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1.
J Endocrinol ; 258(3)2023 09 01.
Article in English | MEDLINE | ID: mdl-37343234

ABSTRACT

11ß-Hydroxysteroid dehydrogenase 1 (11ßHSD1) is a drug target to attenuate adverse effects of chronic glucocorticoid excess. It catalyses intracellular regeneration of active glucocorticoids in tissues including brain, liver and adipose tissue (coupled to hexose-6-phosphate dehydrogenase, H6PDH). 11ßHSD1 activity in individual tissues is thought to contribute significantly to glucocorticoid levels at those sites, but its local contribution vs glucocorticoid delivery via the circulation is unknown. Here, we hypothesised that hepatic 11ßHSD1 would contribute significantly to the circulating pool. This was studied in mice with Cre-mediated disruption of Hsd11b1 in liver (Alac-Cre) vs adipose tissue (aP2-Cre) or whole-body disruption of H6pdh. Regeneration of [9,12,12-2H3]-cortisol (d3F) from [9,12,12-2H3]-cortisone (d3E), measuring 11ßHSD1 reductase activity was assessed at steady state following infusion of [9,11,12,12-2H4]-cortisol (d4F) in male mice. Concentrations of steroids in plasma and amounts in liver, adipose tissue and brain were measured using mass spectrometry interfaced with matrix-assisted laser desorption ionisation or liquid chromatography. Amounts of d3F were higher in liver, compared with brain and adipose tissue. Rates of appearance of d3F were ~6-fold slower in H6pdh-/- mice, showing the importance for whole-body 11ßHSD1 reductase activity. Disruption of liver 11ßHSD1 reduced the amounts of d3F in liver (by ~36%), without changes elsewhere. In contrast disruption of 11ßHSD1 in adipose tissue reduced rates of appearance of circulating d3F (by ~67%) and also reduced regenerated of d3F in liver and brain (both by ~30%). Thus, the contribution of hepatic 11ßHSD1 to circulating glucocorticoid levels and amounts in other tissues is less than that of adipose tissue.


Subject(s)
Cortisone , Glucocorticoids , Male , Mice , Animals , Hydrocortisone , Adipose Tissue , Steroids , 11-beta-Hydroxysteroid Dehydrogenase Type 1/genetics
2.
Epidemiol Infect ; 147: e175, 2019 01.
Article in English | MEDLINE | ID: mdl-31063115

ABSTRACT

Declining mortality following invasive pneumococcal disease (IPD) has been observed concurrent with a reduced incidence due to effective pneumococcal conjugate vaccines. However, with IPD now increasing due to serotype replacement, we undertook a statistical analysis to estimate the trend in all-cause 30-day case fatality rate (CFR) in the North East of England (NEE) following IPD. Clinical, microbiological and demographic data were obtained for all laboratory-confirmed IPD cases (April 2006-March 2016) and the adjusted association between CFR and epidemiological year estimated using logistic regression. Of the 2510 episodes of IPD included in the analysis, 486 died within 30 days of IPD (CFR 19%). Increasing age, male sex, a diagnosis of septicaemia, being in ⩾1 clinical risk groups, alcohol abuse and individual serotypes were independently associated with increased CFR. A significant decline in CFR over time was observed following adjustment for these significant predictors (adjusted odds ratio 0.93, 95% confidence interval 0.89-0.98; P = 0.003). A small but significant decline in 30-day all-cause CFR following IPD has been observed in the NEE. Nonetheless, certain population groups remain at increased risk of dying following IPD. Despite the introduction of effective vaccines, further strategies to reduce the ongoing burden of mortality from IPD are needed.


Subject(s)
Pneumococcal Infections/mortality , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , England/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Mortality/trends , Pneumococcal Infections/microbiology , Young Adult
3.
J Endocrinol ; 241(3): 279-292, 2019 06 01.
Article in English | MEDLINE | ID: mdl-31013474

ABSTRACT

Endogenous glucocorticoid action is important in the structural and functional maturation of the fetal heart. In fetal mice, although glucocorticoid concentrations are extremely low before E14.5, glucocorticoid receptor (GR) is expressed in the heart from E10.5. To investigate whether activation of cardiac GR prior to E14.5 induces precocious fetal heart maturation, we administered dexamethasone in the drinking water of pregnant dams from E12.5 to E15.5. To test the direct effects of glucocorticoids upon the cardiovascular system we used SMGRKO mice, with Sm22-Cre-mediated disruption of GR in cardiomyocytes and vascular smooth muscle. Contrary to expectations, echocardiography showed no advancement of functional maturation of the fetal heart. Moreover, litter size was decreased 2 days following cessation of antenatal glucocorticoid exposure, irrespective of fetal genotype. The myocardial performance index and E/A wave ratio, markers of fetal heart maturation, were not significantly affected by dexamethasone treatment in either genotype. Dexamethasone treatment transiently decreased the myocardial deceleration index (MDI; a marker of diastolic function), in control fetuses at E15.5, with recovery by E17.5, 2 days after cessation of treatment. MDI was lower in SMGRKO than in control fetuses and was unaffected by dexamethasone. The transient decrease in MDI was associated with repression of cardiac GR in control fetuses following dexamethasone treatment. Measurement of glucocorticoid levels in fetal tissue and hypothalamic corticotropin-releasing hormone (Crh) mRNA levels suggest complex and differential effects of dexamethasone treatment upon the hypothalamic-pituitary-adrenal axis between genotypes. These data suggest potentially detrimental and direct effects of antenatal glucocorticoid treatment upon fetal heart function.


