Multiple roles of class I HDACs in proliferation, differentiation, and development

Class I Histone deacetylases (HDACs) play a central role in controlling cell cycle regulation, cell differentiation, and tissue development. These enzymes exert their function by deacetylating histones and a growing number of non-histone proteins, thereby regulating gene expression and several other cellular processes. Class I HDACs comprise four members: HDAC1, 2, 3, and 8. Deletion and/or overexpression of these enzymes in mammalian systems has provided important insights about their functions and mechanisms of action which are reviewed here. In particular, unique as well as redundant functions have been identified in several paradigms. Studies with small molecule inhibitors of HDACs have demonstrated the medical relevance of these enzymes and their potential as therapeutic targets in cancer and other pathological conditions. Going forward, better understanding the specific role of individual HDACs in normal physiology as well as in pathological settings will be crucial to exploit this protein family as a useful therapeutic target in a range of diseases. Further dissection of the pathways they impinge on and of their targets, in chromatin or otherwise, will form important avenues of research for the futur

Patterns of Alcohol Consumption Among Individuals With Alcohol Use Disorder During the COVID-19 Pandemic and Lockdowns in Germany

Importance Alcohol consumption (AC) leads to death and disability worldwide. Ongoing discussions on potential negative effects of the COVID-19 pandemic on AC need to be informed by real-world evidence. Objective To examine whether lockdown measures are associated with AC and consumption-related temporal and psychological within-person mechanisms. Design, Setting, and Participants This quantitative, intensive, longitudinal cohort study recruited 1743 participants from 3 sites from February 20, 2020, to February 28, 2021. Data were provided before and within the second lockdown of the COVID-19 pandemic in Germany: before lockdown (October 2 to November 1, 2020); light lockdown (November 2 to December 15, 2020); and hard lockdown (December 16, 2020, to February 28, 2021). Main Outcomes and Measures Daily ratings of AC (main outcome) captured during 3 lockdown phases (main variable) and temporal (weekends and holidays) and psychological (social isolation and drinking intention) correlates. Results Of the 1743 screened participants, 189 (119 [63.0%] male; median [IQR] age, 37 [27.5-52.0] years) with at least 2 alcohol use disorder (AUD) criteria according to the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) yet without the need for medically supervised alcohol withdrawal were included. These individuals provided 14 694 smartphone ratings from October 2020 through February 2021. Multilevel modeling revealed significantly higher AC (grams of alcohol per day) on weekend days vs weekdays (β = 11.39; 95% CI, 10.00-12.77; P < .001). Alcohol consumption was above the overall average on Christmas (β = 26.82; 95% CI, 21.87-31.77; P < .001) and New Year’s Eve (β = 66.88; 95% CI, 59.22-74.54; P < .001). During the hard lockdown, perceived social isolation was significantly higher (β = 0.12; 95% CI, 0.06-0.15; P < .001), but AC was significantly lower (β = −5.45; 95% CI, −8.00 to −2.90; P = .001). Independent of lockdown, intention to drink less alcohol was associated with lower AC (β = −11.10; 95% CI, −13.63 to −8.58; P < .001). Notably, differences in AC between weekend and weekdays decreased both during the hard lockdown (β = −6.14; 95% CI, −9.96 to −2.31; P = .002) and in participants with severe AUD (β = −6.26; 95% CI, −10.18 to −2.34; P = .002). Conclusions and Relevance This 5-month cohort study found no immediate negative associations of lockdown measures with overall AC. Rather, weekend-weekday and holiday AC patterns exceeded lockdown effects. Differences in AC between weekend days and weekdays evinced that weekend drinking cycles decreased as a function of AUD severity and lockdown measures, indicating a potential mechanism of losing and regaining control. This finding suggests that temporal patterns and drinking intention constitute promising targets for prevention and intervention, even in high-risk individuals

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Genomic Relationships, Novel Loci, and Pleiotropic Mechanisms across Eight Psychiatric Disorders

Genetic influences on psychiatric disorders transcend diagnostic boundaries, suggesting substantial pleiotropy of contributing loci. However, the nature and mechanisms of these pleiotropic effects remain unclear. We performed analyses of 232,964 cases and 494,162 controls from genome-wide studies of anorexia nervosa, attention-deficit/hyper-activity disorder, autism spectrum disorder, bipolar disorder, major depression, obsessive-compulsive disorder, schizophrenia, and Tourette syndrome. Genetic correlation analyses revealed a meaningful structure within the eight disorders, identifying three groups of inter-related disorders. Meta-analysis across these eight disorders detected 109 loci associated with at least two psychiatric disorders, including 23 loci with pleiotropic effects on four or more disorders and 11 loci with antagonistic effects on multiple disorders. The pleiotropic loci are located within genes that show heightened expression in the brain throughout the lifespan, beginning prenatally in the second trimester, and play prominent roles in neurodevelopmental processes. These findings have important implications for psychiatric nosology, drug development, and risk prediction.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Die Rolle von LIN9 in der Mausentwicklung

