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Issue published June 2, 2014 Previous issue | Next issue

  • Volume 124, Issue 6
Go to section:
  • Conversations with Giants in Medicine
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  • Corrigenda

On the cover: EMT in ovarian cancer metastasis

The cover image represents a view of ovarian cancer spheroids (cream-colored) spreading in between mesothelial cells (green) as a model of ovarian cancer metastasis. On page 2611, Davidowitz et al. examined the mechanisms controlling the invasion of ovarian tumor cells into the mesothelial cell lining. Their findings show that mesenchymal gene expression promotes the ability of ovarian cancer cells to attach to mesothelial monolayers and may contribute to the metastatic activity of ovarian tumors.
Image credit: Rachel A. Davidowitz.
Conversations with Giants in Medicine
A conversation with P. Roy Vagelos
Ushma S. Neill
Ushma S. Neill
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2291-2292. https://doi.org/10.1172/JCI76755.
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A conversation with P. Roy Vagelos

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Abstract

Authors

Ushma S. Neill

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Review Series
Kidney disease: new technologies translate mechanisms to cure
John F. O’Toole, John R. Sedor
John F. O’Toole, John R. Sedor
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2294-2298. https://doi.org/10.1172/JCI76825.
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Kidney disease: new technologies translate mechanisms to cure

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Kidney disease is one of the most prevalent chronic conditions and is a frequent complication of diabetes, cardiovascular disease, and obesity. Recent advances in biomedical research and novel technologies have created opportunities to study kidney disease in a variety of platforms, applied to human populations. The Reviews in this series discuss the kidney in hypertension, diabetes, and monogenic forms of kidney disease, as well as the cellular and molecular mediators of acute kidney injury and fibrosis, IgA nephropathy and idiopathic membranous nephropathy, and kidney transplantation. In this introduction, we briefly review new insights into focal segmental glomerulosclerosis and the role of podocytes in health and disease. Additionally, we discuss how new technologies, therapeutics, and the availability of patient data can help shape the study of kidney disease and ultimately inform policies concerning biomedical research and health care.

Authors

John F. O’Toole, John R. Sedor

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Cellular and molecular mechanisms in kidney fibrosis
Jeremy S. Duffield
Jeremy S. Duffield
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2299-2306. https://doi.org/10.1172/JCI72267.
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Cellular and molecular mechanisms in kidney fibrosis

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Fibrosis is a characteristic feature of all forms of chronic kidney disease. Deposition of pathological matrix in the interstitial space and within the walls of glomerular capillaries as well as the cellular processes resulting in this deposition are increasingly recognized as important factors amplifying kidney injury and accelerating nephron demise. Recent insights into the cellular and molecular mechanisms of fibrogenesis herald the promise of new therapies to slow kidney disease progression. This review focuses on new findings that enhance understanding of cellular and molecular mechanisms of fibrosis, the characteristics of myofibroblasts, their progenitors, and molecular pathways regulating both fibrogenesis and its resolution.

Authors

Jeremy S. Duffield

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Membranous nephropathy: from models to man
Laurence H. Beck Jr., David J. Salant
Laurence H. Beck Jr., David J. Salant
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2307-2314. https://doi.org/10.1172/JCI72270.
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Membranous nephropathy: from models to man

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As recently as 2002, most cases of primary membranous nephropathy (MN), a relatively common cause of nephrotic syndrome in adults, were considered idiopathic. We now recognize that MN is an organ-specific autoimmune disease in which circulating autoantibodies bind to an intrinsic antigen on glomerular podocytes and form deposits of immune complexes in situ in the glomerular capillary walls. Here we define the clinical and pathological features of MN and describe the experimental models that enabled the discovery of the major target antigen, the M-type phospholipase A2 receptor 1 (PLA2R). We review the pathophysiology of experimental MN and compare and contrast it with the human disease. We discuss the diagnostic value of serological testing for anti-PLA2R and tissue staining for the redistributed antigen, and their utility for differentiating between primary and secondary MN, and between recurrent MN after kidney transplant and de novo MN. We end with consideration of how knowledge of the antigen might direct future therapeutic strategies.

Authors

Laurence H. Beck Jr., David J. Salant

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Genetic mechanisms and signaling pathways in autosomal dominant polycystic kidney disease
Peter C. Harris, Vicente E. Torres
Peter C. Harris, Vicente E. Torres
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2315-2324. https://doi.org/10.1172/JCI72272.
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Genetic mechanisms and signaling pathways in autosomal dominant polycystic kidney disease

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Recent advances in defining the genetic mechanisms of disease causation and modification in autosomal dominant polycystic kidney disease (ADPKD) have helped to explain some extreme disease manifestations and other phenotypic variability. Studies of the ADPKD proteins, polycystin-1 and -2, and the development and characterization of animal models that better mimic the human disease, have also helped us to understand pathogenesis and facilitated treatment evaluation. In addition, an improved understanding of aberrant downstream pathways in ADPKD, such as proliferation/secretion-related signaling, energy metabolism, and activated macrophages, in which cAMP and calcium changes may play a role, is leading to the identification of therapeutic targets. Finally, results from recent and ongoing preclinical and clinical trials are greatly improving the prospects for available, effective ADPKD treatments.

Authors

Peter C. Harris, Vicente E. Torres

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The genetics and immunobiology of IgA nephropathy
Krzysztof Kiryluk, Jan Novak
Krzysztof Kiryluk, Jan Novak
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2325-2332. https://doi.org/10.1172/JCI74475.
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The genetics and immunobiology of IgA nephropathy

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IgA nephropathy (IgAN) represents the leading cause of kidney failure among East Asian populations and the most frequent form of primary glomerulonephritis among Europeans. Patients with IgAN develop characteristic IgA1-containing immune complexes that deposit in the glomerular mesangium, producing progressive kidney injury. Recent studies define IgAN as an autoimmune trait of complex architecture with a strong genetic determination. This Review summarizes new insights into the role of the O-glycosylation pathway, anti-glycan immune response, mucosal immunity, antigen processing and presentation, and the alternative complement pathway in the pathogenesis of IgAN.

Authors

Krzysztof Kiryluk, Jan Novak

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Molecular mechanisms of diabetic kidney disease
Kimberly Reidy, … , Thomas Hostetter, Katalin Susztak
Kimberly Reidy, … , Thomas Hostetter, Katalin Susztak
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2333-2340. https://doi.org/10.1172/JCI72271.
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Molecular mechanisms of diabetic kidney disease

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Diabetic kidney disease (DKD) is the leading cause of kidney failure worldwide and the single strongest predictor of mortality in patients with diabetes. DKD is a prototypical disease of gene and environmental interactions. Tight glucose control significantly decreases DKD incidence, indicating that hyperglycemia-induced metabolic alterations, including changes in energy utilization and mitochondrial dysfunction, play critical roles in disease initiation. Blood pressure control, especially with medications that inhibit the angiotensin system, is the only effective way to slow disease progression. While DKD is considered a microvascular complication of diabetes, growing evidence indicates that podocyte loss and epithelial dysfunction play important roles. Inflammation, cell hypertrophy, and dedifferentiation by the activation of classic pathways of regeneration further contribute to disease progression. Concerted clinical and basic research efforts will be needed to understand DKD pathogenesis and to identify novel drug targets.

Authors

Kimberly Reidy, Hyun Mi Kang, Thomas Hostetter, Katalin Susztak

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The inextricable role of the kidney in hypertension
Steven D. Crowley, Thomas M. Coffman
Steven D. Crowley, Thomas M. Coffman
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2341-2347. https://doi.org/10.1172/JCI72274.
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The inextricable role of the kidney in hypertension

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An essential link between the kidney and blood pressure control has long been known. Here, we review evidence supporting the premise that an impaired capacity of the kidney to excrete sodium in response to elevated blood pressure is a major contributor to hypertension, irrespective of the initiating cause. In this regard, recent work suggests that novel pathways controlling key sodium transporters in kidney epithelia have a critical impact on hypertension pathogenesis, supporting a model in which impaired renal sodium excretion is a final common pathway through which vascular, neural, and inflammatory responses raise blood pressure. We also address recent findings calling into question long-standing notions regarding the relationship between sodium intake and changes in body fluid volume. Expanded understanding of the role of the kidney as both a cause and target of hypertension highlights key aspects of pathophysiology and may lead to identification of new strategies for prevention and treatment.

Authors

Steven D. Crowley, Thomas M. Coffman

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Complement as a multifaceted modulator of kidney transplant injury
Paolo Cravedi, Peter S. Heeger
Paolo Cravedi, Peter S. Heeger
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2348-2354. https://doi.org/10.1172/JCI72273.
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Complement as a multifaceted modulator of kidney transplant injury

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Improvements in clinical care and immunosuppressive medications have positively affected outcomes following kidney transplantation, but graft survival remains suboptimal, with half-lives of approximately 11 years. Late graft loss results from a confluence of processes initiated by ischemia-reperfusion injury and compounded by effector mechanisms of uncontrolled alloreactive T cells and anti-HLA antibodies. When combined with immunosuppressant toxicity, post-transplant diabetes and hypertension, and recurrent disease, among other factors, the result is interstitial fibrosis, tubular atrophy, and graft failure. Emerging evidence over the last decade unexpectedly identified the complement cascade as a common thread in this process. Complement activation and function affects allograft injury at essentially every step. These fundamental new insights, summarized herein, provide the foundation for testing the efficacy of various complement antagonists to improve kidney transplant function and long-term graft survival.

Authors

Paolo Cravedi, Peter S. Heeger

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Therapeutic translation in acute kidney injury: the epithelial/endothelial axis
Bruce A. Molitoris
Bruce A. Molitoris
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2355-2363. https://doi.org/10.1172/JCI72269.
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Therapeutic translation in acute kidney injury: the epithelial/endothelial axis

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Acute kidney injury (AKI) remains a major clinical event with rising incidence, severity, and cost; it now has a morbidity and mortality exceeding acute myocardial infarction. There is also a documented conversion to and acceleration of chronic kidney disease to end-stage renal disease. The multifactorial nature of AKI etiologies and pathophysiology and the lack of diagnostic techniques have hindered translation of preclinical success. An evolving understanding of epithelial, endothelial, and inflammatory cell interactions and individualization of care will result in the eventual development of effective therapeutic strategies. This review focuses on epithelial and endothelial injury mediators, interactions, and targets for therapy.

Authors

Bruce A. Molitoris

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Commentaries
Which comes first: the antigen or the adjuvant?
Sallie R. Permar, Herman F. Staats
Sallie R. Permar, Herman F. Staats
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2364-2365. https://doi.org/10.1172/JCI76263.
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Which comes first: the antigen or the adjuvant?

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Recent attempts to develop an HIV-1 vaccine indicate that viral replication can be limited by the induction of viral-specific T cell responses; however, recent trials of vaccine candidates designed to target CD8+ T cell responses were unsuccessful. In this issue, Sui and colleagues used a nonhuman primate model to investigate the effect of various vaccine adjuvants on the efficacy of SIV immunization. Unexpectedly, Sui et al. discovered that animals given adjuvant alone in the absence of SIV antigen exhibited a pronounced decrease in viral load following viral challenge. Vaccination with viral antigens combined with adjuvant correlated with the expansion of a population of cells with similarity to myeloid-derived suppressor cells (MDSCs) that may have suppressed vaccine-elicited T cell responses. Together, these results suggest that both innate and adaptive vaccine-elicited immune responses will need to be considered in future HIV-1 vaccine development.

