Global signal peptide profiling reveals principles of selective Sec61 inhibition

Cotransins target the Sec61 translocon and inhibit the biogenesis of an undefined subset of secretory and membrane proteins. Remarkably, cotransin inhibition depends on the unique signal peptide (SP) of each Sec61 client, which is required for cotranslational translocation into the endoplasmic reticulum. It remains unknown how an SP's amino acid sequence and biophysical properties confer sensitivity to structurally distinct cotransins. Here we describe a fluorescence-based, pooled-cell screening platform to interrogate nearly all human SPs in parallel. We profiled two cotransins with distinct effects on cancer cells and discovered a small subset of SPs, including the oncoprotein human epidermal growth factor receptor 3 (HER3), with increased sensitivity to the more selective cotransin, KZR-9873. By comparing divergent mouse and human orthologs, we unveiled a position-dependent effect of arginine on SP sensitivity. Our multiplexed profiling platform reveals how cotransins can exploit subtle sequence differences to achieve SP discrimination.

The eRF1 degrader SRI-41315 acts as a molecular glue at the ribosomal decoding center

Translation termination is an essential cellular process, which is also of therapeutic interest for diseases that manifest from premature stop codons. In eukaryotes, translation termination requires eRF1, which recognizes stop codons, catalyzes the release of nascent proteins from ribosomes and facilitates ribosome recycling. The small molecule SRI-41315 triggers eRF1 degradation and enhances translational readthrough of premature stop codons. However, the mechanism of action of SRI-41315 on eRF1 and translation is not known. Here we report cryo-EM structures showing that SRI-41315 acts as a metal-dependent molecular glue between the N domain of eRF1 responsible for stop codon recognition and the ribosomal subunit interface near the decoding center. Retention of eRF1 on ribosomes by SRI-41315 leads to ribosome collisions, eRF1 ubiquitylation and a higher frequency of translation termination at near-cognate stop codons. Our findings reveal a new mechanism of release factor inhibition and additional implications for pharmacologically targeting eRF1.

Direct mapping of ligandable tyrosines and lysines in cells with chiral sulfonyl fluoride probes

Advances in chemoproteomic technology have revealed covalent interactions between small molecules and protein nucleophiles, primarily cysteine, on a proteome-wide scale. Most chemoproteomic screening approaches are indirect, relying on competition between electrophilic fragments and a minimalist electrophilic probe with inherently limited proteome coverage. Here we develop a chemoproteomic platform for direct electrophile-site identification based on enantiomeric pairs of clickable arylsulfonyl fluoride probes. Using stereoselective site modification as a proxy for ligandability in intact cells, we identify 634 tyrosines and lysines within functionally diverse protein sites, liganded by structurally diverse probes. Among multiple validated sites, we discover a chiral probe that modifies Y228 in the MYC binding site of the epigenetic regulator WDR5, as revealed by a high-resolution crystal structure. A distinct chiral probe stimulates tumour cell phagocytosis by covalently modifying Y387 in the recently discovered immuno-oncology target APMAP. Our work provides a deep resource of ligandable tyrosines and lysines for the development of covalent chemical probes.

Signal peptide mimicry primes Sec61 for client-selective inhibition

Preventing the biogenesis of disease-relevant proteins is an attractive therapeutic strategy, but attempts to target essential protein biogenesis factors have been hampered by excessive toxicity. Here we describe KZR-8445, a cyclic depsipeptide that targets the Sec61 translocon and selectively disrupts secretory and membrane protein biogenesis in a signal peptide-dependent manner. KZR-8445 potently inhibits the secretion of pro-inflammatory cytokines in primary immune cells and is highly efficacious in a mouse model of rheumatoid arthritis. A cryogenic electron microscopy structure reveals that KZR-8445 occupies the fully opened Se61 lateral gate and blocks access to the lumenal plug domain. KZR-8445 binding stabilizes the lateral gate helices in a manner that traps select signal peptides in the Sec61 channel and prevents their movement into the lipid bilayer. Our results establish a framework for the structure-guided discovery of novel therapeutics that selectively modulate Sec61-mediated protein biogenesis.

Predicting the Risk of Injuries Through Assessments of Asymmetric Lower Limb Functional Performance: A Prospective Study of 415 Youth Taekwondo Athletes

Background

The impact of interlimb asymmetries on sport injuries is unclear because of inconsistent findings, and there is a lack of research on youth athletes and the sport of taekwondo.

Purpose

To examine the effects of functional interlimb asymmetries on noncontact lower limb injuries in youth athletes.

Study Design

Cohort study; Level of evidence, 2.

Methods

A total of 415 taekwondo athletes (318 boys and 97 girls) aged 6 to 17 years underwent baseline testing to determine interlimb asymmetries through the single-leg countermovement jump (CMJ), hop, and triple hop tests as well as the Star Excursion Balance Test. The athletes were then evaluated for 12 months to observe the occurrence of noncontact lower limb injuries.

Results

During the study, 98 athletes (70 boys and 28 girls) sustained at least 1 noncontact lower limb injury. Athletes with higher interlimb asymmetries in single-leg CMJ height showed a significantly increased risk of noncontact lower limb injuries (boys: odds ratio [OR], 1.053 [95% CI, 1.027-1.080], P < .001; girls: OR, 1.070 [95% CI, 1.016-1.128], P = .011). Asymmetry in single-leg CMJ height of ≥15.28% was found to be the cutoff point for predicting noncontact lower limb injuries in boys (OR, 4.652 [95% CI, 2.577-8.398]; P < .001).

Conclusion

This study highlights the utility of interlimb asymmetries in unilateral jump performance as a tool for assessing the risk of noncontact lower limb injuries in youth taekwondo athletes of both sexes. A proper evaluation of interlimb asymmetries may improve prevention strategies for youth athletes.

Large library docking for novel SARS-CoV-2 main protease non-covalent and covalent inhibitors

Antiviral therapeutics to treat SARS-CoV-2 are needed to diminish the morbidity of the ongoing COVID-19 pandemic. A well-precedented drug target is the main viral protease (MPro ), which is targeted by an approved drug and by several investigational drugs. Emerging viral resistance has made new inhibitor chemotypes more pressing. Adopting a structure-based approach, we docked 1.2 billion non-covalent lead-like molecules and a new library of 6.5 million electrophiles against the enzyme structure. From these, 29 non-covalent and 11 covalent inhibitors were identified in 37 series, the most potent having an IC50 of 29 and 20 μM, respectively. Several series were optimized, resulting in low micromolar inhibitors. Subsequent crystallography confirmed the docking predicted binding modes and may template further optimization. While the new chemotypes may aid further optimization of MPro inhibitors for SARS-CoV-2, the modest success rate also reveals weaknesses in our approach for challenging targets like MPro versus other targets where it has been more successful, and versus other structure-based techniques against MPro itself.

Masters athlete screening study (MASS): incidence of cardiovascular disease and major adverse cardiac events and efficacy of screening over five years

BACKGROUND

The efficacy of cardiovascular screening in Masters athletes (MAs) (≥35 y), and whether screening decreases their risk of major adverse cardiac events (MACEs) is unknown.

PURPOSE

To evaluate the effectiveness of yearly cardiovascular screening, and the incidence of cardiovascular disease (CVD) and MACE over five years.

METHODS AND RESULTS

MAs (≥35 y) without previous history of CVD underwent yearly cardiovascular screening. Participants with an abnormal screen underwent further evaluations. In the initial year, 798 MAs (62.7% male, 55 ± 10 y) were screened; 11.4% (n = 91) were diagnosed with CVD. Coronary artery disease (CAD) was the most common diagnosis (n = 64; 53%). During follow-up, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years one to four, respectively. The most common diagnoses during follow-up were arrhythmias (n = 33; 37%). Increasing age (OR = 1.047, 95% confidence interval (CI): 1.003-1.094; P = 0.0379), Framingham Risk Score (FRS) (OR = 1.092, 95% CI: 1.031-1.158; P = 0.003), and LDL cholesterol (OR = 1.709, 95% CI: 1.223-2.401; P = 0.002) were predictive of CAD, whereas moderate intensity activity (min/wk) (OR = 0.997, 95% CI: 0.996-0.999; P = 0.002) was protective. Ten MACE (2.8/1000 athlete-years) occurred. All of these MAs were male, and 90% had ≥10% FRS. All underwent further evaluations with only two identified to have obstructive CAD.