LINC, the human homologue of an evolutionary conserved complex, regulates the transcription of a set of genes essential during the G2/M transition (Osterloh et al., 2007; Schmit et al., 2007). One component of the LINC core module is LIN-9. LIN-9 is essential for the transcriptional activation of LINC target genes and also promotes differentiation in association with pRB (Gagrica et al., 2004). However, nothing is known about its function in vivo. Histological and molecular analysis revealed that Lin9 is ubiquitously expressed throughout embryonic development and in all examined adult organs. Additionally, Lin9 mRNA is expressed in ES cells and blastocysts. Moreover the analogous distribution of the other LINC components suggested that they all function in the same cells and most likely in the same pathway. To deeper investigate the role of LIN9 in cell cycle and differentiation in vivo, a Lin9 gene trap mouse model (GT) was successfully generated and examined. Heterozygouse Lin9GT/+ mice were inconspicuous and develop normally. However, homozygouse knockout embryos were never obtained. The Lin9GT/GT embryos die at peri-implantation, probably due to a defect in the development of the epiblast, which could be shown with in situ hybridization with specific lineage markers. In vitro, the ICM of Lin9-deficient blastocysts did not develop properly. These data suggest that the loss of Lin9 leads to embryonic lethality at peri-implantation, and indicates that LIN9 is required for proper formation of the epiblast. In parallel, the first conditional Lin9 mouse model based on the Cre-loxP technology was generated. The Lin9fl/fl allele can be deleted by Cre-recombinase, in vivo and in vitro. Therefore an inducible system with Lin9fl/fl mice harboring Cre-ERT2 was established. The MEFs generated from these transgenic mice carried a nearly complete knockout upon induction with tamoxifen. Deletion of LIN9 in MEFs had a major impact upon the cell cycle and growth rates. Specifically, they arrested in G2/M phase and stopped to proliferate. Taken together, I was able to generate a lin9 gene trap and a lin9 conditional knockout mouse model. All results obtained so far demonstrate, that Lin9 is an essential gene for embryonic development and cell cycle control. It will be of great interest to further investigate Lin9-deficiency to gain insights into the mechanism of cell cycle control in early embryonic development and cell differentiation.LINC, das humane Homolog eines evolutionär konservierten Komplexes, reguliert die Transkription von Genen, die essentiell für die G2/M Transition sind (Osterloh et al., 2007; Schmit et al., 2007). Eine Komponente des LINC Komplexes ist LIN-9. LIN-9 ist für die transkriptionelle Aktivierung LINC spezifischer Zielgene essentiell und kann, in Assoziation mit pRB, die Differenzierung humaner Zellen fördern (Gagrica et al., 2004). Bisher ist jedoch nichts über die in vivo Funktion LIN9s bekannt. Histologische und molekulare Analysen der Maus machen deutlich, dass Lin9 während der embryonalen Entwicklung und in allen untersuchten adulten Organen ubiquitär exprimiert wird. Zusätzlich wird Lin9 mRNA in ES Zellen und in Blastocysten exprimiert. Außerdem legt die analoge Verteilung anderer LINC Komponenten nahe, dass sie sehr wahrscheinlich gemeinsam in den gleichen Zellen und Signalwegen agieren. Um die Funktion des LIN9 Proteins im Zellzyklus und der Differenzierung in vivo genauer zu erforschen, wurde ein Lin9 „Gene Trap“ Maus Modell (GT) generiert und untersucht. Heterozygote Lin9GT/+ Mäuse sind unauffällig und entwickeln sich normal. Allerdings wurden keine Lin9 knockout Embryonen erhalten. Lin9GT/GT Embryonen sterben in der peri-Implantationsphase, vermutlich auf Grund eines Entwicklungsdefekts des Epiblasten, was mit in situ Hybridisierung von Abstammungslinien spezifischen Markern gezeigt werden konnte. Die ICM Lin9 defizienter Blastocysten entwickelte sich in vitro nicht richtig. Diese Daten machen deutlich, dass der Verlust von Lin9 zu embryonaler Letalität im Peri-Implantations-stadium führt, und zeigt dass Lin9 für die richtige Ausbildung des Epiblasten benötigt wird. Gleichzeitig wurde das erste konditionelle Lin9 Maus Modell, basierend auf der Cre-loxP Technologie, generiert. Das Lin9fl/fl Allele kann in vivo und in vitro mit der Cre-Recombinase deletiert werden. Deshalb wurde ein induzierbares System mit Lin9fl/fl Mäusen, die zusätzlich Cre-ERT2 tragen, etabliert. Die MEFs dieser transgenen Mäuse trugen nach Induktion mit Tamoxifen einen kompletten Lin9 Knockout. Die Deletion von LIN9 hat dramatische Auswirkung auf den Zellzyklus und die Wachstumsrate der MEFs. Neben der Akkumulation in der G2/M Phase des Zellzyklus kommt es zu einem vollständigen Proliferationsstop. Zusammenfassend war es möglich, ein Lin9 „Gene Trap“ und ein konditionelles Knockout Maus Modell zu generieren. Beide Mausmodelle belegen, dass Lin9 ein essenzielles Gen für die Embryonalentwicklung und die Kontrolle des Zellzyklus ist. Die weitere Erforschung der LIN9 Defizienz wird dazu beitragen, grundlegende Mechanismen der frühen Zellzykluskontrolle und der embryonalen Entwicklung zu verstehen

LIN9, a Subunit of the DREAM Complex, Regulates Mitotic Gene Expression and Proliferation of Embryonic Stem Cells

The DREAM complex plays an important role in regulation of gene expression during the cell cycle. We have previously shown that the DREAM subunit LIN9 is required for early embryonic development and for the maintenance of the inner cell mass in vitro. In this study we examined the effect of knocking down LIN9 on ESCs. We demonstrate that depletion of LIN9 alters the cell cycle distribution of ESCs and results in an accumulation of cells in G2 and M and in an increase of polyploid cells. Genome-wide expression studies showed that the depletion of LIN9 results in downregulation of mitotic genes and in upregulation of differentiation-specific genes. ChIP-on chip experiments showed that mitotic genes are direct targets of LIN9 while lineage specific markers are regulated indirectly. Importantly, depletion of LIN9 does not alter the expression of pluripotency markers SOX2, OCT4 and Nanog and LIN9 depleted ESCs retain alkaline phosphatase activity. We conclude that LIN9 is essential for proliferation and genome stability of ESCs by activating genes with important functions in mitosis and cytokinesis