Blood and urine multi-omics analysis of the impact of e-vaping, smoking, and cessation: from exposome to molecular responses

Cigarette smoking is a major preventable cause of morbidity and mortality. While quitting smoking is the best option, switching from cigarettes to non-combustible alternatives (NCAs) such as e-vapor products is a viable harm reduction approach for smokers who would otherwise continue to smoke. A key challenge for the clinical assessment of NCAs is that self-reported product use can be unreliable, compromising the proper evaluation of their risk reduction potential. In this cross-sectional study of 205 healthy volunteers, we combined comprehensive exposure characterization with in-depth multi-omics profiling to compare effects across four study groups: cigarette smokers (CS), e-vapor users (EV), former smokers (FS), and never smokers (NS). Multi-omics analyses included metabolomics, transcriptomics, DNA methylomics, proteomics, and lipidomics. Comparison of the molecular effects between CS and NS recapitulated several previous observations, such as increased inflammatory markers in CS. Generally, FS and EV demonstrated intermediate molecular effects between the NS and CS groups. Stratification of the FS and EV by combustion exposure markers suggested that this position on the spectrum between CS and NS was partially driven by non-compliance/dual use. Overall, this study highlights the importance of in-depth exposure characterization before biological effect characterization for any NCA assessment study.

Suppression of pyrrolidine ring biosynthesis and its effects on gene expression and subsequent accumulation of anatabine in leaves of tobacco (N. tabacum L.)

BACKGROUND

Anatabine, although being one of four major tobacco alkaloids, is never accumulated in high quantity in any of the naturally occurring species from the Nicotiana genus. Previous studies therefore focused on transgenic approaches to synthetize anatabine, most notably by generating transgenic lines with suppressed putrescine methyltransferase (PMT) activity. This led to promising results, but the global gene expression of plants with such distinct metabolism has not been analyzed. In the current study, we describe how these plants respond to topping and the downstream effects on alkaloid biosynthesis.

RESULTS

The surge in anatabine accumulation in PMT transgenic lines after topping treatment and its effects on gene expression changes were analyzed. The results revealed increases in expression of isoflavone reductase-like (A622) and berberine bridge-like enzymes (BBLs) oxidoreductase genes, previously shown to be crucial for the final steps of nicotine biosynthesis. We also observed significantly higher methylputrescine oxidase (MPO) expression in all plants subjected to topping treatment. In order to investigate if MPO suppression would have the same effects as that of PMT, we generated transgenic plants. These plants with suppressed MPO expression showed an almost complete drop in leaf nicotine content, whereas leaf anatabine was observed to increase by a factor of ~ 1.6X.

CONCLUSION

Our results are the first concrete evidence that suppression of MPO leads to decreased nicotine in favor of anatabine in tobacco roots and that this anatabine is successfully transported to tobacco leaves. Alkaloid transport in plants remains to be investigated to higher detail due to high variation of its efficiency among Nicotiana species and varieties of tobacco. Our research adds important step to better understand pyrrolidine ring biosynthesis and its effects on gene expression and subsequent accumulation of anatabine.

Application of Secondary Electrospray Ionization Coupled with High-Resolution Mass Spectrometry in Chemical Characterization of Thermally Generated Aerosols

Inhalation as a route for administering drugs and dietary supplements has garnered significant attention over the past decade. We performed real-time analyses of aerosols using secondary electrospray ionization (SESI) technology interfaced with high-resolution mass spectrometry (HRMS), primarily developed for exhaled breath analysis with the goal to detect the main aerosol constituents. Several commercially available inhalation devices containing caffeine, melatonin, cannabidiol, and vitamin B12 were tested. Chemical characterization of the aerosols produced by these devices enabled detection of the main constituents and screening for potential contaminants, byproducts, and impurities in the aerosol. In addition, a programmable syringe pump was connected to the SESI-HRMS system to monitor aerosolized active pharmaceutical ingredients (APIs) such as chloroquine, hydroxychloroquine, and azithromycin. This setup allowed us to detect caffeine, melatonin, hydroxychloroquine, chloroquine, and cannabidiol in the produced aerosols. Azithromycin and vitamin B12 in the aerosols could not be detected; however, our instrument setup enabled the detection of vitamin B12 breakdown products that were generated during the aerosolization process. Positive control was realized by liquid chromatography-HRMS analyses. The compounds detected in the aerosol were confirmed by exact mass measurements of the protonated and/or deprotonated species, as well as their respective collision-induced dissociation tandem mass spectra. These results reveal the potential wide application of this technology for the real-time monitoring of aerosolized active pharmaceutical ingredients that can be administered through the inhalation route.

