Dedifferentiation and redifferentiation of canine articular chondrocytes

Articular cartilage can be damaged directly through injury or osteoarthritis (OA). This tissue is very poor at regenerating itself due to its avascular nature and the immobility of chondrocytes within the tissue. There are a range of surgical techniques to repair cartilage lesions. Cellular therapies such Autologous Chondrocyte Implantation (ACI) and later modifications have been used to repair cartilage lesions for the past two decades. However, there is currently no completely successful treatment of cartilage lesions, with the newly generated cartilage often possessing very poor mechanical properties. Also, cell-based therapies require large numbers of chondrocytes which have to be expanded in monolayer. A consequence of this expansion is a loss of the chondrocyte phenotype (dedifferentiation). The overall aim of this thesis was to develop a greater understanding of chondrocyte dedifferentiation and redifferentiation in vitro using canine chondrocytes. Dogs can also suffer with OA and have been used extensively as a model for OA. Firstly, canine chondrocytes were expanded in monolayer up to P5 to confirm dedifferentiation. These cells were shown to have lost their typical chondrocytic phenotype through decreased expression of collagen type II and increased expression of collagen type I and CD44. A considerable part of this element of the thesis also involved identifying antibodies that would cross-react with the target canine antigens. The next aim of the thesis was to redifferentiate dedifferentiated chondrocytes through three-dimensional (3D) culture. Initial problems with high density pellet culture led to the selection of a supporting material. Alginate was chosen as it is a naturally occurring polymer which has previously been used to culture chondrocytes in 3D. After making several adjustments to the set-up and downstream analysis of the beads, chondrocytes from different passages were seeded into them. Alginate beads seeded with P2 chondrocytes appeared to contain cells with a more chondrocyte-like phenotype compared to P3- and P4-seeded beads. However, expression of collagen type I was still relatively high in P2-seeded beads, indicating 3D culture alone is not enough to induce complete redifferentiation. Therefore, the final aim of this thesis was to enhance the redifferentiation of dedifferentiated canine chondrocytes. Two initial conditions were selected; addition of 25μg/ml ascorbate to the culture medium and incubating the beads under reduced oxygen conditions (2.4%). Culturing the beads under reduced oxygen conditions (2.4%) appeared to enhance redifferentiation. However addition of ascorbate to the culture medium had mixed results. This culture system can now be further adapted and modified to better enhance chondrocyte redifferentiation. This work could include combining the two conditions already tested as well as adding growth factors to the culture medium. More successful maintenance of the chondrocyte phenotype in vitro, could potentially lead to better articular cartilage regeneration both in vitro and in vivo

Dedifferentiation and redifferentiation of canine articular chondrocytes

Articular cartilage can be damaged directly through injury or osteoarthritis (OA). This tissue is very poor at regenerating itself due to its avascular nature and the immobility of chondrocytes within the tissue. There are a range of surgical techniques to repair cartilage lesions. Cellular therapies such Autologous Chondrocyte Implantation (ACI) and later modifications have been used to repair cartilage lesions for the past two decades. However, there is currently no completely successful treatment of cartilage lesions, with the newly generated cartilage often possessing very poor mechanical properties. Also, cell-based therapies require large numbers of chondrocytes which have to be expanded in monolayer. A consequence of this expansion is a loss of the chondrocyte phenotype (dedifferentiation). The overall aim of this thesis was to develop a greater understanding of chondrocyte dedifferentiation and redifferentiation in vitro using canine chondrocytes. Dogs can also suffer with OA and have been used extensively as a model for OA. Firstly, canine chondrocytes were expanded in monolayer up to P5 to confirm dedifferentiation. These cells were shown to have lost their typical chondrocytic phenotype through decreased expression of collagen type II and increased expression of collagen type I and CD44. A considerable part of this element of the thesis also involved identifying antibodies that would cross-react with the target canine antigens. The next aim of the thesis was to redifferentiate dedifferentiated chondrocytes through three-dimensional (3D) culture. Initial problems with high density pellet culture led to the selection of a supporting material. Alginate was chosen as it is a naturally occurring polymer which has previously been used to culture chondrocytes in 3D. After making several adjustments to the set-up and downstream analysis of the beads, chondrocytes from different passages were seeded into them. Alginate beads seeded with P2 chondrocytes appeared to contain cells with a more chondrocyte-like phenotype compared to P3- and P4-seeded beads. However, expression of collagen type I was still relatively high in P2-seeded beads, indicating 3D culture alone is not enough to induce complete redifferentiation. Therefore, the final aim of this thesis was to enhance the redifferentiation of dedifferentiated canine chondrocytes. Two initial conditions were selected; addition of 25μg/ml ascorbate to the culture medium and incubating the beads under reduced oxygen conditions (2.4%). Culturing the beads under reduced oxygen conditions (2.4%) appeared to enhance redifferentiation. However addition of ascorbate to the culture medium had mixed results. This culture system can now be further adapted and modified to better enhance chondrocyte redifferentiation. This work could include combining the two conditions already tested as well as adding growth factors to the culture medium. More successful maintenance of the chondrocyte phenotype in vitro, could potentially lead to better articular cartilage regeneration both in vitro and in vivo

