Toward a clearer diagnosis of chronic fatigue syndrome

Researchers at the RIKEN Center for Life Science Technologies, in collaboration with Osaka City University and Kansai University of Welfare Sciences, have used functional PET imaging to show that levels of neuroinflammation, or inflammation of the nervous system, are higher in patients with chronic fatigue syndrome than in healthy people.

Chronic fatigue syndrome, which is also known as myalgic encephalomyelitis, is a debilitating condition characterised by chronic, profound, and disabling fatigue. Unfortunately, the causes are not well understood.
Neuroinflammation—the inflammation of nerve cells—has been hypothesised to be a cause of the condition, but no clear evidence has been put forth to support this idea. Now, in this clinically important study, the researchers found that indeed the levels of neuroinflammation markers are elevated in CFS/ME patients compared to the healthy controls.
The researchers performed PET scanning on nine people diagnosed with CFS/ME and ten healthy people, and asked them to complete a questionnaire describing their levels of fatigue, cognitive impairment, pain, and depression. For the PET scan they used a protein that is expressed by microglia and astrocyte cells, which are known to be active in neuroinflammation.

The researchers found that neuroinflammation is higher in CFS/ME patients than in healthy people. They also found that inflammation in certain areas of the brain—the cingulate cortex, hippocampus, amygdala, thalamus, midbrain, and pons—was elevated in a way that correlated with the symptoms, so that for instance, patients who reported impaired cognition tended to demonstrate neuroinflammation in the amygdala, which is known to be involved in cognition. This provides clear evidence of the association between neuroinflammation and the symptoms experienced by patients with CFS/ME.
Though the study was a small one, confirmation of the concept that PET scanning could be used as an objective test for CFS/ME could lead to better diagnosis and ultimately to the development of new therapies to provide relief to the many people around the world afflicted by this condition. Dr. Yasuyoshi Watanabe, who led the study at RIKEN, stated, ‘We plan to continue research following this exciting discovery in order to develop objective tests for CFS/ME and ultimately ways to cure and prevent this debilitating disease.’ RIKEN

Screening reveals additional link between endometriosis and ovarian cancer

Some women with endometriosis, a chronic inflammatory disease, are predisposed to ovarian cancer, and a genetic screening might someday help reveal which women are most at risk, according to a University of Pittsburgh Cancer Institute (UPCI) study, in partnership with Magee-Womens Research Institute (MWRI).
Monday at the American Association for Cancer Research (AACR) Annual Meeting 2014, UPCI and MWRI researchers will present the preliminary results of the first comprehensive immune gene profile exploring endometriosis and cancer.
‘A small subset of women with endometriosis go on to develop ovarian cancer, but doctors have no clinical way to predict which women,’ said senior author Anda Vlad, M.D., Ph.D., assistant professor of obstetrics, gynecology and reproductive sciences at MWRI. ‘If further studies show that the genetic pathway we uncovered is indicative of future cancer development, then doctors will know to more closely monitor certain women and perhaps take active preventative measures, such as immune therapy.’
Endometriosis is a painful, often invasive and recurrent condition that happens when the tissue that lines the uterus grows outside of the uterus, causing inflammation. It affects approximately one in 10 women.
By screening tissue samples from women with benign endometriosis, endometriosis with pre-cancerous lesions and endometriosis-associated ovarian cancer, Dr. Vlad and her colleagues identified the complement pathway, which refers to a series of protein interactions that trigger an amplified immune response, as the most prominent immune pathway that is activated in both endometriosis and endometriosis-associated ovarian cancer.
‘If, as our study indicates, a problem with the immune system facilitates cancer growth through chronic activation of the complement pathway, then perhaps we can find ways to change that and more effectively prime immune cells to fight early cancer, while controlling the complement pathway,’ said lead author Swati Maruti Suryawanshi, Ph.D., a post-doctoral research fellow at MWRI. EurekAlert

