Kinase Suppressor of RAS 1 (KSR1) Maintains the Transformed Phenotype of BRAFV600E Mutant Human Melanoma Cells.

Kinase Suppressor of RAS 1 (KSR1) is a scaffolding protein for the RAS-RAF-MEK-ERK pathway, which is one of the most frequently altered pathways in human cancers. Previous results have shown that KSR1 has a critical role in mutant RAS-mediated transformation. Here, we examined the role of KSR1 in mutant BRAF transformation. We used CRISPR/Cas9 to knock out KSR1 in a BRAFV600E-transformed melanoma cell line. KSR1 loss produced a complex phenotype characterised by impaired proliferation, cell cycle defects, decreased transformation, decreased invasive migration, increased cellular senescence, and increased apoptosis. To decipher this phenotype, we used a combination of proteomic ERK substrate profiling, global protein expression profiling, and biochemical validation assays. The results suggest that KSR1 directs ERK to phosphorylate substrates that have a critical role in ensuring cell survival. The results further indicate that KSR1 loss induces the activation of p38 Mitogen-Activated Protein Kinase (MAPK) and subsequent cell cycle aberrations and senescence. In summary, KSR1 function plays a key role in oncogenic BRAF transformation.

Metabolic stress regulates ERK activity by controlling KSR-RAF heterodimerization.

Altered cell metabolism is a hallmark of cancer, and targeting specific metabolic nodes is considered an attractive strategy for cancer therapy. In this study, we evaluate the effects of metabolic stressors on the deregulated ERK pathway in melanoma cells bearing activating mutations of the NRAS or BRAF oncogenes. We report that metabolic stressors promote the dimerization of KSR proteins with CRAF in NRAS-mutant cells, and with oncogenic BRAF in BRAFV600E-mutant cells, thereby enhancing ERK pathway activation. Despite this similarity, the two genomic subtypes react differently when a higher level of metabolic stress is induced. In NRAS-mutant cells, the ERK pathway is even more stimulated, while it is strongly downregulated in BRAFV600E-mutant cells. We demonstrate that this is caused by the dissociation of mutant BRAF from KSR and is mediated by activated AMPK. Both types of ERK regulation nevertheless lead to cell cycle arrest. Besides studying the effects of the metabolic stressors on ERK pathway activity, we also present data suggesting that for efficient therapies of both genomic melanoma subtypes, specific metabolic targeting is necessary.

Targeting MAPK Signaling in Cancer: Mechanisms of Drug Resistance and Sensitivity.

Mitogen-activated protein kinase (MAPK) pathways represent ubiquitous signal transduction pathways that regulate all aspects of life and are frequently altered in disease. Here, we focus on the role of MAPK pathways in modulating drug sensitivity and resistance in cancer. We briefly discuss new findings in the extracellular signaling-regulated kinase (ERK) pathway, but mainly focus on the mechanisms how stress activated MAPK pathways, such as p38 MAPK and the Jun N-terminal kinases (JNK), impact the response of cancer cells to chemotherapies and targeted therapies. In this context, we also discuss the role of metabolic and epigenetic aberrations and new therapeutic opportunities arising from these changes.

The complexities and versatility of the RAS-to-ERK signalling system in normal and cancer cells.

The intricate dynamic control and plasticity of RAS to ERK mitogenic, survival and apoptotic signalling has mystified researches for more than 30 years. Therapeutics targeting the oncogenic aberrations within this pathway often yield unsatisfactory, even undesired results, as in the case of paradoxical ERK activation in response to RAF inhibition. A direct approach of inhibiting single oncogenic proteins misses the dynamic network context governing the network signal processing. In this review, we discuss the signalling behaviour of RAS and RAF proteins in normal and in cancer cells, and the emerging systems-level properties of the RAS-to-ERK signalling network. We argue that to understand the dynamic complexities of this control system, mathematical models including mechanistic detail are required. Looking into the future, these dynamic models will build the foundation upon which more effective, rational approaches to cancer therapy will be developed.

MultiBac: from protein complex structures to synthetic viral nanosystems.