Authors

Sallie R. Permar, Herman F. Staats

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Inhibiting HDAC for human hematopoietic stem cell expansion
Hal E. Broxmeyer
Hal E. Broxmeyer
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2365-2368. https://doi.org/10.1172/JCI75803.
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Inhibiting HDAC for human hematopoietic stem cell expansion

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In this issue of the JCI, Chaurasia and colleagues report an impressive ex vivo expansion of HSCs from human cord blood (CB) using cytokines and altering epigenetic modifications. The application of this protocol provides information that has potential for clinical consideration. The enhanced expansion of CB HSCs is a substantial advance over recent work from the Chaurasia and Hoffman group, in which ex vivo production of human erythroid progenitor cells from CB was promoted by chromatin modification. Moreover, this study takes advantage of information from the rapidly emerging, but not yet fully elucidated, field of epigenetics.

Authors

Hal E. Broxmeyer

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Unraveling the relationship between microbial translocation and systemic immune activation in HIV infection
Liang Shan, Robert F. Siliciano
Liang Shan, Robert F. Siliciano
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2368-2371. https://doi.org/10.1172/JCI75799.
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Unraveling the relationship between microbial translocation and systemic immune activation in HIV infection

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Chronic immune activation is a key factor in HIV-1 disease progression. The translocation of microbial products from the intestinal lumen into the systemic circulation occurs during HIV-1 infection and is associated closely with immune activation; however, it has not been determined conclusively whether microbial translocation drives immune activation or occurs as a consequence of HIV-1 infection. In an important study in this issue of the JCI, Kristoff and colleagues describe the role of microbial translocation in producing immune activation in an animal model of HIV-1 infection, SIV infection of pigtailed macaques. Blocking translocation of intestinal bacterial LPS into the circulation dramatically reduced T cell activation and proliferation, production of proinflammatory cytokines, and plasma SIV RNA levels. This study directly demonstrates that microbial translocation promotes the systemic immune activation associated with HIV-1/SIV infection.

Authors

Liang Shan, Robert F. Siliciano

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Targeting secondary immune responses to cetuximab: CD137 and the outside story
Julie E. Bauman, Jennifer R. Grandis
Julie E. Bauman, Jennifer R. Grandis
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2371-2375. https://doi.org/10.1172/JCI76264.
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Targeting secondary immune responses to cetuximab: CD137 and the outside story

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Cetuximab is a murine-human chimeric IgG1 mAb directed against the EGFR that is approved for use in patients with colorectal and head and neck carcinomas. While some patients benefit greatly from cetuximab, many do not; therefore, strategies to increase the efficacy of this drug are of great clinical interest. In this issue of the JCI, Kohrt and colleagues report a strategy for enhancing the secondary immune response to cetuximab that involves sequential targeting with an agonist mAb against CD137 expressed on NK and T cells.

Authors

Julie E. Bauman, Jennifer R. Grandis

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Sex, drugs, and trial design: sex influences the heart and drug responses
Elizabeth Murphy, Charles Steenbergen
Elizabeth Murphy, Charles Steenbergen
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2375-2377. https://doi.org/10.1172/JCI76262.
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Sex, drugs, and trial design: sex influences the heart and drug responses

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Preclinical studies indicate that the phosphodiesterase 5 (PDE5) inhibitor sildenafil is protective against hypertrophy-induced cardiac remodeling. Despite an initial clinical study demonstrating sildenafil-dependent amelioration of pathological remodeling, the cardioprotective effect of this drug was not significant in a large placebo-controlled clinical trail. In this issue, Sasaki and colleagues reveal that the efficacy of PDE5 inhibition in female mice requires estrogen. Induction of cardiac stress in male and intact female mice resulted in increased activation of protein kinase G (PKG) signaling, which was further enhanced by sildenafil. PKG activity was not enhanced in ovariectomized (OVX) female mice as a result of cardiac stress, but administration of estrogen restored PKG activation and enhancement by sildenafil. These data highlight the importance of considering sex-specific differences and drug responses in clinical trial design.

Authors

Elizabeth Murphy, Charles Steenbergen

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Research Articles
Epigenetic reprogramming induces the expansion of cord blood stem cells
Pratima Chaurasia, … , Sunita D’Souza, Ronald Hoffman
Pratima Chaurasia, … , Sunita D’Souza, Ronald Hoffman
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2378-2395. https://doi.org/10.1172/JCI70313.
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Epigenetic reprogramming induces the expansion of cord blood stem cells

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Cord blood (CB) cells that express CD34 have extensive hematopoietic capacity and rapidly divide ex vivo in the presence of cytokine combinations; however, many of these CB CD34+ cells lose their marrow-repopulating potential. To overcome this decline in function, we treated dividing CB CD34+ cells ex vivo with several histone deacetylase inhibitors (HDACIs). Treatment of CB CD34+ cells with the most active HDACI, valproic acid (VPA), following an initial 16-hour cytokine priming, increased the number of multipotent cells (CD34+CD90+) generated; however, the degree of expansion was substantially greater in the presence of both VPA and cytokines for a full 7 days. Treated CD34+ cells were characterized based on the upregulation of pluripotency genes, increased aldehyde dehydrogenase activity, and enhanced expression of CD90, c-Kit (CD117), integrin α6 (CD49f), and CXCR4 (CD184). Furthermore, siRNA-mediated inhibition of pluripotency gene expression reduced the generation of CD34+CD90+ cells by 89%. Compared with CB CD34+ cells, VPA-treated CD34+ cells produced a greater number of SCID-repopulating cells and established multilineage hematopoiesis in primary and secondary immune–deficient recipient mice. These data indicate that dividing CB CD34+ cells can be epigenetically reprogrammed by treatment with VPA so as to generate greater numbers of functional CB stem cells for use as transplantation grafts.

Authors

Pratima Chaurasia, David C. Gajzer, Christoph Schaniel, Sunita D’Souza, Ronald Hoffman

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Endothelial HIF-2 mediates protection and recovery from ischemic kidney injury
Pinelopi P. Kapitsinou, … , Timothy A. Sutton, Volker H. Haase
Pinelopi P. Kapitsinou, … , Timothy A. Sutton, Volker H. Haase
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2396-2409. https://doi.org/10.1172/JCI69073.
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Endothelial HIF-2 mediates protection and recovery from ischemic kidney injury

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The hypoxia-inducible transcription factors HIF-1 and HIF-2 mediate key cellular adaptions to hypoxia and contribute to renal homeostasis and pathophysiology; however, little is known about the cell type–specific functions of HIF-1 and HIF-2 in response to ischemic kidney injury. Here, we used a genetic approach to specifically dissect the roles of endothelial HIF-1 and HIF-2 in murine models of hypoxic kidney injury induced by ischemia reperfusion or ureteral obstruction. In both models, inactivation of endothelial HIF increased injury-associated renal inflammation and fibrosis. Specifically, inactivation of endothelial HIF-2α, but not endothelial HIF-1α, resulted in increased expression of renal injury markers and inflammatory cell infiltration in the postischemic kidney, which was reversed by blockade of vascular cell adhesion molecule-1 (VCAM1) and very late antigen-4 (VLA4) using monoclonal antibodies. In contrast, pharmacologic or genetic activation of HIF via HIF prolyl-hydroxylase inhibition protected wild-type animals from ischemic kidney injury and inflammation; however, these same protective effects were not observed in HIF prolyl-hydroxylase inhibitor–treated animals lacking endothelial HIF-2. Taken together, our data indicate that endothelial HIF-2 protects from hypoxia-induced renal damage and represents a potential therapeutic target for renoprotection and prevention of fibrosis following acute ischemic injury.

Authors

Pinelopi P. Kapitsinou, Hideto Sano, Mark Michael, Hanako Kobayashi, Olena Davidoff, Aihua Bian, Bing Yao, Ming-Zhi Zhang, Raymond C. Harris, Kevin J. Duffy, Connie L. Erickson-Miller, Timothy A. Sutton, Volker H. Haase

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Atrogin-1 deficiency promotes cardiomyopathy and premature death via impaired autophagy
Tania Zaglia, … , Marco Mongillo, Marco Sandri
Tania Zaglia, … , Marco Mongillo, Marco Sandri
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2410-2424. https://doi.org/10.1172/JCI66339.
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Atrogin-1 deficiency promotes cardiomyopathy and premature death via impaired autophagy

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Cardiomyocyte proteostasis is mediated by the ubiquitin/proteasome system (UPS) and autophagy/lysosome system and is fundamental for cardiac adaptation to both physiologic (e.g., exercise) and pathologic (e.g., pressure overload) stresses. Both the UPS and autophagy/lysosome system exhibit reduced efficiency as a consequence of aging, and dysfunction in these systems is associated with cardiomyopathies. The muscle-specific ubiquitin ligase atrogin-1 targets signaling proteins involved in cardiac hypertrophy for degradation. Here, using atrogin-1 KO mice in combination with in vivo pulsed stable isotope labeling of amino acids in cell culture proteomics and biochemical and cellular analyses, we identified charged multivesicular body protein 2B (CHMP2B), which is part of an endosomal sorting complex (ESCRT) required for autophagy, as a target of atrogin-1–mediated degradation. Mice lacking atrogin-1 failed to degrade CHMP2B, resulting in autophagy impairment, intracellular protein aggregate accumulation, unfolded protein response activation, and subsequent cardiomyocyte apoptosis, all of which increased progressively with age. Cellular proteostasis alterations resulted in cardiomyopathy characterized by myocardial remodeling with interstitial fibrosis, with reduced diastolic function and arrhythmias. CHMP2B downregulation in atrogin-1 KO mice restored autophagy and decreased proteotoxicity, thereby preventing cell death. These data indicate that atrogin-1 promotes cardiomyocyte health through mediating the interplay between UPS and autophagy/lysosome system and its alteration promotes development of cardiomyopathies.

