OP0236 THE EFFECT OF UV-B RADIATION EXPOSURE ON THE RISK OF DEVELOPING RHEUMATOID ARTHRITIS

Background:

UV-B radiation has known immunomodulatory properties, but to what extent UV-B radiation exposure might affect the occurrence of rheumatoid arthritis (RA) has been relatively little studied, and with partially contradictory results.

Objectives:

To investigate the association between sun- and travel habits, as proxy markers for UV-B radiation exposure, and risk of incident RA, overall and by RA subtype.

Methods:

We performed a matched case-control study of 1151 incident cases with new-onset RA and 2374 population controls from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, recruited between 2006 and 2017. The association between sunbathing frequency, solarium use, and frequency of travels to sunnier countries than Sweden (exposures) and risk of RA (outcome) were assessed as odds ratios (OR) with 95 % confidence intervals (CI) through logistic regression, and adjusted for age, sex, residential region, year of study entry, body mass index, education, income, smoking and alcohol consumption. We further assessed effect modification by self-reported skin type, income and education, and by rheumatoid factor (RF) serostatus.

Results:

Overall, the frequency of sunbathing, and solarium use, were similar among RA cases and controls: ‘never doing sunbathing’ amongst RA cases vs. controls: 22% vs. 21 %, ‘sunbathing daily when possible’: 10% vs. 12%, and solarium use 13% vs. 12%. The proportion of ‘not travelled abroad to a sunnier country than Sweden during the past 5 years’ was higher for RA cases than controls: 27% vs. 23%, and ‘travelling abroad more than once a year’ was less common among RA cases: 15% vs. 20%.

Sunbathing frequency was not linked to risk of RA (OR 0.91, 95% CI 0.69-1.20), nor was solarium use (OR 1.07, 95% CI 0.85-1.35). Stratification by skin type revealed no major effect modification, nor did stratification by RF status. In contrast, frequency of travel to sunnier countries than Sweden was inversely associated with RA risk comparing the most to least frequent travelers (OR 0.68, 95% CI 0.54-0.87). When stratified by educational level, this association was confined to individuals with medium (OR 0.69, 95% CI 0.48-0.98) or high (OR 0.60, 95% CI 0.50-0.91) and absent among subjects with low education (OR 1.10, 95% CI 0.56-1.99). No such interaction was observed between travel habits and income.

Table 1.

RA cases and controls with adjusted odds ratios and confidence intervals for overall risk of RA and by RA serostatus.

NOR* for RA (95% CI)Exposure variableRA casesControlsRF+RF-All RARF+RF-SunbathingaNever24949516185refrefrefAt least once a month3988442651241.05 (0.85-1.29)1.07 (0.84-1.36)0.98 (0.72-1.34)At least once a week3767512391301.11 (0.90-1.38)1.07 (0.83-1.37)1.21 (0.88-1.66)Daily12027875430.91 (0.69-1.20)0.86 (0.62-1.20)0.96 (0.64-1.46)TravelbNever314537208103refrefRefSeldom294568193970.98 (0.79-1.21)0.98 (0.77-1.25)0.98 (0.71-1.35)Once a year3598052271210.82 (0.67-1.01)0.80 (0.63-1.02)0.83 (0.61-1.13)More than once a year176463112610.68 (0.54-0.87)0.68 (0.51-0.91)0.70 (0.48-1.01)SolariumcNever9912083634336refrefRefOnce per year or more153290107461.07 (0.85-1.35)1.08 (0.83-1.40)1.11 (0.77-1.59)

OR = adjusted odds ratio, CI = confidence interval, N = number of participants, RA = rheumatoid arthritis, ref = reference, RF= rheumatoid factor. a Frequency of sunbathing if the weather invites to it? b Frequency of travels to a country sunnier than Sweden in the last 5 years? c Frequency of solarium use in the last 5 years? *Adjusting for age, sex, region, index year, BMI, smoking, alcohol consumption, education level and income. <4 % of data was missing for all variables.

Conclusion:

Proxy markers for UV-B exposure (sunbathing frequency and solarium use within the past five years) do not seem to be strong risk factors for RA. Frequency of travels abroad was inversely associated to RA risk. The nature behind this association remains unclear.

Disclosure of Interests:

Johanna Hagman: None declared, Bénédicte Delcoigne: None declared, Lars Klareskog: None declared, Lars Alfredsson: None declared, Johan Askling Grant/research support from: JA acts or has acted as PI for agreements between Karolinska Institutet and the following entities, mainly in the context of the ARTIS national safety monitoring programme of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB Pharma

Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial

Background

Dental caries is a major public health issue affecting a large proportion of the general population. The disease is associated with behavioural factors and is thus preventable to a high degree. Individuals may need assistance to be able to change their oral health behaviour. There is a lack of such interventions for adults affected by severe caries. The aim of the study was to evaluate the effect of Acceptance and Commitment Therapy (ACT), a form of cognitive behavioural therapy, on oral health behaviour in young adults with poor oral health.

Methods

The study included a two group parallel randomised controlled trial at general dental clinics, with young adults, 18–25 years of age, ≥ two manifest proximal dental caries lesions (n = 135); 67 were treated with ACT and 68 with standard disease information only, respectively. Primary outcomes: oral health behaviours (tooth-brushing, flossing, use of toothpicks, and additional fluoride use). The CONSORT principles for RCTs were used, including intention-to-treat and per protocol analyses. The Chi-square, Mann-Whitney, and Wilcoxon Signed Rank tests were applied, including effect sizes.

Results

The study groups did not differ with regard to oral health behaviour variables at baseline. The intervention group improved all their oral health behaviours significantly over time (effect sizes, 0.26–0.32), while the control group showed improved behaviours on two measures (flossing and additional use of fluoride, effect sizes, 0.22–0.23).

