Activity-Based Sensing with a Metal-Directed Acyl Imidazole Strategy Reveals Cell Type-Dependent Pools of Labile Brain Copper

Copper is a required nutrient for life and particularly important to the brain and central nervous system. Indeed, copper redox activity is essential to maintaining normal physiological responses spanning neural signaling to metabolism, but at the same time copper misregulation is associated with inflammation and neurodegeneration. As such, chemical probes that can track dynamic changes in copper with spatial resolution, especially in loosely bound, labile forms, are valuable tools to identify and characterize its contributions to healthy and disease states. In this report, we present an activity-based sensing (ABS) strategy for copper detection in live cells that preserves spatial information by a copper-dependent bioconjugation reaction. Specifically, we designed copper-directed acyl imidazole dyes that operate through copper-mediated activation of acyl imidazole electrophiles for subsequent labeling of proximal proteins at sites of elevated labile copper to provide a permanent stain that resists washing and fixation. To showcase the utility of this new ABS platform, we sought to characterize labile copper pools in the three main cell types in the brain: neurons, astrocytes, and microglia. Exposure of each of these cell types to physiologically relevant stimuli shows distinct changes in labile copper pools. Neurons display translocation of labile copper from somatic cell bodies to peripheral processes upon activation, whereas astrocytes and microglia exhibit global decreases and increases in intracellular labile copper pools, respectively, after exposure to inflammatory stimuli. This work provides foundational information on cell type-dependent homeostasis of copper, an essential metal in the brain, as well as a starting point for the design of new activity-based probes for metals and other dynamic signaling and stress analytes in biology.

Unusual Presentation Of Sarcoidosis: Case Report

Sarcoidosis is a multisystem granulomatous disease with polymorphic manifestations, of unknown etiology, that can affect any organ in the body, but most commonly the lungs [1,2,3]. Extrapulmonary involvement is common, can occur in association with or in the absence of intrathoracic disease, and all organs can be involved, but it is rare to find an isolated extrapulmonary disease (less than 10% of patients) [3,4]. On occasion, the presentation of sarcoidosis may be atypical.

We report a case of systemic sarcoidosis, with particular clinical data: extrathoracic onset with subdiaphragmatic lymph nodes, hepatomegaly and splenomegaly.

Major drivers influencing adherence and quality of life during antiviral triple therapy in patients with chronic hepatitis C

Background & Aims. Triple therapy with Peg-IFNs, Ribavirin and protease inhibitors raise the treatment success for hepatitis C up to 83%, but also bring together with the significantly higher rates of sustained virologic response (SVR) more side effects, interfering with patient’s quality of life (QoL) and work productivity. We aimed to analyze the factors influencing the adherence and the QoL during triple therapy using Peg-IFNs, Ribavirin and protease inhibitors in 50 patients diagnosed with chronic hepatitis C with first line therapy failure. Multivariate Cox proportional hazards regression was used to analyze determinants of retreatment initiation and treatment compliance, according to patient features. Results: We identified as major drivers of retreatment initiation the younger age, the female gender, the urban provenience, the high income, and the psychiatric and alcohol or drugs abuse history. The adherence and the QoL during retreatment therapy were similar, despite the regimen used, and obvious lower in patients with history of previous abandon, drugs and alcohol abuse or hematologic/ psychiatric decompensation. A lower capacity to work and a temporary withdrawal from job necessary to continue the therapy were seen similar in patients taking Boceprevir/Telaprevir. Abandon of therapy without a known reason was more frequent in males, with alcohol and drugs intake history, from rural region, with low income, and with psychiatric disturbances in personal history. Conclusion. Physicians should focus to develop medical strategies or drugs to increase the adherence and to provide a better QoL for patients with chronic hepatitis C making antiviral therapy.

How long shall we record electroencephalography?

BACKGROUND

The duration of electroencephalography (EEG) recordings varies widely among laboratories. Although several recommendations had been published, there are no previous studies directly addressing this.

AIMS OF THE STUDY

To assess the effect of the recording duration on detection of EEG abnormalities in a tertiary referral centre for epilepsy.

METHODS

We have reviewed 1005 EEG recordings and determined the shortest recording duration necessary to identify interictal EEG abnormalities.