Authors

Tania Zaglia, Giulia Milan, Aaron Ruhs, Mauro Franzoso, Enrico Bertaggia, Nicola Pianca, Andrea Carpi, Pierluigi Carullo, Paola Pesce, David Sacerdoti, Cristiano Sarais, Daniele Catalucci, Marcus Krüger, Marco Mongillo, Marco Sandri

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Dynamic Treg interactions with intratumoral APCs promote local CTL dysfunction
Christian A. Bauer, … , Natalie M. Claudio, Thorsten R. Mempel
Christian A. Bauer, … , Natalie M. Claudio, Thorsten R. Mempel
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2425-2440. https://doi.org/10.1172/JCI66375.
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Dynamic Treg interactions with intratumoral APCs promote local CTL dysfunction

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Tregs control various functions of effector T cells; however, where and how Tregs exert their immunomodulatory effects remain poorly understood. Here we developed a murine model of adoptive T cell therapy and found that Tregs induce a dysfunctional state in tumor-infiltrating CTLs that resembles T cell exhaustion and is characterized by low expression of effector cytokines, inefficient cytotoxic granule release, and coexpression of coinhibitory receptors PD-1 and TIM-3. Induction of CTL dysfunction was an active process, requiring local TCR signals in tumor tissue. Tregs infiltrated tumors only subsequent to Ag-dependent activation and expansion in tumor-draining LNs; however, Tregs also required local Ag reencounter within tumor tissue to induce CTL dysfunction and prevent tumor rejection. Multiphoton intravital microscopy revealed that in contrast to CTLs, Tregs only rarely and briefly interrupted their migration in tumor tissue in an Ag-dependent manner and formed unstable tethering-interactions with CD11c+ APCs, coinciding with a marked reduction of CD80 and CD86 on APCs. Activation of CTLs by Treg-conditioned CD80/86lo DCs promoted enhanced expression of both TIM-3 and PD-1. Based on these data, we propose that Tregs locally change the costimulatory landscape in tumor tissue through transient, Ag-dependent interactions with APCs, thus inducing CTL dysfunction by altering the balance of costimulatory and coinhibitory signals these cells receive.

Authors

Christian A. Bauer, Edward Y. Kim, Francesco Marangoni, Esteban Carrizosa, Natalie M. Claudio, Thorsten R. Mempel

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Intrinsic TGF-β signaling promotes age-dependent CD8+ T cell polyfunctionality attrition
Rajarshi Bhadra, … , Ioannis Eleftherianos, Imtiaz A. Khan
Rajarshi Bhadra, … , Ioannis Eleftherianos, Imtiaz A. Khan
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2441-2455. https://doi.org/10.1172/JCI70522.
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Intrinsic TGF-β signaling promotes age-dependent CD8+ T cell polyfunctionality attrition

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Advanced age is associated with immune system deficits that result in an increased susceptibility to infectious diseases; however, specific mediators of age-dependent immune dysfunction have not been fully elucidated. Here we demonstrated that aged mice exhibit poor effector CD8+ T cell polyfunctionality, primarily due to CD8+ T cell–extrinsic deficits, and that reduced CD8+ T cell polyfunctionality correlates with increased susceptibility to pathogenic diseases. In aged animals challenged with the parasite Encephalitozoon cuniculi, effector CD8+ T cell survival and polyfunctionality were suppressed by highly elevated TGF-β1. Furthermore, TGF-β depletion reduced effector CD8+ T cell apoptosis in both young and aged mice and enhanced effector CD8+ T cell polyfunctionality in aged mice. Surprisingly, intrinsic blockade of TGF-β signaling in CD8+ T cells was sufficient to rescue polyfunctionality in aged animals. Together, these data demonstrate that low levels of TGF-β1 promote apoptosis of CD8+ effector T cells and high TGF-β1 levels associated with age result in both CD8+ T cell apoptosis and an altered transcriptional profile, which correlates with loss of polyfunctionality. Furthermore, elevated TGF-β levels are observed in the elderly human population and in aged Drosophila, suggesting that TGF-β represents an evolutionarily conserved negative regulator of the immune response in aging organisms.

Authors

Rajarshi Bhadra, Magali M. Moretto, Julio C. Castillo, Constantinos Petrovas, Sara Ferrando-Martinez, Upasana Shokal, Manuel Leal, Richard A. Koup, Ioannis Eleftherianos, Imtiaz A. Khan

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Neuronal GLP1R mediates liraglutide’s anorectic but not glucose-lowering effect
Stephanie Sisley, … , Darleen A. Sandoval, Randy J. Seeley
Stephanie Sisley, … , Darleen A. Sandoval, Randy J. Seeley
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2456-2463. https://doi.org/10.1172/JCI72434.
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Neuronal GLP1R mediates liraglutide’s anorectic but not glucose-lowering effect

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Glucose control and weight loss are cornerstones of type 2 diabetes treatment. Currently, only glucagon-like peptide-1 (GLP1) analogs are able to achieve both weight loss and glucose tolerance. Both glucose and body weight are regulated by the brain, which contains GLP1 receptors (GLP1R). Even though the brain is poised to mediate the effects of GLP1 analogs, it remains unclear whether the glucose- and body weight–lowering effects of long-acting GLP1R agonists are via direct action on CNS GLP1R or the result of downstream activation of afferent neuronal GLP1R. We generated mice with either neuronal or visceral nerve-specific deletion of Glp1r and then administered liraglutide, a long-acting GLP1R agonist. We found that neither reduction of GLP1R in the CNS nor in the visceral nerves resulted in alterations in body weight or food intake in animals fed normal chow or a high-fat diet. Liraglutide treatment provided beneficial glucose-lowering effects in both chow- and high-fat–fed mice lacking GLP1R in the CNS or visceral nerves; however, liraglutide was ineffective at altering food intake, body weight, or causing a conditioned taste aversion in mice lacking neuronal GLP1R. These data indicate that neuronal GLP1Rs mediate body weight and anorectic effects of liraglutide, but are not required for glucose-lowering effects.

Authors

Stephanie Sisley, Ruth Gutierrez-Aguilar, Michael Scott, David A. D’Alessio, Darleen A. Sandoval, Randy J. Seeley

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PDE5 inhibitor efficacy is estrogen dependent in female heart disease
Hideyuki Sasaki, … , David A. Kass, Eiki Takimoto
Hideyuki Sasaki, … , David A. Kass, Eiki Takimoto
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2464-2471. https://doi.org/10.1172/JCI70731.
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PDE5 inhibitor efficacy is estrogen dependent in female heart disease

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Abstract

Inhibition of cGMP-specific phosphodiesterase 5 (PDE5) ameliorates pathological cardiac remodeling and has been gaining attention as a potential therapy for heart failure. Despite promising results in males, the efficacy of the PDE5 inhibitor sildenafil in female cardiac pathologies has not been determined and might be affected by estrogen levels, given the hormone’s involvement in cGMP synthesis. Here, we determined that the heart-protective effect of sildenafil in female mice depends on the presence of estrogen via a mechanism that involves myocyte eNOS–dependent cGMP synthesis and the cGMP-dependent protein kinase Iα (PKGIα). Sildenafil treatment failed to exert antiremodeling properties in female pathological hearts from Gαq-overexpressing or pressure-overloaded mice after ovary removal; however, estrogen replacement restored the effectiveness of sildenafil in these animals. In females, sildenafil-elicited myocardial PKG activity required estrogen, which stimulated tonic cardiomyocyte cGMP synthesis via an eNOS/soluble guanylate cyclase pathway. In contrast, eNOS activation, cGMP synthesis, and sildenafil efficacy were not estrogen dependent in male hearts. Estrogen and sildenafil had no impact on pressure-overloaded hearts from animals expressing dysfunctional PKGIα, indicating that PKGIα mediates antiremodeling effects. These results support the importance of sex differences in the use of PDE5 inhibitors for treating heart disease and the critical role of estrogen status when these agents are used in females.

Authors

Hideyuki Sasaki, Takahiro Nagayama, Robert M. Blanton, Kinya Seo, Manling Zhang, Guangshuo Zhu, Dong I. Lee, Djahida Bedja, Steven Hsu, Osamu Tsukamoto, Seiji Takashima, Masafumi Kitakaze, Michael E. Mendelsohn, Richard H. Karas, David A. Kass, Eiki Takimoto

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Synthetic triterpenoid induces 15-PGDH expression and suppresses inflammation-driven colon carcinogenesis
Sung Hee Choi, … , Sanford D. Markowitz, John J. Letterio
Sung Hee Choi, … , Sanford D. Markowitz, John J. Letterio
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2472-2482. https://doi.org/10.1172/JCI69672.
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Synthetic triterpenoid induces 15-PGDH expression and suppresses inflammation-driven colon carcinogenesis

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Abstract

Colitis-associated colon cancer (CAC) develops as a result of inflammation-induced epithelial transformation, which occurs in response to inflammatory cytokine-dependent downregulation of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and subsequent suppression of prostaglandin metabolism. Agents that both enhance 15-PGDH expression and suppress cyclooxygenase-2 (COX-2) production may more effectively prevent CAC. Synthetic triterpenoids are a class of small molecules that suppress COX-2 as well as inflammatory cytokine signaling. Here, we found that administration of the synthetic triterpenoid 2-cyano-3,12-dioxooleana-1,9(11)-dien-C28-methyl ester (CDDO-Me) suppresses CAC in mice. In a spontaneous, inflammation-driven intestinal neoplasia model, deletion of Smad4 specifically in T cells led to progressive production of inflammatory cytokines, including TNF-α, IFN-γ, iNOS, IL-6, IL-1β; as well as activation of STAT1 and STAT3; along with suppression of 15-PGDH expression. Oral administration of CDDO-Me to mice with SMAD4-deficient T cells increased survival and suppressed intestinal epithelial neoplasia by decreasing production of inflammatory mediators and increasing expression of 15-PGDH. Induction of 15-PGDH by CDDO-Me was dose dependent in epithelial cells and was abrogated following treatment with TGF-β signaling inhibitors in vitro. Furthermore, CDDO-Me–dependent 15-PGDH induction was not observed in Smad3–/– mice. Similarly, CDDO-Me suppressed azoxymethane plus dextran sodium sulfate–induced carcinogenesis in wild-type animals, highlighting the potential of small molecules of the triterpenoid family as effective agents for the chemoprevention of CAC in humans.

Authors

Sung Hee Choi, Byung-Gyu Kim, Janet Robinson, Steve Fink, Min Yan, Michael B. Sporn, Sanford D. Markowitz, John J. Letterio

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Type I IFN signaling in CD8– DCs impairs Th1-dependent malaria immunity
Ashraful Haque, … , Geoffrey R. Hill, Christian R. Engwerda
Ashraful Haque, … , Geoffrey R. Hill, Christian R. Engwerda
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2483-2496. https://doi.org/10.1172/JCI70698.
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Type I IFN signaling in CD8– DCs impairs Th1-dependent malaria immunity

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Abstract

Many pathogens, including viruses, bacteria, and protozoan parasites, suppress cellular immune responses through activation of type I IFN signaling. Recent evidence suggests that immune suppression and susceptibility to the malaria parasite, Plasmodium, is mediated by type I IFN; however, it is unclear how type I IFN suppresses immunity to blood-stage Plasmodium parasites. During experimental severe malaria, CD4+ Th cell responses are suppressed, and conventional DC (cDC) function is curtailed through unknown mechanisms. Here, we tested the hypothesis that type I IFN signaling directly impairs cDC function during Plasmodium infection in mice. Using cDC-specific IFNAR1-deficient mice, and mixed BM chimeras, we found that type I IFN signaling directly affects cDC function, limiting the ability of cDCs to prime IFN-γ–producing Th1 cells. Although type I IFN signaling modulated all subsets of splenic cDCs, CD8– cDCs were especially susceptible, exhibiting reduced phagocytic and Th1-promoting properties in response to type I IFNs. Additionally, rapid and systemic IFN-α production in response to Plasmodium infection required type I IFN signaling in cDCs themselves, revealing their contribution to a feed-forward cytokine-signaling loop. Together, these data suggest abrogation of type I IFN signaling in CD8– splenic cDCs as an approach for enhancing Th1 responses against Plasmodium and other type I IFN–inducing pathogens.

