Pesquisar Neste Blog

quinta-feira, 16 de junho de 2011

Cientistas identificam gene vinculado à paralisia cerebral

Uma equipe de pesquisadores que traçou a sequência genética de dois irmãos gêmeos afetados pela paralisia cerebral identificou o gene causador do transtorno nas crianças, segundo estudo publicado nesta quarta-feira pela revista "Science Translational Medicine".

A descoberta permitiu oferecer aos irmãos um tratamento efetivo que ameniza os sintomas da doença.

O menino Noah Berry e a irmã dele, Alexis, foram diagnosticados com paralisia cerebral quando tinham dois anos. Aos quatro, os tratamentos aos quais foram submetidos apresentaram resultados efêmeros.

A paralisia cerebral, um transtorno permanente e não progressivo que afeta a psicomotricidade do paciente e limita a atividade da pessoa, é atribuída a problemas no desenvolvimento cerebral do feto. A doença não tem cura conhecida.

A incidência do transtorno em países desenvolvidos é de aproximadamente 2 a 2,5 em cada mil nascimentos e não diminuiu nas últimas seis décadas, apesar dos avanços médicos como a monitoração dos sinais vitais dos fetos.

As crianças herdaram duas cópias do gene SPR que sofreram mutação --uma da mãe e uma do pai.

A mutação do SPR transtornou a senda celular responsável não só pela produção de dopamina, mas também de outros dois neurotransmissores: a serotonina e a noradrenalina.

Os dois neurotransmissores operam na sinapse, ponto de contato no qual um neurônio passa sinais elétricos e químicos para outro. Para suprir a deficiência de dopamina e serotonina, os médicos recomendaram uma dose pequena de um suplemento chamado 5-HTP a seus outros remédios.

"Um mês depois do início do novo tratamento, a respiração de Alexis melhorou notavelmente", comentou Reeta, mãe das crianças, acrescentando que a menina voltou a correr.

Noah também se beneficiou e sua mãe afirmou que o menino consegue escrever melhor e está mais concentrado na escola.

A identificação da sequência genética é resultado da tecnologia avançada do Centro Baylor de Sequenciamento do Genoma Humano, dos EUA, que contou com a colaboração de médicos e pesquisadores de outras partes do país.

O Centro Baylor é pioneiro no traçado completo da sequência genética de indivíduos desde que o prêmio Nobel James Watson apresentou seu mapa genético em 2007.

Laminin's Role in Cancer Formation Illuminated


ScienceDaily (June 15, 2011) — Laminin, long thought to be only a structural support protein in the microenvironment of breast and other epithelial tissue, is "famous" for its cross-like shape. However, laminin is far more than just a support player with a "pretty face." Two studies led by one of the world's foremost breast cancer scientists have shown how laminin plays a central role in the development of breast cancer, the second most leading cause of cancer death among women in the United States. In one study it was shown how laminin influences the genetic information inside a cell's nucleus. In the other study it was shown how destruction of laminin can play a detrimental role in the early stages of tumor development.

A 3D cell culture assay developed by Mina Bissell and her research group enables breast cells to reproduce actual structural units, an advantage that was essential for understanding the role of laminin in breast cancer development. 
Mina Bissell is famous for having discovered the critical role in breast cancer development played by the extracellular matrix (ECM), the network of fibrous and globular proteins surrounding a breast cell. Her "dynamic reciprocity" theory holds that the fate of cells -- whether they stay healthy or become cancerous -- hinges on the chemical signals exchanged between the ECM and a cell's nucleus. In these latest studies, Bissell and her collaborators focused on laminin and its connections with two other proteins -- actin, a cytoplasmic protein that has been linked to nuclear activities; and MMP9, an enzyme that is secreted outside the cells and is known to break down ECM constituents.

