Neuropeptides as Targets for the Development of Anticonvulsant Drugs

Epilepsy is a common neurological disorder characterized by recurrent seizures. These seizures are due to abnormal excessive and synchronous neuronal activity in the brain caused by a disruption of the delicate balance between excitation and inhibition. Neuropeptides can contribute to such misbalance by modulating the effect of classical excitatory and inhibitory neurotransmitters. In this review, we discuss 21 different neuropeptides that have been linked to seizure disorders. These neuropeptides show an aberrant expression and/or release in animal seizure models and/or epilepsy patients. Many of these endogenous peptides, like adrenocorticotropic hormone, angiotensin, cholecystokinin, cortistatin, dynorphin, galanin, ghrelin, neuropeptide Y, neurotensin, somatostatin, and thyrotropin-releasing hormone, are able to suppress seizures in the brain. Other neuropeptides, such as arginine-vasopressine peptide, corticotropin-releasing hormone, enkephalin, β-endorphin, pituitary adenylate cyclase-activating polypeptide, and tachykinins have proconvulsive properties. For oxytocin and melanin-concentrating hormone both pro- and anticonvulsive effects have been reported, and this seems to be dose or time dependent. All these neuropeptides and their receptors are interesting targets for the development of new antiepileptic drugs. Other neuropeptides such as nesfatin-1 and vasoactive intestinal peptide have been less studied in this field; however, as nesfatin-1 levels change over the course of epilepsy, this can be considered as an interesting marker to diagnose patients who have suffered a recent epileptic seizure.     

Product formation controlled by substrate dynamics in leukotriene A4 hydrolase

Leukotriene A₄ hydrolase/aminopeptidase (LTA4H) (EC 3.3.2.6) is a bifunctional zinc metalloenzyme with both an epoxide hydrolase and an aminopeptidase activity. LTA4H from the African claw toad, Xenopus laevis (xlLTA4H) has been shown to, unlike the human enzyme, convert LTA₄ to two enzymatic metabolites, LTB₄ and another biologically active product Δ⁶-trans-Δ⁸-cis-LTB₄ (5(S),12R-dihydroxy-6,10-trans-8,14-cis-eicosatetraenoic acid). In order to study the molecular aspect of the formation of this product we have characterized the structure and function of xlLTA4H. We solved the structure of xlLTA4H to a resolution of 2.3 Å. It is a dimeric structure where each monomer has three domains with the active site in between the domains, similar as to the human structure. An important difference between the human and amphibian enzyme is the phenylalanine to tyrosine exchange at position 375. Our studies show that mutating F375 in xlLTA4H to tyrosine abolishes the formation of the LTB₄ isomeric product Δ⁶-trans-Δ⁸-cis-LTB₄. In an attempt to understand how one amino acid exchange leads to a new product profile as seen in the xlLTA4H, we performed a conformer analysis of the triene part of the substrate LTA₄. Our results show that the Boltzmann distribution of substrate conformers correlates with the observed distribution of products. We suggest that the observed difference in product profile between the human and the xlLTA4H arises from different level of discrimination between substrate LTA₄ conformers.     

Structure and interactions of the Bacillus subtilis sporulation inhibitor of DNA replication,SirA, with domain I of DnaA

Chromosome copy number in cells is controlled so that the frequency of initiation of DNA replication matches that of cell division. In bacteria, this is achieved through regulation of the interaction between the initiator protein DnaA and specific DNA elements arrayed at the origin of replication. DnaA assembles at the origin and promotes DNA unwinding and the assembly of a replication initiation complex. SirA is a DnaA‐interacting protein that inhibits initiation of replication in diploid Bacillus subtilis cells committed to the developmental pathway leading to formation of a dormant spore. Here we present the crystal structure of SirA in complex with the N‐terminal domain of DnaA revealing a heterodimeric complex. The interacting surfaces of both proteins are α‐helical with predominantly apolar side‐chains packing in a hydrophobic interface. Site‐directed mutagenesis experiments confirm the importance of this interface for the interaction of the two proteins in vitro and in vivo. Localization of GFP–SirA indicates that the protein accumulates at the replisome in sporulating cells, likely through a direct interaction with DnaA. The SirA interacting surface of DnaA corresponds closely to the HobA‐interacting surface of DnaA from Helicobacter pylori even though HobA is an activator of DnaA and SirA is an inhibitor.     

Evidence for Steric Regulation of Fibrinogen Binding to Staphylococcus aureus Fibronectin-binding Protein A (FnBPA)

The adjacent fibrinogen (Fg)- and fibronectin (Fn)-binding sites on Fn-binding protein A (FnBPA), a cell surface protein from Staphylococcus aureus, are implicated in the initiation and persistence of infection. FnBPA contains a single Fg-binding site (that also binds elastin) and multiple Fn-binding sites. Here, we solved the structure of the N2N3 domains containing the Fg-binding site of FnBPA in the apo form and in complex with a Fg peptide. The Fg binding mechanism is similar to that of homologous bacterial proteins but without the requirement for “latch” strand residues. We show that the Fg-binding sites and the most N-terminal Fn-binding sites are nonoverlapping but in close proximity. Although Fg and a subdomain of Fn can form a ternary complex on an FnBPA protein construct containing a Fg-binding site and single Fn-binding site, binding of intact Fn appears to inhibit Fg binding, suggesting steric regulation. Given the concentrations of Fn and Fg in the plasma, this mechanism might result in targeting of S. aureus to fibrin-rich thrombi or elastin-rich tissues.     