Authors

Ashraful Haque, Shannon E. Best, Marcela Montes de Oca, Kylie R. James, Anne Ammerdorffer, Chelsea L. Edwards, Fabian de Labastida Rivera, Fiona H. Amante, Patrick T. Bunn, Meru Sheel, Ismail Sebina, Motoko Koyama, Antiopi Varelias, Paul J. Hertzog, Ulrich Kalinke, Sin Yee Gun, Laurent Rénia, Christiane Ruedl, Kelli P.A. MacDonald, Geoffrey R. Hill, Christian R. Engwerda

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MHC-derived allopeptide activates TCR-biased CD8+ Tregs and suppresses organ rejection
Elodie Picarda, … , Ignacio Anegon, Carole Guillonneau
Elodie Picarda, … , Ignacio Anegon, Carole Guillonneau
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2497-2512. https://doi.org/10.1172/JCI71533.
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MHC-derived allopeptide activates TCR-biased CD8+ Tregs and suppresses organ rejection

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In a rat heart allograft model, preventing T cell costimulation with CD40Ig leads to indefinite allograft survival, which is mediated by the induction of CD8+CD45RClo regulatory T cells (CD8+CD40Ig Tregs) interacting with plasmacytoid dendritic cells (pDCs). The role of TCR-MHC-peptide interaction in regulating Treg activity remains a topic of debate. Here, we identified a donor MHC class II–derived peptide (Du51) that is recognized by TCR-biased CD8+CD40Ig Tregs and activating CD8+CD40Ig Tregs in both its phenotype and suppression of antidonor alloreactive T cell responses. We generated a labeled tetramer (MHC-I RT1.Aa/Du51) to localize and quantify Du51-specific T cells within rat cardiac allografts and spleen. RT1.Aa/Du51-specific CD8+CD40Ig Tregs were the most suppressive subset of the total Treg population, were essential for in vivo tolerance induction, and expressed a biased, restricted Vβ11-TCR repertoire in the spleen and the graft. Finally, we demonstrated that treatment of transplant recipients with the Du51 peptide resulted in indefinite prolongation of allograft survival. These results show that CD8+CD40Ig Tregs recognize a dominant donor antigen, resulting in TCR repertoire alterations in the graft and periphery. Furthermore, this allopeptide has strong therapeutic activity and highlights the importance of TCR-peptide-MHC interaction for Treg generation and function.

Authors

Elodie Picarda, Séverine Bézie, Vanessa Venturi, Klara Echasserieau, Emmanuel Mérieau, Aurélie Delhumeau, Karine Renaudin, Sophie Brouard, Karine Bernardeau, Ignacio Anegon, Carole Guillonneau

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Decreased RORC-dependent silencing of prostaglandin receptor EP2 induces autoimmune Th17 cells
David M. Kofler, … , Vijay K. Kuchroo, David A. Hafler
David M. Kofler, … , Vijay K. Kuchroo, David A. Hafler
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2513-2522. https://doi.org/10.1172/JCI72973.
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Decreased RORC-dependent silencing of prostaglandin receptor EP2 induces autoimmune Th17 cells

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Prostaglandin E2 (PGE2) promotes Th17 expansion while otherwise inhibiting other CD4+ T cell subsets. Here, we identified a PGE2-dependent pathway that induces pathogenic Th17 cells in autoimmune disease and is regulated by the transcription factor RORC. Compared with other CD4+ cell types from healthy subjects, there is a surprising lack of the prostaglandin receptor EP2 on Th17 cells; therefore, we examined the hypothesis that RORγt, which is highly expressed in Th17 cells, mediates EP2 downregulation. Chromatin immunoprecipitation followed by DNA sequencing revealed that RORγt binds directly to Ptger2 (the gene encoding EP2 receptor) in Th17 cells isolated from WT mice. In Th17 cells isolated from humans, RORC repressed EP2 by directly silencing PTGER2 transcription, and knock down of RORC restored EP2 expression in Th17 cells. Compared with Th17 cells from healthy individuals, Th17 cells from patients with MS exhibited reduced RORC binding to the PTGER2 promoter region, resulting in higher EP2 levels and increased expression of IFN-γ and GM-CSF. Finally, overexpression of EP2 in Th17 cells from healthy individuals induced a specific program of inflammatory gene transcription that produced a pathogenic Th17 cell phenotype. These findings reveal that RORC directly regulates the effects of PGE2 on Th17 cells, and dysfunction of this pathway induces a pathogenic Th17 cell phenotype.

Authors

David M. Kofler, Alexander Marson, Margarita Dominguez-Villar, Sheng Xiao, Vijay K. Kuchroo, David A. Hafler

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KLF4-dependent epigenetic remodeling modulates podocyte phenotypes and attenuates proteinuria
Kaori Hayashi, … , Yusuke Sakamaki, Hiroshi Itoh
Kaori Hayashi, … , Yusuke Sakamaki, Hiroshi Itoh
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2523-2537. https://doi.org/10.1172/JCI69557.
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KLF4-dependent epigenetic remodeling modulates podocyte phenotypes and attenuates proteinuria

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The transcription factor Kruppel-like factor 4 (KLF4) has the ability, along with other factors, to reprogram somatic cells into induced pluripotent stem (iPS) cells. Here, we determined that KLF4 is expressed in kidney glomerular podocytes and is decreased in both animal models and humans exhibiting a proteinuric. Transient restoration of KLF4 expression in podocytes of diseased glomeruli in vivo, either by gene transfer or transgenic expression, resulted in a sustained increase in nephrin expression and a decrease in albuminuria. In mice harboring podocyte-specific deletion of Klf4, adriamycin-induced proteinuria was substantially exacerbated, although these animals displayed minimal phenotypical changes prior to adriamycin administration. KLF4 overexpression in cultured human podocytes increased expression of nephrin and other epithelial markers and reduced mesenchymal gene expression. DNA methylation profiling and bisulfite genomic sequencing revealed that KLF4 expression reduced methylation at the nephrin promoter and the promoters of other epithelial markers; however, methylation was increased at the promoters of genes encoding mesenchymal markers, suggesting selective epigenetic regulation of podocyte gene expression. Together, these results suggest that KLF4 epigenetically modulates podocyte phenotype and function and that the podocyte epigenome can be targeted for direct intervention and reduction of proteinuria.

Authors

Kaori Hayashi, Hiroyuki Sasamura, Mari Nakamura, Tatsuhiko Azegami, Hideyo Oguchi, Yusuke Sakamaki, Hiroshi Itoh

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Vaccine-induced myeloid cell population dampens protective immunity to SIV
Yongjun Sui, … , Genoveffa Franchini, Jay A. Berzofsky
Yongjun Sui, … , Genoveffa Franchini, Jay A. Berzofsky
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2538-2549. https://doi.org/10.1172/JCI73518.
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Vaccine-induced myeloid cell population dampens protective immunity to SIV

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Abstract

Vaccines are largely evaluated for their ability to promote adaptive immunity, with little focus on the induction of negative immune regulators. Adjuvants facilitate and enhance vaccine-induced immune responses and have been explored for mediating protection against HIV. Using a regimen of peptide priming followed by a modified vaccinia Ankara (MVA) boost in a nonhuman primate model, we found that an SIV vaccine incorporating molecular adjuvants mediated partial protection against rectal SIVmac251 challenges. Animals treated with vaccine and multiple adjuvants exhibited a reduced viral load (VL) compared with those treated with vaccine only. Surprisingly, animals treated with adjuvant alone had reduced VLs that were comparable to or better than those of the vaccine-treated group. VL reduction was greatest in animals with the MHC class I allele Mamu-A*01 that were treated with adjuvant only and was largely dependent on CD8+ T cells. Early VLs correlated with Ki67+CCR5+CD4+ T cell frequency, while set-point VL was associated with expansion of a myeloid cell population that was phenotypically similar to myeloid-derived suppressor cells (MDSCs) and that suppressed T cell responses in vitro. MDSC expansion occurred in animals receiving vaccine and was not observed in the adjuvant-only group. Collectively, these results indicate that vaccine-induced MDSCs inhibit protective cellular immunity and suggest that preventing MDSC induction may be critical for effective AIDS vaccination.

Authors

Yongjun Sui, Alison Hogg, Yichuan Wang, Blake Frey, Huifeng Yu, Zheng Xia, David Venzon, Katherine McKinnon, Jeremy Smedley, Mercy Gathuka, Dennis Klinman, Brandon F. Keele, Sol Langermann, Linda Liu, Genoveffa Franchini, Jay A. Berzofsky

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Leptin-dependent neuronal NO signaling in the preoptic hypothalamus facilitates reproduction
Nicole Bellefontaine, … , Sebastien G. Bouret, Vincent Prevot
Nicole Bellefontaine, … , Sebastien G. Bouret, Vincent Prevot
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2550-2559. https://doi.org/10.1172/JCI65928.
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Leptin-dependent neuronal NO signaling in the preoptic hypothalamus facilitates reproduction

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The transition to puberty and adult fertility both require a minimum level of energy availability. The adipocyte-derived hormone leptin signals the long-term status of peripheral energy stores and serves as a key metabolic messenger to the neuroendocrine reproductive axis. Humans and mice lacking leptin or its receptor fail to complete puberty and are infertile. Restoration of leptin levels in these individuals promotes sexual maturation, which requires the pulsatile, coordinated delivery of gonadotropin-releasing hormone to the pituitary and the resulting surge of luteinizing hormone (LH); however, the neural circuits that control the leptin-mediated induction of the reproductive axis are not fully understood. Here, we found that leptin coordinated fertility by acting on neurons in the preoptic region of the hypothalamus and inducing the synthesis of the freely diffusible volume-based transmitter NO, through the activation of neuronal NO synthase (nNOS) in these neurons. The deletion of the gene encoding nNOS or its pharmacological inhibition in the preoptic region blunted the stimulatory action of exogenous leptin on LH secretion and prevented the restoration of fertility in leptin-deficient female mice by leptin treatment. Together, these data indicate that leptin plays a central role in regulating the hypothalamo-pituitary-gonadal axis in vivo through the activation of nNOS in neurons of the preoptic region.

