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PTH1R Mutants Found in Patients with Primary Failure of Tooth Eruption Disrupt G-Protein Signaling
(2016)
Aim
Primary failure of tooth eruption (PFE) is causally linked to heterozygous mutations of the parathyroid hormone receptor (PTH1R) gene. The mutants described so far lead to exchange of amino acids or truncation of the protein that may result in structural changes of the expressed PTH1R. However, functional effects of these mutations have not been investigated yet.
Materials and Methods
In HEK293 cells, PTH1R wild type was co-transfected with selected PTH1R mutants identified in patients with PFE. The effects on activation of PTH-regulated intracellular signaling pathways were analyzed by ELISA and Western immunoblotting. Differential effects of wild type and mutated PTH1R on TRESK ion channel regulation were analyzed by electrophysiological recordings in Xenopus laevis oocytes.
Results
In HEK293 cells, activation of PTH1R wild type increases cAMP and in response activates cAMP-stimulated protein kinase as detected by phosphorylation of the vasodilator stimulated phosphoprotein (VASP). In contrast, the PTH1R mutants are functionally inactive and mutant PTH1R/Gly452Glu has a dominant negative effect on the signaling of PTH1R wild type. Confocal imaging revealed that wild type PTH1R is expressed on the cell surface, whereas PTH1R/Gly452Glu mutant is mostly retained inside the cell. Furthermore, in contrast to wild type PTH1R which substantially augmented K+ currents of TRESK channels, coupling of mutated PTH1R to TRESK channels was completely abolished.
Conclusions
PTH1R mutations affect intracellular PTH-regulated signaling in vitro. In patients with primary failure of tooth eruption defective signaling of PTH1R mutations is suggested to occur in dento-alveolar cells and thus may lead to impaired tooth movement.
This thesis focuses on the investigation of the electronic structure of amino acids and
salts in aqueous solution using X-ray spectroscopic methods. Both material groups are
of fundamental importance with regards to many physiological reactions, especially
for the Hofmeister effect which describes the solubility of proteins in salt solutions.
Hence, the investigation of the electronic structure of amino acids and the influence of
ions on the hydrogen bonding network of liquid water are important milestones to a
deeper understanding of the Hofmeister series.
Besides investigating the electronic structure of amino acids in aqueous solution,
the spectra were used to develop a building block model of the spectral fingerprints of
the functional groups and were compared to spectral signatures of suitable reference
molecules. In the framework of this thesis, it is shown that the building block approach
is a useful tool with allows the interpretation of spectral signatures of considerably
more complex molecules
In this work, the focus lies on the investigation of the occupied and unoccupied
electronic states of molecules in solid state, as well as in aqueous solution. Hereby,
different X-ray spectroscopic methods were applied. X-ray emission spectroscopy
(XES) was used to probe the occupied electronic structure of the solution, while the
unoccupied electronic structure was addressed by using X-ray absorption spectroscopy
(XAS). Finally, resonant inelastic X-ray scattering (RIXS) as a combination of XAS
and XES measurements provides the combined information about the unoccupied and
occupied molecular levels. The element specific character of the three measurement
methods is a feature which allows the investigation of the local electronic structure of
a single functional group. With RIXS, also non-equivalent atoms of the same element
can be addressed separately.
Within this thesis firstly, a library of the XE spectra of all 20 proteinogenic amino
acids in zwitterionic form is presented. From this sample-set XES fingerprints of
the protonated alpha-amino group NH3+ and the deprotonated carboxylic group COO- were evaluated and used to identify the XES fingerprints of the nitrogen and oxygen
containing functional groups of the side chains of the amino acids. The data is discussed
based on a building block approach. Furthermore, the XE spectra of the functional
groups of lysine and histidine, namely the NH2 group and the C3N2H4 ring structure,
are both compared to XE spectra of suitable reference molecules (imidazole, ammonia
and methylamine). It is found that the XE and RIXS spectra of the side chains of lysine
and histidine show large similarities to the XE spectra of the reference molecules. This
agreement in the XE and RIXS spectra allows a qualitative investigation of XE and
RIXS spectra of more complex amino acids using the XE and RIXS spectra of suitable
reference molecules.
