Application of CRISPR/Cas9 to Autophagy Research

The ability to efficiently modulate autophagy activity is paramount in the study of the field. Conventional broad-range autophagy inhibitors and genetic manipulation using RNA interference (RNAi), although widely used in autophagy research, are often limited in specificity or efficacy. In this chapter, we address the problems of conventional autophagy-modulating tools by exploring the use of three different CRISPR/Cas9 systems to abrogate autophagy in numerous human and mouse cell lines. The first system generates cell lines constitutively deleted of ATG5 or ATG7 whereas the second and third systems express a Tet-On inducible-Cas9 that enables regulated deletion of ATG5 or ATG7. We observed the efficiency of autophagy inhibition using the CRISPR/Cas9 strategy to surpass that of RNAi, and successfully generated cells with complete and sustained autophagy disruption through the CRISPR/Cas9 technology.

Beyond Reproduction: Pituitary Hormone Actions on Bone

The long-held belief that pituitary hormones act solely on master targets was first questioned when we documented G protein-coupled receptors for thyroid-stimulating hormone, follicle-stimulating hormone, adrenocorticotrophic hormone, oxytocin, and vasopressin on bone cells. These evolutionarily conserved hormones and their receptors are known to have primitive roles, and exist in invertebrate species as far down as coelenterates. It is not surprising therefore that each such hormone has multiple hitherto unrecognized functions in mammalian integrative physiology, and hence, becomes a potential target for therapeutic intervention. Here we discuss the skeletal actions of pituitary hormones.

Synchronous fire activity in the tropical high Andes: an indication of regional climate forcing

Global climate models suggest enhanced warming of the tropical mid and upper troposphere, with larger temperature rise rates at higher elevations. Changes in fire activity are amongst the most significant ecological consequences of rising temperatures and changing hydrological properties in mountainous ecosystems, and there is a global evidence of increased fire activity with elevation. Whilst fire research has become popular in the tropical lowlands, much less is known of the tropical high Andean region (>2000 masl, from Colombia to Bolivia). This study examines fire trends in the high Andes for three ecosystems, the Puna, the Paramo and the Yungas, for the period 1982-2006. We pose three questions: (i) is there an increased fire response with elevation? (ii) does the El Niño- Southern Oscillation control fire activity in this region? (iii) are the observed fire trends human driven (e.g., human practices and their effects on fuel build-up) or climate driven? We did not find evidence of increased fire activity with elevation but, instead, a quasicyclic and synchronous fire response in Ecuador, Peru and Bolivia, suggesting the influence of high-frequency climate forcing on fire responses on a subcontinental scale, in the high Andes. ENSO variability did not show a significant relation to fire activity for these three countries, partly because ENSO variability did not significantly relate to precipitation extremes, although it strongly did to temperature extremes. Whilst ENSO did not individually lead the observed regional fire trends, our results suggest a climate influence on fire activity, mainly through a sawtooth pattern of precipitation (increased rainfall before fire-peak seasons (t-1) followed by drought spells and unusual low temperatures (t0), which is particularly common where fire is carried by low fuel loads (e.g., grasslands and fine fuel). This climatic sawtooth appeared as the main driver of fire trends, above local human influences and fuel build-up cyclicity.

A regulatory circuit that involves HR23B and HDAC6 governs the biological response to HDAC inhibitors

Histone deacetylase (HDAC) is an emergent anticancer target, and HR23B is a biomarker for response to HDAC inhibitors. We show here that HR23B has impacts on two documented effects of HDAC inhibitors; HDAC inhibitors cause apoptosis in cells expressing high levels of HR23B, whereas in cells with low level expression, HDAC inhibitor treatment is frequently associated with autophagy. The mechanism responsible involves the interaction of HDAC6 with HR23B, which downregulates HR23B and thereby reduces the level of ubiquitinated substrates targeted to the proteasome, ultimately desensitising cells to apoptosis. Significantly, the ability of HDAC6 to downregulate HR23B occurs independently of its deacetylase activity. An analysis of the HDAC6 interactome identified HSP90 as a key effector of HDAC6 on HR23B levels. Our results define a regulatory mechanism that involves the interplay between HR23B and HDAC6 that influences the biological outcome of HDAC inhibitor treatment.

