The sodium pump (SP or Na+,K+-ATPase) is a membrane embedded protein complex that pumps 3 sodium ions out and 2 potassium ions into the cell per cycle and in so doing creates a cell membrane electrochemical potential. The membrane potential is critical for any functional cell. In the vasculature, reduction in the voltage potential causes vascular smooth muscle contraction and a narrowing of blood vessels (vasoconstriction) which can lead to increased blood pressure (hypertension). Substantial research over the past several decades has provided a vast amount of research on SP inhibitors, sometimes called endogenous digitalis-like factors (EDLF). Increased levels of these factors have been implicated in many hypertensive disorders including preeclampsia (PE), a life-threatening complication of pregnancy. It has been demonstrated that EDLF might be a causative factor in the pathophysiology of hypertension in PE. In order to elucidate EDLF production and regulation in PE, We developed a radioimmunoassay (RIA) measuring EDLF that could be applied to serum from pregnant women, placental homogenate and placental tissue culture. This assay employs Digibind, a commercially available Fab fragment derived from polyclonal antidigoxin antibodies that cross reacts with EDLF, as the primary antibody. Using Digibind RIA, we demonstrated that placenta is a source of EDLF production and regulation. Moreover, the identification of an inhibitor, ketoconazole and a substrate, 17-hydroxyprogesterone of the synthetic pathway of EDLF in placenta proved that this pathway shares steps with the steroid synthetic pathway. Some potential regulatory agents which have elevated levels in PE or be associated in PE and thus are thought to mediate PE, such as hydrogen peroxide, tumor necrosis factor-α (TNF-α) and hypoxia have also been demonstrated to be stimuli of EDLF production in placenta. These findings are helpful to the further study on EDLF synthesis and regulation in placenta. Once we elucidate the mechanisms, it could be easier to provide deeper insights into the pathogenesis of PE and subsequently develop earlier diagnosis and effective prevention of or therapeutic approaches to PE.

Perisotin-like-factor (PLF) is a member of the Fasciclin family of proteins, which are characterized by the presence of 150 amino acid long conserved Fasciclin domains. Members of this family have been implicated in numerous cellular processes like adhesion, migration, axonal guidance and growth cone extension. PLF plays an important role during embryonic development, however very low levels are present in adults. PLF is up regulated in adult tissues when they are exposed to stress or insult. We have previously shown that PLF is up regulated in heart when they are mechanically overloaded and in lung when exposed to cigarette smoke. Similarly in bone, PLF is highly up regulated in fractured bone calli, albeit not present in normal adult bone. Furthermore PLF leads to increased bone formation in vivo in the bone marrow cavity when over expressed adenovirally. These results suggest that PLF promotes tissue repair and healing after injury. Additionally, PLF expression was up regulated in musculoskeletal tissues in our innovative model of Upper extremity-Work Related Musculoskeletal Disorder (WMSD). In this model, which draws parallels between the exposure to risk factors and development of associated disorders in human PLF was expressed in bone, skeletal muscle, tendon and nerves. Coincidentally, these are the same tissues in which PLF is expressed during embryonic development. Additionally, PLF was detected in inflammatory cells like macrophages suggesting a role for PLF in inflammation. Molecules like PLF which play important roles during development, reappear when the tissues require them, promoting their remodeling and recovery can be targeted as therapeutic agents. Such molecules can be targeted after injury or disease. In this study we focus our attention on the role of PLF in musculoskeletal (muscle and bone) remodeling in our animal model of WMSD. / Anatomy

