Assessment of Nutrition Knowledge and Attitudes in Preclinical Osteopathic Medical Students.

BACKGROUND: Nutrition is often overlooked in everyday health care despite the definitive connection between diet and health. Many practicing physicians and medical students feel unqualified to discuss specific dietary recommendations with patients, which may be attributed to inadequate nutrition education during medical school. OBJECTIVE: To assess the nutrition knowledge of osteopathic medical students and their attitudes regarding the importance of nutrition counseling in their future role as practicing physicians. METHODS: Using a descriptive, cross-sectional study design, the authors evaluated first- and second-year osteopathic medical students' nutrition knowledge and attitudes toward nutrition counseling. A questionnaire that assessed attitudes toward nutrition counseling and a quiz that tested nutrition knowledge were used. RESULTS: A total of 257 first-year (n=139) and second-year (n=118) medical students (mean [SD] age, 24.8 [3.4] years; 52.8% female and 78.2% white) completed the quiz and survey. The average score of the nutrition knowledge quiz was 69.5%, with 130 participants (50.6%) scoring below the school's passing rate of 72.5%. Second-year students performed better than first-year students on the quiz (mean, 74.2% vs 65.9%; t=-5.17; P<.001). The majority of participants (143 [55.6%]) felt comfortable counseling patients on nutrition recommendations; however, only 30 (11.9%) were aware of the current dietary reference intakes. Qualitatively, most participants acknowledged the importance of providing patient education, promoting overall health and wellness, and preventing and treating disease. CONCLUSION: The majority of participants felt comfortable counseling future patients on nutrition recommendations; however, most participants lacked knowledge of dietary reference intakes and medical nutrition therapy. Because half of osteopathic medical students typically enter primary care, students and their future patients would benefit from the integration of more nutrition education in medical school.

Structures of the procapsid and mature virion of enterovirus 71 strain 1095.

Enterovirus 71 (EV71) is an important emerging human pathogen with a global distribution and presents a disease pattern resembling poliomyelitis with seasonal epidemics that include cases of severe neurological complications, such as acute flaccid paralysis. EV71 is a member of the Picornaviridae family, which consists of icosahedral, nonenveloped, single-stranded RNA viruses. Here we report structures derived from X-ray crystallography and cryoelectron microscopy (cryo-EM) for the 1095 strain of EV71, including a putative precursor in virus assembly, the procapsid, and the mature virus capsid. The cryo-EM map of the procapsid provides new structural information on portions of the capsid proteins VP0 and VP1 that are disordered in the higher-resolution crystal structures. Our structures solved from virus particles in solution are largely in agreement with those from prior X-ray crystallographic studies; however, we observe small but significant structural differences for the 1095 procapsid compared to a structure solved in a previous study (X. Wang, W. Peng, J. Ren, Z. Hu, J. Xu, Z. Lou, X. Li, W. Yin, X. Shen, C. Porta, T. S. Walter, G. Evans, D. Axford, R. Owen, D. J. Rowlands, J. Wang, D. I. Stuart, E. E. Fry, and Z. Rao, Nat. Struct. Mol. Biol. 19:424-429, 2012) for a different strain of EV71. For both EV71 strains, the procapsid is significantly larger in diameter than the mature capsid, unlike in any other picornavirus. Nonetheless, our results demonstrate that picornavirus capsid expansion is possible without RNA encapsidation and that picornavirus assembly may involve an inward radial collapse of the procapsid to yield the native virion.

The enterovirus 71 A-particle forms a gateway to allow genome release: a cryoEM study of picornavirus uncoating.