Conclusions

By testing a psychological intervention on young adults (18–25 years of age) with a high prevalence of caries, we found an immediate positive effect with improved oral health behaviours.

Trial registration

TRN ISRCTN15009620, retrospectively registered 14/03/2018.

Pixel-based analysis of FRAP data with a general initial bleaching profile

In Jonasson et al. (2008), we presented a new pixel-based maximum likelihood framework for the estimation of diffusion coefficients from data on fluorescence recovery after photobleaching (FRAP) with confocal laser scanning microscopy (CLSM). The main method there, called the Gaussian profile method below, is based on the assumption that the initial intensity profile after photobleaching is approximately Gaussian. In the present paper, we introduce a method, called the Monotone profile method, where the maximum likelihood framework is extended to a general initial bleaching profile only assuming that the profile is a non-decreasing function of the distance to the bleaching centre. The statistical distribution of the image noise is further assumed to be Poisson instead of normal, which should be a more realistic description of the noise in the detector. The new Monotone profile method and the Gaussian profile method are applied to FRAP data on swelling of super absorbent polymers (SAP) in water with a Fluorescein probe. The initial bleaching profile is close to a step function at low degrees of swelling and close to a Gaussian profile at high degrees of swelling. The results obtained from the analysis of the FRAP data are corroborated with NMR diffusometry analysis of SAP with a polyethylene glycol probe having size similar to the Fluorescein. The comparison of the Gaussian and Monotone profile methods is also performed by use of simulated data. It is found that the new Monotone profile method is accurate for all types of initial profiles studied, but it suffers from being computationally slow. The fast Gaussian profile method is sufficiently accurate for most of the profiles studied, but underestimates the diffusion coefficient for profiles close to a step function. We also provide a diagnostic plot, which indicates whether the Gaussian profile method is acceptable or not.

Diagnosis of pigmented skin lesions by dermoscopy: web-based training improves diagnostic performance of non-experts

BACKGROUND

Dermoscopy has been shown to enhance the diagnosis of melanoma. However, use of dermoscopy requires training and expertise to be effective.

OBJECTIVES

To determine whether an Internet-based course is a suitable tool in teaching dermoscopy, and to evaluate the diagnostic value of pattern analysis and diagnostic algorithms in colleagues not yet familiar with this technique.

METHODS

Sixteen colleagues who were not experts in dermoscopy were asked to evaluate the dermoscopic images of 20 pigmented skin lesions using different diagnostic methods (i.e. pattern analysis, ABCD rule, seven-point checklist and Menzies' method), before and after an Internet-based training course on dermoscopy. Mean +/- SEM sensitivity, specificity and diagnostic accuracy, and kappa (kappa) intraobserver agreement were evaluated for each diagnostic method before and after training for the 16 participants. Differences between mean values were assessed by means of two-tailed Wilcoxon rank-sum tests.

RESULTS

There was a considerable improvement in the dermoscopic melanoma diagnosis after the Web-based training vs. before. Improvements in sensitivity and diagnostic accuracy were significant for the ABCD rule and Menzies' method. Improvements in sensitivity were also significant for pattern analysis, whereas the sensitivity values were high for the seven-point checklist in evaluations both before and after training. No significant difference was found for specificity before and after training for any method. There was a significant improvement in the kappa intraobserver agreement after training for pattern analysis and the ABCD rule. For the seven-point checklist and Menzies' method there was already good agreement before training, with no significant improvement after training.

CONCLUSIONS

We demonstrated that Web-based training is an effective tool for teaching dermoscopy.

Structural studies of Ets-1/Pax5 complex formation on DNA

Pax5 regulates the B cell-specific expression of the mb-1 gene together with members of the Ets family of transcriptional activators. The Ets proteins on their own bind poorly to the Pax5/Ets binding site, but can be recruited to the site by cooperative interactions with Pax5. The structure of the ETS domain of Ets-1 and the paired domain of Pax5 bound to DNA reveals the molecular details of the selective recruitment of different Ets proteins by Pax5. Comparison with structures of Ets-1 alone bound to both high- and low-affinity DNA sites reveals that Pax5 alters the Ets-1 contacts with DNA. The ability of one protein to alter the DNA sequence-specific contacts of another provides a general mechanism for combinatorial regulation of transcription.

Highly conserved amino acids in Pax and Ets proteins are required for DNA binding and ternary complex assembly

Combinatorial association of DNA-binding proteins on composite binding sites enhances their nucleotide sequence specificity and functional synergy. As a paradigm for these interactions, Pax-5 (BSAP) assembles ternary complexes with Ets proteins on the B cell-specific mb-1 promoter through interactions between their respective DNA-binding domains. Pax-5 recruits Ets-1 to bind the promoter, but not the closely related Ets protein SAP1a. Here we show that, while several different mutations increase binding of SAP1a to an optimized Ets binding site, only conversion of Val68 to an acidic amino acid facilitates ternary complex assembly with Pax-5 on the mb-1 promoter. This suggests that enhanced DNA binding by SAP1a is not sufficient for recruitment by Pax-5, but instead involves protein-protein interactions mediated by the acidic side chain. Recruitment of Ets proteins by Pax-5 requires Gln22 within the N-terminal beta-hairpin motif of its paired domain. The beta-hairpin also participates in recognition of a subset of Pax-5-binding sites. Thus, Pax-5 incorporates protein-protein interaction and DNA recognition functions in a single motif. The Caenorhabditis elegans Pax protein EGL-38 also binds specifically to the mb-1 promoter and recruits murine Ets-1 or the C.elegans Ets protein T08H4.3, but not the related LIN-1 protein. Together, our results define specific amino acid requirements for Pax-Ets ternary complex assembly and show that the mechanism is conserved between evolutionarily related proteins of diverse animal species. Moreover, the data suggest that interactions between Pax and Ets proteins are an important mechanism that regulates fundamental biological processes in worms and humans.

