Mitofusin-2 Regulates Platelet Mitochondria and Function.

BACKGROUND: Single-nucleotide polymorphisms linked with the rs1474868 T allele (MFN2 [mitofusin-2] T/T) in the human mitochondrial fusion protein MFN2 gene are associated with reduced platelet MFN2 RNA expression and platelet counts. This study investigates the impact of MFN2 on megakaryocyte and platelet biology. METHODS: Mice with megakaryocyte/platelet deletion of Mfn2 (Mfn2-/- [Mfn2 conditional knockout]) were generated using Pf4-Cre crossed with floxed Mfn2 mice. Human megakaryocytes were generated from cord blood and platelets isolated from healthy subjects genotyped for rs1474868. Ex vivo approaches assessed mitochondrial morphology, function, and platelet activation responses. In vivo measurements included endogenous/transfused platelet life span, tail bleed time, transient middle cerebral artery occlusion, and pulmonary vascular permeability/hemorrhage following lipopolysaccharide-induced acute lung injury. RESULTS: Mitochondria was more fragmented in megakaryocytes derived from Mfn2-/- mice and from human cord blood with MFN2 T/T genotype compared with control megakaryocytes. Human resting platelets of MFN2 T/T genotype had reduced MFN2 protein, diminished mitochondrial membrane potential, and an increased rate of phosphatidylserine exposure during ex vivo culture. Platelet counts and platelet life span were reduced in Mfn2-/- mice accompanied by an increased rate of phosphatidylserine exposure in resting platelets, especially aged platelets, during ex vivo culture. Mfn2-/- also decreased platelet mitochondrial membrane potential (basal) and activated mitochondrial oxygen consumption rate, reactive oxygen species generation, calcium flux, platelet-neutrophil aggregate formation, and phosphatidylserine exposure following dual agonist activation. Ultimately, Mfn2-/- mice showed prolonged tail bleed times, decreased ischemic stroke infarct size after cerebral ischemia-reperfusion, and exacerbated pulmonary inflammatory hemorrhage following lipopolysaccharide-induced acute lung injury. Analysis of MFN2 SNPs in the iSPAAR study (Identification of SNPs Predisposing to Altered ALI Risk) identified a significant association between MFN2 and 28-day mortality in patients with acute respiratory distress syndrome. CONCLUSIONS: Mfn2 preserves mitochondrial phenotypes in megakaryocytes and platelets and influences platelet life span, function, and outcomes of stroke and lung injury.

Student-led approaches to mental health support.

Mental health issues amongst university students are rife. Increasing mental health literacy and an emphasis on wellbeing have revealed the importance of having a plethora of resources available to students surrounding mental health support. The Welfare Hub is a student-led project created at the University of Nottingham Medical School to destigmatise mental health discussion, enhance mental health education, and share experiences of healthcare professionals regarding their mental health and university support. In this paper, we incorporate discussion around improvements the Welfare Hub can make regarding its content and how to best support future students. This project identified that the Welfare Hub's Instagram account was closely associated with mental health awareness and education, and that the best performing posts were those that offered positive connotations of support relevant to medical students and those that detailed lived medical student's experiences and advice. The Welfare Hub has had a positive impact on committee members and allowed them to fulfil their desires regarding destigmatising and discussing mental health. Future development following these findings aim to produce more educational and supportive content, develop connections of the Welfare Hub within the University and other institutions, and host events for the well-being of medical students.

A Prospective Analysis of the Simplified Student Sight Savers Program on Open-Angle Glaucoma Cost Burden in Underserved Communities.

(1) Background: Glaucoma is a leading cause of irreversible blindness worldwide. Unfortunately, no noticeable symptoms exist until mid- to late-stage glaucoma, leading to substantial costs to the patient and the healthcare system. (2) Methods: The Student Sight Savers Program, an initiative started at Johns Hopkins University, was designed to meet the needs of community screening for glaucoma. Several medical students at the Rocky Vista University in Saint George, Utah, were trained, and screened patients at local fairs and gathering places using a modified version of this program. Patients found to have elevated pressure (>21 mmHg) or other ocular abnormalities were referred for an ophthalmological examination. (3) Results: Individuals from medically underserved areas/populations (MUA/Ps) were nearly three times as likely to have elevated intraocular pressure as individuals not in underserved areas (p = 0.0141). A further analysis demonstrates that medical students can help reduce medical costs for patients and the healthcare system by providing referrals to ophthalmologists and reaching populations that are not usually screened for glaucoma. (4) Conclusions: Allowing medical students to perform community-based glaucoma screening events in MUA/Ps using handheld tonometers may decrease the cost burden associated with late diagnosis, and raise awareness about glaucoma, especially in underserved populations.