Subject(s)
Dexamethasone/pharmacology , Diastole/drug effects , Fetal Heart/drug effects , Maternal Exposure , Animals , Body Weight , Female , Fetal Heart/diagnostic imaging , Genotype , Glucocorticoids/pharmacology , Hypothalamo-Hypophyseal System/metabolism , Male , Mice , Mice, Inbred C57BL , Muscle, Smooth, Vascular/metabolism , Myocytes, Cardiac/metabolism , Organ Size , Pituitary-Adrenal System/metabolism , RNA, Messenger/metabolism , Receptors, Glucocorticoid/metabolism
4.
Neurology ; 90(19): e1692-e1701, 2018 05 08.
Article in English | MEDLINE | ID: mdl-29643084

ABSTRACT

OBJECTIVE: To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). METHODS: This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. RESULTS: We studied 219 patients (53% males) with a median (25th-75th percentiles [p25-p75]) age of 3.9 (1.2-9.5) years in whom rSE started out of hospital (141 [64.4%]) or in hospital (78 [35.6%]). The median (p25-p75) time from seizure onset to treatment was 16 (5-45) minutes to first benzodiazepine (BZD), 63 (33-146) minutes to first non-BZD antiepileptic drug (AED), and 170 (107-539) minutes to first continuous infusion. Factors associated with more delays to administration of the first BZD were intermittent rSE (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.14-2.09; p = 0.0467) and out-of-hospital rSE onset (HR 1.5, 95% CI 1.11-2.04; p = 0.0467). Factors associated with more delays to administration of the first non-BZD AED were intermittent rSE (HR 1.78, 95% CI 1.32-2.4; p = 0.001) and out-of-hospital rSE onset (HR 2.25, 95% CI 1.67-3.02; p < 0.0001). None of the studied factors were associated with a delayed administration of continuous infusion. CONCLUSION: Intermittent rSE and out-of-hospital rSE onset are independently associated with longer delays to administration of the first BZD and the first non-BZD AED in pediatric rSE. These factors identify potential targets for intervention to reduce time to treatment.


Subject(s)
Anticonvulsants/therapeutic use , Benzodiazepines/therapeutic use , Drug Resistant Epilepsy/drug therapy , Status Epilepticus/drug therapy , Time-to-Treatment , Adolescent , Child , Child, Preschool , Female , Hospitalization/statistics & numerical data , Humans , Infant , Infant, Newborn , Male , Prospective Studies , Retrospective Studies , Statistics, Nonparametric , Treatment Outcome , Young Adult
5.
Sci Rep ; 7(1): 13835, 2017 10 23.
Article in English | MEDLINE | ID: mdl-29062028

ABSTRACT

Malaria is a global disease associated with considerable mortality and morbidity. An appropriately balanced immune response is crucial in determining the outcome of malarial infection. The glucocorticoid (GC) metabolising enzyme, 11ß-hydroxysteroid dehydrogenase-1 (11ß-HSD1) converts intrinsically inert GCs into active GCs. 11ß-HSD1 shapes endogenous GC action and is immunomodulatory. We investigated the role of 11ß-HSD1 in two mouse models of malaria. 11ß-HSD1 deficiency did not affect survival after malaria infection, but it increased disease severity and parasitemia in mice infected with Plasmodium chabaudi AS. In contrast, 11ß-HSD1 deficiency rather decreased parasitemia in mice infected with the reticulocyte-restricted parasite Plasmodium berghei NK65 1556Cl1. Malaria-induced antibody production and pathology were unaltered by 11ß-HSD1 deficiency though plasma levels of IL-4, IL-6 and TNF-α were slightly affected by 11ß-HSD1 deficiency, dependent on the infecting parasite. These data suggest that 11ß-HSD1 is not crucial for survival of experimental malaria, but alters its progression in a parasite strain-specific manner.


Subject(s)
11-beta-Hydroxysteroid Dehydrogenase Type 1/deficiency , Malaria/metabolism , Parasitemia/metabolism , Plasmodium chabaudi/metabolism , Animals , Cytokines/genetics , Cytokines/metabolism , Female , Malaria/genetics , Male , Mice , Mice, Mutant Strains , Parasitemia/genetics , Species Specificity
6.
Epidemiol Infect ; 144(12): 2654-69, 2016 09.
Article in English | MEDLINE | ID: mdl-27193457

