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Issue published June 1, 2015 Previous issue | Next issue

  • Volume 125, Issue 6
Go to section:
  • Conversations with Giants in Medicine
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  • Corrigenda

On the cover: Retinal neuron and capillary crosstalk

The cover image is a false-colored scanning electron micrograph of a cross section of an adult murine retina. On page 2335, Usui et al. uncover an important function for retinal neurons in maintaining vasculature and promoting photoreceptor function.

Conversations with Giants in Medicine
A conversation with Craig Thompson
Ushma S. Neill
Ushma S. Neill
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2181-2183. https://doi.org/10.1172/JCI82626.
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A conversation with Craig Thompson

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Abstract

Authors

Ushma S. Neill

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Review Series
Putting together the autoimmunity puzzle
Antonio La Cava
Antonio La Cava
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2184-2186. https://doi.org/10.1172/JCI82041.
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Putting together the autoimmunity puzzle

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Abstract

Autoimmune diseases classically present with a complex etiology in which different factors concur in the generation and maintenance of autoreactive immune responses. Some mechanisms and pathways that lead to the development of imbalanced immune homeostasis and loss of self-tolerance have been identified as common to multiple autoimmune disorders. This Review series focuses on the general concepts of development and progression to pathogenic autoimmune phenotypes. A mechanistic discussion of the most recent advances in the field, together with related considerations of possible therapies, make this series of particular interest to both the basic and translational science communities.

Authors

Antonio La Cava

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Sexual dimorphism in autoimmunity
Kira Rubtsova, … , Philippa Marrack, Anatoly V. Rubtsov
Kira Rubtsova, … , Philippa Marrack, Anatoly V. Rubtsov
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2187-2193. https://doi.org/10.1172/JCI78082.
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Sexual dimorphism in autoimmunity

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Autoimmune diseases occur when the immune system attacks and destroys the organs and tissues of its own host. Autoimmunity is the third most common type of disease in the United States. Because there is no cure for autoimmunity, it is extremely important to study the mechanisms that trigger these diseases. Most autoimmune diseases predominantly affect females, indicating a strong sex bias. Various factors, including sex hormones, the presence or absence of a second X chromosome, and sex-specific gut microbiota can influence gene expression in a sex-specific way. These changes in gene expression may, in turn, lead to susceptibility or protection from autoimmunity, creating a sex bias for autoimmune diseases. In this Review we discuss recent findings in the field of sex-dependent regulation of gene expression and autoimmunity.

Authors

Kira Rubtsova, Philippa Marrack, Anatoly V. Rubtsov

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Autoantibodies in systemic autoimmune diseases: specificity and pathogenicity
Jolien Suurmond, Betty Diamond
Jolien Suurmond, Betty Diamond
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2194-2202. https://doi.org/10.1172/JCI78084.
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Autoantibodies in systemic autoimmune diseases: specificity and pathogenicity

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In this Review we focus on the initiation of autoantibody production and autoantibody pathogenicity, with a special emphasis on the targeted antigens. Release of intracellular antigens due to excessive cell death or to ineffective clearance of apoptotic debris, modification of self-antigens during inflammatory responses, and molecular mimicry contribute to the initiation of autoantibody production. We hypothesize that those autoreactive B cells that survive and produce pathogenic autoantibodies have specificity for self-antigens that are TLR ligands. Such B cells experience both B cell receptor (BCR) activation and TLR engagement, leading to an escape from tolerance. Moreover, the autoantibodies they produce form immune complexes that can activate myeloid cells and thereby establish the proinflammatory milieu that further negates tolerance mechanisms of both B and T cells.

Authors

Jolien Suurmond, Betty Diamond

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Checkpoints that control B cell development
Fritz Melchers
Fritz Melchers
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2203-2210. https://doi.org/10.1172/JCI78083.
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Checkpoints that control B cell development

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B cells differentiate from pluripotent hematopoietic stem cells (pHSCs) in a series of distinct stages. During early embryonic development, pHSCs migrate into the fetal liver, where they develop and mature to B cells in a transient wave, which preferentially populates epithelia and lung as well as gut-associated lymphoid tissues. This is followed by continuous B cell development throughout life in the bone marrow to immature B cells that migrate to secondary lymphoid tissues, where they mature. At early stages of development, before B cell maturation, the gene loci encoding the heavy and light chains of immunoglobulin that determine the B cell receptor composition undergo stepwise rearrangements of variable region-encoding gene segments. Throughout life, these gene rearrangements continuously generate B cell repertoires capable of recognizing a plethora of self-antigens and non–self-antigens. The microenvironment in which these B cell repertoires develop provide signaling molecules that play critical roles in promoting gene rearrangements, proliferation, survival, or apoptosis, and that help to distinguish self-reactive from non–self-reactive B cells at four distinct checkpoints. This refinement of the B cell repertoire directly contributes to immunity, and defects in the process contribute to autoimmune disease.

Authors

Fritz Melchers

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Pouring fuel on the fire: Th17 cells, the environment, and autoimmunity
Patrick R. Burkett, … , Gerd Meyer zu Horste, Vijay K. Kuchroo
Patrick R. Burkett, … , Gerd Meyer zu Horste, Vijay K. Kuchroo
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2211-2219. https://doi.org/10.1172/JCI78085.
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Pouring fuel on the fire: Th17 cells, the environment, and autoimmunity

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Cytokines play a critical role in controlling the differentiation of CD4 Th cells into distinct subsets, including IL-17–producing Th17 cells. Unfortunately, the incidence of a number of autoimmune diseases, particularly those in which the IL-23/IL-17 axis has been implicated, has risen in the last several decades, suggesting that environmental factors can promote autoimmunity. Here we review the role of cytokines in Th17 differentiation, particularly the role of IL-23 in promoting the differentiation of a pathogenic subset of Th17 cells that potently induce autoimmune tissue inflammation. Moreover, we highlight emerging data that indicate that environmental factors, including the intestinal microbiota and changes in diet, can alter normal cytokine regulation with potent effects on Th17 differentiation and thus promote autoimmunity, which has strong implications for human disease.

Authors

Patrick R. Burkett, Gerd Meyer zu Horste, Vijay K. Kuchroo

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T cell signaling abnormalities contribute to aberrant immune cell function and autoimmunity
Vaishali R. Moulton, George C. Tsokos
Vaishali R. Moulton, George C. Tsokos
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2220-2227. https://doi.org/10.1172/JCI78087.
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T cell signaling abnormalities contribute to aberrant immune cell function and autoimmunity

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Systemic lupus erythematosus (SLE) is a prototype systemic autoimmune disease that results from a break in immune tolerance to self-antigens, leading to multi-organ destruction. Autoantibody deposition and inflammatory cell infiltration in target organs such as kidneys and brain lead to complications of this disease. Dysregulation of cellular and humoral immune response elements, along with organ-defined molecular aberrations, form the basis of SLE pathogenesis. Aberrant T lymphocyte activation due to signaling abnormalities, linked to defective gene transcription and altered cytokine production, are important contributors to SLE pathophysiology. A better understanding of signaling and gene regulation defects in SLE T cells will lead to the identification of specific novel molecular targets and predictive biomarkers for therapy.

Authors

Vaishali R. Moulton, George C. Tsokos

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Mechanisms of human autoimmunity
Michael D. Rosenblum, … , Kelly A. Remedios, Abul K. Abbas
Michael D. Rosenblum, … , Kelly A. Remedios, Abul K. Abbas
Published April 20, 2015
Citation Information: J Clin Invest. 2015;125(6):2228-2233. https://doi.org/10.1172/JCI78088.
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Mechanisms of human autoimmunity

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Autoimmune reactions reflect an imbalance between effector and regulatory immune responses, typically develop through stages of initiation and propagation, and often show phases of resolution (indicated by clinical remissions) and exacerbations (indicated by symptomatic flares). The fundamental underlying mechanism of autoimmunity is defective elimination and/or control of self-reactive lymphocytes. Studies in humans and experimental animal models are revealing the genetic and environmental factors that contribute to autoimmunity. A major goal of research in this area is to exploit this knowledge to better understand the pathogenesis of autoimmune diseases and to develop strategies for reestablishing the normal balance between effector and regulatory immune responses.