CONCLUSION

MACE occurred despite yearly screening. All MAs who had an event had an abnormal screen; however, cardiac functional tests failed to detect underlying CAD in most cases. It may be appropriate to offer computed coronary tomography angiography in MAs with ≥10% FRS to overcome the limitations of functional testing, and to assist with lifestyle and treatment modifications.

mRNA decoding in human is kinetically and structurally distinct from bacteria

In all species, ribosomes synthesize proteins by faithfully decoding messenger RNA (mRNA) nucleotide sequences using aminoacyl-tRNA substrates. Current knowledge of the decoding mechanism derives principally from studies on bacterial systems1. Although key features are conserved across evolution2, eukaryotes achieve higher-fidelity mRNA decoding than bacteria3. In human, changes in decoding fidelity are linked to ageing and disease and represent a potential point of therapeutic intervention in both viral and cancer treatment4-6. Here we combine single-molecule imaging and cryogenic electron microscopy methods to examine the molecular basis of human ribosome fidelity to reveal that the decoding mechanism is both kinetically and structurally distinct from that of bacteria. Although decoding is globally analogous in both species, the reaction coordinate of aminoacyl-tRNA movement is altered on the human ribosome and the process is an order of magnitude slower. These distinctions arise from eukaryote-specific structural elements in the human ribosome and in the elongation factor eukaryotic elongation factor 1A (eEF1A) that together coordinate faithful tRNA incorporation at each mRNA codon. The distinct nature and timing of conformational changes within the ribosome and eEF1A rationalize how increased decoding fidelity is achieved and potentially regulated in eukaryotic species.

An E3 ligase network engages GCN1 to promote the degradation of translation factors on stalled ribosomes

Ribosomes frequently stall during mRNA translation, resulting in the context-dependent activation of quality control pathways to maintain proteostasis. However, surveillance mechanisms that specifically respond to stalled ribosomes with an occluded A site have not been identified. We discovered that the elongation factor-1α (eEF1A) inhibitor, ternatin-4, triggers the ubiquitination and degradation of eEF1A on stalled ribosomes. Using a chemical genetic approach, we unveiled a signaling network comprising two E3 ligases, RNF14 and RNF25, which are required for eEF1A degradation. Quantitative proteomics revealed the RNF14 and RNF25-dependent ubiquitination of eEF1A and a discrete set of ribosomal proteins. The ribosome collision sensor GCN1 plays an essential role by engaging RNF14, which directly ubiquitinates eEF1A. The site-specific, RNF25-dependent ubiquitination of the ribosomal protein RPS27A/eS31 provides a second essential signaling input. Our findings illuminate a ubiquitin signaling network that monitors the ribosomal A site and promotes the degradation of stalled translation factors, including eEF1A and the termination factor eRF1.

IFITM proteins assist cellular uptake of diverse linked chemotypes

The search for cell-permeable drugs has conventionally focused on low-molecular weight (MW), nonpolar, rigid chemical structures. However, emerging therapeutic strategies break traditional drug design rules by employing flexibly linked chemical entities composed of more than one ligand. Using complementary genome-scale chemical-genetic approaches we identified an endogenous chemical uptake pathway involving interferon-induced transmembrane proteins (IFITMs) that modulates the cell permeability of a prototypical biopic inhibitor of MTOR (RapaLink-1, MW: 1784 g/mol). We devised additional linked inhibitors targeting BCR-ABL1 (DasatiLink-1, MW: 1518 g/mol) and EIF4A1 (BisRoc-1, MW: 1466 g/mol), uptake of which was facilitated by IFITMs. We also found that IFITMs moderately assisted some proteolysis-targeting chimeras and examined the physicochemical requirements for involvement of this uptake pathway.

Synthesis and single-molecule imaging reveal stereospecific enhancement of binding kinetics by the antitumour eEF1A antagonist SR-A3

Ternatin-family cyclic peptides inhibit protein synthesis by targeting the eukaryotic elongation factor-1α. A potentially related cytotoxic natural product ('A3') was isolated from Aspergillus, but only 4 of its 11 stereocentres could be assigned. Here, we synthesized SR-A3 and SS-A3-two out of 128 possible A3 epimers-and discovered that synthetic SR-A3 is indistinguishable from naturally derived A3. Relative to SS-A3, SR-A3 exhibits an enhanced residence time and rebinding kinetics, as revealed by single-molecule fluorescence imaging of elongation reactions catalysed by eukaryotic elongation factor-1α in vitro. An increased residence time-stereospecifically conferred by the unique β-hydroxyl in SR-A3-was also observed in cells. Consistent with its prolonged duration of action, thrice-weekly dosing with SR-A3 led to a reduced tumour burden and increased survival in an aggressive Myc-driven mouse lymphoma model. Our results demonstrate the potential of SR-A3 as a cancer therapeutic and exemplify an evolutionary mechanism for enhancing cyclic peptide binding kinetics via stereospecific side-chain hydroxylation.

Didemnin B and ternatin-4 differentially inhibit conformational changes in eEF1A required for aminoacyl-tRNA accommodation into mammalian ribosomes

Rapid and accurate mRNA translation requires efficient codon-dependent delivery of the correct aminoacyl-tRNA (aa-tRNA) to the ribosomal A site. In mammals, this fidelity-determining reaction is facilitated by the GTPase elongation factor-1 alpha (eEF1A), which escorts aa-tRNA as an eEF1A(GTP)-aa-tRNA ternary complex into the ribosome. The structurally unrelated cyclic peptides didemnin B and ternatin-4 bind to the eEF1A(GTP)-aa-tRNA ternary complex and inhibit translation but have different effects on protein synthesis in vitro and in vivo. Here, we employ single-molecule fluorescence imaging and cryogenic electron microscopy to determine how these natural products inhibit translational elongation on mammalian ribosomes. By binding to a common site on eEF1A, didemnin B and ternatin-4 trap eEF1A in an intermediate state of aa-tRNA selection, preventing eEF1A release and aa-tRNA accommodation on the ribosome. We also show that didemnin B and ternatin-4 exhibit distinct effects on the dynamics of aa-tRNA selection that inform on observed disparities in their inhibition efficacies and physiological impacts. These integrated findings underscore the value of dynamics measurements in assessing the mechanism of small-molecule inhibition and highlight potential of single-molecule methods to reveal how distinct natural products differentially impact the human translation mechanism.

Reversible lysine-targeted probes reveal residence time-based kinase selectivity

The expansion of the target landscape of covalent inhibitors requires the engagement of nucleophiles beyond cysteine. Although the conserved catalytic lysine in protein kinases is an attractive candidate for a covalent approach, selectivity remains an obvious challenge. Moreover, few covalent inhibitors have been shown to engage the kinase catalytic lysine in animals. We hypothesized that reversible, lysine-targeted inhibitors could provide sustained kinase engagement in vivo, with selectivity driven in part by differences in residence time. By strategically linking benzaldehydes to a promiscuous kinase binding scaffold, we developed chemoproteomic probes that reversibly and covalently engage >200 protein kinases in cells and mice. Probe-kinase residence time was dramatically enhanced by a hydroxyl group ortho to the aldehyde. Remarkably, only a few kinases, including Aurora A, showed sustained, quasi-irreversible occupancy in vivo, the structural basis for which was revealed by X-ray crystallography. We anticipate broad application of salicylaldehyde-based probes to proteins that lack a druggable cysteine.