Quantification of UV-B flux through time using UV-B-absorbing compounds contained in fossil Pinus sporopollenin

UV-B radiation currently represents c. 1.5% of incoming solar radiation. However, significant changes are known to have occurred in the amount of incoming radiation both on recent and on geological timescales. Until now it has not been possible to reconstruct a detailed measure of UV-B radiation beyond c. 150 yr ago. Here, we studied the suitability of fossil Pinus spp. pollen to record variations in UV-B flux through time. In view of the large size of the grain and its long fossil history, we hypothesized that this grain could provide a good proxy for recording past variations in UV-B flux. Two key objectives were addressed: to determine whether there was, similar to other studied species, a clear relationship between UV-B-absorbing compounds in the sporopollenin of extant pollen and the magnitude of UV-B radiation to which it had been exposed; and to determine whether these compounds could be extracted from a small enough sample size of fossil pollen to make reconstruction of a continuous record through time a realistic prospect. Preliminary results indicate the excellent potential of this species for providing a quantitative record of UV-B through time. Using this technique, we present the first record of UV-B flux during the last 9500 yr from a site near Bergen, Norway.

Clinical review 130: Addison's disease 2001

Whereas it is now more than 150 yr since T. Addison first described the clinical and pathological features of adrenal failure (1 ), the disease remains underdiagnosed, leading to unnecessary morbidity and mortality. Over the past decade, there have been important advances in elucidating the pathogeneses and underlying genetics of the individual forms of the disease. This review emphasizes the multiple etiologies and the diagnostic steps to be taken with consideration to age at onset and gender and summarizes new genetic insights in the disease.

Mental health service utilization by victims of crime

Records of 318 adult and 608 child victims of crime, eligible for Crime Victims Compensation (CVC) in Washington State, were examined. Demographic, crime, and mental health information was collected. A majority of child victims had experienced sexual assault (88%); adults were victims of both sexual (38%) and physical assault (40%). The median number of mental health sessions used by children was 23 sessions, at an average cost of $975 per case to the CVC program. Adults used a median of 15 mental health sessions at a cost of $905. Patterns of treatment utilization were associated with some demographic, crime, and psychological variables. Sexual assault and PTSD diagnosis were associated with greater use for both children and adults. Therapist variables were unrelated to use. Findings are discussed in light of concerns about coverage of mental health services.

The impact of health care reform: a survey of victim and offender treatment providers

Health care reform and, especially, managed care may have important consequences for providers of mental health treatment to sexual assault victims and sexual offenders. This study is an initial effort to identify the impact of changes in health care delivery systems on specialist providers. A survey was mailed to 380 therapists in Washington state who were identified as having specialized expertise in either victim or offender treatment. Of the total sample, 39% (N = 135) responded, including 64 providers of treatment to sexual offenders and 86 providers of treatment to victims of sexual abuse. A substantial minority of subjects (46%) reported having made changes in the type of client or treatment approach or seeing fewer clients (43%). A majority (68%) stated that requirements for documentation or reports had increased. Overall, three-quarters of respondents reported that managed care had at least a moderate level of impact on their practice. Differences between providers of treatment to victims and providers to offenders emerged only in the perceived degree of impact on practice, with therapists who work with victims reporting significantly greater impact. Comments from providers revealed that reductions in the number of sessions, increases in administrative expectations, and compromised confidentiality were considered significant threats to the delivery of effective services. It is suggested that the impact of health care reform is more likely to be experienced by victim treatment providers. Offender evaluation and treatment have rarely been covered by commercial insurance and are often sought because of external pressure. As a result, managed care will have less effect on current offender treatment practice.

Risk factors for development of sexually abusive behaviour in sexually victimised adolescent boys: cross sectional study

OBJECTIVE

To identify factors that may increase the risk of a sexually victimised adolescent boy developing sexually abusive behaviour.

DESIGN

Sexually victimised boys who had sexually abused other children were compared with sexually victimised boys who had not done so.

SETTING

Social services departments in south east England were invited to refer sexually abused and sexually abusing boys to a London postgraduate teaching hospital.

SUBJECTS

25 adolescent boys aged between 11 years and 15 years and 11 months.

MAIN OUTCOME MEASURES

Adjusted odds ratios estimated from unconditional logistic regression.

RESULTS

Unadjusted odds rations for witnessing (8.1) as well as experiencing (18.0) intrafamilial violence and discontinuity of care (7.2) discriminated boys who had sexually abused from others who were solely victims of sexual abuse. Only the adjusted odds ratios for witnessing intrafamilial violence (39.7) discriminated the two groups.