The MultiBac baculovirus/insect cell expression vector system was conceived as a user-friendly, modular tool-kit for producing multiprotein complexes for structural biology applications. MultiBac has allowed the structure and function of many molecular machines to be elucidated, including previously inaccessible high-value drug targets. More recently, MultiBac developments have shifted to customized baculoviral genomes that are tailored for a range of applications, including synthesizing artificial proteins by genetic code expansion. We review some of these developments, including the ongoing rewiring of the MultiBac system for mammalian applications, notably CRISPR/Cas9-mediated gene editing.

HiQuant: Rapid Postquantification Analysis of Large-Scale MS-Generated Proteomics Data.

Recent advances in mass-spectrometry-based proteomics are now facilitating ambitious large-scale investigations of the spatial and temporal dynamics of the proteome; however, the increasing size and complexity of these data sets is overwhelming current downstream computational methods, specifically those that support the postquantification analysis pipeline. Here we present HiQuant, a novel application that enables the design and execution of a postquantification workflow, including common data-processing steps, such as assay normalization and grouping, and experimental replicate quality control and statistical analysis. HiQuant also enables the interpretation of results generated from large-scale data sets by supporting interactive heatmap analysis and also the direct export to Cytoscape and Gephi, two leading network analysis platforms. HiQuant may be run via a user-friendly graphical interface and also supports complete one-touch automation via a command-line mode. We evaluate HiQuant's performance by analyzing a large-scale, complex interactome mapping data set and demonstrate a 200-fold improvement in the execution time over current methods. We also demonstrate HiQuant's general utility by analyzing proteome-wide quantification data generated from both a large-scale public tyrosine kinase siRNA knock-down study and an in-house investigation into the temporal dynamics of the KSR1 and KSR2 interactomes. Download HiQuant, sample data sets, and supporting documentation at http://hiquant.primesdb.eu .

Splicing factor hnRNP A2 activates the Ras-MAPK-ERK pathway by controlling A-Raf splicing in hepatocellular carcinoma development.

In recent years, it has become clear that splicing factors play a direct role in cancer development. We showed previously that splicing factors SRSF1, SRSF6, and hnRNP A2/B1 are up-regulated in several cancers and can act as oncogenes when up-regulated. Here we examined the role of splicing factors hnRNP A1/A1b and hnRNP A2/B1 in hepatocellular carcinoma (HCC). We show that the splicing factors hnRNP A1 and hnRNP A2 are up-regulated in HCC tumors derived from inflammation-induced liver cancer mouse model. Overexpression of hnRNP A1 or hnRNP A2, but not the splicing isoform hnRNP B1, induced tumor formation of immortalized liver progenitor cells, while knockdown of these proteins inhibited anchorage-independent growth and tumor growth of human liver cancer cell lines. In addition, we found that cells overexpressing hnRNP A2 showed constitutive activation of the Ras-MAPK-ERK pathway. In contrast, knockdown of hnRNP A2 inhibited the Ras-MAPK-ERK pathway and prevented ERK1/2 activation by EGF. Moreover, we found that hnRNP A2 regulates the splicing of A-Raf, reducing the production of a short dominant-negative isoform of A-Raf and elevating the full-length A-Raf transcript. Taken together, our data suggest that hnRNP A2 up-regulation in HCC induces an alternative splicing switch that down-regulates a dominant-negative isoform of A-Raf, leading to activation of the Raf-MEK-ERK pathway and cellular transformation.

HGF induces epithelial-to-mesenchymal transition by modulating the mammalian hippo/MST2 and ISG15 pathways.

Epithelial to mesenchymal transition (EMT) is a fundamental cell differentiation/dedifferentiation process which is associated with dramatic morphological changes. Formerly polarized and immobile epithelial cells which form cell junctions and cobblestone-like cell sheets undergo a transition into highly motile, elongated, mesenchymal cells lacking cell-to-cell adhesions. To explore how the proteome is affected during EMT we profiled protein expression and tracked cell biological markers in Madin-Darby kidney epithelial cells undergoing hepatocyte growth factor (HGF) induced EMT. We were able to identify and quantify over 4000 proteins by mass spectrometry. Enrichment analysis of this revealed that expression of proteins associated with the ubiquitination machinery was induced, whereas expression of proteins regulating apoptotic pathways was suppressed. We show that both the mammalian Hippo/MST2 and the ISG15 pathways are regulated at the protein level by ubiquitin ligases. Inhibition of the Hippo pathway by overexpression of either ITCH or A-Raf promotes HGF-induced EMT. Conversely, ISG15 overexpression is sufficient to induce cell scattering and an elongated morphology without external stimuli. Thus, we demonstrate for the first time that the Hippo/MST2 and ISG15 pathways are regulated during growth-factor induced EMT.