Association between Inter-Limb Asymmetries in Lower-Limb Functional Performance and Sport Injury: A Systematic Review of Prospective Cohort Studies

Background: Inter-limb asymmetry in lower-limb functional performance has been associated with increased risk of sport injury; however, findings are not always consistent. Purpose: To conduct a systematic review on whether inter-limb asymmetry in lower-limb functional performance can predict sport injury. Methods: Four electronic databases (MEDLINE, EMBASE, Web of Science, and SportDiscus) were systematically searched for prospective cohort studies reporting the association between inter-limb asymmetry in lower-limb functional performance and sport injury. Results: A total of 28 prospective cohort studies were included in the analyses. Collectively, the findings were highly inconsistent, and a clear statement on the association between each asymmetry and sport injury was difficult. Conclusions: Highly inconsistent findings make it difficult to create clear recommendations on the relationship between the inter-limb asymmetry in lower-limb functional performance (power, muscle flexibility, and dynamic balance) and sport injury. The influence of potential factors (selection of tests/parameters, participant characteristics, definition of injury, and ways of calculating asymmetry) should be considered when using previous findings.

Masters Athlete Screening Study (MASS): Insights Into the Psychological Impact of Cardiovascular Preparticipation Screening

OBJECTIVE

To determine the psychological impact of a cardiovascular disease (CVD) diagnosis identified during preparticipation screening (PPS) of masters athletes.

DESIGN

Cross-sectional study.

SETTING

Masters athletes diagnosed with CVD through the Masters Athletes Screening Study.

PARTICIPANTS

Sixty-seven athletes (89.6% male, mean age at diagnosis 60.1 ± 7.1 years, range 40-76) with diagnoses of coronary artery disease (CAD) (73.1%), high premature ventricular contraction burden (9.0%), mitral valve prolapse (7.5%), atrial fibrillation (AF) (3.0%), bicuspid aortic valve (3.0%), aortic dilatation (1.5%), coronary anomaly (1.5%), and rheumatic heart disease (1.5%). Three participants had multiple diagnoses.

INTERVENTION

Online survey distributed to masters athletes identified with CVD.

MAIN OUTCOME MEASURES

Assessment of psychological distress [Impact of Event Scale-Revised (IES-R)], perceptions of screening, and preferred support by CVD type.

RESULTS

The median total IES-R and subscale scores were within the normal range {median [interquartile range (IQR)] total 2.0 [0-6.0]; intrusion 1.0 [0-3.0]; avoidance 0 [0-3.0]; hyperarousal 0 [0-1.0]}. Athletes with bicuspid aortic valve [20.5 (IQR, 4.0-37.0)], AF [7.0 (IQR, 0-14.0)], and severe CAD [5.5 (IQR, 1.0-12.0)] had the highest total IES-R scores. One individual with bicuspid aortic valve reported a significant stress reaction. Ten athletes (14.9%) had scores >12. Ninety-three percent of athletes were satisfied having undergone PPS. Preferred type of support varied by cardiovascular diagnosis.

CONCLUSIONS

The majority of masters athletes diagnosed with CVD through PPS do not experience significant levels of psychological distress. Athletes diagnosed with more severe types of CVD should be monitored for psychological distress. Support should be provided through a multidisciplinary and individualized approach.

Masters Athlete Screening Study (MASS): incidence of cardiovascular disease and major adverse cardiac events over five years of screening

Background

The long-term implications of cardiovascular disease (CVD) in masters athletes, and whether screening decreases their risk of major adverse cardiac events (MACE) is unknown.

Purpose

To evaluate the incidence of CVD and MACE over five years of a screening study.

Methods

Masters athletes (≥35 years) from a variety of sports without previous history of coronary artery disease (CAD) underwent yearly cardiovascular screening. The screen consisted of anthropometrics, blood pressure, resting electrocardiogram, modified American Heart Association 14-element recommendations, cardiovascular event questionnaire, physical examination (year 1) and Framingham Risk Score (years 1–3). Participants with an abnormal screen according to the European Association of Cardiovascular Prevention and Canadian Cardiology Society Guidelines underwent further evaluations (computed coronary tomography angiography was not included for all athletes but based on clinical assessment). Participants who withdrew during the study received a follow-up questionnaire to determine MACE and vital status.

Results

In the first year of the Masters Athlete Screening Study, 798 masters athletes (62.7% male, 54.6±9.5 years) were screened; 91 (11.4%) of the cohort were found to have CVD. CAD was the most common diagnosis (69.2%). During the following four years, there were an additional 89 CVD diagnoses with an incidence rate of 3.58/100, 4.14/100, 3.74/100, 1.19/100, for years two to five, respectively. Fifteen participants had more than one diagnosis. The most common diagnoses over the five years were arrhythmias (n=33; 37.1%), aortic dilatation (n=20; 22.5%), CAD (n=18; 20.2% (5 obstructive, 13 non-obstructive)) and other (n=7; 7.9%) (myocarditis (n=2), myocardial bridging (n=1), cerebrovascular disease (n=1), dilated cardiomyopathy (n=1), probable Long QT syndrome (n=1), papillary fibroelastoma (n=1)). A total of 10 MACE occurred (two cardiovascular deaths, five myocardial infarctions and three cerebrovascular accidents). All events occurred in male athletes (63.6±12.5 years). Out of the 136 participants that received the lost to follow-up questionnaire, 101 (74.3%) completed it. Of those, one male athlete underwent percutaneous coronary intervention. The incidence of MACE over the study period was 0.30/100 athletes per year.

Conclusion

Yearly cardiovascular screening of masters athletes identified ∼3 new diagnoses per 100 athletes per year. Ten MACE occurred despite yearly screening and high CV fitness of masters athletes.

Funding Acknowledgement

Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): MITACs and CIHR

Tailored physical activity behavior change interventions: challenges and opportunities

A physically active lifestyle provides innumerable benefits; yet, few individuals are physically active enough to reap those benefits. Tailored physical activity interventions may address low rates of physical activity by offering individualized strategies that consider a person's characteristics, needs, preferences, and/or context, rather than the traditional one-size-fits-all approach. However, the tailoring methodology is in its nascency, and an understanding of how best to develop such interventions is needed. In this commentary, we identify future directions to enhance the impact of tailored interventions designed to increase physical activity participation. A multi-country collaborative was established to review the literature and discuss an agenda for future research. Two overarching research opportunities are suggested for improving the development of tailored, behavioral physical activity interventions: (a) optimize the engagement of diverse knowledge users in intervention co-design and (b) examine ethical considerations that may impact the use of technology to support tailored physical activity delivery. Specifically, there is a need for better reporting and evaluation of knowledge user involvement alongside targeting diversity in the inclusion of knowledge users. Furthermore, while technology boasts many opportunities to increase the scale and precision of interventions, examinations of how it impacts recipients' experiences of and participation in tailored interventions are needed to ensure the benefits of technology use outweigh the risks. A better understanding of these research areas will help ensure that the diverse needs of individuals are met, technology is appropriately used to support tailoring, and ultimately it improves the effectiveness of tailored physical activity interventions.

Identifying the Cellular Target of Cordyheptapeptide A and Synthetic Derivatives

Cordyheptapeptide A is a lipophilic cyclic peptide from the prized Cordyceps fungal genus that shows potent cytotoxicity in multiple cancer cell lines. To better understand the bioactivity and physicochemical properties of cordyheptapeptide A with the ultimate goal of identifying its cellular target, we developed a solid-phase synthesis of this multiply N-methylated cyclic heptapeptide which enabled rapid access to both side chain- and backbone-modified derivatives. Removal of one of the backbone amide N-methyl (N-Me) groups maintained bioactivity, while membrane permeability was also preserved due to the formation of a new intramolecular hydrogen bond in a low dielectric solvent. Based on its cytotoxicity profile in the NCI-60 cell line panel, as well as its phenotype in a microscopy-based cytological assay, we hypothesized that cordyheptapeptide was acting on cells as a protein synthesis inhibitor. Further studies revealed the molecular target of cordyheptapeptide A to be the eukaryotic translation elongation factor 1A (eEF1A), a target shared by other lipophilic cyclic peptide natural products. This work offers a strategy to study and improve cyclic peptide natural products while highlighting the ability of these lipophilic compounds to effectively inhibit intracellular disease targets.