Authors

Nicole Bellefontaine, Konstantina Chachlaki, Jyoti Parkash, Charlotte Vanacker, William Colledge, Xavier d’Anglemont de Tassigny, John Garthwaite, Sebastien G. Bouret, Vincent Prevot

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Peripheral nervous system plasmalogens regulate Schwann cell differentiation and myelination
Tiago Ferreira da Silva, … , Mónica M. Sousa, Pedro Brites
Tiago Ferreira da Silva, … , Mónica M. Sousa, Pedro Brites
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2560-2570. https://doi.org/10.1172/JCI72063.
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Peripheral nervous system plasmalogens regulate Schwann cell differentiation and myelination

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Rhizomelic chondrodysplasia punctata (RCDP) is a developmental disorder characterized by hypotonia, cataracts, abnormal ossification, impaired motor development, and intellectual disability. The underlying etiology of RCDP is a deficiency in the biosynthesis of ether phospholipids, of which plasmalogens are the most abundant form in nervous tissue and myelin; however, the role of plasmalogens in the peripheral nervous system is poorly defined. Here, we used mouse models of RCDP and analyzed the consequence of plasmalogen deficiency in peripheral nerves. We determined that plasmalogens are crucial for Schwann cell development and differentiation and that plasmalogen defects impaired radial sorting, myelination, and myelin structure. Plasmalogen insufficiency resulted in defective protein kinase B (AKT) phosphorylation and subsequent signaling, causing overt activation of glycogen synthase kinase 3β (GSK3β) in nerves of mutant mice. Treatment with GSK3β inhibitors, lithium, or 4-benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione (TDZD-8) restored Schwann cell defects, effectively bypassing plasmalogen deficiency. Our results demonstrate the requirement of plasmalogens for the correct and timely differentiation of Schwann cells and for the process of myelination. In addition, these studies identify a mechanism by which the lack of a membrane phospholipid causes neuropathology, implicating plasmalogens as regulators of membrane and cell signaling.

Authors

Tiago Ferreira da Silva, Jessica Eira, André T. Lopes, Ana R. Malheiro, Vera Sousa, Adrienne Luoma, Robin L. Avila, Ronald J.A. Wanders, Wilhelm W. Just, Daniel A. Kirschner, Mónica M. Sousa, Pedro Brites

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Enhanced sphingosine-1-phosphate receptor 2 expression underlies female CNS autoimmunity susceptibility
Lillian Cruz-Orengo, … , Seth D. Crosby, Robyn S. Klein
Lillian Cruz-Orengo, … , Seth D. Crosby, Robyn S. Klein
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2571-2584. https://doi.org/10.1172/JCI73408.
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Enhanced sphingosine-1-phosphate receptor 2 expression underlies female CNS autoimmunity susceptibility

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Multiple sclerosis (MS) is an inflammatory disease of the CNS that is characterized by BBB dysfunction and has a much higher incidence in females. Compared with other strains of mice, EAE in the SJL mouse strain models multiple features of MS, including an enhanced sensitivity of female mice to disease; however, the molecular mechanisms that underlie the sex- and strain-dependent differences in disease susceptibility have not been described. We identified sphingosine-1-phosphate receptor 2 (S1PR2) as a sex- and strain-specific, disease-modifying molecule that regulates BBB permeability by destabilizing adherens junctions. S1PR2 expression was increased in disease-susceptible regions of the CNS of both female SJL EAE mice and female patients with MS compared with their male counterparts. Pharmacological blockade or lack of S1PR2 signaling decreased EAE disease severity as the result of enhanced endothelial barrier function. Enhanced S1PR2 signaling in an in vitro BBB model altered adherens junction formation via activation of Rho/ROCK, CDC42, and caveolin endocytosis-dependent pathways, resulting in loss of apicobasal polarity and relocation of abluminal CXCL12 to vessel lumina. Furthermore, S1PR2-dependent BBB disruption and CXCL12 relocation were observed in vivo. These results identify a link between S1PR2 signaling and BBB polarity and implicate S1PR2 in sex-specific patterns of disease during CNS autoimmunity.

Authors

Lillian Cruz-Orengo, Brian P. Daniels, Denise Dorsey, Sarah Alison Basak, José G. Grajales-Reyes, Erin E. McCandless, Laura Piccio, Robert E. Schmidt, Anne H. Cross, Seth D. Crosby, Robyn S. Klein

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Inhibition of ER stress–associated IRE-1/XBP-1 pathway reduces leukemic cell survival
Chih-Hang Anthony Tang, … , Juan R. Del Valle, Chih-Chi Andrew Hu
Chih-Hang Anthony Tang, … , Juan R. Del Valle, Chih-Chi Andrew Hu
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2585-2598. https://doi.org/10.1172/JCI73448.
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Inhibition of ER stress–associated IRE-1/XBP-1 pathway reduces leukemic cell survival

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Activation of the ER stress response is associated with malignant progression of B cell chronic lymphocytic leukemia (CLL). We developed a murine CLL model that lacks the ER stress–associated transcription factor XBP-1 in B cells and found that XBP-1 deficiency decelerates malignant progression of CLL-associated disease. XBP-1 deficiency resulted in acquisition of phenotypes that are disadvantageous for leukemic cell survival, including compromised BCR signaling capability and increased surface expression of sphingosine-1-phosphate receptor 1 (S1P1). Because XBP-1 expression requires the RNase activity of the ER transmembrane receptor IRE-1, we developed a potent IRE-1 RNase inhibitor through chemical synthesis and modified the structure to facilitate entry into cells to target the IRE-1/XBP-1 pathway. Treatment of CLL cells with this inhibitor (B-I09) mimicked XBP-1 deficiency, including upregulation of IRE-1 expression and compromised BCR signaling. Moreover, B-I09 treatment did not affect the transport of secretory and integral membrane-bound proteins. Administration of B-I09 to CLL tumor–bearing mice suppressed leukemic progression by inducing apoptosis and did not cause systemic toxicity. Additionally, B-I09 and ibrutinib, an FDA-approved BTK inhibitor, synergized to induce apoptosis in B cell leukemia, lymphoma, and multiple myeloma. These data indicate that targeting XBP-1 has potential as a treatment strategy, not only for multiple myeloma, but also for mature B cell leukemia and lymphoma.

Authors

Chih-Hang Anthony Tang, Sujeewa Ranatunga, Crystina L. Kriss, Christopher L. Cubitt, Jianguo Tao, Javier A. Pinilla-Ibarz, Juan R. Del Valle, Chih-Chi Andrew Hu

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β-Catenin–regulated myeloid cell adhesion and migration determine wound healing
Saeid Amini-Nik, … , Boris Hinz, Benjamin A. Alman
Saeid Amini-Nik, … , Boris Hinz, Benjamin A. Alman
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2599-2610. https://doi.org/10.1172/JCI62059.
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β-Catenin–regulated myeloid cell adhesion and migration determine wound healing

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A β-catenin/T cell factor–dependent transcriptional program is critical during cutaneous wound repair for the regulation of scar size; however, the relative contribution of β-catenin activity and function in specific cell types in the granulation tissue during the healing process is unknown. Here, cell lineage tracing revealed that cells in which β-catenin is transcriptionally active express a gene profile that is characteristic of the myeloid lineage. Mice harboring a macrophage-specific deletion of the gene encoding β-catenin exhibited insufficient skin wound healing due to macrophage-specific defects in migration, adhesion to fibroblasts, and ability to produce TGF-β1. In irradiated mice, only macrophages expressing β-catenin were able to rescue wound-healing deficiency. Evaluation of scar tissue collected from patients with hypertrophic and normal scars revealed a correlation between the number of macrophages within the wound, β-catenin levels, and cellularity. Our data indicate that β-catenin regulates myeloid cell motility and adhesion and that β-catenin–mediated macrophage motility contributes to the number of mesenchymal cells and ultimate scar size following cutaneous injury.

Authors

Saeid Amini-Nik, Elizabeth Cambridge, Winston Yu, Anne Guo, Heather Whetstone, Puviindran Nadesan, Raymond Poon, Boris Hinz, Benjamin A. Alman

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Mesenchymal gene program–expressing ovarian cancer spheroids exhibit enhanced mesothelial clearance
Rachel A. Davidowitz, … , Ronny Drapkin, Joan S. Brugge
Rachel A. Davidowitz, … , Ronny Drapkin, Joan S. Brugge
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2611-2625. https://doi.org/10.1172/JCI69815.
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Mesenchymal gene program–expressing ovarian cancer spheroids exhibit enhanced mesothelial clearance

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Metastatic dissemination of ovarian tumors involves the invasion of tumor cell clusters into the mesothelial cell lining of peritoneal cavity organs; however, the tumor-specific factors that allow ovarian cancer cells to spread are unclear. We used an in vitro assay that models the initial step of ovarian cancer metastasis, clearance of the mesothelial cell layer, to examine the clearance ability of a large panel of both established and primary ovarian tumor cells. Comparison of the gene and protein expression profiles of clearance-competent and clearance-incompetent cells revealed that mesenchymal genes are enriched in tumor populations that display strong clearance activity, while epithelial genes are enriched in those with weak or undetectable activity. Overexpression of transcription factors SNAI1, TWIST1, and ZEB1, which regulate the epithelial-to-mesenchymal transition (EMT), promoted mesothelial clearance in cell lines with weak activity, while knockdown of the EMT-regulatory transcription factors TWIST1 and ZEB1 attenuated mesothelial clearance in ovarian cancer cell lines with strong activity. These findings provide important insights into the mechanisms associated with metastatic progression of ovarian cancer and suggest that inhibiting pathways that drive mesenchymal programs may suppress tumor cell invasion of peritoneal tissues.

Authors

Rachel A. Davidowitz, Laura M. Selfors, Marcin P. Iwanicki, Kevin M. Elias, Alison Karst, Huiying Piao, Tan A. Ince, Michael G. Drage, Judy Dering, Gottfried E. Konecny, Ursula Matulonis, Gordon B. Mills, Dennis J. Slamon, Ronny Drapkin, Joan S. Brugge

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ER stress regulates myeloid-derived suppressor cell fate through TRAIL-R–mediated apoptosis
Thomas Condamine, … , Thomas Bauer, Dmitry I. Gabrilovich
Thomas Condamine, … , Thomas Bauer, Dmitry I. Gabrilovich
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2626-2639. https://doi.org/10.1172/JCI74056.
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ER stress regulates myeloid-derived suppressor cell fate through TRAIL-R–mediated apoptosis

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Myeloid-derived suppressor cells (MDSCs) dampen the immune response thorough inhibition of T cell activation and proliferation and often are expanded in pathological conditions. Here, we studied the fate of MDSCs in cancer. Unexpectedly, MDSCs had lower viability and a shorter half-life in tumor-bearing mice compared with neutrophils and monocytes. The reduction of MDSC viability was due to increased apoptosis, which was mediated by increased expression of TNF-related apoptosis–induced ligand receptors (TRAIL-Rs) in these cells. Targeting TRAIL-Rs in naive mice did not affect myeloid cell populations, but it dramatically reduced the presence of MDSCs and improved immune responses in tumor-bearing mice. Treatment of myeloid cells with proinflammatory cytokines did not affect TRAIL-R expression; however, induction of ER stress in myeloid cells recapitulated changes in TRAIL-R expression observed in tumor-bearing hosts. The ER stress response was detected in MDSCs isolated from cancer patients and tumor-bearing mice, but not in control neutrophils or monocytes, and blockade of ER stress abrogated tumor-associated changes in TRAIL-Rs. Together, these data indicate that MDSC pathophysiology is linked to ER stress, which shortens the lifespan of these cells in the periphery and promotes expansion in BM. Furthermore, TRAIL-Rs can be considered as potential targets for selectively inhibiting MDSCs.

