Cytokine upregulation in a murine model of familial amyotrophic lateral sclerosis.

Although pronounced changes in astrocytes and microglia accompany the neuronal degeneration observed in a murine model of familial amyotrophic lateral sclerosis, the significance of non-neuronal cell contribution to the disease process remains unclear. Activated astrocytes and microglia are capable of secreting numerous cytokines, some of which may have potentially harmful effects on neuron survival. For this reason we wished to determine the expression pattern of various cytokines in the spinal cords of transgenic mice expressing a Cu-Zn superoxide dismutase mutation (Tgn G93A SOD1) by using semi-quantitative RT-PCR. Three different patterns of cytokine expression were observed in G93A SOD1 transgenic mice. For most cytokines, we were unable to detect mRNA expression in Tgn G93A SOD1 mouse spinal cords at any age, yet message was readily detected in spleen or activated splenocytes. A second pattern, typified by TNF-alpha, was characterized by mRNA expression prior to the onset of motor deficits and increasing until the terminal stages of the disease. For other cytokines, including TGF-beta1 and M-CSF, mRNA expression was detected in young presymptomatic Tgn G93A SOD1 mice (as well as wild-type and transgenic mice expressing wild-type SOD1 (Tgn SOD1)), with upregulation later occurring only in G93A SOD1 transgenic mice. These results indicate a temporal correlation between the expression of certain cytokines and the onset of motor dysfunction in Tgn G93A SOD1 mice and suggest a potential role for these molecules in the disease.

Stress, coping styles, and hopelessness in self-poisoners.

This study examined the association between level of hopelessness with stress and coping style for a sample of 80 people who had recently attempted suicide. Higher levels of hopelessness were found to be associated with higher levels of stress. Level of hopelessness was also associated with the use of problem-focused but not with emotion-focused coping. Analyses of the interaction between stress and coping style suggested that these variables influence the level of hopelessness in an independent and linear fashion. The implications for clinical intervention are discussed.

Zinc and copper in the pathogenesis of amyotrophic lateral sclerosis.

1. Missense mutations in the gene encoding Cu,Zn superoxide dismutase (SOD1) are responsible for causing one form of familial amyotrophic lateral sclerosis (FALS) linked to chromosome 21q. 2. Mutant SOD1-induced disease is clearly related to a toxic gain of function for the abnormal enzyme, and recent work has begun to investigate the mechanisms underlying this toxicity. In addition to its well known and likely beneficial dismutase activity, wild type SOD1 also possesses the ability to participate in other enzymatic reactions that may be injurious to cells including peroxidation or nitration. 3. Many of the SOD1 mutations associated with FALS appear to increase the likelihood that the enzyme will perform either one of these potentially harmful functions resulting in increased hydroxyl radical formation or the addition of nitro groups to tyrosine residues within cellular proteins.

Endometrial adenocarcinoma and polycystic ovary syndrome: risk factors, management, and prognosis.

This report presents the development of endometrial adenocarcinoma after diagnosis of polycystic ovary syndrome (PCOS) in three premenopausal women. Such cases illustrate the increased potential for endometrial hyperplasia and malignancy in the setting of chronic anovulation associated with PCOS and underscore the need for prompt identification and treatment. Attention to endometrial thickness (as measured by transvaginal sonogram) and elevated insulin level (as measured by fasting plasma insulin) can improve clinical surveillance of both conditions and preserve reproductive potential for women with PCOS.

Transport of lactate and pyruvate in the intraerythrocytic malaria parasite, Plasmodium falciparum.

The mature, intraerythrocytic form of the human malaria parasite, Plasmodium falciparum, is reliant on glycolysis for its energetic requirements. It produces large quantities of lactic acid, which have to be removed from the parasite's cytosol to maintain the cell's integrity and metabolic viability. Here we show that the monocarboxylates lactate and pyruvate are both transported across the parasite's plasma membrane via a H(+)/monocarboxylate symport process that is saturable and inhibited by the bioflavonoid phloretin. The results provide direct evidence for the presence at the parasite surface of a H(+)-coupled monocarboxylate transporter with features in common with members of the MCT (monocarboxylate transporter) family of higher eukaryotes.

