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Issue published July 1, 2001 Previous issue | Next issue

  • Volume 108, Issue 1
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  • In this issue
  • Spotlight
  • Perspectives
  • Commentaries
  • Research Articles
In this issue
In This Issue
John Ashkenas
John Ashkenas
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):1-1. https://doi.org/10.1172/JCI119929.
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In This Issue

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Abstract

Authors

John Ashkenas

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Spotlight
Golgi nucleotide sugar transport and leukocyte adhesion deficiency II
Carlos B. Hirschberg
Carlos B. Hirschberg
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):3-6. https://doi.org/10.1172/JCI13480.
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Golgi nucleotide sugar transport and leukocyte adhesion deficiency II

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Abstract

Authors

Carlos B. Hirschberg

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Perspectives
Cyclooxygenase-selective inhibition of prostanoid formation: transducing biochemical selectivity into clinical read-outs
Carlo Patrono, … , Paola Patrignani, Luis A. García Rodríguez
Carlo Patrono, … , Paola Patrignani, Luis A. García Rodríguez
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):7-13. https://doi.org/10.1172/JCI13418.
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Cyclooxygenase-selective inhibition of prostanoid formation: transducing biochemical selectivity into clinical read-outs

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Abstract

Authors

Carlo Patrono, Paola Patrignani, Luis A. García Rodríguez

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Mixed messages: modulation of inflammation and immune responses by prostaglandins and thromboxanes
Stephen L. Tilley, … , Thomas M. Coffman, Beverly H. Koller
Stephen L. Tilley, … , Thomas M. Coffman, Beverly H. Koller
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):15-23. https://doi.org/10.1172/JCI13416.
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Mixed messages: modulation of inflammation and immune responses by prostaglandins and thromboxanes

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Abstract

Authors

Stephen L. Tilley, Thomas M. Coffman, Beverly H. Koller

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Genetic and pharmacological analysis of prostanoid receptor function
Shuh Narumiya, Garret A. FitzGerald
Shuh Narumiya, Garret A. FitzGerald
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):25-30. https://doi.org/10.1172/JCI13455.
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Genetic and pharmacological analysis of prostanoid receptor function

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Abstract

Authors

Shuh Narumiya, Garret A. FitzGerald

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Commentaries
Immunomodulatory therapy of human type 1 diabetes: lessons from the mouse
Jerry P. Palmer
Jerry P. Palmer
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):31-33. https://doi.org/10.1172/JCI13445.
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Immunomodulatory therapy of human type 1 diabetes: lessons from the mouse

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Abstract

Authors

Jerry P. Palmer

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The multiple contributions of thyroid hormone to heat production
J. Enrique Silva
J. Enrique Silva
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):35-37. https://doi.org/10.1172/JCI13397.
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The multiple contributions of thyroid hormone to heat production

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Abstract

Authors

J. Enrique Silva

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Regulation of hypoxia-induced angiogenesis: a chaperone escorts VEGF to the dance
Gregg L. Semenza
Gregg L. Semenza
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):39-40. https://doi.org/10.1172/JCI13374.
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Regulation of hypoxia-induced angiogenesis: a chaperone escorts VEGF to the dance

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Abstract

Authors

Gregg L. Semenza

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Research Articles
Expression of the oxygen-regulated protein ORP150 accelerates wound healing by modulating intracellular VEGF transport
Kentaro Ozawa, … , Satoshi Ogawa, Tohru Ohshima
Kentaro Ozawa, … , Satoshi Ogawa, Tohru Ohshima
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):41-50. https://doi.org/10.1172/JCI11772.
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Expression of the oxygen-regulated protein ORP150 accelerates wound healing by modulating intracellular VEGF transport

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Abstract

Expression of angiogenic factors such as VEGF under conditions of hypoxia or other kinds of cell stress contributes to neovascularization during wound healing. The inducible endoplasmic reticulum chaperone oxygen-regulated protein 150 (ORP150) is expressed in human wounds along with VEGF. Colocalization of these two molecules was observed in macrophages in the neovasculature, suggesting a role of ORP150 in the promotion of angiogenesis. Local administration of ORP150 sense adenovirus to wounds of diabetic mice, a treatment that efficiently targeted this gene product to the macrophages of wound beds, increased VEGF antigen in wounds and accelerated repair and neovascularization. In cultured human macrophages, inhibition of ORP150 expression caused retention of VEGF antigen within the endoplasmic reticulum (ER), while overexpression of ORP150 promoted the secretion of VEGF into hypoxic culture supernatants. Taken together, these data suggest an important role for ORP150 in the setting of impaired wound repair and identify a key, inducible chaperone-like molecule in the ER. This novel facet of the angiogenic response may be amenable to therapeutic manipulation.