EGL-38 Pax regulates theovo-related genelin-48duringCaenorhabditis elegansorgan development

The Pax gene egl-38 plays an important role in the development of several organs in C. elegans. To understand how a Pax transcription factor influences distinct developmental choices in different cells and tissue types, we have characterized a second gene, lin-48. lin-48 functions with egl-38 in the development of one structure, the hindgut, but not in other tissues such as the egg-laying system. We show that lin-48 encodes a C2H2 zinc-finger protein that is similar to the product of the Drosophila gene ovo and is expressed in the hindgut cells that develop abnormally in lin-48 mutants. We present evidence that lin-48 is a target for EGL-38 in hindgut cells. We show that lin-48 requires egl-38 for its expression in the hindgut. Using deletion analysis, we have identified two elements in the lin-48 promoter that are necessary for lin-48 expression. We demonstrate that EGL-38 binds with high affinity to one of these elements. In addition, we have observed genetic interactions between mutations in the lin-48 promoter and specific alleles of egl-38. These experiments demonstrate a functional link between Pax and Ovo transcription factors, and provide a model for how Pax transcription factors can regulate different target genes in different cells.

A site in the complement receptor 2 (CR2/CD21) silencer is necessary for lineage specific transcriptional regulation

Expression of human complement receptor type 2 (CR2/CD21) is primarily restricted to mature B cells and follicular dendritic cells. We previously described an intronic transcriptional silencer that controls the appropriate B cell-specific and developmentally restricted expression of human CR2/CD21 in both stably transfected cell lines and transgenic mice. Here we report the identification of a nucleotide sequence within the 2.5 kb CR2 silencer (CRS) that is crucial to its silencer function. This site comprises a binding site for the transcriptional repressor CBF1 (RBP-J or RBP-Jkappa) as well as Sp1 and other as yet uncharacterized proteins. A 2-bp mutation which eliminates the binding of CBF1 and other protein(s) in vitro results in loss of silencer activity in vivo. These results demonstrate the importance of this site in regulating CR2 expression and suggest that CBF1, a component of the developmentally important Notch signaling pathway, may play a role in the control of human CR2 gene expression.

The highly conserved beta-hairpin of the paired DNA-binding domain is required for assembly of Pax-Ets ternary complexes

Pax family transcription factors bind DNA through the paired domain. This domain, which is comprised of two helix-turn-helix motifs and a beta-hairpin structure, is a target of mutations in congenital disorders of mice and humans. Previously, we showed that Pax-5 (B-cell-specific activator protein) recruits proteins of the Ets proto-oncogene family to bind a composite DNA site that is essential for efficient transcription of the early-B-cell-specific mb-1 promoter. Here, evidence is provided for specific interactions between Ets-1 and the amino-terminal subdomains of Pax proteins. By tethering deletion fragments of Pax-5 to a heterologous DNA-binding domain, we show that 73 amino acids (amino acids 12 to 84) of its amino-terminal subdomain can recruit the ETS domain of Ets-1 to bind the composite site. Furthermore, an amino acid (Gln22) within the highly conserved beta-hairpin motif of Pax-5 is essential for efficient recruitment of Ets-1. The ability to recruit Ets proteins to bind DNA is a shared property of Pax proteins, as demonstrated by cooperative DNA binding of Ets-1 with sequences derived from the paired domains of Pax-2 and Pax-3. The strict conservation of sequences required for recruitment of Ets proteins suggests that Pax-Ets interactions are important for regulating transcription in diverse tissues during cellular differentiation.

Ets transcription factors: nuclear effectors of the Ras-MAP-kinase signaling pathway

The Ets family of transcription factors includes nuclear phosphoproteins that are involved in cell proliferation, differentiation and oncogenic transformation. The family is defined by a conserved DNA-binding domain (the ETS-DBD), which forms a highly conserved, winged, helix-turn-helix structural motif. As targets of the Ras-MAPK signaling pathway, Ets proteins function as critical nuclear integrators of ubiquitous signaling cascades. To direct signals to specific target genes, Ets proteins interact with (other) transcription factors that promote the binding of Ets proteins to composite Ras-responsive elements.

Rescue of thymocytes from glucocorticoid-induced cell death mediated by CD28/CTLA-4 costimulatory interactions with B7-1/B7-2

During the differentiation of thymocytes to mature T cells the processes of positive and negative selection result in signals that either protect thymocytes from cell death, or delete, through apoptosis, thymocytes with self-reactive T cell receptors (TCR). Glucocorticoids have been shown to induce thymocyte apoptosis and are produced within the thymic microenvironment. Furthermore, steroid-induced apoptosis of thymocytes has been suggested as a potential mechanism for removal of nonselected thymocytes. In this report, we demonstrate that thymocytes can be rescued from glucocorticoid-induced apoptosis by incubation with cells that express high levels of B7-1 or B7-2. In addition, the ability to be rescued by B7-1 and/or B7-2 can precede expression of the TCR. We demonstrate that CD3(+)-depleted or CD3+/ TCR-beta(+)-doubly depleted thymocytes can be rescued from glucocorticoid-induced apoptosis through the interaction of CD28 or CTLA-4 on thymocytes with cells bearing high levels of B7-1 or B7-2. Furthermore, these transfected cells are major histocompatibility complex (MHC) class II negative and, while they may express MHC class I, there is no preferential rescue of CD8+ thymocytes in the presence of glucocorticoids. Together, these data suggest that the rescue of thymocytes from glucocorticoids can be independent of the TCR. We also demonstrate that, in addition to CD28, CTLA-4 is expressed on thymocytes, suggesting that rescue from glucocorticoid-induced cell death can be mediated by both CD28 and CTLA-4. A CTLA-4Ig fusion protein which binds to both B7-1 and B7-2 was shown to completely block the rescue of thymocytes from glucocorticoid-induced cell death. Therefore, we conclude that interactions between B7-1/B7-2 and CD28/CTLA-4 are sufficient and necessary for rescue of thymocytes from glucocorticoid-induced cell death.

