Obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care institution: A cross-sectional study.

OBJECTIVE:: The purpose of this study was to assess the prevalence of obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care academic institution. METHODS:: This was a cross-sectional quantitative, single-method survey with group comparison using the Beliefs About Obese Persons scale (BAOP) and the Attitudes Toward Obese Persons scale. Both instruments were administered as a single 28 question survey via email to 450 students and 46 faculty members in a doctor of chiropractic (DC) program. Differences were determined by 2 tailed t tests. RESULTS:: The response rate for faculty and students was 31% and 65%, respectively. One hundred forty-three DC students, preclinical ( n = 65) and clinical ( n = 78), and 30 DC faculty, preclinical ( n = 15) and clinical ( n = 15) completed the survey. Both students and faculty harbored antiobesity attitudes and moderate antiobesity beliefs. Students demonstrated slightly more positive attitudes toward obese persons than did preclinical faculty. Although preclinical faculty did not demonstrate more biased attitudes than did preclinical students ( p = .057), they were more biased than clinical students ( p = .26). On the BAOP, preclinical faculty scored significantly lower than both preclinical students and clinical students ( p = .013 and .017, respectively). CONCLUSION:: Obesity bias was common among clinical and preclinical chiropractic students and faculty at our institution. A cultural shift that reduces bias may require changes in both the curriculum and cocurriculum.

Perceptions of interprofessional education and practice within a complementary and alternative medicine institution.

A survey of the constituents of a complementary and alternative medicine (CAM) institution was conducted to identify perceptions of interprofessional education (IPE) and practice (IPP). A 22 question survey was developed and administered to: chiropractic students, acupuncture and oriental medicine students, faculty and alumni of both professions, staff and administrators. The majority of the 321 respondents demonstrated positive perceptions of IPE and IPP, however many reported a lack of understanding of the distinct roles of select healthcare professions. The study also suggested that the campus community is not homogenous in its understanding of CAM or allopathic professions, or is it homogenous in its understanding of IPE and IPP. While the overall positive attitudes toward IPE and IPP imply a willingness to improve collaboration between these groups, the lack of understanding of profession-specific roles must be addressed to support effective implementation of IPE.

A three-dimensional in vitro model of angiogenesis in the airway mucosa.

Bronchial asthma is an inflammatory disease characterized by chronic intermittent bronchoconstriction. A key feature of the disease is structural changes in the airway wall (airway remodeling) consistent with tissue growth and chronic wound healing including angiogenesis. The epithelium directs mesenchymal processes during both embryogenesis and wound healing, and thus we hypothesized that the bronchial epithelium plays a critical role in directing angiogenesis. To study angiogenesis in the airways, we have developed a three-dimensional (3-D) in vitro model of the airway mucosa that consists of normal differentiated human bronchial epithelial cells (NHBE), normal human lung fibroblasts (NHLF), and human umbilical vein endothelial cells (HUVEC). The HUVEC are coated on dextran beads and suspended in a fibrin gel approximately 2mm beneath a confluent monolayer of NHLF which are just beneath the confluent monolayer of differentiated NHBE. In the presence of fibroblasts, visible capillaries reaching lengths of up to 1mm sprout from the HUVEC-coated beads. Over 11 days in culture, the bronchial epithelium produces transforming growth factor-beta2 (TGFbeta2, 60pg/ml), significantly increases vascular endothelial growth factor (VEGF) more than 6-fold to a concentration of 1.85ng/ml, but does not significantly impact total network formation. Exogenous TGFbeta2 stimulates VEGF production in a dose-dependent fashion (0-400pg/ml) through a MAPK-dependent pathway, but also inhibits capillary network formation. We conclude that the bronchial epithelium produces biologically relevant concentrations of VEGF and TGFbeta2 in a 3-D model of the airway mucosa that may be useful in probing mechanisms of angiogenesis in asthma.

Epithelial-derived TGF-beta2 modulates basal and wound-healing subepithelial matrix homeostasis.