Authors

Michael D. Rosenblum, Kelly A. Remedios, Abul K. Abbas

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Genetic basis of autoimmunity
Alexander Marson, … , William J. Housley, David A. Hafler
Alexander Marson, … , William J. Housley, David A. Hafler
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2234-2241. https://doi.org/10.1172/JCI78086.
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Genetic basis of autoimmunity

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Autoimmune diseases affect up to approximately 10% of the population. While rare Mendelian autoimmunity syndromes can result from monogenic mutations disrupting essential mechanisms of central and peripheral tolerance, more common human autoimmune diseases are complex disorders that arise from the interaction between polygenic risk factors and environmental factors. Although the risk attributable to most individual nucleotide variants is modest, genome-wide association studies (GWAS) have the potential to provide an unbiased view of biological pathways that drive human autoimmune diseases. Interpretation of GWAS requires integration of multiple genomic datasets including dense genotyping, cis-regulatory maps of primary immune cells, and genotyped studies of gene expression in relevant cell types and cellular conditions. Improved understanding of the genetic basis of autoimmunity may lead to a more sophisticated understanding of underlying cellular phenotypes and, eventually, novel diagnostics and targeted therapies.

Authors

Alexander Marson, William J. Housley, David A. Hafler

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MicroRNA regulation of lymphocyte tolerance and autoimmunity
Laura J. Simpson, K. Mark Ansel
Laura J. Simpson, K. Mark Ansel
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2242-2249. https://doi.org/10.1172/JCI78090.
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MicroRNA regulation of lymphocyte tolerance and autoimmunity

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Understanding the cell-intrinsic cues that permit self-reactivity in lymphocytes, and therefore autoimmunity, requires an understanding of the transcriptional and posttranscriptional regulation of gene expression in these cells. In this Review, we address seminal and recent research on microRNA (miRNA) regulation of central and peripheral tolerance. Human and mouse studies demonstrate that the PI3K pathway is a critical point of miRNA regulation of immune cell development and function that affects the development of autoimmunity. We also discuss how miRNA expression profiling in human autoimmune diseases has inspired mechanistic studies of miRNA function in the pathogenesis of multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, type 1 diabetes, and asthma.

Authors

Laura J. Simpson, K. Mark Ansel

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T cells in the control of organ-specific autoimmunity
Jeffrey A. Bluestone, … , Mickie Cheng, Mark Anderson
Jeffrey A. Bluestone, … , Mickie Cheng, Mark Anderson
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2250-2260. https://doi.org/10.1172/JCI78089.
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T cells in the control of organ-specific autoimmunity

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Immune tolerance is critical to the avoidance of unwarranted immune responses against self antigens. Multiple, non-redundant checkpoints are in place to prevent such potentially deleterious autoimmune responses while preserving immunity integral to the fight against foreign pathogens. Nevertheless, a large and growing segment of the population is developing autoimmune diseases. Deciphering cellular and molecular pathways of immune tolerance is an important goal, with the expectation that understanding these pathways will lead to new clinical advances in the treatment of these devastating diseases. The vast majority of autoimmune diseases develop as a consequence of complex mechanisms that depend on genetic, epigenetic, molecular, cellular, and environmental elements and result in alterations in many different checkpoints of tolerance and ultimately in the breakdown of immune tolerance. The manifestations of this breakdown are harmful inflammatory responses in peripheral tissues driven by innate immunity and self antigen–specific pathogenic T and B cells. T cells play a central role in the regulation and initiation of these responses. In this Review we summarize our current understanding of the mechanisms involved in these fundamental checkpoints, the pathways that are defective in autoimmune diseases, and the therapeutic strategies being developed with the goal of restoring immune tolerance.

Authors

Jeffrey A. Bluestone, Hélène Bour-Jordan, Mickie Cheng, Mark Anderson

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Commentaries
Embryonic stem cells as sources of donor-independent platelets
Matthew C. Canver, … , Daniel E. Bauer, Stuart H. Orkin
Matthew C. Canver, … , Daniel E. Bauer, Stuart H. Orkin
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2261-2263. https://doi.org/10.1172/JCI82348.
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Embryonic stem cells as sources of donor-independent platelets

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The creation of a donor-independent source of platelets has been challenging; however, recent advances show growing promise for alternative platelet sources. Pluripotent stem cells have the capacity to differentiate into mature megakaryocytes with the ability to produce functional platelets. In this issue of JCI, Noh et al. provide a proof-of-principle demonstration that embryonic stem cells can be used to produce platelets on a clinical scale by controlling the level of the transcription factor GATA1. This study emphasizes the importance of precise regulation of gene expression for regenerative medicine applications.

Authors

Matthew C. Canver, Daniel E. Bauer, Stuart H. Orkin

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Tumor suppressor p53 stole the AKT in hypoxia
Zhong Yun, Peter M. Glazer
Zhong Yun, Peter M. Glazer
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2264-2266. https://doi.org/10.1172/JCI82058.
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Tumor suppressor p53 stole the AKT in hypoxia

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The presence of hypoxia within a tumor is associated with poor clinical outcome, which is often exacerbated by loss of the tumor suppressor p53. In the presence of functional p53, hypoxic conditions promote apoptosis; however, the p53-dependent genes that mediate this process are not well understood. In this issue of the JCI, Leszczynska and colleagues identify a p53-dependent six-gene signature that is specifically induced in hypoxia and mediates apoptosis. In patients with a variety of cancers, downregulation of this gene signature was associated with poor clinical outcome. Induction of p53-dependent apoptosis under hypoxia was mediated by AKT inhibition, and treatment with the combination of an AKT inhibitor and ionizing radiation decreased tumor size in a p53-deficient xenograft model more substantially than either single-agent treatment. The results of this study provide important insight into p53-mediated apoptosis under hypoxia and suggest that AKT inhibition has therapeutic potential for inducing apoptosis in hypoxic, p53-deficient cancers.

Authors

Zhong Yun, Peter M. Glazer

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Kidney growth and hypertrophy: the role of mTOR and vesicle trafficking
Qais Al-Awqati
Qais Al-Awqati
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2267-2270. https://doi.org/10.1172/JCI81508.
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Kidney growth and hypertrophy: the role of mTOR and vesicle trafficking

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The kidney, like other organs, grows in constant proportion to the rest of the body. When one kidney is removed, the remaining one hypertrophies. In a comprehensive series of studies, Chen et al. show that growth during maturation is mediated by the mTORC1 signaling pathway, which is induced by EGF-like peptides, and requires PI3K, PDK, AKT, mTORC2, and activation of mTORC1 through the combined effects of TSC and RHEB as part of a multiprotein complex localized on lysosomes. However, compensatory growth is mediated by amino acids, which act on mTORC1 independently of the previous pathway, and requires a class III PI3K (VPS34) that is known to be involved in vesicle trafficking to the lysosomes.

Authors

Qais Al-Awqati

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Honing a harder-hitting hammerhead improves broadly neutralizing antibody breadth and potency
George K. Lewis
George K. Lewis
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2271-2274. https://doi.org/10.1172/JCI82057.
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Honing a harder-hitting hammerhead improves broadly neutralizing antibody breadth and potency

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While current HIV-1 therapies have greatly improved the quality and duration of life for infected individuals, a vaccine to prevent transmission of the virus is lacking. Broadly neutralizing monoclonal antibodies (bnmAbs) with the capacity to neutralize multiple HIV-1 variants have been isolated from HIV-1–infected individuals, and there has been a great effort to investigate how these bnmAbs arise, due their potential for HIV-1 vaccination. In this issue of the JCI, Willis and colleagues apply a computational approach to design variants of the bnmAb PG9 in an attempt to enhance potency and neutralization breadth. One of these variants was able to target multiple PG9-resistant strains, as the result of stabilization of the long heavy chain complementarity determining region 3 (HCDR3). The results of this study provide important insight and a unique approach to optimizing HIV-1 bnmABs.

Authors

George K. Lewis

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Fertility and fragrance: another cause of Kallmann syndrome
Shlomo Melmed
Shlomo Melmed
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2275-2278. https://doi.org/10.1172/JCI82061.
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Fertility and fragrance: another cause of Kallmann syndrome

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Kallmann syndrome is an inherited deficiency of gonadotropin-releasing hormone (GnRH) that is characterized by hypogonadism with delayed or absent puberty and dysfunctional olfaction. While Kallmann syndrome–associated mutations have been identified in some sets of patients, for many of these individuals, the underlying cause remains unknown. In this issue of the JCI, Cariboni and colleagues identify mutations in semaphorin 3E (SEMA3E) in two brothers with Kallmann syndrome. In animal models, loss of SEMA3E signaling recapitulated phenotypes of the probands and resulted in enhanced GnRH neuron death during development. The results of this study offer important insight into the development of Kallmann syndrome and provide tools for elucidating mutations that underlie complex hormonal phenotypes.