The chemical structure of histidine and proline is quite different from the structures
of the other proteinogenic amino acids. Due to the unique chemical structure of
the side chain which in both cases consists of a heterocyclic ring structure, these two
amino acids were investigated in more detail. Zubavichus et al. [1] have shown that
amino acids are decomposing while exposed to X-ray radiation of the experiment. The
damage is irreversible and molecular fragments can adsorb on the membrane of the
experimental setup. This contamination can also create a spectral signature which
then overlaps with the signal of the solution and which complicates the interpretation
of the data. To record spectra which are free from contributions of adsorbed molecular
fragments on the membrane, the adsorption behavior was investigated.
In contrast to the solid phase in which the amino acids are present as salts in one
electronic conformation, the charge state of the amino acids can be manipulated in
aqueous solution by tuning the pH-value. By doing this, all possible charge states are
accessible (cation, anion, zwitterion). In this work it is shown that also the spectra
of the different charge states can be modeled by the spectra of suitable reference
molecules using the building block approach. The spectral changes occurring upon
protonation and deprotonation of the functional groups are explored and verified by
comparing them to theoretical calculations.
The comparison with measurements of pyrrolidine show that the electronic structure
which surrounds the nitrogen atom of proline is strongly influenced by the
ring structure of the side chain. Furthermore, the proline, pyrrolidine, and histidine
molecules are also degrading during the liquid sample measurements. This can be
observed by the detection of a new spectral component which increases with the
measurement time originating from the window membrane. In all cases, the speed of
the agglomeration of molecular fragments at the membrane was observed to be highly
sensitive to the pH value of the solution.
To understand the Hofmeister series, also the impact of the salt ions have to be
investigated. In this study the influence of potassium chloride (KCl) on the hydrogen
bond network of water was studied by using non-resonantly excited XES as well as
RIXS. A decreased dissociation of hydrogen molecules and changes in the molecular
vibrations could be detected. These changes were interpreted with a molecular
reorganization of the water molecules and a decreased number of hydrogen bonds.
Background
In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process.
Study design
This multi-center, prospective controlled study has a two-phase cohort design.
Methods
Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to the first visit to the CRD’s outpatient clinic (T0), at the first visit (T1) and 12 months thereafter (T2).
Outcomes
Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30% in standard care to 40% in the innovative dual expert cohort. Secondary outcomes are (a) time to diagnosis/diagnoses explaining the symptomatology; (b) proportion of patients successfully referred from CRD to standard care; (c) costs of diagnosis including incremental cost effectiveness ratios; (d) predictive value of screening instruments administered at T0 to identify patients with mental disorders; (e) patients’ quality of life and evaluation of care; and f) physicians’ satisfaction with the innovative care approach.
Conclusions
This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease.
Objective: To assess patterns and impact of small nerve fiber dysfunction and pathology in patients with fibromyalgia syndrome (FMS).
Methods: One hundred seventeen women with FMS underwent neurological examination, questionnaire assessment, neurophysiology assessment, and small fiber tests: skin punch biopsy, corneal confocal microscopy, microneurography, quantitative sensory testing including C-tactile afferents, and pain-related evoked potentials. Data were compared with those of women with major depressive disorder and chronic widespread pain (MD-P) and healthy women.
Results: Intraepidermal nerve fiber density (IENFD) was reduced at different biopsy sites in 63% of FMS patients (MDP: 10%, controls: 18%; p < 0.001 for each). We found 4 patterns of skin innervation in FMS: normal, distally reduced, proximally reduced, and both distally and proximally reduced (p < 0.01 for each compared to controls). Microneurography revealed initial activity-dependent acceleration of conduction velocity upon low frequencies of stimulation in 1A fibers, besides 1B fiber spontaneous activity and mechanical sensitization in FMS patients. FMS patients had elevated warm detection thresholds (p < 0.01), impaired C-tactile afferents (p < 0.05), and reduced amplitudes (p < 0.001) of pain-related evoked potentials compared to controls. Compared to FMS patients with normal skin innervation, those with generalized IENFD reduction had higher pain intensity and impairment due to pain, higher disease burden, more stabbing pain and paresthesias, and more anxiety (p < 0.05 for each). FMS patients with generalized IENFD reduction also had lower corneal nerve fiber density (p < 0.01) and length (p < 0.05).
