When Students Grieve: Teachers of Students With Intellectual Disabilities

The identification and provision of support for the emotional needs of children with intellectual disabilities is essential as these students are often “disenfranchised grievers”-- meaning their grief is not recognized by others. The purpose of this study was to explore the experiences of teachers who have had elementary students with intellectual disabilities who have lost a parent or guardian. Additionally, this study documented behavioral changes and grief symptoms noted by teachers in their students, as well as how teachers responded to these perceived expressions of grief. Five teachers participated in two interviews designed to elicit information on their experience with grieving students. Constructivist grounded theory methods were used to analyze the data. Findings indicated that students were deeply impacted by the death of their parent or guardian. They displayed a range of grieving symptoms such as crying and aggression. Teachers overwhelmingly supported their grieving students despite being emotionally impacted themselves. They responded in ways suggested by grief and educational professionals such as when they provided concrete and simple explanations to assist with student understanding of death. Teachers expressed concern about the surviving caregivers’ own grief and the subsequent impact on their students. Teachers also highlighted the need for more grieving resources

The basic helix loop helix transcription factor twist1 is a novel regulator of ATF4 in osteoblasts

Parathyroid hormone (PTH) is an essential regulator of endochondral bone formation and an important anabolic agent for the reversal of bone loss. PTH mediates its functions in part by regulating binding of the bone‐related activating transcription factor 4 (ATF4) to the osteoblast‐specific gene, osteocalcin. The basic helix‐loop‐helix (bHLH) factors Twist1 and Twist2 also regulate osteocalcin transcription in part through the interaction of the C‐terminal “box” domain in these factors and Runx2. In this study, we discovered a novel function of PTH: its ability to dramatically decrease Twist1 transcription. Since ATF4 is a major regulator of the PTH response in osteoblasts, we assessed the mutual regulation between these factors and determined that Twist proteins and ATF4 physically interact in a manner that affects ATF4 DNA binding function. We mapped the interaction domain of Twist proteins to the C‐terminal “box” domain and of ATF4, to the N‐terminus. Furthermore, we demonstrate that Twist1 overexpression in osteoblasts attenuates ATF4 binding to the osteocalcin promoter in response to PTH. This study thus identifies Twist proteins as novel inhibitory binding partners of ATF4 and explores the functional significance of this interaction. J. Cell. Biochem. 113: 70–79, 2012. © 2011 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/89496/1/23329_ftp.pd

Caractérisation fonctionnelle de variations génétiques dans PALB2, un gène de susceptibilité au cancer du sein

PALB2 (Partner And Localizer of BRCA2) est un gène de prédisposition au cancer du sein à forte pénétrance. En effet, les mutations pathogéniques dans PALB2 augmentent le risque de développer la maladie de 8 à 9 fois pour les porteuses de moins de 40 ans et de 3 à 4 fois au cours de leur vie. À ce jour, environ 200 variations de type faux sens localisées dans PALB2 ont été identifiées en clinique, chez des patientes atteintes d’un cancer du sein, mais très peu ont été caractérisées fonctionnellement. De plus, aucune méthode d’analyse fonctionnelle à grande échelle de ces variants de signification incertaine n’a été élaborée pour le moment. Par conséquent, les médecins et conseillers en génétique ne sont pas en mesure d’interpréter l’effet de ces variations en termes de risque et la prise de décision quant au suivi de ces porteuses, la communication de leur risque, la divulgation aux membres de la famille, le recours aux chirurgies préventives ou encore le choix des stratégies de traitement est complexe. La compréhension de l’effet des variations faux sens sur la fonction de PALB2 est donc indispensable pour leur classification et leur interprétation en clinique. PALB2 étant un médiateur de la réparation des cassures double-brin par recombinaison homologue, nous avons proposé d’établir une méthode systématique d’essais biochimiques et cellulaires, centrée sur la fonction de PALB2 dans la recombinaison homologue. Nous avons émis l’hypothèse que cette méthode de caractérisation fonctionnelle est suffisante pour classer ces variants comme bénins ou délétères pour la fonction de PALB2 dans la recombinaison homologue. Ainsi, au cours de mon doctorat, j’ai participé à la caractérisation fonctionnelle d’une centaine de variations faux sens ainsi qu’une mutation tronquante localisées dans PALB2. Nos travaux montrent que notre méthode systématique est pertinente pour la caractérisation fonctionnelle des variants de signification incertaine. En effet, nous avons identifié plusieurs variants faux sens qui présentent des défauts importants ou intermédiaires de recombinaison homologue et qui favorisent ainsi l’instabilité génomique et la carcinogénèse. Enfin, nous avons montré que le score de formation de foyers RAD51 est un bon marqueur des tumeurs de cancer du sein avec des défauts de recombinaison homologue sensibles aux traitements basés sur les inhibiteurs de PARP

Le syndrome lupique à expression cutanée chez le chien : synthèse des données actuelles

