Autosomal recessive spastic ataxia of Charlevoix Saguenay (ARSACS) is an early onset neurodegenerative disorder resulting from mutations in the SACS gene that encodes the protein sacsin. Sacsin is a 520kDa multi-domain protein localised at the cytosolic face of the outer mitochondrial membrane with suggested roles in proteostasis and most recently in the regulation of mitochondrial morphology. An excessively interconnected mitochondrial network was observed as a consequence of reduced levels of sacsin protein following SACS knockdown in neuroblastoma cells as well as in an ARSACS patient carrying the common Quebec homozygous SACS mutation 8844delT. Moreover, it was suggested that sacsin has a role in mitochondrial fission as it was found to interact with mitochondrial fission protein Dynamin related protein 1 (Drp1). The aim of this thesis was to explore sacsin’s role in the regulation of mitochondrial morphology and dynamics in non-Quebec ARSACS patients and sacsin knockdown fibroblasts. This study shows that loss of sacsin function promotes a more interconnected mitochondrial network in non-Quebec ARSACS patients and in sacsin knockdown fibroblasts. Moreover, recruitment of the essential mitochondrial fission protein Drp1 to the mitochondria was significantly reduced in ARSACS patient cells and in sacsin knockdown fibroblasts. This reduced recruitment of Drp1 to mitochondria also occurred when cells were treated to induce mitochondrial fission. Furthermore, both the size and intensity of Drp1 foci localised to the mitochondria were significantly reduced in both sacsin knockdown and patient fibroblasts. Finally, reduced ATP production, decreased respiratory capacity of mitochondria and an increase in mitochondrial reactive oxygen species demonstrated impaired mitochondrial function in ARSACS patient and sacsin knockdown fibroblasts. These results suggest a role for sacsin in the stabilisation or recruitment of cytoplasmic Drp1 to prospective sites of mitochondrial fission similar to that observed by other mitochondrial fission accessory proteins.

OBJECTIVE: To examine the likelihood of self-reporting a diagnosis for PCOS with the presentation of menstrual irregularity in a diverse, multiethnic population, based on data collected between August 9th, 2017 and October 24th, 2017 for the pilot of the Ovulation and Menstruation (OM) Study at Boston University School of Medicine. BACKGROUND: Polycystic ovary syndrome, or PCOS, is the most common endocrine disorder among reproductive age women. It is typically diagnosed by variable combinations of menstrual irregularity, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound. An alternative is its diagnosis as one of exclusion due to similarities in presentation to other endocrine disorders. As a result, PCOS may often be misdiagnosed and mismanaged in the course of a patient’s care, further exacerbated by a poor understanding of the syndrome, a lack of easily available resources, and patient frustration with clinician interactions. The early identification of key hallmarks of the disorder, such as menstrual irregularity, and awareness of its linkage to PCOS, could lead to early diagnosis and intervention. METHODS: 248 participants enrolled and participated in the Ovulation and Menstruation (OM) Health Study’s as members of its pilot cohort. Inclusion criteria were women ages 18-45 currently experiencing menstrual periods without a history of chemotherapy, radiation, or surgical menopause. Participants completed the relevant sections of the OM Study survey related to demographics, menstrual cycle patterns, and history of PCOS. Demographic questions pertained to the age, race/ethnicity, country of birth, and education levels of the participants. The menstrual cycle questions provided information regarding the age of menarche, length and pattern of menses and the menstrual cycle overall. The questions regarding history of PCOS ascertained the presence of an official or self-diagnosis for PCOS for the participant, and the age at which this was determined. The descriptive measures were presented for comparison before determining the concurrence of the presence of menstrual irregularity and the diagnosis of PCOS across demographic categories and calculating an associated prevalence ratio. RESULTS: Among women reporting a history of menstrual irregularity for 3 months or greater, PCOS was the second-highest self-reported cause for menstrual irregularity, with 20.7% of participants endorsing it as the cause for their irregularity. The presence of menstrual irregularity for 3 or more months was also more likely to be present in concurrence with a clinician diagnosis, or to a lesser extent, a self-diagnosis, for PCOS. Participants were also far more likely to have a clinician diagnosis for PCOS if they were White, US-born, young, or educated. The same applied for the likelihood of a self-diagnosis with the exception of age. CONCLUSIONS: The association between menstrual cycle irregularities and likelihood of being diagnosed with PCOS is supported by the data and appears to be influenced by demographic factors such as race/ethnicity, age, and education.