CONCLUSIONS

The risk of adolescent boys who have been victims of sexual abuse engaging in sexually abusive behaviour towards other children is increased by life circumstances which may be unrelated directly to the original abusive experience, in particular exposure to a climate of intrafamilial violence. Our findings have implications for the management of boys found to have been sexually abused and raise important questions about the possibility of secondary prevention of subsequent abusive behaviour in those at greatest risk.

Community support to families living with HIV in London: an agency overview

In 1996 a structured questionnaire, relating to services provided, was completed by 12 agencies providing support to families with HIV in London. A wide range of information, practical and therapeutic services were available from these agencies but these usually had a primary focus on supporting the adults in these families. Only one agency had been set up specifically to offer a direct service for children within their own home or community. Services for children within most agencies consisted of organized child care or social activities, often provided to enable parents to access other services at the centre. Concern was frequently expressed that the normal and emotional needs, especially of older children, were not being met. Many children attending events at these agencies were unaware of the diagnosis or the reasons for attending these centres. Implications are discussed on how future development of services in the voluntary and statutory sector will need to address the specific and changing needs of infected and affected children.

Bone marrow transplantation for Sanfilippo disease type B

Allogeneic bone marrow transplantation was performed on twins with Sanfilippo B disease. They were the first two patients with this disorder to undergo the procedure. There was definite evidence of engraftment as shown by conversion to donor blood group antigen and tissue type, and increased leukocyte alpha-glucosaminidase activity. Nine years post transplant, neither twin is as handicapped as her untreated brothers were at the same age, although in one twin hyperactivity and behavioural problems, characteristic of the disorder, are present. Details of the twins' intellectual development and growth, their alpha-glucosaminidase activity and urinary glycosaminoglycan excretion are reported.

The impact of prenatal screening and diagnostic testing upon the cognitions, emotions and behaviour of pregnant women

The purpose of most screening and diagnostic tests is to initiate treatment when a problem is found and, otherwise, to allay anxiety. The extent to which the second of these objectives is met was studied in a prospective study of 179 pregnant women. Women who had amniocentesis to detect Down's Syndrome or were screened for a fetal neural tube defect had significantly lower anxiety levels in the third trimester of pregnancy than women who did not undergo these tests. Undergoing screening for a neural tube defect was also associated with a more positive attitude towards the pregnancy in the second trimester. These results suggest that the previously reported raised levels of anxiety in women undergoing such tests do not necessarily remain high for the duration of the pregnancy and, indeed, undergoing testing may serve to protect women against high levels of anxiety in the third trimester of pregnancy.

Adrenal response in children receiving high doses of ketoconazole for systemic coccidioidomycosis

The effect of ketoconazole on adrenal cortical function was studied in 10 prepubertal children receiving long-term (3 to 52 months) high-dose (10 to 23 mg/kg/d) orally administered ketoconazole treatment because of systemic coccidioidomycosis. Four hours after the once daily morning dose of ketoconazole, the patients had significantly elevated baseline desoxycorticosterone (DOC) and precursor/product ratios, and blunted cortisol and aldosterone responses to ACTH stimulation. Twenty-four hours after ketoconazole ingestion, both DOC and DOC/corticosterone ratio were approaching normal; the cortisol response to ACTH was normal in all but two of the 10 study patients, and these two had significantly improved response compared with their own 4-hour values. There appeared to be no differential adrenal response related to either duration of treatment (greater than 12 vs less than 12 months) or dose of medication per kilogram (greater than 18 or less than 18 mg/kg/d). Our data suggest that ketoconazole impairs production of cortisol and aldosterone by imposing a partial and temporary block at the 11-beta-hydroxylase step of steroid hormone synthesis. None of the patients required adrenal steroid replacement therapy in times of acute illness or surgery, and none had clinical evidence of adrenal insufficiency.

Hormones and handedness: left-hand bias in female congenital adrenal hyperplasia patients

An excess of left-handers among males has been attributed to early androgen exposure. This theory was supported by our observation that girls with congenital adrenal hyperplasia (CAH) are more left-biased than their normal sisters. Male CAH patients, with prenatal androgen exposure similar to that of unaffected brothers, had typical male-handedness patterns.