Le syndrome lupique à expression cutanée, l'une des dermatoses auto-immunes les plus fréquentes chez le chien, regroupe plusieurs entités distinctes. Leur pathogénie est complexe, de nombreux facteurs, d'ordre immunologique ou non, étant impliqués. La classification actuelle des Lupus cutanés chez le chien distingue les formes à expression exclusivement cutanée des formes à expression systémique. Les manifestations cliniques varient en fonction de la forme lupique considérée. La mise en oeuvre du diagnostic est souvent très difficile et fait appel à l'ensemble des critères épidémiologiques, cliniques, histopathologiques et immunopathologiques. Le traitement des Lupus repose sur l'immunosuppression ; les substances immunomodulatrices ayant souvent d'importants effets secondaires, leur utilisation doit être faîte avec précaution et à adapter au cas par cas

The role of osteocalcin in the endocrine cross-talk between bone remodelling and energy metabolism

Abstract Bone remodelling, which maintains bone mass constant during adulthood, is an energy-demanding process. This, together with the observation that the adipocyte-derived hormone leptin is a major inhibitor of bone remodelling, led to the hypothesis that bone cells regulate energy metabolism through an endocrine mechanism. Studies to test this hypothesis identified osteocalcin, a hormone secreted by osteoblasts, as a positive regulator of insulin secretion, insulin resistance and energy expenditure. Remarkably, insulin signalling in osteoblasts is a positive regulator of osteocalcin production and activation via its ability to indirectly enhance bone resorption by osteoclasts. In contrast, leptin is a potent inhibitor of osteocalcin function through its effect on the sympathetic tone. Hence, osteocalcin is part of a complex signalling network between bone and the organs more classically associated with the regulation of energy homeostasis, such as the pancreas and adipose tissue. This review summarises the molecular and cellular bases of the present knowledge on osteocalcin biology and discusses the potential relevance of osteocalcin to human metabolism and pathology

FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

Background: The aim of our study was to evaluate the relevance of FGF23-klotho axis in the predisposition for bone fractures in type 2 diabetic patients with early chronic kidney disease. Methods: In a prospective study we included 126 type 2 diabetic patients with CKD stages 2-3 (from 2010 to 2017). We used descriptive statistics, ANOVA and chi-square test. Our population was divided into two groups according to the occurrence of a bone fracture event or not, and the groups were compared considering several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors for bone fracture events and hazard ratios (HR) were calculated using a backward stepwise likelihood ratio (LR) Cox regression. Results: Patients with a fracture event displayed higher levels of FGF-23, Phosphorus, PTH, TNF-alpha, OxLDL, HOMA-IR, calcium x phosphorus product and ACR and lower levels of Osteocalcin, alpha-Klotho, 25(OH)D3 and eGFR compared with patients without a fracture event (p < 0.001). The number of patients with a fracture event was higher than expected within inclining CKD stages (chi 2, p = 0.06). The occurrence of fracture and the levels of TNF-alpha, klotho, 25(OH)D3 and OxLDL were found to predict patient entry into RRT (p < 0.05). Age, osteocalcin, alpha-Klotho and FGF-23 independently influenced the occurrence of bone fracture (p < 0.05). Conclusions: alpha-Klotho and FGF-23 levels may have a good clinical use as biomarkers to predict the occurrence of fracture events. (C) 2019 Elsevier Inc. All rights reserved.info:eu-repo/semantics/publishedVersio

Identification of an osteocalcin isoform in fish with a large acidic prodomain

Osteocalcin is a small, secreted bone protein whose gene consists of four exons. In the course of analyzing the structure of fish osteocalcin genes, we recently found that the spotted green pufferfish has two possible exon 2 structures, one of 15 bp and the other of 324 bp. Subsequent analysis of the pufferfish cDNA showed that only the transcript with a large exon 2 exists. Exon 2 codes for the osteocalcin propeptide, and exon 2 of pufferfish osteocalcin is ∼3.4-fold larger than exon 2 previously found in other vertebrate species. We have termed this new pufferfish osteocalcin isoform OC2. Additional studies showed that the OC2 isoform is restricted to a unique fish taxonomic group, the Osteichthyes; OC2 is the only osteocalcin isoform found so far in six Osteichthyes species, whereas both OC1 and OC2 isoforms coexist in zebrafish and rainbow trout. The larger size of the OC2 propeptide is due to an acidic region that is likely to be highly phosphorylated and has no counterpart in the OC1 propeptide. We propose 1) that OC1 and OC2 are encoded by distinct genes that originated from a duplication event that probably occurred in the teleost fish lineage soon after divergence from tetrapods and 2) that the novel OC2 propeptide could be, if secreted, a phosphoprotein that participates in the regulation of biomineralization through its large acidic and phosphorylated propeptide

Nell-1, a key Functional Mediator of Runx2, Partially Rescues Calvarial Defects in Runx2+/− Mice