Gene family linked to brain evolution is implicated in autism severity

The same gene family that may have helped the human brain become larger and more complex than in any other animal also is linked to the severity of autism, according to new research from the University of Colorado Anschutz Medical Campus.
The gene family is made up of over 270 copies of a segment of DNA called DUF1220. DUF1220 codes for a protein domain – a specific functionally important segment within a protein. The more copies of a specific DUF1220 subtype a person with autism has, the more severe the symptoms, according to a paper.
This association of increasing copy number (dosage) of a gene-coding segment of DNA with increasing severity of autism is a first and suggests a focus for future research into the condition Autism Spectrum Disorder (ASD). ASD is a common behaviourally defined condition whose symptoms can vary widely – that is why the word ‘spectrum’ is part of the name. One federal study showed that ASD affects one in 88 children.
‘Previously, we linked increasing DUF1220 dosage with the evolutionary expansion of the human brain,’ says James Sikela, PhD, a professor in the Department of Biochemistry and Molecular Genetics, University of Colorado School of Medicine. Sikela led the autism study which also involved other members of his laboratory.

‘One of the most well-established characteristics of autism is an abnormally rapid brain growth that occurs over the first few years of life. That feature fits very well with our previous work linking more copies of DUF1220 with increasing brain size. This suggests that more copies of DUF1220 may be helpful in certain situations but harmful in others.’

The research team found that not only was DUF1220 linked to severity of autism overall, they found that as DUF1220 copy number increased, the severity of each of three main symptoms of the disorder — social deficits, communicative impairments and repetitive behaviours – became progressively worse.
In 2012, Sikela was the lead scientist of a multi-university team whose research established the link between DUF1220 and the rapid evolutionary expansion of the human brain. The work also implicated DUF1220 copy number in brain size both in normal populations as well as in microcephaly and macrocephaly (diseases involving brain size abnormalities).

Jack Davis, PhD, who contributed to the project while a postdoctoral fellow in the Sikela lab, has a son with autism and thus had a very personal motivation to seek out the genetic factors that cause autism.

The research by Sikela, Davis and colleagues at the Anschutz campus in Aurora, Colo., focused on the presence of DUF1220 in 170 people with autism.
Strikingly, Davis says, DUF1220 is as common in people who do not have ASD as in people who do. So the link with severity is only in people who have the disorder.

‘Something else is at work here, a contributing factor that is needed for ASD to manifest itself,’ Davis says. ‘We were only able to look at one of the six different subtypes of DUF1220 in this study, so we are eager to look at whether the other subtypes are playing a role in ASD.’
Because of the high number of copies of DUF1220 in the human genome, the domain has been difficult to measure. As Sikela says, ‘To our knowledge DUF1220 copy number has not been directly examined in previous studies of the genetics of autism and other complex human diseases .So the linking of DUF1220 with ASD is also confirmation that there are key parts of the human genome that are still unexamined but are important to human disease.’ University of Colorado Denver

Stago moves to its new Headquarters on the banks of the Seine

Asnières sur Seine (April 14, 2014) — Leading Haemostasis specialist Stago has moved its Headquarters to a brand new building fully dedicated to its business activities.
“The rapid acceleration in our international expansion meant we needed a new Head Office, more closely reflecting the Stago image and its operations today,” said Deputy Vice President Patrick Monnot.
The sober, functional and contemporary 8,300 m² building is perfectly designed to accommodate not only the Group’s various global functions but also the activities of its French subsidiary. It will allow the company to optimise its everyday operations and to greet partners and customers in an even more welcoming environment.
Officially recognised as a low-energy, high environmental quality building, this development is part of a sustainable quality approach embodying the values that have guided Stago for nearly 70 years!
This investment is an indicator of the company’s healthy balance sheet. It was made possible by its employees’ expertise and hard work, and above all by the strong support of the Haemostasis scientific and medical community.

New address:
From 14 April 2014
Your contacts’ phone and fax numbers will remain the same
Diagnostica Stago
3 Allée Thérésa
CS 10009
92665 Asnières sur Seine Cedex
France
Ph: +33 (0) 1 46 88 20 20
Fax: +33 (0) 1 47 91 08 91 webmaster@stago.com www.stago.com