Low plasma androgens in women with systemic lupus erythematosus

The high ratio of women with systemic lupus erythematosus (SLE) has remained unexplained, despite the recent description of metabolic abnormalities of estrogen and androgen metabolism. Alterations of steroid metabolism in patients with SLE could be important in the pathogenesis of this disease, since it has been reported that gonadal steroids modulate the immune system. Moreover, research with inbred lupus mice has shown that estrogens have adverse effects on the disease in both sexes, whereas androgen therapy or oophorectomy is protective in females. Recently, the finding of elevated testosterone oxidation at C-17 in females with SLE suggested that plasma androgen levels in males and females with SLE should be examined more closely. We studied the varying degrees of clinical activity, with regard to plasma levels of 4 significant androgens: testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate in a series of 5 male and 42 female SLE patients. Decreased levels of all androgens were observed in women with SLE. The lowest levels of plasma androgens were found in female patients who had active disease, as determined by laboratory and clinical assessment. These data support the fact that specific abnormalities of androgen metabolism in the female are associated with SLE, and may contribute in some way to morbidity and mortality. More importantly, these data may have implications for future therapeutic regimens based on male hormone replacement.

Neuronal ceroid lipofuscinosis with hypergonadotropic hypogonadism

A case of adolescent-onset neuronal ceroid lipofuscinosis presenting with chorea and evidencing pyramidal and cerebellar dysfunction as well as hypergonadotropic hypogonadism is reported. In this patient, primary ovarian failure may be due to accumulation of ceroid in the ovaries.

HLA-DR 3 is associated with a more slowly progressive form of type 1 (insulin-dependent) diabetes

The presence of HLA-DR 3 was analysed in 745 patients with Type 1 (insulin-dependent) diabetes with age at diagnosis between 1-19 years. HLA-DR 3 and/or 4 was found in 678/745 (91%) of the patients. Presence of DR2 with neither DR 3 nor 4 was demonstrated in 15 patients. Patients with HLA-DR 3 without DR 4 presented with Type 1 diabetes more evenly over the year; they also presented without incidence peaks at 7 years or 10-11 years, as seen especially in DR 3/4 patients. The DR 3 patients more often had mild disease with less ketonuria at diagnosis, less often ketoacidotic symptoms and more often a subsequent partial remission. The apparently more severe disease among diabetic girls may, at least to some extent, be explained by their higher prevalence of HLA-DR 4. The differences found were similar in North America and Europe. The results suggest that Type 1 diabetes is a genetically heterogeneous disease and that HLA-typing may be a useful marker of this heterogeneity.

Evidence that variation among untreated rabbits in hepatic progesterone 21-hydroxylase activity is indicative of enzyme heterogeneity rather than a transient inductive effect

Previous work has shown that the 21-hydroxylation of progesterone in the hepatic microsomal fraction of outbred NZW rabbits varies over a tenfold range. In contrast, the 16-hydroxylase activity is relatively constant and is not correlated to the activity of the 21-hydroxylase. The distribution of the 21-hydroxylase activity is roughly bimodal with about one-third of the animals (21-H) exhibiting 21-hydroxylase activity exceeding 1 nmol/min/mg microsomal protein, whereas the remainder (21-L) generally exhibit an activity that is less than 1 nmol/min/mg protein. To determine if this was due to a transient phenomenon, liver punch biopsies were collected from 28 rabbits at intervals of approximately three weeks for at least three serial samples. The 21- and 16-hydroxylase activities were determined in the postmitochondrial fractions of these biopsy samples. A substantial variability in both 21- and 16-hydroxylase activities was observed for serial biopsy samples from individual rabbits. The variation of the 16-hydroxylase activity paralleled, however, that of the 21-hydroxylase, thus suggesting that the variation between biopsy samples for individual rabbits was due to factors such as contamination with blood and connective tissue, which would affect both activities equally. Rabbits, therefore, were phenotyped as 21-H or 21-L on the basis of the 21/16-hydroxylase ratio. The mean ratio was 3.2 +/- 1.2 and 0.8 +/- 0.3 for rabbits phenotyped as 21-H and 21-L, respectively. Similar values for this ratio were obtained for the other group of rabbits phenotyped as 21-H and 21-L, 3.8 +/- 1.6 and 0.5 +/- 0.2, respectively, following the isolation of microsomes from whole liver homogenates. The ratio of 21/16-hydroxylase activity was found to be relatively constant for biopsy samples obtained from the same animal over the course of this study, thus indicating that the elevated 21-hydroxylase activity is not a transient phenomenon.