A presente investigação teve por objetivo estudar o papel do eixo GH-IGF-IGFBP no tecido hepático e nos linfócitos T e B de pacientes portadores do vírus da hepatite C, em terapia com INF-alfa e ribavirina nos períodos pré e pós-tratamento. Dados da literatura têm evidenciado o envolvimento do IGF-I na modulação da resposta imune, bem como sua atuação como fator de crescimento para células imunológicas, além de apresentar valor preditivo na avaliação da reserva hepática desses pacientes. O número final de pacientes abordados perfez o total de 80. Destes, 39 iniciaram tratamento conforme protocolo estabelecido pela equipe clínica. Quatro pacientes foram excluídos durante o curso do tratamento, sendo 2 por óbito e 2 por transtorno depressivo grave com ideação suicida. Dos 35 pacientes que concluíram o tratamento, 18 apresentaram resposta virológica ao final do tratamento. Destes, 15 pacientes (43%) obtiveram resposta virológica sustentada (RVS). As médias das U.A. (unidades arbitrárias) das enzimas AST e ALT foram estatisticamente diferentes entre os períodos pré e pós-tratamento, tanto para os pacientes que apresentaram RVS quanto para aqueles que não apresentaram tal resposta. No grupo de pacientes com RVS, observou-se que a média dos níveis basais de AST foi menor quando comparada à do grupo de pacientes sem RVS. A média das concentrações plasmáticas basais de IGF-I livre no grupo de pacientes com RVS foi estatisticamente maior quando comparada à do grupo de pacientes não respondedores. As médias das concentrações de IGFBP3 circulante no período pós-tratamento foram estatisticamente diferentes entre os grupos com e sem RVS. Um aumento do conteúdo de mRNA do gene do IGF-IR foi observado em tecido hepático de todos os pacientes com HCC quando comparado com o tecido hepático normal. Este resultado foi confirmado por análise imuno-histoquímica para o IGF-IR. Nos pacientes que apresentaram RVS a magnitude de expressão de mRNA do IGF-IR em amostras de tecido hepático após o tratamento foram estatisticamente menores em relação ao basal. Tal fato não foi observado no grupo de pacientes não respondedores. Não houve diferença estatisticamente significativa entre a média do conteúdo de mRNA do IGF-I em tecido hepático dos grupos de pacientes com e sem RVS, pré ou pós-tratamento. A média do conteúdo de mRNA do IGF-I em linfócitos T no grupo de pacientes com RVS foi estatisticamente maior em relação à do grupo de pacientes não respondedores quando se consideram os períodos pré e pós-tratamento conjuntamente. Não se observou diferença estatisticamente significativa entre as médias do conteúdo de mRNA do IGF-IR nos grupos com e sem RVS, pré ou pós-tratamento. Não houve diferença estatisticamente significativa entre as médias do conteúdo de mRNA de IGF-I e IGF-IR em linfócitos B de pacientes portadores do VHC, com e sem RVS e nos períodos pré e pós-tratamento. A diminuição de expressão de mRNA do IGF-IR em tecido hepático, observada no grupo de pacientes com RVS, sugere uma melhora da doença hepática. A hipótese de que um efeito do INF-? sobre os componentes do sistema IGF possa contribuir para este achado não pode ser descartada, porém, é provável que este efeito não seja tão importante, pois não se observou diferença nos níveis de expressão do IGF-IR hepático no grupo de pacientes não respondedores. Embora a supra-regulação (\"up-regulation\") do IGF-IR possa participar da regeneração hepática, é preciso elucidar se o aumento da expressão do IGF-IR na HCC resulta da ativação direta do gene pelo VHC ou se é uma conseqüência da agressão ao parênquima. As concentrações plasmáticas de IGF-I livre >1,35 ng/mL puderam ser consideradas preditivas da resposta ao tratamento da hepatite C com uma razão de probabilidade (\"odds ratio\") de 17,33±1,02 (Limite de confiança: 2,26-127,34) / The current investigation aimed to study the role of the GH-IGF-IGFBP axis in liver tissue and in T and B lymphocytes in patients with hepatitis C virus (HCV) before and after therapeutic regimen based on interferon alfa-2a or alfa-2b (3 million U SC 3x/wk) and ribavirin (1000-1200 mg qid). It has been shown that IGF-I plays an important role in the modulation of the immune response, besides its role as a growth factor for the immunologic cells. It also presents a predictive value in the evaluation of the hepatic reserve of these patients. Among 80 patients enrolled for this investigation, 39 began treatment with interferon-? and ribavirin, according to an established protocol. Two patients were excluded during treatment due to severe depressive disorders accompanied by suicidal thoughts and 2 patients died. Of the 35 patients who concluded the treatment, 18 eventually presented virological response. Of these, 15 (43%) maintained sustained virological response (SVR). The levels of AST and ALT enzymes in both pre and post-treatment periods were statistically different for both patients with SVR and those who did not present such response. In the group with SVR, aminotransferases basal levels were statistically lower when compared to the group of patients without SVR. In the group of non-responsive patients, the average of the scores of parenchyma activity was statistically lower in post-treatment period when compared to pre-treatment period. Furthermore, comparing