External membrane vesicles from Helicobacter pylori induce apoptosis in gastric epithelial cells

The Helicobacter pylori infection of gastric mucosa is one of the most common infectious diseases and is associated with a variety of clinical outcomes, including peptic ulcer disease and gastric cancer. Helicobacter pylori-induced damage to gastric mucosal cells is controlled by bacterial virulence factors, which include VacA and CagA. Outer membrane vesicles are constantly shed by the bacteria and can provide an additional mechanism for pathogenicity by releasing non-secretable factors which can then interact with epithelial cells. The present report shows that external membrane vesicles are able to induce apoptosis not mediated by mitochondrial pathway in gastric (AGS) epithelial cells, as demonstrated by the lack of cytochrome c release with an activation of caspase 8 and 3. Apoptosis induced by these vesicles does not require a classic VacA+ phenotype, as a negative strain with a truncated and therefore non-secretable form of this protein can also induce cell death. These results should be taken into account in future studies of H. pylori pathogenicity in strains apparently VacA-.     

Surgical mask to prevent influenza transmission in households: a cluster randomized trial

Background

Facemasks and respirators have been stockpiled during pandemic preparedness. However, data on their effectiveness for limiting transmission are scarce. We evaluated the effectiveness of facemask use by index cases for limiting influenza transmission by large droplets produced during coughing in households.

Methodology and Principal Findings

A cluster randomized intervention trial was conducted in France during the 2008–2009 influenza season. Households were recruited during a medical visit of a household member with a positive rapid influenza A test and symptoms lasting less than 48 hours. Households were randomized either to the mask or control group for 7 days. In the intervention arm, the index case had to wear a surgical mask from the medical visit and for a period of 5 days. The trial was initially intended to include 372 households but was prematurely interrupted after the inclusion of 105 households (306 contacts) following the advice of an independent steering committee. We used generalized estimating equations to test the association between the intervention and the proportion of household contacts who developed an influenza-like illness during the 7 days following the inclusion. Influenza-like illness was reported in 24/148 (16.2%) of the contacts in the intervention arm and in 25/158 (15.8%) of the contacts in the control arm and the difference between arms was 0.40% (95%CI: −10% to 11%, P = 1.00). We observed a good adherence to the intervention. In various sensitivity analyses, we did not identify any trend in the results suggesting effectiveness of facemasks.

Conclusion

This study should be interpreted with caution since the lack of statistical power prevents us to draw formal conclusion regarding effectiveness of facemasks in the context of a seasonal epidemic.

Trial Registration

clinicaltrials.gov {"type":"clinical-trial","attrs":{"text":"NCT00774774","term_id":"NCT00774774"}}NCT00774774     

Purified PTP1 protein induces antigen-specific protective immunity against Encephalitozoon cuniculi

Microsporidiosis poses a problem for immunocompromised individuals including patients with HIV infection as well as those with organ transplantation. Recent reports from Africa have suggested that microsporidiosis with diarrhea is an independent risk factor for malnutrition in children. Previous studies from our laboratory have demonstrated that CD8⁺ T cells are an essential component of protective immunity against the microsporidium Encephalitozoon cuniculi. Mutant mice lacking this T cell subset or cytotoxic function are unable to clear the infection and ultimately succumb to the disease. However, information regarding the antigens involved in the elicitation of CD8⁺ T cell response is not available. In this study, we report that immunization of animals with Encephalitozoon hellem polar tube protein 1 (rEhPTP1) induces a strong T cell response in vaccinated animals. Splenic dendritic cells pulsed with rEhPTP1 are able to induce E. cuniculi specific CD8⁺ T cell response with no effect on the CD4⁺ T cell subset. This is the first report identifying a protein capable of inducing CD8⁺ T cell immunity, which is conserved in other microsporidial species of human importance.     

Whole body leucine flux in HIV-infected patients treated with or without protease inhibitors

The present study was carried out to assess the effects of protease inhibitor (PI) therapy on basal whole body protein metabolism and its response to acute amino acid-glucose infusion in 14 human immunodeficiency virus (HIV)-infected patients. Patients treated with PIs (PI+, 7 patients) or without PIs (PI-, 7 patients) were studied after an overnight fast during a 180-min basal period followed by a 140-min period of amino acid-glucose infusion. Protein metabolism was investigated by a primed constant infusion of l-[1-(13)C]leucine. Dual-energy X-ray absorptiometry for determination of fat-free mass (FFM) and body fat mass measured body composition. In the postabsorptive state, whole body leucine balance was 2.5 times (P < 0.05) less negative in the PI+ than in the PI- group. In HIV-infected patients treated with PIs, the oxidative leucine disposal during an acute amino acid-glucose infusion was lower (0.58 +/- 0.09 vs. 0.81 +/- 0.07 micromol x kg FFM(-1) x min(-1) using plasma [(13)C]leucine enrichment, P = 0.06; or 0.70 +/- 0.10 vs. 0.99 +/- 0.08 micromol x kg FFM(-1) x min(-1) using plasma [(13)C]ketoisocaproic acid enrichment, P = 0.04 in PI+ and PI- groups, respectively) than in patients treated without PIs. Consequently, whole body nonoxidative leucine disposal (an index of protein synthesis) and leucine balance (0.50 +/- 0.10 vs. 0.18 +/- 0.06 micromol x kg FFM x (-1) x min(-1) in PI+ and PI- groups respectively, P < 0.05) were significantly improved during amino acid-glucose infusion in patients treated with PIs. However, whereas the response of whole body protein anabolism to an amino acid-glucose infusion was increased in HIV-infected patients treated with PIs, any improvement in lean body mass was detected.     

