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Parkinson's disease (PD) is a frequent neurodegenerative process in old age. Accumulation and aggregation of the lipid-binding SNARE complex component α-synuclein (SNCA) underlies this vulnerability and defines stages of disease progression. Determinants of SNCA levels and mechanisms of SNCA neurotoxicity have been intensely investigated. In view of the physiological roles of SNCA in blood to modulate vesicle release, we studied blood samples from a new large pedigree with SNCA gene duplication (PARK4 mutation) to identify effects of SNCA gain of function as potential disease biomarkers. Downregulation of complexin 1 (CPLX1) mRNA was correlated with genotype, but the expression of other Parkinson's disease genes was not. In global RNA-seq profiling of blood from presymptomatic PARK4 indviduals, bioinformatics detected significant upregulations for platelet activation, hemostasis, lipoproteins, endocytosis, lysosome, cytokine, Toll-like receptor signaling and extracellular pathways. In PARK4 platelets, stimulus-triggered degranulation was impaired. Strong SPP1, GZMH and PLTP mRNA upregulations were validated in PARK4. When analysing individuals with rapid eye movement sleep behavior disorder, the most specific known prodromal stage of general PD, only blood CPLX1 levels were altered. Validation experiments confirmed an inverse mutual regulation of SNCA and CPLX1 mRNA levels. In the 3′-UTR of the CPLX1 gene we identified a single nucleotide polymorphism that is significantly associated with PD risk. In summary, our data define CPLX1 as a PD risk factor and provide functional insights into the role and regulation of blood SNCA levels. The new blood biomarkers of PARK4 in this Turkish family might become useful for PD prediction.
Patient-reported outcomes (PROs) such as quality of life and work productivity are important for measuring patient's experience. We assessed PROs during and after treatment of hepatitis C virus (HCV) patients.Data were obtained from a phase 3 open label study of sofosbuvir and ribavirin (SOF + RBV) with and without interferon (IFN). Patients completed 4 PRO assessment instruments (SF-36, Functional Assessment of Chronic Illness Therapy-Fatigue, Chronic Liver Disease Questionnaire- HCV, Work Productivity and Activity-Specific Health Problem) before, during, and after treatment.A total of 533 patients with chronic HCV were enrolled; 28.9% treatment-naïve, 23.1% cirrhotic, 219 received IFN + SOF + RBV and 314 received IFN-free SOF + RBV. At baseline, there were no differences in PROs between the IFN-free and IFN-containing treatment arms (all P > 0.05). During treatment, patients receiving IFN + SOF + RBV had a substantial impairment in their PROs (up to -24.4% by treatment week 12, up to -8.3% at week 4 post-treatment). The PRO decrements seen in the SOF + RBV arm were smaller in magnitude (up to -7.1% by treatment week 12), and all returned to baseline or improved by post-treatment week 4. By 12 weeks after treatment cessation, patients who achieved sustained viral response-12 showed some improvement of PRO scores regardless of the regimen (up to +7.1%, P < 0.0001) or previous treatment experience. In multivariate analysis, the use of IFN was independently associated with lower PROs.IFN-based regimens have a profoundly negative impact to PROs. By contrast, the impact of RBV on these PROs is relatively modest. Achieving HCV cure is associated with improvement of most of the PRO scores.
Expression, perception and recognition of intense emotions in healthy and depressed individuals
(2017)
Die Fähigkeit die Gefühle anderer zu erkennen und einzuordnen ermöglicht es soziale Situationen richtig einzuschätzen und soziale Beziehungen aufzubauen. Da Emotionen also in unserem Leben eine wichtige Rolle spielen, kann eine Dysregulation der Emotionsverarbeitung auch zu elementaren Einschränkungen führen. Menschen, die unter depressiven Episoden leiden, durchleben beispielsweise regelmäßig Phasen intensiver und anhaltender Traurigkeit. Jedoch ist noch nicht vollständig erklärt, wie es zu dieser verzerrten Emotionswahrnehmung kommt. Diese Dissertation hatte deshalb das Ziel, den Ausdruck, die Wahrnehmung und das Erkennen extremer Emotionen genauer zu beleuchten.
In Studie 1 wurden der Ausdruck und das Erkennen extremer Emotionen untersucht.
Hierbei dienten aus dem Internet bezogene Videosequenzen von Kindern und Erwachsenen als Basis, in denen diese sich in Situationen befanden, die sie extrem negative oder extrem positive Emotionen durchleben ließen. Die Gesichtsausdrücke der Kinder und Erwachsenen wurden dann zum Zeitpunkt der stärksten emotionalen Erregung in ein Bild umgewandelt und von unabhängigen Ratern auf ihre Valenz und ihr Arousal eingeschätzt. Es wurde beobachtet, dass - entgegen der Vorhersage etablierter Emotionstheorien (z.B. Ekman, 1993) – Emotionen hoher positiver und negativer Intensität schwer auseinander zu halten sind. Tatsächlich wurden positive Emotionsausdrücke häufig als negativ eingeschätzt. Eine mögliche Erklärung dafür liefern Aragón und Kollegen (2015). Sie schätzen den Ausdruck negativer Emotionen in positiven Situationen als Emotionsregulationsstrategie ein, die dazu dient ein emotionales Equilibrium wieder herzustellen, das durch die überwältigenden positiven Emotionen aus dem Gleichgewicht gebracht wurde.
