Extending the honey bee venome with the antimicrobial peptide apidaecin and a protein resembling wasp antigen 5

Honey bee venom is a complex mixture of toxic proteins and peptides. In the present study we tried to extend our knowledge of the venom composition using two different approaches. First, worker venom was analysed by liquid chromatography-mass spectrometry and this revealed the antimicrobial peptide apidaecin for the first time in such samples. Its expression in the venom gland was confirmed by reverse transcription PCR and by a peptidomic analysis of the venom apparatus tissue. Second, genome mining revealed a list of proteins with resemblance to known insect allergens or venom toxins, one of which showed homology to proteins of the antigen 5 (Ag5)/Sol i 3 cluster. It was demonstrated that the honey bee Ag5-like gene is expressed by venom gland tissue of winter bees but not of summer bees. Besides this seasonal variation, it shows an interesting spatial expression pattern with additional production in the hypopharyngeal glands, the brains and the midgut. Finally, our immunoblot study revealed that both synthetic apidaecin and the Ag5-like recombinant from bacteria evoke no humoral activity in beekeepers. Also, no IgG4-based cross-reactivity was detected between the honey bee Ag5-like protein and its yellow jacket paralogue Ves v 5

Current Issues and Recent Advances in Pacemaker Therapy

Patients with implanted pacemakers or defibrillators are frequently encountered in various healthcare settings. As these devices may be responsible for, or contribute to a variety of clinically significant issues, familiarity with their function and potential complications facilitates patient management. This book reviews several clinically relevant issues and recent advances of pacemaker therapy: implantation, device follow-up and management of complications. Innovations and research on the frontiers of this technology are also discussed as they may have wider utilization in the future. The book should provide useful information for clinicians involved in the management of patients with implanted antiarrhythmia devices and researchers working in the field of cardiac implants

Closed-Loop Quantitative Verification of Rate-Adaptive Pacemakers

Rate-adaptive pacemakers are cardiac devices able to automatically adjust the pacing rate in patients with chronotropic incompetence, i.e. whose heart is unable to provide an adequate rate at increasing levels of physical, mental or emotional activity. These devices work by processing data from physiological sensors in order to detect the patient’s activity and update the pacing rate accordingly. Rate-adaptation parameters depend on many patient-specific factors, and effective personalisation of such treatments can only be achieved through extensive exercise testing, which is normally intolerable for a cardiac patient. In this work, we introduce a data-driven and model-based approach for the automated verification of rate-adaptive pacemakers and formal analysis of personalised treatments. To this purpose, we develop a novel dual-sensor pacemaker model where the adaptive rate is computed by blending information from an accelerometer, and a metabolic sensor based on the QT interval. Our approach enables personalisation through the estimation of heart model parameters from patient data (electrocardiogram), and closed-loop analysis through the online generation of synthetic, model-based QT intervals and acceleration signals. In addition to personalisation, we also support the derivation of models able to account for the varied characteristics of a virtual patient population, thus enabling safety verification of the device. To capture the probabilistic and non-linear dynamics of the heart, we define a probabilistic extension of timed I/O automata with data and employ statistical model checking for quantitative verification of rate modulation. We evaluate our rate-adaptive pacemaker design on three subjects and a pool of virtual patients, demonstrating the potential of our approach to provide rigorous, quantitative insights into the closed-loop behaviour of the device under different exercise levels and heart conditions

Studies on the dynamics of chaotic multi-wavelet reentrant propagation using a hybrid cellular automaton model of excitable tissue

There is a compelling body of evidence implicating continuous propagation (reentry) sustained by multiple meandering wavelets in the pathology of advanced human atrial fibrillation (AF). This forms the basis for many current therapies such as the Cox MAZE procedure and its derivatives, which aim to create non-conducting lesions in order to "transect" these circuits before they form. Nevertheless, our ability to successfully treat persistent and permanent AF using catheter ablation remains inadequate due to current limitations of clinical mapping technology as well as an incomplete understanding of how to place lesions in order to maximize circuit transection and, more importantly, minimize AF burden. Here, we used a hybrid cellular automaton model to study the dynamics of chaotic, multi-wavelet reentry (MWR) in excitable tissue. First, we used reentry as an exemplar to investigate a hysteretic disease mechanism in a multistable nonlinear system. We found that certain interactions with the environment can cause persistent changes to system behavior without altering its structure or properties, thus leading to a disconnect between clinical symptoms and the underlying state of disease. Second, we developed a novel analytical method to characterize the spatiotemporal dynamics of MWR. We identified a heterogeneous spatial distribution of reentrant pathways that correlated with the spatial distribution of cell activation frequencies. Third, we investigated the impact of topological and geometrical substrate alterations on the dynamics of MWR. We demonstrated a multi-phasic relationship between obstacle size and the fate of individual episodes. Notably, for a narrow range of sizes, obstacles appeared to play an active role in rapidly converting MWR to stable structural reentry. Our studies indicate that reentrant-pathway distributions are non-uniform in heterogeneous media (such as the atrial myocardium) and suggest a clinically measurable correlate for identifying regions of high circuit density, supporting the feasibility of patient-specific targeted ablation. Moreover, we have elucidated the key mechanisms of interaction between focal obstacles and MWR, which has implications for the use of spot ablation to treat AF as some recent studies have suggested