post-treatment periods in both groups with and without SVR, the average of the scores of parenchyma activity was statistically lower in the group without SVR when compared to the group with SVR. Mean plasma concentrations of free IGF-I before treatment in patients who eventually achieved SVR was statistically higher in comparison to the group of non-responsive patients. Mean plasma concentrations of IGFBP3 were statistically higher in the group with RVS when compared to the group of patients without SVR. An increase of IGF-IR mRNA content was observed in hepatic tissue from all patients with CHC in comparison to normal liver. These results were confirmed by immunohistochemical analysis for the IGF-IR. IGF-IR mRNA content in liver tissue samples from patients who achieved SVR after treatment was statistically lower than that observed before treatment There was not statistical difference between IGF-I mRNA content in hepatic tissues from both groups of patients with and without SVR, in pre and post-treatment periods. IGF-I mRNA expression in T lymphocytes from patients with SVR was statistically higher in comparison to the non-responsive group of patients, considering both pre and post-treatment periods altogether. No statistical difference was observed in IGF-IR mRNA expression in both groups of patients with and without SVR, in pre and post-treatment periods. The statistical analysis did not disclose any statistically significant differences in IGF-I or IGF-IR mRNA expressions in B lymphocytes from patients with or without SVR, in pre and post-treatment periods. A decrease in hepatic IGF-IR mRNA content observed in patients who achieved SVR after therapy, suggested an improvement in hepatic damage. The hypothesis that the INF-? affects components of the IGF system contributing to these findings could not be discarded. However, it is unlike that these effects would play relevant role because any differences were observed in the hepatic IGF-IR mRNA expression in non-responsive patients. It remains to be elucidated whether IGF-IR up-regulation would be involved in hepatocyte regeneration or CHC would result from direct activation of IGF-IR gene by HCV and/or as a consequence of chronic aggression to hepatic parenchyma. Plasma concentration of free IGF-I >1.35 ng/ml was considered to be a predictive response to the treatment of hepatitis C with a probability ratio (odds ratio) of 17.33±1.02 (confidence interval: 2.26 -127.34)

A presente investigação teve por objetivo estudar o papel do eixo GH-IGF-IGFBP no tecido hepático e nos linfócitos T e B de pacientes portadores do vírus da hepatite C, em terapia com INF-alfa e ribavirina nos períodos pré e pós-tratamento. Dados da literatura têm evidenciado o envolvimento do IGF-I na modulação da resposta imune, bem como sua atuação como fator de crescimento para células imunológicas, além de apresentar valor preditivo na avaliação da reserva hepática desses pacientes. O número final de pacientes abordados perfez o total de 80. Destes, 39 iniciaram tratamento conforme protocolo estabelecido pela equipe clínica. Quatro pacientes foram excluídos durante o curso do tratamento, sendo 2 por óbito e 2 por transtorno depressivo grave com ideação suicida. Dos 35 pacientes que concluíram o tratamento, 18 apresentaram resposta virológica ao final do tratamento. Destes, 15 pacientes (43%) obtiveram resposta virológica sustentada (RVS). As médias das U.A. (unidades arbitrárias) das enzimas AST e ALT foram estatisticamente diferentes entre os períodos pré e pós-tratamento, tanto para os pacientes que apresentaram RVS quanto para aqueles que não apresentaram tal resposta. No grupo de pacientes com RVS, observou-se que a média dos níveis basais de AST foi menor quando comparada à do grupo de pacientes sem RVS. A média das concentrações plasmáticas basais de IGF-I livre no grupo de pacientes com RVS foi estatisticamente maior quando comparada à do grupo de pacientes não respondedores. As médias das concentrações de IGFBP3 circulante no período pós-tratamento foram estatisticamente diferentes entre os grupos com e sem RVS. Um aumento do conteúdo de mRNA do gene do IGF-IR foi observado em tecido hepático de todos os pacientes com HCC quando comparado com o tecido hepático normal. Este resultado foi confirmado por análise imuno-histoquímica para o IGF-IR. Nos pacientes que apresentaram RVS a magnitude de expressão de mRNA do IGF-IR em amostras de tecido hepático após o tratamento foram estatisticamente menores em relação ao basal. Tal fato não foi observado no grupo de pacientes não respondedores. Não houve diferença estatisticamente significativa entre a média do conteúdo de mRNA do IGF-I em tecido