Pax-5 (BSAP) recruits Ets proto-oncogene family proteins to form functional ternary complexes on a B-cell-specific promoter

The paired box transcription factor Pax-5 (B-cell-specific activator protein) is a key regulator of lineage-specific gene expression and differentiation in B-lymphocytes. We show that Pax-5 functions as a cell type-specific docking protein that facilitates binding of the early B-cell-specific mb-1 promoter by proteins of the Ets proto-oncogene family. Transcriptional activity of the mb-1 promoter in pre-B-cells is critically dependent on binding sites for Pax-5:Ets complexes. Ternary complex assembly requires only the Pax-5 paired box and ETS DNA-binding domains. Mutation of a single base pair in the ternary complex binding site allows for independent binding by Ets proteins but, conversely, inhibits the binding of Pax-5 by itself. Strikingly, the mutation reverses the pattern of complex assembly: Ets proteins recruit Pax-5 to bind the mutated sequence. Recruitment of Net and Elk-1, but not SAP1a, by Pax-5 defines a functional difference between closely related Ets proteins. Replacement of a valine (V68) in the ETS domain of SAP1a by aspartic acid (as found in c-Ets-1, Elk-1, and Net) enhanced ternary complex formation by more than 60-fold. Together, these observations define novel transcription factor interactions that regulate gene expression in B cells.

Regulation of gene expression at early stages of B-cell and T-cell differentiation

The expression of distinct sets of genes at different stages of B-lymphocyte and T-lymphocyte differentiation is controlled at the level of transcription. A number of recent studies have described interactions between transcription factors in lymphocytes that provide new insights into mechanisms regulating gene expression. These mechanisms include the assembly of higher order nucleoprotein complexes and other protein-protein interactions that enhance the functional specificity of transcriptional regulators in lymphocytes.

EBF contains a novel zinc coordination motif and multiple dimerization and transcriptional activation domains

Early B cell factor (EBF) was identified and cloned as a transcription factor expressed specifically in B lymphocytes and adipocytes. This protein was also identified as olfactory factor 1 (Olf-1) in olfactory neurons. In this study, we analyzed the structural requirements for DNA binding, homodimerization and transcriptional activation by EBF. A carboxyl-terminal region, containing a repeat of alpha-helices related to the helix-loop-helix motif, is important for dimerization of EBF in solution and can confer dimerization upon a heterologous DNA binding protein. The amino-terminal DNA binding domain by itself is monomeric, but can mediate assembly of dimers on optimized and correctly spaced half-sites. Mutational analysis of the DNA binding domain of EBF indicated that a novel zinc coordination motif consisting of H-X3-C-X2-C-X5-C is important for DNA recognition. Deletion analysis and transfer of regions of EBF onto a heterologous DNA binding domain identified a serine/threonine-rich transcriptional activation domain. Moreover, the DNA binding domain of EBF can mediate transcriptional activation from optimized binding sites. Thus, EBF contains both a complex DNA binding domain that allows for dimerization and transcriptional activation, and additional dimerization and activation domains.

Regulation of gene expression at early stages of B-cell differentiation

The phenotype of B lymphocytes at various stages of differentiation is, in part, controlled at the transcriptional level. Recently, a number of B-cell lineage and stage-specific transcription factors have been identified as candidate determinants for the developmental regulation of gene expression in B lymphocytes.

Clonal deletion of V beta 5+ T cells by transgenic I-E restricted to thymic medullary epithelium

A variety of cell types expressing MHC class II molecules is known to function as APC in vitro. We employed the Ig kappa gene enhancer and promoter to target the class II E alpha gene, and thereby I-E, exclusively to B cells to address their APC function in vivo. Although transgenic I-E was expressed on B lymphocytes, we unexpectedly obtained I-E on thymic medullary epithelium but not macrophages and at low frequency on dendritic cells. Using these transgenic mice, we constructed bone marrow irradiation chimeras with I-E expressed only on medullary epithelium, in order to determine the role of this cell type in tolerance by clonal deletion in the thymus. Although it is accepted that bm-derived cells play a primary role in deletion, and thymic epithelium can delete clones to a lesser degree, the role of cortical vs medullary thymic epithelium has not been directly dissected. We demonstrate that medullary epithelium alone can tolerize by partial deletion of I-E-reactive V beta 5+ T cells. These results indicate a role for medullary epithelium in deletion during the later stages of thymic development, and support the notion that positive and negative selection of developing T cells can occur in distinct temporal and anatomic compartments.

Clonal deletion of V beta 5+ T cells by transgenic I-E restricted to thymic medullary epithelium

A variety of cell types expressing MHC class II molecules is known to function as APC in vitro. We employed the Ig kappa gene enhancer and promoter to target the class II E alpha gene, and thereby I-E, exclusively to B cells to address their APC function in vivo. Although transgenic I-E was expressed on B lymphocytes, we unexpectedly obtained I-E on thymic medullary epithelium but not macrophages and at low frequency on dendritic cells. Using these transgenic mice, we constructed bone marrow irradiation chimeras with I-E expressed only on medullary epithelium, in order to determine the role of this cell type in tolerance by clonal deletion in the thymus. Although it is accepted that bm-derived cells play a primary role in deletion, and thymic epithelium can delete clones to a lesser degree, the role of cortical vs medullary thymic epithelium has not been directly dissected. We demonstrate that medullary epithelium alone can tolerize by partial deletion of I-E-reactive V beta 5+ T cells. These results indicate a role for medullary epithelium in deletion during the later stages of thymic development, and support the notion that positive and negative selection of developing T cells can occur in distinct temporal and anatomic compartments.

