Personalised therapies for all : Targeting alternative chloride channels in Cystic Fibrosis

Cystic Fibrosis (CF) is a life-shortening genetic disorder caused by mutations in the CF Transmembrane Conductance Regulator (CFTR) gene, which encodes a cAMP-regulated chloride (Cl−) and bicarbonate (HCO3−) channel expressed at the apical membrane of epithelial cells. Faulty CFTR causes unbalanced salt and fluid transport, resulting in dehydrated lung secretions, enhanced mucus viscosity, and impaired mucociliary clearance, culminating in progressive obstruction of the airways. Other organs such as the intestine, reproductive tissues, and pancreas are also affected in CF. Despite recent progress in the development of therapies targeting the root cause of the disease, several people with CF, namely the ones with rare or “unrescuable” mutations, still lack effective treatments. An alternative would be to develop “mutation-agnostic” therapies, namely through the modulation of other (non-CFTR) anion channels/transporters. The main goal of this work was to understand if and how these alternative channels can be used as therapeutic targets in CF. TMEM16A is the major contributor to Ca2+-activated Cl– secretion in the airways and has the potential to bypass defective CFTR-dependent Cl– secretion. Here we developed a screening platform that was used to identify novel modulators of TMEM16A trafficking and function (Chapter 1). We have also demonstrated an overlap between Ca2+ and cAMP-induced currents, implying an intimate relationship between TMEM16A and CFTR (Chapter 2). Furthermore, another member of the TMEM16 family, TMEM16F, was also shown to regulate CFTR trafficking and function (Chapter 2). Another interesting alternative target is SLC26A9, a constitutively active Cl– transporter. We showed that CFTR expression, function, and rescue by modulators are dependent on SLC26A9 expression levels (Chapter 3). Finally, we have also identified regulators of SLC26A9 trafficking, that can potentially be used as novel therapeutic targets in CF therapies (Chapter 3). Taken together, our findings support a role for TMEM16A and SLC26A9 as clinically relevant disease modifiers and promising therapeutic targets to circumvent deficient Cl– secretion in CF

Atitudes do enfermeiro em contexto de ensino clínico: uma revisão da literatura

Com o decorrer do Ensino Clínico torna-se crucial compreender de que modo as atitudes dos enfermeiros influenciam o desempenho dos alunos. Cuidados de excelência só podem ser assegurados com a passagem de testemunho do Enfermeiro para o aluno. Nesta linha, as atitudes que os enfermeiros supervisores apresentam, tornam-se o “espelho” e o reflexo do futuro profissional. O supervisor tem a capacidade de melhorar a qualidade da formação do estudante, sendo que este tem o dever de ser o catalisador da mudança. Um processo interactivo e dinâmico facilitador da aprendizagem experiencial que permite a melhoria e a continuidade dos cuidados

Regulation of TMEM16A by CK2 and Its Role in Cellular Proliferation

Casein kinase 2 (CK2) is a highly ubiquitous and conserved serine/threonine kinase that forms a tetramer consisting of a catalytic subunit (CK2 alpha) and a regulatory subunit (CK2 beta). Despite being ubiquitous, CK2 is commonly found at higher expression levels in cancer cells, where it inhibits apoptosis, and supports cell migration and proliferation. The Ca2+-activated chloride channel TMEM16A shows similar effects in cancer cells: TMEM16A increases cell proliferation and migration and is highly expressed in squamous cell carcinoma of the head and neck (HNSCC) as well as other malignant tumors. A microscopy-based high-throughput screening was performed to identify proteins that regulate TMEM16A. Within this screen, CK2 was found to be required for proper membrane expression of TMEM16A. small interfering (si) RNA-knockdown of CK2 reduced plasma membrane expression of TMEM16A and inhibited TMEM16A whole cell currents in (cystic fibrosis bronchial epithelial) CFBE airway epithelial cells and in the head and neck cancer cell lines Cal33 and BHY. Inhibitors of CK2, such as TBB and the preclinical compound CX4549 (silmitasertib), also blocked membrane expression of TMEM16A and Ca2+-activated whole cell currents. siRNA-knockout of CK2 and its pharmacological inhibition, as well as knockdown or inhibition of TMEM16A by either niclosamide or Ani9, attenuated cell proliferation. Simultaneous inhibition of CK2 and TMEM16A strongly potentiated inhibition of cell proliferation. Although membrane expression of TMEM16A is reduced by inhibition of CK2, our data suggest that the antiproliferative effects by inhibition of CK2 are mostly independent of TMEM16A. Simultaneous inhibition of TMEM16A by niclosamide and inhibition of CK2 by silmitasertib was additive with respect to blocking cell proliferation, while cytotoxicity was reduced when compared to solely blockade of CK2. Therefore, parallel blockade TMEM16A by niclosamide may assist with anticancer therapy by silmitasertib