hepático dos grupos de pacientes com e sem RVS, pré ou pós-tratamento. A média do conteúdo de mRNA do IGF-I em linfócitos T no grupo de pacientes com RVS foi estatisticamente maior em relação à do grupo de pacientes não respondedores quando se consideram os períodos pré e pós-tratamento conjuntamente. Não se observou diferença estatisticamente significativa entre as médias do conteúdo de mRNA do IGF-IR nos grupos com e sem RVS, pré ou pós-tratamento. Não houve diferença estatisticamente significativa entre as médias do conteúdo de mRNA de IGF-I e IGF-IR em linfócitos B de pacientes portadores do VHC, com e sem RVS e nos períodos pré e pós-tratamento. A diminuição de expressão de mRNA do IGF-IR em tecido hepático, observada no grupo de pacientes com RVS, sugere uma melhora da doença hepática. A hipótese de que um efeito do INF-? sobre os componentes do sistema IGF possa contribuir para este achado não pode ser descartada, porém, é provável que este efeito não seja tão importante, pois não se observou diferença nos níveis de expressão do IGF-IR hepático no grupo de pacientes não respondedores. Embora a supra-regulação (\"up-regulation\") do IGF-IR possa participar da regeneração hepática, é preciso elucidar se o aumento da expressão do IGF-IR na HCC resulta da ativação direta do gene pelo VHC ou se é uma conseqüência da agressão ao parênquima. As concentrações plasmáticas de IGF-I livre >1,35 ng/mL puderam ser consideradas preditivas da resposta ao tratamento da hepatite C com uma razão de probabilidade (\"odds ratio\") de 17,33±1,02 (Limite de confiança: 2,26-127,34) / The current investigation aimed to study the role of the GH-IGF-IGFBP axis in liver tissue and in T and B lymphocytes in patients with hepatitis C virus (HCV) before and after therapeutic regimen based on interferon alfa-2a or alfa-2b (3 million U SC 3x/wk) and ribavirin (1000-1200 mg qid). It has been shown that IGF-I plays an important role in the modulation of the immune response, besides its role as a growth factor for the immunologic cells. It also presents a predictive value in the evaluation of the hepatic reserve of these patients. Among 80 patients enrolled for this investigation, 39 began treatment with interferon-? and ribavirin, according to an established protocol. Two patients were excluded during treatment due to severe depressive disorders accompanied by suicidal thoughts and 2 patients died. Of the 35 patients who concluded the treatment, 18 eventually presented virological response. Of these, 15 (43%) maintained sustained virological response (SVR). The levels of AST and ALT enzymes in both pre and post-treatment periods were statistically different for both patients with SVR and those who did not present such response. In the group with SVR, aminotransferases basal levels were statistically lower when compared to the group of patients without SVR. In the group of non-responsive patients, the average of the scores of parenchyma activity was statistically lower in post-treatment period when compared to pre-treatment period. Furthermore, comparing post-treatment periods in both groups with and without SVR, the average of the scores of parenchyma activity was statistically lower in the group without SVR when compared to the group with SVR. Mean plasma concentrations of free IGF-I before treatment in patients who eventually achieved SVR was statistically higher in comparison to the group of non-responsive patients. Mean plasma concentrations of IGFBP3 were statistically higher in the group with RVS when compared to the group of patients without SVR. An increase of IGF-IR mRNA content was observed in hepatic tissue from all patients with CHC in comparison to normal liver. These results were confirmed by immunohistochemical analysis for the IGF-IR. IGF-IR mRNA content in liver tissue samples from patients who achieved SVR after treatment was statistically lower than that observed before treatment There was not statistical difference between IGF-I mRNA content in hepatic tissues from both groups of patients with and without SVR, in pre and post-treatment periods. IGF-I mRNA expression in T lymphocytes from patients with SVR was statistically higher in comparison to the non-responsive group of patients, considering both pre and post-treatment periods altogether. No statistical difference was observed in IGF-IR mRNA expression in both groups of patients with and without SVR, in pre and post-treatment periods. The statistical analysis did not disclose any statistically significant differences in IGF-I or IGF-IR mRNA expressions in B lymphocytes from patients with or without SVR, in pre and post-treatment periods. A decrease in hepatic IGF-IR mRNA