BACKGROUND: The prevalence of Vitamin D deficiency is roughly 40% in the world and is increasing every year. Populations 65 years and older show a higher prevalence of vitamin D deficiency, because the aging process decreases the capacity of the skin to produce vitamin D. Some studies have reported that the prevalence of vitamin D deficiency is higher in the winter, however the effect of seasonal change on serum vitamin D level remains controversial in some specific populations. Moreover, this association remains uncertain in the elderly population because there is no study that specifically targets individuals over the age of 65. This study investigated the effect of seasonal changes and serum 25-hydroxyvitamin D among individuals 65 years and older residing in the Boston, Massachusetts and Stockholm, Sweden. METHODS: Cross-sectional and longitudinal cohort designs were both adapted to examine an existing data from VIVE2 parent study; the data was collected from 2012 to 2014. Data from the subjects who had finished this 6-month trial were analyzed for this study. Serum 25(OH)D levels, BMI, sex, study sites and age were collected and analyzed by univariate regression analysis and t-test. Serum 25(OH)D and confounders were included in multivariate analysis. Study sites were analyzed by effect modification model. RESULTS: In total, the prevalence of vitamin D deficiency (serum 25(OH)D levels less than 20 ng/ml) was 70%, while the mean serum 25(OH)D level was 20 ng/ml in summer and 16.4 ng/ml in winter. The average of seasonal serum 25(OH)D level changes were 6 ng/ml and 3 ng/ml in Stockholm, Sweden and Boston, MA, respectively. In addition, the prevalence of vitamin D deficiency increased 80% during winter (95CI: 1.1 – 2.9). There was no significant different in serum 25(OH)D levels among elderly populations between low latitude study site Boston, MA and high latitude site Stockholm, Sweden. There was no significant relation found in BMI, age and sex with serum 25(OH)D levels in the study. The seasonal serum 25(OH)D level changes was significantly different in the cross-sectional study design but not in the longitudinal study. CONCLUSION: Serum 25(OH)D levels were higher in the summer than in the winter among the elderly population resided in Boston, MA and Stockholm, Sweden.

Sufficient vitamin D is important for overall health. However, cutaneous production of vitamin D is limited by season and little vitamin D naturally occurs in food. Therefore, vitamin D supplementation is necessary. Vitamin D is available in pharmacies as vitamin D2 and vitamin D3, and can also be obtained by irradiating mushrooms to produce vitamin D2. Types of vitamin D supplementation were tested to compare their ability to increase vitamin D status and their effect on broad gene expression in human white blood cells. 2000 IU of vitamin D2, vitamin D3 or vitamin D2 in irradiated mushroom powder were given to subjects daily for twelve weeks. A placebo mushroom powder group was included in the second half of the study. To determine the effect of different supplementation on vitamin D status, whole blood was obtained weekly and serum was assayed for 25(OH)D2 and 25(OH)D3. Change in total 25(OH)D was determined from baseline to twelve weeks; 25(OH)D levels in the placebo mushroom powder group did not change significantly at 1.8 ± 1.8 ng/ml (9.6 ± 9.6%), the mushroom D2 group increased by 10.9 ± 10.2 ng/ml (53.2 ± 49.8%), the supplemental D2 group increased by 11.8 ± 7.4 ng/ml (60.2 ± 37.8%) and the supplemental D3 group increased by 21.7 ± 8.9 ng/ml (114.2 ± 46.8%). As expected, the total active form of vitamin D (1,25-dihydroxyvitamin D) showed no change in all groups because of its tight regulation. To determine the potential influence of vitamin D supplementation on differential gene expression in the immune system, white blood cells were isolated from whole blood samples taken before and after supplementation. RNA was extracted, and microarray assays were performed. Gene Set Enrichment Analysis was completed to determine strongly influenced pathways. However, due to the numerous variables between halves of the study, gene expression data was treated as separate studies. Even so, pathways involving RNA activation and degradation were significant between mushroom powder and mushroom D2 supplementation in both halves of the study, indicating the influence of compounds in mushrooms on RNA metabolism pathways. Supplemental vitamin D2 affected gene expression, though only two pathways showed significant change. Supplemental vitamin D3 was found to influence pathways involved in replication, transcription, and translation in both halves of the study. In conclusion, mushrooms powder, mushroom vitamin D2, supplemental vitamin D2, and supplemental vitamin D3 all influence differential gene expression in human white blood cells.

