Autophagy: for better or for worse

Autophagy is a lysosomal degradation pathway that degrades damaged or superfluous cell components into basic biomolecules, which are then recycled back into the cytosol. In this respect, autophagy drives a flow of biomolecules in a continuous degradation-regeneration cycle. Autophagy is generally considered a pro-survival mechanism protecting cells under stress or poor nutrient conditions. Current research clearly shows that autophagy fulfills numerous functions in vital biological processes. It is implicated in development, differentiation, innate and adaptive immunity, ageing and cell death. In addition, accumulating evidence demonstrates interesting links between autophagy and several human diseases and tumor development. Therefore, autophagy seems to be an important player in the life and death of cells and organisms. Despite the mounting knowledge about autophagy, the mechanisms through which the autophagic machinery regulates these diverse processes are not entirely understood. In this review, we give a comprehensive overview of the autophagic signaling pathway, its role in general cellular processes and its connection to cell death. In addition, we present a brief overview of the possible contribution of defective autophagic signaling to disease.     

Autophagy: for better or for worse, in good times or in bad times

Autophagy is a bulk cytosolic degradative process which in the last few years has become a key pathway for the advancement of molecular medicine. Autophagy (cellular self-eating) has several implications in human disorders involving accumulation of cytosolic protein aggregates such as Alzheimer, Parkinson, Huntington diseases, as well as in myopathies caused by deficient lysosomal functions and in cancer. Moreover, autophagy affects intracellular microorganism lifespan, acting either as a cellular defense mechanism or, on the contrary, promoting pathogen replication. Furthermore, autophagy also participates in antigen presentation, as a part of the adaptive immune response. Therefore, autophagy association with cell survival or cell death would depend on cell nutrition conditions, presence of cell intruders, and alterations in oncogene or suppressor gene expression. In this review we will focus on the wide spectra of disease-related topics where autophagy is involved, particularly, in those processes concerning microorganism infections.     

For better or worse: Relationship status and body mass index

Recent increases in the incidence of obesity and declines in marriage have prompted policymakers to implement policies to mitigate these trends. This paper examines the link between these two outcomes. There are four hypotheses (selection, protection, social obligation and marriage market) that might explain the relationship between marital status transitions and changes in Body Mass Index (BMI). The selection hypothesis suggests that those with a lower BMI are more likely to be selected into marriage. The protection hypothesis states that married adults will have better physical health as a result of the increased social support and reduced incidence of risky behavior among married individuals. The social obligation hypothesis states that those in relationships may eat more regular meals and/or richer and denser foods due to social obligations which may arise because of marriage. Finally, the marriage market hypothesis indicates that when adults are no longer in the marriage market they may not maintain a healthy BMI because doing so is costly and they are in a stable union—or on the other hand, adults may enhance their prospects in the marriage market by losing weight. Taking advantage of longitudinal data and complete marriage histories in the National Longitudinal Survey of Youth 1979, we estimate individual fixed effects models to examine associations between the change in log BMI and the incidence of overweight and obesity, and changes in relationship status controlling for the effects of aging and other respondent characteristics. We find no support for the marriage protection hypothesis. Rather we find evidence supporting the social obligation and marriage market hypotheses—BMI increases for both men and women during marriage and in the course of a cohabiting relationship. Separate analyses by race and ethnicity reveal substantial differences in the response of BMI to relationship status across these groups.     

How serpins change their fold for better and for worse

The serpins differ from the many other families of serine protease inhibitors in that they undergo a profound change in topology in order to entrap their target protease in an irreversible complex. The solving of the structure of this complex has now provided a video depiction of the changes involved. Cleavage of the exposed reactive centre of the serpin triggers an opening of the five-stranded A-sheet of the molecule, with insertion of the cleaved reactive loop as an additional strand in the centre of the sheet. The drastic displacement of the acyl-linked protease grossly disrupts its active site and gives an overall loss of 40% of ordered structure. This ability to provide effectively irreversible inhibition explains the selection of the serpins to control the proteolytic cascades of higher organisms. The conformational mechanism provides another advantage in its potential to modulate activity. Sequential crystallographic structures now provide clear depictions of the way antithrombin is activated on binding to the heparans of the microcirculation, and how evolution has utilized this mobile mechanism for subtle variations in activity. The complexity of these modulatory mechanisms is exemplified by heparin cofactor II, where the change in fold is seen to trigger multiple allosteric effects. The downside of the mobile mechanism of the serpins is their vulnerability to aberrant intermolecular beta-linkages, resulting in various disorders from cirrhosis to thrombosis. These provide a well defined structural prototype for the new entity of the conformational diseases, including the common dementias, as confirmed by the recent identification of the familial neuroserpin dementias.     