content observed in patients who achieved SVR after therapy, suggested an improvement in hepatic damage. The hypothesis that the INF-? affects components of the IGF system contributing to these findings could not be discarded. However, it is unlike that these effects would play relevant role because any differences were observed in the hepatic IGF-IR mRNA expression in non-responsive patients. It remains to be elucidated whether IGF-IR up-regulation would be involved in hepatocyte regeneration or CHC would result from direct activation of IGF-IR gene by HCV and/or as a consequence of chronic aggression to hepatic parenchyma. Plasma concentration of free IGF-I >1.35 ng/ml was considered to be a predictive response to the treatment of hepatitis C with a probability ratio (odds ratio) of 17.33±1.02 (confidence interval: 2.26 -127.34)

Bakterielle Pneumonien sind weltweit eine der häufigsten Todesursachen und S. pneumoniae ist das häufigste klinische Isolat. Neutrophile Granulozyten gehören zur Klasse der myeloiden Zellen und sind eine wichtige Komponente der angeborenen Immunität gegen bakterielle Infektionen. Krüppel-like factor 4 (KLF4) spielt dabei nicht nur eine Rolle in der Differenzierung der Zellen des Immunsystems, sondern auch während der Infektion bei der Vermittlung inflammatorischer Signale in unterschiedlichen Zelltypen. Diese Studie zeigt zum ersten Mal in vivo, dass myeloides KLF4 Einfluss auf den Krankheitsverlauf hat und die mit einer bakteriellen Pneumonie einhergehende Entzündungsreaktion reguliert. Die hier aufgeführten Ergebnisse demonstrieren, dass der Transkriptionsfaktor KLF4 während einer Pneumokokken Pneumonie in humanen und murinen neutrophilen Granulozyten induziert wird. Diese Induktion ist Zeit- und Dosisabhängig. Außerdem wird die Expression von myeloidem KLF4 durch die Autolyse von S. pneumoniae reguliert, aber nicht über Toll-like Rezeptor 2 (TLR2), TLR4 oder TLR9 vermittelt. Studien in einem Maus-Pneumonie Modell zeigen, dass myeloides KLF4 einen proinflammatorischen Phänotyp bewirkt. Mäuse mit einem KLF4 knockout (KLF4-/-) in myeloiden Zellen haben im Vergleich zu Wildtyp (KLF4+/+) Mäusen eine höhere Bakterienlast in Lunge, Blut und Milz. Obwohl die Produktion proinflammatorischer Zytokine (wie TNF-α, IL-1β und KC) in BALF und Plasma von KLF4-/- Mäusen geringer war, gab es keine Unterschiede bei der Zellrekrutierung in der BALF von KLF4-/- und KLF4+/+ Mäusen. Allerdings war die Zellrekrutierung im Blut der KLF4-/- Mäuse geringer als bei den KLF4+/+ Mäusen. Außerdem wurde eine erhöhte vaskuläre Permeabilität verbunden mit perivaskulären Ödemen und Pleuritis bei KLF4-/- Mäusen während der S. pneumoniae-induzierten Infektion beobachtet. Diese Mäuse erreichten auch eher die humanen Endpunkte als die vergleichbaren KLF4+/+ Mäuse. / Bacterial pneumonia is one of the leading causes of death worldwide. Streptococcus pneumoniae is the most frequently isolated pathogen from clinical pneumonia samples. Neutrophils belong to the class of myeloid cells and forms an important component of this innate immune system against bacterial infections. Krüppel-like factor 4 (KLF4) has been reported to not only play a role in differentiation of cells of the immune system but also in mediating inflammatory signals in different kinds of host cells during infection. This study shows myeloid KLF4 has an impact on pneumococcal pneumonia outcome and regulates the inflammation associated with bacterial pneumonia in vivo in mice. The results presented in the work show that the transcription factor KLF4 is induced in human and mice neutrophils during pneumococcal pneumonia. The induction of KLF4 is time and dose dependent. Additionally, the expression of myeloid KLF4 is regulated by the autolysis of S. pneumoniae but is not mediated via Toll-like receptor (TLR) 2, TLR4 or TLR9. Studies using a mouse pneumonia model showed that myeloid KLF4 exhibits a pro-inflammatory phenotype. Mice with KLF4 knockout (KO) or KLF4-/- in myeloid cells had higher bacterial load in their lungs, blood and spleen in comparison to wildtype (WT) or KLF4+/+ mice. Although there was less pro-inflammatory cytokine (such as TNF-α, IL-1β and KC) production in the broncho-alveolar lavage fluid (BALF) and plasma of KLF4-/- mice yet there no differences in cell recruitment in the BALF of the KLF4-/- and KLF4+/+ mice. There was however less cell recruitment in the blood of KLF4-/- mice in comparison to KLF4+/+ mice. Additionally, an increased vascular permeability associated with perivascular edema and pleuritis was seen during Streptococcus pneumoniae-induced infection in KLF4-/- mice, which also reached earlier the human endpoints than the KLF4+/+ mice.

