mutant Prdx6 (S32A), in Prdx6(KD) cells dramatically induces the recovery of TNF-induced apoptosis, AA release, and IL-1β production, indicating specific roles for the PLA(2) activity of Prdx6. Our results provide new insights into the distinct roles of bifunctional Prdx6 with peroxidase and PLA(2) activities in oxidative stress-induced and TNF-induced apoptosis, respectively.

Neighborhood frequency does affect performance in the Reicher task: encoding or decision?

Three experiments using the Reicher task show that performance on low-frequency words is disrupted if the incorrect alternative forms a higher frequency word. This neighborhood frequency effect occurs for both energy and pattern masks and for different sets of items. When the upcoming word is primed and its accessibility is enhanced, the neighborhood frequency effect is eliminated. Experiments 4a and 4b tested the neighborhood frequency effect using a same-different task and a signal-detection analysis. Neighborhood frequency affected the decision criterion but not the sensitivity of the perceptual system. Experiment 5 showed that many words with a frequency in the range from 1 to 5 per million are not recognized out of context. These results are consistent with the hypothesis that frequency effects in the Reicher task are caused by a bias in the decision system and can be simulated with the stochastic activation-verification model.

Neighborhood frequency does affect performance in the Reicher task: encoding or decision?

Three experiments using the Reicher task show that performance on low-frequency words is disrupted if the incorrect alternative forms a higher frequency word. This neighborhood frequency effect occurs for both energy and pattern masks and for different sets of items. When the upcoming word is primed and its accessibility is enhanced, the neighborhood frequency effect is eliminated. Experiments 4a and 4b tested the neighborhood frequency effect using a same-different task and a signal-detection analysis. Neighborhood frequency affected the decision criterion but not the sensitivity of the perceptual system. Experiment 5 showed that many words with a frequency in the range from 1 to 5 per million are not recognized out of context. These results are consistent with the hypothesis that frequency effects in the Reicher task are caused by a bias in the decision system and can be simulated with the stochastic activation-verification model.

Discrete threshold versus continuous strength models of perceptual recognition

Two experiments were designed to test discrete-threshold models of letter and word recognition against models that assume that decision criteria are applied to measures of continuous strength. Although our goal is to adjudicate this matter with respect to broad classes of models, some of the specific predictions for discrete-threshold are generated from Grainger and Jacobs' (1994) Dual-Readout Model (DROM) and some of the predictions for continuous strength are generated from a revised version of the Activation-Verification Model (Paap, Newsome, McDonald, & Schvaneveldt, 1982). Experiment 1 uses a two-alternative forced-choice task that is followed by an assessment of confidence and then a whole report if a word is recognized. Factors are manipulated to assess the presence or magnitude of a neighbourhood-frequency effect, a lexical-bias effect, a word-superiority effect, and a pseudoword advantage. Several discrepancies between DROM's predictions and the obtained data are noted. Both types of models were also used to predict the distribution of responses across the levels of confidence for each individual participant. The predictions based on continuous strength were superior. Experiment 2 used a same-different task and confidence ratings to enable the generation of receiver operating characteristics (ROCs). The shapes of the ROCs are more consistent with the continuous strength assumption than with a discrete threshold.

Community health centers: unrecognized partners in health professions education

Increasing demand for health professionals with training in ambulatory and primary care practice is placing stress on existing training site capacity. Community health centers can serve as model training sites, offering comprehensive multidisciplinary health care services and teaching clinician role models. In this study, 32 Illinois community and migrant health centers and federally qualified health centers were surveyed to asses their involvement with training in the past three years. Thirty centers had offered training to students from many disciplines, with nursing (27 centers) and medicine (24) the most frequent. Most centers had established formal relationships with training institutions but generally had limited involvement with course planning. Continued participation will likely require adequate funding, with some centers also seeking stronger institutional relationships and better integration of community health issues. Educators and policy makers may need to take a more active role in supporting centers, acquiring funds, and other enabling factors.

Imaging of an unusual case of parasitic twinning

Conjoined twins are rare in the literature and parasitic conjoined twins are rarer still. To our knowledge no cases of parasitic conjoined twins have previously been reported in the radiology literature. We present a case of parasitic conjoined twins in which radiographic findings played an important role in management.

Identifying victims of elder abuse and neglect: a training video for prehospital personnel

INTRODUCTION

The majority of prehospital emergency medical services (EMS) personnel lack specific training relating to elder abuse and neglect.

OBJECTIVES

To develop and test an audio-visual training program that focuses on the identification and reporting of domestic violence in the elderly.

METHODS

A videotape was designed to be used as a 45-minute training course for prehospital personnel using one-half inch, super-VHS recording. A convenience sample of 60 EMS personnel working in Kent County then were asked to evaluate the videotape program. Each volunteer completed a pre-test on elder abuse and neglect, watched the 45-minute videotape, and then answered 12 questions on a post-test.

RESULTS

Participants had an average of 12.4 years (range: 1-30 years) prehospital emergency-care experience. Only four (7%) could recall any previous training relating to elder abuse or neglect during their careers. Although the prevalence of elder abuse in their community was described as "rather rare" by most (60%) of the subjects, 85% (51/60) had seen a suspected case of elder abuse or neglect during their careers; 47% (28/60) had seen a case during the past six months. Only 29% of these suspected cases were reported to county authorities. Approximately 40% of the questions on the pre-test were answered correctly (mean score, 4.8 +/- 3.0). In comparison, 83% of the questions on the post-test were answered correctly (10.0 +/- 3.0). Although participants had a number of suggestions to improve the video program, 78% (47/60) expected this material to change the way they will evaluate elderly patients in the future.

CONCLUSION

Prehospital personnel do not feel confident identifying or reporting victims of elder abuse or neglect. A videotape training program may be an effective way of presenting this information as a means of continuing education.

Intramuscular prochlorperazine versus metoclopramide as single-agent therapy for the treatment of acute migraine headache

To compare the efficacy of intramuscular prochlorperazine and metoclopramide in the short-term treatment of migraine headache in the emergency department 86 eligible adult patients with moderate to severe migraine headache were evaluated prospectively at a university-affiliated community hospital. After randomization, each subject received a 2-mL intramuscular injection of sterile saline, prochlorperazine (10 mg), or metoclopramide (10 mg). No other analgesics were administered during the 60-minute study period; patient assessment of relief was followed using visual analog scales. Reduction in median headache scores was significantly better among those treated with prochlorperazine (67%) compared to metoclopramide (34%) or placebo (16%). Similarly, symptoms of nausea and vomiting were significantly relieved in the prochlorperazine group (chi 2 = 17.1, P < .001). However, rescue analgesic therapy was necessary in the majority of patients treated with prochlorperazine (16/28) and metoclopramide (23/29) after the 60-minute study period. Although intramuscular prochlorperazine appears to provides more effective relief than metoclopramide, these results do not recommend either drug as single-agent therapy for acute migraine headache.

Lead increases red cell sodium-lithium countertransport

The effect of 1, 3, 5, and 20 mumol/L lead on normal red cell sodium-lithium countertransport was studied in vitro. Red cell suspensions incubated with lead had increased sodium-lithium countertransport at all concentration levels compared with paired, unleaded controls when all groups were evaluated by analysis of covariance (F = 19.2, P less than 0.001). The effect of lead was concentration dependent (r = 0.998, P less than 0.001). These observations suggest that abnormalities in sodium transport are involved in the pathogenesis of lead-induced hypertension. Because increased red cell sodium-lithium countertransport is characteristic of essential hypertension, these observations further suggest that lead-induced and essential hypertension may share common pathophysiological mechanisms.