Finding the switch: Researchers create roadmap for gene expression

In a new study, researchers from North Carolina State University, UNC-Chapel Hill and other institutions have taken the first steps toward creating a roadmap that may help scientists narrow down the genetic cause of numerous diseases. Their work also sheds new light on how heredity and environment can affect gene expression.
Pinpointing the genetic causes of common diseases is not easy, as multiple genes may be involved with a disease. Moreover, disease-causing variants in DNA often do not act directly, but by activating nearby genes. To add to the complexity, genetic activation is not like a simple on/off switch on a light, but behaves more like a ‘dimmer switch’ – some people may have a particular gene turned all the way up, while others have it only turned halfway on, completely off, or somewhere in between. And different factors, like DNA or the environment, play a role in the dimmer switch’s setting.
According to Fred Wright, NC State professor of statistics and biological sciences, director of NC State’s Bioinformatics Center and co-first author of the study, ‘Everyone has the same set of genes. It’s difficult to determine which genes are heritable, or controlled by your DNA, versus those that may be affected by the environment. Teasing out the difference between heredity and environment is key to narrowing the field when you’re looking for a genetic relationship to a particular disease.’
Wright, with co-first author Patrick Sullivan, Distinguished Professor of Genetics and Psychiatry at UNC-Chapel Hill and director of the Center for Psychiatric Genomics, and national and international colleagues, analyzed blood sample data from 2,752 adult twins (both identical and fraternal) from the Netherlands Twin Register and an additional 1,895 participants from the Netherlands Study of Depression and Anxiety. For all 20,000 individual genes, they determined whether those genes were heritable – controlled by the DNA ‘dimmer switch’ – or largely affected by environment.
‘Identical twins have identical DNA,’ Wright explains, ‘so if a gene is heritable, its expression will be more similar in identical twins than in fraternal twins. This process allowed us to create a database of heritable genes, which we could then compare with genes that have been implicated in disease risk. We saw that heritable genes are more likely to be associated with disease – something that can help other researchers determine which genes to focus on in future studies.’
‘This is by far the largest twin study of gene expression ever published, enabling us to make a roadmap of genes versus environment,’ Sullivan says, adding that the study measured relationships with disease more precisely than had been previously possible, and uncovered important connections to recent human evolution and genetic influence in disease.
The Netherlands Twin Register has followed twin pairs for over 25 years and in collaboration with the longitudinal Netherlands Study of Depression and Anxiety established a resource for genetic and expression studies. Professor Dorret Boomsma, who started the twin register, says, ‘in addition to the fundamental insights into genetic regulation and disease, the results provide valuable information on causal pathways. The study shows that the twin design remains a key tool for genetic discovery.’ EurekAlert

Virus-fighting genes linked to mutations in cancer

Our understanding of the biological processes that cause cancer is limited. UV light and smoking are two well-understood cancer-causing processes. Exposure to either of these processes causes distinguishable patterns of genetic damage, or ‘signatures’, on the genome that can lead to cancer. All cancer-causing processes leave their own distinct imprint or signature, on the genomes of cancer cells.
The APOBEC family of genes control enzymes that are believed to have evolved in humans to fight off viral infections. Scientists have speculated that these enzymes are responsible for a very distinct signature of mutations that is present in approximately half of all cancer types. Therefore, understanding the cancer-causing process behind this common genetic signature is pivotal for disease control and prevention.
The team studied the genomes of breast cancers in patients with a specific inherited deletion in two of these APOBEC genes. They found that these cancer genomes had a much greater prevalence of the distinct mutational signature that is thought to be driven by the APOBEC family of genes.
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‘The increased frequency of this common cancer signature in breast cancer patients with APOBEC gene abnormalities supports our theory that these enzymes play a role in generating this mutational signature,’ says Dr Serena Nik-Zainal, first author from the Wellcome Trust Sanger Institute.
This genetic deletion is found on chromosome 22 where the APOBEC genes, APOBEC3A and APOBEC3B, sit next to each other. Women with this genetic deletion have previously been reported to be more susceptible to breast cancer.
The team examined 923 samples of breast cancer from women from across the world and found more than 140 people with either one or two copies of the deletion on each chromosome. Breast cancer in women with the deletion had a much greater quantity of mutations of this particular genetic signature.
However, the mutational activity of the APOBEC genes appears to be a double-edged sword. This genetic deletion is much more prevalent in some populations than others: it is found in only 8 per cent of Europeans, but is present in 93 per cent of the population of Oceania. Although this deletion increases risk of cancer development, it also seems to provide a currently unknown advantage in populations where it is more common. Wellcome Trust Sanger Iinstitute