ABSTRACT

Invasive pneumococcal disease (IPD), caused by infection with Streptococcus pneumoniae, has a substantial global burden. There are over 90 known serotypes of S. pneumoniae with a considerable body of evidence supporting serotype-specific mortality rates immediately following IPD. This is the first study to consider the association between serotype and longer-term mortality following IPD. Using enhanced surveillance data from the North East of England we assessed both the short-term (30-day) and longer-term (⩽7 years) independent adjusted associations between individual serotypes and mortality following IPD diagnosis using logistic regression and extended Cox proportional hazards models. Of the 1316 cases included in the analysis, 243 [18·5%, 95% confidence interval (CI) 16·4-20·7] died within 30 days of diagnosis. Four serotypes (3, 6A, 9N, 19 F) were significantly associated with overall increased 30-day mortality. Effects were observable only for older adults (⩾60 years). After extension of the window to 12 months and 36 months, one serotype was associated with significantly increased mortality at 12 months (19 F), but no individual serotypes were associated with increased mortality at 36 months. Two serotypes had statistically significant hazard ratios (HR) for longer-term mortality: serotype 1 for reduced mortality (HR 0·51, 95% CI 0·30-0·86) and serotype 9N for increased mortality (HR 2·30, 95% CI 1·29-4·37). The association with serotype 9N was no longer observed after limiting survival analysis to an observation period starting 30 days after diagnosis. This study supports the evidence for associations between serotype and short-term (30-day) mortality following IPD and provides the first evidence for the existence of statistically significant associations between individual serotypes and longer-term variation in mortality following IPD.


Subject(s)
Pneumococcal Infections/mortality , Population Surveillance , Serogroup , Streptococcus pneumoniae/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , England/epidemiology , Humans , Infant , Infant, Newborn , Middle Aged , Pneumococcal Infections/microbiology , Streptococcus pneumoniae/genetics , Young Adult
7.
J Neuroendocrinol ; 28(1)2016 Jan.
Article in English | MEDLINE | ID: mdl-26563879

ABSTRACT

Mice deficient in the glucocorticoid-regenerating enzyme 11ß-HSD1 resist age-related spatial memory impairment. To investigate the mechanisms and pathways involved, we used microarrays to identify differentially expressed hippocampal genes that associate with cognitive ageing and 11ß-HSD1. Aged wild-type mice were separated into memory-impaired and unimpaired relative to young controls according to their performance in the Y-maze. All individual aged 11ß-HSD1-deficient mice showed intact spatial memory. The majority of differentially expressed hippocampal genes were increased with ageing (e.g. immune/inflammatory response genes) with no genotype differences. However, the neuronal-specific transcription factor, Npas4, and immediate early gene, Arc, were reduced (relative to young) in the hippocampus of memory-impaired but not unimpaired aged wild-type or aged 11ß-HSD1-deficient mice. A quantitative reverse transcriptase-polymerase chain reaction and in situ hybridisation confirmed reduced Npas4 and Arc mRNA expression in memory-impaired aged wild-type mice. These findings suggest that 11ß-HSD1 may contribute to the decline in Npas4 and Arc mRNA levels associated with memory impairment during ageing, and that decreased activity of synaptic plasticity pathways involving Npas4 and Arc may, in part, underlie the memory deficits seen in cognitively-impaired aged wild-type mice.


Subject(s)
11-beta-Hydroxysteroid Dehydrogenase Type 1/metabolism , Aging/metabolism , Basic Helix-Loop-Helix Transcription Factors/metabolism , Cytoskeletal Proteins/metabolism , Hippocampus/metabolism , Memory Disorders/metabolism , Nerve Tissue Proteins/metabolism , 11-beta-Hydroxysteroid Dehydrogenase Type 1/genetics , Aging/genetics , Animals , Basic Helix-Loop-Helix Transcription Factors/genetics , Cytoskeletal Proteins/genetics , Maze Learning/physiology , Memory/physiology , Memory Disorders/genetics , Mice , Mice, Knockout , Nerve Tissue Proteins/genetics , RNA, Messenger/genetics , RNA, Messenger/metabolism , Spatial Memory/physiology
8.
Mol Cell Endocrinol ; 414: 120-31, 2015 Oct 15.
Article in English | MEDLINE | ID: mdl-26219824

ABSTRACT

BACKGROUND: Transient early-life perturbations in glucocorticoids (GC) are linked with cardiovascular disease risk in later life. Here the impact of early life manipulations of GC on adult heart structure, function and gene expression were assessed. METHODS AND RESULTS: Zebrafish embryos were incubated in dexamethasone (Dex) or injected with targeted glucocorticoid receptor (GR) morpholino knockdown (GR Mo) over the first 120 h post fertilisation (hpf); surviving embryos (>90%) were maintained until adulthood under normal conditions. Cardiac function, heart histology and cardiac genes were assessed in embryonic (120 hpf) and adult (120 days post fertilisation (dpf)) hearts. GR Mo embryos (120 hpf) had smaller hearts with fewer cardiomyocytes, less mature striation pattern, reduced cardiac function and reduced levels of vmhc and igf mRNA compared with controls. GR Mo adult hearts were smaller with diminished trabecular network pattern, reduced expression of vmhc and altered echocardiographic Doppler flow compared to controls. Dex embryos had larger hearts at 120 hpf (Dex 107.2 ± 3.1 vs. controls 90.2 ± 1.1 µm, p < 0.001) with a more mature trabecular network and larger cardiomyocytes (1.62 ± 0.13 cells/µm vs control 2.18 ± 0.13 cells/µm, p < 0.05) and enhanced cardiac performance compared to controls. Adult hearts were larger (1.02 ± 0.07 µg/mg vs controls 0.63 ± 0.06 µg/mg, p = 0.0007), had increased vmhc and gr mRNA levels. CONCLUSION: Perturbations in GR activity during embryonic development results in short and long-term alterations in the heart.