Analysis of central Hox protein types across bilaterian clades: on the diversification of central Hox proteins from an Antennapedia/Hox7-like protein.

Hox proteins are among the most intensively studied transcription factors and represent key factors in establishing morphological differences along the anterior-posterior axis of animals. They are generally regarded as highly conserved in function, a view predominantly based on experiments comparing a few (anterior) Hox proteins. However, the extent to which central or abdominal Hox proteins share conserved functions and sequence signatures remains largely unexplored. To shed light on the functional divergence of the central Hox proteins, we present an easy to use resource aimed at predicting the functional similarities of central Hox proteins using sequence elements known to be relevant to Hox protein functions. We provide this resource both as a stand-alone download, including all information, as well as via a simplified web-interface that facilitates an accurate and fine-tuned annotation of novel Hox sequences. The method used in the manuscript is, so far, the only published sequence-based method capable of differentiating between the functionally distinct central Hox proteins with near-identical homeodomains (such as the Drosophila Antp, Ubx and Abd-A Hox proteins). In this manuscript, a pairwise-sequence-similarity based approach (using the bioinformatics tool CLANS) is used to analyze all available central Hox protein sequences. The results are combined with a large-scale species phylogeny to depict the presence/absence of central Hox sequence-types across the bilaterian lineage. The obtained pattern of distribution of the Hox sequence-types throughout the species tree enables us to infer at which branching point a specific type of central Hox protein was present. Based on the Hox sequences currently available in public databases, seven sequence-similarity groups could be identified for the central Hox proteins, two of which have never been described before (Echi/Hemi7 and Echi/Hemi8). Our work also shows, for the first time, that Antp/Hox7-like sequences are present throughout all bilaterian clades and that all other central Hox protein groups are specific to sub-lineages in the protostome or deuterostome branches only.

Interactome dynamics of RAF1-BRAF kinase monomers and dimers.

RAF kinases play major roles in cancer. BRAFV600E mutants drive ~6% of human cancers. Potent kinase inhibitors exist but show variable effects in different cancer types, sometimes even inducing paradoxical RAF kinase activation. Both paradoxical activation and drug resistance are frequently due to enhanced dimerization between RAF1 and BRAF, which maintains or restores the activity of the downstream MEK-ERK pathway. Here, using quantitative proteomics we mapped the interactomes of RAF1 monomers, RAF1-BRAF and RAF1-BRAFV600E dimers identifying and quantifying >1,000 proteins. In addition, we examined the effects of vemurafenib and sorafenib, two different types of clinically used RAF inhibitors. Using regression analysis to compare different conditions we found a large overlapping core interactome but also distinct condition specific differences. Given that RAF proteins have kinase independent functions such dynamic interactome changes could contribute to their functional diversification. Analysing this dataset may provide a deeper understanding of RAF signalling and mechanisms of resistance to RAF inhibitors.

A Combination of Conformation-Specific RAF Inhibitors Overcome Drug Resistance Brought about by RAF Overexpression.

Cancer cells often adapt to targeted therapies, yet the molecular mechanisms underlying adaptive resistance remain only partially understood. Here, we explore a mechanism of RAS/RAF/MEK/ERK (MAPK) pathway reactivation through the upregulation of RAF isoform (RAFs) abundance. Using computational modeling and in vitro experiments, we show that the upregulation of RAFs changes the concentration range of paradoxical pathway activation upon treatment with conformation-specific RAF inhibitors. Additionally, our data indicate that the signaling output upon loss or downregulation of one RAF isoform can be compensated by overexpression of other RAF isoforms. We furthermore demonstrate that, while single RAF inhibitors cannot efficiently inhibit ERK reactivation caused by RAF overexpression, a combination of two structurally distinct RAF inhibitors synergizes to robustly suppress pathway reactivation.