Risk Factors for Non-Contact Lower-Limb Injury: A Retrospective Survey in Pediatric-Age Athletes

Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents and/or legal guardians of 2269 athletes aged between 6–17 years were recruited. Each participant completed an online questionnaire that contained 10 questions about the athlete’s training and non-contact lower-limb injury in the preceding 12 months. Results: The multivariate logistic regression model determined that lateral dominance in sport (adjusted OR (laterally vs. non-laterally dominant sports), 1.38; 95% CI, 1.10–1.75; p = 0.006), leg preference (adjusted OR (right vs. left-leg preference), 0.71; 95% CI, 0.53–0.95; p = 0.023), increased age (adjusted OR, 1.21; 95% CI, 1.16–1.26; p = 0.000), training intensity (adjusted OR, 1.77; 95% CI, 1.43–2.19; p = 0.000), and training frequency (adjusted OR, 1.36; 95% CI, 1.25–1.48; p = 0.000) were significantly associated with non-contact lower-limb injury in pediatric-age athletes. Length of training (p = 0.396) and sex (p = 0.310) were not associated with a non-contact lower-limb injury. Conclusions: Specializing in laterally dominant sports, left-leg preference, increase in age, training intensity, and training frequency indicated an increased risk of non-contact lower-limb injury in pediatric-age athletes. Future research should take into account exposure time and previous injury.

Using the VERT wearable device to monitor jumping loads in elite volleyball athletes

Sport is becoming increasingly competitive and athletes are being exposed to greater physical demands, leaving them prone to injuries. Monitoring athletes with the use of wearable technology could provide a way to potentially manage training and competition loads and reduce injuries. One such technology is the VERT inertial measurement unit, a commercially available discrete wearable device containing a 3-axis accelerometer, 3-axis gyroscope and 3-axis magnetometer. Some of the main measurement outputs include jump count, jump height and landing impacts. While several studies have examined the accuracy of the VERT's measures of jump height and jump count, landing impact force has not yet been investigated. The objective of this research study was to explore the validity of the VERT landing impact values. We hypothesized that the absolute peak VERT acceleration values during a jump-land cycle would fall within 10% of the peak acceleration values derived simultaneously from a research-grade accelerometer (Shimmer). Fourteen elite university-level volleyball players each performed 10 jumps while wearing both devices simultaneously. The results showed that VERT peak accelerations were variable (limits of agreement of -84.13% and 52.37%) and had a propensity to be lower (mean bias of -15.88%) when compared to the Shimmer. In conclusion, the validity of the VERT device's landing impact values are generally poor, when compared to the Shimmer.

A Bibliometric Analysis of the Top Cited Articles in Sports and Exercise Medicine

Background:

Although citation analysis is common in many areas of medicine, there is a lack of similar research in sports and exercise medicine.

Purpose:

To identify and examine the characteristics of the 100 top cited articles in the field of sports and exercise medicine in an effort to determine what components make an article highly influential.

Study Design:

Cross-sectional study.

Methods:

The Web of Science, Scopus, and PubMed databases were used to determine the 100 top cited articles from 46 journals in the field of sports and exercise medicine. Each of the 100 articles was then analyzed by 2 independent reviewers, and results were compared. Basic information was collected, including journal title, country of origin, and study type. Different categories were compared using descriptive statistics of counts or percentages.

Results:

The 100 top cited articles were published in 15 of the 46 identified sports and exercise medicine journals, with the most prolific being Medicine and Science in Sports and Exercise (n = 49), American Journal of Sports Medicine (n = 18), and Sports Medicine (n = 7). In terms of country of origin, the top 3 contributors were the United States (n = 65), Canada (n = 9), and Sweden (n = 8). The most commonly researched anatomic areas were the knee (n = 15) and the brain (n = 3). Narrative reviews were the most common study type (n = 38), and only a single study on the 100 top cited articles list used a randomized controlled trial design. The most prevalent fields of study were exercise science (55% of articles) and well-being (16% of articles).

Conclusion:

Narrative reviews from the United States and published in English-language journals were the most likely to be highly cited. In addition, the knee was a common anatomic area of study on the top cited list of research in sports and exercise medicine

The effect of fatigue on asymmetry between lower limbs in functional performances in elite child taekwondo athletes

BACKGROUND

Inter-limb asymmetry above a certain threshold in functional performance indicates increased injury risk in sports. Fatigue has been found to increase bilateral asymmetry in lower-limb jumping performance among high-school and adult athletes, whereas this impact has not been examined in child athletes. This study aimed to examine the effect of fatigue on inter-limb asymmetry in functional performances in elite Taekwondo athletes aged between 9 and 11 years.

METHODS

Performance of single-leg jumps, Star Excursion Balance Test (SEBT), and muscle (hamstring and gastrocnemius) flexibility were measured for 13 elite male child Taekwondo athletes (aged 9.85 ± 0.80 years) at both the rested and fatigued states to examine the inter-limb asymmetry. A two-way repeated measures ANOVA was conducted to examine for difference and the interaction between limb (dominant, non-dominant leg) and state (rested, fatigued state) for each test. Paired t test or Wilcoxon signed-rank test was used to compare the asymmetry magnitude at the rested vs. fatigued state for each test, and the variation of performance post fatigue in the dominant vs. non-dominant leg when appropriate.

RESULTS

The inter-limb asymmetry in triple-hop distance significantly (p = 0.046) increased with fatigue, whereas the asymmetry significantly (p = 0.004) decreased with fatigue in anterior (ANT) reach distance in SEBT. A significant (p = 0.027) limb by state interaction was shown for posterolateral (PL) reach distance in SEBT, wherein a significant (p = 0.005) bilateral difference was only shown at the rested state. The PL reach distance showed a significantly greater decrease (p = 0.028) post fatigue when using the dominant leg for support compared to using the non-dominant leg.

CONCLUSIONS

Fatigue significantly impacts inter-limb asymmetry in jump performances and dynamic balance for child athletes, while the variation of inter-limb asymmetry post fatigue may be different across tests. For the purpose of injury prevention, practitioners should consider assessing the inter-limb asymmetry for children at both the rested and fatigued state and be mindful of the fatigue response of each leg in functional tests.

p90RSK-MAGI1 Module Controls Endothelial Permeability by Post-translational Modifications of MAGI1 and Hippo Pathway

Previously, we reported that post-translational modifications (PTMs) of MAGI1, including S741 phosphorylation and K931 de-SUMOylation, both of which are regulated by p90RSK activation, lead to endothelial cell (EC) activation. However, roles for p90RSK and MAGI1-PTMs in regulating EC permeability remain unclear despite MAGI1 being a junctional molecule. Here, we show that thrombin (Thb)-induced EC permeability, detected by the electric cell-substrate impedance sensing (ECIS) based system, was decreased by overexpression of dominant negative p90RSK or a MAGI1-S741A phosphorylation mutant, but was accelerated by overexpression of p90RSK, siRNA-mediated knockdown of magi1, or the MAGI1-K931R SUMOylation mutant. MAGI1 depletion also increased the mRNA and protein expression of the large tumor suppressor kinases 1 and 2 (LATS1/2), which inhibited YAP/TAZ activity and increased EC permeability. Because the endothelial barrier is a critical mediator of tumor hypoxia, we also evaluated the role of p90RSK activation in tumor vessel leakiness by using a relatively low dose of the p90RSK specific inhibitor, FMK-MEA. FMK-MEA significantly inhibited tumor vessel leakiness at a dose that does not affect morphology and growth of tumor vessels in vivo. These results provide novel insights into crucial roles for p90RSK-mediated MAGI1 PTMs and the Hippo pathway in EC permeability, as well as p90RSK activation in tumor vessel leakiness.