Authors

Thomas Condamine, Vinit Kumar, Indu R. Ramachandran, Je-In Youn, Esteban Celis, Niklas Finnberg, Wafik S. El-Deiry, Rafael Winograd, Robert H. Vonderheide, Nickolas R. English, Stella C. Knight, Hideo Yagita, Judith C. McCaffrey, Scott Antonia, Neil Hockstein, Robert Witt, Gregory Masters, Thomas Bauer, Dmitry I. Gabrilovich

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The tumor suppressor folliculin regulates AMPK-dependent metabolic transformation
Ming Yan, … , Andrew R. Tee, Arnim Pause
Ming Yan, … , Andrew R. Tee, Arnim Pause
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2640-2650. https://doi.org/10.1172/JCI71749.
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The tumor suppressor folliculin regulates AMPK-dependent metabolic transformation

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The Warburg effect is a tumorigenic metabolic adaptation process characterized by augmented aerobic glycolysis, which enhances cellular bioenergetics. In normal cells, energy homeostasis is controlled by AMPK; however, its role in cancer is not understood, as both AMPK-dependent tumor-promoting and -inhibiting functions were reported. Upon stress, energy levels are maintained by increased mitochondrial biogenesis and glycolysis, controlled by transcriptional coactivator PGC-1α and HIF, respectively. In normoxia, AMPK induces PGC-1α, but how HIF is activated is unclear. Germline mutations in the gene encoding the tumor suppressor folliculin (FLCN) lead to Birt-Hogg-Dubé (BHD) syndrome, which is associated with an increased cancer risk. FLCN was identified as an AMPK binding partner, and we evaluated its role with respect to AMPK-dependent energy functions. We revealed that loss of FLCN constitutively activates AMPK, resulting in PGC-1α–mediated mitochondrial biogenesis and increased ROS production. ROS induced HIF transcriptional activity and drove Warburg metabolic reprogramming, coupling AMPK-dependent mitochondrial biogenesis to HIF-dependent metabolic changes. This reprogramming stimulated cellular bioenergetics and conferred a HIF-dependent tumorigenic advantage in FLCN-negative cancer cells. Moreover, this pathway is conserved in a BHD-derived tumor. These results indicate that FLCN inhibits tumorigenesis by preventing AMPK-dependent HIF activation and the subsequent Warburg metabolic transformation.

Authors

Ming Yan, Marie-Claude Gingras, Elaine A. Dunlop, Yann Nouët, Fanny Dupuy, Zahra Jalali, Elite Possik, Barry J. Coull, Dmitri Kharitidi, Anders Bondo Dydensborg, Brandon Faubert, Miriam Kamps, Sylvie Sabourin, Rachael S. Preston, David Mark Davies, Taren Roughead, Laëtitia Chotard, Maurice A.M. van Steensel, Russell Jones, Andrew R. Tee, Arnim Pause

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MicroRNA-486–dependent modulation of DOCK3/PTEN/AKT signaling pathways improves muscular dystrophy–associated symptoms
Matthew S. Alexander, … , Jeffrey J. Widrick, Louis M. Kunkel
Matthew S. Alexander, … , Jeffrey J. Widrick, Louis M. Kunkel
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2651-2667. https://doi.org/10.1172/JCI73579.
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MicroRNA-486–dependent modulation of DOCK3/PTEN/AKT signaling pathways improves muscular dystrophy–associated symptoms

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Abstract

Duchenne muscular dystrophy (DMD) is caused by mutations in the gene encoding dystrophin, which results in dysfunctional signaling pathways within muscle. Previously, we identified microRNA-486 (miR-486) as a muscle-enriched microRNA that is markedly reduced in the muscles of dystrophin-deficient mice (Dmdmdx-5Cv mice) and in DMD patient muscles. Here, we determined that muscle-specific transgenic overexpression of miR-486 in muscle of Dmdmdx-5Cv mice results in reduced serum creatine kinase levels, improved sarcolemmal integrity, fewer centralized myonuclei, increased myofiber size, and improved muscle physiology and performance. Additionally, we identified dedicator of cytokinesis 3 (DOCK3) as a miR-486 target in skeletal muscle and determined that DOCK3 expression is induced in dystrophic muscles. DOCK3 overexpression in human myotubes modulated PTEN/AKT signaling, which regulates muscle hypertrophy and growth, and induced apoptosis. Furthermore, several components of the PTEN/AKT pathway were markedly modulated by miR-486 in dystrophin-deficient muscle. Skeletal muscle–specific miR-486 overexpression in Dmdmdx-5Cv animals decreased levels of DOCK3, reduced PTEN expression, and subsequently increased levels of phosphorylated AKT, which resulted in an overall beneficial effect. Together, these studies demonstrate that stable overexpression of miR-486 ameliorates the disease progression of dystrophin-deficient skeletal muscle.

Authors

Matthew S. Alexander, Juan Carlos Casar, Norio Motohashi, Natássia M. Vieira, Iris Eisenberg, Jamie L. Marshall, Molly J. Gasperini, Angela Lek, Jennifer A. Myers, Elicia A. Estrella, Peter B. Kang, Frederic Shapiro, Fedik Rahimov, Genri Kawahara, Jeffrey J. Widrick, Louis M. Kunkel

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Targeting CD137 enhances the efficacy of cetuximab
Holbrook E. Kohrt, … , John Sunwoo, Ronald Levy
Holbrook E. Kohrt, … , John Sunwoo, Ronald Levy
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2668-2682. https://doi.org/10.1172/JCI73014.
View: Text | PDF | Retraction

Targeting CD137 enhances the efficacy of cetuximab

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Abstract

Treatment with cetuximab, an EGFR-targeting IgG1 mAb, results in beneficial, yet limited, clinical improvement for patients with head and neck (HN) cancer as well as colorectal cancer (CRC) patients with WT KRAS tumors. Antibody-dependent cell-mediated cytotoxicity (ADCC) by NK cells contributes to the efficacy of cetuximab. The costimulatory molecule CD137 (4-1BB) is expressed following NK and memory T cell activation. We found that isolated human NK cells substantially increased expression of CD137 when exposed to cetuximab-coated, EGFR-expressing HN and CRC cell lines. Furthermore, activation of CD137 with an agonistic mAb enhanced NK cell degranulation and cytotoxicity. In multiple murine xenograft models, including EGFR-expressing cancer cells, HN cells, and KRAS-WT and KRAS-mutant CRC, combined cetuximab and anti-CD137 mAb administration was synergistic and led to complete tumor resolution and prolonged survival, which was dependent on the presence of NK cells. In patients receiving cetuximab, the level of CD137 on circulating and intratumoral NK cells was dependent on postcetuximab time and host FcyRIIIa polymorphism. Interestingly, the increase in CD137-expressing NK cells directly correlated to an increase in EGFR-specific CD8+ T cells. These results support development of a sequential antibody approach against EGFR-expressing malignancies that first targets the tumor and then the host immune system.

Authors

Holbrook E. Kohrt, A. Dimitrios Colevas, Roch Houot, Kipp Weiskopf, Matthew J. Goldstein, Peder Lund, Antonia Mueller, Idit Sagiv-Barfi, Aurelien Marabelle, Ruth Lira, Emily Troutner, Lori Richards, Amanda Rajapaska, Jonathan Hebb, Cariad Chester, Erin Waller, Anton Ostashko, Wen-Kai Weng, Lieping Chen, Debra Czerwinski, Yang-Xin Fu, John Sunwoo, Ronald Levy

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Neural peptidase endothelin-converting enzyme 1 regulates endothelin 1–induced pruritus
Makiko Kido-Nakahara, … , Masutaka Furue, Martin Steinhoff
Makiko Kido-Nakahara, … , Masutaka Furue, Martin Steinhoff
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2683-2695. https://doi.org/10.1172/JCI67323.
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Neural peptidase endothelin-converting enzyme 1 regulates endothelin 1–induced pruritus

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Abstract

In humans, pruritus (itch) is a common but poorly understood symptom in numerous skin and systemic diseases. Endothelin 1 (ET-1) evokes histamine-independent pruritus in mammals through activation of its cognate G protein–coupled receptor endothelin A receptor (ETAR). Here, we have identified neural endothelin–converting enzyme 1 (ECE-1) as a key regulator of ET-1–induced pruritus and neural signaling of itch. We show here that ETAR, ET-1, and ECE-1 are expressed and colocalize in murine dorsal root ganglia (DRG) neurons and human skin nerves. In murine DRG neurons, ET-1 induced internalization of ETAR within ECE-1–containing endosomes. ECE-1 inhibition slowed ETAR recycling yet prolonged ET-1–induced activation of ERK1/2, but not p38. In a murine itch model, ET-1–induced scratching behavior was substantially augmented by pharmacological ECE-1 inhibition and abrogated by treatment with an ERK1/2 inhibitor. Using iontophoresis, we demonstrated that ET-1 is a potent, partially histamine-independent pruritogen in humans. Immunohistochemical evaluation of skin from prurigo nodularis patients confirmed an upregulation of the ET-1/ETAR/ECE-1/ERK1/2 axis in patients with chronic itch. Together, our data identify the neural peptidase ECE-1 as a negative regulator of itch on sensory nerves by directly regulating ET-1–induced pruritus in humans and mice. Furthermore, these results implicate the ET-1/ECE-1/ERK1/2 pathway as a therapeutic target to treat pruritus in humans.

Authors

Makiko Kido-Nakahara, Jörg Buddenkotte, Cordula Kempkes, Akihiko Ikoma, Ferda Cevikbas, Tasuku Akiyama, Frank Nunes, Stephan Seeliger, Burcu Hasdemir, Christian Mess, Timo Buhl, Mathias Sulk, Frank-Ulrich Müller, Dieter Metze, Nigel W. Bunnett, Aditi Bhargava, Earl Carstens, Masutaka Furue, Martin Steinhoff

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ZEB1 sensitizes lung adenocarcinoma to metastasis suppression by PI3K antagonism
Yanan Yang, … , Chad J. Creighton, Jonathan M. Kurie
Yanan Yang, … , Chad J. Creighton, Jonathan M. Kurie
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2696-2708. https://doi.org/10.1172/JCI72171.
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ZEB1 sensitizes lung adenocarcinoma to metastasis suppression by PI3K antagonism

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Abstract

Epithelial tumor cells that have undergone epithelial-to-mesenchymal transition (EMT) are typically prone to metastasis and drug resistance and contribute to a poor clinical outcome. The transcription factor ZEB1 is a known driver of EMT, and mediators of ZEB1 represent potential therapeutic targets for metastasis suppression. Here, we have shown that phosphatidylinositol 3-kinase–targeted (PI3K-targeted) therapy suppresses metastasis in a mouse model of Kras/Tp53-mutant lung adenocarcinoma that develops metastatic disease due to high expression of ZEB1. In lung adenocarcinoma cells from Kras/Tp53-mutant animals and human lung cancer cell lines, ZEB1 activated PI3K by derepressing miR-200 targets, including amphiregulin (AREG), betacellulin (BTC), and the transcription factor GATA6, which stimulated an EGFR/ERBB2 autocrine loop. Additionally, ZEB1-dependent derepression of the miR-200 and miR-183 target friend of GATA 2 (FOG2) enhanced GATA3-induced expression of the p110α catalytic subunit of PI3K. Knockdown of FOG2, p110α, and RHEB ameliorated invasive and metastatic propensities of tumor cells. Surprisingly, FOG2 was not required for mesenchymal differentiation, suggesting that mesenchymal differentiation and invasion are distinct and separable processes. Together, these results indicate that ZEB1 sensitizes lung adenocarcinoma cells to metastasis suppression by PI3K-targeted therapy and suggest that treatments to selectively modify the metastatic behavior of mesenchymal tumor cells are feasible and may be of clinical value.