A psychological "sense-of-control" profile of patients with anorexia nervosa and bulimia nervosa

To investigate control and self-control issues for patients with eating disorders, 10 individuals diagnosed with anorexia nervosa or bulimia nervosa were compared to two sex-matched groups of 9 and 50 adults on the Shapiro Control Inventory. Analysis of variance and subsequent planned comparisons showed significant differences indicative of pathology between the eating-disordered group and one or both comparison groups on the general domain sense of control scale and the positive sense of control scale. Three of the four mode scales and the domain-specific sense of control scale were also in the expected direction. Several clinically relevant individual items also supported this trend. The discussion notes the clinical importance of refining how control is measured for eating-disordered populations.

Purification of early-B-cell factor and characterization of its DNA-binding specificity

Early-B-cell factor (EBF) is a nuclear protein that recognizes a functionally important sequence in the promoter of the mb-1 gene. Like the mb-1 gene, which encodes an immunoglobulin-associated protein, EBF is specifically expressed in the early stages of B-lymphocyte differentiation. We purified EBF by sequence-specific DNA affinity chromatography and examined its biochemical properties and DNA-binding specificity. Crude nuclear extract and affinity-purified EBF generated protein-DNA complexes with the mb-1 promoter that were indistinguishable in electrophoretic mobility shift and DNase I footprint assays. Fractionation of affinity-purified EBF by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and renaturation of isolated polypeptides indicated that EBF DNA-binding activity could be reconstituted from polypeptides with molecular masses of 62 to 65 kDa. Gel filtration chromatography suggested that native EBF has a molecular mass of 140 kDa, if a globular shape of the protein is assumed. Thus, EBF appears to be a dimer with subunits of 62 to 65 kDa. To characterize the DNA-binding specificity of purified EBF, we performed two sets of experiments. First, we examined various mutant EBF-binding sites for interaction with purified EBF in an electrophoretic mobility shift assay. Second, we used oligonucleotides containing pairs of randomized bases in a binding-site selection and amplification experiments to determine a preferred sequence for DNA binding by EBF. Taken together, the results of these experiments indicated that EBF recognizes variations on the palindromic sequence 5'-ATTCCCNNGGGAAT, with an optimal spacer of 2 bp between the half-sites.

Cloning and functional characterization of early B-cell factor, a regulator of lymphocyte-specific gene expression

Early B-cell factor (EBF) was identified previously as a tissue-specific and differentiation stage-specific DNA-binding protein that participates in the regulation of the pre-B and B lymphocyte-specific mb-1 gene. Partial amino acid sequences obtained from purified EBF were used to isolate cDNA clones, which by multiple criteria encode EBF. The recombinant polypeptide formed sequence-specific complexes with the EBF-binding site in the mb-1 promoter. The cDNA hybridized to multiple transcripts in pre-B and B-cell lines, but transcripts were not detected at significant levels in plasmacytoma, T-cell, and nonlymphoid cell lines. Expression of recombinant EBF in transfected nonlymphoid cells strongly activated transcription from reporter plasmids containing functional EBF-binding sites. Analysis of DNA binding by deletion mutants of EBF identified an amino-terminal cysteine-rich DNA-binding domain lacking obvious sequence similarity to known transcription factors. DNA-binding assays with cotranslated wild-type and truncated forms of EBF indicated that the protein interacts with its site as a homodimer. Deletions delineated a carboxy-terminal dimerization region containing two repeats of 15 amino acids that show similarity with the dimerization domains of basic-helix-loop-helix proteins. Together, these data suggest that EBF represents a novel regulator of B lymphocyte-specific gene expression.

An inhibitory carboxyl-terminal domain in Ets-1 and Ets-2 mediates differential binding of ETS family factors to promoter sequences of the mb-1 gene

The mb-1 gene is expressed only during the early stages of B-lymphocyte differentiation. Here we show that the mb-1 proximal promoter region contains a functionally important binding site for members of the ETS family of DNA-binding proteins. We found that both the E26 virus-encoded v-ets and the myeloid/B-cell-specific factor PU.1 bind efficiently to this site in vitro. By contrast, Ets-1, the lymphocyte-specific cellular homologue of v-ets, and the related, more ubiquitously expressed Ets-2 protein interacted weakly with this binding site. DNA binding by both Ets-1 and Ets-2, however, could be increased 20- to 50-fold by deleting as few as 16 carboxyl-terminal amino acids. The inhibitory carboxyl-terminal amino acid sequence is highly conserved between Ets-1 and Ets-2 but is not present in either v-ets or PU.1. Replacement of the carboxyl-terminal amino acids of v-ets with those of Ets-1 decreased DNA binding by v-ets drastically. Cotranslation of Ets-1 transcripts encoding proteins of different lengths suggested that Ets-1 binds DNA as a monomer. Therefore, the carboxyl-terminal inhibitory domain appears to interfere directly with DNA binding and not with homodimerization. Finally, the functional relevance of ETS factor binding to the mb-1 promoter site was evidenced by the stimulation of transcription through this site by a v-myb-v-ets fusion protein. Together, these data suggest that one or more ETS family factors are involved in the regulation of mb-1 gene expression.