Authors

Shlomo Melmed

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Research Articles
Glycosphingolipid synthesis inhibition limits osteoclast activation and myeloma bone disease
Adel Ersek, … , Nicole J. Horwood, Anastasios Karadimitris
Adel Ersek, … , Nicole J. Horwood, Anastasios Karadimitris
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2279-2292. https://doi.org/10.1172/JCI59987.
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Glycosphingolipid synthesis inhibition limits osteoclast activation and myeloma bone disease

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Glycosphingolipids (GSLs) are essential constituents of cell membranes and lipid rafts and can modulate signal transduction events. The contribution of GSLs in osteoclast (OC) activation and osteolytic bone diseases in malignancies such as the plasma cell dyscrasia multiple myeloma (MM) is not known. Here, we tested the hypothesis that pathological activation of OCs in MM requires de novo GSL synthesis and is further enhanced by myeloma cell–derived GSLs. Glucosylceramide synthase (GCS) inhibitors, including the clinically approved agent N-butyl-deoxynojirimycin (NB-DNJ), prevented OC development and activation by disrupting RANKL-induced localization of TRAF6 and c-SRC into lipid rafts and preventing nuclear accumulation of transcriptional activator NFATc1. GM3 was the prevailing GSL produced by patient-derived myeloma cells and MM cell lines, and exogenous addition of GM3 synergistically enhanced the ability of the pro-osteoclastogenic factors RANKL and insulin-like growth factor 1 (IGF-1) to induce osteoclastogenesis in precursors. In WT mice, administration of GM3 increased OC numbers and activity, an effect that was reversed by treatment with NB-DNJ. In a murine MM model, treatment with NB-DNJ markedly improved osteolytic bone disease symptoms. Together, these data demonstrate that both tumor-derived and de novo synthesized GSLs influence osteoclastogenesis and suggest that NB-DNJ may reduce pathological OC activation and bone destruction associated with MM.

Authors

Adel Ersek, Ke Xu, Aristotelis Antonopoulos, Terry D. Butters, Ana Espirito Santo, Youridies Vattakuzhi, Lynn M. Williams, Katerina Goudevenou, Lynett Danks, Andrew Freidin, Emmanouil Spanoudakis, Simon Parry, Maria Papaioannou, Evdoxia Hatjiharissi, Aristeidis Chaidos, Dominic S. Alonzi, Gabriele Twigg, Ming Hu, Raymond A. Dwek, Stuart M. Haslam, Irene Roberts, Anne Dell, Amin Rahemtulla, Nicole J. Horwood, Anastasios Karadimitris

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Targeted inhibition of tumor-specific glutaminase diminishes cell-autonomous tumorigenesis
Yan Xiang, … , Dean W. Felsher, Chi V. Dang
Yan Xiang, … , Dean W. Felsher, Chi V. Dang
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2293-2306. https://doi.org/10.1172/JCI75836.
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Targeted inhibition of tumor-specific glutaminase diminishes cell-autonomous tumorigenesis

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Glutaminase (GLS), which converts glutamine to glutamate, plays a key role in cancer cell metabolism, growth, and proliferation. GLS is being explored as a cancer therapeutic target, but whether GLS inhibitors affect cancer cell–autonomous growth or the host microenvironment or have off-target effects is unknown. Here, we report that loss of one copy of Gls blunted tumor progression in an immune-competent MYC-mediated mouse model of hepatocellular carcinoma. Compared with results in untreated animals with MYC-induced hepatocellular carcinoma, administration of the GLS-specific inhibitor bis-2-(5-phenylacetamido-1,3,4-thiadiazol-2-yl)ethyl sulfide (BPTES) prolonged survival without any apparent toxicities. BPTES also inhibited growth of a MYC-dependent human B cell lymphoma cell line (P493) by blocking DNA replication, leading to cell death and fragmentation. In mice harboring P493 tumor xenografts, BPTES treatment inhibited tumor cell growth; however, P493 xenografts expressing a BPTES-resistant GLS mutant (GLS-K325A) or overexpressing GLS were not affected by BPTES treatment. Moreover, a customized Vivo-Morpholino that targets human GLS mRNA markedly inhibited P493 xenograft growth without affecting mouse Gls expression. Conversely, a Vivo-Morpholino directed at mouse Gls had no antitumor activity in vivo. Collectively, our studies demonstrate that GLS is required for tumorigenesis and support small molecule and genetic inhibition of GLS as potential approaches for targeting the tumor cell–autonomous dependence on GLS for cancer therapy.

Authors

Yan Xiang, Zachary E. Stine, Jinsong Xia, Yunqi Lu, Roddy S. O’Connor, Brian J. Altman, Annie L. Hsieh, Arvin M. Gouw, Ajit G. Thomas, Ping Gao, Linchong Sun, Libing Song, Benedict Yan, Barbara S. Slusher, Jingli Zhuo, London L. Ooi, Caroline G.L. Lee, Anthony Mancuso, Andrew S. McCallion, Anne Le, Michael C. Milone, Stephen Rayport, Dean W. Felsher, Chi V. Dang

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Albumin-associated free fatty acids induce macropinocytosis in podocytes
Jun-Jae Chung, … , Jeffrey H. Miner, Andrey S. Shaw
Jun-Jae Chung, … , Jeffrey H. Miner, Andrey S. Shaw
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2307-2316. https://doi.org/10.1172/JCI79641.
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Albumin-associated free fatty acids induce macropinocytosis in podocytes

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Podocytes are specialized epithelial cells in the kidney glomerulus that play important structural and functional roles in maintaining the filtration barrier. Nephrotic syndrome results from a breakdown of the kidney filtration barrier and is associated with proteinuria, hyperlipidemia, and edema. Additionally, podocytes undergo changes in morphology and internalize plasma proteins in response to this disorder. Here, we used fluid-phase tracers in murine models and determined that podocytes actively internalize fluid from the plasma and that the rate of internalization is increased when the filtration barrier is disrupted. In cultured podocytes, the presence of free fatty acids (FFAs) associated with serum albumin stimulated macropinocytosis through a pathway that involves FFA receptors, the Gβ/Gγ complex, and RAC1. Moreover, mice with elevated levels of plasma FFAs as the result of a high-fat diet were more susceptible to Adriamycin-induced proteinuria than were animals on standard chow. Together, these results support a model in which podocytes sense the disruption of the filtration barrier via FFAs bound to albumin and respond by enhancing fluid-phase uptake. The response to FFAs may function in the development of nephrotic syndrome by amplifying the effects of proteinuria.

Authors

Jun-Jae Chung, Tobias B. Huber, Markus Gödel, George Jarad, Björn Hartleben, Christopher Kwoh, Alexander Keil, Aleksey Karpitskiy, Jiancheng Hu, Christine J. Huh, Marina Cella, Richard W. Gross, Jeffrey H. Miner, Andrey S. Shaw

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Mast cells mediate malignant pleural effusion formation
Anastasios D. Giannou, … , Theodora Agalioti, Georgios T. Stathopoulos
Anastasios D. Giannou, … , Theodora Agalioti, Georgios T. Stathopoulos
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2317-2334. https://doi.org/10.1172/JCI79840.
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Mast cells mediate malignant pleural effusion formation

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Mast cells (MCs) have been identified in various tumors; however, the role of these cells in tumorigenesis remains controversial. Here, we quantified MCs in human and murine malignant pleural effusions (MPEs) and evaluated the fate and function of these cells in MPE development. Evaluation of murine MPE-competent lung and colon adenocarcinomas revealed that these tumors actively attract and subsequently degranulate MCs in the pleural space by elaborating CCL2 and osteopontin. MCs were required for effusion development, as MPEs did not form in mice lacking MCs, and pleural infusion of MCs with MPE-incompetent cells promoted MPE formation. Once homed to the pleural space, MCs released tryptase AB1 and IL-1β, which in turn induced pleural vasculature leakiness and triggered NF-κB activation in pleural tumor cells, thereby fostering pleural fluid accumulation and tumor growth. Evaluation of human effusions revealed that MCs are elevated in MPEs compared with benign effusions. Moreover, MC abundance correlated with MPE formation in a human cancer cell–induced effusion model. Treatment of mice with the c-KIT inhibitor imatinib mesylate limited effusion precipitation by mouse and human adenocarcinoma cells. Together, the results of this study indicate that MCs are required for MPE formation and suggest that MC-dependent effusion formation is therapeutically addressable.

