Evaluating weight gain with the initiation of antiretroviral therapy: A comparison of integrase strand transfer inhibitors to other antiretrovirals

Background: Existing research has observed a potential association between antiretroviral therapy (ART) exposed individuals and a high prevalence of weight gain and obesity. However, the impact of these metabolic changes imparted by integrase strand transfer inhibitor based regimens in particular remains unclear. The objective of this study is to evaluate weight change in treatment-naive patients with newly initiated ART in a Ryan White Clinic.Methods: This IRB-approved, retrospective chart review study utilized EMR records to identify patients aged 18 years or older with a diagnosis of HIV-1, who are treatment-naive or have been without ART for >6 months, initiated on ART between January 1, 2013 and January 1, 2018, maintained therapy for ≥24 months, had weight values recorded at least twice during the study period, and were initiated on any three-drug NNRTI, INSTI, or PI-based regimen. The following data was collected, recorded without patient identifiers, and maintained confidentially: patient regimen, age, gender, ethnicity, AIDS status, plasma HIV-1 RNA (viral load), CD4+ T-cell count, weight, BMI, and BMI categories. Patient weight, BMI, and BMI categories were evaluated at baseline, 6 months, and 18 months on ART.Results: Of the 3,054 patients identified, a total of 200 patients were included in the final analysis. The patient population consisted primarily of Caucasian (55.0%) males (81.0%) with an average age of 38.3 years. At initiation of treatment, the median CD4+ T-cell count = 356.2 cells/uL, HIV-1 RNA viral load = 481,801 copies/mL, weight = 80.8 kg, and BMI = 26.2 kg/m2. For all classes evaluated, the highest percentage of patients at baseline fell within BMI category indicating normal weight (18.5-24.9 kg/m2). A total of 42 (21.0%), 50 (25.0%), and 113 (56.5%) patients were initiated on NNRTI, PI, and INSTI-based regimens, respectively. Of the 113 patients who were initiated on an INSTI-based regimen, 82 (72.5%) patients began regimens containing doultegravir, 25 (22.1%) patients began regimens containing elvitegravir, and 6 (5.3%) patients began regimens containing raltegravir. All 6 patients who were initiated on raltegravir were also on concomitant darunavir. At 18 months of therapy, a median increase in weight of 2.2 kg and BMI of 0.5 kg/m2 was associated with NNRTI-based regimens, compared to a 3.9 kg and 1.3 kg/m2 increase associated with PI-based regimens. Of the INSTI-based regimens, use of dolutegravir was associated with a 4.3 kg and 1.7 kg/m2 increase, elvitegravir a 1.1 kg and 0.4 kg/m2 increase, and raltegravir a 7.7 kg and 2.5 kg/m2 increase in weight and BMI, respectively. At 18-months, 37.8% and 50.0% of patients initiated on dolutegravir and raltegravir-based therapy, respectively, were considered obese with an associated BMI of ≥ 30 kg/m2.Conclusions: Treatment naive patients with HIV-1 initiating therapy with dolutegravir-based regimens were associated with a higher incidence of increase in weight and BMI at 18-months than those initiating elvitegravir, NNRTI, and PI-based regimens. Those initiating raltegravir-based regimens, which also contained the PI darunavir, were associated with the highest incidence of increase in weight and BMI at 18-months compared to all other regimens. Further study is recommended

Spindle Formation in the Mouse Embryo Requires Plk4 in the Absence of Centrioles

During the first five rounds of cell division in the mouse embryo, spindles assemble in the absence of centrioles. Spindle formation initiates around chromosomes, but the microtubule nucleating process remains unclear. Here we demonstrate that Plk4, a protein kinase known as a master regulator of centriole formation, is also essential for spindle assembly in the absence of centrioles. Depletion of maternal Plk4 prevents nucleation and growth of microtubules and results in monopolar spindle formation. This leads to cytokinesis failure and, consequently, developmental arrest. We show that Plk4 function depends on its kinase activity and its partner protein, Cep152. Moreover, tethering Cep152 to cellular membranes sequesters Plk4 and is sufficient to trigger spindle assembly from ectopic membranous sites. Thus, the Plk4-Cep152 complex has an unexpected role in promoting microtubule nucleation in the vicinity of chromosomes to mediate bipolar spindle formation in the absence of centrioles

Over-expression of Plk4 induces centrosome amplification, loss of primary cilia and associated tissue hyperplasia in the mouse