Subject(s)
Dexamethasone/adverse effects , Glucocorticoids/metabolism , Heart/drug effects , Receptors, Glucocorticoid/administration & dosage , Zebrafish/embryology , Animals , Embryo Culture Techniques , Gene Expression Regulation, Developmental/drug effects , Heart/embryology , Heart/physiopathology , Heart Function Tests/drug effects , Myocytes, Cardiac/drug effects , Myocytes, Cardiac/metabolism , Myocytes, Cardiac/pathology , Somatomedins/genetics , Ventricular Myosins/genetics , Zebrafish Proteins/genetics
9.
Cell Death Differ ; 22(7): 1106-16, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25361084

ABSTRACT

Glucocorticoid levels rise dramatically in late gestation to mature foetal organs in readiness for postnatal life. Immature heart function may compromise survival. Cardiomyocyte glucocorticoid receptor (GR) is required for the structural and functional maturation of the foetal heart in vivo, yet the molecular mechanisms are largely unknown. Here we asked if GR activation in foetal cardiomyocytes in vitro elicits similar maturational changes. We show that physiologically relevant glucocorticoid levels improve contractility of primary-mouse-foetal cardiomyocytes, promote Z-disc assembly and the appearance of mature myofibrils, and increase mitochondrial activity. Genes induced in vitro mimic those induced in vivo and include PGC-1α, a critical regulator of cardiac mitochondrial capacity. SiRNA-mediated abrogation of the glucocorticoid induction of PGC-1α in vitro abolished the effect of glucocorticoid on myofibril structure and mitochondrial oxygen consumption. Using RNA sequencing we identified a number of transcriptional regulators, including PGC-1α, induced as primary targets of GR in foetal cardiomyocytes. These data demonstrate that PGC-1α is a key mediator of glucocorticoid-induced maturation of foetal cardiomyocyte structure and identify other candidate transcriptional regulators that may play critical roles in the transition of the foetal to neonatal heart.


Subject(s)
Fetal Heart/physiology , Glucocorticoids/pharmacology , Mitochondria/metabolism , Myocytes, Cardiac/physiology , Transcription Factors/physiology , Animals , Gene Expression Regulation, Developmental , Mice , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha , Receptors, Glucocorticoid/metabolism , Signal Transduction
10.
Mutagenesis ; 29(3): 165-75, 2014 May.
Article in English | MEDLINE | ID: mdl-24675152

ABSTRACT

Recent restrictions on the testing of cosmetic ingredients in animals have resulted in the need to test the genotoxic potential of chemicals exclusively in vitro prior to licensing. However, as current in vitro tests produce some misleading positive results, sole reliance on such tests could prevent some chemicals with safe or beneficial exposure levels from being marketed. The 3D human reconstructed skin micronucleus (RSMN) assay is a promising new in vitro approach designed to assess genotoxicity of dermally applied compounds. The assay utilises a highly differentiated in vitro model of the human epidermis. For the first time, we have applied automated micronucleus detection to this assay using MetaSystems Metafer Slide Scanning Platform (Metafer), demonstrating concordance with manual scoring. The RSMN assay's fixation protocol was found to be compatible with the Metafer, providing a considerably shorter alternative to the recommended Metafer protocol. Lowest observed genotoxic effect levels (LOGELs) were observed for mitomycin-C at 4.8 µg/ml and methyl methanesulfonate (MMS) at 1750 µg/ml when applied topically to the skin surface. In-medium dosing with MMS produced a LOGEL of 20 µg/ml, which was very similar to the topical LOGEL when considering the total mass of MMS added. Comparisons between 3D medium and 2D LOGELs resulted in a 7-fold difference in total mass of MMS applied to each system, suggesting a protective function of the 3D microarchitecture. Interestingly, hydrogen peroxide (H2O2), a positive clastogen in 2D systems, tested negative in this assay. A non-genotoxic carcinogen, methyl carbamate, produced negative results, as expected. We also demonstrated expression of the DNA repair protein N-methylpurine-DNA glycosylase in EpiDerm™. Our preliminary validation here demonstrates that the RSMN assay may be a valuable follow-up to the current in vitro test battery, and together with its automation, could contribute to minimising unnecessary in vivo tests by reducing in vitro misleading positives.