We have demonstrated that simvastatin and sphingosine 1-phosphate (S1P) both attenuate increased vascular permeability in preclinical models of acute respiratory distress syndrome. However, the underlying mechanisms remain unclear. As Kruppel-like factor 2 (KLF2) serves as a critical regulator for cellular stress response in endothelial cells (EC), we hypothesized that simvastatin enhances endothelial barrier function via increasing expression of the barrier-promoting S1P receptor, S1PR1, via a KLF2-dependent mechanism. S1PR1 luciferase reporter promoter activity in human lung artery EC (HPAEC) was tested after simvastatin (5 mu M), and S1PR1 and KLF2 protein expression detected by immunoblotting. In vivo, transcription and expression of S1PR1 and KLF2 in mice lungs were detected by microarray profiling and immunoblotting after exposure to simvastatin (10 mg/kg). Endothelial barrier function was measured by trans-endothelial electrical resistance with the S1PR1 agonist FTY720-(S)-phosphonate. Both S1PR1 and KLF2 gene expression (mRNA, protein) were significantly increased by simvastatin in vitro and in vivo. S1PR1 promoter activity was significantly increased by simvastatin (P < 0.05), which was significantly attenuated by KLF2 silencing (siRNA). Simvastatin induced KLF2 recruitment to the S1PR1 promoter, and consequently, significantly augmented the effects of the S1PR1 agonist on EC barrier enhancement (P < 0.05), which was significantly attenuated by KLF2 silencing (P < 0.05). These results suggest that simvastatin upregulates S1PR1 transcription and expression via the transcription factor KLF2, and consequently augments the effects of S1PR1 agonists on preserving vascular barrier integrity. These results may lead to novel combinatorial therapeutic strategies for lung inflammatory syndromes.

The most widely transfused blood component is red blood cells (RBCs), and voluntary donation is the main resource for RBC transfusion. In the UK, 7,000 units of RBCs are transfused daily but this life-saving cell therapy is completely dependent on donors and there are persistent problems associated with transfusion transmitted infections and in blood group compatibility. Furthermore, the quality, safety and efficiency of donated RBCs gradually decrease with storage time. A number of novel sources of RBCs are being explored including the production of RBCs from adult haematopoietic progenitor cells, erythroid progenitor cell lines and induced pluripotent stem cells (iPSCs). The iPSC source could essentially provide a limitless supply and a route to producing cells that are matched to the recipient. A number of protocols have been described to produce mature RBCs from human pluripotent stem cells but they are relatively inefficient and would be difficult to scale up to the levels required for clinical translation. We tested and evaluated a defined feeder- and serum-free differentiation protocol for deriving erythroid cells from hiPSCs. RBC production was not efficient, the cells that were produced did not enucleate efficiently and they expressed embryonic rather than adult globin. We hypothesised that the production of RBCs from iPSCs could be enhanced by enforced expression of erythroid-specific transcription factors (TFs). Previous studies had demonstrated that Krüppel-like factor 1 (KLF1) plays an important role in RBC development and maturation so we generated iPSC lines expressing a tamoxifen-inducible KLF1-ERT2 fusion protein. Using zinc finger nuclease technology, we targeted the expression cassette to the AAVS1 locus to ensure consistent expression levels and to avoid integration site specific effects and/or silencing. These iKLF1 iPSCs were applied to our