Sacsin, which is mutated in the neurodegenerative disease Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS), is a 520 kDa modular protein with regions of homology to molecular chaperones and domains linking to the ubiquitin proteasome system. This suggests a role in proteostasis. Previously, sacsin has been shown to partially localise with mitochondria, and loss of sacsin results in elongated and dysfunctional mitochondria. Moreover, alterations in neurofilaments have recently been reported in a mouse model of ARSACS. Despite these findings, pathophysiological mechanisms of ARSACS are poorly understood. The aim of this thesis was to elucidate the cellular role of sacsin by determining how loss of its function leads to the observed mitochondrial and intermediate filament defects. This hoped to shed light on the mechanism of disease in ARSACS. The results indicate that the mitochondrial elongation seen in ARSACS is likely due to reduced mitochondrial localisation of the essential fission factor DRP1. This may be mediated by loss of function of a complex involving sacsin and dynactin-6, a subunit of the dynein-dynactin motor complex, which has previously been shown to be required for DRP1 mitochondrial recruitment. DRP1-mediated mitochondrial fission is necessary for mitochondrial quality control; hence a disruption to mitochondrial quality control is likely to occur in sacsin deficient cells, which may explain the mitochondrial dysfunction in ARSACS. Furthermore, sacsin null cells display a dramatic collapse and perinuclear bundling of the vimentin intermediate filament network. This is coupled with the displacement of cellular organelles, particularly mitochondria, early endosomes and the Golgi, which accumulate at the periphery of the vimentin bundle. These are characteristic features of aggresome formation, indicating an aggregation of misfolded protein, which occurs due to disrupted proteostasis. Further supporting this, the proteostasis components ubiquitin, HSP70, LAMP2 and p62 are recruited to the perinuclear vimentin bundles. In summary, the findings of this thesis indicate a role for sacsin in mitochondrial and protein quality control, the dysfunction of which is likely to be particularly detrimental in neurons. Mitochondrial dysfunction along with protein misfolding and aggregation are implicated in many neurodegenerative diseases, and ARSACS is no exception.

Não existe relato da condição periodontal em indivíduos com Deficiência Isolada do Hormônio do Crescimento (IGHD). O objetivo deste estudo foi investigar possíveis associações entre IGHD e a perda clínica de inserção periodontal (PCI) em uma população com IGHD congênita, presente no Nordeste do Brasil. Material e Métodos: Todos os indivíduos previamente identificados com IGHD e com idade 12 anos foram elegíveis para participar do estudo (n=46). A amostra final ficou composta por 33 casos (IGHD) e 33 controles (não - IGHD) após a exclusão dos edêntulos (n=5) e dos que haviam recebido previamente tratamento com reposição do Hormônio do Crescimento (n=8). Eles foram pareados por idade, gênero, condição sócio-econômica, hábito de fumo e diabetes. Todos foram submetidos a exame periodontal completo em 6 sítios por dente, e entrevistados por meio de um questionário estruturado. Resultados: Indivíduos com IGHD apresentaram quantidade semelhante de biofilme (p=0,32), menos cálculo supragengival (p=0,01), e mais sangramento à sondagem (p<0,01) em comparação com os controles. Após uma série de análises de regressão logística múltipla condicional, ajustada para cálculo supragengival, indivíduos com IGHD mostraram maior chance de apresentar Perda Clínica de Inserção Periodontal 7mm (OR= 18,1; IC 95% = 2,4 - 137,2). Conclusão: Indivíduos com IGHD severa e congênita possuem maior chance de apresentar Perda Clínica de Inserção Periodontal. / There are no reports of periodontal status in subjects with Isolated Growth Hormone Deficiency (IGHD). The aim of this study was to investigate possible associations between IGHD and periodontal clinical attachment loss (CAL) in a population affected by congenital IGHD, residing in Northeastern Brazil. Material and Methods: All previously identified IGHD subjects age 12 years were eligible for this study (n=46). The final study sample comprised 33 cases (IGHD) and 33 controls (non - IGHD) after excluding edentulous (n = 5) and subjects previously treated with GH replacement (n = 8). They were matched by age, gender, socioeconomic status, smoking and diabetes status. Subjects were submitted to a full-mouth clinical examination of six sites per tooth and were interviewed using a structured, written questionnaire. Results: IGHD subjects had same amount visible plaque (p=0.32), less supragingival calculus (p = 0.01), and more bleeding on probing (p < 0.01) than controls. After performance of conditional multiple regression analyses adjusted by supragingival calculus, IGHD subjects had a higher likelihood of having CAL 7 mm (OR = 18.1; 95% Cl = 2.4 - 137.2). Conclusion: Severe congenital IGHD subjects have a greater chance of having Periodontal Clinical Attachment Loss.

Prader-Willi syndrome (PWS) is caused by a loss of paternally expressed genes in an imprinted region of chromosome 15q. Among the canonical PWS phenotypes are hyperphagic obesity, central hypogonadism, and low growth hormone. Rare microdeletion PWS patients define a 91 kb minimum critical deletion region encompassing three genes, including the non-coding SNORD116. Induced pluripotent stem cells were generated from skin cells of three large deletion (5-6 Mb) PWS patients and one novel microdeletion (118 kb) PWS patient. We found that genes within the PWS region, including SNRPN and NDN, showed persistence of DNA methylation after iPSC reprogramming and differentiation to neurons. Genes within the PWS minimum critical deletion region remain silenced in both PWS large deletion and microdeletion iPSC following reprogramming. We find that NHLH2 and PC1 (protein and transcript) are reduced in PWS patient iPSC-derived neurons. Nhlh2 and Pcsk1 expression are reduced in hypothalami of fasted Snord116p-/m+ mice while hypothalamic AgRP and Npy remain elevated following refeeding in association with relative hyperphagia. Nhlh2-/- mice have growth deficiencies from 4-7 weeks of age, develop hyperphagic obesity as adults, and are hypogonadal. Nhlh2 promotes expression of the prohormone convertase, Pcsk1 (PC1). PC1 is a neuroendocrine prohormone convertase that catalyzes the processing of hormones to “mature,” active hormones. Humans and mice deficient in PC1 display hyperphagic obesity, hypogonadism, decreased growth hormone, and hypoinsulinemic diabetes due to impaired prohormone processing. Snord116p-/m+ mice display in vivo functional defects in prohormone processing of proinsulin, proGHRH, and proghrelin in association with reductions in islet, hypothalamic, and stomach PC1 content. Our findings suggest that the major neuroendocrine features of PWS are due to PC1 deficiency which results from absence of functional SNORD116. In addition to hyperphagic obesity and endocrinopathies, global developmental delay (delayed motor milestones, delayed language development) is a major characteristic of the Prader-Willi syndrome (PWS). We identified neuroanatomical defects in iPSC-derived neurons of individuals with PWS and mice deficient for Snord116. iPSC-derived neurons from PWS patients and neurons from Snord116p-/m+ mice, have smaller soma and decreased numbers of neurites. Reduced neuron cell body size is apparent in utero and persists at least until 4 weeks of age in Snord116p-/m+ mice. The reduction in neuronal soma size is associated with smaller neuronal nucleoli. There are also developmental defects in the endocrine pancreas of Snord116p-/m+ animals that persist into adulthood (≥20 weeks). Mice lacking Snord116 have smaller pancreatic islets and within the islet the percentage of δ-cells is increased, while the percentage of α-cells is reduced. In Snord116p-/m+ isolated islets, Sst and Hhex are upregulated while Ins1, Ins2, Pdx1, Nkx6-1, and Pax6 are downregulated. There is a 3-fold increase in the percentage of polyhormonal cells in the neonatal islets of Snord116p-/m+ mice, which was due to an increase in cells co-positive with somatostatin. Snord116 may play a role in islet cell lineage specification. Overall, this work suggests that the Snord116 gene cluster is important for developmental processes in the brain as well as endocrine pancreas and prohormone processing in multiple tissues. Loss of elements within this cluster could account for the PWS by virtue of effects on the expression of PCSK1.