Authors

Kentaro Ozawa, Toshikazu Kondo, Osamu Hori, Yasuko Kitao, David M. Stern, Wolfgang Eisenmenger, Satoshi Ogawa, Tohru Ohshima

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IFN-γ and Fas/FasL are required for the antitumor and antiangiogenic effects of IL-12/pulse IL-2 therapy
Jon M. Wigginton, … , Timothy C. Back, Robert H. Wiltrout
Jon M. Wigginton, … , Timothy C. Back, Robert H. Wiltrout
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):51-62. https://doi.org/10.1172/JCI10128.
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IFN-γ and Fas/FasL are required for the antitumor and antiangiogenic effects of IL-12/pulse IL-2 therapy

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Abstract

Systemic administration of IL-12 and intermittent doses of IL-2 induce complete regression of metastatic murine renal carcinoma. Here, we show that overt tumor regression induced by IL-12/pulse IL-2 is preceded by recruitment of CD8+ T cells, vascular injury, disrupted tumor neovascularization, and apoptosis of both endothelial and tumor cells. The IL-12/IL-2 combination synergistically enhances cell surface FasL expression on CD8+ T lymphocytes in vitro and induces Fas and FasL expression within tumors via an IFN-γ–dependent mechanism in vivo. This therapy also inhibits tumor neovascularization and induces tumor regression by mechanisms that depend critically on endogenous IFN-γ production and an intact Fas/FasL pathway. The ability of IL-12/pulse IL-2 to induce rapid destruction of tumor-associated endothelial cells and regression of established metastatic tumors is ablated in mice with a dysregulated Fas/FasL pathway. The common, critical role for endogenous IFN-γ and the Fas/FasL pathway in early antiangiogenic effects and in antitumor responses suggests that early, cytokine-driven innate immune mechanisms and CD8+ T cell–mediated responses are interdependent. Definition of critical early molecular events engaged by IL-12/IL-2 may provide new perspective into optimal therapeutic engagement of a productive host-antitumor immune response.

Authors

Jon M. Wigginton, Eilene Gruys, Lisa Geiselhart, Jeffrey Subleski, Kristin L. Komschlies, Jong-Wook Park, Theresa A. Wiltrout, Kunio Nagashima, Timothy C. Back, Robert H. Wiltrout

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Reversal of established autoimmune diabetes by restoration of endogenous β cell function
Shinichiro Ryu, … , David A. Schoenfeld, Denise L. Faustman
Shinichiro Ryu, … , David A. Schoenfeld, Denise L. Faustman
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):63-72. https://doi.org/10.1172/JCI12335.
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Reversal of established autoimmune diabetes by restoration of endogenous β cell function

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In NOD (nonobese diabetic) mice, a model of autoimmune diabetes, various immunomodulatory interventions prevent progression to diabetes. However, after hyperglycemia is established, such interventions rarely alter the course of disease or allow sustained engraftment of islet transplants. A proteasome defect in lymphoid cells of NOD mice impairs the presentation of self antigens and increases the susceptibility of these cells to TNF-α–induced apoptosis. Here, we examine the hypothesis that induction of TNF-α expression combined with reeducation of newly emerging T cells with self antigens can interrupt autoimmunity. Hyperglycemic NOD mice were treated with CFA to induce TNF-α expression and were exposed to functional complexes of MHC class I molecules and antigenic peptides either by repeated injection of MHC class I matched splenocytes or by transplantation of islets from nonautoimmune donors. Hyperglycemia was controlled in animals injected with splenocytes by administration of insulin or, more effectively, by implantation of encapsulated islets. These interventions reversed the established β cell–directed autoimmunity and restored endogenous pancreatic islet function to such an extent that normoglycemia was maintained in up to 75% of animals after discontinuation of treatment and removal of islet transplants. A therapy aimed at the selective elimination of autoreactive cells and the reeducation of T cells, when combined with control of glycemia, is thus able to effect an apparent cure of established type 1 diabetes in the NOD mouse.J. Clin. Invest.108:63–72 (2001). DOI:10.1172/JCI200112335.

