New tech promises fast, accurate stroke diagnosis

Alex Travis, associate professor at the Baker Institute for Animal Health, co-authored the study that led to the development of a new stroke diagnosis tool.
Minutes count when treating stroke, but current diagnostics take as long as three hours, careful lab work and skilled technicians to arrive at a conclusive diagnosis. Scientists at Cornell’s Baker Institute for Animal Health have developed a device that helps diagnose stroke in less than 10 minutes using a drop of blood barely big enough to moisten your fingertip.

Having demonstrated proof of principle, the technology eventually could be expanded and used in point-of-care testing devices to diagnose other conditions in humans and animals, including traumatic brain injury (concussion), some forms of dementia, and even some types of cancer and heart disease.

The study’s lead author, Roy Cohen, a research scientist at the Baker Institute, says the technology represents the successful pairing of two big goals in medical diagnostics – small size and simplicity, a combination that means testing could be carried out at a patient’s bedside.

“Three-quarters of stroke patients suffer from ischemic stroke – a blockage of a blood vessel in the brain. In those cases, time is of the essence, because there is a good drug available, but for a successful outcome it has to be given within three or four hours after the onset of symptoms,” says Cohen. “By the time someone identifies the symptoms, gets to the hospital and sits in the emergency room, you don’t have much time to obtain the full benefit of this drug.” Enhancing the speed of diagnosis could save many people from suffering lasting effects of ischemic stroke, he says.

To diagnose stroke, a condition in which blood flow to an area of the brain is limited or cut off, the technology will one day detect several bloodborne biomarkers, molecules that appear in the blood when the stroke occurs. The technology uses enzymes attached to nanoparticles to detect the biomarker molecules and convert that detection into light.

To demonstrate the effectiveness of this new approach, the researchers focused on the biomarker neuron-specific enolase (NSE), a substance found in higher concentrations in the blood of victims of stroke and other conditions. By measuring the amount of light produced from various samples, Cohen and his colleagues can determine the concentration of NSE in the sample. At each step of the way, the signal from the NSE is amplified, so even minute quantities give off enough light for detection.

The idea to tether the enzymes, says co-author Alex Travis, associate professor of reproductive biology at the Baker Institute for Animal Health, came from the hardworking enzymes tethered to the shafts of sperm tails. These sperm enzymes efficiently turn sugars into energy that powers the flagellum and moves the sperm along. The fact that they’re attached to the sperm tail instead of floating around in solution enables the enzymes to efficiently pass the substrate along from point to point and get the most “bang for the buck” from a sugar molecule, according to Travis.

Going forward, Travis and his team will collaborate with a private company to develop the stroke-detecting technique for clinical testing and eventually make it available for use in hospitals. But he’s also excited to expand the system to diagnose other conditions.

“This system could be tailored to detect multiple biomarkers,” says Travis. “That’s the strength of the technique. You could assemble a microfluidic card based on this technology that could detect 10 biomarkers in different wells, and the readout would be the same for each one: light.” Using the same detection system for multiple different biomarkers would make for a simple system in a relatively small package, he says. Cornell University

Proteome analysis for detection of diabetic nephropathy

The German Institute for Quality and Efficiency in Health Care (IQWiG) examined the benefit of a diagnostic-therapeutic strategy using urinary proteome analysis for detection of diabetic nephropathy (DN) versus a conventional diagnostic strategy in patients with diabetes mellitus and arterial hypertension. After publication of the preliminary report in June 2015, interested persons and parties had the opportunity to comment on the preliminary results.

No studies relevant for the research question were identified in the systematic literature search conducted by IQWiG. As no references to relevant studies were submitted in the commenting procedure either, the Institute maintains its conclusion: Due to a lack of studies, the patient-relevant benefit or harm of proteome analysis for detection of DN is equally unclear as the diagnostic or prognostic accuracy of this type of analysis.

Can impending diabetic nephropathy be detected earlier?
DN is a chronic kidney disease caused by chronic hyperglycaemia (high blood sugar levels) in patients with diabetes mellitus and can be negatively influenced by arterial hypertension (high blood pressure). It can lead to permanent failure of the kidneys (end-stage renal disease).

