Mechanism of Borrelia immune evasion by FhbA-related proteins

Immune evasion facilitates survival of Borrelia, leading to infections like relapsing fever and Lyme disease. Important mechanism for complement evasion is acquisition of the main host complement inhibitor, factor H (FH). By determining the 2.2 Å crystal structure of Factor H binding protein A (FhbA) from Borrelia hermsii in complex with FH domains 19–20, combined with extensive mutagenesis, we identified the structural mechanism by which B. hermsii utilizes FhbA in immune evasion. Moreover, structure-guided sequence database analysis identified a new family of FhbA-related immune evasion molecules from Lyme disease and relapsing fever Borrelia. Conserved FH-binding mechanism within the FhbA-family was verified by analysis of a novel FH-binding protein from B. duttonii. By sequence analysis, we were able to group FH-binding proteins of Borrelia into four distinct phyletic types and identified novel putative FH-binding proteins. The conserved FH-binding mechanism of the FhbA-related proteins could aid in developing new approaches to inhibit virulence and complement resistance in Borrelia.     

Analysis of Fcgamma receptor haplotypes in rheumatoid arthritis: FCGR3A remains a major susceptibility gene at this locus, with an additional contribution from FCGR3B

The Fcgamma receptors play important roles in the initiation and regulation of many immunological and inflammatory processes, and genetic variants (FCGR) have been associated with numerous autoimmune and infectious diseases. The data in rheumatoid arthritis (RA) are conflicting and we previously demonstrated an association between FCGR3A and RA. In view of the close molecular proximity with FCGR2A, FCGR2B and FCGR3B, additional polymorphisms within these genes and FCGR haplotypes were examined to refine the extent of association with RA. Biallelic polymorphisms in FCGR2A, FCGR2B and FCGR3B were examined for association with RA in two well characterized UK Caucasian and North Indian/Pakistani cohorts, in which FCGR3A genotyping had previously been undertaken. Haplotype frequencies and linkage disequilibrium were estimated across the FCGR locus and a model-free analysis was performed to determine association with RA. This was followed by regression analysis, allowing for phase uncertainty, to identify the particular haplotype(s) that influences disease risk. Our results reveal that FCGR2A, FCGR2B and FCGR3B were not associated with RA. The haplotype with the strongest association with RA susceptibility was the FCGR3A-FCGR3B 158V-NA2 haplotype (odds ratio 3.18, 95% confidence interval 1.13-8.92 [P = 0.03] for homozygotes compared with all genotypes). The association was stronger in the presence of nodules (odds ratio 5.03, 95% confidence interval 1.44-17.56; P = 0.01). This haplotype was also more common in North Indian/Pakistani RA patients than in control individuals, but not significantly so. Logistic regression analyses suggested that FCGR3A remained the most significant gene at this locus. The increased association with an FCGR3A-FCGR3B haplotype suggests that other polymorphic variants within FCGR3A or FCGR3B, or in linkage disequilibrium with this haplotype, may additionally contribute to disease pathogenesis.     

Development of residual strains in human vertebral trabecular bone after prolonged static and cyclic loading at low load levels

Development of irreversible residual strains in trabecular bone may be a mechanism by which age-related non-traumatic vertebral fractures occur. To investigate this concept, static and cyclic loading tests were conducted at low loading levels for cylindrical cores of cadaveric vertebral trabecular bone. Stresses were applied equivalent to elastic strains of either 750 or 1,500 microstrain. Creep strains were measured during the tests, which lasted for 125,000 seconds (about 35 h), and for an additional 125,000 seconds after complete unloading. Emphasis was placed on the residual strains that developed, defined as the strain remaining at the end of the unloading phase. The results indicated that appreciable residual strains did develop, and were similar for static and cyclic loading. Irrespective of the applied load levels and loading modes, the residual strains that remained after the unloading phase were similar in magnitude to the originally applied elastic strain. Extrapolation of the observed residual strains to full recovery indicated that the time that would be required for full recovery was over 20 times longer than the duration of the applied loads. These results indicate that human vertebral trabecular bone does not creep in a linear viscoelastic fashion at low stress levels, and that creep mechanisms dominate the residual strains regardless of the loading mode. Taken together, these findings support the concept that non-traumatic vertebral fractures may be related to long-term creep effects because the trabecular bone does not have sufficient time to recover mechanically from creep deformations accumulated by prolonged static or cyclic loading.     

Delirium after elective surgery among elderly patients taking statins

Background

Postoperative delirium after elective surgery is frequent and potentially serious. We sought to determine whether the use of statin medications was associated with a higher risk of postoperative delirium than other medications that do not alter microvascular autoregulation.

Methods

We conducted a retrospective cohort analysis of 284 158 consecutive patients in Ontario aged 65 years and older who were admitted for elective surgery. We identified exposure to statins from outpatient pharmacy records before admission. We identified delirium by examining hospital records after surgery.

