Hippocampal overexpression of NOS1AP promotes endophenotypes related to mental disorders.

BACKGROUND Nitric oxide synthase 1 adaptor protein (NOS1AP; previously named CAPON) is linked to the glutamatergic postsynaptic density through interaction with neuronal nitric oxide synthase (nNOS). NOS1AP and its interaction with nNOS have been associated with several mental disorders. Despite the high levels of NOS1AP expression in the hippocampus and the relevance of this brain region in glutamatergic signalling as well as mental disorders, a potential role of hippocampal NOS1AP in the pathophysiology of these disorders has not been investigated yet. METHODS To uncover the function of NOS1AP in hippocampus, we made use of recombinant adeno-associated viruses to overexpress murine full-length NOS1AP or the NOS1AP carboxyterminus in the hippocampus of mice. We investigated these mice for changes in gene expression, neuronal morphology, and relevant behavioural phenotypes. FINDINGS We found that hippocampal overexpression of NOS1AP markedly increased the interaction of nNOS with PSD-95, reduced dendritic spine density, and changed dendritic spine morphology at CA1 synapses. At the behavioural level, we observed an impairment in social memory and decreased spatial working memory capacity. INTERPRETATION Our data provide a mechanistic explanation for a highly selective and specific contribution of hippocampal NOS1AP and its interaction with the glutamatergic postsynaptic density to cross-disorder pathophysiology. Our findings allude to therapeutic relevance due to the druggability of this molecule. FUNDING This study was funded in part by the DFG, the BMBF, the Academy of Finland, the NIH, the Japanese Society of Clinical Neuropsychopharmacology, the Ministry of Education of the Russian Federation, and the European Community

Der Einfluss von PDZ Interaktionen der neuronalen Stickstoffmonoxidsynthase (NOS-I) auf neuropsychiatrische Störungen

Neuronal nitric oxide (NO) synthase (NOS-I) and its adaptor protein (NOS1AP) have been repeatedly and consistently associated with neuropsychiatric disorders in several genetic association and linkage studies, as well as functional studies. NOS-I has an extended PDZ domain which enables it to interact with postsynaptic density protein 95 (PSD-95) bringing NOS-I in close proximity to NMDA receptors. This interaction allows NMDA receptor activity dependent calcium-influx to activate NOS-I, linking NO synthesis to regulation of glutamatergic signaling pathways. NOS1AP is a PDZ-domain ligand of NOS-I and has been proposed to compete with PSD-95 for NOS-I interaction. Studies performed on post-mortem brain tissues have shown increased expression of NOS1AP in patients with schizophrenia and bipolar disorder, suggesting that increased NOS-I/NOS1AP interactions might be involved in neuropsychiatric disorders possibly through disruption of NOS-I PDZ interactions. Therefore, I have investigated the involvement of NOS-I in different endophenotypes of neuropsychiatric disorders by targeting its specific PDZ interactions in vitro and in vivo. To this end, I used recombinant adeno-associated virus (rAAV) vectors expressing NOS1AP isoforms/domains (NOS1AP-L: full length NOS1AP; NOS1AP-LC20: the last 20 amino acids of NOS1AP-L, containing the PDZ interaction motif suggested to stabilize interaction with NOS-I; NOS1AP-LΔC20: NOS1AP-L lacking the last 20 amino acids; NOS1AP-S: the short isoform of NOS1AP), residues 396-503 of NOS1AP-L (NOS1AP396-503) encoding the full NOS-I interaction domain, and N-terminal 133 amino acids of NOS-I (NOS-I1-133) encoding for the extended PDZ-domain. Neuropsychiatric disorders involve morphological brain changes including altered dendritic development and spine plasticity. Hence, I have examined dendritic morphology in primary cultured hippocampal and cortical neurons upon overexpression of constructed rAAV vectors. Sholl analysis revealed