Subject(s)
Micronucleus Tests/methods , Skin/drug effects , Skin/pathology , Automation , Carbamates/toxicity , Cell Line , DNA Glycosylases/genetics , Dose-Response Relationship, Drug , Gene Expression/drug effects , Humans , Hydrogen Peroxide/toxicity , Keratinocytes/drug effects , Keratinocytes/metabolism , Keratinocytes/pathology , Methyl Methanesulfonate/toxicity , Micronucleus Tests/statistics & numerical data , Mitomycin/toxicity , RNA, Messenger/genetics , RNA, Messenger/metabolism , Reproducibility of Results , Skin/metabolism , Tissue Culture Techniques/methods
11.
J Public Health (Oxf) ; 35(4): 558-69, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23447693

ABSTRACT

BACKGROUND: Some communicable diseases disproportionately affect poor and vulnerable groups. Invasive pneumococcal disease (IPD) is an important cause of morbidity and mortality; however, the relationship between IPD and deprivation has not been well described. METHODS: Population based study assessing the relationship between incidence of IPD and deprivation in the North East of England using data from an enhanced IPD surveillance system and the 2010 Indices of Multiple Deprivation and the Rural and Urban Area Classification. RESULTS: The incidence of IPD increased linearly with increasing deprivation from 7.0 per 100 000 population to 13.6 per 100 000 population. This association was demonstrated for the 16-64 and ≥65 year age groups, but not the <16 year age group. IPD incidence was strongly associated with all individual domains of deprivation except for the 'barriers to housing and services' domain. IPD incidence was higher in urban than rural areas. CONCLUSIONS: The risk of IPD is strongly associated with deprivation in adults, but not children. The mechanisms producing the associations observed remain unclear and require further investigation. Findings from this study reinforce the need to address social inequalities to reduce the burden of disease. Targeting vaccination at adults living in deprived areas could reduce the burden of IPD.


Subject(s)
Pneumococcal Infections/epidemiology , Poverty/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , England/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Population Surveillance , Risk Factors , Rural Population/statistics & numerical data , Urban Population/statistics & numerical data , Young Adult
12.
Psychoneuroendocrinology ; 38(5): 648-58, 2013 May.
Article in English | MEDLINE | ID: mdl-22980941

ABSTRACT

An imbalance between central glucocorticoid (GR) and mineralocorticoid (MR) receptors is proposed to underlie the HPA axis dysregulation that associates with susceptibility to psychopathology (anxiety, PTSD). To test this 'balance hypothesis' we examined whether the impact of MR levels upon HPA-axis control and behaviour depended on the relative levels of GR and vice versa. Avoiding antenatal maternal 'programming' effects by using littermates, we generated mice with forebrain MR over-expression (MR(hi)) and/or simultaneous global GR under-expression (GR(lo)). We found a significant interaction between MR and GR in control of the HPA-axis under stressed but not basal conditions. With reduced GR levels, HPA-axis activity in response to restraint stress was enhanced, likely due to impaired negative feedback. However, high MR in concert with reduced GR minimised this HPA-axis overshoot in response to stress. MR:GR balance also played a role in determining strategies of spatial memory during a watermaze probe trial: when coupled with GR under-expression, MR(hi) show enhanced perseveration, suggesting enhanced spatial recall or reduced exploratory flexibility. Other alterations in cognitive functions were specific to a single receptor without interaction, with both MR(hi) and GR(lo) manipulations independently impairing reversal learning in spatial and fear memory tasks. Thus, MR and GR interact in specific domains of neuroendocrine and cognitive control, but for other limbic-associated behaviours each receptor mediates its own repertoire of responses. Since modulation of HPA-axis and behavioural dysfunction associated with high levels of MR, selective ligands or transcriptional regulators may afford novel therapeutic approaches to affective psychopathologies.


Subject(s)
Behavior, Animal/physiology , Hypothalamo-Hypophyseal System/metabolism , Pituitary-Adrenal System/metabolism , Receptors, Glucocorticoid/genetics , Receptors, Mineralocorticoid/genetics , Animals , Cognition/physiology , Gene Expression Regulation/physiology , Hypothalamo-Hypophyseal System/physiology , Hypothalamo-Hypophyseal System/physiopathology , Male , Memory/physiology , Mice , Mice, Inbred C57BL , Mice, Transgenic , Pituitary-Adrenal System/physiopathology , Receptors, Glucocorticoid/metabolism , Receptors, Mineralocorticoid/metabolism , Restraint, Physical/physiology
13.
Epidemiol Infect ; 141(2): 344-52, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22564258

ABSTRACT

The 7-valent pneumococcal conjugate vaccine (PCV7) has been included in the routine childhood immunization programme in the UK since September 2006. A population-based study of serotypes causing invasive pneumococcal disease (IPD) post-PCV7 in North East England was conducted using data from a regional enhanced IPD surveillance system. Overall, there was a 20% reduction [95% confidence interval (CI) 5-32] from 12·1 cases/100 000 population in 2006/2007 to 9·7 in 2009/2010. There was a fall in IPD caused by PCV7 serotypes in all age groups, with reductions of 90% (95% CI 61-99) in children aged <5 years, 50% (95% CI 4-75) in persons aged 5-64 years and 66% (95% CI 40-82) in adults aged ⩾65 years. There was a non-significant increase in IPD caused by non-PCV7 serotypes in children aged <5 years of 88% (95% CI -10 to 312) and adults aged ⩾65 years of 12% (95% CI -19 to 50), which was largely caused by serotypes 7F, 19A and 22F. Replacement disease appears to have reduced the benefits of PCV7 in North East England.