RESULTS

Standard, awake recordings shorter than 20 min yielded a significantly lower incidence of abnormal findings as compared to longer recordings. Although there was an increase in the diagnostic yield from 30 to 180 min recording duration, this failed to reach the level of significance. For sleep recordings, there was no significant increase in the diagnostic yield beyond 30 min.

CONCLUSIONS

Our results provide evidence for recommending at least 20 min recording duration for standard awake EEGs and 30 min for sleep EEG recordings. As data were derived from patients referred to our epilepsy centre, the results are only valid for epilepsy-related indications.

Insights in classification of seizures and epilepsies – review of key concepts throughout history

Since the Babylonian era up to nowadays, the large complexity of epileptic disorders made the attempt of classifying and organizing concepts one of the most challenging. The 1981 classification was a revision of the one devised by Henri Gastaut for the ILAE and published in 1970. The distinction between simple and complex partial seizures represented a significant difference. In 1989 the report of ILAE classification and terminology task force introduced the concept of epileptic syndrome. An epileptic syndrome is defined by the sum of signs and symptoms that tend to occur together, not reflecting a particular etiology and prognosis, these latter features being the hallmark not of a syndrome, but of a disease condition. Firstly, any epileptic disorder can be described as either idiopathic (primary, whose etiology is probably genetic), symptomatic (with a known or presumed cerebral pathology) or cryptogenic (with an occult cause). The epileptic diagnostic tree ramifies into four main branches in the 1989 ILAE Classification: localization-related (focal, local, or partial) epilepsies and syndromes, generalized epilepsies and syndromes, epilepsies and syndromes undetermined whether focal or generalized and special syndromes. The next important milestone in epilepsy classification was settled by ILAE in 2001, when a glossary for ictal semiology was developed and multiaxial approach of diagnosing epilepsy was proposed. The necessity of processing the new insights in epilepsy was answered by the latest ILAE Report released in February 2010, which brings awareness of and appropriately integrates the currently available data. It presents a modular approach of diagnosing epilepsy and recommends to keep a flexible vision on this topic, as every individual case requires a different prioritizing scheme.

Induction of tolerance in solid organ transplantation: the rationale to develop clinical protocols in liver transplantation

Minimization or withdrawal of immunosuppressive treatments after organ transplantation represents a major objective for improving quality of life and long-term survival of grafted patients. Such a goal may be reached under some clinical conditions, particularly in liver transplantation, making these patients good candidates for tolerance trials. In this context in liver transplantation, the central questions are (1) how to promote the natural propensity of the liver graft to be accepted, (2) which type of immunosuppressive drug should be used for induction and maintenance, and (3) which biomarkers could be used to discriminate tolerant patients from those requiring long-term immunosuppression. Induction therapies using aggressive T-cell-depleting agents may favor graft acceptance. However, persistent and/or rapidly reemerging cell lines, such as memory-type cells or CD8(+) T cells, could represent a significant barrier for induction of tolerance. The type of maintenance drugs also remains questionable. Calcineurin inhibitors may be eventually deleterious in the context of tolerance protocols, through inhibitory effects on regulatory T cells, that are not observed with rapamycin. In conclusion, significant efforts must be made to achieve reliable strategies for immunosuppression minimization or withdrawal after organ transplantation into the clinics.

Mapping and developmental expression analysis of the WD-repeat gene Preb

We have isolated from mouse a novel WD-motif-containing gene designated Preb. This gene encodes a predicted protein of 416 amino acids and has significant homology with other members of the WD-motif gene superfamily that play a role in cell fate determination. Preb maps to the proximal end of chromosome 5 in mouse, near the Hmx1 homeobox gene. Preb is detectable in early stage embryos in the peripheral nervous system, developing liver, and surface ectoderm. Later, Preb is expressed in the anterior portion of Rathke's pouch, which gives rise to the anterior pituitary, the organ responsible for the production of prolactin and other hormones. In midgestation embryos, the most extensive expression of Preb is observed in the perichondrium of the craniofacial, axial, and appendicular skeleton. The expression pattern of Preb in murine embryos suggests a potential role in the specification of multiple cell types, in particular, the fetal skeleton.