Botulinum toxin intramuscular injections for neck pain: a systematic review and metaanalysis.


To assess the effect of intramuscular botulinum toxin type A (BoNT-A) injections on pain, function/disability, global perceived effect, and quality of life (QOL) in adults with neck pain (NP).
METHODS: We searched Central, Medline, and Embase databases up to June 2010. A minimum of 2 authors independently selected articles, abstracted data, and assessed risk of bias and clinical applicability. We estimated standard mean differences (SMD) with 95% CI, relative risks (RR), and performed metaanalyses (SMD(p)) using a random-effects model for nonheterogeneous data. The approach of the Grading of Recommendations Assessment, Development, and Evaluation working group summarizes the quality of evidence.
RESULTS: We selected 14 trials. High-quality evidence suggested BoNT-A was no better than saline at 4 weeks [4 trials/183 participants; SMD(p) -0.21 (95% CI -0.50 to 0.07)] and 6 months for chronic NP. Moderate-quality evidence showed a similar effect for subacute/chronic whiplash-associated disorder (WAD) on pain [4 trials/122 participants; SMD(p) -0.21 (95% CI -0.57 to 0.15)], disability, and QOL. Very low-quality evidence indicated BoNT-A combined with exercise and analgesics was not significant for chronic NP reduction at 4 weeks [3 trials/114 participants; SMD(p) -0.08 (95% CI -0.45 to 0.29)] but was at 6 months [2 trials/43 participants; SMD(p) -0.66 (95% CI -1.29 to -0.04)].
CONCLUSION: Current evidence does not confirm a clinically or statistically significant benefit of BoNT-A used alone on chronic NP in the short term or on subacute/chronic WAD pain, disability, and QOL. Larger trials, subgroups, and predictors of responses defined a priori (to facilitate selection of patients most likely to benefit) and factorial designs to explore BoNT as an adjunct treatment to physiotherapeutic exercise and analgesics are needed.

source: journal of rheumatology

Proteomics: A day in the half-life of a protein


 
 
 
 

One of the ways that a cell regulates itself is by removing proteins that it no longer needs or that are detrimental to its health. This happens by two major mechanisms: degradation (such as via the proteasome) or dilution of the protein owing to cell growth. Rapidly dividing cells such as bacteria mainly rely on dilution to remove proteins, but terminally differentiated mammalian cells mostly use degradation. Because protein removal is often dominated by one process or another depending on the cell type, “the balance between degradation and dilution is often ignored,” says Eran Eden. “We wanted a way to measure both.”

Eden, a recently minted Ph.D. from Uri Alon’s group at the Weizmann Institute of Science, Alon and their colleagues considered the traditional methods for measuring protein degradation rates, which include pulse-chase and translation inhibition. Although pulse-chase has been used for decades, this method requires radioactive labeling and protein-specific antibodies for detection. Protein synthesis inhibitors, in contrast, can greatly perturb the cell. The researchers wanted a non-radioactive method that would minimally perturb the cells and that could be scaled to follow the fate of a large number of proteins.

They came up with a method to measure protein half-lives that they call bleach-chase. They label the protein of interest with a fluorescent YFP tag and then shine light on the cells, just for long enough to bleach 10–60% of the fluorophores; the short bleaching time does not substantially perturb the cells. “Conceptually, we can think of this as an ‘anti-tag’ that is generated at timepoint zero,” explains Eden. “If you monitor the cells through time you will see that the new protein that is produced is the YFP-tagged protein.” The problem with the anti-tag, however, is that it is invisible to fluorescence detection. Thus, to determine the protein removal rate, the researchers perform the experiment twice, once with bleaching and once without bleaching, using fluorescence time-lapse microscopy for detection. Then they simply subtract the fluorescence levels to obtain the dynamics of the ‘invisible’ proteins.

Because bleach-chase can be used to accurately quantify protein half-life, the method can help clearly identify which proteins are being actively degraded and which are being diluted as the cell divides. Eden, co–first author Naama Geva-Zatorsky, Alon and their colleagues have been working with human cancer cells, which have moderate growth rates, so the balance of degradation and dilution is important. In determining half-lives for 100 diverse proteins, they found that about 48% were regulated by degradation, 10% by dilution and the remaining 42% by a mixture of the two processes.

