Gut microbial communities from patients with anorexia nervosa do not influence body weight in recipient germ-free mice.

Anorexia nervosa (AN) is a psychiatric disorder that presents with profound weight dysregulation, metabolic disturbances, and an abnormal composition of gut microbial communities. As the intestinal microbiota can influence host metabolism, the impact of enteric microbial communities from patients with AN on host weight and adiposity was investigated. Germ-free (GF) mice were colonized with fecal microbiotas from either patients with AN (n = 4) prior to inpatient treatment (AN T1, n = 50 recipient mice), the same 4 patients following clinical renourishment (AN T2, n = 53 recipient mice), or age- and sex-matched non-AN controls (n = 4 human donors; non-AN, n = 50 recipient mice). Biological and fecal microbiota data were analyzed with linear mixed-effects models. Body weight did not differ significantly between AN recipient mice (T1 and T2) and non-AN recipient mice following 4 weeks of colonization. Enteric microbiotas from recipient mice colonized with AN T1 and AN T2 fecal microbiotas were more similar to each other compared with enteric microbiotas from non-AN recipient mice. Specific bacterial families in the Actinobacteria, Bacteroidetes, and Firmicutes phyla were significantly associated with body weight, fat mass, and cecum weight irrespective of the donor group. These data suggest that body weight, fat mass, and cecum weight of colonized GF mice are associated with human fecal microbes and independent of donor AN status, although additional analyses with larger cohorts are warranted.

Sequence variant analysis reveals poor correlations in microbial taxonomic abundance between humans and mice after gnotobiotic transfer.

Transplanting human gut microbiotas into germ-free (GF) mice is a popular approach to disentangle cause-and-effect relationships between enteric microbes and disease. Algorithm development has enabled sequence variant (SV) identification from 16S rRNA gene sequence data. SV analyses can identify which donor taxa colonize recipient GF mice, and how SV abundance in humans is replicated in these mice. Fecal microbiotas from 8 human subjects were used to generate 77 slurries, which were transplanted into 153 GF mice. Strong correlations between fecal and slurry microbial communities were observed; however, only 42.15 ± 9.95% of SVs successfully transferred from the donor to the corresponding recipient mouse. Firmicutes had a particularly low transfer rate and SV abundance was poorly correlated between donor and recipient pairs. Our study confirms human fecal microbiotas colonize formerly GF mice, but the engrafted community only partially resembles the input human communities. Our findings emphasize the importance of reporting a standardized transfer rate and merit the exploration of other animal models or in silico tools to understand the relationships between human gut microbiotas and disease.

Nonconserved active site residues modulate CheY autophosphorylation kinetics and phosphodonor preference.

In two-component signal transduction, response regulator proteins contain the catalytic machinery for their own covalent phosphorylation and can catalyze phosphotransfer from a partner sensor kinase or autophosphorylate using various small molecule phosphodonors. Although response regulator autophosphorylation is physiologically relevant and a powerful experimental tool, the kinetic determinants of the autophosphorylation reaction and how those determinants might vary for different response regulators and phosphodonors are largely unknown. We characterized the autophosphorylation kinetics of 21 variants of the model response regulator Escherichia coli CheY that contained substitutions primarily at nonconserved active site positions D + 2 (CheY residue 59) and T + 2 (CheY residue 89), two residues C-terminal to conserved D57 and T87, respectively. Overall, the CheY variants exhibited a >10(5)-fold range of rate constants (kphos/KS) for reaction with phosphoramidate, acetyl phosphate, or monophosphoimidazole, with the great majority of rates enhanced versus that of wild-type CheY. Although phosphodonor preference varied substantially, nearly all the CheY variants reacted faster with phosphoramidate than acetyl phosphate. Correlation between the increased positive charge of the D + 2 and T + 2 side chains and faster rates indicated electrostatic interactions are a kinetic determinant. Moreover, sensitivities of rate constants to ionic strength indicated that both long-range and localized electrostatic interactions influence autophosphorylation kinetics. The increased nonpolar surface area of the D + 2 and T + 2 side chains also correlated with an enhanced autophosphorylation rate, especially for reaction with phosphoramidate and monophosphoimidazole. Computer docking suggested that highly accelerated monophosphoimidazole autophosphorylation rates for CheY variants with a tyrosine at position T + 2 likely reflect structural mimicry of phosphotransfer from the sensor kinase histidyl phosphate.

Comparison of hospital admission medication lists with primary care physician and outpatient pharmacy lists.