that overexpression of NOS1AP-L and NOS1AP-LΔC20 mildly reduced dendritic length/branching. Moreover, overexpression of all NOS1AP isoforms/domains resulted in highly altered spine plasticity including significant reduction in the number of mature spines and increased growth of filopodia. These findings suggest that NOS1AP affects dendritic growth and development of dendritic spines, which may involve both, increased NOS-I/NOS1AP interaction as well as interaction of NOS1AP with proteins other than NOS-I. Interestingly, the observed alterations in dendritic morphology were reminiscent of those observed in post-mortem brains of patients with neuropsychiatric disorders. Given the dendritic alterations in vitro, I have examined, whether disruption of NOS-I PDZ interaction would also result in behavioral deficits associated with neuropsychiatric disorders. To this end, rAAV vectors expressing NOS1AP-L, NOS1AP396-503, NOS-I1-133, and mCherry were stereotaxically delivered to the dorsal hippocampus of 6-week-old male C57Bl/6J mice. One week after surgery, mice were randomly separated into two groups. One of those groups underwent three weeks of chronic mild stress (CMS). Afterwards all mice were subjected to a comprehensive behavioral analysis. The findings revealed that overexpression of the constructs did not result in phenotypes related to anxiety or depression, though CMS had an anxiolytic effect independent of the injected construct. Mice overexpressing NOS-I1-133, previously shown to disrupt NOS-I/PSD-95 interaction, showed impaired spatial memory, sensorimotor gating, social interaction, and increased locomotor activity. NOS1AP overexpressing mice showed mild impairments in sensorimotor gating and spatial working memory and severely impaired social interaction. NOS1AP396-503 overexpressing mice also showed impaired social interaction but enhanced sensorimotor gating and reduced locomotor activity. Taken together, these behavioral findings indicate an involvement of NOS-I PDZ interactions in phenotypes associated with positive symptoms and cognitive deficits of psychotic disorders. In summary, this study revealed an important contribution of NOS-I protein interactions in the development of endophenotypic traits of neuropsychiatric disorders, in particular schizophrenia, at morphological and behavioral levels. These findings might eventually aid to a better understanding of NOS-I-dependent psychopathogenesis, and to develop pharmacologically relevant treatment strategies.Die neuronal Stickstoffmonoxid(NO)synthase (NOS-I) und deren Adapterprotein (NOS1AP) wurden in mehreren Genassoziations- und Genkopplungsstudien, sowie funktionellen Studien, wiederholt und konsistent mit neuropsychiatrischen Störungen assoziiert. NOS-I trägt eine erweiterte PDZ Domäne, die eine Interaktion mit postsynaptic density protein 95 (PSD-95) ermöglicht und es in die Nähe von NMDA Rezeptoren bringt. Diese Interaktion erlaubt es NMDA Rezeptoraktivitätsabhängigen Kalziumeinstrom NOS-I zu aktivieren, was die Synthese von NO an die Regulierung glutamaterger Signalwege koppelt. NOS1AP ist ein Ligand der NOS-I PDZ Domäne und NOS1AP kompetiert mit PSD-95 um die Bindung mit NOS-I. Post mortem Untersuchungen zeigten eine erhöhte Expression von NOS1AP im Gehirn von Patienten mit Schizophrenie und bipolarer Störung, was eine erhöhte NOS-I/NOS1AP Interaktion (was möglicherweise zu gestörter NOS-I PDZ Interaktion führt) mit neuropsychiatrischen Störungen verbindet. Daher habe ich den Einfluss von NOS-I auf Endophänotypen neuropsychiatrischer Störungen untersucht, indem ich spezifische PDZ Interaktionen von NOS-I in vitro und in vivo gestört habe. Dazu verwendete ich rekombinante Adenoassozierte virale (rAAV) Vektoren, die NOS1AP Isoformen/Domänen (NOS1AP-L: Volllänge NOS1AP; NOS1AP-LC20: Die letzten 20 Aminosäuren von NOS1AP-L, welche das PDZ Interaktionsmotiv enthalten, das zur Stabilisierung der Interaktion mit