When clear symptoms occur the disease is already far progressed. Proteome analysis is a new diagnostic method in which the concentration of several biomarkers in the urine is determined by means of mass spectrometry. The values calculated in this analysis are supposed to allow earlier and more precise clinical conclusions on DN than conventional diagnostic methods.

The commission awarded to IQWiG by the Federal Joint Committee (G‑BA) specifies two aims: Firstly, the Institute was to assess the patient-relevant benefit or harm of a diagnostic-therapeutic strategy using proteome analysis versus a conventional strategy in patients with diabetes mellitus and arterial hypertension. Secondly, the diagnostic and prognostic accuracy of proteome analysis for the detection of DN was to be assessed.

No completed studies relevant for these assessments were identified by IQWiG’s researchers up to publication of the preliminary report in June 2015. The PRIORITY study will run up to the end of 2107. It is yet unclear how informative its results will be for the present research question.

No comments with references to further relevant studies were submitted in the public commenting procedure either. This seems astonishing in view of the promising PR messages disseminated in the past months – in part specifically in reference to the current benefit assessment – by a provider of screening tests based on proteome analyses.

This was commented on by Stefan Sauerland, Head of IQWiG’s Department of Non-Drug Interventions, as follows: “One cannot just postulate a `monumental breakthrough`, which proteome analysis is supposed to represent. The benefit for the respective patients has to be proven. As long as the `numerous studies and scientific publications´ proudly referred to do not include a single study proving the benefit of the test for the early detection of diabetic nephropathy, one should not be surprised by a negative conclusion of the assessment.”

Thus both the patient-relevant benefit or harm of a diagnostic-prognostic strategy using proteome analysis for detection of DN, as well as the diagnostic and prognostic accuracy of this type of analysis, remain unclear. German Institute for Quality and Efficiency in Health Care

A different kind of anaesthesia a possible treatment for stress induced cardiomyopathy

Stress induced cardiomyopathy after cerebral haemorrhage has been shown to increase the risk of further brain damage. These patients can now be identified by a simple blood test, and a possible treatment for stress induced cardiomyopathy has been discovered – a different kind of anaesthesia than that currently being used.

Stress induced cardiomyopathy is a relatively recently discovered disease where part of the heart muscle ceases to function and results in the heart having reduced pumping capacity. Approximately 90 percent of those affected are upper middle-aged women. The onset is similar to a heart attack, with chest pain and difficulty breathing, but stress induced cardiomyopathy follows a different course.

With stress induced heart failure, the heart spontaneously recovers within a few weeks and thus the prognosis has been seen as good; but, new findings show the prognosis to be approximately the same as for acute ischemic heart disease.

In a new thesis from Sahlgrenska Academy, all patients from the region that suffered a specific type of cerebral haemorrhage (subarachnoid haemorrhage) were followed for two years. In conjunction with the haemorrhage, patients experience a strong stress component. Stress induced cardiomyopathy is therefore relatively common (10-20 percent of the patients) following this type of cerebral haemorrhage, which can cause significant brain damage.
“We saw that patients with stress induced cardiomyopathy had an increased risk of further brain damage in the aftermath of a cerebral haemorrhage and had a worse long-term prognosis, even after we made adjustments for other risk factors,” says Jonatan Oras, PhD Student at Sahlgrenska Academy.

In the thesis, two biomarkers were identified that can be used to identify patients who suffer from stress induced heart failure.
“With a blood test, we are now able to quickly identify patients with stress induced heart failure and apply the right measures sooner,” says Jonatan Oras.

In the experimental part of the thesis, an animal model was used with rats to find a possible treatment for stress induced heart failure. It was found that if the animals were anesthetized with a particular anaesthetic (isoflurane), they did not develop heart failure and the heart muscle retained its elasticity and pumping capacity.

“When we used other anaesthetics, including those currently in use in healthcare, we saw no cardioprotective effect. This is the first potential cardioprotective treatment for stress induced cardiomyopathy to be presented,” says Jonatan Oras.