Fluid shear stress and the vascular endothelium: for better and for worse

As blood flows, the vascular wall is constantly subjected to physical forces, which regulate important physiological blood vessel responses, as well as being implicated in the development of arterial wall pathologies. Changes in blood flow, thus generating altered hemodynamic forces are responsible for acute vessel tone regulation, the development of blood vessel structure during embryogenesis and early growth, as well as chronic remodeling and generation of adult blood vessels. The complex interaction of biomechanical forces, and more specifically shear stress, derived by the flow of blood and the vascular endothelium raise many yet to be answered questions:How are mechanical forces transduced by endothelial cells into a biological response, and is there a "shear stress receptor"?Are "mechanical receptors" and the final signaling pathways they evoke similar to other stimulus-response transduction systems?How do vascular endothelial cells differ in their response to physiological or pathological shear stresses?Can shear stress receptors or shear stress responsive genes serve as novel targets for the design of diagnostic and therapeutic modalities for cardiovascular pathologies?The current review attempts to bring together recent findings on the in vivo and in vitro responses of the vascular endothelium to shear stress and to address some of the questions raised above.     

For better or worse: reduced adult lifespan following early-life stress is transmitted to breeding partners

Stressful conditions early in life can give rise to exaggerated stress responses, which, while beneficial in the short term, chronically increase lifetime exposure to stress hormones and elevate disease risk later in life. Using zebra finches Taeniopygia guttata, we show here that individuals whose glucocorticoid stress hormones were experimentally increased for only a brief period in early post-natal life, inducing increased stress sensitivity, had reduced adult lifespans. Remarkably, the breeding partners of such exposed individuals also died at a younger age. This negative effect on partner longevity was the same for both sexes; it occurred irrespective of the partner's own early stress exposure and was in addition to any longevity reduction arising from this. Furthermore, this partner effect continued even after the breeding partnership was terminated. Only 5 per cent of control birds with control partners had died after 3 years, compared with over 40 per cent in early stress-early stress pairs. In contrast, reproductive capability appeared unaffected by the early stress treatment, even when breeding in stressful environmental circumstances. Our results clearly show that increased exposure to glucocorticoids early in life can markedly reduce adult life expectancy, and that pairing with such exposed partners carries an additional and substantial lifespan penalty.     

Doing better by getting worse: posthypnotic amnesia improves random number generation

Although forgetting is often regarded as a deficit that we need to control to optimize cognitive functioning, it can have beneficial effects in a number of contexts. We examined whether disrupting memory for previous numerical responses would attenuate repetition avoidance (the tendency to avoid repeating the same number) during random number generation and thereby improve the randomness of responses. Low suggestible and low dissociative and high dissociative highly suggestible individuals completed a random number generation task in a control condition, following a posthypnotic amnesia suggestion to forget previous numerical responses, and in a second control condition following the cancellation of the suggestion. High dissociative highly suggestible participants displayed a selective increase in repetitions during posthypnotic amnesia, with equivalent repetition frequency to a random system, whereas the other two groups exhibited repetition avoidance across conditions. Our results demonstrate that temporarily disrupting memory for previous numerical responses improves random number generation.     

>For better or worse, till death us do part<--spousal age gap and differential longevity: evidence from historical demography

Based on a set of 2,371 family related entries dating from 1688 to 1921, the current study tried to verify longevity differentials due to interspousal age difference. For the purpose of the analysis, age-heterogamy was operationalized in terms of sample-specific marital age gap (3.2 years) with a standard deviation of 6.1 years. Based on this, five marriage groups were isolated. Female mean age at marriage experienced a slight increase over time, while the male mean at marriage decreased. This led to an appreciable narrowing of the spousal age gap. Age-homogamous unions were most prevalent in the lower socio-economic class (day-laborers, industrial workers) (p<0.01). In both husband-older and wife-older unions, the interspousal gap increased with marriage order. In accord with previous studies, mean age at death varied significantly by marriage group. Females, who married younger men, died later than females, who married older men. In contrast, male longevity was most depressed within age-similar marriages, while those who married older or younger wives displayed higher life spans. Overall, marriage to a younger spouse seemed to increase longevity prospects (p<0.05). These differentials were not exclusively a function of the marital age gap, but were affected by diverse confounders such as reproductive output and socio-economic status.     

Which is better for cDNA-microarray-based classification: ratios or direct intensities

MOTIVATION: There are two general methods for making gene-expression microarrays: one is to hybridize a single test set of labeled targets to the probe, and measure the background-subtracted intensity at each probe site; the other is to hybridize both a test and a reference set of differentially labeled targets to a single detector array, and measure the ratio of the background-subtracted intensities at each probe site. Which method is better depends on the variability in the cell system and the random factors resulting from the microarray technology. It also depends on the purpose for which the microarray is being used. Classification is a fundamental application and it is the one considered here. RESULTS: This paper describes a model-based simulation paradigm that compares the classification accuracy provided by these methods over a variety of noise types and presents the results of a study modeled on noise typical of cDNA microarray data. The model consists of four parts: (1) the measurement equation for genes in the reference state; (2) the measurement equation for genes in the test state; (3) the ratio and normalization procedure for a dual-channel system; and (4) the intensity and normalization procedure for a single-channel system. In the reference state, the mean intensities are modeled as a shifted exponential distribution, and the intensity for a particular gene is modeled via a normal distribution, Normal(I, alphaI), about its mean intensity I, with alpha being the coefficient of variation of the cell system. In the test state, some genes have their intensities up-regulated by a random factor. The model includes a number of random factors affecting intensity measurement: deposition gain d, labeling gain, and post-image-processing residual noise. The key conclusion resulting from the study is that the coefficient of variation governing the randomness of the intensities and the deposition gain are the most important factors for determining whether a single-channel or dual-channel system provides superior classification, and the decision region in the alpha-d plane is approximately linear.     