NOS-I beiträgt; NOS1AP-LΔC20: NOS1AP-L dessen letzte 20 Aminosäuren fehlen; NOS1AP-S: die Kurzform von NOS1AP), Aminosäurereste 396-503 von NOS1AP-L (NOS1AP396-503), welche die volle NOS-I Interaktionsdomäne kodieren, und die N-terminalen 133 Aminosäuren von NOS-I (NOS-I1-133), welche die erweiterte PDZ Domäne enthalten. Bei neuropsychiatrischen Störungen kommt es zu morphologischen Änderungen des Gehirns, einschließlich veränderter dendritischer Entwicklung und Plastizität dendritischer Dornfortsätze (‚spines‘). Daher habe ich die dendritische Morphologie in primär kultivierten Hippokampal- und Kortikalneuronen nach Überexpression der konstruierten rAAV Vektoren untersucht. Eine Sholl Analyse ergab dabei, dass die Überexpression von NOS1AP-L und NOS1AP-LΔC20 die Länge und Anzahl dendritscher Verzweigungen leicht reduzierte. Zudem führte die Überexpression aller NOS1AP Isoformen/Domänen zu einer stark veränderten Plastizität dendritischer ‚spines‘, einschließlich einer signifikanten Reduktion der Anzahl ausgereifter ‚spines‘ und einem erhöhten Wachstum von Filopodien. Diese Ergebnisse zeigen, dass NOS1AP einen Einfluss auf das dendritische Wachstum und die Entwicklung dendritischer ‚spines‘ hat, dem sowohl eine erhöhte NOS-I/NOS1AP Interaktion, sowie Interaktionen von NOS1AP mit anderen Proteinen zugrunde liegen könnten. Interessanterweise, ähnelten die beobachteten Veränderungen solchen, die in post mortem Gehirnen von Patienten mit neuropsychiatrischen Störungen beobachtet wurden. Aufgrund der Beobachtungen in vitro, habe ich untersucht, ob eine Störung der NOS-I PDZ Interaktion auch zu Verhaltensdefiziten, die mit neuropsychiatrischen Störungen assoziiert sind, führt. Zu diesem Zweck, wurden rAAV Vektoren, die NOS1AP-L, NOS1AP396-503, NOS-I1-133,und mCherry exprimieren, stereotaxisch in den dorsalen Hippokampus von sechs Wochen alten männlichen C57Bl/6J Mäusen injiziert. Eine Woche nach der Operation wurden die Mäuse zufällig in zwei Gruppen aufgeteilt. Eine dieser Gruppen wurde für drei Wochen dem ‚chronic mild stress‘(CMS) Paradigma unterzogen. Im Anschluss daran wurden alle Mäuse einer umfassenden Verhaltensanalyse unterzogen. Die Ergebnisse zeigten, dass die Überexpression der Konstrukte nicht zu Angst- oder Depressionsassoziierten Phänotypen führten. Jedoch hatte das CMS Paradigma einen anxiolytischen Effekt, der unabhängig vom injizierten Konstrukt war. Eine Überexpression des NOS-I1-133 Konstruktes, von welchem zuvor eine Störung der NOS-I/PSD-95 Interaktion nachgewiesen wurde, führte zu Störungen des räumlichen Kurzzeitgedächtnisses, der Reaktionsunterdrückung (‚sensorimotor gating‘) und der sozialen Interaktion, sowie zu erhöhter lokomotorischer Aktivität. NOS1AP überexprimierende Mäuse zeigten leichte Störungen in der Reaktionsunterdrückung und des räumlichen Kurzzeitgedächtnisses, sowie erheblich gestörte soziale Interaktionen. NOS1AP396-503 überexprimierende Mäuse zeigten ebenfalls gestörte soziale Interaktion, jedoch eine erhöhte Reaktionsunterdrückung und verminderte lokomotorische Aktivität. Zusammengenommen, deuten diese Verhaltensuntersuchungen auf einen Beitrag der NOS-I PDZ Interaktionen zu Phänotypen, die mit positiven Symptomen und kognitiven Defiziten bei Psychosen assoziiert sind, hin. Zusammengefasst konnte diese Studie einen wichtigen Beitrag der NOS-I Proteininteraktionen bei der Entstehung endophenotypischer Züge (morphologisch sowie im Verhalten) neuropsychiatrischer Störungen, insbesondere der Schizophrenie, aufzeigen. Diese Erkenntnisse könnten zu einem besseren Verständnis NOS-I abhängiger Psychopathogenese, sowie zur Entwicklung relevanter pharmakologischer Behandlungsstrategien führen

Involvement of Neuronal Nitric Oxide Synthase (NOS-I) PDZ Interactions in Neuropsychiatric Disorders