Further studies of this possible treatment for stress induced cardiomyopathy on patients at risk of developing stress induced cardiomyopathy should be conducted,” Jonatan Oras points out. Sahlgrenska Academy

New gene map reveals cancer’s Achilles’ heel

Toronto researchers led by U of T Professor Jason Moffat switched off almost 90 per cent of the entire human genome, to find the genes essential for cell survival
Scientists have mapped out the genes that keep our cells alive, creating a long-awaited foothold for understanding how our genome works and which genes are crucial in disease like cancer.

A team of Toronto researchers, led by Professor Jason Moffat from the University of Toronto’s Donnelly Centre, with a contribution from Stephane Angers from the Faculty of Pharmacy, have switched off, one by one, almost 18,000 genes, 90 per cent of the entire human genome, to find the genes that are essential for cell survival.

By turning genes off in five different cancer cell lines, including brain, retinal, ovarian, and two kinds of colorectal cancer cells, the team uncovered that each tumour relies on a unique set of genes that can be targeted by specific drugs. The finding raises hope of devising new treatments that would target only cancer cells, leaving the surrounding healthy tissue unharmed.

“It’s when you get outside the core set of essential genes, that it starts to get interesting in terms of how to target particular genes in different cancers and other disease states,” says Moffat, who is also a professor in the department of molecular genetics and a Senior Fellow at the Canadian Institute For Advanced Research (CIFAR).

Sequencing of the human genome 12 years ago allowed scientists to compile a list of parts – our 20,000 genes – that make up our cells and bodies. Despite this major achievement, we still didn’t understand the function of each gene, or how some genes make us sick when they go wrong. To do this, scientists realized they would have to switch genes off, one by one across the entire genome to determine what processes go wrong in the cells. But the available tools were either inaccurate or too slow.

The recent arrival of the gene editing technology CRISPR has finally made it possible to turn genes off, swiftly and with pinpoint accuracy, kicking off a global race among multiple competing research teams. The Toronto study, along with the paper from Harvard and MIT , found that roughly 10 per cent of our genes are essential for cell survival.

These findings show the majority of human genes play more subtle roles in the cell because switching them off doesn’t kill the cell. But if two or more of such genes are mutated at the same time, or the cells are under environmental stress, their loss begins to count.

Because different cancers have different mutations, they tend to rely on different sets of genes to survive. Moffatt’s team have identified distinct sets of “smoking gun” genes for each of the tested cancers – each set susceptible to different drugs.

“We can now interrogate our genome at unprecedented resolution in human cells that we grow in the lab with incredible speed and accuracy. In short order, this will lead to a functional map of cancer that will link drug targets to DNA sequence variation,” says Moffat.

His team has already shown how this can work. In his study, metformin, a widely prescribed diabetes drugs successfully killed brain cancer cells and those of one form of colorectal cancer – but was useless against the other cancers he studied. However, the antibiotics chloramphenicol and linezolid were effective against another form of colorectal cancer, and not against brain or other cancers studied. These data illustrate the clinical potential of the data in pointing to more precise treatments for the different cancers – and show the value of personalized medicine. University of Toronto

How a genetic locus protects adult blood-forming stem cells

A particular location in DNA, called the Dlk1-Gtl2 locus, plays a critical role in protecting hematopoietic, or blood-forming, stem cells–a discovery revealing a critical role of metabolic control in adult stem cells, and providing insight for potentially diagnosing and treating cancer, according to researchers from the Stowers Institute for Medical Research.

In their study, Stowers Investigator Linheng Li, Ph.D., and first author Pengxu Qian, Ph.D., along with other collaborators, reveal how the mammalian imprinted Gtl2, located on mouse chromosome 12qF1, protects adult hematopoietic stem cells by restricting metabolic activity in the cells’ mitochondria.

The research focused on imprinted genes–genes ‘stamped’ according to whether they are inherited from the mother or father. With imprinted genes, one working copy, or allele, is inherited instead of two. Either the copy from the mother or father is inactivated or ‘silenced.’ Typically, the paternally inherited allele’s expression promotes growth, while the maternally inherited allele’s expression suppresses it.