Subject(s)
Epidemiological Monitoring , Pneumococcal Infections/epidemiology , Pneumococcal Vaccines/immunology , Streptococcus pneumoniae/immunology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , England , Hospitalization , Humans , Immunization Programs/statistics & numerical data , Middle Aged , Pneumococcal Infections/immunology , Pneumococcal Infections/prevention & control , Serotyping , Vaccination , Vaccines, Conjugate/immunology
14.
Horm Metab Res ; 42(11): 821-5, 2010 Oct.
Article in English | MEDLINE | ID: mdl-20711951

ABSTRACT

Peroxisomal proliferator-activated receptors (PPARs) play an important role in the regulation of lipid metabolism. The aim of this study was to investigate the effects of a maternal high-fat (HF) diet on serum lipid concentration and PPAR gene expression in liver and adipose tissue in the early life of the rat offspring. Female Sprague-Dawley rats were fed either an HF or control (CON) diet 6 weeks before mating and throughout gestation and lactation. Blood and tissue samplings of male offspring were carried out at birth or weaning. Birth weights were similar and serum triglyceride (TG) and nonesterified fatty acid (NEFA) levels showed no significant difference between HF and CON newborns, despite greatly increased hepatic PPARα mRNA expression in the HF newborns (p<0.05). Both HF newborns and weanlings revealed significantly decreased hepatic PPARγ expression compared with controls (p<0.0001). Hepatic PPARα expression in the HF weanlings was reduced markedly compared with CON weanlings (p<0.0001) and showed a negative correlation with serum TG levels (r=-0.743, p<0.05). However, epididymal expression of PPARγ in the HF weanlings was upregulated significantly compared with controls (p<0.05) and demonstrated a positive correlation with epididymal fat mass (r=0.733, p<0.05). These were accompanied by obesity as well as a rise in serum TG by 79% (p<0.05) and NEFA concentration by 36% (p<0.05) in these HF weanlings. Our findings suggest that maternal HF diet leads to alterations in PPAR gene expression in the weanling offspring, which is associated with the disturbed lipid homeostasis.


Subject(s)
Dietary Fats/pharmacology , Lipids/blood , Peroxisome Proliferator-Activated Receptors/metabolism , Animals , Animals, Newborn , Body Weight/drug effects , Female , Rats , Rats, Sprague-Dawley
15.
FASEB J ; 22(11): 3896-907, 2008 Nov.
Article in English | MEDLINE | ID: mdl-18697839

ABSTRACT

Glucocorticoid hormones are critical to respond and adapt to stress. Genetic variations in the glucocorticoid receptor (GR) gene alter hypothalamic-pituitary-adrenal (HPA) axis activity and associate with hypertension and susceptibility to metabolic disease. Here we test the hypothesis that reduced GR density alters blood pressure and glucose and lipid homeostasis and limits adaption to obesogenic diet. Heterozygous GR(betageo/+) mice were generated from embryonic stem (ES) cells with a gene trap integration of a beta-galactosidase-neomycin phosphotransferase (betageo) cassette into the GR gene creating a transcriptionally inactive GR fusion protein. Although GR(betageo/+) mice have 50% less functional GR, they have normal lipid and glucose homeostasis due to compensatory HPA axis activation but are hypertensive due to activation of the renin-angiotensin-aldosterone system (RAAS). When challenged with a high-fat diet, weight gain, adiposity, and glucose intolerance were similarly increased in control and GR(betageo/+) mice, suggesting preserved control of intermediary metabolism and energy balance. However, whereas a high-fat diet caused HPA activation and increased blood pressure in control mice, these adaptions were attenuated or abolished in GR(betageo/+) mice. Thus, reduced GR density balanced by HPA activation leaves glucocorticoid functions unaffected but mineralocorticoid functions increased, causing hypertension. Importantly, reduced GR limits HPA and blood pressure adaptions to obesogenic diet.


Subject(s)
Blood Pressure/drug effects , Diet/adverse effects , Dietary Fats/adverse effects , Hypertension/metabolism , Hypothalamo-Hypophyseal System/metabolism , Pituitary-Adrenal System/metabolism , Receptors, Glucocorticoid/metabolism , Adiposity/drug effects , Adiposity/genetics , Aldosterone/metabolism , Angiotensins/metabolism , Animals , Blood Glucose/metabolism , Cell Line , Dietary Fats/pharmacology , Glucose Intolerance/genetics , Glucose Intolerance/metabolism , Humans , Hypertension/chemically induced , Hypertension/genetics , Lipid Metabolism/genetics , Mice , Mice, Transgenic , Receptors, Glucocorticoid/genetics , Renin/metabolism , Weight Gain/drug effects , Weight Gain/genetics
17.
Endocrinology ; 149(4): 1861-8, 2008 Apr.
Article in English | MEDLINE | ID: mdl-18174284