Organization of the integrin LFA-1 in nanoclusters regulates its activity

The beta2-integrin LFA-1 facilitates extravasation of monocytes (MOs) into the underlying tissues, where MOs can differentiate into dendritic cells (DCs). Although DCs express LFA-1, unlike MOs, they cannot bind to ICAM-1. We hypothesized that an altered integrin organization on the DC plasma membrane might cause this effect and investigated the relationship between membrane organization and function of LFA-1 on MOs and DCs. High-resolution mapping of LFA-1 surface distribution revealed that on MOs LFA-1 function is associated with a distribution in well-defined nanoclusters (100-150-nm diameter). Interestingly, a fraction of these nanoclusters contains primed LFA-1 molecules expressing the specific activation-dependent L16-epitope. Live imaging of MO-T-cell conjugates showed that only these primed nanoclusters are dynamically recruited to the cellular interface forming micrometer-sized assemblies engaged in ligand binding and linked to talin. We conclude that besides affinity regulation, LFA-1 function is controlled by at least three different avidity patterns: random distributed inactive molecules, well-defined ligand-independent proactive nanoclusters, and ligand-triggered micrometer-sized macroclusters.     

Spatial Regulation of Cyclic AMP-Epac1 Signaling in Cell Adhesion by ERM Proteins

Epac1 is a guanine nucleotide exchange factor for the small G protein Rap and is involved in membrane-localized processes such as integrin-mediated cell adhesion and cell-cell junction formation. Cyclic AMP (cAMP) directly activates Epac1 by release of autoinhibition and in addition induces its translocation to the plasma membrane. Here, we show an additional mechanism of Epac1 recruitment, mediated by activated ezrin-radixin-moesin (ERM) proteins. Epac1 directly binds with its N-terminal 49 amino acids to ERM proteins in their open conformation. Receptor-induced activation of ERM proteins results in increased binding of Epac1 and consequently the clustered localization of Epac1 at the plasma membrane. Deletion of the N terminus of Epac1, as well as disruption of the Epac1-ERM interaction by an interfering radixin mutant or small interfering RNA (siRNA)-mediated depletion of the ERM proteins, impairs Epac1-mediated cell adhesion. We conclude that ERM proteins are involved in the spatial regulation of Epac1 and cooperate with cAMP- and Rap-mediated signaling to regulate adhesion to the extracellular matrix.Cyclic AMP (cAMP) is a second messenger that relays a wide range of hormone responses. The discovery of Epac as a direct effector of cAMP (15, 29) has triggered the elucidation of many cAMP-regulated processes that could not be explained by the previously known effectors protein kinase A (PKA) and cyclic nucleotide-regulated ion channels (21). Both Epac family members, Epac1 and Epac2, act as guanine nucleotide exchange factors (GEFs) for the small G proteins Rap1 and Rap2. Thereby, Epac functions in processes such as exocytosis (28, 48, 59), cell-cell junction formation (13, 20, 30, 53, 64), and cell-extracellular matrix (ECM) adhesion (55). Adhesion to the ECM induced by Epac1 and Rap is mediated by actin-linked integrin molecules and is implicated in diverse biological processes such as homing of endothelial progenitor cells to ischemic tissue (9), remodeling of the vasculature (10, 36), and transendothelial migration of leukocytes (37, 60).Epac1 and Epac2 are multidomain proteins containing a C-terminal catalytic region, which consists of a CDC25 homology domain responsible for GEF activity, a Ras exchange motif (REM), which stabilizes the CDC25 homology domain, and a Ras association (RA) domain. In the autoinhibited state, the catalytic site is sterically covered by the N-terminal regulatory region, which harbors a DEP (Dishevelled, Egl-10, and pleckstrin) domain and one or two cyclic nucleotide-binding domains in Epac1 and Epac2, respectively. As demonstrated by the crystal structures of both active and inactive Epac2, autoinhibition is released by a conformational change induced by the binding of cAMP (56, 57).After its production at the plasma membrane (PM) by adenylate cylases, cAMP becomes compartmentalized due to local degradation by spatially restricted phosphodiesterases (1). Further compartmentalization of cAMP signaling is established by the confined targeting of the cAMP effector proteins. Numerous adaptor proteins that target PKA to distinct subcellular locations and mediate the assembly of large signaling complexes have been identified (3). Similarly, cAMP-Epac signaling appears to be spatially regulated by diverse anchoring mechanisms, which may reflect the many different functions assigned to Epac. For instance, the DNA damage-responsive kinase DNA-PK is regulated by nuclear Epac1 (26), whereas membrane recruitment by activated Ras is essential for the role of Epac2 in neurite outgrowth (34, 35). Recently, we reported that Epac1 translocates to the PM upon the binding of cAMP and that this translocation contributes to Rap-mediated cell-ECM adhesion (51). Although the anchor at the PM remains elusive, it has become clear that the cAMP-dependent translocation of Epac1 involves its DEP domain (amino acids 50 to 148) and requires the cAMP-induced conformation.In this study, we reveal an additional targeting mechanism of Epac1 by showing that its N terminus interacts with members of the ezrin-radixin-moesin (ERM) family. ERM proteins show high sequence similarity and function as scaffolding proteins that link the actin cytoskeleton to the PM (18, 42, 47). Inactive ERM proteins reside in the cytoplasm in an autoinhibited state maintained by an intramolecular interaction between the N-terminal FERM (4.1 protein, ezrin, radixin, moesin) domain and the C-terminal actin binding domain (ABD). This autoinhibition is released by binding to phosphatidylinositol-4,5-bisphosphate (PIP₂) and threonine phosphorylation of the ABD, which induce the open conformation of the protein (reviewed in reference 8). Several kinases have been implicated in phosphorylation of this threonine in the ABD, including protein kinase C α (PKC α), PKC θ, NIK, Mst4, and the Rho effector ROCK (2, 40, 46, 50, 61). Active ERM proteins directly link the actin cytoskeleton to the PM and allow the recruitment of multiple signaling proteins. In this manner, ERM proteins function in numerous processes, such as the formation of microvilli, adherens junction stabilization, and leukocyte polarization (12, 18, 42, 47). Here, we demonstrate that ERM proteins also function as PM anchors for Epac1. The underlying interaction is mediated by the N terminus (residues 1 to 49) of Epac1 and is independent of its conformational state. Instead, the interaction is regulated at the level of the ERM proteins, which bind Epac1 when they are in their active, open conformation. G protein-coupled receptor (GPCR)-mediated signaling that results in activation of ERM proteins increases binding of Epac1 and results in a clustered localization of Epac1 at the PM. Together with DEP domain-mediated PM translocation, ERM proteins control cell adhesion mediated by Epac1. In conclusion, our data show that ERM proteins mediate PM recruitment of Epac1 and couple Epac1 activity to integrin-mediated cell adhesion.     

