Hyperactivity is a Core Endophenotype of Elevated Neuregulin-1 Signaling in Embryonic Glutamatergic Networks.

The neuregulin 1 (NRG1) ErbB4 module is at the core of an "at risk" signaling pathway in schizophrenia. Several human studies suggest hyperstimulation of NRG1-ErbB4 signaling as a plausible pathomechanism; however, little is known about the significance of stage-, brain area-, or neural cell type-specific NRG1-ErbB4 hyperactivity for disease-relevant brain endophenotypes. To address these spatiotemporal aspects, we generated transgenic mice for Cre recombinase-mediated overexpression of cystein-rich domain (CRD) NRG1, the most prominent NRG1 isoform in the brain. A comparison of "brain-wide" vs cell type-specific CRD-NRG1 overexpressing mice revealed that pathogenic CRD-NRG1 signals for ventricular enlargement and neuroinflammation originate outside glutamatergic neurons and suggests a subcortical function of CRD-NRG1 in the control of body weight. Embryonic onset of CRD-NRG1 in glutamatergic cortical networks resulted in reduced inhibitory neurotransmission and locomotor hyperactivity. Our findings identify ventricular enlargement and locomotor hyperactivity, 2 main endophenotypes of schizophrenia, as specific consequences of spatiotemporally distinct expression profiles of hyperactivated CRD-NRG1 signaling.

Localization and dynamic changes of neuregulin-1 at C-type synaptic boutons in association with motor neuron injury and repair.

C-type synaptic boutons (C-boutons) provide cholinergic afferent input to spinal cord motor neurons (MNs), which display an endoplasmic reticulum (ER)-related subsurface cistern (SSC) adjacent to their postsynaptic membrane. A constellation of postsynaptic proteins is clustered at C-boutons, including M2 muscarinic receptors, potassium channels, and σ-1 receptors. In addition, we previously found that neuregulin (NRG)1 is associated with C-boutons at postsynaptic SSCs, whereas its ErbB receptors are located in the presynaptic compartment. C-bouton-mediated regulation of MN excitability has been implicated in MN disease, but NRG1-mediated functions and the impact of various pathologic conditions on C-bouton integrity have not been studied in detail. Here, we investigated changes in C-boutons after electrical stimulation, pharmacological treatment, and peripheral nerve axotomy. SSC-linked NRG1 clusters were severely disrupted in acutely stressed MNs and after tunicamycin-induced ER stress. In axotomized MNs, C-bouton loss occurred in concomitance with microglial recruitment and was prevented by the ER stress inhibitor salubrinal. Activated microglia displayed a positive chemotaxis to C-boutons. Analysis of transgenic mice overexpressing NRG1 type I and type III isoforms in MNs indicated that NRG1 type III acts as an organizer of SSC-like structures, whereas NRG1 type I promotes synaptogenesis of presynaptic cholinergic terminals. Moreover, MN-derived NRG1 signals may regulate the activity of perineuronal microglial cells. Together, these data provide new insights into the molecular and cellular pathology of C-boutons in MN injury and suggest that distinct NRG1 isoform-mediated signaling functions regulate the complex matching between pre- and postsynaptic C-bouton elements.-Salvany, S., Casanovas, A., Tarabal, O., Piedrafita, L., Hernández, S., Santafé, M., Soto-Bernardini, M. C., Calderó, J., Schwab, M. H., Esquerda, J. E. Localization and dynamic changes of neuregulin-1 at C-type synaptic boutons in association with motor neuron injury and repair.

Spironolactone is an antagonist of NRG1-ERBB4 signaling and schizophrenia-relevant endophenotypes in mice.

Enhanced NRG1-ERBB4 signaling is a risk pathway in schizophrenia, and corresponding mouse models display several endophenotypes of the disease. Nonetheless, pathway-directed treatment strategies with clinically applicable compounds have not been identified. Here, we applied a cell-based assay using the split TEV technology to screen a library of clinically applicable compounds to identify modulators of NRG1-ERBB4 signaling for repurposing. We recovered spironolactone, known as antagonist of corticosteroids, as an inhibitor of the ERBB4 receptor and tested it in pharmacological and biochemical assays to assess secondary compound actions. Transgenic mice overexpressing Nrg1 type III display cortical Erbb4 hyperphosphorylation, a condition observed in postmortem brains from schizophrenia patients. Spironolactone treatment reverted hyperphosphorylation of activated Erbb4 in these mice. In behavioral tests, spironolactone treatment of Nrg1 type III transgenic mice ameliorated schizophrenia-relevant behavioral endophenotypes, such as reduced sensorimotor gating, hyperactivity, and impaired working memory. Moreover, spironolactone increases spontaneous inhibitory postsynaptic currents in cortical slices supporting an ERBB4-mediated mode-of-action. Our findings suggest that spironolactone, a clinically safe drug, provides an opportunity for new treatment options for schizophrenia.

Manifestaciones cutáneas de enfermedades sistémicas / Cutaneous manifestations of systematic diseases

Un gran número de enfermedades sistémicas durante su evolución pueden presentar manifestaciones cutáneas, enocasiones propias de la dolencia, aunque en otras pueden ser el único indicador de la presencia de una enfermedadinterna asintomática, por ello es fundamental su reconocimiento. Su aparición debe alertar al médico sobre el probableinicio de ciertos desórdenes sistémicos, lo que permitirá realizar un diagnóstico precoz, con las implicanciasclínicas y terapéuticas de intervención a corto y largo plazo. El propósito de este trabajo es describir las lesionescutáneas que con mayor frecuencia se asocian a enfermedades internas, lo cual puede ser de gran utilidad para elejercicio de médicos generalistas, internistas y dermatólogos.

