Role of serotonergic signaling in GABAA receptor phosphorylation and functional expression

γ-aminobutyric acid type-A (GABAA) receptors are heteropentameric ligand-gated chloride channels that mediate the majority of fast synaptic inhibition in the brain. Emerging evidence indicates that their functional expression is subject to dynamic modulation by phosphorylation. However, the cell signaling molecules responsible for regulating GABAA receptor phosphorylation and thus the efficacy of neuronal inhibition remain to be identified. The β subunits are of particular interest in this context as their intracellular domains contain conserved serine residues (S409 in β1, S410 in β2 and S408/9 in β3), known substrates for a number of protein kinases, including PKA and PKC. In vitro binding experiments showed that phosphorylation and/or mutation of these residues confers a reduction in binding of GABAA receptor β subunits to the μ2 adaptin of the clathrin adaptor protein (AP)-2 complex - a critical regulator of GABAA receptor endocytosis and surface number. Consistent with this, coimmunoprecipitation of AP2-μ2 adaptin with endogenous GABAA receptor β3 subunits was significantly reduced in cultured neurons treated with a potent inhibitor of S408/9 dephosphorylation that was accompanied by an increase in the stability of GABAA receptor β3 subunits at the cell surface. Interestingly, recent studies have implicated PKA and PKC in the mediation of serotonergic modulation of GABAA receptor activity in the prefrontal cortex, suggesting that phosphorylation of GABAA receptor β subunits may underlie this regulation. To address this, a phospho-specific antibody directed against β3 at S408/9 was developed. Immunoblotting with anti-pS408/9-β3 demonstrated a PKC-dependent increase in the phosphorylation state of GABAA receptor β3 subunits following enhanced 5-hydroxytryptamine type-2 (5-HT2) receptor activation ex vivo. Moreover, in vivo biochemical and immunohistochemical studies revealed region-specific increases in GABAA receptor β3 subunit phosphorylation in mice dosed with the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac™), a commonly prescribed antidepressant. Together, the results presented herein suggest that the phospho-dependent increase in GABAA receptor functional expression may underlie the therapeutic action of SSRIs

Systemic exosomal siRNA delivery reduced alpha-synuclein aggregates in brains of transgenic mice.

Alpha-synuclein (α-Syn) aggregates are the main component of Lewy bodies, which are the characteristic pathological feature in Parkinson's disease (PD) brain. Evidence that α-Syn aggregation can be propagated between neurones has led to the suggestion that this mechanism is responsible for the stepwise progression of PD pathology. Decreasing α-Syn expression is predicted to attenuate this process and is thus an attractive approach to delay or halt PD progression. We have used α-Syn small interfering RNA (siRNA) to reduce total and aggregated α-Syn levels in mouse brains. To achieve widespread delivery of siRNAs to the brain we have peripherally injected modified exosomes expressing Ravies virus glycoprotein loaded with siRNA. Normal mice were analyzed 3 or 7 days after injection. To evaluate whether this approach can decrease α-Syn aggregates, we repeated the treatment using transgenic mice expressing the human phosphorylation-mimic S129D α-Syn, which exhibits aggregation. In normal mice we detected significantly reduced α-Syn messenger RNA (mRNA) and protein levels throughout the brain 3 and 7 days after treatment with RVG-exosomes loaded with siRNA to α-Syn. In S129D α-Syn transgenic mice we found a decreased α-Syn mRNA and protein levels throughout the brain 7 days after injection. This resulted in significant reductions in intraneuronal protein aggregates, including in dopaminergic neurones of the substantia nigra. This study highlights the therapeutic potential of RVG-exosome delivery of siRNA to delay and reverse brain α-Syn pathological conditions

Pin1-dependent signaling negatively affects GABAergic transmission by modulating neuroligin2/gephyrin interaction