Contraceptive progestins with androgenic properties stimulate breast epithelial cell proliferation

Hormonal contraception exposes women to synthetic progesterone receptor (PR) agonists, progestins, and transiently increases breast cancer risk. How progesterone and progestins affect the breast epithelium is poorly understood because we lack adequate models to study this. We hypothesized that individual progestins differentially affect breast epithelial cell proliferation and hence breast cancer risk. Using mouse mammary tissue ex vivo, we show that testosterone-related progestins induce the PR target and mediator of PR signaling-induced cell proliferation receptor activator of NF-κB ligand (Rankl), whereas progestins with anti-androgenic properties in reporter assays do not. We develop intraductal xenografts of human breast epithelial cells from 36 women, show they remain hormone-responsive and that progesterone and the androgenic progestins, desogestrel, gestodene, and levonorgestrel, promote proliferation but the anti-androgenic, chlormadinone, and cyproterone acetate, do not. Prolonged exposure to androgenic progestins elicits hyperproliferation with cytologic changes. Androgen receptor inhibition interferes with PR agonist- and levonorgestrel-induced RANKL expression and reduces levonorgestrel-driven cell proliferation. Thus, different progestins have distinct biological activities in the breast epithelium to be considered for more informed choices in hormonal contraception.

The secreted protease Adamts18 links hormone action to activation of the mammary stem cell niche

Estrogens and progesterone control breast development and carcinogenesis via their cognate receptors expressed in a subset of luminal cells in the mammary epithelium. How they control the extracellular matrix, important to breast physiology and tumorigenesis, remains unclear. Here we report that both hormones induce the secreted protease Adamts18 in myoepithelial cells by controlling Wnt4 expression with consequent paracrine canonical Wnt signaling activation. Adamts18 is required for stem cell activation, has multiple binding partners in the basement membrane and interacts genetically with the basal membrane-specific proteoglycan, Col18a1, pointing to the basement membrane as part of the stem cell niche. In vitro, ADAMTS18 cleaves fibronectin; in vivo, Adamts18 deletion causes increased collagen deposition during puberty, which results in impaired Hippo signaling and reduced Fgfr2 expression both of which control stem cell function. Thus, Adamts18 links luminal hormone receptor signaling to basement membrane remodeling and stem cell activation.

How hormonal signaling in the mammary epithelium controls the surrounding extracellular matrix is unclear. Here, the authors show that a secreted protease, Adamts18, induced by upstream estrogen-progesterone activated Wnt4 in myoepithelial cells, remodels the basement membrane and contributes to mammary epithelial stemness.

Autophagy Controls CSL/RBPJκ Stability through a p62/SQSTM1-Dependent Mechanism

Cancer-associated fibroblasts (CAFs) are important at all tumor stages. CSL/RBPJκ suppresses the gene expression program leading to CAF activation and associated metabolic reprogramming, as well as autophagy. Little is known about CSL protein turnover, especially in the tumor microenvironment. We report that, in human dermal fibroblasts (HDFs), conditions inducing autophagy—often found in tumor stroma—down-regulate CSL protein levels but do not affect its mRNA levels. Genetic or pharmacologic targeting of the autophagic machinery blocks CSL down-modulation. Mechanistically, endogenous CSL associates with the autophagy and signaling adaptor p62/SQSTM1, which is required for CSL down-modulation by autophagy. This is functionally significant, because both CSL and p62 levels are lower in skin cancer-derived CAFs, in which autophagy is increased. Increasing cellular CSL levels stabilizes p62 and down-modulates the autophagic process. We reveal here an autophagy-initiated mechanism for CSL down-modulation, which could be targeted for stroma-focused cancer prevention and treatment.