Authors

Anastasios D. Giannou, Antonia Marazioti, Magda Spella, Nikolaos I. Kanellakis, Hara Apostolopoulou, Ioannis Psallidas, Zeljko M. Prijovich, Malamati Vreka, Dimitra E. Zazara, Ioannis Lilis, Vassilios Papaleonidopoulos, Chrysoula A. Kairi, Alexandra L. Patmanidi, Ioanna Giopanou, Nikolitsa Spiropoulou, Vaggelis Harokopos, Vassilis Aidinis, Dionisios Spyratos, Stamatia Teliousi, Helen Papadaki, Stavros Taraviras, Linda A. Snyder, Oliver Eickelberg, Dimitrios Kardamakis, Yoichiro Iwakura, Thorsten B. Feyerabend, Hans-Reimer Rodewald, Ioannis Kalomenidis, Timothy S. Blackwell, Theodora Agalioti, Georgios T. Stathopoulos

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Neurovascular crosstalk between interneurons and capillaries is required for vision
Yoshihiko Usui, … , Michael I. Dorrell, Martin Friedlander
Yoshihiko Usui, … , Michael I. Dorrell, Martin Friedlander
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2335-2346. https://doi.org/10.1172/JCI80297.
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Neurovascular crosstalk between interneurons and capillaries is required for vision

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Abstract

Functional interactions between neurons, vasculature, and glia within neurovascular units are critical for maintenance of the retina and other CNS tissues. For example, the architecture of the neurosensory retina is a highly organized structure with alternating layers of neurons and blood vessels that match the metabolic demand of neuronal activity with an appropriate supply of oxygen within perfused blood. Here, using murine genetic models and cell ablation strategies, we have demonstrated that a subset of retinal interneurons, the amacrine and horizontal cells, form neurovascular units with capillaries in 2 of the 3 retinal vascular plexuses. Moreover, we determined that these cells are required for generating and maintaining the intraretinal vasculature through precise regulation of hypoxia-inducible and proangiogenic factors, and that amacrine and horizontal cell dysfunction induces alterations to the intraretinal vasculature and substantial visual deficits. These findings demonstrate that specific retinal interneurons and the intraretinal vasculature are highly interdependent, and loss of either or both elicits profound effects on photoreceptor survival and function.

Authors

Yoshihiko Usui, Peter D. Westenskow, Toshihide Kurihara, Edith Aguilar, Susumu Sakimoto, Liliana P. Paris, Carli Wittgrove, Daniel Feitelberg, Mollie S.H. Friedlander, Stacey K. Moreno, Michael I. Dorrell, Martin Friedlander

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STIM1 controls T cell–mediated immune regulation and inflammation in chronic infection
Ludovic Desvignes, … , Joel D. Ernst, Stefan Feske
Ludovic Desvignes, … , Joel D. Ernst, Stefan Feske
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2347-2362. https://doi.org/10.1172/JCI80273.
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STIM1 controls T cell–mediated immune regulation and inflammation in chronic infection

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Abstract

Chronic infections induce a complex immune response that controls pathogen replication, but also causes pathology due to sustained inflammation. Ca2+ influx mediates T cell function and immunity to infection, and patients with inherited mutations in the gene encoding the Ca2+ channel ORAI1 or its activator stromal interaction molecule 1 (STIM1) are immunodeficient and prone to chronic infection by various pathogens, including Mycobacterium tuberculosis (Mtb). Here, we demonstrate that STIM1 is required for T cell–mediated immune regulation during chronic Mtb infection. Compared with WT animals, mice with T cell–specific Stim1 deletion died prematurely during the chronic phase of infection and had increased bacterial burdens and severe pulmonary inflammation, with increased myeloid and lymphoid cell infiltration. Although STIM1-deficient T cells exhibited markedly reduced IFN-γ production during the early phase of Mtb infection, bacterial growth was not immediately exacerbated. During the chronic phase, however, STIM1-deficient T cells displayed enhanced IFN-γ production in response to elevated levels of IL-12 and IL-18. The lack of STIM1 in T cells was associated with impaired activation-induced cell death upon repeated TCR engagement and pulmonary lymphocytosis and hyperinflammation in Mtb-infected mice. Chronically Mtb-infected, STIM1-deficient mice had reduced levels of inducible regulatory T cells (iTregs) due to a T cell–intrinsic requirement for STIM1 in iTreg differentiation and excessive production of IFN-γ and IL-12, which suppress iTreg differentiation and maintenance. Thus, STIM1 controls multiple aspects of T cell–mediated immune regulation to limit injurious inflammation during chronic infection.

Authors

Ludovic Desvignes, Carl Weidinger, Patrick Shaw, Martin Vaeth, Theo Ribierre, Menghan Liu, Tawania Fergus, Lina Kozhaya, Lauren McVoy, Derya Unutmaz, Joel D. Ernst, Stefan Feske

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BCL11A deletions result in fetal hemoglobin persistence and neurodevelopmental alterations
Anindita Basak, … , Zdenek Sedlacek, Vijay G. Sankaran
Anindita Basak, … , Zdenek Sedlacek, Vijay G. Sankaran
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2363-2368. https://doi.org/10.1172/JCI81163.
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BCL11A deletions result in fetal hemoglobin persistence and neurodevelopmental alterations

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Abstract

A transition from fetal hemoglobin (HbF) to adult hemoglobin (HbA) normally occurs within a few months after birth. Increased production of HbF after this period of infancy ameliorates clinical symptoms of the major disorders of adult β-hemoglobin: β-thalassemia and sickle cell disease. The transcription factor BCL11A silences HbF and has been an attractive therapeutic target for increasing HbF levels; however, it is not clear to what extent BCL11A inhibits HbF production or mediates other developmental functions in humans. Here, we identified and characterized 3 patients with rare microdeletions of 2p15-p16.1 who presented with an autism spectrum disorder and developmental delay. Moreover, these patients all exhibited substantial persistence of HbF but otherwise retained apparently normal hematologic and immunologic function. Of the genes within 2p15-p16.1, only BCL11A was commonly deleted in all of the patients. Evaluation of gene expression data sets from developing and adult human brains revealed that BCL11A expression patterns are similar to other genes associated with neurodevelopmental disorders. Additionally, common SNPs within the second intron of BCL11A are strongly associated with schizophrenia. Together, the study of these rare patients and orthogonal genetic data demonstrates that BCL11A plays a central role in silencing HbF in humans and implicates BCL11A as an important factor for neurodevelopment.

Authors

Anindita Basak, Miroslava Hancarova, Jacob C. Ulirsch, Tugce B. Balci, Marie Trkova, Michal Pelisek, Marketa Vlckova, Katerina Muzikova, Jaroslav Cermak, Jan Trka, David A. Dyment, Stuart H. Orkin, Mark J. Daly, Zdenek Sedlacek, Vijay G. Sankaran

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Inducible Gata1 suppression expands megakaryocyte-erythroid progenitors from embryonic stem cells
Ji-Yoon Noh, … , Mortimer Poncz, Mitchell J. Weiss
Ji-Yoon Noh, … , Mortimer Poncz, Mitchell J. Weiss
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2369-2374. https://doi.org/10.1172/JCI77670.
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Inducible Gata1 suppression expands megakaryocyte-erythroid progenitors from embryonic stem cells

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Transfusion of donor-derived platelets is commonly used for thrombocytopenia, which results from a variety of clinical conditions and relies on a constant donor supply due to the limited shelf life of these cells. Embryonic stem (ES) and induced pluripotent stem (iPS) cells represent a potential source of megakaryocytes and platelets for transfusion therapies; however, the majority of current ES/iPS cell differentiation protocols are limited by low yields of hematopoietic progeny. In both mice and humans, mutations in the gene-encoding transcription factor GATA1 cause an accumulation of proliferating, developmentally arrested megakaryocytes, suggesting that GATA1 suppression in ES and iPS cell–derived hematopoietic progenitors may enhance megakaryocyte production. Here, we engineered ES cells from WT mice to express a doxycycline-regulated (dox-regulated) shRNA that targets Gata1 transcripts for degradation. Differentiation of these cells in the presence of dox and thrombopoietin (TPO) resulted in an exponential (at least 1013-fold) expansion of immature hematopoietic progenitors. Dox withdrawal in combination with multilineage cytokines restored GATA1 expression, resulting in differentiation into erythroblasts and megakaryocytes. Following transfusion into recipient animals, these dox-deprived mature megakaryocytes generated functional platelets. Our findings provide a readily reproducible strategy to exponentially expand ES cell–derived megakaryocyte-erythroid progenitors that have the capacity to differentiate into functional platelet-producing megakaryocytes.