A Review of Anonymization for Healthcare Data.

Mining health data can lead to faster medical decisions, improvement in the quality of treatment, disease prevention, and reduced cost, and it drives innovative solutions within the healthcare sector. However, health data are highly sensitive and subject to regulations such as the General Data Protection Regulation, which aims to ensure patient's privacy. Anonymization or removal of patient identifiable information, although the most conventional way, is the first important step to adhere to the regulations and incorporate privacy concerns. In this article, we review the existing anonymization techniques and their applicability to various types (relational and graph based) of health data. Besides, we provide an overview of possible attacks on anonymized data. We illustrate via a reconstruction attack that anonymization, although necessary, is not sufficient to address patient privacy and discuss methods for protecting against such attacks. Finally, we discuss tools that can be used to achieve anonymization.

The secret life of kinases: functions beyond catalysis.

Protein phosphorylation participates in the regulation of all fundamental biological processes, and protein kinases have been intensively studied. However, while the focus was on catalytic activities, accumulating evidence suggests that non-catalytic properties of protein kinases are essential, and in some cases even sufficient for their functions. These non-catalytic functions include the scaffolding of protein complexes, the competition for protein interactions, allosteric effects on other enzymes, subcellular targeting, and DNA binding. This rich repertoire often is used to coordinate phosphorylation events and enhance the specificity of substrate phosphorylation, but also can adopt functions that do not rely on kinase activity. Here, we discuss such kinase independent functions of protein and lipid kinases focussing on kinases that play a role in the regulation of cell proliferation, differentiation, apoptosis, and motility.

Spatial regulation of ARAF controls the MST2-Hippo pathway.

The RAF-MAPK signaling pathway regulates several very diverse cellular processes such as proliferation, differentiation, apoptosis, and transformation. While the canonical function of RAF kinases within the MAPK pathway is the activation of MEK, our group could demonstrate an important crosstalk between RAF signaling and the pro-apoptotic mammalian sterile 20-like kinase (MST2) tumor suppressor pathway in several cancer entities, including head and neck, colon, and breast. Here, the RAF kinases CRAF and ARAF sequester and inhibit the pro-apoptotic kinase MST2 independently of their own kinase activity. In our recent study, we showed that the ARAF-MST2 complex is regulated by subcellular compartmentalization during epithelial differentiation. Proliferating cells of the basal cell layer in squamous epithelia and tumor cells express ARAF at the mitochondria thus allowing for efficient sequestration of MST2. In contrast, non-malignant squamous epithelia have ARAF localized at the plasma membrane, where the control of MST2-mediated apoptosis is compromised. This re-distribution is regulated by the scaffold protein kinase suppressor of Ras 2 (KSR2). Here, we summarize how spatial and temporal regulation of RAF signaling complexes affect cellular signaling and functions.

Use of Emergency Departments by Frail Elderly Patients: Temporal Patterns and Case Complexity.

Emergency department (ED) care for frail elderly patients is associated with an increased use of resources due to their complex medical needs and frequently difficult psycho-social situation. To better target their needs with specially trained staff, it is vital to determine the times during which these particular patients present to the ED. Recent research was inconclusive regarding this question and the applied methods were limited to coarse time windows. Moreover, there is little research on time variation of frail ED patients' case complexity. This study examines differences in arrival rates for frail vs. non-frail patients in detail and compares case complexity in frail patients within vs. outside of regular GP working hours. Arrival times and case variables (admission rate, ED length of stay [LOS], triage level and comorbidities) were extracted from the EHR of an ED in an urban German teaching hospital. We employed Poisson time series regression to determine patterns in hourly arrival rates over the week. Frail elderly patients presented more likely to the ED during already high frequented hours, especially at midday and in the afternoon. Case complexity for frail patients was significantly higher compared to non-frail patients, but varied marginally in time only with respect to triage level and ED LOS. The results suggest that frailty-attuned emergency care should be available in EDs during the busiest hours. Based on EHR data, hospitals thus can tailor their staff needs.

Improving the Prediction of Emergency Department Crowding: A Time Series Analysis Including Road Traffic Flow.