Comparison between the efficacy of neostigmine versus sugammadex reversal of rocuronium induced neuromuscular blockade in paediatric patients

A reversal agent is commonly given to improve neuromuscular function after intra-operative administration of non-depolarizing neuromuscular blocking agents. The administration of conventional reversal agent neostigmine is associated with many undesirable side effects. For almost a decade, a new novel drug sugammadex has been used to specifically antagonize the effect of aminosteroidal neuromuscular blocking agents.The aim of this study is to compare the recovery time, haemodynamic stability and complications between these 2 reversal agents in antagonizing the effects of rocuronium in the paediatric population. This was a prospective, double-blinded, randomized controlled trial involving 80 paediatric patients aged between 2-12 years old scheduled for surgery under general anaesthesia requiring rocuronium induced neuromuscular blockade.They were randomized equally into two groups, 40 patients each group for reversal with neostigmine or reversal with sugammadex. All patients were induced with sevoflurane, intravenous access obtained, then 2mcg/kg of fentanyl was administered. Neuromuscular function monitoring (acceleromyography) of the adductor pollicis muscle was done using train-of-four (TOF) method. TOF-Watch Sx was placed along the ulnar groove of the hand and calibrated. After a baseline TOF reading was taken, and 0.6mg/kg of rocuronium was given. Patients were intubated once TOF count was less than 1. TOF was monitored and maintained at count of 2-3 throughout the surgery by administering 0.2mg/kg of rocuronium once TOF count was more than 3. The haemodynamic parameters pre-reversal and post-reversal was documented. The neuromuscular recovery time, from reversal administration at TOF count 2 or 3 to TOF ratio 0.9 was documented. Any complications observed postextubation were documented. The neuromuscular recovery time from TOF count 2 or 3 to TOF ratio 0.9 post-reversal was significantly higher in the neostigmine group, with a mean of 501.58 seconds as compared to only 84.45 seconds in the sugammadex group.The mean difference was 417.13 seconds. This difference was statistically significant evidenced by p<0.05. There were also significant changes in the means of systolic blood pressure, diastolic blood pressure and mean arterial pressure pre-reversal and post-reversal in both groups. However the mean differences were much lower in the sugammadex group, ranging from -2.38 to -2.93 as compared to the neostigmine group, which were from -4.85 to -6.80. The mean heart rate pre-reversal and postreversal showed significant changes in the neostigmine group, but the changes were not significant in the sugammadex group. The incidence of complications postreversal was higher in the neostigmine group with 17.5% (7 patients) post-operative nausea vomiting and 2.5% (1 patient) sweating. There were no complications noted in the sugammadex group. Sugammadex has a significantly shorter recovery time (from TOF count of 2 or 3 to TOF ratio of more than 0.9) as compared to neostigmine. Sugammadex has a more stable haemodynamic profile as compared to neostigmine when used to reverse rocuronium induced neuromuscular blockade in paediatric patients. Sugammadex causes less complications or side effects when used in paediatric patients as a reversal for rocuronium induced neuromuscular bloackade

The autophagy protein ATG16L1 is required for Sindbis virus-induced eIF2α phosphorylation and stress granule formation