The researchers found that when the Gtl2 locus is expressed from the maternally inherited allele, it produces non-coding RNAs to curb metabolic activity. Mechanistically, Gtl2’s ‘megacluster’ of microRNA, the largest cluster of microRNA in the mammalian genome, suppresses the mTOR signaling pathway and downstream mitochondrial biogenesis and metabolism, thus blocking mitochondrial-associated byproducts called reactive oxygen species (ROS) that can damage adult stem cells.

‘Reactive oxygen species are like the potentially harmful by-products that come from industrial manufacturing,’ says Li. ‘ROS are unavoidable derivatives of the mitochondrial metabolic process and need to be managed by the cell,’ he explains.

Hematopoietic stems cells renew themselves and differentiate into other cells, including white blood cells, red blood cells, and platelets, constantly renewing the body’s blood supply in a process called hematopoiesis. Because of their extraordinary transformative qualities, the transplantation or transfusion of isolated human hematopoietic stem cells has been used in the treatment of anemia, immune deficiencies, and other diseases, including cancer.

While hematopoietic stem cells have gained attention in research, it remains largely unknown how cell metabolic states are controlled. The new findings shed light on the delicate metabolic control required to balance hematopoietic stem cell maintenance and action and the associated healthy hematopoiesis.

An upset in that balance can cause cells to grow abnormally and lead to disease. Abnormalities in the Gtl2 locus on human chromosome 14q32.2 are associated with uniparental disomy in which an individual receives two copies of a chromosome from one parent and no copy from the other parent. Uniparental disomy may cause delayed development, mental retardation, or other medical problems. Differences in gene expression at the Gtl2 locus have also been linked to fetal alcohol exposure disorder.

But when working properly, the Gtl2 locus acts as a great protector of cells.

‘Most of the non-coding RNAs at the Gtl2 locus have been documented to function as tumor suppressors to maintain normal cell function,’ Qian says.

Li’s team zeroed in on Gtl2 by studying hematopoietic stem cells in mice with support from Stowers core centers including cytometry, bioinformatics, histology and electron microscopy, molecular biology, and tissue culture. Other collaborators included researchers from the University of Kansas; the University of Kansas Medical Center; Tianjin Medical University, China; Christian Medical College, Vellore, India; Tokyo University of Agriculture, Japan; and University of Cambridge, United Kingdom.

Over the three-year study, investigators used transcriptome profiling to analyze 17 hematopoietic cell types and found that non-coding RNAs expressed from the Gtl2 locus are predominantly located in a subset of the cell types, including adult ‘long-term’ hematopoietic stem cells which have long-term self-renewal capacity. In subsequent experiments, deleting the locus from the maternally inherited allele in hematopoietic stem cells increased mitochondrial biogenesis and subsequent metabolic activity as well as increased ROS levels, with the latter inducing cell death.

The finding opens the possibility for Gtl2 to be used as a biomarker because it could help label dormant (or reserve) stem cells in normal or potentially cancerous stem cell populations, Li says. The addition of a fluorescent tag to the Gtl2 locus could allow researchers to mark other adult stem cells in the gut, hair follicle, muscle, and neural systems. EurekAlert

Gene pair plays crucial role in colon cancer

Colon cancer is one of the leading causes of cancer-related deaths worldwide, and researchers are hard at work to understand the disease’s complex molecular underpinnings. In a new study researchers from the University of Pennsylvania describe two related genes in the Musashi family that are required for colon cancer to develop, and that may be useful targets for effective treatment.

The work, led by Christopher Lengner, an assistant professor in the Department of Biomedical Sciences in Penn’s School of Veterinary Medicine, challenges a paradigm in the field whereby activation of a molecular signalling cascade known as the Wnt pathway is held responsible for the majority of colon cancer cases in humans. The new findings suggest that the Musashi genes, MSI1 and MSI2, act in a path parallel to the Wnt pathway and may be equally important for driving colon cancer.

The work also indicates that the two genes, which encode RNA-binding proteins, are functionally redundant.