The epithelium influences the mesenchyme during dynamic processes such as embryogenesis, wound healing, fibrosis, and carcinogenesis. Since transforming growth factor-beta (TGF-beta) modulates these processes, we hypothesized that epithelial-derived TGF-beta also plays a critical role in maintaining the extracellular matrix at basal conditions. We utilized an in vitro model of the epithelial-mesenchymal trophic unit in the human airways to determine the role of epithelial-derived TGF-beta in modulating the extracellular matrix under basal and wound-healing conditions. When differentiated at an air-liquid interface, the human bronchial epithelium produces active TGF-beta2 at a concentration of 50-70 pg/ml, whereas TGF-beta1 is undetectable. TGF-beta2 increases two- to threefold following scrape injury in a dose-dependent fashion and significantly enhances both alpha-smooth muscle actin expression in the underlying collagen-embedded fibroblasts and secretion of tenascin-C into the matrix. Multiphoton microscopy demonstrates substantially enhanced second harmonic generation from fibrillar collagen in the matrix. Pretreatment of the matrix with either sirolimus (2.5 nM) or paclitaxel (10 nM) abolishes the increases in both TGF-beta2 and second harmonic generation in response to epithelial injury. In the absence of the epithelium, exogenous active TGF-beta2 (0-400 pg/ml) produces a biphasic response in the second harmonic signal with a minimum occurring at the epithelial-derived basal level. We conclude that epithelial-derived TGF-beta2 is secreted in response to injury, significantly alters the bulk optical properties of the extracellular matrix, and its tight regulation may be required for normal collagen homeostasis.

Surface plasmon resonance-based sensors to identify cis-regulatory elements.

In eukaryotes, transcription is regulated by multiprotein complexes binding to specific regions of genomic DNA, called cis-regulatory elements. Comprehensive identification of these elements is an important goal of functional genomics. Hence, it is of practical interest to develop a high-throughput assay to identify cis-regulatory elements. Toward that goal, we demonstrate that a surface plasmon resonance-based assay can identify whether a specific region of DNA binds to proteins present in raw nuclear lysate. Specifically, we immobilized a 16-basepair double-stranded DNA region of the SQSTM1 promoter to the Texas Instruments Spreeta, a surface plasmon resonance sensor. As a control, in a separate experiment, we immobilized a similar piece of DNA that differed by only a single base pair. We observed a significant difference in surface plasmon resonance signal when these two probes were exposed to raw nuclear lysate from NIH/3T3 cells. Using a luciferase-reporter vector transfected into live NIH/3T3 cells, we measured a significant difference in transcriptional activity between the two pieces of DNA. We conclude that a surface plasmon resonance-based sensor is capable of identifying physiologically significant cis-regulatory elements.

Post-translationally modified S12, absent in transformed breast epithelial cells, is not associated with the 26S proteasome and is induced by proteasome inhibitor.

The 26S proteasome, consisting of the 20S core and 19S regulatory complexes, regulates intracellular protein concentration through proteolytic degradation of targeted substrates. Composition of the 19S regulatory complex as well as posttranslational modifications of the 19S subunits can effectively regulate the activity of the 26S proteasome. Aberrant activity of the 26S proteasome affects the cell cycle, apoptosis and other cellular processes related to cancer. Recent data show an additional proteasome-independent role of 19S subunits in transcriptional regulation. S12 (Rpn8), the human homologue of mouse Mov-34, is a non-ATPase 19S regulatory subunit of the 26S proteasome. Previous studies have identified phosphorylated S12. In our study, we identify a modified S12 isoform (S12-M) with distinct biochemical properties. The S12-M isoform was found in 6 normal, but not 4 transformed, breast epithelial cell lines. Modification of S12 protein can be induced in vitro by addition of the proteasome inhibitor PSI. Modified and unmodified S12 have similar mass, but different isoelectric points, consistent with phosphorylation. In normal cells, unmodified S12 associates with the 26S proteasome, while modified S12-M does not. Whereas transformed cell line nuclei contain neither S12 isoform, S12-M is predominantly cytosolic in normal cells, with the unmodified S12 present in both the nuclei and cytosol. Together with the role of 19S subunits in transcriptional regulation, homology between S12 and eIF3 and TFIIH subunits, coelution with immunoproteasome subunits, and differential posttranslational modification and nuclear localization, these data suggest a differential nuclear function of modified and unmodified S12 in cancer.

