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Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.136982.
Abstract
BACKGROUND. Metabolically healthy obesity (MHO) and metabolically healthy overweight (MH-OW) have been suggested to be an important and emerging phenotype with an increased risk of cardiovascular disease (CVD). However, whether MHO and MH-OW are associated with all-cause mortality remains inconsistent. METHODS. The association of MHO and MH-OW and all-cause mortality was determined in China community-based prospective cohort study (Kailuan Study) including 93,272 adults at baseline. Data were analyzed from 2006 to 2017. Participants were categorized into six mutually exclusive groups according to the body mass index (BMI) and metabolic syndrome (MetS) status. The primary outcome is all-cause death, whereas accidental deaths were excluded. RESULTS. During a median follow-up of 11.04 years (interquartile range: 10.74-11.22 years), 8,977 deaths occurred. Compared to healthy participants with normal BMI (MH-NW), MH-OW had lowest risk of all-cause mortality (multivariate-adjusted hazard ratio [aHR]: 0.926; 95% confidence interval [CI]: 0.861 to 0.997), whereas there was no increased or decreased risk for MHO (aHR: 1.009; 95% CI: 0.886 to 1.148). Stratified analyses and sensitivity analyses further validated that nonsignificant association between MHO and all-cause mortality. CONCLUSIONS. Overweight and obesity do not predicate increased risk of all-cause mortality in metabolic healthy Chinese individuals.
Authors
Qiuyue Tian, Anxin Wang, Yingting Zuo, Shuohua Chen, Haifeng Hou, Wei Wang, Shouling Wu, Youxin Wang
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.135385.
Abstract
Mutations in PKD1 (encoding for Polycystin-1, PC1) are found in 80-85% of patients with ADPKD. We tested the hypothesis that changes in actin dynamics result from PKD1 mutations through dysregulation of compartmentalised centrosomal RhoA signalling mediated by specific RhoGAP (ARHGAP) proteins resulting in the complex cellular cystic phenotype. Initial studies revealed that the actin cytoskeleton was highly disorganised in PKD1 patient-derived cells and was associated with an increase in total and centrosomal RhoA activation and ROCK signalling. Using cilia length as a phenotypic readout for centrosomal RhoA activity, we identified ARHGAP5, 29, 35 as essential regulators of ciliation in normal human renal tubular cells. Importantly, a specific decrease in centrosomal ARHGAP35 was observed in PKD1 null cells using a centrosome-targeted proximity ligation assay and by immunofluorescence labelling. Finally, we demonstrate that another ROCK inhibitor (hydroxyfasudil) reduced cyst expansion in both human PKD1 3D cyst assays and an inducible Pkd1 mouse model. In summary, we report a novel interaction between PC1 and ARHGAP35 in the regulation of centrosomal RhoA activation and ROCK signalling. Targeting the RhoA/ROCK pathway inhibited cyst formation in vitro and in vivo indicating its relevance to ADPKD pathogenesis and for developing new therapies to inhibit cyst initiation.
Authors
Andrew J. Streets, Philipp P. Prosseda, Albert C.M. Ong
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.138137.
Abstract
Clostridioides difficile is a leading cause of nosocomial infection responsible for significant morbidity and mortality with limited options for therapy. Secreted C. difficile toxin B (TcdB) is a major contributor to disease pathology and select TcdB-specific Abs may protect against disease recurrence. However, the high frequency of recurrence suggests that the memory B cell response, essential for new Ab production following C. difficile re-exposure, is insufficient. We therefore isolated TcdB-specific memory B cells from individuals with a history of C. difficile infection and performed single-cell deep sequencing of their Ab genes. Herein, we report that TcdB-specific memory B cell-encoded antibodies showed somatic hypermutation but displayed limited isotype class switch. Memory B cell-encoded monoclonal antibodies generated from the gene sequences revealed low to moderate affinity for TcdB and a limited ability to neutralize TcdB. These findings indicate that memory B cells are an important factor in C. difficile disease recurrence.
Authors
Hemangi B. Shah, Kenneth Smith, Edgar J. Scott, II, Jason L. Larabee, Judith A. James, Jimmy D. Ballard, Mark L. Lang
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.140418.
Abstract
Post-prandial triglycerides (TGs) are elevated in people with type 2 diabetes (T2D) and glucoregulatory agents such as Glucagon-like-peptide-1 (GLP-1) receptor agonists and Dipeptidyl Peptidase-4 (DPP-4) inhibitors simultaneously reduce post-prandial TG excursion. Although the glucose-lowering mechanisms of DPP-4 have been extensively studied, how the reduction of DPP-4 activity improves lipid tolerance remains unclear. Here we demonstrate that gut-selective and systemic inhibition of DPP-4 activity reduces post-prandial TG excursion in young mice. Genetic inactivation of Dpp4 simultaneously within endothelial cells (ECs) and hematopoietic cells using Tie2-Cre reduces intestinal lipoprotein secretion under regular chow (RC) diet conditions. Bone marrow transplantation revealed a key role for hematopoietic cells in modulation of lipid responses arising from genetic reduction of DPP-4 activity. Unexpectedly, deletion of Dpp4 in enterocytes increases TG excursion in high fat diet (HFD)-fed mice. Moreover, chemical reduction of DPP-4 activity and increased levels of GLP-1 are uncoupled from triglyceride excursion in older or HFD-fed mice, yet lipid tolerance remains improved in older Dpp4-/- and Dpp4EC-/- mice. Taken together, this study defines new roles for specific DPP-4 compartments, age, and diet as modifiers of DPP-4 activity linked to control of gut lipid metabolism.