Benefits of recombinant adeno-associated virus (rAAV)-mediated insulinlike growth factor I (IGF-I) overexpression for the long-term reconstruction of human osteoarthritic cartilage by modulation of the IGF-I axis

Administration of therapeutic genes to human osteoarthritic (OA) cartilage is a potential approach to generate effective, durable treatments against this slow, progressive disorder. Here, we tested the ability of recombinant adeno-associated virus (rAAV)-mediated overexpression of human insulinlike growth factor (hIGF)-I to reproduce an original surface in human OA cartilage in light of the pleiotropic activities of the factor. We examined the proliferative, survival and anabolic effects of the rAAV-hIGF-I treatment in primary human normal and OA chondrocytes in vitro and in explant cultures in situ compared with control (reporter) vector delivery. Efficient, prolonged IGF-I secretion via rAAV stimulated the biological activities of OA chondrocytes in all the systems evaluated over extended periods of time, especially in situ, where it allowed for the long-term reconstruction of OA cartilage (at least for 90 d). Remarkably, production of high, stable amounts of IGF-I in OA cartilage using rAAV advantageously modulated the expression of central effectors of the IGF-I axis by downregulating IGF-I inhibitors (IGF binding protein [IGFBP]-3 and IGFBP4) while up-regulating key potentiators (IGFBP5, the IGF-I receptor and downstream mitogen-activated protein kinase/extracellular signal-regulated kinase 1/2 [MAPK/ERK-1/2] and phosphatidylinisitol-3/Akt [PI3K/Akt] signal transduction pathways), probably explaining the enhanced responsiveness of OA cartilage to IGF-I treatment. These findings show the benefits of directly providing an IGF-I sequence to articular cartilage via rAAV for the future treatment of human osteoarthritis.     

Redundant Hydrogen Peroxide Scavengers Contribute to Salmonella Virulence and Oxidative Stress Resistance