Authors

Shinichiro Ryu, Shohta Kodama, Kazuko Ryu, David A. Schoenfeld, Denise L. Faustman

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c-Jun N-terminal kinase is required for metalloproteinase expression and joint destruction in inflammatory arthritis
Zuoning Han, … , Anthony M. Manning, Gary S. Firestein
Zuoning Han, … , Anthony M. Manning, Gary S. Firestein
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):73-81. https://doi.org/10.1172/JCI12466.
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c-Jun N-terminal kinase is required for metalloproteinase expression and joint destruction in inflammatory arthritis

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Mitogen-activated protein kinase (MAPK) cascades are involved in inflammation and tissue destruction in rheumatoid arthritis (RA). In particular, c-Jun N-terminal kinase (JNK) is highly activated in RA fibroblast-like synoviocytes and synovium. However, defining the precise function of this kinase has been difficult because a selective JNK inhibitor has not been available. We now report the use of a novel selective JNK inhibitor and JNK knockout mice to determine the function of JNK in synoviocyte biology and inflammatory arthritis. The novel JNK inhibitor SP600125 (anthra[1,9-cd]pyrazol-6(2H)-one) completely blocked IL-1–induced accumulation of phospho-Jun and induction of c-Jun transcription in synoviocytes. Furthermore, AP-1 binding and collagenase mRNA accumulation were completely suppressed by SP600125. In contrast, complete inhibition of p38 had no effect, and ERK inhibition had only a modest effect. The essential role of JNK was confirmed in cultured synoviocytes from JNK1 knockout mice and JNK2 knockout mice, each of which had a partial defect in IL-1–induced AP-1 activation and collagenase-3 expression. Administration of SP600125 modestly decreased the rat paw swelling in rat adjuvant-induced arthritis. More striking was the near-complete inhibition of radiographic damage that was associated with decreased AP-1 activity and collagenase-3 gene expression. Therefore, JNK is a critical MAPK pathway for IL-1–induced collagenase gene expression in synoviocytes and in joint arthritis, indicating that JNK is an important therapeutic target for RA.

Authors

Zuoning Han, David L. Boyle, Lufen Chang, Brydon Bennett, Michael Karin, Li Yang, Anthony M. Manning, Gary S. Firestein

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Systemic IFN-β gene therapy results in long-term survival in mice with established colorectal liver metastases
Hiroomi Tada, … , James M. Wilson, Francis R. Spitz
Hiroomi Tada, … , James M. Wilson, Francis R. Spitz
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):83-95. https://doi.org/10.1172/JCI9841.
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Systemic IFN-β gene therapy results in long-term survival in mice with established colorectal liver metastases

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Most patients succumbing to colorectal cancer fail with liver-predominant metastases. To make a clinical impact in this disease, a systemic or whole-liver therapy may be required, whereas most cancer gene therapy approaches are limited in their ability to treat beyond local disease. As a preclinical model for cancer gene therapy, recombinant adenovirus containing the human IFN-β (hIFN-β) cDNA was delivered systemically in nude mouse xenograft models of human colorectal cancer liver metastases. The vector targeted hepatocytes that produced high levels of hIFN-β in the liver, resulting in a profound apoptotic response in the tumors and significant tumor regression. hIFN-β gene therapy not only resulted in improved survival and long-term cure in a micrometastatic model, but provided similar benefits in a clinically relevant gross disease model. A similar recombinant adenovirus containing the murine IFN-β (mIFN-β) cDNA also resulted in a therapeutic response and improved survival in syngeneic mouse models of colorectal cancer liver metastases. Depletion studies demonstrate a contribution of natural killer cells to this therapeutic response. The toxicity of an adenoviral vector expressing murine IFN-β in a syngeneic model is also presented. These encouraging results warrant further investigation of the use of cancer gene therapy for targeting metastatic disease.