To address the long-known relationship between supernumerary centrosomes and cancer, we have generated a transgenic mouse that permits inducible expression of the master regulator of centriole duplication, Polo-like-kinase-4 (Plk4). Over-expression of Plk4 from this transgene advances the onset of tumour formation that occurs in the absence of the tumour suppressor p53. Plk4 over-expression also leads to hyperproliferation of cells in the pancreas and skin that is enhanced in a p53 null background. Pancreatic islets become enlarged following Plk4 over-expression as a result of equal expansion of α- and β-cells, which exhibit centrosome amplification. Mice overexpressing Plk4 develop grey hair due to a loss of differentiated melanocytes and bald patches of skin associated with a thickening of the epidermis. This reflects an increase in proliferating cells expressing keratin 5 in the basal epidermal layer and the expansion of these cells into suprabasal layers. Such cells also express keratin 6, a marker for hyperplasia. This is paralleled by a decreased expression of later differentiation markers, involucrin, filaggrin and loricrin. Proliferating cells showed an increase in centrosome number and a loss of primary cilia, events that were mirrored in primary cultures of keratinocytes established from these animals. We discuss how repeated duplication of centrioles appears to prevent the formation of basal bodies leading to loss of primary cilia, disruption of signalling and thereby aberrant differentiation of cells within the epidermis. The absence of p53 permits cells with increased centrosomes to continue dividing, thus setting up a neoplastic state of error prone mitoses, a prerequisite for cancer development

Over-expression of Plk4 induces centrosome amplification, loss of primary cilia and associated tissue hyperplasia in the mouse.

To address the long-known relationship between supernumerary centrosomes and cancer, we have generated a transgenic mouse that permits inducible expression of the master regulator of centriole duplication, Polo-like-kinase-4 (Plk4). Over-expression of Plk4 from this transgene advances the onset of tumour formation that occurs in the absence of the tumour suppressor p53. Plk4 over-expression also leads to hyperproliferation of cells in the pancreas and skin that is enhanced in a p53 null background. Pancreatic islets become enlarged following Plk4 over-expression as a result of equal expansion of α- and β-cells, which exhibit centrosome amplification. Mice overexpressing Plk4 develop grey hair due to a loss of differentiated melanocytes and bald patches of skin associated with a thickening of the epidermis. This reflects an increase in proliferating cells expressing keratin 5 in the basal epidermal layer and the expansion of these cells into suprabasal layers. Such cells also express keratin 6, a marker for hyperplasia. This is paralleled by a decreased expression of later differentiation markers, involucrin, filaggrin and loricrin. Proliferating cells showed an increase in centrosome number and a loss of primary cilia, events that were mirrored in primary cultures of keratinocytes established from these animals. We discuss how repeated duplication of centrioles appears to prevent the formation of basal bodies leading to loss of primary cilia, disruption of signalling and thereby aberrant differentiation of cells within the epidermis. The absence of p53 permits cells with increased centrosomes to continue dividing, thus setting up a neoplastic state of error prone mitoses, a prerequisite for cancer development

Organic contaminants in western pond turtles in remote habitat in California

Remote aquatic ecosystems are exposed to an assortment of semivolatile organic compounds (SOCs) originating from current and historic uses, of local and global origin. Here, a representative suite of 57 current- and historic-use pesticides, polychlorinated biphenyls, and polycyclic aromatic hydrocarbons were surveyed in the plasma of the western pond turtle (Emys marmorata) and their potential prey items and habitat. California study sites included Sequoia National Park, Whiskeytown National Recreation Area, and Six Rivers National Forest. Each was downstream of undeveloped watersheds and varied in distance from agricultural and urban pollution sources. SOCs were detected frequently in all sites with more found in turtle plasma and aquatic macroinvertebrates in the two sites closest to agricultural and urban sources. Summed PCBs were highest in Whiskeytown National Recreation Area turtle plasma (mean; 1.56 ng/g ww) compared to plasma from Sequoia National Park (0.16 ng/g ww; p = 0.002) and Six Rivers National Forest (0.07 ng/g ww; p = 0.001). While no current-use pesticides were detected in turtle plasma at any site, both current- and historic-use pesticides were found prominently in sediment and macroinvertebrates at the Sequoia National Park site, which is immediately downwind of Central Valley agriculture. SOC classes associated with urban and industrial pollution were found more often and at higher concentrations at Whiskeytown National Recreation Area. These findings demonstrate a range of SOC exposure in a turtle species with current and proposed conservation status and shed additional light on the fate of environmental contaminants in remote watersheds