Congenital heart disease gene found

Researchers have explored the role of a master gene that controls the functioning of other genes involved in heart development. Variations in this gene – NR2F2 – are responsible for the development of severe forms of congenital heart disease.
Approximately one per cent of all babies are born with congenital heart disease, where the normal workings of the heart are affected. Because the damage to the heart is structural, most babies will need surgery to correct the problem. Although genetic causes are known to underlie the disease, these causes are not very well understood.
Scientists have previously shown that mice with a less active NR2F2 gene had abnormal heart development. To see if the gene was involved in severe forms of human congenital heart disease, the team looked at DNA sequences of parents and affected children and found that variation on the NR2F2 caused the structural damage that underlies these conditions.
The team found that these genetic variants were typically only present in the child and not the parents, revealing that congenital heart disease producing variants occur in the womb.
‘What we see is that these rare variants in the NR2F2 gene interfere with the normal heart development and cause severe forms of congenital heart disease during human development,’ says Saeed Al Turki, first author from the Wellcome Trust Sanger Institute.
NR2F2 is a master regulator for other genes involved in the development of a healthy functioning heart – once the activity of NR2F2 is affected it has a knock-on effect on these other genes affecting the healthy development of the heart.
The team found that different types of damage in the NR2F2 gene cause different types of heart defects. Genetic variants that completely deactivate the NR2F2 gene tended to cause damage to the left side of the heart. In contrast, genetic variants that alter activity of the gene but do not deactivate it more commonly caused a specific sub-type of holes in the hearts of patients. Wellcome Trust Sanger Institute

Newly discovered gene regulator could precisely target sickle cell disease

A research team from Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and other institutions has discovered a new genetic target for potential therapy of sickle cell disease (SCD). The target, called an enhancer, controls a molecular switch in red blood cells called BCL11A that, in turn, regulates haemoglobin production.
The researchers were led by Daniel Bauer, MD, PhD, and Stuart Orkin, MD, of Dana-Farber/Boston Children’s.
Prior work by Orkin and others has shown that when flipped off, BCL11A causes red blood cells to produce foetal haemoglobin that, in SCD patients, is unaffected by the sickle cell mutation and counteracts the deleterious effects of sickle haemoglobin. BCL11A is thus an attractive target for treating SCD.
The disease affects roughly 90,000 to 100,000 people in the United States and millions worldwide.

However, BCL11A plays important roles in other cell types, including the immune system’s antibody-producing B cells, which raises concerns that targeting it directly in sickle cell patients could have unwanted consequences.
The discovery of this enhancer—which regulates BCL11A only in red blood cells—opens the door to targeting BCL11A in a more precise manner. Approaches that disable the enhancer would have the same end result of turning on foetal haemoglobin in red blood cells due to loss of BCL11A, but without off-target effects in other cell types.

The findings were spurred by the observation that some patients with SCD spontaneously produce higher levels of foetal haemoglobin and enjoy an improved prognosis. The researchers found that these individuals possess naturally occurring beneficial mutations that function to weaken the enhancer, turning BCL11A’s activity down and allowing red blood cells to manufacture some foetal haemoglobin.

‘This finding gives us a very specific target for sickle cell disease therapies,’ said Orkin, a leader of Dana-Farber/Boston Children’s who serves as chairman of pediatric oncology at Dana-Farber Cancer Institute and associate chief of hematology/oncology at Boston Children’s Hospital. ‘Coupled with recent advances in technologies for gene engineering in intact cells, it could lead to powerful ways of manipulating haemoglobin production and new treatment options for haemoglobin diseases.’ Boston Children’s Hospital

Hereditary trauma

Extreme and traumatic events can change a person – and often, years later, even affect their children. Researchers of the University of Zurich and ETH Zurich have now unmasked a piece in the puzzle of how the inheritance of traumas may be mediated.
The phenomenon has long been known in psychology: traumatic experiences can induce behavioural disorders that are passed down from one generation to the next. It is only recently that scientists have begun to understand the physiological processes underlying hereditary trauma. ‘There are diseases such as bipolar disorder, that run in families but can’t be traced back to a particular gene’, explains Isabelle Mansuy, professor at ETH Zurich and the University of Zurich. With her research group at the Brain Research Institute of the University of Zurich, she has been studying the molecular processes involved in non-genetic inheritance of behavioural symptoms induced by traumatic experiences in early life.