Autophagic conditions are often found in the tumor stroma, where CSL/RBPJκ levels are down-modulated. Goruppi et al. identify a key role for autophagy in the degradation of CSL through a direct interaction with the p62 adaptor. This induces CSL-repressed genes involved in CAF activation and autophagy, linking the two processes.

Nucleolin mediates microRNA-directed CSF-1 mRNA deadenylation but increases translation of CSF-1 mRNA

CSF-1 mRNA 3'UTR contains multiple unique motifs, including a common microRNA (miRNA) target in close proximity to a noncanonical G-quadruplex and AU-rich elements (AREs). Using a luciferase reporter system fused to CSF-1 mRNA 3'UTR, disruption of the miRNA target region, G-quadruplex, and AREs together dramatically increased reporter RNA levels, suggesting important roles for these cis-acting regulatory elements in the down-regulation of CSF-1 mRNA. We find that nucleolin, which binds both G-quadruplex and AREs, enhances deadenylation of CSF-1 mRNA, promoting CSF-1 mRNA decay, while having the capacity to increase translation of CSF-1 mRNA. Through interaction with the CSF-1 3'UTR miRNA common target, we find that miR-130a and miR-301a inhibit CSF-1 expression by enhancing mRNA decay. Silencing of nucleolin prevents the miRNA-directed mRNA decay, indicating a requirement for nucleolin in miRNA activity on CSF-1 mRNA. Downstream effects followed by miR-130a and miR-301a inhibition of directed cellular motility of ovarian cancer cells were found to be dependent on nucleolin. The paradoxical effects of nucleolin on miRNA-directed CSF-1 mRNA deadenylation and on translational activation were explored further. The nucleolin protein contains four acidic stretches, four RNA recognition motifs (RRMs), and nine RGG repeats. All three domains in nucleolin regulate CSF-1 mRNA and protein levels. RRMs increase CSF-1 mRNA, whereas the acidic and RGG domains decrease CSF-1 protein levels. This suggests that nucleolin has the capacity to differentially regulate both CSF-1 RNA and protein levels. Our finding that nucleolin interacts with Ago2 indirectly via RNA and with poly(A)-binding protein C (PABPC) directly suggests a nucleolin-Ago2-PABPC complex formation on mRNA. This complex is in keeping with our suggestion that nucleolin may work with PABPC as a double-edged sword on both mRNA deadenylation and translational activation. Our findings underscore the complexity of nucleolin's actions on CSF-1 mRNA and describe the dependence of miR-130a- and miR-301a-directed CSF-1 mRNA decay and inhibition of ovarian cancer cell motility on nucleolin.

Motor unit number estimation: sample size considerations

A computer model of the motor unit number estimation procedure was developed to evaluate the sampling error associated with estimates of the number of motor units in muscles. Two different distributions were used to model the motor unit amplitude distribution and were chosen in such a manner that they qualitatively matched the distributions observed under both normal and neurogenic conditions. As expected, the results indicated that estimation error decreases as a function of sample size. However, the relationship between these two variables was nonlinear in the sense that successive increases in sample size lead to progressively smaller decreases in estimation error. The results also indicated that the shape of the motor unit amplitude distribution plays an important role. Specifically, estimates obtained using the distribution modeling normal muscle were generally higher than the actual number of motor units in the muscle, which was not the case for the distribution modeling neurogenic muscle. In addition, the neurogenic distribution was associated with much smaller estimation error, suggesting that motor unit number estimation is well suited to the analysis of neurogenic disease processes.

