Protamine is an antagonist of apelin receptor, and its activity is reversed by heparin.

Apelin signaling plays an important role during embryo development and regulates angiogenesis, cardiovascular activity, and energy metabolism in adulthood. Overexpression and hyperactivity of this signaling pathway is observed in various pathologic states, such as cardiovascular diseases and cancer, which highlights the importance of inhibiting apelin receptor (APJ); therefore, we developed a cell-based screening assay that uses fluorescence microscopy to identify APJ antagonists. This approach led us to identify the U.S. Food and Drug Administration-approved compound protamine-already used clinically after cardiac surgery-as an agent to bind to heparin and thereby reverse its anticlotting activity. Protamine displays a 390-nM affinity for APJ and behaves as a full antagonist with regard to G protein and ß-arrestin-dependent intracellular signaling. Ex vivo and in vivo, protamine abolishes well-known apelin effects, such as angiogenesis, glucose tolerance, and vasodilatation. Remarkably, protamine antagonist activity is fully reversed by heparin treatment both in vitro and in vivo Thus, our results demonstrate a new pharmacologic property of protamine-blockade of APJ-that could explain some adverse effects observed in protamine-treated patients. Moreover, our data reveal that the established antiangiogenic activity of protamine would rely on APJ antagonism.-Le Gonidec, S., Chaves-Almagro, C., Bai, Y., Kang, H. J., Smith, A., Wanecq, E., Huang, X.-P., Prats, H., Knibiehler, B., Roth, B. L., Barak, L. S., Caron, M. G., Valet, P., Audigier, Y., Masri, B. Protamine is an antagonist of apelin receptor, and its activity is reversed by heparin.

Understanding Who Uses Whole Health Services: A Program Evaluation.

Background: The Veterans Health Administration is rolling out a Whole Health system of care as part of an enhanced focus on proactive, person-centered healthcare. Objective: Our program evaluation seeks to characterize what Veterans use Whole Health services, for what diagnoses they are seeking Whole Health services, and to examine "high utilizers" of Whole Health services. Methods: Data were collected on 174 Veterans using Whole Health services from December 2018 through March 2020 and consisted of chart review and self-report data. Results: Women were more likely than men Veterans to use individual only Whole Health services. High utilizers (the top 30% of the sample in Whole Health services used) were more likely to attend groups than the remainder of the sample. Conclusion: Future work should examine the community-building aspects of Whole Health and ways to create group programming tailored to women Veterans.

Randomized Clinical Trial of Brief Primary Care-Based Mindfulness Training Versus a Psychoeducational Group for Veterans With Posttraumatic Stress Disorder.

Objective: Individuals with posttraumatic stress disorder (PTSD) symptoms are often reluctant to engage in traditional mental health care but do seek primary care services. Alternative strategies are needed to develop emotional regulation skills among individuals with PTSD symptoms. This study examined the feasibility and effectiveness of Primary Care Brief Mindfulness Training (PCBMT) compared to a psychoeducational group for reducing PTSD symptoms.Methods: Primary care patients (n = 55) with DSM-5 PTSD symptoms but not engaged in PTSD psychotherapies were randomized to 4-week PCBMT or a PTSD psychoeducation group (EDU). Both groups were cofacilitated by mental health providers and veteran peer specialists. Between January 2019 and March 2020, assessments were completed at baseline, post-treatment, and 16- and 24-week follow-up.Results: PCBMT participants had significantly larger decreases in PTSD symptoms from pre- to post-treatment (d = 0.57) and depression from pre-treatment to 16- and 24-week follow-ups (d = 0.67, 0.60) compared to EDU. PCBMT participants also reported significantly greater improvements in health responsibility (d = 0.79), stress management (d = 0.99), and not feeling dominated by symptoms (d = 0.71). Both interventions resulted in the majority of participants "stepping up" to a higher level of PTSD care.Conclusions: Brief mindfulness training is effective for reducing psychiatric symptoms and improving broader recovery outcomes and health promoting behaviors. For individuals who are not yet willing to engage in trauma-focused PTSD treatment, PCBMT may be preferable and more effective than psychoeducational classes as preliminary treatments. Further research is needed to confirm the effectiveness of PCBMT in a larger sample and investigate factors that will support wider implementation in primary care settings.Clinical Trials Registration: ClinicalTrials.gov identifier: NCT03352011.

C-terminal regions of the human telomerase catalytic subunit essential for in vivo enzyme activity.

Most human cancer cells are thought to acquire the ability to divide beyond the capacity of normal somatic cells through illegitimately activating the gene hTERT, which encodes the catalytic subunit of telomerase. While telomerase reverse transcriptase (TERT) is conserved in most eukaryotes, mounting evidence suggests that the C terminus of the human protein may have functions unique to higher eukaryotes. To search for domains responsible for such functions, we assayed a panel of tandem substitution mutations encompassing this region of human TERT for in vitro and in vivo functionality. We found four clusters of mutations that inactivated the biochemical and biological functions of telomerase, separated by mutations that had little or no effect on enzyme activity. We also identified a region where mutations generate catalytically active but biologically inert proteins. This C-terminal region that dissociates activities of telomerase (C-DAT) does not appear to be involved in nuclear localization or protein multimerization. Instead, it appears that the C-DAT region is involved in a step of in vivo telomere synthesis after the assembly of a catalytically active enzyme. Intriguingly, all of the described regions reside in a portion of TERT that is dispensable for cellular viability in yeast, arguing for a divergent role of the C terminus in higher eukaryotes.