ABSTRACT

Glucocorticoid excess promotes visceral obesity and cardiovascular disease. Similar features are found in the highly prevalent metabolic syndrome in the absence of high levels of systemic cortisol. Although elevated activity of the glucocorticoid-amplifying enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) within adipocytes might explain this paradox, the potential role of 11beta-HSD1 in preadipocytes is less clear; human omental adipose stromal vascular (ASV) cells exhibit 11beta-dehydrogenase activity (inactivation of glucocorticoids) probably due to the absence of cofactor provision by hexose-6-phosphate dehydrogenase. To clarify the depot-specific impact of 11beta-HSD1, we assessed whether preadipocytes in ASV from mesenteric (as a representative of visceral adipose tissue) and sc tissue displayed 11beta-HSD1 activity in mice. 11beta-HSD1 was highly expressed in freshly isolated ASV cells, predominantly in preadipocytes. 11beta-HSD1 mRNA and protein levels were comparable between ASV and adipocyte fractions in both depots. 11beta-HSD1 was an 11beta-reductase, thus reactivating glucocorticoids in ASV cells, consistent with hexose-6-phosphate dehydrogenase mRNA expression. Unexpectedly, glucocorticoid reactivation was higher in intact mesenteric ASV cells despite a lower expression of 11beta-HSD1 mRNA and protein (homogenate activity) levels than sc ASV cells. This suggests a novel depot-specific control over 11beta-HSD1 enzyme activity. In vivo, high-fat diet-induced obesity was accompanied by increased visceral fat preadipocyte differentiation in wild-type but not 11beta-HSD1(-/-) mice. The results suggest that 11beta-HSD1 reductase activity is augmented in mouse mesenteric preadipocytes where it promotes preadipocyte differentiation and contributes to visceral fat accumulation in obesity.


Subject(s)
11-beta-Hydroxysteroid Dehydrogenase Type 1/physiology , Adipocytes/enzymology , Intra-Abdominal Fat/metabolism , Obesity/etiology , Stem Cells/enzymology , 11-beta-Hydroxysteroid Dehydrogenase Type 1/analysis , 11-beta-Hydroxysteroid Dehydrogenase Type 1/genetics , Animals , Cyclin-Dependent Kinase Inhibitor p27/analysis , Dietary Fats/administration & dosage , Male , Mice , Mice, Inbred C57BL , RNA, Messenger/analysis
18.
Nucleic Acids Res ; 35(5): 1402-10, 2007.
Article in English | MEDLINE | ID: mdl-17284462

ABSTRACT

Cre is widely used for DNA tailoring and, in combination with recombineering techniques, to modify BAC/PAC sequences for generating transgenic animals. However, mammalian genomes contain recombinase recognition sites (cryptic loxP sites) that can promote illegitimate DNA recombination and damage when cells express the Cre recombinase gene. We have created a new bioinformatic tool, FuzznucComparator, which searches for cryptic loxP sites and we have applied it to the analysis of the whole mouse genome. We found that cryptic loxP sites occur frequently and are homogeneously distributed in the genome. Given the mammalian nature of BAC/PAC genomic inserts, we hypothesised that the presence of cryptic loxP sites may affect the ability to grow and modify BAC and PAC clones in E. coli expressing Cre recombinase. We have observed a defect in bacterial growth when some BACs and PACs were transformed into EL350, a DH10B-derived bacterial strain that expresses Cre recombinase under the control of an arabinose-inducible promoter. In this study, we have demonstrated that Cre recombinase expression is leaky in un-induced EL350 cells and that some BAC/PAC sequences contain cryptic loxP sites, which are active and mediate the introduction of single-strand nicks in BAC/PAC genomic inserts.


Subject(s)
Chromosomes, Artificial, Bacterial , Chromosomes, Artificial, P1 Bacteriophage , Genetic Engineering/methods , Genomics/methods , Integrases/metabolism , Recombination, Genetic , Software , Animals , Attachment Sites, Microbiological , Computational Biology , Escherichia coli/genetics , Escherichia coli/growth & development , Humans , Mice , Transformation, Bacterial
19.
Diabetologia ; 49(6): 1412-20, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16570165

ABSTRACT

AIMS/HYPOTHESIS: Prenatal glucocorticoid exposure causes lifelong hyperglycaemia in rat offspring, associated with permanently increased hepatic phosphoenolpyruvate carboxykinase 2 (PCK2), the rate-controlling enzyme of gluconeogenesis. To elucidate the mechanisms underlying the 'programming' of PCK2, this study examined the effect of prenatal dexamethasone treatment on expression of transcription factors that regulate Pck2. MATERIALS AND METHODS: Real-time RT-PCR and in situ hybridisation were used to measure and localise hepatic mRNA transcribed from the genes for PCK2, hepatocyte nuclear factor 4, alpha (HNF4A), transcription factor 1 (TCF1), CCAAT/enhancer binding protein, alpha (CEBPA), CEBPB, the glucocorticoid receptor (NR3C1) and peroxisome proliferative activated receptor, gamma, coactivator 1 alpha (PPARGC1A) in foetal and adult offspring of dams treated with dexamethasone or vehicle during the last week of gestation. RESULTS: Prenatal dexamethasone exposure significantly elevated Hnf4a mRNA expression in foetal and adult liver. This resulted from increased expression of isoforms derived from the 'adult' (P1) Hnf4a promoter. In contrast, isoforms from the 'foetal' (P2) promoter were markedly suppressed by dexamethasone. Like Pck2, the increase in hepatic Hnf4a mRNA occurred exclusively in the periportal zone. Foetal Tcf1 expression was also increased by dexamethasone treatment, but this did not persist into adulthood. Prenatal dexamethasone did not affect the amounts of foetal and/or adult Cebpa, Cebpb, Nr3c1 or Ppargc1a mRNA. CONCLUSIONS/INTERPRETATION: Prenatal dexamethasone exposure caused a permanent increase in hepatic Hnf4a mRNA. This increase, which was associated with a premature switch from foetal to adult promoter predominance, was congruent with changes in Pck2 expression. These data suggest that HNF4A might mediate Pck2 overexpression and subsequent hyperglycaemia.