Motor unit estimates obtained using the new "MUESA" method

Motor unit number estimates were obtained from the extensor digitorum brevis and thenar muscles using a new method called MUESA. MUESA is distinguished from other estimation methods in the manner in which it deals with probabilistic motor unit activation, which is more commonly referred to as "alternation." Because of "alternation," incremental increases in the observed muscle potentials often cannot be interpreted in terms of the successive activation of single motor units. In the MUESA method, the nerve is subjected to a number of constant-intensity stimulus trains, and the resultant muscle response sequences are decomposed into their constituent motor unit action potentials. In general, if a stimulus train results in the probabilistic activation of n motor units, we can expect to see up to 2n different potentials, with each potential representing a unique combination of active and/or inactive motor units. If all 2n potentials are indeed observed, the decomposition of the observed potential sequence into its constituent motor unit action potentials is very straightforward. For the majority of the cases in which the number of observed potentials is not an integer power of 2, we have developed a novel decomposition method based on the analysis of the relative firing rates of the motor units.

Vibration and noise in pediatric emergency transport vehicles: a potential cause of morbidity?

BACKGROUND

Noise and vibration are stressors that may adversely affect the well-being of infants and children being transported between facilities. Although the problem has been recognized, little has been done to rectify the situation.

HYPOTHESIS

That noise levels in transport incubators during use in transport vehicles exceed the recommended standards, and that vibration levels exceed those that are "very uncomfortable" for healthy adults.

METHODS

We measured noise and vibration (n/v) levels inside and outside a neonatal transport incubator in seven transport vehicles (land, air, and water), and calculated maximum and average, weighted and unweighted levels.

RESULTS

The maximum and average unweighted noise levels in all but one vehicle were over 99 dB. The incubator amplified noise at the lower frequencies (The Canadian Standards Association 1992 recommendation is that the noise level in transport incubators not exceed 60 dBA). The maximum vibration levels ranged from 0.86 m.S-2 to 2.35 m.S-2, and the average levels ranged from 0.33 m.S-2 to 1.46 m.S-2. (Vibration in excess of 1.5 is considered "very uncomfortable," and in excess of 2.0 is "extremely uncomfortable" for healthy adults.)

CONCLUSIONS

Noise and vibration levels inside transport incubators in our most-commonly used transport vehicles often exceed the recommended limits. For neurologically immature and/or physiologically compromised infants and children, current levels of n/v in transport vehicles are too high, and could affect patient morbidity. These n/v levels require further study, and modification of equipment, primarily the incubators, is overdue.

Detection of pYV+ Yersinia enterocolitica isolates by P1 slide agglutination

Rabbit polyclonal antisera were raised against the pYV-encoded outer membrane protein P1 of five Yersinia enterocolitica strains belonging to serogroups O:3, O:5,27, O:8, and O:9. Analysis of these strains with the sera showed that P1 presented at least six different antigenic factors. Two of the serum specimens were chosen to test the P1 agglutinability of 797 strains isolated from various sources. This technique appeared to be more reliable than autoagglutination and Ca2+ dependency to monitor the presence of the pYV plasmid. Hence, we propose this P1-mediated agglutination as a new and easy virulence test.

Comparison of patient-controlled epidural analgesia and conventional intermittent "top-up" injections during labor

In a prospective, randomized manner, bolus injection patient-controlled epidural analgesia (PCEA; n = 30) and conventional intermittent "top-up" injections (CIT; n = 28) of bupivacaine in nulliparous parturients during first stage of labor were compared. Group A (PCEA) patients self-administered, using a patient-controlled analgesia device, 4-mL increments of 0.125% bupivacaine with 1: 400,000 epinephrine, to a maximum 12 mL/h as required. Group B (CIT) patients received 12 mL of the same solution, on request, from the anesthesiologist. Hourly assessments of pain relief (visual analogue scale), satisfaction, sensory and motor block, blood pressure, and cervical dilatation were made. In addition, retrospective pain assessments were made in patients requesting analgesia in the preceding hour, indicating their maximum pain during that time. The groups were demographically comparable and equally low hourly bupivacaine requirements were seen (group A, 6.36 +/- 0.43 mg; group B, 6.23 +/- 0.39 mg) producing similar mean sensory levels. Pain relief obtained in both groups was similar but was associated with greater satisfaction in patients using PCEA (P less than 0.05). This study shows that PCEA is a viable alternative for providing pain relief in the first stage of labor.