Laminin and Cell Quiescence

"Quiescence" is the process by which a biological cell stops growing or dividing. This is the opposite of a cancerous state, in which cell growth and division is often unchecked. Signals from laminin-111, an ECM protein that helps the cell and its ECM stick together, have been linked to cell quiescence but the mechanism was unknown. Bissell and postdoctoral fellow, Virginia Spencer, in Berkeley Lab's Life Sciences Division, have now shown that the addition of laminin-111 leads to quiescence in breast epithelial cells through changes in nuclear actin.

"We found that high levels of laminin-111 depleted nuclear actin and this in turn induced cell quiescence," Bissell says. "Furthermore, this process can be prevented if a form of actin that can not exit the nucleus is introduced. Under these conditions the cells do not stop growing even in the presence of laminin."

In their study, Bissell and Spencer and their colleagues used a unique three-dimensional cell culture assay developed by Bissell's research group, and worked with mouse and human mammary epithelial cells. Through the addition of laminin-111, they were able to decrease nuclear actin levels in the cultured cells, which reduced DNA synthesis and transcription. When nuclear actin levels were deliberately over-expressed, the effects were reversed and cells were prevented from becoming quiescent even in the presence of laminin-111. Furthermore, the high levels of nuclear actin were concentrated in regions of the breast cells where there was little or no laminin-111. Taken together, the results implicate laminin-111 as the regulator of nuclear actin and nuclear actin as a key mediator of epithelialcell quiescence.

"In collaboration with Ole Petersen's laboratory, we had found previously that the ECM surrounding tissues from breast cancers has a dramatic reduction in laminin-111 in comparison to the ECM surrounding a normal breast cell, which is rich in laminin-111," Bissell says. "However, just giving laminin back to cancer cells was not enough to make them normal so other factors are clearly also involved and one such factor we now know is how laminin-111 and nuclear actin talk to each other!"

Says Spencer, "Ours is the first study to actually identify laminin-111 as the physiological regulator of nuclear actin and to implicate the loss of nuclear actin as a key step in reaching quiescence and homeostasis in the mammary gland in vivoand in culture."

Spencer believes that the interaction between laminin-111 and nuclear actin could provide a new target for diagnostic therapeutic efforts, but this will require further study.

"While it remains to be determined whether dysregulation of the levels or organization of nuclear actin is responsible for the inability of malignant cells to respond to growth-inhibitory signals from laminin-111, our preliminary results point in this direction," she says. "In addition, the findings that laminin-111 expression is lost in myoepithelial cells isolated from human tumors should place the interaction of laminin-111 and breast tumor cells at the forefront of future investigations."

A paper detailing the results of this study appears in theJournal of Cell Science. The paper is titled "Depletion of nuclear actin is a key mediator of quiescence in epithelial cells." Co-authoring the paper with Bissell and Spencer were Sylvain Costes, Jamie Inman, Ren Xu, James Chen and Michael Hendzel.

Laminin, MMP9 and Tumor Growth

In the second study, which was related to the role of laminin-111 in cell quiescence, Bissell and another group of collaborators examined laminin-111 in the context of matrix metalloproteinase-9 (MMP9), a zinc-dependent enzyme that plays a huge role in tissue function by virtue of its ability to cleave or degrade many of the ECM constituent proteins, including laminin-111.

"Organization into polarized three-dimensional tissue structures defines whether epithelial cells are normal or malignant," Bissell says. "We have shown that when MMP9 degrades laminin-111 in the ECM, the tissue architecture of breast cells becomes lost and cell proliferation is initiated. This is the first demonstration of how the degradation of laminin-111 by MMP9 in a physiological context contributes to tumor progression."

A paper detailing the results of this study has appeared in the journal Genes and Development. The paper is titled "Raf-induced MMP9 Disrupts Tissue Architecture of Human Breast Cells in Three-Dimensional Culture and is Necessary for Tumor Growth in vivo." Co-authoring the paper with Bissell were Alain Beliveau, Joni Mott, Alvin Lo, Emily Chen, Antonius Koller, Paul Yaswen and John Muschler.