Authors

Yanan Yang, Young-Ho Ahn, Yulong Chen, Xiaochao Tan, Lixia Guo, Don L. Gibbons, Christin Ungewiss, David H. Peng, Xin Liu, Steven H. Lin, Nishan Thilaganathan, Ignacio I. Wistuba, Jaime Rodriguez-Canales, Georgia McLendon, Chad J. Creighton, Jonathan M. Kurie

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Estrogen promotes Leydig cell engulfment by macrophages in male infertility
Wanpeng Yu, … , Ituro Inoue, Xiangdong Li
Wanpeng Yu, … , Ituro Inoue, Xiangdong Li
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2709-2721. https://doi.org/10.1172/JCI59901.
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Estrogen promotes Leydig cell engulfment by macrophages in male infertility

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Abstract

Male infertility accounts for almost half of infertility cases worldwide. A subset of infertile men exhibit reduced testosterone and enhanced levels of estradiol (E2), though it is unclear how increased E2 promotes deterioration of male fertility. Here, we utilized a transgenic mouse strain that overexpresses human CYP19, which encodes aromatase (AROM+ mice), and mice with knockout of Esr1, encoding estrogen receptor α (ERαKO mice), to analyze interactions between viable Leydig cells (LCs) and testicular macrophages that may lead to male infertility. In AROM+ males, enhanced E2 promoted LC hyperplasia and macrophage activation via ERα signaling. E2 stimulated LCs to produce growth arrest–specific 6 (GAS6), which mediates phagocytosis of apoptotic cells by bridging cells with surface exposed phosphatidylserine (PS) to macrophage receptors, including the tyrosine kinases TYRO3, AXL, and MER. Overproduction of E2 increased apoptosis-independent extrusion of PS on LCs, which in turn promoted engulfment by E2/ERα-activated macrophages that was mediated by AXL-GAS6-PS interaction. We further confirmed E2-dependant engulfment of LCs by real-time 3D imaging. Furthermore, evaluation of molecular markers in the testes of patients with nonobstructive azoospermia (NOA) revealed enhanced expression of CYP19, GAS6, and AXL, which suggests that the AROM+ mouse model reflects human infertility. Together, these results suggest that GAS6 has a potential as a clinical biomarker and therapeutic target for male infertility.

Authors

Wanpeng Yu, Han Zheng, Wei Lin, Astushi Tajima, Yong Zhang, Xiaoyan Zhang, Hongwen Zhang, Jihua Wu, Daishu Han, Nafis A. Rahman, Kenneth S. Korach, George Fu Gao, Ituro Inoue, Xiangdong Li

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MicroRNA-7a regulates pancreatic β cell function
Mathieu Latreille, … , Patrik Rorsman, Markus Stoffel
Mathieu Latreille, … , Patrik Rorsman, Markus Stoffel
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2722-2735. https://doi.org/10.1172/JCI73066.
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MicroRNA-7a regulates pancreatic β cell function

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Abstract

Dysfunctional microRNA (miRNA) networks contribute to inappropriate responses following pathological stress and are the underlying cause of several disease conditions. In pancreatic β cells, miRNAs have been largely unstudied and little is known about how specific miRNAs regulate glucose-stimulated insulin secretion (GSIS) or impact the adaptation of β cell function to metabolic stress. In this study, we determined that miR-7 is a negative regulator of GSIS in β cells. Using Mir7a2 deficient mice, we revealed that miR-7a2 regulates β cell function by directly regulating genes that control late stages of insulin granule fusion with the plasma membrane and ternary SNARE complex activity. Transgenic mice overexpressing miR-7a in β cells developed diabetes due to impaired insulin secretion and β cell dedifferentiation. Interestingly, perturbation of miR-7a expression in β cells did not affect proliferation and apoptosis, indicating that miR-7 is dispensable for the maintenance of endocrine β cell mass. Furthermore, we found that miR-7a levels are decreased in obese/diabetic mouse models and human islets from obese and moderately diabetic individuals with compensated β cell function. Our results reveal an interconnecting miR-7 genomic circuit that regulates insulin granule exocytosis in pancreatic β cells and support a role for miR-7 in the adaptation of pancreatic β cell function in obesity and type 2 diabetes.

Authors

Mathieu Latreille, Jean Hausser, Ina Stützer, Quan Zhang, Benoit Hastoy, Sofia Gargani, Julie Kerr-Conte, Francois Pattou, Mihaela Zavolan, Jonathan L.S. Esguerra, Lena Eliasson, Thomas Rülicke, Patrik Rorsman, Markus Stoffel

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Bicc1 is a genetic determinant of osteoblastogenesis and bone mineral density
Larry D. Mesner, … , Thomas L. Clemens, Charles R. Farber
Larry D. Mesner, … , Thomas L. Clemens, Charles R. Farber
Published May 1, 2014
Citation Information: J Clin Invest. 2014;124(6):2736-2749. https://doi.org/10.1172/JCI73072.
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Bicc1 is a genetic determinant of osteoblastogenesis and bone mineral density

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Abstract

Patient bone mineral density (BMD) predicts the likelihood of osteoporotic fracture. While substantial progress has been made toward elucidating the genetic determinants of BMD, our understanding of the factors involved remains incomplete. Here, using a systems genetics approach in the mouse, we predicted that bicaudal C homolog 1 (Bicc1), which encodes an RNA-binding protein, is responsible for a BMD quantitative trait locus (QTL) located on murine chromosome 10. Consistent with this prediction, mice heterozygous for a null allele of Bicc1 had low BMD. We used a coexpression network–based approach to determine how Bicc1 influences BMD. Based on this analysis, we inferred that Bicc1 was involved in osteoblast differentiation and that polycystic kidney disease 2 (Pkd2) was a downstream target of Bicc1. Knock down of Bicc1 and Pkd2 impaired osteoblastogenesis, and Bicc1 deficiency–dependent osteoblast defects were rescued by Pkd2 overexpression. Last, in 2 human BMD genome-wide association (GWAS) meta-analyses, we identified SNPs in BICC1 and PKD2 that were associated with BMD. These results, in both mice and humans, identify Bicc1 as a genetic determinant of osteoblastogenesis and BMD and suggest that it does so by regulating Pkd2 transcript levels.

Authors

Larry D. Mesner, Brianne Ray, Yi-Hsiang Hsu, Ani Manichaikul, Eric Lum, Elizabeth C. Bryda, Stephen S. Rich, Clifford J. Rosen, Michael H. Criqui, Matthew Allison, Matthew J. Budoff, Thomas L. Clemens, Charles R. Farber

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Elevated sphingosine-1-phosphate promotes sickling and sickle cell disease progression
Yujin Zhang, … , Harinder S. Juneja, Yang Xia
Yujin Zhang, … , Harinder S. Juneja, Yang Xia
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2750-2761. https://doi.org/10.1172/JCI74604.
View: Text | PDF | Corrigendum

Elevated sphingosine-1-phosphate promotes sickling and sickle cell disease progression

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Abstract

Sphingosine-1-phosphate (S1P) is a bioactive lipid that regulates multicellular functions through interactions with its receptors on cell surfaces. S1P is enriched and stored in erythrocytes; however, it is not clear whether alterations in S1P are involved in the prevalent and debilitating hemolytic disorder sickle cell disease (SCD). Here, using metabolomic screening, we found that S1P is highly elevated in the blood of mice and humans with SCD. In murine models of SCD, we demonstrated that elevated erythrocyte sphingosine kinase 1 (SPHK1) underlies sickling and disease progression by increasing S1P levels in the blood. Additionally, we observed elevated SPHK1 activity in erythrocytes and increased S1P in blood collected from patients with SCD and demonstrated a direct impact of elevated SPHK1-mediated production of S1P on sickling that was independent of S1P receptor activation in isolated erythrocytes. Together, our findings provide insights into erythrocyte pathophysiology, revealing that a SPHK1-mediated elevation of S1P contributes to sickling and promotes disease progression, and highlight potential therapeutic opportunities for SCD.

Authors

Yujin Zhang, Vladimir Berka, Anren Song, Kaiqi Sun, Wei Wang, Weiru Zhang, Chen Ning, Chonghua Li, Qibo Zhang, Mikhail Bogdanov, Danny C. Alexander, Michael V. Milburn, Mostafa H. Ahmed, Han Lin, Modupe Idowu, Jun Zhang, Gregory J. Kato, Osheiza Y. Abdulmalik, Wenzheng Zhang, William Dowhan, Rodney E. Kellems, Pumin Zhang, Jianping Jin, Martin Safo, Ah-Lim Tsai, Harinder S. Juneja, Yang Xia

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Combined MEK and JAK inhibition abrogates murine myeloproliferative neoplasm
Guangyao Kong, … , James C. Mulloy, Jing Zhang
Guangyao Kong, … , James C. Mulloy, Jing Zhang
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2762-2773. https://doi.org/10.1172/JCI74182.
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Combined MEK and JAK inhibition abrogates murine myeloproliferative neoplasm

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Abstract

Overactive RAS signaling is prevalent in juvenile myelomonocytic leukemia (JMML) and the myeloproliferative variant of chronic myelomonocytic leukemia (MP-CMML) in humans, and both are refractory to conventional chemotherapy. Conditional activation of a constitutively active oncogenic Nras (NrasG12D/G12D) in murine hematopoietic cells promotes an acute myeloproliferative neoplasm (MPN) that recapitulates many features of JMML and MP-CMML. We found that NrasG12D/G12D-expressing HSCs, which serve as JMML/MP-CMML–initiating cells, show strong hyperactivation of ERK1/2, promoting hyperproliferation and depletion of HSCs and expansion of downstream progenitors. Inhibition of the MEK pathway alone prolonged the presence of NrasG12D/G12D-expressing HSCs but failed to restore their proper function. Consequently, approximately 60% of NrasG12D/G12D mice treated with MEK inhibitor alone died within 20 weeks, and the remaining animals continued to display JMML/MP-CMML–like phenotypes. In contrast, combined inhibition of MEK and JAK/STAT signaling, which is commonly hyperactivated in human and mouse CMML, potently inhibited human and mouse CMML cell growth in vitro, rescued mutant NrasG12D/G12D-expressing HSC function in vivo, and promoted long-term survival without evident disease manifestation in NrasG12D/G12D animals. These results provide a strong rationale for further exploration of combined targeting of MEK/ERK and JAK/STAT in treating patients with JMML and MP-CMML.