Interpretation: The extent of small fiber pathology is related to symptom severity in FMS. This knowledge may have implications for the diagnostic classification and treatment of patients with FMS.
In our study, we aimed at investigating corneal langerhans cells (LC) in patients with fibromyalgia syndrome (FMS) and small fiber neuropathy (SFN) as potential contributors to corneal small fiber pathology. We enrolled women with FMS (n = 134) and SFN (n = 41) who underwent neurological examination, neurophysiology, prostaglandin analysis in tear fluid, and corneal confocal microscopy (CCM). Data were compared with those of 60 age‐matched female controls. After screening for dry eye disease, corneal LC were counted and sub‐classified as dendritic (dLC) and non‐dendritic (ndLC) cells with or without nerve fiber association. We further analyzed corneal nerve fiber density (CNFD), length (CNFL), and branch density (CNBD). Neurological examination indicated deficits of small fiber function in patients with SFN. Nerve conduction studies were normal in all participants. Dry eye disease was more prevalent in FMS (17%) and SFN (28%) patients than in controls (5%). Tear fluid prostaglandin levels did not differ between FMS patients and controls. While corneal LC density in FMS and SFN patients was not different from controls, there were fewer dLC in association with nerve fibers in FMS and SFN patients than in controls (P < .01 each). Compared to controls, CNFL was lower in FMS and SFN patients (P < .05 each), CNFD was lower only in FMS patients (P < .05), and CNBD was lower only in SFN patients (P < .001). There was no difference in any CCM parameter between patients with and without dry eyes. Our data indicate changes in corneal innervation and LC distribution in FMS and SFN, potentially based on altered LC signaling.
Idiopathic Parkinson’s disease (PD) is characterized by a progredient degeneration of the brain, starting at deep subcortical areas such as the dorsal motor nucleus of the glossopharyngeal and vagal nerves (DM) (stage 1), followed by the coeruleus–subcoeruleus complex; (stage 2), the substantia nigra (SN) (stage 3), the anteromedial temporal mesocortex (MC) (stage 4), high-order sensory association areas and prefrontal fields (HC) (stage 5) and finally first-order sensory association areas, premotor areas, as well as primary sensory and motor field (FC) (stage 6). Autoimmunity might play a role in PD pathogenesis. Here we analyzed whether anti-brain autoantibodies differentially recognize different human brain areas and identified autoantigens that correlate with the above-described dissemination of PD pathology in the brain. Brain tissue was obtained from deceased individuals with no history of neurological or psychiatric disease and no neuropathological abnormalities. Tissue homogenates from different brain regions (DM, SN, MC, HC, FC) were subjected to SDS-PAGE and Western blot. Blots were incubated with plasma samples from 30 PD patients and 30 control subjects and stained with anti-IgG antibodies to detect anti-brain autoantibodies. Signals were quantified. Prominent autoantigens were identified by 2D-gel-coupled mass spectrometry sequencing. Anti-brain autoantibodies are frequent and occur both in healthy controls and individuals with PD. Glial fibrillary acidic protein (GFAP) was identified as a prominent autoantigen recognized in all plasma samples. GFAP immunoreactivity was highest in DM areas and lowest in FC areas with no significant differences in anti-GFAP autoantibody titers between healthy controls and individuals with PD. The anti-GFAP autoimmunoreactivity of different brain areas correlates with the dissemination of histopathological neurodegeneration in PD. We hypothesize that GFAP autoantibodies are physiological but might be involved as a cofactor in PD pathogenesis secondary to a leakage of the blood–brain barrier.