The MOVE.TE Falls Prevention and Management Program: lessons learnt in the Portuguese context

MOVE.TE is a non-profit participatory physiotherapy platform that aims at translating knowledge in the field of physiotherapy and developing freely available evidence-based physiotherapy programmes targeting the primary care services of the Portuguese National Health service. A group of volunteer academics and clinicians collaborated at different stages and time points to create the first ever falls prevention and management programme and guidance for Physiotherapy in primary care, in Portugal. This report describes this seven-step process. In spite of many challenges, this project constitutes an example of advocacy in physiotherapy for the promotion of better healthcare for older adults.info:eu-repo/semantics/publishedVersio

Efficacy, Stability, and Safety Evaluation of New Polyphenolic Xanthones Towards Identification of Bioactive Compounds to Fight Skin Photoaging

Antioxidants have long been used in the cosmetic industry to prevent skin photoaging, which is mediated by oxidative stress, making the search for new antioxidant compounds highly desirable in this field. Naturally occurring xanthones are polyphenolic compounds that can be found in microorganisms, fungi, lichens, and some higher plants. This class of polyphenols has a privileged scaffold that grants them several biological activities. We have previously identified simple oxygenated xanthones as promising antioxidants and disclosed as hit, 1,2-dihydroxyxanthone (1). Herein, we synthesized and studied the potential of xanthones with different polyoxygenated patterns as skin antiphotoaging ingredients. In the DPPH antioxidant assay, two newly synthesized derivatives showed IC₅₀ values in the same range as ascorbic acid. The synthesized xanthones were discovered to be excellent tyrosinase inhibitors and weak to moderate collagenase and elastase inhibitors but no activity was revealed against hyaluronidase. Their metal-chelating effect (FeCl₃ and CuCl₂) as well as their stability at different pH values were characterized to understand their potential to be used as future cosmetic active agents. Among the synthesized polyoxygenated xanthones, 1,2-dihydroxyxanthone (1) was reinforced as the most promising, exhibiting a dual ability to protect the skin against UV damage by combining antioxidant/metal-chelating properties with UV-filter capacity and revealed to be more stable in the pH range that is close to the pH of the skin. Lastly, the phototoxicity of 1,2-dihydroxyxanthone (1) was evaluated in a human keratinocyte cell line and no phototoxicity was observed in the concentration range tested.This research was supported by national funds through FCT, Foundation for Science and Technology, within the scope of UIDB/04423/2020 and UIDP/04423/2020 under the project PTDC/SAU-PUB/28736/2017 (reference POCI-01-0145-FEDER-028736), cofinanced by COMPETE 2020, Portugal 2020 and the European Union through the ERDF and by FCT through national funds, as well as CHIRALBIOACTIVE-PI-3RL-IINFACTS-2019, and supported by the Applied Molecular Biosciences Unit-UCIBIO which is financed by national funds from FCT/MCTES (UID/Multi/04378/2019). Thanks are also due to FCT, the European Union, QREN, FEDER, COMPETE, by funding cE3c center (Ref. UID/BIA/00329/2019) and Direcao Regional da Ciencia e Tecnologia (Azores Government) by funding Azorean Biodiversity Group.info:eu-repo/semantics/publishedVersio