Since its discovery in 1969, enterovirus 71 (EV71) has emerged as a serious worldwide health threat. This human pathogen of the picornavirus family causes hand, foot, and mouth disease, and also has the capacity to invade the central nervous system to cause severe disease and death. Upon binding to a host receptor on the cell surface, the virus begins a two-step uncoating process, first forming an expanded, altered "A-particle", which is primed for genome release. In a second step after endocytosis, an unknown trigger leads to RNA expulsion, generating an intact, empty capsid. Cryo-electron microscopy reconstructions of these two capsid states provide insight into the mechanics of genome release. The EV71 A-particle capsid interacts with the genome near the icosahedral two-fold axis of symmetry, which opens to the external environment via a channel ∼10 Šin diameter that is lined with patches of negatively charged residues. After the EV71 genome has been released, the two-fold channel shrinks, though the overall capsid dimensions are conserved. These structural characteristics identify the two-fold channel as the site where a gateway forms and regulates the process of genome release.

The regulation of N-terminal Huntingtin (Htt552) accumulation by Beclin1.

AIM: Huntingtin protein (Htt) was a neuropathological hallmark in human Huntington's Disease. The study aimed to investigate whether the macroautophagy regulator, Beclin1, was involved in the degradation of Htt. METHODS: PC12 cells and primary cultured brain neurons of rats were examined. pDC316 adenovirus shuttle plasmid was used to mediate the expression of wild-type Htt-18Q-552 or mutant Htt-100Q-552 in PC12 cells. The expression of the autophagy-related proteins LC3 II and Beclin1, as well as the lysosome-associated enzymes Cathepsin B and L was evaluated using Western blotting. The locations of Beclin1 and Htt were observed with immunofluorescence and confocal microscope. RESULTS: Htt552 expression increased the expression of LC3 II, Beclin1, cathepsin B and L in autophagy/lysosomal degradation pathway. Treatment with the autophagy inhibitor 3-MA or the proteasome inhibitors lactacystin and MG-132 increased Htt552 levels in PC12 cells infected with Ad-Htt-18Q-552 or Ad-Htt-100Q-552. The proteasome inhibitor caused a higher accumulation of Htt552-18Q than Htt552-100Q, and the autophagy inhibitor resulted in a higher accumulation of Htt552-100Q than Htt552-18Q. Similar results were observed in primary cultured neurons infected with adenovirus. In Htt552-expressing cells, Beclin1 was redistributed from the nucleus to the cytoplasm. Htt siRNA prevented Beclin1 redistribution in starvation conditions. Blockade of Beclin1 nuclear export by leptomycin B or Beclin1 deficiency caused by RNA interference induced the formation of mHtt552 aggregates. CONCLUSION: Beclin1 regulates the accumulation of Htt via macroautophagy.

Mutant huntingtin impairs vesicle formation from recycling endosomes by interfering with Rab11 activity.

Huntingtin (Htt) localizes to endosomes, but its role in the endocytic pathway is not established. Recently, we found that Htt is important for the activation of Rab11, a GTPase involved in endosomal recycling. Here we studied fibroblasts of healthy individuals and patients with Huntington's disease (HD), which is a movement disorder caused by polyglutamine expansion in Htt. The formation of endocytic vesicles containing transferrin at plasma membranes was the same in control and HD patient fibroblasts. However, HD fibroblasts were delayed in recycling biotin-transferrin back to the plasma membrane. Membranes of HD fibroblasts supported less nucleotide exchange on Rab11 than did control membranes. Rab11-positive vesicular and tubular structures in HD fibroblasts were abnormally large, suggesting that they were impaired in forming vesicles. We used total internal reflection fluorescence imaging of living fibroblasts to monitor fluorescence-labeled transferrin-carrying transport intermediates that emerged from recycling endosomes. HD fibroblasts had fewer small vesicles and more large vesicles and long tubules than did control fibroblasts. Dominant active Rab11 expressed in HD fibroblasts normalized the recycling of biotin-transferrin. We propose a novel mechanism for cellular dysfunction by the HD mutation arising from the inhibition of Rab11 activity and a deficit in vesicle formation at recycling endosomes.

Pox proteomics: mass spectrometry analysis and identification of Vaccinia virion proteins.