BACKGROUND: Crowding in emergency departments (ED) has a negative impact on quality of care and can be averted by allocating additional resources based on predictive crowding models. However, there is a lack in effective external overall predictors, particularly those representing public activity. OBJECTIVES: This study, therefore, examines public activity measured by regional road traffic flow as an external predictor of ED crowding in an urban hospital. METHODS: Seasonal autoregressive cross-validated models (SARIMA) were compared with respect to their forecasting error on ED crowding data. RESULTS: It could be shown that inclusion of inflowing road traffic into a SARIMA model effectively improved prediction errors. CONCLUSION: The results provide evidence that circadian patterns of medical emergencies are connected to human activity levels in the region and could be captured by public monitoring of traffic flow. In order to corroborate this model, data from further years and additional regions need to be considered. It would also be interesting to study public activity by additional variables.

It Needs More Than Just User Participation: Combining Perspectives of Clinical Leaders and Chief Information Officers on Determinants of Hospitals' IT Innovativeness.

Although user participation may facilitate the realisation of IT innovations, various literature analyses show only minimal to moderate evidence for such effects possibly due to disregard of mediating factors. Against this background, this study examines the extent to which joint intrapreneurship of clinical leaders and IT leaders as well as a distinct innovation culture mediate the effect of user participation on hospitals' IT innovativeness. IT innovativeness was measured by the availability and usability of IT functions and by the perceived 'innovative power' of a hospital. An empirical model was developed and tested with data from 168 clinical leaders and IT leaders who participated pairwise in a survey representing 84 German hospitals. Three parallel mediation analyses indicated that the participation of users could only lead to IT innovativeness if they were accompanied by intrapreneurial leadership on the part of clinical directors and IT leaders and if a pronounced innovation culture prevailed.

Diffusion dynamics of electronic health records: A longitudinal observational study comparing data from hospitals in Germany and the United States.

BACKGROUND: While aiming for the same goal of building a national eHealth Infrastructure, Germany and the United States pursued different strategic approaches - particularly regarding the role of promoting the adoption and usage of hospital Electronic Health Records (EHR). OBJECTIVE: To measure and model the diffusion dynamics of EHRs in German hospital care and to contrast the results with the developments in the US. MATERIALS AND METHODS: All acute care hospitals that were members of the German statutory health system were surveyed during the period 2007-2017 for EHR adoption. Bass models were computed based on the German data and the corresponding data of the American Hospital Association (AHA) from non-federal hospitals in order to model and explain the diffusion of innovation. RESULTS: While the diffusion dynamics observed in the US resembled the typical s-shaped curve with high imitation effects (q = 0.583) but with a relatively low innovation effect (p = 0.025), EHR diffusion in Germany stagnated with adoption rates of approx. 50% (imitation effect q = -0.544) despite a higher innovation effect (p = 0.303). DISCUSSION: These findings correlate with different governmental strategies in the US and Germany of financially supporting EHR adoption. Imitation only seems to work if there are financial incentives, e.g. those of the HITECH Act in the US. They are lacking in Germany, where the government left health IT adoption strategies solely to the free market and the consensus among all of the stakeholders. CONCLUSION: Bass diffusion models proved to be useful for distinguishing the diffusion dynamics in German and US non-federal hospitals. When applying the Bass model, the imitation parameter needs a broader interpretation beyond the network effects, including driving forces such as incentives and regulations, as was demonstrated by this study.

Understanding the Characteristics of Frequent Users of Emergency Departments: What Role Do Medical Conditions Play?

Frequent users of emergency departments (ED) pose a significant challenge to hospital emergency services. Despite a wealth of studies in this field, it is hardly understood, what medical conditions lead to frequent attendance. We examine (1) what ambulatory care sensitive conditions (ACSC) are linked to frequent use, (2) how frequent users can be clustered into subgroups with respect to their diagnoses, acuity and admittance, and (3) whether frequent use is related to higher acuity or admission rate. We identified several ACSC that highly increase the risk for heavy ED use, extracted four major diagnose subgroups and found no significant effect neither for acuity nor admission rate. Our study indicates that especially patients in need of (nursing) care form subgroups of frequent users, which implies that quality of care services might be crucial for tackling frequent use. Hospitals are advised to regularly analyze their ED data in the EHR to better align resources.