Identification of the protein Zibra, its genomic organization, regulation, and expression in breast cancer cells.

The mRNA that encodes zibra (zinc, in-between-ring finger, ubiquitin-associated domain), previously known as hypothetical protein FLJ10111, or RNF31 is expressed in several distinct cancers. Little is known about the genomic organization, expression, or regulation of zibra. Using RNA ligase-mediated rapid amplification of cDNA ends (RLM-RACE), we cloned the full-length zibra cDNA from a transformed breast cell line. We identified a novel exon, the 5' untranslated region including the +1 start site, and three alternatively spliced zibra transcripts. The zibra protein contains three zinc ring-finger motifs, an ubiquitin-associated domain, and an in-between-ring-finger domain, characteristic of ubiquitin ligases. We obtained an antibody to zibra and confirmed the presence of translated zibra protein for the first time. Promoter studies localized a core element responsible for basal activity to a 14-bp region in the 5' untranslated region. Although there are numerous consensus Ets factor binding sites in the zibra promoter, we found no affect on promoter activity from Ets-1, PDEF, or PEA-3/E1A-F. Treatment of cells with the proteasome inhibitor I (PSI) decreased zibra protein to an undetectable level after 8 h. Zibra remained undetectable even after 32 h, while mRNA levels remained essentially unchanged. In conclusion, zibra is a translationally regulated putative ubiquitin ligase that is frequently overexpressed in different forms of cancer.

p62 overexpression in breast tumors and regulation by prostate-derived Ets factor in breast cancer cells.

p62 is a multifunctional cytoplasmic protein able to noncovalently bind ubiquitin and several signaling proteins, suggesting a regulatory role connected to the ubiquitin-proteasome pathway. No studies to date have linked p62 protein expression with pathological states. Here we demonstrate the overabundance of p62 protein in malignant breast tissue relative to normal breast tissue. The proteasome inhibitor PSI increased p62 mRNA and protein; however, PSI treatment of breast epithelial cells transfected with the p62 promoter did not affect promoter activity. High levels of prostate-derived Ets factor (PDEF) mRNA have been identified in breast cancer compared to normal breast. Only the PSA and maspin promoters have been identified as targets of this transcription factor. Here we show that PDEF stimulates the p62 promoter through at least two sites, and likely acts as a coactivator. PSI treatment abrogates the PDEF-stimulated increase of p62 promoter activity by 50%. Thus, multiple mechanisms for the induction of p62 exist. We conclude that (1) p62 protein is overexpressed in breast cancer; (2) p62 mRNA and protein increase in response to PSI, with no change of basal promoter activity; (3) PDEF upregulates p62 promoter activity through at least two sites; and (4) PSI downregulates PDEF-induced p62 promoter activation through one of these sites.

Identification and confirmation of a module of coexpressed genes.

We synthesize a large gene expression data set using dbEST and UniGene. We use guilt-by-association (GBA) to analyze this data set and identify coexpressed genes. One module, or group of genes, was found to be coexpressed mainly in tissue extracted from breast and ovarian cancers, but also found in tissue from lung cancers, brain cancers, and bone marrow. This module contains at least six members that are believed to be involved in either transcritional regulation (PDEF, H2AFO, NUCKS) or the ubiquitin proteasome pathway (PSMD7, SQSTM1, FLJ10111). We confirm these observations of coexpression by real-time RT-PCR analysis of mRNA extracted from four model breast epithelial cell lines.