Objective
End points currently used in lupus nephritis (LN) clinical trials lack uniformity and questionably reflect long‐term kidney survival. This study was undertaken to identify short‐term end ...points that predict long‐term kidney outcomes for use in clinical trials.
Methods
A database of 944 patients with LN was assembled from 3 clinical trials and 12 longitudinal cohorts. Variables from the first 12 months of treatment after diagnosis of active LN (prediction period) were assessed as potential predictors of long‐term outcomes in a 36‐month follow‐up period. The long‐term outcomes examined were new or progressive chronic kidney disease (CKD), severe kidney injury (SKI), and the need for permanent renal replacement therapy (RRT). To predict the risk for each outcome, hazard index tools (HITs) were derived using multivariable analysis with Cox proportional hazards regression.
Results
Among 550 eligible subjects, 54 CKD, 55 SKI, and 22 RRT events occurred. Variables in the final CKD HIT were prediction‐period CKD status, 12‐month proteinuria, and 12‐month serum creatinine level. The SKI HIT variables included prediction‐period CKD status, International Society of Nephrology (ISN)/Renal Pathology Society (RPS) class, 12‐month proteinuria, 12‐month serum creatinine level, race, and an interaction between ISN/RPS class and 12‐month proteinuria. The RRT HIT included age at diagnosis, 12‐month proteinuria, and 12‐month serum creatinine level. Each HIT validated well internally (c‐indices 0.84–0.92) and in an independent LN cohort (c‐indices 0.89–0.92).
Conclusion
HITs, derived from short‐term kidney responses to treatment, correlate with long‐term kidney outcomes, and now must be validated as surrogate end points for LN clinical trials.
Insects are the largest group of animals when it comes to the number and diversity of species. Yet, with the exception of
, no information is currently available on the primary structure of their ...sperm nuclear basic proteins (SNBPs). This paper represents the first attempt in this regard and provides information about six species of Neoptera:
, and
. The SNBPs of these species were characterized by acetic acid urea gel electrophoresis (AU-PAGE) and high-performance liquid chromatography fractionated. Protein sequencing was obtained using a combination of mass spectrometry sequencing, Edman N-terminal degradation sequencing and genome mining. While the SNBPs of several of these species exhibit a canonical arginine-rich protamine nature, a few of them exhibit a protamine-like composition. They appear to be the products of extensive cleavage processing from a precursor protein which are sometimes further processed by other post-translational modifications that are likely involved in the chromatin transitions observed during spermiogenesis in these organisms.
Abstract
Background
There is mounting evidence for the presence of postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), but there is limited ...information on the spectrum, magnitude, duration, and patterns of these sequelae as well as their influence on quality of life.
Methods
We assembled a cohort of adults with a documented history of SARS-CoV-2 RNA positivity at ≥2 weeks past onset of coronavirus disease 2019 (COVID-19) symptoms or, if asymptomatic, first positive test. At 4-month intervals, we queried physical and mental health symptoms and quality of life.
Results
Of the first 179 participants enrolled, 10 were asymptomatic during the acute phase of SARS-CoV-2 infection, 125 were symptomatic but not hospitalized, and 44 were symptomatic and hospitalized. During the postacute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping, and anosmia/dysgeusia were most common through 8 months of observation. Symptoms were typically at least somewhat bothersome and sometimes exhibited a waxing-and-waning course. Some participants experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with performance of usual activities. The median visual analogue scale rating of general health was lower at 4 and 8 months compared with pre-COVID-19. Two clusters of symptom domains were identified.
Conclusions
Many participants report bothersome symptoms following onset of COVID-19 with variable patterns of persistence and impact on quality of life. The substantial variability suggests the existence of multiple subphenotypes of PASC. A rigorous approach to the prospective measurement of symptoms and functional manifestations sets the stage for the next phase of research focusing on the pathophysiologic causes of the various subgroups of PASC.
