Déterminants moléculaires du clivage protéolytique nécessaire à la fonction de la sous-unité CaVα2δ1 du canal calcique CaV1.2

Le canal calcique de type-L CaV1.2 participe au couplage excitation-contraction des cardiomyocytes. Cav1.2 est composé d’une sous-unité principale CaVα1, associée aux sous-unités auxiliaires CaVβ et CaVα2δ1. Lorsque présente à la membrane, c’est CaVα2δ1 qui est responsable de moduler la densité du courant calcique. Elle ne possède qu’un seul segment transmembranaire présent du côté C-terminal, au niveau de la protéine δ, ce qui en fait une protéine transmembranaire de type I. Certaines protéines qui appartiennent à cette famille doivent être clivées au niveau du site dit « omega », une modification post-traductionnelle nécessaire à leur fonction. Une fois clivées, ces protéines sont retenues à la membrane plasmique par une ancre glycosyl-phosphatidyl-inositol (GPI). Nos études en microscopie confocale montrent que la protéine sauvage est sensible à l’action de la phospholipase C qui clive de manière spécifique les groupements phosphoinositol, ce qui est compatible avec la présence d’une ancre GPI fonctionnelle. De plus, la mutation des résidus formant le site « omega » en isoleucine au niveau des sites G1060 et G1061 prévient l’adressage membranaire de CaVα2δ1 estimé par cytométrie en flux et imagerie confocale, et réduit la modulation des courants calciques mesurés par la méthode du « patch-clamp ». Les mutants G1060I et G1061I sont aussi associés à un changement dans le patron de migration de la partie C-terminale, suggérant un processus protéolytique défecteueux. Les mutations simples des glycines en alanines préservent les propriétés de la protéine mais le double mutant G1060A/G1061A réduit significativement l’expression de CaVα2δ1 à la surface de la cellule et sa modulation sur le canal CaV1.2. Ces données suggèrent fortement que le clivage requiert spécifiquement un résidu Glycine en position 1060 ou 1061 pour produire le clivage protéolytique dominant chez CaVα2δ1, et que cet ancrage GPI est essentiel à la fonction du canal.Voltage-gated calcium channels CaV1.2 play an essential role in the regulation of cardiac excitability. Functional channels are formed by the CaVα1 subunit and the intracellular CaVβ and the extracellular CaVα2δ1 subunits. CaVα2δ1 are type I transmembrane proteins that undergo a posttranslational modification producing their association at the plasma membrane through a glycosylphosphatidylinositol (GPI) anchor. The molecular determinants required for the proteolytic cleavage of the recombinant CaVα2δ1 protein were studied using biochemical, immunocytochemical, fluorescence, and electrophysiological methods. Enzymatic treatment with a phospholipase C specific for the cleavage of phosphatidyl inositol lipids abolished the colocalisation of CaVα2δ1 with a plasma membrane marker as shown using live-cell confocal imaging. Single point mutations G1060I or G1061I in the predicted transmembrane CaVδ domain was shown to significantly reduce the cell surface fluorescence of CaVα2δ1 as characterized by two-color flow cytometry assays and confocal imaging, and to prevent the CaVα2δ1-mediated increase in the peak current density and voltage-dependent gating of CaV1.2 currents. The isoleucine mutations were also associated with a change in the migration pattern of the C-terminal fragments suggesting that proteolytic processing was altered. Single glycine to alanine mutations preserved the protein properties but the double mutant G1060A/G1061A significantly impaired cell surface expression of CaVα2δ1 and its functional regulation of CaV1.2. Altogether our data support a model where one Glycine residue at position 1060 or 1061 is required to produce the dominant proteolytic cleavage of CaVα2δ1 and further suggest that the GPI-anchored form of CaVα2δ1 is essential for channel function

A CACNA1C variant associated with cardiac arrhythmias provides mechanistic insights in the calmodulation of L-type Ca2+ channels