Bilateral difference between lower limbs in children practicing laterally dominant vs. non-laterally dominant sports

Bilateral asymmetry in lower-limb power and dynamic balance has been associated with increased risk of sport injury, whereas there is a lack of research examining this asymmetry for child athletes. Twenty-eight fencers (19 boys and 9 girls, aged 9.71 ± 1.08 years) and 28 Taekwondo athletes (19 boys and 9 girls, aged 9.71 ± 1.08 years) were examined on the single-leg jump and Star Excursion Balance Test (SEBT) performance. A mixed model design ANOVA (2 [Sex: Boys, Girls] × 2 [Sport group: Fencing, Taekwondo] × 2 [Limb: Dominant, Non-dominant Leg]) was conducted to examine for difference for each test. There was a significant main effect of limb on hop and triple hop distance (p < 0.05). A significant limb by sex interaction (p = 0.000) was shown for the single-leg countermovement jump (CMJ) performance, wherein a bilateral difference was only shown in boys. In SEBT, a main effect (p = 0.007) of limb was identified for posterolateral (PL) reach distance. A limb by sex interaction (p = 0.009) was also shown for posteromedial (PM) reach distance, wherein a bilateral difference was only shown in girls. These findings suggest that child athletes in both laterally dominant and non-laterally dominant sports showed inter-limb asymmetry of leg power and dynamic balance. Sex should be an important consideration when evaluating bilateral difference of leg power and dynamic balance for child athletes.

A SARS-CoV-2 protein interaction map reveals targets for drug repurposing

A newly described coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent of coronavirus disease 2019 (COVID-19), has infected over 2.3 million people, led to the death of more than 160,000 individuals and caused worldwide social and economic disruption1,2. There are no antiviral drugs with proven clinical efficacy for the treatment of COVID-19, nor are there any vaccines that prevent infection with SARS-CoV-2, and efforts to develop drugs and vaccines are hampered by the limited knowledge of the molecular details of how SARS-CoV-2 infects cells. Here we cloned, tagged and expressed 26 of the 29 SARS-CoV-2 proteins in human cells and identified the human proteins that physically associated with each of the SARS-CoV-2 proteins using affinity-purification mass spectrometry, identifying 332 high-confidence protein-protein interactions between SARS-CoV-2 and human proteins. Among these, we identify 66 druggable human proteins or host factors targeted by 69 compounds (of which, 29 drugs are approved by the US Food and Drug Administration, 12 are in clinical trials and 28 are preclinical compounds). We screened a subset of these in multiple viral assays and found two sets of pharmacological agents that displayed antiviral activity: inhibitors of mRNA translation and predicted regulators of the sigma-1 and sigma-2 receptors. Further studies of these host-factor-targeting agents, including their combination with drugs that directly target viral enzymes, could lead to a therapeutic regimen to treat COVID-19.

Iliotibial band syndrome rehabilitation in female runners: a pilot randomized study

Background

Iliotibial band syndrome (ITBS) carries marked morbidity in runners. Its management is not standardized and lacks evidence base. We evaluated the effectiveness of three different exercises programs in reducing ITBS symptoms.

Methods

Patients were divided into three equal treatment groups: ITB stretching (group A), conventional exercise (group B), and experimental hip strengthening exercise (group C). Numeric pain rating scale (NPRS; every week), lower extremity functional scale (LEFS; every 2 weeks), dynamometer (DN; weeks 0, 2, 4, 6, 8), single-limb mini squat (SLMS; week 0, 8), and Y-balance test™ (YBT), between and within group’s differences were evaluated using ANOVA model.

Results

Twenty-four female runners (age 19–45 years) were included into one of three groups (A, B, and C). Statistical significance (p < 0.05) within group C was observed for composite YBT and DN for injured and non-injured leg, the YBT (injured leg for the posterior medial), LEFS, NPRS, and the SLMS. Statistical significance (p < 0.05) was found between group A and group C. The stretching group exhibited statistically significant (p < 0.05) YBT anterior reach for the injured/non-injured leg and the LEFS.

Conclusion

There were no statistical differences between the three groups. The subjects who underwent experimental hip strengthening exercises consistently showed improvements in outcome measures, and never scored less than the other two groups.

Trial registration

ClinicalTrials.gov identifier (NCT number): NCT0229615

A SARS-CoV-2 protein interaction map reveals targets for drug repurposing

A newly described coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the causative agent of coronavirus disease 2019 (COVID-19), has infected over 2.3 million people, led to the death of more than 160,000 individuals and caused worldwide social and economic disruption^1,2. There are no antiviral drugs with proven clinical efficacy for the treatment of COVID-19, nor are there any vaccines that prevent infection with SARS-CoV-2, and efforts to develop drugs and vaccines are hampered by the limited knowledge of the molecular details of how SARS-CoV-2 infects cells. Here we cloned, tagged and expressed 26 of the 29 SARS-CoV-2 proteins in human cells and identified the human proteins that physically associated with each of the SARS-CoV-2 proteins using affinity-purification mass spectrometry, identifying 332 high-confidence protein-protein interactions between SARS-CoV-2 and human proteins. Among these, we identify 66 druggable human proteins or host factors targeted by 69 compounds (of which, 29 drugs are approved by the US Food and Drug Administration, 12 are in clinical trials and 28 are preclinical compounds). We screened a subset of these in multiple viral assays and found two sets of pharmacological agents that displayed antiviral activity: inhibitors of mRNA translation and predicted regulators of the sigma-1 and sigma-2 receptors. Further studies of these host-factor-targeting agents, including their combination with drugs that directly target viral enzymes, could lead to a therapeutic regimen to treat COVID-19.

A SARS-CoV-2-Human Protein-Protein Interaction Map Reveals Drug Targets and Potential Drug-Repurposing

An outbreak of the novel coronavirus SARS-CoV-2, the causative agent of COVID-19 respiratory disease, has infected over 290,000 people since the end of 2019, killed over 12,000, and caused worldwide social and economic disruption 1,2 . There are currently no antiviral drugs with proven efficacy nor are there vaccines for its prevention. Unfortunately, the scientific community has little knowledge of the molecular details of SARS-CoV-2 infection. To illuminate this, we cloned, tagged and expressed 26 of the 29 viral proteins in human cells and identified the human proteins physically associated with each using affinity-purification mass spectrometry (AP-MS), which identified 332 high confidence SARS-CoV-2-human protein-protein interactions (PPIs). Among these, we identify 66 druggable human proteins or host factors targeted by 69 existing FDA-approved drugs, drugs in clinical trials and/or preclinical compounds, that we are currently evaluating for efficacy in live SARS-CoV-2 infection assays. The identification of host dependency factors mediating virus infection may provide key insights into effective molecular targets for developing broadly acting antiviral therapeutics against SARS-CoV-2 and other deadly coronavirus strains.

Discovery of Lysine-Targeted eIF4E Inhibitors through Covalent Docking

Eukaryotic translation initiation factor 4E (eIF4E) binds the m7GTP cap structure at the 5'-end of mRNAs, stimulating the translation of proteins implicated in cancer cell growth and metastasis. eIF4E is a notoriously challenging target, and most of the reported inhibitors are negatively charged guanine analogues with negligible cell permeability. To overcome these challenges, we envisioned a covalent targeting strategy. As there are no cysteines near the eIF4E cap binding site, we developed a covalent docking approach focused on lysine. Taking advantage of a "make-on-demand" virtual library, we used covalent docking to identify arylsulfonyl fluorides that target a noncatalytic lysine (Lys162) in eIF4E. Guided by cocrystal structures, we elaborated arylsulfonyl fluoride 2 to 12, which to our knowledge is the first covalent eIF4E inhibitor with cellular activity. In addition to providing a new tool for acutely inactivating eIF4E in cells, our computational approach may offer a general strategy for developing selective lysine-targeted covalent ligands.

Senescent Phenotype Induced by p90RSK-NRF2 Signaling Sensitizes Monocytes and Macrophages to Oxidative Stress in HIV-Positive Individuals

BACKGROUND

The incidence of cardiovascular disease is higher in HIV-positive (HIV⁺) patients than it is in the average population, and combination antiretroviral therapy (cART) is a recognized risk factor for cardiovascular disease. However, the molecular mechanisms that link cART and cardiovascular disease are currently unknown. Our study explores the role of the activation of p90RSK, a reactive oxygen species-sensitive kinase, in engendering senescent phenotype in macrophages and accelerating atherogenesis in patients undergoing cART.