Subject(s)
Gene Expression Regulation, Developmental , Hepatocyte Nuclear Factor 4/genetics , Hyperglycemia/embryology , Liver/embryology , Animals , Base Sequence , DNA Primers , Dexamethasone/pharmacology , Embryonic Development , Female , Fetal Development , Glucocorticoids/pharmacology , Hepatocyte Nuclear Factor 4/drug effects , Pregnancy , RNA, Messenger/genetics , Rats , Transcription, Genetic
20.
Neuroscience ; 118(4): 975-84, 2003.
Article in English | MEDLINE | ID: mdl-12732243

ABSTRACT

Hyperactivity of the hypothalamic-pituitary-adrenal axis is a characteristic feature of depressive illness. The centrally located corticosteroid receptors, the glucocorticoid and mineralocorticoid receptors, are thought to be important modulators of this axis and changes in the levels of these receptors, particularly in the hippocampus, may underlie the hyperactivity observed. Various antidepressant drugs increase hippocampal mineralocorticoid and glucocorticoid receptor levels in vivo. These effects are thought to be mediated via alterations in monoaminergic neurotransmission. We examined whether serotonin (5HT) and noradrenaline (NA) have direct effects on glucocorticoid receptor and mineralocorticoid receptor expression in primary hippocampal neurones, and whether antidepressants also exert direct effects on target neurones. Exposure of hippocampal cells to 5HT for 4 days increased both glucocorticoid and mineralocorticoid receptor mRNA and protein expression. The induction of mineralocorticoid receptor mRNA was completely blocked by the 5HT(7) receptor antagonist SB 269970. In contrast glucocorticoid receptor induction was insensitive to the 5HT(7) receptor, whilst studies with the 5HT(1A) receptor agonist 8-hydroxy-2-(di-n-proplamino) tetralin hydrochloride and the 5HT(1A) receptor antagonist N-[2-[4-2-[O-methoxyphenyl)-1-piperazinyl]ethyl]-N-(2-pyridinyl) cyclohexane carboxamide trihydrochloride (WAY 100635) suggest a partial role for 5HT(1A) receptors in hippocampal glucocorticoid receptor regulation. Treatment with NA for 4 days also increased glucocorticoid receptor expression but had no effect on mineralocorticoid receptor expression. This was blocked by propanolol suggesting action via beta-adrenergic receptors. Similarly to NA, fluoxetine and amitriptyline also selectively increased glucocorticoid receptor mRNA and protein levels over this time course. However, glucocorticoid receptor induction by fluoxetine or amitriptyline was not blocked by WAY 100635 or propanolol. These results show that 5HT, NA and antidepressants act directly but via distinct mechanisms on hippocampal neurones to regulate mineralocorticoid and glucocorticoid receptor expression. Thusly, manipulation of neurotransmitter or antidepressant levels in the brain may aid in reversing hypothalamic-pituitary-adrenal axis hyperactivity by restoring hippocampal corticosteroid receptor balance.


Subject(s)
Antidepressive Agents/pharmacology , Biogenic Monoamines/pharmacology , Gene Expression Regulation/drug effects , Hippocampus/drug effects , Membrane Transport Proteins , Nerve Tissue Proteins , Receptors, Steroid/genetics , 8-Hydroxy-2-(di-n-propylamino)tetralin/pharmacology , Adrenergic beta-Antagonists/pharmacology , Amitriptyline/pharmacology , Animals , Animals, Newborn , Blotting, Western/methods , Carrier Proteins/biosynthesis , Carrier Proteins/genetics , Culture Techniques , DNA Primers/metabolism , DNA, Complementary/biosynthesis , Drug Interactions/genetics , Female , Fluoxetine/pharmacology , Gene Expression Regulation/physiology , Hippocampus/metabolism , Membrane Glycoproteins/biosynthesis , Membrane Glycoproteins/genetics , Phenols/pharmacology , Piperazines/pharmacology , Pregnancy , Propranolol/pharmacology , Pyridines/pharmacology , RNA, Messenger/biosynthesis , Rats , Rats, Wistar , Receptors, Adrenergic/biosynthesis , Receptors, Adrenergic/genetics , Receptors, Serotonin/biosynthesis , Receptors, Serotonin/genetics , Receptors, Steroid/metabolism , Reverse Transcriptase Polymerase Chain Reaction/methods , Serotonin Plasma Membrane Transport Proteins , Serotonin Receptor Agonists/pharmacology , Selective Serotonin Reuptake Inhibitors/pharmacology , Sulfonamides/pharmacology
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