defined RBC differentiation protocol and the activity of KLF1 was induced by adding tamoxifen. Activation of KLF1 from day 10 accelerated erythroid differentiation and maturation with an increase in the proportion of erythroblasts, a higher level of expression of erythroid genes associated with maturation and an apparently more robust morphology. However, KLF1 activation had an anti-proliferation effect resulting in significantly less cell generated overall and HPLC analysis demonstrated that KLF1-activated cells expressed higher levels of embryonic globin compared to control iPSCs-derived cells. Many of the effects that were observed when KLF1 was activated from day 10 were not observed when activated from day 18. We therefore concluded that activation of exogenous KLF1 is able to promote erythroid cell production and maturation in progenitors (day 10) but not at the later stage of erythropoiesis (day 18). We hypothesised that KLF1 might require a co-factor to regulate RBC maturation and adult globin expression at the later stage of erythropoiesis. The TF, B-cell lymphoma/leukaemia 11a (BCL11A), plays a key role in the suppression of foetal globin expression, thereby completing globin switching to adult globin. Preliminary data showed that iPSC-derived erythroid cells were able to express adult globin when transduced with a BCL11A-expressing lentiviral-vector. Based on that finding we then generated an iPSC line expressing tamoxifen-inducible BCL11AERT2 and KLF1-ERT2 fusion proteins, applied this iBK iPSC line to our differentiation protocol. Activation of both TFs from day 18 slightly increased the expression of genes associated with RBC maturation and the inclusion of BCL11A appeared to eliminate the anti-proliferation effect of KLF1. Most importantly, activation of both BCL11A and KLF1 from day 18 of the differentiation protocol increased the production of α- globin (foetal / adult globin) indicating that some definitive-like erythroid cells might be generated by activation of both TFs at the later stage of erythroid differentiation. Collectively, these findings demonstrate that enforced expression of erythroid TFs could be a useful strategy to enhance RBC maturation from iPSCs.

Nuclear factor erythroid-2-related factor 1 (NRF1) and NRF2 are essential for maintaining redox homeostasis and coordinating cellular stress responses. They are highly homologous transcription factors that regulate the expression of genes bearing antioxidant-response elements (AREs). Genetic ablation of NRF1 or NRF2 results in vastly different phenotypic outcomes, implying that they play different roles and may be differentially regulated. Kelch-like ECH-associated protein 1 (KEAP1) is the main negative regulator of NRF2 and mediates ubiquitylation and degradation of NRF2 through its NRF2-ECH homology-like domain 2 (Neh2). Here, we report that KEAP1 binds to the Neh2-like (Neh2L) domain of NRF1 and stabilizes it. Consistently, NRF1 is more stable in KEAP1(+/+) than in KEAP1(-/-) isogenic cell lines, whereas NRF2 is dramatically stabilized in KEAP1(-/-) cells. Replacing NRF1's Neh2L domain with NRF2's Neh2 domain renders NRF1 sensitive to KEAP1-mediated degradation, indicating that the amino acids between the DLG and ETGE motifs, not just the motifs themselves, are essential for KEAP1-mediated degradation. Systematic site-directed mutagenesis identified the core amino acid residues required for KEAP1-mediated degradation and further indicated that the DLG and ETGE motifs with correct spacing are insufficient as a KEAP1 degron. Our results offer critical insights into our understanding of the differential regulation of NRF1 and NRF2 by KEAP1 and their different physiological roles.