Dimorphisms occur when alternative developmental pathways produce discrete phenotypes within a species, and may promote evolutionary novelty in morphology, life history, and behavior. Among marine ...invertebrates, intra-specific dimorphism in larval type (poecilogony) is notably rare, but should provide insight into the selective forces acting on larval strategies. Most established cases of poecilogony appear to be allelic polymorphisms, with local expression regulated by population-genetic processes. Here, we present evidence that dimorphic larval development in the sea slug Alderia willowi is a seasonal polyphenism; the type of larvae produced by an adult slug depends on the rearing environment in which that slug matured. In field surveys of 1996–1999 and 2007–2009, the population in Mission Bay, San Diego (California, USA) produced only short-lived lecithotrophic larvae in summer and early fall, but a varying proportion of slugs expressed planktotrophy in winter and spring. In laboratory experiments, slugs reared under summer conditions (high temperature, high salinity) produced the highest proportion of lecithotrophic offspring, whereas winter conditions (low temperature, low salinity) induced the lowest proportion of lecithotrophy. The shift to a nondispersive morph under summer conditions may be an adaptive response to historical closure of coastal wetlands during the dry season in southern California, which would inhibit dispersal by larvae of back-bay taxa. In most animal polyphenisms, a single larval type is produced and the rearing environment determines which adult phenotype develops. In contrast, alternative larval morphs are produced by A. willowi in response to seasonal cues experienced by the adult stage, varying the phenotype and dispersal potential of offspring. As the only known case of polyphenism in mode of larval development, A. willowi should become a model organism for mechanistic studies of dimorphism and the evolution of alternative life histories.
In many marine animals, adult habitat is selected by lecithotrophic (non-feeding) larvae with a limited lifespan. In generalist species, larvae may increasingly accept sub-optimal habitat over time ...as energy stores are depleted ('desperate larva' hypothesis). If the fitness cost of suboptimal habitat is too high, larvae of specialists may prolong the searching phase until they encounter a high-quality patch or die ('death before dishonor' hypothesis). In generalists, starvation is hypothesized to lead to a decline in inhibitory nitric oxide (NO) signaling, thereby triggering metamorphosis. Here, we document alternative functions for identified signaling pathways in larvae having 'desperate' versus 'death before dishonor' strategies in lecithotrophic clutches of a habitat specialist, the sea slug Alderia willowi. In an unusual dimorphism, each clutch of A. willowi hatches both non-selective larvae that settle soon after hatching and siblings that delay settlement in the absence of cues from the alga Vaucheria, the sole adult food. Pharmacological manipulation of NO signaling induced metamorphosis in non-selective but not selective stages. However, decreased NO signaling in selective larvae lowered the threshold for response to habitat cues, mimicking the effect of declining energy levels. Manipulation of cGMP or dopamine production induced metamorphosis in selective and non-selective larvae alike, highlighting a distinct role for the NO pathway in the two larval morphs. We propose a model in which NO production (1) links nitrogen metabolism with sensory receptor signaling, and (2) shifts from a regulatory role in 'desperate larva' strategies to a modulatory role in 'death before dishonor' strategies. This study provides new mechanistic insight into how the function of conserved signaling pathways may change in response to selection on larval habitat choice behaviors.
Simultaneous hermaphrodites offer the chance to study antagonistic coevolution between the sexes when individuals function in both roles. Traumatic mating by hypodermic insemination has repeatedly ...evolved in hermaphroditic taxa, but evidence for the fitness costs of such male-advantage traits is lacking. When reared in isolation, specimens of the sea slug Alderia willowi (Opisthobranchia: Sacoglossa) initially laid clutches of unfertilized eggs but 4 days later began self-fertilizing; this is only the third report of selfing in an opisthobranch. Hypodermic insemination may allow selfing in Alderia if penetration of the body wall bypasses internal mechanisms that promote outcrossing. Selfing specimens and slugs reared in pairs had reduced fecundity compared to isolated slugs laying unfertilized clutches, suggesting that hypodermic insemination imposes a cost of mating. Egg production increased for field-caught slugs separated after mating compared to slugs held in pairs, a further indication that accessibility to mates imposes a fitness cost to the female function. Such antagonism can confer a competitive advantage to slugs mating in the male role but diminish reproduction in the female role among hermaphrodites capable of long-term sperm storage. Alderia willowi is also a rare case of poecilogony, with adults producing either planktotrophic or lecithotrophic larvae. Our rearing studies revealed that most slugs switched between expressed development modes at some point; such reproductive flexibility within individuals is unprecedented, even among poecilogonous species.