Skin signs of systemic diseases occur frequently, and sometimes constitute the first symptoms of an internal disease; furthermore,these manifestations may be the sole expressions of otherwise asymptomatic systemic disorders, so it is neecessary tobecome acquainted with them. Their appearance should alert us of the likely onset of a systemic disorder, which allows anearly diagnosis, with clinical and therapeutic implications both in the short and the long term. We describe the clinicalfeatures of skin lesions observed in several internal diseases which will be useful to general practitioners, internists anddermatologists in the diagnosis of systemic diseases.

Manifestaciones cutáneas de enfermedades sistémicas / Cutaneous manifestations of systematic diseases

Un gran número de enfermedades sistémicas durante su evolución pueden presentar manifestaciones cutáneas, enocasiones propias de la dolencia, aunque en otras pueden ser el único indicador de la presencia de una enfermedadinterna asintomática, por ello es fundamental su reconocimiento. Su aparición debe alertar al médico sobre el probableinicio de ciertos desórdenes sistémicos, lo que permitirá realizar un diagnóstico precoz, con las implicanciasclínicas y terapéuticas de intervención a corto y largo plazo. El propósito de este trabajo es describir las lesionescutáneas que con mayor frecuencia se asocian a enfermedades internas, lo cual puede ser de gran utilidad para elejercicio de médicos generalistas, internistas y dermatólogos.(AU)

Skin signs of systemic diseases occur frequently, and sometimes constitute the first symptoms of an internal disease; furthermore,these manifestations may be the sole expressions of otherwise asymptomatic systemic disorders, so it is neecessary tobecome acquainted with them. Their appearance should alert us of the likely onset of a systemic disorder, which allows anearly diagnosis, with clinical and therapeutic implications both in the short and the long term. We describe the clinicalfeatures of skin lesions observed in several internal diseases which will be useful to general practitioners, internists anddermatologists in the diagnosis of systemic diseases.(AU)

In vivo and in vitro genetic evidence of involvement of neuregulin 1 in immune system dysregulation.

Neuregulin 1 (NRG1) has been implicated in several disorders including breast cancer, multiple sclerosis, and schizophrenia. Also, recent evidence suggests that NRG1 may play a role in regulation of inflammation and immune system response. We therefore hypothesized that a schizophrenia-associated missense mutation (valine to leucine) we identified within the transmembrane region of NRG1 would also be linked to immune dysregulation. We used plasma samples from families carrying the mutation to measure levels of antibodies to 41 autoimmune markers and six cytokines (IL-1b, IL-6, IL-10, IL-8, IL-12p70, and TNF-α) and used these levels as quantitative traits to evaluate association with the NRG1 mutation, using FBAT. Next, we used Epstein-Barr virus-transformed B cells from heterozygous mutation carriers and wild-type individuals to evaluate protein and mRNA cytokine expression in vitro using quantitative PCR and ELISA assays. In vivo, increased levels of 25 autoimmune markers as well as elevated levels of cytokines were significantly associated with the NRG1 mutation. In vitro, we observed a significant increase in protein secretion levels of IL-6, TNF-α, and IL-8 in mutation carriers compared with controls. At the mRNA level, we observed a significant increase in IL-6 expression, while IL-4 levels appeared to be down-regulated in heterozygous individuals compared with wild-type controls. This is the first report of association of a NRG1 mutation with immune dysregulation. This study could contribute towards understanding the role of NRG1 in the pathogenesis of schizophrenia and other disorders in which inflammation plays an important role.

Methionine sulfoxide reductase: a novel schizophrenia candidate gene.

Methionine sulfoxide reductase (MSRA) is an antioxidant enzyme implicated in protection against oxidative stress and protein maintenance. We have previously reported the association of marker D8S542, located within the MSRA gene, with schizophrenia in the Central Valley of Costa Rica (CVCR). By performing fine mapping analysis, we have now identified a potential three-marker at risk haplotype within MSRA in the same CVCR sample, with a global P-value slightly above nominal significance (P = 0.0526). By sequencing the MSRA gene in individuals carrying this haplotype, we identified a novel 4-base pair deletion 1,792 bases upstream of the MSRA transcription start site. This deletion was significantly under-transmitted to schizophrenia patients in the CVCR sample (P = 0.0292) using FBAT, and this was replicated in a large independent sample of 321 schizophrenia families from the Hispanic population (P = 0.0367). These findings suggest a protective effect of the deletion against schizophrenia. Further, MSRA mRNA levels were significantly lower in lymphoblastoid cell lines of individuals homozygous for the deletion compared to carriers of the normal allele (P = 0.0135), although significance was only evident when genotypes were collapsed. This suggests that the deleted sequence may play a role in regulating MSRA expression. In conclusion, this work points towards MSRA as a novel schizophrenia candidate gene. Further studies into the mechanisms by which MSRA is involved in schizophrenia pathophysiology may shed light into the biological underpinnings of this disorder.

Papel del estrés oxidativo en la esquizofrenia / The role of oxidative stress in schizophrenia

La esquizofrenia es una enfermedad mental severa que se presenta en alrededor del 1 por ciento de la población mundial. Para que se manifieste son necesarios tanto factores genéticos como ambientales, por lo que el genotipo de riesgo no conlleva al desarrollo de la enfermedad sino a una mayor susceptibilidad de presentarla. Existe evidencia de que el balance entre la producción de radicales libres y el sistema de defensa antioxidante está alterado en pacientes con esquizofrenia. Sin embargo, no se sabe con certeza si la producción de RLs tiene un papel causal en el desarrollo de la enfermedad o es producido durante el curso de la enfermedad, o por el uso de neurolépticos. En este artículo se revisa la evidencia de la participación de estas sustancias en el desarrollo de la enfermedad.