“The data suggest that either MSI protein is sufficient to support cancer,” Lengner said. “If you want to use these proteins as a drug target, you’d have to design a drug that will inhibit both of them.”

While researchers have known for some time that MSI1 was expressed in colon cancer, the mechanism by which it acted and its functional requirement for the disease were not well understood. The related protein MSI2 had not been rigorously examined in the context of colon cancer until earlier this year, when a paper by Lengner and colleagues found that it could trigger activation of cellular metabolic processes that fuel cancerous cells in the intestines.

“Considering the expression patterns of these two proteins during homeostasis, or normal conditions, you would expect their function when they were hijacked by cancer could be similar in supporting tumour growth,” said Ning Li, first author on the study and a postdoctoral fellow in Lengner’s lab.

The current work took both proteins into account. Whereas the prior paper found that MSI2 was consistently overexpressed in intestinal cancer tissue, Lengner and colleagues found that MSI1 was more variable, overexpressed in some samples and under-expressed in others, compared to normal tissue. When they bred mice in which they could induce overexpression of MSI1 in the intestine, the cells of the intestine began to divide rapidly and lost their ability to differentiate, just as mice with inducible overexpression of MSI2 had.

They found that inducing MSI1 turned on a similar set of genes as MSI2 overexpression did, including genes related to RNA processing and translation, necessary processes for manufacturing the required components for cancer’s rapid cell growth. The analysis also revealed that activating MSI1 caused a set of genes to be expressed that match the effect of losing the function of APC, a tumour suppressor gene that is inactivated in more than 80 percent of cases of human colon cancer.

As they had done with MSI2, the researchers also conducted an experiment that reveals the RNA transcripts to which MSI1 binds, and they found high levels of similarity to the set of transcripts bound by MSI2. Notably, both proteins bind tumor suppressors, such as Pten, which activates cellular metabolism through a protein complex called mTORC1. Further experiments confirmed MSI1 promoted mTORC1 activity.

“We concluded that these proteins are functioning in the same pathways and acting redundantly not only because they are binding similar proteins but also because when you overexpress them, the phenotype is identical,” Lengner said. “They appear to have identical oncogenic properties.” Penn News

Genetic variants tied to increased risk of bone complications in young leukaemia patients

Variations in genes involved in normal bone development are associated with an 8- to 15-fold increased risk for osteonecrosis in young patients with acute lymphoblastic leukaemia (ALL), according to research led by St. Jude Children’s Research Hospital and Children’s Oncology Group investigators.

Osteonecrosis is a major side effect of ALL treatment with chemotherapy. About 15 percent of ALL patients develop the complication, which is caused by reduced blood flow to bones in the hips and other joints and leads bone to break down faster than it is replaced. For patients, the results may include stiffness, pain, disability and joint-replacement surgery. ALL patients aged 10 to 20 years old are at particularly high risk for osteonecrosis.

This study is the first to focus on genetic risk factors for osteonecrosis in ALL patients less than 10 years old, an age group that accounts for about 75 percent of newly identified ALL patients and about half of ALL patients who develop osteonecrosis. Researchers used genome-wide association studies to check the DNA of 1,186 ALL patients less than 10 years old for single changes in the 3.2 billion “letters” or chemical bases that make up the human genetic code.

Researchers checked for genetic variations that were more common in 82 young ALL patients who developed osteonecrosis than in 287 who did not. The screening was then repeated with an additional 817 ALL patients younger than 10 years old. The patients were treated in clinical trials of the Children’s Oncology Group, an international clinical trials group focused exclusively on paediatric cancer.

Patients with osteonecrosis were eight to 15 times more likely to have genetic variations located near BMP7, a gene important for normal bone development.

“The goal of this and earlier studies is to identify and understand genetic and other risk factors for osteonecrosis so we can identify patients at high risk for the side effect and develop interventions to prevent the disease,” said first author Seth Karol, M.D., a St. Jude Physician Scientist Training Program fellow. Karol works with the study’s senior author Mary Relling, Pharm.D., chair of the St. Jude Department of Pharmaceutical Sciences.