Authors

Ji-Yoon Noh, Shilpa Gandre-Babbe, Yuhuan Wang, Vincent Hayes, Yu Yao, Paul Gadue, Spencer K. Sullivan, Stella T. Chou, Kellie R. Machlus, Joseph E. Italiano Jr., Michael Kyba, David Finkelstein, Jacob C. Ulirsch, Vijay G. Sankaran, Deborah L. French, Mortimer Poncz, Mitchell J. Weiss

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KANK deficiency leads to podocyte dysfunction and nephrotic syndrome
Heon Yung Gee, … , Zhe Han, Friedhelm Hildebrandt
Heon Yung Gee, … , Zhe Han, Friedhelm Hildebrandt
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2375-2384. https://doi.org/10.1172/JCI79504.
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KANK deficiency leads to podocyte dysfunction and nephrotic syndrome

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Steroid-resistant nephrotic syndrome (SRNS) is a frequent cause of progressive renal function decline and affects millions of people. In a recent study, 30% of SRNS cases evaluated were the result of monogenic mutations in 1 of 27 different genes. Here, using homozygosity mapping and whole-exome sequencing, we identified recessive mutations in kidney ankyrin repeat-containing protein 1 (KANK1), KANK2, and KANK4 in individuals with nephrotic syndrome. In an independent functional genetic screen of Drosophila cardiac nephrocytes, which are equivalents of mammalian podocytes, we determined that the Drosophila KANK homolog (dKank) is essential for nephrocyte function. RNAi-mediated knockdown of dKank in nephrocytes disrupted slit diaphragm filtration structures and lacuna channel structures. In rats, KANK1, KANK2, and KANK4 all localized to podocytes in glomeruli, and KANK1 partially colocalized with synaptopodin. Knockdown of kank2 in zebrafish recapitulated a nephrotic syndrome phenotype, resulting in proteinuria and podocyte foot process effacement. In rat glomeruli and cultured human podocytes, KANK2 interacted with ARHGDIA, a known regulator of RHO GTPases in podocytes that is dysfunctional in some types of nephrotic syndrome. Knockdown of KANK2 in cultured podocytes increased active GTP-bound RHOA and decreased migration. Together, these data suggest that KANK family genes play evolutionarily conserved roles in podocyte function, likely through regulating RHO GTPase signaling.

Authors

Heon Yung Gee, Fujian Zhang, Shazia Ashraf, Stefan Kohl, Carolin E. Sadowski, Virginia Vega-Warner, Weibin Zhou, Svjetlana Lovric, Humphrey Fang, Margaret Nettleton, Jun-yi Zhu, Julia Hoefele, Lutz T. Weber, Ludmila Podracka, Andrej Boor, Henry Fehrenbach, Jeffrey W. Innis, Joseph Washburn, Shawn Levy, Richard P. Lifton, Edgar A. Otto, Zhe Han, Friedhelm Hildebrandt

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Hypoxia-induced p53 modulates both apoptosis and radiosensitivity via AKT
Katarzyna B. Leszczynska, … , Francesca M. Buffa, Ester M. Hammond
Katarzyna B. Leszczynska, … , Francesca M. Buffa, Ester M. Hammond
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2385-2398. https://doi.org/10.1172/JCI80402.
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Hypoxia-induced p53 modulates both apoptosis and radiosensitivity via AKT

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Abstract

Restoration of hypoxia-induced apoptosis in tumors harboring p53 mutations has been proposed as a potential therapeutic strategy; however, the transcriptional targets that mediate hypoxia-induced p53-dependent apoptosis remain elusive. Here, we demonstrated that hypoxia-induced p53-dependent apoptosis is reliant on the DNA-binding and transactivation domains of p53 but not on the acetylation sites K120 and K164, which, in contrast, are essential for DNA damage–induced, p53-dependent apoptosis. Evaluation of hypoxia-induced transcripts in multiple cell lines identified a group of genes that are hypoxia-inducible proapoptotic targets of p53, including inositol polyphosphate-5-phosphatase (INPP5D), pleckstrin domain–containing A3 (PHLDA3), sulfatase 2 (SULF2), B cell translocation gene 2 (BTG2), cytoplasmic FMR1-interacting protein 2 (CYFIP2), and KN motif and ankyrin repeat domains 3 (KANK3). These targets were also regulated by p53 in human cancers, including breast, brain, colorectal, kidney, bladder, and melanoma cancers. Downregulation of these hypoxia-inducible targets associated with poor prognosis, suggesting that hypoxia-induced apoptosis contributes to p53-mediated tumor suppression and treatment response. Induction of p53 targets, PHLDA3, and a specific INPP5D transcript mediated apoptosis in response to hypoxia through AKT inhibition. Moreover, pharmacological inhibition of AKT led to apoptosis in the hypoxic regions of p53-deficient tumors and consequently increased radiosensitivity. Together, these results identify mediators of hypoxia-induced p53-dependent apoptosis and suggest AKT inhibition may improve radiotherapy response in p53-deficient tumors.

Authors

Katarzyna B. Leszczynska, Iosifina P. Foskolou, Aswin G. Abraham, Selvakumar Anbalagan, Céline Tellier, Syed Haider, Paul N. Span, Eric E. O’Neill, Francesca M. Buffa, Ester M. Hammond

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Macrophage migration inhibitory factor promotes cyst growth in polycystic kidney disease
Li Chen, … , Jared J. Grantham, Xiaogang Li
Li Chen, … , Jared J. Grantham, Xiaogang Li
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2399-2412. https://doi.org/10.1172/JCI80467.
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Macrophage migration inhibitory factor promotes cyst growth in polycystic kidney disease

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Autosomal dominant polycystic kidney disease (ADPKD) is characterized by renal cyst formation, inflammation, and fibrosis. Macrophages infiltrate cystic kidneys, but the role of these and other inflammatory factors in disease progression are poorly understood. Here, we identified macrophage migration inhibitory factor (MIF) as an important regulator of cyst growth in ADPKD. MIF was upregulated in cyst-lining epithelial cells in polycystin-1–deficient murine kidneys and accumulated in cyst fluid of human ADPKD kidneys. MIF promoted cystic epithelial cell proliferation by activating ERK, mTOR, and Rb/E2F pathways and by increasing glucose uptake and ATP production, which inhibited AMP-activated protein kinase signaling. MIF also regulated cystic renal epithelial cell apoptosis through p53-dependent signaling. In polycystin-1–deficient mice, MIF was required for recruitment and retention of renal macrophages, which promoted cyst expansion, and Mif deletion or pharmacologic inhibition delayed cyst growth in multiple murine ADPKD models. MIF-dependent macrophage recruitment was associated with upregulation of monocyte chemotactic protein 1 (MCP-1) and inflammatory cytokine TNF-α. TNF-α induced MIF expression, and MIF subsequently exacerbated TNF-α expression in renal epithelial cells, suggesting a positive feedback loop between TNF-α and MIF during cyst development. Our study indicates MIF is a central and upstream regulator of ADPKD pathogenesis and provides a rationale for further exploration of MIF as a therapeutic target for ADPKD.

Authors

Li Chen, Xia Zhou, Lucy X. Fan, Ying Yao, Katherine I. Swenson-Fields, Mihaela Gadjeva, Darren P. Wallace, Dorien J.M. Peters, Alan Yu, Jared J. Grantham, Xiaogang Li

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Dysfunctional SEMA3E signaling underlies gonadotropin-releasing hormone neuron deficiency in Kallmann syndrome
Anna Cariboni, … , Fanny Mann, Christiana Ruhrberg
Anna Cariboni, … , Fanny Mann, Christiana Ruhrberg
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2413-2428. https://doi.org/10.1172/JCI78448.
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Dysfunctional SEMA3E signaling underlies gonadotropin-releasing hormone neuron deficiency in Kallmann syndrome

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Abstract

Individuals with an inherited deficiency in gonadotropin-releasing hormone (GnRH) have impaired sexual reproduction. Previous genetic linkage studies and sequencing of plausible gene candidates have identified mutations associated with inherited GnRH deficiency, but the small number of affected families and limited success in validating candidates have impeded genetic diagnoses for most patients. Using a combination of exome sequencing and computational modeling, we have identified a shared point mutation in semaphorin 3E (SEMA3E) in 2 brothers with Kallmann syndrome (KS), which causes inherited GnRH deficiency. Recombinant wild-type SEMA3E protected maturing GnRH neurons from cell death by triggering a plexin D1–dependent (PLXND1-dependent) activation of PI3K-mediated survival signaling. In contrast, recombinant SEMA3E carrying the KS-associated mutation did not protect GnRH neurons from death. In murine models, lack of either SEMA3E or PLXND1 increased apoptosis of GnRH neurons in the developing brain, reducing innervation of the adult median eminence by GnRH-positive neurites. GnRH neuron deficiency in male mice was accompanied by impaired testes growth, a characteristic feature of KS. Together, these results identify SEMA3E as an essential gene for GnRH neuron development, uncover a neurotrophic function for SEMA3E in the developing brain, and elucidate SEMA3E/PLXND1/PI3K signaling as a mechanism that prevents GnRH neuron deficiency.