Authors

Hiroomi Tada, David J. Maron, Eugene A. Choi, James Barsoum, Hanqin Lei, Qing Xie, Wenbiao Liu, Lee Ellis, A. David Moscioni, John Tazelaar, Stephen Fawell, Xiao Qin, Kathleen J. Propert, Alan Davis, Douglas L. Fraker, James M. Wilson, Francis R. Spitz

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Thyroid hormone–sympathetic interaction and adaptive thermogenesis are thyroid hormone receptor isoform–specific
Miriam O. Ribeiro, … , Antonio C. Bianco, Gregory A. Brent
Miriam O. Ribeiro, … , Antonio C. Bianco, Gregory A. Brent
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):97-105. https://doi.org/10.1172/JCI12584.
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Thyroid hormone–sympathetic interaction and adaptive thermogenesis are thyroid hormone receptor isoform–specific

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In newborns and small mammals, cold-induced adaptive (or nonshivering) thermogenesis is produced primarily in brown adipose tissue (BAT). Heat production is stimulated by the sympathetic nervous system, but it has an absolute requirement for thyroid hormone. We used the thyroid hormone receptor-β–selective (TR-β–selective) ligand, GC-1, to determine by a pharmacological approach whether adaptive thermogenesis was TR isoform–specific. Hypothyroid mice were treated for 10 days with varying doses of T3 or GC-1. The level of uncoupling protein 1 (UCP1), the key thermogenic protein in BAT, was restored by either T3 or GC-1 treatment. However, whereas interscapular BAT in T3-treated mice showed a 3.0°C elevation upon infusion of norepinephrine, indicating normal thermogenesis, the temperature did not increase (<0.5°C) in GC-1–treated mice. When exposed to cold (4°C), GC-1–treated mice also failed to maintain core body temperature and had reduced stimulation of BAT UCP1 mRNA, indicating impaired adrenergic responsiveness. Brown adipocytes isolated from hypothyroid mice replaced with T3, but not from those replaced with GC-1, had normal cAMP production in response to adrenergic stimulation in vitro. We conclude that two distinct thyroid-dependent pathways, stimulation of UCP1 and augmentation of adrenergic responsiveness, are mediated by different TR isoforms in the same tissue.

Authors

Miriam O. Ribeiro, Suzy D. Carvalho, James J. Schultz, Grazia Chiellini, Thomas S. Scanlan, Antonio C. Bianco, Gregory A. Brent

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Molecular basis of ocular abnormalities associated with proximal renal tubular acidosis
Tomohiko Usui, … , Makoto Araie, George Seki
Tomohiko Usui, … , Makoto Araie, George Seki
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):107-115. https://doi.org/10.1172/JCI11869.
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Molecular basis of ocular abnormalities associated with proximal renal tubular acidosis

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Proximal renal tubular acidosis associated with ocular abnormalities such as band keratopathy, glaucoma, and cataracts is caused by mutations in the Na+-HCO3– cotransporter (NBC-1). However, the mechanism by which NBC-1 inactivation leads to such ocular abnormalities remains to be elucidated. By immunological analysis of human and rat eyes, we demonstrate that both kidney type (kNBC-1) and pancreatic type (pNBC-1) transporters are present in the corneal endothelium, trabecular meshwork, ciliary epithelium, and lens epithelium. In the human lens epithelial (HLE) cells, RT-PCR detected mRNAs of both kNBC-1 and pNBC-1. Although a Na+-HCO3– cotransport activity has not been detected in mammalian lens epithelia, cell pH (pHi) measurements revealed the presence of Cl–-independent, electrogenic Na+-HCO3– cotransport activity in HLE cells. In addition, up to 80% of amiloride-insensitive pHi recovery from acid load in the presence of HCO3–/CO2 was inhibited by adenovirus-mediated transfer of a specific hammerhead ribozyme against NBC-1, consistent with a major role of NBC-1 in overall HCO3– transport by the lens epithelium. These results indicate that the normal transport activity of NBC-1 is indispensable not only for the maintenance of corneal and lenticular transparency but also for the regulation of aqueous humor outflow.

Authors

Tomohiko Usui, Masumi Hara, Hiroaki Satoh, Nobuo Moriyama, Humie Kagaya, Shiro Amano, Tetsuro Oshika, Yasuo Ishii, Nobuhiro Ibaraki, Chiaki Hara, Motoei Kunimi, Eisei Noiri, Kazuhisa Tsukamoto, Jun Inatomi, Hayato Kawakami, Hitoshi Endou, Takashi Igarashi, Astuo Goto, Toshiro Fujita, Makoto Araie, George Seki