Heterogeneously initiated transcription from the pre-B- and B-cell-specific mb-1 promoter: analysis of the requirement for upstream factor-binding sites and initiation site sequences

The mb-1 gene, encoding a membrane immunoglobulin-associated protein, is developmentally regulated and expressed specifically in pre-B and mature B lymphocytes. Analysis of the TATA-less mb-1 promoter indicated that it directs initiation of transcription from multiple sites. Promoter sequences between -68 and +70 conferred the correct pattern of cell type-specific transcription upon a heterologous gene. Two nuclear factor-binding sites that are important for promoter function were identified between -59 and -38. Both sites interacted with ubiquitous nuclear factors in vitro. One of these factors was identified as Sp1. Multimerized copies of both factor-binding sites augmented expression from a heterologous minimal promoter in both lymphoid and nonlymphoid cells, suggesting that additional mb-1 promoter sequences are involved in determining the correct cell type specificity. Analysis of the heterogeneity of transcription initiation indicated that a mutation which increased the distance between upstream sequences and the region of initiation resulted in the utilization of a novel set of initiation sites. Moreover, an insertion of a TATA element into the mb-1 promoter at -30 biased initiation of transcription to +1 but did not abolish the use of the other sites. Mutation of an initiator sequence homology encompassing one of the major initiation sites had only a minor effect on its utilization. From these data, we conclude that upstream factor-binding sites in the TATA-less mb-1 promoter define a region in which initiation of transcription occurs at multiple sites.

A novel lineage-specific nuclear factor regulates mb-1 gene transcription at the early stages of B cell differentiation

The mb-1 gene, which encodes a protein associated with membrane-bound antibody, is expressed only at the early stages of B cell differentiation. To gain insight into the mechanisms that underlie temporally regulated gene expression, we examined the mb-1 promoter region for interactions with cell type-specific DNA binding proteins. Here, we report the characterization of a novel nuclear factor that recognizes the mb-1 promoter. This DNA binding activity, termed Early B cell Factor, or EBF, is expressed in early stage B cells, but not in late stage B cells, T cells or non-lymphoid cells. EBF recognizes the nucleotide sequence 5'-CAAGGGAAT-3' in the mb-1 and major histocompatibility complex (MHC) class II A alpha d promoters. The binding of EBF to DNA was characterized by DNase I footprinting and by methylation interference analysis which indicated both major and minor groove contacts. The specificity of EBF binding is distinct from that of other nuclear factors expressed in hematopoietic cells. EBF appears to consist of at least two polypeptides of approximately 70-75 kDa and 80-85 kDa. The EBF binding site was important for maximal mb-1 promoter activity in early stage B cells. Moreover, the EBF binding site conferred correct lineage- and stage-specific transcriptional activity upon a heterologous promoter in a context-dependent manner. Thus, EBF appears to represent an important transcriptional regulator of B cell specific gene expression.

Abnormal EEG slow activity in left temporal areas in senile dementia of the Alzheimer type

Resting 32-channel topographical measures of EEG slow activity were compared in 12 elderly controls and 12 patients with senile dementia of the Alzheimer type. The patients had higher amplitude delta and theta than controls, especially in the left temporal regions. This greater amount of low frequency EEG activity in the left temporal area is consistent with recent EEG, neuropsychological assessment, and positron emission tomography findings in SDAT patients. Five patients with mild-to-moderate dementia (as determined by the Folstein Mini-Mental State scale) primarily exhibited focal, abnormal slow activity in the left temporal regions. Seven patients with severe dementia exhibited increased slow activity across the head, which was still most abnormal in the left temporal regions.

A novel enhancer in the immunoglobulin lambda locus is duplicated and functionally independent of NF kappa B

As a first step toward defining the elements necessary for lambda immunoglobulin gene regulation, DNase I hypersensitive sites were mapped in the mouse lambda locus. A hypersensitive site found 15.5 kb downstream of C lambda 4 was present in all the B-cell but not in the T-cell lines tested. This site coincided with a strong B-cell-specific transcriptional enhancer (E lambda 2-4). This novel enhancer is active in myeloma cells, regardless of the status of endogenous lambda genes, but is inactive in a T-cell line and in fibroblasts. The enhancer E lambda 2-4 functions in the absence of the transcription factor NF kappa B, which is necessary for kappa enhancer function. No evidence could be found for NF kappa B binding by this element. Rearrangement of V lambda 2 to JC lambda 3 or JC lambda genes deletes E lambda 2-4; however, a second strong enhancer was found 35 kb downstream of C lambda 1, which cannot be eliminated by lambda gene rearrangements. The second lambda enhancer (E lambda 3-1) is 90% homologous to the E lambda 2-4 sequence in the region determined to comprise the active enhancer and likewise lacks the consensus binding site for NF kappa B. The data support a model for the independent activation of kappa and lambda gene expression based on locus-specific regulation at the enhancer level.

Greater left cerebral hemispheric metabolism in bulimia assessed by positron emission tomography

Eight women with bulimia and eight age- and sex-matched normal control subjects were studied with positron emission tomography using [18F]-fluorodeoxyglucose (FDG) as a tracer of brain metabolic rate. Subjects performed a visual vigilance task during FDG uptake. In control subjects, the metabolic rate was higher in the right hemisphere than in the left, but patients with bulimia did not have this normal asymmetry. Lower metabolic rates in the basal ganglia, found in studies of depressed subjects, and higher rates in the basal ganglia, reported in a study of anorexia nervosa, were not found. This is consistent with the suggestion that bulimia is a diagnostic grouping distinct from these disorders.