Preeclampsia (PE) is a multisystem disorder that contributes to maternal and fetal mortality and morbidity worldwide. It is characterized by de-novo hypertension and proteinuria or other maternal organ damage after 20 weeks of gestation. Evidence suggested that endogenous digitalis-like factor (EDLF) contributes to the pathogenesis of PE, and that the potential source of EDLF is the placenta. EDLF can inhibit the sodium pump (SP) specifically and may lead to hypertension, it has also been associated with hypoxia, oxidative stress and other abnormalitites present in PE.We studied whether normal human placenta responded to SP inhibition casued by EDLF with a change in abundance of lipids in the placental cytosol, and whether there was a characteristic set of lipid changes that could serve as a signature for EDLF exposure if there were such changes. Placenta tissues from 20 normal pregnancies were incubated for 48 hr in the presence and absence of ouabain, a widely studied EDLF, followed by tissue homogenization, lipid extraction, and the study of lipids using a mass spectrometery (MS) based lipidomics approach. 1207 lipidomic markers were surveyed by paired Student t-test, among which 26 markers had significantly different abundances between cases and control at the FDR=0.05 level. A set of 8 lipidomic markers were selected by a statistical model built with a sparse partial least squares discriminant analysis method (sPLS-DA) and a bootstrap procedure. All eight markers were then chemically characterized and partially identified using tandem MS. These markers might be used to identify placentas that have been previously exposed to EDLF in return.Endogenous peptides and small proteins might contribute to the pathophysiology of various diseases. Therefore, we investigated the potential peptidomic profile of placenta tissues in response to EDLF exposure as well. Placenta tissues from 20 normal pregnancies were incubated for 25 hr with and without the addition of ouabain, followed by homogenization, protein depletion, and the study of the peptides by a LC-MS based peptidomics approach. 275 peptidomic markers were evaluated by Student t-test. A set of 8 markers was chosen using a logistic regression model build with the Akaike information criterion (AIC). However, no peptidomics markers or set of markers showed specific, statististically significantly different changes in abundances between cases and controls after applying a false discovery rate (FDR) correction or using more conservative methods to overcome over-fitting. Using an optimal sPLS- DA, cross-validation studies and logistic regression models, we also found that the addition of any peptidomic marker to the previously selected lipidomic profile was unlikely to help identify placentas that had been exposed to EDLF.Alzheimer's disease (AD) is the most common form of dementia and the number of AD cases worldwide is currently estimated to be 36 million. The exact pathogenesis of AD remainsiielusive and available therapeutic strategies can only delay its progession temporarily. Several hypotheses have been proposed regarding the pathophysiology of AD and the beta-amyloid (Aβ) hypothesis is considered the core mechanism. However, the majority of studies concerning AD, or AD biomarkers specifically, have ignored a potentially important variable that is gender, despite reported gender differences in the risk of developing AD, the risk factors, clinical symptoms and CSF biomarkers of the disease, among many other aspects.We analyzed data obtained from a previous study of diagnostic serum lipid biomarkers for AD with the consideration of potential gender difference. Firstly, we studied the interaction between gender and disease stage using analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Lipid markers that showed statistically significant interaction were selected after applying a FDR correction. Secondly, using a lasso logistic regression model with binary classification (control vs. all AD stages), we identified gender-specific markers and found different coefficient estimates for different genders as well. Lastly, we build a new ordinal model with the addition of a gender-specific marker using a Bayesian lasso probit ordinal regression model. The predictive performance of the new model was found to be statistically significantly better than the previous model which was built without the consideration of gender.In conclusion, we successfully discovered, chemically characterized lipidomic markers indicative of EDLF exposure in placenta and detected gender-specific lipid markers for AD.

The transcription factor Krueppel-like factor (KLF) 4 fosters the pro-inflammatory immune response in macrophages and polymorphonuclear neutrophils (PMNs) when stimulated with Streptococcus pneumoniae, the main causative pathogen of community-acquired pneumonia (CAP). Here, we investigated the impact of KLF4 expression in myeloid cells such as macrophages and PMNs on inflammatory response and disease severity in a pneumococcal pneumonia mouse model and in patients admitted to hospital with CAP. We found that mice with a myeloid-specific knockout of KLF4 mount an insufficient early immune response with reduced levels of pro-inflammatory cytokines and increased levels of the anti-inflammatory cytokine interleukin (IL) 10 in bronchoalveolar lavage fluid and plasma and an impaired bacterial clearance from the lungs 24 hours after infection with S. pneumoniae. This results in higher rates of bacteremia, increased lung tissue damage, more severe symptoms of infection and reduced survival. Higher KLF4 gene expression levels in the peripheral blood of patients with CAP at hospital admission correlate with a favourable clinical presentation (lower sequential organ failure assessment (SOFA) score), lower serum levels of IL-10 at admission, shorter hospital stay and lower mortality or requirement of intensive care unit treatment within 28 days after admission. Thus, KLF4 in myeloid cells such as macrophages and PMNs is an important regulator of the early proinflammatory immune response and, therefore, a potentially interesting target for therapeutic interventions in pneumococcal pneumonia.