In Studie 2 und 3 wurde die Wahrnehmung negativer Emotionen bei depressiven Menschen im Vergleich zu gesunden Kontrollprobanden auf subjektiver und physiologischer Ebene untersucht. Hierbei wurde zunächst im Rahmen von Studie 2 untersucht, ob Parameter des autonomen Nervensystems (ANS) sich zwischen depressiven und gesunden Probanden unterscheiden. ANS-Parameter umfassten Hormone (Cortisol und DHEA), Herzratenvariabilität (HRV), Hautleitfähigkeit (GSR), Hauttemperatur (TEMP) und Atemfrequenz (RSP). Es konnten erhöhte DHEA-Werte, eine erhöhte Hauttemperatur und eine reduzierte Atemfrequenz in der Patientengruppe gefunden werden. Eine erhöhte Hauttemperatur korrelierte zudem mit der Ausprägung depressiver Symptome und der aktuellen Stimmung. Reduzierte HRV-Werte wurden hauptsächlich auf antidepressive Medikation zurückgeführt.
In Studie 3 wurde dann die Reaktion der Probanden auf emotionsevozierende Stimuli verschiedener Valenzkategorien (neutral, leicht negative, hoch negative) untersucht. Hierbei wurden sowohl physiologische Parameter (TEMP, HRV, GSR, RSP) als auch die subjektive Einschätzung der Stimuli bezüglich ihrer Valenz und ihres Arousal erhoben. Die Befunde bezüglich Hauttemperatur und HRV-Werte aus Studie 2 konnten in Studie 3 repliziert
werden. Zudem zeigte sich eine akzentuierte Reaktion der RSP sowie höhere Valenz- und Arousalratings in der Patientengruppe. Das subjektiv intensivere Empfinden der Stimuli bei den Patienten hing zusätzlich mit emotionaler und sozialer Kompetenz zusammen.
In dieser Dissertation konnte gezeigt werden, dass Ausdrücke intensiver Emotionen im Gesicht oft als zweideutig wahrgenommen werden. Um ein genaueres Verständnis der Emotionswahrnehmung bei depressiven Menschen zu erlangen, konnten zudem mehrere Parameter des ANS identifiziert werden, die teils noch nicht untersucht wurden und einer intensiveren Emotionswahrnehmung bei depressiven Patienten zugrunde liegen könnten.
Hierbei wurden zusätzlich Zusammenhänge zu weiteren Aspekten der Depression, wie Defiziten in sozialen Kompetenzen, aufgezeigt. Damit gibt diese Dissertation umfassende Aufschlüsse über Emotionsverarbeitungsprozesse bei gesunden und depressiven Menschen.
Ocular gene therapy approaches have been developed for a variety of different diseases. In particular, clinical gene therapy trials for RPE65 mutations, X-linked retinoschisis, and choroideremia have been conducted at different centers in recent years, showing that adeno-associated virus (AAV)-mediated gene therapy is safe, but limitations exist as to the therapeutic benefit and long-term duration of the treatment. The technique of vector delivery to retinal cells relies on subretinal injection of the vector solution, causing a transient retinal detachment. Although retinal detachments are known to cause remodeling of retinal neuronal structures as well as significant cell loss, the possible effects of this short-term therapeutic retinal detachment on retinal structure and circuitry have not yet been studied in detail. In this study, retinal morphology and apoptotic status were examined in healthy rat retinas following AAV-mediated gene transfer via subretinal injection with AAV2/5.CMV.d2GFP or sham injection with fluorescein. Outer plexiform layer (OPL) morphology was assessed by immunohistochemical labeling, laser scanning confocal microscopy, and electron microscopy. The number of synaptic contacts in the OPL was quantified after labeling with structural markers. To assess the apoptotic status, inflammatory and pro-apoptotic markers were tested and TUNEL assay for the detection of apoptotic nuclei was performed. Pre- and postsynaptic structures in the OPL, such as synaptic ribbons or horizontal and bipolar cell processes, did not differ in size or shape in injected versus non-injected areas and control retinas. Absolute numbers of synaptic ribbons were not altered. No signs of relevant gliosis were detected. TUNEL labeling of retinal cells did not vary between injected and non-injected areas, and apoptosis-inducing factor was not delocalized to the nucleus in transduced areas. The neuronal circuits in the OPL of healthy rat retinas undergoing AAV-mediated gene transfer were not altered by the temporary retinal detachment caused by subretinal injection, the presence of viral particles, or the expression of green fluorescent protein as a transgene. This observation likely requires further investigations in the dog model for RPE65 deficiency in order to determine the impact of RPE65 transgene expression on diseased retinas in animals and men.