Authors
Elodie M. Varin, Antonio Hanson, Jacqueline L. Beaudry, My-Anh Nguyen, Xiemin Cao, Laurie Baggio, Erin E. Mulvihill, Daniel J. Drucker
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.139377.
Abstract
Recent evidence shows that the naïve heart harbors a population of intravascular recirculating B cells that make close contact with the microvascular endothelium of the heart and arrest their transit as they pass through the heart. However, the timing of their appearance and their organ specificity remain unknown. To address this knowledge gap, we performed a systematic analysis of B cells isolated from the myocardium and other organs, from embryonic life to early adulthood. We found that B cells are present in the developing heart by day E13.5. The phenotype of myocardial B cells changed dynamically during development. While neonatal heart B cells were mostly CD11b+ and CD11b-CD21-CD23-, adult B cells were predominantly CD11b-CD21+CD23+. Histological analysis and intravital microscopy of lung and liver showed that organ-associated B cells in contact with the microvascular endothelium were not specific to the heart. Flow cytometric analysis of perfused hearts, livers, lungs and spleen at different developmental stages showed that the dynamic changes in B cell subpopulations observed in the heart during development mirrored changes observed in the spleen, peripheral blood and other organs. Single cell RNAseq analysis of B cells showed that myocardial-associated B cells were part of a larger population of organ-associated B cells that had a distinct gene expression profile. These findings broaden our understanding of the biology of myocardial-associated B cells and suggest that current models of the dynamics of naïve B cell during development are incomplete.
Authors
Cibele Rocha-Resende, Wei Yang, Wenjun Li, Daniel Kreisel, Luigi Adamo, Douglas Mann
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.139558.
Abstract
Skin lesions in dermatomyositis (DM) patients are common, frequently refractory, and have prognostic significance. Histologically, DM lesions appear like cutaneous lupus erythematosus (CLE) lesions and frequently cannot be differentiated. We thus undertook to examine the transcriptional profile of DM biopsies and compared them to CLE lesions in order to identify unique features. Type I interferon (IFN) signaling, including upregulation of IFN kappa, was a common pathway in both DM and CLE, but CLE also exhibited other inflammatory pathways. Importantly, DM lesions could be distinguished from CLE by a 5-gene biomarker panel that included an upregulation of IL18. Using single-cell RNA-sequencing, we further identified keratinocytes as the main source of increased IL-18 in DM skin. The novel molecular signature identified in this study has significant clinical implications for differentiating DM from CLE lesions, and we have highlighted the potential role for IL-18 in the pathophysiology of DM skin disease.
Authors
Lam Tsoi, Mehrnaz Gharaee-Kermani, Celine C. Berthier, Tori Nault, Grace Hile, Shannon N. Estadt, Matthew T. Patrick, Rachael Wasikowski, Allison C. Billi, Lori Lowe, Tamra J. Reed, Johann Gudjonsson, J. Michelle Kahlenberg
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.138619.
Abstract
Background: Our objective is to investigate whether primary Sjogren’s syndrome (pSS) is associated with multiple system atrophy (MSA). Methods: We performed a retrospective cohort study assessing rates of (a) MSA in a cohort of patients with pSS, and (b) and rates of pSS in a cohort of patients with MSA. These data were, compared to rates in respective control groups. We additionally reviewed the neuropathologic findings in two patients with pSS, cerebellar degeneration, parkinsonism, and autonomic dysfunction. Results: Our cohort of 308 pSS patients had a greater incidence of MSA compared with four large population-based studies and had had a significantly higher prevalence of at least probable MSA (1% vs. 0%, p = 0.02) compared to 776 patients in a control cohort of patients with other autoimmune disorders. Our cohort of 26 autopsy-proven MSA patients had a significantly higher prevalence of pSS compared with a cohort of 115 patients with other autopsy-proven neurodegenerative disorders (8% vs. 0%, p = 0.03). The two patients we described with pSS and progressive neurodegenerative disease showed classic MSA pathology at autopsy. Conclusion: Our findings provide evidence for an association between MSA and pSS that is specific to both pSS, among autoimmune disorders, and MSA, among neurodegenerative disorders. The two cases we describe of autopsy-proven MSA support that MSA pathology can explains neurologic disease in a subset of pSS patients. These findings together support the hypothesis that systemic autoimmune disease plays role in neurodegeneration. Study funding: The Michigan Brain Bank is supported in part through an NIH grant P30AG053760.
Authors
Kyle S. Conway, Sandra Camelo-Piragua, Amanda O. Fisher-Hubbard, William Perry, Vikram G. Shakkottai, Sriram Venneti
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.135412.