We recently reported the identification of a de novo single nucleotide variant in exon 9 of CACNA1C associated with prolonged repolarization interval. Recombinant expression of the glycine to arginine variant at position 419 produced a gain in the function of the L-type CaV1.2 channel with increased peak current density and activation gating but without signif- icant decrease in the inactivation kinetics. We herein reveal that these properties are replicated by overexpressing calmodulin (CaM) with CaV1.2 WT and are reversed by expo- sure to the CaM antagonist W-13. Phosphomimetic (T79D or S81D), but not phosphoresistant (T79A or S81A), CaM surro- gates reproduced the impact of CaM WT on the function of CaV1.2 WT. The increased channel activity of CaV1.2 WT following overexpression of CaM was found to arise in part from enhanced cell surface expression. In contrast, the prop- erties of the variant remained unaffected by any of these treatments. CaV1.2 substituted with the α-helix breaking pro- line residue were more reluctant to open than CaV1.2 WT but were upregulated by phosphomimetic CaM surrogates. Our results indicate that (1) CaM and its phosphomimetic analogs promote a gain in the function of CaV1.2 and (2) the structural properties of the first intracellular linker of CaV1.2 contribute to its CaM-induced modulation. We conclude that the CAC- NA1C clinical variant mimics the increased activity associated with the upregulation of CaV1.2 by Ca2+–CaM, thus main- taining a majority of channels in a constitutively active mode that could ultimately promote ventricular arrhythmias

Identification of glycosylation sites essential for surface expression of the Caᵥα2δ1 subunit and modulation of the Cardiac Caᵥ1.2 channel activity

Alteration in the L-type current density is one aspect of the electrical remodeling observed in patients suffering from cardiac arrhythmias. Changes in channel function could result from variations in the protein biogenesis, stability, post-translational modification, and/or trafficking in any of the regulatory subunits forming cardiac L-type Ca2+ channel complexes. CaVα2δ1 is potentially the most heavily N-glycosylated subunit in the cardiac L-type CaV1.2 channel complex. Here, we show that enzymatic removal of N-glycans produced a 50-kDa shift in the mobility of cardiac and recombinant CaVα2δ1 proteins. This change was also observed upon simultaneous mutation of the 16 Asn sites. Nonetheless, the mutation of only 6/16 sites was sufficient to significantly 1) reduce the steady-state cell surface fluorescence of CaVα2δ1 as characterized by two-color flow cytometry assays and confocal imaging; 2) decrease protein stability estimated from cycloheximide chase assays; and 3) prevent the CaVα2δ1-mediated increase in the peak current density and voltage-dependent gating of CaV1.2. Reversing the N348Q and N812Q mutations in the non-operational sextuplet Asn mutant protein partially restored CaVα2δ1 function. Single mutation N663Q and double mutations N348Q/N468Q, N348Q/N812Q, and N468Q/N812Q decreased protein stability/synthesis and nearly abolished steady-state cell surface density of CaVα2δ1 as well as the CaVα2δ1-induced up-regulation of L-type currents. These results demonstrate that Asn-663 and to a lesser extent Asn-348, Asn-468, and Asn-812 contribute to protein stability/synthesis of CaVα2δ1, and furthermore that N-glycosylation of CaVα2δ1 is essential to produce functional L-type Ca2+ channels

Heterozygous deletion of the Williams-Beuren syndrome critical interval in mice recapitulates most features of the human disorder