The cell adhesion molecule Neuroligin2 (NL2) is localized selectively at GABAergic synapses, where it interacts with the scaffolding protein gephyrin in the post-synaptic density. However, the role of this interaction for formation and plasticity of GABAergic synapses is unclear. Here, we demonstrate that endogenous NL2 undergoes proline-directed phosphorylation at its unique S714-P consensus site, leading to the recruitment of the peptidyl-prolyl cis-trans isomerase Pin1. This signalling cascade negatively regulates NL2' s ability to interact with gephyrin at GABAergic post-synaptic sites. As a consequence, enhanced accumulation of NL2, gephyrin and GABA A receptors was detected at GABAergic synapses in the hippocampus of Pin1-knockout mice (Pin1\ufffd/\ufffd) associated with an increase in amplitude of spontaneous GABA A -mediated post-synaptic currents. Our results suggest that Pin1-dependent signalling represents a mechanism to modulate GABAergic transmission by regulating NL2/gephyrin interaction. \ufffd 2014 Macmillan Publishers Limited. All rights reserved

Symptomatic, biochemical and radiographic recovery in patients with Covid-19

Background: The symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described. Methods: Retrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness. Results: 75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge. Conclusions: Patients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19

GABAergic Gene Expression in Postmortem Hippocampus from Alcoholics and Cocaine Addicts; Corresponding Findings in Alcohol-Naïve P and NP Rats

BACKGROUND:By performing identical studies in humans and rats, we attempted to distinguish vulnerability factors for addiction from neurobiological effects of chronic drug exposure. We focused on the GABAergic system within the hippocampus, a brain region that is a constituent of the memory/conditioning neuronal circuitry of addiction that is considered to be important in drug reinforcement behaviors in animals and craving and relapse in humans. METHODOLOGY:Using RNA-Seq we quantified mRNA transcripts in postmortem total hippocampus from alcoholics, cocaine addicts and controls and also from alcohol-naïve, alcohol preferring (P) and non-preferring (NP) rats selectively bred for extremes of alcohol-seeking behavior that also show a general addictive tendency. A pathway-targeted analysis of 25 GABAergic genes encoding proteins implicated in GABA synthesis, metabolism, synaptic transmission and re-uptake was undertaken. PRINCIPAL FINDINGS:Directionally consistent and biologically plausible overlapping and specific changes were detected: 14/25 of the human genes and 12/25 of the rat genes showed nominally significant differences in gene expression (global p values: 9×10⁻¹⁴, 7×10⁻¹¹ respectively). Principal FDR-corrected findings were that GABBR1 was down-regulated in alcoholics, cocaine addicts and P rats with congruent findings in NSF, implicated in GABAB signaling efficacy, potentially resulting in increased synaptic GABA. GABRG2, encoding the gamma2 subunit required for postsynaptic clustering of GABAA receptors together with GPHN, encoding the associated scaffolding protein gephryin, were both down-regulated in alcoholics and cocaine addicts but were both up-regulated in P rats. There were also expression changes specific to cocaine addicts (GAD1, GAD2), alcoholics (GABRA2) and P rats (ABAT, GABRG3). CONCLUSIONS/SIGNIFICANCE:Our study confirms the involvement of the GABAergic system in alcoholism but also reveals a hippocampal GABA input in cocaine addiction. Congruent findings in human addicts and P rats provide clues to predisposing factors for alcohol and drug addiction. Finally, the results of this study have therapeutic implications

Role of serotonergic signaling in GABAA receptor phosphorylation and functional expression.