Inhibition of immunoglobulin gene rearrangement by the expression of a lambda 2 transgene

The rearrangement of Ig genes is known to be regulated by the production of H and kappa L chains. To determine whether lambda L chains have a similar effect, transgenic mice were produced with a lambda 2 gene. It was necessary to include the H chain enhancer, since a lambda gene without the added enhancer did not result in transgene expression. The lambda 2 transgene with the H enhancer was expressed in lymphoid cells only. The majority of the B cells of newborn transgenic mice produced lambda, whereas kappa + cells were reduced. Concomitantly, serum levels of kappa and kappa mRNA were diminished. By 2 wk after birth the proportion of kappa-expressing cells was dramatically increased. Adults had reduced proportions of B cells that produced lambda only, but the levels of lambda were still higher than in normal littermates. Also, kappa + cells were still lower than in normal mice. Analysis of hybridomas revealed that reduction of kappa gene rearrangement was the basis for the decreased frequency of kappa + cells. Furthermore, many cells also contained an unrearranged H chain allele. It was concluded that feedback inhibition by the lambda 2 together with endogenous H protein may have inhibited recombinase activity in early pre-B cells, leading to inhibition of both H chain and kappa gene rearrangement. Thus, lambda 2 can replace kappa in a feedback complex. The levels of serum lambda 1 and, to a lesser degree, of spleen lambda 1 mRNA were reduced in the lambda 2 transgenic mice. However, the proportion of hybridomas with endogenous lambda gene rearrangement was at least as high as in normal mice. It was therefore concluded that the suppression of functional lambda 1 may be a consequence of decreased selection of endogenous lambda-producing cells because of the excess of transgenic lambda. The escape of kappa-producing cells from feedback inhibition may be the result of several mechanisms that operate to varying degrees, among them: (a) kappa rearrangement during a period in which the recombinase is still active after appearance of a lambda 2/mu stop signal; (b) a B cell lineage that is not feedback inhibited at the pre-B cell stage; (c) subthreshold levels of transgenic lambda 2 in some pre-B cells; and (d) loss of the lambda 2 transgenes in rare pre-B cells.

Ig lambda-producing B cells do not show feedback inhibition of gene rearrangement

In order to study the regulation of expression of Ig lambda genes we have analyzed lambda-producing hybridomas derived from transgenic mice which harbor a functionally rearranged kappa transgene. We also analyzed lambda-producing hybridomas from nontransgenic mice. Surprisingly, all but one of the transgenic lambda-hybridomas co-produce kappa L chains. Also, in contrast to transgenic kappa-hybridomas, most lambda-hybridomas have rearranged endogenous kappa genes despite the presence of transgenic kappa-chains and endogenous H chains. Analysis of spleen cells and hybridomas from nontransgenic mice shows that about 20% of lambda-producing B cells in the spleen co-produce kappa, and a similar proportion of lambda-hybridomas from normal spleens produce both kappa- and lambda-chains. The data argue strongly against the strictly sequential expression of kappa and lambda genes. We present a new model for the regulation of kappa and lambda gene expression, whose key feature is the distinction between a kappa cell lineage in which Ig gene rearrangement is susceptible to feedback by a complete antibody molecule at the pre-B cell stage, and a kappa lambda B cell lineage which does not show feedback inhibition during B cell development.

Ig lambda-producing B cells do not show feedback inhibition of gene rearrangement

In order to study the regulation of expression of Ig lambda genes we have analyzed lambda-producing hybridomas derived from transgenic mice which harbor a functionally rearranged kappa transgene. We also analyzed lambda-producing hybridomas from nontransgenic mice. Surprisingly, all but one of the transgenic lambda-hybridomas co-produce kappa L chains. Also, in contrast to transgenic kappa-hybridomas, most lambda-hybridomas have rearranged endogenous kappa genes despite the presence of transgenic kappa-chains and endogenous H chains. Analysis of spleen cells and hybridomas from nontransgenic mice shows that about 20% of lambda-producing B cells in the spleen co-produce kappa, and a similar proportion of lambda-hybridomas from normal spleens produce both kappa- and lambda-chains. The data argue strongly against the strictly sequential expression of kappa and lambda genes. We present a new model for the regulation of kappa and lambda gene expression, whose key feature is the distinction between a kappa cell lineage in which Ig gene rearrangement is susceptible to feedback by a complete antibody molecule at the pre-B cell stage, and a kappa lambda B cell lineage which does not show feedback inhibition during B cell development.

Cloning of a gamma 2b gene encoding anti-Pseudomonas aeruginosa H chains and its introduction into the germ line of mice

A complete, functional gamma 2b gene (pVCM) was cloned from a mouse hybridoma (VD93) with antibody activity to Pseudomonas aeruginosa. DNA sequencing of the VDJ region of pVCM determined that the VH gene was a member of the J558 family rearranged to JH2. Upon transfection into myeloma cells the gamma 2b gene gave rise to high levels of gamma 2b mRNA and gamma 2b protein. The gamma 2b protein had the same IEF pattern as the parent hybridoma protein VD93 and the antibodies formed from a combination of the pVCM gamma 2b chains and the myeloma lambda-chains bound weakly to P. aeruginosa. However, the hybrid antibodies did not discriminate between the serotypes 2 and 3, whereas the parent protein was specific for serotype 3. Transgenic mice were produced with the pVCM gamma 2b gene which expressed the gamma 2b mRNA (both membrane and secreted forms) only in lymphoid organs. However, contrary to expectations, the gamma 2b mRNA levels were higher in T cells than in B cells in three different transgenic lines. The serum of the transgenic mice had no activity to P. aeruginosa indicating the importance of L chains for the conformation of the Ag binding site. These gamma 2b transgenic mice provide a convenient tool for the study of feedback inhibition of Ig gene rearrangement.