Attenuation of ischemia-reperfusion injury in a canine model of autologous renal transplantation.

BACKGROUND: This study examined the potential therapeutic effects of a combination therapy consisting of 5-aminoimidazole-4-carboxamide-1-beta-D-ribonucleoside (AICAR) and N-acetyl cysteine (NAC) to attenuate ischemia-reperfusion (I/R) injury in a canine model of autologous renal transplantation. METHODS: Male mongrel dogs (15-20 kg) underwent left nephrectomy followed by flushing and static preservation of the kidney in University of Wisconsin (UW) solution for 48 hr. The treatment group received AICAR (50 mg/kg) plus NAC (100 mg/kg) intravenously before the left nephrectomy. The compounds were added to the UW solution as well. All dogs underwent right nephrectomy 48 hr later followed by autotransplantation of the preserved left kidney. Treated dogs received a second dose of AICAR and NAC before implantation of the renal autograft. RESULTS: The treated dogs had excellent urine output posttransplant, with peak serum creatinine of 7.26 mg/dL on postoperative day (POD) 3 that normalized after 14 days. The control group were anuric and developed clinical symptoms of uremia on POD 1. Morphologic evaluation supported the protective effects of combination therapy. Immunohistochemical analysis revealed decrease of tumor necrosis factor-alpha, interferon-gamma, and inducible nitric oxide synthase; and TUNEL assay showed decreased apoptosis in the treated group. CONCLUSIONS: Combination therapy with AICAR and NAC attenuates renal I/R injury and improves the outcome of the transplanted kidney after prolonged cold preservation.

A mesocosm study of the effects of wet-dry cycles on nutrient release from constructed wetlands in agricultural landscapes.

Given the projection that wet-dry periods will be more frequent in the US Midwest, a study was conducted to understand the impact of these hydro-climatic alterations on nutrient dynamics in wetlands constructed on former croplands in the region. Soil cores were collected from two constructed wetlands and a wooded riparian area (surface: 0-20 cm; subsurface: 40-60 cm) downslope from an agricultural field. Cores were either kept moist or subjected to a 5-week drying treatment, after which all cores were flooded for 36 days. Initial nitrate flux was significantly (p < 0.001) higher in the dry than in the moist treatment (44.5 vs. 1.9 mg N m(-2) per day), likely due to mineralization of organic matter. The NO3(-) released was rapidly denitrified (N2O flux: 18.9 mg N m(-2) per day), except in the subsurface soil cores in which processing of available N (N2O flux: 0.33 mg N m(-2) per day) was limited by low microbial activity (4 times lower CO2 production rate). The dry treatment also resulted in significantly (p < 0.01) higher inorganic P (Pi) flux (3.1 versus 1 mg P m(-2) per day in moist cores), with water-extractable soil P being the best predictor (r(2): 0.93, p < 0.03) of that flux. Despite a decline in redox potential (as low as -36.4 mv) and progressive increase in pore-water dissolved Fe, no relationship between floodwater Pi and dissolved Fe was observed, suggesting either limited contribution of reductive dissolution to Pi dynamics or rapid adsorption of the Pi released within the cores. Compared to the moist cores, geochemical modeling showed a consistent shift toward greater solubility of the calcium-phosphate minerals controlling pore-water Pi concentration in the dry treatment cores. These results suggest that dissolution of Ca-phosphate minerals could be a key factor controlling Pi mobility in constructed wetlands subjected to wet-dry cycles.

Depression and anxiety in urban hemodialysis patients.

Depression is well established as a prevalent mental health problem for people with ESRD and is associated with morbidity and mortality. However, depression in this population remains difficult to assess and is undertreated. Current estimates suggest a 20 to 30% prevalence of depression that meets diagnostic criteria in this population. The extent of other psychopathology in patients with ESRD is largely unknown. The aim of this study was to expand the research on psychiatric complications of ESRD and examine the prevalence of a broad range of psychopathology in an urban hemodialysis center and their impact on quality of life. With the use of a clinician-administered semistructured interview in this randomly selected sample of 70 predominately black patients, >70% were found to have a psychiatric diagnosis. Twenty-nine percent had a current depressive disorder: 20% had major depression, and 9% had a diagnosis of dysthymia or depression not otherwise specified. Twenty-seven percent had a current major anxiety disorder. A current substance abuse diagnosis was found in 19%, and 10% had a psychotic disorder. The mean Beck Depression Inventory score was 12.1 +/- 9.8. Only 13% reported being in current treatment by a mental health provider, and only 5% reported being prescribed psychiatric medication by their physician. A total of 7.1% had compound depression or depression coexistent with another psychiatric disorder. The construct of depression was also disentangled from the somatic effects of poor medical health by demonstrating a unique relationship between depressive affect and depression diagnosis, independent of health status. This study also suggests the utility of cognitive variables as a meaningful way of understanding the differences between patients who have ESRD with clinical depression or other diagnoses and those who have no psychiatric comorbidity. The findings of both concurrent and isolated anxiety suggest that the prevalence of psychopathology in patients with ESRD might be higher than previously expected, and the disorders may need to be treated independently. In addition, the data suggest that cognitive behavioral therapeutic techniques may be especially advantageous in this population of patients who are treated with many medications.