γ-aminobutyric acid type-A (GABAA) receptors are heteropentameric ligand-gated chloride channels that mediate the majority of fast synaptic inhibition in the brain. Emerging evidence indicates that their functional expression is subject to dynamic modulation by phosphorylation. However, the cell signaling molecules responsible for regulating GABAA receptor phosphorylation and thus the efficacy of neuronal inhibition remain to be identified. The β subunits are of particular interest in this context as their intracellular domains contain conserved serine residues (S409 in β1, S410 in β2 and S408/9 in β3), known substrates for a number of protein kinases, including PKA and PKC. In vitro binding experiments showed that phosphorylation and/or mutation of these residues confers a reduction in binding of GABAA receptor β subunits to the μ2 adaptin of the clathrin adaptor protein (AP)-2 complex - a critical regulator of GABAA receptor endocytosis and surface number. Consistent with this, coimmunoprecipitation of AP2-μ2 adaptin with endogenous GABAA receptor β3 subunits was significantly reduced in cultured neurons treated with a potent inhibitor of S408/9 dephosphorylation that was accompanied by an increase in the stability of GABAA receptor β3 subunits at the cell surface. Interestingly, recent studies have implicated PKA and PKC in the mediation of serotonergic modulation of GABAA receptor activity in the prefrontal cortex, suggesting that phosphorylation of GABAA receptor β subunits may underlie this regulation. To address this, a phospho-specific antibody directed against β3 at S408/9 was developed. Immunoblotting with anti-pS408/9-β3 demonstrated a PKC-dependent increase in the phosphorylation state of GABAA receptor β3 subunits following enhanced 5-hydroxytryptamine type-2 (5-HT2) receptor activation ex vivo. Moreover, in vivo biochemical and immunohistochemical studies revealed region-specific increases in GABAA receptor β3 subunit phosphorylation in mice dosed with the selective serotonin reuptake inhibitor (SSRI) fluoxetine (Prozac™), a commonly prescribed antidepressant. Together, the results presented herein suggest that the phospho-dependent increase in GABAA receptor functional expression may underlie the therapeutic action of SSRIs.

Mapping the burden of severe forms of epidermolysis bullosa – Implications for patient managementCapsule Summary

Background: The pathophysiological processes underlying the phenotypic spectrum of severe forms of epidermolysis bullosa (EB) are complex and poorly understood. Objective: To use burden mapping to explore relationships between primary pathomechanisms and secondary clinical manifestations in severe forms of EB (junctional and dystrophic EB [JEB/DEB]) and highlight strengths and weaknesses in evidence regarding the contribution of different pathways. Methods: Literature searches were performed to identify evidence regarding the pathophysiological and clinical aspects of JEB/DEB. Identified publications and clinical experience were used to construct burden maps to visually communicate plausible connections and their relative importance by subtype. Results: Our findings suggest that most of the clinical consequences of JEB/DEB may result from an abnormal state and/or faulty skin remodeling driven by a vicious cycle of delayed wound healing, predominantly mediated through inflammation. The quantity and quality of evidence varies by individual manifestations and disease subtype. Limitations: The burden maps are provisional hypotheses requiring further validation and are limited by the published evidence base and subjectivity in clinical opinion. Conclusions: Delayed wound healing appears to be a key driver of the burden of JEB/DEB. Further studies are warranted to understand the role of inflammatory mediators and accelerated wound healing in patient management

Targeted long-read sequencing identifies missing pathogenic variants in unsolved Werner syndrome cases.

BACKGROUND: Werner syndrome (WS) is an autosomal recessive progeroid syndrome caused by variants in WRN. The International Registry of Werner Syndrome has identified biallelic pathogenic variants in 179/188 cases of classical WS. In the remaining nine cases, only one heterozygous pathogenic variant has been identified. METHODS: Targeted long-read sequencing (T-LRS) on an Oxford Nanopore platform was used to search for a second pathogenic variant in WRN. Previously, T-LRS was successfully used to identify missing variants and analyse complex rearrangements. RESULTS: We identified a second pathogenic variant in eight of nine unsolved WS cases. In five cases, T-LRS identified intronic splice variants that were confirmed by either RT-PCR or exon trapping to affect splicing; in one case, T-LRS identified a 339 kbp deletion, and in two cases, pathogenic missense variants. Phasing of long reads predicted all newly identified variants were on a different haplotype than the previously known variant. Finally, in one case, RT-PCR previously identified skipping of exon 20; however, T-LRS did not detect a pathogenic DNA sequence variant. CONCLUSION: T-LRS is an effective method for identifying missing pathogenic variants. Although limitations with computational prediction algorithms can hinder the interpretation of variants, T-LRS is particularly effective in identifying intronic variants