Cathelicidin suppresses lipid accumulation and hepatic steatosis by inhibition of the CD36 receptor.

BACKGROUND AND OBJECTIVES: Obesity is a global epidemic which increases the risk of the metabolic syndrome. Cathelicidin (LL-37 and mCRAMP) is an antimicrobial peptide with an unknown role in obesity. We hypothesize that cathelicidin expression correlates with obesity and modulates fat mass and hepatic steatosis. MATERIALS AND METHODS: Male C57BL/6 J mice were fed a high-fat diet. Streptozotocin was injected into mice to induce diabetes. Experimental groups were injected with cathelicidin and CD36 overexpressing lentiviruses. Human mesenteric fat adipocytes, mouse 3T3-L1 differentiated adipocytes and human HepG2 hepatocytes were used in the in vitro experiments. Cathelicidin levels in non-diabetic, prediabetic and type II diabetic patients were measured by enzyme-linked immunosorbent assay. RESULTS: Lentiviral cathelicidin overexpression reduced hepatic steatosis and decreased the fat mass of high-fat diet-treated diabetic mice. Cathelicidin overexpression reduced mesenteric fat and hepatic fatty acid translocase (CD36) expression that was reversed by lentiviral CD36 overexpression. Exposure of adipocytes and hepatocytes to cathelicidin significantly inhibited CD36 expression and reduced lipid accumulation. Serum cathelicidin protein levels were significantly increased in non-diabetic and prediabetic patients with obesity, compared with non-diabetic patients with normal body mass index (BMI) values. Prediabetic patients had lower serum cathelicidin protein levels than non-diabetic subjects. CONCLUSIONS: Cathelicidin inhibits the CD36 fat receptor and lipid accumulation in adipocytes and hepatocytes, leading to a reduction of fat mass and hepatic steatosis in vivo. Circulating cathelicidin levels are associated with increased BMI. Our results demonstrate that cathelicidin modulates the development of obesity.

General anesthesia for cesarean delivery and childhood neurodevelopmental and perinatal outcomes: a secondary analysis of a randomized controlled trial.

BACKGROUND: In 2016, the U.S. Food and Drug Administration expressed concern that neurodevelopment may be negatively affected by anesthesia or sedation exposure in pregnancy or before three years of age. We examined the association between general anesthesia at the time of cesarean delivery and early childhood neurodevelopment. METHODS: A secondary analysis of a multicenter randomized controlled trial assessing magnesium for prevention of cerebral palsy in infants at risk for preterm delivery. Exposure was general compared to neuraxial anesthesia. The primary outcome was motor or mental delay at two years of age, assessed by Bayley Scales of Infant Development II (BSIDII). Secondary outcomes included BSIDII subdomains and perinatal outcomes. Multivariable logistic regression models were performed to control for confounders. RESULTS: Of 557 women undergoing cesarean delivery, 119 (21%) received general anesthesia. There were no differences in the primary composite outcome of developmental delay (aOR 0.93, 95% CI 0.61 to 1.43) or the BSIDII subdomains of mild, moderate, or severe mental delay, or mild or moderate motor delay. Severe motor delay was more common among infants exposed to general anesthesia (aOR 1.98, 95% CI 1.06 to 3.69). Infants exposed to general anesthesia had longer neonatal intensive care stays (51 vs 37 days, P=0.010). CONCLUSIONS: General anesthesia for cesarean delivery was not associated with overall neurodevelopmental delay at two years of age, except for greater odds of severe motor delay. Future studies should evaluate this finding, as well as the impact on neurodevelopment of longer or multiple anesthetic exposures across all gestational ages.

Risk-reducing surgery in FAP: role for surgeons beyond the incision.

BACKGROUND: Although primary therapy in familial adenomatous polyposis (FAP) is surgical, little is known about patients' surgical decision-making experience. The objective was to explore the decision-making process surrounding risk-reducing surgery in FAP using qualitative methodology. METHODS: In-depth, semi-structured interviews with 14 FAP patients and 11 healthcare providers with experience caring for FAP patients were conducted. Using grounded theory, line-by-line content analysis identified categories from which themes describing patients' experiences emerged; analysis continued until data saturation. RESULTS: Median age at surgery was 23 (7-37) years; at interview 41 (19-74) years. Two patients underwent surgery secondary to cancer, the remainder for risk-reduction. Content experts included colorectal surgeons (3), geneticists (2), gastroenterologists (3), nurses (3).Three themes emerged: Information: Family was the primary information source, and patients' level of information varied. The importance of up-front information was emphasized. Influences on decision-making: Influential factors included family experiences, youth, emotional state, support, and decision-making role. Although patients often sought opinions, most (12/14) wanted an active/shared role in decision-making. Life after surgery: Patients described surgery as the "easy part," emphasizing the need for long-term relationships with care providers. CONCLUSIONS: Decisions surrounding risk-reducing surgery in FAP are unique. A decision support tool may facilitate decision-making, better preparing patients for life after surgery.