Cloning of a gamma 2b gene encoding anti-Pseudomonas aeruginosa H chains and its introduction into the germ line of mice

A complete, functional gamma 2b gene (pVCM) was cloned from a mouse hybridoma (VD93) with antibody activity to Pseudomonas aeruginosa. DNA sequencing of the VDJ region of pVCM determined that the VH gene was a member of the J558 family rearranged to JH2. Upon transfection into myeloma cells the gamma 2b gene gave rise to high levels of gamma 2b mRNA and gamma 2b protein. The gamma 2b protein had the same IEF pattern as the parent hybridoma protein VD93 and the antibodies formed from a combination of the pVCM gamma 2b chains and the myeloma lambda-chains bound weakly to P. aeruginosa. However, the hybrid antibodies did not discriminate between the serotypes 2 and 3, whereas the parent protein was specific for serotype 3. Transgenic mice were produced with the pVCM gamma 2b gene which expressed the gamma 2b mRNA (both membrane and secreted forms) only in lymphoid organs. However, contrary to expectations, the gamma 2b mRNA levels were higher in T cells than in B cells in three different transgenic lines. The serum of the transgenic mice had no activity to P. aeruginosa indicating the importance of L chains for the conformation of the Ag binding site. These gamma 2b transgenic mice provide a convenient tool for the study of feedback inhibition of Ig gene rearrangement.

Characterization of adrenocorticotropin receptors that appear when 3T3-L1 cells differentiate into adipocytes

The binding of an 125I-labeled analog of ACTH, [125I]Tyr23,Phe2,Nle4-ACTH-(1-38), to differentiated 3T3-L1 fat cells was characterized. Time-dependent binding, which was inhibited by saturating concentrations of unlabeled ACTH (0.44 microM), could be demonstrated in the differentiated cells. Using 0.4 nM [125I]ACTH analog and increasing concentrations of ACTH, the half-maximal concentration for inhibition by ACTH was 4.3 nM. Scatchard analysis demonstrated a single class of ACTH binding. There were approximately 3500 binding sites/cell. The binding of [125I]ACTH analog was specific in that it could be displaced by ACTH, ACTH-(1-19), ACTH-(1-17), and N-acetyl-Ser1-ACTH, but not by high concentrations of insulin, beta-endorphin, or polylysine. There was an excellent correlation between the ability of ACTH and its analogs to inhibit [125I]ACTH analog binding and the ability of ACTH and its analogs to stimulate cAMP production. In contrast, no saturable binding could be demonstrated when undifferentiated 3T3-L1 fibroblasts, which are not responsive to ACTH, were studied. Thus, differentiation of 3T3-L1 cells into the adipocyte form is accompanied by the appearance of receptors for ACTH. These receptors allow the adipocytes to respond to ACTH.

The syndrome of bulimia. Review and synthesis

This comprehensive review of the syndrome of bulimia outlines treatment modalities including response prevention, cognitive behavioral and group interventions, and antidepressant pharmacotherapy. The authors propose an etiologic model that synthesizes available data indicating that young women who are at risk for developing bulimia appear to have a biologic vulnerability to affective instability, have family environments that are conflicted and disorganized, and a variety of personality traits that result in low self-esteem and self-regulatory difficulties.

Synthesis of human corticotropinyl-thiolglycine and its specific conjugation to bovine serum albumin

Human corticotropin containing a thiolglycine residue at the carboxyl terminal (I) was synthesized by the solid-phase method. The citraconyl derivative of peptide I was coupled to either a model tetrapeptide or bovine serum albumin by reaction with silver nitrate/N-hydroxysuccinimide in water. The extent of reaction with bovine serum albumin was determined by radioimmunoassay, and the peptide-protein conjugate was shown to possess 12% of the steroidogenic activity of porcine adrenocorticotropin in isolated rat adrenal cells. Peptide I and its conjugate with the model tetrapeptide were fully active in the same system.

Persistent activation of steroidogenesis in adrenocortical cells by photoaffinity labeling of corticotropin receptors

Photolysis of rat adrenocortical cells in the presence of the photoreactive derivative [(2-nitro-5-azidophenylsulfenyl)Trp9]-adrenocorticotropic hormone (2,5-NAPS-ACTH) at 24 degrees C resulted in persistent activation of corticosterone production. The basal rate of steroidogenesis became maximal when photolysis was performed at 24 degrees C but remained the same as that of control cells when irradiation was performed at 0 degrees C. No increase in basal rate was observed with dark controls or cells photolyzed with [(2,4-dinitrophenylsulfenyl)Trp9]ACTH, a photoresistant analog of the hormone. Prephotolyzed 2,5-NAPS-ACTH failed to induce persistent activation. Both ACTH and 2,4-(dinitrophenylsulfenyl)Trp9-ACTH blocked the photo-induced activation of steroidogenesis elicited by 2,5-NAPS-ACTH. Under photolysis conditions which caused the basal rate of steroidogenesis to become maximal, a 3-fold increase in the basal rate of cAMP formation was observed.

A sensitive radioimmunoassay for corticotropin using a fully biologically active 125I-labeled ligand

The human corticotropin (ACTH) analog, Phe2,Nle4-ACTH-(1-38) was iodinated by the chloramine-T procedure and the product was purified by reverse phase high performance liquid chromatography. The specific radioactivity of [125I]Tyr23,Phe2,Nle4-ACTH-(1-38) was determined by comparing the antiserum binding curves of the iodinated peptide and [3H]ACTH of known specific activity. This method gave a value of 1800 +/- 75 Ci/mmol, which is close to the theoretical radioactivity expected for the introduction of a single 125I atom into the peptide. [125I]Tyr23,Phe2,Nle4-ACTH-(1-38) was as potent as ACTH in stimulating corticosterone production in isolated rat adrenocortical cells. The concentrations for half-maximal steroidogenesis were 36.5 +/- 6.1 pM for the 125I derivative and 37.6 +/- 6.7 pM for ACTH. By the use of this 125I-labeled ligand, a highly sensitive RIA capable of detecting 1 pg aCTH was developed.l The antiserum employed in this study appeared to be directed against residues 11-13 of ACTH.