Mesenchymal stem cell commitment to an osteoprogenitor lineage requires the activity of Runx2, a molecule implicated in the etiopathology of multiple congenital craniofacial anomalies. Through promoter analyses, we have recently identified a new direct transcriptional target of Runx2, Nell-1, a craniosynostosis (CS)–associated molecule with potent osteogenic properties. This study investigated the mechanistic and functional relationship between Nell-1 and Runx2 in regulating osteoblast differentiation. The results showed that spatiotemporal distribution and expression levels of Nell-1 correlated closely with those of endogenous Runx2 during craniofacial development. Phenotypically, cross-mating Nell-1 overexpression transgenic (CMV-Nell-1) mice with Runx2 haploinsufficient (Runx2+/−) mice partially rescued the calvarial defects in the cleidocranial dysplasia (CCD)–like phenotype of Runx2+/− mice, whereas Nell-1 protein induced mineralization and bone formation in Runx2+/− but not Runx2−/− calvarial explants. Runx2-mediated osteoblastic gene expression and/or mineralization was severely reduced by Nell-1 siRNA oligos transfection into Runx2+/+ newborn mouse calvarial cells (NMCCs) or in N-ethyl-N-nitrosourea (ENU)–induced Nell-1−/− NMCCs. Meanwhile, Nell-1 overexpression partially rescued osteoblastic gene expression but not mineralization in Runx2 null (Runx2−/−) NMCCs. Mechanistically, irrespective of Runx2 genotype, Nell-1 signaling activates ERK1/2 and JNK1 mitogen-activated protein kinase (MAPK) pathways in NMCCs and enhances Runx2 phosphorylation and activity when Runx2 is present. Collectively, these data demonstrate that Nell-1 is a critical downstream Runx2 functional mediator insofar as Runx2-regulated Nell-1 promotes osteoblastic differentiation through, in part, activation of MAPK and enhanced phosphorylation of Runx2, and Runx2 activity is significantly reduced when Nell-1 is blocked or absent. © 2011 American Society for Bone and Mineral Research

Integrative Physiology: Defined Novel Metabolic Roles of Osteocalcin

The prevailing model of osteology is that bones constantly undergo a remodeling process, and that the differentiation and functions of osteoblasts are partially regulated by leptin through different central hypothalamic pathways. The finding that bone remodeling is regulated by leptin suggested possible endocrinal effects of bones on energy metabolism. Recently, a reciprocal relationship between bones and energy metabolism was determined whereby leptin influences osteoblast functions and, in turn, the osteoblast-derived protein osteocalcin influences energy metabolism. The metabolic effects of bones are caused by the release of osteocalcin into the circulation in an uncarboxylated form due to incomplete γ-carboxylation. In this regard, the Esp gene encoding osteotesticular protein tyrosine phosphatase is particularly interesting because it may regulate γ-carboxylation of osteocalcin. Novel metabolic roles of osteocalcin have been identified, including increased insulin secretion and sensitivity, increased energy expenditure, fat mass reduction, and mitochondrial proliferation and functional enhancement. To date, only a positive correlation between osteocalcin and energy metabolism in humans has been detected, leaving causal effects unresolved. Further research topics include: identification of the osteocalcin receptor; the nature of osteocalcin regulation in other pathways regulating metabolism; crosstalk between nutrition, osteocalcin, and energy metabolism; and potential applications in the treatment of metabolic diseases

BMP2 commitment to the osteogenic lineage involves activation of Runx2 by DLX3 and a homeodomain transcriptional network

Several homeodomain (HD) proteins are critical for skeletal patterning and respond directly to BMP2 as an early step in bone formation. RUNX2, the earliest transcription factor proven essential for commitment to osteoblastogenesis, is also expressed in response to BMP2. However, there is a gap in our knowledge of the regulatory cascade from BMP2 signaling to the onset of osteogenesis. Here we show that BMP2 induces DLX3, a homeodomain protein that activates Runx2 gene transcription. Small interfering RNA knockdown studies in osteoblasts validate that DLX3 is a potent regulator of Runx2. Furthermore in Runx2 null cells, DLX3 forced expression suffices to induce transcription of Runx2, osteocalcin, and alkaline phosphatase genes, thus defining DLX3 as an osteogenic regulator independent of RUNX2. Our studies further show regulation of the Runx2 gene by several homeodomain proteins: MSX2 and CDP/cut repress whereas DLX3 and DLX5 activate endogenous Runx2 expression and promoter activity in non-osseous cells and osteoblasts. These HD proteins exhibit distinct temporal expression profiles during osteoblast differentiation as well as selective association with Runx2 chromatin that is related to Runx2 transcriptional activity and recruitment of RNA polymerase II. Runx2 promoter mutagenesis shows that multiple HD elements control expression of Runx2 in relation to the stages of osteoblast maturation. Our studies establish mechanisms for commitment to the osteogenic lineage directly through BMP2 induction of HD proteins DLX3 and DLX5 that activate Runx2, thus delineating a transcriptional regulatory pathway mediating osteoblast differentiation. We propose that the three homeodomain proteins MSX2, DLX3, and DLX5 provide a key series of molecular switches that regulate expression of Runx2 throughout bone formation. <br/