Authors

Anna Cariboni, Valentina André, Sophie Chauvet, Daniele Cassatella, Kathryn Davidson, Alessia Caramello, Alessandro Fantin, Pierre Bouloux, Fanny Mann, Christiana Ruhrberg

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Phosphatidylinositol 3-kinase signaling determines kidney size
Jian-Kang Chen, … , Eric G. Neilson, Raymond C. Harris
Jian-Kang Chen, … , Eric G. Neilson, Raymond C. Harris
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2429-2444. https://doi.org/10.1172/JCI78945.
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Phosphatidylinositol 3-kinase signaling determines kidney size

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Abstract

Kidney size adaptively increases as mammals grow and in response to the loss of 1 kidney. It is not clear how kidneys size themselves or if the processes that adapt kidney mass to lean body mass also mediate renal hypertrophy following unilateral nephrectomy (UNX). Here, we demonstrated that mice harboring a proximal tubule–specific deletion of Pten (PtenptKO) have greatly enlarged kidneys as the result of persistent activation of the class I PI3K/mTORC2/AKT pathway and an increase of the antiproliferative signals p21Cip1/WAF and p27Kip1. Administration of rapamycin to PtenptKO mice diminished hypertrophy. Proximal tubule–specific deletion of Egfr in PtenptKO mice also attenuated class I PI3K/mTORC2/AKT signaling and reduced the size of enlarged kidneys. In PtenptKO mice, UNX further increased mTORC1 activation and hypertrophy in the remaining kidney; however, mTORC2-dependent AKT phosphorylation did not increase further in the remaining kidney of PtenptKO mice, nor was it induced in the remaining kidney of WT mice. After UNX, renal blood flow and amino acid delivery to the remaining kidney rose abruptly, followed by increased amino acid content and activation of a class III PI3K/mTORC1/S6K1 pathway. Thus, our findings demonstrate context-dependent roles for EGFR-modulated class I PI3K/mTORC2/AKT signaling in the normal adaptation of kidney size and PTEN-independent, nutrient-dependent class III PI3K/mTORC1/S6K1 signaling in the compensatory enlargement of the remaining kidney following UNX.

Authors

Jian-Kang Chen, Kojiro Nagai, Jianchun Chen, David Plieth, Masayo Hino, Jinxian Xu, Feng Sha, T. Alp Ikizler, C. Chad Quarles, David W. Threadgill, Eric G. Neilson, Raymond C. Harris

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Lineage fate of ductular reactions in liver injury and carcinogenesis
Simone Jörs, … , Jens T. Siveke, Fabian Geisler
Simone Jörs, … , Jens T. Siveke, Fabian Geisler
Published April 27, 2015
Citation Information: J Clin Invest. 2015;125(6):2445-2457. https://doi.org/10.1172/JCI78585.
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Lineage fate of ductular reactions in liver injury and carcinogenesis

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Abstract

Ductular reactions (DRs) are observed in virtually all forms of human liver disease; however, the histogenesis and function of DRs in liver injury are not entirely understood. It is widely believed that DRs contain bipotential liver progenitor cells (LPCs) that serve as an emergency cell pool to regenerate both cholangiocytes and hepatocytes and may eventually give rise to hepatocellular carcinoma (HCC). Here, we used a murine model that allows highly efficient and specific lineage labeling of the biliary compartment to analyze the histogenesis of DRs and their potential contribution to liver regeneration and carcinogenesis. In multiple experimental and genetic liver injury models, biliary cells were the predominant precursors of DRs but lacked substantial capacity to produce new hepatocytes, even when liver injuries were prolonged up to 12 months. Genetic modulation of NOTCH and/or WNT/β-catenin signaling within lineage-tagged DRs impaired DR expansion but failed to redirect DRs from biliary differentiation toward the hepatocyte lineage. Further, lineage-labeled DRs did not produce tumors in genetic and chemical HCC mouse models. In summary, we found no evidence in our system to support mouse biliary-derived DRs as an LPC pool to replenish hepatocytes in a quantitatively relevant way in injury or evidence that DRs give rise to HCCs.

Authors

Simone Jörs, Petia Jeliazkova, Marc Ringelhan, Julian Thalhammer, Stephanie Dürl, Jorge Ferrer, Maike Sander, Mathias Heikenwalder, Roland M. Schmid, Jens T. Siveke, Fabian Geisler

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Suppression of NLRX1 in chronic obstructive pulmonary disease
Min-Jong Kang, … , Yeon-Mok Oh, Jack A. Elias
Min-Jong Kang, … , Yeon-Mok Oh, Jack A. Elias
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2458-2462. https://doi.org/10.1172/JCI71747.
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Suppression of NLRX1 in chronic obstructive pulmonary disease

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Abstract

Cigarette smoke (CS) and viruses promote the inflammation and remodeling associated with chronic obstructive pulmonary disease (COPD). The MAVS/RIG-I–like helicase (MAVS/RLH) pathway and inflammasome-dependent innate immune pathways are important mediators of these responses. At baseline, the MAVS/RLH pathway is suppressed, and this inhibition must be reversed to engender tissue effects; however, the mechanisms that mediate activation and repression of the pathway have not been defined. In addition, the regulation and contribution of MAVS/RLH signaling in CS-induced inflammation and remodeling responses and in the development of human COPD remain unaddressed. Here, we demonstrate that expression of NLRX1, which inhibits the MAVS/RLH pathway and regulates other innate immune responses, was markedly decreased in 3 independent cohorts of COPD patients. NLRX1 suppression correlated directly with disease severity and inversely with pulmonary function, quality of life, and prognosis. In murine models, CS inhibited NLRX1, and CS-induced inflammation, alveolar destruction, protease induction, structural cell apoptosis, and inflammasome activation were augmented in NLRX1-deficient animals. Conversely, MAVS deficiency abrogated this CS-induced inflammation and remodeling. Restoration of NLRX1 in CS-exposed animals ameliorated alveolar destruction. These data support a model in which CS-dependent NLRX1 inhibition facilitates MAVS/RHL activation and subsequent inflammation, remodeling, protease, cell death, and inflammasome responses.

Authors

Min-Jong Kang, Chang Min Yoon, Bo Hye Kim, Chang-Min Lee, Yang Zhou, Maor Sauler, Rober Homer, Anish Dhamija, Daniel Boffa, Andrew Phillip West, Gerald S. Shadel, Jenny P. Ting, John R. Tedrow, Naftali Kaminski, Woo Jin Kim, Chun Geun Lee, Yeon-Mok Oh, Jack A. Elias

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Hyperglycemia modulates extracellular amyloid-β concentrations and neuronal activity in vivo
Shannon L. Macauley, … , Courtney L. Sutphen, David M. Holtzman
Shannon L. Macauley, … , Courtney L. Sutphen, David M. Holtzman
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2463-2467. https://doi.org/10.1172/JCI79742.
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Hyperglycemia modulates extracellular amyloid-β concentrations and neuronal activity in vivo

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Abstract

Epidemiological studies show that patients with type 2 diabetes (T2DM) and individuals with a diabetes-independent elevation in blood glucose have an increased risk for developing dementia, specifically dementia due to Alzheimer’s disease (AD). These observations suggest that abnormal glucose metabolism likely plays a role in some aspects of AD pathogenesis, leading us to investigate the link between aberrant glucose metabolism, T2DM, and AD in murine models. Here, we combined two techniques — glucose clamps and in vivo microdialysis — as a means to dynamically modulate blood glucose levels in awake, freely moving mice while measuring real-time changes in amyloid-β (Aβ), glucose, and lactate within the hippocampal interstitial fluid (ISF). In a murine model of AD, induction of acute hyperglycemia in young animals increased ISF Aβ production and ISF lactate, which serves as a marker of neuronal activity. These effects were exacerbated in aged AD mice with marked Aβ plaque pathology. Inward rectifying, ATP-sensitive potassium (KATP) channels mediated the response to elevated glucose levels, as pharmacological manipulation of KATP channels in the hippocampus altered both ISF Aβ levels and neuronal activity. Taken together, these results suggest that KATP channel activation mediates the response of hippocampal neurons to hyperglycemia by coupling metabolism with neuronal activity and ISF Aβ levels.