HMb, metabólito da leucina, utilizado para aumentar a síntese protéica. Investigamos o efeito do HMb sobre o eixo somatotrófico, bem como o mRNA de IGF-I e miostatina muscular. Ratos tratados com HMb (320 mg/Kg de peso corporal /mL de salina-0,9%), ou salina (controle), gavagem, 4 semanas, decapitados, sangue para avaliação sérica: insulina (RIE), glicose (colorimetria) e IGF-I (RIE). Extração de RNA total, para avaliação do mRNA de IGF-I e miostatina (Fígado, músculo extensor digital longo, Sóleo), avaliação da expressão do mRNA do GH, por Northern Blot, e expressão do GH ,Western blotting (hipófise). Dados analisados pelo teste-T de Student (P<0,05). Tratamento aumentou o conteúdo de mRNA de GH (> 60%), da proteína GH (>20%), do mRNA do IGF-I (~24%), da concentração sérica de IGF-I (p<0,05), indicando uma ativação do eixo somatotrófico pelo HMb, sem alterações no mRNA de miostatina e IGF-I muscular, ainda um aumento da insulina (~2x), sem alterações na glicose sérica, resultado do efeito hiperglicemiante do GH, ou um efeito direto do HMb na secreção de insulina. / HMb, metabolite of leucine, used to increase protein synthesis. Evaluate the effect HMb on the somatotrophic axis activity, as well as muscle mRNA IGF-I and myostatin. Rats treated with HMb (320 mg / kg body weight / mL of saline-0, 9%) or saline (control), gavage, 4 weeks, decapitated, blood for evaluation of serum: insulin (RIA), glucose (colorimetric) and IGF-I (RIA). Extraction of RNA total, for evaluation the mRNA IGF-I and myostatin (liver, muscle extensor digitalis longus (EDL) and soleus), evaluation of the GH mRNA expression of by Northern blot, and GH content, western blotting (pituitaries). Data analyzed by Student t-test (P <0.05). HMb treatment increased the content of GH mRNA (> 60%), GH (> 20%), IGF-I mRNA (~ 24%), IGF-I (p <0.05), indicates that the somatotrophic axis activity is increased by the HMb, without changes in mRNA of myostatin and muscle IGF-I, insulin also increased (~ 2x), without changes in serum glucose, hyperglycemiant result of the effect of GH or a direct effect of HMb in the secretion of insulin.