Abstract
Evidence has mounted that insulin can be synthesized in various brain regions including the hypothalamus. However, the distribution and functions of insulin-expressing cells in the hypothalamus remain elusive. Herein, we show that in the mouse hypothalamus, the perikarya of insulin-positive neurons are located in the paraventricular nucleus (PVN) and their axons project to the median eminence; these findings define parvocellular neurosecretory PVN insulin neurons. Contrary to corticotrophin-releasing hormone expression, insulin expression in the PVN was inhibited by restraint stress (RS) in both adult and young mice. Acute RS–induced inhibition of PVN insulin expression in adult mice decreased both pituitary growth hormone (GH) mRNA level and serum GH concentration, which were attenuated by overexpression of PVN insulin. Notably, PVN insulin knockdown or chronic RS in young mice hindered normal growth via the down-regulation of GH gene expression and secretion, whereas PVN insulin overexpression in young mice prevented chronic RS–induced growth retardation by elevating GH production. Our results suggest that in both normal and stressful conditions, insulin synthesized in the parvocellular PVN neurons plays an important role in the regulation of pituitary GH production and body length, unveiling a physiological function of brain-derived insulin.
Authors
Jaemeun Lee, Kyungchan Kim, Jae Hyun Cho, Jin Young Bae, Timothy P. O’Leary, James D. Johnson, Yong Chul Bae, Eun-Kyoung Kim
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.136220.
Abstract
Acute rejection (AR) in renal transplantation is an established risk factor for reduced allograft survival. The incidence of AR is 10-20% despite standard of care immunosuppression, suggesting molecular pathways exist which are inadequately suppressed by current therapy. Molecules with regulatory control among these could serve as important targets for therapeutic manipulation to prevent rejection. Here, an integrative network-based computational strategy incorporating gene expression and genotype data of human renal allograft biopsy tissue was applied, to identify the master regulators- the key driver genes (KDGs)- within dyregulated AR pathways. A 982 meta-gene signature with differential expression in AR versus non-AR, was identified from a meta-analysis of microarray data from 735 human kidney allograft biopsy samples across seven data sets. Among the upregulated genes, enriched biologic processes include the immune response, leucocyte activation and antigen processing and presentation; where monocytes, macrophages and dendritic cells were identified as the major immune cell populations. Genomic key driver analysis of this signature predicted 14 KDGs. Expression of the KDGs provided risk stratification for subsequent graft loss with high prediction accuracy at 2 years post transplant (AUC=0.913) and 2 years post biopsy (AUC=0.889) in separate clinical cohorts. Interrogation of two drug-repositioning resources identified compounds with predicted efficacy against individual KDGs or a key driver-based gene set respectively, and therefore be repositioned for AR prevention. Minocycline, an FDA-approved tetracycline antibiotic, was chosen for experimental validation in a murine cardiac allograft model of AR. Minocycline alone attenuated the inflammatory profile of AR compared with controls, and when co-administered with immunosuppression prolonged graft survival. This study demonstrates the proof-of-concept that a network-based strategy, using gene expression and genotype data assists target prioritization for therapeutics in renal allograft rejection.
Authors
Zhengzi Yi, Karen L. Keung, Li Li, Min Hu, Bo Lu, Leigh Nicholson, Elvira Jimenez-Vera, Madhav C. Menon, Chengguo Wei, Stephen I. Alexander, Barbara Murphy, Philip J. O’Connell, Weijia Zhang
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.137029.
Abstract
Critical illness is accompanied by the release of large amounts of the anaphylotoxin, C5a. C5a suppresses antimicrobial functions of neutrophils which is associated with adverse outcomes. The signalling pathways that mediate C5a-induced neutrophil dysfunction are incompletely understood. Healthy donor neutrophils exposed to purified C5a demonstrated a prolonged defect (7 hours) in phagocytosis of Staphylococcus aureus. Phosphoproteomic profiling of 2712 phosphoproteins identified persistent C5a signalling and selective impairment of phagosomal protein phosphorylation on exposure to S. aureus. Notable proteins included early endosomal marker ZFYVE16 and V-ATPase proton channel component ATPV1G1. A novel assay of phagosomal acidification demonstrated C5a-induced impairment of phagosomal acidification which was recapitulated in neutrophils from critically ill patients. Examination of the C5a-impaired protein phosphorylation indicated a role for the phosphatidylinositol 3-kinase VPS34 in phagosomal maturation. Inhibition of VPS34 impaired neutrophil phagosomal acidification and killing of S. aureus. This study provides a phosphoproteomic assessment of human neutrophil signalling in response to S. aureus and its disruption by C5a, identifying a defect in phagosomal maturation and new mechanisms of immune failure in critical illness.
Authors
Alexander J.T. Wood, Arlette M. Vassallo, Marie-Helene Ruchaud-Sparagano, Jonathan Scott, Carmelo Zinnato, Carmen Gonzalez-Tejedo, Kamal Kishore, Clive S. D’Santos, A. John Simpson, David K. Menon, Charlotte Summers, Edwin R. Chilvers, Klaus Okkenhaug, Andrew Conway Morris
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