Mansuy and her team have succeeded in identifying a key component of these processes: short RNA molecules. These RNAs are synthesised from genetic information (DNA) by enzymes that read specific sections of the DNA (genes) and use them as template to produce corresponding RNAs. Other enzymes then trim these RNAs into mature forms. Cells naturally contain a large number of different short RNA molecules called microRNAs. They have regulatory functions, such as controlling how many copies of a particular protein are made.

The researchers studied the number and kind of microRNAs expressed by adult mice exposed to traumatic conditions in early life and compared them with non-traumatised mice. They discovered that traumatic stress alters the amount of several microRNAs in the blood, brain and sperm – while some microRNAs were produced in excess, others were lower than in the corresponding tissues or cells of control animals. These alterations resulted in misregulation of cellular processes normally controlled by these microRNAs.

After traumatic experiences, the mice behaved markedly differently: they partly lost their natural aversion to open spaces and bright light and had depressive-like behaviours. These behavioural symptoms were also transferred to the next generation via sperm, even though the offspring were not exposed to any traumatic stress themselves.

The metabolism of the offspring of stressed mice was also impaired: their insulin and blood-sugar levels were lower than in the offspring of non-traumatised parents. ‘We were able to demonstrate for the first time that traumatic experiences affect metabolism in the long-term and that these changes are hereditary’, says Mansuy. The effects on metabolism and behaviour even persisted in the third generation.

‘With the imbalance in microRNAs in sperm, we have discovered a key factor through which trauma can be passed on,’ explains Mansuy. However, certain questions remain open, such as how the dysregulation in short RNAs comes about. ‘Most likely, it is part of a chain of events that begins with the body producing too much stress hormones.’

Importantly, acquired traits other than those induced by trauma could also be inherited through similar mechanisms, the researcher suspects. ‘The environment leaves traces on the brain, on organs and also on gametes. Through gametes, these traces can be passed to the next generation.’

Mansuy and her team are currently studying the role of short RNAs in trauma inheritance in humans. As they were also able to demonstrate the microRNAs imbalance in the blood of traumatized mice and their offspring, the scientists hope that their results may be useful to develop a blood test for diagnostics. ETH Zurich

Confirmation of the neurobiological origin of attention – deficit disorder

A study, carried out on mice, has just confirmed the neurobiological origin of attention-deficit disorder (ADD), a syndrome whose causes are poorly understood. Researchers from CNRS, the University of Strasbourg and INSERM have identified a cerebral structure, the superior colliculus, where hyperstimulation causes behaviour modifications similar to those of some patients who suffer from ADD. Their work also shows noradrenaline accumulation in the affected area, shedding light on this chemical mediator having a role in attention disorders.

Attention-deficit disorder affects between 4-8% of children. It manifests mainly through disturbed attention and verbal and motor impulsiveness, sometimes accompanied by hyperactivity. About 60% of these children still show symptoms in adulthood. No cure exists at this time. The only effective treatment is to administer psychostimulants, but these have substantial side effects, such as dependence. Persistent controversy surrounding the neurobiological origin of this disorder has hindered the development of new treatments.
The study in Strasbourg investigated the behaviour of transgenic mice having developmental defects in the superior colliculus. This structure, located in the midbrain, is a sensory hub involved in controlling attention and visual and spatial orientation. The mice studied were characterised by duplicated neuron projections between the superior colliculus and the retina. This anomaly causes visual hyperstimulation and excess noradrenaline in the superior colliculus. The effects of the neurotransmitter noradrenaline, which vary from species to species, are still poorly understood. However, we do know that this noradrenaline imbalance is associated with significant behavioural changes in mice carrying the genetic mutation. By studying them, researchers have observed a loss of inhibition: for example mice hesitate less to penetrate a hostile environment. They have difficulties in understanding relevant information and demonstrate a form of impulsiveness. These symptoms remind us of adult patients suffering from one of the forms of ADD.
Currently, the fundamental work on ADD uses mainly animal models obtained by mutations that disturb dopamine production and transmission pathways. In mice with a malformed superior colliculus, these pathways are intact. The changes occur elsewhere in the neural networks of the midbrain. By broadening the classic boundary used to research its causes, using these new models would allow a more global approach to ADD to be developed. Characterizing the effects of noradrenaline on the superior colliculus more precisely could open the way to innovative therapeutic strategies. INSERM