Chronic wasting disease risk assessment in Portugal: analysis of variability and genetic structure of the Portuguese roe deer population

Among the Transmissible Spongiform Encephalopathies, Chronic Wasting Disease (CWD) in cervids is now the rising concern in wildlife within Europe after the first case detected in Norway in 2016. CWD shows a notable horizontal transmission, affecting both free-ranging and captive cervids. Furthermore, several genetic variants in the Prion Protein (PRNP) gene coding sequence of the cervid were identified, which increase the susceptibility to the disease.This work was supported by the project WastingPrionRisk [POCI-01-0145-FEDER-029,947/ PTDC/CVT-CVT/29947/2017] funded by the Portuguese Foundation for Science and Technology (FCT). FCT PhD grant [SFRH/BD/146961/2019] financed by FCT through FSE (Fundo Social Europeu). This work was also supported by national funds [UIDB/CVT/00772/2020], [LA/P/0059/2020] and [UIDB/04033/2020] by FCT.info:eu-repo/semantics/publishedVersio

CFTR interactome mapping using the mammalian membrane two-hybrid high-throughput screening system

Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) is a chloride and bicarbonate channel in secretory epithelia with a critical role in maintaining fluid homeostasis. Mutations in CFTR are associated with Cystic Fibrosis (CF), the most common lethal autosomal recessive disorder in Caucasians. While remarkable treatment advances have been made recently in the form of modulator drugs directly rescuing CFTR dysfunction, there is still considerable scope for improvement of therapeutic effectiveness. Here, we report the application of a high-throughput screening variant of the Mammalian Membrane Two-Hybrid (MaMTH-HTS) to map the protein-protein interactions of wild-type (wt) and mutant CFTR (F508del), in an effort to better understand CF cellular effects and identify new drug targets for patient-specific treatments. Combined with functional validation in multiple disease models, we have uncovered candidate proteins with potential roles in CFTR function/CF pathophysiology, including Fibrinogen Like 2 (FGL2), which we demonstrate in patient-derived intestinal organoids has a significant effect on CFTR functional expression

Standardized evaluation of algorithms for computer-aided diagnosis of dementia based on structural MRI: The CADDementia challenge

Algorithms for computer-aided diagnosis of dementia based on structural MRI have demonstrated high performance in the literature, but are difficult to compare as different data sets and methodology were used for evaluation. In addition, it is unclear how the algorithms would perform on previously unseen data, and thus, how they would perform in clinical practice when there is no real opportunity to adapt the algorithm to the data at hand. To address these comparability, generalizability and clinical applicability issues, we organized a grand challenge that aimed to objectively compare algorithms based on a clinically representative multi-center data set. Using clinical practice as the starting point, the goal was to reproduce the clinical diagnosis. Therefore, we evaluated algorithms for multi-class classification of three diagnostic groups: patients with probable Alzheimer's disease, patients with mild cognitive impairment and healthy controls. The diagnosis based on clinical criteria was used as reference standard, as it was the best available reference despite its known limitations. For evaluation, a previously unseen test set was used consisting of 354 T1-weighted MRI scans with the diagnoses blinded. Fifteen research teams participated with a total of 29 algorithms. The algorithms were trained on a small training set (n = 30) and optionally on data from other sources (e.g., the Alzheimer's Disease Neuroimaging Initiative, the Australian Imaging Biomarkers and Lifestyle flagship study of aging). The best performing algorithm yielded an accuracy of 63.0% and an area under the receiver-operating-characteristic curve (AUC) of 78.8%. In general, the best performances were achieved using feature extraction based on voxel-based morphometry or a combination of features that included volume, cortical thickness, shape and intensity. The challenge is open for new submissions via the web-based framework: http://caddementia.grand-challenge.org