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Familial CD8 deficiency due to a mutation in the CD8α gene
Oscar de la Calle-Martin, … , Jose L. Rodriguez-Sanchez, Teresa Espanol
Oscar de la Calle-Martin, … , Jose L. Rodriguez-Sanchez, Teresa Espanol
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):117-123. https://doi.org/10.1172/JCI10993.
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Familial CD8 deficiency due to a mutation in the CD8α gene

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CD8 glycoproteins play an important role in both the maturation and function of MHC class I-restricted T lymphocytes. A 25-year-old man, from a consanguineous family, with recurrent bacterial infections and total absence of CD8+ cells, was studied. Ab deficiencies and ZAP-70 and TAP defects were ruled out. A missense mutation (gly90→ser) in both alleles of the immunoglobulin domain of the CD8α gene was shown to correlate with the absence of CD8 expression found in the patient and two sisters. Conversely, high percentages of CD4–CD8–TCRαβ+ T cells were found in the three siblings. A novel autosomal recessive immunologic defect characterized by absence of CD8+ cells is described. These findings may help to further understanding of the role of CD8 molecules in human immune response.

Authors

Oscar de la Calle-Martin, Manuel Hernandez, Jose Ordi, Natalia Casamitjana, Juan I. Arostegui, Isabel Caragol, Monserrat Ferrando, Moises Labrador, Jose L. Rodriguez-Sanchez, Teresa Espanol

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Acetylcholine receptor δ subunit mutations underlie a fast-channel myasthenic syndrome and arthrogryposis multiplex congenita
Sharon Brownlow, … , John Newsom-Davis, David Beeson
Sharon Brownlow, … , John Newsom-Davis, David Beeson
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):125-130. https://doi.org/10.1172/JCI12935.
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Acetylcholine receptor δ subunit mutations underlie a fast-channel myasthenic syndrome and arthrogryposis multiplex congenita

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Abstract

Limitation of movement during fetal development may lead to multiple joint contractures in the neonate, termed arthrogryposis multiplex congenita. Neuromuscular disorders are among the many different causes of reduced fetal movement. Many congenital myasthenic syndromes (CMSs) are due to mutations of the adult-specific ε subunit of the acetylcholine receptor (AChR), and, thus, functional deficits do not arise until late in gestation. However, an earlier effect on the fetus might be predicted with some defects of other AChR subunits. We studied a child who presented at birth with joint contractures and was subsequently found to have a CMS. Mutational screening revealed heteroallelic mutation within the AChR δ subunit gene, δ756ins2 and δE59K. Expression studies demonstrate that δ756ins2 is a null mutation. By contrast, both fetal and adult AChR containing δE59K have shorter than normal channel activations that predict fast decay of endplate currents. Thus, δE59K causes dysfunction of fetal as well as the adult AChR and would explain the presence of joint contractures on the basis of reduced fetal movement. This is the first report of the association of AChR gene mutations with arthrogryposis multiplex congenita. It is probable that mutations that severely disrupt function of fetal AChR will underlie additional cases.

Authors

Sharon Brownlow, Richard Webster, Rebecca Croxen, Martin Brydson, Brian Neville, Jean-Pierre Lin, Angela Vincent, John Newsom-Davis, David Beeson

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Adenosine deaminase deficiency increases thymic apoptosis and causes defective T cell receptor signaling
Sergey G. Apasov, … , Patrick T. Smith, Michail V. Sitkovsky
Sergey G. Apasov, … , Patrick T. Smith, Michail V. Sitkovsky
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):131-141. https://doi.org/10.1172/JCI10360.
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Adenosine deaminase deficiency increases thymic apoptosis and causes defective T cell receptor signaling

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Abstract

Adenosine deaminase (ADA) deficiency in humans results in a severe combined immunodeficiency (SCID). This immunodeficiency is associated with severe disturbances in purine metabolism that are thought to mediate lymphotoxicity. The recent generation of ADA-deficient (ADA–/–) mice has enabled the in vivo examination of mechanisms that may underlie the SCID resulting from ADA deficiency. We demonstrate severe depletion of T and B lymphocytes and defects in T and B cell development in ADA–/– mice. T cell apoptosis was abundant in thymi of ADA–/– mice, but no increase in apoptosis was detected in the spleen and lymph nodes of these animals, suggesting that the defect is specific to developing thymocytes. Studies of mature T cells recovered from spleens of ADA–/– mice revealed that ADA deficiency is accompanied by TCR activation defects of T cells in vivo. Furthermore, ex vivo experiments on ADA–/– T cells demonstrated that elevated adenosine is responsible for this abnormal TCR signaling. These findings suggest that the metabolic disturbances seen in ADA–/– mice affect various signaling pathways that regulate thymocyte survival and function. Experiments with thymocytes ex vivo confirmed that ADA deficiency reduces tyrosine phosphorylation of TCR-associated signaling molecules and blocks TCR-triggered calcium increases.