BACKGROUND: Although many vaccinia virus proteins have been identified and studied in detail, only a few studies have attempted a comprehensive survey of the protein composition of the vaccinia virion. These projects have identified the major proteins of the vaccinia virion, but little has been accomplished to identify the unknown or less abundant proteins. Obtaining a detailed knowledge of the viral proteome of vaccinia virus will be important for advancing our understanding of orthopoxvirus biology, and should facilitate the development of effective antiviral drugs and formulation of vaccines. RESULTS: In order to accomplish this task, purified vaccinia virions were fractionated into a soluble protein enriched fraction (membrane proteins and lateral bodies) and an insoluble protein enriched fraction (virion cores). Each of these fractions was subjected to further fractionation by either sodium dodecyl sulfate-polyacrylamide gel electophoresis, or by reverse phase high performance liquid chromatography. The soluble and insoluble fractions were also analyzed directly with no further separation. The samples were prepared for mass spectrometry analysis by digestion with trypsin. Tryptic digests were analyzed by using either a matrix assisted laser desorption ionization time of flight tandem mass spectrometer, a quadrupole ion trap mass spectrometer, or a quadrupole-time of flight mass spectrometer (the latter two instruments were equipped with electrospray ionization sources). Proteins were identified by searching uninterpreted tandem mass spectra against a vaccinia virus protein database created by our lab and a non-redundant protein database. CONCLUSION: Sixty three vaccinia proteins were identified in the virion particle. The total number of peptides found for each protein ranged from 1 to 62, and the sequence coverage of the proteins ranged from 8.2% to 94.9%. Interestingly, two vaccinia open reading frames were confirmed as being expressed as novel proteins: E6R and L3L.

Lysosomal proteases are involved in generation of N-terminal huntingtin fragments.

N-terminal mutant huntingtin (N-mhtt) fragments form inclusions and cause cell death in vitro. Mutant htt expression stimulates autophagy and increases levels of lysosomal proteases. Here, we show that lysosomal proteases, cathepsins D, B and L, affected mhtt processing and levels of cleavage products (cp) known as A and B, which form inclusions. Adding inhibitors of cathepsin D, B and L to clonal striatal cells reduced mhtt, especially mhtt fragment cp A. Mutant htt fully degraded in cathepsin-L-treated lysates but formed stable N-mhtt fragments upon exposure to cathepsin D. Mutagenesis analysis of htt cDNA suggested that cathepsin D and the protease for cp A may cleave htt in the same region. Brain lysates from HD knock-in mice expressed N-mhtt fragments that accumulated with cathepsin D treatment and declined with aspartyl protease inhibition. Findings implicate lysosomal proteases in formation of N-mhtt fragments and clearance of mhtt.

Huntingtin associates with acidic phospholipids at the plasma membrane.

We have identified a domain in the N terminus of huntingtin that binds to membranes. A three-dimensional homology model of the structure of the binding domain predicts helical HEAT repeats, which emanate a positive electrostatic potential, consistent with a charge-based mechanism for membrane association. An amphipathic helix capable of inserting into pure lipid bilayers may serve to anchor huntingtin to the membrane. In cells, N-terminal huntingtin fragments targeted to regions of plasma membrane enriched in phosphatidylinositol 4,5-bisphosphate, receptor bound-transferrin, and endogenous huntingtin. N-terminal huntingtin fragments with an expanded polyglutamine tract aberrantly localized to intracellular regions instead of plasma membrane. Our data support a new model in which huntingtin directly binds membranes through electrostatic interactions with acidic phospholipids.

Mass spectrometry analysis of synthetically myristoylated peptides.