Sindbis virus (SINV) infection induces eIF2α phosphorylation, which leads to stress granule (SG) assembly. SINV infection also stimulates autophagy, which has an important role in controlling the innate immune response. The importance of autophagy to virus-induced translation arrest is not well understood. In this study, we show that the autophagy protein ATG16L1 not only regulates eIF2α phosphorylation and the translation of viral and antiviral proteins, but also controls SG assembly. Early in infection (2hpi), capsids were recruited by host factors Cytotoxic Granule-Associated RNA Binding Protein (TIA1), Y-box binding protein 1 (YBX1), and vasolin-containing protein 1 (VCP), to a single perinuclear body, which co-localized with the viral pattern recognition sensors, double stranded RNA-activated protein-kinase R (PKR) and RIG-I. By 6hpi, there was increased eIF2α phosphorylation and viral protein synthesis. However, in cells lacking the autophagy protein ATG16L1, SG assembly was inhibited and capsid remained in numerous small foci in the cytoplasm containing YBX1, TIA1 with RIG-I, and these persisted for over 8hpi. In the absence of ATG16L1, there was little phosphorylation of eIF2α and low levels of viral protein synthesis. Compared to wild type cells, there was potentiated interferon protein and interferon-stimulated gene (ISG) mRNA expression. These results show that ATG16L1 is required for maximum eIF2α phosphorylation, proper SG assembly into a single perinuclear focus, and for attenuating the innate immune response. Therefore, this study shows that, in the case of SINV, ATG16L1 is pro-viral, required for SG assembly and virus replication

BCL-3 loss sensitises colorectal cancer cells to DNA damage by targeting homologous recombination

The proto-oncogene BCL-3 is upregulated in a subset of colorectal cancers (CRC), where it has been shown to enhance tumour cell survival. However, although increased expression correlates with poor patient prognosis, the role of BCL-3 in determining therapeutic response remains largely unknown. In this study, we use combined approaches in multiple cell lines and pre-clinical mouse models to investigate the function of BCL-3 in the DNA damage response. We show that suppression of BCL-3 increases γH2AX foci formation and decreases homologous recombination in CRC cells, resulting in reduced RAD51 foci number and increased sensitivity to PARP inhibition. Importantly, a similar phenotype is seen in Bcl3-/- mice, where Bcl3-/- mouse crypts also exhibit sensitivity to DNA damage with increased γH2AX foci compared to wild type mice. Additionally, Apc.Kras-mutant x Bcl3-/- mice are more sensitive to cisplatin chemotherapy compared to wild type mice. Taken together, our results identify BCL-3 as a regulator of the cellular response to DNA damage and suggests that elevated BCL-3 expression, as observed in CRC, could increase resistance of tumour cells to DNA damaging agents including radiotherapy. These findings offer a rationale for targeting BCL-3 in CRC as an adjunct to conventional therapies and suggest that BCL-3 expression in tumours could be a useful biomarker in stratification of rectal cancer patients for neo-adjuvant chemoradiotherapy

Quantitative and Qualitative Responses to Topical Cold in Healthy Caucasians Show Variance between Individuals but High Test-Retest Reliability.

Increased sensitivity to cold may be a predictor of persistent pain, but cold pain threshold is often viewed as unreliable. This study aimed to determine the within-subject reliability and between-subject variance of cold response, measured comprehensively as cold pain threshold plus pain intensity and sensation quality at threshold. A test-retest design was used over three sessions, one day apart. Response to cold was assessed at four sites (thenar eminence, volar forearm, tibialis anterior, plantar foot). Cold pain threshold was measured using a Medoc thermode and standard method of limits. Intensity of pain at threshold was rated using a 10cm visual analogue scale. Quality of sensation at threshold was quantified with indices calculated from subjects' selection of descriptors from a standard McGill Pain Questionnaire. Within-subject reliability for each measure was calculated with intra-class correlation coefficients and between-subject variance was evaluated as group coefficient of variation percentage (CV%). Gender and site comparisons were also made. Forty-five healthy adults participated: 20 male, 25 female; mean age 29 (range 18-56) years. All measures at all four test sites showed high within-subject reliability: cold pain thresholds r = 0.92-0.95; pain rating r = 0.93-0.97; McGill pain quality indices r = 0.87-0.85. In contrast, all measures showed wide between-subject variance (CV% between 51.4% and 92.5%). Upper limb sites were consistently more sensitive than lower limb sites, but equally reliable. Females showed elevated cold pain thresholds, although similar pain intensity and quality to males. Females were also more reliable and showed lower variance for all measures. Thus, although there was clear population variation, response to cold for healthy individuals was found to be highly reliable, whether measured as pain threshold, pain intensity or sensation quality. A comprehensive approach to cold response testing therefore may add validity and improve acceptance of this potentially important pain measure.Thus, although there was clear population variation, response to cold for healthy individuals was found to be highly reliable, whether measured as pain threshold, pain intensity or sensation quality. A comprehensive approach to cold response testing therefore may add validity and improve acceptance of this potentially important pain measure