Ciliary feeders vary in the arrangement of ciliary bands and mechanisms of capture of food. Some larvae use opposed parallel bands of preoral (prototroch) and postoral (metatroch) cilia. Hypotheses ...for the mechanism of particle capture include filtration by adhesion to a cilium that overtakes a particle (direct interception), but until now unequivocal evidence for this mechanism has been lacking. Here, high-speed video recordings of veliger larvae of the gastropod Lacuna vincta demonstrated direct interception of particles by prototrochal cilia. Adhesion between cilium and particle was seen when a prototrochal cilium tugged a diatom chain into the food groove while in contact with one part of the chain. In several recorded events, a prototochal cilium overtook a particle during its effective stroke and subsequently pulled the particle inward with its recovery stroke; thereupon, the particle was deposited onto the food groove and transported to the mouth. Captures varied, however. In some cases the particle was intercepted multiple times in one capture event; in others, several cilia passed a particle without interception. Particles occasionally remained in the area of recovery strokes, indicating retention without continuing adhesion to a cilium. In three events, a particle lost from prototrochal cilia was intercepted and moved into the food groove by metatrochal cilia. Particles as wide as or wider than the food groove were also captured and transported but were not ingested.
Documenting larval behavior is critical for building an understanding of larval dispersal dynamics and resultant population connectivity. Nocturnal diel vertical migration (DVM), a daily migration ...towards the surface of the water column at night and downward during the day, can profoundly influence dispersal outcomes. Via laboratory experiments we investigated whether marine gastropod Kelletia kelletii larvae undergo nocturnal DVM and whether the behavior was influenced by the presence of light, ontogeny, and laboratory culturing column height. Larvae exhibited a daily migration pattern consistent with nocturnal diel vertical migration with lower average vertical positioning (ZCM) during day-time hours and higher vertical positioning at night-time hours. ZCM patterns varied throughout ontogeny; larvae became more demersal as they approached competency. There was no effect of column height on larval ZCM. DVM behavior persisted in the absence of light, indicating a possible endogenous rhythm. Findings from field plankton tows corroborated laboratory nocturnal DVM findings; significantly more K. kelletii were found in surface waters at midnight compared to at noon. Unraveling the timing of and the cues initiating DVM behavior in K. kelletii larvae can help build predictive models of dispersal outcomes for this emerging fishery species.
Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) strategies with proven in vivo efficacy rely on antiretroviral drugs, creating the potential for drug resistance and complicated ...treatment options in individuals who become infected. Moreover, on-demand products are currently missing from the PrEP development portfolio. Griffithsin (GRFT) is a non-antiretroviral HIV entry inhibitor derived from red algae with an excellent safety profile and potent activity in vitro. When combined with carrageenan (CG), GRFT has strong activity against herpes simplex virus-2 (HSV-2) and human papillomavirus (HPV) in vitro and in vivo. Here, we report that GRFT/CG in a freeze-dried fast dissolving insert (FDI) formulation for on-demand use protects rhesus macaques from a high dose vaginal SHIV SF162P3 challenge 4 h after FDI insertion. Furthermore, the GRFT/CG FDI also protects mice vaginally against HSV-2 and HPV pseudovirus. As a safe, potent, broad-spectrum, on-demand non-antiretroviral product, the GRFT/CG FDI warrants clinical development.
Summary
Aging of the world population and a concomitant increase in age‐related diseases and disabilities mandates the search for strategies to increase healthspan, the length of time an individual ...lives healthy and productively. Due to the age‐related decline of the immune system, infectious diseases remain among the top 5–10 causes of mortality and morbidity in the elderly, and improving immune function during aging remains an important aspect of healthspan extension. Calorie restriction (CR) and more recently rapamycin (rapa) feeding have both been used to extend lifespan in mice. Preciously few studies have actually investigated the impact of each of these interventions upon in vivo immune defense against relevant microbial challenge in old organisms. We tested how rapa and CR each impacted the immune system in adult and old mice. We report that each intervention differentially altered T‐cell development in the thymus, peripheral T‐cell maintenance, T‐cell function and host survival after West Nile virus infection, inducing distinct but deleterious consequences to the aging immune system. We conclude that neither rapa feeding nor CR, in the current form/administration regimen, may be optimal strategies for extending healthy immune function and, with it, lifespan.
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