Neuronal nitric oxide (NO) synthase (NOS-I) and its adaptor protein (NOS1AP) have been repeatedly and consistently associated with neuropsychiatric disorders in several genetic association and linkage studies, as well as functional studies. NOS-I has an extended PDZ domain which enables it to interact with postsynaptic density protein 95 (PSD-95) bringing NOS-I in close proximity to NMDA receptors. This interaction allows NMDA receptor activity dependent calcium-influx to activate NOS-I, linking NO synthesis to regulation of glutamatergic signaling pathways. NOS1AP is a PDZ-domain ligand of NOS-I and has been proposed to compete with PSD-95 for NOS-I interaction. Studies performed on post-mortem brain tissues have shown increased expression of NOS1AP in patients with schizophrenia and bipolar disorder, suggesting that increased NOS-I/NOS1AP interactions might be involved in neuropsychiatric disorders possibly through disruption of NOS-I PDZ interactions. Therefore, I have investigated the involvement of NOS-I in different endophenotypes of neuropsychiatric disorders by targeting its specific PDZ interactions in vitro and in vivo. To this end, I used recombinant adeno-associated virus (rAAV) vectors expressing NOS1AP isoforms/domains (NOS1AP-L: full length NOS1AP; NOS1AP-LC20: the last 20 amino acids of NOS1AP-L, containing the PDZ interaction motif suggested to stabilize interaction with NOS-I; NOS1AP-LΔC20: NOS1AP-L lacking the last 20 amino acids; NOS1AP-S: the short isoform of NOS1AP), residues 396-503 of NOS1AP-L (NOS1AP396-503) encoding the full NOS-I interaction domain, and N-terminal 133 amino acids of NOS-I (NOS-I1-133) encoding for the extended PDZ-domain. Neuropsychiatric disorders involve morphological brain changes including altered dendritic development and spine plasticity. Hence, I have examined dendritic morphology in primary cultured hippocampal and cortical neurons upon overexpression of constructed rAAV vectors. Sholl analysis revealed that overexpression of NOS1AP-L and NOS1AP-LΔC20 mildly reduced dendritic length/branching. Moreover, overexpression of all NOS1AP isoforms/domains resulted in highly altered spine plasticity including significant reduction in the number of mature spines and increased growth of filopodia. These findings suggest that NOS1AP affects dendritic growth and development of dendritic spines, which may involve both, increased NOS-I/NOS1AP interaction as well as interaction of NOS1AP with proteins other than NOS-I. Interestingly, the observed alterations in dendritic morphology were reminiscent of those observed in post-mortem brains of patients with neuropsychiatric disorders. Given the dendritic alterations in vitro, I have examined, whether disruption of NOS-I PDZ interaction would also result in behavioral deficits associated with neuropsychiatric disorders. To this end, rAAV vectors expressing NOS1AP-L, NOS1AP396-503, NOS-I1-133, and mCherry were stereotaxically delivered to the dorsal hippocampus of 6-week-old male C57Bl/6J mice. One week after surgery, mice were randomly separated into two groups. One of those groups underwent three weeks of chronic mild stress (CMS). Afterwards all mice were subjected to a comprehensive behavioral analysis. The findings revealed that overexpression of the constructs did not result in phenotypes related to anxiety or depression, though CMS had an anxiolytic effect independent of the injected construct. Mice overexpressing NOS-I1-133, previously shown to disrupt NOS-I/PSD-95 interaction, showed impaired spatial memory, sensorimotor gating, social interaction, and increased locomotor activity. NOS1AP overexpressing mice showed mild impairments in sensorimotor gating and spatial working memory and severely impaired social interaction. NOS1AP396-503 overexpressing mice also showed impaired social interaction but enhanced sensorimotor gating and reduced locomotor activity. Taken together, these behavioral findings indicate an involvement of NOS-I PDZ interactions in phenotypes associated with positive symptoms and cognitive deficits of psychotic disorders. In summary, this study revealed an important contribution of NOS-I protein interactions in the development of endophenotypic traits of neuropsychiatric disorders, in particular schizophrenia, at morphological and behavioral levels. These findings might eventually aid to a better understanding of NOS-I-dependent psychopathogenesis, and to develop pharmacologically relevant treatment strategies