Glutamate transporter EAAT2 splice variants occur not only in ALS, but also in AD and controls.

OBJECTIVE: To ascertain the specificity of alternatively spliced mRNA variants of the astroglial glutamate transporter EAAT2 for ALS. BACKGROUND: An important hypothesis for ALS pathogenesis is that motor neuron injury may result from chronically elevated glutamate levels in the CNS. Supporting this idea are reports of decreased glutamate transport in ALS. This in turn has recently been suggested to be due to the presence of aberrant mRNA splice variants for EAAT2 in ALS. METHODS: Postmortem human brain tissue was obtained from different brain regions of patients with ALS, normal controls (NC), and patients with AD and Lewy body dementia (LB)-neurodegenerative diseases in which motor neurons are unaffected. Brain RNA was analyzed for EAAT2 isoforms using reverse transcription PCR and cDNA cloning/sequencing methods. RESULTS: Splice variants lacking exons 7 or 9 were present in ALS brain, as previously reported, but were also present in brains from NC, AD, and LB patients. PCR product sequence analyses from non-ALS brain show variant splicing identical to that reported for ALS. Quantitative PCR analysis shows that these isoforms may be somewhat more abundant in ALS than AD, LB, and NC brains. CONCLUSIONS: EAAT2 mRNA splice variants are found in the brains of NC and AD patients, as in ALS. The authors cannot exclude the possibility that quantitative changes in variant EAAT2 isoforms might relate directly, or indirectly, to ALS pathology. However, the qualitative presence of these "abnormal" EAAT2 splice variants does not appear to be sufficient to explain motor neuron degeneration in ALS.

A quantitative study of the interactions of Bacillus anthracis edema factor and lethal factor with activated protective antigen.

Bacillus anthracis secretes three proteins, which associate in binary combinations to form toxic complexes at the surface of mammalian cells. Receptor-bound protective antigen (PA) is proteolytically activated, yielding a 63 kDa fragment (PA(63)). PA(63) oligomerizes into heptamers, which bind edema factor (EF) or lethal factor (LF) to form the toxic complexes. We undertook a quantitative analysis of the interactions of EF with PA(63) by means of surface plasmon resonance (SPR) measurements. Heptameric PA(63) was covalently bound by amine coupling to an SPR chip, or noncovalently bound via a C-terminal hexahistidine tag on the protein to Ni(2+)nitrilotriacetate groups on the chip. Values of k(on) and k(off) for EF at 23 degrees C were approximately 3 x 10(5) M(-)(1) s(-)(1) and (3-5) x 10(-)(4) s(-)(1), respectively, giving a calculated K(d) of (1-2) x 10(-)(9) M. A similar value of K(d) (7 x 10(-)(10) M) was obtained when we measured the binding of radiolabeled EF to receptor-bound PA(63) on the surface of L6 cells (at 4 degrees C). Each of these analyses was also performed with LF and LF(N) (the N-terminal 255 residues of LF), and values obtained were comparable to those for EF. The similarity in the dissociation constants determined by SPR and by measurements on the cell surface suggests that the presence of the receptor does not play a large role in the interaction between PA(63) and EF/LF.

Metallothionein expression is altered in a transgenic murine model of familial amyotrophic lateral sclerosis.