Characterization of variations in rabbit hepatic progesterone 21-hydroxylase activity by serial biopsy

Earlier work has shown that the 21-hydroxylation of progesterone in the hepatic microsomal fraction of outbred New Zealand White rabbits varies over a 10-fold range. To determine whether the differences in 21-hydroxylase activity were due to a transient inductive effect, livers from a group of 28 rabbits were serially biopsied at least three times over a minimum period of two months. Both progesterone 21- and 16 alpha-hydroxylase activities were determined in the post-8700g supernatant of homogenates prepared from these biopsy samples. A substantial variability in both the 21- and 16 alpha-hydroxylase activity was observed for serial biopsy samples from individual rabbits. Each animal was found, however, to maintain relatively constant ratios of 21/16 alpha-hydroxylase activity throughout the course of the study. Previous studies have indicated that the 21-hydroxylase activity does not correlate with the 16 alpha-hydroxylase activity and that the 21-hydroxylase phenotype could be determined from the ratio of these activities. On the basis of this ratio, two groups of animals could be distinguished in the present study. Approximately 25% of the animals exhibited an elevated 21/16 alpha-hydroxylase ratio (greater than 1.5), the remainder were below this level. Furthermore, the expression of elevated levels of the 21-hydroxylase activity were found to be consistent within this subpopulation suggesting that a transient inductive effect is not responsible for the differences in 21-hydroxylase activity among populations of outbred New Zealand White rabbits. This study demonstrates the determination of the hepatic enzymatic phenotype while maintaining the animal for long periods of time and for subsequent investigations.

Delayed puberty in males with chronic renal failure

The effects of chronic renal failure on the pituitary-testicular axis of 31 males, aged 11.7 to 20.0 yr (mean, 16.0 yr) were studied. Nine patients not on hemodialysis (group I) had serum creatinines between 2.5 and 8.0 mg/dl, 10 patients were on hemodialysis (group II) and 12 patients had received a renal transplant (group III). The Tanner stage of pubertal development was delayed relative to chronologic age. Testosterone (T), delta 4-androstenedione (delta 4), and urinary 17-keto steroids were normal when related to pubertal stage in groups I and II; and dehydroepiandrosterone (DHEA) and DHEA sulfate (DS) were in the low normal range. In group III, adrenal androgens (delta 4, DHEA, DS) were decreased as a consequence of prednisone therapy whereas T was normal. Luteinizing hormone levels were normal in all. Follicle-stimulating hormone levels were normal in all. Follicle-stimulating hormone (FSH) was significantly increased in groups I and II. In group III, FSH was normal in 6 of 9 patients with serum creatinine concentrations < 2 mg/dl. FSH levels were uniformly elevated in Tanner I-V patients with creatinines > 2 mg/dl. The data shows that FSH is elevated in patients with chronic renal failure even in prepuberty and early adolescence. This may reflect damage to germinal epithelium prior to the advent of spermatogenesis, whereas Leydig cell function appears to remain intact.

Serologic detection of a y-linked gene in xx males and xx true hermaphrodites

To test the hypothesis that H-Y antigen (present on both somatic and germ cells in normal males but not normal females) is essential for testicular differentiation, we studied four XX males and three XX true hermaphrodites. Blood cells from six subjects and cultured gonadal fibroblasts from a seventh expressed H-Y antigen. Since expression of this antigen requires the presence of a gene normally carried by the Y chromosome, this gene, and perhaps additional Y chromosomal material, should have been present in the genome of these subjects. In one patient this presence is accounted for by a Y-to-X translocation, detectable by chromosome banding. In another a normal Y chromosome was present in a minor population of cells. In the remaining five, no karyotypic abnormality was detectable. Immunologic detection of H-Y antigen is a sensitive test for the presence of the Y chromosome or of its male-determining segment.

Pseudovaginal perineoscrotal hypospadias (PPSH) in sibs

Pseudovaginal perineoscrotal hypospadias (PPSH) is a descriptive name applied to a specific developmental disorder of sexual development in males. Incomplete masculinization of the external genitals of affected individuals-essentially the only abnormal feature of the syndrome-results in varying degrees of genital ambiguity. Testes are present, however, and generalized virilization occurs at puberty, emphasizing the importance of accurate diagnosis early in life. Our report of three affected sibs born to related parents appears to confirm earlier suggestions that PPSH is a genetic disorder, transmitted in autosomal recessive fashion.