Using a model of human breast cancer where breast epithelial cells were grown in three-dimensional cultures of basement membrane, a thin layer of ECM material that envelops breast and other glandular tissue, Bissell and her co-authors found that not only did excessive MMP9 activity disrupt tissue architecture, but that silencing MMP9 restored tissue architecture and decreased the ability of human beast cancer cells to form tumors in mice.

"We found that in all conditions where tumor cells could be reverted to a normal phenotype in our 3D assays, a novel signaling loop through a pathway of Raf/MEK/ERK proteins was responsible for MMP9 activity in the breast tumor cells," says co-author Joni Mott, a researcher with Bissell's group in Berkeley Lab's Life Sciences Division. "Once MMP9 was activated, the proteinase targeted the destruction of laminin-111 within the basement membrane."

Laminin-111 in the basement membrane, Mott explains, allows mammary epithelial cells to establish a normal polarized structural unit called an "acinus," which is responsible for storing milk and making it available for babies when they suckle.

In their Genes and Development paper, Bissell, Mott and their co-authors reported that when the integrity of the tissue architecture was compromised by laminin proteolysis, the basement membrane no longer provided the appropriate signals to restrain epithelial cell proliferation. The result was a sustained signaling of the Raf/MEK/ERK pathway that leads to continued MMP9 production and further disruption of tissue architecture and loss of cell growth control.

"This work is particularly poignant because it provides potential new therapeutic targets for controlling breast cancer and revitalizes the possibility of targeting MMPs in cancer therapy," Bissell says. "New information on how MMP9 and other MMPs truly function may provide highly targeted and effective therapeutic strategies to control MMP activity in cancer, and may soon lead to the development of novel cancer treatments."

Both studies were funded in part by grants from the U.S. Department of Energy's Office of Science, the National Cancer Institute, and the U.S. Department of Defense.

Low-Carbohydrate, High-Protein Diets May Reduce Both Tumor Growth Rates and Cancer Risk

ScienceDaily (June 15, 2011) — Eating a low-carbohydrate, high-protein diet may reduce the risk of cancer and slow the growth of tumors already present, according to a study published in Cancer Research, a journal of the American Association for Cancer Research.
A new study in mice suggests that eating a low-carbohydrate, high-protein diet may reduce the risk of cancer and slow the growth of tumors already present. 
The study was conducted in mice, but the scientists involved agree that the strong biological findings are definitive enough that an effect in humans can be considered.

"This shows that something as simple as a change in diet can have an impact on cancer risk," said lead researcher Gerald Krystal, Ph.D., a distinguished scientist at the British Columbia Cancer Research Centre.

Cancer Research editor-in-chief George Prendergast, Ph.D., CEO of the Lankenau Institute for Medical Research, agreed. "Many cancer patients are interested in making changes in areas that they can control, and this study definitely lends credence to the idea that a change in diet can be beneficial," said Prendergast, who was not involved with the study.

Krystal and his colleagues implanted various strains of mice with human tumor cells or with mouse tumor cells and assigned them to one of two diets. The first diet, a typical Western diet, contained about 55 percent carbohydrate, 23 percent protein and 22 percent fat. The second, which is somewhat like a South Beach diet but higher in protein, contained 15 percent carbohydrate, 58 percent protein and 26 percent fat. They found that the tumor cells grew consistently slower on the second diet.

As well, mice genetically predisposed to breast cancer were put on these two diets and almost half of them on the Western diet developed breast cancer within their first year of life while none on the low-carbohydrate, high-protein diet did. Interestingly, only one on the Western diet reached a normal life span (approximately 2 years), with 70 percent of them dying from cancer while only 30 percent of those on the low-carbohydrate diet developed cancer and more than half these mice reached or exceeded their normal life span.

Krystal and colleagues also tested the effect of an mTOR inhibitor, which inhibits cell growth, and a COX-2 inhibitor, which reduces inflammation, on tumor development, and found these agents had an additive effect in the mice fed the low-carbohydrate, high-protein diet.