Missense mutations in the gene encoding copper zinc superoxide dismutase (SOD1) have been found to cause one form of familial amyotrophic lateral sclerosis (FALS). Although the exact mechanism of disease is unknown, abnormalities in the ability of mutant SOD1 to bind zinc or copper ions may be crucial in the pathogenesis of disease. Because members of the metallothionein (MT) family of zinc and copper binding proteins function as important cellular regulators of metal ion bioavailability in the central nervous system, we used in situ hybridization and immunohistochemistry to study the expression pattern of these molecules in a transgenic mouse model of familial ALS. In adult wild-type mouse spinal cord, expression of MT-I and MT-II is restricted to ependymal cells and a subset of astrocytes located in white matter tracts, while MT-III synthesis is limited to neurons within gray matter. Compared to wild-type littermates, transgenic mice carrying the G93A SOD1 mutation demonstrate markedly increased expression of MT-I and MT-II within astrocytes in both white and gray matter as weakness develops. MT-III synthesis in neurons is also greatly upregulated as G93A SOD1 animals age, with glial cell expression of MT-III evident by later stages of the disease. Changes in MT expression occur before the onset of motor deficits or significant motor neuron pathology in G93A SOD1 mice and remarkably extend beyond ventral horn populations of neurons and glia. These results are consistent with the hypothesis that metallothioneins may serve an early and important protective function in FALS.

Restricted expression of G86R Cu/Zn superoxide dismutase in astrocytes results in astrocytosis but does not cause motoneuron degeneration.

Evidence garnered from both human autopsy studies and genetic animal models has suggested a potential role for astrocytes in the pathogenesis of amyotrophic lateral sclerosis (ALS). Currently, mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1) represent the only known cause of motoneuron loss in the disease, producing 21q linked familial ALS (FALS). To determine whether astrocytic dysfunction has a primary role in familial ALS, we have generated multiple lines of transgenic mice expressing G86R mutant SOD1 restricted to astrocytes. In GFAP-m SOD1 mice, astrocytes exhibit significant hypertrophy and increased GFAP reactivity as the animals mature. However, GFAP-mutant SOD1 transgenic mice develop normally and do not experience spontaneous motor deficits with increasing age. Histological examination of spinal cord in aged GFAP-mSOD1 mice reveals normal motoneuron and microglial morphology. These results indicate that 21q linked FALS is not a primary disorder of astrocytes, and that expression of mutant SOD1 restricted to astrocytes is not sufficient to cause motoneuron degeneration in vivo. Expression of mutant SOD1 in other cell types, most likely neurons, is critical for the initiation of disease.

Experimental models of amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a chronic neurodegenerative disease characterized by the progressive loss of motor neurons, leading to profound weakness and eventual death of affected individuals. For the vast majority of patients with ALS, the etiology of the disorder is unknown, and although multiple clinical trials of various therapeutic agents have been undertaken, truly effective therapy is not currently available for the disease. The selection of treatments used in ALS clinical trials frequently has its basis in promising data obtained from experimental model systems in which the proposed agent has shown some effect in protecting motor neurons from a particular insult. The likelihood of a successful clinical outcome for a given treatment in ALS would therefore depend on two principal factors, including the similarity of the model to the disease and the biologic action of the potential therapeutic agent. Partly because early experimental models of ALS failed to replicate the disease process, treatment success in these models did not carry over into human trials. Recently, however, a variety of newer model systems have been developed and utilized to investigate motor neuron degeneration as related to ALS. For example, in this issue, Corse et al. use a rat spinal cord organotypic slice subjected to glutamate excitotoxicity as a model system to test the effectiveness of neurotrophic factors in preventing motor neuron degeneration. This review will assess the strengths and weaknesses of differing ALS model systems that have been used to preclinically test potential drug efficacy in ALS.

Brachial amyotrophic diplegia: a slowly progressive motor neuron disorder.