A variation in the glutamate receptor gene GRID2 was also associated with a greater likelihood of osteonecrosis in ALL patients younger than 10. GRID2 belongs to a family of genes that carries instructions for assembling receptor proteins on the cell membrane that cells rely on to respond to the chemical messenger glutamate. The finding confirms previous research that reported variations in other glutamate receptor genes were associated with an elevated risk of osteonecrosis, with the prior study primarily identifying the risk in patients aged 10 and older.

“The finding that the genetic variations that affect osteonecrosis risk differ by age was unexpected,” Karol said. “The results suggest that as children age, particularly when bone growth is accelerated during adolescence, certain gene variants may become more or less important.”

Additional research is planned to expand the search for osteonecrosis genetic risk factors to include additional ALL treatment regimens and subtypes of the disease. Working in laboratory models, researchers also plan to study how gene variants affect osteonecrosis risk in order to help lay the groundwork for intervention to prevent the disease. St. Jude Children’s Research Hospital

Unravelling the genetic basis of sudden unexpected death in epilepsy

The leading cause of epilepsy-related death is a poorly understood phenomenon known as sudden unexpected death in epilepsy (SUDEP). The risk factors and causes of SUDEP remain unclear but researchers have proposed explanations ranging from irregular heart rhythm to genetic predisposition to accidental suffocation during sleep. Three studies to be presented at the American Epilepsy Society’s (AES) 69th Annual Meeting parse the contributions of genetics to SUDEP in hopes of uncovering new strategies for prevention.

Researchers from the Universities of Melbourne and Sydney report that genetic variants associated with cardiac sudden death may be to blame for SUDEP. The authors examined DNA samples from 62 people who died from SUDEP, searching for mutations in genes known to contribute to cardiac arrhythmia, respiratory function and epilepsy.

Their results reveal that nearly a quarter of people who experienced SUDEP carried mutations linked to cardiac sudden death, suggesting that irregular heart rhythms may underlie a significant number of deaths in epilepsy. Furthermore, one-quarter of the cases had genetic mutations associated with epilepsy.

‘These findings raise the possibility that SUDEP might be prevented in some cases by avoiding the use of anti-epileptic drugs known to alter the heart’s electrical activity’ says Douglas Crompton, M.D., Ph.D., a neurologist at the University of Melbourne. ‘In some cases, it may be advisable to recommend beta blockers, pacemakers or implantable defibrillators.’

In a second study, researchers from New York University’s Langone Medical Center find that genetic mutations altering the transmission of electrical impulses in the heart and brain may raise the risk of SUDEP in people.

The authors searched for genetic mutations that might explain the disproportionately high risk of SUDEP in people with poorly controlled focal epilepsy, which, by definition stems from a specific area of the brain. To identify genetic risk factors for SUDEP, the authors analysed brain tissue that had been removed during epilepsy surgery from 8 people who later experienced SUDEP and from seven living people with similar histories.

The study found mutations in 607 genes in brain tissue from patients who died from SUDEP that were not seen in the tissue from the living people. Analysis of affected genes revealed possible functional effects from 532 of the mutations. Three of people who experienced SUDEP had mutations in six genes linked to cardiac arrhythmia. The other five people who died from SUDEP had mutations in seven genes involved in GABA/Glutamate pathways.

‘Genetic testing for these mutations could potentially allow for the early identification of people with epilepsy who are at high risk of sudden death,’ notes author Daniel Friedman, M.D., an assistant professor of neurology at NYU.

A third study pinpoints a specific genetic mutation that may raise the risk of SUDEP in patients with early-infantile epileptic encephalopathy — a severe, drug-resistant disorder that manifests in the first 3 months of life. Researchers from the University of Michigan set out to explore whether genetic mutations in voltage-gated Na+ channels (VGSCs), which promote the transmission of electrical impulses in the heart and brain, increase the risk of SUDEP in patients with early-infantile epileptic encephalopathy.