Authors

Shannon L. Macauley, Molly Stanley, Emily E. Caesar, Steven A. Yamada, Marcus E. Raichle, Ronaldo Perez, Thomas E. Mahan, Courtney L. Sutphen, David M. Holtzman

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Prevention of PKG1α oxidation augments cardioprotection in the stressed heart
Taishi Nakamura, … , Philip Eaton, David A. Kass
Taishi Nakamura, … , Philip Eaton, David A. Kass
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2468-2472. https://doi.org/10.1172/JCI80275.
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Prevention of PKG1α oxidation augments cardioprotection in the stressed heart

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Abstract

The cGMP-dependent protein kinase-1α (PKG1α) transduces NO and natriuretic peptide signaling; therefore, PKG1α activation can benefit the failing heart. Disease modifiers such as oxidative stress may depress the efficacy of PKG1α pathway activation and underlie variable clinical results. PKG1α can also be directly oxidized, forming a disulfide bond between homodimer subunits at cysteine 42 to enhance oxidant-stimulated vasorelaxation; however, the impact of PKG1α oxidation on myocardial regulation is unknown. Here, we demonstrated that PKG1α is oxidized in both patients with heart disease and in rodent disease models. Moreover, this oxidation contributed to adverse heart remodeling following sustained pressure overload or Gq agonist stimulation. Compared with control hearts and myocytes, those expressing a redox-dead protein (PKG1αC42S) better adapted to cardiac stresses at functional, histological, and molecular levels. Redox-dependent changes in PKG1α altered intracellular translocation, with the activated, oxidized form solely located in the cytosol, whereas reduced PKG1αC42S translocated to and remained at the outer plasma membrane. This altered PKG1α localization enhanced suppression of transient receptor potential channel 6 (TRPC6), thereby potentiating antihypertrophic signaling. Together, these results demonstrate that myocardial PKG1α oxidation prevents a beneficial response to pathological stress, may explain variable responses to PKG1α pathway stimulation in heart disease, and indicate that maintaining PKG1α in its reduced form may optimize its intrinsic cardioprotective properties.

Authors

Taishi Nakamura, Mark J. Ranek, Dong I. Lee, Virginia Shalkey Hahn, Choel Kim, Philip Eaton, David A. Kass

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Bacterial induction of Snail1 contributes to blood-brain barrier disruption
Brandon J. Kim, … , David Traver, Kelly S. Doran
Brandon J. Kim, … , David Traver, Kelly S. Doran
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2473-2483. https://doi.org/10.1172/JCI74159.
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Bacterial induction of Snail1 contributes to blood-brain barrier disruption

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Abstract

Bacterial meningitis is a serious infection of the CNS that results when blood-borne bacteria are able to cross the blood-brain barrier (BBB). Group B Streptococcus (GBS) is the leading cause of neonatal meningitis; however, the molecular mechanisms that regulate bacterial BBB disruption and penetration are not well understood. Here, we found that infection of human brain microvascular endothelial cells (hBMECs) with GBS and other meningeal pathogens results in the induction of host transcriptional repressor Snail1, which impedes expression of tight junction genes. Moreover, GBS infection also induced Snail1 expression in murine and zebrafish models. Tight junction components ZO-1, claudin 5, and occludin were decreased at both the transcript and protein levels in hBMECs following GBS infection, and this repression was dependent on Snail1 induction. Bacteria-independent Snail1 expression was sufficient to facilitate tight junction disruption, promoting BBB permeability to allow bacterial passage. GBS induction of Snail1 expression was dependent on the ERK1/2/MAPK signaling cascade and bacterial cell wall components. Finally, overexpression of a dominant-negative Snail1 homolog in zebrafish elevated transcription of tight junction protein–encoding genes and increased zebrafish survival in response to GBS challenge. Taken together, our data support a Snail1-dependent mechanism of BBB disruption and penetration by meningeal pathogens.

Authors

Brandon J. Kim, Bryan M. Hancock, Andres Bermudez, Natasha Del Cid, Efren Reyes, Nina M. van Sorge, Xavier Lauth, Cameron A. Smurthwaite, Brett J. Hilton, Aleksandr Stotland, Anirban Banerjee, John Buchanan, Roland Wolkowicz, David Traver, Kelly S. Doran

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Notch promotes recurrence of dormant tumor cells following HER2/neu-targeted therapy
Daniel L. Abravanel, … , Christopher J. Sterner, Lewis A. Chodosh
Daniel L. Abravanel, … , Christopher J. Sterner, Lewis A. Chodosh
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2484-2496. https://doi.org/10.1172/JCI74883.
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Notch promotes recurrence of dormant tumor cells following HER2/neu-targeted therapy

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Abstract

Breast cancer mortality is principally due to recurrent tumors that arise from a reservoir of residual tumor cells that survive therapy. Remarkably, breast cancers can recur after extended periods of clinical remission, implying that at least some residual tumor cells pass through a dormant phase prior to relapse. Nevertheless, the mechanisms that contribute to breast cancer recurrence are poorly understood. Using a mouse model of recurrent mammary tumorigenesis in combination with bioinformatics analyses of breast cancer patients, we have identified a role for Notch signaling in mammary tumor dormancy and recurrence. Specifically, we found that Notch signaling is acutely upregulated in tumor cells following HER2/neu pathway inhibition, that Notch signaling remains activated in a subset of dormant residual tumor cells that persist following HER2/neu downregulation, that activation of Notch signaling accelerates tumor recurrence, and that inhibition of Notch signaling by either genetic or pharmacological approaches impairs recurrence in mice. Consistent with these findings, meta-analysis of microarray data from over 4,000 breast cancer patients revealed that elevated Notch pathway activity is independently associated with an increased rate of recurrence. Together, these results implicate Notch signaling in tumor recurrence from dormant residual tumor cells and provide evidence that dormancy is a targetable stage of breast cancer progression.

Authors

Daniel L. Abravanel, George K. Belka, Tien-chi Pan, Dhruv K. Pant, Meredith A. Collins, Christopher J. Sterner, Lewis A. Chodosh

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MicroRNA-26a regulates insulin sensitivity and metabolism of glucose and lipids
Xianghui Fu, … , David D. Moore, Wendong Huang
Xianghui Fu, … , David D. Moore, Wendong Huang
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2497-2509. https://doi.org/10.1172/JCI75438.
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MicroRNA-26a regulates insulin sensitivity and metabolism of glucose and lipids

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Abstract

Type 2 diabetes (T2D) is characterized by insulin resistance and increased hepatic glucose production, yet the molecular mechanisms underlying these abnormalities are poorly understood. MicroRNAs (miRs) are a class of small, noncoding RNAs that have been implicated in the regulation of human diseases, including T2D. miR-26a is known to play a critical role in tumorigenesis; however, its function in cellular metabolism remains unknown. Here, we determined that miR-26a regulates insulin signaling and metabolism of glucose and lipids. Compared with lean individuals, overweight humans had decreased expression of miR-26a in the liver. Moreover, miR-26 was downregulated in 2 obese mouse models compared with control animals. Global or liver-specific overexpression of miR-26a in mice fed a high-fat diet improved insulin sensitivity, decreased hepatic glucose production, and decreased fatty acid synthesis, thereby preventing obesity-induced metabolic complications. Conversely, silencing of endogenous miR-26a in conventional diet–fed mice impaired insulin sensitivity, enhanced glucose production, and increased fatty acid synthesis. miR-26a targeted several key regulators of hepatic metabolism and insulin signaling. These findings reveal miR-26a as a regulator of liver metabolism and suggest miR-26a should be further explored as a potential target for the treatment of T2D.

Authors

Xianghui Fu, Bingning Dong, Yan Tian, Philippe Lefebvre, Zhipeng Meng, Xichun Wang, François Pattou, Weidong Han, Xiaoqiong Wang, Fang Lou, Richard Jove, Bart Staels, David D. Moore, Wendong Huang

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Anacetrapib lowers LDL by increasing ApoB clearance in mildly hypercholesterolemic subjects
John S. Millar, … , Henry N. Ginsberg, Daniel J. Rader
John S. Millar, … , Henry N. Ginsberg, Daniel J. Rader
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2510-2522. https://doi.org/10.1172/JCI80025.
View: Text | PDF | Corrigendum Clinical Research and Public Health

Anacetrapib lowers LDL by increasing ApoB clearance in mildly hypercholesterolemic subjects

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Abstract

BACKGROUND. Individuals treated with the cholesteryl ester transfer protein (CETP) inhibitor anacetrapib exhibit a reduction in both LDL cholesterol and apolipoprotein B (ApoB) in response to monotherapy or combination therapy with a statin. It is not clear how anacetrapib exerts these effects; therefore, the goal of this study was to determine the kinetic mechanism responsible for the reduction in LDL and ApoB in response to anacetrapib.

METHODS. We performed a trial of the effects of anacetrapib on ApoB kinetics. Mildly hypercholesterolemic subjects were randomized to background treatment of either placebo (n = 10) or 20 mg atorvastatin (ATV) (n = 29) for 4 weeks. All subjects then added 100 mg anacetrapib to background treatment for 8 weeks. Following each study period, subjects underwent a metabolic study to determine the LDL-ApoB-100 and proprotein convertase subtilisin/kexin type 9 (PCSK9) production rate (PR) and fractional catabolic rate (FCR).