Calcium-mediated change in neuronal intrinsic excitability in weakly electric fish: biasing mechanisms of homeostatis for those of plasticity

textAlthough the processes used for temporarily storing and manipulating neural information have been extensively studied at the synaptic level far less attention has been given to the underlying cellular and molecular mechanisms that contribute to change in the intrinsic excitability of neurons. More importantly, how do these mechanisms of plasticity integrate with ongoing mechanisms of regulation of neural intrinsic excitability and, in turn, homeostasis of entire neural circuits? In this dissertation I describe the underlying mechanisms that contribute to persistent neural activity and, more globally, sensorimotor adaptation using weakly electric fish as my model system. Weakly electric fish have evolved a behavior adaptation known as the jamming avoidance response (JAR), and it is this adaptation that allows the organism to elevate its own electrical discharge in response to intraspecific interactions and subsequent distortions of the animal’s electric field. The elevation operates over a wide range and in vivo can last tens of hours upon cessation of a jamming stimulus. I demonstrate that the underlying mechanisms of the adaptation are mediated by calcium-dependent signaling in the pacemaker nucleus and that calcium-mediated phosphorylation plays an important role in the regulation of the long-term frequency elevation (LTFE). I demonstrate using an in vitro brain slice preparation from the weakly electric fish, Apteronotus leptorhynchus that the engram of memory formation depends on the cooperativity of calcium-dependent protein kinases and protein phosphatases. In addition, I show that the memory formation (in the form of LTFE) does not depend on the continued flux of calcium, but rather the phosphorylation events downstream of NMDA receptor activation. Moreover, I describe the differences in the expression of protein phosphatases and protein kinases as they relate to species-specific differences in sensorimotor adaptation. It is important to note that this is the first time that the cooperativity between different isoforms of protein kinase C (PKC) have been shown to play a role in graded long-term change in neuronal activity and, in turn, providing the neural basis of species-specific behavior. The neural adaptation of the electromotor system in weakly electric fish provides an excellent model system to study the underlying cellular and molecular events of vertebrate memory formation.Biological Sciences, School o

Decoding atrial fibrillation:Personalized identification and quantification of electropathology

Electrophysiological mapping-guided ablation strategies targeting atrial fibrillation (AF) have improved considerably over the past few years. However, it remains a major challenge to design effective strategies for particularly persistent AF. This can be partially explained by the inadequate understanding of the mechanisms and electropathological substrate underlying AF. Progression of AF is accompanied by structural and electrical remodeling, resulting in complex electrical conduction disorders, which is defined as electropathology. The severity of electropathology thus defines the stage of AF and is a major determinant of the effectiveness of AF therapy. In this thesis, features of electrophysiological properties of atrial tissue have been explored, developed and quantified during normal sinus rhythm, programmed electrical stimulation and AF. In addition, inter- and intra-individual variation in these quantified parameters has been examined in patients with and without prior episodes of AF. The most suitable objective parameters will aid in the identification of patients at risk for early onset or progression of AF. Part I of this thesis focusses on quantified electrogram features related to electropathology. In part II, abnormalities in wavefront propagation due to heterogeneous conduction properties were explored. Part III focusses on identification of post-operative AF and the relation with electropathology. In part IV of this thesis, some clinical implications of high-resolution mapping during cardiac surgery and application of quantified electrophysiological features are discussed

Dynamics in Biological Soft Materials

I present applications of imaging and spectroscopy to understand mechanical, chemical, and electrical dynamics in biological materials. The first part describes the development and characterization of a protein-based fluorescent calcium and voltage indicator (CaViar). The far-red fluorescence of CaViar faithfully tracks the cardiac action potential in cardiomyocytes. CaViar's green fluorescence reports the resulting calcium transients. I demonstrated the applicability of CaViar in vivo with transgenic zebrafish designed to express CaViar in their hearts. Spinning disk confocal imaging allowed detailed three-dimensional mapping of simultaneous voltage and calcium dynamics throughout the heart of zebrafish embryos, in vivo, as a function of developmental stage. I tested the effect of channel blockers on voltage and calcium dynamics and discovered a chamber-specific transition from a calcium-dependent to a sodium-dependent action potential. I also describe a new measurement technique using a fluorescent voltage indicator to report absolute voltage via the indicator's temporal response.Physic

An investigation into the effects of radiotherapy on implanted cardiac devices

Introduction The number of cancer patients with CIEDs presenting for radiotherapy treatment is increasing. Technological advances in CIEDs have now made them more sensitive to ionising radiation and electromagnetic interference (EMI) than older bipolar semiconductor devices. External beam radiotherapy has the potential to cause CIED malfunction, this might be temporary but nevertheless, could result in catastrophic failure of the cardiac conduction system of the heart. It is not possible to predict the exact behaviour of a CIED when it is within, or close to, the radiotherapy treatment field. Published literature is inconsistent in its findings regarding the safe levels of ionising radiation dose delivered to CIEDs. The aims of this research are to determine the effects of ionising radiation and electromagnetic interferences upon CIEDs and leads. Method This research will adopt an experimental approach to data collection, under laboratory conditions, when CIEDs and CIEDs leads are exposed to ionising radiation and EMI. Results The scientific arm of this research focused on the effect of ionising radiation and EMI on CIEDs and CIED leads. The results showed that CIEDs exhibited a range of temporary and permanent malfunctions when exposed to cumulative ionising ! iv! radiation doses ranging from 0.5Gy to 3Gy. Results also, recommend that CIED leads should not be in the treatment field however, if this is unavoidable the radiation dose should be kept as low as possible. All CIEDs exhibited an effect when exposed to EMI and it is recommended that all patients with CIEDs receiving radiotherapy treatment should be monitored when in the radiotherapy treatment room. Conclusion This research identifies how CIEDs are adversely affected by ionising radiation and / or EMI, how these effects can be minimised, provide safe radiotherapy tolerance doses to CIEDs and issue recommendations for the publication of national guidelines for the safe management of patients with CIEDs undergoing radiotherapy treatment