The expert novice - living and working with malignant hyperthermia.

Acute care common stem training involves developing competencies within anaesthesia. At this stage of their career, most doctors have little or no anaesthetic experience, and work under direct consultant supervision for the majority of the placement. An emergency medicine trainee with a known diagnosis of malignant hyperthermia undertook a 6-month anaesthetic rotation in a large teaching hospital, adding a unique set of considerations to his training. Having malignant hyperthermia posed a novel challenge to the department, and it was met with an understandable degree of uncertainty and caution. Providing the trainee with a useful and comparable introduction to anaesthesia was of concern, particularly on paediatric lists where there is increased potential for exposure to volatile anaesthetic agents. This report focuses on the trainee's personal reflection of the impact on his experience, as well as looking at how the department responded to this unfamiliar situation, and the learning points to share should a similar scenario be encountered in the future.

Namoratunga: the first archeoastronomical evidence in sub-saharan Africa.

Namoratunga, a megalithic site in northwestern Kenya, has an alignment of 19 basalt pillars that are nonrandomly oriented toward certain stars and constellations. The same stars and constellations are used by modern eastern Cushitic peoples to calculate an accurate calendar. The fact that Namoratunga dates to about 300 B.C. suggests that a prehistoric calendar based on detailed astronomical knowledge was in use in eastern Africa.

The cloning of a family of genes that encode the melanocortin receptors.

Melanocyte-stimulating hormone (MSH) and adrenocorticotropic hormone (ACTH) regulate pigmentation and adrenal cortical function, respectively. These peptides also have a variety of biological activities in other areas, including the brain, the pituitary, and the immune system. A complete understanding of the biological activities of these hormones requires the isolation and characterization of their corresponding receptors. The murine and human MSH receptors (MSH-Rs) and a human ACTH receptor (ACTH-R) were cloned. These receptors define a subfamily of receptors coupled to guanine nucleotide-binding proteins that may include the cannabinoid receptor.

Molecular genetic analysis of Drosophila rDNA arrays.

Large repeated DNA arrays are a major component of the eukaryotic genome, but we know little about their internal organization. Understanding their architecture, however, is critical for describing genome structure and for inferring the mechanisms that shape it. One repeated family that is yielding a picture of how structure, function and recombination mechanisms come together is the ribosomal DNA (rDNA) of Drosophila melanogaster.

Specificity of chromosome damage caused by the Rex element of Drosophila melanogaster.

Rex is a multicopy genetic element that maps within an X-linked ribosomal RNA gene (rDNA) array of D. melanogaster. Acting maternally, Rex causes recombination between rDNA arrays in a few percent of early embryos. With target chromosomes that contain two rDNA arrays, the exchanges either delete all of the material between the two arrays or invert the entire intervening chromosomal segment. About a third of the embryos produced by Rex homozygotes have cytologically visible chromosome damage, nearly always involving a single chromosome. Most of these embryos die during early development, displaying a characteristic apoptosis-like phenotype. An experiment that tests whether the cytologically visible damage is rDNA-specific is reported here. In this experiment, females heterozygous for Rex and an rDNA-deficient X chromosome were crossed to males of two genotypes. Some of the progeny from the experimental cross entirely lacked rDNA, while all of the progeny from the control cross had at least one rDNA array. A significantly lower frequency of early-lethal embryos in the experimental cross, proportionate to the fraction of rDNA-deficient embryos, demonstrates that Rex preferentially damages rDNA.

The Meiotic Effects of a Deficiency in DROSOPHILA MELANOGASTER: Identification of Two Dosage-Sensitive Sites.

Heterozygosity for a deficiency for the entire zeste-white region of the X chromosome of Drosophila melanogaster females causes both reduced recombination and increased nondisjunction. The location of the dosage-sensitive sites responsible for these two meiotic defects has been studied by use of a set of deficiencies that subdivide the region. Recombination is reduced when the zw7-zw11 region is present in one dose, while nondisjunction is increased only if the doses of both the zw8-zw10 and zw6-zw11 segments are reduced. Examination of trans heterozygotes of two deficiencies explicitly demonstrates the compound nature of the meiotic dose effect and further delimits the location of the proximal disjunctional site to the zw12-zw11 interval. In inversion/deficiency heterozygotes, reduced dose of the zw8-zw10 region alone, without reduced dose of the proximal site, yields increased nondisjunction, suggesting that the proximal element that affects disjunction is the same as that which affects recombination. Thus, the zeste-white region contains at least two dosagesensitive loci that affect meiosis: reduced dosage of one locus, in the zw7-zw11 interval, causes reduced recombination; reduced dose of another, in the zw8-zw10 region, increases the probability that nonexchange chromosomes will nondisjoin. A slight effect on the regional distribution of exchange may also be a property of the zw8-zw10 region locus, but could be an effect of yet another locus or of structural heterozygosity. The implications of these results for understanding meiotic control and the prospects for further analysis of the structure of the zeste-white interval are considered.