Testing models of the APC tumor suppressor/ß-catenin interaction reshapes our view of the destruction complex in Wnt signaling.

The Wnt pathway is a conserved signal transduction pathway that contributes to normal development and adult homeostasis, but is also misregulated in human diseases such as cancer. The tumor suppressor adenomatous polyposis coli (APC) is an essential negative regulator of Wnt signaling inactivated in >80% of colorectal cancers. APC participates in a multiprotein "destruction complex" that targets the proto-oncogene ß-catenin for ubiquitin-mediated proteolysis; however, the mechanistic role of APC in the destruction complex remains unknown. Several models of APC function have recently been proposed, many of which have emphasized the importance of phosphorylation of high-affinity ß-catenin-binding sites [20-amino-acid repeats (20Rs)] on APC. Here we test these models by generating a Drosophila APC2 mutant lacking all ß-catenin-binding 20Rs and performing functional studies in human colon cancer cell lines and Drosophila embryos. Our results are inconsistent with current models, as we find that ß-catenin binding to the 20Rs of APC is not required for destruction complex activity. In addition, we generate an APC2 mutant lacking all ß-catenin-binding sites (including the 15Rs) and find that a direct ß-catenin/APC interaction is also not essential for ß-catenin destruction, although it increases destruction complex efficiency in certain developmental contexts. Overall, our findings support a model whereby ß-catenin-binding sites on APC do not provide a critical mechanistic function per se, but rather dock ß-catenin in the destruction complex to increase the efficiency of ß-catenin destruction. Furthermore, in Drosophila embryos expressing some APC2 mutant transgenes we observe a separation of ß-catenin destruction and Wg/Wnt signaling outputs and suggest that cytoplasmic retention of ß-catenin likely accounts for this difference.

Neonatal presentation of chromosome 9q33.2-q34.3 duplication.

Partial terminal duplication of chromosome 9 is a rare anomaly that is known to be associated with specific dysmorphic features. While having common characteristics, these patients also have inconsistent phenotypic features. These inconsistent features may be attributed to the length and the region of the duplicated segment of chromosome 9. We discuss a case of an infant with similar physical features to those previously reported including dysmorphology of the craniofacial region, hands and feet. However we also describe findings of malrotation and renal anomalies. Microarray demonstrated duplication of 9q33.2-q34.3 with normal parental karyotyping. This is the first reported case of duplication of this specific region of chromosome 9q and the phenotypic presentation represents a new constellation of clinical findings.

Poly(vinyl alcohol) hydrogel as a biocompatible viscoelastic mimetic for articular cartilage.

The prevalence of suboptimal outcome for surgical interventions in the treatment of full-thickness articular cartilage damage suggests that there is scope for a materials-based strategy to deliver a more durable repair. Given that the superficial layer of articular cartilage creates and sustains the tribological function of synovial joints, it is logical that candidate materials should have surface viscoelastic properties that mimic native articular cartilage. The present paper describes force spectroscopy analysis by nano-indentation to measure the elastic modulus of the surface of a novel poly(vinyl alcohol) hydrogel with therapeutic potential as a joint implant. More than 1 order of magnitude decrease in the elastic modulus was detected after adsorption of a hyaluronic acid layer onto the hydrogel, bringing it very close to previously reported values for articular cartilage. Covalent derivatization of the hydrogel surface with fibronectin facilitated the adhesion and growth of cultured rat tibial condyle chondrocytes as evidenced morphologically and by the observance of metachromatic staining with toluidine blue dye. The present results indicate that hydrogel materials with potential therapeutic benefit for injured and diseased joints can be engineered with surfaces with biomechanical properties similar to those of native tissue and are accepted as such by their constituent cell type.