OBJECTIVE: To describe a sporadic motor neuron disorder that remains largely restricted to the upper limbs over time. BACKGROUND: Progressive amyotrophy that is isolated to the upper limbs in an adult often suggests ALS. The fact that weakness can remain largely confined to the arms for long periods of time in individuals presenting with this phenotype has not been emphasized. METHODS: We reviewed the records of patients who had a neurogenic "man-in-the-barrel" phenotype documented by examination at least 18 months after onset. These patients had severe bilateral upper-extremity neurogenic atrophy that spared lower-extremity, respiratory, and bulbar musculature. RESULTS: Nine of 10 patients meeting these criteria had a purely lower motor neuron disorder. During follow-up periods ranging from 3 to 11 years from onset, only three patients developed lower-extremity weakness, and none developed respiratory or bulbar dysfunction or lost the ability to ambulate. CONCLUSION: Patients presenting with severe weakness that is fully isolated to the upper limbs, without pyramidal signs, may have a relatively stable variant of motor neuron disease.

Anthrax protective antigen: prepore-to-pore conversion.

PA(63), the active 63 kDa form of anthrax protective antigen, forms a heptameric ring-shaped oligomer that is believed to represent a precursor of the membrane pore formed by this protein. When maintained at pH >/=8.0, this "prepore" dissociated to monomeric subunits upon treatment with SDS at room temperature, but treatment at pH

Mutation analysis in Emery-Dreifuss muscular dystrophy.

The purpose of this study was to search for STA gene defects in three families with clinically typical Emery-Dreifuss muscular dystrophy. Emery-Dreifuss is an X-linked muscular dystrophy with humeroperoneal weakness and life-threatening, but treatable, cardiac abnormalities in male patients and in female carriers. The defect is in the gene coding for emerin, a 254 amino acid protein of unknown function. Complementary and genomic DNA from T lymphocytes from the reported patients and their family members were amplified, cloned, and sequenced. A novel mutation, a 26 base-pair deletion in three brothers and a carrier mother, was detected in one family. A splicing mutation with one base pair insertion and a five base-pair deletion, which have been described previously, were found in the second and third families, respectively. The additional novel mutation detected and the findings of three different mutations in these three families support the idea of genetic heterogeneity of Emery-Dreifuss muscular dystrophy with different mutations in different families.

Effects of mutations in proline 345 on insertion of diphtheria toxin into model membranes.

Translocation of the catalytic domain of diphtheria toxin (DT) across the endosomal membrane to the cytoplasm of mammalian cells requires the low-pH-dependent insertion of a hydrophobic helical hairpin (TH8-TH9) that is buried within the T domain of the native protein. Mutations of Pro345, which terminates helix TH8, have been reported to block toxicity for Vero cells. We found that mutant toxins in which Pro345 had been replaced by Cys, Glu, or Gly were profoundly defective at low pH in forming channels in planar phospholipid bilayers and in permeabilizing phospholipid vesicles to entrapped fluorophores. Experiments with isolated T domain containing a polarity-sensitive fluorophore attached to Cys at position 332 suggest that the P345E mutation blocks membrane insertion. None of the Pro345 mutations shifted the pH-dependence of binding in solution of the hydrophobic fluorophore, 2-p-toluidinyl-naphthalene 7-sulfonate. The results indicate that proline at position 345 is required for the T domain to insert into phospholipid bilayers or to adopt a functional conformation within the bilayer.

Visual factors and mobility in persons with age-related macular degeneration.

The objectives of this study were to determine the effects of reducing light level on mobility performance in persons with age-related macular degeneration (ARMD) and how performance relates to measures of visual sensory and perceptual function. ARMD results in the loss of central, high-acuity vision and is the leading cause of vision loss in veterans participating in the blind rehabilitation programs of the Department of Veterans Affairs. In 41 subjects with ARMD acuity, peak letter contrast sensitivity, visual field extent, glare disability, color confusion, spatio-temporal contrast sensitivity, motion sensitivity, scanning ability, and figure-ground discrimination were measured to determine their ability to predict mobility performance. Mobility performance was assessed under photopic (high illumination) and mesopic (low illumination) lighting conditions on a laboratory obstacle course and two real-world courses, an indoor hallway and an outdoor residential route. Reducing illumination resulted in significant increases in the time to complete each course and the number of mobility incidents (errors) that occurred. Two measures of overall performance, total time and total mobility incidents, were calculated for each course by summing time and incidents over the two illumination levels. Combinations of vision variables were able to account for 30 to 60% of the variance in the measures of overall performance. Log contrast sensitivity measured with the Pelli-Robson chart test and visual field extent were the most important predictors of performance. Other variables making significant contributions to prediction in multi-predictor models included: scanning ability, glare sensitivity, color confusion, and peak contrast sensitivity to drifting gratings.