Authors

Sergey G. Apasov, Michael R. Blackburn, Rodney E. Kellems, Patrick T. Smith, Michail V. Sitkovsky

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Involvement of FAN in TNF-induced apoptosis
Bruno Ségui, … , Martin Krönke, Thierry Levade
Bruno Ségui, … , Martin Krönke, Thierry Levade
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):143-151. https://doi.org/10.1172/JCI11498.
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Involvement of FAN in TNF-induced apoptosis

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Abstract

TNF-α is a pleiotropic cytokine activating several signaling pathways initiated at distinct intracellular domains of the TNF receptors. Although the C-terminal region is believed to be responsible for apoptosis induction, the functions of more membrane-proximal domains, including the domain that couples to neutral sphingomyelinase activation, are not yet fully elucidated. The roles of this region and of the associated adapter protein FAN (factor associated with neutral SMase activation) in the cytotoxic response to TNF have been investigated. We have now shown that stable expression in human fibroblasts of a dominant negative form of FAN abrogates TNF-induced ceramide generation from sphingomyelin hydrolysis and reduces caspase processing, thus markedly inhibiting TNF-triggered apoptosis. However, the cytotoxic responses to daunorubicin and exogenous ceramide remain unaltered, as do the TNF-induced p42/p44 MAPK activation and CD54 expression. Fibroblasts from FAN-knockout mice also proved to be resistant to TNF toxicity. These findings highlight the previously unrecognized role of the adapter protein FAN in signaling cell death induction by TNF.

Authors

Bruno Ségui, Olivier Cuvillier, Sabine Adam-Klages, Virginie Garcia, Sophie Malagarie-Cazenave, Sophie Lévêque, Sylvie Caspar-Bauguil, Jérôme Coudert, Robert Salvayre, Martin Krönke, Thierry Levade

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Glucose toxicity and the development of diabetes in mice with muscle-specific inactivation of GLUT4
Jason K. Kim, … , Barbara B. Kahn, Gerald I. Shulman
Jason K. Kim, … , Barbara B. Kahn, Gerald I. Shulman
Published July 1, 2001
Citation Information: J Clin Invest. 2001;108(1):153-160. https://doi.org/10.1172/JCI10294.
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Glucose toxicity and the development of diabetes in mice with muscle-specific inactivation of GLUT4

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Abstract

Using cre/loxP gene targeting, transgenic mice with muscle-specific inactivation of the GLUT4 gene (muscle GLUT4 KO) were generated and shown to develop a diabetes phenotype. To determine the mechanism, we examined insulin-stimulated glucose uptake and metabolism during hyperinsulinemic-euglycemic clamp in control and muscle GLUT4 KO mice before and after development of diabetes. Insulin-stimulated whole body glucose uptake was decreased by 55% in muscle GLUT4 KO mice, an effect that could be attributed to a 92% decrease in insulin-stimulated muscle glucose uptake. Surprisingly, insulin’s ability to stimulate adipose tissue glucose uptake and suppress hepatic glucose production was significantly impaired in muscle GLUT4 KO mice. To address whether these latter changes were caused by glucose toxicity, we treated muscle GLUT4 KO mice with phloridzin to prevent hyperglycemia and found that insulin-stimulated whole body and skeletal muscle glucose uptake were decreased substantially, whereas insulin-stimulated glucose uptake in adipose tissue and suppression of hepatic glucose production were normal after phloridzin treatment. In conclusion, these findings demonstrate that a primary defect in muscle glucose transport can lead to secondary defects in insulin action in adipose tissue and liver due to glucose toxicity. These secondary defects contribute to insulin resistance and to the development of diabetes.

Authors

Jason K. Kim, Ariel Zisman, Jonathan J. Fillmore, Odile D. Peroni, Ko Kotani, Pascale Perret, Haihong Zong, Jianying Dong, C. Ronald Kahn, Barbara B. Kahn, Gerald I. Shulman

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