Salmonella enterica serovar Typhimurium is an intracellular pathogen that can survive and replicate within macrophages. One of the host defense mechanisms that Salmonella encounters during infection is the production of reactive oxygen species by the phagocyte NADPH oxidase. Among them, hydrogen peroxide (H₂O₂) can diffuse across bacterial membranes and damage biomolecules. Genome analysis allowed us to identify five genes encoding H₂O₂ degrading enzymes: three catalases (KatE, KatG, and KatN) and two alkyl hydroperoxide reductases (AhpC and TsaA). Inactivation of the five cognate structural genes yielded the HpxF⁻ mutant, which exhibited a high sensitivity to exogenous H₂O₂ and a severe survival defect within macrophages. When the phagocyte NADPH oxidase was inhibited, its proliferation index increased 3.7-fold. Moreover, the overexpression of katG or tsaA in the HpxF⁻ background was sufficient to confer a proliferation index similar to that of the wild type in macrophages and a resistance to millimolar H₂O₂ in rich medium. The HpxF⁻ mutant also showed an attenuated virulence in a mouse model. These data indicate that Salmonella catalases and alkyl hydroperoxide reductases are required to degrade H₂O₂ and contribute to the virulence. This enzymatic redundancy highlights the evolutionary strategies developed by bacterial pathogens to survive within hostile environments.Salmonella is a facultative intracellular pathogen that is associated with gastroenteritis, septicemia, and typhoid fever. This gram-negative bacterium survives and replicates in macrophages during the course of infection and can be exposed to a number of stressful environments during its life cycle (16). One of the host defense mechanisms that Salmonella encounters upon infection is the production of superoxide anion O₂⁻ by the phagocyte NADPH oxidase (1, 25). This radical can pass the outer membrane of the bacteria and represents one of the major weapons used by the macrophage to kill engulfed pathogens (18). Evidence that phagocyte-produced superoxide is a key mechanism for avoiding Salmonella infection is clear: mice and humans who are genetically defective in superoxide production are significantly more susceptible to infection (36, 38). Superoxide dismutases, located in the bacterial periplasm and in the cytoplasm, dismutate superoxide O₂⁻ to hydrogen peroxide H₂O₂ and molecular oxygen. Unlike superoxide, hydrogen peroxide can diffuse readily across bacterial membranes and form HO hydroxyl radicals in the presence of Fe(II) (18). These reactive oxygen species (ROS) can oxidize and damage proteins, nucleic acids, and cell membranes.To scavenge and degrade H₂O₂ molecules generated either as a by-product of aerobic metabolism or by the phagocyte NADPH oxidase, Salmonella has evolved numerous defense mechanisms. The KatE and KatG catalases are involved in H₂O₂ degradation, with katE being described as a member of the RpoS regulon (17, 22) and katG being OxyR dependent (26, 39). Both enzymes share the ability to reduce hydrogen peroxide to water and molecular oxygen, and their role was shown to be predominant at millimolar concentrations of H₂O₂ since they do not require any reductant (32). This observation is of particular importance, since these enzymes are not limited by the availability of a reductant, such as NADH, which cannot be generated fast enough to face a burst of H₂O₂. However, the katG and katE simple mutants, as well as the katE katG double mutant, did not show any increased susceptibility in macrophage or virulence attenuation in mice (5, 27). A possible reason could be the presence of a third nonheme and manganese-dependent catalase called KatN (30). This enzyme may contribute to hydrogen peroxide resistance under certain environmental conditions, but its involvement in virulence remains unknown. Moreover, katE, katG, and katN single mutants did not show any susceptibility to exogenous millimolar H₂O₂, essentially due to the compensatory function of the remaining catalases (5, 30).Another family of enzymes was shown to play an alternative role in H₂O₂ scavenging: the alkyl hydroperoxide reductases. These proteins directly convert organic hydroperoxides to alcohols, e.g., hydrogen peroxide to water. The alkyl hydroperoxide reductase AhpC belongs to the two-cysteine peroxiredoxin family, and the gene encoding this enzyme was identified as a member of the OxyR regulon (26, 39). The redox system consists of two proteins, AhpC and AhpF, with the latter being a thioredoxin reductase-like protein that contains two disulfide centers and transfers electrons from NADH to AhpC (13). AhpC was shown to be a predominant scavenger at low concentrations of H₂O₂, mainly because its catalytic efficiency was better than those of catalases (32). Recently the alkyl hydroperoxide reductase from Helicobacter hepaticus, TsaA (Thiol-Specific Antioxidant), was characterized (24). The tsaA mutant was found to be more sensitive to oxidizing agents like superoxide anion or t-butyl hydroperoxide. Surprisingly, this mutant was more resistant than the wild-type to H₂O₂, essentially because the level of catalase was increased in this background (24). In gastric pathogens, TsaA plays a critical role in the defense against oxygen toxicity that is essential for survival and growth (2). Interestingly, Salmonella contains two genes encoding alkyl hydroperoxide reductases, ahpC and tsaA, whereas a single copy was found in Escherichia coli (ahpC) or in Helicobacter pylori (tsaA).The redundancy of these antioxidant proteins could explain the extremely high resistance of Salmonella to hydrogen peroxide. It has been shown by Imlay and coworkers that in E. coli, three genes were involved in H₂O₂ scavenging: two catalase genes (katE and katG) and an alkyl hydroperoxide reductase gene (ahpC) (32). Simultaneous inactivation of the katE, katG, and ahpCF genes negated H₂O₂ degradation. As a consequence, this triple mutant, called the Hpx⁻ mutant, accumulates intracellular H₂O₂ (32). Moreover, H₂O₂ generated by aerobic metabolism was found to be sufficient to create toxic levels of DNA damage in such a background (28). In the present study, we deleted the Salmonella katE, katG, and ahpCF genes and two more genes absent in E. coli, katN and tsaA, to obtain the HpxF⁻ mutant, which lacks three catalases and two alkyl hydroperoxide reductases. HpxF⁻ cells exhibited the incapacity to degrade micromolar concentrations of H₂O₂, whereas this phenotype was not observed for the Kat⁻ (katE katG katN) and Ahp⁻ (ahpCF tsaA) mutants. Therefore, the HpxF⁻ mutant exhibited a high sensitivity to this compound. Moreover, this mutant did not show any proliferation within macrophages and presented reduced virulence in mice, suggesting that Salmonella catalases and alkyl hydroperoxide reductases form a redundant antioxidant arsenal essential for survival and replication within host cells.     

Identification of a novel duplication CFTRdup2 and functional impact of large rearrangements identified in the CFTR gene

The aim of this study was to investigate associations of two candidate gene SNPs of the endocannabinoid receptor type 1 gene (CNR1) with overweight, obesity and obesity-related traits in Chinese retired women. The study subjects were a subsample of the Taizhou Retiree Women Cohort, consisting of 2812 retired women aged 50-64 years recruited from Taizhou, Jiangsu, China. Neither rs2023239 nor rs806381 polymorphism was significantly associated with body mass index-defined overweight and obesity or waist-to-hip-ratio-defined obesity. For obesity-related traits, rs2023239 was significantly associated with glutamate pyruvate transaminase (GPT) (median, 18.00 vs 17.00 for TT and TC genotypes, respectively, P=0.043). The rs806381 also showed significant association with triglyceride (TG) (mean±SD, 1.46±0.20 vs 1.53±0.20 for GA and GG+AA genotypes, respectively, P=0.013) under the dominant genetic model. In conclusion, the rs2023239 and rs806381 polymorphisms of CNR1 were not associated with increased overweight and obesity risk. But the rs2023239 polymorphism was significantly associated with GPT, and the rs806381 polymorphism was significantly associated with TG.