When asked to speculate on the biological mechanism, Krystal said that tumor cells, unlike normal cells, need significantly more glucose to grow and thrive. Restricting carbohydrate intake can significantly limit blood glucose and insulin, a hormone that has been shown in many independent studies to promote tumor growth in both humans and mice.

Furthermore, a low-carbohydrate, high-protein diet has the potential to both boost the ability of the immune system to kill cancer cells and prevent obesity, which leads to chronic inflammation and cancer.

Drug Significantly Improves Glycemic Control in Type 1 Diabetics on Insulin, Study Suggests


ScienceDaily (June 15, 2011) — Results of a small, observational study conducted at the University at Buffalo suggest that liraglutide, an injectable medication used to treat type 2 diabetes, also helps type 1 diabetics on insulin achieve optimal control of their blood glucose levels.The research has been published online ahead of print in the European Journal of Endocrinology. It also was recently presented at the annual meeting of the Endocrine Society in Boston, where it received recognition as one of the most outstanding abstracts presented and the best in the field of diabetes.
Results of a small, observational study conducted at the University at Buffalo suggest that liraglutide, an injectable medication used to treat type 2 diabetes, also helps type 1 diabetics on insulin achieve optimal control of their blood glucose levels
If the findings are confirmed in a larger, prospective, randomized study now being planned by the UB researchers, they could mean the first significant, new treatment for type 1 diabetes since insulin was discovered and made available in the 1920s.

"Since the development of injectable insulin, there has been nothing definitive in terms of a significant advance in type 1 diabetes treatments," says Paresh Dandona, MD, PhD, UB distinguished professor of medicine in the School of Medicine and Biomedical Sciences and senior author on the study. "That is the tragedy of the type 1 diabetic.

"This study shows that liraglutide can provide even well-controlled type 1 diabetics with additional benefits that help them achieve even better blood glucose levels," says Dandona.

The patients on liraglutide, which is marketed as Victoza, also saw a reduction in appetite and food intake and the paper reports that body weight significantly fell in patients who took the drug for 24 weeks.

The unfunded study was a retrospective analysis of data. It was conducted at Kaleida Health's Diabetes-Endocrinology Center of Western New York, which Dandona directs.

At the start of the study, all 14 patients had hemoglobin A1C levels of under 7, which is considered optimal. They were characterized in the paper as "well-controlledÂ…meticulous and disciplined" in terms of their ability to control their blood glucose levels with insulin.

Nevertheless, Dandona notes, even well-controlled type 1 diabetics still experience "glycemic excursions," fairly wide swings in their blood glucose numbers ranging from the hyperglycemic, from 150 milligrams per deciliter to 250 mg/dl or higher to the hypoglycemic, under 70 mg/dl.

"The addition of liraglutide to insulin therapy in these well-controlled type 1 diabetics resulted in a significant and rapid reduction in glycemic excursions and, as a consequence, a rapid reduction in the amount of insulin they needed to take," Dandona explains. Several figures in this presentation by Dandona clearly demonstrate this effect.

These improvements occurred rapidly, within 1-2 days of beginning treatment with liraglutide and they reversed just as rapidly when treatment was discontinued, signifying that it was the drug that was responsible for these beneficial effects.

The mechanism behind these improvements is not well-understood but Dandona and his co-authors suggest that liraglutide may be suppressing the post-meal increase in glucagon, the hormone that raises glucose levels, in type 1 diabetics.

Dandona and his colleagues are now planning a much larger, multicenter study of liraglutide in type 1 diabetics.

"We will be investigating in detail the hypothesis that it is liraglutide's ability to suppress glucagon that significantly reduces the wide swings in blood glucose levels that type 1 diabetics -- even those with very good glucose control -- live with everyday," says Dandona.

The retrospective study involved 14 adult type 1 diabetics who took liraglutide for periods ranging from one week to 24 weeks.