METHODS

Peripheral whole blood from cART-treated HIV⁺ individuals and nontreated HIV-negative individuals was treated with H₂O₂ (200 µmol/L) for 4 minutes, and p90RSK activity in CD14⁺ monocytes was measured. Plaque formation in the carotids was also analyzed in these individuals. Macrophage senescence was determined by evaluating their efferocytotic ability, antioxidation-related molecule expression, telomere length, and inflammatory gene expression. The involvement of p90RSK-NRF2 signaling in cART-induced senescence was assessed by p90RSK-specific inhibitor (FMK-MEA) or dominant-negative p90RSK (DN-p90RSK) and NRF2 activator (NRF2A). Further, the severity of atherosclerosis was determined in myeloid cell-specific wild-type and DN-p90RSK transgenic mice.

RESULTS

Monocytes from HIV⁺ patients exhibited higher levels of p90RSK activity and were also more sensitive to reactive oxygen species than monocytes from HIV-negative individuals. A multiple linear regression analysis involving cART, Reynolds cardiovascular risk score, and basal p90RSK activity revealed that cART and basal p90RSK activity were the 2 significant determinants of plaque formation. Many of the antiretroviral drugs individually activated p90RSK, which simultaneously triggered all components of the macrophage senescent phenotype. cART inhibited antioxidant response element reporter activity via ERK5 S496 phosphorylation. NRF2A reversed the H₂O₂-induced overactivation of p90RSK in cART-treated macrophages by countering the induction of senescent phenotype. Last, the data obtained from our gain- or loss-of-function mice conclusively showed the crucial role of p90RSK in inducing senescent phenotype in macrophages and atherogenesis.

CONCLUSIONS

cART increased monocyte/macrophage sensitivity to reactive oxygen species- in HIV⁺ individuals by suppressing NRF2-ARE activity via p90RSK-mediated ERK5 S496 phosphorylation, which coordinately elicited senescent phenotypes and proinflammatory responses. As such, our report underscores the importance of p90RSK regulation in monocytes/macrophages as a viable biomarker and therapeutic target for preventing cardiovascular disease, especially in HIV⁺ patients treated with cART.

Abstract 3860: Discovery and characterization of novel anti-cancer small molecule inhibitors of Sec61

Secreted and membrane proteins play key roles in malignant transformation and tumor growth, including autocrine growth factor expression, receptor oncogene signal transduction pathways, metastasis, and immune system evasion. The biogenesis of most secreted and transmembrane proteins involves cotranslational translocation of nascent polypeptides into the endoplasmic reticulum through the Sec61 translocon. Broad inhibition of protein secretion can be mediated by natural product-derived Sec61 inhibitors that also possess anti-tumor activity, suggesting that Sec61 represents an untapped therapeutic target for cancer treatment. Here we describe a process for discovering and evaluating novel Sec61 inhibitors with varying degrees of selectivity for therapeutically relevant targets in oncology.

We used HEK293 reporter cell lines stably transfected to express secreted and transmembrane proteins of interest fused to luciferase to enable high-throughput screening of potential inhibitors of Sec61-dependent protein secretion. As expected, target selectivity was largely dependent on respective signal sequences. However, full-length protein constructs were found to be 5-10 fold less sensitive to inhibition compared to reporters containing only the signal sequence plus 10 amino acids, suggesting that additional interactions beyond the signal sequence are involved in promoting cotranslational translocation. To verify that novel compounds specifically targeted Sec61, we found that compounds were unable to inhibit the activity of luciferase localized to the cytosol and had reduced potency in reporter cells expressing a Sec61 mutant known to confer resistance to published inhibitors such as cotransin, mycolactone, and apratoxin. We assessed compound selectivity using a library of 37 transiently expressed Sec61-client proteins of therapeutic relevance, revealing 4 distinct chemical scaffolds differentiated by target selectivity profile. Consistent with data from published compounds, broad inhibitors of protein secretion had anti-tumor activity. Of particular interest were compounds able to block expression of multiple immune checkpoints including PD-1, PD-L1, CTLA-4, and CD96. Activity in primary cells, such as receptor expression on activated T-cells and cytokine release from stimulated PBMC, was assessed to verify specificity. Compounds with adequate in vitro metabolic stability were tested in mice for pharmacokinetics as well as inhibition of target protein secretion and global inhibition of Sec61 activity.

Taken together, our data suggest that Sec61 is a novel therapeutic target which represents a unique opportunity to both selectively block expression of multiple proteins involved in tumor growth and globally modulate protein homeostasis, resulting in tumor cell death.

Citation Format: Eric Lowe, Janet L. Anderl, Andrea R. Fan, Ying Fang, Jing Jiang, Henry W. Johnson, Christopher J. Kirk, Dustin McMinn, Tony Muchamuel, Meera Rao, Phillip P. Sharp, Jack Taunton, Jinhai Wang, Jennifer A. Whang. Discovery and characterization of novel anti-cancer small molecule inhibitors of Sec61 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3860.

Abstract 3087: KZR-8834: A novel, small molecule inhibitor of Sec61-dependent protein secretion with anti-tumor activity

The majority of secreted and transmembrane (TM) proteins, including growth factors and TM oncogenes, require translocation through Sec61 into the ER for further processing. Sec61, therefore, represents a unique drug discovery opportunity through blockade of typically “undruggable” targets and modulation of protein homeostasis. Multiple inhibitors of protein secretion have been described that directly target Sec61 and have anti-tumor activity but lack adequate pharmaceutical properties and/or tolerability to be considered clinical candidates. We aimed to discover novel, selective inhibitors of Sec61 with increased tolerability as a potential treatment for various malignancies.

Sec61 inhibitors were identified using HEK293 cell lines stably expressing secreted or TM proteins of interest fused to a luciferase reporter. Selective anti-tumor activity was assessed via HEK293 reporter cell viability in comparison to tumor cell lines with known levels of sensitivity to published Sec61-modulating compounds. An initial screen resulted in KZR-4152 (4152), which blocked secretion of several target proteins but had no impact on tumor cell viability. Following a medicinal chemistry campaign, KZR-8834 (8834) was identified, which exhibited a 60-fold increase in potency against target proteins relative to 4152. On-target activity of 8834 was demonstrated via protein secretion assays in cells overexpressing a previously described Sec61 mutant with resistance to published compounds. In addition, 8834 did not affect the viability of HEK293 cells or endotoxin- or TCR-stimulated PBMCs.

8834 induced cell death in H929 multiple myeloma cells in vitro (IC50 = 98 nM) with rapid activation (≤8 hours) of caspase 3/7 via dual activation of caspases 8 and 9. When assessed in a panel of 346 human cancer cell lines across 25 different tumor types, head and neck squamous cell carcinoma, acute lymphocytic leukemia, non-Hodgkin’s lymphoma, melanoma, multiple myeloma, and prostate cancer were among the most sensitive tumor types. Weekly and twice-weekly administration of 8834 was effective in an H929 mouse xenograft model at doses that resulted in &gt;90% tumor growth inhibition without significant body weight loss or clinical signs of toxicity. Anti-tumor activity was &gt;50% at doses 1/3rd of the maximum tolerated dose, suggesting a broad therapeutic index. 8834 was also effective in the B16F0 melanoma model, showing tumor growth inhibition similar to that of anti-PD1 therapy.

KZR-8834 is a novel, small molecule inhibitor of Sec61-dependent translocation of multiple Sec61 client proteins. 8834 exhibits a broad anti-tumor profile in vitro and therapeutic activity in multiple mouse tumor models, demonstrating a potential new therapy for the treatment of malignant diseases.

Citation Format: Eric Lowe, Janet L. Anderl, Andrea R. Fan, Jing Jiang, Henry W. Johnson, Christopher J. Kirk, Dustin McMinn, Tony Muchamuel, Jack Taunton, Jennifer A. Whang. KZR-8834: A novel, small molecule inhibitor of Sec61-dependent protein secretion with anti-tumor activity [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3087.