Oral care training in the basic education of care professionals

doi:10.1111/j.1741‐2358.2009.00304.x
Oral care training in the basic education of care professionals Objective: To investigate the quantity and quality of oral care training in the basic education of future long‐term care (LTC) professionals in Norway. Background: The level of oral hygiene has often proved inadequate in LTC facilities. It has been maintained that this could be due to insufficient knowledge of oral care among care professionals. Materials and methods: A self‐administered questionnaire was sent to all 270 schools in Norway which offered basic education of LTC personnel in 2004/05. Information on theoretical and practical oral care training, scope of oral care in teaching material and curriculum, educational background of the teaching staff and schools opinion regarding adequacy of their training programme was collected. Results: Of the 203 respondents (75% response rate), 188 (participants) included oral care in their educational programme. Approximately two‐thirds of the participating schools provided 3 h or more of oral care training and many of the important themes were presented in the textbooks that were recommended. Moreover, the practical exercises performed in practice placement supplemented the knowledge. Conclusion: The results could not confirm that LTC professional’s basic education concerning oral care was inadequate. There may therefore be other explanations for the poor oral hygiene in many LTC facilities.     

Non-equivalent role of inter- and intramolecular hydrogen bonds in the insulin dimer interface

Apart from its role in insulin receptor (IR) activation, the C terminus of the B-chain of insulin is also responsible for the formation of insulin dimers. The dimerization of insulin plays an important role in the endogenous delivery of the hormone and in the administration of insulin to patients. Here, we investigated insulin analogues with selective N-methylations of peptide bond amides at positions B24, B25, or B26 to delineate their structural and functional contribution to the dimer interface. All N-methylated analogues showed impaired binding affinities to IR, which suggests a direct IR-interacting role for the respective amide hydrogens. The dimerization capabilities of analogues were investigated by isothermal microcalorimetry. Selective N-methylations of B24, B25, or B26 amides resulted in reduced dimerization abilities compared with native insulin (K(d) = 8.8 μM). Interestingly, although the N-methylation in [NMeTyrB26]-insulin or [NMePheB24]-insulin resulted in K(d) values of 142 and 587 μM, respectively, the [NMePheB25]-insulin did not form dimers even at high concentrations. This effect may be attributed to the loss of intramolecular hydrogen bonding between NHB25 and COA19, which connects the B-chain β-strand to the core of the molecule. The release of the B-chain β-strand from this hydrogen bond lock may result in its higher mobility, thereby shifting solution equilibrium toward the monomeric state of the hormone. The study was complemented by analyses of two novel analogue crystal structures. All examined analogues crystallized only in the most stable R(6) form of insulin oligomers (even if the dimer interface was totally disrupted), confirming the role of R(6)-specific intra/intermolecular interactions for hexamer stability.