They then applied stress to the cells in the form of a chemotherapy drug, which slowed the growth rate, and looked at the effect this had on the protein removal rate. Whereas the degradation rate of short-lived proteins did not really change, the half-lives of the long-lived proteins, which are largely removed by dilution, became even longer. When they tested other stresses, which also slowed cell growth but at a different rate, they observed the same effect. “We think this is quite a general phenomenon,” Eden says. “This is a simple principle that can help one understand a lot about the removal rate of a protein in response to different stresses.” Notably, this result seems to suggest that cells do not use protein degradation to compensate for changes in the dilution rate.

The bleach-chase method should be useful to anyone who needs to measure protein half-lives. “Doing these experiments is very, very simple compared to pulse-chase,” says Eden. Because the method allows one to generate results much more rapidly than with pulse-chase, “it can really open the ability to measure protein half-life on a large scale,” he says. One drawback is that the proteins must be fluorescently tagged, which could alter the protein removal rate, but the researchers were careful to rule out this possibility with pulse-chase control experiments.

As fluorescently tagged protein libraries are becoming available for more and more organisms, the method is likely to be widely applicable.

Source: nature signal gateway

 

 

BRCA1: moving beyond the nucleus


BRCA1 interacts via its BRCT domains with ezrin, radixin and moesin, and colocalizes with F-actin at the plasma membrane to control cell spreading and motility.

For well over a decade, the exact mechanism through which breast cancer susceptibility 1 (BRCA1) functions as a tumor suppressor has evaded scientists. However, research by Coene et al., outlined in The Journal of Cell Biology, has uncovered an unexpected function for full-length BRCA1 beyond its known nuclear roles — in suppressing cell invasion.

Full-length BRCA1 contains an amino-terminal RING domain with E3 ubiquitin ligase activity and a pair of BRCA1 carboxy-terminal (BRCT) domains, which are essential for its tumor-suppressive activity. The authors probed HeLa postnuclear membrane pellet fractions (to exclude nuclear BRCT-interacting proteins) using a region of BRCA containing the two BRCT domains tagged with enhanced green fluorescent protein — EGFP-CTD. They identified the proteins ezrin, radixin and moesin (ERM), which are known to link the plasma membrane to the actin cytoskeleton during cell migration, as independent binding partners. EGFP-CTD colocalized not only with the ERM complex but also with filamentous actin (F-actin) in membrane extensions and at points of cell adhesion with the extracellular matrix.

This interaction led the authors to hypothesize that BRCA1 might affect migration, and when they induced migration in HeLa cells, colocalization of F-actin, ERM and EGFP-CTD increased in membrane ruffles. As full-length endogenous BRCA1 also associated with F-actin and ERM, Coene et al. speculated that the recombinant truncated protein might compete with native BRCA1. Indeed, expressing high levels of EGFP-CTD in CHO cells (CHO-High) displaced endogenous BRCA1 from along the plasma membrane where it normally colocalized with F-actin in wild-type CHO cells (CHO-WT).

How, then, might the absence of the N-terminal domain and central region of BRCA1 affect cell behavior? More CHO-WT cells than CHO-High cells were spread out 3 hours after plating, although there were no differences after 24 hours. CHO-High cells moved faster than CHO-WT cells and CHO cells expressing low levels of EGFP-CTD (CHO-Low), indicating that endogenous full-length BRCA1 might regulate cell migration. Consistent with this notion, MCF-7 cells express full-length functional BRCA1, show low motility and are not metastatic; these cells moved slower than HCC1937 cells, which contain a null BRCA1 allele and a truncating mutation in BRCA1 and are highly motile and invasive. Expressing EGFP-CTD in MCF-7 cells increased motility, whereas restoring expression of full-length BRCA1 in HCC1937 cells reduced motility. However, a point mutation in BRCA1 that abolishes its E3 ubiquitin ligase activity abrogated its effect in HCC1937 cells. Finally, individual EGFP-CTD-expressing CHO cells displayed haphazard and fast movement in wound healing assays compared with CHO-WT cells.

These results suggest that full-length, functional BRCA1 inhibits metastasis and invasion. Mutations that disrupt its localization at the plasma membrane (with ERM or, potentially, other membrane proteins) or that abrogate E3 ubiquitin ligase activity might confer an invasive phenotype by failing to control (through ubiquitylation) the levels of proteins that are present at cell-matrix and/or cell-cell contacts and that promote migration.

source: nature cell biology