Maternal-Zygotic Lethal Interactions in DROSOPHILA MELANOGASTER : Zeste-White Region Single-Cistron Mutations.

Thirty-eight mutations in 13 essential loci in the zeste-white region were tested for interacting maternal and zygotic gene activity. Maternal mutant heterozygosity provided a partial maternal defect and position-effect variegation was used to alter the level of zygotic gene activity. This method yields a minimum estimate of the number of genes for which zygotic development depends upon both gene products stored in the egg and gene products synthesized in the zygote. Lethal interactions were found for one or more alleles at 10 of the 13 loci. The implications of these observations with respect to gene regulation and developmental sequence are considered.

Do-it-yourself statistics: A computer-assisted likelihood approach to analysis of data from genetic crosses.

Graduate school programs in genetics have become so full that courses in statistics have often been eliminated. In addition, typical introductory statistics courses for the "statistics user" rather than the nascent statistician are laden with methods for analysis of measured variables while genetic data are most often discrete numbers. These courses are often seen by students and genetics professors alike as largely irrelevant cookbook courses. The powerful methods of likelihood analysis, although commonly employed in human genetics, are much less often used in other areas of genetics, even though current computational tools make this approach readily accessible. This article introduces the MLIKELY.PAS computer program and the logic of do-it-yourself maximum-likelihood statistics. The program itself, course materials, and expanded discussions of some examples that are only summarized here are available at http://www.unisi. it/ricerca/dip/bio_evol/sitomlikely/mlikely.h tml.

Maternal-zygotic lethal interactions in Drosophila melanogaster: the effects of deficiencies in the zeste-white region of the X chromosome.

The possibility that essential loci in the zeste-white region of the Drosophila melanogaster X chromosome are expressed both maternally and zygotically has been tested. Maternal gene activity was varied by altering gene dose, and zygotic gene activity was manipulated by use of position-effect variegation of a duplication. Viability is affected when both maternal and zygotic gene activity are reduced, but not when either maternal or zygotic gene activity is normal. Tests of a set of overlapping deficiencies demonstrate that at least three sections of the zeste-white region yield maternal zygotic lethal interactions. Single-cistron mutations at two loci in one of these segments have been tested, and maternal heterozygosity for mutations at both loci give lethal responses of mutant-duplication zygotes. Thus, at least four of the 13 essential functions coded in the zeste-white region are active both maternally and zygotically, suggesting that a substantial fraction of the genome may function at both stages. The normal survival of zygotes when either maternal gene expression or zygotic gene expression is normal, and their inviability when both are depressed, suggests that a developmental stage exists when maternally determined functions and zygotically coded functions are both in use.

Developmental use of gene products in Drosophila: the maternal-zygotic transition.

Recent results suggest that activity of a large fraction of the Drosophila genome is needed at multiple developmental stages. The timing of the transition from dependence on maternally stored gene products to reliance on zygotically coded products has been examined for several zygotic-lethal mutations in the z-w region of the X chromosome. The mutants differ in zygotic sensitivity to reduced maternal activity, and they have a wide range of times of lethality. Nevertheless, both temperature shift experiments and clonal analysis indicate that all of the maternal-zygotic transitions occur around the time of blastoderm formation.

Genetically induced mitotic exchange in the heterochromatin of Drosophila melanogaster.

Multiple copies of the 18S and 28S ribosomal RNA cistrons are present in both the X and Y chromosomes of Drosophila melanogaster. Data are presented here that identify a locus, Rex, that causes exchange-like events between duplicated ribosomal complexes at the ends of an attached-XY chromosome. Rex: (1) is close to or in the basal heterochromatin of the X chromosome; (2) is semidominant and (its effect) is temperature sensitive; (3) acts maternally; and (4) affects behavior of paternally derived attached-XY chromosomes shortly after fertilization. Though, at this point, the existence of Rex is known only from its effects on behavior of a particular compound chromosome, it presents intriguing possibilities for understanding regulation of chromosome behavior and organization of the ribosomal cistrons.