PURPOSE: Medication reconciliation is a process to reduce errors and harm associated with loss of medication information as the patient enters and moves through the healthcare system. This study examines medication list accuracy upon hospital admission. DESIGN: This prospective study enrolled 75 English-speaking medical and surgical patients (18 years of age or older) who were taking prescription medications. The study took place at a rural, tertiary teaching hospital in the northeastern United States. Data collection occurred from November 2006 to March 2009. METHODS: Nursing admission team medication lists were reconciled with primary care physician (PCP) and outpatient pharmacy (OP) lists. Outcome measures were accuracy of medication history generated by admission nurses (ANs) compared with PCP and OP lists, and identification of factors influencing probability of accurate medication list generation by ANs. The Generalized Estimating Equations modeling approach was used to compare AN, OP, and PCP medication list accuracy. Additionally, sex and age were analyzed as covariates and included in the model. FINDINGS: Forty-five males and 30 females (N= 75) with a mean age of 60 years (SD 15) participated. Fifty-seven subjects (76%) used over-the-counter or herbal medications, but the AN recorded only 31 (41%) cases. Patients received outpatient care from 1 to 12 providers. Forty patients (67%) obtained medications from one pharmacy, 22 (29%) from two, and 3 (4%) from three pharmacies. OP medication lists were completely accurate more often than PCP but not AN lists (19/75 [25%] OP vs. 6/75 [8%] PCP vs. 14/75 [19%] AN; 95% confidence interval [CI] of the difference [0.07, 0.50]). No difference between AN and PCP list accuracy was found. Completely accurate AN lists were more than twice as likely with male and younger patients (95% CI of the difference [1.07, 6.22] and [0.94, 0.99], respectively). CONCLUSIONS: Like other studies, this study showed admission medication reconciliation lists are often inaccurate. Our results suggest that verification of admission medication lists with outpatient provider lists may improve accuracy. Patients, with guidance from outpatient care providers, should assume accountability for maintaining accurate medication lists. A secure, universal, interactive electronic medical record may be a future solution for organizing and sharing medication data between providers. CLINICAL RELEVANCE: Medication reconciliation upon inpatient admission remains a high-volume and high-acuity problem. We found that not only hospital medication lists, but source lists, including those maintained by the patient, the PCP, and the OP, are vastly inaccurate.

Measurement of response regulator autodephosphorylation rates spanning six orders of magnitude.

Two-component regulatory systems, comprising sensor kinase and response regulator proteins, carry out signal transduction in prokaryotic and eukaryotic microorganisms, as well as plants. Response regulators act as phosphorylation-mediated switches, turning on and off cellular responses to environmental stimuli. Self-catalyzed dephosphorylation is an important determinant of the duration of the response regulator activated state. Reported response regulator autodephosphorylation rates vary over almost a million-fold range, consistent with control of biological processes that occur on widely different timescales. We describe general considerations for the design and execution of in vitro assays to measure the autodephosphorylation rates of purified response regulator proteins, as well as specific methods that utilize loss of 32P, changes in fluorescence, or release of inorganic phosphate. The advantages and disadvantages of different methods are discussed, including suitability for different timescales. In addition to outlining established methods, an assay modification is proposed to measure fast autodephosphorylation rates with radioactivity, and optimization of the fluorescence/pH jump method is described.

Matching biochemical reaction kinetics to the timescales of life: structural determinants that influence the autodephosphorylation rate of response regulator proteins.

In two-component regulatory systems, covalent phosphorylation typically activates the response regulator signaling protein, and hydrolysis of the phosphoryl group reestablishes the inactive state. Despite highly conserved three-dimensional structures and active-site features, the rates of catalytic autodephosphorylation for different response regulators vary by a factor of almost 10(6). Previous studies identified two variable active-site residues, corresponding to Escherichia coli CheY residues 59 and 89, that modulate response regulator autodephosphorylation rates about 100-fold. Here, a set of five CheY mutants, which match other "model" response regulators (ArcA, CusR, DctD, FixJ, PhoB, or Spo0F) at variable active-site positions corresponding to CheY residues 14, 59, and 89, were characterized functionally and structurally in an attempt to identify mechanisms that modulate autodephosphorylation rate. As expected, the autodephosphorylation rates of the CheY mutants were reduced 6- to 40-fold relative to wild-type CheY, but all still autodephosphorylated 12- to 80-fold faster than their respective model response regulators. Comparison of X-ray crystal structures of the five CheY mutants (complexed with the phosphoryl group analogue BeF(3)(-)) to wild-type CheY or corresponding model response regulator structures gave strong evidence for steric obstruction of the phosphoryl group from the attacking water molecule as one mechanism to enhance phosphoryl group stability. Structural data also suggested that impeding the change of a response regulator from the active to the inactive conformation might retard the autodephosphorylation reaction if the two processes are coupled, and that the residue at position '58' may contribute to rate modulation. A given combination of amino acids at positions '14', '59', and '89' adopted similar conformations regardless of protein context (CheY or model response regulator), suggesting that knowledge of residue identity may be sufficient to predict autodephosphorylation rate, and hence the kinetics of the signaling response, in the response regulator family of proteins.

Two variable active site residues modulate response regulator phosphoryl group stability.

Many signal transduction networks control their output by switching regulatory elements on or off. To synchronize biological response with environmental stimulus, switching kinetics must be faster than changes in input. Two-component regulatory systems (used for signal transduction by bacteria, archaea and eukaryotes) switch via phosphorylation or dephosphorylation of the receiver domain in response regulator proteins. Although receiver domains share conserved active site residues and similar three-dimensional structures, rates of self-catalysed dephosphorylation span a >or= 40,000-fold range in response regulators that control diverse biological processes. For example, autodephosphorylation of the chemotaxis response regulator CheY is 640-fold faster than Spo0F, which controls sporulation. Here we demonstrate that substitutions at two variable active site positions decreased CheY autodephosphorylation up to 40-fold and increased the Spo0F rate up to 110-fold. Particular amino acids had qualitatively similar effects in different response regulators. However, mutant proteins matched to other response regulators at the two key variable positions did not always exhibit similar autodephosphorylation kinetics. Therefore, unknown factors also influence absolute rates. Understanding the effects that particular active site amino acid compositions have on autodephosphorylation rate may allow manipulation of phosphoryl group stability for useful purposes, as well as prediction of signal transduction kinetics from amino acid sequence.