The authors reproduced this disorder in mice to explore whether mutations in a particular VGSC, encoded by the SCN8A gene, increase the risk of cardiac arrhythmia, which might, in turn, influence susceptibility to SUDEP. Animal experiments revealed that mice carrying a mutated SCN8A gene had reduced heart rate compared with their healthy littermates, and that administration of caffeine produced an abnormal heart rhythm known as accelerated idioventricular rhythm. Examination of cardiac cells revealed a number of molecular changes that further altered the heart rhythm.

‘Taken together, our results suggest that SCN8A mutations in people with early-infantile epileptic encephalopathy may increase the risk of SUDEP by creating an environment in which the heart has a higher susceptibility to arrhythmias,’ explains author Chad Frasier, Ph.D., a postdoctoral researcher at the University of Michigan. American Epilepsy Society

Repetitive DNA provides a hidden layer of functional information

In the first study to run a genome-wide analysis of Short Tandem Repeats (STRs) in gene expression, a large team of computational geneticists led by investigators from Columbia Engineering and the New York Genome Center have shown that STRs, thought to be just neutral, or ‘junk,’ actually play an important role in regulating gene expression.

“Our work expands the repertoire of functional genetic elements,” says the study’s leader Yaniv Erlich, who is an assistant professor of computer science at Columbia Engineering, a member of Columbia’s Data Science Institute, and a core member of the New York Genome Center. “We expect our findings will lead to a better understanding of disease mechanisms and perhaps eventually help to identify new drug targets.”

Genomic variants are what makes our DNA different from each other, and come,
Erlich explains, “like spelling errors in different flavours.” The most common
variants are SNPs (single nucleotide polymorphisms). Computational geneticists
have been focused mostly on SNPs that look like a single letter typo—mother vs.
muther—and their effect on complex human traits.

Erlich’s study looked at Short Tandem Repeats (STRs), variants that create what
look like typos: stutter vs. stututututututter. Most researchers, assuming that
STRs were neutral, dismissed them as not important. In addition, these variants
are extremely hard to study. “They look so different to analysis algorithms,” Erlich notes, “that they just usually classify them as noise and skip these positions.”

Erlich used a multitude of statistical genetic and integrative genomics analyses to
reveal that STRs have a function: they act like springs or knobs that can expand
and contract, and fine-tune the nearby gene expression. Different lengths
correspond to different tensions of the spring and can control gene expression and disease traits. He is calling these variants eSTRs, or expression STRs, to note that they regulate gene expression. He and his team also discovered that these eSTRs can be associated with a range of conditions including Crohn’s diseases, high blood pressure, and a range of metabolites. These eSTRs explain on average 10 to 15% the genetic differences of gene expression between individuals.
“We’ve known that STRs are known to play a role in these diseases, but no one has ever conducted a genome-wide scan to find their effect on complex traits,” Erlich adds. “If we want to do personalized medicine, we really need to understand every part of the genome, including repeat elements—there’s a lot of exciting biologyahead.” New York Genome Centre

Leukaemia study reveals therapy clues

Genes that act as brakes to stop the development of an aggressive form of leukaemia have been identified by researchers. Their findings offer fresh insights into how to tackle the disease and could lead to new therapies that prevent relapses.

Scientists have found that two molecules – Hif-1alpha and Hif-2alpha – work together to stop the formation of leukemic stem cells in an aggressive type of blood cancer called Acute Myeloid Leukaemia (AML). The cancer occurs when production of new blood cells by the bone marrow goes awry. This leads to the formation of leukemic stem cells, which fuel the disease and provide a constant flow of abnormal leukaemia cells.

The University of Edinburgh study shows that blocking Hif-2alpha – or both Hif-1alpha and Hif-2alpha – accelerates the development of leukaemia.  The findings are surprising because previous research had suggested that blocking Hif-1alpha or Hif-2alpha may stop leukaemia progression.

Researchers say that their new results suggest that therapies designed to block these molecules may have no impact or could even worsen disease.
Conversely, designing new therapies that promote the activity of Hif-1alpha and Hif-2alpha could help to treat AML or stop the disease from recurring after chemotherapy. University of Edinburgh