Plk4 and Aurora A cooperate in the initiation of acentriolar spindle assembly in mammalian oocytes

Establishing the bipolar spindle in mammalian oocytes after their prolonged arrest is crucial for meiotic fidelity and subsequent development. In contrast to somatic cells, the first meiotic spindle assembles in the absence of centriole-containing centrosomes. Ran-GTP can promote microtubule nucleation near chromatin, but additional unidentified factors are postulated for the activity of multiple acentriolar microtubule organizing centers in the oocyte. We now demonstrate that partially overlapping, nonredundant functions of Aurora A and Plk4 kinases contribute to initiate acentriolar meiosis I spindle formation. Loss of microtubule nucleation after simultaneous chemical inhibition of both kinases can be significantly rescued by drug-resistant Aurora A alone. Drug-resistant Plk4 can enhance Aurora A–mediated rescue, and, accordingly, Plk4 can phosphorylate and potentiate the activity of Aurora A in vitro. Both kinases function distinctly from Ran, which amplifies microtubule growth. We conclude that Aurora A and Plk4 are rate-limiting factors contributing to microtubule growth as the acentriolar oocyte resumes meiosis.L. Bury was the recipient of a Cancer Research UK research studentship from Cambridge Cancer Centre. P.A. Coelho is supported by Cancer Research UK program grant C3/A18795 to D.M. Glover. M. Zernicka-Goetz is a Wellcome Trust Senior Fellow. P.A. Eyers acknowledges North West Cancer Research for additional support (grants CR1037 and CR1088)

Fc Effector Function Contributes to the Activity of Human Anti-CTLA-4 Antibodies.

With the use of a mouse model expressing human Fc-gamma receptors (FcγRs), we demonstrated that antibodies with isotypes equivalent to ipilimumab and tremelimumab mediate intra-tumoral regulatory T (Treg) cell depletion in vivo, increasing the CD8+ to Treg cell ratio and promoting tumor rejection. Antibodies with improved FcγR binding profiles drove superior anti-tumor responses and survival. In patients with advanced melanoma, response to ipilimumab was associated with the CD16a-V158F high affinity polymorphism. Such activity only appeared relevant in the context of inflamed tumors, explaining the modest response rates observed in the clinical setting. Our data suggest that the activity of anti-CTLA-4 in inflamed tumors may be improved through enhancement of FcγR binding, whereas poorly infiltrated tumors will likely require combination approaches

Cohesin Removal Reprograms Gene Expression upon Mitotic Entry

As cells enter mitosis, the genome is restructured to facilitate chromosome segregation, accompanied by dramatic changes in gene expression. However, the mechanisms that underlie mitotic transcriptional regulation are unclear. In contrast to transcribed genes, centromere regions retain transcriptionally active RNA polymerase II (Pol II) in mitosis. Here, we demonstrate that chromatin-bound cohesin is necessary to retain elongating Pol II at centromeres. We find that WAPL-mediated removal of cohesin from chromosome arms during prophase is required for the dissociation of Pol II and nascent transcripts, and failure of this process dramatically alters mitotic gene expression. Removal of cohesin/Pol II from chromosome arms in prophase is important for accurate chromosome segregation and normal activation of gene expression in G1. We propose that prophase cohesin removal is a key step in reprogramming gene expression as cells transition from G2 through mitosis to G1

Alpha-satellite RNA transcripts are repressed by centromere–nucleolus associations

© Bury et al. Although originally thought to be silent chromosomal regions, centromeres are instead actively transcribed. However, the behavior and contributions of centromere-derived RNAs have remained unclear. Here, we used single-molecule fluorescence in-situ hybridization (smFISH) to detect alpha-satellite RNA transcripts in intact human cells. We find that alpha-satellite RNA-smFISH foci levels vary across cell lines and over the cell cycle, but do not remain associated with centromeres, displaying localization consistent with other long non-coding RNAs. Alpha-satellite expression occurs through RNA polymerase II-dependent transcription, but does not require established centromere or cell division components. Instead, our work implicates centromere– nucleolar interactions as repressing alpha-satellite expression. The fraction of nucleolar-localized centromeres inversely correlates with alpha-satellite transcripts levels across cell lines and transcript levels increase substantially when the nucleolus is disrupted. The control of alpha-satellite transcripts by centromere-nucleolar contacts provides a mechanism to modulate centromere transcription and chromatin dynamics across diverse cell states and conditions