Exchange within heterozygous inversions in Drosophila melanogaster.

The exchange behavior of non-attached, whole arm, X chromosome inversions was reexamined using nondisjunction in XXY females as an indirect measure of the frequency of nonexchange tetrads. Crossing over is quite normal in these inversion heterozygotes and is independent of the arrangement of the basal heterochromatin.

Are unpaired chromosomes spermicidal?: A maximum-likelihood analysis of segregation and meiotic drive in Drosophila melanogaster males deficient for the ribosomal-dna.

Meiosis in Drosophila melanogaster males is achiasmate and requires special systems to ensure normal segregation. Several situations that yield frequent nondisjunction also produce high levels of chromatin-dependent sperm lethality, suggesting the possibility of a simple and direct connection between defective disjunction and defective sperm development. One hypothesis that has been offered is that pairing not only ensures disjunction, but also changes the physical state of chromosomes so that they can be packaged in sperm. Here, I present an analysis of extensive data on disjunction and sperm survival in rDNA-deficient males collected by B. McKee and D. Lindsley. This analysis demonstrates that, although nondisjunction and sperm lethality are indeed correlated, the basis of this is not the presence of unpaired chromosomes in the sperm. Chromosomes that have failed to disjoin are not themselves spermicidal.

The meiotic effect of a deficiency in Drosophila melanogaster with a model for the effects of enzyme deficiency on recombination.

The meiotic effects of heterozygosity for a deficiency of the zeste-white region of the X chromosome include reduced recombination and increased non-disjunction of the entire chromosome complement. Reduced dosage of a gene or genes in the zeste-white interval, rather than structural heterozygosity, is responsible for the meiotic effect. A model for the recombination effects of reduced enzyme concentration has been developed, and its consequences are comparable with the results obtained for deficiency heterozygosity. Thus, all of the observations can be accounted for by imagining a dosage-sensitive locus in the zeste-white region that codes for an enzyme involved in the recombination process. The interaction of the interchromosomal effect of heterozygous inversions with the deficiency has been examined, and the possibility of using the model for the analysis of other meiotic phenomena is considered.

Chromosome damage and early developmental arrest caused by the Rex element of Drosophila melanogaster.

Rex (Ribosomal exchange) is a genetically identified repeated element within the ribosomal DNA (rDNA) of Drosophila melanogaster. Rex has a semidominant maternal effect that promotes exchange between and within rDNA arrays in the first few embryonic mitoses. Several of Rex's genetic properties suggest that its primary effect is rDNA-specific chromosome breakage that is resolved by recombination. We report here that rDNA crossovers are only a small, surviving minority of Rex-induced events. Cytology of embryos produced by Rex-homozygous females reveals obvious chromosome damage in at least a quarter of the embryos within the first three mitotic divisions. More than half of the embryos produced by Rex females die, and the developmental arrest is among the earliest reported for any maternal-effect lethal. The striking lethal phenotype suggests that embryos with early chromosome damage could be particularly fruitful subjects for analysis of the cell biology of early embryos.

Rex and a suppressor of Rex are repeated neomorphic loci in the Drosophila melanogaster ribosomal DNA.

The Rex locus of Drosophila melanogaster induces a high frequency of mitotic exchange between two separated ribosomal DNA arrays on a single chromosome. The exchanges take place in the progeny of Rex mothers and occur very early, before the third mitotic division. A number of common laboratory stocks have also been found to carry dominant suppressors of Rex (Su(Rex)). Rex was mapped to the X centric heterochromatin, proximal to su(f), by genetic and molecular analysis of two spontaneous recombinants. Using deficiencies and duplications of the heterochromatin, both Rex and one Su(Rex) were shown to behave as neomorphs. Rex-induced exchange in a target chromosome bearing both Rex and Su(Rex) was then used to map these functions to the bb locus itself. Molecular analysis of the recombinants, using length variants of the ribosomal DNA intergenic spacer as genetic markers, mapped Su(Rex) and Rex within the bb locus and demonstrated that both are repeated elements.

Rex-induced recombination implies bipolar organization of the ribosomal RNA genes of Drosophila melanogaster.

Rex-induced mitotic recombination was used to determine whether nucleolus organizers can pair in both inverted and noninverted orientations. Two target chromosomes, each duplicated for the rDNA region, were exposed to maternal Rex activity. Recombination in one orientation should yield deletion of the material between the two nucleolus organizers, recombination in the other orientation should yield inversion of the same material. Both products were recovered from both target chromosomes. The generality of using Rex-mediated recombination for analysis of the rDNA is considered.