Hyponatremia is the most common and by far underestimated electrolyte disorder in clinical practice. Especially in elderly patients, treatment of symptomatic hyponatremia is challenging. Herein we describe the case of an octogenarian with recurrent symptomatic hyponatremia due to idiopathic syndrome of inappropriate antidiuretic hormone release (SIADH). Fluid restriction was insufficient to prevent repeated episodes of hyponatremia complicated by falls and coma. After introduction of a low-dose therapy with tolvaptan, serum sodium levels as well as the clinical condition were stable under vaptan therapy, without any relapse for more than six years now. This case demonstrates that long-term tolvaptan treatment for hyponatremia caused by SIADH is safe and well tolerated, even in the elderly.
The first myrmecophilous fl ea beetle genus (Myrmeconycha Konstantinov and Tishechkin, new genus) with four new species (M. erwini Konstantinov and Tishechkin, new species – Ecuador, M. gordoni Konstantinov and Tishechkin, new species – Brazil, M. pakaluki Konstantinov and Tishechkin, new species – Panama, and M. pheidole Konstantinov and Tishechkin, new species – Costa Rica) is described and illustrated. It is compared with fl ea beetles of the subtribe Disonychina (Coleoptera: Chrysomelidae: Galerucinae: Alticini) and may be easily differentiated based on the external and internal features, which include the waxy surface of the head and pronotum, reticulated surface of the pronotum, and four longitudinal ridges on each elytron.
A new species of Autostichidae, Eraina beechei nov. sp., is described from specimens collected in the Andean mountains of Ñuble, Biobío. Diagnostic characters for the species are presented; photographs of adults, illustrations of male and female genitalia, and a key for identifi cation of Eraina species are provided.
The species of Dipropus Germar (Coleoptera: Elateridae) of the west-central region of North America are taxonomically reviewed. Historical records of D. approximatus (Candèze), D. ferreus (LeConte), D. simplex (LeConte) and D. soleatus (Say) in the region are based on misidentifi cations. Dipropus pericu new species is described from Baja California Sur. Dipropus reinae new species, D. sonora new species and D. yaqui new species are described from southern Arizona, New Mexico and Sonora. Dipropus warneri new species is described from Arizona, New Mexico and Texas. Dipropus sus (Candèze) is reported from Morelos, Sonora and Sinaloa as new state records. Keys to the species of the region are provided. The historical value of a specimen of Elater soleatus Say in the Dejean collection is discussed and its lectotype designated. Ischiodontus oblitus Candèze is treated as an objective synonym of Dipropus soleatus.
Ptyoiulus Cook 1895, the dominant parajulid diplopod genus in the eastern United States (US), comprises two species – P. impressus (Say 1821), with a slanted, fl ared, circumferentially entire, and marginally serrate apical calyx on the anterior gonopod coxal process, and P. montanus (Cope 1869), n. comb., with a smooth, upright, cupulate calyx that is open caudad and coaxial with the process’ stem. The genus occupies a broad area between the Mississippi River and Atlantic Ocean extending from southern New England, Ontario, and Michigan to the Florida Panhandle and four small disjunct ones – from Montreal, Québec, to northern Vermont, along southwestern Lake Michigan in Wisconsin and Illinois; northeastern/eastcentral Arkansas, primarily in Crowley’s Ridge physiographic feature and beside the “bootheel” of Missouri; and a point locality in northeastern Louisiana just south of the Arkansas line. A male from Chester County (Co.), Pennsylvania, is designated as the neotype of Julus impressus, as is one from Durham Co., North Carolina, for J. montanus. As both species inhabit Montgomery Co., Virginia, the type locality of J. montanus, we exercise the right of first reviser, conserve the latter name, and assign it to the species with the smooth, cupulate, and coaxial calyx. We also exercise first reviser rights and assign Parajulus ectenes Bollman 1887 to this form, thereby relegating it to synonymy under Ptyoiulus montanus. Other new synonymies include Ptyoiulus georgiensis Chamberlin 1943 under P. impressus and P. coveanus Chamberlin 1943 under P. montanus. Both Ptyoiulus and P. impressus are projected for Delaware and Rhode Island and newly reported from Québec, Connecticut, District of Columbia, Maryland, Mississippi, South Carolina, Vermont, West Virginia, and Wisconsin, and the genus and species, respectively, are newly documented from Louisiana and Arkansas; P. montanus is newly cited from Alabama, Arkansas, Georgia, Mississippi, and South Carolina. Ptyoiulus impressus occupies every state except perhaps Louisiana and is the only species in areas that were inundated during the Cretaceous and glaciated during the Pleistocene; by contrast, P. montanus inhabits a relatively narrow east/west transect through the center of the generic range. Their distribution patterns suggest an old species, montanus, being actively displaced by the younger and more successful impressus. The decurvature of the epiproct in uroblaniulinines appears to increase with age and developmental stage. A key is presented to parajulid familygroup taxa in the US and Canada east of the Rocky Mountains.