Retreatment for hepatitis C virus direct-acting antiviral therapy virological failure in primary and tertiary settings: The REACH-C cohort

Virological failure occurs in a small proportion of people treated for hepatitis C virus (HCV) with direct-acting antiviral (DAA) therapies. This study assessed retreatment for virological failure in a large real-world cohort. REACH-C is an Australian observational study (n = 10,843) evaluating treatment outcomes of sequential DAA initiations across 33 health services between March 2016 to June 2019. Virological failure retreatment data were collected until October 2020. Of 408 people with virological failure (81% male; median age 53; 38% cirrhosis; 56% genotype 3), 213 (54%) were retreated once; 15 were retreated twice. A range of genotype specific and pangenotypic DAAs were used to retreat virological failure in primary (n = 56) and tertiary (n = 157) settings. Following sofosbuvir/velpatasvir/voxilaprevir availability in 2019, the proportion retreated in primary care increased from 21% to 40% and median time to retreatment initiation declined from 294 to 152 days. Per protocol (PP) sustained virological response (SVR12) was similar for people retreated in primary and tertiary settings (80% vs 81%; p = 1.000). In regression analysis, sofosbuvir/velpatasvir/voxilaprevir (vs. other regimens) significantly decreased likelihood of second virological failure (PP SVR12 88% vs. 77%; adjusted odds ratio [AOR] 0.29; 95%CI 0.11–0.81); cirrhosis increased likelihood (PP SVR12 69% vs. 91%; AOR 4.26; 95%CI 1.64–11.09). Indigenous Australians had lower likelihood of retreatment initiation (AOR 0.36; 95%CI 0.15–0.81). Treatment setting and prescriber type were not associated with retreatment initiation or outcome. Virological failure can be effectively retreated in primary care. Expanded access to simplified retreatment regimens through decentralized models may increase retreatment uptake and reduce HCV-related mortality

Genetic Drivers of Heterogeneity in Type 2 Diabetes Pathophysiology

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P \u3c 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care

Genetic drivers of heterogeneity in type 2 diabetes pathophysiology

Type 2 diabetes (T2D) is a heterogeneous disease that develops through diverse pathophysiological processes1,2 and molecular mechanisms that are often specific to cell type3,4. Here, to characterize the genetic contribution to these processes across ancestry groups, we aggregate genome-wide association study data from 2,535,601 individuals (39.7% not of European ancestry), including 428,452 cases of T2D. We identify 1,289 independent association signals at genome-wide significance (P &lt; 5 × 10-8) that map to 611 loci, of which 145 loci are, to our knowledge, previously unreported. We define eight non-overlapping clusters of T2D signals that are characterized by distinct profiles of cardiometabolic trait associations. These clusters are differentially enriched for cell-type-specific regions of open chromatin, including pancreatic islets, adipocytes, endothelial cells and enteroendocrine cells. We build cluster-specific partitioned polygenic scores5 in a further 279,552 individuals of diverse ancestry, including 30,288 cases of T2D, and test their association with T2D-related vascular outcomes. Cluster-specific partitioned polygenic scores are associated with coronary artery disease, peripheral artery disease and end-stage diabetic nephropathy across ancestry groups, highlighting the importance of obesity-related processes in the development of vascular outcomes. Our findings show the value of integrating multi-ancestry genome-wide association study data with single-cell epigenomics to disentangle the aetiological heterogeneity that drives the development and progression of T2D. This might offer a route to optimize global access to genetically informed diabetes care.</p