Endothelial senescence is induced by phosphorylation and nuclear export of telomeric repeat binding factor 2-interacting protein

The interplay among signaling events for endothelial cell (EC) senescence, apoptosis, and activation and how these pathological conditions promote atherosclerosis in the area exposed to disturbed flow (d-flow) in concert remain unclear. The aim of this study was to determine whether telomeric repeat-binding factor 2-interacting protein (TERF2IP), a member of the shelterin complex at the telomere, can regulate EC senescence, apoptosis, and activation simultaneously, and if so, by what molecular mechanisms. We found that d-flow induced p90RSK and TERF2IP interaction in a p90RSK kinase activity-dependent manner. An in vitro kinase assay revealed that p90RSK directly phosphorylated TERF2IP at the serine 205 (S205) residue, and d-flow increased TERF2IP S205 phosphorylation as well as EC senescence, apoptosis, and activation by activating p90RSK. TERF2IP phosphorylation was crucial for nuclear export of the TERF2IP-TRF2 complex, which led to EC activation by cytosolic TERF2IP-mediated NF-κB activation and also to senescence and apoptosis of ECs by depleting TRF2 from the nucleus. Lastly, using EC-specific TERF2IP-knockout (TERF2IP-KO) mice, we found that the depletion of TERF2IP inhibited d-flow-induced EC senescence, apoptosis, and activation, as well as atherosclerotic plaque formation. These findings demonstrate that TERF2IP is an important molecular switch that simultaneously accelerates EC senescence, apoptosis, and activation by S205 phosphorylation.

MAGI1 as a link between endothelial activation and ER stress drives atherosclerosis

The possible association between the membrane-associated guanylate kinase with inverted domain structure-1 (MAGI1) and inflammation has been suggested, but the molecular mechanisms underlying this link, especially during atherogenesis, remain unclear. In endothelial cells (ECs) exposed to disturbed flow (d-flow), p90 ribosomal S6 kinase (p90RSK) bound to MAGI1, causing MAGI1-S741 phosphorylation and sentrin/SUMO-specific protease 2 T368 phosphorylation-mediated MAGI1-K931 deSUMOylation. MAGI1-S741 phosphorylation upregulated EC activation via activating Rap1. MAGI1-K931 deSUMOylation induced both nuclear translocation of p90RSK-MAGI1 and ATF-6-MAGI1 complexes, which accelerated EC activation and apoptosis, respectively. Microarray screening revealed key roles for MAGI1 in the endoplasmic reticulum (ER) stress response. In this context, MAGI1 associated with activating transcription factor 6 (ATF-6). MAGI1 expression was upregulated in ECs and macrophages found in atherosclerotic-prone regions of mouse aortas as well as in the colonic epithelia and ECs of patients with inflammatory bowel disease. Further, reduced MAGI1 expression in Magi1-/+ mice inhibited d-flow-induced atherogenesis. In sum, EC activation and ER stress-mediated apoptosis are regulated in concert by two different types of MAGI1 posttranslational modifications, elucidating attractive drug targets for chronic inflammatory disease, particularly atherosclerosis.

Lysine-Targeted Inhibitors and Chemoproteomic Probes

Covalent inhibitors are widely used in drug discovery and chemical biology. Although covalent inhibitors are frequently designed to react with noncatalytic cysteines, many ligand binding sites lack an accessible cysteine. Here, we review recent advances in the chemical biology of lysine-targeted covalent inhibitors and chemoproteomic probes. By analyzing crystal structures of proteins bound to common metabolites and enzyme cofactors, we identify a large set of mostly unexplored lysines that are potentially targetable with covalent inhibitors. In addition, we describe mass spectrometry-based approaches for determining proteome-wide lysine ligandability and lysine-reactive chemoproteomic probes for assessing drug-target engagement. Finally, we discuss the design of amine-reactive inhibitors that form reversible covalent bonds with their protein targets.

Comparative Flavivirus-Host Protein Interaction Mapping Reveals Mechanisms of Dengue and Zika Virus Pathogenesis

Mosquito-borne flaviviruses, including dengue virus (DENV) and Zika virus (ZIKV), are a growing public health concern. Systems-level analysis of how flaviviruses hijack cellular processes through virus-host protein-protein interactions (PPIs) provides information about their replication and pathogenic mechanisms. We used affinity purification-mass spectrometry (AP-MS) to compare flavivirus-host interactions for two viruses (DENV and ZIKV) in two hosts (human and mosquito). Conserved virus-host PPIs revealed that the flavivirus NS5 protein suppresses interferon stimulated genes by inhibiting recruitment of the transcription complex PAF1C and that chemical modulation of SEC61 inhibits DENV and ZIKV replication in human and mosquito cells. Finally, we identified a ZIKV-specific interaction between NS4A and ANKLE2, a gene linked to hereditary microcephaly, and showed that ZIKV NS4A causes microcephaly in Drosophila in an ANKLE2-dependent manner. Thus, comparative flavivirus-host PPI mapping provides biological insights and, when coupled with in vivo models, can be used to unravel pathogenic mechanisms.

Assessment of cardiovascular risk and preparticipation screening protocols in masters athletes: the Masters Athlete Screening Study (MASS): a cross-sectional study

Background

Underlying coronary artery disease (CAD) is the primary cause of sudden cardiac death in masters athletes (>35 years). Preparticipation screening may detect cardiovascular disease; however, the optimal screening method is undefined in this population. The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and the American Heart Association (AHA) Preparticipation Screening Questionnaire are often currently used; however, a more comprehensive risk assessment may be required. We sought to ascertain the cardiovascular risk and to assess the effectiveness of screening tools in masters athletes.

Methods

This cross-sectional study performed preparticipation screening on masters athletes, which included an ECG, the AHA 14-element recommendations and Framingham Risk Score (FRS). If the preparticipation screening was abnormal, further evaluations were performed. The effectiveness of the screening tools was determined by their positive predictive value (PPV).

Results

798 athletes were included in the preparticipation screening analysis (62.7% male, 54.6±9.5 years, range 35–81). The metabolic equivalent task hours per week was 80.8±44.0, and the average physical activity experience was 35.1±14.8 years. Sixty-four per cent underwent additional evaluations. Cardiovascular disease was detected in 11.4%, with CAD (7.9%) being the most common diagnosis. High FRS (>20%) was seen in 8.5% of the study population. Ten athletes were diagnosed with significant CAD; 90% were asymptomatic. A high FRS was most indicative of underlying CAD (PPV 38.2%).

Conclusion

Masters athletes are not immune to elevated cardiovascular risk and cardiovascular disease. Comprehensive preparticipation screening including an ECG and FRS can detect cardiovascular disease. An exercise stress test should be considered in those with risk factors, regardless of fitness level.

Pathological Insights From Quantitative Susceptibility Mapping and Diffusion Tensor Imaging in Ice Hockey Players Pre and Post-concussion

Myelin sensitive MRI techniques, such as diffusion tensor imaging and myelin water imaging, have previously been used to reveal changes in myelin after sports-related concussions. What is not clear from these studies, however, is how myelin is affected: whether it becomes degraded and possibly removed, or whether the myelin sheath loosens and becomes “decompacted”. Previously, our team revealed myelin specific changes in ice hockey players 2 weeks post-concussion using myelin water imaging. In that study, 45 subjects underwent a pre-season baseline scan, 11 of which sustained a concussion during play and received follow-up scans: eight were scanned within 3 days, 10 were scanned at 14 days, and nine were scanned at 60 days. In the current retrospective analysis, we used quantitative susceptibility mapping, along with the diffusion tensor imaging measures axial diffusivity and radial diffusivity, to investigate this myelin disruption. If sports-related concussive hits lead to myelin fragmentation in regions of lowered MWF, this should result in a measurable increase in magnetic susceptibility, due to the anisotropic myelin fragmenting into isotropic myelin debris, and the diamagnetic myelin tissue being removed, while no such changes should be expected if the myelin sheath simply loosens and becomes decompacted. An increase in radial diffusivity would likewise reveal myelin fragmentation, as myelin sheaths block water diffusion out of the axon, with little to no changes expected for myelin sheath loosening. Statistical analysis of the same voxels-of-interest that were found to have reduced myelin water fraction 2 weeks post-concussion, revealed no statistically significant changes in magnetic susceptibility, axial diffusivity, or radial diffusivity at any time-point post-concussion. This suggests that myelin water fraction changes are likely due to a loosening of the myelin sheath structure, as opposed to fragmentation and removal of myelin debris.