Cabras leiteiras das raças Saanen e Toggenburg (n=10) mantidas num rebanho particular no Estado de São Paulo tiveram seus níveis séricos de progesterona e estradiol comparados às concentrações fecais, durante o período correspondente a três ciclos estrais. O perfil hormonal foi confrontado com as manifestações comportamentais de estro visando uma contribuição ao conhecimento do ciclo das cabras destas raças em condições brasileiras, que leve a um manejo reprodutivo mais eficiente. As correlações entre níveis séricos e fecais foram calculadas, sugerindo a validade do modelo de dosagem hormonal nas fezes em cervídeos. Foi verificada correlação extremamente significante entre as concentrações séricas de progesterona e as de progestinas fecais, com r=0,83 e p<0,0001. Entre as concentrações séricas de estradiol e as de seus metabólitos nas fezes não foi verificada correlação significante, com r=-0,16 e p<0,3916. A partir da observação dos resultados e sua análise estatística, pode-se concluir que, dentro das condições deste trabalho, as concentrações de progestinas fecais apresentam variação correspondente à da progesterona sérica ao longo do ciclo estral das cabras; por outro lado, diferentemente das observações de outros autores, o mesmo não ocorre com os metabólitos fecais do estradiol em relação ao estradiol sérico. / Saanen e Toggenburg dairy goats (n=10) kept in a private flock in São Paulo State had their serum levels of progesterone and estradiol compared to faecal concentrations of the respective metabolites, through an interval corresponding to 3 estrous cycles. Hormonal profile was checked with behavioural manifestations of estrous searching for a better knowledge of the cycle of these breeds in brazilian environment, leading to a more efficient reproductive management. Correlations between serum and faecal levels were calculated, suggesting that the model of faecal hormone measurements could be valuable in cervidae. It was found an extremely significant correlation between progesterone serum concentration and progestin faecal concentration, with r=0,83 and p<0,0001. Between estradiol serum concentrations and its faecal metabolites? concentrations no significant correlation was found, with r=-0,16 and p<0,3916. Based on results observation and statistical analysis, we can assume that, in the circumstances of this trial, progestin faecal concentrations show a variation profile similar to that one of serum progesterone, through estrous cycle of goats; however, this fact could not be observed for estradiol metabolites, compared to serum estradiol concentrations.

A endocrinologia ovariana de cinco fêmeas de bugio da espécie Alouatta caraya foi estudada por meio de extração e dosagem de metabólitos fecais de estrógenos e progestinas durante um período de cinco meses. Adicionalmente observou-se a presença de eritrócitos por meio de citologia vaginal em três das fêmeas estudadas. Duas fêmeas, uma em condição nutricional desfavorável e outra pré-púbere, apresentaram concentrações basais de estrógenos com mediana menor que 3,7 ng/g e de progestinas menor que 29,7 ng/g de fezes úmidas. Nas outras três fêmeas a mediana dos valores de pico de estrógenos fecais foi 711,55 ng/g e dos valores basais 130,51 ng/g de fezes úmidas. Para as progestinas fecais a mediana dos valores de pico foi 2653,54 ng/g e dos valores basais foi 149,88 ng/g de fezes úmidas. Nestes três animais as concentrações de ambos os metabólitos apresentaram uma variação cíclica e o intervalo entre picos de estrógenos fecais foi 19,6&plusmn;1,9 dias (média&plusmn;EPM). Estes metabólitos permaneceram elevados durante 9,1&plusmn;0,9 dias. Elevações sustentadas de metabólitos fecais de progestinas acompanhadas de pico e elevações de metabólitos fecais de estrógenos foram observadas em apenas quatro períodos. Nestes casos ambos os metabólitos elevaram-se aproximadamente ao mesmo tempo e estimou-se que a ovulação tivesse ocorrido antes do início destas elevações. Os períodos de sangramento coincidiram com a queda nas concentrações de estrógenos e progestinas fecais. / The ovarian endocrinology was assessed in five female howler monkeys (Alouatta caraya) by means of estrogen and progestogen metabolites extracted from fecal samples. Measurements were conducted for a period of five months, and erythrocytes were observed by vaginal cytology, in three females. In one subadult and in one undernourished female, estrogen concentrations remained at median basal levels &lt;3.7ng/g, and the progestogen concentrations were &lt;29.7ng/g of wet feces for almost the entire period of the experiment. For the other three females, median fecal estrogen peak concentration was 711.55ng/g and basal concentration was 130.51ng/g of wet feces. Median fecal progestogen concentration was 2653.54ng/g and for basal concentration was 149.88 ng/g of wet feces. The three females were found with a cyclical pattern for both metabolites concentrations, with fecal estrogen peak intervals of 19.6&plusmn;1.9 (mean&plusmn;SEM) days and the estrogen metabolites remained elevated for 9.1&plusmn;0.9 days. Fecal progestogen showed sustained elevations concurrently with fecal estrogen increase only in four periods and it was presumed that ovulation had occurred before the onset of those elevations. Bleeding periods occurred with the falling of both steroid metabolites.