Results

About 7% (n = 19 501) of the patients were taking statins. Overall, 3195 patients experienced postoperative delirium; the rate was significantly higher among patients taking statins (14 per 1000) than among those not taking statins (11 per 1000) (odds ratio [OR] 1.30, 95% confidence interval [CI] 1.15–1.47, p < 0.001). The increased risk of postoperative delirium persisted after we adjusted for multiple demographic, medical and surgical factors (OR 1.28, 95% CI 1.12–1.46) and exceeded the increased risk of delirium associated with prolonging surgery by 30 minutes (OR 1.20, 95% CI 1.19– 1.21). The relative risk associated with statin use was somewhat higher among patients who had noncardiac surgery than among those who had cardiac surgery (adjusted OR 1.33, 95% CI 1.16–1.53), and extended to more complicated cases of delirium. We did not observe an increased risk of delirium with 20 other cardiac or noncardiac medications.

Interpretation

The use of statins is associated with an increased risk of postoperative delirium among elderly patients undergoing elective surgery.Delirium is an acute change in mental status that is worrisome to patients and families, especially after elective surgery. This condition may contribute to delays in extubation, a prolonged need for intensive care, increased risk of nosocomial infections and about a 1-week rise in total length of stay in hospital for the average patient.^1,2 Delirium also disrupts many specific aspects of care, including the administration of medications, treatment of wounds, physiotherapy, nutrition, hygiene, discharge planning and dignity.³ The management of delirium is awkward and may lead to a cascade of nonspecific testing and sedation, with an average net increase in hospital costs of $2500 per patient.⁴ In some cases, the delirium never completely disappears, and the patient is left with a degree of permanent disability.⁵The causes of postoperative delirium are not well understood. Hypoglycemia, hypoxemia and hypotension are all possible and correctable, but they rarely have an immediate resolution.⁶ Medical imaging studies typically do not show specific changes; however, they may show markers of prior stroke or other lesions. One underlying factor may be cerebral ischemia secondary to inadequate perfusion. Altered cerebral perfusion may result in altered metabolism, an increased predisposition to drug toxicity or other factors during anesthesia and surgery.⁷ Cerebral ischemia may also explain commonly observed risk factors for postoperative delirium, including advanced age, baseline cognitive dysfunction and the failure of drug antagonists, major tranquilizers or modern volatile anesthetics to prevent postoperative delirium.^8,9,10Statins have pleiotropic properties that alter the tone of smooth muscle in small blood vessels. Experiments on endothelial cells indicate that these changes are mediated by expression of endothelial nitric oxide synthase that is unrelated to cholesterol levels or vascular disease.¹¹ In turn, activity of endothelial nitric oxide synthase contributes to arteriolar vasodilation by relaxing the surrounding smooth-muscle cells, thereby shifting the distribution of blood flow in the microvasculature of the brain. This can compromise individual neurons even if aggregate blood flow is maintained.¹² These effects can be beneficial for reducing the size of stroke or other long-term neurologic disorders; however, altered cerebral blood flow autoregulation might predispose patients to delirium after anesthesia.^13–15We sought to determine whether the use of statins was associated with postoperative delirium among elderly patients undergoing elective surgery.     

Outer surface protein E antibody response and its effect on complement factor H binding to OspE in Lyme borreliosis

Borrelia burgdorferi sensu stricto and B. afzelii, but not B. garinii, are able to escape complement attack by binding factor H via OspE proteins. Recent finding of ospE genes also in B. garinii isolates has raised the question whether, under in vivo-conditions, B. garinii also expresses OspE proteins and consequently induces an antibody response. We set up an IgG ELISA by using recombinant OspE as an antigen. Sixty percent of acute and 64% of convalescent 25 erythema migrans patient samples were positive for anti-OspE antibodies. Anti-OspE antibodies were also found in the sera (83.6%) and cerebrospinal fluids (36%) of patients with neuroborreliosis. Since B. garinii is the major causative agent of neuroborreliosis, the result suggests that OspE is expressed by B. garinii in vivo. Of the 10 acrodermatitis chronica atrophicans patients, 80% had anti-OspE antibodies. Anti-OspE antibody positive sera inhibited factor H binding to Borrelia more efficiently than normal control sera (65% vs. 33.7%). Our results indicate that Borrelia spirochetes, including B. garinii, can induce the production of anti-OspE antibodies. This implies that OspE protein is produced in vivo by B. garinii possibly enabling it to escape complement and cause a CNS infection.     

Mechanism of Intramembrane Cleavage of Alcadeins by γ-Secretase

Background

Alcadein proteins (Alcs; Alcα, Alcβand Alcγ) are predominantly expressed in neurons, as is Alzheimer''s β-amyloid (Aβ) precursor protein (APP). Both Alcs and APP are cleaved by primary α- or β-secretase to generate membrane-associated C-terminal fragments (CTFs). Alc CTFs are further cleaved by γ-secretase to secrete p3-Alc peptide along with the release of intracellular domain fragment (Alc ICD) from the membrane. In the case of APP, APP CTFβ is initially cleaved at the ε-site to release the intracellular domain fragment (AICD) and consequently the γ-site is determined, by which Aβ generates. The initial ε-site is thought to define the final γ-site position, which determines whether Aβ40/43 or Aβ42 is generated. However, initial intracellular ε-cleavage sites of Alc CTF to generate Alc ICD and the molecular mechanism that final γ-site position is determined remains unclear in Alcs.