Myristoylpeptides were synthesized in order to determine if a neutral loss of 210 Da, C14H26O (the mass of the myristoyl moiety), was universal and observable by both liquid chromatography electrospray ionization quadrupole ion trap (LC-ESI-QIT) and matrix-assisted laser desorption/ionization time-of-flight time-of-flight (MALDI-ToF/ToF) mass spectrometry. Myristoylation was successfully introduced on the N-terminus, internally on the amino group of lysine and arginine. Larger peptides and the arginine compounds needed elevated temperatures for myristoylation. To our knowledge, this is the first report of a chemically-synthesized myristoylated arginine in a peptide. Collision energy studies for the LC-ESI-QIT instrument showed that modified peptides and a loss of 210 Da could be detected under commonly used conditions (energy level between 30 and 42%) with picomole amounts of sample. The loss of myristoyl moiety is observed on the MALDI-Tof/Tof mass spectrometer as well. Due to the hydrophobic properties of the myristoyl moiety, it is not surprising that the modified peptides all formed at least dimers, and in some cases trimers. We were also able to distinguish a mixture of two mono-myristoylated peptides. MS3 data from the LC-ESI-QIT instrument on a di-myristoylated peptide indicates the loss of 210 Da at either the N-terminus or lysine. We were also able to analyze a mixture of modified and unmodified peptides on the MALDI-ToF/ToF instrument. The data presented in this paper demonstrates the constant neutral loss of the 210 Da, C14H26O, from both N-terminally and internally myristoylated peptides can be identified unambiguously using LC-ESI-QIT or MALDI-ToF/ToF mass spectrometers. This will be a useful tool in determining the myristoylation status of candidate proteins after enzyme digestion, and in elucidating the modification sites of internal myristoyl proteins.

Sequence-independent acylation of the vaccinia virus A-type inclusion protein.

N-Terminal myristoylation of proteins typically occurs cotranslationally via an amide bond to the penultimate glycine residue within the canonical motif (M)GXXX(S/T/A) in a reaction catalyzed by N-myristoyltransferase. A second, less common myristoylation reaction occurs internally at dibasic amino acid doublets of proteins such as alpha-TNF. In this case, myristoylation occurs within a portion of the preprotein, which is subsequently removed by N-terminal proteolysis. The identity of the enzyme catalyzing internal myristoylation is unknown. Considering this information, the vaccinia virus (VV) A-type inclusion protein (ATI) presents a conundrum. Although this cytosolic protein is clearly myristoylated, the protein does not have the N-terminal myristoylation motif nor is it subject to proteolytic maturation. In the experiments reported here, we cleaved VV ATI with cyanogen bromide and determined that the myristoyl moiety was present in the C-terminal half of the protein. We also subjected a tryptic digest of VV ATI to liquid chromatography electrospray ionization quadrupole ion trap mass spectrometry analyses, which indicated that ATI is randomly myristoylated at six different lysines or arginines. Analysis of the modification sites reveals no obvious conserved acceptor motifs or dibasic doublets. Mutation of these residues alone or in combination does not abrogate myristoylation of the protein, suggesting utilization of alternative modification sites. This information implies that the VV ATI protein is myristoylated in a sequence-independent manner. Because viral acylproteins typically utilize the host cell modification apparatus, this result suggests there may be an alternative type of myristoylation pathway in mammalian cells.

Autophagy regulates the processing of amino terminal huntingtin fragments.

The N-terminus of mutant huntingtin (htt) has a polyglutamine expansion and forms neuronal aggregates in the brain of Huntington's disease (HD) patients. Htt expression in vitro activates autophagy, but it is unclear whether autophagic/lysosomal pathways process htt, especially N-terminal htt fragments. We explored the role of autophagy in htt processing in three cell lines, clonal striatal cells, PC12 cells and rodent embryonic cells lacking cathepsin D. Blocking autophagy raised levels of exogenously expressed htt1-287 or 1-969, reduced cell viability and increased the number of cells bearing mutant htt aggregates. Stimulating autophagy promoted htt degradation, including breakdown of caspase cleaved N-terminal htt fragments. Htt expression increased levels of the lysosomal enzyme cathepsin D by an autophagy-dependent pathway. Cells without cathepsin D accumulated more N-terminal htt fragments and cells with cathepsin D were more efficient in degrading wt htt than mutant htt in vitro. These results suggest that autophagy plays a critical role in the degradation of N-terminal htt. Altered processing of mutant htt by autophagy and cathepsin D may contribute to HD pathogenesis.