Authors

Guangyao Kong, Mark Wunderlich, David Yang, Erik A. Ranheim, Ken H. Young, Jinyong Wang, Yuan-I Chang, Juan Du, Yangang Liu, Sin Ruow Tey, Xinmin Zhang, Mark Juckett, Ryan Mattison, Alisa Damnernsawad, Jingfang Zhang, James C. Mulloy, Jing Zhang

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RASA1 functions in EPHB4 signaling pathway to suppress endothelial mTORC1 activity
Jun Kawasaki, … , Steven J. Fishman, Joanne Chan
Jun Kawasaki, … , Steven J. Fishman, Joanne Chan
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2774-2784. https://doi.org/10.1172/JCI67084.
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RASA1 functions in EPHB4 signaling pathway to suppress endothelial mTORC1 activity

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Abstract

Vascular malformations are linked to mutations in RAS p21 protein activator 1 (RASA1, also known as p120RasGAP); however, due to the global expression of this gene, it is unclear how these mutations specifically affect the vasculature. Here, we tested the hypothesis that RASA1 performs a critical effector function downstream of the endothelial receptor EPHB4. In zebrafish models, we found that either RASA1 or EPHB4 deficiency induced strikingly similar abnormalities in blood vessel formation and function. Expression of WT EPHB4 receptor or engineered receptors with altered RASA1 binding revealed that the ability of EPHB4 to recruit RASA1 is required to restore blood flow in EPHB4-deficient animals. Analysis of EPHB4-deficient zebrafish tissue lysates revealed that mTORC1 is robustly overactivated, and pharmacological inhibition of mTORC1 in these animals rescued both vessel structure and function. Furthermore, overexpression of mTORC1 in endothelial cells exacerbated vascular phenotypes in animals with reduced EPHB4 or RASA1, suggesting a functional EPHB4/RASA1/mTORC1 signaling axis in endothelial cells. Tissue samples from patients with arteriovenous malformations displayed strong endothelial phospho-S6 staining, indicating increased mTORC1 activity. These results indicate that deregulation of EPHB4/RASA1/mTORC1 signaling in endothelial cells promotes vascular malformation and suggest that mTORC1 inhibitors, many of which are approved for the treatment of certain cancers, should be further explored as a potential strategy to treat patients with vascular malformations.

Authors

Jun Kawasaki, Sandrine Aegerter, R. Dawn Fevurly, Akiko Mammoto, Tadanori Mammoto, Mustafa Sahin, John D. Mably, Steven J. Fishman, Joanne Chan

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Epac1-dependent phospholamban phosphorylation mediates the cardiac response to stresses
Satoshi Okumura, … , Hikaru Tanaka, Yoshihiro Ishikawa
Satoshi Okumura, … , Hikaru Tanaka, Yoshihiro Ishikawa
Published April 24, 2014
Citation Information: J Clin Invest. 2014;124(6):2785-2801. https://doi.org/10.1172/JCI64784.
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Epac1-dependent phospholamban phosphorylation mediates the cardiac response to stresses

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Abstract

PKA phosphorylates multiple molecules involved in calcium (Ca2+) handling in cardiac myocytes and is considered to be the predominant regulator of β-adrenergic receptor–mediated enhancement of cardiac contractility; however, recent identification of exchange protein activated by cAMP (EPAC), which is independently activated by cAMP, has challenged this paradigm. Mice lacking Epac1 (Epac1 KO) exhibited decreased cardiac contractility with reduced phospholamban (PLN) phosphorylation at serine-16, the major PKA-mediated phosphorylation site. In Epac1 KO mice, intracellular Ca2+ storage and the magnitude of Ca2+ movement were decreased; however, PKA expression remained unchanged, and activation of PKA with isoproterenol improved cardiac contractility. In contrast, direct activation of EPAC in cardiomyocytes led to increased PLN phosphorylation at serine-16, which was dependent on PLC and PKCε. Importantly, Epac1 deletion protected the heart from various stresses, while Epac2 deletion was not protective. Compared with WT mice, aortic banding induced a similar degree of cardiac hypertrophy in Epac1 KO; however, lack of Epac1 prevented subsequent cardiac dysfunction as a result of decreased cardiac myocyte apoptosis and fibrosis. Similarly, Epac1 KO animals showed resistance to isoproterenol- and aging-induced cardiomyopathy and attenuation of arrhythmogenic activity. These data support Epac1 as an important regulator of PKA-independent PLN phosphorylation and indicate that Epac1 regulates cardiac responsiveness to various stresses.

Authors

Satoshi Okumura, Takayuki Fujita, Wenqian Cai, Meihua Jin, Iyuki Namekata, Yasumasa Mototani, Huiling Jin, Yoshiki Ohnuki, Yayoi Tsuneoka, Reiko Kurotani, Kenji Suita, Yuko Kawakami, Shogo Hamaguchi, Takaya Abe, Hiroshi Kiyonari, Takashi Tsunematsu, Yunzhe Bai, Sayaka Suzuki, Yuko Hidaka, Masanari Umemura, Yasuhiro Ichikawa, Utako Yokoyama, Motohiko Sato, Fumio Ishikawa, Hiroko Izumi-Nakaseko, Satomi Adachi-Akahane, Hikaru Tanaka, Yoshihiro Ishikawa

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Early microbial translocation blockade reduces SIV-mediated inflammation and viral replication
Jan Kristoff, … , Cristian Apetrei, Ivona Pandrea
Jan Kristoff, … , Cristian Apetrei, Ivona Pandrea
Published May 16, 2014
Citation Information: J Clin Invest. 2014;124(6):2802-2806. https://doi.org/10.1172/JCI75090.
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Early microbial translocation blockade reduces SIV-mediated inflammation and viral replication

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Abstract

Damage to the intestinal mucosa results in the translocation of microbes from the intestinal lumen into the circulation. Microbial translocation has been proposed to trigger immune activation, inflammation, and coagulopathy, all of which are key factors that drive HIV disease progression and non-HIV comorbidities; however, direct proof of a causal link is still lacking. Here, we have demonstrated that treatment of acutely SIV-infected pigtailed macaques with the drug sevelamer, which binds microbial lipopolysaccharide in the gut, dramatically reduces immune activation and inflammation and slightly reduces viral replication. Furthermore, sevelamer administration reduced coagulation biomarkers, confirming the contribution of microbial translocation in the development of cardiovascular comorbidities in SIV-infected nonhuman primates. Together, our data suggest that early control of microbial translocation may improve the outcome of HIV infection and limit noninfectious comorbidities associated with AIDS.

Authors

Jan Kristoff, George Haret-Richter, Dongzhu Ma, Ruy M. Ribeiro, Cuiling Xu, Elaine Cornell, Jennifer L. Stock, Tianyu He, Adam D. Mobley, Samantha Ross, Anita Trichel, Cara Wilson, Russell Tracy, Alan Landay, Cristian Apetrei, Ivona Pandrea

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Retraction
The IL-12Rβ2 gene functions as a tumor suppressor in human B cell malignancies
Irma Airoldi, … , Alberto Amadori, Vito Pistoia
Irma Airoldi, … , Alberto Amadori, Vito Pistoia
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2807-2807. https://doi.org/10.1172/JCI76855.
View: Text | PDF | Amended Article

The IL-12Rβ2 gene functions as a tumor suppressor in human B cell malignancies

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Abstract

Authors

Irma Airoldi, Emma Di Carlo, Barbara Banelli, Lidia Moserle, Claudia Cocco, Annalisa Pezzolo, Carlo Sorrentino, Edoardo Rossi, Massimo Romani, Alberto Amadori, Vito Pistoia

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Expression of concern
Equilibrative nucleoside transporter 1 (ENT1) regulates postischemic blood flow during acute kidney injury in mice
Almut Grenz, … , Michail Sitkovsky, Holger K. Eltzschig
Almut Grenz, … , Michail Sitkovsky, Holger K. Eltzschig
Published May 8, 2014
Citation Information: J Clin Invest. 2014;124(6):2807-2807. https://doi.org/10.1172/JCI76888.
View: Text | PDF | Amended Article

Equilibrative nucleoside transporter 1 (ENT1) regulates postischemic blood flow during acute kidney injury in mice

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Abstract

Authors

Almut Grenz, Jessica D. Bauerle, Julee H. Dalton, Douglas Ridyard, Alexander Badulak, Eunyoung Tak, Eóin N. McNamee, Eric Clambey, Radu Moldovan, German Reyes, Jost Klawitter, Kelly Ambler, Kristann Magee, Uwe Christians, Kelley S. Brodsky, Katya Ravid, Doo-Sup Choi, Jiaming Wen, Dmitriy Lukashev, Michael R. Blackburn, Hartmut Osswald, Imogen R. Coe, Bernd Nürnberg, Volker H. Haase, Yang Xia, Michail Sitkovsky, Holger K. Eltzschig

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Corrigenda
Disrupted cortical function underlies behavior dysfunction due to social isolation
Tomoyuki Miyazaki, … , Roberto Malinow, Takuya Takahashi
Tomoyuki Miyazaki, … , Roberto Malinow, Takuya Takahashi
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2807-2807. https://doi.org/10.1172/JCI76901.
View: Text | PDF | Amended Article

Disrupted cortical function underlies behavior dysfunction due to social isolation

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Abstract

Authors

Tomoyuki Miyazaki, Kenkichi Takase, Waki Nakajima, Hirobumi Tada, Daisuke Ohya, Akane Sano, Takahisa Goto, Hajime Hirase, Roberto Malinow, Takuya Takahashi

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Sympathetic activity–associated periodic repolarization dynamics predict mortality following myocardial infarction
Konstantinos D. Rizas, … , Georg Schmidt, Axel Bauer
Konstantinos D. Rizas, … , Georg Schmidt, Axel Bauer
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2808-2808. https://doi.org/10.1172/JCI76791.
View: Text | PDF | Amended Article

Sympathetic activity–associated periodic repolarization dynamics predict mortality following myocardial infarction

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Abstract

Authors

Konstantinos D. Rizas, Tuomo Nieminen, Petra Barthel, Christine S. Zürn, Mika Kähönen, Jari Viik, Terho Lehtimäki, Kjell Nikus, Christian Eick, Tim O. Greiner, Hans P. Wendel, Peter Seizer, Jürgen Schreieck, Meinrad Gawaz, Georg Schmidt, Axel Bauer

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A spastic paraplegia mouse model reveals REEP1-dependent ER shaping
Christian Beetz, … , Britta Qualmann, Christian A. Hübner
Christian Beetz, … , Britta Qualmann, Christian A. Hübner
Published June 2, 2014
Citation Information: J Clin Invest. 2014;124(6):2809-2809. https://doi.org/10.1172/JCI76634.
View: Text | PDF | Amended Article

A spastic paraplegia mouse model reveals REEP1-dependent ER shaping

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Abstract

Authors

Christian Beetz, Nicole Koch, Mukhran Khundadze, Geraldine Zimmer, Sandor Nietzsche, Nicole Hertel, Antje-Kathrin Huebner, Rizwan Mumtaz, Michaela Schweizer, Elisabeth Dirren, Kathrin N. Karle, Andrey Irintchev, Victoria Alvarez, Christoph Redies, Martin Westermann, Ingo Kurth, Thomas Deufel, Michael M. Kessels, Britta Qualmann, Christian A. Hübner

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