Repurposing tofacitinib as an anti-myeloma therapeutic to reverse growth-promoting effects of the bone marrow microenvironment

The myeloma bone marrow microenvironment promotes proliferation of malignant plasma cells and resistance to therapy. Activation of JAK/STAT signaling is thought to be a central component of these microenvironment-induced phenotypes. In a prior drug repurposing screen, we identified tofacitinib, a pan-JAK inhibitor Food and Drug Administration (FDA) approved for rheumatoid arthritis, as an agent that may reverse the tumor-stimulating effects of bone marrow mesenchymal stromal cells. Herein, we validated in vitro, in stromal-responsive human myeloma cell lines, and in vivo, in orthotopic disseminated xenograft models of myeloma, that tofacitinib showed efficacy in myeloma models. Furthermore, tofacitinib strongly synergized with venetoclax in coculture with bone marrow stromal cells but not in monoculture. Surprisingly, we found that ruxolitinib, an FDA approved agent targeting JAK1 and JAK2, did not lead to the same anti-myeloma effects. Combination with a novel irreversible JAK3-selective inhibitor also did not enhance ruxolitinib effects. Transcriptome analysis and unbiased phosphoproteomics revealed that bone marrow stromal cells stimulate a JAK/STAT-mediated proliferative program in myeloma cells, and tofacitinib reversed the large majority of these pro-growth signals. Taken together, our results suggest that tofacitinib reverses the growth-promoting effects of the tumor microenvironment. As tofacitinib is already FDA approved, these results can be rapidly translated into potential clinical benefits for myeloma patients.

Inhibition of Sec61-dependent translocation by mycolactone uncouples the integrated stress response from ER stress, driving cytotoxicity via translational activation of ATF4

Mycolactone is the exotoxin virulence factor of Mycobacterium ulcerans that causes the neglected tropical disease Buruli ulcer. We recently showed it to be a broad spectrum inhibitor of Sec61-dependent co-translational translocation of proteins into the endoplasmic reticulum (ER). An outstanding question is the molecular pathway linking this to its known cytotoxicity. We have now used translational profiling to better understand the reprogramming that occurs in cells exposed to mycolactone. Gene ontology identified enrichment in genes involved in cellular response to stress, and apoptosis signalling among those showing enhanced translation. Validation of these results supports a mechanism by which mycolactone activates an integrated stress response meditated by phosphorylation of eIF2α via multiple kinases (PERK, GCN, PKR) without activation of the ER stress sensors IRE1 or ATF6. The response therefore uncouples the integrated stress response from ER stress, and features translational and transcriptional modes of genes expression that feature the key regulatory transcription factor ATF4. Emphasising the importance of this uncoupled response in cytotoxicity, downstream activation of this pathway is abolished in cells expressing mycolactone-resistant Sec61α variants. Using multiple genetic and biochemical approaches, we demonstrate that eIF2α phosphorylation is responsible for mycolactone-dependent translation attenuation, which initially protects cells from cell death. However, chronic activation without stress remediation enhances autophagy and apoptosis of cells by a pathway facilitated by ATF4 and CHOP. Our findings demonstrate that priming events at the ER can result in the sensing of stress within different cellular compartments.

The effects of different passive static stretching intensities on recovery from unaccustomed eccentric exercise - a randomized controlled trial

Effects of passive static stretching intensity on recovery from unaccustomed eccentric exercise of right knee extensors was investigated in 30 recreationally active males randomly allocated into 3 groups: high-intensity (70%-80% maximum perceived stretch), low-intensity (30%-40% maximum perceived stretch), and control. Both stretching groups performed 3 sets of passive static stretching exercises of 60 s each for hamstrings, hip flexors, and quadriceps, over 3 consecutive days, post-unaccustomed eccentric exercise. Muscle function (eccentric and isometric peak torque) and blood biomarkers (creatine kinase and C-reactive protein) were measured before (baseline) and after (24, 48, and 72 h) unaccustomed eccentric exercise. Perceived muscle soreness scores were collected immediately (time 0), and after 24, 48, and 72 h postexercise. Statistical time × condition interactions observed only for eccentric peak torque (p = 0.008). Magnitude-based inference analyses revealed low-intensity stretching had most likely, very likely, or likely beneficial effects on perceived muscle soreness (48-72 h and 0-72 h) and eccentric peak torque (baseline-24 h and baseline-72 h), compared with high-intensity stretching. Compared with control, low-intensity stretching had very likely or likely beneficial effects on perceived muscle soreness (0-24 h and 0-72 h), eccentric peak torque (baseline-48 h and baseline-72 h), and isometric peak torque (baseline-72 h). High-intensity stretching had likely beneficial effects on eccentric peak torque (baseline-48 h), but likely had harmful effects on eccentric peak torque (baseline-24 h) and creatine kinase (baseline-48 h and baseline-72 h), compared with control. Therefore, low-intensity stretching is likely to result in small-to-moderate beneficial effects on perceived muscle soreness and recovery of muscle function post-unaccustomed eccentric exercise, but not markers of muscle damage and inflammation, compared with high-intensity or no stretching.

IL-2Rβ abundance differentially tunes IL-2 signaling dynamics in CD4+ and CD8+ T cells

Interleukin-2 (IL-2) stimulates both activated CD4⁺ and CD8⁺ T cells to proliferate. IL-2 signals through an identical receptor complex and promotes the same dose-dependent phosphorylation of the canonical transcription factor STAT5 in both cell types. Despite this, CD8⁺ T cells enter the S phase earlier and proliferate to a greater extent than do CD4⁺ T cells in response to IL-2. We identified distinct IL-2 signaling dynamics in CD4⁺ and CD8⁺ T cells. In IL-2-stimulated CD8⁺ T cells, STAT5 phosphorylation increased rapidly and was sustained for 6 hours. In contrast, CD4⁺ T cells had a biphasic response, with maxima at 15 min and 2 to 4 hours after stimulation. Both cell types required vesicular trafficking, but only CD4⁺ T cells required new protein synthesis to maintain high phosphorylation of STAT5. Two subunits of the IL-2 receptor, IL-2Rβ and IL-2Rγ, were twice as abundant in CD8⁺ T cells than in CD4⁺ T cells. Reduction of IL-2Rβ abundance by 50% was sufficient to convert CD8⁺ T cells to a CD4⁺ T cell-like signaling pattern and delay S phase entry. These results suggest that the larger pool of IL-2Rβ chains in CD8⁺ T cells is required to sustain IL-2 signaling and contributes to the quantitatively greater proliferative response to IL-2 relative to that of CD4⁺ T cells. This cell type-specific difference in IL-2Rβ abundance appears to tune responses, potentially preventing extensive, autoimmune proliferation of CD4⁺ T cells, while still enabling sufficient proliferation of CD8⁺ T cells to control viral infections.

Apratoxin Kills Cells by Direct Blockade of the Sec61 Protein Translocation Channel

Apratoxin A is a cytotoxic natural product that prevents the biogenesis of secretory and membrane proteins. Biochemically, apratoxin A inhibits cotranslational translocation into the ER, but its cellular target and mechanism of action have remained controversial. Here, we demonstrate that apratoxin A prevents protein translocation by directly targeting Sec61α, the central subunit of the protein translocation channel. Mutagenesis and competitive photo-crosslinking studies indicate that apratoxin A binds to the Sec61 lateral gate in a manner that differs from cotransin, a substrate-selective Sec61 inhibitor. In contrast to cotransin, apratoxin A does not exhibit a substrate-selective inhibitory mechanism, but blocks ER translocation of all tested Sec61 clients with similar potency. Our results suggest that multiple structurally unrelated natural products have evolved to target overlapping but non-identical binding sites on Sec61, thereby producing distinct biological outcomes.