RESULTS. Anacetrapib markedly reduced the LDL-ApoB-100 pool size (PS) in both the placebo and ATV groups. These changes in PS resulted from substantial increases in LDL-ApoB-100 FCRs in both groups. Anacetrapib had no effect on LDL-ApoB-100 PRs in either treatment group. Moreover, there were no changes in the PCSK9 PS, FCR, or PR in either group. Anacetrapib treatment was associated with considerable increases in the LDL triglyceride/cholesterol ratio and LDL size by NMR.

CONCLUSION. These data indicate that anacetrapib, given alone or in combination with a statin, reduces LDL-ApoB-100 levels by increasing the rate of ApoB-100 fractional clearance.

TRIAL REGISTRATION. ClinicalTrials.gov NCT00990808.

FUNDING. Merck & Co. Inc., Kenilworth, New Jersey, USA. Additional support for instrumentation was obtained from the National Center for Advancing Translational Sciences (UL1TR000003 and UL1TR000040).

Authors

John S. Millar, Gissette Reyes-Soffer, Patricia Jumes, Richard L. Dunbar, Emil M. deGoma, Amanda L. Baer, Wahida Karmally, Daniel S. Donovan, Hashmi Rafeek, Laura Pollan, Junichiro Tohyama, Amy O. Johnson-Levonas, John A. Wagner, Stephen Holleran, Joseph Obunike, Yang Liu, Rajasekhar Ramakrishnan, Michael E. Lassman, David E. Gutstein, Henry N. Ginsberg, Daniel J. Rader

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Redesigned HIV antibodies exhibit enhanced neutralizing potency and breadth
Jordan R. Willis, … , Jens Meiler, James E. Crowe Jr.
Jordan R. Willis, … , Jens Meiler, James E. Crowe Jr.
Published May 18, 2015
Citation Information: J Clin Invest. 2015;125(6):2523-2531. https://doi.org/10.1172/JCI80693.
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Redesigned HIV antibodies exhibit enhanced neutralizing potency and breadth

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Abstract

Several HIV envelope-targeting (Env-targeting) antibodies with broad and potent neutralizing activity have been identified and shown to have unusual features. Of these, the PG9 antibody has a long heavy chain complementarity determining region 3 (HCDR3) and possesses unique structural elements that interact with protein and glycan features of the HIV Env glycoprotein. Here, we used the Rosetta software suite to design variants of the PG9 antibody HCDR3 loop with the goal of identifying variants with increased potency and breadth of neutralization for diverse HIV strains. One variant, designated PG9_N100FY, possessed increased potency and was able to neutralize a diverse set of PG9-resistant HIV strains, including those lacking the Env N160 glycan, which is critical for PG9 binding. An atomic resolution structure of the PG9_N100FY fragment antigen binding (Fab) confirmed that the mutated residue retains the paratope surface when compared with WT PG9. Differential scanning calorimetry experiments revealed that the mutation caused a modest increase in thermodynamic stability of the Fab, a feature predicted by the computational model. Our findings suggest that thermodynamic stabilization of the long HCDR3 in its active conformation is responsible for the increased potency of PG9_N100FY, and strategies aimed at stabilizing this region in other HIV antibodies could become an important approach to in silico optimization of antibodies.

Authors

Jordan R. Willis, Gopal Sapparapu, Sasha Murrell, Jean-Philippe Julien, Vidisha Singh, Hannah G. King, Yan Xia, Jennifer A. Pickens, Celia C. LaBranche, James C. Slaughter, David C. Montefiori, Ian A. Wilson, Jens Meiler, James E. Crowe Jr.

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Nanoparticulate STING agonists are potent lymph node–targeted vaccine adjuvants
Melissa C. Hanson, … , Stefanie Mueller, Darrell J. Irvine
Melissa C. Hanson, … , Stefanie Mueller, Darrell J. Irvine
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2532-2546. https://doi.org/10.1172/JCI79915.
View: Text | PDF Technical Advance

Nanoparticulate STING agonists are potent lymph node–targeted vaccine adjuvants

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Abstract

Cyclic dinucleotides (CDNs) are agonists of stimulator of IFN genes (STING) and have potential as vaccine adjuvants. However, cyclic di-GMP (cdGMP) injected s.c. shows minimal uptake into lymphatics/draining lymph nodes (dLNs) and instead is rapidly distributed to the bloodstream, leading to systemic inflammation. Here, we encapsulated cdGMP within PEGylated lipid nanoparticles (NP-cdGMP) to redirect this adjuvant to dLNs. Compared with unformulated CDNs, encapsulation blocked systemic dissemination and markedly enhanced dLN accumulation in murine models. Delivery of NP-cdGMP increased CD8+ T cell responses primed by peptide vaccines and enhanced therapeutic antitumor immunity. A combination of a poorly immunogenic liposomal HIV gp41 peptide antigen and NP-cdGMP robustly induced type I IFN in dLNs, induced a greater expansion of vaccine-specific CD4+ T cells, and greatly increased germinal center B cell differentiation in dLNs compared with a combination of liposomal HIV gp41 and soluble CDN. Further, NP-cdGMP promoted durable antibody titers that were substantially higher than those promoted by the well-studied TLR agonist monophosphoryl lipid A and comparable to a much larger dose of unformulated cdGMP, without the systemic toxicity of the latter. These results demonstrate that nanoparticulate delivery safely targets CDNs to the dLNs and enhances the efficacy of this adjuvant. Moreover, this approach can be broadly applied to other small-molecule immunomodulators of interest for vaccines and immunotherapy.

Authors

Melissa C. Hanson, Monica P. Crespo, Wuhbet Abraham, Kelly D. Moynihan, Gregory L. Szeto, Stephanie H. Chen, Mariane B. Melo, Stefanie Mueller, Darrell J. Irvine

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Erratum
Human prion protein sequence elements impede cross-species chronic wasting disease transmission
Timothy D. Kurt, … , Qingzhong Kong, Christina J. Sigurdson
Timothy D. Kurt, … , Qingzhong Kong, Christina J. Sigurdson
Published May 11, 2015
Citation Information: J Clin Invest. 2015;125(6):2548-2548. https://doi.org/10.1172/JCI82647.
View: Text | PDF | Amended Article

Human prion protein sequence elements impede cross-species chronic wasting disease transmission

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Abstract

Authors

Timothy D. Kurt, Lin Jiang, Natalia Fernández-Borges, Cyrus Bett, Jun Liu, Tom Yang, Terry R. Spraker, Joaquín Castilla, David Eisenberg, Qingzhong Kong, Christina J. Sigurdson

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Corrigenda
MHCII-independent CD4+ T cells protect injured CNS neurons via IL-4
James T. Walsh, … , Frauke Zipp, Jonathan Kipnis
James T. Walsh, … , Frauke Zipp, Jonathan Kipnis
Published May 4, 2015
Citation Information: J Clin Invest. 2015;125(6):2547-2547. https://doi.org/10.1172/JCI82458.
View: Text | PDF | Amended Article

MHCII-independent CD4+ T cells protect injured CNS neurons via IL-4

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Abstract

Authors

James T. Walsh, Sven Hendrix, Francesco Boato, Igor Smirnov, Jingjing Zheng, John R. Lukens, Sachin Gadani, Daniel Hechler, Greta Gölz, Karen Rosenberger, Thomas Kammertöns, Johannes Vogt, Christina Vogelaar, Volker Siffrin, Ali Radjavi, Anthony Fernandez-Castaneda, Alban Gaultier, Ralf Gold, Thirumala-Devi Kanneganti, Robert Nitsch, Frauke Zipp, Jonathan Kipnis

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CTLA4 aptamer delivers STAT3 siRNA to tumor-associated and malignant T cells
Andreas Herrmann, … , Marcin Kortylewski, Hua Yu
Andreas Herrmann, … , Marcin Kortylewski, Hua Yu
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2547-2547. https://doi.org/10.1172/JCI82555.
View: Text | PDF | Amended Article

CTLA4 aptamer delivers STAT3 siRNA to tumor-associated and malignant T cells

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Abstract

Authors

Andreas Herrmann, Saul J. Priceman, Piotr Swiderski, Maciej Kujawski, Hong Xin, Gregory A. Cherryholmes, Wang Zhang, Chunyan Zhang, Christoph Lahtz, Claudia Kowolik, Steve J. Forman, Marcin Kortylewski, Hua Yu

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Emerging mechanisms of molecular pathology in ALS
Owen M. Peters, … , Mehdi Ghasemi, Robert H. Brown Jr.
Owen M. Peters, … , Mehdi Ghasemi, Robert H. Brown Jr.
Published June 1, 2015
Citation Information: J Clin Invest. 2015;125(6):2548-2548. https://doi.org/10.1172/JCI82693.
View: Text | PDF | Amended Article

Emerging mechanisms of molecular pathology in ALS

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Abstract

Authors

Owen M. Peters, Mehdi Ghasemi, Robert H. Brown Jr.

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