Methodology

Using HEK293 cells expressing Alcs plus presenilin 1 (PS1, a catalytic unit of γ-secretase) and the membrane fractions of these cells, the generation of p3-Alc possessing C-terminal γ-cleavage site and Alc ICD possessing N-terminal ε-cleavage site were analysed with MALDI-TOF/MS. We determined the initial ε-site position of all Alcα, Alcβ and Alcγ, and analyzed the relationship between the initially determined ε-site position and the final γ-cleavage position.

Conclusions

The initial ε-site position does not always determine the final γ-cleavage position in Alcs, which differed from APP. No additional γ-cleavage sites are generated from artificial/non-physiological positions of ε-cleavage for Alcs, while the artificial ε-cleavage positions can influence in selection of physiological γ-site positions. Because alteration of γ-secretase activity is thought to be a pathogenesis of sporadic Alzheimer''s disease, Alcs are useful and sensitive substrate to detect the altered cleavage of substrates by γ-secretase, which may be induced by malfunction of γ-secretase itself or changes of membrane environment for enzymatic reaction.     

Off-pathway aggregation can inhibit fibrillation at high protein concentrations

Ribosomal protein S6 fibrillates readily at slightly elevated temperatures and acidic pH. We find that S6 fibrillation is retarded rather than favored when the protein concentration is increased above a threshold concentration of around 3.5 mg/mL. We name this threshold concentration C_FR, the concentration at which fibrillation is retarded. Our data are consistent with a model in which this inhibition is due to the formation of an off-pathway oligomeric species with native-like secondary structure. The oligomeric species dominates at high protein concentrations but exists in dynamic equilibrium with the monomer so that seeding with fibrils can overrule oligomer formation and favors fibrillation under C_FR conditions. Thus, fibrillation competes with formation of off-pathway oligomers, probably due to a monomeric conversion step that is required to commit the protein to the fibrillation pathway. The S6 oligomer is resistant to pepsin digestion. We also report that S6 forms different types of fibrils dependent on protein concentration. Our observations highlight the multitude of conformational states available to proteins under destabilizing conditions.     

Apolipoprotein A-I exerts bactericidal activity against Yersinia enterocolitica serotype O:3

Apolipoprotein A-I (apoA-I), the main protein component of high density lipoprotein (HDL), is well recognized for its antiatherogenic, antioxidant, and antiinflammatory properties. Here, we report a novel role for apoA-I as a host defense molecule that contributes to the complement-mediated killing of an important gastrointestinal pathogen, Gram-negative bacterium Yersinia enterocolitica. We specifically show that the C-terminal domain of apoA-I is the effector site providing the bactericidal activity. Although the presence of the lipopolysaccharide O-antigen on the bacterial surface is absolutely required for apoA-I to kill the bacteria, apoA-I does not interact with the bacteria directly. To the contrary, exposure of the bacteria by serum proteins triggers apoA-I deposition on the bacterial surface. As our data show that both purified lipid-free and HDL-associated apoA-I displays anti-bacterial potential, apoA-I mimetic peptides may be a promising therapeutic agent for the treatment of certain Gram-negative infections.     

Stress distributions and material properties determined in articular cartilage from MRI-based finite strains

The noninvasive measurement of finite strains in biomaterials and tissues by magnetic resonance imaging (MRI) enables mathematical estimates of stress distributions and material properties. Such methods allow for non-contact and patient-specific modeling in a manner not possible with traditional mechanical testing or finite element techniques. Here, we employed three constitutive (i.e. linear Hookean, and nonlinear Neo-Hookean and Mooney-Rivlin) relations with known loading conditions and MRI-based finite strains to estimate stress patterns and material properties in the articular cartilage of tibiofemoral joints. Displacement-encoded MRI was used to determine two-dimensional finite strains in juvenile porcine joints, and an iterative technique estimated stress distributions and material properties with defined constitutive relations. Stress distributions were consistent across all relations, although the stress magnitudes varied. Material properties for femoral and tibial cartilage were found to be consistent with those reported in literature. Further, the stress estimates from Hookean and Neo-Hookean, but not Mooney-Rivlin, relations agreed with finite element-based simulations. A nonlinear Neo-Hookean relation provided the most appropriate model for the characterization of complex and spatially dependent stresses using two-dimensional MRI-based finite strain. These results demonstrate the feasibility of a new and computationally efficient technique incorporating MRI-based deformation with mathematical modeling to non-invasively evaluate the mechanical behavior of biological tissues and materials.