Williams-Beuren syndrome is a developmental multisystemic disorder caused by a recurrent 1.55-1.83 Mb heterozygous deletion on human chromosome band 7q11.23. Through chromosomal engineering with the cre-loxP system, we have generated mice with an almost complete deletion (CD) of the conserved syntenic region on chromosome 5G2. Heterozygous CD mice were viable, fertile and had a normal lifespan, while homozygotes were early embryonic lethal. Transcript levels of most deleted genes were reduced 50% in several tissues, consistent with gene dosage. Heterozygous mutant mice showed postnatal growth delay with reduced body weight and craniofacial abnormalities such as small mandible. The cardiovascular phenotype was only manifested with borderline hypertension, mildly increased arterial wall thickness and cardiac hypertrophy. The neurobehavioral phenotype revealed impairments in motor coordination, increased startle response to acoustic stimuli and hypersociability. Mutant mice showed a general reduction in brain weight. Cellular and histological abnormalities were present in the amygdala, cortex and hippocampus, including increased proportion of immature neurons. In summary, these mice recapitulate most crucial phenotypes of the human disorder, provide novel insights into the pathophysiological mechanisms of the disease such as the neural substrates of the behavioral manifestations, and will be valuable to evaluate novel therapeutic approaches.This work was supported by the Spanish Ministry of Ecomomy and Competitivity to V.C. (grant SAF2012-40036) and to L.P.J. (FIS PM002512 and SAF2004-06382), the European AnEuploidy project to L.P.J., M.D. and Y.H. The Rare Diseases CIBER (CIBERER) Fellowship supported M.S-P. and C.B

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

Diagnosis and treatment patterns for patients with leptomeningeal metastasis from solid tumors across Europe

International audienceLeptomeningeal metastases are a late manifestation of systemic cancer which affects up to 10% of patients with solid tumors. Prognosis is poor, and overall survival at 1 year is only approximately 10%. Management depends mainly on general and neurological condition, primary tumor, and patterns of metastasis, notably absence or presence of concurrent systemic or solid brain metastases. Here we set out to characterize current practice patterns of diagnosis and treatment of patients with leptomeningeal metastasis in Europe. We prepared a web-based survey including 25 simple or multiple choices questions on best practice supplemented by eight case vignettes with various diagnosis and management options. The survey was sent to the membership of the European Association of Neuro-Oncology and the European Organisation for Research and Treatment of Cancer Brain Tumor Group. Between April 7, 2016 and August 8, 2016, 224 colleagues from 26 countries initiated the survey, 115 colleagues completed the whole survey. There were major differences both in the general diagnostic and therapeutic approach, e.g., regarding the use of cerebrospinal fluid (CSF) flow studies, intra-CSF chemotherapy, various types of radiotherapy, and even more so when selecting decisions on diagnostic and therapeutic measures for single case vignettes. Diagnosis and treatment decisions for patients with leptomeningeal metastasis from solid tumors vary widely across Europe. Standardization of diagnosis and evaluation tools as well as controlled studies to improve the level of evidence for all therapeutic approaches to LM are required

Vaccination coverage of children with inflammatory bowel disease after an awareness campaign on the risk of infection

International audienceBACKGROUND: Children with inflammatory bowel disease are at risk of vaccine-preventable diseases mostly due to immunosuppressive drugs. AIM: To evaluate coverage after an awareness campaign informing patients, their parents and general practitioner about the vaccination schedule. METHODS: Vaccination coverage was firstly evaluated and followed by an awareness campaign on the risk of infection via postal mail. The trial is a case-control study on the same patients before and after the awareness campaign. Overall, 92 children were included. A questionnaire was then completed during a routine appointment to collect data including age at diagnosis, age at data collection, treatment history, and vaccination status. RESULTS: Vaccination rates significantly increased for vaccines against diphtheria-tetanus-poliomyelitis (92% vs. 100%), Haemophilus influenzae (88% vs. 98%), hepatitis B (52% vs. 71%), pneumococcus (36% vs. 57%), and meningococcus C (17% vs. 41%) (p\textless0.05). Children who were older at diagnosis were 1.26 times more likely to be up-to-date with a minimum vaccination schedule (diphtheria-tetanus-poliomyelitis, pertussis, H. influenzae, measles-mumps-rubella, tuberculosis) (p=0.002). CONCLUSION: Informing inflammatory bowel disease patients, their parents and general practitioner about the vaccination schedule via postal mail is easy, inexpensive, reproducible, and increases vaccination coverage. This method reinforces information on the risk of infection during routine visit

Valorisation des ressources forestières régionales pour la production de moules de cuisson en bois déroulé

International audienc