Several Methods for Early Diagnosis of Alzheimer's Disease Developed

ScienceDaily (June 15, 2011) — PredictAD is an EU-funded research project that develops objective and efficient methods for enabling earlier diagnosis of Alzheimer's disease. Diagnosis requires a holistic view of the patient combining information from several sources, such as, clinical tests, imaging and blood samples.

An MRI scan reveals details of brain structure and function.
"The aim of the PredictAD project is to develop an objective indicator to diagnose Alzheimer's disease at the earliest stage possible. Current diagnostic guidelines emphasise the importance of various biomarkers in diagnostics. We have developed novel approaches to extract biomarkers from imaging data, electrophysiological data and blood samples, and a unique and clinically useful software tool for integrating all these heterogeneous measurements." says the Scientific Coordinator of the project, Dr Jyrki Lötjönen from VTT Technical Research Centre of Finland.

Magnetic resonance imaging for identifying atrophy

Atrophy in the mediotemporal lobe is a well-known hallmark of Alzheimer's disease. Magnetic resonance imaging is an excellent tool for measuring this tissue loss. In current clinical practice, images are interpreted mostly only by visual inspection but there is a great need for objective measurements.

PredictAD has developed several methods to meet this need. "We have managed to develop efficient tools for measuring the size of the hippocampus, the atrophy rate of the hippocampus, and two modern approaches based on comparing patient data with previously diagnosed cases available in large databases." says the leader of the imaging biomarkers work-package, professor Daniel Rueckert from Imperial College London. Positron emission tomography (PET) imaging is another imaging technology studied in the project. A novel tracer developed recently especially for diagnostics of Alzheimer's disease provides promises for very early diagnosis of the disease.

Detecting changes in the electrophysiology of the brain

Alzheimer's disease is known to affect the electromagnetic activity of the brain. In PredictAD, we have studied the performance of a novel technology, transcranial magnetic stimulation (TMS) combined with electroencephalographic (EEG) measures in detecting the disease. The strength of TMS/EEG is that it allows direct and non-invasive perturbation of the human cerebral cortex without requiring the subject's collaboration. Our study has shown significant changes in Alzheimer's patients compared with healthy aging people.

Non-invasive techniques to find biomarkers of the disease

Molecular level biomarkers are currently under extensive studies in Alzheimer's research. Many biomarkers, such as tau proteins and b-amyloid 42, measured from the cerebrospinal fluid (CSF), the liquid surrounding the cerebral cortex, have been found to be strongly related with the disease. One major challenge of these biomarkers is that taking samples from CSF is an invasive measurement limiting their usability in early diagnostics. Blood samples would be an excellent source for detecting Alzheimer's disease as blood sampling is not considered an invasive technique. PredictAD has studied the role of metabolomic and protein compounds in Alzheimer's disease from blood samples. The preliminary results reveal several promising compounds.

Methodology for measuring the state of the patient

Currently, clinicians make the final diagnosis by combining heterogeneous measurements with information from interviews of the patient and relatives. This process involves subjective reasoning and requires strong expertise from the clinicians. Modern hospitals have huge data reserves containing hidden information that could be utilised in diagnostics by systematic mathematical modelling.

PredictAD has designed a totally novel approach for measuring objectively the state of the patient. This decision support system, developed in close collaboration with clinicians, compares patient measurements with measurements of other patients in large databases and provides at the end an index and graphical representation reflecting the state of the patient. "The PredictAD tool provides a new option to support decision making," says Prof. Hilkka Soininen from the University of Eastern Finland, leading the clinical validation of the project.

Possibilities for significant savings in health costs

Prof. Gunhild Waldemar from Copenhagen University Hospital, Rigshospitalet emphasises the importance of the Alzheimer's disease research: "Successful, early diagnostics combined with the novel drugs under development and early psychosocial care may delay the institutionalisation of patients, reducing suffering and the costs to the society. It has been calculated that delaying the onset of the disease by five years would halve all costs of Alzheimer's disease and delaying onset and progression by only one year would reduce the number of Alzheimer's cases by about 10%."