Characterization of membrane translocation by anthrax protective antigen.

Solving the crystallographic structure of the ring-shaped heptamer formed by protective antigen (PA), the B moiety of anthrax toxin, has focused attention on understanding how this oligomer mediates membrane translocation of the toxin's A moieties. We have developed an assay for translocation in which radiolabeled ligands are bound to proteolytically activated PA (PA63) at the surface of CHO or L6 cells, and translocation across the plasma membrane is induced by lowering the pH. The cells are then treated with Pronase E to degrade residual surface-bound material, and protected ligands are quantified after fractionation by SDS-PAGE. Translocation was most efficient (35%-50%) with LFN, the N-terminal PA binding domain of the anthrax lethal factor (LF). Intact LF, edema factor (EF), or fusion proteins containing LFN fused to certain heterologous proteins [the diphtheria toxin A chain (DTA) or dihydrofolate reductase (DHFR)] were less efficiently translocated (15%-20%); and LFN fusions to several other proteins were not translocated at all. LFN with different N-terminal residues was found to be degraded according to the N-end rule by the proteasome, and translocation of LFN fused to a mutant form of DHFR with a low affinity for methotrexate (MTX) protected cells from the effects of MTX. Both results are consistent with a cytosolic location of protected proteins. Evidence that a protein must unfold to be translocated was obtained in experiments showing that (i) translocation of LFNDTA was blocked by introduction of an artificial disulfide into the DTA moiety, and (ii) translocation of LFNDHFR and LFNDTA was blocked by their ligands (MTX and adenine, respectively). These results demonstrate that the acid-induced translocation by anthrax toxin closely resembles that of diphtheria toxin, despite the fact that these two toxins are unrelated and form pores by different mechanisms.

Visual correlates of mobility in real world settings in older adults with low vision.

PURPOSE: To determine the effects of reducing light level from photopic to mesopic on performance of real world mobility tasks and how performance of these tasks relates to measures of visual sensory and perceptual function. METHODS: The visual functions, acuity, peak letter contrast sensitivity, visual field extent, glare disability, color confusion, motion sensitivity, spatio-temporal contrast sensitivity, scanning ability, and figure-ground discrimination were measured to determine their ability to predict mobility performance of visually impaired adults on indoor hallway and outdoor residential travel routes under photopic and mesopic lighting conditions. RESULTS: Time to complete routes and number of mobility incidents were significantly increased under mesopic conditions. Depending on the task, lighting conditions, and performance measure, predictive models consisting of 4 vision variables were able to account for 30 to 42% of the variance in overall performance. The two most important variables in these models were visual field extent and scanning ability, followed by color confusion, grating contrast sensitivity, or spatial resolution. CONCLUSIONS: Reducing illumination levels from photopic to mesopic has an adverse effect upon mobility in older visually impaired adults. The aspects of vision which best predict performance include measures of sensory and perceptual visual function. The results compare well with those obtained under controlled laboratory conditions.

Visual correlates of obstacle avoidance in adults with low vision.

This study examined how mobility performance in a heterogeneous sample of visually impaired adults relates to measures of visual sensory and perceptual function. We found that the best predictors of mobility performance under photopic and scotopic lighting conditions were models that incorporated visual field extent (VFE) and scanning ability. Together with measures of contrast sensitivity and spatial resolution, these models accounted for approximately 50% of the variance in mobility performance. We also found that VFE and scanning ability were the dominant predictor variables when the sample was broken down by subjects' type of vision loss into an acuity loss, a visual field restriction, and a combination loss group.