Thorax computed tomography (CTX) guided ground truth annotation of CHEST radiographs (CXR) for improved classification and detection of COVID-19

Several data sets have been collected and various artificial intelligence models have been developed for COVID-19 classification and detection from both chest radiography (CXR) and thorax computed tomography (CTX) images. However, the pitfalls and shortcomings of these systems significantly limit their clinical use. In this respect, improving the weaknesses of advanced models can be very effective besides developing new ones. The inability to diagnose ground-glass opacities by conventional CXR has limited the use of this modality in the diagnostic work-up of COVID-19. In our study, we investigated whether we could increase the diagnostic efficiency by collecting a novel CXR data set, which contains pneumonic regions that are not visible to the experts and can only be annotated under CTX guidance. We develop an ensemble methodology of well-established deep CXR models for this new data set and develop a machine learning-based non-maximum suppression strategy to boost the performance for challenging CXR images. CTX and CXR images of 379 patients who applied to our hospital with suspected COVID-19 were evaluated with consensus by seven radiologists. Among these, CXR images of 161 patients who also have had a CTX examination on the same day or until the day before or after and whose CTX findings are compatible with COVID-19 pneumonia, are selected for annotating. CTX images are arranged in the main section passing through the anterior, middle, and posterior according to the sagittal plane with the reformed maximum intensity projection (MIP) method in the coronal plane. Based on the analysis of coronal MIP reconstructed CTX images, the regions corresponding to the pneumonia foci are annotated manually in CXR images. Radiologically classified posterior to anterior (PA) CXR of 218 patients with negative thorax CTX imaging were classified as COVID-19 pneumonia negative group. Accordingly, we have collected a new data set using anonymized CXR (JPEG) and CT (DICOM) images, where the PA CXRs contain pneumonic regions that are hidden or not easily recognized and annotated under CTX guidance. The reference finding was the presence of pneumonic infiltration consistent with COVID-19 on chest CTX examination. COVID-Net, a specially designed convolutional neural network, was used to detect cases of COVID-19 among CXRs. Diagnostic performances were evaluated by ROC analysis by applying six COVID-Net variants (COVIDNet-CXR3-A, -B, -C/COVIDNet-CXR4-A, -B, -C) to the defined data set and combining these models in various ways via ensemble strategies. Finally, a convex optimization strategy is carried out to find the outperforming weighted ensemble of individual models. The mean age of 161 patients with pneumonia was 49.31 ± 15.12, and the median age was 48 years. The mean age of 218 patients without signs of pneumonia in thorax CTX examination was 40.04 ± 14.46, and the median was 38. When working with different combinations of COVID-Net's six variants, the area under the curve (AUC) using the ensemble COVID-Net CXR 4A-4B-3C was.78, sensitivity 67%, specificity 95%; COVID-Net CXR 4a-3b-3c was.79, sensitivity 69% and specificity 94%. When diverse and complementary COVID-Net models are used together through an ensemble, it has been determined that the AUC values are close to other studies, and the specificity is significantly higher than other studies in the literature