Vanadyl-thiazolidinedione combination agents for diabetes therapy

A series of vanadium compounds, chelated by ligands containing a thiazolidinedione moiety as an additional insulin-enhancing component, were produced in this study to create potentially synergistic compounds. A set of four bifunctional ligand precursors were synthesized: (+/-)-5-[4-[(5-hydroxy-4-oxo-4H-pyran-2-ylmethyl)amino]benzyl]thiazolidine-2,4-dione (HL(1)), (+/-)-5-[4-[(5-hydroxy-1-methyl-4-oxo-1,4-dihydro-pyridin-2-ylmethyl)amino]benzyl]thiazolidine-2,4-dione (HL(2)), 5-[4-(5-hydroxy-4-oxo-4H-pyran-2-ylmethoxy)benzylidene]thiazolidine-2,4-dione (HL(3)), and (+/-)-5-[4-(5-hydroxy-4-oxo-4H-pyran-2-ylmethoxy)benzyl]thiazolidine-2,4-dione (HL(4)), each containing a metal chelating portion as well as a thiazolidinedione moiety. From this set of ligand precursors, air-stable VO(L(1))(2), VO(L(3))(2), and VO(L(4))(2) were prepared. The four ligand precursors and three complexes were tested for insulin-enhancing potential in STZ-diabetic rats and compared to rosiglitazone and BMOV, respectively. Both the ligand precursors HL(1) and HL(3) showed enhanced activity compared with that of rosiglitazone. The complex VO(L(3))(2) showed the most efficacious hypoglycemic effects in this study; however, neither additive nor synergistic effects were observed using this acute animal model.     

Osteoporosis: the current status of mesenchymal stem cell-based therapy

Osteoporosis, or bone loss, is a progressive, systemic skeletal disease that affects millions of people worldwide. Osteoporosis is generally age related, and it is underdiagnosed because it remains asymptomatic for several years until the development of fractures that confine daily life activities, particularly in elderly people. Most patients with osteoporotic fractures become bedridden and are in a life-threatening state. The consequences of fracture can be devastating, leading to substantial morbidity and mortality of the patients. The normal physiologic process of bone remodeling involves a balance between bone resorption and bone formation during early adulthood. In osteoporosis, this process becomes imbalanced, resulting in gradual losses of bone mass and density due to enhanced bone resorption and/or inadequate bone formation. Several growth factors underlying age-related osteoporosis and their signaling pathways have been identified, such as osteoprotegerin (OPG)/receptor activator of nuclear factor B (RANK)/RANK ligand (RANKL), bone morphogenetic protein (BMP), wingless-type MMTV integration site family (Wnt) proteins and signaling through parathyroid hormone receptors. In addition, the pathogenesis of osteoporosis has been connected to genetics. The current treatment of osteoporosis predominantly consists of antiresorptive and anabolic agents; however, the serious adverse effects of using these drugs are of concern. Cell-based replacement therapy via the use of mesenchymal stem cells (MSCs) may become one of the strategies for osteoporosis treatment in the future.     

Impact of definitive therapy with beta-lactam monotherapy or combination with an aminoglycoside or a quinolone for Pseudomonas aeruginosa bacteremia

Background

Bacteremia by Pseudomonas aeruginosa represents one severe infection. It is not clear whether beta-lactam monotherapy leads to similar rates of treatment success compared to combinations of beta-lactams with aminoglycosides or quinolones.

Methods

Retrospective cohort study from 3 tertiary hospitals (2 in Greece and 1 in Italy). Pseudomonas aeruginosa isolates were susceptible to a beta-lactam and an aminoglycoside or a quinolone. Patients received appropriate therapy for at least 48 hours. Primary outcome of interest was treatment success in patients with definitive beta-lactam combination therapy compared to monotherapy. Secondary outcomes were treatment success keeping the same empirical and definitive regimen, mortality, and toxicity.

Results

Out of 92 bacteremias there were 54 evaluable episodes for the primary outcome (20 received monotherapy). Treatment success was higher with combination therapy (85%) compared to beta-lactam monotherapy (65%), however not statistically significantly [Odds ratio (OR) 3.1; 95% Confidence Interval (CI) 0.69–14.7, p = 0.1]. Very long (>2 months) hospitalisation before bacteremia was the only factor independently associated with treatment success (OR 0.73; 95% CI 0.01–0.95, p = 0.046), however this result entailed few episodes. All-cause mortality did not differ significantly between combination therapy [6/31 (19%)] and monotherapy [8/19 (42%)], p = 0.11. Only Charlson comorbidity index was associated with excess mortality (p = 0.03).

Conclusion

Our study, in accordance with previous ones, indicates that the choice between monotherapy and combination therapy may not affect treatment success significantly. However, our study does not have statistical power to identify small or moderate differences. A large randomized controlled trial evaluating this issue is justified.